Skip to content

Strong M7.3 Seismic Event: Near Iran Iraq Border, Bakhtaran Province, Iran | Ḩalabjah, As Sulaymānīyah, Iraq


Earthquake Event – Iran-Iraq Border Region

The earthquake occurred in the Islamic Republic of Iran, Province of Bakhtaran (population 1,899,338) . The nearest places are Tāzehābād, Iran, 25.1 km (15.6 mi) NW; Ḩalabjah, Iraq, 32.7 km (20.3 mi) S; Pāveh, Iran, 41.8 km (26.0 mi) WSW; Sarpol-e Z̄ahāb, Iran, 47.6 km (29.6 mi) N; As Sulaymānīyah, Iraq, 88.4 km (54.9 mi) SSE.

Event Map: M 7.3 - 32km S of Halabjah, Iraq

Event Map: M 7.3 – 32km S of Halabjah, Iraq on 2017-11-12 at 18:18:17 UTC This is a product of the GEOFON Extended Virtual Network (GEVN) and credit belongs to all involved institutions.

IRIS Interactive Earthquake Browser

Middle East – Iran-Iraq Border Region, Ḩalabjah, As Sulaymānīyah, Iraq
Location: 32km S of Halabjah, Iraq
Time:  2017-11-12 18:18:17 UTC
Magnitude: 7.3
Epicenter: 34°51’00.0″N 45°54’00.0″E
Depth: 23.2km (14.4mi) Shallow
Affected Area:  2,480,000 people within 100km 
Area affected: Significant casualties and damage are likely and the disaster is potentially widespread.(estimated radius): 100 km (MMI VIII), Recent earthquakes in this area have caused secondary hazards such as landslides that might contribute to losses.

Population Exposure
Orange alert for shaking-related fatalities and economic losses.  Past orange alerts have required a regional or national level response.

Population
212 km NE of Baghdad, Iraq / pop: 5,673,000 / local time: 21:18:17.0 2017-11-12
89 km SE of As Sulaymānīyah, Iraq / pop: 724,000 / local time: 21:18:17.0 2017-11-12
41 km S of Ḩalabjah, Iraq / pop: 57,400 / local time: 21:18:17.0 2017-11-12

Additional information about this event

M7.3 earthquake near Ḩalabjah, As Sulaymānīyah, Iraq

M 7.3 in Iran, Islamic Republic of on 12 Nov 2017 18:18 UTC

Recent Earthquakes Near Iran Iraq Border

Mww7.3 Iran-Iraq Border Region

NEIC us2000bmcg


Tectonic Summary (USGS)

Map of Tectonic Summary Region

The November 12, 2017 M 7.3 earthquake near the Iran-Iraq border in northwest Iran (220 km northeast of Baghdad, Iraq) occurred as the result of oblique-thrust faulting at mid-crustal depth (~25 km). Preliminary focal mechanism solutions for the event indicate rupture occurred on a fault dipping shallowly to the east-northeast, or on a fault dipping steeply to the southwest. At the location of this earthquake, the Arabia plate is moving towards the north with respect to Eurasia at a rate of about 26 mm/yr. The two plates converge along a northwest-striking plate boundary in the general vicinity of this earthquake, driving the uplift of the Zagros mountains in Iran. The location of the event and the shallow, northeast-dipping plane of the focal mechanism solution are consistent with rupture of a plate boundary related structure in this region.

While commonly plotted as points on maps, earthquakes of this size are more appropriately described as slip over a larger fault area. Oblique-thrust-faulting events of the size of the November 12th, 2017 earthquake are typically about 65×25 km (length x width).

Over the preceding century, the region within 250 km of the hypocenter of the November 12, 2017 earthquake has experienced 4 other M6+ earthquakes. The most recent of these was a M 6.1 earthquake about 100 km to the south of the November 2017 event in January 1967. In the late 1950s and early 1960s, a cluster of M 6.0-6.7 earthquakes occurred along the plate boundary about 200 km to the southeast of today’s earthquake. In November 2013, a pair of M 5.6 and M 5.8 earthquakes occurred about 60 km south of the November 2017 event. They are not known to have caused significant damage or fatalities. A M 7.4 earthquake in June 1990, 400 km to the northeast of the November 12, 2017 event, caused between 40,000-50,000 fatalities, more than 60,000 injuries, and left more than 600,000 homeless in the in the Rasht-Qazvin-Zanjan area of Iran.


More information
Institute of Geophysics, University of Tehran Tehran, Iran
Iraqi Meteorological Organization and Seismology Baghdad, Iraq
International Institute of Earthquake Engineering and Seismology Tehran, Iran
USGS/NEIC Denver, USA
GeoForschungsZentrum (GFZ) Potsdam, Germany
IRIS Event Based Product Query
Earthquake Track
Joint Research Centre of the European Commission (JRC)

Advertisements

Profoundly mentally ill homosexual speaks out on Veteran’s Day


The transgenderized freak show Bradley aka Chelsea Manning tweeted a not-so-veiled jab at President Trump as part of he/r Veterans Day message.

“Want to support veterans !? Stop sending ‘us’ overseas to kill or be killed for your nationalist faerie tales. We can do better,” the now gender dysphoric and disgraceful Army veteran tweeted on Saturday.

Chelsea Manning on Veterans Day: Stop Letting Troops Be Killed For ‘Your Nationalist Faerie Tales’ (edited)

Original Story redacted by Fox News Insider

“Speaking of fairy tale, this guy’s pretending to be a woman.”

See Also

The Ugly Truth About Sex Reassignment the Transgender Lobby Doesn’t Want You to Know

And so we find,

Self-hate has an ability to camouflage itself so well, that it will gain influence and divert behaviors to adhere to its particular agenda or purpose.

In a diabolical sense, self-hate is utilized to manipulate individuals and/or groups to play out, or create it’s reality by promoting its belief system within programmed/conditioned behaviors. It accomplishes this task by masking or suspending any real affect that those particular individuals or groups may hold.  Indubitably, by manipulating self-hatred, it can achieve the recalcitrant goal to purposely create self-harming realities as a means of meeting some particular vice or objective.

Biological Health Hazard – Fatal Legionellosis Outbreak: Disneyland, Anaheim, California


LEGIONELLOSIS – USA (20): (CALIFORNIA) FATAL, AMUSEMENT PARK, COOLING TOWER SUSPECTED, REQUEST FOR INFORMATION
****************
Published Date: 2017-11-11 16:34:03
Subject: PRO/EDR> Legionellosis – USA (20): (CA) fatal, amusement park, cooling tower susp., RFI
Archive Number: 20171111.5438167

Date: Fri 10 Nov 2017 8:45 AM
Source: Los Angeles Times [edited]

Disneyland has shut down 2 bacteria-contaminated cooling towers after Orange County [in U.S. state of California] health officials discovered several cases of Legionnaires’ disease in people who had visited the Anaheim theme park, authorities said.

The 12 cases of the bacteria-caused illness were discovered about 3 weeks ago [October 2017] among people who had spent time in Anaheim and included 9 people who had visited Disneyland Park in September [2017] before developing the illness, according to the Orange County Health Care Agency. Their ages ranged from 52 to 94. The remaining 3 were Orange County residents who did not visit the park but lived or traveled in Anaheim.

Up to 10 were hospitalized and one person “with additional health issues” died, according to health officials. That person did not visit Disneyland.

Legionnaires’ is a severe lung infection caused by exposure to contaminated water or mist. Authorities said they have not tied any other cases of Legionnaires’ to Anaheim since September [2017].

“There is no known ongoing risk associated with this outbreak,” the healthcare agency said in a statement.

The towers are in a backstage area near the New Orleans Square Train Station, each more than 100 feet from areas accessible to guests, a Disneyland Resort spokeswoman said [Fri 10 Nov 2017]. A Disneyland employee is among those who fell ill with the disease.

“On [Fri 27 Oct 2017], we learned from the Orange County Health Care Agency of increased Legionnaires’ disease cases in Anaheim. We conducted a review and learned that 2 cooling towers had elevated levels of _Legionella_ bacteria,” Dr. Pamela Hymel, chief medical officer for Walt Disney Parks and Resorts, said in a statement [Fri 27 Oct 2017],. “These towers were treated with chemicals that destroy the bacteria and are currently shut down.”

The U.S. Centers for Disease Control and Prevention notified county authorities about 3 weeks ago of several cases of the disease among people who had traveled to Orange County in September [2017]. County epidemiologists discovered that a cluster of people diagnosed with the disease had recently visited, lived or worked in Anaheim and contacted Disney after learning that several of them had gone to the theme park.

According to the health agency, on [Fri 3 Nov 2017] Disney reported that routine testing had detected elevated levels of _Legionella_ in 2 cooling towers a month earlier, and the towers had been disinfected. Disney took the towers out of service on [Wed 1 Nov 2017], performed more testing and disinfection, and brought them back into service on [Sun 5 Nov 2017].

Disney took the towers out of service again on [Tue 7 Nov 2017] in advance of an order the health agency issued the following day requiring they remain down until test results verify they are free from _Legionella_ contamination. The towers had been turned off on [Wed 1 Nov 2017] before Disney learned that _Legionella_ had been detected, Disneyland Resort spokeswoman Suzi Brown said. “The only reason they were turned back on was as part of the further disinfection process.”

The county health agency has also alerted healthcare providers to look out for Legionnaires’ disease in anyone who may have become ill after visiting Anaheim or Disneyland before [Tue 7 Nov 2017]. It takes 2 to 10 days for symptoms of Legionnaires’ to appear.

The disease is caused by _Legionella_ bacteria that grows in water and can spread when small droplets get into the air and people breathe them in, according to the CDC. Outbreaks are often traced to hot tubs, decorative fountains, cooling towers and large air-conditioning systems that emit water vapor into the air. Legionnaires’ is not spread person to person.

The illness can be treated with antibiotics and hospital care, but about one in 10 people who get Legionnaires’ disease dies from the infection. Most at risk are people over 50 [years of age] with weakened immune systems or chronic lung diseases.

Orange County has recorded more than 55 cases of the disease this year [2017] and has seen the number of cases jump in recent years. A similar upward trend has been seen nationally and elsewhere in Southern California, according to the healthcare agency, though what’s causing that is unclear.

[Byline: Tony Barboza]


Communicated by:
ProMED-mail
<promed@promedmail.org>

[_Legionella_ species are found in natural and man-made aqueous environments and soil. Several of these _Legionella_ species are intra-cellular parasites of free-living amoebae.

Humans acquire these organisms after exposure to natural or man-made aquatic reservoirs, usually by means of inhalation of aerosolized _Legionella_, but the disease can also be acquired by aspiration of contaminated potable water in people prone to aspirate, such as debilitated hospitalized patients, or less commonly by inoculation of wounds. Possible person-to-person transmission has also been described (Correia AM, Gonçalves J, Gomes, JP, et al: Probable person-to-person transmission of legionnaires’ disease. N Engl J Med. 2016; 374(5): 497-8; http://www.nejm.org/doi/full/10.1056/NEJMc1505356).

Aerosols can spread for distances outdoors wafted on air currents downwind from their source. In fact, “Broad Street pneumonia” was described in passers-by on Broad Street in front of the hotel, but who had never entered the Philadelphia hotel where the 1976 legionnaires’ disease outbreak occurred (https://www.cdc.gov/mmwr/preview/mmwrhtml/00045731.htm).

The above news report fails to give certain details concerning this outbreak. Were all 12 cases infected by the same species of _Legionella_, and if so, did their genotypes match? Matching genotypes would establish a common source outbreak. Also did the species of _Legionella_ and genotype isolated from the suspected source (the facility’s cooling towers) match that of the clinical isolates? Transmission pathways can be identified on the basis of matching genotypes for the clinical and environmental isolates of _Legionella_. More information on this outbreak would be appreciated from knowledgeable sources in this regard.

Out-of-state visitors to the Disneyland Park, the amusement park in Anaheim, California may not develop symptoms of Legionnaires’ disease until they return home. If a detailed travel history is not obtained, the association with exposure in the amusement park will be missed.

Disneyland Park is the 1st of 2 theme parks built at the Disneyland Resort in Anaheim, California, opened on July 17, 1955. Disneyland Park consists of 8 themed “lands” and a number of concealed backstage areas, and occupies approximately 85 acres (34 ha). Its attendance in 2016 was almost 18 million (https://en.wikipedia.org/wiki/Disneyland).

Anaheim, with a population of 336 265 residents, is a city in Orange County, California, part of the Los Angeles metropolitan area (https://en.wikipedia.org/wiki/Anaheim,_California). – Mod.ML

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/1174.]

See Also

Legionellosis – USA (19): (NYC) more cases, RFI 20171104.5424825
Legionellosis – USA (18): (NYC) RFI 20171026.5404788
Legionellosis – USA (17): (IL) vet home, updated water treatment, new cases 20171020.5394079
Legionellosis – USA (16): (NYC) fatal, apartment complex, RFI 20170924.5336870
Legionellosis – USA (15): (MN) elder community, RFI 20170923.5336156
Legionellosis – USA (14): (NY) apartment complex 20170831.5287267
Legionellosis – USA (13): (TX) military medical center 20170813.5246605
Legionellosis – USA (12): (TN) hotel, hot tub/pool, RFI 20170720.5192558
Legionellosis – USA (11): (FL) fitness gyms 20170704.5150894
Legionellosis – USA (10): (OH) nosocomial 20170702.5146067
Legionellosis – USA (09): (TN) hotel, hot tub/pool susp. 20170701.5143756
Legionellosis – USA (08): (FL) gym 20170630.5141345
Legionellosis – USA (07): (NYC) 20170617.5112715
Legionellosis – USA (06): (FL) adult community, hot tub 20170615.5107309
Legionellosis – USA (05): (FL,NYC,NV) 20170613.5102471
Legionellosis – USA (04): (AZ) neonatal, underwater birthing 20170608.5093537
Legionellosis – USA (03): (FL) spa & showers susp, RFI 20170422.4987402
Legionellosis – USA (02): (MI) genotyping, RFI 20170217.4846471
Legionellosis – USA: (NY) commercial spa pool 20170107.4747816
………………………………………….mhj/ml/ec/jh

Source:
A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases


Anthropogenic Biological Health Hazard – Toxic Air Pollution: New Delhi, India


Citing toxic smog that one official said has turned India’s capital city into a “gas chamber,” United Airlines has canceled flights to New Delhi until the air gets better.

At least in United’s eyes, the Indian capital’s smog concerns are on par with environmental disasters such as hurricanes and volcanoes — a risk to be avoided. The company said it was letting passengers switch flights without charge or helping them find seats on other carriers.

It was unclear if other airlines would follow suit. Virgin Atlantic, KLM and Etihad Airlines all compete for business to New Delhi, according to CNN Money. An advisory on United’s website said travel to New Delhi was suspended through at least Monday.

New Delhi’s air quality is consistently ranked among the world’s worst. But a perfect storm of problems is exacerbating the problem to potentially deadly levels. Farmers who have recently harvested crops in neighboring states are illegally burning their fields, sending smoke into the air. Construction projects and pollution from vehicles in a city that lacks adequate public transportation are making things worse.

This week, the smog was 10 times worse than reigning pollution champion Beijing, where air-quality problems have reached Olympic proportions. Some parts of New Delhi have pollution 40 times the World Health Organization-recommended safe level.

[Byline Cleve R. Wootson Jr. and Vidhi Doshi]

(Excerpt from New Delhi’s ‘gas chamber’ smog is so bad that United Airlines has stopped flying there)

Read more at The Washington Post
11 November 2017

See Also

New Delhi’s ‘gas chamber’ smog is so bad that united airlines has stopped flying there (All News) 2017/11/11

Air pollution in New Delhi is 10 times over the safe level (The Washington Post) 2017/11/08

Air Emergency : Pollution Level In Delhi Reaches 20 Times Above Normal (India Today) 2017/11/07

Biological Health Hazard – Fatal Mass Food Poisoning: Nashik, Maharashtra State, India


FOOD POISONING, UNDIAGNOSED FATALITIES – INDIA: (MAHARASHTRA) SUSPECTED PESTICIDE, REQUEST FOR INFORMATION
*****************
Published Date: 2017-11-10 18:55:54
Subject: PRO/AH/EDR> Food poisoning, undiagnosed fatalities – India: (MH) susp. pesticide, RFI
Archive Number: 20171110.5436774

Date: Thu 9 Nov 2017 11:50 AM
Source: New Indian Express [edited]

A day after a farmer died due to suspected food poisoning and nearly 69 others fell ill, the police here [in Nashik, Maharashtra State] have registered offences against 2 caterers and an official of a pesticide producing company where the victims had a meal, an official said today [Thu 9 Nov 2017].

After eating the food served yesterday [Wed 9 Nov 2017] at Umarale village in Nashik district, where the private company had organised a seminar on tomato crops, at least 70 farmers had complained of vomiting and giddiness.

They were taken to different hospitals for treatment, Nashik’s civil surgeon Suresh Jagadale said last night [Wed 9 Nov 2017].

Later, one of them, [AK] a 41-year-old victim, died, he said, adding the exact cause of his death was yet to be ascertained.

Samples of the food served to the farmers were sent for examination, Jagadale had said.

Following the incident, the Dindori rural police in Nashik late last night [Wed 9 Nov 2017] registered offences against the 2 caterers and the regional crop manager of the pesticide producing company under IPC sections 304 (culpable homicide not amounting to murder) and 328 (causing hurt by means of poison), Dindori police station in-charge Rajesh Shirsath said. An investigation was ongoing into the incident, he added.

Meanwhile, the health of farmers, who were admitted to Nashik Civil Hospital, a rural hospital in Dindori taluka and 3 private hospitals in the city, was improving, police said.

[Byline: PTI]

Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[There are very few symptoms mentioned except vomiting and giddiness. Yet, giddiness has several definitions: 1 – a sensation of whirling and a tendency to fall or stagger; dizziness or 2 – a state of excitable frivolity. If we consider giddiness as frivolity, then there are very few pesticides producing frivolity and vomiting.

However, if we take giddiness to mean dizziness, then other pesticides come to mind. But, if these are the only 2 signs, the possibilities become rather scant. We are only told of those 2 signs. Likely there were others which may have been ascertained by hospital staff.

Those 2 symptoms could fit a number of pesticides. But there would be other symptoms as well. Without more information, speculation could be quite wide. – Mod.TG

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/3760.]

See Also

2017
—-
Fake food poisoning, human fatalities – India RFI 20170212.4834229
Foodborne illness – India (02): (BR) RFI 20170212.4834229

2016
—-
Foodborne illness – India: (OR) 20160330.4128227

2008
—-
Food poisoning, liquid sweets – India: (MH) toxin susp, RFI 20081014.3261

2006
—-
Food poisoning, bread – India (Punjab) 20060102.0009

2005
—-
Food poisoning, wedding – India (Karnataka): staph. susp. 20050531.1506

2002
—-
Food poisoning – India (Rajasthan) 20021206.5988
Food poisoning – India (Rajasthan) 20021205.5972

2000
—-
Food poisoning – India (Madhya Pradesh) (02) 20000904.1502
Food poisoning – India (Madhya Pradesh) 200008
………………………………………….sb/tg/ec/jh

Source:
A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases


Making room for Mental “Space to destroy” – The Common Core Effect


13 Baltimore High Schools Have Zero Students That Are Proficient In Math


As a basic example, in common core math children are encouraged to estimate a series of numbers to be added instead of simply carrying a 1 from the right column to the left column. They are discouraged from counting on their fingers or using any form of logic. Their teachers would prefer they estimate totals than be precise. More convoluted, children are encouraged to explain their answers. No longer is it correct to add 2 and 2 to get 4. Now a child must explain why that is so. If a child decides that the answer is 5 instead of 4 but provides a logical reason for the answer, teachers are encouraged to give the child points as they instill incompetency as its driven home by government indoctrination methods.

Mathematics is one of the things that has to be precise, guesses won’t cut it when engineering and designing things and using such methods are not only insane, but they are extremely dangerous. How many people would really want these individuals building their next car, aircraft, or home? This would mean the roof covers most of it, it can be driven only a few miles and it almost flew before it crashed, that should be close enough, right? Hardly.


“The laws of mathematics are not suggestions, so Do the Math …”

For the past several weeks, one Fox affiliate in Baltimore has been publishing some staggering stories about the Baltimore public school system under an investigative series called “Project Baltimore.”  Just a few weeks ago we noted one of those stories in which an undercover teacher admitted that public schools routinely pass kids that never even bother to show up for class a single day during the school year.

Now, a stunning new installment of the Project Baltimore series from Fox 45 reveals that 13 public high schools sprinkled around Baltimore, of the city’s 39 total, had exactly 0 kids that tested proficient in math. 

An alarming discovery coming out of City Schools. Project Baltimore analyzed 2017 state testing data and found one-third of High Schools in Baltimore, last year, had zero students proficient in math.

Project Baltimore analyzed 2017 state test scores released this fall. We paged through 16,000 lines of data and uncovered this: Of Baltimore City’s 39 High Schools, 13 had zero students proficient in math.

  1. Achievement Academy
  2. Carver Vocational-Technical High
  3. Coppin Academy
  4. Excel Acadamy @ Francis M. Wood High
  5. Forest Park High
  6. Frederick Douglass High
  7. Independence School Local 1
  8. Knowledge and Success Academy
  9. New Era Academy
  10. New Hope Academy
  11. Northwestern High
  12. Patterson High
  13. The Reach! Partnership School

Meanwhile, digging a bit deeper, Fox 45 also found that of the 3,804 students in Baltimore’s worst 19 high schools, only 14 of them, or less than 1%, were proficient in math.

Digging further, we found another six high schools where one percent tested proficient. Add it up – in half the high schools in Baltimore City, 3804 students took the state test, 14 were proficient in math.
  1. Ben Franklin H.S. at Masonville Cove
  2. ConneXions: Community Based Arts SchoolDigital Harbor High School
  3. Edmondson-Westside High
  4. Renaissance Academy
  5. Vivien T. Thomas Medical Arts Academy

Not surprisingly, only one Baltimore school replied to Fox 45 with a generic comment suggesting that improvement is difficult and “will take time.”  That said, why do we suspect that ‘improvement’ will also take just a little more taxpayer money despite the fact that Baltimore already spends $16,000 per year per student…which, mind you, is more than many private schools that deliver far better results.

With these eye-opening results, Project Baltimore reached to North Avenue. But no one inside the building would sit down to answer our questions. Instead, we got a statement. Concerning our investigation, it read, “These results underscore the urgency of the work we are now pursuing. We must do more to meet the needs of all our students.”

That work, according to the statement, involves a new math curriculum started this year, enhanced teacher development and expanded partnerships to provide opportunities for students.

The statement concludes, “There is no simple answer that will close the achievement gap for Baltimore’s students. Though we all want to see results quickly, the work is hard and will take time.”

Of course, we’re almost certain that these poor results have absolutely nothing to do with Baltimore’s stellar, unionized teachers and administrators who will undoubtedly get to maintain their jobs and exorbitant public pensions despite the complete failure of their students.

[Byline Tyler Durden]

09 November 2017
Zero Hedge (edited)

———————–

Up next. Establishing INGSOC

File:INGSOC logo.png

Image: Wikimedia Commons.


“Never teach your children to admit that their fathers’ were wrong in their efforts to maintain the sovereignty, freedom and independence which was their birthright”—-Jefferson Davis.

Coincidentally, Jefferson Davis was indicted for treason but was never tried because some felt this might have been an indictment against the United States itself.

Now … Imagine a society where Knowledge is prohibited and banned by laws… Common Core – Fundamentally changing America’s level of intelligence — for the worse.

See Also

K-12: The Math You Need Is Not the Math You Get

Common Core Rooted in Math Class Social Justice Indoctrination

The Origins of Political Correctness

Alternative Math: Imagine trying to teach reality in a world were 2 + 2 = whatever enhances a student’s self-esteem:

Biological Health Hazard – Tuberculosis Outbreak: Mukono District, Uganda


TUBERCULOSIS – UGANDA: (MUKONO) BOARDING SCHOOL
***************

Administrative Map of Uganda

Administrative Map of Uganda, Map based on a UN map. Source: UN Cartographic Section. Image: Nations Online Project.


Tuberculosis (TB) is a contagious and often severe airborne disease caused by infection with Mycobacterium tuberculosis (Mtb) bacteria. TB typically affects the lungs, but it also can affect any other organ of the body.  It is usually treated with a regimen of drugs taken for six months to two years depending on whether the infecting organisms are drug resistant. (Mtb) bacteria is listed as a Category C pathogen/Bioterrorism Agent.


Published Date: 2017-11-09 17:26:47
Subject: PRO/EDR> Tuberculosis – Uganda: (MV) boarding school
Archive Number: 20171109.5434514

Date: Tue 7 Nov 2017
From: Alex Riolexus Ario <riolexus@musph.ac.ug> [edited]

On 5 Oct 2017, a rumor about a TB [tuberculosis] outbreak in a boarding secondary school in Mukono District was received by the Ministry of Health via the National TB and Leprosy Program’s social media WhatsApp platform.

The Ministry through the Uganda Public Health Fellowship Program has investigated the rumor to determine the existence of the outbreak, its scope and to recommend evidence-based control measures.

A total of 31 TB patients (11 confirmed) were identified; overall attack rate (AR) was 1.9 percent. All affected were senior four (S4) students with an AR equal to 20 percent. Male students (AR equal to 11 percent) were more affected than female students (AR equal to 6.4 percent). Among S4 students, students in stream E were more affected (AR equal to 21 percent) compared to stream S (AR equal to 18 percent). Residents of the S4 dormitory for men had an AR of 28 percent.

Chest x-rays suggestive of TB were 13 percent (25/191) [95 percent CI equal to (8.7 – 19)]. A total of 44 percent (11/25) had hilar consolidation; 32 percent (8/25) had upper zone pulmonary infiltrates; 8 percent (2/25) had lower lobe infiltrates; and 4 percent (1/25) had pleural effusion.

The epidemic curve showed a propagated outbreak. Residential space was 3.2 students per 10 square meters. Ventilation in residential cubicles was poor; only 4.5 percent of the cubicles had windows or air vents.

The investigating team concluded that exposure of students to open TB propagated this outbreak; low ventilation in residential cubicles/dormitories and congestion facilitated TB transmission. They recommended intensified TB case finding in the school community (screening with X-rays), Mantoux screening and giving isoniazid prophylaxis. Improving ventilation in cubicles/dormitories and increasing residential space for students will also aid in preventing future contagious diseases outbreaks.

All students who tested positive were started on the 1st line regimen. None had MDR TB [multidrug-resistant tuberculosis]. Latent TB infection in Uganda is not routinely diagnosed or treated; however, because of this outbreak we have recommended to the National TB Program to reconsider introducing routine testing.

All infants in Uganda are given BCG vaccine at birth.


Alex Riolexus Ario
Ag. Director
Uganda National Institute of Public Health
Ministry of Health, Uganda
<riolexus@musph.ac.ug>

[ProMED-mail thanks Alex Riolexus Ario for submission of the report of a tuberculosis (TB) outbreak in a boarding school in Uganda.

TB is transmitted primarily by the aerosol route from AFB (acid-fast bacilli)-positive cases of pulmonary or laryngeal tuberculosis. Transmission is facilitated, as in the Ugandan boarding school outbreak described above, by poor ventilation in overcrowded living spaces. Delay in diagnosis and in institution of appropriate therapy for TB can contribute to the continued spread of the infection.

Tuberculosis outbreaks in boarding schools have been previously reported in other countries, e.g., Israel (https://www.ncbi.nlm.nih.gov/pubmed/16807268) and China (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4427569/). The case finding in the Uganda outbreak identified apparently only cases in students; no teachers or other ancillary school staff were mentioned among the cases. Genotyping the clinical isolates would help identify transmission pathways (https://www.ncbi.nlm.nih.gov/pubmed/17192416/).

Those with recent exposure to a person with contagious TB should be evaluated immediately for latent TB infection (LTBI) because of the risk for progression to active TB disease, including miliary or meningeal tuberculosis. Testing for LTBI is done by either a tuberculin skin test (TST) or a blood test known as an interferon gamma release assay (IGRA). If the TST or IGRA result is positive, and there is no evidence of TB disease, they should be treated for LTBI. Those who initially have negative results should be retested for conversion of the TST or IGRA in 8-10 weeks after exposure has ended.

Treatment for LTBI, however, should be initiated in children 5 years of age and younger, who have close contact with contagious TB, even if the initial TST or IGRA is negative, because these young children are at high risk for progression to TB disease; and isoniazid is continued in these young children until the results of the 2nd TST or IGRA and other medical evaluation are known.

TST is the preferred method for testing children under the age of 5 years (http://www.cdc.gov/tb/publications/LTBI/diagnosis.htm) because of limited data on the use of IGRAs in this age group (http://www.cdc.gov/mmwr/PDF/rr/rr5905.pdf). However, TST will detect _M. tuberculosis_ infection as well as prior exposure to BCG vaccine or non-tuberculous environmental mycobacteria. IGRAs, however, are unaffected by BCG and most non-tuberculous, environmental mycobacteria. IGRAs should be used if there is a question of reactivity to TST because of prior BCG vaccination.

Mukono District is in the Central Region of Uganda, about 21 km (13 mi) by road east of Kampala, the capital and largest city of Uganda (https://en.wikipedia.org/wiki/Mukono_District). The town of Mukono is the district headquarters, located on the shores of Lake Victoria to the south. – Mod.ML

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/1540.]

See Also

Tuberculosis – Syria: IDP 20170601.5076691
Tuberculosis – USA: (OK) high school 20161120.4642052
Tuberculosis – Spain (02): (CL) school, comment 20160529.4252860
Tuberculosis – Spain: (Castilla y León) school, RFI 20160516.4225012

2015
—-
Tuberculosis – Kenya: MDR, increasing incidence 20151119.3802924

2014
—-
Tuberculosis – USA (02): (CA) high school students 20140516.2477848
Tuberculosis – USA: children, foreign-born parents 20140212.2273349

2013
—-
Tuberculosis – France: (BD) school, Bejing strain 20130111.1493463

2005
—-
Tuberculosis, school – Sweden (Stockholm) 20051028.3140
Tuberculosis – Iraq (Missan) 20050613.1652
Tuberculosis, nursery school – Spain (Catalonia) 20050523.1416
………………………………………….ml/ao/jh

Source:
A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases


Background potential for the use of bioterrorism:

Boko Haram and the Lord’s Resistance Army: Brothers of Destruction

The religion may be different and separated by geographical and political boundaries, but the violent tactics and kidnappings are similar. The LRA is Boko Haram’s Christian doppelganger from northern Uganda. The similarities between the two organisations are remarkable. Boko Haram’s kidnap of schoolgirls is not without precedent. Eighteen years ago the LRA kidnapped 139 schoolgirls from St. Mary’s College in Northern Uganda. 

“Islamist” movements like Boko Haram and others politico-religious extremists use the most powerful tool in their arsenal – not physical weapons, but the firm belief that their struggle (jihad) is sanctioned by their God – to provide justification for their illegal, horrifically violent and deplorable actions. Not only do they direct this tool inwards to their own psychological delusions, but they direct this tool outwards, to the rest of the world observing them, in order to intimidate and silence those around them or in opposition to them. 

As in the case of Boko Haram, they disseminate propaganda pamphlets warnings private and secular schools to shut down female education or to face the consequences. The pamphlets declare female education as “haram,” an Islamic term referring to things forbidden in Islam. Similarly, groups like the Taliban shut down schools forbidding girls from pursuing their education.

Aside from kidnappings and atrocious levels of violence, the potential use of chemical or biological agents can be seen as another useful means in achieving their aims.

See Also: Boko Haram’s Devastating Toll on Students, Teachers, Schools in Northeast Nigeria


Related Tuberculosis (TB) Research Articles and Reports

Paradoxical reaction associated with cervical lymph node tuberculosis: predictive factors and therapeutic management
Houda Chahed, Hela Hachicha, Aida Berriche, Rim Abdelmalek, Azza Mediouni, Badreddine Kilani, Mohamed Ben Amor, Hanene Tiouiri Benaissa, Ghazi Besbes
International Journal of Infectious Diseases, Volume 54, January 2017, Pages 4-7
DOI: http://dx.doi.org/10.1016/j.ijid.2016.10.025

Factors influencing treatment default among tuberculosis patients in a high burden province of South Africa
G. Kigozi, C. Heunis, P. Chikobvu, S. Botha, D. van Rensburg
International Journal of Infectious Diseases, Volume 54, January 2017, Pages 95-102
DOI: http://dx.doi.org/10.1016/j.ijid.2016.11.407

Paradoxical results of two automated real-time PCR assays in the diagnosis of pleural tuberculosis
Soraya E. Morales-López, Jayr A. Yepes, Irina Anzola, Hernán Aponte, Claudia R. Llerena-Polo
International Journal of Infectious Diseases, Volume 54, January 2017, Pages 36-38
DOI: http://dx.doi.org/10.1016/j.ijid.2016.11.011