Archive for category: Health

Information and stories on health topics.

Medical Crisis in Gaza By Hamas

crisis in gaza
Since the kidnapping and killing of three Israeli teenagers last month by the terrorist organization Hamas, tensions between Israel and Gaza have skyrocketed. Israel retaliated this week by launching missiles into Palestinian territory, killing over 120 Palestinians, including many women and children, and injuring over 800.

Residents are warned before the bombings, but local hospitals in Gaza are still overwhelmed and unable to effectively treat the inundation of patients.

Emergency rooms across the territory are crowded and patients have resorted to sleeping on hospital floors. In Al-Shifa hospital, the central medical center in Gaza, all 12 beds in the intensive care unit are in use.

Gaza launched numerous missiles into Israel this week as well.

“Gaza is completely missing about 30 percent of essential drugs,” said Ashraf al-Qedra, Gaza’s Health Ministry spokesman.

The numbers of medicines, gloves, urine catheters and other medical supplies are dwindling.

Fuel shortages have further limited what medical treatment Palestinians have access to. Only half of the ambulances have enough fuel to run, and hospital lights may fail within the next few days as generators give out. This puts patients who rely on incubators, dialysis machines and other lifesaving equipment at especial risk.

As violence continues to devastate the Israel and Palestine region, there is a beacon of hope, a potential for peace; many injured Palestinians have been treated in Israeli hospitals, despite the airstrikes on both sides. If other Palestinians and Israelis overcome the differences of nationality and religion, the death toll may finally slow.

– Adam Kaminski

Sources: Al Jazeera America, CNN, New York Times
Photo: JFJFP

Neeti Kailas: Preventing Newborn Hearing Loss

Indian entrepreneur Neeti Kailas has developed a new device for detecting hearing loss in early stages of a baby’s life. Kailas states that her ultimate goal with the new technology is to “prevent late detection of hearing loss” that has already resulted in speech problems for countless Indian youth.

Hearing is crucial to the cognitive, language and speech development of a child, and early detection is the key to preventing speech loss in adolescents. There is currently no standard screening system in the Indian healthcare system that exists, and hearing impairment goes undetected for anywhere between 100,000 to 150,000 Indian babies each year.

“At age 3, people realize ‘Oh my god, she’s not saying anything. By the time the parents go to the pediatrician and get sent to someone else and then finally she gets a hearing screening, she’s already lost speech,” Kailas said. “Speech loss is preventable if a baby is diagnosed early enough and given the right rehabilitation.”

Kailas is the director and co-founder of Sohum Innovation Lab with Nitin Sisodia, her husband, an engineer. Sisodia won the Stanford-India Biodesign fellowship in 2010, funded by the Union government’s department of biotechnology, in partnership with the All India Institute of Medical Sciences and Indian Institute of Technology in New Delhi, the Indo-US Science and Technology Forum and American University.

Four years ago, Sisodia’s fellowship fueled this power couple’s journey to health centers in Delhi and surrounding areas to study needs. Kailas and Sisodia recognized infant hearing loss as a relevant problem with a feasible solution, so they made it their organization’s focus. The new auditory screening device is the Sohum Innovation Lab’s first product, currently in its prototype stage, but developing quickly.

Sohum Innovation Lab is exactly what it purports itself to be: innovative. Their new technology addresses cost, usability and environmental factors that currently limit reliable testing in India and other developing nations. Domestic manufacturing and the lack of disposable parts will severely reduce production costs and drive the price down. The instrument will cost as little as one fifth the price of instruments in use now, which range between $12,000 and $29,000. It is also battery powered, portable and designed to be intuitively operated by untrained users.

The instrument is impressively non-invasive and fits easily over the patient’s cranium, like a headband. Non-stick electrodes on the scalp measure the auditory brain-stem response (ABR) to auditory stimuli. If the patient’s brain shows no response, there is indication that the child suffers from a hearing disorder.

One of the most innovative additions to Kailas’ device addresses the typically noisy setting of an Indian hospital. Sohum’s new testing system incorporates noise-cancelling technology that foreign-designed systems, which often result in false positives, lack.

Kailas was one of the five winners globally of the 2014 Rolex Awards for Enterprise, prized 50,000 Swiss Francs ($56,000). The prize money will propel the device into clinical trials for sensitive fine-tuning before it hits the market. The Sohum Innovation Lab hopes to have its product on the market by 2016, giving thousands of Indian children a chance at a brighter (and louder) future.

– Edward Heinrich

Sources: Washington Post, Live Mint, Daiji World
Photo: Rolex

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UN Votes to Send Aid to Syrian Rebels

On July 14, the United Nations Security Council voted unanimously to send cross-border humanitarian aid to areas of Syria controlled by Syrian rebels in desperate need of food and medicine. This decision was made despite strong objections from the Syrian government.

The vote came out 15 to 0, meaning that all members of the U.N. Security Council agreed on this decision. The unanimity is notably rare in U.N. council meetings.

Approximately 10.8 million Syrians—nearly half of the country’s population—are in need of food, medicine and other supplies due to Syria’s on-going war. This is a huge increase from about one million citizens in 2011. And nearly half of these people live in rebel-held areas.

The conflict in Syria has thus far left 150,000 people dead, and created widespread instability in the country. U.N. officials refer to this situation as one of the world’s biggest humanitarian disasters.

Until now, nearly 90 percent of aid from the U.N. Security Council was appropriated for those in government-controlled regions. The new initiative will bring aid to an additional 1.3 million people in need.

Russia and China threatened to veto the resolution, resulting in a weaker compromise than many Western nations had hoped for, according to the BBC’s Nick Bryant. The Syrian government also warned the U.N. that it would consider such resolutions a violation of national sovereignty.

Prior to this vote, aid going to Syria first went through the nation’s capital of Damascus, on President Bashar al-Assad’s orders. This meant that Assad gained control of all aid coming in. Many believed this aid was used as leverage against the rebel efforts, since very little of it ever made it to their held regions.

U.N. ambassador from Luxembourg, Sylvie Lucas, said that Assad’s denial of supplies to rebel-controlled regions was the main reason the resolution came about.

She said that under the new resolution, “the consent of the Syrian government will no longer be necessary.”

The new resolution authorizes U.N. agencies and other aid organizations to send humanitarian assistance using routes across four conflict border lines in Turkey, Jordan and Iraq. These routes will allow the U.N. to monitor aid shipments in these three countries before they are sent across the Syrian border. These routes will come in addition to those previously used for aid.

Nongovernmental organizations such as Save the Children and Oxfam welcomed the resolution, and will likely assist the U.N. in carrying it out.

Bashar al Jaafari, Syria’s U.N. ambassador, was strongly opposed to the measure. He was invited to attend the vote, and was sharply critical of the resolution, citing Syria’s efforts to accommodate international relief. He also stated that Turkey, Saudi Arabia and Qatar—countries advocating humanitarian access—were in large part responsible for empowering Islamic extremists destabilizing Syria and Iraq.

“First and foremost, terrorism must stop for the humanitarian situation in Syria to improve,” he said.

Despite opposition and warning from Syrian government officials, humanitarian assistance in rebel-held areas will be implemented in the near future.

– Paige Frazier

Sources: BBC, The New York Times, CBC News
Photo: NPR

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Remote Control Contraceptive

remote control contraceptive
In less than four years, women could be receiving a remote control contraceptive. The implanted microchip provides a reliable dose of hormones every day for 16 years, which could make family planning and contraception much easier for women in the developing world.

The Bill & Melinda Gates Foundation-backed project is based off of research done in the 1990s by Professor Robert Langer of MIT. Langer leased his technology to MicroCHIPS, a company currently developing implants to release osteoporosis treatments into the body over regular intervals.

The microchip, roughly the size of a Scrabble tile at 20mm x 20mm x 7mm, has wells filled with the hormone levonorgestrel. When activated, a small electric charge triggers every day, melting the covering of the wells and releasing 30 micrograms of levonorgestrel into the body. The wells are covered with a mixture of titanium and platinum, which causes no harm to the body when melted.

The chip can be implanted in the abdomen, upper arm or buttocks. The process to inject the contraceptive is fairly simple, taking less than 30 minutes and using a local anesthetic.

Since many women may want to take a break from the birth control before the end of 16 years, the remote control allows them to switch their treatment on and off themselves. This puts power in the hands of women. There are security issues, such as the possibility for hacking, which could be a major problem if women do not realize their dosing has been tampered with. MicroCHIPS has promised that the control must be used right next to the skin, so no one can interfere with a women’s contraception without her knowledge.

Another issue is that injectable contraceptives do not protect against STDs, and some have even been shown to increase the chance of contracting HIV. Also, becoming fertile again after using hormones can take a while. These issues have not been addressed by the company.

This is not the first injectable contraceptive, but it lasts the longest. The most durable contraceptive on the market right now lasts only five years. This microchip could simplify women’s lives all across the developing world. Injectable contraceptives are already popular in these countries, so making the switch would be easy to do.

Burkina Faso will soon implement the contraceptive Sayana Press, as will Niger, Senegal and Uganda. Sayana Press only lasts three months, and while the countries will provide delivery services for women who cannot come to hospitals or clinics every few months, it is still difficult to reach every woman in need of an injection. Some women may also forget to get a new injection.

South Africa currently has a system for a three-year contraceptive. The device is similar, except it cannot be remotely controlled and it must be replaced sooner. It is a Silicone, matchstick-sized implant made by Merck and marketed as Implanon. The Stanger Hospital in South Africa actually ran out of the implants and is struggling to provide enough for the women who want the contraception.

There is a large desire for this kind of contraceptive in the developing world, and a controllable device could be the key to making family planning easier for women.

There are also further applications for implantable drug dispensers beyond female contraception. The technology could be applied to other treatments, like MicroCHIPS’ work with osteoporosis treatment. If trials prove successful, it is possible that many other drugs could be put in the wells and released periodically.

The contraceptive will be submitted for testing in 2015, and by 2018 the microchips could be on the market. The claim is that they will be “competitively priced,” making the technology a real possibility for women around the world to have a worry-free method of birth control.

– Monica Roth

Sources: Elite Daily, Extreme Tech, The Guardian, CNet, Africa Science News, Daily Maverick, MicroCHIPS
Photo: The Telegraph

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Medical Aid To Palestine Due to Violence

The World Health Organization warns of the critical medical situation within Palestine and the Gaza Strip. The four days of rocket attacks from both Palestine and Israel has left those in Gaza in a critical state.

The recent violence has increased medical emergencies, and the Palestinian healthcare system is struggling to cope with the new burden. WHO reported that large amounts healthcare debt, in addition to medical and fuel shortages, have severely crippled health services in Gaza, the West Bank and East Jerusalem. Unless the international community takes immediate action, Palestinians will not be able to have their basic medical needs met.

With the most recent strikes by Israel on Gaza on June 11, 2014, the death toll in Palestine has reached nearly 100. Over 570 people have been injured since the conflict started on July 6, 2014. Those in Gaza continue to fight back, and it appears that the conflict will only continue to escalate.

The fighting has weakened the already inadequate medical system in Palestine, and especially in Gaza. WHO is now making an international plea for funding and medical aid to help Palestinians receive urgent medical care.

To make matters worse, the hospitals in Gaza only have 10 days worth of fuel left to run the buildings. The lack of fuel is alarming, as the fighting continues to interrupt electricity. In an effort to conserve money, the hospitals are only performing operations on those in life-threatening conditions. Those with less threatening, but still serious, medical problems cannot receive treatment.

The Israeli airstrikes damaged a hospital, three clinics and a water sanitation facility in a refugee camp in Gaza, according to the Palestinian Ministry of Health. The organization reports that hospitals in East Jerusalem are struggling financially because of unpaid referral services, and there is a shortage of medications in both the West Bank and Gaza.

While the attacks on Israel have left multiple civilians injured, the poorer and militarily inferior Palestine is grappling to provide essential services for those injured and affected by the conflict.

The Palestinian Ministry of Health, with backing from WHO, is making a pressing appeal for $40 million in aid, enough to provide critical medical supplies for six months. The United Nations has also stepped in to help organize the relief effort.

The hope is that with numerous aid agencies involved in bringing the severity of the situation in Palestine into the international spotlight, hospitals will receive the supplies they need, and victims of the fighting will receive the care they desperately require.

– Kathleen Egan
Sources: The New York Times, WHO, Ma’an News Agency
Photo: The New York Times

10 Facts About Global Health

Global health issues are being addressed now more than ever, here is a list of 10 facts about global health that show how far the world has come and how much more progress needs to be made.

1.

Around the world, cardiovascular diseases are the leading cause of death. They account for approximately 30 percent of all deaths. At least 80 percent of these deaths that occur prematurely could be prevented by adhering to a healthy diet, getting regular physical activity and avoiding use of tobacco products.

2.

Improving sanitation, water supply, personal hygiene and management of water resources could prevent nearly 10 percent of diseases and 6.3 percent of all deaths around the world.

3.

Currently, approximately 6.6 million children under the age of 5 die annually. By the year 2025, it is estimated that there will still be five million deaths among this age group. Ninety-seven percent of these deaths will occur in developing countries, and most will be a result of infectious diseases like pneumonia and diarrhea or malnutrition.

4.

Sixty-five percent of people around the world live in a country where overweight and obesity kills more people than underweight.

5.

It is estimated that 39.5 million people worldwide are living with HIV or AIDS. Sub-Saharan Africa accounts for about 70 percent of the cases.

6.

There are about 200 million women around the world who do not have access to effective family planning methods, like reproductive information and care services, despite the desire to use these resources. If these resources can be more widely accessed, unplanned pregnancy rates would drop, unsafe abortions would become less frequent and maternal and infant deaths would be reduced significantly.

7.

Preterm birth, birth before 37 weeks of pregnancy, is the most common cause of infant mortality globally. Fifteen million babies are born preterm every year and more than one million of them will die.

8.

The global average life expectancy has increased significantly over the past 20 years. The overall average is now 70 years; in low-income countries it is 62 and in high-income countries it is 79.

9.

Eight hundred women die everyday due to complications related to pregnancy and childbirth.

10.

The global population today is made up of 613 million children under age five, 1.7 billion children and adolescents between the ages of 5 and 19, 3.1 billion adults between the ages of 20 and 64, and 390 million elderly over the age of 65.

— Hannah Cleveland

Sources: WHO 1, WHO 2, Facing the Future, Bill & Melinda Gates Foundation
Photo: WHOIAA

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Five of the Most Common Killer Diseases

The Global Post has drawn up a list of the world’s biggest killers by using information from the World Health Organization. Below are a list of some of our most common killer diseases per country.

5. Cirrhosis of the Liver

Caused by excessive drinking, the disease is unique to Mexico as the only place in the world where it is the primary cause of death. Yet the disease is nothing to roll your eyes at: caused by healthy liver tissue being replaced by scar tissue, the scar tissue blocks the flow of blood, nutrients and other important proteins through the liver. Cirrhosis of the liver is the 12th leading cause of death by disease in the world — except for in Mexico, where it’s number one.

4. Tuberculosis

Tuberculosis is often thought of as a disease of the past, but it is still affecting millions of people around the world. In fact, it’s on the rise — the World Health Organization reports around 500,000 new TB cases each year, and it is second only to AIDS as an infectious killer worldwide. A bacterial infection that can spread through the lymph nodes and blood stream to any other part of the body, TB is the leading cause of death in areas such as Pakistan and North and South Africa.

3. HIV/AIDS

Despite the enormous progress made at slowing down the spread of HIV/AIDS, it is still the leading cause of death throughout most of Africa. Just two years ago, around 25 million people — roughly 70 percent of the global total — were living with HIV/AIDS in Sub-Saharan Africa, and an estimated 1.6 million new HIV infections and 1.2-million AIDS related deaths were reported that same year. In areas such as South Africa, Botswana and Swaziland, the percentage of HIV-prevalence is as high as 26.5 percent.

2. Cancer

It would be hard to find someone not somehow directly affected by cancer. As the second-leading cause of death in the world, cancer has certainly taken its toll — especially in areas such as France, the Iberian peninsula, Austria, Switzerland, the Netherlands and Denmark, where cancer (primarily lung and throat) is the leading cause of death. Classified as the rapid growth of cells, there are more than 100 types of cancer that we currently know about.

1. Heart Disease

It’s no surprise that heart disease tops the list as the world’s deadliest killer, but it is a little shocking to see the massive list of countries where heart disease outranks all other diseases. These countries include Canada, the United States, Russia, Australia, most of South America and part of Africa, to name a few. From first- to third-world countries, heart disease continues to remain the deadliest disease in the world.

– Nick Magnanti

Sources: International Business Times, WebMD 1, WebMD 2, The New York Times, Medical News Today, AVERT, CDC
Photo: Diseases-Causes-Cure blog

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Cholera in the Developing World

In the 1800s, cholera emerged from its place of origin in India and ravaged the world. Millions have died in the seven cholera pandemics that have occurred since the first appearance of the disease. While it has been eradicated in some regions, others continue to suffer from recurring epidemics.

Cholera is rarely seen in industrialized countries due to proper sanitation systems. Additionally, the World Health Organization (WHO) states that up to 80 percent of cholera cases can be “successfully treated with oral rehydration salts.” However, the bacteria that causes cholera can easily “continue to thrive” in areas with poor sanitation and overcrowded housing. While the developed world may not face the threat of cholera, in recent years, developing nations have seen deadly outbreaks.

Cholera is an “acute diarrheal disease,” which, in severe cases, can cause “profuse watery diarrhea,” vomiting, and muscle cramps. The Centers for Disease Control and Prevention reports that even more severe symptoms include “acute renal failure, severe electrolyte imbalances and coma.” The disease is potentially fatal just hours after developing symptoms.

The severity of cases often varies, says the WHO. Of those infected with the bacteria, 75 percent do not develop symptoms. While this may seem like a non-issue, the bacteria continue to exist in their fecal matter for up to two weeks. Without proper sewage sanitation, others may come in contact with the bacteria as well.

The remaining 25 percent of people infected do develop symptoms. However, 80 percent of those with symptoms only have mild or moderate ones. The other 20 percent of people experience serious, potentially deadly symptoms.

In 2008, the Vietnamese city of Hanoi experienced a cholera outbreak that produced upwards of 2,490 cases. The outbreak was attributed to sewage from septic tanks contaminating lakes where people sometimes wash food. Additionally, street food stalls and “dog meat” restaurants were closed down due to improper sanitation. Thirty lakes in Hanoi had to be sanitized due to the presence of cholera bacteria.

A cholera outbreak in Haiti, which began in 2010, has claimed 8,562 lives, according to the New York Times. Although relief efforts have reduced the number of cases, “clean drinking water and sanitation remain as scarce as when the epidemic began.” The number of cholera treatment centers has shrunk from 120 to 40, and the number of patients dying in treatment centers is rising. Doctors fear that the rainy season will cause the number of cases to skyrocket.

Medical News Today reports the ominous prediction that a cholera outbreak will strike Iraq. “Cholera is endemic in northern Iraq” already, says the report, and with the number of displaced people and refugees rising, the risk is even higher. Syrian refugee camps are overflowing with people, putting the water and sanitation standards at stake.

Two oral cholera vaccines exist, though the WHO has never recommended the vaccine “due to its low protective efficacy and the high occurrence of severe adverse reactions.” The best way to handle an outbreak, says the WHO, is to provide “prompt access to treatment, and to control the spread of the disease by providing safe water, proper sanitation and health education.”

These solutions, however, need to be applied in areas with the greatest need. The United Nations has come under fire for its response to the cholera outbreak in Haiti. The UN has failed to raise the amount of money necessary for vaccinations. While that would provide some immediate relief, Haiti also lacks the $2 billion necessary to construct safe water and sanitation services. Lasting relief is still in the distant future for the slowly recovering nation.

– Bridget Tobin

Sources: WHO 1, WHO 2, Medical News Today, IRIN, CDC, The New York Times
Photo: Medical News Today

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Jhpiego Receives USAID Award

Jhpiego is an international nonprofit health organization and an affiliate of Johns Hopkins University. Jhpiego’s programs are primarily centered on the prevention of unnecessary deaths of women and children in developing countries. The organization works on the front lines in urban slums and rural settings to design accessible and affordable healthcare solutions. Jhpiego is currently active in 40 countries, concentrated in Africa, Asia, Latin America and the Caribbean.

The organization works with healthcare professionals, influential community members and government leaders to deliver quality healthcare for those in need. It also focuses on developing sustainable strategies for communities in developing countries to manage their own well-being. Jhpiego trains local healthcare workers, improves the quality of community health systems and makes delivery of care, services or products more efficient and dependable. It focuses on developing technologies and solutions that can be used both in hospitals or in the home. The organization’s provision of affordable healthcare for women and families ensures of level of care previously unattainable by many of the recipients.

Jhpiego began as an acronym for the Johns Hopkins Program for International Education in Gynecology and Obstetrics, yet the organization has now expanded its efforts to tackle issues such as the prevention and treatment of HIV/AIDS, infection, malaria, tuberculosis and cervical cancer. Jhpiego’s science division also researches innovative technology that has the potential to help poor and vulnerable communities. The ultimate goal is sustainability—giving poor communities the tools and education they need to build a foundation of good health and continue the cycle without outside assistance or aid.

As an affiliate of a prestigious university, Jhpiego has the advantage of being well-connected. In June 2014, the United States Agency for International Development (USAID) awarded $500 million to Jhpiego to fund a program to alleviate maternal and child mortality. Jhpiego is currently using the funds to spearhead a five-year program centered around preventing child deaths due to treatable causes like diarrhea and pneumonia. By working in conjunction with other partners and nonprofits, Jhpiego seeks to create a network of aid to mothers and children in need.

Jhpiego will use the funds to provide cost-effective vaccines and antibiotics to the 24 countries with the highest numbers of child mortality. Jhpiego will also provide other medical equipment, train community medical providers and reach out to women in slums and rural areas. The USAID funds will be used to research prevention and treatments for the leading causes of death for mothers and children. Among mothers, the leading causes of mortality include uncontrolled bleeding after birth, infections and high blood pressure during pregnancy. Among newborns, asphyxia and low birth rate. And among young children, pneumonia, malaria and diarrhea.

Since 1990, the global child mortality rate has nearly been halved. Yet Jhpiego’s efforts instill hope that the number can be further lowered. Jhpiego works with NGOs and government policymakers alike to increase accessibility to quality health services. By focusing on sustainable, cost-effective health solutions, Jhpiego can help provide care for underrepresented, vulnerable populations.

– Mari LeGagnoux 

Sources: Baltimore Sun, Jhpiego
Photo: Jhpiego

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All About Dengue Fever

Dengue Fever
Though similar to malaria in its mode of transmission, dengue fever is its own monster. With up to 400 million people infected every year, dengue has been a leading cause of illness and death worldwide since the 1950s. According to the World Health Organization (WHO), 2.5 billion people around the world are at risk of contracting dengue fever.

Dengue is spread through the bite of a female Aedes aegypti mosquito, a species that seeks out prey during the daytime. The mosquito has recently spread to areas in North America and Europe, though it typically resides in tropical areas. Its presence in tourist destinations like Puerto Rico have caused a global spread, and put more people at risk.

Upon contracting dengue, symptoms present in a manner similar to the flu with high fever, headache, aches and pains and vomiting. The secondary symptoms require immediate treatment to ensure that dengue runs its course without escalation.

However, in developing countries where adequate medical care is unavailable, dengue fever escalates to dengue hemorrhagic fever, which is characterized by more extreme symptoms including hemorrhaging. This can then lead to dengue shock syndrome, and in 50 percent of shock cases there is a fatality.

There is no vaccine or treatment for dengue fever, but there are many preventative measures that can be taken to minimize infection. Insecticide can prevent transmission of the virus, as can mosquito nets and clothing that covers exposed skin. Additionally, proper disposal of waste and trash can cut down on mosquitoes.

While in developed countries dengue fever is very survivable, usually lasting between two and seven days, this virus hits the developing world much harder. Not only is there a higher prevalence in many impoverished tropical areas, they are also least equipped to prevent and handle dengue fever when it occurs.

The presence of such a debilitating and sometimes fatal disease worsens the poverty conditions in a country, in which a community needs resources and money to better protect themselves from the disease. Before that can happen, they need to be able to establish a healthy community to begin the transition out of poverty. This vicious cycle is difficult to overcome, making organizations like the World Health Organization instrumental in keeping these countries afloat.

The WHO assists in minimizing the burden of dengue fever by supporting “countries in the confirmation of outbreaks through its collaborating network of laboratories,” providing “technical support and guidance to countries for the effective management of dengue outbreaks,” and a slew of other helpful measures.

Raising awareness about the causes of dengue fever, as well as how to prevent it in the first place, is the first and most important step toward minimizing outbreaks, especially in the developing world. With the assistance of humanitarian organizations and the training of medical professionals to better respond to the virus, dengue fever will become a more manageable virus with fewer fatalities.

— Maggie Wagner

Sources: CDC, WHO, MedicineNet.com, National Institute of Allergy and Infectious Disease
Photo: NY Times