Saudi MOH Announces 4 New MERS Cases

 

# 10,498

 

The drumbeat of MERS reports continues from the Saudi MOH, which for the 35th day in a row has announced new cases.  Three are from hard-hit Riyadh, with unspecified exposure history, while one is from Madinah.  Three fatalities and two recoveries are also announced.

The Madinah case is listed as a `contact’ of a confirmed or suspected case, although this is the first case we’ve seen reported from Al Madinah in many months.

Hopefully we’ll learn more when the WHO releases an update on these cases.

 

During the first 7 days of September – normally a quiet time of year for MERS cases -  Saudi Arabia has announced 36 new cases.  With the start of the Hajj now only a couple of weeks away, last week the World Health Organization warned:

 

. . . . the current outbreak is occurring close to the start of the Hajj and many pilgrims will return to countries with weak surveillance and health systems. The recent outbreak in the Republic of Korea demonstrated that when the MERS virus appears in a new setting, there is great potential for widespread transmission and severe disruption to the health system and to society.

 

For those intending to make this year’s pilgrimage, the CDC has some important health advice (see  CDC Traveler’s Advice: Umrah, The Hajj and MERS).

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WHO MERS Update – Jordan: Sept 6th

Credit WHO

#10,497

 

On Saturday (see Jordan: 3rd MERS Fatality Of 2015) we saw a media report of a third fatality and a reference to a 7th patient in Jordan’s recent MERS cluster, but without details. The first 4 cases were described last week in WHO Update On Jordanian MERS Cluster, while today we have descriptions of cases #5 and #6.

 

Both of these cases had the ill fortune to be seeking medical care at a facility already treating a MERS case.  While the exact route of exposure is unknown, the update states:

`Investigation of possible epidemiological links with the MERS-CoV cases admitted to their hospital or with shared health care workers is ongoing.’

 

To date, at least 26 countries have dealt with MERS cases, yet only 4 nations (Saudi Arabia, South Korea, UAE, & Jordan) account for 97% of the world’s known cases, and all have reported extended nosocomial outbreaks. The remaining 22 affected countries been able to identify, isolate, and treat MERS cases with either minimal or no secondary transmission to patients or hospital staff. 

 

Whether - or how long -  that luck will hold is an open question.  But the experience so far suggests that a combination of vigilance and good infection protocols can prevent the spread of this virus. 

 

After their spectacular failure to contain MERS earlier this summer, last week Korea Announced Major Changes In Wake Of MERS Outbreak they hope will prevent a reoccurrence.  Unless and until a similar commitment is forthcoming from hospitals and Health Ministries across the Arabian Peninsula, healthcare facilities there are likely to continue to amplify outbreaks of the virus.  

 

 

Middle East Respiratory Syndrome coronavirus (MERS-CoV) – Jordan

Disease outbreak news
6 September 2015

Between 30 and 31 August 2015, the National IHR Focal Point of Jordan notified WHO of 2 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 1 death. Both cases are associated with a MERS-CoV outbreak currently occurring in a hospital in Amman city.

Details of the cases

1. A 73-year-old female from Amman city was admitted to hospital due to her chronic conditions on 21 August and, on 24 August, was discharged. This hospital has been experiencing a MERS-CoV outbreak. On 28 August, the patient developed symptoms and, on the same day, was admitted to the same hospital. She was treated symptomatically and discharged from hospital on 29 August. As her symptoms worsened, the patient visited a different hospital and was admitted on the same day. She tested positive for MERS-CoV on 31 August. Currently, the patient is in stable condition in a negative pressure isolation room on a ward. Investigation of possible epidemiological links with the MERS-CoV cases admitted to her hospital or with shared health care workers is ongoing. The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms.
2. A 56-year-old male from Amman city was admitted to hospital for a medical procedure on 18 August. This hospital has been experiencing a MERS-CoV outbreak. While hospitalized, on 28 August, the patient developed symptoms and, on 30 August, tested positive for MERS-CoV. The patient, who had comorbidities, passed away on 1 September. Investigation of possible epidemiological links with the MERS-CoV cases admitted to her hospital or with shared health care workers is ongoing. The patient had no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms.

Contact tracing of household and healthcare contacts is ongoing for these cases.

Globally, the WHO has been notified of 1,495 laboratory-confirmed cases of infection with MERS-CoV, including at least 528 related deaths.

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University College Dublin - Ireland

Why Dublin?

Global Business  
The European headquarters capital - Home to over 1,000 multinational companies including Google, Microsoft, Facebook, KPMG, Citibank, Deloitte, Eli Lilly, Glaxo Smith Kline and Pfizer. 

World class education  
Top 200 world ranked universities  University College Dublin 161 (THE 2013/14) & 
139 (QS 2013) Trinity College Dublin 129 (THE 2013/14) & 61 (QS 2013).

Post Study Work  
The only native English-speaking European city to offer international students a one year postgraduate visa.  

Work experience  
Work placements & internship form part of the curriculum on many of the degree programmes. 

Why University College Dublin? 

1. Ranked in the top 200 universities in the world with many subjects ranked top 100, 150 or 200.   
2. Irelands largest, most international university – a modern campus set in a 350 acre park land site.  
3. Triple accreditation - The Quinn School of Business is 1 of only 59 business schools to hold AACSB (US), EQUIS (Europe) & AMBA (UK) accreditation.  
4. Business degrees at UCD take three years to complete. 
5. Progression to:

•  3 & 4 year Business degrees 
•  Science-related degrees 
•  Health sciences-related degrees 
•  Agriculture and Food Science Related Degrees 
• Architecture and engineering-related degrees 

Scholarships available up to €10,000 over 4 years 

€2,500 for the International Foundation Year and €2,500 for each subsequent year of study at UCD, based on maintaining a B average.  

For more information, please contact/visit your nearest JM Office today

                  

                                                                                                                               Article is courtesy of  University College Dublin

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Swinburne University of Technology - Australia

Top five reasons to choose Swinburne

Swinburne is a world-ranked and internationally recognised university in Melbourne. We equip our students with the knowledge and capabilities they need to establish successful careers through high-quality teaching and industry engagement.

Melbourne is a great destination in which to live and study. The city was named the most liveable city in the world by the Economist Intelligence Unit's Global Liveability Index (2011–14).

1. A world-ranked university

Swinburne is ranked in the top 400 universities in the world and in the top 100 universities in the world in the field of physics by the Academic Ranking of World Universities 2015. We produce outstanding research and continue to invest in research infrastructure.

In 2015, Swinburne was also ranked for the first time in the Times Higher Education 100 Under 50 Rankings, an index of the world’s top universities under the age of 50.

Swinburne has also been recognised as having one of the best design schools in the world by the 2015 QS World Rankings of Universities by Subject. The university was one of only four institutions in Melbourne to be listed in the top 100 for the Art and Design subject area.

2. Support services for international students

At Swinburne we offer many services to help you achieve your academic goals and to enhance your life as a student.

We have agents all over the world to help you choose the right course. If you are in Melbourne, we offer one-on-one appointments so that you can speak with a course adviser to answer all your questions.

We care about your wellbeing at Swinburne. We have dedicated International Student Advisers who can provide advice on academic and personal needs. They can help you access study support, health services and counselling.

3. Quality teaching

At Swinburne you will learn from highly experienced staff. Our courses provide access to opportunities that allow you to learn in innovative ways.

Our close ties with industry mean our courses are relevant and up to date. Many of our courses are recognised by professional organisations and they offer you invaluable experiences across all study levels.

4. Prepare for your career

Swinburne is recognised for producing graduates who are ready for employment. We offer a range of programs that extend beyond what you learn in the classroom to prepare you for your career. They include:

• careers and employment services
• projects with industry
• Professional Year Programs
• short-term international study programs
• Student Leadership and Volunteer Program.

5. Fantastic facilities

Our Hawthorn campus has state-of-the-art laboratories and teaching facilities at the Advanced Technologies Centre and the Advanced Manufacturing and Design Centre. There’s on-campus accommodation and the campus is easily accessible by public transport. A range of services is also available on campus, including career and health services.

The Swinburne Advantage

Turning knowing into know-how

New Courses available in 2015

For more information, please contact/visit your nearest JM Office today

                  

                                                                                                                               Article is courtesy of  Swinburne University of Technology

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Saudi MOH Announces 7 New MERS Cases, 3 Fatalities

 

#10,496

 

Another busy update from the Saudi MOH, indicating 7 additional MERS cases in the Saudi capital, and reporting 8 recoveries, and 3 deaths.

 

Remarkably, 4 of the 7 cases announced today are healthcare workers. 

 

Since mid-July, this brings to 28 the number of HCWs reportedly infected with MERS in Saudi Arabia.  A clear indication that after 3 years and 1200 MERS cases - when it comes to identifying, isolating, and safely treating MERS cases – they still don’t have a handle on it. .

 

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Study Suggests Low Dose Aspirin Doesn’t Reduce Flu Vaccine Immune Response

 

# 10,495

 

Although it doesn’t answer all of the questions, we’ve a new study that suggests that using low-dose aspirin doesn’t significantly reduce the immune response from flu vaccines in elderly persons, a concern which we’ve looked at several times over the years.

 

About six years ago, in A Few Inflammatory Remarks, we saw several studies that suggested that taking antipyretic medications – like acetaminophen, Aspirin, or other NSAIDs – could reduce the effectiveness of some vaccinations or blunt the level of acquired immunity from actual infection.

 

A study by researchers at the University of Rochester, appearing in the journal  Cell Immunology (see Ibuprofen and other widely used non-steroidal anti-inflammatory drugs inhibit antibody production in human cells) warned:

 

The implications of this research are that the use of widely available NSAIDs after infection or vaccination may lower host defense. This may be especially true for the elderly who respond poorly to vaccines and heavily use NSAIDs.

A study appearing in the Lancet found a similar dampening effect on vaccine response in children given acetaminophen to control post-injection fever.  They advised:

 

Although febrile reactions significantly decreased, prophylactic administration of antipyretic drugs at the time of vaccination should not be routinely recommended since antibody responses to several vaccine antigens were reduced.

 

A couple of months later, in Anti-Inflammatory Meds And Vaccines, we saw animal studies  from the University of Missouri that specifically called out low-dose aspirin as potentially attenuating the effects of flu vaccination.  From their press release.

 

Aspirin, Tylenol May Decrease Effectiveness of Vaccines

Wednesday, December 02, 2009 :: Staff infoZine

Mizzou scientists discover aspirin and Tylenol block enzymes that could inhibit vaccines

Columbia, MO - infoZine - With flu season in full swing and the threat of H1N1 looming, demand for vaccines is at an all-time high. Although those vaccines are expected to be effective, University of Missouri researchers have found further evidence that some over-the-counter drugs, such as aspirin and Tylenol, that inhibit certain enzymes could impact the effectiveness of vaccines.

“If you’re taking aspirin regularly, which many people do for cardiovascular treatment, or acetaminophen (Tylenol) for pain and fever and get a flu shot, there is a good chance that you won’t have a good antibody response,” said Charles Brown, associate professor of veterinary pathobiology.

(Continue . . . )

 

The operative word in the above title being `May’, as what works in animals, or in vitro experiments, doesn’t always pan out in the human population. 

Today we’ve the results of a study that looked at the immune response to a single, specific flu vaccine (2009 monovalent H1N1)  in older adults who were taking low-dose aspirin, and compared that to elderly adults not taking LD aspirin, and came away with encouraging news.   

 

Low-dose aspirin use does not diminish the immune response to monovalent H1N1 influenza vaccine in older adults

M. L. JACKSON^{a1 c1}, A. BELLAMY^a2, M. WOLFF^a2, H. HILL^a2 and L. A. JACKSON^a1

^a1 Group Health Research Institute, Seattle, WA, USA

^a2 The EMMES Corporation, Rockville MD, USA

SUMMARY

Non-steroidal anti-inflammatory drugs (NSAIDs) may inhibit antibody production by peripheral blood mononuclear cells; one consequence of this could be decreased effectiveness of vaccines in NSAID users. Because many older adults use low-dose aspirin for primary or secondary prevention of coronary events, any inhibitory effect of aspirin on vaccine immune response could reduce the benefits of vaccination programmes in older adults.

We tested whether immune response to vaccination differed between users vs. non-users of low-dose aspirin, using data from four randomized trials of monovalent 2009 pandemic influenza A(H1N1) vaccine. Geometric mean haemagglutination inhibition antibody titres were not significantly lower in low-dose aspirin users compared to non-users. Our results provide reassurance that influenza vaccination effectiveness is probably not reduced in older adults taking chronic low-dose aspirin.

(Accepted August 19 2015)

 

While encouraging, a few caveats apply here.

This was a limited study, that only looked at the immune response to one specific flu shot, in an elderly cohort that normally sees a reduced immune response to flu vaccines.  How LD aspirin use might affect the immune response in younger individuals wasn’t determined.

 

This study only looked at low-dose aspirin use, and therefore cannot be automatically assumed to apply to other NSAIDs or antipyretics, or larger doses of aspirin.

 

Still, for those who take a daily LD aspirin, this should provide some peace of mind that they probably aren’t sabotaging their yearly flu shot.

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#NatlPrep : Create A Family Communications Plan

 

Note: This is day 6 of National Preparedness Month.  Follow this year’s campaign on Twitter by searching for the #NatlPrep hash tag.  This month, as part of NPM15, I’ll be rerunning some updated  preparedness essays, along with some new ones.

 

# 10,494

 

September is National Preparedness Month , and this year the central theme is “Don’t Wait. Communicate. Make Your Emergency Plan Today.”    

 

High on the list of things in your emergency plan should be a comprehensive family communications plan.

 

Disasters can strike with little or no warning, and some family members may be at school, work, or simply away from home.  In the event of a sudden evacuation or displacement, you’ll want to have a meeting place already decided upon, and for everyone to have a list of emergency contact information.

 

To drive home the message, FEMA has produced a PSA called `Waiting’, which shows anxious parents in a community shelter trying – and failing – to reconnect with their child during a disaster.

 
Ready.gov has produced an updated Emergency Communications planning guide to help you and your family prepare for the kinds of communications interruptions, and separations, that can occur during a disaster.  Below you’ll find easy to use fill-in-the-blanks PDF templates for creating emergency communications cards, and other planning aids.

 

Emergency Communication Plan

This page explains what an emergency communication plan is and why you should make one. It also provides tips and templates on how to make a plan.

 

Why Make a Plan

Your family may not be together if a disaster strikes, so it is important to think about the following situations and plan just in case. Consider the following questions when making a plan:

• How will my family/household get emergency alerts and warnings?
• How will my family/household get to safe locations for relevant emergencies?
• How will my family/household get in touch if cell phone, internet, or landline doesn’t work?
• How will I let loved ones know I am safe?
• How will family/household get to a meeting place after the emergency?

Download and Print a Plan

Here is a template that you can download, print, and fill out:

• For parents (PDF)
• For kids (PDF)
• For transit commuters (PDF)
• For your wallet (PDF)
• Steps to make a plan (PDF)
• Tips on emergency alerts and warnings (PDF)

Here are a few easy steps to start your emergency communication plan:

1. Understand how to receive emergency alerts and warnings. Make sure all household members are able to get alerts about an emergency from local officials. Check with your local emergency management agency to see what is available in your area, and learn more about alerts by visiting: www.ready.gov/alerts.
2. Discuss family/household plans for disasters that may affect your area and plan where to go. Plan together in advance so that everyone in the household understands where to go during a different type of disaster like a hurricane, tornado, or wildfire.  
3. Collect information. Create a paper copy of the contact information for your family that includes:

• phone (work, cell, office)
• email
• social media
• medical facilities, doctors, service providers
• school

4. Identify information and pick an emergency meeting place. Things to consider:

• Decide on safe, familiar places where your family can go for protection or to reunite.
• Make sure these locations are accessible for household members with disabilities or access and functional needs.
• If you have pets or service animals, think about animal-friendly locations.

Examples of meeting places:

• In your neighborhood: A mailbox at the end of the driveway, or a neighbor’s house.
• Outside of your neighborhood: library, community center, place of worship, or family friend’s home.
• Outside of your town or city: home of a relative or family friend. Make sure everyone knows the address of the meeting place and discuss ways you would get there.

5. Share information. Make sure everyone carries a copy in his or her backpack, purse, or wallet. You should also post a copy in a central location in your home, such as your refrigerator or family bulletin board.
6. Practice your plan. Have regular household meetings to review your emergency plans, communication plans and meeting place after a disaster, and then practice, just like you would a fire drill.

 

 

Filling out these cards may seem a small step, but that's what most preparedness involves.

 

Taking small, organized steps that, when put together, create a fabric of individual and community preparedness.  If you do just one small step each day, in almost no time you’ll find yourself and your family far better prepared to face any emergency.

 

For more on how to prepare, visit these websites:

FEMA http://www.fema.gov/index.shtm

READY.GOV http://www.ready.gov/

AMERICAN RED CROSS http://www.redcross.org/

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