HEALTH

Measles deaths ‘staggering and tragic’

More than 140,000 people died from measles last year as the number of cases around the world surged once again, official estimates suggest.
Most of the lives cut short were children aged under five.
The situation has been described by health experts as staggering, an outrage, a tragedy and easily preventable with vaccines.
Huge progress has been made since the year 2000, but there is concern that incidence of measles is now edging up.
In 2018, the UK – along with Albania, the Czech Republic and Greece, lost their measles elimination status.
And 2019 could be even worse.
The US is reporting its highest number of cases for 25 years, while there are large outbreaks in the Democratic Republic of Congo, Madagascar and Ukraine.
The Pacific nation of Samoa has declared a state of emergency and unvaccinated families are hanging red flags outside their homes to help medical teams find them.
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What is measles?
Measles is a highly infectious virus spread in droplets from coughs, sneezes or direct contact
It can hang in the air or remain on surfaces for hours
Measles often starts with fever, feeling unwell, sore eyes and a cough followed by a rising fever and rash
At its mildest, measles makes children feel very miserable, with recovery in seven-to-10 days – but complications, including ear infections, seizures, diarrhoea, pneumonia and brain inflammation, are common
The disease is more severe in the very young, in adults and in people with immunity problems
What are the numbers?
The global estimates are calculated by the World Health Organization (WHO) and the US Centers for Diseases Control and Prevention.
They show:
In 2000 – there were 28.2 million cases of measles and 535,600 deaths
In 2017 – there were 7.6 million cases of measles and 124,000 deaths
In 2018 – there were 9.8 million cases of measles and 142,000 deaths
Measles cases do not go down every year – there was an increase between 2012 and 2013, for example.
However, there is greater concern now that progress is being undone as the number of children vaccinated stalls around the world.
“The fact that any child dies from a vaccine-preventable disease like measles is frankly an outrage and a collective failure to protect the world’s most vulnerable children,” said Dr Tedros Ghebreysus, director-general of the WHO.
How are the numbers calculated?
Every single case of measles cannot be counted. In 2018, only 353,236 cases were officially recorded (out of the 7.8 million estimated).
So scientists perform complex maths for each country. -BBC
They take reported cases, the population size, deaths rates, the proportion of children vaccinated and more to eventually produce a global estimate.
Dr Minal Patel, who performed the number-crunching, told the BBC: “We’ve had a general trajectory downwards for deaths, which is great. Everyone involved in vaccination programmes should be very proud.
“But we’ve been stagnating in numbers of deaths for about the past seven years, and what’s really concerning is from last year we’ve gone up, and it looks like we’ve gone backwards.”
What is going on?
In short, not enough children are being vaccinated.
In order to stop measles spreading, 95% of children need to get the two doses of the vaccine.
But the figures have been stubbornly stuck for years at around 86% for the first jab, and 69% for the second.
Why enough children are not being vaccinated is more complicated – and the reasons are not the same in every country.
The biggest problem is access to vaccines, particular in poor countries.
The five worst-affected countries in 2018 were Democratic Republic of Congo, Liberia, Madagascar, Somalia and Ukraine.
The Ebola outbreak in Liberia (2014-16) and plague in Madagascar (2017) have taken a toll on their healthcare systems.
“Democratic Republic of Congo, Somalia and Ukraine, the other countries hardest-hit by measles, each face conflicts, with DRC additionally battling a serious Ebola outbreak and rampant distrust,” Prof Heidi Larson, from the London School of Hygiene & Tropical Medicine, explained.
The other issue is people who do have access to vaccines choosing not to immunise their children.
Will things be worse next year?
It looks likely.
The number of reported cases by mid-November this year was 413,000 compared with 353,000 for the whole of last year.
What do the experts say?
Henrietta Fore, Unicef’s executive director, said: “The unacceptable number of children killed last year by a wholly preventable disease is proof that measles anywhere is a threat to children everywhere.”
Dr Seth Berkley, chief executive of Gavi, the Vaccine Alliance, said: “It is a tragedy that the world is seeing a rapid increase in cases and deaths from a disease that is easily preventable with a vaccine.
“While hesitancy and complacency are challenges to overcome, the largest measles outbreaks have hit countries with weak routine immunisation and health systems.”
Prof Larson said: “These numbers are staggering. Measles, the most contagious of all vaccine-preventable diseases, is the tip of the iceberg of other vaccine-preventable disease threats and should be a wake-up call.” -BBC

She’s changing the cultural stigma around women’s periods

Mekelle, Ethiopia (CNN)When Freweini Mebrahtu got her period at age 13, she panicked. “I was terrified,” she said. “And I remembered (hearing) that it’s actually a curse to have a period … or that it meant I am ready to be married, or (that) I’m being bad.”
Like most girls in northern Ethiopia, she suffered in silence, never mentioning it to her mother or sisters. With no access to sanitary products, she coped by using rags.
“One time I had an accident in class and I was so scared and ashamed,” said Mebrahtu, now 54. “Even today I remember how I felt.”
Mebrahtu went on to study chemical engineering in the United States. She still remembers her first trip to an American drugstore in 1983.
“I saw overwhelming choices of sanitary pads,” she said. “I started thinking … ‘What about the girls that I left behind?’”
In Ethiopia — and many other parts of the world — menstruation is still considered taboo.
According to UNICEF, the subject is generally not taught in schools and most girls never discuss it with another person. Disposable sanitary products are very expensive and often unavailable, so nearly 75% of Ethiopian women and girls don’t have access to the menstrual supplies they need to manage their periods.
The situation has serious consequences. On average, one in 10 girls in Ethiopia miss school for reasons related to their periods; in some rural areas, this increases almost 50%. Missing school can lead girls to fall behind in class and eventually drop out.
Mebrahtu believes no girl should miss school because of her period.
In 2005, she designed and patented a reusable menstrual pad. Today, she and her team produce 750,000 pads a year at her Mariam Seba Sanitary Products Factory, named for her daughter.

Schoeman revived after six-hour cardiac arrest

A British woman whose heart stopped beating for six hours has been brought back to life in what doctors have described as an “exceptional case”.
Audrey Schoeman developed severe hypothermia when she was caught in a snowstorm while hiking in the Spanish Pyrenees with her husband in November.
Doctors say it is the longest cardiac arrest ever recorded in Spain.
Mrs Schoeman, who has made a near-full recovery after the ordeal, says she hopes to be hiking again by spring.
The 34-year-old, who lives in Barcelona, began having trouble speaking and moving during severe weather in the Pyrenees, later falling unconscious.
Her condition worsened while waiting for emergency services and her husband Rohan believed she was dead.
At a press conference on Thursday, Mr Schoeman told Catalan channel TV3: “I was trying to feel a pulse… I couldn’t feel a breath, I couldn’t feel a heartbeat.”
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When the rescue team arrived two hours later, Mrs Schoeman’s body temperature had fallen to 18C.
Upon arrival at Barcelona’s Vall d’Hebron Hospital, she had no vital signs.
But the low mountain temperatures which made Mrs Schoeman ill also helped to save her life, her doctor Eduard Argudo has said.
“She looked as though she was dead,” he said in a statement.
“But we knew that, in the context of hypothermia, Audrey had a chance of surviving.”
Hypothermia had protected her body and brain from deteriorating while unconscious, Mr Argudo said, despite also bringing her to the brink of death.
He added: “If she had been in cardiac arrest for this long at a normal body temperature, she would be dead.”
In a race against time, doctors treating Mrs Schoeman turned to a specialised machine capable of removing blood, infusing it with oxygen and reintroducing it to the patient.
Once her body temperature had reached 30C, they used a defibrillator to jump-start her heart some six hours after emergency services were contacted.
Mrs Schoeman was released from hospital 12 days later, with only some lingering issues with the mobility and sensitivity of her hands due to the hypothermia.
What happens to the body in very cold temperatures?
There have been other cases of adults and children surviving for long periods in very cold temperatures, then being slowly re-warmed in hospital using specialist equipment.
But there is always the risk of brain damage.
Normal body temperature is around 37C (98.6F). When it goes below 35C, shivering, confusion and tiredness can set in. Below 32C, people can pass out altogether and the heart can stop.
In Mrs Schoeman’s case, although extremely dangerous, the cold proved to be a blessing. -BBC