Smallpox, Measles, Cardiomyopathy, Eczema, Rickets, New Contraceptive Pill, Smoking & Gender, Caesarians, Ecstasy, Pre-eclampsia

SMALLPOX

The news that the government has ordered 16 million doses of smallpox vaccine (although there are 60 million people in this country) has been in the papers recently. This will take some time to produce but seems to be a sensible precaution given that there are supplies of smallpox in laboratories in the former Soviet Union that may not have had adequate security.

We do not remember how dreadful smallpox was; it could not only kill but caused severe scarring and disfigurement in the survivors. The vaccine itself is not without side effects as it can cause skin lesions (blisters, ulcers and scarring) at the vaccination site. The vaccine only protects you for 5 to 10 years so people who were vaccinated as children are not immune to smallpox now. The vaccination programme was ended in 1972 when the World Health Organisation declared that smallpox was officially eradicated worldwide. Read about the disease and vaccine in our section on smallpox. Also read ‘Why defeat of a scourge left world vulnerable’ and ‘Ministers rule out mass vaccination for smallpox’ which discusses how the smallpox vaccinations would be used in an outbreak.

MEASLES

This weekend there were reports of a measles outbreak in Ireland with 20 cases so far. This has not been followed up in the national press and is presumably a localised outbreak at present. There was an outbreak of measles in Ireland last year blamed on low uptake of MMR vaccine - read ‘Measles outbreak warning’ from the BBC.

CARDIOMYOPATHY

The newspapers this week have been full of reports about nine year-old Abbey Cape who is clinging to life at Great Ormond Street Hospital. Abbey was well until three weeks ago when she was suddenly struck down by cardiomyopathy. This is not a virus that eats the heart as reported in some papers. The word cardiomyopathy simply means thickening of the heart muscle. This condition usually comes on gradually and can run in families. Sufferers do not know that they have it until they suddenly develop heart failure. In Abbey’s case this may have been triggered by infection. Other known causes of cardiomyopathy include previous radiotherapy and chemotherapy.

Abbey’s only hope is for a heart transplant but the Alder Hey Hospital’s organ donation scandal has cut the number of potential donors. She needs a heart that not only matches her tissue type but is also the right size and healthy. She is basically waiting for a healthy child to be killed and for those parents to be brave enough to allow their child’s heart to be used for the transplant. The NHS has launched a campaign recently aimed at black people who currently provide less than 1% of organs for transplantation - read about it at Organ Donation. Be Part of the Solution. If you feel that you would like your organs donated make sure that your next of kin all know. Read ‘Time running out for heart girl’, and also our article on cardiomyopathy.

ECZEMA

The Daily Telegraph reviewed a book this week written by Sue Armstrong Brown who suffered from eczema. She has used her common sense to find a way to control her eczema – by reducing the itch-scratch-itch cycle which damages the skin. Her book is called ‘The Eczema Solution:The Revolutionary Programme for Skin that Looks and Feels Great’. She combined various scratch control techniques with conventional treatment to cure herself. Read about her in ‘Take the itch out of eczema’. For advice about controlling eczema in young children and babies, read our section on eczema.

A report in the British Medical Journal recently compared treating childhood eczema with topical steroids either at high doses for a short time or with a low dose cream for a longer period of time They used the stronger cream (betamethasone 0.1%) for only three days followed by four days of emollient creams containing no steroids and compared this with using a weaker cream (1% hydrocortisone – which is available without prescription) for seven days. They found that both groups got dramatically better but that there was no difference in the outcome between the two groups. Outcome was measured as scratch free days. The authors suggest that a short burst of a stronger steroid could be used as effectively as a longer course of a milder one. Read an abstract of the report.

RICKETS ON THE INCREASE IN THE UK

Rickets is caused by a lack of Vitamin D. Vitamin D can be made in the skin on exposure to sunlight or absorbed with fats in the diet. Dark skinned people need more sun exposure to make their own Vitamin D. There have been 24 cases of rickets reported in the Midlands recently, mostly in Asian and Afro-Caribbean patients. Vitamin D allows the bones to take up calcium and without it bones become soft and deformed – it can be treated with vitamin D but if left untreated leads to permanent deformity. Read about rickets on the increase in the Times.

NEWS IN BRIEF

YASMIN Contraceptive Pill

The contraceptive pill called Yasmin, due for release here this week using an advert claiming ‘pure chemistry’ for the user, has had its safety questioned in Holland where there have been 40 cases of deep vein thrombosis and one death in a 17 year-old girl taking it. Read the report at ‘Dutch GPs warned against new contraceptive pill’.

Smokers More Likely to Have Girl Babies

A report from Japan was discussed in this week’s Daily Mail – apparently smoking damages the Y chromosome (which is smaller than the X chromosome) and so makes conceiving male children less likely. The report is not available online.

Caesarean Sections

Reports are out this week that mothers who have emergency Caesarean sections do not or cannot have another child in one out of three cases. An emergency Caesarean is one where the mother planned to have a normal delivery but after the start of labour complications develop suggesting that a Caesarean delivery would be safer (or life-saving) for the mother or child. The research was done at Leeds University and showed that one in three mothers have infertility problems after emergency sections and one in five are too traumatised to want to go through childbirth again. The papers have confused emergency Caesareans with routine (elective) ones but you can read a report at ‘Caesareans linked to risk of infertility’.

This is a completely different situation from planned Caesareans, which are causing concern in the medical profession for different reasons. The label ‘too posh to push’ has been given to mothers like Elizabeth Hurley who choose not to go through labour – but midwives and doctors fear that they are often not properly informed of the health risks of Caesareans which are major operations and can result in an increased risk of maternal death as happened in the Portland Hospital in London last week. You can also read ‘'There are always risks'’.

Ecstasy

Reports of brain damage caused by ecstasy may be misleading – read this article in the Independent.

Working Mothers More Likely to Develop Pre-Eclampsia

The papers this week reported that mothers who work are more likely to develop pre-eclampsia – a dangerous and occasionally fatal form of high blood pressure in pregnant women. It is commonest in the first pregnancy and appears to be due to an immune response by the mother’s body to the placenta – why this should be aggravated by working is not known. Read about pre-eclampsia in the Independent and the Telegraph. The treatment for pre-eclampsia includes bed rest – sometimes in hospital and drugs to control the blood pressure. If are pregnant and have any concerns do consult your doctor or midwife.