Fears of a polio resurgence in the US have health officials on high alert – a virologist explains the history of this dreaded disease - The Hindu | Canada News Media
Connect with us

Health

Fears of a polio resurgence in the US have health officials on high alert – a virologist explains the history of this dreaded disease – The Hindu

Published

 on


An unvaccinated adult man in New York had contracted polio – the first case in the US since 2013. Image for Representation.
| Photo Credit: Reuters

Fears of polio gripped the US in the mid-20th century. Parents were afraid to send their children to birthday parties, public pools or any place where children mingled. Children in wheelchairs served as a stark reminder of the ravages of the disease.

To prevent polio outbreaks, government officials used tactics now familiar in the era of COVID-19: They closed public spaces and shut down restaurants, pools and other gathering places.

In 1952, two years prior to the introduction of a trial polio vaccine, there were an estimated 58,000 cases of polio and 3,145 deaths due to polio in the US. These cases included children who were paralysed for life. But those numbers dropped dramatically following a widespread vaccination campaign against polio, beginning in 1955.

By the 1970s, there were fewer than 10 cases of paralysis due to polio in the US, and the polio virus was considered eliminated from the US by 1979. Since then, collective fear of the virus has been mostly lost to history – many people alive today are lucky enough not to know someone who has experienced polio.

Also Read: New York governor declares disaster emergency after polio found in wastewater

So when news broke in July 2022 that an unvaccinated adult man in New York had contracted polio – the first case in the US since 2013 – and developed paralysis from the disease, it sent a ripple of fear throughout the public health community and raised the question of whether an old foe was making a comeback.

I am a virologist and a professor of immunology and microbiology and have spent my career both teaching about and doing research on how viruses can cause disease.

There is no cure for polio. The only treatment is prevention. And the tool for prevention is vaccination, the same tool that eliminated polio in the US in the first place.

Life cycle of the poliovirus

Polio – or poliomyelitis – the disease, is caused by the poliovirus, which is passed from person to person through the mouth. And while no one would knowingly ingest a virus, touching a contaminated object like a spoon or a glass or accidentally swallowing contaminated water can unknowingly lead to infection.

When someone is infected with the poliovirus, they shed the infectious virus in their faeces. This is why recent reports that poliovirus has been circulating in New York City wastewater for months and that the virus now has been detected in three New York counties are particularly concerning.

In August 2022, New York State Health Commissioner Mary Basset said that the state health department is “treating the single case of polio as just the tip of the iceberg of much greater potential spread”.

“Based on earlier polio outbreaks,” she added, “New Yorkers should know that for every one case of paralytic polio observed, there may be hundreds of other people infected.”

A single case of polio reflects a larger potential spread of the virus because most people infected either don’t show any symptoms or have a very mild illness with symptoms similar to the flu. But even without symptoms, an infected person is still excreting virus in their faeces, which means they can be a source of infection to others.

The virus, which is very stable in the environment, is easily spread through surface contamination. For this reason, hand-washing is a critical prevention tool. Although many disinfecting agents, such as alcohol or diluted Lysol, fail to inactivate the virus, chlorine bleach does destroy it. This is why public health officials started chlorinating swimming pools decades ago in order to inactivate the polio virus.

Typically, the human body uses stomach acid to protect against ingested viruses. But poliovirus can survive stomach acid to travel to your gastrointestinal tract. There, the virus reproduces itself to establish an infection.

What is paralytic polio?

Unfortunately, one person out of about 200 people infected with poliovirus will develop paralysis. Scientists still don’t know why one person is susceptible to the paralytic disease while most are not.

In the small subset of people that get paralytic polio, the virus can attack the lower motor neurons found in the brain stem and spinal cord, which are important for controlling muscles. Infection of those neurons leads to the muscle paralysis that is characteristic of paralytic polio. The legs are typically affected – often on only one side of the body – and paralysis can range from mild to severe. Other muscle groups can also be affected.

In the worst cases of paralytic polio, the virus can damage the centers of the nervous system that control breathing. Respirators known as “iron lungs” were early medical devices that aided those with damaged respiratory muscles, helping them breathe until their muscles healed enough to work on their own. Patients could die when the paralysis was severe and sustained.

Levels of severity

Although polio can be devastating for those who contract the severe form of it, most people’s immune systems are well-equipped to combat it. When someone recovers from polio, researchers can detect poliovirus-fighting antibodies in the blood.

But even long-term survivors of paralytic polio can develop late-onset muscle weakness and fatigue, which is known as post-polio syndrome. While the muscular effects of post-polio syndrome are well-recognised, a number of other symptoms can be associated with post-polio syndrome, including chronic pain, sleep disturbances, cold intolerance and difficulty swallowing.

Because post-polio syndrome is diagnosed only based on symptoms, there is no consensus on the number of polio survivors who develop it, but estimates range from 15% to upward of 80%.

Prevention of polio is key

The decline in polio in the US and globally is a direct result of the introduction of vaccines and the willingness of the public to accept them. In 1988, the World Health Organisation, in partnership with Rotary International, the Centres for Disease Control and Prevention and other national governments, launched the Global Polio Eradication Initiative with the goal to wipe out polio worldwide, as is the case with smallpox.

When this initiative was launched, there were still an estimated 350,000 children with polio in 125 countries. In 2021, there were only six reported cases.

Two types of polio vaccine are in use worldwide. The one used in the US since 2000 is an injection made from inactivated poliovirus. Inactivation kills the virus and prevents it from spreading. Children in the US get this shot at 2 months, 4 months and between 6 to 15 months of age, and it essentially provides lifelong protection from polio.

The second vaccine type, still in use in many parts of the world, is an attenuated – or weakened – form of the virus that is taken orally. In places where community transmission remains significant, like Pakistan, the oral vaccine is preferred because it prevents people from getting polio and also stops person-to-person transmission.

Also Read: London children under nine to get Polio vaccine after more virus detected in sewage

In the US, where person-to-person transmission of the poliovirus has been virtually nonexistent for decades, the inactivated vaccine is preferred since the focus is on preventing disease in the vaccinated person and there’s less concern about spreading the virus.

But in extremely rare cases, the vaccine virus mutates after it’s been excreted in faeces. And if immunisation levels fall below a critical threshold – as is the case in some areas of the world – this poliovirus can cause disease. The recent New York polio case has been traced back to a mutated vaccine-derived poliovirus thought to be acquired overseas.

Most people in the US are vaccinated through routine childhood vaccinations. Because immunity to polio following vaccination is lifelong, the CDC is not recommending booster vaccinations for the general population for people who completed the full series. However, the CDC does recommend that anyone who has not been vaccinated against polio virus get vaccinated, including adults.

In my office, I keep a painting of Dr Jonas Salk, the virologist who developed the first polio vaccine. It serves as my reminder of the importance of biomedical research to help eliminate human suffering caused by infectious diseases.

(The Conversation)

Adblock test (Why?)



Source link

Continue Reading

Health

Here is how to prepare your online accounts for when you die

Published

 on

 

LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

Source link

Continue Reading

Health

Pediatric group says doctors should regularly screen kids for reading difficulties

Published

 on

 

The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

Source link

Continue Reading

Health

UK regulator approves second Alzheimer’s drug in months but government won’t pay for it

Published

 on

 

LONDON (AP) — Britain’s drug regulator approved the Alzheimer’s drug Kisunla on Wednesday, but the government won’t be paying for it after an independent watchdog agency said the treatment isn’t worth the cost to taxpayers.

It is the second Alzheimer’s drug to receive such a mixed reception within months. In August, the U.K. regulator authorized Leqembi while the same watchdog agency issued draft guidance recommending against its purchase for the National Health Service.

In a statement on Wednesday, Britain’s Medicines and Healthcare regulatory Agency said Kisunla “showed some evidence of efficacy in slowing (Alzheimer’s) progression” and approved its use to treat people in the early stages of the brain-robbing disease. Kisunla, also known as donanemab, works by removing a sticky protein from the brain believed to cause Alzheimer’s disease.

Meanwhile, the National Institute for Health and Care Excellence, or NICE, said more evidence was needed to prove Kisunla’s worth — the drug’s maker, Eli Lilly, says a year’s worth of treatment is $32,000. The U.S. Food and Drug Administration authorized Kisunla in July. The roll-out of its competitor drug Leqembi has been slowed in the U.S. by spotty insurance coverage, logistical hurdles and financial worries.

NICE said that the cost of administering Kisunla, which requires regular intravenous infusions and rigorous monitoring for potentially severe side effects including brain swelling or bleeding, “means it cannot currently be considered good value for the taxpayer.”

Experts at NICE said they “recognized the importance of new treatment options” for Alzheimer’s and asked Eli Lilly and the National Health Service “to provide additional information to address areas of uncertainty in the evidence.”

Under Britain’s health care system, most people receive free health care paid for by the government, but they could get Kisunla if they were to pay for it privately.

“People living with dementia and their loved ones will undoubtedly be disappointed by the decision not to fund this new treatment,” said Tara Spires-Jones, director of the Centre for Discovery Brain Sciences at the University of Edinburgh. “The good news that new treatments can slow disease even a small amount is helpful,” she said in a statement, adding that new research would ultimately bring safer and more effective treatments.

Fiona Carragher, chief policy and research officer at the Alzheimer’s Society, said the decision by NICE was “disheartening,” but noted there were about 20 Alzheimer’s drugs being tested in advanced studies, predicting that more drugs would be submitted for approval within years.

“In other diseases like cancer, treatments have become more effective, safer and cheaper over time,” she said. “ We hope to see similar progress in dementia.”

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The Canadian Press. All rights reserved.

Source link

Continue Reading

Trending

Exit mobile version