New York #NY | 21st #SecondChance #FDNY #ResuscitationReunion

The 11 survivors of cardiac arrests with the #FDNY150 ambulance
The 11 survivors of cardiac arrests with the #FDNY150 ambulance

Wednesday, May 20 the 21st annual Second Chance Ceremony was held at the FDNY Training Academy on Randall’s Island. This event reunites eleven survivors of cardiac arrest with the Paramedics, Emergency Medical Technicians (EMTs), FDNY EMS Officers, Firefighters, bystanders and other first responders who helped save their lives.

“Each of the survivors we welcome for this wonderful ceremony to celebrate National EMS Week 2015 would not be with us if not for the calm, professional response that is a hallmark of FDNY EMTs, Paramedics and Firefighters,” said Commissioner Daniel A. Nigro. “More than 1.6 million times last year alone FDNY members responded to emergencies; bringing their life-saving training to those who needed it most.”

In the 20 years that this ceremony has been held, more than 200 survivors have been reunited with the FDNY members who saved their lives. This year, the eleven survivors include two people visiting New York City on vacation, a woman attending mass in Queens, a man playing softball in Brooklyn and an FDNY Fire Alarm Dispatcher who was dispatching FDNY units to emergencies in Brooklyn.

“I love New York City, it is the city that saved my life,” said Brittany Williams, who experienced cardiac arrest in a restaurant while vacationing with her parents in Manhattan. She was aided by two bystanders on-scene, before Firefighters from Engine Company 23, Paramedics and EMTs from Mt. Sinai and a Lieutenant from Station 10 arrived minutes later.

Another survivor at the ceremony was Gabriel Hernandez who collapsed while standing on the street in the Bronx. Onlookers flagged-down an FDNY ambulance passing nearby, which was being driven by a newly graduated EMT – Fernando Frias. EMT Frias who was off-duty and returning the ambulance to his station alone, began CPR on Mr. Hernandez. He was soon joined in his efforts by Firefighters from Engine Company 68, Paramedics from Station 14, an officer from Station 17, and EMTs from Bronx Lebanon Hospital.  Together, they were able to restore Mr. Hernandez’s pulse and breathing.

“At any moment, the call comes in that there’s a patient in cardiac arrest – and that’s the most critical medical call we receive,” said Chief of Department James E. Leonard. “And we will do everything we can to save that person.”

Five of the survivors received cardiopulmonary resuscitation (CPR) from bystanders before on-duty FDNY members arrived.  Immediate CPR, coupled with defibrillation within the first few minutes after sudden cardiac arrest, can greatly increase a victim’s chance of survival. This year, thanks to support from the FDNY Foundation, the FDNY Mobile CPR Training Unit trained its 100,000th person to perform bystander CPR.

For more information about learning bystander CPR for free from the FDNY Mobile CPR Training Unit, call 311 or visit

J Gabriel Hernandez was standing on Ogden Avenue in the Bronx on
March 6, 2015, when he collapsed without warning. At that
moment, an ambulance driven by rookie FDNY Emergency
Medical Technician Fernando Frias was flagged down by bystanders.
This was his first week in the field and he was returning to EMS Station 17, no longer in service and without his partner; however, whenever flagged, an FDNY ambulance must stop to help. EMT Frias did not hesitate to perform his sworn duty.

EMT Frias found Mr. Hernandez with no pulse and initiated CPR.
Minutes later, Captain Michael Nigro and Firefighters Jason Davis,
Michael Ryan, Kevin Fitzpatrick and Paul Castle of Engine Company
68 arrived to assist. Together they applied one shock from the external defibrillator and continued CPR until Paramedics Kevin Bratholt and Luke Hardcastle from EMS Station 14 arrived to administer advanced care. After multiple defibrillator shocks, Mr. Hernandez regained his pulse, began breathing on his own and was able to speak and answer questions.

Lieutenant Joseph Pastor of EMS Station 17 and Emergency Medical Technicians Kelsey Paulino and Kenny Rosario of Bronx Lebanon Hospital arrived to assist with the transport of Mr. Hernandez to Bronx Lebanon Hospital. Thanks to a quick-thinking rookie and a quick-responding team of veteran FDNY members, Mr. Hernandez is doing well and enjoying his second chance.

David Jacobs was walking with his family on Manhattan’s East
side on June 19, 2014 when he collapsed. He was barely breathing
and had lost his pulse. Nearby Engine Company 5 was the first to respond. Lieutenant Christian Childs and Firefighters Gary Stegmeier, Peter Santiago, Eric Schaming and Christopher Connolly began CPR and administered one shock with the external defibrillator. They were soon joined by FDNY Emergency Medical Technicians Alexis Ward and Abraham Kasner of EMS Station 8, Paramedics Gregory Floyd and Timothy Janis of EMS Station 4 and Lieutenant Bernard Pogrebinsky of EMS Station 10. Together, the members on scene worked side-by-side to restore Mr. Jacobs’ pulse to the point where he could speak.

Once in the ambulance to be transported, Mr. Jacobs’ heart stopped beating and he was once again in cardiac arrest. The Paramedics shocked him for a second time, restored his pulse yet again and brought him to Beth Israel Medical Center for continued care. FDNY units from four different facilities across Manhattan worked tirelessly to save Mr. Jacobs’ life. Thanks to their tenacity and refusal to quit, he is alive, well, and making the most of his second chance.

FDNY Fire Alarm Dispatcher (FAD) Sherri Johnson-Campbell
was on-duty dispatching FDNY units in Brooklyn when she
began to have a seizure on August 8, 2014. Fellow FDNY members responded immediately to assist FAD Johnson-Campbell. They found her with a weak pulse and barely breathing.

Lieutenant Edgar Baez and EMT Herbert Kammerman of Emergency Medical Dispatch began patient care, but within moments, she had stopped breathing and slipped into cardiac arrest. CPR was initiated and an external defibrillator was applied.

Numerous FDNY members working in Emergency Medical Dispatch that day raced to FAD Johnson-Campbell’s side including Captains Rudy Medina and Gaetano Lazzara; Lieutenants Evelyn Rios, Inmaculada Gattas, and Tracy Joseph; and Emergency Medical Technicians Lance Winfield, John Amore, Scott Funk, Anthony  Ranieri, Daynar Castro and Decosta Wright. Despite this chaotic and emotional situation, FDNY members continued to respond to 911 calls and dispatch field units to medical emergencies and fires.

After a shock with the external defibrillator, return of spontaneous circulation was achieved as Paramedics Bryant Gutierrez and Lothaire Germain from EMS Station 31 arrived. The Paramedics provided advance life support efforts and worked with Emergency Medical Technicians Luis Paulino and Juan Toledo of Brooklyn Hospital and FDNY Lieutenant Brian Smith to transport FAD Johnson-Campbell to Brooklyn Hospital.

When one of their own was in need, FDNY members responded in the calm, cool and professional manner that is a hallmark of the
Department. Thanks to the outstanding efforts of the men and women she works closely with every single day to keep New York City safe, FAD Sherri Johnson-Campbell is back at work, helping FDNY units reach those in need and enjoying her second chance at life.

Richard Johnson was with his wife on the morning of June 24,  2013, when, without warning, he collapsed in his home. His wife wasted no time and called 911 for help.

Minutes later, Paramedics Festus Ogude and Enrique Arroyo of Mt. Sinai Roosevelt Hospital responded to find Mr. Johnson barely  breathing. They provided oxygen and, using a cardiac monitor, found his heart was in a lethal cardiac rhythm. Two shocks were administered using an external defibrillator.

FDNY Lieutenant Kevin Mazuzan of EMS Station 7 arrived to supervise the operation. They were joined by Emergency Medical
Technicians Paul Soto and Lea Vasquez of Mt. Sinai Roosevelt
Hospital. Working together, the responding units gave Mr. Johnson
intravenous medications, cold saline and inserted a breathing tube.
After ten minutes of difficult, life-saving work, Mr, Johnson’s heart
began beating again. He was transported to the Bellevue Hospital
where a specialized procedure allowed doctors to quickly open the
blockage in his arteries.

Thanks to quick response and outstanding effort that morning by so
many medical professionals, Mr. Johnson is alive and well, with a second chance.

Gregory Moquin of North Chesterfield, Virginia was visiting family in New York City on February 22, 2014. That night, chest pains woke him from his sleep in his Manhattan hotel room. Due to the severe pain he was experiencing and his medical history of cardiac issues, he called the front desk and asked that they call 911.

Several minutes later, Emergency Medical Technicians Michael Delsorbo and James Acevedo of EMS Station 4 arrived to begin a patient assessment of Mr. Moquin. They found he was displaying symptoms of Myocardial Infraction. Paramedics Kam Wong and Gregory Floyd, also of EMS Station 4, arrived soon after and  initiated advanced care, including cardiac monitoring, which showed there was a critical blockage in his heart.

Paramedics Floyd and Wong contacted FDNY On-Line Medical Control to receive further patient care instructions. Working with EMTs Delsorbo and Acevedo, they transported Mr. Moquin to Bellevue Hospital. Upon entering the Emergency Room, Mr. Moquin’s heart stopped beating. The FDNY members immediately began CPR and shocked him once with their external defibrillator in an attempt to restart his heart. They continued CPR until doctors and nurses from the hospital assumed care of Mr. Moquin.

The team of Paramedics and EMTs who answered the call that night demonstrated that the FDNY stands ready to respond to help every person who lives in, works in and visits New York City. Thanks to the
timely response and accurate patient assessment, Mr. Moquin  received the advance care needed in his hotel room – and at the hospital – that gave him his second chance.

Laura Murphy was not feeling well on the morning of Monday,
March 31, 2014. Home with her husband, she made the decision
to call out sick from work. Minutes later, she took a drastic
turn for the worse and was in cardiac arrest. Her husband quickly
called 911 for help.

Captain Michael Smithwick and Firefighters Christopher Dunic, Richard Garcia, James Reichman, John McCoy and William Long Squad Company 288 were in Ms. Murphy’s home shortly after that call, finding her with no pulse and not breathing. They initiated CPR and shocked her once with the external defibrillator.

Next through the door were FDNY Paramedics Vanessa Tenorio and Michele Baiocco and Emergency Medical Technicians Andrey Kirichenko and Joseph Segot, all from EMS Station 45. Together, they continued CPR, administered an additional defibrillator shock and provided intravenous medications. The collective efforts of all who responded helped restore Ms. Murphy’s pulse and breathing.

With the assistance of Lieutenant William Duncklee of EMS Station 46, Ms. Murphy was transported to Elmhurst Hospital where she made a full recovery. Thanks to tremendous effort from every responding FDNY member that morning, Ms. Murphy is back at work, doing well and enjoying her second chance.

Carlos Reyes was on the mound pitching for his softball team in
the early morning on Sunday, April 13, 2014, when he suddenly
collapsed. His teammates called 911.

Within minutes, Captain Thomas Smith and Firefighters James Becker, Adam Reichert, Tom Leanza and Chris Tufano from Engine Company 309 arrived to find Mr. Reyes in cardiac arrest. They immediately began CPR and administered two shocks from their automatic external defibrillator.

The members of Engine Company 309 were joined by Lieutenant Moshe Klein of EMS Station 43, Paramedics Lionel Roman and Vladimir Nikulin of EMS Station 43, and Emergency Medical Technicians Eugenia Carrero and Lauren Norris of New York Community Hospital who worked together to continue care for Mr. Reyes. Paramedics Roman and Nikulin began advanced life support, intubating Mr. Reyes and providing intravenous medications and  cardiac monitoring as he was transported to Lutheran Medical Center.

Thanks to the teamwork of all involved – from his teammates to those who responded to the call for help – Mr. Reyes is feeling better, enjoying his second chance and working hard to get back on the field.

Sharon Rhodie attended church with her mother on January 26,
2014 in Queens despite the fact that she was not feeling well.
Inside the Deliverance Baptist Church, her condition worsened
and she fell to the floor in cardiac arrest.

Attending the same mass were four nurses – Kerry Stewart, Gwen
Cockrane, Linda Cockrane-Hill and Sandra White Lowman – who came to Ms. Rhodie’s side to perform CPR. They were joined by Lieutenant George Murphy and Firefighters Laurence Mooney, Vincent Schieda, Christopher Scott and Ralph Miller of Engine Company 317 as well as Lieutenant Wilfredo Silvestry of EMS Station 45. The FDNY members took over CPR and delivered multiple shocks with an external defibrillator.

FDNY Paramedics Vijay Rampersad and Joel Orr from EMS Station 47 were the next arriving members to the scene. They initiated advanced life support efforts and administered additional defibrillator shocks.

Working closely with Emergency Medical Technicians Reginald
McLaurin-Bey and Raz-Giem Graves, they restored Ms. Rhodie’s
heartbeat before she arrived at Long Island Jewish Medical Center.

Ten FDNY members and four Good Samaritans joined together to save Ms. Rhodie’s life that day. Thanks to their incredible efforts, she now has a second chance.

Howard Rosenbluth was in line to see a show at the Gramercy Theater when he collapsed in front of a large crowd of theatergoers
on September 16, 2014.

Luckily for Mr. Rosenbluth, off-duty Firefighter Luke Jackson of Engine Company 3 was waiting in that same line. Firefighter Jackson immediately sprang into action, asking a friend to call 911, securing an external defibrillator from a security guard at the theater and performing CPR. After minutes of CPR and one shock with the defibrillator by Firefighter Jackson, Mr. Rosenbluth became responsive again.

Lieutenant Eugene McConnell and Firefighters Guy Kirschberg, John Dilillo, Richard Nix and Markus Geis of Engine Company 14;
Paramedics Timothy Anson and Robert Persaud of EMS Station 8 and Lieutenant Wa-il Eldahry of EMS Station 20 joined Firefighter Jackson to continue patient care. Paramedics Anson and Persaud provided intravenous medications and cardiac monitoring and transported Mr. Rosenbluth to Bellevue hospital.

Thanks to the Firefighter Jackson’s commitment to duty and the quick response of so many FDNY members, Mr. Rosenbluth’s life was saved and he was given a second chance.

Joseph Shelmet was in Penn Station, headed home from work,
when, while entering the train, he felt dizzy and fell to the floor.
Many bystanders and first responders would quickly come to his

First to his side were two of his co-workers; Karen Ronan, a nurse, and Kim Vida. They initiated CPR, and continued until Amtrak Police
Officers Jean Dorcely, Michael Eib and Joseph Nativo arrived with an external defibrillator. The Officers continued CPR and administered one shock before the arrival of Lieutenant Robert Wilson and Firefighters Martin Lydon, Russell Bakunas, David Struble and Robert Rivera from Engine Company 1.

The arriving Firefighters provided oxygen and continued care until Mr. Shelmet’s respirations and pulse were restored. Paramedics Daniel Riccobono and Starsky Von Prime from EMS Station 7 were next on scene, finding Mr. Shelmet disoriented, but able to speak. They provided advanced care, administering intravenous fluids and cardiac monitoring.

Emergency Medical Technicians Filomena DeLeon and Samuel Hernandez, as well as Lieutenant Jeff Krulfeifer, all of EMS Station 7 assisted with transporting Mr. Shelmet to NYU Medical Center to receive additional care.

Thanks to the quick response of his co-workers, law enforcement officers and FDNY members, Mr. Shelmet is alive and well and enjoying his second chance.

Cardiac arrest survivor Brittany Williams thanks one of the responding EMS members
Cardiac arrest survivor Brittany Williams thanks one of the responding EMS members

Brittany Williams was in New York City for a vacation and having
lunch with her family on December 6, 2014 when she began
to have difficulty breathing and collapsed onto the floor of the

Eating at the same restaurant were Dr. Nicholas Farber and Dr. Brandon Johnson, who ran to her side. Without a moment’s hesitation, they began to perform CPR – a decision that would help save Ms. Williams’ life.

Minutes later, Lieutenant Anthony Perciavalle and Firefighters Michael Imperio, Anthony Bertolini, Barnard Randall and Patrice Castor of Engine Company 23 arrived to take over CPR and deliver a shock from an external defibrillator which restored her heartbeat.
The Doctors and Firefighters were soon joined by Paramedics Eric
Unterman and David West and Emergency Medical Technicians Andrea DeSalvo and Eugine Morabito of Mt Sinai Roosevelt Hospital, who, along with FDNY Lieutenant George Kroustallis, continued care of Ms. Williams and transported her to Mt. Sinai Roosevelt Hospital. After nine days in the hospital, Ms. Williams had improved and was well enough to return home to Tallahassee, Florida.

Thanks to bystander CPR and so many highly-trained Firefighters,
Paramedics and EMTs, Ms. Williams is back home and enjoying her
second chance at life.


Delaware #DE | #Volunteers needed for new State #Animal #Response Team

The Delaware Animal Response (DAR) program is offering a unique opportunity for Delawareans to support state and county efforts to keep animals, small and large, safe and protected during emergencies and disasters. The program is recruiting community volunteers for the new Delaware State Animal Response Team (DE SART) and their specialized unit, the Delaware Veterinary Medical Reserve Corps (DE VMRC).

Managed by the Division of Public Health’s Office of Animal Welfare (OAW), the program is looking for volunteers with various experiences and skills, including:

  • Small or large animal care, handling, control, training, sheltering, or rescue experience
  • First responders and others with experience in emergency preparedness and response
  • Veterinarians, veterinary technicians, and veterinary assistants
  • Persons interested in animal welfare and animal protection.

The deadline to sign up for the first round of recruitment is Monday, June 1, 2015. Training will be provided in a range of areas, including community outreach, animal emergency sheltering, and field response.

These programs were developed to protect the health, safety, and welfare of companion animals, and promote the human-animal bond in the state of Delaware. When the OAW assumed responsibility for animal response in 2014, Executive Director Hetti Brown enthusiastically welcomed the program and saw it as a logical fit. “The animal response program’s primary mission is to ensure that pet owners are taken into consideration in state preparedness efforts and that the needs of Delaware’s animals are addressed during emergencies or disasters,” Brown said.

As outlined in the Delaware Emergency Operations Plan (DEOP), the program is responsible for a range of animal emergency preparedness and response areas, including community education, animal emergency sheltering, animal evacuation and transportation, and animal search and rescue.

“Volunteers on the state’s animal response team and veterinary medical reserve corps will provide the critical management and staffing support necessary to set up and run successful animal emergency shelters during times of extreme need, and will assist with community outreach and education events,” said Program Coordinator P. Jane Walmsley. “As the program evolves, they will have the option to specialize in other areas of animal response and take on leadership roles based on their skills and interests.”

The program was originally established to meet the requirements of the groundbreaking Pets Evacuation and Transportation Standards (PETS) Act passed by Congress in 2006. This federal legislation was a direct response to lessons learned from Hurricane Katrina, when many would not leave home without their pets and many pets had to be left behind by those who did evacuate. It became clear that pets must be included in emergency planning for the safety and welfare of all. The PETS Act requires states to take into account the needs of household and service animals before, during, and after an emergency or disaster.

Those interested in becoming a SART or VMRC volunteer are also encouraged to sign up to attend an introductory training to be held in late spring of 2015, and the companion animal shelter training, which will be provided this summer.

For more information or to apply to become a volunteer, call (302) 255-4628 or email

Iowa #IA | Two more probable cases of #HPAI #H5 #BirdFlu in #Adair and #Webster counties

The Iowa Department of Agriculture and Land Stewardship is responding to two probable cases of highly pathogenic avian influenza (HPAI) in Adair and Webster counties.

With the new announcements, Iowa now has 66 cases of the disease in the state. The Department has quarantined the premises and once the presence of the disease is confirmed, all birds on the property will be humanely euthanized to prevent the spread of the disease.

Adair 1 – Commercial laying operation with an estimated 975,000 birds that has experienced increased mortality.  Initial testing showed it positive for H5 avian influenza.  Additional confirmatory testing is pending from the APHIS National Veterinary Services Laboratories (NVSL) in Ames.

Webster 1 – Commercial laying operation with an estimated 160,000 birds that has experienced increased mortality.  Initial testing showed it positive for H5 avian influenza.  Additional confirmatory testing is pending from the APHIS National Veterinary Services Laboratories (NVSL) in Ames.

As the Department receives final confirmations of the disease updated information will be posted to the Iowa Department of Agriculture and Land Stewardship’s website at

The Center for Disease Control (CDC) and Iowa Department of Public Health considers the risk to people from these HPAI H5 infections in wild birds, backyard flocks and commercial poultry, to be low.  No human infections with the virus have ever been detected and there is no food safety risk for consumers.



The U.S. Department of Agriculture’s Incident Response team in Iowa reported that 35 loads of biological materials were transported over the weekend to the Cherokee County Landfill and Recycling Center.  The team anticipates that the large incinerator will begin processing materials this week.

“This marks an encouraging step forward in the response, providing an additional method and location for the disposal of large numbers of affected poultry,” said Dr. Ken Angel, current Incident Commander of the USDA response in Iowa.  After incineration at the landfill, the resulting ash will be deposited there.

Several safe methods are available to dispose of the poultry carcasses including composting, onsite burial, incineration, rendering, and landfilling, each with benefits and limitations. USDA and its State partners evaluate those methods based on factors such as the size of the flock, space requirements, associated costs, local conditions, and regulations.  Some euthanized poultry are being composted, buried, or incinerated on-site at Iowa poultry premises when appropriate.  In addition to the incinerator site in Cherokee County, two landfills have agreed to landfill remains under criteria set by the Iowa Department of Natural Resources.

USDA has more than 1500 staff and contractors helping respond to the avian influenza situation in Iowa.  To date, depopulation has been completed on all previously announced turkey sites.  Composting of turkeys is still ongoing.  Also, 19.1 million commercial layers and pullets have been euthanized as of May 25.



Concerned residents both within and outside the areas affected by avian influenza are encouraged to use the Iowa Concern Hotline at 1-800-447-1985 if they have questions or need disaster counseling. The Iowa Concern Hotline is available 24 hours a day. All calls are free and confidential, and the operators are willing to assist wherever possible.

Iowa State University Extension and Outreach operates the hotline and is partnering with the Iowa Department of Agriculture and Land Stewardship, the Iowa Department of Health, Iowa Department of Natural Resources, Iowa Homeland Security and Emergency Management Department and Egg Industry Council to provide up-to-date information to Iowans about the disease.



Iowa Department of Agriculture and Land Stewardship (IDALS)

  • Quarantining all infected sites
  • Subject to facilities implementing nationally approved biosecurity measures, the Dept. permits the movement of materials such as feed and other supplies on and off of infected sites
  • Leading efforts to monitor poultry within a 10-kilometer circle of each infected site
  • Coordinating state communication efforts on the disease
  • Working with federal and state officials to ensure the humane depopulation and disposal of all birds from infected sites

Iowa Homeland Security and Emergency Management Department (HSEMD)

  • Coordinating partial activation of the State Emergency Operations Center (SEOC) with several state agencies, including the Iowa Departments of Agriculture and Land Stewardship, Public Health, Natural Resources, Transportation, Public Safety, and the Iowa National Guard. USDA, Iowa Turkey Federation, and Iowa Poultry Association are also present at the SEOC.
  • Providing resource support coordination as requested.
  • Regularly providing information for situational awareness with county emergency management coordinators.
  • Providing support for IDALS communications activities.

Iowa Department of Public Health (IDPH) – in conjunction with local public health officials

  • Sharing CDC recommendations on the use of personal protective equipment by persons working directly with sick chickens and carcasses.
  • Following up with workers who had direct contact with sick birds without the use of personal protective equipment.
  • Providing sound risk information, making sure the public understands that the virus presents no food safety concern or risk to the general public.

Iowa Department of Natural Resources (DNR)

  • DNR Air Quality has issued two variances for portable incinerators.  The DNR has also issued a variance for a thermal treatment unit.
  • The DNR’s primary concern is that disposal methods protect surface water, groundwater and air quality and does not result in further spreading of the AI virus
  • Investigating the feasibility and the potential benefits and problems associated with various disposal options including landfilling, composting, incinerating, and burying.
  • Looking at potential criteria for emergency air permits if needed for the incineration process.
  • Working with contacts at several landfills to determine the ability of those operations to take dead poultry as well as being able to wash and disinfect transport vehicles on site.
  • Investigating and maintaining contact with wastewater treatment facilities on the ability to accept and adequately treat leachate  produced by any landfill for the AI virus that may take dead poultry.
  • Developed solid waste acceptance criteria for landfills willing to accept AI infected poultry.
  • Contacted numerous potential sources of wood chips that can be used for composting. The wood chips would be used as part of the composting process.  The DNR has issued several variances to facilities to expand wood chipping capacity.
  • Preparing maps of infected facilities that show quarantine boundaries and to determine the proximity of other poultry operations and neighbors.
  • Investigating the geology involved with operations to determine the optimum potential locations for burial if needed.
  • Working with the U.S. Fish and Wildlife Service to conduct sampling of waterfowl for AI.

Iowa Department of Human Services (DHS)

  • Communicated to the Disaster Behavioral Health Response Team (DBHRT) that volunteers were needed to assist with damage assessment surveying in the northwest region.  Three DBHRT members did volunteer to assist.
  • The Division of Mental Health and Disability Services (MHDS) is responding to requests from Buena Vista and Kossuth counties for mental health support; a plan is being structured in collaboration with businesses in Buena Vista and Kossuth counties.
  • MHDS is in communication with Iowa Concern staff who are taking calls from people with concerns relating to the Avian flu.  If calls are received from people who need additional support, contact will be made to MHDS and a plan will be put in place utilizing either local resources or DBHRT support.

Iowa Department of Transportation (IDOT)

  • Water hauling to assist with USDA operations continues.
  • Motor Carrier Services has provided a contact number for carriers that are transporting poultry carcasses up to 90,000 lbs to contact them for routing directions; directions are good for 24 hours.
  • Districts have applied dust control to gravel shoulders along Highways 3, 17, and 69 in Wright County.
  • Established permitting requirements for carriers transporting carcasses up to 90,000 lbs.
  • Working to craft messaging to be placed on the 511 and the 511 truckers page as to what to do if drivers will be hauling poultry products in Iowa.
  • Contacted Turkey and Poultry Associations to notify counterparts in neighboring states to be aware of Iowa’s travel restrictions of poultry products.

Iowa National Guard

  • Supporting mission for IDALS incident command post.


Background Information

The United States has the strongest Avian Influenza (AI) surveillance program in the world.  As part of the existing USDA avian influenza response plans, Federal and State partners as well as industry are responding quickly and decisively to these outbreaks by following these five basic steps: 1) Quarantine – restricting movement of poultry and poultry-moving equipment into and out of the control area; 2) Eradicate – humanely euthanizing the affected flock(s); 3) Monitor region – testing wild and domestic birds in a broad area around the quarantine area; 4)  Disinfect – kills the virus in the affected flock locations; and 5) Test – confirm that poultry farms in the area are free of the virus.

The Iowa Department of Agriculture and Land Stewardship in partnership with the Iowa Department of Public Health are working directly with poultry workers at the affected facility to ensure proper precautions are being taken.

These virus strains can travel in wild birds without those birds appearing sick. People should avoid contact with sick/dead poultry or wildlife. If contact occurs, wash your hands with soap and water and change clothing before having any contact with healthy domestic poultry and birds.

All bird owners, whether commercial producers or backyard flock owners, should continue to practice good biosecurity, prevent contact between their birds and wild birds, and report sick birds or unusual bird deaths to state/federal officials, either through their state veterinarian at 515-281-5321 or through USDA’s toll-free number at 1-866-536-7593.

Information will also be posted to the Iowa Department of Agriculture and Land Stewardship’s website at

New Jersey #NJ | Traveler returning from West Africa dies after contracting #LassaFever

The Centers for Disease Control and Prevention (CDC) has confirmed a diagnosis of Lassa fever in an Essex County man who recently returned from West Africa.

The patient, 55, was admitted to a hospital on May 21 with fever and sore throat and was placed in isolation. Blood samples submitted to CDC tested positive for Lassa fever today.  The patient’s condition continued to decline and he passed away this evening.

Lassa fever is a viral disease that is common in West Africa, but rarely seen in the United States. It is not spread through casual contact or through the air. According to the CDC, there has never been person to person transmission of Lassa fever documented in the U.S. In rare cases, it can be transmitted through direct contact with a sick person’s blood or bodily fluids, or through sexual contact.

Despite the unlikelihood of person to person transmission, the Department of Health is working with hospital officials to identify all close contacts including health care workers, family members and anyone who may have come in contact with the patient out of an abundance of caution. They will be monitored for symptoms.

There have been five other cases of Lassa fever in travelers returning to the U.S. since 1969, including in a New Jersey patient who died in 2004 and a Minnesota case last year. Although Lassa fever can produce hemorrhagic symptoms in infected persons, the disease is not related to Ebola, which is responsible for the current outbreak in West Africa. The patient tested negative for Ebola.

In West Africa, Lassa virus is carried by rodents and transmitted to humans through contact with urine or droppings of infected rodents. 100,000 to 300,000 cases of Lassa fever, and 5,000 deaths, occur in West Africa each year.

“Given what we know about how Lassa virus spreads to people, we think the risk to the public is extremely low,” said State Epidemiologist Dr. Tina Tan.

For additional information about Lassa fever see the CDC website at


#UK | Isle of Wight – New training tool gives real experience of reduced mobility

gert_m_3emaillgeA specially designed bodysuit which enables users to experience what it might be like to be elderly is being used by the Island’s NHS Memory Service. 

NHS staff are encouraged to experience the age-simulation suit as part of a training programme to raise awareness of the difficulty patients with restricted mobility may have when undertaking simple, everyday movements.

Speaking about the benefits of this type of training, Bev Malone, IoW NHS Trust Memory Service Liaison Nurse said: “The suit is to raise awareness and for everyone to experience, from clinical and non clinical staff, Consultants, Doctors, Porters, Nurses, Allied Health Professionals, both at the hospital and in the community. We want all staff to have the opportunity to gain an understanding and to enable staff to empathise with those of the older population who, as they get older may experience reduced flexibility, rigidity of movement and the potential impact this may have on daily living, for example, when your neck doesn’t move or you’re in a bit of a stoop, simple, everyday movements feel almost impossible to you.

“The suit is an excellent way to take training onto the hospital wards without pulling staff away from the workplace and it really gets staff thinking about how people with restricted mobility feel when they’re lying in bed, as a patient, and how slow and unbalanced their movements can be. It is really interesting to watch staff experiencing the suit and their reaction. Everyone takes something away with them, all have experienced a sense of increased vulnerability and disempowerment, whether it’s an understanding of the difficulty of a task as simple as putting a spoon to their mouth or brushing their hair, and on finding their elbows have restricted movement, they quickly gave up due to the effort that was involved. Staff may believe that a patient has left their meal as they are not hungry when in fact it might be that they are fatigued by the effort involved or anxious that that they may drop their food or drink. It was really good for staff to experience that within the ward environment.”

The age-simulation suit was kindly funded by the Friends of St. Mary’s. The Memory Service hope to be able to purchase additional items such as gloves which simulate trembling of the hands, knee braces to give restriction and overshoes which simulate an unsteady gait.

Bev Malone continued: “The suit certainly raises interest which is what we wanted. The experiential training is what people really engage with and we are looking forward to taking it around to all the hospital wards and out into the community. Looking to the future we will be making the suit available for hire to external organisations who are interested in experiencing it.”

Research | Disaster investigations may benefit from explosion-sizing innovation

Disaster investigators and emergency personnel may find themselves better able to assess and respond to terrorist attacks and industrial accidents with the aid of a new computational tool that determines the energy from explosions near the Earth’s surface.

As a first test of the new approach, its developers have analyzed a deadly explosion which reportedly killed dozens of regime soldiers in the Syrian civil war.

Computing the energy yield of an explosion just below, at, or above the ground poses difficult challenges, while deep-underground blasts are more readily evaluated. The new capability could help investigators figure out what types of explosives were used in such near-surface detonations and how much damage was done to structures, said Michael Pasyanos of Lawrence Livermore National Laboratory in Livermore, California, leader of the team that came up with the technique. It could also help emergency planners anticipate which areas are likely to be most affected if an explosion were to occur, he added.

Starting from seismic signals produced by explosions, the new tool can estimate the energy released by military ordnance, mining events, industrial accidents, plane crashes, terrorist attacks, and other close-to-the-Earth explosions, according to a new study accepted for publication in Geophysical Research Letters, a journal of the American Geophysical Union.

Pasyanos and his colleague Sean Ford calibrated the new tool using a series of controlled surface explosions at the White Sands Missile Range in New Mexico in 2012. Then, Pasyanos saw footage of a May 2014 Syrian explosion. “I saw the video of this and I said, ‘wow’! And the next thing was, ‘Can I see that? And if I can see that, I think I can model it.’ ”

Syrian rebels claimed to have detonated 60 tons of explosives in a tunnel under a military base in northwest Syria, which sent debris hundreds of feet into the air and destroyed the western entrance of the base. Pasyanos and his colleagues used data from seismic stations in Turkey that recorded the explosion, along with information about the geology of the area and news reports, to estimate the yield of the event.

Unlike deep-underground explosions, those near or on the surface release energy in many different forms, making it hard to piece together the total energy released by these events. There is currently no standard method that scientists can use to calculate their yield. Blast energy gets released as heat, noise, seismic waves, and in other forms. The seismic and acoustic signals produced by the explosion can provide some information about its magnitude, but they only represent a fraction of the total energy released in a blast.

The new method uses the relationships between these various forms of energy and the signals from the blast to calculate the total energy output. It also takes into account how the energy and the signals produced vary if the same amount of explosive is detonated at different depths relative to the surface or even slightly above it. For instance, an explosion hundreds of feet underground will generate different forms of energy and different signals than an explosion on the surface. Having established these relationships using known explosions, scientists can process a seismic signal with the new method to calculate the total energy of an unfamiliar explosion.

The new research builds on a technique Pasyanos and his colleagues developed for determining the energy released by underground explosions, like nuclear tests. The researchers modified this technique to take into account how proximity to the Earth’s surface affects the different types of energy and signals produced by an explosion.

“It essentially makes this method applicable to a totally new class of events than what we had traditionally been looking at,” Pasyanos said.

When tested on the Syrian explosion, the new method found that the energy released was likely between 20 and 40 tons, depending on how deep the explosives were buried. The calculated yield could be less than the 60 tons the rebels claimed for many reasons: the rebels could have exaggerated or over-reported the yield, the energy density of the explosives they used could be less than the energy density of TNT that is used as a reference explosive in the new method, or not all of the explosive material might have detonated.

Given these and other uncertainties about the Syrian explosion, Pasyanos said his team’s estimate of the yield is reasonable. The next step is to test the method with other near-surface explosions, he said.

As in the case of the Syrian blast, the new tool can be used over large distances, Pasyanos explained, allowing scientists to calculate yields of explosions that occur hundreds or thousands of kilometers away from a seismic station.

“We think that this could be applicable to a large class of problems,” he said.

Keith Koper, an associate professor of geology and geophysics at the University of Utah in Salt Lake City, said the new study shows the tool works well but needs additional testing. If the new technique passes additional tests, it could be a very important tool for investigators, law enforcement officials, and others who need to understand the energy released by different near-surface explosions, said Koper, who was not involved with the new study. Seismometers around the world are continuously capturing signals from these types of events, he noted.

“I think it is something that really could be used in the future when there’s different kinds of accidents or whether there’s a terrorist attack or whatever it is that causes a big boom,” Koper said. “I think this could be one of the tools that is going to be really valuable for people who are doing a forensic investigation of whatever incident it is.”

Research | New research leads to #FDA approval of first drug to treat #radiation sickness

As a result of research performed by scientists at the University of Maryland School of Medicine (UM SOM), the U.S. Food and Drug Administration has approved the use of a drug to treat the deleterious effects of radiation exposure following a nuclear incident. The drug, Neupogen®, is the first ever approved for the treatment of acute radiation injury.

The research was done by Thomas J. MacVittie, PhD, professor, and Ann M. Farese, MA, MS, assistant professor, both in the University of Maryland School of Medicine (UM SOM) Department of Radiation Oncology’s Division of Translational Radiation Sciences. The investigators did their research in a non-human clinical model of high-dose radiation.

“Our research shows that this drug works to increase survival by protecting blood cells,” said Dr. MacVittie, who is considered one of the nation’s leading experts on radiation research. “That is a significant advancement, because the drug can now be used as a safe and effective treatment for the blood cell effects of severe radiation poisoning.”

Radiation damages the bone marrow, and as a result decreases production of infection-fighting white blood cells. Neupogen® counteracts these effects. The drug, which is made by Amgen, Inc., was first approved in 1991 to treat cancer patients receiving chemotherapy. Although doctors may use it “off label” for other indications, the research and the resulting approval would speed up access to and use of the drug in the event of a nuclear incident.

This planning is already under way. In 2013, the Biomedical Advanced Research and Development Authority (BARDA), an arm of the Department of Health and Human Services, bought $157 million worth of Neupogen® for stockpiles around the country in case of nuclear accident or attack.

Neupogen® is one of several “dual-use” drugs that are being examined for their potential use as countermeasures in nuclear incidents. These drugs have everyday medical uses, but also may be helpful in treating radiation-related illness in nuclear events. Dr. MacVittie and Ms. Farese are continuing their research on other dual-use countermeasures to radiation. They are now focusing on remedies for other aspects of radiation injury, including problems with the gastrointestinal tract and the lungs.

The research builds on 40 years of work that Dr. MacVittie and his team have conducted in the field of radiation research, during which they have helped to define the field. The Neupogen study is also part of a broad portfolio of research being conducted by faculty in the Department of Radiation Oncology. Among these are Minesh Mehta, MD, the medical director of the Maryland Proton Treatment Center, who is focusing on research into thoracic oncology, neuro-oncology, integrating imaging advances with radiation therapy, and innovative applications of new radiation therapy technologies to test biological concepts. Another researcher in the department is Zeljko Vujaskovic, MD, PhD, director of the Division of Translational Radiation Sciences; he is doing research on identifying potential biomarkers predicting individual patient risk for injury, and to develop novel therapeutic interventions/strategies to prevent, mitigate, or treat radiation injury.

“In terms of both research and treatment, our department is leading the way in developing the most effective discovery-based clinical applications to help protect and heal patients,” says William F. Regine, MD, professor and Isadore & Fannie Schneider Foxman Endowed Chair in Radiation Oncology at the UM SOM.

He added that research has served as the foundation for the Department of Radiation Oncology’s recent development of four clinical modalities for the treatment of cancer through radiation:

  • Proton Treatment, a precise approach to cancer, which targets tumors while minimizing harm to surrounding tissues. Proton treatment uses protons traveling at about two-thirds the speed of light to precisely deliver beams of radiation to the tumor. This treatment will be available in the new 110,000 sq ft Maryland Proton Treatment Center before the end of the year;
  • Selective Internal Radiation Therapy, a precision modality for treating patients with particularly difficult to remove tumors involving the liver such as those from colorectal cancers;
  • Gammapod, a new, high-precision, noninvasive method of treating early-stage breast cancer;
  • Thermal Therapies, the use of “heat” in treating a broad spectrum of malignancies.

“The Department of Radiation Oncology’s work is just one example of how the School of Medicine is discovering innovative ways to repurpose existing drugs that are able fight a broader array of critical diseases,” said Dean E. Albert Reece, MD, PhD, MBA, who is also the vice president for Medical Affairs, University of Maryland, and the John Z. and Akiko K. Bowers Distinguished Professor and Dean of the School of Medicine. “We are particularly proud of the Neupogen research as it is not only important scientifically; it is crucial for our country’s public health and its national security.”

Research | KSU researchers develop vaccines for #H5N1 and #H7N9 avian flu strains

A recent study with Kansas State University researchers details vaccine development for two new strains of avian influenza that can be transmitted from poultry to humans. The strains have led to the culling of millions of commercial chickens and turkeys as well as the death of hundreds of people.

The new vaccine development method is expected to help researchers make vaccines for emerging strains of avian influenza more quickly. This could reduce the number and intensity of large-scale outbreaks at poultry farms as well as curb human transmission.

It also may lead to new influenza vaccines for pigs, and novel vaccines for sheep and other livestock, said Jürgen Richt, Regents distinguished professor of veterinary medicine and director of the U.S. Department of Homeland Security’s Center of Excellence for Emerging and Zoonotic Animal Diseases.

Richt and his colleagues focused on the avian influenza virus subtype H5N1, a new strain most active in Indonesia, Egypt and other Southeast Asian and North African countries. H5N1 also has been documented in wild birds in the U.S., though in fewer numbers.

“H5N1 is a zoonotic pathogen, which means that it is transmitted from chickens to humans,” Richt said. “So far it has infected more than 700 people worldwide and has killed about 60 percent of them. Unfortunately, it has a pretty high mortality rate.”

Researchers developed a vaccine for H5N1 by combining two viruses. A vaccine strain of the Newcastle disease virus, a virus that naturally affects poultry, was cloned and a small section of the H5N1 virus was transplanted into the Newcastle disease virus vaccine, creating a recombinant virus.

Tests showed that the new recombinant virus vaccinated chickens against both Newcastle disease virus and H5N1.

Researchers also looked at the avian flu subtype H7N9, an emerging zoonotic strain that has been circulating in China since 2013. China has reported about 650 cases in humans and Canada has reported two cases in people returning from China. About 230 people have died from H7N9.

“In Southeast Asia there are a lot of markets that sell live birds that people can buy and prepare at home,” Richt said. “In contrast to the H5N1 virus that kills the majority of chickens in three to five days, chickens infected with the H7N9 virus do not show clinical signs of sickness. That means you could buy a bird that looks perfectly healthy but could be infected. If an infected bird is prepared for consumption, there is a high chance you could get sick, and about 1 in 3 infected people die.”

Using the same method for developing the H5N1 vaccine, researchers inserted a small section of the H7N9 virus into the Newcastle disease virus vaccine. Chickens given this recombinant vaccine were protected against the Newcastle disease virus and H7N9.

“We believe this Newcastle disease virus concept works very well for poultry because you kill two birds with one stone, metaphorically speaking,” Richt said. “You use only one vector to vaccinate and protect against a selected virus strain of avian influenza.”

Using the Newcastle disease virus for vaccine development may extend beyond poultry to pigs, cattle and sheep, Richt said.

Researchers found they were able to protect pigs against an H3 influenza strain by using the Newcastle disease virus to develop a recombinant virus vaccine. Wenjun Ma, Kansas State University assistant professor of diagnostic medicine and pathobiology, is building on this finding and using the Newcastle disease virus to make a vaccine for porcine epidemic diarrhea virus, a disease that has killed an estimated 6 million pigs.

Richt conducted the avian influenza study with Ma, Adolfo Garcia-Sastre at the Icahn School of Medicine at Mount Sinai in New York, and several other colleagues. They published their findings in the Journal of Virology study, “Newcastle disease virus-vectored H7 and H5 live vaccines protect chickens from challenge with H7N9 or H5N1 avian influenza viruses.” It is the first study to look at an H7N9 vaccine in chickens, the animals the disease originates in.

Saudi Arabia #KSA | 12 additional cases of #MERS including 2 deaths

Between 11 and 13 May, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 12 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 2 deaths.

Details of the cases are as follows:

  • A 66-year-old male from Qunfuthah city developed symptoms on 12 May while admitted to hospital since 3 May due to an unrelated medical condition. A nasopharyngeal swab tested positive for MERS-CoV on 14 May. The patient has a history of frequent contact with camels and sheep as well as consumption of raw camel milk. He has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, the patient is in stable condition in a negative pressure isolation room on a ward.
  • A 31-year-old male from Hafouf city developed symptoms on 4 May and was admitted to hospital on the same day. A nasopharyngeal swab tested positive for MERS-CoV on 13 May. The patient is a smoker and has no comorbid conditions. He has a history of contact with two laboratory-confirmed MERS-CoV cases that were reported in previous DONs on 17 May (case n. 4) and on 29 April (case n. 2). The patient has a history of frequent contact with camels and consumption of raw camel milk. He has no history of exposure to other known risk factors in the 14 days prior to onset of symptoms. Currently, the patient is in stable condition in a negative pressure isolation room on a ward.
  • A 36-year-old male from Jeddah city developed symptoms on 10 May and was admitted to hospital on the same day. A nasopharyngeal swab tested positive for MERS-CoV on 11 May. The patient has no comorbidities. He has a history of contact with a laboratory-confirmed MERS-CoV case that was reported in a previous DON on 17 May (case n. 3). The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, the patient is in stable condition in a negative pressure isolation room on a ward.
  • A 46-year-old, non-national male from Riyadh city developed symptoms on 25 April and was admitted to hospital on 9 May. A nasopharyngeal swab tested positive for MERS-CoV on 10 May. The patient has comorbidities. He has a history of frequent contact with camels and consumption of raw camel milk. The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, he is in stable condition in a negative pressure isolation room on a ward.
  • A 71-year-old male from Riyadh city developed symptoms on 3 May and was admitted to hospital on 6 May. A nasopharyngeal swab tested positive for MERS-CoV on 10 May. The patient has comorbidities. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing.
  • A 33-year-old, non-national male from Riyadh city developed symptoms on 1 May and was admitted to hospital on 7 May. A nasopharyngeal swab tested positive for MERS-CoV on 9 May. The patient has no comorbidities. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing. Currently, the patient is in stable condition in a negative pressure isolation room on a ward.
  • A 33-year-old, non-national male from Riyadh city developed symptoms on 1 May and was admitted to hospital on 6 May. A nasopharyngeal swab tested positive for MERS-CoV on 8 May. The patient had no comorbidities. He passed away on 14 May. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing.
  • A 74-year-old male from Taif city developed symptoms on 9 May while admitted to hospital since 28 April due to an unrelated medical condition. A nasopharyngeal swab tested positive for MERS-CoV on 10 May. The patient had comorbidities. He was admitted to the same ward and treated by the same health workers as a laboratory-confirmed MERS-CoV case that was reported in a previous DON on 17 May (case n. 3). The patient had no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. He passed away on 10 May.
  • A 30-year-old female from Hafouf city developed symptoms on 4 May and was admitted to hospital on the same day. A nasopharyngeal swab tested positive for MERS-CoV on 10 May. The patient has no comorbidities. She has a history of contact with two laboratory-confirmed MERS-CoV cases that were reported in previous DONs on 17 May (case n. 4) and on 29 April (case n. 2). The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, she is in stable condition in a negative pressure isolation room on a ward.
  • A 59-year-old female from Hafouf city developed symptoms on 4 May and was admitted to hospital on the same day. A nasopharyngeal swab tested positive for MERS-CoV on 10 May. The patient has comorbidities. She has a history of contact with two laboratory-confirmed MERS-CoV cases that were reported in previous DONs on 17 May (case n. 4) and on 29 April (case n. 2). The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, she is in stable condition in a negative pressure isolation room on a ward.
  • A 24-year-old female from Hafouf city developed symptoms on 4 May and was admitted to hospital on the same day. A nasopharyngeal swab tested positive for MERS-CoV on 10 May. She has a history of contact with two laboratory-confirmed MERS-CoV cases that were reported in previous DONs on 17 May (case n. 4) and on 29 April (case n. 2). The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, she is in stable condition in a negative pressure isolation room on a ward.
  • A 30-year-old male national from Hafouf city developed symptoms on 4 May and was admitted to hospital on the same day. A nasopharyngeal swab tested positive for MERS-CoV on 10 May. The patient has no comorbidities. He has a history of contact with two laboratory-confirmed MERS-CoV cases that were reported in previous DONs on 17 May (case n. 4) and on 29 April (case n. 2). The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, the patient is in stable condition in a negative pressure isolation room on a ward.

Contact tracing of household contacts and healthcare contacts is ongoing for these cases.

The National IHR Focal Point for the Kingdom of Saudi Arabia also notified WHO of the death of 2 previously reported MERS-CoV cases. The cases were reported in previous DONs on 17 May (case n. 4) and on 29 April (case n. 2).

Globally, WHO has been notified of 1130 laboratory-confirmed cases of infection with MERS-CoV, including at least 427 related deaths.

WHO advice

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. It is not always possible to identify patients with MERS-CoV early because like other respiratory infections, the early symptoms of MERS-CoV are non-specific. Therefore, health-care workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS‐CoV infection. Therefore, these people should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.

New South Wales #NSW | Emergency #Exercise in #Sydney CBD on Sunday 24 May

A major emergency management exercise will be carried out in the Sydney CBD tomorrow (Sunday 24 May) to test emergency management arrangements in case of an incident in the city

Exercise ‘Sydney CBD’ is a multi agency emergency management exercise involving more than 500 emergency service personnel commencing at 9:00am and concluding at midday.

The Sydney CBD Evacuation Sub Plan has been under review for the past 12 months and Sunday’s exercise is part of the review process and provides police and emergency service organisations with the guidance required in a range of events, including the need to move large numbers of people out of the city.

Those involved in the exercise include the NSW Police Force, Fire & Rescue NSW, Roads and Maritime Services, NSW Ambulance, Transport Management Centre, Transport for NSW, City of Sydney Council, NSW Health – Disaster/Crisis, the Ministry of Police and Emergency Services, Dept of Premier and Cabinet, and Surf Life Saving Australia.

300 volunteers from the RFS, SES and Surf Life Saving Australia will role play workers being evacuated.

Be well. Practice big medicine.