Beursonline.nl

Grand Cru 11 mei 2008 13:01

2

BANGKOK - Voor anderhalf miljoen mensen in Myanmar (Birma) die door orkaan Nargis zijn getroffen, dreigt de dood als ze niet snel de beschikking krijgen over schoon water en sanitaire voorzieningen.

Dat heeft Sarah Ireland, regiodirecteur Oost-Azië van de hulporganisatie Oxfam, zondag gezegd.

"Meer dan 100.000 mensen zijn waarschijnlijk omgekomen en alles duidt op een grotere catastrofe", aldus Ireland, die vanuit Thailand reageerde. Ze stelde dat het dodental kan oplopen tot het vijftienvoudige van wat het nu is.

Vervuild

Ireland liet weten dat het dodental stijgt door gebrek aan voedsel en omdat mensen vervuild water moeten drinken. Ze waarschuwde voor de uitbraak van ziektes als cholera en tyfus.

Rode Kruis

Inmiddels is een vliegtuig met aan boord 35 ton hulpgoederen van het Internationale Rode Kruis zondag in de hoofdstad Yangon van Myanmar aangekomen. Dat heeft het Rode Kruis in een verklaring laten weten.

Het materiaal is bestemd voor de mensen die zijn getroffen door de cycloon Nargis. Het vliegtuig vervoerde onder meer een voorraad medicijnen waarmee gedurende drie maanden aan 10.000 mensen een basisgezondheidszorg kan worden verleend.

Verder heeft het Rode Kruis aan Myanmar een mobiele machine voor het zuiveren van water verstrekt.

flosz 11 mei 2008 13:59

1

De Samenwerkende Hulporganisaties (SHO) hebben gironummer 555 opengesteld voor de slachtoffers van de cycloon Nargis in Myanmar. De SHO is een samenwerkingsverband van acht Nederlandse hulporganisaties. Bij grote rampen werken zij samen in een Nationale Actie, dit keer onder de slogan 'Help de slachtoffers cycloon Myanmar!'.
www.giro555.nl/nl-NL/default.aspx

….en nu de junta een schop onder de kont!
www.nytimes.com/2008/05/10/world/asia...

www.youtube.com/watch?v=Z72Uv-qMci0
And love is not the easy thing
The only baggage you can bring...
And love is not the easy thing...
The only baggage you can bring
Is all that you can't leave behind

And if the darkness is to keep us apart
And if the daylight feels like it's a long way off
And if your glass heart should crack
And for a second you turn back
Oh no, be strong

Walk on, walk on
What you got they can�t steal it
No they can�t even feel it
Walk on, walk on...
Stay safe tonight

You're packing a suitcase for a place none of us has been
A place that has to be believed to be seen
You could have flown away
A singing bird in an open cage
Who will only fly, only fly for freedom

Walk on, walk on
What you've got they can't deny it
Can�t sell it, can�t buy it
Walk on, walk on
Stay safe tonight

And I know it aches
And your heart it breaks
And you can only take so much
Walk on, walk on

Home... hard to know what it is if you�ve never had one
Home... I can�t say where it is but I know I'm going home
That's where the hurt is

I know it aches
How your heart it breaks
And you can only take so much
Walk on, walk on

Leave it behind
You've got to leave it behind
All that you fashion
All that you make
All that you build
All that you break
All that you measure
All that you steal
All this you can leave behind
All that you reason
All that you sense
All that you speak
All you dress up
All that you scheme...

flosz 12 mei 2008 10:33

1

quote:
Grand Cru schreef:
Ze waarschuwde voor de uitbraak van ziektes als cholera en tyfus.

Dukoral
Dukoral® is an oral vaccine with a documented protective effect against diarrhea caused by cholera. The vaccine stimulates a protective immune response in the gut and has demonstrated a protective efficacy against cholera of approximately 85%. The vaccine is suitable for travelers and is indicated for use in adults and children over two years of age. Pregnant and lactating women may use it.

Dukoral® was first licensed in 1992 and is licensed in over 50 countries. It is presently the only internationally licensed oral cholera vaccine. To date, over 9 million doses of Dukoral® have been supplied with very few adverse events reported.

Cholera is an acute intestinal infection often caused by eating food or drinking water contaminated with the Vibrio cholerae bacteria. In its most severe form, the disease can cause a sudden onset of acute watery diarrhea that can lead to severe dehydration, kidney failure and ultimately death if treatment is not promptly given. Most people infected with cholera do not develop any symptoms, although the bacterium is present in their feces for 7-14 days, potentially infecting other individuals.

Morbidity and mortality
Cholera remains a global threat, particularly in developing countries where access to safe drinking water and adequate sanitation cannot be guaranteed. The number of cholera cases reported to the WHO in 2006 was close to 240 000 cases, including approximately 6300 deaths. It is likely the morbidity and mortality caused by V. cholerae is grossly underreported – less than 10% - to the WHO. As a result, the true burden of this disease is severely underestimated.

Geographical distribution
Cholera remains a global threat. Almost every developing country, where poor sanitary conditions prevail, faces cholera outbreaks and the threat of a cholera epidemic. Altogether seven cholera pandemics have been reported. The latest, still ongoing pandemic started in Indonesia in 1961, spreading to Africa in 1971 and to the Americas in 1991. Cholera is considered endemic in many countries.

Transmission
Cholera is spread by fecal contamination of water and food, linked to poor sanitation. Person-to-person transmission of cholera is rare.

Symptoms
About 75% of people infected with cholera do not develop symptoms. Of those who do develop symptoms, 80% are considered mild to moderate cases and 10 to 20% are severely affected. Children and the elderly are most susceptible.

Symptoms include acute, profuse watery diarrhea (“rice-water stools”) and often vomiting. Tachycardia, loss of skin turgor, dry mucous membranes, hypotension and thirst are often signs of dehydration. In extreme cases and if left untreated, severe dehydration can lead to kidney failure and death. Cholera is one of the most rapidly fatal infectious illnesses known.

Treatment and prevention
Rehydration is the key form of treatment. Mild or moderate dehydration can be treated with simple oral rehydration solutions containing salts and glucose. Severe cases of dehydration require treatment with intravenous fluids and antibiotics. WHO recommends that antibiotics are only used in severe cases as overuse of antibiotics has led to the emergence of multiresistant strains, some of which where found to be highly virulent.

Cholera can be prevented through the provision of clean water and proper sanitation. For travelers to endemic areas, it is recommended to “boil it, cook it, peel it, or forget it” and to avoid eating high-risk foods. An internationally licensed oral vaccine is currently available on the market and is suitable for travelers. In 2006, WHO published official recommendations for oral vaccines use in complex emergencies.

flosz 12 mei 2008 10:34

1

Tyfus is een uitputtende en levensgevaarlijke ziekte die door de S. Typhi bacterie wordt veroorzaakt. Paratyfus is vergelijkbaar met Tyfus maar het ziektebeeld is over het algemeen milder. Paratyfus wordt veroorzaakt door de serotypen van S. Paratyphi A, B of C. Elk jaar krijgen ongeveer 16 miljoen mensen Tyfus. In de endemische gebieden komt Tyfus het meest voor bij kinderen tussen de 5 en 19 jaar.

Geografische spreiding
Tyfus komt in de meeste delen van de wereld voor behalve in geïndustrialiseerde gebieden zoals de Verenigde Staten, Canada, westelijk Europa, Australië, en Japan. In deze landen hebben de juiste sanitaire faciliteiten de ziekte vrijwel geëlimineerd. De meeste ziektegevallen die in geïndustrialiseerde landen worden gemeld zijn gerelateerd aan reizigers naar endemische gebieden zoals Afrika, Azië (behalve Japan) en Latijns-Amerika. Daarom zouden de mensen die naar deze gebieden reizen, voorzorgsmaatregelen tegen de ziekte moeten overwegen.

Overdracht
Tyfus wordt over het algemeen overgedragen via de ontlasting - mond route, door verontreiniging van voedsel of water, of door persoonlijk contact. Het overdragen van de ziekte is vaak het gevolg van slechte hygiëne en slechte sanitaire voorzieningen. Iemand kan de bacterie bij zich dragen en verspreiden zonder de ziekte symptomen te ervaren. Volgens de Centers for Disease Control and Prevention (CDC), blijven 5% van mensen die tyfus hebben gehad drager van de bacterie.

Symptomen
De symptomen van tyfus zijn koorts, maagpijn, gewichtsverlies, verlies van eetlust, delirium, erge diarree (bij kinderen) en constipatie (bij volwassenen). De personen met tyfus hebben gewoonlijk een hoge aanhoudende koorts van 39 tot 40 °C. Soms hebben de patiënten vlakke, dieproze gekleurde vlekken op de huid. Bij een klassiek verlopend ziektebeeld zijn er twee fasen te onderscheiden na een gebruikelijke incubatieperiode van 7-14 dagen:

Eerste fase: de temperatuur neemt geleidelijk toe tot 40 °C, met periodes van zweten, verlies van eetlust, hoesten en hoofdpijn. Constipatie en huid afwijkingen kunnen de duidelijkste symptomen zijn. Kinderen kunnen vaak braken en diarree hebben. Deze fase duurt ongeveer een week, met toenemende lusteloosheid en een minder scherp bewustzijn.

Tweede fase: in de tweede tot derde week van de ziekte, ontwikkelen zich de symptomen van de maagdarm besmetting. De koorts blijft hoog en de polsslag wordt zwak en snel. In de derde week wordt de constipatie vervangen door erwtensoep-achtige diarree. De ontlasting kan bloed bevatten. In de vierde of vijfde week zakt de koorts en verbetert de algemene conditie langzaam.

Behandeling en preventie
Tyfus is over het algemeen goed te behandelen met een intensieve antibiotica kuur. Gemiddeld duurt de behandeling 18 dagen en worden er 60 tabletten antibiotica ingenomen. Omdat intensief antibiotica gebruik in verband gebracht wordt met resistentie ontwikkeling gaat de voorkeur ernaar uit om met vaccinatie, voorzorgmaatregelen en verbetering van hygiëne en sanitaire voorzieningen de verspreiding van de ziekte te controleren. Voor reizigers naar endemische landen betekent dat naast vaccinatie strikte aandacht voor voedsel en water.

Vivotif
www.crucell.nl/page/downloads/Bijslui...

flosz 12 mei 2008 18:56

2

WHO, Cyclone Nargis: Myanmar

Vaccination recommendations:
Essential:
Diptheria 10 years Can be combined with tetanus
Tetanus 10 years Booster dose is recommended if not taken in the last 10 years
Polio 10 years Potential risk of importation of wild virus with displaced
populations.
Typhoid 3 years
Hepatitis A life If there is no proof of immunity by vaccine or illness, even if
departure at short notice.
Can be combined with Hepatitis B
Hepatitis B 15 years

Cholera 6 months If there is sufficient time to receive the 2 oral doses to be
taken at one week interval before departure.
(Immunity is obtained one week after the second dose of a
combination Oral cholera & ETEC (enterotoxigenic, E.Coli)
vaccine (Brand name DUKORAL).

Given the structural damage caused by the cyclone and flooding of water supplies there is an additional
risk of waterborne diseases affecting large numbers of the urban, rural and displaced populations. In
addition, extensive damage to infrastructure and distribution systems, as well as power supplies, will make
it virtually impossible to prepare food safely, posing an additional risk of foodborne diseases. Chlorine
powder, water purification units, plastic sheeting for shelter, cooking utensils, ready-to-eat survival food
rations, essential medicines, cholera kits, antimalarial drugs, long lasting insecticide-treated bednets and
supplies for the management of corpses are urgently needed.

The populations affected by the cyclone in Myanmar are at immediate risk from outbreaks of waterborne
and foodborne diseases, particularly cholera, typhoid, Shigella dysenteriae type 1(Sd1). There is
increasing evidence of significant antimicrobial resistance, including multi-drug resistance (resistance to
more than three antimicrobials) in Sd1 isolates from the region.
Cholera and shigellosis are endemic in the region. Usual water sources can become unsafe for drinking
for several reasons: the incursion of floodwaters, faecal contamination caused by overflow of latrines,
inadequate sanitation and upstream contamination of interconnected water sources.

flosz 12 mei 2008 19:09

0

Link:
www.searo.who.int/LinkFiles/MyanmarCy...

flosz 12 mei 2008 19:25

2

Cholera: Disease of disaster
Friday, May 9, 2008

In the days after Cyclone Nargis sent a wall of seawater through Burma's low-lying Irrawaddy Delta in May 2008, the threat of disease became a major concern for survivors.
The United Nations estimated that at least 1.5 million people were "severely affected," needing food, shelter and clean drinking water.
Clean drinking water is especially critical in the wake of a disaster of this magnitude. Without it, people begin to dehydrate within a few days. And with seawater and large numbers of decomposing bodies overwhelming water supplies, disease quickly becomes a threat.
Among the most common diseases to hit areas where drinking water is compromised is cholera.
What is cholera?
Cholera is an intestinal infection caused by the bacterium Vibrio cholerae.
You get it from drinking Refugee girls fetch water from a hand well in Kabul, Afghanistan. More than 2,000 suspected cases of cholera detected in the Afghan capital in June 2005. At least eight people have died. (Tomas Munita/Associated Press) contaminated water or eating contaminated food. About five per cent of infected people will become severely ill and will develop profuse watery diarrhea, vomiting, and leg cramps.

In severely ill people, cholera will cause rapid dehydration and shock. If you have a severe case and you are not treated, you could die within a few hours.
However, most people who are infected don't get sick, although the bacterium can be present in their feces for up to two weeks.
Of those who do get sick, 80-90 per cent of cases are either mild or moderate and often indistinguishable from other types of acute diarrhea.
How prevalent is cholera?
According to the World Health Organization, there were at least 236,896 cases of cholera in 52 countries in 2006. After years of declines, the number of cases rose dramatically in 2006 to levels not seen since the 1990s.
All but 2,000 of those cases were reported in Africa.
The number of deaths in 2006 was 6,306 — three times the number recorded a year earlier.
How is cholera treated?
Rehydrating the patient is the most effective way of treating someone with severe cholera. There are at least two ways of doing this:
• By drinking large quantities of a rehydration solution — a prepackaged mixture of sugar and salts that can be mixed with clean water.
• By intravenously replacing lost fluids, in severe cases.
Antibiotics may also be used in an effort to shorten the course and the severity of the illness. But antibiotics are not as critical in the treatment as rehydration.
Is cholera just a risk in areas hit by disaster?
Cholera is a risk anywhere that hygiene and access to clean drinking water is a problem. It was not uncommon in North America in the 1800s, but it has been rare in industrialized countries for the past 100 years or so.
Cholera remains a threat in many developing countries. There have been a few cases in Canada over the past several years, but they have all involved travellers returning from countries where cholera was present.
How do I protect myself?
The best way to ensure that you do not get infected is to practise good personal hygiene and make sure you drink clean water. If you have doubts about the drinking water, stick to bottled water or water that you have boiled or treated with chlorine or iodine. Eat only foods that have been thoroughly cooked and are still hot.
There are two oral vaccines available. Dukoral offers some protection against traveller's diarrhea for up to three months. Mutachol is partially effective against one strain of cholera.
The U.S. Centers for Disease Control does not recommend oral cholera vaccines, nor does the World Health Organization — UNDER NORMAL CIRCUMSTANCES. Reasons cited include:
• The risk of contracting the disease for travellers is low.
• The vaccines are expensive.
• The vaccines offer limited protection.

However, the WHO does recommend pre-emptive use of oral cholera vaccines in emergency situations. The trick is getting enough of the vaccine to stricken areas
www.cbc.ca/health/story/2008/05/09/f-...

JonnyBlazze wrote:Posted 2008/05/10
at 7:28 PM ET
If the world stands by and allows this (cholera) to happen; then as humans we are as pathetic as the junta.

[verwijderd] 12 mei 2008 20:11

0

quote:
flosz schreef:
There are two oral vaccines available. Dukoral offers some protection against traveller's diarrhea for up to three months. Mutachol is partially effective against one strain of cholera.

Dokoral = SBL
Mutachol = Berna

[verwijderd] 12 mei 2008 20:18

1

quote:
aragana schreef:
[quote=flosz]
There are two oral vaccines available. Dukoral offers some protection against traveller's diarrhea for up to three months. Mutachol is partially effective against one strain of cholera.
[/quote]

Dokoral = SBL
Mutachol = Berna

Het tuig van het regime in Birma laat haar bevolking liever verrotten dan dat ze vacinatie accepteren.

flosz 12 mei 2008 20:26

1

quote:
aragana schreef:
Dukoral = SBL
Mutachol = Berna

.......oraler attenuierter Impfstoff (Orochol®): seit 2004 weltweit
nicht mehr am Markt
www.lgl.bayern.de/aktuell/veranstaltu...
crucell.yourbb.nl/viewtopic.php?f=9&t...

Orochol=Mutachol

flosz 12 mei 2008 20:37

2

quote:
flosz schreef:
[quote=aragana]

Dukoral = SBL
Mutachol = Berna
[/quote]

.......oraler attenuierter Impfstoff (Orochol®): seit 2004 weltweit
nicht mehr am Markt
www.lgl.bayern.de/aktuell/veranstaltu...
crucell.yourbb.nl/viewtopic.php?f=9&t...

Orochol=Mutachol

Vaccines for Cholera Control: Does Herd Immunity Play a Role

Lorenz von Seidlein
Funding: The author received no funding for this article.
Competing interests: The author has in the past received funding from International Vaccine Institute and from World Health Organization.
Citation: von Seidlein L (2007) Vaccines for Cholera Control: Does Herd Immunity Play a Role. PLoS Med 4(11): e331 doi:10.1371/journal.pmed.0040331
Currently two cholera vaccines are internationally licensed: (1) Dukoral, consisting of inactivated whole cells of V. cholerae O1 combined with the B-subunit (BS-WC) of the cholera toxin, and (2) the live attenuated vaccine CVD 103HgR (Orochol or Mutacol). Both vaccines have an excellent safety profile and afford high rates of protection over several years. The companies producing each vaccine have been acquired in the last two years by the publicly listed Dutch company Crucell. Only Dukoral is currently produced, and for this reason was used in the above-mentioned vaccination campaigns in Mozambique, Sudan, and Indonesia. Dukoral costs travellers more than US$10 per dose, and two doses two weeks apart are recommended for immunisation. Most tourists can afford this vaccine, and well-supported foundations can purchase this vaccine for interventions in larger populations. Yet Dukoral is likely to remain too expensive for governments of cholera-endemic regions to vaccinate at-risk populations. The technology on which Dukoral is based has previously been transferred to manufacturers in Vietnam, and has been more recently transferred to an Indian vaccine producer with certification to produce internationally licensed vaccines. There is therefore a justified hope that this vaccine candidate will become available internationally at an affordable price.
medicine.plosjournals.org/perlserv/?r...

In another case, a Dutch company, which holds the rights to a cholera vaccine, retains the rights in the developed world, but shares those rights with manufacturers in developing countries. The result is a cholera vaccine made in Vietnam that costs less than $1 a dose—and that includes delivery and the costs of an immunization campaign. There are a number of industries that can take advantage of this kind of tiered pricing to offer valuable medicine and technology to low-income people.
www.gatesfoundation.org/MediaCenter/S...

The first vaccine (Dukoral, licensed by SBL Vaccin, Sweden) consists of four batches of heat- or formalin-killed whole-cell V. cholerae O1, representing both serotypes (Inaba and Ogawa) and both biotypes (classical and El Tor), and added with purified recombinant cholera toxin subunit B (CTB). The whole cell/recombinant B subunit (WC/rBS) vaccine – given orally with buffer to neutralize stomach acidity – was found, in field trials in Bangladesh and Peru, to confer 80–90% protection during 6 months in all age groups after administration of 2 doses 1–2 weeks apart. In Bangladesh, protection declined in young children after 6 months, but was still about 60% in older children and adults after three years. The vaccine was also successfully used for mass vaccination in refugee camps in Uganda and in Dafur, Sudan. Efficacy in a demonstration study in Beira, Mozambique was shown to be close to 80% in a high HIV prevalence population. Because LT cross-reacts with CT, the vaccine also provides short-term protection against ETEC, which is of added benefit for travellers.
A variant of the Dukoral vaccine containing no recombinant CTB-subunit has been produced and tested in Viet Nam. It is administered in two doses, one week apart. A field trial conducted in Nha-Trang, Viet Nam, showed an efficacy of 66% against V. cholerae El Tor after 8 months in all age groups tested. The vaccine has been licensed in Viet Nam and is currently being produced in Indonesia. A bivalent O1 and O139 whole-cell oral vaccine without CTB developed in Viet Nam was shown to be safe and immunogenic in both adults and children. This bivalent vaccine is currently the only existing vaccine against O139 serogroup infection.
www.who.int/vaccine_research/diseases...

The cholera
vaccine is modelled on a widely available oral
vaccine, Dukoral, which was developed in
Sweden during the 1970s.
But at several dollars a dose, Dukoral is too
expensive for most developing countries.
Vietnamese scientists licensed the technology
in the early 1990s and formulated a cheaper
version at about 20 cents per dose.
With the IVI and Kolkata-based National
Institute of Cholera and Enteric Diseases
(NICED), Shantha Biotechnics, an Indian
biotechnology company, is developing a local
version of the Vietnamese vaccine and has
procured regulatory clearances for the Kolkata
trials. It has also secured the right to market
the vaccine if it is approved, says Raman Rao,
head of clinical research for Shantha.
www.scidev.net/pdffiles/nature/436484...

flosz 12 mei 2008 21:18

1

quote:
Dirk R. Wijnen schreef:
Het tuig van het regime in Birma laat haar bevolking liever verrotten dan dat ze vacinatie accepteren.

Helaas idd.

Constitutional referendum flouts human rights
www.amnesty.org/en/for-media/press-re...

In the wake of Cyclone Nargis, which has already killed tens of thousands of people and displaced around a million more, the government of Myanmar (formerly Burma) is deliberately impeding life-saving assistance. Its failure to open the borders to the massive relief efforts required, including expertise, will lead to further deaths and suffering for those affected by the cyclone.

8 mei 2008 Amnesty International roept de regering van Myanmar (Birma) op om onmiddellijk alle hulpverlening toe te laten voor slachtoffers van de verwoestende cycloon Nargis.
De cycloon kostte aan tienduizenden mensen het leven en naar schatting een miljoen mensen werden dakloos. 'Mensenlevens gaan verloren doordat de overheid blijft vasthouden aan uitgebreide visumregelingen en donoren hun hulpverlening uitstellen uit angst dat het wordt doorgesluisd naar het leger', zegt Benjamin Zawacki, Myanmar-onderzoeker voor Amnesty. 'De regering moet het land open stellen voor buitenlandse hulpverleners en hen een veilige doorgang verlenen.'

Tegenwerking
Amnesty roept de regering van Myanmar op visa-aanvragen en douaneprocedures te versoepelen. Door tegenwerking kwam de internationale hulpverlening de afgelopen dagen maar moeizaam op gang en werd acute hulp aan het noodlijdende gebied vertraagd. Terwijl de eerste hulp Yangon (Rangoon) binnendruppelt heeft de overheid nog geen aanstalten gemaakt om de bevolking in de hardst getroffen gebieden te bereiken en van hulp te voorzien.
Amnesty roept de regering op samen te werken met internationale hulpverleners en zonder restricties en zonder uitzondering hulp te verlenen aan iedereen die getroffen is door de cycloon. Ook moet de regering ervoor zorgen dat de naar schatting 1 miljoen mensen die dakloos zijn geraakt, worden opgevangen en toegang krijgen tot water, voedsel en medische verzorging

Schrijf eens een “briefje”, hulp is steeds welkom!
(Make my day!)
www.amnesty.nl/in_actie_lopende_acties

Yahoo…YaBoo
Yahoo heeft toegegeven de privégegevens van journalist Shi Tao aan de Chinese autoriteiten te hebben verstrekt.
www.amnesty.nl/in_actie_actie/21639

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