News Pouch 11 July 2019

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Pandemic Threats and Health Emergencies

News Pouch: 11 July 2019

Welcome to this issue of the newsletter where we highlight key latest news and literature relevant to health emergencies preparedness and response research and policy, tagged by thematic area.
We welcome receiving your reports, articles and studies to share widely within our network. Please contact Chadia Wannous via email at

wishing you useful reading!

  • Spotlight: Ebola Outbreak Situation
  • 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
    • Health and Climate Change
    • Urban Health
    • Migration Health
    • Global Health
    • Contact us


    Ebola Outbreak Situation

    WHO External Situation Report 49: 09 July 2019
    While the number of new cases continues to ease in former hotspots, such as Butembo, Katwa and Mandima health zones, there has been an increase in cases in Beni and a high incidence continues in parts of Mabalako Health Zone. Response support from the bordering countries of Uganda and South Sudan continues to support operational readiness activities. Furthermore, resources are being put towards monitoring the Uganda-Democratic Republic of the Congo border in that area.
    Overall, EVD case incidence rates remained largely unchanged in the past week. In the 21 days between 17 June to 7 July 2019, 70 health areas within 21 health zones reported new cases, representing 11% of the 664 health areas within North Kivu and Ituri provinces. During this period, a total of 250 confirmed cases were reported, the majority of which were from the health zones of Beni (36%, n=91) and Mabalako (22%, n=54), which are the main active areas in the outbreak. As of 7 July 2019, a total of 2418 EVD cases, including 2324 confirmed and 94 probable cases, were reported. A total of 1630 deaths were reported (overall case fatality ratio 67%), including 1536 deaths among confirmed cases. Of the 2418 confirmed and probable cases with known age and sex, 56% (1363) were female, and 29% (700) were children aged less than 18 years. Cases continue to rise among health workers, with the cumulative number infected increasing to 131 (5% of total cases).
    click here to download the complete situation report (PDF).

    ‘We know better than this’: As Ebola outbreak rages, the world just watches

    'Sometimes we have to abandon the patients': Treating Ebola in Congo's warzone

    The truth about PHEICs

    Declare Ebola outbreak in DRC an emergency, says UK’s Rory Stewart
    On two-day visit, DfID minister says outbreak is heartbreaking and very dangerous. He singled out some other European countries with links to the DRC for giving “strikingly little”, suggesting France, for example, may have provided as little as $1m (£800,000). The UK and US have provided more than half of the funding for the emergency.
    “We are critically short of money,” Stewart said. “There is going to be a funding gap of $100m, and probably of $300m through to December

    Ebola outbreak demonstrates science’s need to ‘nudge’
    Human behaviour can be as destructive to human health as any deadly pathogen

    Ebola responders call for a 'reset' in the response. What does that mean?
    Different organizations involved in the response point to some common issues that need to be resolved: better coordination, clarification of roles, and concretization of community engagement. Some also called for more dialogue, among responders.
    Representatives from NGOs Devex has spoken with were unanimous in their opinion that the goal of putting communities at the heart of the response remains a work in progress. Some of them think this is due to the response’s heavy focus on medical approaches, such as on treatment and case detection.

    Ebola outbreak in the Democratic Republic of Congo: It’s more than a public health problem
    it’s estimated that only about 30 percent of those infected have been identified, meaning the majority are moving around, possibly infecting others without knowing.

    New Spike in Displacement in Eastern DRC Further Complicates Ebola Response, Requires Urgent Relocation and Response

    Effects of vaccines in protecting against Ebola virus disease: protocol for a systematic review

    Apply to trial Ebola vaccines in DR Congo, says ministry

    Canadian who helped design Ebola vaccine says there isn't enough to stop current outbreak in Congo

    Politics and mistrust of foreigners slows fight against Ebola

    Massive Displacement in DR Congo’s Ebola-Affected Ituri Province Poses Serious Health Hazard.

    Our fight against Ebola, others, by U.S.
    The spokesman of the Department of State, Morgan Ortagus, in a briefing in Washington, speaks on the Ebola virus, which has cropped up again in Africa after it was defeated by Nigeria and others. She also speaks on other global issues. Excerpts

    CDC made a synthetic Ebola virus to test treatments. It worked
    The results, reported Tuesday in the journal Lancet Infectious Diseases, are encouraging, but also raise questions about why outside research groups have not received direct access to viral specimens from the DRC and instead had to create a synthetic version. The paper noted that there have been no Ebola samples available to the scientific community from the past four outbreaks in the DRC. Those outbreaks occurred in 2014, 2017, and 2018.

    To Contain Ebola, the United States Must Fulfill Its Promise to the World Health Organization
    Over the past few weeks, Nature has been reporting from the frontline of efforts by the Democratic Republic of the Congo to combat an escalating Ebola outbreak in a war zone.

    Ebola spread in Africa raises questions about WHO’s priorities

    The World Health Organisation is more concerned with enabling governments to paternalistically control the lifestyle choices of their people

    "We must employ all of the tools at our disposal" to tackle Ebola outbreak in DRC
    LSHTM Director Professor Peter Piot says more must be done to support DRC including "better community engagement, high-level political support, and the employment of all of the tools at our disposal including the large-scale use of the two available vaccines."
    Read More →

    Communities and coordination are crucial in fighting Ebola
    Other G-7 countries should do more to plug the $54 million funding gap in the Ebola response, according to DFID chief Rory Stewart.
    [Anne Gulland, The Telegraph]

    The 2013–2016 Ebola epidemic: evaluating communication strategies between two affected countries in West Africa

    Vitamin A Supplementation Was Associated with Reduced Mortality in Patients with Ebola Virus Disease during the West African Outbreak


    Priority Diseases

    The biweekly global influenza update

    The latest FluNet summary of lab-confirmed data from GISRS

    Sub-Saharan Africa HPAI Situation Update from FAO/EMPRES – Animal Health

    Characterisation of Infectious Ebola Virus from the Ongoing Outbreak to Guide Response Activities in the Democratic Republic of the Congo: A Phylogenetic and In Vitro AnalysisThe ongoing Ebola virus outbreak in the Ituri and North Kivu Provinces of the Democratic Republic of the Congo, which began in July, 2018, is the second largest ever recorded. Despite civil unrest, outbreak control measures and the administration of experimental therapies and a vaccine have been initiated.

    Susceptibility of Influenza A, B, C, and D Viruses to Baloxavir
    Baloxavir showed broad-spectrum in vitro replication inhibition of 4 types of influenza viruses (90% effective concentration range 1.2–98.3 nmol/L); susceptibility pattern was influenza A ˃ B ˃ C ˃ D. This drug also inhibited influenza A viruses of avian and swine origin, including viruses that have pandemic potential and those resistant to neuraminidase inhibitors.

    Pneumonia patients get too many antibiotics, study finds
    Fully 67.8% of patients received antibiotics for longer than recommended.
    More »

    Study says baloxavir fights all 4 flu types, many animal flu viruses
    The drug was active against flu A, B, C, and D, as well as avian and swine strains.
    More »
    ASF Asia Update for 11 July from FAO/EMPRES – Animal Health.
    * China reported two outbreaks in Guangxi Zhuang Autonomous Region.
    * Viet Nam detected ASF outbreak in Tay Ninh Province for the first time.
    * Cambodia and Lao PDR reported additional outbreaks.   

    Bulgaria reports new case of African swine fever

    Opinion: Why the elimination of malaria matters more than ever

    Diagnostics for Nipah virus: a zoonotic pathogen endemic to Southeast Asia

    Maternal Zika infection tied to poor development in 32% of tots
    In one group, 35% scored below average for language, 10% for cognitive development, and 16% for motor development.
    More »

    Underreporting of Fatal Congenital Zika Syndrome, Mexico, 2016–2017
    Congenital Zika syndrome, described in Brazil in 2015, consists of a set of congenital malformations (saliently microcephaly) and an increased risk for stillbirth and early childhood death. Epidemiologic studies have demonstrated that Zika virus causes CZS and that Zika virus–associated birth defects developed in ≈5% of fetuses and newborns of infected pregnant women.

    More than six billion at increased risk of dengue fever by 2080
    African countries, particularly those in the Sahel regional and southern part of the continent, face a substantial increase in risk of dengue fever over the next 65 years. The research is the first to include the projected spread of mosquitoes that carry dengue virus. 
    Read More →
    Lessons Learned from Dengue Surveillance and Research, Puerto Rico, 1899–2013

    In 1916, Walter W. King, a surgeon in the US Public Health Service, stationed at the San Juan (Puerto Rico) Quarantine Station, presented to the American Society of Tropical Medicine a firsthand account of his experiences during the 1915 dengue outbreak in Puerto Rico.
    Worldwide Reduction in MERS Cases and Deaths Since 2016
    From 2012 through May 31, 2019, Middle East respiratory syndrome coronavirus (MERS-CoV) has infected 2,442 persons and killed 842 worldwide. MERS-CoV is currently circulating in dromedary camels in Africa, the Middle East, and southern Asia; however, most cases of human infection have been reported in the Arabian Peninsula.

    Data show MERS cases, deaths on decline since 2016
    As many as 1,465 cases and 293 to 520 deaths from MERS-CoV may have been averted.
    More »

    US measles cases reach 1,109 as studies point to early vaccination
    Data from Pakistan and South Africa highlight advantages of vaccination early in life.
    More »
    The time of cholera.
    In Yemen, the rainy season's increased threat of cholera is looming — with over 200,000 children affected so far in 2019. As the death toll is set to rise, aid groups struggle to support the country's growing need for assistance.
    An estimated 19 million people carry a complex and latent form of TB, which could threaten efforts to eradicate the disease.
    [Sarah Newey, The Telegraph]

    One Health  

    Celebrating World Zoonoses Day with a focus on ILRI’s research on zoonotic diseases

    Diagnostics for Nipah virus: a zoonotic pathogen endemic to Southeast Asia
    Biodiversity and Ecosystem
    Breaching a 'Carbon Threshold' Could Lead to Mass Extinction  
    In the brain, when neurons fire off electrical signals to their neighbors, this happens through an "all-or-none" response. The signal only happens once conditions in the cell breach a certain threshold. Now an MIT researcher has observed a similar phenomenon in a completely different system: Earth's carbon cycle.

    The drive to alter an animal forever
    From self-destructing mosquitoes to sterilized rodents, altering the genomes of entire animal populations offers the tantalizing prospect of defeating disease and controlling pests. But researchers worry about the consequences of unleashing ‘gene drives’ — genetic modifications designed to spread through a population at higher-than-normal rates of inheritance — into the wild. Nature explores how gene drives work, how to test them and who should decide if and when they should be used.
    Nature | 11 min read

    Adding 1 Billion Hectares of Forest Could Help Check Global Warming
    Global temperatures could rise 1.5° C above industrial levels by as early as 2030 if current trends continue, but trees could help stem this climate crisis. A new analysis finds that adding nearly 1 billion additional hectares of forest could remove two-thirds of the roughly 300 gigatons of carbon humans have added to the atmosphere since the 1800s

    Amazon population at risk from forest fire pollution

    Everyone Agrees This Superbug Is a Threat. Few Are Willing to Fund Research to Stop It
    In the universe of scary drug-resistant pathogens that can kill, Candida auris is having a moment. The freaky fungus, which is behaving in ways scientists didn’t think fungi could act, has been garnering headlines because of its uncanny ability to resist multiple antifungal drugs and settle into hospital rooms so persistently it can take renovations to get rid of it.

    The awful toll of superbugs in India’s hospitals

    UK to test new payment model for antibiotics
    The idea is to delink profit from the volume sold, pay for antibiotics based on their public health value, and encourage development of new antibiotics.
    More »

    Stewardship / Resistance Scan for Jul 05, 2019

    • Unnecessary antibiotics for Lyme disease
    • Gut persistence of urinary E coli clones

    More »

    Stewardship / Resistance Scan for Jul 10, 2019

    • UK antibiotic prescribing decline
    • MCR-1 E coli in Michigan

    More »

    Emergencies and Disasters

     WHO Situation Report Week 27: 01 - 07 July 2019
    The WHO Health Emergencies Programme is currently monitoring 74 events in the region. This week’s edition covers key new and ongoing events, including:

    • Circulating vaccine-derived poliovirus type 2 in Angola
    • Ebola virus disease in Democratic Republic of the Congo
    • Dengue fever in Côte d’Ivoire
    • Humanitarian crisis in north-east Nigeria.
    Sharing data can help prevent public health emergencies in Africa

    Safeguarding health in a warming world

    ‘Nothing left to go back for’: UN News hears extraordinary stories of loss, and survival as Mozambique rebuilds from deadly cyclones

    Two dead and 2,700 displaced at Rohingya camps in Bangladesh following heavy monsoon rains that also damaged makeshift schools and latrines.
    [Irwin Loy, The New Humanitarian]

    Preserving our freedom: Ending institutionalization of people with disabilities during and after disasters
    This report examines occurrences of institutionalization of people with disabilities, as well as threats of institutionalization that were thwarted, in 2017 and 2018, including during Hurricanes Harvey, Irma, Maria, Florence, and Michael, and the California wildfires. This report: Examines how, when, and why people with disabilities were institutionalized during and after recent disasters.

    OpenWHO releases flagship course in Spanish: IMS Tier 2 – Working in WHO’s Incident Management System

    Climate Change

    Fourth Edition of SDG Index and Dashboards Highlights Performance Gaps on SDGs 12, 13, 14, 15
    The report states that trends on endangered species and GHG emissions are moving in the wrong direction and identifies challenges related to poverty eradication, income and wealth inequalities and gaps in health and education outcomes. The report warns that high-income countries are generating environmental and socio-economic spillovers.

    Governments and firms in 28 countries sued over climate crisis – report
    More than 1,300 legal actions over global heating brought since 1990, say researchers

    Major update to ocean-heat record could shrink 1.5C carbon budget
    The UK’s Met Office recently released “HadSST4”, the largest update since 2011 to its widely used sea surface temperature (SST) record.
    The new version provides more accurate estimates of SSTs in the period during and after the second world war, as well as over the past decade. It suggests that the world’s oceans have warmed by around 0.1C more than previously thought since pre-industrial times.

    Anchorage roasts as heat records break across Alaska

    We really (really) need to shut off construction of new fossil fuel plants
    Operation of already existing power plants, factories, and other fossil-fuel infrastructure could be enough to push the world past 1.5 °C of warming.
    Read More

    Climate change censored from US research
    Officials from the administration of US President Donald Trump intervened to cut mentions of the impact of climate change from a press release communicating research about that very thing. The US Geological Survey (USGS) study estimated that climate-change-driven flooding will affect US$150 billion in property and 600,000 people in California by 2100 — much more than previously estimated. “It's been made clear to us that we’re not supposed to use climate change in press releases anymore. They will not be authorized,” said an anonymous federal researcher. A spokesperson for the USGS said the agency has no formal policy to avoid references to climate change.
    E&E News | 7 min read
    Read more: Trump administration hardens its attack on climate science (The New York Times, 22 min read)
    Reference: Scientific Reports paper

    Urban Health

    Despite funding loss, cities vow to continue resilience push

    Migration Health

    Squalid Conditions at Border Detention Centers, Government Report Finds

    A Crime by Any Name
    The Trump administration’s commitment to deterring immigration through cruelty has made horrifying conditions in detention facilities inevitable.

    Whatever we call them, wherever they are, detention centres are a disgrace

    California First State To Offer Health Benefits To Adult Undocumented Immigrants
    The plan does not cover all unauthorized immigrants under 25, only those whose incomes are low income to qualify. State officials estimate in the first year the program will cover around 138,000 residents and cost California taxpayers $98 million.
    Trump has publicly attacked Newsom's plans.  "It's crazy what they're doing. It's crazy," Trump told reporters last week. "And it's mean, and it's very unfair to our citizens. And we're going to stop it, but we may need an election to stop it."

    Migrants, Stuck in Libya, Demand Evacuation as Conflict Escalates

    Intersectoral and integrated approaches in achieving the right to health for refugees on resettlement: a scoping review

    Global Health

    Monitoring Frameworks for Universal Health Coverage: What About High-Income Countries?

    WHO and ITU establish benchmarking process for artificial intelligence in health

    New report identifies how healthcare industry can achieve gender parity
    Each year, W2O, a leading healthcare marketing and communications firm, conducts a study that examines how companies are maintaining or failing in relevance, which affects sales, profitability, recruitment, retention, innovation, leadership and valuation. The company’s 2019 study added gender and diversity as a key measure of corporate reputation. Learn more about how relevant Fortune 500 healthcare companies were on the topic of diversity in 2018 and what can be done to create real actionable change

    New Essential Medicines and Diagnostics Lists published today
    WHO updates global guidance on medicines and diagnostic tests to address health challenges, prioritize highly effective therapeutics, and improve affordable access. New additions include tests for infectious diseases including Zika and dengue.

    Meet the UNAIDS leadership contenders
    HIV/AIDS advocates have mixed views on the five candidates shortlisted to lead the Joint United Nations Programme on HIV/AIDS, but agree there is much at stake as the agency fights for its existence. Secrecy surrounds the process to replace former executive director Michel Sidibé, who left in May this year amid controversy over his handling of harassment and bullying at the agency.

    ANALYSIS AND COMMENTARY: How can the Global Fund finance innovation to improve health product supply chains in resource-limited settings?
    Access to medicines and quality health products to ensure healthy populations is a global issue. As 60% of the Global Fund’s financial resources are earmarked for health products, managing the supply chain is crucial given the increase in demand (the scaling-up of ARV treatments, changes in treatment directives, new diagnostic technologies and a growing number of treatment centers). This will necessarily involve reforming the supply chain, aligning partners with a common roadmap and government leadership in developing countries, say senior experts from the Centre Humanitaire des Métiers de la Pharmacie.




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    We welcome receiving your reports, articles and studies to share widely within our network.
    Please contact Chadia Wannous via email at 

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