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Ebola fever outbreak confirmed in Gabon
Ebola fever outbreak confirmed in Gabon outbreak of Ebola haemorfever in Gabon has been confirmed with the isolation of the virus in some of the blood samples collected from nine of the young admitted to men hospital in Makokou, the capital of OgooueIvindo province in Gabon. Laboratory isolation of the virus was done at the Centre International de Recherches Medicales de Franceville in Gabon and at the WHO Collaborating Centre at the Institut Pasteur in Paris. The virus has not yet been typed. As of Feb 21, there were 20 cases and 7 suspected cases in Gabon. 13 of the patients have died; 12 of these had had direct contact with the blood of a dead monkey, and the thirteenth was the 6-month-old child of one of the original 19 patients admitted to the hospital in Mokokou on Feb 5-6. A sibling of this child has been admitted to the hospital with fever. The other 6 suspected cases are
n
rhagic
Nutritional
The the
for in abundance in
are
Thailand-burgers-and-fries, doughnuts, and rich pastries-but to the casual observer the people of this obese. Yet the threat of lifestyle generally, and the west’s dietary habits in particular, was a recurrent theme for the largely Asia-Pacific attendance at the 5th International Symposium on Clinical Nutrition (Bangkok, Feb 5-7). The "economic miracle" in the Pacific rim is beginning to create a new social class-well-off, urban, and sedentary, and, according to several speakers, at risk . W P T James (UK) urged clinicians in the Asia-Pacific not to look to western medicine for the answers. Doctors know too little about food and nutrition but those in Thailand and similar countries did have the advantage over their western colleagues. Broadly speaking, the dietary strategies required can be found within traditional diets. "The Asian challenge therefore is how best to persuade doctors to advocate the importance of maintaining many (but not all) of the traditional features of an Asian diet" . Since 1903 actuaries have been saying that, as relative weight goes up, so does mortality. Yet doctors nation
are not
a western
528
Vivien Choo
of
outbreak alopecia A children Chernivtsi, in Western in due n
among
in
1988, was "probably" Ukraine, to heavy metal poisoning, says a special commission of the Ukrainian parliament. However, it could not find a specific source of the contamination. There have been 21 separate medical inquiries into the outbreak, in which 172 children were said to have been affected. The Commission, which superintended these investigations, now states that electromagnetic and ionising radiation can be ruled out. It also says that the pattern of spread does not support claims that the cause was a spill of noxious fluid when a military lorry hit a tree. Member of Parliament Taras Kyyak said that alopecia has been spreading even beyond the Chernivtsi region. The Health Ministry is thus to conduct nationwide study of alopecia. Vera Rich
strategies for Asia-Pacific region
temptations, especially young,
under iolation and close surveillance in Mayibout II, the village from which all 20 cases came from, and where a small field laboratory is being set up. Several dead animalsa chimpanzee, a wild cat, an antelope, and two gorillas-have been found in the Mayibout bush, and animal life in the affected area is under surveillance The international team investigating the outbreak in Mayibout II is also looking into rumours of illness in two neighbouring villages, Mvadi and Mayibout I. No case of Ebola has been reported among staff at the Makokou hospital. For now WHO is not recommending any travel restrictions to or within Gabon. It says that "If proper isolation of all persons with suspected early Ebola infection is ensured, there is no need for quarantine measures".
Alopecia in Ukraine due to heavy metals?
have
not
found the best way
to
obesity. George Bray (USA) James noted some hopeful signs. Bray’s review of the causes of obesity ended with genes. We now have the ob gene and its product, leptin, and that story is already moving from mouse to man (N Engl -7 Med 1996; 334: 292-95). There is
manage
and
more than one gene. We do not yet have the list for man, Bray said, but we do have the db mouse, with its defect at the receptor end; the "yellow mouse"; and the prosaic "fat mouse", in which prohormone conversion (eg, to peptide Y) is blocked. There was good news too from a re-examination of some participants in an American study published last year (Am y Epidemiol 1995; 141: 1128-41). In more than 15 000 people with a body mass index of
27
kg/m2
such
or more
plus co-morbidity
coronary heart disease, diabetes, or hypertension, any intentional weight loss was associated with a 20% reduction in all-cause mortality. James argued that the features (raised cholesterol, high blood presas
sure, threat of
diabetes) can be manwithout aged necessarily touching the obesity. This was "a completely new view". Weight would continue to rise if nothing was done about it, but there had been two misconceptions
in the traditional, and failing, medical approach. One was the shorttermism of trials. The other was the assumption that normal weight is the only measure of success. Such success was unusual, James said, and "would probably do a lot of harm to those who cannot lose that amount". So, stop further increases, and then minor weight loss can achieve a lot (see Bray). Targets above 1 kg weekly are "far too fast". In the Philippines (J S Eusebio), in rural Thailand, in parts of Bangkok, and no doubt elsewhere in the region the risk of obesity is negligible. Population growth in the Philippines is above 2% a year, and a diet based on rice, fish, and vegetables still leaves many people with intakes below recommended allowances in a country whose agricultural production is occasionally devastated by typhoons. B S Chand (India) put up a poster describing "epidemic dropsy" in Pipar City, Rajasthan, in June, 1993. The cause was contaminated cooking oil, probably from sanuinarine in the inedible oil of the Mexican poppy (Argimone mexicalla). Deliberate contamination, Chand said. Obesity is not the only nutritional challenge left in Asia-Pacific. David Sharp
n
rhagic
Nutritional
The the
for in abundance in
are
Thailand-burgers-and-fries, doughnuts, and rich pastries-but to the casual observer the people of this obese. Yet the threat of lifestyle generally, and the west’s dietary habits in particular, was a recurrent theme for the largely Asia-Pacific attendance at the 5th International Symposium on Clinical Nutrition (Bangkok, Feb 5-7). The "economic miracle" in the Pacific rim is beginning to create a new social class-well-off, urban, and sedentary, and, according to several speakers, at risk . W P T James (UK) urged clinicians in the Asia-Pacific not to look to western medicine for the answers. Doctors know too little about food and nutrition but those in Thailand and similar countries did have the advantage over their western colleagues. Broadly speaking, the dietary strategies required can be found within traditional diets. "The Asian challenge therefore is how best to persuade doctors to advocate the importance of maintaining many (but not all) of the traditional features of an Asian diet" . Since 1903 actuaries have been saying that, as relative weight goes up, so does mortality. Yet doctors nation
are not
a western
528
Vivien Choo
of
outbreak alopecia A children Chernivtsi, in Western in due n
among
in
1988, was "probably" Ukraine, to heavy metal poisoning, says a special commission of the Ukrainian parliament. However, it could not find a specific source of the contamination. There have been 21 separate medical inquiries into the outbreak, in which 172 children were said to have been affected. The Commission, which superintended these investigations, now states that electromagnetic and ionising radiation can be ruled out. It also says that the pattern of spread does not support claims that the cause was a spill of noxious fluid when a military lorry hit a tree. Member of Parliament Taras Kyyak said that alopecia has been spreading even beyond the Chernivtsi region. The Health Ministry is thus to conduct nationwide study of alopecia. Vera Rich
strategies for Asia-Pacific region
temptations, especially young,
under iolation and close surveillance in Mayibout II, the village from which all 20 cases came from, and where a small field laboratory is being set up. Several dead animalsa chimpanzee, a wild cat, an antelope, and two gorillas-have been found in the Mayibout bush, and animal life in the affected area is under surveillance The international team investigating the outbreak in Mayibout II is also looking into rumours of illness in two neighbouring villages, Mvadi and Mayibout I. No case of Ebola has been reported among staff at the Makokou hospital. For now WHO is not recommending any travel restrictions to or within Gabon. It says that "If proper isolation of all persons with suspected early Ebola infection is ensured, there is no need for quarantine measures".
Alopecia in Ukraine due to heavy metals?
have
not
found the best way
to
obesity. George Bray (USA) James noted some hopeful signs. Bray’s review of the causes of obesity ended with genes. We now have the ob gene and its product, leptin, and that story is already moving from mouse to man (N Engl -7 Med 1996; 334: 292-95). There is
manage
and
more than one gene. We do not yet have the list for man, Bray said, but we do have the db mouse, with its defect at the receptor end; the "yellow mouse"; and the prosaic "fat mouse", in which prohormone conversion (eg, to peptide Y) is blocked. There was good news too from a re-examination of some participants in an American study published last year (Am y Epidemiol 1995; 141: 1128-41). In more than 15 000 people with a body mass index of
27
kg/m2
such
or more
plus co-morbidity
coronary heart disease, diabetes, or hypertension, any intentional weight loss was associated with a 20% reduction in all-cause mortality. James argued that the features (raised cholesterol, high blood presas
sure, threat of
diabetes) can be manwithout aged necessarily touching the obesity. This was "a completely new view". Weight would continue to rise if nothing was done about it, but there had been two misconceptions
in the traditional, and failing, medical approach. One was the shorttermism of trials. The other was the assumption that normal weight is the only measure of success. Such success was unusual, James said, and "would probably do a lot of harm to those who cannot lose that amount". So, stop further increases, and then minor weight loss can achieve a lot (see Bray). Targets above 1 kg weekly are "far too fast". In the Philippines (J S Eusebio), in rural Thailand, in parts of Bangkok, and no doubt elsewhere in the region the risk of obesity is negligible. Population growth in the Philippines is above 2% a year, and a diet based on rice, fish, and vegetables still leaves many people with intakes below recommended allowances in a country whose agricultural production is occasionally devastated by typhoons. B S Chand (India) put up a poster describing "epidemic dropsy" in Pipar City, Rajasthan, in June, 1993. The cause was contaminated cooking oil, probably from sanuinarine in the inedible oil of the Mexican poppy (Argimone mexicalla). Deliberate contamination, Chand said. Obesity is not the only nutritional challenge left in Asia-Pacific. David Sharp