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Canary. Photo by 4028mdk09.

A brief update from the news here and here on the Ebola outbreak from where last we left off in October about the new outbreak spreading in the Congo within the active war zone in the eastern region of the country which borders with Uganda.

The Associated Press reported Monday the WHO would be convening a meeting that Wednesday “to determine whether Congo’s latest Ebola outbreak constitutes a public health emergency of international concern” as alarm grows over the fact that “new cases have more than doubled in the month of October and that “community resistance to Ebola containment efforts in some cases has turned violent” and the area still remains an active threat from rebels attacking health care workers and has compared the area to a ‘war zone.’

TNB; Oct 20 2018

On Friday, the Center for Infectious Disease Research and Policy (CIDRAP) reported that Dr. Oly Ilunga Kalenga, Congo’s Minister of Health, said in an update statement that with a report of seven new confirmed cases “raises the out break total to 319 confirmed or probable cases, making the outbreak in North Kivu and Ituri provinces the country’s biggest in its history.”

In September’s report those numbers were approximately 100 deaths and 150 confirmed cases. By October those numbers where almost doubled and now into November 198 have died and more cases continue to be confirmed, meaning this is not even beginning to be in containment stages, and that the WHO’s September warning may be coming true, that this new outbreak, happening in a region of the Congo that has never seen an Ebola outbreak, in the war zone border region may turn out to be a “perfect storm” of factors preventing its containment.

Thirty new cases have been recorded that have spread out and are now emerging into six new villages.

“No other epidemic in the world has been as complex as the one we are currently experiencing,” Kalenga added. “Since their arrival in the region, the response teams have faced threats, physical assaults, repeated destruction of their equipment, and kidnapping. Two of our colleagues in the Rapid Response Medical Unit even lost their lives in an attack.”

Even with the extensive use of Merck’s Ebola vaccine, the virus has held the region captive as response efforts have been slowed by violent skirmishes and community resistance over the last 3 months.

CIDRAP; Nov 9 2018

Further frustrating efforts, Jeremy Youde, PhD, an associate professor at the Australian National University, wrote an article in the Washington Post on Nov 8 reporting on the Ebola outbreak, that the “US federal government pulled out on-the-ground support in the DRC in mid-October.”

Despite arguments from the US Centers for Disease Control and Prevention (CDC) Director Robert Redfield, MD, to the contrary, the federal government said that keeping American workers on the ground was too dangerous. Other countries, however, including Canada and Great Britain, have personnel in the region, as does the Gates Foundation.

Youde said that, while US involvement wouldn’t suddenly end the outbreak, pulling out support sets a dangerous precedent for America.


Amesh Adalja
Infectious disease MD

According to the Charlotte Observer, in Mecklenbury County, North Carolina, county health director Gibbie Harris announced last week the latest in a “months-long outbreak” of Hepatitis A coming in the same week the North Carolina Dept of Health and Human Services “reported its first death from a national outbreak,” that “as many as 150 people” may have been exposed and are “at risk of getting Hepatitis A” Oct 30 at a local eatery the Village Tavern, and “should seek a vaccination by Tuesday.”

Authorities learned about the risk Wednesday when a worker from the restaurant on Congress Street went to a hospital with symptoms of the virus. Customers could have been exposed because the employee served and prepared food, Harris said.

The news came the same week the N.C. Department of Health and Human Services reported its first death from a national outbreak. States such as Kentucky, California and Michigan have been especially hard hit with dozens of deaths, according to a report from the (Raleigh) News and Observer.

Hepatitis A is a liver disease usually transmitted through eating or drinking food or water contaminated with fecal material. Symptoms can include fatigue, stomach pain, nausea and jaundice.

Charlotte Observer; Nov 8 2018 (Updated Nov 12)

Doctor of Infectious Diseases at the Mayo Clinic Stacey Rizza, M.D., gives us “The ABCs of hepatitis” and their differences.

With cold and flu season now upon us, secondary infections, such as Pneumonia is always a concern. Live Science reports on a recent research study conducted at the Intermountain Heart Institute at Intermountain Medical Center in Salt Lake City, Utah, found that “patients diagnosed with bacterial pneumonia are more serious than in patients diagnosed with viral pneumonia.”

The study was presented in Chicago at the annual meeting of the American Heart Association’s Scientific Sessions on Nov 11, but the study has not been published yet.

Live Science

In the study, the researchers looked at data from 2007 to 2014 on around 4,800 patients at a Utah hospital who had been diagnosed with pneumonia and hospitalized. Around 80 percent of the patients had been diagnosed with bacterial pneumonia. The researchers then looked at data on those patients for the 90 days following their diagnosis, noting which patients experienced heart attack, stroke, heart failure or death. (The researchers tracked the patients for 90 days because previous research has shown that the risk of these complications is increased for 90 days following a pneumonia diagnosis.)

The researchers found that 34 percent of the patients with bacterial pneumonia had a major heart complication within that 90-day window, compared with 26 percent of the patients diagnosed with viral pneumonia.

So, why might the bacterial version pose a greater threat to the heart? This difference is most likely because bacterial pneumonia causes more inflammation in the arteries — a risk factor for heart disease — than viral pneumonia does, said senior author Dr. Joseph Brent Muhlestein, a cardiologist at Intermountain Heart institute in Utah.

Live Science; Nov 11 2018

And just to add a little diversity, because how cool is this?!

For the first time, a team of astronomers has observed several pairs of galaxies in the final stages of merging together into single, larger galaxies. Peering through thick walls of gas and dust surrounding the merging galaxies’ messy cores, the research team captured pairs of supermassive black holes — each of which once occupied the center of one of the two original smaller galaxies — drawing closer together before they coalescence into one giant black hole.

Science Daily; Nov 7 2018

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