A Yellow Fever Epidemic: A New Global Health Emergency?

The worst yellow fever epidemic in Angola since 1986 is rapidly spreading, including the capital, Luanda. In Angola, the epidemic began in December 2015 and the laboratory-confirmed outbreak was reported to the World Health Organization (WHO) on January 21, 2016. Angola has had 2023 suspected cases and 258 deaths as of April 26, 2016. China, the Democratic Republic of Congo, and Kenya also have reported cases arising from infected travelers from Angola. Namibia and Zambia also share a long border with Angola, with considerable population movement between the countries. Similar to other recent epidemics, quick and effective action to stop the spread of yellow fever is the responsibility of the world’s health community

The Emerging Zika Pandemic: Enhancing Preparedness

The Zika virus (ZIKV), a flavivirus related to yellow fever, dengue, West Nile, and Japanese encephalitis, originated in the Zika forest in Uganda and was discovered in a rhesus monkey in 1947. The disease now has “explosive” pandemic potential, with outbreaks in Africa, Southeast Asia, the Pacific Islands, and the Americas. Since Brazil reported Zika virus in May 2015, infections have occurred in at least 20 countries in the Americas. Puerto Rico reported the first locally transmitted infection in December 2015, but Zika is likely to spread to the United States. The Aedes species mosquito (an aggressive daytime biter) that transmits Zika virus (as well as dengue, chikungunya, and yellow fever) occurs worldwide, posing a high risk for global transmission. Modeling anticipates significant international spread by travelers from Brazil to the rest of the Americas, Europe, and Asia. What steps are required now to shore up preparedness in the Americas and worldwide

The Ebola Epidemic: A Public Health Emergency of International Concern

On August 8, 2014, the World Health Organization (WHO) Director-General Margaret Chan declared the West Africa Ebola crises a “public health emergency of international concern,” triggering powers under the 2005 International Health Regulations (IHR). The most affected West African states have attempted classic public health measures with varied success, including quarantine and isolation, social distancing, risk communication, and travel restrictions. These have involved a trade off between population health and human rights; sometimes to the disadvantage of both. At the same time, the countries’ health systems and human resources are fragile, impeding an effective response. Beyond the public health and humanitarian implications, this crisis has raised controversial ethical issues concerning the withholding or providing early access to investigational therapies, the preference given to foreign aid workers, and the disproportionate impact of Ebola on domestic health care workers. The WHO director-general’s declaration of a public health emergency of international concern underscores the urgency of a coordinated international response and the imperative of raising the health systems capacity of low-income states. However, the current outbreak demonstrates how global governance has suffered from a lack of binding international commitment to sustainable capacity building and technical assistance in low-income states

Emerging dynamics of human campylobacteriosis in Southern Ireland

Infections with Campylobacter spp. pose a significant health burden worldwide. The significance of Campylobacter jejuni/Campylobacter coli infection is well appreciated but the contribution of non-C. jejuni/C. coli spp. to human gastroenteritis is largely unknown. In this study, we employed a two-tiered molecular study on 7194 patient faecal samples received by the Microbiology Department in Cork University Hospital during 2009. The first step, using EntericBio® (Serosep), a multiplex PCR system, detected Campylobacter to the genus level. The second step, utilizing Campylobacter species-specific PCR identified to the species level. A total of 340 samples were confirmed as Campylobacter genus positive, 329 of which were identified to species level with 33 samples containing mixed Campylobacter infections. Campylobacter jejuni, present in 72.4% of samples, was the most common species detected, however, 27.4% of patient samples contained non-C. jejuni/C. coli spp.; Campylobacter fetus (2.4%), Campylobacter upsaliensis (1.2%), Campylobacter hyointestinalis (1.5%), Campylobacter lari (0.6%) and an emerging species, Campylobacter ureolyticus (24.4%). We report a prominent seasonal distribution for campylobacteriosis (Spring with C. ureolyticus (March) preceeding slightly C. jejuni/C. coli (April/May)

Campylobacter ureolyticus: an emerging gastrointestinal pathogen?

A total of 7194 faecal samples collected over a 1-year period from patients presenting with diarrhoea were screened for Campylobacter spp. using EntericBios, a multiplex-PCR system. Of 349 Campylobacter-positive samples, 23.8% were shown to be Campylobacter ureolyticus, using a combination of 16S rRNA gene analysis and highly specific primers targeting the HSP60 gene of this organism. This is, to the best of our knowledge, the first report of C. ureolyticus in the faeces of patients presenting with gastroenteritis and may suggest a role for this organism as an emerging enteric pathogen

The Dipole Anisotropy of the First All-Sky X-ray Cluster Sample

We combine the recently published CIZA galaxy cluster catalogue with the XBACs cluster sample to produce the first all-sky catalogue of X-ray clusters in order to examine the origins of the Local Group's peculiar velocity without the use of reconstruction methods to fill the traditional Zone of Avoidance. The advantages of this approach are (i) X-ray emitting clusters tend to trace the deepest potential wells and therefore have the greatest effect on the dynamics of the Local Group and (ii) our all-sky sample provides data for nearly a quarter of the sky that is largely incomplete in optical cluster catalogues. We find that the direction of the Local Group's peculiar velocity is well aligned with the CMB as early as the Great Attractor region 40 h^-1 Mpc away, but that the amplitude of its dipole motion is largely set between 140 and 160 h^-1 Mpc. Unlike previous studies using galaxy samples, we find that without Virgo included, roughly ~70% of our dipole signal comes from mass concentrations at large distances (>60 h^-1 Mpc) and does not flatten, indicating isotropy in the cluster distribution, until at least 160 h^-1 Mpc. We also present a detailed discussion of our dipole profile, linking observed features to the structures and superclusters that produce them. We find that most of the dipole signal can be attributed to the Shapley supercluster centered at about 150 h^-1 Mpc and a handful of very massive individual clusters, some of which are newly discovered and lie well in the Zone of Avoidance.Comment: 15 Pages, 9 Figures. Accepted by Ap

Integronlike Structures in Campylobacter spp. of Human and Animal Origin

Resistance to antimicrobial agents used to treat severe Campylobacter spp. gastroenteritis is increasing worldwide. We assessed the antimicrobial resistance patterns of Campylobacter spp. isolates of human and animal origin. More than half (n = 32) were resistant to sulphonamide, a feature known to be associated with the presence of integrons. Analysis of these integrons will further our understanding of Campylobacter spp. epidemiology