The Jim Bakker Show

Hard to detect, China bird flu virus may be more widespread

quarantine researcher checking chickens on poultry farm for bird flu

By Dominique Patton

BEIJING (Reuters) – Bird flu infection rates on Chinese poultry farm

BEIJING (Reuters) – Bird flu infection rates on Chinese poultry farms may be far higher than previously thought, because the strain of the deadly virus that has killed more than 100 people this winter is hard to detect in chickens and geese, animal health experts say.

s may be far higher than previously thought, because the strain of the deadly virus that has killed more than 100 people this winter is hard to detect in chickens and geese, animal health experts say.

Poultry that have contracted the H7N9 strain of the avian flu virus show little or no sign of symptoms. That means any infection is only likely to be detected if farmers or health authorities carry out random tests on a flock, the experts said.

But in humans, it can be deadly.

That’s different to other strains, such as the highly pathogenic H5N6 that struck South Korean farms in December, prompting the government to call in the army to help cull some 26 million birds.

But that strain didn’t kill any people.

There have been multiple outbreaks of bird flu around the world in recent months, with at least half a dozen different strains circulating. The scale of the outbreaks and range of viral strains increases the chances of viruses mixing and mutating, with new versions that can spread more easily between people, experts say.

For now, H7N9 is thought to be relatively difficult to spread between people. China’s Center for Disease Control and Prevention has said the vast majority of people infected by H7N9 reported exposure to poultry, especially at live markets.

“There are very few, if any, clinical signs when this (H7N9) virus infects birds, and that’s the main reason we’re not seeing reporting coming from poultry farms in China,” said Matthew Stone, deputy director general for International Standards and Science at the World Organisation for Animal Health (OIE).

INTENSIVE OUTBREAK

As many as 79 people died from H7N9 bird flu in China in January alone, up to four times higher than the same month in past years.

While spikes in contamination rates are normal in January – the main influenza season – the high level of human infections has prompted fears the spread of the virus among people could be the highest on record – especially as the number of bird flu cases reported by farmers has been conspicuously low.

The high number of human infections points to a significant outbreak in the poultry population that is not being detected, says Guan Yi, director of the State Key Laboratory of Emerging Infectious Diseases and the Center of Influenza Research at the University of Hong Kong.

“If we have so many human infections, naturally it reflects activity, an intensive outbreak in chickens. They are highly associated,” he said.

China has the world’s largest flock of chickens, ducks and geese, and slaughtered more than 11 billion birds for meat in 2014, according to the United Nations’ Food and Agriculture Organisation (FAO).

The last major bird flu outbreak in China, in 2013, killed 36 people and cost the farming industry around $6.5 billion.

CONTROL CHALLENGE

The experts’ assessment underscores the challenge for China’s government and health ministry in monitoring and controlling the H7N9 outbreak in both people and poultry.

While, with few visible signs of infection in birds, it’s easier for farmers to flout the reporting rules and continue selling poultry at market, Stone at the OIE said China has a “very significant” surveillance program at live markets.

The government promised on Thursday to tighten controls on markets and poultry transport to help battle the virus.

The agriculture ministry last month collected more than 102,000 serum samples and 55,000 virological samples from birds in 26 provinces. Of the latter samples, only 26 tested positive for the virus, according to data on the ministry’s website.

But the rapid rise in human infections and spread to a wider geographic area is likely to increase pressure on Beijing to do more poultry testing at markets and on farms.

The ministry did not respond to faxed questions on its surveillance efforts.

The National Health and Family Planning Commission said on Thursday the spread of H7N9 among people was slowing.

Some Chinese netizens have called for more timely reports on infections, and some experts have said China has been slow to respond to the human outbreak. The authorities have warned the public to stay alert for the virus, cautioning against panic.

Others played down the threat to humans, as long as they stay away from live markets.

“As scientists, we should be watching this outbreak and the effectiveness of any control measures,” said Ian Mackay, a virologist and associate professor at the University of Queensland in Australia. “We don’t have a vaccine available for H7N9 in humans, but we do have effective antivirals.”

“So far, the virus does not spread well between humans,” he added. “As members of the public, who do not seek out live poultry from markets in China, we have almost nothing to worry about from H7N9 right now.”

(Reporting by Dominique Patton in BEIJING, with additional reporting by Ben Hirschler in LONDON; Editing by Josephine Mason and Ian Geoghegan)

Venezuelan girl’s diphtheria death highlights country’s health crisis

a mother who lost her child in Venezuela due to disease and health crisis

By Alexandra Ulmer and Maria Ramirez

PARIAGUAN, Venezuela (Reuters) – Eliannys Vivas, 9, started to get a sore throat on a Friday last month in this languid Venezuelan town where papaya trees shade poor cinder-block homes.

Five days later, Eliannys was dead, likely a victim of diphtheria, a serious bacterial infection that is fatal in 5 to 10 percent of cases and particularly lethal for children.

Her death and a wider Venezuelan outbreak of diphtheria, once a major global cause of child death but increasingly rare due to immunizations, shows how vulnerable the country is to health risks amid a major economic crisis that has sparked shortages of basic medicines and vaccines.

Eliannys’ story is also one of misdiagnoses and missed signals worsened by government secrecy around the disease. Her family had never heard of diphtheria and local doctors did not immediately suspect it, despite the infection having affected hundreds of people just a few hours away in Bolivar.

After Eliannys was taken to a local hospital, doctors, thinking the disease was asthma, used a sort of inhaler on her.

But the usually chatty girl – “a little parrot,” in the words of her day-laborer father — kept weakening, so doctors transferred her to a larger government hospital once an ambulance became available hours later.

At El Tigre hospital, all the devices to examine throats had broken three years ago, so no one checked her properly, according to a nursing assistant.

“They said it was asthma, asthma, asthma,” said her mother, Jennifer Vivas. But as Eliannys struggled to speak, she was rushed to a third and then a fourth hospital in neighboring Bolivar state.

There, doctors discovered with horror Eliannys suffered from grossly inflamed throat membranes – the classic symptom of diphtheria.

But even the fourth hospital lacked adequate treatment for the infection, so she received only a half dose of antitoxins and no penicillin at all, according to a medical professional who treated her there.

As Eliannys’ airwaves blocked up, she suffered two successive heart failures and died on Jan. 18.

“If the diphtheria diagnosis had been made earlier and she had gotten antitoxins, she would have had a chance of surviving,” the source who treated her said, asking to remain anonymous because the government has banned health professionals from speaking to the media.

DIPHTHERIA RETURNS

Venezuela controlled diphtheria in the 1990s, but it reappeared in the vast jungle state of Bolivar in mid-2016.

At least two dozen children died last year, doctors say, and cases are now thought to have spread to a half-dozen other states.

Shortages of basic drugs and vaccines, emigration of underpaid doctors, and crumbling infrastructure have made it easier for diseases to spread, medical associations said.

Many poor and middle-class Venezuelans also have weakened immune systems because they are no longer able to eat three meals a day or bathe regularly due to product scarcity, reduced water supply and raging inflation.

Government secrecy has compounded the problem.

“The fact people don’t know (about diphtheria) helps the bacteria spread,” said Caracas-based epidemiologist Julio Castro, who has been tracking the diphtheria outbreak and who showed photos sent to him of patients with thick white membranes coating their throat.

The unpopular leftist government of President Nicolas Maduro said in October there were no proven cases of diphtheria and admonished those seeking to spread “panic.”

It has since informed the World Health Organization of 20 confirmed diphtheria cases and five deaths, and emphasized there is a major vaccination drive under way, but has yet to provide a full national picture of the disease’s effects amid a generalized clampdown on data.

The Information and Health Ministries, as well as the Venezuelan Social Security Institute, which is in charge of some drug distribution and hospitals, did not respond to multiple requests for comment about Eliannys’ case and diphtheria more generally.

The only other country in the region with a significant number of confirmed diphtheria cases last year was Haiti with 33, the WHO said in December.

MORE ILLNESS AHEAD?

Doctors think diphtheria first spread from the rough-and-tumble illegal gold mines in Bolivar state, which is attracting poor Venezuelans as the minimum monthly wage languishes around $30.

After Eliannys’ family was forced to start skipping dinner in December, her father, Tulio Medina, decided to work in Bolivar’s yucca and yams plantation where he made more money but might have brought the infection home.

The disease has already spread to capital Caracas, where doctors say a 32-year-old mother died last year, and could yet affect more states.

With the Venezuelan pharmaceutical association estimating that roughly 85 percent of drugs are unavailable at any given time and in light of the short supply of vaccines, doctors are bracing for further increases in illnesses like malaria, pneumonia and tuberculosis.

Venezuela’s rate of immunization with the pentavalent vaccine, which protects children from five major infections including diphtheria, had slipped to 78 percent between January and November 2016, according to Health Ministry figures leaked to former Health Minister José Felix Oletta and seen by Reuters.

“At this rate, we’re going to see more illnesses, more deaths, more doctors leaving the country,” said pediatrician Hugo Lezama, the head of Bolivar’s doctors association, who himself earns only a handful of dollars a month.

“Those of us who stay are going hysterical trying to perform miracles so our patients don’t die.”

(Writing by Alexandra Ulmer; Editing by Christian Plumb and Matthew Lewis)

Yellow fever kills 600 monkeys in Brazil’s Atlantic rainforest

By Anthony Boadle

BRASILIA (Reuters) – An outbreak of yellow fever has claimed the lives of more than 600 monkeys and dozens of humans in Brazil’s Atlantic rainforest region, threatening the survival of rare South American primates, a zoologist said on Wednesday.

The monkeys, mostly brown howlers and masked titis, are falling out of trees and dying on the ground in the forests of Espirito Santo state in Brazil’s southeast.

“The number of dead monkeys increases every day,” said Sergio Lucena, he said of the impact of the disease’s spread in his state, “We now know that the rare buffy-headed marmoset is also threatened by the yellow fever virus and dying.”

The howler’s sounds closely resemble grunts or barks. It was the silence that fell on the forests that first alerted farmers that something was amiss, sparking specialists to investigate.

The masked titi is considered as “vulnerable” by the Swiss-based International Union for Conservation of Nature, which has placed it on its Red List of Threatened Species.

No evidence has so far surfaced of the affliction felling woolly spider monkeys, considered one of the world’s most endangered by the IUCN.

WORST YELLOW FEVER OUTBREAK IN DECADES

Brazil is suffering the worst yellow fever outbreak in decades that has killed at least 69 humans, nearly all in central state of Minas Gerais, where the problems began.

Most people recover from yellow fever after the first phase of infection, which usually involves fever, headache, shivers, loss of appetite and nausea or vomiting, according to the World Health Organization.

Millions of Brazilians have been vaccinated as health authorities scramble to prevent the outbreak from turning into an epidemic. There is no such protection available for monkeys.

Yellow fever is a viral disease found in tropical regions of Africa and the Americas that mainly affects humans and monkeys and is transmitted by the same type of mosquito that spreads dengue and the Zika virus.

Hundreds of thousands of people died from it in the Americas before a vaccine was developed in 1938.

Brazil’s federal health officials are investigating if the latest outbreak is linked to a tailings dam collapse last year in Minas Gerais at the Samarco iron ore mine co-owned by BHP
Billiton and Vale SA.

The dam accident, which polluted the Rio Doce river, is regarded as the country’s worst environmental disaster.

Some scientists have said that calamity may have made the monkeys more susceptible to contracting yellow fever by decimating their habitat and food supplies.

Proliferation of bird flu outbreaks raises risk of human pandemic

wokers gather ducks that may have bird flu

By Kate Kelland

LONDON (Reuters) – The global spread of bird flu and the number of viral strains currently circulating and causing infections have reached unprecedented levels, raising the risk of a potential human outbreak, according to disease experts.

Multiple outbreaks have been reported in poultry farms and wild flocks across Europe, Africa and Asia in the past three months. While most involve strains that are currently low risk for human health, the sheer number of different types, and their presence in so many parts of the world at the same time, increases the risk of viruses mixing and mutating – and possibly jumping to people.

“This is a fundamental change in the natural history of influenza viruses,” Michael Osterholm, an infectious disease specialist at University of Minnesota, said of the proliferation of bird flu in terms of geography and strains – a situation he described as “unprecedented”.

Global health officials are worried another strain could make a jump into humans, like H5N1 did in the late 1990s. It has since caused hundreds of human infections and deaths, but has not acquired the ability to transmit easily from person to person.

The greatest fear is that a deadly strain of avian flu could then mutate into a pandemic form that can be passed easily between people – something that has not yet been seen.

While avian flu has been a prominent public health issue since the 1990s, ongoing outbreaks have never been so widely spread around the world – something infectious disease experts put down to greater resilience of strains currently circulating, rather than improved detection or reporting.

While there would normally be around two or three bird flu strains recorded in birds at any one time, now there are at least half a dozen, including H5N1, H5N2, H5N8 and H7N8.

The Organization for Animal Health (OIE) says the concurrent outbreaks in birds in recent months are “a global public health concern”, and the World Health Organization’s director-general warned this week the world “cannot afford to miss the early signals” of a possible human flu pandemic.

The precise reasons for the unusually large number and sustained nature of bird outbreaks in recent months, and the proliferation of strains, is unclear – although such developments compound the global spreading process.

Bird flu is usually spread through flocks through direct contact with an infected bird. But Osterholm said wild birds could be “shedding” more of the virus in droppings and other secretions, increasing infection risks. He added that there now appears to be “aerosol transmission from one infected barn to others, in some cases many miles away”.

Ian MacKay, a virologist at Australia’s University of Queensland, said the current proliferation of strains means that “by definition, there is an increased risk” to humans.

“You’ve got more exposures, to more farmers, more often, and in greater numbers, in more parts of the world – so there has to be an increased risk of spillover human cases,” he told Reuters.

BRITAIN TO BANGLADESH

Nearly 40 countries have reported new outbreaks of highly pathogenic avian influenza in poultry or wild birds since November, according to the WHO.

In China, H7N9 strains of bird flu have been infecting both birds and people, with the of human cases rising in recent weeks due to the peak of the flu season there. According to the WHO, more than 900 people have been infected with H7N9 bird flu since it emerged in early 2013.

In birds, latest data from the OIE should that outbreaks of highly pathogenic avian flu have been detected in Britain, Italy, Kuwait and Bangladesh in the last few days alone.

Russia’s agriculture watchdog issued a statement describing the situation as “extremely tense” as it reported H5N8 flu outbreaks in another four regions. Hungarian farmers have had to cull 3 million birds, mostly geese and ducks.

These come on top of epidemics across Europe and Asia which have been ongoing since late last year, leading to mass culling of poultry in many countries.

Strains currently documented as circulating in birds include H5N8 in many parts of Europe as well as in Kuwait, Egypt and elsewhere, and H5N1 in Bangladesh and India.

In Africa – which experts say is especially vulnerable to missing flu outbreak warning signs due to limited local government capacities and weak animal and human health services – H5N1 outbreaks have been reported in birds in Burkina Faso, Cameroon, Ghana, Niger, Nigeria and Togo. H5N8 has been detected in Tunisia and Egypt, and H7N1 in Algeria.

The United States has, so far this year, largely escaped bird flu, but is on high alert after outbreaks of H5N2, a highly pathogenic bird flu, hit farms in 15 states in 2015 and led to the culling of more than 43 million poultry.

David Nabarro, a former senior WHO official who has also served as U.N. system senior coordinator for avian and human influenza, says the situation is worrying. “For me the threat from avian influenza is the most serious (to public health), because you never know when,” he told Reuters in Geneva.

HIGHLY PATHOGENIC H5N1

H5N1 is under close surveillance by health authorities around the world. It has long been seen as one to watch, feared by infectious disease experts because of its pandemic potential if it were to mutate an acquire human-to-human transmission capability.

A highly pathogenic virus, it jumped into humans in Hong Kong in 1997 and then re-emerged in 2003/2004, spreading from Asia to Europe and Africa. It has caused hundreds of infections and deaths in people and prompted the culling of hundreds of millions of poultry.

Osterholm noted that some currently circulating H5 strains – including distant relatives of H5N1 – are showing significant capabilities for sustaining their spread between wild flocks and poultry, from region to region and farm to farm.

“What we’re learning about H5 is, that whether its H5N6, H5N8, H5N2 or H5N5, this is a very dangerous bird virus.”

Against that background, global health authorities and infectious disease experts want awareness, surveillance and vigilance stepped up.

Wherever wild birds are found to be infected, they say, and wherever there are farms or smallholdings with affected poultry or aquatic bird flocks, regular, repeated and consistent testing of everyone and anyone who comes into contact is vital.

“Influenza is a very tough beast because it changes all the time, so the ones we’re tracking may not include one that suddenly emerges and takes hold,” said MacKay.

“Right now, it’s hard to say whether we’re doing enough (to keep on top of the threat). I guess that while it isn’t taking off, we seem to be doing enough.”

(Additional reporting by Ed Stoddard in Johannesburg, Stephanie Nebehay in Geneva, Polina Devitt in Moscow and Sybille de La Hamaide in Paris; Editing by Pravin Char)

Hundreds of cats quarantined in New York City bird flu outbreak

By Gina Cherelus

NEW YORK (Reuters) – Hundreds of domestic cats have been quarantined in New York City after contracting a strain of highly contagious avian flu at shelters operated by a major animal rescue organization, and the virus also infected at least one veterinarian, officials said.

It is the first time the H7N2 strain of the virus, commonly found in birds, has infected domestic cats, according to the New York City Health Department.

Symptoms are generally mild, and include sneezing, coughing and runny eyes and noses.

The virus was first detected last month in 45 cats housed at a Manhattan shelter run by Animal Care Center of NYC, and later turned up in cats at shelters in the boroughs of Queens and Brooklyn. It was not immediately clear how the cats contracted the virus or how it spread so quickly, the city’s health department said in a statement on Thursday.

“We continue to urge New Yorkers who have adopted cats from ACC shelters to be on alert for symptoms in their pets and take proper precautions,” Health Commissioner Mary Bassett said in a statement.

She said the risk to human health from H7N2 is low.

H7N2 is a type of avian influenza virus, also known as the bird flu, that can mutate and transfer onto mammals such as cats. It could infect other mammals as well, including humans, according to the Centers for Disease Control and Prevention’s (CDC) website. The CDC provides guidance on bird flu in cats on its website. (https://www.cdc.gov/flu/spotlights/avian-influenza-cats.htm)

More than 450 cats will remain at a temporary shelter for up to 90 days until a University of Wisconsin lab confirms they are no longer contagious, the city’s health department said. ACC, the New York Health Department and the American Society for the Prevention of Cruelty to Animals are monitoring the animals together.

In December, the city’s health department and the CDC confirmed that a veterinarian had been infected at the ACC’s Manhattan shelter. It was the first case of cat-to-human-transmission of the flu, the city’s health department said. The illness was mild and short-lived.

The health department screened more than 160 ACC employees for the virus and contacted more than 80 percent of pet adopters from the Manhattan shelter, but no other cases have been found.

Residents who adopted a cat from an ACC shelter between Nov. 12 and Dec. 15 should monitor their pets for signs of sickness, officials said.

(Editing by Frank McGurty and Matthew Lewis)

U.N. alarmed at migrants dying of cold, ‘dire’ situation in Greece

By Stephanie Nebehay

GENEVA (Reuters) – Refugees and migrants are dying in Europe’s cold snap and governments must do more to help them rather than pushing them back from borders and subjecting them to violence, the U.N. refugee agency UNHCR said on Friday.

“Children are particularly prone to respiratory illnesses at a time like this. It’s about saving lives, not about red tape and keeping to bureaucratic arrangements,” Sarah Crowe, a spokeswoman for the U.N. children’s agency UNICEF told a U.N. briefing in Geneva. “The dire situation right now is Greece.”

UNHCR spokeswoman Cecile Pouilly cited five deaths so far from cold and said about 1,000 people including children were in unheated tents and dormitories on the Greek island of Samos, calling for them to be transferred to shelter on the mainland.

Hundreds of others had been moved to better accommodation on the islands of Lesbos and Chios in the past few days.

In Serbia, about 80 percent of the 7,300 refugees, asylum seekers and migrants are staying in heated government shelters, but 1,200 men were sleeping rough in informal sites in Belgrade.

The bodies of two Iraqi men and a young Somali woman were found close to the Turkish border in Bulgaria and two Somali teenagers were hospitalized with frostbite after five days in a forest, Pouilly said. The body of a young Pakistani man was found along the same border in late December.

A 20-year-old Afghan man died after crossing the Evros River on the Greece-Turkey land border at night when temperatures were below -10 degrees Celsius. The body of a young Pakistani man was found on the Turkish side of the border with Bulgaria.

“Given the harsh winter conditions, we are particularly concerned by reports that authorities in all countries along the Western Balkans route continue to push back refugees and migrants from inside their territory to neighboring countries,” Pouilly said.

Some refugees and migrants said police subjected them to violence and many said their phones were confiscated or destroyed, preventing them from calling for help, she said.

“Some even reported items of clothing being confiscated thus further exposing them to the harsh winter conditions,” she said. “These practices are simply unacceptable and must be stopped.”

Joel Millman, spokesman for the International Organization for Migration (IOM), said migrant movements across the Mediterranean had “started out in a big way” in 2017, and the death toll for the year was already 27.

The World Meteorological Organization said a movement of cold Siberian air into southeastern Europe had driven temperatures in Greece, Italy, Turkey and Romania 5-10 degrees Celsius lower than normal. Such cold outbreaks happen about once in 35 years on average, the WMO said.

(additional reporting by Tom Miles; Editing by Janet Lawrence)

Scientists link higher dementia risk to living near heavy traffic

By Kate Kelland

LONDON (Reuters) – People who live near roads laden with heavy traffic face a higher risk of developing dementia than those living further away, possibly because pollutants get into their brains via the blood stream, according to researchers in Canada.

A study in The Lancet medical journal found that people who lived within 50 meters (55 yards) of high-traffic roads had a 7.0 percent higher chance of developing dementia compared to those who lived more than 300 meters away from busy roadways.

“Air pollutants can get into the blood stream and lead to inflammation, which is linked with cardiovascular disease and possibly other conditions such as diabetes. This study suggests air pollutants that can get into the brain via the blood stream can lead to neurological problems,” said Ray Copes, an environmental and occupational health expert at Public Health Ontario (PHO) who conducted the study with colleagues from Canada’s Institute for Clinical Evaluative Sciences.

Dementia is caused by brain diseases, most commonly Alzheimer’s disease, which result in the loss of brain cells and affect memory, thinking, behavior, navigational and spatial abilities and the ability to perform everyday activities.

The World Health Organization estimates the number of people with dementia in 2015 at 47.5 million, and that total is rising rapidly as life expectancy increases and societies age. The incurable condition is a leading cause of disability and dependency, and is starting to overtake heart disease as a cause of death in some developed countries.

Independent experts said the Canadian study had important implications for public health around the world. Tom Dening of the Center for Old Age and Dementia at Britain’s Nottingham University said the findings were “interesting and provocative”.

“It is unlikely that Ontario has the worst air quality in the world, so the risks might be even greater in cities that are habitually wrapped in smog,” he said.

Chen’s team analyzed records of more than 6.5 million Ontario residents aged 20 to 85 and found 243,611 cases of dementia between 2001 and 2012. Then they mapped residents’ proximity to major roadways using postal codes.

The increase in the risk of developing dementia went down to 4.0 percent if people lived 50 to 100 meters from major traffic, and to 2.0 percent if they lived within 101 to 200 meters. At more than 200 meters, the elevated risk faded away.

The team also explored links between living close to major roads and Parkinson’s disease and multiple sclerosis – two other major neurological disorders – but the findings suggested no increased risk of these from living near heavy traffic.

The scientists said their results could be used to help town and city planners take traffic conditions and air pollution into account as urban areas become more densely populated.

(Editing by Raissa Kasolowsky)

California bill would require reporting of ‘superbug’ infections, deaths

By Yasmeen Abutaleb

SAN FRANCISCO (Reuters) – A California state senator introduced a bill on Monday that would mandate reporting of antibiotic-resistant infections and deaths and require doctors to record the infections on death certificates when they are a cause of death.

The legislation also aims to establish the nation’s most comprehensive statewide surveillance system to track infections and deaths from drug-resistant pathogens. Data from death certificates would be used to help compile an annual state report on superbug infections and related deaths.

In September, a Reuters investigation revealed that tens of thousands of superbug deaths nationwide go uncounted every year. The infections are often omitted from death certificates, and even when they are recorded, they aren’t counted because of the lack of a unified national surveillance system.

“The (Reuters) story highlighted some of the problems that have come from the lack of information, the lack of reporting, especially deaths,” said state Senator Jerry Hill, who introduced the bill. “I wasn’t aware that on death certificates, antibiotic-resistant infections have never been called out.”

Because there is no federal surveillance system, monitoring of superbug infections and deaths falls to the states. A Reuters survey of all 50 state health departments and the District of Columbia found that reporting requirements vary widely.

California is among the states that do not require reporting of superbug-related deaths. A Reuters analysis of death certificates from 2003 to 2014 identified more than 20,000 deaths linked to the infections in California, the most of any state – and probably an undercount, given the unreliability of death certificate data.

Hill’s bill would require hospitals and clinical labs to submit an annual summary of antibiotic-resistant infections to the California Department of Health beginning July 1, 2018; amend a law governing death certificates by requiring that doctors specify on death certificates when a superbug was the leading or a contributing cause of death; and require the state Health Department to publish an annual report on resistant infections and deaths, including data culled from death certificates.

Hill introduced legislation in 2014 that would require reporting of superbug infections – not deaths. It was ultimately stripped down to mandate that all hospitals in California implement “stewardship” programs to prevent the overprescription of antibiotics that promotes drug resistance. Hill said the state medical association and other physician groups opposed the initial proposal.

The 2014 legislation followed a 2013 threat report from the Centers for Disease Control and Prevention, which estimated that at least 23,000 people in the U.S. die every year from antibiotic-resistant infections. A Reuters analysis of the agency’s math found that the numbers are based on such small sample sizes that they are mostly guesswork.

Hill has written several superbug-related bills that have been signed into law in recent years. Those include laws that regulate antibiotic use in livestock and others that mandate antibiotic stewardship programs in nursing homes and other healthcare facilities.

“We don’t know how (superbugs) affect California,” Hill said. “We could be overreacting in certain areas or underreacting in areas that could create real problems for people.”

(Edited by John Blanton)

Zika striking women at higher rates than men: U.S. study

By Julie Steenhuysen

CHICAGO (Reuters) – Adult women in Puerto Rico were significantly more likely to develop Zika than men, researchers said on Thursday, raising new questions about the potential role of sexual transmission of the virus from males to females.

The study, published in the U.S. Centers for Disease Control and Prevention’s weekly report on death and disease, evaluated more than 29,000 laboratory-confirmed cases of Zika since the outbreak began in Puerto Rico in November 2015.

The data show that of all Zika cases with laboratory evidence of infection, 62 percent were female. The results pattern similar observations from Brazil and El Salvador, the authors said.

One obvious explanation might be that pregnant women are more likely than men to seek treatment for Zika because of the potential risk of birth defects.

To account for that, the researchers excluded all pregnant women who tested positive for the virus. Of the remaining 28,219 non-pregnant women and men testing positive for Zika, 61 percent of these cases occurred in women over the age of 20.

The Zika findings differ from prior outbreaks in Puerto Rico of arboviruses transmitted by the same mosquitoes as Zika. For example, in the 2010 dengue outbreak and the 2014 chikungunya outbreak, infections were equally distributed among men and women.

“It is possible that male-to-female sexual transmission is a contributing factor to this skewing of the burden of disease toward women,” the CDC said in a statement summarizing the findings.

However, the contribution of sexual transmission to overall Zika rates is just beginning to be explored, the CDC said. It could be that women are more likely than men to seek care if they are sick, or that women are more likely to develop Zika symptoms if they become infected.

The CDC is conducting blood tests of individuals living near people with confirmed Zika to try to answer some of these questions.

Zika infections in pregnant women have been shown to cause microcephaly – a severe birth defect in which the head and brain are undersized – as well as other brain abnormalities. The connection between Zika and microcephaly first came to light last year in Brazil, which has since confirmed more than 2,000 cases of microcephaly.

(Reporting by Julie Steenhuysen; Editing by Andrew Hay)

Disease stalks Yemen as hospitals, clinics devastated by war

LONDON (Thomson Reuters Foundation) – More than half of war-battered Yemen’s hospitals and clinics are closed or only partially functioning, the World Health Organization (WHO) said on Monday, warning a lack of adequate health services was increasing the risk of disease outbreaks.

Only 45 percent of 3,507 health facilities surveyed by WHO were fully functional and accessible, while more than 40 percent of districts faced a “critical” shortage of doctors, WHO said.

“These critical shortages in health services mean that more people are deprived of access to life-saving interventions,” WHO said in a statement.

“Absence of adequate communicable diseases management increases the risk of outbreaks such cholera, measles, malaria and other endemic diseases.”

The 18-month-old conflict between a Saudi Arabia-led coalition and the Iran-aligned Houthi group which controls much of northern Yemen has destroyed much of Yemen’s infrastructure, killed more than 10,000 people and displaced millions.

UNICEF says the humanitarian disaster in the country has left 7.4 million children in need of medical help and 370,000 at risk of severe acute malnutrition.

Yemen’s Health Ministry announced a cholera outbreak in early October in the capital Sanaa. By the end of the month, WHO said the number of suspected cholera cases had ballooned to more than 1,400.

In 42 percent of 276 districts surveyed by WHO there were only two doctors or less, while in nearly a fifth of districts there were none.

WHO said new mothers and their babies lacked essential ante-natal care and immunization services, while people suffering from acute or chronic conditions were forced to spend more on treatment or forgo treatment altogether.

(Reporting by Magdalena Mis; Editing by Ros Russell)

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