Health Security Digest

  • Johns Hopkins SPH Center for Health Security

    Eurosurveillance: The re-emergence of HPAI H7N9 Human Infection in Mainland China, 2019

    23 May 2019 - Avian Flu Diary

    Via JHCHS

    Two years ago pandemic concerns were heightened as the world watched the biggest human outbreak of Avian Influenza on record, in Mainland China.  The culprit was H7N9 - which emerged as an LPAI virus in 2013 - but evolved into co-circulating LPAI & HPAI strains in late 2016. 

  • Frontiers

    Editorial: Epidemiology of Avian Influenza Viruses

    22 May 2019 - Frontiers

    Mathilde C. Paul et al.,

    The international dimension and the difficulties in effectively controlling these epidemics, highlight the need for more scientific information in relation to the epidemiology and patterns of the disease in affected countries, especially in East Asia, as well as the need for effective policies against HPAI. This Research Topic aims at contributing to fill this gap. It includes 10 papers. Control can be particularly challenging in endemic areas, such as Indonesia, where multiple HPAI virus subtypes and clades may circulate, as described by Durr et al. Another great challenge of HPAI control is the intense circulation of AI viruses in waterfowl populations, which act as a natural reservoir with periodic spill-over to domestic poultry.The two studies presented by Scott et al. illustrate the relevance of such approaches in the context of early warning systems in disease-free areas. Scenario tree modeling approaches made it possible to assess the pathways of LPAI exposure, as well as to quantify the risk of LPAI and HPAI spread within and between Australian commercial chicken farms.

  • OIE

    Highly pathogenic avian influenza, Vietnam

    20 May 2019 - OIE

    Via CIDRAP

    Vietnam's outbreak began on May 4 in a village in Hau Giang province in the far south of the country, according to a notification from the World Organization for Animal Health (OIE). The report didn't say how many birds died from the virus, but it noted that authorities culled 1,120 of them. The country reported its last H5N1 detection in March.

  • Frontiers

    Antibiotic Application and Resistance in Swine Production in China: Current Situation and Future Perspectives

    17 May 2019 - Frontiers

    This paper reviews the consumption of antibiotics in swine production as well as AMR and the development of novel antibiotics or alternatives in China. China unveiled a national plan to tackle antibiotic resistance in August 2016, but more support is needed for the development of new antibiotics or alternatives like plant extracts. Antibiotic resistance has been a major global challenge, so international collaboration between China and Europe is needed.

  • bioRxiv

    Chikungunya Outbreak in Bangladesh (2017): Clinical and hematological findings

    15 May 2019 - bioRxiv

    A massive outbreak of Chikungunya occurred in Bangladesh during the period of April-September, 2017 and over two million people were at risk of getting infected by the virus. A prospective cohort of viremic patients was constituted and analyzed to define the clinical, hematological and long-term aspects of this outbreak. A 35-day long comprehensive survey was conducted in two major, neighboring cities, Dhaka and Mymensingh. One-hundred and eighty-seven clinically proven Chikungunya cases were enrolled in the cross-sectional cohort study. Additionally, a smaller group of 48 Chikungunya patients was monitored for post-infection effects for 12 months. Clinical data revealed that a combination of fever and arthralgia (oligoarthralgia and/or polyarthralgia) was the cardinal hallmark (97.9% of cases) of the infection.

  • Johns Hopkins SPH Center for Health Security

    Understanding the Human-to-Human Transmissibility of Nipah

    14 May 2019 - Johns Hopkins Center for Health Security

    Among the several emerging infectious diseases that the world faces, Nipah virus is of particular concern. This RNA virus that originates in bats has caused sporadic outbreaks in several Asian countries, resulting in severe disease and death with mortality rates reaching 70%. Bangladesh is one of the countries that regularly reports Nipah cases. While largely considered a zoonotic disease with poor human-to-human transmissibility – the prerequisite for a pandemic – it is not exclusively so. This study includes 248 cases that occurred in Bangladesh over a 14-year period. Nikolay and colleagues analyzed data on all confirmed or probable Nipah cases reported between April 2001 and April 2014. Contacts of cases were defined as those who had in-person physical (touching) contact or had verbal contact (ie, in the same room talking with the patient) with a patient within 15 days of disease onset.

  • nature

    Vaccination lags behind in middle-income countries

    14 May 2019 - Nature

    Via CIDRAP

    Indonesia, Iraq and South Africa now rank among the ten countries with the highest number of under-immunized children worldwide, even though these countries are richer than many of their neighbours. What is going on? As the World Health Assembly meets in Geneva, Switzerland, next week, the development community must tackle an emerging conundrum: how do we increase access to vaccines, primary health care and other essential health interventions in countries that can — at least according to their gross national incomes — afford them?

  • nature

    Comparative Analysis of Eleven Healthcare-Associated Outbreaks of Middle East Respiratory Syndrome Coronavirus (Mers-Cov) from 2015 to 2017

    14 May 2019 - Nature

    Via CIDRAP

    Since its emergence in 2012, 2,260 cases and 803 deaths due to Middle East respiratory syndrome coronavirus (MERS-CoV) have been reported to the World Health Organization. Most cases were due to transmission in healthcare settings, sometimes causing large outbreaks. We analyzed epidemiologic and clinical data of laboratory-confirmed MERS-CoV cases from eleven healthcare-associated outbreaks in the Kingdom of Saudi Arabia and the Republic of Korea between 2015–2017.

  • Science Direct

    Trust collapse caused by the Changsheng vaccine crisis in China

    13 May 2019 - Science Direct

    The public acceptance and implementation of vaccination programs is essential to prevent infectious diseases. However, vaccine adverse events may cause public panic and eventually lead to an increasing number of populations who were hesitant or refuse to participate in these vaccination programs. In 2018, the Changsheng vaccine crisis broke out in mainland China, and 252,600 unqualified DTP vaccines were reported to be used for child vaccination. In this study, we observed media and public reactions toward the vaccine crisis.During the crisis, huge number of articles emerged on Internet, 125,882,894 articles (including forwarding) on WeChat friends circle, 1,877,660 Sina Weibo posts, 648,265 online news and 4,986,521 Baidu search indexes. Most of these articles were negative and expressed the public’s weak confidence to the China-made vaccines. Public confidence in vaccines was undermined by the actions of the manufacturer and the government.

  • Indonesia observes World Malaria Day in Bali, highlights 5 provinces that have yet to eradicate the disease

    13 May 2019 - Coconuts Bali

    Did you know that five Indonesian provinces have yet to declare themselves Malaria-free? This important fact was highlighted during the observance of this year’s World Malaria Day in Indonesia, which took place today in Bali. Bali is one of 29 provinces which have been declared malaria-free, but the battle is still ongoing in Papua, West Papua, Maluku, North Maluku and East Nusa Tenggara. Perhaps not-so-shockingly, 79% of the country’s malaria cases take place in underdeveloped Papua, according to the Health Ministry.


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