In recent months, kennel cough cases have spiked nationally, forcing kennels to close for sanitation and veterinary visits to surge.
Bacteria or viruses cause kennel cough infection. It causes respiratory irritation and a deep, painful-sounding cough.
Stephan Carey, is the associate chairperson in the small animal clinical sciences department at Michigan State University’s College of Veterinary Medicine.
Here, Carey answers questions about the warning signs of kennel cough and explains how its outbreak is connected to the COVID-19 pandemic:
The periods before pregnancy and in between pregnancies are key times to address preeclampsia risk factors like obesity, diabetes, and hypertension, according to a new study.
Preeclampsia—a complication that occurs in about 1 in every 25 pregnancies in the United States—is characterized by high blood pressure and signs of damage to an organ system, most often the liver or kidneys. It usually begins after 20 weeks of pregnancy in women whose blood pressure had previously been normal.
“Preconception health care is really important as it’s a window of opportunity to think about your future health,” says S. Michelle Ogunwole, a fellow in the division of general internal medicine at Johns Hopkins University School of Medicine. “We encourage patients to work on chronic disease issues before their pregnancies and between their pregnancies.”
A woman who develops preeclampsia during her first pregnancy is more at risk of the condition repeating during a second or any successive pregnancies, Ogunwole says.
“As an internist concerned about maternal outcomes, I am interested in what health care providers can do to help women reduce their risk of preeclampsia, including being a big proponent of preconception counseling.”
In the study in the Journal of the American Heart Association, Ogunwole and her colleagues statistically compared two sets of women who were participating in the Boston Birth Cohort, an ongoing collaboration between Johns Hopkins Bloomberg School of Public Health and Boston University.
Since 1998, the cohort has looked at a broad array of early life factors and their effects on pregnancy, infancy, and child health outcomes.
The researchers wanted to understand the differences between women who developed preeclampsia and those who did not, and how a first case of the condition affects subsequent pregnancies. The team studied 618 women to gain “rich maternal health data among racially and ethnically diverse pregnant women,” Ogunwole says.
“We wanted to make sure that we’re asking questions in a population that looks like the populations we serve,” she says. “I’m interested in the life course of women and pregnancy complications that can shape the trajectory of their future health.”
The team found that obesity, diabetes, high blood pressure, gestational diabetes, and preterm birth were common factors in women who had preeclampsia during both first and second pregnancies, or developed the condition during gestation with a second or later child.
“We know that improving weight will improve other conditions, so we advise that women create healthier lifestyles before and between pregnancies,” says Ogunwole. “Whether you have another pregnancy again or not, you can still improve your overall health.”
Ogunwole says future research will hopefully include larger studies to confirm the findings of the current research. She also plans to study the structural barriers that may keep women from engaging in healthy lifestyles and develop strategies to improve long-term health outcomes for women.
A Swedish healthcare reform more than a decade ago allowing patients to choose their own doctor has unexpectedly led to widespread discrimination against medics with foreign-sounding names.
Title: Israeli Study Shows Pfizer Booster Gives Seniors Big Rise in Immunity Category: Health News Created: 8/23/2021 12:00:00 AM Last Editorial Review: 8/23/2021 12:00:00 AM
Title: Just Starting Exercise in Your 60s? It'll Still Do a World of Good Category: Health News Created: 8/25/2021 12:00:00 AM Last Editorial Review: 8/25/2021 12:00:00 AM
The global COVID-19 pandemic has forced many people to live in relative isolation for more than a year. As adolescents return to school, public health experts caution parents to pay close attention to signs of tobacco use among teens. While there has been a decline in smoking traditional cigarettes among youth as well as adults, e-cigarette use continues to increase.
A recent poll shows that families are heading into the school year worried about the impending impact of COVID-19 on students. ROBYN BECK/AFP via Getty Images
A new study found parents felt a mix of worries — some were more traditional back-to-school jitters, while others were far more anxiety-inducing, given the current COVID-19 climate.
At least 62 percent of parents polled said they would feel safer with higher school vaccination rates.
Classes are restarting for students across the nation as coronavirus delta variant cases are still surging.
With school just around the corner and coronavirus delta variant cases on the rise, families’ back-to-school jitters are looking slightly different this year.
After more than a year of pandemic disruptions, a poll published today shows that families are heading into the school year worried about the impending impact of COVID-19 on students.
The poll was conducted by the University of Michigan Health’s C.S. Mott Children’s Hospital. It’s an annual National Poll on Children’s Health. The results were based on responses from 1,669 parents with at least one child between the ages of 7 and 18.
What the study found was a mix of worries — some were more traditional back-to-school jitters, while others were far more anxiety-inducing, given the current COVID-19 climate.
What was the outlook from the previous academic year?
“The Mott Poll on children’s health is a recurring one. It’s a different report each month. As we were thinking about different topics to explore, we noticed that in the last month or two, families were turning the corner to think about what the coming school year would be like,” said Sarah Clark, MPH, and the co-director for the Mott Poll.
“We talked about how people’s experiences, both kids and parents, from the last school year might influence the way they were thinking about this upcoming school year,” she said.
According to the poll, more than half of the parents rated the 2020-2021 academic school year as worse than the previous year: 25 percent on academic performance, 36 percent on connections with teachers, 40 percent for the impact on relationships with other students, and 32 percent for general attitude.
However, there was a small portion — about one-third — of parents who actually reported that last school year was better for their child.
“Some kids are able to do virtual learning more independently,” said Clark. “In some cases, kids didn’t miss much school at all and some were able to maintain relationships, which says something about good teachers.”
However, a quarter of parents reported that their children are concerned about having to do virtual school again, which is becoming more and more of a possibility as the delta variant has already caused some schools to roll back to virtual.
Children under 12 are still not eligible for the vaccine, and now nearly all the serious COVID-19 cases in the United States are among people who are unvaccinated.
What are the concerns going forward?
“Going into this upcoming school year, there are a lot of kids that are looking forward to it, but they have some pretty important worries that reflect their experiences from last year,” said Clark.
The major concern is the return to virtual learning, according to the poll results.
Parents and kids thought there might be a return to normalcy, but it is looking more and more like that idea is slipping away.
“I, too, as a parent, am concerned about the interruption in school for a second straight year,” said Dr. Eric Cioe-Peña, director of global health at Northwell Health in New York.
“I’m worried that municipalities won’t mandate vaccinations among eligible students and staff and that because of that, outbreaks at school will force remote schooling,” Cioe-Peña said.
In addition to returning to virtual learning, kids are also worried about not feeling comfortable around larger groups of children. After more than a year practicing physical distancing, the return to certain social scenes is enough to drive anyone’s anxiety up.
At least 22 percent of children fear being behind on academics, and another 22 percent are concerned about getting along with friends.
“When you think about it, it’s not that surprising,” said Clark. “We were all working hard to stay separated. And then when we started coming back, it was shocking at how many people were around. While adults could ease back into life, school is abrupt for kids.”
A note of confidence
However, after spending a difficult year largely with virtual schooling, more parents report feeling confident that they will be able to help their kids navigate another challenging year.
At least 51 percent of people polled feel that they will know how to help their children be successful with school.
Another 47 percent of people are confident they can help their kids bounce back when things don’t go well, and 44 percent feel strongly that they will be able to help their children deal with peer problems.
Kids are feeling optimistic, too. Forty-one percent of parents said their children are more enthusiastic about the upcoming year, 16 percent are less enthusiastic, and 43 feel about the same.
How can we help?
Increasing the vaccination rate is the number one way to help protect kids who are too young to be vaccinated, and to help keep school shutdowns and rollbacks at a minimum.
At least 62 percent of parents polled said they would feel safer with higher school vaccination rates.
“I think remote schooling, especially in younger grades, is detrimental to learning,” said Cioe-Peña.
Cioe-Peña’s standing “by the CDC and the American Academy of Pediatrics in expecting a full return to in-person schooling, with masking and vaccines as a strategy to protect our students, teachers, and staff.”
The second way parents can help would be to listen to the concerns of their kids and try to have plans in place in order to make them feel more comfortable.
“Parents need to put aside their own COVID-19 views for a second and be willing to hear their kids,” said Clark. “Let them express anything they may be worried about. Let’s turn this into a problem-solving thing.”
That may involve finding out what the school is or is not doing and figuring out how we are going to make kids feel comfortable. Some kids may be OK with the bus, while others may not.
“Make a phone call to the school to understand the options. Let’s see what is under our control. Make mask requirements fun by picking out fun-looking masks. Do whatever you have to do to help your kids feel like they are able to take a little ownership of their school environment,” said Clark.
The other thing to keep in mind is that playing catch-up is not going to be quick. It’s not something that can be tackled in a day or even a month.
“Listen to your kids’ concerns. Offer to look into a tutor if it is a possibility. Turn that anxiety into a problem-solving exercise and figure out what we can do,” Clark said.
Moving emergency care patients to other hospital departments by wheelchair or trolley is prone to a high rate of mishaps, finds a study at one large Australian hospital, published online in the Emergency Medicine Journal.
(HealthDay)—Acute heat and cold exposure can increase mortality risk for multiple causes of death, with cold-attributable mortality exceeding heat-attributable mortality, according to a study published in the Aug. 21 issue of The Lancet.
Reevaluating data from a brutal 1940s study on vitamin C suggests people need more vitamin C than current recommendations specify.
It was wartime and food was scarce. Leaders of England’s effort to wage war and help the public survive during World War II needed to know: Were the rations in lifeboats adequate for survival at sea? And, among several experiments important for public as well as military heath, how much vitamin C did a person need to avoid the deadly disease scurvy?
In one experiment at the Sorby Research Institute in Sheffield, called the “shipwreck” experiment, volunteers were fed only what the navy carried in lifeboats. The grueling experiment resulted in more water and less food being carried in lifeboats.
“…an average daily vitamin C intake of 95 mg is required to prevent weak scar strength for 97.5% of the population.”
One of the more robust experiments involving human subjects during this time in England, which has had long-lasting public health consequences, was a vitamin C depletion study started in 1944, also at Sorby. This medical experiment involved 20 subjects, most of whom were conscientious objectors living in the building where many experiments, including the shipwreck experiment, took place. A future Nobel Prize winner oversaw the study, and the researchers kept detailed data on each participant.
“The vitamin C experiment is a shocking study,” says Philippe Hujoel, lead author of a new analysis of the Sorby vitamin C experiment, a practicing dentist, and professor of oral health sciences in the University of Washington School of Dentistry. “They depleted people’s vitamin C levels long-term and created life-threatening emergencies. It would never fly now.”
Even though two trial participants developed life-threatening heart problems because of the vitamin C depletion, Hujoel adds, none of the subjects suffered permanent harm, and in later interviews several participants said they would volunteer again given the importance of the research.
Because of the war and food shortages, there was not enough vitamin C available, and they wanted to be conservative with the supplies, explains Hujoel, who is also an adjunct professor of epidemiology. The goal of the Sorby investigators was not to determine the required vitamin C intake for optimal health; it was to find out the minimum vitamin C requirements for preventing scurvy.
Vitamin C and scar strength
Vitamin C is an important element in your body’s ability to heal wounds because the creation of scar tissue depends on the collagen protein, and the production of collagen depends on vitamin C. In addition to knitting skin back together, collagen also maintains the integrity of blood vessel walls, thus protecting against stroke and heart disease.
In the Sorby trial, researchers assigned participants zero, 10, or 70 milligrams of vitamin C a day for an average of nine months. The depleted subjects were then repleted and saturated with vitamin C. Experimental wounds were made during this depletion and repletion. The investigators used the scar strength of experimental wounds as a measure of adequate vitamin C levels since poor wound healing, in addition to such conditions as bleeding gums, are an indication of scurvy.
In the end, the Sorby researchers said 10 milligrams a day was enough to ward off signs of scurvy. Partly based on these findings, the WHO recommends 45 milligrams a day. Hujoel says that the findings of the re-analyses of the Sorby data suggest that the WHO’s recommendation is too low to prevent weak scar strength.
Old data, new recommendations
In a bit of scientific detective work, Hujoel says he tracked down and reviewed the study’s data, and with the aid of Margaux Hujoel, a scientist with Brigham and Women’s Hospital/Harvard Medical School, put the data through modern statistical techniques designed to handle small sample sizes, techniques not available to the original scientists. The results of their work appear in the American Journal of Clinical Nutrition.
The Hujoels discovered that the data from this unique study—which has been a cornerstone used by WHO and other agencies for establishing healthy levels of vitamin C in humans—needed more than an “eyeball method” of data assessment.
“It is concluded that the failure to reevaluate the data of a landmark trial with novel statistical methods as they became available may have led to a misleading narrative on the vitamin C needs for the prevention and treatment of collagen-related pathologies,” the researchers write.
“Robust parametric analyses of the (Sorby) trial data reveal that an average daily vitamin C intake of 95 mg is required to prevent weak scar strength for 97.5% of the population. Such a vitamin C intake is more than double the daily 45 mg vitamin C intake recommended by the WHO but is consistent with the writing panels for the National Academy of Medicine and (other) countries,” they add.
The Hujoels’ study also found that recovery from a vitamin C deficiency takes a long time and requires higher levels of vitamin C. Even an average daily dose of 90 milligrams a day of vitamin C for six months failed to restore normal scar strength for the depleted study participants.
The Centers for Disease Control and Prevention has recommended that everyone—including the vaccinated—resume mask-wearing while indoors in public places where transmission rates are on the rise.
The change comes as COVID-19’s delta variant creates dangerous hotspots of community spread across the country.
At this point, it’s starting to feel like we’ll be wearing masks forever. While that’s not exactly the case, it’s an oversimplification with a kernel of truth: Whether facing a global pandemic or a typical cold and flu season, mask-wearing carries significant public health benefits, so periodic masking is here to stay, according to Crystal Watson, a senior associate at the Johns Hopkins Center for Health Security and an assistant professor in the environmental health and engineering department at the Johns Hopkins Bloomberg School of Public Health.
Watson’s policy research focuses on public health risk assessment and medical preparedness and response to emerging infectious diseases. She specializes in helping to improve the decision-making process for organizations during public health emergencies, and with COVID-19, Watson has been assisting organizations in making decisions about mitigation measures in their community or at their facility. She has also been working with the World Health Organization to develop decision support tools around COVID-19 and seasonal influenza.
Here, Watson discusses the present and future of masking while offering practical risk-assessment tips for getting comfortable with our on again, off again relationship with masking:
Eating a hot dog could cost you 36 minutes of healthy life, while choosing to eat a serving of nuts instead could help you gain 26 minutes of healthy time alive, according to new study.
The study in the journal Nature Food evaluates more than 5,800 foods, ranking them by their nutritional disease burden to humans and their impact on the environment. It found that substituting 10% of daily caloric intake from beef and processed meats for a mix of fruits, vegetables, nuts, legumes, and select seafood could reduce your dietary carbon footprint by one-third and allow people to gain 48 minutes of healthy minutes per day.
“Generally, dietary recommendations lack specific and actionable direction to motivate people to change their behavior, and rarely do dietary recommendations address environmental impacts,” says Katerina Stylianou, who did the research as a doctoral candidate and postdoctoral fellow in the department of environmental health sciences at the University of Michigan’s School of Public Health. She now works as the director of public health information and data strategy at the Detroit Health Department.
Minutes of healthy life
The researchers base the work on a new epidemiology-based nutritional index, the Health Nutritional Index, which the investigators developed in collaboration with nutritionist Victor Fulgoni III from Nutrition Impact LLC. HENI calculates the net beneficial or detrimental health burden in minutes of healthy life associated with a serving of food.
The index is an adaptation of the Global Burden of Disease in which disease mortality and morbidity are associated with a single food choice of an individual. For HENI, researchers used 15 dietary risk factors and disease burden estimates from the GBD and combined them with the nutrition profiles of foods consumed in the United States, based on the What We Eat in America database of the National Health and Nutrition Examination Survey.
Foods with positive scores add healthy minutes of life, while foods with negative scores are associated with health outcomes that can be detrimental for human health.
To evaluate the environmental impact of foods, the researchers used IMPACT World+, a method to assess the life cycle impact of foods (production, processing, manufacturing, preparation/cooking, consumption, waste), and added improved assessments for water use and human health damages from fine particulate matter formation. They developed scores for 18 environmental indicators taking into account detailed food recipes as well as anticipated food waste.
Red, yellow, and green food choices
Finally, researchers classified food choices into three color zones: green, yellow, and red, based on their combined nutritional and environmental performances, like a traffic light.
The green zone represents foods that people are recommended to eat more of and contains foods that are both nutritionally beneficial and have low environmental impacts. Foods in this zone are predominantly nuts, fruits, field-grown vegetables, legumes, whole grains, and some seafood.
The red zone includes foods that have either considerable nutritional or environmental consequences and that people should reduce or avoid in their diet. Nutritional effects primarily came from processed meats, and climate and most other environmental impacts from beef and pork, lamb, and processed meats.
The researchers acknowledge that the range of all indicators varies substantially and also point out that nutritionally beneficial foods might not always generate the lowest environmental impacts and vice versa.
“Previous studies have often reduced their findings to a plant vs. animal-based foods discussion,” Stylianou says. “Although we find that plant-based foods generally perform better, there are considerable variations within both plant-based and animal-based foods.”
What to cut and what to keep
Based on their findings, the researchers suggest:
Decreasing foods with the most negative health and environmental consequences, including highly processed meat, beef, shrimp, followed by pork, lamb, and greenhouse-grown vegetables.
Increasing the most nutritionally beneficial foods, including field-grown fruits and vegetables, legumes, nuts, and low-environmental impact seafood.
“The urgency of dietary changes to improve human health and the environment is clear,” says Olivier Jolliet, professor of environmental health science at the University of Michigan and senior author of the paper. “Our findings demonstrate that small targeted substitutions offer a feasible and powerful strategy to achieve significant health and environmental benefits without requiring dramatic dietary shifts.”
The project took place within the frame of an unrestricted grant from the National Dairy Council and of the University of Michigan Dow Sustainability Fellowship. The researchers are also working with partners in Switzerland, Brazil, and Singapore to develop similar evaluation systems there. Eventually, they would like to expand it to countries all around the world.
Experts are trying to figure out if a COVID-19 booster shot will help fight the pandemic. Scott Olson/Getty Images
Israel and other countries are rolling out third doses of COVID-19 vaccines to people fully vaccinated. But more research is needed on the benefits and timing of booster doses.
Germany plans to start offering booster doses in September to older adults and people with weakened immune systems. The United Kingdom will also begin its own booster rollout next month.
The United States has yet to fully embrace COVID-19 boosters.
As Delta variant surges threaten to erode pandemic progress, some highly vaccinated countries are offering booster doses of COVID-19 vaccines to their citizens.
This week, Israel began administering third doses of the Pfizer-BioNTech vaccine to people over age 60 who are already fully vaccinated, reports the Associated Press.
According to Reuters, Germany plans to start offering booster doses in September to older adults and people with weakened immune systems. The United Kingdom will also begin its own booster rollout next month.
The United States has yet to fully embrace COVID-19 boosters, but it’s edging in that direction.
As recently as early July, the Centers for Disease Control and Prevention (CDC), along with the Food and Drug Administration (FDA), said “Americans who have been fully vaccinated do not need a booster shot at this time.”
But the agencies added that they’re continuing to monitor the scientific data in order to decide if and when a booster might be needed.
However, Biden administration officials are warming to the possibility that older adults and immunocompromised people who’ve had two doses of an mRNA vaccine — Pfizer-BioNTech or Moderna-NIAID — might need a third dose.
In addition, the CDC’s Dr. Amanda Cohn said the agency is “actively looking into ways” to provide certain people access to booster doses “earlier than any potential change in regulatory decisions,” according to The New York Times.
The FDA would need to modify a vaccine’s current emergency use authorization (EUA) to allow a booster dose to be given. Another option would be full FDA approval, which would enable doctors to recommend a booster dose “off-label.”
The FDA could make a decision on full approval of the Pfizer-BioNTech vaccine by early September, reports the Times.
In anticipation of the potential need for boosters — in addition to vaccinating children under age 12 if the FDA approves the vaccines for this group — the U.S. government is bolstering its vaccine supply, reports Reuters.
Are COVID-19 boosters needed?
Even as some countries roll out boosters, data on the need for an extra dose of the vaccines is limited, especially for the general public.
The clearest benefits are for those with weakened immune systems, such as people with cancer, organ transplant recipients, and older adults with chronic medical conditions.
These people might not generate as robust an immune response after vaccination, something the CDC warns about on its website.
“We’re probably going to have to be giving boosters to immunocompromised people and [other] people who are susceptible,” Dr. Ezekiel J. Emanuel, an oncologist at the University of Pennsylvania, said during an Infectious Diseases Society of America media briefing. “I think that’s where we’re going to start.”
For the rest of the population, the vaccine protection appears to hold up well at least for several months, even in the face of the Delta variant — although some studies suggest that some aspects of this protection may wane over time.
Data from Pfizer’s ongoing clinical trial found that the efficacy of its vaccine against symptomatic cases dropped from 96 percent to 84 percent during the 6 months after vaccination, according to a preprint released last week.
More than half of Americans vaccinated against the coronavirus have received Pfizer-BioNTech’s vaccine.
However, efficacy over 80 percent is still high — the FDA had initially set the efficacy bar for COVID-19 vaccines at 50 percent.
The Pfizer study also found that the vaccine continued to offer strong protection against severe disease — 97 percent efficacy — during the 6 months after vaccination.
Moderna released data in April showing that two doses of its vaccine had a 6-month efficacy of 90 percent against symptomatic cases and 95 percent against severe disease. The company didn’t provide any details on whether this changed over time.
Vaccines holding up against Delta variant
It’s not clear if the drop in efficacy against symptomatic infection seen in Pfizer’s study is due to changes in the immune response, the spread of Delta and other variants during that time, or changes in people’s behaviors as pandemic restrictions were lifted.
Some studies have found that certain vaccines hold up well against the Delta variant, although the results have been mixed.
In a study published in The New England Journal of Medicine, researchers found that two doses of the Pfizer-BioNTech vaccine was 88 percent effective against symptomatic infection caused by the Delta variant.
This was lower than the 94 percent protection offered against the Alpha variant.
However, recent data from Israel, which has fully vaccinated more than 62 percent of its population, suggests a larger drop in protection.
Data from the Israeli Ministry of Health showed that between June 20 and July 17, the Pfizer-BioNTech vaccine was 39 percent effective against infection caused by Delta, reports Bloomberg.
This low protection was a shock to many.
Dr. Anthony S. Fauci, who heads the infectious disease division of the National Institutes of Health, said the low effectiveness had people “raising their eyebrows a bit,” reports the Times. He added that he would like to compare this to similar data being collected by the CDC.
As with other studies, though, the Israel data still showed strong protection — 91 percent — against severe illness caused by Delta, with 88 percent effectiveness against hospitalization.
Ongoing research needed on boosters
While any drop in protection offered by a COVID-19 vaccine should be closely monitored, experts say the need for boosters would depend on how well the vaccines still protect people against severe disease.
This will require ongoing real-world monitoring of the effectiveness of the vaccines, like the data being collected regularly by the Israeli government and CDC.
In addition, scientists will continue to monitor antibody levels and other markers of immune protection in people who have been fully vaccinated to see how these change over time.
Vaccine makers are already studying the benefits of booster doses, with a focus on variants of concern.
Pfizer released data in an earnings report last week suggesting that a third dose of its vaccine “strongly” enhances protection against the Delta variant.
The data showed that people ages 18 to 55 who received a third dose of the vaccine had more than fivefold higher levels of antibodies that target the Delta variant, compared to levels after the second dose.
In people ages 65 to 85, the third dose boosted Delta-specific antibodies more than 11-fold.
These data were released as part of Pfizer’s quarterly earnings report and haven’t been peer-reviewed.
It’s not clear whether the higher levels of antibodies reported by Pfizer translate to greater protection, or if the level of antibodies provided by two doses is sufficient.
To know this, a clinical trial is needed. The company started one recently which will look at whether people who receive a third dose are better protected against the coronavirus in the real world, compared to those with only two doses.
The company also said in its quarterly report that it plans to request FDA emergency approval for a booster dose as early as August.
Many countries struggle to secure first doses
Even with the shortage of data on the benefits of boosters, some people are seeking them out on their own at local pharmacies, in other states, and in other countries — wherever there’s no record of their original vaccination.
Some of this stems from concerns about the spread of the Delta variant.
The FDA’s Dr. Peter Marks said on Tuesday that the agency “does not recommend taking things into your own hands” regarding COVID-19 vaccine booster doses.
“It’s actually not something you’re supposed to do under emergency use authorization,” he said during a discussion hosted by the COVID-19 Vaccine Education and Equity Project briefing.
With Delta surges happening throughout the United States, but especially in areas with low vaccination rates, Emanuel thinks more efforts should be made to reach the third of eligible Americans who haven’t had a single dose.
“Way more important than [giving] boosters to people who have already been vaccinated twice is getting people who haven’t been vaccinated, fully vaccinated,” he said. “I think we need to put our priorities in the right place, as a country.”
“So far, more than 4 billion vaccine doses have been administered globally. More than 80 percent have gone to high- and upper-middle income countries, even though they account for less than half of the world’s population,” World Health Organization Director General Dr. Tedros Adhanom Ghebreyesus said in a briefing.
Low vaccination rates in other countries put their most at-risk citizens in danger of hospitalization and dying from COVID-19.
But ongoing high transmission of the coronavirus also increases the chances that another variant of concern will emerge. This is also a concern in parts of the United States with low vaccination rates.
Ghebreyesus called for a moratorium on boosters until at least the end of September to allow all countries to vaccinate 10 percent or more of their population.
The Marburg virus is spread by fruit bats. Bonnie Jo Mount/The Washington Post via Getty Images
Health authorities in the West African nation of Guinea confirmed a case of Marburg virus disease earlier this month.
This is the first time this virus, which causes a highly infectious hemorrhagic fever similar to Ebola, has been detected in West Africa.
The WHO calls the disease “epidemic-prone,” meaning that it can spread easily between people if not prevented.
As the world focuses on battling COVID-19, another dangerous virus was detected in Africa this month, causing concern among health experts.
Health authorities in the West African nation of Guinea confirmed a case of Marburg virus disease on August 9, in the southern Gueckedou prefecture, according to the World Health Organization (WHO).
This is the first time this virus, which causes a highly infectious hemorrhagic fever similar to Ebola, has been detected in West Africa.
“We applaud the alertness and the quick investigative action by Guinea’s health workers. The potential for the Marburg virus to spread far and wide means we need to stop it in its tracks,” Dr. Matshidiso Moeti, WHO Regional Director for Africa, said in a statement. “We are working with the health authorities to implement a swift response that builds on Guinea’s past experience and expertise in managing Ebola, which is transmitted in a similar way.”
According to the WHO, Gueckedou, where this case of Marburg disease was identified, is the same region that experienced cases of the 2021 Ebola outbreak in Guinea, and where the 2014–2016 West Africa outbreak was initially detected.
What is Marburg virus disease?
Dr. Eric Cioe-Peña, director of global health at Northwell Health in New Hyde Park, New York, told Healthline that Marburg virus is a type of viral hemorrhagic fever.
“Hemorrhagic fever is any infectious fever that causes internal bleeding,” he explained. “Usually from an overwhelming inflammatory reaction that decreases a patient’s platelets and clotting factors.”
The Centers for Disease Control and Prevention (CDC) says that although some types of hemorrhagic fever viruses can cause relatively mild illnesses, many of these viruses can cause severe, life threatening disease.
According to the CDC, viral hemorrhagic fevers (VHFs) are caused by four distinct virus families: Arenaviridae, Bunyaviridae, Filoviridae, and Flaviviridae. The Marburg virus is considered a filovirus (filoviridae).
“Filovirus is the same family of viruses that Ebola belongs to,” said Cioe-Peña. “Symptoms are virtually identical to Ebola and mortality ranges widely from less than Ebola — about 28 percent is the lowest mortality and 88 percent is the highest recorded mortality.”
Cioe-Peña said symptoms include fever, malaise, body aches, nausea, vomiting, diarrhea, and internal hemorrhaging.
Marburg virus is ‘epidemic prone,’ says WHO
The WHO calls the disease “epidemic-prone,” meaning that it can spread easily between people if not prevented. There have been previous Marburg outbreaks in other parts of Africa, including Angola, Uganda, and South Africa.
“The filoviruses are not as contagious as what we’re used to with COVID-19,” said Cioe-Peña. “Infection usually occurs with direct contact with the body fluids of an infected individual, usually close family members, or people participating in funeral rituals that involve close contact with the body.”
The good news, he added, is that awareness of preventing viral hemorrhage and fever is “very fresh” on the minds of those in Guinea, due to the Ebola outbreak in 2014.
“The fact that this was detected after one case speaks to the surveillance and commitment of the governments of West African countries to prevent another epidemic like 2014,” he said.
Where the Marburg virus comes from
A 2012 article published in the journal Viruses found that the first reported filovirus hemorrhagic fever outbreak took place in Germany and the former Yugoslavia in 1967.
It began when lab workers in Marburg and Frankfurt, Germany, in Belgrade, and Yugoslavia (now Serbia), contracted a “previously unknown infectious agent.”
Of 31 patients that developed severe disease, it caused death in 7 cases. According to the article, the source of infection was traced back to African green monkeys imported from Uganda and shipped to all three locations.
Decades later, we understand that monkeys weren’t the primary source of the virus.
“The host of Marburg virus is the fruit bat,” said Cioe-Peña. “They don’t show signs of illness, however, and can carry the virus.”
He explained that the virus can then jump to an intermediate host, like a monkey, which can transmit to humans, or it can transmit to humans directly by contact with fruit bats or their guano.
Signs and symptoms of Marburg disease
Dr. Teresa Murray Amato, chair of emergency medicine at Long Island Jewish Forest Hills, in New York, said the signs and symptoms of Marburg HF (hemorrhagic fever) are experienced within 5 to 10 days of exposure and include:
sudden onset of high fever
chills
headache
body aches
“After about 5 days of the initial symptoms, a rash develops mostly on the chest and back,” she said. “ Additional symptoms then occur that include nausea, vomiting and diarrhea, chest pain, and abdominal pain.”
She pointed out that after this, there may be skin color changes where the skin appears yellow (jaundice).
“The pancreas and the liver become inflamed leading to liver failure and massive bleeding,” continued Amato.
Treating Marburg disease
Amato explained that while there’s no specific treatment for Marburg disease, most people seeking care will require intravenous (IV) fluids, replacement of electrolytes, supplemental oxygen, and replacement of blood and blood products.
She confirmed that there’s currently no vaccine against this virus.
“About 25 to 30 percent of people who contract Marburg HF will succumb to the disease,” she continued, and warned that the disease isn’t easy to identify.
“Marburg HF may be difficult to diagnose initially, as the presentation initially resembles many more common viral infections,” she said.
Amato emphasized that it’s very important for patients to tell their doctor if they’ve traveled to an area that may be associated with an exposure to the virus that causes Marburg disease.
The bottom line
The WHO confirmed that health authorities in the West African nation of Guinea have recently identified a case of Marburg virus disease.
This virus causes symptoms similar to Ebola. It’s a type of hemorrhagic fever that causes internal bleeding and originates in a species of fruit bat.
Experts say that Guinea’s recent experience with an Ebola outbreak in 2014 has enabled the West African nation to quickly control the situation.
An estimated 3 million asthmatics and over half of the states in the United States are being affected by particulates that are blowing over them from fires in Canada and the western U.S., according to new research at The University of Alabama in Huntsville (UAH), a part of the University of Alabama System.
At a COVID-19 vaccination site in the Ugandan capital, Kampala, tempers flared among those waiting for scarce AstraZeneca jabs, with some accusing others of trying to jump the queue.
(HealthDay)—Health care encounters for the diagnosis of sunburn are uncommon but not negligible, according to a research letter published online Aug. 11 in JAMA Dermatology.
Nearly three months since the eruption of the Nyiragongo volcano in the east of the DR Congo, authorities warned local people on Thursday that a salt-like substance in the lava flows is unfit for human consumption.
Title: 6 Tips on Getting Back to Your Regular Doctor's Checkup Category: Health News Created: 8/8/2021 12:00:00 AM Last Editorial Review: 8/9/2021 12:00:00 AM
MIAMI—Intense blooms of toxic algae are becoming common occurrences along the coast of Florida and elsewhere. Results from a new study led by University of Miami (UM) scientists found that wearing the face mask everyone has become accustomed to during the COVID-19 pandemic may help protect against these airborne toxins too.
A new gene therapy could eventually provide an alternative treatment for Fuchs’ endothelial corneal dystrophy, a genetic eye disease that affects roughly one in 2,000 people globally.
Currently, the only treatment is corneal transplant, a major surgery with associated risks and potential complications.
“When you do a transplant you make a huge difference for that person, but it’s a big deal for the patient with lots of visits, lots of eye drops, lots of co-pays, and if you had a medical treatment that did not require surgery, that would be great,” says Bala Ambati, a research professor at the University of Oregon who led an eight-year study involving the development of the gene therapy.
“Not only could it help patients who need a transplant, but it could also help a lot of other people who could have used that (corneal) tissue.”
For the study in the journal eLife, investigators focused on a rare, early-onset version of the disease and carried out the research in mice. They used CRISPR-Cas9, a powerful tool for editing genomes, to knock out a mutant form of a protein that is associated with the disease.
Fuchs’ dystrophy occurs when cells in the corneal layer called the endothelium gradually die off and stressed cells produce structures known as guttae. These cells normally pump fluid from the cornea to keep it clear, but when they die, fluid builds up, the cornea gets swollen, and vision becomes cloudy or hazy.
“We were able to stop this toxic protein expression and study it in a mouse model,” says coauthor Hiro Uehara, a senior research associate in the Ambati lab.
“We confirmed that (in mice who received it), our treatment was able to rescue loss of corneal endothelial cells, reduce guttata-like structures, and preserve the corneal endothelial cell pump function.”
Corneal cells are non-reproducing, meaning you’re born with all of the cells you will ever have, Ambati says. One of the challenges of the study involved using CRISPR gene editing technology on such cells, a process that is technically difficult.
Uehara developed an innovative workaround that increases the utility of the CRISPR technology and could eventually lead to treatments for other diseases involving non-reproducing cells, including some neurologic diseases, immune diseases, and certain genetic disorders affecting the joints. The study marks the first time that researchers have applied the technique, called start codon disruption, to non-reproducing cells.
“It’s potentially expanding the therapeutic target pool for CRISPR-Cas system to tissues that are not capable of cell division,” Ambati says.
To test the safety of the treatment, the researchers examined surrounding tissues and other genes to make sure they had not been adversely affected by the therapy. Future research will examine the therapy in human donor corneas from eye banks and other animal models with an eye toward eventual clinical testing in humans.
Additional coauthors are from Johns Hopkins University, the University of Virginia, the University of Utah, and the University of Massachusetts.
Support for the research came from the National Institutes of Health/National Eye Institute and Research to Prevent Blindness, Inc.
Title: Seniors Have Higher Risk of Falling During Pandemic Category: Health News Created: 8/3/2021 12:00:00 AM Last Editorial Review: 8/3/2021 12:00:00 AM
Many students have been out of their classrooms for a year and a half, and though this fall is shaping up to be more “normal,” there are still plenty of questions about what back to school will look like.
Gearing up for this year’s back-to-school season means thinking about a lot more than notebooks and highlighters.
“We may be quarantined at different times or back to e-learning. We may or may not be wearing masks,” says Jennifer Katzenstein, director of psychology and neuropsychology and co-director of the Center for Behavioral Health at Johns Hopkins All Children’s Hospital.
“And there are going to be times throughout our return to school when it’s going to be tougher. There will be more demands throughout the day—of social interactions and academics. So there are going to be times when we’re frustrated.”
The key to getting through all this is as much preparation as possible, Katzenstein says. That includes setting up play dates to ease kids into seeing more friends again, encouraging family discussions about feelings, and seeking out help when mood changes and elevated anxiety levels are affecting a child’s ability to engage in everyday life.
Here, Katzenstein shares her advice for families entering yet another phase of uncertainty:
While much of the health research around men who have sex with men (MSM) involves HIV, these communities are at increased risk for other health problems including certain types of cancer, substance use and mental health issues. A new scoping review by VCU School of Medicine and Massey Cancer Center researchers finds that a specific type of data collection methodology called ecological momentary assessment (EMA), alongside of or as an intervention itself, could be particularly effective in supporting these populations.
Restaurants and bars in some cities have begun to require that customers show proof of vaccination before they’re allowed to dine indoors. Medical experts say it’s a responsible move that may help slow the spread of the coronavirus. Grandbrothers/Getty Images
Some bars and restaurants are requiring customers to show proof of vaccination if they want to dine inside.
Medical experts say this is a brave and bold move to protect customers and help with public health measures against COVID-19.
They also say allowing only vaccinated people indoors at bars and restaurants will help curb the spread of the coronavirus.
Before the Centers for Disease Control and Prevention (CDC) announced on July 27 that fully vaccinated Americans should wear masks inside in locations where transmission of the coronavirus is high, some bars and restaurants took a stance on stopping the spread and protecting their patrons.
Due to an increase in COVID-19 cases in San Francisco, restaurants in the Bay Area like 7 Stills Brewery and Distillery and clubs like Mr. Tipple’s Recording Studio are requiring that customers show proof of vaccination if they want to dine or visit inside their venues.
The manager for 7 Stills Brewery and Distillery told NBC News that they are accepting vaccination cards or photos of the cards as proof of vaccination.
Several restaurants in New York, including Union Square Cafe and Gramercy Tavern, announced they will also begin requiring customers to show proof of vaccination before they’re allowed to dine indoors.
Medical professionals like Dr. Sunitha Posina, an internist in New York City, say this is a responsible move.
“I think it is a great idea. The current concern is the spread amongst unvaccinated people and putting themselves at great risk of becoming infected. There is an increase in the new number of cases in multiple states throughout the country,” Posina told Healthline.
Noah Greenspan, PT, board certified clinical specialist in cardiovascular and pulmonary physical therapy, says the requirements are a good way to keep customers safe.
“With bars and restaurants reopening, there will obviously be people congregating, eating, drinking, and speaking in close proximity, who aren’t wearing masks because, well, that’s what people do in bars and restaurants,” he told Healthline.
Although from a health perspective, this choice is a safe one, Greenspan points out that bars and restaurants may experience pushback from customers who have different views on the use of masks and vaccinations.
“This can potentially range from verbal or even physical abuse to the loss of income threatening the business itself… I would like to express my appreciation for businesses and other organizations that are willing to take a bold stand in the interest of public safety and prioritizing the well-being of all over any individual, especially when the stakes are so high,” he said.
Only allowing vaccinated people in bars could help curb the spread
Given the Delta variant is highly transmissible, requiring people to be vaccinated if they want to dine or drink inside venues could help reduce the spread of COVID-19.
According to the CDC, the Delta variant is one of a few variants of SARS-CoV-2 that seems to spread more easily and quickly than other variants. This could lead to more cases of COVID-19, which can put more strain on healthcare resources, and lead to more hospitalizations and potentially more deaths.
“In this scenario, there are many factors that can increase or decrease the level of risk, including the size of the space, the density of people and their proximity to each other, as well as the size, type, and quality of the ventilation, air conditioning, and filtration systems,” said Greenspan.
In general, he points out the following as factors that will affect risk level:
Frequency. The more frequently you are exposed, the greater the risk.
Intensity. The greater the viral load you are exposed to, the greater the risk. For example, if 10 people in a bar you are sitting in have the virus, your risk increases.
Duration. The longer you are exposed, the higher your risk. In other words, if you are sitting next to a person with the virus at a restaurant for 2 hours versus 5 minutes in passing, your risk is greater.
Type or method. If your dining partner coughs on your arm and you immediately wash it off, you might be less at risk than if they coughed directly in your face, where the virus can enter through your nose or mouth.
Greenspan notes that the risk in each scenario above decreases if one or more person in the situation is wearing masks and are vaccinated.
While only allowing vaccinated people inside bars and restaurants can reduce the risk of transmission, he adds that it’s not foolproof.
“In addition, alcohol is known to lessen inhibitions and impair judgment, potentially leading to riskier behaviors in all shapes and sizes,” Greenspan said.
A nudge to get vaccinated?
Posina says more requirements like this could encourage people to get vaccinated, so they can continue social interactions safely without jeopardizing their health or putting others at risk.
“Vaccines are the strongest weapon to fight this war against the COVID-19 pandemic that has taken over our world and people’s lives and well-being. They are highly effective at preventing deaths and hospitalizations,” said Posina.
While masking, hygiene, social restrictions, and vaccines over the past few months have helped with the spread, she says more is needed.
“[We] shouldn’t regress now, and the best way to tackle it is by people getting vaccines and masking,” Posina said.
For those who are vaccinated, taking precautions is still necessary, especially with the Delta variant circulating.
“Vaccine is likely to protect you from serious illness, but you can still get mild or asymptomatic infections, and [you are] also likely to spread it to other vaccinated and unvaccinated individuals,” said Posina.
Cathy Cassata is a freelance writer who specializes in stories around health, mental health, medical news, and inspirational people. She writes with empathy and accuracy and has a knack for connecting with readers in an insightful and engaging way. Read more of her work here.
Scientists propose a modeling framework that could predict how antibiotic resistance will evolve in response to different drug combinations.
The research could help doctors optimize the choice, timing, dose, and sequence of antibiotics used to treat common infections in order to help halt the growing threat of antibiotic resistance to modern medicine.
“Drug combinations are a particularly promising approach for slowing resistance, but the evolutionary impacts of combination therapy remain difficult to predict, especially in a clinical setting,” says Erida Gjini, a researcher at the University of Lisbon, Portugal, and first author of the paper in eLife.
“Interactions between antibiotics can accelerate, reduce, or even reverse the evolution of resistance, and resistance to one drug might also influence resistance to another. These interactions involve genes, competing evolutionary pathways, and external stressors, making it a complex scenario to pick apart.”
In their study, Gjini and University of Michigan biophysicist Kevin Wood sought to simplify things. They took a fundamental measurement of microbe fitness—their growth rate, measured by a simple growth curve over time—and linked this to resistance to two theoretical drugs. In the model, they assumed that drug-resistant mutants respond to a high concentration of drug in exactly the same way that drug-sensitive cells respond to a low concentration of drug.
This rescaling assumption means that the growth behavior of mutants can be inferred from the behavior of the ancestral (sensitive) cells, simply by measuring their growth over a range of concentrations. The team then connected this assumption to a famous statistical relationship, called the Price equation, to explain how drug interactions and cross-resistance affect the way populations evolve resistance quantitatively and adapt to drug combinations.
This rescaling model showed that the selection of resistance traits is determined by both the drug interaction and by cross-resistance (where cells develop resistance to one of the drugs and become resistant to the second drug at the same time). A mixture of two drugs in the model leads to markedly different growth trajectories and rates of growth adaptation, depending on how the drugs interact.
For example, growth adaptation can be slowed by drugs that mutually weaken one another—drugs that interact “antagonistically”—but the effect can be tempered or even reversed if resistance to one drug is highly correlated with resistance to the other. The predictions of the model help explain counterintuitive behavior observed in past experiments, such as the slowed evolution seen when combinations of tigecycline and ciprofloxacin—two antibiotics commonly used in clinical settings—are applied simultaneously to the opportunistic pathogen E. faecalis.
Having established the basic model, the team then added in the effect of mutations on drug resistance. They looked at two different routes to accumulating mutations. In the first, there was a uniform pathway between the ancestral genetics and all possible mutation combinations. In the second, they assumed that mutations must arise in a specific sequence. They used a theoretical combination of two drugs, one at a higher dose than the other, and found that the sequential pathway leads to slower adaptation of growth, reflecting its evolution to the first fittest mutant before adapting further.
In addition to being able to include mutations in the model, they also tested whether they could predict the effects of different timings and sequences of antibiotic treatment. They studied two sequential regimes, A and B, based on different dosage combinations of tigecycline and ciprofloxacin. They found that both the resistance levels to the two drugs and the growth rate increases during treatment, as they anticipated. But the dynamics of this increase depends on the relative duration of each treatment and the total treatment length.
“We have built a model that incorporates drug interactions and cross-resistance to predict how microbes will adapt over time in a way that can then be experimentally measured,” says Wood, an associate professor of biophysics and physics.
“In contrast to the classical genetics-based approaches to studying drug resistance, we used simple scaling assumptions—something commonly used in physics—to dramatically reduce the complexity of the problem. The approach helps us unravel a number of competing evolutionary effects and may eventually offer a framework for optimizing time-dependent, multidrug treatments.”
Support for the work came from Fundação Luso-Americana para o Desenvolvimento (FLAD), Instituto Gulbenkian de Ciência (to Gjini), the National Institutes of Health (to Wood), and the National Science Foundation (also to Wood).
