Will The Pandemic Lead To Outbreaks Of Other Maladies?
An unusual silence fills the waiting area of my fellow pediatrician’s office in suburban Maryland. On a typical day, one would expect to see the animated bustle of children. Nowadays, only two out of 10 scheduled visits might take place. Unused vaccine vials rapidly accumulate as families shelter at home.
With lockdowns and fears of the pandemic, this scene has been playing out in pediatricians’ offices around the country.
Data from the Centers for Disease Control and Prevention’s Vaccine Safety Datalink show an almost 50 percent drop in children being vaccinated for measles during the first quarter of 2020, compared with the same period in 2019.
This situation also unfolded across the world as countries ordered lockdowns of varying severity. At least 25 countries suspended mass measles immunization campaigns in the face of the pandemic as of late last month, according to UNICEF. As the coronavirus continues its relentless spread, leaving death and economic devastation, other ancient diseases may gain a foothold as vaccination rates drop precipitously.
Measles can cause pneumonia, swelling of the brain and death. Very young children and susceptible adults are more likely to suffer from these complications. Like the coronavirus, it is spread person-to-person through droplets in the air. But the measles virus is about 10 times more transmissible than the coronavirus, and often deadlier. Vaccination coverage of up to 95 percent is needed to prevent measles transmission in communities.
Before the pandemic, global measles cases were already surging, reaching an estimated 10 million in 2018 with 140,000 measles-related deaths — a 58 percent increase from the previous two years. Although measles was all but eliminated in the United States in 2000, misinformation and a loss of public trust in vaccines resulted in 1,200 cases of measles in 2019 — the highest number in almost three decades.
In recent years, many measles cases entered the United States from foreign travel destinations. Now, with diminished vaccinations of children causing a wider gap in community immunity, there is clear and present danger that hard-won gains could be reversed. As schools start reopening their doors, vaccination rates among children could improve. However, school vaccination requirements are not ironclad; medical and nonmedical exemptions will leave some children unprotected. Public understanding of this risk and improved confidence in vaccines is crucial.
And yet, the anti-vaccine movement has seized on the Covid-19 pandemic as a rallying point, inexplicably arguing against any vaccine that may be developed. The assertions are baseless and endanger public health.
At the same time, other deadly scourges lurk in the shadows. Poliomyelitis, one of the most feared diseases of the early 1900s, was headed toward global eradication, with only a few remaining pockets of transmission in the world. Now these clusters are expanding. The Global Polio Eradication Initiative’s interactive map indicates that polio cases have increased this year. Diphtheria, another deadly disease of the early 20th century, has resurged recently in places like Venezuela, Bangladesh and Yemen, where state failure, conflict or the displacement of populations have severely weakened public health systems.
The danger is that the continuing pandemic will disrupt immunizations and monitoring of infectious diseases, which could lead to the further spread of these ancient diseases into new populations instead of being consigned to history.
No example from the recent past could be more poignant than the West African Ebola virus disease outbreak in 2014, whose devastating impact extended far beyond just Ebola cases and deaths. Ebola overwhelmed local health care systems, while societal stigma and anxiety led to reduced vaccination. An estimated 200,000 cases of measles may have resulted because of these disruptions.
And then, in 2019, twice as many children died from a fast-moving outbreak of measles in the Democratic Republic of Congo than from an Ebola outbreak there that received far more public attention.
As the pandemic advances and universal immunization keeps slipping worldwide, preventable diseases in children will keep surging in the background. Many outpatient dispensaries and vaccination clinics were shuttered as health care systems shifted to support the response to the coronavirus, public transport became unavailable, and fear of Covid-19 became rife. The World Health Organization says routine immunization services should be prioritized, yet estimations indicate that over 100 million children around the world are unlikely to receive their basic vaccines.
The Greek historian Thucydides vividly described the plague of Athens of 430 B.C. He attributed the strikingly deadly toll not just to disease but also to the failed societal response. History can be instructive, but only if we take its lessons seriously.
Avoiding vaccine-preventable deaths is critical for nations to preserve their gains in child survival. To do so, governments should establish vaccination as an essential service and reinstate services to stop diseases from re-emerging, particularly among vulnerable populations. Next, while Covid-19 control measures are being instituted, countries must catch up on missed immunizations. Third, governments should improve how they communicate with the public, to allay concerns about vaccinations and re-establish community demand for them.
Finally, health agencies should expand collaborations with nutrition, education and other government operations — and especially with regional and national governments. Disease surveillance within and across nations is essential to these public health efforts. Neither the coronavirus nor the measles virus respects geographic boundaries.
In the face of the current pandemic, it can be easy to lower our guard against the potential for future public health disasters. We cannot let that happen. Governments at all levels must work together to protect children from the deadly preventable scourges we have done so much to eradicate.
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Regular Exercise May Help Prevent Ailments Causing Vision Loss!!
Apart from the many benefits of doing exercise, new research has now found that exercise can slow down or prevent the development of macular degeneration and may benefit other common causes of vision loss, such as glaucoma and diabetic retinopathy.
The new study from the University of Virginia School of Medicine found that exercise reduced the harmful overgrowth of blood vessels in the eyes of lab mice by up to 45 per cent. This tangle of blood vessels is a key contributor to macular degeneration and several other eye diseases.
The study represents the first experimental evidence showing that exercise can reduce the severity of macular degeneration, a leading cause of vision loss, the scientists report. Ten million Americans are estimated to have the condition.
“There has long been a question about whether maintaining a healthy lifestyle can delay or prevent the development of macular degeneration. The way that question has historically been answered has been by taking surveys of people, asking them what they are eating and how much exercise they are performing,” said researcher Bradley Gelfand, PhD, of UVA’s Center for Advanced Vision Science.
“That is basically the most sophisticated study that has been done. The problem with that is that people are notoriously bad self-reporters … and that can lead to conclusions that may or not be true. This [study] offers hard evidence from the lab for the very first time,” Gelfand added.
Enticingly, the research found that the bar for receiving the benefits from exercise was relatively low – more exercise didn’t mean more benefit.
“Mice are kind of like people in that they will do a spectrum of exercise. As long as they had a wheel and ran on it, there was a benefit. The benefit that they obtained is saturated at low levels of exercise,” Gelfand said.
An initial test comparing mice that voluntarily exercised versus those that did not found that exercise reduced the blood vessel overgrowth by 45%. A second test, to confirm the findings, found a reduction of 32 per cent.
The scientists aren’t certain exactly how exercise is preventing the blood vessel overgrowth. There could be a variety of factors at play, they say, including increased blood flow to the eyes.
Gelfand, of UVA’s Department of Ophthalmology and Department of Biomedical Engineering, noted that the onset of vision loss is often associated with a decrease in exercise.
“It is fairly well known that as people’s eyes and vision deteriorate, their tendency to engage in physical activity also goes down. It can be a challenging thing to study with older people. … How much of that is one causing the other?” he said.
The researchers already have submitted grant proposals in hopes of obtaining funding to pursue their findings further.
“The next step is to look at how and why this happens, and to see if we can develop a pill or method that will give you the benefits of exercise without having to exercise,” Gelfand said.
He explained, “We’re talking about a fairly elderly population [of people with macular degeneration], many of whom may not be capable of conducting the type of exercise regimen that may be required to see some kind of benefit.” (He urged people to consult their doctors before beginning any aggressive exercise program.)
Gelfand, a self-described couch potato, disclosed a secret motivation for the research: “One reason I wanted to do this study was sort of selfish. I was hoping to find some reason not to exercise,” he joked. “It turned out exercise really is good for you.”
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Think Before You Get A Tattoo; Toxic Nanoparticles May Harm Your Immune System
A new study reveals that the toxic particles can enlarge lymph nodes.
Getting a permanent tattoo can cause toxic nanoparticles to travel inside the body, leading to chronic enlargement of the lymph nodes – an important part of our immune system, a study has warned.
Toxic impurities that make up the ink in tattoos can travel inside the body in the form of nanoparticles and affect the lymph nodes, researchers said.
Little is known about the potential impurities in the colour mixture applied to the skin. Most tattoo inks contain organic pigments, but also include preservatives and contaminants like nickel, chromium, manganese or cobalt.
Besides carbon black, the second most common ingredient used in tattoo inks is titanium dioxide (TiO2), a white pigment usually applied to create certain shades when mixed with colorant, researchers said.
TiO2 is also commonly used in food additives, sunscreens and paints. Delayed healing, along with skin elevation and itching, are often associated with white tattoos, and by consequence with the use of TiO2.
The hazards that potentially derive from tattoos were previously known only by chemical analysis of the inks and their degradation products in vitro.
Researchers at European Synchrotron Radiation Facility (ESRF) in Germany used X-ray fluorescence measurements which allowed them to locate titanium dioxide at the micro and nano range in the skin and the lymphatic environment.
They found a broad range of particles up to several micrometres in size in human skin, but only smaller (nano) particles were transported to the lymph nodes.
This may lead to the chronic enlargement of the lymph node and lifelong exposure, researchers said.
Scientists also used the technique of Fourier transform infrared spectroscopy to assess biomolecular changes in the tissues in the proximity of the tattoo particles.
“We already knew that pigments from tattoos would travel to the lymph nodes because of visual evidence. The lymph nodes become tinted with the colour of the tattoo. It is the response of the body to clean the site of entrance of the tattoo,” researchers said.
“What we didn’t know is that they do it in a nano form, which implies that they may not have the same behaviour as the particles at a micro level. And that is the problem we don’t know how nanoparticles react,” said Bernhard Hesse, from ESRF The study was published in the journal Scientific Reports.
Source: http://www.dnaindia.com/health/report-think-before-you-get-a-tattoo-toxic-nanoparticles-in-inks-may-harm-your-immune-system-2545283
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Don’t ignore early signs. Think your baby’s missed a milestone? See a doctor
Parental denial is keeping children with special needs from getting help. For the sake of your child don’t listen to people who tell you ‘he’ll catch up’ or ‘just give it time’.
At what point do you admit that something is seriously amiss. It’s not an easy call to make, but developmental experts are saying that parental denial is hampering diagnosis, and treatment, of children with special needs.
Ninam was diagnosed with autism at 18 months; he is now nearly 3. His mother Sarita Lama is vehement that parents need to open up to the special needs of their child. “Unless you change, society won’t,” she says.
Early signs that a child may need special care include babies not making eye contact, not responding to people by smiling or gesticulating, delayed speech, focusing intently on something to the exclusion of others for long periods, or making repetitive movements, such as rocking and twirling.
“Four As — awareness, acceptance, action and acknowledgement — are the pillars crucial to supporting differently abled kids. It is very important to empower parents, especially mothers, as they are usually the ones taking care of the child all day,” says Dr Deepak Gupta, consultant child and adolescent psychiatrist at Sir Ganga Ram Hospital.
Identifying the right therapy centre takes time as it is, so the quicker one acts the better.
“Getting the right help at an early stage can change the trajectory of the child’s development and future success in learning and socialisation,” says Jackie Harland, clinical director at the London Learning Centre (LLC) in New Delhi. “It is hard to see children whom you know would make significant progress with the right help, not receiving that support. With the right programme, all children can make progress.”
Three young Delhi mothers share their journeys, from symptoms through diagnoses and finding the right therapy for their babies.
‘Sharing the news has helped’
When Ninam was still not responding to his name at 18 months, Sarita consulted a paediatrician, who suspected autism spectrum disorder and referred her son to a psychiatrist.
“I had no clue what autism was, so I went home and Googled to read up,” says mother Sarita Lama. “The next day, we went to a therapy centre to get a psychiatric diagnosis for our son.”
While many prefer to keep such information to themselves, Sarita looped in her friends and family on the day of diagnosis.
“I mailed them reading material so they would be sensitive to Ninam’s needs. Since I was proactive, my friends have also started forwarding interesting information they come across,” says Sarita, who now actively uses Facebook and WhatsApp to spread awareness about autism.
“I also regularly share updates on my son’s progress. I know he will never outgrow it; some issues will always be there. I just want him to be as independent and self-sufficient as possible.”
The biggest parenting challenge for her is that Ninam has trouble sleeping, which also affects her sleep. “I thought it would pass but it’s been two years and eight months since I slept well, which makes me physically and emotionally exhausted. There are days when you feel very down but then you push yourself, especially when you hear about children who’ve overcome challenges,” says Sarita, who gave up her job as a teacher in Delhi’s Nirmal Bharti School to spend time with her son.
With therapy, Ninam can now communicate his basic needs. “He comes to the kitchen and says ‘I want food’, which is a huge achievement,” she says.
‘If you start late, everything will take longer’
Kalpana Jacob discovered that her son Zach was not able to form words when he was 18 months old. “Zach was doing fine till the age of one, and then there was a big lag. He even stopped saying words he had said earlier. He turned hyperactive, running around as an excuse for not talking,” Jacob says.
She adds that it helped that she had friends and family who didn’t sympathise but rather supported. “They are sensitive to his needs but are also firm when required.”
Not being able to talk made him under-confident, which made him socially withdrawn. “But since he is also a sensory seeker with sensory needs, certain things calm him down, like play dough. We let him play in the mud without worrying about his immunity. That helps,” says Kalpana, who runs an organization that offers life skills and leadership training to teenagers though music and storytelling.
Her experience has taught her that early intervention is key to helping children meet their development goals and integrate socially.
“As parents, you must watch for signs, however small, and track milestones,” she says. “You shouldn’t listen when people say your child will catch up. If you start late, everything will take longer — the child will learn to socialise late and may become withdrawn.”
Source: http://www.hindustantimes.com/health/don-t-ignore-early-signs-think-your-baby-s-missed-a-milestone-see-a-doctor/story-cCW0hs8YUwxXm07UG1nxoI.html
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A ‘Cure for Heart Disease’? A Single Shot Succeeds in Monkeys!!
What if a single injection could lower blood levels of cholesterol and triglycerides — for a lifetime?
In the first gene-editing experiment of its kind, scientists have disabled two genes in monkeys that raise the risk for heart disease. Humans carry the genes as well, and the experiment has raised hopes that a leading killer may one day be tamed.
“This could be the cure for heart disease,” said Dr. Michael Davidson, director of the Lipid Clinic at the University of Chicago Pritzker School of Medicine, who was not involved in the research.
But it will be years before human trials can begin, and gene-editing technology so far has a mixed tracked record. It is much too early to know whether the strategy will be safe and effective in humans; even the monkeys must be monitored for side effects or other treatment failures for some time to come.
The results were presented on Saturday at the annual meeting of the International Society for Stem Cell Research, this year held virtually with about 3,700 attendees around the world. The scientists are writing up their findings, which have not yet been peer-reviewed or published.
The researchers set out to block two genes: PCSK9, which helps regulate levels of LDL cholesterol; and ANGPTL3, part of the system regulating triglyceride, a type of blood fat. Both genes are active in the liver, which is where cholesterol and triglycerides are produced. People who inherit mutations that destroyed the genes’ function do not get heart disease.
People with increased blood levels of triglycerides and LDL cholesterol have dramatically greater risks of heart disease, heart attacks and strokes, the leading causes of death in most of the developed world. Drug companies already have developed and are marketing two so-called PCSK9 inhibitors that markedly lower LDL cholesterol, but they are expensive and must be injected every few weeks.
Researchers at Verve Therapeutics, led by Dr. Sekar Kathiresan, the chief executive, decided to edit the genes instead. The medicine they developed consists of two pieces of RNA — a gene editor and a tiny guide that directs the editor to a single sequence of 23 letters of human DNA among the genome’s 32.5 billion letters.
The RNA is shrouded in tiny lipid spheres to protect the medicine from being instantly degraded in the blood. The lipid spheres travel directly to the liver where they are ingested by liver cells. The contents of the spheres are released, and once the editor lands on its target, it changes a single letter of the sequence to another — like a pencil erasing one letter and writing in another.
Not only did the system work in 13 monkeys, the researchers reported, but it appeared that every liver cell was edited. After gene editing, the monkeys’ LDL levels dropped by 59 percent within two weeks. The ANGPTL3 gene editing led to a 64 percent decline in triglyceride levels.
One danger of gene editing is the process may result in modification of DNA that scientists are not expecting. “You will never be able to have no off-target effects,” warned Dr. Deepak Srivastava, president of the Gladstone Institutes in San Francisco.
In treating a condition as common as heart disease, he added, even an uncommon side effect can mean many patients are affected. So far, however, the researchers say that they have not seen any inadvertent editing of other genes.
Another question is how long the effect on cholesterol and triglyceride levels will last, Dr. Davidson said. “We hope it will be one-and-done, but we have to validate that with clinical trials,” he said.
Jennifer Doudna, a biochemist of the University of California, Berkeley, and a discoverer of Crispr, the revolutionary gene editing system, said: “In principle, Verve’s approach could be better because it’s a one-time treatment.”
But it is much too soon to say if it will be safe and long-lasting, she added.
If the strategy does work in humans, its greatest impact may be in poorer countries that cannot afford expensive injections for people at high risk of heart disease, said Dr. Daniel Rader, chairman of the department of genetics at the University of Pennsylvania and a member of Verve’s scientific advisory board.
Dr. Kathiresan, of Verve, noted that half of all first heart attacks end in sudden death, making it imperative to protect those at high risk.
Dr. Kathiresan began the research at the Massachusetts General Hospital and the Broad Institute, where he and his colleagues found a collection of genes that increase risk of heart attack at a relatively young age, as well as eight genes that, when mutated, decrease risk.
Those protective genes, he reasoned, could be targets for gene editing if there were a way to alter them in people. Gene editing is only now succeeding, and so far its successes have been in rare diseases.
Other investigators and companies have tried editing genes in mice to prevent heart disease, with some success, but primates are a much more difficult challenge.
Dr. Kathiresan said that to his knowledge, his study is the first to use the pencil-and-eraser type gene editing in primates for a very common disease. Verve licensed the technology, called base editing, from Beam Therapeutics.
If all goes well, Dr. Kathiresan hopes in a few years to begin treating people who have had heart attacks and still have perilously high cholesterol. For them, the risk of another heart attack is so high that the possible benefit may far outweigh the risks of the treatment.
Heart disease generally occurs only after decades of high cholesterol levels, Dr. Davidson noted. By age 50, people most likely to have a heart attack already have a significant accumulation of plaque in their arteries.
But if the PCSK9 gene could be knocked out in 20-year-olds, he said, “there would be no heart disease in their future.”
Source: https://www.nytimes.com/2020/06/27/health/heart-disease-gene-editing.html
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High BP can cause organ damage in teenagers too
The damage in teenagers occurs at blood pressure levels that are below the clinical definition of hypertension in the age group. Teenagers are at risk of heart and vessel damage as well.
Is your teenage son or daughter suffering from high blood pressure? Beware, if left uncontrolled the condition can lead to organ damage as in adults, according to a research. The findings showed that organ damage — damage to the heart and blood vessels — from high blood pressure does not only occur in adults, but also in teenagers.
Importantly, the damage in teenagers occurs at blood pressure levels that are below the clinical definition of hypertension in the age group, the researchers said. “Some adolescents may have organ damage related to blood pressure and are not targeted for therapy,” said Elaine M. Urbina, Director at the Cincinnati Children’s Hospital in Ohio.
“Imaging of the heart may be useful in youth in the high-normal range of blood pressure to determine how aggressive therapy should be.” High blood pressure in teenagers is defined on the basis of percentiles, rather than blood pressure level as in adults.
In the study, presented at the 2017 American Heart Association (AHA) Council on Hypertension in San Francisco, the team looked at whether organ damage in teens develops below the 95th percentile — the clinical definition of high blood pressure in teenagers.
The researchers examined blood pressure and measured organ damage in 180 teenagers (14-17 years old, 64 per cent white, 57 per cent males). The results showed evidence of organ damage even among the youth categorised as “normal” with blood pressure less than in the 80th percentile.
It also revealed heart and vessel damage in the mid-risk group, which had blood pressures in the 80th to 90th percentiles and the high-risk group, with blood pressures above the 90th percentile.
Source: http://indianexpress.com/article/lifestyle/health/high-bp-can-cause-organ-damage-in-teenagers-too/
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