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WHO says Congo faces ‘very high’ risk from Ebola outbreak

FILE PHOTO: Congolese Health Ministry officials carry the first batch of experimental Ebola vaccines in Kinshasa, Democratic Republic of Congo May 16, 2018. REUTERS/Kenny Katombe/File Photo

By Tom Miles and Fiston Mahamba

GENEVA/KINSHASA (Reuters) – Democratic Republic of Congo faces a “very high” public health risk from Ebola because the disease has been confirmed in a patient in a big city, the World Health Organization (WHO) said on Friday, raising its assessment from “high” previously.

The risk to countries in the region was now “high”, raised from “moderate”, but the global risk remained “low”, the WHO said.

The reassessment came after the first confirmed case in Mbandaka, a city of around 1.5 million on the banks of the Congo River in the northwest of the country.

The case raised concerns that the virus, previously found in more rural areas, would be tougher to contain and could reach downstream to the capital Kinshasa, which has a population of 10 million.

It also followed the announcement by Congo’s health ministry of 11 newly confirmed cases in the smaller town of Bikoro, near the northwest village where the virus was first detected.

“The confirmed case in Mbandaka, a large urban center located on major national and international river, road and domestic air routes, increases the risk of spread within the Democratic Republic of the Congo and to neighboring countries,” the WHO said.

WHO Deputy Director-General for Emergency Preparedness and Response Peter Salama had told reporters on Thursday that the risk assessment was being reviewed.

“Urban Ebola is a very different phenomenon to rural Ebola because we know that people in urban areas can have far more contacts so that means that urban Ebola can result in an exponential increase in cases in a way that rural Ebola struggles to do.”

Later on Friday, the WHO will convene an Emergency Committee of experts to advise on the international response to the outbreak, and decide whether it constitutes a “public health emergency of international concern”.

The nightmare scenario is an outbreak in Kinshasa, a crowded city where millions live in unsanitary slums not connected to a sewer system.

Jeremy Farrar, an infectious disease expert and director of the Wellcome Trust global health charity, said the outbreak had “all the features of something that could turn really nasty”.

“As more evidence comes in of the separation of cases in space and time, and healthcare workers getting infected, and people attending funerals and then traveling quite big distances – it’s got everything we would worry about,” he told Reuters.

WHO spokesman Tarik Jasarevic said on Friday that Congo’s Ministry of Health had provided updated figures: 45 cases overall since April 4, including 14 confirmed, 10 suspected and 21 probable. There had been 25 deaths, but no new infections among healthworkers, Jasarevic told reporters.

The WHO is sending 7,540 doses of an experimental vaccine to try to stop the outbreak in its tracks, and 4,300 doses have already arrived in Kinshasa. It will be used to protect health workers and “rings” of contacts around each case.

The vaccine supplies will be enough to vaccinate 50 rings of 150 people, the WHO said. Each ring represents the number of people including health workers who may have come into contact with an Ebola patient.

As of 15 May, 527 contacts had been identified and were being followed up and monitored.

(This story corrects to clarify location of Mbandaka.)

(Additional reporting by Kate Kelland in London; Writing by Tom Miles and Edward McAllister; Editing by Matthew Mpoke Bigg)

WHO says 19 dead, 39 infected so far in Congo Ebola outbreak

A health worker is sprayed with chlorine after visiting the isolation ward at Bikoro hospital, which received a new suspected Ebola case, in Bikoro, Democratic Republic of Congo May 12, 2018. REUTERS/Jean Robert N'Kengo

GENEVA (Reuters) – Democratic Republic of Congo reported 39 suspected, probable or confirmed cases of Ebola between April 4 and May 13, including 19 deaths, the World Health Organization said on Monday.

It said 393 people who identified as contacts of Ebola patients were being followed up. Information about the outbreak in Bikoro, Iboko and Wangata health zones in Equateur province was still limited, the WHO said in a statement.

At present the outbreak did not meet the criteria for declaring a “public health event of international concern”, which would trigger the formation of an emergency WHO committee.

(Reporting by Tom Miles, Editing by William Maclean)

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)

Missiles ‘will be coming’ to Syria, Trump warns Russia

A man walks with his bicycle at a damaged site in the besieged town of Douma, Eastern Ghouta, in Damascus, Syria March 30, 2018. REUTERS/Bassam Khabieh

By Susan Heavey, Makini Brice and Tom Perry

WASHINGTON/BEIRUT (Reuters) – U.S. President Donald Trump warned Russia on Wednesday of imminent military action in Syria over a suspected poison gas attack, declaring that missiles “will be coming” and lambasting Moscow for standing by Syrian President Bashar al-Assad.

Trump was reacting to a warning from Russia on Tuesday that any U.S. missiles fired at Syria over the deadly assault on a rebel enclave would be shot down and the launch sites targeted.

“Russia vows to shoot down any and all missiles fired at Syria. Get ready Russia, because they will be coming, nice and new and ‘smart!’,” Trump wrote in a post on Twitter.

“You shouldn’t be partners with a Gas Killing Animal who kills his people and enjoys it!” Trump tweeted, referring to Moscow’s alliance with Assad.

In response, Russia’s Foreign Ministry said in a Facebook post that “smart missiles should fly towards terrorists, not towards the lawful government”.

Foreign Ministry spokeswoman Maria Zakharova said any U.S. missile strike could be an attempt to destroy evidence of the reported gas attack in the Syrian town of Douma, for which Damascus and Moscow have denied any responsibility.

In Damascus, the foreign ministry accused the United States, which has supported some rebel groups in the Syrian civil war, of using “fabrications and lies” as an excuse to hit its territory.

“We are not surprised by such a thoughtless escalation by a regime like the United States regime, which sponsored terrorism in Syria and still does,” the state news agency SANA cited an official source in the ministry as saying.

After the Douma attack, the insurgent group dug in there – Jaish al-Islam – finally agreed to withdraw. That sealed a major victory for Assad in the war, crushing a protracted rebellion in the eastern Ghouta region near the capital Damascus.

White House officials did not immediately reply to a Reuters request for more detail about Trump’s remarks. The U.S. Defense Department said it “does not comment on potential future military actions”.

Trump’s decision to disclose his decision to strike as well as the kind of weaponry to be used in a future military operation is likely to frustrate military planners, who hold such information closely.

He had repeatedly said he would not telegraph military moves toward foes, including North Korea and Islamic State. On Monday Trump said he would make a decision within 48 hours on a strong, forceful response to the attack in Syria, later telling reporters: “When I will not say, because I don’t like talking about timing.”

43 DEAD FROM CHEMICAL WEAPONS EXPOSURE -WHO

The World Health Organization said on Wednesday that 43 people had died in Saturday’s attack on Douma from “symptoms consistent with exposure to highly toxic chemicals”, and more than 500 in all had been treated.

Moscow’s threat to down U.S. missiles came from its ambassador to Lebanon, Alexander Zasypkin, who said he was referring to a statement by President Vladimir Putin and the Russian armed forces chief of staff.

Zasypkin also said that any hostilities with Washington should be avoided and Moscow was ready for negotiations.

But his remarks could raise fears of direct conflict for the first time between major powers backing opposing sides in Syria’s protracted civil war.

Oil prices hit their highest level in more than three years on Wednesday after Trump’s threat to unleash missiles, and U.S. stock index futures fell sharply over rising concern about possible Russian-U.S. conflict over Syria.

The Kremlin said earlier on Wednesday it hoped all sides involved in Syria would avoid doing anything to destabilize an already volatile situation in the Middle East, and made clear it strongly opposed any U.S. strike on Damascus.

STANDOFF

Moscow and Washington stymied attempts by each other at the United Nations Security Council on Tuesday to set up international investigations into chemical weapons attacks in Syria.

Trump canceled on Tuesday a planned trip to Latin America later this week to focus instead on talks with Western allies about possible military action to punish Assad.

Zasypkin, the Russian ambassador, made his comments to Hezbollah’s al-Manar TV. “If there is a strike by the Americans, then … the missiles will be downed and even the sources from which the missiles were fired,” he said in Arabic.

The Russian military said on March 13 that it would respond to any U.S. strike on Syria by targeting any missiles and launchers involved. Russia is Assad’s most powerful ally and its devastating air power has helped him wrest back large areas of territory from rebels since 2015.

Zasypkin also said a clash between Russia and the United States over Syria “should be ruled out and therefore we are ready to hold negotiations”.

MISSILE SALVO FROM MEDITERRANEAN?

Any U.S. strike is likely to involve the navy, given the risk to aircraft from Russian and Syrian air defence systems. A U.S. Navy guided-missile destroyer, the USS Donald Cook, is in the Mediterranean.

With tensions growing, pan-European air traffic control agency Eurocontrol warned airlines to exercise caution in the eastern Mediterranean due to the possible launch of air strikes into Syria over the next 72 hours.

Eurocontrol said that air-to-ground and cruise missiles could be used within that period and there could be intermittent disruptions of radio navigation equipment.

Aviation regulators have been stepping up monitoring of conflict zones since Malaysia Airlines flight MH17 was downed by a surface-to-air missile over Ukraine in 2014, killing all 298 people on board. Recent warnings have tended to be after military action has started, so Eurocontrol’s pre-emptive notice suggests a heightening of regulatory scrutiny.

Both Russia and Iran, Assad’s other main ally, have warned his enemies against military action in recent days, underlining their commitment to the Syrian government they have armed and supported through years of conflict.

Ali Akbar Velayati, the top adviser to Iranian Supreme Leader Ayatollah Ali Khamenei, said during a visit to Damascus on Tuesday that an Israeli attack on an air base in Syria earlier this week would “not remain without response”.

Members of Syrian forces of President Bashar al Assad stand guard near destroyed buildings in Jobar, eastern Ghouta, in Damascus, Syria April 2, 2018. REUTERS/Omar Sanadiki/File Photo

RISK OF “UNCONTROLLABLE ESCALATION”

On Monday, U.N. Syria peace envoy Staffan de Mistura cited the air base strike along with other recent events in Syria in a briefing to the Security Council, cautioning against a “situation of uncontrollable escalation”.

Syria’s Russian-supplied air defences shot down an Israeli F-16 jet in February during a previous bombing run against what Israel described as Iranian-backed positions in Syria.

Last year, the United States carried out strikes from two Navy destroyers against a Syrian air base after another toxic gas attack on a rebel-controlled pocket.

The U.S. and Russian militaries have sought to avoid conflict in Syria, notably last year in the Euphrates River Valley where they supported rival sides in the campaign against Islamic State militants.

However, U.S. forces in February killed or injured hundreds of Russian contractors fighting on Assad’s side during a confrontation in Deir al-Zor province.

SYMPTOMS OF POISON GAS ATTACK

The WHO said that among the more than 500 people treated for symptoms of gas poisoning in Douma, “there were signs of severe irritation of mucous membranes, respiratory failure and disruption to central nervous systems of those exposed”.

France and Britain discussed with the Trump administration how to respond to the Douma attack. Both stressed that the culprit still needed to be confirmed.

The Hague-based Organisation for the Prohibition of Chemical Weapons said Assad’s government had been asked to make necessary arrangements for an OPCW investigation team to visit shortly.

The mission will aim to determine whether banned munitions were used but not assign blame.

Despite the international revulsion over chemical weapons attacks, the death toll from such incidents in Syria is only a fraction of the hundreds of thousands of combatants and civilians killed since the war erupted in 2011.

(Additional reporting by Dahlia Nehme in Beirut, Michelle Nichols at the United Nations, Andrew Osborn and Maria Kiselyova in Moscow, Anthony Deutsch in Amsterdam, Steve Holland, Idrees Ali, Mark Hosenball and Patricia Zengerle in Washington, Jamie Freed in Singapore, Stephanie Nebehay in Geneva; Writing by Mark Heinrich; Editing by David Stamp)

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)

United Nations hopes imports will help stave off famine in Yemen as diphtheria spreads

A nurse holds a premature baby in an incubator at the child care unit of a hospital in Sanaa, Yemen January 16, 2018.

By Stephanie Nebehay

GENEVA (Reuters) – United Nations aid agencies called on Tuesday for the Yemeni port of Hodeidah to remain open beyond Friday, the date set by a Saudi-led military coalition, to permit continued delivery of life-saving goods.

Yemen is the world’s worst humanitarian crisis, where 8.3 million people are entirely dependent on external food aid and 400,000 children suffer from severe acute malnutrition, a potentially lethal condition, they said.

The Arab coalition, under international pressure, eased a three-week blockade which was imposed on Yemeni ports and airports in November in response to a ballistic missile fired by the Houthi movement toward the Saudi capital Riyadh.

Four mobile cranes arrived in the important Houthi-controlled Hodeidah port, the U.N. said on Monday, after the coalition agreed to let them into Yemen, where nearly three years of war have pushed it to the verge of famine.

“The port in theory is going be open to the 19th of this month. Then we don’t know if the coalition will close or (leave) it open,” Meritxell Relano, U.N. Children’s Fund (UNICEF) Representative in Yemen, told a news briefing in Geneva.

“Obviously the feeling is that they extend this period so that the commercial goods can come in, but especially the fuel,” she said, speaking from the capital Sanaa.

Before the conflict, Hodeidah port handled around 70 percent of Yemen’s imports, including food and humanitarian supplies.

Fuel is vital to power water and sanitation stations to provide clean water and help avoid diseases, she said.

More than 11 million Yemeni children – virtually all – need humanitarian assistance, Relano said. UNICEF figures show 25,000 Yemeni babies die at birth or before the age of one month.

A child lies in a bed at a hospital in Sanaa, Yemen January 16, 2018. REUTERS/Khaled Abdullah

“Yemen is in the grips of the world’s biggest hunger crisis,” World Food Programme (WFP) spokeswoman Bettina Luescher said. “This is a nightmare that is happening right now.”

“We appeal to parties on (the) ground in order to stave off famine that we can continue regularly to get food in, to get medicines in, to get fuel in, be it from the humanitarian or the commercial side,” she said.

Luescher, asked about prospects for the Hodeidah port lifeline to remain open, replied: “Obviously since the cranes were imported and are operational, we are hopeful and optimistic that our work can continue.”

A diphtheria outbreak in Yemen is “spreading quickly”, with 678 cases and 48 associated deaths in four months, Fadela Chaib of the World Health Organisation said.

The number of cases has doubled since Dec 22, when the WHO reported 333 people affected by the highly-contagious disease, with 35 deaths. Ibb and Hodeidah are the worst-hit of the 19 affected governorates, Chaib said.

“We can stop the outbreak by providing antibiotics and also vaccinating,” she said. Some 2.5 million doses have been imported for a planned immunization campaign, she said.

(Reporting by Stephanie Nebehay; Editing by Larry King, William Maclean)

Suspected cholera cases in Yemen hit 1 million: Red Cross

A health worker reviews a list of patients admitted to a cholera treatment center in Sanaa, Yemen

DUBAI (Reuters) – The number of suspected cholera cases in Yemen has hit 1 million, the International Committee of the Red Cross said on Thursday, as war has left more than 80 percent of the population short of food, fuel, clean water and access to healthcare.

Yemen, one of the Arab world’s poorest countries, is in a proxy war between the Houthi armed movement, allied with Iran, and a U.S.-backed military coalition headed by Saudi Arabia.

The United Nations says it is suffering the world’s worst humanitarian crisis. The World Health Organization has recorded 2,219 deaths since the cholera epidemic began in April, with children accounting for nearly a third of infections.

Cholera, spread by food or water contaminated with human faeces, causes acute diarrhea and dehydration and can kill within hours if untreated. Yemen’s health system has virtually collapsed, with most health workers unpaid for months.

On Dec 3, the WHO said another wave of cholera could strike within months after the Saudi-led coalition closed air, land and sea access, cutting off fuel for hospitals and water pumps and aid supplies for starving children.

The ports were closed in retaliation for a missile fired from Yemen by the Houthis. On Wednesday, despite a fresh missile attack on Riyadh, Saudi Arabia said it would allow the Houthi-controled port of Hodeidah, vital for aid, to stay open for a month.

(Reporting by Sylvia Westall; Editing by Kevin Liffey)

Philippines orders probe into Sanofi dengue vaccine for 730,000 children

Concepcion Yusop, a national immunization program manager, shows an anti-dengue vaccine Dengvaxia inside a vaccine storage room in Sta. Cruz city, Metro Manila, Philippines December 4, 2017.

By Manolo Serapio Jr and Neil Jerome Morales

MANILA (Reuters) – The Philippines ordered an investigation on Monday into the immunization of more than 730,000 children with a vaccine for dengue that has been suspended following an announcement by French drug company Sanofi that it could worsen the disease in some cases.

The World Health Organization said it hoped to conduct a full review by year-end of data on the vaccine, commercially known as Dengvaxia. In the meantime, the WHO recommended that it only be used in people who had a prior infection with dengue.

The government of Brazil, where dengue is a significant health challenge, confirmed it already had recommended restricted use of the vaccine but had not suspended it entirely.

Amid mounting public concern, Sanofi explained its “new findings” at a news conference in Manila but did not say why action was not taken after a WHO report in mid-2016 that identified the risk it was now flagging.

A non-governmental organization (NGO) said it had received information that three children who were vaccinated with Dengvaxia in the Philippines had died and a senator said he was aware of two cases.

However, Department of Health Undersecretary Gerardo Bayugo told Reuters the three referred to by the NGO died due to causes not related to the vaccine and Sanofi said no deaths had been reported as a result of the program.

“As far as we know, as far as we are made aware, there are no reported deaths that are related to dengue vaccination,” said Ruby Dizon, medical director at Sanofi Pasteur Philippines.

Last week, the Philippines Department of Health halted the use of Dengvaxia after Sanofi said it must be strictly limited due to evidence it can worsen the disease in people not previously exposed to the infection.

In a statement, Sanofi said the long-term safety evaluation of the vaccines showed significantly fewer hospitalizations due to dengue in vaccinated people over 9 years old compared with those who had not been vaccinated.

Nearly 734,000 children aged 9 and over in the Philippines have received one dose of the vaccine as part of a program that cost 3.5 billion pesos ($69.54 million).

The Department of Justice on Monday ordered the National Bureau of Investigation to look into “the alleged danger to public health … and if evidence so warrants, to file appropriate charges thereon.”

There was no indication that Philippines health officials knew of any risks when they administered the vaccination.

However, the WHO said in a July 2016 research paper that “vaccination may be ineffective or may theoretically even increase the future risk of hospitalized or severe dengue illness in those who are seronegative at the time of first vaccination regardless of age.”

Singapore’s Health Sciences Authority said last week that it flagged risks when Dengvaxia was approved there in October 2016, and was working with Sanofi to strengthen risk warnings on the drug’s packaging.

According to Sanofi in Manila, 19 licences were granted for Dengvaxia, and it was launched in 11 countries, two of which – the Philippines and Brazil – had public vaccination programs.

Brazil’s healthcare regulator Anvisa said in a statement that it now recommends that people who have never been infected with dengue not take the vaccine, which was approved for use in Brazil at the end of 2015.

It was not known whether many people have taken the vaccine, if it was part of any government immunization program or if any illnesses or deaths linked to the drug have been reported to the government.

Anvisa did not immediately respond to a request for comment, nor did the Health Ministry.

A spokesman for Sanofi in Paris was not immediately available for comment. “A SHAMELESS SCAM” A spokesman for Philippines President Rodrigo Duterte said on Sunday the government would hold to account those responsible for the program.

Former Health Secretary Janette Garin, who implemented the program under the administration of then-President Benigno Aquino, said she welcomed the investigation.

“In the event that there will be authorities who will point culpability to me, I am ready to face the consequences,” she told ANC TV. “We implemented it in accordance with WHO guidance and recommendations.”

Presidential spokesman Harry Roque said there had been no reported case of severe dengue infection since the vaccine was administered and urged the public “not to spread information that may cause undue alarm.”

Volunteers Against Crime and Corruption, an NGO, said it was checking a report that three children on the northern island of Luzon had died since being vaccinated in April 2016 but the Department of Health said the deaths were not due to Dengvaxia.

“When we evaluated the clinical records, it was not related to the dengue vaccination,” Bayugo said.

A prominent senator, Richard Gordon, told Reuters he was aware of two deaths – but gave no details – and said approval and procurement for the program was done with “undue haste.”

Dengue is a mosquito-borne tropical disease. Although it is not as serious as malaria, it is spreading rapidly in many parts of the world, killing about 20,000 people a year and infecting hundreds of millions.

While Sanofi’s Dengvaxia is the first-ever approved vaccine for dengue, scientists already recognized it was not perfect and did not protect equally against the four different types of the virus in clinical tests.

A new analysis from six years of clinical data showed Dengvaxia vaccine provides persistent protective benefit against dengue fever in those who had prior infection.

But for those not previously infected by the virus, more cases of severe disease could occur in the long term following vaccination, Sanofi said.

(Additional reporting by Karen Lema in Manila, John Geddie in Singapore and Brad Brooks in Sao Paulo and Anthony Boadle in Brasilia; Writing by John Chalmers; Editing by Raju Gopalakrishnan and Bill Trott)

Yemen set to run out of fuel and vaccine in a month: UNICEF

A boy is being treated at a malnutrition treatment center in Sanaa, Yemen November 4, 2017.

GENEVA (Reuters) – Yemen’s stocks of fuel and vaccines will run out in a month unless a Saudi-led military coalition allows aid into the blockaded port of Hodeidah and Sanaa airport, UNICEF’s representative in the country said on Friday.

Meritxell Relano, speaking by phone to reporters in Geneva, said fuel prices had risen 60 percent and there were urgent concerns about a diphtheria outbreak, as well as food shortages because of the port closure.

“The situation that was already catastrophic is just getting worse,” she said. “The impact of this is unimaginable in terms of health and diseases.”

After two years of civil war, Yemen has 7 million people on the brink of famine and has had 900,000 suspected cholera cases in the past six months.

The number of new cases has fallen consistently for the past eight weeks, according to data from the World Health Organization.

But progress against cholera, which has killed 2,196 people, could be reversed by the blockade, WHO spokeswoman Fadela Chaib told a regular U.N. briefing in Geneva.

“If the closure is not stopped in the coming days, we may see that the progress is stopped,” Chaib said. “We can see even more cases and more deaths as a result of not being able to get access to people.”

The closure of Hodeidah port prevented a ship setting sail from Djibouti with 250 tonnes of WHO medical supplies on Wednesday. Trauma kits in particular are running short.

“If the hostilities continue and the ports remain closed, we will not be able to perform life-saving surgeries or provide basic healthcare,” Chaib said.

(Reporting by Tom Miles; Editing by Andrew Roche)

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

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

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