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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