Without a doubt, Stephen King is one of the most recognized names in literature and he has become the focus of both academic courses and even graduate theses. His books are almost guaranteed to make the bestseller list but only a few have become legendary, sticking in the memories of those who have read his fictionalized passages and the curiosity of those who have yet to read his tomes.

His books also have a striking similarity to strains of the flu and how they affect public health.

Each year, the influenzavirus circles around the globe, infecting between five and 15% of the global population, causing millions to suffer from the classical symptoms of respiratory problems, fever, chills and aches.

Sadly, between 250,000 and 500,000 individuals die. These viruses, which usually take the names H1N1 or H3N2 are known as seasonal strains. They have a bestseller -- or best infecter -- status as they occupy our worries and the headlines for a short period of time, usually around the fall and winter months but then with the coming of summer, disappear from the public mindset.

Occasionally, a new strain emerges with an unexpected ferocity leading to unspeakable consequences. These iconic strains, more appropriately coined best killers, can lead to fear and even panic amongst the masses. The most renowned of these is the 1918 strain of influenza, the Spanish flu. This version of the virus led to between 20-50 million deaths and sent the entire world into a panic not seen since the days of the Black Plague, which was killing at a rate of 200 people per day. The effect on humanity was immense and was akin to turning the fiction of one of King's greatest works, The Stand, into reality.

More recently, the pandemic of 2009, caused by the ignobly named Swine Flu also took the world by storm although its effect was significantly less dramatic. While this strain kept the public worry high for over a year, when all the analysis was completed, it had done little more than a best-infecter. As such, it has all but disappeared from the public discussion while 1918 continues to spark engaging conversation -- at least amongst microbiologists.

Now a new set of flu strains have emerged, revolutionizing the way we look at these viruses. Rather than being one-time bestsellers or gaining that ever elusive legendary status, these strains have relatively little impact on public health yet somehow manage to sustain their prevalence in the public eye; they are best persisters. Like King's Carrie, which seems to pop up every decade and maintain its status as a book to be read and remembered, these particular strains become household names though they not as striking as their seasonal or pandemic counterparts.

The benchmark was H5N1, which appeared in Hong Kong in 1997 and led to 18 infections and 6 deaths. The virus was not only new, it was unexpected and caught the world by surprise. Thankfully, the virus could not be spread from person to person, making the likelihood of a killer pandemic unlikely.

Over the last 16 years, however, H5N1 has made sporadic appearances worldwide, killing only a handful of people at any given time. Yet each appearance brings back the media and the worry. While there is no reason for panic, the concern remains at a steady level as we wait to see whether this persister will eventually become a killer.

Now another new strain of influenza has emerged, H7N9, which at the moment is proving to be a potential best killer. The epidemic, which is centred in the eastern areas of China is continuing with dozens of confirmed cases, and about 20% perishing. The numbers are expected to rise as is the general panic in the public.

But this reaction may be far too premature and H7N9 may have a different fate. There are few indications that this strain will lead to a pandemic highlighted by the fact that there are no confirmed cases of human to human transmission, much like H5N1. Without this ability, there can be no pandemic. As we are seeing right now, there exists an opportunity for officials to work together to stop the tide before the situation gets worse. And it is exactly what they are doing with relative success. Within a month, the H7N9 epidemic may be a thing of the past.

However, that doesn't mean that H7N9 is gone for good. This virus also has all the markings of a best persister. Much like H5N1, infections appear to be linked to migratory birds . If this is the case, then the virus will most likely spread to Hong Kong and eventually to other countries including Vietnam, Indonesia and Egypt. The cases will most likely be sporadic and not lead to a large number of infections or deaths but because of its potential, it will occupy the headlines and citizen concern for years and maybe decades to come.

Much like any new offering from Stephen King, which requires time to determine its place in his legacy, the new H7N9 flu requires more than just a few weeks to determine its place in the historical records of infectious disease.

While at this time, the trend appears to be that of a best persister, things could change quite rapidly and we could be facing a new best-killer. However, one thing is certain: much like the New York Times Best Sellers list, which tracks and lists the literary hits of our time, we can always turn to the World Health Organization to help us better understand the impact of H7N9 or any other infectious disease breakout so that we are not only aware but also prepared for whatever possible horror novelty may come our way.

(source: www.huffingtonpost.ca)

The World Health Organization says World Immunization Week, beginning April 20 aims to promote one of the world's most powerful tools for health – the use of vaccines to protect people of all ages against disease.

It said in honour of the week, it would soon publish new research in vaccine highlighting the need for better supply systems, better support for remote and marginalized groups and better information in order to reach the estimated 22 million children in developing countries who are still not protected with basic vaccines.

A statement issued by Fadéla Chaib, WHO Communications Officer/ Spokesperson copied to the Ghana News Agency over the weekend said, other challenges include overcoming complacency about immunization, dispelling myths and improving research.

The World Immunization Week is an opportunity for the world to come together to address such barriers; under the global slogan "Protect your world – get vaccinated".

WHO encourages individuals and organizations working at international, regional, national, and community levels, in the public and private sectors, to coordinate and engage in activities during World Immunization Week.

Immunization Week initiatives began in the Region of the Americas in 2003. The Week was observed simultaneously in WHO's six regions for the first time in 2012, with the participation of more than 180 countries and territories. GNA

(source: vibeghana.com)

Paper Edition | Page: 8

The Depok administration is deploying 6,845 community-based tuberculosis (TB) assistants, a higher number than other cities and regencies in the country, to detect sufferers in the early stages of the disease.

Depok Mayor Nur Mahmudi Ismail says the administration is targeting zero growth of TB with the help of the new assistants who will survey every part of the municipality, which has a population of 1.8 million.

"We are engaging different people to join our team: teachers, school students, university students, military personnel and police officers," he said on Wednesday on the sidelines of the inauguration of the new assistants at the Army Strategic Reserves Command (Kostrad) in Cilodong, Depok.

"They are all aware [of the importance] of early detection so that sufferers of the disease can receive immediate treatment."

Nur Mahmudi said the assistants had acquired knowledge about the disease in terms of how to prevent it and how to treat it. They could also assist TB sufferers in taking their medicine.

He also called on Depok residents to immediately visit their doctors if they believed they had become infected with the Mycobacterium tuberculosis bacteria, which causes tuberculosis.

"The sooner the disease is discovered, the better [for the patients]. And don't worry, all TB treatment is free of charge," he said.

Kostrad Division I Cilodong commander Maj. Gen. Daniel Ambat said his soldiers were ready to support the administration in combating TB.

"Fighting TB is mandatory to have a healthy society with high productivity to help develop the nation," said Daniel.

Depok is ranked 19th for the number of TB sufferers nationwide.

The Depok Health Agency said it found 283 new cases in the first three months of the year and had cured 656 TB sufferers out of a total of 1,980 suspected TB sufferers.

However, agency head Hardiono could not provide either the exact number of TB sufferers or the number of TB-related deaths for 2012.

Smoking, nocturnal lifestyles and air pollution are believed to be contributory factors in causing TB.

The World Health Organization's (WHO) Southeast Asian division reported that Indonesia was one of the top-five Asian countries in treating TB, with a 90 percent success rate.

Symptoms of TB:

• Chronic cough for more than three weeks
• Nighttime fever and cold sweat
• Constant malaise
• Loss of appetite
• Reduced body weight
• Chest pains
• Coughing up blood

The World Health Organization (WHO) lauded the Sri Lankan government for taking prompt action in connection with implementing the recommendations in the WHO Report of Chronic Kidney Disease spreading in certain parts of the country, a Health Ministry spokesman said.

The spokesman said WHO Country Representative Dr Firdosi Rustom Mehta had stated that the Sri Lankan government made a significant contribution towards the three year study conducted by the WHO to find the cause for the rapidly increasing chronic kidney disease in the North Central Province and other areas in the country.

Implementing recommendations in the WHO report, the Sri Lankan government stopped importing insecticides Propanyl, Carboryl and Chloropyriphos to control Chronic Kidney Disease. Arrangements will also be made to minimise the use of Triple Super Phosphate (TSP) fertiliser with a high cadmium content.

Dr Mehta said even rich Balkan countries were unable to find out the reason for the rapidly increasing chronic kidney disease.

"Sri Lanka found the cause for this. President Mahinda Rajapaksa personally intervenes in the efforts of controlling communicable and Non Communicable Diseases and to upgrade the nutrition of the people. The efforts by Sri Lanka to develop the health sector are highly commendable," he said.

Dr Mehta expressed those views during the regional consultation to finalise the framework on health in all policies for South East Asian in Colombo with the participation of representatives from Sri Lanka, Bangladesh, Maldives, Bhutan, Indonesia, Nepal, Thailand and Myanmar.

The South East Asian Regional Office of the WHO decided to hold the meeting in Colombo.

(source: www.dailynews.lk)

KUCHING: Despite being second best to neighbours Singapore and Thailand, Malaysia is quickly becoming a popular destination for health travellers, boosting the country's image on the medical tourism front in Asia.

Inside Investors noted in its report that medical tourism in Malaysia had emerged as one of the fastest growing segments over the last few years despite the global economic downturn with approximately 400,000 health tourist generating over RM380 million in revenue for 2010 alone.

It explained that a majority of the health visitors came from neighbouring countries such as Indonesia, accounting for 69 per cent and Singapore accounting for 12 per cent. Other note worthy visitors came from Japan, Australia, the UK, the Gulf Cooperation Council (GCC) as well as the rest of Europe.

"With support from the Malaysian government, a large number of Malaysian private hospitals are actively participating in health tourism. The treatment sought by patients coming to Malaysia is predominantly cardiac, cosmetics, ophthalmology, dental, diagnostic services (MRI and CT Scans) and orthopedic," the business intelligence unit stated.

Over the past few years however, the number of medical tourists to Malaysia was lower than expected attributed to the global recession.

According to the Performance Management and Delivery Unit (Pemandu), markets such as Singapore and Thailand had weathered the downturn better by positioning themselves as leaders in specific niches of the industry, offering high quality care and high value health experiances.

"Nonetheless, the Malaysian government is optimistic about the healthcare travel industry in the country, targetting ten per cent per annum revenue growth for the period 2011 to 2015."

(source: theborneopost.com)

BANGKOK, 8 April 2013 (IRIN) - Officials throughout Asia are implementing measures to protect people from a new strain of bird flu - H7N9 - that has so far infected 24 people in China, killing seven.

These are the first human infections and deaths to have been recorded from this virus strain worldwide. China's neighbours have reacted by boosting hospital capabilities and disease surveillance, strengthening border control, issuing reminders to ban illegal poultry imports, and more vigorously testing what is imported.

Following a mass poultry culling on 5 April in Shanghai - one of the Chinese cities affected - pandemic expert and virologist Yi Guan from the University of Hong Kong told IRIN he expects human cases to "drop or stop". But he added that experts still have much to learn about the disease.

The virus has proved to be a "low-pathogenic" virus in infected land-based birds, so it is not clear why the virus has been so severe in humans, he noted. The true spread of the disease is also still unknown.

"We have a knowledge gap and do not know the full picture. There may be people with minor infections or who are asymptomatic among [the] population as a result of H7N9," said Yi.

Experts have not been able to learn how or why the 21 persons became infected. While some people had contact with animals or their habitats, and infections are suspected to originate in poultry, the virus's host and source have not been lab-confirmed.

The UN Food and Agriculture Organization has noted that knowing what species is responsible for the fatal outbreak is "essential to target response actions accordingly, including trade restrictions".

Indonesia

Since the H5N1 bird flu virus first appeared in 2003, there have been 622 laboratory-confirmed human cases globally, 371 of them fatal, according to the World Health Organization (WHO). Indonesia has seen the largest number of deaths from H5N1: 160.

"We face a similar situation to China because the high risks of the animal-human interface, and inadequate bio-security among many poultry farmers. That's why [holding a] public awareness campaign is important, and we continue to closely monitor genetic mutations of the bird flu virus," said Emil Agustiono, the head of Indonesia's National Zoonosis Committee.

He said no "special measures" have been enacted as the country does not import live poultry from China.

The WHO has not advised any travel or restrictions or any special screenings linked to the flu outbreak.

Tjandra Yoga Aditama, director general for disease control and environmental health at Indonesia's Health Ministry, told IRIN the call for "intensive surveillance" has been made to local health departments. They have also been called upon to immediately respond to "any cases of influenza-like illness and severe acute respiratory infection, which may be found in communities, hospitals and other health care providers, seaports and airports."

Vietnam

Vietnam, which does import live poultry from China, issued a government directive on 4 April reminding officials working near the border with China to be vigilant about keeping out illegal poultry imports and about inspecting all legal imports before distribution.

Vietnam's health ministry has designated laboratories to analyse blood samples of suspected cases.

The Institute for Tropical Diseases in the capital, Hanoi, has ready 8,000 doses of Tamiflu (reported by Chinese authorities to be effective in treating the infection at early stages), 23 respirators and two dialysis machines. On 5 April, the Health Ministry promulgated an action plan in the case of an H7N9 outbreak.

China

Local media reported that Hong Kong government officials have cautioned against panic-buying and confirmed the availability of 1,400 hospital beds to quarantine any patients infected with H7N9.

Following his visit to a local poultry market on 8 April, Hong Kong's secretary for food and health, Ko Wing-man, told reporters that officials in Hong Kong and mainland China are collaborating to boost surveillance of all poultry imports. All poultry are to receive rapid tests for H5N1 virus as well as H7N9 before being released to the markets for sales in Hong Kong.

(source: www.irinnews.org)

Paper Edition | Page: 4

Health Minister Nafsiah Mboi has said that the Education and Culture Ministry should address the spread of HIV/AIDS by providing proper sex and reproductive health education for schoolchildren.

Nafsiah said on Wednesday that cooperation between the two ministries was important, because the Health Ministry could only prevent the rising prevalence of HIV/AIDS on the downstream by promoting safe sex, while the Education and Culture Ministry was responsible on the upstream for disseminating information to youngsters.

"The Education and Culture Ministry is also responsible [for] sharing adequate knowledge on morality, religion and ethics, while the Health Ministry is responsible [for] introducing condoms, providing health services and an even distribution of antiretroviral treatment [ARV] for patients," she said.

Last year, following her appointment as Health Minister, Nafsiah said she would promote condom-use to youngsters, which led to rallies by those who considered it to be promoting indecency among the country's youth.

The prevalence of HIV/AIDS in the country continues to rise. A report by the Joint UN Program on HIV/AIDS (UNAIDS) disclosed that the rate of new HIV infections in Indonesia increased by more than 25 percent between 2001 and 2011.

"Our country has not yet been successful in combating the rising prevalence of HIV/AIDS, which is mostly transmitted through unprotected sex," Nafsiah said. "Most people who became infected were aged between 15 and 25. Therefore, [...] sex and reproductive education should be introduced before high school."

In November 2011, the ministry launched the Aku Bangga Aku Tahu (I am proud I know) campaign to improve the understanding of HIV/AIDS for people aged 15-24 years. Nafsiah pointed out that the campaign should also be supported by proper sex education at schools.

"With education, teenagers would have the mental toughness to say no to sex before marriage, unprotected sex and drugs."

Despite the fact that he once said it was unnecessary to teach sex education in schools, Education and Culture Minister Muhammad Nuh responded to Nafsiah's comments by saying that the new national curriculum to be implemented in July this year would integrate sex education within biology.

"Students will not only study reproductive organs [...] but also reproductive health and ethics [...] to prevent them from getting involved in sexual misconduct," he said.

He added that information about HIV/AIDS would also be covered in religion and civics (PPKN) subjects.

Nafsiah reflected that the integration of sex education within curriculum subjects would not be easy to implement.

"Most teachers still see sex as a taboo issue," Nafsiah explained. "When in fact, all people, including teenagers, deserve to be informed [about reproductive health] even though they are not yet married."

Nuh indicated that the ministry would offer training to teachers about integrating sex education in to their subjects and extra-curricular activities.

"Educational institutions should provide a private space for students to share their problems about this issue [sex]," Nuh stated. "There should be a commitment from the country's top officials to [set a good] example to the public."

(source; www.thejakartapost.com)

The Deputy Governor of Jakarta in Indonesia has indicated that the government will start to crack down on those who make fake ID cards, as many counterfeits have surfaced as of late.

"We have received numerous reports about people using fake ID cards to get KJS facility," Jakarta Deputy Governor Basuki T Purnama said in a report in Berita Jakarta. "We will criminally charge the makers as well as theusers of fake ID cards. We will investigate to find who the culprits are, because this is an obscure plot that involves individuals who work in healthcare sector. We will reveal it. The sanction has been stipulated in Criminal Code (KUHPP)."

Reportedly, samples were taken from ID cards used by residents to acquire free healthcare services, and of the sample of 15 cards, one was fake. As to how the card made it through verification is still under investigation.

Following this discovery, health centers will check ID card receipts against population and civil registration department databases to verify legitimate cardholders and recipients of Jakarta's healthcare system.

Counterfeiting, or even the bogus creation of cards with biometric details is something that has plagued other systems recently. Reported previously in BiometricUpdate.com, The UIDAI has cancelled 384,000 Aadhaar numbers of the total 410,000 numbers issued under the biometric exception clause. It has recently been discovered that many agencies had exploited the clause to generate money as for each successful enrollment, the agency is paid a nominal amount of money.

That being said, it is unclear who is producing the fake health ID cards in Indonesia, though as Basuki said, it's a plot that involves individuals who work internally in the healthcare sector.

Also in India, earlier this year, 150 bogus ration cards issued under the biometric system were discovered. These bogus cards were also created internally, as it was reported that they were produced by the food and civil supplies department deputy director in collusion with three fair price shop owners, as well as the biometric franchisee.

(source: www.biometricupdate.com)