Measles outbreaks spread across Europe: European Immunization Week offers chance to promote immunization

Thirty countries in WHO’s European Region have reported a marked increase in measles cases, with 6 500 so far in 2011. Epidemiological investigations and genotyping by laboratories confirm exportation of the virus among several countries in the Region and to other regions of the world. Outbreaks and the further spread of measles are likely to continue so long as people remain unimmunized or do not get immunized on time according to the routine immunization schedule. An increase in international travel during the Easter holidays will further increase the risk of exportation and importation of measles.
This provides a compelling reason to promote European Immunization Week (EIW), which runs from 23 to 30 April 2011. This year, more than 50 countries will take part in the initiative, the largest number since EIW began in 2005.
“With shared borders and considerable population movement, countries share health threats,” said Zsuzsanna Jakab, WHO Regional Director for Europe. “There is a need to create strong partnerships to prevent and control diseases, such as measles, in our Region. European Immunization Week reminds us that there is much to celebrate about the good work already done on immunization, but there also remains a great deal of work to do – and quickly.”
As part of the activities planned for EIW 2011, the WHO Regional Office for Europe will host a regional launch in Brussels, Belgium on 26 April at 10:00 (CET). Her Royal Highness Princess Mathilde of Belgium will open the launch, as WHO/Europe’s Special Representative for Immunization. The launch will be followed by a roundtable discussion focused on measles outbreaks that will involve representatives from several European countries that are currently experiencing outbreaks.
“EIW 2011 provides a platform for countries to come together and collaborate on joint planning of preventive measures and effective responses to the common threats we face from vaccine-preventable diseases”, said Ms Jakab. “Only through this kind of collaboration can we achieve the goals of boosting vaccination coverage and eliminating measles and rubella by 2015.”
In Belgium, the national surveillance system has reported 100 cases of measles so far in 2011. The country reported only 40 measles cases in the whole of 2010. In the hot spot of this outbreak, Ghent, the virus is affecting primarily children younger than one year (and therefore unimmunized) and students of anthroposophic schools (unimmunized due to beliefs).
France faces the largest outbreak, with 4 937 measles cases officially reported from January to March 2011, a figure almost equal to the total of 5 090 cases reported for whole of 2010. The national immunization system is implementing measures to get children vaccinated during the outbreak, including vaccinating infants at nine months of age, in line with WHO recommendations for a measles outbreak, and offering vaccine to all unimmunized and under-immunized people over the age of nine months. Other significant outbreaks are taking place in Serbia, Spain (Andalusia), The former Yugoslav Republic of Macedonia and Turkey.
Measles remains one of the leading causes of death among young children globally, despite the availability of a safe and effective vaccine. To prevent further exportation and importation of measles, both inside and outside the Region, WHO/Europe encourages health authorities of Member States to advocate for immunization before international travel and to make vaccinations available to travellers.
During European Immunization Week, other countries around the Region will take action on their own immunization priorities. Seven Member States (Azerbaijan, Kazakhstan, Kyrgyzstan, the Russian Federation, Tajikistan, Turkmenistan and Uzbekistan) will synchronize rounds of polio supplementary immunization activities with trivalent oral polio vaccine (tOPV) in April and May 2011. Many of these activities will take place during European Immunization Week and will be recognized as part of EIW activities.
In Albania, a subregional meeting will bring together representatives from more than 10 countries to discuss shared solutions to boosting immunization among migrant and vulnerable populations. Other Member States will participate in EIW through media and information campaigns, press conferences and immunization outreach via mobile immunization teams, as well as through a range of meetings, workshops, training events for health care workers and conferences.

**WHO Europe

La Clínica Universidad de Navarra, el hospital con mejor reputación asistencial de España

La Clínica Universidad de Navarra es por segundo año consecutivo el hospital con mejor reputación en el sector de la asistencia sanitaria, según el ranking elaborado por el Monitor Empresarial de Reputación Corporativa (MERCO) para el año 2011. La aseguradora Sanitas es la compañía que ocupa el primer lugar en esta clasificación sectorial y la Clínica Universidad de Navarra, el segundo como empresa y el primero como hospital.
El Monitor Empresarial de Reputación Corporativa es un instrumento de evaluación similar al que publica la revista Fortune en Estados Unidos. Desde el año 2000, MERCO se ocupa de medir la reputación de las empresas que desarrollan su actividad en España. Once años después es uno de los monitores de referencia en el mundo gracias a su metodología, ya que es el único del mundo con cinco evaluaciones, avalado por el Instituto de Análisis e Investigación. Por segundo año, MERCO 2011 cuenta con el Informe de Revisión Independiente que realiza la auditora KPMG, por lo que, según señala la organización, se convierte en el primer monitor de reputación verificado en el mundo. Toda la metodología, así como los criterios de ponderación de MERCO son públicos y pueden consultarse en la web: www.merco.info/es/

MERCO surge como una investigación universitaria en el seno de la cátedra del profesor Justo Villafañe en la Universidad Complutense de Madrid y se materializa gracias al acuerdo entre Villafañe & Asociados, el Grupo Vocento y Análisis e Investigación.

*Pie de foto: La Clínica Universidad de Navarra repite por segundo año como mejor hospital en el índice sectorial sanitario de MERCO.

El Instituto de Obesidad resalta la importancia de la Ley de Seguridad Alimentaria

El Instituto de Obesidad quiere resaltar la importancia de la nueva Ley de Seguridad Alimentaria y Nutrición, aprobada la semana pasada en el Congreso de los Diputados, como norma que persigue cuidar y mejorar los hábitos alimenticios de los menores españoles, limitando la venta de alimentos y bebidas con altos contenidos en ácidos grasos saturados, ácidos grasos trans, sal y azúcares en los colegios e institutos españoles. De este modo, la ley persigue, en última instancia, combatir la obesidad creciente en España, sobre todo entre los menores, cuya prevalencia se sitúa ya por encima del 30%. Para ello, también hace alusión a los menús escolares, que deben cuidar el consumo de alimentos y bebidas.

Así, los centros escolares proporcionarán a los padres o tutores información detallada sobre las calorías y nutrientes de los menús así como unas directrices para que la cena actúe de modo complementario a la alimentación recibida en el colegio. “Se trata de una norma fundamental para fijar hábitos adecuados entre nuestros menores. No debemos olvidar que España es el segundo país de la Unión Europea, detrás de Malta, con mayor porcentaje de niños obesos o con sobrepeso entre los 7 y los 11 años”, explica el doctor Adelardo Caballero, director del Instituto de Obesidad. La nueva norma prevé, también, que los responsables de supervisar los menús escolares sean profesionales acreditados en las áreas de Nutrición Humana y Dietética, con el objetivo de que la oferta alimentaria sea variada y adecuada a las necesidades nutricionales de los alumnos.

Además, la ley regula la publicidad de alimentos, estableciendo que los centros escolares estarán libres de publicidad salvo en aquellos casos en los cuales las autoridades escolares y sanitarias estimen que es beneficioso para el alumnado.“Todas estas medidas contribuirán a una mayor concienciación social entre los padres a la hora de hacer frente al problema de la obesidad infantil, que es, sin duda, una de las principales dificultades a las que debemos hacer frente. España ha triplicado en menos de dos décadas sus cifras de obesidad entre la población infantil y juvenil (2-24 años), con las graves consecuencias que de esto se derivan. Todos debemos tomar conciencia de ello y actuar para solucionarlo”,expone Caballero.
En este sentido, cabe resaltar, también, la importancia de la ley para combatir un marco social que ha derivado hacia la ocupación del tiempo libre a través del ordenador, la consola o el televisor, reduciendo la práctica y los tiempos de las actividades deportivas.Así, desde el Instituto de Obesidad se apuesta por una correcta alimentación en todas las etapas de la vida, especialemente durante la infancia, sin olvidar, tampoco, una adecuada práctica deportiva que compense el exceso de sedenterismo al que está expuesto, hoy en día, la población infantil y juvenil de nuestro país.

Peppermint earns respect in mainstream medicine

University of Adelaide researchers have shown for the first time how peppermint helps to relieve Irritable Bowel Syndrome, which affects up to 20% of the population. In a paper published this week in the international journal Pain, researchers from the University's Nerve-Gut Research Laboratory explain how peppermint activates an "anti-pain" channel in the colon, soothing inflammatory pain in the gastrointestinal tract.
Dr Stuart Brierley says while peppermint has been commonly prescribed by naturopaths for many years, there has been no clinical evidence until now to demonstrate why it is so effective in relieving pain.
"Our research shows that peppermint acts through a specific anti-pain channel called TRPM8 to reduce pain sensing fibres, particularly those activated by mustard and chilli. This is potentially the first step in determining a new type of mainstream clinical treatment for Irritable Bowel Syndrome (IBS)," he says.
IBS is a gastrointestinal disorder, causing abdominal pain, bloating, diarrhoea and/or constipation. It affects about 20% of Australians and costs millions of dollars each year in lost productivity, work absenteeism and health care.
"This is a debilitating condition and affects many people on a daily basis, particularly women who are twice as likely to experience Irritable Bowel Syndrome," Dr Brierley says.
"Some people find their symptoms appear after consuming fatty and spicy foods, coffee and alcohol, but it is more complex than that. There appears to be a definite link between IBS and a former bout of gastroenteritis, which leaves nerve pain fibres in a heightened state, altering mechanisms in the gut wall and resulting in ongoing pain."
Dr Brierley says the recent floods in Queensland and Victoria could result in a spike of gastroenteritis cases in Australia due to the contamination of some water supplies in affected regions.
He said case studies in Europe and Canada showed that many people who contracted gastroenteritis from contaminated water supplies went on to experience IBS symptoms that persisted for at least eight years.
There is no cure for IBS and it often comes and goes over a person's lifetime.
Apart from gastroenteritis and food intolerance, IBS can be brought on by food poisoning, stress, a reaction to antibiotics, and in some cases is genetic.
Dr Brierley is one of 25 researchers who work at the University of Adelaide's Nerve-Gut Research Laboratory, hoping to find cures and treatments for a range of intestinal diseases.

**Source: University of Adelaide

Sanidad financia la píldora tradicional y un anticonceptivo subcutáneo

La ley de Salud Sexual, reproductiva y de interrupción voluntaria del embarazo establecía que en el plazo de un año las autoridades sanitarias debían incorporar a la oferta de anticonceptivos financiados la llamada píldora tradicional, aquella que pese a llevar en el mercado español décadas (su comercialización comenzó ahora hace 51 años) debían ser sufragadas íntegramente por las casi dos millones de usuarias actuales. Y así lo hizo la comisión interministerial de Precios de los Medicamentos celebrada ayer por la mañana en la sede del Ministerio de Sanidad, que ha incluido entre los medicamentos que debe financiar el Sistema Nacional de Salud dos tipos de anticonceptivos orales (mensual y trimestral) y otro, que aún no está en el mercado, subcutáneo y que está especialmente indicado para las mujeres que no pueden tolerar el dispositivo intrauterino (DIU).
Los precios sin receta médica varían entre los 6,34 euros, los tratamientos orales mensuales, y 17,92 euros los trimestrales. El anticonceptivo subcutáneo costará 97 euros. Fuentes de Sanidad explicaron que si las usuarias acuden al ginecólogo para la correspondiente receta, el coste que deberán pagar se reducirá un 40 por ciento.
Las presentaciones orales a las que se ha fijado precio para ser financiadas son las mensuales de 21 y 28 comprimidos de Dretine y Dretinelle (varía la cantidad de etinilestradiol y drospirenona). “Estos dos genéricos tienen la misma composición que los medicamentos de precio libre y no financiados Yasmime y Yasminelle”, indican las citadas fuentes.
Asimismo, la comisión ha fijado el precio para su financiación por el SNS de un nuevo medicamento anticonceptivo en la forma de implante subcutáneo. Se trata del Implanon NXT que contiene un progestágeno, el etonorgestrel. “Es un implante que tiene que insertarse y extraerse en la consulta del ginecólogo con un aplicador en el antebrazo. Tiene una duración contraceptiva de tres años y el precio fijado es de 97 euros”, indican desde el Ministerio de Sanidad.

Este nuevo implante presenta ventajas respecto a otro implante ya financiado, entre ellas que es radiopaco, lo que posibilita su localización en el antebrazo a efectos de la extracción. Además, se presenta con un aplicador que facilita al médico su inserción subcutánea. La incisión es menos profunda que con el otro implante financiado y evita la intervención quirúrgica. Este método contraceptivo de larga duración (3-5 años) es una opción para mujeres que no toleren el DIU. La ministra Pajín justificó ayer la decisión de financiar nuevos anticonceptivos, además de que así lo establecía la ley, a que el Gobierno “tiene la responsabilidad de facilitar y poner al alcance de las mujeres todas las posibilidades para evitar embarazos no deseados”. Pajín asegura que el objetivo del Ejecutivo es “seguir trabajando” para que el descenso cercano al 4 por ciento de abortos que se registró el año pasado, principalmente por la dispensación de la píldora del día siguiente sin receta médica, no sólo se mantenga sino que disminuya.
La financiación de la píldora tradicional, el segundo método anticonceptivo más usado, era una demanda histórica de los colectivos femeninos, así como de expertos en contracepción. En un reciente encuentro de la Fundación Salud 2000, profesionales de distintas disciplinas reclamaron la financiación de los anticonceptivos orales para evitar embarazos no deseados.

**Publicado en "LA VANGUARDIA"

More accurate diagnosis of Alzheimer's

A new study from the University of Gothenburg, Sweden, shows how analysing spinal fluid can help to detect Alzheimer's disease at an early stage. The researchers behind the study hope that their findings will contribute to a greater international breakthrough for this type of diagnostic method. It all comes down to biomarkers, substances that are found at abnormally high or low levels in patients who go on to develop Alzheimer's. The most common biomarkers to be identified by the researchers in the spinal fluid of patients with Alzheimer's are proteins and peptides – short chains of amino acids.
"What's new about our study is that the biomarkers are really good, better than in the past, as the study was carried out extremely carefully with suitable participants via clinical trials and well implemented and controlled laboratory analyses," says docent Johan Svensson, who is working with professor Kaj Blennow's research group at the Sahlgrenska Academy, which has long been involved in researching the development of these biomarkers and advocating their use.
A total of 60 patients who were being investigated for dementia took part in the study, along with 20 healthy controls.
"We measured levels of the biomarkers in the spinal fluid and found that high levels of these substances confirmed the diagnosis of Alzheimer's with a high degree of accuracy compared with levels in healthy controls and patients with other forms of dementia," says Svensson.
"We also saw that patients who hadn't yet met all the clinical criteria for Alzheimer's had similar levels of the biomarkers in their spinal fluid to patients who had developed the disease fully."
The research group therefore concludes that these measurements can also be used to identify Alzheimer's during the early stages of the disease. In such cases, the biomarkers can be used to identify those patients with mild symptoms who are most likely to benefit from treatment.
"If a medication that affects the course of the disease does become available, it will probably be most effective during the early stages, and these biomarkers could be used in the development of such a medication," says Svensson.
The study will be published in the Journal of Alzheimer's Disease.

*Source: University of Gothenburg

Routine rotavirus vaccination in Brazil has reduced diarrhea deaths in children

Rotavirus vaccination in all areas of Brazil is associated with reduced diarrhea-related deaths and hospital admissions in children aged under five years, reports a study in this week's PLoS Medicine. Manish Patel from the Centers for Disease Control and Prevention in Atlanta, Georgia, USA, and colleagues show that these real-world impact data—what actually happens in reality rather than in strictly controlled clinical trial settings—are consistent with the clinical trials and conclude that their study strengthens the evidence base for use of rotavirus vaccination as an effective measure for controlling severe and fatal childhood diarrhea.
Brazil has a high incidence of diarrhea-related deaths and hospital admissions in young children and, in July 2006, the Brazilian Ministry of Health introduced rotavirus vaccination simultaneously in all 27 states, allowing the authors to conduct a ''before'' and ''after'' intervention analysis.
Using routinely collected national data, the authors found that in 2007 an estimated 80% of infants received two doses of rotavirus vaccine, and by 2009 that this proportion rose to 84% of children younger than one year of age. In the three years following the introduction of rotavirus vaccination, diarrhea-related mortality rates and admissions among children aged under five years were, respectively, 22% and 17% lower than expected, with a cumulative total of 1,500 fewer diarrhea deaths and 130,000 fewer hospital admissions.
Furthermore, the largest reductions in deaths and admissions were among children who had the highest rates of vaccination (less than two years of age), and the lowest reductions were among children who were not age-eligible for vaccination during the study period (aged 2𔃂 years).
The authors say: "This time-series analysis provides evidence of substantial reductions following the introduction of rotavirus vaccination of both diarrhea-related deaths and diarrhea-related hospital admissions from a large middle-income country in the Americas with both developing and developed regions."
They continue: "In middle-income countries that are not eligible for financial support from donors, the potential reductions in diarrhea-related hospital admissions and other health-care costs will be important for cost-effectiveness considerations to justify the purchase of these relatively expensive vaccines."

*Source: Public Library of Science