Why Madagascar is Facing Its Worst Plague Outbreak in Years ( Pittsburgh Post-Gazette) Madagascar sees cases of plague nearly every year in the rainy season. This year is different. Instead of cases in the hinterlands where plague is endemic, the disease--which is initially spread by flea bites and was known as the Black Death in medieval times--has spread to the capital, Antananarivo, and other densely populated cities for the 1st time, killing 45 people and sparking panic. Go to article

See also: Confirmed & Suspected Plague Now Exceeds 800 Cases ( Avian Flu Diary) We have the 1st update from Madagascar's Ministry of Health since the 14th, posted on the BRGNC Madagascar website. The number of cases continues to increase, adding 195 cases and 11 deaths since Saturday's report. Go to article

See also: Plague in Madagascar: Rapid Diagnostic Tests Suspended ( H5N1) People who were alarmed by the plague and believed to have clinical signs of plague could not pass the rapid diagnostic test yesterday. Go to article

Domestic Preparedness & Response

Wildfire Suppression Spending: Background, Issues, and Legislation in the 115th Congress ( Congressional Research Service) Congress has directed that the federal government is responsible for managing wildfires that begin on federal lands, such as national forests or national parks. States are responsible for managing wildfires that originate on all other lands. Go to article

As Santa Rosa Hospital Staff's Own Homes Burned, They Kept Saving Lives ( SF Gate) Santa Rosa Memorial Hospital stayed open even though 51 of its doctors lost their homes. It stayed open even when twice as many patients as normal crowded into its emergency room, coughing and gasping. It stayed open and delivered 36 babies. Go to article

After the Las Vegas Shooting, Concertgoers Became Medics ( New York Times) In the days after the shootings at the Route 91 Harvest festival in Las Vegas, many stories emerged of bystander courage. Volunteers combed the grounds for survivors and carried out the injured. Strangers used belts as makeshift tourniquets to stanch bleeding, and then others sped the wounded to hospitals in the back seats of cars and the beds of pickup trucks. Go to article

Global Health & Security

US Global Health Assistance: FY2001-FY2018 Request ( Congressional Research Service) Congressional interest in and support for global health programs has remained strong for several years. In FY2017, US global health funding reached an estimated $9.6 billion. These funds are managed by several US agencies and the Global Fund to Fight AIDS, Tuberculosis and Malaria--a multilateral organization aimed at combating the 3 diseases worldwide. Go to article

WHO Supports the Immunization of 874,000 People Against Yellow Fever in Nigeria ( WHO) The Government of Nigeria has launched a campaign to immunize 873 837 people against yellow fever in the states of Kwara and Kogi. The 10-day campaign began on Friday, 13 October 2017, and mobilizes more than 200 health workers and volunteers. It targets residents aged 9 months to 45 years old. Go to article

GAVI, the Vaccine Alliance, is Exploring New Partnerships to Increase Access to Immunization ( Devex) Gavi, the Vaccine Alliance, spends $35 to fully immunize a child. But it would spend $36 or $37 per child if that extra investment meant better tracking and therefore savings over time. Multiply an extra $1 or $2 by the number of children for whom Gavi purchases vaccines and you get the kind of scale that Silicon Valley is looking for. Go to article

Amid Fear and Guns, Polio Finds a Refuge ( Undark) In a crowded square in the ancient Nigerian city of Kano, outside the palace of one of the Emir's princelings, a menagerie of community leaders gathered this spring to combat an age-old foe. Mullahs, musicians, dignitaries, doctors, and traditional leaders, the last swathed in robes and turbans, are all enlisted in an elaborate public-service extravaganza--one orchestrated to both distribute and increase awareness of polio vaccine. Go to article

IFRC to Deploy First-Ever Plague Treatment Centre, Releases 1 Million Swiss Francs as Infection Spreads ( ReliefWeb) The International Federation of Red Cross and Red Crescent Societies is deploying a treatment centre to provide urgent care for hundreds of people in Madagascar who have been infected with plague. Go to article

Rohingya in Bangladesh: An Unfolding Public Health Emergency ( H5N1) I am writing from Cox's Bazar, Bangladesh, where a large number of Rohingya have taken refuge and where our organisation, Médecins Sans Frontières, has been providing emergency medical assistance. I am working as the medical emergency manager in Kutupolong, a makeshift settlement in the Cox's Bazar district, which borders Myanmar. Go to article

Government Affairs & National Security

Trump Drug Czar Nominee Withdraws ( The Hill) Rep. Tom Marino (R-Pa.) is withdrawing his name from consideration as the nation's drug czar, President Trump announced Tuesday. The withdrawal followed a Washington Post-"60 Minutes" joint investigation that highlighted his support for legislation that weakened the government's ability to go after drug companies, something critics say has contributed to the nation's opioid crisis. Go to article

Opponents Say USDA Reorganization Has Multiple Problems ( Food Safety News) Critics are continuing to noddle Secretary of Agriculture Sonny Perdue's plan to reorganize his large department, finding things they don't like about it. Perdue's desire to move US involvement in world food standards to USDA's trade office, taking it away from food safety, was the 1st change to stir controversy. Go to article

Medicine & Public Health

If Puerto Rico Were a State, Its Health Care System Would Recover Faster from Maria ( FiveThirtyEight) Nearly 3 weeks after Hurricane Maria landed in Puerto Rico as a Category 4 hurricane, health care providers are still struggling. Almost all of the community health centers--which are a lifeline for the poorest people--on the western half of the island were still closed Friday or operating at partial capacity. Go to article

California's Hepatitis A Outbreak Shows Why People Need Easy Access to Health Care ( Popular Science) Some outbreaks come from papayas. Others originate with puppies. The most worrisome happen because parents don't vaccinate their children against easily preventable infections. But California's hepatitis A outbreak isn't like any of these--it's spreading almost exclusively amongst homeless and drug abusing populations. Go to article

Crisis in the Sustainability of the US Blood System ( The New England Journal of Medicine) A nation's blood supply is both a public trust and a strategic resource. The availability of safe blood is a key component of current medical practice. Whether in support of trauma management, surgery, chemotherapy for cancer, or postpartum hemorrhage, blood transfusion affects almost every American family. Go to article

What It Costs to Treat Gunshot Wounds in Hospitals ( The Trace) Following the mass shooting in Las Vegas earlier this week, hundreds of gunshot victims were sped to local hospitals. Some have since been released; those with more serious injuries are still being treated. Understanding the full extent of their medical needs will take years, even lifetimes. Many, almost certainly, face a long, painful recovery--and mounting medical bills. Go to article

Science & Technology

How to Remake Puerto Rico's Grid to Survive the Next Storm ( Motherboard) Three weeks after Hurricane Maria ravaged Puerto Rico, most of the island is still living in the dark. Hospitals running on spotty generators have no lamps for doctors to look closely at patient wounds. Intersections lack traffic signals to safely guide cars. People can't rely on air conditioners to temper the year-round heat. Go to article

Illumina Ventures Raises $230M for First Fund ( GenomeWeb: subscription required) Illumina Ventures has raised $230 million for its first fund, which focuses on supporting firms involved in genomics and precision medicine. Illumina launched the independent, early-stage venture capital firm in 2016 with an investment of $100 million. Go to article

Developing a Dengue Forecast Model Using Machine Learning: A Case Study in China ( PLOS: Neglected Tropical Diseases) In China, dengue remains an important public health issue with expanded areas and increased incidence recently. Accurate and timely forecasts of dengue incidence in China are still lacking. We aimed to use the state-of-the-art machine learning algorithms to develop an accurate predictive model of dengue. Go to article