# 6334

Yesterday in NEJM: Cardiovascular Risks Of Taking Azithromycin I wrote about a study that found a `small absolute increase in cardiovascular deaths’ among patients taking the macrolide antibiotic Azithromycin when compared to a control group taking no antibiotics or with taking amoxicillin.

In response to that study, the FDA has released the following statement:

FDA Statement regarding azithromycin (Zithromax) and the risk of cardiovascular death

[05-17-2012] The U.S. Food and Drug Administration (FDA) is aware of the study published in the New England Journal of Medicine, on May 17, 2012, that compared the risks of cardiovascular death in patients treated with azithromycin (Zithromax), amoxicillin, ciprofloxacin (Cipro), levofloxacin (Levaquin), and no antibacterial drug.  The study reported a small increase in cardiovascular deaths, and in the risk of death from any cause, in persons treated with a 5-day course of azithromycin (Zithromax) compared to persons treated with amoxicillin, ciprofloxacin, or no drug. The risks of cardiovascular death associated with levofloxacin treatment were similar to those associated with azithromycin treatment.  FDA is reviewing the results from this study and will communicate any new information that results from the FDA review.

 

Patients taking azithromycin should not stop taking their medicine without talking to their healthcare professional.

 

Healthcare professionals should be aware of the potential for QT interval prolongation and heart arrhythmias when prescribing or administering antibacterial drugs. (See additional information below.)

 

Azithromycin belongs to a class of antibacterial drugs called macrolides, which have been associated with cardiovascular effects; specifically, prolongation of the QT interval. Prolongation of the QT interval can lead to torsades de pointes (TdP), an abnormal heart rhythm, which can be fatal.  Azithromycin was the only macrolide examined in the published study; the study did not address other macrolide antibacterial drugs, such as clarithromycin (Biaxin) and erythromycin, regarding the potential for cardiovascular death.

 

In 2011, FDA reviewed macrolide drug labeling information related to QT interval prolongation and TdP. The WARNINGS AND PRECAUTIONS section of the Zmax drug label (azithromycin extended release for oral suspension) was revised in March 2012 to include new information regarding risk for QT interval prolongation, which appears to be low. The drug labels for clarithromycin and erythromycin also contain information about QT interval prolongation in the WARNINGS section. FDA is in the process of updating risk information in the drug labels for additional macrolide antibacterial drugs.

 

FDA-approved indications for azithromycin include:

• Acute bacterial exacerbations of chronic pulmonary disease
• Acute bacterial sinusitis
• Community-acquired pneumonia
• Pharyngitis/tonsillitis
• Uncomplicated skin and skin structure infections
• Urethritis and cervicitis
• Genital ulcer disease

FDA will communicate any new information on azithromycin and this study or the potential risk of QT interval prolongation after the agency has completed its review.

# 6333

Every few months we get an update from Hong Kong’s swine surveillance program conducted by the University of Hong Kong. Twice a month they sample pigs arriving at Sheung Shui slaughterhouse for influenza viruses.

Several influenza viruses commonly circulate in swine (primarily H1N1, H1N2, H3N2), but what these researchers are looking for are signs of new, or novel strains.

 

Of 1,100 samples tested between February and April of this year, 8 were found to be reassortments of swine flu viruses with genetic material from the 2009 H1N1 virus.

This is a lower number than the last report (see Hong Kong Swine Influenza Surveillance) which detected a total of 27 reassortant viruses out of 1,500 samples.

Reassortment happens when two different influenza viruses co-infect the same host, swap genetic material, and produce a hybrid virus. 

 

This report today is from the Hong Kong Government.

FEHD releases results of regular influenza virus surveillance in pigs from February to April

Friday, May 18, 2012

The Centre for Food Safety (CFS) of the Food and Environmental Hygiene Department today (May 18) announced results of the regular influenza virus surveillance programme on pigs at the Sheung Shui Slaughterhouse conducted by the University of Hong Kong (HKU) for February to April this year.

 

Among some 1,100 samples tested, no human swine influenza virus (pandemic H1N1) was detected.

 

A total of eight samples were found to contain viruses that were essentially swine influenza viruses but had picked up some genes of the human swine influenza virus.

 

According to Professor J S M Peiris, the HKU expert in charge of the surveillance programme, such viruses are unlikely to pose any major human health risks or cause problems in food safety.

 

Under the programme, the CFS has been helping HKU researchers to collect blood and tracheal and nasal swabs from pigs at the Sheung Shui Slaughterhouse twice a month to monitor influenza virus activity in pigs.

 

"Starting from the next cycle (covering results for May to July), regular reports and relevant data of the surveillance programme will be uploaded to the CFS website (www.cfs.gov.hk) on a quarterly basis for public information. Results of the surveillance programme will be announced immediately if findings have significant impact on food safety and public health," a spokesman for the CFS said.

 

(Continue . . . )

While neither particularly alarming or surprising, these virus detections are ongoing evidence of the evolution of influenza viruses in swine populations.

Here in the United States we’ve been watching our own emergent swine flu virus - the H3N2v – which has infected at least 13 people across 6 states since late last summer. My most recent blog on that virus may be read at Eurosurveillance: Cross Reactive Antibodies to H3N2v In Norway.

For more on the potential threat posed by reassortant swine viruses, I would invite you revisit my 2010 essay called:

The (Swine) Influenza Reassortment Puzzle

# 6332

While unlikely to gladden the hearts of travel agents around the globe, the ECDC, through the European Network for Arthropod Vector Surveillance for Human Public Health (VBORNET), has released a new set of maps showing the prevalence of various tick species in Europe.

These maps, along with similar maps generated for exotic and invasive mosquitoes and for Plebotomine sandflies, gain new importance as the threat of vector-borne illnesses increase across Europe.

First the release information and links to the maps, and then I’ll return with more on the growing threat of arthropod carried diseases in Europe.

ECDC launches maps on the distribution of tick species in Europe

17 May 2012

ECDC

ECDC, through the VBORNET network, publishes regularly on its website maps on exotic mosquitoes and on phlebetomines  - to provide the ECDC stakeholders and the general public with the most updated information on vector distribution. The maps are updated and improved quarterly.

 

For the first time maps on the distribution of tick species are presented, covering four tick species: Dermacentor reticulates, Hyalomma marginatum, Ixodes persulcatus, Ixodes ricinus. Another improvement is that from now on the maps on phlebotomines are provided at a finer level of geographical detail:  at the administrative level NUTS3 instead of NUTS1 level.

 

The vector distribution maps are the outcome of collaborative work of the VBORNET network and are based on collecting existing data by the network members. VBORNET is a network of medical entomologists and public health experts, funded by the European Centre for Disease Prevention and Control (ECDC).

 

ECDC, through the VBORNET network, continues to  improve the data collection for the maps: the VBORNET network is therefore looking for vector-borne disease experts who are interested in data sharing and networking (experts can contact VBORNET at vbornet@ecdc.europa.eu).

See and download latest maps on vector distribution (updated 16 May 2012):
VBORNET maps – Tick species
VBORNET maps - Mosquitoes
VBORNET maps – Phlebotomines/Sandflies

In Europe ticks are known to carry and transmit a variety of diseases, including Crimean Congo hemorrhagic fever, Borreliosis, Tick-borne encephalitis, Tick-borne relapsing fever, Tularaemia, and Rickettsios.

And with changes in the climate, the range of ticks and the pattern of disease spread is likely to evolve over time.

The ECDC provides communication toolkits, designed for a variety of recipients, on tick-borne illnesses.

Communication toolkit on tick-borne diseases

This communication toolkit, developed by ECDC, includes template materials such as posters, leaflets, factsheets, etc. for different audiences with information on tick-borne diseases and preventive measures. The aim of the toolkit is to assist public health authorities in Member States in the development of strategies and communication materials to raise awareness on prevention and control of tick-borne diseases.

One of the ECDC toolkits available for download

And it isn’t just ticks.

The list of mosquito-borne diseases that could in the future (or already do) threaten parts of Europe includes West Nile Virus, Dengue, Malaria, Yellow Fever, Chikungunya, Zika Virus, Yellow Fever, Ockelbo virus, and even Rift Valley Fever.

In 2010 the journal Eurosurveillance devoted an entire issue to The Threat Of Vector Borne Diseases, with perhaps the biggest threat outlined in Yellow fever and dengue: a threat to Europe? by P Reiter.

For more on the mosquito-borne threat to Europe you may wish to revisit last April’s ECDC: Status & Importance Of Invasive Mosquito Breeds In Europe and from last year, ECDC: Local Malaria Acquisition In Greece.

And while less commonly known, Visceral Leishmaniasis (VL) is the most serious of the sandfly-borne diseases in Europe. While it rarely causes symptoms in healthy individuals - it can pose a deadly threat to those with HIV or compromised immune systems.

With these new maps the ECDC not only hopes to alert the public as to how to prevent vector borne illness but to track the changes in their geographic range over time.

All of this highlights the fact that you don’t have to travel thousands of miles to some exotic tropical clime in order to be exposed to Dengue, Malaria, Borreliosis, or West Nile Virus.

While still relatively rare in Europe (and North America, as well), these diseases continue to make inroads, and over time are likely to  increase as serious threats to public health.

# 6331

Although it isn’t always fully appreciated, one of the `truths’ about medicine is that all drugs carry with them some risk of side effects. There is simply no such thing as a 100% safe and totally benign drug.

Often, adverse effects are so rare as to not show up during a drug’s clinical trials, and only become apparent after the drug has been in wide use for years.

It is axiomatic that anytime you take a drug, you must weigh its likely benefits against any potential health risks it may introduce. 

Today the NEJM has an article about the potential cardiovascular risks of taking one of the world’s most popular antibiotics; azithromycin. 

`Zith’ is a macrolide antibiotic chemically similar to erythromycin that is effective against a wide variety of bacteria. It is commonly used for middle ear infections, bronchitis, pneumonia, sinusitis and several sexually transmitted infections.

While generally well tolerated (and effective), known side effects include gastrointestinal difficulties (nausea, vomiting, diarrhea)  among less than 5% of those taking the drug, and more rarely, abnormal liver tests, allergic reactions, and nervousness.

Although some antibiotics are known to cause potentially dangerous cardiac arrhythmias, up until now `Zith’  has not been counted among them. 

Today’s study in the NEJM finds a small absolute increase in cardiovascular deaths during a 5-day treatment course with azithromycin compared to taking no antibiotics or with taking amoxicillin, particularly among those with cardiac risk factors.

Azithromycin and the Risk of Cardiovascular Death

Wayne A. Ray, Ph.D., Katherine T. Murray, M.D., Kathi Hall, B.S., Patrick G. Arbogast, Ph.D., and C. Michael Stein, M.B., Ch.B.

N Engl J Med 2012; 366:1881-1890 May 17, 2012

 

Conclusions

During 5 days of azithromycin therapy, there was a small absolute increase in cardiovascular deaths, which was most pronounced among patients with a high baseline risk of cardiovascular disease.

Before anyone starts pitching their Z-packs down the loo, the actual number of cardiovascular incidents was relatively small. And this study was a retrospective analysis of Tennessee Medicaid records between 1992 and 2006 – not a randomized control trial (RCT) - and therefore subject to a number of limitations.

Since the full study is behind a pay wall, for more on all of this we turn to coverage from MedPage Today:

 

Azithromycin May Up Risk of Cardiac Death

By Nancy Walsh, Staff Writer, MedPage Today

Published: May 16, 2012

Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston.

Action Points

• Explain that a Medicaid database study found an increased risk for cardiovascular death, sudden death, and overall all-cause mortality associated with a 5-day course of azithromycin.
• Note that the same findings were not true for amoxicillin or ciprofloxacin compared with controls taking no antibiotics, but there were excess deaths associated with levofloxacin.

Use of a common antibiotic, azithromycin, appears to significantly increase the risk of sudden cardiac death when compared with no antibiotic treatment, according to analysis of data from Medicaid patients.

(Continue . . . )

None of this makes azithromycin a `bad medicine’, but it does highlight the need to recognize and balance the risks of taking this (or any other) drug with its likely benefits. 

And for some patients with elevated cardiac risk factors, it may be prudent for their doctors to now consider other antibiotic treatments.

Although antibiotics can often be lifesaving, evidence continues to mount that their use is less benign that previously thought.

The CDC reports that 50% of antibiotic use in hospitals is ` unnecessary or inappropriate’, and better antibiotic stewardship is needed if we are to combat the growing threat of antibiotic resistance.

You’ll find the CDC maintains an excellent GET SMART ABOUT ANTIBIOTICS webpage, which provides information on the prudent use of antibiotics.

And for more on the potential dangers of antibiotic use (and misuse) you may wish to revisit:

The Other Reason Not To Abuse Antibiotics

Get Smart About Antibiotics Week

ECDC/EMEA: Joint Report On Resistant Bacteria

U.S. Volcanoes and Current Activity Alerts

# 6330

While Alaska and Hawaii are famed for their volcanic activity, it may come as a surprise to many Americans that the United States has 169 `active’ volcanoes within its borders, with about 40 of those in the `lower 48’ states.

Washington is one of the states with a large number of volcanoes, and so May has been proclaimed Volcano Awareness Month.

The Washington State EMD (Emergency Management Division) has advice and information for those living in close proximity of volcanoes.

News / Activities:
USGS / EMD Volcano Awareness Month Announcement

USGS Cascades Volcano Observatory

Preparedness for Volcano Hazards

In English PDF
In Spanish PDF
In Russian PDF
In Korean PDF
In Chinese PDF
In Vietnamese PDF

What To Do: During an eruption and ashfall (see page #2) (PDF)

How to Shelter-in-Place (PDF)     

Shelter-in-Place Video (Quicktime Required)

From the USGS we have a FAQ with that addresses many of the questions the public may have about volcanoes in the United States.  A brief snippet below, but follow the link to read it in its entirety.

Frequently Asked Questions About Volcano Monitoring

To anticipate the awakening or reawakening of a volcano, volcanologists watch for changes caused by moving or pressurizing magma and associated changes in the hydrothermal system surrounding the magma. Magma moving toward the surface can cause swarms of earthquakes; swelling, subsidence, or cracking of the volcano’s flanks; and changes in the amount or types of gases that are emitted from a volcano. The USGS continuously monitors many volcanoes in the states of Washington, Oregon, California, Hawaii, Alaska, and Wyoming (Yellowstone) to detect unusual activity.

Q: Why is it important to monitor volcanoes?

A: The United States and its territories contain 169 geologically active volcanoes, of which 54 volcanoes are a very high or high threat to public safety [National Volcano Early Warning System (NVEWS)]. Many of these volcanoes have erupted in the recent past and will erupt again in the foreseeable future. As populations increase, areas near volcanoes are being developed and aviation routes are increasing. As a result, more people and property are at risk from volcanic activity. Future eruptions could affect hundreds of thousands of people. To help prevent loss of life and property, the U.S. Geological Survey and its partners monitor these volcanoes, and issue warnings of impending eruptions.

Real-time monitoring of volcanoes, with the use of volcano seismology, gas, thermal, and surface deformation measurements, permits scientists to anticipate with varying degrees of certainty, the style and timing of an eruption. While our present state of knowledge does not allow us to predict the exact time and place of eruptions, we can detect changes from usual behavior that precede impending eruptions. We communicate these changes in our volcano updates. The information in the volcano updates allows scientists, public officials, and people in communities at risk to make preparations that can reduce losses during an eruption. Because volcanoes can erupt with little warning, continuous monitoring is important even if a volcano is not showing signs of activity.

(Continue . . . )

 

While major volcanic eruptions on the U.S. mainland are rare events, they have the potential to be extremely disruptive when they do occur. 

For that reason, emergency planners urge:

Before a volcanic eruption:

• Plan ahead. Have emergency supplies, food and water stored. 
• Plan an evacuation route away from rivers or streams that may carry lahars.
• Keep a battery-operated radio available at all times.
• If there is an eruption predicted, monitor the radio or TV for information. Follow the advice given by authorities.

Note: Lahars are debris or mud flows from a volcano, and can be particularly dangerous. 

While it may sound a bit like a broken record, the advice for citizens to be prepared – whether it be for a volcanic eruption, tsunami, earthquake, or some other disaster – continues to ring forth from numerous federal, state and local agencies.

They know that during any serious disaster that emergency services will be severely strained, and that during the opening hours and even days, many people will have to fend for themselves.

The government takes these threats seriously, and so should you. To learn more on how to prepare for any type of disaster, visit Ready.gov and FEMA.

# 6329

The World Health Organization has released the 2012 edition of their World Health Statistics report, an annual compilation of health-related data from its 194 Member States. This report also summarizes progress being made in achieving the health-related Millennium Development Goals (MDGs).

While infectious diseases get most of the world’s attention, it continues to be the NCDs (Non-Communicable Diseases) - like high blood pressure, heart disease , diabetes, and tobacco related illnesses – that exact the greatest toll on human health.

Some excerpts from today’s press release highlights these findings:

New data highlight increases in hypertension, diabetes incidence

News release

16 May 2012 | Geneva - The World health statistics 2012 report, released today, puts the spotlight on the growing problem of the noncommunicable diseases burden.

 

One in three adults worldwide, according to the report, has raised blood pressure – a condition that causes around half of all deaths from stroke and heart disease. One in 10 adults has diabetes.

 

“This report is further evidence of the dramatic increase in the conditions that trigger heart disease and other chronic illnesses, particularly in low- and middle-income countries,” says Dr Margaret Chan, Director-General of WHO. “In some African countries, as much as half the adult population has high blood pressure.”

<SNIP>

Published annually by WHO, the World health statistics is the most comprehensive publication of health-related global statistics available. It contains data from 194 countries on a range of mortality, disease and health system indicators including life expectancy, illnesses and deaths from a range of diseases, health services and treatments, financial investment in health, as well as risk factors and behaviours that affect health.

Some key trends in this year’s report are:

• Maternal mortality: In 20 years, the number of maternal deaths has decreased from more than 540 000 deaths in 1990 to less than 290 000 in 2010 – a decline of 47%. One third of these maternal deaths occur in just two countries – India with 20% of the global total and Nigeria with 14%.
• 10 year trends for causes of child death: Data from the years 2000 to 2010 show how public health advancements have helped save children’s lives in the past decade. The world has made significant progress, having reduced the number of child deaths from almost 10 million children aged less than 5 years in 2000 to 7.6 million annual deaths in 2010. Declines in numbers of deaths from diarrhoeal disease and measles have been particularly striking.

 

(Continue . . . )

DOWNLOAD THE SUMMARY BROCHURE

Available in 3 languages

• English pdf, 381kb
• French  pdf, 389kb
• Spanish pdf, 389kb

DOWNLOAD THE FULL REPORT

Available in 3 languages

• English pdf, 2.47Mb
• French pdf, 2.69Mb
• Spanish pdf, 2.84Mb

Of considerable interest to those of us who follow disease outbreaks around the world is the lack of disease and mortality information available from many low-resource countries.

Among low income countries, only about 1% of deaths (and their causes) are recorded, while just 34 countries – representing 15% of the world’s population – produce high quality cause-of-death documentation.

The two most populous countries in the world – India and China – do not have national civil registration systems in place, and instead generate estimates of births and deaths based on smaller population samples.

All of which helps to explain why, nearly two years after the end of the 2009 H1N1 pandemic, we still don’t have a good handle on how many people died from the virus.

This lack of surveillance and reporting extends far beyond just births and deaths, which is why there is so much ambiguity regarding the true prevalence of many diseases (including H5N1) around the world.

Much of the data that is available can be accessed via the WHO’s Global Health Observatory, which allows tailored online searches for health information by country or region.

Global Health Observatory (GHO)

• Global Health Observatory
• Data repository
• Reports
• Country statistics
• Map gallery
• Standards

# 6328

As I’ve mentioned previously, once a month the CDC  presents a Public Health Grand Rounds webcast, that focuses on a single public health issue. In April of last year I gave considerable blog space to CDC Grand Rounds: Sodium Reduction. 

 

Later today (1 pm EDT) the CDC will live stream their latest Grand Rounds presentation, this time on the growing threat of multi-drug resistant gonorrhea.

 

Tuesday, May 15, 2012 1 p.m. – 2 p.m., EDT

Watch live webcast

This is a subject that both Maryn McKenna (see Drug-Resistant Gonorrhea: How We Lost Track and The Clap Came Back: Multidrug-Resistant Gonorrhea) and I have written about in the past.

A couple of my offerings include:

The Path Of Increased Resistance

True in the 1940s, but sadly, no longer the case – Photo Credit scdhec.gov

 

and . . .

Going, Going, Gonorrhea

Here is the CDC’s announcement for today’s Grand Rounds:

 

Public Health Grand Rounds

 The Growing Threat of Multidrug-Resistant Gonorrhea

This session of Grand Rounds will explore the development of antibiotic resistance in Neisseria gonorrhoeae as a growing public health concern because the United States gonorrhea control strategy relies on effective antibiotic therapy. Since antibiotics were first used for treatment of gonorrhea, N. gonorrhoeae has progressively developed resistance to the antibiotic drugs prescribed to treat it: sulfonilamides, penicillin, tetracycline, and ciprofloxacin. Currently, CDC STD treatment guidelines recommend dual therapy with a cephalosporin antibiotic (ceftriaxone is preferred) and either azithromycin or doxycycline to treat all uncomplicated gonococcal infections among adults and adolescents in the United States.

 

Given the ability of N. gonorrhoeae to develop antibiotic resistance, it is critical to continuously monitor gonococcal antibiotic resistance and encourage research and development of new treatment regimens for gonorrhea.

(Continue . . . )

Today’s presenters include:

Edward Hook III, MD
Professor of Medicine and Epidemiology
University of Alabama, Birmingham

William Shafer, PhD
Professor of Microbiology and Immunology
Emory University

Carolyn Deal, PhD
Chief, Sexually Transmitted Diseases Branch
National Institute of Allergy and Infectious Diseases
National Institutes of Health

Robert D. Kirkcaldy, MD, MPH
Medical Officer
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

 

 

If you miss the live broadcast, you’ll be able to view this latest Grand Rounds presentation on the CDC’s Streaming Health Youtube Channel in about 48 hours.

Source FEMA IPAWS Video

# 6327

Today a guide for the acronym-impaired as the federal government makes ready for the launch of their new cell phone emergency alert system dubbed the Personal Localized Alert Network (aka PLAN), also known as CMAS (Commercial Mobile Alert System) or alternately as WEA (Wireless Emergency Alerts).

Emergency text messages are to be delivered via the IPAWS (Integrated Public Alert and Warning System) program, and can include localized Presidential messages, Amber Alerts, and imminent threat alerts such as severe weather warnings.

All of this is part of the larger EAS (Emergency Alert System) which broadcasts emergency warnings on radio, TV, and other media (see Emergency Alert System (EAS) Test Today).

Essentially, with PLAN,  authorized government agencies (either local, tribal, state, or federal) can send an emergency text of up to 90 characters to millions of cell phone users simultaneously, providing instant warning of a localized threat such as a tornado, tsunami, or public safety hazard.

The good news is this service is free to cellular customers, and will be offered to nearly all cell phone users in the United States. The bad new is older cell phones may not support this technology, and you may need to upgrade your phone in order to be able to access it.

Just over a year ago the FEMA BLOG  carried a detailed report on this new technology, which you can access at:

Emergency Alerts Delivered to Your Phone: What Our New PLAN Means to You

Posted by: Damon Penn, Assistant Administrator, National Continuity Programs

And from the FCC Encyclopedia, we get this Q&A FAQ on this new PLAN.

What is PLAN?

The Personal Localized Alerting Network (PLAN) is a new public safety system that allows customers who own an enabled mobile device to receive geographically-targeted, text-like messages alerting them of imminent threats to safety in their area.

This new technology ensures that emergency alerts will not get stuck in highly congested user areas, which can happen with standard mobile voice and texting services.

<SNIP>

FAQ

 

Q: Who will receive PLAN alerts?

A: Alerts are geographically targeted, so a customer living in downtown New York would not receive a threat alert if they happen to be in Chicago when the alert is sent.  Similarly, someone visiting downtown New York from Chicago on that same day would receive the alert.  This requires a PLAN enabled mobile device and participation by the wireless provider in PLAN.

 

Q: Do consumers have to sign up to receive alerts?

A: Customers of participating carriers are automatically signed up.  PLAN allows government officials to send emergency alerts to all subscribers with PLAN-capable devices if their wireless carrier participates in the program. Consumers do not need to sign up for this service.

 

Q: How much will consumers pay to receive PLAN alerts ?

A: Alerts Are Free. Customers do not pay to receive PLAN alerts.

 

Q: What alerts will PLAN deliver?

A: Alerts from PLAN cover only critical emergency alerts. Consumers will receive only three types of alerts:

1. Alerts issued by the President
2. Alerts involving imminent threats to safety of life
3. Amber Alerts

Participating carriers may allow subscribers to block all but Presidential alerts.

 

Q: What will consumers experience when they receive a PLAN alert?

A: PLAN uses a unique signal and vibration, and appears much like a text message.  A PLAN alert will be accompanied by a unique attention signal and vibration, which is particularly helpful to people with hearing or vision-related disabilities. The PLAN alert will appear as a pop-up text on the handset screen much like a text message.

 

Q: Are PLAN alerts text messages?

A: No, PLAN messages are not text messages. Alerts will not have to be opened like SMS text messages, but will “pop up” on the handset’s screen. PLAN alerts are transmitted using a new technology that is separate and different from voice calls and SMS text messages. This new technology that ensures emergency alerts will not get stuck in highly congested user areas, which can happen with standard mobile voice and texting services. 

 

Q:Will consumers need a new phone or a smart phone to receive alerts?

A: Some phones may require only software upgrades to receive alerts, while in other cases a subscriber may need to purchase a new PLAN-capable handset. Consumers should check with their wireless carrier regarding the availability of PLAN-capable handsets.

During a sudden emergency, the most important asset you can have is timely information; being aware of an impending threat, so you can deal with it.

 

Sometimes a few minutes advance warning can make all the difference in the world. 

 

As the EAS system expands and modernizes to include cell phones, Internet, and cable TV – your odds of being blindsided by a tornado, earthquake, or other disaster decreases.

But to be truly effective, you need to have a disaster plan already in place to deal with any alerts that the government’s PLAN delivers. 

To become better prepared as an individual, family, business owner, or community to deal with all types of disasters, I would invite you to visit the following preparedness sites.

FEMA http://www.fema.gov/index.shtm

READY.GOV http://www.ready.gov/

AMERICAN RED CROSS http://www.redcross.org/

The Centre for Health Protection today warned the public to be vigilant against influenza, as flu activity remains high.   

The weekly number of flu virus detections increased from 199 in the week ending April 14, to 442 in the week ending May 12.   

The influenza A (H3N2) virus was the most common flu strain in the past four weeks, causing 88% of cases.   

There have been 159 cases of intensive care unit admissions, including 92 deaths, involving laboratory-confirmed influenza since January 13.

# 6326

Around the globe cities are increasingly where jobs are to be found, and where goods and services are most likely to be available. And so not surprisingly, today, half the world’s population – some 3.5 billion people – now live in urban areas.

With the clustering of millions of people into relatively small areas, we’ve created a scores of `target-rich environments’ for natural disasters such as earthquakes, floods, and severe storms. 

The equation is pretty simple. More people in a small space = more potential casualties.

 

And the more densely populated a region is, the more economic impact a disaster will have as well.

Last year, in UNDP: Supercities At Seismic Risk, we looked at the concerns that half of the world’s supercities  (urban areas with 2 million – 15 million inhabitants) are at risk of significant seismic activity.

Last December, in WHO e-Atlas Of Natural Disaster Risks To Europe, we looked at some of the disaster threats facing Europe, and in January of this year I blogged that a UN Agency Warns On Global Seismic Risks.

 

In 2010, more than 200,000 inhabitants in and around Port-au-Prince, Haiti died during their 7.0 magnitude earthquake. Much of that death toll can be attributed to the poor construction standards in that region that led to tens of thousands of building collapses.

While we can’t stop earthquakes from striking, or hurricanes from making landfall, we can design our cities to be more resilient for when they do.  Not only can this reduce the death toll and human suffering, it can reduce the economic impact as well.

Which brings us to a new publication from the United Nations International Strategy For Disaster Reduction (ISDR).

How to make cities more resilient: a handbook for local government leaders

A contribution to the global campaign 2010-2015 Making Cities Resilient – ‘My City is Getting Ready!’:

This handbook provides mayors, governors, councillors and other local government leaders with a generic framework for risk reduction and points to good practices and tools that are already being applied in different cities for that purpose. It discusses why building disaster resilience is beneficial; what kind of strategies and actions are required; and how to go about the task. It offers practical guidance to understand and take action on the "Ten Essentials for Making Cities Resilient" as set out in the global campaign "Making Cities Resilient: My City is Getting Ready!".

 

A web-based information platform, where cities and local governments can share their own tools, plans, regulations and practices, complements the Handbook and will be available through the Campaign website.

While billed as a handbook primarily for city officials, citizens and residents of these urban areas have a deep seated interest in seeing that the proper steps are taken to mitigate potential disaster losses.

I’m a firm believer that true resilience is built from the bottom up, not the top down.  And so it behooves everyone – no matter where they live, or what position in their community they may hold – to look at their surroundings and do a basic threat assessment. 

And then take whatever prudent steps they can to to reduce those risks, and to encourage those around them to do the same.

 

No matter where you live in the world, the resources of the FEMA, and READY.GOV websites can be used to help make you and your community better prepared to deal with disasters.

While designed specifically for the threats facing southern California, the The L. A. County Emergency Survival Guide provides an excellent starting place for any family doing `all threats’ emergency planning.

Most importantly, everyone needs an appropriate disaster plan, just as everyone should have a good first aid kit, a `bug-out bag’, and sufficient emergency supplies to last a bare minimum of 72 hours.

For more on  disaster preparedness, I would invite you revisit these blogs:

When 72 Hours Isn’t Enough

In An Emergency, Who Has Your Back?

An Appropriate Level Of Preparedness

The Gift Of Preparedness 2011