Though the last major outbreak in the United States occurred in 1911, cholera remains a persistent health concern in many parts of the world, including Asia, the Middle East, Latin America, and sub-Saharan Africa. Recent outbreaks have been seen in Nigeria, where cholera has killed more than 1,500 people this year, and in Haiti, where survivors of the massive January earthquake have been affected by an outbreak that has infected an estimated 2,300 people and killed at least 200. Due to cholera, there are an estimated three to five million new cases reported worldwide and between 100,000 and 120,000 deaths each year. Like other diarrheal illnesses, cholera is easily treatable and can be prevented through the provision of safe water, improved sanitation services, and education about the importance of hygiene.
Cholera is an acute diarrheal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. Though three-quarters of individuals infected with V. cholerae do not exhibit any symptoms, they may shed the bacteria in their stool for seven to 14 days, potentially infecting others. While V. cholerae is the direct source of cholera infection, the deadly effects of the disease are caused by a toxin called CTX, that the bacteria produce in the small intestine of the host. CTX binds to the intestinal walls and interferes with the normal flow of sodium and chloride, causing the body to secrete large amounts of water and leading to diarrhea accompanied by dehydration. In individuals exhibiting the severe form of the disease, the rapid loss of fluids can lead to dehydration and shock, and without treatment death can occur within hours. Approximately one in 20 individuals infected with the bacteria develops symptoms associated with cholera, which include: severe, watery diarrhea; nausea and vomiting; muscle cramps; dehydration; and shock.
The rapid loss of fluids in a short period of time – often as much as a quart in an hour - associated with diarrhea due to cholera, makes the disease particularly deadly. In order to replenish the fluids and electrolytes that an individual with severe cholera has lost, Oral Rehydration Salts (ORS) must be administered. If a pre-formulated solution is not available, experts suggest combining one-half teaspoon salt, one-half teaspoon baking soda, and three tablespoons sugar in one liter of safe drinking water. With the prompt delivery of ORS, up to 80 percent of people can be treated successfully, with a fatality rate below one percent. Antibiotics may be used in conjunction with ORS to shorten the course and lessen the severity of the illness, however their delivery is less critical to cholera patients than rehydration. To help control the spread of the disease, two types of oral cholera vaccines are also available, but according to experts they provide only a short-term effect and should be administered in areas where ongoing water and sanitation improvement programs are in place.
Despite the simplicity of the cure, thousands of people die each year in regions that lack effective sanitation and water purification systems. Following man-made or natural disasters, the risk of an initial outbreak of cholera growing into an epidemic is greatly increased. As seen recently following floods in Pakistan and Nigeria, the spread of cholera becomes a major public health concern when there is a lack of clean water. By providing treatment as well as information about the importance of boiling water before drinking and maintaining personal hygiene, it may be possible to slow or even stop the spread of cholera and other communicable diseases.
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Monday, November 1, 2010
On Cholera Worldwide
Monday, October 18, 2010
On Food Allergies and Intolerances
Individuals may experience allergies to any number of substances, but reports indicate that a growing number of Americans suffer from allergies to particular foods. Food allergies affect approximately 12 million Americans, including three million children. ”Food intolerances,” though frequently discussed in conjunction with food allergies, are quite different. Individuals with “intolerance” to certain foods may experience adverse reactions and discomfort if they are consumed. It is important to have an understanding not only of the severity and potential risk of food allergies, but of the difference between true allergies and intolerances.
The majority of adverse reactions linked to particular foods are due food intolerances. Individuals can be intolerant to lactose, gluten, or other foods, and may experience nausea, vomiting, stomach cramping, and diarrhea. While these symptoms are surely unpleasant, they are markedly different from the immune response seen in individuals with food allergies. In addition to bowel discomfort, food allergies can cause an anaphylactic response, leading to tingling and swelling of the mouth and face, hives, trouble breathing, dizziness, or fainting. These symptoms are caused by an response in which the body’s immune system mistakenly identifies a particular food as a harmful substance. An allergic reaction involves two components of the immune system: an antibody called immunoglobulin E (IgE), and a mast cell. When an individual consumes - or in some cases is in close contact with - a food to which they have an allergy, the allergen stimulates specialized white blood cells called lymphocytes which produce the IgE antibody for that specific allergen. This IgE is then released and attaches to the surface of the mast cells in the tissues of the body, prompting the cells to release histamine.
Allergic reactions can range in severity, but reports indicate that they cause 30,000 cases of anaphylaxis, 2,000 hospitalizations, and 150 deaths each year in the United States. According to the U.S. Centers for Disease Control and Prevention (CDC), there are eight foods which account for 90 percent for all food-allergy reactions: cow’s milk, eggs, peanuts, tree nuts (walnuts, pecans, etc.), fish, shellfish, soybeans, and wheat. One of the most common food allergies in the United States is to peanuts, affecting an estimated 3.3 million Americans. The incidence of peanut allergies is increasing, and reports indicate that between 1997 and 2008, the rate of child peanut allergies has tripled. Rates of other food allergies have also increased in recent years, and according to the CDC, the number of children with food allergies increased by 18 percent, between 1997 and 2007. While the cause of the increase is not fully understood, it may be due in part to the risk factors associated with food allergies, which include a family history of asthma and allergies, and elevated IgE levels.
Though there is no proven treatment for food allergies other than the avoidance of the allergen, experts recommend that individuals with food allergies carry injectable epinephrine at all times, as it can help to mitigate severity of the allergic response. In addition to the physical health-related issues resulting from food allergies, reports indicate that more than 30 percent of children with food allergies have experienced teasing or bullying related to their allergy. By gaining an understanding of food allergies and sharing information about them with others, it may be possible ensure that individuals are better informed about how to help prevent allergic reactions, and lessen the stigma faced by children with food allergies.
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Monday, October 4, 2010
On Alzheimer's Disease
Dementia is not a specific disease, but rather a group of symptoms affecting intellectual and social functioning. The most common form is a progressive form of presenile dementia first identified in 1906 by Dr. Alois Alzheimer, known as Alzheimer’s disease. Experts indicate that the number of individuals with Alzheimer’s worldwide could increase from 35.6 million to 65.7 million by 2030, due in part to the growth in aging populations. Additional reports indicate that in the U.S. alone there are currently 5.3 million people living with the disease, and this figure is projected to increase to 16 million by 2050. While there is no cure for Alzheimer’s disease, through treatment and education, it may be possible to improve outcomes for those with the condition.
Accounting for 50 to 80 percent of dementia cases, Alzheimer’s disease is marked by the loss of intellectual and social abilities severe enough to interfere with an individual’s daily functioning. As it progresses, Alzheimer’s disease may lead to mood swings, distrust of others, social withdrawal, and depression. Though it is not a “normal” part of the aging process, the risk of developing Alzheimer’s disease increases with age. Approximately five percent of people between the ages of 65 and 74, and nearly half of those over the age of 85 have Alzheimer’s disease. Although there is no known direct cause for the disease or means to ensure its prevention, research suggests that there may be a genetic link to the development of Alzheimer’s, and that lifestyle choices like maintaining a healthy weight and exercising one’s body and mind can at least delay the onset of the condition.
Alzheimer’s disease is most often diagnosed using a combination of blood or spinal fluid tests to rule out other possible causes of dementia, and brain scans to locate any visible abnormalities. Though doctors can accurately diagnose 90 percent of Alzheimer’s patients, the condition can only be diagnosed with complete accuracy during an autopsy. A post-mortem microscopic examination of the tissues of the brain of individuals with Alzheimer’s, reveals two abnormal structures called “Plaques” and “Tangles,” which are damaging to nerve cells. Plaques contain deposits of a protein fragment called beta-amyloid and build up between nerve cells, while twisted fibers of tau protein known as Tangles form inside dying cells. Though researchers do not yet have a full understanding of the role that Plaques and Tangles play in the progression of Alzheimer’s disease, experts believe that they block the communication among nerve cells and disrupt cell activities. Recent research has shown that Tangles may offer some insight into how quickly Alzheimer’s disease will progress in an individual, leading to the development of potentially tau-lowering drug treatments.
New research suggests that large doses of vitamin B may halve the rate of brain shrinkage in individuals with mild cognitive impairment. Though the mechanism by which B vitamins slow the progression of Alzheimer’s has not been identified, some B vitamins have been shown to control levels of homocystieine, an amino acid associated with an increased risk of Alzheimer’s. These new treatments, as well as the medications commonly used to help improve some of the symptoms of Alzheimer’s, which include cholinesterase inhibitors and memantine can help to improve the lives of individuals with Alzheimer’s. On average, these live half as long as a peer who does not have the disease – meaning that a 75-year-old diagnosed with Alzheimer’s can expect to live another six years, while a 75-year-old without the condition may live 12 years. However, because of the variance in the severity of cases and the speed with which symptoms progress, the life-expectancy of individuals with Alzheimer’s varies greatly.
Further research related to testing, diagnostic, and treatment procedures may lead to improved outcomes for individuals with Alzheimer’s. By gaining a better understanding of this condition and its causes, it may be possible to slow or halt its progression and improve the lives of millions of elderly individuals worldwide.
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Accounting for 50 to 80 percent of dementia cases, Alzheimer’s disease is marked by the loss of intellectual and social abilities severe enough to interfere with an individual’s daily functioning. As it progresses, Alzheimer’s disease may lead to mood swings, distrust of others, social withdrawal, and depression. Though it is not a “normal” part of the aging process, the risk of developing Alzheimer’s disease increases with age. Approximately five percent of people between the ages of 65 and 74, and nearly half of those over the age of 85 have Alzheimer’s disease. Although there is no known direct cause for the disease or means to ensure its prevention, research suggests that there may be a genetic link to the development of Alzheimer’s, and that lifestyle choices like maintaining a healthy weight and exercising one’s body and mind can at least delay the onset of the condition.
Alzheimer’s disease is most often diagnosed using a combination of blood or spinal fluid tests to rule out other possible causes of dementia, and brain scans to locate any visible abnormalities. Though doctors can accurately diagnose 90 percent of Alzheimer’s patients, the condition can only be diagnosed with complete accuracy during an autopsy. A post-mortem microscopic examination of the tissues of the brain of individuals with Alzheimer’s, reveals two abnormal structures called “Plaques” and “Tangles,” which are damaging to nerve cells. Plaques contain deposits of a protein fragment called beta-amyloid and build up between nerve cells, while twisted fibers of tau protein known as Tangles form inside dying cells. Though researchers do not yet have a full understanding of the role that Plaques and Tangles play in the progression of Alzheimer’s disease, experts believe that they block the communication among nerve cells and disrupt cell activities. Recent research has shown that Tangles may offer some insight into how quickly Alzheimer’s disease will progress in an individual, leading to the development of potentially tau-lowering drug treatments.
New research suggests that large doses of vitamin B may halve the rate of brain shrinkage in individuals with mild cognitive impairment. Though the mechanism by which B vitamins slow the progression of Alzheimer’s has not been identified, some B vitamins have been shown to control levels of homocystieine, an amino acid associated with an increased risk of Alzheimer’s. These new treatments, as well as the medications commonly used to help improve some of the symptoms of Alzheimer’s, which include cholinesterase inhibitors and memantine can help to improve the lives of individuals with Alzheimer’s. On average, these live half as long as a peer who does not have the disease – meaning that a 75-year-old diagnosed with Alzheimer’s can expect to live another six years, while a 75-year-old without the condition may live 12 years. However, because of the variance in the severity of cases and the speed with which symptoms progress, the life-expectancy of individuals with Alzheimer’s varies greatly.
Further research related to testing, diagnostic, and treatment procedures may lead to improved outcomes for individuals with Alzheimer’s. By gaining a better understanding of this condition and its causes, it may be possible to slow or halt its progression and improve the lives of millions of elderly individuals worldwide.
Discuss this and other health topics in the iCons in Medicine forums
Monday, September 20, 2010
On Breast Cancer Worldwide
This October marks the 25th annual celebration of Breast Cancer Awareness Month, during which organizations in the U.S. and worldwide will hold events aimed at raising awareness and providing education about breast cancer. In spite of ongoing efforts to inform the public about breast cancer, it continues to be a major health concern worldwide. According to the National Cancer Institute (NCI), in 2010, there will be 209,060 new cases of breast cancer in the United States. Reports from the World Health Organization (WHO) indicate that incidence rates vary worldwide, however as the adoption of “western lifestyles” increase in the developing world, breast cancer has become more common. Due to the lack of adequate diagnosis and treatment facilities in these regions, survival rates are often also significantly lower. In 2004 an estimated 519,000 women died worldwide due to breast cancer, with 69 percent of these deaths occurring in developing nations. By ensuring that information about breast cancer and early detection programs are available, treatment outcomes worldwide can be greatly improved.
Like other types of cancer, breast cancer develops when abnormal cells divide in an uncontrolled fashion and spread to surrounding tissue (metastasize). Breast cancer is a malignant form of tumor growth which can develop in both men and women, but is approximately 100 times less common in men. An estimated one in every eight women will be diagnosed with breast cancer during their lifetime, making it the second most commonly diagnosed cancer after skin cancer in women in the United States. There are many types of breast cancer, but two of the most common are ductal carcinoma, which begins in the cells that line the milk ducts of the breast; and lobular carcinoma, which begins in the lobes or lobules of the breast. Unlike less common forms of breast cancer, including inflammatory breast cancer which is marked by heat, redness, and swelling of the breast, these common types of breast cancer tend to manifest similarly.
The first signs of breast cancer may include a lump in the breast or thickening of breast tissue, change in shape of the breast, changes in the breast or nipple skin, or bloody discharge from the nipple. Tumors in the breasts may be detected during clinical breast exams, mammograms and other imaging tests, or self breast exams. A mammogram is a black-and-white image of the breast similar to an X-ray. Though some recommendations differ, the American Cancer Society suggests that women undergo yearly mammograms beginning at age 40. Though mammography has proven to be an effective screening method and can help ensure early diagnosis of breast cancer, the Centers for Disease Control and Prevention (CDC) indicates that more than 7 million women in the United States have not had a recent mammogram.
Following the identification of a tumor within the breast, a determination must be made regarding how advanced the spread of the cancer is so that it can be effectively treated. The “Stages” into which breast cancer are categorized – from Stage 0, defined by abnormal cells that are not invasive cancer, to Stage IV, defined by cancer which has spread throughout the tissues of the body. The Stages indicate how aggressively the cancer is spreading within the breast, to the surrounding tissue and lymph nodes, and throughout the rest of the body. Depending on the progression of the cancer, treatment options may include chemotherapy and surgery. Chemotherapy is a drug treatment that uses powerful chemicals to slow the growth of cancer in the body or kill off the cancer cells. Though it is effective, chemotherapy, which can produce a number of side effects, including nausea, vomiting, hair loss, and fatigue, is often used in combination with surgical interventions. Breast-sparing surgeries, which aim to remove cancer from the breast while preserving the surrounding tissue; and mastectomies, in which the entire breast is removed, are often employed.
Though breast cancer treatment can be physically and emotionally painful, there are currently over 2.5 million breast cancer survivors in the U.S. and many more around the world. Breast cancer can occur at any age, but the risk of its development increases as an individual gets older. While the cause is still unknown, there are a number of factors linked to an increased risk of developing breast cancer including the presence of certain “breast cancer genes,” a woman’s age, family history, and age at the onset of menstruation and menopause can increase their risk of developing breast cancer. While little can be done about some of these factors, some women with a genetic predisposition to developing cancer have opted to undergo preventative mastectomies to reduce their risk. Individuals can also help to reduce their risk by maintaining a healthy lifestyle.
By ensuring that individuals are made aware of the importance of regular clinical and self breast evaluations and that early detection and diagnosis programs are made available, treatment outcomes can be greatly improved.
Like other types of cancer, breast cancer develops when abnormal cells divide in an uncontrolled fashion and spread to surrounding tissue (metastasize). Breast cancer is a malignant form of tumor growth which can develop in both men and women, but is approximately 100 times less common in men. An estimated one in every eight women will be diagnosed with breast cancer during their lifetime, making it the second most commonly diagnosed cancer after skin cancer in women in the United States. There are many types of breast cancer, but two of the most common are ductal carcinoma, which begins in the cells that line the milk ducts of the breast; and lobular carcinoma, which begins in the lobes or lobules of the breast. Unlike less common forms of breast cancer, including inflammatory breast cancer which is marked by heat, redness, and swelling of the breast, these common types of breast cancer tend to manifest similarly.
The first signs of breast cancer may include a lump in the breast or thickening of breast tissue, change in shape of the breast, changes in the breast or nipple skin, or bloody discharge from the nipple. Tumors in the breasts may be detected during clinical breast exams, mammograms and other imaging tests, or self breast exams. A mammogram is a black-and-white image of the breast similar to an X-ray. Though some recommendations differ, the American Cancer Society suggests that women undergo yearly mammograms beginning at age 40. Though mammography has proven to be an effective screening method and can help ensure early diagnosis of breast cancer, the Centers for Disease Control and Prevention (CDC) indicates that more than 7 million women in the United States have not had a recent mammogram.
Following the identification of a tumor within the breast, a determination must be made regarding how advanced the spread of the cancer is so that it can be effectively treated. The “Stages” into which breast cancer are categorized – from Stage 0, defined by abnormal cells that are not invasive cancer, to Stage IV, defined by cancer which has spread throughout the tissues of the body. The Stages indicate how aggressively the cancer is spreading within the breast, to the surrounding tissue and lymph nodes, and throughout the rest of the body. Depending on the progression of the cancer, treatment options may include chemotherapy and surgery. Chemotherapy is a drug treatment that uses powerful chemicals to slow the growth of cancer in the body or kill off the cancer cells. Though it is effective, chemotherapy, which can produce a number of side effects, including nausea, vomiting, hair loss, and fatigue, is often used in combination with surgical interventions. Breast-sparing surgeries, which aim to remove cancer from the breast while preserving the surrounding tissue; and mastectomies, in which the entire breast is removed, are often employed.
Though breast cancer treatment can be physically and emotionally painful, there are currently over 2.5 million breast cancer survivors in the U.S. and many more around the world. Breast cancer can occur at any age, but the risk of its development increases as an individual gets older. While the cause is still unknown, there are a number of factors linked to an increased risk of developing breast cancer including the presence of certain “breast cancer genes,” a woman’s age, family history, and age at the onset of menstruation and menopause can increase their risk of developing breast cancer. While little can be done about some of these factors, some women with a genetic predisposition to developing cancer have opted to undergo preventative mastectomies to reduce their risk. Individuals can also help to reduce their risk by maintaining a healthy lifestyle.
By ensuring that individuals are made aware of the importance of regular clinical and self breast evaluations and that early detection and diagnosis programs are made available, treatment outcomes can be greatly improved.
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Wednesday, September 1, 2010
Flooding in Pakistan
Reports indicate that recent flooding in Pakistan has affected the lives of at least 15.4 million people and left a third of the nation – including approximately 7.9 million acres of cultivated land900,000 homes have been destroyed by surges of water, and a reported six million people do not have access to food, shelter, and potable water. In addition, the United Nations indicates that 1,600 have died and more lives are at risk as the threat of water-borne illness continues to rise.
Floods began in late July following a period of particularly heavy monsoon rains and have continued through August. Many have sought shelter in camps established by aid organizations, but public health experts warn that the crowding associated with displaced persons camps could exacerbate the spread of disease. Scabies, a skin infection caused by mites that burrow and cause pimple-like irritation, is becoming increasingly common in the camps. According to some reports, tens of thousands of infected individuals are among the 600,000 people in relief camps set up in Sindh province. In these tented camps which have been established in army compounds, schools, and public buildings, healthcare providers are struggling to contain outbreaks of acute diarrhea, the precursor to fatal cholera.
According to Mark Ward, acting director of the U.S. Agency for International Development’s office for foreign disaster assistance, “When you are dealing with this much water and that many people it [cholera] is almost unavoidable.” In addition, the World Health Organization (WHO) has reported 204,000 cases of acute diarrhea, 263,300 cases of skin diseases, and 204,600 cases of acute respiratory diseases in flood-affected regions. Thousands of cases of suspected malaria have also been documented and the conditions for mosquito-borne as well as water-borne illness are present.
The delivery of treatment for these fast-spreading communicable diseases has been compounded by the lack of adequate clinical facilities. Reports indicate that 200 health facilities were damaged or destroyed. Vaccination programs have been established in Charsadda and Peshawar regions and more than 100,000 children have received polio shots. Despite these efforts, millions, including 3.5 million children are at risk of contracting disease, and require water, shelter, or emergency care. Radio and text messaging campaigns have also been put in place to distribute information about the importance of hand washing and good hygiene.
While funding for humanitarian aid has been limited to date, the UN and other international organizations continue their efforts to garner support. Assuring that food, water, shelter, and medical treatment are available for those who need them is the primary concern of aid organizations currently working in Pakistan. By delivering effective medical treatment in a timely fashion while also working to prevent the spread of diseases, outbreaks can be contained.
Find out how you can contribute to iCons in Medicine’s efforts to provide assistance to healthcare providers in Pakistan
Learn more about how you can participate in iCons in Medicine’s ongoing efforts to support rehabilitation relief in Haiti - under water. At least
Floods began in late July following a period of particularly heavy monsoon rains and have continued through August. Many have sought shelter in camps established by aid organizations, but public health experts warn that the crowding associated with displaced persons camps could exacerbate the spread of disease. Scabies, a skin infection caused by mites that burrow and cause pimple-like irritation, is becoming increasingly common in the camps. According to some reports, tens of thousands of infected individuals are among the 600,000 people in relief camps set up in Sindh province. In these tented camps which have been established in army compounds, schools, and public buildings, healthcare providers are struggling to contain outbreaks of acute diarrhea, the precursor to fatal cholera.
According to Mark Ward, acting director of the U.S. Agency for International Development’s office for foreign disaster assistance, “When you are dealing with this much water and that many people it [cholera] is almost unavoidable.” In addition, the World Health Organization (WHO) has reported 204,000 cases of acute diarrhea, 263,300 cases of skin diseases, and 204,600 cases of acute respiratory diseases in flood-affected regions. Thousands of cases of suspected malaria have also been documented and the conditions for mosquito-borne as well as water-borne illness are present.
The delivery of treatment for these fast-spreading communicable diseases has been compounded by the lack of adequate clinical facilities. Reports indicate that 200 health facilities were damaged or destroyed. Vaccination programs have been established in Charsadda and Peshawar regions and more than 100,000 children have received polio shots. Despite these efforts, millions, including 3.5 million children are at risk of contracting disease, and require water, shelter, or emergency care. Radio and text messaging campaigns have also been put in place to distribute information about the importance of hand washing and good hygiene.
While funding for humanitarian aid has been limited to date, the UN and other international organizations continue their efforts to garner support. Assuring that food, water, shelter, and medical treatment are available for those who need them is the primary concern of aid organizations currently working in Pakistan. By delivering effective medical treatment in a timely fashion while also working to prevent the spread of diseases, outbreaks can be contained.
Find out how you can contribute to iCons in Medicine’s efforts to provide assistance to healthcare providers in Pakistan
Learn more about how you can participate in iCons in Medicine’s ongoing efforts to support rehabilitation relief in Haiti - under water. At least
Monday, August 23, 2010
West Nile
West Nile virus (WNV) is an infection transmitted to humans and animals by mosquitoes which have fed on infected birds. According to the Centers for Disease Control and Prevention (CDC), between 1999 and 2008, 28,961 confirmed and probable cases of WNV were reported. Though 80 percent of individuals infected with WNV show no symptoms, approximately one in 150 develop severe illness with symptoms including high fever, vision loss, and paralysis. Though there is no vaccine or cure for WNV, it is important for individuals to have an understanding of how best to protect themselves from infection.
First identified in Uganda in 1937, WNV occurs when Culex pipiens mosquitoes feed on infected birds, which serve as vectors for the virus, and then pass the virus on to humans. WNV cannot be passed from one individual to another through close personal contact, and the primary method of transmission is through the bite of an infected mosquito. Mild infections (West Nile fever) are seen in approximately 20 percent of individuals, and are marked by symptoms including fever, headache, and body aches. Individuals with severe infections (severe West Nile disease) may experience inflammation of the brain (encephalitis) or of the brain and surrounding membranes (meningoencephalitis), and three to 15 percent of WNV infections result in death. According to CDC statistics, in 2009 there were a total of 663 cases of WNV in the United States, and 30 of these resulted in death.
The CDC indicates that WNV is an established seasonal epidemic in North America, beginning in the summer and continuing into the fall. In addition to documented cases in the United States, both sporadic cases and major outbreaks of encephalitis related to WNV have been reported in Africa, West Asia, Australia, Europe, and the Middle East. Recent reports have documented outbreaks in Greece and British Columbia, Canada; as well as in New York, Pennsylvania, and northwestern Indiana.
Like malaria, dengue, and other mosquito-borne illness, rates of WNV infection increase during periods of warm weather when mosquito populations are most active. Torrential rains in early summer and persistent high humidity in many regions of the United States have created the ideal breeding climate for mosquitoes. Experts recommend taking preventative measures to avoid infection including the “5 D’s”:
First identified in Uganda in 1937, WNV occurs when Culex pipiens mosquitoes feed on infected birds, which serve as vectors for the virus, and then pass the virus on to humans. WNV cannot be passed from one individual to another through close personal contact, and the primary method of transmission is through the bite of an infected mosquito. Mild infections (West Nile fever) are seen in approximately 20 percent of individuals, and are marked by symptoms including fever, headache, and body aches. Individuals with severe infections (severe West Nile disease) may experience inflammation of the brain (encephalitis) or of the brain and surrounding membranes (meningoencephalitis), and three to 15 percent of WNV infections result in death. According to CDC statistics, in 2009 there were a total of 663 cases of WNV in the United States, and 30 of these resulted in death.
The CDC indicates that WNV is an established seasonal epidemic in North America, beginning in the summer and continuing into the fall. In addition to documented cases in the United States, both sporadic cases and major outbreaks of encephalitis related to WNV have been reported in Africa, West Asia, Australia, Europe, and the Middle East. Recent reports have documented outbreaks in Greece and British Columbia, Canada; as well as in New York, Pennsylvania, and northwestern Indiana.
Like malaria, dengue, and other mosquito-borne illness, rates of WNV infection increase during periods of warm weather when mosquito populations are most active. Torrential rains in early summer and persistent high humidity in many regions of the United States have created the ideal breeding climate for mosquitoes. Experts recommend taking preventative measures to avoid infection including the “5 D’s”:
- Dusk and Dawn – avoid being outdoors during these periods which are when mosquitoes are most active
- Dress – wear clothing that limits exposed skin
- DEET – use repellents containing DEET (picaridin and oil of lemon eucalyptus are other repellant options)
- Drainage – eliminate areas of standing water in which mosquitoes lay eggs.
In addition, dead birds, particularly crows, which display signs of illness should be reported to authorities for proper disposal. As health officials continue to track outbreaks of WNV, individuals can take appropriate measures to limit their risk of infection and keep their community healthy.
Discuss this and other public health topics in the iCons in Medicine Forums
Discuss this and other public health topics in the iCons in Medicine Forums
Monday, August 9, 2010
Web-Accessibility for People with Disabilities
Though substantial progress has been made to ensure that all individuals with disabilities are afforded the same opportunities as those without, some barriers still remain. While millions of individuals with disabilities currently utilize the Internet to some degree, gaining access to and fully experiencing materials presented on the Internet can be problematic for individuals with certain types of disabilities. Those with motor impairments, low vision or blindness, low hearing or deafness, and/or language or cognitive disabilities often require assistive technologies or devices to access websites. A report from the Disability Statistics Center of the Institute for Health and Aging indicates that at least 2.1 million of the reported 54.4 million Americans with disabilities use the Internet from their homes or on another computer. The American Federation for the Blind states that around 1.5 million of the 7.8 million Americans who experience vision loss use computers, with just under one million reporting regular computer use. Additionally, an estimated 7.8 million people over the age of 15 experience some form of hearing loss, and a report in the American Annals of the Deaf indicates that 63 percent of those who took part in a recent study reported regular computer use. New legislative measures may help to make the web more accessible to any individual with a disability.
The World Wide Web Consortium (W3C) states “not all…disabilities affect access to the Web, but problems with vision, hearing, dexterity and short-term memory can have a significant impact on a person's ability to use online information and services.” Individuals with disabilities frequently employ assistive technologies or make other accommodations to access information online. These may include screen readers, software utilized by individuals with visual impairments which converts information on screen into speech; alternative text (ALT text), HTML tags which provide descriptions of images for blind individuals; and closed captioning, the display of text coinciding with audio content for individuals with low hearing or deafness.
The majority of websites are still primarily inaccessible to individuals with disabilities, and the efforts by others to ensure that they are accessible to people with disabilities have been minimal. A number of “mainstream” websites have instituted accessibility features, including Facebook and YouTube, which have begun implementing changes that will improve the browsing experience of individuals with disabilities. These adaptations include the following:
The World Wide Web Consortium (W3C) states “not all…disabilities affect access to the Web, but problems with vision, hearing, dexterity and short-term memory can have a significant impact on a person's ability to use online information and services.” Individuals with disabilities frequently employ assistive technologies or make other accommodations to access information online. These may include screen readers, software utilized by individuals with visual impairments which converts information on screen into speech; alternative text (ALT text), HTML tags which provide descriptions of images for blind individuals; and closed captioning, the display of text coinciding with audio content for individuals with low hearing or deafness.
The majority of websites are still primarily inaccessible to individuals with disabilities, and the efforts by others to ensure that they are accessible to people with disabilities have been minimal. A number of “mainstream” websites have instituted accessibility features, including Facebook and YouTube, which have begun implementing changes that will improve the browsing experience of individuals with disabilities. These adaptations include the following:
- Facebook provides an audio captcha alternative to for those using screen readers, as well as an HTML-only version of the website and instructions for increasing font size in a number of web browsers.
- YouTube provides closed captioning options for users with low-hearing or who may not be able to hear or understand the audio portions of videos. However, captions must be added to the video by the individual who uploads it
- Twitter has not yet addressed the issues that prevent its use by many individuals with disabilities. However, AccessibleTwitter offers “a simple, consistent layout and navigation,” “assures that all links are keyboard accessible,” and “uses large default text size and high color contrast.” In addition, the recently introduced service TweetCall allows users to speak their tweets, which are then transcribed to text. For individuals who may have difficulty typing or using a computer, this creates an opportunity for the utilization of Twitter.
To further improve the accessibility of the Internet, Congress recently approved legislation that would set federal standards for the telecommunications industry , including online delivery of information. These new regulations coincide with the 20th anniversary of the Americans With Disabilities Act (ADA), a landmark legislation that helped to ensure equal opportunities and accessibility. Though the ADA has led to vast improvements in many areas, as Representative Edward Markey, D-Mass, noted “The ADA mandated physical ramps into buildings, today, individuals with disabilities need online ramps to the Internet so that they can get to the Web from wherever they happen to be.”
You can evaluate the level of accessibility of a website using the online tool WAVE.
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