Plight of stranded Syrians worsens as food blocked

FILE PHOTO: Syrian refugees wait to board a Jordanian army vehicle after crossing into Jordanian territory with their families, in Al Ruqban border area, near the northeastern Jordanian border with Syria, and Iraq, near the town of Ruwaished, 240 km (149 miles) east of Amman September 10, 2015. REUTERS/Muhammad Hamed/File Photo

By Suleiman Al-Khalidi

AMMAN (Reuters) – Thousands of Syrians stranded on Jordan’s border with Syria are running out of food as routes leading to their camp are closed by the Syrian army and Jordan is blocking aid deliveries, relief workers and refugees said on Thursday.

The Syrian army has tightened its siege of the camp, in Rukban, near the northeastern Jordanian border with Syria and Iraq, preventing smugglers and traders from delivering food to its 50,000 inhabitants, mostly women and children.

“More than a week ago the Syrian regime cut all the routes of supplies towards the camp. There are now only very small amounts of food that smugglers bring,” Abu Abdullah, the head of the civil affairs council that runs the camp, told Reuters.

“The camp is a balloon that could explode at any moment because of hunger, sickness and lack of aid … if the situation continues like this there will be real starvation,” he added by phone.In the last three years, tens of thousands of people have fled to the camp from Islamic State-held parts of Syria that were being targeted by Russian and U.S.-led coalition air strikes.

Rukban is located near a U.S. garrison in southeastern Syria at Tanf on the Iraqi-Syrian border. The camp falls within a so-called deconfliction zone set up by the Pentagon with the aim of shielding the Tanf garrison from attacks by pro-Assad forces.

Damascus says the U.S. forces are occupying Syrian territory and providing a safe-haven in that area for rebels it deems terrorists.

Jordan has since the start of the year blocked any aid deliveries to the camp over its frontier and says now that the Syrian government had recovered territory around the camp, it could not be made responsible for delivering aid.

LIVES AT RISK

With Damascus intransigent, U.N. aid agencies have been pressing Jordan to let in urgent deliveries to stave off more deaths, aid workers and diplomatic sources said.

The U.N. children’s agency UNICEF warned on Thursday that without “critical action” by parties to the conflict to “allow and facilitate access” the lives of thousands of children in the camp were at risk.

“The situation for the estimated 45,000 people – among them many children – will further worsen with the cold winter months fast approaching, especially when temperatures dip below freezing point in the harsh desert conditions,” Geert Cappelaere, UNICEF regional director for Middle East and North Africa, said in a statement.

Already two more infants died in the last 48 hours, Cappelaere added. Relief workers inside the camp say a woman also died this week.

Jordan wants the United Nations and Russia to put pressure on Damascus to give the written authorizations needed to allow supplies into Rukban from Syrian government-held territory.

Jordanian Foreign Minister Ayman Safadi said recently that his country, already burdened with hundreds of thousands of refugees fleeing war-torn Syria, could not be made responsible for delivering aid to the camp.

Western diplomatic sources believe the siege of the camp is part of a Russian-backed Syrian government effort to put pressure on Washington to get out of Tanf.

(Reporting by Suleiman Al-Khalidi; Editing by Tom Perry, William Maclean)

Trader Joe’s recalls cashews amid salmonella concerns

A possible salmonella contamination has prompted Trader Joe’s to recall some cashews.

The grocery store chain issued a statement about the recall late last week, saying that one particular kind of Trader Joe’s Raw Cashew Pieces could be contaminated with the bacteria.

The cashews are marked “BEST BEFORE 07.17.2016TF4,” the company said, and were distributed to stores in 30 states across the country, as well as the District of Columbia.

It wasn’t clear exactly how many packages were included in the recall.

Trader Joe’s said it learned of the possible contamination from a supplier, but didn’t elaborate.

A recall notice on the Food and Drug Administration website says Heritage International (USA) Inc. was voluntarily recalling the cashew lot after routine lab tests found salmonella in it.

The bacteria can cause people to fall ill.

Trader Joe’s said it hasn’t received any reports of anyone getting sick from the cashews, though it has stopped selling all Trader Joe’s Raw Cashew Pieces in its stores pending an investigation.

The grocery chain encourages anyone who bought the cashews marked “BEST BEFORE 07.17.2016TF4” to return them for a full refund or throw them out without eating them.

According to the CDC, salmonella sickens about 1.2 million Americans every year. Symptoms include diarrhea, fever and abdominal cramps, and most people fully recover in 4 to 7 days. In extreme cases, though, infections can spread beyond the intestines and become more severe.

The bacteria leads to about 450 deaths and 19,000 hospitalizations every year, the CDC says. Children, older adults and people with weak immune systems are particularly at risk.

Hawaiian child born with birth defect was infected with Zika virus

A Hawaiian child who was recently born with a rare birth defect called microcephaly had been infected with the mosquito-borne Zika virus, the state Department of Health announced.

Officials made the announcement on Friday, the same day the Centers for Disease Control and Prevention (CDC) issued updated travel warnings for regions where Zika outbreaks are present.

The Zika virus usually only causes a mild illness and most people typically recover in a week, the CDC says, but the virus is collecting global attention because scientists are currently working to see if it is responsible for causing birth defects such as the one found in the Hawaiian child.

According to the CDC, children born with microcephaly have smaller-than-usual heads, and the defect may lead to other issues such as seizures, developmental delays and vision problems.

The Brazilian Ministry of Health reported a significant rise in the birth defect since the virus arrived in May. The country used to see fewer than 200 cases per year, but now has about 3,500.

The Hawaiian baby’s mother was living in Brazil last May, the state Department of Health said in a news release, and likely transmitted the virus to her child while he or she was in the womb.

Microcephaly can be caused by a variety of issues including genetic changes, malnutrition, alcohol exposure and certain kinds of infections, according to the CDC, but it’s still a relatively rare defect and only surfaces in about 2-12 babies out of every 10,000 born in the United States.

“We are saddened by the events that have affected this mother and her newborn,” Hawaii Department of Health State Epidemiologist Sarah Park said in a statement.

Hawaii health officials said neither the mother nor the child are currently at risk of transmitting Zika, nor were they ever at risk of spreading the virus throughout Hawaii. The country has yet to see a locally contracted case of Zika, the CDC has said.

However, the Hawaii Department of Health reported six people have gotten infected while visiting foreign countries and returned to the state.

The CDC on Friday sent out updated travel notices for Puerto Rico, Mexico, Central America, South America and the Caribbean, where Zika is found in local mosquitos, asking travelers — especially pregnant women — to “practice enhanced precautions” to prevent mosquito bites. Previously, the CDC had only been asking travelers to “practice usual precautions.”

There isn’t any vaccine against a Zika infection, the CDC says.

“The virus is spreading fairly rapidly throughout the Americas,” Dr. Lyle Petersen, the director of CDC’s division of vector-borne diseases, told reporters during a Friday evening news briefing, according to a transcript posted on the CDC’s website. “We know in populations that it does affect, a large percentage of the population may be become infected. And because of this growing risk of or growing evidence that there’s a link between Zika virus and microcephaly, which is a very severe and devastating outcome, it was important to warn people as soon as possible.”

Petersen told the news briefing that the CDC recently found its “strongest scientific evidence to date” of a link between Zika and “poor pregnancy outcomes” like microcephaly, but more tests and studies were needed to determine the risks the Zika virus may pose to pregnant women.

Common symptoms of Zika include fever, joint pain and rash, the CDC says. However, Petersen told the news briefing that only 1 in 5 people infected with the virus will display those symptoms.

Petersen also told reporters there have been at least eight United States travelers who tested positive for Zika after traveling overseas in the past 15 months, compared to just 12 who tested positive for the virus between 2007 and 2014. And the CDC is also still receiving samples from people displaying symptoms, so that number could increase as more test results come back.

While the specific kind of mosquito that transmit the virus are present in parts of the United States, Petersen told reporters that improvements in housing construction, air conditioning and mosquito control have helped prevent large outbreaks of other mosquito-borne illnesses.

He told the news briefing it would be difficult to determine exactly how Zika may spread in the coming months.

“I think we’re just going to have to wait to see how this all plays out,” he told reporters. “These viruses certainly can spread in populations for some time. But, again, this is new. This is a dynamic and changing situation. I think it’s really impossible for us to speculate what may happen in three or four or even next month for that matter.”

Separately, Hawaii is dealing with another outbreak of a mosquito-borne illness.

The state Department of Health says there have been 223 cases of dengue fever since Sept. 11. It’s the first locally-acquired outbreak of the disease since 2011.

The World Health Organization says dengue, which can cause fevers, headaches, muscle and joint pains and rashes, has become increasingly common in the past 50 years — spreading to more than 100 countries and placing about half the world’s population at risk of an infection.

French drug trial disaster leaves one brain dead, five injured

PARIS (Reuters) – One person has been left brain dead and five others have been hospitalized after taking part in a clinical trial in France of an experimental drug made by Portuguese drug company Bial, French Health Minister Marisol Touraine said on Friday.

In total, 90 people have taken part in the trial, taking some dosage of the drug aimed at tackling mood and anxiety issues, as well as movement coordination disorders linked to neurological issues, Touraine said.

The six men aged 28 to 49 had been in good health until taking the oral medication at the Biotrial private facility that specializes in clinical trials, she said.

“This is unprecedented,” Touraine told a news conference after meeting volunteers and their families in Rennes, western France. “We’ll do everything to understand what happened.”

Prosecutors have opened an investigation into the case.

The six men started taking the drug on Jan. 7. The brain-dead volunteer was admitted to hospital on Monday, the minister said.

For three of the five others – who went in on Wednesday and Thursday – there are fears of irreversible handicap, doctor Gilles Edan said, though he still hoped that would not be the case. One of the six had no symptoms but was being carefully monitored, he said.

Testing had already been carried out on animals, including chimpanzees, starting in July, Touraine said.

All trials on the drug have now been suspended and all volunteers who have taken part in the trial are being called back, the health ministry added.

The medicine involved is a so-called FAAH inhibitor that works by targeting the body’s endocannabinoid system, which is also responsible for the human response to cannabis.

Bial said in a statement it was committed to ensuring the wellbeing of test participants and was working with authorities to discover the cause of the injuries, adding that the clinical trial have been approved by French regulators.

The company said five people, rather than six, had been hospitalized, including one left brain dead, without explaining the discrepancy with the official French figures.

Cases of early-stage clinical trials going badly wrong are rare but not unheard of. In 2006, six healthy volunteers given an experimental drug in London ended up in intensive care. One was described as looking like “the elephant man” after his head ballooned. Another lost his fingertips and toes.

“INHERENT RISK”

In the initial Phase I stage of clinical testing, a drug is given to healthy volunteers to see how it is handled by the body and what is the right dose to give to patients.

“Undertaking Phase 1 studies is highly specialist work,” said Daniel Hawcutt, a lecturer in clinical pharmacology at Britain’s University of Liverpool.

Medicines then go into larger Phase II and Phase III trials to assess their effectiveness and safety before they are finally approved for sale.

Europe has strict regulations governing the conduct of clinical trials, with Phase I tests subject to particular scrutiny. But Ben Whalley, a professor of neuropharmacology at the University of Reading, said these could only minimize risks, not abolish them.

“There is an inherent risk in exposing people to any new compound,” he said.

The 2006 London trial led to the collapse of Germany’s TeGenero, the company developing a medicine known as TGN1412. The drug has since gone back into tests for rheumatoid arthritis and is showing promise when given at a fraction of the original dose.

(Additional reporting by Ben Hirschler, John Irish, Noelle Mennella; Writing by Ben Hirschler and Ingrid Melander; Editing by Michel Rose and Andrew Heavens)

Chipotle hit with federal subpoena over California norovirus outbreak

(Reuters) – Chipotle Mexican Grill Inc <CMG.N>, under scrutiny for months over outbreaks of foodborne illness across several U.S. states, said on Wednesday it was served with a subpoena in a federal criminal probe linked to a norovirus case in California last year.

Shares of the burrito chain fell more than 5 percent to $424.95, their lowest in more than two years, as the Denver-based company grapples with a wave of norovirus and E. coli outbreaks that have sickened customers and battered sales.

The company in a filing also projected a 14.6 percent plunge in fourth-quarter same-store sales, compared with a previously estimated 8-11 percent drop, which would be the first such decline in the company’s history.

Chipotle said it received the subpoena as a part of a criminal investigation by the U.S. Department of Justice and the Food and Drug Administration. A federal grand jury will decide whether to press charges in the case.

Norovirus is the leading cause of food-related illnesses and outbreaks in the United States, often occurring when infected restaurant employees and food workers touch raw ingredients before serving. The highly contagious virus can cause vomiting and diarrhea.

The investigation announced on Wednesday is the latest headache for the company, which has seen sales slump after an E. coli outbreak sickened more than 50 people in nine states in October and November.

That outbreak was followed by a norovirus incident at a restaurant in Brighton, Massachusetts the week of Dec. 7, in which 120 Boston College students fell ill.

BROAD RANGE OF DOCUMENTS

Chipotle said the subpoena was served in December. It requires the company to produce a broad range of documents related to the August norovirus incident at its restaurant in Simi Valley, California, which sickened more than 200 people, including 18 workers.

In September, two California residents sued Chipotle for damages in U.S. court after they said they became sick from eating at the Simi Valley location.

Alyssa McDonald vomited repeatedly, developed “explosive diarrhea,” and suffered chest pains after eating at restaurant, according to court documents. Another customer said she had to go to a hospital emergency room for days.

The Ventura County Health Department found her stool tested positive for norovirus, the lawsuit said.

Ventura County health official Doug Beach said his office was interviewed by the FDA and U.S. Attorney’s office in the fall. Authorities, he said, focused their lines of enquiry squarely on Chipotle.

A federal investigation into a one-restaurant outbreak is surprising since there wasn’t a clear interstate element, said Bill Marler, a Seattle-based lawyer who is representing customers saying they were sickened in Simi Valley.

The FDA declined to comment specifically on the investigation. The U.S. Attorney’s office declined to comment, as did Chipotle spokesman Chris Arnold.

Chipotle said same-store sales were trending down 16 percent at the onset of December but fell 34 percent after the Brighton incident and the subsequent national media attention it garnered.

Overall same-restaurant sales for December were down 30 percent, the company said.

Any more incremental bad news, particularly if there is an unfavorable decision from the grand jury, could trigger consideration among shareholders of a management change, Maxim Group analyst Stephen Anderson said.

The company, which also announced a $300 million share buyback, said it will fully cooperate with the probe.

The company’s shares have fallen nearly 30 percent since Oct. 31, when the first E. coli outbreak was reported.

(Reporting by Siddharth Cavale and Subrat Patnaik in Bengaluru, Sarah N. Lynch in Washington, and Tom Polansek in Chicago; Writing and additional reporting by Eric M. Johnson in Seattle; Editing by Don Sebastian and Meredith Mazzilli)

Hawaii Reports Additional Cases of Dengue Fever

The number of people infected with dengue fever in Hawaii is climbing, officials said Monday.

The Hawaii Department of Health reported that it was investigating 167 total cases of the mosquito-borne illness, which can lead to fatal consequences in extreme cases. There were 122 confirmed dengue cases as of Dec. 2, signifying 45 additional infections in about three weeks.

State health officials said only three of the 167 cases are currently infectious. The other people got sick between Sept. 11 and Dec. 10, so they are no longer at risk of transmitting the disease.

The health department also reported there were 659 additional potential dengue infections that had been ruled out, either through test results or the illnesses failing to meet the case criteria.

Dengue isn’t endemic (regularly found) in Hawaii, though health officials said it can occasionally be brought in from travelers who got infected in endemic regions. But this latest outbreak on the Big Island is unique because it’s the first cluster of locally acquired cases since 2011, when Centers for Disease Control and Prevention (CDC) records indicate five people got sick in Oahu.

According to the World Health Organization (WHO), an arm of the United Nations, dengue is transmitted when an infected mosquito bites a human. The infection generates a flu-like illness — from which most people usually recover within a week — though it sometimes progresses to severe dengue. In those instances, people can suffer organ impairment and severe bleeding.

The WHO estimates severe dengue hospitalizes about 500,000 people per year, and about 2.5 percent of them die. Dengue is much more common, with some estimates indicating as many as 136 million people falling ill every year, but non-severe cases of the disease are rarely ever fatal. Symptoms can include severe headaches, swollen glands, joint and muscle pain and a high fever.

The Hawaii outbreak reflects a global trend in which dengue is spreading to new locales.

The WHO reports the disease was traditionally found in the tropics and subtropics, but it’s now endemic in more than 100 countries and about half the world’s population is at risk of infection. Still, early detection and access to good medical care keeps the mortality rate below 1 percent. Without those, the WHO says severe dengue can be fatal in more than 20 percent of cases.

Hawaii health officials say it’s still safe to visit the island. The department encourages travelers to use insect repellant and wear long sleeves and pants to help prevent mosquitos from biting.