Connect with us

Health

Earlier ebola outbreaks and how the world overcame them

Published

on



The current outbreak in the Democratic Republic of Congo is only the second-largest inhistory, but undoubtedly the most frustrating.


Scientists are fairly certain they have the medical tools needed for victory: one vaccine that appears to work about 98 per cent of the time, another that has worked well in monkeys, and four therapies that may block the virus if they are given early enough.


Instead, scientists are being thwarted by the nightmarish conflicts and politics of eastern Congo. Health workers have been murdered, treatment centres have been torched, rumours have repeatedly outwrestled the truth. An overwhelming sense of divisiveness and fear has undone almost every effort to save the stricken and protect the vulnerable.


Three previous outbreaks have demonstrated how a response can succeed — or how, in an atmosphere of suspicion, it can go badly wrong.


The outbreak just before the current one ushered in a new era in the war against Ebola: a new Merck vaccine stopped the outbreak in just three months, after only 33 deaths.


The virus was thwarted even after it had slithered down the dirt tracks from its rural birthplace and had appeared in Mbandaka, a city of 1 million people that — like Goma, the eastern city the virus recently reached — was a major transportation hub near an international border.


Geography was important. The northwestern province where the outbreak occurred had a relatively peaceful, ethnically homogeneous population with good relations with the national government in Kinshasa.


Radio messages about the virus were taken seriously, there was little violence, and most victims’ families cooperated with contact-tracers and vaccinators. The first cases were diagnosed in April 2018, and the last were seen in June, after less than 4,000 doses of the vaccine were given out.


By contrast, the provinces along the Congo’s eastern borders with Uganda, Rwanda, Burundi and South Sudan are today a maelstrom.


Those nearby countries have had periodic explosions of fratricidal violence between ethnic groups, including the 1994 Rwandan genocide. Refugees from the butchery fled to the volcanic plains and deep forests of eastern Congo and often settled.


They speak a variety of languages, and some groups have formed their own militias, which sometimes clash. Distrust of the national government and its police and army are widespread in these areas; it was aggravated by the government’s decision to not let three eastern cities vote in the last national election, ostensibly for fear that long lines would spread disease.


Rumours are rife that the virus was made up by government officials hoping to get rich on Western aid, that the vaccine is dangerous, and that bodies of those killed by the virus are being dissected and sold to practitioners of witchcraft.




©2019 The New York Times News Service


Click to comment

You must be logged in to post a comment Login

Leave a Reply

Health

Sick hospital workers often expose patients to contagious illness

Published

on



Hospital workers often come to work with contagious respiratory illnesses, against the recommendations of public regulators, a Canadian study suggests.


Nearly all of the 2,093 care workers in the study who had such symptoms came to work at some point while sick.


For the study, published in the Journal of Infection Control & Hospital Epidemiology, nurses, doctors, and support staff at nine across Canada filled in online illness diaries during four flu seasons, recording symptoms such as a runny or stuffy nose, fever, cough or scratchy throat.


Of the 1,036 participants who had contagious respiratory illnesses during the study period, 52% reported working on every scheduled day of work and 94.6% reported working at least one day of their illness.


The most common reason given for working while sick was that the illness seemed mild and manageable. Compared to other care workers, physicians were more likely to work while sick and nurses were less likely.


But nurses who thought their managers expected them to show up unless they were too sick were more likely to feel obligated to work.


For most people, in fact, feeling obligated was a driving factor behind their decision to come to work sick, as was their perceptions of what managers expected from them. Younger workers, and workers without paid sick leave, were more likely to say they could not afford to stay home.


“It is only by knowing these reasons that managers and employers can take steps to mitigate the risk of infection to other people,” said Brenda Coleman, senior study author of the study from the Dalla Lana School of Public Health, University of Toronto, in email to Reuters Health. Eleven percent of the hospital workers said they had come to work even while feeling miserable because they had “things to do.” Physicians were under-represented in the study, and self-reporting of the illnesses may also confound the results, the authors acknowledge in their report.


The US Centers for Disease Control and Prevention advises workers to take seven days off or consider temporary reassignment if they have a fever and respiratory symptoms.


The research team suggests that changing sick leave policies and cultural norms could help reduce the risk of disease transmission from sick health care workers to patients.


Also needed, the researchers say, is an understanding of how to balance the costs and risks of absenteeism by sick workers against the costs and risks of illness transmission associated with working while ill.


Continue Reading

Health

First two cases of Ebola confirmed in Congo’s South Kivu: Officials

Published

on



A woman and her child were the first two cases confirmed with in Congo’s South Kivu region this week, opening a new front in the fight against the outbreak.


Health officials said on Friday that the latest cases were more than 700 km (430 miles) south of where the outbreak was first detected.


has killed at least 1,900 people in Democratic Republic of Congo over the past year. This is the second biggest toll ever and militia violence combined with local resistance have made the outbreak harder to contain.


The 24-year-old woman had been identified as a high-risk contact of another case in Beni, more than 700 km north, last month, according to a government statement issued on Friday.


She travelled by bus, boat and road with her two children to Mwenga, in South Kivu, where she died on Tuesday night, according to a slide from a presentation by health officials.


Continue Reading

Health

Research shows how nordic walking may benefit breast cancer patients

Published

on



Nordic walking, an aerobic activity performed with walking poles similar to ski poles, may benefit patients with breast cancer, according to a review of existing research.


The low-impact exercise improved swelling, physical fitness, disability and quality of life, the study authors conclude in the European Journal of Cancer Care.


“The main strategy in rehabilitation for women with is a change of habits, where physical exercise is a fundamental tool,” said study co-author Jorge Torres of the Faculty of Educational Sciences and Sports at the University of Vigo in Pontevedra, Spain.


“It’s not easy to turn a sedentary person into an amateur athlete, so sports such as Nordic walking are accepted more easily,” Torres told Reuters Health by email, particularly since the activity doesn’t require expensive equipment, can be done in a group with others, and is easy to learn.


Introduced in the 1980s as a summer training exercise that was similar to cross-country, or Nordic, skiing, Nordic walking became more widespread in the 2000s. It’s now part of some exercise-based rehabilitation programs, especially in Northern Europe where it is more common, Torres noted.


He also owns a personal training company, Vigo Entrena, that creates physical activity programs for people with specific needs, including injuries, obesity, pregnancy, postpartum and women with breast cancer, and he specializes in Nordic walking training.


To see if this form of exercise helps women treated for to reduce side effects like arm swelling, and offers other benefits of exercise, Torres and his colleagues analyzed nine studies. Four studies were randomized controlled trials comparing Nordic walking to other activities; the other studies focused on specific effects of Nordic walking.


Periods of exercise in the studies ranged from 30 to 80 minutes and were performed on one to five days a week for up to 12 weeks.


In eight of the nine studies, Nordic walking had a positive effect on a number of symptoms, including lymphedema, fitness, upper-body strength, disability and perceptions of pain and swelling.


A handful of studies also showed improvements in depression, self-efficacy for managing pain and improvements in physical activity levels. They didn’t find any adverse effects, and the study participants seemed to stick with the programs.


The biomechanical gesture of Nordic walking, compared to just walking, seemed to counteract some of the side effects that can come from cancer treatment, such as shoulder-arm mobility and postural problems, the study team writes.


“(Many) health professionals and therapists do not realize that there are contraindicated exercises during breast cancer rehabilitation and that alternatives such as Nordic walking can be very effective,” Torres said.


“Nordic walking is a structured form of physical activity which nowadays has been shown to be ‘more complete’ than basic walking,” said Marco Bergamin of the University of Padova in Italy, who wasn’t involved in the research review.


“Another important point that is less stressed by these authors: quality of life,” Bergamin said in an email. “Nordic walking gives huge benefits because breast cancer patients are survivors, and from a socio-psychological point of view, that really impacts their life.”


Future studies should also investigate the intensity, frequency, duration, and length of exercise needed to help breast cancer patients, said Lucia Cugusi of the University of Cagliari in Italy, who also wasn’t involved in the review.


“What is most evident is the growing interest of the scientific community in tracking the needs, interests and preferences of patients,” Cugusi said by email.


“Offering them novel forms of physical activity that are both effective and engaging has become one of the new and stimulating research fields in cancer therapy and management.”


Continue Reading

Trending