Author: ihsection

The Communications Committee is working to revive the global health news round-up, which has been a popular feature in the past. Stay tuned!

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WHO has released its latest situation report on Zika virus. The Director-General has announced that the cluster of microcephaly and other neurologic disorders in Brazil is a Public Health Emergency of International Concern. Experts also agreed that there is an urgent need for coordinated international efforts to understand the relationship between Zika virus and such neurologic disorders.

Nearly 25% of the South Sudanese population face food insecurity and in need of food assistance. This is particularly worrisome because this increase in hunger has occurred during the post-harvest season, a time when the country has traditionally been food secure.

A recent article in Health Affairs assessed the return on investment from childhood immunization programs to prevent diseases associated with 10 antigens in low- and middle- income countries. Their study shows that net gains were greater than costs across all 10 antigens.

Dr. Paul Farmer and 16 others who comprise the Commission on a Global Health Risk Framework for the Future have said in their 130-page report that pandemics are inevitable and that a key solution is investing in the countries’ health systems.

An analysis of the data from the Global Burden of Disease 2013 Study published in JAMA Pediatrics showed that “road injuries were the leading cause of death among adolescents globally.” Road traffic injuries killed nearly 115,000 young people, compared with ~76,000 deaths due to HIV/AIDS.

by Abbhirami Rajagopal

Zika virus was originally reported in 1952 in the Transactions of Royal Society of Tropical Medicine and Hygiene. The original study involved placing a Rhesus monkey in a cage in the ZIka forest in Uganda. The monkey subsequently developed a fever and the researchers were identified a transmissible agent from its serum, and called it the ZIka virus. The virus belongs to the Flaviviridae virus family, related to dengue, yellow fever and West Nile virus, and it is transmitted by the day-time active mosquitoes, such as those of the genus Aedes.

CDC estimates that “about 1 in 5 people infected with Zika will get sick and for those who get sick, the illness is usually mild. The most common symptoms of Zika virus disease are fever, rash, joint pain, or conjunctivitis (red eyes). Symptoms typically begin 2 to 7 days after being bitten by an infected mosquito.”

Currently, the virus has spread to nearly 23 countries, with countries like Colombia reporting that they have about 20,000 confirmed cases that include ~2000 pregnant women. Pregnant women are the focus of this epidemic, as recent studies showed a link between Zika virus infection and microcephaly, a devastating birth defect that results in smaller brain size. CDC has issued travel warnings for nearly 25 countries, and several South American countries are strongly urging women to not get pregnant.

WHO recently declared Zika virus a global health emergency with the potential for infecting nearly 4 million people. In the US there have been 36 cases including 4 pregnant women and in Houston, where I live and work, thus far seven cases have been reported. All cases in the US are travel-related and not due to local transmission.

There is real concern at the alarming rise in the number of infected individuals. The other potential cause for worry might be the summer Olympics in Rio De Janeiro in a few months. Brazil has stepped up its surveillance program and the hope is that the cooler, drier climate will control the mosquito population.

President Obama has called on U.S. health officials and scientists to examine the link with microcephaly and rapid development and testing of vaccines for Zika virus.

While we wait, protect yourself from mosquito bites and if you are traveling make sure to check the CDC ZIka Virus page.

Our Section’s own Mary Anne Mercer was featured in the Winter edition of Johns Hopkins magazine! The piece tells the story of Dr. Mercer’s career in public health, with a particular focus on a program she developed in East Timor to decrease maternal mortality by combining a text-message alert service for pregnant women with a training program for midwives. The article is a slightly longer read, but here is an excerpt:

Back in Seattle, Mercer began writing SMS messages that could be sent to pregnant women, dispensing advice and reminders about how best to stay healthy. These were translated into Tetum, the most commonly spoken language in the country. HAI purchased smartphones to distribute to midwives, and Mercer flew out in January 2012 to oversee the first midwife training. The program was simple. When a woman came in for her first prenatal care visit, the midwife asked if she had a phone, and if she did, the midwife took her picture and some basic information: her name, her estimated due date, her phone number, the village in which she lived, and other pieces of identifying information. Then, twice a week, the woman began receiving messages appropriate for her stage of pregnancy. The first message read: “Congratulations on your pregnancy! You should be checked by the midwife at least 4 times at a health center to ensure a healthy pregnancy and healthy baby.” A first trimester message read, “During the [antenatal] visit the midwife will measure your blood pressure and feel your belly to see how your baby is growing and moving.” A message as the woman’s due date approached was, “The baby is getting bigger and may cause your back to hurt. You should stay active but try not to lift heavy things like water or other children.” The messages were meant in part to get women to think about having a midwife, now trained by HAI, present for the delivery. After birth, the messages continued for six weeks, with advice on postpartum and newborn care.

The program’s early results were so impressive that HAI and Catalpa International were asked to scale up the program into three new districts, with a tentative plan to expand to all of the country’s 13 districts in the next five years. In Manufahi, the number of deliveries in clinics rose by 70 percent, and total births assisted by a skilled attendant, whether at home or in a facility, increased by 32 percent. But Mercer is the first to take those numbers with a grain of salt. “There are a lot of complicated factors involved in evaluating whether the program works,” she says. The ultimate outcome they hope for, of course, is decreased maternal mortality. But those numbers are hard for HAI or the Timorese Ministry of Health to measure, given how expensive and difficult it is to gather them. So the key outcome measure remains whether the women use a midwife or doctor. In the most densely populated area with the largest number of midwifery staff—the places “close to the road,” as Mercer would have said in Nepal—the results were swift and impressive: more women came in for prenatal care visits, more women had their births attended by a skilled attendant, and more births occurred in a health facility.

The full article is available here.