172 Million RwF is total amount given by Liquid Telecom Rwanda to the Ministry of Health Rwanda to tackle Ebola. The event happened yesterday 4th Nov 2014 and the large ceremonial cheque was officially handled over by Sam Nkusi, Chairman Liquid Telecom Rwanda to the Hon. Minister of Health, Dr. Agnes Binagwaho.

The Hon. Minister expressed her gratitude to Liquid Telecom Rwanda as the first private company to support Government’s efforts to fight Ebola and urged other private sector companies to emulate this example as Ebola is now a global issue that requires the collaboration of all sectors.

Dr. Binagwaho added that so far, Rwanda has spent 400 million francs to prepare almost 300 isolation centers and to train health personnel in all districts in preparedness of Ebola response in the country.

Sam Nkusi, Chairman Liquid Telecom Rwanda mentioned that prevention is better than cure and that’s why all Rwandans need to support the MoH in the fight against the deadly Ebola. He added that this aid can be used in many ways such as training health staff, acquiring equipment, raising awareness and education in population, etc.

Ebola is now a global issue as new cases increase every day with West African countries mostly affected being Guinea, Liberia and Sierra Leone. Two other countries, Nigeria and Senegal, have had cases but were recently declared Ebola-free. The DR Congo had an outbreak of a different strain of Ebola that now looks like it might be contained. And while there has been one case of the disease in Mali, the patient died and no others have been confirmed.

The East African countries are Ebola free and have set up various efforts to prevent against entry of the virus. Rwanda specifically has set up an Emergency Ebola Preparedness and Response Team in charge of implementing and monitoring preventive measures established at all levels including screening of all arrivals at different border points especially airports and following up all suspected cases. In the last two weeks thirty people, mostly Rwandans returning home, have been declared free of suspicion of infection after being quarantined for the mandatory 22 days.

Liquid Telecom is the leading independent data, voice and IP provider in Eastern, Southern and Central Africa. Liquid Telecom has built Africa’s largest single fiber network, currently stretching over 17,000km across Uganda, Kenya, Rwanda, Zambia, Zimbabwe, Botswana, DRC, Lesotho and South Africa.

Dr. Gilbert Biraro

KigaliHe.com

How would Papua New Guinea deal with Ebola?

By Michael Toole, AM, Burnet Institute

Contemplating how Papua New Guinea (PNG) would deal with Ebola may not be that different from asking the same of Liberia 12 months ago. While PNG’s per capita gross national income (US$2,540 in 2013) is much higher than Liberia (US$880), there are similarities between their health systems. Each country, for example, has around six doctors for every 100,000 residents.

The Ebola epidemic in West Africa remains out of control, with the cumulative case count doubling every 20 days. As of October 27, the World Health Organization (WHO) reported a total of 13,703 suspected cases and 4,920 deaths. The WHO predicts that there could be as many as 10,000 new Ebola cases per week by December 2014.

As the number of cases increases rapidly, the likelihood of exportation to other countries rises and PNG is not immune, having an international airport with direct flights from at least eight foreign cities. PNG is, of course, Australia’s closest neighbour and the Commonwealth government says it is preparing to respond to any regional outbreak.

The PNG government has established a National Response Technical Taskforce on Ebola. Construction of a quarantine facility at the country’s international airport is underway and a traveller declaration form will be issued at airports where flights to PNG originate. However, the country’s capacity to treat infected patients and prevent further spread is very limited.

PNG’s gross national income has grown more than threefold since 2005 as a result of the resources boom. However, the health system has not kept pace with economic growth. Expenditure on health was just US$114 per capita in 2012, comparable with Sudan. Life expectancy is shorter and infant mortality is higher than most neighbouring Pacific countries.

Many government-run health clinics have closed in recent years due to lack of trained personnel. Availability of basic essential medical supplies in health centres rarely surpassed 60% of requirements between 1999 and 2010. A recent study published in DevPolicy Blog found an 18% decline in patients utilising a health clinic between 2002 and 2012, despite a 30% increase in the population during that period.

The poor capacity of the health system in PNG to control infectious diseases is illustrated by the continuing high transmission of tuberculosis (TB) and the emergence of highly resistant TB strains. The national rate of new cases of TB is unknown; however, based on data from Western and Gulf Provinces, it may be higher than 700 per 100,000 population, which is among the highest in the world.

There has been a rapid increase in drug-resistant TB circulating in communities; for example, in Western Province in 2013, 20% of new TB cases were drug-resistant. An external review of the national TB program early in 2014 found that infection control and isolation facilities were sub-standard in most health facilities.

Another worrying sign of lack of preparedness is the cholera outbreak that began in July 2009 and was still not under control by mid-2011 by which time there had been 15,500 cases and more than 500 deaths. It is unlikely that PNG health facilities could cope with any number of patients with Ebola, which is much more challenging to treat (and prevent) than cholera.

So, how could Australia help reduce the impact of Ebola if the virus were to arrive in PNG?

Assistance in developing a preparedness plan is the most urgent priority. This plan needs to map out the details of diagnosis, treatment, infection control, contact tracing, surveillance, and public education and identify the resources to implement the plan. In the event of Ebola cases occurring in the country, direct Australian assistance in the form of medical teams, equipment and logistical support may be needed.

It is difficult to know how the Australian government is planning to respond to Ebola outbreaks in the region because there is very little public information available. The aid section of the DFAT website, for example, makes no reference to Ebola.

The Department of Health website has information for consumers and health professionals on preparedness in Australia but does not refer to Australia’s potential role in the Asia-Pacific region. Nor is there any reference to Ebola on the website of the National Critical Care and Trauma Response Centre in Darwin, which hosts Australian Medical Assistance Teams (AUSMAT).

On 22 October, the Chief Medical Officer Professor Chris Baggoley told a Senate Estimates Hearing that it would take up to two weeks to train AUSMAT teams before they would be ready to assist in the response to Ebola outbreaks in the region. However, the health minister Peter Dutton responded by saying:

A team of 20 is ready to be dispatched to anywhere in the region, possibly Papua New Guinea, if an outbreak occurs nearby.

Based on the recent performance of the health system in PNG, the country is ill-prepared to deal with an outbreak of Ebola. If this should happen, the logical source of external assistance would be Australia. But there is no coherent evidence that Australia is capable of doing so.

Michael Toole, AM does not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article, and has no relevant affiliations.

This article was originally published on The Conversation.
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Health Check: what does my blood group mean?

By Ashley Ng, Walter and Eliza Hall Institute

Few discoveries have revolutionised the practice of medicine as much as the discovery of human red blood cell groups.

Unlike modern vampire and Time Lord mythologies, blood groups don’t have a particular flavour (Tru blood) or make humans susceptible to hypnotic mind control (Dr Who). Rather, blood is categorised by the naturally occurring proteins and sugars on the surface of red blood cells.

For most people, which blood group you are does not matter one jot, unless your life is at risk and you need a blood transfusion. In this case, the proteins and sugars can act as a barrier to safe transfusion of red blood cells from one person to another.

The ABO blood group system

Prior to the 20th century, early attempts at transfusing blood into humans could be unpredictable and lead to death. Looking for a solution, immunologist Karl Landsteiner found that the blood of two people could be either “compatible” or “incompatible” in a predictable way: “incompatible” blood led to “clumping” (agglutination) of red blood cells in a test tube, while “compatible blood” did not.

Along with Alfred von Decastello and Adriano Sturli, Landsteiner identified the four major blood groups: O, A, B and AB or what is known as the ABO blood group system.

Landsteiner realised what made blood types compatible or incompatible were antibodies produced against specific red blood cell sugar molecules, causing agglutination of the red cells in the test tube and destruction of the red cells in the circulation. For this work, Landsteiner was awarded the Nobel Prize in Medicine.

Ludwig Hektoen developed rigorous testing procedures of blood grouping and cross matching in 1907 which were first performed by Reuben Ottenberg. These methods have been used to reliably select the correct donor blood ever since.

Beyond the ABO blood group

In general, everyone can be classified within ABO blood group system, based on the ABO sugars. Red blood cells also contain many other proteins and sugars, known as red cell antigens. Researchers have discovered more than 300 blood group antigens, each representing different proteins on the red blood cell that perform different functions.

The importance of these red cell blood groups, however, is not necessarily what they do; you could live without several blood group antigens and be none the wiser. Their importance of lies in how they elicit an immune antibody response, and whether these new antibodies can destroy foreign red cells against which they are targeted.

The immune system of person who doesn’t have these antigens can be stimulated to make antibodies against red cell antigens that aren’t their own. This can cause red cell destruction (haemolysis) which, in its most immediate and dramatic form, can lead to severe stress to the heart and circulation, kidney failure and death. It can also lead to a delayed form of red cell destruction that occurs a week or so after a blood transfusion.

Positive or negative

One of the most important non-ABO blood groups is the Rhesus blood group system, which Landsteiner discovered in 1940 in collaboration with Alexander Weiner. This system categorises people as either positive or negative, depending on whether they have Rhesus D antigen on their red cells (O- or O+ for example).

Since the late 1800s, physicians had noted that following a successful first pregnancy, some mothers could lose their subsequent babies through a disease called haemolytic disease of the fetus and newborn. For the majority of babies, this condition was attributable to the Rhesus D antigen.

Researchers realised that Rhesus D-negative mothers were exposed to Rhesus D antigen through the course of their pregnancy. The baby had inherited this red cell antigen from their father. The mother’s immune system therefore reacted against this foreign red cell antigen by producing antibodies which could cross the placenta and destroy the red cells of the baby in subsequent pregnancies.

The understanding of the Rhesus system led to strategies that have dramatically reduced haemolytic disease among newborns. Rhesus D-negative women of child-bearing age are only given blood transfusions of Rhesus D-negative blood to prevent stimulating the immune system against this antigen.

Pregnant Rhesus D-negative women are also given special anti-D immunoglobulin during their pregnancy, after delivery and following any trauma or pregnancy-related procedure. Again, this helps prevent foreign Rhesus D-positive red cells from stimulating the mother’s immune system.

Rare blood groups

What ultimately determines our blood group is our genetics: our parents, our ancestors and also their migration patterns.

Rare blood groups arise from inheritable mutations of red blood cell genes in different populations. This can make it very difficult to find correctly “matched” blood donor units for people with rare blood groups simply because they are uncommon in the usual volunteer blood donor population.

The red cell blood group Kidd(null) phenotype (Jka-b-) which is more common in Finnish and Polynesian populations, for instance, is very rare in Australian blood donors. Unless a correctly matched Jka-b- blood is found, there is a risk of developing a haemolytic transfusion reaction or haemolytic disease of the newborn, as patients develop antibodies that are acquired to Kidd red cell blood groups on the transfused blood.

People with the Bombay red cell phenotype have only a one in a million chance of finding a suitable blood donor. In this setting, transfusion may be sought from a family member, who is much more likely to have the correct blood phenotype.

It’s likely that you or someone you know will require a blood transfusion at some stage in life. One of the simplest things we can do as individuals is to become a volunteer blood donor.

Ashley Ng currently receives funding from The National Health and Medical Research Council.
He has previously received funding from the Leukaemia Foundation Australia and Cure Cancer Australia.
He has previously been the Lions Fellow of the Cancer Council of Victoria and has been awarded a Sir Edward Dunlop Fellowship.

This article was originally published on The Conversation.
Read the original article.

Bad breath, also known as halitosis, is breath that has an unpleasant odor. This odor can strike periodically or be persistent, depending on the cause. In many people, the millions of bacteria that live in the mouth (particularly on the back of the tongue) are the primary causes of bad breath. The mouth’s warm, moist conditions make an ideal environment for these bacteria to grow. Most bad breath is caused by something in the mouth.

Maintaining proper oral health can help reduce or eliminate bad breath.

Some types of bad breath, such as “morning mouth,” are considered to be fairly normal, and they usually are not health concerns. The “morning mouth” type of bad breath occurs because the saliva that regularly washes away decaying food and odors during the daytime diminishes at night while you sleep. Your mouth becomes dry, and dead cells adhere to your tongue and to the inside of your cheeks. Bacteria use these cells for food and expel compounds that have a foul odor.

 

In addition, bad breath can be caused by the following:

Poor dental hygiene — Infrequent or improper brushing and flossing can leave food particles to decay inside the mouth.

When a person does not brush or floss their teeth thoroughly, food particles that may remain in the mouth can rot and cause foul odors. In addition, food particles over time can promote the growth ofbacteria, which can also cause foul odors. The bacteria can also lead to tooth decay and gum disease.

Foods with strong odors also affect the air a person exhales. Foods commonly known to contribute to bad breath include onions andgarlic, exotic spices (such as curry), some cheeses, fish, and acidic beverages such as coffee. Foods are absorbed into the bloodstream and then transferred to the lungs, causing noticeable odors when exhaled. These foods may also cause stomach and gastrointestinal upset and belching, which can contribute to bad breath. In addition, certain supplements, such as fish oil capsules, can contribute to bad breath.

Low-carbohydrate diets may also cause what is known as “ketone breath.” So-called “low carb” diets cause the body to burn fat as its energy source. The end product of making this energy is ketones, which cause a fruity acetone-like odor on the breath when exhaled.

Infections in the mouth — Periodontal (gum) disease

Respiratory tract infections

Throat infections, sinus infections, lung infections

External agents

Garlic, onions, coffee, cigarette smoking, chewing tobacco

Dry mouth (xerostomia)

Bad breath can also be caused by decreased flow of saliva, which is a vital part of the digestive process and removes odor-causing particles in the mouth. Also called xerostomia, dry mouth may be caused by medications, breathing through the mouth, or salivary gland problems.

Systemic illnesses

Diabetes, liver disease, kidney disease, lung disease, sinus disease, reflux disease and others

Dentures or Dental Appliances

Dentures or dental appliances, such as braces, can contribute to bad breath. Most often, it is due to food particles that are not properly cleansed from the appliances. Loose-fitting dentures can contribute to sores and localized infections in the mouth, which can cause bad breath.

Psychiatric illness — Some people may perceive that they have bad breath, but it is not noticed by oral-health-care professionals or others. This is referred to as “pseudohalitosis.”

Symptoms

A person may not always know that he or she has bad breath. This phenomenon is because odor-detecting cells in the nose eventually become accustomed to the constant flow of bad smells from the mouth. Others may notice and react by recoiling as you speak.

Other associated symptoms depend on the underlying cause of bad breath:

Poor dental hygiene — Teeth are coated with film or plaque, food debris trapped between teeth, pale or swollen gums

Infections in the mouth — Gums may be red, swollen and bleed easily, especially after brushing or flossing; pus may drain from between teeth; a pocket of pus (abscess) at the base of a tooth; loose teeth or a change in “fit” of a denture; painful, open sores on the tongue or gums

Respiratory tract infections — Sore throat, swollen lymph nodes (“swollen glands”) in the neck, fever, stuffy nose, a greenish or yellowish nasal discharge, a mucus-producing cough

External agents — Cigarette stains on fingers and teeth, a uniform yellow “coffee stain” on teeth

Dry mouth — Difficulty swallowing dry foods, difficulty speaking for a prolonged period because of mouth dryness, a burning sensation in the mouth, an unusually high number of dental caries, dry eyes (in Sjögren’s syndrome)

Systemic (bodywide) illnesses — Symptoms of diabetes, lung disease, kidney failure or liver disease

Diagnosis

A dentist or physician may notice the patient’s bad breath while the patient is discussing his or her medical history and symptoms. In some cases, depending on the smell of the patient’s breath, the dentist or physician may suspect a likely cause for the problem. For example, “fruity” breath may be a sign of uncontrolled diabetes. A urine-like smell, especially in a person who is at high risk of kidney disease, can sometimes indicate kidney failure.

Your dentist will review your medical history for medical conditions that can cause bad breath and for medications that can cause dry mouth. Your dentist also will ask you about your diet, personal habits (smoking, chewing tobacco) and any symptoms, including when the bad breath was noticed and by whom.

Your dentist will examine your teeth, gums, oral tissues and salivary glands. He or she also will feel your head and neck and will evaluate your breath when you exhale from your nose and from your mouth. Once the physical examination is finished, your dentist may refer you to your family physician if systemic problems are the most likely cause. In severe cases of gum disease, your dentist may recommend that you be seen by a periodontist (dentist who specializes in gum problems).

You will need diagnostic tests if the doctor suspects a lung infection, diabetes, kidney disease, liver disease or Sjögren’s syndrome. Depending on the suspected illness, these tests may include blood tests, urine tests, X-rays of the chest or sinuses, or other specialized testing.

Expected Duration

How long bad breath lasts depends on its cause. For example, when the problem results from poor dental hygiene, proper dental care will begin to freshen the mouth immediately, with even more impressive results after a few days of regular brushing and flossing. Periodontal disease and tooth abscess also respond quickly to proper dental treatment. Bad breath resulting from chronic sinusitis may be a recurring problem, especially if it is caused by a structural abnormality of the sinuses.

Bad breath the results from a systemic illness may be a long-term problem that can often be controlled with proper medical care.

Prevention

Bad breath caused by dental problems can be prevented easily. Daily maintenance calls for brushing your teeth, tongue and gums after meals, flossing, and rinsing with mouthwashes. Regular visits to the dentist (at least twice a year) should be made for dental examinations and for professional teeth and gum cleaning.

Bad breath also can be combated by drinking plenty of water every day to encourage saliva production. An occasional swish of the mouth with water can loosen food particles. Other products that keep breath fresh and prevent plaque from forming include sugar-free gum, sugarless lozenges, raw carrots and celery.

Treatment

The treatment of bad breath depends on its cause.

Visit your dentist promptly if you have bad breath with painful, swollen gums that bleed easily or loose teeth. Also, visit doctor if you have bad breath along with a fever, sore throat, a postnasal drip, a discolored nasal discharge or a mucus-producing cough. Even if you have none of these associated symptoms, call your dentist or physician if your bad breath continues despite a good diet and proper dental hygiene.

If you have diabetes, gastroesophageal reflux disease (GERD) or chronic liver or kidney disease, ask your doctor how bad breath can be a sign that your underlying medical condition needs immediate medical attention.

By Omar Sydney

Kigalihe.com

Gastritis is inflammation (irritation) of the stomach lining. This may be caused by many factors including infection, alcohol, particular medications and some allergic and immune conditions. Gastritis can be either acute (with severe attacks lasting a day or two) or chronic (with long-term appetite loss or nausea). In many cases, gastritis has no symptoms (asymptomatic).

Gastritis must be identified and treated to prevent further pain, discomfort, and complications. Paying attention to your body’s warning signs can help pinpoint gastritis earlier, so the inflammation clears up and you can begin enjoying life once more.

One of the most common forms of gastritis is caused by medication, the widely used painkillers, which include ibuprofen , diclofenac, and naproxen , are known to affect the stomach and lead to irritation and swelling if taken on a routine basis.

Some forms, including chronic atrophic gastritis, have been associated with an increased risk of stomach cancer. Treatment options include avoiding exposure to known irritants and taking medication to reduce the amount of gastric juices.

Symptoms

In many cases, gastritis has no symptoms. Common symptoms can include:

Loss of appetite

Pain in the upper abdomen just under the ribs

Nausea or indigestion

Hiccups

Vomiting

Blood in the vomit

Blood in the bowel actions, if the stomach lining has ulcerated (this turns stools black and is called melaena)

Weight loss.

 

Risk factors:

Although anyone can get gastritis, certain factors can raise your risk. These include:

Infection with H. pylori, a common bacteria associated with stomach ulcers

Smoking

Drinking alcohol

Thinning of the tissues lining the stomach

Viral infections

Overproduction of stomach acid

Older people or those with weakened immune systems are at a greater risk of developing gastritis. Some people may have genetic abnormalities that predispose them to developing gastritis. Those who take NSAIDs consistently to treat chronic conditions like arthritis or pain should be aware of their risk of developing gastritis and talk to their doctors about protecting their stomachs.

Besides smokers and heavy drinkers, others at risk of getting gastritis include those who drink acidic beverages (like coffee) and are under constant stress (which produces lots of gastric acid).

 

Diagnosis:

Diagnosing gastritis involves a variety of tests, including:

History and physical examination

Endoscopy – a thin flexible tube is threaded down the oesophagus into the stomach. The endoscope is fitted with a small camera so the physician can look at the stomach lining. If the gastric mucosa is reddened, this may indicate gastritis. A biopsy is needed for confirmation.

Biopsy – small tissue samples are taken during an endoscopy and tested in a laboratory. The pathologist will look for changes, including the presence of inflammatory cells and epithelium damage.

Once your gastritis is diagnosed — either by your clinical history or an upper endoscopy treatment can begin.

 

Gastritis treatment varies from person to person and depends on what’s causing the inflammation. Treatments generally focus on fixing the problem that’s actually causing the gastritis, like clearing up an infection.

 

If you’re taking a drug that is irritating your stomach and causing gastritis, your doctor will probably put you on something less irritating. You might also be given medication to reduce stomach acid in order to control the inflammation. And you might have to stop consuming certain foods and beverages, like coffee, alcohol, and acidic fruit juices, that can worsen gastritis symptoms.

Identifying the cause – once the cause is identified, steps can be taken to avoid exposure. For example, if alcohol is triggering the inflammation, you can abstain or reduce the amount of alcohol you drink. Anti-inflammatory drugs taken to help manage other conditions may need to be stopped or replaced with an alternative.

Medications – tablets are available to reduce the acid content in the gastric juices. You may need to take these medications for a few weeks or months, depending on your situation.

Dietary modifications – such as limiting or avoiding alcohol and caffeine, which can irritate the stomach lining.

No treatment – often gastritis is found by chance during an endoscopy. If Helicobacter pylori is not present, and there are no other features seen on biopsy, there is usually no need to treat the gastritis.

Helicobacter pylori infection:

The Helicobacter pylori bacterium causes gastritis and is also responsible for most peptic ulcers. A peptic ulcer is a hole in the lining of the stomach, duodenum or oesophagus. Helicobacter pylori bacterium is thought to be a cause of indigestion and a contributing factor in the development of stomach cancer.

 

The germs live in the lining of the stomach and the chemicals they produce cause irritation and inflammation. Diagnosis includes a special breath test to check for gaseous by-products of the bacteria. Treatment includes a combination of different antibiotics and antiacids.

Omar Sydney

Kigalihe.com

 

Dr. Cyprien SHYIRAMBERE, a Pediatrician in Rwanda’s Butaro District Hospital has earned the Award for Best Poster Presentation during the 46^th Congress of The International Society of Pediatrician Oncology that ended today in Toronto, Canada.

The Annual SIOP (French acronym for “Société Internationale d’Oncologie Pédiatrique”) Meeting held between 22 and 25^th October 2014 is the only truly international scientific and educational meeting in the area of Pediatric Oncology held in the world. It reflects the intimate international structure of SIOP, providing high quality opportunities and a comprehensive view of the latest news in the entire field of childhood cancer within a three day period.

The Toronto meeting brought something innovative “Young Investigator Awards”, a prize initiated by the SIOP Scientific Meeting. More than 1300 abstracts were submitted for SIOP 2014 and Dr. Cyprien’s abstract was selected among the Awards winners. Ten awards were given out to the best scientific research submitted by young investigators for SIOP 2014.

 

Dr. Cyprien presented a poster on the “Preliminary Treatment Outcomes Utilizing SIOP Guidelines in a Novel Oncological Care Model for Wilms’ Tumor in Rwanda; as part of an assessment done in cancer patients who were treated in Rwanda’s most advanced cancer care center located in rural Butaro Hospital.

Cancer, along with other non-communicable diseases like diabetes and heart disease, are said to be ‘diseases of development,’ and seem to be increasing just as fast as Rwanda is developing. An “Analysis of Facility-based Cancer Registries in Rwanda from 2007 to 2013 revealed a total of 5,430 cancer cases registered in Rwanda among which 360 were in children ages 15 and younger.

Apart from Butaro Hospital, cancer services in Rwanda are also found at CHUK, CHUB, KFH, KMH, Rwinkwavu hospitals. Cancer is an emerging public health problem in Africa, the International Agency for Research on Cancer (IARC), cites about 715,000 new cancer cases and 542,000 cancer deaths occurred in 2008 on the continent.

The figures have potentially increased because of the adoption of behaviors and lifestyles associated with economic development, such as smoking, unhealthy diets, and physical inactivity but also simply due to the aging and growth of the population.

The SIOP Annual meeting has been an important platform where medical experts, researchers, and scientists convened to share experiences and lessons based on the most up to date research in pediatric oncology. The next meeting will take place next year in South Africa.

By Dr. Gilbert Biraro

Kigalihe.com

Infection projections: how the spread of Ebola is calculated

By Jonathan Keith, Monash University

The number of reported Ebola cases is doubling roughly every five weeks in Sierra Leone, and in as little as two to three weeks in Liberia.

The number of reported cases globally is projected to reach 10,000 by the end of October. The actual number of cases may be twice the official figure. So how are such figures estimated – and what can bioinformatics do to help control the disease?

The 2014 Ebola outbreak in West Africa appeared suddenly and spread rapidly, and is thought to have started with a single animal-to-human transfer in December last year. It’s an example of an emerging infectious disease (EID): one that has newly appeared in a population or has undergone a rapid increase in incidence. SARS and various strains of avian influenza are examples of EIDs.

EIDs are often zoonoses – animal diseases that have infected humans as hosts and become transmissible. Such “host-switching” events can happen anywhere at any time, and preparedness to respond rapidly and effectively when this occurs is an important aspect of public health policy.

One parameter that epidemiologists use to quantify the rate of a disease’s spread is the basic reproduction number: R0 (R-nought).

This is the number of new cases generated on average by each infected individual, in idealised conditions. Diseases with R0 less than 1 are not likely to become epidemics, but those with R0 more than 1 have the potential to spread exponentially.

Current estimates for Ebola indicate an R0 of around 2 – higher than the R0 of some strains of influenza – although it varies between regions.

Other parameters that determine the spread dynamics of a disease include the length of time the disease takes to incubate, and the period of time during which diseased individuals are infectious.

A key parameter is the proportion of cases that are identified. Many cases, including some that result in death, are not reported, either because victims do not seek medical care, or because overwhelmed medical personnel might fail to accurately record all interventions.

This is important not only because under-reporting reduces the effectiveness of management strategies, but also because it can influence estimates of the other parameters mentioned above, particularly if there is variation in reporting levels across regions.

Attempts have been made by the Centre for Disease Control to estimate the degree of under-reporting for Ebola, but these are currently not very accurate. The World Health Organization (WHO) estimates that the actual number of cases in Guinea is about 1.5 times the reported figure, with corresponding factors of 2 for Sierra Leone and 2.5 for Liberia.

(The WHO hasn’t published the methodology used to estimate these figures: they may be little more than guesses.)

Putting the pieces together

Bioinformatics plays a key role in detecting, monitoring and responding to EIDs.

In the case of Ebola, the bioinformatics community has responded rapidly. For example, the current outbreak of Ebola in Sierra Leone was first detected in May, but by September a study reported sequencing 99 Ebola virus genomes from 78 patients diagnosed with the disease between late May and mid-June.

The process of sequencing a genome involves assembling many thousands of short sequences – gene fragments obtained from all over the genome. Algorithms for assembling genome sequences detect overlaps between fragments, and align and merge them to reconstruct the sequence of the whole genome.

Bioinformaticians have been developing and refining algorithms for sequence assembly since the late 1980s, and are constantly adapting them so they can handle new sequencing technologies and ever-larger scales of assembly.

By the end of September this year, the UC Santa Cruz Genomics Institute had released a new Ebola genome browser with an alignment of 148 individual viral genomes, including 102 from the current outbreak. This was a monumental effort: UCSC researcher Jim Kent led a team that reportedly worked around the clock in the last week of September to produce the browser.

Such genome browsers will undoubtedly accelerate global efforts to develop a vaccine and antiserum.

One of the advantages of having whole genome sequences is that they can be used to reconstruct the family tree (phyolgeny) of Ebola viruses, and trace the course of the outbreak. Reconstructions of this kind can provide important insights into the successes and failures of current management strategies.

They can also be used to estimate parameters that govern how rapidly the virus spreads, in terms of both number of cases and geographic range.

These can, in turn, be used to forecast the future course of the epidemic and predict the impact of various management strategies.

There are many other ways in which bioinformatics contributes to the management of EIDs. Genomic sequence analyses can lead to a better understanding of the biology of a disease, the features that make it pathogenic, and potential drug targets or clinical interventions.

A recent survey of Australian life sciences conducted by Bioinformatics Resource Australia EMBL (BRAEMBL) found that bioinformatics is seen by many laboratory scientists as core to their work, but also identified marked community concern about a lack of expertise and access to expertise in bioinformatics.

In light of the importance of bioinformatics in managing EIDs, and its growing role in facilitating research in the life sciences more generally, it is important that students and early career researchers from mathematics, statistics, computer science and biology are attracted into this field, and receive world-class training in its practice and implementation.

Bioinformatics is, and will continue to be, a core component of the international response to Ebola and other EIDs, and patients, medical staff and those close to them need all the help they can get.

The annual BioInfoSummer conference and training workshop is an initiative of the Australian Mathematical Sciences Institute. This year the event is being hosted by Monash University on 1-5 December.

Jonathan Keith is Director of the BioInfoSummer 2014 conference and workshop.

This article was originally published on The Conversation.
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When you’re stressed or just finished up a hard workout, jumping into a warm shower probably seems only natural. The warm water promotes blood flow to your skin, helping to soothe tired, achy muscles and helping you to relax. However, there may be good reason to turn the faucet to cold when you shower,both after a workout and on an intermittent basis.

Exposure to cold temperatures via cold water and ice baths, otherwise known as cold water immersion or “cryotherapy,” is a popular technique among amateur and professional athletes, but it may offer health-boosting benefits for virtually everyone.

 

Why Take a Cold Shower After Exercise?

Cold works by lowering the damaged tissue’s temperature and locally constricting blood vessels.vUsing targeted cold therapy, such as an ice pack, immediately after an injury helps prevent bruising and swelling from the waste and fluid build-up.vCold also helps numb nerve endings, providing you with instant, localized pain relief.

 

On a whole-body scale, immersing yourself in a cold tub of water brings down your heart rate and increases your circulation, minimizing inflammation and helping you recover faster.In fact, cold-water baths appear to be significantly more effective than rest in relieving delayed-onset muscle soreness, which typically occurs one to four days after exercise or other physical activity.

 

In one study, after analyzing 17 trials involving over 360 people who either rested or immersed themselves in cold water after resistance training, cycling or running, researchers found the cold-water baths were much more effective in relieving sore muscles one to four days after exercise.ivJust how cold does the water need to be?

 

In this case, most of the studies involved a water temperature of 10-15 degrees C (50-59 degrees F), in which participants stayed for about 24 minutes. Some of the trials involved colder temperatures or “contrast immersion,” which means alternating between cold and warm water.

 

This study did not show a significant benefit compared to rest for contrast immersion, but some experts do believe that alternating hot and cold water helps drive oxygen and nutrients to your internal organs, while encouraging detoxification. Research also shows it may help reduce pain and speed recovery by decreasing blood lactate concentration.ii

 

Cold Water Might Increase Your Body’s Tolerance to Stress and Disease

 

Ever since reading Tim Ferriss’ Four Hour Body last year, which first introduced me to the concept, I have been experimenting with this concept. I now go into the shower without allowing it to warm up. I also jump in the ocean without a wet suit on when no one else is in the water. I have found that if I hold my breath it really helps adjust to the shock and I rapidly acclimate to the cold. I have come to enjoy it and now view it as a healthy stress very similar to exercise.

 

Exposing your whole body to cold water for short periods of time is used to promote “hardening.” Hardening is the exposure to a natural stimulus, such as cold water, that results in increased tolerance to stress and/or disease. This was demonstrated by a study involving 10 healthy people who swim regularly in ice-cold water during the winter.iii Following exposure to the cold water, researchers noted a:

 

“Drastic” decrease in uric acid levels: High levels of uric acid are normally associated with gout, but it has been long known that people with high blood pressure, kidney disease and people who are overweight, often have elevated uric acid levels. When your uric acid level exceeds about 5.5 mg per deciliter, you have an increased risk for a host of diseases including heart disease, fatty liver, obesity, diabetes, hypertension, kidney disease and more.

Increase in glutathione: Glutathione is your body’s most powerful antioxidant, which keeps all other antioxidants performing at peak levels.

Can Cold Water Help You Burn Fat?

 

Drinking cold water is known to speed up your metabolic rate, as your body must work to raise the temperature of the water. But cold showers and other types of cold-water or ice therapy may also help boost your fat-burning abilities.

 

Tim Ferriss also reviews the concept of activating your brown fat to boost fat burning by exposing yourself to frigid temperatures. He claims you can increase your fat burning potential by as much as 300 percent simply through adding ice therapy to your dieting strategy. This is based on the premise that by cooling your body, you’re essentially forcing it to burn much more calories by activating your brown fat.

 

Brown fat is a heat-generating type of fat that burns energy instead of storing it, acting more like muscle than fat. Research has shown that brown fat can be activated to burn more fat by cooling your body.iv Ferriss’ suggestions, from easy to ‘hard core,’ include the following. If you want to give his technique a try, make sure you advance slowly. It may be inadvisable to go straight to the ice bath if you’re not used to frigid temperatures:

 

Placing an ice pack on your upper back and upper chest for 30 minutes per day (you can do this while relaxing in front of the TV for example)

Drinking about 500 ml of ice water each morning

Cold showers

Immersing yourself in ice water up to your waist for 10 minutes, three times per week. (Simply fill your tub with cold water and ice cubes)

Most studies on cold water immersion report benefits with minimal or no side effects, so if you’re willing to spend 20 minutes or so in a cold tub of water, this may be another simple and inexpensive tool to support optimal health and longevity. Of course, common sense is advised. When you immerse yourself in cold water, it will shock your body to some degree so you need to make sure the water is not too cold, and that you do not stay in it for too long. As always, listen to your body and work up to the more advanced ice-therapy techniques gradually.

 

References:

i The Cochrane Library February 15, 2012

ii Journal of Science and Medicine in Sport Volume 10, Issue 6 , Pages 398-402, December 2007

iii Free Radical Biology and Medicine March 1994

iv New England Journal of Medicine 2009 Apr 9;360(15):1518-25