Does being exposed to more virus particles mean you’ll develop more severe illness? Data suggests the relationship between infection and severity may be complex
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Substantial progress has been made during the past decade to prevent and control schistosomiasis (also known as bilharziasis) globally. The disease affects more than 230 million people, mostly in sub-Saharan Africa.
Progress is mainly due to large-scale periodic treatment of affected populations with praziquantel, the only medicine recommended by the World Health Organization (WHO) against all forms of schistosomiasis. Regular treatment cures mild symptoms and prevents
progression to severe, chronic disease.
“Through progressive scale-up of periodic large-scale treatment
to control morbidity in many endemic countries, we are closer to
achieving the minimum target of 75% global coverage of all school‐aged
children,” said Dr Amadou Garba Djirmay, who leads WHO’s global schistosomiasis control programme. “But
if we want to achieve elimination, we must go a step further to
introduce snail control in hot spots and in areas targeting elimination.
This is bound to increase impact and accelerate progress towards
interruption of transmission.”
Expansion of treatment is largely supported by donated praziquantel from Merck KGaA of up to 250 million tablets annually. In 2018, almost 78 million children were treated, representing 63% of all school‐aged children eligible for treatment.
Schistosomiasis is an acute, chronic parasitic disease caused by infection with trematode worms of the genus Schistosoma. It is prevalent in tropical and subtropical areas, especially in poor, rural communities that have little or no access to
safe drinking‐water and basic sanitation. Infection is transmitted when people suffering from schistosomiasis contaminate freshwater sources when evacuating urine and faeces containing the parasite’s eggs.
Once an egg comes into contact with fresh water, it releases miracidia (hatchlings) which enter a snail and produce hundreds of cercariae (larvae) daily. The cercariae enter the human body on contact with the skin and develop into adult worms.
Besides treatment with praziquantel, eliminating snail hosts and improving sanitation are important methods for sustainable prevention of the disease. Dam and irrigation projects are known to be potential sites for outbreaks of the disease. Snail management,
often achieved through mollusciciding, can help to reduce transmission by eliminating these intermediate snail hosts.
In 2017, the World Health Assembly – WHO’s decision making body – adopted resolution WHA70.16 on the Global Vector Control
Response, calling on Member States to develop or adapt national vector control strategies and operational plans. The strategy aims to reduce by at least 40% the incidence of vector borne diseases, including schistosomiasis, by 2025.
In response, WHO is reinforcing snail control as part of its strategic approach to achieve the target of eliminating schistosomiasis as a public health problem and, ultimately, the goal of elimination of transmission. Snail control will complement mass
treatment campaigns and sustain the public health impact of this core intervention.
To facilitate implementation of snail control, in 2019 WHO published on specific, standardized procedures and criteria for efficacy
testing and evaluation and in 2017 a manual on the use of molluscicides in the field. WHO is also planning to strengthen capacities
of health staff in medical malacology in order to reinforce snail control activities in countries.
In the past, molluscicides (particularly niclosamide1 based products) were widely used in schistosomiasis control programmes. For example, in China programmes largely relied on snail control for over 30 years to overcome the disease as a public
health problem. In other parts of the world, however, snail control programmes were gradually discontinued and competencies faded away.
“Snail control is a crucial component of the global schistosomiasis elimination strategy,” said Dr Rajpal Yadav, Scientist, WHO Department of Control of Neglected Tropical Diseases. “It
is time we look for new snail control products that are cost–effective
and of low risk to humans and the environment. Some efforts are being
made to explore molluscicide compounds from plants, marine algae and
microorganisms.”
An integrated control strategy involving mass treatment with praziquantel, snail control and environmental modification, wider access to sanitation and safe water, economic and environmental development, health education and poverty-alleviation can greatly
contribute to sustainable control and elimination of schistosomiasis.
WHO’s new road map on neglected tropical diseases for 2021–2030, due to be launched later this year, advocates enhanced financial and political support to achieve the target of interruption of transmission. Additional research to address gaps,
develop tools and optimize the impact of existing programmes with snail control will complement the core strategic approach.
There are two major forms of schistosomiasis – intestinal and urogenital.
Intestinal schistosomiasis usually results in diarrhoea and blood in the stool; enlargement of the liver and of the spleen and portal hypertension are common in advanced cases.
Urogenital schistosomiasis is characterized by the presence of blood in the urine. Chronic infection results in fibrosis of the bladder and ureter that can evolve to hydronephrosis and create conditions for bladder cancer.
In women, urogenital schistosomiasis can cause vaginal bleeding, pain during sexual intercourse and nodules in the vulva, a condition now described as female genital schistosomiasis. In men, urogenital schistosomiasis can induce disease in the seminal
vesicles and prostate.
1Limitations with the use of formulations based on niclosamide include restrictions on the usage of water immediately after application and temporary toxicity to non-target aquatic organisms including
fish, amphibians and invertebrates.
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https://www.who.int/news-room/detail/25-03-2020-schistosomiasis-elimination-refocusing-on-snail-control-to-sustain-progress
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A number of potential drugs for treating the coronavirus are in trials. There are some promising candidates but it’s unclear if they’ll help those who need them most
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https://www.newscientist.com/article/2238491-we-havent-identified-any-new-drugs-for-severe-covid-19-cases-yet/?utm_campaign=RSS%7CNSNS&utm_source=NSNS&utm_medium=RSS&utm_content=home
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Greta Thunberg says she and her father, Swedish actor Svante Thunberg, appear to have been infected by the coronavirus, though they have not been tested as their native Sweden is only doing so for severe cases
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PETALING JAYA: Sabah’s first Covid-19 patient, a 58-year-old man from Tawau who had been admitted to Hospital Tawau after attending the Seri Petaling mosque tabligh gathering, has died today.
Health director-general Datuk Dr Noor Hisham Abdullah confirmed this in a Facebook post, saying the man had died at 6.27pm today.
He said the man, who is case 152, is a Malaysian who was admitted to Hospital Tawau on March 9 after experiencing Severe Acute Respiratory Infection symptions.
“He was given the assistance using the ventilator and was admitted into intensive care unit on the same day. His health deteriorated day by day and he was confirmed dead on March 20, 6.27pm,“ he said, while expressing his condolences to his immediate family.
This makes the death toll rise to 3 cases, after a 60-year-old pastor from Sarawak and a 34-year-old man from Johor had died due to Covid-19 infections. The 34-year-old man had also attended the same tabligh gathering.
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https://www.thesundaily.my/local/third-casualty-from-covid-19-as-58-year-old-man-from-tawau-dies-KC2163914
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Pregnant people don’t seem to be at greater risk of experiencing severe covid-19, and the virus doesn’t seem to pass to fetuses, but there’s still a lot we don’t know
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KUALA LUMPUR: A total of 41 new COVID-19 cases were reported as at noon today, bringing cumulative cases in the country to 238, Health Director-General Datuk Dr Noor Hisham Abdullah said.
He said all 41 new cases were linked to the tabligh religious gathering, and they involved 37 patient under investigation (PUI) cases while four more are close contact cases.
“To date, a total 203 cases are still being treated, with five in the intensive care unit (ICU) and requiring ventilator support. The five are also being given anti-viral treatment.
“Also, as of today, a total 1,321 samples from influenza-like-illnesses (ILI) and severe acute respiratory infections (SARI) have been tested at the Institute for Medical Research (IMR), all public health laboratories and hospitals. Of those, three samples tested positive for COVID-19,” he said in a statement, here today.
In another development, two earlier cases (case 35 and 61) have recovered and have been discharged from the Sungai Buloh hospital, he said.
This brings the number of recovered cases to 35 so far.
Dr Noor Hisham also advised the public to remain calm and not to spread inaccurate information with regard to the tabligh religious gathering that took place from Feb 28-March 1.
Also, to prevent risk of infection on those from the vulnerable communities and those prone to infection, especially the Orang Asli community, the Health Ministry (MOH) is advising organisations or groups who have plans to conduct activities with these communities to postpone them, he said.
Dr Noor Hisham said the ministry will continue to provide health services to rural communities through outreach activities.
“The ministry also welcomes any form of medical aid, contributions or collaborations from any party, including non-governmental organisations,” he said, adding that offers or inquiries can be submitted through the ministry’s email cprc@moh.gov.my.
Meanwhile in an updated statement issued at 7pm, the MOH said a total 4,942 participants from the tabligh event at the Sri Petaling mosque have been identified.
Of these, 3,069 reported themselves in at Health Clinics for examination and screening while another 137 were referred to hospitals.
“Only 1,634 of them experienced respiratory tract infection symptoms and samples were taken, while 2,932 of them were asked to undergo home surveillance for 14 days from the last day of the gathering. Investigations and tracking of the event participants is ongoing,” the statement read. — Bernama
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https://www.thesundaily.my/local/covid-19-41-new-cases-reported-tally-now-238-EC2127446
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Despite a previous warning by Ben-Gurion University of the Negev (BGU) researchers, who exposed vulnerability in the 911 system due to distributed denial of service attacks (DDoS), the next generation of 911 systems that now accommodate text, images and video still have the same or more severe issues.
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This Medical Product Alert relates to a series of confirmed falsified antimalarials circulating in West and Central Africa. Medicines subject of this alert display a similar logo to the outdated
WHO Essential Drugs Programme logo.
Since 2013, different falsified medicines, all displaying the outdated WHO Essential Drugs Programme logo, have been reported to the WHO Global Surveillance and Monitoring System by various stakeholders. The continued and widespread availability of these falsified medicines highlights a strong need for additional vigilance. WHO previously published two alerts on this issue (No.132 in Oct 2014, and No.131 in March 2014)
This WHO medical product alert N°1/2020 refers to falsified Quinine Sulphate 300mg presented in six different combinations of batch numbers, expiry and manufacturing dates (see Table 1). The fraudulent use of the outdated WHO Essential Drugs Programme logo may create a false sense of product quality.
Table 1: List of identified falsified Quinine Sulphate 300mg, subject of WHO Alert N°1/2020
Recently received results of analysed samples show they do not contain any of the expected active ingredients.
Quinine sulphate is referenced on the WHO Model List of Essential Medicines, to manage and treat severe malaria. At this stage, no adverse reactions attributed to these falsified products have been reported to WHO.
All the above falsified products claim to be manufactured by REMEDICA LTD – Cyprus and to contain 300mg of quinine sulphate. Remedica Ltd has confirmed that:
These falsified medicines display the following common characteristics (please see photographs):
Product details, photographs and advice to the public are available on the following pages.
1. Falsified
Quinine Sulphate Tablets B.P 300mg identified
in Chad (Batch 44680)
WHO requests increased vigilance within the supply chains of countries likely to be affected by these falsified products. Increased vigilance should include hospitals, clinics, health centres, wholesalers, distributors, pharmacies and any other suppliers of medical products.
If you are in possession of the above products, please do not use. If you have used these falsified products, or if you suffer an adverse event having used these products, please seek immediate advice from a qualified healthcare professional, and ensure they report the incident to your local Ministry of Health/National Medicines Regulatory Authorities/National Pharmacovigilance Centre.
All medical products must be obtained from authentic and reliable sources. Their authenticity and condition should be carefully checked. Seek advice from a healthcare professional in case of doubt.
National health authorities are asked to immediately notify WHO if these falsified products are discovered in their country. If you have any information concerning the manufacture, distribution, or supply of these products, please contact rapidalert@who.int .
For further information, please visit our website: www.who.int/medicines/regulation/ssffc/en/
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https://www.who.int/news-room/detail/09-03-2020-medical-product-alert-n-1-2020-english-version
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