TUBERCULOSIS: Could your cat give you TB? Vets warn pets are catching deadly strain found in cattle

Could your cat give you TB? Vets warn pets are catching deadly strain found in cattle and could pass it on to humans

• As many as 100 out of every 100,000 cats carry tuberculosis, experts say
• About a fifth infected by Mycobacterium bovis, found in cattle and badgers
• Close contact with humans 'ramps up degree of public health risk'

By HELEN LAWSON

PUBLISHED: 09:40 GMT, 30 June 2013 | UPDATED: 11:15 GMT, 30 June 2013

Pet cats are being infected by tuberculosis and could pass the disease on to the owners, vets say

Cats could pass on deadly bovine tuberculosis to their owners, according to vets.

Adventurous felines are catching the disease during their exploration of badger setts or by coming into contact with rodents who have done the same.

They can also pick up bovine TB directly from cattle or infected milk.

Now experts says vets should be more aware that domestic cats can carry the disease.

'The real issue with cats with TB is that unless they are feral, they tend to have close contact with humans,' Carl Padgett, former president of the British Veterinary Association, told the Sunday Telegraph.

'That is where you ramp up a degree of the public health risk through direct contact with cats that have TB and that is where I see the importance rather than driving the outbreak among cattle.'

Scientists at the University of Edinburgh Royal School of Veterinary Studies say that as many as 100 out of every 100,000 cats could have a form of tuberculosis, more than previously thought. 

A fifth of those are thought to be infected by Mycobacterium bovis - the strain found in cattle and badgers.

Most were caused by Mycobacterium microti, usually found in voles.

Professor Danielle Gunn-Moore, who led the study, told the newspaper: 'You need to be aware that cats are acting as sentinels for other small furries that are infected. 

'You might clear the cattle, but if you don’t clear the cats as well, you could potentially get reinfection.'

The Edinburgh team found that, in one year, 17 per cent of the 187 reported cases of TB in cats were caused by the bovine strain.

Their findings have been published in the journal of Transboundary and Emerging Diseases.

 

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Government figures show that only 80 cases of bovine TB in cats have been reported to the Department of Environment, Food and Rural Affairs since 2009, with nine of those reported last year.

Mr Padgett welcomed the Edinburgh findings and said the low number of cases was likely to be caused by vets being unaware that they should look out for feline tuberculosis.

But he also told the Sunday Telegraph that there was no suggestion that cats are the main spreader of TB and said the pets do not pose a major health risk to humans.

Chief veterinary officer Nigel Gibbens told BBC Radio 4’s Farming Today: '[Cats] roam and do explore and could get into fights with feral cats and badgers themselves.

Cats could pick up Mycobacterium bovis from badger setts, rodents that have been in badger setts or with fights with badgers themselves

'There is a threat to humans. If an animal has an unresolving bite wound or a respiratory problem that won’t go away, they should talk to their vets, and vets need to bear this in mind. 

'Transmission to people is possible and has happened but the number of cases in pets is low and so the possibility of this is low.'

Between 1994 and 2011 there were 570 cases of bovine tuberculosis in humans.

Those with the cattle strain of the illness were mainly over the age of 65 and had drunk infected unpasteurised milk.

Less than 1 per cent of the 8,963 human cases of TB in 2011 were caused by Mycobacterium bovis.

About 5,000 badgers are due to be culled in Somerset and Gloucestershire before the end of the year because authorities say they spread tuberculosis among cattle.

Badgers are blamed for spreading the disease to livestock, devastating herds and costing dairy farmers and the taxpayer millions of pounds a year.

Ministers say that unless everything possible is done to control the disease, the bill to the country will top £1billion over the next decade.

But critics favour other methods, including vaccination, and say that the science behind the cull is not sound.

Read more: http://www.dailymail.co.uk/news/article-2351817/Could-cat-TB-Vets-warn-pets-catching-deadly-strain-cattle-pass-humans.html#ixzz2Xi0OwtKT
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MALARIA: Niger statistics

• During the first semester of 2013, 813 708 cases of malaria have been reported in Niger, compared to 590 229 during the same period in 2012. So far 476 deaths have been recorded, compared to 244 in 2012, meaning that both the number of cases and deaths has nearly doubled. (full article reported)

http://ec.europa.eu/echo/news/echo-flash/2013/20130628_en.htm

 

POVERTY: Yemen: Deprivation, despair at a migrant dead-end

Photo: John James/IRIN

Ethiopian teenage migrants taking part in a voluntarily programme to return home

HARADH, 27 June 2013 (IRIN) - In temperatures in the high forties around 1,000 Ethiopian migrants, sweating profusely, turn their backs to Saudi Arabia and start the walk south - away from the Yemeni border town of Haradh and their dreams of a new life. 

On the road they silently pass others heading north, still hopeful of crossing the border. 

Haradh is at the crossroads of these dreams - a potential gateway to a new life in Saudi Arabia, but getting there is becoming increasingly difficult. 

To get here, the migrants have endured considerable hardship; often taking on debt to fund the journey, walking for weeks to get to the East African coast and then crossing the shark-infested Red Sea. 

Thousands get picked up by smugglers in Yemen who kidnap and torture them to extract ransom money. 

Then, they reach what for many is the end of the road and their hopes: a dusty poverty-stricken town, 10km from an increasingly impenetrable Saudi Arabia. 

"There’s a general feeling of depression. They come with dreams. Some just keep trying - they owe so much money", Fatwa Abdok, psychiatrist, MSF

“There’s a general feeling of depression. They come with dreams. Some just keep trying - they owe so much money,” Fatwa Abdok, a psychiatrist working with Médecins Sans Frontières in Haradh, told IRIN. 

She describes hearing testimonies of “torture you can never imagine” from those held captive by smugglers. 

“Some of them are completely destroyed. Some get consumed just coping with it. It all depends on the strength of the person. Some recover when they have food and a place to sleep. Ethiopians are strong people, but some go crazy,” she said. 

The numbers of arrivals in Yemen from the Horn of Africa in the last three years has doubled - from 53,382 in 2010 to a record 107,532 in 2012. 

Ethiopians make up the majority of arrivals - up from 64 percent in 2010 to 78 percent last year. 

The fence 

“The Saudis have cracked down. The border’s not closed but it’s more difficult to get in,” said one aid worker who asked not to be named. 

“You see the migrants on the road and they’re stuck. They trudge up to the border from Haradh. It’s an awful place. There’s nothing there. They trudge up to the border and they come back and they’re stuck.” 

Earlier this year, Saudi Arabia announced plans to resume construction of a 3m-high fence along its 1,800km border with Yemen. 

Work on the controversial project initially started in 2003, but was suspended a year later. In 2008 a fence was put up along the coastal area around Haradh where much of the cross-border smuggling of people, drugs and weapons is concentrated. 

In addition to the fence, Saudi Arabia has also cleared the border areas of settlements and uses floodlights and thermal detection cameras to try to stop the often heavily-armed smugglers. 

Growing crisis 

These restrictions have led to a build-up of pressure in Haradh and the surrounding Hajjah Governorate, where poverty is widespread. 

The governorate, which depends on economic ties with Saudi Arabia, already supports more than a 100,000 internally displaced persons (IDPs) who fled neighbouring Sa’dah Governorate after the 2004 Houthi uprising and subsequent conflicts. 

Some of the IDP families at the al-Mazraq IDP camps a short drive from Haradh rely on breadwinners in Saudi Arabia, but residents complain that the border restrictions have pushed them into poverty. 

“We used to work in construction in Saudi, but now because of the fence, lots of Yemenis have been jailed there. Now there are video cameras and machine guns stopping us getting across,” said one camp resident, Saleh Hassan. 

Recent changes to Saudi labour laws have also threatened tens of thousands of Yemenis with expulsion, which would further add to the country’s economic difficulties two years after the turmoil of the Arab Spring. 

Press reports quoted government officials this week saying 53,000 Yemenis had been deported from Saudi Arabia since the beginning of June, and tens of thousands more are expected in the coming days. 

Photo: John James/IRIN

Women migrants at the IOM centre in Haradh

Community leaders in Haradh say the new restrictions have led to a significant decrease in economic activity, making it more and more difficult for the town to support the tens of thousands of African migrants. 

“We are afraid for the migrants because of the torture they often suffer, and also of them. Now with the fence up, they are creating more problems,” the head of the local council in Haradh, Sheik Hamoud Haidar, told IRIN. 

“We are afraid of them because they are hungry. A hungry man is an angry man.” 

Around 2,000 migrants have also been freed around Haradh in recent months following army raids on smuggling yards to free them from captivity. Deportations from Saudi Arabia also push African migrants back into Haradh - an estimated 40 percent of the 3,000 migrants using the International Organization for Migration (IOM) Migrant Response Centre in Haradh have come from Saudi Arabia. 

“It is clear that it is the right of any country to close its borders to clandestine operations. Having said that, we are today faced with 25,000 people who are trapped in the border,” said Ismail Ould Cheikh Ahmed, the humanitarian coordinator in Yemen. 

“Every time there is a military operation, we discover another 500 or 700 who have been in this or that camp controlled by human traffickers and abusers. So the number is only increasing - 25,000 is something that Yemen today cannot absorb.” 

Returns 

The increase in demand for migrant services in Haradh this year came at just the wrong time for the supply of humanitarian relief services, which face cutbacks due to funding shortfalls. 

IOM suspended large-scale return flights in September 2012, and the World Food Programme’s provision of hot meals to around 3,000 migrants at the IOM centre was scaled back temporarily in January by 90 percent, though these have now been restored. 

The UN Children’s Fund (UNICEF) has been working with NGO InterSOS and the Yemeni government in providing temporary support to a Child Protection Centre in Haradh, where IRIN met 50 Ethiopian children getting ready to fly back home. 

“We were beaten, tortured and scarred by armed gunmen when we arrived in Yemen. We escaped and made it into Saudi Arabia, but we were caught,” said Saed Oumar Youssouf, 16. 

“After a night in jail, and 12 nights elsewhere, we were shipped back to Yemen.” 

All the children said they were looking forward to returning to Ethiopia. Preliminary registration at the IOM centre in Haradh for return flights to Ethiopia restarted at the end of May, and since early June 633 migrants have voluntarily returned, with places given as a priority to the most vulnerable. 

Health 

IOM’s operations in Haradh are focused on the Migrant Response Centre set up in October 2010. It has voluntarily returned nearly 10,000 migrants since then, and treated 52,000 at the health centre, where they deal with 100-150 cases per day depending on the season. 

New arrivals in Yemen
Year	Total arrivals	Ethiopians
2010	53,382	34,422
2011	103,154	75,651
2012	107,532	84,376
2013*	42,137	35,240
*up to 31 May                                                Source: UNHCR

“The numbers are just growing. Many of the cases we see are infectious diseases and diarrhoea; their immunity is very weak due to malnutrition,” said IOM’s doctor at the centre, Fadl Mansour Ali. 

He said a large number of patients had malaria and other parasite infections, and also depression and anxiety. 

Not everyone recovers. The morgue in Haradh has room for 17 bodies, but has been keeping around 50, almost all unclaimed bodies of dead migrants. The electricity supply is unreliable and the single generator repeatedly breaks down creating a terrible smell. 

Korom Asmro Noqassa from the Tigray region in northern Ethiopia shares a bed with another patient inside the small cabin that forms the main part of the IOM clinic. 

After four months in Haradh, he says he is ready to go home. “I wanted to go back as soon as I realized it was so hard to get across; back home maybe I can find a job and support my family. Most here want to go back home now,” he said. 

“I’m going to tell people my own story. Smugglers cost money and aren’t reliable. But it’s very hard for people to say that they have failed.” 

Changing perceptions 

There is broad recognition that tackling the migration at source can really help reduce the suffering. 

“IOM is talking about flying back 500 but by that time there will be another 2,000 here,” said Haradh local council chief Sheik Haidar. 

“I’m willing to go to Ethiopia and Djibouti to explain how challenging migration is because the picture there now is that you can go to Saudi, [and you can get] thousands of dollars and dream jobs,” he added. 

Conversations with migrants in Haradh suggest many think it will be socially difficult to explain their lack of success, and that means thousands continue to cross into Yemen with little appreciation of the risks and difficulties. 

“The problem is that somehow at the origin people are not receiving the information. They are still thinking that this is an El Dorado and it will change their lives,” said Ould Cheikh Ahmed. 

“The reality is that the border is now totally fenced or closed and the camps that are receiving them in Yemen are completely overwhelmed, so it’s a dramatic situation.” 

He says part of a solution would be a regional conference between the concerned countries including Yemen, Ethiopia and Saudi Arabia among others. 

“It’s a case that has to be addressed with a sub-regional approach. The point is simply to say that it goes beyond the possible effort of the government of Yemen and the possible financial means and capacity of Yemen.” 

jj/cb 

TUBERCULOSIS: mycobacteria and rheumatoid arthritis in the era of biologic therapy

Bedfellows: mycobacteria and rheumatoid arthritis in the era of biologic therapy
Nature Reviews Rheumatology , 06/26/2013  Review Article

Winthrop KL et al. – In modern times a relationship between tuberculosis (TB) and rheumatoid arthritis (RA) has been firmly recognized, and is primarily attributable to the immunosuppressive therapies used to treat RA. Whereas TB can complicate the successful management of RA, nontuberculous mycobacteria have now perhaps become as important as (if not more so than) TB in the setting of RA, and can represent an even greater challenge to the rheumatologist wishing to use immunosuppressive therapies. This article reviews our most recent understanding of the epidemiological and clinical aspects of mycobacterial disease as it relates to RA, and the existing and emerging immunosuppressive therapies used to treat this disease.

Malaria eradication: is it possible? Is it worth it? Should we do it?

Malaria eradication: is it possible? Is it worth it? Should we do it? : The Lancet Global Health

The malaria map is rapidly shrinking. In 1900, endemic malaria was present in almost every country. Nowadays, the disease has been eliminated in 111 countries and 34 countries are advancing towards elimination.1 Elimination is defined as the absence of transmission in a defined geography—typically a country.2 Successful malaria control programmes in the remaining 64 countries with ongoing transmission have helped to reduce global incidence by 17% and mortality by 26% since 2000.3 For the 34 eliminating countries, the reductions were 85% in incidence and 87% in mortality.1 This progress is encouraging, but is worldwide eradication of human malaria possible? If so, is it a worthwhile goal and should we commit to it?

Is eradication possible? Probably yes; however, substantial challenges exist. First, despite progress, the burden of malaria is still great and it is widespread. In 2010, an estimated 219 million cases of malaria were reported and 660 000 people died in 98 countries.3 Second, drug and insecticide resistance are on the rise. In Burma, Cambodia, China, Thailand, and Vietnam, resistance of Plasmodium falciparum, the major human malarial parasite species, to artemisinin, the most widely used first-line drug, has been detected and could be spreading despite efforts to contain it.3, 4 Resistance to pyrethroid insecticides can happen quickly and has emerged after large-scale distributions of bednets in several regions.5 Although new drugs and insecticides are being sought, none are expected to be available in the near future. Third, increased mobility of people not only makes containment of resistance difficult, but also threatens the introduction or reintroduction of malaria parasites to receptive areas. Fourth, outside sub-Saharan Africa, Plasmodium vivax, the second major human malarial parasite species, is the main challenge. P vivax is much less researched than is P falciparum. P vivax is harder to diagnose and failure to successfully treat its dormant liver stage results in relapses that can fuel onward transmission. Furthermore, in Borneo and neighbouring regions, evidence now exists of human infection by a monkey parasite species, Plasmodium knowlesi. Zoonotic reservoirs challenge all campaigns for eradication of human infection. Fifth, extreme events, such as wars or natural disasters, greatly disrupt malaria control and elimination activities, and can lead to substantial resurgence. When accompanied by large population movements, these events can introduce malaria into previously malaria-free areas. Sixth, as malaria becomes rare, persuasion of governments to allocate finances to maintain effective elimination or post-elimination programmes is increasingly difficult. Since 1930, 75 resurgences of malaria have been recorded and nearly all are linked to the scaling back of programmes.6These six factors present notable challenges on the road to eradication. However, all have potential solutions resulting from substantial international collaborative efforts that range from basic research to improvements in policy and financing arrangements.............

 http://www.thelancet.com/journals/langlo/article/PIIS2214-109X%2813%2970002-0/fulltext

Malaria Nexus Weekly Update: June 25 2013

Latest News   Posted on 20 June 2013 Identification of merozoite antigens as promising malaria vaccine candidates A study recently published online in The Journal of Immunology describes numerous merozoite antigens that are targets of human immunity and could become interesting malaria vaccine candidates.   Posted on 19 June 2013 Abstract submission deadline for the 6th MIM Pan-African Malaria Conference is approaching soon! The MIM Pan-African Malaria Conference will be held this year from October 6 to 11 in Durban, South Africa. The registration deadline for abstract submission is June 30.   Feature Articles   Posted on 19 June 2013 Structure–activity relationships for ferriprotoporphyrin IX association and β-hematin inhibition by 4-aminoquinolines using experimental and... Bioorganic and Medicinal Chemistry, Volume 21, Issue 13, 1 July 2013, Pages 3738-3748 Samkele Nsumiwa, David Kuter, Sergio Wittlin, Kelly Chibale, Timothy J. Egan   Posted on 19 June 2013 Ability of TEP1 in intestinal flora to modulate natural resistance of Anopheles dirus Experimental Parasitology, Volume 134, Issue 4, August 2013, Pages 460-465 Yanyan Wang, Ying Wang, Jingru Zhang, Wenyue Xu, Jian Zhang, Fu Sheng Huang   Posted on 19 June 2013 Antiplasmodial activity of sesquiterpene lactones and a sucrose ester from Vernonia guineensis Benth. (Asteraceae) Journal of Ethnopharmacology, Volume 147, Issue 3, 3 June 2013, Pages 618-621 Ngeh J. Toyang, Michael A. Krause, Rick M. Fairhurst, Pierre Tane, Joseph Bryant, Rob Verpoorte   Posted on 19 June 2013 Comparison of the effects of extracts from three Vitex plant species on Anopheles gambiae s.s. (Diptera: Culicidae) larvae Acta Tropica, Volume 127, Issue 3, September 2013, Pages 199-203 Mokua G. Nyamoita, Innocent Ester, Mbwambo H. Zakaria, Lwande Wilber, Ochola J. Bwire, Hassanali Ahmed

| www.malarianexus.com.

MALNUTRITION: Uganda's nodding syndrome centres low on drugs, food

Photo: Charles Akena/IRIN

No drugs, no food (file photo)

GULU/LIRA, 24 June 2013 (IRIN) - As scientists continue to search for the cause of and cure for nodding syndrome - a debilitating condition that causes seizures and stunting in children - health centres say they need better funding to continue to feed and treat those affected. 

Some 3,995 children have sought assistance at four nodding syndrome rehabilitation centres set up by the government in 2012. The worst-affected districts, all in the country's northern region, are: Kitgum, which has recorded 2,034 cases; Pader, with 1,210 cases; Lamwo, with 347; and Gulu, which has seen 330. 

"We are out of food to provide to children," Joseph Okwera, who runs the rehabilitation centre in Kitgum, told IRIN. 

Short on drugs, food 

Goretti Adero, whose 12-year-old son was admitted to a health centre in Lira District, said she withdrew him from the facility because there was insufficient food and an erratic drug supply. 

"For me, I decided to bring my child back home where the family can feed him. At that time, there were no drugs at centre, so it was pointless to stay there," she said. "His situation remains the same. Maybe he will get better or not, I don't know, but I will struggle within my means." 

Patients at the centres are treated with anti-epileptic medication and nutritional supplements, including folic acid and vitamin B complex. 

"We are seeing improvements among the children undergoing rehabilitation at the centre, but the challenge remains poor coordination where we have to follow up for the drugs, yet the district [administration] should have brought them to centre," Robert Omiya, who is in charge of the rehabilitation centre in Gulu, told IRIN. 

Stigma 

Children who improve return to their communities, but many say they face stigma from schoolmates and adults. 

"When I go to school, pupils always tell me that I am demon-possessed. My friends no longer stay with me, and some teachers fear me," 15-year-old Adoch* said. "Even at home, I feel lonely because our neighbours don't want their children to play with me." 

Adoch has since dropped out of school. 

Health workers say there is a need to hire trained psychosocial health personnel to follow up with children who have returned home from the centres. The government plans to train teachers in affected districts to deal with special-needs children, including those recovering from nodding syndrome, but poor funding has hampered these efforts. 

"For Gulu, we need 25 teachers trained in special needs to handle the children. We are working on that, but it will depend on the budget we have," said Vincent Ocen, Gulu District's education officer. 

In the meantime, the government and international partners, including the US Centres for Disease Control and Prevention, continue to search for the cause of the syndrome. Possible theories include a link between the syndrome and river blindness, as well as a possible relationship between nodding syndrome and two parasitic roundworms - mansonella streptocerca and mansonella perstans. 

First detected in the 1960s in parts of Tanzania, nodding syndrome also appeared in what is now South Sudan in the 1990s. It began attracting international attention in 2011 as hundreds of cases were reported in northern Uganda. 

*not her real name 

ca/kr/rz 

MALARIA: severity reset by mosquito

The way malaria is transmitted controls how strongly the host's immune system reacts

Mosquito transmission of P.c. chabaudi modifies parasite gene expression in the blood stage of the cycle. [DOI: 10.1038/nature12231]

For the first time, researchers have proven that the way in which malaria is transmitted to the host affects how severe the resulting infection will be.

The route of infection modifies the malaria parasite's gene activity levels and regulates the parasite's spread in the blood by controlling the mouse's immune response. This study begins to understand how protective immunity to malaria occurs, an important step for the development of effective vaccines.

Researchers have known that the severity of symptoms of malaria increases when the malaria parasite is transferred repeatedly through blood samples in mice rather than by a mosquito, but up until now they have not known why.

"Understanding how malaria becomes more or less virulent is central to understanding how to manage and treat the disease," says Dr Matt Berriman, a senior author from the Wellcome Trust Sanger Institute. "We studied a rodent malaria species, that exhibits many of the same responses as seen in a human malaria infection. Our understanding of how the parasite interacts with the immune system is fundamentally changed by this study."

To explore the effect that the route of transmission had, the team examined the levels of gene activity in the malaria parasite during its life cycle in mice....http://www.sanger.ac.uk/about/press/2013/130529.html

 

MALARIA & Tuberculosis: Tanzania second largest beneficiary of Global Fund

:	William Brieger
Date:	Sun, Jun 23, 2013 11:17 am

SINCE 2002, Tanzania has received over 253.2bn/-

from the French government to fight HIV/Aids,
Tuberculosis and Malaria under the Global Fund
(GFATM). A press statement released by French
Embassy in Dar es Salaam on Friday said that as a
complement of its bilateral cooperation, Tanzania is
now the second largest country in the world benefitting
from GFATM.
“In terms of volumes, France has been funding an
equivalent of approximately 15 million USD per year to
Tanzania since 2002, totalizing 155 million USD
(253,2bn/-): 119 million dollars went to the GFATM, 29
million was contributed to UNITAID funding, and 6,9
million dollars went to GAVI-Alliance (immunization
programmes),” read the statement in part.
The report further indicates that the French support contributes to procurement and distribution of insecticidetreated
nets, sponsoring of anti-malaria treatments (28 million doses), provision of antiretroviral treatments for
420,000 adults and 31,000 children living with AIDS, AIDS. According to the report, other support includes
screening for pregnant women and possible mother-child viral transmission, anti-TB treatments for 12,000 children
and improvement of immunisation processes......

 

http://dailynews.co.tz/index.php/local-news/18955-tanzania-benefits-immensely-from-global-fund