28 Nov 2014

AHS rules out #Ebola in #Calgary #patient in isolation at South Health Campus; some lessons learned (Calgary Sun, November 28 2014)

[Source: Calgary Sun, full page: (LINK).]

AHS rules out Ebola in Calgary patient in isolation at South Health Campus; some lessons learned [      ]

By Bill Kaufmann, Calgary Sun / First posted: Friday, November 28, 2014 10:08 AM MST | Updated: Friday, November 28, 2014 12:49 PM MST

Dealing with a city Ebola scare that proved negative has revealed some shortcomings in the response, the Calgary region’s medical officer for health said Friday.




#Arizona, Ahwatukee #man tested for #Ebola; 'very low risk' for virus (AZ Central, November 28 2014)

[Source: Arizona Central, full page: (LINK).]

Ahwatukee man tested for Ebola; 'very low risk' for virus [      ]

Ken Alltucker, The Republic | azcentral.com 12:49 p.m. MST November 28, 2014

A 32-year-old Ahwatukee man who had recently returned from Sierra Leone was hospitalized early Friday with flu-like symptoms, triggering a protocol used to treat patients who might be infected with Ebola, authorities said.




Highly pathogenic #avian #influenza #H5N8, #UK (#OIE World Animal Health Information System, November 28 2014, edited)

[Source: OIE, full page: (LINK). Edited.]

Highly pathogenic avian influenza H5N8, United Kingdom [      ]

Information received on 27/11/2014 from Dr Nigel Gibbens, Chief Veterinary Officer, Department for Environment, Food and Rural Affairs, Department for Environment, Food and Rural Affairs, LONDON, United Kingdom

  • Summary
    • Report type Follow-up report No. 2
    • Date of start of the event 14/11/2014
    • Date of pre-confirmation of the event 16/11/2014
    • Report date 27/11/2014
    • Date submitted to OIE 27/11/2014
    • Reason for notification Reoccurrence of a listed disease
    • Date of previous occurrence 20/08/2008
    • Manifestation of disease Clinical disease
    • Causal agent Highly pathogenic avian influenza virus
    • Serotype H5N8
    • Nature of diagnosis Laboratory (advanced)
    • This event pertains to a defined zone within the country
    • Related reports
  • Outbreaks
    • There are no new outbreaks in this report
  • Epidemiology
    • Source of the outbreak(s) or origin of infection
      • Unknown or inconclusive
  • Epidemiological comments
    • Update on 27 November 2014
      • The IVPI result is now available - 2.88 (highly pathogenic)
      • No further cases have been identified and surveillance and tracing activities have indicated no evidence of spread to date (27 November 2014)
      • The epidemiological investigation is ongoing and disease control measures remain in place. Updates will be provided in the weekly reports as further information becomes available.
  • Control measures
    • Measures applied
      • Stamping out
      • Quarantine
      • Movement control inside the country
      • Screening
      • Zoning
      • Disinfection of infected premises/establishment(s)
      • Vaccination prohibited
      • No treatment of affected animals
    • Measures to be applied
      • No other measures
  • Diagnostic test results
    • Laboratory name and type – Species – Test - Test date – Result
      • Animal and Plant Health Agency (APHA) Weybridge (OIE’s Reference Laboratory) – Birds - haemagglutination inhibition test (HIT) - 16/11/2014 – Negative
      • Animal and Plant Health Agency (APHA) Weybridge (OIE’s Reference Laboratory) – Birds - intravenous pathogenicity index (IVPI) test  - 21/11/2014 – Positive
      • Animal and Plant Health Agency (APHA) Weybridge (OIE’s Reference Laboratory) – Birds - nucleotide sequencing - 16/11/2014 – Positive
      • Animal and Plant Health Agency (APHA) Weybridge (OIE’s Reference Laboratory) – Birds – reverse transcription - polymerase chain reaction (RT-PCR) - 16/11/2014 – Positive
  • Future Reporting
    • The event is continuing. Weekly follow-up reports will be submitted.



#Fever in North #Darfur localities claims lives (Radio Dabanga, November 28 2014)

[Source: Radio Dabanga, full page: (LINK).]

Fever in North Darfur localities claims lives [      ]

TAWILA  / Residents of a camp for displaced people in Tawila locality, North Darfur, have reported a rise in the number of deaths caused by a spreading unknown fever, along with a lack of medicines in the only health centre in the area. The state's Ministry of Health reported that the possible deadly haemorrhagic fever in some localities remain a major concern.




#Ebola Infected Italian #Doctor #Health #Status #Update, as of November 28 2014 (MoH, edited)

[Source: Ministry of Health of Italy, full page in Italian: (LINK). Translated, edited.]

#Ebola Infected Italian #Doctor #Health #Status #Update, as of November 28 2014 [      ]

Health Update Report No. 4, November 28 2014


General health status of the patient is improved; the case subjectively reported to feel better.

Body temperature is below 38°C [100°F].

All other vital parameters continue to be normal so far.

The case is in good mental status, walks unassisted in his isolation room and interacts with health care workers.

His hematological parameters are improved (white blood cells count & platelets count).

Liver and kidneys functions are normal.

No new symptoms related to Ebola Virus Disease have developed, notably hemorrhages.

Last update: 28 november 2014



#Epidemiological #update: #Outbreak of #Ebola virus disease in West #Africa, 28 Nov 2014 (@ECDC_EU, edited)

[Source: European Centre for Disease Prevention and Control (ECDC), full page: (LINK). Edited.]

Epidemiological update: Outbreak of Ebola virus disease in West Africa, 28 Nov 2014 [      ]

Since December 2013 and as of 23 November 2014, WHO has reported 15 935 confirmed, probable and suspected cases of Ebola virus disease (EVD) in six affected countries (Guinea, Liberia, Mali, Sierra Leone, Spain and the United States of America) and two previously affected countries (Nigeria and Senegal).

There have been 5 689 reported deaths. This is an increase of 780 cases and 269 deaths since 16 November 2014.


Distribution of cases

  • Countries with widespread and intense transmission:
    • Guinea:
      • 2 134 cases and
      • 1 260 deaths (as of 23 November 2014),
    • Liberia:
      • 7 168 cases and
      • 3 016 deaths (as of 22 November 2014),
    • Sierra Leone:
      • 6 599 cases and
      • 1 398 deaths (as of 23 November 2014).
  • Countries with an initial case or cases, or with localised transmission:
    • United States:
      • four cases including one death,
    • Spain:
      • one case, no deaths,
    • Mali:
      • eight cases, six deaths,
    • Nigeria:
      • 20 cases and eight deaths. Nigeria was declared Ebola free on 19 October 2014,
    • Senegal:
      • one confirmed imported case. Senegal was declared Ebola free on 17 October 2014.


Figure 1. Distribution of cases of EVD by week of reporting in Guinea, Sierra Leone, Liberia, Nigeria, Senegal and Mali, weeks 48/2013 to 48/2014, as of 26 November 2014.


* In week 45/2014, WHO carried-out retrospective correction in the data resulting in reporting 299 fewer cases resulting in a negative value for new cases in week 45 which is not plotted. 

** According to WHO the marked increase in the cumulative total number of cases in week 43 is due to a more comprehensive assessment of patient databases leading to 3 792 additional reported cases. However, these cases have occurred throughout the epidemic period .

The green line represents the trend based on a five week moving average plotted on the fifth week of the moving average window. The figure includes cases in Nigeria (20), Senegal (1) and Mali (4).


Situation in specific West African countries

According to WHO, in the three countries with widespread and intense transmission, reported case incidence seems stable in Guinea, stable or declining in Liberia, but still increasing in Sierra Leone. All administrative districts in Liberia and Sierra Leone have reported at least one confirmed or probable case of EVD since the start of the epidemic. Cases and deaths continue to be under-reported.

On 25 November 2014, WHO confirmed two additional cases of EVD in Bamako, Mali. The first case was the 23-year-old fiancée of a 25-year-old nurse who attended the Imam from Guinea (the index case in this outbreak) and the second case is part of a family of previously confirmed and deceased patients. In total, eight cases of EVD, including six deaths, have been reported in Mali (seven in Bamako and one in Kayes). To date, all seven cases in Bamako can be linked to contact with an Imam who developed symptoms on 17 October in his native village of Kourémalé, Guinea, and arrived in Bamako on 25 October for treatment at the Pasteur Clinic. All identified contacts connected with this initial case have now completed 21-days follow-up. Among the cases in Bamako, two are healthcare workers (HCWs) who cared for the imported case from Guinea. According to WHO, as of 24 November 2014, 285 of 288 contacts linked with the current outbreak in Bamako have been followed-up.


Figure 2. Distribution of cases of EVD by week of reporting, Guinea, Liberia and Sierra Leone, as of week 48/2014.


* The marked increase in the number of cases reported in Sierra Leone (week 44) and Liberia (week 43) results from a more comprehensive assessment of patient databases. The additional 3 792 cases have occurred throughout the epidemic period. Source: Data are based on official information reported by ministries of health up to the end of 2 November for Guinea and Sierra Leone and 31 October for Liberia. 

** In week 45/2014, WHO reported 476 fewer cases than the week before in Sierra Leone due to retrospective corrections.

§ In week 44/2014, WHO reported zero cases for Liberia.


Figure 3. Distribution of cases of EVD by week of reporting in Guinea, Sierra Leone, Liberia and Mali (as of week 47/2014).


Source: Data from ministries of health reports (suspected, probable and confirmed cases).


Situation among healthcare workers

As of 16 November WHO reported a total of 592 health-care workers (HCWs) infected with EVD, 340 of whom have died. According to WHO early indication a substantial proportion of infections among HCWs occurred outside the context of Ebola treatment and care centres.


Table 2. Number of Ebola cases and deaths among healthcare workers, as of 23 November 2014.

[Country - Healthcare worker cases (% of reported cases) - Healthcare worker deaths (% of reported deaths)]

  • Guinea - 97 (4.5) - 56 (4.4)
  • Liberia - 342 (4.8) - 172 (5.7)
  • Mali - 2 (25.0) - 2 (33.3)
  • Nigeria - 11 (55.0) - 5 (62.5)
  • Sierra Leone - 136 (2.1) - 105 (7.5)
  • Spain - 1 (100) – 0
  • United States - 3 (75.0) – 0
  • Total - 592 (3.7) - 340 (6.0)


Source: Data are based on official information reported by Ministries of Health.


Situation outside West Africa


No new autochthonous EVD cases have been reported since 23 October. The latest autochthonous reported case concerns a medical aid worker who volunteered in Guinea and recently returned to the United States. He was hospitalised in New York City and was discharged healthy on 11 November 2014.



No new cases have been reported since 6 October when a healthcare worker was infected while caring for an Ebola-infected patient in Madrid. She recovered and tested negative for EVD on 19 October. A second negative test was obtained on 21 October. All 83 contacts of the HCW have completed a 21-day follow-up. Spain will be declared free of EVD next 42 days after the date of the second negative test if no new cases are reported.


Medical evacuations and repatriations from EVD-affected countries

Twenty two individuals have been evacuated or repatriated from the EVD-affected countries. As of 27 November, there have been 11 medical evacuations of confirmed EVD-infected patients to Europe (three to Germany, three to Spain, two to France, one to the UK, one to Norway and one to Italy). Two persons exposed to Ebola have been repatriated to the Netherlands and tested negative. One individual was evacuated to Switzerland and was not confirmed for EVD in September.

The most recent case is an Italian doctor who was medically evacuated from Sierra Leone on 24 November. According to the Italian Ministry of Health, he was working in the Medical Centre of the NGO Emergency in Sierra Leone when he was diagnosed with EVD. The patient, a 50-year-old Sicilian man, was transported to the National Institute for Infectious Diseases (INMI) Lazzaro Spallanzani in Rome and was hospitalised in a high isolation unit to receive the appropriate treatment.


Table 3. Medical evacuation and repatriation from EVD-affected countries, as of 28 November 20144. Medical evacuations and repatriations from EVD-affected countries, as of 28 November 2014.

[Date of Evacuation - Evacuated from  - Evacuated to  - Profession  - Status  - Confirmed  - Citizenship]

  1. 02 August 2014  - Liberia  - Atlanta (USA)  - Healthcare worker  - Discharged  - Yes  - USA
  2. 05 August 2014  - Liberia  - Atlanta (USA)  - Healthcare worker  - Discharged  - Yes  - USA
  3. 06 August 2014  - Liberia  - Madrid (Spain)  - Healthcare worker  - Death  - Yes  - Spain
  4. 24 August 2014  - Sierra Leone  - London (United Kingdom)  - Healthcare worker  - Discharged  - Yes  - UK
  5. 27 August 2014  - Sierra Leone  - Hamburg (Germany)  - Epidemiologist  - Recovered  - Yes  - Senegal
  6. 04 September 2014  - Monrovia, Liberia  - Omaha (USA)  - Physician (obstetrician)  - Discharged  - Yes  - USA
  7. 09 September 2014  - Kenema, Sierra Leone  - Atlanta (USA)  - Physician  - Discharged  - Yes  - USA
  8. 14 September 2014  - Sierra Leone  - Leiden (the Netherlands)  - Healthcare worker  - Discharged  - No  - the Netherlands
  9. 14 September 2014  - Sierra Leone  - Leiden (the Netherlands)  - Healthcare worker  - Discharged  - No  - the Netherlands
  10. 19 September 2014  - Liberia  - Paris (France)  - Healthcare worker  - Discharged  - Yes  - France
  11. 22 September 2014 - Sierra Leone  - Madrid (Spain)  - Healthcare worker  - Death  - Yes  - Spain
  12. 22 September 2014  - Sierra Leone  - Geneva (Switzerland)  - Healthcare worker  - Admitted  - Unknown  - Non-Swiss
  13. 28 September 2014  - Sierra Leone  - Maryland (USA)  - Healthcare worker  - Admitted  - Unknown  - USA
  14. 02 October 2014  - Sierra Leone  - Frankfurt (Germany)  - Healthcare worker  - Stable  - Yes  - Uganda
  15. 02 October 2014  - Liberia  - Omaha (USA)  - Cameraman  - Discharged  - Yes  - USA
  16. 06 October 2014  - Sierra Leone  - Oslo (Norway)  - Healthcare worker  - Discharged  - Yes  - Norway
  17. 08 October 2014  - Liberia  - Leipzig (Germany)  - Laboratory worker  - Death  - Yes – Sudan
  18. 01 November 2014 - Sierra Leone  - Paris (France)  - UN worker  - Unknown  - Yes  - Sierra Leone
  19. 15 November 2014  - Sierra Leone - Nebraska (USA) - Healthcare worker – Death – Yes – USA
  20. 20 November 2014 - Sierra Leone - Geneva (Switzerland) - Healthcare worker – Unknown – Yes – Cuba
  21. 21 November 2014 – Mali - Madrid (Spain) - Healthcare worker – Unknown – No – Spain
  22. 24 November 2014 - Sierra Leone - Rome (Italy) - Healthcare worker – Admitted – Yes – Italy

Figure 4: Medical Evacuations and repatriations from EVD-affected countries, as of 28 November 2014.





A dual character of #flavonoids in #influenza A virus #replication and spread through modulating cell-autonomous immunity by MAPK signaling pathways (Scientific Reports, abstract, edited)

[Source: Scientific Report, full page: (LINK). Abstract, edited.]

Scientific Reports | Article

A dual character of flavonoids in influenza A virus replication and spread through modulating cell-autonomous immunity by MAPK signaling pathways [      ]

Wenjuan Dong,1, Xiuli Wei,1, Fayun Zhang,1, Junfeng Hao,2, Feng Huang,1, Chunling Zhang1, & Wei Liang1

Journal name: Scientific Reports - Volume: 4, Article number: 7237 - DOI: doi:10.1038/srep07237

Received 26 February 2014 - Accepted 06 November 2014 - Published 28 November 2014



Flavonoids are well known as a large class of polyphenolic compounds, which have a variety of physiological activities, including anti-influenza virus activity. The influenza A/WSN/33 infected A549 cells have been used to screen anti-influenza virus drugs from natural flavonoid compounds library. Unexpectedly, some flavonoid compounds significantly inhibited virus replication, while the others dramatically promoted virus replication. In this study, we attempted to understand these differences between flavonoid compounds in their antivirus mechanisms. Hesperidin and kaempferol were chosen as representatives of both sides, each of which exhibited the opposite effects on influenza virus replication. Our investigation revealed that the opposite effects produced by hesperidin and kaempferol on influenza virus were due to inducing the opposite cell-autonomous immune responses by selectively modulating MAP kinase pathways: hesperidin up-regulated P38 and JNK expression and activation, thus resulting in the enhanced cell-autonomous immunity; while kaempferol dramatically down-regulated p38 and JNK expression and activation, thereby suppressing cell-autonomous immunity. In addition, hesperidin restricted RNPs export from nucleus by down-regulating ERK activation, but kaempferol promoted RNPs export by up-regulating ERK activation. Our findings demonstrate that a new generation of anti-influenza virus drugs could be developed based on selective modulation of MAP kinase pathways to stimulate cell-autonomous immunity.

Subject terms: Infection • Viral host response •  Pathogenesis



#HK, #Notification of confirmed #human case of #avian #influenza A(#H7N9) in #Guangdong (CHP, November 28 2014)

[Source: Centre for Health Protection, Hong Kong PRC SAR, full page: (LINK).]

Notification of confirmed human case of avian influenza A(H7N9) in Guangdong [      ][      ]

The Centre for Health Protection (CHP) of the Department of Health (DH) has been notified by the Health and Family Planning Commission of Guangdong Province of a confirmed human case of avian influenza A(H7N9) today (November 28) affecting a 31-year-old woman in Dongguan, Guangdong Province.

The patient, who is in critical condition, is currently receiving treatment in a hospital in Guangzhou.

To date, 444 human cases of avian influenza A(H7N9) have been confirmed on the Mainland in:

  1. Zhejiang (139 cases),
  2. Guangdong (110 cases),
  3. Jiangsu (58 cases),
  4. Shanghai (41 cases),
  5. Hunan (24 cases),
  6. Fujian (22 cases),
  7. Anhui (17 cases),
  8. Jiangxi (eight cases),
  9. Beijing (five cases),
  10. Shandong (five cases),
  11. Henan (four cases),
  12. Xinjiang Uygur Autonomous Region (four cases),
  13. Guangxi (three cases),
  14. Jilin (two cases),
  15. Guizhou (one case) and
  16. Hebei (one case).

"Locally, we will remain vigilant and work closely with the World Health Organization and relevant health authorities to monitor the latest developments," a spokesman for the DH said.

"In view of cases confirmed on the Mainland, members of the public should maintain good personal, food and environmental hygiene at all times during travel," the spokesman urged.

"All boundary control points have implemented disease prevention and control measures. Thermal imaging systems are in place for body temperature checks of inbound travellers. Suspected cases will be immediately referred to public hospitals for follow-up investigation," the spokesman added.

Regarding health education for travellers, the display of posters and broadcast of health messages in departure and arrival halls, environmental health inspection and provision of regular updates to the travel industry via meetings and correspondence are proceeding.

Travellers, especially those returning from avian influenza-affected areas with fever or respiratory symptoms, should immediately wear masks, seek medical attention and reveal their travel history to doctors. Healthcare professionals should pay special attention to patients who might have had contact with poultry, birds or their droppings in affected areas.

The public should remain vigilant and take heed of the advice against avian influenza below:

  • Do not visit live poultry markets and farms. Avoid contact with poultry, birds and their droppings;
  • If contact has been made, thoroughly wash hands with soap;
  • Avoid entering areas where poultry may be slaughtered and contact with surfaces which might be contaminated by droppings of poultry or other animals;
  • Poultry and eggs should be thoroughly cooked before eating;
  • Wash hands frequently with soap, especially before touching the mouth, nose or eyes, handling food or eating; after going to the toilet or touching public installations or equipment (including escalator handrails, elevator control panels and door knobs); and when hands are dirtied by respiratory secretions after coughing or sneezing;
  • Cover the nose and mouth while sneezing or coughing, hold the spit with a tissue and put it into a covered dustbin;
  • Avoid crowded places and contact with fever patients; and
  • Wear masks when respiratory symptoms develop or when taking care of fever patients.

The public may visit the avian influenza page of the CHP of the DH (www.chp.gov.hk/en/view_content/24244.html) for more information on avian influenza. The updated information of affected areas can be found on the following webpage: www.chp.gov.hk/files/pdf/global_statistics_avian_influenza_e.pdf .



#Guangdong Province reported a #human case of #avian #influenza A/(#H7N9) virus #infection (DoH, November 28 2014, edited)

[Source: China PRC Guangdong Province Department of Health, full page in Chinese: (LINK). Automatic translation, edited.]

#Guangdong Province reported a #human case of #avian #influenza A/(#H7N9) virus #infection [      ][      ]

2014-11-28 22:21:04   Ministry of Health and Family Planning 

The Health and Family Planning Commission of Guangdong Province reported during November 28 briefing, a case of human infection with H7N9 bird flu virus.

The case is a female, 31 years old, currently living in Dongguan City. On November 28 the infection has been confirmed; the patient is currently in critical condition in a Guangzhou hospital.



#Saudi Arabia reported two new #MERS-CoV cases in the last 24 hours (@SaudiMOH, November 28 2014, edited)

[Source: Saudi Arabia Ministry of Health, full page: (LINK). Edited.]

#Saudi Arabia reported two new #MERS-CoV cases in the last 24 hours [      ][      ]



New Cases:

  1. man, 34 years old, foreign citizen, resident in Saqaqa, currently in stable condition; history of exposure with confirmed/suspected cases in the community;
  2. man, 40 years old, foreign citizen, resident in Taif, currently in stable condition; contacts history under investigation.

Earlier reported cases discharged from hospital:

  1. man, 53 years old, Saudi national, resident in Saqaqa.

Deaths in previously announced cases:

  1. man, 42 years old, foreign citizen, resident in Taif.