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Sunday, October 21, 2012

Rwanda: Health Ministry Warns on Marburg Fever

 21 OCTOBER 2012

The Ministry of Health (MoH) has called on the public to immediately report any signs or suspected cases of Marburg hemorrhagic fever, as steps are taken to prevent the deadly virus.
The warning comes at a time when an outbreak of the deadly virus has been confirmed in neighbouring Uganda. On Friday, Uganda's Health Ministry confirmed the highly infectious viral hemorrhagic fever in Kitumba Sub-county, Kabale District in South-Western Uganda.
"Following reported outbreaks of the deadly Marburg hemorrhagic fever in neighbouring Uganda, the Ministry of Health is cautioning the public to remain vigilant as the government steps up measures of preventing in-flow of the deadly virus into Rwanda," reads the warning, a copy of which The Sunday Times has received.
By Saturday, the deadly virus had claimed four people from the same family in Kabale.
Marburg hemorrhagic fever is a highly contagious disease transmitted from person to person and characterised by fever, headache, joint and muscle pain.
A person suffering from it also experiences sore throat, weakness, diarrhoea, vomiting, abdominal pains and bleeding from all body openings, i.e eyes, nose,gums, ears, anus and the skin.
"Kabale District borders Rwanda, and specifically, the Districts of Gicumbi, Musanze, Nyagatare, and Burera that share a boarder with Uganda are at a high risk," the warning reads.
MoH, in collaboration with its partners, and through the emergency preparedness team, is taking actions to prevent potential health risks that might be caused by the deadly disease.
Alert warnings have been issued to all health centres on how to detect and handle cases once they arise. Health care providers at District Hospitals and Health Centres have been trained to prevent and manage the fever.
All necessary kits and medical supplies needed have been dispatched to all health facilities.
Members of public are required to seek medical attention at the nearest health facility especially those who visited Uganda and are experiencing signs or suspect they might be having the virus.
The ministry says it has elaborated plans to effectively respond should there be an outbreak. It, however, urges the public to stay calm.  http://allafrica.com/stories/201210210096.html

Health Ministry warns on Marburg outbreak



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The Ministry of Health has this Friday warned the general public of an outbreak of a deadly Marburg virus in Kitumba sub-county, Kabale district in western Uganda.

Health experts have confirmed an outbreak of the deadly Marburg after samples from two relatives taken to the Uganda Virus Institute and tested positive.
Police Thursday stopped the burial of Boaz Turyahikayo a lecturer at Uganda Christian University and his sister Mildrid Asasira after it emerged that their family had lost four people from a mysterious disease in just a month.
 

The other two are Lillian Banegura their mother and an elder brother Bernard Rutaro who passed away early this month.
 ..

Alert on as Marburg death toll rises to five

By Robert Muhereza

Posted Sunday, October 21 2012 at 01:00
IN SUMMARY

New case. One more death reported in Kabale as health officials monitor another confirmed case who crossed to Rukungiri, seeking help from preachers.
The death toll from an outbreak of the Marburg virus, a rare and highly contagious form of hemorrhagic fever closely related to the Ebola, has risen to five in just four days, with a new suspected case registered Friday night.

Nathan Biryamurabaho 50, a resident of Bukora Kitumba Sub-county, was the fifth person to die of the virus that was confirmed on Friday in the south-western district of Kabale by the Ministry of Health. The developments come 16 days after Uganda was declared Ebola free.

The Kabale Regional Referral Hospital Director, Dr Placid Mihayo, said the patient died a few hours after he had been referred from Rugarama Hospital when his condition worsened.


The victim is a relative to the family that lost four people in the same sub-county who tested positive to the Marburg virus. “The deceased died at our isolated ward. The symptoms are exactly similar to those of his relatives who died on Thursday at this hospital. We need experts from the Ministry to demonstrate how to handle this emergency scare so that our members of staff can learn from them,” Dr Mihayo said.

The Kabale District Health Officer, Dr Patrick Tusiime, said the relatives of the deceased sneaked the body out of the hospital after the medical team abandoned them.

“We are planning to go to the residence of the deceased and pick the body for postmortem. Such handling of suspected Marburg case should stop because the virus shall spread very fast to other people,” Dr Tusiime said.

October deaths
Another four people who have died since October 4 were also suspected to have been killed by the disease, the Health ministry said in a statement. 
“Preliminary reports from the district indicate that four other people had allegedly died of a strange disease since October 4th,” said a press statement issues by Health ministry.

Dr Tusiime said another confirmed victim of the highly-infectious viral hemorrhagic fever only identified as Obed had crossed into Rukungiri District. Obed is said to be seeking healing from religious leaders as he claims to have been bewitched. He escaped from the health facility on Wednesday.

“The results from the Uganda Virus Research Institute clearly show that this man is Marburg positive. We have located where he is and we have liaised with our health counterparts in Rukungiri to monitor him from there,” Dr Tusiime said.

Despite the availability of protective gears and first aid treatment, fear has gripped the medical workers who are now abandoning the hospital.
“Last evening (Friday), when health officials learnt that the victims who passed away had similar symptoms as those of the four confirmed cases who had died earlier, they run away because they are scared of the disease,” said Dr Tusiime.

Experts requested for
The hospital has now requested for experts from the Ministry of Health to handle the patients. A team of health officials have already been dispatched to the district to support both clinical and public health investigations. Also a National Taskforce has reactivated its rapid response committees to quickly act on any emergencies.

Efforts are also underway to trace and list all possible contacts that were exposed to the suspects and confirmed cases. The Ministry of Health urges the general public to report any suspected patient to a nearby health unit and avoid public gatherings or direct contact with body fluids of a person suffering from Marburg by using gloves and masks. 
The last outbreak of Marburg in Uganda came in 2007 and killed two miners in the district.http://www.monitor.co.ug/News/Nation...z/-/index.html

Wednesday, October 17, 2012

DRC: Continuing efforts to contain Ebola



Containing Ebola
NAIROBI, 17 October 2012 (IRIN) - An Ebola outbreak that has killed several people in the Democratic Republic of Congo (DRC) appears to be slowing down, but health workers say there is a need for continued vigilance in order to contain the virus.

"Their last confirmed case was admitted in the MSF [Médecins Sans Frontières]/Ministry of Health Ebola ward on October 10, after two weeks with no confirmed cases," Olimpia de la Rosa, MSF medical emergency coordinator, told IRIN in an email. "The decrease in the number of admissions in our facility makes us think that we are on the way to contain the outbreak, but containment efforts must continue until no cases are confirmed for at least 21 days."

According to the UN World Health Organization's (WHO) 8 Octoberupdate, the disease had claimed 24 lives by 7 October, while 31 cases had been confirmed and 18 were suspected. The outbreak, first reported on 17 August, is in Isiro and Viadana health zones in the country's north-eastern Orientale Province.

The Ministry of Health is working with a task force that includes, among others, MSF, the International Federation of Red Cross and Red Crescent Societies, the US Centers for Disease Control and Prevention, the UN Children’s Fund (UNICEF) and WHO. Its activities involve surveillance, health worker training, community education and the implementation of biosafety measures. MSF has also set up a centre for supportive treatment of Ebola patients.

Ebola, which causes fever and bleeding from orifices, can cause death within days. There is no cure or vaccine for it, so efforts are concentrated on stopping its spread. The current strain in DRC has been identified as Ebola-Bundibugyo - named for a Ugandan district that borders the DRC. The fatality rate rate for this strain is estimated at about 40 percent.

Medical situation delicate

According to MSF's de la Rosa, there is "a need to reinforce health staff knowledge about the ways of transmission of the disease and about the ways to protect patients and themselves from contagion". 

Ebola is new to the area, and few local health workers had been trained to deal with it when the outbreak began. Several health workers have succumbed to the outbreak. Maintaining empathy for severely ill patients while ensuring health workers remain disease-free is a challenge.

"For the health staff providing care in the treatment centre, it is a big challenge to make compatible biosafety measures and establish[ing] an empathic patient-care giver relationship. Gloves, goggles, masks, gowns… pose a barrier to transmission but also to human contact and communication," she said.

"Physical contact through the protection material, words [of support] and provision of good medical care in the most friendly facility that biosafety allows can help to overcome this challenge and ensure the providing of quality medical treatment and patients' well-being."

Prevention a problem

According to WHO, "Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals." Fruit bats are considered to be the natural host of the virus.

Preventing future outbreaks will remain difficult as long as the response is reactionary, de la Rosa noted. "It is very difficult to prevent an Ebola outbreak from appearing because we still ignore [the virus] in non-epidemic periods, making impossible to stop the appearance of the first cases," she said. "We can just detect outbreaks when some patients become infected, usually when they die of unknown causes."  http://www.irinnews.org/Report/96572/DRC-Continuing-efforts-to-contain-Ebola

Meanwhile, neighbouring Uganda, which experienced a fatal Ebola outbreak in the western district of Kibaale in July, was declared Ebola-free by the country’s Ministry of Health on 4 October.

Meningitis outbreak: Illness linked to 3rd fungus


Meningitis victims sue as probe continues

2:25 AM, Oct 17, 2012
A third fungus — black mold most commonly found on outdoor plants — is likely part of the national meningitis outbreak linked to a Massachusetts compounding pharmacy that supplied epidural steroids and other drugs.\
On Tuesday, the Centers for Disease Control and Prevention confirmed one Cladosporium infection, and CDC Medical Epidemiologist Tom Chiller linked it to the outbreak. He shared the news in a conference call with doctors and pharmacists nationwide.
At the same time, agents with the U.S. Food and Drug Administration raided the closed-down New England Compounding Center in Framingham, Mass., carting off samples and documents.
An FDA spokesman called the raid part of the agency’s ongoing investigation. That includes checking drug samples from New England Compounding Center, reviewing the facility’s operations — including whether it had valid prescriptions for the drugs it compounded — and learning where the drugs went.
The Framingham plant shut down Oct. 3. On Oct. 4, New England Compounding Center recalled all of its 1,200 products.
The FDA is trying to determine how many doses of those products were shipped to clinics nationwide. In the meningitis outbreak, 17,676 vials of the steroid methylprednisolone acetate were shipped to 23 states.
At this point, the most frequent contaminant found in cases related to the compounding pharmacy is the fungus Exserohilum. Another fungus, Aspergillus, was detected in one patient — the September case at Vanderbilt University Medical Center that alerted officials to the meningitis outbreak that has now sickened 233 patients in 15 states. Fifteen of those patients have died.
In Tennessee, 59 patients with fungal meningitis had steroid epidurals into their spinal columns. Those were provided at PCA Pain Center in Oak Ridge, Saint Thomas Outpatient Neurosurgery Center in Nashville and the Specialty Surgery Center in Crossville.
The number of confirmed deaths in Tennessee remains at six.
Like the other two molds in the outbreak, Cladosporium is commonly found in the environment on decaying plant matter and soil, said Stephanie Petty, an environmental scientist at Nashville-based Resolution Inc., which provides environmental consulting for businesses.     

Tuesday, October 16, 2012

Indonesian crew member dies from meningitis


Another in critical condition in Livorno hospital

16 October, 21:05 
Livorno, October 16 - One of the four crew members of an Italian cruise liner who was hospitalized last week following an outbreak of bacterial meningitis died Tuesday evening, doctors said.

Indonesian crew member Ermandiasa I Gede, 32, died from septic shock, despite numerous attempts by doctors to resuscitate him.

The four were admitted to a hospital in the Tuscan port of Livorno on October 7 at the end of a cruise by MSC's Orchestra liner.

A 26-year-old Brazilian crew member was released Tuesday and will return with his wife to his home country in the upcoming days.

Doctors said that the prognosis for a 32-year-old Filipino crew member is positive and that he should be released in the next several days.

A 47-year-old Italian from Sorrento remains in serious condition in the intensive care department of the Livorno hospital.  http://www.ansa.it/web/notizie/rubriche/english/2012/10/16/Indonesian-crew-member-infected-meningitis-dies_7642643.html?

Australia-Mother paralysed as flu rates soar


Shara Helmstedt sustained nerve damage to her legs after contracting influenza B.
Shara Helmstedt sustained nerve damage to her legs after contracting influenza B. Photo: Anthea Gleeson/The Chronicle
October 17, 2012 - 4:00AM
Queensland's influenza rates have soared to become the highest in Australia, with one Toowoomba mother left paralysed by an infection.
Shara Helmstedt, 31, is just one of 2023 Queenslanders who were diagnosed with influenza last month.
Victoria recorded the second largest number of  cases last month (883).
Last year, Queensland had the third highest rate of influenza cases at 227.3 per 100,000 people but this year the state has the highest rate in the country with 354.9 cases per 100,000 people.
Ms Helmstedt, a Zumba and fitness instructor with two young sons, contracted the flu two and a half weeks ago.
Two days after first catching it, she thought to herself "geez this has really knocked me around".
Two days after that, she was in hospital unable to move or feel her legs.
The nerves in Ms Helmstedt's legs had been damaged by a strain of influenza B and she has spent the past two weeks regaining feeling in her legs, which are now at 75 per cent movement.
"I was really scared because I have two young boys so I was just thinking 'oh no, this cannot be happening'," she said.
"It was really scary because they like to play footy and wrestle and everything and that's what I like to do with them.
"I knew I can't dwell on it, I've got to keep moving forward and I'll beat it and I will."
Ms Helmstedt had driven herself to the doctor at 20 km/h when she could only drag her legs behind her. Her eight-year-old son PJ helped her struggle in to the clinic.
She was hospitalised immediately.
"He's [PJ] a trooper, he's done it before," she said.
"I didn't realise I was pregnant a few years ago and I fainted and hit my head and was unconscious and he called triple-0 so he's my little guardian angel."
Ms Helmstedt is hoping to get out of hospital next week but is waiting for a Brisbane neurologist to visit Saint Vincent's Hospital in Toowoomba to carry out tests on how damaged her nerves are.
Until then doctors do not know if she will ever recover full use of her legs.
"I'm very fit and active and always out there and it knocked me for six," she said.
"[My family] were scared at first but they know I'm pretty strong and I'll get through it."
Ms Helmstedt said she had no idea "at all" a flu could cause so much damage and thought flu shots were for "old people".
"I'll be getting them from now on," she said.
"When the kids have a sniffle I take them to the doctor, now I'll be going to the doctor as soon as I have a sniffle too."  http://www.smh.com.au/queensland/mother-paralysed-as-flu-rates-soar-20121016-27ot2.html

Meningitis Outbreak Is 'Nowhere Near The End,' Expert Says


 

http://www.huffingtonpost.com/2012/10/16/meningitis-outbreak-nowhere-near-end-wiliam-schaffner_n_1969927.html

CDC says another 19 people diagnosed with meningitis in U.S. outbreak



Tue, 16 Oct 2012 18:55 GMT
Source: Reuters // Reuters
Oct 16 (Reuters) - Another 19 people have been diagnosed with fungal meningitis linked to possibly tainted vials of a steroid medication, the U.S. Centers for Disease Control and Prevention said on Tuesday, bringing the total number of cases to 231.
The CDC said there were two additional cases of infection in joints after a steroid injection but these were not confirmed as meningitis, bringing the total of infections nationwide to 233.
The death toll from the unprecedented outbreak was unchanged at 15, the CDC said.
The new cases were in Tennessee (6), Florida (2), Indiana (2), Maryland (1), Michigan (1), New Hampshire (2), New Jersey (2), Ohio (2), and Virginia (1).
The federal Food and Drug Administration on Monday said it had widened its investigation to other drugs produced by New England Compounding Center, the specialist pharmacy at the center of the outbreak. The Massachusetts company faces multiple investigations and lawsuits over the tainted medication linked to the meningitis scare.  http://www.trust.org/alertnet/news/cdc-says-another-19-people-diagnosed-with-meningitis-in-us-outbreak?

Vietnam-Stops all transport of live poultry from North to South


Pause transport of live poultry from North to South

(TNO) 16:10 this afternoon, Pham Van Dong, director of the Veterinary Department (MARD) said today all over the country there are five provinces with avian influenza within 21 days, including: Quang Ngai, Ha Tinh, Tuyen Quang Hoa Binh and the Pacific.

In particular, in Quang Ngai are complicated with five new outbreaks arise in two weeks. Currently the province has had to 125,000 children infected poultry.
According to the East, though this dangerous disease is gradually put under control, the risk of further recurrence and spread on a large scale is very high.
"The provinces are translated to the destruction of infected animals and monitored areas with outbreaks, organized vaccination drive enclosure, prohibited activities and movement of poultry slaughter spread of disease," he East note.
According to the head of the Department of Animal Health, will continue to suspend the transportation of live poultry quarantine from the north to the south through the province of Quang Ngai and Kon Tum to prevent the H5N1 virus from 2.3.2.1 to branch the southern provinces until the country to control the current bird flu outbreak.  http://www.thanhnien.com.vn/pages/20121016/tam-dung-van-chuyen-gia-cam-song-tu-bac-vao-nam.aspx

Meningitis outbreak: CDC reports 233 infections


Meningitis outbreak: CDC reports 233 infections

Investigators find a third type of mold in vials

1:57 PM, Oct 16, 2012
A third type of mold has been found in unopened vials produced by a compounding lab linked to a national outbreak of fungal infections that now stands at 233 cases, the U.S. Centers for Disease Control and Prevention said today.
That number compares to 214 on Monday. All but two of the infections are fungal meningitis. The nationwide death count did not rise. In Tennessee, illnesses increased to 59, but the death count stayed at six.
The third mold is Cladosporium, which CDC officials described as a black mold similar to the dominant one, Exserohilum. Exserohilum has been confirmed in 26 cases. A third mold, Aspergillus, was detected in one patient. The vials came from New England Compounding Center’s Framingham, Mass., facility.
The number of confirmations for mold types is fewer than the number of people sickened because of the time it takes for grow a mold sample.

Monday, October 15, 2012

Suspected Hantavirus case in Adirondacks


Oct 15, 2012 6:27 PM EDT
ELIZABETHTOWN, N.Y. -
It's a vacation to the Adirondacks that changed Michael Vaughan's life forever. 

"I might not have made it," said Michael Vaughan.

While hiking near Mount Marcy, the 72-year-old from Long Island decided to rest for the night in a lean-to, despite hearing mice crawling around everywhere. "There was a little bit of blood under my finger nail and I was like, 'oh, a mouse must have bitten me,'" he said.

The researcher at Stony Brook University thought nothing of it until a month later. "I had nausea -- headaches from climbing the stairs," he said.

His doctors diagnosed him with Hantavirus, an infection that attacks the lungs. It is contracted by  breathing in fumes from rodent droppings -- mainly mice. Vaughan spent four days in the intensive care unit. 

"It does have a mortality rate of 35-percent of those who are infected," said Dr. Erich Mackow with Stoney Brook Medicine.

Vaughan has fully recovered. Meanwhile, the New York Health Department and the Center for Disease Control are now working to confirm the doctor's initial lab tests.  

"This is nothing we have seen in the Adirondacks before," said Linda Beers, Essex County's Health Director.

Local health officials say there is no reason for local residents to be on high alert at this point, but they have added information about Hantavirus -- and how to prevent it -- on the county's web site. 

"We are taking a look see, wait see attitude," Beers said. "We're not overly concerned at this point."

The state health department hopes to have the lab results back by the end of the week. http://www.wcax.com/story/19826439/suspected-hantavirus-case-in-adirondacks

Ebola antibody treatment, produced in plants, protects monkeys from lethal disease



posted on: october 15, 2012 - 7:30pm

A new Ebola virus study resulting from a widespread scientific collaboration has shown promising preliminary results, preventing disease in infected nonhuman primates using monoclonal antibodies.
In this week's online edition of the Proceedings of the National Academy of Sciences (PNAS), the research team describes a proof-of-concept for using a "cocktail" of monoclonal antibodies, or mAbs, to prevent lethal disease in rhesus macaques. When administered one hour after infection, all animals survived. Two-thirds of the animals were protected even when the treatment, known as MB-003, was administered 48 hours after infection.
Ebola virus, which causes hemorrhagic fever with human case fatality rates as high as 90 percent, has been responsible for numerous deaths in central Africa over the past several months. In addition to being a global health concern, the virus also is considered a potential biological threat agent. Currently there are no available vaccines or treatments approved for use in humans.
The work is the culmination of more than a decade of effort between government and industry partners. According to lead investigator Gene Olinger, Ph.D., a virologist at the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), this consortium of investigators has taken very distinct technologies and combined them to develop a cutting-edge medical countermeasure against a lethal viral disease.
"It is rare that an antiviral compound prevents Ebola virus infection with limited to no morbidity in treated animals at any point of treatment following infection by this lethal virus," said Olinger. "Until recently, attempts to utilize antibodies to provide protection against Ebola virus have been met with failure. The level of protection against disease that we saw with MB-003 was impressive."
In addition, the production method used in this study offers the potential to make an economical and effective medical countermeasure, according to the authors. Initially developed as a monoclonal antibody cocktail in the mouse model, MB-003 was successfully humanized and then produced in the tobacco plant-based production system.
"We were pleased to see how well the humanized mAbs of MB-003 performed," said Larry Zeitlin, Ph.D., president of Mapp Biopharmaceutical and senior author on the study. "We also were pleasantly surprised by the superiority of the plant-derived mAbs compared to the same mAbs produced in traditional mammalian cell culture."
Further improvement in antibody efficacy was developed at Kentucky BioProcessing (KBP). Using a fully automated production system that operates in accordance with good manufacturing practices (GMP), antibody is produced in a tobacco plant system. This new development process significantly decreases the amount of time required for production, increases the quantity of antibody produced, and slashes the cost of manufacturing, according to Barry Bratcher, chief operating officer of KBP and co-author on the PNAS study.
"Our GMP facility can generate a new antibody lot in two weeks to rapidly address new threats and new outbreaks," said Bratcher.
Olinger said efforts are underway to advance MB-003 to clinical safety testing as his team at USAMRIID continues to determine the true therapeutic capability of the cocktail.

FDA: Massachusetts compounding problem may be broader than steroid injection


“At this point in FDA’s investigation, the sterility of any injectable drugs … produced by [The New England Compounding Center] are of significant concern,” the agency wrote in a statement posted on its website, “and out of an abundance of caution, patients who received these products should be alerted to the potential risk of infection.”


Read more: [link to www.politico.com

Jumping DNA rides aboard a virus


Jumping DNA rides aboard a virus, which infects a giant virus, which infects an amoeba, which infected a woman’s eye

Earlier this year, a 17-year-old French woman arrived at her ophthalmologist with pain and redness in her left eye. She woman had been using tap water to dilute the cleaning solution for her contact lenses, and even though they were meant to be replaced every month, she would wear them for three. As a result, the fluid in her contact lens case had become contaminated with three species of bacteria, an amoeba called Acanthamoeba polyphaga that can caused inflamed eyes.
The mystery of the woman’s inflamed eyes was solved, but Bernard La Scola and Christelle Desnueslooked inside the amoeba, they found more surprises.
It was carrying two species of bacteria, and a giant virus that no one had seen before—they called it Lentille virus. Inside that, they found a virophage—an virus that infects other viruses—which they called Sputnik 2. And in both Lentille virus and Sputnik 2, they found even smaller genetic parasites – tiny chunks of DNA that can hop around the genomes of the virus, and stow away inside the virophage. They called these transpovirons.
So, the poor red eyes of the French patient were carrying an entire world of parasites, nested within one another like Russian Matryoshka nesting dolls. The transpovirons were hidden in the virophage, which infected the giant virus, which infected the amoeba, which infected the woman’s eyes.
Rise of the virophages
The same team found the first virophage – Sputnik – back in 2008, under similar circumstances. In dirty water from a Parisian cooling tower, they had i..

Deadly Meningitis Outbreak"POISONING" Tied to More Drugs, FDA Says



A second steroid manufactured by New England Compounding Center has been linked to another potential meningitis infection, U.S. regulators said.

A different steroid, methylprednisolone acetate, used as an injection for back pain from the Framingham, Massachusetts-based pharmacy has been tied to a fungal meningitis outbreak that has led to 214 infections in 15 U.S. states, killing 15 people.

The second steroid, triamcinolone acetonide, is used to treat skin conditions that result in itching, redness, dryness, and inflammation, according to the National Institutes of Health.The patients received the medication through an epidural injection. Transplant patients have also experienced fungal infections after being given a drug from t..
[link to www.bloomberg.com

Efforts to curb the epidemic of Ebola continue


Efforts to curb the epidemic of Ebola continue


Postponement
-
Doctors Without Borders and other organizations are trying to contain an outbreak of Ebola in Eastern Province, in the northeast of the Democratic Republic of Congo (DRC). In three months, the disease has already been 34 victims, according to data from the Ministry of Health.
Twelve new cases have been confirmed since September 11, and four patients are being treated in hospital Isiro, the epicenter of the epidemic. Since the start of operations in August, MSF medical teams are doing everything possible to improve the well-being of patients by providing them and their families the care and psychosocial support...

Meningitis outbreak toll: 214 cases, 15 deaths

2:01 PM, Oct 15, 2012 

An outbreak of fungal meningitis has been linked to steroid shots for back pain. The medication, made by a specialty pharmacy in Massachusetts, has been recalled.
Latest numbers from the Centers for Disease Control and Prevention:
Illnesses: 214; 212 cases of fungal meningitis, two ankle infections.
Deaths: 15
States: 15; Florida, Idaho, Illinois, Indiana, Maryland, Michigan, Minnesota, New Hampshire, New Jersey, North Carolina, Ohio, Pennsylvania, Tennessee, Texas and Virginia. 
http://www.ksdk.com/news/health/article/343097/9/Steroid-linked-meningitis-outbreak-toll-214-cases-15-deaths-?

Pic from Nepal outbreak


Rapid Response Team holds a culled rooster as he walks in a poultry farm infected by bird flu in Bode

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A member of the Rapid Response Team (RRT) holds a rooster that was culled as he walks in a poultry farm infected by H5N1 bird flu virus at Bode in Bhaktapur October 15, 2012. The District Administration Office has declared emergency in the area after an outbreak of bird flu was confirmed at the poultry farm. REUTERS/Navesh Chitrakar   http://www.trust.org/alertnet/multimedia/pictures/detail.dot?mediaInode=9abb5dcd-cf93-4ca9-a40c-3248e14833a2