Date: Wed, 25 Jul 2018 18:25:40 +0200

Moscow, July 25, 2018 (AFP) - Russia on Tuesday announced that it will stop running all long-distance trains across its 11 time zones on Moscow time (GMT+3), ending a frequent cause of confusion for travellers.   Russian Railways, the state monopoly, said it made the move to "improve the quality of service for passengers."   From August 1, at all stations, all information boards, clocks and loudspeaker anouncements on the time on arrival and departure of long-distance trains will use the local time, the railway company said.   Since May, the railway company has been printing train tickets for August and beyond showing both the local time and Moscow time.

Currently the time for a train departing from the Pacific city of Vladivostok at the end of the Trans-Siberian route, will be shown on station timetables, display boards and tickets according to Moscow time, even though there is a seven-hour time difference.   This rule was introduced in the Soviet era to achieve consistency across the network and so passengers don't have to keep changing their watches.   But it often causes confusion for passengers joining trains in cities across Russia who may not be familiar with the current Moscow time.   The time difference can even mean that passengers need to buy tickets for a different date than they were expecting.   Under the Soviet Union, all trains across all the republics ran according to Moscow time.    Russia has recently tinkered with its time zones, cutting them down to nine in 2011 and then going back to 11 in 2014.   It has also been on permanent winter time since 2014 after a failed experiment to put the nation on summer time all year round.
Date: Thu 21 Jun 2018
Source: N Engl J Med [edited]
<https://www.nejm.org/doi/full/10.1056/NEJMicm1716138>
Citation Kartashev V and Simon F. Migrating Dirofilaria repens. N Engl J Med. 2018;378(25):e35. doi: 10.1056/NEJMicm1716138.

A 32-year-old woman presented to an ophthalmologist with a 2-week history of nodules that moved around her face. She had first noted a nodule below her left eye (Panel A) [for images see URL]. Five days later, it had moved to above her left eye (Panel B), and 10 days after that to the upper lip (Panel C). She documented these changes by taking photographs of her face (i.e., "selfies"). The nodules occasionally caused a localized itching and burning sensation, but otherwise she had no symptoms.

She had recently travelled to a rural area outside Moscow and recalled being frequently bitten by mosquitoes. A physical examination showed a superficial moving oblong nodule at the left upper eyelid. A parasite was fixed with forceps and removed surgically (Panel D). The parasite was identified by means of a polymerase-chain-reaction assay as _Dirofilaria repens_, which is a zoonotic filarial nematode.

Dogs and other carnivores are the definitive hosts, and mosquitoes serve as vectors. Humans can become aberrant hosts. Surgical excision of the worm is curative. After removal of the worm, the patient had a full recovery. -- Communicated by: ProMED-mail <promed@promedmail.org> [Human infections with _D. repens_ is well known in Russia and a recent review included data from 236 human patients (Ermakova LA, Nagorny SA, Krivorotova EY, Pshenichnaya NY, Matina ON. _Dirofilaria repens_ in the Russian Federation: current epidemiology, diagnosis, and treatment from a federal reference center perspective. Int J Infect Dis. 2014 Jun;23:47-52. doi: 10.1016/j.ijid.2014.02.008).

The reservoir are dogs and the infection is transmitted to humans by mosquitoes and is also described from other European countries (Miterpáková M et al. Heartworm on the rise-new insights into _Dirofilaria immitis_ epidemiology.

Parasitol Res. 2018 Jul;117(7):2347-2350. doi: 10.1007/s00436-018-5912-9;  Blaizot R et al.
Systemic Infection With _Dirofilaria repens_ in Southwestern France.
Ann Intern Med. 2018 Feb 6;168(3):228-229. doi: 10.7326/L17-0426). - ProMED Mod.EP]
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[Until 2014 human dirofilariasis in the Russian Federation was considered as a rare helminthiasis. According to information by the Center of Hygiene and Epidemiology of Rospotrebnadzor, at the end of 2012, 1093 cases infected by _D. repens_ have been recorded in Russian Federation (since 1915, where the 1st case in Russia was recorded). But now, due to the sudden increase of infectious cases, the human dirofilariasis is recording separately from other Helminthiasis in the official statistical reports.

Due to the favorable natural and climatic conditions, as well as the high affection of definitive (dogs and other animals of the family of canines and felines) and intermediate hosts (mosquitoes), the territory of the South of Russia is a risk area for sustainable transmission of infestation. The incidence of human infestation correlated with the extent of infestation in final and intermediate hosts.

Dogs are the most important source for human transmission. The largest number of cases was revealed in the Rostov, Volgograd and Nizhny Novgorod regions. At the beginning of 2013, 242 patients with dirofilariasis were recorded in the Rostov region. This is 22.1 percent of all cases recorded in the Russian Federation. Often patients addressed for medical assistance in hospital due to detection under the skin dense fixed formations, up to 1.5 cm, or in cases of the visualization of thread like moving worms under the skin in various localization.

A migration of the parasite we observed in 43.6 percent of patients. In 17.7 percent of cases, worms moved considerable distances: from the knee to the groin area; lower back, upper eyelid or from periorbital region to shin and buttocks. Common localizations of _Dirofilaria_ were head and neck (most often in the periorbital area, and conjunctivitis (face, scalp and forehead), or more rarely in the area of the trunk and extremities. In 6 patients (2.3 percent), worms were found in the external genitals. - ProMED Mod.NP]
 
[HealthMap/ProMED-mail map Russia:
<http://healthmap.org/promed/p/98>]
Date: Mon 18 Jun 2018 8:53 UTC+3
Source: Tass Russian News Agency [edited]
<http://tass.com/society/1009933>

Russia's federal service for the oversight of consumer rights protection, Rospotrebnadzor, has called on the Russians to get vaccination for measles before trips abroad, as the disease is spearing in a number of regions of the world.

"Rospotrebnadzor calls public attention to the reports [on the spread of measles] and notes separately that vaccination offers the only reliable preventive protection against measles," the agency said in a warning at its website. "Therefore we make a recommendation to the people who have not been vaccinated and have not been down with measles previously to get vaccination at least 14 days before the scheduled trip," the report said.

Rospotrebnadzor quoted information from the World Health Organization, which pointed out a notable increase in the incidence of measles in 28 South American countries -- Argentina, Brazil, Ecuador, Colombia, Mexico, Peru, Venezuela, and also in the US and Canada.

"The Center for Public Health at the Healthcare Ministry of Ukraine points out the level of incidence of measles in Ukraine in 2017 exceeded the figures for 2016 by a factor of 70," the report said. "In all, as many as 20 553 cases of measles have been registered there since the beginning of this year, including 8331 cases among adults and 12 222 cases among children."

"Eleven people have died from complications caused by the disease," the agency said.

As the root-cause of the situation, it pointed out the low levels of vaccination among the rank-and-file people.
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[HealthMap/ProMED-mail map of Russia:
<http://healthmap.org/promed/p/98>.]
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Russia: FIFA World cup, PAHO/WHO
Date: Fri 1 Jun 2018
Source: PAHO/WHO [edited]
<https://www.paho.org/hq/index.php?option=com_content&view=article&id=14394>

The Pan American Health Organization/World Health Organization (PAHO/WHO) has recommended that all those travelling to the 2018 FIFA World Cup ensure that they're up-to-date with all their vaccinations, including the measles, mumps, and rubella vaccine (also known as MMR). The 2018 World Cup will be hosted this year by Russia between 14 Jun and 15 Jul.

The increase in international travel and the mass movement of people during events such as the World Cup increases the risk of transmission of diseases. It also increases the likelihood of travellers returning to their countries with diseases such as measles, which is highly contagious and can have grave consequences on the health of unvaccinated populations.
Date: Fri, 27 Apr 2018 00:54:01 +0200

Moscow, April 26, 2018 (AFP) - Hundreds of commercial and cultural sites in Russia fall below fire safety standards, authorities said Thursday following checks after a fire in Siberia killed more than 60 people in March.   Local prosecutors were ordered to check whether safety regulations were being followed in shopping malls, cultural and children's entertainment sites across Russia after a shopping centre fire in Kemerovo left at least 64 people dead, including 41 children.

In one region alone, the eastern island of Sakhalin, 93 percent of the 230 sites checked did not comply with fire safety instructions, the local prosecutor's office said in a statement Thursday.   Stairs and fire exits are often congested, fire alarms and automatic water sprinklers do not work and the walls are covered with highly flammable materials, the statement said, adding that 156 lawsuits have been launched.

In Volgograd in western Russia, the Sports Palace which holds 2,500 spectators was closed due to the lack of an automatic water sprinkler system and emergency exits that are difficult to access, the Tass press agency quoted the local prosecutor's office as saying.   Fire safety rules are often violated in Russia due to corruption as building permits are given by officials in exchange for bribes.
Date: Thu 22 Mar 2018
Source: Yahoo New [edited]
<https://au.news.yahoo.com/world/a/39587369/50-children-fall-ill-from-russian-landfill-gas/>

Doctors in a Russian town treated dozens of children complaining of dizziness and nausea on [Wed 21 Mar 2018] because of noxious fumes coming from a local dump, authorities said.  Residents of Volokolamsk, some 120 km [approx. 75 mi] west of the Russian capital, have long complained about high levels of hydrogen sulfide and nitric oxide from the Yadrovo landfill. Riot police were called in this month to disperse a protest calling for the closure of the site. Doctors treated 50 children from different schools in the town, the regional authorities said in a statement, adding that the main complaints were nausea and dizziness.

Andrei Vorobyov, the governor of the Moscow region, said plans were in place to send the affected children out of the area.  "The situation is getting worse and worse with each passing day... because of the gases coming from the landfill," town mayor Pyotr Lazarev told Business FM radio. Around 200 people had gathered outside the Volokolamsk hospital [Wed 21 Mar 2018], an AFP journalist said.  One person was holding a sign reading: "We are suffocating! We so want to live, you know."  "Don't kill our kids," another placard read.

Anna Luzova, 10, said she had worn a medical mask to school on [Wed 21 Mar 2018] because the smell outside was so strong. "It smelled like something had exploded. I almost couldn't breathe. Sometimes, almost every night, we wake up from that smell. What will it be like in summer? I don't know how we can live like this," she told AFP.  "It's been impossible to breathe here for 2 months. Our children are suffering from nausea and hypertension," Anna Grapeh, a 50-year-old resident said.

Governor Vorobyov visited the landfill site in the afternoon, his press service said. He then arrived at the Volokolamsk hospital, where residents shouted "Shame!" and threw snowballs at him, an AFP journalist saw.  Three buses of riot police were also at the scene. "This is unfortunately not the first story of its kind. This is a very complicated situation," Vorobyov said. He added that a new facility would be built which would not emit gases.

The Yadrovo landfill should be covered with earth within the next few days, authorities said. The ministry for emergency situations said the landfill was the source of "pollution in the air" in Volokolamsk and the surrounding area. But following an air quality test, it said "no threat to residents of the town had been detected".

On social media, several people complained of an unpleasant smell in the town and said their children were forced to leave school earlier than usual because they felt ill.  [Byline: Maxime Popov]
=====================
[Hydrogen sulfide has many synonyms including dihydrogen sulfide, sulfur hydride, sulfurated hydrogen, hydrosulfuric acid, "sewer gas," "swamp gas," hepatic acid, sour gas, and "stink damp."

Hydrogen sulfide is a colorless, highly flammable and explosive gas produced naturally by decaying organic matter and by certain industrial processes. Hydrogen sulfide has a characteristic rotten-egg odor.

Hydrogen sulfide is well absorbed through the lungs; cutaneous absorption is minimal. Exposure by any route can cause systemic effects.

Inhalation is the major route of hydrogen sulfide exposure. The gas is rapidly absorbed by the lungs. The odor threshold (0.5 ppb) is much lower than the OSHA ceiling (20 ppm). However, although its strong odor is readily identified, olfactory fatigue occurs at high concentrations and at continuous low concentrations. For this reason, odor is not a reliable indicator of hydrogen sulfide's presence and may not provide adequate warning of hazardous concentrations. Hydrogen sulfide is slightly heavier than air and may accumulate in enclosed, poorly ventilated, and low-lying areas.

Children exposed to the same levels of hydrogen sulfide as adults may receive larger doses because they have greater lung surface area/body weight ratios and increased minute volumes/weight ratios. In addition, they may be exposed to higher levels than adults in the same location because of their short stature and the higher levels of hydrogen sulfide found nearer to the ground. Children may be more vulnerable to corrosive agents than adults because of the relatively smaller diameter of their airways.

It may also cause skin and eye irritation.

Hydrogen sulfide is produced naturally by decaying organic matter and is released from sewage sludge, liquid manure, sulfur hot springs, and natural gas. It is a by-product of many industrial processes including petroleum refining, tanning, mining, wood-pulp processing, rayon manufacturing, sugar-beet processing, and hot-asphalt paving. Hydrogen sulfide is used to produce elemental sulfur, sulfuric acid, and heavy water for nuclear reactors.

We are not told about contents of the land fill but the situation is very detrimental to health and safety. One wonders if there is industrial waste as well as usual household waste there. Covering up the land fill may solve the problem for a time, but any leaks in the covering earth when hard rains come may allow the situation to return, and therefore requires continued monitoring. Furthermore, if another land fill is started in the area, it is likely the same situation could re-occur.

Portions of this comment were extracted from:
<https://www.atsdr.cdc.gov/mmg/mmg.asp?id=385&tid=67> - ProMED Mod.TG]

[HealthMap/ProMED-mail map:
Russia: <http://healthmap.org/promed/p/98>]
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