News Pouch: 20 June 2019

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Pandemic Threats and Health Emergencies

News Pouch: 20 June 2019


  • Spotlight: Ebola situation in DRC and Uganda
  • Updates and News on main Outbreaks
    • Priority Infectious Diseases
      • Influenza
      •  VBD, and more
  • One Health
    • Biodiversity and ecosystem
    • Food Security and Safety
    • AMR
    • Health in Emergencies and Disasters
    • Climate Change
    • Urban Health
    • Migration Health
    • Global Health
    • Contact us


    Ebola Outbreak Situation

    WHO External Situation Report 46: 18 June 2019
    As of 16 June 2019, a total of 2168 EVD cases, including 2074 confirmed and 94 probable cases, were reported. A total of 1449 deaths were reported (overall case fatality ratio 67%), including 1355 deaths among confirmed cases. Of the 2168 confirmed and probable cases with known age and sex, 57% (1226) were female, and 29% (632) were children aged less than 18 years. Cases continue to rise among health workers, with the cumulative number infected increasing to 121 (6% of total cases). On 14 June 2019, a meeting of the Emergency Committee was convened by the WHO Director-General under the International Health Regulations (IHR). The Committee expressed its deep concern about the ongoing outbreak, which, despite some positive epidemiological trends, especially in the epicentres of Butembo and Katwa, shows that the extension and/or reinfection of disease in other areas like Mabalako, presents, once again, challenges around community acceptance and security. In addition, the response continues to be hampered by a lack of adequate funding and strained human resources. It was noted that the cluster of cases in Uganda is not unexpected, and the rapid response and initial containment is a testament to the importance of preparedness in neighbouring countries.
     click here to download the complete situation report (PDF).

    Ebola case counts spike again in DRC
    Rise in Ebola in DRC with almost 50 new cases in 3 days and 19 fatalities over the weekend, including 8 in the community. Also 2 health workers infected, both refused vaccination, raising the total of health workers infected to 118, including 39 deaths.

    WHO experts again say Ebola not global health emergency

    Ebola: 'WHO between a rock and a hard place'

    300,000 flee flare-up of ethnic violence in north-eastern DR Congo
    The mobility of the population in north Kivu and in Ituri is a risk factor when it comes to Ebola, warns WHO.

    Uganda Clears Three Experimental Ebola Treatments, Watches for Spread
    Health workers have got the all-clear to use three experimental Ebola treatments in Uganda, a week after the deadly disease spread over the border from Democratic Republic of Congo, authorities said on Tuesday.
    Go to article
    Estimating undetected Ebola spillovers
    It is estimated that at least half of all spillover events have failed to be reported since EVD was first recognized.  also estimate the probability of detecting outbreaks of different sizes, which is likely less than 10% for single-case spillover events.

    EU commits an additional €3.5 million to tackle Ebola

    Ebola Escalation Keeps World Bank’s ‘Pandemic Bonds’ in Spotlight 
    The World Bank’s “pandemic bonds” are under scrutiny again following an escalation in the Ebola outbreak in central Africa.
    Go to article

    Why it’s hard to stop Ebola spreading – between people and across borders

    Update on African Union Actions in Response to Recent Ebola Outbreaks
    Following the recent outbreak of Ebola cases reported in Uganda, The African Union is collaborating with the Ministry of Health of the Republic of Uganda to mobilise support to ensure adequate response and implementation of prevention and control measures, including deployment of senior experts from the AU’s Africa Centres for Disease Control and Prevention.
    Go to article

    Priority Diseases

    The secret social lives of viruses
    Scientists are listening in on the ways viruses communicate and cooperate. Decoding what the microbes are saying could be a boon to human health.

    The Not-Flashy, Essential Part of Outbreak Preparedness and Response
    When an outbreak hits, how do we immediately get a Ministry of Health representative, an animal health specialist, a communications expert and a laboratory sample transporter on the same page?
    Go to article

    Harness Microbes for Humanity’s Future
    This week, part of the Scientists’ Warning movement calls attention to a factor that has been largely ignored: microbes. In a Consensus Statement published in Nature Reviews Microbiology, 33 leading microbiologists from around the world “put humanity on notice” that the impact of climate change will depend heavily on the response of microorganisms, which are essential for achieving an environmentally sustainable future.

    Largest World Stock of Animal-Killing Virus Destroyed by UK Lab  
    These stocks accounted for most of the world's lab samples of rinderpest, which were held at The Pirbright Institute in Surrey.
    Go to article
    Why Another Flu Pandemic Is Likely Just a Matter of When
    Despite the availability of vaccines, the flu still kills tens of thousands of people in the U.S. each year, and hundreds of thousands more worldwide. But public health officials fear that an even graver threat lies ahead: the emergence of a new, much more deadly flu virus. As William Brangham reports, the scenario has occurred before.
    Go to article
    ASF Asia Update for 14 June from FAO/EMPRES - Animal Health.
    * China reported ASF outbreak in Guizhou Province.
    * In Viet Nam, ASF outbreak was reported in Ho Chi Minh City for the first time.  
    Shifting burdens: Malaria risks in a hotter Africa
    Climate variability and change present both immediate and future risks to human health. Changes in temperature, precipitation and in the frequency and intensity of extreme weather events will alter the nature of vector borne diseases, such as malaria, across sub-Saharan Africa, placing more people at risk of exposure.

    The effect of global change on mosquito-borne disease
    More than 80% of the global population is at risk of a vector-borne disease, with mosquito-borne diseases being the largest contributor to human vector-borne disease burden. Although many global processes, such as land-use and socioeconomic change, are thought to affect mosquito-borne disease dynamics, research to date has strongly focused on the role of climate change.

    Dogs can alert human risk to Lyme disease
    A new study quantifies the incidence between tick exposure in dogs and Lyme disease in humans.

    Dengue and Zika Virus Diagnostic Testing for Patients with a Clinically Compatible Illness and Risk for Infection with Both Viruses. 
    Dengue and Zika viruses are closely related mosquito borne flaviviruses with similar transmission cycles, distribution throughout the tropics and subtropics, and disease manifestations including fever, rash, myalgia, and arthralgia. For patients with suspected dengue or Zika virus disease, nucleic acid amplification tests (NAATs) are the preferred method of diagnosis. Immunoglobulin M (IgM) antibody testing can identify additional infections and remains an important tool for the diagnosis of these diseases, but interpreting the results is complicated by cross-reactivity, and determining the specific timing of infection can be difficult. 
    (MMWR; 06/14/2019)
    A new Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Situation Update from FAO/EMPRES – Animal Health

    • Twelve new human cases have been reported in Saudi Arabia, including 5 fatalities;
    • Updated epidemiological timeline (by exposure source) and global distribution map of MERS-CoV human cases;
    • Six new relevant publications;
    • Project updates by Egypt, Ethiopia, Jordan, and Kenya;

    Pakistan: HIV outbreak in Sindh province
    The outbreak was first reported on 25 April 2019, and a major HIV screening programme started on 28 April. It was expanded on 8 May, with additional health workers being deployed. Testing is ongoing.
    So far more than 600 HIV cases have been identified. The majority are among children and young people: more than half those affected are children under the age of 5. This poses a particular challenge. Prior to this outbreak, there were just over 1200 children diagnosed with HIV and receiving antiretroviral treatment in the whole of Pakistan.

    Record US measles year adds 22 more cases
    CDC experts also highlight the spread of measles in Europe, consequences for travelers, and advice for clinicians.
    More »
    New York Ends Religious Exemption for Vaccines Amid Measles Outbreak
    New York eliminated the religious exemption to vaccine requirements for schoolchildren Thursday, as the nation’s worst measles outbreak in decades prompts states to reconsider giving parents ways to opt out of immunization rules.
    Go to article

    Ukraine reports nearly 1,000 measles cases in past week

    One Health  

    The One Health Lancet Commission
    One Health is the recognition of the interaction between humans, animals and the environment as a prerequisite for understanding and managing global health threats.
    The One Health Lancet Commission is hosted by the Centre for Global Health at University of Oslo (UiO). The Lancet has nominated the two co-chairs: Dr. John Amuasi, Kumasi Centre for Collaborative Research in Tropical Medicine at the Kwame Nkrumah University of Science and Technology, Ghana, and Prof. Andrea Winkler, Centre for Global Health at UiO and Center for Global Health at the Technical University of Munich. A core group comprising of staff from the Centre for Global Health at UiO, WHO and Imperial College is driving the direction, design and implementation of the Commission

    The Great Insect Dying
    Four-part exclusive series in Mongabay by Jeremy Hance. Despite the fact that arthropods make up most of the species on Earth, and much of the planet’s biomass, they are significantly understudied compared to mammals, plants, birds, amphibians, reptiles, fish and much else.
    June 3, 2019 Part 1: A global look at a deepening crisis (
    June 6, 2019 Part II: “Vanishing act in Europe and North America (
    Part III & Part IV Coming Soon!
    USA - One Health Certified food label program reaches milestone
    The new labeling program aimed at creating a new standard for chicken and other animal protein is partnering with the New York Academy of Sciences.
    The 1st Annual Scientific Meeting of the One Health European Joint Programme

    New Challenges of Applying One Health Approach in a Changing Environment
    September 24-26, 2019 
    Quebec City, Canada. 5th International Congress of Pathogens at the Human-Animal Interface (ICOPHAI). Organized by The Ohio State University and University de Montreal. Registration now open.  

    Concepts and Experiences in Framing, Integration and Evaluation of One Health and EcoHealth

    Rabies: A Forgotten Killer
    CDC’s latest Vital Signs report gives an update on the status of rabies in the United States. The U.S. averages 1-3 human cases of rabies a year now, down from 30-50 cases per year in the 1940s. This decrease is largely due to routine pet vaccination and availability of post-exposure prophylaxis (PEP), which combines rabies vaccine and rabies immune globulin to prevent infection after exposure to the virus. Each year, about 55,000 people in the U.S. seek PEP after a potential rabies exposure. Rabies is nearly always fatal if people don’t get rabies PEP before symptoms start.
    Biodiversity and Ecosystem
    Biodiversity and Health in the Face of Climate Change
    Event: The 9th Trondheim Conference on Biodiversity
    2-5 July 2019. Trondheim, Sor-Trondelag, Norway
    The main focus of the ninth Trondheim Conference on Biodiversity is to provide support for the ongoing discussions on a post-2020 global biodiversity framework. The meeting will be an opportunity for stakeholders to discuss the latest and best available knowledge relevant to biodiversity and ecosystem functions and services, and to consider the implications of this knowledge for the development of the post-2020 global biodiversity framework.

    Event: IUCN World Conservation Congress

    11-19 June 2020
    Host a session during the Forum
    Organisations and individuals can propose hosting a session during the Forum of the IUCN World Conservation Congress. Hosting a session is an excellent opportunity to inform debate and drive conservation action on the issues that matter most to you or your organisation.
    Food Safety and Security
     Breeding Crops to Feed 10 Billion
    Crop improvements can help us to meet the challenge of feeding a population of 10 billion, but can we breed better varieties fast enough? 
    Go to article

    PLOS Latest Research on AMR
    Trends and correlates of antimicrobial use in broiler and turkey farms: a poultry company registry-based study in Italy
    Multiple antibiotic resistance as a risk factor for mortality and prolonged hospital stay: A cohort study among neonatal intensive care patients with hospital-acquired infections caused by gram-negative bacteria in Vietnam
    A cross-sectional national survey of community pharmacy staff: Knowledge and antibiotic provision
    Close proximity interactions support transmission of ESBL-K. pneumoniae but not ESBL-E. coli in healthcare settings
    Clinical outcomes in patients admitted to a hospitalist service exposed to an antimicrobial stewardship program – a retrospective matched cohort study
    The impact of a short-term training program on workers’ sterile processing knowledge and practices in 12 Ethiopian hospitals: A mixed methods study
    Use of germicides in health care settings—is there a relationship between germicide use and antimicrobial resistance: A concise review
    Knowledge, attitudes, and practices related to antibiotic use in Paschim Bardhaman District: A survey of healthcare providers in West Bengal, India
    Evaluation of a library of FDA-approved drugs for their ability to potentiate antibiotics against multidrug resistant Gram-negative pathogens
    NNRTI Hyper-Susceptibility and Resistance: Mutational Analysis of Residue 181 in HIV-1 Reverse Transcriptase
    Impact of species diversity on the design of RNA-based diagnostics for antibiotic resistance in Neisseria gonorrhoeae
    Short vs. long duration antimicrobial treatment for community-onset bacteremia: A propensity-score matching study - ScienceDirect
    Rapid ultrasensitive detection platform for antimicrobial susceptibility testing
    Antibacterial mass drug administration for child mortality reduction: Opportunities, concerns, and possible next steps
    How to accelerate antimicrobial susceptibility testing
    WHO- Monitoring and Evaluation of the Global Action Plan on Antimicrobial Resistance

    New Interactive Graphic Novel for Environmental Services (EVS) Personnel

    EVS personnel play a critical role in preventing the spread of germs and healthcare-associated infections
    EVS and the Battle Against Infection” is an interactive graphic novel illustrating the important role of EVS personnel in the prevention of healthcare-associated infections. The online version of the training tool features real-world infection prevention and control scenarios and allows participants to choose options that affect the outcome of the story. “EVS and the Battle Against Infection” is also available as a downloadable PDF.
    Handouts are also available from CDC.
    Access these and other infection control training resources at the CDC Infection Control website.

    Interactive Infection Control Training for Healthcare Professionals with Free CE

    Learn how to identify infection risks and prevent the spread of healthcare-associated infections
    Let’s Talk Patient Safety: Reducing HAI Transmission Risk,” to help healthcare professionals identify infection risks and prevent the spread of HAIs. The free online training can be completed anywhere. It has two modules and takes approximately 30 minutes to complete the entire training.
    Access these and other resources at the CDC Infection Control website.

    Investors push restaurant chains to cut antibiotics in meat supply
    A new report from a global coalition of investors suggests the world's largest fast food and casual dining companies are getting the message about their role in addressing antibiotic resistance.

    Urban wildlife may add to antibiotic resistance threat
    Most samples from wildlife in Nairobi carried multidrug-resistant E coli.
    More »

    New AWaRe tool aims to guide antibiotic use globally
    WHO director: "All countries must strike a balance between ensuring access to life-saving antibiotics and slowing drug resistance."
    More »

    Stewardship / Resistance Scan for Jun 18, 2019

    • Rapid test for bloodstream infections
    • Funds for new antibiotic class
    • Resistant E coli in Alaskan gulls

    More »

    Emergencies and Disasters

    WHO AFRO - Outbreaks and Emergencies Bulletin - Week 24/2019
    10 - 16 June 2019
    The WHO Health Emergencies Programme is currently monitoring 72 events in the region. This week’s edition covers key new and ongoing events, including:

    • Ebola virus disease in Uganda
    • Ebola virus disease in Democratic Republic of the Congo
    • Measles in Democratic Republic of the Congo
    • Humanitarian crisis in Mali.

    Yemen: maternal and newborn health ‘on the brink of total collapse’, UNICEF alerts

    South Sudanese facing famine in all but name, warns UN food agency

    Humanitarian sector prepares for 'third emergency' in Mozambique
    Mozambique was pummeled with two Category 4 cyclones in the span of only six weeks this year, creating one of the worst weather-related disasters to hit the southern hemisphere on record. Cyclone Idai destroyed some 1.8 million acres of crops and Cyclone Kenneth destroyed another 70,000 acres. Widespread dependency on food aid is expected to continue until the next main harvest, in April of next year. Humanitarian responders are now concerned that this reality, coupled with underfunded response and recovery efforts, could lead to a third crisis.

    Natural disasters and infectious disease in Europe: a literature review to identify cascading risk pathways

    Cross border disease outbreak simulation exercise reinforces preparedness in East Africa
    EU and Mongolia complete nuclear safety project
    Concurrent 2018 hot extremes across Northern Hemisphere due to human‐induced climate change
    Extremely high temperatures pose an immediate threat to humans and ecosystems. In recent years, many regions on land and in the ocean experienced heatwaves with devastating impacts that would have been highly unlikely without human‐induced climate change. Impacts are particularly severe when heatwaves occur in regions with high exposure of people or crops.
    Global heating to inflict more droughts on Africa as well as floods
    A lawsuit filed in Uganda accuses WFP of negligence in providing contaminated food aid, after four people died and 300 others fell ill.

    Climate Change

    Increasing mitigation ambition to meet the Paris Agreement’s temperature goal avoids substantial heat-related mortality in U.S. cities
    Current greenhouse gas mitigation ambition is consistent with ~3°C global mean warming above preindustrial levels. There is a clear need to strengthen mitigation ambition to stabilize the climate at the Paris Agreement goal of warming of less than 2°C. The authors specify the differences in city-level heat-related mortality between the 3°C trajectory and warming of 2° and 1.5°C.

    A path to climate consensus
    Eleven diverse specialists came together to discuss one of the most controversial questions in the study of interactions between the climate system and human society: Will the risk of armed conflict increase in a warmer world? The moderated 3-day discussion was an example of ‘expert elicitation’, a way to generate a synthesis of the evidence and the specialists’ often conflicting views. The group’s conclusion was not Earth-shattering — climate change has already increased the risk of armed conflict, but the effect is small relative to the effects of other factors. The deeper importance of the work, argues a Nature editorial, lies in the approach, and in the recognition that common ground, however modest, can emerge from diverse and opposing lines of evidence.
    Nature | 2 min read
    Reference: Nature paper

    Unlocking the potential of agricultural innovation to improve farmers’ resilience to drought

    Emissions need to be halved to avoid 3C warming - scientists

    Pope Francis declares 'climate emergency' and urges action
    Addressing energy leaders, pope warns of ‘catastrophic’ effects of global heating

    The Earth Observations for Sustainable Development Goals (EO4SDG) Initiative invites you to submit nominations for consideration under sectoral and special categories.
    Download and complete the Nominations Form for the GEO Awards on Earth Observations for Sustainable Development Goals. Additionally, refer to the Suggestions for Nominators document for considerations in developing a nomination.
    Email completed nomination forms
    Nomination Entry Deadline – June 30, 2019

    Urban Health

    Urbanisation, commercial farms threaten Asia's forests, U.N. warns
    Asia region has the world's lowest per capita forest area of 19% compared to the global average of 32%, even as the total forest area increased by nearly 18 million hectares (44 million acres) between 1990 and 2015, a report by the Food and Agriculture Organization (FAO) said. “conflicts related to protected areas, land-grabbing, tenure and benefit sharing, are prevalent in the region and may be exacerbated by climate change,"

    ICLEI Europe, in cooperation with the EKLIPSE project, is hosting a two-day capacity-building workshop titled, “Financing Greener Cities – Strengthening the capacity of local authorities and practitioners for making informed decisions on financing nature-based solutions.”
    The event will consist of a preparatory webinar on 23 July 2019, followed by an interactive workshop from 8-9 October 2019 in Athens (Greece). The two-day workshop will bring together diverse stakeholders from across Europe.
    To apply, please fill in the online form found here. Forms must be submitted by 23 June 2019, 23:59 CET. 

    Migration Health

    Dealing with the migrant dead
    ‘We just have to wait for the wind and waves to carry them to the land.’
    In a recently released report the IOM calls crossing the Mediterranean “one of the deadliest journeys in the world” for migrants, with almost 1,000 deaths recorded last year. Take a look back at our photo feature on the volunteer workers in Libya who make sure that bodies are identified and buried with dignity.

    Global displacement rises above 70 million
    "The world is not facing a refugee crisis – it’s a crisis in solidarity,” the UN's refugee chief Filippo Grandi said Wednesday, launching the annual UN survey of refugee trends. "If there is a crisis, it’s the incapacity of the international community to resolve conflicts," he added. Numbers of forcibly displaced people have doubled in 20 years, to a new high of 70.8 million people. Of those, 25.9 million are refugees, 41 million are internally displaced, and 3.5 million are asylum seekers.


    Global Health

    WHO and EU reinforce cooperation for Universal Health Coverage
    The ‘Health System Strengthening for UHC partnership programme worth EUR 123,750 million (US$ 135 million) will support activities between 2019-2022.

    Drone Deliveries Are Advancing in Health Care
    A few years ago Jeff Bezos made a prediction. By 2018 his e-commerce empire, Amazon, would be delivering items by drone. Prime Air has yet to launch.
    Go to article

    Revealing global attitudes to science and health
    The launch of WellcomeTrust Global Monitor - the first-ever survey of How the world thinks & feels about science and health.

    • People living in high-income countries have the lowest confidence in vaccines.
    • In most parts of the world, higher confidence in health systems, governments, and scientists is a sign of high trust in vaccines – but the picture is more complicated in Europe.
    • Overall, 72% of people globally trust scientists.
    • But over half (57%) of the world’s population don’t think they know much – if anything – about science.
    • Almost one in five (19%) believe that science does not benefit them personally.

    Survey shows crisis of confidence in vaccines in parts of Europe
    Just half of people in eastern Europe think vaccines are safe, compared with 79% worldwide

    How France is persuading its citizens to get vaccinated
    One in three French people think vaccines are unsafe, but across the country vaccine coverage is rising. Alex Whiting looks at how France is fighting back against vaccine scepticism.




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