Health Watch

‘Keep your surroundings clean to prevent dengue’

Nipuni Wimalapala

Obviously the most crucial health issue and the gravest disease at the moment in Sri Lanka is dengue. Every day the numbers are going up and cases are being reported from every district of the country.

Commenting on the issue, the Additional Secretary of the Health Ministry, Dr. Palitha Mahipala said that dengue is not entirely a health issue, but it is rather an environmental issue and a considerable percentage of its responsibility- to trim down dengue is held by the public.

Dengue is a viral disease which has some symptoms which are not that specific. The main symptoms of dengue are, Severe frontal headache

* High fever

* Joint ache and pain ?Vomitishness

* Muscle ache and pain

According to Dr.Mahipala people have to be very concerned if they suffer from continuous fever for days. If fever continues for more than 2 days, you must go to the closest government hospital to get treatments. Until you see a doctor the best thing is to take paracetamol. You should never take pain killers.

Dr. Mahipala stressed that dengue is not limited to Sri Lanka, but it is an issue faced by most of the countries in the tropical belt. The mainly affected countries are Malaysia, Singapore, Brazil, Latin America and some of the African countries.

In these countries the situation is worse and has gone out of control. There are about 110 countries which have been affected by dengue so far. In Brazil there are 1 million cases reported. Roughly the half of the global population is affected by this serious issue. 3.5 billion people are affected and per year 100 million are affected. That is the global situation.

As analysed by Dr.Mahipala, Dengue is mainly an environment issue. Since the weather patterns have changed during past years, there are climate changes. Due to global warming many issues have come up. It has been predicted that the climate change directly contributes to increase the dengue issue.

So this is not a mere health issue. Since the globalization process rapidly occurs many changes are seen around. The population density has gone up in a noticeable manner. Due to urbanization a chain of issues takes place. Environment pollution, improper waste disposal systems, high population density help boost the mosquito breeding places.

“In Sri Lanka the most vulnerable periods are after the South West monsoonal rains and North East monsoonal rains. Each and every year during these two periods, there is a considerable ascend of dengue according to our past records. And also due to the frequent rains occur the number of cases can go up.”

“National Mosquito prevention and control month (from June 25 to July 25)was declared mainly to make people more aware of the issue and actually it is a preventive measure. I believe that prevention is really better than cure. So we wish to enlighten general public, schools, government officials, private sector and all the other sectors over the issue and motivate them to get involved in the prevention campaign. The basic thing we focus is to convince them the importance of cleaning their own premises to reduce the breeding places”, Dr. Mahipala said.

The objectives of the National Mosquito prevention and control month are,

* To motivate the public to keep their premises clean without giving mosquitoes a chance to breed.

* To strengthen the waste disposal methods.

* To have a consorted effort to be prevented from dengue

* To mobilize the public

* To get the support of the private sector organizations

* To make civil society involved in the preventive measures.

According to him, so far the government has declared dengue prevention weeks, but this time they thought of having a whole month to make people more concerned about this serious issue. It is predicted that due to the inter monsoonal rains the mosquito density could go up and the number of cases could also rise. That is why they started this collective effort.

“I must say that dengue cannot be destroyed within a month. This is just a strong start of a long term effort to get rid of dengue. The necessary activities to clean and reduce breeding places have to be carried on a regular basis. All the scientific activities such as entomological surveillances are regularly done by the relevant bodies.

But we need to have more emphasis on cleaning processes. According to the entomological surveillance data 50 percent of the breeding places are small containers such as yoghurt cups, small bottles etc. Hence the public has to take care of their own premises”, he noted.

The importance of everybody's involvement in the preventive measures is emphasized. They have formed an Inter-ministerial Committee to address the remaining issues. There are 12 ministries involved in this. Basically the Health Ministry, Defense Ministry, Environment Ministry, Local Government Ministry, Education Ministry, Public Administration Ministry and Media Ministry are some of them. Each ministry has a role to play. They have identified their responsibilities and work to achieve the expectations. As an example the education ministry has the responsibility of making school students aware of the issue and to get all the school premises cleaned under the guidance of principals and school teachers. And also the message can be sent to the parents.

Likewise all the ministries are very concerned over their role and responsibility in preventing dengue. And they were asked to form up a proper plan to carry the activities not only during this month, but throughout the year to make it a long term endeavour.

Dr. Mahipala said that, so far approximately 50,000 dengue cases have been reported in Sri Lanka. There are few districts which are identified as most vulnerable areas. They are Colombo, Kalutara, Gampaha, Kegalle, Ratnapura, Matara, Batticaloa and Kurunegala. The whole Western province is highly affected and more than 50 percent of the cases have been reported from Western Province.

Health Ministry has appointed an officer for each district to monitor and supervise the activities. And the case reporting has been started online. They receive data then and now. They have started expanding laboratory facilities, strengthening fever surveillance mechanisms, and forming fever corners in the hospitals. Once a fever patient comes to a hospital, he is directed to the fever corner by the OPD.

Then the blood test is done within half an hour to identify the disease. It helps a lot to do the necessary admissions immediately and to avoid the unnecessary admissions. Apart from that, a lot of training programmes are done to develop the measures. And also the ministry works with WHO which helps a lot to reduce breeding places.

Preimplantation genetic diagnosis for IVF ‘is safe’

Taking an eighth of a developing embryo during IVF treatment to test for genetic diseases is “completely safe”, according to the largest study of babies born following the technique.

Preimplantation genetic diagnosis (PGD) can help doctors spot diseases like cystic fibrosis before deciding whether to continue with fertility treatment.

However, there have been concerns about PGD's safety.

Experts in the UK said they were hugely reassured by the new research.

Three days after an egg has been fertilised in an IVF clinic, the developing embryo would be made up of just eight cells.It is at this stage that doctors can delicately remove one of those cells to test for more than 100 genetic diseases.

If the embryo is given the all-clear, it can then be transferred into the woman's womb.

‘Safe option’

PGD is rare, but the University Clinic in Brussels, Belgium, part of the Free University, performs about 600 PGD cycles every year.

Its data on 995 babies born through the technique between 1993 and 2008 was presented at the European Society for Human Reproduction and Embryology conference in Turkey.

It suggested the risks of low birth weight, premature birth, major malformations and the perinatal death rate was the same as for other forms of IVF.

Lead researcher Dr Sonja Desmyttere said: “Embryo biopsy does not adversely affect the health of newborn PGD children.

She advised prospective parents should “go for it,” but added that research was still taking place on the impact of the test later in life.

Mr Stuart Lavery, director of IVF at Hammersmith Hospital in London, said: “This is quite an important paper.

“For many of these cases they will have been done on day three when you are removing 12.5% of the whole genetic mass of the embryo.

“So to know that is OK for the baby is hugely reassuring.”

Breast cancer

Other research on PGD presented at the conference suggested that testing for hereditary breast cancer was a “good” and “feasible” option for parents.

The genes BRCA1 and BRCA2 are known to hugely increase the risk of breast cancer.

Women with one of these genes have a 60% to 80% chance of developing breast cancer in their lifetimes. There is also an increased risk of ovarian cancer.

The genes can be detected by PGD, meaning embryos could be selected that do not have a heightened risk of breast cancer.

Doctors at two large fertility clinics at university hospitals in Maastricht, in the Netherlands, and Brussels, have reported 42 pregnancies after screening for BRCA genes between 2006 and 2011.

Prof William Verpoest, from the Vrije University in Brussels said: “We now believe that this technique offers an established option for those couples seeking to avoid the risk of inherited BRCA in their children.”

However, he admitted this “would never be a default option” for all couples with BRCA genes, as the procedure was ethically controversial.

-BBC

Role of stress in dementia investigated

UK experts are to begin a study to find out if stress can trigger dementia.

The investigation, funded by the Alzheimer's Society, will monitor 140 people with mild cognitive impairment or “pre-dementia” and look at how stress affects their condition.

The researchers will take blood and saliva samples at six-monthly intervals over the 18 months of the study to measure biological markers of stress.

They hope their work will reveal ways to prevent dementia.

The results could offer clues to new treatments or better ways of managing the condition, they say.

Dementia triggers

People who have mild cognitive impairment are at an increased risk of going on to develop dementia - although some will remain stable and others may improve.

And past work suggests mid-life stress may increase a person's risk of Alzheimer's disease.

A Swedish study that followed nearly 1,500 women for a period of 35 years found the risk of dementia was about 65% higher in women who reported repeated periods of stress in middle age than in those who did not. Scottish scientists, who have done studies in animals, believe the link may be down to hormones the body releases in response to stress which interfere with brain function.

Prof Clive Holmes, from the University of Southampton, who will lead the study, said: “All of us go through stressful events. We are looking to understand how these may become a risk factor for the development of Alzheimer's.

“Something such as bereavement or a traumatic experience - possibly even moving home - are also potential factors.

“This is the first stage in developing ways in which to intervene with psychological or drug-based treatments to fight the disease.

“We are looking at two aspects of stress relief - physical and psychological - and the body's response to that experience.”

Dr Simon Ridley, of Alzheimer's Research UK, said: “We welcome any research that could shed new light on Alzheimer's disease and other causes of dementia.

“Understanding the risk factors for Alzheimer's could provide one piece of the puzzle we need to take us closer to a treatment that could stop the disease in its tracks.”

-BBC

One in six cancers ‘caused by treatable infections’

Bacteria, viruses and parasites responsible for 2m cases of cancer each year, according to scientists

Bacteria, viruses and parasites cause around 2m cases of cancer in the world each year, experts believe.

Of the 7.5m global deaths from cancer in 2008, an estimated 1.5m may have been due to potentially preventable or treatable infections.

Scientists carried out a statistical analysis of cancer incidence to calculate that around 16% of all cancers diagnosed in 2008 were infection-related.

The proportion of cancers linked to infection was three times higher in developing countries than in developed ones.

Key cancer-causing infectious agents include human papillomavirus (HPV), the gastric bug Helicobacter pylori and the hepatitis B (HBV) and C viruses.

These four were together believed to be responsible for 1.9m cases of cancer, mostly gastric, liver and cervical cancers.

Cervical cancer accounted for around half of infection-related women's cancers. In men, more than 80% of infection-related cancers affected the liver, stomach and colon.

Dr Catherine de Martel and Dr Martyn Plummer, from the International Agency for Research on Cancer in Lyon, wrote in the Lancet Oncology journal: “Infections with certain viruses, bacteria, and parasites are one of the biggest and preventable causes of cancer worldwide ... Application of existing public-health methods for infection prevention, such as vaccination, safer injection practice, or antimicrobial treatments, could have a substantial effect on future burden of cancer worldwide.”

The researchers used information from a number of sources, including a cancer-incidence database covering 27 cancers from 184 countries.

Commenting on the findings, Dr Goodarz Danaei from the Harvard School of Public Medicine in Boston, wrote: “Their estimates show the potential for preventive and therapeutic programmes in less developed countries to significantly reduce the global burden of cancer and the vast disparities across regions and countries.

“Since effective and relatively low-cost vaccines for HPV and HBV are available, increasing coverage should be a priority for health systems in high-burden countries.” Guardian

Study finds mismatch between kids and vitamins

Vitamin supplements are meant to fill-in where diet may be lacking, but a new study finds that US kids may not be getting some of the most needed nutrients from their vitamin pills and the kids taking vitamins may not be the ones who need them the most.

Looking at the diets and supplement use of more than 7,000 kids, researchers found that between the ages of nine and 18 many had low levels of certain vitamins and minerals, and few took supplements, while younger kids had adequate levels of most nutrients and were possibly getting too much of some vitamins and minerals.

Most children under eight, for instance, got the nutrition they needed from the food they ate, regardless of whether or not they took supplements, the study found.

Even with the use of supplements, however, more than a third of children failed to get sufficient calcium and vitamin D. And users sometimes overloaded on essential nutrients such as iron and vitamin A. Zinc and folate were consumed to excess across all age groups.

“We don't know if these excessive amounts cause any harm,” said Regan Bailey, a nutritional epidemiologist at the National Institutes of Health in Bethesda, Maryland, who led the study.

But, Bailey and her coauthors note in The Journal of Pediatrics, their findings suggest that makers of children's vitamins should consider reformulating their products to better match kids’ needs and modern diets. Bailey's team used dietary surveys to assess mineral and vitamin intake among children between the ages of two and 18 who took part in a major government health survey between 2003 and 2006.

About 40 percent of children between ages two and eight take a supplement, the study found. Supplement usage was lower among older kids - 29 percent of kids between nine and 13 years old took them and 26 percent of teenagers did.

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