The WHO recommends exclusive breastfeeding for a baby’s first six months and continued breastfeeding up to two years of age. Uganda’s parliament has been promoting breastfeeding with a free, day care center for female legislators and staffers. Halima Athumani reports for VOA.
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A study published this month in the online scientific journal Nature stunned the world: Scientists were able to fix a hereditary genetic mutation in a human embryo. The milestone achievement was quickly tempered by the ethical question: Will this lead to the making of designer babies?’ VOA’s George Putic explains.
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Many indigenous populations suffer from high rates of viral hepatitis, and are 2 to 5 times as likely as the surrounding general population to contract it. But efforts to eliminate the diseases have begun to show promise, some researchers say.

Globally, 71 million people have hepatitis C and 257 million have hepatitis B. The viruses cause inflammation of the liver and can lead to cirrhosis and, especially with hepatitis C, liver cancer.

Most cases come from contact with infected blood, drug use, tattoos with unclean needles, or sexual transmission. Before the screening of blood in 1992, blood transfusions were a frequent source. The infection also can pass from a mother to her newborn child.

At the World Indigenous People’s Conference on Viral Hepatitis this week in Anchorage, Alaska, scientists reported on the problem and the efforts to solve it, including one of the first efforts to eliminate hepatitis C from a population.

​Reasons for high rates of infection

Homie Razavi and Devin Razavi-Shearer, epidemiologists from the Polaris Observatory, examined why infection rates were so high among indigenous communities. In Canada, hepatitis B rates were five times higher than the general population, and hepatitis C, three times higher. In Australia, indigenous people were four times as likely to contract hepatitis B and three times as likely to contract hepatitis C.

The researchers said the rates were likely because to “disproportionately high rates of poverty, injection drug use, and incarceration in indigenous populations. This, in combination with the lack of access to health care and prevention measures, greatly increases the risk and thus prevalence of hepatitis C.”

But great progress is being made. In the 1980s, vaccination programs began to cut infection rates of hepatitis B.

Dr. Brian McMahon, director of the Alaska Native Tribal Health Consortium, told the conference that new surveys have shown that the disease has been virtually eliminated in young indigenous people in Alaska.

Eliminating infection

Jorge Mera, director of infectious diseases for Cherokee Nation Health Services in Oklahoma, reported on an effort there to eliminate hepatitis C.

“Of the people we think have hepatitis C in the community, we’ve treated one-third of them,” he told VOA, “and that’s pretty good for a program that we started two years ago.”

That program is the first effort in the United States, and one of the first in the world, to attempt to wipe out the virus. Treatments for hepatitis C have improved dramatically over the past decade, making these efforts possible.

Mera said there are many programs around the world in the planning stages, and he pointed to a number of things those programs can learn from the Cherokee Nation’s effort.

“Most of the patients that we’re detecting positive are coming in through the urgent care and emergency department,” he said, “so if you have limited resources, these are areas that I would focus on.”

Health officials in the Cherokee Nation are screening everyone between the ages of 20 and 69. This effort includes screening people during dental appointments.

The Centers for Disease Control and Prevention has recommended screening older adults, but Mera said there were high rates of hepatitis infection in people in their 20s and 30s. He suggested that others setting up elimination programs first determine the prevalence of infection in their respective communities before deciding whom to screen.

He said history has led to high rates of hepatitis in indigenous populations. 

“When you have a population that has been oppressed or traumatized for centuries due to the nature of how the Western colonization process developed, those are factors that may lead substantial portions of that population to seek some relief in nonconventional ways like intravenous drug use,” Mera said.

Preventing transmission is crucial to eliminating hepatitis C, Mera said. One way to combat transmission, he said, is to legalize and expand needle exchanges and opiate-substitution programs.
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A ferocious seagoing crocodile that menaced coastal waters about 164 million years ago during the Jurassic Period has been given a name honoring the similarly ferocious heavy-metal rocker Lemmy, the late frontman for the British band Motörhead .

Scientists said on Wednesday they had named the 19-foot-long (5.8 meters) reptile Lemmysuchus, meaning “Lemmy’s crocodile.” Its fossils were unearthed near the eastern English city of Peterborough in 1909 and were recently re-examined and determined to be a distinct genus in need of a name.

Its enlongated, narrow snout resembled those of modern fish-eating crocs from India called gharials. It boasted large, blunt teeth, perfect for crushing turtle shells or other hard-bodied prey like hard-scaled fish, said University of Edinburgh paleontologist Michela Johnson, lead author of the study published in the Zoological Journal of the Linnean Society.

“It’s big, ugly and quite scary. We think that Lemmy would have liked it. For me, this is a career high, and I can now die happy,” added another of the researchers, Lorna Steel, who came up with the name.

Known for hard living and hard rocking, gravelly voiced Ian “Lemmy” Kilmister, died of cancer at age 70 in 2015 in Los Angeles. He formed his influential band Motörhead in 1975.

“I wanted to name something after Lemmy after he died,” said Steel, senior curator for fossils from the croc family, birds and flying reptiles at the Natural History Museum in London.

“At that time, late December 2015, I was working with colleagues from Edinburgh University on this particular fossil specimen,” she said. “I kept the thought to myself for a while but then floated the idea past the others. They all thought it was great, and it really is the most appropriate fossil to bear Lemmy’s name.”

Lemmysuchus was a member of a group called teleosaurs, seagoing crocodiles that thrived for tens of millions of years during the age of dinosaurs. The seas at the time were also populated by a number of types of marine reptiles, including long-necked plesiosaurs and dolphin-like ichthyosaurs.

Johnson studied the fossil specimen held at the Natural History Museum and determined that it had been incorrectly classified as another teleosaur called Steneosaurus.
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Scientists have the first major evidence that blood tests called liquid biopsies hold promise for screening people for cancer. Hong Kong doctors tried it for a type of head and neck cancer, and boosted early detection and one measure of survival.

The tests detect DNA that tumors shed into the blood. Some are used now to monitor cancer patients, and many companies are trying to develop versions of these for screening, as possible alternatives to mammograms, colonoscopies and other such tests. The new study shows this approach can work, at least for this one form of cancer and in a country where it’s common.

“This work is very exciting on the larger scale” because it gives a blueprint for how to make tests for other tumor types such as lung or breast, said Dr. Dennis Lo of Chinese University of Hong Kong. “We are brick by brick putting that technology into place.”

He led the study, published Wednesday by the New England Journal of Medicine. Lo is best known for discovering that fetal DNA can be found in a mom’s blood, which launched a new era of non-invasive testing for pregnant women.

The study involved nasopharyngeal cancer, which forms at the top of the throat behind the nose. It’s a good test case for DNA screening because it’s an aggressive cancer where early detection matters a lot, and screening could be tried in a population where the cancer is most common — middle-aged Chinese men.

Also, the Epstein-Barr virus is involved in most cases, so tests could hunt for viral DNA that tumors shed into the blood in large quantities, rather than rare bits of cancer cells themselves. 

About 20,000 men were screened, and viral DNA was found in 1,112, or 5.5 percent. Of those, 309 also had the DNA on confirmatory tests a month later. After endoscope and MRI exams, 34 turned out to have cancer.

More cases were found at the earliest stage — 71 percent versus 20 percent of a comparison group of men who had been treated for nasopharyngeal cancer over the previous five years. That’s important because early cases often are cured with radiation alone, but more advanced ones need chemotherapy and treatment is less successful.

Screening also seemed to improve how many survived without worsening disease — 97 percent at three years versus 70 percent of the comparison group.

Only one person who tested negative on screening developed nasopharyngeal cancer within a year. 

The researchers estimate 593 people would need to be screened at a total cost of $28,600 to identify one cancer case. It may be worth it in Hong Kong, but maybe not in places like the U.S. where the disease is rare, and more people would have to be screened at a greater cost to find each case, said Dr. Richard Ambinder of Johns Hopkins School of Medicine, who wrote a commentary in the journal.

Still, “this is showing that liquid biopsies have great promise,” he said. “This is an advance that will indeed save lives.”

The study was sponsored by an Asian foundation and the Hong Kong government. Lo and some other authors founded Cirina, a Hong Kong-based company focused on early cancer detection, and get royalties related to DNA blood tests. In May, Cirina merged with Grail Inc., a California company working on cancer screening blood tests with more than $1 billion from drug companies and big-name investors such as Jeff Bezos and Bill Gates.
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The International Organization for Migration (IOM) is calling for rapid action to prevent a cholera epidemic in South Sudan from spiraling out of control as the rainy season in the country progresses.

More than 18,000 cases of cholera, including 328 deaths have been reported in South Sudan since June 2016. The International Organization for Migration warns the number of cases and deaths is likely to grow as the rainy season this year will leave as much as 60 percent of the country inaccessible by road.

IOM spokeswoman, Olivia Headon, tells VOA a combination of factors including the ongoing crisis, the rainy season and the movement of displaced people across the country is making it extremely difficult to contain this deadly disease.

“So, if you are maybe infected with cholera or someone in your family if you come in contact with this and then you move to a different part of the country, you are also bringing the infection with you,” she said. “We hope that it does not spiral out of control and IOM with other partners in the U.N. and NGO [non-governmental organization] implementers on the ground are working so it does not.”

IOM reports the scale of needs in this conflict-ridden country is unprecedented, with more than 7.5 million people dependent on humanitarian aid. The agency says disease outbreaks, such as cholera, are particularly dangerous for displaced and vulnerable populations. This includes children under five, thousands of whom are severely acutely malnourished and at risk of dying without therapeutic help.

Headon says IOM and partners are leading oral cholera vaccination campaigns across South Sudan. She says they are distributing cholera kits, including jerry cans, water treatment supplies and soap. She says aid workers also are repairing boreholes and conducting hygiene promotion in cholera-affected areas across the country.

 
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The World Health Organization in Myanmar says a recent outbreak of H1N1 in the country is not unusual for the time of the year, and while there may be more cases in the future the available data suggests it is not a cause for panic.

Myanmar’s state media reported on Wednesday that since July 21 there have been 166 confirmed cases and 17 deaths from the virus, known commonly as swine flu after a global pandemic in 2009 was found to have originated in infected pigs. The respiratory infection is now considered a normal human flu.

Seasonal event

Dr. Stephan Paul Jost, WHO’s country representative in Myanmar, said in an interview the consensus based on the evidence so far is that “this is a seasonal event, it’s a seasonal influenza, and there are likely to be also more cases because it is seasonal. And it is not in itself a cause for alarm.”

“Influenza of course can be a serious disease and people can also die from it,” he added. “It happens in every country in the world in the flu season and sometimes even outside it.”

The damp and slightly cooler conditions of Myanmar’s rainy season are also favorable for the influenza virus.

But Jost said the numbers are generally in line with what WHO is seeing in countries in the region.

“It is not in itself an unusual event. Of course we are keeping a close eye on it,” he said.

Monitoring

Dr. Than Htun Aung, the deputy director of the public health department with Myanmar’s Ministry of Health and Sports, said the government is in the process of stepping up monitoring and that it’s too early to say whether the virus has tapered off.

“Now we’re controlling. We are waiting [for] more information from the surveillance. We can’t say now,” he said. “I think we can control like other countries did. USA was the same, they had more patients than we had. Now we’re learning what they have done and planning procedures.”

WHO is providing technical support in terms of specific guidelines, consulting with regional experts, and facilitating samples to be sent to laboratories abroad.

It has also worked with Facebook representatives in the region and locally to look at various messaging and discussion about H1N1 on social media, which some believe contributed to an unnecessary panic over the outbreak, with large numbers of people in the commercial capital Yangon donning surgical masks as a main line of defense.

“We’re looking at the different terminology used in Facebook for influenza and for this particular outbreak to see whether we can work together to get more systematic and authoritative messages out that are quite simple but … recommended by WHO,” Jost said, adding it was an ongoing process. “We are still working together on this to actually find the best way forward.”

A representative for the social media platform in Singapore was not immediately available for comment as August 9 is a public holiday in the country.

Surgical masks

Jost described the use of surgical masks in Myanmar as perhaps a “bit overdone,” in particular N95 masks, which are not recommended for the public as they are difficult to wear and better for hospital environments and health workers.

However, light surgical masks that fit easily on the face can be useful in some situations, he said, especially if you know you have the flu. They may even cut down on transmission in crowded places like buses.

“Influenza is transmitted by a fine droplet. It’s not airborne, you don’t get it just by breathing air. It’s fine droplets, by sneezing and coughing, that are dispersed, that’s transmitted, and that’s usually then also by hand, either by shaking hands or it lands in your hand and you rub your eyes and it enters your system,” he said. “So even masks would not protect from that. You could have a mask and you are rubbing your eyes and you are still getting it.”

“But if you are sick [and wearing a mask] you are preventing then the dispersal of these fine droplets to others. That is definitely helping. That is good,” he added.

One of the other issues that arose in response to the outbreak was a lack of past data that could help authorities assess the scope of the problem.

Jost said WHO had suggested health officials could strengthen the surveillance of cases so “a picture would really emerge that is more consistent, more complete than what is currently available and would give us a better idea historically, what is the historical activity of the influenza viruses in the country.”

He said Myanmar had a lot of cases in 2010, the year after the worldwide outbreak, and also in 2014.

“But how complete this information is we are not as sure as perhaps we could be. And that’s true for many countries,” he said.

Jost also complimented Myanmar’s health officials and government partners on the outbreak response, saying it was “very encouraging.”

Aung Naing Soe contributed to this report.

 
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