HealthReport2011(截止五月).doc

Health Report Form Jua to May,2011People With Chronic Hepatitis B Often Do Not Know ItToday we answer a question. Vu Quang Hien from Vietnam wants to know more about hepatitis B. Hepatitis is the name for a group of viral infections that attack the liver. These are called A, B, C and so on.An estimated two billion people are infected with hepatitis B. The rates are highest in China and other parts of Asia. The World Health Organization says most of these infections happen during childhood.Hepatitis B is spread through contact with infected blood or other body fluids. Mothers can infect babies at birth. Unsafe injections and sexual contact can also spread the virus. Experts say it can survive outside the body for at least a week.There are two forms of hepatitis B - acute and chronic. Acute cases last for several weeks, although recovery can take months. Chronic cases can lead to death from cirrhosis or scarring of the liver and liver cancer.Yet people with long-term liver infections can live for years and not even know they are infected. The ones most likely to develop chronic hepatitis B are young children.In the United States, experts at the Centers for Disease Control and Prevention urge medical providers to test Asian-American patients.DR. JOHN WARD: The bottom line - since most people of Asian heritage came to the US from endemic countries or were born to parents from these countries, they should be screened for chronic hepatitis B.For acute hepatitis B, patients may receive care to replace lost fluids, but there are no treatments. Doctors can treat chronic cases with interferon and antiviral drugs. But these medicines cost too much for most of the worlds poor.A vaccine to prevent hepatitis B has been available for thirty years. The researcher who discovered this vaccine - and hepatitis B itself - was an American named Baruch Blumberg. Dr. Blumberg also showed that the virus could cause liver cancer.He and another researcher at the Fox Chase Cancer Center in Philadelphia, Irving Millman, invented the vaccine in nineteen sixty-nine. But Dr. Blumberg said it took some time to find a drug company willing to produce it.He first became interested in studying infectious disease when he volunteered in Surinam during his medical training.His discoveries with hepatitis B saved many lives and earned him a Nobel Prize in medicine. But he also had other interests - including the search for life in outer space.In the late nineties, he helped launch the Astrobiology Institute at NASA. He was at a space agency conference in California in April when he died, apparently of a heart attack. Baruch Blumberg was eighty-five years old.How Early Treatment Can Limit the Spread of HIVFor people infected with HIV, the earlier they start treatment, the better - and better not just for them. A new study shows that early treatment greatly reduces the risk that the partner of an infected person will also get infected. HIV is the virus that causes AIDS.Dr. Anthony Fauci is with the United States National Institutes of Health which paid for the study.ANTHONY FAUCI: Many studies have been showing that the earlier you start, the better it is for the person who is infected. This study shows that not only is it better for the person who is infected, but it helps that person from transmitting to the person thats their sexual partner, heterosexual partner.Researchers cannot say if the results would be the same in men who have sex with men. Most of the couples in the study were heterosexual.The study took place in Botswana, Brazil, India, Kenya, Malawi, South Africa, Thailand, the United States and Zimbabwe. It involved almost two thousand couples divided into two groups.In one group, the infected man or woman began to take a combination of three antiretroviral drugs immediately after being found to have HIV. In the other group, the infected partners began drug treatment only when they started to show signs of getting AIDS.The researchers say both groups received equal amounts of HIV-related care and counseling. That included information about safe sex practices, free condoms and regular HIV testing.The study began in two thousand five. It was supposed to last until twenty-fifteen. But researchers stopped it early because the results were so clear. Only one case of infection was reported in couples where the infected partner began immediate treatment.Dr. Fauci says earlier treatment led to a ninety-six percent reduction in the spread of HIV to uninfected partners.ANTHONY FAUCI: This is a powerful bit of evidence that will go into the thinking and formulation of guidelines and of global policy, policy by WHO, by UNAIDS, by the international organizations that help to provide drugs in the developing world.The study shows the value in testing and treating HIV before a person even feels sick enough to see a doctor. But in many countries, public health budgets are already stretched thin. In sub-Saharan Africa, the area hardest hit by AIDS, for every person who gets treated, two others go untreated.Antiretroviral drugs suppress the virus. Once people start treatment, they have to continue it daily for the rest of their life.Chronic Diseases an Impending Disaster for Some NationsWhen we think of threats to public health, we often think of communicable diseases. But experts say non-communicable diseases - those that do not spread from person to person - are the leading killer today. These are often the result of poor diet, environmental influences including tobacco and alcohol use, or genetics.Now, the World Health Organization has released its first Global Status Report on Non-Communicable Diseases. In two thousand eight, they caused sixty-three percent of all deaths. And eighty percent of those deaths were reported in developing countries.These countries are spending billions to treat conditions like cancer, heart disease and diabetes. The WHO says the costs of treating non-infectious diseases are pushing millions of people into poverty. WHO Director-General Margaret Chan says: For some countries it is no exaggeration to describe the situation as an impending disaster . a disaster for health, society and national economies.Conditions that last for years are also known as chronic diseases. Population changes are driving the increase in cases. Populations in many developing countries are growing quickly and living more in cities. Aging populations also play a part. Chronic diseases become more common as people get older.Dr. James Hospedales is a chronic disease expert at the WHO. He says chronic diseases are a major problem in big countries like the United States, India and China and across Latin America and the Mediterranean. And they are expected to become the leading cause of death in many African nations by twenty-twenty.JAMES HOSPEDALES: We cannot wait until we have dealt with HIV, dealt with malaria. No, its upon us. As a matter of fact, one of the major contributors to tuberculosis going up in several countries is because diabetes is going up - and obesity. So there is a link between diabetes and TB.Dr. Hospedales says some middle- and low-income countries are beginning to recognize that their health policies must deal more with prevention.JAMES HOSPEDALES: We estimate in WHO that over thirty million lives can be saved in the next ten years by simple measures - reducing the level of salt by fifteen to twenty percent, reducing the amount of tobacco, and increasing the number of people who are at risk of a heart attack and stroke to be on simple preventive treatment.The WHO is the United Nations health agency. The General Assembly plans to hold its first high-level meeting on the prevention and control of non-communicable diseases. The meeting will take place in New York this September.Why Sleep Apnea Raises Risk of Stroke, Heart AttackLoud snoring can be a problem - and not just for other people trying to sleep with the noise. It can also be a sign of sleep apnea. People with this condition repeatedly stop breathing while they sleep, and may not even know it.Doctor David Gross is a lung specialist at the National Rehabilitation Hospital of Washington.DAVIS GROSS: Sleep apnea means that the airway, the upper airway, cuts off at night. So the person, while hes breathing normally in the daytime, when he goes to sleep, the muscles get all relaxed and cut off and this can happen over and over again, sixty to one hundred times an hour.Most people who snore do not have sleep apnea. But doctors say most people with sleep apnea do snore. Sleep apnea not only reduces sleep quality and makes people feel tired during the day. More and more studies show that it can also lead to strokes and heart attacks.Dr. Michael Twery of the National Institutes of Health explains why.MICHAEL TWERY: Whenever we run out of enough air to breathe, it sends alerting signals to our minds. It raises the level of stress hormones. It tells our heart to work harder.When a person stops breathing, oxygen levels in the blood decrease. This happens again and again with sleep apnea.MICHAEL TWERY: And its constantly exposing us, night after night, to periods of insufficient oxygen. The level of oxygen in our blood will actually decrease to levels that would be considered a medical emergency.Dr. Twery compares the effect of sleep apnea to racing a car engine for long periods of time.MICHAEL TWERY: Our heart becomes overworked and we become more vulnerable to heart attack.And also strokes. Dr. Twery led a study of about nine thousand people who had sleep apnea but no history of heart disease. The researchers followed their progress for nine years.MICHAEL TWERY: They found that men can experience up to a three-fold increased risk of stroke, and that risk seemed to be well correlated with the severity of sleep apnea.In other words, the more severe the sleep apnea, the greater the chance of a stroke.The next step will involve sleep apnea patients who have already had a stroke or heart attack. Researchers will study whether patients can reduce the risk of a second one with a machine called a CPAP. CPAP is continuous positive airway pressure. It provides a continuous flow of air into the throat and lungs while the person sleeps.Sleep apnea seems to be more common in men than in women, and it becomes more common as people get older. The most common form is called obstructive sleep apnea. People who have it are often overweight or have it in their family, but it can affect anyone. In children, for example, enlarged tonsils in the throat can interfere with breathing as they sleep.Travelers May Spread Drug-Resistance Gene From South AsiaScientists say they have found dangerous forms of bacteria in the drinking water of New Delhi, India. The bacteria has a gene scientists call New Delhi metallo-beta-lactamase, or NDM-1. The gene is dangerous because it can make bacteria resistant to antibiotic drugs.Researchers from the University of Cardiff in Britain led the study. They found the NDM-1 bacteria present in two of fifty drinking water samples. They also found it in seepage water the water that children might play in on streets. The gene was found in eleven bacterial species, including those that cause cholera and dysentery, a diarrheal disease.The researchers also reported finding NDM-1 in bacteria from medical patients. The patients were from India and other South Asian countries, Europe and North America.The scientists now estimate that about one hundred million Indians with the bacteria are traveling around the world. Timothy Walsh leads the NDM-1 research at University of Cardiff. He says he is concerned about the gene spreading.TIMOTHY WALSH: The gene pool in India, probably Pakistan, probably Bangladesh, probably in Sri Lanka,is absolutely huge.And wherever these people travel, they will take that normal flora with them in one hundred trillion bacteria. and therefore out of consequence of that this is it spread a worldwide.The United States government reported the presence of NDM-1 in three people last year. All had been to India earlier for medical treatment.Experts say people with the NDM-1 form of bacteria in their body can remain healthy. The danger is created if you get bacteria that cause disease. The gene can produce the disease bacteria and make enzymes to fight even the most powerful antibiotics. Antibiotics are the main treatment for bacterial infections.Officials in India say its water supply is safe. Vishwa Mohan Katoch is the Director General of Health Services. He says the bacteria do not usually cause a problem.However, officials in New Delhi are investigating. Timothy Walsh says he offered his team to help in the investigation, but Indian officials rejected the invitation. He worries about the science of the study.TIMOTHY WALSH: My fear is that this investigation that they are going to undertake will almost certainly not employ the right methods and the study designed will be quite poor and therefore Im not convinced that the outcome will be scientifically credible.Professor Walsh also says its time for the international community to force countries to follow World Health Organization guidelines for antibiotic use.What Do You Know About the Common Cold?Do you think getting cold can give you a cold? Is it bad to drink milk when you have a cold? Can chicken soup cure a cold?Ranit Mishori is a family medicine doctor at Georgetown University Medical Center in Washington. She says colds are more common in winter, but not because of low temperatures. The cold weather just means people stay inside more.RANIT MISHORI: People tend to congregate and be together and the way the common cold virus is transmitted from one person to another is through handshakes, through sneezing, or coughing on one another.Adults generally get two to three colds a year. Children are likely to catch four or five. Dr. Mishori says some people mistakenly believe they can become resistant to colds.RANIT MISHORI: There are about two hundred different viruses that cause the common cold. People think that once you get infected one time you develop immunity for the rest of your life. This is wrong.There is still no cure for the common cold. But Dr. Mishori says there are ways to feel better sooner.RANIT MISHORI: So if you get a cold and on day one and you start taking about two grams of vitamin C a day, there is evidence that it might shorten the number of days that you will be suffering with these symptoms.She says honey can also help.RANIT MISHORI: There is increased evidence that it helps shorten the duration of the common cold sometimes even by two to three days.Dr. Mishori says honey seems to be especially effective in children with colds. But the Agriculture Department says never to feed honey to babies less than one year old. It says even honey in prepared foods may contain substances that can make babies very sick.Some people believe in treating a cold with chicken soup. Does it work?RANIT MISHORI: Chicken soup has anti-inflammatory properties, so it helps reduce the duration of the cold but also it helps clear the mucus.Mucus is the sticky substance that can make you cough and have trouble breathing during a cold.Have you ever heard the old saying feed a cold, starve a fever? Dr. Mishori says this is not necessarily a good guideline to follow. She says if you have a cold but do not feel hungry, then dont eat.RANIT MISHORI: But you have to drink a lot and you can drink water or you can drink tea - anything that gets fluids into your body. Thats very important.But what about drinking milk during a cold? Some people think it only causes more mucus. Dr. Mishori says yes and no.RANIT MISHORI: Dairy products do not cause increased secretions, but they can thicken the secretions. So its possible that discomfort is somewhat more enhanced when you drink milk. But obviously, if youre a baby and thats all you drink, you should not stop giving babies milk. A New Reason for Why the Deaf May Have Trouble ReadingDeaf people may have no trouble communicating English words through American Sign Language, or ASL. But studies of ASL users show that, on average, educated deaf adults are likely to read at the level of a nine-year-old.The explanation has always been that this is because they never learned to connect letters with sounds. But a recent study shows that deaf readers are just like other people learning to read in a second language. Linguist Jill Morford led the study.JILL MORFORD: The assumption has always been that the problems with reading were educational issues with whats the right way to teach reading when you cant associate sounds with letters. But what were finding is that all this time weve been ignoring the fact that theyre actually learning a new language.Ms. Morford is a professor at the University of New Mexico and part of a research center at Gallaudet University in Washington. Most students at Gallaudet are deaf; the center studies how deaf people learn and use language.Professor Morford says signers are like English learners whose first language uses a different alphabet.JILL MORFORD: Anyone who has a first language that has a written system thats very different than English, like Arabic or Chinese or Russian, knows that learning to recognize and understand words in English is much more challenging than if you already speak a language that uses the same orthography.The orthography is the written system and spelling of a language. Of course, with signers, their first language has no written system at all, just hand gestures. Gallaudet professor Tom Allen explains what effect this has on reading.TOM ALLEN: Were not dealing with representations in the brain which are