Public health round-up
Tobacco protocol agreed
Stopping the illicit trade in tobacco products is the focus of a new protocol agreed by more than 135 countries on 4 April after four years of negotiations.
The World Health Organization (WHO) protocol sets the rules for combating illicit trade in tobacco products, such as smuggling, through greater control of the supply chain. It also establishes what constitutes unlawful conduct with regard to this illicit trade and sets out related enforcement and international cooperation measures.
Under the protocol, countries plan to establish a global tracing system for tobacco products and reached agreement on other measures, such as licensing, liability, information sharing and mutual legal assistance.
Illicit trade often means that tobacco products are cheaper, as sellers do not pay tax, and more accessible, thus contributing to the spread of the tobacco epidemic.
The protocol will be submitted for consideration and adoption by the Conference of the Parties, the governing body of WHO’s Framework Convention on Tobacco Control (FCTC), in Seoul, Republic of Korea, in November 2012.
Once adopted, it would become the first protocol to the WHO FCTC, which is itself the first and only global health treaty negotiated under the auspices of WHO.
Polio grant given
Nigeria has been given a boost in its polio eradication efforts by a grant of US$ 7.85 billion from the Government of Japan, the African country’s health ministry said last month.
The money will be used for routine immunization programmes, including providing oral polio vaccine and buying cold-chain equipment.
In 2012, the Nigerian government has scaled up its commitment to fight polio with 4.7 billion naira (US$ 2.9 billion) earmarked for polio eradication. To date in 2012, Nigeria has reported 17 polio cases.
New guidelines on how to manage chikungunya, a mosquito-borne viral disease which causes severe fever and joint pain, have been published.
The disease, which is occasionally fatal, could start circulating in the western hemisphere if mosquito populations in the United States of America (USA) or elsewhere in the Americas become infected with the virus and begin spreading it to people in that area.
The Guidelines for Preparedness and Response for Chikungunya Introduction in the Americas, a joint publication from the Pan American Health Organization (PAHO), the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) in the United States, notes that two million people have been infected with the virus in Africa and Asia since 2004.
From 2006 to 2010, 106 laboratory-confirmed or probable cases of chikungunya were detected among travellers returning to the USA. This compares with only three cases reported from 1995 to 2005.
“The broad distribution of mosquitoes capable of spreading chikungunya virus, coupled with the fact that people in the Americas have not been exposed to chikungunya virus, places this region at risk for the introduction and spread of the virus,” write the authors, Otavio Oliva, PAHO advisor on viral diseases, José Luis San Martín, PAHO advisor on dengue and Roger S Nasci, chief of the Arboviral Diseases Branch at CDC.
Dengue triples in Sri Lanka
Sri Lanka has reported a threefold increase in the number of dengue fever cases reported in the first quarter of this year.
Health authorities in the country said 9317 dengue cases and 38 deaths were reported in the first three months of 2012, compared to 3103 in the first quarter of 2011. They said intermittent rains in the country were the main cause of the rise, as they allowed breeding grounds to develop.
The highest number occurred in January, when 3892 cases were reported, followed by 3004 in February and 2421 in March.
According to the World Health Organization (WHO), dengue is the most common mosquito-borne viral disease in humans. Some 2.5 billion people – two-fifths of the world's population – are at risk from dengue fever, with an estimated 50 million infections worldwide every year.
Public health timeline
The history of medical discoveries, including those in the field of public health, is the subject of an interactive timeline launched by a medical journal.
The New England Journal of Medicine, which celebrates its 200th anniversary in 2012, has launched the timeline, a clickable interface which shows highlights from the history of medicine.
Different areas of medicine are covered by different-coloured circles. The user clicks on a particular square to find out more information about that discovery.
Highlights from the public health field include the eradication of smallpox, the Salk polio vaccine and the discovery of HIV.
Women and lung cancer
The number of women suffering from lung cancer in the United Kingdom of Great Britain and Northern Ireland is on the rise, according to new figures.
More than 18 000 UK women were diagnosed with lung cancer in 2009, compared with fewer than 8000 in 1975.
Lung cancer incidence in women was 39 in every 100 000 women in 2009 – but 22 in 1975.
The overall percentage of British women who smoke is now at around 20%. In the 1960s, around 45% of women smoked.
The new figures, from charity Cancer Research UK, also revealed that the total number of British lung cancer deaths stands at almost 35 000 – 19 410 men and 15 449 women died from the disease in 2010.
Jean King, Cancer Research UK’s director of tobacco control, said: “These latest figures highlight the deadly impact of tobacco. The continuing rise of lung cancer in women reflects the high number of female smokers several decades ago when attitudes were different.”
Dental X-rays cancer link
Researchers in the USA have identified a correlation between past frequent dental X-rays and the country’s most common brain tumour, meningioma.
In the study, data from 1433 patients diagnosed with meningioma between 20 and 79 years of age between May 2006 and April 2011 were compared to data from a control group of 1350 participants with similar characteristics. They found that patients with meningioma were twice as likely to report having a specific type of dental X-ray called a bitewing exam, and that those who reported having them yearly or more frequently were 1.4 to 1.9 times as likely to develop a meningioma when compared to the control group.
Lead researcher Elizabeth Claus, of Brigham and Women’s Hospital and the Yale University School of Medicine, said: “The findings suggest that dental X-rays obtained in the past at increased frequency and at a young age, may be associated with increased risk of developing this common type of brain tumour.
“This research suggests that although dental x-rays are an important tool in maintaining good oral health, efforts to moderate exposure to this form of imaging may be of benefit to some patients.”
She noted, however, that the dental X-rays of today use far less radiation than those in the past.
Drug-resistant malaria targeted
As drug-resistant malaria spreads in south-east Asia, researchers have identified a region of the malaria parasite genome which underlies resistance to the most effective current treatment, artemisinin.
In the research, conducted by Cheeseman et al., 3202 patients were studied between 2001 and 2010. Parasite clearance half-lives lengthened from a mean of 2.6 hours in 2001 to 3.7 hours in 2010, compared with a mean of 5.5 hours in 119 patients in western Cambodia measured between 2007 and 2010. The proportion of slow-clearing infections, with a half-life equal to or greater than 6.2 hours, increased from 0.6% in 2001 to 20% in 2010. This slowing of parasite clearance was shown to result from a genetic trait. The authors say more genetic analysis is needed to know whether the parasites from the two regions have a common origin.
The authors say: “Genetically determined artemisinin resistance in P. falciparum emerged along the Thailand–Myanmar border at least eight years ago and has since increased substantially. At this rate of increase, resistance will reach rates reported in western Cambodia in 2–6 years.”
21–26 May: Sixty-Fifth World Health Assembly, Geneva, Switzerland http://www.who.int/mediacentre/events/2012/wha65
31 May: World No Tobacco Day – Tobacco industry interference http://www.who.int/tobacco/wntd
14 June: World Blood Donor Day http://www.who.int/worldblooddonorday
28 July: World Hepatitis Day http://www.who.int/mediacentre/events/annual/world_hepatitis_day
1–7 August: World Breastfeding Week http://worldbreastfeedingweek.org
19 August: World Humanitarian Day http://ochaonline.un.org/whd
10 September: World Suicide Prevention Day http://www.iasp.info/wspd