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Dr Charlie Weller : Why Ebola keeps coming back

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The Ebola virus has reared its head again, this time in the Democratic Republic of Congo. While it is impossible to predict exactly where and when the next outbreak will occur, we now know much more about how to prevent a crisis.

The news of an Ebola outbreak in the town of Bikoro in north-west DR Congo instantly brings to mind the horror of the epidemic that took 11,000 lives and infected 28,000 people in West Africa between 2014 and 2016.



It is a nightmare no-one wants to relive – or should have to.

Since 4 April in DR Congo, there have been more than 30 possible cases – involving 18 deaths – although only two incidents have so far been confirmed as Ebola.

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So why does Ebola keep coming back and what work is being done to prevent a repeat of the tragedy in West Africa?

Out of control

Ebola can spread rapidly, through contact with even small amounts of bodily fluid of those infected. Its early flu-like symptoms are not always obvious.

Its appearance in Bikoro – a market town close to other local towns, well connected by major rivers and near the national border – is a cause for concern.

This is an area where people connect, trade and travel – an environment ripe for spreading disease.

The West African epidemic of 2014-16 began in a small border village in Guinea, its first victim thought to be a two-year-old boy who died in December 2013.

An Ebola quarantine unit in DRC in June 2017

The disease spread quickly across Guinea and neighbouring Sierra Leone and Liberia, spiralling out of control when it reached urban centres.

DR Congo is thousands of miles from the West African countries devastated by that epidemic.

That it should reappear so far away is not in itself a surprise.

The Ebola virus has been traced back to two simultaneous outbreaks in 1976 – 151 people died in the Nzara area, South Sudan, and 280 in the Yambuku area, near the Ebola river, from which the disease takes its name.

This latest outbreak is the ninth in DR Congo, which has seen all three Ebola outbreaks to have occurred since the 2014-16 epidemic.

In total, there have been 24 recorded outbreaks – in addition to the 2014-16 epidemic – in west and central Africa, including in DR Congo, Uganda, Sudan and Gabon. The number of deaths has ranged from one to 280.

While we can identify high-risk areas, it is unrealistic to expect that we could ever eradicate this disease and impossible to know when or where the next outbreak will occur.

Fruit bats are thought to be the main host of the disease, but it is also introduced into the human population through close contact with the blood, organs or other bodily fluids of other infected animals. These can include chimpanzees, gorillas, monkeys, antelope and porcupines.

The disease is endemic to the area and it is not possible to eradicate all the animals who might be a host for Ebola. As long as humans come in contact with them, there is always a possibility that Ebola could return

Looking for ‘patient zero’

We can, however, stop outbreaks becoming epidemics and we can better protect people.

A swift and well-co-ordinated response can ensure disease is contained early on, so as few people as possible become ill and die.

For example, an outbreak in DRC almost a year ago was quickly contained.

An Ebola victim being buried near Freetown, Sierra Leone, in 2014

It was in a very remote area in the country’s northern region, further from borders and so perhaps less of a risk than the current outbreak.

But an immediate response was still critical and meant the impact was limited to four deaths and four survivors.

First-response teams of health workers and scientists from DR Congo, World Health Organization and aid agencies are now in the area of the latest outbreak.

Establishing the strain of the virus and tracking all possible transmissions will be their priority.

They will be working to identify “patient zero” as fast as possible.

They will want to know all the people they’ve been in contact with and, in turn, all the people they have been in contact with.

Suspected patients and the people they have been in contact with will be cared for in local health facilities.

Scrupulous hygiene procedures will be paramount – including the use of face-shields, gowns and gloves to block splashes of bodily fluid or other contact with infected materials.

Communication to all at risk is vital, and the response teams will be expert in ensuring all those living locally have the best information.

Blood samples from patients in the current outbreak have been sent to the national lab in Kinshasa for testing.

Vaccine stockpiled

There are five identified strains of the Ebola virus, the deadliest to date being the Zaire strain.

This is the strain involved in the latest outbreak, for which there is now a vaccine ready for emergency use.

A suspected Ebola victim in isolation in Zaire in 1976

In December 2016, final results of a large trial of this vaccine – with funding from the Wellcome Trust and the UK and Norwegian governments – confirmed it provides a high level of protection.

It was developed rapidly during the 2014-16 epidemic but came too late to have a significant impact at the time.

It is not yet fully licensed, but thanks to global efforts it has been proved safe for human use and 300,000 doses are stockpiled.

Crucially, it would be free for patients and could be in the area within three to four days.

WHO guidelines recommend that should there be an Ebola outbreak before licensing has been granted, the vaccine should be given to all suspected patients, contacts and health workers at risk. The decision on giving this vaccine is one for the DR Congo Ministry of Health to make.

The DR Congo response to recent outbreaks has proved the country’s government is well-prepared.

But no country could or should be expected to manage this alone.

Global support and an early, well co-ordinated response is essential to ensuring outbreaks are effectively contained.

This outbreak will be a challenge for local teams on the ground.

But it is also a challenge and an opportunity for the global community to prove it has learned lessons from the West African epidemic.

We cannot hope that Ebola will simply disappear but we can hope to make tackling it so routine that it can be quickly stopped in its tracks.

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Top 10 Most Beautiful Places To Visit Before You Die!

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Everyone wants to travel the world and visit the beautiful sites, but with so many places to visit where do you start? Here we come to you with the list of 10 most incredibly super awesome places to visit around the world, before you die.

Whitehaven Beach – Australia

Whitehaven-Beach_Australia

Whitehaven Beach is known for its white sands. The Beach is a 7 km stretch along Whitsunday Island. The island is accessible by boat from the mainland tourist ports of Airlie Beach and Shute Harbour, as well as Hamilton Island. The Beach was named the top Eco Friendly Beach in the world by CNN.com. Dogs are not permitted on the beach and cigarette smoking is prohibited.

Westin Maui Resort & Spa Hawaii

Westin Maui Resort & Spa Hawaii
A fantastic lobby with waterfalls and pools greets visitors to this lush Kaanapali resort where the impressive scenery, friendly service, fabulous spa and awesome swimming pools are the highlights. The Westin Maui Resort & Spa, Ka’anapali is located along a breathtaking stretch of the gorgeous, white-sand Ka’anapali Beach.

The Fairy Pools on the Isle of Skye – Scotland

The Fairy Pools on the Isle of Skye - Scotland
If you are backpacking in Scotland generally or are planning a trip to the Isle of Skye then I heartily recommend that you visit the so-called Fairy Pools.The Fairy Pools is located in Cuillins Hills, Isle of Skye, Scotland. The Fairy Pools are a series of clear, cold pools and waterfalls formed as Allt Coir’ a’ Mhadaidh tumbles down from the foothills of the Black Cuillins into Glen Brittle.

Marble Caverns of Carrera Lake – Chile

Marble Caverns
Azure temple, Lake General Carrera in Patagonia, Chile, A natural wonder that could be the world’s most beautiful cave network. An Azure Temple created by nature, the walls of this network of water-filled marble caverns show just how magnificent the precious geography of our planet can be.

The Shahara Bridge – Yemen

The Shahara Bridge - Yemen
This bridge was constructed in 17th century to connect towns at the tops of mountains in the state of Yemen. Shahara Bridge built to fight against Turkish invaders. It’s a scary bridge and a popular tourist attraction.

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Havasu Falls – Grand Canyon National Park

Havasu Falls - Grand Canyon National Park
Havasu Falls is paradise on Earth. This is an absolutely amazingly beautiful waterfall located in a remote canyon of Arizona. The spectacular waterfalls and isolated community within the Havasupai Indian Reservation attract thousands of visitors each year. The Havasupai are intimately connected to the water and the land. This blue- green water is sacred to the Havasupai.

Fjaðrárgljúfur Canyon – Iceland

Fjaðrárgljúfur Canyon
Fjaðrárgljúfur is a canyon in south east Iceland which is up to 100 m deep and about 2 kilometres long, with the Fjaðrá river flowing through it. It is located near the Ring Road, not far from the village of Kirkjubæjarklaustur.The canyon was created by progressive erosion by flowing water from glaciers through the rocks and palagonite over millennia.

Arang Kel, Neelum Valley – Kashmir, Pakistan

Arang Kel, Neelum Valley - Kashmir, Pakistan
A Breathtaking, Lush Green Village in Neelum Valley, Kashmir. Situated at the hill top near Kel, about 1500 feet ascend from River Neelam. It is also a village full of beautiful sceneries. It is a piece of utmost beauty, one can find in Kashmir. Visit Neelum Valley for Arang Kel, a worth visiting place.

Arang Kel, also known as the Pearl of Neelum Valley. It is undoubtedly one of the most beautiful places to visit once in life. Its an amazing 30-45 mins trek from Kel. I must say! It’s just breathtaking.

The Dark Hedges – Northern Ireland

The Dark Hedges - Northern Ireland
This beautiful avenue of beech trees was planted by the Stuart family in the eighteenth century. The Dark Hedges is one of the most photographed natural phenomena in Northern Ireland and a popular attraction for tourists from across the world. It was intended as a compelling landscape feature to impress visitors.

This beautiful tree tunnel has been used to film a scene in HBO’s popular television series Game of Thrones. Since that the Dark Hedges became so popular, and that’s why we included it “top most beautiful places to visit before you die! In addition, the Dark Hedges have also been used in the 2017 Transformers film The Last Knight.

Coast near Marsa Matruh – Egypt

Coast near Marsa Matruh - Egypt
Mersa Matruh is a major Egyptian tourist resort and serves as a getaway resort for Europeans as well as Cairenes eager to flee the capital in the sweltering summer months. It is served by Mersa Matruh Airport. The city is known for its white soft sands and calm transparent waters.

Marsa Matruh is a cool attraction for beach lovers. It has become a destination for millions of tourists. The beach there is too good. Sugar sand, crystal clear blue water that has a coolness to it during the most hot months of the year. However, not much coral or underwater activities there.

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Carbon dioxide could help reduce belly fat

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Scientists have identified a new technique that eliminates stomach fat with the first randomised, controlled trial testing of carbon dioxide gas injections.

A report published in the Northwestern Medicine noted that the changes were modest and did not result in long-term fat reduction.

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The lead author and the vice-chair of dermatology at Northwestern University, Feinberg School of Medicine, Dr. Murad Alam, said, “Carboxytherapy could potentially be a new and effective means of fat reduction. It still needs to be optimised. So, it is long lasting.”

The paper was published in the Journal of the American Academy of Dermatology described the new technique as a “safe, inexpensive gas, and injecting it into fat pockets may be preferred by patients who like natural treatments.”

According to sciencedaily.com, the current technologies routinely used for non-invasive fat reduction include cryolipolysis, high intensity ultrasound, radiofrequency, chemical adipocytolysis and laser-assisted fat reduction.

The new technique, known as Carboxytherapy, has been performed primarily outside the United States, with a few clinical studies suggesting that it may provide a lasting improvement in abdominal contours.

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Researchers Identifies the genome of the most common cancer among younger men

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In the case of UNC’s testicular cancer mapping, researchers analyzed 137 testicular germ cell tumors to find unique molecular features. They discovered certain changes in the RAS gene family. These are the type of genes that make proteins involved in cell signaling pathways that control cell growth and death. Members of the RAS family include KRAS, HRAS, and NRAS, the most common oncogenes in human cancer.

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“We identified distinct molecular events that were associated with different histological types of testicular germ cell cancer,” Hoadley said. “While we found recurrent mutations in KIT, KRAS, and NRAS, they were only discovered in a subset of seminomas. However, we noted strong epigenetic components — DNA methylation and miRNA — that are likely very important in testicular germ cell tumorigenesis. We also identified a previously underappreciated subset of seminomas defined by KIT mutations that likely occur early. These tumors had a complete global lack of DNA methylation that locks them in a state with similarity to primordial germ cells.”

Hopefully, this turns out to be yet another piece in the puzzle on the road to curing cancer once and for all. While we’re still a long way from that, mapping the genome of existing cancers will give scientists far more information about exactly what it is that they’re up against.

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