News Pouch: 30 October 2019

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Pandemic Threats and Health Emergencies

News Pouch: 30 October 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  cwannous@yahoo.com  

Wishing you useful reading!
Chadia
=============
Topics: 

  • 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 65: 29 October 2019
    In the 21 days from 7 to 27 October 2019, the number of affected health areas has remained the same, with 16 health areas and nine health zones reporting cases. During this period, a total of 56 confirmed cases were reported, with the majority coming from the health zones of Mandima (54%; n=30 cases) and Mabalako (18%; n=10 cases). As of 27 October 2019, a total of 3264 EVD cases were reported, including 3147 confirmed and 117 probable cases, of which 2181 cases died (overall case fatality ratio 67%). Of the total confirmed and probable cases, 56% (1838) were female, 28% (926) were children aged less than 18 years, and 5% (163) were healthcare workers.
    click here to download the complete situation report (PDF).

    More Ebola cases in DRC, including Butembo
    As cases reach 3,260, the US remains the top donor, but the future of Ebola funding remains unclear.
    More »

    Ebola cases continue slow rise in DRC outbreak
    Four new cases raise the outbreak total to 3,264 infections, and 3 new deaths bring the fatality toll to 2,181.
    More »

    US leads Ebola donors, but future uncertain
    From August 2018 to September 2019, KFF estimates $546 million was provided by donors to address Ebola in the DRC, with $148 million coming from the United States. Other top donors included the World Bank ($130 million), the WHO Contingency Fund for Emergencies ($73 million), the United Kingdom ($64 million), and the European Commission ($52 million). But not all of the $546 million provided direct support to the DRC's response efforts. "Only half of funding (50%), including about a third of U.S. funding, was provided in direct support of the official DRC response plans, which guide national response strategy and enumerate resource needs," the KFF analysis said.
    https://www.kff.org/global-health-policy/issue-brief/data-note-donor-funding-for-the-current-ebola-response-in-the-drc
     

    Officials track movement of Ebola patients from DRC hot spot
    Cases involving travel make it difficult for responders to investigate quickly.
    More »
     
    Scientists Were Hunting for the Next Ebola. Now the U.S. Has Cut Off Their Funding.  PREDICT, a government research program, sought to identify animal viruses that might infect humans and to head off new pandemics. In a move that worries many public health experts, the federal government is quietly shutting down a surveillance program for dangerous animal viruses that someday may infect humans. The United Nations Environment Program estimates that a new animal disease that can also infect humans is discovered every four months. Ending the program, experts fear, will leave the world more vulnerable to lethal pathogens like Ebola and MERS that emerge from unexpected places, such as bat-filled trees, gorilla carcasses and camel barns.
    https://www.nytimes.com/2019/10/25/health/predict-usaid-viruses.html

    Subsequent mortality in survivors of Ebola virus disease in Guinea: a nationwide retrospective cohort study
    https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(19)30313-5/fulltext
     
    Offline: The mistakes we made over Ebola
    The failures the global health community made collectively over Ebola, argued Caroline Voûte (Médecins Sans Frontières) were not simply abstract errors in outbreak responses. They were errors that failed people. Systems were designed around the disease, not those affected. Money was invested in global surveillance and response systems, but little attention was given to standards of care and the effects of the outbreak on families, communities, and health workers. 
    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32634-0/fulltext

    Climate change could push Ebola into untouched regions, report warns
    In a study published in Nature Communications journal, researchers used a statistical model to predict how increases in temperature and socio-economic development will affect the spread of Ebola over the next five decades. They found that in a worst-case scenario, the area at risk of disease outbreaks could increase by 14.7 per cent, stretching beyond the current endemic zone of central Africa.  
    https://www.telegraph.co.uk/global-health/science-and-disease/climate-change-could-push-ebola-untouched-regions-report-warns/
     

    Priority Diseases

    The world is flunking in the fight against disease
    https://www.washingtonpost.com/opinions/global-opinions/the-world-is-flunking-in-the-fight-against-disease/2019/10/28/35252c12-f9aa-11e9-ac8c-8eced29ca6ef_story.html
     
    ===============
     
    Influenza
     
    WHO guidance document "Non-pharmaceutical public health measures for mitigating the risk and impact of epidemic and pandemic influenza".
    The document provides recommendations for the use of non-pharmaceutical public health measures to mitigate the risk and impact of epidemic and pandemic influenza. The recommendations are based on review of existing guidance documents and the latest scientific evidences that were gathered through a series of systematic literature reviews on the effectiveness of non-pharmaceutical public health measures. The findings of the systematic reviews are summarized in the Annex: report of systematic literature reviews which is available at the same site.
    https://www.who.int/influenza/publications/public_health_measures/publication/en/ 
     
    WHO-AFRO announce the launch of the AFRO Influenza Dashboard.
    This dashboard specifically displays influenza data from AFRO countries and allows viewing of influenza data as a region, by transmission zone and by country. The data that populates this site is a direct reflection of the data contributed to FluNet/FluID either through AFRO or by each individual country. At present country profiles are not available, however, country profiles will come online in the coming months.
    (click to visit the dashboard: http://apps.rsis.afro.who.int/influenza/
     
    WHO biweekly global influenza update
    www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/
     
    The latest FluNet summary of lab-confirmed data from GISRS
      www.who.int/influenza/gisrs_laboratory/updates/summaryreport
     
    Avian Influenza A Viruses among Occupationally Exposed Populations, China, 2014–2016
    Human infection with avian influenza viruses (AIVs) has been reported in China since the late 1990s. Since then, human infections with subtypes H5N1, H5N6, H6N1, H7N4, H7N9, H9N2, and H10N8 have been reported continuously and are a substantial threat to public health in the country.
    https://wwwnc.cdc.gov/eid/article/25/12/19-0261_article
    ==================
     
    Vector-Borne Diseases (VBD)

    Vector-borne disease and climate change adaptation in African dryland social-ecological systems
    https://idpjournal.biomedcentral.com/articles/10.1186/s40249-019-0539-3

    Impact of past and on-going changes on climate and weather on vector-borne diseases transmission: a look at the evidence
    https://idpjournal.biomedcentral.com/articles/10.1186/s40249-019-0565-1

    Can the world eradicate malaria by 2050?
    Eradicating malaria is without a doubt a bold ambition. But is it attainable? A point-counterpoint discussion examined the evidence.
    https://www.hsph.harvard.edu/news/features/can-the-world-eradicate-malaria-by-2050
     
    Dengue: Brazil tops 2 million cases in 2019, Mexico cases double from last year
    UN health officials released the latest dengue fever numbers for the Region of the Americas recently and the total cases now stand at 2,668,877, including 1,162 deaths. Brazil has reported more than 1 million dengue cases in a year several times–1.5 million in 2016, 1.65 million in 2015 and 1.47 million in 2013. In 2019, for the first time they have topped 2 million cases (2.04 million). Brazil has also reported 676 fatalities. Mexico has also seen a dramatic increase in dengue this year. In fact, the number of cases have doubled compared to 2018. To date, Mexico has seen 163,662 cases, while last year they reported 78,621.
    http://outbreaknewstoday.com/dengue-brazil-tops-2-million-cases-in-2019-mexico-cases-double-from-last-year-76470/
     
    Co-circulation and misdiagnosis led to underestimation of the 2015-2017 Zika epidemic in the Americas
    During the 2015-2017 Zika epidemic, dengue and chikungunya -- two other viral diseases with the same vector as Zika -- were also in circulation. Clinical presentation of these diseases can vary from person to person in terms of symptoms and severity, making it difficult to differentially diagnose them. 
    https://www.medrxiv.org/content/10.1101/19010256v1
    ============
    ASF
     
    African Swine Fever: An Unexpected Threat to Global Supply of Heparin
    African swine fever (ASF) outbreaks in China pose an unexpected threat to the global supply of heparin due to its impact on pig populations. Since August 2018, China has culled more than one million pigs in efforts to contain the spread of ASF within the country.
    https://bit.ly/2VXm7JU   
     
     ASF Asia Update for 24 October from FAO/EMPRES – Animal Health.
    * In the Republic of Korea, since 17 September, a total of 14 outbreaks in domestic pigs and 14 cases in wild boars has been confirmed near DMZ so far.
    * The Philippines announced confirmation of ASF in additional three provinces.
    * Viet Nam released statistics up to the month of September, showing 19% decrease in the number of live pigs over the same period last year.
    http://www.fao.org/ag/againfo/programmes/en/empres/ASF/Situation_update.html             
     
    South Korea deploys snipers and drones to fend off deadly pig virus
    South Korea has mobilized military snipers and drones along the demilitarized zone between itself and North Korea to stave off wild boars carrying African swine fever. The country is the latest to report cases of the highly contagious and lethal virus in pigs, which has wiped out tens of millions of the animals across Asia.
    https://www.nature.com/articles/d41586-019-03237-5

    ==============
    Polio

    World Polio Day 2019
    https://www.cdc.gov/globalhealth/immunization/wpd/index.html
     
    ================
     HIV
     
    Panic in Pakistani City After 900 Children Test Positive for H.I.V.
    Nearly 900 children in the small Pakistani city of Ratodero were bedridden early this year with raging fevers that resisted treatment. Parents were frantic, with everyone seeming to know a family with a sick child.  
    https://www.nytimes.com/2019/10/26/world/asia/hiv-aids-pakistan-ratodero.html
    ============
    TB

    End the tuberculosis emergency: a promise is not enough
    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32459-6/fulltext
     
    A new test could identify tuberculosis in less than an hour
    Tuberculosis remains a global health burden. Ahmad et al. used machine learning to develop an algorithm that distinguished active tuberculosis from other diseases with similar symptoms by measuring expression of four proteins in blood samples.
    https://stm.sciencemag.org/content/11/515/eaaw8287
     
    Assessing the effectiveness of pre-entry active and post-entry latent tuberculosis screening in UK migrants.
    Read this Article
     
    Final Analysis of a Trial of M72/AS01E Vaccine to Prevent Tuberculosis
    Results of an earlier analysis of a trial of the M72/AS01E candidate vaccine against Mycobacterium tuberculosis showed that in infected adults, the vaccine provided 54.0% protection against active pulmonary tuberculosis disease, without evident safety concerns. We now report the results of the 3-year final analysis of efficacy, safety, and immunogenicity.
    https://www.nejm.org/doi/full/10.1056/NEJMoa1909953
     
    Light At the End of the Tunnel: Battling Tuberculosis in Iraq
    Read more
     
     

    One Health  

    PREDICT, a pandemic preparedness program, thrived under Bush and Obama. Now it’s canceled.
    https://www.vox.com/future-perfect/2019/10/29/20936921/usaid-predict-pandemic-preparedness
     
    Applying Big Data solutions to One Health challenges in the Mediterranean region
    Are animal health stakeholders fully prepared to use geospatial Big Data for disease monitoring and ready to respond to the challenge of transforming the exponential growth of data into intelligence-driven information for action? Can leadership and an enabling environment be provided for a future-focused community-of-practice in One Health data analysis? Discussions at the ‘One Health for the Mediterranean Region in the Age of Big Data’ conference held in Sardinia, Italy earlier this month addressed these issues and more.
    Read about the conference HERE.

    Bringing livestock research and business together for sustainable agriculture
    https://livestock.cgiar.org/2019/10/24/bringing-livestock-research-and-business-together-for-sustainable-agriculture/

    Towards sustainable food system transformations in the Global South
    https://news.ilri.org/2019/10/24/towards-sustainable-food-system-transformation-in-the-global-south/
     
    Call to expand the Nagoya protocol for global collaborative research.
    “The One Health approach, where human, animal and environmental health are considered as inevitably linked, is widely accepted as a pillar of public health. The Nagoya protocol, in its current form, does not sufficiently recognize the need for global collaborative research on genetic resources that have the potential to become a risk to public health. The protocol neglects the non-commercial basic research on microorganisms needed for the global capacity to prevent epidemics. Parties to the Convention are urged to consider simplified measures for non-commercial research, in their legislation on access and benefit sharing, including exceptions or fast track options for research on pathogens.” 
    See The Nagoya protocol and research on emerging infectious diseases.
     https://bit.ly/2pG7n67  
     
    The Nagoya protocol and research on emerging infectious diseases
    https://www.who.int/bulletin/volumes/97/6/19-232173.pdf
     
    One Health in South Asia and its challenges in implementation from stakeholder perspective
    https://www.ncbi.nlm.nih.gov/pubmed/29084821
     
    One Health/EcoHealth capacity building programs in South and South East Asia: a mixed method rapid systematic review.
    https://www.ncbi.nlm.nih.gov/pubmed/28962571
     
    Building a foundation for 'One Health': an education strategy for enhancing and sustaining national and regional capacity in endemic and emerging zoonotic disease management
    https://www.ncbi.nlm.nih.gov/pubmed/24264805
     
    Event
    1st International Africa One Health Forum
    Addis Abbaba, Ethiopia.
    November 14-15, 2019
    Hosted by the Africa CDC, organized by the One Health Platform, this invitational forum will focus on strengthening the public health practice of national public health institutes (NPHIs) in Africa. Substantial consensus building for One Health public health practice has already been done by WHO, FAO, OIE, US CDC, and other partners and many African countries have conducted disease prioritization workshops and initiated programmes for surveillance and control of specific zoonotic diseases. While NPHIs serve the human health sector, this One Health Forum will ensure adequate representation from animal and environmental sectors to reach balanced recommendations for prioritization, surveillance, and risk assessment. https://bit.ly/2mrxEUd
     
    ===================
     
    Biodiversity and Ecosystem

    More people at risk of rising seas
    The most detailed maps yet of coastal topography vastly increase estimates of the number of people whose homes are threatened by rising seas. Under worst-case climate-change scenarios, up to 630 million people will face flooding at least once a year by 2100 — three times as many as previously thought. Researchers used neural networks to reduce the errors in satellite data from NASA, which can falsely identify built-up areas and forests as higher ground.
    New Scientist | 4 min read
    Reference: Nature Communications paper
     
    Agricultural land-uses consistently exacerbate infectious disease risks in Southeast Asia: 
    meta-analysis of disease-agriculture relationships in Southeast Asia find that those who work or live on agricultural land have, on average, a 74% increase in infectious disease risk than those unexposed, specifically within forest monoculture (palm oil and rubber) and non-poultry based livestock farming. 
     https://www.nature.com/articles/s41467-019-12333-z
    ================
    Food Safety and Security
     
    Moving forward on food loss and waste reduction: 
    Themes of planetary health emerge from the latest FAO report on the state of food and agriculture, focused on global food loss and waste and its implications on food and economic security, nutrition, environmental sustainability, and policy-making.
    https://reliefweb.int/sites/reliefweb.int/files/resources/ca6030en.pdf

    The global effect of extreme weather events on nutrient supply: a superposed epoch analysis
    https://www.sciencedirect.com/science/article/pii/S2542519619301937

    The Feed Assessment Tool (FEAST) – new developments
    https://feeding-innovation.ilri.org/2019/10/28/the-feed-assessment-tool-feast-new-developments/
    =============
     
    AMR

    Improving the estimation of the global burden of antimicrobial resistant infections
    https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(19)30276-2/fulltext

    Standardising the reporting of microbiology and antimicrobial susceptibility data
    https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(19)30561-4/fulltext

    A governance framework for development and assessment of national action plans on antimicrobial resistance
    https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(19)30415-3/fulltext
     
    Scientists developing test to detect antibiotic resistance in less than 45 minutes
    Scientists are developing a low cost, rapid diagnostic sensor test which aims to show the susceptibility of bacteria to antibiotics within 45 minutes. NHS laboratory testing of samples can take up to two days and the new test aims to allow doctors to be able to prescribe the correct antibiotic to a patient for an infection more quickly.
    https://www.strath.ac.uk/whystrathclyde/news/scientistsdevelopingdiagnostictesttodetectantibioticresistanceinlessthan45minutes/

    Reframing Resistance
    The Wellcome Trust has launched a new piece of research and toolkit on communicating Antimicrobial Resistance following 12 months doing extensive work in Germany, India, Japan, Kenya, Thailand, the UK and the US and with over 50 experts from the AMR community. A set of evidence based principles and practical resources for practitioners
    https://wellcome.ac.uk/reports/reframing-antimicrobial-resistance-antibiotic-resistance .
     
    Stewardship / Resistance Scan for Oct 25, 2019

    • New guidelines for dental antibiotics
    • Antibiotics R&D roadmap

    More »

    Stewardship / Resistance Scan for Oct 24, 2019

    • Colistin-resistant K pneumoniae in India
    • Transmissibility of MDR-TB

    More »

    Stewardship / Resistance Scan for Oct 23, 2019

    • High-intensity stewardship
    • Urgent care antibiotic prescribing

    More »

    Stewardship / Resistance Scan for Oct 28, 2019

    • XDR-TB drug maker chosen
    • Resistant Klebsiella in Germany
    • New pneumonia antibiotic OK'd

    More »
     
    Webinar: "Value of Diagnostics in Antimicrobial Stewardship: An Asia-Pacific Outlook"
     Tuesday, Nov 5. 2:00 pm Singapore Standard Time/China Standard Time 
    Please visit the registration page to learn more obtaining continuing education credit for participation in this webinar.
     

    Emergencies and Disasters
     

    WHO AFRO - Outbreaks and Emergencies Bulletin - Week 43/2019
    The WHO Health Emergencies Programme is currently monitoring 68 events in the region. This week's edition covers key new and ongoing events, including:

    • Humanitarian crisis in Democratic Republic of the Congo
    • Malaria outbreak in Burundi
    • Humanitarian crisis in South Sudan
    • Ebola virus disease in Democratic Republic of the Congo.

    https://apps.who.int/iris/bitstream/handle/10665/329488/OEW43-2127102019.pdf

    The health sector’s multi-hazard response framework
    This document was developed in response to the expressed desire of the Member States of the Pan American Health Organization to improve their health emergency and disaster response preparedness. This is in accordance with the general objectives of the Sendai Framework for Disaster Risk Reduction 2015-2030 and with the commitment of the PAHO Member States to applying, implementing, and meeting the International Health Regulations (IHR).
    More information at: https://bit.ly/33CF2MK.

    Inaugural Global Health Security Index notes wide readiness gaps
    http://www.centerforhealthsecurity.org/newsroom/center-news/2019-10-24-GHSindex.html

    Outbreak response as an essential component of vaccine development
    https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(19)30305-6/fulltext
     
    Six Months after Cyclone Kenneth, Recovery Still in Process 
    Read more
     
    California's blackouts reveal health care's fragile power system.
    https://www.theverge.com/2019/10/28/20932780/california-blackout-healthcare-electricity-fires

    Humanitarian aid and reestablishment of health services: a priority in Bahamas in the wake of Hurricane Dorian
    https://www.paho.org/disasters/newsletter/index.php
     

    Climate Change

    Strengthening the capacities of the health sector and meteorological services to address heatwaves
    https://www.paho.org/hq/index.php?option=com_content&view=article&id=15130:heatwave&Itemid=4206&lang=en

    Africa’s forgotten climate data
    Millions of Africa’s meteorological records are mouldering in cardboard boxes or languishing on obsolete technology spread across the continent. Those data could be worth “far more than gold and diamonds” in efforts to predict and protect against severe impacts of climate change in parts of Africa. Despite international offers to help digitize the information, some nations have declined because they’re concerned that giving away access to the data now will prevent them from selling the information later.
    Nature | 4 min read
     
    Climate change is impacting population health and our future patients: remaining silent is not an option
    https://bit.ly/2J6bIXm
     
    The Global Burden of (How we Manage) Animal Disease: Learning Lessons from Southern Africa
    https://www.jwildlifedis.org/doi/pdf/10.7589/2019-01-024
     

    Urban Health

    Disproportionately higher exposure to urban heat in lower-income neighborhoods: a multi-city perspective: 
    Chakraborty et al. (2019) measure differential urban heat island intensities and health impacts across various intra-city demographic groups, finding elevated risk of heat stress, correlated with lower neighborhood vegetation, in socioeconomically vulnerable populations.
    https://iopscience.iop.org/article/10.1088/1748-9326/ab3b99
     

    Migration Health

    Mediterranean Migrant Arrivals Reach 82,978 In 2019; Deaths Reach 1,080 
    https://www.iom.int/news/mediterranean-migrant-arrivals-reach-82978-2019-deaths-reach-1080
     
    Migrant Kids, Infectious Diseases, and the Ongoing Border Crisis
    Experts urge vaccination, better healthcare practices to curb infection-related deaths. Seven migrant children have died in U.S. custody during the past year, and conditions in detention centers may be encouraging the unchecked spread of infectious diseases, a researcher argued. In the last 2 months alone, outbreaks of other infectious disease outbreaks, including flu, the mumps, and chicken pox have led to quarantines of migrants, he noted.
    https://www.medpagetoday.com/infectiousdisease/publichealth/82935

    The U.S. detained a record number of minors traveling alone
    over 75,000 — who tried to cross the southern border in the last fiscal year.
    Detentions have surged as the Trump administration’s aggressive policy toward migrants has collided with an exodus of children fleeing Central America.
    Read More »

    The 39 people who died in the lorry were victims. Why does the law treat them as criminals?
    https://www.theguardian.com/commentisfree/2019/oct/29/39-people-lorry-victims-law-criminals-immigration-slavery
     
    Climate migration isn't handled by one international body — that might be OK, experts say
    The number of climate refugees is expected to grow in the decades to come, supporting those impacted by climate change will likely require a diverse preventative and responsive approach, spanning from new regional frameworks to global compacts.
    People displaced by climate change largely move within their countries. But those who do cross country borders do not have the international protection guaranteed to refugees. They lie outside the scope of the nearly 70-year-old international definition of a refugee — someone who has fled their country because of fears of being persecuted for reasons of race, religion, nationality, or membership of a social group or political opinion.
    https://www.devex.com/news/a-super-framework-for-climate-migration-isn-t-on-the-way-95903

    Guidance on migration and health -PAHO
    for the Member States in addressing the migration-related challenges facing public health and health systems, including health promotion and the protection of migrants throughout the migratory process. It also is designed to help integrate the health needs of migrants in national policies, strategies, and programs in order to protect not only the health of this population, but also the health of the receiving population.
    More information at: https://bit.ly/32m7TF3.

     

    Global Health

    Bringing women to the forefront of global health
    Women currently account for around 70% of the global health workforce but hold only about 25% of its leadership positions. A recent panel examined ways to keep pushing for gender equity.
    https://news.harvard.edu/gazette/story/2019/10/harvard-panel-discusses-women-in-the-global-health-workforce/
     
    Communicating science with policymakers: six strategies for success
    No matter how hard scientists work, our impact will almost always be limited to our immediate academic circles if our results never catch the attention of those who have the power to act on them. These people are often policymakers — local, state or central-government officials who write laws and regulations, craft budgets and govern communities. But effective collaboration requires strong communication. The policy world can be tricky to navigate. Institutions can seem impenetrable, and decision-making is often opaque. Fortunately, simple strategies can help scientists to communicate effectively with policymaker.
    https://www.nature.com/articles/d41586-019-02372%203
     

     

     

    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 cwannous@yahoo.com  

     

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