Cases are spreading rapidly. reaching new countries every day. Thankfully no-one has died outside of mexico (yet). The WHO has updated the priority of the disease to a stage 4.
Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion.
Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.
Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is under way.
Below is an update on the number and locations of cases as of today. Click for a larger image.
The WHO has published a leaflet on pandemic preparedness. Read it here.
The info in this post is from the World Malaria Day website. I only just found out it was world malaria day at the weekend, a sign that it didn't recieve much publicity, perhaps?
World Malaria day - A Day to Act
25 April is a day of unified commemoration of the global effort to provide effective control of malaria around the world. This year's World Malaria Day marks a critical moment in time. The international malaria community has merely two years to meet the 2010 targets of delivering effective and affordable protection and treatment to all people at risk of malaria, as called for by the UN Secretary-General, Ban Ki-Moon.
World Malaria Day represents a chance for all of us to make a difference. Whether you are a government, a company, a charity or an individual, you can roll back malaria and help generate broad gains in multiple areas of health and human development.
Reducing the impact of malaria would significantly propel efforts to achieve the Millennium Development Goals, agreed by every United Nations member state. These include not only the goal of combatting the disease itself, but also goals related to women's and children's rights and health, access to education and the reduction of extreme poverty.
Hundreds of RBM partners - governments, international organizations, companies, academic and research institutions, foundations, NGOs and individuals - are already gaining ground against malaria. Diverse partner initiatives are guided by a single strategy, outlined in the Global Malaria Action Plan.
Counting malaria out
In 2008 the Roll Back Malaria (RBM) Partnership unveiled the Global Malaria Action Plan (GMAP), which clearly sets out what needs to be done to meet the short, medium and long term goals of malaria control, elimination and eventual eradication.
On World Malaria Day, the Roll Back Malaria (RBM) Partnership will kick-start its "Counting malaria out" campaign. This 2-year campaign will intensify global efforts to reach the first important malaria milestone by 2010 and to strenghen systems in endemic countries for the long haul of sustained malaria control and elimination.
Click for source, near-zero deaths by 2015 and the gradual elimination of malaria.
To be able to successfully combat malaria, countries and their international partners need to strengthen systems for collecting data at district, national, regional and global levels. Reliable data-collection, sound data analysis and effective data communication enable an informed and efficient response to malaria and are critical to the long-term success of the global malaria control effort.
We need to monitor challenges that may impede the implementation of the GMAP. We need to keep track of the new initiatives and solutions that are being put in place. We need to be able to tell where exactly we are at in the areas of development, production and delivery of nets and treatments, building malaria control capacity, committing funds and resources for scale-up of interventions, monitoring malaria cases, or informing, educating and mobilizing communities to act against malaria.
Help count the strides we collectively make towards eliminating malaria. Make the lives of every man, woman and child count.
Key Figures
What we need
The following interventions need to be delivered worldwide by 2010:
More than 700 million insecticide-treated bednets – half of those in Africa
More than 200 million of doses of effective treatment
Indoor spraying for around 200 million homes annually
Approximately 1.5 billion diagnostic tests annually
What it will cost
In 2009, roughly $5.3 billion will be needed for malaria control worldwide
In 2010, $6.2 billion will be needed
From 2011 to 2020, roughly $5 billion per year will be need to sustain the gains of control measures.
In addition, about $1 billion per year will be needed for research and development of new prevention and treatment tools
What will be the impact
A dramatically expanded access to core anti-malaria interventions (protective nets, spraying, diagnostics and effective drugs) will result in a sharp decline of malaria cases and deaths. However, these measures will not eliminate the mosquito vector, the parasite or the favorable environmental conditions for transmission in many countries and regions. In some countries with naturally high transmission rates, control measures may need to be maintained for 15- 20 years or longer until new tools enabling elimination are developed or new research indicates that control measures can be safely reduced without risk of resurgence.
Nothing too serious here, just a message that a bracing walk with the family, for example dog-walking, can do wonders for your health. Running the world can be so tiresome!
Two new stories on the BBC today made me smile for different reasons. Both involved medical trials. The first is the promising news of development of a new, more effective vaccine for TB. Progress in fighting diseases of poverty is often painfully slow as there isn't much money in it for drug companies. Lets hope they can develop an effective and affordable vaccine for those who need it most.
The second shows just how easy it can be to get participants for drug trials when the drug on trial is CHOCOLATE!
TB vaccine enters new trial stage
The trial is being carried out on children in South Africa
The first new TB vaccine for 80 years has started to be given to infants in the next stage of trials, according to Oxford University researchers.
The experimental vaccine MVA85A is to be given to nearly 2,784 infants in South Africa to test its effectiveness.
Oxford University researcher Dr Helen McShane said: "This trial will hopefully show that the vaccine can protect people from getting TB."
The first stage of the trials in 2007 proved that the jab was safe.
TB kills more than two million people worldwide each year.
If the latest tests are successful the researchers hope the vaccine will be available by 2016.
The new drug would be given alongside the current BCG vaccine.
It works by stimulating immune system cells called T-cells to produce a stronger response to the BCG jab.
Chocolate plea gets 1,500 replies
Hundreds of people replied about the potential benefits of dark chocolate
An appeal for volunteers to help researchers see how dark chocolate might help fight disease has attracted 1,500 responses worldwide in a day.
The scientists in Aberdeen aim to assess how flavonoids, found naturally in cocoa, could fend off heart disease.
Thursday's BBC Scotland news website story had more than 200,000 hits, and researchers said it sparked replies from as far afield as America.
Forty volunteers aged between 18 and 70 will be selected to take part.
They will be asked to eat a cocoa-rich dark chocolate specially made for the study, standard chocolate, or white chocolate.
Aside from medicine a major interest of mine is a sport of figure skating. As with many elite sports, the athletes at the very top level are pushing their bodies to the limit in the attempt for olympic Gold. I am aware that whilst I have chosen to focus on figure skating, the same could be said for any elite/professional sport, for example gymnastics.
Whilst this video was made in 2003, the issues still remain. Promising young talents are being forces to end their careers in their late teens or twenties due to hip and back injuries from constant jumping, forced flexiblity and repetitive falls.
In order to protect young skaters the International Skating Union (ISU) introduced a minimum age limit of 15/16 for championships such as Worlds, Europeans and Olympics. A skater must be 15 by the previous July 1st, therefore most will be 16 by the world championships, held in March. This issue has sparked controversy, particularly in Ladies skating. In 2008, 3 of the top 4 ladies at the US championships were too young to go to the Worlds. In 2006 a young Japanese phenom, Mao Asada beat all 3 of the eventual olympic medallists at one point in the season but was 87 days to young to go to Torino. The 1994 and 1998 olympic ladies champions were also both 15 years old at the time they won.
One of the most dangerous disciplines in figure skating is the Pairs event due to the high risk throws and overhead lifts. Although in the 2008-09 seasion all 3 of the world medallists in Ice Dance (considered safer due to the lack of jumps) had missed part of the season due to injury. The 2008 world champions were unable to defend their title as they too were injured. There have been some terrible injuries and accidents in figure skating as a result of the risks taken to achieve perfection.
So what can be done to protect elite and recreational athletes? As Olympic Champion Alexei Yagudin said in the first video here, very little! It is nigh-on impossible to stop young athletes pushing themselves to the limit in the hope of being the best in the world. Every year the standard required to be competitive on the world scene gets higher. Many female skaters and gymnasts reach their peak prior to puberty and teenage growth spirts.
Kimmie Meissner, the 2006 World Champion at 16 has had a heartbreaking fall from the top of the sport since then (More here). In Beijing 2008 the tiny chinese gymnasts sparked controversy over their official ages when they beat the more mature, taller, curvier USA team.
Can we reverse this trend? Are we limiting the progress of sport in the attempt to protect the young?
Reading this article on the bbc today brought up an issue that has been close to my heart since I too went to work as a volunteer in Ghana last summer. 20 year old Harry Yirrell spent 4 months teaching at and helping to build a school in Brenu Aykinim, between Cape Coast and Takoradi in the Central Region. Whilst he was there he made the decision to give away his malaria prevention drugs and sleep without a mosquito net. Within a week of returning home he had died from malaria. Now his Mum Jo has visited the place where Harry stayed to see the effects of malaria on those who live in an endemic area and raise awareness of this unforgiving butpreventable disease.
Whilst I do not want to be judgemental, even Harry's mum admits it was foolish to assume that he didn't need to protect himself against malaria. Being a traveller he would have been at very high risk as he had no immunity against the disease.
"Malaria doesn't need to kill anyone, which is the irony of Harry's death. He had the tablets with him - he just didn't take them." (Jo)
During my own time at Cape Coast hospital in summer 2007, I saw upto half the patients walking in the doors having symptoms of malaria, most of them being young children, carried in by their mothers having been sapped of even the energy to walk.
Malaria is easily treatable if recognised early. Virtually everyone with a fever was treated as having malaria. However, it can be even easier and far more preferable to prevent the disease in the first place with bed-nets, insect repellents and preventative drugs. Sadly most Ghanaians do not protect themselves, either because they can't afford to or because they do not feel the need. Most people are infected with malaria at some point in their lifes, this allows them to build up a level of immunity against the symptoms of the disease, but not against the infection itself, which can be caused by a single mosquito bite. Until education and aid provide better protection for all people in endemic areas, malaria will continue to be one of the biggest killers in Africa.
A few shocking facts about malaria A child dies of malaria every 30 seconds in Africa. Children under 5 and pregnant women are most at risk. Malaria costs the african economy £8bn a year Worldwide, malaria causes around 350 to 500 million illnesses and more than one million deaths annually. Malaria is treatable and preventable but many communities do not have access to the correct medication, relying on herbal remedies or incomplete doses.
Harry's mum has become an ambassador for the charity Malaria No More which aims to ensure the leaders of G8 and EU countries deliver their goal to provide 100 million bed nets to sub-Saharan Africa by the end of 2010. For more information visit the charity website, or one of these other links below. World Health Organization Malaria Site NHS Wikipedia
Below- Harry's trip to Ghana- He felt he was 'big and strong' enough to get by without protection and gave his medication to the children in his village. Also a photo from my own time in Ghana, with delightful children from the Human Service Trust Orphanage, Cape Coast. Some of these children we had to take to the hospital when they too contracted malaria. They had only tatty bed nets (some with holes in) to protect them from mosquito bites.
Previous medics have told me these are the first books I will have to dispense with my hard-earned cash for. Whilst I I can't wait to have a good nosey inside, I'm holding off for a little as Amazon.co.uk informs me there will be a new edition of Kumar and Clark out in June. Gray's Anatomy (Not to be confused with Grey's anatomy- the highly amusing and rather silly american sitcom) has just come out with the new edition below, but it doesn't seem to have made it to all the shops yet.
Anyway - a little 'light' reading for the summer I think.
Strange to think of this as just the beginning. After a very long application process and nerve-wracking wait I've recieved an offer of a place at medical school on a graduate-entry course. That's 4 more years of studenthood before the REAL work begins.
I hope this blog offers those who are interested to follow my journey and learn what the life of a 'mini-medic' is really like. I haven't actually finished my undergrad degree yet (Natural Sciences). Medical adventures begin in September so this may be slow off the ground.
