Archive for August, 2010

The Plague: Timely Treatment is Critical

Thursday, August 5th, 2010 by

In an eerie throwback to a bygone era, the Peruvian minister of health reported on Monday that a 14 year old boy had died and that at least 31 others had become infected with the plague last week.  The vast majority were of the bubonic (lymph node) type – spread by fleas – while a small number suffered from the pneumonic (lung) variety spread by airborne bacteria.

Although the plague is treatable with antibiotics, the lack of timely intervention can be deadly, particularly for the pneumonic type.  Untreated, the mortality from either form of the plague approaches 75%, and is thought to have been the cause of  Black Death – the mid 14th century epidemic that killed over 25 million people, or one third of the population of Europe.  Epidemiologists believe that it was the bubonic type, spread by fleas hosted by rats, that was responsible.  

So far, the cases in Peru have been confined to the Northern coastal province of Ascope, located approximately 325 miles northwest of Lima.  The popular international resort of Chicama beach is not far away. Health Minister Oscar Ugarte has ordered authorities to screen sugar, fish and meat exports from this area. 

There is no vaccine available for the plague.  Both the bubonic type, which results in swollen, painful lymph nodes, and the pneumonic type, which causes a rapidly progressive pneumonia, can progress without treatment to involve the entire body.  This third, or septic form, results in fever and chills, abdominal pain, vomiting, diarrhea, bleeding from the mouth, nose or rectum, shock and ultimately blackening and death of tissue (gangrene) in the extremities.  This darkening of fingers toes and the nose lead to the coining of the term “Black Death” over 500 years ago.

Anyone who has traveled to an area endemic for the plague should seek immediate medical attention for any flu like symptoms since early treatment with antibiotics is over 90% effective in preventing the more deadly consequences of this historic illness.

Photo by markfftang

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New Book Chronicles Malaria’s Chokehold on Human Progress

Wednesday, August 4th, 2010 by

Journalist Sonia Shah brings us an important new account of how malaria has impeded human progress for half a million years and counting. Her book, The Fever: How Malaria Has Ruled Humankind for 500,000 Years (Farrar, Straus, Giroux) ranges across history, geography vast numbers of victims and the many modern-day players who are pursuing its eradication.  World travelers and anyone with an interest in how one disease can subjugate a wide swath of humanity will want to delve into Shah’s reporting.

Shah has previously tackled topics ranging from the story of crude oil to an account of pharmaceutical companies testing drugs on indigent patients. In The Fever she displays, according to one reviewer, “the same curiosity, eye for history, and anger on behalf of the oppressed.” Here are some other excerpts from recent reviews: 

From New Scientist, Martin de Smet

The Fever is a mine of information, drawing on diverse accounts from medical experts and field workers. This is an important book on the historical lessons we must not forget and the mistakes we are still making today in the battle against what remains a formidable killer.

Critically, The Fever exposes the growing threat posed by donors who want to see immediate results. The issue is all too familiar to field workers, who see aid flooding into countries where success is more or less guaranteed, but poor investment in chaotic post-conflict countries where the burden of the disease is often heaviest. Everyone – politicians, donors, research institutes, lobby groups and the pharmaceutical industry – has their own agenda when it comes to malaria. Shah’s examination explores them all.

From NPR, Michael Schaub

Malaria has been a global scourge since the Ice Age, and despite the fact that it’s treatable, it still kills about 1 million people a year. Scientists and physicians have worked for decades upon decades to eliminate the disease, but after tens of thousands of years, it’s beginning to look unkillable.

It’s a compelling account of a disease that remains out of sight — and thus out of mind — for most Americans, even as it slowly tightens its grip on other parts of the world. Despite Shah’s engaging prose and obvious enthusiasm, the subject matter means it’s far from an easy read — but it might well be an essential one.

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