The Independent and Health-Informed Tourist?

Mers-virus-3D-imageFULLBy Scinceside – Own work, CC BY-SA 3.0

An innocuous visit to Dubai
A young friend of my extended family was recently taken seriously ill and ended up in a London hospital following a short trip to Dubai to visit a partner working abroad for a few months. The symptoms of the infection, taken together with the location, and the fact that the trip involved taking a camel ride, led the hospital to suspect deadly MERS (Middle Eastern Respiratory Syndrome). Acting on that basis, the partner was tested in a local hospital in Dubai and sent home to wait-out the 14 day transmission window for this disease.

About MERS
Its caused by a coronavirus (MERS-CoV), and infection is linked to travel in the Middle East and close contact with camels, camel secretions and uncooked camel products. The fatality rate is 40%, but deaths are usually linked to underlying medical conditions which weaken the immune response. There is no vaccine: disease transmission is controlled by hygiene, by contact tracing of confirmed cases and the wearing of personal protective equipment by hospital staff (1). Since 2012, 27 countries (including UK) have reported 2266 cases, the majority in Saudi Arabia, with a serious imported outbreak in 2015 in South Korea.

Fortunately the friend turned out not to have MERS but it was a very difficult and traumatic 24 hours finding information to reassure relatives (40% fatality is a scary statistic) … and it set me thinking:

How much can you be expected to know as an independent traveller and what is the responsibility of your tour organiser to inform you? Continue reading

The recognition of Mycetoma: much needed attention finally given to long neglected tropical disease (NTD)

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Image: Woman in the West Indies with mycetoma caused by a fungal organism
CDC/ Dr. Lucille K. Georg

From Harpur Schwartz, an economics/global health student from Connecticut College, USA,  interning with Cabi’s Global Health team.

While tuning in to the live broadcast of the Sixty-ninth World Health Assembly taking place at the World Health Organization (WHO) headquarters in Geneva, Switzerland, mycetoma reached the discussion floor. At the risk of sounding naïve, I’m going to tell you that I had never heard of mycetoma – although a quick google search revealed images resembling elephantiasis. As a student studying global health, I was a little disappointed with myself; I mean I have at least heard of the other neglected tropical diseases (NTDs). But if mycetoma was unfamiliar to me, how many other people had never heard of this disease? I have provided answers to some basic questions I had about mycetoma in case you too are unfamiliar with this disease…

What is mycetoma?

The World health Organization describes mycetoma as, “… a chronic, progressively destructive morbid inflammatory disease usually of the foot but any part of the body can be affected”. This disease is caused by a bacterial (actinomycetoma) or fungal (eumycetoma) infection where the organism enters the body through a minor trauma or a penetrating injury (i.e. commonly a thorn prick). It is believed that the infection enters the body after this pricking occurs, but there are no concrete studies determining transmission. A good video on it can be found here in Global Health Now's Spotlight on Mycetoma by Amy Maxmen.

Is there a cure?

In terms of treatment, curing actinomycetoma using antibiotics has about a 90% success rate. The use of antifungals to treat eumycetoma has a success rate of about 35%, but in 2016 a new antifungal agent, fosravuconazole, will be the subject of the First Clinical Trial in Mycetoma conducted by Drugs for Neglected Diseases Institute (DNDi). Because the disease takes a slow, relatively pain-free progression, mycetoma is at its most advanced stages once it is diagnosed. It is at these later stages when amputation becomes necessary.

Continue reading

Air pollution, can we reduce the impact of cars on urban air quality?

Air pollution in Delhi

Air pollution in Delhi

In January 2016, Delhi, India, improved air quality on its streets when it conducted a 2-week air pollution reduction experiment, with private cars allowed on the streets only on alternate days, depending on license plate numbers.   The idea is not new and has been tried elsewhere (Paris and Rome) but I guess its novelty (“who’d have thought” brigade) to the USA explained why it made The New York Times!

Last year, it was all headlines about Bejing [China] and the air quality citizens had to deal with. However it would seem that actually Beijing’s levels of PM10 (particulate matter up to 10 micrometres in size), a measure of air quality, decreased by 40% from 2000 to 2013, whereas Delhi's PM10 levels have increased 47% from 2000 to 2011.

Delhi's PM10 levels are nearly twice as much as in Beijing, and it has the worst PM 2.5 levels of 1600 cities in the world. Thus the need for the license plate experiment. In a BBC article, you can read more about the reasons “Why Delhi is losing its clean air war” and discover the varied & innovative measures China has taken to ameliorate motor car use.

No doubt spurred on by Delhi’s experiment, a health journalist in Bangladesh alerted the HIFA forum to the equally bad situation in India’s neighbour, Bangladesh.

Continue reading

Middle Eastern Respiratory Virus Syndrome strikes the UK

   Coughs  Sneezes Spread Diseases2
This week
, the UK became the latest country in 2015 to suffer suspected MERS cases.  Two suspected cases of the Middle Eastern Respiratory Virus Syndrome (MERS) have forced a hospital in Manchester to shut its emergency department.  In May, similar events in South Korea (MERS-CoV in Republic of Korea at a glance), mishandled through ignorance and poor infection control within several hospitals, caused multiple outbreaks and a national emergency. Manchester has obviously learnt from their experience.

MERS is the latest virus to act as a global threat, hot on the heels of Ebola and SARS. It emerged in 2012 and has been an ongoing problem spreading to 10 countries in the Middle East, but the Ebola outbreak in West Africa in 2014, replaced it in world headlines (read MERS the next pandemic threat, which appeared also in the Global Health Knowledge Base.

What would happen should MERS ever reach a country with a poor health system?

Continue reading

Teaching tools for Ebola & public health diseases

Ebola_toy
Credit:Wendie Norris

Band Aid is a tried and tested method of public engagement, bringing Ebola to public attention and giving us all something we can do to help rather than just scaring us. What is also needed here and in West Africa, is education.

For a novel method of education, I bring you Giant Microbes, which are sold as teaching tools. They are soft plush “cuddly” toys, anthropomorphised versions of microscopic images of microbes, and provide information on the microbe and the disease it causes in the attached label. Apparently they are currently sold out!

I own their version of Ebola virus (shown opposite is the actual toy sitting on my desk): its based on the shape of the virus seen in an electron microsopic image. My colleague owns a tuberculosis (TB) virus toy. Bought at a public health conference, the label for my Ebola toy is dated 2004 and describes the symptoms, the 50-90% mortality but also tells me that outbreaks are limited to a few hundred cases. The toy produced now, in 2014, will have a very different set of statistics to present.

The West African outbreak today stands at 14383 cases, with 5165 deaths in 6 countries.

Of those 6 African countries, Nigeria and Senegal have had their Ebola Virus Disease (EVD) outbreaks declared as officially over. [A national EVD outbreak is considered to be over when 42 days (double the 21-day incubation period of the Ebola virus) has elapsed since the last patient in isolation became laboratory negative for EVD].

Last week, my colleague had house-guests.  On seeing the TB “cuddly toy” at home, they asked where was the Ebola one (?) and she was gratified to say “its at work”!  Clearly information on Ebola has successfully entered UK public consciousness.

Continue reading

Ebola: a “filthy little virus” says Bob Geldorf

Sierra_Leone_National_Ebola_Emergency_Operations_Center _CDC
Sierra Leone National Ebola Emergency Operations Center
Credit: Jennifer Brooks, CDC.


Following
the launch of Band Aid 30, "the Ebola song”, on X-factor [Sunday 16 November 2014], Bob Geldorf did the media rounds on the Monday morning including BBC 5live, to further drive home the message. People are dying from Ebola in West Africa because they are poor, living in countries without the health service infrastructure to stop it in its tracks, and “we are all just a plane ride away from it”.AS of that Monday, you can buy and download the song here via Amazon, Itunes and Google Play, or purchase the CD.

WE at CABI, devoted last month’s focus of the Global Health Knowledge Base e-newsletter to Ebola research.

With the charitable effort of Band Aid 30 ringing in our ears, I thought it timely to highlight another such effort, from researchers, specifically from the Wellcome Trust.

Wellcome Trust: Emergency Ebola initiative
 The Wellcome Trust (WT), the world's second largest private funder  of medical research after Bill & Melinda Gates Foundation,  are funding a multi-million pound emergency research package [Emergency Ebola Initiative] to investigate new approaches to treat, prevent and contain Ebola viral disease, during the current epidemic in West Africa. WT will also support research into the ethical challenges of testing experimental medicines during epidemics, and has a £40 million long-term investment in African science.

One of their anti-Ebola vaccines is being fast-tracked.

Further Reading

A new rapid sequencing method created for Lassa, was applied to Ebola virus, sequencing nearly 100 Ebola patient blood samples In Sierra Leone, within 10 days. The method is also cost-effective, and may help West African nations rapidly and effectively track outbreaks with limited resources. This article is one of the records on CABI's Global Health database.

 

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More from AHILA14: Information literacy, ICT and the problems in rural areas

AHILA Congress2
AHILA14 delegates. Courtesy of Jean Shaw, Phi.

Report from Jean Shaw of Partnerships in Health Information, attending the 14th biennial AHILA congress.  Dar Es Salaam, Tanzania. AHILA14 Days 2-4.

The papers at the past three days at the AHILA Congress have covered a wide spectrum of subjects reflecting the Congress themes: ICTs and access to information and knowledge. Information seeking behaviours, access to and resources for health information have been extensively reported in papers covering disparate groups ranging from academic researchers and students to mothers and students, teenage pregnant girls and older people (60 onwards).

Health information in rural areas..the role of community health workers

The problems of providing health information in rural areas, where some religious and cultural values can be a barrier to western medicine were the subject of a number of studies and lengthy discussion. They were enhanced by a session organised by Dr. Neil Pakenham-Walsh of HIFA, who had invited community health workers and their Project Manager, Dr. Edoardo Occa, to describe the work of CUAMMDoctors with Africa (an Italian organization involved in the training of Community Health Workers at the grassroots level in seven African countries). 

 

AHILA Congress4_crop

Dr.Occa with Tanzania community health workers & trainers, CUAMM. The NGO works in Angola, Ethiopia, Mozambique, South Sudan, Sierra Leone, Tanzania and Uganda.

 

IT was an eye-opener to learn of the tremendous workload and the problems they met.

Neither of the two health workers who spoke had ever been to Dar es Salaam and their presentations were given in almost instant translation by Mr. G. Faresi a community health worker trainer with the project. To round it off we were shown all the books and equipment that has to be carried by visiting health workers as they cycle great distances. It is obviously very heavy.

This was followed up by an excellent and complementary description of training Community Health Extension Workers in Kenya – an initiative carefully planned and carried out by the Kenya Chapter of AHILA (Ken-AHILA).

This blog also appears on Global Health Knowledge Base

 Editors comment

  •  the 3rd day of AHILA 14 was devoted to the  2nd HIFA conference.
    The session on community health workers & CUAMM, formed part of the HIFA conference.
  • CABI's Global Health database has 1030 records on community health workers (FREETEXT search).  Even more records can be achieved using this searchstring:  "community health" and "medical auxillaries".

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