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Date: Wed, 23 Aug 2017 10:40:35 +0200

Tokyo, Aug 23, 2017 (AFP) - Guam's number two politican Wednesday rolled out the welcome mat to tourists, promising his sun-kissed tropical island is safe -- despite North Korea's threat to launch missiles toward the Pacific US territory.   Lieutenant Governor Raymond Tenorio made the comments in Tokyo where he was joined by Guam's tourism boss Jon Nathan Denight, amid fears that Pyongyang's sabre-rattling will hammer the key tourism industry.

Last year, Japanese tourists made up about half of the 1.5 million visitors to the island, which is about a four-hour flight from Tokyo.   "We're one of the most protected and safe islands you'll find in the world," Tenorio told reporters at the Foreign Correspondents' Club of Japan.   He added there was a big US military presence on Guam, a strategic outpost in the Pacific with its own missile defence system.

Added Denight: "Guam's brand image was built as a very safe and family-friendly destination. I want to reassure people of Japan that there has been no change and Guam is safe for travel."   The unusual appeal to tourists comes several weeks after Pyongyang said it was considering firing a salvo of missiles toward the island -- prompting an angry reaction from US President Donald Trump.

Unlike Trump, however, Guam's 162,000-odd residents seem to be taking it all in stride, including Tenorio.   "By and large, 99 percent of our population just go about their lives every single day. Things are normal on Guam," he said.   "I have to admit sometimes it's really hard to do my job in my office. If you look outside...(from) where I'm sitting at my desk many times you'll see dolphins chasing the fish."
Date: Fri, 11 Aug 2017 12:10:33 +0200

Hagatna, Guam, Aug 11, 2017 (AFP) - Tourism-dependent Guam is looking to cash in on its new-found fame as a North Korean missile target, tapping an unlikely promotional opportunity to attract visitors to the idyllic island and prove that all publicity is good publicity.   Pyongyang's threats to launch four missile strikes near the US territory has stirred global curiosity in the remote Pacific destination, with it trending heavily on search engines as social media users wondered, "what is Guam?"

Although Guam hosts two US military installations and 6,000 US soldiers, making it the target of North Korea's wrath, tourism authorities are keen to dispel any impression of danger to the tranquil island and its secluded beaches.   "The circumstances are unfortunate but this is a good opportunity for us to educate the world about Guam and our culture, about where we are, and who we are," said Josh Tyquiengco, marketing director at Guam Visitors Bureau, the official agency for the island.

"Guam is more than a military base. We are a safe family destination. We reassure potential visitors that we continue to be a safe... place to visit," Tyquiengco told AFP.   Despite North Korea's threats to prepare plans within days that would surround Guam with "enveloping fire", fears of a potential attack have not deterred tourists from visiting Guam, he said.   "We heard about a few booking cancellations from South Korea, but it's too minimal to affect the industry," he said. 

Governor Eddie Calvo, in a briefing late Friday, said any attack on Guam "would be met with overwhelming force", pointing out that the biggest threat facing the island was the looming typhoon season.   "With that, everybody should conduct their lives like business as usual. It's the weekend. Go out, have a good time, enjoy the beaches tomorrow and live your lives.   "At this point, there are thousands of tourists coming in on a daily basis... from Japan, (South) Korea, Taiwan and China and other areas. It is our belief that they should enjoy themselves here."

As aircraft after aircraft -- packed with tourists -- landed Friday at Guam's international airport, the latest visitors to the island appeared untroubled by the prospect of missile strikes.   Sun Doojin, who arrived with her husband and two-year-old daughter on a flight from Seoul, responded with an emphatic "no" when asked if she was concerned about an attack during her visit.

- 'A hidden gem' -
The Guam Daily Post, in an editorial, said the spotlight on the territory offered an opportunity to show the world why an island of 162,000 people draws more than 1.5 million tourists a year.    "The beach waters are crystal clear, beaches aren't overrun, and nature hiking trails are very accessible.   "The different cultures that are showcased on the island through food make Guam a hidden gem, a tropical vacation getaway but with the amenities and comforts of some of the small cities stateside."

Guam's history of earthquakes and typhoons mean its infrastructure is built to robust standards and authorities insist that the island is prepared for any emergency, including a North Korean strike.   Homeland Security spokeswoman Jenna Gaminde told the Guam Daily News that in the event of an attack, residents would be immediately notified by sirens from the All-Hazards Alert Warning System located throughout the island.   "If you hear the sirens, tune into local media -- radio, print, television -- for further instructions," she said. 

Pyongyang has said it would take less than 18 minutes for a missile to cross the 3,400-kilometre (2,100-mile) distance to the US territory.   In addition to the US military bases, Guam is also equipped with the sophisticated THAAD weapons system which is capable of destroying intermediate-range missiles in the final phase of flight.

Officials, however, have sought to brush off fears and say there has been no change in the threat level for now.   "I don't think there's anything to worry about. No missile is going to land on Guam," said Carl Peterson, who serves on the Guam Chamber of Commerce's armed forces committee.   "We've got defense mechanisms in place... they have the ability to seek out the missiles with kinetic energy and destroy it."
Date: Thu, 8 Jun 2017 21:02:05 +0200

Miami, June 8, 2017 (AFP) - Five percent of women in the US territories who were infected with the Zika virus while pregnant had fetus or babies with defects, including microcephaly, government health data said Thursday.   The report by the US Centers for Disease Control and Prevention covered the US territories of Guam, American Samoa, the US Virgin Islands, Micronesia, the Republic of Marshall Islands and Puerto Rico.   The report is the first based on data from the US territories and the largest study of its kind to date.

CDC experts said the findings are consistent with previous findings about Zika cases in the mainland United States.   "Women in the US territories and elsewhere who have continued exposure to mosquitoes carrying Zika are at risk of infection," said CDC acting director Anne Schuchat.    "We must remain vigilant and committed to preventing new Zika infections."   The rate of birth defects was slightly higher -- eight percent, or one in 12 -- in women whose infections were confirmed early in the pregnancy, during the first trimester, said the report.

The findings were based on the cases of 2,549 women with possible Zika virus infection who completed their pregnancies.   Among these women, 1,508 had confirmed Zika virus infection from January 1, 2016 to April 25, 2017.   Over 120 pregnancies resulted in Zika-associated birth defects, including infants born with unusually small heads, an irreversible condition known as microcephaly.   Other complications in babies included seizures and problems with movement, coordination, eating and near constant crying.

Zika can be spread by the bite of infected mosquito or via sexual contact.  Pregnant women are urged to avoid areas where Zika is spreading.   Since Zika erupted on a large scale in mid-2015, more than 1.5 million people have been infected, mostly in Brazil and other countries in South America.    Some 70 countries have been impacted.   Zika may lead to an itchy rash and although it is dangerous for pregnant women and their fetuses, it often causes no symptoms in adults.   In November 2016, the World Health Organization announced that the Zika virus outbreak no longer poses a world public health emergency, though it warned the epidemic remains a challenge.
Date: Fri 27 Mar 2015
Source: Outbreak News Today [edited]

Health authorities on the Pacific Island of Guam say the pertussis, or whooping cough outbreak has reached 11 cases to date. This comes after the Department of Public Health and Social Services (DPHSS) received 3 additional laboratory confirmed cases of the vaccine-preventable disease in a 9 month old child, 3 year old child, and 41 year old adult. Investigation into the newest cases show no epidemiological linkage with each other or previous reported cases.  [Byline: Robert Herriman]
=======================
[Guam is an organized, unincorporated territory of the United States in the western Pacific Ocean. A map of the island can be found at <http://www.lib.utexas.edu/maps/islands_oceans_poles/guam.gif>.

There are likely a number of reasons for the upswing of pertussis in the USA and elsewhere, which include the well-recognized normal swings in incidence, the increase in the number of unvaccinated individuals whose parents chose not to vaccinate them, and waning immunity which has caused public health officials to advise boosters for all adults and especially pregnant women. However, research by both Dr Frits R Mooi from the Netherlands (Pertussis - Australia (04): newly emerging clones, discussion 20120322.1078115) and Dr Lyn Gilbert from Australia (Pertussis - Australia (03): newly emerging clones 20120321.1076103) have been previously highlighted in ProMED-mail, reflecting antigenic changes in circulating clones of _Bordetella pertussis_ which may be causing the increased number of pertussis cases throughout the world. These changes may result in a need for modifications of the currently used acellular pertussis vaccines. - ProMED Mod.LL]
Date: Thu 29 Jan 2015
Source: KUAM [edited]

Two cases of pertussis or whooping cough have been confirmed by the Department of Public Health [Guam]. The 2 cases were found in an 11 year old and a 2 month old.

Project manager Annette Aguon said, "So far with our case investigation they are not linked to each other, they have no recent travel history or no off-island visitors, and so that's what we are looking into, if there are someone else around the 2 month old as well as the 11 year old who had a persistent cough."  [byline: Jolene Toves]
=======================
[Guam (<http://en.wikipedia.org/wiki/Guam>) is an organized, unincorporated territory of the USA in the western Pacific Ocean. It is one of 5 US territories with an established civilian government. Guam is listed as one of 17 Non-Self-Governing Territories by the Special Committee on Decolonization of the United Nations. Guam is the largest and southernmost of the Mariana Islands. - ProMED Mod.LL]

[A HealthMap/ProMED-mail map showing Guam is available at
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World Travel News Headlines

Date: Mon, 10 Sep 2018 07:28:56 +0200

Wellington, Sept 10, 2018 (AFP) - A strong 6.9 magnitude earthquake struck New Zealand's remote Kermadec Islands on Wednesday but authorities said there was no tsunami threat.   The quake struck at 4.19pm (0419GMT) at a depth of 111 kilometres (69 miles), with its epicentre 770 kilometres northeast of Auckland, the US Geological Survey said.   "Based on all available data, there is no tsunami threat from this earthquake," the Hawaii-based Pacific Tsunami Warning Center said.   The uninhabited Kermadecs are New Zealand's northernmost islands.   They are part of the Pacific Ring of Fire, a hotbed of volcanic and earthquake activity at the intersection of several tectonic plates.
Date: Mon, 10 Sep 2018 07:17:20 +0200

Tokyo, Sept 10, 2018 (AFP) - The death toll from a powerful earthquake that triggered massive landslides in northern Japan rose to 44 on Monday with tens of thousands of police and troops still on the ground to support survivors.   Chief Cabinet Secretary Yoshihide Suga said no one was left on a missing list, which suggested the figure could be the final death toll.   Around 40,000 police, fire fighters, troops and maritime safety officials were providing assistance, with more than 2,700 people still forced to stay in shelters after the killer quake struck the northern Japanese island of Hokkaido last week.

The majority of the dead are from the small rural town of Atsuma, where a cluster of dwellings were wrecked when a hillside collapsed from the force of the 6.6-magnitude quake, causing deep brown scars in the landscape.   "The government will strive to get hold of what is needed on the ground and take every possible measure so that people can return to a normal, safe life as soon as possible," Suga told a news conference.   He also warned that islanders should remain on alert as rainfall was forecast in the region, which could trigger fresh landslides.

The quake was the latest in a string of natural disasters to batter the island nation.   Western parts of the country are still recovering from the most powerful typhoon to strike Japan in a quarter of a century, which claimed 11 lives and shut down the main regional airport.   Launching a campaign for another term as head of his ruling party, Prime Minister Shinzo Abe reiterated his government will "do its best" to restore the disasters-hit regions.
Date: Mon, 10 Sep 2018 07:13:22 +0200
By Gregory DANEL, Romain FONSEGRIVES

Paris, Sept 10, 2018 (AFP) - Seven people including two British tourists were wounded in Paris late Sunday by a knife-wielding man, a terrifying attack that bystanders tried to stop by throwing petanque balls at the assailant.   Four of the victims were in a critical condition, police said, after the man brandishing a large blade and and iron bar went on the rampage next to a canal in the northeast of the capital.   The suspect is believed to be an Afghan national and has been arrested, said a source close to the enquiry, adding he had targeted "strangers" but that "nothing at this stage shows signs of a terrorist nature".

Chaos erupted on the banks of the Bassin de la Villette, an area popular with locals and visitors who frequent the cafes, cinemas and other cultural venues along its banks, just after 11:00pm (2100 GMT).   Eyewitness Youssef Najah, 28, said he was walking beside the canal when he saw a man running and holding a knife about 25-30 cm (10-11 inches) long.   "There were around 20 people chasing him. They started throwing petanque balls at him," Najah said, referring to the sport popular in France also known as boules.   "Around four or five balls hit him in the head, but they weren't able to stop him," he added.

According to the same witness, the attacker then dived into an alleyway, where the man "tried to hide behind two British tourists. We said to them: 'Watch out, he has a knife". But they didn't react".    The pair were then attacked, he said.   A security guard at one of two cinemas on either side of the water said he had seen the attacker running away from two men who were trying to stop him.   "He had an iron bar in his hand which he threw at the men chasing him, then he took out a knife," he told AFP.   The UK foreign office said it was aware of reports of the attack and was "urgently investigating this incident" in cooperation with French authorities, British media reported.

- High alert -
A police investigation has been launched for attempted murder, according to a judicial source.   It is the latest of several knife attacks France has seen in recent months, with terrorism being ruled out in most cases.   On August 23, a man stabbed his mother and sister to death and seriously injured another person in a town near Paris before being shot dead by police.

The motive for the violence remained unclear despite a claim by the Islamic State (IS) group that it was an attack by one of its fighters responding to the terror organisation's propaganda.   Authorities said the 36-year-old had serious mental health problems and had been on a terror watch list since 2016.   That attack came days after an Afghan asylum-seeker was arrested in town of Perigueux for a drunken rampage with a knife in which four people were wounded, one seriously.   Police said investigators had "very quickly" dismissed a terrorist motive after the August 13 incident.

And on June 17, two people were hurt in another southern town when a woman shouting "Allahu akbar" (God is greatest) attacked them in a supermarket with a boxcutter knife.   France has been on high alert following a string of jihadist attacks in recent years, often by people who have become radicalised or claim to have acted in the name of the IS group.   More than 240 people have been killed by Islamist extremists since a massacre at the Charlie Hebdo satirical magazine in Paris in January 2015.
Date: Mon, 10 Sep 2018 06:41:23 +0200

Miami, Sept 10, 2018 (AFP) - Hurricane Florence is expected to become a dangerous "major hurricane" by late Monday as it heads toward the US East Coast, the National Hurricane Center said, as states of emergency were declared in preparation for the storm.   The center of Florence was located about 685 miles (1,100 kilometres) southeast of Bermuda, the NHC in its 0300 GMT Monday advisory.   Florence had maximum sustained winds of 90 miles per hour, making it a Category 1 storm on the five-level Saffir-Simpson hurricane scale.

The NHC warned that Florence "is forecast to rapidly strengthen to a major hurricane by Monday night, and is expected to remain an extremely dangerous major hurricane through Thursday."   The storm is moving towards the west at seven miles per hour, and is forecast to drench a large swath of the US East Coast running from northern Florida to New Jersey.   On its current track Florence is expected to slam the Carolinas and Virginia the hardest -- and all three states have issued emergency declarations to speed preparations.

Virginia Governor Ralph Northam's office described Florence as possibly the state's "most significant hurricane event in decades," warning of "catastrophic inland flooding, high winds and possible widespread power outages."   It added: "The largest threat to life from hurricanes is not the high winds. Flooding is the deadliest result of these storms."   The US navy has ordered ships at its major base in Hampton Roads, Virginia, base to put to sea, saying "the forecasted destructive winds and tidal surge are too great to keep the ships in port."

- Two more hurricanes -
North Carolina Governor Roy Cooper's office said that Florence is already being felt along the state's coast, with large sea swells resulting in life-threatening rip currents and surf.   "Everyone in North Carolina needs to keep a close eye on Florence and take steps now to get ready for impacts later this week," Cooper said.

The storm "is too powerful and its path is too uncertain to take any chances," South Carolina Governor Henry McMaster said in issuing his state's emergency declaration.   Florence was producing large swells expected to reach from the northern Caribbean to the southern coasts of Canada's Maritime provinces.   At this statistical height of the Atlantic hurricane season, Florence was being trailed on east-to-west paths by two hurricanes, Helene and Issac.   Helene -- currently just southeast of the Cabo Verde islands off the African coast -- had winds of 85 miles per hour, and was expected to turn northwest and then north into the open Atlantic by midweek, the NHC said.

Hurricane Isaac -- which late Sunday became the fifth hurricane of the season -- is heading west towards the Caribbean.   At 0300 GMT Issac was about 1,305 miles east of the Windward Islands -- a region still recovering from last year's powerful Hurricane Maria -- with winds of 75 miles per hour.   Issac is expected to gain strength in the next days, but then weaken by the middle of the week when it approaches the Caribbean.   Maria -- which killed at least 3,057 people, most in Puerto Rico -- is elieved to be the third costliest tropical cyclone on record.
Date: 9 Sep 2018
Source: ProMED-mail promed@promedmail.org

[There has been significant chatter on social media from individuals working in Haiti and their colleagues, friends and family, suggesting there is a "new, as yet undiagnosed outbreak," possibly of a mosquito-borne disease, in the expat and local Haitian communities. Some of the content of this social media chatter is excerpted below [edited for clarity/readability - CopyEd.MSP]. - ProMED Mod.MPP]

"...there is some sort of new mosquito-borne virus in Haiti. Do I know for sure that it is a virus caused by a flying insect? No. Do I have a lot of unqualified and under-documented personal research to back up my belief nonetheless? Yes. If you know a guy or gal at the CDC, tell them to come chat with me. Something is going around, and many people are not well. It is eerily similar to chikungunya and malaria."

"Mayaro virus?"

"I have been saying the same thing! Well, when my fever brain has been capable of putting thoughts together this week. 2014 was ChikV; 2016 was Zika, so it does seem time for a new one. This new one is no fun at all."

"My person is negative for everything, Zika, chikV, malaria, dengue. It started with high fever, aches, joint pain, then progressed to stomach ache, headache. Now it's just persistent joint aches and sharp stabbing pain."

"We have this all over Mirebalais as well. Here, it also seems to be often accompanied by severe lower abdominal pain."

"Yes! My son just asked me if there is another mosquito borne illness yesterday!"

"Several of our girls have been sick with these same symptoms! It's awful."

"We all had it too and are seeing a lot of patients at our clinic with it!"

"I was sick for days before the uprising in July [2018] ... totally felt like malaria but tested negative. My BP was 80/40 at best, and it was pa bon [not good]."

"Yes! I've been sick this week as well as a few others I know! Lots of body pain."

"People thought that I was crazy!"

"You're not crazy! Several cases showing up at the Maternity Center here, and I also think there is influenza A going around. Some cases have respiratory stuff (to me that is the flu/influenza A), and several cases have nothing respiratory but have the fever and aches and terrible headache."
======================
[According to Wikipedia (in an unsubstantiated report without references) "Mirebalais is a commune in the Centre department of Haiti, approximately 60 km northeast of Port-au-Prince on National Road 3. The city was established in 1702. During the United Nations occupation of 2005, Nepalese troops were stationed in the city, using the city jail as their headquarters,"  (<https://en.wikipedia.org/wiki/Mirebalais>).

"Mirebalais is served by the teaching hospital Hopital Universitaire de Mirebalais, the largest solar-operated hospital in the world," a hospital that is run by the US-based Partners in Health,  (<https://www.pih.org/pages/mirebalais>).

>From the sound of the social media chatter, there is an as yet undiagnosed outbreak affecting parts of Haiti. Trying to connect the dots, there is concern that it is malaria-like (fever, chills and headaches), but in those that have been tested for malaria, laboratory results have not supported the diagnosis, and possibly dengue- or chikungunya-like (fever, headache, joint pains) with the addition of complaints of lower abdominal pain (notably described in Mayaro virus disease.

If the symptoms are similar to those of dengue, chikungunya, and Zika virus infections, they need to be ruled out by laboratory testing. There is the possibility that Mayaro virus (MAYV) may be circulating in Haiti. Mayaro virus was isolated from a child with acute febrile illness in rural Haiti. The case report stated that "on 8 Jan 2015, an 8-year-old boy was examined at the school clinic because of fever and abdominal pain. His temperature was 100.4 F [38 C]; lung sounds were clear, and his abdomen was soft and not tender. He had no rash and no conjunctivitis. On the basis of this clinical presentation, the clinic physician empirically diagnosed typhoid and administered co-trimoxazole... MAYV was detected in viral RNA extracted from infected Vero cells.

A question now is: if this is another MAYV infection, is this a continuation of the 2015 transmission or a new introduction into Haiti? Clearly, laboratory follow up is needed to establish the etiology of the current cases of febrile disease to determine an etiology and rule out other pathogens. If MAYV presence is established, surveillance is needed to determine the extent of its distribution, and health care providers and laboratories in Haiti, the Dominican Republic, and other countries in the Caribbean Basin need to be informed to be on the alert and to be prepared to make a diagnosis should any cases occur there.

Of additional curiosity is a recent media report in the Jamaican Star relating a tale of 3 Haitians recently arrived claiming illness, with malaria suspected in one of them. Testing is still pending, but given the social media chatter, one can't help but wonder whether this isn't malaria. Could it be part of the same as of yet undiagnosed outbreak reported in the above chatter? ...

References:
1- Lednicky J, De Rochars V, Elbadry M, Loeb J, Telisma T, Chavannes S, et al. Mayaro Virus in Child with Acute Febrile Illness, Haiti, 2015. Emerg Infect Dis. 2016;22(11):2000-2002.

2- Mavian C, Rife BD, Dollar JJ, Cella E, Ciccozzi M, Prosperi MCF, Lednicky J, Morris JG, Capua I, Salemi M. Emergence of recombinant Mayaro virus strains from the Amazon basin. Sci Rep. 2017 Aug 18;7(1):8718. doi: 10.1038/s41598-017-07152-5.

A HealthMap/ProMED map of Haiti can be found at:

More information from knowledgeable sources would be greatly appreciated, especially results of laboratory testing on individuals presenting with the above-mentioned symptoms, and results of clinical as well as epidemiologic investigations. - ProMED Mods.MPP/TY]
Date: Sun, 9 Sep 2018 14:04:57 +0200

Rome, Sept 9, 2018 (AFP) - Authorities have issued health alert after 150 cases of pneumonia were recorded in a week, mainly in towns near the northern Italian city of Brescia.   Suspecting the presence of a pneumonia-causing virus in the water supply, they have taken samples from the distribution network for analysis.   Results are expected in several days.

Autopsies will be conducted on a 69-year-old woman and an 85-year-old man who died this week to determine whether they died from pneumonia, according to local media reports.   Pneumonia is usually caused when bacteria, viruses or fungi infect the lungs.   It can be life-threatening, especially among the elderly and those with serious health conditions.

Provincial health services have called on residents to take precautions, including disinfecting tap filters and shower hoses and to let hot water run for a period of time with the windows open before using it.   Hospital emergencies in several municipalities to the south and east of Brescia identified 121 cases of pneumonia, the health officer in the Lombardy region Giulio Galera said on television.   A survey of general practitioners found at least 30 other people had been affected.
Date: Sun, 9 Sep 2018 10:04:14 +0200

Tokyo, Sept 9, 2018 (AFP) - Japan is suffering its first outbreak of pig cholera in more than 25 years, authorities said Sunday after culling more than 600 animals and suspending pork exports.    A farm in central Japan saw 80 pigs die last week after catching the highly-contagious disease, an agricultural ministry official told AFP.

Early tests showed negative results for classical swine fever, as the illness is officially known.   But follow-up tests came out positive Sunday, prompting the cull of all 610 pigs at the farm, he added.   "We are now processing the livestock there and disinfecting the farm," he said, adding that officials had set up sterilisation points on access roads to the affected farm.

The government has set up a team of specialists to analyse possible infection routes, the agricultural ministry said in a statement.   Tokyo halted pork exports after the outbreak was confirmed. The nation sold roughly $9 million in raw pork meat to foreign markets last year.   Japan saw its last case of classic swine fever, which does not affect humans, in 1992.   The disease continues to rage in many parts of Asia, Europe and Latin America.
Date: Sat, 8 Sep 2018 21:58:47 +0200

Kinshasa, Sept 8, 2018 (AFP) - Health authorities in Kinshasa declared the Ebola virus under control five weeks after the latest outbreak left 89 people dead in eastern Democratic Republic of Congo.   The health ministry announced the outbreak on August 1 in North Kivu province and on Thursday revealed that it had spread to Butembo, a city of a million people.

But Health Minister Dr Oly Ilunga Kalenga said: "Since August 13, there have been practically no more cases, we can say that the situation has been brought under control at the epicentre (of Mabalako)."   The latest outbreak of the virus is 10th to strike DR Congo since 1976, when the disease was first identified and named after a river in the country's north.   "To date, we have 129 cases (31 probable and 98 confirmed), 89 deaths and 33 patients cured," Dr Oly Ilunga said.   Fears that the disease might  spread further had been expressed Thursday after news of two deaths in Butembo, a commercial hub and popular transit point for neighbouring Uganda.

A woman and one of the medical staff who had been treating her died ini the city.   "Even at Butembo, the situation is not critical," the minister told a news conference also attended by Congolese professor and leading Ebola researcher Professor Jean-Jacques Muyembe, who urged people to report any sign of the disease.   "The Ebola virus is circulating here and in Africa in general ... we must be vigilant," Muyembe said.

Complicating the battle against the spread of the disease is the fact it is afflicting an area of Congo wracked by insecurity owing to the presence of armed groups.   Even so, Dr Oly Ilunga said teams treating sufferers had enjoyed army and police backing as well as support from the UN mission Monusco.   The previous outbreak of Ebola, which left 33 people dead in the northwestern province of Equateur, was decreed over on July 24.
Date: Sat, 8 Sep 2018 13:02:52 +0200

Seoul, Sept 8, 2018 (AFP) - South Korea reported its first case of Middle East Respiratory Syndrome (MERS) in three years, health officials said on Saturday.   A 61-year-old businessman was diagnosed with the highly contagious viral respiratory illness, according to officials at the Korea Centers for Disease Control and Prevention (KCDC).   He returned to South Korea Friday from a business trip in Kuwait where he stayed for three weeks, the KCDC said a statement.

"Authorities have traced and separated 20 people who have come in close contact with the infected person," KCDC head Chung Eun-gyeong told journalists.   They include medical staff, flight attendants and passengers of the plane the man flew back to South Korea on, she said.    He was hospitalised with fever and phlegm and has been quarantined at a university hospital, she added.   It is the first case of MERS diagnosed in South Korea since 2015, when an outbreak killed 38 people and triggered widespread panic.
Date: Wed 5 Sep 2018
Source: El Comercio [in Spanish, machine trans. edited]
<https://elcomercio.pe/mundo/latinoamerica/chile-brote-hepatitis-suma-201-casos-region-antofagasta-noticia-nndc-554166>

Health authorities in the region of Antofagasta in northern Chile are on alert for an outbreak of hepatitis A that adds 201 cases so far in 2018, 2 more than those recorded throughout 2017, they said today, 5 Sep 2018. "Unfortunately, we are having about 5 cases every 2 weeks, which means that we are facing an epidemic," Cooperativa Rossana Díaz, ministerial regional Secretary of Health, told Radio. It is a situation "that is controllable with the help of the community," which, in his opinion, has a fundamental role in the prevention of this disease, which can "be fulminating, create a risk to life, and require organ transplantation." Diaz stressed that hepatitis A can be prevented with simple measures, such as constant hand washing and optimal handling and preparation of food.

The authorities must combat street food sales and control businesses, "but we do not get anything if people continue to consume food on the street or in places that do not have sanitary authorization for that," he said. The profusion of cases, according to the official, corresponds to the increase in the consumption of food in unauthorized places and the lack of vaccinated personnel or strict hygiene regulations in establishments that do have a permit.

The authorities have set up an Outbreak Response Committee in the region and questioned contacts of the confirmed cases and of the suspects in order to find the origin of transmission. The cases registered in Antofagasta range from 2 to 60 years, with an average of 23 years, of which 62% are men and 38% are women, and although the presence of immigrants is large in the region, 98% of the cases are Chileans, the regional authorities reported.

Hepatitis A, according to the Institute of Public Health, can be prevented with a vaccine, and its detection requires a medical diagnosis in addition to laboratory tests or diagnostic imaging studies. It is transmitted through water, contaminated food, or through contact with an infected person. It is considered a disease with worldwide distribution that occurs sporadically or epidemically with a seasonal cycle, which in Chile is an intermediate endemic, with epidemic outbreaks every 4 or 5 years, and there are no chronic carriers.
==============================
[It seems to be the case that the cases are occurring at a low, steady rate rather than from a specific recent exposure.

Antofagasta (<https://en.wikipedia.org/wiki/Antofagasta>) is a port city in northern Chile, about 1100 km (700 mile) north of Santiago. It is the capital of Antofagasta province and the Antofagasta region. Formerly part of Bolivia, Antofagasta was captured by Chile in the War of the Pacific (1879-83), and the transfer of sovereignty was finalized in the 1904 Treaty of Peace and Friendship between the 2 countries. - ProMED Mod.LL]

[HealthMap/ProMED map available at: Antofagasta, Antofagasta, Chile:
<http://healthmap.org/promed/p/11048>]