Tag Archives: public health

World Hunger, Rising Obesity, Anorexia: which nutrition group to stress on World Food Day? @FAOWFD #wfd2013


Ironically, while we try to end world hunger, we are also fighting the twin wars of rising obesity and anorexia. The Centers of Disease Control says 35% of US adults are obese and 69% of US adults are overweight (including obese).  A Brown University study says 0.5% to 3.7% of females will suffer from anorexia in their lifetimes.  About 5-15% of total anorexics will be men.  Anorexia is significant weight loss due to an intentional starvation for “beauty”.

Pursue Natural has a suggestion on how to solve obesity and anorexia while helping stop world hunger: Encourage such individuals to actively participate in ending world hunger activities by actually interacting with starving people around the world.  The interaction between these groups will leave a lasting impression.  On one hand, hunger when there is no other option other than to starve versus intentional hunger to become thin (Anorexia) and on the other hand, an obese individual whose calorie needs are not sustainable by  his/her genes (obesity and genes).  Our select collection of photos here emphasize these three groups.

Photos on nutrition

Hunger exists in parts of the world where generosity and kindness is lacking among leaders and influential people. You can do something about it.

Finding enough fish to feed increasing population numbers -The Fisherman on the River Ganga (Ganges) by Sumit Sen

Finding enough fish to feed increasing population numbers -The Fisherman on the River Ganga (Ganges) by Sumit Sen

Hunger: No obesity exists among the displaced citizens of the world

Hunger: No obesity exists among the displaced citizens of the world

A new USA 2013 citizen - with the promise of no hunger, obesity or anorexia?

A new USA 2013 citizen – with the promise of no hunger, obesity or anorexia?

Mayor Bloomberg wants to restrict sugared drinks to 16oz size max

Mayor Bloomberg wants to restrict sugared drinks to 16oz size max in New York City to conquer obesity

Adults often try to make healthy food choices

Adults often try to make healthy food choices

It is quite difficult even for adults to resist such candy choices

It is quite difficult even for adults to resist such candy choices

Weight issues haunt the young in USA

Weight issues haunt the young in USA

photo-4

New York City introduces subsidized bike rentals to ride your way out of obesity

New York City introduces subsidized bike rentals to ride your way out of obesity

Hunger Obesity BrainObesity 2013

How to grow enough rice for exploding population growth - A rice field in Korea

How to grow enough rice for exploding population growth – A rice field in Korea

Modern grocery stores promised better food than such local farmer shops could provide.

Modern grocery stores promised better food than such local farmer shops could provide.

A severely Anorexic woman  - who intentionally starved herself to feel "more beautiful"

A severely Anorexic woman – who intentionally starved herself to feel “more beautiful”

Buy this placemat to end hunger program by Church World Service CWS - What can you do? Order Online or call 1-800-297-1516

Buy this placemat to end hunger program by Church World Service CWS – What can you do? Order Online or call 1-800-297-1516

Be a part of the solution and learn, get inspired and take action
We can end hunger. The body needs a certain amount of energy or calories from food to keep up basic life functions. Obesity rates have more than doubled in adults and children since the 1970s and continues to be a leading public health problem in the US (Food Research and Action Center).

Join the global movement to end hunger
The World Food Day theme for 2013 is “Sustainable Food Systems for Food Security and Nutrition”. A noteworthy discussion is posted by Worldlife Conservation Society, “World Food Day: A Time to Embrace the farming We Want”, where they stress the crucial challenge in conserving biodiversity.

World Food Day is celebrated every year on October 16 to honor the date of the founding of the Food and Agricultural Organization of the United Nations on 1945. Every year a different theme is adopted and most center around agriculture.

End malnutrition and hunger through education
Prevent intergenerational malnutrition and hunger by promoting education of women and girls. Read this 40 page 2013 article on Right to Food- Global Strategic Framework – women/gender.

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Now is the time for your 2013 – 2014 flu vaccine


The 2013- 2014 flu season is here for the Northern Hemisphere. Los Angeles has reported it’s first flu case early September (Click here). New York city residents are surprised that flu season has already arrived and reaching people before their scheduled flu vaccination date. The first Los Angeles case is an H1N1 which is in this year’s flu vaccine combination to protect those vaccinated this season. The New York city strain has yet to be reported.  Fortunately, the flu vaccine of 2013 – 2014 has either three flu strains (trivalent) or the newly introduced four flu strains (quadrivalent) described more in detail below.  If you live in the Northern Hemisphere, you might want to begin flu vaccination plans much earlier this flu season, since the flu has already arrived atleast in two major USA cities and it is only early September. However, in Australia and countries of the Southern Hemisphere, the peak of the 2012 – 2013 flu season is expected to have just ended in August 2013, since the seasons are opposite.

This is what the flu virus looks like

This is what the flu virus looks like

Why should you take the flu vaccine?
The reason one has to take the vaccine every year is because the vaccine only provides immunity for about a year. Unlike the natural infection which gives you lifetime immunity, a flu vaccine does not. Even if in certain years the vaccine flu strain composition is exactly the same as in the previous year. The individual is  advised to take the flu vaccine annually. The answer is explained in detail in this previous article.

However, do take your doctor’s advice before vaccination. Certain flu vaccines are not recommended for all ages. For example, CDC recommends that one brand of inactivated flu vaccine called Affluria, should not be given to children 8 years of age or younger. A related vaccine was related with fever and fever – related seizures in young children in Australia. More about side effects below.  Young children who get inactivated flu vaccine and pneumococcal vaccine (PCV13) at the same time may be at increased risk for seizures caused by fever. Ask your doctor for more information. Tell your doctor if a child who is getting flu vaccine has ever had a seizure.addition,

Egg and/or latex allergy?
What if you have an egg and/or latex allergy? Consult your doctor. The answer is in this previous article.  However, there is a major update for individuals with egg allergy waiting to be vaccinated – Flublok.  In 2013, FDA has approved Flublok, for 18-49 year old, which is not developed in eggs but in insects. Hence, Flublok may be suitable for adults (but not children, teens and seniors) with egg and/or latex allergy.  Traditionally, the flu vaccine has been developed in eggs.  To learn more you may read a previous article, “Tracking the history of the development of the flu vaccine”, by clicking here.  The ability to develop the flu vaccine in insects instead of eggs is heralded as a boon to egg allergic individuals.  However, since it has been newly introduced in 2013, it remains to be clinically tested in individuals other than adults and hence, is not yet FDA approved in children, teens and seniors, since their immune system is different than a typical healthy adult.

Please, discuss with your doctor.  It is highly recommended to take the flu vaccine to avoid hospitalization and other secondary complications from a flu infection.  It is highly contagious.  Certain age groups are more susceptible than others.  The Centers of Disease Control of USA reports a total of 12,343 hospitalizations that occurred from October 1, 2012 through April 30, 2013, which translates to a cumulative rate of 44.3 influenza-associated hospitalizations per 100,000 people in the United States. The total number of influenza-associated pediatric deaths reported to CDC for 2012-2013 was 146 in USA. While the vast majority of the tested virus samples (>99%) showed susceptibility to the antiviral drugs oseltamivir and zanamivir, some varieties showed resistance. Watch an animated video of how the flu virus enters, and multiplies inside the human body.

Why do I feel fatigued after my flu vaccine?
The vaccine composition is changed every year. The WHO meets twice a year to discuss the varieties of flu strains causing flu infections and hopes to include the most “popular” strains in the flu vaccine composition (see below for for the 2013-2014 composition). However, the vaccine can accomodate a maximum of three to four flu strains. There might be a new flu strain that emerges later in the year. There might be a fifth or sixth flu strain also causing infections. The flu vaccine assists an individual in easing the “suffering from symptom” period. Therefore, a person who has the vaccine can still get the flu from a flu strain not included in the vaccine but the symptoms will be weaker. This is because the flu strains differ from each other very slightly and most of their characteristic proteins are included in the vaccine, hence “teaching” the body’s immune system to be ready to fight the flu infection.

There can be a slight fever and other side effects (see below) after the flu vaccine.  The symptoms would start right away and last 2 to 3 days. This might happen if the flu vaccine composition includes one or more flu strains that were not included in the previous year’s vaccine composition. If the individual has never been exposed to 1 or more of the flu strains in the vaccine, the immune system might react with symptoms like the flu. It is the immune system getting ready. The individual does not get flu from the inactivated flu vaccine and the live flu vaccine is too weakened to cause the flu. You may also read “Why am I feeling fatigued after taking the flu vaccine?

The New Quadrivalent Flu Vaccine: Until recently, the vaccine compositions have only had three different kinds (trivalent) of circulating flu varieties. This year, the vaccine choices include those with four different kinds (quadrivalent) of circulating flu varieties, approved by the WHO (see quote below). Do be aware of your vaccine choices in 2013 to 2014 – trivalent or quadrivalent and discuss with your care provider. The FDA approved companies in 2013 manufacturing the new quadrivalent flu vaccine are:

1) GlaxoSmithKline – Fluarix
2) AstraZeneca – MedImmune
3) Sanofi Aventis – Fluzone approved in June 2013 for children 6 months or older, adolescents and adults.

Two methods of delivery of Flu Vaccine

One method of delivery of Flu Vaccine

One method of delivery of flu vaccine

One method of delivery of flu vaccine

The 2013-2014 Influenza/Flu virus compostion
The compostion of the 2013 – 2014 trivalent and quadrivalent flu vaccine for the Northern Hemisphere:

The World Health Organization has met in Geneva Switzerland in February 2013 to decide upon the composition of the Influenza or flu vaccine composition of the upcoming 2013-2014 flu season. Read more.

Influenza/flu vaccine Adverse Effects

The CDC site has the following safety information. In addition to including three to four different flu varieties in the vaccine composition (trivalent or quadrivalent), the flu vaccine may be either inactivated or live. If inactivated, it can never cause the flu because it does not contain a live virus. However, inactivated flu vaccine could be associated with Guillain-Barré Syndrome (GBS), no more than 1 or 2 cases per million people. If the flu vaccine is live, it is made from a weakened virus and does not cause flu. Both may cause allergic reactions in less than one in million doses. Quote
Influenza (inactivated) vaccine side-effects
What are the risks from inactivated influenza vaccine?

With a vaccine, like any medicine, there is a chance of side effects. These are usually mild and go away on their own.

Serious side effects are also possible, but are very rare. Inactivated flu vaccine does not contain live flu virus, so getting flu from this vaccine is not possible.

Brief fainting spells and related symptoms (such as jerking movements) can happen after any medical procedure, including vaccination. Sitting or lying down for about 15 minutes after a vaccination can help prevent fainting and injuries caused by falls. Tell your doctor if you feel dizzy or light-headed, or have vision changes or ringing in the ears.

Mild Problems

soreness, redness, or swelling where the shot was given
hoarseness; sore, red or itchy eyes; cough
fever
aches
headache
itching
fatigue
If these problems occur, they usually begin soon after the shot and last 1 or 2 days.

Moderate Problems

Young children who get inactivated flu vaccine and pneumococcal vaccine (PCV13) at the same time may be at increased risk for seizures caused by fever. Ask your doctor for more information. Tell your doctor if a child who is getting flu vaccine has ever had a seizure.

Severe Problems

A severe allergic reaction could occur after any vaccine (estimated less than 1 in a million doses).
There is a small possibility that inactivated flu vaccine could be associated with Guillain-Barré Syndrome (GBS), no more than 1 or 2 cases per million people vaccinated. This is much lower than the risk of severe complications from flu, which can be prevented by flu vaccine.
The safety of vaccines is always being monitored. For more information, visit: Vaccine Safety Monitoring and Vaccine Safety Activities.

One brand of inactivated flu vaccine, called Afluria, should not be given to children 8 years of age or younger, except in special circumstances. A related vaccine was associated with fevers and fever-related seizures in young children in Australia. Your doctor can give you more information.

This information was taken directly from the Inactivated Influenza VIS
(This information taken from Inactivated Influenza VIS dated 7/26/2013. If the actual VIS is more recent than this date, the information on this page needs to be updated.)

Influenza (live) vaccine side-effects
What are the risks from LAIV?

With a vaccine, like any medicine, there is a chance of side effects. These are usually mild and go away on their own.

Serious side effects are also possible, but are very rare. LAIV is made from weakened virus and does not cause flu.

Mild Problems
Some children and adolescents 2-17 years of age have reported:

runny nose, nasal congestion or cough
fever
headache and muscle aches
wheezing
abdominal pain or occasional vomiting or diarrhea
Some adults 18-49 years of age have reported:

runny nose or nasal congestion
sore throat
cough, chills, tiredness/weakness
headache
Severe Problems

A severe allergic reaction could occur after any vaccine (estimated less than 1 in a million doses).

The safety of vaccines is always being monitored. For more information, visit: Vaccine Safety Monitoring and Vaccine Safety Activities.

This information was taken directly from the LAIV VIS
(This information taken from Live Influenza VIS dated 7/2/12. If the actual VIS is more recent than this date, the information on this page needs to be updated.)

 

The WHO headquarters in Geneva, Switzerland

The WHO headquarters in Geneva, Switzerland

A meeting in action at the WHO headquarters in Geneva, Switzerland

A meeting in action at the WHO headquarters in Geneva, Switzerland

World Health Organization (WHO) headquartered in Geneva, Switzerland recommends the flu vaccine composition each year for the Northern Hemisphere and the Southern Hemisphere.

Related Article:
Review by Anne Sealey: A Cruel Wind: Pandemic Flu in America, 1918-1920; Author Dorothy A. Pettit and Janice Bailie (Timberlane Books, 2008): The book has an excellent chapter on the biological detail of the flu virus, a historical narrative of the 1918 pandemic, and an intimate portrait of political life and social environment during the pandemic. It includes plenty of charts for statistical support.

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The first Phenome Center established to research interactions between genes and the environment


Certain people become more susceptible to environmental toxins and food allergens than other people exposed to the very same factors. Why is that? How are some people completely healthy even after they eat food that makes other people very sick? Why are some children in the autistic spectrum disorder growing up in the same environment and eating the same food as their healthy neighbors children?

To research the answers to these growing questions in an increasingly post – industrial modern society used to extremely convenient modes of transportation and fast food, a large scale multi-disciplinary approach is required.  Joining together in this effort are  the MRC-NIHR Phenome Centre, which opened recently in the United Kingdom, with a collaboration between Imperial College London, King’s College London and analytical technology companies Waters Corporation and Bruker Biospin.

The center has ten million pounds of funding for the first five years. However, if you wish to support such relevant research do not hesitate to contact the institute. Studying the phenome will help determine how diet, lifestyle, the environment and genes combine to affect biochemical processes that lead to disease.

Professor Frank Kelly, co-investigator at the Centre and director of Analytical and Environmental Sciences Division at King’s College London, said, “This technology is already in use in medical research but only on a small-scale. With the creation of this new facility, it will now be possible to get a complete and accurate biological read-out of thousands of individuals.” Reported in  Pharmabiz, June 13, 2013. Instruments of the highest degree of sophistication will detect the different types of bacteria naturally occurring in the gut, which can influence our health. Read this previous article on how hook worms can cure multiple sclerosis in some patients or this previous link on “the worm theory and how it could strengthen the immune system”.

The Centre will also include a state-of-the-art international training facility. There are no limits to the breakthroughs in health we might see as a result of this visionary, large data work approach at the NIHR-MRC Phenome Centre.

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Autism in pristine Phu Quoc island of Vietnam – is the rise in numbers simple overdiagnosis?


Phu Quoc is a pristine, mountainous, Vietnamese island, surrounded by sun-drenced beaches and clear, blue water, about 70 miles off the coast of Cambodia.  Most of the island is covered by Phu Quoc National Forest. The main industries are plantations and fish sauce. It hosts the annual Vietnam Kennel Association (VKA) Phu Quoc National Dog Show. The Phu Quoc Ridgeback is a native dog breed with web feet, an island treasure that has thrived on Phu Quoc Island since the 19th century. Yet, Aeir Talk, an App for a communication device for autistic kids, believes that this island would benefit from knowledge that a device to assist Autistic kids exists (Click here for advertisement, by scrolling below to a post by Jav123 on Mar 2012). Why should this remote island be interested in an Autism device? Read about the naval history of this island in Vietnam by clicking here.

Should men be more careful about protecting their sperm before they begin to make babies? Fathers provide the sperm and the mother, as you know, provides the egg and when the egg is fertilized by the sperm the baby results. There is increasing evidence that the father or grandfather may contribute a new genetic change that might be inherited; such a new genetic change when perhaps exposed  to an otherwise harmless environmental pollutant becomes a “toxin” to this child carrying this new genetic change. The grandfather may even pass this new genetic trait through his daughters. Fathers have been cautioned against excessive coffee drinking three months before making babies. Perhaps fathers need to avoid exposure to environmental triggers too? Maybe, strategic research would help to pinpoint such triggers and help prevent more autism related to exposures of potential fathers in the future. History cannot be changed but our society is quite capable of taking action when inspired. Read Lynne Peeple’s Huffington Post article (May 2012) on the rising rates of autism by clicking here.

Rise of Autism in some countries

Here is an article detailing and discussing the rise of autism in Vietnam. Among Asian countries, this country appears to have far higher rates. Is it simply a matter of higher diagnosis? You may click here to read this brief article (March, 2013) in a China Weekly newspaper, on the city of Hanoi, Vietnam. This may be of interest to international researchers of Autism. Why Hanoi? Hopefully, even searching for an answer in Hanoi will lead researchers closer to factors that might trigger ASD.

Is the rise of Autism simply overdiagnosis?

There is no doubt that some cases of ASD are simply over diagnosed. However, once you have been in the same room, train, class room, event with a kid (mostly boys) with even an average level of ASD or worse autism, even as a non – psychologiist you will know that the child needs help. The uneducated citizen might request that this child be punished for “misbehavior” or request this child “shut-up” or “stop shuffing people or yelling”. Those aware of ASD will realize this is a child with autism or aspergers and intervene on behalf of the child. As those educated about this growing issue of ASD know, this child’s mind is fully knowledgeable and understands but cannot control his/her actions. Give the child an ipad and this child will communicate to those in the room and may even apologize but unable to stop the movement or noise causing the discomfort to the public. As a society, together we can help prevent future suffering. We are losing our boys and some girls. Your opinion matters. If you suspect any factor that could be contributing to the growing rise of autism/asperbers/allergy/ASD do not hesitate to share. None of us want to lose the advantages of modern conveniences. We cannot imagine life without cars, trains, and automobiles, aeroplanes and modern industry, modern agriculture and green lawns without weeds. Yet, since progress must come with side effects, let’s discover how to live together safely, among these industrial advantages. We are quite capable of dealing with and preventing side effects.

Which other countries have higher rates of Autism than their neighboring countries?

Which countries have similar health and hospital facilities and yet have higher levels of Autism? There have been indications that areas with higher automobile oil manufacturing chemical waste, may have higher rates of autism or childhood leukemia. Some elementary classrooms in such locations have several children arriving to school in wheelchairs with juvenile rheumatoid arthritis or many parents waiting together outside a local pediatric hospital which had not timely diagnosed their infants with childhood leukemia; four year olds were dying. Autism aids are in many such classrooms. Is there a connection? Can some action steps put in place protective and preventive features perhaps in the local water system or the herbicide spraying system in home lawns to protect possible harm to the sperm and egg? Would there be a connection with such chemical waste and a carrier of the new genetic inherited trait? If you have answers or suggestions do share. 

Related Article:

Why is there little Autism in under-developed countries?

The G-proteins, the connector proteins that try to prevent autism spectrum disorder.

Phu Quoc – Vietnam’s largest island and home of the Phu Quoc National Forest

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Sperm and Egg Donation: Should the children know their origins before choosing a mate?


Yes, because there are a few donors who are increasingly selected and are quite popular. Which means that a child born from such a donor might very well be meeting a half-sibling often and not know it at all. Now, normally that would not be a major issue. How often do we realize that we do not enjoy the company of our relatives?  We cannot choose our relatives. This situation is truly magnified in a child born from a popular donor sperm. The mothers may very well be from the same town and the children may even be in the same classroom. Yet, the donor himself might have been flown in from a different state for a few hours. This way the donor is not morally or emotionally connected to the results of his donation. This impending tsunami of children born to same sex unions or infertile couples is waiting to happen in twenty years when they grow up and form their own unions. Many of the donor’s childrens’ parents are single men/women, gay or lesbian couples or infertile couples.

“Are you my sibling?” Will that be the first question after “hello”?

Hilarious situations can arise when if in a hypothetical high school classroom a dozen students discover they are half-siblings through a donor. Now imagine the number of happy reunions in which the same sex couples choose to have a donor. Add to this the following scenario: a check list of donors. Why? is that very important? See this chart of rising number of same sex unions. If each union uses a donor and more than one uses the same popular donor do you see what might happen? How do we help a teen be sure that good looking teen is not a sibling from the same anonymous donor? Should we legislate an anonymous number system for those donors who wish to remain anonymous?

How many eggs can a woman donate?
A woman can donate only so many eggs and yet a woman may choose to be a popular donor. Even her most enthusiastic attempts cannot match that of an inspired male sperm donor. Department of Health admits that donors are not well informed. A Columbia university student asks anonymously questions about donating eggs on reading an advertisement on a Columbia Health site, where “Go Ask Alice” addresses her fears and concerns. On this Huffington Post site a woman donor explains how she does not want to be a mother and yet, donating her eggs to a couple who want to have children made her feel less guilty.

How many sperms can a man donate
A man has the potential to donate an unlimited number of sperms. Fortunately, ethical sperm banks will allow the donator to have a maximum of ten children. The sperm donor goes through a stringent selection process as described in this Stanford University list for a sperm donor. Intelligent, virile young men are much in demand as sperm donors to father a child. Not surprisingly, such men are found in universities and so, many such sperm clinics are near universities.

More than a dozen siblings from a sperm donor?
A documentary film “Donor Unknown” documents the search for Donor 150 who is the anonymous donor of more than a dozen children in a small beach community, who discover each other on a web site set up for such descendants. There is an interesting article on Boston.com about this young father who sired more than 70 children through donating his sperm in college. His fiance was a little miffed on finding out about his offsprings on a reality TV show, during which he was introduced to two of his biological children.

A typical male sperm donor description

If you are at least 5’10”, between the ages of 18 and 35 years, have post-secondary education (college, vocational or technical) and are within normal limits of weight for your muscular build and height, you may be a potential candidate to become a donor. We need donors with all types of racial and ethnic backgrounds. We are not able to accept applicants who use tobacco products in any form, including smoking or ingesting marijuana. Use of these substances will be tested for throughout the donation process.

The quote above is from a real sperm bank that has a several locations. Yet, what if several women selected the same donor at the same location? Well, many children would be born in the same town not knowing they are siblings, unless they had a way to know that.

Donors donate for financial or emotional reasons or both. Legislators need to plan for this impending tsunami of children born to same sex unions or infertile couples who in twenty years will want to be certain they are not dating their sibling, from an anonymous donor.

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Norovirus, reactive arthritis and should a child with diarrhea be vaccinated?


Below is a wonderful, detailed, thorough excerpt from the Centers of Disease Control about the Norovirus. When infected, the symptoms include diarrhea, vomiting and cramping.  In some individuals, perhaps with a genetic predisposition, a reactive arthritis appears following a norovirus attack. As a result of the infection by the norovirus the body’s immune system continues to attack “self” cells believing they are enemy “norovirus” cells. Read the detailed original description of the Norovirus here. Cruise ships, nursing homes, college dorms are places were a norovirus infection spreads quickly where people live in enclosed conditions.

A cruise ship with a reported norovirus infection during a year when there were several diarrhea epidemics on cruise ships. Photo inlay of Norovirus. Photo ABC news

My question was that should a child with diarrhea or gastroenteritis be allowed to be vaccinated say perhaps with MMR vaccine or should this child wait until the child is fully recovered? How long should this gap be? The MMR vaccine contains components of three viruses to prevent three diseases. The vaccine aims to train the child’s immune system to recognize the foreign material and train in advance to prepare against an infection. Is the child with gasteroenteritis or diarrhea compromised in any way prior to being vaccinated? I could not find any scientific study published to answer this question. Is there any study on how many children had an infection upto one month prior to any immunization? How did they fare after that?

The second question which follows is which is more dangerous – losing a child to measles given a 1 in 1000 chance or having a child live a dependent life forever with Autism Spectrum Disorder with a 1 in 100 chance? I wonder which is more of a public burden. Should it be safer to ask a family with a norovirus infection to give a far lengthier gap prior to vaccinating a child? Except for an Italian court ruling a connection between a child with autism and a MMR vaccine (following a gastroenteritis infection), all official scientific studies have ruled out a connection between the MMR vaccine and autism. Yet, most parents continue to insist that their child was a normal baby who was able to communicate prior to the MMR vaccine. Could the norovirus provide one more clue to this puzzle?

Quote:

Biology and Epidemiology

The Virus

Noroviruses are a group of nonenveloped, single-stranded RNA viruses classified into the genus Norovirus (previously referred to as Norwalk-like viruses [NLVs] or small round-structured viruses [SRSVs]) of the family Caliciviridae. Other genera within the Caliciviridae family include Sapovirus (previously referred to as Sapporo-like viruses [SLVs]), which also cause acute gastroenteritis (AGE) in persons, as well as Lagovirus, Vesivirus, and Nebovirus, which are not pathogenic for humans (11). Noroviruses can be divided into at least five genogroups, designated GI–GV, based on amino acid identity in the major structural protein (VP1) (12). The strains that infect humans (referred to collectively as “human noroviruses”) are found in GI, GII, and GIV, whereas the strains infecting cows and mice are found in GIII and GV, respectively (Figure 1). Although interspecies transmission of noroviruses has not been documented, strains that infect pigs are found in GII (13), and a GIV norovirus was discovered recently as a cause of diarrhea in dogs (14), suggesting the potential for zoonotic transmission. On the basis of >85% sequence similarity in the complete VP1 genome, noroviruses can be classified further into genotypes, with at least eight genotypes belonging to GI and 21 genotypes belonging to GII (12,13; CDC, unpublished data, 2011). Since 2001, GII.4 viruses have been associated with the majority of viral gastroenteritis outbreaks worldwide (15). Recent studies have demonstrated that these viruses evolve over time through serial changes in the VP1 sequence, which allow evasion of immunity in the human population (15,16).

Clinical Features

Noroviruses cause acute gastroenteritis in persons of all ages. The illness typically begins after an incubation period of 12–48 hours and is characterized by acute onset, nonbloody diarrhea, vomiting, nausea, and abdominal cramps. Some persons might experience only vomiting or diarrhea. Low-grade fever and body aches also might be associated with infection, and thus the term “stomach flu” often is used to describe the illness, although there is no biologic association with influenza. Although symptoms might be severe, they typically resolve without treatment after 1–3 days in otherwise healthy persons. However, more prolonged courses of illness lasting 4–6 days can occur, particularly among young children, elderly persons, and hospitalized patients (17,18). Approximately 10% of persons with norovirus gastroenteritis seek medical attention, which might include hospitalization and treatment for dehydration with oral or intravenous fluid therapy (7,19,20). Norovirus-associated deaths have been reported among elderly persons and in the context of outbreaks in long-term–care facilities (21,22). Necrotizing enterocolitis in neonates, chronic diarrhea in immunosuppressed patients, and postinfectious irritable bowel syndrome also have been reported in association with norovirus infection (23–25); however, more data from analytic studies are needed to confirm a causal link with these conditions.

Norovirus is shed primarily in the stool but also can be found in the vomitus of infected persons, although it is unclear if detection of virus alone indicates a risk for transmission. The virus can be detected in stool for an average of 4 weeks following infection, although peak viral shedding occurs 2–5 days after infection, with a viral load of approximately 100 billion viral copies per gram of feces (26). However, given the lack of a cell culture system or small animal model for human norovirus, whether these viruses represent infectious virus is unknown, and therefore the time after illness at which an infected person is no longer contagious also is unknown. Furthermore, up to 30% of norovirus infections are asymptomatic, and asymptomatic persons can shed virus, albeit at lower titers than symptomatic persons (26–28). The role of asymptomatic infection in transmission and outbreaks of norovirus remains unclear.

Immunity

Protective immunity to norovirus is complex and incompletely understood. In human challenge studies, infected volunteers were susceptible to reinfection with the same strain as well as to infection with heterologous strains (29–32). In addition, those with preexisting antibodies were not protected from infection unless repeated exposure to the same strain occurred within a short period. Two of these studies demonstrated that homologous antibody protection might last anywhere from 8 weeks to 6 months (30,31). However, the infectious dose of virus given to volunteers in these challenge studies was several-fold greater than the dose of virus capable of causing human illness, and thus immunity to a lower natural challenge dose might be greater and more cross-protective.

Because preexisting antibodies among challenged volunteers did not necessarily convey immunity, and some persons seemed to remain uninfected despite significant exposure, both innate host factors and acquired immunity have been hypothesized to contribute to the susceptibility to infection (31). Histo-blood group antigens (HBGAs), including H type, ABO blood group, and Lewis antigens have been proposed as candidate receptors for norovirus. Expression of HBGAs is associated with strain-specific susceptibility to norovirus infection (17,33–38). Resistance to norovirus infections has been associated with mutations in the 1,2-fucosyltransferase (FUT2) gene leading to a lack of expression of HBGAs on the surface of intestinal cells (33–35,39). Thus, persons who have the normal FUT2 gene and who express these antigens are termed “secretors” whereas mutations in the FUT2 gene leading to the absence of HBGA expression result in “nonsecretor” persons who are less susceptible to infection. However, secretor status does not completely explain the differences seen among infected and uninfected persons for all strains of norovirus. Thus, additional mechanisms of immunity are likely involved, and this remains an ongoing field of research. In addition, evidence suggests that new GII.4 variants evolve to escape the build-up of acquired immunity and innate resistance in the human population (16,40).

Transmission

Norovirus is extremely contagious, with an estimated infectious dose as low as 18 viral particles (41), suggesting that approximately 5 billion infectious doses might be contained in each gram of feces during peak shedding. Humans are the only known reservoir for human norovirus infections, and transmission occurs by three general routes: person-to-person, foodborne, and waterborne. Person-to-person transmission might occur directly through the fecal-oral route, by ingestion of aerosolized vomitus, or by indirect exposure via fomites or contaminated environmental surfaces. Foodborne transmission typically occurs by contamination from infected food handlers during preparation and service but might also occur further upstream in the food distribution system through contamination with human waste, which has been demonstrated most notably by outbreaks involving raspberries and oysters as vehicles (42–46). A recent outbreak involving consumption of delicatessen meat also demonstrated the potential for norovirus contamination during processing (47). Finally, recreational and drinking water can serve as vehicles of norovirus transmission and result in large community outbreaks (48,49). These outbreaks often involve well water that becomes contaminated from septic tank leakage or sewage (50) or from breakdowns in chlorination of municipal systems (51).

Sporadic Disease

As diagnostic methods have improved and become more widely available, the role of noroviruses as the leading cause of sporadic gastroenteritis in all age groups has become clear. Approximately 21 million illnesses caused by norovirus are estimated to occur each year in the United States, approximately one quarter of which can be attributed to foodborne transmission (52). A recent systematic review of 31 community, outpatient, and hospital-based studies in both developed and developing countries estimated that noroviruses accounted for 10%–15% of severe gastroenteritis cases in children aged <5 years and for 9%–15% of mild and moderate diarrhea cases among persons of all ages (53). Although laboratory-based data on endemic norovirus disease in the United States are sparse, recent studies suggest that norovirus is the leading cause of acute gastroenteritis in the community and among persons seeking care in outpatient clinics or emergency departments across all age groups (54,55; CDC, unpublished data, 2011).

Serosurveys have demonstrated that norovirus infections are prevalent throughout the world, with initial exposure typically occurring early in life (5). In population-based studies from Australia, England, Hong Kong, and the Netherlands, norovirus infection has accounted for 9%–24% of gastroenteritis cases (19,20,56–58). In these studies, infection was more frequent in certain age groups (e.g., children aged <5 years and adults aged >65 years). In studies that have used sensitive molecular assays, a relatively high prevalence of norovirus-positive samples in asymptomatic persons has been detected, ranging from 5% in the Netherlands to 16% in England (20,56). This background rate of asymptomatic infection, coupled with innate resistance attributable to secretor status and acquired immunity, helps explain why attack rates rarely exceed 50% in outbreaks.

Outbreaks

Noroviruses are the predominant cause of gastroenteritis outbreaks worldwide. Data from the United States and European countries have demonstrated that norovirus is responsible for approximately 50% of all reported gastroenteritis outbreaks (range: 36%–59%) (5). Outbreaks occur throughout the year although there is a seasonal pattern of increased activity during the winter months. In addition, periodic increases in norovirus outbreaks tend to occur in association with the emergence of new GII.4 strains that evade population immunity (Table) (40,59). These emergent GII.4 strains rapidly replace existing strains predominating in circulation and can sometimes cause seasons with unusually high norovirus activity, as in 2002–2003 and 2006–2007. Because the virus can be transmitted by food, water, and contaminated environmental surfaces as well as directly from person to person, and because there is no long lasting immunity to norovirus, outbreaks can occur in a variety of institutional settings (e.g., nursing homes, hospitals, and schools) and affect people of all ages. Whereas prior national estimates of outbreak attribution by mode of transmission were likely biased toward foodborne disease (60,61), more recent data from individual states indicate that the majority of norovirus outbreaks primarily involve person-to-person transmission (62,63). Multiple routes of transmission can occur within an outbreak; for example, point-source outbreaks from a food exposure often result in secondary person-to-person spread within an institution or community. Of the 660 norovirus outbreaks laboratory confirmed by CDC during 1994–2006 that indicated the setting, 234 (35.4%) were from long-term–care facilities (e.g., nursing homes); 205 (31.1%) were from restaurants, parties, and events; 135 (20.5%) were from vacation settings (including cruise ships); and 86 (13.0%) were from schools and communities (59). Although GII.4 variants predominate overall, the role of GI and other GII genotypes appears to be greater in settings that involve foodborne or waterborne transmission (Figure 2).

Long-Term Care and Other Health-Care Facilities

Health-care facilities including nursing homes and hospitals are the most commonly reported settings of norovirus outbreaks in the United States and other industrialized countries (59,60,63–65). Virus can be introduced from the community into health-care facilities by staff, visitors, and patients who might either be incubating or infected with norovirus upon admission or by contaminated food products. Outbreaks in these settings can be prolonged, sometimes lasting months (66). Illness can be more severe in hospitalized patients than for otherwise healthy persons (18), and associated deaths have been reported (21,22). Strict control measures (including isolation or cohorting of symptomatic patients, exclusion of affected staff, and restricting new admissions into affected units) are disruptive and costly but might be required to curtail outbreaks (9,67,68).

Restaurants and Catered Events

Norovirus is now recognized as the leading cause of foodborne disease outbreaks in the United States. Norovirus accounted for 822 (35%) of the 2,367 foodborne disease outbreaks reported to CDC during 2006–2007 (Figure 3) and half of the 1,641 foodborne disease outbreaks with a confirmed or suspected etiology (69,70). Food can become contaminated with norovirus at any point during production, processing, distribution, and preparation. Thus, a variety of products have been implicated in outbreak investigations; foods eaten raw (e.g., leafy vegetables, fruits, and shellfish) are identified most commonly (69,70). Handling of ready-to-eat foods by infected food employees is commonly identified as a contributing factor in outbreaks of foodborne norovirus associated with food-service establishments (71,72). Norovirus outbreaks also have resulted from fecal contamination of certain food products at the source. For example, oysters harvested from fecally contaminated growing waters and raspberries irrigated with sewage-contaminated water have been implicated in outbreaks (44,73). Because gross sewage contamination will contain a collection of viruses circulating in the community, multiple norovirus genotypes often are detected in such outbreaks. Contamination with norovirus also can occur during processing, as demonstrated by a recent outbreak involving delicatessen meat (47). Only a small dose of virus is needed to cause infection, and thus infected food handlers can contaminate large quantities of product. For example, approximately 500 cases of gastroenteritis were reported during a 2006 outbreak caused by a foodhandler who vomited at work (74). Drinking water or ice also might become contaminated with norovirus and result in outbreaks in food-service settings. Secondary person-to-person transmission is common following point-source food or water exposures.

Schools and Other Institutional Settings

Norovirus outbreaks occur in a range of other institutional settings including schools, child care centers, colleges, prisons, and military encampments. Outbreaks of gastroenteritis in child care centers also are caused by other pathogens, including rotavirus, sapovirus, and astrovirus, as a result of a lack of immunity to these viruses in young populations (75). Outbreaks have been reported recently from multiple universities in different states and have led to campus closures (76). An intervention study in elementary schools demonstrated that improved hand hygiene and surface disinfection can lead to lower rates of absenteeism caused by nonspecific gastroenteritis and reduced surface contamination with norovirus (77). Norovirus was also the most common cause of gastroenteritis in U.S. marines during Operation Iraqi Freedom (78) and a common cause of outbreaks among deployed British troops (79).

Cruise Ships and Other Transportation Settings

Passengers and crew aboard cruise ships are affected frequently by norovirus outbreaks (80). Virus generally is introduced on board by passengers or crew infected before embarkation but might also result from food items contaminated before loading or persistently contaminated environmental surfaces from previous cruises. Virus also might be acquired when ships dock in countries where sanitation might be inadequate, either through contaminated food or water or passengers becoming infected while docked. Repeated outbreaks can occur in subsequent sailings as a result of environmental persistence or infected crew, particularly if control measures have not been implemented consistently and thoroughly. Genotyping of outbreak strains from repeated outbreaks has demonstrated that this can occur through the introduction of new virus or recrudescence of virus from one sailing to the next (81,82). CDC’s Vessel Sanitation Program assists the cruise ship industry in preventing and controling the introduction and transmission of gastrointestinal illness by inspecting cruise ships, monitoring gastrointestinal illnesses, and responding to outbreaks (http://www.cdc.gov/nceh/vsp). Outbreaks also have been reported in association with bus tours and air travel, in which environmental contamination and proximity to ill passengers facilitated norovirus transmission (83,84).

Unquote
Read the entire original article here by Centers of Disease Control of the United States.

Related Articles

Autism walks in 2012
Norovirus infection among children with acute gastroenteritis in Recife, Brazil: disease severity is comparable to rotavirus gastroenteritis by scientists in the journal Archives of Virology, 2008
147 frozen brains thawed and lost to research; one third of those were from autism patients.

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World’s largest collection of frozen Autism brains ruined in freezer malfunction


Harvard University’s brain bank at McLean Hospital in Belmont,Massachusetts, had frozen 147 brains for research purposes. They were damaged in late May 2012 for three to four days, in a freezer malfunction. The distressing fact is that 53 or one-third of those brains had been derived from rare, diseased autistic persons. This will certainly slow Autism research in particular, since the rise in Autism cases has been observed only in recent decades and the reason for this spike is not understood. About 1 in 100 children born today in the developed world may be diagnosed with Autism spectrum disorder with the percentage observed to be higher in boys than girls. These frozen autistic brains may have held a clue. They may have provided a direction for future autism research direction. They may have helped autism researchers suggest current, preventive measures faster, and sooner so that as a society we can help prevent any child in the future to be burdened with this “mind fogging, communication disabling” brain condition.

The loss of these brains to the researchers is a major step back for the public health of a developed country like USA or Sweden. Somali immigrants from Somalia, Africa to USA and Sweden have noticed that autism has been diagnosed only in the Somali children born in USA or Sweden but not in Somalia. They insist it has never been observed in the Somali children born in Somalia (Read here). Recently, researchers have begun to look at what environmental or exogenous conditions, in addition to perhaps a genetic predisposition could cause a child to develop the Autism Spectrum Disorder. Such research teams are being led by CDC Director Dr. Thomas Frieden and the University of Rochester Medical Center’s Dr. Susan Hyman, the chair of the Autism Subcommittee of the American Academy of Pediatrics. To better understand what they do not know, to identify the risk factors, to pinpoint why boys are five times more likely than girls and to better prevent Autism are some of the goals of the researchers (Read here May 29, 2012 interview by pbs.org).

The NICHD Brain and Tissue Bank for Developmental Disorders at the University of Maryland and the Harvard center at McLean are the only repositories in the US that distribute autism brain tissue to researchers around the world. Autism brain donors are in short supply.

Walk Now For Autism Research say Thomas, who has an amazing lightening-fast brain; and his mom, Dagny Power, a member of “Libertyville district 70” team

To read the scientific explanation and implication of the loss of the frozen brains click on this link for the premier blog by nature.com on June 11, 2012. What is perplexing is that both the main alarm and the back up alarm to monitor the temperature of the freezer failed. This article discusses in detail the human and technological errors that may have caused such a major loss. Apparently, all the frozen brains had been transferred to a single freezer instead of the normal 24 freezers because of a special visit by the Autism tissue program in preparation for distribution to brain sample requests by autism researchers.

Fortunately, the DNA in these brains will probably be intact into the infinite future. However, the RNA and protein matter by nature is very fragile and was destroyed, and lost to researchers. It is a public loss.

Related Articles
G proteins – the connector proteins that try to prevent Autism Spectrum Disorder
List of Autism events in USA – walk or speak for Autism
Preclinical studies: Autism compound KM-391 significantly decreased plasticity of brains and increased serotoninlevels
Half of each brain preserved in formaldehyde available for research purposes by Martina’s blog
Call for more oversight to Freezer safety and attention by Jeff Evans of Clinical Neurology News
Brain samples from people who had died and who had had conditions such as autism, Parkinson’s disease, Alzheimer’s disease, or schizophrenia by Lifescience Log

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65th World Health Assembly in Geneva: Mental Health and Vaccinations Resolutions 2012


From May 21-26, 2012, the 65th World Health Assembly met in Geneva, Switzerland, to resolve how to improve world public health. They re-elected Dr. Margaret Chan for a second five year term as Director General of WHO, World Health Organization. Mental Health, vaccinations, maternal and child nutrition and financing for implementing resolutions and several other public health issues were discussed over plenary sessions. You may click here for details of sessions and resolutions. We shall update you here as the financing decisions of the resolutions are announced. Hopefully, we shall update you after the meeting in Rio coming up.

Re-election of Dr. Margaret Chan for second five year term as Director General of WHO

Professor Thérèse N’Dri-Yoman, President of the Sixty-fifth World Health Assembly, addresses the delegates at the plenary session.

Notes: Saturday, 26 May 2012

Financing research and development

The Health Assembly unanimously adopted the resolution on the Consultative Expert Working Group on Research and Development: Financing and Coordination in the form presented as draft by the drafting group and circulated yesterday.
To continue reading resolutions for each day from May 21-26, 2012, click here.

World Health Assembly forum 2012

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Are we less healthy than our parents and grandparents – both mentally and physically?


Our grandparents could walk for miles. Our parents could drive for miles and walk for miles too. What do we do?
Today, many of us have indoor bikes which assure us we are cycling for miles; some of us do indoor aerobics at least once a week for 40 minutes. Others prefer doing several laps of indoor swimming in chlorinated pools assuring us they are germ free. Some do calisthetics while others do indoor deep breathing yoga or modern forms of indoor yoga like those in 105 degrees only. Some do indoor iceskating. Others reach out for indoor rock climbing or gym activities like indoor weight lifting.

Who is healthiest long-term?

Most of us prefer modern entertainment and news formats like TV or computer games and our grandparents wistfully talk of the days when news was exchanged in social gathering holes like the local church or temple or the country bar or village market. Our parents talk of their childhood when they ran across and collected their neighbors to play after school or on holidays. There was never any talk of “play dates” supervised by hovering helicopter parents. Child predators and child kidnappers must have existed through millennia and yet, this generation of parents are extra vigilant of child predators and kidnappers lurking everywhere and children have to be escorted everywhere, even to school and playgrounds. Do children go exploring in the woods alone any more? Did any parent shudder when I mentioned this?

The summer Olympics in Great Britain of 2012, will witness Olympians breaking many previous records, demonstrating speed and strength unimaginable by our ancestors. Are we truly a superior human race today?

The fastest runners in the world

All this, and yet, this generation may be the first modern generation in which many parents may outlive their children, or the parents may be too scared to out live their child with Autism, and “new” debilating musculo skeletal and mental disorders. Many have fibromyalgia. Many are way beyond fat and the term obese needs to be replaced by a term implying double, triple or multiple times of what would qualify as a fat person until the 1970s. This is the first generation were women are being crippled by knee pain which was rare in their grandmothers. Young women are being diagnosed with juvenile rheumatoid arthritis in numbers unheard off in their parents or grandparents generation. It is not unusual to have classrooms trying to accomodate for Autism Spectrum Disorder, and several young children with leukemia, or childhood cancers.

Several athletes are confessing to strength enhancing drugs undetectable by current standards of drug testing. Such drugs are in the hands of only the most “developed” nations and although in the knowledge of the athletes of the “underdeveloped” competitors through locker room conversations, it is unaffordable. So, the ancient Olympic and Cycling competitions have become a show case of which nation has access to the latest drug test busting, strength enhancing know-how; clearly demonstrated by the human athletes of “inferior” nations trailing far behind the “superior” nations. Has the human race evolved differently when divided by oceans in a few decades, when evolution from apes to neanderthals and humans took millennia? Unlikely, but athletes have positive attitudes and never complain. They simply do their best. It would be nice to know if our current generation of athletes are truly superior to those ancient Greeks in that first Olympics at Athens.

All fair in love and cycling competition?

What has changed? Is it our attitude? Here are a few views below with links to their recent original articles:
If you want to form an argument based on knowledge, click these links below. You have more links? Leave them in comments to share with our readers. We want to hear what you think has changed.
1) A series of articles in New York Times on Obesity of which the most emailed one by Dr Carson Chow on May 14, 2012, entitled, “A mathematical challenge to obesity“, in which the conclusion is that while physical activity has not changed much in thirty years, food consumption has increased, and may be the leading cause of the rise in obesity”. Compare with article below.
2) Studies question the pairing of food deserts and obesity by Gina Kolata, April 17, 2012, also part of the above series of articles in New York Times, which summarizes conclusions from several scholarly studies finding that there is no correlation between food sold in a neighborhood and childhood obesity. Compare with article above.
3)The largest ever genome – wide study of childhood obesity by Dr Grant and his team, at Childhood hospital of Philadelphia. They characterize and identify a genetic predisposition to childhood obesity. They caution that babies born with these genes will not necessarily grow into obese children. To avoid obesity they advise better diet and a more active lifestyle.

Note from PursueNatural: Above authors say better diet and more active lifestyle – wait, is it not exactly what this generation is supposed to be doing? Yet, obesity rates are over 30% higher than in 1970s, while these obesity genes have existed for millennia, presumably even as we evolved from apes and neanderthals and our healthy, non-obese grandparents.

4) An article you must read is by Prof Yan Yu, in April 2012, in the journal, Obesity, as reported by Nature.com: “Educational Differences in Obesity in the United States: A Closer Look at the Trends” Quote.

……Using the National Health and Nutrition Examination Surveys (NHANES), we address these issues and examine changing educational differences in obesity from 1971–1980 to 1999–2006 for non-Hispanic whites and blacks in two separate age groups (25–44 vs. 45–64 years). We find that (i) obesity differentials by education have remained largely stable, (ii) compared with college graduates, less educated whites and younger black women continue to be more likely to be obese, (iii) but the differentials are larger for women than men, and weak or nonexistent among black men and older black women. There are exceptions to the overall trend…..

Unquote Read more.

5) “Why Have Americans Become More Obese?” by Professors David M. Cutler, Edward L. Glaeser and Jesse M. Shapiro, offering an economic impact of this obesity epidemic. Quote…

In the early 1960s, the average American adult male weighed 168 pounds. Today, he weighs nearly 180 pounds. Over the same time period, the average female adult weight rose from 143 pounds to over 155 pounds (U.S. Depart- ment of Health and Human Services, 1977, 1996). In the early 1970s, 14 percent of the population was classified as medically obese. Today, obesity rates are two times higher (Centers for Disease Control, 2003).
Weights have been rising in the United States throughout the twentieth century, but the rise in obesity since 1980 is fundamentally different from past changes. For most of the twentieth century, weights were below levels recom- mended for maximum longevity (Fogel, 1994), and the increase in weight repre- sented an increase in health, not a decrease. Today, Americans are fatter than medical science recommends, and weights are still increasing. While many other countries have experienced significant increases in obesity, no other developed country is quite as heavy as the United States.
What explains this growth in obesity? Why is obesity higher in the United States than in any other developed country? The available evidence suggests that

….Unquote. Read more.

Why is the average little child super obese today, when compared to our grandparents generation? Simply look around you. Strong4life.com

Note from PursueNatural Yes, you may be very thin and working hard towards being healthy the best way you know how. Yet, if your neighbor or the person in the next town is super, super obese and their three year old child is 200 lbs, yes, your tax dollars will be used towards this public epidemic of obesity related health issues. Money that could be used to improve roads and schools and repair century old bridges and tunnels and airports and pay for increased vigilance and security, will go towards treating the millions of super – super obese, unless you act now to add your voice to question this modern epidemic of obesity. Science says, the rate of rise of the super-super obese since the 1970s does not follow what would be considered a rational trend.

Read the above links. Be informed. Be knowledgeable. Be proactive. Is not your goal to be healthier and live in a cleaner, safer and more technologically superior environment than your grandparents? We may be planning a space module with overbooked flights carrying celebreties to space. However, our infrastructure on this earth may crumble due to lack of tax funding. Perhaps, begin to raise private funds towards infrastructure maintainance while the “new” diseases of obesity and Autism Spectrum Disorder and resultant health issues are worked out?

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Review of current Tourettes treatments that may be available for Le Roy girls


Quote…”The best treatment of Tourette’s symptoms out of the methods described – between antipsychotic medications, behavioral remedies, and simply letting time take its toll – is perhaps the behavioral method. As in Susan’s case, the symptoms were drastically reduced within the length of the experiment. Those who use this method will not have to deal with recurring and costly medication fees and also would not have to deal with the side-effects involved in taking medication. By learning to suppress tics, one can maintain a more long-term effect of tic reduction. Behavioral methods such as response prevention, therefore, may be the best option for Tourette’s patients.  …

habit reversal, appears to be a good alternative for Tourette’s patients who do not wish to use medicinal treatments due to the side-effects or other reasons. Response prevention has been shown to have about the same high level of efficacy as habit reversal (Phelps, 2008).

The final method of treatment, as of now, is simply time. A significant reduction in tics occurs naturally by the age of 19 or 20, and one affected by Tourette’s could choose to wait for that (Phelps, 2008). Of course, waiting for the tics to recede naturally is not guaranteed; Tourette’s-afflicted adults still tic although often to a lesser degree. Going without treatment may not be the best option, however. Those who have Tourette’s experience the worst of the symptoms during their childhood and adolescence. The social consequences of freely exhibiting tics often include teasing, bullying, and estrangement, as seen in the case study examined. The psychological impact on the child may have very negative effects for self-esteem, especially during school age years when the child’s peers are more prone to making hurtful comments,

The best treatment of Tourette’s symptoms out of the methods described – between antipsychotic medications, behavioral remedies, and simply letting time take its toll – is perhaps the behavioral method.”

…unquote

This quote is from this article by a researcher who summarized the then current view on Tourettes therapy. It is a well-written, thoughtfully researched article by a scholar who truly cares about the plight of Tourettes patients in a community of peers who find it difficult to accept anybody different. Exhibiting Tics in a society setting is treated as an embarrassment.

The abstract of the article by a researcher in Psychology Kathy Chen, follows below. She has listed relevant references from 1980 until 2009.
Tourette’s Syndrome
Abstract
This paper describes of the symptoms of Gilles de la Tourette’s Syndrome and the treatment
options available for those who have this disorder. One case study of a man with Tourette’s is examined, which provides information about the disorder’s effect on his social interactions with others as well as his explanations for the irresistible tics he experiences. The three main types of treatment methods – medicinal, behavioral, and the natural reduction of symptoms with time – are discussed. Then, a specific experiment which describes a girl named Susan and her successful treatment with a behavioral remedy is discussed.

Kathy Chen has summarized current choices in Tourettes therapy in her article and explains why behavioral therapy may prove to be most beneficial. Now, how does current research in Tourettes syndrome assist the 12 girls in Le Roy High school exhibiting similar symptoms?

Tourettes and Public Health
As a society, we have failed to stop the rising trend of Tic exhibiting diseases. While the Tourettes name was given to a diagnosis in 1884, the sudden rise in Tourettes like symptoms since 1980s has been largely ignored by citizens. Parents of patients have had to resort to forming their own communities and locate physicians willing to research this rising phenomenon. Generally, Tourettes is found in young, school aged boys. It appears to improve by the age of 19, with Tics presenting sometimes under stressful situations.

12 girls with Tourettes like syndrome at Le Roy High School
This makes the situation at Le Roy High School with 12 girls, all of them 17 years of age, presenting with the symptoms an unusual situation. That is why is heartening to learn that the National Institute of Health (NIH), Bethesda, Maryland has offered to treat these girls free of charge. Their unusual case requires not only personalized treatment but also extensive, collaborative, multi-pronged research into why 12 girls and not boys showed Tourettes like symptoms. Some factors the girls may have shared:

1) Everybody knows how stressful the final years of school can be, especially when grades and sports become equally important for college applications. Those applications begin in september and are mostly done by December. The girls began showing symptoms in september. Stress was a common factor.

2) Did  all the girls have the gardasil vaccine?

3) Did all these girls have a strep throat infection?

4) Did all these girls get exposed to the same lawn herbicide just before a game?

5) Did all these girls have the same snack with a long list of ingredients perhaps before a game or from the same snack machine? Perhaps, an energy drink? Perhaps, a crunchy snack?

6) Are all these girls bulimic perhaps, and share a mineral imbalance from binging and throwing up?

7) Do all these girls have a member in their family with multiple sclerosis, autism, or dyslexia?

The researchers are going to look into what else the girls had in common. What factors did they share that caused only them to exhibit symptoms? All 17 year olds in that school were exposed to similar levels of stress, similar environment in school grounds and lived within a few miles of each other and so the same community environment.

Erin Brokovich’s inquiry into Le Roy Tourettes cases
The train derailment in 1970 close to that community was brought to light by environmental crusader Erin Brokovich and her research team. It was one of the worst chemical spills in the state of New York resulting in a superfund clean up site, one of several in the nation. Her team wants answers to two primary questions:
1) Is it a temporary occurrence in the environment?
2) Temporary occurrence from some sort of biological event (not ruling out the role of environment)?

Genetics and its role in Le Roy Tourettes cases
Tourettes patients have shown to have genetics connecting them to some members of their family, especially some twins, showing similar symptoms. While there is a supposedly genetic connection, no single gene or set of genes stands out. This is therefore, a complex research scenario when in Tourettes cases in Le Roy all were 17 year old girls, within the same environment, with no obvious genetic history to the Tourettes symptoms. How then are the researchers to proceed?

Naturally, a multi-pronged research study will be the choice. One cannot rule out any factor the girls may have shared until proved otherwise. Then, the role of stress genes and how they might interplay with the genes triggered by the said common factor/s identified.

The Le Roy High School girls are fortunate that NIH researchers will now examine their unusual case from every possible angle. NIH has some of the finest researchers in this field. All along, dedicated Physicians will attempt to treat the symptoms with no knowledge of what may have caused the Tourettes-like symptoms to appear in the first place. Naturally, they will try the behavior treatment detailed above by Kathy Chen, which has proven beneficial in the past. This will have the least or no adverse affect. They might also prescribe clinical drugs, but these may have adverse effects. Considering that such symptoms ease by the age of 19, the physicians will have to balance their choices. Should they wait for these girls to show improvement around age 19? Tourettes has mostly been observed until recently in boys and hence studied in boys. Would it also follow a similar course in girls?

Do you see Tourettes-like cases in your community rising?
Do your grandparents observe that such cases like Tourettes and Autism were never seen in their communities?
Do your parents observe that Tourettes and Autism were never seen in such large numbers in their classrooms?
In recent years, does your school district have rising numbers of children with Tourettes, Autism, Leukemia and Juvenile rheumatoid arthritis?
If yes, have you ever wondered why? If yes, have you begun to ask questions?

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