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Thailand first in Asia to eliminate mother-to-baby HIV: WHO

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WHO weighs H7N9 risk as cases mount

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Ivonne Wierink / ThinkstockMost patients in the current H7N9 outbreak wave have had contact with poultry or live-bird markets.

Against the backdrop of four new H7N9 influenza illnesses reported from China today, a detailed look at the second wave of the outbreak reveals that cases are trending slightly younger, with a lower case fatality rate (CFR), though severe pneumonia is still one of the disease’s hallmarks.

So far more than 80 new cases—the large majority from the first of the year—have been reported in the outbreak’s second spike that began in October. Over the past few weeks China has often reported five to seven new cases each day, equaling the pace seen during last spring’s first-wave peak.

Cases trending younger, less deadly?

World Health Organization (WHO) experts said today in their latest risk assessment that most cases in the first wave involved middle-aged or older men, but the age distribution in the new wave isn’t as skewed toward older age-groups. The mean age in the new surge of cases is slightly lower than the first wave: 52 years compared with 58 years.

H7N9 is still striking males more frequently than females, and the CFR is not as high as the outbreak’s first wave, the WHO said. It cautioned, however, that CFR patterns need to be monitored closely, because many of the recently infected patients are still hospitalized. Some milder cases have been reported, but it’s clear that H7N9 infections are marked by rapidly progressing severe pneumonia, according to the risk assessment.

Lab analysis of H7N9 samples from patients, animals, and the environment collected during the second wave shows that the hemagglutinin (HA) and neuraminidase (NA) genes are similar to viruses from the first wave, the report said. It added that they are also similar to the influenza A/Anhui/1/2013 strain recommended for H7N9 vaccine development.

Tests on a subset of recent viruses to monitor for antiviral resistance have identified no markers linked to resistance to neuraminidase inhibitors, including oseltamivir (Tamiflu) and zanamivir (Relenza).

Resistance to frontline treatments such as oseltamivir and zanamivir has been a worry since the outbreak’s early days, when an NA resistance marker was found in one of the first three lab-confirmed H7N9 cases. The resistant viruses have also been linked to treatment failures in some severely ill patients.

Several questions remain about the source of human infections, though most of the evidence points to exposure to infected live poultry and their contaminated environments, the WHO said. It added that most patients who were sickened by H7N9 were exposed to birds or live-poultry markets, that H7N9 viruses from humans are genetically similar to ones collected from birds and the environment, and that live-poultry markets linked to human infections are more likely to yield positive H7N9 samples.

The WHO’s analysis found no increase in the number of illness clusters, including healthcare-associated ones, that would point to any increased risk of human-to-human transmission. It said an investigation into a recent infection in one health worker, presumably that of a 31-year-old doctor from Shanghai whose H7N9 death was reported this week, found that the patient may have been exposed to poultry or a contaminated environment. So far no other H7N9 cases linked to the patient have been identified.

Though the virus doesn’t seem to transmit easily among humans, the detection of several less severe cases during flulike illness surveillance, along with continuing severe cases, shows that continued vigilance is needed, the WHO said. Overall, the public health risk hasn’t changed from the WHO’s last assessment in December.

More sporadic H7N9 cases are expected to be reported in humans, especially with increases in poultry production, trade, and transport in advance of China’s Lunar New Year holiday season and because H7N9 seems to be following a more active winter seasonal pattern seen with other avian influenza viruses, the WHO said. Travel-associated cases could occur, but the agency said the threat of international spread is low, unless the virus adapts for more efficient human-to-human transmission.

China reports four more cases

The four new case-patients from China include a 71-year-old man from Jiangsu province whose illness was reported late yesterday and three from Zhejiang province: a 53-year-old man, a 71-year-old man, and a 63-year-old woman.

According to a translation of a provincial health ministry report posted by the Avian Flu Diary infectious disease news blog, the patients from Zhejiang province are all hospitalized in critical condition. A statement from Hong Kong’s Centre for Health Protection (CHP) said the patient from Jiangsu province is also hospitalized.

The new cases boost the outbreak total to 220, according to a running tally updated each day with patients’ details by the FluTrackers infectious disease message board. The group’s total includes the case of an asymptomatic child that’s not included in WHO totals. The unofficial number of deaths is 57.

In a related development today, the WHO released more details about five more lab-confirmed cases it received from China on Jan 20. Hong Kong’s CHP had announced only basic information about the cases on Jan 20.

The patients include two people from Shanghai who died from their infections, the 31-year-old male doctor noted above and a 77-year-old man, as well as three patients from Zhejiang province, all who are hospitalized. They are a 55-year-old man, a 71-year-old woman, and a 63-year-old man. One is in serious and two in critical condition. All had been exposed to poultry before they got sick.

Poultry and environmental H7N9 findings

The WHO’s Western Pacific Region office (WPRO) today released a situation update, noting that continued vigilance is needed as case numbers rise, given the Lunar New Year activities and the unpredictable nature of flu viruses.

It also includes the results from China’s agriculture ministry on the latest H7N9 tests in birds and their environments from two of the outbreak’s hot spots: Guangdong and Zhejiang provinces.

In Zhejiang province, tests of 18 of 200 samples from three agricultural products markets and a wholesale market were positive for the H7N9 virus. Serologic testing of 85 samples yielded 7 positives.

In Guangdong province, testing at 151 sites found only 2 positives from two agricultural markets. Serologic testing of 2,192 samples in Guangdong found no positive specimens. The report also mentions positive tests reported earlier this month from a restaurant and live markets in Guangdong province.

via WHO weighs H7N9 risk as cases mount | CIDRAP.

減重先享「瘦」!必吃5種瘦素食物

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只要每天攝取500毫升的全脂牛奶,體內的瘦素濃度就會在1個月內增加3成。

 

今年接近尾聲了,跨年餐廳早已預訂一空,為什麼有的人去吃到飽餐廳,怎麼吃都吃不胖?有的人則是一餐下來,卻多增加1至2公斤體重?其實兩者差別在於容易吃胖的人,體內缺少「瘦素」Leptin所致。WHO建議,只要戒除一些壞習慣,同時攝取5種富含瘦素的食品,還是有機會控制體重。

什麼是瘦素?瘦素是由脂肪產生的一種激素,主要存在於脂肪細胞製造的白色脂肪組織內,它也可以從棕色脂肪組織,包括胎盤、卵巢、骨骼肌、胃、 乳腺上皮細胞、骨髓和肝產生,瘦素負責調節能量攝入和能量消耗。

瘦素濃度過低 導致脂肪堆積肥胖

2007年由美國生物學家道格拉斯•科爾曼(Douglas Coleman)所發現,找到真正的肥胖關鍵:瘦素含量高的人,新陳代謝高,能抑制脂肪合成;相反的,瘦素濃度過低,就會導致脂肪堆積,使體重增加。如果肥胖的人能有效吸收瘦素,就能夠促使脂肪燃燒,同樣有瘦身的機會。

一般人能維持正常體重,是由於能量的攝取與消耗達到平衡;而能量的攝取與消耗則是靠下視丘來調控,正巧瘦素即是作用於下視丘的受體在大腦的抑制食慾的地方,一旦缺乏瘦素,將無法控制食物攝取量,於是導致肥胖產生。

WHO推薦:TOP 5富含瘦素食物

世界衛生組織WHO推薦以下TOP 5富含瘦素的食品,可作為平時調整體重的參考:

★瘦素NO. 1:牛乳

英國諾丁漢大學的營養專家發現,能分泌飽食瘦素的最大功臣是乳類脂肪,只要每天攝取500毫升的全脂牛奶,體內的瘦素濃度就會在1個月內增加3成。

研究指出,每天吃兩個雞蛋,飽腹指數會上升20%。

研究指出,每天吃兩個雞蛋,飽腹指數會上升20%。

 

★瘦素NO.2:苦瓜

世界衛生組織的研究專員指出,苦瓜中含有高能清脂素,也是瘦素的一種。長期食用,能使飽和脂肪酸的吸收量減少40%。如果不喜歡苦苦的味道,可以用鹽水將苦瓜片浸泡4至5分鐘祛除苦味。

★瘦素NO. 3:雞蛋

研究指出,每天吃兩個雞蛋,飽腹指數會上升20%。日本營養專家也發現,將雞蛋與黃豆同時食用,可提高氨基酸在體內的吸收率。另外,食用雞蛋的最好時間是早上,每天早晨8點,瘦素的合成速度是晚上的2倍左右。

★瘦素NO. 4:蘋果醋

蘋果中的果膠成分和醋中的酵素相互作用,不僅能清洗消化道,還能讓身體產生抑制高血壓的鉀離子,促進瘦素的合成和分泌。但是,如果胃酸分泌過多,就不宜選擇蘋果醋瘦身,會使胃中的酸性環境失衡,造成消化不良,反而增加發胖的可能性。

★瘦素NO. 5:杏仁

杏仁中含有豐富的礦物質鎂,可以穩定血糖、提高血液中的瘦素。美國營養專家指出,杏仁細胞壁的成分還能降低人體對脂肪的吸收,在飲食平衡的情況下,讓瘦素發揮最大的效果。

控制體重 仍必需靠規律運動

根據研究發現,體內瘦素每增加1%,細胞內脂肪燃燒率快3%,平均體重就會下降0.37公斤。但是,僅靠攝取含有瘦素的食物,並非完全解決的方法;有研究顯示,持續且規律的運動,也可以幫助體內的瘦素維持正常濃度,所以,控制體重沒有捷徑,除了飲食還必需靠規律的運動,才能達到目的。

via 減重先享「瘦」!必吃5種瘦素食物 | 20131215 | 華人健康網.

Polio outbreak fears in war-ravaged Syria

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Polio can be prevented but not cured

 

Experts are concerned that polio may have made a return to war-torn Syria.

The World Health Organization says it has received reports of the first suspected outbreak in the country in 14 years.

Syrian’s Ministry of Public Health is launching an urgent response, but experts fear the disease will be hard to control amid civil unrest.

Immunisation is almost impossible to carry out in regions under intense shellfire.

As a result, vaccination rates have been waning – from 95% in 2010 to an estimated 45% in 2013.

At least a third of the country’s public hospitals are out of service, and in some areas, up to 70% of the health workforce has fled.

Outbreak risks have also increased due to overcrowding, poor sanitation and deterioration in water supply.


Polio

  • Caused by a highly-infectious virus
  • Mainly affects children under five years
  • Can lead to irreversible muscle paralysis
  • A course of vaccines against polio can protect a child for life
  • Global eradication efforts continue
  • The disease remains endemic in only a few countries – Afghanistan, Nigeria and Pakistan
  • Mass vaccination is needed to eradicate polio

More than four million Syrians who have relocated to less volatile areas of the country are mostly living in overcrowded, unsanitary conditions.

The WHO says it is already seeing increased cases of measles, typhoid and hepatitis A in Syria.

Dr Jaouad Mahjour, director of the department for communicable diseases at WHO’s regional office for the Eastern Mediterranean, said: “Given the scale of population movement both inside Syria and across borders, together with deteriorating environmental health conditions, outbreaks are inevitable.”

The cluster of suspected polio cases was detected in early October 2013 in Deir al-Zour province.

Initial results from a laboratory in Damascus indicate that at least two of the cases could indeed be polio.

A surveillance alert has been issued for the region to actively search for additional potential cases. Supplementary immunisation activities in neighbouring countries are currently being planned.

WHO’s International Travel and Health recommends that all travellers to and from polio-infected areas be fully vaccinated against polio.

Most people infected with the poliovirus have no signs of illness and are never aware they have been infected. These symptomless people carry the virus in their intestines and can “silently” spread the infection to thousands of others before the first case of polio paralysis emerges.

Polio is spread by eating food or drink contaminated with faeces or, more rarely, directly from person-to-person via saliva.

via BBC News – Polio outbreak fears in war-ravaged Syria.

No Case Of Mers Reported In Malaysia – Health Minister

PETALING JAYA, July 2 (Bernama) — There has been no report of Malaysians, including umrah pilgrims, returning from Saudi Arabia and displaying symptoms of the deadly Middle East Respiratory Syndrome (Mers).

Nevertheless, the health ministry exercises caution and takes the relevant measures, which includes checking the body temperatures of those arriving at the airport.

Minister Datuk Seri Dr S. Subramaniam said, any person found to display symptoms of fever, would be asked to go for further medical examination.

Dr Subramaniam said this when commenting on the spread of the Mers virus which took the lives of 33 people in Saudi Arabia since September last year.

Fifty-five others fell ill as a result of the virus, in that country, he added.

He was speaking to reporters after launching the Malaysian Private Hospitals Association International Health Exhibition 2013 here Tuesday.

The World Health Organisation (WHO) has yet to find a vaccine to prevent Mers, as well as the cause of the deadly infectious disease.

Fever, breathing difficulty, diarrhoea and vomiting are among the symptoms of Mers.

Dr Subramaniam said Kuala Lumpur would continue to monitor developments in Jeddah and follow suggestions and opinions given by the Saudi Arabian authorities on ways to avoid the infection.

Earlier in his speech, the minister told the audience that the Malaysian healthcare industry was one of the most dynamic and vibrant sectors in the country as it was supported by the private healthcare sector.

Touching on healthcare technology, Dr Subramaniam said it had come into every aspect of daily life, way before the onset of illness.

“In the event of illness, healthcare technology will assist in decision-making and selection of appropriate medical practitioners through a central directory in the wellness data base,” he added.

— BERNAMA

via BERNAMA – No Case Of Mers Reported In Malaysia – Health Minister.

WHO | WHO issues new HIV recommendations calling for earlier treatment

30 JUNE 2013 | GENEVA – New HIV treatment guidelines by WHO recommend offering antiretroviral therapy (ART) earlier. Recent evidence indicates that earlier ART will help people with HIV to live longer, healthier lives, and substantially reduce the risk of transmitting HIV to others. The move could avert an additional 3 million deaths and prevent 3.5 million more new HIV infections between now and 2025.

The new recommendations are presented in WHO’s “Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection”, as new data reveal a total of 9.7 million people were taking these lifesaving drugs at the end of 2012.

“These guidelines represent another leap ahead in a trend of ever-higher goals and ever-greater achievements,” says WHO Director-General Dr Margaret Chan. “With nearly 10 million people now on antiretroviral therapy, we see that such prospects – unthinkable just a few years ago – can now fuel the momentum needed to push the HIV epidemic into irreversible decline.”

Call to initiate treatment at 500 CD4 cells/mm³ or less

The new recommendations encourage all countries to initiate treatment in adults living with HIV when their CD4 cell count falls to 500 cells/mm³ or less – when their immune systems are still strong. The previous WHO recommendation, set in 2010, was to offer treatment at 350 CD4 cells/mm³ or less. 90% of all countries have adopted the 2010 recommendation. A few, such as Algeria, Argentina and Brazil, are already offering treatment at 500 cells/mm3.

WHO has based its recommendation on evidence that treating people with HIV earlier, with safe, affordable, and easier-to-manage medicines can both keep them healthy and lower the amount of virus in the blood, which reduces the risk of passing it to someone else. If countries can integrate these changes within their national HIV policies, and back them up with the necessary resources, they will see significant health benefits at the public health and individual level, the report notes.

Further recommendations

The new recommendations also include providing antiretroviral therapy – irrespective of their CD4 count – to all children with HIV under 5 years of age, all pregnant and breastfeeding women with HIV, and to all HIV-positive partners where one partner in the relationship is uninfected. The Organization continues to recommend that all people with HIV with active tuberculosis or with hepatitis B disease receive antiretroviral therapy.

Another new recommendation is to offer all adults starting to take ART the same daily single fixed-dose combination pill. This combination is easier to take and safer than alternative combinations previously recommended and can be used in adults, pregnant women, adolescents and older children.

“Advances like these allow children and pregnant women to access treatment earlier and more safely, and move us closer to our goal of an AIDS-free generation,” said UNICEF Executive Director, Anthony Lake. “Now, we must accelerate our efforts, investing in innovations that allow us to test new born babies faster and giving them the appropriate treatment so that they enjoy the best possible start in life.”

The Organization is further encouraging countries to enhance the ways they deliver HIV services, for example by linking them more closely with other health services, such as those for tuberculosis, maternal and child health, sexual and reproductive health, and treatment for drug dependence.

“The new WHO guidelines are very timely in view of the rapid progress we have made in expanding programmes for prevention and treatment,” says Dr Mark Dybul, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. “This is an example of how the Global Fund and the WHO work together to support countries as we move towards removing HIV as a threat to public health.” Since its creation in 2002, the Global Fund has supported more than 1,000 programmes in 151 countries, providing HIV treatment for 4.2 million people.

Challenges remain

Challenges still remain. Alongside the new treatment guidelines, a treatment progress update by WHO, UNAIDS, UNICEF identified areas in need of attention.

While the number of all eligible children on ART has increased by 10% between 2011 and 2012, this is still too slow compared to the 20% increase in adults. A further complication is that many key populations such as people who inject drugs, men who have sex with men, transgender people and sex workers, continue to face legal and cultural barriers that prevent them getting treatment that otherwise would be more easily available. Another factor that needs to be addressed is the significant proportion of people who, for many reasons, ‘drop out’ of treatment.

Data reinforces feasibility of recommendations

Despite this, the Global update on HIV treatment: results, impact and opportunities contains encouraging data that reinforces the feasibility of the new WHO recommendation on earlier ART, which would expand the global number of people eligible for antiretroviral therapy to 26 million.

Between 2011 and 2012, the largest acceleration ever of people enrolled on ART was achieved, with an extra 1.6 million people benefitting from antiretroviral therapy, increasing the total to 9.7 million people. Furthermore, increased coverage of treatment occurred in every region of the world, with Africa leading. Four out of 5 people who started treatment in 2012 were living in sub-Saharan Africa.

“Today nearly 10 million people have access to lifesaving treatment. This is a true development triumph,” says Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). “But we now have a new challenge – ensuring that all 26 million people eligible for treatment have access – not one person less. Any new HIV infection or AIDS-related death due to lack of access to antiretroviral therapy is unacceptable.”

Today’s recommendations were released by WHO on the opening day of the International AIDS Society 2013 conference in Kuala Lumpur. Among those endorsing the recommendations at the launch were representatives from countries, where such earlier ART intervention is already national policy, along with development agencies who are providing technical and financial support.

The International AIDS Society conference is held every two years and attracts leading scientists, clinicians, public health experts and community leaders to examine the latest developments in HIV-related research, and to explore how scientific advances can inform the global response to HIV/AIDS.

via WHO | WHO issues new HIV recommendations calling for earlier treatment.

Efforts to promote health face serious challenges from ‘big businesses”, says UN official

KUALA LUMPUR June 11: Global efforts to promote health face serious challenges, including from ‘big businesses’, according to the World Health Organisation WHO director general Dr Margaret Chan.

In a statement on the United Nations’ UN website on June 10, Chan was quoted as saying efforts to promote good health were more vital than ever given that non-communicable diseases have overtaken infectious diseases as the leading cause of death, in her address to the 8th Global Conference on Health Promotion held in Helsinki, Finland.

“Economic growth, modernization, and urbanization have opened wide the entry point for the spread of unhealthy lifestyles,” she was quoted as saying.

She said that getting people to lead healthy lifestyles and adopt healthy behaviours faced opposition from forces that were “not so friendly.”

“Efforts to prevent non-communicable diseases go against the business interests of powerful economic operators. In my view, this is one of the biggest challenges facing health promotion,” she said.

“It is not just Big Tobacco anymore. Public health must also contend with Big Food, Big Soda, and Big Alcohol. All of these industries fear regulation, and protect themselves by using the same tactics,” said Chan.

Chan said these tactics included front groups, lobbies, promises of self-regulation, lawsuits, and industry-funded research that “confuses the evidence and keeps the public in doubt.”

They also include gifts, grants, and contributions to worthy causes that cast these industries as respectable corporate citizens in the eyes of politicians and the public, she added.They include arguments that place the responsibility for harm to health on individuals, and portray Government actions as interference in personal liberties and free choice.

“This is formidable opposition. Market power readily translates into political power. Few Governments prioritize health over big business. As we learned from experience with the tobacco industry, a powerful corporation can sell the public just about anything,” said Chan.

Chan also voiced concern about two recent and related trends.

“The first relates to trade agreements. Governments introducing measures to protect the health of their citizens are being taken to court, and challenged in litigation. This is dangerous,” she stated.

“The second is efforts by industry to shape the public health policies and strategies that affect their products. When industry is involved in policy-making, rest assured that the most effective control measures will be downplayed or left out entirely. This, too, is well documented, and dangerous.

“In the view of WHO, the formulation of health policies must be protected from distortion by commercial or vested interests,” said Chan.

via Efforts to promote health face serious challenges from ‘big businesses”, says UN official.

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