Enfermedades infecciosas (Continuación)

InternacionalSalud Pública,

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 »

InternacionalSalud Pública,

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 »

A child suspected of being infected with cholera sits outside a makeshift hospital in Sana'a, Yemen.

MundoOriente Próximo, , ,

From a lack of basic public services, to violations of internal humanitarian law by warring parties, Yemen’s humanitarian crisis is daunting. But infectious disease outbreaks, like the cholera currently sweeping Yemen, should not be considered inevitable. By pressuring donors to urgently deliver on pledged resources, and by supporting humanitarian advocacy efforts to protect and promote access to health and other essential commodities and services, cholera can be stopped.

The outbreak

In terms of health security risks, cholera in Yemen is a ‘known known’. We know that infectious diseases such as cholera spread in conflict zones, where there is lack of water, poor sanitation and a weak or absent health system.…  Seguir leyendo »

What to Know About the Ebola Outbreak in the Democratic Republic of Congo

MundoÁfrica, , ,

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 »
President Ellen Johnson Sirleaf of Liberia, center, surrounded by heavy security visiting to quarantined neighborhood in Monrovia, Liberia, in 2014. Credit Daniel Berehulak for The New York Times

MundoÁfrica, , ,

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 »

InternacionalSalud Pública

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 »

InternacionalSalud Pública,

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 »

A man walks past a billboard to educate Liberians about the treatment of Ebola in Monrovia on July 10, 2015. (Ahmed Jallanzo/European Pressphoto Agency)

MundoÁfrica, , ,

Liberia was finally declared Ebola-free a year ago this month. The 2013-2015 outbreak wreaked havoc on the lives of thousands of Liberians, infecting at least 10,675 and killing 4,809. Many more were affected: 4 in 10 Liberians reported having a relative or close friend die during the outbreak.

During Liberia’s epidemic, analysts pointed to multiple obstacles blocking effective response: inadequate health facilities and resources, citizens’ mistrust of government, and the slow international response. There were questions about whether the Ebola outbreak would have severe consequences for Liberia’s already embattled government, leaving citizens even more distrustful of government and its ability to protect and provide for them.…  Seguir leyendo »

WHO guidelines have focused on deworming school-aged children. Noor Khamis/Reuters

InternacionalSalud Pública,

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 Zika virus was first disovered in April 1947 near Lake Victoria in Uganda. Isaac Kasamani/Agence France-Presse — Getty Images

InternacionalSalud Pública, , ,

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 »

The Red Queen has to keep running just to stay where she is. Wikimedia Commons

InternacionalSalud Pública, ,

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 »

Mary Mallon, foreground, became known as Typhoid Mary and died after being quarantined for 23 years. Credit Bettmann, via Getty Images

InternacionalSalud Pública

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 »

People bathe and clean clothes in a river cutting through Roche a Bateau, Haiti, after the devastation caused by Hurricane Matthew. PATRICK FARRELL pfarrell@miamiherald.com

MundoAmérica, , ,

With the number of suspected cases of cholera in Haiti now in the hundreds, the race is on to try to prevent further death and devastation following Hurricane Matthew.

With one million doses of cholera vaccine due to arrive this week, the hope is that we can prevent a repeat of the horrific outbreak in 2010 that infected nearly 800,000 Haitians, killing more than 9,000 people. But, even if we are successful in Haiti, the fact is for a highly preventable disease like cholera, vaccine stockpiles while certainly helpful cannot be a long-term solution.

Ten million people live in Haiti alone, and yet fewer than 6 million doses of cholera vaccine are currently produced each year, to maintain a global emergency stockpile of 2.2 million, with two doses recommended per person.…  Seguir leyendo »

InternacionalSalud Pública,

El 24 de octubre de 2016 tendría que haber sido un hito en la historia de la polio. Si todo va según lo planeado, sería el último Día Mundial de la Lucha contra Poliomielitis antes de la erradicación de esta enfermedad. Pero no son momentos de celebrar ni ser complacientes: si bien sabemos cómo eliminarla, aún no hemos acabado de hacerlo.

Piénsese en lo siguiente: en agosto de 2014 la Organización Mundial de la Salud declaró la crisis del Ébola en África Occidental una Emergencia de Salud Pública de Importancia Internacional (ESPII); levantó ese estado en marzo de 2016. En mayo de 2014, la OMS también declaró como ESPII la propagación del poliovirus, y ese estado sigue activo al día de hoy, lo que hace que nos preguntemos si los líderes mundiales le están prestando suficiente atención.…  Seguir leyendo »

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

MundoAméricaInternacionalONU, , , ,

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 »

In Zika fight, ‘don’t get pregnant’ is lousy advice

MundoAmérica, , ,

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 »

Zika: The Millennials’ S.T.D.?

InternacionalSalud Pública, ,

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 »

InternacionalSalud Pública,

Hoy día enfrentamos una dura realidad: el tratamiento y la prevención de las enfermedades infecciosas no han logrado avances de magnitud similar a la que tuvieron los primeros éxitos con las vacunas y las terapias antimicrobianas. En cierto sentido el mundo ha retrocedido, ya que microbios que alguna vez fue tratables se han tornado resistentes a las terapias disponibles y continúan surgiendo nuevas infecciones para las que no existen intervenciones eficaces.

La situación representa una amenaza grave e inminente para el mundo. Consideremos el impacto mundial de la crisis del ébola en África Oriental en 2014, o del brote de SARS en 2003, que llegó incluso a poner en peligro a economías ricas como las de Singapur y Canadá.…  Seguir leyendo »

MundoAmérica, , , ,

An expert panel convened by the World Health Organization just declared that there is no scientific basis for canceling, postponing or moving the 28th Summer Olympics in Rio de Janeiro in August or the Paralympics in September because of the Zika outbreak. While many of us experts have expressed concerns about how WHO handled Ebola and other outbreaks, this time WHO got it right.

There are ample reasons for alarm: The Zika virus continues to spread in Brazil. Zika infection during pregnancy can have devastating effects on developing fetuses, leading to severe brain damage. The risk is so substantial that WHO has called the Zika outbreak and its effects on pregnant women a public health emergency of international concern.…  Seguir leyendo »

MundoAmérica, ,

The Zika virus exploded out of Brazilian slums at 21st-century speeds, and raced north into Central America and the Caribbean in a matter of months. A full-blown outbreak in the United States looks imminent.

This statistically small virus is part of a global insurgency that adapts rapidly to developments of human progress. It exploits cultural dynamics: rapid over-urbanization, a changing climate and increased levels of travel and economic activity among countries.

This narrative could just as easily describe the growth of international terrorism. And the same sort of well-crafted U.S. government-led strategy that was designed to combat transnational terrorism is needed to blunt this deadly mosquito-transmitted illness.…  Seguir leyendo »