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August 15, 2018

Immunizations, or vaccines as they’re also known, safely and effectively use a small amount of a weakened or killed virus or bacteria or bits of lab-made protein that imitate the virus in order to prevent infection by that same virus or bacteria. When you get an immunization, you’re injected with a weakened form of (or a fragment of) a disease. This triggers your body’s immune response, causing it to either produce antibodies to that particular ailment or induce other processes that enhance immunity. Then, if you’re ever again exposed to the actual disease-causing organism, your immune system is prepared to fight the infection. A vaccine will usually prevent the onset of a disease or else reduce its severity.

Why Should Someone Get Immunized?

The goal of public health is to prevent disease. It’s much easier and more cost-effective to prevent a disease than to treat it. That’s exactly what immunizations aim to do. Immunizations protect us from serious diseases and also prevent the spread of those diseases to others. Over the years immunizations have thwarted epidemics of once common infectious diseases such as measles, mumps, and whooping cough. And because of immunizations we’ve seen the near eradication of others, such as polio and smallpox. Some vaccines need to be given only once; others require updates or “boosters” to maintain successful immunization and continued protection against disease.

Can I Defer Immunization?

There are few occasions when deferral of immunization is required, if an individual is acutely unwell, immunization may be postponed until they have fully recovered. This is to avoid wrongly attributing any new symptom or the progression of symptoms to the vaccine. Secondly, if an individual with an evolving neurological condition, immunization should be deferred until the
neurological condition has resolved or stabilized.

The following conditions are NOT contraindications to routine immunization:

  1. Family history of any adverse reactions following immunization.Previous history of the disease (with the exception of BCG for people who have evidence of past exposure to tuberculosis).Prematurity.

  2. Stable neurological conditions such as cerebral palsy and Down’s syndrome.

  3. Asthma, eczema or hay fever.

  4. Mild self-limiting illness without fever, e.g. runny nose.

  5. Treatment with antibiotics or locally acting (e.g. topical or inhaled) steroids.

  6. Currently breast-feeding or being breast-fed.

  7. History of jaundice after birth.

  8. Under a certain weight.Recent or imminent elective surgery.

  9. Imminent general anaesthesia.

Almost all individuals can be safely vaccinated with all vaccines. In very few individuals, vaccination is contraindicated or should be deferred. Where there is doubt, rather than withholding vaccine, advice should be sought from an appropriate consultant pediatrician or the immunization coordinator.

All vaccines are contraindicated in those who have had:

  1. A confirmed anaphylactic reaction to a previous dose of a vaccine containing the same antigens, or

  2. A confirmed anaphylactic reaction to another component contained in the relevant vaccine.

  3. Live vaccines may be temporarily contraindicated in individuals who are:

  4. Immunosuppressed

  5. Pregnant.

*NB:
LIVE VACCINES include:
BCG
OPV (sabin)
Yellow fever

Chicken pox
Rubella
Influenza
Mumps, Measles
Endemic typhus

KILLED/LIVE ATTENUATED VACCINES include:
Rabies vaccine
Influenza, IPV
OPV(Salk)
Hepatitis A
Hepatitis B
CS Meningitis

Posted in Blog
July 27, 2018

Conception , pregnancy and child-bearing at 40 years and above is  still very possible ! Due to the reality of our time and age , women have now attained more ferrdom and equality  from the society and the world at large . They can now afford to spend their 20s and 30s in pursuit of Education , passions , focus more on their careers, develop innate gifts and talents, as well as making their creative dreams true. More women than ever before now ,  are trying to conceive over the age of 40 , that is a fact . In other words , a whole lot of women wait so long to have children these days. So, therefore, it is pertinent to understand female fertility for women aged 40 and above.

        WHAT HAPPENS TO MY FERTILITY AS I AGE?
A pat of the brain called the hypothalamus produces Gonadotrophin -releasing hormone (GnRH) which signals to the pituitarygland to produce a hormone – Luteinising hormone (LH) and Folllicle stimulating hormone(FSH) . The release of GnRH is pulsatile in younger women with regular menstrual cycles. This normal pulsatile release of GnRH signals some of the follicles in the ovary to begin maturing and it is this maturing follicles that contain the ovum or egg and they also release oestrogen . Now , as the follicle gets bigger and matures more , they increase their release of the hormone estrogen over time. The rising oestrogen level signals the pituitary gland back in the brain to curb the re/ease of FSH. This is called the FOLLICULAR PHASE OF THE OVARIAN CYCLE ,occurs from Day 1-13 of the cycle .
        In a normal functioning follicle , the estrogen levels rise and signal the pituitary again , to release Luteinizing Hormone (LH) . LH signals the follicle to open and release the now mature ovum( egg). This is called OVULATION and usually occurs on the Day 14 of the cycle.Ovulation is followed by the luteal phase . After the egg is the released from the follicle , the follicle now turns into a yellowish organ that is responsible for releasing yet another hormone called PROGESTERONE and a fairly constant levels of oestrogen .This is the LUTEAL CYCLE OF THE OVARIAN CYCLE.
         It is imperative to highlight at this point , that a woman’s ovary is a STORAGE ORGAN like water resevoir unlike men’s testis that is a MANUFACTURING ORGAN. The testis produces sperm cells every 90 days as long as a man lives. For the females , when the number of eggs stored in ovary is exhausted , it is indeed exhausted. The peak reproductive age of females is 28 years, after here , there is a slow decline in the number of eggs untill it is completely exhausted at menopause. The period of this gradual reduction in the amount of eggs contained in the ovary is called the CLIMACTERIC YEARS and this is approximately between the ages of  40 -60 years. Menopause occurs within the climateric years.Also , because the eggs have stored or long , the quality of the eggs decline with egg ,together with all cells in our body.
                               UTERINE CYCLE
This cycle like the ovarian cycle , also is made up of 3 phases :
a) Menstruation or shedding of the endometrium
b) Proliferative phase
c)  Secretory phase
At the same time the brain is releasing FSH to stimulate the ovaries for growth and maturation of eggs ,the uterine lining or endometrium is thin because it has just been shed or menstruation has just finished stopped. The growing follicles release oestrogen which travel from the ovary , down to the fallopian tubes and into the uterine cavity to commence its proliferation or its growth . Now , after the release of the egg from the ovarian follicle in the presence of the LH , the follicle changes to corpus luteum , which is what the follicle that just released the egg is now called , begins to secrete increasing quantities of progestrone. This hormone now finds its way to the uterus and causes the endometrium to develop more in thickness, more blood vessels  and mucus , capable of nourishing  a developing embryo – an embryo is the result of fertilization of an egg and a sperm usually occurs in the ampulla section of the fallopian tube . If fertilization does not occur , the decline of hormones causes this highly receptive endometrium to shed , this shedding is called MENSTRUATION . When oestrogen reaches a low enough point the hypothalamus releases GnRH  and the cycle starts all over again. This cycle lasts an average of 28 DAYS, though it may vary from woman to woman.
                 As a woman approaches  40 , the ovarian sore begins to empty and the menstrual cycle length begins to shorten from about 28 days to around 26 cycles. Over the next many years , the hormonal decline causes more menstrual cycle changes. Cycles may become shorter , longer or the cycle maybe skipped .Ovulation may or maynot  occur  during any given as a woman approaches  menopause . Menopause is confirmed once a woman  has  not had her menstrual cycle for at least one full year , and is between the ages of 40 -45. Menopause may take 1-7 years to complete, the changing hormone levels continue untill climacteric is complete , which may last untill around the age of 60.
                 One is tempted to ask: why did nature design the female fertility system this way? Why would a woman not cycle untill she is old like her male counterpart ? Menopause has  actually been proven to be scientifically protective of women because  , any ovary which is aloowed to cycle indefinitely willsurely wind -up with an ovarian dysfunction , notable among this will be OVARIAN CANCER and also to a lesser extent ENDOMETRIAL CANCER, if the uterus is exposed to unopposed oestrogen for a prolonged period of time .
                Meopause is a very normal and natural phenomenon. The human female body is designed to go through these changes very slowly over time , any sudden change in a short period of time may cause more severe symptoms in the body . This great shift in fertility may produce many unwanted physical symptoms like:   – Irregularity of the menstrual cycle
          – Reduced changes of natural conception.
          – Atrophy of vaginal muscles , cervix , uterus and ovaries ( they get smaller)
          – Loss of muscular tone of vagina and pelvic floor muscles
          – Lack of cervical mucous
          – Body mass declines
          – Metabolic rate slows
          – Change in breast shape , firmness and size
          – Hot flashes
          – Mood changes , depression , insomnia and anxiety
          – Mild incontinence due to muscle weakness
          – Heart palpitations
          – Loss of the feminine shape into ” pear shape “
          – Decreasing fecundity
          – Hormonal level changes
          – Elevated FSH level between 60 – 100 miu / L done on 2 separate times
          – Elevated LH level greater than 50 miu/ L
          – Decreased oestrogen / oestradiol level less than 50pg/ml
Knowing what is happening to your body gives you an advantage . It helps you to know the key areas you need to focus on to give yourself the best possible chance at conception .
PREPARING FOR CONCEPTION OVER 40
1. Regular intake of  wholesome meals , taking supplements that contain anti- oxidants , folic acid .
2. Drink water often at least 8 glasses per day-dehydration prevents adequate blood circulation.
3. Exercise – sweating helps the body get rid of toxins especially – xenohormones which are man-made chemical toxins shown to cause hormonal imbalance through endocrine disruption . Exercise also , helps to reduce fatness , quell depression , increase a sense of well- being by the release of endogenous endorphines , increase stamina and strength to carry the pregnancy and early motherhood.
4. Stress Management – stress leads to anxiety ,inhibits ovulation and can cause stressinduced hypertension.
5. Medical Options – If you have been attempting to get pregnant at 40 years and above , it would be wise to see a Doctor . Due to the diminishing ovarian reserve , the options can be : – IVF
                                 – ICSI
                                  – Use of a donor egg
6. Get adequate amount of sleep and rest
In conclusion , conception , pregnancy and child -bearing over the age of 40  is an achieviable feat . Yes, you too can !
Posted in Uncategorized
July 25, 2018
Louise Brown with the 'test tube' in which she was conceived Louise Brown with the ‘test tube’ in which she was conceived  CREDIT: GETTY IMAGES EUROPE 

Louise Brown, the world’s first test tube baby has backed the genetic editing of human embryos to cure disease arguing that people also condemned IVF when it was first attempted.

Mrs Mullinder nee Brown, was speaking ahead of her 40th birthday on Wednesday at the Science Museum in London, which is launching a new exhibition on the history of assisted reproduction.

Around eight million babies have been born through IVF since Mrs Mullinder became the first in July 1978 and last week a review by the Nuffield Council on Bioethics concluded that it may be ‘morally permissible’ to genetically edit test-tube babies to free them of inherited diseases.

Louise Brown, the world's first test tube baby, at the Science Museum, London, to mark the 40th anniversary of IVF
Louise Brown, the world’s first test tube baby, at the Science Museum, London, to mark the 40th anniversary of IVF CREDIT:  JONATHAN BRADY PA

“If it is for health reasons, I completely agree,” said Mrs Mullinder.  “People condemned what they were doing when I was born and you just need to trust in the doctors to take it as far as it needs to go.

“I mean obviously you always get some people trying to take it further but I think you need to trust the medical councils, to say what they can do and what they can’t do.”

Mrs Mullinder also described how she first found out that she was born through IVF.

“My parents sat me down when I was four and told me and showed me the footage,” she said. “I was more mortified because you see me as a baby being picked out of my mum, and it’s weird to think that was you.

“You don’t really know where babies come from at that age anyway, then when you get to school and you learn the sex education bit it all sort clicks in and you go aaaah. I get it.  It’s very odd and very weird.

“I knew I was different, and kids can be quite cruel but I never had any problems.”

More than eight million babies have now been born through IVF
More than eight million babies have now been born through IVF CREDIT: SCIENCE PHOTO LIBRARY RF SEBASTIAN KAULITZKI

Immediately after the birth, she was faced with a battery of tests to check that she was healthy.

“Mum was actually quite upset because, she had a c-section and hadn’t seen me straight after the birth and there was black ink all over my fingers, so she asked why, and they said they had taken my fingerprints.

“I don’t think we ever got to the reason why they took my fingerprints,” she added.

Source: Telegraph UK

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March 19, 2018

Abakaliki – In an effort to prevent further outbreak of Lassa fever, Ebonyi Government is to begin intensive campaigns against rat consumption in rural areas where inhabitants erroneously believe rats have high nutritional value.

Lassa-fever The state Commissioner for Environment, Chief Donatus Njoku, told the News Agency of Nigeria (NAN) on Monday in Abakaliki that the government would explore all avenues to dissuade the citizens from consuming rats. Lassa fever outbreak in the state in January resulted in four deaths. Njoku said:

“Rats are the primary vectors of the disease, and we are vigorously carrying out enlightenment through mass media, workshops, seminars and various ministries’ communication channels. “We will collaborate with traditional rulers and other opinion leaders at the grassroots to educate rural dwellers to shun such a notion and realise that rat is the disease’s primary vector.

“We have also continued to sensitise the populace to urgently report suspected cases to relevant health agencies. “With the total functionality of the state government-owned South-East Virology Centre, such an occurrence can be expeditiously handled.’’ On sanitation, Njoku said that contrary to insinuations, non-observance of the monthly sanitation in the state did not affect effective sanitation. “State and Federal Government functions sometimes fall on the last Saturday of the month, and when this occurs, we have to comply.

“The state government has evolved policies which make the populace to clean their environments on daily basis and not wait for designated days,” he said. Njoku told NAN that the state Ministry of Environment ensured that state government ministries and parastatal-agencies cleaned their environments daily as directed by the governor.

“We assess their performances to ascertain the level of compliance; to show his seriousness toward the directive, the governor visits the ministries for on-the-spot assessments. “We encourage the people to keep their environments clean to improve their health,” he said. (NAN)

Source: Vanguard

Posted in Blog | Tags: , , , , , ,
March 5, 2018

From 1 January through 25 February 2018, 1081 suspected cases and 90 deaths have been reported from 18 states (Anambra, Bauchi, Benue, Delta, Ebonyi, Edo, Ekiti, Federal Capital Territory, Gombe, Imo, Kogi, Lagos, Nasarrawa, Ondo, Osun, Plateau, Rivers, and Taraba). During this period, 317 cases have been classified as confirmed and eight as probable, including 72 deaths (case fatality rate for confirmed and probable cases = 22%). A total of 2845 contacts have been identified in 18 states.

Fourteen health care workers have been affected in six states (Benue, Ebonyi, Edo, Kogi, Nasarawa, and Ondo), with four deaths (case fatality rate= 29%). As of 18 February, four out of the 14 health care workers were confirmed positive for Lassa fever.

Lassa fever case management centers are operational in four states (Anambra, Abakaliki, Edo, and Ondo States). The health care workers working in these centers are trained in standard infection control and prevention (IPC) as well as use of personal protective equipment (PPE). In addition, the suspected cases and deaths reported in community settings are being actively investigated by the field teams and contacts are being followed up. Currently, three laboratories are operational and testing samples for Lassa fever by polymerase chain reaction (PCR). WHO continues to support the outbreak response, mainly in the domains of enhanced surveillance, contact tracing, strengthening of diagnostic capacity and risk communication.

Lassa fever is endemic in the West African countries of Ghana, Guinea, Mali, Benin, Liberia, Sierra Leone, Togo and Nigeria. As of 22 February 2018, 10 suspected cases who fell ill in Nigeria were reported in Benin, and confirmed cases have been reported from Beninese states that border Nigeria. The outbreak of Lassa fever is considered active in one Nigerian state that borders Benin and two that border Cameroon. Lassa fever is not considered endemic in Cameroon and no outbreaks of Lassa fever have been reported in recent years.

Public health response

  • A national Lassa fever Emergency Operations Centre (EOC) was activated in Abuja on 22 January and continues to coordinate response activities in collaboration with WHO and other partners.
  • A team of Nigerian Centre for Disease Control (NCDC) staff and Nigeria Field Epidemiology and Laboratory Training Program (NFELTP) residents were deployed to respond to the Ebonyi, Ondo, and Edo outbreaks.
  • The three most affected states of Edo, Ondo and Ebonyi have dedicated Lassa fever treatment units and ribavirin is available for treatment of confirmed cases. NCDC is collaborating with a non-governmental organization, the Alliance for International Medical Action (ALIMA), to conduct an assessment of treatment units.
  • Enhanced surveillance is ongoing in states with an active outbreak and state line lists of cases are being uploaded to a national level database, a viral haemorrhagic fever management system.
  • NCDC has supplied Irrua Specialist Teaching Hospital and Federal Medical Centre Owo with tents and beds to increase in-patient capacity.
  • Staff from Irrua Specialist Teaching Hospital are providing clinical case management advice to other hospitals with suspected cases, and a 24-hour Lassa fever case management call line has been established.

WHO risk assessment

Lassa fever is a viral haemorrhagic fever that is transmitted to humans via contact with food or household items contaminated with rodent urine or faeces. Person-to-person infections and laboratory transmission can also occur. The overall case fatality rate is 1%; it is 15% among patients hospitalized with severe illness. Early supportive care with rehydration and symptomatic treatment improves survival. The antiviral drug ribavirin seems to be an effective treatment for Lassa fever if given early on in the course of clinical illness. There is no evidence to support the role of ribavirin as post-exposure prophylactic treatment for Lassa fever. Lassa fever is known to be endemic in Benin, Guinea, Ghana, Liberia, Mali, Sierra Leone, Togo and Nigeria, and most likely exists in other West African countries.

The current Lassa fever outbreak in Nigeria shows an increasing trend in the number of cases and deaths in recent weeks with 317 confirmed cases reported in 2018 so far. This is the largest outbreak of Lassa fever ever reported in Nigeria.

The infection of 14 health care workers that were not working in Lassa fever case management centers highlights the urgent need to strengthen infection prevention and control practices in all health care setting for all patients, regardless of their presumed diagnosis. Given the high number of states affected, the clinical management will likely happen in health centers that are not appropriately prepared to care for patients affected by Lassa fever and the risk of infection in health care workers will increase.

The reporting of confirmed cases in different parts of the country and porous borders with neighbouring countries indicate a risk of spread nationally and to neighbouring countries. An overall moderate level of risk remains at the regional level. Public health actions should be focused on enhancing ongoing activities including surveillance, contact tracing, laboratory testing, and case management. Greater coordination and information sharing regarding Lassa fever cases and contacts with Benin would also contribute to rapid detection and response to cross-border spread of the outbreak.

WHO advice

Prevention of Lassa fever relies on community engagement and promoting hygienic conditions to discourage rodents from entering homes. In healthcare settings, staff should consistently implement standard infection prevention and control measures when caring for patients to prevent nosocomial infections.

Travellers from areas where Lassa fever is endemic can export the disease to other countries, although this rarely occurs. The diagnosis of Lassa fever should be considered in febrile patients returning from West Africa, especially if they have been in rural areas or hospitals in countries where Lassa fever is endemic. Health care workers seeing a patient suspected to have Lassa fever should immediately contact local and national experts for guidance and to arrange for laboratory testing.

Source: WHO

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March 5, 2018

Lagos, Nigeria (CNN)

Nigeria is facing its worst Lassa fever outbreak on record, with 72 people confirmed to be dead from the virus and 317 infected, according to the World Health Organization.

A further 764 are suspected to be infected, and 2,845 contacts have been identified.

On average, Lassa fever is deadly in 1% of all individuals infected, with higher rates of 15% morbidity among people hospitalized for the illness. As of Sunday, the case fatality ratio was 22%, according to the Nigeria Centre for Disease Control.

Although it’s endemic to the country, Lassa fever numbers have never reached this proportion before, according to the WHO.

Nigeria’s Centre for Disease Control said Wednesday that it was facing an “unprecedented outbreak” that has spread to 18 states since it began in January.

The disease can cause fever and hemorrhaging of various parts of the body — including the eyes and nose — and can be spread through contact with an infected rat.

Person-to-person transmission is low but has been seen in Nigerian hospital settings this year. Fourteen health workers were infected, of whom four died within eight weeks.

The WHO said Wednesday that health facilities were overstretched in the southern states of Edo, Ondo and Ebonyi, and it is working with national reference hospitals and the Alliance for International Medical Action to rapidly expand and better equip treatment centers.

It also hopes to reduce further infections to hospital staff.

“The ability to rapidly detect cases of infection in the community and refer them early for treatment improves patients’ chances of survival and is critical to this response,” said Dr. Wondimagegnehu Alemu, the WHO representative to Nigeria.

State health authorities are mobilizing doctors and nurses to work in treatment centers. Four UK researchers have also been deployed to Nigeria to help control the unusually large outbreak.

“Given the large number of states affected, many people will seek treatment in health facilities that are not appropriately prepared to care for Lassa fever,” Alemu said.”The risk of infection to health care workers is likely to increase.”

Lassa fever is endemic in most of West Africa, especially Nigeria, where it was discovered in 1969.

Edo, Ondo and Ebonyi states account for 85% of cases, said Dr. Chikwe Ihekweazu, director of the Nigeria Centre for Disease Control, in a statement.

According to the US Centers for Disease Control and Prevention, touching, eating or sniffing foods and other household items that have been contaminated by multimammate rat feces or urine can aid transmission.

Nigerians, especially in those three states, should “continue focusing on prevention by ensuring they prevent access to their foodstuff by rodents,” Ihekweazu said.

There is risk of the virus spreading to other West African countries due to increased migration, said Dr. Oyewale Tomori, professor of virology at Redeemer’s University in Nigeria and the former regional virologist for the WHO’s Africa Region.

“There is always cause for alarm in West Africa, where the rodent host of can be found in virtually all countries of West Africa,” he said.

Benin, Liberia and Sierra Leone have all reported cases of Lassa fever over the past month, according to the WHO, but risk of further international transmission is low for now.

 

Source: CNN

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February 9, 2018

 

The Nigerian Metrological Agency (NIMET) has warned Nigerians to prepare for more hot days and warm nights.

Nigerians has therefore been advised to engage in smart adaptation practices such as;

  1. Take advantage of the cooling power of water. Fill buckets or basins and soak your feet. Wet towels and bandannas can have a cooling effect when worn on the shoulders or head. Take cool showers or baths, and consider using a spray bottle filled with cold water for refreshing spritzes throughout the day.
  2. Head downstairs. Since hot air rises, the upper stories of a home will be warmer than the ground floor. A basement can be a cool refuge from the midday heat.
  3. Eliminate extra sources of heat. Incandescent light bulbs can generate unnecessary heat, as can computers or appliances left running. Eat fresh foods that do not require you to use the oven or stove to prepare.
  4. Remember to maintain an adequate level of hydration, which means you’ll need to consume more water than you usually do when it’s hot. If you’re sweating profusely, you will also need to replace electrolytes by eating a small amount of food with your water or by drinking specially-formulated electrolyte replacement drinks. Thirst is the first sign of dehydration; you should drink sufficient amounts of fluids before you feel thirsty in order to prevent dehydration.
  5. Avoid alcoholic beverages and caffeine, as both of these substances can act as diuretics and promote dehydration.
  6. For a homemade “air conditioning” system, sit in the path of a box fan that is aimed at an open cooler, or pan filled with ice.
  7. Try to visit public buildings with air conditioning during the hottest hours of the day if the heat becomes unbearable. Libraries, shopping malls, and movie theaters can all be good places to cool down.
  8. Don’t eat large, protein-rich meals that can increase metabolic heat and warm the body.
  9. Be able to recognize the symptoms of heat-related illnesses and true heat emergencies (heat cramps, heat rash, heat exhaustion, heat stroke).
  10. Finally, remember that pets also suffer when the temperature rises. Cooling animals (dogs, rabbits, cats) by giving them a “cool” bath or shower will help keep their body temperature down. A cool towel on a tile floor to lay on, a cool towel or washcloth laying over the skin next to a fan will also help cool the animal. Make sure they have plenty of cool water to drink as well. Signs of a heat stroke in a pet are:

rapid panting,

wide eyes,

lots of drooling,

hot skin,

twitching muscles,

vomiting and

a dazed look.