COVID-19 update
（195）イラン，米国，ベネズエラ
（196）高感染国
（197）食品工場のアウトブレイク，WHO
（198）オランダ，ミンクからヒトへの感染疑い
● 馬ヘルペスウイルス－カナダ，米国
PRO/AH/EDR> Equine herpesvirus - North America (06): Canada (ON), USA (ND) horse
Archive Number: 20200520.7359991
[1] カナダ，Ontario
情報源 Horse Racing Nation 2020年5月17日
Woodbine Race Course においてウマ 2頭が，馬ヘルペスウイルス equine herpesvirus (EHV-1) 検査陽性であることが確認され，the equine center at nearby University of Guelph に移送された ...
[2] 米国，North Dakota
情報源 The Horse 2020年5月19日
州農業当局 the North Dakota Department of Agriculture (NDDA) が a Ward County horse with the neurologic form of equine herpesvirus-1 (EHV-1), equine herpesvirus myeloencephalopathy (EHM) 感染を確認した。同厩舎において，最近新たなウマの出入りはなかった。
（195）イラン，米国，ベネズエラ
（196）高感染国
（197）食品工場のアウトブレイク，WHO
（198）オランダ，ミンクからヒトへの感染疑い
● 馬ヘルペスウイルス－カナダ，米国
PRO/AH/EDR> Equine herpesvirus - North America (06): Canada (ON), USA (ND) horse
Archive Number: 20200520.7359991
[1] カナダ，Ontario
情報源 Horse Racing Nation 2020年5月17日
Woodbine Race Course においてウマ 2頭が，馬ヘルペスウイルス equine herpesvirus (EHV-1) 検査陽性であることが確認され，the equine center at nearby University of Guelph に移送された ...
[2] 米国，North Dakota
情報源 The Horse 2020年5月19日
州農業当局 the North Dakota Department of Agriculture (NDDA) が a Ward County horse with the neurologic form of equine herpesvirus-1 (EHV-1), equine herpesvirus myeloencephalopathy (EHM) 感染を確認した。同厩舎において，最近新たなウマの出入りはなかった。
● ウシ熱ダニ－米国
PRO/AH/EDR> Texas cattle fever tick - USA: (TX) cattle
Archive Number: 20200520.7359977
情報源 Texas Animal Health Commission 2020年5月15日
州動物衛生当局 The Texas Animal Health Commission (TAHC) および農務省 the U.S. Department of Agriculture's Cattle Fever Tick Eradication Program (CFTEP) が 15日，テキサス州南部の検疫地域外 outside of established quarantined areas において，確認されるダニの増加を報告した。outside of the established quarantine areas in Cameron, Hidalgo, Jim Wells, Jim Hogg, and Willacy counties において，ウシのダニ Fever ticks が確認されたとしている。
● COVID-19(198)－オランダ 飼育ミンクからヒトへの感染疑い
PRO/AH/EDR> COVID-19 update (198): Netherlands (NB) farmed mink, animal-to-human infect susp
Archive Number: 20200520.7359976
情報源 A letter from the Minister of Agriculture to the Dutch House of Representatives [in Dutch] 2020年5月19日
感染のあった 3カ所のミンク飼育農場 COVID-19-infected mink farms に関する報告。
公衆衛生当局 RIVM [National Institute for Public Health and the Environment] と獣医学専門家らは，以下の結論に達した:
1. 感染のあったミンク保有企業体のうちの 1つの従業員 1名（後に回復）が，ミンクからウイルス SARS-CoV-2 に感染した可能性がある ;
2. ミンクは COVID-19 に感染するが症状を示さない subclinically ;
そして
3. 企業体間の感染伝播へのネコの関与をさらに調べる事が重要。
...
上記の結論をふまえ，動物衛生福祉法に従い，動物感染症として ”ミンクの SARS-CoV-2 感染症” を確認した。
Infected employee and subclinical infections
... ミンクの COVID-19 が無症候性感染であることが別の研究で示されている。すなわち，ミンクは SARS-CoV-2 に感染しても，何ら症状を示さないことを意味する。現在各農家に報告が義務づけられているのは，死亡数の増加または呼吸症状などの症状が見られた場合に限られている。無症候性感染が発生した農場は覚知されないことになる ... ため，以下の対策を加える。
- 農場での抗体スクリーニング検査 Screening of mink farms (for antibodies)
...
Farm cats and COVID-19
2カ所の農場で検出されたウイルス株 the virus strains は非常に近い very similar と報告されている。3 of the 11 farm cats ネコがウイルス抗体を保有していたことから，農場間のウイルス伝播にネコが関与した疑いがあり，さらに調査することが重要。農場内に棲みついているネコだが，飼育されていたわけではない。
A concise version of the issue on the English pages of the Dutch Ministry's website.
● COVID-19（197）食品工場でのアウトブレイク，WHO
PRO/AH/EDR> COVID-19 update (197): global, food plant outbreak, WHO
Archive Number: 20200520.7359641
[1] Global update: Worldometer accessed 20 May 2020 11:21 GMT
情報源 Worldometer 2020年5月20日
Confirmed cases Start of data recording: 1st data / ... / 1 Mar 2020 / ... / 1 Apr 2020 / ... / 1 May 2020 / ... / 20 May Country
...
Countries with major activity (more than 5000 cases with community spread)
[2] New countries/territories confirming cases (none)
No newly identified countries with 1st cases of COVID-19 confirmed.
[3] 米国 (Ohio): food plant outbreaks
情報源 The Courier 2020年5月20日
それぞれが離れた場所にある，オハイオ州の 2カ所の食品工場 Ohio food plants, including Hearthside Food Solutions in McComb で発生した，2 separate COVID-19 outbreaks の調査が行われている。19日，クッキーとクラッカーを製造する the Hancock County food plant に関する注意喚起が行われた。The Clark County Combined Health District 郡保健当局は，Dole Food Company's Springfield salad plant に関連して 20 cases of COVID-19 が確認している。12人が従業員で，8人がその接触者であり，1例目は 4月22日に確認された ...
[4] WHO situation report 121 (as of 20 May 2020)
情報源 WHO 2020年5月20日
Highlights
----------
- WHO Regional Director for the Americas Dr Carissa F. Etienne highlighted that addressing COVID-19 will require protecting vulnerable groups including women, underprivileged populations, indigenous populations, and migrants, by addressing health, social, and economic inequalities.
- WHO has published a new Case Report Form for "suspected cases of multisystem inflammatory syndrome (MIS) in children and adolescents temporally related to COVID-19" intended for use by public health professionals for collecting standardized data on clinical presentations, severity, and outcomes.
- Uganda commissioned the 1st Port Health COVID-19 laboratory at the main Uganda-Tanzania border in light of potential COVID-19 importation by truck drivers. Two GeneXpert machines will be used to test all truck drivers arriving at the Mutukula point of entry, where results will become available within 45 minutes.
- A doctor from Cairo, Egypt, describes how he became infected with and recovered from COVID-19 and highlights the need for healthcare workers to practice basic infection, prevention, and control measures when interacting with patients.
- Evidence from social science can help officials develop and implement policies in ways that are more likely to work because they are tailored to local needs.
- In the 'Subject in Focus' below, we look at how WHO is implementing the COVID-19 Research Roadmap agenda to translate evidence from the social sciences into action:
Subject in Focus: Infodemics Management - Social science evidence in outbreak response
To tackle the health, social, and economic challenges of COVID-19, decision-makers need data and research from many different disciplines. At the Global Research and Innovation meeting held in Geneva on 11-12 Feb 2020, over 400 scientists, member state representatives, public health professionals, donors, and private sector representatives came together to agree on priorities to accelerate research for the COVID-19 response.
Social science was one of the 9 research areas that featured on the meeting's agenda. Social science is a broad disciplinary field that includes anthropology, psychology, behavioural science, political science, and social epidemiology. Evidence from social science can help officials develop and implement policies in ways that are more likely to work because they are tailored to local needs and to the realities of where and how people live, think, and act, as individuals and as a group.
A technical working group of social scientists across the world's regions was convened to guide and support further development of the COVID-19 Research Roadmap agenda. The aim of this group is to translate evidence from the social sciences into action that can inform response strategies by developing and sharing protocols, tools, and technical expertise, for example on key considerations from social science on public use of face masks, immunity passports, homecare, routine immunization programmes, and vaccine implementation.
The group achieves its objectives through collaboration and by coordinating action with other initiatives, including with the research arm of the Global Outbreak Alert and Response Network (GOARN). The COVID-19 Research Roadmap highlighted the need for social science research in 3 priority areas: 1st, research about the impacts of COVID-19 and the public health response, including secondary impacts, will help countries at different phases of the response to learn from others. This is key to informing and tailoring local and national responses. For example, research on how public health lock-down measures have affected mental health and household incomes can help officials plan how best to support communities once these measures are lifted. Under the COVID-19 Research Roadmap, a research group in China is studying the lessons learned following the public health measures taken in that country.
2nd, research on health systems and models of care in different regions will enable adaptation and efficiencies specific to the COVID-19 healthcare response. Research in this area can help officials plan best approaches for managing patient flows and also provide the right support to those providing care in formal and informal community settings. A review of different models of homecare is currently underway to identify and share best methods for low-resource settings. Working with infection prevention and control experts, a research protocol guidance document and data collection tools have also been developed to study the views of health workers on infection prevention and control procedures and on their well-being. Research groups in different regions are implementing this study and are meeting regularly to share experiences, results, and learning.
3rd, research on the flows of information, misinformation, and disinformation, and on effective approaches for addressing stigma, will help science-based information and recommendations reach intended audiences. Data-driven insights can help officials tackle the infodemic and implement strategies to build trust.
Across all these areas, there is an essential need to define and prioritize vulnerable populations so that evidence can inform policy development which accounts for and meets their needs.
The working group continues to collaborate with colleagues working on different technical areas and groups -- immunization, ethics, gender, maternal and child health, and sexual and reproductive health, to name a few -- informing social science evidence in the work of WHO. A toolbox on good participatory practice for COVID-19 clinical trials and on working with community advisory boards for COVID-19-related clinical studies is also now available.
Surveillance
------------
[The following data come from "Situation in numbers." The regional case totals are inclusive of China. - Mod.UBA]
WHO region (no. countries/territories): Total confirmed cases (new) / Total deaths (new)
Western Pacific Region (19): 169 955 (777) / 6780 (15)
European Region (61): 1 928 799 (19 207) / 169 033 (1035)
South-East Asia Region (10): 156 211 (7450) / 4971 (191)
Eastern Mediterranean Region (22): 361 902 (5153) / 10 303 (154)
Region of the Americas (54): 2 105 670 (22 782) / 125 843 (1176)
African Region (49): 65 956 (2435) / 1846 (50)
Other:
Cases on an international conveyance (Diamond Princess): 712 (0) / 13 (0)
Confirmed cases (new conf cases) / Total deaths (new deaths)
Grand total: 4 789 205 (57 804) / 318 789 (2621)
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The number of countries and territories reporting confirmed cases of COVID-19 to WHO remains at 215. This includes 19 countries (including 4 territories) from the Western Pacific region, 61 countries (including 7 territories) from the European region, 10 countries from the South-East Asia region, 22 countries (including 1 territory) from the Eastern Mediterranean region, 54 countries (including 19 territories) from the Americas region, and 49 countries (including 2 territories) from the African region.
In the 24 hours since the last WHO update:
------------------------------------------
The Americas region reported 22 782 new cases (39.4% of the global newly reported cases), and 1176 deaths (44.9%) for this 24-hour period. Of the newly confirmed cases in the region, 57.7% were reported by Brazil, Peru 11.7%, and Mexico 10.6%. The cases from USA are not available in this Sitrep. The Americas region is maintaining its status as having the highest cumulative case count of the 6 WHO regions, with the European region as the 2nd-highest region.
The European region reported 19 207 new cases (33.2% of the global newly reported cases) and 1035 deaths (39.5%). Russia reported 45.6% of the newly confirmed cases in the region, followed by the UK 12.6%, Turkey 5.3%, Belarus 4.9%, Italy at 4.2%, Germany at 4.1%, and France at 2.4%.
The Eastern Mediterranean region reported 5153 new cases (8.9% of the global newly reported cases) and 154 deaths (5.9%). Iran reported 41.0% of the regional newly reported cases, followed by Pakistan 23.6%, and Egypt at 14.0%, and Afghanistan at 9.5%. Today's Sit Rep does not have the new case numbers from Qatar, Kuwait, Saudi Arabia, and the United Arab Emirates.
The African region reported 2435 new cases (4.2% of the global newly reported cases) and 50 deaths (1.9%). South Africa reported 31.5% of the newly reported cases in the region in the past 24 hours, followed by Ghana at 14.8%, Nigeria 9.3%, DRC at 7.9%, and Algeria at 7.2%.
The Western Pacific region reported 777 new cases (1.3% of the global newly reported cases) and 15 deaths (0.6%). Singapore reported 58.0% of the newly reported cases, followed by the Philippines 28.8%, Malaysia 4.8%, S. Korea at 4.1%, and Japan at 2.5%.
The South-East Asia region reported 7450 new cases (12.9% of the global newly reported cases) and 191 deaths (7.3%). India reported 75.3% of newly reported cases, followed by Bangladesh 16.8%, and Indonesia 6.5%. These 3 countries make up 98.6% of all reported cases in the region. Removing India from the denominator, Bangladesh represents 68.0% of the newly reported cases, Indonesia 26.4%, Maldives 2%, and Sri Lanka 1.9%.
Figure 2. Epidemic curve of confirmed COVID-19 cases, by date of report and WHO region, 30 Dec 2019 through 20 May 2020, at the source URL above, is an excellent representation of the epidemic starting in the Western Pacific, transitioning to multiregional activity as the virus travelled. Europe has significantly decreased. The Americas is increasing, as is South-East Asia and the Eastern Mediterranean.
A somewhat repetitive but necessary reminder: It is clear that the number of reported confirmed cases differs from different reporting websites and is somewhat a function of time of day the website is updated. For example, I note the time we've accessed the Johns Hopkins' CSSE or Worldometer website, but by the time the post is actually finished with the editing process, those numbers have, at times, significantly changed. Case counting is clearly a moving target, and depending upon when the website updates, the numbers may be different. I try to start each post with the latest figures for the calendar day (the Johns Hopkins CSSE or Worldometer table) and close with the figures from the start of the calendar day (the WHO tables), defining the calendar day as DST (now GMT-4). - Mod.UBA]
● COVID-19（197）食品工場でのアウトブレイク，WHO
PRO/AH/EDR> COVID-19 update (197): global, food plant outbreak, WHO
Archive Number: 20200520.7359641
[1] Global update: Worldometer accessed 20 May 2020 11:21 GMT
情報源 Worldometer 2020年5月20日
Confirmed cases Start of data recording: 1st data / ... / 1 Mar 2020 / ... / 1 Apr 2020 / ... / 1 May 2020 / ... / 20 May Country
...
Countries with major activity (more than 5000 cases with community spread)
[2] New countries/territories confirming cases (none)
No newly identified countries with 1st cases of COVID-19 confirmed.
[3] 米国 (Ohio): food plant outbreaks
情報源 The Courier 2020年5月20日
それぞれが離れた場所にある，オハイオ州の 2カ所の食品工場 Ohio food plants, including Hearthside Food Solutions in McComb で発生した，2 separate COVID-19 outbreaks の調査が行われている。19日，クッキーとクラッカーを製造する the Hancock County food plant に関する注意喚起が行われた。The Clark County Combined Health District 郡保健当局は，Dole Food Company's Springfield salad plant に関連して 20 cases of COVID-19 が確認している。12人が従業員で，8人がその接触者であり，1例目は 4月22日に確認された ...
[4] WHO situation report 121 (as of 20 May 2020)
情報源 WHO 2020年5月20日
Highlights
----------
- WHO Regional Director for the Americas Dr Carissa F. Etienne highlighted that addressing COVID-19 will require protecting vulnerable groups including women, underprivileged populations, indigenous populations, and migrants, by addressing health, social, and economic inequalities.
- WHO has published a new Case Report Form for "suspected cases of multisystem inflammatory syndrome (MIS) in children and adolescents temporally related to COVID-19" intended for use by public health professionals for collecting standardized data on clinical presentations, severity, and outcomes.
- Uganda commissioned the 1st Port Health COVID-19 laboratory at the main Uganda-Tanzania border in light of potential COVID-19 importation by truck drivers. Two GeneXpert machines will be used to test all truck drivers arriving at the Mutukula point of entry, where results will become available within 45 minutes.
- A doctor from Cairo, Egypt, describes how he became infected with and recovered from COVID-19 and highlights the need for healthcare workers to practice basic infection, prevention, and control measures when interacting with patients.
- Evidence from social science can help officials develop and implement policies in ways that are more likely to work because they are tailored to local needs.
- In the 'Subject in Focus' below, we look at how WHO is implementing the COVID-19 Research Roadmap agenda to translate evidence from the social sciences into action:
Subject in Focus: Infodemics Management - Social science evidence in outbreak response
To tackle the health, social, and economic challenges of COVID-19, decision-makers need data and research from many different disciplines. At the Global Research and Innovation meeting held in Geneva on 11-12 Feb 2020, over 400 scientists, member state representatives, public health professionals, donors, and private sector representatives came together to agree on priorities to accelerate research for the COVID-19 response.
Social science was one of the 9 research areas that featured on the meeting's agenda. Social science is a broad disciplinary field that includes anthropology, psychology, behavioural science, political science, and social epidemiology. Evidence from social science can help officials develop and implement policies in ways that are more likely to work because they are tailored to local needs and to the realities of where and how people live, think, and act, as individuals and as a group.
A technical working group of social scientists across the world's regions was convened to guide and support further development of the COVID-19 Research Roadmap agenda. The aim of this group is to translate evidence from the social sciences into action that can inform response strategies by developing and sharing protocols, tools, and technical expertise, for example on key considerations from social science on public use of face masks, immunity passports, homecare, routine immunization programmes, and vaccine implementation.
The group achieves its objectives through collaboration and by coordinating action with other initiatives, including with the research arm of the Global Outbreak Alert and Response Network (GOARN). The COVID-19 Research Roadmap highlighted the need for social science research in 3 priority areas: 1st, research about the impacts of COVID-19 and the public health response, including secondary impacts, will help countries at different phases of the response to learn from others. This is key to informing and tailoring local and national responses. For example, research on how public health lock-down measures have affected mental health and household incomes can help officials plan how best to support communities once these measures are lifted. Under the COVID-19 Research Roadmap, a research group in China is studying the lessons learned following the public health measures taken in that country.
2nd, research on health systems and models of care in different regions will enable adaptation and efficiencies specific to the COVID-19 healthcare response. Research in this area can help officials plan best approaches for managing patient flows and also provide the right support to those providing care in formal and informal community settings. A review of different models of homecare is currently underway to identify and share best methods for low-resource settings. Working with infection prevention and control experts, a research protocol guidance document and data collection tools have also been developed to study the views of health workers on infection prevention and control procedures and on their well-being. Research groups in different regions are implementing this study and are meeting regularly to share experiences, results, and learning.
3rd, research on the flows of information, misinformation, and disinformation, and on effective approaches for addressing stigma, will help science-based information and recommendations reach intended audiences. Data-driven insights can help officials tackle the infodemic and implement strategies to build trust.
Across all these areas, there is an essential need to define and prioritize vulnerable populations so that evidence can inform policy development which accounts for and meets their needs.
The working group continues to collaborate with colleagues working on different technical areas and groups -- immunization, ethics, gender, maternal and child health, and sexual and reproductive health, to name a few -- informing social science evidence in the work of WHO. A toolbox on good participatory practice for COVID-19 clinical trials and on working with community advisory boards for COVID-19-related clinical studies is also now available.
Surveillance
------------
[The following data come from "Situation in numbers." The regional case totals are inclusive of China. - Mod.UBA]
WHO region (no. countries/territories): Total confirmed cases (new) / Total deaths (new)
Western Pacific Region (19): 169 955 (777) / 6780 (15)
European Region (61): 1 928 799 (19 207) / 169 033 (1035)
South-East Asia Region (10): 156 211 (7450) / 4971 (191)
Eastern Mediterranean Region (22): 361 902 (5153) / 10 303 (154)
Region of the Americas (54): 2 105 670 (22 782) / 125 843 (1176)
African Region (49): 65 956 (2435) / 1846 (50)
Other:
Cases on an international conveyance (Diamond Princess): 712 (0) / 13 (0)
Confirmed cases (new conf cases) / Total deaths (new deaths)
Grand total: 4 789 205 (57 804) / 318 789 (2621)
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The number of countries and territories reporting confirmed cases of COVID-19 to WHO remains at 215. This includes 19 countries (including 4 territories) from the Western Pacific region, 61 countries (including 7 territories) from the European region, 10 countries from the South-East Asia region, 22 countries (including 1 territory) from the Eastern Mediterranean region, 54 countries (including 19 territories) from the Americas region, and 49 countries (including 2 territories) from the African region.
In the 24 hours since the last WHO update:
------------------------------------------
The Americas region reported 22 782 new cases (39.4% of the global newly reported cases), and 1176 deaths (44.9%) for this 24-hour period. Of the newly confirmed cases in the region, 57.7% were reported by Brazil, Peru 11.7%, and Mexico 10.6%. The cases from USA are not available in this Sitrep. The Americas region is maintaining its status as having the highest cumulative case count of the 6 WHO regions, with the European region as the 2nd-highest region.
The European region reported 19 207 new cases (33.2% of the global newly reported cases) and 1035 deaths (39.5%). Russia reported 45.6% of the newly confirmed cases in the region, followed by the UK 12.6%, Turkey 5.3%, Belarus 4.9%, Italy at 4.2%, Germany at 4.1%, and France at 2.4%.
The Eastern Mediterranean region reported 5153 new cases (8.9% of the global newly reported cases) and 154 deaths (5.9%). Iran reported 41.0% of the regional newly reported cases, followed by Pakistan 23.6%, and Egypt at 14.0%, and Afghanistan at 9.5%. Today's Sit Rep does not have the new case numbers from Qatar, Kuwait, Saudi Arabia, and the United Arab Emirates.
The African region reported 2435 new cases (4.2% of the global newly reported cases) and 50 deaths (1.9%). South Africa reported 31.5% of the newly reported cases in the region in the past 24 hours, followed by Ghana at 14.8%, Nigeria 9.3%, DRC at 7.9%, and Algeria at 7.2%.
The Western Pacific region reported 777 new cases (1.3% of the global newly reported cases) and 15 deaths (0.6%). Singapore reported 58.0% of the newly reported cases, followed by the Philippines 28.8%, Malaysia 4.8%, S. Korea at 4.1%, and Japan at 2.5%.
The South-East Asia region reported 7450 new cases (12.9% of the global newly reported cases) and 191 deaths (7.3%). India reported 75.3% of newly reported cases, followed by Bangladesh 16.8%, and Indonesia 6.5%. These 3 countries make up 98.6% of all reported cases in the region. Removing India from the denominator, Bangladesh represents 68.0% of the newly reported cases, Indonesia 26.4%, Maldives 2%, and Sri Lanka 1.9%.
Figure 2. Epidemic curve of confirmed COVID-19 cases, by date of report and WHO region, 30 Dec 2019 through 20 May 2020, at the source URL above, is an excellent representation of the epidemic starting in the Western Pacific, transitioning to multiregional activity as the virus travelled. Europe has significantly decreased. The Americas is increasing, as is South-East Asia and the Eastern Mediterranean.
A somewhat repetitive but necessary reminder: It is clear that the number of reported confirmed cases differs from different reporting websites and is somewhat a function of time of day the website is updated. For example, I note the time we've accessed the Johns Hopkins' CSSE or Worldometer website, but by the time the post is actually finished with the editing process, those numbers have, at times, significantly changed. Case counting is clearly a moving target, and depending upon when the website updates, the numbers may be different. I try to start each post with the latest figures for the calendar day (the Johns Hopkins CSSE or Worldometer table) and close with the figures from the start of the calendar day (the WHO tables), defining the calendar day as DST (now GMT-4). - Mod.UBA]
● A 型肝炎－米国
PRO/EDR> Hepatitis A - USA (05): (WA, MO) CDC
Archive Number: 20200520.7355308
[1] Washington
情報源 The Watchdog Online 2020年5月11日
この 4か月間に King County で A 型肝炎患者 hepatitis A cases が増加し，年平均 5-16 であるところ 71 例が確認されている
[2] Missouri
情報源 KY3 2020年5月15日
The Taney County Health Department 郡保健当局が 3 cases of hepatitis A を確認。食品取り扱いやレストランには関係していない ...
[3] CDC
情報源 CDC, Viral hepatitis, Outbreaks, Hepatitis A Outbreaks 2020年5月18日
PRO/EDR> Hepatitis A - USA (05): (WA, MO) CDC
Archive Number: 20200520.7355308
[1] Washington
情報源 The Watchdog Online 2020年5月11日
この 4か月間に King County で A 型肝炎患者 hepatitis A cases が増加し，年平均 5-16 であるところ 71 例が確認されている
[2] Missouri
情報源 KY3 2020年5月15日
The Taney County Health Department 郡保健当局が 3 cases of hepatitis A を確認。食品取り扱いやレストランには関係していない ...
[3] CDC
情報源 CDC, Viral hepatitis, Outbreaks, Hepatitis A Outbreaks 2020年5月18日
● コレラーカメルーン，エチオピア，ケニア，イエメン
PRO/EDR> Cholera, diarrhea & dysentery update (03): Africa, Asia
Archive Number: 20200520.7343735
[1] Cholera - カメルーン (Douala, Littoral)
情報源 MENAFN 2020年5月13日
首都ドアラ Douala の地区保健当局 the commercial capital of Cameroon [Littoral region] は 12日，コレラ cholera アウトブレイクにより 4人が死亡したと明らかにした。2週間で 20人の感染が確認されている。
[2] Cholera - エチオピア (South Omo Zone, Southern Nations, Nationalities, and Peoples' Region)
情報源 New Business Ethiopia 2020年5月14日
南部 Southern parts of Ethiopia [Southern Nations, Nationalities, and Peoples' Region], South Omo area, Dasenech district において，コレラアウトブレイク A cholera outbreak によりこれまでに 931 cholera cases and 11 deaths in Dasenech area が報告されていると，報じられている。患者はケニア国境の湖 Lake Turkana 周辺の住民らである。Dasenech area では毎日最大 70例の感染が報告されていたが，医療従事者らにより現在は15例にまで減少している。エチオピア国内では，Gambella and Benshangul Gumz を除く全国でコレラ患者が報告され，2019年はこの時期までに合計 7000例以上の患者と 100人の死亡が報告された。
[3] Cholera - ケニア (Marsabit County)
情報源 Kenyans 2020年5月14日
2020年3月半ば以降，the outbreak of cholera in Marsabit County により 23人以上のケニア人が死亡した。Abalakwa Island in Lake Turkana and Illeret village に住む漁業社会の住民らが支援を求めている。
[4] Cholera - イエメン
情報源 Anadolu Agency 2020年5月14日
There have been approximately 113 000 suspected cases of cholera in war-torn Yemen since January [2020], according to the World Health Organization (WHO). A total of 56 cases were confirmed by laboratory research and 29 deaths were registered from cholera ...
関連項目
Cholera, diarrhea & dysentery update (02): Africa, Asia 20200503.7289037
PRO/EDR> Cholera, diarrhea & dysentery update (03): Africa, Asia
Archive Number: 20200520.7343735
[1] Cholera - カメルーン (Douala, Littoral)
情報源 MENAFN 2020年5月13日
首都ドアラ Douala の地区保健当局 the commercial capital of Cameroon [Littoral region] は 12日，コレラ cholera アウトブレイクにより 4人が死亡したと明らかにした。2週間で 20人の感染が確認されている。
[2] Cholera - エチオピア (South Omo Zone, Southern Nations, Nationalities, and Peoples' Region)
情報源 New Business Ethiopia 2020年5月14日
南部 Southern parts of Ethiopia [Southern Nations, Nationalities, and Peoples' Region], South Omo area, Dasenech district において，コレラアウトブレイク A cholera outbreak によりこれまでに 931 cholera cases and 11 deaths in Dasenech area が報告されていると，報じられている。患者はケニア国境の湖 Lake Turkana 周辺の住民らである。Dasenech area では毎日最大 70例の感染が報告されていたが，医療従事者らにより現在は15例にまで減少している。エチオピア国内では，Gambella and Benshangul Gumz を除く全国でコレラ患者が報告され，2019年はこの時期までに合計 7000例以上の患者と 100人の死亡が報告された。
[3] Cholera - ケニア (Marsabit County)
情報源 Kenyans 2020年5月14日
2020年3月半ば以降，the outbreak of cholera in Marsabit County により 23人以上のケニア人が死亡した。Abalakwa Island in Lake Turkana and Illeret village に住む漁業社会の住民らが支援を求めている。
[4] Cholera - イエメン
情報源 Anadolu Agency 2020年5月14日
There have been approximately 113 000 suspected cases of cholera in war-torn Yemen since January [2020], according to the World Health Organization (WHO). A total of 56 cases were confirmed by laboratory research and 29 deaths were registered from cholera ...
関連項目
Cholera, diarrhea & dysentery update (02): Africa, Asia 20200503.7289037
● COVID-19 update (196) 中国，韓国，高感染伝播国
PRO/AH/EDR> COVID-19 update (196): China, S Korea, countries w/ high local transmission
Archive Number: 20200520.7357017
In this update:
[1] 中国: National Health Commission 19 May 2020; 82 965 total cases, 4634 deaths
[2] 韓国: 11 078 confirmed cases, 263 deaths
[3] イタリア: 226 699 total cases, 32 169 deaths
[4] イラン: 124 603 total cases, 7199 deaths
[5] 米国: 1 570 583 cases, 93 533 deaths
[6] スペイン: 232 037 [278 813] cases, 27 778 deaths
[7] イタリア: continued openings, phase 2
[1] 中国: National Health Commission 19 May 2020; 82 965 total cases, 4634 deaths
情報源 China National Health Commission 2020年5月19日
19日，31 provincial-level regions on the Chinese mainland as well as the Xinjiang Production and Construction Corps から新たに 5 new cases of confirmed infections (1 imported case in Inner Mongolia autonomous region and 4 indigenous cases in Jilin province) と 16 new asymptomatic cases (including 1 imported case) が報告。また，1708 cases of imported confirmed infections and no deaths も報告された。
19日までの累計報告患者数 reports of 82 965 confirmed cases and 4634 deaths in 31 provincial-level regions on the Chinese mainland and the Xinjiang Production and Construction Corps が報告された ...
[2] 韓国: 11 110 confirmed cases, 263 deaths
情報源 Ministry of Health and Welfare, Korean CDC [In Korean] 2020年5月20日
Date and time:
19 May 2020 0:00 AM KT 11 078 confirmed cases, 263 deaths
20 May 2020 0:00 AM KT 11 110 confirmed cases, 263 deaths
Change: 32 newly confirmed infections; 0 new deaths
Distribution of cases by metropolitan city/province（原文参照願います。）
...
From the English language page, Notice: 322 of 19 May 2020 :
- Of the 13 new cases [in yesterday's (18 May 2020) update], 4 were imported cases and 9 were locally transmitted cases.
-- 7 of the locally transmitted cases are related to the nightclub cluster; 2 visitors to nightclubs/etc., 5 contacts.
-- 1 local case is from Seoul City. This case is a healthcare worker at Samsung Medical Center in Seoul. ...
[3] イタリア: 226 699 total cases, 32 169 deaths
Cases in Italy as of 6:00 pm 19 May 2020 CET
情報源 Italian Government Health Ministry [in Italian] 2020年5月19日
- 226 699 cumulative cases, increase of 813 from 17 May 2020
- 65 129 people are currently positive for the virus;
Case distribution by province: number of cases (原文参照願います。)
an excellent interactive map
［Mod.MPP 注－3月9日，イタリアはアウトブレイクが限局性に発生していた北部地域の封鎖を発表。同10日に全国に拡大され，11日には必要不可欠なビジネス以外の閉鎖が発表された。封鎖から66日間が経過している。5月3日まで延長された封鎖が解除されるイタリアを，世界が注視している。20200505.7300349 for details on phase 2 opening が詳述されている］
[4] イラン: 124 603 total cases, 7199 deaths
情報源 WION News 2020年5月19日
19日，イラン政府当局はこの 24時間に 2000人を超える感染が確認され，10 provinces において死者が ０，ほか 6 others でも死亡はわずか 1例であったと明らかにした。イランではこれまでに 7199 fatalities due to COVID-19 with 124 603 virus cases が確認されている。several provinces including Kermanshah, north Khorasan, Baluchistan, Kerman が厳重に監視されている。"Khuzestan province は依然として a critical situation " とされ "red" in coronavirus risk index in the country に色づけされている。2月にイランで初めての死者が報告されたのは宗教都市 the pilgrimage city of Qom であった。4月の報告では，Khuzestan 州を含む 8つの地域が増加傾向またはピークにあるとされていた。緩和に向けて 24日大統領は，レストランの再開やモスクの施設の外での礼拝を許可する予定である。
[5] 米国: 1 570 583 cases, 93 533 deaths
情報源 Worldometer 2020年5月18日
USA cases by state
State: Total cases / New cases
New York: 362 630 / 1364 ...
[6] スペイン: 232 037 [278 813] cases, 27 778 deaths
COVID-19 update 110 [data as of 19 May 2020 21:00 CET]
情報源 Spanish government COVID-19 update 110 [in Spanish] 2020年5月19日
スペイン国内で今日までに a total of 232 037 PCR confirmed cases of COVID-19 with 27 778 deaths (Tables 1 and 2, Figures 1 and 2) が確認。
The distribution by autonomous community of hospitalized, ICU, and deceased cases is shown in Table 2.
Madrid: 66 643 / 92 / 33.44 ...
Total: 232 037 / 295 / 18.36
［Mod.MPP 注－the WHO Situation Report 98 from 27 Apr 2020 によれば，4月25日以降スペインは only PCR positive confirmations のみを WHO に報告しており，抗体検査による報告はしていない。抗体により確認された累積症例数は just above Figure 3 で確認できる。5月16－17日の24時間に PCR で新たに確認された患者数が 285例であったのに対し，この 24時間に新たに確認された症例数は 295例で，the PCR- [plus number confirmed including all tests] confirmed cumulative total to 232 037 [278 813] cases となった。2週間に全国で発生した人口 10万対症例数は減少し続け，18.36となった。4月7日の 214.4から 26日間緩やかに減り続けている ... ］
●
PRO/AH/EDR> COVID-19 update (195): global, Iran GI pres, USA (CA) nursing home, Venezuela, WHO
Archive Number: 20200520.7356886
CORONAVIRUS DISEASE 2019 UPDATE (195): GLOBAL, IRAN CLINICAL PRESENTATION NOW GASTROINTESTINAL, USA (CALIFORNIA) SKILLED NURSING FACILITY, VENEZUELA INDIGENOUS POPULATIONS, WHO
********************************************************************************************************************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Global update: Worldometer accessed 19 May 2020 21:42 EDT (GMT-4)
[2] New countries/territories confirming cases (none)
[3] Iran: clinical presentation gastrointestinal
[4] USA (California): skilled nursing facility
[5] Indigenous Amazon tribes: Venezuela
[6] WHO situation report 120 (as of 19 May 2020)
******
[1] Global update: Worldometer accessed 19 May 2020 21:42 EDT (GMT-4)
Date: Tue 19 May 2020
Source: Worldometer [edited]
https://www.worldometers.info/coronavirus/
Confirmed cases Start of data recording: 1st data / ... / 1 Mar 2020 / ... / 1 Apr 2020 / ... / 1 May 2020 / ... / 17 May 2020 / 18 May 2020 / 19 May 2020 / Country
Countries with marked decreases in daily newly confirmed cases post major activity
-------------------------------------------------------------------
2 Feb 2020: 17 187 / ... / 80 024 / ... / 81 589 / ... / 82 875 / ... / 82 954 / 82 960 / 82 965 / Mainland China
2 Feb 2020: 15 / ... / 3726 / ... / 9976 / ... / 11 065 / 11 078 / 11 110 / South Korea
Countries with major activity (more than 5000 cases with community spread)
------------------------------------------------------------------
2 Feb 2020: 11 / ... / 76 / ... / 215 081 / ... / 1 131 280 / ... / 1 527 664 / 1 550 294 / 1 570 583 / USA
2 Feb 2020: 2 / ... / 2 / ... / 2777 / ... / 114 431 / ... / 281 752 / 290 678 / 299 941 / Russia
[In the table above, NA is not applicable; those countries whose 1st case was reported after 1 Mar 2020 did not have cases on 1 Mar 2020. - Mod.MPP]
Countries with more than 5000 cases not on the list above (as the list is growing longer, we will freeze it here and maintain a list of countries passing the 5000-case mark):
Argentina (8809), Afghanistan (7653), Bahrain (7532), Algeria (7377), Kazakhstan (6751), Nigeria (6401), Moldova (6340), Ghana (6096), Oman (5671), Armenia (5041)
Countries and territories with more than 1000 cases:
Luxembourg, Hungary, Thailand, Greece, Iraq, Uzbekistan, Croatia, Cameroon, Azerbaijan, Bosnia and Herzegovina, Guinea, Bolivia, Iceland, Bulgaria, Estonia, Cuba, North Macedonia, New Zealand, Cote d'Ivoire, Slovenia, Lithuania, Slovakia, Senegal, Honduras, Djibouti, Somalia, Guatemala, Hong Kong, Tunisia, Sudan, Mayotte, Kyrgyzstan, Congo DR, El Salvador, Gabon, Tajikistan, Maldives, Latvia, Guinea-Bissau, Sri Lanka
Countries with more than 500 cases (and fewer than 1000):
Cyprus, Albania, Niger, Costa Rica, Andorra, Lebanon, Burkina Faso, Uruguay, Mali, Georgia, San Marino, Channel Islands, Kenya, Jordan, Tanzania, Paraguay, Jamaica, Malta, Equatorial Guinea, Zambia, Venezuela, Chad, Sierra Leone, Haiti
Countries with notable overnight changes or escalating reports to keep an eye on:
Brazil, Canada, Chile, India, Kuwait, Saudi Arabia, Portugal, Belarus, Qatar, Iran, Belgium, Indonesia, Bangladesh, Armenia, Guatemala, Honduras, Ghana, El Salvador, Paraguay, Bolivia, Croatia, Mexico, Bosnia and Herzegovina, Tajikistan, Chad, Haiti, South Sudan, Mauritania, Venezuela, South Africa, Nepal, Burundi, Nicaragua
Total number of reported deaths: 324 889
Total number of worldwide cases: 4 985 825
Number of newly confirmed cases in past 24 hours: 94 957
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[According to the data on the Worldometer website, the total number of cases of COVID-19 worldwide is now 4 985 825, with reports of cases by 217 countries and territories worldwide. The total number of confirmed cases reported from outside China now represents 98.3% of the total number of reported cases. The epicenter has shifted outside of China to Western Europe and the USA. The USA, with more than 1.57 million confirmed cases, now represents 31.5% of the global cases of COVID-19. A global total of 324 889 deaths have been reported, with 320 255 (98.6%) outside mainland China.
In descending rank order, the USA is number 1 for numbers of confirmed cases of COVID-19, Russia is number 2, and Spain is number 3, followed by Brazil number 4; the UK now number 5 has surpassed Italy, which is now number 6, France 7, Germany 8, Turkey 9, and Iran is number 10. China is now number 13. The USA reported the highest number of newly confirmed cases in the past 24 hours (22 630) followed by Brazil (16 517), Russia (9263), India (6147), Peru (4550), Chile (3520). Mexico (2713), Saudi Arabia (2509), the UK (2412), and Iran (2111) reporting the 10th-highest 24-hour newly confirmed case numbers. - Mod.MPP]
******
[2] New countries/territories confirming cases (none)
Date: Tue 19 May 2020
No newly identified countries with 1st cases of COVID-19 confirmed.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[There are now 217 countries and territories that have reported COVID-19 cases; 21 countries have not reported any cases as yet. - Mod.MPP]
******
[3] Iran: gastrointestinal clinical presentation
Date: Mon 18 May 2020
Source: Radio Farda [edited]
https://en.radiofarda.com/a/iran-experts-say-coronavirus-symptoms-changing-from-respiratory-to-gastrointestinal-/30620493.html
Iranian epidemiologists say the symptoms associated with COVID-19 in Iran have changed from respiratory to gastrointestinal. They also believe the shift to gastrointestinal symptoms which are often accompanied with no fever or only low fever cause a delay in diagnosis and result in the further spread of the virus by those who are infected but have no obvious respiratory symptoms to be tested.
"COVID-19 had symptoms such as coughs, shortness of breath, and high fever before. These symptoms were observed in the 1st 2 months after the outbreak. But now the most important symptoms of COVID-19 are gastrointestinal," Dr Mohammad-Reza Mahboubfar, a viral epidemiologist and member of the Coronavirus Taskforce, said on Monday [18 May 2020].
According to Dr Mahboubfar symptoms such as acute diarrhea, abdominal spasms, stomachache, nausea, vomiting, loss of appetite, low fever, and loss of taste and smell are more prevalent now in COVID-19 patients from various age groups including the elderly and children. On [16 May 2020], Dr Seyed Hassan Abedi, a gastroenterologist at Babol Medical Sciences University, warned about the change in the symptoms of COVID-19 and said fewer patients with respiratory symptoms were being hospitalized but there was an increase in those suffering from gastrointestinal complications.
Dr Abedi maintains that a quarter of all COVID-19 patients only show gastrointestinal symptoms and for the same reason seek medical care later than those whose respiratory symptoms are more pronounced. He warns that delayed diagnosis of coronavirus in patients with milder gastrointestinal symptoms may cause the virus to spread at a higher rate.
According to Dr Abedi who serves at one of the hospitals for coronavirus patients in the northern city of Babol, one of the earliest hotspots of the epidemic, gastrointestinal symptoms are not accompanied by high temperature in about 1/3 of patients but diarrhea in these patients is acute, may occur at least 5 times a day and last up to 2 weeks.
Some Iranian health specialists have pointed out that coronavirus can also cause liver and pancreas damage in COVID-19 patients. Dr Seyed Reza Fatemi, a gastroenterologist from Shahid Beheshti University of Tehran, says that up to 50 percent of COVID-19 patients show gastrointestinal symptoms and that the virus causes liver damage and inflammation of the pancreas in 20 to 30 percent of all patients, especially those with other acute symptoms.
Cases of brain stroke due to coronavirus have also been reported in Iran. Dr Mahmoud-Reza Ashrafi, a professor of medicine at Tehran University of Medical Sciences says in March [2020] there were even several cases of brain stroke in children which may have been due to coronavirus. "Oxygen deprivation and inflammation resulting from COVID-19 can result in thrombosis in arteries and brain strokes," he says.
Some experts, however, say mutation of the virus which may be the cause of new symptoms should not cause too much concern. "Coronavirus is not like the common flu virus that mutates constantly. It may change over time and cause atypical symptoms such as gastrointestinal symptoms, but we shouldn't worry that it will mutate quickly to the point of infecting those who have become immune again," Dr Hossein Keivani, professor of virology at Tehran University told Radio Farda. Dr Mahboubfar who is also a crisis management expert says the change of the symptoms may be affecting the Health Ministry's official statistics on COVID-19. The Ministry's figures do not include patients with the newly emerged gastrointestinal symptoms who are not tested and are therefore lower than the real figures, he says.
Chinese researchers have also noted that the characteristics of gastrointestinal symptoms in COVID-19 are more insidious than the respiratory symptoms, making them easy to overlook. Their findings show that patients might have only gastrointestinal symptoms during the whole course of this disease, and some continue to shed the virus in faeces, despite respiratory samples testing negative.
Dr Mahboubfar predicts that the official number of cases and deaths is going to rise in the coming days because the disease is spreading again in places where it was on decline. "The 2nd wave of coronavirus epidemic has happened as we had predicted," he notes. Dr Mahboubfar attributes the relaxation of the lockdown in the country to the government's concerns about the economic and social consequences of the lockdown rather than the spread of the virus having come under control.
According to official figures which many believe are too low due to being based solely on cases confirmed by testing, 125 000 cases of COVID-19 have been diagnosed and more than 7000 have lost their lives since mid-February [2020].
[Byline: Maryam Sinaiee]
--
Communicated by:
ProMED-mail
<promed@promedmail.com>
[In the original Chinese publications, gastrointestinal symptoms were noted to occur in about 5% of the cases. But reading the media report above, one can't help but wonder if the case definition used at that time around the world mandated respiratory symptoms and it was a case of "don't look and it isn't there" (the corollary to "seek and ye shall find"). I'm working under the presumption that these cases have been tested and virus PCR was identified in stool specimens. It would be interesting to hear from other countries to know if this same phenomenon is occurring -- an increase in gastrointestinal disease (without respiratory symptoms. - Mod.MPP
HealthMap/ProMED-mail map of Iran: http://healthmap.org/promed/p/128]
******
[4] USA (California): skilled nursing facility
Date: Mon 18 May 2020 5:35 PM PDT
Source: San Francisco Chronicle [edited]
https://www.sfchronicle.com/bayarea/article/Eleven-residents-dead-in-Vallejo-nursing-home-15279262.php
[Solano] County officials said 11 residents have died in a COVID-19 outbreak at a Vallejo skilled nursing facility where more than 130 people have been infected with the coronavirus [SARS-CoV-2]. In total, 99 residents and 32 staff members at Windsor Vallejo Care Center have been infected with the coronavirus as of Monday morning [18 May 2020], said Dr Bela Matyas, county health officer.
Matyas said 9 of the residents who died were on "comfort care" before they tested positive for COVID-19, meaning they were receiving end-of-life treatment and died at the facility. The other 2 people who died were between the ages of 40 and 65. Both were at the facility for rehabilitation and had underlying health issues. 4 other residents were hospitalized for COVID-19 and survived.
The outbreak has infected more than 80% of the facility's population of 120 residents, Matyas said. The majority are asymptomatic and up to 70 of the cases remain active. "We are obviously not out of the woods until everybody has been able to come out of that COVID unit within the nursing home," Matyas said.
Solano County has 16 deaths in total, meaning the facility's deaths mark 68% of the county's fatalities. The cases account for 31% of the county's total 424 cases as of Monday [18 May 2020]. "That's a very big share," Matyas said. "It's an indication of the profound impact (these outbreaks) can have on the overall picture for a county."
County and public health officials are working with facility staff on outbreak management and infection control, Matyas said. Positive patients are in a separate wing of the facility and monitored for temperature and symptoms 3 times a day. Officials have traced contacts of positive staff members, testing their families and coworkers at other facilities, but have discovered no other infections, Matyas said.
In recent weeks, staffing levels at the Vallejo facility dropped to concerning lows because so many staff had tested positive and had to stay home, Matyas said. The company, which runs 44 facilities in California and Arizona, sent staff from other facilities. "There were times in the course of the last several weeks when their staffing was getting to the point where we were mutually concerned," Matyas said.
Officials began testing at the facility more than 2 weeks ago after receiving reports of possible infections and confirmed 18 cases on [1 May 2020]. The number quickly grew to 99 cases -- 76 residents and 23 staff -- 3 days later.
Solano County plans to offer testing for residents and staff at the county's other skilled nursing facilities within the next few weeks as a prevention measure, Matyas said. So far, single infections but no larger outbreaks have been detected in congregate settings. The Vallejo facility marks the latest congregate care setting to be ravaged by the deadly virus.
In the Bay Area, at least 17 deaths are linked to an outbreak at Gateway Care and Rehabilitation in Hayward, according to recent data from the state. In a separate outbreak, 17 residents have died at Turlock Nursing and Rehabilitation Center (Stanislaus County), the company reported on Saturday [16 May 2020].
[Byline: Anna Bauman]
--
Communicated by:
ProMED-mail
<pormed@promedmail.org>
[Unfortunately, this is becoming a common occurrence in the USA and in other countries around the world where skilled nursing facilities exist. In a 9 May 2020 article in the NY Times, a tally of "at least 28 100 residents and workers have died from the coronavirus at nursing homes and other long-term care facilities for older adults in the United States, according to a New York Times database. The virus so far has infected more than 153 000 at some 7700 facilities." The article goes on to mention that while the cases in these facilities account for 11% of USA reported cases, the deaths account for 1/3 of reported deaths in the USA. (https://www.nytimes.com/interactive/2020/05/09/us/coronavirus-cases-nursing-homes-us.html). The article has a table showing state by state in the USA, the number of skilled nursing facilities, the number of cases, the number of deaths, and the percentage of state reported deaths. - Mod.MPP
HealthMap/ProMED-mail map of California, United States: http://healthmap.org/promed/p/10461
California county map: https://www.mapsofworld.com/usa/states/california/california-county-map.html]
******
[5] Indigenous Amazon tribes: Venezuela
Date: Wed 20 May 2020 12:03 AM
Source: Gulf Times, Agence France-Presse (AFP) report [edited]
https://www.gulf-times.com/story/663612/Indigenous-Venezuela-refugees-dangerously-exposed-
Venezuela's displaced indigenous communities are "dangerously exposed" to the coronavirus [COVID-19] pandemic, the United Nations warned yesterday [19 May 2020].
Indigenous people displaced across the border in neighbouring Brazil and Colombia are "at risk" as the novel coronavirus sweeps through South America, said the UN refugee agency [UNHCR].
The UNHCR said the number of suspected and confirmed COVID-19 cases was increasing, while the 1st deaths had been reported among indigenous communities. The agency said there were almost 5000 indigenous Venezuelans displaced in Brazil, mainly from the Warao ethnic group, but also from the Enapa, Karina, Pemon, and Ye'kwana communities.
"With COVID-19 hitting this Amazon region hard and Brazil emerging as an epicentre of the pandemic, UNHCR is worried that many may struggle without adequate health and sanitation conditions," said spokeswoman Shabia Mantoo.
Meanwhile, a number of indigenous groups live around the Venezuelan border with Colombia. "While their ancestral homes straddle both countries, many have not been able to regularise their stay in Colombia and are undocumented. Some now also face threats from irregular armed groups who control the areas where they live," said Mantoo. She said many were in isolated areas, lacking access to health services and clean water, while others were in cramped dwellings.
"Most of the border indigenous groups are threatened by physical and cultural extinction because of insufficient food and severe malnutrition that can increase the risk of contagion," said Mantoo. Meanwhile, national lockdowns have stopped many of their livelihood activities and faced with increasing poverty, some were having to peddle goods on the streets. "Not only does that expose them to the risk of infection but also stigmatisation and discrimination for perceived inability to comply with lockdown and physical distancing measures," Mantoo said.
The UNHCR said increased resources were urgently required to continue the "life-saving" work being done by host countries and humanitarian organisations and urged countries attending an upcoming donor conference to pledge their financial support. "Alarmingly, the regional response plan for refugees and migrants from Venezuela is currently just 4-percent funded," said Mantoo. The European Union and Spain are to host the online donor conference on [26 May 2020] to support millions of migrants fleeing Venezuela. The event aims to mobilise funds and raise awareness of the plight of more than 5 million people who have escaped the political and economic chaos engulfing Venezuela.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Another area and indigenous population threatened by COVID. While this doesn't mention the Amazon region specifically, these groups tend to live in the Amazon region in Colombia and Brazil. These groups are outside of the normal lives in these countries and have limited access to healthcare. And the countries in Latin America are undergoing the pandemic with limited surge capacity. - Mod.MPP
HealthMap/ProMED-mail map of Venezuela: http://healthmap.org/promed/p/29]
******
[6] WHO situation report 120 (as of 19 May 2020)
Date: Tue 19 May 2020
Source: WHO [abridged, edited]
https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200519-covid-19-sitrep-120.pdf?sfvrsn=515cabfb_2
*The situation report includes information provided by national authorities as of 10:00 CEST, 19 May 2020.
Highlights
----------
- In his opening remarks at the World Health Assembly, WHO Director-General Dr Tedros declared: 'We have come together as the nations of the world to confront the defining health crisis of our time.' In concluding he asserted that the COVID-19 pandemic reminds us that we need a healthier, safer, and fairer world with a stronger WHO to support this goal (https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-world-health-assembly).
- Countries around the world have put in place a range of public health and social measures to suppress or stop community spread of COVID-19. WHO has published a document to provide an overview of public health and social measures, and to propose strategies to limit any possible harm resulting from these interventions (https://www.who.int/publications-detail/overview-of-public-health-and-social-measures-in-the-context-of-covid-19).
- A new WHO report on the health behaviours of 11-15-year-olds in Europe reveals more adolescents have been reporting mental health concerns. The results were based on data between 2014 and 2018 and provide a baseline against which future studies can measure the impact of COVID-19 on young people's lives (http://www.euro.who.int/en/media-centre/sections/press-releases/2020/who-report-on-health-behaviours-of-1115-year-olds-in-europe-reveals-more-adolescents-are-reporting-mental-health-concerns).
- The WHO Regional Office for the Western Pacific has released a timeline outlining some of the key moments and actions to respond to COVID-19 in the Region (https://www.who.int/westernpacific/news/detail/18-05-2020-covid-19-timeline-in-the-western-pacific).
Surveillance
------------
[The following data come from "Situation in numbers." The regional case totals are inclusive of China. - Mod.MPP]
WHO region (no. countries/territories): Total confirmed cases (new) / Total deaths (new)
Western Pacific Region (19): 169 178 (663) / 6765 (22)
European Region (61): 1 909 592 (19 125) / 167 998 (825)
South East Asia Region (10): 148 761 (7168) / 4780 (198)
Eastern Mediterranean Region (22) 356 749 (18 189) / 10 149 (170)
Region of the Americas (54): 2 082 945 (65 134) / 124 668 (3059)
African Region (49): 63 521 (2358) / 1796 (48)
Other:
Cases on an international conveyance (Diamond Princess): 712 (0) / 13 (0)
Confirmed cases (new conf cases) / Total deaths (new deaths)
Grand total: 4 731 458 (112 637) / 316 169 (4322)
［Mod.MPP 注－
The number of countries and territories reporting confirmed cases of COVID-19 to WHO remains at 215. This includes 19 countries (including 4 territories) from the Western Pacific region, 61 countries (including 7 territories) from the European region, 10 countries from the South-East Asia region, 22 countries (including 1 territory) from the Eastern Mediterranean region, 54 countries (including 19 territories) from the Americas region, and 49 countries (including 2 territories) from the African region.
In the 24 hours since the last WHO update:
------------------------------------------
The Americas region reported 65 134 new cases (57.8% of the global newly reported cases), and 3059 deaths (70.8%) for this 24-hour period. Of the newly confirmed cases in the region, 69.5% were reported by the USA, followed by Brazil 12.2%, and Peru 5.7%. Removing the USA from the denominator as it overshadows other countries in the region, Brazil then accounts for 39.9% of the newly confirmed cases, Peru 18.8%, Chile 11.5%, Mexico 10.4%, and Canada 5.5%. The Americas region is maintaining its status as having the highest cumulative case count of the 6 WHO regions, with the European region as the 2nd-highest region.
The European region reported 19 125 new cases (17.0% of the global newly reported cases) and 825 deaths (19.1%). Russia reported 48.4% of the newly confirmed cases in the region, followed by the UK 14.2%, Turkey 6.1%, Belarus 4.8%, Germany at 2.7%, and France and Italy at 2.4% each.
The Eastern Mediterranean region reported 18 189 new cases (16.1% of the global newly reported cases) and 170 deaths (3.9%). Saudi Arabia reported 28.0% of the regional newly reported cases, followed by Qatar 16.5%, Iran at 12.6%, Kuwait 10.5%, Pakistan 10.1%, and the United Arab Emirates at 9.3%.
The African region reported 2358 new cases (2.1% of the global newly reported cases) and 48 deaths (1.1%). South Africa reported 38.9% of the newly reported cases in the region in the past 24 hours, followed by Cameroon at 20.4%, Nigeria 9.2%, Algeria at 7.7%, Gabon at 4.7% and Equatorial Guinea at 4.5%. Benin reduced its cumulative case count by 210 cases, and Sao Tome and Principe reduced their cumulative case count by 4 cases.
The Western Pacific region reported 663 new cases (0.6% of the global newly reported cases) and 22 deaths (0.5%). Singapore reported 46.0% of the newly reported cases, followed by the Philippines 30.9%, Japan at 9.0%, and Malaysia 7.1%.
The South-East Asia region reported 7168 new cases (6.4% of the global newly reported cases) and 198 deaths (4.6%). India reported 69.3% of newly reported cases, followed by Bangladesh 22.3% and Indonesia 6.9%. These 3 countries make up 98.6% of all reported cases in the region. Removing India from the denominator, Bangladesh represents 72.9% of the newly reported cases, Indonesia 22.6%, and Nepal 3.2%.
Figure 2. Epidemic curve of confirmed COVID-19 cases, by date of report and WHO region, 30 Dec 2019 through 19 May 2020, at the source URL above, is an excellent representation of the epidemic starting in the Western Pacific, transitioning to multiregional activity as the virus travelled. Europe has significantly decreased. The Americas is increasing, as is South-East Asia and the Eastern Mediterranean.
A somewhat repetitive but necessary reminder: It is clear that the number of reported confirmed cases differs from different reporting websites and is somewhat a function of time of day the website is updated. For example, I note the time we've accessed the Johns Hopkins' CSSE or Worldometer website, but by the time the post is actually finished with the editing process, those numbers have, at times, significantly changed. Case counting is clearly a moving target, and depending upon when the website updates, the numbers may be different. I try to start each post with the latest figures for the calendar day (the Johns Hopkins CSSE or Worldometer table) and close with the figures from the start of the calendar day (the WHO tables), defining the calendar day as DST (now GMT-4). - Mod.MPP]
関連項目
COVID-19 update (194): China, S Korea, countries w/ high local trans, Italy phase 2 20200519.7352327
PRO/AH/EDR> COVID-19 update (196): China, S Korea, countries w/ high local transmission
Archive Number: 20200520.7357017
In this update:
[1] 中国: National Health Commission 19 May 2020; 82 965 total cases, 4634 deaths
[2] 韓国: 11 078 confirmed cases, 263 deaths
[3] イタリア: 226 699 total cases, 32 169 deaths
[4] イラン: 124 603 total cases, 7199 deaths
[5] 米国: 1 570 583 cases, 93 533 deaths
[6] スペイン: 232 037 [278 813] cases, 27 778 deaths
[7] イタリア: continued openings, phase 2
[1] 中国: National Health Commission 19 May 2020; 82 965 total cases, 4634 deaths
情報源 China National Health Commission 2020年5月19日
19日，31 provincial-level regions on the Chinese mainland as well as the Xinjiang Production and Construction Corps から新たに 5 new cases of confirmed infections (1 imported case in Inner Mongolia autonomous region and 4 indigenous cases in Jilin province) と 16 new asymptomatic cases (including 1 imported case) が報告。また，1708 cases of imported confirmed infections and no deaths も報告された。
19日までの累計報告患者数 reports of 82 965 confirmed cases and 4634 deaths in 31 provincial-level regions on the Chinese mainland and the Xinjiang Production and Construction Corps が報告された ...
[2] 韓国: 11 110 confirmed cases, 263 deaths
情報源 Ministry of Health and Welfare, Korean CDC [In Korean] 2020年5月20日
Date and time:
19 May 2020 0:00 AM KT 11 078 confirmed cases, 263 deaths
20 May 2020 0:00 AM KT 11 110 confirmed cases, 263 deaths
Change: 32 newly confirmed infections; 0 new deaths
Distribution of cases by metropolitan city/province（原文参照願います。）
...
From the English language page, Notice: 322 of 19 May 2020 :
- Of the 13 new cases [in yesterday's (18 May 2020) update], 4 were imported cases and 9 were locally transmitted cases.
-- 7 of the locally transmitted cases are related to the nightclub cluster; 2 visitors to nightclubs/etc., 5 contacts.
-- 1 local case is from Seoul City. This case is a healthcare worker at Samsung Medical Center in Seoul. ...
[3] イタリア: 226 699 total cases, 32 169 deaths
Cases in Italy as of 6:00 pm 19 May 2020 CET
情報源 Italian Government Health Ministry [in Italian] 2020年5月19日
- 226 699 cumulative cases, increase of 813 from 17 May 2020
- 65 129 people are currently positive for the virus;
Case distribution by province: number of cases (原文参照願います。)
an excellent interactive map
［Mod.MPP 注－3月9日，イタリアはアウトブレイクが限局性に発生していた北部地域の封鎖を発表。同10日に全国に拡大され，11日には必要不可欠なビジネス以外の閉鎖が発表された。封鎖から66日間が経過している。5月3日まで延長された封鎖が解除されるイタリアを，世界が注視している。20200505.7300349 for details on phase 2 opening が詳述されている］
[4] イラン: 124 603 total cases, 7199 deaths
情報源 WION News 2020年5月19日
19日，イラン政府当局はこの 24時間に 2000人を超える感染が確認され，10 provinces において死者が ０，ほか 6 others でも死亡はわずか 1例であったと明らかにした。イランではこれまでに 7199 fatalities due to COVID-19 with 124 603 virus cases が確認されている。several provinces including Kermanshah, north Khorasan, Baluchistan, Kerman が厳重に監視されている。"Khuzestan province は依然として a critical situation " とされ "red" in coronavirus risk index in the country に色づけされている。2月にイランで初めての死者が報告されたのは宗教都市 the pilgrimage city of Qom であった。4月の報告では，Khuzestan 州を含む 8つの地域が増加傾向またはピークにあるとされていた。緩和に向けて 24日大統領は，レストランの再開やモスクの施設の外での礼拝を許可する予定である。
[5] 米国: 1 570 583 cases, 93 533 deaths
情報源 Worldometer 2020年5月18日
USA cases by state
State: Total cases / New cases
New York: 362 630 / 1364 ...
[6] スペイン: 232 037 [278 813] cases, 27 778 deaths
COVID-19 update 110 [data as of 19 May 2020 21:00 CET]
情報源 Spanish government COVID-19 update 110 [in Spanish] 2020年5月19日
スペイン国内で今日までに a total of 232 037 PCR confirmed cases of COVID-19 with 27 778 deaths (Tables 1 and 2, Figures 1 and 2) が確認。
The distribution by autonomous community of hospitalized, ICU, and deceased cases is shown in Table 2.
Madrid: 66 643 / 92 / 33.44 ...
Total: 232 037 / 295 / 18.36
［Mod.MPP 注－the WHO Situation Report 98 from 27 Apr 2020 によれば，4月25日以降スペインは only PCR positive confirmations のみを WHO に報告しており，抗体検査による報告はしていない。抗体により確認された累積症例数は just above Figure 3 で確認できる。5月16－17日の24時間に PCR で新たに確認された患者数が 285例であったのに対し，この 24時間に新たに確認された症例数は 295例で，the PCR- [plus number confirmed including all tests] confirmed cumulative total to 232 037 [278 813] cases となった。2週間に全国で発生した人口 10万対症例数は減少し続け，18.36となった。4月7日の 214.4から 26日間緩やかに減り続けている ... ］
●
PRO/AH/EDR> COVID-19 update (195): global, Iran GI pres, USA (CA) nursing home, Venezuela, WHO
Archive Number: 20200520.7356886
CORONAVIRUS DISEASE 2019 UPDATE (195): GLOBAL, IRAN CLINICAL PRESENTATION NOW GASTROINTESTINAL, USA (CALIFORNIA) SKILLED NURSING FACILITY, VENEZUELA INDIGENOUS POPULATIONS, WHO
********************************************************************************************************************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this update:
[1] Global update: Worldometer accessed 19 May 2020 21:42 EDT (GMT-4)
[2] New countries/territories confirming cases (none)
[3] Iran: clinical presentation gastrointestinal
[4] USA (California): skilled nursing facility
[5] Indigenous Amazon tribes: Venezuela
[6] WHO situation report 120 (as of 19 May 2020)
******
[1] Global update: Worldometer accessed 19 May 2020 21:42 EDT (GMT-4)
Date: Tue 19 May 2020
Source: Worldometer [edited]
https://www.worldometers.info/coronavirus/
Confirmed cases Start of data recording: 1st data / ... / 1 Mar 2020 / ... / 1 Apr 2020 / ... / 1 May 2020 / ... / 17 May 2020 / 18 May 2020 / 19 May 2020 / Country
Countries with marked decreases in daily newly confirmed cases post major activity
-------------------------------------------------------------------
2 Feb 2020: 17 187 / ... / 80 024 / ... / 81 589 / ... / 82 875 / ... / 82 954 / 82 960 / 82 965 / Mainland China
2 Feb 2020: 15 / ... / 3726 / ... / 9976 / ... / 11 065 / 11 078 / 11 110 / South Korea
Countries with major activity (more than 5000 cases with community spread)
------------------------------------------------------------------
2 Feb 2020: 11 / ... / 76 / ... / 215 081 / ... / 1 131 280 / ... / 1 527 664 / 1 550 294 / 1 570 583 / USA
2 Feb 2020: 2 / ... / 2 / ... / 2777 / ... / 114 431 / ... / 281 752 / 290 678 / 299 941 / Russia
[In the table above, NA is not applicable; those countries whose 1st case was reported after 1 Mar 2020 did not have cases on 1 Mar 2020. - Mod.MPP]
Countries with more than 5000 cases not on the list above (as the list is growing longer, we will freeze it here and maintain a list of countries passing the 5000-case mark):
Argentina (8809), Afghanistan (7653), Bahrain (7532), Algeria (7377), Kazakhstan (6751), Nigeria (6401), Moldova (6340), Ghana (6096), Oman (5671), Armenia (5041)
Countries and territories with more than 1000 cases:
Luxembourg, Hungary, Thailand, Greece, Iraq, Uzbekistan, Croatia, Cameroon, Azerbaijan, Bosnia and Herzegovina, Guinea, Bolivia, Iceland, Bulgaria, Estonia, Cuba, North Macedonia, New Zealand, Cote d'Ivoire, Slovenia, Lithuania, Slovakia, Senegal, Honduras, Djibouti, Somalia, Guatemala, Hong Kong, Tunisia, Sudan, Mayotte, Kyrgyzstan, Congo DR, El Salvador, Gabon, Tajikistan, Maldives, Latvia, Guinea-Bissau, Sri Lanka
Countries with more than 500 cases (and fewer than 1000):
Cyprus, Albania, Niger, Costa Rica, Andorra, Lebanon, Burkina Faso, Uruguay, Mali, Georgia, San Marino, Channel Islands, Kenya, Jordan, Tanzania, Paraguay, Jamaica, Malta, Equatorial Guinea, Zambia, Venezuela, Chad, Sierra Leone, Haiti
Countries with notable overnight changes or escalating reports to keep an eye on:
Brazil, Canada, Chile, India, Kuwait, Saudi Arabia, Portugal, Belarus, Qatar, Iran, Belgium, Indonesia, Bangladesh, Armenia, Guatemala, Honduras, Ghana, El Salvador, Paraguay, Bolivia, Croatia, Mexico, Bosnia and Herzegovina, Tajikistan, Chad, Haiti, South Sudan, Mauritania, Venezuela, South Africa, Nepal, Burundi, Nicaragua
Total number of reported deaths: 324 889
Total number of worldwide cases: 4 985 825
Number of newly confirmed cases in past 24 hours: 94 957
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[According to the data on the Worldometer website, the total number of cases of COVID-19 worldwide is now 4 985 825, with reports of cases by 217 countries and territories worldwide. The total number of confirmed cases reported from outside China now represents 98.3% of the total number of reported cases. The epicenter has shifted outside of China to Western Europe and the USA. The USA, with more than 1.57 million confirmed cases, now represents 31.5% of the global cases of COVID-19. A global total of 324 889 deaths have been reported, with 320 255 (98.6%) outside mainland China.
In descending rank order, the USA is number 1 for numbers of confirmed cases of COVID-19, Russia is number 2, and Spain is number 3, followed by Brazil number 4; the UK now number 5 has surpassed Italy, which is now number 6, France 7, Germany 8, Turkey 9, and Iran is number 10. China is now number 13. The USA reported the highest number of newly confirmed cases in the past 24 hours (22 630) followed by Brazil (16 517), Russia (9263), India (6147), Peru (4550), Chile (3520). Mexico (2713), Saudi Arabia (2509), the UK (2412), and Iran (2111) reporting the 10th-highest 24-hour newly confirmed case numbers. - Mod.MPP]
******
[2] New countries/territories confirming cases (none)
Date: Tue 19 May 2020
No newly identified countries with 1st cases of COVID-19 confirmed.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[There are now 217 countries and territories that have reported COVID-19 cases; 21 countries have not reported any cases as yet. - Mod.MPP]
******
[3] Iran: gastrointestinal clinical presentation
Date: Mon 18 May 2020
Source: Radio Farda [edited]
https://en.radiofarda.com/a/iran-experts-say-coronavirus-symptoms-changing-from-respiratory-to-gastrointestinal-/30620493.html
Iranian epidemiologists say the symptoms associated with COVID-19 in Iran have changed from respiratory to gastrointestinal. They also believe the shift to gastrointestinal symptoms which are often accompanied with no fever or only low fever cause a delay in diagnosis and result in the further spread of the virus by those who are infected but have no obvious respiratory symptoms to be tested.
"COVID-19 had symptoms such as coughs, shortness of breath, and high fever before. These symptoms were observed in the 1st 2 months after the outbreak. But now the most important symptoms of COVID-19 are gastrointestinal," Dr Mohammad-Reza Mahboubfar, a viral epidemiologist and member of the Coronavirus Taskforce, said on Monday [18 May 2020].
According to Dr Mahboubfar symptoms such as acute diarrhea, abdominal spasms, stomachache, nausea, vomiting, loss of appetite, low fever, and loss of taste and smell are more prevalent now in COVID-19 patients from various age groups including the elderly and children. On [16 May 2020], Dr Seyed Hassan Abedi, a gastroenterologist at Babol Medical Sciences University, warned about the change in the symptoms of COVID-19 and said fewer patients with respiratory symptoms were being hospitalized but there was an increase in those suffering from gastrointestinal complications.
Dr Abedi maintains that a quarter of all COVID-19 patients only show gastrointestinal symptoms and for the same reason seek medical care later than those whose respiratory symptoms are more pronounced. He warns that delayed diagnosis of coronavirus in patients with milder gastrointestinal symptoms may cause the virus to spread at a higher rate.
According to Dr Abedi who serves at one of the hospitals for coronavirus patients in the northern city of Babol, one of the earliest hotspots of the epidemic, gastrointestinal symptoms are not accompanied by high temperature in about 1/3 of patients but diarrhea in these patients is acute, may occur at least 5 times a day and last up to 2 weeks.
Some Iranian health specialists have pointed out that coronavirus can also cause liver and pancreas damage in COVID-19 patients. Dr Seyed Reza Fatemi, a gastroenterologist from Shahid Beheshti University of Tehran, says that up to 50 percent of COVID-19 patients show gastrointestinal symptoms and that the virus causes liver damage and inflammation of the pancreas in 20 to 30 percent of all patients, especially those with other acute symptoms.
Cases of brain stroke due to coronavirus have also been reported in Iran. Dr Mahmoud-Reza Ashrafi, a professor of medicine at Tehran University of Medical Sciences says in March [2020] there were even several cases of brain stroke in children which may have been due to coronavirus. "Oxygen deprivation and inflammation resulting from COVID-19 can result in thrombosis in arteries and brain strokes," he says.
Some experts, however, say mutation of the virus which may be the cause of new symptoms should not cause too much concern. "Coronavirus is not like the common flu virus that mutates constantly. It may change over time and cause atypical symptoms such as gastrointestinal symptoms, but we shouldn't worry that it will mutate quickly to the point of infecting those who have become immune again," Dr Hossein Keivani, professor of virology at Tehran University told Radio Farda. Dr Mahboubfar who is also a crisis management expert says the change of the symptoms may be affecting the Health Ministry's official statistics on COVID-19. The Ministry's figures do not include patients with the newly emerged gastrointestinal symptoms who are not tested and are therefore lower than the real figures, he says.
Chinese researchers have also noted that the characteristics of gastrointestinal symptoms in COVID-19 are more insidious than the respiratory symptoms, making them easy to overlook. Their findings show that patients might have only gastrointestinal symptoms during the whole course of this disease, and some continue to shed the virus in faeces, despite respiratory samples testing negative.
Dr Mahboubfar predicts that the official number of cases and deaths is going to rise in the coming days because the disease is spreading again in places where it was on decline. "The 2nd wave of coronavirus epidemic has happened as we had predicted," he notes. Dr Mahboubfar attributes the relaxation of the lockdown in the country to the government's concerns about the economic and social consequences of the lockdown rather than the spread of the virus having come under control.
According to official figures which many believe are too low due to being based solely on cases confirmed by testing, 125 000 cases of COVID-19 have been diagnosed and more than 7000 have lost their lives since mid-February [2020].
[Byline: Maryam Sinaiee]
--
Communicated by:
ProMED-mail
<promed@promedmail.com>
[In the original Chinese publications, gastrointestinal symptoms were noted to occur in about 5% of the cases. But reading the media report above, one can't help but wonder if the case definition used at that time around the world mandated respiratory symptoms and it was a case of "don't look and it isn't there" (the corollary to "seek and ye shall find"). I'm working under the presumption that these cases have been tested and virus PCR was identified in stool specimens. It would be interesting to hear from other countries to know if this same phenomenon is occurring -- an increase in gastrointestinal disease (without respiratory symptoms. - Mod.MPP
HealthMap/ProMED-mail map of Iran: http://healthmap.org/promed/p/128]
******
[4] USA (California): skilled nursing facility
Date: Mon 18 May 2020 5:35 PM PDT
Source: San Francisco Chronicle [edited]
https://www.sfchronicle.com/bayarea/article/Eleven-residents-dead-in-Vallejo-nursing-home-15279262.php
[Solano] County officials said 11 residents have died in a COVID-19 outbreak at a Vallejo skilled nursing facility where more than 130 people have been infected with the coronavirus [SARS-CoV-2]. In total, 99 residents and 32 staff members at Windsor Vallejo Care Center have been infected with the coronavirus as of Monday morning [18 May 2020], said Dr Bela Matyas, county health officer.
Matyas said 9 of the residents who died were on "comfort care" before they tested positive for COVID-19, meaning they were receiving end-of-life treatment and died at the facility. The other 2 people who died were between the ages of 40 and 65. Both were at the facility for rehabilitation and had underlying health issues. 4 other residents were hospitalized for COVID-19 and survived.
The outbreak has infected more than 80% of the facility's population of 120 residents, Matyas said. The majority are asymptomatic and up to 70 of the cases remain active. "We are obviously not out of the woods until everybody has been able to come out of that COVID unit within the nursing home," Matyas said.
Solano County has 16 deaths in total, meaning the facility's deaths mark 68% of the county's fatalities. The cases account for 31% of the county's total 424 cases as of Monday [18 May 2020]. "That's a very big share," Matyas said. "It's an indication of the profound impact (these outbreaks) can have on the overall picture for a county."
County and public health officials are working with facility staff on outbreak management and infection control, Matyas said. Positive patients are in a separate wing of the facility and monitored for temperature and symptoms 3 times a day. Officials have traced contacts of positive staff members, testing their families and coworkers at other facilities, but have discovered no other infections, Matyas said.
In recent weeks, staffing levels at the Vallejo facility dropped to concerning lows because so many staff had tested positive and had to stay home, Matyas said. The company, which runs 44 facilities in California and Arizona, sent staff from other facilities. "There were times in the course of the last several weeks when their staffing was getting to the point where we were mutually concerned," Matyas said.
Officials began testing at the facility more than 2 weeks ago after receiving reports of possible infections and confirmed 18 cases on [1 May 2020]. The number quickly grew to 99 cases -- 76 residents and 23 staff -- 3 days later.
Solano County plans to offer testing for residents and staff at the county's other skilled nursing facilities within the next few weeks as a prevention measure, Matyas said. So far, single infections but no larger outbreaks have been detected in congregate settings. The Vallejo facility marks the latest congregate care setting to be ravaged by the deadly virus.
In the Bay Area, at least 17 deaths are linked to an outbreak at Gateway Care and Rehabilitation in Hayward, according to recent data from the state. In a separate outbreak, 17 residents have died at Turlock Nursing and Rehabilitation Center (Stanislaus County), the company reported on Saturday [16 May 2020].
[Byline: Anna Bauman]
--
Communicated by:
ProMED-mail
<pormed@promedmail.org>
[Unfortunately, this is becoming a common occurrence in the USA and in other countries around the world where skilled nursing facilities exist. In a 9 May 2020 article in the NY Times, a tally of "at least 28 100 residents and workers have died from the coronavirus at nursing homes and other long-term care facilities for older adults in the United States, according to a New York Times database. The virus so far has infected more than 153 000 at some 7700 facilities." The article goes on to mention that while the cases in these facilities account for 11% of USA reported cases, the deaths account for 1/3 of reported deaths in the USA. (https://www.nytimes.com/interactive/2020/05/09/us/coronavirus-cases-nursing-homes-us.html). The article has a table showing state by state in the USA, the number of skilled nursing facilities, the number of cases, the number of deaths, and the percentage of state reported deaths. - Mod.MPP
HealthMap/ProMED-mail map of California, United States: http://healthmap.org/promed/p/10461
California county map: https://www.mapsofworld.com/usa/states/california/california-county-map.html]
******
[5] Indigenous Amazon tribes: Venezuela
Date: Wed 20 May 2020 12:03 AM
Source: Gulf Times, Agence France-Presse (AFP) report [edited]
https://www.gulf-times.com/story/663612/Indigenous-Venezuela-refugees-dangerously-exposed-
Venezuela's displaced indigenous communities are "dangerously exposed" to the coronavirus [COVID-19] pandemic, the United Nations warned yesterday [19 May 2020].
Indigenous people displaced across the border in neighbouring Brazil and Colombia are "at risk" as the novel coronavirus sweeps through South America, said the UN refugee agency [UNHCR].
The UNHCR said the number of suspected and confirmed COVID-19 cases was increasing, while the 1st deaths had been reported among indigenous communities. The agency said there were almost 5000 indigenous Venezuelans displaced in Brazil, mainly from the Warao ethnic group, but also from the Enapa, Karina, Pemon, and Ye'kwana communities.
"With COVID-19 hitting this Amazon region hard and Brazil emerging as an epicentre of the pandemic, UNHCR is worried that many may struggle without adequate health and sanitation conditions," said spokeswoman Shabia Mantoo.
Meanwhile, a number of indigenous groups live around the Venezuelan border with Colombia. "While their ancestral homes straddle both countries, many have not been able to regularise their stay in Colombia and are undocumented. Some now also face threats from irregular armed groups who control the areas where they live," said Mantoo. She said many were in isolated areas, lacking access to health services and clean water, while others were in cramped dwellings.
"Most of the border indigenous groups are threatened by physical and cultural extinction because of insufficient food and severe malnutrition that can increase the risk of contagion," said Mantoo. Meanwhile, national lockdowns have stopped many of their livelihood activities and faced with increasing poverty, some were having to peddle goods on the streets. "Not only does that expose them to the risk of infection but also stigmatisation and discrimination for perceived inability to comply with lockdown and physical distancing measures," Mantoo said.
The UNHCR said increased resources were urgently required to continue the "life-saving" work being done by host countries and humanitarian organisations and urged countries attending an upcoming donor conference to pledge their financial support. "Alarmingly, the regional response plan for refugees and migrants from Venezuela is currently just 4-percent funded," said Mantoo. The European Union and Spain are to host the online donor conference on [26 May 2020] to support millions of migrants fleeing Venezuela. The event aims to mobilise funds and raise awareness of the plight of more than 5 million people who have escaped the political and economic chaos engulfing Venezuela.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Another area and indigenous population threatened by COVID. While this doesn't mention the Amazon region specifically, these groups tend to live in the Amazon region in Colombia and Brazil. These groups are outside of the normal lives in these countries and have limited access to healthcare. And the countries in Latin America are undergoing the pandemic with limited surge capacity. - Mod.MPP
HealthMap/ProMED-mail map of Venezuela: http://healthmap.org/promed/p/29]
******
[6] WHO situation report 120 (as of 19 May 2020)
Date: Tue 19 May 2020
Source: WHO [abridged, edited]
https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200519-covid-19-sitrep-120.pdf?sfvrsn=515cabfb_2
*The situation report includes information provided by national authorities as of 10:00 CEST, 19 May 2020.
Highlights
----------
- In his opening remarks at the World Health Assembly, WHO Director-General Dr Tedros declared: 'We have come together as the nations of the world to confront the defining health crisis of our time.' In concluding he asserted that the COVID-19 pandemic reminds us that we need a healthier, safer, and fairer world with a stronger WHO to support this goal (https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-world-health-assembly).
- Countries around the world have put in place a range of public health and social measures to suppress or stop community spread of COVID-19. WHO has published a document to provide an overview of public health and social measures, and to propose strategies to limit any possible harm resulting from these interventions (https://www.who.int/publications-detail/overview-of-public-health-and-social-measures-in-the-context-of-covid-19).
- A new WHO report on the health behaviours of 11-15-year-olds in Europe reveals more adolescents have been reporting mental health concerns. The results were based on data between 2014 and 2018 and provide a baseline against which future studies can measure the impact of COVID-19 on young people's lives (http://www.euro.who.int/en/media-centre/sections/press-releases/2020/who-report-on-health-behaviours-of-1115-year-olds-in-europe-reveals-more-adolescents-are-reporting-mental-health-concerns).
- The WHO Regional Office for the Western Pacific has released a timeline outlining some of the key moments and actions to respond to COVID-19 in the Region (https://www.who.int/westernpacific/news/detail/18-05-2020-covid-19-timeline-in-the-western-pacific).
Surveillance
------------
[The following data come from "Situation in numbers." The regional case totals are inclusive of China. - Mod.MPP]
WHO region (no. countries/territories): Total confirmed cases (new) / Total deaths (new)
Western Pacific Region (19): 169 178 (663) / 6765 (22)
European Region (61): 1 909 592 (19 125) / 167 998 (825)
South East Asia Region (10): 148 761 (7168) / 4780 (198)
Eastern Mediterranean Region (22) 356 749 (18 189) / 10 149 (170)
Region of the Americas (54): 2 082 945 (65 134) / 124 668 (3059)
African Region (49): 63 521 (2358) / 1796 (48)
Other:
Cases on an international conveyance (Diamond Princess): 712 (0) / 13 (0)
Confirmed cases (new conf cases) / Total deaths (new deaths)
Grand total: 4 731 458 (112 637) / 316 169 (4322)
［Mod.MPP 注－
The number of countries and territories reporting confirmed cases of COVID-19 to WHO remains at 215. This includes 19 countries (including 4 territories) from the Western Pacific region, 61 countries (including 7 territories) from the European region, 10 countries from the South-East Asia region, 22 countries (including 1 territory) from the Eastern Mediterranean region, 54 countries (including 19 territories) from the Americas region, and 49 countries (including 2 territories) from the African region.
In the 24 hours since the last WHO update:
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The Americas region reported 65 134 new cases (57.8% of the global newly reported cases), and 3059 deaths (70.8%) for this 24-hour period. Of the newly confirmed cases in the region, 69.5% were reported by the USA, followed by Brazil 12.2%, and Peru 5.7%. Removing the USA from the denominator as it overshadows other countries in the region, Brazil then accounts for 39.9% of the newly confirmed cases, Peru 18.8%, Chile 11.5%, Mexico 10.4%, and Canada 5.5%. The Americas region is maintaining its status as having the highest cumulative case count of the 6 WHO regions, with the European region as the 2nd-highest region.
The European region reported 19 125 new cases (17.0% of the global newly reported cases) and 825 deaths (19.1%). Russia reported 48.4% of the newly confirmed cases in the region, followed by the UK 14.2%, Turkey 6.1%, Belarus 4.8%, Germany at 2.7%, and France and Italy at 2.4% each.
The Eastern Mediterranean region reported 18 189 new cases (16.1% of the global newly reported cases) and 170 deaths (3.9%). Saudi Arabia reported 28.0% of the regional newly reported cases, followed by Qatar 16.5%, Iran at 12.6%, Kuwait 10.5%, Pakistan 10.1%, and the United Arab Emirates at 9.3%.
The African region reported 2358 new cases (2.1% of the global newly reported cases) and 48 deaths (1.1%). South Africa reported 38.9% of the newly reported cases in the region in the past 24 hours, followed by Cameroon at 20.4%, Nigeria 9.2%, Algeria at 7.7%, Gabon at 4.7% and Equatorial Guinea at 4.5%. Benin reduced its cumulative case count by 210 cases, and Sao Tome and Principe reduced their cumulative case count by 4 cases.
The Western Pacific region reported 663 new cases (0.6% of the global newly reported cases) and 22 deaths (0.5%). Singapore reported 46.0% of the newly reported cases, followed by the Philippines 30.9%, Japan at 9.0%, and Malaysia 7.1%.
The South-East Asia region reported 7168 new cases (6.4% of the global newly reported cases) and 198 deaths (4.6%). India reported 69.3% of newly reported cases, followed by Bangladesh 22.3% and Indonesia 6.9%. These 3 countries make up 98.6% of all reported cases in the region. Removing India from the denominator, Bangladesh represents 72.9% of the newly reported cases, Indonesia 22.6%, and Nepal 3.2%.
Figure 2. Epidemic curve of confirmed COVID-19 cases, by date of report and WHO region, 30 Dec 2019 through 19 May 2020, at the source URL above, is an excellent representation of the epidemic starting in the Western Pacific, transitioning to multiregional activity as the virus travelled. Europe has significantly decreased. The Americas is increasing, as is South-East Asia and the Eastern Mediterranean.
A somewhat repetitive but necessary reminder: It is clear that the number of reported confirmed cases differs from different reporting websites and is somewhat a function of time of day the website is updated. For example, I note the time we've accessed the Johns Hopkins' CSSE or Worldometer website, but by the time the post is actually finished with the editing process, those numbers have, at times, significantly changed. Case counting is clearly a moving target, and depending upon when the website updates, the numbers may be different. I try to start each post with the latest figures for the calendar day (the Johns Hopkins CSSE or Worldometer table) and close with the figures from the start of the calendar day (the WHO tables), defining the calendar day as DST (now GMT-4). - Mod.MPP]
関連項目
COVID-19 update (194): China, S Korea, countries w/ high local trans, Italy phase 2 20200519.7352327