U.S. to modernize poultry inspections to boost food safety


(Reuters) – The U.S. Department of Agriculture said on Thursday it will modernize its decades-old inspection methods for poultry in an attempt to crack down on food-borne illness.

USDA’s Food Safety and Inspection Service (FSIS) will require all poultry companies to take measures to prevent Salmonella and Campylobacter contamination, rather than addressing contamination after it occurs.

“The United States has been relying on a poultry inspection model that dates back to 1957 … The system we are announcing today imposes stricter requirements on the poultry industry and places our trained inspectors where they can better ensure food is being processed safely,” said USDA Secretary Tom Vilsack.

(Reporting by Ros Krasny; Editing by Sandra Maler)

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'Tape measure test' call on diabetes








By James Gallagher
Health editor, BBC News website


The fat man


People are being urged to whip out the tape measure to assess their risk of developing type 2 diabetes.

Public Health England said there was a “very high risk” of diabetes with waistlines over 40in (102cm) in men or 35in (88cm) in women.

It warned that the disease could “cripple” the NHS, 10% of whose budget was already spent on it.

The charity Diabetes UK said the country was facing a “devastating” type 2 diabetes epidemic.

Type 2 diabetes is an inability to control blood sugar levels that has dire consequences for health.

It increases the risk of heart attacks and strokes, is the leading cause of blindness in people of working age, damages blood vessels and nerves and results in 100 foot amputations each week in the UK.

If someone has type 2 diabetes at the age of 50, they can expect to die six years earlier than someone without the disease.


How fat?

Obesity is the biggest risk factor driving the disease.

Public Health England (PHE) says men with a 40in (102cm) waist are five times more likely to get type 2 diabetes than those with a slimmer waistline.

Women were at three times greater risk once they reached 35in (88cm).

The PHE report also warns men with a 37-40in waistline (94-102cm) or women at 31-35in (80-88cm) may not be in the most dangerous group, but still faced a “higher risk” of the disease.

Dr Alison Tedstone, the chief nutritionist at Public Health England, said obesity was now so prevalent “we don’t even recognise it”.

She urged people to “keep an eye on your waist measurement” as losing weight was “the biggest thing you can do” to combat the disease.

Earlier this month, the National Institute of Health and Care Excellence said people with type 2 diabetes should have weight loss surgery.


Chocolate and fruitChocolate or fruit? Type 2 diabetes is mostly caused by lifestyle choices.

However, many people mistakenly think their trouser size counts as their waistline, conveniently forgetting about a bothersome beer belly.

Dr Tedstone told the BBC: “People get it wrong, particularly men.

“They measure their waist under their bellies, saying they haven’t got fatter because their trouser size is the same, forgetting they’re wearing their trousers lower and lower.

“So the tip is to measure across the belly button.”


‘Unsustainable’

A different form of diabetes – type 1 – is caused by the body’s own immune system rebelling and destroying the cells needed to control blood sugar.

About 3.2 million people have been diagnosed with some form of diabetes in the UK and that figure is projected to reach five million by 2025.

The NHS already spends a 10th of its budget on the diseases.

“That’s a huge amount of money and that could possibly double over the next few years, and that could cripple the NHS,” said Dr Tedstone.

Baroness Barbara Young, the chief executive of Diabetes UK, said: “With many millions of people in the UK now at high risk of type 2 diabetes, this is an epidemic that looks likely to get even worse, and if this happens then the impact on the nation’s health would be devastating and the increase in costs to the NHS would be unsustainable.”

She said the government needed to intervene.

“It needs to urgently consider making healthy food more accessible through taxation, other financial measures and more robust regulation of the food industry,” she said.

Prof Jonathan Valabhji, the national clinical director for obesity and diabetes for NHS England, said: “We are seeing huge increases in type 2 diabetes because of the rising rates of obesity, and we clearly need a concerted effort on the prevention, early diagnosis and management of diabetes to slow its significant impact not only on individual lives but also on the NHS.”

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Sierra Leone declares emergency as Ebola death toll hits 729

Sierra Leone's President Ernest Bai Koroma attends a meeting of regional group Economic Community of West African States (ECOWAS) in Yamoussoukro June 29, 2012. REUTERS/Thierry Gouegnon

Sierra Leone’s President Ernest Bai Koroma attends a meeting of regional group Economic Community of West African States (ECOWAS) in Yamoussoukro June 29, 2012.

Credit: Reuters/Thierry Gouegnon


(Reuters) – Sierra Leone has declared a state of emergency and called in troops to quarantine Ebola victims, joining neighboring Liberia in imposing controls as the death toll from the outbreak of the virus hit 729 in West Africa.

The World Health Organization said it would launch a $100 million response plan on Friday during a meeting with the affected nations in Guinea. It was in urgent talks with donors and international agencies to send more medical staff and resources to the region, it said.

The WHO reported 57 new deaths in the four days to July 27 in Guinea, Liberia, Sierra Leone and Nigeria.

“The scale of the Ebola outbreak, and the persistent threat it poses, requires WHO and Guinea, Liberia and Sierra Leone to take the response to a new level, and this will require increased resources,” WHO Director General Margaret Chan said.

Sierra Leone President Ernest Bai Korom announced a series of emergency measures, to initially last 60 to 90 days, in a speech on Wednesday night.

“Sierra Leone is in a great fight. Failure is not an option,” he said.

Security forces will enforce a quarantine on all centers of the disease and help health officers and aid workers to work unhindered, following attacks on health workers by local people.

The moves followed steps by Liberia which included the closure of all schools and a possible quarantine of affected communities.

The outbreak of the hemorrhagic fever, for which there is no known cure, began in the forests of eastern Guinea in February, but Sierra Leone now has the highest number of cases.

Koroma said he would discuss ways to combat the epidemic with the leaders of Liberia and Guinea at Friday’s meeting.

The jump in the number of cases and death toll has raised international concern and place poor health facilities in the region under strain.

The United States was providing material and technical support to Guinea, Sierra Leone and Liberia, the senior U.S. diplomat for Africa, Linda Thomas-Greenfield said.

African officials will discuss further assistance at a meeting in Washington next week, she said.

The U.S. Centers for Disease Control and Prevention on Thursday issued a travel advisory against non-essential travel to Guinea, Liberia and Sierra Leone in an effort to curb the spread of the Ebola outbreak.

CDC Director Thomas Frieden said the agency will send an additional 50 health experts to help efforts to control it.

Authorities in Nigeria, which recorded its first Ebola case last week when a U.S. citizen died after arriving on a flight from Liberia, said all passengers traveling from areas at risk would be temperature-screened for the virus.

But international airlines association IATA said the WHO was not recommending any travel restrictions or border closures due to the outbreak, and there would be a low risk to other passengers if an Ebola patient flew.

NEW AIRPORT CONTROLS

The disease kills up to 90 percent of those infected, though the fatality rate in the current epidemic is running at around 60 percent. In the final stages, its symptoms include external bleeding, internal bleeding, vomiting and diarrhea – at which point the virus becomes highly contagious.

Sierra Leone said passengers arriving and departing Lungi International Airport would be subject to new measures, including body temperature scans.

Two regional airlines, Nigeria’s Arik and Asky, canceled all flights to Freetown and Monrovia after a U.S. citizen, Patrick Sawyer, died in Lagos last week after arriving on an Asky flight from Liberia.

The WHO said authorities in Nigeria had identified 59 people in the airport and hospital who had come into contact with Sawyer, whose flight also stopped in Ghana and Togo.

Nigeria’s Civil Aviation Authority suspended Asky for bringing Ebola to Lagos, a city of 21 million people.

Health officials are scrambling to avoid an Ebola outbreak in Lagos, the continent’s biggest metropolis, but say there are so far no signs of further cases.

Ghana is introducing body temperature screening of all travelers from West African countries at Accra airport and other entry points. Authorities there are monitoring 11 passengers who disembarked from Sawyer’s flight.

The U.S. Peace Corps said it was withdrawing 340 volunteers from Liberia, Sierra Leone and Guinea after two of them came in contact with a person who later died of the virus.

(Additional reporting by Daniel Flynn in Dakar, Tom Miles in Geneva, Tim Cocks in Lagos, Clair MacDougall in Monrovia and Adam Bailes in Freetown, Kwasi Kpodo in Accra, Writing by Daniel Flynn and Bate Felix, Editing by; Angus MacSwan)

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Loyola's Sexual Wellness Clinic to help break down the stigma associated with sexual dysfunction

Sexual dysfunction among couples is common, yet it often goes untreated, according to specialists at Loyola University Health System’s Sexual Wellness Clinic.

Loyola’s clinic, which opened last fall, has helped to break down the stigma associated with sexual dysfunction and the barriers that prevent couples from seeking help. The clinic will offer another six-week program this fall for couples who are experiencing sexual health problems. The program will combine the expertise of various specialists to address common emotional and physical challenges that couples face in their sexual relationships.

“We received a tremendous response from couples involved with our program over the past year,” said Mary Lynn, DO, co-director of the Loyola Sexual Wellness Clinic and assistant professor, Department of Obstetrics & Gynecology, Loyola University Chicago Stritch School of Medicine (SSOM). “This program has helped couples communicate and resolve underlying physical and emotional issues to improve their sexual relationship.”

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The most common problems that affect sexual health include decreased libido, painful intercourse, inability to have an orgasm, erectile dysfunction and premature ejaculation.

This program will address these issues in six weekly visits led by a team of obstetricians and gynecologists, urologists, psychologists, nurses, social workers, dietitians and yoga instructors. Each week will include group educational sessions and private counseling for couples. A private physical examination also will be offered with an obstetrician/gynecologist and a urologist during the second session.

The group educational sessions will focus on envisioning greater intimacy, becoming open and vulnerable, finding life and relationship balance, exploring healthier possibilities, connecting mind and body and gaining and keeping momentum. Clinicians also will address nutrition and yoga for sexual wellness. These group sessions are informational only. Participants will not be asked to talk about their sexual relationship in a group setting.

The clinic will take place from 6:30 to 9 p.m. beginning Wednesday, Sept. 3, through Wednesday, Oct. 8. The program will be available again beginning in January and in the spring.

“Our sexual wellness specialists recognize that there are many factors that affect intimacy,” said Pat Mumby, PhD, co-director of the Loyola Sexual Wellness Clinic and professor, Department of Psychiatry & Behavioral Neurosciences, SSOM. “Loyola’s program takes a holistic approach to help couples manage their sexual health and rediscover their relationship.”

Source:

Loyola University Health System

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Psoriatic arthritis patients need better screening, warns panel of experts

Leading experts have joined together for the first time to call for better screening of psoriatic arthritis to help millions of people worldwide suffering from the condition.

Psoriatic arthritis (PsA) causes painful joint inflammation and can cause irreversible joint damage if left untreated.

PsA tends to affect people with the skin condition psoriasis, which causes a red, scaly rash, and affects approximately two per cent of people in the UK.

Around one in five go on to develop PsA — usually within ten years of the initial skin problem being diagnosed.

Coming together to tackle the gaps in the treatment and diagnosis of psoriatic arthritis, expert rheumatologists, dermatologists and patient representatives from Europe and North America formed the Psoriatic Arthritis Forum, and have now made a series of recommendations to combat the condition.

The recommendations were published the journal Arthritis Care and Research.

They included:

  • Developing a screening tool for dermatologists and primary care doctors to identify suspected PsA patients
  • Raising awareness about the progression, health-related quality of life components, and other health issues associated with PsA
  • Improving communication between healthcare providers and patients

Dr Philip Helliwell, of the School of Medicine at the University of Leeds, a member of the Psoriatic Arthritis Forum, said:

“We believe up to 50% of psoriasis patients with psoriatic arthritis are undiagnosed, living with sore, stiff and tender joints, without understanding what is causing this pain. Our review points the way forward for effective screening and treatment, in the hope that detection rates of the condition are improved and patients enjoy a better quality of life.”

In addition to better screening, experts have called for improved referrals of patients, as well as an algorithm — a step-by-step procedure for primary care physicians — to be developed to help community physicians on patient evaluation and treatment decisions.

Dr Helliwell added: “These recommendations serve as a guide for improving the timely diagnosis of PsA, as well as promoting global awareness of PsA. We need to develop better screening tools as a matter of urgency, as these will be cost-effective and lead to better health outcomes for thousands of people.”

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The above story is based on materials provided by University of Leeds. Note: Materials may be edited for content and length.

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U.S. FDA panel reviews Baxter immune therapy's long-term safety


(Reuters) – Advisors to the U.S. Food and Drug Administration will meet on Thursday to discuss the relative risks and benefits of Baxter International Inc’s experimental treatment for certain hereditary disorders of the immune system.

The FDA on Wednesday posted its preliminary assessment of the data on its website. The agency is seeking guidance from a panel of outside experts on whether the benefits of the product outweigh the risks. The FDA is not obligated to follow the recommendations of its advisors, but typically does so.

Baxter’s therapy, HyQvia, is designed to treat primary immunodeficiency diseases. These are genetic disorders in which certain cells of the immune system are missing, leading to a infections, recurrent pneumonia and abscesses of the organs.

HyQvia combines immune globulin (IG), a substance made from human blood plasma, and one vial of recombinant human hyaluronidase, or rHuPH20, a genetically engineered enzyme that increases absorption of the IG and allows it to be used less frequently than traditional products.

The FDA declined to approve the product in 2012, and asked for more information about its possible impact after some patients in a clinical trial developed antibodies against rHuPH20, which Baxter licensed from Halozyme Therapeutics Inc. HyQvia was approved in Europe in 2013.

Baxter’s data showed the elevated antibodies, which the immune system produces to fight foreign bodies, had no clinical impact on patients. However, the FDA was concerned about the theoretical potential of long-term exposure to the product to cause inflammation of the brain and bowel, as well as fertility problems.

“The risk-benefit considerations are very different for HyQvia compared to other IG products because the main immunogenetic component of concern (rHuPH20) is not a life-saving therapeutic,” the FDA’s report noted. The benefit of the product is primarily one of convenience.

Eun Yang, an analyst at Jefferies LLC, said in a research note that without therapeutic advantages in a well-supplied market, the “FDA does not have to take risks of approving HyQvia.”

Even if approved, Yang added, its commercial potential would likely be very limited given the concerns about male fertility. He estimated that peak U.S. and European sales would reach $740 million, translating into royalty revenue for Halozyme of $37 million.

Existing immune globulin therapies are given intravenously once every three to four weeks in a hospital, or by injection at home once every one to two weeks. HyQvia is designed to be injected at home once every three to four weeks.

(Reporting by Toni Clarke in Washington. Editing by Andre Grenon)

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Liberia shuts schools, quarantines communities in bid to halt Ebola


(Reuters) – Liberia will close schools and consider quarantining some communities, it said on Wednesday, announcing the toughest measures yet imposed by a West African government to halt the worst Ebola outbreak on record.

Security forces in Liberia were ordered to enforce the steps, part of an action plan that includes placing all non-essential government workers on 30-day compulsory leave.

Ebola has been blamed for 672 deaths in Liberia, neighboring Guinea and Sierra Leone, according to World Health Organisation figures, as under-funded healthcare systems have struggled to cope with the epidemic. Liberia accounted for just under one-fifth of those deaths.

“This is a major public health emergency. It’s fierce, deadly and many of our countrymen are dying and we need to act to stop the spread,” Lewis Brown, Liberia’s information minister, told Reuters.

“We need the support of the international community now more than ever. We desperately need all the help we can get.”

But highlighting international concern about the crisis, the U.S. Peace Corps said it was withdrawing 340 volunteers from Liberia, Sierra Leone and Guinea.

President Ellen Johnson Sirleaf said in a speech posted on the presidency’s website that the government was considering quarantining several communities based on the recommendation of the health ministry.

An earlier draft of the measures sent to Reuters specified communities to be quarantined.

“When these measures are instituted, only health care workers will be permitted to move in and out of those areas. Food and other medical support will be provided to those communities and affected individuals,” she said.

All markets in border areas are to be closed, she added.

Referring to the orders issued to the security forces to impose the plan, Brown, the information minister, added: “We are hoping there will be a level of understanding and that there will not be a need for exceptional force.”

Mike Noyes, head of humanitarian response at Action Aid UK, said people affected by Ebola should be treated with compassion rather than “criminalized”.

“Enforced isolation of a whole community is a medieval approach to controlling the spread of disease,” he said.

The first cases of this outbreak were confirmed in Guinea’s remote southeast in March. It then spread to the capital, Conakry, and into neighboring Liberia and Sierra Leone.

Concern deepened last week when a Liberian-American died from Ebola in Nigeria having traveled from Liberia. Authorities in Nigeria, as well as Ghana and Togo, where he passed through en route to Lagos, are trying to trace passengers who were on the same plane as him.

Some airlines in the region have cut routes to countries affected by Ebola despite the WHO saying it does not recommend travel restrictions as a step to control outbreaks.

Britain on Wednesday held a top-level government meeting to discuss the spread of Ebola in West Africa, saying the outbreak was a threat it needed to respond to. A U.S. administration official said on Monday President Barack Obama was also monitoring the situation.

OVERWHELMED

Earlier on Wednesday, Liberian health officials said an isolation unit for Ebola victims in Liberia’s capital, Monrovia, was overrun with cases and health workers are being forced to treat up to 20 new patients in their homes.

Protests by the local community against the construction of a new isolation unit at Elwa Hospital have ended, said Tolbert Nyenswah, an assistant minister of health, but patients with Ebola symptoms will have to wait at home until work is finished.

“The staff here are overwhelmed. This is a humanitarian crisis in Liberia,” Nyenswah told Reuters by telephone.

Nyenswah said the suspected patients were being treated by trained medical staff with full protective gear, but it would take at least 24-36 hours to build the new unit.

Initial resistance to building a new isolation unit highlighted the fear and mistrust health workers have faced across West Africa as they battle the outbreak, which has strained the region’s weak health systems.

Dozens of local health workers – including Sierra Leone and Liberia’s top two Ebola doctors – have died treating patients. Two Americans working for Samaritan’s Purse, a U.S. charity operating in Liberia, were infected over the past week.

Samaritan’s Purse said on Wednesday that Kent Brantly, a doctor working for the charity, and Nancy Writebol, a colleague who was also volunteering in Liberia, had shown a slight improvement but their condition was still serious.

However, the organization said that it would stop running case-management centers in Liberia after an attack on employees over the weekend and resistance from the local community to the expansion of their unit in Monrovia. The organization is withdrawing non-essential staff from the country, it added.

(Additional reporting by Kwasi Kpodo in Ghana, Clair MacDougall in Monrovia, Misha Hussain for the Thomson Reuters Foundation in Dakar; Writing by David Lewis; Editing by Daniel Flynn/Ruth Pitchford)

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England records rise in dementia








By Helen Briggs
Health editor, BBC News website


SeasideSeaside towns such as the Isle of Wight have a high number of dementia diagnoses


The number of people in England diagnosed with dementia has risen by 62% over seven years.

In 2013-14, 344,000 people received a diagnosis – up from 213,000 in 2006-07, when statistics were first collected.

The provisional figures also suggest an 8% rise in the number of recorded dementia cases since 2012-13.

The rise could be due to a number of factors, including an ageing population and improved diagnosis, the Health and Social Care Information Centre said.

Half of people living with dementia were still not registered as having the condition, said George Mcnamara, of the Alzheimer’s Society.

“With an ageing population and more people developing the condition, diagnosing dementia must remain a priority,” he added.

Hilary Evans, of Alzheimer’s Research UK, said the figures gave some idea of the scale of the challenge in England.

“This report does not set out to investigate the reasons for the rising figures, but it’s likely that recent moves to improve dementia diagnosis rates, along with an ageing population, will have contributed to this increase,” she said.

The Health and Social Care Information Centre said the data would be used in planning services.

“We are all aware of the challenges facing our ageing population, and these figures will be vital for those planning and monitoring the effectiveness of dementia treatments and services,” said chairman Kingsley Manning.

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Sierra Leone's top Ebola doctor dies from virus

Sheik Umar Khan, head doctor fighting the deadly tropical virus Ebola in Sierra Leone, poses for a picture in Freetown, June 25, 2014. REUTERS/Umaru Fofana

Sheik Umar Khan, head doctor fighting the deadly tropical virus Ebola in Sierra Leone, poses for a picture in Freetown, June 25, 2014.

Credit: Reuters/Umaru Fofana


(Reuters) – The doctor leading Sierra Leone’s fight against the worst Ebola outbreak on record died from the virus on Tuesday, the country’s chief medical officer said.

The death of Sheik Umar Khan, who was credited with treating more than 100 patients, follows those of dozens of local health workers and the infection of two American medics in neighboring Liberia, highlighting the dangers faced by staff trying to halt the disease’s spread across West Africa.

Ebola is believed to have killed 672 people in Guinea, Liberia and Sierra Leone since the outbreak began in February, according to the World Health Organisation.

The contagious disease, which has no known cure, has symptoms that include vomiting, diarrhea and internal and external bleeding. The fatality rate of the current outbreak is around 60 percent although Ebola can kill up to 90 percent of those who catch it.

The 39-year-old Khan, hailed as a “national hero” by the Health Ministry, had been moved to a treatment ward run by the medical charity Medecins Sans Frontieres in the far north of Sierra Leone.

He died less than a week after his diagnosis was announced, and shortly before President Ernest Bai Koroma arrived to visit his treatment center in the northeastern town of Kailahun.

“It is a big and irreparable loss to Sierra Leone as he was the only specialist the country had in viral hemorrhagic fevers,” said the chief medical officer, Brima Kargbo.

FOOTBALL BAN

Weak health systems are struggling to contain the disease despite international help ranging from doctors to safety equipment.

Guinea, where the outbreak originated, has seen new cases in the capital Conakry and in the eastern mining town of Siguiri, where a new isolation ward has opened. In both areas, the infection spread through contact with visitors from Sierra Leone, according to Aboubacar Sidiki Diakite, who leads Guinea’s efforts to stop the outbreak.

In neighboring Liberia, the national soccer authority suspended matches nationwide, a spokesman said.

While the WHO has stopped short of recommending travel restrictions, the Togolese airline Asky has suspended flights to and from Sierra Leone and Liberia as concern over the spread of the virus has increased since the first death was reported last week in Nigeria’s coastal city of Lagos, home to 21 million people.

The dead man was Patrick Sawyer, a consultant for Liberia’s Finance Ministry in his 40s who had flown to Nigeria with Asky via its home hub, Lome.

His wife Decontee told the U.S. channel NBC News on Tuesday that he was an American from Minnesota.

Asky said it would no longer take on food in Guinea, and that passengers leaving the Guinean capital Conakry would be checked for signs of the disease before departure.

The airline added that medical teams would be deployed to screen passengers in transit through Lome.

Nigeria’s largest carrier, Arik Air, has suspended flights to Liberia and Sierra Leone because of the Ebola risk.

On Monday, a U.S. administration official said President Barack Obama was receiving updates and noted that U.S. agencies had stepped up assistance to help contain the virus.

(Additional reporting by Emma Farge and Bate Felix in Dakar and Clair MacDougall in Monrovia; Writing by David Lewis and Daniel Flynn; Editing by Kevin Liffey)

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