Risk of pneumonia in the elderly doubled by sleeping in dentures

Poor oral health and hygiene are increasingly recognized as major risk factors for pneumonia among the elderly. To identify modifiable oral health-related risk factors, lead researcher Toshimitsu Iinuma, Nihon University School of Dentistry, Japan, and a team of researchers prospectively investigated associations between a constellation of oral health behaviors and incidences of pneumonia in the community-living of elders 85 years of age or older. This study, titled “Denture Wearing During Sleep Doubles the Risk of Pneumonia in Very Elderly,” has been published by the International and American Associations for Dental Research (IADR/AADR in the OnlineFirst portion of the Journal of Dental Research (JDR).

At baseline, 524 randomly selected seniors (228 males, 296 females, average age was 87.8 years old) were examined for oral health status and oral hygiene behaviors as well as medical assessment, including blood chemistry analysis, and followed up annually until first hospitalization for or death from pneumonia. Over a three-year follow-up period, 48 events associated with pneumonia were identified (20 deaths and 28 acute hospitalizations). Among 453 denture wearers, 186 (40.8%) who wore their dentures during sleep, were at higher risk for pneumonia than those who removed their dentures at night.

In a multivariate Cox model, both perceived swallowing difficulties and overnight denture wearing were independently associated with approximately 2.3-fold higher risk of the incidence of pneumonia, which was comparable with the high risk attributable to cognitive impairment, history of stroke and respiratory disease. In addition, those who wore dentures while sleeping were more likely to have tongue and denture plaque, gum inflammation, positive culture for Candida albicans, and higher levels of circulating interleukin-6 as compared to their counterparts.

This study provides empirical evidence that denture wearing during sleep is associated not only with oral inflammatory and microbial burden but also with incident pneumonia, suggesting potential implications of oral hygiene programs for pneumonia prevention in the community. Frauke Mueller, University of Geneva, Switzerland, wrote a perspective titled “Oral Hygiene Reduces the Mortality From Aspiration Pneumonia in Frail Elders,” commenting that these findings lead to a simple and straight forward clinical recommendation – denture wearing during the night should be discouraged in geriatric patients.

 

http://www.medicalnewstoday.com/releases/283627.php

 

 

 

Could compound in red wine, grapes treat acne?

New study published in the journal Dermatology and Therapy claims a compound derived from red grapes and found in red wine – resveratrol – may be an effective treatment for acne, particularly when combined with an already existing medication for the disorder.

Acne affects 40-50 million Americans, and around 85% of us develop acne at some point in our lives. The condition is characterized by pimples, blocked pores and/or cysts that can appear on the face, neck, chest, back, shoulders and upper arms.

Acne can be caused overproduction of oil in the skin, blockage of hair follicles from which the oil is released, and growth of bacteria called Propionibacterium acnes in the hair follicles.

There are medications that help treat acne, such as benzoyl peroxide – an oxidant that produces free radicals that kill P. acnes bacteria.

But the researchers of this latest study – including first author Dr. Emma Taylor of the division of dermatology at the David Geffen School of Medicine, the University of California-Los Angeles – note that this medication can sometimes cause skin irritation, such as redness, itching and peeling skin.

Past research has indicated that resveratrol – an antioxidant found naturally in red grapes that prevents free radicals from forming – may be effective against acne, but the mechanisms behind this have been unclear. Dr. Taylor and colleagues set out to investigate.

A ‘two-pronged attack’ on acne bacteria

The team applied resveratrol, benzoyl peroxide, and a combination of both compounds to colonies of P. acnesbacteria, and assessed their antibacterial effects for 10 days. They also cultured human skin cells and blood cells with the compounds.

They found that all concentrations of benzoyl peroxide were able to kill P. acnes, but this effect lasted no longer than 24 hours.

Resveratrol, however, appeared to kill P. acnes by weakening the outer membrane of the bacteria. Such effects lasted for 48 hours, although a concentration of at least 50 ug/mL was required.

But the team says they were surprised to find that the strongest effect against acne occurred when both resveratrol and benzoyl peroxide were combined. Not only did this combination kill bacteria at all concentrations, but the effects lasted longer.

“It was like combining the best of both worlds and offering a two-pronged attack on the bacteria,” says senior author Dr. Jenny Kim, also of the division of dermatology at the Geffen School.

Commenting on the findings, Dr. Taylor says:

“We initially thought that since actions of the two compounds are opposing, the combination should cancel the other out, but they didn’t.

This study demonstrates that combining an oxidant and an antioxidant may enhance each other and help sustain bacteria-fighting activity over a longer period of time.”

Potential for new acne treatments

From culturing human skin cells and blood cells with the compounds, the team also found that benzoyl peroxide had much higher toxicity than resveratrol, which may explain why benzoyl peroxide can cause skin irritation.

The researchers point out, however, that this toxicity reduced when both resveratrol and benzoyl peroxide were combined, indicating that both of the compounds together could treat acne more effectively but produce fewer side effects.

The findings, the researchers say, may even lead to new acne treatments. “We hope that our findings lead to a new class of acne therapies that center on antioxidants such as resveratrol,” says Dr. Taylor.

The researchers note that further research is warranted to better determine how the two compounds work together to kill acne bacteria, and their findings will need to be validated in patients with acne.

Medical News Today recently reported in a study presented at the 5th American Society for Microbiology Conference on Beneficial Microbes in Washington, DC, claiming a certain bacteria could help treat acne and other skin disorders.

A number of studies have also hailed resveratrol for other benefits. In 2012, MNT reported on a study claimingresveratrol has anti-aging properties, while researchers of a more recent study claim to have identified why resveratrol may prevent heart disease and cancer.

Written by Honor Whiteman

Copyright: Medical News Today

http://www.medicalnewstoday.com/articles/283406.php

 

 

 

Malaria severity influenced by five human genes, say researchers

A large, international multi-center study – the largest of its kind to investigate the human genetics of malaria – has uncovered some new clues about susceptibility to severe malaria.

 

Writing in the journal Nature Genetics, the team, including Dr. Sarah Dunstan of The Nossal Institute of Global Health at the University of Melbourne in Australia, reports how it found five genes that have a complex role in either protecting or making people more susceptible to severe malaria.

Even with good hospital treatment, around 20% of patients who develop severe malaria die. The researchers hope their findings will lead to new drugs and vaccines to target the disease.

Malaria is a disease that develops when a mosquito infected by the parasite Plasmodium bites a person. The parasite invades and lives in the new host’s red blood cells.

There are several species of Plasmodium, of which P. falciparum is the one that most commonly causes severe disease in patients that are not immune.

Severe malaria can develop within a few days of infection. The condition affects many vital organs. If it affects the brain it can cause coma or cerebral malaria. If it affects the kidneys it can cause renal failure; in the lungs it can cause respiratory failure. It can also make the blood very acidic and lead to severe anemia and death.

Unprecedented study used large amount of data

For their study, Dr. Dunstan and colleagues analyzed data on nearly 12,000 cases of severe malaria collected from 12 sites across Africa, Asia and islands around the Pacific Ocean where access to treatment facilities can be difficult.

She says because of the international consortium behind it, the study was able to access a large amount of data to investigate genes that influence susceptibility to malaria on an unprecedented scale:

“It involved a large number of severe malaria patients from multiple countries, which allows us to identify genes that truly have an effect on whether or not you develop severe malaria.”

Of the 27 malaria resistance genes that they analyzed, the team found five – HBB, ABO, ATP2B4, G6PD and CD40LG – that were significantly involved in determining human susceptibility to severe malaria.

Role of genes in severe malaria more complex than previously thought

The results also show the role of common human genetic disorders in severe malaria are more complex than previously thought, as Dr. Dunstan explains, in reference to one of the genes:

“Our findings revealed that deficiency in G6PD, which causes a genetic blood disorder, can both reduce risk of cerebral malaria and increase risk of severe malarial anemia, both of which are fatal complications of malaria.”

The consortium behind the study is the Malaria Genomic Epidemiology Network (MalariaGEN), a global research group that is trying to understand immunity to malaria from the point of view of genetics.

MalariaGEN is based at the Wellcome Trust Centre for Human Genetics, at the University of Oxford in the UK. Professor Dominic Kwiatkowski, senior author of the study, is the principal investigator of the MalariaGEN consortium.

One of the features of the malaria parasite that makes it difficult to study is the fact it takes less than 60 seconds to travel from one blood cell to infect another, and it quickly loses its infective ability within minutes of leaving a cell.

But the parasite’s journey from one cell to another should be much easier to study in detail, now that a group based at the Wellcome Trust Sanger Institute, near Cambridge in the UK, has developed laser optical tweezers to see how malaria invades red blood cells.

Written by Catharine Paddock PhD

http://www.medicalnewstoday.com/articles/283154.php

 

Leaky gut – a source of non-AIDS complications in HIV-positive patients

Human immunodeficiency virus (HIV) infection is no longer a fatal condition, thanks to newer medications inhibiting the retrovirus, but a puzzling phenomenon has surfaced among these patients – non-AIDS complications. Scientists at Case Western Reserve University School of Medicine have resolved the mystery with their discovery of the leaky gut as the offender. Bacterial products seep out of the colon, trigger inflammation throughout the body and set into motion the processes of cardiovascular, neurodegenerative, chronic kidney and metabolic diseases, and cancer. Their findings appear in PLOS Pathogens.

“Because the space inside the colon (the lumen) contains the highest concentration of bacteria in the body, we provide evidence that bacterial products are leaking out of the colon into the bloodstream of these patients,” said senior author, Alan D. Levine, PhD, professor of medicine, pharmacology, pathology, molecular biology and microbiology, and pediatrics, Case Western Reserve University School of Medicine. “The immune system responds by launching an attack on these bacterial products, activating inflammation throughout the body that never stops.”

Bacteria can induce serious illness, but bacterial products are harmless remnants of dead bacteria. However, the immune system does not easily distinguish between live bacteria and bacterial products. Therefore, an immune attack is launched when bacterial products enter the bloodstream. In an HIV infection, tight junctions within the colon become the weak link providing an entryway for bacterial products to leak out.

Tight junctions are small, indented areas along the epithelial surface of the colon, something like the interior folds of a partially inflated accordion. Tight junctions form a barrier within the colon by sealing adjacent epithelial cells, and each tight junction seals the gut lumen (colon interior) from the colon exterior. Epithelial (or surface) cells are compacted against each other, but a miniscule opening (the intercellular space) allows ultra fine molecules to pass through. The tight junction complex forms tiny strands to seal that intercellular space.

Levine and colleagues demonstrated in their investigation that patients whose HIV was well controlled with antiretroviral medications still had weakened intestinal tight junctions. They came to this conclusion by comparing biopsies from 31 virally suppressed HIV-positive patients and from 35 healthy patients who had no HIV infection. (Virally suppressed means the level of circulating virus in the bloodstream is extremely low or undetectable.) The biopsies were obtained from patients at University Hospitals Case Medical Center during routine colonoscopies, a procedure to inspect visually the health of the colon. During the procedure, biopsies were collected from three places in patients’ intestines: the end of the small intestine (terminal ileum), the beginning and middle portions of the colon (ascending and transverse) and toward the end of the colon (descending).

“Not only did we find evidence of less tight junctions in the virally suppressed HIV-positive patients, we found that the reduction in tight junctions increased the farther down we went into the colon,” Levine said. “So essentially, these patients had the weakest tight junctions where the most bacteria are located. Additionally, we correlated the reduced tight junctions with increased inflammation.”

Investigators examined the biopsy tissue that sealed the spaces between epithelial cells and formed a barrier against luminal bacteria. They found that the number of cells and their density (or packing) was unchanged, meaning the leaks are not caused by cell death or pronounced changes in tissue structure or epithelial surface. However, the RNA and proteins that contribute to the organization of the tight junctions in the colon were decreased.

“The decline of the tight junctions correlated with increased microbial translocation and a greater level of inflammation throughout the body,” Levine said. “This finding provides evidence that a defect in the gut wall allowing bacterial products to leak out is the likely source of immune activation and subsequent inflammation. Basically, we found with this group of HIV-positive patients that the gut is leaky and why.”

These findings provide a clear target for clinical intervention – repair the molecular and structural epithelial leakiness in the tight junctions of the colon. However, critical questions must be resolved: Is the disruption caused by an HIV infection, the remaining HIV virus itself, antiretroviral drugs or all three combined to play a role in weakened tight junctions? What changes in epithelial cells might cause decreased activity of the tight junctions? Will repairs to the tight junction lead to stronger barrier function and reduced gut leakiness? Will reduced gut leakiness result in less systemic inflammation and therefore cause less cardiovascular, neurodegenerative, chronic kidney and metabolic diseases, and cancer in the virally suppressed HIV-positive patient?

“The key observation here is that virally suppressed HIV-positive patients have an important molecular and tissue defect – a leaky gut,” Levine said. “Thus, the clinical implication is quite clear. We will need additional supplemental therapeutic approaches to repair this damaged epithelium in the colon.”

This work was supported by grants from the National Institutes of Health (AI 076174, T32 GM007250, TL1 TR000441 and T32 GM-008803), the Case Western Reserve University Center for AIDS Research (AI 036219), Skin Diseases Research Center (P30 AR-039750), Visual Sciences Research Center Core (P30-EY11373) and School of Dental Medicine (P01 DE-019759).

http://www.medicalnewstoday.com/releases/282082.php

 

 

Ebola management lessons from 14th century Venice

Lessons from the past can help us deal with today’s emerging threats like drug- resistance, infectious disease outbreaks, climate change and even terrorism, say experts who studied the response of Italy’s city, Venice, when it was visited by the plague in the 14th century.

The approach the Venetians took is an example of resilience management, write the authors of a study on the subject published in the journal Environment Systems and Decisions.

Lead author Igor Linkov, of the US Army Engineer Research and Development Center and a visiting professor at the Ca Foscari University in Italy, says:

“Resilience management can be a guide to dealing with the current Ebola outbreak in Africa, and others.”

14th century Venetians took resilience management approach to tackling plague

Venice was an important maritime power and commercial hub for trade into central Europe, when it was struck by the deadly plague in 1347.

At first, the Venetians responded by intensifying prayers and rituals, but when that did not work, their efforts took the form of what experts today call resilience management.

The authorities did not focus on the disease itself, which they did not understand, but on what they could manage: the movements of people, social interactions and surveillance.

For example, they instituted a system of inspection, set up quarantine periods with isolation stations on nearby islands, and issued protective clothing.

These measures did not stop the plague from killing many Venetians at the time, but they probably ensured their city experienced only sporadic outbreaks in the following centuries while epidemics raged in Greece and southern Europe:

“[…] a set of systemic actions across the social, economic, and transportation networks of the city taken by officials and doctors eventually slowed and arguably stopped the spread of the disease,” note the authors.

Lessons for Ebola outbreak

Drawing parallels with the current Ebola outbreak, Prof. Linkov points to economic and cultural factors that impede risk management in West Africa.

It will take time to overcome the deeply rooted traditions that are helping the spread of the virus and the local people’s mistrust in what the authorities are trying to do to contain it.

But there are things that health experts and national leaders can do to bolster other parts of the system to be more resilient to re-emergence of the disease.

To apply the principles of resilience management, you have to view the city or community as a complex system so it can prepare, absorb, recover and adapt to unexpected threats, says Prof. Linkov, who adds:

“Similar to what the officials of Venice did centuries ago, approaching resilience at the system level provides a way to deal with the unknown and unquantifiable threats we are facing at an increasing frequency.”

He and his colleagues also believe that resilience management can be “a guide to addressing current issues of population growth and rising sea level in modern day Venice and across the globe.”

Resilience as a concept for building communities affected by disasters

The concept of resilience is gaining ground with organizations working to reduce risks in communities affected by disasters. It is also framing thinking about sustainable futures in an environment of growing risk and uncertainty.

A 2012 report commissioned by the International Federation of the Red Cross (IFRC) concludes that a safe and resilient community:

1. Assesses, manages and monitors its risks, learns new skills and builds on experience.
2. Identifies problems, sets priorities and acts.
3. Maintains links with external organizations that can provide support, goods and services when needed.
4. Has strong housing, transport, power, water and sanitation systems and is able to maintain, repair and renovate them.
5. Manages its natural assets by recognizing their value, protecting, enhancing and maintaining them.
6. Has diverse employment opportunities, income and financial services and the resourcefulness and flexibility to respond proactively to change.

Meanwhile, Medical News Today recently learned how pioneering research of the late 19th century inspired the method used to develop the experimental drug ZMapp, which may have saved the lives of two American missionaries struck down by Ebola in West Africa.

Written by Catharine Paddock PhD

http://www.medicalnewstoday.com/articles/281577.php

Heavier patients more likely to survive sepsis, study finds

While the usual medical view of obesity is that it is bad for health and likely to shorten lifespan, paradoxically, when it comes to surviving severe sepsis, carrying too much weight could be an advantage. So says new research that studied over 1,400 obese and normal weight US patients who were hospitalized with the life-threatening infection.

Published in the journal Critical Care Medicine, the study raises interesting questions about how obesityaffects the body’s response to infection. Most studies have linked it to worse, not better health outcomes.

Lead author Dr. Hallie C. Prescott, a pulmonary and critical care medicine clinical lecturer at the University of Michigan (U-M) Health System in Ann Arbour, says:

“Physicians expect obese patients to do poorly, and this belief can affect the care and counseling they provide to patients and their families. Our study indicates obese sepsis patients actually have lower mortality and similar functional outcomes as normal weight patients.”

Rates of sepsis have increased in the US

Sepsis, sometimes referred to as blood poisoning or septicaemia, is a potentially life-threatening condition where the body’s immune system overreacts to an infection, which may result in septic shock. Affected patients often have to spend time in the intensive care unit.

According to research that shows it affects around 750,000 patients and kills over 250,000 Americans a year,sepsis is the leading cause of death in US hospitals.

Incidence of sepsis in the US has doubled in the last 15 years, making it an increasingly important subject of research and area of spending in Medicare.

Medicare spending on sepsis now costs more than $16 billion a year in hospital bills, which is about four times the total hospital bill for heart attacks. The Medicare system now pays for around a million hospitalizations a year due to severe sepsis.

Most patients who survive severe sepsis need rehabilitation care in a specialist facility. Around half of survivors die within a year of leaving the hospital.

Obese patients less likely to die within a year of hospitalization for severe sepsis

Evidence of a link between obesity and improved chance of surviving sepsis has been mounting for a while, but it has attracted criticism in that it could be biased by not properly accounting for preferential admission of obese patients to critical care. Also, those studies have not necessarily followed up patients after they leave the hospital and looked at other health outcomes.

For their study, Dr. Prescott and colleagues set out to examine whether “1-year mortality, healthcare utilization, and functional outcomes following a severe sepsis hospitalization differ by body mass index.”

They examined data on 1,404 older Medicare beneficiaries hospitalized with severe sepsis who were enrolled in a nationally representative study. Of the participants, 334 (23.8%) were obese or severely obese, 473 (33.7%) were overweight and 597 (42.5%) were normal weight.

They found that patients with a higher body mass index (BMI) were less likely to die within a year of leaving the hospital after treatment for severe sepsis.

They also found there was a “dose-response relationship” between BMI and mortality, with severely obese patients showing a lower rate of mortality than obese patients.

In terms of functional outcomes, they found the obese patients fared just as well as the normal weight patients, noting that “total function limitations following severe sepsis did not differ by body mass index category.”

The results also showed that the total time spent in hospital and rehabilitation care was greatest among obese patients, as was Medicare spending, but average daily use and average daily Medicare spend was about the same for normal weight and obese survivors of severe sepsis.

Senior author Theodore Iwashyna, assistant professor of internal medicine at the U-M Health System, says:

“Obese patients who survive their sepsis hospitalization use more health care resources and require more Medicare spending – but this apparent increase in resource use is a result of living longer, not increased use per day alive.”

The authors note excess weight may cause the body to respond differently to critical illness, and more studies should be done to understand why, so health care providers can improve care for all patients with sepsis and other critical conditions.

In October 2013, researchers in the UK reported how they were developing a rapid bedside blood test for sepsis that returns results within 2 hours. Such a test could save thousands of lives worldwide every year by ensuring sepsis patients get prompt treatment with the correct antibiotic for the particular bacteria behind their infection.

Written by Catharine Paddock PhD

http://www.medicalnewstoday.com/articles/280672.php

Ebola outbreak in West Africa shows no sign of slowing down

The spread of deadly Ebola in West Africa appears to be increasing and getting out of control, as a leading medical charity warns of over-stretched resources, and concerns are raised that it may spread to other continents. Meanwhile, European and American authorities suggest while the risk of spread is “low,” the situation remains volatile and requires constant vigilance.

As of 23 July 2014, there have been over 1,200 reported cases of Ebola virus disease in West Africa, including 672 deaths, say the World Health Organization, making this the largest outbreak of Ebola in history.

Ebola virus disease – formerly known as Ebola hemorrhagic fever – is one of the world’s most virulent diseases. Without medical care, as few as 1 in 10 patients are expected to survive. Severely ill patients require intensive, supportive care.

During an outbreak, those at higher risk of infection are health workers and family members, and any other individuals with close contact to infected people and the bodies of dead victims.

Infection can be controlled through the use of protective techniques in clinics, in hospitals, in the home, and places where communities gather. These require health care workers to be able to identify the infection and be trained in barrier nursing methods such as correct use of masks, gowns, gloves and goggles, as well as equipment sterilization, routine use of disinfectant, and making sure infected patients do not come into contact with unprotected individuals.

Guinea seeing decline in cases, but rising in Liberia and Sierra Leone

In Guinea, where the outbreak began in February 2014, the number of cases has declined significantly, say Doctors Without Borders (MSF). However, in neighboring Sierra Leone and Liberia, the virus appears to be infecting more and more people.

After receiving no reports of new cases for 21 days, MSF has now closed its Ebola treatment center in Telimélé, in the west of Guinea. Twenty-one infected people were admitted to the treatment center over the 7 weeks it was open. Seventy-five percent of them recovered, a rate that the charity describes as “astonishing.”

Meanwhile, the leading medical charity says it is stepping up its response in the most affected areas, which are now in Sierra Leone and Liberia, but “with resources already stretched, health authorities and international organizations are struggling to bring the outbreak under control.”

There are also reports that dozens of health workers have died treating patients, and two American humanitarian workers, are currently fighting for their lives after becoming infected with the virus in Liberia.

One of them is Kent Brantly, 33-year-old doctor and father-of-two from Texas, who works for the charity Samaritan’s Purse. The other is Nancy Writebol, 60-year-old mother-of-two from North Carolina, who works as a missionary with Serving in Mission (SIM).

Bruce Johnson, President of SIM USA, told the UK newspaper MailOnline that both victims of the virus are entering a critical phase of their illness and they will know within the next few days if they are likely to survive.

Charity warns of ‘tsunami of destruction’ in Liberia

Mr. Johnson says the outbreak has the potential to become a “tsunami of destruction for the country of Liberia,” and calls for the international community to respond, as charities become overwhelmed.

The situation is deteriorating rapidly in Liberia, with cases of Ebola now confirmed in seven counties, including in the capital, Monrovia.

MSF also reports that the situation is deteriorating rapidly in Liberia, with cases of Ebola now confirmed in seven counties, including in the capital, Monrovia:

“There are critical gaps in all aspects of the response, and urgent efforts are needed to scale up, particularly in terms of contact tracing, organizing safe burials, and establishing a functioning alert system,” they urge.

Meanwhile, Reuters reported on Wednesday that Liberian government officials say an isolation unit at Elwa Hospital in Monrovia is so overrun with cases of Ebola that health workers are having to treat up to 20 patients in their homes.

Efforts to build another unit were at first resisted by the local community, highlighting the fear and mistrust toward health workers trying to battle the disease with a straining health system across West Africa.

MSF describe Sierra Leone as the current “epicenter” of the outbreak – with 454 cases recorded so far. There are now 22 international and 250 Sierra Leone health workers currently dealing with the outbreak there.

Likelihood of spread outside of West Africa ‘low’

Reports that a man who arrived in Nigeria from Liberia by plane died of Ebola infection has sparked fears that the outbreak will spread to other continents. However, experts suggest this is unlikely.

In a press telebriefing on Monday, Dr. Stephan Monroe, deputy director of the National Center for Emerging Zoonotic and Infectious Diseases at the US Centers for Disease Control and Prevention (CDC), said there have been no reported cases of Ebola in the US, and the “likelihood of this outbreak spreading outside of West Africa is very low.”

He says that while it is possible someone infected with the virus in Africa could get on a plane to the US, it is unlikely the disease would spread to fellow passengers:

“The Ebola virus spreads through direct contact with the blood, secretions, or other body fluids of ill people, and indirect contact – for example with needles and other things that may be contaminated with these fluids,” he explains.

As in the current outbreak, most people who become infected with Ebola are those in close contact with people who have already caught the disease and are showing symptoms, he adds.

Nevertheless, says Dr. Monroe, as people do travel between Africa and the US, the American authorities still need to prepare for the possibility that a traveler sick with the virus will make their way into the country.

The CDC is sending out Health Alert Notices to remind health care workers in the US how to prevent spread of Ebola. These notices urge health workers to take travel histories of their patients, know the symptoms of Ebola (headache, fever, weakness, joint and muscle aches, vomiting, diarrhea, stomach pain, lack of appetite and in some cases bleeding), know how to isolate a patient suspected of having the disease, and then follow precautions to prevent spread, and most importantly, avoid contact with blood and body fluids of any infected persons.

The European Commission (EC) also assesses the current risk of Ebola spreading to Europe as low, since “most cases are in remote areas in the affected countries and those who are ill or in contact with the disease are encouraged to remain isolated.”

However, as in the case of the CDC in the US, the European Centre for Disease Prevention and Control (ECDC) is keeping the situation under review and has issued several Rapid Risk Assessments that give guidance on how to proceed if suspected cases are detected in European Union (EU) countries.

“To date no cases have been detected among returning travellers in Europe,” they said in a news briefing on Wednesday.

Need to scale up international response

The EC is allocating an additional €2 million to respond to the Ebola epidemic in West Africa, bringing the Commission’s total aid to funding the fight against the current West African epidemic to €3.9 million.

Teams of specialists from both the US and countries in Europe have been deployed to the affected countries since the outbreak began. They are helping humanitarian partners and local health authorities carry out assessments, assist with data collection and management, coordinate response, and provide health education.

However, Kristalina Georgieva, EU Commissioner for International Cooperation, Humanitarian Aid and Crisis Response, says, “The level of contamination on the ground is extremely worrying and we need to scale up our action before many more lives are lost.” She calls for a “sustained effort from the international community to help West Africa deal with this menace.”

Meanwhile, Medical News Today recently reported how, through a statement published in The Lancet medical journal, researchers working in Sierra Leone are also calling for improvements to health care resources, diagnostic systems and disease surveillance to help tackle the growing Ebola crisis.

Written by Catharine Paddock PhD

http://www.medicalnewstoday.com/articles/280395.php