Thursday 31st December 2015- Centers of Disease Control and Prevention: First case of Zika virus reported in Puerto Rico

‘The Puerto Rico Department of Health reported today the first locally acquired case of Zika virus infection in Puerto Rico.  Zika was confirmed in a resident of Puerto Rico with no known travel history.  CDC is working closely with the Puerto Rico Department of Health to investigate how the patient may have contracted the virus. Health officials in Puerto Rico are monitoring for other cases of Zika virus infection.

CDC has issued a travel notice advising people traveling to Puerto Rico to take usual precautions to protect themselves from mosquito bites to reduce their risk of infection with Zika virus and other mosquito-borne viruses, such as dengue and chikungunya.  These steps include wearing insect repellent, using air conditioning or window and door screens to keep mosquitoes outside, wearing long pants and long-sleeved shirts when possible, and emptying standing water inside and outside the home.

Zika virus, originally identified in 1947 from Zika forest of Uganda, is transmitted to people primarily through the bite of an infected Aedes species mosquito. These mosquitoes are found throughout tropical regions of the world and are the same mosquitoes that spread dengue and chikungunya viruses. Mosquitoes become infected with the Zika virus when they feed on a person already infected with the virus. Infected mosquitoes can then spread the virus to other people through bites. There is no vaccine to prevent or medicine to treat Zika virus infection.

Outbreaks of Zika have occurred in Africa, Southeast Asia, and the Pacific Islands. Because the Aedes species mosquitoes that spread Zika virus are found throughout the world, it is likely that outbreaks will spread to new countries. To date, Zika virus has been reported in several countries and territories in the Americas.  Brazil is investigating the possible association between Zika virus infection and cases of microcephaly (smaller than expected head size) in infants.

The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis. The illness is usually mild with symptoms lasting from several days to a week. Infection is thought to provide lifelong immunity. Severe disease requiring hospitalization is uncommon. Deaths are rare. Travelers returning from areas with Zika activity (see map) should seek medical care if they experience a fever and symptoms of infection. Health care providers in areas with reported cases should be on the alert for possible cases.

Related Articles:

First case of Zika virus reported in Puerto Rico

Zika virus infection – Panama- The World Health Organisation

Thursday 31st December 2015- The Guardian: Breakthrough offers hope to those with Duchenne muscular dystrophy

‘Gene-editing injections could one day offer hope to those with the inherited disease Duchenne muscular dystrophy, research suggests.

Researchers were able to halt the progression of DMD in adult mice using a recently developed technique that has been hailed as the scientific breakthrough of 2015.

In a series of studies, three teams of US researchers showed how the gene-editing tool could be used to “correct” a mutation in the animals’ muscle DNA that prevented them producing the protein dystrophin, leading to partial recovery.

[BBC News:

‘A team at Duke University used a system known as CRISPR-Cas9 to delete DNA that was preventing cells from producing a protein essential for muscle function.

And a virus was used to deliver DNA alterations into the cells of mice.

Writing in the journal Science, the team say when they injected the therapy direct into the legs of adult mice, it resulted in improved muscle strength.

When they injected it into the bloodstream – tests showed improvements in muscles responsible for heart and lung function.’]

DMD is one of the most common and severe of a group of inherited muscle-wasting conditions that affect around 70,000 people in the UK, according to the charity Muscular Dystrophy UK. It is usually diagnosed in boys in early childhood, causing muscle degeneration, disability and premature death. Sufferers become increasingly immobile, and most can only expect to live to their 20s or 30s.

It is incurable, but the new research suggests that with gene-editing it might be possible to treat the condition simply by deleting a small piece of scrambled DNA whose presence prevents the gene working normally.

Although the treated mice were not completely cured, dystrophin gene activity was restored to a level that would be expected to achieve adequate muscle function in a patient with DMD.’

Related Articles:

Breakthrough offers hope to those with Duchenne muscular dystrophy

Gene editing treats disease in mice- BBC News

Gene-editing could fight musclar dystrophy, says new research- The Independent

Thursday 31st December 2015- The Telegraph: Hundreds of patients left without medicines over Christmas due to technical problems at online pharmacy

‘Almost 2,000 NHS patients have been unable to pick up medicines for weeks because of severe technical glitches at the UK’s biggest online phamacy.

NHS England warned Leeds-based Pharmacy2U that it needed to “raise its game” as patients compained that their calls and emails to the company have gone unanswered.

Many have been told they will be unable to pick up essential medicines and prescriptions until the week beginning January 11.

The problems have been blamed on the internet phamacy’s move to a different warehouse in November, with a new, automated system designed to speed up its service.

But technical problems prompted NHS England to write to GPs and other primary care service providers before Christmas to warn them about the “unacceptable” disruption to services.

The General Pharmaceutical Council has also stated that it intends to inspect the company.’

See:

Hundreds of patients left without medicines over Christmas due to technical problems at online pharmacy

Thursday 31st December 2015- The Guardian: Woman whose body turns food into alcohol beats drink-drive charge

‘Drunken-driving charges against a woman in upstate New York have been dismissed based on an unusual defence: her body is a brewery.

The woman was arrested while driving with a blood-alcohol level more than four times the legal limit. She then discovered she has a rare condition called “auto-brewery syndrome”, in which her digestive system converts ordinary food into alcohol, her lawyer Joseph Marusak said.

A town judge in the Buffalo suburb of Hamburg dismissed the charges after Marusak presented research by a doctor showing the woman had the previously undiagnosed condition in which high levels of yeast in her intestines fermented high-carbohydrate foods into alcohol.

The rare condition, also known as gut fermentation syndrome, was first documented in the 1970s in Japan, and both medical and legal experts in the US say it is being raised more frequently in drunken-driving cases as it is becomes more known.

“At first glance, it seems like a get-out-of-jail-free card,” said Jonathan Turley, a law professor at George Washington University. “But it’s not that easy. Courts tend to be sceptical of such claims. You have to be able to document the syndrome through recognised testing.”

The condition was first documented in the US by Barbara Cordell of Panola College in Texas, who published a case study in 2013 of a 61-year-old man who had been experiencing episodes of debilitating drunkenness without drinking liquor.

Marusak contacted Cordell for help with his client who insisted she had not had more than three drinks in the six hours before she was pulled over for erratic driving 11 October 2014. The woman was charged with driving while intoxicated when a breath test showed her blood-alcohol content to be 0.33%.

Cordell referred Marusak to Dr Anup Kanodia of Columbus, Ohio, who eventually diagnosed the woman with auto-brewery syndrome and prescribed a low-carbohydrate diet that brought the situation under control. Her case was dismissed on 9 December, leaving her free to drive without restrictions.’

See:

Woman whose body turns food into alcohol beats drink-drive charge

Thursday 31st December 2015- The Telegraph:GP records IT system delayed at ‘huge cost’ to the taxpayer

‘Controversial plans for the IT system which provides information for a giant medical database of GP records has been heavily delayed and will cost twice as much as expected, MPs have said.

The Public Accounts Committee highlighted severe failures in the creation of an IT system designed to extract data from all GP practice computers in England.

The IT system supplies records for the “care data” programme, has been the subject of huge controversy after doctors leaders and campaigners said that the public had not been informed about their right to opt out.

MPs said that the predicted cost of the project has risen from £14million to £40million during the planning and procurement stage after failings by a private contractor.

The system, which was due to be online in 2009, is still only used by two of the eight organisations supposed to be able to access it today.’

See:

GP records IT system delayed at ‘huge cost’ to the taxpayer

Wednesday 30th December 2015- The British Medical Journal: Voluntary euthanasia is now legal in Quebec, says appeal court

‘Quebec’s law permitting assisted dying and voluntary euthanasia is now in force, even though the federal government in Ottawa is still drawing up national legislation on the right to die. Quebec has been allowed to go ahead with its own law after the province’s highest court rejected a challenge led by a physicians’ group and a disabled patient.’

See:

Voluntary euthanasia is now legal in Quebec, says appeal court

Wednesday 30th December 2015- BBC News: London air ambulance trials hand-held brain scanner

‘London’s air ambulance is trialling a hand-held scanner which can detect potentially life-threatening brain injuries.

The device, called an “infrascanner”, can spot clots on the surface of the brain, which – if left untreated – can lead to disability or death.’

See:

London air ambulance trials hand-held brain scanner

Tuesday 29th December 2015- World Health Organisation: End of Ebola transmission in Guinea

‘Today the World Health Organization (WHO) declares the end of Ebola virus transmission in the Republic of Guinea. Forty-two days have passed since the last person confirmed to have Ebola virus disease tested negative for the second time. Guinea now enters a 90-day period of heightened surveillance to ensure that any new cases are identified quickly before they can spread to other people.

“WHO commends the Government of Guinea and its people on the significant achievement of ending its Ebola outbreak. We must render homage to the Government and people of Guinea who, in adversity, have shown extraordinary leadership in fighting the epidemic,” says Dr Mohamed Belhocine, WHO Representative in Guinea. “WHO and its partners will continue to support Guinea during the next 90 days of heightened surveillance and in its early efforts to restart and strengthen essential health services throughout 2016.”

A milestone for the Ebola outbreak    

The end of Ebola transmission in Guinea marks an important milestone in the Ebola outbreak in West Africa. The original chain of transmission started two years ago in Gueckedou, Guinea in late December 2013 and drove the outbreak which spread to neighbouring Liberia and Sierra Leone and, ultimately, by land and air travel to seven other countries.

“This is the first time that all three countries – Guinea, Liberia and Sierra Leone – have stopped the original chains of transmission that were responsible for starting this devastating outbreak two years ago,” says Dr Matshidiso Moeti, WHO Regional Director for Africa. “I commend the governments, communities and partners for their determination in confronting this epidemic to get to this milestone. As we work towards building resilient health care systems, we need to stay vigilant to ensure that we rapidly stop any new flares that may come up in 2016.”’

Related Articles:

End of Ebola transmission in Guinea

Ebola transmission ends in Guinea- The BMJ

Ebola outbreak ends in Guinea, says WHO- BBC News

Guinea declared free of Ebola- The Guardian

Tuesday 29th December 2015- The Telegraph: E-cigarettes are no safer than smoking tobacco, scientists warn

‘Vaping is no safer that smoking, scientists have warned after finding that e-cigarette vapour damages DNA in ways that could lead to cancer.

Researchers at the University of California created an extract from the ‘smoke’ of e-cigarettes and used it to treat human cells in a lab.

The exposed cells developed DNA damage and died far sooner than those left untreated. Nicotine free e-cigarettes caused 50 per cent more DNA strand breaks, while for those containing nicotine the damage rose three fold over eight weeks.’

‘”There haven’t been many good lab studies on the effects of these products on actual human cells,” said Dr Jessica Wang-Rodriquez, professor of pathology at the University of California, San Diego, and one of the lead researchers on the new study.

“Our study strongly suggests that electronic cigarettes are not as safe as their marketing makes them appear to the public.

“We were able to identify that e-cigarettes on the whole have something to do with increased cell death. We hope to identify the individual components that are contributing to the effect.

“Based on the evidence to date I believe they are no better than smoking regular cigarettes.”

Scientists and health officials are divided over whether they are safe. Earlier this year Public Health England urged smokers to switch to vaping, saying e-cigarettes were far safer than traditional tobacco.

But the World Health Organisation and scientists from the London School of Hygiene and Tropical Medicine and the University of Liverpool remain concerned about their safety.’

Related Articles:

E-cigarettes are no safer than smoking tobacco, scientists warn

E-cigarettes may be ‘no better’ than regular cigarettes- The Guardian

Vaping ‘no better’ than smoking regular cigarettes- The Independent

Wednesday 23rd December 2015- The BMJ: Zika virus spreads across Americas as concerns mount over birth defects

‘While a vaccine for dengue virus was approved this week in Mexico and the Philippines, dengue’s lesser known cousin the Zika virus has ballooned into a public health crisis across large parts of Latin America.

Zika’s rapid geographic spread would be causing less concern to public health authorities were it not for worrying evidence that the disease is less benign than initially thought. Hundreds of cases of Guillain-Barré syndrome have sprung up in the wake of Zika infection, but it is an explosion of microcephaly among infants born to infected women that has caused Brazil to declare Zika a “public health emergency of national importance.”

Brazil’s first confirmed Zika infection was in March 2015. Over the previous five years, the country of 204 million saw between 130 and 170 cases of microcephaly each year. In the first nine months of 2015, this figure roughly doubled. In the past three months, over 2400 further cases have been reported.

The Pan American Health Organization (PAHO) issued an epidemiological alert on 1 December warning of a suspected link between Zika and neurological syndrome or congenital malformation, but it noted that final proof was lacking.

Related Articles:

Zika virus spreads across Americas as concerns mount over birth defects

Brazil warns women not to get pregnant as zika virus is linked to rare birth defect- The Guardian