Category Archives: Health

Health, Science, Society, United Nations, World Health Organisation

Global cases of cholera are on the rise

CHOLERA

CASES of cholera are increasing, with 22 countries around the world experiencing an outbreak. After many years of decline, incidences rose in 2022 due to vaccine shortages, climate change and escalating conflict. It is a trend that is expected to continue.

. Science Book

Some 26,000 cholera cases were reported in Africa during the first 29 days of January 2023. This is already 30 per cent of the continent’s total in 2022. At the end of February, the World Health Organisation (WHO) said that more than 1 billion people across 43 countries are at risk.

Overall, Malawi appears to be the worst-hit country, with the highest number of deaths. It reported just under 37,000 cholera cases and 1,210 fatalities from 3 March 2022 to 9 February 2023.

This was triggered by a cyclone that hit in March 2022. This led to wastewater contaminating drinking water supplies.

Cholera is spread by the ingestion of food or water that is contaminated with the bacterium Vibrio cholerae. When it enters the body, some types of V. cholerae release a toxin that interacts with the cells lining the surface of the intestine, leading to diarrhoea.

In some cases, this can result in severe dehydration and death. In Malawi, 3.3 per cent of people with cholera die of the infection. With treatment, this is typically around 1 per cent.

In 2022, Malawi vaccinated millions of people in districts that were facing cholera outbreaks, but the cyclone has allowed the disease to spread to all of its districts, putting unvaccinated people at risk.

Extreme weather, driven by climate change, means many more countries are at risk of wastewater contamination. Cyclone Freddy, which hit Mozambique on 24 February, is expected to exacerbate the country’s cholera outbreak.

Climate change-driven droughts in countries such as Kenya and Ethiopia have also forced people to rely on water sources that may be contaminated with V. cholerae, according to UNICEF. Many people in these regions are malnourished, which affects their immune health, leaving them more vulnerable to severe cholera complications.

Displacement, whether due to conflict in countries like the Democratic Republic of the Congo or disasters such as the earthquake that hit part of Syria on 6 February, can also play a role in cholera outbreaks if people are forced to move to less sanitary areas, or if already infected people take the bacteria with them.

The destruction of health facilities and infrastructures [in Syria] that bring water to people could lead to more cases. According to the United Nations, the country reported more than 37,700 suspected cases in the cities of Idlib and Aleppo from 25 August 2022 to 7 January 2023 – 18 per cent of which were in people in displaced camps.

The unprecedented scale of the cholera outbreaks in 2022 – with 30 countries reporting cases, compared with an average of fewer than 20 in the previous five years – has also depleted global vaccine supplies. Only 37 million doses are available.

The International Coordinating Group on Vaccine Provision, which manages the WHO’s global vaccine stockpile, therefore recommends that at-risk people be vaccinated with a single dose of a cholera vaccine rather than the typical two doses. The one-dose regimen gives only about one year of protection, compared with three years with two doses. If the outbreaks continue as they are, this year of protection might not be enough time to get them under control.

Cholera has always been an issue, which prompted the UN to publish a road map in 2017 to cut 90 per cent of cholera deaths globally by 2030.

Several countries have made progress. The fact that Malawi has detected cholera outbreaks so quickly points to the work that officials have done to increase health surveillance.

But with just seven years to go until 2030, many aren’t convinced that the UN’s target will be reached. They say there hasn’t been enough investment in water infrastructure around the world to reach those goals.

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Books, Health, Medical, Research, Science

Book Review: A Silent Fire

THE FLAMES WITHIN

Intro: A fascinating primer explores the crucial role of inflammation in our bodies and how it can go awry. What you need to know about inflammation in the body

INFLAMMATION is a crucial tool of the body’s immune system. As the first line of defence against injury or invaders, it traps bacteria and viruses, heals wounds and signals to other cells for help. It results in symptoms such as pain and swelling. Once a threat is remedied, inflammation, along with its ensuing discomfort, disappears – or at least it should.

In her debut book A Silent Fire: The story of inflammation, diet and disease, gastroenterologist Shilpa Ravella explains how inflammatory responses can turn against us. Crucially, she shows how chronic inflammation plays a role in many common conditions such as heart disease and cancer, and why Western diets are at least partially to blame.

This primer sees Ravella start with some fascinating history, travelling all the way back to the 1st century, when Aulus Cornelius Celsus first described four of the five main signs of inflammation: pain, heat, redness and swelling. The fifth, a loss of function, was identified in the mid-1800s.

Ravella spends a lot of time examining the work of Victorian scientists, such as Élie Metchnikoff, who won a Nobel Prize in 1908 for discovering immune cells called phagocytes that engulf pathogens and particles. Eventually, she moves on to modern-day researchers like Charles Serhan, who helped identify molecules known as resolvins that turn off inflammation.

This lays a proper foundation for the book’s second section, which connects these discoveries to inflammation’s possible role in disease. Low levels of inflammation have been found in people with conditions such as cancer. While inflammation is a normal response to injury and disease, persistent inflammation is now being viewed as a potential cause of illness.

Ravella further speculates that inflammation can contribute to conditions like depression and Alzheimer’s disease, though as a responsible medical professional, she provides important caveats and stresses the need for more research.

The most damning evidence links inflammation to autoimmune conditions – which occur when the body damages its own cells – such as rheumatoid arthritis. Characterised by long-lasting, low levels of inflammation, these conditions increase susceptibility to other problems like bone loss, heart disease and kidney disease.

The book wraps up by detailing how factors like diet and exercise can contribute to inflammation as well as help dampen it. For many, this won’t be new, but what may be illuminating is Ravella’s explanation of lifestyle significance.

For instance, she devotes a whole chapter to the gut microbiome, describing how processed foods and animal products, like red meat and dairy, disrupt microbial composition, setting off a chain of events that leads to increased inflammation. She then explains why fruits, vegetables and whole grains can help undo these effects.

A Silent Fire is no quick read: it is packed with information, combining medical history, innovative research and first-hand clinical experiences. At times, it feels over-ambitious, as Ravella crams in as much as possible rather than clearly connecting the various topics. It can also be difficult to keep track of all the different microbes, scientists and immune cells involved, especially if you lack a scientific or medical background.

But Ravella’s writing style keeps even the most dense page engaging. She breathes life into biological function, at one point describing types of white blood cells as “sophisticated warriors” that “voraciously gobble up” particles. Ultimately, the book is perfect for those looking to delve deeper into the history and intricate workings of immunology, diet and disease.

– A Silent Fire is published by Bodley Head

– Rheumatoid arthritis, as shown in this X-ray, is a chronic inflammatory condition
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Arts, Health, Mental Health

Warrior Body

RESILIENCE

IT’S easier to face adversity when you’re feeling fit and strong. Take care of yourself by exercising regularly. Experts recommend around 30 minutes of physical activity each day.

Exercise helps build resilience in several ways: it produces endorphins and serotonin which lift your spirits, and it changes the way your brain responds to stress, making it more resistant to anxiety. It can also increase your energy, boost your confidence, and promote better sleep, all of which will help you to bounce back from stressful situations.

Any activity counts if it raises your heart rate and makes you breathe faster and feel warmer, whether it’s brisk walking, dancing, rollerblading or swimming. Signing up for a team sport or exercise class, or exercising with a friend, can motivate you to stick with it and work harder. It also makes getting fit more fun!

(Podcast ends)

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