Chart showing distribution of whooping cough cases by state through June 9 2012 and the personal exemptions status of the state. Prepared by Charles Simmins. Click for a larger image.

Whooping cough cases in the United States jumped by at least 1,421 in the last week, according to the Centers for Disease Control (CDC) and several state health departments that are posting their own data. The data is for week 23, through June 9, 2012. Cases counts for the year are preliminary and will not be finalized for about 18 months.
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The Washington State Department of Health (DoH) has released its latest data on the continuing whooping cough epidemic in the state. For 2012, through May 19, 1,736 cases of pertussis have been reported. For the same period in 2011, there were 146 cases.

The Centers for Disease Control (CDC) have the latest data on immunization rates in the state of Washington. The data was provided for students entering kindergarten and those entering sixth grade. The 2010-2011 school year is the latest data.
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As of 25 December 2008, a total of 26 497 cases, including 1 518 deaths, have been reported by the Ministry of Health in Zimbabwe. Cases are now being reported from all 10 of the country’s provinces. Harare, particularly Budiriro suburb in the south west, accounts for the majority of cases, followed by Beitbridge in Matabeleland South and Mudzi in Mashonaland East. The current outbreak is the largest ever recorded in Zimbabwe and is not yet under control. In fact, the epidemiological week ending 20 December saw over 5 000 new cases – an increase in the number of weekly cases relative to previous weeks – and an increase in deaths outside treatment/health centres.

The overall Case Fatality Rate (CFR) has risen to 5.7% – far above the 1% which is normal in large outbreaks – and in some rural areas it has reached as high as 50%. Mortality outside of healthcare facilities remains very high. This is a clear indication that better case management and access to healthcare is needed – in particular an increased use of oral rehydration therapy with Oral Rehydration Salts in communities very early after onset of the disease.

The outbreak has taken on a subregional dimension with cases being reported from neighboring countries. In South Africa as of 26 December, 1 279 cumulative cases and 12 deaths (CFR of 0.9%) had been recorded, with the bulk of the cases (1 194) in the Limpopo area. Cases have also been reported in Botswana (Palm Tree).

The current situation is closely linked to the lack of safe drinking water, poor sanitation, declining health infrastructure, and reduced numbers of healthcare staff reporting to work. Other current risk factors include the commencement of the rainy season and the movement of people within the country, and possibly across borders, during the Christmas season. WHO, together with the Ministry of Health and partners from the health and Water and Sanitation clusters, has established a cholera outbreak response coordination unit in order to strengthen the reporting and early detection of cases, improve the response mechanism and access to healthcare and ensure proper case management. WHO has also deployed experts in public health, water and sanitation, logistics and social mobilization. In light of the extent and pace of expansion of the outbreak, reinforcing all control activities across the country is critical.

Given the current dynamic of the outbreak and the context of the collapsed health system, a cholera vaccination is not recommended. Moreover, the use of the internationally available WHO prequalified oral cholera vaccine is not recommended once an outbreak has started due to its 2-dose regimen and the time required to reach protective efficacy, high cost and the heavy logistics associated to its use. The use of the parenteral cholera vaccine has never been recommended by WHO due to its low protective efficacy and the occurrence of severe adverse events.

In controlling the spread of cholera WHO does not recommend any special restrictions to travel or trade to or from affected areas. However, neighboring countries are encouraged to reinforce their active surveillance and preparedness systems. Mass chemoprophylaxis is strongly discouraged, as it has no effect on the spread of cholera, can have adverse effects by increasing antimicrobial resistance and provides a false sense of security.

WHO

2 January 2009 — The Ministry of Health of the Democratic Republic of the Congo (DRC) is continuing to respond to the ongoing outbreak of Ebola haemorrhagic fever in the Mweka health zone, Province of Kasai Occidental with the support of a wide range of international partners.

As of 31st December there has been a total of 3 laboratory-confirmed cases of Ebola haemorrhagic fever. WHO is aware of 36 additional suspected cases including 12 deaths associated with this outbreak. A further 184 contacts have been identified and are being followed up.

Laboratory analysis was undertaken at the Institut National de Recherches Biomédicales (INRB) in Kinshasa , DRC , the Centre International de Recherches Médicales de Franceville (CIRMF), Gabon, and the National Institute for Communicable Diseases (NICD), South Africa.

The WHO Country Office, Regional Office and Headquarters are supporting the MoH in Kinshasa, in Kananga and in the field at the location of the outbreak. WHO has deployed five vehicles to the field and has sent outbreak response equipment and medical supplies. The local health authorities in the affected area are working closely with social mobilization experts to develop key information messages for the local communities.

The international response to the outbreak includes partners from Caritas (Belgium), the Congolese Red Cross (DRC) , Médecins Sans Frontières (Belgium), UNICEF, the United Nations Organization Mission in the Democratic Republic of the Congo (MONUC), and the World Food Programme (WFP) .

WHO

I just returned from a mandated course on Weapons of Mass Destruction that is required for my NYS EMT recertification. It was a steaming pile of crap.

The “All Hazards” approach is the one being taught now. So, for the first 45 minutes we talked about how little money the US has offered Burma for cyclone relief and how the “government” failed the people of New Orleans. You see, all those people who had been cared for by the government for four generations were abandoned and they didn’t know enough to evacuate on their own.

So, the talk began with liberal politics and continued in that manner.

Explosives has been added to the list of Weapons of Mass Destruction. Follow me on this, it’s interesting. The instructor points to Oklahoma City, then moves to “We’ve all been exposed to WMD” as slides appear showing firearms. Yes, the Public Health weenies that consider firearms crimes as an epidemic have infected WMD training.

Columbine was a WMD event, apparently, though I somehow missed that announcement. Now I know because I took the NYS class.

Oh, and BTW, the people that died at the WTC did so because they were following their emergency plan. I guess Rick Rescorla was an idiot.

Essentially, the class was an exercise in attempting to conflate civilian incidents, including but not limited to haz mat incidents, with WMD attacks. Eric Rudolph came up as an example. Crazed bombers like him and Ted Kuzinscki are WMD for our purposes.

Curiously, the instructor maintained that there had never been an insurgent terrorist attack on US soil. I recalled for her the FALN attack on Congress in the late 1940′s and the Black Muslim attack in Washington in the 1970′s. I could have gone on but she wanted to talk about other matters.

We got the usual crap about bird flu and pandemics, without a mention that most people have lived through at least one flu pandemic.

And… as a final criticism, she managed to discuss car bombs without mentioning that both Oklahoma City and WTC I were VIED’s.