Cholera and other tropical diseases

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Cholera is another good reason to have governments.

Good governance

 

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Cameroon makin' progress in the fight against malaria...

Cameroon Winning Battle to Reduce Malaria
August 24, 2012 — It’s a Monday morning at the Yaounde central hospital, and one of the busiest days of the week for the doctors and nurses who work here. Hundreds of sick people wait for their turn in one of the consultation rooms. For many, their fate is known in advance. One in four will be diagnosed with malaria.

Malaria is a leading cause of hospital visits – and death - in the country. Victims are mostly children and pregnant women. Everyone in Cameroon is considered at risk. Last year, the disease inflicted more than 1.8 million people. Sunny and humid, most of Cameroon is a breeding ground for anopheles mosquitoes that transmit the malaria parasite. The country’s 20 million people are now on the frontline of the war on malaria in Africa. Dr. Esther Tallah is the manager of the Cameroon Coalition against Malaria and a major player in the struggle against the disease. She says the war is being won by expanding effective prevention and treatment. "Once you invest in the right things that we know work for malaria prevention and control, you see results immediately," she said, "The world has shown and repeatedly proven that when [people] adopt the habit of sleeping under mosquito nets and that you achieve universal coverage you see a drop in the incidence of malaria. "If the country decides that they want to do indoor residual spraying, and they do it effectively," she continued, "you see a drop in the incidence of malaria. In some cases, countries decide to combine indoor residual spraying and sleeping under long-lasting insecticidal mosquito nets."

The government and NGOs like Tallah’s coalition distributed more than eight million long-lasting insecticidal nets nationwide. The government has also scaled up affordable treatment using a combination of anti-malaria drugs including artemisinin. Together, they attack the reproductive cycle of the malaria parasite, thereby curing and reducing transmission at the same time. As part of the push to end malaria, patients pay less than $1 (U.S.) for several days’ treatment. Pregnant women and children under that age of five are treated for free. Health officials say universal protection and effective treatments are paying off. Doctors across the country are seeing fewer and fewer patients each year. Cases reported by hospitals dropped to 28 percent in April 2012 from 30 percent in April 2011. The National Malaria Control Committee’s reports show a steady fall since the end of 2008, when the sickness rate was around 44.5 percent. But the gains remain fragile.

In most of Cameroon, poor drainage leaves standing water in which mosquitoes breed. Health workers say many people have nets but are not using them. The mosquitoes are also developing resistance to insecticides. Talla says such problems are being tackled. "The national anti-malaria commission has conducted studies, and we have a map of resistance to insecticides by the anopheles mosquitoes that transmit malaria," she said. "There is a plan to follow up on that and put in place a system that ensures that that is taken into account."

She said that even where there's resistance, the nets are still effective, "though the people who produce the nets are conscious of resistance and are coming out with a third-generation nets that combine two products." Cameroon hopes to reduce malaria infections in the country by 50 percent in a few years. For the first time, campaigners are already talking about ending the scourge. But to eradicate malaria in Cameroon, Tallah says the public must play its part. Early treatment, correct use of long-lasting insecticidal mosquito nets and hygienic living can greatly reduce new infections.

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Lingerin' leprosy lurkin' in Liberia...

Liberia Steps Up Fight Against Leprosy
August 28, 2012
In an effort to combat the spread of lebrosy, Liberia's Health Ministry has set up its first-ever TB & Leprosy Treatment Center in the northeastern town of Ganta in Nimba County - where dozens of people have contracted the diseases. The treatment center is trying to battle not only the disease but also the belief that lepers have been cursed by their ancestors.

The Ganta Leprosy Center treats some 300 men, women and children living with leprosy. John Saah Brimah, who runs the center, says one priority is to educate the community on how to prevent the transmission of leprosy. “The first line of prevention is somebody who you know has leprosy and is not on treatment, when they are coughing or sneezing you ask them to cover their mouth and nose while coughing," Brimah says. "The second line could be you take all of the children that are born, to be vaccinated. Because one of the vaccines, which is BCG help you to reduce the getting of the worst part of leprosy. I am not saying that when you take the vaccine you will not get leprosy but you will not get the worst one.”

The spread of the disease in rural Liberia is due to widely held belief that the disease is caused by mystical powers and one that cannot be cured by modern medicine, according to Brimah, who adds more health workers are being trained to educate patients and their families. “We have trained people who are working in those TB clinics more about leprosy. So whenever you see these things I am talking about, a red mark on you that is not hurting and it is not itching, you have to report to these clinics," he says. "Any of the big hospitals in Liberia are all having TB clinics open in them because this leprosy and TB they are like uncle and nephew. It is the same germ that can cause both of them. So every TB clinic should have the facility of also treating leprosy.”

Abraham Tamba, 40, a patient at the center, has been receiving treatment for more than seven months. His hands are deformed and he says family members abandoned him because of his condition. “My conditions are terrible. All of my hands are deformed. I have been suffering from this illness for several months now," Tamba says. "And to make my situation more worsen, my family members have turned against me and no one wants to care for me. I am doing everything be myself. That’s how it looks.”

Leprosy is a chronic bacterial disease of the skin and nerves in the hands and feet and, in some cases, the lining of the nose. It is not clear how the leprosy germ is spread, but household and prolonged close contact is important. The germs probably enter the body through the nose and possibly through broken skin. The germs get in the air through nasal discharge of untreated lepromatous patients. Patients with leprosy should be treated by a doctor who has experience with the disease. Treatment is with multiple drugs for six months to two years. The TB and Leprosy Control program of Liberia plans to publish nationwide figures on instances of leprosy in Liberia soon. But, for now, it is providing treatment and shelter for more than 1,000 patients suffering from the disease.

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Encephalitis outbreak in India...

Numerous Encephalitis Cases Devastate North India
September 21, 2012 - Health officials in northern India report that a serious outbreak of Japanese encephalitis has infected hundreds of children. The viral brain disease, which can cause permanent disabilities and sometimes death, is a common seasonal disease in Asia. Experts say it is likely the virus also is spreading in other countries in the region, but is going undetected due to inadequate surveillance and diagnostics.

In India every year, during the rainy monsoon season, hundreds of children die or become disabled, physically or mentally, after contracting Japanese encephalitis. Doctor K. P. Kushwaha is a senior pediatrician at a government hospital in Gorakhpur, in the Indian state of Uttar Pradesh. "We have the highest number of patients admitted in one day, which is 550 patients," said Kushwaha. "We have never got such figures in the past. In the current cases of encephalitis, the children not only have swelling in their brains, but their skin, kidney, liver and heart also show swelling.” "Japanese encephalitis is interesting because it is in animals as well as in people. This is a virus that will never be eradicated or eliminated,” said Dr. Julie Jacobson, who is trained in clinical tropical medicine and is a senior program officer at the Gates Foundation, a private philanthropy.

She explained that encephalitis is a zoonotic infection that is found in humans, as well as in a variety of domesticated and wild animals. Pigs and migratory birds pose a special danger because they are so-called "amplifying hosts" - they store the virus in large amounts in their systems without getting sick. When mosquitoes bite an infected pig or bird, they pick up the virus and can transmit it to humans when they bite them.

Jacobson said Japanese encephalitis, when it is not fatal, can leave victims with severe physical and mental damage. “People’s personality changes - they have behavioral issues," she said. "A very striking finding is that within families when you are talking to them, the children who have survived, kids will not recognize a family member. So they will be crying, crying to talk to their sister, 'I want my sister, I want my sister I want to talk to my sister' - it is very devastating for families to have that kind of disability that comes to the household.”

Health experts say the best way to protect people against this crippling disease is to immunize them with the encephalitis vaccine. They recommend that children especially be routinely vaccinated. Jacobson said there also is an urgent need for public health agencies to step up surveillance and diagnostic operations in endemic countries - to look for early signs of encephalitis and take steps to limit its terrible toll.

Source

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16 Die from Disease at Refugee Camp in South Sudan
September 21, 2012: The international humanitarian agency Oxfam is warning that living conditions of refugees in a camp in Upper Nile state are becoming increasingly desperate, and more people will probably die if help does not arrive soon.

More than 100,000 refugees have fled fighting between Sudanese armed forces and rebels in Sudan’s Blue Nile and Southern Kordofan states. At least 16 refugees have died in the past two weeks from an outbreak of Hepatitis E, according to the U.N.

Pauline Ballaman, Oxfam’s South Sudan director, said the best way to curb the spread of the water-borne disease is to relocate thousands of Sudanese refugees to a safer place. “The government of South Sudan and UNHCR, who are the lead agencies, would encourage them to look at all other possibilities because this is not going to be a sustainable job or solution,” Ballaman said.

South Sudan and the UN refugee agency considered relocating the refugees to areas along the Nile River, according to Ballaman, but she said no decision has been made so far. Ballaman said more people are showing symptoms of Hepatitis E. She added, “there are a lot more people affected and, of course, it is far more serious for the nursing and pregnant mothers and young children, and malnutrition kicks in as well,”

According to Ballaman, no season is favorable to housing more than 100,000 refugees. Widespread flooding during South Sudan’s rainy season is the problem right now, but when the dry season arrives the problem will be not enough water.

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Wide distribution of malaria drugs can significantly reduce the number of new cases of the disease...

Study: Malaria Drugs Significantly Prevent Disease in Africa
September 24, 2012 - A new study shows that widely distributing anti-malaria drugs to healthy children in African countries can significantly reduce the number of new cases of the disease.

The medical aid group Doctors Without Borders says it gave intermittent doses of anti-malaria drugs to 175,000 children in Mali and Chad. It says the result was a 67 percent decrease in the number of simple malaria cases in the region of Mali where the study took place, and up to an 86 percent drop in Chad.

Doctors Without Borders says there also was a significant decrease in the number of cases of severe malaria.

The study was launched in July and will continue through next month, a period of high transmission for malaria. Children between three months and five years were given a dose of anti-malaria drugs (amodiaquine and one of sulphadoxine or pryrimethamine) over a three-day period once a month.

The World Health Organization estimates that 650,000 people die from malaria each year. It says 90 percent of the cases occur in sub-Saharan Africa, mainly among young children.

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Uncle Ferd says is God gettin' `em fer all dat spam emails dey been sendin' us...

Polio Surges in Nigeria
September 28, 2012 — Polio is again on the rise in Nigeria and doctors said the entire region should be on alert. An alarming number of new cases have been found in the north, where authorities are already dealing with the unrest caused by the militant group Boko Haram. Health officials warn that even a few cases of polio can lead to a devastating outbreak.

These young men say that polio not only robbed them of the use of their legs, but of their ability to work for a living. They say they beg for money in this Abuja market for food and school fees. ​​“I believe that getting polio eradication is one of the smartest allocations of resources that the world can make," said billionaire philanthropist Bill Gates. "The world is coming together to do something truly amazing -- protect every single child everywhere from this crippling virus.” On Thursday in New York, Gates spoke to world leaders, calling for a renewed commitment to polio eradication, saying $2 billion yearly will be enough to wipe the disease off the face of the planet by 2018.

On Thursday in Nigeria, 20-year-old Mohammad Shehu was seated on a wooden slat with wheels. His thin, useless legs were folded underneath him. He pushed himself through the markets, calling for spare change to pay for food. Shehu said he was one of three boys in his town to get polio when he was about four years old. As he spoke, two friends crowd around him. One young man wais also seated on wooden slat, with pink flip-flops on his hands. The other was propped up on a single good leg and a crudely-made crutch. The friends said they have never been to a doctor, and they don’t know why their legs don’t work. Health workers say it is undoubtedly polio, a disease that can kill or cripple. This year, all but three countries in the world are polio-free, but the disease is spreading in Nigeria.

There have been 90 new cases reported this year, including 13 since September 5. Frank Mahoney, Centers for Disease Control Chief Health Officer for Polio Response says these numbers may seem small, but it’s a big deal. "One of the things people don’t remember, since the eradication program began, the case counts have remarkably gone down so very few people are getting paralytic polio like it used to be," said Mahoney. "And so if the program were to fail, and we don’t eradicate polio the number of children that would get paralytic disease would certainly increase. So that’s the big concern. If we don’t complete the job, polio will come back and there will be many, many cases." Mahoney said the rise in polio in northern Nigeria is particularly worrying because nomadic life-styles and cross-border trade are common there, and the disease could spread to other countries. Northern Nigeria has also been struggling with an Islamist insurgency in recent years, and Mahoney says the threat to health workers is partially responsible for the recent surge in polio cases. Health workers also struggle with access to remote, transitory communities, he says.

Polio is preventable with a vaccine, but there is no cure. Spokesperson for the State Minister of Health, Tashikalmah Hallah, says health workers struggle with fear and rejection of the vaccine in many communities, and the government is working to convince people that the vaccine is not dangerous for children. “There are some that still reject it. If vaccinators approach them, they’ll say, ‘No.’ But on this issue, with the help of traditional rulers as well as religious leaders within the communities, that case of rejection has gone down," said Hallah. As he spoke, Nigerian leaders and officials, including President Goodluck Jonathan, were in New York, partially to meet with leaders like Bill Gates on strategies to combat the rise of polio in Nigeria, and its continued presence in Pakistan and Afghanistan. At the same time, the three young polio victims in the Abuja market decided to take a break from begging and use their earnings, in bills worth 1-30 cents, to have a small lunch.

Polio Surges in Nigeria

 

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Typhoid vaccine crisis in England...

Typhoid vaccine failure warning
8 October 2012 - Typhoid fever is uncommon in England, with an estimated 350 cases occurring each year

More than 700,000 people recently immunised against typhoid may not have full protection because of a dud vaccine that has now been recalled, say experts. Manufacturer Sanofi Pasteur MSD has recalled 88% of its stock - 16 batches - of Typhim Vi vaccine because tests found some samples were too weak. Anyone immunised with the vaccine since January 2011 could be affected. Officials stress that the vaccine was safe and posed no health threat.

But it could mean as many as 729,606 people who potentially received the affected vaccine are not fully immunised against typhoid, according to the body that regulates drugs in the UK, the Medicines and Healthcare products Regulatory Agency (MHRA). Experts say people should not get revaccinated but should take precautions against typhoid when abroad. If you received this vaccine and have recently returned from abroad, and are unwell, you should contact your doctor.

Precautions

Typhoid fever is uncommon in the UK, but people visiting South Asia and South East Asia, where the life-threatening bacterial disease is most common, are at greater risk. Typhoid is very contagious. An infected person can pass the bacteria in their faeces. If someone else eats food or drinks water that has been contaminated, they can catch typhoid fever. It can be treated with antibiotics if diagnosed early enough.

The MHRA said: "There are no concerns over the safety of this vaccine, but the recall has taken place because the vaccine may not be as effective as it should be. "Anyone who has been to a typhoid region of the world and has a fever, abdominal pain and vomiting should contact a healthcare professional. They can also give them information and advice about minimising the risk of getting typhoid."

More BBC News - Typhoid vaccine failure warning

 

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Dial M for malaria...

Mobile Phones Used to Track Malaria Transmission Patterns
October 11, 2012 WASHINGTON — Scientists are studying the use of mobile phones to track patterns of malaria transmission in endemic nations. The research is part of an effort by many countries to control or eliminate the mosquito-borne disease.

On their own, malaria-carrying mosquitoes can’t travel very far. But the insects that are responsible for nearly one million deaths around the world each year can, and do, hitch rides in the belongings of people who travel. Malaria can also be transmitted to healthy individuals by asymptomatic people who venture from an area where many people are sick with the disease, to a location, such as a city, where residents are seldom exposed to malarial mosquitoes. Such is the case in Kenya, where researchers have determined the disease primarily spreads east from the country’s Lake Victoria region toward Nairobi with people who travel to the country’s capital.

Their finding is based on an analysis of the mobile phone data of 15 million Kenyan subscribers, by researchers at Harvard University's School of Public Health in Boston, Massachusetts. Kenya has a population of 43 million people. Caroline Buckee says many countries are launching aggressive efforts to eliminate malaria. One of the first steps in the campaign is to figure out how human travel patterns might be contributing to its spread. Buckee, an assistant professor at the Harvard school, says until recently, it’s been difficult to track large population movements. Traditional methods, using census data and road networks, have not worked very well. “But mobile phones offer a really unique way, on an unprecedented scale, to understand how a whole population is moving around,” said Buckee.

In Kenya, Buckee explains, the researchers calculated the destination and duration of each phone user's trip away from their primary home, based on transmissions to and from the mobile phone carrier’s 12,000 transmission towers. Then, overlaying a map of malaria prevalence data in different regions of the country, researchers calculated each resident’s probability of being infected in a particular area as well as the likelihood that a visitor to that destination would become infected. The result was a pattern showing malaria transmission routes emanating from Lake Victoria.

Buckee says having such data could influence malaria control efforts, particularly in non-endemic regions. “One thing you could consider is sending text messages to people coming to high risk cell towers, for example, reminding them to use a bed net," she said. "And I think those types of approaches are simple but they would hopefully target people who are asymptomatic and are unaware that they are carrying parasites, reminding them that they can still contribute to malaria in that region.” Buckee says researchers are investigating using mobile phone records in other countries to help identify malaria transmission routes, where pockets of the disease are less obvious than in Kenya. An article on this approach is published in the journal Science.

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Health Officials Report Rise in US Meningitis Deaths
October 11, 2012: U.S. federal health officials say the number of deaths from an outbreak of rare fungal meningitis caused by a contaminated steroid has risen to 14.

The Centers for Disease Control and Prevention said Thursday that there are 169 confirmed cases of the disease. It says 90 percent of all patients who received the tainted medicine have been identified. Officials say more than 50 vials of the steroid manufactured by the New England Compounding Center in Massachusetts have tested positive for the fungus.

They also say the company may have broken state law by making large batches of the steroid and selling it out of state. Under Massachusetts law, compounding pharmacies are only permitted to make small doses of made-to-order prescription drugs.

The patients who have come down with meningitis were being treated for back pain. Others patients were injected in the knee, neck, or ankle joints and are only at a slight risk for meningitis. Health experts say they do not know how many people will actually become sick. They say it could take several months for a fungal infection to develop.

Meningitis is a disease infecting membranes protecting the brain and spinal cord. There are five different types. Fungal meningitis is the rarest form. Other types are caused by bacteria, a virus or a parasite.

Contaminated Steroid Injections Spotlight Role of Custom Drug Firms

 

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Like Granny says, "It's the lil' things in life dat'll sneak up an' get ya...

West Nile Surge Keeps Exterminator Busy
October 15, 2012 — Four years ago, the mosquitoes around Virginia resident Stephanie Sample’s house and neighborhood were voracious.

“They would get into the car and before you could shut the car doors," Sample says. "We would be driving and getting bitten by mosquitoes.” So she hired the Mosquito Squad to spray her yard. Damien Sanchez, who owns the pest control company, says the chemical spray not only kills mosquitoes, but has a long-term repellent effect as well. Since he started his company five years ago, Sanchez says the demand for his services has increased considerably, especially this year. Aided by a mild winter and rainy spring, West Nile disease has been confirmed in 48 U.S. states. "Sales-wise, we’ve increased sales 10 times,” Sanchez says.

That doesn’t surprise mosquito expert Jorges Arias, a supervisor at the Fairfax County Health Department in Virginia. “The CDC [Centers for Disease Control] has reported over 3,100 cases in the U.S.," Arias says. "We have had over 130 fatalities so far.” Most people infected with West Nile have no symptoms and recover completely. About 20 percent get headaches, muscle pain and fever. “Then a percentage of that 20 percent could develop what we call neuroinvasive disease, it's either encephalitis or meningitis," Arias says. "Then these are much more serious. These people can go into coma. Then there is a certain percentage of these people that do die.”

The entomologist speaks from experience. Arias contracted West Nile last year and was in a coma for six days. He came out of it with a neurological problem: he couldn’t sit up or walk. “I received therapy for six months and then it took me four months to be able to walk again," he says, "and I’m here walking.”

Arias believes raising awareness about the disease is essential to preventing it. His office prepares and distributes dozens of publications showing people how to protect themselves and their family from West Nile. “Wear an insect repellent. Wear long, loose-fitting, light-colored clothing, because mosquitoes like dark clothing," he says. "Eliminate anything with water around your house. If you can’t eliminate it, treat it.” That's because mosquitoes breed in standing water. And that means the mosquito control industry will likely stay very busy as the threat of West Nile Disease in the United States continues.

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Are pharmas gettin' rich off international malaria scheme?...

Concern raised about finance scheme for malaria drugs
24 October 2012 - Combining drugs can reduce the risk of resistance

The charity Oxfam has cast doubt on an international scheme that aims to boost the provision of the most effective treatment for malaria. The UK government has contributed £70m to the Affordable Medicines Facility for malaria (AMFm). Oxfam says there is no evidence the programme has saved the lives of the most vulnerable people. The body behind the AMFm says an independent study shows it has improved access and reduced drug prices.

The scheme was introduced three years ago by the Global Fund to Fight Aids, TB and Malaria. It acts as a global subsidy to provide greater access to combination therapy for malaria, particularly through private-sector drug retailers in developing countries. The idea is to reduce the use of older treatments that carry a higher risk of resistance, and to untap the potential of the private sector in reaching remote communities.

More than 200 million people contract malaria every year and 655,000 die from the disease - most of them are young children. The scheme is being piloted in seven countries including Kenya, Ghana and Nigeria. Its future will be considered at a meeting of the Global Fund's board next month. Oxfam has criticised it as "risky and dangerous".

The charity's senior health policy advisor, Dr Mohga Kamal Yanni, said: "It is dangerous to put the lives of sick children in the hands of a shopkeeper with no medical training, and to pursue a scheme that doesn't help those people who need it the most. "There is no cheap option or short cut to combat malaria. "The AMFm is a dangerous distraction from genuine solutions like investing in community health workers, who have slashed the number of malarial deaths in countries such as Zambia and Ethiopia. "The Global Fund board must act on the evidence and put a stop to the AMFm now." The Global Fund said Oxfam's claims were "simply untrue".

More BBC News - Concern raised about finance scheme for malaria drugs

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Uganda Faces Fresh Outbreak of Hemorrhagic Fever
October 24, 2012 — Uganda is struggling to contain the spread of the deadly Marburg virus, just weeks after an outbreak of Ebola killed at least 16 people.

Last week, health officials declared an outbreak of the rare and deadly Marburg virus, a type of hemorrhagic fever similar to Ebola. Five people have died so far, six have been placed in isolation and over 150 more are being monitored for symptoms. One of the cases is being treated in the capital, Kampala. The outbreak comes just two weeks after Uganda was declared free of Ebola earlier this month. At least 16 people died of Ebola, a virus which in the past has killed hundreds.

The cases of Marburg have all come from the southwestern district of Kabale, a heavily forested area where the vectors for the disease, monkeys and bats, are most commonly found. Ministry of Health spokesperson Rukia Nakamatte says the medical team working to contain the outbreak has considerable experience handling such diseases, which have been recurring in Uganda for decades. “There is a team of experts that is in Kabale district. These are experts that have handled the previous outbreaks, like the Ebola we had in Gulu in 2000. Most of these people are trained in handling patients of Ebola and Marburg," she said.

According to the U.S. Centers for Disease Control and Prevention, or CDC, this is the first outbreak of Marburg in Uganda since 2008, when a Dutch tourist died after visiting a cave filled with bats. But in terms of the number of fatalities, the current outbreak is the most severe in Uganda since the first reported cases in the 1960s. The Marburg virus kills around 80 percent of those infected. It is highly contagious, and is spread through contact with bodily fluids. Symptoms of the virus include fever and headache, followed by a skin rash and, eventually, severe hemorrhaging.

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Outdated drugs have no affect on DR-malaria...

Outdated Drugs Slow Nigerian Malaria Treatment
October 25, 2012 — A large percentage of people killed by malaria each year are in Nigeria, and the disease is the country’s number one killer of small children. Health officials say modern life-saving drugs are available but the widespread use of out-dated drugs on a resistant strain of malaria continues to cost lives.

In this hospital in Nigeria's Zamfara State, these small patients have malaria. Mothers travel for hours to get to treatment for their children because there is no medicine in their villages. "I brought the baby here because I noticed he had a high fever, and then he got diarrhea,” explains a mother. Aid workers say the current surge in malaria began over the summer, and patients continue to pour in. "At the end of July, my team called me and said, ‘Malaria exploded," says Chloe Wurr, a physician with Doctors Without Borders in the northern state of Sokoto. "We have so many children coming. Some of them arrived and we could barely keep them alive. They died before we could give them treatment."

Wurr says one out of every 10 children with severe malaria here dies, and that's with the best of care. "Heath personnel are often very committed and want to help their community but they often don’t have the resources to treat people," she said. "If I do find any treatment present, it’s usually that that health worker has gone to a local pharmacy and purchased a drug and the drug they are most likely to purchase is chloroquine.” The doctor says chloroquine can treat malaria in some countries. But in Nigeria, the disease has been resistant to the drug since the 1980s. There are drugs that have been effective against malaria in Nigeria for the past decade and they are known as ACTs.

However Doctors Without Borders says the vast majority of clinics they have visited in the country don't have them, and the U.S. Centers for Disease Control says they are not available to most Nigerians. The Nigerian government says it’s planning to increase ACT availability along with providing more bed-nets, which can keep the mosquitoes that transmit the disease from biting in the night. But with the U.N. Children's Fund (UNICEF) saying that 250,000 Nigerian children under the age of five die every year from malaria, aid workers claim the program has a long way to go.

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Malaria rates still high in Asia...

Asia needs new response to malaria threat: experts
Sat, Nov 03, 2012 - DEADLY SCOURGE:Tougher political leadership and regionally coordinated action are needed against the parasite, which is becoming increasingly drug-resistant

Asia is hit with 30 million cases of malaria a year resulting in 42,000 deaths, a report said yesterday as experts called for an urgent response to the disease that stalks billions in the region. Most international efforts to defeat malaria have so far been concentrated on Africa, where the majority of the 650,000 worldwide deaths occur. However, out of the 3.3 billion people at risk from the mosquito-borne disease, 2.5 billion live outside the African region — mostly in Asia, where growing resistance to the frontline drug treatment is also causing concern. Leading scientists and health experts meeting in Sydney this week at the “Malaria 2012: Saving Lives in the Asia-Pacific” conference flagged the need for tougher political leadership and regional coordination.

Fatoumata Nafo-Traore, director of the Roll Back Malaria Partnership, the global framework for coordinated action against the disease, called for a renewed focus in Asia, which has the second-highest malaria burden after Africa. “In the face of persistent economic uncertainty and profound changes in the landscape of global development aid, the region needs strong political leadership,” she said. “It also needs to develop financing strategies that include substantive and sustained domestic investment, traditional multilateral and bilateral aid, and truly innovative sources of funding,” Nafo-Traore added.

She was speaking at the launch of a new report, Defeating Malaria in Asia, the Pacific, Americas, Middle East and Europe, a joint initiative with the WHO. It showed that the parasite threatens more than 2 billion people each year in the Asia-Pacific region, while smaller numbers are at risk in the Americas (160 million) and Middle East (250 million). There were about 34 million cases of malaria outside Africa in 2010, claiming the lives of an estimated 46,000 people.

The Asia-Pacific, which includes 20 malaria-endemic countries, accounted for 88 percent, or 30 million, of these cases and 91 percent, or 42,000, of the deaths. India, Indonesia, Pakistan, Myanmar and Papua New Guinea were hardest hit. Australian Foreign Minister Bob Carr, who attended the three-day Sydney conference, yesterday pledged US$100 million over the next four years to fight the scourge in the Asia-Pacific. “Malaria does not respect borders,” he said. “Our focus must be on cross-regional action alongside traditional single-country strategies.”

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Doctors: West Nile Virus May Have Dangerously Mutated...

Hints of a more virulent, mutating West Nile virus emerge
Nov 9, 2012 - But CDC says it hasn't seen evidence of that

Last month, Leis asked a Food and Drug Administration scientist who studies the genetics of the virus whether a new, more virulent strain was circulating. “You are absolutely right . . . that new genetic variants of WNV might have appeared this year,” the scientist replied in an Oct. 23 e-mail obtained by The Washington Post. The scientist continued that “it is not easy to correlate” the new mutations with any specific type of brain damage. Thirty minutes after Leis *received the message, another *e-mail from the same scientist arrived. It said the previous message had been “recalled.”

When contacted by phone, the FDA scientist, who works at the agency’s Center for Biologics Evaluation and Research, declined to discuss the messages, saying that his superiors had instructed him not to talk to reporters. In an e-mail, FDA spokeswoman Heidi Rebello said that the agency is studying the genetics of West Nile viruses collected from 270 blood donors this year but that “it is premature for us to draw any conclusions about new genetic variants . . . or of any possible association of new genetic variants with increased virulence.”

Centers for Disease Control and Prevention/Reuters - West Nile virus, spread by mosquitoes, can lead to inflammation of the brain, damaging its speech, language and thinking centers.

West Nile virus, made of error-prone RNA instead of the hardier DNA found in human cells, can evolve rapidly. In 2002, a new strain appeared that quickly churns out copies of itself inside mosquitoes. This fast-replicating version swiftly replaced the earlier dominant variety. In 2003, another genetic variant, now dubbed the Southwestern strain, appeared in New Mexico and Arizona. The West Nile virus, first described in Uganda in 1937, arrived in New York City in 1999, killing eight in the city. Infected birds transmit the virus to mosquitoes, which then infect people, who cannot infect one another. By 2003, the virus had crossed the country.

So far this year, health authorities have reported more than 5,000 cases of West Nile illness and 228 deaths in 48 states, with Texas, California, Illinois and Michigan having the most cases. The CDC has classified about half of the illnesses as “neuroinvasive” — meaning the virus has gotten into the spinal cord or brain, causing encephalitis or other brain ailments. That’s the most dangerous type of illness caused by West Nile virus. In the other cases, patients come down with fevers or other flulike symptoms.

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[52ndStreet]

Preventing ebola...

Critical Protein Discovery Could Help Prevent Lethal Ebola Virus
August 25, 2011 - An international team of scientists has discovered a biochemical route used by the deadly Ebola virus to infect human cells.

Scientists say the discovery points the way to new drugs that could prevent or treat one of the world’s 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 it’s 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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The next killer disease to visti America. Ebola.
You don't have to travel to the third world to get it, it will eventually come here to America.

 

[waltky]

Experimental malaria vaccine shows disappointing results...

Experimental Malaria Vaccine Falls Short
November 09, 2012 - The world's first experimental malaria vaccine produced disappointing results in a large-scale test among African infants, raising questions about its potential for fighting the disease.

The vaccine, promoted as a new weapon in the malaria fight, reduced the risk of malaria by only 30 percent. The study involved more than 6,500 babies aged six to 12 weeks. The results, released Friday, showed the vaccine providing less than half the protection it did in a previous smaller trial involving infants. The report said the "modest protection" the vaccine, which is also known as RTS,S or Mosquirix, has been provided in this latest trial was also lower than the 50 percent reported last year among older children.

Dr. Jennifer Cohn, a doctor with Doctors Without Borders, told the Associated Press that the vaccine’s effectiveness was “unacceptably low.” Vaccinating babies is seen as a more cost effective way of battling the disease since it could be added to the regimen of other infant vaccinations. Billionaire Microsoft founder and philanthropist Bill Gates, whose foundation is helping fund the vaccine, said the effectiveness rate came back lower than hoped.

But the top British drug manufacturer developing the vaccine, GlaxoSmithKline (GSK), will continue its efforts. Chief executive Andrew Witty said the drugmaker remains convinced the vaccine has a role to play in tackling malaria. “We’ve been at this for 30 years, and we’re certainly not going to give up now, he said during a conference call with reporters.

The company, which has invested $300 million in the drug, does not expect to profit from the drug, which will be sold only in poor countries. “The results look bad now, but they will probably be worse later,” said Adrian Hill of Oxford University to the Associated Press. The results were released during a conference in South Africa Friday as part of a continuing study that will end in 2014. The World Health Organization estimates that more than 650,000 people die from the mosquito-borne illness each year. The vast majority are children in sub-Saharan Africa.

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In Nigeria, Time Running Out for Kids Poisoned by Lead
November 09, 2012 — The medical aid group Doctors Without Borders estimates that 1,500 children are suffering from lead poisoning in a northern Nigerian village, and can not be treated until the lead is cleaned up. The organization says if the cleanup does not begin soon, it may not be able to treat the children when, or if the cleanup ever happens.

In the quiet village of Bagega, in northern Nigeria, the children were exposed when small-scale gold mining near the village released poisonous lead dust into the air. Hours away at a café in the capital, Abuja, Doctors Without Borders humanitarian affairs officer Hosanna Fox says it is not just medical workers that are alarmed. "All the state agencies, all the community leaders, people that are involved in various aspects of mining. They’re all joining forces with one message: There’s no more time left," Fox explains. "Children are suffering and dying from lead poisoning. Further government delay will have catastrophic effects for a group of children that have already been victims for two years.”

Fox says cleanup of the lead is possible, and the government set aside more than $4 million in May for the project, but the money is tied up in the bureaucracy. She says unless the money is released by the middle of this month, there won't be enough time to complete the cleanup before the rainy season begins in April or May. If the cleanup is delayed until next year, she says, the treatment of the children will have to be delayed too, because treatment cannot be successful if lead dust is still in the environment.

Fox says Doctors Without Borders will not commit to taking Bagega children into the group's lead poison treatment program unless the cleanup begins soon. “We’ve had really great success medically, but unfortunately we can’t wait indefinitely for the government of Nigeria to take action and at some point we will have to put limitations on our commitment,” he warns. The Zamfara lead poisoning outbreak began in 2010 and has been called the largest in recorded history. Hundreds of children died and others continue to suffer long-term mental and emotional problems and disabilities like paralysis and cerebral palsy. Aid workers say lead poisoning also affects adults in Zamfara state but treatment is not available.

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[waltky]

107 Dead In Sudan Yellow Fever Outbreak...

WHO: 107 dead from yellow fever in Sudan
November 13. 2012 - Sudan is working on an emergency vaccination drive for yellow fever, which is spreading.

A yellow fever outbreak in Sudan's Darfur region has killed 107 people in the last six weeks, the World Health Organization reported Tuesday, warning that the disease could spread all over the country. The number of deaths from the outbreak is steadily rising, and Sudan is working on an emergency vaccination drive. Officials reported last week that 67 people had died in the outbreak. There is no medicinal cure for yellow fever, which is spread by mosquitoes. Doctors treat the main symptoms — dehydration, fever, bleeding and vomiting — and wait for the viral infection to pass. The WHO estimates that more than 500 million people in 32 countries in Africa are at risk of yellow fever infection.

As part of the emergency response program, 2.4 million doses of the yellow fever vaccine are scheduled to arrive in the Sudanese capital next week, Dr. Anshu Banerjee of the WHO office in Sudan told the Associated Press by phone on Tuesday. More than 350 suspected cases of yellow fever have been reported in Darfur since late September, and more than 30% of people showing symptoms have died, according to a WHO statement. Around 70% are under 29 years old, according to a statement released Monday by the Sudanese Health Ministry and the WHO.

Banerjee warned that yellow fever cases are "definitely spreading" to new areas of the remote region of Darfur, where Sudan's government has been battling rebel groups since 2003. More than 300,000 people have been killed in the conflict, and health care services are not available to many residents as a result of the turmoil. He said that while no yellow fever cases have been found outside Darfur, the WHO is planning a risk assessment in the next two weeks on the assumption that all areas in Sudan may be at risk of infection. Banerjee said that Darfur's heavy rainy season this year created additional breeding sites for the disease-carrying mosquitos. Sudan's last outbreak of yellow fever killed 160 people in the South Kordofan region in 2005.

WHO: 107 dead from yellow fever in Sudan

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Study Reveals Need to Tailor Vaccines to Developing World
November 13, 2012 — The research arm of Doctors Without Borders reports vaccines created for industrialized countries are not being adapted for use in the developing world, meaning that millions of children born each year could be receiving less-effective vaccines, or missing out on the basic vaccination package.

The results of a new study by Epicentre, the research division of Doctors Without Borders, have added to what the group calls a “growing body of evidence” that vaccines may not be one-size-fits-all. Rebecca Grais, director of Epidemiology and Population Health at Epicentre, says vaccines against life-threatening diseases must be modified for use in Africa if they are to protect children. "We want to make sure that the living vaccine and the vaccines that we do have are both adapted to the population where we are working, in presentation and composition, and we want them to be as easy to use as possible for both the mother and for the health infrastructure," she said.

Many areas in Africa don't have access to adequate refrigeration or electricity to keep vaccines stored at proper temperatures. Bad roads and other logistical issues make getting the vaccines out to communities a challenge. And the vaccines are not always easy to use or administer in proper doses. Grais said these factors must all be taken into consideration during the development and testing phases of a vaccine. She and her team spent two years looking at the incidence of diarrhea among more than 10,000 children under the age of five in Niger. Diarrhea is one of the leading causes of child mortality in Africa and is often caused by an infection known as rotavirus.

Epicentre says the two available vaccines for rotavirus were developed and tested in industrialized countries where they have been found to be 90 percent effective. However, those same vaccines are estimated to be only 50 to 60 percent effective when used in Africa and Asia. "There’s been great success in the U.S. and Europe with, in particular, two currently available rotavirus vaccines," said Grais. "We've seen a great decline in the incidence of rotavirus and of course subsequently severe rotavirus gastroenteritis, which may lead to death, and so this has been a success. So the question is: how can we use these vaccines in the best way in the areas of the world with the highest diarrheal burden, which is sub-Saharan Africa?"

Grais said that while their study focused on the rotavirus vaccine, its findings are relevant to vaccinations in general. Epicentre has launched two additional studies looking at alternative methods to deliver tetanus vaccine in Chad and the vaccine for pneumococcal disease in Uganda. Researchers hope the findings will further convince pharmaceutical companies that they need to tailor vaccines to the challenges of the developing world.

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[waltky]

Polio almost gone the way of smallpox...

Polio Mostly Eradicated Globally
November 15, 2012 - But pockets of the disease remain in South Asia and Africa

The global scourge of polio has been virtually eradicated, reaching historically low numbers this year. But pockets of the disease remain in South Asia and Africa because of the refusal of some parents to immunize their children. International public health officials counted 177 polio cases worldwide for the first ten months of this year. That’s a drop from just over 500 cases in 2011. Public health officials credit the drop to successful immunization campaigns against the illness, which attacks the nervous system and can cause partial or total paralysis. The malady has disappeared from most countries where it was once epidemic. For example, in India, there have been no cases of polio reported in two years.

But in neighboring Pakistan and Afghanistan, and in Nigeria, West Africa, reservoirs of the viral illness remain. Experts say that is due to the refusal of many parents to vaccinate their children against the infection. Anita Zaidi is head of pediatrics at Aga Khan University in Karachi, Pakistan. She says intensive public health efforts are underway to vaccinate children against polio. But she says the gains are fragile in some areas and among some ethnic groups, particularly among the country's Pashtun community.

Zaidi says seventy-four percent of Pashtun children go unvaccinated because many parents believe the immunization is harmful. “They believe that it can cause sterility in their children or that it’s a conspiracy to sterilize Muslim populations so that their population growth falls, or they believe in the ..value of a vaccine so they think it’s not harmful but it won’t do anything so why take it," she said. Polio is acquired through contact with feces-contaminated water. Often, Zaidi says, infected children don’t develop symptoms right away so they are unaware that they are exposing other children to the disease. This scenario is common in very dense urban slums, where the availability of clean water is low.

But polio is easily preventable with a series of oral vaccines beginning in infancy. Zaidi says the key to a successful vaccination campaign in these pockets of polio infection is to engage members of the community to help. “So that is you have a refusal, [so] you get somebody from that community that you’ve built up trust with, that the community has built up trust with, and you get them to talk to the family," she said. Pediatrician Anita Zaidi presented a progress report on polio eradication efforts at a meeting this week of the American Society of Tropical Medicine and Hygiene in Atlanta, Georgia.

Polio Mostly Eradicated Globally

 

[waltky]

Controlling malaria outbreaks with new test...

Test Could Revolutionize Malaria Treatment
November 29, 2012 - A new diagnostic test could revolutionize the treatment of malaria, one of the world’s most persistent and deadly diseases, making it possible to diagnose the illness from a single drop of blood or saliva.

The test, developed by researchers at Aarhus University in Denmark, detects very low levels of an enzyme produced by the Plasmodium parasite, the organism that causes malaria. This could allow intervention before an outbreak develops, researchers say. “The great advantage of our method is that we can test for malaria using saliva samples and the the detection limit is very low - less than one parasite per microliter,” said Birgitta Knudsen, an associate professor at Aarhus University’s Interdisciplinary Nanoscience Centre and the Department of Molecular Biology and Genetics. “This means that it will be possible to also screen non-symptomatic individuals and discover cases with very low parasite concentrations. Hence, it will be possible to treat even mildly infected patients and thereby prevent outbreaks before it is too late.”

The two most common forms of malaria testing both require blood samples, and there are drawbacks to each. One requires a skilled technician to test the blood, while the other cannot detect low levels of the parasite, Knudsen said. The new method, which uses a technology called REEAD (Rolling Circle-Enhanced Enzyme Activity Detection), could prove more time- and cost-effective than current diagnostic methods, and could be performed by personnel who have no specialized training. It could also be used in developing areas, where expensive equipment, clean water and electricity might not be readily available.

Knudsen said the team hopes to conduct extensive field testing in about two years. The Danish team was assisted by molecular biologists, doctors, engineers and statisticians at various universities around the world including Duke University, the University of Rome, the University of St. Andrews and the University of Lyon. The World Health Organization estimates that more than 650,000 people die from malaria each year. The vast majority are children in sub-Saharan Africa. Earlier this month British drug manufacturer GlaxoSmithKline, revealed disappointing results for what would be the world’s first vaccination against the mosquito-borne disease.

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[waltky]

Yellow Fever outbreak in Sudan prompts vaccination drive...

Sudan Begins Emergency Vaccinations to Fight Yellow Fever Outbreak
December 07, 2012 — Sudan’s Federal Ministry of Health is organizing an emergency mass vaccination campaign against mosquito-borne yellow fever in the Darfur region. The latest figures from the World Health Organization put the number of suspected cases of yellow fever at 732, including 165 deaths.

This is the worst yellow fever epidemic to strike Africa in two decades. The last outbreak 20 years ago, also was in Sudan. At that time, 604 cases, with 156 deaths were reported in South Kordofan state, the epicenter of the disease. Given the number of cases and deaths reported in Darfur, the World Health Organization notes the current epidemic already has surpassed the last one.

WHO reports the emergency-response vaccination campaign will cover 5.5 million people. It is being conducted in three phases. The first phase of the campaign began November 21 to cover 2.2 million people in 12 districts with the highest number of cases.

Targeting Cities

The second phase of the campaign aims to reach 1.2 million people and is to start next week. Vaccines are due to arrive in Sudan on Sunday and will cover urban areas. WHO Representative in Sudan, Dr. Anshu Banerjee, said people in urban areas are more vulnerable to getting Yellow Fever than are people in rural areas. He explained this is because the disease is quickly transmitted from mosquitoes to humans in the cities, whereas in the rural areas, monkeys are the reservoir of the virus and the spread is slower.

Banerjee said an additional 2.2 million people will be vaccinated in a third round in all other districts where positive cases are found. “The challenges mainly are to reach the remote areas, partly because of transportation - no roads, etcetera, and also because of insecurity, because of high risk of hijacking of cars, etcetera," said Banerjee. "So, transport modalities, which are being used now are like using donkeys to transport vaccines, which takes about eight to 10 hours for people to transport vaccines to remote areas.”

Nomads hit hard

 

[waltky]

Granny says, "Dat's right - dey need to spend more money on public health...

Tools to Fight Infectious Diseases Rely on Public Health Programs
December 14, 2012 WASHINGTON — Epidemics have sickened and killed millions of people throughout history. HIV/AIDS has claimed 25 million lives since it was first identified in 1981. It's one of the new infectious diseases, but much older diseases still cause countless deaths and suffering: cholera, yellow fever, tuberculosis and malaria, to name a few.

A simple bite from a mosquito can end someone's life or change it forever. A sneeze, a handshake or even sharing of a desk can do the same thing. That's how H1N1 - or swine flu - spread around the world a few years ago. Infectious diseases such as malaria, HIV/AIDS and tuberculosis are among the leading causes of death globally. Diarrheal diseases like cholera kill more than 100,000 people every year. Haiti and the Dominican Republic say they need $2 billion to fight the cholera epidemic that first erupted in 2010. Since then, it has killed nearly 8,000 people and sickened more than half a million.

At a Washington symposium, leading U.S. health experts met to discuss the challenge of confronting persistent and newly-emerging infectious diseases. Dr. Anthony Fauci, with the National Institutes of Health, said most of these diseases result from the fact that as human populations grow, people come into closer contact with animals. "When you have encroachment upon the environment, and you put humans in greater contact with animals that they would not have been in contact with, often that is one of, not the only, but one of the major contributors to the issue of emerging infectious diseases," said Fauci.

New threats, better tools

New infectious diseases also emerge when bacteria or viruses mutate and no longer respond to drugs that once killed them. An example is drug-resistant tuberculosis. Other factors include climate change or the expanded habitat of an infectious agent. Dengue is now found in half the countries of the world. It's caused by a bite from a mosquito infected with the virus. While these threats are great, we now have better tools to fight these diseases, said Dr. Thomas Frieden, head of the U.S Centers for Disease Control and Prevention: "We’ve got new technology, we’ve got better communication, we’ve got better lab work, more people who are trained," he said.

Vaccines prove crucial

This means less time elapses between the discovery of a new disease, identifying its genetic makeup and developing drugs or a vaccine to protect against it. "Immunization is really one of the great discoveries of the past century. Today’s vaccines prevent about three million deaths every single year. And the vaccines that are being rolled out can prevent millions more," said Frieden. Controlling these diseases depends on the continued vigilance of public health systems throughout the world. A recent study found that weaknesses in public health infrastructure are the major driving factors in infectious disease outbreaks. A case in point: the cholera outbreak in Haiti after the massive 2010 earthquake destroyed the country's ability to care for its sick.

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Cheap vitamin D 'would boost health'
14 December 2012 - Greater access to cheap vitamin D supplements would improve the health of at-risk groups, experts say.

The Royal College of Paediatrics and Child Health (RCPCH) says up to 25% of UK children are vitamin D deficient, leading to a rise in rickets cases. In the BBC's Scrubbing Up column, the college's Prof Mitch Blair called for concerted action to tackle the problem. The government said those with the greatest need already received free supplements. The RCPCH said other options to increase vitamin D levels, such as fortifying a wider range of foods, should be considered. Half of the UK's white population, and up to 90% of the black and Asian people in the country are thought to be affected by vitamin D deficiency.

The first signs of deficiency include muscle and bone pain as well as swelling around the wrists and ribs. A lack of the nutrient is linked to a higher incidence of diabetes, tuberculosis, multiple sclerosis as well as rickets - a disease that causes bones to become soft and deformed. The number of cases of rickets has been rising, from 183 in 1996 to 762 in 2011. In January this year, the chief medical officer for England, Dame Sally Davies, recommended all pregnant and breastfeeding women, children aged six months to five-years-old and the over-65s should take vitamin D supplements.

'Short supply'

Writing in Scrubbing Up, Prof Blair said: "Vitamin D can be found in some foods such as oily fish, eggs and mushrooms - but only 10% of a person's recommended daily amount is found naturally in food. "Put bluntly, eating more fish and getting out in the sun a bit more won't make much of a difference to your vitamin D levels." The RCPCH is also calling for a public awareness campaign to raise awareness of the warning signs of vitamin D deficiency and how to prevent it, and more research into the link between vitamin D deficiency and bone disease. It says this is needed to help investigations into bone injuries in children.

Prof Blair added: "The government's Healthy Start programme provides vitamins free to low income families and 'at risk' groups. "But these vitamins appear to be in short supply and uptake is low. Ensuring people are aware they're available is crucial." The college is to produce leaflets in a bid to raise awareness of vitamin D deficiency among the profession. In addition, the Scientific Advisory Committee on Nutrition (SACN) is looking into proposals for further fortification of food and drink, as happens in countries including the US, Canada and Finland.

'Best placed'