#Assessment of #malnutrition in preschool-aged #children by mid-upper arm circumference in the #Gaza Strip (January, 2024–August, 2025): a longitudinal, cross-sectional, surveillance study

 

Summary

Background

Since October, 2023, Palestinian children in the Gaza Strip have suffered war-induced displacement, food insecurity, malnutrition, and elevated risks of famine and mortality. In this study, we aimed to document the extent of, and patterns in, wasting malnutrition in children aged 6–59 months across the Gaza Strip between January, 2024, and August, 2025.

Methods

This longitudinal, cross-sectional, surveillance study was conducted across a total of 16 UN Relief and Works Agency for Palestine Refugees in the Near East health centres and 78 medical points established within school shelters and tent encampments across the five governorates of Gaza. Children aged 6–59 months were screened for wasting malnutrition by mid-upper arm circumference (MUAC) measurement. Children with a MUAC of less than 125 mm were enrolled into therapeutic feeding regimens. MUAC Z scores were derived from published WHO age-specific and sex-specific arm circumferential growth curves. Monthly prevalence of acute wasting (MUAC Z scores less than –2) and severe wasting (MUAC Z scores less than –3) were described by age, sex, type of screening facility, and governorate.

Findings

Between Jan 1, 2024, and Aug 15, 2025, 265 974 measurements were obtained from 219 783 uniquely identified children, with two-thirds of children screened in Khan Younis and Middle Governorates. The monthly prevalence of acute wasting ranged from 5% (34 of 722 children) to 7% (794 of 10 907) between January and June, 2024. After approximately 4 months of severe aid restrictions between September, 2024, and mid-January, 2025, the prevalence of wasting increased from 8·8% (1601 of 18 225 children) to 14·3% (1661 of 11 619), with the highest prevalence observed in Rafah (32·2%; 95 of 295) and among children aged 24–59 months (21·0%; 1366 of 6518). After a 6-week ceasefire, marked by a substantial increase in the number of aid trucks entering through territory borders, by March, 2025, the prevalence of wasting had declined to 5·5% (831 of 15 165). However, after an 11-week blockade from March to May, 2025, and continued severely restricted entry of food, water, medicines, fuel, and other essentials thereafter, by early August, 2025, 15·8% (1213 of 7668) of screened children were acutely wasted, including 3·7% (280 of 7668) severely wasted, equating to more than 54 600 children in need of therapeutic care.

Interpretation

After nearly 2 years of war and severe restrictions in humanitarian aid, tens of thousands of preschool-aged children in the Gaza Strip are suffering from preventable acute malnutrition and facing an increased risk of mortality.

Funding

UN Relief and Works Agency for Palestine Refugees in the Near East.

Source: The Lancet, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)01820-3/abstract?rss=yes

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Detection of #WNV, #USUV and #Insect-Specific #Bunyaviruses in #Culex spp. Mosquitoes, #Greece, 2024

 

Abstract

Greece is one of the countries in Europe most affected by West Nile virus (WNV), and since 2010, when the virus caused a large outbreak with 197 human neuroinvasive cases, outbreaks occur almost every year. Mosquito surveillance is an indirect sign of virus circulation; therefore, the purpose of the study was the molecular detection of WNV in 45,988 C. pipiens s.l. mosquitoes collected during 2024 in four Regions of Greece and the genetic characterization of the virus strains. WNV was detected in 41 of 1316 (3.12%) Culex spp. mosquito pools. Next-generation sequencing was applied to the WNV-positive samples that had a high viral load. All WNV sequences belong to Cluster B of the sub-lineage Europe WNV-2A presenting a temporal clustering. The WNV infection rates varied highly across the Regions, regional units and months, being higher in Thessaly and Central Macedonia Regions, especially in July and September. All mosquito pools were also tested for Usutu virus (USUV), and one pool was found positive, with sequence clustering into the EU-2 lineage. A subset of mosquitoes (737 pools) was tested for additional viruses, and bunya-like viruses were detected in 6 pools with sequences clustering into four distinct subclades. The prompt detection of pathogenic viruses is helpful for the design of control measures, while the detection of insect-specific viruses provides insights into viral diversity and evolution.

Source: Viruses, https://www.mdpi.com/1999-4915/17/11/1414

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#UK - High pathogenicity avian #influenza #H5N1 viruses (#poultry) (Inf. with) - Immediate notification

 

{England} Premises of 32,000 free range laying hens. Samples taken were positive for HPAI H5N1. Birds presented clinical signs prior to testing.

Source: WOAH, https://wahis.woah.org/#/in-review/6914

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#Resurgence of Zoonotic Highly Pathogenic Avian #Influenza #H5N1 Virus in #Cambodia

 

{Excerpts}

To the Editor:

After a decade of no reported human cases, Cambodia faces a resurgence of highly pathogenic avian influenza (HPAI) A(H5N1) virus infections, with an overall mortality of 38%. Cases have occurred primarily in children and adolescents who were exposed to infected poultry (...). From February 2023 through August 2024, a total of 16 infections were detected through the long-standing national influenza-like illness and severe acute respiratory infection surveillance systems, both of which were strengthened by expanded laboratory-testing capacity that was developed during the coronavirus disease 2019 pandemic. All 16 patients reported exposure to sick or dead poultry, and outbreak investigations identified contemporary, genetically similar viruses in poultry collected in or around case households or from active, longitudinal surveillance of live-bird markets. Genomic sequencing revealed an avian origin for all the human infections, and sequences have been publicly shared through the Global Initiative on Sharing All Influenza Data (also known as GISAID).

(...)

Of note, this virus carries genomic signatures (e.g., PB2:E627K) that are linked to enhanced polymerase activity, virulence, and replication capacity in birds and mammals,3 which poses an increased potential risk to the poultry industry as well as an increased potential risk of zoonotic transmission (...)

Source: The New England Journal of Medicine, https://www.nejm.org/doi/full/10.1056/NEJMc2504302?query=TOC&cid=DM2422812_NEJM_Non_Subscriber&bid=-1106918107

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Development of a cross-protective common #cold #coronavirus #vaccine

 

ABSTRACT

Common cold coronaviruses, such as OC43 and HKU1, typically cause mild respiratory infections in healthy people. However, they can lead to severe illness in high-risk groups, including immunocompromised individuals and older adults. Currently, there is no clinically approved vaccine to prevent infection by common cold coronaviruses. Here, we developed an mRNA vaccine expressing a stabilized spike protein derived from OC43 coronavirus and tested its efficacy in different challenge models in C57BL/6 mice. This novel OC43 vaccine elicited OC43-specific immune responses, as well as cross-reactive immune response against other embecoviruses, including HKU1 and mouse hepatitis virus (MHV-A59). Interestingly, this OC43 vaccine protected mice not only against a lethal OC43 infection but also against a distant embecovirus, MHV-A59. These findings provide insights for the development of common cold coronavirus vaccines, demonstrating their potential to protect against various coronaviruses.

Source: Journal of Virology, https://journals.asm.org/doi/full/10.1128/jvi.01526-25?af=R

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#Clinical Characteristics of #Paediatric #RSV, #Influenza, and #SARS-CoV-2 Infections: Insights from Three Consecutive Seasons

 

Abstract

Background: 

The purpose of this study was to retrospectively analyse the clinical presentation of RSV, Influenza, and SARS-CoV-2 infections in children across three consecutive seasons (2022/2023; 2023/2024; and 2024/2025). 

Methods: 

Of the 321 hospitalised patients, 129 (36%) tested positive for RSV, 110 (38%) for Influenza, and 82 (26%) for SARS-CoV-2. Children were aged ≤ 17 years (median: 15 months). The data were statistically analysed using the χ2 test, multinomial multivariable logistic regression, OR (odds ratio), and 95% CI (confidence interval). 

Results: 

Significant independent predictors of RSV infection were auscultatory abnormalities (OR: 15.9 [1.49–169]) and hospital admission ≥ 4 days after symptom onset (OR: 32.5 [1.19–907]). Among RSV-positive patients, compared with those aged < 6 months, those aged 7–24 months were more likely to present with higher CRP levels (OR 1.06 [1.003–1.13]), reduced appetite (OR 6.7 [1.62–27.67]), and longer duration of fever (OR 7.22 [1.47–35.59]), while in children > 24 months, only a longer duration of fever remained significant (OR 16.82 [2.14–162.4]). In Influenza, reduced appetite was the only characteristic feature in the 7–24-month age group (OR 13.55 [1.79–102.81]). In COVID-19, children aged 7–24 months more frequently had higher CRP levels (OR 1.108 [1.001–1.226]) and chronic diseases (OR 7.59 [1.115–51.64]), whereas in those >24 months, only CRP was significant (OR 1.16 [1.047–1.31]). 

Conclusions: 

RSV was associated with severe respiratory manifestations and later hospital admission, whereas Influenza and SARS-CoV-2 were characterised by milder courses with predominant upper respiratory symptoms. Observed age- and virus-specific patterns highlight the importance of continued surveillance and comparative research on major respiratory viruses in children.

Source: WOAH, https://www.mdpi.com/1999-4915/17/11/1403

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#Belgium - High pathogenicity avian #influenza #H5N1 viruses (#poultry) (Inf. with) - Immediate notification

 

{Di Riki7 - Opera propria, Pubblico dominio, https://commons.wikimedia.org/w/index.php?curid=6957499}

A farm with Meleagris gallopavo species birds in Vlaanderen Region. 

Source: WOAH, https://wahis.woah.org/#/in-review/6921

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#Belgium - #Influenza A #H5N1 viruses of high pathogenicity (Inf. with) (non-poultry including wild birds) (2017-) - Immediate notification

Non-poultry birds at a hobbyist's premise in Wallonie Region.

Source: WOAH, https://wahis.woah.org/#/in-review/6908

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#Japan - #Influenza A #H5N1 viruses of high pathogenicity (Inf. with) (non-poultry including wild birds) (2017-) - Immediate notification

 

{By Norbert Kenntner, Berlin - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=1062838}

A wild Northern Goshawk in Hokkaido Region.

Source: WOAH, https://wahis.woah.org/#/in-review/6909

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#Japan - High pathogenicity avian #influenza viruses (#poultry) (Inf. with) - Immediate notification

{ob1-Shiraoi-Town} On 21 October 2025, a Livestock Hygiene Service Centre (LHSC) in Hokkaido Prefecture received a notification from a domestic layer farm regarding an increase in bird mortality. Samples were collected from birds on the farm by LHSC officers and tested positive for influenza A virus using a viral antigen rapid test. On 22 October, the LHSC conducted RT-PCR and rRT-PCR tests and confirmed that the virus is of high pathogenicity. Movement and shipment restriction have been imposed on farms within a radius of 3 km and 10 km of the affected farm, respectively. Stamping-out and relevant control measures, including disinfection, are ongoing. The National Institute of Animal Health (NIAH) is sequencing the virus genome and will identify the subtype.

Source: WOAH, https://wahis.woah.org/#/in-review/6911

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#Slovakia - High pathogenicity avian #influenza #H5N1 viruses (#poultry) (Inf. with) - Immediate notification

 

Establishment registered for the direct supply of small quantities of animal products from the farm to the consumer: - 150 pcs Gallus gallus (22 dead) - 26 pcs geese (5 dead) - 21 pcs ducks (no clinical signs) Sudden deaths, haemorrhagies of the inner organs (intestines, spleen, lungs). Depopulation is ongoing.

Source: WOAH, https://wahis.woah.org/#/in-review/6916

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Cross-Species #Transmission #Risks of a #Quail-Origin #H7N9 #Influenza Virus from #China Between Avian and #Mammalian Hosts

 

Abstract

The H7N9 influenza viruses, which are capable of causing severe respiratory syndrome in humans, were first discovered to infect humans in 2013 and continue to pose a persistent public health threat. Quail has been proposed as a potential intermediate host that may facilitate the emergence of novel reassorted influenza A viruses with the capacity to infect humans across species barriers; however, information on the biological characterization of quail H7N9 remains limited. In this study, we isolated and identified an avian H7N9 influenza virus from quails, designated as A/quail/Hebei/CH06-07/2018 (H7N9) and abbreviated as CH06-07, in Hebei, China. Phylogenetic analyses revealed that both the HA gene and the NA gene of CH06-07 were clustered in the Eurasian lineage. Furthermore, CH06-07 exhibited binding affinity for both α2,3-linked and α2,6-linked sialic acid receptors and demonstrated high pathogenicity in both quails and mice. Notably, transmission studies revealed that CH06-07 not only exhibited efficient inter-quail transmission and inter-guinea pig transmission but also demonstrated effective cross-species transmission. Importantly, infected quails and guinea pigs generated significant quantities of viral aerosols (≥18,998 ± 1672 copies per liter of air at 3 days post-infection), and infectious viruses were successfully recovered from environmental aerosols. These findings highlight the necessity for continuous surveillance of the prevalence of quail-origin H7N9 influenza A viruses in poultry populations due to their potential threat to human health.

Source: Viruses, https://www.mdpi.com/1999-4915/17/10/1402

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#Italy, #WNV & #USUV Integrated #Surveillance - Weekly Bulletin No. 14, 15 Ocotber 2025 (ISS, edited)

 

{Summary}

-- New human cases of West Nile Virus infection continue to be reported albeit with reduced intensity. 

-- During current epidemiological week (from 9 to 15 October 2025) 26 new confirmed cases have been reported. 

-- The total number of cases so far is 767 (they were 740 last week), of these: 

- 366 were West Nile Neuroinvasive Disease (WNND): 17 in Piedmont, 56 Lombardy, 34 Veneto, 4 Friuli-Venezia Giulia, 1 Liguria, 32 Emilia-Romagna, 10 Tuscany, 1 Marche, 86 Latium, 2 Molise, 83 Campania, 2 Apulia, 2 Basilicata, 5 Calabria, 3 Sicily, 28 Sardinia, 

- 57 were asymptomatic cases among blood donors, 

- 333 were West Nile Fever cases (of which 1 imported from Kenya, 1 from Egypt and 1 from Maldive), 

- 3 asymptomatic cases, 

- eight unspecified cases. 

-- Among confirmed cases, 69 fatalities have been reported: 7 in Piedmont, 9 Lombardy, 2 Emilia-Romagna, 18 Latium, 29 Campania, 2 Calabria, 1 Sicily, 1 Sardinia. 

-- The case-fatality rate in WNND cases stands at 18.8% (in 2018 it was 20%, in 2024 it was 14%). 

-- So far this season, 10 cases of Usutu virus infection have been recorded: 2 in Piedmont, 3 Lombardy, 2 Veneto, 3 Latium.

(...)

Source: High Institute of Health, https://www.epicentro.iss.it/westnile/bollettino/Bollettino_WND_2025_14.pdf

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#Cambodia notified two additional #human cases of infection with #influenza #H5N1, #Bangladesh one case of #H5, #China four cases of #H9N2 (HK CHP, Nov. 21 '25)

{Excerpt}

This Week:

[Date of report - Country - Province / Region District / City - Sex - Age - Condition at time of reporting  - Subtype of virus]

1) .../10/2025 - Cambodia - Takeo Province - F - 14 - Hospitalised - H5N1 

2) 16/10/2025 - Cambodia - Kampong Speu Province - F - 3 - Under intensive care - H5N1

(...)

[Place of occurrence - No. of cases  (No. of deaths) - Details]

-- Bangladesh - 1(0) 

- Avian influenza A(H5): 

1) Sylhet Division: A boy with onset on July 27, 2025. 

-- Chinese Mainland - 4(0) 

- Avian influenza A(H9N2): 

- Guangdong Province: 

1) An individual with onset in February 2025. The case was retrospectively reported. 

- Guangxi Zhuang Autonomous Region: 

2, 3) Two individuals with onset in February 2025. Both cases were retrospectively reported.  

- Tianjin Municipality: 

4) An individual with onset in February 2025. The case was retrospectively reported. 

-- Mexico - 1(0) 

- Avian influenza A(H5): 

1) Mexico City: A 23-year-old woman with onset on September 14, 2025. 

(...)

Source: Centre for Health Protection, Hong Kong PRC SAR, https://www.chp.gov.hk/files/pdf/2025_avian_influenza_report_vol21_wk42.pdf

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Spatial #Variation of #SARS-CoV-2 #Exposure in Urban #Rodents from the Metropolitan Area of Buenos Aires, #Argentina: Implications for Public Health in Latin American Cities

 

Abstract

Background: 

The COVID-19 pandemic, driven by the SARS-CoV-2 virus, has become an unprecedented global public health challenge. Comprehensive investigation of the virus transmission dynamics requires exploration of all potential routes, including the role of animal reservoirs. This study aimed to assess the presence of SARS-CoV-2 RNA and antibodies in urban rodents captured within two landscape units (low-income neighborhoods and green spaces) in the metropolitan area of Buenos Aires (MABA), Argentina.

Methods: 

Between July 2020 and September 2022, 125 synanthropic rodents (68 Rattus norvegicus, 22 R. rattus, and 35 Mus musculus) from seven low-income neighborhoods and seven green spaces in the MABA were captured and examined for SARS-CoV-2 exposure and infection by indirect immunofluorescence serology and RT-qPCR, targeting the N, E, and ORF1ab genes.

Results: 

Two M. musculus and six R. norvegicus from five different low-income neighborhoods tested positive for SARS-CoV-2 antibodies. No rodent with positive serology was detected in green spaces. All rodents tested negative for SARS-CoV-2 RNA when analyzed by RT-qPCR.

Conclusion: 

The results of this study provide valuable insights into the ecological dynamics of SARS-CoV-2 in synanthropic rodents in two landscape units within a Latin American city, with seropositive rodents detected in low-income neighborhoods, suggesting a possible increased exposure risk in these settings. This information is critical for developing management strategies for potentially zoonotic viruses and underscores the importance of continued surveillance of SARS-CoV-2 in rodents as part of an integrated One Health approach.

Source: Vector-Borne and Zoonotic Diseases, https://www.liebertpub.com/doi/abs/10.1177/15303667251389403

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#UK - High pathogenicity avian #influenza #H5N1 viruses (#poultry) (Inf. with) - Immediate notification

{England} 300k laying hen premises. Samples were taken and were tested positive for HPAI H5N1. Clinical signs were presented prior to testing.

Source: WOAH, https://wahis.woah.org/#/in-review/6907

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#Evolution of #antibody cross-reactivity to #influenza #H5N1 #neuraminidase from an N2-specific germline

 

Highlights

• Human antibody HB420 cross-reacts with neuraminidases from H3N2 and H5N1

• HB420 engages the neuraminidase active site via a single Asp residue

• Germline HB420 is N2 specific but gains reactivity to N1 through somatic mutation

• HB420 provides in vivo protection against both H3N2 and H5N1

Summary

The ongoing spread of highly pathogenic avian influenza H5N1 clade 2.3.4.4b virus in animals and its occasional spillover to humans have raised concerns about a potential H5N1 pandemic. Although recent studies have shown that pre-existing human antibodies can recognize H5N1 neuraminidase, the molecular basis of how this cross-reactivity develops remains poorly understood. In this study, we used a phage display antibody library derived from 245 healthy donors to isolate an antibody, HB420, that cross-reacts with neuraminidases of human H3N2 and avian H5N1 clade 2.3.4.4b viruses and confers protection in vivo. Cryogenic electron microscopy analysis reveals that HB420 targets the neuraminidase active site by mimicking sialic acid binding through a single Asp residue. Furthermore, the inferred germline of HB420 is N2 specific but acquires cross-reactivity to H5N1 neuraminidase through somatic hypermutation. Overall, our findings provide insights into how neuraminidase antibody evolves breadth, which has important implications for the development of broadly protective influenza vaccines.

Source: Cell Host & Microbe, https://www.sciencedirect.com/science/article/pii/S1931312825003816?via%3Dihub

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#WHO occupied #Palestinian Territory 60 Day #Ceasefire #Plan for #Gaza, October 2025 (edited)

 

PURPOSE AND SCOPE 

-- With the initiation of the first phase of the ceasefire, humanitarian needs remain dire. 

-- In the current situation, it is crucial to scale up humanitarian aid in a coordinated manner while ensuring the start of early recovery and reconstruction. 

-- This document summarizes WHO’s key planning assumptions, strategic priorities and selected activities. 

-- The activities fall within the scope of the overall 2025 WHO operational response and early recovery plan for the occupied Palestinian territory and the One-UN multi-sectoral Gaza Ceasefire Humanitarian Response Plan Summary 60 days (13 October 2025).

ASSUMPTIONS 

-- This plan is developed under the following assumptions:  

- Continuation of ceasefire and improvement of the law-and-order situation.

- Improved access for UN with access/registration issues for INGOs remaining.

- Gradual emergence of a clear and functional governance structure. 

- Improved flexibility of entry of medical supplies and equipment, including dual use items. 

- Free movement in Gaza Strip Zone 1.

- Sustained opening of the Rafah Crossing and other corridors for persons, including medical evacuation and adequate numbers of medical evacuation offers from receiving countries.

- Public health risks largely in line with WHO’s 10th Public Health Situation Analysis for Gaza (Sept 2025 – ceasefire update ongoing). 

STRATEGIC PRIORITIES AND KEY ACTIVITIES 

-- WHO will scale up the provision of humanitarian aid and initiation of early recovery efforts, in collaboration with partners and stakeholders. 

A. Maintain and expand life-saving essential health services

- Provide essential medicines, medical supplies and equipment for primary and secondary health services (including Reproductive Maternal, Newborn, Child and Adolescent Health; Nutrition; Noncommunicable Disease; Trauma) ensuring appropriate standards in line with the WHO Priority Medicines List for Gaza. 

- Scale up the processing, clearance and entry of medical supplies and equipment to the Gaza Strip safely for WHO and partner organizations who require support.

- Scale-up of medical evacuations up to 50 patients per day plus companions, in line with the previous ceasef ire (currently over 15 000 patients are on the priority list).

- Re-establish and support utilities and support services at hospital level, e.g. oxygen plants, electricity/fuel and generators, mobile storage units. 

- Support the medical referral system, including spare parts for ambulances, ICU units for special transfers,  and coordination between facilities. 

- Scale up of rehabilitation services at all levels of health care, including limb reconstruction services and provision of assistive devices.

- Scale up of mental health and psychosocial support services at all levels of health care, up to specialized clinical care.

- Continue and expand WHO’s existing full support to 3 field hospitals.

- Intensify technical support to health service delivery across the health sector through assessments, monitoring, and capacity building.

- Ensure preparedness and health facility readiness for the possibility of a new escalation. 

B. Public health intelligence, early warning, and prevention and control of communicable disease

- Expansion and strengthening of surveillance for communicable diseases through the provision of surveillance equipment, expansion of Early Warning Alert and Response System, introducing linkages with laboratory and WASH data, and capacity building for Rapid Response Teams.

- Re-establish the Gaza Central Public Health Building, including rehabilitation of laboratory infrastructure, provision of essential equipment, and staffing capacity.

- Provide hospital laboratories with essential diagnostic and antimicrobial resistance equipment and testing supplies.

- Support the availability of safe blood, including entry of blood into the Gaza Strip, restarting local donations, and safety testing.

- Implement the catch-up campaign for immunization to target 40 000 children under the age of 3 that are missing doses or zero-dose for immunizations.

- Provide infection prevention and control support including establishment of isolation capacity, supplies, and capacity building. 

- Continue water quality testing and support to WASH in health facilities.

- Undertake modelling exercises to estimate excess mortality, in collaboration with academic and local partners. 

C. Health emergency coordination

- Health Cluster coordination and support to over 88 health partners to scale up humanitarian support to essential health services for the population of Gaza.

- Emergency Medical Teams (EMTs) scale up from approximately 30 deployed teams to approximately 40 deployed teams to support Gaza’s health system.

- Strengthen the Humanitarian-Development-Peace Nexus through the establishment and leadership of a dedicated technical working group under the Health Cluster to enable coordination between humanitarian and recovery efforts in health.

- Ensure Prevention of Sexual Exploitation and Abuse (PSEA) technical advice and support to partners.

- Coordinate the European Gaza Hospital (EGH) committee under the Health Cluster to operationalize the resumption of services (phase one to restore minimum functionality – two weeks, phase two towards partial functionality – two months). 

D. Early recovery, rehabilitation and reconstruction 

-- WHO will focus its early recovery planning around the priorities and activities outlined below. 

-- It is important to note that implementation of these activities will extend beyond the initial 60-day period. However, WHO will require initial resources to prepare, plan and launch the early recovery efforts. 

• Primary health care (PHC) services

- Rehabilitation of 10 primary health care centres (Level III and IV).

- Rehabilitation and restoration/expansion of 3 primary health care services with pre-fabricated structures, equipment and medical supplies, and operational costs. 

• Secondary/tertiary health services

- Two field-hospitals - expand bed capacities for the hospitals (e.g. Al Wafaa Rehabilitation Hospital, Al Shifa Hospital).

- Two pre-fabricated modular clinics - ensure continuity of services during the reconstruction of hospitals.

- Early rehabilitation/expansion of 3 selected general hospitals (e.g. Al Shifa Hospital in Gaza City; Al Aqsa Hospital in Middle Area; EGH Hospital in Khan Younis or Indonesian Hospital in North Gaza). 

• Support the coordination of health sector recovery and recovery planning

- Engage with emerging governance structure, Interim Rapid Damage and Needs Assessment (IRNDA)  up-date and plan/prepare for the implementation of early recovery priorities. 

- Health system design: Support the development of a strategic framework for rebuilding a resilient, equitable, and integrated health facility network across the Gaza Strip (rationalized, health needs-based, and cost-effective reconstruction). 

• Facilitating early recovery

- Strengthen and increase the number of health workforce: with salary/incentive payments and deployment of specialized EMTs with surge and training capacities (physical rehabilitation and noncommunicable diseases advanced services).

- Supply chain management, forecasting, warehousing facilities (2 warehouses for medical supplies, decentralized North/South).

REQUIREMENT 

-- Pillar

{A}. Maintain and expand life-saving essential health services: USD 19,500,000

{B}. Public health intelligence, early warning, and prevention and control of communicable disease:  5,500,000

{C}. Health emergency coordination (including Health Cluster and EMT coordination): 1,000,000

{D}. Early recovery, rehabilitation and reconstruction: 19,000,000

{Total} 45,000,000 

Note: Operations costs are integrated in pillars A-D. 

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Source: World Health Organization, https://www.who.int/publications/m/item/60-day-ceasefire-plan-for-gaza

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The Virgin and Child Reading, Jan van Eyck (1433)

 

Public Domain.

Source: WikiArt, https://www.wikiart.org/en/jan-van-eyck/madonna-from-the-inn-s-hall-1433

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Host #Immunomodulatory Interventions in Severe #Influenza

 

Abstract

Currently, no immunomodulatory agents have been conclusively shown to benefit severe influenza. The World Health Organization conditionally advises against the use of systemic corticosteroids, macrolides, plasma therapy, mechanistic target of rapamycin inhibitors, and nonsteroidal anti-inflammatory drugs for such patients. High-dose systemic corticosteroids may increase mortality and morbidity in severe influenza; the potential of low-dose corticosteroids merits further study given survival benefits in patients with severe coronavirus disease 2019 (COVID-19). Passive immunotherapy using convalescent plasma or intravenous immunoglobulin (IVIG) from healthy donors has not proven effective, suggesting that future research should focus on hyperimmune plasma or IVIG from recent infections. An open-label randomized controlled trial (RCT) found that a triple combination of oseltamivir, clarithromycin, and naproxen improved outcomes in severe influenza. One RCT has indicated that sirolimus with corticosteroids can expedite liberation from mechanical ventilation and reduce viral load, warranting larger trials of sirolimus alone. In contrast, adding macrolides or nitazoxanide has not consistently improved clinical outcomes. Promising evidence exists for anti-C5a antibodies in COVID-19, while case reports hint that intravenous N-acetylcysteine may benefit severe influenza pneumonia. Observational data on statins remain conflicting. Further studies on COX-2 inhibitors in combination with antivirals and other immunomodulators are needed. Mycophenolic acid, pamidronate, and peroxisome proliferator-activated receptor gamma agonists are low priorities due to toxicity concerns. Research into human mesenchymal stromal cells and herbal medicine remains inconclusive. Overall, these findings support large-scale trials to validate promising results and address limitations in small studies. Treatment of severe influenza requires a multidisciplinary approach that integrates antiviral and immunomodulatory strategies. Clarifying these roles may enhance patient outcomes.

Source: Journal of Infectious Diseases, https://academic.oup.com/jid/article/232/Supplement_3/S262/8287912

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