{"id":121093,"date":"2024-11-02T05:28:44","date_gmt":"2024-11-01T22:28:44","guid":{"rendered":"https:\/\/hotvideos24.online\/?p=121093"},"modified":"2024-11-02T05:28:44","modified_gmt":"2024-11-01T22:28:44","slug":"goats-and-soda-npr","status":"publish","type":"post","link":"https:\/\/hotvideos24.online\/?p=121093","title":{"rendered":"Goats and Soda : NPR"},"content":{"rendered":"<p> <script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3711241968723425\"\r\n     crossorigin=\"anonymous\"><\/script>\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-format=\"fluid\"\r\n     data-ad-layout-key=\"-fb+5w+4e-db+86\"\r\n     data-ad-client=\"ca-pub-3711241968723425\"\r\n     data-ad-slot=\"7910942971\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script><br \/>\n<\/p>\n<div id=\"storytext\">\n<div id=\"resg-s1-31491\" class=\"bucketwrap image large\">\n<div class=\"imagewrap has-source-dimensions\" data-crop-type=\"\" style=\"&#10;        --source-width: 5260;&#10;        --source-height: 3455;&#10;    \">\n        <picture><source srcset=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/5260x3455+0+0\/resize\/1100\/quality\/85\/format\/webp\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F96%2F42%2F80a644e143d4929e25d279e47544%2Fap24274394055358.jpg\" class=\"img\" type=\"image\/webp\" data-template=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/5260x3455+0+0\/resize\/{width}\/quality\/{quality}\/format\/{format}\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F96%2F42%2F80a644e143d4929e25d279e47544%2Fap24274394055358.jpg\" data-format=\"webp\"\/><source srcset=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/5260x3455+0+0\/resize\/1100\/quality\/85\/format\/jpeg\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F96%2F42%2F80a644e143d4929e25d279e47544%2Fap24274394055358.jpg\" class=\"img\" type=\"image\/jpeg\" data-template=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/5260x3455+0+0\/resize\/{width}\/quality\/{quality}\/format\/{format}\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F96%2F42%2F80a644e143d4929e25d279e47544%2Fap24274394055358.jpg\" data-format=\"jpeg\"\/><img decoding=\"async\" src=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/5260x3455+0+0\/resize\/1100\/quality\/85\/format\/jpeg\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F96%2F42%2F80a644e143d4929e25d279e47544%2Fap24274394055358.jpg\" class=\"img\" alt=\"Marburg is an incredibly deadly virus. An outbreak in Rwanda is being handled with an \" unprecedented=\"\" rate=\"\" of=\"\" success=\"\" say=\"\" public=\"\" health=\"\" experts.=\"\" in=\"\" this=\"\" photo=\"\" from=\"\" a=\"\" outbreak=\"\" kenya=\"\" medical=\"\" worker=\"\" protective=\"\" gear=\"\" carries=\"\" meal=\"\" to=\"\" man=\"\" quarantined=\"\" an=\"\" isolation=\"\" tent=\"\" after=\"\" coming=\"\" into=\"\" contact=\"\" uganda=\"\" with=\"\" marburg=\"\" carrier.=\"\" data-template=\"https:\/\/npr.brightspotcdn.com\/dims3\/default\/strip\/false\/crop\/5260x3455+0+0\/resize\/{width}\/quality\/{quality}\/format\/{format}\/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F96%2F42%2F80a644e143d4929e25d279e47544%2Fap24274394055358.jpg\" data-format=\"jpeg\"\/>\n        <\/picture>\n<\/div>\n<div class=\"credit-caption\">\n<div class=\"caption-wrap\">\n<div class=\"caption\" aria-label=\"Image caption\">\n<p>\n                Marburg can be an exceptionally deadly virus. An outbreak in Rwanda is being handled with &#8220;unprecedented&#8221; success, say public health experts. In this photo from a 2014 Marburg outbreak in Kenya, a medical worker in protective gear carries a meal to a man quarantined in an isolation tent after coming into contact with a virus carrier.<br \/>\n                <b class=\"credit\" aria-label=\"Image credit\"><\/p>\n<p>                    Ben Curtis\/AP<\/p>\n<p>                <\/b><br \/>\n                <b class=\"hide-caption\"><b>hide caption<\/b><\/b>\n            <\/p>\n<\/p><\/div>\n<p>            <b class=\"toggle-caption\"><b>toggle caption<\/b><\/b>\n    <\/div>\n<p>    <span class=\"credit\" aria-label=\"Image credit\"><\/p>\n<p>        Ben Curtis\/AP<\/p>\n<p>    <\/span>\n<\/div>\n<\/p><\/div>\n<p>Marburg virus is notorious for its killing ability. In past outbreaks, as many as 9 out of 10 patients have died from the disease. And there are no approved vaccines or medications.<\/p>\n<p>That was the grim situation in Rwanda just over a month ago, when officials made the announcement that nobody wants to make: <a href=\"https:\/\/www.npr.org\/sections\/goats-and-soda\/2024\/10\/01\/nx-s1-5133987\/marburg-virus-rwanda-vaccines\"><u>The country was in the midst of its first Marburg outbreak.\u00a0<\/u><\/a><\/p>\n<p>Now those same Rwandan officials have better news to share. Remarkably better.<\/p>\n<p>\u201cWe are at a case fatality rate of 22.7% \u2014 probably among the lowest ever recorded [for a Marburg outbreak],\u201d said <a href=\"https:\/\/rbc.gov.rw\/Rwanda_Evidence\/speakers\/dr-yvan-butera\/\"><u>Dr. Yvan Butera<\/u><\/a>, the Rwandan Minister of State for Health at a press conference hosted by Africa Centers for Disease Control and Prevention on Thursday.<\/p>\n<aside id=\"ad-backstage-wrap\" class=\"ad-wrap backstage\" aria-label=\"advertisement\">\n<\/aside>\n<p>There\u2019s more heartening news: Two of the Marburg patients, who experienced multiple organ failure and were put on life support, have now been extubated \u2014 had their breathing tubes successfully removed \u2014 and have recovered from the virus.<\/p>\n<p>\u201cWe believe this is the first time patients with Marburg virus have been extubated in Africa,\u201d says Tedros Adhanom Ghebreyesus, director general of the World Health Organization. \u201cThese patients would have died in previous outbreaks.\u201d<\/p>\n<p>The number of new cases in Rwanda has also dwindled dramatically, from several a day to just 4 reported in the last two weeks, bringing the total for this outbreak to 66 Marburg patients and 15 deaths.<\/p>\n<p>\u201cIt&#8217;s not yet time to declare victory, but we think we are headed in a good direction,\u201d says Butera. Public health experts are already using words like \u201cremarkable,\u201d \u201cunprecedented\u201d and \u201cvery, very encouraging\u201d to characterize the response.<\/p>\n<p>How did Rwanda \u2014 an African country of some 14 million \u2014 achieve this success? And what can other countries learn from Rwanda\u2019s response?<\/p>\n<h3 class=\"edTag\">Doing the basics really well<\/h3>\n<p>Rwanda is known for the horrific 1994 genocide \u2014 one of the worst in modern times. Since then, the country has charted a different path. In 20 years, life expectancy increased by <a href=\"https:\/\/data.who.int\/countries\/646\"><u>20 years<\/u><\/a> from 47.5 years old in 2000 to 67.5 years old in 2021 \u2014 about double the gains seen across the continent. And Rwanda has spent decades building up a robust health-care system.<\/p>\n<aside id=\"ad-secondary-wrap\" class=\"ad-wrap secondary\" aria-label=\"advertisement\">\n<\/aside>\n<p>\u201cThe health infrastructure, the health-care providers in Rwanda \u2014 they&#8217;re really, really great,\u201d says <a href=\"https:\/\/pandemics.sph.brown.edu\/people\/craig-spencer-md-mph\"><u>Dr. Craig Spencer<\/u><\/a>, an emergency physician and professor at Brown University School of Public Health. Spencer specializes in global health issues and has been following the Rwandan outbreak closely.<\/p>\n<p>There are well-run hospitals and well-trained nurses and doctors, he says. There are laboratories that can quickly do diagnostic testing. There is personal protective equipment for medical workers.<\/p>\n<p>For this outbreak, there was the know-how and infrastructure to set up a separate Marburg treatment facility. That&#8217;s been a boon for other patients and medical staff, preventing exposure to the virus \u2014 which crosses over from bats to humans and can be transmitted through bodily fluids like blood, sweat and diarrhea.<\/p>\n<p>And even though there aren&#8217;t approved medications to treat Marburg, patients in Rwanda have received good supportive care for all their symptoms \u2014 like the IV fluids critical for symptoms like high fevers, nausea, vomiting and diarrhea.<\/p>\n<p>This stands in stark contrast to the response in past Marburg scenarios. For example, the Democratic Republic of Congo \u2014 next door to Rwanda \u2014 had an outbreak between 1998 and 2000. <a href=\"https:\/\/www.rstmh.org\/about-us\/who-we-are\/policy-advisers\/daniel-bausch\">Dr. Daniel Bausch<\/a>, a pronow fessor at the London School of Hygiene and Tropical Medicine and an expert in tropical diseases like Marburg, provided care in that outbreak. He says what the country\u2019s health centers were able to offer patients was rudimentary at best.<\/p>\n<p>\u201cWe called it a care center or treatment center, but really it was a separate mud hut that people were placed in. We didn&#8217;t have really anything available to us,\u201d he remembers. \u201cPeople were lucky that they got paracetamol, or Tylenol, and some fluids to drink, if they could get them down without the nausea and vomiting preventing them.\u201d<\/p>\n<p>That outbreak had a fatality rate of 83% with 154 cases and 128 deaths.<\/p>\n<aside id=\"ad-third-wrap\" class=\"ad-wrap third\" aria-label=\"advertisement\">\n<\/aside>\n<p>In the world&#8217;s <a href=\"https:\/\/www.cdc.gov\/marburg\/outbreaks\/index.html\"><u>18 recorded Marburg outbreaks<\/u><\/a>, the mortality rate varies considerably. Several small outbreaks have had fatality rates below 30% but the largest outbreak \u2014 in Angola in 2004 and 2005 \u2014 had a case fatality rate of 90% with 252 cases and 227 deaths.<\/p>\n<p>Rwanda\u2019s \u201cmore modern medical centers\u201d make a big difference, Bausch says.<\/p>\n<h3 class=\"edTag\">Getting to patients lickety-split<\/h3>\n<p>It wasn\u2019t just the caliber of care that made a difference. It\u2019s also the speed with which patients get care.<\/p>\n<p>As soon as the outbreak started, Rwandan officials jump-started a major operation to trace the contacts of those who were infected, monitoring the health of over 1,000 family members, friends, health-care workers and others at risk. They also started door-to-door surveillance in neighborhoods where there might have been an exposure.<\/p>\n<p>And they did a lot of testing \u2013 over 6,000 tests, especially among health-care workers, who\u2019ve comprised 80% of the Marburg patients in this outbreak.<\/p>\n<p>Spencer says many of these capabilities were built up during the COVID pandemic and could be rolled out rapidly. \u201cIn Rwanda, you have providers able \u2014 within hours really of this outbreak being declared \u2014 to get tested,\u201d says Spencer, who has worked with Doctors Without Borders treating Ebola patients. \u201c[Rwanda\u2019s testing is] absolutely remarkable in terms of the response.\u201d<\/p>\n<p>This surveillance and testing allowed \u201cus to detect cases quickly and provide them with treatments in the very, very early phases of their diseases,\u201d explains Butera. He says that caring for patients before they become critically ill likely helped lower the mortality rate.<\/p>\n<h3 class=\"edTag\">Embracing experimental vaccines and medications<\/h3>\n<p>Rwanda\u2019s speed carried over into other anti-Marburg efforts.<\/p>\n<p>\u201cEverything I have witnessed was really expedited,\u201d says WHO\u2019s Ghebreyesus, who visited Rwanda last week and said what he saw was \u201cvery, very encouraging.\u201d<\/p>\n<p>While there are no vaccines or treatments approved for Marburg, Rwanda acted quickly to get experimental vaccines and treatments to people at the center of the outbreak.<\/p>\n<aside id=\"ad-overflow-3-wrap\" class=\"ad-wrap overflow\" aria-label=\"advertisement\">\n<\/aside>\n<p>\u201cI can&#8217;t imagine another scenario in which a country went from identifying this outbreak to just over a week later having investigational [experimental] vaccines in country already being provided to frontline health-care workers,\u201d says Spencer, who adds the doses started being administered the same day they arrived in the country. The nonprofit Sabin Vaccine Institute provided the doses, which were developed with major support from the U.S. government.<\/p>\n<p>\u201cI rarely, rarely use the word unprecedented in global health response\u201d Spencer says, but this speed was \u201cunprecedented.\u201d<\/p>\n<p>The vaccine itself is still in development. Testing has shown that it\u2019s safe \u2014 but not whether it actually works. Nonetheless, Rwanda decided to inoculate those at risk, hoping that it would help.<\/p>\n<p>Those officials also decided to vaccinate without a randomized controlled trial, where a segment of the recipients get a placebo. Some in the international scientific community say this was a missed opportunity to start learning whether the vaccine is effective \u2014 although they concede that it\u2019s far more complicated and slow to roll out a trial. And the size of the outbreak was unlikely to yield enough data to be conclusive.<\/p>\n<p>Did the vaccines help stop the spread or reduce the mortality rate? It\u2019s impossible to know, says Bausch. He points out that in the first recorded Marburg outbreak \u2014 in 1967 in Marburg, Germany and what was then Yugoslavia \u2014 the mortality rate was 23% with only good supportive care. <\/p>\n<p>Meanwhile, in Rwanda, the <a href=\"https:\/\/www.sabin.org\/resources\/sabin-sends-more-marburg-vaccines-for-rwandas-outbreak\/\"><u>next round of vaccines<\/u><\/a> will go to at-risk groups, including mine workers who are in close proximity to the fruit bats that can spread Marburg; that vaccine effort will be randomized.<\/p>\n<p>In addition to the vaccines, Rwanda very swiftly started giving patients two medications \u2014 an antiviral called Remdesivir and a monoclonal antibody. As with the vaccine, they hoped these treatments would help even though they haven\u2019t been approved for Marburg.<\/p>\n<aside id=\"ad-overflow-4-wrap\" class=\"ad-wrap overflow\" aria-label=\"advertisement\">\n<\/aside>\n<h3 class=\"edTag\">An early stumble, a course correction<\/h3>\n<p>In addition to the speed and high-quality patient care, there\u2019s another less glamorous \u2014 but equally important \u2014 dimension to quashing Marburg and other viruses, says Bausch. It\u2019s infection control: basically, ensuring Marburg patients don\u2019t infect others. In the hospital, this means that staff take precautions like wearing gowns, masks and double gloves. In public, it can mean sanitizing shared items like motorcycle helmets and installing handwashing stations in public places, as Rwanda has done.<\/p>\n<p>Rwanda stumbled early on with infection control. That\u2019s because it took a couple weeks to diagnose the disease in the individual who is considered the first patient in this outbreak \u2014 and the first known Marburg case in the country.<\/p>\n<p>That individual, who likely contracted the virus from exposure to fruit bats in a mining cave, also had a severe case of malaria. Clinicians did not determine that Marburg was also present until other people around that patient started falling ill. As a result, many health care workers were exposed before infection control measures were improved.<\/p>\n<p>While Rwanda rapidly improved their infection control once officials understood what they were dealing with \u2014 and not just in health facilities. The mining community linked to the initial patient has seen several cases. So surveillance needs to be sure to cover those populations, says Rob Holden, WHO\u2019s incident manager for Marburg.<\/p>\n<p>\u201cAs we go forward, we fine tune, we refine, we reinforce all our surveillance systems, our contact follow ups, our investigations, and we leave no stone unturned,\u201d he says. \u201cIf we let our guard down, then I think we&#8217;ll end up with some nasty surprises and a very long tail on this outbreak.\u201d<\/p>\n<p>Spencer agrees. But he is optimistic. He says that Rwanda\u2019s robust health infrastructure and speedy response has helped protect the rest of the world from a much bigger Marburg outbreak.<\/p>\n<\/div>\n<p><script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3711241968723425\"\r\n     crossorigin=\"anonymous\"><\/script>\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-format=\"fluid\"\r\n     data-ad-layout-key=\"-fb+5w+4e-db+86\"\r\n     data-ad-client=\"ca-pub-3711241968723425\"\r\n     data-ad-slot=\"7910942971\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script><br \/>\n<br \/><div data-type=\"_mgwidget\" data-widget-id=\"1660802\">\r\n<\/div>\r\n<script>(function(w,q){w[q]=w[q]||[];w[q].push([\"_mgc.load\"])})(window,\"_mgq\");\r\n<\/script>\r\n<br \/>\n<br \/><a href=\"https:\/\/www.npr.org\/sections\/goats-and-soda\/2024\/11\/01\/g-s1-30948\/virus-marburg-outbreak-rwanda-unprecedented-success\">Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Marburg can be an exceptionally deadly virus. An outbreak in Rwanda is being handled with &#8220;unprecedented&#8221; success, say public health experts. In this photo from a 2014 Marburg outbreak in &hellip; <a href=\"https:\/\/hotvideos24.online\/?p=121093\" class=\"more-link\">Read More<\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-121093","post","type-post","status-publish","format-standard","hentry","category-health","entry"],"_links":{"self":[{"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/posts\/121093","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=121093"}],"version-history":[{"count":0,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/posts\/121093\/revisions"}],"wp:attachment":[{"href":"https:\/\/hotvideos24.online\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=121093"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=121093"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=121093"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}