YCLOAK

Scientists have developed a skin patch that may soon take the “ouch” out of being vaccinated.

Every year, in the United States, less than half of the adults who should get a flu vaccine actually get the shot.  That’s a problem because while most people tend to think of influenza as a mild disease, the infection can be deadly, especially in the elderly, young children and people with compromised immune systems.

To help raise that percentage researchers have developed a self-administered skin patch to protect against seasonal influenza as well as a shot.   Researchers who developed the vaccine patch said it has a lot of advantages over an injection.

Nadine Rouphael was principal investigator of the patch at Emory University School of Medicine in Georgia where she’s a professor of infectious diseases.  “The patch looks more like a Band Aid, like a nicotine patch, and then it has multiple very small needles that contain, in this case, influenza vaccine.  Those microneedles completely dissolve into the skin and there will be no sharp waste afterwards,” said Rouphael.

The flu vaccine is currently administered by an injection into the muscle of the upper arm.  It is painful and can leave some redness and swelling, which is why an estimated 60 percent of adults do not get immunized against seasonal flu. 

In the first human clinical trial of the patch at Emory’s Hope Clinic, 100 participants aged 18-49, tested the effectiveness of the vaccine patch.

The trial, reported in the journal The Lancet, took place in June 2015.  None of the participants had received a flu vaccine during the previous influenza season.  The participants were divided into four groups.  In one group the patch was administered by a health care provider, in the second it was self-administered by each participant, a third group received the vaccine via injection and a fourth group got a placebo.

Rouphael said the patch, whether it was put on the skin by a health care provider or by the participants, was as safe and effective as the intramuscular injection.  Side effects were limited to mild redness and swelling that lasted for a few days.  More importantly, the researchers found the immune responses were present in both the patch group and those who received the injection six months later, meaning they offered comparable protection.

Rouphael added the participants who used the patch liked it.  “We do have a lot of people who are typically scared of needles and they were more prone or more excited as being part of this clinical trial so they could try the microneedle instead.” 

The patch would only have to be put on the skin for a few minutes and then thrown away.  Rouphael said 70 percent of those who received the patch in the trial indicated they would prefer it over an injection. 

Because it does not need refrigeration, Rouphael said the patch could be bought off a store shelf or mailed to patients.  The fact that it is painless, said Rouphael, means more people are likely to get vaccinated against the seasonal flu virus.  The patch’s manufacturer, Global Center for Medical Innovation in Atlanta, is investigating using the device for other vaccines, including for measles, mumps and rubella.
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A quarter-century-old project to repopulate the steppes of Mongolia with wild horses was kept alive as four animals made the long trip back to their ancestral home from the Prague Zoo.

Driven to extinction in their homeland in the 1960s, the Przewalski’s horses survived in captivity before efforts began to re-introduce them to the arid desert and mountains along Mongolia’s border with China.

Zoos organized the first transport to Mongolia of the strong, stocky beasts in 1992.

For the past decade, Prague Zoo has been the only one continuing that tradition and it holds the studbook of a species whose ancestors – unlike other free-roaming horses such as the wild mustangs of the United States – were never domesticated.

The zoo completed its seventh transport last week, releasing four mares born in captivity in the Czech Republic, Germany and Denmark in the Gobi desert. They will spend the next year in an enclosed area to acclimatize before being freed.

“All the mares are looking very well, they are not hobbling, they are calm, eating hay and trying to test the taste of the new grass,” Prague Zoo veterinarian Roman Vodicka said after making observations a few days after the release.

Prague has released 27 horses in total and officials estimate around 190 are now back in the wild in the Gobi B park, where the most recent arrivals were sent.
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Professional football players are still not getting properly checked for concussions, despite a pledge by the sport’s governing body. That was obvious from a review of footage from the games in FIFA’s 2014 World Cup, the international men’s football championship held every four years.

The review, published in the Journal of the American Medical Association,  found that out of 81 head collisions there were only 12 assessments that fit the minimum requirements.

Co-author Michael Cusimano, a neurosurgeon at St. Michael’s Hospital in Toronto, told VOA, “There were only two collisions [where] I could be happy and confident that a proper assessment was actually done.”

According to the 2012 Consensus Statement on Concussion in Sport, of which FIFA was a signatory, players showing any sign of concussion should immediately be withdrawn from play and assessed by a health care professional on the sideline. But players in the World Cup only received that full assessment 15 percent of the time.

More than half of the time, an assessment was done on the field or by a referee or another player. And 26 percent of the time, they received no assessment at all, despite showing as many as three signs of concussion. Those symptoms include being slow to get up, disorientation, obvious disequilibrium, unconsciousness, seizure-like movements, and head clutching.

The impact of concussions can accumulate over years and may lead to trouble with memory, attention, depression, anxiety, and early onset dementia. In rare cases, repeated blows to the head over a short period of time, even mild ones, can lead to death.

A concussion ignored

There was obviously something wrong with Christoph Kramer during the final game of the World Cup. The German player was struck on the side of his head by a shoulder and thrown to the ground. Following a brief assessment on the pitch, he was returned to play, despite showing at least three signs of concussion. After 13 minutes of strange, confused behavior, he was removed from the game.

A referee later told the Gazzetta dello Sport, “Shortly after the blow, Kramer came to me asking: ‘Ref, is this the final?’” The referee told teammates, but Kramer continued to play.

“Had he been injured to his knee and couldn’t walk there would be no doubt that he would have been taken off,” Cusimano said, “so why are we treating people with brain injuries any different than people who have, say, a leg injury?”

In response, FIFA soon created a policy to allow referees to stop play for as long as three minutes, so that players can receive an on-pitch assessment by health care personnel. But it is only at the discretion of the referee. This is not enough for Cusimano. He points out it was an on-pitch assessment that failed to catch Kramer’s apparent concussion, and it takes at least seven minutes to properly diagnose the condition. So he wants to see mandatory assessments on the sidelines, just as the 2012 Consensus advises.

‘Whole world is watching’

FIFA declined a request to speak with VOA, but shared a written statement highlighting their recent rule change, and their participation in the most recent International Consensus Conference on Concussion.

“Protecting the health of football players is and will remain a top priority in developing the game,” it said.

Researchers decided to analyze the World Cup because of the size of the audience. Over a billion people tuned in. That means that the World Cup provides an opportunity to set an example for how to handle concussions. They hope that better policy at the premier sporting event might not just protect those playing in the World Cup, but those playing in little leagues too.

“The whole world is watching,” said Dr. Cusimano. “FIFA has all the ability to do this properly.”
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Imagine going to the doctor and getting a cooking lesson! That’s what happens at a doctor’s practice near Washington D.C. Dr. Yum Pediatrics is half doctor’s office, with waiting area and exam rooms, half kitchen.  Food is an important part of her approach to treatment.  

In the exam rooms, she explains to her patients and their parents the crucial importance of eating nutritious meals. In the kitchen, she shows them how to prepare those meals.

Dr. Fernando’s goal is to help children establish good eating habits and inspire families to prepare nutritious meals with the ingredients they have in hand.

Food for good health

Fernando has seen first-hand the connection between what kids eat and their well-being.

“In the first glance, you think of diet-related illnesses, mainly just pediatric obesity, and it’s true that 30 percent of kids in our community and nationwide are obese. And that’s a pretty staggering number,” she says, adding, “but as I paid more attention to a lot of the symptomology that I was seeing in kids who even weren’t obese or overweight, I was seeing that those symptoms often traced back some way to the diet.”

To help change that, the pediatrician co-authored a book, Raising a Healthy, Happy Eater: A Parent’s Handbook.  She also started a blog and a website.

“I simply posted recipes on that website and when I would see patients in the office and felt like I didn’t have enough time to go over the nutrition topics with them I would point them to that website.”

In 2012, she went a step further, co-founding the Dr. Yum Project.  She developed a curriculum that preschool teachers can use to introduce nutrition lessons in their classrooms.  Inside her practice, Fernando leads cooking classes.

Cooking with your doctor

Young patients, their parents and members of the community are invited to cook with Dr. Fernando and her team.  They try different recipes and use different tools that make cooking an easy, fun everyday experience.

“Maybe it’s using our menu planners to see how they can make meal planning easy for them,” Fernando explains. “Maybe it’s using budget-friendly recipes to figure out how to eat really healthy on a budget.  Maybe it’s our baby food options so that they can see how they can feed their babies the same food they’re eating.”

Yara Esquivel, a working mother of two, has been taking cooking classes with Dr. Yum for more than three years.  “Even my husband and I are eating better because we’re making sure the kids are eating better,” she says.

Almost all of the ingredients used in the cooking classes come from the clinic’s garden.

“As part of our classes, we really want to create a playful experience around feeding and eating,” Fernando says.  “We also want to create a rich sensory experience.  So taking kids out to the garden where they can grow food, plant food and harvest it and bring it to the kitchen, then cook it with their own hands, it really inspires them and makes it easier for them to accept new foods because they’re invested in it.”

Delicious, Healthy Meals Made Easy

Dr. Yum co-founder, Heidi DiEugenio, says all the recipes are taste-tested and posted online.  “Every single recipe is tasted by our families and we have the real feedback from some families, parents and kids about the food.  We tagged all those recipes, making it very easy for them to find.”

The ultimate goal of this project is to change the culture around kids’ food.

“There is a lot going in the media, kinds of advertising and things going around that say kids food, like ‘lunchables,’ kids like processed food, kids wouldn’t eat fresh carrots, they would eat Doritos,” DiEugenio says.  “You have to remember that these messages are out there because those companies are trying to make money.  But it’s not necessarily the case.  It’s a matter of being able to be patient with your kids, you have to learn how to try new foods all the time.”

The Dr. Yum team hopes to inspire pediatricians around the country to start cooking lessons to help families enjoy real, nutritious meals.
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Doctors encourage their patients to eat a healthful diet, and often give them tips on how to do that. But a pediatrician in Spotsylvania, Virginia, is doing even more. Dr. Nimali Fernando is showing her young patients and their parents how to eat healthy by offering them a variety of cooking classes, from baby food for parents to cooking with preschoolers and older kids. Faiza Elmasry has the story. Faith Lapidus narrates.
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When we’re buying groceries by weight, being a few grams off may not be a big deal. But we do expect the store scales to be calibrated to show the exact measure. The situation becomes more complicated when we want to know the exact measure of something weighing a hundred tons or more. VOA’s George Putic visited a lab that calibrates large-force instruments.
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Ethiopia’s highlands traditionally have a built-in protection for the people who live there. The elevation and the cool temperatures have meant that malaria, the deadly mosquito-borne illness, cannot be transmitted.

But climate change may be putting an end to that safeguard. A new study led by a researcher at the University of Maine found that since 1981, the elevation needed to protect people from malaria has risen by 100 meters.

For the first time, people living in Ethiopia’s highlands could be vulnerable to the disease.

“What’s happening is the conditions, at least in terms of temperature, that are suitable for malaria are slowly creeping up at higher elevations,” said Bradfield Lyon at Maine’s Climate Change Institute and School of Earth and Climate Sciences. “The same thing would be true in other highland locations throughout the tropics.”

“It’s sort of eroding this natural buffer,” he said.

The two most common types of parasites that cause malaria in the region require consistent temperatures above 18 degrees Celsius and 15 degrees Celsius respectively.

Lyon’s study found that temperatures in the Horn of Africa are rising by an average of 0.2 degrees Celsius per decade due to climate change. He said this may not sound like a major change, but that over the course of the years studied (1981 to 2014), more than 6 million people who once lived areas protected from malaria may have lost that protection.

Ethiopia’s capital Addis Ababa, at 2,300 meters above sea level, still sits well above the threshold for malaria. Lyon said the communities potentially at risk are at elevations between 1,200 and 1,700 meters.

Still, he emphasized that this is simply a meteorological study. He has not seen evidence that people in the described areas actually contracted malaria. But the research is pointing out that it is possible.

“It does not mean that these people, therefore, are going to get malaria. It just says that it is slowly enhancing the risk if we leave all other factors alone,” Lyon said. “I mean the hope is through interventions and so forth that we can, in fact, eradicate malaria in this and other regions of the tropics.”

In 2015, about 212 million people worldwide fell ill with malaria and about 429,000 died, according to the World Health Organization. About nine-tenths of the cases and deaths occurred in sub-Saharan Africa.

Worldwide, about 214 million people fall ill with malaria each year and 438,000 people die as a result, according to the Centers for Disease Control and Prevention. The most vulnerable are children living in sub-Saharan Africa.
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More than 75 people, mostly young children, have gotten measles in the U.S. state of Minnesota. Nearly all were unvaccinated.

Measles is one of the most highly contagious diseases that exists. All it takes is a sneeze or a cough to spread the virus in tiny droplets through the air.

One person can infect up to 18 others. Each one of those people infects another dozen or so people, and it spreads from there.

Ninety percent of those exposed will get the virus, unless they have been vaccinated or have already had measles.

The measles virus can linger on doorknobs, tables, any surface for up to two hours. Touch it and you’re exposed.

‘Not a trivial disease’

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, says, “Measles is not a trivial disease. If you have a measles outbreak, a proportion of people are going to have serious complications.”

The complications can be as serious as permanent brain damage. It can leave a child blind or deaf. Measles also kills.

Dr. Peter Hotez is a professor at Baylor College of Medicine. He’s also the director of Texas Children’s Hospital Center for Vaccine Development.

Hotez told VOA, “In the pre-vaccine era, we had about 500 kids die of measles every year in the U.S. and 50,000 hospitalizations.”

And that’s not all. Dr. Flavia Bustreo at the World Health Organization says measles can have lingering consequences.

“Measles can lead to pneumonia, and a reduction in immune function for some time after the infection, so the child becomes weaker and more susceptible to other infections,” Bustreo said.

The U.S. was declared measles free in 2000. Last year the World Health Organization declared the Americas measles free. This came after a 22-year campaign to eradicate this disease in both North and South America. The achievement was considered a historic milestone.

International hub

So, why, you could ask, have more than 75 people, mostly children, gotten measles in the Midwestern state of Minnesota?

All cases of measles in the Americas are imported. In Minnesota, the outbreak started among the Somali-American community and spread because this group had low vaccination rates for measles.

Minneapolis is an international hub where people arrive from countries around the world. As of now, no one knows the identity of the first patient with measles, whether it was someone visiting from abroad or if an unvaccinated American brought the disease home after traveling overseas.

Like most pediatricians in the U.S., Dr. Hope Scott counts herself lucky to have never seen a case of measles. “The kids who get measles are really, really sick. It’s a pretty big deal to get measles,” she says.

The first signs of measles are a runny nose, cough and a fever followed by a blotchy rash that starts on the face and then spreads all over the body. Once the rash appears, the fever spikes.

An infected person can spread the virus to others about four days before the rash appears and for about four more days afterward.

Hospitalizations

About a third of the children who have acquired measles in Minnesota have been hospitalized. There is no treatment that can get rid of a measles infection, but doctors can treat the symptoms.

Patsy Stinchfield, a nurse practitioner who’s overseeing care at Children’s Minnesota, where these children have been treated, says they are exhausted and dehydrated when they arrive. But, she told VOA, that so far none of the children has suffered any complications.

The American Academy of Pediatrics has asked doctors to work with parents who are reluctant to get their children vaccinated.

Reston Town Center Pediatrics in Virginia allows parents to set up a delayed vaccine schedule for their children, to a point.

Scott says the practice will work with the parents until the child is about 2 years old. Then, if the child is not vaccinated and the parents don’t have a plan to do so, Scott said the office sends them a letter saying their children can no longer be treated at the practice.

Measles is not just a childhood disease. Adults can get it, too, and adults are also at risk for complications. 

The best protection is to get two doses of the measles vaccine. The Centers for Disease Control and Prevention recommends children get the first dose after their first birthday and the second when they are 4 to 6 years old. The two doses together provide 97 percent protection against measles.

Stinchfield said Children’s Minnesota has a walk-in clinic for measles vaccinations. She said before the outbreak, about 500 children would get vaccinated against the virus in a week. Since the outbreak, 3,000 people of all racial and ethnic backgrounds get vaccinated each week.
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More than 75 people, mostly young children, have gotten measles in the U.S. state of Minnesota. Nearly all were unvaccinated. The same is true in every other country worldwide. That’s why pediatricians and public health doctors want every child to get vaccinated against this virus. VOA’s Carol Pearson takes a look at measles to find out why.
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We know that forests are carbon sinks. That means they absorb a lot of planet-warming carbon dioxide. But researchers are trying to find out just how good they are at storing carbon, and if there is a limit to how much they can absorb. VOA’s Kevin Enochs reports.
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