Smallpox Breman, Joel G
The Journal of infectious diseases,
09/2021, Letnik:
224, Številka:
Supplement_4
Journal Article
Recenzirano
Odprti dostop
Before knowledge and use of vaccines, protection against smallpox was practiced more than a thousand years ago by traditional approaches. Invoking the good graces of smallpox gods, goddesses, and ...saints by individuals and communities was common 2. Isolation of patients was the only means known to appease and contain the bad spirits that brought and spread the disease.Traditional medical practitioners in some areas of China, India, Egypt, Ethiopia, and elsewhere collected materials from the pustules or crusts of the afflicted and inserted these into the noses or skin of healthy persons seeking protection 2. This procedure, called inoculation or variolation, probably had little effect on curtailing epidemics because of its limited use and variability of potency of the inoculum.It is remarkable that some early inoculators inserted scabs into the nose, without understanding that smallpox is acquired via the respiratory route, and, that scratching pustular material into the skin could have the same salutary effect. Nasal inoculation or dermal variolation, using material containing live virus, resulted sometimes in mild illness and protection. However, some cases of smallpox in recipients had the potential to spread within persons and communities.
The Threat of Artemisinin-Resistant Malaria Dondorp, Arjen M; Fairhurst, Rick M; Slutsker, Laurence ...
The New England journal of medicine,
09/2011, Letnik:
365, Številka:
12
Journal Article
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Since the 1970s, when Chinese researchers demonstrated the artemisinins' antimalarial potency, artemisinin-based combination therapy has become key to malaria control. But reduced susceptibility of
...Plasmodium falciparum
to artemisinin is now being seen in some places.
In the 1970s, Chinese government scientists working on a secret “Project 523” developed a new class of potent antimalarial drugs, the artemisinins or qinghaosu derivatives. In mostly unpublished work that has just been recognized by a 2011 Lasker Award to Tu Youyou, researchers in China isolated the active compounds from the plant
Artemisia annua,
tested them in mice, analyzed the chemical structure of the artemisinins, and demonstrated their high potency and rapid efficacy in human trials. Although they were widely used in China during the 1980s, only in the 1990s did the artemisinins come to wider global attention in the . . .
2020 marks 40 years since the World Health Assembly accepted the 1979 conclusion of the Global Commission for the Certification of Smallpox Eradication that the dread disease had been eradicated. It ...is fitting to reflect on the history and conduct of the eradication program, focusing on Africa. Not only is Africa where the first and last cases of the disease were recorded, but where some of the unique control and eradication strategies and tactics were discovered and deployed. The control of the COVID-19 pandemic will be dependent on many of the principles and practices used in smallpox eradication, another reason to examine the past.
Summary Poor-quality antimalarial drugs lead to drug resistance and inadequate treatment, which pose an urgent threat to vulnerable populations and jeopardise progress and investments in combating ...malaria. Emergence of artemisinin resistance or tolerance in Plasmodium falciparum on the Thailand–Cambodia border makes protection of the effectiveness of the drug supply imperative. We reviewed published and unpublished studies reporting chemical analyses and assessments of packaging of antimalarial drugs. Of 1437 samples of drugs in five classes from seven countries in southeast Asia, 497 (35%) failed chemical analysis, 423 (46%) of 919 failed packaging analysis, and 450 (36%) of 1260 were classified as falsified. In 21 surveys of drugs from six classes from 21 countries in sub-Saharan Africa, 796 (35%) of 2297 failed chemical analysis, 28 (36%) of 77 failed packaging analysis, and 79 (20%) of 389 were classified as falsified. Data were insufficient to identify the frequency of substandard (products resulting from poor manufacturing) antimalarial drugs, and packaging analysis data were scarce. Concurrent interventions and a multifaceted approach are needed to define and eliminate criminal production, distribution, and poor manufacturing of antimalarial drugs. Empowering of national medicine regulatory authorities to protect the global drug supply is more important than ever.
The Origin of COVID-19 and Why It Matters Morens, David M; Breman, Joel G; Calisher, Charles H ...
The American journal of tropical medicine and hygiene,
09/2020, Letnik:
103, Številka:
3
Journal Article
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The COVID-19 pandemic is among the deadliest infectious diseases to have emerged in recent history. As with all past pandemics, the specific mechanism of its emergence in humans remains unknown. ...Nevertheless, a large body of virologic, epidemiologic, veterinary, and ecologic data establishes that the new virus, SARS-CoV-2, evolved directly or indirectly from a β-coronavirus in the sarbecovirus (SARS-like virus) group that naturally infect bats and pangolins in Asia and Southeast Asia. Scientists have warned for decades that such sarbecoviruses are poised to emerge again and again, identified risk factors, and argued for enhanced pandemic prevention and control efforts. Unfortunately, few such preventive actions were taken resulting in the latest coronavirus emergence detected in late 2019 which quickly spread pandemically. The risk of similar coronavirus outbreaks in the future remains high. In addition to controlling the COVID-19 pandemic, we must undertake vigorous scientific, public health, and societal actions, including significantly increased funding for basic and applied research addressing disease emergence, to prevent this tragic history from repeating itself.
Falsified and substandard medicines are associated with tens of thousands of deaths, mainly in young children in poor countries. Poor-quality drugs exact an annual economic toll of up to US$200 ...billion and contribute to the increasing peril of antimicrobial resistance. The WHO has emerged recently as the global leader in the battle against poor-quality drugs, and pharmaceutical companies have increased their roles in assuring the integrity of drug supply chains. Despite advances in drug quality surveillance and detection technology, more efforts are urgently required in research, policy, and field monitoring to halt the pandemic of bad drugs. In addition to strengthening international and national pharmaceutical governance, in part by national implementation of the Model Law on Medicines and Crime, a quantifiable Sustainable Development Goal target and an international convention to insure drug quality and safety are urgent priorities.
COVID-19: Shining the Light on Africa Rosenthal, Philip J; Breman, Joel G; Djimde, Abdoulaye A ...
The American journal of tropical medicine and hygiene,
06/2020, Letnik:
102, Številka:
6
Journal Article
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Rosenthal et al discuss COVID-19 in Africa. Africa has faced epidemics throughout its history, from smallpox to recurrent epidemics of malaria, sleeping sickness, and many other lethal diseases. By ...early April, nearly every country in Africa reported COVID-19, with hundreds to thousands of cases reported in the hardest-hit countries, presumably many additional infections that were unidentified, and hundreds of deaths from COVID-19 noted across the continent. Africa has reacted quickly to COVID-19. An emergency meeting of African health ministers to discuss the pandemic was hosted by the African Union Commission on February 22, resulting in the rapid establishment of the Africa Taskforce for Coronavirus Preparedness and Response by the African Union Commission, Africa CDC, and the WHO Regional Office for Africa (AFRO), in partnership with African governments and other stakeholders.
The authors discuss the substantial surge in COVID cases in mid-March which is resulting in nearly every country in Latin America and the Caribbean (LAC) reporting COVID-19. Data arer reported to the ...Pan American Health Organization (PAHO) regional office from national ministries of health and as such may have inherent weaknesses of timing, completeness and accuracy. However, they do provide insight on trends and hotspots in the region. Daily COVID-19 knowledge continues to grow with regard to disease dynamics and most appropriate, life-saving responses. Many LAC countries acknowledge the importance of case identification and isolation, contact tracing and quarantine, while continuing to implement physical distancing and hygienic measures.
Background. In 1976, the first cases of Ebola virus disease in northern Democratic Republic of the Congo (then referred to as Zaire) were reported. This article addresses who was responsible for ...recognizing the disease; recovering, identifying, and naming the virus; and describing the epidemic. Key scientific approaches used in 1976 and their relevance to the 3-country (Guinea, Sierra Leone, and Liberia) West African epidemic during 2013-2016 are presented. Methods. Field and laboratory investigations started soon after notification, in mid-September 1976, and included virus cell culture, electron microscopy (EM), immunofluorescence antibody (IFA) testing of sera, case tracing, containment, and epidemiological surveys. In 2013-2016, medical care and public health work were delayed for months until the Ebola virus disease epidemic was officially declared an emergency by World Health Organization, but research in pathogenesis, clinical presentation, including sequelae, treatment, and prevention, has increased more recently. Results. Filoviruses were cultured and observed by EM in Antwerp, Belgium (Institute of Tropical Medicine); Porton Down, United Kingdom (Microbiological Research Establishment); and Atlanta, Georgia (Centers for Disease Control and Prevention). In Atlanta, serological testing identified a new virus. The 1976 outbreak (280 deaths among 318 cases) stopped in < 11 weeks, and basic clinical and epidemiological features were defined. The recent massive epidemic during 2013-2016 (11 310 deaths among 28 616 cases) has virtually stopped after > 2 years. Transmission indices (R₀) are higher in all 3 countries than in 1976. Conclusions. An international commission working harmoniously in laboratories and with local communities was essential for rapid success in 1976. Control and understanding of the recent West African outbreak were delayed because of late recognition and because authorities were overwhelmed by many patients and poor community involvement. Despite obstacles, research was a priority in 1976 and recently.
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