Immunization and surveillance gaps pose risks:WHO

16/10/2010

The World Health Organization (WHO) has warned that goals to eliminate measles and reduce hepatitis B infections by 2012 and maintaining a polio-free status are at risk due to the immunization and surveillance gaps in the Western Pacific region. This warning comes despite the regions substantial progress in controlling vaccine-preventable diseases. WHO adds that some member states within the region continue to have inadequate coverage of routine or supplementary immunizations to eliminate these diseases. Dr. Shin Young-soo WHO Regional Director for the Western Pacific told a meeting of WHO Regional Committee members that countries need to make available additional human and financial resources to fully implement the established strategies against vaccines-preventable diseases. Dr. Shin added that preventing the potential spread of imported wild poliovirus by reducing immunization and surveillance gaps in countries is far more cost effective than bringing a polio outbreak under control. Statistics show that the annual number of measles deaths within the Western Pacific region is currently less than 2000a and an estimated 27 countries and area, comprising 88% of the region’s population are likely to achieve the interim milestone of reducing chronic hepatitis B infection to less than 2% among 5 year old children in 2012. By Repeka Nasiko  http://www.fijilive.com/news_new/index.php/news/show_news/28353

Spinal Cord Injury, Spasms, and Serotonin

For release: Monday, September 20, 2010

When people think of spinal cord injury, they tend to think of paralysis.  But a spinal cord injury can also cause debilitating muscle spasms.  Although the drug baclofen can control these spasms, many patients cannot tolerate its side effects, which include general sedation and dizziness.  A new study sheds light on how a spinal cord injury leads to spasms, and on the promise of more precisely targeted drugs with fewer side effects.

The study focuses on what happens to muscle-controlling nerve cells (motor neurons) after a spinal cord injury.  In an intact spinal cord, these neurons are under the command of signals from the brain.  Some signals tell the motor neurons to fire, which causes their associated muscles to contract.  Other signals silence the motor neurons and cause muscle relaxation.

After a spinal cord injury, both kinds of signals are interrupted.  The motor neurons are not under the brain’s control anymore, but they continue to fire spontaneously, leading to spasms.  The new study explains how this spontaneous activity occurs.

The research was led by David Bennett, Ph.D., and Karim Fouad, Ph.D., neuroscientists at the University of Alberta in Canada.  Partial funding came from the National Institute of Neurological Disorders and Stroke.  Dr. Bennett’s lab has a novel system for studying spinal cord injuries in rats; it is the only system in the world that enables researchers to precisely control the environment surrounding the injured spinal cord and simultaneously record the electrical activity of individual spinal neurons.

The researchers theorized that after an injury, spasticity could occur because a small number of intact fibers in the spinal cord continue to produce serotonin – a brain-derived chemical that excites motor neurons.  Yet, in rats with spinal cord injury, there was no evidence of residual serotonin.  Instead, the motor neurons below the injury began producing higher levels of a serotonin receptor that is persistently “on,” even in the absence of serotonin.

“A receptor is supposed to receive by definition,” said Dr. Bennett in an interview with Nature Medicine,* where the study was published.  “The analogy would be a telephone starting to talk without anyone talking into it,” he said.

The research comes full circle with prior clinical studies of cyproheptadine, a drug that blocks many different types of serotonin receptors.  Years ago, cyproheptadine was found to reduce spasticity in patients with spinal cord injury, but it can also lead to overeating and obesity.  Plus, until now, no one understood how it worked.

Dr. Bennett and his colleagues tested cyproheptadine in their rat model of spinal cord injury, and found that it reduces spontaneous motor neuron activity.  They also tested cyproheptadine in several people with spinal cord injury.  By monitoring spasms in the patients’ leg muscles using electromyography (EMG), the team confirmed that the drug acts through the same mechanism in humans as it does in rats.

The experimental drug SB206553, which is more specific than cyproheptadine for the subtype of serotonin receptors found on motor neurons, also reduced spasms in rats.  A drug like SB206553 might be the answer to the side effects observed with cyproheptadine and baclofen, Dr. Bennett said.

SB206553 must be injected directly into the spinal cord, and has not yet been tested in humans. 

And there is another important cautionary note.  Researchers have long recognized that the spontaneous neuronal activity and spasms that follow a spinal cord injury are not uniformly harmful.  For people with partial spinal cord injuries, these changes can actually help maintain muscle tone and support limited movements.  Dr. Bennett and his team confirmed that when rats with a partial spinal cord injury received a high dose of SB206553, they had poor locomotor recovery compared to injured but untreated rats.  This means that careful dosing will be just as important as finding a drug that hits the right target.

-By Daniel Stimson, Ph.D.

*Murray KC et al.  “Recovery of motoneuron and locomotor function after spinal cord injury depends on constitutive activity in 5-HT_2C receptors.”  Nature Medicine, June 2010, Vol. 16, pp. 694-701.

Date Last Modified: Monday, September 20, 2010
http://www.ninds.nih.gov/news_and_events/news_articles/SCI_spasms_serotonin.htm





México a la vanguardia en el Síndrome de Post Polio

Epidemiological Brief WHOi 8: polio outbreak in the European Region and country responses

Poliomyelitis

WHO Epidemiological Brief 8: polio outbreak in the European Region and country responses

Available in:

• English (PDF), 208.8 KB Bajar PDF

As of 30 September, Tajikistan had reported 458 laboratory-confirmed cases of wild poliovirus type 1, including 26 deaths. The last confirmed case had a date of onset of 4 July. Since the beginning of the year, the Russian Federation had reported 12 poliomyelitis (polio) cases and Turkmenistan, 3 cases.

Four rounds of supplementary immunization activities (SIAs) have taken place in Tajikistan and three rounds in Uzbekistan. Kyrgyzstan held its second round of national immunization days (NIDs) on 23–27 August. Turkmenistan’s third round of NIDs took place on 20–29 September. Coverage was extremely high in all rounds in all countries. 

Poliomyelitis

• One of the major challenges of vaccination campaigns is to ensure that every child is vaccinated. This can be particularly difficult in rural, hard-to-reach areas, and among transient populations. (Photo: WHO)

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Fighting polio in Tajikistan

In April 2010, the Government of Tajikistan reported a sharp increase in cases of acute flaccid paralysis (AFP) in the country. AFP – a sudden weakness, paralysis and loss of muscle tone, with no obvious cause (such as trauma) – is the most common sign of poliomyelitis (polio).

Polio is a highly infectious and sometimes fatal disease, which invades the nervous system and can cause total paralysis in a matter of hours. The disease usually affects children under 5 years of age. It can be prevented by immunizing children with a relatively low-cost, easy-to-administer vaccine.

Laboratory analysis of the AFP cases reported in Tajikistan confirmed an outbreak of wild poliovirus type 1. In response, the Ministry of Health and international partners began a comprehensive national immunization campaign consisting of four rounds. The first two rounds focused on immunizing children aged under 5 years of age, and the last two, on children under 15, in health centres and house to house nationwide.

In addition, WHO and its partners have deployed international experts to provide technical support to governments on surveillance and the planning and implementation of immunization campaigns and advocacy initiatives.

More broadly, WHO/Europe supports Member States by monitoring polio immunization coverage and AFP surveillance performance, conducting risk assessments for importation, providing guidance and helping to ensure political commitment. European Immunization Week, held in April each year, is one of the main advocacy initiatives in the WHO European Region to increase the success of immunization programmes.

WHO is keeping all European Member States informed about the situation, and seeking funding for additional immunization initiatives in central Asia. http://www.euro.who.int/en/what-we-do/health-topics/diseases-and-conditions/poliomyelitis/publications/2010/who-epidemiological-brief-8-polio-outbreak-in-the-european-region-and-country-responses

Global Outbreak Alert & Response Network

The Global Outbreak Alert and Response Network (GOARN) is a technical collaboration of existing institutions and networks who pool human and technical resources for the rapid identification, confirmation and response to outbreaks of international importance. The Network provides an operational framework to link this expertise and skill to keep the international community constantly alert to the threat of outbreaks and ready to respond.

GOARN partners working in the field. (wmv, 3:15 min)
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(French)

The Global Outbreak Alert and Response Network (GOARN) (wmv, 1 min)
Download video
(French, Spanish)

To view the videos, download a free version of Windows Media Player 

:: OBJECTIVES

The Global Outbreak Alert and Response Network contributes towards global health security by:

• combating the international spread of outbreaks
• ensuring that appropriate technical assistance reaches affected states rapidly
• contributing to long-term epidemic preparedness and capacity building.

Newspaper Examines Gene That Enables Drug Resistance In Bacteria



The Washington Post looks atthe gene NDM-1, which makes bacteria "resistant to many medications [and] marks a worrying development in the fight against infectious diseases, which can mutate to defeat humans' antibiotic arsenal." The article examines the presumed origin of the gene in India and notes that it "has not jumped into bugs spread by coughing or sneezing, and the three U.S. patients [who have so far been identified with the gene] did not transmit their infections to anyone else. But the microbes can spread readily through other common ways, including contaminated sewage, water and medical equipment and lax personal hygiene such as inadequate hand-washing. Many patients eventually recover, but it remains unclear how many people have died and what the mortality rate is" (Stein, 10/11).

Work Needed To Maintain Fight Against Polio In Nigeria Read more http://www.medicalnewstoday.com/articles/204406.php
México a la vanguardia en Polio y  Síndrome de Post Polio