I always love spotlighting polio eradication. Along with Guinea worm, it is one of the few candidates to follow smallpox to the eternal (or so we all hope) halls of eradicated diseases. While the eradication effort has suffered its setbacks in recent years, public health workers have persisted, steadily marching onward. And frankly, there has been so much hand-wringing in global health in recent weeks that it is important to occasionally remember that there are still wins we can, and should, celebrate.
What makes this success possible in addition to trackable is the global network of polio surveillance systems, which was featured in CDC’s MMWR at the beginning of April:
The primary means of detecting poliovirus transmission is surveillance for acute flaccid paralysis (AFP) among children aged [less than] 15 years, combined with collection and testing of stool specimens from persons with AFP for detection of WPV and vaccine-derived polioviruses (VDPVs)…in WHO-accredited laboratories within the Global Polio Laboratory Network. AFP surveillance is supplemented by environmental surveillance for polioviruses in sewage from selected locations. Genomic sequencing of the VP1-coding region of isolated polioviruses enables mapping transmission by time and place, assessment of potential gaps in surveillance, and identification of the emergence of VDPVs. For public health nerds like me, all of MMWR’s polio reports can be found here.
Basically, a combination of syndromic and environmental surveillance allows public health systems to track polio where it pops up, and genetic sequencing helps to trace how the virus got to where it did to shed light on transmission patterns and find gaps in surveillance.
The WHO followed with two YouTube videos featuring the global polio surveillance system and polio vaccination, which is what will make eradication possible:
This is all pretty straightforward stuff – we all know generally that surveillance systems do, in fact, work when their infrastructure is properly supported and that children should be vaccinated against polio. But it’s important to not lose focus on our successes and global health progress, even when it is simple, straightforward, and sometimes slow.
I came across a very encouraging article in last week’s MMWR (the CDC’s Morbidity and Mortality Weekly Report) this morning about polio eradication. After several reappearances in 2013, cases are down again this year and, if things continue to go well, the end may be in sight:
Four of six WHO regions have been certified as free of indigenous WPV, and endemic transmission of WPV continued in only three countries in 2014. In 2013, the global polio eradication effort suffered setbacks with outbreaks in the Horn of Africa, Central Africa, and the Middle East; however, significant progress was made in 2014 in response to all three outbreaks. Nonetheless, the affected regions remain vulnerable to WPV re-importation from endemic areas and to low-level, undetected WPV circulation. Continued response activities are needed in these regions to further strengthen AFP surveillance and eliminate immunity gaps through high-quality SIAs and strong routine immunization programs.
Progress in Nigeria since 2012 has brought the goal of interrupting the last known chains of indigenous WPV transmission in Africa within reach. Elimination of all poliovirus transmission in Nigeria in the near term is feasible, through intensified efforts to 1) interrupt cVDPV2 transmission, 2) strengthen routine immunization services, and 3) increase access to children in insecure areas. Similar efforts should be implemented in all countries in Africa, where 9 months have passed without a reported WPV case, and 6 months have passed since the last reported cVDPV2 case.
The eradication push has suffered major blows in the last two years. In 2013, after six years of being polio-free, a major outbreak in Somalia contributed more polio cases to the year’s tally than the rest of the world combined; meanwhile, the virus made its way back into Syria that same fall after a 14-year hiatus. Luckily, extraordinary efforts in the midst of conflict zones on the part of health workers were able to beat the virus back to the heart of the fight – the final three countries in which it remains endemic.
Most (86%) WPV cases in Afghanistan in 2014 resulted from importation from Pakistan; however, the detection of orphan viruses highlights the need to strengthen the quality of both polio vaccination and AFP surveillance (10). Efforts are also needed to increase population immunity by intensifying routine polio immunization activities to ensure high coverage among infants with at least 3 OPV doses.
Recent challenges to the secure operation and public acceptance of the polio eradication program in Pakistan are unprecedented (10). Although poliovirus transmission has been concentrated primarily in the FATA region of northwest Pakistan, transmission has continued in the greater Karachi area, and WPV cases have been reported from all major Pakistan provinces. Successful efforts to enhance security to protect health workers and increase public demand for vaccination are urgently needed.
The recent gains in control and elimination of poliovirus transmission globally must be maintained and built upon through innovative strategies to access populations during SIAs in areas with complex security and political challenges, improve AFP surveillance, and strengthen routine immunization. With the progress achieved in 2014 to interrupt endemic WPV transmission in Nigeria and polio outbreaks in Africa and the Middle East, permanent interruption of global poliovirus transmission appears possible in the near future, provided that similar progress can be made in Afghanistan and Pakistan; progress there would also reduce the risk for future importation-related outbreaks in polio-free countries.
While there have been several cases of circulating vaccine-derived poliovirus in northern Nigeria, the fact that no wild poliovirus has been seen in the country since last July is extremely encouraging – eradication in Africa may be in sight. The final stronghold will be Pakistan and Afghanistan (primarily its regions that border Pakistan) – where, as the global health community has discussed ad nauseum, militants take advantage of the lack of public trust in eradication owing to bad intelligence schemes, among other things.
Obviously, it is still too early to tell. Gaps in surveillance mean incomplete data; there are most likely more cases that have not been reported. Furthermore, ongoing conflict (not to mention the recent Ebola outbreak) has left the health systems of many countries devastated, so vulnerabilities are everywhere. Nevertheless, with continued dedication (and a little luck), we may very well get there. Here’s hoping.
The Food and Drug Administration has announced that it will begin exercising its authority given under a 2009 law, power to regulate cigarettes and other tobacco products that they believe pose public health risks.
In an effort intensify campaign to publicize new health insurance options and to persuade consumers, the White House is recruiting mayors, county commissioners and other local officials.
A health check program has been launched in Accra, in order to reach out to the people of Ghana who are challenged with non-communicable diseases (NCDS), in an affordable and effective way.
The United Kingdom (UK) is starting a rotavirus vaccination program to protect the babies from infection which causes diarrhea, vomiting, abdominal pain, fever and dehydration.
Ben & Catherine Ivy foundation grants more that $9 million for brain cancer research.
To help avert 3 million AIDS deaths by 2025, the World Health Organization (WHO) through its guidelines is recommending the patients the start medicine at earlier stage of the deadly disease.
According to global Diabetes attitudes, wishes and needs 2 study one in five people with diabetes feel discriminated against them because of their condition. About 16% people suffering from this condition are at risk of depression.
According to the United Nations Program on HIV/AIDS (UNAIDS), Ghana cuts new HIV infections among children by 76% since 2009. It states that one three in ten children in need of treatment have access to it.
A report released by the United Nations state that Nigeria has highest number of children with HIV/AIDS virus in the world. It states that the incidence rate has not increased much but the increase in the prevalence rate has remained stagnant.
According to the scientists, new World Health Organization (WHO) test- based approach against malaria does not work everywhere. There must be a hard diagnosis before the disease is treated.
According to the research results published in the Journal of Infectious diseases, infant rotavirus vaccine is effective against this disease in Ghana. Results showed a significant response in parameters of efficacy, safety and immune impact of vaccine.
A study published in the journal’ Diabetologia’, ethnicity should be considered while making guidelines for physical activity. They state that south Asians need more exercise than white Europeans to reduce diabetes risk.
According to a research review published in BMJ, high consumption of fish reduces risk of breast cancer by 14%. It replenishes the body with all omega 3 essential fatty acids which can only be acquired from external sources as body cannot manufacture it.
In a study published in Cell Transplantation journal, type 2 diabetes patients who receive self-donated bone marrow stem cells require less insulin. According to the scientist’s good glycemic control appeared as a critical factor in the transplanted and non-transplanted control group.
A study indicates that consuming more than 2-3 standard alcohol drinks per day is linked to deadly digestive tract cancers including mouth, throat, larynx and esophageal. They also warn of risk of bowel, breast and prostate cancers.
The scientists have found out that the patients of Crohn’s disease also have a virus – enterovirus in their intestines as compared to those who did not have this disease. It also said that the genes associated with the onset of this disease are vital for the immune response against this virus.
According to the researcher’s malaria parasite are full of iron which they cannot digest nor can excrete them. Their invention- hand-held battery operated malaria detector will use the power of magnets to detect them.
Diseases & Disasters:
Reports state that Lusaka (Zambia) records approximately 185 new HIV/ AIDS infections every day. It has high prevalence rate of 20.8 percent as compared to the other districts of Zambia.
The cholera epidemic in the Democratic Republic of the Congo claims lives of 257 people. Lack of proper sanitation and clear water are stated to be the main cause of the outbreak.
Polio outbreak in Somalia jeopardizes global eradication. Before this there was no case of this disease for more than five years. This outbreak is reported in its early stages and WHO experts see more cases coming in next few weeks.
A report released by Greenpeace suggests that a Chinese herbal medicine contains a variety of pesticides. It is increasingly accepted in the western countries for medicinal use.
Reports have shown a new trend of HIV infection among the youths of Manipur (India). Unsafe sex practice has been indicated to be the major mode of HIV transmission among them.
According to the UK’s Medicines and Healthcare Products Regulatory Agency (MHRA). Diclofenac, a common painkiller raises the risk of heart attack and stroke among the patients with serious underlying heart conditions.
Health officials are warning that tularemia cases are on rise in New Mexico. Four cases have been so far been reported.
Japan and Poland are facing epidemic of rubella. Travel warnings have been issued by the Centers for Disease Control and Prevention for the pregnant females visiting these countries.
May 31 was observed as World anti-tobacco day by the World Health Organization.
The Fitness Industry Council Canada has announced June 1 as National Health and Fitness Day.
Politics and Policies:
The Republic of Congo has passed a law that prohibits the purchase, consumption and possession of tobacco for minors, pregnant women and mentally ill. The advising and any kind of promotion of tobacco are also prohibited in the country. Smoking is prohibited in public places.
According to the World Health Organization On June 10thEthiopia is launching an emergency mass-vaccination campaign against yellow fever.
According to the Ghana’s Minister of Health, the country is committed to ban all forms of tobacco advertisements and promotions.
Russia’s smoking ban came into effect on Saturday. It involves no smoking in public places and curbing cigarette advertising and sales.
The World Health Organization (WHO) in Gambia is launching polio campaign to vaccinate 400,000 children under five years.
The Ministry of Finance of Lesotho has signed two agreements totaling $17 million with the Global Fund to fight against HIV/AIDS, tuberculosis and malaria.
Professionals for Humanity International (PROFOH) have announced its third free medical screening in this year in Nigeria.
After the discovery of polio this week, United Nations emergency team rushes to vaccinate 424,000 people living in a refugee camp in Kenya.
Zimbabwe is going to conduct its first national tuberculosis prevalence survey with an objective to determine the national prevalence of bacteriologically-confirmed pulmonary TB among people aged 15 and over.
Rotary India extends its help to Pakistan in its polio vaccination drive.
The World Health Organization is calling on the countries to ban advertising about the tobacco products.
Improvement of maternal health and reduction in child mortality in some countries was highlighted in a recently released report ‘Accountability for Maternal, newborn and Child Survival ‘.
According to the director of the National Institute of Combat of HIV (INLS), the prevalence of HIV in Angola has not changed since 1997.
According to the researchers patients who have developed oral cancer due to HPV can have sex with their spouses or long term partners.
According to a study done by the researchers at the Institute for Clinical Evaluative Sciences, rates of diabetes have jumped 15 fold within a decade for the Chinese Canadians.
A systemic review confirms that the licensed medicines for smoking cessation are successful in assisting people to quit smoking.
Scientists are using new optics-based single virus detecting methods for determining the exact viral load of a sample by counting individual virus sample.
New malaria vaccine developed by the team Japanese researchers has cut the infection rates by 72%.
A study conducted in over 13 hospitals in Indonesia, Singapore, Thailand and Vietnam shows that doubling Tamiflu vaccine dose does not help in severe flu.
Results of a study warn development of resistance to drug used in treatment of H7N9 virus.
A group of scientists discover how a single gene mutation helps brain cancer cells to survive and drive tumor growth.
According to the United Nations scientists, Fukushima No.1 nuclear plant has very low radiation doses and there is no increased risk of cancer on local residents.
According to the experts nearly one-sixth of young adults in Sri Lanka are overweight. Lack of nutrition education and food culture of the country are reasons for this problem.
A study states that particular combination of bacteria in the human digestive system can identify patients who have or are likely to develop Type 2 diabetes.
A study shows that the Coenzyme Q10 cuts the mortality rate by half in heart failure patients.
Report released by EU says that several new health risks are emerging from new chemicals, products and changing lifestyle patterns. It is important to address these issues all together.
The International Labor Organization celebrates the World day for Safety and Health at Work on the 28th of April, 2013.
Politics and Policies:
The State House of Representatives voted to allow physicians to prescribe marijuana to patients with specific terminal illnesses or debilitating medical conditions.
Health officials in Australia have recommended a heavy government subsidy for the abortifacient drug RU-486.
First online mapping tool was launched in Kenya to tackle the burden of malaria by tracking insecticide resistance in malaria causing mosquitoes.
Healthcare workers expanding their vaccination programs in Somalia. The country is among the first few African Nations to receive new vaccines against five deadly diseases- diphtheria, tetanus, whooping cough, hepatitis B and influenza.
Peace Corps volunteers on the occasion of World Malaria day participated in malaria eradication activities worldwide.
In their sixth ordinary session at the African Union the African Union Commission has called for more domestic investment in health to fight the increasing burden of non-communicable diseases and tropical diseases.
The Ministry of Heath of Ghana receives mobile clinic facilitates to boost health delivery and improving health care access to people.
Health groups at the United Nations –backed Global Vaccine Summit announced that they will get rid of polio by 2018 with $5.5 billion vaccination and monitoring plan to stop this disease.
The U.S Food and Drug Administration has announced the development of a new hand held device called C-3 capable of detecting substandard or counterfeit anti-malaria medicines.
World athletics governing body IAAF will open a blood test center (BTC) in Kenya’s rift Valley town of Eldoret for Kenyan and Ethiopian runners.
A donation of US $2.3 million has been announced by the Government of Japan to the United Nations World Food Program to assist people of Lesotho to help to boost food security.
Japan donates US$1.5 million to Nambia for its rapid reduction of child mortality, malaria related deaths and mother-to-child HIV transmission rates.
The Federal government of Canada will allocate $250 million between 2013 and 2018 to support eradication of polio in Afghanistan, Nigeria and Pakistan.
European Union has pledged more than 14.5 million euros to support Sudan health-related programs.
The International Union against Tuberculosis and Lung disease has issued guidelines for multidrug resistant tuberculosis bacteria management – appropriate treatment.
According to an analysis of previous studies published in the British Medical Journal, smokers with HIV were at double risk of contracting bacteria pneumonia compared to HIV-positive non-smokers.
According to the data obtained from a recently published study, childhood malaria admission rates in three out of four hospital chosen for the purpose of study in Malawi has increased between 2000- 2010. An increase from 41 to 100% was noted.
According to a survey more men die due to HIV related deaths as compared to women. It was due their living in denial and failed access to treatment.
A study published in American College of Nutrition suggests that intake of minerals zinc and chromium or taking zinc and or chromium supplements helps people suffering from type 2 diabetes.
According to a survey in done in the U.K., parents risk children’s future health by failing to understand sun protection.
In a study done by the Chinese scientists there is no evidence that new bid flu passes between people.