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Commemorating Smallpox Eradication – a legacy of hope, for COVID-19 and other diseases

On 8 May 1980, the 33rd World Health Assembly officially declared: ‘The world and all its peoples have won freedom from smallpox.’

The declaration marked the end of a disease that had plagued humanity for at least 3 000 years, killing 300 million people in the 20th century alone.

It was ended, thanks to a 10-year global effort, spearheaded by the World Health Organization, that involved thousands of health workers around the world to administer half a billion vaccinations to stamp out smallpox.

The US$ 300m price-tag to eradicate smallpox saves the world well over US$ 1 billion every year since 1980.

Speaking at a virtual event hosted at WHO-HQ, involving key players in the eradication effort, WHO Director-General, Dr Tedros Adhanom Ghebreyesus said, “As the world confronts the COVID-19 pandemic, humanity’s victory over smallpox is a reminder of what is possible when nations come together to fight a common health threat.”

The world got rid of smallpox thanks to an incredible demonstration of global solidarity, and because it had a safe and effective vaccine. Solidarity plus science equalled solution!

Dr Tedros highlighted that smallpox eradication also offers hope for efforts to eliminate other infectious diseases, including polio, which is now endemic in just two countries. To date, 187 countries, territories and areas have been certified free of Guinea worm disease, with seven more to go. And the fight against malaria has so far resulted in 38 countries and territories certified as malaria-free. In the case of Tuberculosis (TB), 57 countries and territories with low TB incidence are on track to reach TB elimination.

At the event, Dr Tedros unveiled a commemorative postal stamp to recognize the global solidarity that drove the initiative and honour the efforts of health workers who ensured its success.

The stamp, developed by the United Nations Postal Administration (UNPA), in collaboration with WHO, signifies what national unity and global solidary can achieve. Numerous countries, such as Guinea, India, Nigeria, Philippines, Togo and others issued smallpox stamps to show support for, and raise awareness about WHO’s Intensified Smallpox Eradication Programme launched in 1967.

WHO Regional Director for Africa, Dr Matshidiso Moeti’s earliest memories of smallpox is of her father. “I was visiting WHO headquarters, and I saw a photo of my Dad, standing with the other experts on the Global Commission. I remember him going out, doing follow-up visits with patients. He often would go with a driver and disappear into the bush for days. I felt in awe of his tireless work. The strategies used to eradicate smallpox still apply today.”

“Lessons learned from smallpox are used today to respond to disease outbreaks. For example, house-to-house active case-finding underpins the polio eradication programme, and ring vaccination of contacts is helping to combat the spread of the Ebola virus disease. Similarly, surveillance, case-finding, testing, contact-tracing, quarantine, and communication campaigns to dispel misinformation are central to controlling COVID-19, “ explained David Heymann, Professor of Infectious Disease Epidemiology at The London School of Hygiene & Tropical Medicine (LSHTM) and Distinguished Fellow, Global Health Security at Chatham House, London.

Following smallpox eradication, WHO and UNICEF launched the Expanded Programme on Immunization, under which 85% of the world’s children are vaccinated and protected from debilitating diseases.

With the potential of a COVID-19 vaccine ahead, ensuring sufficient supplies and reaching people in hard to reach places is a high priority. Addressing vaccine hesitancy poses a significant challenge to stop the virus. Access to accurate public health information and education is critical to ensure that the public has the facts to keep themselves and others safe.

To permanently commemorate the eradication of smallpox and the lessons learned on a global scale, rather than every 10-years, WHO is calling museums, exhibition companies, designers, curators and associations to develop an immersive, interactive and educational exhibition on smallpox and its relevance for COVID-19 and global health security. The exhibition, which will be unveiled later this year, will promote a better understanding of public health and empower people to keep informed and safe during a pandemic.

Notes to the media

Smallpox stamp

The smallpox stamp is in the denomination of CHF 1,70. It was designed by Sergio Baradat (United Nations) in collaboration with the World Health Organization and is available for purchase at unstamps.org. The stamp can be used to mail postcards and letters around the world, provided that they are sent from the UN headquarters in New York, Geneva or Vienna respectively.

Smallpox Eradication dates

On 9 December 1979, a global commission certified that smallpox had been eradicated, and this certification was officially accepted by the 33rd World Health Assembly in 1980.

Museum Exhibition

Exhibition design companies, museums, curators and other companies/organizations in this field are invited to express their interest to develop an immersive, educational exhibition on smallpox and its relevance for COVID-19 and global health security by writing to privatesectorpartners@who.int

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May 9, 2020
WHO and European Investment Bank strengthen efforts to combat COVID-19 and build resilient health systems to face future pandemics
- WHO and the European Investment Bank enhance cooperation to support countries in addressing the health impact of COVID-19
- The first phase will address urgent needs and strengthen primary health care in ten African countries
- Enhanced WHO-EIB partnership will scale up financing to assure the chain of essential supplies, including personal protective equipment, diagnostics and clinical management
- New initiative will accelerate investment in health preparedness and primary health care with a focus on health work force, infrastructure, and water, sanitation and hygiene
- The initiative involves measures to address the growing threat of antimicrobial resistance
The World Health Organization and the European Investment Bank will boost cooperation to strengthen public health, supply of essential equipment, training and hygiene investment in countries most vulnerable to the COVID-19 pandemic.

The new partnership between the United Nations health agency and the world’s largest international public bank, announced at WHO headquarters in Geneva earlier today, will help increase resilience to reduce the health and social impact of future health emergencies.

“Combining the public health experience of the World Health Organization and the financial expertise of the European Investment Bank will contribute to a more effective response to COVID-19 and other pressing health challenges,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

“WHO looks forward to strengthening cooperation with the EIB to improve access to essential supplies including medical equipment and training, and deliver better water, sanitation and hygiene where most needed. New initiatives to improve primary health care in Africa and support the EU Malaria Fund hint at the potential impact of our new partnership,” Dr Tedros concluded.

“The world is facing unprecedented health, social and economic shocks from COVID-19. The European Investment Bank is pleased to join forces with the World Health Organization as a key part of Team Europe’s efforts to address the global impact of the COVID-19 pandemic. The EU Bank’s new partnership with the WHO will help communities most at risk by scaling up local medical and public health efforts and better protect people around the world from future pandemics. This new cooperation will enable us to combat malaria, address anti-microbial resistance and enhance public health in Africa more effectively,” said Werner Hoyer, President of the European Investment Bank.

Improving local public health efforts to tackle coronavirus

The WHO and the EIB will increase cooperation to help governments in low- and middle-income countries to finance and secure access to essential medical supplies and protective equipment through central procurement.

Building resilient health systems in vulnerable countries across Africa

The WHO and the EIB will reinforce cooperation to support immediate COVID-19 needs and jointly develop targeted financing to enhance health investment and build resilient health systems and primary health care to address public health emergencies as well as accelerate progress towards Universal Health Coverage.

The partnership will benefit from the EIB’s planned 1.4 billion EUR response to address the health, social and economic impact of COVID-19 in Africa.

This will address immediate needs in the health sector and provide both technical assistance and support for medium-term investment in specialist health infrastructure.

The collaboration envisages rapid identification and fast-track approval of financing for health care, medical equipment and supplies.

The first phase of the collaboration will see public health investment in ten African countries.

Long-term collaboration to overcome market failures in global health

The agreement signed today establishes a close collaboration to overcome market failure and stimulate investments in global health, accelerating progress towards Universal Health Coverage. Increased cooperation between the WHO and the EIB will strengthen the resilience of national public health systems and enhance preparedness of vulnerable countries against future pandemics, thanks to investments in primary care infrastructure, health workers and improved water, sanitation and hygiene.

Future cooperation will strengthen the EIB’s 5.2 billion EUR global response to COVID-19 outside the European Union.

Scaling up investment to tackle antimicrobial resistance

The two organisations will also cooperate in an initiative to address investment barriers hindering development of new antimicrobial treatment and related diagnostics. Antimicrobial resistance is amongst the most significant global health threats.

The WHO and the EIB are working on a new financing initiative to support development of novel antimicrobials and address the estimated 1 billion EUR needed to provide medium-term solutions to antimicrobial resistance. Other crucial partners have been invited to join this discussion.

Improving the effectiveness of malaria treatment

Under the new agreement the EIB and WHO will support development of the EU Malaria Fund, a new 250 million EUR public-private initiative intended to address market failures holding back more effective malaria treatment.

Strengthening EIB support for healthcare, life science and COVID-19 investment

In recent years the European Investment Bank has provided more than 2 billion EUR annually for health care and life science investment.

In the context of the COVID-19 pandemic, the EIB is currently assessing over 20 projects in the field of vaccine development, diagnostic and treatment, leading to potential investments in the 700 million EUR range. The EIB will also take part in the EU’s rolling pledging effort for the coronavirus global response that is taking place on May 4th.

Background information

The European Investment Bank (EIB) is the long-term lending institution of the European Union owned by its Member States. It makes long-term finance available for sound investment in order to contribute towards EU policy goals.

The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing. For updates on COVID-19 and public health advice to protect yourself from coronavirus, visit www.who.int and follow WHO on Twitter, Facebook, Instagram, LinkedIn, TikTok, Pinterest, Snapchat, YouTube

WHO’s information site on the COVID-19 pandemic

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May 9, 2020
Statement on the third meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of coronavirus disease (COVID-19)
The third meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (2005) (IHR) regarding the coronavirus disease (COVID-19), took place on Thursday, 30 April 2020, from 12:00 to 17:45 Geneva
time (CEST).

Proceedings of the meeting

Members and advisors of the Emergency Committee were convened by teleconference. Membership of the Emergency Committee was expanded
to reflect the nature of the pandemic and the need to include additional areas of expertise.

The Director-General welcomed the Committee, thanked them for their commitment to enhancing global public health, and provided an overview of the major achievements in the COVID-19 response since the last Emergency Committee meeting on 30 January 2020.
Representatives of the legal department and the Department of Compliance, Risk Management, and Ethics (CRE) briefed the members on their roles and responsibilities.

The Ethics Officer from CRE provided the members and advisers with an overview of the WHO Declaration of Interest process. The members and advisers were made aware of their individual responsibility to disclose to WHO, in a timely manner, any interests
of a personal, professional, financial, intellectual or commercial nature that may give rise to a perceived or direct conflict of interest. They were additionally reminded of their duty to maintain the confidentiality of the meeting discussions and
the work of the committee. Only those committee members and advisers who were not considered to have any perceived or direct conflict of interest participated in the meeting.

The Secretariat turned the meeting over to the Chair, Professor Houssin. He also welcomed the Committee and reviewed the objectives and agenda of the meeting.

The WHO Regional Emergency Directors and the Executive Director of the WHO Health Emergencies Programme (WHE) provided regional and the global situation overview. After ensuing discussion, the Committee unanimously agreed that the outbreak still constitutes
a public health emergency of international concern (PHEIC) and offered advice to the Director-General.

The Director-General declared that the outbreak of COVID-19 continues to constitute a PHEIC. He accepted the advice of the Committee to WHO and issued the Committee’s advice to States Parties as Temporary Recommendations under the IHR.

The Emergency Committee will be reconvened within three months or earlier, at the discretion of the Director-General. The Director-General thanked the Committee for its work.

Advice to WHO

Coordination, planning, and monitoring
- Continue to lead and coordinate the global response to the COVID-19 pandemic in collaboration with countries, the United Nations (UN), and other partners.
- Work with fragile states and vulnerable countries that require additional technical, logistical and commodity support.
- Establish mechanisms to compile lessons learned from country and partner experiences and WHO missions and share the best practices and updated recommendations.
- Provide further guidance to countries about adjusting public health measures, taking into account the different epidemiological situations of the pandemic.
- Promote the inclusion of all interested countries, including low- and middle-income countries from all regions, in the Solidarity clinical trials for therapeutics and vaccines.
- Continue efforts with partners to obtain equitable access to personal protective equipment, diagnostics, and biomedical equipment essential to the pandemic COVID-19 response.
- Continue to coordinate global expert networks in epidemiology, laboratory, vaccines, clinical care, infection prevention and control, social sciences, and operational research; modelling; and other technical support.
One Health
- Work with the World Organisation for Animal Health (OIE), the Food and Agriculture Organization of the United Nations (FAO), and countries to identify the zoonotic source of the virus and the route of introduction to the human population, including
  the possible role of intermediate hosts. This should be accomplished through efforts such as scientific and collaborative field missions, which will enable targeted interventions and a research agenda to reduce the risk of similar events.
- Work closely with OIE and FAO to provide guidance on how to prevent SARS-CoV-2 infections in animals and humans and prevent the establishment of new zoonotic reservoirs.
- Work with partner organizations and countries to strengthen the global food supply chain, protect food workers, properly manage food markets, and mitigate possible disruptions to the food supply.
Essential Health Services
- Support countries to assess and manage the unintended consequences of public health measures implemented to control the COVID-19 pandemic, including gender-based violence and child neglect.
- Support countries to monitor their ability to provide and strengthen essential health services throughout a likely extended COVID-19 response. This should include, but is not limited to, essential prevention for communicable diseases, particularly
  vaccination; services related to reproductive health, including care during pregnancy and childbirth; care of vulnerable populations, such as young infants and older adults; provision of medications and supplies for the ongoing management of chronic
  diseases, including mental health conditions; continuity of critical inpatient therapies; management of emergency health conditions and common acute presentations that require time-sensitive intervention; and auxiliary services, such as basic
  diagnostic imaging, laboratory services, and blood bank services.
- Support countries to address shortages of essential medicines and health products, personal protective equipment, and other medical supplies and to establish sustainable risk management practices to prevent future shortages.
Risk communication and community engagement
- Continue risk communications and community engagement activities through the WHO Information Network for Epidemics (EPI-WIN) and other platforms to counter rumours and misinformation.
- Continue to regularly communicate clear messages, guidance, and advice about the evolution of the COVID-19 pandemic, how to reduce transmission, and save lives.
- Work with partners and countries to articulate potential long-term consequences of COVID-19 pandemic, emphasizing the need for strengthened cross-sectoral preparedness, transparency and global coordination.
Surveillance
- Clarify the testing strategy, support countries to increase testing capacity, and aim to provide equitable access to diagnostic tests and supplies in light of market failures and global shortages.
- Continue to provide guidance on monitoring disease trends using Severe Acute Respiratory Infections (SARI) and Influenza Like Illness (ILI) surveillance systems in anticipation of the co-circulation of influenza viruses.
- Develop qualitative and quantitative indicators that countries can use to assess and monitor SARS-CoV-2 transmission at all levels of public health response.
- Continue to support countries and partners by providing technical and operational guidance, training platforms, and tools such as Go.Data,to enhance case identification and contact tracing capacity, strengthen the public health workforce, and engage
  communities for contact tracing.
- Provide clear qualitative and quantitative indicators to monitor SARS-CoV-2 transmission to inform the adjustment of public health and social measures.
Travel and Trade
- Continue working with countries and partners to enable essential travel needed for pandemic response, humanitarian relief, repatriation, and cargo operations.
- Develop strategic guidance with partners for the gradual return to normal operations of passenger travel in a coordinated manner that provides appropriate protection when physical distancing is not feasible.
- Update recommendations on appropriate travel measures and analyze their effects on international transmission of COVID-19, with consideration of the balance between benefits and unintended consequences, including entry and exit screening, education
  of travelers on responsible travel behaviour, case finding, contact tracing, isolation, and quarantine, by incorporating evidence on the potential role of pre-symptomatic and asymptomatic transmission.
To all States Parties

Coordination and Collaboration
- Support WHO leadership and continue to collaborate with WHO at all levels of the organization and with other countries to enable effective global COVID-19 pandemic preparedness and response.
- Participate in global solidarity efforts to enable access to essential supplies for all.
- Document and share lessons learned from efforts to control the pandemic, including the timing, pace, and sequencing of the application and lifting of public health measures.
Preparedness
- Strengthen preparedness for health emergencies, and build resilient health systems, incorporating lessons learned during different stages of the pandemic, and sharing experiences with other countries.
Surveillance
- Work with WHO and multisectoral partners to interrupt transmission by maintaining robust surveillance systems; enhancing capacities for case detection, testing, isolation of cases, contact tracing, quarantine of contacts, and rapid response; strengthening
  the public health workforce; and actively engaging communities for contact tracing, with a particular focus on high risk areas.
- In settings where testing a large proportion of suspected cases is not possible, monitor overall trends; undertake early detection through laboratory confirmation of a limited number of cases with a focus on health workers; and rapidly implement
  public health measures.
- Share with WHO all data necessary to conduct global risk assessments through data platforms, such as the Global Influenza Surveillance and Response System and the IHR mechanism. These data should include SARI and ILI where available.
- Use the WHO qualitative and quantitative indicators to assess and monitor SARS-CoV-2 transmission at all levels of public health response.
Additional Health Measures
- Avoid restrictions on international transport of food, medical and other essential supplies and permit the safe movement of essential personnel required for an effective pandemic response.
- Implement appropriate travel measures with consideration of their public health benefits, including entry and exit screening, education of travelers on responsible travel behaviour, case finding, contact tracing, isolation, and quarantine, by
  incorporating evidence on the potential role of pre-symptomatic and asymptomatic transmission.
- Implement and monitor case finding and contact tracing of travellers, using digital tools where appropriate.
- Continue to review travel and trade measures based on regular risk assessments, transmission patterns at origin and destination, cost-benefit analysis, evolution of the pandemic, and new knowledge of COVID-19.
- Engage in global efforts to respond to the challenges of COVID-19 in managing maritime vessels.
- Do not implement trade restrictions beyond those considered to be of public health importance in accordance with relevant international agreements.
- Continue to provide appropriate public health rationale to WHO for additional health measures in accordance with IHR.
Health Workers
- Prioritize the protection of the health workforce through access to training and provision of personal protective equipment, infection prevention and control measures, improved working conditions, application of WHO recommended testing strategies,
  and prevention of stigma and attacks on health workers.
Food Security
- Work with WHO and partners to strengthen the global food supply chain, protect food workers, properly manage food markets, and mitigate possible disruptions to the food supply, especially for vulnerable populations.
One Health
- Promote sound practices to manage risks of trade of live animals in food markets and regulate trade of exotic wildlife.
Risk Communications and Community Engagement
- Continue to engage communities to address rumours and misinformation and keep the public informed, with a focus on vulnerable populations.
Research and development
- Address research gaps such as: routes of transmission, including the role of asymptomatic and pre-symptomatic infection droplet, contact, fomite and aerosol transmission; and viral shedding; and animal source and intermediate hosts, in collaboration
  with partners.
- Continue to support and conduct COVID-19 research, in line with the WHO Research and Development Blueprint, and the road map for COVID-19 vaccines, diagnostics, and therapeutics.
- Continue sharing full genome sequences to increase global understanding of virus evolution and phylogenetics and their application to public health practices.
Essential Health Services
- Maintain essential health services throughout a likely extended COVID-19 response. This should include essential prevention for communicable diseases, particularly vaccination; services related to reproductive health, including care during pregnancy
  and childbirth; care of vulnerable populations, such as young infants and older adults; provision of medications and supplies for the ongoing management of chronic diseases, including mental health conditions; continuity of critical inpatient
  therapies; management of emergency health conditions and common acute presentations that require time-sensitive intervention; and auxiliary services, such as basic diagnostic imaging, laboratory services, and blood bank services.
- Continue to track and document the impact of COVID-19 on essential health services.
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May 9, 2020
Massive proportion of world’s population are living with herpes infection

Virus causing genital herpes may put millions of people at greater risk of infection with HIV

About half a billion people worldwide are living with genital herpes, and several billion have an oral herpes infection, new estimates show.

Authored by staff at the University of Bristol, World Health Organization (WHO), and Weill Cornell Medical College-Qatar, and published in the Bulletin of the World Health Organization,
the new study estimates the global infection prevalence and incidence of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) in 2016.

“Herpes infection affects millions of people across the globe and can have far-reaching health effects. We need more investment and commitment to develop better treatment and prevention tools for this infection.” says Dr Sami Gottlieb, Medical
Officer at WHO and an author of the study.

Prevalence and incidence

An estimated 491.5 million people were living with HSV-2 infection in 2016, equivalent to 13.2% of the world’s population aged 15 to 49 years. HSV-2 is almost exclusively sexually transmitted, causing infection in the genital or anal area (genital
herpes).

An estimated 3.7 billion people had HSV-1 infection during the same year – around 66.6% of the world’s population aged 0 to 49. HSV-1 is mainly transmitted by oral to oral contact to cause infection in or around the mouth (oral herpes). However,
HSV-1 can also be transmitted to the genital area through oral-genital contact – during oral sex – to cause genital herpes. Most HSV-1 infections were oral; however, between 122 million to 192 million people were estimated to have genital
HSV-1 infection, depending on the assumptions used in the estimation model.

Because herpes is a lifelong infection, estimated prevalence increased with age; HSV-2 prevalence was also higher among women and in the WHO African Region.

Health and social impacts

Most people living with herpes, caused by either HSV-1 or 2, are unaware they have the infection.

When symptoms do occur however, oral herpes infection can lead to painful sores around the mouth (“cold sores”). Genital herpes infection can cause recurring, often painful, genital sores, often referred to as genital ulcer disease.

WHO and partners published a study in March 2020 estimating that around 5% of the world’s population (187 million people) suffered from at least one episode of herpes-related genital ulcer disease in 2016 (1). Most of these episodes were due to
HSV-2, which can recur frequently over many years.

Recurrent symptoms of genital herpes can lead to stigma and psychological distress, and can have an important impact on quality of life and sexual relationships. However, in time, most people with herpes adjust to living with the infection.

“Genital herpes is a substantial health concern worldwide – beyond the potential pain and discomfort suffered by people living with the infection, the associated social consequences can have a profound effect on sexual and reproductive health”
says Dr Ian Askew, Director of the Department of Sexual and Reproductive Health and Research at WHO.

Herpes and HIV

A strong association exists between HSV-2 infection and HIV infection. In 2019, WHO commissioned a modeling study to estimate how much HSV-2 infection might contribute to HIV incidence. The study estimated that almost 30% of new sexually acquired HIV
infections in 2016 worldwide were likely attributable to HSV-2 infection (2).

Evidence shows that people with HSV-2 infection are at least three times more likely to become infected with HIV, if exposed. HSV-2 leads to inflammation and small breaks in the genital and anal skin that can make it easier for HIV to cause infection.
In addition, people with both HIV and HSV-2 infection are more likely to spread HIV to others.

Women have higher biologic susceptibility to both HSV-2 and HIV. Women living in the WHO Africa Region have the highest HSV-2 prevalence and exposure to HIV – putting them at greatest risk of HIV infection, with negative implications for their health
and well-being.

For people living with HIV (or who are living with other conditions that compromise their immune systems) as well as HSV-2, the symptoms of herpes can be more severe and more frequent.

Neonatal herpes

Neonatal herpes can occur when an infant is exposed to HSV in the genital tract during delivery. This is a rare condition, occurring in an estimated 10 out of every 100,000 births globally, but can lead to lasting neurologic disability or death. The risk
for neonatal herpes is greatest when a mother acquires HSV infection for the first time in late pregnancy. Women who have genital herpes before they become pregnant are at very low risk of transmitting HSV to their infants.

No cure – better treatment and prevention needed

There is no cure for herpes. At present, antiviral medications, such as acyclovir, famciclovir, and valacyclovir, can help to reduce the severity and frequency of symptoms but cannot cure the infection.

As well as increasing awareness about HSV infection and its symptoms, improved access to antiviral medications and heightened HIV prevention efforts for those with genital HSV symptoms are needed globally.

In addition, development of better treatment and prevention interventions is needed, particularly HSV vaccines. WHO and partners are working to accelerate research to develop new strategies for prevention and control of HSV infections. Such research includes
the development of HSV vaccines and topical microbicides. Several candidate vaccines and microbicides are currently being studied.

“A vaccine against HSV infection would not only help to promote and protect the health and well-being of millions of people, particularly women, worldwide – it could also potentially have an impact on slowing the spread of HIV, if developed
and provided alongside other HIV prevention strategies” says Dr Meg Doherty, Director of the WHO Department of Global HIV, Hepatitis, and STI Programmes.

Related publications

WHO guidelines for the treatment of Genital Herpes Simplex Virus

WHO preferred product characteristics for herpes simplex virus vaccines

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(1) Looker KJ, Johnston C, Welton NJ, et al. The global and regional burden of genital ulcer disease due to herpes simplex virus: a natural history modelling study. BMJ Glob Health. 2020;5(3):e001875. doi: 10.1136/bmjgh-2019- 001875.

(2) Looker KJ, Welton NJ, Sabin KM, et al.Global and regional estimates of the contribution of herpes simplex virus type 2 infection to HIV incidence: a population attributable fraction analysis using published epidemiological data. Lancet Infect Dis.2020;20(2):240-249. doi: 10.1016/S1473-3099(19)30470-0.

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May 9, 2020
New FAQs address healthcare workers questions on breastfeeding and COVID-19

Mothers and healthcare workers who support them have many questions and concerns about whether it is safe for mothers with confirmed or suspected COVID-19 to be close to and breastfeed their babies during the pandemic.

To address their questions, WHO has released a list of Frequently asked questions: Breastfeeding and COVID-19. The FAQ complements the WHO interim guidance: Clinical management of severe acute respiratory infection when COVID-19 is suspected and draws upon other WHO recommendations on infant and young child feeding.

The FAQs aim to provide information to healthcare workers supporting mothers and families in maternity services and community settings, and communicate how the interim guidance should be implemented. Additionally, the FAQs provide information about the protective effects of breastfeeding and skin-to-skin contact, and the harmful effects of inappropriate use of infant formula milk.

Accompanying the FAQs is a decision tree which provides step-by-step guidance to health workers on how to support mothers with confirmed or suspected COVID-19 to breastfeed. It provides advice on what to do if mothers are not well enough to breastfeed, as well as appropriate hygiene measures for mothers, including wearing a medical mask if available, to reduce the possibility of the COVID-19 virus being spread to her infant.

Benefits of breastfeeding outweigh potential risks

The COVID-19 virus has not been detected in the breastmilk of any mother with confirmed and suspected COVID-19 and there is no evidence so far that the virus is transmitted through breastfeeding. Researchers continue to test breastmilk from mothers with the infection.

WHO recommends that all mothers with confirmed or suspected COVID-19 continue to have skin-to-skin contact and to breastfeed. In all socio-economic settings, breastfeeding improves survival and provides lifelong health and development advantages to newborns and infants. Breastfeeding also reduces the risk of breast and ovarian cancer for the mother. Skin-to-skin contact, including kangaroo mother care, reduces neonatal mortality, especially for low birth weight newborns.

While infants and children can contract COVID-19, they are at low risk of infection. The few confirmed cases of COVID-19 in young children to date have experienced only mild or asymptomatic illness.

WHO’s recommendations on the care and feeding of infants whose mothers have confirmed or suspected COVID-19 aim to improve the immediate and lifelong survival, health and development of their newborns and infants. These recommendations consider the likelihood and potential risks of COVID-19 in infants and also the risks of serious illness and death when infants are not breastfed or when infant formula milk are used inappropriately.

WHO’s Q&A on breastfeeding and COVID-19 also provides additional infection prevention advice to mothers with confirmed or suspected COVID-19.

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May 9, 2020
Maternal infections in health facilities

A clearer picture of the global impact

New research from the Global Maternal Sepsis Study (GLOSS), a major WHO/HRP initiative, shows that infection has a much larger impact on global maternal mortality and morbidity than previously thought.

The
results from GLOSS, published in The Lancet Global Health, are the first to provide data on frequency of maternal infections and
sepsis across the pregnancy and post-pregnancy period, in a large number of health facilities around the world.

Around 11 women per 1000 live births had an infection which resulted in or contributed to what is known as a severe maternal outcome – either they died or nearly died – during their hospitalization.

Urgent improvement is needed to manage this life-threatening risk faced by all pregnant and recently pregnant women, wherever they are in the world.

What is maternal sepsis and how does it lead to maternal death?

Maternal sepsis is a life-threatening condition that arises when the body’s response to infection causes injury to its own tissues and organs during pregnancy, child-birth, post-abortion or the postpartum period.

The latest global estimates place sepsis due to obstetric infections as the third most common cause of maternal mortality. However, this only includes infections as a direct result of pregnancy, such as endometritis or post-caesarean wound infections.

Few
previous studies include post-abortion infections. Neither do they address indirect infections such as respiratory and meningitis, which are aggravated by pregnancy but not directly caused by it.

A better understanding of maternal infection

GLOSS was a massive facility-based data collection effort led by WHO, accompanied by a ‘STOP SEPSIS!’ campaign to increase awareness among healthcare providers.

The study gathered data on women who were admitted with suspected or confirmed infection during pregnancy or post-pregnancy over a one-week period in 2017. More than 2800 women participated in the study in 52 countries.

GLOSS included healthcare facilities that care for women during pregnancy, childbirth or at the end of pregnancy, as well as facilities without maternity service but where women could be hospitalized during or after pregnancy, and data on infections
which are not usually recorded as maternal sepsis, including post-abortion and indirect infections.

The result is a more complete understanding of the frequency and impact of maternal infections in health facilities.

GLOSS calls attention not only to the wider range of risks faced by pregnant women but also to the long period of time during which they are at risk.

Putting global numbers on maternal infection and sepsis

Overall, around 70 pregnant or recently-pregnant women per 1000 live births were found to have a maternal infection needing hospital management.

Across the study, 11 women with either direct or indirect infection per 1000 live births developed a severe maternal outcome, but in low- and middle-income countries up to 15 women per 1000 births were affected.

Infections were the underlying cause of most of the deaths recorded during the study, primarily post-abortion infection and indirect infections. Infections were also present in about a third of deaths attributed to other causes, such as postpartum
haemorrhage.

This suggests that the contribution of infection to global maternal mortality and morbidity may be larger than current reports of maternal sepsis mortality suggest.

Preventing, identifying and treating maternal infection and sepsis

Some of the most common maternal infections found in the study, such as urinary tract infections, post-caesarean and post-abortion infections, are largely preventable and treatable.

GLOSS results suggest that current levels of monitoring and clinical care across health facilities are not enough to prevent, identify and treat levels of maternal infection effectively.

For instance, a complete set of vital signs was not reported for a third of the women in the study, on the day their infection was suspected or diagnosed. Delays in antimicrobial therapy were frequent.

GLOSS also shows marked differences across countries, with the highest burden in low- and middle-income countries, compared with high-income countries.

This may reflect the impact of broader health determinants in different country contexts. Challenges of overcrowding, limited access to water and sanitation and constraints to safe births by skilled birth attendants can reduce the ability of healthcare
providers to manage the frequency and outcome of maternal infections.

An opportunity to implement evidence-based practice

GLOSS gives healthcare providers, policy-makers, and the public at large an opportunity: to mobilise around these data improve evidence-based practice, and save lives.

WHO has produced a number of resources which can support timely action to prevent, diagnose and treat maternal infection, as well as activities such as the upcoming SAVE LIVES: Clean Your Hands campaign
on 5 May which celebrates the central role played by nurses and midwives in clean health care.

In addition, WHO will publish a global sepsis epidemiology report around the 73rd World Health Assembly (WHA) in May, as requested in the
2017
WHA Resolution on Improving the prevention, diagnosis and clinical managementof sepsis.

Understanding why and how infection affects women is essential for equipping healthcare providers with life-saving knowledge and enabling health care systems to bring down global maternal mortality and morbidity.

Related publications

WHO recommendations for prevention and treatment of maternal peripartum infections

WHO Clinical practice handbook for safe abortion

Global guidelines on the prevention of surgical site infection

WHO statement on maternal sepsis

World Health Assembly resolution on Improving the prevention, diagnosis and clinical management of sepsis

Health Topics

Antimicrobial resistance

Infection Prevention and Control

Water Sanitation Hygiene

Other links

Global Maternal Sepsis Study

SAVE LIVES: Clean Your Hands 5 May 2020

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https://www.who.int/news-room/detail/27-04-2020-maternal-infections-in-health-facilities

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May 9, 2020
Selling with Confidence: How to Keep Revenue and Prices Up

Selling with confidence gives sales professionals the skills and support they need to resist growing pressure to discount prices. Such confidence is more critical than ever because the pressure to discount comes from two sources. First?no surprise?it comes from customers. In today?s world, when demand is slowing and globalization introduces low-cost competitors, existing and new customers are more insistent than ever that sales people discount and then discount some more. The battle to maintain profits by resisting discounting pressures from customers is tough enough without more pressure coming from yet a second source: the sales person?s sales managers and corporate executives.

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http://www.associationofmarketing.org/whitepapers/view.php?whitepaper_id=71

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April 11, 2020
MIEA warns public to beware of property scams

KUALA LUMPUR: The Malaysian Institute of Estate Agents (MIEA) is advising the public to be cautious in buying and selling properties during the Movement Control Order (MCO) period to avoid falling prey to scams.

MIEA noted that amid the MCO, the majority of Malaysians who are keen to buy or sell property will be relying on online platforms.

“Be extra vigilant as there are still a high number of cases where the general public has fallen prey to these property pitfalls,” it said yesterday.

MIEA president Lim Boon Ping highlighted that registered estate agents (REA) and negotiators (REN) are recognised as professionals under Malaysian law and that there are firm requirements that need to be adhered to when publishing an advertisement in order to protect the public’s interest.

Among others, they are required to include their name, REN/REA number, contact number and the real estate firm they represent with its E registration number and the firm’s telephone number, which the public can verify on www.lppeh.gov.my.

“There will a sudden surge on online and offline advertisement by those illegal brokers who will take advantage on the Covid-19 rise in low priced property deals and these advertisements will not contain the before-mentioned authenticity information and the public should avoid calling them,“ warned Lim.

He reminded that if one sees an advertisement or a property deal that looks “too good to be true”, be extra cautious and do your research”.

“Always engage a registered estate agent or a certified negotiator to verify these potential property deals,“ added Lim. — Bernama

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https://www.thesundaily.my/local/miea-warns-public-to-beware-of-property-scams-AB2245651

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April 11, 2020
MAEPS quarantine centre in Serdang to receive Covid-19 patients next week

KUALA LUMPUR: The Covid-19 Low-Risk Patient Quarantine and Treatment Centre at the Malaysia Agro Exposition Park Serdang (MAEPS) in Serdang near here is expected to receive patients next week.

Mardi Corp Group chief executive officer Zaidi Shahrim however said so far, it had no information on the exact date when the authorities would send the Covid-19 patients there for quarantine.

“MAEPS will receive low-risk Covid-19 patients from around the Klang Valley, Malacca and several areas in Perak,” he said last night in an interview via Skype that broadcast live on the Bernama 7.45 programme.

On the challenges faced throughout the process of transforming MAEPS into a quarantine centre in just a short period of time, Zaidi said said it was difficult to get supplies from contractors as many were ‘bound’ by the Movement Control Order (MCO).

“We received the instruction during the first phase of the MCO but Alhamdulillah, with the close cooperation between various government agencies such as the Ministry of Health (MOH), Nadma (the National Disaster Management Agency), the Fire and Rescue Department and private companies, we managed to realise it within four days,” he added.

Zaidi said MAEPS is equipped with hospital-like facilities such as beds, bathrooms, dressing room, toilet, lounge and so on.

Among the services provided at the centre are clinical services, ward for Covid-19 patients, resuscitation rooms to stabilise patients in emergency situations, ambulance, pharmacy, X-ray, and pathology laboratory services.

The quarantine centre which has the capacity to place up to 600 patients at any one time is coordinated by Nadma with the cooperation of the MOH, the Malaysian Armed Forces, the Fire and Rescue Department, the Civil Defence Force, the Social Welfare Department and the Public Works Department. — Bernama

Read More
https://www.thesundaily.my/local/maeps-quarantine-centre-in-serdang-to-receive-covid-19-patients-next-week-MB2245538

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April 11, 2020
Glossary of Youth: Its Education, Regimen, and Hygiene, by G. Stanley Hall

GLOSSARY

AGAMIC. Unmarried; unmarriageable, sometimes non-sexed.

AGENIC. Lacking in reproductive power; sterile.

AMPHIMIXIS. That form of reproduction which involves the mingling of substance from two individuals so as to effect a mixture of hereditary characteristics. It includes the phenomena of conjugation and fertilization among both unicellular and multicellular organisms.

ANABOLISM. See METABOLISM.

ANAMNESIC. Pertaining to or aiding recollection.

ANEMIC. Deficient in blood; bloodless.

ANTHROPOMORPHISM. The attributing of human characteristics to natural, supernatural, or divine beings.

ANTHROPOMETRY. Science of measurement of the human body.

ARTIFACT. Any artificial product.

APHASIA. Impairment or lose of the ability to understand or use speech.

ASSOCIATIONISM. The psychological theory which regards the laws of association as the fundamental laws of mental action and development.

ATAVISTIC. Pertaining to reversion through the influence of heredity to remote ancestral characteristics.

ATAXIC. Pertaining to inability to coördinate voluntary movements; irregular.

CALAMO-PAPYRUS. Reed papyrus or pen-paper.

CATABOLISM. See METABOLISM.

CATHARSIS. Purgation or cleansing. Aristotle’s esthetic theory that little renders immune for much.

CEREBRATION. Brain action, conscious or unconscious.

CHOREA. St. Vitus’s dance; a nervous disease marked by irregular and involuntary movements of the limbs and face.

CHRESTOMATHY. A collection of extracts and choice pieces.

CHRISTENTHUM. The Christian belief; the spirit of Christianity.

COMMANDO EXERCISES. Gymnastic exercises whose order is dependent upon the spoken command of the director.

CORTEX. The gray matter of the brain, mostly on its surface.

CORTICAL. Pertaining to the cortex.

CRANIOMETRY. The measurement of skulls.

CRYPTOGAMOUS. Having an obscure mode of fertilization; or, of plants that do not blossom.

CULTUS. A system of religious belief and worship.

DEUTSCHENTHUM. The spirit of the German people.

DIATHESIS. A constitutional predisposition.

EPHEBIC. Pertaining to the Greek system of instruction given to young men to fit them for citizenship; adolescent.

EPIGONI. Successors; followers who only follow.

EPISTEMOLOGY. The theory of knowledge; that branch of logic which undertakes to explain how knowledge is possible and to define its limitations, meaning, and worth.

EUPEPTIC. Having good digestion.

EUPHORIA. The sense of well-being; of fullness of life.

EVIRATION. Emasculation; loss of manly characteristics.

FERAL. Wild by nature; untamed; undomesticated.

FORMICARY. An artificial ants’ nest.

GEMÜTH. Disposition; the entire affective soul and its habitual state.

HEBETUDE. Dullness; stupidity.

HEDONISTIC. Relating to hedonism, that form of Greek philosophy which taught that pleasure is the chief end of existence.

HETAERA. A Greek courtesan. This class was often highly trained in music and social art, and represented the highest grade of culture among Greek women.

HETEROGENY. (1) The spontaneous generation of animals and vegetables, low in the scale of organization, from inorganic elements. (2) That kind of generation in which the parent, whether plant or animal, produces offspring differing in structure or habit from itself, but in which after one or more generations the original form reappears.

HETERONOMOUS. Having a different name.

HOROLOGY. The science of measuring time and of constructing instruments for that purpose.

HYGEIA. The Greek goddess of health; health.

HYPERMETHODIC. Methodic to excess; overmethodic.

HYPERTROPHY. Excessive growth.

INDISCERPTIBLE. Incapable of being destroyed by separation of parts.

INHIBITION. Interference with the normal result of a nervous excitement by an opposing force.

IRRADIATION. The diffusion of nervous stimuli out of the path of normal discharge which, as a result of the excitation of a peripheral end organ may excite other central organs than those directly connected with it.

KINESOLOGICAL. Pertaining to the science of tests and measurements of bodily strength.

KINESOMETER. An instrument for measuring muscular strength.

MEDULLATION. The investment of nerve fibers with a protective covering or medullary sheath, consisting of white, fat-like matter.

MERISTIC. Pertaining to the levels or spinal and cerebral segments of the body.

METABOLISM. The act or process by which, on the one hand, dead food is built up into living matter—anabolism, and by which, on the other, the living matter is broken down into simpler products within a cell or organism—catabolism.

METAMORPHOSIS. Change of form or structure; transformation.

METEMPSYCHOSIS. The doctrine of the transmigration of the soul from one body to another.

MONOPHRASTIC. Pertaining to or consisting of a single phrase.

MONOTECHNIC. Pertaining to a single art or craft.

MORPHOLOGY. The science of form and structure of plants and animals without regard to function.

MYOLOGY. The scientific knowledge of the muscular system.

MYTHOPOEIC. Producing or having a tendency to produce myths.

NOETIC. Of, pertaining to, or conceived by, mind.

NUANCE. Slight shade; difference; distinction; degree.

ORTHOGENIC. Pertaining to right beginning and development.

ORTHOPEDIC. Relating to the art of curing deformities.

OSSUARY. A depository of dry bones.

PALEOPSYCHIC. Pertaining to the antiquity of the soul.

PANTHEISTIC. Relating to that doctrine which holds that the entire phenomenal universe, including man and nature, is the ever-changing manifestation of God, who rises to self-consciousness and personality only in man.

PATRISTICS. That department of study occupied with the doctrines and writings of the fathers of the Christian Church.

PHOBIA. Excessive or morbid fear of anything.

PHYLETICALLY. In accordance with the phylum or race; racially.

PHYLETIC. Pertaining to a race or clan.

PHYLOGENY. The history of the evolution of a species or group; tribal history; ancestral development as opposed to ontogeny or the development of the individual.

PHYLUM. A term introduced by Haeckel to designate the great branches of the animal and vegetable kingdoms. Each phylum may include several classes.

PICKELHAUBE. The spiked helmet of the German army.

PLANKTON. Sea animals and plants collectively; distinguished from coast or bottom forms and floating in a great mass.

POLYGAMIC (LOVE). Pertaining to the habit of having more than one mate of the opposite sex.

POLYPHRASTIC. Having many phrases; pertaining to rambling, incoherent speech.

POST-SIMIAN. Pertaining to an age later than that in which simian or monkey-like forms prevailed.

PRENUBILE. Pertaining to the age before sexual maturity or marriageability is reached.

PRIE DIEU. A praying desk.

PROPEDEUTIC. Preliminary; introductory.

PROPHYLACTIC. Any medicine or measure efficacious in preventing disease.

PSEUDOPHOBIAC. Pertaining to a morbid condition in which the subject is continually in fear of having said something not strictly true.

PSYCHOGENESIS. The origin and development of soul.

PSYCHONOMIC. Pertaining to the laws of mind.

PSYCHOSIS. Mental constitution or condition; any change in consciousness, especially if abnormal.

PUBERTY. The age of sexual maturity.

PUBESCENT. Relating to the dawning of puberty.

PYGMOID. Of pygmy size and form.

RABULIST. A chronic wrangler; one who argues about everything.

SCHEMA. A synopsis; a summary. In the Kantian sense, a general type.

SCHEMATISM. An outline of any systematic arrangement; an outline.

SUPERFOETATION. A second conception some time after a prior one, by which two foetuses of different age exist together in the same female. Often used figuratively.

TEMIBILITY. (From Italian temibile, to be feared.) The principle of adjustment of penalty to crime in just that degree necessary to prevent a repetition of the criminal act.

TIC. A nervous affection of the muscles; a twitching.

TRANSCENDENTAL. In the Kantian system having an a priori character, transcending experience, presupposed in and necessary to experience.

TRAUMATA. Wounds.

TRAUMATISM. A wound; any morbid condition produced by wounds or other external violence.

VERBIGERATION. The continual utterance of certain words or phrases at short intervals, without reference to their meaning, as seen in insane Gedankenflucht or rapid flight of thought.

Extract from Youth: Its Education, Regimen, and Hygiene, by G. Stanley Hall

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April 9, 2020