We report two cases of respiratory toxigenic Corynebacterium diphtheriae infection in fully vaccinated UK born adults following travel to Tunisia in October 2019. Both patients were successfully treated with antibiotics and neither received diphtheria antitoxin. Contact tracing was performed following a risk assessment but no additional cases were identified. This report highlights the importance of maintaining a high index of suspicion for re-emerging infections in patients with a history of travel to high-risk areas outside Europe.

A panel of experts has produced a Statement of Principles of Christian Law, drawn from an examination of their internal regulatory instruments. These principles are offered for further examination by comparative scholars of church law, as an expression of shared ecclesiology, and in furtherance of the ecumenical endeavour.

These are personal views immediately following upon the publication of the White Paper on Airports Policy and not those of any organisation with which I am associated. They are, however, my views of the national interest.

I would expect there to be considerable disagreement with a White Paper which traverses so many areas where local conflicts abound. No policy could satisfy all on a subject which evokes so great an emotive response from many quarters, and in which even the smallest of pressure groups reacts with frenzied fury against any proposal with which it disagrees.

While regular astronomical image archive searches can find images at a fixed location, they cannot find images of moving targets such as asteroids or comets. The Solar System Object Image Search (SSOIS) at the Canadian Astronomy Data Centre allows users to search for images of moving objects, allowing precoveries. SSOIS accepts as input either an object designation, a list of observations, a set of orbital elements, or a user-generated ephemeris for an object. It then searches for observations of that object over a range of dates. The user is then presented with a list of images containing that object from a variety of archives. Initially created to search the CFHT MegaCam archive, SSOIS has been extended to other telescopes including Gemini, Subaru/SuprimeCam, WISE, HST, the SDSS, AAT, the ING telescopes, the ESO telescopes, and the NOAO telescopes (KPNO/CTIO/WIYN), for a total of 24.5 million images. As the Pan-STARRS and Hyper Suprime-Cam archives become available, they will be incorporated as well. The SSOIS tool is located on the web at http://www.cadc-ccda.hia-iha.nrc-cnrc.gc.ca/en/ssois/.

The hallmark of a successful response to a nuclear detonation will be the resilience of the community, region, and nation. An incident of this magnitude will rapidly become a national incident; however, the initial critical steps to reduce lives lost, save the lives that can be saved with the resources available, and understand and apply resources available to a complex and dynamic situation will be the responsibility of the local and regional responders and planners. Expectations of the public health and health care systems will be met to the extent possible by coordination, cooperation, and an effort to produce as consistent a response as possible for the victims. Responders will face extraordinarily stressful situations, and their own physical and psychological health is of great importance to optimizing the response. This article illustrates through vignettes and supporting text how the incident may unfold for the various components of the health and medical systems and provides additional context for the discipline-related actions outlined in the state and local planners’ playbook.

(Disaster Med Public Health Preparedness. 2011;5:S73-S88)

For efficient and effective medical responses to mass casualty events, detailed advanced planning is required. For federal responders, this is an ongoing responsibility. The US Department of Health and Human Services (DHHS) prepares playbooks with formal, written plans that are reviewed, updated, and exercised regularly. Recognizing that state and local responders with fewer resources may be helped in creating their own event-specific response plans, subject matter experts from the range of sectors comprising the Scarce Resources for a Nuclear Detonation Project, provided for this first time a state and local planner's playbook template for responding to a nuclear detonation. The playbook elements are adapted from DHHS playbooks with appropriate modification for state and local planners. Individualization by venue is expected, reflecting specific assets, populations, geography, preferences, and expertise. This playbook template is designed to be a practical tool with sufficient background information and options for step-by-step individualized planning and response.

(Disaster Med Public Health Preparedness. 2011;5:S89-S97)

The purpose of this article is to set the context for this special issue of Disaster Medicine and Public Health Preparedness on the allocation of scarce resources in an improvised nuclear device incident. A nuclear detonation occurs when a sufficient amount of fissile material is brought suddenly together to reach critical mass and cause an explosion. Although the chance of a nuclear detonation is thought to be small, the consequences are potentially catastrophic, so planning for an effective medical response is necessary, albeit complex. A substantial nuclear detonation will result in physical effects and a great number of casualties that will require an organized medical response to save lives. With this type of incident, the demand for resources to treat casualties will far exceed what is available. To meet the goal of providing medical care (including symptomatic/palliative care) with fairness as the underlying ethical principle, planning for allocation of scarce resources among all involved sectors needs to be integrated and practiced. With thoughtful and realistic planning, the medical response in the chaotic environment may be made more effective and efficient for both victims and medical responders.

(Disaster Med Public Health Preparedness. 2011;5:S20-S31)