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February 17th, 2012 posted by Paul Rega, MD, FACEP February 17, 2012 @ 5:46 pm

WHO: Deadly bird flu studies……shhhhhhh…..,0,3965563.story

Baltimore Sun

Stephanie Nebehay and Kate Kelland Reuters4:35 p.m. EST, February 17, 2012

GENEVA/LONDON (Reuters) – “Two studies showing how scientists mutated the H5N1 bird flu virus into a form that could cause a deadly human pandemic will be published only after experts fully assess the risks, the World Health Organisation (WHO) said on Friday.

Speaking after a high-level meeting of flu experts and U.S. security officials in Geneva, a WHO official said an deal had been reached in principle to keep details of the controversial work secret until deeper risk analyses could be carried out…..”

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February 17th, 2012 posted by Paul Rega, MD, FACEP @ 5:32 pm

Amine el-Khalifi: Lone Wolf?


Washington Post, 2/17/12

Federal agents arrest man who allegedly planned suicide bombing on U.S. Capitol


By , and , Updated: Friday, February 17, 5:09 PM

“The FBI and the U.S. Capitol Police arrested a Moroccan man Friday in downtown Washington after a lengthy investigation into an alleged plot to carry out a shooting spree and a suicide bombing at the Capitol.Amine el-Khalifi, 29, was picked up while carrying an inoperable MAC-10 automatic weapon and a fake suicide vest provided to him by undercover FBI agents posing as al-Qaeda associates, U.S. officials said. They said he entered the United States when he was 16 and was living as an illegal immigrant in Northern Virginia, having overstayed his visitor’s visa for years….”


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February 17th, 2012 posted by Paul Rega, MD, FACEP @ 5:27 pm

Air cargo security : are we really safe?


Al Qaeda’s biggest threat

By Paul Cruickshank, Nic Robertson, and Tim Lister, CNN

Editor’s note: This report is based on a one-year investigation by CNN into air cargo security in light of a thwarted plot by al Qaeda in October 2010 to blow up cargo jets over the United States. CNN’s Nic Robertson’s report “Deadly Cargo” airs on CNN Presents, Saturday and Sunday February 18, 19 at 8 p.m. ET.

“Ibrahim al-Asiri is the sort of terrorist who keeps intelligence officials awake at night. He’s al Qaeda’s chief bomb-maker, and he built explosive devices hidden in printer cartridges that got onto several planes in October 2010. He’s still at large in Yemen. The bomb plots he’s alleged to have masterminded – the 2009 underwear bomb plot and printer bombs dispatched to the United States in 2010 – have very nearly worked. And security experts say al-Asiri and al Qaeda in Yemen may yet penetrate the security screening that is meant to protect aviation…..”

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February 17th, 2012 posted by Paul Rega, MD, FACEP @ 5:23 pm

Khalifi: Arrested for planning suicide attack on The Capitol



Washington (CNN)

U.S. Capitol Police and the FBI on Friday arrested a Moroccan man who was planning a suicide attack on the Capitol.

He was given what he thought was a vest with explosives and a gun.

 He was living in the United States illegally.

He was not connected to a terrorist organization and was acting alone.

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February 17th, 2012 posted by Paul Rega, MD, FACEP @ 6:18 am

Texas: doctors, pharmacists, and law enforcement officials may easily identify patients who are abusing pain medications


Texas: Texas Readies a new weapon against ‘doctor shopping’ for prescription drugs
American-Statesman (02/02/2012) Laylan Copelin

After years of collecting Texas citizens’ prescription histories, the Texas Department of Public Safety (DPS) plans to make the data available online so doctors, pharmacists, and law enforcement officials may easily identify patients who are abusing pain medications.
In 2011 the Texas Legislature passed a law making ‘doctor shopping’ a felony. In 2012 the Legislature will consider requiring doctors to check the state prescription database before even writing a prescription.

Many Texas lawmakers feel the laws are necessary to curb the growing problem. “Prescription drug abuse is an epidemic in our state and the nation . . . A lot of folks think, ‘I’m not a drug abuser because I got this [the prescription drugs] from a pharmacy,’” said Texas Senator Tommy Williams.

While there appears to be broad agreement that there is a prescription drug abuse problem, some are yet concerned about what effect the state’s efforts will have on the doctor-patient relationship and confidentiality. “How it is implemented will have a lot to do with the impact on privacy concerns.” Said Lisa Graybill, legal director of the American Civil Liberties Union of Texas.

DPS has indicated that the prescription records are protected by the Federal Health Insurance Portability and Accountability Act (HIPAA). Patient information is currently protected because access to the database is limited to drug investigation officers.

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February 17th, 2012 posted by Paul Rega, MD, FACEP @ 5:43 am

Raw Clover Sprouts & STEC O26


Investigation Announcement: Multistate Outbreak of Shiga Toxin-producing Escherichia coli O26 Infections Linked to Raw Clover Sprouts at Jimmy John’s Restaurants

Posted February 15, 2012 1:30 PM ET

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February 17th, 2012 posted by Paul Rega, MD, FACEP @ 5:06 am

Rubella in Romania


Janta D, Stanescu A, Lupulescu E, Molnar G, Pistol A. Ongoing rubella outbreak among adolescents in Salaj, Romania, September 2011–January 2012. Euro Surveill. 2012;17(7):pii=20089. Available online:

A rubella outbreak has been ongoing in Salaj, Romania since September 2011 involving 1,840 probable and confirmed cases among mainly unvaccinated adolescents.

This negatively-stained transmission electron micrograph (TEM) revealed the presence of Rubella virus virions, as they were in the process of budding from the host cell surface to be freed into the host’s system, thereby, producing an enveloped virus particle, which means that after budding, the spherical virions’ icosahedral capsid is enclosed in the host cell membrane. Inside the capsid lies the Rubella virus’ positive-sense single-stranded RNA ((+)ssRNA) genome. The Rubella virus is known to be the cause of rubella, otherwise known as German measles.

Rubella, also known as German measles or 3-day measles, is a respiratory viral infection characterized by mild respiratory symptoms and low-grade fever, followed by a maculopapular rash lasting about 3 days. In children there may be no significant respiratory prodrome and the illness may not be diagnosed since the rash may be mild and mimic other conditions. It is estimated that 20-50% of infections are subclinical. Complications occur more frequently in adult women, who may experience arthritis or arthralgia, often affecting the fingers, wrists and knees. These joint symptoms rarely last for more than a month after appearance of the rash.

Up to 85% of infants infected with rubella in the first trimester of pregnancy will suffer birth defects and/or neurologic abnormalities (Congenital rubella syndrome, CRS).

Credit:  CDC-PHIL

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February 17th, 2012 posted by Paul Rega, MD, FACEP @ 5:02 am

Cambodia: Deadly home-made rice wine ; Methanol poisoning?


“……Sok Touch, director of communication disease control department of the Health Ministry, said that 49 Cambodians had died and 318 others were hospitalized by drinking home-made rice wine in the country between October 2010 and by Jan. 31, 2012……..

Sok Touch said that the incidents occurred in seven provinces and a city including Pursat, Siem Reap, Kratie, Kompong Cham, Prey Veng, Sihanoukville and Phnom Penh…….”

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February 17th, 2012 posted by Paul Rega, MD, FACEP @ 4:57 am

In 2011, 20 cases have been confirmed by the Gaol Street Health Centre in Hereford, compared to less than five during 2010.


Hereford Times (UK)

Syphilis increase in Herefordshire

9:49am Wednesday 15th February 2012

“A RISE in cases of infectious syphilis affecting men across Herefordshire has prompted health experts to urge those at risk to get tested.

NHS services and the Health Protection Agency (HPA) are investigating the rise in cases of the sexually transmitted infection, which has predominantly affected men who have sex with men…..”

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February 17th, 2012 posted by Paul Rega, MD, FACEP @ 4:39 am

WHO: A Leprosy Primer



Fact sheet N°101
February 2010



Leprosy is a chronic infectious disease caused by Mycobacterium leprae, an acid-fast, rod-shaped bacillus. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract and also the eyes, apart from some other structures.

Leprosy is curable and treatment provided in the early stages averts disability.

Multidrug therapy (MDT) treatment has been made available by WHO free of charge to all patients worldwide since 1995, and provides a simple yet highly effective cure for all types of leprosy.

Leprosy today

The diagnosis and treatment of leprosy today is easy and most endemic countries are striving to fully integrate leprosy services into existing general health services. This is especially important for those under-served and marginalised communities most at risk from leprosy, often the poorest of the poor.

According to official reports received from 121 countries and territories, the global registered prevalence of leprosy at the beginning of 2009 stood at 213 036 cases, while the number of new cases detected during 2008 was 249 007. The number of new cases detected globally has fallen by 9126 (a 4% decrease) during 2008 compared with 2007.

Pockets of high endemicity still remain in some areas of Angola, Brazil, Central African Republic, Democratic Republic of Congo, India, Madagascar, Mozambique, Nepal, and the United Republic of Tanzania. These countries remain highly committed to eliminating the disease, and continue to intensify their leprosy control activities.

Brief history – disease and treatment

Leprosy was recognized in the ancient civilizations of China, Egypt and India. The first known written mention of leprosy is dated 600 BC. Throughout history, the afflicted have often been ostracized by their communities and families.

Although leprosy was treated differently in the past, the first breakthrough occurred in the 1940s with the development of the drug dapsone, which arrested the disease. But the duration of the treatment was many years, even a lifetime, making it difficult for patients to follow. In the 1960s, M. leprae started to develop resistance to dapsone, the world’s only known anti-leprosy drug at that time. In the early 1960s, Rifampicin and clofazimine, the other two components of MDT, were discovered.

In 1981, a World Health Organization (WHO) Study Group recommended multidrug therapy (MDT). MDT consists of 3 drugs: dapsone, rifampicin and clofazimine and this drug combination kills the pathogen and cures the patient.

Since 1995, WHO provides free MDT for all patients in the world, initially through the drug fund provided by the Nippon Foundation and since 2000, through the MDT donation provided by Novartis and the Novartis Foundation for Sustainable Development.

Elimination of leprosy as a public health problem

In 1991 WHO’s governing body, the World Health Assembly (WHA) passed a resolution to eliminate leprosy as a public health problem by the year 2000. Elimination of leprosy as a public health problem is defined as a prevalence rate of less than one case per 10 000 persons. The target was achieved on time and the widespread use of MDT reduced the disease burden dramatically.

Actions and resources required

In order to reach all patients, treatment of leprosy needs to be fully integrated into general health services. This is a key to successful elimination of the disease. Moreover, political commitment needs to be sustained in countries where leprosy remains a public health problem. Partners in leprosy elimination also need to continue to ensure that human and financial resources are made available for the elimination of leprosy.

The age-old stigma associated with the disease remains an obstacle to self-reporting and early treatment. The image of leprosy has to be changed at the global, national and local levels. A new environment, in which patients will not hesitate to come forward for diagnosis and treatment at any health facility, must be created.

Strategy for leprosy elimination

The following actions are part of the ongoing leprosy elimination campaign:

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