News Pouch: 25 November 2019

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Pandemic Threats and Health Emergencies

News Pouch: 25 November 2019

Welcome to this issue of the newsletter where we highlight latest research and policy news and literature on health emergencies preparedness and response, tagged by thematic area.

Please send your feedback, articles and reports, or questions you would like to share to Dr. Chadia Wannous via email  

Wishing you useful reading!

  • Spotlight: Ebola Outbreak Situation
  • Updates and News on 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 68: 20 November 2019
    Over the last three months, there has been a steady decrease in the incidence of confirmed Ebola Virus Disease (EVD) cases in Democratic Republic of the Congo (DRC). In the week of 11 to 17 November 2019, nine new confirmed EVD cases were reported from three health zones in two affected provinces, compared to 126 cases reported at the peak of the epidemic in the last week of April 2019. Although the number of weekly reported cases is decreasing, it is expected that the outbreak response will encounter more complex circumstances as some transmission continues within rural and hard to reach communities.
    In the 21 days from 28 October to 17 November 2019, 12 health areas and five health zones have reported cases. During this period, a total of 31 confirmed cases were reported, with Mabalako (45%; n=14 cases), Beni (29%; n=9) and Mandima (19%; n=6) cases as the principal hot spots. As of 17 November 2019, a total of 3296 EVD cases were reported, including 3178 confirmed and 118 probable cases, of which 2196 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (1854) were female, 30% (996) were children aged less than 18 years, and 5% (162) were healthcare workers.
    click here to download the complete situation report
    First Ebola vaccine approved
    European regulators have approved the first immunization against the deadly Ebola virus. The drug, made by US company Merck, has already been administered on an emergency basis, including to quell the ongoing outbreak in the Democratic Republic of the Congo. The drug regulator’s approval means that the product can now be stockpiled and, potentially, distributed more widely — in particular in Africa. Seven other Ebola vaccines are in various stages of clinical testing.
    Nature | 4 min read
    The exacerbation of Ebola outbreaks by conflict in the Democratic Republic of the Congo
    There is limited understanding of what ramifications conflict events have on disease transmission and control in regions plagued by civil unrest and violence. Furthermore, the multifaceted nature of the conflict events during an epidemic is yet to be characterized. Using conflict data, ethnographic appraisal, and a mathematical model, we provide a descriptive timeline of the events during the ongoing Ebola outbreak in the Democratic Republic of the Congo.
    Ebola in DR Congo: New transmission chain risks reversing major gains
    Amid multiple deadly attacks on civilians by armed groups in the eastern Democratic Republic of the Congo (DRC), an Ebola death “unlinked to any chain of transmission” risks reversing major gains against the epidemic, which is now down to just a handful of cases, a top UN medic said on Friday.

    Priority Diseases

    FDA Issues Final Guidance for Development of Smallpox Treatments as Part of Critical Preparedness Efforts. 
    The US Food and Drug Administration has issued final guidance, Smallpox (Variola Virus) Infection: Developing Drugs for Treatment or Prevention, which is designed to assist drug manufacturers designing studies to appropriately establish the safety and efficacy of drugs to treat or prevent smallpox infection. This guidance finalizes draft guidance issued on July 11, 2018, which revised draft guidance issued on November 23, 2007. This final guidance clarifies the recommended immunological characterization of animals in key studies and includes minor editorial changes from the draft
    Pakistan deploys new vaccine against 'superbug' typhoid outbreak
    Pakistan began vaccinating millions of children against typhoid on Friday to try to control a drug-resistant superbug outbreak of the fever that has already infected some 11,000 people since 2016 and risks spreading internationally.
    Gene Editors Could Find New Use as Rapid Detectors of Pathogenic Threats 
    In a twist on how gene editing technology might be applied in the future, DARPA’s newest biotechnology funding opportunity aims to incorporate gene editors into detectors for distributed health biosurveillance and rapid, point-of-need diagnostics for endemic, emerging, and engineered pathogenic threats.
    The publication of a supplement to the influenza manual for estimating disease burden associated with seasonal influenza.
    This guide provides public health officials with the tools to prepare and perform a hospital admission survey (HAS) to determine what proportion of the population living in a hospital’s catchment area seeks care at the sentinel site for a severe respiratory illness, compared with other admitting facilities in the area. The catchment population will serve as the denominator when calculating rates of influenza-associated hospitalizations for the hospital. Developed as an extension of the WHO manual, this HAS guide cites, where appropriate, relevant section numbers from the WHO manual.

    The manual and the supplement can be found here:

    Vector-Borne Diseases (VBD)

    Mosquito sterilization offers new opportunity to control chikungunya, dengue, and Zika
    Dengue fever ravages the Asia Pacific
    An outbreak of dengue in Bangladesh, an epidemic in the Philippines, and a growing number of dengue victims in Thailand - more and more countries experience severe and unpredictable dengue outbreaks. Public Health Specialist Mashida Rashid explains why the number of cases is increasing.
    Rift Valley fever outbreak reported in Sudan
    Officials have reported 293 suspected cases in 6 states alongside outbreaks of the disease in goats.
    Dengue cases in Americas region hit record high
    As of the middle of October, the WHO Americas region has experienced the most dengue cases in its history, topping the number reported in the 2015 epidemic year by 13%, the WHO's Pan American Health Organization (PAHO) said in a Nov 11 update.
    Across several continents, infecting mosquitoes with bacteria results in dramatic drops in dengue illness, trials show
    The number of people infected by dengue and at least one related virus has plunged in places where mosquitoes bred to be infected with a bacterium called Wolbachia have been released and have established themselves, scientists reported Thursday.
    China's Inner Mongolia reports fresh bubonic plague case
    China’s Inner Mongolia reported a fresh, confirmed case of bubonic plague on Sunday, despite an earlier declaration by the country’s health officials that the risk of an outbreak was minimal.
    Plague in Zimbabwe from 1974 to 2018: A review article
    Plague is a zoonotic disease caused by the bacterium Yersinia pestis and is transmitted through the bites of infected rodent fleas. Plague is well known for causing 3 major human pandemics that have killed millions of people since 541 A.D.

    ASF Asia Update for 14 November from FAO/EMPRES – Animal Health.
    * The Republic of Korea reported additional 3 cases only in wild pigs in Gangwon-do.
    * China reported an additional ASF outbreak in Yunnan Province; and a vehicle illegally transporting piglets were intercepted in Chongqing, tested positive for ASF.
    * A floating dead pig arrived in Xiaojinmen Island (Taiwan Province, located closely to Fujian Province) on 6 November, tested positive for ASF. This is the first floating dead pig landing report since 14 June. The last reported outbreak in Fujian Province was in December 2018.             


    Camel contact noted in latest Saudi MERS case
    Saudi Arabia's Ministry of Health (MOH) today reported one more MERS-CoV case, which involves a 71-year-old man in the city of Al Khurma in Taif region, located in the western part of the country. As of the end of October, the WHO has received reports of 2,482 cases, at least 854 of them fatal. Saudi Arabia has been by far the hardest-hit country.
    Nov 18 Saudi MOH report

    Skipping measles vaccine tied to triple risk of disease spread
    Unvaccinated people may be 3 to 4 times more infectious than those with measles who were vaccinated.
    More »
    Samoa closes schools as measles epidemic kills at least 6
    Schools in the Pacific island nation of Samoa were closed indefinitely on Monday and children have been barred from public gatherings amid a measles epidemic that has killed at least six people, most of them younger than age 2.


    Update on Vaccine-Derived Poliovirus Outbreaks — Worldwide, January 2018–June 2019. 
    Following the synchronized switch from trivalent oral poliovirus vaccine (tOPV, types 1, 2, and 3) to bivalent oral poliovirus vaccine (bOPV, types 1 and 3 only) in 2016, transmission of type 2 cVDPVs was detected in 12 countries in Africa and also in China. Type 1 cVDPVs were identified in Indonesia, Myanmar, and Papua New Guinea, and type 3 cVDPVs were identified in Somalia
    The Art of Survival: The Polio Virus Continues to Exploit Human Frailties
    Our last report followed an in-depth field review of the remaining polio endemic countries. We commissioned and coordinated this important piece of work. Its findings together with the subsequent IMB report led to a searching analysis and the identification of profound reasons for concern about the state of polio eradication at the end of 2018.
    How stigma subverts public health  
    As a public-health researcher working on HIV around the globe, I have seen the devastation that stigma can cause. It leads to people being shunned and isolated, and discriminated against in health care, at work and at school. And it inhibits them from accessing life-saving services and medications.

    One Health  

    Critical Importance of a One Health Approach to Antimicrobial Resistance
    One Health and Antibiotic Resistance in Agroecosystems
    » Abstract   » Full text HTML   » Full text PDF
    The future of livestock in the developing world: myths, complexities and trade-offs
    Building capacity of African researchers in genomics to play key role in boosting productivity of livestock systems
    Biodiversity and Ecosystem

    Antimicrobial Resistance and Ecology: A Dialog Yet to Begin

    More plastic than fish in marine nursery
    Larval fish are eating tiny pieces of plastic in the waters off Hawaii. Bits of plastic outnumbered baby fish by seven to one in areas known to be important nurseries for marine life. Researchers dissected hundreds of larval fish and found that almost one in ten had ingested plastic — including species that are food to birds and other fish.
    BBC | 4 min read
    Reference: PNAS paper
    Rangelands and drylands go global at the Global Landscapes Forum
    Food Safety and Security

    Europe-banned insecticide ‘threatens Africa’s food security’
    Report calls on African policymakers to control use of neonicotinoids because of their harmful effects on the environment.
    Over 10 million people in Afghanistan have "severe acute food insecurity," with one-third of Afghans requiring urgent humanitarian action.
    [UN News]
    Sustainable fishing staying afloat in developed world, sinking in poorer regions
    More people than ever rely on fisheries and aquaculture for food, and income, but the seafood industry is facing a “dangerous” sustainability divide when comparing trends in the developed world versus those in poorer regions, the Food and Agriculture Organization (FAO) revealed on Monday.

    A global diet—designed to protect the planet—is too costly for 1.5 billion people
    A new study considers a shortcoming in the influential dietary recommendations from the EAT-Lancet Commission: it doesn't factor in affordability across the globe.
    Read More
    World Antibiotic Awareness Week 2019: WAAW 2019: 18-24 November
    More People in the United States Dying from Antibiotic-Resistant Infections than Previously Estimated. 
    The Centers for Disease Control and Prevention today released its updated Antibiotic Resistance Threats in the United States indicating that antibiotic-resistant bacteria and fungi cause more than 2.8 million infections and 35,000 deaths in the United States each year. That means, on average, someone in the United States gets an antibiotic-resistant infection every 11 seconds and every 15 minutes someone dies. When Clostridioides difficile, a bacterium which is not typically resistant but can cause deadly diarrhea and is associated with antibiotic use, is added to these, the US toll of all the threats in the report exceeds 3 million infections and 48,000 deaths.
    HHS Advances Development of Tests to Distinguish Bacterial from Viral Infections across Multiple Healthcare Settings. 
    A novel diagnostics technology that reads gene expression patterns in the immune system to distinguish bacterial infections from viral infections and determines the severity within minutes will receive advanced development support from the US Department of Health and Human Services. The technology is being designed for use in outpatient and inpatient healthcare settings. The Biomedical Advanced Research and Development Authority, part of the HHS Office of the Assistant Secretary for Preparedness and Response, will support the advanced development of the new testing technology, known as host-response testing, under a 14-month, $6 million contract with Inflammatix Inc., of Burlingame, California
    When global health goes local: Tackling infectious diseases and antimicrobial resistance in Kenya
    Drug-resistant infections are on the rise, and low- and middle-income countries are particularly burdened by the challenges posed. In Kenya, an initiative is combating these problems by strengthening local systems and focusing on primary health care.
    Vulnerability assessment tools for infectious threats and antimicrobial resistance: a scoping review protocol

    Euro health workers spotty on antibiotic knowledge
    Under 60% of the respondents were able to answer 7 true/false questions about antibiotics correctly.
    More »
    Webinar: WHO Practical Toolkit to Implement Antimicrobial Stewardship Programmes in Health-Care Facilities in LMICs. Thursday,21 November, 2019. 12:30-13:30 GVA
    WHO has published its first guidance document on antimicrobial stewardship programmes for health-care facilities in low-and middle-income countries ( . The aim is to help countries build essential structures at national and facility level, to develop a stepwise AMS implementation plan that includes what interventions to do, how to implement them and how to assess their impact on reducing inappropriate antibiotic use, save lives and reduce healthcare costs. Join the webinar to learn more about how the toolkit can help you implement AMS in your country.
    Link to connect to the webinar:
    ReAct interview: UNICEF’s new internal technical guidance paper on AMR
    Antibiotic development — economic, regulatory and societal challenges
    Antibiotic resistance is undoubtedly one of the greatest challenges to global health, and the emergence of resistance has outpaced the development of new antibiotics.
    Stewardship / Resistance Scan for Nov 22, 2019

    • Outpatient prescribing in Tennessee
    • UNICEF response to AMR

    More »

    Stewardship / Resistance Scan for Nov 18, 2019

    • EU antibiotic resistance response
    • Guidance on drug-resistant TB

    More »

    Stewardship / Resistance Scan for Nov 15, 2019

    • Dental antibiotic stewardship
    • Host-response diagnostic tests
    • Antibiotic use, resistance in Europe
    • Pakistan and typhoid vaccine

    More »

    Emergencies and Disasters

    WHO AFRO Emergencies and Outbreaks: Week 46: 11 - 17 November 2019
     The WHO Health Emergencies Programme is currently monitoring 64 events in the region. This week’s main articles cover key new and ongoing events, including:

    • Yellow fever in Nigeria
    • Cholera in Burundi
    • Circulating vaccine-derived poliovirus type 2 in Côte d’Ivoire
    • Ebola virus disease in Democratic Republic of the Congo.
    ‘Three-country crisis’ across central Sahel puts whole generation at risk, warns UN food agency
    How does poor air quality from bushfire smoke affect our health?
    Tainted water: How a crippling bone disease is linked to drought in Indi
    A race against time: Resilient roads for effective emergency response
    Venice flooding calls for new attention to controversial MOSE prevention plan
    Flood defences simply aren’t good enough – here’s what needs to be done
    More than 20,000 People Displaced by Floods in Bangui, Central African Republic
    Heavy, unseasonable rains in Bangui, Central African Republic for the past three weeks continue to cause significant material damage, displacing at least 20,500 people and exposing to further danger a population that has weathered repeated cycles of violence since 2013.
    IOM Reporter Videos

    Climate Change

    The 2019 report of The Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate
    This report presents an annual update of 41 indicators across five key domains: climate change impacts, exposures, and vulnerability; adaptation, planning,and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement.

    Environment at a Glance - OECD Indicators
    This new OECD platform for environmental indicators gives access to recent data through interactive graphics and provides trends on major environmental issues. The indicators help track environmental performance and compare country progres
    Health and climate change in Australia and the Asia Pacific Region: From Townsville to Tuvalu
    From Townsville to Tuvalu, from Nillumbik to the Northern Territory, impacts of climate change on health include potential for increased prevalence of many other conditions: heat illness, asthma, heart disease, anaemia, injuries, and other infectious diseases including diarrhoea. Many of our water sources will become undrinkable. Climate change has even been linked to depression.
    Warming Weather Patterns Tied to Increased Rate of Infectious Disease. 
    Increasingly frequent warming patterns of weather are tied to increasing rates of infectious disease. 2018 was one of the hottest on record, with more than 220 million additional exposures to heatwaves compared with a 1986-2005 climatological baseline. Increasing temperatures are linked to rising mortality from dengue fever, particularly in Southeast Asia. Rising temperatures also increase areas of coastline suitable for Vibrio bacteria, which has increased by 31% in the Baltic coastline and 29% in the northeastern coastline of the United States.

    India's Finance Commission likely to reject $12 billion package to help utilities cut pollution: source
    India's Finance Commission has told the power ministry that its proposal to award utilities 835 billion rupees ($11.6 billion) in incentives to install equipment to curb emissions is "unviable," a senior official at the ministry told Reuters on Tuesday.

    Climate change ‘poses lifelong threat to children’s health’
    Children are at increasing risk from pollution, malnutrition and disease as global temperatures rise, report finds.

    Flying is even worse for air quality than for climate
    Researchers suggest the best ways to reduce the societal impact of aviation's climate and pollution emissions Read More
    Temporally compound heat wave events and global warming: An emerging hazard
    This study examines the temporal structure of heat waves having widely varying substantial human impact, with many featuring a compound structure of hot days interspersed with cooler breaks. In contrast, many heat wave definitions employed by meteorologists include a continuous threshold-exceedance duration criterion.
    The global and regional impacts of climate change under representative concentration pathway forcings and shared socioeconomic pathway socioeconomic scenarios
    This paper presents an evaluation of the global and regional consequences of climate change for heat extremes, water resources, river and coastal flooding, droughts, agriculture and energy use. It presents change in hazard and resource base under different rates of climate change (representative concentration pathways (RCP)), and socio-economic impacts are estimated for each combination of RCP and shared socioeconomic pathway.

    Urban Health

    Canada: 3 Ways cities can prepare for climate emergencies
    Managing risks for safer built environment in Malawi. Building regulatory capacity assessment
    In a rapidly urbanising world, Malawi remains one of the least urbanised countries in Africa. Approximately 16.7 percent of Malawi’s population live in urban areas. Nevertheless, the country is urbanising at a moderate rate of approximately 3.7–3.9 percent per year. If growth continues at this rate, by 2030, approximately 20 percent of the population will be city dwellers, reaching 30 percent in 2050. This urban growth has the potential...
    Which urban land covers/uses are associated with residents’ mortality? A cross-sectional, ecological, pan-European study of 233 cities

    Migration Health

    How Migration Makes the World Brainier
    Read more

    Global Health

    Dangers, health risks faced by sanitation workers exposed
    Report lays bare the plight of manual workers who empty pits and latrines without tools or protection.
    ‘Transformational benefits’ of ending outdoor defecation: Why toilets matter
    Ending the practice of defecating in the open, rather than in a toilet, will have “transformational benefits” for some of the world’s most vulnerable people, says the UN’s partner sanitation body, the WSSCC (Water Supply and Sanitation Collaborative Council).
    UN, African Union make significant joint commitment to global health
    In the drive towards universal health coverage, the World Health Organization (WHO) and the African Union (AU) Commission cemented their mutual commitment to global health by signing on Monday an historic agreement.
    Call for papers: Human Resources for Universal Health
    Main theme and key topics are
    1. Strengthening and consolidation of governance and leadership of human resources for health
    2. Development of conditions and capacities of human resources for health to expand access to health and health coverage with equity and quality
    3. Interaction with the education sector to respond to the needs of health systems in their transformation towards universal access to health and universal health coverage
    Papers will be accepted in Spanish, English or Portuguese. The manuscript selection process will follow the journal peer review usual procedures.
    Questions: Please include in the Subject: “Human Resources for Health”
    Read the complete call for papers here: English | Espanõl | Português

    Childhood disease outbreaks trigger laws to limit vaccine exemptions
    States with epidemics saw upticks in proposed bills to restrict vaccine exemptions.
    More »
    Google partners with major U.S. health system, gaining access to vast patient data in the process
    Google has quietly launched a project with one of the nation’s largest nonprofit health systems in which it has gained access to millions of patient records, including names and birth dates, to help deliver more targeted medical treatment.

    Google health-data scandal spooks researchers
    Google and one of the largest health-care networks in the United States are embroiled in a data-privacy controversy that researchers fear could jeopardize public trust in data-sharing practices and, potentially, academic studies. At issue is a project dubbed Nightingale that gives Google access to the health-care information of tens of millions of people without their knowledge. The patients were treated at facilities run by the health network Ascension. Google and Ascension say that they abided by US laws to protect health-care information. But the lack of informed consent — and the fact that identifiable data weren’t scrubbed from the records — has caused US lawmakers to cry foul.
    Nature | 4 min read

    Apple launches virtual health studies aiming to enroll hundreds of thousands of customers
    The studies, plans for which were first announced in September, represent an emerging, and ambitious, approach to medical research.

    Translation of “Accelerating progress towards health-related SDGs” now available
    To view the following announcement in Arabic, please click here.
    A French version of the course can be accessed through the following link:
    A Spanish version of the course can be accessed through the following link:
    Artificial intelligence for global health
    Artificial intelligence (AI) has demonstrated great progress in the detection, diagnosis, and treatment of diseases. Deep learning, a subset of machine learning based on artificial neural networks, has enabled applications with performance levels approaching those of trained professionals in tasks including the interpretation of medical images and discovery of drug compounds.



    Knowledge Sharing

    Thank you for reading. If you have thoughts, feedback, story ideas, or questions you would like to share or interested in partnering with us on a special event coverage, please send a note to Chadia Wannous via email  


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