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The East African : April 14th 2014
The EastAfrican 30 OUTLOOK APRIL 12-18,2014 S CI E N C E Seven lessons to guide global response to the Ebola virus The outb≥eak is now unfolding in Guinea — the fi≥st in West Af≥ica in 20 yea≥s By LAURIE GARRETT Washington Post D espite millions of dollars in research on vaccines and treat- ments, the deadly and frightening Ebola virus is best tackled today the same way it was during its first epidemic in 1976: With soap, clean water, protective gear, and quarantine. The outbreak now unfolding in Guinea — the first in West Africa in 20 years — has also spilled over into neighbouring Liberia and possibly Sierra Leone. With 122 cases and 78 deaths reported to date, the epidemic has officially been declared a “regional threat.” The Ebola haemorrhagic disease is terrifying, as the virus punches microscopic holes in the endothelial lining of blood veins, vessels and capillaries, causing blood to leak from its normal pipelines coursing through the body. Within hours, the punctures enlarge, the leaking turns into a flood, and blood pours into the intestines, bowels and respiratory channels. As the victims become feverish — raging in pain and hallucinations — their tears drip red with blood. The crimson liquid flows from their noses, ears, bowels, bladders, mouths, while old wounds reopen all over their bodies. The deterioration is swift, going from infection to death typically within five days. And Ebola is spread, via the infected body fluids, to attendant family members, health-care workers and funeral attendants. Unchecked viral growth: Virus spreads to cell types throughout body by binding ������������ to receptors on cell surfaces RNA genome Glycoprotein Viral envelope VP40, VP24: Proteins enable virus reproduction Nucleoprotein 1. Symptoms: Onset of illness is abrupt and is characterized by fever, headache, joint and muscle aches, sore throat, red eyes, and weakness 2. Cytokine storm: Immune cells get caught in endless loop, releasing extreme levels of ��������� – proteins within cells which cause inflammation – and attracting yet more immune cells ������������ $21(/ +%3(/ #20&2+%/ ,*''+( +%3(/ "--(/ &.%1 .) &(++0 3. Septic shock: Infected cells detach from blood vessels, causing massive haemorrhage. Loss of blood leads to kidney and liver failure Source: University of Texas Medical Branch Researchers have learned at least seven lessons that can effectively guide responders today in Guinea and its neighbouring countries. First, the index case — the ini- tial person contaminated with the Ebola virus — is usually a hunter Picture: Public Library of Science © GRAPHIC NEWS or villager who recently spent time deep in a tropical forest and came into contact with an animal carrying the virus. Second stopping the spread must include cutting off contact between forest animals and human beings, especially tropical 1 #($. +$)'- "%,*$ -, &'$&*/ Ebola is a viral illness which infects through direct contact with blood or bodily fluids of a sick person or animal, or with contaminated objects. It leads to haemorrhage and organ failure and kills up to 90% of victims Infection: Ebola genome contains four genes which together prevent ��������������� – in skin, nose, lungs and digestive system – from sending messages to trigger immune system fruit bats that harbour the virus without harm to themselves, and the monkeys and apes that eat the bats or the fruit that they chew on, contracting Ebola in the process. There is some evidence that the virus mutates inside monkeys and apes, adapting to become more infectious to primates, including human beings. Third, the bravest interventions, and most essential, are those carried at great personal peril by local Red Cross volunteers. Stopping an Ebola epidemic requires removing ailing individuals from their homes and placing them in isolation quarantine. Fourth, burials must — despite religious and cultural preferences to the contrary — be carried out without ceremony, with bodies placed in deep-dug graves to avoid spread within funerals. Traditional practices of touching or kissing the cadaver in open-casket ceremonies must be prohibited. Fifth, though it is rare, the Ebola virus can be spread through the air among people. Every health worker, Red Cross volunteer, gravedigger and outbreak investigator must wear protective face masks when near an infected animal or individual. Sixth, Doctors Without Borders now has much experience with Ebola, as teams of the Nobel Prize-winning organisation’s medical and humanitarian response personnel have been engaged in nearly every Ebola outbreak. Seventh, forget about high- 2 3 tech solutions, “cures,” and vaccines: They do not exist. Tests of Ugandan Ebola survivors show that their bodies make antibodies against the virus that persist in their bloodstreams for many years, but researchers have had little luck in concocting an Ebola vaccine or proven antisera. And private-sector vaccine developers see no commercial basis for Ebola products given the rarity of outbreaks and the impoverished status of those most likely to need immunisation. Garrett is senior fellow for global health at the Council on Foreign Relations and a Pulitzer Prizewinning science writer Male infe≥tility cases linked to eve≥yday chemicals exposu≥e By DEBORAH BLUM New York Times News Service TO STUDY the impact of everyday chemicals on fertility, US researchers recently spent four years tracking 501 couples as they tried to have children. One of the findings stood out: While men and women were both exposed to known toxic chemicals, men seemed much more likely to suffer fertility problems as a result. The gender gap was particularly wide when it came to phthalates, those ubiquitous compounds used to make plastics more flexible and cosmetic lotions slide on more smoothly. Women who wore cosmetics often had higher levels of phthalates in their bodies, as measured by urinalysis. But only in their male partners did phthalate levels correlate with infertility. “It’s the males in the study that are driving the effect,” said Germaine Buck Louis, an epidemiologist and the lead author of the report, published in Fertility and Sterility. Phthalates belong to a group of industrial High levels of phthalates have been linked to infertility in men. Picture: FILE compounds known as endocrine disrupters because they interfere with the endocrine system, which governs the production and distribution of hormones in the body. The chemicals have been implicated in a range of health problems, including birth defects, cancers and diabetes. But it is their effect on the human reproduc- tive system that has most worried researchers. A growing body of work over the past two decades suggests that phthalates can rewire the male reproductive system, interfering with the operation of androgenic hormones, such as testosterone, that play key roles in male development. That mechanism, some experts believe, explains findings that link phthalate exposure to changes in everything from testicular development to sperm quality. Phthalates are found in PVC pipes carrying water and in the tubing used in hospitals to deliver medications; enteric coatings on pills, including some aspirin; materials used to create time-release capsules; and countless other products. But the transient nature of these compounds means that consumers can take fairly simple measures to reduce their phthalate levels. One is to read the labels on cosmetics and other personal care products and to choose those without phthalates. Another is to be cautious with plastic food containers, and to avoid using them to heat food and drink, as the phthalates in them may be transferred to what you consume. BRIEFS Can vaccine stem deaths linked to pneumonia? Better uptake of the new pneumococcal conjugate vaccine (PCV) in children under five along with more robust health monitoring systems at the community level could help stem pneumonia-related deaths in children in Kenya. About 20 per cent of deaths in children under five are attributed to the disease, according to the Ministry of Health. The government has been targeting children under five for the PCV vaccination through a partnership with the Global Alliance for Vaccines and Immunisations (GAVI). Global salt consumption too high, scientists warn Scientists have cited consumption of too much salt as one of the main risk factors of cardiovascular disease and hypertension or raised blood pressure. They say that there’s too much salt intake by a large population of the world. Out of 17.3 million cardiovascular related deaths each year, over half — 9.4 million — are linked to hypertension. Though the World Health Organisation recommends that adults should have no more than 5g of salt a day — less than one full teaspoon, in most countries, the average person consumes between 9g and 12g a day. The average person is consuming too much salt. Picture: File Using technology to predict disease outbreaks Satellite and other new technologies could be used to help predict disease outbreaks and give governments more time to devise strategies to counter them, says a new report. The Intergovernmental Panel on Climate Change (IPCC) report focuses on climate change impacts, adaptation and vulnerability. NASA scientists say it is possible to predict outbreaks like Ebola. They have found that outbreaks of the disease coincide with a particularly dry period followed by a sudden very wet season. Initiative aims to raise HIV/Aids survival rates The Aga Khan Development Network in partnership with the Conrad L Hilton Foundation has launched an initiative to train community leaders to help improve the survival rates for young children affected by HIV/Aids. The one-week “Science of Early Child Development” course will train partners and grantees of the Conrad Hilton Foundation working in Kenya, Malawi, Mozambique, South Africa, Tanzania and Zambia. Twenty-five participants will take part in the first of a series of training sessions.
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