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tisdag 30 december 2014

BBC kertoo tänään 2014 ebolapurkauksen lähtöpaikan (Sitaatti)


First Ebola boy likely infected by playing in bat tree


Bat being captured to be tested for Ebola Other researchers have been testing bats in West Africa for Ebola virus

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The Ebola victim who is believed to have triggered the current outbreak - a two-year-old boy called Emile Ouamouno from Guinea - may have been infected by playing in a hollow tree housing a colony of bats, say scientists.
They made the connection on an expedition to the boy's village, Meliandou.
They took samples and chatted to locals to find out more about Ebola's source.
The team's findings are published in EMBO Molecular Medicine.
Ebola trail
Meliandou Meliandou is a small village surrounded by farmland and large trees
Meliandou is a small village of 31 houses.
It sits deep within the Guinean forest region, surrounded by towering reeds and oil palm cultivations - these are believed to have attracted the fruit bats carrying the virus passed on to Emile.
During their four-week field trip in April 2014, Dr Fabian Leendertz and colleagues found a large tree stump situated about 50m from Emile's home.
Villagers reported that children used to play frequently in the hollow tree.
Emile - who died of Ebola in December 2013 - used to play there, according to his friends.
The villagers said that the tree burned on March 24, 2014 and that once the tree caught fire, there issued a "rain of bats".
the tree Children from the village used to play in and around the tree
A large number of these insectivorous free-tailed bats - Mops condylurus in Latin - were collected by the villagers for food, but disposed of the next day after a government-led ban on bushmeat consumption was announced.
While bushmeat is thought to be a possible source of Ebola, the scientists believe it didn't trigger the outbreak.
Instead, it was Emile's exposure to the bats and their droppings as he played with his friends in the hollowed tree.
Pest control The scientists took and tested ash samples from the tree and found DNA traces that were a match for the animals.
While they were unable to test any of the bushmeat that the villagers had disposed of, they captured and tested any living bats they could find in and around Meliandou.
No Ebola could be detected in any of these hundred or so animals, however.
But previous tests show this species of bat can carry Ebola.
Dr Leendertz, from the Robert Koch Institute in Germany, and his colleagues say this must be a pretty rare occurrence though.
The expedition team
Dr Leendertz said: "That is also obvious when you think about how many tonnes of bat meat is consumed every year.
"If more bats carried the virus, we would see outbreaks all the time."
He says it is vital to find out more about the bats.
"They have moved into human settlements. They do not just live in the trees but also under the roofs of houses in the villages.
"The Ebola virus must jump through colonies from bat to bat, so we need to know more."
But culling the animals is not the answer.
"We need to find ways to live together with the wildlife. These bats catch insects and pests, such as mosquitoes. They can eat about a quarter of their body weight in insects a day.
"Killing them would not be a solution. You would have more malaria."

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söndag 28 december 2014

Kointähden hohtoa Sierra Leonessa: E-Sierra Leonen KONON alueen 14 päällikkökuntaa organisoituneet. yhteistyöhön


WHO 24. 12. 2014  Yhteiskunnallinen organisoituminen päällikkötasoa myöten tapahtunut Ebolan voittamiseksi!

Sierra Leone communities organize Ebola response

December 2014
Meeting of Ebola Taskforce in Nimiyama Chiefdom, Eastern Sierra Leone, aiming to mobilise all community members in the fight against the disease.
Meeting of Ebola Taskforce in Nimiyama Chiefdom, Eastern Sierra Leone, aiming to mobilise all community members in the fight against the disease.
WHO/Saffea Gborie
“In our chiefdom we have the necessary structures in place— leaders of all the villages are part of the Ebola response and fully involved, we have an active surveillance approach, and the population is well informed,” explains Philip Musa Koroma, Deputy Paramount Chief of Nimiyama Chiefdom in Kono district in Eastern Sierra Leone.

He has just finished a meeting with the chiefdom Ebola Taskforce, where village leaders and representatives of civil society groups proposed and discussed solutions to the current situation. Aiming to mobilize all community members, this Ebola Taskforce embodies local, collective ownership in the fight against the disease.
"After I tested positive for Ebola in the district hospital in Koidu, I was transferred to Kenema for treatment. I think my full recovery was due to the early use of supportive medicines and intravenous fluid. I requested this treatment while still waiting for the transfer."
Umaru Sow, head of Nimiyama community health centre, Sierra Leone
The chiefdom saw its first case of Ebola two months ago. In the last two weeks, more than 20 cases have been reported.
“Our great challenge is logistics. We don’t have ambulances. It takes a long time for teams to arrive while roads are difficult and distances long,” explains Chief Koroma. “The imminent construction of a Community Care Center in our chiefdom and of an Ebola Treatment Center in the district capital Koidu will help patients receive care early.”
One of those who recognises the importance of early care is Umaru Sow, head of Nimiyama main community health centre in the chiefdom. “I got infected when treating a patient who did not give me full information, so I assumed he would not be a possible Ebola case,” recalls Mr Sow. “After I tested positive for Ebola in the district hospital in Koidu, I was transferred to Kenema for treatment. I think my full recovery was due to the early use of supportive medicines and intravenous fluid. I requested this treatment while still waiting for the transfer.”

Timely and coordinated response

Authorities of Kono district were quick to react to the new wave of cases and to mobilise available resources both locally and from international partners. The Kono district has 14 chiefdoms and each one has set up an Ebola Taskforce with regular meetings at District level to coordinate the response.
Daily command centre meetings are chaired by the District Ebola Response Centre Coordinator and aim to coordinate incoming assistance from international partners now on the ground.
The first week of December, the World Health Organisation (WHO) and US Centers for Disease Control joined the Ministry of Health and the National Ebola Response Center in a mission to assist authorities evaluate the situation. With assistance fromm the United Nations Mission for Ebola Emergency Response (UNMEER), supplies and personnel were flown in rapidly. 

The International Federation of Red Cross (IFRC) helped Koidu hospital to better organise its temporary holding centre. The IFRC is currently building a new Ebola Treatment Center (ETC) which will eliminate the need to transfer critically-ill patients via a 4-hour journey on a difficult road to the closest ETC in Kenema.

The United Nations Population Fund (UNFPA) has just completed training more than 300 contact tracers and supervisors.
 UNICEF is supporting social mobilization,
 while the International Rescue Committee supported training 45 hospital staff on safe infection prevention and control measures.
 Other partners such as the World Food Programme,
 Partners in Health and World Vision are also supporting the response.
Umaru Sow, branding the discharge certificate from Ebola treatment centre in front of temporarily closed community health center in Nimiyama chiefdom, Sierra Leone
Umaru Sow, branding the discharge certificate from Ebola treatment centre in front of temporarily closed community health center in Nimiyama chiefdom, Sierra Leone
 
WHO/Saffea Gborie
“The construction of an ETC will improve the situation as we will no longer need to move patients who test positive to Kenema,” explains Mr Michael N`dolie, WHO Team Leader in Koidu. “The biggest issue remains mobility and logistics. We urgently need ambulances for case management teams and vehicles for burial teams and surveillance teams.”

Non-Ebola health needs

Back in Nimiyama Chiefdom, the community health centre run by Umaru Sow is now closed. It needs to be disinfected since seven Ebola patients came through the centre. All of Umaru’s co-workers are quarantined, as they had contact with him and with those seven patients that slept at the centre before they were transferred to a holding centre in Koidu.
“People with non-Ebola needs now must walk more than an hour to get some assistance,” Umaru adds. People are said to fear going to health centers for fear of catching Ebola there. According to a local midwife, a number of deliveries are now being done at homes assisted by traditional birth attendants.
“It takes time, but we hope when we reopen the health centre at the end of the month that people will be using it again.”

lördag 27 december 2014

Suomen THL antaa enterovirus EV D68:sta samanasteisen tiedon . Ei täysin uusi virus kuitenkaan.

Enterovirus D68 voi aiheuttaa vakavia infektioita

SITAATTI Terveyden ja Hyvinvoinnin Laitoksen nettikohdasta  https://blogi.thl.fi/sv/web/infektiouutiset/etusivu/-/blogs/enterovirus-d68-voi-aiheuttaa-vakavia-infektioita


Artikkelin kirjoittanut : Carita Savolainen-Kopra

Enterovirus D68 (EV-D68) -tartunnat jatkuvat edelleen laajasti Yhdysvalloissa ja Kanadassa. EV-D68 on osoitettu jo yli tuhannelta vakavaan hengitystieinfektioon sairastuneelta potilaalta. Sairastuneista suurin osa on lapsia ja tauti on vaatinut sairaalahoitoa varsinkin astmaa sairastavilla. EV-D68 on löytynyt myös muutamilta potilailta, joilla on ollut hengitystieinfektion jälkeen neurologisia, polionkaltaisia halvausoireita. Viruksen ja neurologisen taudin mahdollista yhteyttä selvitetään edelleen.
Euroopassa, ja myös Suomessa, on tänä syksynä aloitettu EV-D68:n tehostettu diagnostiikka, jonka tarkoituksena on kartoittaa tämän virustyypin esiintymistä ja sen aiheuttamaa taudinkuvaa. Viruksen kierrosta väestössä ei ole aikaisemmin ollut kattavaa tietoa. Enterovirukset aiheuttavat yleensä oireiltaan lieviä hengitystieinfektioita, joista näytteitä otetaan harvoin. Vakavimmissakaan infektioissa hengitystienäytteiden enteroviruksia ei aina tyypitetä. EV-D68:n varma tunnistaminen edellyttää aina positiivisen näytteen jatkotutkimuksia ja tyypitys tehdään useimmiten sekvenssianalyysilla.

EV-D68 on osoitettu elo-lokakuussa kuudelta hengitystieinfektiota sairastavalta potilaalta Lounais-Suomen alueelta. Euroopan ensimmäinen neurologiseen tautiin yhdistetty EV-D68 -infektio raportoitiin Keski-Ranskasta lokakuun 2014 alussa. EV-D68 todettiin ainoana mikrobiologisena löydöksenä 4-vuotiaalla potilaalla, jolla oli vakavan hengitystieinfektion lisäksi myös mm. aivokalvontulehdus ja halvausoireita. Viruksen esiintymistä seurataan edelleen aktiivisesti sekä suomalaisissa että useissa muissa eurooppalaisissa laboratorioissa.

EV-D68 ei ole Euroopassa täysin uusi virus. Suomessa EV-D68:ia on löydetty satunnaisesti sellaisissa tutkimuksissa, joissa hengitystienäytteiden viruksia on tarkemmin tyypitetty. EV-D68:n tiedetään kiertäneen viime vuosina myös muualla Euroopassa. Esimerkiksi Hollannissa oli EV-D68:n aiheuttama epidemia vuonna 2010, minkä jälkeen EV-D68:ia on löydetty hengitystienäytteistä joka syksy.

Lisätietoa
Non polio enterovirus (CDC)
Continued seasonal circulation of enterovirus D68 in the Netherlands 2011–2014 (Eurosurveillance)
All Known Human Rhinovirus Species Are Present in Sputum Specimens of Military Recruits During Respiratory Infection
Mikä on enterovirus?

Enterovirus D68 mainitaan tämän syksyn seurattavissa asioissa

  • Ruotsin Kansanterveysviraston  palstalla  mainitaan seurattavana asiana  enterovirus D68. 
Ruotsalainen SITAATTI: kertoo, että elokuun  2014 puolesta välistä on ollut Amerikassa ja Kanadassa enterovirus D68 -purkausta ja virusta on diagnosoitu marraskuun lopulle mennessä  yli 1300 henkilöstä, joilla on esiintynyt vakavaa  tämän viruksen aiheuttamaa keuhkosairautta. Useimmat näistä ovat olleet lapsia. Karolinskassa on havaittu ensimmäiset  tapaukset  Ruotsistakin  marraskuun lopussa. Sen takia on testattu useampikin näyte lapsilta, joilla on ollut  positiivinen PCR enteroviruksille, rhinovirukselle tai  näille molemmille. Kaikenkaikkiaan on  tunnistettu kuusi   EV-D68 positiivista näytettä  Viisi oli alle 4 -vuotiaita lapsia ja yksi hieman vanhempi.  Viidellä oli hengitystieinfektio ja kaksi joutui aivan tehohoito-osastolle asti.  Neljällä lapsella oli  ennestään obstruktiivista keuhkosairautta.  Kenelläkään ei ollut keuhkotulehdusta. Kuudennella lapsella oli enemmänkin yleisen virusinfektion oireita.  Kaikki lapset tervehtyivät eikä kellekään tullut halvausoireita. Muita mikrobiologisia löytöjä ei ollut selittämässä lasten oireita.

Enterovirus D68 påvisat i Sverige
Publicerat
Sedan mitten av augusti 2014 pågår ett utbrott av enterovirus D68 (EV-D68) i USA och Kanada. Hittills har mer än 1300 personer diagnosticerats med allvarlig luftvägssjukdom orsakad av EV-D68 och de allra flesta har varit barn. Nu har de första svenska fallen identifierats på Karolinska Universitetssjukhuset i Solna.
För att få en indikation på om EV-D68 förekommer i Stockholmsområdet har Mikrobiologen på Karolinska Universitetssjukhuset genomfört en undersökning av drygt 20 luftvägsprov från barn som testat positivt i PCR för enterovirus, rhinovirus eller bägge.
Totalt sex fall har identifierats med EV-D68. Fem av barnen var under 4 år och ett var lite äldre. Fem av barnen hade luftvägsinfektion och två barn fick vårdas några dagar på intensivvårdsavdelning. Fyra hade obstruktiv lungsjukdom sedan tidigare. Ingen hade lunginflammation. Det sjätte barnet hade mer allmänna symtom på virusinfektion. Alla barn har tillfrisknat och inget hade förlamningssymptom. Inga andra mikrobiologiska fynd påvisades som förklaring på barnens symtom.
  • Todetut virukset ovat sukua  USA:n purkauksen viruskannoille

Kaikki   testatut näytteet on otettu heinäkuun- lokakuun  ajanjaksona 2014. Tähän mennessä on tyypitetty 21 näytettä ja niistä on osoitettu kuudessa  EV-D68. Tarkempi analyysi virusten sukulaisuussuhteista on osoittanut, että kaikki virustyypit ovat hyvin lähisukuisia keskenään ja  sukua USA:n viruskannoille.

Stammar från utbrottet i USA
Samtliga prov var tagna mellan juli och oktober 2014. Hittills har 21 prover typats och EV-D68 påvisades i 6 av dessa prover. Släktskapsanalys visar att alla sex virusstammarna är mycket nära besläktade med varandra och med stammar från utbrottet i USA 2014.
  •  Löytö ei ole yllättävä

 Löydöt osoittavat, että Ruotsissa kiertelee EV-D68 virusta, mikä ei sinänsä yllätä, koska sitä kiertelee  muuallakin Euroopassa.  Mutta ei tiedetä, miten tavallinen se on ja miten laajalti se on geografisesti levinnyt.  Saattaa olla, että sen leviäminen on rajoittumaan päin, kuten tavallisesti  käy rhinovriuksilla ja enteroviruksilla  loppusyksyä kohden. Tästä huolimatta tulee ottaa huomioon EV-D68 viruksen mahdollisuus, jos  hengitystieinfektio on vakava ja siihen liittyy  lapsen halvauksia.  Ruotsin kansanterveysvirastolle ei ole kuitenkaan tullut raporttia Ruotsin alueella ilmenneestä vakavasta EV-D68 viruksen aiheuttamasta tautitapauksesta.  Tämän viruksen tyypittäminen tehdään kansanterveysvirastossa ja  Karoliinisen Yliopistosairaalan Mikrobiologian laitoksella.

Inte oväntade fynd
Fynden visar att EV-D68 cirkulerar i Sverige, vilket inte är oväntat eftersom viruset påvisats på andra håll i Europa. Det är oklart hur vanligt förekommande och geografiskt utbrett viruset är. Det är möjligt att spridningen kan vara på väg att minska såsom vanligen sker mot slutet av hösten med rhinovirus och enterovirus. Trots detta bör möjligheten av EV-D68 infektion övervägas vid fall av allvarlig luftvägsinfektion eller förlamning hos barn. Folkhälsomyndigheten har inte fått någon rapport av allvarlig sjukdom orsakad av EV-D68 i Sverige.
Typning av EV-D68 görs på Folkhälsomyndigheten och Mikrobiologen på Karolinska Universitetssjukhuset.

Lisätietoa tästä  viruksesta  saa allamainitusta linkistä:
Läs mer
Utbrott av enterovirus D68 i USA, Kanada och Europa

Suomennosta  27.12. 2014

torsdag 25 december 2014

Onko rokotetta uutta A(H5N1) influenssavirusta vastaan? Is there any vaccine against A(H5N1)?

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm376444.htm

FDA NEWS RELEASE

 
For Immediate Release: Nov. 22, 2013
Media Inquiries: Jennifer Rodriguez, 301-796-8232, jennifer.rodriguez(at)fda.hhs.gov
Consumer Inquiries: 888-INFO-FDA,OCOD(at)fda.hhs.gov
 
FDA approves first adjuvanted vaccine for prevention of H5N1 avian influenza
Vaccine to supplement National Stockpile, not intended for commercial availability
 
The U.S. Food and Drug Administration today approved the first adjuvanted vaccine for the prevention of H5N1 influenza, commonly known as avian or bird flu. The vaccine, Influenza A (H5N1) Virus Monovalent Vaccine, Adjuvanted, is for use in people 18 years of age and older who are at increased risk of exposure to the H5N1 influenza virus.  
 
Avian influenza is an infectious disease of birds caused by certain influenza A viruses. Most avian influenza A viruses do not infect people. However some viruses, such as H5N1, have caused serious illness and death in people outside of the U.S., mostly among people who have been in close contact with infected and ill poultry. When people do become infected with H5N1, about 60 percent die, according to the World Health Organization. H5N1 is an influenza virus with pandemic potential because it continues to infect wild birds with occasional outbreaks of influenza disease in poultry populations, and most humans have no immunity to it.
 
“This vaccine could be used in the event that the H5N1 avian influenza virus develops the capability to spread efficiently from human to human, resulting in the rapid spread of disease across the globe,” said Karen Midthun, M.D., director of the FDA’s Center for Biologics Evaluation and Research. “Vaccines are critical to protecting public health by helping to counter the transmission of influenza disease during a pandemic.”
 
The H5N1 avian influenza vaccine is not intended for commercial availability. The U.S. Department of Health and Human Services has purchased the vaccine from the manufacturer, ID Biomedical Corporation of Quebec, Quebec City, Canada (a subsidiary of GlaxoSmithKline Biologicals), for inclusion within the National Stockpile for distribution by public health officials if needed. 
 
The vaccine is made using an egg-based manufacturing process, which is also used for ID Biomedical Corporation’s seasonal influenza vaccine, FluLaval. It contains the adjuvant AS03, an oil-in-water emulsion. An adjuvant is a substance incorporated into some vaccines to enhance or direct the immune response of the vaccinated individual. The adjuvant makes it possible to use a small amount of influenza protein per dose of vaccine to elicit the desired immune response in an individual to prevent influenza disease. Reducing the amount of influenza protein per dose helps to increase the total number of doses of a safe and effective vaccine available for the public during a pandemic. 
 
The H5N1 component and the AS03 adjuvant component are supplied in two separate vials, which must be combined prior to use. The vaccine is administered via intramuscular injection in two doses, 21 days apart.
 
The evaluation of safety compared approximately 3,400 adults 18 years of age and older who received the vaccine to about 1,100 adults who received placebo in a multi-center study. The most common side effect reported during the clinical studies among the vaccine recipients was injection site pain. Muscle aches, headache, fatigue and injection site redness and swelling were also common. To determine how well the vaccine works, the immune response was evaluated in about 2,000 of the vaccinated adults. The results showed that 91 percent of individuals between the ages of 18 and 64 years and 74 percent of individuals 65 years and older who received the two-dose regimen developed antibodies at a level that is expected to reduce the risk of getting influenza.
 
The manufacturer will collaborate with the FDA and other U.S. governmental agencies on plans to collect additional safety and effectiveness data through U.S. government-sponsored studies of the vaccine, in the event that it is used during an H5N1 influenza virus pandemic.
 
For more information:
 
The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.
 
# # #

onsdag 24 december 2014

A H5N1 influenssassa on ongelmana HLH:n kaltainen reaktiotapa

  • Pahamaineinen HLH on harvinainen, letaali solutason immunologinen häiriötila. Siinä on vikaa immuunisysteemin normaalissa ylläpidossa säätelyteitten kriittisissä kontrollipisteissä ja silloin immunologisen vasteen luonnollisten päätöstapahtumien varmistuminen estyy.
Haemophagocytic lymphohistiocytosis (HLH, OMIM #267700, #603553) is a rare, lethal, cellular immunological disorder that draws attention to critical, genetically determined checkpoints in the regulatory pathways that normally maintain homeostasis within the immune system and ensure the natural termination of effector immune responses. 
  • HLH, hemofagosyyttinen lymfohistiosytoosi,  käsittää useita erilaisia tautikokonaisuuksia kuten primäärin tai perinnöllisen muodon ja sekundäärisen muodon, jota liittyy infektioihin tai maligniteetteihin.
  •  ( Huom: lintuinfluenssan H5N1 yhteydessä on mainittu HLH:n kaltainen reaktiotapa yhtenä komplikaationa)

Kanadassa lintuinfluenssaa A(H5N1). Myös yksi nuori nainen menehtynyt siihen.

http://www.calgaryherald.com/news/metro/Avian+detected+Fraser+Valley+farms+CFIA/10433853/story.html
Tämä lintuvirus A(H5N1) on  tarkasti seurannassa, koska se on interfaasissa  ihmiskuntaan. Ihmistapaukset ovat olleet vaikeita.