Tuesday, October 31, 2023

Chad's first dengue outbreak: what you should know

Report from EconoTimes - https://www.econotimes.com/

By Dr. Eunice Anyango Owino*

Dated Monday, 30 October 2023, 10:56 AM UTC - here is a copy in full:

Chad's first dengue fever outbreak: what you should know

Chad has reported its first dengue outbreak, according to the World Health Organization (WHO). The country’s health ministry declared an outbreak on 15 August and so far 1,342 suspected cases have been reported, 41 of them confirmed in the laboratory. One death was reported among the patients with lab-confirmed cases. The outbreak started in Ouaddaï province in eastern Chad, currently the outbreak epicentre. Illnesses have also been reported in three other provinces. Godfred Akoto Boafo spoke to medical entomologist Eunice Anyango Owino about the disease.

Mosquitoes are the primary medium for contracting dengue. Oregon State University/Flickr

What causes dengue fever and how does it affect people?

Dengue fever is a mosquito-borne viral disease caused by one of the four dengue virus serotypes. It is primarily transmitted by the Aedes aegypti mosquito and to a lesser extent the Aedes albopictus mosquito, mainly in the tropical and sub-tropical areas of the world.

Infection with one serotype provides long-term immunity to that particular serotype, but not the others. That means that, after recovery, a person can still be infected by the other three serotypes. Serotypes are groups within a single species of microorganisms, such as bacteria or viruses, which share distinctive surface structures.

Most infections produce only mild flu-like illness; 80% of cases are asymptomatic. But getting infected with different serotypes one after the other puts a person at a greater risk of severe dengue, also known as dengue hemorrhagic fever. It is characterised by serious internal bleeding and organ damage, and a sudden drop in blood pressure that causes shock which can be fatal.

How widespread is it in the Sahel? Why is this first outbreak in Chad significant?

Dengue fever has been endemic in Sudan, with outbreaks documented in 2010, 2013, 2017 and 2019. Unfortunately, due to years of political and civil conflicts, the control and response capacity of the public health sector in Sudan has been limited.

The risk of spread in the Sahel region, which includes Niger, Mali and Chad, has always been high. This is because these countries all host the suitable mosquito vectors (Aedes). They also share the same tropical climate with seasonal heavy rains and floods.

To add to the problem, countries like Chad are grappling with a massive influx of refugees and returnees from Sudan who might be carrying the disease. The epicentre of the current outbreak, the province of Ouaddai at the eastern border with Sudan, hosts more than 400,000 refugees.

The cities at the border with Sudan are densely populated and have poor sanitation. This provides a favourable environment for the vectors to breed.

In addition, Chad lacks effective disease control programmes. This is its first dengue outbreak. It doesn’t have the necessary public health preparedness and response capacities. So the risk posed by this outbreak is high.

The movement of the returning refugees has the potential to spread the outbreak in Chad and even across the border to other countries in the Sahel, the rest of Africa, and the world at large.

What treatment is available?

There’s currently no available treatment for dengue in the world. Timely detection and case management, especially treatment of dehydration and plasma leakage by oral or intravenous rehydration, are key in preventing severe illness and death.

There is an approved dengue vaccine (Dengvaxia) for use in people aged 9-45 years. But for it to be effective they must have had one infection of dengue by any of the four serotype viruses, which must be confirmed by a laboratory test.

The vaccine is given in three doses within 12 months and protects against all the four dengue virus serotypes with an efficacy of 80%. However, its availability in developing countries in Africa isn’t assured, although it has been licensed by several national regulatory authorities.

Apart from the vaccine, the only other guard against dengue fever is prevention of mosquito bites and vector control.

What is the way forward in controlling the disease?

More investment should be put on expanding clinical and laboratory capabilities to deal with the disease. 

Given that this is Chad’s first outbreak, it needs to:

• put in place standard operating procedures for clinical management of suspected and confirmed dengue cases

• expand the capacity for early detection of cases – this could be done by procurement of rapid diagnostic tests and by alerting communities

• strengthen disease surveillance and coordinate the response by actively finding cases. Cases within the community are likely to be underreported as dengue is unknown to the public. Also, clinicians might not be familiar with the disease presentation. It could be confused with other common fevers.

• put in place effective vector control measures, like draining stagnant water around residential areas, cleaning and replenishing water storage containers on a weekly basis, distributing insecticide-treated nets, spraying indoors and using window and door screens.

• strengthen surveillance to assess the vector breeding potential in containers and to monitor insecticide resistance. This is critical for selecting the most effective insecticides.

• make communities aware of the risks of infection and how to protect themselves. Engaged communities can take ownership of the vector control strategy and adopt healthy behaviours.

• strengthen cross-border collaboration. The current outbreak most likely spread from Sudan. The focus should be on prevention and vector control measures in border areas.

• mobilise resources for a national contingency plan for dengue preparedness and response. And seek help from experienced organisations like the WHO.

View original: https://www.econotimes.com/Chads-first-dengue-fever-outbreak-what-you-should-know-1665123

*About Author: Eunice Anyango Owino
Dr. Eunice Anyango Owino is a Medical Entomologist based at the School of Biological Sciences, the University of Nairobi, specialising on arthropod borne diseases. 
Medical Entomologist at the School of Biological Sciences, University of Nairobi 
Source: https://www.econotimes.com/contributors/17080


Over 100 dead from cholera, dengue in Sudan

Report from Medical X press - medicalxpress.com 


Dated Sunday, 29 October 2023 - here is a copy in full:

Over 100 dead from cholera, dengue in war-torn Sudan

Scanning electron microscope image of Vibrio cholerae. Credit: Wikipedia

Outbreaks of cholera and dengue fever in war-torn Sudan have left more than 100 people dead since August, the health ministry said on Saturday.

A total of 1,049 cases of cholera, 73 of them fatal, were recorded in Khartoum, Al-Jazira state to its south and Gedaref state to the its west, the ministry said.

Khartoum has been one of the main battlegrounds in the fighting between rival generals that has gripped the country since April.

Hundreds of thousands of residents of greater Khartoum have fled to calmer areas of Gedaref and Al-Jazira, overwhelming the supply of clean water.

Nine Sudanese states have recorded cases of mosquito-borne dengue, with 49 deaths from a total of 3,316 cases, the ministry said.

Gedaref state, which borders Ethiopia, reported 2,152 of the cases and 33 of the deaths.

Even before the fighting broke out in April, Sudan's health care system struggled to contain the disease outbreaks that accompany the country's rainy season which begins in June.

Now—with hospitals bombed, medicines running low and many doctors fleeing the country—the health care system has been pushed to the brink.

The health ministry report said 70 percent of hospitals in war-torn areas are out of service.

© 2023 AFP

View original:  https://medicalxpress.com/news/2023-10-dead-cholera-dengue-war-torn-sudan.html


Monday, October 30, 2023

VIDEO TRANSCRIPT: ICC Prosecutor's statement after visiting Rafah Border between Egypt & Gaza

“International Criminal Court Prosecutor Karim A.A. Khan KC addresses journalists after visiting the Rafah Border Crossing between Egypt and the Gaza Strip on 29 October 2023. From Cairo, the Prosecutor gives a statement on the current situation in Israel and the State of Palestine”. 

Video courtesy of Al Arabiya - english.alarabiya.net.  


Follow along using the transcript facility at the video.


VIDEO: ICC Prosecutor speaks in Cairo on the situation in Israel and Palestine after his visit to Rafah


ICC prosecutor at Rafah border crossing between Egypt and Gaza says he hopes to visit Gaza, Israel

Report at Al Arabiya - english.alarabiya.net
With AFP (Agence France-Presse)
Published Sunday, 29 October 2023: 08:57 PM GST
Updated Monday, 30 October 2023: 01:52 AM GST - here is a copy in full:

ICC prosecutor at Rafah border crossing says hopes to visit Gaza, Israel

International Criminal Court Prosecutor Karim Khan speaks during an interview with Reuters about the violence in Israel and the occupied Palestinian territories in The Hague, Netherlands October 12, 2023. (File photo: Reuters)

International Criminal Court prosecutor Karim Khan said Sunday preventing access to humanitarian could be a crime, after visiting Egypt’s Rafah crossing with Gaza, the main entry point for international aid.

“Impeding relief supplies as provided by the Geneva conventions may constitute a crime within the court jurisdiction,” Khan told reporters in Cairo.

He said he wanted “to underline clearly to Israel that there must be discernible efforts without further delay to make sure civilians” in the Hamas-run Palestinian territory “receive basic food, medicines”.

“I saw trucks full of goods full of humanitarian assistance stuck where nobody needs them, stuck in Egypt, stuck at Rafah,” Khan said.

“These supplies must get to the civilians of Gaza without delay.”

On Sunday the United Nations warned it feared a breakdown of public order after looting at food aid centres in Gaza run by its agency for Palestinian refugees, UNRWA.

UN chief Antonio Guterres said the situation was “growing more desperate by the hour” as casualties in the war increase and essential supplies of food, water, medicine and shelter dwindle.

People in the Palestinian territory have lived under Israeli blockade for 16 years and under complete siege for the past three weeks after the territory’s Hamas rulers launched deadly attacks into Israel that sparked a war.

Hamas militants stormed across the Gaza border on October 7 in the deadliest attack in Israel’s history, killing 1,400 people, mostly civilians, and kidnapping 239 others, according to Israeli officials.

The Palestinian health ministry in Gaza says the retaliatory Israeli bombardment has killed more than 8,000 people, mainly civilians and half of them children.

Khan said his office had an ongoing investigation into “any crimes committed on the territory of Palestine and any crimes committed, whether it’s by Israel and Palestine or whether it’s acts committed on the territory of Palestine or from Palestine into Israel.”

“This includes current events in Gaza and also current events in the West Bank,” Khan said, adding that he was “very concerned also by the spike of the number of reported incidents of attack by settlers against Palestinian civilians” in the territory Israel has occupied since 1967.

Khan also said hostage taking was a breach of the Geneva Conventions.

“I call for the immediate release of all hostages taken from Israel and for their safe return to their families,” Khan said.

The British lawyer said “Israel has clear obligations in relation to its war with Hamas, not just moral obligations but legal obligations” to comply with the laws of conflict.

“These principles equally apply to Hamas in relation to firing indiscriminate rockets into Israel,” he said.

View original: https://english.alarabiya.net/News/middle-east/2023/10/29/ICC-prosecutor-at-Rafah-border-crossing-says-hopes-to-visit-Gaza-Israel


VIDEO: ICC Prosecutor speaks outside compound by Rafah border crossing between Egypt and Gaza Strip

THE International Criminal Court (ICC) Prosecutor Karim Khan KC was at the Rafah crossing point between Egypt and the Gaza Strip this weekend. Watch his remarks on the current situation in Israel and the State of Palestine in this clip filmed outside the compound of the Rafah crossing.


Sunday, October 29, 2023

RESCUE MISSION British SAS troops on standby in Cyprus to rescue hostages and Brits stranded in Gaza

Exclusive report at The Sun - thesun.co.uk
By Jerome Starkey
Dated Fri 27 Oct 2023; Updated: 1:05, Sat 28 Oct 2023 - here is a full copy:

RESCUE MISSION SAS troops on standby in Cyprus to rescue hostages and Brits stranded in Gaza

Officials also fear the war could spread, trapping more Brits in Egypt’s Sinai peninsular and Lebanon.

SAS troops are now in Cyprus on standby for hostage rescue missions in Gaza.

The elite soldiers are also braced to free UK citizens trapped by the bloodbath.

SAS troops are now in Cyprus on standby for hostage rescue missions in Gaza Credit: BBC

200 Brits are stranded in Gaza after Israel and Egypt sealed the strip’s borders Credit: 2023 Anadolu

Some 200 Brits are stranded in Gaza after Israel and Egypt sealed the strip’s borders and five are held there by Hamas terrorists.

Britain’s military bases in Cyprus offer a strategic presence in the eastern Med.

And the SAS sabre squadron has been joined on the island by a 100-strong crisis command team.

Their primary focus is the Gaza Strip but officials fear the war could spread, trapping more Brits in Egypt’s Sinai peninsular and Lebanon.

The SAS in Cyprus have the Special Forces Support Group with them and a fleet of their modified helicopters.

A similar joint force scrambled to Cyprus ahead of the Khartoum Airlift that rescued some 2,000 from war-torn Sudan in spring.

A source told The Sun: “The UK has permanent bases in Cyprus.

"You would expect us to make use of them when there is a crisis in the region like this.”

Defence and Border Force staff have also been deployed to Egypt in the hope that Cairo relaxes its chokehold on Gaza’s Rafah border crossing.

The MoD refused to comment on details of Special Forces operations.

Meanwhile, the Israeli army’s most elite fighting force Sayeret Matkal is likely to spearhead any hostage rescue in Gaza.

The shadowy unit, who wear maroon berets, are modelled on the SAS and have the same “Who Dares Wins” motto.

Israeli PM Benjamin Netanyahu is a former team leader in the crack military group, as was his brother.

Yonatan Netanyahu was killed in the famous air hijack hostages rescue involving Sayeret Matkal commandoes at Entebbe, Uganda, in 1976.

View original: https://www.thesun.co.uk/news/24552018/sas-troops-standby-cyprus-rescue-gaza-hostages-brits/