Infectious Diseases

  1. Ebola and food security: local impacts of the outbreak

    October 22, 2014 by Arianna Yanes

    WFP response to EbolaEbola has been all over the news for the past few months. We’ve heard stories about American aid workers and journalists contracting the disease and being flown back to the U.S. for treatment. We’ve heard about the increasing numbers of deaths in West Africa. We’ve heard about the breach in infection control protocol at Texas Health Presbyterian Hospital in Dallas.

    What has been largely left out of the news is the effect of this Ebola outbreak on the lives of West Africans. Currently, food security is a major concern.

    The Ebola outbreak has profoundly affected food security in West Africa, causing prices to rise by an average of 24 percent.  The cost of food and accessibility pose barriers for individuals in Liberia, Sierra Leone, and Guinea, the countries in which the current outbreak is spreading.

    Fear and restrictions on movement have led to panic buying and food shortages. Additionally, labor shortages on farms have affected rice and maize production. Border crossing closures and reduction of trade has also profoundly impacted the food availability in these countries.

    Elisabeth Byrs, a WFP spokesperson, told Reuters that  “planting and harvesting [are] being disrupted.”

    The United Nations’ World Food Program (WFP) has approved plans for 65,000 tonnes of food to 1.3 million people; to patients, cases in isolation, and communities badly affected. Just this Saturday, food rations were delivered to 265,000 people in the Waterloo district outside of Freetown, the capital of Sierra Leone. The deliveries aim to prevent the spread of the virus, by stabilizing quarantined families and removing the necessity to leave their homes in search of food.

    The aim of the food deliveries is to “prevent this health crisis from becoming a food and nutrition crisis,” Gon Myers, the WFP Country Director in Sierra Leone told ABC News.

    Additionally, the World Food Program (WFP) is using mobile phones to carry out a food security survey in Liberia, Sierra Leone, and Guinea. The first round of the survey has reached 800 people in Sierra Leone.

    On Wednesday, October 15, international representatives gathered to the annual World Food Prize Award Ceremony. Though not initially scheduled as a topic, African leaders discussed the effects of Ebola on the food supplies in a press conference, with an available webcast online.

    “I think the impact on regional trade is going to be very, very serious,” said Dr. Kanayo Nwanze, President of the United Nations International Fund for Agricultural Development. “And so we believe that like in any other situation where you have a crisis, we should begin to plan for the aftermath of the crisis.”

     

  2. Feinberg Global Health Day gathers panel to discuss Ebola outbreak

    September 11, 2014 by Arianna Yanes

    Ebola has been on the global radar the past few months and the current outbreak in West Africa continues to spread rapidly. As a part of the Feinberg School of Medicine’s Global Health Day, hosted by the Center for Global Health, a panel of experts from the university came together for a presentation and panel on the current state of the Ebola outbreak.

    Chad Achenbach explains the basics of the ebola epidemic to attendees

    Chad Achenbach explains the basics of the Ebola epidemic to attendees

    Chad Achenbach, Assistant Professor in the Division of Infectious Diseases, started the presentation with foundational knowledge about the virus, describing how it started and how it continues to be transmitted. In 2004, he said, this particular strain of the Ebola virus, EBOV, was circulating around animals. It remains unclear how it was introduced into humans in this outbreak. This is the largest outbreak of Ebola in history, with 42% of the nearly 4,000 cases from the past month, he said.

    The virus strain of the Ebola outbreak doesn’t appear to be more virulent or have higher case fatality rates than other outbreaks- so, why does this outbreak have more cases than all other Ebola outbreaks combined? As Achenbach described, unlike past outbreaks in more rural areas, this virus has made its way into dense urban areas, as a result of increased mobility of populations to move within countries and across borders.

    The Center for Global Health at Feinberg is currently collaborating with a laboratory in Mali to test samples for the presence of the Ebola virus. Of twenty samples received thus far in Mali, all have been negative. Achenbach anticipates this lab will be “active and very involved” in the coming months.

    “It’s been done before. We can do it- it’s just going to be a massive effort,” Achenbach said in regards to controlling transmission.

    After Achenbach’s presentation, the discussion was opened up to the panel, moderated by Robert Murphy, director of the Center for Global Health. Panel member Juliet Sorensen, Clinical Associate Professor at Northwestern Law School, described the role of the World Health Organization as that of a “global coordinator” to control the virus in the short term. However, the WHO is only as strong as its member countries, she described.

    “Now is the time for the international community to step up,” Sorensen said.

    The panel had Baldwin Auditorium at capacity with members of the Northwestern communit

    The panel had Baldwin Auditorium at capacity with members of the Northwestern community

    Jennifer Chan, Assistant Professor of Emergency Medicine at Feinberg, identified communication as one of the greatest challenges in this outbreak. Difficulties arise not only in getting messages to local communities about what to do, but also in getting the communities to trust the messages they receive.

    Mike Schmidt, also an Assistant Professor of Emergency Medicine at Feinberg, addressed the protocol of Northwestern Memorial Hospital’s Emergency Department in regards to Ebola. Each patient is screened for travel history and potential exposure to the virus as part of the initial evaluation. Though no patients have presented at the hospital with the virus, Murphy described Chicago as a city with many travelers to and from West Africa.

    “If the person had a travel history that was concerning, those patients would be placed in particular areas of the emergency department where we can isolate them,” Schmidt described.

    Following the panel, a poster session showcased student research and projects in global health. In the evening, the Global Health Social Hour gave students and residents the opportunity to share abroad experiences and discuss project successes and challenges. On the Center for Global Health’s Facebook page, images capturing these travels are displayed as a part of a photo contest. Take a look at what the medical students have been doing and “like” your favorites to vote.

    Feinberg students presented global health projects and research from all across the world

    Feinberg students presented global health projects and research from across the globe

  3. The Ebola Outbreak: Fast Facts and Resources

    August 4, 2014 by Emily Drewry

    The global health world is abuzz this summer with the frightening spread of Ebola, a deadly virus that has emerged in frightening force over the past few months in West Africa. Officials are labeling the outbreak responsible for 826 deaths as of August 4, as organizations across the globe are stepping in to try and contain the spread before the count grows.  As the media coverage continues to escalate, so does the challenge of keeping up with it, especially the quick facts. Read on to get a quick overview, then follow the links under each question for further information.

    Ebola Virus

    Ebola Virus. Source: Associated Press

    What is Ebola? Ebola is a group of viruses that cause deadly hemorrhagic fevers. According to the WHO, the virus has a case fatality rate of 90%. It can be transmitted by direct contact with blood, body fluids, and tissues of infected people or animals, and is known to be one of the world’s most virulent diseases. The current strain is considered to be the most lethal strain of the group, but in many cases, can be treated if identified.

    (More: http://www.who.int/csr/disease/ebola/en/)

    Background information: Ebola is named after the river in Zaire where it first emerged in 1976. The virus produces a protein called ebolavirus glycoprotein that attacks the body’s cells and creates the hemorrhagic symptoms that often appear in patients. However, not all cases of Ebola are identified with extreme hemorrhaging – instead, the cases generally begin with flu-like symptoms. Therefore, much of the danger of the outbreak lies in the challenge of containing those who carry the virus and avoiding exposure, which often takes place in funeral circumstances or through the work of health care providers.

    (More: http://www.huffingtonpost.com/2014/08/02/ebola-symptoms-infection-virus_n_5639456.html)

    Where is the outbreak? The cases of this summer’s outbreak have been located along the shared borders of the West African countries of Sierra Leone, Liberia, and Guinea. There is fear of the virus spreading after an infected man flew on a commercial airliner from Liberia to Nigeria last week, but as of now, officials have yet to report any cases. On July 31 the CDC issued a travel advisory for the three countries where Ebola has been identified, urging a temporary halt to nonessential travel.

    (More: http://abcnews.go.com/Health/ebola-/story?id=24733669, http://time.com/3065176/ebola-outbreak-cdc/)

    How does this outbreak compare? This year’s outbreak is now officially the largest in history, with over 1,300 infected this year. Past outbreaks have been reported across the world since the first recognition of the disease in 1976. An outbreak in 2000-2001 in Uganda infected 425 individuals, with a 53% death rate reported.  Ebola has been identified in three continents since 1976, and has been a collaborative research project for the CDC and various national health departments for years.

    (More: http://www.cdc.gov/vhf/ebola/resources/outbreak-table.html)

    What is happening in the US? Two Americans, who were infected with the Ebola virus while working in Liberia, are being transported to Emory University Hospital in Atlanta for treatment this week. A 33-year old American doctor arrived in Atlanta on Saturday and a 59-year old aid worker is scheduled to arrive in the US tomorrow. The news created a stir of responses from individuals afraid of the healthcare system’s abilities to keep the virus contained. A Pentagon spokesman confirmed the move, acknowledging that specially trained teams will be handling the cases. This is the first time an Ebola patient has been brought to the US, according to the CDC.

    (More: http://www.washingtonpost.com/national/health-science/us-confirms-2-americans-with-ebola-coming-home-for-treatment/2014/08/01/c20a27cc-1995-11e4-9e3b-7f2f110c6265_story.html)

    What does the WHO have to say? The WHO has kept their updates quite frequent, updating their website with response plans and resources as the outbreak has progressed.  Most recently, they informed the public of an intensified Ebola outbreak response plan to be put in place by Dr. Margaret Chen, Director-General of the WHO and the presidents of the West African nations affected.  The $100 million response plan will “require increased resources, in-country medical expertise, regional preparedness and coordination,” says Dr. Chen.

    (More: http://www.who.int/mediacentre/news/releases/2014/ebola-outbreak-response-plan/en/)

    Where can I get more information? All the links above will bring you to articles with coverage of the current outbreak. In addition, the CDC (cdc.gov) and WHO (who.gov) websites contain valuable background and updated information.

  4. HIV/AIDS Learning Institute: An Interdisciplinary Perspective on Important Health Issues

    May 30, 2014 by Janka Pieper

    Guest Post by Kate Klein. This post was originally published on the Northwestern Public Health Review Blog.

    Screen Shot 2014-05-30 at 11.10.04 AMFor the past year I have been working with the Interdisciplinary Health Network (IHN), a collective of public health and medicine students from all over the country, interested in creating free courses on important health issues from an interdisciplinary perspective. The IHN was founded on the core belief that an integrated approach across disciplines to combating disease is needed. IHN’s mission is to create a training program that addresses this need and to develop a network across different academic sectors.  The goal of the IHN is to empower students to achieve their goals as future global health professionals by providing a holistic educational environment that allows for innovative thinking in global health.

    As someone who has worked on HIV prevention issues, I was particularly keen to develop a course that would bring together lecturers from a range of disciplines all working on HIV/AIDS. I was able to recruit and record lectures from leaders in the fields of advocacy, laboratory work, social entrepreneurship, clinical care and operational research. I was lucky to bring in leaders in these fields who, collectively, provide a fantastic history of HIV/AIDS, what we know, how we are fighting it (in the lab, the hospital and the field) and where vaccine and prevention research is going.

    Besides the HIV/AIDS Institute, my colleagues are developing Institutes on Tuberculosis and Neglected Tropical Diseases. Each Learning Institute will be a three-week online course, with lectures that you can view at your convenience and live interactive Q&A sessions. Dates and links to the full curriculums can be found here:

    AIDS Learning Institute: June 23rd – July 12 Curriculum

    Speakers Include:
    ▪    Mitchell Warren, Executive Director, AVAC: Global Advocacy for HIV Prevention
    ▪    Alice Gandelman, MPH, Director, California STD/HIV Prevention Training Center
    ▪    Dr. Shannon Galvin, Director of Clinical Programs and Training, Center for Global Health, Northwestern University
    ▪    Dr. Laila Woc-Colburn, Director of Medical Education, National School of Tropical Medicine and Assistant Professor, Infectious Diseases, Baylor College of Medicine
    ▪    Dr. Joseph Tucker, Assistant Professor, University of North Carolina School of Medicine, Director UNC-China Programs
    ▪    Dr. Dorothy Lewis, Professor of Infectious Diseases, Internal Medicine, University of Texas-Houston

    TB Learning Institute: July 7-July 25 Curriculum

    Speakers Include:
    ▪    Dr. Amy Bloom, Senior Technical Advisor, USAID
    ▪    Colleen Daniels, TB/HIV Project Director, TAG Zeroes Campaign

    NTDs Learning Institute: (pending -TBD in July) Curriculum

    Speakers Include:
    ▪    Dr. Peter Hotez, Founding Dean, National School of Tropical Medicine

    These courses are meant for just about anyone with an interest in the topic. If you are would like to apply, the application can be found on the IHN website, http://www.ihealthnetwork.org.

  5. Pneumonia, leading cause of death in children

    April 4, 2014 by Kathleen Ferraro

    Seeing as many of my courses and global health experiences have focused on the same few global health initiatives, I thought I would take a look at other conditions that I have encountered less frequently: for instance, pneumonia.

    Distribution of deaths from pneumonia and other causes in children aged less than 5 years, by WHO region. Image Courtesy: WHO

    Distribution of deaths from pneumonia and other causes in children aged less than 5 years, by WHO region. Image Courtesy: WHO

    Pneumonia–a respiratory infection in the lungs brought on by viruses, bacteria, or fungi that causes painful breathing and limited oxygen intake–is the leading cause of death in children throughout the world. The WHO measures the specifics of this data, detailing that 1.1 million children age five and under and killed by  pneumonia every year; most of which are in sub-Saharan Africa and South Asia.

    In sub-Saharan Africa, people living in extreme poverty are particularly susceptible to contracting pneumonia due to malnourishment, poor sanitation, and contaminated food and water sources. Furthermore, sub-Saharan Africa hosts some of the highest rates of HIV in the world, and HIV puts an individual at a higher risk of developing pneumonia. The deadly combination of HIV and pneumonia necessitates numerous and expensive medications, assuming these medications can be obtained in the first place. And even if patients obtain the right treatments, they are at increased risk of developing resistance to the drugs.

    Like sub-Saharan Africa, people in South Asia are at higher risk of pneumonia due to extreme poverty. Indoor air pollution, smoking, and chronic obstructive pulmonary disease are other risk factors prevalent in the region. Again, high rates of HIV are problematic due to increased risk of contracting pneumonia, excessive medication, and drug resistance. While there are many existing interventions designed to combat pneumonia in South Asia, few of these interventions are present in places where they are needed the most: consequently, pneumonia remains a significant problem.

    As with many common infections, pneumonia is easily prevented and treated given easy access to primary care and antibiotics. Immunization, good personal nutrition, personal hygiene, and a healthy, sanitary environment are all prevention strategies. Treatment involves a simple round of antibiotics. While these prevention and treatment are effective for those with access to medical care and who live in a stable, healthy environment, pneumonia often proves fatal for those already experiencing malnourishment or unhygienic living conditions.

    What can be done? Because the bulk of pneumonia-related deaths occur in impoverished countries, attending to environmental risk factors (pollution, water sources, food sources, overcrowding) is one preventative measure. As far as treatment interventions go, there must be increased access to care via community health workers or clinics who can provide vaccinations, antibiotics, and/or clean oxygen. The WHO has taken steps to address both prevention and treatment strategies in regions where pneumonia is a leading cause of death with the Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea, which aims to end preventable deaths by pneumonia and diarrhoea by 2025. This initiative includes the dispersal of vaccinations, soap, clean indoor stoves, water treatments, promoting breastfeeding, and, of course, working to expand the reach of clinics and health workers.

    Northwestern’s 2014 Global Health Case Competition focused on this often-overlooked problem. The Case Competition featured eight teams, all of whom were presented a case about childhood pneumonia and then asked to develop a solution. Elizabeth Larsen, a sophomore participant, emphasizes the significance of the issue, stating, “It’s important to give attention to the often overlooked problem of childhood pneumonia because it continues to kill millions of children around the world.” Because of this far-reaching impact, it is important for events like the Global Health Case Competition and individuals everywhere to continue to focus on pneumonia.

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