Will the water still run during a pandemic?

(CIDRAP Source Weekly Briefing) – Has your business taken into account what happens to your water supply when an influenza pandemic begins? Do you know whether the water utilities that

MPS Installs WaveSub at FaBTest

UK wave technology development company Marine Power Systems (MPS) has installed its prototype WaveSub wave energy converter at marine test centre FaBTest, marking the start of a new phase of sea-based testing.

Mozambique declared free of landmines

Mozambique’s National Demining Institute has declared the country free of land mines at last.The country removed its last known landmine after two decades of work to get rid of the

Dan Crenshaw, Star Republican Freshman, Holds On to Texas House Seat

first_imgRepresentative Dan Crenshaw, Republican of Texas, won a second term in Congress on Tuesday, fending off a Democratic challenge in his Houston area from Sima Ladjevardian, an Iranian-born immigrant who had been an adviser to former Representative Beto O’Rourke.Mr. Crenshaw, whose victory was called by The Associated Press, had been a favorite to retain his seat, despite Democrats’ high hopes for Texas and efforts to expand their reach into the suburbs. A former member of the Navy SEALs, he has been one of the best-known freshmen in Congress since 2018, when the “Saturday Night Live” comedian Pete Davidson joked disastrously about his eye patch.- Advertisement – – Advertisement – The National Republican Congressional Committee and other political organizations demanded that Mr. Davidson apologize to Mr. Crenshaw, who lost an eye in combat. His graceful acceptance on the air the next week (“Thanks for making a Republican look good,” he joked to Mr. Davidson) helped make him a political celebrity, a draw for Republican donors and a regular on political talk shows.He has been a stalwart supporter of President Trump on issues ranging from the border wall to athletes kneeling for the national anthem, and has energetically defended the president’s pandemic response. Ms. Ladjevardian, who immigrated with her family from Iran to Europe and then to the United States, arrived in Houston with her husband in the 1990s after finishing law school in California. In 2015, she served on Hillary Clinton’s national finance committee.- Advertisement –center_img Two years later, she joined Mr. O’Rourke’s Senate campaign as a senior adviser, then worked on his brief presidential campaign before entering the primary in the Second Congressional District. She campaigned as a moderate, supporting a path to citizenship for the young undocumented immigrants known as Dreamers who were brought to the United States as children but opposing the “defunding” movement to shift money from police departments into social service programs.Despite endorsements from Houston Democrats, however, she remained a long shot. Even in the primary, she had failed to muster the 50 percent majority needed to avoid a runoff, and escaped one only because the second-place candidate withdrew from the election.The turnout in Harris County, while unusually high, failed to supply the margin she needed to take the seat. – Advertisement –last_img read more

Royi N99 Replaceable Silicone Face Mask is protective and reusable » Gadget Flow

first_imgThe Royi N99 Replaceable Silicone Face Mask protects you from all PM 2.5—not just COVID-19. With an FDA-approved design, this N99 mask is also reusable. So you can simply wash the main mask body and then use it over and over again. That means this silicone face mask is more eco-friendly than others as you won’t toss it to use an entirely new mask. What’s more, the filter inside the mask is replaceable when it’s worn out. Lab-tested and certified to have N99-level mask protection, this fully sealed mask ensures nothing nasty gets in anywhere. Additionally, it’s totally nontoxic, antibacterial, and odorless so you can ensure it won’t bother your skin. Because it seals so well against your face, this mask won’t fog up your glasses, either. Finally, choose from several colors: Black, White, Grey, Blue, and Pink. – Advertisement –last_img read more

Watch Dogs: Legion Source Code Allegedly Leaked, Ubisoft Investigating the Breach

first_imgAre iPhone 12 mini, HomePod mini the Perfect Apple Devices for India? We discussed this on Orbital, our weekly technology podcast, which you can subscribe to via Apple Podcasts, Google Podcasts, or RSS, download the episode, or just hit the play button below. Now, a new report by Rock Paper Shotgun states that the source code for Watch Dogs: Legion (Review) has been leaked and it includes 558GB of data on filesharing sites. Egregor mocked Ubisoft’s security and said “We found source codes in free access in the main network. Passwords in the doc files without any protection, all the employees and developers data and personal information, contract, game engines and a lot of more.”The report also mentions that Ubisoft gave a statement acknowledging the ransomware group’s claim and that it is investigating a “potential data security incident.”Watch Dogs: Legion was released last week and this data breach comes at a critical time for the developers who will have to try their best to plug the leak. It is unclear if Ubisoft has contacted Egregor or if the leaked data is still accessible. Further, there is no information on whether Crytek has been able to solve the case of this data breach as Egregor had reportedly encrypted the company’s files.- Advertisement – – Advertisement –center_img Watch Dogs: Legion, Ubisoft’s latest entry into the ‘hack the world’ Watch Dogs franchise, has been reportedly hacked. The source code for the game has been allegedly leaked by a ransomware group called Egregor, however, it is unclear exactly what data has been leaked. According to the report, Ubisoft is aware of the hacker’s claims and is investigating the leak. Additionally, the ransomware group also claims to have breached the security of another video game developer as well — Crytek. It is also unclear what Egregor’s demands are.It started with a data breach at Ubisoft and Crytek by Egregor back in October, as per a report by ZDNet. At the time, the hackers claimed they posted the data pertaining to Watch Dogs: Legion on their dark web portal. They also leaked 20MB of Ubisoft’s data and 300MB of Crytek’s data. Egregor reportedly asked Ubisoft to contact them at the time of breach but it seems like the company did not respond. “In case Ubisoft will not contact us we will begin posting the source code of upcoming Watch Dogs and their engine,” the hackers reportedly said.- Advertisement –last_img read more

‘Bachelor,’ ‘Bachelorette’ Stars Who Found Love After Show: Photos

first_imgFedotowsky, for one, opened up exclusively to Us Weekly in July 2019 about her intentions for signing on to the ABC hit. “I went on the show for a good time. I didn’t go on for love. Nobody goes on the show for love and then they’re just surprised when they actually do fall in love,” she admitted. “They go on there like, ‘This could be fun.’”The reality star went on to confess that her motives would be a bit different if she starred on the series in this era. “If I went on the show right now, I [would] 100 percent be thinking Instagram followers. … I think to not think that way is kinda dumb,” she revealed. “Like … That’s gotta be in the back of your mind. … I’m an entrepreneur, I have an entrepreneurial type way of thinking.”- Advertisement – Better off! Some Bachelor and Bachelorette stars had more luck in the love department outside the reality dating series, finding forever without the prying eyes of cameras.DeAnna Pappas, Juan Pablo Galavis, Ali Fedotowsky and Emily Maynard are among the former leads who broke up with their final picks, only to find The One after starring on the show.- Advertisement – Maynard, for her part, does not have particularly fond memories of her time in the franchise. “I always say I should not give anyone any Bachelor and Bachelorette advice because it has been kind of a train wreck, to be quite honest,” she said during a January 2017 appearance on Good Morning America. “My time on the show was a bit of a mess.”However, everything is not necessarily smooth sailing for post-show relationships either. Pappas, who wed Stephen Stagliano in 2012, endorsed couples counseling in August 2016. “It forced us to work through our marriage,” she told Us at the time. “This is it, me and him. There is no giving up, no turning back.”Scroll to discover which Bachelor Nation alums found love after reality TV heartbreak.- Advertisement –center_img – Advertisement –last_img read more

5 Things to Know About the Future Vice President

first_imgHistory in the making! Joe Biden‘s 2020 presidential election win was a miraculous feat — but he couldn’t have done it without Senator Kamala Harris by his side.On Saturday, November 7, the Biden-Harris ticket emerged victorious over President Donald Trump and Vice President Mike Pence. Harris, 56, is the first woman, the first Black person and the first South Asian to be elected vice president.- Advertisement – Scroll down to learn more about the Vice President-elect! – Advertisement – In January 2019, Harris officially announced her candidacy for president of the United States. Though she was briefly considered a top contender, she suspended her campaign just under a year later. She quickly threw her support behind Biden, who confirmed in August that he had selected Harris as his running mate. After making history once again, Harris sent an inspiring message to young girls around the country.“While I may be the first woman in this office, I will not be the last,” Harris said on Saturday night. “Because every little girl watching tonight sees that this is a country of possibilities. And to the children of our country, regardless of your gender, our country has sent you a clear message: Dream with ambition, lead with conviction and see yourself in a way that others might not see you, simply because they’ve never seen it before. And we will applaud you every step of the way.”- Advertisement – The longtime politician began her impressive career as district attorney of San Francisco, California, in 2004. She held the seat until 2011 and was the city’s first person of color to be elected district attorney. Harris worked her way up the ranks, serving as California’s attorney general from 2011 to 2017, taking over from Jerry Brown.Throughout her career, Harris has been no stranger to breaking barriers. After winning her race in the 2016 Senate election, she became the second Black woman and first South Asian American to serve in the Senate. As the daughter of both a Jamaican immigrant and a native Indian, Harris’ fearless demeanor was instilled in her from a young age.“My mother, who raised me and my sister, was a proud woman,” Harris recalled in a November 2019 video. “She was a brown woman. She was a woman with a heavy accent. She was a woman, who many times people would overlook her, or not take her seriously. Or because of her accent, assume things about her intelligence. … Every time she proved them wrong.”- Advertisement –last_img read more

The Races That Haven’t Been Called

first_imgNew YorkWhat’s uncalled: Eight House races (First, Second, Third, 11th, 18th, 19th, 22nd and 24th Districts)New York has been slow to even start counting mail ballots. As a result, even a couple of races that might not be close remain uncalled simply because there are so many unreported votes. District 42: Representative Ken Calvert, a Republican, is leading his Democratic opponent, Liam O’Mara, by more than 11 percentage points, but the race hasn’t been called because only 68 percent of estimated votes have been counted. District 39: Young Kim, a Republican who lost in 2018, is leading Representative Gil Cisneros, a Democrat, by almost 3,500 votes in a rematch with more than 98 percent of estimated ballots counted. CaliforniaWhat’s uncalled: Eight House races (Fourth, Eighth, 21st, 25th, 34th, 39th, 42nd and 48th Districts)California is known for counting mail ballots slowly. Some of these races will probably be called in the next few days, but the closest ones could drag out for weeks; in 2018, the last House race in California wasn’t called until early December. North CarolinaWhat’s uncalled: Presidential race, Senate raceSenator Thom Tillis, a Republican, is narrowly ahead of his Democratic challenger, Cal Cunningham, with 98 percent of estimated votes counted. Final results are delayed because North Carolina will accept absentee ballots that arrive through Nov. 12 as long as they were postmarked by Election Day.Mr. Trump is also narrowly ahead of Mr. Biden in the race for North Carolina’s 15 electoral votes, but they can’t change the outcome of the presidential election.TexasWhat’s uncalled: One House race (24th District)The 24th Congressional District is the last opportunity for Democrats to flip a district in Texas after losing every other race for a competitive Republican seat there. With 95 percent of estimated votes counted, Beth Van Duyne, a Republican, is narrowly leading Candace Valenzuela, a Democrat who would be the first Afro-Latina in Congress if elected.UtahWhat’s uncalled: One House race (Fourth District) Republican incumbents are ahead in both congressional contests in Alaska with 61 percent of the estimated vote counted: Senator Dan Sullivan over Al Gross, and Representative Don Young over Alyse Galvin. Many Democrats voted by mail, and while it’s unlikely that the results will flip, it is mathematically possible.It’s not clear how long it will take to count everything, but the state’s target date for formally certifying the results is Nov. 25.ArizonaWhat’s uncalled: Presidential race, one House seat (First District)- Advertisement – Here’s an overview of the results we were waiting for as of Monday evening. (This article does not include races that are going to runoffs: Louisiana’s Fifth Congressional District on Dec. 5, and Georgia’s two Senate contests on Jan. 5.) This article will be updated as races are called, and you can find full results here for the House and here for the Senate.AlaskaWhat’s uncalled: Presidential race, Senate race, one House seat (at-large)Alaska didn’t start counting mail ballots until this week, making it impossible to call its Senate race and at-large House race. Its three electoral votes are also uncalled, though the national outcome is clear: Joseph R. Biden Jr. is the president-elect. District 21: Representative T.J. Cox, a Democrat, is trailing David Valadao, the Republican former representative he narrowly defeated in 2018, by about 4,500 votes with 83 percent of estimated ballots counted. District 1: Representative Lee Zeldin, a Republican, is very likely to beat his Democratic challenger, Nancy Goroff, whom he is leading by more than 20 points. But the race hasn’t been called because only 77 percent of estimated ballots have been counted. District 4: Representative Tom McClintock, a Republican, is leading Brynne Kennedy by just under 10 percentage points with 96 percent of estimated ballots counted. The outcome is pretty clear — Ms. Kennedy even conceded on Friday — but The Associated Press hasn’t called it. IowaWhat’s uncalled: One House race (Second District)Iowa’s Second Congressional District is home to one of the closest House races in the country. Just 150 votes separate Rita Hart, a Democrat, from Mariannette Miller-Meeks, a Republican, with 89 percent of estimated votes counted. District 48: Representative Harley Rouda, a freshman Democrat, trails his Republican opponent, Michelle Steel, by just under 7,000 votes with more than 98 percent of estimated votes counted. District 8: Jay Obernolte, a Republican, is ahead of Christine Bubser, a Democrat, by 11 points. Only 85 percent of estimated ballots have been counted. Representative Ben McAdams, a Democrat whose victory in 2018 was one of the biggest upsets of the midterm elections, is narrowly leading his Republican challenger, Burgess Owens. Mr. McAdams is ahead by half a percentage point in Utah’s Fourth Congressional District with 97 percent of estimated votes counted.WashingtonWhat’s uncalled: One House race (Eighth District)Representative Kim Schrier, a first-term Democrat, is leading her Republican challenger, Jesse Jensen, by a little over three percentage points with more than 98 percent of estimated ballots counted in Washington’s Eighth Congressional District. District 24: Representative John Katko, a Republican, is very likely to win re-election over his Democratic challenger, Dana Balter. Mr. Katko is ahead by more than 20 points with 78 percent of estimated votes reported. District 34: This Los Angeles-based district is solidly Democratic; the question is which Democrat will win it. Representative Jimmy Gomez is about 12,000 votes ahead of David Kim with 98 percent of estimated ballots counted. Updated Nov. 9, 2020, 7:57 p.m. ET District 25: This is an extremely close race between Representative Mike Garcia, a Republican, and Christy Smith, a Democrat. Mr. Garcia is ahead by a little over 1,000 votes with 98 percent of estimated ballots counted. – Advertisement – District 2: The Republican candidate, Andrew Garbarino, is more than 16 points ahead of Jackie Gordon, a Democrat, but only 78 percent of estimated ballots have been counted. District 3: Representative Thomas Suozzi, a Democrat, is expected to be re-elected once the remaining 28 percent of estimated ballots are counted, but at the moment he is narrowly behind his Republican challenger, George Santos. – Advertisement – District 18: With 78 percent of estimated votes reported, Representative Sean Patrick Maloney, a Democrat, leads his Republican challenger, Chele Farley, by just under three points. District 22: Former Representative Claudia Tenney, a Republican who was unseated by Anthony Brindisi in 2018, is now leading him in a rematch with 80 percent of estimated ballots counted. District 19: Representative Antonio Delgado, a first-term Democrat, is narrowly ahead of his Republican challenger, Kyle Van De Water, with 80 percent of estimated ballots counted. District 11: Nicole Malliotakis, a Republican, is ahead of Representative Max Rose, a first-term Democrat, by double digits with 85 percent of estimated votes reported. GeorgiaWhat’s uncalled: Presidential raceMr. Biden is ahead in Georgia by about 11,000 votes with more than 98 percent of estimated ballots counted. State officials have said they expect the results to be close enough for a recount. Nationally, though, Mr. Biden already has more than 270 electoral votes, and the outcome in Georgia will have no bearing on the race.IllinoisWhat’s uncalled: One House race (14th District)After trailing in early results, Representative Lauren Underwood, a first-term Democrat, has pulled narrowly ahead of her Republican challenger, Jim Oberweis, in Illinois’s 14th Congressional District with more than 98 percent of estimated ballots counted. The race is likely to be called in the next few days. A week after Election Day, ballots are still being counted in many states.This isn’t unusual. But because of how many people voted by mail, the process isn’t as far along as it would normally be at this point, and that means the outcomes of quite a few races remain unclear.- Advertisement – Representative Tom O’Halleran, a Democrat, is ahead of his Republican challenger, Tiffany Shedd, by about 12,000 votes, but there are still outstanding mail and provisional ballots. The count is ongoing, and the race could be called in the next few days.The same is true for the presidential race. Mr. Biden leads President Trump in Arizona by a little over 15,000 votes with 98 percent of estimated ballots counted, though the race is over nationally and Arizona’s 11 electoral votes won’t change the result.last_img read more

Harry Styles’ Mom Defends His ‘Vogue’ Cover Amid Drama

first_img“I think maybe I had something to do with it because I was always a big fan of doing fancy dress with the kids when they were smaller, which Gemma hated but Harry always embraced,” Twist said. “Who doesn’t love doing a bit of dress up?”Harry Styles' Mom Chimes in on Her Son's 'Vogue' Cover DramaHarry Styles on the cover of Vogue, December 2020. Kelly of course is referencing conservative author Candace Owens’ comments about the lack of masculinity represented. “There is no society that can survive without strong men,” she wrote. “The East knows this. In the west, the steady feminization of our men at the same time that Marxism is being taught to our children is not a coincidence. It is an outright attack. Bring back manly men.”But Kelly and Twist aren’t the only ones coming to the former One Direction member’s defense. Lots of celebrities have responded to Owens’ criticism, from Olivia Wilde to Jameela Jamil to Elijah Wood.- Advertisement – “Harry Styles is plenty manly, because manly is whatever you want it to be, not what some insecure, toxic, woman-hating, homophobic d–kheads decided it was hundreds of years ago. He’s 104% perfect,” Jamil wrote in a tweet. “Also…he looked fit as f–k.”Twist’s admission on Tuesday isn’t anything new. In fact, Gemma noted in the cover story that Harry always liked indulging in their mom’s costume play. “My mum loved to dress us up,” Gemma told Vogue. “I always hated it, and Harry was always quite into it.” And he agreed! “As a kid I definitely liked fancy dress.”- Advertisement – Listen on Spotify to Get Tressed With Us to get the details of every hair love affair in Hollywood, from the hits and misses on the red carpet to your favorite celebrities’ street style ‘dos (and don’ts!) – Advertisement – Harry Styles' Mom Chimes in on Her Son's 'Vogue' Cover DramaHarry Styles and mom Anne Twist. Richard Young/ShutterstockOne proud mama! Harry Styles’ mom, Anne Twist, addressed her son’s Vogue cover drama in the most adorable way.On Tuesday, November 17, Twist appeared on the U.K. talk show Lorraine to chat about her two kids, Harry and Gemma. When host Lorraine Kelly defended the criticism Harry’s received for wearing a gown on the cover of the fashion magazine, Twist chimed in.- Advertisement –last_img read more

Will the water still run during a pandemic?

first_img(CIDRAP Source Weekly Briefing) – Has your business taken into account what happens to your water supply when an influenza pandemic begins? Do you know whether the water utilities that serve your enterprise are prepared to keep the water running and safe for your operations and employees?In Texas, Eugene “Buck” Henderson has repeatedly invited the state’s 6,700 water utilities to sign up for a free mutual aid program that would give them onsite emergency assistance in an influenza pandemic or natural disaster if they agree to help other utilities as needed.Fewer than 300 have taken him up on it.Just as surprising, the number that signed up for another free preparedness resource—installation of an electrical harness for quick hookup to a generator—didn’t even break 100, says Henderson, manager of the public drinking water section of the Texas Commission on Environmental Quality (TCEQ) based in Austin. “My greatest concern is for the smaller water systems, especially those that supply less than 3,300 businesses and households, because they have not been required to have a vulnerability assessment and an emergency response plan,” as have the bigger plants, he says.The inertia is especially puzzling, given that Hurricane Rita incapacitated 1,100 water utilities along the southeastern Texas coast in September 2005, according to Henderson. Some were up and running again in a day or 2, but others took 3 months to recover. In the meantime, they relied on just the sort of assistance that the Texas Water/Wastewater Agency Response Network TxWARN would provide: emergency generators, staff, and other supplies.”People have a tendency not to see an urgent situation until it happens,” he says. “Water is sometimes taken for granted until it isn’t there—until the well runs dry.” But imagine what could happen (or not happen) to your enterprise if water stops running, pumps shut down, or purification cannot be guaranteed during an influenza pandemic.Brian Good has. The director of operations and maintenance for Denver Water estimates at least 110 of the utility’s 1,100 employees will be needed to ensure uninterrupted service to its 1.2 million customers, make major repairs, and do limited meter reading, billing, and information technology (IT) support. He’s developed a cross-training program to allow operation with such a “barebones” staff.Further, Good has purchased 2,000 N-95 respirators and stashed 37 emergency kits containing tools, sleeping bags, and food at different locations. The kits, which Good estimates could sustain 2 people for 3 to 5 days, are marked with dates and shrink-wrapped. The utility has its own medical clinic and plans to identify and track employees who recover from pandemic influenza (if there is a way to distinguish such employees from those who have had seasonal flu or other illnesses). Presumably, recovered employees would have developed immunity and could return to work after the first wave of infection.Some water utilities are ahead of others in planning for a pandemic, says Kevin Morley, regulatory analyst for the American Water Works Association (AWWA), a trade organization headquartered in Denver, representing 4,700 water utilities. “People are thinking about it,” he says. Even so, he adds, questions remain about what would be expected of a utility and the surrounding community.Workers firstWhat water utilities do seem to agree on is this: of the 3 essential and interrelated resources—workers, electrical power, and chemicals—workers are the most critical. Although the effects of a pandemic on a workforce are unpredictable, no one disputes that small utilities will be hardest hit, Morley says. “Thirty to 40% of a utility that has 400 or 500 employees is going to be different than 30 to 40% of a utility that has 10 employees.”In Texas, says Henderson, “If you count all the water systems that serve fewer than 3,300 households or businesses, that’s 80%.”That’s why the AWWA and the US Environmental Protection Agency (EPA) have teamed up to help water utilities form intrastate—and soon, interstate—mutual aid pacts, similar to TxWARN. Such agreements are intended to enable utilities to get assistance without waiting for the federal government. Utilities who sign up for a pact identify their own needs and what resources they could offer another utility in an emergency. And that’s important. “For the first 72 hours, you’re on your own,” Morley says.In addition to Texas, California, Florida, and Louisiana have established mutual-aid pacts, and Oregon, Georgia, Tennessee, New Jersey, and Connecticut are well on their way, according to John Whitler of the EPA’s Water Security Division. Other states, such as Oregon, Minnesota, Wisconsin and Iowa, are in various stages of planning, he says.In addition to the mutual aid pacts, the EPA is offering water utilities several business-continuity tools, says Jane Downing, chief of the EPA’s Drinking Water Branch in Boston. “We’re working with EPA headquarters to develop a cross-training compendium,” she says. The catalog will point operators to online resources to ramp up their expertise on, for example, disinfection.However, not all roles lend themselves to cross-training. In the case of a laboratory worker who processes federally mandated water samples, Morley says, regulations may have to be temporarily relaxed. “You may not be able to take all of those samples, and the labs may not be able to process them,” he says.Whether workers are going to be willing to come to work—let alone to help out another utility—is another issue, Morley says. “You’re basically asking someone to go into a known infectious area, expose themselves, and then risk bringing it back to their families,” he says.Depending on power and ITPower and water often have a reciprocal relationship, Good says. “The type of power plants we have, a lot of them rely on our water,” he says. “They can’t run without our water, and we can’t run without their power.”Denver Water has placed diesel generators at critical facilities and invested in polyvinyl water storage bladders that can be distributed to central locations in the event of a loss of water pressure. The only “downside” of this plan, says Good, is that it relies on “people getting together,” which could potentially spread infection.Utilities with their own telecommunications system will fare best at sustaining operations and communicating with vendors, partners, suppliers and employees, experts say. In Texas, says Henderson, the TCEQ provides its own IT services and has provided notebook computers for workers in the field to allow workers critical access to databases of the area’s water systems.Utilities that contract for services may encounter fierce competition for bandwidth as other organizations, a panicked public, and bored schoolchildren log on to the Internet, Morley says.’Upstream’ supply chainWater utilities require disinfectants such as chlorine to make water drinkable. And because water utilities can store only about 3 weeks’ worth of chlorine, they rely heavily on suppliers. While Good believes his pandemic plan is solid, “the problem is that our plan is only as good as the plan of our suppliers.”A disruption could occur at each link in the supply chain, including the production of chlorine and other treatment chemicals by petrochemical companies in the United States and Canada, Morley says. “There is no sector that is immune from the effects of a pandemic,” he says. “If 30% of my workforce is affected, why wouldn’t 30% of their workforce be affected?” A little further down the chain, a transportation breakdown (rail or highway) is also a likely scenario.Not wanting to take chances, Good had representatives from the US Department of Homeland Security tour Denver Water. “They have assured us that they can help, as far as distributing chlorine to some of the plants, if we need it,” he says. To conserve supplies in a pandemic, Denver Water may introduce water rationing, similar to restrictions enacted in a drought, and temporarily shut down 2 of its 4 plants.The EPA will continue to work with state regulatory agencies and water trade associations to conduct community-based emergency preparedness workshops, doing the drills and presentations it has since 9/11, now expanding its efforts toward pandemic preparedness, Downing says. But first, she says, “A lot of the efforts need to start to happen locally.”last_img read more

Exposure source unclear in 25% of human H5N1 cases

first_imgJan 16, 2008 (CIDRAP News) – In at least 25% of human infections with the H5N1 avian influenza virus, just how the person was exposed to the virus remains a mystery, according to a report by an expert panel set up by the World Health Organization (WHO).”In one quarter or more of patients with influenza A (H5N1) infection virus infection, the source of exposure is unclear, and environment-to-human transmission remains possible,” says the report, which appears today in the New England Journal of Medicine.The predominant source of exposure in H5N1 cases is contact with infected poultry in the week before onset of illness, the article notes. But in cases involving no such contact, patients might have touched contaminated objects (fomites) or fertilizer containing poultry feces or have inhaled aerosolized infectious material. The only known risk factor for some patients was visiting a live-poultry market, the article says.The discussion of exposure sources is part of a review of all aspects of human H5N1 cases, including epidemiology, clinical features, diagnosis, treatment, and prevention. The report is based on the WHO’s Second Consultation on Clinical Aspects of Human Infection with Avian Influenza A (H5N1), a meeting held in Antalya, Turkey, in March 2007.About a quarter of all human cases have occurred in clusters of two or more that were epidemiologically linked, the report says. More than 90% of the clusters have involved blood relatives, suggesting a possible genetic susceptibility to the infection. Most people in the clusters probably were infected through common exposure to poultry, “but limited, nonsustained human-to-human transmission has probably occurred during very close, unprotected contact with a severely ill patient,” the article states.Regarding the virus’s evolution, the report has a chart that shows a total of 10 different clades (including the original 1997 strain from Hong Kong), or lineages, plus five subclades in clade 2.”Changes in multiple viral genes”—not just the surface protein known as hemagglutinin—”are probably required to generate a potentially pandemic influenza A (H5N1) virus,” the article says. So far, the virus is not transmissible among ferrets or swine, and reassortment (hybridization) between an H5N1 virus and an H3N2 (human-adapted) virus did not produce a virus transmissible among ferrets.Concerning host responses, the report does not fully endorse the “cytokine storm” theory: the proposition that the severe disease in H5N1 cases is a result of an overly intense immune response. The tissue damage “probably results from the combined effects of unrestrained viral infection and inflammatory responses” induced by the infection, it says.Further, the current understanding of the immune response to the infection is not adequate to guide efforts to treat the disease by modifying the immune response, the panel says.In line with that, the report repeats previous WHO advice against the routine use of corticosteroids in H5N1 patients. Corticosteroid therapy has not been effective, and prolonged or high-dose corticosteroids can lead to serious adverse events.As for antiviral drugs, the panel says that clade 1 viruses and most clade 2 viruses from Indonesia are fully resistant to M2 inhibitors (amantadine and rimantadine), but the other clade 2 viruses from other parts of Eurasia and Africa are usually susceptible to these older drugs.The article repeats the standard recommendation for early treatment with oseltamivir, a neuraminidase inhibitor. The panel also reiterates previous WHO statements that doubling the standard oseltamivir dose and duration of treatment may be reasonable. Resistance to the drug has been seen in a few patients, and clade 1 viruses seem to be more susceptible than some clade 2 viruses, though the clinical relevance of this difference is unclear.Concerning H5N1 vaccines, the panel writes that certain proprietary adjuvants seem to be highly effective in antigen sparing (reducing the amount of antigen needed to generate an immune response) and inducing cross-reactive antibody responses. However, the antibody levels needed for protection against the virus are unknown.The report stops short of endorsing prepandemic vaccination—giving an existing H5N1 vaccine before a pandemic in the hope that it will yield some protection against a later H5N1-based pandemic strain or will at least prime the immune system so that just one dose of a specific pandemic vaccine would be necessary.Decisions about prepandemic vaccination require complex risk-benefit and cost-benefit analyses because of likely effects on seasonal vaccine production and the chance that mass vaccinations would trigger adverse events, the article says.Some other observations in the report:The median age of H5N1 case-patients is about 18, and 90% of patients have been 40 years or younger.While the disease typically leads to severe pneumonia, febrile upper respiratory illnesses without pneumonia have been seen in children, particularly since 2005.About 15% to 20% of older adults have some antibodies to H5N1 and might respond to a single dose of vaccine.See also: Writing Committee of the Second World Health Organization Consultation on Clinical Aspects of Human Infection with Avian Influenza A (H5N1) Virus. Update on avian influenza A (H5N1) virus infection in humans. N Engl J Med 2008 Jan 17;358(3) [Full text]Apr 20, 2007, CIDRAP News story “WHO warns against steroids for H5N1 patients”last_img read more