Hurricane Preparedness Week: Inland Flooding

 

 

# 6358

 

Hurricane Agnes, which made landfall in Florida’s panhandle as a category 1 storm in 1972, would scarcely be remembered today were it not for the 12 to 18 inches of rain it dumped across Pennsylvania, New York, and Virginia almost a week later.

 

 

Amazingly, of the 122 deaths associated with this storm, only 9 occurred in Florida where Agnes made landfall. The rest - 113 fatalities - were caused by inland fresh water flooding, with New York and Pennsylvania suffering the highest loses.

 

NOAA describes the flooding damage this way:

 

Hurricane Agnes was the costliest natural disaster in the United States at that time. Damage was estimated at $3.1 billion and 117 deaths were reported. Hardest hit was Pennsylvania, with $2.1 billion in damages and 48 deaths, making Hurricane Agnes the worst natural disaster ever to hit the state. The damage over Pennsylvania was so extreme, the entire state was declared a disaster area by President Richard Nixon.

 

While we tend to concern ourselves most over the rare CATEGORY 5 storm (like Andrew in 1992 or Camille in 1969), it is often the slow moving minimal hurricane or tropical storm that produces extensive damage hundreds . . . sometimes more than 1000 miles inland.

 

Other storms with far-reaching impact include:

 

• Hurricane Hazel, which had already devastated Haiti (400-1000 deaths) came ashore on the North-South Carolina border in August of 1954.  She claimed 95 lives in the United States and was responsible for as many as 100 deaths in Canada.
• The CAT 5 monster Camille, which claimed 143 lives along the Gulf coast also killed 113 people in associated flooding in Virginia.
• And Audrey, the horrific `surprise’ gulf coast CAT 4 storm of 1957 -that claimed more than 550 lives -  at least 15 of those victims were in Canada.

 

Which is why today’s focus in NOAA’s National Hurricane Preparedness Week is inland flooding.

 

 

 

A graphics used in this video is one I’ve featured before, showing that the majority of hurricane related deaths between 1970 and 1999 were due to fresh water drowning.

 

 

 

For more on this week’s preparedness campaign, click on the graphic below, and watch the videos on USWEATHERGOV’s Youtube Channel.

 

 

And to become better prepared as an individual, family, business owner, or community to deal with hurricanes, or any other type of disaster: visit the following preparedness sites.

 

FEMA http://www.fema.gov/index.shtm

READY.GOV http://www.ready.gov/

AMERICAN RED CROSS http://www.redcross.org/

Referral: McKenna On Chagas Disease

 

 

Photo Credit CDC PHIL

 

# 6357

 

 

A fascinating look this morning at Chagas Disease, which is spread by the Triatoma bug, from Maryn McKenna in her Superbug blog.  

 

With more than 10 million people believed infected in Central and South America, and increasing numbers being found in the United States, there is growing concern over its impact and spread.

 

For the link to read:

 

 

Chagas Disease: Poverty, Immigration, And The “New HIV/AIDS”

• By Maryn McKenna May 30, 2012 | 

FDA Warning On Fake Adderall

 

 

 

# 6356

 

 

Counterfeit drugs are a problem that has been around for some time, but appears to be getting worse as manufacturing delays and drug shortages send desperate customers in search of new sources for medications that they need.

 

A little more than a week ago, we saw from the Lancet: 1/3rd Of Malaria Drugs Fake Or Sub-Standard, and when the H1N1 pandemic was just getting started, we looked at the burgeoning business of selling fake antivirals in Spamalot: Fake Tamiflu

 

 

Yesterday the FDA issued a warning on a new internet drug scam, one that is selling counterfeit Adderall – a medication commonly used for attention deficit hyperactivity disorders (ADHD) and narcolepsy.

 

In recent months, Adderall has been one of hundreds of drugs that have come in short supply (see FDA’s Current Drug Shortages list), prompting some desperate parents and patients to seek online sources for the drug.

 

Unfortunately, what some of these people got was not Adderall – but a potentially dangerous mixture of Tramadol and acetaminophen.

 

Here is the FDA announcement, with information on how to spot fake, or counterfeit medications.

 

FDA NEWS RELEASE

For Immediate Release: May 29, 2012
Media Inquiries: Shelly Burgess, 301-796-4651, shelly.burgess@fda.hhs.gov
Consumer Inquiries: 888-INFO-FDA

FDA warns consumers about counterfeit version of Teva’s Adderall

Tablets purchased on the Internet contain wrong active ingredients

The U.S. Food and Drug Administration is warning consumers and health care professionals about a counterfeit version of Teva Pharmaceutical Industries’ Adderall 30 milligram tablets that is being purchased on the Internet. Adderall, which is approved to treat attention deficit hyperactivity disorders (ADHD) and narcolepsy, is a prescription drug classified as a controlled substance – a class of drugs for which special controls are required for dispensing by pharmacists.

 

FDA’s preliminary laboratory tests revealed that the counterfeit version of Teva’s Adderall 30 mg tablets contained the wrong active ingredients. Adderall contains four active ingredients – dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate. Instead of these active ingredients, the counterfeit product contained tramadol and acetaminophen, which are ingredients in medicines used to treat acute pain.

 

Currently on the FDA’s drug shortage list, Adderall is in short supply due to active pharmaceutical ingredient supply issues. Teva continues to release product as it becomes available. Consumers should be extra cautious when buying their medicines from online sources.  Rogue websites and distributors may especially target medicines in short supply for counterfeiting.

 

The counterfeit Adderall tablets are round, white and do not have any type of markings, such as letters or numbers. Any product that resembles the tablets or the packaging in the photos below and claims to be Teva’s Adderall 30 mg tablets should be considered counterfeit. The counterfeit versions of Adderall should be considered as unsafe, ineffective and potentially harmful.

 

Authentic Adderall 30 mg tablets produced by Teva are round, orange/peach, and scored tablets with “dp” embossed on one side and “30” on the other side of the tablet. Teva’s Adderall 30 mg tablets are packaged only in a 100-count bottle with the National Drug Code (NDC) 0555-0768-02 listed.

Pictures of the counterfeit version of Teva’s Adderall 30 mg tablets and packaging

The Adderall 30 mg product may be counterfeit if:

1. The product comes in a blister package.

2. There are misspellings on the package.

• “NDS” instead of “NDC”
• “Aspartrte” instead of “Aspartate”
• “Singel” instead of “Single”

3. The tablets are white in color, round in shape, and are smooth.

4. The tablets have no markings on them.

Pictures of authentic Adderall 30 mg tablets (immediate release) by Teva (front and back side of tablet)

Anyone who believes they have the counterfeit version of Teva’s Adderall 30 mg tablets should not take or should stop taking the product. Consumers should talk to their health care professional about their condition and options for treatment.

 

Consumers and health care professionals are encouraged to report adverse events or side effects from the suspect counterfeit Adderall to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program:

• Complete and submit the report online: www.fda.gov/MedWatch/report.htm.
• Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178.

Consumers who believe they have received counterfeit Adderall should contact the FDA’s Office of Criminal Investigations (OCI) at 800-551-3989 or http://www.fda.gov/OCI.

 

 

 

The problem isn’t just limited to Adderall and Tamiflu.

 

While there are scores of legitimate online pharmacies, it doesn’t take much searching to find sites (particularly out of India and Asia) that offer to sell everything from antibiotics to narcotics – often without a prescription.

But what you get when you order these meds is anyone’s guess. 

 

The FDA has an online FAQ on Buying Medicines and Medical Products Online. 

Petition: Public Access To Publicly Funded Research

 

# 6355

 

 

It sounds like a no-brainer.

 

If tens of billions of our tax dollars are used each year to to fund scientific research, then the results of that research should be published in an open-access journal – not printed in expensive subscription-only access journals.

 

But unless the U.S. government funds came from the NIH, there are currently no rules compelling open access publishing of government funded research. 

 

And even NIH funded research isn’t always immediately available to the public that paid for it. 

 

The NIH PUBLIC ACCESS POLICY:

 

. . .  ensures that the public has access to the published results of NIH funded research. It requires scientists to submit final peer-reviewed journal manuscripts that arise from NIH funds to the digital archive PubMed Central upon acceptance for publication.

 

To help advance science and improve human health, the Policy requires that these papers are accessible to the public on PubMed Central no later than 12 months after publication.

 

 

There is a grass-roots movement afoot spearheaded by access2research.org to get the Whitehouse to direct that all government funded research be made available to the people who paid for it – the public – and a petition that you can sign that will help.

 

Right now, there are just over 20,000 signatures, and the goal of at least 25,000 petitioners before June 19th is within reach. But the more signers, the stronger the message it will send.

 

So if you haven’t already, consider going to the Whitehouse.gov’s  petition site, and adding your voice.

 

For more background on this issue, access2research has produced this brief video.

 

 

 

Today PLoS Medicine ran an editorial supporting this petition in their Speaking of Medicine Blog (Public Access to Publicly Funded Research By Michael Morris) and last week one of my favorite bloggers – David Dobbs at Neuron Culture, penned:

 

Open-Science Geeks Invite Obama Onto Roller Coaster

By David Dobbs May 25, 2012 | 

 

 

You’ll find a long list of additional press coverage of this movement on the access2research press page, but a few recent examples include:

 

Nature News: White House Petitioned To Make Research Free To Access

 

Wired Blogs | Neuron Culture: Open Science Geeks Invite Obama Onto Roller Coaster 

Open and Shut? The People’s Petition (Richard Poynder)

 

GOOD Magazine: Help Make Publicly Funded Science Free To The Public

 

Chronicle of Higher Education - Wired Campus Blog: Petition Urges White House To Require Public Access To Federally Financed Research

 

 

Whether this petition will have the desired effect, I have no way of knowing.

 

But if you feel that government funded research shouldn’t be held hostage by pay-to-view journals, it is certainly worth a shot.

Hong Kong: Flu Activity Continues To Rise

 

 

# 6354

 

 

Normally by the end of May influenza activity in the Northern Hemisphere has returned to summer background levels, and our focus turns to the Southern Hemisphere’s flu season. 

 

Last week the May 24th edition of Hong Kong’s Flu Express indicated that influenza activity continues at unusually high levels for this time of year.

 

 

According to a Hong Kong Centre For Health Protection press release today, influenza activity continues to rise in their city, and a general caution has been issued.

 

 

29 May 2012

Influenza activity reaches highest level this year 

The Centre for Health Protection (CHP) of the Department of Health today (May 29) called on the public to maintain vigilance against seasonal influenza as the latest surveillance data shows that local influenza activity is at its highest level this year.

 

The Public Health Laboratory Centre (PHLC) of the CHP has detected a further increase in the number of influenza detections. The weekly number of influenza detections at the PHLC increased from 329 in the week ending May 5 to 1,113 in the week ending May 26, the highest number recorded so far this year. The number of institutional influenza-like illness (ILI) outbreaks increased from 16 to 64 during the same period. The current circulating influenza virus strain is influenza A(H3N2) virus, accounting for more than 95 per cent of all the influenza detections in the past four weeks.

 

From January 13 to noon on May 28, there were 214 cases (including 128 deaths), with ICU admissions or deaths with laboratory-confirmed influenza recorded by the enhanced surveillance system set up by CHP with the Hospital Authority and private hospitals to monitor the severity of influenza activity during influenza peak seasons. Fourteen paediatric cases (including two deaths) with severe influenza-associated complications or deaths have been recorded this year (as of May 28).  Compared with the winter flu season in the first quarter of 2011, the 2012 flu season has caused a higher proportion of serious/fatal cases among elderly people aged 65 years or above, and a lower proportion of serious/fatal cases among children aged below 5 years.

A spokesperson for the CHP said, "Influenza activity is expected to stay high for some weeks to come, and we will continue to see some serious/fatal cases among all age groups, especially the elderly."

(Continue . . . )

 

According to last week’s Flu Express, the predominant flu strain (by far) was H3:

 

In week 20,  the number of influenza viruses
detected in the Public Health Laboratory Centre was 852, including 827 influenza A (H3) viruses, 22
influenza B viruses, 2 influenza A(H1N1)2009
viruses and 1 influenza A virus (Figure 3).

 

 

Although the flu season across Europe and the Americas was late in starting, and short in duration, there were signs that the seasonal H3N2 virus circulating had drifted antigenically – prompting a change in the formulation of this fall’s flu vaccine.

 

It will be interesting to see if further analysis reveals any antigenic changes in the H3 virus circulating in Hong Kong, and how closely they match with the new vaccine strain (A/Victoria/361/2011 (H3N2)-like virus).

5.8 Mag. Quake Rocks Northern Italy

 

 

# 6353

 

 

For the second time in 10 days, a strong temblor has rocked northern Italy, and early reports indicate at least ten people have died as a result. In the hours since the 5.8 quake struck, there have been several lesser aftershocks.

 

 

 

If you say `earthquake’ and `Europe’ in one sentence, most people would naturally assume you are talking about Italy, or perhaps Greece. Eastern and central Mediterranean regions after all, are well known for seismic activity.

 

But two of the strongest earthquakes to strike Europe over the past millennium occurred in Switzerland  and Portugal.

 

And as the following Seismic Hazard Map (produced by GSHAP – Global Seismic Hazard Assessment Program) shows, other areas of western, central and northern Europe are vulnerable as well.

 

 

Last year in A Look At Europe’s Seismic Risks, we took look at some of the devastating earthquakes to strike Europe over the past 700 years, including the quake that leveled the Swiss town of Basel in 1356 and the horrific earthquake and tsunami that struck Portugal in 1755 on November 1st (All Saint’s Day).

 

In December of last year, in WHO e-Atlas Of Natural Disaster Risks To Europe, we looked at some of the seismic risks to Europe. And in April of 2011 (see UNDP: Supercities At Seismic Risk) we saw a report that stated that half of the world’s supercities (urban areas with 2 million – 15 million inhabitants) are at high risk for seismic activity.

 

And more recently, in January of this year (see UN Agency Warns On Global Seismic Risks), the United Nations International Strategy For Disaster Reduction (UNIDSR.Org) issued a cautionary warning about ignoring seismic threats.

 

UNISDR warns against ignoring seismic threats as quakes wreak havoc for second year

302 human impact disasters claimed 29,782 lives; affected 206 million and inflicted record economic damages of $366 billion in 2011

Geneva, 18 January 2012 – For two consecutive years the long-term disasters trend has been bucked by major earthquakes which claimed thousands of lives and affected millions in both 2010 and 2011, according to new statistics published today by CRED and the UN office for disaster risk reduction, UNISDR.

 

UNISDR Chief, Margareta Wahlström, said today: “The Great East Japan Earthquake and the accompanying tsunami is a reminder to us all that we cannot afford to ignore the lessons of history no matter how forgotten. The many major cities located in seismic zones need to take seriously the probability of return events even if many years have passed since the last seismic event of major magnitude.

(Continue . . . )

 

 

 

While we can’t predict where the next earthquake will strike, or do anything to stop it, we can prepare to deal with one when it happens.

 

For good, solid information on how prepare for `the big one’ (even if you live someplace other than Los Angeles), I would recommend you download, read, and implement the advice provided by the The L. A. County Emergency Survival Guide.

 

While US-centric, FEMA  has an earthquake hazard webpage with a lot of resources that would be of use to just about anyone, including the following preparedness information.

 

Emergencies happen every day.  Disasters, admittedly, less often. But in either event, preparedness is key.

 

At a bare minimum, every household should have a disaster plan, a good first aid kit (and the knowledge to use it), and emergency supplies to last a minimum of 72 hours during a disaster.

 

Personally, I’d be uncomfortable with anything less than a week.

 

To become better prepared as an individual, family, business owner, or community to deal with these types of disasters: visit the following preparedness sites.

FEMA http://www.fema.gov/index.shtm

READY.GOV http://www.ready.gov/

AMERICAN RED CROSS http://www.redcross.org/

WHO: Cambodian H5N1 Update

 

# 6352

 

Yesterday we learned of a third H5N1 fatality this year in Cambodia, that of a 10 year-old girl from Kampong Speu Province (see Cambodia Announces Bird Flu Fatality).

 

Today the World Health Organization has posted an update on the case, with details provided by the Cambodian Health Ministry.

 

 

Avian Influenza – situation in Cambodia – update

29 May 2012 - The Ministry of Health (MoH) of the Kingdom of Cambodia has announced a confirmed case of human infection with avian influenza A (H5N1) virus.

 

The case was a 10 years old female from Kampong Speu Province. She developed symptoms on 20 May 2012 and after initial treatment at the village was eventually admitted to the hospital on 25 May with symptoms of fever and shortness of breath. Infection with avian influenza A(H5N1) virus was confirmed by Institute Pasteur du Cambodge on 26 May 2012, however, despite intensive medical care, she died on 27 May 2012.

 

There are reports of recent deaths among poultry in her village and the patient prepared sick chicken for food prior to becoming sick.

 

The girl is the twenty-first person in Cambodia to become infected with A(H5N1) virus and 19 have died from the disease.

 

The National and local Rapid Response Teams (RRT) are conducting outbreak investigation and response following the national protocol. In addition, a public health education campaign is being conducted in the village to inform families on how to protect themselves from contracting avian influenza.

 

 

This case makes the 26th H5N1 case - and 17th fatality - reported to the WHO in 2012, bringing the total to just over 600 cases since 2003.

 

How many human infections (and deaths) have really occurred is a matter of some debate.

 

While the evidence for there being a lot of mild cases is sparse (see The Great CFR Divide), it does seem likely that we are missing some number of cases.

A couple of weeks ago in WHO: 2012 World Health Statistics Report, we looked at the lack of disease and mortality information available from many low-resource countries.

 

Among low income countries, only about 1% of deaths (and their causes) are recorded, while just 34 countries – representing 15% of the world’s population – produce high quality cause-of-death documentation.

 

 

This helps to explain why there is so much ambiguity regarding the true prevalence of most diseases around the world, including H5N1.

 

While we continue to see isolated human infections around the world, and the virus continues to evolve (see H5N1: An Increasingly Complex Family Tree), for now H5N1 is primarily a threat to poultry.

 

The concern, of course, is that over time that could change.

 

And so the world remains at Pre-pandemic Phase III on the H5N1 virus, and we continue to watch for signs that the virus is adapting better to humans.

Storm Surge Monday

 

# 6351

 

Today is day two of Hurricane Preparedness week, with today’s emphasis on deadly storm surge.

 

 

First a short video from the NHC on storm surge, then a visit to their storm surge information page.

 

 

 

 

Storm Surge Overview

Along the coast, storm surge is often the greatest threat to life and property from a hurricane. In the past, large death tolls have resulted from the rise of the ocean associated with many of the major hurricanes that have made landfall. Hurricane Katrina (2005) is a prime example of the damage and devastation that can be caused by surge. At least 1500 persons lost their lives during Katrina and many of those deaths occurred directly, or indirectly, as a result of storm surge.

Storm Surge vs. Storm Tide

Storm surge is an abnormal rise of water generated by a storm, over and above the predicted astronomical tides. Storm surge should not be confused with storm tide, which is defined as the water level rise due to the combination of storm surge and the astronomical tide. This rise in water level can cause extreme flooding in coastal areas particularly when storm surge coincides with normal high tide, resulting in storm tides reaching up to 20 feet or more in some cases.

Storm Surge vs. Storm Tide

(Continue . . . )

Last year in Getting SLOSHed For Hurricane Season I wrote about the Sea, Lake and Overland Surges from Hurricanes computer model that emergency planners use to plan for coastal evacuations.

In order to know in advance how far inland a storm surge or tide will encroach, emergency planners run hundreds of SLOSH models for populated regions along the coast. 

They vary the size, intensity, direction, and forward speed of hurricanes in the model in order to determine the worst case impact for each category of storm.

 

Evacuation maps and routes are then generated using this information.

This evacuation map of Pinellas County (St. Petersburg-Clearwater) Florida shows that a storm even as low as a CAT 3 could temporarily cut the southern half of the county off from the north.

 

Of course much depends upon the speed, direction, and point of landfall of the storm, and so not all CAT 3 storms impacting this area would produce this dramatic of an effect.

 

But if you are asked to evacuate by your local authorities, don’t hesitate. 

 

Just do it.

Cambodia Announces Bird Flu Fatality

 

# 6350

 

 

The Straits Times is reporting the third Cambodian H5N1 fatality of 2012, this time the victim is a 10 year-old girl from Kampong Speu province. On March 30th a 6-year-old girl from neighboring Kampong Chhnang province also died from the virus (see LINK). 

 

After seeing only 4 cases of H5N1 infection in humans between 2007 and 2010, Cambodia suddenly become the focus of renewed attention after 8 fatal cases were reported during 2011, and now 3 have been reported this year.

 

Here is the link to the story from the Straits Times.

 

Cambodian girl, 10, dies from bird flu: WHO

Published on May 28, 2012

PHNOM PENH (AFP) - A 10-year-old Cambodian girl has died from bird flu, the World Health Organization said on Monday, the country's third fatality from the virulent disease this year.

 

The child developed a fever and shortness of breath on May 20 and died on Sunday, the WHO said in a joint statement with the Cambodian health ministry.

 

(Continue . . . )

 

Of the 12 cases reported out of Cambodia since 2010, none have survived.  Prior to 2010, 7 of 9 known cases had died.

 

While it is probable that some number of H5N1 cases go undetected, how many remains a mystery. Evidence for there being a lot of missed cases is scant, but for more on this debate you may wish to revisit The Great CFR Divide.

 

For now, bird flu remains primarily a threat to poultry. The virus remains poorly adapted to human physiology, and despite ample opportunities to cause illness in humans, the virus only causes rare, sporadic infections.

 

The concern, of course, is that over time the virus will adapt further and pose a pandemic threat to humans.

CDC Issues HFMD Travel Notice For Vietnam

 

Photo Credit University of Iowa

#6349

 

In terms of threat levels, the CDC issues several different types of travel notices, with the lowest threat belonging to the category called `In The News’. 

 

Essentially, this is an acknowledgement there are reports of sporadic cases of a disease in a specific country or region, but that they pose `No increased risk over baseline for travelers observing standard recommendations’.

 

On Friday, the CDC issued an `In The News’ travel notice on the ongoing outbreak of HFMD in Vietnam.

 

HFMD (Hand Foot Mouth Disease) is a relatively common, and usually mild, viral illness seen mainly in children under the age of 10 (although adults are vulnerable as well) and may be caused by several of the non-polio enteroviruses.

 

The 60+ non-polio enteroviruses identified to date are among the most prevalent viral infections in the world, probably only second to the myriad and ubiquitous variants of Rhinovirus (`common cold’) that circulate every year.

 

The most common causes of HFMD are the Coxsackie A16 virus, and the Enterovirus-71 (EV-71), and more rarely the Coxsackie A10 virus. In recent years, we’ve also seen the emergence of the Coxsackie A6 virus as a cause, first in Finland, and this past year, even in the United States (see MMWR: Coxsackievirus A6 Notes From The Field).

 

HFMD in the United States is most often due to the Coxsackie A16 virus, which is generally mild, rarely causes serious illness, and outbreaks of which are not uncommon in childcare facilities.

 

EV-71 HFMD is most commonly found in the Asia, with serious outbreaks recorded over the past dozen years in places like China, Malaysia, Hong Kong and most recently, Vietnam.

 

This version of the HFMD can sometimes be quite serious, with viral meningitis - and less commonly, encephalitis – complicating matters.

 

Two major genotypes of EV-71, EV-71 B and EV-71 C, have been identified as being responsible for a number of severe outbreaks in Australia, Japan, China, Malaysia, and Taiwan since 1997.

 

A couple of years ago, the Virology Journal, published an analysis of an EV-71 HFMD virus that caused a major disease outbreak in Fuyang City, China in 2008 that showed it was due to an emerging recombinant virus (see China: A Recombinant EV-71).

 

A reminder that viruses are always changing, evolving, looking for an evolutionary advantage.

 

Yesterday, the Thanh Nien Daily carried a story indicating that the number of HFMD cases in Vietnam this year is 10 times greater than last year, and that researchers are looking to see if the virus has mutated.

 

 

Cases of HFMD in Vietnam increase more than tenfold year on year

Saturday, May 26, 2012 04:20:00

The number of hand, foot and mouth disease (HFMD) cases in Vietnam is 10.2 times higher over the first five months of 2012 than it was for the same period last year.

 

According to the Ministry of Health’s report on Friday, 46,277 HFMD cases have been recorded across Vietnam since the beginning of this year.

 

Twenty-seven deaths have also been reported, 1.7 times more than last year, it said.

 

(Continue . . . )

 

 

With that in mind, here are some excerpts from the CDC’s Travel Notice, and some resources on HFMD from the CDC Website.

 

 

In the News
Hand, Foot, and Mouth Disease in Vietnam

This information is current as of today, May 27, 2012 at 15:03 EDT

Released: May 25, 2012

What Is the Current Situation?

As of April 29, 2012, the Vietnam Ministry of Health has confirmed nearly 40,000 cases of hand, foot, and mouth disease (HFMD) since the beginning of 2012. Cases have occurred in 63 provinces, and 20 deaths (all in children under 5) have occurred in 10 provinces. Hai Phong in the North has the highest number of cases, followed by Bac Can, Yen Bai, Lao Cai, Hoa Binh, Da Nang, Vinh Phuc, Quang Tri, Dong Thap, and Binh Dinh Provinces in the Center and Southern Regions. The Vietnam Ministry of Health is taking steps to control the outbreak.

 

Large outbreaks of severe HFMD occur frequently in some countries in Asia. Thousands of people may get infected during these outbreaks. Some people, particularly young children, may have severe disease requiring hospitalization or even causing death. To learn more outbreaks occurring around the world, visit the World Health Organization’s website.

<SNIP>

How Can Travelers Protect Themselves?

There is currently no vaccine or medicine to prevent HFMD. However, you can protect yourself from HFMD by practicing healthy personal hygiene.

• Wash your hands often with soap and water, especially before eating and after going to the bathroom or changing a diaper. If soap and water are not available, use an alcohol-based hand cleaner with at least 60% alcohol. Consider packing alcohol-based hand cleaner in your carry-on luggage to ensure you have it when needed.
• Disinfect dirty surfaces and soiled items. If you are able, first wash the items with soap and water; then disinfect them with a solution of chlorine bleach (made by mixing 1 tablespoon of bleach with 4 cups of water) or a cleaning product that contains bleach.
• Avoid close contact such as kissing, hugging, or sharing eating utensils or cups with people who have HFMD.

There is no specific treatment for HFMD. If you do develop mouth sores:

• Take over-the-counter medications to relieve pain and fever. (Caution: Aspirin should not be given to children.)
• Use mouthwashes or sprays that numb mouth pain.
• Drink plenty of liquids to stay hydrated.

Seek medical care:

• If you are sick and unsure if you have HFMD.
• If you cannot swallow liquids to stay hydrated.

 

 

You obviously don’t have to travel to Vietnam, or other parts of Asia, to be exposed to HFMD. 

 

For that reason, everyone should learn about the virus, and how it is spread.  To that end, we’ve a couple of multimedia products related to hand, foot, and mouth disease from the CDC.

 

• CDC Feature: Hand, Foot, & Mouth Disease
  An article that provides the basics about hand, foot, and mouth disease, who is commonly affected, symptoms, how it spreads, and ways to prevent it.
• Podcast: Hand, Foot, and Mouth Disease
  A CDC pediatrician and dad talks about hand, foot, and mouth disease, its symptoms, and tips to prevent your family from getting this disease.

A Matter Of Respect

 

 

# 6348

 

 

 

As a second generation Floridian, one who has spent roughly a quarter of his life living aboard boats, I have developed a deep and abiding respect for hurricanes and tropical storms.

 

My `first hurricane’ was the infamous Donna of 1960, which I rode out at the age of six in St. Petersburg, Florida. She put part of a large oak tree through our roof, but otherwise we came away unscathed.

 

In the years that followed I had brief but memorable encounters with several storms, including Betsy in 1965, the fringes of Abby and Gladys in 1968, Agnes in 1972 and Elena in 1985.

 

I also saw the devastation first-hand after Camille tore through Mississippi in 1969, and Katrina swamped New Orleans in 2005. 

 

While hurricanes sometimes fail to live up to the pre-landfall hype, every once in awhile we get an Andrew, Camille, or Katrina, and they can exceed all expectations.

 

 

It may be hard for folks to believe it today, but as recently as the late 1950s - before weather satellites  - hurricanes could get `lost’ . . . sometimes for hours or days  . . .  and could show up unexpectedly and with little warning.

 

It was a very big deal, I can tell you, when on April 1st 1960 Tiros I - the world's first weather satellite - was launched into Earth orbit from Cape Canaveral, Florida. 

 

Our view of our world changed, practically overnight. It was a wondrous day for everyone, except possibly for members of the Flat Earth Society.

 

The pictures were grainy, and the resolution laughable by today's standards, but for the first time we could watch from aloft and observe how and where hurricanes formed.

It meant we were no longer solely dependent on ship's reports and Hurricane Hunter aircraft to know if disaster lay just beyond the horizon.

 

For some truly remarkable real-time satellite photos (and loops), the National Hurricane Center’s website maintains links to an extensive list of Latest Satellite Imagery.

 

But knowing a disaster is coming, and being prepared to deal with it, are two different things.  

 

Which is why every year agencies like NOAA, NWS, FEMA, READY.GOV and organizations like the American Red Cross, work every year to get people to prepare.  Not just for hurricanes, but for all manner of emergencies.

 

Today begins National Hurricane Preparedness Week, and as I do every year, I’ll be devoting a fair amount of blog space to this campaign.

 

This from the NHC website:

 

 

Hurricane Preparedness Week

---

Preparedness Week | Hazards | Watches & Warnings | Be Ready

---

History teaches that a lack of hurricane awareness and preparation are common threads among all major hurricane disasters. By knowing your vulnerability and what actions you should take, you can reduce the effects of a hurricane disaster.

 

Hurricane hazards come in many forms, including storm surge, heavy rainfall, inland flooding, high winds, tornadoes, and rip currents. The National Weather Service is responsible for protecting life and property through issuance of timely watches and warnings, but it is essential that your family be ready before a storm approaches. Furthermore, mariners should be aware of special safety precautions when confronted with a hurricane.

 

Download the Tropical Cyclone Preparedness Guide (PDF) or follow the links for more information. But remember, this is only a guide. The first and most important thing anyone should do when facing a hurricane threat is to use common sense.

National Hurricane Preparedness Week 2012 runs from May 27th through June 2nd.

 

To start off the campaign, NOAA has prepared this short PSA.
 

 

 

 

Every year I give hurricane preparedness a prominent place in this blog because for more than 50 million Americans living in coastal areas (and millions more in other countries), hurricanes and their byproducts (flooding, tornadoes, lightning) are probably their greatest natural disaster threat.

 

From Escambia County Hurricane Preparedness Information

While South Florida and the northern Gulf coast are at highest risk of direct hurricane impact, even those areas not shaded in – even hundreds of miles inland – can still feel the effects of a hurricane.

 

All this week we’ll be focusing on the specific hazards from these tropical systems, and how you can prepare your home, family, an business for their arrival.

Roll Out The Beryl

 

 

# 6347

 

 

As predicted by the NHC, overnight the disturbed area off the eastern seaboard has coalesced into sub-tropical storm Beryl, and is forecasted to impact the Northern Florida – Southern Georgia coastline late tomorrow.

 

Unlike a classic tropical storm, sub-tropical storms tend to have their heaviest winds and storms some distance from the center. Sub-tropical storms can sometimes transition into tropical storms.

 

Tropical storm force winds, heavy rains, and a surge tide of 1 to 3 feet is currently forecast, and residents along the coast and inland are being urged to monitor the storm and prepare for its effects.

For the latest updates, visit the National Hurricane Center website. You can follow the NHC on twitter at @NHC_Atlantic.

 

 

Beryl’s expected arrival tomorrow coincides with the first day of National Hurricane Preparedness Week, and if nothing else, should serve a good reminder of the value of preparedness.

 

To help you along, NOAA, FEMA, and the American Red Cross have released an updated preparedness guide for the 2011 tropical season.

 

To become better prepared as an individual, family, business owner, or community to deal with hurricanes, or any other type of disaster: visit the following preparedness sites.

 

FEMA http://www.fema.gov/index.shtm

READY.GOV http://www.ready.gov/

AMERICAN RED CROSS http://www.redcross.org/

CDC: The Close Of A Mild Season

 

# 6346

 

The last FluView report of the 2011-2012 flu season has been issued by the CDC, along with a report that summarizes the end to what was an unusually late, and exceptionally mild flu season. 

 

Graph of a remarkably mild flu influenza season.

 

This from the CDC’s summary.

 

2011-2012 Flu Season Draws to a Close

Last full FluView posted May 25, 2012 Shows U.S. Influenza Activity at Summer Levels

A Late and Mild Flu Season

May 25, 2012 – Today the Centers for Disease Control and Prevention issued the final full influenza surveillance report for the 2011-2012 season. The report – titled “FluView” – shows that influenza activity in the United States is minimal across most of the country, wrapping up a season that began late and was mild compared to most previous seasons for which surveillance data is available. In fact, the season set a new record for the lowest and shortest peak for influenza-like-illness since this type of surveillance began.

 

Influenza-like-illness (ILI) in the United States typically begins to increase in late December or early January and peaks in February most commonly. This season, ILI remained low through February and did not exceed baseline – and then only slightly -- until mid-March. ILI stayed above baseline for just one week in March and did not exceed baseline again. According CDC’s Dr. Joseph Bresee, “This is the first time since CDC started this kind of influenza-like-surveillance (ILI) that the percentage of patient visits for ILI was elevated for only one week of the season.” Dr. Bresee is Chief of the Epidemiology and Prevention Branch in CDC’s Influenza Division. In past seasons, ILI has remained above baseline for between 8 and 20 weeks, with an average of 13 weeks at or above baseline each season since this type of surveillance began in 1997-1998. Bresee adds, “In terms of ILI, this not only the shortest time we were above baseline, but it’s also the lowest ‘peak’ ever recorded.” The graph below compares ILI from five different seasons, including the current season (2011-2012), the 2009 H1N1 pandemic season, a ‘moderately severe’ flu season (2007-2008), as well as a season classified as ’moderate’ in severity (2002-03).

For a more detailed view of the graphic, please click on the image or visit ILI Weekly National Summary detail.

(Continue . . . )

 

The CDC has also announced several new interactive data display tools, which show various datasets over time.

 

Interactive Web Tools

A new interactive web application in “FluView,” displays information – from this season and previous season’s – related to flu-related pediatric deaths. Other interactive tools display ILI over time and ILI and laboratory data on a national and regional level over time.

 

 

Interactive View of Pediatric Deaths related to Influenza

 

As to why this current flu season has been so mild, solid answers are hard to find. The CDC’s Dr. Joseph Bresee is quoted as saying:

 

“The reason for the mildness and lateness of the season isn’t certain, but it’s likely that there were a number of contributing factors, including a mild winter, the fact that most of the influenza viruses circulating this season were similar to those that have circulated for the past two seasons and the fact that most circulating viruses were similar to the viruses that the 2011-2012 vaccine was designed to protect against.” The low levels of influenza virus “drift” (change) for two consecutive years and “steadily increasing influenza vaccination coverage in the country likely contributed to broad levels of immunity in the population,” says Bresee.

 

 

Whatever the cause, it’s probably too much to hope for a repeat next year. Which makes getting the flu shot when it becomes available in the fall, the smart thing to do.

Not Exactly A Beryl Of Fun

 

 

 

# 6345

 

 

It isn’t even the first of June, the official start of the Atlantic Hurricane Season, and already forecasters are watching a second area of disturbed weather with the potential to become a named storm.

 

Earlier this month, Tropical Storm Alberto formed briefly off the South Carolina coast.

 

This morning, forecasters at the NHC are giving an area of disturbed weather a 70% chance of developing into a tropical system over the next 48 hours. 

 

Should that happen, it would be christened `BERYL’.

 

 

SPECIAL TROPICAL WEATHER OUTLOOK
NWS NATIONAL HURRICANE CENTER MIAMI FL
425 AM EDT FRI MAY 25 2012

FOR THE NORTH ATLANTIC...CARIBBEAN SEA AND THE GULF OF MEXICO...

A BROAD AREA OF LOW PRESSURE LOCATED NEAR THE NORTHWESTERN BAHAMAS IS PRODUCING AN EXTENSIVE AREA OF SHOWERS AND THUNDERSTORMS OVER THE BAHAMAS AND CUBA.  WHILE THE ORGANIZATION OF THIS SYSTEM HAS NOT IMPROVED OVER THE PAST FEW  HOURS... ENVIRONMENTAL CONDITIONS ARE EXPECTED TO BECOME MORE CONDUCIVE FOR THE FORMATION OF A SUBTROPICAL OR TROPICAL CYCLONE BY SATURDAY OR SUNDAY.  THE LOW SHOULD MOVE TOWARD THE NORTHEAST AT ABOUT 15 MPH DURING THE NEXT DAY OR SO...FOLLOWED BY A GRADUAL TURN BACK TOWARD THE WEST ON SATURDAY.  THIS SYSTEM HAS A HIGH CHANCE...70 PERCENT... OF BECOMING A TROPICAL OR SUBTROPICAL CYCLONE DURING THE NEXT 48 HOURS.

 

LOCALLY HEAVY RAINFALL...FLOODING...AND GUSTY WINDS ARE POSSIBLE TODAY OVER PORTIONS OF THE NORTHWESTERN AND CENTRAL BAHAMAS...AS
WELL AS CENTRAL CUBA. INTERESTS ALONG THE SOUTHEASTERN UNITED STATES COAST SHOULD CLOSELY MONITOR THE PROGRESS OF THIS SYSTEM
OVER THE MEMORIAL DAY WEEKEND.  ANOTHER SPECIAL TROPICAL WEATHER OUTLOOK FOR THIS SYSTEM WILL BE ISSUED LATER TODAY.  FOR ADDITIONAL INFORMATION ON THIS SYSTEM...PLEASE SEE HIGH SEAS FORECASTS ISSUED BY THE NATIONAL WEATHER SERVICE...AND PRODUCTS FROM YOUR LOCAL WEATHER OFFICE.

ELSEWHERE...TROPICAL CYCLONE FORMATION IS NOT EXPECTED DURING THE NEXT 48 HOURS.

 

While off-season tropical storms and depressions are not uncommon, these systems only rarely achieve hurricane status.

 

The last time that happened was in December of 2005, with long-lasting Hurricane Epsilon. Since then, we’ve seen 6 off-season tropical systems form of less than hurricane strength.

 

 

All of this serves as a reminder that storms don’t read calendars, and that it pays to be prepared all year-round.

 

Next week kicks off National Hurricane Preparedness Week, but today isn’t too soon to talk about preparing.  This reminder from today’s FEMA Blog.

 

 

FEMA Urges Preparedness for Hurricanes and Severe Weather

Mobile wireless emergency alerting capabilities will be available nationwide through participating carriers

Release Date: May 24, 2012

FEMA urges individuals and businesses to take action to prepare themselves in advance of severe weather and hurricanes such as taking the pledge to prepare at www.ready.gov/pledge.  This is the first step in making sure  you and your family are ready for an emergency  This includes filling out your family communications plan that you can email to yourself, assembling an emergency kit , keeping important papers and valuables in a safe place, and getting involved.

 

With the start of hurricanes season it is even more important to know your risk, take action, and be an example. While hurricanes often offer some warning that a threat is approaching, severe weather can occur at anytime and in any place, including high winds, inland flooding, severe storms and tornadoes. 

(Continue . . .)

NOAA: `Near Normal’ Hurricane Season Predicted

 

 

# 6344

 

In late May, just before the start of the Atlantic Hurricane season, we get a number extended outlooks that attempt to predict the amount of tropical activity we might expect to see over the next six months. 

 

Earlier this year Professor William Gray and Phillip Klotzbach of Colorado University’s Department of Atmospheric Science released their updated 2012 Extended-Range Hurricane Forecast for the Atlantic Tropical basin, where they called for a below-average hurricane season (see It Only Takes One).

 

Gray and Klotzbach will provide an updated outlook again in early June.

 

 

Today, NOAA has released their extended outlook, and after several very active years, they are calling for a 70% chance of seeing a `normal’ hurricane season.  

 

Here are some excerpts from today’s story.

 

NOAA predicts a near-normal 2012 Atlantic hurricane season

Anniversary of Hurricane Andrew underscores necessity to prepare every year

May 24, 2012

Conditions in the atmosphere and the ocean favor a near-normal hurricane season in the Atlantic Basin this season, NOAA announced today from Miami at its Atlantic Oceanographic and Meteorological Laboratory, and home to the Hurricane Research Division.

 

For the entire six-month season, which begins June 1, NOAA’s Climate Prediction Center says there’s a 70 percent chance of nine to 15 named storms (with top winds of 39 mph or higher), of which four to eight will strengthen to a hurricane (with top winds of 74 mph or higher) and of those one to three will become major hurricanes (with top winds of 111 mph or higher, ranking Category 3, 4 or 5). Based on the period 1981-2010, an average season produces 12 named storms with six hurricanes, including three major hurricanes.

 

“NOAA’s outlook predicts a less active season compared to recent years,” said NOAA Administrator Jane Lubchenco, Ph.D. “But regardless of the outlook, it’s vital for anyone living or vacationing in hurricane-prone locations to be prepared. We have a stark reminder this year with the 20th anniversary of Hurricane Andrew.” Andrew, the Category 5 hurricane that devastated South Florida on August 24, 1992, was the first storm in a late-starting season that produced only six named storms.

 

Favoring storm development in 2012: the continuation of the overall conditions associated with the Atlantic high-activity era that began in 1995, in addition to near-average sea surface temperatures across much of the tropical Atlantic Ocean and Caribbean Sea, known as the Main Development Region. Two factors now in place that can limit storm development, if they persist, are: strong wind shear, which is hostile to hurricane formation in the Main Development Region, and cooler sea surface temperatures in the far eastern Atlantic.

 

“Another potentially competing climate factor would be El Niño if it develops by late summer to early fall. In that case, conditions could be less conducive for hurricane formation and intensification during the peak months (August-October) of the season, possibly shifting the activity toward the lower end of the predicted range,” said Gerry Bell, Ph.D., lead seasonal hurricane forecaster at NOAA’s Climate Prediction Center.

(Continue . . . )

 

 

Next week will kick off Hurricane Preparedness Week, and again this year I’ll have a number of blogs on the subject.

 

 

 

And just as a reminder:

 

The NHC has two Twitter accounts, one for the Atlantic basin (which includes the Gulf of Mexico and the Caribbean Sea):

U.S. National Hurricane Center (Atlantic) - @NHC_Atlantic

 

and one for the Eastern North Pacific basin:
U.S. National Hurricane Center (Eastern Pacific) - @NHC_Pacific

 

In addition to the Twitter notifications, NHC also provides product notifications by email. Please visit hurricanes.gov/signup.shtml to sign up for this service.

And if you aren’t already following

• FEMA
• CraigAtFEMA
• Ready.gov
• Red Cross

on twitter, you might want to add them to your list.

Interspecies Transmission Of Canine H3N2 In The Laboratory

 

 

# 6343

 

Readers with good memories may recall that in July of 2011, in a blog called Korea: Interspecies Transmission of Canine H3N2, I wrote about a study that reported on a recently emerged canine H3N2 influenza virus that had been observed to infect and sicken domestic cats at an animal shelter in South Korea.

 

This canine H3N2 was of a different lineage than the human H3N2 we have been dealing with since the late 1960s. It first appeared in Korea in 2007 – and unlike the other canine flu (H3N8)  -which jumped from equines to dogs, this strain appears to have emerged directly from an avian source.

 

In 2008 the CDC’s EID Journal carried the following report on this newly emerging canine flu.

 

Transmission of Avian Influenza Virus (H3N2) to Dogs

Daesub Song, Bokyu Kang, Chulseung Lee, Kwonil Jung, Gunwoo Ha, Dongseok Kang, Seongjun Park, Bongkyun Park, and Jinsik Oh

Abstract

In South Korea, where avian influenza virus subtypes H3N2, H5N1, H6N1, and H9N2 circulate or have been detected, 3 genetically similar canine influenza virus (H3N2) strains of avian origin (A/canine/Korea/01/2007, A/canine/Korea/02/2007, and A/canine/Korea/03/2007) were isolated from dogs exhibiting severe respiratory disease.

 

To determine whether the novel canine influenza virus of avian origin was transmitted among dogs, we experimentally infected beagles with this influenza virus (H3N2) isolate. The beagles shed virus through nasal excretion, seroconverted, and became ill with severe necrotizing tracheobronchitis and bronchioalveolitis with accompanying clinical signs (e.g., high fever).

 

Consistent with histologic observation of lung lesions, large amounts of avian influenza virus binding receptor (SAα 2,3-gal) were identified in canine tracheal, bronchial, and bronchiolar epithelial cells, which suggests potential for direct transmission of avian influenza virus (H3N2) from poultry to dogs.

 

Our data provide evidence that dogs may play a role in interspecies transmission and spread of influenza virus.

 

Which brings us today to a new study by the same group of researchers that reported on the initial species jump to cats, that looks at laboratory transmission of the canine H3N2 virus to cats, and to ferrets.

 

Inter- and intraspecies transmission of canine influenza virus (H3N2) in dogs, cats, and ferrets

Hyekwon Kim^, Daesub Song, Hyoungjoon Moon, Minjoo Yeom, Seongjun Park, Minki Hong, Woonseong Na, Richard J. Webby, Robert G. Webster, Bongkyun Park, Jeong-Ki Kim, Bokyu Kang

Article first published online: 23 MAY 2012

DOI: 10.1111/j.1750-2659.2012.00379.x

ABSTRACT (excerpts)

Results The interspecies transmission of CIV H3N2 via airborne was only observed from dogs to cats and not from dogs to ferrets. However, direct intranasal infection of either cats or ferrets with CIV could induce influenza-like clinical signs, viral shedding, and serological responses. Additionally, naïve cats and ferrets could be infected by CIV via direct contact with infected animals of the same species.

 

Conclusion Cats appear to be another susceptible host of CIV H3N2, whereas ferrets are not likely natural hosts. The molecular-based mechanism of interspecies and intraspecies transmission of CIV H3N2 should be further studied.

(Continue . . . )

 

CIDRAP NEWS published some details not available in the abstract above in their flu news roundup last night.

 

Follow the link to read:

Study: Canine influenza H3N2 can spread to cats

In a laboratory study, the canine influenza virus (CIV) H3N2 spread from dogs to cats via respiratory droplets, suggesting that cats could be another host for the virus, according to a report published today in Influenza and Other Respiratory Viruses.

 

<SNIP details of experiment>

 

"These data suggest that cats, in addition to dogs, can be another susceptible host of CIV H3N2; ferrets may not be susceptible host but may be susceptible after viral adaptation," the researchers write. They say the transmission of the virus between dogs and cats "underscores the concern that these same viruses might also be able to infect humans who come in contact with the animals."

May 23 Influenza Other Respi Viruses

abstract

 

 

Many of the common illnesses we think of as `human’ diseases actually began in other species, and only later adapted and migrated to humans.

 

• The scourge of Tuberculosis, which now infects 1/3rd of humanity, probably jumped to humans when man began to corral and raise its traditional hosts; goats and cattle.
• Measles appears to have evolved from canine distemper and/or the Rinderpest virus of cattle.  
• Influenza, as most of you know, is native to aquatic birds – but jumped species thousands of years ago and many strains have adapted to humans, pigs, and other species.

 

 

The list of zoonotic diseases (those shared between humans and animals) is long and continually expanding, and includes: SARS, Babesiosis, Borrelia (Lyme), Nipah, Hendra, Malaria, Hantavirus, Ebola, Bartonella, Leptospirosis, Q-Fever, bird flu and many, many others.

 

So understandably, anytime we see a virus – particularly a flu virus – jump species, it gets our attention.

 

The good news is that so far, these new canine viruses haven’t shown the ability to infect humans. 

 

But as the author’s of the 2008 EID study pointed out:

 

Transmission of avian influenza A virus to a new mammalian species is of great concern, because it potentially allows the virus to adapt to a new mammalian host, cross new species barriers, and acquire pandemic potential.

 

 

And when they infect companion animals, such as dogs and cats, it becomes of even greater concern because of how closely we humans interact with them.