Epidemics

During March 2013-February 24, 2017, annual epidemics of avian influenza A(H7N9) in China resulted in 1,258 avian influenza A(H7N9) virus infections in humans being reported to the World Health Organization (WHO) by the National Health and Family Planning Commission of China and other regional sources (1). During the first four epidemics, 88% of patients developed pneumonia, 68% were admitted to an intensive care unit, and 41% died (2). Candidate vaccine viruses (CVVs) were developed, and vaccine was manufactured based on representative viruses detected after the emergence of A(H7N9) virus in humans in 2013. During the ongoing fifth epidemic (beginning October 1, 2016),* 460 human infections with A(H7N9) virus have been reported, including 453 in mainland China, six associated with travel to mainland China from Hong Kong (four cases), Macao (one) and Taiwan (one), and one in an asymptomatic poultry worker in Macao (1). Although the clinical characteristics and risk factors for human...

In May 2005, an epidemic of the cestode Triaenophorus crassus occurred in the Salvelinus umbla population of Lake Grundlsee, an oligotrophic Austrian Alpine Lake. Based on catches with a standardized multi-mesh gillnet survey 53% of S. umbla were infected with up to 17 cysts of T. crassus per fish. This is the first documented record of an epidemic of this tapeworm in S. umbla.

On October 6, 2017, an outbreak of cholera was declared in Zambia after laboratory confirmation of Vibrio cholerae O1, biotype El Tor, serotype Ogawa, from stool specimens from two patients with acute watery diarrhea. The two patients had gone to a clinic in Lusaka, the capital city, on October 4. Cholera cases increased rapidly, from several hundred cases in early December 2017 to approximately 2,000 by early January 2018 (Figure). In collaboration with partners, the Zambia Ministry of Health (MoH) launched a multifaceted public health response that included increased chlorination of the Lusaka municipal water supply, provision of emergency water supplies, water quality monitoring and testing, enhanced surveillance, epidemiologic investigations, a cholera vaccination campaign, aggressive case management and health care worker training, and laboratory testing of clinical samples. In late December 2017, a number of water-related preventive actions were initiated, including increasing...

Kaygusuz Abdal Menakıbnamesi’nde veba ordularının komutanı olduğu yazılan Pir Abdal Musa Sultan, dergahı Antalya Elmalı’da bulunan, 14. Yüzyılda yaşadığı söylenen bir Bektaşi Evliyasıdır. Abdal Musa Sultan Dersim bölgesinde karşımıza, kızamık, kızamıkçık ve suçiçeği getiren, yabani kurtlar ve çekirge salgınlarıyla özdeşleştirilen Abdal Musa Orduları’nın komutanı olarak çıkar. Bu çalışmada, sözlü ve yazılı anlatılar temelinde, Abdal Musa Orduları örneğinin, geleneksel Anadolu sağlık dünyasında salgınlar, doğal felaketler ve insan toplumları arasındaki ilişki hakkında nelere işaret ettiği tartışılmıştır. Her gelenek gibi zaman içinde değişen Anadolu sağlık geleneklerinin dönüşümlerine yol açan dinamikler, 20. Yüzyılın Dersim’inde Abdal Musa anlatısının geçirdiği değişim incelenerek, analiz edilecektir. 

Pir Abdal Musa Sultan, a Bektashi Saint of the 14th century, is mentioned as the commander of the “plague armies” in the hagiography of  Kaygusuz Abdal. Saint Abdal Musa, whose shrine is in Antalya Elmalı, is known in Dersim as the commander of the “armies of Abdal Musa”, an army of divine origin bringing measles and smallpox epidemics. They also appear  in the form of locust swarms, wild wolve hordes and wild poplar groves. On the basis of written and oral accounts, this study attempts to analyse what this army indicates about the relationship between the human society and epidemics, in the lifeworld of Dersim before the 1970’s. Like all traditions, local Anatolian traditions of care and cure change over time. The changes traceable in the local identity of Abdal Musa in the last 50 years can provide traces about the dynamics effecting this relationship.

ABSTRACT: Since the beginning of time, microorganisms have been in existence. With time, new pathogens have emerged as a result of complex interplay of anthropogenic and natural factors like, human migration, shifts in weather pattern, genetic shuffling of the organisms themselves and more which have been discussed in detail. This review article focuses solely on emerging and re-emerging viruses: Chikungunya, Coronavirus, Dengue, Ebola, Hepatitis C, Herpes Simplex Virus (HSV), Human Immunodeficiency Virus (HIV), Human Papilloma Virus (HPV), Influenza and Zika; and the latest progresses made in finding effective antiviral drugs via drug repurposing as we know this approach outplays de novo production significantly with respect to time and money. In a time where new diseases are being reported once every year, drug repurposing will certainly come in handy in developing antiviral therapeutics promptly. Moreover, the article also discusses major challenges in drug repurposing from finding a patent, dealing with all relevant governing frameworks, to careful and safe handling of viruses, these are some challenges faced by drug repurposing, to name a few.  Additionally, the study elaborates on the mechanisms of actions of these drugs as well as the targets whilst including recent and well-known incidences of deadly, viral outbreaks.

Epidemics are often modelled using non-linear dynamical systems observed through partial and noisy data. In this paper, we consider stochastic extensions in order to capture unknown influences (changing behaviors, public interventions, seasonal effects etc). These models assign diffusion processes to the time-varying parameters, and our inferential procedure is based on a suitably adjusted adaptive particle MCMC algorithm. The performance of the proposed computational methods is validated on simulated data and the adopted model is applied to the 2009 H1N1 pandemic in England. In addition to estimating the effective contact rate trajectories, the methodology is applied in real time to provide evidence in related public health decisions. Diffusion driven SEIR-type models with age structure are also introduced.

One key factor that appears to be crucial in the rejection of quarantines, isolation and other social controls during epidemic outbreaks is trust—or rather distrust. Much like news reporting and social media, popular culture such as fictional novels, television shows and films can influence people’s trust, especially given that the information provided about an epidemic disease is sometimes seen as grounded in ‘scientific fact’ by societies. As well as providing information on the ‘correct science’ behind disease transmission, spread and illness in films and literature, popular culture can also inform societies about how to feel and how to react during epidemics—that is to say create some expectations about the kinds of societal responses that could potentially occur. In this article we closely analyse three films that centre around epidemic diseases—Contagion (Steven Soderbergh, 2011), Blindness (Fernando Meirelles, 2008) and The Painted Veil (John Curran, 2006)—in order to highlight three categories of distrust that have recently been identified and conceptualised in broader discussions regarding trust and health: institutional, social and interpersonal. These films raise two key issues about trust and social responses during epidemics. First, while certain aspects of trust are badly diminished during epidemic disease outbreaks, epidemics can also interact with pre-existing structural inequalities within society—based on race, gender or wealth—to create mixed outcomes of discord, prejudice and fear that coexist with new forms of cohesion. Second, the breakdown in trust seen at certain levels during epidemics, such as at the institutional level between communities and authorities or elites, might be mediated or negotiated, perhaps even compensated for, by heightened solidity of trust at the social level, within or between communities.

Question:
What is the information and evidence on the seasonal vulnerability and risk calendar in Nepal at a national and sub-national level?

Summary
Nepal faces many seasonal disasters, including floods, landslides, fires, droughts and diseases. Findings of this rapid review indicates that:
◾Most people are killed and injured during July–September which is in the monsoon period.
◾Preparedness activities could take place in anticipation of seasonal disasters.
◾The Tarai is vulnerable to floods, lightening, epidemics and drought in the monsoon period; and fires, windstorms, and drought in the dry season.
◾The Hills are vulnerable to floods, landslides, drought, epidemics, lightening, and hailstorms in the monsoon period; and fires, windstorms, and drought in the dry season.
◾The Mountains are vulnerable to landslides, glacial lake outburst floods, drought, lightening, and epidemics in the lower parts of the mountain region in the monsoon period; windstorms in the dry season; and avalanches in the winter period.
◾The monsoon season (June-September) often experiences landslides, flooding, thunderstorms, disease (cholera, gastroenteritis, diarrhoea, encephalitis, meningitis, typhoid, jaundice, malaria, Japanese encephalitis) and drought (when the monsoon rains fail).
◾The dry season (March-June) often experiences household and wildfires, drought, heatwaves, and windstorms.
◾The winter season (November-February) often experiences avalanches, avian influenza, and crop damage.
◾Nepal is very vulnerable to climate change which is expected to lead to more extreme weather and changing seasons.
◾Summer cropping season (June-September) involves rice, maize and millet, while the winter cropping season (October-May) involves wheat, barley and potatoes.
◾Seasonal food shortages are quite common in many parts of Nepal. July-August and January-March are traditionally agricultural lean seasons, leading to increased risks of food insecurity.
◾Water-borne diseases are common between June-August. Water sources may be seasonal.
◾Seasonal migration is related to the agricultural cycle, with young men leaving to find work, leaving those behind more vulnerable to disasters.

Other seasonal events which may increase vulnerability include:
◾The main festival season, which is in October/November. Festivals can see mass gatherings of people.
◾Autumn and spring, which are the main tourist trekking and hiking seasons in Nepal.

Sophocles, one of the most noted playwrights of the ancient world, wrote the tragedy Oedipus Rex in the first half of the decade 430–420 bc. A lethal plague is described in this drama. We adopted a critical approach to Oedipus Rex in analyzing the literary description of the disease, unraveling its clinical features, and defining a possible underlying cause. Our goals were to clarify whether the plague described in Oedipus Rex reflects an actual historical event; to compare it with the plague of Athens, which was described by Thucydides as occurring around the same time Sophocles wrote; and to propose a likely causative pathogen. A critical reading of Oedipus Rex and a comparison with Thucydides’ history, as well as a systematic review of historical data, strongly suggests that this epidemic was an actual event, possibly caused by Brucella abortus.

Geographical maps indicating the value of the basic reproduction number, R₀, can be used to identify areas of higher risk for an outbreak after an introduction. We develop a methodology to create R₀ maps for vector-borne diseases, using bluetongue virus as a case study. This method provides a tool for gauging the extent of environmental effects on disease emergence. The method involves integrating vector-abundance data with statistical approaches to predict abundance from satellite imagery and with the biologically mechanistic modelling that underlies R₀. We illustrate the method with three applications for bluetongue virus in the Netherlands: 1) a simple R₀ map for the situation in September 2006, 2) species-specific R₀ maps based on satellite-data derived predictions, and 3) monthly R₀ maps throughout the year. These applications ought to be considered as a proof-of-principle and illustrations of the methods described, rather than as ready-to-use risk maps. Altogether, this is a first step towards an integrative method to predict risk of establishment of diseases based on mathematical modelling combined with a geographic information system that may comprise climatic variables, landscape features, land use, and other relevant factors determining the risk of establishment for bluetongue as well as of other emerging vector-borne diseases.

Dengue cases range from asymptomatic to severe, eventually leading to hospitalization and death. Timely and appropriate management is critical to reduce morbidity. Since 1980, dengue has spread throughout Brazil, affecting an increasing number of individuals. This paper describes age and regional differences in dengue's clinical presentation and associated risk of hospitalization based on more than 5 million cases reported to the Brazilian Ministry of Health from 2000-2014. We performed a retrospective analysis of ∼5,450,000 dengue cases, relating clinical manifestations and the risk of hospitalization to age, gender, previous infection by dengue, dengue virus serotype, years of formal education, delay to first attendance and the occurrence of dengue during outbreaks and in different Brazilian regions. Complicated forms of dengue occurred more frequently among those younger than 10 years (3.12% vs 1.92%) and those with dengue virus 2 infection (7.65% vs 2.42%), with a delay to f...

The Ethiopian Field Epidemiology and Laboratory Training Program (EFELTP) is a comprehensive two-year competency-based training and service program designed to build sustainable public health expertise and capacity. Established in 2009, the program is a partnership between the Ethiopian Federal Ministry of Health, the Ethiopian Health and Nutrition Research Institute, Addis Ababa University School of Public Health, the Ethiopian Public Health Association and the US Centers of Disease Control and Prevention. Residents of the program spend about 25% of their time undergoing didactic training and the 75% in the field working at program field bases established with the MOH and Regional Health Bureaus investigating disease outbreaks, improving disease surveillance, responding to public health emergencies, using health data to make recommendations and undertaking other field Epidemiology related activities on setting health policy. Residents from the first 2 cohorts of the program have co...

Recent studies argue that major crises can have long lasting effects on individual behavior. While most studies focused on natural disasters, we explore the consequences of the global pandemic caused by a lethal influenza virus in 1918-19: the so-called “Spanish Flu”. This was by far the worst pandemic of modern history, causing up to 100 million deaths worldwide. Using information about attitudes of respondents to the  general Social Survey (GSS), we find evidence that experiencing the pandemic likely had permanent consequences in terms of individuals’ social trust. Our findings suggest that lower social trust was passed on to the descendants of the survivors of the Spanish Flu who migrated to the US. As trust is a crucial factor for long-term economic development, our research offers a new angle from which to assess current health threats.

Films illustrate 2 ways that epidemics can affect societies: fear leading to a breakdown in sociability and fear stimulating preservation of tightly held social norms. The first response is often informed by concern over perceived moral failings within society, the second response by the application of arbitrary or excessive controls from outside the community.

Upon a heavy defeat against the Balkan Alliance formed by Bulgaria, Serbia, Greece, and Montenegro, the Ottoman Empire had to leave the Balkan geography, which it had governed for nearly 500 years, in 1913. In 1912, the war that started in the Balkans in an environment where alliances were formed and tensions increased in Europe caused the attention of the world, especially the European public, to focus on this geography. Journalists who purposed to follow the war went to the capitals of the warring states, especially Istanbul, and presented some news from the front after a while. In addition, military experts, diplomats, and other officials from neutral states followed the war for various missions or as observers. Clyde Sinclair Ford, who was serving as a military doctor with the rank of major commander in the US Army, was one of these people. His travel to Europe due to sick leave in 1912 took a completely different turn with the start of the First Balkan War. He served as the chief surgeon in two wards of the Taşkışla Hospital in Istanbul on behalf of the US Red Cross during the First Balkan War, and he also provided medical service to the Bulgarian army in the Second Balkan War. After returning to the United States, he gave a series of lectures on the Balkan Wars to officers at The Army Service Schools Fort Leavenworth in 1915. In addition to the causes of the Balkan Wars, the development of the war, and the situation of the Ottoman and Bulgarian armies, he conveyed his observations about war injuries and epidemic diseases in these lectures because he was a military doctor and took part in the war. The lectures he gave were published in the same year with the title “The Balkan Wars: Being a Series of Lectures delivered at the Army Service Schools, Fort Leavenworth”. In this present study, a brief biography of Clyde Sinclair Ford is given, the chapters in his work are evaluated, and his medical observations about the war are tried to be explained because he was a military doctor.