Biological Health Hazard – Chikungunya Virus
North-America - USA | State of Florida, Statewide
Bio-hazard Level: 2/4 Medium
Location: N 37° 39.224, W 97° 31.483
Mosquito Virus That Walloped Caribbean Spreads in U.S. Tuesday, 30 September, 2014 at 19:47:15 UTC
(Bloomberg) 11 cases have been confirmed as originating in Florida, spurring concern this may be the beginning of the type of explosive growth seen elsewhere from a disease that has no vaccine or cure. Medical and environmental experts are debating how best to quell the outbreak before it takes off.
Patients who contract Chikungunya have joint swelling and pain, fever, headache and rash for about a week, though some symptoms last months or years in some patients, according to the U.S. Centers for Disease Control and Prevention.
While the disease generally isn’t fatal, more than 100 people have died in the Western Hemisphere since December, according to the Pan American Health Organization. Treatment includes hydration, rest and medicine that reduces fever or pain such ibuprofen or acetaminophen.
Now that Chikungunya is in Florida, it could infect 10,000 people in that state alone, according to Walter Tabachnick, the director of the Florida Medical Entymology Laboratory, who said his estimate is based on the exponential growth of other outbreaks. More than 700,000 people, for instance, are suspected of being infected with the virus in South America, Central America and the Caribbean since it appeared there, according to the Pan American Health Organization.
An outbreak of several thousand people in Florida could swamp existing medical facilities, putting at risk the state’s large elderly population, according to Tabachnick.
The two types of mosquitoes that carry the virus tend live to among humans, inside people’s houses. That’s unlike West Nile virus, which is spread by a mosquito that lives outside. In Florida similar efforts to stop Chikungunya early on have faltered. Mosquito control efforts have been “particularly unsuccessful,”
The Florida Department of Health and the CDC have issued warnings on the illness and urged people to avoid mosquito bites if they become infected with Chikungunya, since that can infect the mosquitoes, and in turn spread the disease to more people.
Dengue fever, the Chikungunya virus and the Zika virus are spread by the bite of an… Read More
Full article as reported by Kelly Gilblom at bloomberg.com
The potential hazards of chosen destinations for travelers and immigrants, both legal and illegal, and the counties receiving them, need to have an understanding of how best to protect health and minimize the risk of its population from acquiring disease and infection. However, in some if not many cases this important aspect is often overlooked and/or put aside for political reasons, sometime to the detriment of its population and the country or region at large.
Key factors in determining the risks to which a traveler or those in contact with them ,may be exposed are:
- mode of transport
- duration and season of travel
- purpose of travel
- standards of accommodation, food hygiene and sanitation
- behavior of the traveler
- underlying health of the traveler.
Disease information for type and description of specific infectious diseases posing potential health risks for travelers is provided here, as well as below. It does not include vaccine-preventable diseases.
Infectious diseases of potential risk:
Depending on the travel destination, travelers and those at their domestic destinations may be exposed to a number of infectious diseases; exposure depends on the presence of infectious agents in the area of origin. The for the non-emigrant traveler, the risk of becoming infected will also vary according to the purpose of the trip and the itinerary within the area, the standards of accommodation, hygiene and sanitation, as well as the behavior of the traveler. In some instances, disease can be prevented by vaccination, but there are some infectious diseases, including some of the most important and most dangerous, for which no vaccines exist.
General precautions can greatly reduce the risk of exposure to infectious agents and should always be taken for visits to any destination where there is a significant risk of exposure, regardless of whether any vaccinations or medication have been administered.
Modes of transmission and general precautions
The modes of transmission for different infectious diseases and the corresponding general precautions are outlined in the following paragraphs.
- Foodborne and waterborne diseases
- Vector-borne diseases
- Zoonoses (diseases transmitted by animals)
- Sexually transmitted diseases
- Bloodborne diseases
- Airborne diseases
- Diseases transmitted via soil
Specific infectious diseases involving potential health risks for travelers
The main infectious diseases to which travelers may be exposed, and precautions for each, are detailed on the following pages. Information on malaria, one of the most important infectious disease threats for travelers, is provided in topical publications provided by WHO and other sources. The infectious diseases described in these documents have been selected on the basis of the following criteria:
- diseases that have a sufficiently high global or regional prevalence to constitute a significant risk for travelers;
- diseases that are severe and life-threatening, even though the risk of exposure may be low for most travelers;
- diseases for which the perceived risk may be much greater than the real risk, and which may therefore cause anxiety to travelers;
- diseases that involve a public health risk due to transmission of infection to others by the infected traveler.
Information about available vaccines and indications for their use by travelers is also available. Advice concerning the diseases for which vaccination is routinely administered in childhood, i.e. diphtheria, measles, mumps and rubella, pertussis, poliomyelitis and tetanus, and the use of the corresponding vaccines later in life and for travel, is also given.
The most common infectious illness to affect travelers, namely travelers’ diarrhea. Because travelers’ diarrhea can be caused by many different foodborne and waterborne infectious agents, for which treatment and precautions are essentially the same, the illness is not included with the specific infectious diseases.
Some of the diseases such as brucellosis, HIV/AIDS, leishmaniasis and TB, have prolonged and variable incubation periods. Clinical manifestations of these diseases may appear long after the return from travel, so that the link with the travel destination where the infection was acquired may not be readily apparent.
The list below does not include vaccine-preventable diseases).
- Haemorrhagic fevers
- Hantavirus diseases
- Hepatitis C
- Hepatitis E
- HIV/AIDS and other sexually transmitted infections
- Leishmaniasis (cutaneous, mucosal and visceral forms)
- Leptospirosis (including Weil disease)
- Lyme Borreliosis (Lyme disease)
- Lymphatic filariasis
- SARS (Severe Acute Respiratory Syndrome)
- Schistosomiasis (Bilharziasis)
- Typhus fever (Epidemic louse-borne typhus)
- Zoonotic influenza
Other immigration and travel health risks
- Environmental risks
- Exposure to blood and other body fluids
- Infectious diseases and potential risks
- Injury and violence
- Psychological health
Information Sources The World Health Organization
Biological Hazard – H5N1 (highly pathogenic avian influenza)
Africa – Egypt | Governorate of Giza
Bio-hazard Level: 4/4 Hazardous
Location: N 30° 0.783, E 31° 12.531
Biological Hazard in Egypt on Tuesday, 30 September, 2014 at 17:12 (05:12 PM) UTC.
The Egyptian Minister of Health and Population, Dr. Adel Adawi announced a human case of H5N1 avian influenza (AI) in a 3 month girl from the Giza governorate (computer translated). The case, according to the Minister, the date of onset of the illness was Monday, 9/22/ 2014, where she was presenting symptoms of fever, sore throat, cough and vomiting. The girl’s parents took her to the Hospital of the Abbasid and she was released three days later. They said the child had exposure to dead birds. A throat sample was taken and analyzed and confirmed positive for avian influenza virus (A / H5N1). The child was treated with Tamiflu and is reportably in stable condition. According to the Health Ministry, this is the fourth human H5N1 AI case of 2014. However, the people at FluTrackers point out that this is the fifth case of the bird flu, writing on their site.
Biological Hazard in Egypt on Tuesday, 15 July, 2014 at 03:11 (03:11 AM) UTC.
Health officials in Egypt recently reported a deadly new case of avian influenza A (H5N1) in the Menia governorate, bringing the total number of cases confirmed in Egypt to 176. A 34-year-old male construction worker was admitted to the hospital late last month after developing symptoms of the virus, including fever, sore throat, cough and difficulty breathing. He died approximately two weeks later after being listed in critical condition. An initial investigation found the man had close contact with infected poultry at a market near his home, according to the World Health Organization. The WHO said local authorities have since implemented measures to prevent further infection from the poultry market. Three of the four avian influenza A cases reported in 2013 resulted in death. This year, just three cases of the virus were reported, with the most recent patient as the only fatality.
Source: RSOE EDIS
Biological Health Hazard – MERS-COv Disease Outbreak
Epidemic Hazard – Middle East Respiratory Syndrome Coronavirus (MERS-COv)
Europe – Austria | Capital, Wien
Bio-hazard Level: 4/4 Hazardous
Location: N 48° 12.490, E 16° 22.429
Biological Hazard in Austria on Tuesday, 30 September, 2014 at 17:09 (05:09 PM) UTC.
Austrian health authorities confirmed the first case of Middle East Respiratory Syndrome (MERS) and said Tuesday that the female patient from Saudi Arabia was in critical condition.
“The patient is responding to therapy and is on the path to stable condition,” a hospital spokeswoman said. The woman had arrived in Austria a few days earlier and was admitted to an isolation ward in a Vienna hospital, the Health Ministry said Monday. A dozen cases of MERS have been recorded in the European Union sofar, the ministry said. The strain of the coronav irus that causes MERS was first identified in Saudi Arabia in 2012, according to the World Health Organization (WHO).In July, WHO confirmed 291 deaths globally and 837laboratory-confirmed cases of infection. MERS has similarities to severe acute respiratory syndrome (SARS)that broke out in Asia in 2003. It is deadlier but has a lower rate of transmission, with symptoms including fever, pneumonia and kidney failure.
Source: RSOE EDIS
Epidemic Hazard – Typhus Fever (Epidemic louse-borne typhus)
Asia – India | State of Rajasthan, Kota division
Bio-hazard Level: 3/4 High
Location: N 25° 10.950, E 75° 50.333
Biological Hazard in India on Tuesday, 30 September, 2014 at 14:12 (02:12 PM) UTC.
Total number of scrub typhus cases has shot up to 220 in Kota division with 27 new cases being reported, a senior health official said here today. Chief Medical and Health Officer (CMHO) Kota, R N Yadav said 27 new scrub typhus patients surfaced yesterday, with 14 confirmed positive through Elisa test and the remaining 13 through card test. At least 10 people infected with the disease have died in city hospitals so far with six from Kota division, two from Madhya Pradesh and two from the adjoining districts of Bhilwara and Chittogarh respectively, Dr Yadav said. 54 patients of the disease have been detected in Kota district, 35 in Bundi, 33 in Baran and 51 in Jhalawar districts in the region, Yadav said. 40 patients from Madhya Pradesh and seven from other districts of Rajasthan are receiving medical treatment for the fever at different hospitals in the city, Yadav said. Medical officers are on alert and have been asked to carry out survey in areas where the patients with fever have been found, Yadav said. Through the tests carried out, four other patients have also been detected positive for malaria, he added.
Source: RSOE EDIS
Cause: Rickettsia prowazekii.
Transmission: The disease is transmitted by the human body louse, which becomes infected by feeding on the blood of patients with acute typhus fever. Infected lice excrete rickettsia onto the skin while feeding on a second host, who becomes infected by rubbing louse faecal matter or crushed lice into the bite wound. There is no animal reservoir.
Nature of the disease: The onset is variable but often sudden, with headache, chills, high fever, prostration, coughing and severe muscular pain. After 5–6 days, a macular skin eruption (dark spots) develops first on the upper trunk and spreads to the rest of the body but usually not to the face, palms of the hands or soles of the feet. The case–fatality rate is up to 40% in the absence of specific treatment. Louse-borne typhus fever is the only rickettsial disease that can cause explosive epidemics.
Geographical distribution: Typhus fever occurs in colder (i.e. mountainous) regions of central and eastern Africa, central and South America, and Asia. In recent years, most outbreaks have taken place in Burundi, Ethiopia and Rwanda. Typhus fever occurs in conditions of overcrowding and poor hygiene, such as in prisons and refugee camps.
Risk for travelers: Very low for most travelers. Humanitarian relief workers may be exposed in refugee camps and other settings characterized by crowding and poor hygiene.
Precautions:Cleanliness is important in preventing infestation by body lice. Insecticidal powders are available for body-louse control and treatment of clothing for those at high risk of exposure.
Source: World Health Organization, International travel and health
Epidemic Hazard – Hemorrhagic Fever (Ebola virus)
North America - USA | State of Texas, Dallas, Presbyterian Hospital of Dallas
Bio-hazard Level: 4/4 Hazardous
Location: N 32° 46.808, W 96° 48.027
Biological Hazard in USA on Tuesday, 30 September, 2014 at 05:00 (05:00 AM) UTC.
A Dallas hospital expects preliminary test results Tuesday that may confirm whether a patient there has Ebola. Texas Health Presbyterian Hospital of Dallas placed the patient into “strict isolation” after the person’s symptoms and recent travel history raised concerns, spokeswoman Candace White said in a written statement Monday. The name and other details about the patient were not released. The hospital said it is following Centers for Disease Control and Prevention recommendations to ensure the safety of patients, staff members and visitors. No Ebola cases have been confirmed in the United States, though several aid workers who contracted the disease in West Africa have returned to the U.S. for treatment. Last month, patients in Sacramento and New York City were isolated because of concerns they’d contracted the disease, but they tested negative for the virus. Specimens from such patients are delivered to the CDC in Atlanta for testing that takes 24 to 48 hours. There have been more than 6,500 cases of the disease in Africa and more than 3,000 deaths have been linked to it, according to the World Health Organization. Liberia, Sierra Leone and Guinea have been hit the hardest. Ebola has killed up to 90 percent of those it has infected, but the death rate in this outbreak is closer to 60 percent because of early treatment. The virus spreads through direct contact with blood, organs or other bodily fluids and with surfaces contaminated with the fluids. Early signs of Ebola such as fever, diarrhea and vomiting can develop within two days of infection. There is no specific treatment for Ebola, but doctors can provide fluids and pain relief before symptoms become severe. Death occurs from profuse internal and external bleeding that starves the organs of blood. Dr. Kent Brantly, a Fort Worth physician who contracted the virus in July while doing relief work in Africa, was treated in an Atlanta hospital. He was discharged in August after nearly three weeks of treatment. He and another American aid worker, Nancy Writebol, received an experimental treatment called ZMapp. It’s unknown whether the drug helped or whether they improved on their own. On Sunday, an American doctor who was exposed to the Ebola virus while volunteering in Sierra Leone was admitted to an isolation unit at a hospital at the National Institutes of Health near Washington D.C. Another aid worker who contracted Ebola while volunteering in West Africa also remains hospitalized.
Source: RSOE EDIS
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