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Winning the hearts of communities fearful of Ebola

Goma, Democratic Republic of the Congo, 24 June 2019 – “You cant take my son away because I know you..

Goma, Democratic Republic of the Congo, 24 June 2019 – “You cant take my son away because I know you will go kill him. You will inject him with Ebola. Thats what everybody here knows.”

This response from an angry father, faced with the possibility that his son would be moved from a local hospital to an Ebola Treatment Centre, reflects the reality of containing an epidemic in an area where folklore, rumour and suspicion of outsiders abound.

For Dr. Ramses Kalumbi, Surveillance Team Leader for the World Health Organization (WHO) in Goma, reassuring his patients and their families is all in a days work. Empathy, patience and compassion are a vital part of the treatment offered by his team of doctors, psychologists and health workers.

The Ebola-affected city of Butembo, where the 27-year-old man has been working as a driver, is 350km away – an eight-hour journey by road. He had returned home to visit his family when he started to feel unwell.

Initial symptoms indicated malaria but his high fever and diarrhoea have rung alarm bells, and now he is terrified. So far, the tiered system of surveillance set up by the government and WHO have kept the disease out of Goma, but nobody can afford to take any chances.

His case came to the attention of a surveillance team combing health facilities and neighbourhoods to identify patients with symptoms that might indicate Ebola infection.

Such cases are quickly sent to the alert centre which deploys investigators to assess the patient and decide whether to authorise a transfer to the nearest Ebola Treatment Centre for blood tests. If the test returns positive, the patient is isolated for treatment and if negative the patient is returned to the initial health facility or to their family to continue previous treatment.

Coupled with distrust of health workers is a belief among many people in Goma that Ebola does not exist.

“They do not have family members in the regions affected by the disease. They are people who have not travelled to see the devastation,” says Bahati Sabimana Faustin, a traditional healer who works in the Bujavu area of Goma.

Support from traditional healers like Faustin who have had training in how to recognise Ebola symptoms play an important role in containing the disease and in encouraging the community to take precautions.

“If a patient comes to me with high temperature, vomiting, diarrhoea or bleeding, I receive them, put them in a separate room and contact the alert centre for further investigation,” Faustin explains. So far he has referred two patients but both were found not to be suffering from Ebola.

“There are many people who do not believe Ebola is real but after getting the right information, they often change their minds. I tell them that Ebola exists. I am certain it is there. Ebola is real,” he says.

Back in the primary health facility, Dr Kalumbi and a psychologist from the ministry are engaging with the family in an attempt to reassure them that their son will be safe.

“Look at me baba. Look at me. I am one of you,” Dr Kalumbi says, looking in the eyes of the angry father. “I will take care of your son. My promise to you is that no one will hurt him.”

“Look at my son, he is healthy except that he has malaria,” the father replied. “I hear all the time that you take healthy people like him and inject them with Ebola. My son will not leave this hospital. You can take his blood and do the test but you will not take him away.”

The conversation between the father and Dr. Kalumbi went back and forth, with each fear and rumour being met with calm responses from the medical team. Gradually the tension subsided.

“We care about your son and that is why we will take him to the treatment centre,” Dr Kalumbi says. “It will be a protection for him and all of you, if he truly has Ebola.”

Moments later the father agreed, on condition that he could accompany his son as the Ebola tests were administered.

As they arrived at the centre, Dr. Kalumbi received a phone call. It was from the young mans mother who pleaded with him: “Please do not inject my son with Ebola. His life is in your hands.”

She was met with the same calm, reassuring response that no one injects patients with Ebola, it is just a disease that needs to be attended to immediately.

In this case the results were good. The young man was Ebola free and was returned to his family.

As importantly, the trust that was built up between Dr. Kalumbi and the family chips away at the fears and the disinformation that he and hundreds of his colleagues face as they hit the streets again tomorrow and the following days – scouting, screening patients, tracking and engaging communities in order to stop the spread of the Ebola Virus inside the rest of the country and beyond.

“Nothing terrifies families like the isolation of one of their own for Ebola treatment,” Dr. Kalumbi says. “They fear that they will never return. There is only one way to win their trust and that is through an honest discussion and empathy.”

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Covid: Woman caught virus twice within record 20 days

A 31-year-old healthcare worker caught Covid twice within 20 days – the shortest-known gap between infections, Spanish researchers have claimed.

Tests show the woman was infected with two different variants – Delta in late December and then Omicron in January.

This shows that even if you have had Covid before, you can still be infected again even if fully vaccinated, the researchers say.

Reinfections in the UK require 90 days between positive tests.

Based on that definition, health officials say nearly 900,000 people have potentially been infected twice with Covid up to the start of April.

It is difficult to pin down an exact number, because only whole genome sequencing can confirm the infections are caused by different strains, and very few positive tests go through this process.

The Spaniard did not develop any symptoms after her first positive PCR test, but less than three weeks later she developed a cough and fever which prompted her to take another test.

When the tests were analysed further, they showed the patient had been infected by two different strains of coronavirus.

In a presentation at the European Congress of Clinical Microbiology and Infectious Diseases, study author Dr. Gemma Recio said the case highlighted that Omicron can “evade the previous immunity acquired either from a natural infection with other variants or from vaccines”.

She said: “In other words, people who have had Covid-19 cannot assume they are protected against reinfection, even if they have been fully vaccinated.

“Nevertheless, both previous infection with other variants and vaccination do seem to partially protect against severe disease and hospitalisation in those with Omicron,” added Dr Recio, from the Institut Catala de Salut, Tarragona in Spain.

She said monitoring reinfections in people who were fully vaccinated was important, and would help the search for variants which evade vaccines.

Covid reinfections rose sharply in December 2021 after the much more infectious Omicron variant emerged, and there was another increase when a slightly different version of it, called BA.2, appeared in early March.

Before that, 1% of all cases recorded in the UK were labelled as second infection – but that has now gone up to 11%.

Most are likely to be people infected by the Alpha or Delta variants and then infected again by the more contagious Omicron.

Scientists predict that eventually everyone will catch Covid twice, and probably many more times over the course of their lifetime.

Read from: https://www.bbc.com/news/health-61161529

 

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Poverty, crime linked to differences in newborns’ brains

Poverty and crime can have devastating effects on a child’s health. But a new study from researchers at Washington University School of Medicine in St. Louis suggests that some environmental factors influence the structure and function of young brains even before babies make their entrances into the world.

A study published online in the journal JAMA Network Open found that MRI scans performed on healthy newborns. At the same time, they slept indicated that babies facing social disadvantages such as poverty tended to be born with smaller brains than babies whose mothers had higher household incomes.

MRI scans of full-term newborns born to mothers living in poverty revealed smaller volumes across the entire brain — including the cortical grey matter, subcortical grey matter and white matter — than found in the brains of babies whose mothers had higher household incomes.

The brain scans, conducted only a few days to weeks after birth, also showed more miniature folding of the brain among infants born to mothers living in poverty. Fewer and shallower folds typically signify brain immaturity. The healthy human brain folds as it grows and develops, providing the cerebral cortex with a more extensive functional surface area.

A second study of data from the same sample of 399 mothers and their babies — this one published online in the journal Biological Psychiatry — reports that pregnant mothers from neighbourhoods with high crime rates gave birth to infants whose brains functioned differently during their first weeks of life than babies born to mothers living in safer neighbourhoods.

Functional MRI scans of babies whose mothers were exposed to crime displayed weaker connections between brain structures that process emotions and structures that help regulate and control those emotions. Maternal stress is believed to be one of the reasons for the weaker connections in the babies’ brains.

“These studies demonstrate that a mother’s experiences during pregnancy can have a major impact on her infant’s brain development,” said Christopher D. Smyser, MD, one of the principal investigators. “Like that old song about how the ‘knee bone is connected to the shin bone,’ there’s a saying about the brain that ‘areas that fire together wire together.’ We’re analysing how brain regions develop and form early functional networks because how those structures develop and work together may impact long-term development and behaviour.”

Babies in the study were born from 2017 through 2020, before the COVID-19 pandemic. Smyser, a professor of neurology, paediatrics and radiology, said that babies are fed when they arrive for scans because they tend to fall asleep after eating to scan newborns during the first few weeks of life successfully. They are then snugly swaddled into blankets and a device that helps keep them comfortable and still. The brain scans take place while they sleep.

In the study involving the effects of poverty, the researchers focused on 280 mothers and their newborns. First author Regina L. Triplett, MD, a postdoctoral fellow in neurology, had expected to find that maternal poverty — referred to in the paper as a social disadvantage — could affect the babies’ developing brains. But she also expected to see the effects of psychosocial stress, which includes measures of adverse life experiences and anxiety and depression.

“Social disadvantage

affected the brain across many of its structures, but there were no significant effects related to psychosocial stress,” Triplett said. “Our concern is that as babies begin life with these smaller brain structures, their brains may not develop as healthy as the brains of babies whose mothers lived in higher-income households.”

In the second study, which implicated living in high-crime neighbourhoods as a factor in weaker functional connections in the brains of newborns, first author Rebecca G. Brady, a graduate student in the university’s Medical Scientist Training Program, found that unlike the effects of poverty, the results of exposure to crime were focused on particular areas of the babies’ brains.

“Instead of a brain-wide effect, living in a high-crime area during pregnancy seems to have more specific effects on the emotion-processing regions of babies’ brains,” Brady said. “We found that this weakening of the functional connections between emotion-processing structures in the babies’ brains was robust when we controlled for other types of adversity, such as poverty. It appears that stresses linked to crime had more specific effects on brain function.”

Reducing poverty and lowering crime rates are well-established goals in public policy and health. And the researchers believe protecting expectant mothers from crime and helping them out of poverty will do more than improve brain growth and connections in their babies. But if social programs that aim to help people reach their full potential are to succeed, the researchers said the policies must focus on assisting people even before they are born.

“Several research projects around the country are now providing money for living expenses to pregnant mothers. Some cities have determined that raising pregnant mothers out of poverty is good public policy,” Smyser said. “The evidence we’re gathering from these studies certainly would support that idea.”

 

Read from: https://www.technology.org/2022/04/13/poverty-crime-change-newborns-brains/

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Urgent recall of Kinder Surprise over fears of contamination

Food Standards Australia has issued an urgent recall of four Kinder products, over fears the chocolate could be contaminated with salmonella.

The Kinder products that have been recalled are:

  • Kinder Easter Basket 120g (6x20g) – best before dates from 7/10/22 up to and including 20/11/22
  • Kinder Mini Eggs Hazelnut 100g – best before dates from 23/8/22 up to and including 13/9/22
  • Kinder Surprise Maxi 100g – best before dates from 23/8/22 up to and including 13/9/22
  • Kinder Surprise Maxi – Natoons 100g – best before dates from 23/8/22 up to and including 13/9/22

The products have been sold nationally at Coles, Woolworths, Target, Kmart, Big W, independent food retailers including IGA and petrol stations, and online.

The Kinder Surprise 20g single and three-pack eggs in white, blue and pink varieties are not affected, as well as all other Kinder products.

They chocolate could potentially cause illness if consumed, with Food Standards Australia telling consumers not to eat it.

The products can be returned to their place of purchase for a full refund.

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