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…..”
“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….”
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…..”
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.
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
A total of 12 persons infected with the outbreak strain of STEC O26 have been reported from 5 states.
The number of ill persons identified in each state is as follows: Iowa (5), Missouri (3), Kansas (2), Arkansas (1), and Wisconsin (1).
Two ill persons have been hospitalized, and no deaths have been reported.
Preliminary results of the epidemiologic and traceback investigations indicate eating raw clover sprouts at Jimmy John’s restaurants is the likely cause of this outbreak.
FDA’s traceback investigation is ongoing. Traceback information on sprouts has identified a common lot of clover seeds used to grow clover sprouts served at Jimmy John’s restaurant locations where ill persons ate.
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).
Leprosy is a chronic disease caused by a bacillus, Mycobacterium leprae. Official figures show that more than 213 000 people mainly in Asia and Africa are infected, with approximately 249 000 new cases reported in 2008.
M. leprae multiplies very slowly and the incubation period of the disease is about five years. Symptoms can take as long as 20 years to appear.
Leprosy is not highly infectious. It is transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated cases.
Untreated, leprosy can cause progressive and permanent damage to the skin, nerves, limbs and eyes. Early diagnosis and treatment with multidrug therapy (MDT) remain the key elements in eliminating the disease as a public health concern.
Here a Lowenstein-Jensen plate culture has been inoculated with 15 strains of Mycobacteria spp..The genus Mycobacterium contains more than 70 species, included in which are the species M. tuberculosis and M. leprae, the pathogens responsible for tuberculosis and leprosy respectively. Credit: CDC-PHIL
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.
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.
Over the past 20 years, more than 14 million leprosy patients have been cured, about 4 million since 2000.
The prevalence rate of the disease has dropped by 90% – from 21.1 per 10 000 inhabitants to less than 1 per 10 000 inhabitants in 2000.
Dramatic decrease in the global disease burden: from 5.2 million in 1985 to 805 000 in 1995 to 753 000 at the end of 1999 to 213 036 cases at the end of 2008.
Leprosy has been eliminated from 119 countries out of 122 countries where the disease was considered as a public health problem in 1985.
So far, there has been no resistance to antileprosy treatment when used as MDT.
Efforts currently focus on eliminating leprosy at a national level in the remaining endemic countries and at a sub-national level from the others.
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:
ensuring accessible and uninterrupted MDT services available to all patients through flexible and patient-friendly drug delivery systems;
ensuring the sustainability of MDT services by integrating leprosy services into the general health services and building the ability of general health workers to treat leprosy;
encouraging self-reporting and early treatment by promoting community awareness and changing the image of leprosy;
monitoring the performance of MDT services, the quality of patients’ care and the progress being made towards elimination through national disease surveillance systems.