Wednesday, July 01, 2015

Korean MERS Cluster Rises To 183



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The four day hiatus in reporting of new MERS cases has ended in Korea with the announcement tonight of a nurse from Samsung Hospital diagnosed as that country’s 183rd MERS case.    The number of fatalities remains unchanged at 33.


At total of 102 cases have been released from the hospital, leaving 48 case still receiving treatment, 12 of whom are listed in `unstable condition’.


Homers ( Middle respiratory diseases ) one days Tracking

- the treatment of 48 patients (26.2%), hospital 102 patients (55.7%) died 33 persons (18.0%) diagnosed with total 183 persons

- day of treatment compared to four people a sense of small , discharge character 5 persons increases , the death toll unchanged , confirmed 1 persons increased

- it is treated 48 patients condition is stable . 36 persons (75.0%), unstable 12 patients (25.0%).

- Confirmed type of hospital patients 82 patients , families / visit 64 people , hospital workers 37 people

<1> General Status

□ Department of Health and Human Services Homers central management task force is 7.2 at 06 o'clock today , are treating patients with 48 patients (26.2%) in the fourth juleotgo people , who discharged five persons increased a total of 102 patients (55.7%) it said hayeotdago increased .

○ deaths 33 persons (18.0%) had no change in , confirmed personnel 1 people increased total 183 persons were aggregated .

○ condition being treated patients 36 were stable and 12 were unstable .


WHO Confirms Liberian Ebola Case





We have a very brief update posted by the World Health Organization on their July 1st Ebola update confirming the first new Ebola case in Liberia in roughly 3 months (see Liberia: Media Reports A Third Ebola Case, Additional Tests Pending for earlier report), and describing his contacts.


Ebola Situation Report - 1 July 2015


On 29 June, routine surveillance detected a confirmed case of EVD in Margibi County, Liberia—the first new confirmed case in the country since 20 March. The case is a 17-year-old male who first became ill on 21 June. After presenting at a local health facility the patient was treated for malaria and discharged. He died on 28 June and received a safe burial the same day. An oral swab taken before the burial subsequently tested positive twice for EVD. 102 contacts have been identified, although that number is expected to increase as investigations continue. At this stage the origin of infection is not known. The case reportedly had no recent history of travel, contact with visitors from affected areas, or funeral attendance.

HHS Launches National Ebola Training & Education Center

Credit FEMA




When Ebola arrived unannounced in the United States last fall for the first time it quickly became apparent that many healthcare facilities were ill equipped to quickly diagnose, isolate, and treat hemorrhagic viral fever patients.  


As a result a couple of weeks ago the HHS announced they had Selected 9 Regional Ebola & Special Pathogens Treatment Centers to provide specialized care for Ebola, MERS, and Avian flu cases.


Of course an infected patient can show up at any ER, so all hospitals need to be able to identify, and isolate highly infectious patients.  Even if they are to be transferred to a specialized regional facility for long term treatment.

While not an every day occurrence, the risks of someone with Ebola, MERS, H5N1, Lassa Fever, or some other potentially dangerous pathogen walking unannounced into a crowded emergency are very real.  In just over 12 months we’ve seen two Ebola cases (Dallas & New York), two MERS cases (Indiana & Florida), and two Lassa fever cases (New Jersey & Minnesota) show up unexpectedly in American hospitals.

As the number of global health threats increases, along with the rate of international travel, the odds for seeing this sorts of threats only goes up.


Today the HHS has announced funding for three hospitals to serve as training centers to help prepare other medical facilities to deal with Ebola, and other emerging infectious disease threats.



July 1, 2015

Contact: HHS Press Office

HHS launches National Ebola Training and Education Center

Three hospitals funded to train, prepare other U.S. health care facilities for Ebola and emerging threats

To ensure that U.S. health care providers and facilities are prepared to safely identify, isolate, transport, and treat patients with Ebola and other emerging threats, the U.S. Department of Health and Human Services today launched a National Ebola Training and Education Center.

A collaborative effort among HHS’ Office of the Assistant Secretary for Preparedness and Response (ASPR), the Centers for Disease Control and Prevention (CDC) and three academic institutions, the program supports further training of health care providers and facilities on strategies to manage Ebola and other emerging infectious diseases.

Through the effort, ASPR and CDC will provide $12 million over the next five years to Emory University in Atlanta, Georgia; Nebraska Medical Center in Omaha, Nebraska; and Bellevue Hospital Center in New York City, New York, which together will co-lead the National Ebola Training and Education Center.

“The National Ebola Training and Education Center contributes to our nation’s health security by developing and teaching evidence-based practices of experienced providers and health care institutions in caring for patients with Ebola and other serious infectious diseases,” said Dr. Nicole Lurie, HHS’ assistant secretary for preparedness and response. “While this training starts with Ebola, it also will help the health care community deal with other serious infectious diseases in the future.”

Emory University and Nebraska Medical Center have been working with CDC since December to train more than 460 health care workers from 87 health care systems, including 37 designated Ebola treatment centers, on all aspects of infection control and patient care for individuals with Ebola. Emory University and Nebraska Medical Center are offering additional training opportunities this summer for up to 400 staff from Ebola assessment hospitals.

The new National Ebola Training and Education Center will expand on the success of this initial work and offer state health departments and health care facilities additional access to the clinical expertise and training capabilities offered by these institutions.

“The ongoing Ebola epidemic in West Africa is proof that a threat anywhere can be a threat everywhere; the United States must continue to prepare,” said CDC Director Dr. Tom Frieden. “Hospitals are often the first place where a new disease threat is recognized. This new center will help our hospitals and healthcare workers prepare to handle new threats and safely care for patients.”

HHS recently announced nine regional Ebola treatment centers that are part of a national network of 55 Ebola treatment centers, but will have enhanced capabilities to treat a patient with confirmed Ebola or other highly virulent disease. Ebola treatment centers are staffed, equipped and have been assessed to have current capabilities, training and resources to provide the complex treatment necessary to care for a person with Ebola while minimizing risk to health care workers.

For more information on how to access the expertise through the National Ebola Training and Education Center, contact To learn more about Ebola, visit To learn more about preparedness, response and recovery from the health impacts of emergencies, visit

Liberia: Media Reports A Third Ebola Case, Additional Tests Pending





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Although nothing has been posted on the Liberian MOH website, and I’ve seen nothing officially released from the WHO, media sources are reporting a third positive Ebola case in Liberia – and local officials are warning that additional infections may turn up among their contacts.

All three cases have occurred more than 6 weeks after Liberia was officially declared free of the disease on May 9th. 


While getting to zero was difficult, staying there when two neighboring nations (Sierra Leone & Guinea) continue to report cases and the virus likely remains present in local animal reservoirs, is an even a bigger challenge.  Determining how this virus re-emerged will be a top priority, exceeded only by the need to quickly contain this outbreak.



Liberia announces two more confirmed Ebola cases


from Agence France-Presse

Published on 01 Jul 2015

Monrovia, Liberia | AFP | Wednesday 7/1/2015 - 12:40 GMT

Liberia said Wednesday a teenager who died of Ebola fever had spread the virus to at least two more people, confirming the first outbreak of the tropical disease for months.

"Two more people have been confirmed positive. These people had contact with the boy. We are still waiting for more results of blood tests," said health official Cestus Tarpeh.

Tarpeh, a spokesman for the health department in Margibi County, where the 17-year-old got sick, told AFP a herbalist who had treated him had evaded the authorities and was on the run.

(Continue . . . )

WMO, WHO Issue Guidance On Heat Health Warning Systems



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When it comes to weather-related disasters our thoughts normally go to the abrupt, and often dramatic hurricane, tornado, or flood – not to a slow motion events like an extended heat wave.  Yet excessive heat has likely killed more Americans over the past 40 years than all of the tornadoes, floods, and hurricanes combined.


Admittedly, counting the number of fatalities due to excessive heat is both difficult and imprecise, as many of those who succumb are elderly, and have other medical conditions.  


In 2002 Rupa Basu and Jonathan M. Samet wrote in the Journal Epidemiological Reviews (see Relation between Elevated Ambient Temperature and Mortality: A Review of the Epidemiologic Evidence):


An average of 400 deaths annually are counted as directly related to heat in the United States, with the highest death rates occurring in persons aged 65 years or more (3). The actual magnitude of heat-related mortality may be notably greater than what has been reported, since we do not have widely accepted criteria for determining heat-related death (4, 5–7), and heat may not be listed on the death certificate as causing or contributing to death.


This disparity between counted and estimated heat-related deaths can be illustrated by the reports from the infamous heat wave of 1980, which `officially’ claimed `more than 1250 lives’ (cite NOAA Heat Wave: A Major Summer Killer) but which unofficially may have killed as many as 10,000  (Tracking and Evaluating U.S. Billion Dollar Weather Disasters, 1980-2005 (Lott and Ross, 2006).


Eight years later, a heat wave across the central and eastern part of the nation killed as many as 7,500 people (cite). More recently, in 1999, a prolonged heat wave along the Eastern seaboard is believed to have killed 500 (cite).


Over the past few weeks there have been reports of thousands of heat-related deaths in India and Pakistan, but even these events are dwarfed by the European Heat Wave of 2003 which is estimated to have claimed 70,000 lives and the 2010 Russian Heat Wave that may have killed as many as 56,000.

As weather patterns continue to change around the world, monsoon rains fail to appear on time, and more and more people crowd into urban areas these types of weather-related health disasters are only likely to increase over time. 


Today the WMO (World Meteorology Organization) and the WHO (World Health Organization) have released new guidance on Heat Health Warning systems, in the form of a 144 PDF file. Excerpts from the press release, and a link to the guidance, follow:



WMO, WHO Issue Guidance on Heat Health Warning Systems


1 July 2015

Geneva 1 July 2015 (WMO) The World Meteorological Organization (WMO) and the World Health Organization (WHO) have issued new joint guidance on Heat–Health Warning Systems to address the health risks posed by heatwaves, which are becoming more frequent and more intense as a result of climate change.

“Heatwaves are a dangerous natural hazard, and one that requires increased attention,” said Maxx Dilley, Director of WMO’s Climate Prediction and Adaptation Branch, and Maria Neira, Director of WHO’s Department of Public Health, Environmental and Social Determinants of Health. “They lack the spectacular and sudden violence of other hazards, such as tropical cyclones or flash floods but the consequences can be severe.”

Over the past 50 years, hot days, hot nights and heatwaves have become more frequent. The length, frequency and intensity of heatwaves will likely increase over most land areas during this century, according to the Intergovernmental Panel on Climate Change. In addition to the health impact, heatwaves also place an increased strain on infrastructure such as power, water and transport.

In recent weeks alone, both India and Pakistan have been hit by deadly heatwaves, killing hundreds of people. The European heatwaves in the northern hemisphere summer of 2003 was responsible for the deaths of tens of thousands of people, as were the Russian heatwaves, forest fires and associated air pollution in 2010.

Action reduces risks

The good news is that heat-related health risks can be reduced through systematic development of heatwave early warning systems. These provide meteorological and/or climate-prediction-based information on the likelihood of forthcoming hot weather that may have an effect on health. This information is used to alert decision-makers, health services and the general public to trigger timely action to reduce the effects of hot-weather extremes on health.

A number of countries around the world have successfully developed these early warning systems, which necessitates close coordination between meteorological and health services. The WMO-WHO publication Heatwaves and Health: Guidance on Warning-System Development is intended to promote more widespread development and implementation of these warning systems.



Heatwaves and Health: Guidance on Warning System Development is available here

Saudi MOH: 3rd Recent MERS Case In Riyadh



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On Sunday and Monday of this week the Saudi MOH announced  2 MERS Cases In Riyadh Over Two Days, although their barebones reporting did not indicate any link between them.  On Tuesday no new cases were reported, but this morning a 3rd case – again with few details – has been announced from the Saudi Capital.



On a more positive note, we’ve now gone 6 days without a new case reported from Hofuf (aka `Hofoof’, `Hafuf’), where over the past two months we’ve seen a cluster of roughly 40 cases emerge.