World Health Day 2016: Beat diabetes

Diabetes is a serious, chronic disease that occurs either when the pancreas does not produce enough insulin (a hormone that regulates blood sugar, or glucose), or when the body cannot effectively use the insulin it produces. Diabetes is an important public health problem, one of four priority non-communicable diseases (NCDs) targeted for action by world leaders. Both the number of cases and the prevalence of diabetes has been steadily increasing over the past few decades.

 

GLOBAL BURDEN

Globally, an estimated 422 million adults were living with diabetes in 2014, compared to 108 million in 1980. The global prevalence (age-standardized) of diabetes has nearly doubled since 1980, rising from 4.7% to 8.5% in the adult population. This reflects an increase in associated risk factors such as being overweight or obese. Over the past decade, diabetes prevalence has risen faster in low- and middle-income countries than in high-income countries.

Diabetes caused 1.5 million deaths in 2012. Higher-than-optimal blood glucose caused an additional 2.2 million deaths, by increasing the risks of cardiovascular and other diseases. Forty-three percent of these 3.7 million deaths occur before the age of 70 years. The percentage of deaths attributable to high blood glucose or diabetes that occurs prior to age 70 is higher in low- and middle-income countries than in high-income countries.

Because sophisticated laboratory tests are usually required to distinguish between type 1 diabetes (which requires insulin injections for survival) and type 2 diabetes (where the body cannot properly use the insulin it produces), separate global estimates of diabetes prevalence for type 1 and type 2 do not exist. The majority of people with diabetes are affected by type 2 diabetes. This used to occur nearly entirely among adults, but now occurs in children too.

 

COMPLICATIONS

Diabetes of all types can lead to complications in many parts of the body and can increase the overall risk of dying prematurely. Possible complications include heart attack, stroke, kidney failure, leg amputation, vision loss and nerve damage. In pregnancy, poorly controlled diabetes increases the risk of fetal death and other complications.

 

ECONOMIC IMPACT

Diabetes and its complications bring about substantial economic loss to people with diabetes and their families, and to health systems and national economies through direct medical costs and loss of work and wages. While the major cost drivers are hospital and outpatient care, a contributing factor is the rise in cost for analogue insulins which are increasingly prescribed despite little evidence that they provide significant advantages over cheaper human insulins.

 

PREVENTING DIABETES

Type 1 diabetes cannot be prevented with current knowledge. Effective approaches are available to prevent type 2 diabetes and to prevent the complications and premature death that can result from all types of diabetes. These include policies and practices across whole populations and within specific settings (school, home, workplace) that contribute to good health for everyone, regardless of whether they have diabetes, such as exercising regularly, eating healthily, avoiding smoking, and controlling blood pressure and lipids.

 

Taking a life-course perspective is essential for preventing type 2 diabetes, as it is for many health conditions. Early in life, when eating and physical activity habits are formed and when the long-term regulation of energy balance may be programmed, there is a critical window for intervention to mitigate the risk of obesity and type 2 diabetes later in life.

No single policy or intervention can ensure this happens. It calls for a whole-of-government and whole- of-society approach, in which all sectors systematically consider the health impact of policies in trade, agriculture, finance, transport, education and urban planning – recognizing that health is enhanced or obstructed as a result of policies in these and other areas.

 

Read More: http://apps.who.int/iris/bitstream/10665/204874/1/WHO_NMH_NVI_16.3_eng.pdf?ua=1

Cranberry capsules more effective in lowering UTI risk than juice

A urinary tract infection (UTI) can be an unwelcome visitor—leaving you with the urge to sprint for the bathroom every few minutes. You may have heard that drinking a large glass of cranberry juice can effectively 'treat' a bladder infection, but is this remedy more fact or fiction?

 

A UTI is an infection in any part of the urinary system, kidneys, bladder or urethra. They are more common in women and affect more than 3 million Americans per year. Many in the population will turn to sipping on a cranberry juice cocktail to alleviate their symptoms, but, according to a Texas A&M Health Science Center urologist, drinking cranberry juice to treat a UTI is little more than an old wives' tale.

 

"Cranberry juice, especially the juice concentrates you find at the grocery store, will not treat a UTI or bladder infection," said Timothy Boone, M.D., Ph.D., vice dean of the Texas A&M Health Science Center College of Medicine Houston campus and chairman of the department of urology for Houston Methodist Hospital. "It can offer more hydration and possibly wash bacteria from your body more effectively, but the active ingredient in cranberry is long-gone by the time it reaches your bladder."

 

With that said, the active ingredient in cranberry (A-type proanthocyanidins or PACs) can block the adhesion of bacteria to the wall of the bladder. "For a UTI to occur, bacteria must adhere to and invade the lining of the bladder," Boone said. "PACs interfere with the bacteria's ability to bind to the wall of the bladder and create an infection."

 

Unfortunately, PACs aren't present in cranberry juice at all—only in cranberry capsules. "It takes an extremely large concentration of cranberry to prevent bacterial adhesion," Boone added. "This amount of concentration is not found in the juices we drink. There's a possibility it was stronger back in our grandparents' day, but definitely not in modern times."

 

A study published in the American Journal of Obstetrics and Gynecology did conclude that taking cranberry capsules lowered the risk of UTIs by 50 percent in women who had a catheter in place while undergoing gynecological surgery. "In this study, they took the cranberry itself and put it in a capsule—the equivalence of drinking 28 ounces of cranberry juice. As you can see, it takes a large amount of pure cranberry to prevent an infection," Boone said.

 

Symptoms of a UTI include increased urge to urinate, pain with urination, pelvic pain or blood in the urine. While they can be self-diagnosed and are often short-lasting, UTIs usually need to be treated with antibiotics. "Sometimes it easy to confuse a UTI with overactive bladder, so it's always best to consult your physician about any adverse symptoms you're having," Boone said. "UTIs may also progress into kidney infections which are much worse."

 

Treatment of UTIs can be complicated because of the high rates of reoccurrence, and approximately 20 to 30 percent of women will develop multiple UTIs. Another troublesome barrier to treatment is the increasing resistance of bacteria to commonly used antibiotics—enter probiotics.

 

"In these instances, probiotics were shown to be safe alternative to antibiotics in the treatment of UTIs," Boone said. "There are many benefits of probiotics, although more research still need to be done."

 

 

Source:

Texas A&M Health Science Center

New Lyme Disease Bacteria Discovered by CDC

Infection may trigger nausea, vomiting and a more widespread rash, officials say.

The Centers for Disease Control and Prevention, in collaboration with Mayo Clinic and health officials from Minnesota, Wisconsin, and North Dakota, report the discovery of a new species of bacteria (Borrelia mayonii) that causes Lyme disease in people. Until now, Borrelia burgdorferi was the only species believed to cause Lyme disease in North America.

 

Scientists at the Mayo Clinic in Rochester, Minnesota, first suspected the possibility of new bacteria after lab tests from six people with suspected Lyme disease produced unusual results, according to the findings published today in Lancet Infectious Diseases. Additional genetic testing at the Mayo Clinic and CDC found that the bacteria, provisionally named Borrelia mayonii, is closely related to B. burgdorferi.

 

“This discovery adds another important piece of information to the complex picture of tickborne diseases in the United States,” said Dr. Jeannine Petersen, microbiologist at the Centers for Disease Control and Prevention.

 

So far, new Lyme species found only in upper Midwest

 

Limited information from the first six patients suggests that illness caused by B. mayonii is similar to that caused by B. burgdorferi, but with a few possible differences. Like B. burgdorferi, B. mayonii causes fever, headache, rash, and neck pain in the early stages of infection (days after exposure) and arthritis in later stages of infection (weeks after exposure). Unlike B. burgdorferi, however, B. mayonii is associated with nausea and vomiting, diffuse rashes (rather than a single so-called “bull’s-eye” rash), and a higher concentration of bacteria in the blood.

 

The researchers believe that, like B. burgdorferi, B. mayonii is transmitted to humans by the bite of an infected blacklegged (or “deer”) tick. B. mayonii has been identified in blacklegged ticks collected in at least two counties in northwestern Wisconsin. The likely exposure sites for the patients described in Lancet Infectious Diseases are in north central Minnesota and western Wisconsin. It is highly likely, however, that infected ticks are found throughout both states.

 

The newly recognized species was discovered when six of approximately 9,000 samples drawn from residents of Minnesota, Wisconsin, and North Dakota with suspected Lyme disease between 2012 and 2014 were found to contain bacteria that were genetically distinct from B. burgdorferi. Scientists analyzed the DNA sequences of these bacteria and found that they belonged to a previously unrecognized Borrelia species. Blood from two of the patients was also tested by culture at CDC, whereby the organism is grown in the laboratory.

 

To date, the evidence suggests that the distribution of B. mayonii is limited to the upper midwestern United States. The new species was not identified in any of the approximately 25,000 blood samples from residents of 43 other states with suspected tickborne disease taken during the same period, including states in the Northeast and Mid-Atlantic region where Lyme disease is common.

 

Current tests, treatments should work for new Lyme strain

 

Results from the cases described in this report suggest that patients infected with B. mayonii will test positive for Lyme disease with currently available Food and Drug Administration-cleared Lyme disease tests. Specific identification of the organism can be made by using polymerase chain reaction assays (PCR.), which detects the DNA of the Lyme disease bacteria. In some instances, B. mayonii bacteria may also be seen on a blood smear.

 

The patients described in this report were treated successfully with antibiotics commonly used to treat Lyme disease caused by B. burgdorferi. CDC recommends that health care providers who treat people infected with B. mayonii follow the antibiotic regimen described by the Infectious Diseases Society of America.

 

CDC is working closely with state health departments in Minnesota, North Dakota, and Wisconsin to better understand B. mayonii and to plan future investigations, including better descriptions about the clinical aspects of the illness and the geographic extent of the infected ticks.

 

To further support advances in the detection and discovery of tickborne diseases, CDC in 2015 funded a partnership with the Minnesota Department of Health, Mayo Clinic, Tennessee Department of Health, and Vanderbilt University to collect over a 3-year period up to 30,000 clinical specimens from patients with suspected tickborne illness. CDC will use advanced molecular detection methods, including metagenomics screening and whole genome sequencing, to test the specimens for other bacteria that cause tickborne illness.

 

"CDC is investing in advanced technology to bring study of tickborne infections into a new era," said Ben Beard, Ph.D., chief of CDC’s Bacterial Diseases Branch. "Coupling technology with teamwork between federal, state, and private entities will help improve early and accurate diagnosis of tickborne diseases.”

 

To reduce the risk of tick bites and tickborne diseases, CDC recommends that people:

 

Avoid wooded and brushy areas with high grass and leaf litter;

Use insect repellent when outdoors;

Use products that contain permethrin on clothing;

Bathe or shower as soon as possible after coming indoors to wash off and more easily find ticks;

Conduct a full-body tick check after spending time outdoors; and

Examine gear and pets, as ticks can come into the home on these and later attach to people.

 

To view the CDC article online: http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(15)00464-8/fulltext

 

For more information, please visit www.cdc.gov/ticks.

Zika Virus: Things you should know

Key facts

  • Zika virus disease is caused by a virus transmitted by Aedes mosquitoes.
  • People with Zika virus disease usually have a mild fever, skin rash (exanthema) and conjunctivitis. These symptoms normally last for 2-7 days.
  • There is no specific treatment or vaccine currently available.
  • The best form of prevention is protection against mosquito bites. 
  • The virus is known to circulate in Africa, the Americas, Asia and the Pacific.

Introduction

Zika virus is an emerging mosquito-borne virus that was first identified in Uganda in 1947 in rhesus monkeys through a monitoring network of sylvatic yellow fever. It was subsequently identified in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia and the Pacific.

igns and Symptoms 

The incubation period (the time from exposure to symptoms) of Zika virus disease is not clear, but is likely to be a few days. The symptoms are similar to other arbovirus infections such as dengue, and include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild and last for 2-7 days.

During large outbreaks in French Polynesia and Brazil in 2013 and 2015 respectively, national health authorities reported potential neurological and auto-immune complications of Zika virus disease. Recently in Brazil, local health authorities have observed an increase in Zika virus infections in the general public as well as an increase in babies born with microcephaly in northeast Brazil. Agencies investigating the Zika outbreaks are finding an increasing body of evidence about the link between Zika virus and microcephaly. However, more investigation is needed before we understand the relationship between microcephaly in babies and the Zika virus. Other potential causes are also being investigated. 

Transmission

Zika virus is transmitted to people through the bite of an infected mosquito from the Aedes genus, mainly Aedes aegypti in tropical regions. This is the same mosquito that transmits dengue, chikungunya and yellow fever.

Zika virus disease outbreaks were reported for the first time from the Pacific in 2007 and 2013 (Yap and French Polynesia, respectively), and in 2015 from the Americas (Brazil and Colombia) and Africa (Cape Verde). In addition, more than 13 countries in the Americas have reported sporadic Zika virus infections indicating rapid geographic expansion of Zika virus.

Diagnosis

Zika virus is diagnosed through PCR (polymerase chain reaction) and virus isolation from blood samples. Diagnosis by serology can be difficult as the virus can cross-react with other flaviviruses such as dengue, West Nile and yellow fever. 

Prevention

Mosquitoes and their breeding sites pose a significant risk factor for Zika virus infection. Prevention and control relies on reducing mosquitoes through source reduction (removal and modification of breeding sites) and reducing contact between mosquitoes and people. 

This can be done by using insect repellent; wearing clothes (preferably light-coloured) that cover as much of the body as possible; using physical barriers such as screens, closed doors and windows; and sleeping under mosquito nets. It is also important to empty, clean or cover containers that can hold water such as buckets, flower pots or tyres, so that places where mosquitoes can breed are removed.

Special attention and help should be given to those who may not be able to protect themselves adequately, such as young children, the sick or elderly.

During outbreaks, health authorities may advise that spraying of insecticides be carried out. Insecticides recommended by the WHO Pesticide Evaluation Scheme may also be used as larvicides to treat relatively large water containers.

Travellers should take the basic precautions described above to protect themselves from mosquito bites. 

Treatment

Zika virus disease is usually relatively mild and requires no specific treatment. People sick with Zika virus should get plenty of rest, drink enough fluids, and treat pain and fever with common medicines. If symptoms worsen, they should seek medical care and advice. There is currently no vaccine available. 

 

Some Useful Links:

http://www.who.int/mediacentre/factsheets/zika/en/

http://www.cdc.gov/zika/ 

http://www.who.int/features/qa/zika/en/