World Health Organization Declares Second Strain of Polio Eradicated Worldwide

On October 24, 2019, the World Health Organization announced that wild poliovirus type 3 has been eradicated worldwide other than sample specimens held in laboratory containment.

In an historic announcement on World Polio Day, an independent commission of experts concluded that wild poliovirus type 3 (WPV3) has been eradicated worldwide. Following the eradication of smallpox and wild poliovirus type 2, this news represents a historic achievement for humanity.

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There are three individual and immunologically-distinct wild poliovirus strains: wild poliovirus type 1 (WPV1), wild poliovirus type 2 (WPV2) and wild poliovirus type 3 (WPV3). Symptomatically, all three strains are identical, in that they cause irreversible paralysis or even death. But there are genetic and virologic differences which make these three strains three separate viruses that must each be eradicated individually.

WPV3 is the second strain of the poliovirus to be wiped out, following the certification of the eradication of WPV2 in 2015. The last case of WPV3 was detected in northern Nigeria in 2012. Since then, the strength and reach of the eradication programme’s global surveillance system has been critical to verify that this strain is truly gone. Investments in skilled workers, innovative tools and a global network of laboratories have helped determine that no WPV3 exists anywhere in the world, apart from specimens locked in secure containment.

Death By Snake Bite

The Guardian has an interesting story about snake bite deaths in the Democratic Republic of the Congo. The story documents about how the effects of snakebites are compounded by the DRC’s lack of infrastructure and poverty.

One of the fascinating statistics in the story is how many people die worldwide from snakebites,

Globally, about 5m snake bites occur worldwide each year, according to the World Health Organization, resulting in between 81,000 and 138,000 deaths. A bite from a viper, cobra or mamba can kill in a matter of hours or leave a victim suffering life-changing injury.

I would not have thought the total deaths would be so high, so decided to track down the WHO statistics that The Guardian cites,

The World Health Organization (WHO) estimates that about 5 million snakebites occur each year, resulting in up to 2.7 million envenomings. Published reports suggest that between 81,000 and 138,000 deaths occur each year. Snakebite envenoming causes as many as 400,000 amputations and other permanent disabilities. Many snakebites go unreported, often because victims seek treatment from non-medical sources or do not have access to health care. As a result it is believed that many cases of snakebite go unreported.

That underreporting means the actual total of snake bites and deaths may be significantly higher,

One of the consequences of inadequate efforts to control snakebite envenoming in the past is that the available epidemiological data are fragmented and lack both resolution and completeness. Accuracy is further reduced by the fact that many victims do not attend health centres or hospitals, and instead rely on traditional treatments. As a result, in some countries the degree of under-reporting is greater than 70% especially in rural areas with poor infrastructure.

When Is a Dead Baby Not a Dead Baby? (When It’s Born Outside the United States)

Save The Children has released a report on infant mortality that, among other things, claims the United States has the second highest infant mortality rate among industrialized countries. The problem with this claim, however, is that the United States and other countries can’t quite agree on what counts as a dead baby. As such, infant mortality rates aren’t directly comparable between the United States and other countries.

The problem lies in a fact that, as the Save The Children report notes, most infants who die in the industrialized world die because they are either a) born too early or b) have a very low birth weight (and, of course, the earlier the delivery, the lower the birth weight tends to be).

In the United States, an infant born prematurely and weighing less than 400 grams will receive intensive medical interventions to try to keep it alive. If, as is likely, such expensive interventions fail, the event will be recorded as a) a live birth and b) a death.

In much of the rest of the world — including the industrialized world — such extreme medical interventions would never be attempted. Moreover, this would not be recorded as a live birth or as a subsequent death.

The Save The Children report simply relies on World Health Organization statistics, and the WHO itself recommends that births of less than 1,000 grams not be registered as live births in official records. Most countries follow this definition, whereas the United States doesn’t.

How big of a difference does this make? According to the National Center for Health Statistics, in 2003 infants weighing less than 1,000 grams accounted for 48.7 percent of infant deaths in the United States.

Assuming that rate holds for the 2004 U.S. statistics the Save the Children report covers, that results in a >1,000g infant mortality rate of 3.5 per 1,000 births for the United States. That rate puts the United States barely behind countries like Japan, Finland, and Sweden which clock in at 3 deaths per 1,000 births. Not bad, especially given the largely mono-racial nature of those societies as compared to the United States.

Of course, why should we expect advocacy groups or the media to bother with such arcane statistics when U.S. has second worst newborn death rate in modern world, report says makes such a good headline?

Plague Outbreak in the Democratic Republic of Congo

At least 61 people died in February during an outbreak of the pneumonic plauge in the eastern part of the Democratic Republic of Congo.

About 350 people who worked in a mine in the northern Oriental province were infected with the disesae earlier this year, with at least 61 of them ultimately succumbing to the disease.

The pneumonic plague is the rarest and most deadly of the three types of plague. Unlike bubonic and septicimic plague, the pneumonic form of the disease can be passed from person to person through infected droplets transmitted by coughing or sneezing.

According to the World Health Organization, it is almost always fatal if not treated, but responds well to antibiotics. Unfortunately, the Democratic Republic of Congo is still a relatively chaotic place after the end of its four-year civil war in 2002, and more than 2,000 people who worked at the mine quickly left and dispersed after the outbreak of the disease became widely known.

Plague, of course, used to be a major worldwide killer, famously wiping out a significant proportion of the European population in the late medieval period. The World Health Organization reports that in 2003 there were only about 2,000 cases of the disease worldwide, but almost all of those occurred in Africa.

Sources:

Plague outbreak kills 60 in Congo. The BBC, February 18, 2005.

DR Congo plague outbreak spreads. The BBC, February 23, 2005.

Plague Outbreak in Eastern Congo. Cynthia Kirk, Voice of America, March 2, 2005.

Deadly Plague Outbreak Feared in Congo . Craig Timberg, Washington Post, February 18, 2005.

Locust invasions on West Africa. IRIN News, December 2004.

Will Polio Ever Be Eradicated?

The World Health Organization maintains that it will eradicate polio worldwide, but the disease is beginning to re-emerge in African countries that had previously been polio-free. Will anti-polio campaigners ever manage to eradicate polio?

The current outbreak in Africa is directly traceable to a decision by religious extremists in northern Nigeria to suspended polio vaccinations in 2003.

Shortly after that decision, polio cases in Nigeria began to spike. That was soon followed by cases popping up in nearby countries including Burkina Faso, Central African Republic, Chad, Ivory Coast, and Sudan. All five of those countries had been free of polio until 2003. Along with Nigeria, polio still persisted prior to 2003 in Egypt and Niger.

Polio has since spread to an additional seven African countries that had been free of polio, and the disease could spread further.

Admittedly the number of cases is still very small — Nigeria reported the most cases in Africa in 2004 at 763, but the outbreak of cases in previously polio-free countries is jacking up the costs of immunization. According to Dr. David Heymann, who heads up WHO’s polio eradication program, the resurgence of cases in polio-free countries will add at least $150 million to immunization efforts on the continent.

Source:

Health Officials Say They’ll End Polio In Africa, Despite Its Spread. Lawrence Altman, The New York Times, January 16, 2005.

World Hits Milestone for Drinking Water Availability

The Christian Science Monitor recently noted that for the first time in history, the world’s glass is literally half full. According to World Health Organization and UNICEF statistics, about 700 million people in the developing world have gained access to safe drinking water in their residence, pushing the percentage of people with access to drinking water in their homes to more than 50 percent of the entire world population for the first time ever.

This has led to a number of related improvements in quality of life. The obvious improvement is a decline in hygeine-related diseases. Although it hasn’t kept up with the advance in drinking water availability, improvements in sanitation in the developing world have also helped reduce the incidence of such diseases.

Another important advantage is the empowerment of women. For many women in developing countries, obtaining enough safe drinking water is a task which can take up to an entire working day. The Christian Science Monitor notes, for example, that in Tanzania, women might walk four to six hours to obtain safe drinking water for themselves and their families. With women no longer devoting so much time simply obtaining water, they are able to devote themselves to other projects.

Source:

Finally, the world’s drinking glass is more than half full. G. Jeffrey MacDonald, Christian Science Monitor, December 30, 2004.