Malaria - progress in the fight

Malaria is projected to kill more than 430,000 people this year. That's bad enough, but it represents a cut of around 60 per cent since 2000, the year the disease was targeted by the UN's Millennium Development Goals programme.

The WHO says 6 million lives have been saved. Its director general, Dr Margaret Chan, describes this as 'one of the great public health success stories of the past 15 years. It's a sign that our strategies are on target, and that we can beat this ancient killer.' 

Nearly 70 per cent of the reduction is put down to the distribution of a billion insecticide-treated bed nets. But there are some worrying signs. The mosquitoes that carry the disease are becoming more resistant to some insecticides, and the rate at which cases are being reduced is falling. 

Africa still accounts for about 80 per cent of all cases. (See also my posts of 11 June 2009, 23 May 2012, 23 Sept 2011, 29 April 2013.) 

Ebola survivors afflicted by mysterious after effects

Hopes are rising that the worst of the Ebola epidemic in West Africa may finally be over. Liberia, once the worst affected country, has had no new case since March 27, and it is hoped it will be declared Ebola free this week.

But signs are emerging of a disturbing ‘post-Ebola syndrome’ which seems to be affecting some survivors, who are reporting a variety of symptoms such as loss of sight and hearing. A WHO official said she had come across two people who were now blind.

Other complaints include severe joint, muscle and chest pain, and extreme fatigue. Experts acknowledge that so far the focus has, understandably, been on trying to save people’s lives, and that little research has been done on the disease’s long term effects, so that it is not even clear whether the symptoms reported are caused by the illness or its treatment.

The current outbreak is by far the deadliest the world has ever seen, killing 11,000 people. The previous worst came in 1976 when 280 died.  (See also my blogs of April 4, June 7, Aug 8, Oct 30, 2014, and Jan 29, Feb 16, 2015.)

*Thanks to York Library, New Hampshire for this listing of my book Disaster!  http://www.seacoastonline.com/article/20150428/NEWS/150429058/101017/NEWS

Islamic extremists for polio

Pakistan has recorded its highest number of new polio cases for 15 years, and is now one of only three countries in the world where the disease remains endemic. Health officials say the main reason is the killing of health workers carrying out immunisation programmes by Islamic extremists.

The extremists say the health workers are spies and that the immunisations are a Western plot to sterilise Muslims. They claim the US used a fake vaccination programme to track down and kill Osama Bin Laden in Pakistan in 2011.

The latest murder happened in the north-eastern city of Faisalabad where a 40 year old man was shot down by attackers on a motorcycle. Deaths among immunisation workers or police guarding them now number more than 60 over the last two years.

One result is that the World Health Organization has imposed travel restrictions, so that all Pakistanis must now carry proof of vaccination before going abroad. (See also by blogs of 24 February and 3 March.) 

The cost of stopping Ebola

The current death toll of nearly 5,000 means more people have been killed in the present ebola outbreak than in all previous ones put together. If you're wondering why the stricken countries in West Africa have been finding it so difficult to halt the epidemic, the Economist has crunched some interesting numbers.

Experts reckon ebola could be brought under control if 70% of the sick could be got into clinics or treatment centres where the spread of the virus can be halted, but to deal with the kind of case numbers being predicted for the next few weeks, that would require tens of thousands of beds.

Medecins Sans Frontieres and other charities, as well as governments like those of the US and the UK, have been busily building, but the WHO calculates that running just a 50-bed ebola hospital would cost nearly $1 million a month. No wonder the UN says a 20-fold increase in aid is needed.

And it's not just the buildings. The three countries where most people have died - Guinea, Sierra Leone and Liberia - have only a few hundred doctors between them, and some of those have now died of the disease. 

The march of ebola

This is now by far the worst ebola outbreak the world has ever seen, with 3,400 people dead, and 7,500 confirmed cases, though the true figure is thought to be much higher. The deadliest until now saw 280 people die in 1976 in Zaire, now Congo.

Most of the deaths have happened in Guinea, Sierra Leone and Liberia, with the World Health Organisation expressing concern at the poor state of the health services in those countries. Liberia says it is short of ambulances, and that it has only a third of the number of treatment centres it needs.

Now alarm is sweeping through Spain after a nurse who had been treating two missionaries who caught ebola in Africa, was found to be infected herself. It had been hoped that the stringent safety precautions available in modern hospitals would prevent the virus spreading.

Her husband and five other people are now in quarantine and another 50 are being monitored, while the European Commission has asked Spain for an explanation as to how the nurse became infected.

Ebola outbreak deadliest ever

The current Ebola outbreak is by far the worst the world has yet experienced. So far more than 930 people have died in West Africa, while more than 1,700 cases have been reported. The previous worst death toll came in 1976, when 280 people died in Congo and Zaire.

The mortality rate this time appears to be about 55%, though it can reach 90%. The World Health Organisation has now declared an international health emergency, but it is not proposing any bans on trade or travel.

Ebola is a fearsome disease, with symptoms that include high fever, internal and external bleeding, and damage to the central nervous system. There is no vaccine and no cure.

One of the obstacles to containing its spread is the poor state of the health services in the countries it has struck, with a lack of medical staff, laboratory technicians and protective clothing for doctors and nurses.  (See also my blogs of April 4 and June 7.)

Current Ebola outbreak among worst ever

The current outbreak of Ebola in Guinea in West Africa is now perhaps the fourth deadliest ever. The World Health Organisation says it has so far registered 328 confirmed or suspected cases in the country, and that 208 people have died.

The worst ever outbreak so far was in Congo, then Zaire, in 1976, in which the death toll was 280. A further 245 died in the country in 1995.

As well as the cases in Guinea, the disease has cost 6 lives in Sierra Leone, where there are 79 known or confirmed cases, and there are also fears that Ebola has reappeared in Liberia, which suffered 9 deaths earlier this year.

There is no vaccine and no effective treatment for the disease, which causes fever, muscle pain, and severe bleeding.  Death rates can reach 80 per cent or more.

Dengue fever

Honduras has declared a state of emergency following the deaths of 16 people in an outbreak of dengue fever. Altogether more than 12,000 people have been infected with the virus that is borne by mosquitoes.

The disease causes flu-like symptoms and occasionally develops into a potentially lethal form called haemorrhagic dengue. Honduras’s worst outbreak happened in 2010, when 83 people died.

Earlier this year, the authorities in Brazil reported a steep rise in cases of dengue, with more than 200,000 people infected compared with 70,000 in the same period of 2012, though the health minister said most cases were less severe.

The World Health Organisation says that across the world there are 30 times as many cases as there were 50 years ago, with up to 100 million infections a year in more than 100 countries.

Malaria - a pugnacious parasite

New drug-resistant strains of the parasite that causes malaria have been identified in western Cambodia.    There have been reports of drug resistance in the region since 2008, and the problem has now spread to other parts of South-east Asia.

Scientists investigating the new organism say that all the most effective drugs developed in the last few decades ‘have been one by one rendered useless by the remarkable ability of this parasite to mutate and develop resistance.’   They do not know why this part of Cambodia should be such a hotbed of resistance.

In 2010, there were more than 200 million cases of malaria and 600,000 deaths – 90 per cent of them in Africa.   The World Health Organisation has made preventing the spread of resistant strains a major objective.  

See also my blogs of 11 April, 30 May, and 24 Sept, 2009; 21 Oct, 2010; 23 Sept, 2011 and 23 May, 2012.

*I’ve just started to post a series of videos on Britain’s 20 Worst Military Disasters.   This is the first -  https://www.youtube.com/watch?v=D0Bgf-xHHGE

Flu - here we go again?

 

We’ve been here before.   The world is once again anxious about a strain of bird flu spreading through China.    This one is called H7N9. It has infected 60 people and caused 13 deaths.

The World Health Organisation says it is being spread by direct contact with infected birds, and that there is no evidence of direct human-to-human transmission.   Nor it seems are there yet any cases outside China.

Another strain of bird flu, H5N1, (viruses pictured above) has caused the deaths of more than 320 people in China and four other countries since 2003.     In 2009, the WHO declared a pandemic alert over H1N1 swine flu, which killed more than 18,000 people.  

So-called ‘Spanish flu’ caused one of the worst epidemics in history at the end of the First World War, carrying off up to 70 million people.    (See also my blogs of 5 Feb; 14, 30 April; 13 May; 6, 11, July; 24 Oct, 13 Dec, 2009.)  

Haiti - cholera strikes

Back in January, there were fears that the devastating Haiti earthquake might be followed by epidemics, particularly of cholera. Nine months later, the disease has finally arrived.

So far there have been more than 2,600 cases, and nearly 200 people have died. The areas affected are about 60 miles from the heavily populated capital, Port-au-Prince, where tens of thousands of people are still living in crowded tents with poor sanitation and little access to clean drinking water, though there are suspected cases in a suburb of the capital.

Officials say the victims were infected through drinking contaminated river water. Hospitals have been overwhelmed and for a time people were being treated in car parks. The World Health Organisation says this is the first time cholera has struck Haiti in a century.

See also my blogs of Jan 31, 2009 and Jan 14, 15, 16, 19, 22, 23 and 24; July 12 and Aug 26, 2010. The new paperback edition of A Disastrous History of the World also contains a section on the earthquake.

Malaria - is it even worse than we thought?

A new report, produced by the US National Institutes of Health among others, claims there are perhaps 13 times more deaths from malaria in India than official figures suggest. In rural India, well over 1 million people a year die from infectious diseases, where acute fever is the main symptom, but beyond that the condition often goes undiagnosed.

By interviewing a sample of bereaved families, the researchers came to the conclusion that there are up to 205,000 malaria deaths a year in India, compared to the World Health Organisation’s figure of 10-21,000. The WHO does not accept this conclusion, but agrees there might be limitations in its own calculations.

Across the world, malaria is thought to kill more than 1 million people a year, though, if the researchers are right about India, this may be a serious underestimate. The number of cases has risen over the last 30 years, partly through mosquitoes becoming resistant to drugs and insecticides. (See also my blogs of 11 April, 30 May, 24 Sept, 2009.)

*Out next month in paperback! A Disastrous History of the World. http://www.littlebrown.co.uk/Title/9780749909796

Swine flu emergency

The US government has declared swine flu a national emergency. This is essentially an administrative move designed to give the authorities a freer hand in dealing with the disease, but it also reflects the widespread worry that the virus could become a more formidable foe as winter approaches.

More than 1,000 deaths have been linked to the illness in America, while in Britain the figure is 122, with nearly 100 others currently critically ill. Over the last week, the number of cases in the UK almost doubled to 53,000, but earlier estimates that we might start seeing 100,000 new cases a day (see my blog of July 6) have been scaled back dramatically, and the UK authorities are predicting a total of perhaps 1,000 deaths.

The World Health Organisation says that nearly 5,000 people have died from swine flu across the globe, and that there have been more than 400,000 confirmed cases, though it says this is a very considerable underestimate as countries are no longer required to report individual cases.

See also my blogs of Feb 5, May 13, and July 11.

Battling malaria

Fourteen African countries have joined forces to fight malaria, which still kills nearly 900,000 people a year – most of them young children in sub-Saharan Afirca – that’s more than AIDS and tuberculosis combined in those areas. No less than 86% of all the world’s malaria cases, and 91% of the deaths happen in the Dark Continent.

The African Leaders Malaria Alliance has raised nearly £2 billion to buy 240 million mosquito nets treated with insecticide. The aim, which cannot be faulted for ambition, is to stop nearly all malaria-related deaths within six years.

The announcement came just as the World Health Organisation was reiterating the concern that the malaria parasite was growing increasingly resistant to artemisinin, regarded as the most effective drug for combatting the disease.

Malaria is one of the oldest illnesses known to man, and has been infecting human beings for at least 50,000 years. (See also my blogs of April 11th and May 30th)

AIDS - some (kind of) good news

On April 11, I wrote about a new drug that may offer us hope against malaria, now there are grounds for some optimism in the global battle with AIDS. Researchers have discovered two powerful new antibodies against the virus.

They are found in only a minority of those infected and are the first of their type to be identified in more than a decade. It is hoped that the discovery may speed up the search for an effective vaccine, though Keith Alcorn, of the HIV information service NAM, warned that that prospect was still a long way off.

He said this was an extremely complex project and that “we certainly shouldn't expect these findings to lead to a vaccine in a few years.”

Across the world last year, the World Health Organisation said that there were 33 million people living with the AIDS virus, and that 2 million had died from the disease during 2007. About 1.6 million of those deaths were in sub-Saharan Africa - the region that is worst affected with two thirds of the world’s cases. Countries such as Botswana, Swaziland, South Africa and Zimbabwe all have infection rates of over 15 per cent. (see my blog of Feb 18th)

Swine before birds

While we were all watching out for bird flu (see my blog of February 5th), swine flu has nipped in on the blindside and may inflict on the world its first flu pandemic since the one in 1968 that killed perhaps 1 million people.

We had got used to worrying about H5N1, but in fact it is a new version of H1N1 that has got the World Health Organisation to raise its alert to one notch below full pandemic status. H1N1 is the same strain that causes seasonal flu in humans fairly frequently, but this type incorporates genetic material from viruses that attack pigs and, yes, birds.

If the European Commission has its way, though, the name “swine flu” will be short-lived. They want it to be re-christened “novel flu” so it doesn’t stop people buying pork and bacon.

The outbreak seems to have begun in Mexico, where there have been 168 suspected deaths, though only 8 confirmed. Global travel has expanded enormously since the last flu pandemic, giving the virus opportunities to spread further and faster than ever before. There have already been confirmed cases in 13 countries, though only one death outside Mexico. So it is perhaps a hopeful sign that outside Mexico, the disease so far seems to have been generally mild. Touch wood!

AIDS in China + it's only money (6)

AIDS has now been officially recognised as China’s deadliest disease. It killed nearly 7,000 people in the first nine months of last year, overtaking tuberculosis and rabies. The figure represents a big increase, but there are suspicions that the real total may be much higher, as many local officials are thought to be reluctant to report cases. According to UN figures, 700,000 Chinese people were infected with the virus by the end of 2007.

AIDS victims used to have a difficult time in China. A human rights activist was put under house arrest after exposing the failure of the authorities in Henan province to carry out HIV tests on blood donations in the 1990’s, which resulted in an estimated 55,000 people being infected. Other activists were said to have been beaten up with the connivance of the authorities.

Across the world last year, the World Health Organisation said that there were 33 million people living with the AIDS virus, and that 2 million had died during 2007. About 1.6 million of those deaths were in sub-Saharan Africa - the region that is worst affected with two thirds of the world’s cases. Countries such as Botswana, Swaziland, South Africa and Zimbabwe all have infection rates of over 15 per cent.

It’s only money. Has Labour completely lost the plot? We are being told that it is a great victory for the taxpayer that RBS is now going to pay out only £340 million in bonuses instead of the £1 billion it originally planned. That is still a forced contribution of more than £10 from every taxpayer, some of whom will be earning as little as £6,000 a year. RBS is broke. It is only being kept afloat by a huge hand-out of our money. There is no justification for paying any bonuses of any sort. End of story. When will Labour and the bankers get it?

Bird flu

Egypt has just reported its third case of bird flu in humans this year, while China says that four people have died from the disease in 2009 – the latest a 31 year old woman in the Xinjiang Uygur region in the north-west of the country. China has also been accused of covering up an outbreak of the disease in poultry after more than 20 dead birds were washed up on beaches in Hong Kong. At least three have tested positive for the H5N1 bird flu virus.

The World Health Organisation reported 348 cases of the disease in humans up to January 2008 across 14 countries. Two hundred and sixteen of those infected had died. That represents a death rate of more than 60% - stoking fears that if the strain ever did manage to pass from human to human it could threaten us with a pandemic on the scale of that of 1918 in which perhaps 70 million died, including a quarter of a million in Britain (see A Disastrous History of the World and A Disastrous History of Britain).

So far, mercifully, there has been little evidence of transmission of H5N1 from human to human apart from isolated cases in Thailand and Vietnam.