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bigyack-com · 5 years

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Wuhan Coronavirus Looks Increasingly Like a Pandemic, Experts Say

The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe, according to many of the world’s leading infectious disease experts.The prospect is daunting. A pandemic — an ongoing epidemic on two or more continents — may well have global consequences, despite the extraordinary travel restrictions and quarantines now imposed by China and other countries, including the United States.Scientists do not yet know how lethal the new coronavirus is, however, so there is uncertainty about how much damage a pandemic might cause. But there is growing consensus that the pathogen is readily transmitted between humans.The Wuhan coronavirus is spreading more like influenza, which is highly transmissible, than like its slow-moving viral cousins, SARS and MERS, scientists have found.“It’s very, very transmissible, and it almost certainly is going to be a pandemic,” said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Disease.“But will it be catastrophic? I don’t know.”In the last three weeks, the number of lab-confirmed cases has soared from about 50 in China to 14,000 in 23 countries; there have been over 300 deaths, all but one in China.But various epidemiological models estimate that the real number of cases is 100,000 or even more. While that expansion is not as rapid as that of flu or measles, it is an enormous leap beyond what virologists saw when SARS and MERS emerged.When SARS was vanquished in July 2003 after spreading for nine months, only 8,098 cases had been confirmed. MERS has been circulating since 2012, but there have been only about 2,500 known cases.The biggest uncertainty now, experts said, is how many people around the world will die. SARS killed about 10 percent of those who got it, and MERS now kills about one of three.The 1918 “Spanish flu” killed only about 2.5 percent of its victims — but because it infected so many people and medical care was much cruder then, 20 to 50 million died.By contrast, the highly transmissible H1N1 “swine flu” pandemic of 2009 killed about 285,000, fewer than seasonal flu normally does, and had a relatively low fatality rate, estimated at .02 percent.The mortality rate for known cases of the Wuhan coronavirus has been running about 2 percent, although that is likely to drop as more tests are done and more mild cases are found.It is “increasingly unlikely that the virus can be contained,” said Dr. Thomas R. Frieden, a former director of the Centers for Disease Control and Prevention who now runs Resolve to Save Lives, a nonprofit devoted to fighting epidemics.“It is therefore likely that it will spread, as flu and other organisms do, but we still don’t know how far, wide or deadly it will be.”In the early days of the 2009 flu pandemic, “they were talking about Armageddon in Mexico,” Dr. Fauci said. (That virus first emerged in pig-farming areas in Mexico’s Veracruz State.) “But it turned out to not be that severe.”An accurate estimate of the virus’s lethality will not be possible until certain kinds of studies can be done: blood tests to see how many people have antibodies, household studies to learn how often it infects family members, and genetic sequencing to determine whether some strains are more dangerous than others.Closing borders to highly infectious pathogens never succeeds completely, experts said, because all frontiers are somewhat porous. Nonetheless, closings and rigorous screening may slow the spread, which will buy time for the development of drug treatments and vaccines.Other important unknowns include who is most at risk, whether coughing or contaminated surfaces are more likely to transmit the virus, how fast the virus can mutate and whether it will fade out when the weather warms.The effects of a pandemic would probably be harsher in some countries than in others. While the United States and other wealthy countries may be able to detect and quarantine the first carriers, countries with fragile health care systems will not. The virus has already reached Cambodia, India, Malaysia, Nepal, the Philippines and rural Russia.“This looks far more like H1N1’s spread than SARS, and I am increasingly alarmed,” said Dr. Peter Piot, director of the London School of Hygiene and Tropical Medicine. “Even 1 percent mortality would mean 10,000 deaths in each million people.”Other experts were more cautious.Dr. Michael Ryan, head of emergency responses for the World Health Organization, said in an interview with STAT News on Saturday that there was “evidence to suggest this virus can still be contained” and that the world needed to “keep trying.”Dr. W. Ian Lipkin, a virus-hunter at the Columbia University Mailman School of Public Health who is in China advising its Center for Disease Control and Prevention, said that although the virus is clearly being transmitted through casual contact, labs are still behind in processing samples.But life in China has radically changed in the last two weeks. Streets are deserted, public events are canceled, and citizens are wearing masks and washing their hands, Dr. Lipkin said. All of that may have slowed down what lab testing indicated was exponential growth in the infection.It’s unclear exactly how accurate tests done in overwhelmed Chinese laboratories are. On the one hand, Chinese state media have reported test kit shortages and processing bottlenecks, which could produce an undercount.But Dr. Lipkin said he knew of one lab running 5,000 samples a day, which might produce some false-positive results, inflating the count. “You can’t possibly do quality control at that rate,” he said.Anecdotal reports from China, and one published study from Germany, indicate that some people infected with the Wuhan coronavirus can pass it on before they show symptoms. That may make border-screening much harder, scientists said.Epidemiological modeling released Friday by the European Center for Disease Prevention and Control estimated that 75 percent of infected people reaching Europe from China would still be in the incubation periods upon arrival, and therefore not detected by airport screening, which looks for fevers, coughs and breathing difficulties.But if thermal cameras miss victims who are beyond incubation and actively infecting others, the real number of missed carriers may be higher than 75 percent.Still, asymptomatic carriers “are not normally major drivers of epidemics,” Dr. Fauci said. Most people get ill from someone they know to be sick — a family member, a co-worker or a patient, for example.The virus’s most vulnerable target is Africa, many experts said. More than 1 million expatriate Chinese work there, mostly on mining, drilling or engineering projects. Also, many Africans work and study in China and other countries where the virus has been found.If anyone on the continent has the virus now, “I’m not sure the diagnostic systems are in place to detect it,” said Dr. Daniel Bausch, head of scientific programs for the American Society of Tropical Medicine and Hygiene, who is consulting with the W.H.O. on the outbreak.South Africa and Senegal could probably diagnose it, he said. Nigeria and some other countries have asked the W.H.O. for the genetic materials and training they need to perform diagnostic tests, but that will take time.At least four African countries have suspect cases quarantined, according to an article published Friday in The South China Morning Post. They have sent samples to France, Germany, India and South Africa for testing.At the moment, it seems unlikely that the virus will spread widely in countries with vigorous, alert public health systems, said Dr. William Schaffner, a preventive medicine specialist at Vanderbilt University Medical Center.“Every doctor in the U.S. has this top of mind,” he said. “Any patient with fever or respiratory problems will get two questions. ‘Have you been to China? Have you had contact with anyone who has?’ If the answer is yes, they’ll be put in isolation right away.”Assuming the virus spreads globally, tourism to and trade with countries besides China may be affected — and the urgency to find ways to halt the virus and prevent deaths will grow.It is possible that the Wuhan coronavirus will fade out as weather warms. Many viruses, like flu, measles and norovirus, thrive in cold, dry air. The SARS outbreak began in winter, and MERS transmission also peaks then, though that may be related to transmission in newborn camels. Four mild coronaviruses cause about a quarter of the nation’s common colds, which also peak in winter.But even if an outbreak fades in June, there could be a second wave in the fall, as has occurred in every major flu pandemic, including those that began in 1918 and 2009.By that time, some remedies might be on hand, although they will need rigorous testing and perhaps political pressure to make them available and affordable.In China, several antiviral drugs are being prescribed. A common combination is pills containing lopinavir and ritonavir with infusions of interferon, a signaling protein that wakes up the immune system.In the United States, the combination is sold as Kaletra by AbbVie for H.I.V. therapy, and it is relatively expensive. In India, a dozen generic makers produce the drugs at rock-bottom prices for use against H.I.V. in Africa, and their products are W.H.O.-approved.Another option may be an experimental drug, remdesivir, on which the patent is held by Gilead. The drug has not yet been approved for use against any disease. Nonetheless, there is some evidence that it works against coronaviruses, and Gilead has donated doses to China.Several American companies are working on a vaccine, using various combinations of their own funds, taxpayer money and foundation grants.Although modern gene-chemistry techniques have made it possible to build vaccine candidates within just days, medical ethics require that they then be carefully tested on animals and small numbers of healthy humans for safety and effectiveness.That aspect of the process cannot be sped up, because dangerous side effects may take time to appear and because human immune systems need time to produce the antibodies that show whether a vaccine is working.Whether or not what is being tried in China will be acceptable elsewhere will depend on how rigorously Chinese doctors run their clinical trials.“In God we trust,” Dr. Schaffner said. “All others must provide data.” Read the full article

#Coronavirus #Experts #health #HealthNews #Increasingly #Pandemic #Wuhan

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pharmanewstrands-blog · 5 years

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Recombinant Vaccines Market Manufacturers, Future Growth Potentials, Key Drivers

Recombinant vaccines are produced using recombinant DNA technology, with the help of a vector. These vaccines stimulate the immune system of an individual and provide immunity against various lethal disease. These vaccines are safe and have less or no side-effects as compared to conventional vaccines, in the prevention of various diseases such as influenza, cholera, typhoid, and dengue. Recombinant vaccines are also used in animals for prevention of diseases such as foot and mouth disease, pneumonia and septicemia, and pox disease.

Vaccination results in the prevention of disease, by producing antibodies against the protein antigen of pathogenic microorganisms. There is increase in the demand for livestock products, which in turn has increased growth of the animal recombinant vaccine segment and Europe dominates the animal recombinant vaccines market as compared to other regions due to highly organized livestock and huge demand of livestock product for the European population. According to Global Agriculture report, there were around 315 million tons of meat produced worldwide in 2014 and expected to increase to 318.8 million tons in 2015.

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The recent past has witnessed a steady rise in incidence of zoonotic and infectious diseases in humans and animals as well, which lead to the increased research & developments for the innovation of new and effective recombinant vaccines for the prevention of diseases. Government has also taken an initiative to increase awareness regarding vaccination to prevent diseases in community. Manufacturing companies have also started some beneficial programs to provide vaccination free of cost to poor people, which creates a highly conducive environment for growth of the recombinant vaccines market in near future.

National Immunization Program by Queensland Government in Australia and Indradhanush vaccination program in India works to provide vaccination among children throughout the nation. Various organizations such as World Health Organization, World Bank, and United Nations Children’s Funds has also taken and initiative to increase vaccination.

ncrease in the incidence of zoonotic diseases and emerging technologies expected to support the growth of recombinant vaccines market

There is a constant increase in diseases caused by bacteria or virus such as swine flu, malaria, HPV and other diseases, which has raised the demand of vaccination and lead to the eradication of diseases such as polio, and tetanus in few countries. Whit the development in technology there is development in vaccines, which are more effective than conventional vaccines and does not lead to any side effect.

These vaccines are easy to administer in the body orally, intramuscular or intradermal. In the U.S. there were around 212 million malaria cases and 429,000 deaths from malaria is reported in 2015. According to Centers for Disease Control and Prevention report 2017, in the U.S. there were around 49.9% of the children between the ages of 6 months to 17 years received an influenza vaccine.

Continuous investment in research & development for the development of new vaccines and increased awareness and pet adoption are expected to fuel the growth of recombinant vaccines

There are various companies working on the development of vaccine for various disease, which have affected human beings in short span of time such as Ebola, Zika, and H1N1 flu. The companies also working for the development of cancer vaccines different type of cancer includes lung cancer, blood cancer, skin cancer, bladder cancer, brain cancer, kidney cancer, prostate cancer, solid tumors cancer , breast cancer are the target area for recombinant vaccine development, which may expected to support the growth of recombinant vaccine market in the near future. In 2012, according to the World Cancer Research Fund International, globally around 1.7 million new cases of breast cancer are diagnosed. Breast cancers are being targeted in active NCI supported cancer prevention or treatment clinical trials using vaccines.

The vaccine therapy with or without trastuzumab in treating patients with stage IV breast cancer is in phases II clinical trial. The folate receptor alpha peptide vaccine with GM-CSF in patient with triple negative breast cancer trial phase II.

According to National Cancer Institute, in the U.S. there were around 1,685,210 new cases of cancer was reported and 595,690 people died from cancer in 2016. According to American Society for the Prevention of Cruelty to Animals, in the U.S. there were around 3.2 million shelter animals are adopted each year (1.6 million dogs and 1.6 million cats) and adoption of pets are expected to increase, which in turn raise the demand for recombinant vaccines for animals in near future.

Some major key players in the recombinant vaccines market include Merck & Co. Inc., Novartis AG, Protein Science Corporation, GlaxoSmithKline Plc., Green Cross Corporation, Bayer AG, Sanofi S A, Pfizer Inc., and Bharat Biotech.

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strike-back-now-info · 4 years

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The Top 10 Health Scares Of The Decade

The Top 10 Health Scares Of The Decade - ABC News

https://abcnews.go.com/Health/Decade/top-10-health-scares-past-10-years/story?id=9249373 Bottom of Form

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The Top 10 Health Scares Of The Decade

The Medical Unit breaks down what kept you up nights the past 10 years.

JOSEPH BROWNSTEIN<br />ABC News Medical Unit

December 4, 2009, 10:44 AM

Dec. 7, 2009— -- While the past decade has seen great strides in medical technology, it hasn't seen solutions to all of our health problems.

There were novel viruses that threatened to kill us all. There were toxins in our children's toys, and we were told to worry about the junk they were eating.

Some of these threats turned out to be almost nonexistent. Others were arguably overblown. Some caused widespread harm.

So what new threats have been robbing you of sleep since the annual odometer rolled over from 1999 to 2000? Join us as we take a look at the top ten new threats of the last ten years.

1. Swine Flu (H1N1)

Since it came to public attention in the United States in April, the largest health scare of 2009 has been swine flu.

While other forms of the virus typically peak in February and largely affect the elderly, this strain of the H1N1 flu virus came out of season and mostly affected younger people.

In June, the World Health Organization declared the virus a pandemic, meaning that it was widespread on multiple continents.

Manufacturers began producing vaccine at the end of the spring, but there were shortages nationwide, even late into the fall.

While the majority of cases of the flu have been mild, thousands of American deaths have been attributed to the virus.

But no matter the severity, many health experts agree there are lessons to be learned.

"We just have to note, and this was a bit scary, that when H1N1 came along in communities... our capacity to take care of [patients] was stretched," said Dr. William Schaffner, Chair of the Department of Preventive Medicine at Vanderbilt University Medical Center. "We don't have a lot of reserve in the health care system anymore."

2. Bisphenol A (BPA)

While much of the alarm over the chemical bisphenol A, or BPA for short, has come lately, scientists have been looking at it for years.

In January of 2000, an article in the Journal of the American Dental Association discussed how BPA -- which is used in some dental sealants -- was not found at detectible levels in the body more than a few hours after the treatments.

Since then, studies have shown the chemical to cause birth defects in lab animals, and even create some problems in humans in high doses. The chemical, used in household plastics, has also been found in babies, leading to increased scrutiny from regulatory bodies.

But while we know it is present in humans and can create problems at high levels, it remains unclear what the effect of BPA is in humans at lower doses.

"I would say that there's growing evidence that it is a significant concern, but it's not clear yet how much of a concern," said Joel Schwartz, a professor of epidemiology at the Harvard School of Public Health and director of the Harvard Center for Risk Analysis. "There's a lot of things that still need to be understood, but there's certainly enough things to say, 'Yes, this is something that needs to be on our radar screen.'"

3. Lead Paint On Toys From China

In 2007, a number of products made in China were recalled -- but perhaps the recall that drew the most attention was of children's toys containing lead paint, including some from the popular Thomas the Tank Engine line.

The problem wasn't so much one of scientific analysis as it was of enforcement.

"We do know that lead is bad for you," said Schwartz. "Kids and toys are a bad place to put that exposure together. That's a case where that's just outrageous."

The exact effects of the oversight are unknown, but it did shine a spotlight on imported goods.

"It's doing a little more to make sure this stuff doesn't keep slipping in," said Schwartz.

4. Trans-Fats

Concern over trans-fats -- found in such crowd-pleasing but doctor-disapproved foods as doughnuts and French fries -- came to a head in 2006, when New York City became the first city to ban trans-fats from restaurants.

"The issue became viral, and a lot of it was related to population studies that came out of Harvard University," said Keith-Thomas Ayoob, director of the nutrition clinic at the Albert Einstein College of Medicine. "The problem with them is they tend to raise bad cholesterol and lower good cholesterol."

In response to doctors' concerns, most trans-fats have been removed from food products -- but in many cases they may have been replaced by saturated fat, which can also be harmful in excess.

Ayoob said trans-fats were "an easy whipping post."

Trans-fats may have disappeared because they were easy to replace with other ingredients. And ultimately, the virtual disappearance of trans-fats may be a better testament to the power of economics in responding to consumer demand than that of regulation responding to public complaints.

"It's box office poison now, is what it is. No one really wants to list that on an ingredient list," said Ayoob. "That's one where the food industry responded much more quickly than government ever would have. It just didn't pay to keep it in there."

5. Bird Flu (H5N1)

This year's swine flu pandemic wasn't the first time Americans were concerned with a strain of flu named for an animal.

At the beginning of the decade, avian influenza was a concern in Southeast Asia because of the devastation it was causing in chicken populations. But concerns soon arose about its spread to humans and the possibility it would mutate into a form that could spread from person to person.

"These new influenza viruses usually are modified viruses that come from birds, and now, we know, swine," said Schaffner. "We know that influenza viruses change on an annual basis... The world's population will be or will virtually be completely susceptible."

But concerns over avian flu did have one positive effect for the flu vaccine industry, which has been maligned for its reliance on old technologies to create the vaccine each year. Because antigens for flu vaccines are grown in chicken eggs, it was hard to develop a vaccine for a virus that was deadly to birds, and so work had to be done to begin developing a means of creating antigen without using eggs.

Although the new manufacturing processes are not available yet, "It was exactly H5N1 bird flu that stimulated a number of new ways to create new vaccine," said Schaffner. "What we see now actually came forward as a consequence of all that concern with H5N1."

6. Severe Acute Respiratory Syndrome (SARS)

SARS was the first novel virus to captivate the world's attention this decade after it was identified by the World Health Organization in February 2003.

The respiratory infection was first reported in Asia and then spread to North America, South America and Europe before being contained.

Like influenza, the virus could spread through airborne particles, but it was far more deadly when it infected someone. According to the WHO, 8,096 people were infected worldwide. 774 people died. The virus receded by the end of 2003.

"SARS-like infections, I think, epitomize the emerging infectious diseases," said Schaffner. As for whether the strain could re-emerge, he said, "My crystal ball is pretty cloudy about that... Trying to anticipate whether it would come back or not would be very, very difficult."

7. Methicillin-Resistant Staphylococcus Aureus (MRSA)

MRSA is the best-known of a number of bacteria that resist many of the antibiotics used to treat them. The emergence of MRSA and other bacteria has been blamed on a combination of heavy use of antibiotics and a lack of incentives for drug companies, leaving these bacteria, as Schaffner calls it, "a real, very vital threat"

Schaffner said the existence of these bacteria puts responsibility on both food producers and people who would use antibiotics to be more prudent. But he also said the problem could be compounded by the fact that there is currently little financial incentive for drug companies to devise new antibiotics that could fight the threat.

"Clearly, pharma sees the development of new antibiotics to help us treat these drug-resistant infections as high-risk and low-profit," said Schaffner. "I can think of no new product in any line of industry that, once it's released, the experts in that area say, 'Don't use it,' and that's the circumstance when any new antibiotic is created."

MRSA is not untreatable, but when using the stronger antibiotics for it, "You get yourself into a very restricted corner," Schaffner said. "You get patients to whom these drugs are incredibly toxic or you may need to keep patients in the hospital rather than send them home."

8. Hormone Replacement Therapy

At the start of the decade, millions of women were using hormone replacement therapy to relieve unpleasant symptoms of menopause. It was also used prevent osteoporosis and bone fractures, and heart disease as well.

But as early as 2000, some doctors were recommending against the treatment because of a study in the Journal of the American Medical Association suggesting that it increased the risk of breast cancer.

That alarm greatly increased in 2002 when researchers cut short the Women's Health Initiative study of the treatment, citing concerns over heart problems and strokes in women in the study who received HRT.

Some researchers supported the decision to stop the study, leading many women to stop their HRT, but others felt that it discouraged women who should continue the treatments. Meanwhile, studies have come out with contradictory findings, further confusing women who were unsure what to do. Controversy over HRT continued in 2008, when the International Menopause Society released new guidelines saying that HRT was effective for post-menopausal symptoms and should be considered by women and their physicians.

Following the release of the new guidelines, ABC News contributor Dr. Marie Savard wrote a column for this site in which she tried to clear up some of the confusion.

"There is no question that for a woman with severe hot flashes, sleep disturbance and an annoyingly dry vagina, nothing else works as well as estrogen," Savard wrote. "But the risks of breast cancer, stroke and blood clots from estrogen are hard to ignore... So once again, women are asked to balance the benefits of hormones with the risks and make the best decision for them."

9. Anthrax

After the collapse of the World Trade Center in 2001, five people died after inhaling anthrax bacteria sent through the mail.

But the public at large had little to fear from a tainted envelope.

"That was obviously not a major health problem but a significant problem for a small number of people who have been getting exposed," said Schwartz. "I think the primary concern was this might be being used to kill some people."

Senators Tom Daschle of South Dakota and Patrick Leahy of Vermont, among other public figures, had letters mailed to their offices containing anthrax.

No one was ever convicted of sending the letters, but the Federal Bureau of Investigation reportedly planned to charge government researcher Bruce Ivins in the case before he committed suicide in the summer of 2008.

10. Cell Phones

As cell phones became more popular this past decade, concerns over the radiation they emit -- and what effect they might have on human health -- have proliferated. Some have worried that their use may be linked to the development of brain tumors.

Thus far, however, most research suggests there is little to worry about.

Animal studies have shown that magnetic fields can affect melatonin levels, so while radiation only shows up in low levels, it's unclear what effect it has on humans. And a Scandinavian study released last week in the Journal of the National Cancer Institute confirmed what many have been saying about cell phone safety, showing no increase in brain cancer among cell phone users.

"Whether they do something worth worrying about, that's another question," said Schwartz. Similar questions are raised about high-voltage power lines, but Schwartz urged calm. "It seems to be an issue where it hasn't completely resolved, but I would say the evidence is that if something is going on it's not that big."

Of course, cell phones present an unquestioned safety hazard to Americans, but not for reasons related to radiation. Studies have shown that their use while driving poses a very real hazard.

"That's pretty clear -- talking on a cell phone and driving is like driving drunk," said Schwartz. "The radiation effects -- that doesn't look like that's a major public health issue. That doesn't look very compelling."

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brajeshupadhyay · 4 years

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Unregulated use of plasma therapy for COVID-19 can be harmful, writes expert; can expose patients to serious transfusion-related risks

While the disease spread is currently being countered with WHO advocated strategies of containment with lockdown, patient identification by testing for infection and quarantine of patients and suspected patients, these strategies will only slow down the spread of the disease but the world will still need treatment and a vaccine for the prevention of infection.

Some vaccines are under development and will need months before they hit the market, if at all. In the meantime, the global spread of the infection is killing thousands of people daily and there is a severe need to treat the patients with specific medications and other therapy directed at the virus in addition to standard care.

There are a few contender medicines including the malaria drug hydroxychloroquine, an antiviral Remdesivir, and Ivermectin, a drug used for worms and other parasites, but the results are not hugely encouraging and at times conflicting. In this backdrop, plasma therapy is being seen with interest as a cure for COVID-19 patients.

What is plasma?

Human blood is composed of cells like the red cells that carry oxygen, white cells that fight infection and platelets that stop bleeding from cuts. The watery part contains minerals and many proteins like albumin, factors that make the blood clot, and antibodies which are special proteins produced by the body against infective agents. The serum is the plasma from which the clotting factors have been removed.

What is plasma therapy?

Plasma transfusion is a very common process done during major surgeries and in patients with bleeding, mainly to provide clotting factors.

The main component of interest in plasma therapy and serum therapy for infectious diseases like COVID-19 is the antibodies. The principle applied is that a person who has recovered from the infection would have antibodies directed against the infective agent, in this case, the COVID-19 virus.

Click here for Coronavirus Outbreak LIVE Updates

It is assumed that if injected to a person currently having the disease the antibodies would neutralise the virus, helping in achieving an early cure. Injecting the plasma or serum from patients who have recovered from the disease, called convalescent plasma, may achieve this.

Plasma therapy has been used earlier with some success in other infections like in two previous corona viral epidemics SARS-CoV1 and MERS, and also in H1N1 of 2009-10 and Ebola epidemic. Likewise, the animal serum is widely used in the treatment of diseases like tetanus, diphtheria, gas gangrene, botulism, snake and spider bite.

How is plasma therapy done for COVID-19?

Convalescent plasma transfusion is a relatively easy process. It involves collecting plasma by a process called apheresis or whole blood collection as for blood transfusion followed by separation of the plasma in the laboratory from patients who have recovered from the infection.

The donor is tested as for any blood donor and the plasma is then subjected to standard testing as for blood transfusion. In addition, a few more criteria are to be fulfilled which include a positive diagnostic or serological test in the donor and sufficient time has passed since recovery to render the plasma non-infective.

If the donor is female then a special class of antibody called HLA antibody should be absent in the plasma. The donated plasma must have sufficient antibodies against COVID-19 to offer treatment value.

Which COVID-19 patients can have plasma therapy

Currently, India has not framed any guideline for mass use of plasma therapy in COVID-19 patients. The Indian Council of Medical Research (ICMR), the apex medical body in India, is still conducting a trial on the effectiveness of the therapy.

A few centres in India have used it but the number of patients treated is few. The USFDA, the apex body in the US regulating food and drugs and medical equipment and therapies, has on its 13 April 2020 recommendations suggested that plasma therapy be used:

In registered clinical trials for investigational use

expanded access for use in seriously ill patients who are not eligible or are unable to participate in a clinical trial

single patient use of an investigational drug in case of a life-threatening situation on the advice of a licensed physician under FDA authorisation. This is like using the medicine on compassionate ground. Random use of the therapy for COVID-19 patients in the absence of patient selection and treatment guidelines formulated by scientific bodies has not been approved in any country. Significantly, the Union health ministry advised against considering plasma therapy as regular therapy for COVID-19 patients and added that it should only be used for research and trials at present.

Why caution is being exercised on using plasma therapy

At present plasma therapy for COVID-19 is still under investigation and concrete data on its usefulness is not available. All medical devices and drugs pass through stringent evaluation for safety before allowed to be used as a regular therapy.

Plasma transfusion carries a number of risks, some of which are very serious. These include transfusion-related acute lung injury (TRALI) which can cause breathing difficulty/respiratory failure, transfusion-associated circulatory overload (TACO) which can cause heart failure symptoms, allergic reactions or life-threatening anaphylactic shock, risk of infection from other pathogens in the donor's plasma or acquired during processing, fever, graft vs host disease, hemolysis or breakdown of red blood cells in the recipient etc.

Also, we still don’t know exactly at what stage of the illness the patient should be treated, what should exclude a patient from getting this treatment, how much antibody should be present in the plasma to provide the benefit of treatment.

Since every medical therapy has to be decided on risk versus benefit ratio, till the time a clear benefit from the therapy against the disease is established and the benefit clearly outscore the risk it can be harmful to the community if allowed for use beyond controlled settings.

What the available evidence is for its use

Previous studies, though with some flaws in study design, on the use of plasma therapy on H1N1 (Spanish flu), swine flu, SARS-CoV1 has documented positive results. A 2014 Meta-analysis of studies on the use of plasma therapy in influenza and corona viral infections showed a consistent reduction in mortality.

Incidence of severe adverse effects has been quite low. This evidence forms the basis of trying plasma therapy in the current pandemic. However, the pool of evidence on the use of plasma on the COVID-19 is quite small, given the time frame of the disease. We will still need to wait for results from investigational trials to know the answer.

Is there a chance for plasma in COVID-19?

Like many of the options already explored for COVID-19, this is one of the options. It may show modest success, good success or no success. Plasma therapy has always been used in the past and in a variety of conditions but almost always the advent of a vaccine or an antibiotic has pushed plasma therapy to the background.

If it proves to be of some success it will be approved for use in regular clinical settings by regulatory and scientific bodies. If approved for use it will definitely buy some time and save a few lives till a vaccine is available or herd immunity is developed.

It is a promising solution at the present gloomy situation, but till we have reliable evidence on utility unregulated use is to be avoided, as random use does not contribute meaningfully to the database from which a useful conclusion can be drawn. A lot of studies are going on the world over on its use, and hopefully, we will soon know the answer.

The author is a consultant anesthesiologist in a private hospital in Delhi-NCR.

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mastcomm · 5 years

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Wuhan Coronavirus Looks Increasingly Like a Pandemic, Experts Say

The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe, according to many of the world’s leading infectious disease experts.

The prospect is daunting. A pandemic — an ongoing epidemic on two or more continents — may well have global consequences, despite the extraordinary travel restrictions and quarantines now imposed by China and other countries, including the United States.

Scientists do not yet know how lethal the new coronavirus is, however, so there is uncertainty about how much damage a pandemic might cause. But there is growing consensus that the pathogen is readily transmitted between humans.

The Wuhan coronavirus is spreading more like influenza, which is highly transmissible, than like its slow-moving viral cousins, SARS and MERS, scientists have found.

“It’s very, very transmissible, and it almost certainly is going to be a pandemic,” said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Disease.

“But will it be catastrophic? I don’t know.”

In the last three weeks, the number of lab-confirmed cases has soared from about 50 in China to 14,000 in 23 countries; there have been over 300 deaths, all but one in China.

But various epidemiological models estimate that the real number of cases is 100,000 or even more. While that expansion is not as rapid as that of flu or measles, it is an enormous leap beyond what virologists saw when SARS and MERS emerged.

When SARS was vanquished in July 2003 after spreading for nine months, only 8,098 cases had been confirmed. MERS has been circulating since 2012, but there have been only about 2,500 known cases.

The biggest uncertainty now, experts said, is how many people around the world will die. SARS killed about 10 percent of those who got it, and MERS now kills about one of three.

The 1918 “Spanish flu” killed only about 2.5 percent of its victims — but because it infected so many people and medical care was much cruder then, 20 to 50 million died.

By contrast, the highly transmissible H1N1 “swine flu” pandemic of 2009 killed about 285,000, fewer than seasonal flu normally does, and had a relatively low fatality rate, estimated at .02 percent.

The mortality rate for known cases of the Wuhan coronavirus has been running about 2 percent, although that is likely to drop as more tests are done and more mild cases are found.

It is “increasingly unlikely that the virus can be contained,” said Dr. Thomas R. Frieden, a former director of the Centers for Disease Control and Prevention who now runs Resolve to Save Lives, a nonprofit devoted to fighting epidemics.

“It is therefore likely that it will spread, as flu and other organisms do, but we still don’t know how far, wide or deadly it will be.”

In the early days of the 2009 flu pandemic, “they were talking about Armageddon in Mexico,” Dr. Fauci said. (That virus first emerged in pig-farming areas in Mexico’s Veracruz State.) “But it turned out to not be that severe.”

An accurate estimate of the virus’s lethality will not be possible until certain kinds of studies can be done: blood tests to see how many people have antibodies, household studies to learn how often it infects family members, and genetic sequencing to determine whether some strains are more dangerous than others.

Closing borders to highly infectious pathogens never succeeds completely, experts said, because all frontiers are somewhat porous. Nonetheless, closings and rigorous screening may slow the spread, which will buy time for the development of drug treatments and vaccines.

Other important unknowns include who is most at risk, whether coughing or contaminated surfaces are more likely to transmit the virus, how fast the virus can mutate and whether it will fade out when the weather warms.

The effects of a pandemic would probably be harsher in some countries than in others. While the United States and other wealthy countries may be able to detect and quarantine the first carriers, countries with fragile health care systems will not. The virus has already reached Cambodia, India, Malaysia, Nepal, the Philippines and rural Russia.

“This looks far more like H1N1’s spread than SARS, and I am increasingly alarmed,” said Dr. Peter Piot, director of the London School of Hygiene and Tropical Medicine. “Even 1 percent mortality would mean 10,000 deaths in each million people.”

Other experts were more cautious.

Dr. Michael Ryan, head of emergency responses for the World Health Organization, said in an interview with STAT News on Saturday that there was “evidence to suggest this virus can still be contained” and that the world needed to “keep trying.”

Dr. W. Ian Lipkin, a virus-hunter at the Columbia University Mailman School of Public Health who is in China advising its Center for Disease Control and Prevention, said that although the virus is clearly being transmitted through casual contact, labs are still behind in processing samples.

But life in China has radically changed in the last two weeks. Streets are deserted, public events are canceled, and citizens are wearing masks and washing their hands, Dr. Lipkin said. All of that may have slowed down what lab testing indicated was exponential growth in the infection.

It’s unclear exactly how accurate tests done in overwhelmed Chinese laboratories are. On the one hand, Chinese state media have reported test kit shortages and processing bottlenecks, which could produce an undercount.

But Dr. Lipkin said he knew of one lab running 5,000 samples a day, which might produce some false-positive results, inflating the count. “You can’t possibly do quality control at that rate,” he said.

Anecdotal reports from China, and one published study from Germany, indicate that some people infected with the Wuhan coronavirus can pass it on before they show symptoms. That may make border-screening much harder, scientists said.

Epidemiological modeling released Friday by the European Center for Disease Prevention and Control estimated that 75 percent of infected people reaching Europe from China would still be in the incubation periods upon arrival, and therefore not detected by airport screening, which looks for fevers, coughs and breathing difficulties.

But if thermal cameras miss victims who are beyond incubation and actively infecting others, the real number of missed carriers may be higher than 75 percent.

Still, asymptomatic carriers “are not normally major drivers of epidemics,” Dr. Fauci said. Most people get ill from someone they know to be sick — a family member, a co-worker or a patient, for example.

The virus’s most vulnerable target is Africa, many experts said. More than 1 million expatriate Chinese work there, mostly on mining, drilling or engineering projects. Also, many Africans work and study in China and other countries where the virus has been found.

If anyone on the continent has the virus now, “I’m not sure the diagnostic systems are in place to detect it,” said Dr. Daniel Bausch, head of scientific programs for the American Society of Tropical Medicine and Hygiene, who is consulting with the W.H.O. on the outbreak.

South Africa and Senegal could probably diagnose it, he said. Nigeria and some other countries have asked the W.H.O. for the genetic materials and training they need to perform diagnostic tests, but that will take time.

At least four African countries have suspect cases quarantined, according to an article published Friday in The South China Morning Post. They have sent samples to France, Germany, India and South Africa for testing.

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At the moment, it seems unlikely that the virus will spread widely in countries with vigorous, alert public health systems, said Dr. William Schaffner, a preventive medicine specialist at Vanderbilt University Medical Center.

“Every doctor in the U.S. has this top of mind,” he said. “Any patient with fever or respiratory problems will get two questions. ‘Have you been to China? Have you had contact with anyone who has?’ If the answer is yes, they’ll be put in isolation right away.”

Assuming the virus spreads globally, tourism to and trade with countries besides China may be affected — and the urgency to find ways to halt the virus and prevent deaths will grow.

It is possible that the Wuhan coronavirus will fade out as weather warms. Many viruses, like flu, measles and norovirus, thrive in cold, dry air. The SARS outbreak began in winter, and MERS transmission also peaks then, though that may be related to transmission in newborn camels.

Four mild coronaviruses cause about a quarter of the nation’s common colds, which also peak in winter.

But even if an outbreak fades in June, there could be a second wave in the fall, as has occurred in every major flu pandemic, including those that began in 1918 and 2009.

By that time, some remedies might be on hand, although they will need rigorous testing and perhaps political pressure to make them available and affordable.

In China, several antiviral drugs are being prescribed. A common combination is pills containing lopinavir and ritonavir with infusions of interferon, a signaling protein that wakes up the immune system.

In the United States, the combination is sold as Kaletra by AbbVie for H.I.V. therapy, and it is relatively expensive. In India, a dozen generic makers produce the drugs at rock-bottom prices for use against H.I.V. in Africa, and their products are W.H.O.-approved.

Another option may be an experimental drug, remdesivir, on which the patent is held by Gilead. The drug has not yet been approved for use against any disease. Nonetheless, there is some evidence that it works against coronaviruses, and Gilead has donated doses to China.

Several American companies are working on a vaccine, using various combinations of their own funds, taxpayer money and foundation grants.

Although modern gene-chemistry techniques have made it possible to build vaccine candidates within just days, medical ethics require that they then be carefully tested on animals and small numbers of healthy humans for safety and effectiveness.

That aspect of the process cannot be sped up, because dangerous side effects may take time to appear and because human immune systems need time to produce the antibodies that show whether a vaccine is working.

Whether or not what is being tried in China will be acceptable elsewhere will depend on how rigorously Chinese doctors run their clinical trials.

“In God we trust,” Dr. Schaffner said. “All others must provide data.”

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kimoramorory · 7 years

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Tamiflu Reduces The Number Of Cases Of Pneumonia In 'Swine Flu' Patients

Tamiflu Reduces The Number Of Cases Of Pneumonia In 'Swine Flu' Patients. When infatuated soon after the onset of symptoms, the antiviral treatment Tamiflu seems to have protected otherwise healthy swine flu patients from contracting pneumonia during the 2009 H1N1 pandemic, Chinese researchers say antehealth. Tamiflu may also have shortened the spell that patients were contagious and reduced the duration of their fevers, the examination team said. However, reporting in the Sept 29 consummation of 'bmj dot com', the study authors stressed that their findings should be interpreted with caution given that the conclusions are based on an after-the-fact enquiry and on a pool of patients not uniformly given chest X-rays at the time of illness xanogen in iran. The office team, led by Dr Weizhong Yang and Dr Hongjie Yu from the Chinese Center for Disease Control and Prevention in Beijing, note that in 2009 the fast-spreading influenza A (H1N1) virus killed more than 18000 bourgeoisie in over 200 countries. Prior probe has suggested that patients who swallow antiviral medications within two days of experiencing seasonal flu symptoms may emerge a less severe and shorter-lasting illness and may also reduce their risk for complications sister. To gauge to what degree this might be trustworthy for healthy patients with a mild form of H1N1, the research team reviewed the medical records of nearly 1300 Chinese patients diagnosed with the infection in 2009. The ordinary age of the patients was 20. More than three-quarters were given Tamiflu within a median of three days following the commencement of symptoms, and 920 of the patients underwent consolidation chest X-rays. Just 12 percent of those X-rayed had signs of pneumonia, the researchers observed. None of them needed tariff for intensive care, and none required mechanical ventilation. Even after accounting for age, gender, influenza vaccine and antibiotic therapy history, the authors concluded that Tamiflu remedying appeared to offer significant protection against pneumonia. This protective effect was unmistakable in all patients who took Tamiflu, even those who took it more than 48 hours after symptom onset, but those who took the medication within 48 hours competent shorter fevers and were contagious for a shorter time impotence. The Chinese troupe nonetheless called for more follow-up research to investigate the potential benefits of Tamiflu for swine flu.

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hollyrosemassage · 8 years

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Akin to human influenza virus, swine influenza virus in pigs additionally exhibits steady change. Pigs within the respiratory tract of pig, human and chicken flu viruses are delicate to the recipient. Subsequently, pigs, swine influenza virus an infection within the case of the simultaneous emergence of latest influenza viruses is rising the probability. Who’ye, the reason for dying in Mexico of the swine influenza A/H1N1 virus. This virus can infect human to human. A/H1N1 virus, human, pig and is made from a mix of chicken flu virus. Is there a vaccine for swine flu? The vaccine is obtainable to the pigs, however no human vaccine but. Coming back from Mexico in New Zealand, some 25 folks displaying signs of swine flu have been quarantined. New Zealand’s largest group of highschool college students and lecturers yesterday to return the Auckland’e specified. Auckland Regional Public Well being Providers Director Dr. Julia Peters, 1 instructor with 13 college students isn’t a very good state of well being, mentioned a scholar was taken to the hospital. The Ministry of Well being spokesman Michael Flyger an element group have flu-like signs, check outcomes shall be made inside days. Mexico is within the swine flu virus precipitated extreme pneumonia is a thought from 81 folks misplaced their lives. In Mexico colleges, museums, libraries and theaters, multiple thousand folks have been sick off to deal with the epidemics. However, Japan’s greatest worldwide airport, enhance the well being checks, the Philippines got here from Mexico and the hearth was reported that passengers can get quarantined. State well being officers in Thailand and Hong Kong’taki are carefully adopted. China’s pig flu shot inside two weeks from the top of the area and other people with flu signs ought to present the data to the authorities mentioned. Australia go to to Mexico within the Well being Directorate and flu-like sickness to a physician who needed to look. Malaysia and different Asian international locations, the World Well being Group mentioned the brand new descriptions wait. Asia, 2003, the chicken flu virus outbreak H5N1?den was the realm most mustarip. Fowl flu was not less than 257 folks misplaced their lives. Lots of people who trigger dying and unfold to America and Canada, and Europe and in Australia to trace the virus is discovered, folks can go from human to human, pig and chicken flu the combination is outlined as a virus. Supply: How To Get Rid Of Swine Flu Bradford Massage Therapy | Holly Rose Massage Swedish MassageSports MassageDeep Tissue MassagePrenatal MassageAromatherapyTrigger Point Therapy The post How To Get Rid Of Swine Flu appeared first on Holly Rose Massage. http://ift.tt/2fBSloa

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brajeshupadhyay · 4 years

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Since the beginning of the COVID-19 crisis, the global scientific community is struggling to find solutions to stop the spread of the contagion and to effectively treat the infection caused by it. As this is a new and evolving crisis and it has taken the world by storm, abundant theories and remedies are floating around, but no definitely proven therapy has emerged. While the disease spread is currently being countered with WHO advocated strategies of containment with lockdown, patient identification by testing for infection and quarantine of patients and suspected patients, these strategies will only slow down the spread of the disease but the world will still need treatment and a vaccine for the prevention of infection. Some vaccines are under development and will need months before they hit the market, if at all. In the meantime, the global spread of the infection is killing thousands of people daily and there is a severe need to treat the patients with specific medications and other therapy directed at the virus in addition to standard care. There are a few contender medicines including the malaria drug hydroxychloroquine, an antiviral Remdesivir, and Ivermectin, a drug used for worms and other parasites, but the results are not hugely encouraging and at times conflicting. In this backdrop, plasma therapy is being seen with interest as a cure for COVID-19 patients. What is plasma? Human blood is composed of cells like the red cells that carry oxygen, white cells that fight infection and platelets that stop bleeding from cuts. The watery part contains minerals and many proteins like albumin, factors that make the blood clot, and antibodies which are special proteins produced by the body against infective agents. The serum is the plasma from which the clotting factors have been removed. What is plasma therapy? Plasma transfusion is a very common process done during major surgeries and in patients with bleeding, mainly to provide clotting factors. The main component of interest in plasma therapy and serum therapy for infectious diseases like COVID-19 is the antibodies. The principle applied is that a person who has recovered from the infection would have antibodies directed against the infective agent, in this case, the COVID-19 virus. Click here for Coronavirus Outbreak LIVE Updates It is assumed that if injected to a person currently having the disease the antibodies would neutralise the virus, helping in achieving an early cure. Injecting the plasma or serum from patients who have recovered from the disease, called convalescent plasma, may achieve this. Plasma therapy has been used earlier with some success in other infections like in two previous corona viral epidemics SARS-CoV1 and MERS, and also in H1N1 of 2009-10 and Ebola epidemic. Likewise, the animal serum is widely used in the treatment of diseases like tetanus, diphtheria, gas gangrene, botulism, snake and spider bite. How is plasma therapy done for COVID-19? Convalescent plasma transfusion is a relatively easy process. It involves collecting plasma by a process called apheresis or whole blood collection as for blood transfusion followed by separation of the plasma in the laboratory from patients who have recovered from the infection. The donor is tested as for any blood donor and the plasma is then subjected to standard testing as for blood transfusion. In addition, a few more criteria are to be fulfilled which include a positive diagnostic or serological test in the donor and sufficient time has passed since recovery to render the plasma non-infective. If the donor is female then a special class of antibody called HLA antibody should be absent in the plasma. The donated plasma must have sufficient antibodies against COVID-19 to offer treatment value. Which COVID-19 patients can have plasma therapy Currently, India has not framed any guideline for mass use of plasma therapy in COVID-19 patients. The Indian Council of Medical Research (ICMR), the apex medical body in India, is still conducting a trial on the effectiveness of the therapy. A few centres in India have used it but the number of patients treated is few. The USFDA, the apex body in the US regulating food and drugs and medical equipment and therapies, has on its 13 April 2020 recommendations suggested that plasma therapy be used: In registered clinical trials for investigational use expanded access for use in seriously ill patients who are not eligible or are unable to participate in a clinical trial single patient use of an investigational drug in case of a life-threatening situation on the advice of a licensed physician under FDA authorisation. This is like using the medicine on compassionate ground. Random use of the therapy for COVID-19 patients in the absence of patient selection and treatment guidelines formulated by scientific bodies has not been approved in any country. Significantly, the Union health ministry advised against considering plasma therapy as regular therapy for COVID-19 patients and added that it should only be used for research and trials at present. Why caution is being exercised on using plasma therapy At present plasma therapy for COVID-19 is still under investigation and concrete data on its usefulness is not available. All medical devices and drugs pass through stringent evaluation for safety before allowed to be used as a regular therapy. Plasma transfusion carries a number of risks, some of which are very serious. These include transfusion-related acute lung injury (TRALI) which can cause breathing difficulty/respiratory failure, transfusion-associated circulatory overload (TACO) which can cause heart failure symptoms, allergic reactions or life-threatening anaphylactic shock, risk of infection from other pathogens in the donor's plasma or acquired during processing, fever, graft vs host disease, hemolysis or breakdown of red blood cells in the recipient etc. Also, we still don’t know exactly at what stage of the illness the patient should be treated, what should exclude a patient from getting this treatment, how much antibody should be present in the plasma to provide the benefit of treatment. Since every medical therapy has to be decided on risk versus benefit ratio, till the time a clear benefit from the therapy against the disease is established and the benefit clearly outscore the risk it can be harmful to the community if allowed for use beyond controlled settings. What the available evidence is for its use Previous studies, though with some flaws in study design, on the use of plasma therapy on H1N1 (Spanish flu), swine flu, SARS-CoV1 has documented positive results. A 2014 Meta-analysis of studies on the use of plasma therapy in influenza and corona viral infections showed a consistent reduction in mortality. Incidence of severe adverse effects has been quite low. This evidence forms the basis of trying plasma therapy in the current pandemic. However, the pool of evidence on the use of plasma on the COVID-19 is quite small, given the time frame of the disease. We will still need to wait for results from investigational trials to know the answer. Is there a chance for plasma in COVID-19? Like many of the options already explored for COVID-19, this is one of the options. It may show modest success, good success or no success. Plasma therapy has always been used in the past and in a variety of conditions but almost always the advent of a vaccine or an antibiotic has pushed plasma therapy to the background. If it proves to be of some success it will be approved for use in regular clinical settings by regulatory and scientific bodies. If approved for use it will definitely buy some time and save a few lives till a vaccine is available or herd immunity is developed. It is a promising solution at the present gloomy situation, but till we have reliable evidence on utility unregulated use is to be avoided, as random use does not contribute meaningfully to the database from which a useful conclusion can be drawn. A lot of studies are going on the world over on its use, and hopefully, we will soon know the answer. The author is a consultant anesthesiologist in a private hospital in Delhi-NCR.

http://sansaartimes.blogspot.com/2020/04/unregulated-use-of-plasma-therapy-for.html

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