Inside Health

Monkeypox is not a global emergency for now, says WHO

Publish: 10:21 AM, 26 Jun, 2022


Thumbnail

The World Health Organisation (WHO) has decided not to declare monkeypox a public health emergency of international concern. This may change in the future.

However, WHO Director-General Tedros Adhanom Ghebreyesus said he was "deeply concerned" about the evolving threat of monkeypox, which he said had reached more than 50 countries.

There have been more than 4,100 confirmed cases globally, including at least 13 in Australia.

The WHO also acknowledged there were many unknowns about the outbreak.

Here are three things we know about monkeypox and three things we want to find out.

1. Monkeypox is caused by a virus

Monkeypox is a large DNA virus belonging to the orthopoxvirus family. Unlike the related smallpox virus, variola, which only affected humans, monkeypox virus is found in rodents and other animals in parts of Africa.

We know of two clades (virus groupings), and it is the less severe of the two currently circulating outside Africa.

Orthopoxviruses are stable viruses that do not mutate much. Multiple mutations, however, have been described in the virus causing the current outbreak.

In the United States, at least two separate strains have been circulating, suggesting multiple introductions into the country.

2. You can be infected for more than a week and not know

It takes an average 8.5 days from infection to showing symptoms, such as enlarged lymph nodes, fever and a rash, which usually looks like fluid-filled blisters that erupt. People are infectious while they have the rash, and are usually infectious for about two weeks.

Children are most severely affected and have a higher risk of dying from the disease. Historically, in the endemic countries of Africa, almost all deaths have been in children.

The European epidemic is mostly in adult males, so this, together with better access to care, may explain the low rate of deaths in these countries.

3. We have vaccines and treatments

Vaccines work. Past vaccination against smallpox provides 85% protection against monkeypox. Smallpox was declared eradicated in 1980, so most mass vaccination programs ceased in the 1970s.

Australia never had mass smallpox vaccination. However, an estimated 10% of Australians have been vaccinated in the past, mostly migrants.

Vaccines protect for many years but immunity wanes. So declining population-level protection is likely responsible for the resurgence of monkeypox seen since 2017 in Nigeria, one of seven endemic hot spots in Africa.

Mass vaccination is not recommended. But vaccines can be given to contacts of confirmed cases (known as post-exposure prophylaxis) and people at high risk of contracting the virus, such as some lab or health workers (pre-exposure prophylaxis).

There are also treatments, such as vaccinia immune globulin and antivirals. These were developed against smallpox.

1. How much do these new mutations matter?

The virus causing the current outbreak has several mutations compared with versions of the virus circulating in Africa. However, we don't know if these mutations affect clinical disease and how the virus spreads.

The monkeypox virus has a very large genome, so is more complex to study than smaller RNA viruses, such as influenza and SARS-CoV-2 (the virus that causes Covid).

Experts wonder if the mutations have made it more contagious or changed the clinical pattern to be more like a sexually transmitted infection. A study from Portugal shows the mutations likely make the virus more transmissible.

2. How is it spread? Is that changing?

Monkeypox has not been described as a sexually transmitted infection in the past. However, the current transmission pattern is unusual. There seems to be a very short incubation period (of 24 hours) following sexual contact in some, but not all, cases.

It is a respiratory virus, so aerosol transmission is possible. But historically most transmission has been from animal to human. When there was transmission between humans, this usually involved close contacts.

The rapid growth of the epidemic in non-endemic countries in 2022, however, has been all due to spread between humans. There may be many more cases than officially reported.

We do not know why the pattern has changed, whether it is sexually transmitted or simply transmitted due to intimate contact in specific and globally connected social networks, or whether the virus has become more contagious.

The virus is found in the skin rash, mouth and semen, but this does not prove it is sexually transmitted.

3. How far will it spread? Does Covid make a difference?

Will this spread more widely in the community? Does the Covid pandemic increase the risk? Possibly, yes.

We must also not drop the ball on surveillance in the wider community or stigmatise the LGBTQI community.

Due to waning immunity from the smallpox vaccine globally and the spread of monkeypox to many countries already, we may see the epidemic spreading more widely.

If it does so and starts infecting large numbers of children, we could see more deaths because children get more severe infection.

So we should monitor globally for clusters of fever and rash, and misdiagnosis as chickenpox, hand foot and mouth disease, herpes simplex or other diseases with a rash.

Another factor is Covid. As people recover from Covid, their immune system is impaired. So people who have had Covid may be more susceptible to other infections.

We see the same with measles infection. This weakens the immune system and increases the risk of other infections for two to three years afterwards.

If the epidemic becomes established in countries outside the endemic areas, it may infect animals and create new endemic zones in the world.

It is important we do everything possible to stop this epidemic.

- Reuters


Monkeypox   WHO  


Comment


Inside Health

Saima Wazed to assume office of WHO Regional Director today

Publish: 01:25 PM, 01 Feb, 2024


Thumbnail

The newly elected Regional Director for South-East Asia of World Health Organization (WHO) Saima Wazed, a global mental health expert, will take office for the next five years today.

The member states voted to nominate Wazed to the post during a meeting at the 76th session of the WHO Regional Committee for the South-East Asia Region on January 1, 2024.

Later, her nomination was approved during the 154 session of the WHO Executive Board held on January 22-27 in Geneva, Switzerland, according to WHO sources.

Ms. Saima Wazed will replace Dr. Poonam Khetrapal Singh, the outgoing RD of South-East Asia Region of WHO. 

Bangladesh, Bhutan, the Democratic People's Republic of Korea (DPRK), India, Indonesia, Maldives, Nepal, Sri Lanka, Thailand and Timor-Leste took part in the voting in New Delhi. 

Wazed, a renowned autism expert, had secured eight votes. The other candidate, Dr Shambhu Prasad Acharya, nominated by Nepal, received two votes. 

Saima Wazed is the first from Bangladesh and the second woman Regional Director of WHO South-East Asia Region. 

She is the daughter of Prime Minister Sheikh Hasina and is globally famed for her role as a mental health expert-particularly autism. She is an advisor to the WHO's director-general for mental health.

With that, Saima Wazed will be the first Bangladeshi to hold the post created in 1948 as part of WHO's regional divisions.

She spearheaded the campaign for autism awareness in Bangladesh at a time when parents would hide their children with this neurodevelopmental disorder due to the social stigma attached to the developmental disability.

Ms Saima Wazed has a Bachelor degree from Barry University in Florida, USA, and holds a master's degree in clinical psychology. She is a candidate for a doctorate in Organizational Leadership from the same university.

Since 2019, she has been an Advisor to the WHO Director-General on Mental Health and Autism and has been a member of WHO's Expert Advisory Panel on Mental Health since 2014.

Ms Wazed was designated Goodwill Ambassador for Autism in WHO South-East Asia in 2017. She co-authored WHO South-East Asia Regional Strategy on Autism Spectrum Disorder the same year.

She is an Associate Fellow at the Global Health Program Chatham House, UK, Chairperson of the National Advisory Committee on Autism and NDDs, Dhaka Bangladesh, and Chairperson of the Shuchona Foundation, Dhaka, Bangladesh.

Ms Wazed was conferred 'Excellence in Public Health' award by WHO South-East Asia Regional Office in 2014, and Ibrahim Memorial Gold Medal in 2016 by the Dr Ibrahim Memorial Council, Bangladesh, for her work on autism and neurodevelopment disorders.

In 2017, Ms Wazed received International Champion Award from US organization Shema Kolainu for her work on autism in South-East Asia. In 2019, she was conferred Innovative Women Leaders in Global Mental Health award by the Global Mental Health Programs, Columbia University, USA. 

-BSS


South-East Asia   WHO   Saima Wazed  


Comment


Inside Health

SEARO and the Future of Public Health

Publish: 08:45 AM, 01 Oct, 2023


Thumbnail

Over the past few decades, the countries of WHO’s South East Asia region have made major strides in both clinical medicine and public health. They have benefitted from government commitment and the strong human resource capacity of healthcare and health-related personnel, many of whom have led a successful fight against TB, leprosy, polio, malaria, and other communicable diseases as well as maternal, newborn and child health that have long plagued the region. They have done this against a backdrop of massive rural-to-urban migration, the emergence of cities whose health and social services have been pushed to the limit, and epidemiological transition and the emergence of new lifestyles and associated health challenges.

So today, as the SEARO Region prepares for a new Regional Director, the demographic transition, impact on health of climate change, preparedness for future pandemic and most importantly it’s vast range of non-communicable diseases, that are now challenging governments and their ministries of health. Foremost among non-communicable diseases are a series of mental health problems associated with stigma, discrimination, marginalization and misunderstanding that in the past have been poorly addressed, and which now call for urgent attention. Throughout the world more work days are being lost as a result of a pandemic of mental health problems that are undermining family health and stability, eroding many of the gains that have been achieved in education and literacy, and placing demands on healthcare systems that have traditionally focused on communicable diseases and not kept pace with this new world of mental health challenge. Young people in the SEARO region are being threatened as never before, along with alarming suicide rates. All these were recognized at the last SEARO Regional Committee in Bhutan in 2022 WHO, when the member states of WHO adopted the Paro Declaration calling for new vision and commitment to mental health care and the development of services that focus on community participation and primary care that is not only delivered by doctors and nurses, but also by psychiatric social workers, and many other paramedical personnel who can be trained to take on this new and fast-growing problem. The Ministers of Health who came together to address this new challenge agreed that “…there can be no health without mental health” and they called for major investments to be made by governments and external partners in preventing and mitigating mental health problems in ways that reduce treatment costs and increase human productivity, employment and quality of life.

If the SEARO region and its Member States are to move forward and take up this dramatic emerging problem, it must do so with vision and a deep understanding of the world of mental health, psychosocial wellbeing, and the role of community and society in promoting and protecting mental health. This will not be simple or easy, but if it is not taken up just as the regions’ Ministers of Health asked for in their Paro Declaration, countries will find themselves faced with one of the most complex public health problem the region has ever seen, and health and socioeconomic development risks being stunted.

Whoever is selected to take SEARO and its Member States into the new future, must have a clear understanding of the challenge of mental health and a body of experience in the area of mental health prevention and management as well as negotiating power to bring wide range of experts together that can foster and work hand in hand with the region’s member states public health policy makers, healthcare workers and social sector resources in a new and exciting SEARO public health venture. These are qualities not easily come by, and at the time of writing this, Saima Wazed seems to bring the type of mental health background and experience as will needed drive, dedication and expertise.



Comment


Inside Health

Prof. Deen Mohd. Speaks at 38th APAO

Publish: 04:08 PM, 02 Mar, 2023


Thumbnail

Prominent Eye Specialist Prof. Deen Mohd. Noorul Haq was invited as a speaker at the 38th congress of the Asia Pacific Academy of Ophthalmology (APAO) help in Malaysia from 23–26 February 2023, where he delivered speech on “Universal Eye Health Coverage” The Bangladesh Perspective.

Mentioning that the Universal Health Coverage is a Priority for Bangladesh Prof. Deen Mohd. said, the government of Bangladesh is committed to recognizing all people’s rights to the highest attainable standard of physical and mental health under the International Covenant on Economic, Social and Cultural rights and the convention on the Rights of the child.

He also said that, these fundamental human rights could be established through universal health coverage (UHC), which would ensure that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship.

Deen Mohd. said that, the Bangladesh Ministry of Health & Family Welfare (MOHFW) delivers its services through Health Population and Nutrition Sector Program (HPNSP). National Eye Care (NEC) is one of the operational plans (OP) of the HPNSP and it follows the guidelines of the Bangladesh National Council for the Blind (BNCB).

Prof. Deen Mohd. Noorul Haq is known for his great contribution to Community Ophthalmology in Bangladesh. He received many awards for his contribution in his field. 



Comment


Inside Health

New symptoms in dengue, increasing risk of death

Publish: 03:52 PM, 26 Oct, 2022


Thumbnail

The number of dengue patients in the country every day and the panic among the common people is also increasing. Added to this are the new symptoms of dengue. The new symptoms seen in dengue patients this year are not similar to traditional dengue symptoms. These symptoms include diarrhea, pneumonia and headache. Due to these new symptoms, many patients are delaying coming to the hospital without realizing that they are infected with dengue. As a result, there is a risk of death due to delayed treatment. Many are dying after being hospitalized.

On Thursday (October 20), the Directorate General of Health Services reported the death of four people due to dengue. On this day, 896 people were admitted to the hospital due to dengue. With this, the number of patients admitted in various government and private hospitals in the country has reached 3 thousand 174 people. Apart from this, the number of dengue deaths has increased to 110 this year. Earlier on Wednesday, the Department of Health reported the death of seven people infected with dengue.

The dengue situation has suddenly worsened in the past few weeks. Infected patients are increasing in the hospital every day. As a result, the hospital authorities are struggling to provide treatment. Even by creating a separate ward for dengue patients, they are struggling to handle the pressure.

The 10th floor of the capital's Mugda General Hospital has been reserved only for dengue patients. The open area outside the ward also been declared as Dengue dedicated war. But still, many of the hospitalized patients are receiving treatment from the floor without getting a bed.

Mugda General Hospital has a separate ward for children. Two rooms of this ward have been declared dengue ward. But still there are patients on the balcony outside the ward.

Meanwhile, the Department of Health said that most of the dengue victims this year are over 20 years old. But 40-50 years old are dying more. Still, 35 percent of the patients who died were children, that is, those under the age of 18. Many of the affected patients are taken to the hospital late, as a result most of them are dying within three days of admission. This year there are more deaths outside Dhaka. Besides, the mortality rate of women is higher than that of men.


Dengue   Bangladesh  


Comment


Inside Health

US sends experimental antibody, antiviral drug to Uganda for Ebola outbreak

Publish: 09:37 AM, 19 Oct, 2022


Thumbnail

The United States sent Gilead Sciences' remdesivir and Mapp Biopharmaceutical Inc's experimental Ebola antibody drug MBP134 to Uganda last week to help safeguard healthcare workers responding to an outbreak that has infected 60 people and killed 44, U.S. government sources told Reuters.

There are currently no proven vaccines or treatments for the Sudan species of Ebola, one of four known Ebola viruses to cause hemorrhagic fever in humans. The outbreak confirmed by the Ugandan health ministry on Sept. 20 is the largest of the Sudan species since 2000.

Uganda health minister Jane Ruth Aceng disclosed the U.S. shipments at a meeting of African region health officials last week in Kampala and said remdesivir, which has been widely used as a COVID-19 treatment, and an undisclosed monoclonal antibody had been given to healthcare workers.

Providing treatment that protects the lives of healthcare workers could be central to containing the outbreak, said Joel Montgomery, the U.S. Centers for Disease Control and Prevention's chief of the viral special pathogens branch and incident manager for the outbreak.

"If healthcare workers start to fall ill and die, it's going to negatively impact the response," said Montgomery, who had just returned from a trip to Uganda.

For instance, healthcare workers may be reluctant to assist in the response, he said in a phone interview.

The World Health Organization said in a statement the agency is working with partners in Uganda to set up the infrastructure for a clinical trial and is supporting use of the untested antivirals and monoclonal antibodies and will collect data on their efficacy.

A large outbreak of the Zaire species of Ebola in West Africa from 2014-2016 led to effective vaccines and treatment, but there are no proven treatments or vaccines for the Sudan species.

San Diego-based Mapp Biopharmaceutical received a $110 million contract from the U.S. government's Biomedical Advanced Research and Development Authority (BARDA) on October 4 for advanced development and potential purchases of MBP134, a combination of monoclonal antibodies.

Gilead did not immediately respond to a request for comment.

A study of MBP134 and remdesivir in non-human primates showed that either drug given individually rescued 20% of animals infected with the Sudan species of Ebola, but when given in combination, 80% of infected animals survived.

MBP134 is currently being tested in early safety trials in healthy human volunteers, Mapp President Larry Zeitlin said in an email. All participants have completed the study, and the data are currently being analyzed. Overall, MBP134 was well tolerated, he said.

Zeitlin said when requested, the company does provide its drug for free for compassionate use, pending regulatory and ethics approvals. He declined to say how many doses the company provided.

- Reuters


Ebola outbreak   Ebola   Uganda  


Comment


বিজ্ঞাপন