Showing posts with label Epidemics. Show all posts
Showing posts with label Epidemics. Show all posts

Sunday, September 4, 2011

WHO: Wild Poliovirus Confirmed In China

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29 August 2011 - A wild poliovirus was confirmed in China. The Ministry of Health has informed WHO about this wild poliovirus type 1 (WPV1) has been isolated from four young children with ages between four months and two years, with onset of paralysis between 3 and 27 July 2011. All four cases are reported to be from Hetian prefecture, Xinjiang Uygur autonomous region, China.

The genetic sequencing of the said virus indicates that they are genetically related to viruses currently circulating in Pakistan. A group of clinicians, laboratory experts and epidemiologists and public health experts has been dispatched to the affected regions to further investigate and plan response activities.

The local public health authorities in Xinjiang autonomous region are currently conducting an epidemiological investigation that includes collection of stool specimens from contacts and evaluation of vaccine coverage.

The Ministry of Health in China plans to conduct an initial response vaccination campaign in early September, targeting 4.5 million children aged under 15 years in the immediate outbreak area, and children aged under 5 years in adjacent prefectures. Moreover, the Ministry of Health in China and the provincial government have finalized plans for supplementary immunization activities. In a province-wide vaccination campaign, 3.8 million children will be targeted with two rounds of polio immunization. Six of the 14 prefectures in the province, including the provincial capital of Urumqi, will target children under 15 years of age, while the other prefectures will target children under 5 years of age. The map below shows the extend of the upcoming vaccination campaign to take place 8-12 September 2011 and 8-12 October 2011.

What is Poliomyelitis?

Poliomyelitis (polio) is a highly infectious disease caused by a virus that invades the nervous system.  It can cause crippling paralysis, sometimes in a matter of hours. Polio generally affects children under the age of three, but adults can contract it as well.

The virus enters the body through the mouth and multiplies in the intestine. Initial symptoms include fever, weakness, headache, vomiting and pain in the limbs. A lifelong paralysis can set in quickly. Among those paralyzed, 5%-10% die when their breathing muscles become immobilized. Many of those infected with the virus will show no symptoms at all but can pass the virus on to others.

Polio is incurable but it can easily be prevented through immunization. Polio vaccine, given multiple times, almost always protects a child for life. Through quality vaccination and disease-reporting (surveillance) systems, the Western Pacific Region has been polio-free since 19 March 1997 when the Region’s last case caused by an indigenous (locally circulating) poliovirus was reported in Cambodia. Polio continues to occur in other parts of the world.

Once established in the intestines, poliovirus can enter the blood stream and invade the central nervous system—spreading along nerve fibres. As it multiplies, the virus destroys nerve cells (motor neurons), which activate muscles. These nerve cells cannot be regenerated and the affected muscles no longer function. The muscles of the legs are affected more often than the arm muscles. The limb becomes floppy and lifeless - a condition known as acute flaccid paralysis (AFP).

Two types of vaccine against polio are available. The first is a live attenuated (weakened) oral polio vaccine (OPV), which was developed by Dr Albert Sabin in 1961. OPV is given orally and its action is two-pronged: OPV produces antibodies in the blood ('humoral' or serum immunity) to all three types of poliovirus. In the event of infection, this will protect the individual against polio paralysis by preventing the spread of poliovirus to the nervous system. OPV also produces a local immune response in the lining ('mucous membrane') of the intestines—the primary site for poliovirus multiplication. The antibodies limit the multiplication of 'wild' (naturally occurring) virus inside the gut, preventing effective infection.

The unique ability of OPV to induce this intestinal, local immunity is probably responsible for the extraordinary effect of OPV mass campaigns in interrupting wild poliovirus transmission. Due to these advantages, OPV remains the vaccine of choice for the eradication of polio.

The second type, the inactivated polio vaccine (IPV), was developed in 1955 by Dr Jonas Salk. IPV is used primarily in countries where the wild poliovirus has already been eliminated. It has to be injected by a trained health worker.

WHO recommends that polio vaccine be given at birth (in areas where polio is still endemic), at six weeks, 10 weeks and 14 weeks.

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Sunday, July 3, 2011

France First E Coli Death Since Outbreak

France confirmed first E Coli death victim since the outbreak.

The Regional. Health agency said that a 78 year old  woman died of an E coli infection in Bordeaux, France. She was in an intensive care since June 24 at Bordeaux University Hospital. The strain detected on her was said to be different from that of the strain that caused 50 lives in Europe. Seven more people suffering from hemolytic uremic syndrome (HUS) still remained in the same hospital where the reported septuagenarian died. The said syndrome is a rare kidney condition that develops in patients infected with E coli.  Six of the seven patients were confirmed to have been suffering from the same E coli strain that claimed the life of the woman.

Up to this date, no one can tell where this virulent strain originated from. Cucumbers, bean sprouts and other vegetables were speculated to be the culprit. A lot of producers are losing business due to said speculations. German authorities believed that the origin of the outbreak was Hamburg. They remained to be in the dark of  the outbreak’s exact source after ruling out earlier suspicions about Spanish cucumbers. The suspicions prompted a mass recall of Spanish vegetables across the Continent that caused huge losses for Spanish farmers and considerable political upset in Madrid.

The public should be made aware that the symptoms are from mild diarrhea to bloody diarrhea, then kidney failure and bleeding disorders. With proper medical treatment, the vast majority of people will recover, Dr McNamara said. People are urged to seek immediate medical attention should they experience these symptoms. With what's being reported, I guess, we all need to be very careful and cautious in preparing our food. We still do not have the information with regard to its source and what's worse is that our government hasn't come up yet on how to control this new strain of E Coli. 

For more information please see German E coli O104:H4 Outbreak.
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Tuesday, June 14, 2011

New Strain of E-Coli Outbreak

The World Health organization has announced a new and virulent strain E coli claimed the life of 17 people and left 1.500 infected patients across Europe. Three infected British internationals  believed to have developed haemolytic uraemic syndrome. It is a rare and severe kidney complication that destroys red blond cells and can affect the central nervous system. A health official in Germany admitted the precise source of the disease may never be traced.

A microbiologist from the University of Aberdeen, professor Hugh Pennington, told the BBC that the outbreak was unusual because it didn't seem to be affecting young children. Records indicate that in the vast majority of outbreaks, most victims were the elderly or children. However, in the case of the German E coli strain, at least, 13 of the 19 adult women died of the new strain infection.  UK Health Protection Agency, Bob Adak, said that they cannot confirm why women have been disproportionately affected. Cucumbers, lettuce and tomatoes were suspected to be at the centre of the E coli outbreak. Ironically, this may also explain why young women seen to be affected by the bug.


What's alarming is that this aberrant strain is resistant to multiple classes of antibiotics. The question lies where these resistance factors coming from? One nasty bacteria seems to have acquired a toxin from another nasty bacteria which resulted in an even nastier bug.  It's like producing two toxins that causes damage and lead to bloody diarrhea and damage tissues including the kidneys. Acute kidney failure is often a life threatening complication of normal E coli outbreaks.
In the recent news the E.coli outbreak in Germany already claimed its first child victim. A 2-year-old boy succumbed to the virulent strain in the eastern town of Hannover. The death toll for the outbreak is now at 37.