Swine Flu Advice

Our Clinical Director, Dr. David Lalloo, offers the following advise regarding the current Swine Flu situation:

It is becoming clear that the outbreak is spreading to a number of different countries throughout the world and all overseas travellers or contacts of infected individuals in the UK need to be aware of the problem. The list of affected countries will be updated regularly on the NaTHNaC website (LSTM is one of the two clinical centres for NaTHNaC)

As ever, common sense should prevail. At the moment, UK advice is to avoid travel to Mexico only: if this changes, staff will be notified. The information below summarises current UK advice on what to do if you have been potentially exposed and are symptomatic. One of the key issues is to try to avoid spread: so if you are symptomatic you should not come to work or attend hospital (unless extremely unwell): cases will be diagnosed and managed in the community. Please remember that symptoms of flu and malaria can be similar: if you have travelled to malaria endemic areas in the past six months, please contact the clinic staff or doctor on call (07909 910 899) for advice.

We will continue to monitor the situation and update staff if the situation changes

Transmission and clinical illness

Influenza viruses are usually transmitted person to person by respiratory droplets when an infected person coughs in close proximity (less than one to two meters) to others. Contact with contaminated surfaces may also be a mode of transmission. The incubation period and time of infectivity are not entirely known for swine influenza. They are expected to be similar to those of seasonal influenza which has an incubation period of one to four days and an infectivity time form the day before the onset of symptoms to seven days after development of illness. Children may be contagious for longer periods.

Symptoms of swine influenza are similar to typical influenza and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some report diarrhoea and vomiting. Infection has ranged from asymptomatic and mild to severe with pneumonia and death. Those at higher risk for complications are expected to be the same groups as for seasonal influenza: infants, the elderly, immunocompromised, HIV infected, and those with chronic medical conditions, such as diabetes or renal failure.

Swine influenza isolates in samples from infected persons have been killed by the anti-viral drugs oseltamivir and zanamivir, but not amantadine or rimantadine.
A case definition used for the surveillance of respiratory illness to aid in the detection of human swine influenza is: fever ³38°C or history of fever, plus two or more of the following symptoms: cough, sore throat, runny nose, muscle aches or pains, headache.

Advice for travellers

The Foreign and Commonwealth Office has advised travellers to defer non-essential travel to Mexico. There are no other travel restrictions at present, and the WHO has recommended not closing international borders.
Influenza is transmitted via the respiratory route and travellers should exercise sensible precautions:

• it is prudent that if you are ill with a respiratory illness to delay travel
• follow public health guidance at your destination
• avoid crowding or mass gatherings
• avoid close contact (within 2 meters) with persons who are ill with an influenza like illness
• wash hands with soap and water; use alcohol-based hand gels when soap and water is not available
• avoid touching your nose, mouth or eyes, to prevent the spread of germs
• cover your nose and mouth with a tissue when you cough or sneeze and dispose of the tissue promptly
• keep hard surfaces (e.g. door handles, countertops) clean using a normal cleaning solution
• assure that children follow similar advice
• swine influenza is not passed through properly handled or prepared pork; the virus is killed by cooking to temperatures of 70°C
• there is little evidence of the effectiveness of wearing masks at a mass level, however, properly fitted, special grade masks can be worn in situations such as healthcare settings
• receive appropriate vaccines for your destination, including seasonal influenza vaccine if you come under the recommended risk groups (see NaTHNaC Health Information Sheet on Influenza)

Travellers who have visited affected areas should monitor their health for seven days after the visit. If you develop a febrile illness with cough, sore throat, headache and muscle aches, you should:

• check your symptoms on NHS Direct (www.nhsdirect.nhs.uk) or NHS Choices (www.nhs.uk), and if you remain concerned, contact your GP or NHS Direct (0845 4647) and inform them of your travel history
• limit contact with other people
• cover your nose and mouth with a tissue when you cough or sneeze and dispose of the tissue promptly
• wash hands with soap and water
• keep hard surfaces (e.g. door handles, countertops) clean using a normal cleaning solution
• think whether malaria could be a possibility

1976

The current Swine Flu outbreak isn't the first in recent memory. In 1976, an Army recruit from Massachusetts complained of feeling ill to his drill sargeant at Fort Dix. He died of what was later diagnosed as the swine influenza virus and within weeks, fear of an epidemic led to mass vaccinations.



This useful timeline from Google uses archival news coverage to describe the decisions taken by doctors through to then President Gerald Ford in coping with the epidemic and how ultimately the vaccine itself led to more people becoming ill than the virus itself.

Monday's Journals then..

British Medical Journal
Vol.338, No.7701, 25 April 2008.

Archives of Disease in Childhood
Vol.94, No.5, May 2009.
Fetal & Neonatal Edition
Vol.94, No.3, May 2009.

MMWR
Surveillance Summaries Vol.58, No.SS-2, April 17 2009.

Cadernos de Saude Publica
Vol.25, Supp.1 2009.

AIDS
Vol. 23, No.7, 27 April 2009.

South African Medical Journal
Vol.99, No.4, April 2009.
Supp.2 April 2009.
These aren't online yet, hard copy here as usual.

Korean Journal of Internal Medicine
Vol.24, No.1, March 2009.
This journal doesn't have a website. Hard copy here etc. etc....

World Malaria Day

Saturday 25th April is World Malaria Day

The following is from the WHO

World Malaria day - A Day to Act

25 April is a day of unified commemoration of the global effort to provide effective control of malaria around the world. This year's World Malaria Day marks a critical moment in time. The international malaria community has merely two years to meet the 2010 targets of delivering effective and affordable protection and treatment to all people at risk of malaria, as called for by the UN Secretary-General, Ban Ki-Moon.

World Malaria Day represents a chance for all of us to make a difference. Whether you are a government, a company, a charity or an individual, you can roll back malaria and help generate broad gains in multiple areas of health and human development.

Reducing the impact of malaria would significantly propel efforts to achieve the Millennium Development Goals, agreed by every United Nations member state. These include not only the goal of combatting the disease itself, but also goals related to women's and children's rights and health, access to education and the reduction of extreme poverty.

Hundreds of RBM partners- governments, international organizations, companies, academic and research institutions, foundations, NGOs and individuals - are already gaining ground against malaria. Diverse partner initiatives are guided by a single strategy, outlined in the Global Malaria Action Plan.

New Journals

Public Health Reports
Vol.123, No.5, September/October 2008
Vol.123, No.6, November/December 2008
Vol.123, Supplement 3, November/December 2008

The New England Journal of Medicine
Vol.360, No.17, April 23 2009

Clinical & Experimental Immunology
Vol.156, No.2, May 2009

Transactions of the Royal Society of Tropical Medicine & Hygiene
Vol.103, No.5, May 2009
(not available online)

Nature
Vol.458, No.7241, 23 April 2009

Food and Nutrition Bulletin
Vol.30, No.1, March 2009
(not available)
Vol.30, No.1, March 2009 Supplement

Tis a bit cloudy now, but never mind...

Pediatrics
Vol.123, No.4, April 2009.

Journal of Travel Medicine
Vol.16, No.2, March/April 2009.

Environmental Entomology
Vol.38, No.2, April 2009.

American Journal of Epidemiology
Vol.169, No.7, April 1 2009.

Science
Vol.324, No.5925, 17 April 2009.

MMWR Weekly Report, Vol.58, No.13, April 10, 2009.
MMWR, Recommendations and Reports, Vol.58, No.RR-4, April 10, 2009.

Parasite Immunology
Vol.31, No.5, May 2009.

Sunny Tuesday Surprises

Memorias do Instituto Oswaldo Cruz
Vol.103, No.8, December 2008.

Medical Teacher
Vol.31, No.2, February 2009.

Review of Medical & Veterinary Entomology
Vol.97, No.5, May 2009.

South African Medical Journal
Vol.99, No.3, March 2009.
Supp. 2, Vol.99, No.3, March 2009.
These aren't available online yet, hard copies here to read in the Library.

Abstracts on Hygiene & Communicable Diseases
Vol.84, No.4, April 2009.

New Journals

Journal of Tropical Pediatrics
Vol.55, Number 2, April 2009

Journal of Epidemiology & Community Health
Vol.63, No.5, May 2009

BMJ
Vol.338, No.7700, 18 April 2009

LSTM Photo Competition 2009

LSTM is running a competition for the best photo relating to an overseas project.

The competition is open to all LSTM staff and students including staff of subsidiary companies and project partners. Images must communicate an aspect of the project in a professional manner.

There is one prize for the winner of £250.

HOW TO ENTER

Entries are to be submitted by email to Billy Dean at
william.dean@liv.ac.uk detailing when and where the photograph was taken, an explanation of the subject matter and how it relates to an LSTM project. Entrants full name and contact details to be included.

For further information please contact Billy Dean, Development Officer, 0151 705 3272
email: william.dean@liv.ac.uk

TERMS AND CONDITIONS

1. The deadline is the 20th June 2009. The winner will be announced shortly afterwards.
2. Competition is open to LSTM staff and students, employees of subsidiary companies and employees of partner organisations.
3. Image copyright: The entrant must be the sole author and owner of the copyright of all images entered. It is the legal responsibility of the entrant, and not the organisers, to ensure that they comply with ownership and copyright requirements, and own the rights to reproduction of their images.
4. The entrant retains the copyright of all images submitted. Any images submitted may be used for LSTM’s general publicity purposes and the name of the photographer will be credited.
5. Please act responsibly and with consideration when taking photographs of people, and whenever possible please gain the permission of those featured. Any images of children under the age of 18 must have the written consent of their legal guardian.
6. A maximum of five images per entrant may be submitted.
7. All images must be at least 1 megapixel and submitted as jpeg file format via email. Images may be rejected on the grounds of poor image quality.
8. Entry is free.
9. The term “overseas project” includes field research project involving LSTM students.
10. The winner will be selected by professional photographers McCoy Wynne.
11. LSTM reserves the right to amend these terms and conditions.

Thursday's Journals

African Journal of Reproductive Health
Vol. 12, No. 3, 2008.

The Lancet
Vol. 373, No. 9669, 2009.

Tropical Diseases Bulletin
Vol. 106, No.4, 2009.

Science
Vol. 324, No. 5924, 2009.

New England Journal of Medicine
Vol. 360, No.16, 2009.

Nature
Vol. 458, No. 7240, 2009

Wednesday's Journals

Africa Health
Vol. 31, No.3 2009.

Saudi Medical Journal
Vol. 30, No. 3, 2009.

Tropical Medicine International Health (Issue not yet online)
Vol. 14, No. 5, 2009

Morbidity and Mortality Weekly Report
Vol. 58, No. 12, 2009.

Folia Parasitologica
Vol. 56, No.1, 2009

Bulletin of the Wrold Helath Organization.
Vol. 87, no. 4, 2009

Reginal Development Dialogue.
Vol. 29, No.2, 2008.

Medical Decision Making.
Vol. 29, No.2, 2009.

Sexually Transmitted Diseases.
Vol. 36, No. 4, 2009.

Solar-powered cardboard oven targets developing countries

The winner of a contest to find the world's greenest invention is a solar-powered oven made from cardboard. The Kyoto Box oven - which costs just £3.50 to make - can cook casseroles, boil water and bake bread and is the brainchild of Kenya-based entrepreneur Jon Bøhmer. The oven is targeted at the three billion people who use firewood to cook in developing countries. Mr Bøhmer says: "We're saving lives and saving trees." Read more...

Thursday's Journals

MMWR
Vol. 27, No. 11, 2009.

Helminthological Abstracts
Vol. 78, No. 5, 2009.

BMJ
Vol. 338, No. 7699, 2009. (Not online)

Epidemiology and Infectious
Vol. 137, No.5, 2009.

Nature
Vol. 458, 7239, 2009.

The Pediatric Infectious Diseases Journal
Vol. 28, No.4, 2009
Vol. 28, No.4, 2009, Supplement.

Protozoological Abstracts
Vol. 33, No.5, 2009.

New England Journal of Medicine
Vol. 360, No.13, 2009.

Population and Development Review
Vol. 35, No.1, 2009.

Tuesday's Journals

Journal of the Medical Association of Thailand
Vol. 92, No. 4, 2009.

Nature Immunology
Vol. 10, No. 4, 2009.

Science
Vol. 324, No. 5923, 2009.

The Intrnational Journal of Tuberculosis and Lung Diseases
Vol. 13, No. 4, 2009.

Academic Medicine
Vol. 84, No.4, 2009.

Feeling Frankly Freaky Friday(ish)

International Journal of Health Services
Vol.389, No.1, 2009

BMJ
Vol.338, No.7698, 4 April 2009

Tropical Doctor
Vol.39, No.2, April 2009

MMWR
Vol.58, No.10, March 20, 2009
Vol.58, No.SS-1, March 20, 2009

Thursday's Journals

The Milbank Quarterly
Vol. 87, No.1, 2009.

The Journal Of Eukaryotic Microbiology
Vol. 56, No. 1, 2009.

Nature
Vol. 458, No. 7238, 2009.

American Journal of Epidemiology
Vol. 169, No.6, 2009.

British Journal of Midwifery.
Vol. 17, No. 4, 2009. (Not yet Online)

New Journals

Third Sector
Issue 562, 21 Marchy 2009

The New England Journal of Medicine
Vol.360, No.14, April 2 2009

Liverpool Logo

Director of the Liverpool School of Tropical Medicine, Janet Hemingway, is an advocate at a new website introducing a new logo designed to publicise Liverpool throughout the world. She says:

"Liverpool has the oldest school of tropical medicine in the world but we are not resting on our laurels, we're actually leading the charge against malaria eradication with a huge investment from the Bill and Melinda Gates Foundation."

The logo includes, as you can see below, elements of the old and new city and in the case of the Metropolitan Cathedral, something in between. It's spritually similar to the Liverpool '08 symbol which was in use during the Capital of Culture celebrations.