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Enteric and Diarrheal DiseasesEnteric and diarrheal diseases affect 1.7 billion children around the world every year killing over 500,000 children under five annually. The most common enteric and diarrheal diseases are rotavirus, cholera, shigella and typhoid.

Types of Enteric and Diarrheal Diseases

Rotavirus: Rotavirus is a highly transmittable disease and is one of the main causes of severe diarrhea in children. The disease affects millions of individuals around the world every year and is the cause of death in over 215,000 cases. The disease most often transfers via consumption of fecal matter, which can occur when individuals do not have access to proper handwashing and sanitation facilities. The Rotavirus vaccine can help prevent rotavirus. It is effective in preventing severe rotavirus in 90 percent of cases and the WHO has recommended it for use. Typically, children that are two to six months old receive two to three doses of the vaccine. Individuals who do not receive this vaccine and contract rotavirus (or cholera, typhoid, or shigella) most often receive treatment with either zinc supplementation or rehydration therapy or both. Zinc supplementation can reduce the severity of diarrhea in an individual while oral rehydration therapy can help rehydrate an individual that has become dehydrated due to diarrhea.

Cholera: Cholera is another diarrheal illness that individuals can contract by consuming contaminated food or water. It affects roughly three million individuals around the world every year and is the cause of death in nearly 145,000 cases. Furthermore, there have been recent outbreaks in countries like Haiti, Sierra Leone, Zimbabwe and Guinea. Like rotavirus, a specialized vaccine can prevent cholera as well as sound sanitation techniques. Individuals older than six receive the vaccine in two doses while younger individuals receive three doses.

Typhoid: Like rotavirus and cholera, typhoid is transmitted through fecal contamination. It affects 22 million people annually and is the cause of death in roughly 200,000 cases per year. Before recently, no one had developed a vaccine to treat typhoid; however, in 2018, the WHO approved a vaccine called Typbar TCV. Scientists from Bharat Biotech International, a biotechnology company based in Hyderabad, India, developed the vaccine. Hundreds of thousands of individuals have received the vaccine and it has played a key role in stemming a recent typhoid breakout in Pakistan.

Shigella: The last major form of an enteric/diarrheal disease is shigella. Over 165 million individuals contract shigella every year (causing one million deaths), in large part due to the fact that there is no preventative vaccine for the disease. Because of this, much of the effort that has been given to prevent Shigella recently (as well as rotavirus, cholera and typhoid) have focused on ensuring proper hygiene and sanitation in areas that are at risk for fecal contamination. Listed below are some promising solutions to improve hygiene and sanitation in developing countries around the world.

Solutions to Reduce Enteric and Diarrheal Diseases

Janicki Omni Processor (JOP): The Janicki Omni Processor is an innovative solution that can help turn waste into clean drinking water. To do so, wet waste enters the JOP which dries and burns the waste in a controlled fashion. The JOP filters and condenses the resulting steam from the burning process, distilling the water. This water then receives treatment in order to meet clean drinking water standards. The JOP is environmentally friendly (the entire process is self-sustainable) and, through heavy funding from NGOs such as the Bill and Melinda Gates Foundation, it is a cheap and efficient way to provide clean water to communities throughout the developing world.

Nano Membrane Toilet: The Nano Membrane Toilet is a promising solution with regards to sanitation practices throughout the developing world. The toilet is sustainable and requires no water or electricity to function. It works like this: after an individual uses it, the toilet utilizes a waterless flushing system to separate the urine from the feces. The feces are then chopped up into small bits and placed into a combustion chamber. After roughly a week, the feces will turn into a substance similar to ash and people can safely deposit it in the trash. The water, meanwhile, enters a separate tank to purify. The purified water then enters a tank at the front of the toilet for the purpose of outdoor irrigation and cleaning. The Nano Membrane Toilet is a promising solution to help reduce feces contamination because it does not require water to function and is easily implementable in many communities around the world.

Hand Washing: Hand washing isn’t a new technology, but it can go a long way towards preventing a multitude of enteric and diarrheal diseases. Research indicates that diarrheal deaths could decrease by as much as 50 percent if the prevalence of handwashing increased around the globe. NGOs such as The Global Handwashing Partnership and World Vision have done great work in recent years to lead handwashing programs in developing nations and increase awareness about the importance of handwashing.

Looking Ahead

The prevention and treatment of individuals with rotavirus, cholera, typhoid and shigella are some of the biggest challenges facing the world in the coming years. The transmittable nature of these diseases makes them difficult to eradicate, and people cannot fix many of the reasons that they are prevalent (lack of sanitation, poor water quality, etc.) overnight. Continued investments from governments and NGOs around the world in promising technologies like the Janicki Omni Processor and the Nano Membrane Toilet are a step in the right direction towards the prevention of enteric and diarrheal diseases in individuals around the world.

– Kiran Matthias
Photo: Pexels

Common Diseases in SamoaSamoa is a great vacation destination. There are museums, places to go surfing and beaches to relax on. However, the tropical weather and abundance of water gives rise to many infectious diseases. Below is a guide to the most common diseases in Samoa.

Zika Virus
Due to a number of mosquitoes carrying the Zika virus, the virus has become one of the most common diseases in Samoa. Thus, the Centers for Disease Control and Prevention (CDC) recommends taking precautionary measures. The virus is spread via mosquito bites and sexual contact with an infected person. Thus, the CDC advises travelers and locals to avoid bug bites and use condoms whenever possible. This is even more important for pregnant women, as they are at risk of passing the virus onto their offspring.

Also, it is possible to contract the virus and not even know it. It is typical for people to not experience anything beyond a mild sickness (if they get sick at all) or show distinct symptoms. At the time of writing, there are no cures, medication or vaccines for the Zika virus.

Hepatitis A
Spread through contact with the hands of an infected person and contaminated water and food, people are at risk of catching hepatitis A in Samoa. If someone does develop symptoms, they likely won’t appear until the virus has been in their system for a couple of weeks. The symptoms include mild fever, joint pain, loss of appetite, nausea, vomiting, fatigue, abdominal/liver pain or discomfort, jaundice, clay-colored bowel movements and dark urine.

Fortunately, there is a vaccine that people can ask their doctors/nurses for. This, paired with eating foods prepared correctly and safely, drinking clean (preferably carbonated) water, maintaining personal hygiene and avoiding bushmeat, should prevent the contraction hepatitis A.

Hepatitis B
Hepatitis B can be found all over the world, but it is particularly prevalent in Samoa. It is so common that, in 2015, the Samoan Cabinet authorized a doctor to participate in a New Zealand meeting discussing hepatitis B treatment and possible drug donation to Samoans. Hepatitis B can spread via unprotected sex, contact with infected blood, unscreened blood transfusions or during childbirth. Even infected items such as razor blades, needles and unclean medical or dental equipment can spread the virus.

According to IAMAT, a nonprofit focused on giving travelers up-to-date health information, hepatitis B is also asymptomatic for many of those who have it. It typically takes anywhere from one to six months after exposure to experience illness and shares many of its symptoms with hepatitis A. Untreated hepatitis B “can lead to liver failure, liver cancer and even death.”

A series of vaccinations are available for Hep B. IAMAT goes on to recommend other preventative measures such as practicing safe sex; avoiding injuries during physical activities; getting medical and dental care done at a trustworthy institution; not sharing needles or razors and avoid getting any new tattoos or piercings.

Typhoid
Typhoid, like hepatitis A, can spread through contaminated food and water. In addition to common symptoms such as weakness and stomach pains, some can experience constipation and a rash.

A vaccine in the form of a shot or pills is available. The prevention methods are the same as hepatitis A. Additionally, close contact (such as sharing food/utensils/cups/kisses/hugs) with infected individuals should also be avoided.

While the most common diseases in Samoa may not all be life-threatening initially, it is best to err on the side of caution and heed the preventative measures.

Jada Haynes

Photo: Flickr

Typhoid_Outbreak
The U.N. Relief and Works Agency’s (UNWRA) health program has dramatically decreased the risk of communicable and vaccine-preventable disease among Palestinian refugees in Syria. However, doing such great work is challenging among crowded refugee camps that are not easily accessible. The threat of contagious diseases is always present.

The threat of a potential typhoid outbreak spreading to the capital of Damascus was prevalent in July, had UNWRA not been allowed to help. The largest “unofficial” camp at Yarmouk emptied of Palestinian refugees after fighting began between Islamic State, local groups and government forces. Refugees are temporarily in Yalda and other towns close by controlled by armed groups that have reached deals with government. The groups have strong leaders and civilian committees that collaborate with UN agencies.

UNWRA was able to deliver whatever was needed to refugees between April 23 and June 8. They provided 6,000 food parcels each month, and healthcare. Since June 8, UNWRA has no longer been allowed, as a result of assassinations in Yalda, supposedly by insurgents. Those inaccessible places saw the lost of UNWRA host areas for the distribution of water and medical services.

The Syrain Arab Red Crescent and other aid organisations have little access to these areas where there is a strong need for water purification tablets and hygiene kits. In a similar situation last year, access was eventually granted. In other parts of Syria, 10,000 Palestinians have been displaced to a small Aleppo camp with no electricity or water. To the east of Aleppo city, the large Neirab camp is under government control.

UNWRA has done everything it can in the places it can access. UNWRA staff wasted no time when they heard about potential thyphoid outbreak in Yarmouk. They took blood and water samples from those who showed symptoms, and within 24 hours thyphoid medicine was delivered to Yarmouk. Currently, the number of cases are decreasing and under control.

UNWRA is hopeful about preventing outbreaks, with its rapid response of reporting cases to UNWRA senior staff, having medicine in Damacus office and 3 month supply kept at clinics. The concern for areas that are not easily accessible is still present.

Agencies are preparing for worsening conditions in Deraa and Aleppo. Before conflict started in 2011, there were 560,000 Palestinian refugees registered with the UNWRA in Syria; today, there are 480,000, 95 percent of which need constant aid. The number of consultation for medical services have gone up from 100 to 500.

Palestinian refugees are closed off from Jordan and Lebanon, which leaves them with two options: staying in a war zone or being smuggled to Turkey, where they will take unreliable boats to Europe.

UNWRA needs $414 million just for Syria this year due to the 2014 appeal being only half funded. Due to under-funding, it will have to postpone the school year for 700 schools for half a million children unless they receive $101 million from donors by August. A source believes they should qualify, considering they are one of the countries taking part in the US-led campaign against Islamic State in Syria and Iraq, which already has cost $5 billion.

UNWRA devotes half of its budget to education; schools ensure continuity and stability for children in conflicted Syria and Gaza, unstable Lebanon, the Israeli-occupied West Bank and East Jerusalem, and Jordan, all trying to manage the influx of Palestinian and Syrian refugees.

In the past decade, donor contributions have not kept up with population growth. UNWRA offers protection and services to 5 million refugees, but it currently only has enough money to provide relief and healthcare, leaving education out of the equation.

Paula Acevedo

Sources: Europa, Irish Times
Photo: Mashable