E-cigarettes – not healthy

Nicotine3Dan2I was horrified to see e-cigarettes associated with the word ‘healthy’ in a store near me recently. They are not. It is undisputable that nicotine is highly addictive and that there is a risk of poisoning with its use. The question is does this harm outweigh the benefits if e-cigarettes reduce smoking? The evidence that e-cigarettes do lead to a long term reduction in smoking and lung cancer and not to an increase in nicotine addiction and in smoking has yet to be seen so we can't say at this stage. Because of their hazardous and addictive content, E-cigarettes regulations should make sure that the product is properly labelled and packaged to protect children and other vulnerable groups.

(Photo- Nicotine molecule, Credit: Fuse809 at English Wikipedia)

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Mystery disease in Ethiopia solved: linked to weed toxin

Imagine this…

A mysterious disease terrorising your community, not infectious but spreading nonetheless, and killing your relatives and neighbours. All you want to do is pack your bags and flee. Worse, when your plight comes to the attention of the health authorities, they are stumped and its not going to be easy or quick to solve.

A recent example of this kind of illness is “nodding disease (South Sudan, Uganda, and Tanzania), which affects children 5-15 years old: they suffer epileptic seizures which causes their heads to nod, and they end up severely disabled and finally die. The USA’s Centre for Disease Control (CDC) is working to identify the cause: so far, the best guess is that it’s linked to the parasite that causes river blindness combined with an autoimmune reaction, and exposure to chemicals could predispose.

Other examples of non-communicable disease outbreaks

On Global Health, I found there are outbreaks going back to 1911 (epidemic dropsy) but more recent ones were in India,  Bangladesh, Nigeria, Brazil, China, Afghanistan and even the USA.

 What are the likely causes for these outbreaks? The body of research, as found on databases like Global Health, tells us that they could be contamination of food and water supply, exposure to chemicals or heavy metals in the environment, or even use of traditional medicine.

 Mystery liver disease in Ethiopia with a ‘happy’ ending

Can public health authorities in low-income countries solve & stop such outbreaks?   Yes. In 2005, in Ethiopia, a 4 year long outbreak of liver disease in Tseda Emba, a small village of the Tahtay Koraro district of Tigray, finally reached the attention of the Tigray Health Bureau (THB). Now, in 2012, the multidisciplinary and one-health approach they initiated has “solved” the mysterious illness, significantly reducing new cases. 

 The research work was the subject of an entire session at the recent World Congress Public Health (WCPH-2012) in Ethiopia, and is now published as 5 papers in the supplement to April 2012’s edition of Ethiopian Medical Journal (EMJ). [Abstracts to these papers will be available on Global Health]. It demonstrates the relevance of the one-health approach to public health in low-income countries and is a fascinating detective story….

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Xmas camels, tobacco and kids

Camel_7362C     Copyright: W.Norris

My daughter decided to make this camel for the annual school Xmas tree competition. To her, at age 11, camels are “cuddly” and linked to the Three Wise Men, part of the Christmas Story. To me, whilst overseeing her sewing efforts, I’d made the link to the 2 empty packets sitting on my desk waiting for me to write a global health blog.

       You can see them either side here…   Fags_7366 Fags_7367

They are cigarette packets but actually only one has ever contained tobacco…can you tell which? Of course you can: it's the one which says Smoking Kills. But that's a UK packet, you don't see that message dominating on packets sold elsewhere…And you have to be able to read.

And that’s the point.

 

 Candy (sweets) that mimic tobacco products

This is marketing at its best… the package shape and silver foil construction, the  same azure blue sky (it really is), the association of Camel or Sphinx with the romance of Egypt and the  yellow desert: these link the two packets to each other & therefore their contents. But the packet with the Sphinx contained chocolate sticks covered in rice paper, accurate copies of adult cigarettes, and was purchased by my daughter from her favourite sweet shop. She loved them; I objected.

And I had to explain why, because she didn’t know. She had not made the connection.

But I had. When I was a child, pink-tipped white candy sticks were my favourite and I knew that they were a kids' version of adult cigarettes.  Kids love to pretend to be adults. The reason I knew of course was that THEN many adults including my father smoked. I even used to buy him mini-cigars for Xmas, despite the fact that I loathed the smell (it made me feel sick). The white candy sticks are still on sale but they are poor imitations of cigarettes so the link to smoking is now so remote that I’ve not be too worried.

Sphinx candy sticks are a different matter. They operate on a much subtler level.

We are still trying to stop children and adolescents from taking up tobacco smoking, even though overall adult smoking is in decline and is reinforced by the ban on smoking in public places in many European countries (Although Belgium has just relaxed that!).

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Mushrooms, delicious or deadly?

Yunnan sudden death syndrome occurs in remote mountainous villages of the Yunnan province of China in the rainy season, at an altitude of 1800-2400 m: people just drop dead from heart failure. You might think its linked to the season…some waterborne or insect-carried disease, or maybe the altitude & a genetic quirk, but it turns out that it’s because the villagers make their living collecting & selling wild mushrooms. The only one they can’t sell is a white mushroom, because it’s too small & turns brown quickly after picking. So they eat it…and the Chinese CDC have shown that for a minority of the local population, this mushroom is toxic. Its’ thought that they are sensitive to a combination of the mycotoxins and high barium levels found in the mushroom.(see Rare mushroom blamed for mystery deaths in China)

This reminds me of a passage in a book “The Magic Bullet” (a book about drug development) that I read many years ago, which pointed out that in certain graveyards in the UK, you could find whole families who died together in medieval times, and not through the plague. These deaths were linked to poor harvests. It turned out these families’ had been forced to turn to foraging for mushrooms (an action we now term using “famine food”), and even though villagers in general were probably more expert than we are now at identifying safe ones, one mistake added to the family pot, and that was that!

But don’t be complacent: in the UK in 2009 the case of two Thai women hit national headlines. One of them misidentified an English mushroom and the result was that she cooked and ate a number of them, and died.  The other who ate fewer of them became seriously ill with liver failure. It was a death-cap mushroom… just half of one of these is sufficient to kill an adult. (see Isle of Wight woman died… )

I decided to see what records our Global Health database has on toxic mushrooms & other fungi, their toxins (mycotoxins) and cases of human poisoning by them.

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