Zambia says it has made progress in containing a cholera outbreak that has killed about 70 people in the southern African nation since October.

Health Minister Chitalu Chilufya this week said there had been a “drastic reduction” in the number of new cases in the outbreak, which has mostly affected the capital, Lusaka. He says the provision of fresh water and other preventive measures are being taken.

 

The World Health Organization is assisting with the vaccination of Lusaka residents against cholera.

 

Last week, the military moved in after some residents in a densely populated Lusaka slum rioted over the removal of market vendors, a measure designed to curb the disease.

 

Cholera is caused by ingestion of contaminated food or water and can kill within hours if untreated.

 

 
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Every year there are an estimated 78,000 new cases of brain cancer diagnosed in the United States, and nearly 400,000 worldwide. It is a particularly challenging cancer and very seldom are patients ever “cured.” But there are new therapies that are helping patients lead longer, more normal lives. Kevin Enochs reports.
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Britain has appointed a minister of loneliness to combat social isolation experienced by one in 10 Britons. 

Sports Minister Tracey Crouch will add the job to her existing portfolio to advance the work of slain lawmaker Jo Cox, who set up the Commission on Loneliness in 2016.

“For far too many people, loneliness is the sad reality of modern life,” Prime Minister Theresa May said Wednesday. “I want to confront this challenge for our society and for all of us to take action to address the loneliness endured by the elderly, by carers, by those who have lost loved ones — people who have no one to talk to or share their thoughts and experiences with.”

The British Red Cross says more than 9 million Britons describe themselves as being always or often lonely, out of a population of 65.6 million.

Most people over age 75 in Britain live alone, and about 200,000 older people have not had a conversation with a friend or relative in more than a month, government data show.

“We know that there is a real impact of social isolation and loneliness on people, on their physical and mental well-being but also on other aspects in society, and we want to tackle this challenge,” Crouch told the BBC. 
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A prestigious scientific panel is recommending that states significantly lower their drunken driving thresholds as part of a blueprint to eliminate the “entirely preventable” 10,000 alcohol-impaired driving deaths in the United States each year.

The U.S. government-commissioned, 489-page report by a panel of the National Academies of Sciences, Engineering and Medicine released Wednesday throws the weight of the scientific body behind lowering the blood-alcohol concentration threshold from 0.08 to 0.05. All states have 0.08 thresholds. A Utah law passed last year that lowers the state’s threshold to 0.05 doesn’t go into effect until December 30.

The amount of alcohol required to reach 0.05 would depend on several factors, including the person’s size and whether the person has recently eaten. A 150-pound man might be over the 0.05 limit after two beers, while a 120-pound woman could exceed it after a single drink, according to the American Beverage Institute, a national restaurant group.

 

The panel also recommended that states significantly increase alcohol taxes and make alcohol less conveniently available, including reducing the hours and days alcohol is sold in stores, bars and restaurants. Research suggests a doubling of alcohol taxes could lead to an 11 percent reduction in traffic crash deaths, the report said.

 

It also calls for cracking down on sales to people under 21 or who are already intoxicated to discourage binge drinking, and putting limits on alcohol marketing while funding anti-alcohol campaigns similar to those against smoking.

 

All the proposals are likely to draw fierce opposition from the alcohol and restaurant industries. The beverage institute took out full-page newspaper ads opposing Utah’s new law that featured a fake mugshot under a large headline reading, “Utah: Come for vacation, leave on probation.”

 

The recommendation in the academies’ report for lowering the BAC threshold would “do nothing to deter” repeat offenders and high BAC drivers, who represent the “vast majority” of alcohol-impaired driving deaths, the Distilled Spirits Council said in a statement. The council said it also doesn’t support the report’s recommendations for “tax increases and advertising bans, which will have little or no impact on traffic safety.”

 

‘Deadliest and costliest danger on US roads’

The report points out that “alcohol-impaired driving remains the deadliest and costliest danger on U.S. roads,” accounting for 28 percent of traffic deaths. Each day, 29 people in the U.S. die in alcohol-related crashes and many more are injured. Forty percent of those killed are people other than the drunken driver.

 

Rural areas are disproportionately affected. In 2015, 48 percent of drunken driving fatalities occurred in rural areas.

 

The report says many strategies have been effective to prevent drunken driving, but “a coordinated multilevel approach across multiple sectors will be required to accelerate change.”

 

“The problem isn’t intractable,” the report said.

 

From the early 1980s to the early 2000s, there was significant progress as the result of an increase in the drinking age to 21, decreases in the blood-alcohol threshold, and other measures, the report said. But since then, progress has stagnated and recently has begun to reverse.

 

Action to address drunken driving can’t wait for the advent of self-driving cars immune to the lures of a cold beer or a fine wine – it will take too long for autonomous vehicles to replace all the human-driven machines on the road, said the panel’s chairman, Steven Teutsch, a senior fellow for health policy and economics at the University of Southern California in Los Angeles.

 

“In the meantime, we have 10,000 people a year dying and we ought to do something about it,” he said.

 

The report cites studies that show the United States lags behind other high-income countries in preventing drunken driving fatalities. More than 100 countries have adopted the 0.05 threshold lower. In Europe, the share of traffic deaths attributable to drunken driving was reduced by more than half within 10 years after the standard was dropped, the National Transportation Safety Board said in 2013. The safety board has also recommended the 0.05 threshold.

 

Alcoholic beverages have changed significantly over the past 25 years. “They are more affordable, of far greater variety, and more widely advertised and promoted than in earlier periods,” the report said. The lack of consistency in serving sizes and the combination of alcohol with caffeine and energy drinks make it harder for drinkers to estimate their level of impairment.

 

The report was commissioned by the National Highway Traffic Safety Administration, which asked the academies to determine which strategies for reducing drunken driving have been proven effective.

 
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The descriptions are haunting.

Some victims felt fine in the morning and were dead by night. Faces turned blue as patients coughed up blood. Stacked bodies outnumbered coffins.

A century after one of history’s most catastrophic disease outbreaks, scientists are rethinking how to guard against another super-flu like the 1918 influenza that killed tens of millions as it swept the globe.

There’s no way to predict what strain of the shape-shifting flu virus could trigger another pandemic or, given modern medical tools, how bad it might be.

But researchers hope they’re finally closing in on stronger flu shots, ways to boost much-needed protection against ordinary winter influenza and guard against future pandemics at the same time.

“We have to do better and by better, we mean a universal flu vaccine. A vaccine that is going to protect you against essentially all, or most, strains of flu,” said Dr. Anthony Fauci of the National Institutes of Health.

Labs around the country are hunting for a super-shot that could eliminate the annual fall vaccination in favor of one every five years or 10 years, or maybe, eventually, a childhood immunization that could last for life.

Fauci is designating a universal flu vaccine a top priority for NIH’s National Institute of Allergy and Infectious Diseases. Last summer, he brought together more than 150 leading researchers to map a path. A few attempts are entering first-stage human safety testing.

Still, it’s a tall order. Despite 100 years of science, the flu virus too often beats our best defenses because it constantly mutates.

Among the new strategies: Researchers are dissecting the cloak that disguises influenza as it sneaks past the immune system, and finding some rare targets that stay the same from strain to strain, year to year.

“We’ve made some serious inroads into understanding how we can better protect ourselves. Now we have to put that into fruition,” said well-known flu biologist Ian Wilson of The Scripps Research Institute in La Jolla, California.

The somber centennial highlights the need. 

Back then, there was no flu vaccine. It wouldn’t arrive for decades. Today vaccination is the best protection, and Fauci never skips his. But at best, the seasonal vaccine is 60 percent effective. Protection dropped to 19 percent a few years ago when the vaccine didn’t match an evolving virus.

If a never-before-seen flu strain erupts, it takes months to brew a new vaccine. Doses arrived too late for the last, fortunately mild, pandemic in 2009.

Lacking a better option, Fauci said the nation is “chasing” animal flu strains that might become the next human threat. Today’s top concern is a lethal bird flu that jumped from poultry to more than 1,500 people in China since 2013. Last year it mutated, meaning millions of just-in-case vaccine doses in a U.S. stockpile no longer match.

‘Mother of all pandemics’

The NIH’s Dr. Jeffery Taubenberger calls the 1918 flu the mother of all pandemics.

He should know.

While working as a pathologist for the military, he led the team that identified and reconstructed the extinct 1918 virus, using traces unearthed in autopsy samples from World War I soldiers and from a victim buried in the Alaskan permafrost.

That misnamed Spanish flu “made all the world a killing zone,” wrote John M. Barry in The Great Influenza: The Story of the Deadliest Pandemic in History.

Historians think it started in Kansas in early 1918. By winter 1919, the virus had infected one-third of the global population and killed at least 50 million people, including 675,000 Americans. By comparison, the AIDS virus has claimed 35 million lives over four decades.

Three more flu pandemics have struck since, in 1957, 1968 and 2009, spreading widely but nowhere near as deadly. Taubenberger’s research shows the family tree, each subsequent pandemic a result of flu viruses carried by birds or pigs mixing with 1918 flu genes.

“This 100-year timeline of information about how the virus adapted to us and how we adapt to the new viruses, it teaches us that we can’t keep designing vaccines based on the past,” said Dr. Barney Graham, deputy director of NIH’s Vaccine Research Center.

Two proteins

The new vaccine quest starts with two proteins, hemagglutinin and neuraminidase, that coat flu’s surface. The “H” allows flu to latch onto respiratory cells and infect them. Afterward, the “N” helps the virus spread.

They also form the names of influenza A viruses, the most dangerous flu family. With 18 hemagglutinin varieties and 11 types of neuraminidase — most carried by birds — there are lots of potential combinations. That virulent 1918 virus was the H1N1 subtype; milder H1N1 strains still circulate. This winter H3N2, a descendent of the 1968 pandemic, is causing most of the misery.

Think of hemagglutinin as a miniature broccoli stalk. Its flower-like head attracts the immune system, which produces infection-blocking antibodies if the top is similar enough to a previous infection or that year’s vaccination.

But that head also is where mutations pile up.

A turning point toward better vaccines was a 2009 discovery that, sometimes, people make a small number of antibodies that instead target spots on the hemagglutinin stem that don’t mutate. Even better, “these antibodies were much broader than anything we’ve seen,” capable of blocking multiple subtypes of flu, said Scripps’ Wilson.

Scientists are trying different tricks to spur production of those antibodies.

In a lab at NIH’s Vaccine Research Center, “we think taking the head off will solve the problem,” Graham said. His team brews vaccine from the stems and attaches them to ball-shaped nanoparticles easily spotted by the immune system.

In New York, pioneering flu microbiologist Peter Palese at Mount Sinai’s Icahn School of Medicine uses “chimeric” viruses — the hemagglutinin head comes from bird flu, the stem from common human flu viruses — to redirect the immune system.

“We have made the head so that the immune system really doesn’t recognize it,” Palese explained. GlaxoSmithKline and the Gates Foundation are funding initial safety tests.

In addition to working with Janssen Pharmaceuticals on a stem vaccine, Wilson’s team also is exploring how to turn flu-fighting antibodies into an oral drug. “Say a pandemic came along and you didn’t have time to make vaccine. You’d want something to block infection if possible,” he said.

NIH’s Taubenberger is taking a completely different approach. He’s brewing a vaccine cocktail that combines particles of four different hemagglutinins that in turn trigger protection against other related strains.

Obstacles to research

Yet lingering mysteries hamper the research.

Scientists now think people respond differently to vaccination based on their flu history. “Perhaps we recognize best the first flu we ever see,” said NIH immunologist Adrian McDermott.

The idea is that your immune system is imprinted with that first strain and may not respond as well to a vaccine against another.

“The vision of the field is that ultimately if you get the really good universal flu vaccine, it’s going to work best when you give it to a child,” Fauci said.

Still, no one knows the ultimate origin of that terrifying 1918 flu. But key to its lethality was bird-like hemagglutinin.

That Chinese H7N9 bird flu “worries me a lot,” Taubenberger said. “For a virus like influenza that is a master at adapting and mutating and evolving to meet new circumstances, it’s crucially important to understand how these processes occur in nature. How does an avian virus become adapted to a mammal?”

While scientists hunt those answers, “it’s folly to predict” what a next pandemic might bring, Fauci said. “We just need to be prepared.”
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Wearable technology is finding its way into many workouts. The thinking is that constantly monitoring their body can help people get the most out of their time at the gym. That’s the idea behind Orange theory, the newest U.S. fitness fad. VOA’s Kevin Enochs reports.
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