Yemen receives large cholera supply shipment

The World Health Organization (WHO) announced yesterday that a shipment containing 400 tons of equipment and supplies, including ambulances, arrived in Yemen on Jun 30 to help with the country's cholera outbreak.

Besides 20 ambulances, the delivery also included cholera kits, hospital equipment, and intravenous fluid bags. In a statement yesterday, the WHO said 10 ambulances were delivered 3 weeks ago and 10 more are expected to arrive in the weeks ahead.

Nevio Zagaria, the WHO's representative in Yemen, said a special kind of ship is needed to transport ambulances, and luckily, one was found in the region. "It was absolutely enormous. But so are the needs in Yemen right now. So we loaded as many supplies as possible onto it, including some therapeutic feeding items that our sister agency UNICEF will use for children suffering from malnutrition."

The WHO said the supplies were delivered with support from the Emirates Red Crescent, the United Kingdom Department for International Development, the United Nations Central Emergency Response Fund, and the World Bank.

The WHO and UNICEF recently called Yemen's cholera outbreak the world's worst, with about 5,000 new suspected cases reported each day in the conflict-wracked country.
Jul 2 WHO statement

In other cholera developments, doctors in Sudan have urged the government to declare a state of emergency over an outbreak in the country and to delay the start of the school year, which began yesterday, the Associated Press (AP) reported.

The disease has flared across the country, including Khartoum, the capital. A representative from the Central Committee of Sudanese Doctors told the AP that at least 22,000 watery diarrhea cases, at least 700 of them fatal, have been reported since May.
Jul 2 AP story

Study evaluates UTIs, antibiotic use among pregnant women in Uganda

A new study in Clinical Infectious Diseases found that 96% percent of pregnant women with urinary tract infection (UTI) symptoms in Uganda were erroneously given antibiotics, suggesting a need for better diagnostic methods in clinical settings with no access to laboratory service.

In a multi-part study conducted by researchers in Sweden and Uganda, investigators examined 2,562 urine samples to determine the prevalence of bacteriuria among pregnant women with and without UTI symptoms in at a hospital in Kampala, Uganda, and to evaluate different diagnostic methods—dipslide, urine microscopy, and nitrite and leukocyte esterase tests—for possible use in clinical settings without access to a microbiological laboratory and where no medical doctors are available. They also evaluated the susceptibility of Escherichia coli to antibiotics used for pregnant women with UTI in Uganda, where diagnosis of UTI is often based on clinical symptoms and midwives hand out antibiotics free of charge to pregnant women with suspected UTI.

The prevalence of culture-proven UTI among pregnant women with UTI symptoms, all of whom received antibiotics at the hospital's antenatal clinic, was 4%. Slightly more than half (52%) of these bacterial infections were caused by E coli. Susceptibility testing showed that 18% of the E coli strains were extended-spectrum beta-lactamase (ESBL)-producing and 36% were multidrug-resistant. While urine microscopy and nitrite and leukocyte esterase tests demonstrated insufficient diagnostic value, nurses with limited training were able to identify E coli UTI in nearly 80% of cases and no bacterial growth in nearly 100% of negative samples using dipslide testing.

"Compared to clinical diagnosis alone, the use of dipslide would imply substantially decreased antibiotic consumption and as a consequence decreased risk for development of resistance among bacterial pathogens," the authors write. "The massive amount of saved antibiotics might furthermore outweigh, at least in part, the costs associated with the increased diagnostic efforts."
Jun 30 Clin Infect Dis abstract


Two African nations report highly pathogenic avian flu outbreaks

Two African nations reported highly pathogenic avian influenza, Togo with its first H5N1 outbreak since 2016 and the Democratic Republic of Congo (DRC), which reported nine more H5N8 outbreaks, according to separate reports from the World Organization for Animal Health (OIE).

In Togo, H5N1 struck a layer farm in Region Maritime in the south. The outbreak began on Jun 7, killing 3,448 and sickening 3,600 of 35,000 susceptible birds. The surviving birds were slated for culling, and authorities ordered poultry movement restrictions and enhanced surveillance. Officials noted that the facility is an intensive layer farm and that it is properly closed. So far, the source of the virus hasn't been determined. The country's last H5N1 outbreaks occurred in August 2016, which also affected the same region.

Meanwhile, the DRC reported nine more H5N8 outbreaks, all in village birds in Ituri province in the country's northeast. Six of the locations are on the shore of Lake Albert. The events involved chickens and ducks and have start dates ranging from Jun 1 to Jun 10. The virus killed 6,283 birds, and the report didn't say how many were susceptible.
Jul 3 OIE report on H5N1 in Togo
Jul 1 OIE report on H5N8 in the DRC

Tedros begins tenure as WHO director-general

Tedros Adhanom Ghebreyesus, PhD, officially began his role as the World Health Organization's (WHO) director-general on Jul 1, the first African delegate to take the job. Tedros, who goes by his first name, was formerly Ethiopia's foreign affairs minister, and from 2005 to 2012 was the country's health minister.

As director-general, Tedros will be the chief technical and administrative officer for WHO, and oversee all policies for the organization's international work. Tedros follows Margaret Chan, MD, MPH, who served as the director-general from 2007 to this year.

Tedros was elected on May 23 at the World Health Assembly meeting in Geneva. During his time as Ethiopia's health minister, Tedros helped create 3,500 health centers and 16,000 health posts, which played a key role in reducing child mortality by 60%, HIV infections by 90%, malaria mortality by 75%, and mortality from tuberculosis by 64%.
Jul 1 WHO statement


PAHO reports small increase in chikungunya cases

The Pan American Health Organization (PAHO) in its most recent update reported 488 more chikungunya cases in the Americas.

The number of newly reported cases is up from 211 reported the previous week, but still sharply less than other recent weekly totals, which can vary greatly, depending on how frequently countries report their cases.

The majority of new cases were from Bolivia, which reported in with 6 week's worth of cases. Other countries reporting small numbers of new cases included Colombia and a handful of central American countries, including Guatemala, El Salvador, Costa Rica, and Mexico.

Fatalities from the disease, which are rare, remained at 13.

So far this year, countries in the Americas have reported 88,935 suspected, confirmed, and imported chikungunya cases, most of them from Brazil.

Since the first outbreaks in the Caribbean started in 2013, the virus has sickened 2,475,962 people.
Jun 30 PAHO update

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