Back in January we told you about Cephalon’s submission of their sleep disorder drug, Nuvigil, to be approved as a treatment for jet lag by the FDA. The FDA has completed its review, but they have not approved the application because of questions pertaining to some of the data submitted. Cephalon is already following up with the FDA to clarify the points in question and we’ll continue to track its progress through the process.
One of our previous posts speculated that tolerance may be key to health and happiness based on a comparative study of states in the U.S. That line of thinking prompted us to look for comparative data worldwide. We came up with the Global Gender Gap Report, released in 2008 by the World Economic Forum, which rates countries on the disparity between men and women on four measures: economic opportunity, educational attainment, political empowerment and health and survival. The report covers a total of 128 countries that represent 90% of the world’s population.
The smallest gap is “healthy life expectancy”, which takes into account years of health lost to violence, disease and malnutrition. Across the 128 countries surveyed, women were expected to enjoy anywhere from 93% to 98% of the healthy years that men enjoy. Compare these findings to the gaps that exist for economic opportunity (25-79%), educational attainment (47-100%) and political empowerment (0-53%). Clearly health is a necessary but not sufficient condition for women to reach their potential. Rolling these subindices together on an unweighted basis, we find Sweden, Norway, and Finland grabbing the top three spots worldwide (see our chart for the rest of the Top Ten). A country that ranked surprisingly high was Cuba at number 22 in 2007 largely due to a high percentage of women in parliament and ministerial-level positions. A few other countries that ranked relatively low were France at 51 and Italy at 84 due to low income ratios and the low percentage of women among professional workers. Perhaps one of the most surprising rankings was the United States which dropped from 23 in 2006 to 31 in 2007 based on slippage in political empowerment and wage equality.
Why keep track of other countries’ progress towards closing the gap between men and women? We think distinct second-class status for women is a sign of stress in a society that may give “ethical travelers” pause when setting their itineraries and may indicate the potential for discrimination against women when accessing health services. Of course, women keep striving to overcome these disparities. In a study released by Education Week, the gender gap in reading skills grew between 2000 and 2006 but in the other direction — girls have been continually outperforming boys with Argentina, Australia, Bulgaria, Greece, Iceland, Italy, Japan, Mexico, and Spain leading the way. Perhaps these findings indicate that girls work harder in order to have the same opportunities as boys. What do you think?
Despite the World Health Organization’s warning last Friday that Icelanders and Europeans may have to stay inside to avoid respiratory problems once the Icelandic volcanic ash begins to settle, most experts agree that the effects should be minimal. “There is a massive diluting effect in the atmosphere as it gets dispersed by wind which means the amount reaching land is very small,” said Ken Donaldson, professor of respiratory toxicology at the University of Edinburgh in Scotland. He added that little impact has been seen in people’s health from prior volcanic eruptions, except for in those with lung problems in the immediate vicinity of the volcano.
Volcanic ash is composed of fine particles of fragmented volcanic rock. Only very small particles measuring less than 10 microns in size are able to reach the lower respiratory tract in humans and cause adverse effects such as wheezing and coughing. Analysis of the ash that has been released thus far suggests that less than 25% of the particles are small enough to cause problems.
So long as the volcanic ash remains in the upper atmosphere, respiratory toxicologists maintain, there will be no increase in people’s exposure and little to no added health risk. If the ash drops to ground level due to vertical movement of air masses, those with chronic respiratory problems such as emphysema and asthma could experience a slight increase in respiratory symptoms. Rainfall could mitigate the problem, however, by removing the ash particles altogether from the atmosphere.
For now, the World Health Organization is monitoring the situation, and will issue more substantial warnings if the eruption continues for many more weeks and the volcanic ash, now drifting above 20,000 feet, begins to settle over Iceland and Northern Europe.
Dateline: Vienna
Situation: Stranded by Airport Closures
Medical Report: You can breathe the air but check out these developing issues.
There’s no ash in the air here in Austria, but besides all the general travel headaches you are seeing on the news, I’ve uncovered some disconcerting trends in working with our members traveling around the world:
We will keep tracking developments while Ejafjallajokull continues to spew.
Photo info: http://www.flickr.com/photos/gsfc/ / CC BY 2.0
It is the phone call every parent of a child abroad is horrified to receive: “Mom, Dad, please help me!” followed by a concealed voice making monetary demands for the safe return of the kidnapped child. In years past, this usually meant that the child had indeed been abducted and was being held for ransom. In recent years, however, many of these calls are placed by “virtual kidnappers” who may be nowhere near the alleged victim.
One of the consequences of the “information age” and social media such as Facebook and My Space is the widespread availability of names, addresses and phone numbers. The resourceful virtual kidnapper is someone who collects data on prospective victims who have shared details online about upcoming adventures such as a trip down the Amazon, a hike to Machu Picchu, or an African Safari — all places where cell phone reception is spotty or nonexistent, creating the conditions for scams to go undetected.
The calls to the families of the “virtual victims” convey a sense of urgency — that the victim will be executed within the hour unless funds are transferred to a foreign bank account, for instance. Since the family has no way to determine the veracity of the kidnapping, payment is made. Sophisticated virtual kidnappers go to great lengths to “fake out” the families of their victims by pretending to be the victims themselves — speaking in short, frantic sentences that are muffled by “poor cell phone reception.”
Because cell phone coverage has grown ever wider– even the remote jungles of sub-Saharan Africa are often reachable today — many virtual kidnappers do not limit their victims to those whose cell phone reception is marginal. Instead, perpetrators contact prospective victims and tell them that their phones should be turned off for an hour or two for servicing. The virtual kidnappers take advantage of the window to make their calls back home.
The problem has become so severe in Mexico that the country’s government has set up a hot line for victims of virtual extortion. The U.S. State Department, in its section on travel precautions for Central and South American countries such as Mexico, Venezuela and Peru www.travel.state.gov/ suggests that families of victims should: 1) not reveal any personal information over the phone, 2) insist on speaking with the victim to corroborate his/her identity and 3) contact the nearest US Embassy or consulate. Although the temptation to respond immediately to demands is very high, most “virtual kidnappers” will abandon their efforts within an hour or two if payment is not received.
Here are a few imperatives to avoid becoming a victim of “virtual kidnapping”:
Register with the State Department prior to travel
On April 1 the Ministry of Health of Chad reported that during the first three months of 2010, over 1500 cases of suspected meningococcal meningitis were diagnosed. Meningococcal meningitis is a serious bacterial infection that attacks the lining of the brain. Untreated, it is fatal in about 50% of cases. Even with treatment, mortality rates average about 10%. Of those who survive, 15 to 20% lose their limbs, have seizures, become mentally retarded, or experience other long-term neurological problems.
Each year the African “meningitis belt” that stretches from Senegal in the west to Ethiopia in the east, and with a population exceeding 300 million, reports thousands of cases of confirmed meningococcal infections. It’s high season. Most infections occur during the “dry season” (December to June) due to dust winds, overcrowding at the family level, and seasonal pilgrimages. The World Health Organization, the Red Cross, and the International Coordinating Group (ICG) on Vaccine Provision for Epidemic Meningitis are attempting to combat yearly outbreaks by providing immunizations to millions of at-risk children and young adults.
The bacteria responsible for meningitis (Neisseria meningitides) are transmitted from person to person through nasal and throat secretions. Close and prolonged contact with someone who is coughing, sneezing, or sharing drinking utensils facilitates the spread of the illness. The average incubation period is four days, but symptoms of stiff neck, fever, severe headache and rash may occur anywhere from 2 to 10 days following exposure.
Anyone who is considering travelling to the sub-Sahara region should receive the meningitis vaccine. There are two currently available in the United States:
Both vaccines are capable of providing immunity for the A and B subtypes responsible for the epidemics in Africa. Both vaccines also work well, and protect over 90% of those who receive it. Menactra is currently preferred by most infectious disease specialists for those between 10 and 55, as it is believed to give better, longer lasting protection. Menomune should be used for children 2 to 10 years old and adults over 55.
Photo info: http://www.flickr.com/photos/teseum/3533755515/
I am happy to report that our week at sea was uneventful from a health standpoint. Even though there were over 3,000 passengers (including 884 children), I didn’t see anyone that looked sick or on the verge of getting sick. A few passengers sported the scopolamine patch behind their ears, but I felt no need to take any medication or Vitamin B6 (that I dutifully packed for the trip).
There were some medical questions for the passengers when checking in, and if you said yes to having had a cough or other symptom in the past week, you were required to see their medical staff upon boarding. There was also a Purell® station at the entrance to each dining room or eating area, and many passengers were using this. These measures may have helped or we might have been lucky, but I would not avoid a cruise because of health concerns. I would, however, still check the outbreak list when planning your next cruise and take precautions just in case.
Back in November, I posted about our first iPhone app, mPassport Paris, and I am happy to announce that we now have an additional seventeen (17) available in the store. The new destinations are (grouped somewhat geographically):
Next week, Rome and Florence should also go live. The old post sums up the apps well, and we have made many improvements since then. All will soon be iPad compatible, and (drum roll please) all are free for now. So don’t wait to get one or more of these on your phone.
Finally, the mPassport tools and services are available on a worldwide basis through a subscription. This gives you access through mobile and desktop web sites that should work on any device. Learn more about this at http://www.mpassport.com/entry_basicInfo.cfm.
We would love to hear about your experiences using mPassport so get out there and get sick (ok, just play with it and tell us what you think).
If we apply the air quality standard for particulates adopted by the European Union (20 micrograms per cubic meter), urban air pollution is nearly ubiquitous around the world. Of course, air pollution levels vary widely. In some parts of the world, air pollution might go unnoticed. In other places, people can be seen wearing face masks. As travelers, we need to know what we are getting into.
We’ve been digging into data compiled by the World Health Organization for nearly 140 countries, looking specifically at particulate levels in cities with a population of at least 100,000. This widely used measure of air pollution—called PM10 — counts both unnatural and natural particles less than 10 micrograms in diameter. We’re talking about things that are suspended in the air (both liquids and solids) and are less than 1/7th of a strand of hair in diameter.
Why keep track of particles of this size? The reason is that the smaller a particle is, the deeper it can settle in a person’s lungs. And the deeper it gets, the more damage it can do.
And a lot of damage is being done. Of the countries surveyed, only twelve met the EU air quality standard (see Table 1). The U.S. tied for seventeenth with Denmark and South Africa with a relatively clean score of 24. But in many countries around the world, the average urban particulate levels are two, three or four times higher. We put together Table 2 to highlight some frequently visited countries whose levels are a multiple of the U.S. reading. Short visits to urban areas of these countries could cause moderate to severe discomfort or a dangerous flare up of chronic respiratory problems. Long-term stays or relocations portend serious health risks.
We’ll expand our discussion in the coming days. Have you had breathing distress in a destination? How did you manage?
Prompted by allegations that the swine flu pandemic was oversold to promote vaccine sales, researchers at the National Institutes of Health in Bethesda MD have released their assessment of the mortality associated with the H1N1 virus in the U.S during the past flu season. In their own words:
“We conclude that the 2009 A/H1N1 pandemic virus had a substantial health burden in the U.S. over the first few months of circulation in terms of years of life lost, justifying the efforts to protect the population with vaccination programs. Analysis of historic records from three other pandemics over the last century suggests that the emerging pandemic virus will continue to circulate and cause excess mortality in unusually young populations for the next few years.”
Relying on the fact that the average age of an H1N1 victim (37) is far younger than the average of a typical seasonal flu victim (76), researchers calculated that in the U.S. H1N1 cost nearly 2,000,000 years of life versus 600,000 for the seasonal flu.
In an interview with New Scientist magazine, researcher Lone Simonsen warns that most people killed in the 1968 pandemic died in its second wave, and advises vaccination. It’s autumn now in the southern hemisphere, and H1N1 is returning. We will keep tracking its progress for our globally mobile readership.
