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Date: Tue, 30 Aug 2016 12:42:07 +0200

Tokyo, Aug 30, 2016 (AFP) - A strong typhoon slammed into north-eastern Japan on Tuesday, dumping heavy rain and generating high waves that caused flooding along the Pacific coast.   Typhoon Lionrock made landfall near the city of Ofunato shortly before 6 pm (0900 GMT), the Japan Meteorological Agency said, after moving up Japan's Pacific Ocean coastline.   Packing wind gusts up to 162 kilometres (100 miles) per hour, the storm was moving northwest at 50 kilometres per hour, it said.

It is the first typhoon to directly land in the region from the Pacific Ocean since the country's present weather observation system was introduced in 1951, the agency said.   Typhoons usually approach Japan from the south and southwest before moving northward across the archipelago.   While there were no official reports of casualties, local media reported some minor injuries, such as a fall by a 40-year-old woman in strong winds.

Authorities warned of landslides and high water due to expected heavy rain of up to eight centimetres per hour. Landfall, which came at high tide, brought flooding along the coast.   Television footage showed local residents struggling to walk amid water above their knees in the city of Miyako, where some cars were half-submerged and some 600 people were advised to evacuate.

Miyako was one of the northeastern coastline cities hit in March 2011 by a deadly tsunami generated by a massive magnitude 9.0 offshore earthquake, which also triggered meltdown at the Fukushima Daiichi nuclear plant.   Local authorities were using heavy machinery to pile huge sandbags along the coast in a bid to hold back raging waves, as they opened up some public buildings for use as shelters.    Schools were closed across the affected area, broadcasters reported.

At the crippled Fukushima Daiichi nuclear plant, efforts were made to secure construction cranes and equipment from violent winds, operator Tokyo Electric Power Co said. Some sensitive decommissioning work was suspended, they added.   The typhoon was affecting manufacturing and travel, with Toyota suspending production at two of its plants in the region, the company said, though added they were expected to restart on Wednesday.

Some 120 domestic flights have also been cancelled, public broadcaster NHK said.   In the northern part of the country, some Shinkansen super fast bullet trains were suspended.   Lionrock comes on the heels of two others that hit Japan in the past nine days, resulting in two deaths, the cancellation of hundreds of domestic flights and disruptions to train services.

Formed more than 10 days ago, it has become the longest-lasting typhoon of those that have developed north of the 30th parallel north, breaking a 46-year-old record, according to the private Weathernews agency.   The previous record-holding typhoon in that category was in 1970, which survived for nine days and six hours, Weathernews said on its website.   Lionrock was expected to cut across Japan's main island of Honshu and head out to sea towards Russia and China, according to the weather agency.
Date: Tue, 30 Aug 2016 07:08:20 +0200

Miami, Aug 30, 2016 (AFP) - Hurricane Madeline is expected to pass near Hawaii midweek, US weather forecasters said Monday, threatening dangerous flooding and disruptions to a planned visit by President Barack Obama and other dignitaries.   Currently a Category Three hurricane, Madeline is expected to pass "dangerously close" to Hawaii's Big Island on Wednesday, carrying heavy rain and strong winds, the US National Weather Service said.   The hurricane was some 575 miles (925 kilometers) east of Hilo, Hawaii at 0300 GMT Tuesday.   The storm has maximum sustained winds of 125 miles per hour, and was moving toward west-northwest at around 10 miles per hour.

Madeline was expected to begin turning gradually to the west, then move west-southwest Tuesday night into Wednesday.   It is expected to dump five to 10 inches (12.7 to 25.4 centimeters) of rain on Hawaii, with some areas receiving up to 15 inches.   "This rainfall may lead to dangerous flash floods and mudslides," the NWS Central Pacific Hurricane Center said.   Madeline's current path in the central Pacific could also coincide with Obama's planned visit to Hawaii to kick off the World Conservation Congress, a major meeting of thousands of delegates, including heads of state, scientists and policy makers.

The International Union for the Conservation of Nature stages the World Conservation Congress every four years at a different location around the globe.   It is set to take place from Thursday to next Saturday.   Obama is scheduled to address the gathering on its opening day.   He is also expected to travel to Midway Atoll, inside a newly named protected area, where the president burnished his environmental bona fides last week by establishing the world's largest marine reserve, home to thousands of rare sea creatures in the northwestern Hawaiian islands.

Meanwhile, another hurricane in the Atlantic, Gaston, was downgraded to a Category Two storm, US weather trackers said.  A Category Three hurricane earlier on Monday, Gaston was the first major hurricane of the Atlantic season.   The storm was packing top sustained winds of 105 miles per hour as of 0300 GMT Tuesday, around 600 miles east of Bermuda, the Miami-based National Hurricane Center said.   It was moving to the northeast at six miles per hour.   The storm was not an immediate threat to land, and was expected to remain near its current strength, picking up speed as it travels toward the northeast over the next couple of days, forecasters said.
Date: Mon, 29 Aug 2016 16:52:54 +0200
By Elizabeth LAW

Singapore, Aug 29, 2016 (AFP) - Singapore on Monday confirmed more Zika infections, bringing the total number of cases past 50 as mosquito-fighting teams saturated the scene of the outbreak amid growing public alarm.   In a statement, the Ministry of Health and the National Environment Agency said they had found 15 new cases of locally transmitted Zika virus, all in an eastern suburban area known as Aljunied, up from 41 on Sunday.    Most of those affected were foreign workers at a condominium construction project.   Nearly all have recovered, but doctors said more Singaporean women were asking to be tested.

In pregnant women, Zika can cause microcephaly, a deformation in which babies are born with abnormally small brains and heads.   On Monday, inspectors from the environment agency checking for mosquito-breeding sites visited homes in the area as well as dormitories housing foreign workers.    "It's quite frightening because I thought Zika is something happening on the other side of the world. But now it's right here in my neighbourhood," customer service manager Josephine Kwan, who lives in the affected suburb, told AFP.

- Construction sites breed mosquitoes -
Singapore, despite the highest health care standards in Southeast Asia, is a densely populated tropical island with frequent rain. Mosquitoes breed in stagnant water that collects in construction sites, open space and homes.   It is also one of Asia's cleanest cities but has a chronic problem with dengue fever, which is spread by the same Aedes mosquito that carries the Zika virus.   Singapore's first reported case of Zika in May involved a man who had visited Sao Paulo in Brazil earlier in the year.   But all of the latest cases involved local transmission.

The Straits Times newspaper quoted local doctor Tan Thai Keng, whose surgery reported four of the latest cases, as saying more women were visiting the clinic as news of the outbreak spread.   They included a pregnant 32-year-old.   "She wanted to find out whether she had the virus in her blood or not. So we took her blood here and sent it to the lab at Tan Tock Seng," he said, referring to the main national hospital for communicable diseases.

Neighbouring countries took steps to prevent the spread of the disease from Singapore.    Taiwan on Monday issued a travel advisory for Singapore, urging travellers to watch out for mosquito bites and cautioning pregnant women and those planning to conceive to postpone trips to all areas with Zika cases.

Malaysia, Indonesia and the Philippines have also said health officers will closely monitor arrivals from Singapore, which was visited by 15 million people in 2015.    In the city-state inspectors armed with insecticide spray cans on Monday visited high-rise public housing flats to check toilets and other areas for stagnant water.

Owners of homes found with such sites can be fined up to Sg$5,000 ($3,700).   The environment agency said it had inspected 3,600 premises and found and destroyed 36 mosquito "breeding habitats".   Contractors in protective gear carried out insecticide fogging in public places, pumping a mosquito-killing mist over large areas on the ground.

Of the 41 Zika cases confirmed Sunday by the government, 36 were foreigners working at a condominium construction site.   Work was halted at the site on Saturday after environment agency officers found that housekeeping was "unsatisfactory with potential breeding habitats" for mosquitoes.   The latest global outbreak of the disease began in Brazil in early 2015.
Date: Mon, 29 Aug 2016 16:17:29 +0200

Kasserine, Tunisia, Aug 29, 2016 (AFP) - Three Tunisian soldiers were killed in an explosion set off by "terrorists" on Monday near Mount Sammama, a hideout for jihadists at war with the authorities, the defence ministry said.   Defence ministry spokesman Belhassen Oueslati told Mosaique Radio FM that "terrorist elements launched an attack with a large quantity of explosives on a military patrol providing security for workers" tarring a road.

Three soldiers were killed and seven wounded, he said, adding that two militants were believed to have been killed by army fire and their bodies removed.  Mosaique FM radio said earlier that a blast hit a military vehicle as soldiers combed an area near the town of Kasserine.   The violence came on the same day a new unity government took office in Tunisia with security among its top priorities.

Jihadist attacks in Tunisia have cost dozens of lives among security forces as well as civilians, and 59 foreign tourists were also killed in 2015.   Tunisian forces have been tracking jihadists mainly in the mountainous regions of Chaambi and Sammama, southwest of the capital Tunis.
Date: Mon, 29 Aug 2016 11:43:25 +0200

Oslo, Aug 29, 2016 (AFP) - More than 300 wild reindeer have been killed by lightning in southern Norway, Norwegian officials said Monday, in the largest such incident known to date.   The 323 reindeer, including 70 young, were found on Friday by a gamekeeper on the Hardangervidda plateau, a national park where Europe's largest herd of some 10,000 wild reindeer roam freely.

Television footage showed the animals' dead bodies lying close together on the ground.   "There were very strong storms in the area on Friday. The animals stay close together in bad weather and these ones were hit by lightning," an official from the Norwegian Environment Agency, Kjartan Knutsen, told AFP.

Reindeer are social creatures and usually move in packs.   "It's unusual. We've never seen anything like this on this scale," Knutsen said.   Norwegian authorities have yet to decide what to do with the animals.   "We're going to decide soon whether to let nature run its own course or whether we will do something," he said.   Of the 323 reindeer killed, five had to be put down due to their injuries.   Thee are some 25,000 wild tundra reindeer in Norway, located in the southern mountain ranges, according to experts.
Date: Mon, 29 Aug 2016 11:17:03 +0200

Tokyo, Aug 29, 2016 (AFP) - Japan braced Monday for a powerful typhoon -- the third in little more than a week -- and authorities warned of heavy rain, high waves and flooding after the previous storms killed two people.   Typhoon Lionrock, described as "strong", was likely to come ashore northeast of Tokyo on Tuesday before cutting across the country's main island of Honshu and heading out to sea towards Russia and China, the Japan Meteorological Agency said.   At 3:00 pm (0600 GMT) Monday, Lionrock was 330 kilometres (210 miles) east of Hachijo island in the Pacific Ocean southeast of Tokyo, the agency said.

The typhoon, with gusts up to 216 kilometres (135 miles) per hour, was moving northeast at 25 kilometres per hour, the agency said, and was likely to make landfall in northeast Japan on Tuesday afternoon or evening.   "The most significant factor will be heavy rain," agency chief forecaster Tsumoru Matsumoto told a press briefing.   "In advance of the typhoon's approach, we expect heavy rain in wide areas in eastern and northern Japan."   Authorities have also issued warnings for high waves, strong winds and flooding for the area, saying that those could be upgraded Tuesday.

Prime Minister Shinzo Abe, who attended a weekend Africa aid conference in Nairobi, left Kenya hours earlier than planned to get back before the storm hits.   Lionrock comes on the heels of two typhoons that hit Japan in the past eight days and resulted in two deaths.   The storms also caused the cancellation of hundreds of domestic flights, while train services were also disrupted.   The agency attributed the unusual number of typhoons approaching Japan in such a short period to a high-pressure system in the Pacific east of Japan.
Date: Mon, 29 Aug 2016 08:33:25 +0200

Kabul, Aug 29, 2016 (AFP) - Afghanistan launched a polio vaccination campaign on Monday aimed at reaching children in areas previously controlled by Islamic State group militants, officials said.   Afghanistan and Pakistan are the only two countries in the world where polio remains endemic -- a fact blamed on opposition to immunisation by Islamist groups, who claim the vaccines are a conspiracy to sterilise Muslims or a cover for spying.

The latest five-day drive will look to reach about 9.5 million children nationwide, the health ministry's Sardar Parwiz told AFP, with officials hoping to take advantage of reduced fighting in the east following successes from US-backed military operations.    "We have already started contacting locals in areas retaken from Daesh (IS). We will send our teams to those areas, but if they face any problems, we will ask locals to transport their children to our clinics in safer areas," he said.

Fighters pledging allegiance to the IS group had been in control of several districts in eastern Nangarhar province on the border with Pakistan, before they were pushed out by Afghan and NATO forces.   Last month, Afghan troops backed by US airstrikes seized large parts of the mountainous district of Kot in Nangarhar, a key IS stronghold where the jihadists set up Sharia courts and training camps displaying their trademark black flag.

Najibullah Kamawal, the head of the health department in Nangarhar said some districts had been unreachable for over a year, leaving thousands of children without medical assistance.   "It is a challenge, it is risky, but we are determined to go to every village and vaccinate the kids," he said.   Noorul Habib a teacher in Kot district told AFP by phone the elders and the local population were determined to support the campaign.   "We know polio is dangerous, we will do our best to support this campaign. All the elders have sent messages to militants not to disrupt the campaign. We have also told them not to destroy mosques, clinics and schools," he said.   Afghanistan registered eight polio cases, mostly in the eastern part of the country in the first half of the year, according to ministry of health. Most of them believed to have been imported from Pakistan.
Date: Sun, 28 Aug 2016 05:40:15 +0200
By Marion THIBAUT

Vientiane, Aug 28, 2016 (AFP) - "Look at me, stay with us," the paramedics shout as a barely conscious motorcyclist is bundled into a volunteer ambulance in the Laotian capital Vientiane, where rampant drink driving brings nightly carnage to the roads.   It is a grim scene familiar the world over. 

But in Laos, an impoverished and authoritarian communist country with almost no state-funded medical services, these kind of vital lifesavers are volunteers and entirely funded by donations.   And they have never been more in demand.   By the time the crew arrive at a nearby hospital, the Japanese donated ambulance -- a right hand drive vehicle in a left hand drive nation -- has picked up two more injured on the way. Fresh calls for help are coming in all the time.

Founded in 2010 by a group of foreigners, "Vientiane Rescue" is a much needed lifeline for those in need of urgent medical care.    "Before we launched this service, after an accident the wounded were simply left on the roadside or taken away in tuk-tuks. That's obviously disastrous for those with fractures or trauma," explained S├ębastien Perret, a French national and former firefighter who helped found the group.   Poorly maintained roads, dilapidated vehicles, an increase in motorcycle use and the widespread prevalence of drink driving makes Vientiane one of Asia's most precarious capitals for road deaths.

- Years of rapid growth -
The government keeps few statistics, but Perret's group says demand for their services has jumped 30 percent in the last year alone.    "We undertake around 20 to 30 call outs a day. And in 90 percent of cases it is road accidents," he said.   There was a time when Vientiane was famed for its lack of cars.    Backpackers passing through the city in the 1990s would marvel at the wide, French-built boulevards devoid of heavy traffic, bicycles and tuk-tuks the main form of transport.

But years of rapid growth has seen the same streets filled with vehicles in recent years, many of them brand new SUVs and luxury cars driven by the country's communist party elite.    That wealth -- and the volunteer ambulances scooping victims up from the road -- are both a stark illustration of how public services in communist Laos are largely nascent or non-existent despite being one of Asia's fastest growing economies over the last decade.   In the 1990s the country's rulers abandoned free healthcare altogether, meaning ordinary citizens must fend for themselves when they get ill.

- Minimal health spend -
Since 2000, Laos' GDP has increased 12 times, reaching $12.3 billion in 2015.    But the country currently has one of the world's lowest spends on healthcare.    In recent years it has averaged just 0.5 percent of GDP according to the World Bank.    In contrast, similarly impoverished Cambodia spends 1.3 percent while fellow communist nations Vietnam and Cuba spend 3.8 percent and 10.6 percent of GDP respectively.

The Health Ministry in Laos, a country where all foreign journalists must be accompanied by a government minder, declined an AFP interview but did issue a brief statement via email.   In it they admitted there was a shortage of good healthcare.    "The main problems for hospitals in Laos is the lack of qualified staff, equipment, coaching and financial resources," the statement said.   But the ministry did not say whether there were any plans to increase healthcare spending or to tackle the issues in the coming years.   Volunteer groups plug some of the gaps, but even they face shortages.    At Vientiane Rescue bandages are washed and re-used, while several of their ambulances are crudely converted cars.

The service operates 24-hours a day, seven days a week and has also recently expanded into firefighting teams and specialists to counter drownings.   Most of those volunteering are students who are sent to Thailand for first aid training.   Mee Thevanh, 24, began volunteering after she was involved in a motorbike accident and had to make her own way to hospital.    "After that I decided to become a volunteer. I spend most of my nights here," she said in a short break between emergencies.    She admits that like many compatriots she used to regularly drink and drive. But no more.    "And I've calmed down since," she said.
Date: Fri, 26 Aug 2016 05:22:38 +0200
By Pierre DONADIEU

Gorongosa, Mozambique, Aug 26, 2016 (AFP) - Passing through the aged faded gates into Gorongosa National Park, it's difficult to imagine you've just entered Mozambique's largest wildlife sanctuary.   Bled dry by a long civil war that ravaged Mozambique from 1976 to 1992, the park has seen a remarkable turnaround in the last decade.   But even as it rises from the ashes, a fresh bout of conflict and a devastating drought threaten to undermine its revival.

Big mammals like elephants and buffalos are still rare in this 4,000 square kilometre (1,544 square-mile) reserve, but a restoration project launched by American philanthropist Greg Carr in 2004 has seen the return of species once on the brink of extinction.   "Before the launch of this project, we were heading towards extinction," Gorongosa conservation head Pedro Muagara told AFP.   "Now, in terms of reproduction, there are very positive signs. The numbers are growing."   Today, the park has more than 72,000 animals from 20 different species, mainly antelopes and zebras.   But even as wild life returned to Gorongosa, political tensions were growing.

Since 2013, sporadic fighting has broken out between government forces and rebels from the main opposition Renamo party.   Refusing to accept the results of the 2014 national vote, Renamo leader Afonso Dhlakama has holed himself up in the mountains bordering the park.   For villagers fleeing the unrest, the unfenced Gorongosa has proved an easy refuge and food source.   Decked out in his khaki ranger's uniform, Muagara is one of the 150 armed rangers protecting animals from poachers and illegal hunters.   "With the fighting, the park has become a real target because the communities can no longer sustain themselves, so they hunt the animals instead," he said.

- Tourists scared -
An ongoing regional drought sparked by the El Nino weather phenomenon that has ravaged southern Africa for two years has also presented a new challenge, drying up several rivers in the park.   Animals desperate for water now congregate around the few remaining water sources, making them easy targets for poachers.   Faced with the unrelenting scourge of poaching, the park dedicates much of its rehabilitation programmes to educating local communities.   "We're trying to offer them alternatives, like farming options, for example," Gorongosa director of human development Manuel Mutimucuio told AFP.   At the end of the long track cutting through the thick forest is a glistening blue swimming pool at a luxury hotel completely renovated in 2012.   But  today the facility stands empty, deserted by tourists frightened by the conflict. Only a few researchers remain in the luxurious rondavels.

In 2012, Gorongosa received 7,000 registered visitors. Today, even with the fighting confined to the park's extreme north, that number has plummeted to less than 1,000 - mostly expatriates living in the capital Maputo, and South African tourists better informed of the situation on the ground.   "Unfortunately, today we have just four tourists - everybody else here works either directly or indirectly for the park," said hotel manager Paolo Matos, who took up the position just weeks before tensions escalated in 2013.   "We're losing a lot of money."   With Gorongosa's turnaround once again threatened, park employees want to believe in the promise of better days, drawing hope from ongoing peace talks between Renamo and the government.   "During the civil war, everything was destroyed and we rebuilt," sighed Menesses Sousa, a park employee since 1974, before the war.   "But today it's starting again, and I don't what will happen."
Date: Mon 29 Aug 2016
From: Sher Bahadur Pun <drsherbdr@yahoo.com> [edited]

A 62 year old male resident of Thakre village development committee-3, Dhading district, presented (on 21 Aug 2016) to OPD of the Sukraraj Tropical and Infectious Disease Hospital with history of fever with chills, severe lower joint pain and red eyes for 13 days. An eschar was seen in the right axillary region, but he did not develop rash. He tested positive for scrub typhus (ELISA method). The patient was an earthquake victim and has been living with his family in the temporary shelter.

According to him, at least 70 people (relatives and neighbours) had developed fever with other symptoms similar to those of scrub typhus during that time, suggesting that a large outbreak of scrub typhus may have occurred in Dhading district.

According to the Epidemiology and Disease Control Division, so far at least 176 people are reported to have contracted scrub typhus, and 5 of them have died. However, a large number of cases probably are being underreported, and the actual number of scrub typhus cases may be much higher than reported by the government.
-----------------------------------
Dr Sher Bahadur Pun, MD, PhD
Clinical Research Unit
Sukraraj Tropical and Infectious Disease Hospital
Kathmandu, Nepal
====================
[ProMED-mail thanks Dr Sher Bahadur Pun for his continued contributions.

Maps of Nepal can be seen at <http://ncthakur.itgo.com/map04.htm> (regions and districts) and <http://healthmap.org/promed/p/22822>. Dhading District, with a population of 336 067 in 2011 (<https://en.wikipedia.org/wiki/Dhading_District>), is located west of Kathmandu District in the Bagmati Zone in the Central Region of Nepal. - ProMED Mod.ML]

[A HealthMap/ProMED-mail map can be accessed at: