Yemen’s cholera epidemic likely to intensify in coming months: WHO

FILE PHOTO: A nurse walks by women being treated at a cholera treatment center in the Red Sea port city of Hodeidah, Yemen October 8, 2017. REUTERS/Abduljabbar Zeyad

RIYADH (Reuters) – The World Health Organization warned on Monday that a cholera epidemic in Yemen that killed more than 2,000 people could flare up again in the rainy season.

WHO Deputy Director General for Emergency Preparedness and Response Peter Salama said the number of cholera infections had been in decline in Yemen over the past 20 weeks after it hit the 1 million mark of suspected cases.

“However, the real problem is we’re entering another phase of rainy seasons,” Salama told Reuters on the sidelines of an international aid conference in Riyadh.

“Usually cholera cases increase corresponding to those rainy seasons. So we expect one surge in April, and another potential surge in August.”

A proxy war between Iran-aligned Houthis and the internationally recognized government of President Abd-Rabbu Mansour Hadi, which is backed by a Saudi-led alliance, has killed more than 10,000 people since 2015, displaced more than 2 million and destroyed much of the country’s infrastructure, including the health system.

Yemen relies heavily on food imports and is on the brink of famine. The United Nations says more than 22 million of Yemen’s 25 million population need humanitarian assistance, including 11.3 million who are in acute need.

Salama said the country had also had an outbreak of diphtheria, a vaccine-preventable disease that usually affects children and which has largely been eliminated in developed countries.

Both cholera and diphtheria outbreaks are a product of the damage to the health system in the country, he said, adding that less than half of Yemen’s health facilities are fully functioning.

“We’re very concerned we’re going to go from a failing health system to a failed one that’s going to spawn more infectious diseases and more suffering,” Salama said.

However, Salama said that despite more than 2,000 deaths from cholera, the fatality rate has been low, at around 0.2 to 0.3 percent.

The WHO has approval from the government for vaccination campaigns and is working on ensuring all parties to the conflict implement the plan, he added.

(Reporting by Sarah Dadouch; Editing by Alison Williams)

Polio outbreak in Syria poses vaccination dilemma for WHO

A health worker administers polio vaccination to a child in Raqqa, eastern Syria November 18, 2013. REUTERS/Nour Fourat

GENEVA (Reuters) – Vaccinating too few children in Syria against polio because the six-year-old war there makes it difficult to reach them risks causing more cases in the future, the World Health Organization (WHO) said on Friday, posing a dilemma after a recent outbreak.

Two children have been paralyzed in the last few months in Islamic State-held Deir al-Zor in the first polio cases in Syria since 2014 and in the same eastern province bordering Iraq where a different strain caused 36 cases in 2013-2014.

Vaccinating even 50 percent of the estimated 90,000 children aged under 5 in the Mayadin area of Deir al-Zor would probably not be enough to stop the outbreak and might actually sow the seeds for the next outbreak, WHO’s Oliver Rosenbauer said.

Immunisation rates need to be closer to 80 percent to have maximum effect and protect a population, he told a briefing.

“Are we concerned that we’re in fact going to be seeding further future polio vaccine-derived outbreaks? … Absolutely, that is a concern. And that is why this vaccine must be used judiciously and to try to ensure the highest level of coverage,” Rosenbauer said.

“This is kind of what has become known as the OPV, the oral polio vaccine paradox,” he said.

The new cases are a vaccine-derived poliovirus type 2, a rare type which can emerge in under-immunised communities after mutating from strains contained in the oral polio vaccine.

“Such vaccine-derived strains tend to be less dangerous than wild polio virus strains, they tend to cause less cases, they tend not to travel so easily geographically. That’s all kind of the silver lining and should play in our favor operationally,” he said.

All polio strains can paralyze within hours.

Syria is one of the last remaining pockets of the virus worldwide. The virus remains endemic in Afghanistan and Pakistan.

(Reporting by Stephanie Nebehay; Editing by Louise Ireland)

Colombia starts to bury 273 landslide victims, search continues

New coffins for reburials, are seen in a cemetery after flooding and mudslides caused by heavy rains leading several rivers to overflow, pushing sediment and rocks into buildings and roads, in Mocoa, Colombia April 3, 2017. REUTERS/Jaime Saldarriaga

MOCOA, Colombia (Reuters) – Scores of decomposing cadavers were being released for burial on Monday as rescuers continued to search for victims of weekend flooding and landslides that devastated a city in southern Colombia, killing at least 273 people.

Desperate families queued for blocks in the heat to search a morgue for loved ones who died when several rivers burst their banks in the early hours of Saturday, sending water, mud and debris crashing down streets and into houses as people slept.

Bodies wrapped in white sheets lay on the concrete floor of the morgue as officials sought to bury them as soon as possible to avoid the spread of disease. The government has begun vaccination against infection.

“Please speed up delivery of the bodies because they are decomposing,” said Yadira Andrea Munoz, a 45-year-old housewife who expected to receive the remains of two relatives who died in the tragedy.

But officials asked for families to be patient.

“We don’t want bodies to be delivered wrongly,” said Carlos Eduardo Valdes, head of the forensic science institute.

The death toll has ticked up during the day as rescuers searched with dogs and machinery in the mud-choked rubble.

Aerial view of a neighborhood destroyed after flooding and mudslides caused by heavy rains leading several rivers to overflow, pushing sediment and rocks into buildings and roads, in Mocoa, Colombia April 3, 2017. REUTERS/Jaime Saldarriaga

Aerial view of a neighborhood destroyed after flooding and mudslides caused by heavy rains leading several rivers to overflow, pushing sediment and rocks into buildings and roads, in Mocoa, Colombia April 3, 2017. REUTERS/Jaime Saldarriaga

Many families in Mocoa have spent days and nights digging through the debris with their hands despite a lack of food, clean water and electricity.

President Juan Manuel Santos, who made a third visit to the area on Monday, blamed climate change for the disaster, saying Mocoa had received one-third of its usual monthly rain in just one night, causing the rivers to burst their banks.

Others said deforestation in surrounding mountains meant there were few trees to prevent water washing down bare slopes.

More than 500 people were staying in emergency housing and social services had helped 10 lost children find their parents. As many as 43 children were killed.

Families of the dead will receive about $6,400 in aid and the government will cover hospital and funeral costs.

Even in a country where heavy rains, a mountainous landscape and informal construction combine to make landslides a common occurrence, the scale of the Mocoa disaster was daunting compared with recent tragedies, including a 2015 landslide that killed nearly 100 people.

Colombia’s deadliest landslide, the 1985 Armero disaster, killed more than 20,000 people.

Santos urged Colombians to take precautions against flooding and continued rains.

Flooding in Peru last month killed more than 100 people and destroyed infrastructure.

(Reporting by Andres Rojas, Helen Murphy Luis Jaime Acosta and Jaime Saldarriaga; Editing by James Dalgleish and Lisa Shumaker)

Congo declares yellow fever epidemic, 1,000 suspected cases

residents reading reports of yellow fever

KINSHASA (Reuters) – Democratic Republic of Congo on Monday declared a yellow fever epidemic in three provinces, including the capital Kinshasa, after confirming 67 cases of the disease, with another 1,000 suspected cases being monitored.

Health Minister Felix Kabange said only seven of the proven cases were indigenous to the Central African country, while 58 were imported from Angola, where the outbreak began. A further two cases came from remote forested areas not linked to the current outbreak. Five people in total have died, Kabange added.

“I declare today a localized epidemic of yellow fever in the provinces of Kinshasa, Kongo Central and Kwango,” Kabange told a news conference.

Kinshasa is the primary concern for global health officials since it has a densely-packed population of more than 12 million and poor healthcare infrastructure.

Yellow fever is transmitted by the same mosquitoes that spread the Zika and dengue viruses, although it is a much more serious disease. The “yellow” in the name refers to the jaundice that affects some infected patients.

The global stockpile of vaccines has already been depleted twice this year to immunize people in Angola, Uganda and Congo. It stands at 6 million doses, but this may not be enough if there are simultaneous outbreaks in multiple highly-populated areas, experts warn.

Almost 18 million doses have been distributed for emergency vaccination campaigns so far in the three African countries.

The current method for making vaccines, using chicken eggs, takes a year.

World Health Organisation (WHO) advisers have recommended using a fifth of the standard dose of vaccine in the event of a global shortage – enough to immunize temporarily but not to give lifelong immunity.

“An epidemic in such a large city (as Kinshasa) is always difficult to handle,” said WHO’s Congo representative Yokouide Allarangar.

A vaccination campaign has been staged in two of the city’s health zones deemed as high risk because the virus is circulating but is not linked to imported cases, he said.

“We need to quickly try to contain these zones where the virus circulates to prevent the disease from spreading to other zones,” he said, adding that a million of the city’s residents have been vaccinated so far.

Manufacturers of the vaccine include the Institut Pasteur, government factories in Brazil and Russia as well as French drugmaker Sanofi.

Congo’s outbreak, since January, comes at a time when political tensions linked to an upcoming presidential election and an economic crisis stoked by a slump in global commodity prices is already putting a huge strain on the country’s stability.

President Joseph Kabila is facing opposition, which has sometimes turned violent, amid concerns that he will try to cling to power beyond the expiry of his mandate at year-end.

(Writing by Tim Cocks; editing by Matthew Mpoke Bigg and G Crosse)