CDC Releases First Report on Animal Contact Outbreaks

According to CDC’s first report on animal contact outbreaks, 59 outbreaks of enteric (intestinal) disease were linked to contact with animals or their environment in 2017.

Information in the report comes from CDC’s Animal Contact Outbreak Surveillance System, which is part of the National Outbreak Reporting System (NORS). State, local, and territorial public health agencies submit reports of enteric  disease outbreaks through NORS.

Although most illnesses linked to animal contact are not part of a recognized outbreak, these outbreaks can provide important information on germs that spread from animals to people and the types of animals and settings commonly involved. CDC plans to issue annual reports on these outbreaks.

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Highlights

• In 2017, 59 outbreaks of enteric disease associated with animal contact were reported, resulting in 1,518 illnesses, 312 hospitalizations, and 3 deaths.
• Cryptosporidium was the most common cause of confirmed, single-etiology outbreaks, accounting for 21 outbreaks (41%), 158 illnesses, and 6 hospitalizations.
• Salmonella was the second leading cause of confirmed, single-etiology outbreaks with 18 (35%); these outbreaks resulted in the most outbreak associated-illnesses (1,237 illnesses, 84%), hospitalizations (286, 92%), and deaths (2, 67%).
• Livestock (25 outbreaks) and poultry (15) were the most common types of animals implicated. The most outbreak-associated illnesses were from contact with poultry (1,149 illnesses), livestock (132), and reptiles (89).
• Farms or dairies (11 outbreaks, 30%) were the most commonly reported setting among outbreaks with a single location of exposure, followed by private homes (10 outbreaks, 27%).

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According to the CDC, each year, enteric diseases linked to animals or their environments are estimated to cause 450,000 illnesses, 5,000 hospitalizations, and 76 deaths in the United States.

 These illnesses are attributed to contact with an animal’s feces or bodily fluids, which can be present on the animal, in its environment, or in its food or water. Outbreak data can provide insight into human illnesses caused by pathogens transmitted through animal contact and can inform efforts to prevent disease. The findings in this report exemplify the One Health concept by highlighting how the health of people is interconnected with animals and the environment.

During 2017, 59 animal contact outbreaks were reported, resulting in 1,518 illnesses, 312 hospitalizations, and 3 deaths. Forty-six were single-state outbreaks; these were reported from 18 states. Thirteen were multistate outbreaks; exposures occurred in 49 states and Washington, D.C. The median reporting rate among states was 1.1 outbreak per million population; rates ranged from 0.2 in Florida to 6.3 in Nebraska

Eliminating Extreme Poverty Requires Urgent Focus on Fragile and Conflict-Affected Countries – WB

Urgent action is needed in countries impacted by fragility, conflict and violence (FCV) to end extreme poverty globally, according to the World Bank Group.

As crisis situations become increasingly protracted — with dire impacts on people and economies — the World Bank Group on Tuesday released an FCV strategy, which for the first time systematically brings a full suite of financing and expertise to address these challenges in both low-and-middle income countries. 

On the current trajectory, by 2030 up to two-thirds of the world’s extreme poor will live in fragile and conflict-affected countries, according to a World Bank report also released today. Bucking the overall trend of a global decrease in extreme poverty, these countries are seeing sharp increases, threatening decades of progress in the fight against poverty. Fragile and conflict-affected situations take a huge toll on human capital, creating vicious cycles that lower people’s lifetime productivity and earnings and reduce socioeconomic mobility. One in five people in these countries are deprived of money, education and basic infrastructure simultaneously. And the number of people living in close proximity to conflict has nearly doubled in the past 10 years.

 “Addressing humanitarian crises requires immediate support and long-term development approaches,” said World Bank Group President David Malpass. “To end extreme poverty and break the cycle of fragility, conflict, and violence, countries need to ensure access to basic services, transparent and accountable government institutions, and economic and social inclusion of the most marginalized communities. These kinds of investments go hand in hand with humanitarian aid.”

The World Bank Group, founded to support post-conflict reconstruction in Europe after World War II, now emphasizes working before, during, and after crisis situations to tackle poverty. It emphasizes prevention by proactively addressing the root causes of conflict — such as social and economic exclusion, climate change and demographic shocks — before tensions turn into full-blown crises. During active conflict, it focuses on building institutional resilience and preserving essential services like health and education for the most vulnerable communities. 

The strategy also emphasizes long-term support to help countries transition out of fragility, including private sector solutions, such as scaling-up investments in small and medium enterprises that are essential to create jobs and spur economic growth. It addresses the cross-border impacts of FCV, for example by focusing on the development needs of both refugees and host communities.

This institutional shift is backed by increases in financing, both through the World Bank’s General Capital Increase and through the recently approved replenishment of IDA, the World Bank’s fund for the poorest countries, which included over $20 billion for FCV. The Bank and IFC will also make key operational changes, such as deploying more staff and resources to countries impacted by FCV and partnering with a range of international and local actors. IFC and MIGA have also committed to significantly increase their support to private sector investments in economies impacted by FCV.

Looming famine in Yemen could put two million mothers at risk of death – UN agency

UN OCHA/Giles Clarke Four months-old Saleh, admitted in Al Hudaydah’s main hospital in April 2017, and his mother Nora. Close to half a million children and two million mothers in Yemen are at risk of dying from severe acute malnutrition due to ongoing conflict.

The critical difficulties in accessing food in Yemen, and other hardships caused by the ongoing conflict, could lead to the world’s worst famine ever, and place up to two million malnourished, pregnant and lactating women at risk of death, the UN sexual and reproductive health agency, UNFPA, said on Thursday.

“Lack of food, displacement, poor nutrition, disease outbreaks and eroding healthcare have heavily affected the health and well-being of 1.1 million malnourished pregnant and lactating women, causing numerous cases of premature or low-birth weight babies, severe postpartum bleeding, and extremely life-threatening labor processes,” UNFPA warned, adding that if the situation continues to deteriorate, up to two million mothers could end up being affected.

Since conflict escalated in Yemen in 2015 between non-state armed groups and a Saudi-led coalition in support of the Government, constant shelling and bombing has destroyed key civilian infrastructure across the country. Although targeting medical facilities is strictly forbidden under humanitarian law, nearly half of the health facilities are no longer operational, including those established to provide reproductive health services. As a result, many of these women go undiagnosed and untreated.

This past August, for example, Al Thawra, Al Hudaydah’s largest hospital – the only hospital of the area which provides critical neo-natal and emergency care – was attacked, putting the city’s almost 90,000 pregnant women and girls at great risk.

“I felt I was in hell because of what I saw,” said midwife Noha, who was working at the hospital’s obstetric ward when the attack took place on 2 August. “Now pregnant women prefer to give birth at home, where they are exposed to many risks and problems. They do not come to the hospital out of fear for their lives,” she explained.

The humanitarian crisis in Yemen is one of the worst in the world, with three quarters of the population requiring some form of life-saving assistance and protection, according to the UN’s humanitarian coordination office (OCHA). The conflict has rendered civilians’ access to food increasingly difficult through a combination of factors, including unprecedented inflation, import controls, and limited freedom of movement.

“There is now a clear and present danger of an imminent and great big famine engulfing Yemen: much bigger than anything any professional in this field has seen during their working lives,” UN humanitarian chief, Mark Lowcock told the UN Security Council last week.

Although the humanitarian crisis in Yemen is one of the world’s best funded crises, with 71 per cent of the 2018 appeal funded to date, the needs continue to grow and outpace the response. Working with limited funding, UNFPA’s support to the 184 health facilities that offer reproductive health services may stop if additional resources do not become available urgently.