Category Archives: Global Health Options

Two vaccines are better than one

New research suggests using two types of polio vaccine is more effective than using just one. The research team found administering an injection of the inactivated polio virus (IPV) alongside the oral dose of activated poliovirus vaccine (OPV) boosts patients’ immunity. It’s hoped the findings could help speed up the eradication of polio reports expat health.org

Currently, the oral vaccine is leading the battle against polio but this new research from India may change the way we fight the virus. The findings, which World Health Organisation calls “truly historic”, will potentially lead to a total eradication of the disease which is now widespread in only three countries.

Fighting polio has been one of the greatest global health success stories. As recently as 1988 there were 350,000 cases of polio in 125 countries. Once the worldwide vaccination programme was launched in 1988, the number of cases fell dramatically to just 291 in 2012. Polio is currently widespread in only three countries – Nigeria, Pakistan, and Afghanistan.

The disease is spread through contact with infected faeces and the oral vaccine is currently the preferred prevention method as it’s cheap and protects digestive tract from lower transmission of the virus. The injected vaccine works largely in the bloodstream. However, the protection offered by the oral vaccine wanes over time, so repeated doses are needed.

In this latest study, reported in Science Magazine, doctors tested the two vaccines on 1,000 children in northern India. The use of both types of vaccine lowered transmission and infection. “They both have an important role to play in the eradication programme,” said Professor Nick Grassly, co-author of the study.

The use of the IPV is more effective as a booster than multiple doses of the OPV, according to the study. However, the biggest challenge facing health workers, is not which vaccine to use, but accessing children in conflict zones.

South Korea to double to price of cigarettes

The Korean government aims to tackle high smoking rates by doubling the cost of cigarettes.
South Korea is looking at doubling the cost of cigarettes in a bid to lower the smoking rate, reports the BBC. Under the proposed changes, the price of a packet of cigarettes would go up to 4,500 won (€3.35), the price is currently 2,500 won (€1.87).

South Korea has one of the highest male smoking rates among OECD member countries. About 41% of men smoke, according to the Organisation of Economic Cooperation and Development, this is higher than the 26% average reports expat health.org

The proposal, which would come into effect next year, is designed to lower the overall smoking rate (23%), which is also higher than the OECD average of 21%. The last increase in price was in 2004 when it went up by 500 won and the smoking rate fell 15%, reports Korean news agency Yonhap.

There have been many studies which appear to confirm a link between raising the price of cigarettes and a drop in the smoking rate. Researchers agree that a 10% increase in prices results in a 3-5% reduction in cigarette consumption.

Reports from Yonhap also said tobacco manufacturers would be required to print graphic warnings on packaging, and some types of advertising would be banned. General warnings on packaging were introduced in 1976, with graphic warnings originally introduced in 2007.

The South Korean government hopes the price increase will generate an estimated 2.8 trillion won in tax revenue. The opposition have already called it a “deceitful move” which will impact low-income earners as they smoke more than other population groups.

In April this year South Korea’s health agency launched a lawsuit against three of the largest tobacco manufacturers including the local arm of Philip Morris International, to offset the cost of treating smoking-related illness.

What You Should Do If You Feel Sick After Vacation

A great holiday can leave you with lasting memories and souvenirs, not to mention fatigue or jetlag. But what if you’re feeling a little more than just tiredness and a dread of going back to work?

Most post-vacation sicknesses are mild, such as a head cold or upset stomach. But up to eight percent of travelers are sick enough to seek doctor’s care. Following an overseas trip, there are some symptoms the Centers for Disease Control says warrant a trip to your doctor advises the healthytravelblog.com

Fever
If you have a fever, chances are good that it is caused by a less serious illness. But if you have a fever within a month after you leave a country with malaria, you should see your doctor immediately. Even if you took antimalarial medicine, your fever could still be a symptom because the medicine isn’t 100 percent effective.

Malaria typically develops within 30 days, but the CDC says there are rare cases that lie dormant for a year or longer. Because of this, you should tell your doctor about any traveling you have done no matter how long ago it was.

Diarrhea
Diarrhea usually clears up within a few days. Traveler’s diarrhea is the most common illness when traveling. It’s usually caused by a bacterial infection from exposure to E. coli, Campylobacter, Shigella, or Salmonella in undercooked or raw foods, contaminated food, or contaminated water – including ice cubes!

If you are experiencing diarrhea, treat it by drinking fluids to prevent dehydration; begin a diet with simple, bland foods; and, if possible, drink a solution made with oral rehydration salts.

Most cases of traveler’s diarrhea get better within one to three days without medical treatment. But if it persists for two weeks or more, contact your doctor. Prolonged bouts of diarrhea can cause you to lose nutrients. An illness of this length is typically caused by a parasitic infection that needs to be treated with medication.

Skin Problems
Skin problems such as rashes, bug bites, fungal infections or boils, are the most common illnesses following international travel. In most cases, skin problems aren’t serious. But they could be signs of a more serious illness, especially if you also have a fever.

If you do make a visit to your doctor following a vacation, you should tell him or her about your travel. Most post-travel illnesses appear soon after a trip, but incubation periods vary, resulting in some symptoms not appearing for months to years following the initial infection. The CDC suggests providing your doctor with the following information about your trip:

What you did on your vacation
How long you were away
The accommodations you stayed in
What you ate and drank on your trip
If you were bitten by bugs
If you swam in fresh water
Any other possible sources of exposure, including tattoos and piercings

Japan confirms Dengue Fever Outbreak

Tropical diseases are not only found in poor countries.
Health officials in Tokyo have confirmed 19 new cases of dengue fever, bringing the total to 34 in the country’s first domestic outbreak since World War Two. The disease was found in individuals living in Tokyo and surrounding prefectures. None of the victims has been abroad recently, but all had visited Tokyo’s Yoyogi Park.

Officials said the disease was probably carried by mosquitoes found in and around the park, one of central Tokyo’s major green spaces. The disease is transmitted via Tiger mosquitoes which are endemic to Japan, though dengue fever was effectively eradicated from the country after the Second World War.

Dengue symptoms include high fever, headaches, joint and muscle pain, vomiting and bleeding. Most cases are mild, particularly in people who have never had the infection before. Occasionally, serious problems can develop, leading to complications such as dengue haemorrhagic fever, and dengue shock syndrome.

“It is rare for symptoms to worsen among those who have been infected,” a Japanese health ministry official said. “We hope people will seek treatment at a medical facility as soon as possible after developing a high fever within three to seven days after being bitten by a mosquito.”

The Japanese authorities have sprayed 800 litres of pesticide in the park to kill the mosquitoes and halt the spread of the infection. With the proper treatment dengue fever is fatal in only 1 percent of cases.

This outbreak, in one of the world’s richest countries, highlights the fact that neglected tropical diseases (NTDs) are not the sole preserve of poor countries, reports the Guardian. Governments need to realise that G20 countries are susceptible to the “lion’s share” of dangerous, yet low-profile illnesses, a US expert has warned.

Dr Peter Hotez, dean of the National School of Tropical Medicine in Baylor, Texas told the Guardian, northern Argentina, southern Mexico and the southern United States are areas where several NTDs are common. Texas and regions of the Gulf Coast have seen cases of dengue fever, Chagas disease, Chikungunya, and parasitic worm infections. He estimates that 12 million Americans have one or more tropical diseases.

He described his frustration with governments spending millions on HIV, TB, and malaria research while often neglecting NTDs. The UK and USA governments currently provide three-quarters of the development and research budget for NTDs.

“We’re working on the French and the Germans, who, I think are going to be very important. But we need to look even beyond the north and get all of the G20 countries involved – especially the Brics [Brazil, Russia, India, China and South Africa].”

SOURCE : expat health.org

British military sent to tackle Ebola

British military engineers and medics are being sent to Sierra Leone to help fight the world’s largest-ever outbreak of Ebola reports the BBC World News.

They will set up and run a treatment centre near the capital Freetown.

The World Health Organization says more than 2,000 people have now died in the outbreak in West Africa.

Last week, the charity Medecins Sans Frontieres called for a global military intervention in the region.

It said the global response to the outbreak had been “lethally inadequate” with countries turning their back on West Africa and merely reducing the risk of Ebola arriving on their shores.

The UK has announced it will build a centre with 50 beds for people in Sierra Leone and 12 beds for healthcare workers who become ill.

The proposed site will be surveyed this week, with the healthcare worker section of the facility scheduled to be running within eight weeks.

Yesterday, President Obama said the US military would set up isolation units and provide security for public health workers.

International Development Secretary Justine Greening said: “The scale of the problem requires the entire international community to do more to assist the affected countries which is why the UK is working with the government of Sierra Leone to build a new medical treatment facility near their capital Freetown.

“When it is up and running it will enable the UK to provide medical care for local and international health workers, as well as treatment for the wider population.”

The UK government has committed £25m to tackling the outbreak, including running trials for an Ebola vaccine.

The charity Save the Children will eventually take over management of the treatment centre.

Its chief executive, Justin Forsyth, said: “Ebola threatens thousands of people’s lives across West Africa and could set back development many decades.

“The key to combating this epidemic is backing front line health workers and underpinning a fractured health system in Sierra Leone.

“Without urgent action to assist medics, many more children and their families will suffer and die from this most appalling and tragic disease.”

Ebola update from ALC Health

While the outbreak is still not contained and expected to last for the next six months, an increasing number of neighbouring countries have closed their borders with the affected countries during the week.

This week-end, Democratic Republic of Congo has reported several confirmed cases of Ebola in the remote Northern Equateur province. This outbreak is not considered in any way related with the ongoing outbreak in West Africa. Quarantine measures in a radius of 100 km around the location have been announced by the Ministry of Health and no travel advisories for Congo Have been issued.

Health workers are paying a heavy toll to the disease with 240 of them infected and 120 fatalities. This is creating a lack of medical staff in health facilities which are already overwhelmed. WHO is calling for international support from the healthcare professionals.

An experimental treatment (ZMAPP) which had thus far never been tested in humans has raised hopes after the recovery of two US aid workers who were discharged from hospital after being given the treatment. It has not been confirmed that the treatment was the reason for the cure. A Japanese company has announced introduction of an antiviral medication that may help counteract the Ebola virus, but it is in very early stages and untested on animals or humans. Therefore it is important to keep in mind that Ebola remains a disease without available specific treatment.

Locally the risk remains low for (non- healthcare workers) expatriates or travellers who follow strict hygiene rules by avoiding close contact with the patients or contaminated materials in high risk environments. However, expect a heightened state of alert related to the outbreak, resulting in more restrictions on travel. Additionally, expect that transportation entities and government authorities will act very cautiously to enable evacuation of any ill or injured foreigners in Ebola affected areas.

For all above reasons, the general recommendation remains to avoid or interrupt any travel to the countries of Guinea, Sierra Leone, Liberia for non- essential personnel.

Travel insurance versus expat insurance

Travellers are being warned about the importance of buying insurance if they plan on going abroad. According to a recent survey from The Points Guy, only 21 percent of people buy travel insurance, and of those, only 7 percent purchase it regularly.

So what is travel insurance?

Designed for short trips abroad, a standard plan covers cancellation, personal belongings, and emergency medical treatment. It can bought as a single- or multiple-trip policy and prices vary depending on many factors such as: where you are travelling, additional winter or water sports coverage, your age, pre-existing conditions and so on.

And international insurance?

An international medical insurance plan is designed to cover people who are living and working abroad. It generally includes inpatient treatment, check-ups, and long-term care of chronic conditions. An expat health plan usually allows you to choose where you receive treatment, even transferring you to another country if necessary. You can include extras such as compassionate visits, maternity care, and dental treatment. Expat health plans generally last a minimum of 12 months, though there are some options for people moving abroad for less than a year.

Salt consumption has ‘dire impact’ on global health

Are diets low in sodium essential for everyone?
Excessive sodium consumption is putting the world’s health at risk, and placing a large burden on health systems, warns a new study. It is estimated that 1.65 million deaths from cardiovascular disease each year are linked to consuming too much salt on a regular basis.

“That’s remarkably high, that’s almost 1 in 10 of all cardiovascular deaths around the world,” Dariush Mozaffarian, study author told NPR.

“This suggests that a single factor in the diet [salt] could be contributing to almost 10 percent of the cardiovascular burden.”

This latest study adds weight to the argument that everyone should have a diet low in sodium, something many people ignore. Worldwide we consume on average, around 3,950 milligrams of salt per day. Although there are regional daily differences ranging from 2,000 to 5,500 milligrams, the global average is still nearly double what the World Health Organisation recommends (<2,000mg/day). The study found the areas where the most heart attack and stroke deaths are linked to sodium, varies quite a bit. In Canada, the United States, Australia, and New Zealand around 10 percent of cardiovascular deaths can be attributed to salt intake. Interestingly there is a wide-band stretching from Eastern Europe to Central and East Asia where the percentage of sodium attributable deaths jumps to 20-25 percent. The study authors put this down to the centuries old trade routes that link the continents. “What seems to be linking those countries [in this band] … is that this is the Old Silk Road [trade] route, where people traveled many distances and needed salt to preserve their food,” says Mozaffarian. Centuries later, this tradition of eating salt-preserved foods remains strong. A diet high in sodium can cause high blood pressure, which in turn raises the risk of a heart attack or stroke. While sodium occurs naturally in many foods such as milk and eggs, it is found in much higher levels in processed foods and it is these people are being warned to cut down on. There is some disagreement over whether low-salt guidelines are beneficial for everyone. Another study, also published in the New England Journal of Medicine, said the risks associated with high salt consumption are increased in people with elevated blood pressure. It goes on to suggest that people with a healthy blood pressure can have as much as 3,500 milligrams of sodium a day, the typical amount Americans consume. Source : www.expathealth.org

DR Congo confirms Ebola outbreak

The Democratic Republic of Congo has confirmed that an outbreak of haemorrhagic fever in the north of the country has been identified as Ebola.

Health Minister Felix Numbi told the BBC that tests on two people had confirmed the disease in Equateur province, where 13 had already died.

But he said the deaths occurred in an isolated area and the disease seemed a different strain to West Africa’s.

Dr Numbi said a quarantine zone was being set up to contain the disease.

The cases are the first reported outside West Africa since the outbreak there began.

So far 1,427 people have died from the virus.

The speed and extent of the outbreak has been “unprecedented”, the World Health Organization (WHO) says.

An estimated 2,615 people in West Africa have been infected with Ebola since March.

There is no known cure but some affected people have recovered after being given an experimental drug, ZMapp. However, supplies are now exhausted.

SOURCE.. BBC World News

Women with severe, chronic health issues are screened for breast cancer less often

Women with severe disabilities and multiple chronic conditions are screened for breast cancer less often than women with no disabilities or no chronic conditions, a new study has found.

They are also screened less often than women with moderate disabilities or women with only one chronic condition, according to Dr. Sara Guilcher, an affiliate scientist with the Li Ka Shing Knowledge Institute of St. Michael’s Hospital.

Dr. Guilcher said women with disabilities often have other measures of social vulnerability, such as low income and low education levels.

Her research, published in the journal Preventive Medicine, is consistent with other studies showing that low income and education were also associated with lower breast cancer screening rates. Previous research has also shown that having a certain level of disability is associated with higher breast cancer screening rates, perhaps because those women have more frequent contact with the health care system.

However, in contrast to previous research, this study identified higher screening rates for women with moderate disabilities compared to those with severe disabilities – who also have greater contact with physicians than other women with no disabilities.

“Despite the presence of a universal health insurance system in Ontario, our research highlights the persistence of significant health disparities in breast cancer screening, particularly for women who are more vulnerable due to severe disability, multiple chronic conditions, low income and lower education,” said Dr. Guilcher, who has a PhD in Clinical Epidemiology at the Institute of Health Policy, Management and Evaluation, University of Toronto.

The highest rate of screening was 75 per cent, which was among women with moderate level of disability and one chronic condition. Women with severe disability, across levels of chronic conditions, had the lowest rate of breast cancer screening at 61 per cent. Women with two or more chronic conditions were screened particularly less often.

“Women who are at a lower socioeconomic position may be less likely to be assertive and to be strong advocates for their health care management,” said Dr. Guilcher.

Dr. Guilcher noted that in Ontario, women can refer themselves to the Ontario Breast Screening Program, which sends them reminders of when they are due for mammograms and can provide results at the same time the test is done. Further research could explore the demographics of the women who enrol in this program, she said.

Dr. Guilcher said that worldwide, breast cancer is the most prevalent cancer among women and the second leading cause of cancer-related deaths. Deaths have significantly dropped due to advances in prevention and treatment. In Ontario, mortality rates fell 37 per cent for women between the ages of 50 and 74 between 1990 and 2009.

Her study was done in conjunction with the Institute for Clinical Evaluative Studies (ICES), based on health records of 10,363 women in Ontario ages 50-69 whose health records are stored in databases at ICES.