Cholera and other tropical diseases

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Progress against malaria could be lost to funding cuts...

Malaria Programs at Risk From Funding Cuts
December 21, 2012 - World Health Organization also warns in its annual report that latest drugs could soon become ineffective against some deadly malarial parasites

Funding for programs to control malaria and provide universal treatment for the mosquito-borne disease is falling short of international goals, according to the World Health Organization. In its annual report, the WHO also warns that the latest drugs could soon become ineffective against some deadly malarial parasites. Ami Diabate, has brought her three children to a rural clinic to get the latest anti-malarial drugs. The aid agency Médecins Sans Frontières - or Doctors Without Borders - is rolling out the pilot program across Mali. Results are encouraging - a 65-percent drop in infections a week after distribution.

Deadly disease

Diabate said she has noticed an immediate difference. "My children used to have fevers regularly, she said, but since they started taking this medicine, they haven't run a temperature." Malaria kills an estimated 660,000 people every year. Over the past decade, advances in prevention and treatment have cut the death rate by 30 percent. The World Health Organization warns, however, that funding increases over the past two years have slowed significantly - putting such progress at risk. Simon Wright is head of child survival at the aid agency, Save the Children. “The financial crisis means that a lot of governments - not all by any means - but a lot of governments are tailing off in their aid budgets. And so where we were seeing growth we’re not seeing growth any more. But also there’s a factor of maybe donors changing their interests,” said Wright.

Short on supplies

In 2011, international donors made $2.3 billion available to fight malaria - less than half the $5.1 billion that the WHO says is needed annually. The money goes toward some simple tools, said Professor Sir Brian Greenwood of the London School of Hygiene and Tropical Medicine. “One of those is the humble bed-net, which people have been using for hundreds of years. But the relatively new advance has been in treating the nets with insecticide. Now, the insecticide is actually incorporated into the material,” he said. The number of insecticide-impregnated nets delivered to sub-Saharan Africa fell from 145 million in 2010 to 66 million in 2012. Indoor spraying programs also have leveled off.

Increased resistance

Greenwood said the greatest concern is the growing resistance of the malarial parasite to the latest medicines known as artemisinins. “We do have now quite clear evidence that there is resistance to the artemisinins, particularly in Cambodia, but probably in the neighboring countries. Fortunately not yet in Africa, but it would be a disaster if those parasites got loose in Africa, and our main treatment was failing again, like it did with chloroquin,” he said. Until an effective malaria vaccine is developed and made available globally, researchers say it is vital that donors continue to fund prevention and treatment programs that have made such progress until now.

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GM mosquitoes to help stop the spread of disease...

Can genetically modified mosquitoes prevent disease in the US?
4 January 2013 - Insecticides are the standard method used worldwide to combat mosquitoes carrying dengue fever

After a summer of record-high temperatures in the US in 2012, health officials are still dealing with the repercussions of mosquito-borne diseases. Could genetically-modified insects halt their spread? The year 2012 ended with an ignoble distinction. According to the United States' Centers for Disease Control and Prevention (CDCP), it was the worst year for West Nile virus since 2003. The CDCP says record-high temperatures could well have helped the mosquitoes that transmit the disease to thrive.

At the same time, new outbreaks of dengue fever on the Mexican side of the Texas-Mexico border had US officials worried that the virus would slowly spread north. And experts fear that in 2013, it's only going to get worse. A British company, Oxitec, has come up with a plan to control the bugs and combat dengue fever. Its scientists have designed genetically modified mosquitoes that have one mission - to kill off the rest of their species. But is the plan too radical for its own good?

A growing problem

The World Health Organization says dengue ranks as the most important mosquito-borne viral disease in the world. In the last 50 years, incidence has increased 30-fold. It is now endemic in Puerto Rico and in many popular tourist destinations in Latin America and South East Asia. West Nile virus was first identified in Africa in the 1930s, before spreading out from there and appearing in North America in 1999. It is now widely established from Canada to Venezuela. Climate change and globalisation could be major factors behind the increase in mosquito-borne diseases in the US and elsewhere.

Walter Tabachnick, director of the Florida Medical Entomology Laboratory at the University of Florida, says warmer and wetter conditions can make it easier for some mosquitoes to multiply and spread disease. "Viruses replicate more quickly in mosquitoes and are transmitted more easily when average air temperatures rise and increased rainfall in normally dry areas creates more water pools where mosquitoes can thrive," Mr Tabachnick adds. At the same time, greater and faster movement of humans and cargo allows more infected people and mosquitoes to come into contact with previously unaffected populations and areas.

In the US the current method of keeping mosquito populations under control is to spray their larvae with pesticides. This method is only effective when the larvae can actually be found and reached by the spray. Unsprayed eggs can survive for months before hatching. Meanwhile, resistance to the pesticides among mosquitoes is rising. Pest-control authorities say spraying can therefore be highly labour intensive, inefficient and expensive. Enter Oxitec, and their genetically modified mosquitoes.

'Suicide bombers'

 

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Progress in Fight Against 17 Tropical Diseases...

WHO Reports Progress in Fight Against Tropical Diseases
January 16, 2013 — The eradication of some of the world’s neglected tropical diseases is in sight, according to the World Health Organization. The U.N. agency said in a report issued Wednesday that a new global strategy enacted in 2010 is resulting in unprecedented progress against 17 such diseases.

The regular supply of quality assured, cost-effective medicines and support from global partners is at the heart of the new global strategy. In the past two years, millions of people afflicted with 17 of the world’s neglected tropical diseases have benefited from receiving regular treatment. The World Health Organization says this achievement is giving new momentum to efforts to eliminate these conditions. The director of WHO’s Department of Control of Neglected Tropical Diseases, Lorenzo Savioli, says WHO is preparing a road map for the elimination, eradication or control of particular diseases between 2015 and 2020.

He says much of the success of the global strategy is based upon the widespread delivery of safe drugs to treat these ailments. “We have the evidence that over 700 million treatments were delivered regularly every year to the people in need, to the poorest people in the poorest sections of the world. Of the best treatment for the poorest people are delivered every year in a regular way," Savioli said. "In Africa for instance, 36 out of 44 countries have readied plans to implement programs and these programs are expanding progressively and the political commitment from these countries is very much improving.”

WHO is targeting the global eradication of guinea worm disease in 2015 and yaws in 2020. The report outlines six targets set for the elimination of five diseases in 2015 and another 10 targets for nine diseases for 2020, either globally or in selected geographical areas. WHO estimates that up to 200 million people are infected with schistosomiasis, a major parasitic disease, in parts of South America, Asia and Africa. It kills about 280,000 people every year in sub-Saharan Africa.

In the next five years, WHO projects treatment for schistosomiasis will reach 235 million people. The United Nations health agency says increasing the availability of donated medicines and improving distribution at the country level will make this possible. Mario Ottiglio is associate director of Global Health Policy for the International Federation for Pharmaceutical Manufacturers and Association. He says that last year his industry announced the donation of 14 billion treatments to control or eliminate nine NTDs responsible for 90 percent of the total disease burden.

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New skin cream to counter sand fly parasite...

Newly Developed Skin Cream Cures Parasitic Illness
February 06, 2013 - The painless but disfiguring lesions of cutaneous leishmaniasis, caused by the bite of a sand fly, may soon be treatable with an antibiotic cream. Developed by an international team of researchers, the cream would replace lengthy and painful drug treatments for the disease, commonly known as CL, in subtropical and temperate climates.

Right now, treatment for CL involves a 20-day course of drugs which contain toxic heavy metals that must be injected directly into a vein at hospitals and clinics. Public health workers in developing countries report some people infected with cutaneous leishmaniasis have tried to burn their disfiguring lesions with battery acid or red hot machetes rather than seek the medical treatment, which is painful, expensive and lengthy. But CL patients could soon be treated with an antibiotic cream applied directly to the open sores. Major Mara Kreishman-Deitrick of the US Army Medical Research Institute of Infectious Diseases is a lead author of a study of two antibiotic creams - one containing the drugs paromomycin and gentimicin and the other, paromomycin alone.

In a clinical trial of 375 people infected with CL in Tunisia, Kreishman-Deitrick says both creams, applied once a day for 20 days, led to a significant reduction in the size of the sores and improvements in skin regrowth after one hundred days. “What we showed in our study, which we are very excited about, was that both creams that we tested cured more than 80 percent of the lesions in the patients that were treated, with a great safety profile," said Kreishman-Deitrick. "The side effects that we saw were mild and moderate and primarily just minor skin reactions around the application site.” Further studies will be conducted to determine whether the cream actually kills the CL parasite, which is why investigators waited six months to see whether there was a flare-up of the treated lesions.

The Tunisian trial involved infection with L. major, a parasitic species carried by the sand fly in parts of the Middle East and North Africa. However, Kreishman-Deitrick is optimistic the combination antibiotic cream will treat CL in other regions of the world. “Our animal data and preliminary clinical data show that we could see more of a difference in other species of leishmaniasis in parts of the world like Central and South America," she said. An estimated 1.5 million cases of CL are diagnosed each year, including among U.S. military personnel serving abroad.

Service men and women infected with leishmaniasis currently have to return home for treatment. Kreishman-Dietrick says the cream would allow them to be treated on site. Because cutaneous leishmaniasis is considered a neglected tropical disease, Kreishman-Dietrick says U.S. regulators have put consideration of the highly-effective cream on a fast track for approval. An article on the topical treatment for cutaneous leishmaniasis by researchers at the U.S. Army Medical Research Institute, the Tunisian Ministry of Health and investigators at the Instituts Pasteur in Tunis and in Paris is published in The New England Journal of Medicine.

Newly Developed Skin Cream Cures Parasitic Illness

 

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Potentially harmful virus missing from a lab at U-Texas Medical Branch...

Missing virus vial raises concerns at UTMB facility
March 24, 2013 | Guanarito is an emerging disease that has caused deadly outbreaks in Venezuela

A vial containing a potentially harmful virus has gone missing from a laboratory at the University of Texas Medical Branch, officials said. The missing vial, which contains less than a quarter of a teaspoon of an infectious disease, had been stored in a locked freezer designed to handle biological material safely in the Galveston National Laboratory on UTMB's campus, officials said. During a routine internal inspection last week, UTMB officials realized one vial of a virus called Guanarito was not accounted for at the facility. Scott Weaver, the laboratory's scientific director, said Guanarito is an emerging disease that has caused deadly outbreaks in Venezuela. The federal government prioritizes it for research because it has the potential to be used a weapon by terrorists. On Tuesday, an investigator discovered that only four out of five vials were stored of the virus in the grid system. The Centers for Disease Control and Prevention was notified immediately.

Wrongdoing unlikely

Lab officials searched but have not been able to locate the other vial. UTMB said that there was no breach in the facility's security and no indication that any wrongdoing was involved, according to the statement. Weaver said it was possible a vial could have stuck to a figure or a glove and fallen to the floor of the laboratory. "The only way it could pose a risk is if it were stolen and that's unlikely," Weaver said. This marks the first time that any vial containing a select agent has been unaccounted for at UTMB, officials said. "We don't think anything that happened this past week endangers the community," Weaver said. "We think this is an error that any one facility is inevitable and we are going to improve to prevent this in the future." Officials suspect that the virus was likely destroyed during the normal laboratory decontamination and cleaning process, but the investigation is ongoing.

Venezuelan disease

Weaver said those trusted to use the laboratory go through a rigorous security screening and training program. He said the lab is reviewing the procedures for maintaining inventory records and hope to implement a new system to help eliminate human error from the process, which would use electronically encoded system to automatically check inventory based on the vials' labels. Guanarito is native only to Venezuela and can cause hemorrhagic fever. The virus is not known to be transmitted person-to-person and poses no public health risk, according to officials. In the limited area of Venezuela where the virus is found, it is transmitted only by rodents native to the area and is not believe to be capable of surviving naturally in rodents in the United States.

Lab opened in 2009

Weaver said Guanarito is probably largely unknown to people in the U.S. and elsewhere, and the federal government does not believe it's one of the most likely viruses sought after by terrorists. The Galveston National Laboratory has been active since 2009 and the researchers work to control infectious diseases to provide a resource to develop therapies, vaccines and diagnostic tests for naturally occurring emerging diseases as well as microbes that might be employed by terrorists, according to its website.

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Konzo is a crippling neuromotor disease...

Researchers: Konzo Impacts Brain Function
March 28, 2013 - Konzo is a crippling disease found mostly in Central and East Africa, and affecting mainly children. Now, an international team of researchers has found that it can affect the brains as well as the bodies of its young victims.

Konzo is essentially a result of cyanide poisoning. The cyanide comes from a staple food, a starchy tuber called bitter cassava, when it is not properly prepared. The name konzo comes from the Yaka language and means “tied legs.” And there is no cure. “It’s irreversible neuromotor damage,” explains Michael J. Boivin, PhD, MPH, of Michigan State University. “It describes some of the abnormalities in walking and movement of the lower limbs, with the toes pointing in, distention of the heels and of the knees that tends to describe the initial onset of the disease.”

A boy sells Cassava leaves at a market in Bunagana, eastern Democratic Republic of Congo

Since konzo is a neurological disease, Boivin wanted to see whether it was affecting brain function as well as control of the victim’s lower limbs. So he and his colleagues gave standardized tests to konzo-afflicted children in the Democratic Republic of Congo, as well as to children in the same communities who had no outward signs of the disease.

The scientists found that children with konzo scored lower on tests of memory and problem-solving than children without konzo. “But even the non-konzo children were very at-risk in terms of certain aspects of memory and visual-spatial processing, when compared to children in similar living situations but from non-konzo affected communities,” Boivin said in a telephone interview. So even children with no physical symptoms had measurable cognitive impairment.

There’s no cure for konzo, so the focus has to be on prevention. Traditional preparation of bitter cassava includes soaking the tuber in water for several days, followed by drying in the sun. “Those two processing practices," Boivin notes, "will usually break down enough of the cyanide derivatives to make it safe for consumption.”

But when communities face drought and other hardships, people take shortcuts with cassava preparation. So Boivin says the way to fight konzo is to stress traditional ways of preparing bitter cassava as well as to promote substituting other foods for at least some of the potentially toxic cassava. The research by Michael Boivin, principal investigator Desire Tshala-Katumbay, and colleagues is published in the journal Pediatrics.

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Sand fly fever rises in Syria...

Health Experts: Leishmaniasis on the Rise in War-Torn Syria
April 22, 2013 - Health workers in northern Syria have reported a dramatic rise in cases of Leishmaniasis -- locally dubbed “Aleppo Button Disease” for the sores it produces -- and are calling on the World Health Organization and other international agencies for help.

Causes and treatment

Leishmaniasis, transmitted through the bite of the common sandfly, is a complex of diseases affecting different parts of the body. The kind most commonly found in Syria is called cutaneous Leishmaniasis, which is characterized by welts or sores on the skin. These can sometimes become infected. Mark Wiser is Associate Professor at Tulane University’s School of Public Health and Tropical Medicine in the southern U.S. city of New Orleans and an expert on Leishmaniasis. He says the skin sores usually heal on their own, but often not for months or even years, leaving ugly scars. “Generally your immune system will control the parasite and eliminate it,” Wiser said, “and so for the most part, the disease is not life-threatening.”

Sandfly (Phlebotomus papatasi)

However, he says, cutaneous Leishmaniasis can sometimes cause more serious problems affecting the spleen and the liver. “And in that case, it’s very dangerous and the disease is likely to be fatal,” Wiser said. Wiser says he is not surprised to learn about the rise in cases of Leishmaniasis in Syria, as wartime conditions can often compromise immune systems. “And that might be why you are seeing it more in children, whose immune systems are less-developed, and then there’s going to be a lot of malnutrition, which also lowers immunity,” he said. “And if a person’s immune system is not fully able to handle the parasite then it could present fairly serious problems.”

Prevention and Treatment

Before the civil war begin in Syria, health authorities controlled outbreaks by spraying pesticides, but the breakdown of sanitation services has curtailed spraying, and not everyone can afford the price of mosquito nets, at $10 apiece. Dr. Kerem Kinik, director of Doctors Worldwide in Turkey that provides medical help to doctors inside Syria, says Leishmaniasis was always known in the country, particularly Aleppo, and provinces along the border with Turkey. For several years, the health ministries of both countries worked together to prevent and control the incidence of the disease. “But unfortunately, since the beginning of the Syrian uprising two years ago, there are no public services anymore, especially health services,” Kinik said. “Basic conditions are very poor for the Syrian people, so this Leishmaniasis is spreading quickly.”

Power cuts, fuel and water shortages and poor sanitation and a lack of other public services have combined to create conditions ripe for transmission of the disease. Kinik says it is difficult to assess the exact number of cases inside Syria today. “Before the conflict, the program had reduced the number of cases in Syria to 3,000 to 4,000,” Kinik said. But Turkey’s Zaman newspaper reported recently that 100,000 cases of leishmaniasis have been diagnosed since the start of the crisis. The drug Glucantime, which is injected directly into the sores, is usually the first-line treatment, but like so many medicines, it is scarce in war-torn Syria. “This is not a commercially-available medicine in Turkey,” Kinik said, “because traditionally, we have few cases of Leishmaniasis. Now, we are trying to push the public health authority to import Glucantime, so that we can help more cases in Syria.”

Health Experts: Leishmaniasis on the Rise in War-Torn Syria

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Scientists Try New Tactic Against Schistosomiasis
April 22, 2013 — Every year, more than 240 million people get a potentially deadly parasitic infection known as schistosomiasis, transmitted by fresh water snails. Infection rates have risen to as high as 80 percent in some parts of Africa, where communities often rely on rivers and lakes for bathing, cooking and other household chores. In Saint-Louis, Senegal, aid workers are using another indigenous species, the prawn, to keep parasite levels in check in local rivers.

In mid-morning, Coumba Ngiané washes a bucketful of family dishes and clothes. She says the tap water is often cut off in the village, and so the women must come to the river to do laundry and bathe. She says when it gets hot, the children come here to cool off and play. People get sick, she says, and they know it is from the water but they can’t stay away. Freshwater snails are the host for the microscopic parasite that gives you schistosomiasis. That parasite gets in the water and the larvae can enter your body through a cut, or even just the pores of your skin. The larvae then lay eggs in the body, leading to diarrhea, abdominal pain and fever. It infects the intestines and if left untreated, can lead to organ failure and even death. In children, it can stunt growth and brain development.

There is treatment, but that won’t stop you from being re-infected the next time you enter the water. The disease isn’t new to the Saint-Louis region of Senegal. But it got worse after the government built a dam on the Senegal River in 1986 to stop salt water from flowing onto farmers’ fields. The indigenous prawns that eat the snails that carry the parasite were nearly wiped out. Amit Savaia, an Israeli prawn specialist currently working in the Saint-Louis area, said the prawns need to move from fresh water to salt water in order to breed. “The dam that was built prevented them from migrating," said Savaia who is from Ben Gurion University. "So upstream [from] the dam, the prawns were almost sure extinct. And if the prawns are extinct, the snails have a very comfortable habitat to bloom and grow, and spread [schistosomiasis].”

The re-introduction of indigenous prawns into this enclosed area in Lampsar village, in northern Senegal is reducing the rate of schistosomiasis infections.

Savaia says in some villages the rate of infection rose from less than 10 percent to more than 80 percent. Now, “Projet Crevette,” or the “Prawn Project,” is trying to change that. Every three months, the project releases between 50 and 100 prawns into enclosures at seven test sites in the area. Project officer Nicolas Jouanard says the idea is to restore balance to the ecosystem. “The idea with the prawns is that when they arrive they eat the snails that are in place and that are infected," said Jouanard. "You will get new snails because the prawns are not able to eat every snail, but the snails that you will have here will be small snails, a new generation of snails. So for them it will take time to be infected again. When they are young and small they cannot be infected.” Scientists say dam construction has disrupted river ecosystems and increased schistosomiasis infection rates in several parts of the world, including China, Egypt and Ivory Coast, in recent decades.

The founder of the prawn project in Senegal, Elizabeth Huttinger, says their experiment with prawns is a first and the results of the 12-month testing phase are “very promising.” “On the snail info, the very exciting thing is that there are no infected snails there anymore," said Huttinger. "But what is particularly interesting, is that the intensity of the infections at the prawn site are about 15 times lower than what they are at the control site.” That means 15 times fewer people are getting sick in the areas where prawns have been re-introduced. And chronic infections are 40 times lower, as compared to the areas with no shrimp. Because the dam is still in place, to keep the project going, researchers are teaching villagers at the test sites how to raise and breed prawns in plastic barrels full of fresh water and salt water. The villagers can then keep transferring prawns to the river to keep infection rates down. Huttinger said they hope to replicate the project in other villages and, ultimately, apply the model worldwide.

http://www.voanews.com/content/scientists-try-new-tactic-against-sadomasochist/1646439.html

 

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Yellow fever 10 year booster shot not needed...

WHO: Yellow Fever 'Booster' Unnecessary
May 17, 2013 — The yellow fever ‘booster’ vaccination given 10 years after the initial vaccination is not necessary, according to the World Health Organization (WHO).

The WHO's group of experts on immunization believes one dose of vaccination is enough to provide life-long immunity against yellow fever. "This is very important because it will allow endemic countries currently using booster doses in their schedule to consider alleviating this schedule, and it also has implications for travelers," said Dr. Philippe Duclos, a senior health advisor in the department of Immunization, Vaccines, and Biologicals at the World Health Organization. The information was published in an article Friday, noting that during the 80 years since yellow fever vaccination began, there have been only 12 known cases where someone who had been vaccinated developed the disease.

In all 12 cases, they developed yellow fever within five years of the vaccine, before the 10-year booster would have been administered. Yellow fever is an acute viral hemorrhagic disease that is transmitted by infected mosquitoes. It is endemic to 44 countries in tropical areas of Africa and the Americas. Duclos says Friday's news will have the greatest impact in South America, where many countries have been administering the booster. In many African countries, he says the booster is not common practice. "The impact will be mostly for countries in South America," he said. "For countries in Africa, it will be very reassuring for them.

Soldiers clean a backyard to prevent the spread of yellow fever in San Lorenzo, Paraguay

It will allow a vaccine, which is not in large supply, to be used where it is most needed." Every year there are an estimated 200,000 cases of yellow fever around the world. But Duclos says the WHO's most recent figures suggest that the numbers in endemic countries in Africa are much higher than that - with up to 1.9 million people infected every year and up to 68,000 deaths. He says the revised number is due in part to more precise estimates. In the past two decades, the number of yellow fever cases worldwide has increased, he says, because of things like declining population immunity to infection, deforestation, urbanization, population movements and climate change.

A big problem, according to Duclos, is that in a number of African countries, immunization schedules are not in place. "In Africa there are still countries that have not introduced the vaccine in their routine schedule and also countries that have not done catch-up vaccination campaigns to take care of the pool of susceptibles in their population, so the risk is there," he said. Duclos says by the end of 2011 nine African countries were not carrying out routine vaccinations, including Sudan, Uganda, Somalia, and Ethiopia.

WHO: Yellow Fever 'Booster' Unnecessary

 

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NGO fighting cholera and diarrhea in Malawi...

In Malawi, an NGO Saves Rural Dwellers from Waterborne Illnesses
May 25, 2013 — A few years ago, residents of Malawi's southern district of Chikhwawa were often stricken with diarrhea often caused by cholera, an illness spread by unclean drinking water from unprotected sources like wells and rivers. Today, the situation is under control, thanks to an international NGO that's drilling boreholes in the area for fresh drinking water and building latrines for family use.

The Water and Sanitation Project was prompted by a study showing that Chikhwawa - with nearly half a million people -- has relatively few public toilets or other facilities supporting public hygiene. Kate Harawa, the country director of Water for the People, the non-governmental organization sponsoring the effort, says " We looked at the statistics and found out that Chikhwawa was one of the least safety [districts] in terms of water supply and sanitation. At that time [2008] it was around 45 percent access to safe water and sanitation was very, very low. And ... there are a high percent of people who openly defecate.”

Harawa says to avert the situation, the organization is drilling boreholes starting with Makhuwira, Kasisi and Chapanganga --- areas under traditional authority where there's a high risk of contracting waterborne diseases. “We have [built] more than 200 water points," she says, "and this year we are doing [additional] 41 and next year we [will build] 100.” The project is also helping to build latrines in individual homes. Health experts say the initiative has helped reduce incidences of diarrhea among the 8,000 households in the district. They say before the introduction of the project in 2008, 0.2 percent of the district's population were infected, which is very high by world standards. Today, it's been reduced to 0.007 percent.

In Malawi, woman in the central district of Dedza gathers water

Beatrice Munyowa, one of health Instructors in the district, explains how that level was reached. “To maintain the hygiene standards," she says, "we provide chlorine to the communities for treating the water and we also advise them to always cover the water and always keep clean the borehole surroundings.” Besides advice from health experts, villagers themselves have formed committees responsible for the sanitation and the maintenance of the boreholes.

Emily Batumeyo, the secretary of the water point committee at Kasokeza village, says apart from the reduced incidents of water borne diseases, the project has made it easier to access clean water. “Before the initiative," she says, "we used to travel long distances to fetch clean water. For example we would wake up early in the morning to battle for clean water at a water point which was as far as three kilometers away. Sometimes we would spend a night [there].”

The organization is implementing the project with support from international NGOs Global Sanitation Fund, Charity Water and Climate Justice Fund. Harawa says funds permitting; the NGO is planning to extend the initiative to the rest of the district to reach its goal of ensuring that everyone has access to safe water by 2018. Water for the People has similar projects in other parts of Malawi -- in the peri-urban areas of Blantyre, and in the northern district of Rumphi - and in Rwanda and Uganda.

Source

 

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Doctors seek reduction in blinding illness...

Doctors Aim to Reduce Trachoma in Kenya
August 09, 2013 — Health workers in Kenya say more than 60,000 people are living with trachoma, an infectious eye disease that causes blindness if not treated early.

But doctors are working to bring an outbreak of the disease under control in Kajiado, a remote rural village in southern Kenya. A local trachoma monitor in Kajiado is teaching a group of women how to prevent the eye disease and how, and where, to get treatment. Lester Mortai is well known in this area for his work fighting trachoma. He travels through villages, telling people the best ways to avoid getting the painful disease. “At household level I encourage them face cleanness and even the environment. [In] the case of trachoma, the main agent is the flies. We also encourage those who sleep [with] animals around them to separate themselves from animals,” said Mortai.

Trachoma is characterized by the swelling of the eyelids and scarring of the outer surface of the eye, the cornea. Repeated infections make the eye lashes turn in and scratch the cornea, causing pain and, eventually, blindness. According to the African Medical and Research Foundation (AMREF), more than 7,000 people in Kajiado suffer from trachoma. The disease primarily afflicts impoverished pastoral communities. Ngeyan Nge is one of four trachoma sufferers with an advanced stage of the disease. To avoid blindness, Nge will undergo surgery to correct the positioning of her eye lashes. The mother of six says she decided to seek medical treatment after a long time living with pain.

A woman washes her face. Facial cleanliness is one way to prevent Trachoma

She said she was now hopeful about the future, even though in the beginning she was opposed to the surgery. She changed her mind, adding, "after continuous advice from people, and also no matter what medicine I use the pain won’t go away. After the surgery, I hope I will be able to see well and carry my daily activities.” One of the "flying doctors" from AMREF, John Soine, travels to remote areas of Kenya every week to operate on those with serious cases of trachoma. He said the disease was easily treatable if caught early. “If these people with active infections are not treated, they end up developing complications whereby the eyelashes start facing inwards and start rubbing on the eye ball. And at this stage one may lose vision. And the loss of vision in trachoma is irreversible,” he said.

Thirty-nine-year-old Kadogo Salaash had almost lost her vision to the disease more than five years ago. At first she was doubtful that surgery could help her, but eventually she relented. “When I decided to go for the eye surgery, I was worried and uncomfortable,” she said. “I thought after the surgery I would not see again. [But now it’s the opposite; I am confident, happy and I can do my work well.” Health workers said in the last five years active trachoma prevalence has dropped by 11 percent, largely due to vigorous education campaigns and improved access to water, sanitation and hygiene. The next goal is to reduce active trachoma prevalence to under 10 percent, with hopes of eliminating the disease entirely by 2020.

Doctors Aim to Reduce Trachoma in Kenya

 

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Follow-up therapy not happening for African children...

New Research Finds Gap in Diarrhea Care of African Children
April 23, 2014 ~ New research recently published online by the American Society of Tropical Medicine and Hygiene finds that young children suffering from diarrheal diseases are less likely to receive life-saving oral rehydration therapy (ORT) when seeking treatment in private clinics.

This first-ever, large-scale study of child diarrhea treatment practices in sub-Saharan Africa found that closing the gap between public and private clinics with regard to access to ORT could each year save the lives of 20,000 children under 5 years of age. The nine-year study followed the treatment received by 19,000 children in 29 African nations and found that one-fourth of all of the patients sought treatment at private clinics which are less likely to offer the simple inexpensive therapy. The study found that in sub-Saharan Africa, Chad was the only country where private clinics did better in providing ORT over public clinics.

Zachary Wagner, a co-author of the study, described two factors that motivated the study. “The first is that there are hundreds of thousands of children that die from diarrhea each year,” said Wagner, who is a doctoral student in public health at the University of California-Berkeley. “And this is particularly tragic because there is a very effective and very cheap treatment for diarrhea that prevents death. It’s called oral rehydration salts, (ORS), or oral rehydration therapy.” ORT is effective because it basically prevents the dehydration caused by diarrhea, which is usually what kills the child. “This treatment is just widely under-used. That’s why so many children continue to die. It’s been around since the 60s, yet it is still widely under-used,” Wagner noted.

Private clinics grow in popularity

The fact that so many children with diarrhea and diarrheal diseases seek treatment at private clinics was another motivation for the study. “The private health sector is becoming more and more prevalent in sub-Saharan Africa, and throughout the developing world,” says Wagner. “So, understanding what kind of care is being provided in the private sector is really important.” He and the research team set out to understand how care for diarrhea in the private sector compared to care for diarrhea in the public sector. “We found that ORS - this really important treatment - was way less likely to be provided in the private sector for child diarrhea, than the public sector,” he explained.

Hassana Ousmane Hassana Ousmane rests her head against the bed where 21-month-old Zeinab, suffering from diarrhea, Princess Marie Louise Children's Hospital, Accra

Wagner says oral rehydration salts are widely available and distributed to developing countries. It is a well-known treatment among development organizations such as the World Health Organization, and NGOs that have promoted the use of the inexpensive and life-saving therapy for treating diarrhea. There is no reason why private clinics should not be using ORT. “If a child has diarrhea, it is important that the mother or caretaker, takes them to a provider. So, ORS is really important, and it’s really cheap. And they can access it themselves, but it is important to understand how to use it.”

The researcher highlighted the important role private health care providers are now playing in sub-Saharan Africa, and a simple solution of salt packets is a major solution to child mortality. He also said parents and caregivers must make sure children with diarrhea get the care they need to survive. “So, they should definitely seek care. And they should always give their child this ORS. The World Health Organization recommends that all children with diarrhea, regardless of illness severity, receive this solution after every loose stool,” said Wagner.

New Research Finds Gap in Diarrhea Care of African Children

 

[JakeStarkey]

Cholera Cholera: Causes, Symptoms, Treatment, and Prevention Cholera is an infectious disease that causes severe watery diarrhea, which can lead to dehydration and even death if untreated. It is caused by eating food or drinking water contaminated with a bacterium called Vibrio cholerae.

From our own family history of wagons west in the late 1840s and 1850s, the immigrants, we learned, were particularly susceptible to Asiatic cholera, which wreaked havoc on entire wagon companies.

Haiti has had 210 thousand cases since the earth quake more than four years ago, and 8500 have died. Considering the magnitude of the quake and after effects, that is an amazing survival rate.

 

[waltky]

It's here - and it's spreadin' fast...

Fast-spreading virus gains a foothold in much of Caribbean
Sat, May 03, 2014 - A recently arrived mosquito-borne virus that causes an abrupt onset of high fever and intense joint pain is rapidly gaining a foothold in many spots of the Caribbean, health experts said on Thursday.

There are more than 4,000 confirmed cases of the fast-spreading chikungunya virus in the Caribbean, most of them in the French Caribbean islands of Martinique, Guadeloupe and St Martin. Another 31,000 suspected cases have been reported across the region of scattered islands. The often painful illness most commonly found in Asia and Africa was first detected in December last year in tiny St Martin. It was the first time that local transmission of chikungunya had been reported in the Americas. Since then, it has spread to nearly a dozen other islands and French Guiana, an overseas department of France on the north shoulder of South America.

It is rarely fatal and most chikungunya patients rebound within a week, but some people experience joint pain for months to years. There is no vaccine and it is spread by the pervasive Aedes aegypti mosquito that transmits dengue fever, a similar, but often more serious illness, with a deadly hemorrhagic form. The US Centers for Disease Control and Prevention (CDC) is closely monitoring the uncontrolled spread of the new vector-borne virus in the Caribbean and has been advising travelers about how best to protect themselves, such as applying mosquito repellant and sleeping in screened rooms. It is also closely watching for any signs of chikungunya in the US. “To help prepare the United States for possible introduction of the virus, CDC has been working with state health departments to increase awareness about chikungunya, and to facilitate diagnostic testing and early detection of any US cases,” CDC medical epidemiologist Erin Staples said.

In the Caribbean, concern about chikungunya is growing as many countries enter their wettest months. The only way to stop the virus is to contain the population of mosquitoes — a task that commonly relies on individual efforts, such as installing screened windows and making sure mosquitoes are not breeding in stagnant water. Experts say eradicating vector-borne diseases like chikungunya once they become entrenched is an extremely difficult task. James Hospedales, executive director of the Trinidad-based Caribbean Public Health Agency, recently described the virus as the “new kid on the block.”

Late last month, St Vincent and the Grenadines and Antigua and Barbuda became the latest Caribbean countries to report confirmed cases. In the Dominican Republic, there are now 17 confirmed cases and more than 3,000 suspected ones. This week, the virus was discussed by health authorities at a two-day conference in the Dominican Republic attended by representatives of Central American countries. Marie Guirlaine Raymond Charite, general director of the Haitian health ministry, said there are several suspected cases of chikungunya, but none have yet been confirmed.

Fast-spreading virus gains a foothold in much of Caribbean - Taipei Times

See also:

US Confirms First Case of MERS Virus
May 02, 2014 ~ The U.S. Centers for Disease Control has confirmed the first case of the deadly Middle East Respiratory Virus, or MERS, within the United States.

CDC officials Friday said an American health care worker who recently traveled to Saudi Arabia has been hospitalized with the virus in the midwestern state of Indiana. They say the patient has been isolated and is in stable condition. National Center for Immunization and Respiratory Diseases director Anne Schuchat said the case is rapidly evolving, and that the CDC is working to identify people who may have been in contact with the patient. Schuchat said the patient traveled from Riyadh, Saudi Arabia on April 24 to London, and then on to Indiana.

The MERS virus first appeared in September 2012, and all of the cases have been linked to six countries in the Arabian peninsula. Saudi Arabia has seen the most cases. Schuchat said around 400 people have tested positive for the disease since it first appeared, and that about one-third of those people have died from the virus.

MERS is a member of the coronavirus family, which includes germs that cause the common cold, as well as severe acute respiratory syndrome, or SARS. SARS popped up in southern China in 2003, infected about 8,000 people in 29 countries and killed about 800 before it was contained.

A spike in MERS cases in Saudi Arabia that began last week has raised worries among health experts that the virus has mutated into a more spreadable form. Schuchat said the reason for the increase is not yet known. It is not yet clear where MERS came from originally, but camels are the lead suspects.

http://www.voanews.com/content/us-confirms-first-case-of-mers-virus/1906555.html

 

[waltky]

possum likes donuts and mango juice...

Study: Schistosomiasis Treatment Better with Snack
May 13, 2014 ~ Treatment for the parasitic illness schistosomiasis is more effective if children have a snack before receiving the drug praziquantel.

That's the finding of a study conducted in Uganda's Jinja district by researchers from Makerere University in Kampala. They worked with students at 12 primary schools. In addition to an educational message about the parasite, children at some of the schools were given donuts and mango juice prior to treatment. Four weeks later, stool samples were collected from a random sample of 1,284 youngsters to test for the presence of schistosome eggs. Researchers report in the journal PLOS Medicine that children who ate something before getting the medicine had half as many eggs in their stool as those at non-snack schools.

Because food improved uptake of the drug, researchers also found a lower intensity of infection with the parasite S. mansoni in those who snacked. In addition, the youngsters who ate reported fewer side effects from the drug. Experts say schistosomiasis is second only to malaria as the most devastating parasitic illness. It primarily affects the urinary tract and intestines. Chronic infection can lead to kidney disease, bladder cancer or infertility.

Biopholaria Glabrata snails, the intermidiate hosts of the Schistosoma mansoni worms, University of Georgia Center for Tropical and Emerging Global Diseases, Athens, Ga.

According to the World Health Organization, some 250 million people received preventive treatment with praziquantel in 2012 and 42 million were treated for infection. Ninety percent of cases occur in sub-Saharan Africa, although clusters of infection are seen in tropical and sub-tropical regions in Asia and the Middle East. Because children are most vulnerable to infection, the WHO recommends mass treatment campaigns of school children with praziquantel.

The parasitic worm is carried by freshwater snails and the disease is often contracted through bathing or swimming. The worms burrow into the tissues of internal organs after gaining access through the skin.

Study: Schistosomiasis Treatment Better with Snack

 

[waltky]

Chikungunya spreading through the Caribbean...

Painful and rapid spread of new virus in Caribbean
22 May`14 — They suffer searing headaches, a burning fever and so much pain in their joints they can barely walk or use their hands. It's like having a terrible flu combined with an abrupt case of arthritis.

Hospitals and clinics throughout the Caribbean are seeing thousands of people with the same symptoms, victims of a virus with a long and unfamiliar name that has been spread rapidly by mosquitoes across the islands after the first locally transmitted case was confirmed in December. "You feel it in your bones, your fingers and your hands. It's like everything is coming apart," said 34-year-old Sahira Francisco as she and her daughter waited for treatment at a hospital in San Cristobal, a town in the southern Dominican Republic that has seen a surge of the cases in recent days. The virus is chikungunya, derived from an African word that loosely translates as "contorted with pain." People encountering it in the Caribbean for the first time say the description is fitting. While the virus is rarely fatal it is extremely debilitating. "It is terrible, I have never in my life gotten such an illness," said Maria Norde, a 66-year-old woman confined to bed at her home on the lush eastern Caribbean island of Dominica. "All my joints are in pain."

Outbreaks of the virus have long made people miserable in Africa and Asia. But it is new to the Caribbean, with the first locally transmitted case documented in December in French St. Martin, likely brought in by an infected air traveler. Health officials are now working feverishly to educate the public about the illness, knock down the mosquito population, and deal with an onslaught of cases. Authorities are attempting to control mosquitoes throughout the Caribbean, from dense urban neighborhoods to beach resorts. There have been no confirmed cases of local transmission of chikungunya on the U.S. mainland, but experts say the high number of travelers to the region means that could change as early as this summer. So far, there are no signs the virus is keeping visitors away though some Caribbean officials warn it might if it is not controlled. "We need to come together and deal with this disease," said Dominica Tourism Minister Ian Douglas.

One thing is certain: The virus has found fertile ground in the Caribbean. The Pan American Health Organization reports more than 55,000 suspected and confirmed cases since December throughout the islands. It has also reached French Guiana, the first confirmed transmission on the South American mainland. The Pan American Health Organization says seven people in the Caribbean with chikungunya have died during the outbreak but they had underlying health issues that likely contributed to their death. "It's building up like a snowball because of the constant movement of people," said Jacqueline Medina, a specialist at the Instituto Technologico university in the Dominican Republic, where some hospitals report more than 100 new cases per day.

Chikungunya was identified in Africa in 1953 and is found throughout the tropics of the Eastern Hemisphere. It is spread by two species of mosquitoes, aedes aegypti and aedes albopictus. It's also a traveler-borne virus under the right circumstances. It can spread to a new area if someone has it circulating in their system during a relatively short period of time, roughly 2-3 days before the onset of symptoms to 5 days after, and then arrives to an area with the right kind of mosquitoes. For years, there have been sporadic cases of travelers diagnosed with chikungunya but without local transmission. In 2007, there was an outbreak in northern Italy, so health authorities figured it was just a matter of time before it spread to the Western Hemisphere, said Dr. Roger Nasci, of the U.S. Centers for Disease Control and Prevention. "With the increase in travelers the likelihood that something like this would happen goes up and eventually it did," said Nasci, chief of a CDC branch that tracks insect-borne diseases. "We ended up with somebody at the right time and the right place infecting mosquitoes."

The two species of mosquitoes that spread chikungunya are found in the southern and eastern United States and the first local transmissions could occur this summer given the large number of U.S. travelers to the Caribbean, Nasci said. Already, the Florida Department of Health has reported at least four imported cases from travelers to Haiti, the Dominican Republic and Dominica. "What we're seeing now is an increase in the number of infected travelers coming from the Caribbean, which is expected because there's a lot of U.S. travel, a lot of vacation travel, a lot of work travel," he said. Around the Caribbean, local authorities have been spraying fogs of pesticides and urging people to remove standing pools of water where mosquitoes breed. An estimated 60-90 percent of those infected show symptoms, compared to around 20 percent for dengue, which is common in the region. There is no vaccine and the only cure is treatment for the pain and fluid loss. One consolation for those suffering from the illness is that unlike dengue, which has several variants, people only seem to get chikungunya once. "The evidence suggests that once you get it and recover, once your immune system clears the virus you are immune for life," Nasci said.

Painful and rapid spread of new virus in Caribbean

 

[waltky]

Australia bracing for dengue fever outbreak...

Vicious mosquito heads to Australia, its bite loaded with dengue fever
Thursday 29 May 2014 ~ Queensland researchers studying Asian tiger mosquito, saying it's 'only a matter of time' before it reaches Australia

Australia is preparing for an invasion by an aggressive and exotic pest that threatens to spread dengue fever to southern capitals. Queensland scientists have begun breeding the Asian tiger mosquito, a highly invasive species which is able to bite dozens of times a minute. They are closely studying the country's only colony of the insect, caged behind a series of locked doors in Brisbane's QIMR Berghofer Medical Research Institute.

Associate professor Greg Devine says the research is vital given the mosquito's potential to introduce the debilitating chikungunya virus and spread diseases such as dengue to capital cities. “What we'd like to understand is the real risk of transmission in urban centres like Brisbane and Sydney,” he said. “We are also looking at the way it would interact with native mosquitoes so we can determine how rapid its impact will be.”

The Asian tiger mosquito is able to bite dozens of times a minute. Photograph: courtesy federal Agriculture Department

But its greatest impact will be on Australia's outdoor lifestyle because it thrives in and around homes and bites all day. “It's come to be known as the barbecue stopper, and for good reason,” Devine said. The large and aggressive mosquito is capable of spreading several diseases, including Ross River virus, yellow fever and chikungunya. There is no treatment for the Chikungunya virus, common in south-east Asia, which can leave sufferers with severe joint pain for months.

When the Asian tiger mosquito will invade Australia is not known but Devine said it would be a case of when, not if. “It's definitely only a matter of time,” he said. “It arrived in the Torres Strait about 2005, but of course that's not the only route at which it can come in. “There is no doubt it is coming eventually because it's been picked up so many times at Australia's borders.”

Vicious mosquito heads to Australia, its bite loaded with dengue fever | World news | theguardian.com

 

[ArmandoW]

One should be aware and take all the vaccination earlier so that it will not create any further problem in future.

 

[waltky]

possum likes the idea of needle-free vaccines...

Researchers Develop Needle-Free Ebola Vaccine
November 12, 2014 ~ Researchers have developed a single-dose, needle-free Ebola vaccine that protects monkeys against infection for more than four months. The vaccine is administered through the nose, protecting the primates via the respiratory tract.

One key advantage, according to researcher Maria Croyle of the University of Texas at Austin, is that the vaccine could potentially prevent transmission of the virus from unintentional needle sticks through the unsafe handling of medical waste. News of the vaccine is reported in Molecular Pharmaceuticals, a journal of the American Chemical Society.

A researcher holds a vial of an experimental Ebola vaccine in Oxford, England

The inhaled vaccine uses a harmless adenovirus, which causes the common cold, to deliver the vaccine. In a study involving macaque monkeys, none of the three primates that received the vaccine become infected when exposed to the Ebola virus at least 21 weeks later. The researchers also gave the vaccine to the macaques through intravenous injection, which also protected the animals.

The investigators say more work is needed on the formula. An under-the-tongue formulation of the vaccine is also in development. At least two other candidate vaccines against Ebola are in clinical trials in the United States and Africa.

Researchers Develop Needle-Free Ebola Vaccine

See also:

Dengue Fever Epidemic Neglected Amid Ebola Scare
November 13, 2014 ~ As the Ebola epidemic rages on in western Africa, there’s concern that another disease - which sickens and kills more people globally - is largely being ignored. Dengue fever, which is transmitted by mosquitoes, continues to spread in countries, including India and Malaysia, where nearly half of the world’s population resides. But a long-sought vaccine offering some protection against dengue may soon become available.

Dengue fever causes debilitating flu-like symptoms, rashes, headaches and severe muscle and joint pains. For that reason, the infection is sometimes called “breakbone disease.” Like Ebola, dengue is considered a hemorrhagic disease, resulting in death in the worst cases. Scott Halstead is senior scientific advisor to the Dengue Vaccine Initiative, an international consortium of scientists and lay people dedicated to the development of a vaccine.

Unlike Ebola, which - in the current epidemic - has so far infected more than 14,000 people in West Africa, Halstead says the scope of dengue is enormous, with up to 100 million infections every year, mostly across Asia. “I think people in the dengue field feel, 'Golly, ooh, we’re going to be pushed into the shadows.' But because hundreds of thousands, maybe millions, of people require clinical care, it’s a problem. It’s in your face but it’s all over the place," said Halstead.

Family members stand next to a patient suffering from dengue fever, in an isolation ward at a local hospital in Rawalpindi, Pakistan

There are four dengue viruses, all spread by mosquitoes. Surviving infection by one strain provides lifelong immunity against that type but does not protect the person from future infection by the other strains. Two years ago, a candidate vaccine developed by the French pharmaceutical company Sanofi Pasteur was tested in a group of 4,000 Thai schoolchildren and did not perform as well as hoped. Only 30 percent of the children were protected against infection. The researchers' goal was a vaccine that was 70 percent effective against all types of the dengue virus. Now, in advanced clinical trials conducted in five Latin American countries involving almost 21,000 healthy children, the company is reporting promising results with the same vaccine.

In an article published early this month in the New England Journal of Medicine, Sanofi reports the vaccine offered 60 to 80 percent protection, resulting in fewer hospitalizations. The children were followed for two years to see if they came down with the disease. Halstead says the drug seems to work best in those who have already been infected with one of the dengue viruses. “So this seems to be what this efficacy is largely due to, which is boosting the immunity of people who are already partially immune," he said.

Halstead says the vaccine failed in Thailand because most of the treated kids who became infected were stricken with dengue type 2, the strain of the virus that’s proven to be the most difficult of the four to prevent. With future clinical trials planned, Sanofi researchers hope to learn more about how the vaccine protects against dengue fever, with an eye toward improving its effectiveness.

Dengue Fever Epidemic Neglected Amid Ebola Scare

Related:

Global Campaign to Eliminate Measles Stalls
November 13, 2014 — The World Health Organization (WHO) says the global campaign to eliminate measles is in trouble as progress toward that goal has stalled. WHO reports about 145,700 children died from measles in 2013, an increase of 23,700 from the previous year.

WHO says a decline in routine measles vaccine coverage has resulted in large outbreaks of this highly contagious disease in recent years. It also has stalled global efforts to eradicate measles by 2015. The U.N. agency says measles immunization efforts are hampered by lack of money, weak health systems and not enough awareness of the importance of vaccinating children against this killer disease. It notes it only costs about one dollar to vaccinate a child. WHO estimates 15.6 million deaths have been prevented through vaccination between 2000 and 2013.

Dr. Robert Perry of the WHO Department of Immunization, Vaccines and Biologicals, says these huge reductions in mortality are tapering off because of poor vaccine coverage. “So, now we are in a crossroads," he said. "We need adequate funding. We need to find ways to increase the first dose coverage and to increase the uptake of a second dose in routine as well as conducting high quality campaigns or we are likely to see more outbreaks like we have seen in the last few years.”

The World Health Organization reports in 2013 large outbreaks occurred in China, Democratic Republic of Congo and Nigeria. It reports more than 70 percent of global measles deaths occurred last year in just six countries - India, Nigeria, Pakistan, Ethiopia, Indonesia, and Democratic Republic of Congo.

A Syrian girl cries after being vaccinated against the measles at a U.N. registration center in Zahleh, in Lebanon's Bekaa Valley.

Perry says conflict-ridden Iraq and Syria and neighboring countries are having serious problems with measles outbreaks. “These are countries, especially like Syria and Jordan that had very good coverage, had essentially eliminated measles and blocked any measles transmission," he said. "Because of the conflict in Syria, there has been huge population movement, so now there is - the population that used to be all vaccinated now is not vaccinated in Syria and they have moved to other countries. So, now these countries have big populations of kids that are not being reached. And, the conflict in Iraq and Syria is having a bad effect on the ability of teams to reach children. So, there is a lot of measles in those countries.”

Perry notes conflict in Africa is having a similar effect on efforts to reduce death from measles. He says the conflict between the government and Boko Haram militants in northeast Nigeria is creating great instability and making large vaccination campaigns virtually impossible. Although Central African Republic also is hard hit by conflict, he says it was possible to mount a successful measles vaccination campaign there last year. But he adds a number of areas were off limits because of fighting, so many children have been missed.

Global Campaign to Eliminate Measles Stalls

 

[waltky]

Bacterial Protein Found Effective Against Rotavirus...

Bacterial Protein Found Effective Against Diarrheal Disease
November 13, 2014 ~ Researchers are using a bacterial protein to both treat and prevent rotavirus, a viral infection that causes an estimated half-million deaths a year among young children.

A rotavirus vaccine that has reduced the number of cases in the U.S. and other Western countries by 90 percent does not work particularly well in the developing world. The reasons are unclear. Researchers think the vaccine is ineffective because of co-infections, which are common in less developed countries, or the type of bacterial flora that inhabit the children's digestive tracts. The result, according to the U.S. Centers for Disease Control and Prevention, is an estimated 500,000 deaths annually among children who are not protected against the diarrheal illness.

An infant infected with rotavirus sleeps at the San Rafael hospital in Santa Tecla, El Salvador

Now, researchers at the Institute for Biomedical Sciences at Georgia State University in Atlanta have discovered that a protein taken from a bacterium treats and prevents the disease extremely effectively. Andrew Gewirtz, an immunologist at Georgia State, explains that the protein, called flagellin, prompted an immediate response. Flagellin "is a very potent activator of the mucosal immune system," he said. "And it — at least in mice — confers a very strong protection to being infected by rotavirus. Or if a mouse is chronically infected with rotavirus, it results in rapid clearance of the infection.”

Gewirtz envisions using the bacterial protein, which much be injected, "to treat chronic infections and to provide temporary protection ... in the case of outbreaks of infectious disease where other measures were not available.” He said he expected human clinical trials to begin fairly soon. The rotavirus treatment, reported in the journal Science, was developed in collaboration with researchers at Atlanta’s Emory University, Baylor College of Medicine in Texas, Vanderbilt University School of Medicine in Tennessee, Pennsylvania State University and the biotech firm Genentech.

Bacterial Protein Found Effective Against Diarrheal Disease

 

[waltky]

Cholera season breaks out in Africa...

WHO: Tanzania Cholera Epidemic Worsens
August 28, 2015 — The World Health Organization and Tanzanian Ministry of Health are stepping up efforts to contain and discover the source of a cholera epidemic that so far has killed eight people and infected more than 400 others.

WHO data indicates the fast-spreading epidemic broke out in the Dar es Salaam and Morogoro regions nearly two weeks ago; the Dar es Salaam region has been most adversely affected with 354 cases and seven deaths. WHO spokesman Christian Lindmeier tells VOA the outbreak caught health officials by surprise. “The spike is an unusual spike right now because it jumped in short time from a few hundred cases to the 404 cases," he said. "Yet cholera is endemic in Tanzania, so, as such, it is not a worrying situation, but it needs to be addressed."

After assessing needs on the ground in affected areas, WHO officials have begun procuring laboratory reagents for diagnosis. Lindmeier also says the agency is outfitting five operational treatment centers in the affected region with medical supplies and chemicals to treat water and disinfectants.

WHO officials have said they see no connection between the current outbreak and a prior, more serious outbreak in western Tanzania's Kigoma region, which border portions of Lake Tanganyika and Burundi. “The cholera outbreak in Kigoma region reported between May and July related to the refugees coming from Burundi at that time has been brought under control with no new cases from that area for nearly a month," Lindmeier said.

Burundi President Pierre Nkurunziza's April announcement to seek a controversial third term triggered political violence that prompted tens of thousands of Burundians to flee to Kigoma. The epidemic among refugees resulted in more than 4,800 cases and claimed dozens of lives.

Source

Single Cholera Vaccine Dose May Slow Cholera Epidemics
August 26, 2015 : When it comes to a vaccine to prevent cholera, one dose may be as good as two. That is the finding of a new study whose authors say the strategy would make a new vaccine that is in short supply go further.

The World Health Organization is stockpiling 2 million doses of a recently licensed oral cholera vaccine to prevent the severe diarrheal illness. An estimated 1.4 billion people around the world, according to the WHO, are at risk for contracting the water-borne illness, making the stockpile woefully inadequate to meet the need. An outbreak of cholera often follows a natural disaster, when drinking water becomes fouled with human waste.

Single-dose effectiveness

In a new study, researchers looked at the cholera epidemic in Port-au-Prince, Haiti, following the 2010 earthquake. Roughly 120,000 people contracted the bacterial disease and more than 800 died. But writing in the journal PLOS Medicine, they say if a single dose of the oral vaccine had been administered to the population within a year of the earthquake and the first reported cases, more than 78,000 cases of cholera might have been prevented and 783 deaths averted.

Justin Lessler, an epidemiologist at Johns Hopkins University’s Bloomberg School of Public Health, led the study looking at the effectiveness of a one-dose strategy. He compares it to the current vaccination protocol, which calls for giving a dose of the drug to those at risk, followed by a second dose, two weeks later. “Even if a one dose isn’t 50 percent as efficacious as a two dose, it’s still the better strategy because when responding to an outbreak, the important thing is to get as much vaccine into the population as quickly as possible," he said. Using a mathematical model, the researchers found that a vaccination campaign in Haiti using two doses would have protected five percent fewer people than the single-dose strategy.

Additional factors

Lessler said that outcome would be due to problems with refrigeration, as well as the effort of tracking down those who had received the first dose. Investigators also analyzed the 2008-2009 cholera epidemic in Zimbabwe, saying almost 71,000 cases and 3,000 deaths might have been prevented. “By using a one-dose campaign, you can protect the same number of people and protect them earlier, so you ultimately prevent more cases of the disease than if you’d used the two dose protocol,” he said.

Cholera, caused by the bacterium Vibrio cholerae, causes severe diarrhea that can lead to dehydration and death without immediate, supportive care. Children under five years of age are most vulnerable. There is currently an outbreak in Juba, South Sudan, and only 250,000 doses of the oral vaccine are available. Officials are testing the one-dose strategy in that region to see if they can limit cholera’s toll.

Source

http://www.voanews.com/content/single-cholera-vaccine-dose-may-slow-cholera-epidemics/2933482.html