Whooping cough makes a comeback: many not vaccinated

Recent outbreaks of whooping cough highlight the need for adults to be vaccinated against this highly contagious disease, U.S. health officials said.

Not only does vaccination protect adults against the disease, it reduces the odds that they will pass on an illness that can be life-threatening to those most at risk: infants who haven't finished their full vaccination series, according to the U.S. Centers for Disease Control and Prevention (CDC).

A whooping cough outbreak this year in California has already sickened more than 5,270 infants and killed nine, the agency reported. That rate of illness is the highest recorded in the state since 1955, according to the California Department of Public Health.

The best way to protect yourself and the infants you come into contact from getting whooping cough — also known as pertussis — is the tetanus, diphtheria, and pertussis (Tdap) vaccine, the CDC advises.

"A pertussis booster shot is essential to prevent the spread of pertussis to infants," said infectious disease expert Dr. Marc Siegel, an associate professor of medicine at New York University in New York City, who was not involved in the report.

"This vaccine wears off, and if you don't get a booster you are putting babies at risk because the spread of pertussis is on the increase, with 17,000 cases reported in 2009," he said. Most infants that have not had their full vaccination series are under six months of age.

If you take care of an infant or have contact with an infant, you have to get a booster, Siegel said. "That booster is best done by getting Tdap, because you need a tetanus booster anyway, so Tdap makes total sense," he said.

The CDC recommends that all adults 18-64 in contact with infants or working in health care receive a Tdap within two years of their last tetanus vaccination, and that other adults in the same age range be offered the vaccine 10 years or more after their last tetanus shot.

However, in the event of outbreaks or a jump in cases of whooping cough in the community, these adults can be vaccinated even when they got last tetanus shot less than 10 years ago, the agency said.

Tdap, which was first introduced in 2005, offers protection from tetanus, diphtheria, and pertussis.

Beruli Ulcers: The WHO Needs to seriously re-think it's strategy

Buruli ulcers, one of the ‘neglected tropical diseases’ left aside by big pharma and governments alike, are reasonably well treatable, also in poor regions but then more attention has to be paid to early diagnosis and correct treatment.

This means the rules of the World Health Organization urgently need to be changed. So say scientists of the Antwerp Institute of Tropical Medicine (ITM), based on ten years of research in Congo.

The disease is caused by Mycobacterium ulcerans, a nephew of the infamous tuberculosis bacterium. It occurs in tropical and subtropical countries, mainly in Africa. It causes hideously ulcerating ‘holes’ in the skin, that can dig to the bone and can outgrow to diameters of more than 10 centimetres.

Much about the disease is unknown, for instance how exactly people get infected. It is assumed that water plays a role, but only in 2008 scientists — at ITM — succeeded in cultivating the bacterium from a water insect.

For a long time the only treatment consisted of caring for the wounds, and possibly a skin transplantation. Nowadays the WHO proposes a treatment analogous to tuberculosis, with two antibiotics, rifampicin and streptomycin. This works for light cases, but for lesions above 10 cm the effect was not documented.

ITM scientist Anatole Kibadi Kapay collected cases in DR Congo from the previous five years, when surgery combined with antibiotics was used, and from the five year before that, when only surgery was used. In the process he discovered a new focus close to the Angolan border; he assumes it to be correlated to the working conditions in the illegal diamond mines there.

Kibadi Kapay noticed that the WHO guidelines for clinical diagnosis lead to a correct diagnosis in only 2 cases out of 3. As opposed to a Ziehl-Neelsen smear, a microscopic technique that is within reach of poor countries — and that, through a better diagnosis, prevents the needless use of antibiotics.

But when large wounds have to be treated, from a microscopically confirmed Buruli case, antibiotics indeed are of good use. With surgery only, 15% of patients relapse; with parallel use of antibiotics, less than 2% relapse. But antibiotics only, without surgery, make large wounds worse.

Kibadi Kapay — who today received a doctorate from Antwerp University for his work — and his ITM colleagues advocate faster surgery of large ulcerating lesions, without four weeks of waiting with antibiotics only.

The more because patients themselves already wait a long time before consulting a doctor — to them the ulcers are inflicted by witchcraft or fate.

The research by Kibadi Kapay demonstrates the need of a better education of the population, but more important, it shows that WHO guidelines for diagnosis and treatment of Buruli ulcers urgently need to be adapted.

Action and Reaction - He who draws first Loses

Niels Bohr once had a theory on why the good guy always won shoot-outs in Hollywood westerns. It was simple: the bad guy always drew first. That left the good guy to react unthinkingly – and therefore faster. When Bohr tested his hypothesis with toy pistols and colleagues who drew first, he always won.

Andrew Welchman of the University of Birmingham, UK, has now taken this a step further. Bohr may have won a Nobel prize for his work on quantum mechanics, but it turns out the answer to this puzzle is more complicated than he thought.

Welchman pitted pairs of people against each other. The task? Lift your hand off a button, push two other buttons, then return to the first. There was no start bell. "Eventually one decides it's time to move," Welchman says. "The other player will then try to move as fast as possible."

The reacting players took 21 milliseconds less time to move, on average, than the first ones. Welchman thinks reaction movement involves a faster brain pathway than intentional movement. So Bohr was right? Not quite.

There was also a "reaction time", a delay of 200 milliseconds before the players started to respond to their opponent's actions. So although they moved faster, they never won.

H1N1: WHO uncertain whether the Pandemic is over of just Beginning

Senior World Health Organisation official Keiji Fukuda said Thursday that it was too early to declare the swine flu pandemic over, as it continues at "high levels" in parts of Europe and central Asia.

Although the A(H1N1) flu virus is peaking and even declining in parts of the northern hemisphere, and is hardly present in the south, Fukuda said there was an unproven possibility that there could be another wave later in the winter.

"It really probably remains too early to call the pandemic over," Fukuda said in a weekly telephone news conference.

Fukuda, Special Adviser to the WHO Director-General on Pandemic Influenza, said flu "activity continues at quite high levels in several different countries" notably the Czech Republic, France, Kazakhstan, Kyrgyzstan, Russia and Switzerland.

Fukuda also noted that the signs of a peak and a decline in the caseload in North America and parts of Europe had occurred "extraordinarily early for influenza," with several months of the winter left.

As a result, the WHO could not rule out the possibility of another wave of illness in late winter or early spring.

"We simply are unable to answer this question right now. We continue to assess, right now we cannot predict whether we will see another upsurge in activity in the earlier parts of 2010," Fukuda said.

H1N1: Swine Flu Mutations endangers Europe: WHO issues ineffective rhetoric

Swine flu virus mutations are spreading in Europe, French health officials said Friday as the World Health Organisation reported a leap in deaths from the disease by more than 1,000 in a week.

Two patients who were infected by a mutation that was also recently detected in Norway have died in France, the government's Health Surveillance Institute (InVS) said in a statement.

"This mutation could increase the ability of the virus to affect the respiratory tracts and, in particular, the lung tissue," said a statement from "For one of these patients, this mutation was accompanied by another mutation known to confer resistance to oseltamivir," it added, referring to the main drug being used to treat swine flu, under the brand name Tamiflu.

The case was the first drug-resistant strain found in France among the 1,200 strains experts have analysed here, the InVS said, adding that "the effectiveness of vaccines currently available is not being questioned."

The two patients were not related and had been hospitalised in two different cities in France, it said.

The WHO said Friday the death toll had reached at least 7,826 worldwide since the A(H1N1) flu virus was first uncovered in April.

The number of deaths reported to the UN health agency showed the biggest rise in the Americas, where 5,360 deaths have now been recorded compared to 4,806 a week ago.

But Europe also posted a substantial increase percentage-wise with at least 650 fatalities now reported, representing a surge of 300 deaths or 85 percent from data posted a week ago.

The WHO said Thursday it was investigating reports of mutations in the virus, after half a dozen countries recorded such cases.

"The question is whether these mutations again suggest that there is a fundamental change going on in viruses out there -- whether there's a turn for the worse in terms of severity," said Keiji Fukuda, WHO's special adviser on pandemic influenza.

"The answer right now is that we are not sure," he added following reports from China, Japan, Norway, Ukraine and the United States.

He noted, however, that mutations are common in influenza viruses, and "if every mutation is reported out there it would be like reporting changes in the weather."

"What we're trying to do when we see reports of mutations is to identify if these mutations are leading to any kinds of changes in the clinical picture -- do they cause more severe or less severe disease?

"Also we're trying to see if these viruses are increasing out there as that would suggest a change in epidemiology," he added.

China said earlier Thursday that it had discovered eight people with mutated versions of swine flu while Norway reported last week that it had detected one case.

Fukuda also said that the UN health agency was looking into Tamiflu-resistant cases reported in Britain and the United States but noted they concerned people who are already undergoing treatment for other diseases or who have underlying health issues.

The health agency was therefore maintaining its assessment that Tamiflu, produced by Swiss drugmaker Roche, remained "effective" as a treatment for swine flu, but that "we do have to be vigilant in these very susceptible people."

H1N1:Japan experts go to Canada to study flu vaccine reactions - WHO

Tokyo (AFP) Nov 29, 2009 - Japan sent a team of health experts Sunday to Canada to investigate allergic reactions to swine flu vaccinations from British pharmaceutical giant GlaxoSmithKline (GSK).

The World Health Organization said last week that an unusual number of severe allergic reactions to swine flu vaccinations have been recorded in Canada, where a batch of the vaccine from GSK has been recalled. The team from the health and welfare ministry was seen departing from Tokyo's Narita airport.

It is scheduled to spend four days in Canada to study precautionary measures against allergic reactions. Tokyo has ordered doses of GSK-made vaccinations for 37 million people, a shipment due for delivery in December in a country that has a limited supply of domestically-made prophylactics.

Japan started vaccinating medical workers against swine flu in October. Since May, the A(H1N1) virus is known to have killed 70 people in the country, which is now heading into the autumn-winter flu season.

H1N1: Virus Mutation Increases Death Toll by 1,000 per week

Geneva (AFP) Nov 27, 2009 - The number of swine flu deaths showed a sharp jump compared to a week ago, but the World Health Organisation said Friday that the epidemic may have peaked in parts of the northern hemisphere. The number of deaths reported to the WHO was up 1,000 from a week ago, reaching at least 7,826 worldwide since the A(H1N1) virus was first uncovered in April, fresh data showed.

The number of deaths reported to the UN health agency showed the biggest rise in the Americas, where 5,360 deaths have now been recorded compared to 4,806 a week ago but Europe also posted a substantial increase percentage-wise with at least 650 fatalities now reported, representing a surge of 300 deaths or 85 percent from data posted a week ago.

The WHO said influenza activity appears to have peaked across North America, although in Canada, the number of hospitalisations and deaths is increasing. In European countries including Belgium, Bulgaria, Belarus, Ireland, Luxembourg, Norway, Serbia, Ukraine and Iceland, influenza activity also appears to have reached a peak, added the WHO.

H1N! Swine Flu: Second man dies of Pneumonic Plague in China

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A second man has died of pneumonic plague in northwest China. The outbreak prompted authorities to seal off an entire town where about a dozen people are infected with the highly contagious deadly lung disease, a state news agency said.

The man who died on Sunday was identified only as 37-year-old Danzin from Ziketan, the stricken town in Qinghai province, the official Xinhua News Agency said.

Relatives Infected
Danzin was a neighbour of the first person who died, a 32-year-old herdsman whose name was not given. Another 10 people, mostly relatives of the first deceased man, are infected and undergoing isolated treatment in hospital, Xinhua said.

Town Quarantined
The town of 10,000 people has been placed under quarantine and a team of experts is being sent to the area, it said.

The local health bureau warned that anyone with a cough or fever who has visited the town since mid-July should seek treatment at a hospital.

Pneumonic Plague
Pneumonic plague is spread through the air and can be passed from person to person through coughing, according to the World Health Organisation (WHO). It is caused by the same bacteria that occurs in bubonic plague - the Black Death that killed an estimated 25 million people in Europe during the Middle Ages.

Bubonic Plague
While bubonic plague - which is usually transmitted by flea bite - can be treated with antibiotics if diagnosed early, pneumonic plague is one of the deadliest infectious diseases. According to the WHO, humans can die within 24 hours of infection.