(AFP) — The virus causing record cases of avian influenza in birds across the world is changing rapidly, experts have warned, as calls increase for countries to vaccinate their poultry.

While emphasising that the risk to humans remains low, the experts who spoke to AFP said that the surging number of bird flu cases in mammals was a cause for concern.

Since first emerging in 1996, the H5N1 avian influenza virus had previously been confined to mostly seasonal outbreaks.

But “something happened” in mid-2021 that made the group of viruses much more infectious, according to Richard Webby, the head of a World Health Organization collaborating centre studying influenza in animals.

Since then, outbreaks have lasted all year round, spreading to new areas and leading to mass deaths among wild birds and tens of millions of poultry being culled.

Webby, who is a researcher at St Jude Children’s Research Hospital in the US city of Memphis, told AFP it was “absolutely” the largest outbreak of avian influenza the world had seen.

He led research, published this week in the journal Nature Communications, showing how the virus rapidly evolved as it spread from Europe into North America.

The study said the virus increased in virulence, which means it causes more dangerous disease, when in arrived in North America.

The researchers also infected a ferret with one of the new strains of bird flu.

The found an unexpectedly “huge” amount of the virus in its brain, Webby said, indicating it had caused more serious disease than previous strains.

Emphasising that the risk in humans was still low, he said that “this virus is not being static, it’s changing”.

“That does increase the potential that even just by chance” the virus could “pick up genetic traits that allow it to be more of a human virus,” he said.

In rare cases, humans have contracted the sometimes deadly virus, usually after coming in close contact with infected birds.

– ‘Scares us’ –

The virus has also been detected in a soaring number of mammals, which Webby described as a “really, really troubling sign”.

Last week Chile said that nearly 9,000 sea lions, penguins, otters, porpoises and dolphins have died from bird flu along its north coast since the start of the year.

Most mammals are believed to have contracted the virus by eating an infected bird.

But Webby said that what “scares us the most” are indications from a Spanish mink farm, or among sea lions off South America, that the virus could be transmitting between mammals.

Ian Brown, virology head at the UK’s Animal and Plant Health Agency, said there has not yet been “clear evidence that this virus is easily sustaining in mammals.”

While the virus is changing to become “more efficient and more effective in birds,” it remains “unadapted to humans,” Brown told AFP.

Avian viruses bind to different receptors on the host cell than human viruses, Webby said.

It would take “two or three minor changes in one protein of the viruses” to become more adapted to humans, he said.

“That is what we’re really looking out for.”

– Vaccinating poultry –

One way to bring down the number of total bird flu cases, and therefore reduce the risk to humans, would be for countries to vaccinate their poultry, Webby said.

A few nations including China, Egypt and Vietnam have already held vaccination campaigns for poultry.

But many other countries have been reluctant due to import restrictions in some areas, and fears vaccinated birds that nonetheless get infected could slip through the net.

In April, the United States started testing several vaccine candidates for potential use on birds.

France recently said it hopes to start vaccinating poultry as early as autumn this year.

Christine Middlemiss, the UK’s chief veterinary officer, said that vaccinating poultry was not “a silver bullet because the virus changes constantly”.

But traditionally reluctant countries should consider vaccinating poultry more often, Middlemiss told AFP at an event at the UK’s embassy in Paris last week.

World Organisation for Animal Health director general Monique Eloit said that the issue of vaccinating poultry should be “on the table”.

After all, “everyone now knows that a pandemic is not just a fantasy — it could be a reality,” she added.

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Director of the Barbados Drug Service (BDS), Maryam Karga-Hinds, has provided an update regarding some of the drugs which have been affected by recent supply challenges.

Karga-Hinds stated that with respect to the steroid Prednisolone, which is used to treat several conditions, including asthma and Long-COVID, there have been a number of delays in shipment from the contracted supplier, causing the need for a second supplier to be contracted. The shipment of this drug is now scheduled to arrive in two to three weeks. The Drug Service is also currently searching for stock that is readily available.

Additionally, she said there has been an issue with the drug Androcur (Cyproterone), which is used to treat prostate cancer, where the manufacturers have been experiencing shortages with obtaining the raw materials. This has resulted in rationing, leading to buyers not receiving the amounts ordered from the suppliers.

Karga-Hinds noted that the Barbados Drug Service contracted a generic supplier to fill the need, but the product has to be manufactured and the generic is not expected to be ready before the end of June. There is a limited supply on island.

She further stated that in the past few months, there have been significant challenges with Epilim which is used to treat epilepsy. She pointed out that this is not a product which can be easily interchanged.

The local agent has indicated that small quantities of the 300 mg and 500 mg have been shipped, however, the 300 mg strength is scheduled for discontinuation by year-end. The Drug Service is actively looking for a replacement product.

The Director indicated that the supplier of Ibuprofen, an anti-inflammatory drug, has advised that a limited supply is available on island and should be ready for sale shortly.

She also shared that a shipment of Ventolin liquid, which is used to treat asthma, is on its way to the island adding that, recently, a quantity of this drug expired and had to be destroyed because of the lack of demand. Ventolin tablet is no longer on the Barbados national drug formulary.

Karga-Hinds expressed regret over any challenges experienced by the public as it relates to availability of medication. She stated that the management and staff of the Barbados Drug Service will continue to do all in their capacity to re-establish supply of the items that are out of stock.

The Ministry of Health and Wellness is committed to updating the public with relevant information as it becomes available.

The post Drug Service Director explains supply challenges appeared first on Barbados Today.

This call was considered by the medical advisor of the Executive Power, Jorge Marte Baez, as exaggerated because the data available to the authorities do not represent a situation that is cause for alarm.

“There is no doubt that there is an increase in cases, but this is not the first time that there are increases in passing cases in the last two months and that increase lasts for days and fades away. We cannot predict that this time it will be the same, but what we can know is that the number of cases requiring hospital admission remains the same,” said Marte Baez to Diario Libre.

The pneumologist explains that the slight increases in the infections could be due to the sub-variant of Omicron, called XBB.1.5, about which the World Health Organization (WHO) has alerted, which causes mild symptoms and which does not put the life of the patients at risk.

“It is not that we are not concerned, but it seems to me that some people and some entities have perhaps exaggerated this danger a little and are reflected above all in that, in a call to resume the use of masks,” said the doctor when affirming that the State health organizations are alert to any situation that requires a change in the recommendations that up to now have been given to the population.

The also medical director of the Centers for Diagnostic and Advanced Medicine and Medical Conferences and Telemedicine (Cedimat) said that a sign of the low danger so far of the new Covid-19 infections is that, in this center, one of the ones that have treated more patients with this disease, exceeding 26,000 in the last month and a half, only two patients have been admitted. The main reason has been that they have chronic conditions.

Pneumologists ask to resume using masks due to the increase of Covid-19 and other respiratory diseases.
HEALTH
Pneumologists ask to resume using masks due to the increase of Covid-19 and other respiratory diseases.
The Dominican Society of Pneumology and Thoracic Surgery bases its call for using masks on the reports issued by pneumologists from this guild, who warn of an increase in Covid-19 infections.

“In recent weeks, the pulmonologists of the society at the national level, we have observed with concern the increase in the number of patients in consultations who are testing positive to Covid 19 influenza, pneumonia and other viral respiratory processes,” says the entity’s statement.

“It is time for our older adults, pregnant women and people suffering from diseases to start protecting themselves again,” said the pulmonologists’ society when reminding that even though the WHO declared the end of the health emergency due to Covid-19, it does not mean that it has ceased to be a threat to world health.

Public Health on alert
The Minister of Public Health, Daniel Rivera, called on the population not to be alarmed by the alert issued by the Dominican Society of Pneumology and Thoracic Surgery about an increase in positive cases of Covid-19 in the country and assured that the situation is under control.

Rivera warned that Covid-19 is already an endemic disease and that permanent and timely monitoring is maintained by the Epidemiological Surveillance System of this institution that, allows the identification of health events and the taking of appropriate and effective decisions.

“It is not necessary to be alarmed; the Ministry has a permanent monitoring of the disease and has always offered the precise details and in case the data varies, the information will also be offered in a transparent manner, and if it is necessary to retake some measures, it would also be officially informed,” said Rivera when asking the citizenship not to be carried of rumors in networks.

Divided population
Citizens consulted by this media about the return of the use of masks reacted in favor and against this recommendation. Still, they indicated that if ordered, they would put them on again.

In this respect, Dionicio Jiménez says he is not currently using them because he does not consider it necessary. However, he is vigilant if the possibility of doing it again arises.

Others like Felix Caset say that they have never stopped using masks and will continue to use them indefinitely regardless of what the authorities say about it.

Meanwhile, owners of establishments with closed spaces said they would follow the rules established by the authorities in their businesses to help prevent contagion, if necessary.

While in the streets, some people are seen walking with their masks on.

The mandatory use of masks in workplaces and different public spaces was established by resolution 000016 of the Ministry of Public Health on June 22, 2020, and lifted on February 16, 2022; however, its optional use was recommended at that time.

With thousands of Haitians entering the country on Mondays and Fridays to participate in the Dajabón border market, Mayor Santiago Riveron alerted the population and, in the next few hours, will meet with Public Health authorities to prevent possible infected people from entering the trade fair.

So far, the Haitian authorities have not officially announced a cholera outbreak, and according to the information received, they have not taken the necessary sanitary measures.

Public Health authorities will meet to discuss the issue EXTERNAL SOURCE

WHAT IS CHOLERA?
Cholera is an acute diarrheal infection caused by ingesting contaminated food or water. People with reduced immunity, such as malnourished children, are at a higher risk of dying if infected.

For this reason, the Ministry took this weekend to this demarcation of the -Ruta de la Salud- (Health Route).

The participating doctors measured glycosylated hemoglobin to determine blood sugar levels more accurately, thanks to the advanced technology glucometers they obtained.

The day
This was the twenty-third version of the -Health Route: change your lifestyle- where municipalities benefited from more than 35 health services and used advanced technology glucometers that contribute with greater precision to detect blood sugar levels and maintain control in people with diabetes.

Detection
The aim is to identify the major chronic diseases, such as hypertension, diabetes, and obesity, to apply preventive measures comprehensively and thus guarantee people access to quality, free, and humanized health services.

Dr. Daniel Rivera insisted that the incidence of diseases can be reversed with healthy lifestyles that include healthy eating, exercise, and reducing salt, saturated fats, alcoholic beverages, and sugar.

Health education
Dr. Rivera said one of the elements of interest in the Ruta de la Salud is that it can guide thousands of people and serve as multipliers in their communities.

Likewise, he said that diabetes and hypertension can be detected since many people have these ailments but are unaware of their condition. “We need 10,000 steps a day to reduce weight because this leads to hypertension, and here in Salcedo, we have the ideal agricultural production for a healthy diet,” said the doctor. However, he insisted that he wants people to be healthy and that it is unnecessary to go to health centers because there is enough health.

He said that digital glucose meters are high-tech devices that measure glycosylated hemoglobin in diabetic patients or for those who wish to monitor their glucose levels. They are part of a significant donation from the Central American Bank for Economic Integration through the Strengthening Project.

According to official data, so far this year, there have been 1,837 cases of dengue fever, a disease transmitted by the bite of the Aedes aegypti mosquito that breeds in clean water, especially in the water that accumulates in or around homes.

The highest number of cases reported up to epidemiological week 20, when 1,341 cases had been registered, was in Greater Santo Domingo, with 523 cases, followed by Santiago with 290 and Monte Cristi with 112 reports in the surveillance system. In the province of Puerto Plata, 83 cases of dengue had been reported up to that date; in Barahona, 65; in La Altagracia and Maria Trinidad Sanchez, 61, respectively; in San Cristobal, 60 cases; in La Romana, 58 and Sanchez Ramirez, 58 cases of dengue. Luis Rosario, director of the Regional and Provincial Health Directorates, assured that dengue, malaria, and other epidemiological surveillance diseases had registered a decrease so far this year.

Between 2020 and 2021, there was a nearly 19% increase in weight loss surgeries among U.S. youths aged 10 to 19 years, as discovered by researchers from the University of Texas, University of Miami Miller School of Medicine, and University at Buffalo School of Medicine and Biomedical Sciences.

The researchers were particularly interested in looking at these trends after the American Academy of Pediatrics (AAP) released a statement in late 2019 endorsing increased access to bariatric surgery for teens, said lead study author Sarah Messiah, PhD, professor and pediatric obesity researcher at UTHealth Houston School of Public Health.

KIDS AND OBESITY: NEW GUIDELINES RELEASED TO EVALUATE AND TREAT CHILDHOOD, ADOLESCENT WEIGHT ISSUES

The study drew on data from across six years from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, which accredits bariatric surgery centers in the U.S. and Canada.

"Historically, research shows pediatricians have been hesitant to refer their patients with severe obesity to bariatric surgery," Messiah told Fox News Digital in an email. 

"Our findings show a steady increase in usage in the two years after the release of this AAP statement."

The increase was particularly high for racial and ethnic minority groups. That includes Hispanic/Latino, non-Hispanic Black/African American and others, possibly because they are "disproportionately impacted by cardiometabolic disease risk factors versus non-Hispanic Whites," Messiah said.

These risk factors include elevated blood pressure, lipids, insulin, glucose and waist circumference — all of which are risk factors for type 2 diabetes and cardiovascular disease as well as some types of cancer, she added.

MEDICAL EXPERTS FACE BACKLASH OVER 'BARBARIC' CALLS TO TREAT OBESE KIDS WITH DRUGS, SURGERIES

The new study did have some limitations, Messiah said.

"We are always limited to the data we are analyzing in that it does not include the entire universe of all adolescents who have ever completed bariatric surgery in the U.S. during the analytical time period," she said. 

BARIATRIC SURGERY PATIENTS LIVE LONGER BUT FACE A HIGHER SUICIDE RISK, SAYS STUDY

"However, this dataset does include all adolescent patients who completed their surgery at a U.S. accredited center, which is the gold standard," the doctor also said.

In January 2023, the AAP released its new pediatric obesity treatment guidelines, officially endorsing bariatric surgery and weight loss prescriptions for the first time.

"Teens age 13 and older with severe obesity (BMI ≥120% of the 95th percentile for age and sex) should be evaluated for metabolic and bariatric surgery," the guidelines stated.

There are four main types of bariatric surgery, according to the Cleveland Clinic: gastric bypass, sleeve gastrectomy, gastric band and duodenal switch.

There was a lot of resistance to the AAP’s recommendation, Messiah pointed out.

TENNESSEE MAN EATS ONLY MCDONALD'S FOOD FOR 100 DAYS STRAIGHT: HERE'S WHAT HAPPENED

"However, our analysis would suggest that families are following their own path in terms of deciding to move forward with surgery for their adolescent," she said. 

"It will be important that we support these families moving forward to ensure the best health outcomes for their adolescents as they age into adulthood."

Children’s Mercy Hospital in Kansas City, Missouri, offers a laparoscopic sleeve gastrectomy. 

Billed as a minimally invasive procedure, it involves removing a large portion of the stomach to suppress hunger, according to its website.

The hospital recommends exploring weight loss surgery for children who are at least 5 years old, have a BMI of at least 40 (or above 35 with other medical conditions) and have had at least six months of "supervised medical weight loss therapy."

Cincinnati Children’s Hospital in Ohio also has a bariatric surgery program, but its website states that it’s for "severely obese adolescents who haven’t had success with behavioral and nutritional approaches to weight loss."

Nationwide Children’s Hospital in Columbus, Ohio, offers two types of bariatric surgery: gastric bypass and gastric sleeve. 

The website doesn’t specify a minimum age requirement, but patients must be at least 100 pounds over their "ideal body weight."

Patients and physicians have gone online to share experiences and opinions on pediatric weight loss surgery. 

These run the gamut from success stories to cautionary tales.

One bariatric surgeon on Reddit voiced concern about misconceptions of the procedure.

OZEMPIC, WEGOVY AND PREGNANCY RISK: WHAT YOU NEED TO KNOW ABOUT THE ISSUE

"People see it as ‘the easy way out,’ but it's honestly the only way out for 95% of people who are morbidly obese," the doctor wrote. 

"Your metabolic rate will slow down significantly if you try to diet and lose weight, and your progress will slow down — and weight regain is almost inevitable. Bariatric surgery doesn't do that, and something like the gastric bypass hardwires in a malabsorptive component that can't be overridden."

"Do I think we should do bariatric surgery in teenagers? I won't be doing it any time soon, but I think that in a controlled setting with IRB approval, it is appropriate," the surgeon continued, referring to Institutional Review Boards. 

"We have an entire demographic of teenagers with type 2 diabetes, obstructive sleep apnea and serious joint pains because of their weight," the surgeon also wrote. "It would be ignorant to overlook an obvious treatment for those conditions."

Another poster, however, shared that her friend opted for the bypass procedure at 16 years old and did not have a good experience.

"She’s now 26 and has gained all the weight back and more," she wrote. 

"Her brain wasn’t done developing and she wasn’t mature enough to understand the consequences of such major surgery and to stick to the guidelines and deal with her disordered eating."

Meanwhile, a surgery intern in a private hospital posted that the facility had performed an "astonishingly high number of bariatric cases" and recalled seeing many complications — even when very skilled surgeons did the procedures.

Dr. Sue Decotiis, a triple board-certified weight loss physician in New York City, warned of the potential dangers of these surgeries in children and teens, given their "irreversible nature."

She told Fox News Digital, "With bariatric surgery, you're altering the anatomy of the GI tract, and that anatomy — if it's a bypass — can never be returned [to its original state]."

She added, "That means the individual is never going to be able to eat regular meals because the anatomy of the stomach has changed."

Another potential problem is that after the anatomy of the stomach is altered, Decotiis said, the person won’t be able to eat as much high-nutrition and high-fiber food because they will feel full immediately.

"This can make them gravitate toward processed foods because those are a lot easier to get down," she said. 

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Before going the surgery route for a child or teen, Decotiis recommends first making dietary changes, such as cutting out sodas and sugary foods and slowly introducing more nutritious fare.

And in the case of teens with severe obesity, the doctor pointed out that if they start with some of the newer weight loss medications that are available, surgery might not be necessary.

"All the medical options need to be exhausted before they consider surgery, because surgery is irreversible," Decotiis said.

The only exception, she said, is if the child or teen is "morbidly obese" (now known as Class III obesity, which is when a person has a BMI of 40 or higher, or 35 or higher along with obesity-related health conditions, per the Cleveland Clinic). 

"Otherwise, it's not worth it because they will likely gain the weight back — and since their anatomy has been disturbed, getting proper nutrients will be difficult in the future."

Santo Domingo.- The Dominican Society of Pulmonology and Thoracic Surgery has issued a warning to the Dominican population and healthcare professionals regarding the rising number of positive Covid-19 cases and other respiratory illnesses. Pulmonologists belonging to the society have reported a significant increase in patients testing positive for Covid-19, influenza, pneumonia, and other viral respiratory conditions in recent weeks.

While the World Health Organization has declared the end of the health emergency for Covid-19, society emphasized that this does not mean that the virus is no longer a global health threat. They urged the public to understand that the risk from Covid-19 persists and advised against letting their guard down.

Society emphasized the possibility of new variants emerging despite the current low indicators. They recommended the resumption of mask usage, particularly in enclosed spaces and areas with large gatherings. They highlighted the importance of protecting vulnerable populations, such as seniors, pregnant women, and individuals with underlying health conditions.

Society encouraged individuals experiencing symptoms resembling a common cold or flu to seek medical attention for proper diagnosis and appropriate treatment. They strongly advised against self-medication or following treatments intended for others.

Furthermore, society called upon healthcare professionals to take necessary precautions in their practices, including not admitting patients without masks. Vigilance towards new variants, their effects, and the potential for resurgence was emphasized as a crucial aspect of maintaining public health.

The statement serves as a reminder to remain cautious and proactive in the face of the ongoing Covid-19 pandemic, prioritizing the well-being and safety of individuals and the community at large.

Tobacco use remains a major public health concern in the Caribbean Region. There is no safe level of exposure to tobacco smoke. The use of tobacco products in any form harms nearly every organ of the body, irrespective of whether it is smoked, smokeless, or electronic. Of all the forms of tobacco use, most common in the Caribbean region is cigarette smoking. Cigarette smoking is the number one risk factor for lung cancer. Using other tobacco products such as cigars or pipes also increases the risk for this disease.

Second-hand smoke exposure causes stroke, lung cancer, and coronary heart disease in adults; and acute respiratory infections and severe asthma in children. It is a preventable risk factor for noncommunicable diseases (NCDs), which are the leading cause of death, disease and disability among Caribbean people. 

This year, World No Tobacco Day focuses on Grow Food, Not Tobacco. This campaign advocates for ending tobacco cultivation and switching to more sustainable crops that improve food security and nutrition. The campaign observed annually on 31 May, also informs the public on the dangers of direct use, and exposure to tobacco.

In the Caribbean Region, non-communicable diseases (NCDs) are the leading cause of death and disability – 76.8 per cent of the total deaths (non-Latin Caribbean, excluding Haiti) were due to NCDs in 2016. Cardiovascular diseases 30.8 per cent and cancer 17.2 per cent are the leading causes of death due to NCD, both linked to tobacco use. Many of these persons die in the prime of their lives before the age of 70 years old. The prevalence of smokers for overall tobacco products ranged from 57.2 per cent prevalence (95 per cent CI 48.4 to 65.4 percent ) to 16.2 per cent (95 percent CI 11.2 to 23.0 per cent ). 

According to the Report on Tobacco Control in the Region of the Americas (2018) Caribbean countries have the highest levels of tobacco experimentation before the age of 10.

Dr. Joy St. John, Executive Director at the Caribbean Public Health Agency (CARPHA) warned: “Smokeless does not mean harmless. Nicotine in e-cigarettes is a highly addictive drug and can damage children’s developing brains. Children and adolescents who use e-cigarettes at least double their chance of smoking cigarettes later in life. Preventing tobacco product use among youth is therefore critical. It is important that we educate children and adolescents about the harms of nicotine and tobacco product use. We must work to prevent future generations from seeing such products as ‘normal.’”

In 2008, the Caribbean Community (CARICOM) endorsed the recommendation to ban smoking in public spaces. Later, in 2012, CARICOM regulated a standard for labelling retail packages of tobacco products with health warnings. Caribbean civil society organisations (CSOs), working in collaboration with local governments and international partners, have led the charge in fighting for significant gains in tobacco control in the Caribbean region.

Dr Heather Armstrong, Head, Chronic Disease and Injury said: “At CARPHA, we believe that reducing the harm caused by tobacco use requires a collective approach, where government, civil society, and the individual play a critical role. CARPHA promotes the prevention of tobacco use in all forms and commitment to the WHO FCTC. The focus on tobacco control deals with the youth of the Region. Children and adolescents who use e-cigarettes at least double their chance of smoking cigarettes later in life.”

The Chronic Diseases and Injury Department of CARPHA provides leadership, strategic direction, coordinates and implements technical cooperation activities directed towards the prevention and control of NCDs in CARPHA Member States. CARPHA’s message for prevention of tobacco product use has spread across its Member States.

In 2018, CARPHA in partnership with the University of the West Indies (UWI), Global Health Diplomacy Program at the University of Toronto, the Pan American Health Organization (PAHO), and the Healthy Caribbean Coalition evaluated the Port of Spain Declaration to learn which mandates helped to prevent and control NCDs. Taxation, smoke-free public places mandate, and mandatory labelling of tobacco products are some of the leading policies making the biggest impact on reduction of tobacco use in the Caribbean regions.

CARPHA urges Member States to work together to prevent and reduce the use of all forms of tobacco products, and scale-up efforts to implement their commitments under the WHO Framework Convention on Tobacco Control (FCTC). By doing so, the negative impact of smoking and its consequences on the health of our people, especially the younger generation, and the tremendous burden on the economies of the countries in our Region, will greatly be reduced. (CARPHA) 

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The Mahdia Secondary School student, who was badly burnt in last week’s dormitory fire, has undergone her first of many surgeries in a New York hospital, Health Minister Dr Frank Anthony said Tursday. He said the 13-year old girl, who was flown out of Guyana aboard an air ambulance on Saturday, successfully underwent surgery earlier ...