Friday 25 January 2013

Swine flu infected


At least 20% of people, including half of schoolchildren, were infected with swine flu during the first year of the pandemic in 2009, according to data from 19 countries.
It is thought the virus killed 200,000 people around the world.
A World Health Organization-led study looked for evidence of the body's immune system fighting the virus.
It showed large numbers of people had been infected, although not all would have developed full-blown flu.
The H1N1 virus first appeared in Mexico in 2009 and rapidly spread around the world.
Anti-bodies

What is a virus?

H1N1 virus
  • Virus particles - known as virions - are tiny particles responsible for viral infection
  • Typically 100 times smaller than human cells
  • Viruses present wherever there are cells to infect and are most common biological entities on earth
  • Influenza kills a very small proportion of those it infects but viruses such as HIV, polio and smallpox (now eradicated) can be more deadly
An international group of researchers looked at more than 90,000 blood samples before and during the pandemic in countries including India, Australia and the UK.
They looked for antibodies which are produced when the body is infected with H1N1.
By comparing the figures before and during the pandemic, the researchers can determine how many people were infected as the virus spread around the world.
Approximately 24% of people had been infected overall, but half of school-age children showed signs of infection.
One of the researchers, Dr Maria Van Kerkhove from Imperial College London, said fewer than two in every 10,000 people infected died during the pandemic.
"However, those that did die are much younger than in seasonal flu so the years of life lost will be much more," she told the BBC.
"The figures drive home how incredibly infectious the virus is," she said.
Many older people, who typically die during outbreaks of flu, were protected as they had been exposed to the virus decades before.
Prof John Oxford, a virology expert at Queen Mary, University of London, said the figures "make sense".
"It was the busiest virus on the block and it displaced other influenza viruses - it was the only virus in town."
He said a similar pattern would be expected in other countries which were not analysed in the study.

Tuesday 22 January 2013

Long-term aspirin 'blindness


People who regularly take aspirin for many years, such as those with heart problems, are more likely to develop a form of blindness, researchers say.
A study on 2,389 people, in the journal JAMA Internal Medicine, showed aspirin takers had twice the risk of "wet" age-related macular degeneration.
The disease damages the 'sweet spot' in the retina, obscuring details in the centre of a patient's field of vision.
The researchers said there was not yet enough evidence to change aspirin use.
Taking low doses of aspirin every day does reduce the risk of a stroke or heart attack in patients with cardiovascular disease. There are even suggestions itcould prevent cancer.
One in 10 people in the study, conducted at the University of Sydney, were taking aspirin at least once a week. On average the participants were in their mid-60s.
Eye tests were performed after five, 10 and 15 years.

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The evidence is now accumulating about the association of aspirin and wet AMD, however, it is not overwhelming at this point”
Macular Society
By the end of the study, the researchers showed that 9.3% of patients taking aspirin developed wet age-related macular degeneration (AMD) compared with 3.7% of patients who did not take aspirin.
Their report said: "The increased risk of [wet] AMD was detected only after 10 or 15 years, suggesting that cumulative dosing is important.
"Given the widespread use of aspirin, any increased risk of disabling conditions will be significant and affect many people."
Wet AMD is caused by blood vessels growing in the wrong place. They cause swelling and bleeding which damages the retina.
The process can happen very quickly with vision being damaged in days. Age, smoking and a family history are the main risk factors.
High-risk
There are already known risks of aspirin such as causing internal bleeding. The research team suggest the risk of damaging eyesight "may also need to be considered".
They acknowledge that for most patients there is "insufficient evidence" to change how aspirin is prescribed.
However, they suggested using the drug may need to be reappraised in high-risk patients such as those with wet AMD in one eye already.
Prof Jie Jin Wang, an expert in vision research at Sydney University in Australia, said this was something doctors might want to discuss with high-risk patients.
The Macular Society said: "The evidence is now accumulating about the association of aspirin and wet AMD, however, it is not overwhelming at this point.
"For patients at risk of cardio-vascular disease, the health risks of stopping or not prescribing aspirin are much higher than those of developing wet AMD.
"Patients who are taking aspirin because their doctor has prescribed it should not stop taking it without consulting their doctor first."
Matthew Athey, from the RNIB charity, said any concerns should be discussed with a family doctor.
"However, this is interesting research as age-related macular degeneration (AMD) is the leading cause of sight loss in the UK, and this study could contribute to our understanding about why some people may develop 'wet' type macular degeneration.
"Further research is needed to clarify and investigate some of the issues raised in the study, however this association may be valuable for doctors in the future when considering aspirin for their patients."

Meningitis B vaccine


A vaccine to protect children against one of the most common and deadly forms of meningitis has been licensed for use in Europe.
The Bexsero vaccine licensed by the European Commission is the first to cover meningococcal B meningitis - until now vaccines had protected against only some of the bacterial types involved.
About 1,870 people contract meningitis B each year and one in 10 die.
The UK is yet to roll out the jab.
The Joint Committee on Vaccination and Immunisation (JCVI) which provides vaccination advice to the government plan to meet in June when they will discuss the vaccine and whether to add it to the list of vaccines routinely offered to young children.
Meningitis UK said: "We urge the JCVI and UK government to introduce the new MenB vaccine to the childhood immunisation schedule as soon as possible. Every day of unnecessary delay in introducing this vaccine will cost lives. We must not allow children to die from this disease if it can be prevented."
Now it is licensed in the UK and other EC countries, it could potentially be bought and used by healthcare providers.

Meningitis

  • Inflammation of membranes covering brain and spinal cord
  • It can be caused by viruses or bacteria
  • Meningitis B is the most common cause of bacterial meningitis in the UK
  • It can also cause septicaemia
  • There are a number of vaccines that can prevent many cases of viral and bacterial meningitis, including MMR, Meningitis C, PCV and DTaP/IPV/Hib vaccination
About a quarter of all survivors of meningitis B are left with life altering after-effects, such as brain damage or limb loss.
Children under the age of five are the most at risk from the bacterial infection, which leads to inflammation of the brain and spinal cord.
Experts say the jab is likely to be effective against 73% of the different variations of meningitis B.
A vaccine against the less common meningitis C has been administered since 1999 and is now widely given to babies in the first year of their life.
It has led to a large fall in the number of cases in people under the age of 20.

Saturday 19 January 2013

Self-help books 'treat depression'


Prescribing self-help books on the NHS is an effective treatment for depression, a study suggests.
Patients offered books, plus sessions guiding them in how to use them, had lower levels of depression a year later than those offered usual GP care.
The effect was seen in addition to the benefits of other treatments such as antidepressants, Scottish researchers report in the journal Plos One.
Such an approach may help the NHS tackle demand for therapy, they said.
More than 200 patients who had been diagnosed with depression by their GP took part in the study, half of whom were also on antidepressant drugs.
Some were provided with a self-help guide dealing with different aspects of depression, such as being assertive or overcoming sleep problems.
Patients also had three sessions with an adviser who helped them get the most out of the books and plan what changes to make.
After four months those who had been prescribed the self-help books had significantly lower levels of depression than those who received usual GP care.

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Depression saps people's motivation and makes it hard to believe change is possible”
Prof Christopher Williams
A year later, those in the self-help group were more likely to be keeping on top of their depression.
Study leader Prof Christopher Williams, from the University of Glasgow, who also wrote the books called Overcoming Depression and Low Mood, said the guided sessions were the key to getting people engaged.
The sessions can be delivered in general practice without referral to a specialist, taking pressure off waiting lists.
In Scotland, a telephone support service has now been set up to help support those using the books, which can be freely copied and disseminated, he added.
"We found this had a really significant clinical impact and the findings are very encouraging," he said.
"Depression saps people's motivation and makes it hard to believe change is possible."
The challenge for the NHS, where self-help books are already used in many places, is how to implement this model so people have easy supported access in primary care, he said.
'Worth investing in'
There has been huge investment in better treatment for depression in the UK in recent years with the Improving Access to Psychological Therapies programme in England set up to widen access.
It has been estimated this approach could save the NHS up to £272m and the wider public sector £700m.
But, says Prof Williams, despite the huge levels of investment, it is just not possible to refer everyone with depression to mental health services.
Dr Paul Blenkiron, consultant in adult psychiatry at Leeds and York Partnership NHS Foundation Trust, said the results showed that guided self-help is effective and is "something the NHS should be investing in".
He is currently advising on behalf of the Royal College of Psychiatrists, on a National Books On Prescription Scheme, to be rolled out across UK public libraries this year.
Thirty books, including the one used in the study, have been selected.
But Dr Blenkiron said self-help would not be suitable for everyone: "The key thing is that the person is committed to doing some work."