News Article | May 19, 2017
A new study led by Colorado State University researchers found that Aedes aegypti, the primary mosquito that carries Zika virus, might also transmit chikungunya and dengue viruses with one bite. The findings shed new light on what's known as a coinfection, which scientists said is not yet fully understood and may be fairly common in areas experiencing outbreaks. "A mosquito, in theory, could give you multiple viruses at once," said Claudia Ruckert, post-doctoral researcher in CSU's Arthropod-borne and Infectious Diseases Laboratory. Ruckert presented initial findings from the study last fall at the annual meeting of the American Society of Tropical Medicine & Hygiene in Atlanta, Georgia. The research team's paper was published May 19 in Nature Communications. The CSU team infected mosquitoes in the lab with multiple kinds of viruses to learn more about the transmission of more than one infection from a single mosquito bite. While they described the lab results as surprising, researchers said there's no reason to believe that these coinfections are more severe than being infected with one virus at a time. Existing research on coinfections is sparse, and the findings are contradictory. Chikungunya, dengue and Zika viruses are transmitted to humans by Aedes aegypti mosquitoes, which live in tropical, subtropical, and in some temperate climates. As the viruses continue to emerge into new regions, the likelihood of coinfection by multiple viruses may be increasing. At the same time, the frequency of coinfection and its clinical and epidemiologic implications are poorly understood. The first report of chikungunya and dengue virus coinfection occurred in 1967, according to the study. More recently, coinfections of Zika and dengue viruses, Zika and chikungunya, and all three viruses have been reported during various outbreaks, including the recent outbreak of Zika virus in North and South America. Ruckert said the research team found that mosquitoes in the lab can transmit all three viruses simultaneously, although this is likely to be extremely rare in nature. "Dual infections in humans, however, are fairly common, or more common than we would have thought," she said. CSU researchers had expected to find that one virus would prove to be dominant and outcompete the others in the midgut of the mosquito where the infections establish and replicate before being transmitted to humans. "It's interesting that all three replicate in a really small area in the mosquito's body," Ruckert said. "When these mosquitoes get infected with two or three different viruses, there's almost no effect that the viruses have on each other in the same mosquito." Greg Ebel, director of the Arthropod-borne and Infectious Diseases Laboratory and co-author of the study, said the results were surprising. "Based on what I know as a virologist, epidemiologist and entomologist, I thought that the viruses would either compete or enhance each other in some way," he said. "On the one hand, all of these viruses have mechanisms to suppress mosquito immunity, which could lead to synergy. On the other hand, they all likely require similar resources within infected cells, which could lead to competition. We didn't see much evidence of either one of these things in mosquitoes that were infected in the lab by multiple viruses." Zika virus typically results in symptoms similar to the flu and may be accompanied by a skin rash. Last year, however, concerns about the virus skyrocketed following the link between Zika virus infection with microcephaly in Brazil. Microcephaly is when a baby is born with a small head and incomplete brain development. Concerns about Zika virus were also heightened following news that the virus could be transmitted sexually in addition to being spread by mosquitoes. Brian Foy, CSU associate professor in the Arthropod-borne and Infectious Diseases Laboratory, made that connection in 2008. Dengue and chikungunya virus symptoms are similar to an infection with Zika virus, and can also include joint and bone pain, nose or gum bleeding and bruising. What is the threat for people diagnosed with a coinfection? "There's no strong evidence that coinfection of humans results in infections that are clinically more severe," Ruckert said. But findings are contradictory. A team in Nicaragua looked at a large number of coinfection cases in one study, but saw no changes in hospitalization or clinical care. But other studies found a possible link between neurological complications and coinfection. "There might be some indications, but it is still fairly unknown what the effect is from coinfection," said Ruckert. It is also likely that coinfections in humans are significantly underdiagnosed. "Depending on what diagnostics are used, and depending on what the clinicians think, they might not notice there's another virus," Ruckert said. "It could definitely lead to misinterpretation of disease severity." Ruckert and the team in the Ebel Lab are now taking a closer look at what happens when mosquitoes are infected with multiple viruses. They'll explore how a coinfection affects the evolution of viruses within the mosquito. "We will study how these virus-mosquito interactions change when there are two viruses, what gets transmitted from a coinfected mosquito, and how that differs from a mosquito infected with one virus," Ruckert said. The team is also interested in learning more about where the viruses replicate in mosquitoes, and by potentially examining yellow fever, a fourth virus that is carried by Aedes aegypti, as a possibility for coinfection with chikungunya, dengue or Zika viruses. Yellow fever virus is found in tropical and subtropical areas in South America and Africa. The Brazilian Ministry of Health reported an ongoing outbreak in December 2016. It is a very rare cause of illness in U.S. travelers, according to the Centers for Disease Control and Prevention. But between 20 percent and 50 percent of people who develop severe illness related to yellow fever virus may die. "A large urban outbreak of yellow fever virus in a tropical megacity is a terrifying prospect," said Ebel.
News Article | May 16, 2017
Undiagnosed Ebola virus infection was probably very rare in international workers who were deployed during the 2013-2015 outbreak of the virus in West Africa, despite mild and asymptomatic cases of Ebola being known to occur, according to new research published in the journal PLOS Medicine. As part of the study, more than 250 UK and Ireland healthcare and other workers were tested for Ebola virus antibodies after returning from West Africa -- no evidence of missed infections was found. This suggests that the vast majority of volunteers were kept safe by Personal Protective Equipment (PPE) and the Ebola treatment centre procedures in place. However, the study also found that potentially avoidable events putting frontline workers at risk of infection were quite common during the outbreak, with one in six participants classified as having 'near miss' exposure events. In what is believed to be the first study of the prevalence of Ebola infection in international responders the research team, led by the London School of Hygiene & Tropical Medicine and funded by the Wellcome Trust, enrolled 300 UK and Ireland healthcare and other frontline workers¹ for the study and sent them oral fluid collection devices. Among the 268 respondents who returned their samples, 99% showed negative results on an antibody test which the authors had already proved gave very accurate results in Sierra Leone2. The remaining two people, who had no known exposure or symptoms, had positive results, but follow-up testing using different methods was negative, making Ebola virus infection very unlikely.The research team, led by the London School of Hygiene & Tropical Medicine and funded by the Wellcome Trust, enrolled 300 UK and Ireland healthcare and other frontline workers¹ for the study and sent them oral fluid collection devices. Among the 268 respondents who returned their samples, 99% showed negative results on an antibody test which the authors had already proved gave very accurate results in Sierra Leone2. The remaining two people, who had no known exposure or symptoms, had positive results, but follow-up testing using different methods was negative, making Ebola virus infection very unlikely. Lead author Dr Catherine Houlihan from the London School of Hygiene & Tropical Medicine and UCL said: "The 2013-2015 Ebola outbreak was unprecedented - the commitment and bravery of those who volunteered saved many lives. We know a small number of international health workers were infected with the virus but we thought it was possible that some infections had been missed, as we know asymptomatic or unrecognised infections can occur. However, our research suggests undetected infection in this group is, at most, a very rare event, and that the Personal Protective Equipment did its job well." Participants, who included clinicians, laboratory workers and epidemiologists, also completed an online survey which asked if they experienced possible exposure to Ebola virus while in West Africa. Using 268 respondents' descriptions, 16% (43 people) were identified as having 'near miss' exposure events. 27 respondents reported experiencing very low-risk incidents³ such as having a facemask dislodged. Ten were identified as having low-risk exposure events which were classified as having direct physical contact with an Ebola patient who does not have vomiting, diarrhoea, or bleeding. Five faced an intermediate risk incident with one respondent reporting 'being vomited on while wearing just gloves' and not full PPE, and one experienced the high-risk incident of a 'sharp injury with a broken vial of medication inside the 'red zone' with dirty and contaminated gloves'. The antibody tests showed that none of these individuals had any evidence of infection with Ebola. Participants reported PPE suits torn by catching on doorways or corners, PPE breaches in Ebola laboratories, such as torn outer gloves, as well as the additional anxiety and distress these incidents caused them. Dr Catherine Houlihan said: "The scale of the outbreak meant frontline workers faced demanding and draining circumstances. Participants have given crucial insights which provide valuable lessons for future Ebola outbreaks. Regular debriefing after work in the clinical red zone or laboratory, and blame-free reporting of near misses, should be part of routine practice in emergency treatment response work. Simple changes such as banning glass vials in the red zone could reduce the number of staff experiencing skin lacerations, and further testing of the robustness and fit of PPE suits, could potentially save health workers' lives in the future." Participants, who were based mostly in Sierra Leone, were also asked whether they experienced fever or diarrhoea while in West Africa or within one month of their return, and if so whether they were tested for Ebola virus at the time. Despite symptoms in 21% (57/268) of the respondents, 70% were not tested, with those still in West Africa much less likely to receive a test -- 11 out of 17 who fell ill on their return were tested, but just one person out of 21 who fell ill in West Africa was tested. Dr Houlihan said: "This study provides reassuring evidence about the lack of Ebola infection in individuals who had not previously been tested for the virus. However, the high proportion of health workers who didn't get tested when falling ill in West Africa, coupled with returnees' potential exposure to Ebola, are a concern. Although we don't know how many health workers reported being ill and were assessed to decide if they needed to be tested, protocols for the management of possible exposure to the virus, and for the management of illness, may need reviewing and to be standardised across organisations that deploy staff to outbreaks. "Importantly, these protocols must be applicable to national as well as international staff. West African responders worked in large numbers from the early stages of the epidemic right through to its conclusion, and were undoubtedly at the highest risk. We must also ensure that every individual who works in these high-risk settings receives strong support and is thoroughly trained ahead of starting work, including on the use of PPE, how to reduce risk in and out of the red zone, and what to do if they think they have been exposed or if they become unwell." The authors acknowledge limitations of the study including that not all returning responders were included and participants were not a random sample. It is therefore possible that those who knew of possible exposures, or who had had symptoms, were particularly keen to participate. Since these were the people who were most likely to have been infected, the absence of undiagnosed infections is reassuring. Catherine F. Houlihan, Catherine R. McGowan, Steve Dicks, Marc Baguelin, David A. J. Moore, David Mabey, Chrissy h. Roberts, Alex Kumar, Dhan Samuel, Richard Tedder, Judith R. Glynn. Ebola exposure, illness experience, and Ebola antibody prevalence in international responders to the West African Ebola epidemic 2014-2016: A cross-sectional study. PLOS Medicine. DOI:10.1371/journal.pmed.100 1Invitations to participate in the study were sent to individuals known to the authors and through organisations supporting emergency medical team deployment involving UK-based staff, including NGOs, UK government-affiliated institutions, and the London School of Hygiene & Tropical Medicine ²Glynn et al. Asymptomatic infection and unrecognised Ebola virus disease in Ebola-affected households in Sierra Leone: a cross-sectional study using a new non-invasive assay for antibodies to Ebola virus. Lancet Infect Diseases.DOI:10.1016/S1473-3099(17)30111 ³Based on respondents' free-text descriptions and using a published risk assessment method, the risk of infection in individuals was categorised as: About the London School of Hygiene & Tropical Medicine The London School of Hygiene & Tropical Medicine is a world-leading centre for research and postgraduate education in public and global health, with more than 4,000 students and 1,000 staff working in over 100 countries. The School is one of the highest-rated research institutions in the UK, and among the world's leading schools in public and global health. Our mission is to improve health and health equity in the UK and worldwide; working in partnership to achieve excellence in public and global health research, education and translation of knowledge into policy and practice.http://www.
News Article | May 24, 2017
The Democratic Republic of the Congo has moved a step closer to using an unlicensed vaccine to battle an Ebola outbreak that began last month in a remote northeastern part of the country. Yesterday, the country's government submitted a formal vaccine trial protocol, developed with Epicentre, the Paris-based research arm of Doctors Without Borders (MSF), to an ethical review board. If the plan gets the green light, the first doses of the vaccine could go into the arms of people at risk within 2 weeks, according to an official at the World Health Organization (WHO) in Geneva, Switzerland. WHO today issued a “donor alert,” urgently requesting a 6-month budget of $10.5 million to support the vaccine study (which may require 5000 doses), as well as surveillance, treatment, and conventional prevention and control efforts. But whether the shots will actually be needed is unclear. So far, there have been only two confirmed Ebola cases and 41 suspected or probable cases. More than 350 contacts of cases were being monitored. But samples from several dozen suspected cases tested negative on Monday, raising the possibility that the outbreak may be quite small, and perhaps already nearing the end. The outbreak is in the northeastern Bas-Uélé province, about 500 kilometers north of Kisangani, a city of 1.6 million people. The location slows spread but poses huge challenges. Poor and conflict-ridden, the area has few passable roads and bridges. Helicopters carry teams and equipment to the town of Likati, where motorbikes take over. Workers set up two mobile labs, but a generator failed in one and had to be replaced. The vaccine, made by Merck and stored in the United States, was tested in 2015, during the massive outbreak in West Africa that left more than 11,000 dead. WHO and MSF set up a trial in Guinea with an unusual “ring vaccination” design that selectively gave shots to people most likely to have had contact with a known case. People in a control group, also potentially exposed, received shots 3 weeks later. The results showed 100% protection 10 days after immunization, but the unconventional approach led Merck to put off applying for regulatory approval so it could gather more safety and immune data from other studies. For the moment, the vaccine can only be used in experimental settings. Epicentre and the DRC’s Ministry of Health (MoH) have written a protocol for a new ring vaccination study in the DRC. The trial would carefully evaluate safety, but this time there will be no control group because withholding the vaccine from some participants is no longer seen as ethical. As a result, the trial cannot evaluate the vaccine’s efficacy. “We’ll try to bring more data in to help with licensing, but we’re using the vaccine as a public health intervention,” says MSF’s Micaela Serafini in Geneva, Switzerland. If approved, the protocol could also be used in any future outbreaks. The MoH did not respond to emailed questions about why it didn’t request the vaccine sooner. One reason, says Epicentre Director of Research Rebecca Grais, is that the outbreak’s extent remains so unclear. “It’s not like they were dragging their feet,” she says. DRC officials may also feel confident they can stop the outbreak without vaccines, as they have seven times in the past, says Peter Piot, who heads the London School of Hygiene & Tropical Medicine and was part of the team that responded to the first known Ebola outbreak, near Likati, in 1976. “We should really leave some of the decision-making to people on the ground,” Piot says. But Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota in Minneapolis, says authorities should have been prepared to deploy the vaccine more quickly. Every African country at risk of Ebola by now should have approved a study protocol, he says, and the DRC should keep the vaccine ready in a freezer in Kinshasa. Under a WHO emergency-use status, the vaccine could also have been deployed without trials, Osterholm notes. A Merck application for that status filed in December 2015 is in limbo; a WHO spokesperson says “there was not necessarily sufficient data to enable a full assessment.” Even without the vaccine, Ebola experts don’t expect the outbreak to explode as it did in West Africa. “My gut feeling,” says Piot, “is this is going to be more like the outbreaks we had before in DRC,” the largest of which had 318 cases. “Proper isolation of patients and care plus contact tracing and quarantine should really bring this epidemic under control—except if someone gets to Kisangani or Kinshasa.” There's another reason to be optimistic: The international response to the outbreak so far has been overwhelming. Acutely aware of its failings in Liberia, Guinea, and Sierra Leone in 2014 and 2015, the international community is determined to help end the outbreak as soon as possible. Matshidiso Rebecca Moeti, WHO's regional director for Africa, immediately traveled to Kinshasa from her office in Brazzaville, in the neighboring Republic of the Congo, to help coordinate the battle. The United Nations dispatched cargo planes and helicopters, and DRC government officials began holding daily coordinating committee meetings attended by representatives from international aid, and development organizations, WHO, and the U.S. Centers for Disease Control and Prevention. “All those actors have strengthened their presence because of what happened in West Africa,” says epidemiologist Yap Boum, Epicentre’s Africa representative. “People are afraid.”
News Article | February 22, 2017
EVANSTON, Ill. --- Though an estimated two billion people drink unsafe water around the globe, there are currently no methods to precisely measure how many people are affected by not having enough water for all aspects of their daily lives. This lack of measurement makes it difficult to pinpoint effective interventions to improve water insecurity and water-related illnesses. To better measure water insecurity, researchers need to assess whether people have reliable access to water in sufficient quality and quantity for all activities. Under a new £250,000 (approximately $310,000) grant from the U.K.-funded Innovative Metrics and Methods for Agriculture and Nutrition Actions (IMMANA) research initiative, Northwestern University anthropologist Sera Young, a fellow in the University's Institute for Policy Research, and an international team of researchers seek to develop a cross-cultural scale of perceived household water insecurity. IMMANA is supported by UK Aid from the British government's Department for International Development. "We are so excited to be working towards the creation of a scale that can finally measure how water insecurity affects people at the household level -- that is, the food people grow, their economic well-being, and, of course, their health," Young said. Additional investigators include Wendy Jepson, a human geographer at Texas A&M University; Amber Wutich, an anthropologist at Arizona State University's (ASU) School of Human Evolution and Social Change; Phelgona Otieno, a pediatrician at Kenya Medical Research Institute; Sheri Weiser and Craig Cohen, physician researchers at the University of California San Francisco; and Lisa Butler, an epidemiologist at the University of Connecticut. The grant is administered by the London School of Hygiene & Tropical Medicine. Young and her co-investigators posit household water insecurity leads to poorer mental and physical health and lower economic productivity, but in ways distinct from food insecurity -- including increased anxiety, stress, and time/energy expenditure, as well as decreased agricultural production. Though water insecurity likely contributes to adverse consequences for all household members, it often disproportionately affects women, as they bear the burden of water collection and water -- intensive chores in developing countries. For instance, because women in water-insecure communities often need to walk long distances to collect water, they might not have time to care for their children. Preliminary data have shown that many women worry about their physical safety while fetching water, and that anxiety about how they will obtain all the water needed for their daily activities is common. Infectious diseases are another possible effect of water insecurity. In Young's work in Kenya, about 31 percent of women reported being unable to wash their hands after contact with feces, and one-third said they drank unsafe water "sometimes" or "often." The researchers will refine the household water-insecurity scale, using cross-cultural research conducted in at least six countries. ASU faculty and students will lead projects in Bangladesh, Guatemala, Nepal, and Tajikistan, and Texas A&M University faculty and students will do the same in Brazil and Costa Rica. After completing the first round of data collection research, the experts will meet in August at Northwestern University to work on refining an open-access manual that will describe the scale and methods. "This scale will be an important first step in pinpointing how water insecurity impacts some of the most vulnerable populations, including pregnant women, mothers with young children and HIV-infected adults," Young said. The research team hopes this will result in a better understanding of household water insecurity and point to new strategies for intervention. They also aim to help direct limited resources to targeting the causes of water insecurity and the people at greatest risk of adverse effects --especially women and their young children.
News Article | February 21, 2017
Modern houses -- with metal roofs and finished walls--are associated with a more than 9 percent reduction in the odds of malaria in children in sub-Saharan Africa when compared to more traditional thatched houses, according to a study published in PLOS Medicine by Lucy Tusting of the University of Oxford, UK, and colleagues at the London School of Hygiene & Tropical Medicine, UK, Durham University, UK, and the University of Southampton, UK. Insecticide-treated bednets and house spraying have been effective in reducing the prevalence of malaria since the turn of the 21st century, but other approaches are needed for sustainable elimination of the mosquito-transmitted, parasitic disease. Some evidence has suggested that modern houses may protect against the parasite but few studies have rigorously evaluated the association between improved housing and malaria risk. In the new work, researchers analyzed data on malaria prevalence and housing using data collected in 29 surveys carried out in 21 African countries between 2008 and 2015. Information on malaria status -- as tested using a blood smear or rapid test -- was available for 139,318 children under age 5 living in 84,153 households. The proportion of children with malaria detectable in their blood varied by survey, ranging from 0.4% to 45.5% among children living in modern houses and from 0.4% to 70.6% among children living in traditional homes. Across all surveys, modern housing was associated with a 9% to 14% reduction in the odds of malaria infection, after controlling for household wealth and use of insecticides. By comparison, children sleeping under insecticide-treated bednets had a 15% to 16% reduction in odds of testing positive for the disease. Lead author Lucy Tusting from the University of Oxford, said: "Good housing is a core pillar of public health, but is not used widely for malaria control. Well-built housing can block mosquitoes from entering homes and prevent them from transmitting malaria to the people who live there. "This is the first study to compare housing and insecticide-treated nets for malaria control across a range of countries in sub-Saharan Africa. Our study suggests good housing could be an important tool in tackling malaria. This is a welcome finding at a time when we are facing increasing resistance to our most effective insecticides and drugs. We now need to assess the impact of housing improvements on malaria in field trials and to work with architects and urban planners to incorporate protective designs into housing in regions at risk of malaria." The authors note that the effectiveness of improving housing will vary depending on the location. While many mosquitoes enter homes to bite humans at night, outdoor malaria transmission is more common in some places, meaning interventions centered on the home will have less impact. LST is a Skills Development Fellow (#N011570) jointly funded by the UK Medical Research Council and the UK Department for International Development under the MRC/DFID Concordat agreement. PWG is a Career Development Fellow (#K00669X) jointly funded by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement, also part of the EDCTP2 programme supported by the European Union, and receives support from the Bill and Melinda Gates Foundation (#OPP1068048, #OPP1106023, #OPP1132415). AJT is supported by funding from NIH/NIAID (U19AI089674) , the Bill & Melinda Gates Foundation (OPP1106427, 1032350, OPP1134076, OPP1094793) , the Wellcome Trust (106866/Z/15/Z) and the Clinton Health Access Initiative . SWL is supported by the Global Health Trials funded by the MRC-DfID-Wellcome Trust, and The Bill & Melinda Gates Foundation (OPP1053338). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors have declared that no competing interests exist. Tusting LS, Bottomley C, Gibson H, Kleinschmidt I, Tatem AJ, Lindsay SW, et al. (2017) Housing Improvements and Malaria Risk in Sub-Saharan Africa: A Multi-Country Analysis of Survey Data. PLoS Med 14(2): e1002234. doi:10.1371/journal.pmed.1002234 Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom School of Health Sciences, University of Witwatersrand, Johannesburg, South Africa WorldPop, Department of Geography and Environment, University of Southampton, Southampton, United Kingdom Flowminder Foundation, Stockholm, Sweden, 7 Department of Biosciences, Durham University, Durham, United Kingdom IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER: http://journals.
News Article | February 17, 2017
University of British Columbia microbiologists have found a yeast in the gut of new babies in Ecuador that appears to be a strong predictor that they will develop asthma in childhood. The new research furthers our understanding of the role microscopic organisms play in our overall health. "Children with this type of yeast called Pichia were much more at risk of asthma," said Brett Finlay, a microbiologist at UBC. "This is the first time anyone has shown any kind of association between yeast and asthma." In previous research, Finlay and his colleagues identified four gut bacteria in Canadian children that, if present in the first 100 days of life, seem to prevent asthma. In a followup to this study, Finlay and his colleagues repeated the experiment using fecal samples and health information from 100 children in a rural village in Ecuador. Canada and Ecuador both have high rates of asthma with about 10 per cent of the population suffering from the disease. They found that while gut bacteria play a role in preventing asthma in Ecuador, it was the presence of a microscopic fungus or yeast known as Pichia that was more strongly linked to asthma. Instead of helping to prevent asthma, however, the presence of Pichia in those early days puts children at risk. Finlay also suggests there could be a link between the risk of asthma and the cleanliness of the environment for Ecuadorian children. As part of the study, the researchers noted whether children had access to clean water. "Those that had access to good, clean water had much higher asthma rates and we think it is because they were deprived of the beneficial microbes," said Finlay. "That was a surprise because we tend to think that clean is good but we realize that we actually need some dirt in the world to help protect you." Now Finlay's colleagues will re-examine the Canadian samples and look for the presence of yeast in the gut of infants. This technology was not available to the researchers when they conducted their initial study. This research was a collaboration with Marie-Claire Arrieta, a former UBC postdoctoral fellow and now an assistant professor at the University of Calgary, and Philip Cooper, a professor at the Liverpool School of Tropical Medicine. This research was presented today at the 2017 annual meeting for Association for the Advancement of Science: https:/ . Finlay is in Boston for the conference and is also available by phone.
News Article | February 28, 2017
MANILA, Philippines, Feb. 28, 2017 /PRNewswire/ -- Over the past year, many countries in Asia have witnessed an alarming rise in the number of dengue cases that account for more than 70% of the global dengue cases. This translates to an overwhelming 273 million dengue infections per year out of the projected 390 million cases both reported and unreported worldwide. In light of the rapidly increasing burden, leading infectious disease experts from around the world together with government officials, policymakers and public health authorities will convene at the Asia Dengue Summit to identify strategies that can effectively support Asian countries in their fight against dengue. The two-day Summit, which will start in Manila on March 1, is organized by the Asian Dengue Vaccination Advocacy (ADVA), a scientific working group, in partnership with the South East Asian Ministers of Education Tropical Medicine and Public Health Network (SEAMEO TROPMED). Experts at the summit will discuss the concrete steps needed to address the worrying rise in dengue cases as well as new developments in the area of prevention and control. The outcome at the Summit will help in formulating a roadmap for countries in Asia to implement collaborative and cost-effective strategies for dengue prevention and vector control measures. Speaking at the sidelines of the Summit, Prof Usa Thisyakorn, Professor of Pediatrics at Chulalongkorn University and Chairman of ADVA, said, "The success of the inaugural Asia Dengue Summit (ADS) last year shows that countries acknowledge the need to join forces to tackle the situation in Asia. A collaborative approach which encourages the sharing of research findings, epidemiological trends, disease surveillance methods and vaccine implementation strategies will allow countries to harmonise their existing dengue prevention and control efforts. In the war against dengue countries should fight together, not alone." "At the Summit this year, we aim to build on the on-going efforts of countries, strengthen the implementation of vector control, as well as prevention measures such as the use of the dengue vaccine that can ultimately benefit the local population," Prof Thisyakorn further added. ONE OF THE MOST PRESSING HEALTHCARE ISSUES OF OUR TIMES Dengue continues to be one of the most devastating and prevalent mosquito-borne viral diseases on the planet. In the last 50 years, this deadly disease has spread from a handful of countries to over 128 countries and the incidence has increased 30-fold in this time. The severe burden comes at a great cost -- financially and in the number of lives lost. Worldwide, dengue is estimated to cost about $9 billion annually, and in Southeast Asia, the economic toll for dengue was estimated at almost $1 billion on average per year from 2001 to 2010. External factors such as unprecedented urbanization and globalisation have resulted in large mosquito populations living in association with crowded human populations, leading in increased transmission and geographic spread of the viruses, making it difficult to combat dengue outbreaks. In addition, environmental factors including inadequate housing, water, sewage and waste management systems have contributed to an increase in the Aedes Aegypti mosquito populations. This calls for urgent intervention and collaboration between countries towards detection, management and control to stem the spread of dengue across the region. Prof Duane Gubler, Emeritus Professor, Duke-NUS Medical School, Singapore, and Chair of Global Dengue and Aedes-Transmitted Diseases Consortium, said, "The Summit represents a major turning point in Asia's fight against dengue as more countries unite to strengthen and sustain cross-border efforts. Dengue is a disease that must be controlled at the regional level. Countries should continue this momentum at the grassroots via public education and at the national level through vector control and vaccination." "The recently released WHO position paper on dengue vaccine supports the use of vaccination to help prevent dengue as part of a comprehensive dengue control strategy in each endemic country, especially in areas where there is a high burden of disease," Prof Gubler further said. The dengue vaccine could serve as a new line of defense to complement vector control and other prevention efforts by governments, families and individuals, having a greater impact on the disease burden, keeping dengue under control. WHO has laid out the goal of the global strategy to reduce the dengue mortality by 50% and morbidity by 25% by 2020 in endemic countries. Philippines was the first country in Asia to approve the use of the dengue vaccine in December 2015. Since then four other Asian countries, Indonesia, Singapore, Thailand and Cambodia, have approved the vaccine for use for the age group of 9-45 year olds broadly. Advocating an information-sharing approach to effectively control the disease from reaching epidemic proportions, Prof Lulu Bravo, Professor of Pediatric Infectious and Tropical Diseases, University of the Philippines Manila, said, "Philippines has been a front-runner in dengue prevention and became the first country in the world to launch a public immunisation programme. At the Summit, we will share our first-hand experience over the last one year, which shows that vaccine introduction should be part of a comprehensive dengue control strategy, including well-executed and sustained vector control, evidence-based best practices for clinical care and strong dengue surveillance." The Summit will serve as a platform for the sharing of best practices and knowledge exchange among countries. New models for ongoing dengue efforts such as the recent Wolbachia study conducted in Singapore, which showed that male Wolbachia-carrying Aedes aegypti mosquitoes could help in suppressing the population of urban Aedes aegypti mosquitoes, and other initiatives including community engagement and outreach programmes. The Asian Dengue Vaccine Advocacy (ADVA) Group is a scientific working group dedicated to dengue vaccine advocacy in Asia, with the aim of disseminating information and making recommendations on dengue vaccine introduction strategies in Asia. ADVA was set up in 2011 to identify opportunities and make practical recommendations for improving surveillance and laboratory capacity for dengue disease confirmation. For more information, you may visit ADVA's website here.
News Article | January 8, 2017
Anemia is generally perceived as a negative condition. New research, however, suggests that the same health condition, which could be accountable for severe long-term consequences, actually protects children against malaria. The research also points out that addressing the iron deficiency with supplements could also diminish or even completely neutralize its effects against the deadly virus. Iron deficiency is the most common condition caused by nutritional problems worldwide, and about 9.6 percent of the American population suffers from it. However, according to a new research, published in the journal EBioMedicine, the condition has proven to be beneficial against Malaria. The observational study indicates that iron supplementation increases the risk of malaria, although the underlying mechanism of this process is still unknown. "We investigated how anemia inhibits blood stage malaria infection and how iron supplementation abrogates this protection.[...] Iron supplementation completely reversed the observed protection and hence should be accompanied by malaria prophylaxis. Lower hemoglobin levels typically seen in populations of African descent may reflect past genetic selection by malaria," noted the study. The researchers from University of North Carolina, in collaboration with the Medical Research Council Unit in The Gambia and the London School of Hygiene & Tropical Medicine, have investigated the red blood cells of 135 subjects between the ages of 6 months and 24 months in an area where the virus is highly active. The subjects were administered with micronutrient powder to combat the iron deficiency for 84 days, at the end of which they discovered that anemia reduced the blood-stage of malaria by 16 percent. This discovery implies that anemia represents a very powerful natural protector against malaria. Additionally, one of the hypotheses of the research is that the high prevalence of anemia within people from the African desert area is of genetic nature, while also being a signature of malaria. When anemic children were administered iron supplements for seven weeks, the progress of malaria retook its course, and its invasion at the blood level was reversed. Before conducting this research, the same team found that the reason why children seem to be so affected by the virus lies in their young red blood cells, which represent a perfect host for malaria. "This study is elegant in its simplicity, yet remains one of the most substantial and systematic attempts to unveil the cellular-level relationship between anemia, iron supplementation and malaria risk," noted Carla Cerami, M.D. Ph.D., lead scientist on the project at the MRC Unit in The Gambia. According to a WHO report released in 2016, there were 212 million reported cases of malaria in 2015 across the world, and the global incidence between 2010 and 2015 dropped by 21 percent. Additionally, due to the organized efforts to diminish the number of cases, the mortality among patients infected with the disease decreased by 29 percent within the same period. "Nevertheless, significant gaps in program coverage remain. Access to vector control has been greatly extended through mass-distribution campaigns; however, increasing the coverage of chemoprevention, diagnostic testing and treatment requires these interventions to be delivered through health systems that are frequently under-resourced and poorly accessible to those most at risk of malaria. Moreover, the potential for strengthening health systems in malaria endemic countries is often constrained by low national incomes and per capita domestic spending on health and malaria control," noted the report. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.
News Article | February 17, 2017
Researchers exploring why there has been a substantial increase in mortality in England and Wales in 2015 conclude that failures in the health and social care system linked to disinvestment are likely to be the main cause. There were 30,000 excess deaths in 2015, representing the largest increase in deaths in the post-war period. The excess deaths, which included a large spike in January that year, were largely in the older population who are most dependent on health and social care. Reporting their analysis in the Journal of the Royal Society of Medicine, the researchers from the London School of Hygiene & Tropical Medicine, University of Oxford and Blackburn with Darwen Borough Council, tested four possible explanations for the January 2015 spike in mortality. After ruling out data errors, cold weather and flu as main causes for the spike, the researchers found that NHS performance data revealed clear evidence of health system failures. Almost all targets were missed including ambulance call-out times and A&E waiting times, despite unexceptional A&E attendances compared to the same month in previous years. Staff absence rates rose and more posts remained empty as staff had not been appointed. Professor Martin McKee, from the London School of Hygiene & Tropical Medicine, said: "The impact of cuts resulting from the imposition of austerity on the NHS has been profound. Expenditure has failed to keep pace with demand and the situation has been exacerbated by dramatic reductions in the welfare budget of £16.7 billion and in social care spending." He added: "With an aging population, the NHS is ever more dependent on a well-functioning social care system. Yet social care has also faced severe cuts, with a 17% decrease in spending for older people since 2009, while the number of people aged 85 years and over has increased by 9%." "To maintain current levels of social care would require an extra £1.1 billion, which the government has refused." Professor McKee continued: "The possibility that the cuts to health and social care are implicated in almost 30,000 excess deaths is one that needs further exploration. Given the relentless nature of the cuts, and potential link to rising mortality, we ask why is the search for a cause not being pursued with more urgency?" "Simply reorganising and consolidating existing urgent care systems or raising the 'agility' of the current A&E workforce capacity is unlikely to be sufficient to meet the challenges that high levels of admissions of frail elderly people and others who are vulnerable are likely to present this winter and in future winters." The researchers say that there are already worrying signs of an increase in mortality in 2016. Without urgent intervention, they say, there must be concern that this trend will continue. Commenting on the analysis, Professor Danny Dorling, University of Oxford, added: "It may sound obvious that more elderly people will have died earlier as a result of government cut backs, but to date the number of deaths has not been estimated and the government have not admitted responsibility." Why has mortality in England and Wales been increasing? An iterative demographic analysis (DOI: 10.1177/0141076817693599) and What caused the spike in mortality in England and Wales in January 2015? (DOI: 10.1177/0141076817693600) by Lucinda Hiam, Danny Dorling, Dominic Harrison and Martin McKee, will be published by the Journal of the Royal Society of Medicine at 00:05 hrs (UK time) on Friday 17 February 2017. The JRSM is the flagship journal of the Royal Society of Medicine and is published by SAGE. It has full editorial independence from the RSM. It has been published continuously since 1809. Its Editor is Dr Kamran Abbasi. Sara Miller McCune founded SAGE Publishing in 1965 to support the dissemination of usable knowledge and educate a global community. SAGE is a leading international provider of innovative, high-quality content publishing more than 1,000 journals and over 800 new books each year, spanning a wide range of subject areas. A growing selection of library products includes archives, data, case studies and video. SAGE remains majority owned by our founder and after her lifetime will become owned by a charitable trust that secures the company's continued independence. Principal offices are located in Los Angeles, London, New Delhi, Singapore, Washington DC and Melbourne. http://www.
News Article | February 27, 2017
Also publishes five additional immunology, virology and microbiology books CAMBRIDGE, MA--(Marketwired - February 27, 2017) - Elsevier, a world-leading provider of scientific, technical and medical information products and services, today announced the publication of an updated edition of its valuable reference, Genetics and Evolution of Infectious Diseases, edited by Michel Tibayrenc. This book is aimed at controlling and preventing neglected and emerging worldwide diseases that are a major cause of global morbidity, disability and mortality. Using an integrated approach, the book discusses the constantly evolving field of infectious diseases and their continued impact on the health of populations, especially in resource-limited areas of the world. At the same time, Elsevier announced five additional immunology, virology and microbiology books. Genetics and Evolution of Infectious Diseases, Second Edition looks at the worldwide human immunodeficiency virus (HIV) pandemic, increasing antimicrobial resistance, and the emergence of many new bacterial, fungal, parasitic and viral pathogens. With contributions from leading authorities, the book includes developments in the field of infectious disease since it was last published in 2010. It demonstrates how the economic, social and political burden of infectious diseases is most evident in developing countries which must confront the dual burden of death and disability due to infectious and chronic illnesses. Learn more about infectious disease genomics in this sample chapter. Michel Tibayrenc, M.D., Ph.D., has worked on the evolution of infectious diseases for more than 35 years. He is a director of research emeritus at the French Institut de Recherche pour le Développement (IRD) Montpellier, France, and the founder and principal organizer of the international congresses MEEGID (molecular epidemiology and evolutionary genetics of infectious diseases). The author of more than 200 international papers, Dr, Tibayrenc has been the head of the unit of research "genetics and evolution of infectious diseases" at the IRD research center for 20 years. With his collaborator, Jenny Telleria, he is the founder and scientific adviser of the Bolivian Society of Human Genetics. Dr. Tibayrenc has won the prize of the Belgian Society of Tropical Medicine (1985), and the medal of the Instituto Oswaldo Cruz, Rio de Janeiro (2000), for his work on Chagas disease. A fellow of the American Association for the Advancement of Science, he is the founder and editor-in-chief of the Elsevier journal, "Infection, Genetics and Evolution." The six new immunology, virology and microbiology titles are: In order to meet content needs in immunology, virology and microbiology, Elsevier uses proprietary tools to identify the gaps in coverage of the topics. Editorial teams strategically fill those gaps with content written by key influencers in the field, giving students, faculty and researchers the content they need to answer challenging questions and improve outcomes. These new books, which will educate the next generation of immunologists and virologists, and provide critical foundational content for information professionals, are key examples of how Elsevier is enabling science to drive innovation. Note for Editors E-book review copies of the new books are available to credentialed journalists upon request. Contact Jelena Baras at email@example.com. About Elsevier Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions - among them ScienceDirect, Scopus, Research Intelligence and ClinicalKey - and publishes over 2,500 journals, including The Lancet and Cell, and more than 35,000 book titles, including a number of iconic reference works. Elsevier is part of RELX Group, a world-leading provider of information and analytics for professional and business customers across industries. www.elsevier.com