On Organ Donation

As of October 2011, a reported 112,178 patients in the U.S. were awaiting organ donations and every 11 minutes another individual is added to the waiting list. Though an average of 75 people per day receive organ transplants daily and more than 86 million people in the U.S. are registered as donors, a critical shortage of organs remains. Increasing information about the importance of donation could help to encourage new donors and save lives.

Organs and tissues including heart, kidneys, liver, lungs, skin, and corneas can all be donated and transplanted. According to experts, the organs and tissue from a single donor could help as many as 50 recipients. There are no age restrictions for donors, and depending on the type of donation, organs may come from a deceased or living donor. Current data indicates that as of October 7, 2011 there had been 113,693 living donors and 143,662 deceased donors since the tracking of organ donation was initiated.

Any individual is eligible to register as an organ donor, though the process for registering varies by state. If an individual who was not a registered donor dies due to massive trauma to the brain or is declared brain dead and cannot be revived, the individual’s family members must authorize the donation of the individual’s organs. Only organs with blood and oxygen flowing through them at the time of donation are viable for transplant, and each must be transplanted within hours to help prevent rejection by the recipient. When organs become available, they must tissue and blood typed to identify the appropriate individual on the transplant waiting list who is a match, as well as ensuring that they are the appropriate size for the recipient.

The recovery of organs for transplant is performed by a team of surgeons, nurses, and the transplant coordinator in the operating room where the donor received care. Just prior to removal, each organ is flushed free of blood and then placed in a sterile container for transportation to the recipient’s transplant center. Organs must be transplanted quickly – hearts and lungs within four hours, livers within 12-18, and kidneys within 24-48 hours of removal from the donor.

The risks associated with receiving an organ transplant are outweighed by the benefits as individuals receiving transplants are those who would not be able to survive without them. Though all organ recipients must take anti-rejection drugs following transplant, reports indicate that 15 percent still suffer some rejection in the first year. In addition, though the Centers for Disease Control and Prevention (CDC) reports that though the risk of disease transmission from donated organs is rather small, between 2007 and 2010 more than 200 cases of suspected transmission were investigated. To increase the safety of organ transplants, the CDC has drafted new guidelines for advanced organ testing which would screen for hepatitis B and C as well as HIV.

In 2010, 28,665 organ transplants were performed, but reports indicate that as many as 6,000 Americans die each year while waiting for a transplant. By encouraging individuals to consider registering as donors, it may be possible to save thousands of lives each year.



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On the Malaria Vaccine

A recent WHO report indicates that nearly a third of all countries affected by malaria are on course to eliminate the disease over the next 10 years. Though malaria can lead to complications or even death, it is a preventable and curable illness caused by a parasite that is passed from one human to another through the bite of infected Anopheles mosquitoes. Infected individuals frequently experience high fevers, flu-like symptoms, and anemia; and in 2008 malaria caused between 190 and 311 million clinical episodes and between 708,000 and 1,003,000 deaths. Anti-malarial medications, insecticidal nets, and other control and prevention measures have saved an estimated 1.1 million lives in Africa over the past 10 years, but the availability of an effective vaccine is vital to halt its spread.

In the 109 countries and territories where the risk of malaria transmission is the greatest, newly developed malaria vaccines could save lives. Reports indicate that there were 225 million cases of malaria and an estimated 781,000 deaths in 2009, but these figures have steadily declined in recent years. Though preventative measures have helped to reduce infection rates, experts note that the development and use of a malaria vaccine could reduce them further. During a major clinical trial, a recently produced experimental vaccine known as RTS,S halved the risk of children in Africa contracting malaria. Currently children under five years of age account for the majority of the 800,000 people who die each year as a result of malaria. According to the developers of the vaccine, the adverse effects observed during the vaccine trial are comparable to those seen in children receiving other vaccines.

The RTS,S vaccine triggers an immune response which targets the Plasmodium falciparum parasite that causes malaria. This immune response prevents the parasite from maturing and multiplying in the liver of the vaccinated individual. Unlike other previously developed malaria vaccines, this new vaccine has been created to target different forms of the disease and to trigger a range of antibody responses. Though researchers have been working for 40 years to develop an effective malaria vaccine, to date the outcomes have not been entirely successful. Additional research and testing of the RTS,S vaccine is needed, but according to Dr. Mary Hamel of the Centers for Disease Control and Prevention, “these findings show we are on track in the development of a vaccine.”

With further testing and refinement, this vaccine has the potential to save millions of lives each year and eradicate a disease that affects 3.3 million people – half the world’s population. An effective malaria vaccine could reduce malaria-related deaths, 89 percent of which occur in Africa, and could improve the lives of individuals in regions impacted by the diseases.



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On Arthritis Worldwide

Causing swelling and pain in the joints, arthritis leads to substantial activity limitation, work disability, reduced quality of life, and increased healthcare costs, arthritis is the most common cause of disability in the United States with nearly 19 million Americans reporting activity limitations. Experts indicate this figure will balloon to 67 million by 2030. An estimated half a billion people - 10 percent of the world population – experiences some form of impairment or disability, and as the population of the U.S. and other nations increases, it is expected that the incidence of age-related disabilities including arthritis will also increase. Careful monitoring of the condition can help to improve treatment outcomes, and gaining an understanding of the condition and taking precautions to care for one’s joints before arthritis develops may make it possible to mitigate its effects or delay its onset.

Arthritis is caused by the breakdown of the cartilage that normally protects the joints of the body, and is typically seen in individuals 65 and older. The inflammation of one or more joints most commonly associated with arthritis frequently worsens with age. There are over 100 types of arthritis, but osteoarthritis and rheumatoid arthritis are among the most common. Osteoarthritis is caused by wear and tear on the joints and is seen almost exclusively in older individuals, while rheumatoid arthritis is an autoimmune disorder and may be seen in younger individuals as well. Regardless of type, arthritis causes pain, inflammation, and swelling, and restricts movement. Standard treatments focus on relieving symptoms and improving joint function, and may include medications, physical therapy and exercise regimes, lifestyle changes, and surgery if the condition does not improve through the use of more conservative measures.

Steroidal and non-steroidal anti-inflammatory drugs (NSAIDs) can be used to relieve some of the pain and irritation associated with arthritis, and experts are working to identify new medications that may prove beneficial. While medications do provide relief for some individuals, moderate exercise has been found to be highly beneficial to individuals with arthritis. Certain exercises and stretching techniques have been observed to markedly improve the range of motion and strength of muscles surrounding joints in individuals with arthritis. Despite the benefits of moderate exercise to reduce pain and ease stiff joints, a recent study found that many individuals with arthritis do not get the recommended 2.5 hours of moderate-intensity, low-impact activity per week which could improve their condition.

By ensuring that individuals with arthritis and pre-arthritic individuals understand the importance of stretching and exercise, it may be possible to lessen the severity of the condition. In addition to strengthening the joints, these activities can lead to weight loss and improve overall health.



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On Ovarian Cancer

Reports indicate that approximately two million women develop breast or cervical cancer each year, and these rates continue to increase. Though not as common, ovarian cancer - the fifth most common cancer in women – causes more deaths than any other type of female reproductive cancer. According to the National Cancer Institute, to date in 2011 there have been an estimated 21,990 new cases of ovarian cancer, and 15,460 deaths due to the disease. Making women aware of the possible symptoms of ovarian cancer and encouraging them to have routine gynecological appointments may help to improve rates of diagnosis of the condition.

While nearly one in three women will develop breast cancer in their lifetime, one in seven will develop ovarian cancer, but detection and diagnosis is significantly more difficult in ovarian cancer. The symptoms associated with ovarian cancer are often vague, and are commonly associated with other common conditions. According to experts, women should see their doctor if they experience bloating, difficulty eating or feeling full quickly, and pelvic or abdominal pain on a daily basis for more than a few weeks. Because of the difficulty detecting ovarian cancer, it is frequently not detected until it has spread within the pelvis and abdomen. In its late stages it is often fatal, but if diagnosis is made early and treatment is received before the cancer spreads outside of the ovary, the 5-year survival rate is very high. In order to combat difficulties diagnosing ovarian cancer, researchers are working to develop new flureoscence-guided techniques that may make it possible to identify very small tumors that may have been missed using traditional detection methods.

All women are at risk of developing ovarian cancer, but approximately 90 percent of women who get the disease are 40 years of age or older, with the greatest number of cases occurring in women aged 60 and older. Women who have children earlier in life have a decreased risk of developing ovarian cancer, while those who have a personal history of breast cancer or a family history of breast or ovarian cancer have an increased risk. Once ovarian cancer has been positively diagnosed, as with other cancers, it is most often treated surgically. This frequently involves the removal of the uterus, both ovaries and fallopian tubes, and/or removal of the lymph nodes. In addition to the surgical removal of tumors, individuals with ovarian cancer may undergo chemotherapy, however radiation therapy is seldom used in the United States to treat ovarian cancer.

Though difficult to diagnose, if treated quickly ovarian cancer can be beaten. By encouraging women to monitor their health and communicate any concerns to their physician, it may be possible to identify cases more quickly and improve treatment outcomes.



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Salmonella Infection

Bacteria of the Salmonella genus are a major cause of food-borne illness worldwide. Symptoms in most individuals infected with Salmonella are not life-threatening, however in young children, the elderly, and individuals with compromised immune systems, Salmonella infection can be significantly more harmful. By ensuring that food is prepared carefully and properly, it may be possible to reduce the infection rates of Salmonella.

Each year there are approximately 40,000 reported cases of Salmonella infection in the United States, and infection rates are higher in nations with poor sanitation. The majority of infected individuals experience diarrhea, fever, and abdominal cramps within 12 to 72 hours after infection. Though Salmonella infection usually resolves without medical intervention within 7 days, for some individuals dehydration related to diarrhea may become severe and require hospitalization. In addition, a small number of infected individuals develop pain in their joints, irritation of the eyes, and painful urination.

Two serotypes of the approximately 2,500 that have been identified, Salmonella Enteritidis and Salmonella Typhimurium are the most common in the United States and account for half of all human infections. In addition to these common strains, antibiotic strain of Salmonella has recently been identified in 26 states, and to date it has sickened 77 people and killed one. Salmonella infection occurs when the bacterium are ingested, and it is commonly accepted that between 1 million and 1 billion bacteria are needed to cause infection.

The majority of infections are due to the consumption of foods that have been contaminated with animal feces. In recent years, outbreaks have been associated with chicken, turkey, and other meats; as well as eggs, and spinach and a number of other vegetables. To help limit the possibility of infection, experts suggest that consumers follow food preparation guidelines aimed at ensuring that food is properly cleaned and cooked thoroughly. These include washing surfaces and hands frequently, keeping raw meat separate from other ingredients, and ensuring that foods are fully cooked and properly stored. By ensuring that food is handled appropriately, it may be possible to reduce rates of Salmonella infection.



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Ensuring Accessibility During Natural Disasters

Reports indicate that individuals with disabilities are disproportionately affected by natural disasters and emergency situations, due in large part to a lack of adequate planning. Available facilities are frequently inaccessible or are ill equipped to accommodate the needs associated with certain disabilities, therefore, by including individuals with disabilities in all stages of the disaster management process, particularly during the planning and preparation phases, the effectiveness of disaster responses can be greatly improved.

An estimated half a billion people - 10 percent of the world population – experiences some form of impairment or disability. Following recent natural disasters including Hurricane Katrina, studies have found that the regions affected by these disasters are frequently not prepared to evacuate, shelter, transport, or meet the medical needs of individuals with disabilities. In addition, the shelters, transportation services, and emergency communications and information broadcasts available in many regions are often not accessible.

By learning from problems identified following natural disasters, regarding the needs of individuals with disabilities, emergency response initiatives can be modified to ensure that the needs of people with and without disabilities are met. According to experts, all individuals, regardless of their disability status, should prepare for potential disaster situations by having a store of food and water on hand to last a minimum of three days. In addition, it is recommended that individuals with disabilities have a supply of items related to their specific needs - which may include eyeglasses, hearing aides, a laminated communication board, or medications - for at least seven days. FEMA, which recently launched a disaster preparedness app, notes that individuals with certain types of disabilities may need to take additional steps to prepare for and receive assistance following natural disasters. It is suggested that individuals with disabilities establish a network of friends, family, and neighbors who may be able to assist them in the event of an emergency.

While natural disasters affect everyone within a given region, individuals with disabilities may face barriers that can cause additional issues. A number of government agencies, including the Department of Health and Human Services (HHS) have put measures in place to help mitigate the barriers faced by individuals with disabilities in emergency situations. Ensuring the inclusion of individuals with disabilities and their representatives in strategic planning efforts and the provision of information in accessible formats before, during, and following natural disasters are among HHS’s chief concerns. In addition, the UN Convention on the Rights of Persons with Disabilities and other international policy initiatives aim to ensure that humanitarian responses to natural disasters are inclusive of the needs of individuals with disabilities.

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Click here to read the International Disability Rights Monitor (IDRM) report on Disability and Early Tsunami Relief Efforts in India, Indonesia and Thailand

On Chickenpox Worldwide

Chickenpox was once considered a rite of passage for most children, but since the establishment of routine vaccination programs, complications from the virus have seriously decreased. While the condition very seldom leads to secondary infections or other issues, it is highly contagious and can be problematic in some individuals. It is important that parents ensure their children receive vaccinations for chickenpox and other common childhood illnesses, and remain mindful when interacting with infected individuals.

In the 16^th century, the varicella zoster virus (VZV), the virus that causes chickenpox was identified, but it was not until the end of the 19^th century that physicians were able to reliably distinguish chickenpox from smallpox. VZV is a member of the herpes virus group, and like other herpes viruses, it has the capacity to persist in the body after the first infection as a latent infection and can reappear as shingles. Shingles, which manifests as a painful rash on one side of the body, occurs in approximately one in 10 adults. It is the result of re-activation of the VZV virus which persists as a latent infection in sensory nerve ganglia and can occur in any individual who has recovered from chickenpox, but it is most common in individuals over 60.

Spread through direct contact with the rash or droplets dispersed into the air by coughing or sneezing, chickenpox manifests as a red, itchy rash which first appears on the face, trunk, or scalp. The rash usually appears 10 to 21 days after infection, and may be accompanied by a fever, abdominal pain, headache, and a general feeling of unease and discomfort. If scratching the rash is not discouraged through the use of oatmeal or baking soda baths, the application of calamine lotion, or antihistamines, individuals may contract a bacterial infection of the skin. Other complications that can result from chickenpox include viral pneumonia, bleeding problems, and infection of the brain (encephalitis).

Before the introduction of a vaccine, approximately 10,600 people were hospitalized and 100 to 150 died as a result of chickenpox in the U.S. every year. Vaccination became routine practice in the U.S. in 1995, and there are now two live, attenuated VZV-containing vaccines available for use. Recent studies have shown that in children, two doses of the chickenpox vaccine is 98 percent effective in preventing infection, compared with 86 percent effectiveness for a single dose. Recommendations from the Centers for Disease Control and Prevention and the American Academy of Pediatrics indicate that children should receive their first shot at 12 to 15 months, and the second at four to six years to ensure the maximum benefit. While a reported 15 to 20 percent of vaccinated individuals do still become infected with chickenpox if they are exposed to it, their condition is significantly milder and lasts for a shorter period of time.

By increasing awareness about the importance of vaccination, it may be possible to further decrease rates of infection and complications associated with chickenpox. Vaccination against chickenpox and other childhood illnesses can not only protect the individual receiving the vaccination, but can help to protect individuals who may not be able to receive vaccinations due to health conditions by contributing to the herd immunity of their community



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On the Importance of Blood Donation

According to World Health Organization estimates, a country’s basic requirements for safe blood could be met if one percent of that nation’s population donated blood. The WHO reports that 65 percent of all blood donations are made in developed countries, home to just 25 percent of the world’s population, and in some regions access to safe blood is limited. By ensuring that individuals have an understanding of the blood donation process and the importance of donating, it may be possible to ensure that blood supplies are available able to meet the need.

Blood donation has advanced significantly since the first blood transfusion involving a human being was performed in 1667, however the need remains. A reported one in seven people entering a hospital needs blood, and just one pint of blood – the amount obtained during a standard donation procedure – can save up to three lives. Each year, nearly 5 million people in the United States receive life-saving blood transfusions. During surgery, following an accident, or due to a disease or medical condition, individuals may require whole blood or blood components. Whole blood is the most common type of blood donation, during which approximately a pint of blood is given and the blood is then separated into its components. Both platelets and plasma are collected using a process called apheresis, during which the donor is hooked up to a machine that collects the desired blood component and then returns the rest of the blood to the donor. A double red blood cell donation in which only the red blood cells are collected also utilizes apheresis.

In order to be eligible to donate blood an individual must be in good health, at least 17 years old, at least 110 pounds, and able to pass the physical and health history assessment. In addition, before accepting the full donation, the level of iron is tested in a small sample of blood. All donated blood and blood components are subjected to a number of tests to ensure that they are free of bloodborne diseases such as hepatitis, HIV, and syphilis. Blood is also tested to determine the blood type (A, B, AB, or O) and Rh factor (either positive or negative) to ensure that it will be provided to compatible donors. Anyone in need of blood can receive type O red blood cells, and individuals with type AB blood can receive any blood type – thus individuals with type O blood are called “universal donors” and those with type AB blood are “universal recipients.”

Despite the need to maintain an adequate blood supply and the simplicity and safety of the blood donation process, reports indicate that younger individuals say they are “too busy” or “too scared” to give blood, and one in five donors under 30 have stopped donating. An estimated 38 percent of the U.S. population is eligible to donate blood, less than 10 percent donate annually.

Though blood components can be stored – red blood cells for 42 hours refrigerated or up to 10 years frozen, platelets at room temperature for five days, and plasma for up to a year frozen – researchers continue to work to develop a viable synthetic alternative to donated blood. By encouraging people to donate blood and working to find a synthetic blood alternative, it may be possible to ensure that the available blood supply meets the need.

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Malnutrition Worldwide

Estimates indicate that 925 million people – more than one in every seven worldwide – are undernourished, and 98 percent live in the developing world. Malnutrition develops when the body does not have the correct amounts of certain key vitamins, minerals, and nutrients to maintain organ function and healthy tissues. In areas affected by drought or other natural disasters, food supplies may be extremely limited, and increases in the number of malnourished individuals may be seen. By exploring new farming techniques and working to ensure that aid is provided in the affected nations, it may be possible to reduce rates of malnutrition.

Two-thirds of malnourished individuals are concentrated in seven countries: Bangladesh, China, the Democratic Republic of Congo, Ethiopia, India, Indonesia, and Pakistan. Other nations, particularly those in regions affected by drought, are also facing massive food shortages and increasing rates of malnutrition. In the Horn of Africa, a reported 10 million people including children and people with disabilities have been affected by the recent drought in this region – the most severe drought in the area in the past 60 years, which has interrupted food production. UN reports show that those who currently do not have access to a reliable source of food include an estimated 3.2 million people in Ethiopia, 3.5 million in Kenya, 2.5 million in Somalia, 600,000 residents of north-eastern Uganda, and 120,000 individuals in Djibouti.

Children are at a particularly high risk of becoming malnourished. World Health Organization estimates indicate that malnutrition contributes to more than one-third of all child deaths worldwide and the United Nations Children’s Fund approximates that 480,000 children in Somalia, Kenya, and Ethiopia will be severely malnourished this year – a 50 percent increase over last year’s figure. Mark Bowden, the UN humanitarian coordinator for Somalia, notes that the nation is currently facing “the highest rate of malnutrition in the whole of Africa, [and] more than 30 percent of children are suffering from global acute malnutrition.” Many malnourished children can be treated through the administration of calorie-dense, nutrient-rich foods including Ready-to-use Therapeutic Food (RUTF). Though RUTF is still not available in some regions, it based on peanut butter and dried skimmed milk and provides sufficient nutrient intake for complete recovery from malnutrition, and can be stored for three to four months without refrigeration, even at tropical temperatures.

According to UN reports, world food production will need to increase by up to 100 percent by 2050 in order to sustain 9 billion people, the expected global population. In addition to utilizing sustainable farming techniques, some experts have suggested the introduction of “super wheat” – a crop that is more resistant to some types of fungus that can destroy crops. Further exploration of crop options and sustainable farming techniques could help to expand the food supply and help to reduce global rates of malnutrition.

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Medical Uses of Venom

Though the bites and stings of snakes and other creatures can be deadly, researchers have identified compounds and proteins in the venom of some species with potential medical applications. Treatments to slow the growth of some forms of cancer, alleviate chronic pain, and slow the progression of Alzheimer’s disease are in development, and experts are working to identify other possible applications for venoms and animal-derived toxins.

According to John Perez, director of the National Toxins Research Center at Texas A&M University-Kingsville, “Snakes use venom to alter biological functions, and that’s what medicine does too.” The venom of some snakes has been found to have antibacterial applications, as well as slowing cell growth, increasing nerve stimulation, and affecting blood thinning and clotting. Preliminary research has shown that a compound found in the venom of some snakes may be able to inhibit cancer cell migration and slow the growth of tumor cells. Moreover, the anti-clotting proteins that contribute to the lethalness of a snake’s bite have been studied for their possible application as medications for high blood pressure and anti-clotting drugs.

In addition to snake venoms, toxins from a number of other animals have also been found to have medical applications. The saliva of the Gila monster is being studied as a possible drug for the treatment of type 2 diabetes, and proteins which can inhibit or stimulate the growth of blood vessels have been identified within the venom of several amphibians. Naturally occurring and synthesized venom from cone snails are being examined as new treatments for pain, epilepsy, and incontinence. As is the case also in snakes, experts note that there are more than 500 species of cone snail, and that each is able to produce more than 100 unique toxins, all of which could have beneficial medical applications.

Toxins from a number of arachnids and insects have also been examined. Historically bee venom has been used to treat a number of ailments, and in recent years bee venom therapy (BVT) or apitherapy has been touted as a treatment for arthritis, chronic pain, migraines, and multiple sclerosis. Compounds found in scorpion venom which disrupt the growth and spread of invasive tumors have been investigated for possible applications in treating brain cancer. Venoms from spiders have also been studied and research is ongoing to determine if they could be utilized to prevent arterial fibrillation after a heart attack, to regulate and control blood pressure, or to treat erectile dysfunction.

With additional research, it may be possible to identify new treatments for cancer or even HIV/AIDS among the compounds in venoms and toxins. By working to better understand the wealth of resources of the world’s biodiversity, it may be possible to improve global health.

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HIV/AIDS Progress

In the 30 years since it was first identified, the global response to AIDS has achieved significant results. More people than ever before have access to treatment, allowing them to manage their condition, and according to the United Nations rates of new HIV infections are falling by nearly 25 percent. In spite of these successes, it is important that efforts continue to ensure that progress is made towards further improving treatment options and outcomes.

Since 1981, a reported 25 million people worldwide have died from AIDS and an additional 34 million are infected with HIV. According to a recent United Nations report, in the 33 worst-affected countries, the rate of new HIV infections fell by 25 percent between 2001 and 2009, and in India and South Africa, the countries with the largest populations of individuals living with HIV, new infections fell by 50 percent and 35 percent, respectively. According to Michel Sidibé, Executive Director of UNAIDS, through the use of antiretroviral therapy (ART), “AIDS has moved from what was effectively a death sentence to a chronic disease…Antiretroviral therapy is a bigger game-changer than ever before – it not only stops people from dying, but also prevents the transmission of HIV to women, men and children.”

A decade ago, half of the population of several nations in southern Africa were expected to die of AIDS-related causes, but as ART has become more widely available, the death rate is dropping. An estimated 6.6 million people in low- and middle-income countries were receiving ART at the end of 2010 – a nearly 22-fold increase since 2001. In spite of this increase, reports indicate that there are 16 million people worldwide living with HIV/AIDS who could benefit from these medications but many do not receive them. Even in the United States and other developed nations, individuals living with HIV/AIDS are frequently put on long waiting lists to gain access to these life-saving drugs as the supply is not able to meet the demand for them.

While expanded access to ART can help to improve the lives of individuals with HIV/AIDS and help to prevent new infection, a major gap in treatment still exists. Access to treatment for children is significantly lower than for adults, and only 28 percent of all eligible children were receiving treatment in 2009, compared with 36 percent for people of all ages. In addition, while the rate of new HIV infections globally has declined, the total number of individuals with HIV remains high and certain groups, including women of reproductive age, remain at increased risk of infection. By ensuring that antiretroviral medications and education and treatment programs are widely available, it may be possible to further decrease the number of new HIV/AIDS infections worldwide as researchers continue to work to track the spread of the disease and find a cure.



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On MRSA Infections Worldwide

Methicillin-resistant Staphylococcus aureus (MRSA) infection has become increasingly common in recent years, due in large part to overuse of antibiotics. According to a 2007 report in Emerging Infectious Diseases, a publication of the Centers for Disease Control and Prevention (CDC), the average number of MRSA infections doubled nationwide between 1999 and 2005 – from 127,000 to 278,000. During the same period, the number of annual deaths from MRSA infection increased from 11,000 to more than 17,000. By increasing awareness about the risk factors associated with and steps that can be taken to avoid MRSA infection, it may be possible to reduce or eliminate its spread.

MRSA infection is caused by a strain of Staphylococcus (staph) bacteria that has become resistant to the antibiotics commonly used to treat staph infections, which include methicillin and penicillin. Generally, MRSA is spread through skin-to-skin contact, openings in the skin (cuts or abrasions), contact with contaminated surfaces, crowded living conditions, or poor hygiene. MRSA frequently manifests first on the skin as a reddish rash with lesions resembling pimples which may begin to drain pus, or lead to cellulitis, abscesses, and impetigo. In addition, the initial skin infection can spread to almost any other organ in the body, resulting in more serious symptoms and potential complications.

Designations are made between types of MRSA infection based on the location where the infection took place. Hospital-acquired MRSA (also called health-care-acquired, HA-MRSA, or HMRSA) remains one of the most common types of infection. Individuals who are hospitalized, those with invasive medical devices such as catheters, and those residing in nursing homes are at an increased risk of acquiring HA-MRSA. Community-acquired MRSA (CA-MRSA or CMRSA) is another common type of infection, and is seen most frequently in individuals participating in contact sports or those living in crowded or unsanitary conditions. While the average adult death rate among individuals with MRSA is estimated at five percent of infected patients, individuals with HA-MRSA are at an increased risk of experiencing complications including organ damage.

Dr. Marc Siegel, an associated professor of medicine at New York University, and others recommend an evaluation of the overuse of antibiotics by humans as well as in livestock as a means of eradicating MRSA and reducing drug resistance in other strains of bacteria. In addition, experts note the importance of good hygiene practices including washing hands frequently, keeping wounds covered with bandages until they have healed, and washing soiled clothes and sheets in hot water can help to prevent the spread of MRSA. The timely diagnosis of individuals infected with MRSA achieved through an analysis of a skin sample helps to better ensure not only treatment for the individual, but also a decreased risk of infecting others.

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On Non-Communicable Diseases

In 2008, non-communicable diseases (NCDs) accounted for 63 percent of all deaths worldwide. According the World Health Organization’s (WHO) recent Global Status Report on Non-communicable Diseases, without an intervention, NCDs are “projected to kill 52 million people annually by 2030." By informing the public about their risk, encouraging them to make healthy lifestyle changes, and improving treatment for individuals with NCDs, it may help to reduce the incidence of these diseases globally.



NCDs, which include diabetes and cancer, are defined as chronic conditions or diseases which do not result from an acute infectious process. The Centers for Disease Control and Prevention (CDC) report that half of all deaths in the U.S. each year are due to heart disease, cancer, or stroke. In addition to the incidence of NCDs in developed nations, a reported 80 percent of the 36.1 million NCD-associated deaths in 2008 occurred in developing nations. While NCDs can present a burden for any nation’s healthcare infrastructure, Dr. Margaret Chan, WHO Director General, notes that “for some countries it is no exaggeration to describe the situation as an impending disaster.”

Reports indicate that cardiovascular diseases account for the majority of NCD-related deaths, or 17 million annually, followed by cancer (7.6 million annually), respiratory disease (4.2 million annually), and diabetes (1.3 million annually). These four groups of diseases account for nearly 80 percent of all NCD deaths, and share four common risk factors: tobacco use, inadequate physical activity, harmful alcohol use, and poor diet. Almost six million people die as a result of tobacco use each year, and 2.5 million die from alcohol-related causes. In addition, lack of exercise and poor diet contribute to obesity, increasing individual’s risk of heart disease, stroke, and diabetes.

To lessen the impact that NCDs have on global health, the WHO has suggested that a number of measures be taken, including banning smoking in public places and promoting public awareness about the importance of diet and exercise. Encouraging individuals to make healthy lifestyle choices and providing them with information about how to improve their health, it may be possible to reduce the number of NCD-related deaths worldwide.



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On Measles Worldwide

The World Health Organization reports that in 2008, there were 164,000 measles deaths globally, more that 95 percent of which were in low-income countries with weak health infrastructures. This rate equates to nearly 450 a day or 18 per hour. In recent years, targeted vaccination campaigns have greatly reduced the number of measles deaths each year, though in developing nations with weak health infrastructures complications or deaths related to measles infection are still not uncommon. By increasing awareness about the importance of vaccination and making vaccines available in regions where they are needed, the virus that causes measles could be eradicated.



Measles, also called rubeola, is a common and preventable childhood disease, also sometimes seen in individuals with compromised immune systems. Most frequently, infection is marked by a fever lasting a couple of days, followed by a cough, runny nose, and conjunctivitis. Soon after, patients exhibit a rash on the face and upper neck, spreading down the back and trunk to the arms and legs. Reports indicate that 30 percent of people infected with measles will experience complications, ranging from ear infections to pneumonia. Further, one in every 1,000 people will develop inflammation of the brain. If left untreated, the complications associated with measles infection can be life threatening. In regions without widespread access to medical care, an estimated five percent of children die of measles-related causes.

According to William Schaffner, an infectious disease expert at Vanderbilt University School of Medicine, the measles virus infects more than 80 percent of unvaccinated people exposed to it. Though the transmission of endemic measles was declared eliminated in the U.S. in 2000, the disease remains common in other regions and can be imported by travelers. Reports from the Centers for Disease Control and Prevention (CDC) indicate that during 2008, nearly 90 percent of measles cases in the U.S. were either acquired abroad or linked to imported cases. While a safe and cost-effective vaccine is available, more than 20 million people are affected by measles each year and the majority live in developing nations and/or countries with low per capita incomes and weak health infrastructures.

Though measles outbreaks continue to be problematic in some developing regions, the World Health Organization reports that between 2000 and 2007, 576 million children were vaccinated against measles, resulting in a 74 percent decrease in measles-related deaths worldwide. By increasing awareness about the importance of vaccinations and ensuring that vaccines for measles are available, rates of infection, complications due to infection, and death could be even further reduced.

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On Stroke Worldwide

Stroke, sometimes called a “brain attack” or cerebrovascular disease, is the second leading cause of death worldwide and the third in the United States, killing approximately 137,000 people each year. Though many individuals recover from strokes, at least two-thirds of survivors experience some type of disability. A reported 80 percent of strokes are preventable, and by increasing awareness about stroke prevention and treatment, it may be possible to improve individuals’ recovery.

Individuals with high blood pressure or high cholesterol, those over 55 years of age or who have a family history of stroke, and those who smoke or use alcohol are at an increased risk of having a stroke. Though stroke predominantly occurs in middle-aged and older individuals, in recent years an increase in the number of young people affected by stroke has been seen. According to experts, this may be due in part to an increase in the incidence of obesity worldwide.

A stroke occurs when a blood clot blocks an artery or when a blood vessel breaks, interrupting blood flow in an area of the brain. Approximately 87 percent of strokes are Ischemic, meaning that they are caused by a gradual build-up of plaque and other fatty deposits or blood clots which block arteries so that blood cannot be delivered to the heart. In the case of Ischemic stroke, clot-busting medications must be administered as quickly as possible to improve the patient’s chances of survival and minimize the potential of complications. In contrast, Hemorrhagic strokes, which account for 13 percent of all strokes but more than 30 percent of stroke-related death, occur when blood vessels in the brain burst, leaking blood into the brain. For individuals experiencing Hemorrhagic stroke, emergency treatment focuses on controlling bleeding and may involve surgery to repair the broken blood vessel. In addition to the medications commonly used for stroke treatment, new research suggests that a drug derived from turmeric, CNB-001, may be able to help the body repair some of the damaged caused in the immediate aftermath of a stroke.

By depriving brain cells of oxygenated blood, strokes kill off brain cells and trigger a chain reaction that can widen the damaged area and increase the level of disability suffered by the patient. Because the risk of brain damage increases the longer a stroke goes untreated, experts suggest using the F.A.S.T. test to quickly determine if an individual has had a stroke. The procedure for the F.A.S.T. test is as follows:

1. Face: Ask the person to smile. Does one side of the face droop?
2. Arms: Ask the person to raise both arms. Does one arm drift downward?
3. Speech: Ask the person to repeat a simple sentence. Is the speech slurred?
4. Time: If any signs are observed, call 9-1-1 immediately or seek medical attention.

The most common symptom of a stroke is sudden weakness or numbness in the face, arm, or leg, most frequently on one side of the body. Individuals may also experience confusion, difficulty speaking and understanding speech, difficulty seeking with one or both eyes, dizziness, or severe headache with no known cause.

By increasing awareness about the risk factors that contribute to stroke and encouraging individuals to make healthier lifestyle choices, it may be possible to lessen the chances of its occurrence. In addition, providing information about how to determine if an individual is having a stroke can help ensure that those who do will receive life-saving treatment more quickly.

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Water Availability

Though water is the body’s principal chemical component the World Health Organization (WHO) reports that 1.1 billion people lack access to a potable water source. In addition, approximately 2.6 billion people – half the population of the developing world – do not have access to even a simple latrine. While this raises concerns regarding quality of life and lack of resources in general, individuals who do not have access to clean drinking water and sanitation services are at an increased risk of contracting diarrheal illnesses, including cholera. Though these conditions are easily treated, the regions where they are most prevalent frequently also do not have the necessary medications. By increasing awareness about ways to improve the availability of safe water and sanitation services, it may be possible to reduce transmission and infection rates.

Reports indicate that each year the deaths of 1.6 million people – approximately 90 percent of them children under five years of age - are due to diarrheal illnesses that can be attributed to a lack of access to safe drinking water and basic sanitation. The WHO defines “basic sanitation” as “the lowest-cost technology ensuring hygienic excreta and sullage disposal.” Further, individuals are said to have “access to drinking water” - “drinking water” defined by the WHO as “water which is used for domestic purposes, drinking, cooking and personal hygiene” - if they are within 1 kilometer of a source that can reliably produce 20 liters per household member per day. According to Siemens, more than a billion people worldwide currently survive on only 3.8 liters (one gallon) of water per day, though experts suggest an intake of approximately 1.5 liters per day.

According to UN Secretary-General Ban Ki-moon, over the past decade, the number of individuals living in urban areas who lack access to drinking water in their home or the immediate vicinity has increased by an estimated 114 million, while the number who lack access to basic sanitation facilities has risen by 134 million. An estimated 51 million people in the Democratic Republic of Congo have no access to safe drinking water, and between 30 and 60 percent of the urban population of sub-Saharan Africa has no access to the municipal water supply. In these and other regions worldwide where access to potable water and sanitation services are limited, individuals may employ alternative methods of purifying water, such as boiling, chemical disinfection, and filtration. While these methods offer an effective means of generating a supply of safe drinking water, the quality of water used in farming is also critical, as water-borne pathogens on crops can cause diseases such as typhoid and cholera.

Both governmental agencies and non-profit organizations have established initiatives aimed at increasing the availability of water, purifying existing water sources, and improving sanitation services worldwide. By ensuring that safe water is available for consumption and farming, and that sanitation services are sufficient, the transmission of water-borne illnesses can be mitigated. In addition, providing individuals in regions facing shortages of potable water with information about water purification options and treatments for cholera and other diarrheal illnesses can improve the healthcare infrastructure in these areas.

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On Crisis Mapping

Web-based mapping tools have been used to track disease outbreaks, and more recently have been employed in response to natural disasters. Many humanitarian relief efforts have employed crowd-sourcing as a means to gather and share information. By utilizing crowd-sourcing tools including digital maps, government agencies, non-governmental organizations, and other interested parties can collaborate more effectively and improve humanitarian relief responses to natural disasters. For example, crowd-sourced maps can provide disparate networks of volunteers with a simplified way to share information, and can give local relief workers a clearer picture of the situation on the ground as they establish priorities for food, shelter, sanitation services, and healthcare facilities.

The web-reporting platform Ushahidi has been used by human rights and humanitarian aid workers to document and track progress during and immediately following crisis and natural disaster situations. Unlike other similar tools, Ushahidi is open source, and allows for information to be input using cell phones and other web-connected devices. Specialized versions of the Ushahidi crisis-mapping tool are frequently developed following natural disasters, including the recent earthquake in Japan, to allow individuals on the ground to text the locations of individuals in need of assistance or the locations of clinics or hospitals. Recent iterations of Ushahidi have integrated “check-in” functionality as well, further simplifying the process of adding data to the map.

Though crisis-mapping tools were utilized following the 2010 earthquake in Haiti, the majority of their use was by international aid organizations. In contrast, updates to the Japan Crisis Map have been posted by volunteers, government employees, and others. By encouraging the active participation of more individuals, these types of crisis maps can give a fuller understanding of the situation on the ground. In addition, representatives from academic institutions are participating in efforts to examine the data gathered using crowd-sourced crisis maps and identify ways of improving how information is shared during and immediately following natural disasters. A recent report entitled “Disaster Relief 2.0: The Future of Information Sharing in Humanitarian Emergencies” is guiding these efforts by examining how new technologies can influence emergency relief work. The report documents how technology was used during the earthquake in Haiti and in the weeks and months following to locate survivors, provide information about where to receive assistance, and gather donations for aid organizations.

According to experts, “the crisis-mapping response to the earthquake that struck Haiti in 2010 was striking proof of the potential of new mapping tools,” and by examining the successes and shortcomings, the tools and technologies can be improved faster, and more efficient.”

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Zoonotic Diseases

A reported 75 percent of recently emerging infectious diseases are of animal origin, and approximately 60 percent of all human pathogens are zoonotic. Zoonotic diseases (zoonoses) are defined as illnesses commonly found in animals that can be transmitted to humans, and can be caused by bacteria, parasites, fungi, and viruses. To date over 200 zoonotic diseases have been identified, and though seen worldwide, zoonotic diseases are especially prevalent in areas of the developing world where humans and livestock live in close proximity. By gaining an understanding of these illnesses and tracking their spread, it may be possible to limit new infections and prevent potential epidemic outbreaks.

Outbreaks of zoonoses including influenza, ebola, tuberculosis, and severe acute respiratory syndrome (SARS) have been seen worldwide in recent years. In many developing countries, zoonoses are among the diseases that contribute significantly to an already overly burdened public health system. Approximately 700 million people in developing nations keep livestock, frequently living nearby the animals, putting them at an increased risk of contracting a zoonotic disease. Brucellosis (one of the world’s most widespread zoonoses), Q Fever, and Bovine spongiform encephalopthy (BSE or “mad cow disease”) are among the zoonoses commonly encountered in regions where large numbers of farm animals are kept.

The transmission of pathogens between the environment, wildlife, livestock, and humans is a major health concern that affects humans and domestic animals, as well as impacting the sustainability of agriculture and the conservation of wildlife. According to Dr. Martyn Jeggo, director of CSIRO’s Australian Animal Health Laboratory, the recent emergence of diseases in humans which originated animals has “heightened public awareness of the multidimensional linkages between wild animals, livestock production, the environment and global public health.” In addition to those transmitted by farm animals, recent studies suggest that at least 100 of the known zoonotic diseases are derived from domestic pets. According to Dr. Peter Rabinowitz of the Yale School of Medicine, rates may be higher than studies indicate as several million infections passed between pets and people go unreported each year in the United States. Common infections transmitted to humans after sleeping with their cat or dog, or being licked by the animal include hookworm, ringworm, roundworm, cat scratch disease, and drug-resistant staph infections.

According to experts, the key to slowing the spread of zoonotic diseases and reducing the likelihood of epidemic events is careful monitoring. Through programs like the recently launched PREDICT, a project of USAID's Emerging Pandemic Threats Program, it may be possible to develop a global early warning system through which emerging zoonotic diseases can be detected and reduced.



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Using the Internet to Assist Japan

On March 11, 2011, Japan was struck by a 9.0 magnitude earthquake – the fourth largest in the world since 1900 - proceeded by a massive tsunami. Reports indicate that at least 550,000 people have been displaced, and at least 10,000 have lost their lives. In the hours and days following these disasters, individuals and organizations have utilized the Internet as a “virtual crisis center,” using websites particularly social networking sites, to share information and locate friends and family members.

According to Ezra Gottheil, an analyst at Technology Business Research, “Social communications, like Twitter, and social networking sites, like Facebook, are at their best when big news is breaking.” As seen following the recent earthquakes in Haiti and Chile, humanitarian aid organizations have used social networking websites to solicit donations. Individuals have also used the sites to share information about their experiences on the ground and reconnect with friends and family members. Online Social Media, an organization which tracks social media services, reported that just an hour after the earthquake hit Japan, Twitter was experiencing 1,200 tweets per minute, many of them containing hashtags related to the tragedy. Facebook was similarly flooded with posts, which students in the U.S. and Japan are working together to use to paint a picture of the extent of the tragedy.

Large corporations have also created portals to help individuals locate loved ones and provide information about where to obtain medical assistance, food, potable water, and shelter. Google’s Person Finder database, available in Japanese, English, Korean, Chinese, and Portuguese allows users to enter a name and search for missing persons or post updates about people who they know are safe. A local version of the crisis-mapping tool, Ushahidi, has also been created and put in place. Ushahidi allows individuals in Japan to text or input online the locations of trapped people or clinic locations which are then plotted on a map so that users can easily pinpoint where people may be trapped, dangerous areas that should be avoided, and locations where food and clean water can be obtained.

Patrick Meier, director of crisis mapping and new media at Ushahidi, notes that “Ten percent of this [sharing of information] is the technology, and the other 90 percent is the people…That’s truer and truer as the technology gets easier to use.” As technology use and adoption becomes more widespread, the use of technology during the rescue and recovery period is likely to increase. By utilizing existing information and communication technologies and developing new ones, outcomes following natural disasters can be improved.



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FEMA Online Guide to Disaster Preparedness

Mobile applications that can prepare you for or provide assistance in a disaster situation:

• American Red Cross: Shelter View (iPhone – Free)


• Disaster Readiness (iPhone - $0.99)


• Disaster Readiness (Android - $1.99)


• Pocket First Aid & CPR (iPhone - $3.99)


• Pocket First Aid & CPR (Android - $2.99)


• Emergency Radio (iPhone - $0.99)


• Scanner Radio Pro (Android - $2.99)

Mobile Medical Applications

The New York Times recently reported that “more human beings today have access to a cell phone than the United Nations says have access to a clean toilet.” Further reports indicate that there are an estimated 5 billion mobile phone users worldwide with three-quarters of these individuals in developing nations. Mobile broadband subscriptions are on track to surpass one billion by 2011, according to Ericsson, a provider of telecommunication and data communication systems worldwide. For healthcare providers in the developed world, smartphones and mobile devices have become increasingly common, and a reported 72 percent of physicians are utilizing smartphones personally and professionally. This global trend underpins the unprecedented potential of mobile applications to help bridge gaps in medical knowledge and address the lack of trained personnel at the point of care in underserved areas.

Experts note that the use of mobile applications can simplify the process of sharing clinical images and patient data for physicians consulting on a case and may be particularly helpful in rural and remote regions. To date, two mobile applications have been approved for use by the Food and Drug Administration (FDA) to improve the quality of care provided nationwide. The first, Mobile MIM, allows physicians to examine images of patient scans on iPhones or iPads. According to William Maisel, chief scientist and deputy director for science at the FDA’s Center for Devices and Radiological Health, Mobile MIM “provides physicians with the ability to immediately view images and make diagnoses” without requiring that they be near a workstation. Similarly, MobiUS, a simple medical ultrasound imaging system, which has also recently received FDA approval, can be used to simplify the ultrasound process. Requiring only an ultrasound wand and gel, and a smartphone, MobiUS increases the portability, affordability, and accessibility of this type of non-invasive medical imaging and can help improve the delivery of obstetric and gynecological care.

A number of other medical applications have been developed to aid in diagnosis and provide treatment recommendations. MedRed, an organization whose mission is to make medical knowledge accessible to patients and healthcare providers at the point of care, was recently awarded a contract from the Veterans Affairs Department to pilot a software tool aimed at helping healthcare providers more easily share new and innovative treatment strategies for veterans being treated for traumatic brain injury. The system, called Balto, provides for electronic data capture and exchange, and incorporates clinical decision support technology. Balto’s graphical user interface allows the user to enter patient signs and symptoms in a point-and-click fashion, and receive real-time diagnosis and treatment recommendations based on selected clinical guidelines embedded in the system.

The Coags Uncomplicated mobile application was also developed to assist in medical diagnosis, specifically for bleeding disorders, and allows physicians to input test results and receive a list of possible diagnoses. Mobile applications are in development to help diagnose a number of other potentially fatal conditions as well, including cancer. In addition to applications created for use by physicians, some aim to improve patient awareness and the ability to monitor one’s health. According to Kathleen Sebelius, Secretary of Health and Human Services (HHS), “People in communities can improve their healthcare if they just have the information to do it.” Among application created to allow patients to monitor their condition is Prostate Pal, a free iPhone application developed by urologist Dr. Ronald Yap. Designed to help men keep accurate health records and discuss symptoms with their doctors, Prostate Pal allows patients to track their fluid intake and output, and features a symptoms questionnaire from the American Urological Association. Other iPhone applications intended for consumer use, such as Wheelmap, depend heavily on user feedback and the sharing of information. Wheelmap tags places of interest on a map and shows the user the most wheelchair-accessible route. In addition, users are able to indicate how accessible locations are using a color-coding system, and can also rate the routes the application provides and suggest modifications.

The use of medical applications on cell phones, tablets, and personal computers can help to greatly improve the quality of care delivered worldwide. Clinicians and patients can utilize these innovative new tools to inform diagnosis and treatment decisions, share information about medical conditions, and track symptoms to ensure that medical knowledge is available at the point of care.


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FEMA Online Guide to Disaster Preparedness

Mobile applications that can prepare you for or provide assistance in a disaster situation:

American Red Cross: Shelter View (iPhone – Free)

Disaster Readiness (iPhone - $0.99)

Disaster Readiness (Android - $1.99)

Pocket First Aid & CPR (iPhone - $3.99)

Pocket First Aid & CPR (Android - $2.99)

Emergency Radio (iPhone - $0.99)

Scanner Radio Pro (Android - $2.99)