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Dengue spreading fast, says WHO

In Dengue Fever, Uncategorized on January 21, 2013 at 8:35 am

January 20, 2013 in Health & Fitness

Dengue is the world’s fastest-spreading tropical disease and represents a “pandemic threat,” infecting an estimated 50 million people across all continents, the World Health Organisation (WHO) said on Wednesday.

Report by Reuters

Transmitted by the bite of female mosquitoes, the disease is occurring more widely due to increased movement of people and goods — including carrier objects such as bamboo plants and used tyres — as well as floods linked to climate change, the United Nations agency said.

The viral disease, which affected only a handful of areas in the 1950s, is now present in more than 125 countries — significantly more than malaria, historically the most notorious mosquito-borne disease.

The most advanced vaccine against dengue is only 30% effective, trials last year showed.

“In 2012, dengue ranked as the fastest spreading vector-borne viral disease with an epidemic potential in the world, registering a 30-fold increase in disease incidence over the past 50 years,” the WHO said in a statement.

Late last year, Europe suffered its first sustained outbreak since the 1920s, with 2 000 people infected on the Portuguese Atlantic island of Madeira.

Worldwide, two million cases of dengue are reported each year by 100 countries, mainly in Asia, Africa and Latin America, causing 5 000 to 6 000 deaths, said Raman Velayudhan, a specialist at the WHO’s control of neglected tropical diseases department.

But the true number is far higher as the disease has spread exponentially and is now present on all continents, he said.

“The WHO estimates that on average about 50 million cases occur every year. This is a very conservative estimate,” Velayudhan said, adding that some independent studies put the figure at 100 million.

“Dengue is the most threatening and fastest spreading mosquito-borne disease. It is pandemic-prone, but it is a threat only. Definitely a bigger threat now than ever,” he said

Malaria caused more deaths but was on the decline, affecting fewer than 100 countries.

Speaking to a news briefing after the WHO released a report on 17 neglected tropical diseases affecting 1 billion people, Velayudhan said: “The mosquito has silently expanded its distribution.

“So today you have [the] aedes mosquito in over 150 countries. The threat of dengue exists all across the globe.”

In Europe, the aedes mosquitoes that cause both dengue and chikungya disease have spread to 18 countries, often via the importation of ornamental bamboo or second-hand tires, he said.

“But we are trying to address this in a more systematic way, by controlling entry of vectors at points of entry — seaports, airports, as well as the ground crossings,” Velayudhan said, noting that it was hard to detect mosquitoes and their eggs.

The WHO also said it aimed to eliminate globally two neglected tropical diseases, dracunculiasis, known as guinea worm disease, in 2015, and yaws, or treponematoses, in 2020.

Symptoms of dengue

Dengue causes flu-like symptoms that subside in a few days in some sufferers. But the severe form of the disease requires hospitalisation for complications, including severe bleeding, that may be lethal.

There is no specific treatment but early detection and access to proper medical care lowers fatality rates below 1%, according to the Geneva-based WHO.

“You have to bear in mind that it has no treatment and vaccines are still in the research stage,” Velayudhan said.

The most advanced, being developed by French drugmaker Sanofi SA, proved only 30% effective in a large clinical trial in Thailand, far less than hoped, according to results published in September.

But researchers said it did show for the first time that a safe vaccine was possible.

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INDIA’S DENGUE FEVER EPIDEMIC RAISES ALARM

In Dengue Fever, Uncategorized on November 8, 2012 at 2:46 pm

Country has become the focal point for a mosquito-borne plague that is sweeping globe

By GARDINER HARRIS NYT NEWS SERVICE

Originally published November 7, 2012 at 12:01 a.m., updated November 6, 2012 at 6:07 p.m.

NEW DELHI — An epidemic of dengue fever in India is fostering a growing sense of alarm, even as government officials have publicly refused to acknowledge the scope of a problem experts say is threatening hundreds of millions of people, not just in India but around the world.

India has become the focal point for a mosquito-borne plague that is sweeping the globe. Reported in a handful of countries in the 1950s, dengue is now endemic in half the world’s nations.

“The global dengue problem is far worse than most people know, and it keeps getting worse,” said Raman Velayudhan, the World Health Organization’s lead dengue coordinator.

The tropical disease, though life-threatening for a tiny fraction of those infected, can be extremely painful for many who catch it. Growing numbers of Western tourists are returning from warm-weather vacations with the disease, and it’s pierced the shores of the United States and Europe. Last month, health officials in Miami announced a case of locally acquired dengue infection.

In India’s capital, hospitals are overrun and feverish patients are sharing beds and languishing in hallways. At Kalawati Saran Hospital, a pediatric facility, a large crowd of relatives lay on mats and blankets outside the hospital entrance recently.

Officials say 30,002 people in India had been sickened with dengue fever through October, a 59 percent jump from the 18,860 recorded in 2011. But the real number of Indians who get dengue fever annually is in the millions, several experts said.

“I’d conservatively estimate that there are 37 million dengue infections occurring every year in India, and maybe 227,500 hospitalizations,” said Scott Halstead, a tropical disease expert.

A senior Indian government health official, who agreed to speak about the matter only on the condition of anonymity, acknowledged that official figures represent a mere sliver of dengue’s toll. The government only counts cases of dengue that come from public hospitals and have been confirmed by laboratories, the official said. Such a census, “which was deliberated at the highest levels,” is a small subset that is nonetheless informative and comparable from one year to the next, he said.

“There is no denying that the actual number of cases would be much, much higher,” the official said. “Our interest has not been to arrive at an exact figure.”

The problem with that policy, said Manish Kakkar, a specialist at the Public Health Foundation of India, is that India’s “massive underreporting of cases” has contributed to the disease’s spread. Experts from around the world said that India’s failure to construct an adequate dengue surveillance system has impeded awareness of the illness’s vast reach, discouraged efforts to clean up the sources of the disease and slowed the search for a vaccine.

“When you look at the number of reported cases India has, it’s a joke,” said Harold Margolis, chief of the dengue branch at the Centers for Disease Control and Prevention in Atlanta.

Neighboring Sri Lanka, for instance, reported nearly three times as many dengue cases as India through August, according to WHO, even though India’s population is 60 times larger.

Part of India’s problem is that some officials view reports of dengue infections as politically damaging. A central piece of evidence for those who contend that India suffers hundreds of times more dengue cases than the government acknowledges is a recent and as yet unpublished study of dengue infections in West Bengal that found about the same presence of dengue as in Thailand, where almost every child is infected by dengue at least once before adulthood.

“I would say that anybody over the age of 20 in India has been infected with dengue,” said Timothy Endy, chief of infectious disease at Upstate Medical University in Syracuse.

For those who arrive in India as adults, “you have a reasonable expectation of getting dengue after a few months,” said Joseph Vinetz, a professor of medicine at the University of California San Diego. “If you stay for a longer period, it’s a certainty.”

Twenty years ago, 1 of every 50 tourists who returned from the tropics with fever was infected by dengue; now, it is 1 in 6.

http://www.utsandiego.com/news/2012/nov/07/tp-indias-dengue-fever-epidemic-raises-alarm/

Facing anti-malaria nets, mosquitoes alter habits

In Malaria, Uncategorized on September 24, 2012 at 9:06 am

“They found that mosquitoes seemed to change their hours of “peak aggression” from 2 or 3 a.m. to around 5 a.m. three years after nets were put up. And in one village, the proportion of mosquito bites inflicted outdoors rose.

http://in.reuters.com/article/2012/09/20/health-malaria-idINL4E8KK00520120920

Waking up to the Math of Malaria

In Malaria, Uncategorized on June 25, 2012 at 3:11 pm
Photo
Thu, Jun 21 2012

By Ed Cropley

JOHANNESBURG (Reuters) – To the minerals and mobiles underpinning Africa‘s pacy growth over the last decade, you may soon be able to add malaria – or at least its absence.

Besides the huge human cost imposed on the continent – 90 percent of the 655,000 deaths estimated worldwide in 2010 – the mosquito-borne disease is an economic millstone, draining public and private resources and hammering productivity.

According to a 2001 study co-authored by U.S. economist Jeffrey Sachs, the disease imposes an annual “growth penalty” of 1.3 percentage points on afflicted states, which includes most of those south of the Sahara apart from South Africa.

In Nigeria, Africa’s most populous nation and its biggest oil producer, malaria is responsible for up to 25 worker days lost per person per year, or two a month, due to direct infection or the need to stay at home to nurse a sick family member, often for a week or more.

In Zambia, it is the leading cause of absenteeism, accounting for more than twice as many days off as HIV/AIDS, and can consume up to 40 percent of the public health budget in cash-strapped frontline states.

It may not always be thus.

The number of malaria deaths has fallen dramatically in the last decade due to increased aid spending on basic items such as insecticide-treated bed nets and drugs, the World Health Organization (WHO) says.

More excitingly, the holy grail of a vaccine against a notoriously adaptable parasite no longer appears unobtainable after an experimental vaccine from GlaxoSmithKline was shown last year to halve the risk of African children getting the disease.

Even before the prospect of a vaccine, companies across Africa were waking up to the commercial sense of investing in a malaria-free workforce – and the results are encouraging governments to get in on the act.

Faced with endemic malaria in the 240,000 population town around its Obuasi gold mine in Ghana, AngloGold Ashanti, the world’s third largest bullion producer, launched a multi-pronged campaign of bed-nets, indoor insecticide spraying and drugs that cut infections from 79,237 in 2005 to fewer than 16,000 in 2008.

The program cost the Johannesburg-based firm $1.3 million a year, but over that time the malaria drug bill at the mine’s hospital dropped from $55,000 to $9,800 a month, while work days lost each month fell from 6,983 to just 282.

“It really made economic sense because of the absenteeism and the cost of medication,” said Steve Knowles, the head of AngloGold’s anti-malaria operations.

The Ghana model is now being extended to communities around its mines in Democratic Republic of Congo, Tanzania, Mali and Guinea, bringing as many as 500,000 people under its umbrella.

Europe’s financial crisis and relatively sluggish rich-world growth have left a question mark over cash pools such as the Global Fund to Fight AIDS, Tuberculosis and Malaria that have been complementing state and private sector efforts, threatening to unravel the gains made.

But Knowles said many governments were becoming increasingly aware of the mathematics of beating malaria and starting to put their own programs in place.

The prospect of an affordable vaccine is only going to increase the power of that argument for a region forecast to grow at 5.4 percent this year – even with malaria. Without it, that figure could be knocking on 7 percent.

“Now that they’re seeing the aid funding may not be there, it’s a bit of a wake-up call and governments are looking to do it themselves,” Knowles said. “What difference will a vaccine make? If it comes through, it’s going to be huge.”

(Editing by Ed Stoddard and Ron Askew)

http://www.reuters.com/article/2012/06/21/us-africa-money-idUSBRE85K0XI20120621

Predators, Prey and Lyme Disease

In Lyme Disease on June 23, 2012 at 6:25 pm

http://green.blogs.nytimes.com/2012/06/18/predators-prey-and-lyme-disease/

JUNE 18, 2012, 3:00 PM

Predators, Prey and Lyme Disease

By KELLY SLIVKA

Deer ticks are aptly named, in a sense; a Northeastern deer can carry over 1,000 of these ticks on its body. But as far as humans are concerned, the ticks might be more relevantly called mouse ticks. That’s because white-footed mice and other small mammals, not deer, are now known by scientists to be major carriers of Lyme disease.

Lyme disease is spreading in the Northeast and the Midwest, and according to the national Centers for Disease Control, the number of annual cases over the past decade has been increasing. However, no one is quite sure why. In a new study published in the Proceedings of the National Academy of Sciences, researchers tried to figure out what is driving the proliferation of Lyme disease in human populations by studying populations patterns in animals that interact with ticks. Their study suggests that large predators like coyotes and foxes that aren’t typically associated with Lyme disease transmission may have a big impact on the spread of the disease.

The life cycle of deer ticks depends on interactions in the entire ecosystem in which the ticks dwell, said Taal Levi, the study’s lead author, who did the research while a doctoral student at the University of California Santa Cruz and is now an ecologist at the Cary Institute of Ecosystem Studies in New York.

Ticks rely on “bloodmeals” from other animals to move through their three life stages: larva, nymph, and adult, Dr. Levi said. When the ticks hatch into larvae, the bacteria that causes Lyme disease, Borrelia burgdorferi, is not present.

For a tick larva to grow into a nymph, its next life stage, it needs blood. If the larva gets its blood meal from a mouse already carrying B. burgdorferi, the larva picks up the bacteria and becomes a carrier itself. It grows into a nymph and waits for its next host so it can get the blood meal necessary to grow into an adult tick. “Sometimes one of those nymphs doesn’t bite a small mammal but bites a person, and that’s where we get the disease,” Dr. Levi said.

While people used to blame deer for the spread of Lyme disease, Dr. Levi said that scientific evidence has indicated that deer probably aren’t significant transmitters of B. burgdorferi bacteria because their systems tend to quickly flush it out. But “some hosts, like white-footed mice, don’t clear it at all,” he said, which means the bacteria hang around long enough to be transmitted to ticks.

Dr. Levi hypothesized that because these small animals are prey, their abundance – and the spread of the Lyme disease bacteria within them – depends on the abundance of their predators. In the study, he and his colleagues did a computer analysis of known cases of Lyme disease and population data for red foxes — a key predator of rodents — in four states with a high prevalence of the disease: Minnesota, Wisconsin, Pennsylvania and Virginia. For good measure, they also compared deer populations with the tally of Lyme disease cases in Wisconsin, Pennsylvania, Virginia and New York.

The models showed higher numbers of Lyme disease cases in places where there are fewer foxes. They detected no significant relationship between numbers of deer and numbers of Lyme disease cases.

The researchers also ran computer programs comparing Lyme disease cases with coyote populations in the states where they modeled red fox populations. As coyotes have spread through the Midwest and Northeast, they have tended to displace foxes, Dr. Levi said.

But coyotes don’t generally pack themselves as tightly into an area as foxes, meaning that there tend to be fewer coyotes in an area than there were foxes. “If you replace fox habitat with coyote-occupied habitat, you lose a large number of predators, and those predators you’ve lost consumed a high number of mammals,” Dr. Levi said. So the models showed a significant relationship between high numbers of coyotes and high numbers of Lyme disease cases.

So: more coyotes equals fewer foxes, which means fewer predators, which means more small animals are running around that could be carrying the bacteria for Lyme disease. More bacteria is therefore transmitted to more ticks, which then transmit the bacteria to humans. It’s complicated.

In fact, it’s so complicated that Maria Diuk-Wasser, an epidemiologist at the Yale School for Public Health who was not involved in the study, said she was skeptical about the connections drawn between top predators and Lyme disease cases in the study.

Modeling patterns can show relationships between data, but not necessarily the causes of the relationships, she pointed out. For example, to say that there’s a correlation between the number of coyotes in an area and the number of cases of Lyme disease reported there is different than saying that a high number of coyotes in an area causes more cases of Lyme disease in humans.

“What they say is plausible,” Dr. Diuk-Wasser said. But she said she wanted to see more experimental studies performed out in the field to support the models. The models in the study use historical population data recorded by hunters and state wildlife management services rather than data collected specifically for the study.

Dr. Diuk-Wasser said that birds are also major carriers of Lyme disease bacteria and might be even more significant carriers than rodents because of the distances they can easily travel.

Given the health implications, “understanding the ecological mechanisms that drive Lyme disease in nature is very important,” she said.

Rio Declares Dengue Epidemic

In Dengue Fever on April 30, 2012 at 8:35 am

Transmitted by mosquitoes, dengue can cause fever, headaches, rashes and bleeding.

By Agence France-PresseWed, Apr 25 2012 at 1:13 PM EST
A boy receives a handout as part of a preventive campaign against dengue fever
AWARENESS: A boy receives a handout as part of a preventive campaign against dengue fever in Brazil in 2011. (Photo: ZUMA Press)
RIO DE JANEIRO — Rio de Janeiro has declared a dengue epidemic after diagnosing more than 50,000 cases of the tropical mosquito-borne infection this year and over 500 in the last week alone.
“We have a plan focused on the epidemic and we continue to be in a state of alert,” Hans Dohmann, the city’s health secretary, said late on April 24, adding that the number of cases had surpassed 300 per 100,000 residents per month.
State-run Agencia Brasil meanwhile reported that 517 people had been struck with the disease last week alone.
The state of Rio de Janeiro has reported a total of 64,423 confirmed cases thus far this year, with 13 deaths, 12 in the city itself.
Last year authorities recorded 168,242 cases and 140 deaths.
Dengue is caused by any one of four viruses transmitted by Aedes aegypti mosquitoes.
Symptoms include high fever, severe headaches, pain behind the eyes, skin rash and mild bleeding. In its advanced stage the disease causes hemorrhages.
The World Health Organization estimates there are 50-100 million dengue infections worldwide each year.
Copyright 2012  AFP Global Edition

Massive US Effort vs Dengue Fever in Pacific

In Dengue Fever, Uncategorized on November 11, 2011 at 9:23 pm

Marshall Islands: US backs big response to dengue outbreak

Via Fiji Times OnlineUS backs big response to dengue outbreak. Excerpt:

With the number of confirmed dengue fever cases in the Marshall Islands skyrocketing to 579 people as of Wednesday, the capital city of Majuro has launched an aggressive campaign to eradicate mosquitoes with the help of experts from the United States.

Bolstering the dengue control effort is a US Navy team that arrived in Majuro this week to kill mosquitoes with pesticides.

Nearly all the dengue fever cases are on Majuro, with only three confirmed on nearby Arno Atoll.

In response to the outbreak, the US government has mounted a large-scale response involving the US Centers for Disease Control and US Naval Medical Research Unit 2 Pacific.

The World Health Organisation is also on sight as officials work to treat patients pouring into the hospital and eradicate mosquito-breeding areas.

The CDC sent in a team of doctors and entomologists who are working to assess the mosquito varieties causing the outbreak, assisting Majuro Hospital doctors and nurses to treat the many people hospitalized, and developing strategies for containing the illness.

The US Naval Medical Research Unit 2 Pacific sent a five-person insecticide spray team to Majuro early this week. The team members are experts in mosquito control and are all certified by the Defense Department as pesticide applicators, said the Navy unit’s Executive Officer Captain George Schoeler.

“At the request of the Marshall Islands government our team brings the capability to help the CDC and World Health Organizations teams already at work to get this outbreak under control,” Schoeler said.

Cambodia launches campaign to mark national day against dengue

In Dengue Fever on June 20, 2011 at 4:49 am

PHNOM PENH (Xinhua) – Cambodia launched a large-scale campaign here on Monday to mark the national day against dengue fever as the country’s annual rainy season came.

The event was jointly launched by Minister of Health Mam Bunheng and Minister of Education Im Sithy, and participated by government officials, representatives of World Health Organization, relevant stakeholders and some 500 students.

Speaking during the launching, Mam Bunheng said that the celebration was to promote awareness among the public and to encourage them to join together to prevent dengue fever.

“Dengue is caused by mosquitoes, so to prevent the disease, I’d like to appeal to all parents, guardians and students to kill larvae by using the chemical substance known as Abate in water pots and other still water sources,” he said. “Moreover, we have to fill in puddles around houses, which are sources of mosquitoes.”

The minister also encouraged people to sleep under mosquito nets and to raise “seven-colored” fish in their water pots to eat larva.

The outbreak of dengue fever usually begins at the onset of the rainy season from May to October in Cambodia.

The disease causes an acute illness of sudden onset that usually follows symptoms such as headache, fever, exhaustion, severe muscle and joint pain, swollen glands and rash.

At least 11 Cambodian children have died from the disease so far this year with other 1,924 infected, said Ngan Chantha, Director of Dengue Control at the Ministry of Health. It is “a sharp increase” from last year’s 7 deaths with 1,395 infected cases. More

 

 

141 Repellent covered on Fox 31 in Denver

In DEET, Dengue Fever, Malaria, Uncategorized on May 19, 2011 at 8:10 am

“Tracz hopes that his company’s natural pine-oil derivative will be the first non-toxic alternative to DDT, and he believes it could change the face of disease control in the developing world.

The name of his company, 141 Repellent, is based on a business model that means just that: one for one. For every bottle the company sells, it will donate one malaria treatment for a bed net in the developing world.” http://www.kdvr.com/health/la-he-summer-health-natural-repellent20110601,0,4142738.story

Op-Ed: Oz. of Prevention vs Lb(s). of Cure?

In Dengue Fever, Malaria, Uncategorized on April 12, 2011 at 1:06 pm

I was asked to write this as part of the Malaria No More Griot project-dt Dennis Tracz of 141 Repellent

The global disease control community including the World Health Organization, UN, US Govt and NGO’s were energized by Bill and Melinda Gates calling for the ERADICATION of malaria rather than just trying to control the disease.

“Advances in science and medicine, promising research, and the rising concern of people around the world represent an historic opportunity not just to treat malaria or to control it—but to chart a long-term course to eradicate it,” said Melinda Gates in October 2007.

Pound(s) of Cure

Billions of dollars have been invested in research designed to eradicate malaria through the development of vaccines and lethal insecticides impregnated in bed nets. Some people are even shooting lasers at mosquitoes! After WWII grand efforts to eliminate malaria with DDT met with mixed results but certainly drove down deaths from the disease.

Indiscriminate spraying of DDT and other chemicals soon caused mosquitoes to develop resistance against the lethal effects. DDT also created environmental concerns especially with bird egg shells. Many believe the Bald Eagle was almost driven to extinction by DDT and other pesticides. The US banned DDT in the early 1970’s for any use and most of the world followed with similar restrictions except for DDT’s use in malaria disease control. WHO approved DDT for restricted use for spraying on the walls of homes and in treated bed nets.

Since almost all R&D investment is for eradicating malaria, any solution that doesn’t kill the mosquito or treat the symptoms like a vaccine or medicine is ignored. Scientists are racing to develop even more toxic insecticides while a vaccine still eludes researchers.

Ounce of Prevention

DDT and many other chemicals, primarily insecticides made from pyrethroids, are used to treat bed nets with the idea that if a mosquito lands on the bed net the insecticide treatment will kill the insect. Indoor Residual Spraying (IRS) follows the same logic by spraying the interior walls of huts with insecticide.  While only 12% of homes have IRS treatment many more have and are using bednets with signs of success but at a high cost

Surprise! A Spatial Repellent

Some researchers have discovered a surprising benefit from DDT in IRS applications. While mosquitoes have developed resistance to the toxicity of DDT they are repelled by a spatial repellent effect.  Homes that have been treated by DDT seem to PREVENT the mosquitoes carrying malaria from entering the home in the first place. This spatial repellent action and its effectiveness in preventing mosquito bites is the primary reason that WHO and other organizations continue to support the use of DDT in malaria disease control. It doesn’t kill them, just keeps them out of your home!

Here is a chart showing both the spatial repellency and the contact irritancy (mosquitoes fly off because of irritation from the chemical) DDT is far more effective than any other chemical for both spatial repellency and contact irritancy.

My company, 141 Repellent, is developing a new active ingredient in partnership with the USDA that has demonstrated spatial repellency in tests by the US Govt.  Combining a spatial repellent with no toxicity for use in malaria disease control is not in line with current thinking of developing lethal solutions but can save millions of lives if implemented.  An internationally known senior scientist in the malaria field said this about isolongifolenone, our new plant-based active ingredient:

“It could have huge impact saving lives.  It could have utility not only for use in malaria programs but could have huge impact in the control of other diseases… A non- toxic compound would be an absolute first in this business of disease control.  Actually, lets be honest, there really is no such thing as a non-toxic chemical.  However, there is potential that your chemicals are much safer than chemicals in present use.  The reason I say this is that each of the chemicals in use today are in use precisely because they are toxic–your chemicals will be the exception.

There are many obstacles to adopting our ounce of prevention as a solution to malaria but we remain optimistic that we can help millions of people avoid malaria until a permanent solution such as a vaccine can be developed.

The author is the founder and CEO of 141 Repellent, Inc.


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