Monday, July 25, 2011

MSF Fight Measles Epidemic In Malawi

FIGHTING MEASLES IN THE DEVELOPING WORLD

MSF are fighting a measles epidemic in Malawi. Click here to see how.


MEASLES

Every minute a child dies of measles. Even though a safe and effective vaccine exists, outbreaks occur in many parts of the world because routine immunisation programs are not in place or efficient. In many places Médecins Sans Frontières (MSF) teams are confronted with outbreaks and have to organise emergency immunisation campaigns, which represent a complex logistical challenge.
According to the World Health Organisation (WHO), out of the 30 million children affected by measles every year, about half a million die. Most of those deaths occur in Africa and Asia. This contrasts sharply with the Western world where measles cases have become extremely rare thanks to universal routine immunisation. This leads many people to forget that measles is a major killer.
Measles is highly contagious. Symptoms like runny nose, cough, eye infection, and rash appear about 10 to 14 days after exposure to the virus. There are different levels of severity, and deaths following measles infection are usually due to measles-related complications like diarrhoea, dehydration, and respiratory infections (pneumonia, croup). Those deaths can occur weeks after the acute disease and are not always attributed to measles. Mortality can reach 5 percent to 20 percent of measles cases. Initial health condition, access to health care, and proper treatment provision are factors influencing mortality.

2011 International Symposium on Reducing Child Mortality: Thinking outside the hospital for effective medical care

15/07/2011
In the lead-up to the 7th World Congress of the World Society for Paediatric Infectious Diseases held in Melbourne, Australia, Médecins Sans Frontières and Epicentre are hosting a one-day satellite symposium to re-think...
Category: Upcoming Events (Events), Lectures & Seminars

Médecins Sans Frontières welcomes initiative by UNICEF to make vaccine prices public

31/05/2011
Geneva, 27 May 2011— In a bid to increase transparency and stimulate competition to bring down the prices of vaccines needed in the developing world, UNICEF has decided to publish the prices it pays to vaccine manufacturers.
Category: Press releases

Zambia: Measles vaccination campaign underway to immunise 600,000 children

24/05/2011
Mansa, Zambia – Médecins Sans Frontières teams are currently working alongside the Zambian health authorities to carry out a measles vaccination campaign with a target of almost 600,000 children. Médecins Sans Frontières launched...
Category: Field news

Treating measles in a remote province of the Democratic Republic of Congo

17/05/2011
In March, the measles epidemic that has raged in the Democratic Republic of Congo (DRC) for more than six months reached the remote province of Maniema. Despite the logistical challenges, Médecins Sans Frontières teams are...
Category: Field news

Medical and humanitarian emergency continues as violence persists in Ivory Coast

27/04/2011
21 April 2011: The medical and humanitarian emergency in Ivory Coast persists as violence rages in several neighbourhoods in Abidjan, and security in the west of the country remains critically unstable, with populations hiding in...
Category: Field news


DR Congo: “Measles epidemic spiralling out of control” according to Médecins Sans Frontières
28/03/2011
Over the past six months a measles epidemic has been sweeping through the Democratic Republic of Congo (DRC). Médecins Sans Frontières is raising the alarm and calling for concerted action to halt the spread of the disease.
Category: Press releases
Visit Doctors Without Borders and fight Malaria - 

Sunday, July 24, 2011

Research Summary: AMEDEO Parasitic Diseases, 25 July, 2011.

1. AMEDEO Parasitic Diseases
http://www.amedeo.com

2011-07-25

1. DOS SANTOS AO, Costa MA, Ueda-Nakamura T, Dias-Filho BP, et al.
Leishmania amazonensis: Effects of oral treatment with copaiba oil in mice.
Exp Parasitol. 2011.
http://amedeo.com/p2.php?id=21771592&s=pad&pm=0da2afd4a82ab52
ABSTRACT available


2. TAFAGHODI M, Eskandari M, Khamesipour A, Jaafari MR, et al.
Alginate microspheres encapsulated with autoclaved Leishmania major (ALM) and
CpG-ODN induced partial protection and enhanced immune response against murine
model of leishmaniasis.
Exp Parasitol. 2011.
http://amedeo.com/p2.php?id=21767536&s=pad&pm=0da2afd4a82ab52
ABSTRACT available


3. EL-LAKKANY N, Seif El-Din S, Ebeid F.
The use of pentoxifylline as adjuvant therapy with praziquantel downregulates
profibrigenic cytokines, collagen deposition and oxidative stress in experimental
schistosomiasis mansoni.
Exp Parasitol. 2011.
http://amedeo.com/p2.php?id=21762692&s=pad&pm=0da2afd4a82ab52
ABSTRACT available


4. DE ALMEIDA ME, Steurer FJ, Koru O, Herwaldt BL, et al.
Identification of Leishmania spp. by Molecular Amplification and DNA Sequencing
Analysis of a Fragment of the rRNA Internal Transcribed Spacer 2 (ITS2).
J Clin Microbiol. 2011.
http://amedeo.com/p2.php?id=21752983&s=pad&pm=0da2afd4a82ab52
ABSTRACT available


5. DESQUESNES M, Kamyingkird K, Vergne T, Sarataphan N, et al.
An evaluation of melarsomine hydrochloride efficacy for parasitological cure in
experimental infection of dairy cattle with Trypanosoma evansi in Thailand.
Parasitology. 2011.
http://amedeo.com/p2.php?id=21767438&s=pad&pm=0da2afd4a82ab52
ABSTRACT available


6. CARMELO E, Gonzalez G, Cruz T, Osuna A, et al.
Characterization of monomeric DNA-binding protein Histone H1 in Leishmania
braziliensis.
Parasitology. 2011.
http://amedeo.com/p2.php?id=21767437&s=pad&pm=0da2afd4a82ab52
ABSTRACT available


7. NEAL AT.
Male gametocyte fecundity and sex ratio of a malaria parasite, Plasmodium
mexicanum.
Parasitology. 2011.
http://amedeo.com/p2.php?id=21756426&s=pad&pm=0da2afd4a82ab52
ABSTRACT available


8. JACINTO DS, Muniz HD, Venancio TM, Wilson RA, et al.
Curupira-1 and Curupira-2, two novel Mutator-like DNA transposons from the
genomes of human parasites Schistosoma mansoni and Schistosoma japonicum.
Parasitology. 2011.
http://amedeo.com/p2.php?id=21756422&s=pad&pm=0da2afd4a82ab52
ABSTRACT available


9. KIHARA J, Mwandawiro C, Waweru B, Gitonga CW, et al.
Preparing for national school-based deworming in Kenya: the validation and
large-scale distribution of school questionnaires with urinary schistosomiasis.
Trop Med Int Health. 2011 Jul 18. doi: 10.1111/j.1365-3156.2011.02829.
http://amedeo.com/p2.php?id=21767334&s=pad&pm=0da2afd4a82ab52
ABSTRACT available


10. XUE Z, Gebremichael M, Ahmad R, Weldu ML, et al.
Impact of temperature and precipitation on propagation of intestinal
schistosomiasis in an irrigated region in Ethiopia: suitability of satellite
datasets.
Trop Med Int Health. 2011 Jul 18. doi: 10.1111/j.1365-3156.2011.02820.
http://amedeo.com/p2.php?id=21767333&s=pad&pm=0da2afd4a82ab52
ABSTRACT available

We have screened the following journals for you:
Acta Cytol
Am J Gastroenterol
Am J Trop Med Hyg
Antimicrob Agents Chemother
Br J Dermatol
Br J Haematol
Clin Infect Dis
Epidemiol Infect
Eur J Immunol
Exp Parasitol
Infect Immun
Int J Parasitol
J Clin Microbiol
J Eukaryot Microbiol
J Exp Med
J Immunol
J Infect Dis
J Parasitol
JAMA
Lancet
N Engl J Med
Nat Med
Nature
Neurology
Parasite Immunol
Parasitology
Proc Natl Acad Sci U S A
Science
Trop Med Int Health

Thursday, July 21, 2011

The Role of Women in Making and Building Peace: Reflections on Timor-Leste

Last June in Suai, a small town in Timor-Leste, I held an open day with local women and men to mark the tenth anniversary of Security Council Resolution 1325 on women, peace, and security. This resolution recognizes the unique impact of conflict on women’s lives and highlights their often overlooked contributions to resolving and preventing conflict. It also calls on the international community to involve women fully in every aspect of our work for peace and security.

The discussion at the meeting was lively. Women presented their achievements and shared their ideas on how the international community could better help them reach their goals. Topics ranged from community policing to cross-border reconciliation with communities in Indonesia to domestic violence. I was struck by the energy and diversity of the more than one hundred people who came to voice their concerns. Police officers, local government officials, and community leaders joined scores of ordinary women—mothers, wives, breadwinners, and heads of household.

My lasting impression of the women of Suai was that they were not demoralized by their past. On the contrary, they radiated energy and resourcefulness. Their stories and work helped me understand that if the United Nations were to make a lasting contribution to peace and stability in Timor-Leste on my watch, it would be by building on the initiative and resilience of these women and helping them become fully involved in determining the country’s future.

Women’s involvement in decision making is particularly important in Timor-Leste, where men and women are building the economic and social foundations of a stable society and resilient institutions, following a twenty-four-year struggle for independence which claimed the lives of 183,000 Timorese.

One of the women taking on this challenge is Madalena Bi Dau Soares, a former, long-serving fighter in the Timorese guerilla army. I met Madalena in her home in the Liquiça district to which she had returned in 1999 to set up and run two kindergartens that she financed with her small veteran’s pension. When asked why she did it, she gave a simple answer: “I wanted to achieve something good, leave a mark in the community. After fighting for independence, men found other things to do. I wanted the same for me.”

Filomena dos Reis is another independence fighter turned grassroots peace activist. She trains Timorese women in mediation, negotiation, and conflict-resolution. In 2005, Filomena and her colleagues organized a cross-border dialogue between Timorese and Indonesians. The initiative was in response to conflicts between communities, due to cattle straying across parts of the border that were not clearly demarcated. To resolve these disputes, the two sides selected sixty people to participate in the dialogue, which was watched by five hundred observers. The talks, which took place over three days in September 2005, resulted in a set of recommendations that were submitted to the Timorese and Indonesian Governments. One of the recommendations was to conclude ongoing negotiations about passes allowing women to move freely between markets on either side of the border. This became a reality in 2010, when the two Governments issued the border passes.

Madalena’s and Filomena’s achievements are even more impressive in light of the Timorese women’s history over the past decades. In fact, women played a significant role in Timor-Leste’s struggle for independence. During the Indonesian occupation of Timor-Leste from 1975 to 1999, women were guerilla fighters and members of the clandestine front. In Timor-Leste and abroad, they advocated against the Indonesian occupation. They brought resistance fighters food, ammunition, and messages, and gave them shelter. Women’s organizations also contributed by training ¬women in survival and teaching vocational skills.

The women of Timor-Leste now have a huge stake in reconciliation and peacebuilding initiatives. They want their country to learn from its history in order to have a peaceful and stable future. Nevertheless, women were largely absent from high-level dialogue initiatives to end outbreaks of violence in 1999 and 2006. The situation may, however, be changing. Throughout Timor-Leste, women are leading grassroots reconciliation initiatives, and they are moving into the corridors of power. Indeed, female political participation in Timor-Leste, now comprising 30 per cent of parliament members, is the highest in Southeast Asia. Women also lead the ministries of finance, justice, and social solidarity. Across the country, women are carving out a space for themselves at the national, district, and village levels to address domestic violence, economic hardship, and other issues that affect women and the population at large.

Bearing in mind this history of strength, suffering, and survival, what can the United Nations do to help those women in Timor-Leste and other countries who fight for peace and security for themselves and their families? I think one of our most important roles is to provide positive role models for women’s involvement at all levels of decision making. My experience as one of three female Special Representatives of the Secretary-General leading peacekeeping missions is that the presence of a woman in high-level discussions can make a difference. The presence of a female leader can inspire other women in international, national, and local institutions to seek high offices. This was an important motivator for me when I worked in Afghanistan and Sudan, where cultural norms often kept women from holding decision-making positions.

We need female role models at every level of the institutions we support. That is why I encourage police-contributing countries to send a higher proportion of female police officers to Timor-Leste and other countries. The presence of women in uniform sends a clear signal to the population that women have a central role to play in maintaining public safety and security. Timor-Leste is leading the way for the United Nations in this regard—today, women make up almost 20 per cent of the country’s police service, while women represent only 6 per cent of the UN police in the country.

In other areas, however, Timor-Leste can make further strides. For example, only ten of the country’s 442 village chiefs are women. The United Nations should do all it can to help women reach such positions of responsibility traditionally reserved for men.

Women in decision-making positions can also ensure that women’s concerns and interests are taken into account when choices influencing peace and security are made. From my work in different conflict areas, I know that decision makers often fail to include women’s knowledge and interests when making policy. In Afghanistan, for example, the international community did not act as agriculture moved from traditional crops to narcotics. Women were not part of that decision-making process. Another example pertains to the methods used by disarmament programmes to identify combatants, which exclude women associated with or providing support to the armed forces. At the same time, reintegration programmes fail to take into account women’s specific needs for livelihoods. This happens even though we know that women’s abilities to make a living and provide for their families is a crucial factor in bringing a society back from conflict.

By failing to take advantage of women’s thinking and contributions in rural economies, and by underestimating the role women can play in averting the economic collapses that are often at the root of cycles of conflict, we miss important parts of the peace puzzle and risk investing in peace and security solutions that are likely to fail.
The international community has much to learn from Madalena Bi Dau Soares and Filomena dos Reis and their readiness to seek new ways to contribute to the security and well-being of their communities. If peace and stability are to be sustainable, women like them must be involved at every stage, from setting government strategy to carrying out projects, and from voting on laws to implementing them in the communities. As members of the United Nations, we must listen to women, recognize their transformative powers, and defend and promote their inclusion in every way that we can. If we are serious about peace—and we are—it is the only way forward.

Wednesday, July 20, 2011

The world's scientific and social network for malaria professionals


MalariaWorld Newsletter - publishing date: 06/24/2011
Latest scientific publications:


Jun 23, 2011 05:05 pm | Bart Knols


Jun 23, 2011 10:53 am | patrick sampao


Jun 23, 2011 10:14 am | Kabogo


Jun 23, 2011 10:08 am | Kabogo


Jun 23, 2011 03:25 am | Kabogo

Jun 23, 2011 03:02 am | Kabogo


Jun 23, 2011 02:59 am | Kabogo


Jun 23, 2011 02:51 am | Kabogo


Jun 23, 2011 02:43 am | Kabogo


Jun 22, 2011 10:53 am | patrick sampao


Jun 22, 2011 10:30 am | patrick sampao


Jun 22, 2011 10:17 am | patrick sampao


Jun 22, 2011 03:06 am | Kabogo


Jun 22, 2011 03:00 am | Kabogo


Jun 22, 2011 02:50 am | Kabogo


Jun 21, 2011 10:23 am | patrick sampao


Jun 21, 2011 10:05 am | patrick sampao


Jun 21, 2011 09:55 am | Kabogo


Jun 21, 2011 09:49 am | Kabogo


Jun 21, 2011 09:48 am | patrick sampao


Jun 21, 2011 09:01 am | Kabogo


Jun 21, 2011 03:27 am | Kabogo


Jun 21, 2011 03:15 am | Kabogo


Jun 21, 2011 03:08 am | Kabogo


Jun 21, 2011 02:55 am | Kabogo


Jun 21, 2011 02:51 am | Kabogo


Jun 21, 2011 02:47 am | Kabogo


Jun 20, 2011 10:21 am | patrick sampao


Jun 20, 2011 10:16 am | patrick sampao


Jun 18, 2011 11:09 am | Kabogo


Jun 18, 2011 11:05 am | Kabogo


Jun 18, 2011 10:09 am | patrick sampao


Jun 18, 2011 09:54 am | patrick sampao


Jun 18, 2011 09:32 am | patrick sampao


          
               

Monday, July 18, 2011

George Clooney Contracted Malaria in the Sudan... Again

latimes.com/health/boostershots/la-heb-george-clooney-201101,0,4348566.story

Source: latimes.com

George Clooney contracted malaria on Sudan visit -- and recovered, media reports say

By Mary Forgione, Tribune Health - January 20, 2011


George Clooney has perhaps learned an important lesson -- malaria makes traveling the globe a lot less fun than it should be.

Sure, it’s noble to go on philanthropic missions around the world, helping those who can’t help themselves, but it’s probably hard to feel noble when shaking from the chills. And Clooney should know. The actor apparently has just recovered from malaria, which he contracted in Africa earlier this month, media reports said Thursday.

CNN’s Piers Morgan on Wednesday night tweeted that Clooney was fighting the illness and posts this clip of the actor talking about his condition. Clooney apparently got the disease for a second time while in southern Sudan during the pivotal election for independence. People magazine ran a statement from a spokesman Thursday saying the actor is completely over the illness.

Malaria is a serious, sometimes fatal disease contracted by a mosquito bite, the Centers for Disease Control and Prevention says. And Clooney's illness highlights the risk that travelers face. Symptoms include high fevers, shaking chills, and flu-like illness. So take care -- take preventive drugs such as chloroquine phosphate and mefloquine before you go. Here's more information from the CDC.

The World Health Organization reports a risk of malaria in more than 100 countries and says about 30,000 international travelers get the disease each year. It also offers these tips:

"A. Be Aware of the risk, the incubation period and the main symptoms.
B. Avoid being Bitten by mosquitoes, especially between dusk and dawn.
C. Take antimalarial drugs ... to suppress infection where appropriate. D. Immediately seek diagnosis and treatment if a fever develops one week or more after entering an area where there is a malaria risk, and up to 3 months after departure."

So back to Clooney. He is scheduled to appear on Morgan’s show Friday night -- and talk about this recent bout with malaria.

Copyright © 2011, Los Angeles Times

Mosquito Subspecies Presents Challenge in Fighting Malaria

latimes.com/news/science/la-he-malaria-mosquito-20110204,0,3125160.story

Source: latimes.com

Mosquito subspecies presents challenge in fighting malaria

Efforts to wipe out the disease have focused on indoor mosquitoes, but a newly discovered type that's more susceptible to the parasite lives outdoors, where it's harder to battle.

By Amina Khan, Los Angeles Times

February 4, 2011

Researchers have discovered a previously unknown subspecies of mosquito in West Africa that is highly susceptible to the malaria parasite and whose existence may stymie efforts to eradicate the deadly disease.

Unlike the indoor-dwelling mosquitoes that are the usual targets of malaria eradication efforts, members of the newly described subgroup of the species Anopheles gambiae live outdoors, which means they're more difficult to kill, according to the study published online Thursday in the journal Science.

"We've got egg on our face," said William Black, a medical entomologist at Colorado State University who was not involved in the study. "We've been working with this mosquito for so long … and right under our noses, here's this other form of mosquito," he said — one that could force researchers "to start thinking about what's going on outside of those huts."

Malaria is an incurable blood disease caused by parasites in the genus Plasmodium. Mosquitoes spread the parasite by drawing blood from infected humans, becoming carriers themselves and then transmitting the parasite to other humans they bite.

Malaria victims suffer headaches, high fever, chills, vomiting, anemia and sometimes death. There are about 250 million cases and nearly 1 million deaths each year, according to the World Health Organization.

Anopheles gambiae is thought to be the most significant malaria transmitter in Africa, and it has resisted repeated efforts to wipe it out, said Kenneth Vernick, a vector geneticist at the Pasteur Institute in Paris who co-wrote the study. Malaria control projects going back to the 1970s have apparently failed because they used tactics such as indoor sprays and chemically treated bed netting that only targeted mosquitoes inside human homes.

One of the reasons for focusing on indoor insects "is that people imagine that mosquitoes that are in proximity to people might be the most epidemiologically important to transmit malaria," Vernick said. But there's another, less scientific reason as well, he added: "Because it's easy."

Outdoor mosquitoes, on the other hand, are notoriously difficult to kill, let alone capture to study in experiments. Without the benefit of walls and a roof, Vernick said, "you don't have a defined space to spray-bomb and catch them and have them fall on a sheet."

Instead of chasing after the adult insects, the researchers decided to search for them in the larval stage, when they're easier to capture. Mosquitoes breed close to human habitations in puddles of standing water that collects in tire-tracks or hoof prints, for example. In West Africa, standing bodies of water are hard to come by, so all types of mosquitoes would likely be forced to use common puddles to hatch their young.

The researchers traveled across Burkina Faso, collecting larvae from puddles around villages and growing thousands of mosquitoes over a four-year period. They genetically analyzed the young and found that only 43% of the larvae in the puddles were the indoor variety — meaning that 57% were not.

When the researchers fed the mosquitoes blood from humans who had malaria, 58% of the outdoor mosquitoes became infected with the parasite, compared with 35% of the indoor-resting ones.

Now scientists need to capture adult outdoor mosquitoes and study their feeding habits so they can determine whether the insects are a significant malaria threat, Black said. If so, he concluded, "it means we're going to have to change a lot of our control tactics."

amina.khan@latimes.com

Copyright © 2011, Los Angeles Times

Unique Anti-malarial Gets a Foothold

Smell of stinky feet just what malaria doctor ordered

By Marni Jameson, Orlando Sentinel
July 14, 2011.

Want to fend off mosquitoes and ultimately malaria? Wash your feet, or set out stinky sock traps.

Turns out, the smellier your feet, the more mosquitoes — which spread malaria — like them and you. Such was the discovery made by brave Dutch scientist Bart Knols, who, in the interest of us all, stood naked in a dark, mosquito-filled room to find out which parts of him mosquitoes found most edible.

Hands down it was his feet. And the more odorous they were, the more mosquitoes liked them.

Fast forward 15 years, and a new swarm of scientists have taken the funky-foot finding a step further. They are using foot odor to help control malaria.

Dr. Fredros Okuma, a researcher for Tanzania's Ifakara Health Institute, has replicated the odor — a fragrant blend of eight chemicals — and has put it in traps that lure mosquitoes and poison them. The traps were four times more attractive to mosquitoes than a human volunteer.

The simple solution appears so promising that The Bill and Melinda Gates Foundation has awarded two grants totaling $865,000 to Okuma for research on how the traps can be made affordable and used to help prevent the spread of disease in Africa.

Headlice Treatment Answer to Malaria?

Head lice drug may stem spread of malaria

By Daniela Hernandez, Los Angeles Times
July 16, 2011

U.S. researchers in Senegal have found that ivermectin helps kill off disease-carrying mosquitoes that feed from people with the drug in their system.

The drug, ivermectin, has been used in Africa for more than 15 years to treat river blindness, a parasitic disease that often leaves its victims blind and is common in the same regions where malaria is contracted.

Researchers have hit upon a potential new tool to fight the spread of malaria — a drug commonly used to treat head lice and heartworm.
The Colorado State University scientists made the discovery while in Senegal during malaria season in August 2008 and August 2009.

The drug, ivermectin, has been used in Africa for more than 15 years to treat river blindness, a parasitic disease that often leaves its victims blind and is common in the same regions where malaria is contracted. With the assistance of the Senegalese Ministry of Health, the team traveled to three villages where people were receiving ivermectin and collected mosquitoes from inside huts before and two weeks after they had been treated with a single dose of the drug.

The scientists reported in the July issue of the American Journal of Tropical Medicine and Hygiene that the number of malaria-carrying mosquitoes fell by 80% two weeks after the residents had received ivermectin. In untreated villages, the percentage of malaria-laden mosquitoes jumped more than twofold during that same period.
Ivermectin paralyzes mosquitoes if they feed from a person who has been treated with the medication, killing the bloodsuckers before they can infect their next victim. As long as it's in the bloodstream, the drug acts as a 24/7 insecticide that targets mosquitoes that manage to bite.

"There is reason for cautious optimism," commented David Sullivan, a microbiologist at the Johns Hopkins Bloomberg School of Public Health who was not involved in the study. However, he added that the results will need to be repeated to confirm that the drug is an effective tool to control malaria, which kills approximately 1 million people each year, many of them children.

Ivermectin is a particularly attractive anti-malaria strategy because much of the infrastructure to get the drug to affected areas is already in place, experts said.
One complication is that it is typically not given to children younger than 5, which might give mosquitoes "a refugee population in which to hide," said Tom Unnasch, a microbiologist at the University of South Florida who also was not involved in the study.
The study's lead author, Brian Foy, a microbiologist at Colorado State University, said he and his team are seeking funding to study whether monthly administration of the drug could have longer-term effects and to show that cases of malaria — not just numbers of disease-carrying mosquitoes — decline with the treatment.
"We need bigger and better studies," he said.
daniela.hernandez@latimes.com

Source and Copyright © 2011, Los Angeles Times

The Race is On: Polio and Guinea Worm Disease Targeted for Eradication


Water-related Diseases

Guinea-Worm Disease (Dracunculiasis)

The disease and how it affects people

Guinea worm disease is a debilitating and painful infection caused by a large nematode (roundworm), Dracunculus medinensis. It begins with a blister, usually on the leg. Around the time of its eruption, the person may experience itching, fever, swelling and burning sensations. Infected persons try to relieve the pain by immersing the infected part in water, usually open water sources such as ponds and shallow wells. This stimulates the worm to emerge and release thousands of larvae into the water. The larva is ingested by a water flea (cyclops), where it develops and becomes infective in two weeks. When a person drinks the water, the cyclops is dissolved by the acidity of the stomach, and the larva is activated and penetrates the gut wall. It develops and migrates through the subcutaneous tissue. After about one year, a blister forms and the mature worm, 1m long, tries to emerge, thus repeating the life cycle.
For persons living in remote areas with no access to medical care, healing of the ulcers can take several weeks. This can be further complicated by bacterial infection, stiff joints, arthritis and even permanent debilitating contractures of the limbs. People in endemic villages are incapacitated during peak agricultural activities. This can seriously affect their agricultural production and the availability of food in the household, and consequently the nutritional status of their family members, particularly young children.

Distribution

At the beginning of the 20th century, guinea-worm disease, was widespread in many countries in Africa and Asia. It is estimated that there were about 50 million cases in the 1950s. Due to concentrated efforts by the international community and the endemic countries, the number of cases of guinea-worm disease was reduced to about 96 000 by 1999. Guinea-worm disease is prevalent in only 13 countries in Africa including Sudan, Nigeria, Ghana, Burkina Faso, Niger, Togo and Côte d'Ivoire. A small number of cases have also been reported in Uganda, Benin, Mali, Mauritania, Ethiopia and Chad.

Scope of the Problem

Humans are the only known reservoirs for guinea-worm disease, and infection is through the use of contaminated water in remote rural areas of African countries. About two-thirds of the cases (66 000) reported in 1999 were from Sudan, where the continuing civil war is hampering efforts to eradicate the disease.

Interventions

Provision of safe drinking-water in rural and isolated areas is the pillar intervention to eliminate the disease. The disease disappeared from many countries such as from the Islamic Republic of Iran and Saudi Arabia due to improvement in water supply. In 1991, the World Health Assembly adopted a resolution to eradicate the disease.

Dracunculiasis Eradication Programme

WHO has promoted the eradication campaign, which focuses on: interruption of transmission of the disease; surveillance of new cases; and certification of eradication. Specific interventions include: health education, case containment, community-based surveillance systems, provision of safe water, including use of filtering devices and chemical treatment of water sources.
Prepared for World Water Day 2001. Reviewed by staff and experts from the cluster on Communicable Diseases (CDS), and Water, Sanitation and Health unit (WSH), World Health Organization (WHO).
YouTube Clip:
Guinea Worm Disease

Sunday, July 17, 2011

"The UN declared a 2nd disease eradicated off the face of the earth, surprised to read which one." Source @ Bill Gates

Rinderpest, Scourge of Cattle, Is Vanquished


F. Paladini
BEGONE Dr. William P. Taylor, in 1987 in Sudan, examined a cow for rinderpest. The United Nations is announcing this week that the disease has been wiped off the face of the earth.



On Tuesday in a ceremony in Rome, the United Nations is officially declaring that for only the second time in history, a disease has been wiped off the face of the earth.
Multimedia
 The Takeaway: Donald McNeil Talks About Rinderpest
G. R. Thomson
FIELD OF DEATH Cattle carcasses littered a pasture in South Africa in 1900 during a rinderpest epidemic.
HEADING HOME A herd in India in 2006. Rinderpest ended there in the '90s.

Readers’ Comments

Share your thoughts.
The disease is rinderpest.
Everyone has heard of smallpox. Very few have heard of the runner-up.
That’s because rinderpest is an epizootic, an animal disease. The name means “cattle plague” in German, and it is a relative of themeasles virus that infects cloven-hoofed beasts, including cattle, buffaloes, large antelopes and deer, pigs and warthogs, even giraffes and wildebeests. The most virulent strains killed 95 percent of the herds they attacked.
But rinderpest is hardly irrelevant to humans. It has been blamed for speeding the fall of the Roman Empire, aiding the conquests of Genghis Khan and hindering those of Charlemagne, opening the way for the French and Russian Revolutions, and subjugating East Africa to colonization.
Any society dependent on cattle — or relatives like African zebu, Asian water buffaloes or Himalayan yaks — was vulnerable.
As meat and milk, cattle were and are both food and income to peasant farmers, as well as the source of calves to sell and manure for fields. Until recently, they were the tractors that dragged plows and the trucks that hauled crops to market. When herds die, their owners starve.
The long but little-known campaign to conquer rinderpest is a tribute to the skill and bravery of “big animal” veterinarians, who fought the disease in remote and sometimes war-torn areas — across arid stretches of Africa bigger than Europe, in the Arabian desert and on the Mongolian steppes.
“The role of veterinarians in protecting society is underappreciated,” said Dr. Juan Lubroth, chief veterinary officer of the Food and Agriculture Organization of the United Nations, at whose headquarters Tuesday’s ceremony is being held. “We do more than just take care offleas, bathe mascots and vaccinate Pooch.”
The victory is also proof that the conquest of smallpox was not just an unrepeatable fluke, a golden medical moment that will never be seen again. Since it was declared eradicated in 1980, several other diseases — like polio, Guinea worm, river blindness, elephantiasis, measles and iodine deficiency — have frustrated intensive, costly efforts to do the same to them. The eradication of rinderpest shows what can be done when field commanders combine scientific advances and new tactics.
In 1998, a longtime leader of the effort, Sir Gordon R. Scott of the Center for Tropical Veterinary Medicine at the University of Edinburgh, wrote an article saying he had reluctantly concluded that it would fail.
“The major obstacle,” he wrote, “is man’s inhumanity to man. Rinderpest thrives in a milieu of armed conflict and fleeing refugee masses. Until world peace is secured, the nays win the argument.”
He cited Somalia, Sudan, Sri Lanka, Yemen and Kurdish parts of Iraq and Turkey as areas where war drove animals and their owners over borders and life was risky for vaccinators.
Dr. Scott will not be in Rome for the ceremony; he died in 2004. Yet perhaps without realizing it, he did outlive rinderpest. The last known case was in a wild buffalo tested in Mount Meru National Park in Kenya in 2001.
An Ancient Battle
The modern eradication campaign began in 1945, when the Food and Agriculture Organization was founded. But it became feasible only as vaccines improved. An 1893 version made from the bile of convalescent animals was replaced by vaccines grown in goats and rabbits and finally in laboratory cell lines; a heat-stable version was developed in the 1980s.
How long the ancient battle went on is uncertain. Although cattle die-offs did affect all the historical events mentioned above, there is uncertainty about which were from rinderpest and which were something else, like anthrax.
Death from rinderpest is rapid and nasty. Animals get feverish; their eyes and noses run. Their digestive tracts are inflamed from mouth to anus, and they die of diarrhea and protein loss.
But other diseases have overlapping symptoms, and a rapid diagnostic test that could be used next to a dying animal was not developed until the 1990s.
Until recently, it was assumed the disease existed as long ago as 10,000 B.C., when cattle were domesticated in the Indus Valley in what is now Pakistan. It was blamed for an epidemic in Egypt in 3,000 B.C. (the fifth plague of Moses fell on the pharaoh’s herds) and for the widespread die-offs that starved the Roman Empire in the face of fourth-century invaders. In the ninth century, it was the chief suspect in the “mortality upon the horned animals” in the British Isles.
Last year, however, Japanese geneticists studying rinderpest’s mutation patterns estimated that until about A.D. 1000, it was virtually identical to measles — making it likely that pandemics that killed only animals before that time had other causes, like anthrax or possibly an ancestor virus from which both measles and rinderpest evolved.
Some experts now believe the disease arose in the gray oxen of the Central Asian steppes and was swept forward in the trains of baggage and beasts that followed the Mongol armies in the 1200s as they conquered Eurasia from China to Poland. (The Mongols are also suspected of importing bubonic plague from South Asia in flea-bitten rats hiding in grain sacks.)
Like smallpox, rinderpest settled into a pattern of irregularly recurring pandemics, sometimes touched off by imports of Russian steppe cattle, in which the disease smoldered but rarely killed. The longer between waves, the more victims died.
With the exception of a brief, contained outbreak in Brazil in 1920, it did not reach the Americas. It touched Australia in 1923, but the authorities there stamped it out by slaughtering 3,000 animals.
Despite its proximity to Eurasia, Africa was spared until 1887, when the Italian Army, struggling to conquer Abyssinia, imported Indian cattle for food and draft power.
From the port of Massawa in present-day Eritrea, the virus exploded so fast that it reached South Africa within a decade (and is considered one of the factors that impoverished Boer farmers as war with the English approached). It doomed East Africa’s wandering herders, subsisting on milk mixed with cow blood. Historians believe a third of them or more starved to death.
The disease was still leaping water barriers as late as the 1980s, when Indian peacekeepersin Sri Lanka imported sick goats. Until 1999, war-torn Sri Lanka was one of the world’s last pockets of rinderpest.
Finding a Vaccine
As rinderpest advanced and receded over the centuries, it led to some important scientific advances.
In 1713, when it threatened the papal herds, Pope Clement XI asked his personal physician, Dr. Giovanni Maria Lancisi, to stop it. Dr. Lancisi was familiar with the work ofDr. Bernardino Ramazzini, a scholar at the University of Padua who accurately deduced that rinderpest spread by the “virulently poisoned breath of an ox” and its excretions and hide — not by fogs, astrology or other popular theories.
According to Dr. Scott, Dr. Lancisi prescribed quarantine measures that were nearly as brutal to humans as to cattle.
Charlatan “cures” were banned; priests were ordered to stop relying on prayer alone and to preach from the pulpit that all herds with any sick members were to be slaughtered and buried in lime, while healthy herds were to be kept isolated. Any layman who resisted or cheated was to be hanged, drawn and quartered. Any disobeying priest was to be sent to the galleys for life.
Within nine months, the outbreak in the Papal States was snuffed. In the rest of Europe — where Protestants disdained papal orders — it persisted for a century and killed 200 million cattle.
By the 1750s, dairymen in England and the Netherlands were experimenting with a crude early form of inoculation: soaking a cloth in a diseased cow’s mucus, then sewing it into a cut in a healthy cow. It did not always protect, and sometimes killed.
(This was 50 years before Dr. Edward Jenner became famous for preventing smallpox by vaccinating a boy with pus from a milkmaid’s cowpox blister. But Dr. Jenner was not the first; he got the credit because he successfully repeated the vaccination 23 times and published his results.)
In 1761, the first school of veterinary medicine was founded in Lyon, France, specifically to fight rinderpest.
In 1924, a new and devastating European outbreak was the impetus for creating theWorld Organization for Animal Health, the veterinary equivalent of the World Health Organization.
In that decade, the new Soviet Union finally realized the old czarist goal of eradicating rinderpest among steppe cattle.
Under Mao, China followed in the 1950s, relying on quarantine and slaughter measures like Dr. Lancisi’s (except that uncooperative farmers were only imprisoned).
India, however, struggled until 1995.
“You can’t slaughter cows in India,” said Dr. William P. Taylor, a rinderpest expert and technical adviser to that nation. But India did so well at vaccination that near the end it became a problem for global surveillance because health officials were reluctant to stop long enough to prove the disease was gone. (Vaccinated animals test positive despite theirimmunity.)
The Last Frontier
The intractable problem was Africa. The disease was in 32 countries there, and many had pastoralist tribes like the Fulani, Masai, Dinka and Afar, who lived on the borderless fringes and drove cattle up to 50 miles a day, having virtually no contact with governments and getting no veterinary bulletins.
“In the ’60s and ’70s, the biggest problem we had was to convince farmers to bring in their animals,” said Dr. Protus Atang, a former director of the African Union’s veterinary institute. “They believed vaccination brought disease.”
Others had a traditional prevention method — smearing feces from infected animals in the mouths of healthy ones.
Just reaching them was hard. Land Rovers broke down, gasoline and cash ran short. Vaccine was packaged with salt so it could be dissolved in saline, but in remote areas salt was so valuable that it would be stolen.
Announcing vaccination days “was advertising to rustlers where the herds would be that day,” said John Anderson, former chief of laboratory testing for the eradication drive. African veterinary officers were paid so poorly that they survived only through second jobs like breeding chickens or mending watches.
Despite all the drawbacks, by 1979 the effort looked successful, and was ended. By the mid-’80s, rinderpest returned.
“I think they just stopped too early to celebrate,” Dr. Anderson said. “No one’s exactly sure where it came back from.”
Smallpox eradication boosted morale, Dr. Atang said, and a second effort was mounted in 1986, followed by a third in 1998.
A crucial advance was a new vaccine that survived a month without refrigeration. That let herders who could be recruited do their own vaccinating. An education campaign using comic books, flip charts and lecturers who spoke local languages was begun.
“The way we previously did it was really mindless,” said Dr. Peter L. Roeder, who directed the final eradication drive after working on the two earlier ones. “We’d get up before dawn to drive long distances. We’d be wrestling the animals to the ground, it’d get stinking hot, and pretty soon the locals would get fed up and walk away.”
The cattle were nervous and hard to handle, and no wonder, he said: They lived day and night with their owners and now were being roped and tackled by white men wearing khaki and reeking of unfamiliar soaps and deodorants.
“But someone local, dressed as a local, with mutton fat rubbed in his hair, could walk among them and stick in a needle and barely be noticed,” Dr. Roeder said. “We’d be lucky to get 20 percent immunity in a herd; our local guys could get 90, 95 percent.”
His “Paul on the road to Damascus moment” he said, took place in 1991, as Ethiopia’s civil war ended and he could finally drive north.
“We were driving up the edge of the Rift Valley, dropping down into the bottom to meet the Afar people,” Dr. Roeder said, “and almost everywhere we found rinderpest and people crying out for vaccination.
“Later, sitting in a bar drinking smuggled Peroni beer, it came to us: It wasn’t necessary to constantly be doing mass vaccinations. We were trying to get 30 million cattle and never getting more than nine million. We needed to concentrate on these lowland areas where the virus was persistent. We could vaccinate two million and do better.”
While the upland had large, visible outbreaks, he explained, between them the virus lurked in the lowland herds as it had centuries before in steppe oxen. Since the older animals were all survivors and the 1-year-olds were protected by maternal antibodies, he reasoned, only the 2- to 3-year-olds were vulnerable, and their age could be estimated by looking at their teeth. If all members of that group were vaccinated, the virus would slowly disappear.
A later crucial development was the rapid diagnostic test.
In the same way presidents denied that their citizens had AIDS, they denied that their citizens’ cattle had rinderpest. Dr. Roeder said he once loaded a dead cow onto his pickup and drove it to the capital to insist it be tested. (He declined to name the country.)
The new tests, similar to pregnancy kits, but using an eye swab instead of urine, empowered local veterinary officials, said Dr. Anderson, their inventor. Officials in the capital could no longer just dismiss reports as misdiagnoses.
Even though the last known case was in 2001, officials waited 10 years to declare success, since surveillance is harder with animal diseases. Even in Somalia, where the last smallpox case was found, a dying child would be rushed to a hospital. A dying cow would just be left behind.
The whole campaign, from 1945 to the present, cost about $5 billion, the United Nations has estimated.
“At first I thought, that’s quite a lot,” Dr. Roeder said. “Then I thought, that last royal wedding cost $8 billion. This was cheap.”