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Archive for the ‘disease eradication’ Category

By Heba Ijaz

Since Nigeria was declared endemic-free last year, Pakistan has become one of two remaining countries where polio is still an endemic viral infection.

Poliomyelitis is a highly infectious disease caused by the poliovirus that primarily affects children. The virus spreads mainly through the fecal-oral route, although transmission through oral and nasal secretions can also occur. It resides mainly in the throat and intestines, and in certain cases, can enter the bloodstream to invade the brain and spinal cord, leading to paralysis. Contaminated water and food sources along with poor personal hygiene are significant contributors to polio transmission. Two types of vaccines are available today: Oral Polio Vaccine (OPV) is a live attenuated version and Intravenous Polio Vaccine (IPV) is an inactivated version. (more…)

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By Vassilis Ragoussis

I’m sure most of you have read or at least heard about the Zika virus outbreak that has occurred. There has been an explosion of information on social media and news websites that has been alarming, and what I can say, somewhat terrifying.

This panic was certainly an exacerbation due to the reactive nature we have towards diseases.  We scramble beneath the terror of colossal headlines.

“Zika Virus ‘Spreading Explosively’ in Americas, W.H.O. Says”

“Zika virus: Up to 4 million cases predicted”

Let’s look closer at the statistics. In Brazil, there has been an increase from 150 normal cases of microcephaly, to 4,000 cases. Out of the 3 million baby births the risk comes out to a miniscule 0.0013%. Additionally, Nature found that only 270 of the Brazil cases have actually been confirmed as microcephaly, with 462 cases being false diagnoses.

Microencephaly

 

In 2014, the Ebola outbreak in West Africa had the whole world waiting for their impending doom. Government leaders, the public and news media alike demanded clarifications and denounced that not enough was being done. The same is now occurring with Zika.

How did this panic happen?

Do we not learn from previous outbreaks? Having a comprehensive plan to fight against microbial diseases by being proactive and focusing on prevention will certainly give better outcomes in the future.

Mosquito

 

Aedes aegypti is the mosquito to blame. It is currently thriving in large numbers close to human residences. With the increase in human waste and plastic containers there are ample places for rainfall to collect and create breeding areas for Aedes to lay its eggs and multiply.

Mosquitos are vectors of the disease. Controlling the vector will control the disease. In America its close cousin, Aedes albopictus, the Asian tiger mosquito spans over 30 states. For now, this species is not a major player in the transmission of Zika to humans, but what if it did? Then we could face the risk of a serious outbreak.

For me, the logical solution would be managing the vector. Reducing its habitat, removing human waste and places it could live would automatically reduce its ability to breed. Chemically or biologically we can take measures to reduce and control the mosquito population and hence the burden of disease that it can inflict.

Fortunately, the symptoms of Zika are absent to mild for the vast majority. However, there can be some devastating implications if infected. The incidence of microcephaly has increased; this is where babies experience small head growth and resultant brain damage. Zika can also lead to Guillain-Barré syndrome, an autoimmune disorder that can cause paralysis. Nevertheless, we need more data and ultimately more time to research and confirm this causation.

The Zika virus should not have been the complication to remind us how destructive mosquitos can be. The Dengue virus along with Malaria, although not directly prevalent and disastrous in America, have caused worldwide epidemics and caused millions of deaths.

We should have prepared, or even anticipated that something like this would happen.

PPE

Efforts of controlling vector transmission will significantly reduce, but not eliminate the risk of Zika. Wearing protective clothing, net beds, using EPA-registered insect repellents are measures we can take to protect ourselves from mosquitos. The next step would be to develop a vaccine. For this, we need time, and of course, more research.

Going back to the original question posed.

How did this panic happen?

New risks freak us out more than the ones we’re familiar with. As a culture we are more troubled about dangers to babies than adults. With Zika we are clouded by a sense of inadequacy. The general uncertainty we have about the nature of Zika coupled with no present vaccine, leaves us feeling powerless. As creatures, we readily adopt a fatalistic notion and place too much emphasis on the worst-case possibilities of any threat. Although in some cases this is reasonable, we also are equally cautious of excessive fear.

We should have anticipated the large increase in mosquitos that would create a major health crisis. We need to foresee that pandemics will occur, we can certainly prepare in advance to minimize the severity and the spread. Acting now and focusing on prevention needs to be our game plan.

As humans, we must be both rational and intelligent, reacting to crises with the right amount of emotion and investigation will help us remain safe in the future.

 

References:

Tavernise, Sabrina. “Zika Virus ‘Spreading Explosively’ in Americas, W.H.O. Says.” The New York Times. The New York Times, 2016. Web. 26 Feb. 2016.

 

“5 Things You Really Need to Know About Zika.” Public Health Matters Blog. Web. 26 Feb. 2016.

 

Nature.com. Nature Publishing Group. Web. 26 Feb. 2016.

 

“Zika Virus.” World Health Organization. Web. 26 Feb. 2016.

 

“Zika Virus: Three Britons Infected, Say Health Officials – BBC News.” BBC News. Web. 26 Feb. 2016.

 

 

 

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By Cassandra Sunga

In December 2015, the Philippines announced that it would be the first country to launch Sanofi Pasteur’s brand new dengue vaccine Dengvaxia. As dengue infects 200,000 Philippine citizens per year and treatment for the disease costs about 18,000 pesos per patient, this intervention has the potential to save hundreds of thousands of dollars and several lives across the equator. Although this medical feat is one that should be celebrated, one fundamental question remains on its delivery however: who will ultimately be able to obtain this vaccine in the Philippines?

According to a report made by the Philippine Statistics Authority in 2013, poor households are 18.2% less likely than non-poor households to obtain their mandatory first dose of the Hepatitis B vaccine. Furthermore, the World Health Organization (WHO) in 2011 reported that only 55.5% of households in the lowest income bracket were able to obtain a full round of mandatory, WHO EPI vaccines in comparison to 83% of households in the highest income bracket. While the cyclical nature of income disparity and health is a constant in most countries across the globe, the poor in the Philippines are especially susceptible to the consequences as there is essentially no public safety net to ensure that they receive quality health care when needed. Although current President Benigno Aquino has overseen a number of positive reforms in healthcare policy since assuming office in 2010 (e.g. the expansion of their national health insurance program Phil Health and the appropriation of birth control to the public), differential access to quality health care amongst various income groups is still a major issue.

Map.png

Even though the country’s situation seems bleak for the poor and geographically isolated, one NGO has risen above the rest to find a valid solution to the problem. Gawad Kalinga (GK), which means, “to give care” in English, aims to “end the poverty of 5 million poor families by 2024”. The organization started by building quality housing structures and communities for poor families in the early 1990’s, and has since launched about 2,000 different communities across the country. To make each community economically sustainable, GK also partners with business schools and entrepreneurs around the world to empower Philippine citizens with viable livelihoods based on their working skills and what’s naturally available in the environment around them.

In 2010, Center for Disease Control (CDC) head Dr. Thomas Frieden published an article in the American Journal of Public Health on his 5-tier intervention pyramid. The pyramid creates a framework for understanding how impactful public health interventions will be depending on what factors they target. The idea is that if you have an intervention that targets broader segments closer to the bottom of the pyramid (i.e. socioeconomic factors), you will thereby have a broader impact on society. Although simple on the surface, the idea does come with a catch; targets listed towards the bottom are often times the most difficult areas to address or change in public health. Thus, the obstacles and difficulties that ultimately lie in changing the bottom of the pyramid are what largely deter interventions from aiming to make socioeconomic factors a main target.

As Dr. Frieden elaborates within his article, previous models and current interventions often times fail to address infrastructure in health systems. However, this framework is exactly what makes GK’s model so fascinating and exciting! Rather than using interventions that are too focused on the individual or are largely non-preventative, GK is trying to solve health disparity in the country by attacking the root of the problem: income disparity. While GK will most likely be unable to provide all of the people living in its communities with the dengue vaccine, they are providing them with something that is arguably just as essential for community health: hope. By finally creating the quality, sustainable infrastructure this country has needed for the poor, GK has laid down the groundwork for improved population health in the country. They took a leap of faith and started at the bottom of Dr. Frieden’s pyramid. Now, all they simply have to do is continue climbing upwards.

Citations:

 

  1. Frieden, Thomas R. “A Framework for Public Health Action: The Health Impact Pyramid.” American Journal of Public Health 100.4 (2010): 590–595. PMC. Web. 26 Feb. 2016.
  2. “Breastfeeding, Immunization, and Child Mortality.” Philippine Statistics Authority. Philippine Statistics Authority, Oct. 2013. Web. 26 Feb. 2016.
  3. “World’s First Dengue Vaccine Now Available in PH.” CNN Philippines. CNN, 12 Feb. 2016. Web. 26 Feb. 2016.
  4. “Welcome to Gawad Kalinga.” Welcome to Gawad Kalinga. Gawad Kalinga, n.d. Web. 26 Feb. 2016.

 

Image Citation:

 

  1. In the Philippines. Digital image. Gawad Kalinga. Gawad Kalinga, n.d. Web. 26 Feb. 2016.

 

 

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By Jennifer Thompson

To some, “sleeping sickness,” may sound like the most appealing disease to acquire (if you had to have one); however, it’s nowhere near as pleasant as it sounds.  The unusual epidemic of Human African Trypanosomiasis, or “sleeping sickness” in Uganda is extremely concerning considering its devastatingly high mortality rates and relatively unavoidable route of infection.  Not to mention, the effects of it are particularly agonizing; painful brain swelling, joint pain, an uncomfortable sleeping sensation, and a “rabieslike madness.”

I find it incredibly prevailing that the British government and European Union successfully designed a campaign to impede this epidemic in Uganda.  The campaign tackled the source of infection: the tsetse fly.  Because this disease is transmitted by the “trypanosomia parasite” carried by tsetse fly, which typically feed on cattle, leaders of the program injected a majority of cattle in Uganda with antiparasitic drugs while also spraying them with insecticide.  This action has me curious if there are any negative or harmful effects then put on the cattle and other farm-life nearby.  It also has me wondering if spraying and injecting domestic animals has led to any economic implications involving the loss of cattle or farmland, considering farming is one of the major means of business in that geographic area.

The triumph of the campaign was proven when it had been reported that the program cut cattle and human infections by 75 percent; no longer causing 100 deaths a day.  Sleeping sickness isn’t the only one; there are thousands of devastating diseases similar existing all over the world.  The global response to “sleeping sickness” in Uganda is one instance where it is proven that the power to end and reduce the burden of such deadly disease does exist when powerful and resourceful forces join together.

Diseases with symptoms similar to Human African Trypanosomiasis may not seem out of the ordinary to those living in Uganda and in other sub-Saharan African countries, but to me, the route of infection and symptoms appear far more unusual than diseases typically seen in the United States.  Here, it isn’t common for people to become infected with parasites from cattle transmitted via cattle and flies.

This particular epidemic of “sleeping sickness” in Uganda reminds me of the class session a few weeks ago where a group educated the class about “nodding disease,” also seen in Uganda and South Sudan.  “Nodding disease” not only has a similar name to “sleeping sickness,” but similar symptoms due to infection likewise from a parasite.

 

Below is a video from the Doctors Without Borders website regarding sleeping sickness in Sudan.  Researchers and doctors set out on a mission to study specific parasite reservoirs to determine what sleeping sickness programs need to focus on.  According to researchers, “sustained elimination of sleeping sickness is feasible” with appropriate diagnosis and treatment tools.

 

http://www.doctorswithoutborders.org/issue/sleeping-sickness

 

 

 

 

References

  1. Mcneil, Donald G. “New Treatment Slows an Epidemic of Sleeping Sickness.” The New York Times. The New York Times, 09 Nov. 2015. Web. 23 Feb. 2016.
  2. “Sleeping Sickness.” MSF USA. Doctors Without Borders, 17 Dec. 2013. Web. 23 Feb. 2016.

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-By Sarah Esselborn

The consequences of the devastating earthquake in Haiti on January 12, 2010 are still felt today. Specifically, the cholera outbreak brought by U.N. Peacekeepers from Nepal in October of 2010 has had serious effects on the people in Haiti (NBC News 2014). As of March of 2013, more than 650,000 cases had been identified and 7,441 deaths (Grandesso 2014). By contrast, in the United States, the average number of cholera cases per year is 6 (and these are non-fatal). I have spent time in Haiti, my last visit returning the day before this devastating earthquake. These Haitian people getting cholera and dying are people I deeply care for. I want to bring hope to this seemingly devastating situation. (more…)

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-By Samantha Venkatesh

When I traveled to India for the first time in 2005, the last thing I expected to do before my summer vacation was take medication. I distinctly recall my mom handing me a pill box and instructing me to take the medicine daily starting a few days before we left, through the month-long trip, and for a week after we returned. As a ten year old, this seemed overly complicated and unnecessary. In retrospect, I am relieved that my mom remembered this seemingly annoying task, especially considering that my entire body was covered in mosquito bites after the trip. She was able to prevent me from getting malaria, one of the most severe tropical illnesses in the world.

Malaria is a mosquito-borne illness that is caused by species of the parasite Plasmodium and is spread by the bites of the mosquito species Anopheles1. Since 2000, the World Health Organization has been actively attempting to reduce the incidence of malaria worldwide by seventy-five percent as one of its Millennium Development Goals (MDGs)1. To some extent, the WHO has succeeded; estimated malaria mortality decreased by forty-five percent overall in the last decade alone2. But the disease still impacts almost half of the world; more than three billion people are at risk of contracting malaria, and in 2010, there were an estimated 207 million cases globally3. (more…)

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– By Rohit Maruthi

You feel very sick and go to your doctor where you learn that you have a bacterial infection that can typically be treated with antibiotics. Great, problem solved, right? Maybe not… In recent years, there has been a rise in the strains of antibiotic resistant bacteria (ARB) such as methicillin-resistant staphylococcus aureus (MRSA), rendering even the most powerful of our antibiotics ineffective.1 What are the reasons behind this calamity?

The major contributor to ARB has been the excessive use of antibiotics in various aspects of society. For example, “We stuff them into ourselves and our animals; we spray them on crops, [and] dump them in rivers.”1 This is a serious issue due to the high reproduction rate of most bacteria (i.e. some strains reproduce asexually within twenty minutes). Therefore, by natural selection, various strains of bacteria will obtain this resistance, rendering antibiotics – our defense against diseases – futile. The overuse of antibiotics has resulted in some frightening statistics: 70% of bacteria in the world is resistant to at least one antibiotic.1 Furthermore, reports from the Center for Disease Control indicate that at least 2 million Americans become sick and 23,000 die each year as a result of ARB.2

(more…)

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