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Health Secretary Doctor Clement Malau has told PNG's National newspaper 483 people have died while 10,066 have been diagnosed with cholera since the first outbreak in September 2009. Seven of PNG's 19 provinces, including the capital Port Moresby, have been affected by cholera with Dr Malau adding Western Province was the worst hit with 300 deaths. "I am urging the provinces to sustain the response momentum and widen surveillance and awareness activities," he said. "I appeal again to local authorities at the district and provincial levels to respond effectively to the cholera outbreaks in their areas".
In December last year, there were grave concerns that cholera would spread across the Torres Strait into Australia when it was detected in Western Province and on its island centre of Daru. Travel between Australia's Torres Strait Islands and neighbouring PNG communities was restricted, with hundreds turned away in an effort to contain the potentially deadly outbreak. In relief efforts to contain the various outbreaks, the World Health Organisation (WHO), along with Australian aid agency AusAID, flew medical supplies and offered experts for logistics to contain the spread.
But it was an initial poor response and lack of funding by the PNG government that has been blamed for cholera spreading throughout the country. Australia provided $1.7 million in assistance including supplies of intravenous fluids, oral salts and water purification tablets, as well as emergency experts being flown to outbreak centres. Cholera usually makes people only mildly sick, but up to 10 per cent of patients develop a severe illness. It is transmitted by water contaminated by bacteria from an infected person or food contaminated by dirty water, soiled hands or flies.
Read more: PNG cholera death toll nearly 500 | News.com.au
The cholera epidemic in Haiti this year will be far worse than the 400,000 cases predicted by the United Nations, new study findings indicate. There could be nearly twice as many cases of the potentially deadly diarrheal disease -- an estimated 779,000 -- between March and November of this year, according to researchers at the University of California, San Francisco and Harvard Medical School.
The discrepancy is important because U.N. projections determine the allocation of resources to fight the disease, said the authors of the study, published March 16 in The Lancet. "The epidemic is not likely to be short-term," Dr. Sanjay Basu, a UCSF medical resident, said in a university news release. "It is going to be larger than predicted in terms of sheer numbers and will last far longer than the initial projections."
The cholera epidemic erupted in Haiti after last year's devastating earthquake. Cholera -- spread from person-to-person through contaminated food and water -- can be deadly if untreated. In most cases, treatment for the diarrhea caused by the disease involves rehydration with salty liquids.
Late last year, the U.N. projected that a total of 400,000 people in Haiti would eventually become infected with cholera. They reached that total by assuming that cholera would infect 2 to 4 percent of Haiti's population of 10 million. But the U.N. estimate did not take into account existing disease trends, or factors such as where water was contaminated, how the disease is transmitted, or human immunity to cholera, Basu said.
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Health authorities in the Dominican Republic have issued an alert in parts of the capital, Santo Domingo, amid suspected cholera cases. The health ministry has ordered increased monitoring and urged people to take extra care with hygiene. Some 16 people are in hospital with suspected cholera.
The Dominican Republic has had 14 cholera deaths in recent months, while more than 4,500 have died in neighbouring Haiti since late 2010. Monitoring has been stepped up in 17 mainly poor neighbourhoods of Santo Domingo. Like Haiti, the Dominican Republic had not had a confirmed case of cholera in more than a century until the outbreak began in October.
The Dominican Republic tightened its border controls and stepped up health checks to try to stop cholera from spreading from Haiti soon after the first cases were reported. The first case in the Dominican Republic was detected in November and the first death in January.
BBC News - Dominican Republic's capital on alert for cholera
More than 50 million people a year get the dengue virus from being bitten by infected mosquitoes in tropical and subtropical areas, including Southeast Asia. It can cause debilitating high fever, severe headaches, and pain in the muscles and joints, and lead to a potentially fatal complication. There's no vaccine or specific treatment. Some scientists have been trying to fight dengue by limiting mosquito populations. That was the goal in releasing genetically modified mosquitoes last year at sites in Malaysia and the Cayman Islands.
Australian scientists took a different tack, they report in Thursday's issue of the journal Nature. First, they showed that Aedes aegypti mosquitoes, the chief carriers of the dengue virus, resist spreading that virus if they are infected with a particular kind of bacteria. Then they tested whether these resistant mosquitoes could displace their ordinary cousins in the wild, thus reducing the number of dengue-spreading mosquitoes.
The resistant mosquitoes have an advantage in reproduction. Resistant females can mate with either resistant or ordinary mosquitoes, and all their offspring will be resistant. But when ordinary females mate with a resistant male, none of the offspring survive. For the experiment, scientists released more than 140,000 resistant mosquitoes over 10 weeks in each of two isolated communities near Cairns in northeastern Australia, starting last January. By mid-April, monitoring found that resistant mosquitoes made up 90 percent to 100 percent of the wild population.
The result is a "groundbreaking first step," Jason Rasgon of the Johns Hopkins Bloomberg School of Public Health in Baltimore wrote in a commentary accompanying the paper. Rasgon, who did not participate in the study, said the next hurdle is to test the idea in areas where dengue is spread constantly, rather than sporadically as in Australia. Researchers will also have to show it works against varied strains of the dengue virus, he said.
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Tchaikovsky had a premonition of death. "A week after the premiere of his Symphony No. 6 (Tchaikovsky)(Sixth Symphony), Tchaikovsky was dead—6 Nov. 1893. The cause of this indisposition and stomach ache was suspected to be his intentionally infecting himself with cholera by drinking contaminated water. The day before while having lunch with Modest Tchaikovsky (his brother and biographer), he is said to have poured faucet water from a pitcher into his glass and drunk a few swallows. Since the water was not boiled and cholera was once again rampaging Saint Petersburg, Russia, such a connection was quite plausible …."[25]
Other famous people who succumbed to the cholera disease include:
Alexandre Dumas, père, French author of The Three Musketeers and The Count of Monte Cristo, also contracted cholera in the 1832 Paris epidemic and almost died, before he wrote these two novels.
- James K. Polk, ex-President of the United States
- Mary Abigail Fillmore, daughter of ex-U.S. president Millard Fillmore
- Elliott Frost, son of American poet Robert Frost
- Nicolas Léonard Sadi Carnot, French physicist responsible for such concepts as Carnot efficiency, Carnot theorem, Carnot heat engine, and others
- Georg Wilhelm Friedrich Hegel, considered one of the representatives of German idealism
- Samuel Charles Stowe, son of Harriet Beecher Stowe
- Carl von Clausewitz, Prussian soldier famous for his military treatise, Vom Kriege
- George Bradshaw, originator of the railway timetable
- Adam Mickiewicz, Polish poet and writer
- August von Gneisenau, Prussian field marshal
- William Jenkins Worth, U.S. general during the Mexican-American War
- John Blake Dillon, one of the founding members of the Young Ireland movement
- Daniel Morgan Boone, founder of Kansas City, Missouri and son of Daniel Boone
- James Clarence Mangan, Irish poet
- Mohammad Ali Mirza, Dowlatshahi of Persia
- Ando Hiroshige, Japanese ukiyo-e woodblock print artist
- Juan de Veramendi, Mexican Governor of Texas and father-in-law of Jim Bowie
- Grand Duke Constantine Pavlovich of Russia
- William Shelley, son of Mary Shelley
- William Godwin, father of Mary Shelley
- Judge Daniel Stanton Bacon, father-in-law of George Armstrong Custer
- Inessa Armand, mistress of Lenin and the mother of his son, Andre
- Honinbo Shusaku, famous Go (East Asian board game) player renowned for his play
A major cholera pandemic has spread in at least three waves from a single global source: the Bay of Bengal. A study in Nature reveals cholera's spread over the last 60 years into Asia, Africa, Europe and the Americas, continent-hopping on long-haul flights. The research by a team from Cambridge's Sanger Institute showed the infection is evolving, with the newest waves showing antibiotic resistance.
A UK expert said it was "a scandal" cholera was still affecting people. Cholera is a bacterial infection of the intestine that causes diarrhoea. It affects 3-5m people annually in 56 countries, killing between100,000 and 150,000. If untreated, it can kill within hours through dehydration. It is easily treated by drinking clean water, but without this, severe cases have a 30-50% mortality rate.
'Only explanation'
In this study, the researchers sequenced the genome of 154 samples collected from patients around the world. Genome sequencing technologies have been getting better, faster and cheaper. Until recently, sequencing would be carried out on just four or five bacteria samples. Similarities between cholera genomes showed how the various strains are related, while subtle differences showed how it is evolving. By investigating these bacteria at the genetic level, the authors were able to piece together the story of the latest, and ongoing, global cholera pandemic. "We were surprised to see that the pattern we see is very clear. All of the samples were related. There is a single global source of cholera in the Bay of Bengal," said co-author Dr Nick Thomson of the Sanger Institute.
It is not yet clear why the Bay of Bengal is at the centre of the pandemic, though cholera bacteria exist naturally within some marine ecosystems. The local ecology, climate, and the presence of large river deltas are likely to be key factors in its presence there. The results show several cases of cholera suddenly jumping between continents, suggesting that it was spread by passengers on long-haul flights. "I think that's the only possible explanation. Our data show that this has happened, for example from Angola to South America. "Many people can have cholera with no symptoms, so they transmit it without realising," added Dr Thomson.
'One fell swoop'
Scientists say the discovery points the way to new drugs that could prevent or treat one of the worlds most lethal viral diseases. The Ebola hemorrhagic virus, which got its name from the central African river near where the disease first emerged in 1976, kills an estimated 90 percent of the people and non-human primates it infects.
The disease causes very high fever, both internal and external bleeding, and has led to thousands of deaths in many sub-Saharan African countries, including Gabon, Sudan, the Ivory Coast and Uganda, since the first reported outbreak 35 years ago. Although considered a rare disease, Ebola causes panic whenever there is an outbreak, in part because little is known about where the illness comes from or how it spreads.
Experts believe infected bats may be one source of these sporadic occurrences of Ebola, and the disease is then spread from person to person through tainted body fluids or blood. To better understand the biology of Ebola, a team of researchers at Albert Einstein College of Medicine, Harvard Medical School, the Whitehead Institute at MIT and the U.S. Army Medical Research Institute of Infectious Diseases studied how the virus actually infects cells.
Kartik Chandran, a professor of microbiology and immunology at Albert Einstein, is a senior author of the study. The critical step that we were studying is what we call viral entry," Chandran explained. "And its basically the step that results in the virus getting into the cytoplasm where the [genetic] goodies are for making copies of itself. Researchers looked at normal cell proteins that the Ebola virus might be hijacking, in effect, to get inside and infect mammalian cells. Investigators focused on one protein in particular - called Neimann-Pick C1 or NPC1.
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Rotavirus causes severe diarrhea that kills more than a half-million people each year, mostly very young children. A recently-introduced vaccine has proved to be very effective and has shown some unexpected benefits, extending protection beyond the children who received the vaccinations. Rotavirus fatalities are rare in the United States, but the disease does send tens of thousands of children to the hospital each year. Nationwide vaccinations began in the U.S. in 2006, and now researchers are evaluating the results.
They already know that the vaccine is effective, with diarrhea-related hospitalizations down 50 percent just two years after the immunization program started. But researcher Ben A. Lopman, with the U.S. Centers for Disease Control and Prevention, says the protection went far beyond the children who actually got vaccinated. "The vaccine program also was providing indirect protection against hospitalizations in older children, and adults and in the elderly. [There] were fewer hospitalizations in 2008 - over 10,000 fewer hospitalizations in these older age groups - than in previous years." This indirect protection - sometimes called herd immunity - occurs when there are fewer people to pass around an infection, as Lopman explains. "The idea here is that by vaccinating young children, you stop them from transmitting infection to their older siblings, their parents, their grandparents, etc., because those children themselves are not becoming infected because they've been vaccinated."
There's another surprise here - that older children and adults were getting rotavirus infections in significant numbers. While the vaccine is only recommended for young children, Lopman says his study suggests that doctors should be aware that patients with rotavirus symptoms may be infected, regardless of age. Although this study was done in the United States, rotavirus is a much more serious problem in low- and middle-income countries, and the vaccine hasnt been as effective in those areas. So Lopman says he can't say if his findings would apply there. "The kinetics of rotavirus transmission are very different in low-income settings, where there seems to be just much more rotavirus around. So it's not clear at this stage whether these indirect benefits would be afforded in low-income settings or not."
In a commentary published with the research paper, a senior official of the U.S. National Institutes of Health, Roger I. Glass, director of the NIH Fogarty International Center, says more research is needed to measure the effectiveness of a rotavirus vaccination program conducted where the disease is a much more serious threat. But the official writes that Lopman's study suggests the indirect protection benefit should be considered in assessing the value of a vaccination program. The research study by Ben A. Lopman and colleagues is published online by the Journal of Infectious Diseases.
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I missed out on the Cholera party. I had Dengue several years ago.
A hiking partner got yellow fever in Venezuela. Didn't take the vaccine.
"Contagion," a Hollywood thriller that opened last weekend, rocketed to No. 1 at the box office through its gripping tale of a fictional global epidemic driven by a new kind of virus. Audiences have gasped in horror at what happens to Gwyneth Paltrow. Before it was out, the movie made real-life disease investigators anxious, too, though for a different reason: They had worried the filmmakers would take so many artistic liberties with the science that the result would be an incredible movie that was ... not credible.
Well, cue the applause. "It's very plausible," said Dr. Thomas Frieden, head of the Centers for Disease Control and Prevention, which would investigate such an outbreak. A new virus jumping from animals to humans? Nothing fictional about that. Global spread of a disease in a few days? In this age of jet travel, absolutely. A societal meltdown if things get bad? Plan on it. Yikes. The only bit of relief here is that several experts think the odds are pretty long that a new virus could be both so deadly and contagious at the same time.
The team behind the film used several expert consultants and went to other lengths to get scientific details correct. That included working with esteemed Columbia University epidemiologist Dr. W. Ian Lipkin to create the fictional MEV-1 virus. It's modeled on the Nipah virus a dangerous bug first seen in Malaysia a dozen years ago that spread from pigs to farmers. Efforts also involved actress Kate Winslet sitting down with a female CDC disease investigator so she could correctly copy such things as the investigators clothes, mannerisms and even how the scientist might wear her hair on a field assignment.
Overall health officials say they were very pleased with what resulted. During an advance screening for CDC employees in Atlanta last week, some in the audience laughed appreciatively to see visual details and even lingo that they never imagined would be used in a mass-market motion picture. "It was very accurate. It kind of made us all chuckle because there were things that we thought only people at CDC might get," said Laura Gieraltowski, an expert in foodborne illnesses. Indeed, CDC officials have embraced the film. The agency allowed the movie's makers to film at their main campus the first time the agency has allowed a major motion picture studio such access. And CDC officials have opened up their schedules for media interviews, panel appearances and live Internet chats to talk about the movie and potential real-life contagions.
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There were almost 2,000 cases of the debilitating parasitic disease in Africa last year. The push to eradicate guinea worm has been led by The Carter Center - set up by the former US president, Jimmy Carter - since 1986. The Department for International Development (DfID) is ready to donate £20m to the drive.
It's thought this will fill about a third of the funding gap. Ministers are now calling for other donors to make significant contributions. Although it doesn't usually kill, guinea worm causes agonising pain and leaves some sufferers bed-ridden after they contract it by drinking contaminated water. Months after drinking the water, a metre-long spaghetti-like worm emerges from the patient's body through a blister in the skin.
Perpetual cycle
The worm ejects many thousands of larvae if it comes into contact with water - perpetuating a cycle of disease. There is no cure or vaccine, so the UK aid money will be used by the Carter Center to help train people in tracking outbreaks and using cloths to filter drinking water. Last year, there were 1,797 cases of guinea worm in South Sudan, Ethiopia, Mali and Chad. Nigeria, Niger and Ghana have succeeded in recent efforts to wipe out the disease. When the Carter Center began its work on guinea worm 25 years ago, there were about 3.5m cases in 21 countries in Africa and Asia.
Mr Carter said: "Guinea worm has horrendous consequences for sufferers in terms of their immediate health, and their education and employment. "It prevents people from escaping poverty. "I welcome the challenge laid down by the British government. I call on other donors to match their efforts." If the campaign succeeds, it will be the first time a disease has been wiped out through education - rather than the use of a vaccine or medicine. The international development minister, Stephen O'Brien, said: "President Carter's commitment has brought guinea worm to the brink of eradication. "It has never been a question of if we can rid the world of this ancient disease - but when."
BBC News - Fresh push to rid the world of guinea worm by 2015
Scientists have developed a new version of a drug used to treat leishmaniasis. The new formulation may help better battle this tropical parasitic disease. Leishmaniasis is transmitted by the bite of certain sand flies. The World Health Organization says as many as 12 million people are infected with the leishmaniasis parasite. Cutaneous leishmaniasis, which affects the skin and mucus membranes, is the most common form.
But the more serious form, called visceral leishmaniasis, attacks the immune system. Without proper treatment, it's often fatal. One of the drugs used against leishmaniasisis is amphotericin B. Amphotericin is effective, but it has from numerous drawbacks. It's expensive, it has to be given as an injection, it's highly toxic to the kidneys, and it loses effectiveness if exposed to high temperatures. University of British Columbia researcher Kishor Wasan has been testing an improved version he developed.
He says his new formulation addresses all these shortcomings: it's much cheaper, for one, and it can be taken by mouth. "It's tropically stable," Wasan says. "We've been able to develop a formulation that does not need refrigeration, and that's a huge factor in the developing world. And finally, we're looking at a formulation that is very effective, but does not have that kidney toxicity." To test the effectiveness of his new version of amphotericin B, Wasan sent samples to a laboratory at another university, where it was used to treat mice infected with visceral leishmaniasis. "And the results were just remarkable," he says. "We found greater than 99 percent reduction in the parasitic load in less than five days, and remarkably, in 60 percent of the animals, we completely eradicated the infection." After the positive animal-test results, Wasan is now seeking funding to begin human trials.
The new formulation for amphotericin B may be useful against other conditions, too. The drug is also used to treat fungal infections in people with compromised immune systems, such as HIV patients and organ transplant recipients. "The impetus originally to do the work was actually in the fungal infections," Wasan says. "Physicians wanted a cheaper, more accessible form of amphotericin B than the injectable. So the oral formulation was going to help in those situations as well. So, yeah, there actually are multiple uses for this formulation."
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Vaccines against rotavirus, a leading cause of diarrhea-related deaths among young children, first became available in 2006. However, a new study indicates vaccination has been slow to blunt the spread of the infection. The study combines findings from numerous other studies as well as data collected in a World Health Organization-coordinated program, the Global Rotavirus Surveillance Network.
Study co-author Umesh Parashar, of the U.S. Centers for Disease Control and Prevention (CDC) says rotavirus infection is common throughout the world. But he points out that children in richer countries usually get proper treatment if they get sick. "In contrast, in developing countries, you get a lot more fatal outcomes," he says. "And this latest analysis that we have just completed, indicates there are about 453,000 deaths from rotavirus diarrhea globally."
Of the nearly half-million rotavirus deaths each year among children younger than age five, India alone accounted for almost 100,000. Add in Pakistan, Nigeria, Ethiopia, and the Democratic Republic of the Congo, and those five nations account for more than half the rotavirus deaths worldwide. Researchers wanted to establish a baseline of rotavirus-related deaths prior to the introduction of vaccines, which were licensed in 2006 but were just starting to be used in the timeframe covered by the study. Vaccinated populations were not included in this study.
Parashar says the vaccines were initially limited to more developed countries, because more testing was needed before they could be used in resource-poor settings. "In 2009, we actually had data available from these clinical trials in Africa and Asia, and then the World Health Organization expanded to a global recommendation for rotavirus vaccines. So the vaccines are just about to be rolled out over the next two years."
The authors of this new paper say that as the vaccine is rolled out in the developing countries, rotavirus-related deaths should be substantially reduced. "And so it really highlights the need to introduce these vaccines so we can really reap the full reward of vaccination in reducing diarrheal mortality." Umesh Parashar and colleagues published the results of their study online in The Lancet Infectious Diseases.
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