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Over the past few months reports have emerged from the US and UK, detailing the horrible flu epidemic they have just emerged from.
As South Africa faces the annual flu season, should we be on high alert, following the high number of deaths in these countries?
This particular strain of flu is called H3N2, and is a subtype of influenza A. It has been nicknamed the “Aussie flu”, even though it did not originate in Australia. The virus has in fact been around for a while, and continues to mutate.
Because of influenza A, healthcare professionals and authorities, like the National Institute for Communicable Diseases (NICD), are urging South Africans to get vaccinated against the flu.
Professor Cheryl Cohen, co-head of the Centre for Respiratory Diseases and Meningitis, told Health24 that flu strains are constantly updating themselves in order to avoid people’s immune response. She added that this year’s vaccine has been updated and is different to that of the US and the rest of the northern hemisphere, and they hope it will work well against the strains in South Africa.
“There are many factors which would determine if a flu season is severe or not. We need to look at the possible strains we might see in the season ahead along with strains we’ve seen in the past.
“We also need to look at the immunity in the population when looking at different strains. Many people might be immune to a certain strain or not; this can differ from place to place. Another factor is also any underlying conditions in the population – elderly people have a particularly high risk of contracting flu, along with those who have underlying illnesses such as heart diseases, lung diseases and HIV.
“All of these factors together determine whether the season is severe or not, but the message we’re giving to nurses and doctors is that they should be aware that there was a severe strain overseas last year and they should be looking out for flu in their patients.
“People who are at higher risk must go and get the vaccine, because there is still a possibility that it might be a severe season, but on the other hand, there’s no guarantee. It might just be a normal season, or even a mild season.
“Basically, the message is that we need to be aware; we need to monitor the situation, but there is no cause for panic. If the season is more severe, systems will kick in to deal with that.”
Travelling flu virus
Last month, the Stormers Super 15 rugby team struggled with planning because several players were down with the flu.
Coach Robbie Fleck mentioned that a few players had already been hit when they were away in New Zealand.
Prof Cohen added that flu is a highly seasonal disease. “It’s actually the most seasonal disease we know. In temperate countries like South Africa it really only circulates for a few months during the winter season. Outside of that time, we basically don’t see any flu at all, unless it’s in travellers who come from overseas.
“Because of this, there is a discontinuity in timing between the northern hemisphere flu season and the southern hemisphere flu season. Their winter is different to ours – they have their season during December to February and we have ours from April.”
Should you get the pneumonia vaccine too?
Pete Vincent, a doctor at Netcare Travel Clinics and Medicross Tokai, said that the vaccine is still the best protection against the flu, but some individuals should consider having a pneumonia vaccine as well.
Dr Vincent said that bacterial pneumonia can be very dangerous for anyone, but particularly in the case of high-risk individuals, such as the elderly, babies, small children, pregnant women and anyone else with a compromised immune system.
“Pneumonia is one of the most dangerous secondary infections and complications of an influenza infection, and is responsible for many deaths locally and around the world every year.
“While the decision to vaccinate against either flu, pneumonia or both, is a personal one, we recommend that people who are at higher risk consider both the influenza and the streptococcus bacteria vaccinations.
“Travellers to the northern hemisphere should also consider both vaccines, as there are many regions where flu is still prevalent,” Dr Vincent told Health24.
Why do you or do you not get vaccinated for flu? Will you consider getting vaccinated for pneumonia as well? Why or why not? Share your thoughts by emailing email@example.com and we may publish your story. Should you wish to remain anonymous, please let us know.
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London – In a medical first, a French surgeon says he has performed a second face transplant on the same patient – who is now doing well and even spent a recent weekend in Brittany.
Dr. Laurent Lantieri of the Georges Pompidou hospital in Paris first transplanted a new face onto Jerome Hamon in 2010.
But after getting ill in 2015, Hamon was given drugs that interfered with anti-rejection medicines he was taking for his face transplant.
Last November, complications led Lantieri to remove the transplanted face.
That left Hamon without a face, in a condition Lantieri describes as “the walking dead”.
In January, a second transplant was conducted. Lantieri said Hamon is now recovering well.
Doctors say, as with other organ transplants, it’s not unexpected that some face transplants need to be replaced.
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Poor nutrition in early childhood has a number of negative consequences for people later in life, according to Professor Daniela Casale, from Wits University’s School of Economic and Business Sciences.
Prof Casale analysed data from the National Income Dynamics Study (NIDS) and found a link between child health and education outcomes.
The NIDS is a longitudinal survey that collects detailed information on the health status of children, including anthropometric data (body measurements), and on their progression through school.
Stunted cognitive function
“Using South Africa’s first national longitudinal study, which follows participants over time, this work highlighted how children who were stunted in early childhood had poorer educational outcomes later on,” said Prof Casale. “The likely mechanism is through poorer cognitive function in malnourished children.”
She analysed the sample of children aged between six months and seven years in 2008. She then followed their outcomes in in 2014/15, when the children were aged seven to 14 years.
The children who were initially stunted had completed fewer years of schooling by 2014/15 compared to non-stunted children, both because they started school later and were more likely to fail the grades they were enrolled for.
Prof Casale’s analysis suggest that the timing of good nutrition is key in the child’s development, and global research shows that the first 1 000 days, from conception to the child’s second birthday, are critical.
“Policy-makers need to find more creative ways of accessing children and their caregivers in the early childhood period,” said Prof Casale.
“This is a largely under-researched area of analysis for South Africa, and much more work needs to be done on the biological and socio-economic factors that determine malnutrition in the first instance and subsequent recovery,” she said.
Importance of mother’s education
Even though school feeding scheme plays an important role in the child’s nutrition, the prevalence of stunting reaches a peak between two and three years of age, before a child gets to school.
“So clearly something more needs to be done to reach children and their caregivers earlier on. While the child support grant is an important policy intervention, and it has been shown to have many benefits, it appears not to be sufficient to prevent stunting,” said Prof Casale.
Research suggests that, in addition to economic resources, mother’s education is an important protective factor in reducing the chances of stunting
“Policy-makers will need to find ways of reaching mothers early on to ensure that they are well nourished during pregnancy and that they know how to care for and feed their children appropriately,” she said.
According to Prof Casale, clinic interactions during the antenatal and postnatal periods may be one area where policy could be strengthened. “Mothers, and of course fathers, need to be educated and supported, and children’s weight and height need to measured repeatedly in the early period to monitor progress.”
Image credit: iStock
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While syphilis tends to be more common among men who have sex with men, diagnoses among women are on the rise…
The bacterial infection, which can be spread via vaginal, oral or anal sex, progresses in three stages that pretty much go from scary to horrible to terrifying.
In the first two stages, syphilis can easily be treated with a quick round of antibiotics. But if you don’t treat syphilis within 12 months, it goes latent, meaning the bacteria is still in your body but you may not have symptoms for many years.
Ten to 30 years down the line, it can become active again, though. In its third stage, syphilis can damage your brain, nerves, eyes, heart and other organs, leading to blindness, paralysis and even death, according to the American College of Obstetricians and Gynecologists (ACOG).
“It’s important to diagnose and treat syphilis early because it can progress to stages that can affect your brain or your overall health, and it can be transferred to babies if it’s not diagnosed in pregnancy,” says obstetrician and gynaecologist Dr Jessica Shepherd.
Dr Shepherd says most people notice syphilis symptoms in the first or second stages of the disease, although it’s not uncommon for people to not realise their symptoms are caused by syphilis.
Here are eight syphilis symptoms in women you need to know about.
1. Firm, round, painless sores
In the first stage of syphilis, which lasts three to six weeks, you may or may not notice multiple sores at the spot of infection, according to the US Centers for Disease Control and Prevention (CDC).
“They’re painless and firm, and kind of have a vesicular (i.e., a small fluid-filled sac) feel,” explains Dr Shepherd. There are usually several in one area, each slightly larger than a pimple, or about half a centimetre in width. “They do go away. If you don’t go to your doctor in time, you may not see them,” says Dr Shepherd. Untreated, the infection progresses to second-stage syphilis.
2. Fever and swollen lymph glands
Another symptom that can appear at any stage of syphilis is a low-grade fever, generally around 38 to 38.1 degrees Celsius. “It wouldn’t last for very long – a few days, if at all,” says Dr Shepherd.
To be fair, a fever can be a sign of lots of things, so if you haven’t noticed other syphilis symptoms it’s probably nothing to worry about. Still, if you’re concerned it’s never a bad idea to phone your doctor.
3. Skin rashes
Notice a funky rash anywhere on your body? Always a good reason to check in with your doctor. In the secondary stage of untreated syphilis, you may discover a rash on some pretty random parts of your body. “You’ll notice small, rough red bumps, and it may go unnoticed because it doesn’t cause itching,” says Dr Shepherd.
While a syphilis rash most often appears on the palms of your hands or the soles of your feet, it can pop up elsewhere – although Dr Shepherd says it’s usually pretty localised. At this point, the syphilis bacteria has travelled through your blood, she explains, so it’s starting to affect parts of your body beyond where you were first exposed.
4. Sores in the mouth, vagina or anus
Another sign of secondary-stage syphilis: multiple large (1-3cm), raised grey or white sores that appear in moist areas like your mouth, underarms or groin. “They’re wart-like, somewhat raised and not painful,” Dr Shepherd says. “In fact they can be misdiagnosed as genital warts, which aren’t painful either.” Either way, if you notice these kinds of bumps it’s a good idea to book an appointment with your gynae right away.
5. Patchy hair loss
In the secondary stages of syphilis, you might find patchy bald spots on your scalp. Known as syphilitic alopecia, “this is not one of the big symptoms, and it’s not typical in what we would normally see,” says Dr Shepherd. In fact, hair loss in women can have all other kinds of causes, including hormonal changes, medications and medical conditions. “If you have hair loss, we usually see other symptoms like a rash, and we piece it together,” she adds. Once syphilis is treated, hair grows back.
6. Weight loss
Some women notice they might lose a couple of kilos in second-stage syphilis, but nothing dramatic, says Dr Shepherd. “We usually only notice it when we start to piece things together. Women may also have other symptoms rather than just weight loss,” she says. Other symptoms of second-stage syphilis are cold-like and include headaches, muscle aches, sore throat and fatigue, all of which will go away with or without treatment, according to the CDC.
7. Sensory deficits and clumsiness
Once untreated syphilis reaches the tertiary stage, bacteria can eventually affect the brain, says Dr Shepherd. Known as neurosyphilis, according to the CDC, it affects up to 10% of patients with untreated syphilis and can lead to meningitis, or inflammation of the brain and spinal cord.
Read more: 7 things you should know about genital warts
In addition to headaches and difficulty coordinating muscle movements, other symptoms include altered behaviour, paralysis, sensory deficits and dementia, according to the US Mayo Clinic. The good news is, syphilis is treatable at any stage with antibiotics – although you’ll need to see your doctor to get diagnosed, and you’ll likely need to take medication for weeks or potentially be hospitalised for IV antibiotics at this stage.
8. Fuzzy vision
Ocular syphilis is another tertiary effect of untreated syphilis, where bacteria affect the optic nerve in the brain, according to the CDC. Symptoms can include vision changes up to permanent blindness. “Syphilis is a blood-borne pathogen, so once it’s in the brain it will affect that organ. It’s just a matter of time before gets there,” says Dr Shepherd. There’s one more good reason to check in with your doctor right away if you notice any early-stage syphilis symptoms.
This article was originally published on www.womenshealthmag.com
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Earlier this year, doctors diagnosed a “patient zero” in England with a case of gonorrhoea that could not be cured with antibiotics commonly deployed against the sexually transmitted bacteria.
Americans should expect that a super-resistant form of gonorrhoea like that found in the United Kingdom will soon reach these shores, health experts say. The same applies to South Africa and the rest of the world.
An inexorable process
This was shocking to the public, but not unexpected to those in the know, health officials said. According to an article in the New York Post, doctors and scientists have been warning for years that the bacteria that cause gonorrhoea are becoming more resistant to antibiotics.
“The development of antibiotic resistance by gonorrhoea is an inexorable process,” said Dr Edward Hook, an infectious disease expert with the University of Alabama at Birmingham. “It began soon after the first antibiotics were used to treat gonorrhoea, and has continued since that time. It’s progressive and relatively predictable.”
Unless new antibiotics are developed against gonorrhoea, or a vaccine created, these kinds of extreme cases will begin showing up in the United States, said Hook.
Dr Bruce Farber agreed. He is chief of infectious diseases at North Shore University Hospital in Manhasset, New York, and at Long Island Jewish Medical Center in New Hyde Park, New York.
“Resistant gonorrhoea already is all over the United States,” Farber said. “It’s maybe not a strain like that you’ve just read about from the UK, which is extraordinary, but nevertheless generally these cases are occurring.”
A previous Health24 article states that treatment failure of gonorrhoea in the case of third-generation cephalosporins has already been confirmed in South Africa.
Gonorrhoea, also called “the clap”, is one of the most common sexually transmitted diseases worldwide.
It infects an estimated 78 million people globally each year, according to the World Health Organization.
In the United States, gonorrhoea is on the rise, jumping nearly 19% in 2016 from the year before, according to the US Centers for Disease Control and Prevention.
Dr Amesh Adalja is a senior scholar at the Johns Hopkins Center for Health Security, in Baltimore. “Rates of gonorrhoea are increasing and are tied to unsafe sexual behaviours, and these resistant strains could make inroads into the gonorrhoea epidemic in the US,” he said.
“Highly antibiotic-resistant gonorrhoea is one of the most urgent infectious disease threats we face. There truly is the prospect of clinicians encountering untreatable strains of the bacteria,” Adalja warned.
Image credit: iStock
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