Friday Five: Typhoon Haiyan and the Philippines

This week, I focus on the aftermath of the typhoon that hit the Philippines last Friday. One of the strongest storms to ever hit the archipelago, the typhoon is known as Yolanda within the Philippines and is called Haiyan internationally. Background and Geography

Source: Google maps

“Typhoon” is the name for a hurricane that forms in the northwest Pacific Ocean. The Philippines has been hit by four typhoons this year alone, and Haiyan is the third Super Typhoon (roughly equivalent to Category Five in the Atlantic) to bring destruction to the islands in the past five years. The Philippines is particularly susceptible to typhoons because of its location in the warm, tropical Pacific.

Source: New York Times

Haiyan wreaked havoc on some areas more than others. Ormoc, Leyte and Tacloban, Samar were hit particularly hard.

Extent of the human cost and property damage

Source: New York Times

The UN estimates that 11.8 million Filipinos were affected by Haiyan, though the country’s government estimates far fewer. Nearly one million people have been displaced and 2.5 million people are in need of food assistance.

As of this morning, the Official Gazette of the Office of the President of the Philippines reports:

  • 2,360 dead
  • 3,853 injured
  • 77 missing
  •  253,049 houses damaged (136,247 totally / 117,802 partially)
  • All bridges and roads that were previously unpassable are now open
  • Some areas do not have clean water:  Capiz and Iloilo, and the Municipality of Barbaza, Antique, in particular
  • Electricity and cell communications are spotty
  • Food, shelter and medical care are in short supply

Countries providing aid (not comprehensive)

Asian Development Bank: $500 million emergency loans and $23 million in grants

Australia: A$30 millon ($28 million)

China: 10m yuan ($1.6million) in relief goods plus $200,000 from government and Red Cross

European Commission: $11 million

Indonesia: Logistical aid including aircraft, food, generators and medicine

Japan: $50 million, 25-person medical team

South Korea: $5 million, 40-person medical team

UAE: $10 million

UK: $32 million aid package, sending aircraft carrier

US: $20 million, 300 military personnel, aircraft carrier

Potential health concerns

Filipinos are now at risk of tetanus, acute respiratory infections, measles, leptospirosis, and typhoid. Implementing water, sanitation, and hygiene (WASH) facilities, starting a measles vaccine campaign, and restoring the vaccine cold chain are priorities for the Department of Health. In particular, an oral polio vaccine campaign is necessary but cannot be started because there is no way to keep the vaccine cold. An estimated 70,000 pregnant and lactating women and 112,000 children need food. There are limited mental health services to help people begin processing loss and grief. For a far more extensive breakdown, see this report from the UN’s OCHA Philippines.

What can we do to help?

The best thing to do is send money. Choose your favorite organization and give as much as you can. I suggest these organizations for their reliability and proven track record of relief:

Friday Five: National Immunization Awareness Month

national immun awareness monthThis week’s Friday Five focuses on five important or interesting facts about vaccines in honor of National Immunization Awareness Month. Most of the sections are adapted just slightly from other sources. You can find the original source material by clicking the link next to each subheading.  

How do vaccines work? (History of Vaccines)

Vaccines work to prime your immune system against future “attacks” by a particular disease. When a pathogen enters your body, your immune system generates antibodies to try to fight it off…Vaccines work because of this function of the immune system. They’re made from a killed, weakened, or partial version of a pathogen. When you get a vaccine, whatever version of the pathogen it contains isn’t strong or plentiful enough to make you sick, but it’s enough for your immune system to generate antibodies against it. As a result, you gain future immunity against the disease without having gotten sick: if you’re exposed to the pathogen again, your immune system will recognize it and be able to fight it off.

 

What is herd immunity? (Vaccines Today)

Herd immunity is a form of immunity that occurs when the vaccination of a significant portion of a population (or herd) provides a measure of protection for individuals who have not developed immunity. It arises when a high percentage of the population is protected through vaccination against a virus or bacteria, making it difficult for a disease to spread because there are so few susceptible people left to infect…These include children who are too young to be vaccinated, people with immune system problems, and those who are too ill to receive vaccines (such as some cancer patients)…The proportion of the population which must be immunized in order to achieve herd immunity varies for each disease but the underlying idea is simple: once enough people are protected, they help to protect vulnerable members of their communities by reducing the spread of the disease. However, when immunization rates fall, herd immunity can break down leading to an increase in the number of new cases.

 

Do children get too many shots? (from CHOP Vaccine Education Center)

Newborns commonly manage many challenges to their immune systems at the same time. Because some children could receive as many as 25 shots by the time they are 2 years old and as many as five shots in a single visit to the doctor, many parents wonder whether it is safe to give children so many vaccines…From the moment of birth, thousands of different bacteria start to live on the surface of the skin and intestines. By quickly making immune responses to these bacteria, babies keep them from invading the bloodstream and causing serious diseases. In fact, babies are capable of responding to millions of different viruses and bacteria because they have billions of immunologic cells circulating in the bodies. Therefore, vaccines given in the first two years of life are a raindrop in the ocean of what an infant’s immune system successfully encounters and manages every day.

 

What do vaccine preventable illnesses look like? (Immunization Action Coalition)

Most people in the US have never seen a case of polio or diphtheria. This photo gallery may help remind us why immunizing against these diseases is so important.

 

How can we lessen the pain of getting shots? (CHOP Vaccine Education Center)

(This is important for scaredy-cats like me.)

For most children, getting vaccines simply means the pain of getting a shot. Although pain is to some extent unavoidable, there are a few things worth trying in older children.

Blowing away the pain

One technique is called "blowing away the pain." Just before the shot, take out a feather, tell the child to take a deep breath, closing his eyes if he wants, and then to blow out...blow, and blow on the feather until you or the nurse tells them to stop. The distraction of blowing on the feather has been shown in one study to lessen the amount of pain perceived by the child.

Cold versus pain

Another idea is to swab a small amount of alcohol on the forearm of the opposite arm that will receive the vaccine. The child then blows on the alcohol before and during the shot. Our bodies don't feel cold and pain in the same place at the same time. Rather, when confronted with the choice of cold or pain, the body picks cold. So the feeling of pain from the shot will be reduced.

EMLA cream

For older children with severe phobias to needles, you might consider the use of an EMLA patch applied to the skin. The limitation of this technique is that the patch (which helps to numb the area) must be applied at least one hour before the injection. Also, EMLA cream works to decrease pain caused by injections under the skin (called subcutaneous injections), but doesn't lessen the pain of vaccines given in the muscles.

Friday Five: Oklahoma tornado, MERS, 3D printing, polio, live-tweeting surgery

Each Friday, I use  five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week.  

Tornado in Moore, OK is the latest national disaster

On Monday, a mile wide tornado with 200+ mph winds decimated Moore, OK. Approximately 10,000 people were directly affected, 240 injured, and 24 killed, including nine children. Reports of heroism abound, as do shocking photos. Coming just months after the shooting at Sandy Hook and weeks after the Boston Marathon bombing, the Moore tornado victims may find themselves on the losing end of American disaster fatigue. Hopefully Moore will stay in the forefront of American’s minds and not blend in with other communities rebuilding from natural and human-made tragedies.

 

MERS is on the move

After a slow march toward notoriety, MERS is becoming a real threat. This novel coronavirus dubbed Middle East Respiratory Syndrome has been confirmed in 44 people across multiple countries and caused 22 deaths. In this month alone, two new outbreak clusters surfaced—one in Saudi Arabia infected 22 people and killed 10, the other in France infected two, one of whom contracted MERS from a hospital roommate. However, the exact mode of transmission, incubation period, and reservoir (meaning whether or not the virus lives someplace outside of humans) are unknown and research is stymied due to restrictions placed on the virus by Erasmus Medical Center in the Netherlands. For a virus with a 50% mortality rate so far, this is an egregious example of the problems with commercializing organisms needed for public health research. How many others will fall ill and die because of Erasmus’s patent?

 

Child’s life is saved by 3D printed trachea splint

In a groundbreaking and heartwarming use of the new technology of 3D printing, University of Michigan researchers created and implanted a trachea splint in a young child. Kaiba Gionnfrido, who had spent nearly all of his 20-month long life in a hospital on a respirator due to his trachobrochomalacia, or the softening and subsequent collapse of the windpipe. The splint, made to fit Kaiba perfectly, will give structure to his trachea to allow it to grow and is composed of a biopolymer that will be absorbed by his body in about three years. After years of requiring daily resuscitation, the splint allowed Kaiba to come off the respirator three weeks later. We can look forward to the emerging practice of saving lives using 3D printing to create custom-made medical devices.

 

Polio in Kenya and Somalia threatens eradication effort

A four-month old girl developed symptoms of paralysis and two other children tested positive for polio in a Kenyan refugee camp. Just a few weeks ago, Somalia reported its first wild case in five years. Vaccination rates in these areas are low, and nearly 500,000 people travel to and from the Kenyan refugee camp annually, increasing risk for an epidemic. This development complicates the newly adopted six year plan for polio eradication, and mass vaccination campaigns in the area are underway in hopes of containing the virus. Maintaining vaccination in vulnerable areas, even after years pass with no new infections, is crucial to destroying polio forever.

 

Brain surgery documented on Twitter and Vine

In this week’s example of how social media is revolutionizing health care and medicine, UCLA Hospital live tweeted Vine videos of brain surgery. Brad Carter, an actor and musician, underwent awake brain surgery to implant a pacemaker to calm his essential tremors. The Vine videos show distinct improvement in Carter’s guitar playing once the pacemaker was in place. By using Twitter and Vine to document the surgery, UCLA surgeons and Carter do the public a great service—showing exactly how incredible medicine can be. The videos inspire awe while simultaneously taking some of the mystery out of surgery.

 

This week's song to celebrate the end of the week: The Cure's "Friday I'm in Love"

[youtube=http://www.youtube.com/watch?v=b69XWDUtMew]