Category: Berita Internasional

A recent report issued by the World Health Organization reveals that antibiotic resistance is a major threat to public health.

Local health officials say it is important to be aware and take precautions, but people should not live in fear.

“It doesn’t need to be a major scare,” said James Clark, microbiology department manager at Alverno Central Laboratory in Hammond. “You can prevent the spread of anything you may be colonized with – of normal flora – by diligently washing your hands.”

Antibiotics are medicines that fight bacterial infections by killing bacteria or preventing them from reproducing, according to the Centers for Disease Control and Prevention. They do not fight infections caused by viruses, including colds and the flu.

Taking antibiotics when a person is sick from a virus may do more harm than good, because each dosage increases the chance of the bacteria building a resistance.

People can spread an infection antibiotics cannot cure, according to the agency.

Bacteria and organisms can mutate and change genetic makeup to produce compounds to inactivate the antibiotics.

“Over time, they become more and more resistant to the variety of antibiotics,” Clark said.

Resistance is a long-emerging trend.

“It’s accelerating its spread and its incidence,” he said. “In the early ’80s and ’70s, there was very little resistance to antibiotics.”

Pharmaceutical companies are running out of ways to create new, stronger antibiotics. Bacteria are quick to figure out when an antibiotic has been modified, Clark said.

“The killer bugs have a much higher incidence in undeveloped countries where antibiotics are not controlled,” Clark said. “In Mexico, you can walk into a drug store and tell them you have an infection and buy just about any antibiotic.”

Several factors contribute to the growing problem.

The rising use of antibiotics by physicians who are possibly over-treating patients, hospital-acquired infections and agribusiness adding antibiotics worldwide to animal feed are main contributors, said Dr. Alex Stemer, president of Franciscan Medical Specialists.

The World Health Organization report suggests tracking and monitoring the problem, preventing infections in the first place through better hygiene, vaccination and infection control in health care facilities and developing new diagnostics, antibiotics and tools so health care workers can stay ahead of resistance.

In many parts of the world, there has not been antibiotic stewardship, which would restrict people from over-using antibiotics, Stemer said.

Stemer described Chicago and Lake County as “hot zones” for resistance.

“Bugs are geographically localized,” he said.

Lake County has seen an emergence of CREs. CRE stands for carbapenem-resistant enterobacteriaceae, a family of germs difficult to treat because of their high levels of antibiotic resistance, according to the CDC.

“CREs are almost untreatable bugs with high mortality rates,” Stemer said. “We have to be very aware of this and attuned to this.”

Almost all area hospital have adopted a strict antibiotic policy for better stewardship, Stemer said.

“Throughout almost all of Lake County, these efforts have been in place for over a decade,” he said.

Resistance to one of the most commonly used antibiotics to treat urinary tract infections caused by E. coli is widespread.

Fluoroquinolones were first introduced in the 1980s and had virtually zero resistance, according to the World Health Organization. Now, there are countries across the globe where the treatment is ineffective in more than half of the patients, the group’s report states.

“Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill,” said Dr. Keiji Fukuda, assistant director-general for health security for the World Health Organization.

source: www.nwitimes.com

 

Three residents of Pekanbaru, Riau were placed in quarantine because they showed symptoms of Middle East Respiratory Syndrome (MERS) after two men died, likely from the infection, in Denpasar, Bali and Medan, North Sumatra.

“It’s true, there are residents who are suspected to have MERS,” Riau Health Agency head Zainal Arifin said, as quoted by the state-run Antara News Agency on Wednesday. “They’ve just returned from the minor hajj and have MERS indicators.”

The virus is similar to the one that caused Severe Acute Respiratory Syndrome (SARS), which emerged in China between 2002 and 2003, killing some 800 people. It was first detected in Saudi Arabia in 2012.

Saudi Arabia is a nightmare for epidemiologists because hajj pilgrims travel there, spend time in dense crowds, and disperse back to the far corners of the world with the potential to carry infections home. Hundreds of thousands of Indonesians make the journey each year.

The Indonesian government has urged the pious to postpone their pilgrimages until the extent of the outbreak is better understood.

Pulmonologist Azizman Saad, who treated two of the quarantined patients at Awal Bros hospital in Riau, said that they had high fevers and difficulty breathing.

“In the latest examination, the condition of the patients had improved and the fevers had dropped,” he said.

He said throat swabs and blood samples were undergoing tests at a Healthy Ministry laboratory.

“Today we’ve just sent the samples to Jakarta, so there’s no confirmation that the three are positive for MERS,” he said.

Two deaths

A man who died in Medan, North Sumatera on Sunday after returning from Saudi Arabia was likely the country’s first victim of the virus, a health official said on Tuesday.

The man’s family refused to allow doctors to take a saliva sample to test for the virus.

A second possible victim died in Bali on Wednesday morning, also after returning from Saudi Arabia.

The 50-year-old Nusa Dua resident, identified as A.S., passed away twelve hours after he was admitted to Sangha Hospital in Denpasar.

“The patient was treated for 12 hours and he did not survive,” Sanglah Hospital medical support team head Ken Wirasandhi told the Jakarta Globe.

The man sought treatment at Surya Husada hospital on Tuesday after he experienced breathing difficulties and coughing. His family said he had just returned from a pilgrimage to Saudi Arabia.

Ken said the patient suffered from chronic lung disease but that MERS might still have been the cause of death.

“We treated him as a suspected [MERS patient] because of his travel history,” he said, adding that the patient had been placed in quarantine.

The hospital had been through two previous MERS scares — a local resident and a Saudi Arabian tourist — but both tested negative, Ken said.

A.S.’s test results have not come in yet.

source: www.thejakartaglobe.com

 

For the first time ever, the World Health Organization on Monday declared the spread of polio an international public health emergency that could grow in the next few months and unravel the nearly three-decade effort to eradicate the crippling disease.

The agency described current polio outbreaks across at least 10 countries in Asia, Africa and the Middle East as an “extraordinary event” that required a coordinated international response. It identified Pakistan, Syria and Cameroon as having allowed the virus to spread beyond their borders, and recommended that those three governments require citizens to obtain a certificate proving they have been vaccinated for polio before traveling abroad.

“Until it is eradicated, polio will continue to spread internationally, find and paralyze susceptible kids,” Dr. Bruce Aylward, who leads WHO’s polio efforts, said during a press briefing.

Critics, however, questioned whether Monday’s announcement would make much of a difference, given the limits faced by governments confronting not only polio but armed insurrection and widespread poverty.

“What happens when you continue whipping a horse to go ever faster, no matter how rapidly he is already running?” said Dr. Donald A. Henderson, who led the WHO’s initiative to get rid of smallpox, the only human disease ever to have been eradicated.

The WHO has never before issued an international alert on polio, a disease that usually strikes children under 5 and is most often spread through infected water. There is no specific cure, but several vaccines exist.

Experts are particularly concerned that polio is re-emerging in countries previously free of the disease, such as Syria, Somalia and Iraq, where civil war or unrest now complicates efforts to contain the virus. It is happening during the traditionally low season for the spread of polio, leaving experts worried that cases could spike as the weather becomes warmer and wetter in the coming months across the northern hemisphere.

The vast majority of new cases are in Pakistan, a country which an independent monitoring board set up by the WHO has called “a powder keg that could ignite widespread polio transmission.”

Dozens of polio workers have been killed over the last two years in Pakistan, where militants accuse them of spying for the U.S. government. Those suspicions stem at least partly from the disclosure that the CIA used a Pakistani doctor to uncover Osama bin Laden’s hideout by trying to get blood samples from his family under the guise of a hepatitis vaccination program. U.S. commandos killed the al-Qaida leader in May 2011 in the Pakistani garrison town of Abbottabad.

At the end of last month, there were 68 confirmed polio cases worldwide, compared with just 24 at the same time last year. In 2013, polio reappeared in Syria, sparking fears the civil war there could ignite a wider outbreak as refugees flee to other countries across the region. The virus has also been identified in the sewage system in Israel, the West Bank and Gaza, although no cases have been spotted.

In February, the WHO found that polio had also returned to Iraq, where it spread from neighboring Syria. It is also circulating in Afghanistan (where it spread from Pakistan) and Equatorial Guinea (from neighboring Cameroon) as well as Nigeria, Ethiopia, Somalia and Kenya.

Officials also worry countries torn by conflict, such as Ukraine, Sudan and the Central African Republic, are rife for polio reinfection.

Some critics say it may even be time to accept that polio may not be eradicated, since the deadline to wipe out the disease has already been missed several times. The ongoing effort costs about $1 billion a year.

“For the past two years, problems have steadily, and now rapidly mounted,” Henderson said in an email. “It is becoming apparent that there are too many problems (for the polio eradication effort) to overcome, however many resources are assigned.”

Henderson and others have suggested the extraordinary efforts needed for polio eradication might be better spent on other health programs, including routine vaccination programs for childhood diseases. But he conceded that transitioning to a control program would be difficult. “If not eradication, how does one accomplish a ‘soft landing’ which could sustain the global program on immunization?” Henderson said.

Aylward said the WHO and its partners, including the U.S. Centers for Disease Control and Prevention, aren’t yet considering pushing back their latest deadline to eradicate polio by 2018.

CDC Director Dr. Tom Frieden said the reemergence and spread of polio out of Pakistan, Cameroon and Syria pose “a serious threat to our ability to eradicate polio.”

“Conflicts in many areas where polio is circulating are hampering efforts to vaccinate but success remains within reach,” Frieden said.

Still, the independent board monitoring the progress being made on polio has called for overhauling the program.

“Few involved in (polio eradication) can give a clear account of how decisions are made,” concluded a recent report by the group. “If a billion-dollar global business missed its major goal several times, it would be inconceivable that it would not revisit and revise its organizational and decision-making structure.”

source: www.huffingtonpost.com

 

The Indonesian government is warning pilgrims about a viral respiratory disease that spread rapidly in Saudi Arabia in recent weeks.

With an outbreak of the deadly Middle East Respiratory Syndrome coronavirus (MERS-CoV) reported in Saudi Arabia, Indonesian health officials are moving to prevent the infectious disease from spreading to the archipelago.

Hajj pilgrims from Indonesia in particular, could be exposed to the virus in crowds at Mecca and at other sites in the kingdom and then bring it home, officials warn.

On Friday (May 2nd), the Indonesian government announced it would work with Saudi Arabia and other nations to contain the health threat, state-run Antara reported.

The Health Ministry also notified Indonesians travelling to Saudi Arabia– particularly those going on minor Hajj pilgrimages– to take precautions against the disease, Antara quoted Health Minister Nafsiah Mboi as saying. Its symptoms are similar to bird flu or avian influenza.

As many as 138 cases of MERS-CoV were identified in Saudi Arabia between April 11th and 26th, according to the World Health Organisation (WHO). As of April 26th, WHO counted 261 lab-confirmed cases worldwide since September 2012, including 95 fatal ones.

Getting the word out

No MERS-CoV cases have been reported in Indonesia, but a 61-year-old Indonesian man living in Saudi Arabia died of the disease in a Jeddah hospital on April 27th, Tjandra Yoga Aditama, disease control and environment health director for the Health Ministry, told reporters April 29th.

The Indonesian government will follow up by tracking down people who interacted with this man, Tjandra said.

“We will continue this process for the next two weeks with the Indonesian Consulate in Saudi Arabia, as well as with the World Health Organisation. We will also have a meeting with future Muslim pilgrims from Indonesia to ensure their safe travel,” he told Khabar Southeast Asia.

Because as many as 250,000 pilgrims from Indonesia go on Hajj every year, the government is now busy informing those travellers about the risks of exposure to MERS-CoV, Religious Affairs Minister Suryadharma Ali said.

“With this huge number of people, every citizen must be aware of this virus. Every citizen is responsible to look after [his] health and resilience while performing Hajj,” he told reporters.

Despite the health scare, Jakarta resident Farida Manti plans to join the throngs of Muslims from across the globe converging on Mecca for the Hajj in early October.

“I only can take preventative measures to avoid this virus. However, I will not cancel the pilgrim trip. I have been planning this for years,” Farida, who plans to attend with seven relatives, told Khabar.

source: khabarsoutheastasia.com

 

Antibiotic-resistant “super bugs” have become a major threat to public health around the world, the United Nations says in a report released this week.

The U.N. World Health Organization report focuses on bacteria that have evolved to the point where current antibiotics no longer can combat them to treat the infections they’re responsible for.

The report is not a warning for a future time, U.N. officials say, because the threat is here today and puts persons of any age living in any country in the world at risk.

The time to act is now, they say.

“Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill,” said Keiji Fukuda, WHO Assistant Director-General for Health Security.

The United Nations’ concern over the issue is shared by a number of world health entities.

The U.S. Centers for Disease Control and Prevention has predicted “potentially catastrophic consequences” that could prevail if bacteria continue to evade treatment, noting super bug infections are involved in the deaths of around 23,000 in the United States annually.

Elevated resistance rates have been found globally in common bacteria involved in infections of the bloodstream, wounds, and the urinary tract.

Drug-resistant strains of bacteria that cause pneumonia and tuberculosis have also been seen worldwide, the U.N. report noted.

Pneumonia bacteria that are increasingly resistant to penicillin are now showing up in more than 50 percent of pneumonia cases in some areas of the world, it said.

In some parts of the Americas, the reported noted, as many as nine out of 10 infections involving Staphylococcus aureus are proving resistant to the antibiotic methicillin, a situation garnering its own acronym, MRSA.

As more bacteria show signs of antibiotic resistance, it raises the specter of diseases spreading more quickly and a corresponding higher death rate, Fukuda said.

“Effective antibiotics have been one of the pillars allowing us to live longer, live healthier, and benefit from modern medicine,” he said.

Changes are needed in the way in which antibiotics are produced, prescribed and used or more and more of them will become ineffective with disastrous implications for the future, he said.

source: www.techtimes.com

 

Geneva: A landmark challenge to Australia’s plain-packaging law for cigarettes and cigars at the WTO could have vast implications for how governments square the rules of trade with radical public health measures.

The case against Canberra has been spearheaded by cigar-producing nations Cuba, the Dominican Republic and Honduras, which say brandless packaging is an assault on their trading rights.

World Trade Organization chief Roberto Azevedo is expected within days to name a three-member panel of independent experts on the laws of commerce, who will then have six months to issue a ruling on whether Australia is out of line.

“Resolution of this dispute is critical because it will go a long way toward indicating whether the WTO will allow countries to take reasonable actions that are intended to protect the public’s health in an equitable and non-discriminatory fashion”, Michael Siegel, a professor at the Boston University School of Public Health, told AFP.

The WTO panel was authorised in late April by a closed-door meeting of its dispute settlement body.

The Geneva-based WTO ensures that its 159 member economies respect the rules of global commerce and its panels have the power to authorise counter-measures by the wronged countries, such as raising import tariffs on the guilty party’s goods.

An initial ruling would not be the end of the story, however, as the WTO dispute settlement process can grind on for years, amid appeals, counter-appeals and assessments of compliance with rulings.

Australia’s law was fought tooth and nail by the tobacco industry before and since its entry into force in December 2012.

But it is lauded by the World Health Organization and campaigners around the globe, who appreciate Canberra’s longstanding vanguard role in the fight against tobacco use — the leading global cause of preventable death, claiming six million lives a year worldwide.

– Key anti-smoking measure –

The legislation requires all tobacco products to be sold in drab green boxes, use the same typeface and contain graphic images of diseased smokers.

Canberra and its supporters argue that by hitting the industry’s branding power and by pushing stark messages, the law will help curb the number of smokers, notably young people who might otherwise take up the habit and thereby replenish the industry’s customer base.

“Tobacco plain packaging is a legitimate measure designed to achieve a fundamental objective: the protection of public health,” a spokesperson for Australia’s Department of Foreign Affairs and Trade told AFP.

“Australia will vigorously defend the challenges to tobacco plain packaging in the WTO. Australia is confident the tobacco plain packaging measure is consistent with WTO obligations,” the spokesperson said.

“Introducing tobacco plain packaging was the next logical step to restrict promotional material on tobacco products, closing one of the few remaining avenues for tobacco advertising in Australia.”

Australia maintains that because plain packaging treats all players equally, it does not constitute discrimination under the so-called TRIPS agreement covering trade and intellectual property rights.

The argument that the law breaches trademark rules also failed to convince the Australian High Court in a case brought by tobacco firms.

Canberra also accuses its rivals of dragging out the process of filing WTO complaints, thus discouraging other countries from adopting similar legislation until their compatability with trade rules is clear.

Plans to bring in plain packaging rules across the 28-nation European Union have been sluggish, but Britain, Ireland and New Zealand have now said they plan to forge ahead.

– ‘Detrimental to fair competition’ –

Honduras, Cuba and the Dominican Republic say the legislation harms their traditional cigar brands, thereby hurting farmers and hundreds of thousands of cigar-sector employees in the three countries.

“We will do everything we can in order to protect the jobs, export revenues and intellectual property rights that are invaluable to our developing economy,” said the Dominican Republic’s WTO ambassador, Luis Manuel Piantini.

“Plain packaging is not only an ineffective health policy, but also one that is detrimental to fair competition in the marketplace,” he added.

Fellow plaintiffs Indonesia and Ukraine, meanwhile, are both leading raw tobacco and cigarette exporters.

Analysts say the case tests the balance between TRIPS rules and measures that government argue are in the public interest, meaning a ruling could open a Pandora’s box of other cases.

TRIPS public interest exemptions have in the past been interpreted as being related to security or morals, rather than health or the environment, said Fredrik Erixon, director of the European Centre for International Political Economy.

“This is going to set a precedent,” he told AFP.

“What we’re talking about here is the extent to which a government actually can deny a company the right to communicate its own trademark, to distinguish its own goods from other goods.”

source: www.ndtv.com

 

Bacteria resistant to antibiotics have now spread to every part of the world and might lead to a future where minor infections could kill, according to a report published Wednesday by the World Health Organization.

In its first global survey of the resistance problem, WHO said it found very high rates of drug-resistant E. coli bacteria, which causes problems including meningitis and infections of the skin, blood and the kidneys. The agency noted there are many countries where treatment for the bug is useless in more than half of patients.

WHO’s report also found worrying rates of resistance in other bacteria, including common causes of pneumonia and gonorrhea.

Unless there is urgent action, “the world is headed for a post-antibiotic era in which common infections and minor injuries which have been treatable for decades can once again kill,” Dr. Keiji Fukuda, one of the agency’s assistant director-generals, warned in a release.

WHO acknowledged it couldn’t assess the validity of the data provided by countries and that many had no information on antibiotic resistance available.

Health experts have long warned about the dangers of drug resistance, particularly in diseases such as tuberculosis, malaria and flu. In a report by Britain’s Chief Medical Officer last year, Dr. Sally Davies described resistance as a “ticking time bomb” and said it was as big a threat as terrorism.

In 1928, Alexander Fleming’s discovery of penicillin revolutionized medicine by giving doctors the first effective treatment for a wide variety of infections. Despite the introduction of numerous other antibiotics since then, there have been no new classes of the drugs discovered for more than 30 years.

“We see horrendous rates of antibiotic resistance wherever we look…including children admitted to nutritional centers in Niger and people in our surgical and trauma units in Syria,” said Dr. Jennifer Cohn, a medical director at Doctors Without Borders, in a statement. She said countries needed to improve their monitoring of antibiotic resistance. “Otherwise, our actions are just a shot in the dark.”

WHO said people should use antibiotics only when prescribed by a doctor, that they should complete the full prescription and never share antibiotics with others or use leftover prescriptions.

source: latino.foxnews.com

The Health Ministry says an Indonesian citizen is suspected to have contracted the Middle East Respiratory Syndrome Corona Virus (MERS-CoV) and is now receiving a medical treatment at King Saud Hospital in Jeddah, Saudi Arabia.

“The Indonesian citizen has long been domiciled in Saudi Arabia and is not on an umroh (minor haj) pilgrim. The patient allegedly infected with the corona virus is being treated at King Saud Hospital, Jeddah, since April 20,” said the ministry’s director general of disease control and environmental health, Tjandra Yoga Aditama, in a statement in Jakarta on Tuesday, as quoted by Antara news agency.

There are no details on the current condition of the Indonesian, identified only by the initials NA, 61.

Tjandra said however, the ministry had continued to coordinate with related Saudi Arabian authorities to monitor the case.

“I talked directly to the Foreign Ministry’s director general for Asia-Pacific and Africa last night and have just been contacted by the Indonesian Ambassador in Saudi Arabia, confirming that there is a MERS-CoV-infected patient from Indonesia,” said Tjandra.

He said the ministry was closely monitoring the MERS-CoV cases that had been spreading in several Middle Eastern countries.

The World Health Organization (WHO) reported that a number of MERS-CoV cases were found in Mecca and Medina, two main cities for hajj and umroh pilgrims in Saudi Arabia.

“For Indonesia, this becomes very crucial because many umroh pilgrims from Indonesia visit those two cities during the pilgrimage season,” said Tjandra.

Saudi Arabia’s Health Ministry said Sunday that eight more people have died after contracting the lethal virus related to SARS as the kingdom grapples with the rising number of cases, The Associated Press reported.

It said it had detected a total of 16 cases of the MERS-CoV over the past 24 hours. The latest cases bring the number of people who have died after contracting the disease in Saudi Arabia since September 2012 to102. To date a total of 339 cases have been recorded in the kingdom. (ebf)

source: www.thejakartapost.com

 

According to the World Health Organization, nearly 6 million people, including 600,000 non-smokers who are exposed to tobacco smoke, die from smoking-related diseases annually. While cigarette consumption is declining in developed countries, the trend is the opposite in developing countries. According to the Campaign for Tobacco-Free Kids, tobacco kills 225,000 smokers in Indonesia every year.

Indonesia is known to be the world’s main producer of clove cigarettes, as well as one of the biggest tobacco consumers in the world. A lack of control and enforcement of laws related to tobacco by the government has made Indonesia a favorable market and home for major tobacco companies. Even worse, Indonesia seems to position itself as a champion of big tobacco companies’ interests.

At the international level, Indonesia, supported by the tobacco industry, initiated a claim against Australia’s laws on tobacco plain-packaging through the World Trade Organization’s dispute settlement process. Indonesia is the fifth country to do so. Other complainants that have brought the claim are Ukraine, Honduras, the Dominican Republic and Cuba. Under Australia’s plain-packaging laws, all tobacco products have to be sold in drab olive-green boxes, use a brand name displayed in a standard size and font but without brand imagery or logos, and contain graphic images of the health effects of smoking.

The Australian market is not profitable for Indonesia’s cigarette exports. The smoking rate in Australia has declined steadily in the past few years and Indonesia’s exports of cigarettes to Australia are minuscule. The involvement of Indonesia in this case is mainly to help big tobacco companies to prevent further losses. The action is expected to deter other countries that are considering similar schemes to reduce the appeal of smoking. Should Australia’s measures be found to be contrary to WTO law, tobacco companies will also benefit from Indonesia’s participation if Australia does not comply with adverse rulings.

Compared to other developing-country complainants, Indonesia has more power and capability in imposing retaliatory threats against Australia. However, imposing retaliation can economically harm both targeted and retaliating states. WTO retaliation is normally in the form of increasing tariff against the products of violator states. The imposition of retaliation may result in market distortion and welfare loss for consumers and local industries relying on the imported products in the retaliating state and exporters in the violator state.

Indonesia is the only country in Southeast Asia that has not ratified the WHO Framework Convention on Tobacco Control (FCTC). The FCTC is often praised as the world’s first modern public health treaty. The convention provides a set of rules that govern the production, sale, distribution, advertisement and promotion and taxation of tobacco. Today, there are more than 170 WHO member states that have become parties to this convention.

There have been debates over whether or not Indonesia should accede, but it was reported recently that there is no plan under President Susilo Bambang Yudhoyono’s administration to ratify.

The tobacco industry has claimed that ratifying the FCTC will have a negative effect on tobacco and clove farmers, factory workers and vendors. This claim is fatuous. Farmers generally do not rely only on one crop, and there are various alternatives. Additionally, the low price of cigarettes in Indonesia means that taxes are low and labor and materials are cheap. Farmers and factory workers remain vulnerable to economic fluctuations.

It is time for Indonesia to prioritize the well-being and health of its people. Weak enforcement and legislative control will only benefit large tobacco companies. Meanwhile, the costs of smoking to society are immeasurable. The fact that cigarettes often are the second-largest item of household expenditure after food for the poorest families in Indonesia is upsetting. Ratifying the FCTC should be a priority for the next government.

source: www.thejakartaglobe.com