RAISING THE ALERT LEVEL OF BIRD FLU PANDEMIC

WHO should consider raising the bird flu pandemic alert going by recent US actions and Indonesia’s cluster cases? The world may be much closer to a bird flu pandemic than when the first human case of H5N1 infection was diagnosed in late 2003. This could well be what the World Health Organization’s (WHO) recent flurry of activity to clarify its pandemic alert system may have implied. That clarification came after questions arose as to why even a large cluster of human cases in Indonesia seemed to not have nudged the pandemic alert level up a notch.
Most of Indonesia’s reported human cases have come from the Jakarta area or nearby locations In West Java, until its largest cluster to date which involved eight members of a family in North Sumatra. Of these, seven have died. This arguably called for the alert level to be increased to Phase 4. But the WHO did not do so. Instead, it set up a dedicated website about Indonesia’s bird flu situation.
Now consider two recent decisions made by the United States. On March 25, the US decided to use a strain of the virus isolated in Sumatra to make its new pandemic Vaccine. Then, it decided to send a supply of Tamiflu to Asia to prepare for an H5N1 outbreak.
Taken together, these actions suggest some urgency on the part of experts in the know. After all, the US has less of Tamiflu in stock-piles than most industrialized countries, so its deployment in Asia suggests that the situation here could be worse than is let on. Last week, the US Health and Human Services Secretary Mike Leavitt even said that while he refused to specify the amount or the location, he want to make clear that they are beginning to deploy it”.
Reading between the lines, the WHO’S recent attempt to “clarify” its pandemic alert
system suggests that H5N1 spread from human to human has already become more efficient. This is no scare-mongering either. Some folks who survived the Yogyakarta quake on May 27 are taking shelter in chicken sheds where they could be exposed to infected poultry. After all, in 2004, H5N1 was isolated from poultry in Yogyakarta. Meanwhile, in the rest of Indonesia, the virus is now spreading from the thousands of backyard farms found in both urban and rural areas, including Jakarta, where free-range chickens are to be found in many of its neighborhoods.
WHO epidemiologist Steven Biorge told reporters in Jakarta last week: “There is a pandemic in birds.” It is already entrenched in the environment in Indonesia, he added, which is why low-risk groups — not poultry workers — including children and students, are making up to 50 per cent of the cases. He also noted that there was a practice that promoted the bug’s spread — trade in chicken droppings as fertilizer. It is big business in Indonesia but one that helps move the bug across the far-flung archipelago. And that is talking only about the risk of spread from poultry to humans. Reading between the lines, the WHO’S recent attempt to “clarify” its pandemic alert system suggests that H5N1 spread from human to human has already become more efficient.

For in the Sumatra cluster, spread from person to person to person, a three-person chain had been observed for the first time. Despite acknowledging so, however, the WHO has thought best not to raise the alert level, even though, by its own recent explanation, this would be necessary when “small cluster(s)” of human cases appeared.
Since June 3, a family in Pamulang, West Java, with five members who have already fallen ill looks set to become Indonesia’s second-largest cluster to date. Perhaps it is already time to raise the alert level.
The implications for neighboring countries, Singapore included, are enormous if we are that much nearer to a pandemic.
Public health education campaigns may have to be stepped up, businesses might have to start dry runs of their contingency plans sooner rather than later, checks at border entry points might have to be tightened, and so on. While GlaxoSmithKline broke ground for a huge vaccine manufacturing facility in Singapore this week, it will be ready only in 2010. We can only pray that it will come online in time to help us combat a pandemic.

Virgin Coconut and its Health Benefits

The coconut seems to be enjoying resurgence despite all the bad press on saturated fat. Advocates of virgin coconut oil say it helps them lose weight, improve skin tone, have more energy and even reduce their cholesterol ratio. In short, they say it is more than a miracle health supplement. But mainstream medicine says the evidence for the heart benefits of coconut oil, which is 92 per cent saturated, is lacking and the effects on cholesterol are not proven. Heart associations across the board recommend that people with high cholesterol modify their diets and lifestyles as a way to prevent heart disease. Yet, virgin coconut oil has emerged as a hot new supplement on the natural foods circuit. Coconut oil producers in the region are reporting increased demand from the United States and European markets for virgin coconut oil.

The role of fat in heart disease has always been controversial, but the discovery that margarine, with its trans fats, is more likely to harm than protect was indeed one of the biggest nutrition shocks of the decade. Hydrogenated vegetable oils have now emerged as the new villains in raising cholesterol levels and causing heart disease. Therefore, the idea that not all saturated fat is bad for you has also gained credence.

Dr Bruce Fife, the US-based naturopath and author of a book called The Coconut Oil Miracle, said coconut and coconut oil had been wrongly labelled as unhealthy for decades. Not all saturated fatty acids act in the same way. The fat in coconut oil is different from most other fats and has many health giving properties. Coconut oil is a rich source of lauric acid, which has proven anti-bacterial, anti-microbial and anti-viral properties. Lauric acid boosts immunity, has antioxidant properties and is being investigated in reducing viral load in HIV patients. He said the classification of oils by the levels of saturated fat is only part of the story. One should also take into account the size of the carbon chain in the fatty acid. Most of the oils and fats we consume are long-chain fatty acids. Coconut oil is the richest source of medium-chain fatty acids, which actually behave very differently from the long-chain versions. Medium-chain fatty acids in coconut oil, he said, boost the body’s metabolic rate and promote weight loss. Medium-chain fatty acids are broken down immediately in the liver to produce energy and are not stored as fat. In his naturopathic practice in Colorado Springs, Dr Fife uses coconut oil to treat fungal infections, thyroid problems, digestive problems and common infectious diseases.

Mr Marcone Massimo, adjunct professor of food science at Ontario Agricultural College, Canada, during a press conference said that coconut flour, which has a lower glycemic index, could be used as a substitute for regular flour in health products. Glycemic index, or GI, is a dietary index that ranks carbohydrate-based foods according to their effects on blood sugar. Foods with lower’ GI may be help diabetics keep their blood sugar levels from fluctuating too much. White the energy-giving and virus-fighting properties of coconut are riot under debate, the effects on cholesterol and heart disease are. There has been fierce debate on both sides of the saturated-fat issue, especially now that trans fat has been singled out as the nastier fat.

A recent study published in the American Journal of Clinical Nutrition reviewed over 60 controlled trials on the effect of dietary fatty acids on the ratio of total cholesterol to HDL, or good cholesterol. The authors consider this ratio a more specific indicator of the risk of developing heart disease than total cholesterol alone. The study showed that lauric acid in coconut oil increases total cholesterol more than all other fatty acids. But much of the increase was attributed to the increase in HDL. Lauric acid, therefore, had a positive effect on the cholesterol ratio as a whole. But it also raised LDL cholesterol more than any other fatty acid. Despite the positive effect on HDL, the study authors said that coconut fat may promote heart disease through other pathways and that more studies are needed of its effect on heart disease. The burning question for most people is whether they should believe that virgin coconut oil is as miraculous as its marketers’ claim it is.

There is not enough evidence to prove that medium-chain saturated fats can reduce heart attack risk. On the other hand, there is not enough evidence to prove that coconut oil promotes heart disease either. A large study of the populations on the Polynesian islands of Pukapuka and Tokelau, whose diets are high in coconut, showed that heart disease was uncommon among them. In fact, the islanders whose diets were high in saturated coconut fat but low in cholesterol had healthy levels of total cholesterol with higher good cholesterol levels than New Zealanders. But contradictions to the island population study can be found elsewhere, nutritionist Anna Jacob says that a look at the South Indian state of Kerala might put the coconut controversy in context. Kerala is the coconut capital of India and it also has the highest rates of heart disease. It is possible to argue that Indians are genetically predisposed to heart disease, but a diet high in saturated fat as well could heighten that risk. Miss Jacob clarified that she was not advocating staying away from coconut oil altogether, but was only urging caution until more is known about its effects on cholesterol and heart disease. If you are a vegetarian and coconut is the only source of fat in your diet, it may not do you harm. But today, we have so many different sources of fat. Adding coconut fat to this may be risky, since we are still learning about the interaction between diet and genes, she said. But while the heart-protective properties of coconut oil are still in question, other health benefits have been proven. It has been used in traditional cultures for hundreds of years to treat eczema and other skin problems.

Coconut oil contains various useful elements. Butyric acid is used to treat cancer, lauric and myristic acids to treat viral infections and mixtures of medium-chain fats are sold for weight loss. Medium-chain fats show promise for the nutritional support of some premature infants, surgical patients and the critically ill, particularly those unable to absorb adequate nutrition through their intestines. Medium-chain fats have been shown to be useful in treating drug-resistant epilepsy, in one trial of 50 children, eight achieved complete control of their seizures (four without the further use of anti-convulsant drugs). In another trial, five out of 17 people with drug-resistant seizures who were treated with medium-chain fats achieved complete control of their seizures with the lower consumption or discontinuation of drugs. There is also preliminary evidence that medium-chain fats may have some positive effects on immunity and some anti-cancer benefits.

Experts say that great caution should be exercised in the use of medium-chain fats for those with diabetes, acidosis, ketosis and cirrhosis. Adverse effects are rare but high doses can cause diarrhea, nausea, vomiting, irritability and intestinal cramping.

Thalassaemia - A Blood Disorder

Thalassaemia is an inherited form of anaemia caused by faulty synthesis of haemoglobin in the blood. The genetic blood disorder thalassaemia major needs regular blood transfusion to survive. It is a medical condition where the blood is unable to produce normal, functioning haemoglobin in the blood. Haemoglobin carries oxygen from the lungs to various parts of the body, and if it is not working properly, it will leads to severe anaemia and therefore needs blood transfusion to keep life going. Beside blood transfusion, daily oral intakes of Deferiprone or intravenous injections of Desferrioxamine (Desferal) is required to prevent overloading of iron from the blood transfusion. Overloading of iron in the blood can lead to organ damage or premature death.