World bank lanch $200 EBOlA fund

World Bank launches $200m Ebola fund
August 5, 2014 02:47
The World Bank has announced that it is allocating $200m (£120m) in emergency assistance for West African countries battling to contain the Ebola outbreak.

The money will be distributed to the governments of Liberia, Sierra Leone and Guinea as well as to the World Health Organization (WHO).

The number of people killed in the outbreak has reached 887, the WHO says.

The World Bank's announcement came as African leaders including 35 presidents discuss the crisis in Washington.

World Bank President Jim Yong Kim - an expert on infectious diseases - said that he was "deeply saddened" by the spread of the virus and how it was contributing to the breakdown of "already weak health systems in the three countries".

Health workers have to wear protective suits to ensure they do not catch the virus
"I am very worried that many more lives are at risk unless we can stop this Ebola epidemic in its tracks," he said.

The BBC's Paul Blake in Washington says that in the the short term, the money will be used to pay health workers, dispel rumours about the disease in local communities and address the immediate needs of getting sick people into health facilities.

Over the long term, our correspondent says, the funds will be used to help countries deal with the economic impact of the outbreak and to monitor the spread of the disease.

The package is now awaiting approval by the World Bank's Board of Directors, though officials say the confirmation could come as early as this week.

The World Bank and International Monetary Fund say preliminary research suggests the epidemic is likely to shave one percentage point from Guinea's economic output this year.

In other developments:

• Nigeria has recorded its second Ebola case - one of the doctors who treated a man who died from the virus after his arrival from Liberia

• Liberia has ordered that the bodies of people killed by the Ebola virus must be cremated following the refusal of some communities to allow the burial of victims on their land.

The virus spreads by contact with infected blood and bodily fluids.

Touching the body of someone who has died of Ebola is particularly dangerous.

Airports in Nigeria are now screening passengers for Ebola on their arrival
The evacuation of the second US health worker to become infected in Liberia is expected later.

Nancy Writebol will be flown to Atlanta in the US to a special isolation ward at Emory University Hospital, where Dr Kent Brantly, who arrived from Liberia on Saturday, is being treated by infectious disease specialists.

Ebola virus disease (EVD)

• Symptoms include high fever, bleeding and central nervous system damage

• Fatality rate can reach 90%

• Incubation period is two to 21 days

• There is no vaccine or cure

• Supportive care such as rehydrating patients who have diarrhoea and vomiting can help recovery

• Fruit bats are considered to be virus' natural host

On Friday, Margaret Chan, head of the World Health Organization, met the leaders of Guinea, Liberia and Sierra Leone to launch a new $100m (£59m) Ebola response plan.

According to the UN, more than 60 of the Ebola deaths so far have been health care workers.

There is no cure or vaccine for Ebola - but patients have a better chance of survival if they receive early treatment.

The current outbreak is killing between 50% and 60% of people infected.

Ebola since 1976

BBC © 2014

Indian boy has 232 teeth removed

Indian boy has 232 teeth removed
July 23, 2014 5:23 PM

Ashik Gavai is seen here after the operation, with the teeth that were removed
Doctors in India have extracted 232 teeth from the mouth of a 17-year-old boy in a seven-hour operation.

Ashik Gavai was brought in with a swelling in his right jaw, Dr Sunanda Dhiware, head of Mumbai's JJ Hospital's dental department, told the BBC.

The teenager had been suffering for 18 months and travelled to the city from his village after local doctors failed to identify the cause of the problem.

Doctors have described his condition as "very rare" and "a world record".

'Small white pearls'

"Ashik's malaise was diagnosed as a complex composite odontoma where a single gum forms lots of teeth. It's a sort of benign tumour," Dr Dhiware said.

Ashik Gavai's teeth were put on display by doctors after the operation

The teenager had to endure seven hours of medics pulling teeth from his mouth

It was all smiles from the medical team after the operation
"At first, we couldn't cut it out so we had to use the basic chisel and hammer to take it out.

"Once we opened it, little pearl-like teeth started coming out, one-by-one. Initially, we were collecting them, they were really like small white pearls. But then we started to get tired. We counted 232 teeth," she added.

The surgery, conducted on Monday, involved two surgeons and two assistants. The team was led by Dr Vandana Thorawade who heads the hospital's ENT (ear, nose and throat) department. Ashik now has 28 teeth.

Describing Ashik's case as "very rare", Dr Dhiware said she had "not seen anything like this before in my 30-year career", but said she was "thrilled to get such an exciting case".

"According to medical literature available on the condition, it is known to affect the upper jaw and a maximum of 37 teeth have been extracted from the tumour in the past. But in Ashik's case, the tumour was found deep in the lower jaw and it had hundreds of teeth."

Ashik's father Suresh Gavai was quoted by the Mumbai Mirror as saying that his son complained of severe pain a month ago.

"I was worried that it may turn out to be cancer so I brought him to Mumbai," he said.

BBC © 2014

Footballers need concussion care

Footballers 'need concussion care'
July 14, 2014 2:06 AM

Uruguayan defender Alvaro Pereira appeared to be knocked unconscious in a World Cup match
Decisions on whether a footballer can return to the pitch after a head injury should be taken by an independent doctor, and not the player or coach.

An editorial in The Lancet Neurology says these decisions should not be made "by those with a vested interest".

FIFPro, the footballers' union, has called for an investigation into concussion protocols.

This follows incidents during the World Cup where footballers played on after appearing to be concussed.

"Because signs and symptoms of concussion can be delayed, removing an athlete when there is any suspicion of injury would seem to be the safest approach," the journal editors wrote.

They refer to a recent World Cup group match against England, when Uruguay's Alvaro Pereira returned to the pitch after appearing to be knocked unconscious by a blow to the head.

Pereira admitted to arguing with his team doctor, demanding that he should be allowed to continue playing.

Pereira argues for his return to the pitch following his head injury
The editors make the point that the decision on the player's "fitness to play" should not have been left in the hands of the Uruguayan team doctor and team officials.

Instead, "return-to-play decisions should be made on an individual basis", they said.

In the World Cup semi-final between Argentina and the Netherlands, Javier Mascherano stumbled about and then collapsed on the pitch after clashing heads with a Dutch player.

Despite appearing to suffer concussion, the Argentinean midfielder returned to the fray just minutes later.

'Wrong message'

Fifa has been criticised for failing to deal with the incidents safely, by ensuring that the players were immediately taken off the pitch and removed from the game.

While many sporting organisations now recognise the potential damage that mild traumatic brain injury (TBI) can cause, the writers said more needs to be done to reduce how often these injuries occur.

Improving the assessment, monitoring and care of adults and children with sports-related concussion should also be a priority, it states.

Mr Antonio Belli, reader in neurotrauma at the University of Birmingham, said players don't understand how dangerous concussion can be.

"When players return to the pitch and continue playing, they are sending out the wrong message. There are lots of medical reasons not to continue."

The long-term consequences of mild traumatic brain injuries can include dementia and other neurological degenerative diseases.

Headaches and dizziness can appear in the short-term.

BBC © 2014

Malaria parasite hides in the bone

Malaria parasite 'hides in the bone'
July 9, 2014 6:02 PM
By Helen Briggs
Health editor, BBC News website

Mosquito with parasite sucking blood
Parasites infected with malaria can hide inside the bone marrow and evade the body's defences, research confirms.

The discovery could lead to new drugs or vaccines to block transmission.

The research, published in Science Translational Medicine, fills a "key knowledge gap" in the biology of the disease, say scientists at Harvard.

Carried by mosquitoes, the parasite causes the most severe form of malaria, which leads to more than 500,000 deaths every year globally.

The study found that malaria-infected parasites could bury into bone marrow, where they escaped the immune system and caused disease.

The idea that they hide in the bone marrow while they mature has been around for decades.

But a team led by Prof Matthias Marti, of the Harvard School of Public Health, in Boston, pinpointed exactly where the parasites found sanctuaries in bone marrow by analysing tissue samples from autopsies.

"We have confirmed that the parasites that cause malaria can hide in the bone marrow," he told BBC News.

The discovery was "exciting" because it identified "a key knowledge gap in the biology of the parasite", he added.

The hope is that this may help scientists devise a way to target parasites hiding out in bone marrow with new drugs or vaccines.

The most recent figures from the World Health Organization suggest malaria killed more than 600,000 people in 2012, with 90% of these deaths occurring in sub-Saharan Africa.

BBC © 2014

Forgotten us smallpox found in box

'Forgotten' US smallpox found in box
July 8, 2014 8:20 PM

Long forgotten vials of smallpox left in a cardboard box have been discovered by a government scientist at a research centre near Washington, officials say.

The virus, believed dead, was located in six freeze-dried and sealed vials, according to the Centers for Disease Control and Prevention (CDC).

It is said to be the first time unaccounted-for smallpox has been discovered in the US.

The disease was officially declared eradicated in the 1980s.

"The vials appear to date from the 1950s. Upon discovery, the vials were immediately secured in a CDC-registered select agent containment laboratory in Bethesda, [Maryland]," according to a CDC statement.

"There is no evidence that any of the vials labelled variola has been breached, and onsite biosafety personnel have not identified any infectious exposure risk to lab workers or the public," the statement added.

Government agencies were notified of the discovery on 1 July, after National Institutes of Health (NIH) employees discovered the vials labelled "variola", also known as smallpox.

The vials were located in an unused area of a storage room in a Food and Drug Administration laboratory on an NIH campus in Bethesda.

The vials were subsequently transported to a secure facility in Atlanta, Georgia, on 7 July.

The smallpox vials were transported to a secure CDC facility in Atlanta, Georgia
Tests will be conducted on the material to determine if it is viable before it destroyed, the CDC said.

The virus may remain deadly even after freeze-drying, though is it typically kept cold to remain alive.

The CDC also notified the World Health Organization (WHO) of the discovery. The WHO currently oversees two designated repositories for smallpox; one in Atlanta as well as one in Novosibirsk, Russia.

It is the not the first time vials of smallpox have been unexpectedly discovered. Several were found at the bottom of a freezer in Eastern Europe in the 1990s, according to media reports.

BBC © 2014j

Human corneas regrown in mice

'Human corneas re-grown in mice'
July 2, 2014 17:08
By Smitha Mundasad
Health reporter, BBC News

Limbal stem cells in the eye have the capacity to re-generate
Scientists have developed a new technique to regrow human corneas.

Using key tracer molecules, researchers have been able to hunt down elusive cells in the eye capable of regeneration and repair.

They transplanted these regenerative stem cells into mice - creating fully functioning corneas.

Writing in the journal Nature, they say this method may one day help restore the sight of victims of burns and chemical injuries.

Limbal stem cells (LSC) are crucial for healthy eyesight - these cells work to maintain, repair and completely renew our corneas every few weeks.

Without them the cornea - the transparent outermost layer of the eye - would become cloudy and our vision disrupted.

A deficiency of these cells due to disease or damage through injury to the eye are among the commonest reasons behind blindness worldwide.

But the cells have so far been extremely difficult to identify, buried in a matrix of other structures in the limbal part of the eye - the junction between the cornea and the white of the eye (the sclera).

'Fluorescent flags'

Now scientists from the Massachusetts Eye and Ear Infirmary, Boston Children's Hospital, Brigham and Women's Hospital and the VA Boston Healthcare System have identified a key tracer molecule - known as ABCB5 - naturally present on the surface of limbal stem cells.

Though ABCB5 has been known about for some time in other parts of the body, this is the first time it has been spotted on LSCs, helping to single out these elusive cells.

Researchers have been able to tag these cells with fluorescent molecular flags.

In their study, the scientists used this tagging technique to instantly identify a pool of LSCs on donated human corneas.

After being transplanted to mice, these cells were able to generate fully functioning human corneas.

Prof Markus Frank, of Boston Children's Hospital, a lead author in the research, told the BBC: " The main significance for human disease is we have established a molecularly defined population of cells that we can extract from donor tissue.

"And these cells have the remarkable ability to self-regenerate. We hope to drive this research forward so this can be used as a therapy."

Harminder Dua, professor of ophthalmology at the University of Nottingham, who was not involved in this study, said: "This paper represents a very comprehensive and well conducted piece of work that takes use closer to the precise identification of stem cells.

"Applying this knowledge to a clinical setting could help improve the outcomes for patients who need corneal reconstruction."

BBC © 2014

Patients facing longer Gp waits

Patients 'facing longer GP waits'
June 25, 2014 07:27

Medical students give their reasons for favouring alternatives to general practice
By Nick Triggle
Health correspondent
Longer waits to see a GP in the UK are "becoming the norm", the British Medical Association is warning.

BMA GP leader Dr Chaand Nagpaul said "chronic underfunding" meant patients were often having to wait one or two weeks for an appointment.

Some patients struggled to get an appointment, he said. Data from the GP patient survey in England shows one in 10 could not last time they tried.

The government said measures addressing the issue were already in place.

Dr Nagpaul will highlight the issue of funding coupled with rising demand in a speech at the BMA's annual conference on Wednesday.

He will point out that annual consultations have risen by 40 million in England alone since 2008, hitting 340 million a year at the last count.

But he will tell delegates in Harrogate that the increase has come at a time when the amount spent on general practice as a share of the NHS budget has been falling.

Complex conditions

Figures from the Royal College of GPs show that in 2005-6 it stood at 10.7% of NHS spending, but by 2011-12 it had dropped to 8.4%.

Ahead of the speech Dr Nagpaul told the BBC: "Demand is outstripping supply. The patients we are seeing have more complex conditions and yet we still only have 10 minutes for each consultation - that is woefully inadequate.

"General practice is chronically under-funded and that is beginning to have an impact on the patient experience."

He added waits of "one or two weeks were becoming the norm" for patients, although he said those needing urgent appointments would always be seen quickly.

His warning was backed up by the Patients Association.

Its chief executive, Katherine Murphy, said: "We hear daily from patients that they can't get appointments. It's even worse for those who want a named doctor for continuity of care. They are having to wait two or three weeks. It is becoming a real issue.

"We need more investment in general practice, but I think we also need greater flexibility from doctors - it can no longer be a nine to five service."

The Department of Health said this was already happening via its £50m Challenge Fund.

'Not affordable'

More than 1,100 practices - one in eight of those in England - have signed up to the initiative to extend opening hours and make greater use of technologies such as Skype and e-mail.

A spokesman added the measures should make access "more convenient" for patients.

"People need to see a GP at a time to suit them," he said.

But Dr Beth McCarron-Nash, a GP based in Truro, said: "There is a drive towards convenience general practice, and actually we do need an open and honest debate with the public about what general practice is actually funded for.

"We're struggling to cope with providing the need, let alone the convenience of what I call the Martini practice - seven days a week, any time, any place, anywhere. That, unfortunately, is not affordable."

Dr McCarron-Nash also said many practices were failing to recruit doctors.

"Why would you want to be a partner when actually [there is] liability in owning a practice, employing the staff, all the extra work that actually comes with being an employer, along with the workload demands?

"Young doctors are leaving the UK, they're deciding not to be GPs."

Labour shadow health secretary Andy Burnham said: "It is getting harder and harder to get a GP appointment under David Cameron's government.

"The lack of access to GPs is forcing many people to use much more expensive A&E departments.

"The next Labour government will invest £100m to help patients to get a GP appointment - either within 48 hours or a same-day consultation with a doctor or nurse for those who need it."

BBC © 2014

Phones carry bacterial 'fingerprint'
June 24, 2014 11:11
By Helen Briggs
Health editor, BBC News website

The bugs from our bodies end up on our smartphones
Smartphones reflect the personal microbial world of their owners, say US scientists.

More than 80% of the common bacteria that make up our personal bacterial "fingerprints" end up on their screens, a study suggests.

Personal possessions, such as phones, might be useful for tracking the spread of bacteria, they report in PeerJ.

They reflect our microbiome - the trillions of different micro-organisms that live in and on our bodies.

Mobile phone users have been found to touch their devices on average 150 times a day.

Scientists have found an overlap between the collection of micro-organisms naturally present on our bodies and those on the screens of smartphones.

They say this could one day be used to track people's exposure to bacteria.

In the study, biologists from the University of Oregon sequenced the DNA of microbes found on the index fingers and thumbs of 17 people.

They also took swabs of the subjects' smartphones.

A total of 7,000 different types of bacteria were found in 51 samples.

Proof-of-concept

On average, 22% of bacterial families overlapped on fingers and phones.

Some 82% of the most common bacteria present on participants' fingers were also found on their phones.

They included three families that are commonly found on the skin or in the mouth - Streptococcus, Staphylococcus and Corynebacterium.

Men and women both shared bacteria with their phones, but the connection was stronger in women.

Bacteria are naturally present on our skin and in our mouths
Lead researcher Dr James Meadow said while the sample size was small, the findings were "revealing".

"This project was a proof-of-concept to see if our favourite and most closely held possessions microbially resemble us," he said.

"We are ultimately interested in the possibility of using personal effects as a non-invasive way to monitor our health and our contact with the surrounding environment."

The researchers say there is no evidence that mobile phones present any more infection risk than any other possession.

But they say our phones might one day be used to study whether people have been exposed to certain bacteria, particularly healthcare workers.

Emotional connection

The study confirms that "we share more than an emotional connection with our phones - they carry our personal microbiome", Dr Meadow added.

There is increasing scientific interest in the human microbiome - the population of trillions of micro-organisms that live in our gut, mouth, skin and elsewhere on our bodies.

Bacteria can be harmful but they can also have beneficial effects, particularly in the gut, by digesting food and making essential nutrients and vitamins.

BBC © 2014

Polio virus sample found in Brazil
June 23, 2014 17:55

Children are most vulnerable to the highly infectious disease but vaccines offer protection
A strain of the polio virus has been found at an international airport in Brazil, but there are no human cases, the World Health Organization has said.

A WHO statement released on Monday said the virus was found in samples taken from sewage at Viracopos International Airport in Sao Paulo state in March.

It said the local population's high immunity to the disease "appears to have prevented transmission".

Brazil has been polio-free since 1989 and has high vaccination coverage.

The virus was found in "sewage only" and subsequent analysis of similar samples have either been negative or only positive for "non-polio enteroviruses", the organisation said.

The WHO said the sample was a close match with a recent strain isolated in a case in Equatorial Guinea.

The risk of the polio virus spreading from Equatorial Guinea is described as "high" by the UN agency, but it said the risk from Brazil remained "very low".

Polio invades the nervous system and can cause irreversible paralysis within hours. There is no cure for the disease but it can be prevented by immunisation.

Brazil's last national immunisation campaign was conducted a year ago and coverage in Sao Paulo state has been higher than 95%, the WHO said.

Polio: the facts

•A highly infectious viral disease that mainly affects children under five

•Can cause irreversible paralysis

•There is no cure, but polio vaccine given multiple times can protect a child for life

•Afghanistan, Nigeria and Pakistan are the only countries left with endemic polio

BBC © 2014

Diabetes gene 'raises risk tenfold'
June 19, 2014 01:01
By Helen Briggs
BBC News

Greenland: Type 2 diabetes cases are rising as lifestyles change
A genetic susceptibility that gives a tenfold increased risk of developing type 2 diabetes has been discovered.

The gene mutation, found in the population of Greenland, will give clues to the different causes of the condition, say Danish scientists.

The research, published in Nature, adds to evidence genetics plays a role in the chances of developing diabetes.

Other factors included lifestyle, with obesity and a bad diet increasing risks, said a diabetes charity.

Several susceptibility genes have been linked with diabetes, meaning that if an individual is carrying one of these genes they face a greater risk of developing diabetes.

Danish researchers say the new mutation is present in almost one in five of Greenlanders.

But Prof Torben Hansen, of the University of Copenhagen, said it was not found in other European, Chinese or African-American populations, suggesting type 2 diabetes has multiple causes.

The gene variation raised the risk of type 2 diabetes by up to ten times, he told BBC News.

"We have identified a new and novel type 2 diabetes gene with a huge increased risk due to insulin resistance in muscle," he added.

"Type 2 diabetes is not just one disease, it's many diseases."

Balanced diet

In the long term, this kind of research could help provide new ways to prevent and treat the condition, said Richard Elliott, research communications manager at Diabetes UK.

"Until we know more, maintaining a healthy weight by eating a healthy balanced diet and enjoying regular physical activity is the best way to prevent type 2 diabetes," he said.


Greenland: The island's population is only 57,000
Greenlanders are a historically small and isolated population - established by a very small number of individuals.

The island has undergone a rapid transformation from a traditional hunting and fishing society to a modern lifestyle, with an increasing rate of Western diseases.

Type 2 diabetes was once very rare on the island, but it has increased dramatically in the past 50 years.

Blood sugar

Prof Torben Hansen and colleagues screened for genetic links to type 2 diabetes in 2,575 people living in Greenland.

They discovered that a mutation in a gene called TBC1D4, present in 17% of the population studied, increased risk.

The effects are several times larger than any previous findings.

Unlike other mutations that have been found, it causes problems with the regulation of blood sugar levels after eating.



BBC © 2014