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300 million at risk of life-threatening diseases from dirty water

More than 300 million people in Asia, Africa and Latin America are at risk of life-threatening diseases like cholera and typhoid due to the increasing pollution of water in rivers and lakes, the United Nations Environment Programme (UNEP) said.

Between 1990 and 2010, pollution caused by viruses, bacteria and other micro-organisms, and long-lasting toxic pollutants like fertiliser or petrol, increased in more than half of rivers across the three continents, while salinity levels rose in nearly a third, UNEP said in a report on Tuesday.

Population growth, expansion of agriculture and an increased amount of raw sewage released into rivers and lakes were among the main reasons behind the increase of surface water pollution, putting some 323 million people at risk of infection, UNEP said.

"The water quality problem at a global scale and the number of people affected by bad water quality are much more severe than we expected," Dietrich Borchardt, lead author of the report, told the Thomson Reuters Foundation.

However, a significant number of rivers remain in good condition and need to be protected, he said by phone from Germany.

About a quarter of rivers in Latin America, 10 percent to 25 percent in Africa and up to 50 percent in Asia were affected by severe pathogen pollution, largely caused by discharging untreated wastewater into rivers and lakes, the report said.

Some 3.4 million people die each year from diseases such as cholera, typhoid, polio or diarrhoea, which are associated with pathogens in water, UNEP said.

It estimated that up to 164 million people in Africa, 134 million in Asia and 25 million in Latin America were at risk of infection from the diseases.

It said building more sewers was not enough to prevent infections and deaths, adding that the solution was to treat wastewater.

Organic pollution, which can cause water to be completely starved of oxygen, affects one kilometre (0.6 mile) out of seven kilometres (4.4 miles) of rivers in Latin America, Africa and Asia, threatening freshwater fisheries, UNEP said.

Severe and moderate salinity levels, caused by the disposal of salty water from mines, irrigation systems and homes, affect one in 10 rivers on the three continents, making it harder for poor farmers to irrigate their crops, it said.

The trend of worsening water pollution was "critical", Borchardt said.

"It is much more expensive to clean up surface water from severe pollution than to implement proper management which includes prevention of pollution," he said. "Tools are available but the challenge is to implement them."

source: Philippine Star
Health & Medicine

We need to do more to beat rotavirus

Medical science has advanced tremendously over the years and children can be protected against more diseases than before. One of the most successful advancements of medical science has been in immunizing children through vaccinations.

However, if not treated, vaccine-preventable diseases can result in protracted disabilities, high medical bills or long-term disability care, exponentially increasing financial burden on a family.

In 2012, the Philippines became the first country in Southeast Asia to introduce a vaccine against rotavirus, a great achievement in the country’s effort to combat diarrheal diseases.

We focused initially on immunizing children living in the poorest communities, where there exists the highest child morbidity and mortality rates from diarrheal disease. The Philippines’ actions have encouraged our neighbors Indonesia to consider introducing the rotavirus vaccine too.

Rotavirus is a leading killer of Filipino children under age five, taking lives of thousands each year. It can weaken their immune system and slow their growth, affecting their ability to attend school and lead normal, productive lives. Along with this, rotavirus is known to cause repeated episodes of diarrhea. The consequence: increased susceptibility to pneumonia, an acute respiratory infection that can be fatal.

Immunizations, in such cases, can save your family time and money and strengthen the overall health of a nation. Thus it is imperative that every child and infant in the Philippines has access to it.

The vaccine was introduce here in 2012, but is currently only available to infants who qualify under the National Housing Targeting System for Poverty Reduction and further excludes those who cannot get access to private facilities.

The good news is that effective rotavirus vaccines are available. Global health experts, including the World Health Organization (WHO), have recommended that all countries include rotavirus vaccines in their national immunization programs. While more than 80 countries have done so, a few – including the Philippines – have only introduced the vaccine at a sub-national level. In these countries, the vaccine is only available to some children.

To lower the cost of providing the vaccine through the National Immunization Program, allowing for it to be expanded to all children, government should explore different models for purchasing the current vaccine and continue to support the research and development of new, more affordable products.

This year, it’s unconscionable that children are still suffering from diseases we have the knowledge and tools to prevent. Through a collaborative initiative with the government, we can take the health of our children back to our own hands.

ROTA Council recommendations

The ROTA Council, a global body of scientific experts on rotavirus, strongly agrees with the WHO recommendation. It recommends that the key stakeholders in countries where these vaccines have not yet been introduced – or have only been introduce in some states or populations – take action in the following areas:

Countries collaborate with non-governmental agencies (WHO, UNICEF) to develop a set of comprehensive initiatives to reduce diarrhea related illness and death, compliant with the Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea.
National governments and funding agencies should continue to support the researchand development of new, low-cost rotavirus vaccines that are also safe and efficacious.
Global health entities and non-governmental organizations influential in vaccine programs should focus on regulating prices and ensuring affordability towards the individual country’s ability to pay.
National government, global health entities, funding agencies, manufacturers, and other stakeholders should address supply shortages, volume of administration and storage, delivery and storage systems, safety concerns, and cultural sensitivity in low- and middle-income countries. Additional mechanisms may be needed to provide innovative funding options for low-middle income, non-Gavi eligible countries

The Philippines has already made history in Southeast Asia by being the forst to introduce the rotavirus vaccine. We hope that the new government under the leadership of President Duterte takes imminent steps to expedite the immunization program and ensure that health care reaches all children, adequately and effectively.

source: Philippine Star
Health & Medicine

Psoriasis may carry clogged-arteries risk similar to that with diabetes

People with psoriasis may be at increased risk of calcium buildup in the arteries – an indicator of heart disease risk – comparable to that of people with diabetes, according to a new study.

Comparing people in their 50s with psoriasis, diabetes or neither disease, researchers found that moderate to severe calcium buildup, or atherosclerosis, was about five times as common in people with diabetes or psoriasis as it was in the others.

“We know that psoriasis accelerates vascular disease, but we’re not sure how or why,” said senior author Dr. Nehal N. Mehta of the U.S. National Heart, Lung, and Blood Institute in Bethesda, Maryland.

The fact that people with psoriasis have calcium buildups similar to those in diabetes may be a piece of the puzzle, Mehta told Reuters Health. People with type 2 diabetes are regularly screened for heart disease, which may also be advisable for psoriasis patients, he said.

Psoriasis, characterized by itchy red and silvery patches on the skin, is an autoimmune disease that affects about 2 percent of North Americans and Europeans. Diabetes is much more common, affecting about 9 percent of the U.S. population, according to the Centers for Disease Control and Prevention (CDC).

People with diabetes are twice as likely to have heart disease or a stroke as people without diabetes, and to experience these at an earlier age, according to CDC.

One risk factor common to both psoriasis and diabetes and thought to play a role in elevated heart disease risk is chronic inflammation, which is known to promote arterial buildup.

The researchers studied 387 people who were in their early 50s, on average, and were recruited from outpatient clinics between 2013 and 2015. The participants either had moderate to severe psoriasis but no diabetes or other inflammatory health conditions, or they had type 2 diabetes but no psoriasis or other inflammatory conditions or they had neither psoriasis, diabetes nor any other inflammatory conditions.

At least half of each group had no apparent coronary artery calcium build-up, but 19 people with psoriasis had high levels of build-up, as did 20 people with diabetes and just four people with neither disease, according to the results in JAMA Dermatology.

People with psoriasis tended to have fewer other heart disease risk factors like obesity, compared to those with diabetes. And when researchers adjusted for those kinds of factors, especially body mass, the link between diabetes and coronary calcium build-up was no longer significant, but the link to psoriasis remained.

“The results are important confirmation of prior work which has suggested that patients with more severe psoriasis have a similar increased risk of major adverse cardiovascular events compared to diabetes,” said Dr. Joel M. Gelfand, director of the Psoriasis and Phototherapy Treatment Center at the University of Pennsylvania Perelman School of Medicine in Philadelphia.

“The precise mechanism explaining the association of psoriasis and cardiovascular diseases is not known but it is thought that chronic inflammation, common to both disorders, is the primary culprit,” Gelfand, who was not involved in the study, told Reuters Health by email.

In the short term, coronary artery calcium only presents a low risk to the heart, but becomes more dangerous as it builds up over time, he said.

“Get screened for cardiovascular risk factors at least once if you have psoriasis, and after the age of 40 they should get screened annually,” including measures of blood pressure, body mass index and cholesterol levels, Mehta said.

It also makes sense to try to exercise three to four times per week and adhere to a low fat, low salt diet, he said.

source: Reuters Health
http://www.reuters.com/article/us-health-psoriasis-coronary-calcium-idUSKCN1162DH

Study finds strong link between Zika and Guillain-Barre

A comparison of rates of Guillain-Barre syndrome before and after Zika arrived in seven countries has found a strong association between the virus and the illness, researchers from the Pan American Health Organization said on Wednesday.

The current Zika outbreak was first detected in Brazil last year and has since spread across the Americas and the Caribbean.

Pregnant women are considered to be at greatest risk because the virus can cause severe birth defects, including microcephaly, which is marked by small head size and underdeveloped brains. In Brazil, Zika has been linked to more than 1,800 cases of microcephaly.

The first alarms over Zika in Brazil, however, occurred months before microcephaly cases emerged, as adults recovering from Zika infections appeared to have higher-than-normal rates of Guillain-Barre, an autoimmune disorder in which the body attacks itself in the aftermath of an infection, typically occurring in the days following an illness.

In a report published as a letter to the editor of the New England Journal of Medicine, Dr. Marcos Espinal, director of the department of communicable disease at PAHO - the regional arm of the World Health Organization - and colleagues analyzed rates of Guillain-Barre syndrome and Zika in Bahia, Brazil, Colombia, the Dominican Republic, El Salvador, Honduras, Suriname and Venezuela.

They evaluated a total of 164,237 confirmed and suspected cases of Zika virus disease and 1,474 cases of Guillain-Barre that occurred between April 1, 2015 to March 31, 2016, using data collected through official country reports.

Their analysis found a close association between increases in Zika cases and increases in Guillain-Barre. As Zika infections waned in a country, incidence of Guillain-Barre waned as well, the team found.

Compared with pre-Zika rates, Guillain-Barre increased 172 percent in the state of Bahia, Brazil, which was hard hit by the Zika outbreak. They saw similar increases in other countries, with Guillain-Barre cases rising 211 percent in Colombia, 150 percent in the Dominican Republic, 100 percent in El Salvador, 144 percent in Honduras, 400 percent in Suriname and 877 percent in Venezuela.

The team found no link between Guillain-Barre and dengue, a closely related virus that had been suspected as a contributor to the increase in cases.

Based on their findings, the researchers said Zika and Guillain-Barre "are strongly associated," however, they said more study is needed to prove direct causation.

Guillain-Barre causes gradual weakness in the legs, arms and upper body, and in some cases, temporary paralysis. Patients often require intensive care and a respirator to support breathing.

Given these demands, the researchers said Zika imposes "a substantial burden" on populations in Latin America and the Caribbean, where some 500 million people are at risk.

source: Reuters Health
http://www.reuters.com/article/us-health-zika-guillainbarre-idUSKCN1162X8

Don’t travel to Singapore, pregnant women told

In a statement, Health Secretary Paulyn Ubial said it is “very risky” for pregnant women to get infected with Zika virus.

The disease has been linked to birth of babies with severe brain and other neurological defects like microcephaly, a condition where a baby has small head.

Ubial said since Zika is also sexually-transmitted, pregnant women, their partners and others planning for pregnancy should observe safe sex precautions (condoms) to avoid infection.

She urged international travelers to take extra precautions while staying in countries with “ongoing local transmission.”

The Bureau of Quarantine will continue to screen arriving travelers for signs of fever, she added.

Travelers were also reminded to fill out a health declaration checklist upon arrival and to report or visit any government health facility if they become ill with unexplained fever within seven days from arrival.

Ubial urged the public to beef up efforts to eliminate all possible breeding sites of mosquitoes as they could spread not only Zika virus but dengue and Chikungunya as well.

source: Philippine Star
http://www.philstar.com/headlines/2016/09/01/1619336/dont-travel-singapore-pregnant-women-told