New Initiative To Tackle Leading Killer Of Children
Main Category: Infectious Diseases / Bacteria / VirusesAlso Included In: Respiratory / Asthma; Pediatrics / Children's Health; Medical Devices / Diagnostics
Article Date: 23 Feb 2009 - 0:00 PDT
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Johns Hopkins Bloomberg School of Public Health has received three grants from the Bill & Melinda Gates Foundation totaling more than $43 million to be used to help understand the causes of pneumonia, which go unidentified in up to one third of patients. Pneumonia kills more children than any other illness. Scaling up proven and available interventions, like pneumococcal vaccines and antibiotic treatments, could prevent many pneumonia deaths. Research to fully understand the causes of pneumonia in the remaining cases could help develop the tools to prevent even more.
The core initiative at Johns Hopkins, called the Pneumonia Etiology Research for Child Health (PERCH), aims to build a new, rigorous evidence base by studying the causes of pediatric pneumonia in five to ten countries across the developing world using state-of-the-art diagnostics.
"Our current information on pneumonia etiology is about to become obsolete," saidOrin Levine, PhD, associate professor in the Bloomberg School's Department of International Health, and principal investigator of the project. "Most existing information was generated 10 to 20 years ago with laboratory techniques that hadn't changed vastly since Louis Pasteur's time. By applying modern tools with standardized methods, we will be able to provide new, precise information to guide the development of new vaccines and treatments."
Two additional Johns Hopkins studies will strengthen the initiative's fight against pneumonia and related diseases. Hope Johnson, PhD, MPH, will project the burden of disease in adolescents and adults attributable to two dangerous bacteria - the pneumococcus and the meningococcus - that together cause many cases of pneumonia and other life-threatening illnesses such as meningitis. Jennifer Moïsi, MHS, will undertake an evaluation of diagnostic methods for pneumococcal disease, a major cause of childhood pneumonia, particularly in the developing world. Together these projects will influence the development and deployment of lifesaving vaccines throughout the world.
The pneumonia initiative, based at Johns Hopkins Bloomberg School of Public Health's Department of International Health, follows on the heels of the successful PneumoADIP project at the School, which accelerated access to childhood pneumococcal vaccines for the developing world by nearly 10 years. Through the new initiative, the Johns Hopkins group continues to advance protection for all children against pneumonia.
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The Johns Hopkins University and Hospital were founded through a $7 million bequest from Baltimore merchant Johns Hopkins, who died in 1873. Private philanthropy to the Johns Hopkins Institutions provides vital funding for student and faculty support, research and academic programs, and infrastructure needs.
Source:Tim Parsons
Johns Hopkins University Bloomberg School of Public Health
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Pneumonia
posted by Dan on 23 Feb 2009 at 3:54 pmPneumonia Thoughts
Pneumonia is an inflammation and consolidation of lung tissue to due to an infectious agent, such as a bacteria, or virus. Most pneumonia cases are usually acquired in a community setting
Bacterial pneumonia occurs more often due to bacteria called S. Pneumo. About half of all people infected with this bacteria show no overt symptoms.
Also, in comparison with viral pneumonia, bacterial pneumonia has a shorter duration and is also more severe in the damage the bacteria can do to the patient. If left untreated, pneumonia can lead to the critical diseases of meningitis or sepsis, if not death. In fact, pneumonia was the number one cause of death in the United States before the advent of antibiotics.
Approximately 2 million, if not more, people acquire pneumonia every year. 40 to 60 thousand people die due to pneumonia every year, and pneumonia is the most common infectious cause of death that exists. More men get pneumonia than women.
About 20 percent of CAP cases are viral rather than bacterial. So most of the time, an antibiotic will be needed for the pneumonia patient. Also, about 10 million doctor visits are due to CAP and the symptoms from the disease.
Pneumonia acquired while a patient is in a medical institution for another medical reason is called nosocomial pneumonia. Often, the symptoms are more severe, as the patient usually has another serious medical issue that is being treated in the medical facility as they acquire this type of pneumonia.
If this type of pneumonia is acquired at such a location, it usually happens after the first 48 hours of a patient being in such a facility. Also, the microbe that causes nosocomial pneumonia is usually S. Aureus, according to others.
However, frequently the cause of pneumonia is by resistant bacteria that are difficult to kill, as they are shielded from adaptation, these bacteria, from the many existing antibiotics historically used as therapy for patients invaded by bacteria. Such bacteria, as MRSA or VRE, are most resistant to most antibiotics.
Treatment for nosocomial pneumonia usually requires a longer period to restore the health of a patient with this diagnosis. About 25 percent of ICU patients without pneumonia acquire nosocomial pneumonia while there for another medical issue.
Symptoms for the typical pneumonia patient may be a fever, a high heart rate, a productive cough, and inflamed lungs noted on an X-ray. A sputum sample is usually obtained from the suspected patient in order to determine what is causing the pneumonia.
If it is bacterial, antibiotic therapy is initiated for a certain length of time to cure the infection. At the same time, the health care provider should rule out lung cancer or tuberculosis as the provider is assessing the patient. Chest X-Rays usually are taken to rule out such diseases.
Patients who are suspected or are diagnosed with community acquired pneumonia (CAP) are often started an antibiotic regimen from what is called the macrolide class of antibiotics. Macrolides have been proven to shorten the length of time the disease exists in the patient who has pneumonia.
How serious CAP is with a patient can be determined by what is called a risk stratification point system- which lists various symptoms and conditions that may be present in the suspected patient who may have pneumonia.
Points are assigned to these symptoms, and the severity of them regarding the disease of pneumonia. If the point number exceeds 90 points, the pneumonia patient is admitted to a hospital for more aggressive treatment and evaluation. About a third of all patients with community acquired pneumonia require hospitalization.
Elderly patients usually experience this type of severity with their CAP illness, as well as those people with compromised immune systems for whatever reason. Also, primary care physicians diagnose and treat typical pneumonia in the United States. In the United States, about 2 million or more people acquire pneumonia, and over 4 thousand people die from this disease every year.
Worldwide, about 2 million children less than 5 years of age die every year due to pneumonia. Two pneumonia vaccinations are available presently. It has recently been proven that the polysaccharide pneumonia vaccine is not useful in preventing pneumonia. However, the conjugate pneumonia vaccine has been shown to prevent the disease, according to recent studies.
The effective vaccine has experienced greater worldwide access recently to prevent what may be a very deadly disease without prevention and treatment, as it is believed to protect well over 50 percent of people who receive this vaccination from pneumonia.
http://www.lungusa.org
Dan Abshear
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