Category: Health

{In a medical first, a woman in Sweden has given birth after receiving a womb transplant, the doctor who performed the pioneering procedure said Friday.}

The 36-year-old mother received a uterus from a close family friend last year. Her baby boy was born prematurely but healthy last month, and mother and child are now at home and doing well. The identities of the woman and her husband were not disclosed.

“The baby is fantastic,” said Dr. Mats Brannstrom, a professor of obstetrics and gynecology at the University of Gothenburg and Stockholm IVF who led the research and delivered the baby with the help of his wife, a midwife. “But it is even better to see the joy in the parents and how happy he made them.”

Brannstrom said it was “still sinking in that we have actually done it.”
The feat opens up a new but still experimental alternative for some of the thousands of women each year who are unable to have children because they lost a uterus to cancer or were born without one. Before this case proved the concept can work, some experts had questioned whether a transplanted womb would be able to nourish a fetus.

Others have questioned whether such an extreme step, expensive and fraught with medical risks, would even be a realistic option for many women.

Dr. Glenn Schattman, past president of the Society for Assisted Reproductive Technologies and a Cornell University fertility specialist, said womb transplants are likely to remain very uncommon.

“This would not be done unless there were no other options,” he said. “It requires a very long surgery and not without risk and complications.”

For the proud parents, the years of research and experimentation were well worth the wait.

“It was a pretty tough journey over the years, but we now have the most amazing baby,” the father said in a telephone interview. “He is very, very cute, and he doesn’t even scream, he just murmurs.”

He said he and his wife, both competitive athletes, were convinced the procedure would work, despite its experimental nature.

Brannstrom and colleagues transplanted wombs into nine women over the last two years as part of a study, but complications forced removal of two of the organs. Earlier this year, Brannstrom began transferring embryos into the seven other women. He said there are two other pregnancies at least 25 weeks along.

Before these cases, there had been two attempts to transplant a womb, in Saudi Arabia and Turkey, but no live births resulted.

Doctors in Britain, France, Japan, Turkey and elsewhere are planning to try similar operations, but using wombs from women who have just died instead of from live donors.

The Swedish woman had healthy ovaries, but she was born without a uterus, a syndrome seen in one girl in 4,500. She received a uterus from a 61-year-old family friend who had gone through menopause after giving birth to two children.

Brannstrom said that he was surprised such an old uterus was so successful, but that the most important factor seemed to be that the womb was healthy.

The recipient has had to take three medicines to prevent her body from rejecting the new organ. About six weeks after the transplant, she got her menstrual period, a sign the womb was healthy.

After one year, when doctors were confident the womb was working well, they transferred a single embryo created in a lab dish using the woman’s eggs and her husband’s sperm.

The woman, who has only one kidney, had three mild rejection episodes, including one during pregnancy, but all were successfully treated with medicines. The research was paid for by the Jane and Dan Olsson Foundation for Science, a Swedish charity.

The baby’s growth and blood flow to the womb and umbilical cord were normal until the 31st week of pregnancy, when the mother developed a dangerous high-blood-pressure condition called preeclampsia.

After an abnormal fetal heart rate was detected, the baby was delivered by caesarean section. He weighed 3.9 pounds, normal for that stage of pregnancy. Full gestation is about 40 weeks. The baby was released from the neonatal unit 10 days after birth.

“He’s no different from any other child, but he will have a good story to tell,” the father said. “One day he can look at the newspaper articles about how he was born and know that he was the first in the world” to be born this way.

Details of the case are to be published soon in the journal Lancet.
Some critics have said that taking a womb from a live person is unethical and too big a risk to the donor for an operation that isn’t life-saving. But Brannstrom said there were too few deceased donors to consider that option in Sweden.

“Most couples will do just about anything to have a baby. We need to see this happen a little bit more and see how safe it is,” said Dr. Nanette Santoro, obstetrics chief at the University of Colorado in Denver. “It’s not clear to me how many women would choose this, because it seems pretty arduous.”

Brannstrom said he was concerned he might have hurt the womb during the C-section and said they would have to wait a couple of months before knowing if the mother would be able to keep the uterus for a second pregnancy.

For the new parents, the thought of a second baby right now is a little premature.

“We will definitely think about that,” the father said. “But right now, we’re very happy with just one baby.”

(AP)

{A leading charity has warned that a rate of five new Ebola cases an hour in Sierra Leone means healthcare demands are far outstripping supply.}

Save the Children said there were 765 new cases of Ebola reported in the West African state last week, while there are only 327 beds in the country.

Experts and politicians are set to meet in London to debate a global response to the crisis.

It is the world’s worst outbreak of the virus, killing 3,338 people so far.

There have been 7,178 confirmed cases, with Sierra Leone, Liberia and Guinea suffering the most.

Save the Children says Ebola is spreading across Sierra Leone at a “terrifying rate”, with the number of new cases being recorded doubling every few weeks.

It said that even as health authorities got on top of the outbreak in one area, it spread to another.

The scale of the disease is also “massively unreported” according to the charity, because “untold numbers of children are dying anonymously at home or in the streets”.

Earlier this month, Britain said it would build facilities for 700 new beds in Sierra Leone but the first of these will not be ready for weeks, and the rest may take months.

But Save the Children said that unless the international community radically stepped up its response, people would continue to die at home and risk infecting their family and the local community.

“We are facing the frightening prospect of an epidemic which is spreading like wildfire across Sierra Leone, with the number of new cases doubling every three weeks,” said Rob MacGillivray, the charity’s country director in Sierra Leone.

Safety trials for two experimental vaccines are under way in the UK and US, the WHO said on Wednesday, and will be expanded to 10 sites in Africa, Europe and North America in the coming weeks.

It said it expected to begin small-scale use of the experimental vaccines in West Africa early next year.

The Ebola Donors Conference in London on Thursday is being hosted by the UK and Sierra Leone governments. Its main agenda is to discuss what the global community can do to provide an effective international response to the epidemic.

It will be chaired by UK Foreign Secretary Philip Hammond, who said he hoped it would “raise even greater awareness of the disease and what is needed to contain it , encourage ambitious pledges and show our solidarity with Sierra Leone and the region.”

However, the BBC’s Mark Doyle says Sierra Leone’s President Ernest Bai Koroma is unlikely to be able to attend. According to reports from the country’s capital Freetown, the British plane sent to Freetown to collect him has developed a technical fault.

BBC

{A patient being treated at a Dallas hospital is the first person diagnosed with Ebola in the United States, health officials announced Tuesday.}

The unidentified man left Liberia on September 19 and arrived in the United States on September 20, said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.

At that time, the individual did not have symptoms. “But four or five days later,” he began to exhibit them, Frieden said. The individual was hospitalized and isolated Sunday at Texas Health Presbyterian Hospital.

Citing privacy concerns, health officials declined to release any details about how the patient contracted the virus, what he was doing in Liberia or how he was being treated.

“I can say he is ill. He is under intensive care,” Dr. Edward Goodman of the hospital told reporters.

The patient is believed to have had a handful of contacts with people after showing symptoms of the virus, and before being isolated, Frieden said. A CDC team was en route to Texas to help investigate those contacts, and Texas Gov. Rick Perry will be in Dallas on Wednesday to hold a news conference.

Crew members who transported the patient to the hospital have been isolated, the chief of staff for Dallas Mayor Mike Rawlings told CNN. None have shown symptoms of the disease so far.

The ambulance that carried the patient – ambulance # 37 — was in use for two days after the transport but was adequately decontaminated, said Dallas city spokeswoman Sana Syed.

“I do want to stress that the paramedics followed national standards, as they do after each transport, in decontaminating the ambulance,” she said. “The Dallas County health department has confirmed that paramedics did follow proper guidelines to avoid contaminating additional patients.”

Frieden, too, sought to play down the risk to public health. There are currently no other suspected cases of Ebola in Texas.

“It’s a severe disease, which has a high-case fatality rate, even with the best of care, but there are core, tried and true public health interventions that stop it,” Frieden said.

“The bottom line here is that I have no doubt that we will control this importation or this case of Ebola so that it does not spread widely in this country,” he said.

According to the CDC, Ebola causes viral hemorrhagic fever, which can affect multiple organ systems in the body and is often accompanied by bleeding.

Early symptoms include sudden onset of fever, weakness, muscle pain, headaches and a sore throat, each of which can be easily mistaken early on for other ailments like malaria, typhoid fever and meningitis.

Ebola is spread by direct contact with someone sick with the virus. That means people on the patient’s flight are not thought to be at risk, as he did not begin to show symptoms until several days after arriving in the United States, Frieden said.

He spoke about what’s being done at airports to help stop the spread of the disease.

“One of the things that CDC has done in Liberia, Sierra Leone, Guinea and Lagos, is to work with the airports’ authority so 100% of the individuals getting on planes are screened for fever,” the director said. “And if they have a fever, they are pulled out of the line, assessed for Ebola and don’t fly unless Ebola is ruled out.”

He added, however: “As long as there continue to be cases in West Africa, the reality is that patients travel, individuals travel, and, as appears to have happened in this case, individuals may travel before they have any symptoms.”

Frieden declined to answer whether the patient is a U.S. citizen, saying just that he was in Texas to visit family.

He also declined to say, clearly, whether the patient is a man, although he referred to the person as “he” on multiple occasions.

A number of other Americans have been diagnosed with the disease in West Africa and then brought to the United States for treatment.

The Ebola outbreak has been centered in the West African countries of Guinea, Sierra Leone and Liberia, though there have been concerns about international air travel and other factors — including the fact the symptoms might not appear until two to 21 days after one is infected — may contribute to its spread.

More than 3,000 people in West Africa have died after being infected with Ebola, according to a World Health Organization report from last week. The same report stated that there had been 6,553 cases of the virus overall, though the number is suspected to be much higher, given difficulties in tracking and reporting the disease.

“I have no doubt that we’ll stop this in its tracks in the U.S. But I also have no doubt that as long as the outbreak continues in Africa, we need to be on our guard,” said Frieden.

What you need to know about the Ebola virus

Agencies

{{KIGALI, Rwanda, Sept. 30, 2014}}: {The Ministry of Health would like to inform Rwandans and all visitors to Rwanda that Rwanda is Ebola free. }

The lab results of the patient who was reported in the media this past week were negative for the Ebola Virus Disease.

The government has put in place measures aimed at protecting Rwandans from Ebola. Surveillance systems and emergency management systems are in place. Health workers have been trained across the country and are vigilant.

Together with partners, the Ministry of Health has increased sensitization measures about Ebola virus disease through the media and community outreach activities.

All this will enable timely detection, notification and appropriate management of any suspected cases to safeguard Rwandans. The Ministry will always provide credible information on any case that is considered a public health threat.

{It is impossible to guess whether world leaders have done enough to bring the Ebola epidemic under control, given the risks that it will spread to countries beyond West Africa, the technology billionaire and philanthropist Bill Gates said on Monday.}

Countries should get ready to handle a possible outbreak of the deadly hemorrhagic fever in case it spreads further as people from Liberia, Sierra Leone and Guinea move across borders, Gates said at a breakfast meeting sponsored by the newspaper Politico and Bank of America.

“Because of that uncertainty, I am not going to hazard a guess,” Gates said when asked whether he thinks the massive ramping up of international aid over the past few weeks is enough.

The World Bank already has started working with countries on developing plans should the highly infectious disease spread.

The lesson so far is that countries with strong primary healthcare systems already in place are well positioned to halt the march of Ebola, as Nigeria and Senegal have demonstrated in their quick response to cases there, Gates said.

The Bill and Melinda Gates Foundation funneled extra money in July and August towards Nigeria and pledged an additional $50 million on Sept. 10 to fight the epidemic, which so far has infected over 6,000 people mostly in Liberia, Sierra Leone and Guinea.

The World Health Organization warns the infection rate probably is three times that number and could reach 20,000 by November. The death rate is over 50 percent.

To contain the epidemic, the United States on Sept. 16 announced the deployment of 3,000 military engineers and medical personnel to build 17 treatment clinics and train healthcare workers, mostly in Liberia, at a cost of about $1 billion.

The United Kingdom and France also are increasing their assistance and the United Nations has stepped forward to coordinate the international effort.

PRIMARY HEALTHCARE SYSTEMS CRITICAL

The Gates Foundation has deep expertise in fighting infectious diseases, especially malaria, HIV/Aids, polio and tuberculosis, and has invested billions of dollars in developing countries over the past decade. Gates said those efforts have produced tangible results, such as reducing preventable child deaths by half since 1990 and putting the eradication of polio now within grasp.

A byproduct of these disease-specific investments has been the development of a skilled cadre of primary healthcare experts, who can respond quickly to other types of disease outbreaks, he said.

In Nigeria, for example, there is a strong infrastructure of clinics in place from polio vaccine programs. This enabled the country to respond quickly and contain the small number of Ebola cases in Lagos and Port Harcourt that were carried by an infected doctor who traveled there from Liberia.

Rwanda and Ethiopia also have built up strong primary healthcare systems, partly in conjunction with targeted aid programs such as child and maternal healthcare, Gates said.

In contrast, Liberia and Sierra Leone, still recovering from brutal civil wars that left their healthcare systems underfunded, rely heavily on clinics and hospitals run by a network of charities and non-profit groups. Their governments lacked a depth of institutional expertise in healthcare, Gates said.

“If we had had that, this epidemic would have been caught faster,” he said.

Building a healthcare structure in the three countries worst hit by Ebola is critical, otherwise deaths from preventable diseases will quickly outpace those from Ebola, Gates said.

If mothers are afraid to get professional assistance in delivering their babies for fear of contracting Ebola and children cannot get malaria treatments, the long-term impact of the epidemic will be far more damaging, he said

“That will be very tragic, and it won’t get the type of attention that Ebola is getting,” Gates said.

He estimated that it will take 20 years of donor investment in some African countries to build resilient healthcare systems able to control preventable diseases and manage health crises.

WASHINGTON (Thomson Reuters Foundation) –

{The death toll from an outbreak of Ebola in West Africa has risen to at least 3,091 out of 6,574 probable, suspected and confirmed cases, the World Health Organisation said on Friday.}

Liberia has recorded 1,830 deaths, around three times as many as in either Guinea or Sierra Leone, the two other most affected countries, according to WHO data received up to Sept. 23.

An outbreak that began in a remote corner of Guinea has taken hold of much of neighbouring Liberia and Sierra Leone, prompting warnings that tens of thousands of people may die from the worst outbreak of the disease on record.

The WHO update said Liberia had reported six confirmed cases of Ebola and four deaths in the Grand Cru district, which is near the border with Ivory Coast and had not previously recorded any cases of Ebola.

The district of Kindia in Guinea also reported its first confirmed case, the WHO said, a day after it said the spread of Ebola appeared to have stabilised in that country.

Nigeria and Senegal, the two other nations that have had confirmed cases of Ebola in the region, have not recorded any new cases or deaths in the last few weeks.

Reuters

{A senior official from Gavi Alliance, Dr. Karan Singh Sagan announced last week that new vaccines are set to be introduced in Rwanda. The official made these remarks during his visit to Rwanda and stated that the vaccines will be for non-communicable diseases such as hepatitis B.}

The official also commended Rwanda for utilizing resources effectively citing that achievement of vaccination coverage of 97 percent is very remarkable.

“We will work very closely with the Ministry to support the introduction of the new vaccines which are only available in the western world but many developing countries cannot afford them. Global Partners, Donors GAVI Alliance will help to introduce these new vaccines.”

Maurice Gatera, the Head of the vaccines preventable diseases department in RBC said that Rwanda has registered milestones as regards immunization coverage in the past 20 years which has impacted significantly on the reduction of preventable diseases and lowered mortality.

“The progress is clear. No Rwandan child has suffered from measles or polio for the last 21 years. With the introduction of vaccines against non-communicable diseases like hepatitis B among adults, we believe efforts to curb controllable diseases will rise,” Gatera noted.

Dr. Sagan pledged that Gavi will support Rwanda to rise from 97 percent vaccination coverage to 100 percent among children.

Rwanda is a very good performing country in the African region. The main challenge is how to maintain those vaccines.

The tour of the Senior /country officer of Gavi Alliance continued to other parts of the country including health centers to see firsthand Rwanda’s medical services to the citizens in relation to vaccination.

He also visited the Kigali Genocide Memorial Centre in Gisozi.

{Secretary Kerry named Ambassador Nancy Powell to lead the Ebola Coordination Unit at the Department of State. In this role, Ambassador Powell will lead the State Department’s outreach to international partners, including foreign governments, to ensure a speedy and truly global response to this crisis.}

President Obama has declared the Ebola outbreak a national security priority.

Speaking on September 16 at the Centers for Disease Control and Prevention in Atlanta, the President outlined the U.S. Government’s strategy to address the threat from the worsening Ebola epidemic in West Africa.

The four goals of that strategy are 1) controlling the epidemic at its source in West Africa; 2) mitigating second-order impacts, including blunting the economic, social, and political tolls in the region; 3) engaging and coordinating with a broader global audience; and 4) fortifying global health security infrastructure in the region and beyond.

The President emphasized at the CDC the need for more nations to contribute the experienced personnel, supplies and funding. Ambassador Powell, working with leaders from across our government, is leading our efforts to build the coalition required to bring this epidemic under control.

Ambassador Powell most recently served as U.S. Ambassador to India. Prior to that, she was the Director General of the Foreign Service and Director of Human Resources. Ambassador Powell previously served as the State Department’s Senior Coordinator for Avian Influenza, a role for which she was honored with the Homeland Security Service to America Medal in 2006.