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Online Discussion: Tracking new emerging diseases and the next pandemic; Now tracking the Aussie Flu.

Plague !!!

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cobber View Drop Down
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    Posted: November 03 2017 at 1:28am

Deadly airborne plague in Madagascar is now at 'crisis' point and the 'worst outbreak in 50 years' as cases rocket by almost 40% in just 5 DAYS and could hit a further 20,000 in weeks


http://www.dailymail.co.uk/health/article-5043497/Deadly-airborne-plague-cases-rocket-40.html

One to watch!!!

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Post Options Post Options   Thanks (0) Thanks(0)   Quote cobber Quote  Post ReplyReply Direct Link To This Post Posted: November 03 2017 at 1:29am
I hope this is just a case of reporting catching up and not a true jump in numbers...
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Post Options Post Options   Thanks (0) Thanks(0)   Quote cobber Quote  Post ReplyReply Direct Link To This Post Posted: November 03 2017 at 6:43am
Sorry false alarm. Seems this plauge is BS. Just found some numbers

Maybe Margaret Chang needs funding???



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Technophobe View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: November 03 2017 at 7:33am
I've been watching this one for a couple of weeks, Cobber.  

It is coming under control, but there are a few risky senarios available still.  It is nasty, it is drug resistant to ciprofloxacin, which is the main plague treatment to date and it is mostly pneumonic which is also undesirable.  Plague is endemic to Madagascar, but this is the first time it has entered the big cities,

Now the good news:  the WHO and MSF have thrown the book at it, with big funding from the WHO for antibiotics, the numbers of cases are dropping, Azithromycin works on the bug, and Madagascar is an island, which also helps to contain things.

So, the risks are diminishing, but have not gone away yet.  The "it's all over." brigade and the "It's the end of the world!" brigade are both wrong.  It is being contained, but the job is not done yet and there are still some risks to global health.
Absence of proof is not proof of absence.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Dutch Josh Quote  Post ReplyReply Direct Link To This Post Posted: November 03 2017 at 8:52am
Good you keep up-to-date with the Madagascar-Plague item Techno !Thumbs Up

There is some sensationalist reporting on the issue from http://www.thebigwobble.org/2017/10/plague-continues-to-spread-to-10-more.html They claim that the plague spread to several countries in Africa-wich is NOT the case !

There must be a lot of diseases around-journalism seem more often unable to get to the real news. When you look at Ebola in 2016, plague this year-the problems are very large and getting more dangerous by the day. Bad reporting worsens the health-crisis.
Que sera, sera, Whatever will be, will be, The future is not ours to see, Que sera, sera !
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: November 03 2017 at 9:19am
Glad it's contained, although anytime we hear the word "Airborne", it's always a concern.  Not sure it's possible to contain an airborne pathogen, but apparently it is at the moment.  
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: November 03 2017 at 12:50pm
Although ciprofloxacin o longer works on this plague strain, azithromycin does.  The WHO shiped MASSES of antibiotics into the area.  I presume that they are applying some of that prophylaxically, an option not available in viral cases, like flu.  Even when it is airborne, if EVERYWHERE is covered in disinfectant residue, other vectors are eradicated  and all the people are rendered immune by virtue of pre-treatment, then there is nowhere for it to go.

Whatever they are doing, it seems to be working, slowly but surely.

Yes, Josh.  Some of the tabloids are indulging in immense hyperbole.  I guess the word "plague" is just too juicy to resist. 
Absence of proof is not proof of absence.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Diligent Quote  Post ReplyReply Direct Link To This Post Posted: November 03 2017 at 8:13pm
The CDC recently approved the antibiotic - levofloxacin - i.e. Levaquin for treatment of plague.

Not sure about - Azithromycin - though.

D.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: November 04 2017 at 7:06am
Just relaying the info in one of the articles I posted a week or so ago.  Your choice makes more sense though.  Levofloxacin is a stereoisomer/analogue of cipro and as so, would make more biological sense.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: November 04 2017 at 8:44am
WHO is now saying it's hit the crisis point.   Their confidence in containing it appears to be dwindling a bit.  


I'm still not 100% confident that any airborne bug can be contained.  The is far different that Ebola and the others.  Airborne will spread similar to the flu.    People could be in trouble with this one.  
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Dutch Josh Quote  Post ReplyReply Direct Link To This Post Posted: November 04 2017 at 9:36am
Que sera, sera, Whatever will be, will be, The future is not ours to see, Que sera, sera !
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Post Options Post Options   Thanks (0) Thanks(0)   Quote CRS, DrPH Quote  Post ReplyReply Direct Link To This Post Posted: November 04 2017 at 11:12am
I'm a biowarfare guy, this is consistent with my own training.  Doxycycline (oral) is what we are taught to provide in a BT attack. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2870621/

In the case of an aerosolized plague weapon, the United States Working Group of Civilian Biodefense recommended streptomycin or gentamicin as the preferred choice in a contained casualty setting (i.e., modest numbers of patients requiring treatment), with doxycycline, ciprofloxacin, or chloramphenicol as alternative choices. For a mass casualty situation, oral therapy with doxycycline, tetracycline, or ciprofloxacin has been recommended (16). Prevention of human-to-human transmission from patients with plague pneumonia can be achieved by implementing standard isolation procedures until at least 4 days after the initiation of antibiotic treatment (3).
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Albert Quote  Post ReplyReply Direct Link To This Post Posted: November 04 2017 at 1:41pm
Not sure you can stop airborne.  Right on the anniversary of the 1918 pandemic.  

Poor JD.  
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I was on my way back from the airport early this morning, and I stopped into the supermarket which was almost empty, and there in the fresh food aisle was a very short woman who sneezed twice right onto the produce. I thought then, someone will come in here in a little while and pick up one of those items and go home with the flu. 

I can't think of anyway to stop airborne viruses. I'm off on a flight first thing tomorrow and no amount of disinfecting my tray table will stop a virus if someone sneezes in my face.
If it is to be, it is up to me.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote CRS, DrPH Quote  Post ReplyReply Direct Link To This Post Posted: November 04 2017 at 2:59pm
As I said, I'm a biowarfare guy.  Pneumonic plague is no big deal if you identify the agent quickly.   I'd much rather deal with plague in a population than smallpox.  

https://www.osha.gov/SLTC/plague/controls.html

What personal protective equipment should emergency responders use when responding to a potential bio-attack involving plague? How should workers decontaminate themselves if they think they have been exposed to plague?

In a covert attack involving aerosolized plague, there would be no emergency response activity involving emergency responders. The first evidence that a potential attack had occurred would be diagnosis of the disease among exposed individuals, which would happen several days after the actual release. However, it is possible that emergency responders would be required to respond to a bio-attack incident, such as notification regarding an aerosol dissemination device or other suspicious release. The following references provide additional information regarding PPE, decontamination, and other precautions for emergency responders to consider during such an incident.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote KiwiMum Quote  Post ReplyReply Direct Link To This Post Posted: November 04 2017 at 7:29pm
Chuck, do you think a smallpox vaccine gives immunity for life? I was one of the last to get the vaccine, would it still protect me? Would I have passed on that immunity to my children? Thanks. 
If it is to be, it is up to me.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote CRS, DrPH Quote  Post ReplyReply Direct Link To This Post Posted: November 05 2017 at 1:16pm
Originally posted by KiwiMum KiwiMum wrote:

Chuck, do you think a smallpox vaccine gives immunity for life? I was one of the last to get the vaccine, would it still protect me? Would I have passed on that immunity to my children? Thanks. 

Good question, KiwiMum!  Childhood smallpox vaccine likely confers at least some lifelong protection, so even if you were to be exposed and become an active case, your infection would likely be less severe than an unvaccinated person. 

I was vaccinated twice....once as a kid (I'm 62), and again in 1979, when I went on an overseas trip that included Turkey and Egypt, before smallpox was announced as eradicated.  I am reasonably confident that I have lifelong immunity. 

The smallpox vaccine (vaccinia virus) is no laughing matter....it can have serious/life-threatening complications: 

In the 1960s, serious adverse events associated with smallpox vaccination in the United States included death (1/million vaccinations), progressive vaccinia (1.5/million vaccinations), eczema vaccinatum (39/million vaccinations), postvaccinial encephalitis (12/million vaccinations), and generalized vaccinia (241/million vaccinations).20 Adverse events were approximately ten times more common among those vaccinated for the first time compared to revaccinees.20 Fatality rates were also four times higher for primary vaccinees compared to revaccinees.21


The primary concern to us in the civilized (!) world is the use of a weaponized pox virus by a state actor such as NK.  That would be bad news since there is a known shortage of vaccine worldwide.
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