Tag Archives: Outbreak

Miami among cities at risk from yellow fever spread : study

FILE PHOTO: The downtown skyline of Miami, Florida is seen on Nov 5, 2015. REUTERS/Joe Skipper/File Photo

GENEVA (Reuters) – Miami is at risk of a deadly yellow fever outbreak because the disease could thrive there but the city has no checks on travelers arriving from endemic zones, a study to be published by the World Health Organization showed.

Yellow fever is spread by the same mosquito that causes Zika virus, which spread through the Americas after being detected in Brazil in 2015 and has been reported in southern Florida and southern Texas.

The U.S. Centres for Disease Control advises that yellow fever is found in tropical and subtropical areas of Africa and South America, and is a very rare cause of illness in U.S. travelers.

But the study, “International travel and the urban spread of yellow fever”, showed that almost 2.8 million people flew to the United States from endemic yellow fever areas in 2016.

Unlike some countries, the United States does not require travelers from such places to show proof of yellow fever vaccination.

“At a time when global yellow fever vaccine supplies are diminished, an epidemic in a densely populated city could have substantial health and economic consequences,” the researchers based in Canada, the United States and Britain wrote in the study.

Around 9.5 million people live in U.S. urban areas such as Miami that are ecologically suitable for an outbreak, they wrote in the study, issued online ahead of its publication in the Bulletin of the World Health Organization.

They said climate change, mobility, urbanization and a vaccine shortage had increased the risk of yellow fever globally and they called for a review of vaccination policies.

The study found 472 cities suitable for an outbreak in 54 countries, but many, such as New Delhi, Mumbai, Karachi, Manila and Guangzhou, required vaccination certificates on arrival from endemic countries.

WHO spokeswoman Fadela Chaib said the need for vaccination certificates was at each country’s discretion.

The researchers said a substantial proportion of the world’s yellow fever vaccine stocks had been used up by recent epidemics in Africa and Brazil, and further depleted by manufacturing difficulties. Preventive campaigns could cause shortages.

“Should another urban epidemic occur in the near future, vaccine demand could easily exceed the available supply,” they said.

Yellow fever, which can be hard to diagnose, causes symptoms including muscle pain, nausea and vomiting, and about 15 percent of cases lead to a more toxic phase within 24 hours, potentially experiencing jaundice, abdominal pain, deteriorating kidney function and bleeding from the mouth, nose, eyes or stomach.

Half of severe sufferers die within a week or two, but the rest recover without significant organ damage, according to WHO.

(Reporting by Tom Miles; Editing by Hugh Lawson)

Kentucky accuses Endo of contributing to opioid epidemic

Kentucky accuses Endo of contributing to opioid epidemic

By Nate Raymond

(Reuters) – Kentucky accused units of Endo International Plc on Monday of contributing to drug overdoses and an opioid epidemic by deceptively marketing its painkiller Opana ER, the latest lawsuit by state or local governments against the drugmaker.

Kentucky Attorney General Steve Beshear said the lawsuit would seek to hold Endo responsible for illegally building a market for the long-term use of opioids in the state as part of an effort to boost corporate profits.

The lawsuit, filed in a state court in Kentucky, said Endo sought to overstate the benefits of using Opana for the long-term treatment of chronic pain while downplaying the risk of addiction, helping to fuel a public health epidemic.

“My office refuses to sit back and watch families be torn apart while opioid manufacturers like Endo line their pockets at the expense of our communities and our future,” Beshear said in a statement.

Endo’s chief legal officer, Matthew Maletta, said in a statement that Beshear’s allegation that the drugmaker was trying to profit at the expense of people’s health was “patently offensive.”

“We intend to vigorously defend the company against the claims set forth in this lawsuit,” Maletta said.

According to the U.S. Centers for Disease Control and Prevention, opioids were involved in over 33,000 deaths in 2015, the latest year for which data is available. The death rate has continued rising, according to estimates.

Endo has faced a wave of similar lawsuits over the opioid epidemic by Louisiana, New Mexico, Missouri, Mississippi and Ohio, as well as several cities and counties. Many of those cases target other drugmakers as well.

In July, Endo agreed to withdraw the long-acting opioid painkiller Opana ER from the market after the U.S. Food and Drug Administration declared that its benefit did not outweigh public health risks associated with opioid abuse.

In a statement, Beshear called the removal of Opana ER from the market an important step but said that Endo’s practices had already by then harmed people in his state. His office’s lawsuit seeks penalties and compensatory and punitive damages.

(Reporting by Nate Raymond in Boston; Editing by Tom Brown and Grant McCool)

Plague in Madagascar Surprises and Alarms World Health organizations, U.S. not immune

World Health Organization responding to Seychelles plague

By Kami Klein

Experts are alarmed at a recent outbreak of plague that is spreading through major populated areas in Madagascar.  So far there has been 1,836 suspected or confirmed cases of pneumonic plague and 133 deaths in areas that have never seen this form of the disease before.

Every year Africa and Madagascar deal with an outbreak of plague within their borders. The World Health Organization (WHO) anticipates this in outlying areas and is ready to step in with antibiotics and information which eventually curtails the outbreak.  This year, health organizations around the world were surprised as the plague has spread so quickly and is primarily being found in heavily populated areas. While they anticipate around 400 cases a year, this year’s outbreak began sooner and a different strain of the disease has the world watching.

What is causing the alarm is that 65% of the plague occurring in Madagascar, pneumonic plague, is the only form that can be spread from human to human through droplets from coughing.  This makes containing the disease much more difficult and the chances that there will be more deaths almost certain.

According to the Center for Disease Control here in the United States, there are major differences in bubonic plague and pneumonic. Bubonic plague is spread to humans by the bites of infected fleas that live on small mammals such as rats.Without treatment, it kills up to two-thirds of those infected. One in 10 cases will develop into pneumonic plague which is almost always fatal if not treated quickly with antibiotics. This form, can and will spread from human to human which is the case in this outbreak. The good news is that a simple short course of antibiotics can cure the plague, providing it is given early.

Dr. Tim Jagatic told BBC News that the outbreak had spread to populated areas when a man infected with bubonic plague had traveled from the highlands to the capital and then on to the coastal city of Tamatave by bus.

“He had the bubonic form of the plague and entered into one of the major cities, where the bubonic version of the disease had the potential of turning into the pneumonic form without treatment.”

“He was in a closed environment with many people when he started to develop severe symptoms, and he started to transmit the pneumonic form of the disease to others.”

“So it wasn’t recognised until later,” he said, allowing the disease to “proliferate over a period of time unabated”.

This  case infected 31 other people, according to the WHO, four of whom died. It wasn’t until a couple of weeks later that an outbreak of the plague was detected and officially confirmed.

Although a travel ban has not been issued as of yet, officials do expect another spike in the disease before the season ends in April.  Medical personnel are all on  alert in parts of Africa that are most frequented by Madagascar citizens. WHO has delivered nearly 1.2 million doses of antibiotics and released $1.5 million dollars in emergency funds to fight the plague in Madagascar.

Though not widely publicized, the United States does have several cases of plague per year mostly in the Southwest. Dr Tim Jagatic, a doctor with Doctors without Borders currently working in Madagascar stated that the conditions which cause the plague outbreaks on the African island are also found in the US.

“Something today that very few people are aware of is that in the United States for instance, in the south-west, there’s an average of 11 cases of bubonic plague per year.

“These outbreaks occur simply because this is a bacteria which is able to maintain a reservoir in wild animals and every once in awhile, when humans come into contact with fleas that have had contact with the wild animals, it is able to transmit to humans.”

Information Sheet on the Plague

Information Sheet on the Plague

 

Sources:   BBC, WHO,CDC, New York Post  CNN

MSF says closing most cholera centers in Yemen as epidemic wanes

MSF says closing most cholera centers in Yemen as epidemic wanes

By Stephanie Nebehay

GENEVA (Reuters) – The medical charity Medecins Sans Frontieres (Doctors Without Borders) is closing most of its 37 cholera treatment centers in Yemen, saying the epidemic appears to have peaked.

Some 884,368 suspected cholera cases have been recorded in the war-torn country in the past six months, including 2,184 deaths, according to the latest figures from the World Health Organization (WHO). The case fatality rate is now 0.25 percent.

“The number of cholera cases reported in MSF treatment centers has significantly decreased since the peak of the outbreak. As a result, the medical organization is closing the majority of its cholera treatment centers or reducing their capacity,” MSF said in a statement late on Monday.

Some 567 new patients sought treatment for suspected cholera at MSF’s centers in nine governorates of Yemen during the second week of October, down from 11,139 at the peak in the third week in June, it said.

“Only 9 percent of patients admitted by MSF last week needed to be hospitalized and a limited number of patients have symptoms that correspond with the cholera case definition (acute watery diarrhea with or without vomiting),” it said. “The remaining cases are believed to be due to other pathogens.”

Ghassan Abou Chaar, MSF head of mission in Yemen, said: “The cholera outbreak is not over but it is no longer our medical priority in Yemen. However, this should not eclipse the dire health situation of millions of Yemenis who are unable to access basic primary healthcare.”

Civil war in Yemen has killed more than 10,000 people since it began in March 2015. Yemen’s war pits the armed Houthi movement that controls the capital against the internationally-recognized government of President Abd-Rabbu Mansour Hadi, which is backed by a Saudi-led coalition that has launched thousands of air strikes to restore him to power.

Cholera epidemics usually subside once the disease passes through a population, but aid agencies say the Yemen epidemic lasted longer and spread wider than they initially expected because of the war’s toll on health care.

U.N. humanitarian chief Mark Lowcock said on Sunday that an aid effort by the World Health Organization, United Nations Children’s Fund UNICEF, the International Committee for the Red Cross (ICRC) and other agencies had managed to “largely contain the devastating cholera epidemic”, but warned it could flare up again without urgent investment in health, water and sanitation.

ICRC said last month that the humanitarian situation in Yemen is a “catastrophe”, and cholera cases could reach a million by the end of the year.

Alexandre Faite, head of the ICRC delegation in Yemen, said at the time that the “health sector is really on its knees in Yemen … the health staff is on its knees as well because they are not paid.”

“Preventable illnesses and deaths are increasing in Yemen, and this can be partly attributed to the salary crisis,” MSF said, noting that doctors, nurses and other public health workers had not been paid in 13 months.

(Reporting by Stephanie Nebehay; Editing by Peter Graff)

Pharmacist guilty of fraud, not murder, over U.S. meningitis outbreak

Pharmacist guilty of fraud, not murder, over U.S. meningitis outbreak

By Nate Raymond

BOSTON (Reuters) – A Massachusetts pharmacist was convicted of racketeering and fraud charges but was cleared of murder on Wednesday for his role in a 2012 fungal meningitis outbreak that killed 76 people and sickened hundreds more across the United States.

Jurors found that federal prosecutors in Boston failed to prove Glenn Chin, 49, committed second-degree murder in connection with the deaths of 25 people who were injected with mold-tainted steroids produced at the now-defunct New England Compounding Center.

The federal jury instead found Chin guilty on racketeering, conspiracy and mail fraud charges stemming from his role as the pharmacist who supervised the so-called clean rooms in which NECC’s drugs were made.

The verdict came after a separate jury in March found Barry Cadden, NECC’s co-founder and former president, guilty of racketeering and fraud but similarly cleared him of murder. Cadden, 50, was sentenced in June to nine years in prison.

“No matter what these prosecutors tell you, this was never a murder case, ever, ever, ever,” said Stephen Weymouth, Chin’s lawyer.

He called the verdict a victory, noting that a murder conviction would have exposed Chin to a maximum prison sentence of life. Weymouth said he now expected Chin to receive a prison term no longer than Cadden’s when he is sentenced Jan. 30.

Prosecutors say that 778 people nationwide were sickened after being injected with contaminated steroids produced in unsanitary conditions at Framingham, Massachusetts-based NECC.

The outbreak led Congress in 2013 to pass a law that aimed to clarify the U.S. Food and Drug Administration’s ability to oversee large compounding pharmacies that make custom drugs.

Prosecutors said Chin directed staff in NECC’s clean rooms to skip cleaning despite the presence of insects, mice and mold.

They claimed Chin disregarded the probability that people could die if he failed to ensure drugs were produced in sanitary conditions and were properly sterilized in order to keep up with demand from hospitals nationally for its medicines.

His lawyers countered that Chin never meant for anyone to die. They said blame instead rested with Cadden, who made all of the decisions at NECC and trained Chin on how to produce drugs in the ways that prosecutors contend were unsafe.

Lesser charges were filed against 12 other people associated with NECC. Three have pleaded guilty. A federal judge dismissed charges against two defendants in 2016. Charges remain pending against the rest.

(Reporting by Nate Raymond in Boston; Editing by Andrew Hay)

Trial wraps up for pharmacist in deadly U.S. meningitis outbreak

Trial wraps up for pharmacist in deadly U.S. meningitis outbreak

By Nate Raymond

BOSTON (Reuters) – Closing arguments are set for Friday in the trial of a Massachusetts pharmacist accused of murder and fraud for his role in a 2012 fungal meningitis outbreak that killed 76 people and sickened hundreds more across the United States.

Federal prosecutors in Boston contend that Glenn Chin, a former supervisory pharmacist at New England Compounding Center, cut corners while overseeing the production of drugs the company produced in filthy conditions.

Those drugs included steroids tainted with mold that were shipped out to healthcare facilities nationally and then injected into patients, leading to an outbreak that sickened 778 people nationally, prosecutors said.

They said that Chin, 49, recklessly failed to ensure the compounding pharmacy’s drugs were produced in sanitary conditions to keep up with demand from hospitals for its products.

Prosecutors claim Chin directed staff in NECC’s so-called clean rooms where the drugs were made, to skip cleaning, despite the presence of insects, mice and mold.

Chin has pleaded not guilty to charges including racketeering and mail fraud. He faces up to life in prison if he is convicted of second-degree murder charges brought under racketeering law.

Defense lawyers counter that Chin did nothing to kill the 25 people who are the subject of those murder allegations and say blame instead lies with Barry Cadden, NECC’s co-founder and former president.

They say that Cadden directed the corner-cutting at NECC, and note that at his trial earlier this year, prosecutors said people died because Cadden decided to put profits before patient safety.

Cadden was sentenced in June to nine years in prison after he was found guilty of racketeering and fraud charges but cleared of murder.

Lesser charges were filed against 12 other people. Three have pleaded guilty, while a federal judge dismissed charges against two defendants in October 2016. Charges remain pending against the other seven.

(Reporting by Nate Raymond; Editing by Scott Malone and Bernadette Baum)

Michigan to charge top medical official in Flint water deaths

A sign is seen next to a water dispenser at North Western High School in Flint, a city struggling with the effects of lead-poisoned drinking water in Michigan, May 4, 2016.

(Reuters) – Michigan’s top medical official will be charged with involuntary manslaughter for her role in the city of Flint’s water crisis, which was linked to an outbreak of Legionnaires’ disease that caused at least 12 deaths, state prosecutors said on Monday.

Dr. Eden Wells, who already faced lesser charges, would become the sixth current or former official to face involuntary manslaughter charges in connection with the crisis.

The state intends to add involuntary manslaughter and misconduct in office to the other charges of obstruction of justice and lying to police that Wells already faces, a spokeswoman for Michigan Attorney General Bill Schuette said.

An attorney for Wells, the state’s chief medical executive, could not immediately be reached by Reuters but Jerold Lax, one of her attorneys, told the Detroit Free Press they only learned of the proposed additional charges at a pre-trial hearing on Monday.

The charges stem from more than 80 cases of Legionnaires’ disease that were believed to be linked to the water in Flint after the city switched its source from Lake Huron to the Flint River in April 2014.

Wells was among six current and former Michigan and Flint officials charged in June. The other five, including Michigan Health and Human Services Director Nick Lyon, were charged at the time with involuntary manslaughter stemming from their roles in handling the crisis.

Involuntary manslaughter is a felony that carries a sentence of up to 15 years in prison.

In court documents, prosecutor had previously said Wells lied to police about when she became aware of the Legionnaires’ outbreak and that she threatened a team of independent researchers who were studying the source of the disease.

Special prosecutor Todd Flood said Monday he was seeking the new charges based on new review of documents and testimony that came out last week, the newspaper said.

The crisis in Flint erupted in 2015 when tests found high amounts of lead in blood samples taken from children in the predominantly black city of about 100,000.

The more corrosive river water caused lead to leach from pipes and into the drinking water. Lead levels in Flint’s drinking water have since fallen below levels considered dangerous by federal regulators, state officials have said.

 

(Reporting by Peter Szekely in New York; Editing by Bill Trott)

 

Plague outbreak in Madagascar kills 20: WHO

NAIROBI (Reuters) – An outbreak of plague has killed 20 people in the space of a month in Madagascar, with a further 84 infected, the World Health Organisation (WHO) said on Friday.

Plague is mainly spread by flea-carrying rats. Humans bitten by an infected flea usually develop a bubonic form of plague, which swells lymph nodes and can be treated with antibiotics.

But the more dangerous pneumonic form invades the lungs and can kill a person within 24 hours if not treated. About half of the 104 known cases are pneumonic, the WHO said.

WHO spokesman Tarik Jasarevic told reporters in Geneva that areas affected included the capital Antananarivo and the port cities of Mahajenga and Toamasina.

The U.N. health agency said it feared that the outbreak could worsen because the season for plague, which is endemic in Madagascar, had only just begun, and runs until April. On average, 400 cases are reported each year.

“The overall risk of further spread at the national level is high,” WHO said in a statement.

(Reporting by Stephanie Nebehay in Geneva; writing by Elias Biryabarema; Editing by Kevin Liffey)

Yemen cholera cases could hit 1 million by year-end: Red Cross

Yemen cholera cases could hit 1 million by year-end: Red Cross

By Stephanie Nebehay

GENEVA (Reuters) – The humanitarian situation in Yemen is a “catastrophe”, and cholera cases could reach a million by the end of the year, the International Committee of the Red Cross said on Friday.

Warring parties in Yemen – including the western-backed Saudi-led coalition – are all using disproportionate force, leading to “very excessive” civilian casualties, said Alexandre Faite, the head of the Red Cross delegation in Yemen.

In addition, suspected cases of cholera have reached 750,000, with 2,119 deaths, Faite said, and the Red Cross expects at least 900,000 cases by the end of the year.

“The situation has really evolved in a very dramatic way and I think that it’s nothing short of a catastrophe,” Faite told a news briefing in Geneva.

Civil war in Yemen has killed more than 10,000 people since it began in March 2015. Control of the country is split between the Iran-aligned Houthis, who control much of northern Yemen, including the capital, Sanaa. Opposed to the Houthis are a Saudi-led coalition.

With the main port of Hodeidah damaged, the Red Cross brings medical aid, including insulin, into Yemen with occasional cargo planes to Sanaa. Other goods come by land convoys from Jordan and Oman and by ship from Jordan, Oman and Dubai.

A ship from Karachi with 500 metric tonnes of rice is now due on Oct 7 in Hodeidah, the first ICRC shipment there since early February.

Faite called on all sides to open Sanaa airport to commercial flights for essential aid supplies and to make progress toward allowing the Red Cross to visit prisoners of war.

“I don’t think political settlement is coming soon and I’m very worried that the extension of the conflict would lead to more problems,” Faite said.

“This is why humanitarian aid, access of essential goods should be there,” he said. “There is a bottleneck”.

Although the death rate for cholera victims has dropped to less than 0.3 percent, Faite said Yemen’s “health sector is really on its knees in Yemen … the health staff is on its knees as well because they are not paid.”

For the first time, the Red Cross is now providing health workers with food parcels, he said.

“In terms of access to even water, electricity, there isn’t a power grid in the main cities in Yemen. Without the ICRC and other organizations fixing (pumping stations) there wouldn’t be any running water in Sanaa,” he said.

(Reporting by Stephanie Nebehay; editing by John Stonestreet)

Trump plans ‘major briefing’ on opioid crisis

Paramedics display a dose of the opioid overdose reversal drug Narcan, or Naloxone Hydrochloride, in an ambulance in Peabody, Massachusetts, U.S., August 8, 2017. REUTERS/Brian Snyder

By James Oliphant

BRIDGEWATER, N.J. (Reuters) – President Donald Trump has scheduled what he called a “major briefing” for Tuesday on the epidemic of opioid drug use in the United States, a health crisis that kills more than 100 Americans daily.

In the midst of a two-week getaway at his golf club in New Jersey, Trump will meet with Health and Human Services Secretary Tom Price to discuss the matter. Trump frequently mentioned the opioid crisis as a presidential candidate, but has given it less public attention since taking office in January.

A commission created by Trump to study the matter urged him last week to declare a national emergency to address what it called a crisis involving the epidemic use of opioids, framing its death toll in the context of the Sept. 11, 2001, attacks on the United States.

The commission, headed by Republican New Jersey Governor Chris Christie, recommended a series of steps Trump could take on his own without Congress. It called for waiving a federal rule that restricts the number of people who can receive residential addiction treatment under the Medicaid healthcare program for the poor and disabled.

According to the U.S. Centers for Disease Control and Prevention, opioids were involved in more than 33,000 U.S. deaths in 2015, the latest year for which data is available, and estimates show the death rate has continued rising. Price has called the epidemic one of his agency’s top priorities.

The commission cited government data showing that since 1999 U.S. opioid overdoses have quadrupled, adding that nearly two thirds of U.S. drug overdoses were linked to opioids such as heroin and the powerful painkillers Percocet, OxyContin and fentanyl.

“With approximately 142 Americans dying every day, America is enduring a death toll equal to Sept. 11 every three weeks,” commission members wrote in a report. “Your declaration would empower your cabinet to take bold steps and would force Congress to focus on funding and empowering the executive branch even further to deal with this loss of life.”

So far, the White House has given no indication Trump will adopt the panel’s recommendations.

The Republican president’s initial federal budget called for a 2 percent increase in drug treatment programs and would provide funds to increase border security to stop the flow of drugs into the country.

Substance abuse treatment activists have criticized his proposed cuts to federal prevention and research programs as well as his calls to shrink Medicaid, which covers drug treatment for hundreds of thousands of Americans.

Preserving funds to confront the opioid epidemic emerged as a sticking point in congressional efforts to repeal the Affordable Care Act this year.

Republican legislation in the Senate to dismantle the Obamacare healthcare law included $45 billion for fighting the opioid epidemic, on top of the $2 billion in an earlier version of the bill, but the measure was defeated last month.

Trump is away from Washington until later this month while the White House is undergoing renovations. He and his aides have said he is maintaining a daily working schedule. Tuesday’s meeting with Price marks his first public event in days.

“I will be holding a major briefing on the Opioid crisis, a major problem for our country, today at 3:00 P.M. in Bedminster, N.J.,” Trump wrote on Twitter.

Even before the event, the Democratic National Committee slammed Trump, with spokesman Daniel Wessel saying in a statement: “Trump promised he’d come to the aid of communities ravaged by the opioid epidemic, but so far he’s done nothing for them.”

Officials from New Hampshire criticized Trump last week after a leaked transcript of a January conversation with Mexican President Enrique Pena Nieto showed that Trump had called the New England state, hard-hit by the opioid epidemic, a “drug-infested den.”

A study published on Monday in the American Journal of Preventive Medicine and led by University of Virginia researchers found that official figures issued by states on deaths caused by opioid and heroin overdoses were substantially under-reported.

The researchers examined death certificates dating from 2008 to 2014 and found that national mortality rates for opioids were 24 percent above previously reported data, and the heroin mortality rate was 22 percent higher.

(Reporting by Doina Chiacu and James Oliphant; Additional reporting by Yasmeen Abutaleb and Susan Cornwell; Editing by Will Dunham)