In another major advance in the fight against infectious diseases, recently concluded tests have shown an anti-malaria vaccine, GlaxoSmithKline's RTS S/AS02A, to be far more effective than previously believed. Malaria kills over a million people world-wide each year.
The initial six month follow-up showed that the vaccine reduced the risk of clinical malaria by 30%, and the risk of serious disease by 58%. It had been thought that the vaccine would only be effective for about six months, creating a significant logistical challenge to vaccinate African childern twice a year. In a recent report published in The Lancet, researchers working in Mozambique found the jab cut the risk of clinical malaria by 35% and nearly halved the risk of serious malaria even after 18 months.
Melinda Moree, of the Malaria Vaccine Initiative, said: "We are very excited because there is a malaria vaccine that protects children from malaria and it actually lasts long enough to make it a real public health intervention that can have an impact on malaria in Africa."
Tags: disease, Africa, malaria, vaccine
Showing posts with label disease. Show all posts
Showing posts with label disease. Show all posts
Thursday, November 17, 2005
Friday, November 11, 2005
Another one bites the dust!
The global eradication of smallpox is one of the greatest public health successes ever.
Within two years we may see another such success. The BBC reported late yesterday that only six nations (Nigeria, India, Pakistan, Niger, Afghanistan, and Egypt) have had recent polio cases, and that the disease could be completely eradicated within 18 months.
The World Health Organization was making major headway against polio, until 2003, when Islamic clerics in Nigeria organised a boycott of the polio vaccine, claiming it was part a western plot against Muslims. The disease subsequently spread to 15 African countries and was also detected in Yemen and Indonesia.
"This is the light at the end of the tunnel," said Bruce Aylward, WHO co-ordinator for the eradication of polio.
Bruce Aylward, coordinator for the polio eradication project, noted that the WHO is still needs to find $200m for operations in 2006. "Now it's simply [about] getting the financial resources to get this thing finished. You'll never get another chance like it."
Tags: polio, disease, WHO, eradication, Africa, health
Within two years we may see another such success. The BBC reported late yesterday that only six nations (Nigeria, India, Pakistan, Niger, Afghanistan, and Egypt) have had recent polio cases, and that the disease could be completely eradicated within 18 months.
The World Health Organization was making major headway against polio, until 2003, when Islamic clerics in Nigeria organised a boycott of the polio vaccine, claiming it was part a western plot against Muslims. The disease subsequently spread to 15 African countries and was also detected in Yemen and Indonesia.
"This is the light at the end of the tunnel," said Bruce Aylward, WHO co-ordinator for the eradication of polio.
Bruce Aylward, coordinator for the polio eradication project, noted that the WHO is still needs to find $200m for operations in 2006. "Now it's simply [about] getting the financial resources to get this thing finished. You'll never get another chance like it."
Tags: polio, disease, WHO, eradication, Africa, health
Friday, September 02, 2005
In the wake of the storm
In the wake of Hurricane Katrina, Michael Leavitt, Secretary of Health and Human Services, said a public health emergency warning was in place from Louisiana to Florida. He said there were grave concerns about cholera, typhoid and dehydrating diseases.
Mr. Leavitt's warning may have missed the mark, however; outbreaks of diseases such as cholera and typhoid are not probable because the microbes which carry them are virtually non-existent in the US, and so an outbreak like the one in West Africa is very unlikely.
The Centers for Disease Control and Prevention (CDC) records from previous US disasters show the majority of medical problems after the events have been associated with diarrhoea and asthma. The CDC and the Food and Drug Administration are advising people to throw away food that may have come into contact with flood water and only to drink bottled water.
Dr Glenn Morris, a professor of epidemiology at the University of Maryland Medical School in Baltimore, said: "The biggest problem is the sewage contamination of the water. Just splashing around in the water, if there is sewage contamination there is a risk you could get it on to your hands and get it into your mouth." He said viruses such as hepatitis A could be a threat as well as dangerous strains of E.coli.
As many wild animals have been pushed from their normal habitats into limited dry areas (and hence into closer contact with people), rabies may become a problem. Another problem may be mosquito-borne diseases, such as West Nile Viral Encephalitis. Stagnant flood waters may result in a booming mosquito population. WNVE killed more than 200 people in the US in 2004.
Fortunately, these diseases are not directly transmitted from person to person, and so as the water recedes and order returns to the area, any disease outbreak should die off quickly.
Tags: Katrina, Hurricane Katrina, disease, Health
Mr. Leavitt's warning may have missed the mark, however; outbreaks of diseases such as cholera and typhoid are not probable because the microbes which carry them are virtually non-existent in the US, and so an outbreak like the one in West Africa is very unlikely.
The Centers for Disease Control and Prevention (CDC) records from previous US disasters show the majority of medical problems after the events have been associated with diarrhoea and asthma. The CDC and the Food and Drug Administration are advising people to throw away food that may have come into contact with flood water and only to drink bottled water.
Dr Glenn Morris, a professor of epidemiology at the University of Maryland Medical School in Baltimore, said: "The biggest problem is the sewage contamination of the water. Just splashing around in the water, if there is sewage contamination there is a risk you could get it on to your hands and get it into your mouth." He said viruses such as hepatitis A could be a threat as well as dangerous strains of E.coli.
As many wild animals have been pushed from their normal habitats into limited dry areas (and hence into closer contact with people), rabies may become a problem. Another problem may be mosquito-borne diseases, such as West Nile Viral Encephalitis. Stagnant flood waters may result in a booming mosquito population. WNVE killed more than 200 people in the US in 2004.
Fortunately, these diseases are not directly transmitted from person to person, and so as the water recedes and order returns to the area, any disease outbreak should die off quickly.
Tags: Katrina, Hurricane Katrina, disease, Health
Friday, June 17, 2005
New vaccines on the way
The World Heath Organization (WHO) announced Wednesday that they expect the number of vaccines available to prevent diseases to double over the next decade to about 40. The WHO's head of vaccine research, Dr Marie-Paule Kieny, was guardedly optimistic, saying "Experience has shown that the uptake of new vaccines is extremely slow. We urgently must find solutions to deliver these powerful and proven health tools to all people at risk."
New vaccines are being developed against a range of often deadly infectious diseases including meningitis, malaria, and cervical cancer, following recent scientific breakthroughs, however scientific, financial, technical, and regulatory issues continue to present substantial obstacles to delivering vaccines to people in need, she said.
New vaccines are being developed against a range of often deadly infectious diseases including meningitis, malaria, and cervical cancer, following recent scientific breakthroughs, however scientific, financial, technical, and regulatory issues continue to present substantial obstacles to delivering vaccines to people in need, she said.
Friday, May 20, 2005
When, not if
An panel of communicable disease experts convened by the World Health Organization (WHO) to consider the growing threat posed by avian flu H5N1 released its findings yesterday, and they should serve as a call to action for the pharmaceutical and health care industries. The panel suggested that an H5N1 pandemic could easily be as deadly as the worst flu virus yet: the pandemic flu of 1918 that killed 50 million people worldwide — half of them young, healthy adults.
Michael T. Osterholm, director of the Center for Infectious Disease Research at the University of Minnesota, described a likely scenario in the May 5 issue of The New England Journal of Medicine. "We would be facing a 1918-like scenario.... We would have no surge capacity for health care, food supplies, and many other products and services.... We have no detailed plans for staffing the temporary hospitals that would have to be set up in high-school gymnasiums and community centers — and that might need to remain in operation for one to two years.... We have no way of urgently increasing production of critical items such as antiviral drugs, masks for respiratory protection, or antibiotics for the treatment of secondary bacterial infections. ... Nor do we have detailed plans for handling the massive number of dead bodies that would soon exceed our ability to cope with them."
The WHO lists six stages from the detection of a new influenza virus in animals to a global human flu pandemic. Currently the H5N1 bird flu is at stage 4: small, highly localized clusters of human infections. At this stage, the virus cannot spread easily from person to person. New evidence suggests — but does not yet prove — that H5N1 may be moving to stage 5, meaning that the virus is becoming increasingly better at person-to-person spread. When stage 6 is reached, there will be rapid human-to-human flu spread and pandemic flu.
It's only a matter of time, according to virologist Klaus Stöhr, project leader for the WHO Global Influenza Program. "We are in a situation where we simply have to deal with uncertainties on when this will happen — not whether this will happen or not," Stöhr said yesterday in a news conference. "We believe a pandemic will happen, but we don't know when and also [we don't know] the severity of the event."
"In the last 18 months, we have seen an incremental increase in our concern," Stöhr said. "We do not know if a pandemic can occur next week or next year." Only one thing is sure: H5N1 is coming.
Michael T. Osterholm, director of the Center for Infectious Disease Research at the University of Minnesota, described a likely scenario in the May 5 issue of The New England Journal of Medicine. "We would be facing a 1918-like scenario.... We would have no surge capacity for health care, food supplies, and many other products and services.... We have no detailed plans for staffing the temporary hospitals that would have to be set up in high-school gymnasiums and community centers — and that might need to remain in operation for one to two years.... We have no way of urgently increasing production of critical items such as antiviral drugs, masks for respiratory protection, or antibiotics for the treatment of secondary bacterial infections. ... Nor do we have detailed plans for handling the massive number of dead bodies that would soon exceed our ability to cope with them."
The WHO lists six stages from the detection of a new influenza virus in animals to a global human flu pandemic. Currently the H5N1 bird flu is at stage 4: small, highly localized clusters of human infections. At this stage, the virus cannot spread easily from person to person. New evidence suggests — but does not yet prove — that H5N1 may be moving to stage 5, meaning that the virus is becoming increasingly better at person-to-person spread. When stage 6 is reached, there will be rapid human-to-human flu spread and pandemic flu.
It's only a matter of time, according to virologist Klaus Stöhr, project leader for the WHO Global Influenza Program. "We are in a situation where we simply have to deal with uncertainties on when this will happen — not whether this will happen or not," Stöhr said yesterday in a news conference. "We believe a pandemic will happen, but we don't know when and also [we don't know] the severity of the event."
"In the last 18 months, we have seen an incremental increase in our concern," Stöhr said. "We do not know if a pandemic can occur next week or next year." Only one thing is sure: H5N1 is coming.
Thursday, November 11, 2004
A pox on all our houses
In what should be today's top news story, a World Health Organization (WHO) committee has recommended allowing genetic alterations to variola, the virus which causes smallpox. According to WHO spokesman Dick Thompson, "They recommended that experiments be done that would speed the screening of drugs for anti-smallpox activity."
Thompson confirmed this would constitute genetic manipulation — as reported early Thursday morning by National Public Radio — but stressed that the purpose of the experiments would be to try to improve smallpox treatment.
The World Health Assembly — the ruling body of the 192-nation WHO — would make a final decision on whether to approve the experiments. "It will go through the bureaucratic process," Thompson said. "It will be a political decision."
In the United States, however, a senior smallpox expert said he was wary. "I think that it is unwise for us to be continuing research with a smallpox virus," NPR quoted Dr. Donald Henderson, President Bush's former bioterrorism czar, as saying. Henderson ran the successful WHO campaign to wipe out smallpox in the developing countries of Africa, Asia and Latin America from 1966 to 1977.
The aim of the genetic alteration is to speed up the screening of anti-smallpox drugs and help to use up the last remaining stocks of the virus, which are being held in secure laboratories because the disease is so virulent. The modified version of the virus would only be used in testing drugs for people who already have the virus and not for smallpox vaccines. Currently no treatment is available for small pox and the only vaccine is unsafe for people with weakened immune systems, and can seriously harm some healthy people, because it is made with a live virus.
Historically the mortality rate for smallpox was 20% to 40%, however in non-immune populations like the native Americans of the Sixteenth Century the mortality rate has been estimated between 50% and 75%; as the disease swept through North and South America ahead of the Europeans tens of millions of people died.
The last naturally occurring case of Variola Minor was diagnosed on October 26, 1977 and the last naturally occurring case of the more deadly Variola Major was detected two years earlier in November 1975. In 1978 the virus escaped from a research laboratory in the United Kingdom; one person died from the disease, and a second killed himself because he accidentally let it out.
Today no one has a natural immunity, and very few people outside the military have recieved vaccination recent enough to have effect (10 years). Despite recent attempts of the US government, private citizens are less concerned about the potential for smallpox release than about potential side-effects from vaccination (which in the case of smallpox can be quite substantial). Consider then, the disaster of a more widespread smallpox release; 50% to 75% of the US (or even world) population dead within months!
Following the 1978 accident, and because of such concerns, all known smallpox stocks were destroyed except those at the Centers for Disease Control (CDC, in Atlanta) and the Moscow Institute for Viral Preparation. Under such tight control, smallpox would, it was thought, never be let out again. Even though the WHO ordered variola's destruction was ordered in 1993, 1994, 1995, and 1996, the stores continue to be maintained in Atlanta and Moscow. Additional collections of the virus almost certainly exist as the result of military and biological warfare programs, such as the Soviet State Research Center of Virology and Biotechnology (also known as Vector) labs. Smallpox scabs were also recently found in an envelope in a book on Civil War medicine in Santa Fe, New Mexico, and it is extremely likely that other remnants exist outside of medical settings.
Edward Jenner, discoverer of the smallpox vaccine, said, "The annihilation of smallpox - the dreadful scourge of the human race - will be the final result of vaccination." Sadly, that day has not yet come.
Thompson confirmed this would constitute genetic manipulation — as reported early Thursday morning by National Public Radio — but stressed that the purpose of the experiments would be to try to improve smallpox treatment.
The World Health Assembly — the ruling body of the 192-nation WHO — would make a final decision on whether to approve the experiments. "It will go through the bureaucratic process," Thompson said. "It will be a political decision."
In the United States, however, a senior smallpox expert said he was wary. "I think that it is unwise for us to be continuing research with a smallpox virus," NPR quoted Dr. Donald Henderson, President Bush's former bioterrorism czar, as saying. Henderson ran the successful WHO campaign to wipe out smallpox in the developing countries of Africa, Asia and Latin America from 1966 to 1977.
The aim of the genetic alteration is to speed up the screening of anti-smallpox drugs and help to use up the last remaining stocks of the virus, which are being held in secure laboratories because the disease is so virulent. The modified version of the virus would only be used in testing drugs for people who already have the virus and not for smallpox vaccines. Currently no treatment is available for small pox and the only vaccine is unsafe for people with weakened immune systems, and can seriously harm some healthy people, because it is made with a live virus.
Historically the mortality rate for smallpox was 20% to 40%, however in non-immune populations like the native Americans of the Sixteenth Century the mortality rate has been estimated between 50% and 75%; as the disease swept through North and South America ahead of the Europeans tens of millions of people died.
The last naturally occurring case of Variola Minor was diagnosed on October 26, 1977 and the last naturally occurring case of the more deadly Variola Major was detected two years earlier in November 1975. In 1978 the virus escaped from a research laboratory in the United Kingdom; one person died from the disease, and a second killed himself because he accidentally let it out.
Today no one has a natural immunity, and very few people outside the military have recieved vaccination recent enough to have effect (10 years). Despite recent attempts of the US government, private citizens are less concerned about the potential for smallpox release than about potential side-effects from vaccination (which in the case of smallpox can be quite substantial). Consider then, the disaster of a more widespread smallpox release; 50% to 75% of the US (or even world) population dead within months!
Following the 1978 accident, and because of such concerns, all known smallpox stocks were destroyed except those at the Centers for Disease Control (CDC, in Atlanta) and the Moscow Institute for Viral Preparation. Under such tight control, smallpox would, it was thought, never be let out again. Even though the WHO ordered variola's destruction was ordered in 1993, 1994, 1995, and 1996, the stores continue to be maintained in Atlanta and Moscow. Additional collections of the virus almost certainly exist as the result of military and biological warfare programs, such as the Soviet State Research Center of Virology and Biotechnology (also known as Vector) labs. Smallpox scabs were also recently found in an envelope in a book on Civil War medicine in Santa Fe, New Mexico, and it is extremely likely that other remnants exist outside of medical settings.
Edward Jenner, discoverer of the smallpox vaccine, said, "The annihilation of smallpox - the dreadful scourge of the human race - will be the final result of vaccination." Sadly, that day has not yet come.
Tuesday, November 02, 2004
WHO Flu Summit
Partly because I'm getting tired of posting about politics (and we haven't even gotten to the recounts yet!)...
The World Health Organization will host representatives of vaccine manufacturers and of large nations (including the US) in Geneva, Switzerland on November 11 for a summit on the potential for an influenza pandemic.
The World Health Organization's influenza chief recently told the American Society for Microbiology that the world is closer than ever to a pandemic, a world-wide epidemic in which tens of millions of people die. Influenza normally kills about 36,000 people in the US and 1,000,000 worldwide every year, but a pandemic would push the global death toll into the tens of millions.
He said the bird flu is becoming established in Asia, and several worrisome human cases can't be linked directly to exposure to infected poultry. A pandemic is likely to develop when a flu strain changes so dramatically that people have little immunity from previous exposure.
Of course no discussion of influenza epidemics would be complete without mention of the influenza pandemic of 1918-1919, which killed between 20 and 40 million people, more than World War I. It is widely considered one of the most devastating epidemics in recorded world history. More people died of influenza in a single year than in four years of the bubonic plague from 1347 to 1351. Known as "Spanish Flu" or "La Grippe," the influenza of 1918-1919 was a global disaster. The influenza virus had a profound virulence, with a mortality rate at 2.5% compared to the previous influenza epidemics, which were less than 0.1%. The death rate for 15 to 34-year-olds of influenza and pneumonia were 20 times higher in 1918 than in previous years - particularly striking because this is the age range normally least affected. For more information on that particular epidemic, visit this page.
Also in the related realm of epidemiology readings, I recommend Laurie Garrett's excellent book The Coming Plague, which includes a thorough discussion of the 1918-1919 influenza epidemic. The focus of the book is on how global climate change and weakened public health systems (see also Laurie Garrett's Betrayal of Trust) have left us more open than ever before to the possibility of a devastating epidemic. Her thesis has already been partially borne out by the continuing spread in the US of West Nile Viral Encephalitis and other previously tropical (or rare) diseases.
The World Health Organization will host representatives of vaccine manufacturers and of large nations (including the US) in Geneva, Switzerland on November 11 for a summit on the potential for an influenza pandemic.
The World Health Organization's influenza chief recently told the American Society for Microbiology that the world is closer than ever to a pandemic, a world-wide epidemic in which tens of millions of people die. Influenza normally kills about 36,000 people in the US and 1,000,000 worldwide every year, but a pandemic would push the global death toll into the tens of millions.
He said the bird flu is becoming established in Asia, and several worrisome human cases can't be linked directly to exposure to infected poultry. A pandemic is likely to develop when a flu strain changes so dramatically that people have little immunity from previous exposure.
Of course no discussion of influenza epidemics would be complete without mention of the influenza pandemic of 1918-1919, which killed between 20 and 40 million people, more than World War I. It is widely considered one of the most devastating epidemics in recorded world history. More people died of influenza in a single year than in four years of the bubonic plague from 1347 to 1351. Known as "Spanish Flu" or "La Grippe," the influenza of 1918-1919 was a global disaster. The influenza virus had a profound virulence, with a mortality rate at 2.5% compared to the previous influenza epidemics, which were less than 0.1%. The death rate for 15 to 34-year-olds of influenza and pneumonia were 20 times higher in 1918 than in previous years - particularly striking because this is the age range normally least affected. For more information on that particular epidemic, visit this page.
Also in the related realm of epidemiology readings, I recommend Laurie Garrett's excellent book The Coming Plague, which includes a thorough discussion of the 1918-1919 influenza epidemic. The focus of the book is on how global climate change and weakened public health systems (see also Laurie Garrett's Betrayal of Trust) have left us more open than ever before to the possibility of a devastating epidemic. Her thesis has already been partially borne out by the continuing spread in the US of West Nile Viral Encephalitis and other previously tropical (or rare) diseases.
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