Update on Marburg, Ebola’s sister virus in Uganda

Marburg virus has infected and killed three people in Uganda. “The Conversation” reports that “more than 100 people are now being monitored and the country’s health authorities are holding their breath, waiting for the 21-day incubation period of the virus to pass – hopefully, without further cases being reported”.

On average, half of those infected with the Marburg virus will die, however, mortality rates as high as 88% have previously been reported. Thankfully, Uganda has a good track record of handling outbreaks of viruses, including Marburg and its close cousin, Ebola. The latest Marburg outbreak, in the Kween district bordering Kenya, was declared when the first case was confirmed by laboratory tests. The patient subsequently died, but, unfortunately, she had been in contact with family members, including one who traveled to Kenya. It turned out that the patient (the so-called “index case”) was, in fact, not the first case in the current outbreak. For humans and other monkeys, filo-viruses like Marburg and Ebola viruses can kill. Filoviruses are highly infectious and spread by contact with bodily fluids, including blood. As with the Ebola virus, Marburg can also spread via sexual contact and can persist for a long time in humans.

Good news is: there is reason to believe Uganda will cope. The early and rapid response to this Marburg outbreak suggests that the same factors that hampered an effective response in West Africa during the beginning of the 2014 Ebola epidemic are not being repeated here.

nov 13, 2017


A cancer charity has appointed a digital nurse to combat "fake news" online – reports the BBC.

Macmillan Cancer Support found two-fifths of people with cancer looked up information about their diagnosis on the internet. One in eight of those went online because they didn't fully understand what their doctor had told them.

Ellen McPake, the nurse who landed the job, says she wants to correct the misinformation that exists.

She said: "Once the doctor says 'cancer', people automatically then shut down and they don't take in the information that they're given. So they go home, speak to the family. And then they'll sit online that night and get themselves in a frenzy with what they're reading."

She says people focus on the worst-case scenario: "There's quite a lot of myths out there," she said.

Here are some of them:

  • Sodium bicarbonate can cure cancer. "Some people think that drinking it or taking it intravenously can cure cancer. There isn't any evidence to support that," she said.
  • Sugar gives you cancer mistakenly believe that sugar can give you cancer. Ellen said some patients misguidedly think sugar causes cancer. While obesity has been linked to cancer, consumption of sugar itself does not increase risk.
  • Other myths include: Vitamin C cures cancer, Only old people get cancer, Coffee enemas help, It's a modern disease

"There is the idea that it's a man-made modern disease," says Ellen. "But it isn't - it's been found in Egyptian mummies."

One of these, from 2,250 years ago, was found with prostate cancer, while an ancient 1.7 million-year-old toe from South Africa was found to have an aggressive type of bone cancer.

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Oct 30, 2017


Ebola vaccine wins approval from regulators

China's top food and drug authority announced last week that it has approved the country's first vaccine for Ebola virus disease.

This makes China the third country, after the United States and Russia, with vaccines available for use to combat the deadly infectious disease, the China Food and Drug Administration said.

The vaccine, named recombinant Ebola virus disease vaccine (Adenovirus type 5 vector), is available in powder, and, compared with liquid vaccines in the other two countries, is more stable. This highlights its advantages in transportation and use in tropical areas such as Africa, it said.

"Clinical tests conducted on Africans in China showed the vaccine was safe and effective," said Li Lanjuan, a professor in infectious diseases at Zhejiang University,Li, who led the clinical tests in 2015.

Clinical tests for the vaccine also were completed on 120 Chinese in Taizhou, Jiangsu province, in February 2015.

Efforts to develop the Ebola vaccine started at the Academy of Military Medical Sciences more than seven years ago and the process accelerated with the outbreak of the disease in West Africa in 2014, according to a previous report by the news website caixin.com.

The Ebola virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission. Mortality among those infected could reach 90 percent, according to the World Health Organization.

There is yet no proven treatment available for the disease, but a range of potential treatments, including blood products, immunotherapies and drug therapies, are being evaluated, it said.

Read the full article on China Daily: http://www.chinadaily.com.cn/china/2017-10/21/content_33522181.htm

Oct 23, 2017


There’s another outbreak of plague in Madagascar. This one is different.  

We tend to use the word 'plague' to describe pandemic infections. More correctly, plague is an infectious disease caused by a bacterium. The disease — which is initially spread by flea bites and was known as the Black Death in medieval times — has spread to the capital of Madagascar, Antananarivo.

The Los Angeles Times reports that instead of cases in the hinterlands where plague is endemic, the disease has spread densely populated cities for the first time, killing 45 people and sparking panic. This year's outbreak sees much more person-to-person transmission than is the norm. Bubonic plague is easily treated with antibiotics, but if untreated it can reach the lungs, developing into pneumonic plague, which can kill a patient within 24 hours.

Pneumonic plague, the version that is spreading rapidly in Madagascar, is more virulent and dangerous than bubonic plague, because it is swiftly spreads through infected droplets coughed into the air.

oct 16, 2017


High expectations at lung health conference

The 48th Union’s World Conference on Lung Health is under way in Guadalajara, Mexico and there’s excitement at the technological advances in the diagnosis and treatment of tuberculosis being unveiled for the first time. It is the world’s largest gathering of medical experts and policymakers looking into relief for lung disease. The gathering of some 3000 participants from more than a hundred countries is  organized by the International Union Against Tuberculosis and Lung Disease or The Union.

An estimated ten million people die each year from lung diseases. This year’s conference looks at how to accelerate toward elimination on multiple fronts: tuberculosis (TB) and co-infections, improving tobacco control and reducing air pollution.

Oct 13, 2017


Prize for the secrets of good sleep

Three U.S. scientists have been awarded the 2017 Nobel Prize in Physiology or Medicine for unlocking how the body clock works. Jeffrey C. Hall, PhD, Michael Rosbash, PhD, and Michael W. Young, PhD, were able to "peek inside our biological clock and elucidate its inner workings. Their discoveries explain how plants, animals and humans adapt their biological rhythm so that it is synchronized with the Earth's revolutions," said a statement from the Nobel Assembly at the Karolinska Institutet in Stockholm, Sweden.

The laureates worked with fruit flies and isolated a gene that controls biological rhythm.

Their work helps us better understand the reasons we’re awake when it’s light and go to sleep when it’s dark. Importantly, it confirms that sleep is important for good health.

Read more here: https://www.nobelprize.org/nobel_prizes/medicine/laureates/2017/press.html

OCTober 3, 2017


Public health crisis for Rohingya refugees

The medical relief agency Médecins Sans Frontières (MSF) has appealed for a massive scale-up of humanitarian aid in Bangladesh to avoid a public health disaster following the arrival of hundreds of thousands of Rohingya refugees.

After a wave of targeted violence against the Rohingya, more than 422,000 people fled to Bangladesh from Rakhine State in Myanmar within three weeks. The most recent influx of Rohingya refugees has added to the hundreds of thousands of Rohingya who fled across the border during episodes of violence in previous years.

Most of the newly arrived refugees have moved into makeshift settlements without adequate access to shelter, food, clean water, or latrines. Two of the main pre-existing settlements in Kutupalong and Balukhali have effectively merged into one densely populated mega-settlement of nearly 500,000 people, making it one of the largest refugee concentrations in the world.

“These settlements are essentially rural slums that have been built on the side of the only two-lane road that runs through this part of the district,” says Kate White, MSF’s emergency medical coordinator. “There are no roads in or out of the settlement, making aid delivery very difficult. The terrain is hilly and prone to landslides, and there is a complete absence of latrines. When you walk through the settlement, you have to wade through streams of dirty water and human feces.”

Sept 25, 2017

 

 


New insights from mapping the global burden of disease

The Lancet calls the new report “the most comprehensive worldwide observational epidemiological study to date.”

This report, "Mortality by cause for 8 regions of the world: Global Burden Disease Study," is an update - 20 years later – of a revolutionary idea at the time. The two men, Chris Murray, a young Rhodes scholar at the time and Alan Lopez, a WHO epidemiologist, who engineered it started with just over 100 diseases and injuries which has grown to more than 300. In the early years, they considered 10 risk factors for ill health, such as tobacco and alcohol. Today there are 80 risk factors.

Over the years, new infections such as Ebola and Zika have come into play. And the new study shows a rise in non-infectious diseases. Diabetes was the 24th leading contributor to the global burden of disease in 1990. Here are a few more highlights from the study:

  • 1.1 billion people were living with mental health and substance abuse disorders in 2016;
  • tobacco is linked with 7.1 million deaths;
  • poor diet is associated with 1 in 5 deaths;
  • deaths from firearms and terrorism have increased globally;
  • 72 percent of deaths worldwide are caused by non-communicable diseases.

Later this month in Seattle, Bill Gates is scheduled to give the keynote address, as the Bill & Melinda Gates Foundation has been the major funder of the Global Burden of Disease Project. The new study will provide the backdrop against which the world needs to respond to disease and disease risk.

Sept 20, 2017


Old fashioned AIDS is still with us – shocking in 2017

With advances in HIV care, persons with HIV/AIDS (PWHA) can lead healthy lives, but avoidable, HIV-related deaths continue to occur in New York City. Authors, Braunstein, Robbins and others, are reporting in PubMed.

Braunstein et al. used existing laboratory and other data to construct a retrospective analysis of what happened in the intervenable period during which different treatment approaches might have prevented more than 11,000 people from dying with HIV between 2007 and 2013.  They found that a substantial proportion of people were not properly treated, as shown by the finding that 60% of people did not have a suppressed viral load in the period analysed.  This was despite the majority of patients having some engagement with the health system as shown by laboratory records. The challenge seemed to be to provide high quality care with continuity of care and decisions made promptly according to the findings.

Sept 12, 2017


Young women in South Africa and transactions around sex

A study shows young women know they have better bargaining power in sexual relationships if they have some of their own money. Findings suggest there is a nuanced relationship between sex, love and gifts: money has symbolic meaning, and money transfers, when framed as gifts, indicate commitment from the man. Young women express agency in their choice of partner, but their agency weakens once they are in a relationship characterized by exchange. This may undermine their ability to reduce HIV and STI risk.

Using five focus group discussions and 19 in-depth interviews with young women enrolled in the HPTN 068 conditional cash transfer trial (2011–2015), this qualitative study explores young women’s perceptions of transactional sex within the structural and cultural context of rural South Africa.

Evidence shows that HIV prevalence among young women in sub-Saharan Africa increases almost five-fold between ages 15 and 24, with almost a quarter of young women infected by their early-to mid-20s. Transactional sex or material exchange for sex is a relationship dynamic that has been shown to have an association with HIV infection.

sept 6, 2017