Overview of Measle Outbreak in 2013

The following confirmed cases of Measles have been reported worldwide in 2013:

• Australia (Queensland): 51, as reported by Queensland Health
• USA: 159 up to August 2013, as reported by the CDC
• UK: over 800 cases in the Swansea area, as reported by the NHS
• The Netherlands: 2,543 cases, as reported by RIVM
• Canada (Alberta); 42 cases, as reported by Alberta Health Services

Other notable outbreaks occurred in Indonesia (6,300 confirmed cases), Germany (1,520 cases), Turkey (7,132 cases) and Pakistan (over 30,000).
Most of these cases were in unvaccinated (82%) or incompletely vaccinated (13%) people.

In addition to the current measle outbreak, in Germany two cases of subacute sclerosing panencephalitis (SSPE), a rare, late complication of measles have been reported in 2013. SSPE occurs in general about seven years after having a measles infection. The CDC reports that it SSPE concerns a "progressive deterioration of behavior and intellect, followed by ataxia (awkwardness), myoclonic seizures, and eventually death." There is currently no cure for SSPE or measles, but both can be prevented by vaccination.

Pigs that glow (in the dark)

Scientists from the South China Agricultural University in collaboration with experts from University of Hawaii at Manoa have stated that they were able to raise 10 piglets which will glow green in the dark. As explained in their article in Transgenic Research  Zhenfang Wu, Johann Urschitz, Stefan Moisyadi and others describe the use of a new technology to obtain these transgenic pigs. The scientists were able to insert the gene for Green Fluorescent Protein (GFP) from Aequorea Victoria  jellyfish into the porcine DNA using a new technology is called piggyBAC-mediated transposition of transgenes.

It is not the first time that such green-glowing transgenic pigs have been created. In 2006 researchers from the National Taiwan university also reported to have bred three male pigs which glow in the dark.

The ultimate goal of all this research is to introduce beneficial genes into larger animals to create less costly and more efficient medicines. This has for instance already been tried with the gene of transferrin in cows (Stier Herman of Pharming Group NV in the Netherlands as described by Krimpenfort et al in 1991).

Medical review on the alcohol consumption of Bond, James Bond

A highly remarkable article in the British Medical Journal featured the alcohol consumption of one of the world’s favourite spies. The fictional character Commander James Bond, as created by Ian Fleming, has been seen in many movies to order his trademark Martini ‘Shaken, not stirred’. But the authors of this article went beyond the Martinis and made a detailed inventory of how much Mr. Bond would actually drink in real life, if he were a real person. They read the 14 James Bond books, made notes, compared these notes and came to a conclusion, all very much like regular scientific research. Their conclusion: James would have consumed a staggering 92 units of alcohol a week, which is over four times the recommended amount of alcohol. This high level of alcohol intake would put him at high risk of alcohol related diseases such as liver disease, cirrhosis, impotence and most likely an early death (if not by violence or sexually transmitted diseases first). So he would most likely suffer from alcohol induced tremor, not a good thing if you want to pull a gun and shoot a terrorist. Maybe cutting down on the drinking would be a good thing Mr. Bond!

Measle vaccination

Director of the European Centre for Disease Prevention and Control (ECDC) Marc Sprenger has urged doctors and nurses to provide parents who do not want to vaccinate their children (for political, religious or other reasons) with balanced and evidence-based information  to help make informative decisions regarding vaccination. He did so on the Excellence in Paediatrics conference in Doha last week. The vaccinations are not only to protect the children who are invited for vaccination, but also those who are too young to be vaccinated (younger than 9 months). These children are especially at risk as they can contract the disease if the immunity of the community where they grow up is too low. One of the risks for children infected with measles at that age is subactute sclerosing pan-encephalitis (SSPE), also known as Dawson Disease, which is characterized by progressive psycho-neurological deterioration, seizures and coma.  In the Netherlands, the RIVM (Dutch Institute for Public Health and the Environment) has confirmed 2,439 cases of measles (1 May – 4 December 2013), of which a 17-year old girl who died of measles complications. During earlier outbreaks in 1999/2000, 150 children were hospitalized and 3 died.

There currently is no cure or treatment for infection with measles (Morbilli virus) but a vaccine (MMR) is available.

One Million Deaths - survey in India

The Centre for Global Health Research is conducting an incredible research program, called Million Death Study (MDS). This program had been started 16 years ago and has been set up to document death in India using ‘verbal autopsy’ strategies. The MDS involves in-person surveys of more than 1 million households in India to study premature mortality from 1997 to 2013 which occurred outside the hospital.  Using the verbal autopsy method, the researchers can determine the probable causes of death in cases where there was no medical record or formal medical attention. Families are questioned by field-workers about the events that preceded the deaths. The narratives are then sent to physicians to assign a probable cause of death to each case. The data is valuable for public health experts to monitor disease and assess interventions. That is why the CGHR will be providing the results of the Million Death Study to governments, research agencies and the media.

Nature has published an article on this study which highlights the gathering of the data, the progress of the study and of course the preliminary results on the top causes of deaths. The four most significant causes of death for Indians aged 30-69 are vascular disease, chronic respiratory disease, tuberculosis and cancer. However, the real value of the MSD lies in the observed trends and differences between deaths in hospital and in rural areas. For instance, of the deaths attributed to malaria 90% occurred in rural areas outside of hospital or health-care facilities. These estimates

are much higher than the estimates of the WHO. The use of verbal autopsy to gather the data has been criticized, also by the WHO, as it is not always possible to differentiate malaria from other diseases that cause fever symptoms. However, other teams have also reported higher mortality rates due to malaria.

 (c) CGHR: Million Death Study

The MDS was started by Prabhat Jha, an epidemiologist at the University of Toronto, who wanted to found more information on his grandfather’s death, who had died at home in India. Jha went on to found the CGHR, an independent, not-for-profit organization.

Tuberculosis funding by European Commission

On 2 December, the European Commission (EC) announced that the European Union (EU) institutions will support the Global Fund to fight AIDS, Tuberculosis (TB) and Malaria with €370 million for the period 2014-2016. The pledge was announced by European Commissioner for Development Andris Piebalgs. The Global Fund is the single largest and most important international donor for TB, providing almost 90 percent of all international financing for TB programmes.

Previously, 67 health civil society organizations called on the Global Fund’s continued support to countries with growing HIV, TB and malaria epidemics. One of these societies was the TB Europe Coalition, an advocacy alliance that commits to raising awareness of TB and to increase the political will to control the disease throughout the WHO Europe Region and worldwide. In 2012, it was estimated that 74,000 cases of Multi-Drug Resistant TB (MDR-TB) occurred in the WHO European Region.

Tuberculosis is a contagious airborne disease caused by Mycobacterium tuberculosis, which infects one third of the world’s population.

Image: Drug Discovery

Polio emergency in Syrian Arab Republic

Since October 2013 seventeen cases of polio have been recorded in war-torn Syria, a country which did not record polio for over a decade. Attempts are made to vaccinate all children under the age of 5 years, not only in Syria (1.6 million) but also in its neighbouring countries (estimated to be 23 million).  All countries of the WHO Eastern Mediterranean Region declared the escalating polio situation to be an emergency for the entire Region. The WHO is working with UNICEF, other UN agencies, the Syrian Arab Red Crescent, international and national NGOs, and other local and international groups providing humanitarian assistance to Syrians affected by the conflict to ensure that all children are vaccinated, no matter where they live. It is anticipated that outbreak response activities will need to continue for 6 to 8 months, depending on the area and based on the evolving epidemiology.

Image: WHO

Polio is a highly infectious disease caused by a virus. It invades the nervous system, and can cause total paralysis in a matter of hours. One in 200 infections can lead to irreversible paralysis and among those paralysed, 5% to 10% die when their breathing muscles become immobilized. In 2013, only three countries (Afganistan, Nigeria and Pakistan) remain polio-endemic. However, the Global Polio Eradication Initiative (GPEI) has been proven effective as an almost 40% reduction in cases in these countries were seen compared to 2012.

Currently, there is no cure for polio, it can only be prevented. The polio vaccine, given multiple times, can protect a child for life.