Top Travel Tips To Ensure You Don’t Come Back With More Than You Left With

Passport. Check.

Tickets. Check.

Health. Huh?

That’s Right! For those of you planning to get away this summer, SRxA’s Word on Health reminds you get your health planning in before leaving for the airport.  While an overseas trip may appear to be “just what the doctor ordered” , it can also pose various health hazards, depending on the type of travel, length of stay and destination.

Significant changes in altitude, humidity and temperature can lead to illness, and in many parts of the world – especially developing countries and tropical locations – the risk of infectious disease is high.

“Not all countries are high-risk for travelers,” said Christopher Ohl MD, an infectious disease specialist at Wake Forest Baptist Medical Center in Winston-Salem, N.C. “Europe is generally safe, and so are Canada, Japan, Australia. But anybody planning to go to Mexico or Central America, the Caribbean, South America, Africa, most anywhere in Asia, or the Pacific islands should definitely look into what health risks they’ll encounter and what they’ll need to do to minimize their chances of getting ill.”

So where should you look for this information?  The Internet, of course, has a multitude of resources, some better than others, but you still need to be aware that even reputable sites such as those of the U.S. State Department, federal Centers for Disease Control and Prevention and World Health Organization offer only general information about the world’s countries and often do not include specifics about particular locations or activities within those countries.

For someone going to South Africa, there’s a big difference between staying in a modern hotel in Cape Town for a week and going on a two-week budget trip to Kruger National Park!

Because the details of an individual’s health, destination, activities, accommodations and mode of travel are important elements in determining health risk, a travel medicine specialist is probably the best person to consult

Travel clinics also stock the sort of vaccines and anti-malarial medications you’ll need and can advise on up-to-the-minute requirements.

In addition to administering shots and writing prescriptions, travel clinics also provide information on how to avoid insect-borne diseases, how to self-treat diarrhea and other common ailments, what to eat and drink and what to avoid eating and drinking and so on, all based on the person’s health status, where they’re going, what they’re going to be doing and how long they’re going to be there.

And because accidents, not diseases, are the most common cause of injury and death among travelers the clinic can also provide safety tips based on information from the State Department and authoritative foreign sources, such as whether there may be civil disturbances in a particular location, whether it’s advisable to travel at night or even “if it’s safe to rent a scooter.”

But don’t leave it until the last minute. Travelers, regardless of their age or the type of trip they’re planning should visit a travel clinic at least four to six weeks before departure, to allow sufficient time to get prescriptions filled and for vaccines to take effect. Even if the destination doesn’t call for any special shots, he said, a trip abroad presents a good opportunity to see that “routine” vaccinations such as measles-mumps-rubella, diphtheria-pertussis-tetanus, chickenpox and flu, are up to date.

And in the unfortunate event that you return home with something other than a suntan and souvenirs, travel clinics can also provide post-travel medical care. A number of diseases common overseas don’t present symptoms right away, some can even take months to develop, and they might not be recognized by a general practitioner.

Stay safe this summer!

 

Potential treatment for Ebola and other deadly viruses revealed

Illnesses caused by many of the world’s most deadly viruses cannot be effectively treated with existing drugs or vaccines. But this may all be about to change. Scientists have discovered several compounds that can inhibit the highly lethal Ebola virus, as well as the pathogens responsible for rabies, mumps, measles and other pathogenic viruses.

This finding, published in the journal Chemistry & Biology potentially opens up new therapeutic avenues for combating these diseases.

Such treatments are desperately needed. Ebola virus, for example, can be transmitted through direct contact with blood or other body fluids of infected persons or animals, and even close contact with a deceased Ebola-infected body. And mortality rates from ebola can be as high as 90%.

“The medical field currently does not have ideal antiviral therapies, often no therapeutics at all, and the development of broad-spectrum antivirals is a great way to provide treatment in the future,” says study author Claire Marie Filone PhD of Boston University School of Medicine. “Toward that end, we have identified a drug that targets multiple viruses – and may be developed into an antiviral treatment for known and emerging viruses.”

In contrast to the many antibiotics that work against a wide range of bacteria, there are currently no highly effective or safe broad-spectrum drug treatments for viral diseases.

To address this need, researchers screened thousands of diverse compounds for small molecules that showed strong antiviral activity against viruses.  They identified several that inhibited infection in cells exposed to either Ebola or vesicular stomatitis virus (VSV). These molecules, which are related to a class of plant-derived compounds called indoline alkaloids, share a common chemical structure that can be modified to enhance antiviral activity.

The most potent of these compounds demonstrated a consistent mechanism of action against genetically distinct viruses. It works by blocking viral transcription. Because it targets such a critical step in virus replication, in theory, scientists should be able to develop it into a therapeutic that could be used against many different types of viral infections.

As always, SRxA’s Word on Health will bring you further news as it develops.

The biggest-selling drug in 2018 will be…

EvaluatePharma, a UK based company specializing in pharma and biotech analysis has been gazing long and hard into its crystal ball.

Having scrutinized the world’s leading 3,500 pharmaceutical and biotech companies they have come up with a list of what, they believe, will be the top 10 selling drugs in 2018.

1. Januvia       (diabetes) – $9.7 billion
2. Humira        (arthritis) – $8.2 billion
3. Avastin        (cancer) – $7.5 billion
4. Enbrel          (arthritis)  – $7.2 billon
5. Revlimid     (myelodysplastic syndrome) – $6.75 billion
6. Prevnar 13  (pneumococcal vaccine) – $6.72 billion
7. Rituxan         (cancer) – $6.3 billion
8. Lantus           (diabetes) – $5.9 billion
9. Remicade     (arthritis) – $5.8 billion
10. Advair            (COPD)  – $5.7 billion

Surprised?  No conventional molecules, no cholesterol lowering agents, no blood pressure meds and not a single new drug among the top ten.  However, they predict the #11 best seller will be GS-7977 – the much anticipated oral hepatitis C drug from Gilead Sciences .

Not so surprising, given the obesity epidemic sweeping the western world that 2 of the front runners are diabetes drugs. Likewise, given the globally aging population – 3 are for arthritis.

#5 may be a surprise to many. Few people had ever heard of myelodysplastic syndrome before ABC news anchor Robin Roberts announced last week that she has the disease.  Still, it’s predicted number 5 status doesn’t mean that an epidemic is expected – it’s still relatively rare with only 10,000 or so new cases detected each year. Its lofty status on the list is more to do with the price. It costs a staggering $10,000 or so for a 28 day supply of the pills.

Other predictions from the EvaluatePharma World Preview 2018 report:

• Worldwide prescription drug sales are forecast to total $885bn in 2018 an increase of 3.1% from 2011
• Over $290bn of pharmaceutical sales are at risk from patent expirations between now and 2018
• Pfizer was the top company for prescription drug sales in 2011, but  Novartis will top the list by 2018
• Global pharmaceutical R&D spend forecast will grow by 1.5% per year to $149bn in 2018
• Anti-coagulants (blood thinners) are set to record highest growth of major therapy categories to 2018

Interesting stuff. But the problem with such long term predictive models is that they are but a snapshot  trying to project out six years.

In reality, life is a movie, with a frequently changing plot. For example if J&J’s canagliflozin can reduce obesity and improve blood sugar levels better than Januvia then the projected No. 1 ranking is suspect, at best.

There’s a Shot for That

On May 14, 1796 Edward Jenner injected fluid from the cowpox blisters on the hands of dairymaid Sarah Nelmes, into James Phipps, an 8-year-old boy.  Jenner hoped the fluid from the cowpox lesion would somehow inoculate the boy against the smallpox scourge which at the time was killing over 400,000 Europeans a year. His hunch proved correct.

Today vaccines save 3 million lives per year worldwide. By training the human immune system to recognize and ward off dangerous pathogens, vaccines can protect against disease for decades, or even for a lifetime. Preventive vaccines work by introducing harmless microbial chemical markers, known as antigens, which resemble the markers on living microbes. The antigens train the immune system to recognize and destroy those microbes should they ever appear in the body. By injecting cowpox antigens into Phipps bloodstream, Jenner primed his immune system to attack the similar smallpox virus.

Now, medical scientists are taking Jenner’s ideas in a whole new direction. By exploiting a growing understanding of the immune system they are developing therapeutic vaccines targeting established diseases rather than trying to prevent them.

Last spring, the FDA approved Provenge, a personalized immunotherapy that activates a patient’s own immune cells to target and attack advanced prostate cancer. To make the Provenge prostate cancer vaccine, biochemists at Seattle’s Dendreon Corporation extract a sample of a patient’s own immune cells and bathe them in a chemical soup of prostate cancer antigens that are chemically linked to a cytokine that screams, “Attack this!”.  The activated immune cells are then injected back into the patient’s body to spread the call to arms.

While Provenge was the first of the new generation of therapeutic vaccines, it’s certainly not the last. BCC Research has identified 113 therapeutic vaccines in development, many of which are already in human trials. They even go so far as to estimate that the market for therapeutic vaccines will have an annual growth rate of 115% and reach an estimated $2.9 billion in 2014.

Other cancer vaccines are among the front runners. With a near-endless supply of patients willing to undergo novel treatments, cancer researchers have been among the most aggressive in experimenting with therapeutic vaccination. The Cancer Vaccine Collaborative is working on treatments that target multiple cancer antigens, which should trigger a more aggressive immune response and increase the odds of defeating tumors. All of which is good news for the 1.5 million Americans diagnosed with cancer each year.

While cancers cause a proliferation of diseased cells, some autoimmune diseases, cause the cells of the immune system to turn against healthy tissues. In diabetes, for example, the immune system attacks insulin-making pancreatic beta cells.

In multiple sclerosis, it’s the myelin sheaths that are designed to protect the nerves that come under attack.

Autoimmune vaccines hold the promise of shutting down these attacks. One promising approach boosts T-regulatory cells, a subgroup of the white blood cells. At the University of Calgary’s Diabetes Research Centre in Alberta, immunologist Pere Santamaria has attached a cocktail of antigens from pancreatic beta cells to synthetic iron oxide nanoparticles. This stimulates the development of T-regulatory cells into killer T cells that destroy the immune cells which cause the serial killer like autoimmune attack.

Santamaria’s team recently tested his vaccine in diabetes-prone mice. It restored normal blood sugar and insulin levels in animals that already had diabetes and prevented or slowed its onset in young mice that had not yet developed the disease. The team is now readying the vaccine for human trials and is designing related vaccines to treat other autoimmune diseases, including multiple sclerosis, rheumatoid arthritis, and inflammatory bowel disease.

If effective, such therapeutic vaccines could help the three million Americans with type 1 diabetes and the 400,000 people diagnosed with multiple sclerosis. Vaccines against dust mites and asthma are also in the works.

Some of the new therapeutic vaccines are actually designed to attack the body, albeit in a selective way. A new experimental heart-disease vaccine takes aim at unwanted biochemicals within the body, specifically low-density lipoprotein (LDL), better known as bad cholesterol. When large quantities of LDL cholesterol circulate through the bloodstream, it can be deposited on artery walls, leading to a buildup of plaque and triggering inflammation. Anti-cholesterol vaccines encourage the immune system to attack LDL and remove plaques. Scientists have also discovered that the vaccine lowers blood pressure and protects against the rupture of aneurysms, at least in mice.

Clinical trials in humans are expected to start later this year and if successful could help to prevent the 800,000+ deaths per year from cardiovascular disease.

Even more people could be helped by an anti-obesity vaccine. Nearly 75 million adults are classified as obese in the United States. Researchers are working on a vaccine that targets ghrelin – a gastrointestinal hormone that appears to stimulate appetite.

Others, are looking at vaccines to prevent addiction to cocaine, methamphetamines, opiates and nicotine.

It is too soon to know how and when these vaccines will come to market or how effective they will be, but it’s clear that therapeutic vaccines are coming and will be used against a host of the most prevailing public health issues of the 21^st century.

Debunking Myths About HIV Vaccine

In honor of World AIDS Day tomorrow, SRxA’s Word on Health wants to share with our readers the top 10 myths about HIV vaccine research.

With the help of our friends at the HIV Vaccine Trials Network (HVTN), we’d like to set the record straight.

Myth # 1: HIV vaccines can give people HIV

HIV vaccines do not contain HIV and therefore a person cannot get HIV from the vaccine. Some vaccines, like those for typhoid or polio, may contain a weak form of the virus they are protecting against, but this is not the case for HIV vaccines. Think of it like a photocopy: It might look similar, but it isn’t the original. In the past 25 years more than 30,000 volunteers have taken part in HIV vaccine studies worldwide, and no one has been infected with HIV by any of the vaccines tested.

Myth #2: An HIV vaccine already exists

There is no licensed vaccine against HIV or AIDS, but scientists are getting closer than ever before.  In 2009, a large-scale vaccine study conducted in Thailand showed that a vaccine combination could prevent about 32% of new infections. Researchers around the world continue to search for an HIV vaccine that is even more effective. Leading this effort is the HVTN.

Myth #3: Joining an HIV-vaccine study is like being a guinea pig

Unlike guinea pigs, people can say yes or no to participating in research. All study volunteers undergo informed consent to ensure that they fully understand all of the risks and benefits of being in a study and those volunteers are reminded that they may leave a study at any time without losing rights or benefits.

Myth #4: A person must be HIV positive to be in an HIV vaccine study

Not so. While some research groups are conducting studies of vaccines that might be used in people who are already infected with HIV, the vaccines being tested by the HVTN are preventive vaccines which are tested on volunteers who are not infected with HIV.

Myth #5: Vaccine researchers want study participants to practice unsafe behaviors so they can see whether the vaccine really works

Not true. The safety of study participants is the No. 1 priority of HIV vaccine researchers and study site staff. Trained counselors work with study participants to help them develop an individual plan on how to keep from contracting HIV.

Myth #6: Now that there are pills that can prevent HIV infection, an HIV vaccine is no longer necessary

Although high risk, HIV-negative people can take antiretroviral medication to lower their chances of becoming infected if they are exposed to the virus, it has not yet been recommended for widespread use. This type of therapy known as  PreExposure Prophylaxis is unlikely to be an option for everyone because the pills are expensive, are not always covered by insurance, may cause side effects, and not everyone has access to them.

Myth #7: An HIV vaccine is unnecessary because AIDS is easily treated and controlled

While treatment for AIDS has dramatically improved over the last 30 years, it is no substitute for prevention.

Myth #8: The search for an HIV vaccine has been going on for a long time and it’s just not possible to find one that works

The science of HIV-vaccine development is challenging, but scientific understanding continues to improve all the time. Science has come a long way in the 30 years since AIDS was discovered. In comparing preventive HIV vaccine work to other vaccine development, the time it has taken is not so surprising; the polio vaccine took 47 years to develop.

Myth #9: Vaccines cause autism and just aren’t safe

This is not true. Numerous studies in the past decade have found this claim to be false. The British doctor who originally published the finding about vaccines and autism has since been found to have falsified his data.

Myth #10: People who aren’t at risk don’t need an HIV vaccine

Not true either. A person may not currently be at risk for HIV, but life situations can change along with disease risk.

So now you know!  By correcting these myths we hope in some small way to be able to help in the mission of this World AIDS campaign – bringing the number of AIDS deaths to zero.

Fighting Flu

Last night I participated in my annual healthcare lottery. Fortunately for my finances, this didn’t involve scratch cards, ticket stubs or wheel spinning of any kind, nor will it bring me great riches, a new car or a timeshare condo. Instead, if my gamble pays off, I might be spared the flu this winter season.

However, this may be one of the last years that I have to keep my fingers crossed that the vaccine might work.  In future years getting a flu shot may become a safe bet.

In a significant step against the disease that affects billions of people each year, scientists at Oxford University in the UK, just announced that they have successfully tested a universal flu vaccine that could work against all known strains of the illness.

This new vaccine targets a different part of the flu virus to traditional vaccines, meaning it does not need expensive reformulation and guess work  every year to try and match the most prevalent strains of the virus that are circulating the world.

The team, led by Dr Sarah Gilbert at the Jenner Institute, developed a vaccine that targets proteins inside the flu virus that are common across all strains, instead of those that sit on the virus’s external coat, which are liable to mutate.

If used widely, a universal flu vaccine could prevent pandemics, such as the swine flu outbreaks of recent years, and could even end the need for a seasonal flu jab.

A universal vaccine would save the time and money now needed to create vaccines to fight whatever particular virus has emerged in any given year.  The process of developing a seasonal vaccine takes at least four months and if the flu strain is highly pathogenic the delay means people get sick and die before the vaccine is ready.

“If we were using the same vaccine year in, year out, it would be more like vaccinating against other diseases like tetanus,” said Gilbert. “It would become a routine vaccination that would be manufactured and used all the time at a steady level. We wouldn’t have these sudden demands or shortages – all that would stop.”

While traditional vaccines prompt the body to create antibodies, Gilbert’s vaccine boosts the number of the body’s T-cells, another key part of the immune system which can identify and destroy cells that have been infected by a virus.

In her trial, Gilbert vaccinated 11 healthy volunteers and then infected them, along with 11 non-vaccinated volunteers, with a strain of flu virus.  She then monitored the volunteers’ symptoms twice a day.  Her results showed that the vaccine worked as planned.

“Fewer of the people who were vaccinated got flu than the people who weren’t vaccinated,” said Gilbert. “We did get an indication that the vaccine was protecting people, not only from the numbers of people who got flu but also from looking at their T-cells before we gave them flu. The people we vaccinated had T-cells that were more activated. The people we hadn’t vaccinated had T-cells as well but they were in a resting state so they would probably have taken longer to do anything. The volunteers we vaccinated had T-cells that were activated, primed and ready to kill. There were more T-cells in people we vaccinated and they were more activated.”

The trial proved two important things about the vaccine: First, it showed that it was safe; and second it proved that giving people flu virus in the presence of lots of T-cells induced by the vaccine was absolutely fine.

“What we’ll probably do is take the existing flu vaccine and mix in the new virus-vector vaccine, so you get both good antibodies and good T-cells. As well as giving you the antibodies for this season’s strain of flu, we’ll give you some T-cells that will cover this season, next year, and thereafter. It may not be 100% effective against all strains, but at least if there were a pandemic coming around, it would cover you for any strain.”

It is also believed that the vaccine could provide better protection against flu for older people. Traditional flu vaccines are effective in about 70-80% of young people, but only 30-40% of older people, because the older people’s immune systems are less efficient at making new antibodies.

The next step for the new vaccine is a larger scale trial comparing several thousand people who are given and not given the vaccine.

Although that means a commercial product is still some years away, this study represents some potentially very exciting findings not only for flu but possibly for other infectious diseases.

SRxA’s Word on Health looks forward to bringing you this news as it happens.

Roll Up Your Kids’ Sleeves, Before Going Back to School

“There are only two things a child will share willingly,” renowned pediatrician Benjamin Spock once wrote, “communicable diseases and his mother’s age.”

While you can’t control what your little darling will say, you do have a little more control when it comes to his or her health. Whether your child is learning the alphabet or learning to drive, back to school check- ups are a great way for parents to make sure their kids are protected against disease and illness. Vaccination is one of the many important procedures performed during such check-ups. Not only does it  protect your child from acquiring potential serious diseases but also it can protect your community.

With that in mind, and the back-to-school season upon us, SRxA’s Word on Health is pleased to bring you the following information:

Vaccination requirements vary by state and school district. You can contact your local school board to find out exact requirements.

The Center for Disease Control and Prevention (CDC) recommends the following immunizations for children 0-6 years:

• Hepatits B Vaccine (HepB)
• Rotavirus Vaccine (RV)
• Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTap)
• Haemophilus influenzae tybe b conjugate vaccine (Hib)
• Pneumococcal vaccine (PCV and/or PPSV)
• Inactivated poliovirus vaccine (IPV)
• Influenza vaccine (seasonal)
• Measles, mumps and rubella vaccine (MMR)
• Hepatitis A vaccine (HepA)
• Meningococcal conjugate vaccine, quadrivalent (MCV4)

For children aged 7-18 years, the CDC recommends the following immunizations:

• Tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap)
• Human papillomavirus vaccine (HPV)
• Meningococcal conjugate vaccine, quadrivalent (MCV4)
• Influenza vaccine (seasonal)
• Pneumococal vaccines
• Hepatitis A vaccine (HepA)
• Hepatitis B vaccine (HepB)
• Inactivated poliovirus vaccine (IPV)
• Measles, mumps and rubella vaccine (MMR)
• Varicella vaccine

Maybe the thought of all those needles will keep your little one from revealing your age!