Enfermedades infecciosas

Cuando el ciclón Idai azotó a Mozambique, Malawi y Zimbabue en la noche del 14 de marzo, causó una devastación inimaginable y se cobró más de 1.000 vidas. Tras su paso, y el del ciclón Kenneth al mes siguiente, la inundación y la pérdida de infraestructura crearon las condiciones para un brote explosivo de cólera, una enfermedad diarreica mortal que puede matar a una persona en cuestión horas si no recibe tratamiento.

Pero lo que sucedió a continuación es clave: después del paso devastador de Idai, las autoridades lanzaron una iniciativa de respuesta rápida y, en el lapso de 24 horas, dispusieron el suministro de vacunas orales contra el cólera en Mozambique.…  Seguir leyendo »

Why Couldn’t My Ebola Treatment Center Save This Baby

A young mother stepped out of the ambulance into the triage area of our Ebola Transit Center, here in the northeast of the country. She moved slowly, careful not to wake the sick baby, swathed in layers of linens, that she carried in her arms. They had been brought here for testing because health workers suspected the baby might have Ebola.

We are six months into this latest Ebola outbreak. It is the worst on record for the Democratic Republic of Congo, and the second largest ever, after the 2014-2016 epidemic in West Africa. We’ve come a long way since then.…  Seguir leyendo »

El 8 de enero, en esta misma página de ABC, mencioné, con motivo de su centenario, la llamada gripe española de 1918. Hoy sabemos con certeza que no era española, y si creemos a Michael Osterholm, probablemente empezó en Kansas, y desde allí un soldado estadounidense la transportó a Francia, antes de que diera la vuelta al mundo. Al concluir ese texto del 8 de enero, me preguntaba si nuestro mundo está preparado para hacer frente a una nueva epidemia de este tipo, de modo que le pregunté a Osterholm, del Centro de Investigación sobre Enfermedades Contagiosas de la Universidad de Minnesota.…  Seguir leyendo »

Una receta bangladesí contra el cólera

A estas alturas, el cólera debería ser historia. Hace mucho que las autoridades sanitarias saben cómo prevenir la enfermedad, los médicos saben cómo tratarla y los expertos en desarrollo comprenden que allí donde hay saneamiento y agua potable, los brotes rara vez se convierten en epidemias. Por desgracia, el mundo no es tan simple y ordenado, y la pesadilla del cólera persiste.

En muchas partes del mundo, el cólera ya fue domado. Las enfermedades transmitidas por el agua casi no existen en las economías avanzadas. E incluso en países y regiones con escasez de recursos, donde el cólera sigue siendo un problema, la terapia de rehidratación oral (TRO) ayudó a prevenir incontables muertes.…  Seguir leyendo »

Makeshift shelters at the Kutapalong Rohingya refugee camp in Bangladesh. Poor living conditions makes the transmission of disease more likely. Photo by Allison Joyce/Getty Images.

What do a failed South American state, a war-torn Middle Eastern country and a South Asian country with a large refugee population have in common? Not much at first sight, but all three have recently been experiencing large diphtheria outbreaks, killing dozens and affecting thousands.

As of December 2017, Venezuela had reported more than 500 cases (mainly in 5-19 year-olds) and an unspecified number of deaths, with conflicting information about shortages of vaccines and essential medicines and unsanitary living conditions.

In Yemen, entangled in a protracted conflict, more than 300 people – mainly under 20 years of age – are affected, with at least 35 deaths since September 2017.…  Seguir leyendo »

“¿Dónde está el baño?”. Es lo primero que pregunto cada vez que visito un lugar donde estalló un brote de cólera. Las más de las veces, la respuesta es: “No tenemos. Vamos donde podemos”.

El cólera es una enfermedad antigua, y se ha convertido en una enfermedad de la pobreza. No discrimina geográficamente: se ensaña con comunidades vulnerables en áreas con deficiencias de saneamiento.

Arrastrada hasta fuentes de agua potable por una correntada contaminada, transportada sin saberlo por viajeros, ingresada a las casas en productos irrigados con aguas cloacales no tratadas, la bacteria Vibrio cholerae se aloja una vez ingerida en el intestino delgado y causa diarrea aguda y deshidratación.…  Seguir leyendo »

Si bien los mosquitos son diminutos, muerden bastante fuerte. Propagan una serie de enfermedades (como chikungunya, dengue, malaria, fiebre amarilla, fiebre del Nilo Occidental y virus Zika) que en su conjunto matan a millones de personas cada año. La malaria es por sí sola una de los principales asesinos infecciosos del mundo (solo detrás de la tuberculosis y el SIDA), ocasionando 429.000 muertes en 2015. Dada la magnitud y alcance del problema, es un imperativo para el desarrollo actuar con más firmeza para eliminar los mosquitos y las enfermedades de las que son portadores.

La Organización Mundial de la Salud los considera entre las mayores amenazas para la salud pública, especialmente en los países en desarrollo.…  Seguir leyendo »

El mes pasado, gobiernos de todo el mundo y otros donantes prometieron 1200 millones de dólares para ayudar a completar una lucha que ya lleva treinta años contra la poliomielitis. En su peor momento, la epidemia de polio llegó a causar 350 000 casos de parálisis infantil al año. Pero el año pasado sólo se informó de 37 casos, y en lo que va de este año, el número se mantiene en seis.

Por más impresionantes que sean estos avances, la victoria contra la polio todavía no está asegurada. Y hay un factor que será determinante para el éxito: las mujeres vacunadoras.…  Seguir leyendo »

Las epidemias de enfermedades transmisibles en el mundo desarrollado ya son lo suficientemente lamentables desde una perspectiva sanitaria. Pero también tienen serias implicancias en términos de la justicia social, porque exacerban prolongadas crisis de derechos humanos, afectando una prestación de servicios públicos de por sí débil y profundizando las desigualdades existentes.

Al igual que el brote de Ébola de 2014 en África occidental, el brote de Zika en América Central y del Sur en 2015 afectó con mayor fuerza a los grupos sociales vulnerables (mujeres y niños, minorías étnicas y los pobres). Como la fiebre amarilla, el dengue y otras enfermedades, el Zika se transmite por los mosquitos Aedes aegypti.…  Seguir leyendo »

On 9 May, a cluster of undiagnosed illness and deaths in a remote location in the north of the Democratic Republic of Congo (DRC) was reported to the World Health Organization (WHO). Several individuals tested positive for Ebola (Zaire subtype) a few days later. As of 19 May, 29 confirmed and suspected cases, including three deaths, had been reported. With the wounds of the West African Ebola outbreak that killed more than 11,000 between 2014 and 2016 still fresh, the rapidly evolving situation in northern DRC is likely to cause unease locally, nationally and internationally.

Here are six things to understand about this new outbreak:

  1. The potential for international spread is limited.
…  Seguir leyendo »

One of the saddest stories of this year has been the death of Salome Karwah, a Liberian health worker who was featured on the cover of Time magazine as a fighter in the 2014 Ebola epidemic.

She lost most of her family to the disease. She was also infected, but she recovered to return to the clinical front lines to care for hundreds of other patients. Earlier this year in Monrovia, the capital of Liberia, she died from complications of childbirth.

Her death draws new attention to the governing structure in Liberia. The scope of the dysfunction that Ebola revealed is beyond what can be chalked up simply to being a weak state in West Africa.…  Seguir leyendo »

Los líderes empresariales y los inversionistas mundiales están en gran medida obsesionados por dos tipos de riesgo: el macroeconómico y el geopolítico. En el corto plazo, esto significa un énfasis en los inminentes aumentos de las tasas de la Reserva Federal de Estados Unidos y las próximas elecciones en Francia y Alemania. A largo plazo, significa conciencia de los riesgos estructurales como la alta deuda soberana, los cambios demográficos y la escasez de recursos naturales. Pero hay un tercer riesgo, posiblemente más pernicioso, que se esconde bajo el radar de la mayoría de las personas que toman decisiones: las enfermedades infecciosas.…  Seguir leyendo »

Para muchas personas es sorprendente que en Europa y América del Norte la tuberculosis (TB) continúe siendo uno de los grandes flagelos de la historia humana. Una de cada tres personas en el mundo está infectada con tuberculosis latente o subclínica, y los científicos predicen que el 10% de dichas personas manifestarán la enfermedad a medida que envejezcan y otras enfermedades comprometan sus sistemas inmunológicos. En el año 2015, se reportaron más de diez millones de nuevos casos de tuberculosis, y casi dos millones de personas murieron a causa de dicha enfermedad.

Hay tres razones por las cuales la TB persiste: los líderes políticos no entienden la sociología que está tras de esta enfermedad, los científicos carecen de un paradigma efectivo para atacarla, y los ricos y famosos ya no mueren a causa de ella.…  Seguir leyendo »

Expanding the control strategy for intestinal worms to treating adults as well as children could improve the health of millions of people worldwide who are infected or reinfected by these parasites every year.

These intestinal worms – soil-transmitted helminths – are responsible for the most common parasitic disease of humans worldwide. A staggering 1.45 billion people – that’s nearly a fifth of the global population – are affected and at risk of the long-term consequences of this largely preventable infection.

Neglected diseases

Soil-transmitted helminthiasis is one of 17 “neglected tropical diseases”, a grouping that also includes dengue and chikungunya, rabies, and leprosy.…  Seguir leyendo »

The race for a Zika vaccine, one of the most pressing priorities in global health, is at full throttle. More than a dozen companies and government institutions are working to unlock the secrets of the virus, and a vaccine could be available as early as 2018.

But available to whom? If history is any guide, impoverished communities in Africa are likely to be the last in line. And this despite a mounting body of evidence that, contrary to the prevailing wisdom, poor families in Africa might bear the greatest burden of the disease.

Indeed, much of what we have taken for granted about Zika — that it is a threat unique to the Western Hemisphere; that it may only recently have evolved the ability to cause microcephaly and brain damage in babies; and that it hasn’t hurt women and children in Africa — is now in serious doubt.…  Seguir leyendo »

Scientists know that Ebola can cause anything from severe hemorrhagic fever to no symptoms at all (asymptomatic infections). What wasn’t known, until now, is the number of people who experienced asymptomatic infections during the 2013-2016 outbreak of Ebola in West Africa.

This is not the first report of potential asymptomatic cases of Ebola. About one in five people who came into contact with individuals infected during the 1976 outbreak in Sudan had detectable antibodies against Ebola but had not been ill. A 2005-2008 survey of the public in Gabon, which had its first outbreak of Ebola in 1994, suggested 15% had been infected with Ebola but did not show symptoms.…  Seguir leyendo »

The alleged “Patient Zero” of the American AIDS epidemic — a French Canadian flight attendant named Gaétan Dugas, who died of AIDS in 1984 — was exonerated last week.

Genetic sequencing of blood samples stored since the 1970s showed that the strain infecting him had circulated among gay men in New York for several years before he arrived here in 1974. Therefore, although he had hundreds of sexual partners in several cities, he did not introduce the virus to North America; he was a victim before he was a vector.

The revelation, some AIDS experts said, proved that the epidemic’s early days had been overshadowed by a witch hunt.…  Seguir leyendo »

Cholera patients received treatment at the St. Nicholas Hospital in St.-Marc, in 2010. Dieu Nalio Chery/Associated Press

Marseille, France In late 2010, the Haitian government asked me to investigate a cholera outbreak that struck that autumn following the arrival of a United Nations peacekeeping unit. It quickly became evident that some of the peacekeepers, who had been rotating through Haiti as part of a mission started in 2004 to provide security and stability, had introduced cholera from Nepal, where the disease had been flourishing.

By scrutinizing the most affected areas and using maps to trace the disease, I demonstrated how the epidemic originated with the peacekeepers. I published my findings in a July 2011 article, and an independent scientific team confirmed my conclusions within a few months.…  Seguir leyendo »

Don’t get pregnant.” Not now. Maybe not for two years.

This was the advice governments gave women in a number of South American countries when the connection was established between the Zika virus and microcephaly, a serious birth defect that can result in seizures and developmental delays. But details on how they were supposed to accomplish this in countries with limited access to contraception and strict abortion restrictions weren’t provided.

Now Zika has been locally transmitted in the continental United States. The Center for Disease Control and Prevention issued a similar warning, saying women and men who visit affected areas, including Wynwood in Miami, should wait at least eight weeks before trying to get pregnant.…  Seguir leyendo »

I am a millennial; half my peers are single and on Tinder, half are getting ready to start families. I’m also a scientist, working toward a master’s degree in bioethics. And I am more and more worried about Zika.

This summer, I co-wrote a guide for travelers to Rio de Janeiro about how to stay healthy in a place where Zika infection is common. After the Olympics’ closing ceremony, I worry that Americans will stop paying attention to the virus. They shouldn’t. Last month, a Miami hospital treated the first American known to have been infected locally, instead of while traveling abroad.…  Seguir leyendo »