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The 2nd edition of the Dictionary of Disaster Medicine and Humanitarian Relief is an essential and practical reference for all those who work in humanitarian relief. This new, expanded edition presents more than 3000 definitions and acronyms covering the entire multidisciplinary scope of disaster medicine and humanitarian relief, as well as new fields such as climate change and bioterrorism. As natural disasters, humanitarian emergencies, and infectious disease epidemics increase in frequency and seriousness, this book is an important reference to assist international relief workers communicat.

Recurrent health emergencies threaten global health security. International Health Regulations (IHR) aim to prevent, detect and respond to such threats, through increase in national public health core capacities, but whether IHR core capacity implementation is necessary and sufficient has been contested. With a longitudinal study we relate changes in national IHR core capacities to changes in cross‐border infectious disease threat events (IDTE) between 2010 and 2016, collected through epidemic intelligence at the European Centre for Disease Prevention and Control (ECDC). By combining all IHR core capacities into one composite measure we found that a 10% increase in the mean of this composite IHR core capacity to be associated with a 19% decrease (p=0.017) in the incidence of cross‐border IDTE in the EU. With respect to specific IHR core capacities, an individual increase in national legislation, policy & financing; coordination and communication with relevant sectors; surveillance; response; preparedness; risk communication; human resource capacity; or laboratory capacity was associated with a significant decrease in cross‐border IDTE incidence. In contrast, our analysis showed that IHR core capacities relating to point‐of‐entry, zoonotic events or food safety were not associated with IDTE in the EU. Due to high internal correlations between core capacities, we conducted a principal component analysis which confirmed a 20% decrease in risk of IDTE for every 10% increase in the core capacity score (95% CI: 0.73, 0.88). Globally (EU excluded), a 10% increase in the mean of all IHR core capacities combined was associated with a 14% decrease (p=0.077) in cross‐border IDTE incidence. We provide quantitative evidence that improvements in IHR core capacities at country‐level are associated with fewer cross‐border IDTE in the EU, which may also hold true for other parts of the world.

The novelty and uncertainty associated with COVID-19 has created challenges for politicians, citizens, and healthcare providers, leaving no one unaffected. As members of the front line of defense, providers in Emergency Departments (EDs) face the momentous challenge of effectively identifying and treating patients with COVID-19, working with experts in Infectious Disease, Internal Medicine, Critical Care, Public Health, and other disciplines. We must coordinate these efforts while also protecting staff, implementing strategies to reduce transmission, and managing ED patients with conditions unrelated to COVID-19. Striving to maintain a grasp of the rapidly accumulating publications in medical journals and the media, we provide this brief article as a pragmatic summary of the challenges facing the ED.

Background Erythema migrans (EM) is the most common manifestation of Lyme borreliosis. Here, we examined EM patients in Norwegian general practice to find the proportion exposed to tick-transmitted microorganisms other than Borrelia, and the impact of co-infection on the clinical manifestations and disease duration. Methods Skin biopsies from 139/188 EM patients were analyzed using PCR for Neoehrlichia mikurensis, Rickettsia spp., Anaplasma phagocytophilum and Babesia spp. Follow-up sera from 135/188 patients were analyzed for spotted fever group (SFG) Rickettsia, A. phagocytophilum and Babesia microti antibodies, and tested with PCR if positive. Day 0 sera from patients with fever (8/188) or EM duration of >= 21 days (69/188) were analyzed, using PCR, for A. phagocytophilum, Rickettsia spp., Babesia spp. and N. mikurensis. Day 14 sera were tested for TBEV IgG. Results We detected no microorganisms in the skin biopsies nor in the sera of patients with fever or prolonged EM duration. Serological signs of exposure against SFG Rickettsia and A. phagocytophilum were detected in 11/135 and 8/135, respectively. Three patients exhibited both SFG Rickettsia and A. phagocytophilum antibodies, albeit negative PCR. No antibodies were detected against B. microti. 2/187 had TBEV antibodies without prior immunization. There was no significant increase in clinical symptoms or disease duration in patients with possible co-infection. Conclusions Co-infection with N. mikurensis, A. phagocytophilum, SFG Rickettsia, Babesia spp. and TBEV is uncommon in Norwegian EM patients. Despite detecting antibodies against SFG Rickettsia and A. phagocytophilum in some patients, no clinical implications could be demonstrated. ; Funding Agencies|Independent Research Fund Denmark [8020-00344B]; ScandTick Innovation (an EU OKS Interreg program); NorthTick, an Interreg project by North Sea Programme of the European Regional Development Fund of the European Union; Norwegian Institute of Public Health

During the COVID-19 outbreak in Hubei Province, People's Republic of China (PRC), infectious medical waste increased by 600% from 40 tons per day to 240 tons per day. This quickly overwhelmed existing medical transport and disposal infrastructure around hospitals. Other countries will face similar challenges. It is critical that additional waste management systems are put in place to help reduce the further spread of COVID-19 and the emergence of other diseases. To support its developing member countries, the Asian Development Bank (ADB) has compiled the following list of considerations and recommendations to enable governments to rapidly respond to these unprecedented challenges.

1. Forms of Contagion -- 2. 100% Pure Pigs: Cultivating Pure Auckland Island Pigs for Xenotransplantation -- 3. Hierarchies of Valuable Life: Positioning Pigs and Primates in UK Bioethics -- 4. Circulating Non-Human Tissues: Xenotransplantation and Security in the United States -- 5. Ecological and Organismic Body Politics: The Moratorium on Xenotransplantation in Australia -- 6. Conclusion.

History of Medicine is not a discipline destined to culturally enrich only those who work in the health sector. All historians know very well how some medical events have influenced the course of history. In particular, infectious diseases, being interconnected with political, social, economic and war issues, have an important historical significance.Microbial agents are invisible enemies ready to undermine mankind and to find prosperity in human misery.Tuberculosis, better than other, is well suited to study the epistemological path of medical thought, from its origins to the present day.From the Hippocratic and Galenic thought to the anatomo-clinical method, from the advent of microbiology to the antibiotic era up to the postantibiotic era, recognizing the timeless need to implement valid social policies and effective preventive medicine actions to achieve satisfactory results.

Contents -- Preface - Emerging Viruses: From Early Detection to Intervention -- References -- How to Tackle Natural Focal Infections: From Risk Assessment to Vaccination Strategies -- 1 Eco-Epidemiology: How to Predict and Control the Occurrence of Natural Focal Infectious Diseases -- 1.1 Ecological Niche Modelling -- 1.2 The Boosted Regression Trees Method -- 1.3 Macroecology -- 2 Natural Focal Diseases Mapping and Control: Two Paradigmatic Examples -- 2.1 Crimean-Congo Hemorrhagic Fever: A Mapping Exercise -- 2.2 A Vaccine for CCHF: Give Prevention a Chance -- 2.3 Tick Borne Encephalitis: Vaccine Use to Control a Natural Focal Disease -- 3 Conclusions -- References -- Human-Animal Interface: The Case for Influenza Interspecies Transmission -- 1 Introduction -- 2 The Viruses -- 3 Molecular Determinants of Host-Range Restriction and Pathogenesis -- 3.1 Hemagglutinin and Receptor-Binding Specificity -- 3.2 Other Virulence Determinants -- 4 Pandemic Influenza -- 5 Animal Influenza -- 5.1 Wild Bird-Domestic Bird Interface -- 5.2 Domestic Bird-Mammalian Interface -- 5.2.1 Domestic Poultry -- 5.2.2 Swine Influenza -- 6 Increasing Threats of Influenza at the Human-Animal Interface -- Changing Conditions that Favor Influenza Transmissibility -- 7 Conclusions -- References -- Bats and Emerging Infections: An Ecological and Virological Puzzle -- 1 Introduction -- 2 Why the Bats Are Good Virus Reservoirs? -- 2.1 Evolution and Phylogeny of Bats -- 2.2 Species Richness -- 2.3 Ability to Fly -- 2.4 Long Lifespan and Bat Ecology -- 3 Virus Dynamic in Bat Populations -- 4 Changes in Ecology and Management of Bat Populations -- 5 Risk Factors and Prevention Tasks -- References -- The Middle East Respiratory Syndrome Coronavirus - A Continuing Risk to Global Health Security -- 1 Introduction -- 2 Epidemiological Features of MERS-CoV -- 2.1 Discovery and Evolution

Fifty years ago, the age-old scourge of infectious disease was receding in the developed world in response to improved public health measures, while the advent of antibiotics, better vaccines, insecticides and improved surveillance held the promise of eradicating residual problems. By the late twentieth century, however, an increase in the emergence and reemergence of infectious diseases was evident in many parts of the world. This upturn looms as the fourth major transition in human-microbe relationships since the advent of agriculture around 10,000 years ago. About 30 new diseases have been identified, including Legionnaires' disease, human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), hepatitis C, bovine spongiform encephalopathy (BSE)/variant Creutzfeldt-Jakob disease (vCJD), Nipah virus, several viral hemorrhagic fevers and, most recently, severe acute respiratory syndrome (SARS) and avian influenza. The emergence of these diseases, and resurgence of old ones like tuberculosis and cholera, reflects various changes in human ecology: rural-to-urban migration resulting in high-density peri-urban slums; increasing long-distance mobility and trade; the social disruption of war and conflict; changes in personal behavior; and, increasingly, human-induced global changes, including widespread forest clearance and climate change. Political ignorance, denial and obduracy (as with HIV/AIDS) further compound the risks. The use and misuse of medical technology also pose risks, such as drug-resistant microbes and contaminated equipment or biological medicines. A better understanding of the evolving social dynamics of emerging infectious diseases ought to help us to anticipate and hopefully ameliorate current and future risks.

Fifty years ago, the age-old scourge of infectious disease was receding in the developed world in response to improved public health measures, while the advent of antibiotics, better vaccines, insecticides and improved surveillance held the promise of eradicating residual problems. By the late twentieth century, however, an increase in the emergence and reemergence of infectious diseases was evident in many parts of the world. This upturn looms as the fourth major transition in human-microbe relationships since the advent of agriculture around 10,000 years ago. About 30 new diseases have been identified, including Legionnaires' disease, human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), hepatitis C, bovine spongiform encephalopathy (BSE)/variant Creutzfeldt-Jakob disease (vCJD), Nipah virus, several viral hemorrhagic fevers and, most recently, severe acute respiratory syndrome (SARS) and avian influenza. The emergence of these diseases, and resurgence of old ones like tuberculosis and cholera, reflects various changes in human ecology: rural-to-urban migration resulting in high-density peri-urban slums; increasing long-distance mobility and trade; the social disruption of war and conflict; changes in personal behavior; and, increasingly, human-induced global changes, including widespread forest clearance and climate change. Political ignorance, denial and obduracy (as with HIV/AIDS) further compound the risks. The use and misuse of medical technology also pose risks, such as drug-resistant microbes and contaminated equipment or biological medicines. A better understanding of the evolving social dynamics of emerging infectious diseases ought to help us to anticipate and hopefully ameliorate current and future risks.

BACKGROUND: Rift Valley fever virus is an emerging mosquito-borne virus that causes infections in animals and human beings in Africa and the Arabian Peninsula. Outbreaks of Rift Valley fever lead to mass abortions in livestock, but such abortions have not been identified in human bezings. Our aim was to investigate the cause of miscarriages in febrile pregnant women in an area endemic for Rift Valley fever. METHODS: Pregnant women with fever of unknown origin who attended the governmental hospital of Port Sudan, Sudan, between June 30, 2011, and Nov 17, 2012, were sampled at admission and included in this cross-sectional study. Medical records were retrieved and haematological tests were done on patient samples. Presence of viral RNA as well as antibodies against a variety of viruses were analysed. Any association of viral infections, symptoms, and laboratory parameters to pregnancy outcome was investigated using Pearson's χ(2) test. FINDINGS: Of 130 pregnant women with febrile disease, 28 were infected with Rift Valley fever virus and 31 with chikungunya virus, with typical clinical and laboratory findings for the infection in question. 15 (54%) of 28 women with an acute Rift Valley fever virus infection had miscarriages compared with 12 (12%) of 102 women negative for Rift Valley fever virus (p<0·0001). In a multiple logistic regression analysis, adjusting for age, haemorrhagic disease, and chikungunya virus infection, an acute Rift Valley fever virus infection was an independent predictor of having a miscarriage (odds ratio 7·4, 95% CI 2·7-20·1; p<0·0001). INTERPRETATION: This study is the first to show an association between infection with Rift Valley fever virus and miscarriage in pregnant women. Further studies are warranted to investigate the possible mechanisms. Our findings have implications for implementation of preventive measures, and evidence-based information to the public in endemic countries should be strongly recommended during Rift Valley fever outbreaks. FUNDING: Schlumberger Faculty for the Future, CRDF Global (31141), the Swedish International Development Cooperation Agency, the County Council of Västerbotten, and the Faculty of Medicine, Umeå University.

Of 20 cancer drugs considered essential by the independent not-for-profit group US Pharmacopeia, 14 have more than 40% of their production concentrated in a single facility. America's response to COVID-19 continues to be a politically charged topic, but few would dispute that it laid bare serious vulnerabilities in our health supply chains. And while the infectious disease itself may no longer be a pandemic, our public leaders are likely to focus on health supply processes, especially for life-saving medicines, for years to come. US Pharmacopeia's recent Medicine Supply Map suggests that production concentration has made some of our most important medicines vulnerable to supply chain shocks. Perhaps as a result, the Biden administration added pharmaceuticals and active pharmaceutical ingredients (API)—the chemicals that produce many of our medications—to its list of critical product sectors under the purview of the Supply Chain Disruptions Task Force. The US Department of Defense also recently identified drug shortages as a threat to military readiness.More than 60% of our critical chemical supply for pharmaceuticals is sourced in just two countries—India and China; only 10% are produced in the United States. Earlier this year, a manufacturing plant in India responsible for a number of cancer-fighting drugs voluntarily shut down following FDA inspections that identified numerous manufacturing deficiencies. Damage from a hurricane caused disruptions to a manufacturing facility in North Carolina. Our over concentration of sourcing increases the chances that supplies could be significantly impacted by a single disruption, whether caused by humans or nature.Distance itself is an additional supply chain risk. The necessary transportation of drugs and their critical ingredients produced in distant countries exposes them to a level of risk of disruption that domestic or proximately sourced products don't have. And because many of them have vital human health importance, experts argue that the near-shoring push that government leaders have applied to other sectors makes even more sense in the pharmaceutical industry. Mexico, for example, already produces many medicines for its domestic consumption, a large portion of which are also exported. If the Biden administration were to incentivize pharmaceutical sourcing closer to home, it would motivate greater cooperation between the FDA and COFEPRIS, its Mexican counterpart. For many years, American businesses prioritized lowest cost suppliers above nearly all else. The COVID-19 experience reminded us that when it comes to pharmaceuticals that can save and extend lives, and prevent the spread of dangerous diseases, reliability and availability are at least as important.