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Thirst: Our brains tell us when to stop drinking

When the water content of our blood drops, neurons in the brain tell us that we are thirsty. But how do we know when enough is enough?
Water

Water is essential to life. When we get deydrated, it can have serious consequences.

The water content in our body is tightly regulated. Dehydration can lead to dizziness, delirium, and unconsciousness. Drinking fluids restores this balance or homeostasis.

But it takes time for water to travel from our mouths through the body. We stop drinking a long time before this happens.

If we kept drinking during this delay, we would be at serious risk of water intoxication, or water poisoning, which is potentially deadly.

Scientists are beginning to unravel the sophisticated mechanisms that stop us from drinking too much water, and the answer lies in the brain.

What controls thirst?

The brain’s thirst control circuit is a small region in the forebrain called the lamina terminalis (LT).

Once the LT network is activated, we become thirsty. A study published last week in the journal Science demonstrated that thirst creates an uncomfortable feeling in mice, which is alleviated by drinking.

There is one other thing that triggers thirst: eating. As soon as we start to eat, our thirst is stimulated. This is known as prandial thirst.

Water is necessary for us to digest the food that we eat. It also stops electrolytes in food from disturbing homeostasis by balancing out the fluid levels.

Why do we stop drinking?

Zachary A. Knight, Ph.D. – from the Department of Physiology at the University of California, San Francisco – and his team reported in the journal Nature that neurons in the subfornical organ (SFO), which forms part of the LT, might be at the heart of things.

The authors explain that “much normal drinking behavior is anticipatory in nature, meaning that the brain predicts impending changes in fluid balance and adjusts behavior pre-emptively.”

For their study, the researchers used mice and restricted their access to water overnight. “When water was made available,” the authors write, “mice drank avidly and, surprisingly, [SFO] neurons were inhibited within 1 min.”

This drop in neuronal signaling happened much faster than the water was able to reach the blood.

“Drinking resets thirst-promoting SFO neurons in a way that anticipates the future restoration of homeostasis,” they add. This means that our brain anticipates how much water we need to drink to restore homeostasis.

Signals from the mouth to the brain

What is not yet clear is how the brain knows when we are drinking fluids. A recent study published in the journal Nature Neuroscience pointed the finger at receptors in our mouth.

The team – led by Yuki Oka, Ph.D., who is from the Division of Biology and Biological Engineering at the California Institute of Technology in Pasadena – showed that water changes the acid balance in the saliva, which activates acid-taste receptors.

So, what is the best way of quenching thirst? A study by Sanne Boesveldt, Ph.D. – from the Division of Human Nutrition at Wageningen University & Research in the Netherlands – and her team, which will be published in the October edition of the journal Physiology & Behavior, set out to answer this question.

The authors explain that cold drinks are already known to be more thirst quenching, as are sour, flavored, and carbonated drinks.

In their study, the team found that cold, flavored popsicles were significantly more thirst quenching than cold liquids. The most effective flavor was lemon.

So, while the days may be getting colder as fall gets underway in the Northern hemisphere, a lemon popsicle might still be a good option the next time thirst calls.

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EBOLA IN DETAILS

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Key facts on Ebola

  • Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans.
  • The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.
  • The average EVD case fatality rate is around 50%. Case fatality rates have varied from 25% to 90% in past outbreaks.
  • The first EVD outbreaks occurred in remote villages in Central Africa, near tropical rainforests. The 2014–2016 outbreak in West Africa involved major urban areas as well as rural ones.
  • Community engagement is key to successfully controlling outbreaks. Good outbreak control relies on applying a package of interventions, namely case management, infection prevention and control practices, surveillance and contact tracing, a good laboratory service, safe and dignified burials and social mobilisation.
  • Early supportive care with rehydration, symptomatic treatment improves survival. There is as yet no licensed treatment proven to neutralize the virus but a range of blood, immunological and drug therapies are under development.

Background about the epidedmic

The Ebola virus causes an acute, serious illness which is often fatal if untreated. Ebola virus disease (EVD) first appeared in 1976 in 2 simultaneous outbreaks, one in what is now, Nzara, South Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name.

The 2014–2016 outbreak in West Africa was the largest and most complex Ebola outbreak since the virus was first discovered in 1976. There were more cases and deaths in this outbreak than all others combined. It also spread between countries, starting in Guinea then moving across land borders to Sierra Leone and Liberia.

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The virus family Filoviridae includes three genera: Cuevavirus, Marburgvirus, and Ebolavirus. Within the genus Ebolavirus, five species have been identified: Zaire, Bundibugyo, Sudan, Reston and Taï Forest. The first three, Bundibugyo ebolavirus, Zaire ebolavirus, and Sudan ebolavirus have been associated with large outbreaks in Africa. The virus causing the 2014–2016 West African outbreak belongs to the Zaire ebolavirus species.

Transmission of this terrible virus

It is thought that fruit bats of the Pteropodidae family are natural Ebola virus hosts. Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.

Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.

Read about 9 WAYS TO END LUNG CANCERS – NURSE SOLOMON

Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced.

Burial ceremonies that involve direct contact with the body of the deceased can also contribute in the transmission of Ebola.

People remain infectious as long as their blood contains the virus.

Sexual transmission

More surveillance data and research are needed on the risks of sexual transmission, and particularly on the prevalence of viable and transmissible virus in semen over time. In the interim, and based on present evidence, WHO recommends that:

  • All Ebola survivors and their sexual partners should receive counselling to ensure safe sexual practices until their semen has twice tested negative. Survivors should be provided with condoms.
  • Male Ebola survivors should be offered semen testing at 3 months after onset of disease, and then, for those who test positive, every month thereafter until their semen tests negative for virus twice by RT-PCR, with an interval of one week between tests.
  • Ebola survivors and their sexual partners should either:
    • abstain from all types of sex, or
    • observe safe sex through correct and consistent condom use until their semen has twice tested negative.
  • Having tested negative, survivors can safely resume normal sexual practices without fear of Ebola virus transmission.
  • Based on further analysis of ongoing research and consideration by the WHO Advisory Group on the Ebola Virus Disease Response, WHO recommends that male survivors of Ebola virus disease practice safe sex and hygiene for 12 months from onset of symptoms or until their semen tests negative twice for Ebola virus.
  • Until such time as their semen has twice tested negative for Ebola, survivors should practice good hand and personal hygiene by immediately and thoroughly washing with soap and water after any physical contact with semen, including after masturbation. During this period used condoms should be handled safely, and safely disposed of, so as to prevent contact with seminal fluids.
  • All survivors, their partners and families should be shown respect, dignity and compassion.

Symptoms of Ebola virus disease

The incubation period, that is, the time interval from infection with the virus to onset of symptoms is 2 to 21 days. Humans are not infectious until they develop symptoms. First symptoms are the sudden onset of fever fatigue, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding (e.g. oozing from the gums, blood in the stools). Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

Persistent virus in people recovering from Ebola virus disease

Ebola virus is known to persist in immune-privileged sites in some people who have recovered from Ebola virus disease. These sites include the testicles, the inside of the eye, and the central nervous system. In women who have been infected while pregnant, the virus persists in the placenta, amniotic fluid and fetus. In women who have been infected while breastfeeding, the virus may persist in breast milk.

Studies of viral persistence indicate that in a small percentage of survivors, some body fluids may test positive on reverse transcriptase polymerase chain reaction (RT-PCR) for Ebola virus for longer than 9 months.

Relapse-symptomatic illness in someone who has recovered from EVD due to increased replication of the virus in a specific site is a rare event, but has been documented. Reasons for this phenomenon are not yet fully understood.

Diagnosis

It can be difficult to clinically distinguish EVD from other infectious diseases such as malaria, typhoid fever and meningitis. Confirmation that symptoms are caused by Ebola virus infection are made using the following diagnostic methods:

  • antibody-capture enzyme-linked immunosorbent assay (ELISA)
  • antigen-capture detection tests
  • serum neutralization test
  • reverse transcriptase polymerase chain reaction (RT-PCR) assay
  • electron microscopy
  • virus isolation by cell culture.

Careful consideration should be given to the selection of diagnostic tests, which take into account technical specifications, disease incidence and prevalence, and social and medical implications of test results. It is strongly recommended that diagnostic tests, which have undergone an independent and international evaluation, be considered for use.

Current WHO recommended tests include:

  • Automated or semi-automated nucleic acid tests (NAT) for routine diagnostic management.
  • Rapid antigen detection tests for use in remote settings where NATs are not readily available. These tests are recommended for screening purposes as part of surveillance activities, however reactive tests should be confirmed with NATs.

The preferred specimens for diagnosis include:

  • Whole blood collected in ethylenediaminetetraacetic acid (EDTA) from live patients exhibiting symptoms.
  • Oral fluid specimen stored in universal transport medium collected from deceased patients or when blood collection is not possible.

Samples collected from patients are an extreme biohazard risk; laboratory testing on non-inactivated samples should be conducted under maximum biological containment conditions. All biological specimens should be packaged using the triple packaging system when transported nationally and internationally.

Treatment and vaccines

Supportive care-rehydration with oral or intravenous fluids- and treatment of specific symptoms, improves survival. There is as yet no proven treatment available for EVD. However, a range of potential treatments including blood products, immune therapies and drug therapies are currently being evaluated.

An experimental Ebola vaccine proved highly protective against the deadly virus in a major trial in Guinea. The vaccine, called rVSV-ZEBOV, was studied in a trial involving 11 841 people during 2015. Among the 5837 people who received the vaccine, no Ebola cases were recorded 10 days or more after vaccination. In comparison, there were 23 cases 10 days or more after vaccination among those who did not receive the vaccine.

The trial was led by WHO, together with Guinea’s Ministry of Health, Médecins sans Frontieres and the Norwegian Institute of Public Health, in collaboration with other international partners. A ring vaccination protocol was chosen for the trial, where some of the rings are vaccinated shortly after a case is detected, and other rings are vaccinated after a delay of 3 weeks.

Prevention and control

Good outbreak control relies on applying a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation. Community engagement is key to successfully controlling outbreaks. Raising awareness of risk factors for Ebola infection and protective measures (including vaccination) that individuals can take is an effective way to reduce human transmission. Risk reduction messaging should focus on several factors:

  • Reducing the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.
  • Reducing the risk of human-to-human transmission from direct or close contact with people with Ebola symptoms, particularly with their bodily fluids. Gloves and appropriate personal protective equipment should be worn when taking care of ill patients at home. Regular hand washing is required after visiting patients in hospital, as well as after taking care of patients at home.
  • Reducing the risk of possible sexual transmission, based on further analysis of ongoing research and consideration by the WHO Advisory Group on the Ebola Virus Disease Response, WHO recommends that male survivors of Ebola virus disease practice safe sex and hygiene for 12 months from onset of symptoms or until their semen tests negative twice for Ebola virus. Contact with body fluids should be avoided and washing with soap and water is recommended. WHO does not recommend isolation of male or female convalescent patients whose blood has been tested negative for Ebola virus.
  • Outbreak containment measures, including prompt and safe burial of the dead, identifying people who may have been in contact with someone infected with Ebola and monitoring their health for 21 days, the importance of separating the healthy from the sick to prevent further spread, and the importance of good hygiene and maintaining a clean environment.

Controlling infection in health-care settings

Health-care workers should always take standard precautions when caring for patients, regardless of their presumed diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials), safe injection practices and safe burial practices.

Health-care workers caring for patients with suspected or confirmed Ebola virus should apply extra infection control measures to prevent contact with the patient’s blood and body fluids and contaminated surfaces or materials such as clothing and bedding. When in close contact (within 1 metre) of patients with EBV, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures).

Laboratory workers are also at risk. Samples taken from humans and animals for investigation of Ebola infection should be handled by trained staff and processed in suitably equipped laboratories.

Read about 9 WAYS TO END LUNG CANCERS – NURSE SOLOMON

Ebola Virus Disease: Symptoms, Causes, Treatment, prevention

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Now before we go any further, What is Ebola. I want you my audience to appreciate and understand it well to be able to prevent it, or to take the most urgent measures possible to save a life if an incidence happens near you, to you or your friend or family member.

WHAT IS EBOLA?

Ebola viral disease, serious, fatal condition in humans and nonhuman primates. Ebola is one of several viral hemorrhagic fevers known, caused by infection with a virus of the Filoviridae family, genus Ebolavirus. WHO defines Ebola as Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans. The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission. The average EVD case fatality rate is around 50%.

Ebola-virus33

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The mortality rates of Ebola vary depending on the strain. Ebola-Zaire can have a fatality rate of up to 90% while Ebola-Reston has never caused a fatality in humans.

The infection is transmitted by direct contact with the blood, body fluids, and tissues of infected humans and animals. Severely ill patients require intensive supportive care. Major symptoms of Ebola virus disease (EVD) are fever, intense weakness, muscle pain, and headache.

Symptoms of Ebola

The time interval from infection with Ebola to the start of symptoms is 2-21 days, or 8-10 days. Signs and symptoms include:

  • fever
  • headache
  • joint and muscle aches
  • weakness
  • diarrhea
  • vomiting
  • stomach pain
  • lack of appetite

Some patients may also experience:

  • rash
  • hiccups
  • bleeding inside and outside of the body
  • red eyes
  • cough
  • sore throat
  • chest pain
  • difficulty in breathing
  • difficulty in swallowing

Also Read about the 15 Evidence based Easy Ways To Live Healthier. Very comprehensive article

What causes Ebola?

Ebola is caused by viruses in the Ebolavirus and Filoviridae family. Ebola is considered a zoonosis, which means the virus is present in animals and is transmitted to humans.

It is yet to be known how this transmission occurs at the onset of an outbreak in humans.

In Africa, people have developed Ebola after handling infected animals found ill or dead, including chimpanzees, gorillas, fruit bats, monkeys, forest antelope, and porcupines.

Person-to-person transmission occurs after someone infected with Ebolavirus becomes symptomatic. As it can take between 2 and 21 days for symptoms to develop, a person with Ebola may have been in contact with hundreds of people, which is why an outbreak can be hard to control and may spread rapidly.

How does Ebola transmission occur in humans?

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Transmission of Ebola between humans can occur through:

  • Direct contact through broken skin and mucous membranes with the blood, secretions, organs, or other body fluids of infected people.
  • Indirect contact with environments contaminated with such fluids.
  • Exposure to contaminated objects, such as needles.
  • Burial ceremonies in which mourners have direct contact with the body of the deceased.
  • Exposure to the semen of people with Ebola or who have recovered from the disease – the virus can still be transmitted through semen for up to 7 weeks after recovery from illness.
  • Contact with patients with suspected or confirmed EVD – healthcare workers have frequently been infected while treating patients.

There is no evidence that Ebola can be spread via insect bites.

Now, how do you have to control EBOLA?

Prevention and control of EBOLA

Good outbreak control relies on applying a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation. Community engagement is key to successfully controlling outbreaks. Raising awareness of risk factors for Ebola infection and protective measures (including vaccination) that individuals can take is an effective way to reduce human transmission. Risk reduction messaging should focus on several factors:

  • Reducing the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.
  • Reducing the risk of human-to-human transmission from direct or close contact with people with Ebola symptoms, particularly with their bodily fluids. Gloves and appropriate personal protective equipment should be worn when taking care of ill patients at home. Regular hand washing is required after visiting patients in hospital, as well as after taking care of patients at home.
  • Reducing the risk of possible sexual transmission, based on further analysis of ongoing research and consideration by the WHO Advisory Group on the Ebola Virus Disease Response, WHO recommends that male survivors of Ebola virus disease practice safe sex and hygiene for 12 months from onset of symptoms or until their semen tests negative twice for Ebola virus. Contact with body fluids should be avoided and washing with soap and water is recommended. WHO does not recommend isolation of male or female convalescent patients whose blood has been tested negative for Ebola virus.
  • Outbreak containment measures, including prompt and safe burial of the dead, identifying people who may have been in contact with someone infected with Ebola and monitoring their health for 21 days, the importance of separating the healthy from the sick to prevent further spread, and the importance of good hygiene and maintaining a clean environment.

Controlling infection in health-care settings

Health-care workers should always take standard precautions when caring for patients, regardless of their presumed diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials), safe injection practices and safe burial practices.

Health-care workers caring for patients with suspected or confirmed Ebola virus should apply extra infection control measures to prevent contact with the patient’s blood and body fluids and contaminated surfaces or materials such as clothing and bedding. When in close contact (within 1 metre) of patients with EBV, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures).

Laboratory workers are also at risk. Samples taken from humans and animals for investigation of Ebola infection should be handled by trained staff and processed in suitably equipped laboratories.

Read Here for more details on Ebola Virus Disease

 

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What we are gathering about the Ebola Breakout -According to WHO.

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New Ebola outbreak declared in Democratic Republic of the Congo.

Here we shall take you through the protective measures and what next in case you get it. Read HERE

8 May 2018 

News Release/Geneva/Brazzaville/Kinshasa

The Government of the Democratic Republic of the Congo declared a new outbreak of Ebola virus disease (EVD) in Bikoro in Equateur Province today (8 May). The outbreak declaration occurred after laboratory results confirmed two cases of EVD.

The Ministry of Health of Democratic of the Congo (DRC) informed WHO that two out of five samples collected from five patients tested positive for EVD at the Institut National de Recherche Biomédicale (INRB) in Kinshasa. More specimens are being collected for testing.

WHO is working closely with the Government of the DRC to rapidly scale up its operations and mobilize health partners using the model of a successful response to a similar EVD outbreak in 2017.

“Our top priority is to get to Bikoro to work alongside the Government of the Democratic Republic of the Congo and partners to reduce the loss of life and suffering related to this new Ebola virus disease outbreak,” said Dr Peter Salama, WHO Deputy Director-General, Emergency Preparedness and Response. “Working with partners and responding early and in a coordinated way will be vital to containing this deadly disease.”

The first multidisciplinary team comprised of experts from WHO, Médecins Sans Frontières and Provincial Division of Health travelled today to Bikoro to strengthen coordination and investigations.

Bikoro is situated in Equateur Province on the shores of Lake Tumba in the north-western part of the country near the Republic of the Congo. All cases were reported from iIkoko Iponge health facility located about 30 kilometres from Bikoro. Health facilities in Bikoro have very limited functionality, and rely on international organizations to provide supplies that frequently stock out.

“We know that addressing this outbreak will require a comprehensive and coordinated response. WHO will work closely with health authorities and partners to support the national response. We will gather more samples, conduct contact tracing, engage the communities with messages on prevention and control, and put in place methods for improving data collection and sharing,” said Dr Matshidiso Moeti, the WHO Regional Director for Africa.

This is DRC’s ninth outbreak of EVD since the discovery of the virus in the country in 1976. In the past five weeks, there have been 21 suspected viral haemorrhagic fever in and around the iIkoko Iponge, including 17 deaths.

“WHO is closely working with other partners, including Médecins Sans Frontières, to ensure a strong, response to support the Government of the Democratic Republic of the Congo to prevent and control the spreading of the disease from the epicentre of iIkoko Iponge Health Zone to save lives,” said Dr Allarangar Yokouide, WHO Representative in the DRC.

Upon learning about the laboratory results today, WHO set up its Incident Management System to fully dedicate staff and resources across the organization to the response. WHO plans to deploy epidemiologists, logisticians, clinicians, infection prevention and control experts, risk communications experts and vaccination support teams in the coming days. WHO will also be determining supply needs and help fill gaps, such as for Personal Protective Equipment (PPE). WHO has also alerted neighbouring countries.

WHO released US$ 1 million from its Contingency Fund for Emergencies to support response activities for the next three months with the goal of stopping the spread of Ebola to surrounding provinces and countries.

Building on the 2017 response

Ebola is endemic to the Democratic Republic of the Congo. The last Ebola outbreak in the Democratic Republic of the Congo occurred in 2017 in Likati Health Zone, Bas Uele Province, in the northern part of the country and was quickly contained thanks to joint efforts by the Government of DRC, WHO and many different partners.

An effective response to the 2017 EVD outbreak was achieved through the timely alert by local authorities of suspect cases, immediate testing of blood samples due to strengthened national laboratory capacity, the early announcement of the outbreak by the government, rapid response activities by local and national health authorities with the robust support of international partners, and speedy access to flexible funding.

Coordination support on the ground by WHO was critical and an Incident Management System was set up within 24 hours of the outbreak being announced. WHO deployed more than 50 experts to work closely with government and partners.

The Ebola virus causes an acute, serious illness which is often fatal if untreated. The average EVD case fatality rate is around 50%. The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.

#EbolaBreakout #Congo #NearUganda #ByWHO

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