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The Changing Nature and Scope of Public Health Emergencies in Response to Annual Flu. James G. Hodge, Jr.. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science. doi:10.1089/bsp.2013.0022.
“……Though originally conceptualized and once reserved for catastrophic, long-term health–related or bioterrorism events, public health emergency declarations are evolving to address temporary impacts on health care and public health services arising annually from flu outbreaks. This commentary explores the changing nature of public health emergencies and their current and potential impact on the provision of healthcare services in response to national or regional threats to the public’s health……”
Progress Toward Elimination of Onchocerciasis in the Americas — 1993–2012
May 24, 2013 / 62(20);405-408
Onchocerciasis (river blindness) is caused by the parasitic worm Onchocerca volvulus, transmitted to humans by the bite of infected black flies of the genus Simulium, and is characterized by chronic skin disease, severe itching, and eye lesions that can progress to complete blindness. Currently, among approximately 123 million persons at risk for infection in 38 endemic countries, at least 25.7 million are infected, and 1 million are blinded or have severe visual impairment (1). Periodic, communitywide mass drug administration (MDA) with ivermectin (Mectizan, Merck) prevents eye and skin disease and might interrupt transmission of the infection, depending on the coverage, duration, and frequency of MDA. The Onchocerciasis Elimination Program for the Americas (OEPA) was launched in response to a 1991 resolution of the Pan American Health Organization (PAHO) calling for the elimination of onchocerciasis from the Americas. By the end of 2012, transmission of the infection, judged by surveys following World Health Organization (WHO) guidelines, had been interrupted or eliminated in four of the six endemic countries in the WHO Americas Region. Thus, in 2013, only 4% (23,378) of the 560,911 persons originally at risk in the Americas will be under ivermectin MDA. Active transmission currently is limited to two foci among Yanomami indigenes in adjacent border areas of Venezuela and Brazil.
In 2001, WHO established a set of technical guidelines to help onchocerciasis programs determine whether interruption of transmission has occurred and whether MDA with ivermectin could be stopped (2,3). The process includes three key phases: 1) suppression of transmission, when infective-stage larvae are no longer introduced into the human population by the vectors, but the parasite population in the human reservoir maintains the ability to recover if treatments are withdrawn; 2) interruption of transmission, when the parasite population is thought to be unable to recover and treatments can be halted; and 3) elimination of transmission, when a posttreatment surveillance period of at least 3 years confirms that the parasite population has not recovered in the absence of interventions (4). Ocular morbidity is considered eliminated when the prevalence of acute eye lesions attributable to onchocerciasis falls below 1% (3). When all the foci in a country reach the elimination stage, final country verification can be considered by an independent international team of experts convened under the auspices of WHO.
OEPA* was launched in response to a 1991 PAHO resolution that called for the elimination of onchocerciasis morbidity from the Americas by 2007 (5). In 2008, based on significant OEPA achievements, PAHO and its member states renewed the call to eliminate onchocerciasis throughout the region and set a goal to interrupt transmission of the parasite throughout the region by 2012.† A PAHO resolution in 2009 that calls for the elimination or control of 12 neglected, poverty-related infectious diseases in the Americas by 2015 includes onchocerciasis as one of its elimination targets.§
The primary strategy for eliminating onchocerciasis from the Americas has been ivermectin MDA every 6 months, with health education and community mobilization, in all affected communities of the 13 endemic foci in the six affected countries (Figure) (5,6). MDA aims to achieve at least 85% coverage of the population at risk and eligible for treatment. Communities targeted for MDA are divided by baseline onchocerciasis prevalence into hyperendemic (≥60%), mesoendemic (≥20%, but <60%), and hypoendemic (evidence of autochthonous cases, but with prevalence <20%). Transmission is most difficult to break in hyperendemic areas, where MDA might need to be given every 3 months (7).
A total of 11,069,285 MDA ivermectin treatments were administered in the Americas during 1993–2012. By the end of 2012, transmission of the infection, as judged by surveys following established guidelines, had been interrupted or eliminated in four of the six countries, and ivermectin MDAs were halted in 11 of the 13 foci, with active transmission occurring only in two foci among Yanomami indigenous populations in adjacent border areas of southern Venezuela and northern Brazil. In 2013, only 4% (23,378) of the 560,911 persons originally at risk in the Americas will be targeted for ivermectin MDA. Ocular morbidity was detected only in southern Venezuela (Table). Since 1995, no new blindness has been attributed to onchocerciasis in the Americas.
Venezuela. The Northcentral, Northeast, and South foci in Venezuela comprised 119,358 persons at risk for onchocerciasis infection, the third highest national total in the Americas. The South focus in Venezuela had the second highest rate of microfilariae measured in the skin at baseline among the 13 foci in the Americas (Table). Venezuela has conducted MDA semiannually in 100 hyperendemic, 212 mesoendemic, and 297 hypoendemic communities, beginning in 2000. In 2010, the program began conducting MDA quarterly in 66 hyperendemic communities in the South and Northeastern foci, eventually extending this to an additional 35 hyperendemic and five mesoendemic communities. When transmission was interrupted in the Northcentral and Northeast foci in 2010 and 2012, respectively, programs in those two foci had administered 17 and 20 rounds of mass treatment, with reported coverage of ≥85%. In 2013, treatments will be halted in the Northeast focus. The main challenges for the South focus (which had completed 14 rounds of MDA during 2006–2012) now are to search the remaining suspect areas for any still-unidentified endemic Yanomami communities and immediately increase MDA frequency to quarterly in all hyperendemic villages.
Brazil. The single focus of onchocerciasis in Brazil is among the Yanomami population living in an area contiguous with the endemic focus of South in Venezuela. Brazil’s focus includes 12,988 persons in 22 endemic administrative areas (seven hyperendemic, nine mesoendemic, and six hypoendemic) called “polos bases.” As in Venezuela, the affected area is remote and densely forested, and the migratory Yanomami move across the border at will. The Brazilian program administered 24 semiannual MDAs with at least 85% coverage during 2001–2012. The program began administering MDA treatments quarterly to seven hyperendemic and three mesoendemic polo bases in 2011. The latest surveys suggest that Brazil is close to suppressing onchocerciasis transmission in its part of the shared Yanomami area.
Guatemala. With four foci and 231,467 persons at risk, Guatemala had the greatest number of persons at risk for onchocerciasis in the Americas. The four foci encompass a total of 518 endemic communities (42 hyperendemic, 15 mesoendemic, and 461 hypoendemic). During 2001–2011, Guatemala conducted MDA and health education semiannually, achieving a reported 21 rounds of coverage of ≥85%. In 2006 and 2007, respectively, Guatemala’s Santa Rosa and Escuintla foci were the first in the region to interrupt transmission in the Americas, (Table), followed by the Huehuetenango focus in 2008. MDA ended in Guatemala with cessation of treatment in the Central focus in 2012.
Mexico. The second-highest number of persons at risk for onchocerciasis (169,869) in the Americas were in three foci and 670 communities (39 hyperendemic, 220 mesoendemic, and 411 hypoendemic) in Mexico (Table). Mexico has achieved 25 consecutive rounds of MDA with coverage of ≥85% during 2001–2011. In 2003, Mexico began quarterly MDA in 37 hyperendemic communities in the largest of its foci (South Chiapas) in an effort to accelerate interruption of transmission, becoming the first country to adopt this innovation. North Chiapas became the third focus to interrupt transmission in the Americas and Oaxaca was the sixth. MDA ended in Mexico with cessation of treatment in South Chiapas in 2012.
Ecuador. The single focus of onchocerciasis in Ecuador includes 119 communities (42 hyperendemic, 23 mesoendemic, and 54 hypoendemic) distributed among three river valleys in the Province of Esmeraldas. Although Ecuador’s population at risk for onchocerciasis was relatively small (25,863), this focus had the highest prevalence of microfilariae in the skin at baseline of the 13 American foci. One of the two black fly vectors here, Simulium exiguum, is one of the most efficient transmitters of onchocerciasis in the Americas, comparable to Simulium damnosum, the major vector in Africa. Ecuador completed 23 MDA semiannual rounds of ≥85% coverage before interrupting transmission in 2009 and halting MDA in 2010. Posttreatment surveillance was completed successfully throughout the country in 2012. In 2013, Ecuador should become the second country in the Americas to request verification of elimination of onchocerciasis from WHO.
Colombia. The single focus of onchocerciasis in Colombia was a mesoendemic community. Colombia conducted 20 rounds of MDA coverage of at least 85% before it interrupted transmission in 2007 and halted MDA in 2008. Colombia successfully completed posttreatment surveillance in 2010, and applied to WHO for verification of elimination of onchocerciasis in 2012 (7).
By the end of 2012, O. volvulus transmission was interrupted or eliminated in 11 of the 13 foci in the Americas. The current OEPA goal, under PAHO Resolution CD49.R19, is to interrupt transmission throughout the Americas by 2015. The challenges, therefore, are the two remaining endemic crossborder foci of Amazonas in Brazil and South in Venezuela. These are, in fact, a single epidemiologic unit that needs to be addressed through closely coordinated activities by the two countries. To accelerate the elimination process, the OEPA strategy is to increase ivermectin MDA to quarterly administration in the most highly endemic communities alongside the border, and identify and intensively treat any as yet unknown endemic communities.
The OEPA program is distinguished by the substantial proportion (38%) of its costs (approximately $121 million over the past 2 decades, which includes the value of the donated medicines) that was contributed by the six endemic countries. This was supplemented by critical support from external partners. The program also has benefited from its strong emphasis on data-driven decision processes, strong community mobilization, and innovative health education methods.¶ OEPA’s achievements have encouraged reorientation of onchocerciasis goals in the disease’s main stronghold (Africa) from morbidity control to transmission elimination.
* Additional information available at http://www.oepa.net.
† Resolution CD48.R12. Towards the elimination of onchocerciasis (river blindness) in the Americas. Available at http://www1.paho.org/english/gov/cd/cd48.r12-e.pdf .
§ Resolution CD49.R19. Elimination of neglected diseases and other poverty-related infections. Available at http://new.paho.org/hq/dmdocuments/2009/CD49.R19%20(Eng.).pdf .
¶ Additional information is available at http://new.paho.org/blogs/arteysalud.
What is already known on this topic?
In 1991, the Pan American Health Organization called for the elimination of onchocerciasis (river blindness) transmission in the Americas. Since then, the population under mass drug treatment in the Americas for onchocerciasis has been decreasing each year, from an estimated 500,000 to approximately 23,000.
What is added by this report?
Transmission of Onchocerca volvulus has been interrupted in 11 of the 13 foci in the Americas, leaving only 4% of the previous at risk population still needing continued mass drug administration. Colombia, Ecuador, Guatemala, and Mexico have all interrupted transmission. Transmission continues among the Yanomami indigenes in the Amazonian forest area on the border between Brazil and Venezuela.
What are the implications for public health practice?
Although earlier target dates of 2007 and 2012 for elimination of onchocerciasis in the Americas were missed, progress is accelerating, and elimination is likely within the next few years. Success in the final transmission zone will require intensified efforts and cross-border collaboration. Preliminary results from the Brazilian side are encouraging and indicate that transmission also can be interrupted in this region. Successful elimination of onchocerciasis in the Americas has and will continue to provide strong impetus and lessons learned for pursuing elimination of onchocerciasis in Africa.
Value of Pharmacy-Based Influenza Surveillance — Ontario, Canada, 2009
May 24, 2013 / 62(20);401-404
As part of ongoing efforts by the Public Health Agency of Canada (PHAC) to enhance disease surveillance, a retrospective epidemiologic study was undertaken to investigate the usefulness for influenza surveillance of data on changes in the volume of prescriptions for antiviral medications. The weekly numbers of dispensed prescriptions for the antiviral medications oseltamivir and zanamivir, as a proportion of all dispensed prescriptions, were compared with the numbers of confirmed laboratory reports of influenza A(H1N1) at the local health authority level in Ontario, Canada, during the second wave of the outbreak of pandemic influenza A(H1N1) in 2009. Qualitative and quantitative analyses demonstrated that antiviral prescription dispensing dates were a reasonable proxy for influenza A(H1N1) onset dates at the local health authority level. This report describes the results of those analyses, which indicated that 1) antiviral prescription proportions increased in advance of laboratory reports of influenza and 2) antiviral dispensing data can be available in near real-time. These findings suggest that pharmacy prescription data can provide timely intelligence to help characterize local influenza activity.
The value of influenza surveillance depends in part on the timeliness of the generated information. Traditional methods of influenza surveillance, including FluWatch (Canada’s national surveillance system), rely on the collection and aggregation of laboratory results and clinical observations from physicians and public health authorities. Typical for infectious diseases, it can take several days to weeks from symptom onset to data being collected, aggregated, and analyzed (1,2). Pharmacy-based surveillance uses near real-time dispensing data of pharmaceuticals (prescription and over-the-counter drugs) as a proxy for illness in the population. The potential for pharmacy-based surveillance to detect changes in community illness levels earlier than traditional laboratory-based surveillance methods is premised on the fact that the public will routinely seek over-the-counter medications to relieve or alleviate common symptoms of illness, and physicians often will prescribe medications before receiving laboratory confirmation (3,4). Retrospective disease outbreak studies have demonstrated increases in pharmaceutical sales before the recognition of increased illness frequency using traditional public health surveillance methods (5,6).
In this study, the proportion of dispensed prescription medications that were oseltamivir or zanamivir were compared each week with the number of confirmed laboratory reports of influenza A(H1N1) at the local health authority level. Prescription medication data (from 2009) were provided to PHAC by Rx Canada, Inc., and included individual-level prescription data from approximately 75% of Ontario’s community pharmacies (n = 1,202). Each prescription identified the drug, date of dispensing, and the patient’s sex and age. Laboratory reports of influenza A(H1N1) (from 2009) were provided to PHAC by the Ontario Ministry of Health and Long-Term Care.* Each laboratory report provided one of three dates: illness onset date, date specimen was submitted to the laboratory, and date laboratory results were reported to a public health authority. When case onset date was not available, it was estimated based on the mean time differences between date types. Each laboratory report included patient age and sex, and was linked to one of Ontario’s 36 local health authorities.
The relationship between antiviral prescriptions and influenza A(H1N1) laboratory-confirmed cases was investigated using a Poisson regression model. Potential correlation at the local health authority level was accommodated using a generalized estimating equation approach to determine parameter estimates. Weekly antiviral prescriptions dispensed (antivirals per 10,000 other prescriptions) were compared with weekly influenza A(H1N1) case counts. Prescription proportions were used (rather than absolute prescription counts) in an effort to adjust for a number of potential factors, including day-of-the week, holidays, and regional variation in physician prescribing patterns. Lagged weekly influenza A(H1N1) case counts were used to investigate the potential time-lag between influenza A(H1N1) symptom onset dates and antiviral prescription dispensing dates.
During July 1–December 31, 2009, information was available on approximately 43,000 Ontario oseltamivir and zanamivir prescriptions. Patient age and sex were available for 82% of antiviral prescriptions: mean age was 34 years, median age was 33 years, and 57% of patients were female. During this period, information was available on approximately 7,300 Ontario influenza A(H1N1) laboratory confirmations: mean age of patients was 24 years; median age was 18 years, and 47% were female patients. Symptom onset date was available for 56% of the cases, laboratory specimen date for 32% of the cases, and laboratory reporting date for 12% of the cases. The average time difference from mean (median) onset date to mean (median) specimen date was 6 (5) days, and from mean (median) specimen date to mean (median) reporting date was 6 (8) days.
Very little if any lag was observed between the influenza A(H1N1) case onset trend line and the antiviral prescription trend line (Figures 1 and 2). Poisson regression analysis demonstrated a statistically significant relationship between weekly influenza A(H1N1) case counts and antiviral prescriptions at the local health authority level (p<0.001). Statistical significance was greatest when influenza A(H1N1) cases counts were not lagged by time. Analysis results were similar when only the 56% of cases with known onset date were considered.
The findings in this report demonstrate that during the second wave of the influenza A(H1N1) epidemic in 2009 in Ontario, antiviral prescription dispensing mirrored influenza A(H1N1) onset activity at the local level with no appreciable lag time. These results suggest that pharmacy-based surveillance can provide a mechanism to monitor and detect influenza-like activity regardless of whether the underlying pathogen is laboratory confirmed. This might be especially important if the pathogen is not routinely tested for.
The time lag between symptom onset and laboratory reporting to public health officials of a known pathogen can be substantial (2). Even during the second wave of the influenza A(H1N1) outbreak, when public health authorities in Ontario were prepared, an average time lag from symptom onset to reporting of an influenza A(H1N1) confirmation to public health authorities was estimated to be 12 days. If the cause of an influenza-like illness is unknown or not routinely tested for (e.g., a novel coronavirus), the gains achieved in timeliness with pharmacy-based surveillance might be much greater.
The reporting of positive influenza laboratory results in a community likely contributed to increased physician prescribing of antivirals. However, given an estimated 12-day lag time from symptom onset to laboratory reporting to public health authorities, publicized influenza laboratory confirmations likely did not influence prescription patterns during the early phases of increased community activity.
The findings in this report are subject to at least three limitations. First, although analysis results were similar regardless of whether the 44% of cases with estimated onset dates were considered, the validity of estimating onset dates based on specimen or reported date cannot be assessed. Second, the proportion of prescriptions administered for prophylaxis versus treatment is not known, neither is the effect this might have had on the temporal association between onset dates and prescription dispensing dates. Finally, this study focused on one event, the 2009 influenza A(H1N1) pandemic. Additional investigation involving more years of data and more geographic locations are required before any findings can be generalized.
Although laboratory-based surveillance remains a cornerstone of influenza surveillance, the need for more timely surveillance data has never been greater. With the routine and daily movement of persons between communities, an infectious disease can rapidly spread around the world in a matter of days. In addition, much has been learned about how infectious diseases like influenza spread and what methods can and should be used to help minimize spread and potential impacts. Successful results of most mitigation strategies (e.g., cough etiquette, hand washing, staying home when sick, and vaccination reminders) are best achieved if implemented in the community as early as possible.
The contribution of pharmacy-based surveillance to an overall influenza surveillance strategy primarily depends on the timeliness of the pharmacy data. In Canada, as in most industrialized nations, the pharmacy industry maintains sophisticated information systems to manage drug inventory and client data. An ongoing PHAC real-time pharmacy-based surveillance project demonstrates that the collection, aggregation, and analysis of near real-time prescription data from thousands of community pharmacies from across Canada is readily achievable.
FIGURE 2. Average weekly number of influenza A(H1N1) cases and number of antiviral prescriptions per 10,000 other prescriptions reported at the local health authority level — Ontario, Canada, August–December 2009
* Extracted by Public Health Ontario from the Integrated Public Health Information System database on March 21, 2011.
What is already known on this topic?
Traditional methods of influenza surveillance rely on the collection and aggregation of laboratory results and clinical observations from physicians and public health authorities. It can take several days to weeks from symptom onset to data being collected, aggregated, analyzed, and reported.
What is added by this report?
Changes in the ratio of prescriptions for two drugs prescribed for the prophylaxis and treatment of influenza to all other prescriptions coincided with the second wave of the influenza pandemic in Ontario, Canada, during July 1–December 31, 2009. Prescriptions tracked dates of symptom onset ahead of dates of positive influenza laboratory reports at the local health authority level.
What are the implications for public health practice?
Infectious disease mitigation strategies are most effective when implemented early. Real-time surveillance of pharmacy data might be more useful than laboratory data for guiding early implementation of these strategies.
British counter-terrorism police arrest a man who was a
childhood friend of Woolwich murder suspect Michael Adebolajo
after he gave an interview to the BBC Friday night, the British
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Notes from the Field: Ascariasis Associated with Pig Farming — Maine, 2010–2013
May 24, 2013 / 62(20);413-413
During April 2010–March 2013, the Maine Department of Health and Human Services investigated multiple cases of ascariasis that had been reported by health-care providers, veterinarians, and patients. All of the cases were in persons who had lived or worked on Maine farms and had frequent exposure to pigs. Ascariasis, a parasitic roundworm infection caused by Ascaris species, is the most common human intestinal worm infection globally.* However, because ascariasis is not a reportable disease, limited data exist regarding the incidence of this infection in the United States (1), and the number of annual cases in Maine is unknown. After investigation, 14 persons on seven farms in Maine were identified with Ascaris infection.
To better assess the extent of the ascariasis problem, state health officials conducted field investigations at four of the seven farms with reported cases and collected worms from humans and pigs and from pooled pig feces. Human worm and pig worm specimens were sent to CDC for identification and analysis. Confirmed cases were among persons who had excreted in stool at least one worm laboratory-identified as Ascaris species. Probable cases were among persons who reported excreting at least one worm in stool and who were epidemiologically associated with a confirmed case. Suspected cases were among persons with symptoms consistent with larval migration (e.g., coughing up larvae) and who were epidemiologically associated with a confirmed case or who had excreted at least one worm in stool without laboratory confirmation or epidemiologic association with a confirmed case.
A total of 14 patients aged 1–53 years (median: 25 years) from seven farms in six Maine counties had an Ascaris infection (eight confirmed, four probable, and two suspected) during 2010–2013. Thirteen (93%) patients were female. Ten (71%) patients reported no international travel history; of the four patients with a history of international travel, two reported previous treatment for parasites, and two reported no previous screening or treatment. All patients sought medical care and were prescribed anthelminthic medication (e.g., albendazole).
Private reference and university laboratories confirmed Ascaris species in human samples from three farms and in pooled pig feces from two farms. CDC confirmed as Ascaris species four worms collected from humans at four different farms and worms collected from pigs at one of those farms. Transmission from pigs to humans has been reported in other countries and likely occurred on the seven farms in Maine (2). Occurrence of infections among persons with no other likely source of infection and common exposure to pigs suggests that pigs were the source of human infections.
Ascariasis is transmitted by the fecal-oral route. Ascaris eggs and adult worms are excreted in stool. Ascaris infections often are asymptomatic among humans, but symptoms can include gastrointestinal discomfort and cough. Adverse health outcomes can include lung inflammation, intestinal obstruction, and growth delays.
The seven implicated farms grew either organic or conventional produce and raised livestock for household consumption and/or local sale. This unusual disease cluster holds implications for limited-scale agriculture with respect to farming practices and concern over foodborne transmission. Investigators recorded field notes from each of the four farm visits and conducted case investigation interviews regarding international travel history, farming practices, animal husbandry, and hand hygiene. Recommendations to prevent human illness at farms where Ascaris infection has been confirmed include improved hand hygiene, growing vegetables away from areas where pigs are penned, discontinuing use of pig manure as fertilizer, and thoroughly washing produce.
* Additional information available at http://www.cdc.gov/parasites/ascariasis/index.html.
May 23, 2013
In its 2013 Atlantic hurricane season outlook issued today, NOAA’s Climate Prediction Center is forecasting an active or extremely active season this year.
For the six-month hurricane season, which begins June 1, NOAA’s Atlantic Hurricane Season Outlook says there is a 70 percent likelihood of 13 to 20 named storms (winds of 39 mph or higher), of which 7 to 11 could become hurricanes (winds of 74 mph or higher), including 3 to 6 major hurricanes (Category 3, 4 or 5; winds of 111 mph or higher).
These ranges are well above the seasonal average of 12 named storms, 6 hurricanes and 3 major hurricanes.
“With the devastation of Sandy fresh in our minds, and another active season predicted, everyone at NOAA is committed to providing life-saving forecasts in the face of these storms and ensuring that Americans are prepared and ready ahead of time.” said Kathryn Sullivan, Ph.D., NOAA acting administrator. “As we saw first-hand with Sandy, it’s important to remember that tropical storm and hurricane impacts are not limited to the coastline. Strong winds, torrential rain, flooding, and tornadoes often threaten inland areas far from where the storm first makes landfall.”
Three climate factors that strongly control Atlantic hurricane activity are expected to come together to produce an active or extremely active 2013 hurricane season. These are:
“This year, oceanic and atmospheric conditions in the Atlantic basin are expected to produce more and stronger hurricanes,” said Gerry Bell, Ph.D., lead seasonal hurricane forecaster with NOAA’s Climate Prediction Center. “These conditions include weaker wind shear, warmer Atlantic waters and conducive winds patterns coming from Africa.”
NOAA’s seasonal hurricane outlook is not a hurricane landfall forecast; it does not predict how many storms will hit land or where a storm will strike. Forecasts for individual storms and their impacts will be provided throughout the season by NOAA’s National Hurricane Center.
New for this hurricane season are improvements to forecast models, data gathering, and the National Hurricane Center communication procedure for post-tropical cyclones. In July, NOAA plans to bring online a new supercomputer that will run an upgraded Hurricane Weather Research and Forecasting (HWRF) model that provides significantly enhanced depiction of storm structure and improved storm intensity forecast guidance.
Also this year, Doppler radar data will be transmitted in real time from NOAA’s Hurricane Hunter aircraft. This will help forecasters better analyze rapidly evolving storm conditions, and these data could further improve the HWRF model forecasts by 10 to 15 percent.
The National Weather Service has also made changes to allow for hurricane warnings to remain in effect, or to be newly issued, for storms like Sandy that have become post-tropical. This flexibility allows forecasters to provide a continuous flow of forecast and warning information for evolving or continuing threats.
“The start of hurricane season is a reminder that our families, businesses and communities need to be ready for the next big storm,” said Joe Nimmich, FEMA associate administrator for Response and Recovery. “Preparedness today can make a big difference down the line, so update your family emergency plan and make sure your emergency kit is stocked. Learn more about how you can prepare for hurricane season at www.ready.gov/hurricanes.”
Next week, May 26 – June 1, is National Hurricane Preparedness Week. To help those living in hurricane-prone areas prepare, NOAA is offering hurricane preparedness tips, along with video and audio public service announcements in both English and Spanish, featuring NOAA hurricane experts and the FEMA administrator at www.nhc.noaa.gov/prepare/.
NOAA’s outlook for the Eastern Pacific basin is for a below-normal hurricane season and the Central Pacific basin is also expected to have a below-normal season. NOAA will issue an updated outlook for the Atlantic hurricane season in early August, just prior to the historical peak of the season.
NOAA’s mission is to understand and predict changes in the Earth’s environment, from the depths of the ocean to the surface of the sun, and to conserve and manage our coastal and marine resources. Join us on Facebook, Twitter and our other social media channels.
U.K. Police Hold Two New Suspects in Killing
Arrests Made After Others Detained a Day Earlier Emerge in Prior Probes of Islamist Extremists; Cameron Calls for Unity
“……..Authorities said they made two further arrests Thursday—a 29-year-old man and a 29-year-old woman—on suspicion of conspiring to murder. Police said they also searched six residential addresses across London and in Lincolnshire, England.
None of the four suspects have been charged……”
Overall, the population in this region resides in structures that are highly resistant to earthquake shaking, though some vulnerable structures exist.
Recent earthquakes in this area have caused secondary hazards such as landslides and liquefaction that might have contributed to losses.