Belo Horizonte: Brazil declares yellow fever emergency in Minas Gerais

At least 15 people have died there since December. Many areas, including the state capital Belo Horizonte, have been affected. Brazil's south-eastern state of Minas Gerais has declared a public health emergency following a deadly outbreak of yellow fever.

A mass vaccination programme is in place in three southern states.

But queues have formed outside clinics in Rio and Sao Paulo amid concerns that vaccines could run out.
In neighbouring Argentina, there have also been long queues for the vaccine in Buenos Aires and other cities as thousands of prospective tourists prepare to travel to Brazil for carnival.

On Tuesday the WHO recommended that travellers to Sao Paulo state get a yellow fever vaccine before visiting.

Minas Gerais has been the hardest-hit Brazilian state. The health emergency will be in place for six months and will allow local authorities to commission special services and buy in emergency materials.

What is yellow fever?

A woman receives a yellow fever vaccine at a public health post in Caratinga, in the south-eastern state of Minas Gerais, Brazil, on January 13, 2017.Image copyrightAFP

WHO advises people to get a vaccine at least 10 days before travelling to a yellow-fever area

Caused by a virus that is transmitted to humans by mosquitoes

Difficult to diagnose and often confused with other diseases or fevers

Most people recover after the first phase of infection that usually involves fever, muscle and back pain, headache, shivers, loss of appetite, and nausea or vomiting

About 15% of people face a second, more serious phase involving high fever, jaundice, bleeding and deteriorating kidney function

Half of those who enter the "toxic" phase usually die within 10 to 14 days

Source: WHO

The WHO's advice is for all travellers to Sao Paulo to get a vaccination at least 10 days before travelling and to take measures to avoid mosquito bites.

Brazilian Health Minister Antonio Nardi responded by saying that most people attending Brazil's carnival celebrations in February should be safe as they are held in large cities and not the rural and forested areas which have seen the biggest increase in yellow fever cases.

Mr Nardi said Sao Paulo state authorities would speed up their vaccination campaign with the aim of vaccinating half of the state's population by the end of February.

More than 45 million people live in Sao Paulo state.

Source: http://www.bbc.com/news/world-latin-america-42763471

Nearly Two-Thirds: asthma patients not receiving basic care

Nearly two-thirds of people with asthma are still not receiving the basic level of care despite claims it could prevent two out of three asthma deaths a year, according to a survey by Asthma UK.

The study revealed a "frustrating" lack of progress in asthma care, following similar findings last year.
Donna Green's son Tiernan was one of the UK's 1,200 asthma deaths in 2017.

"As a mum who has lost a child to an asthma attack, I don't want any other parent to go through what we have."

Donna, of County Armagh, added: "I didn't realise how serious asthma was, and I found out in the most devastating way, when my boy died in my arms."

According to the survey, Northern Ireland had the best performance for basic asthma care across the UK, with 48.2% receiving basic care - and Donna maintains that Tiernan had been receiving satisfactory support for his asthma.

At his inquest, the coroner said Tiernan had an asthma review lined up with his nurse, but tragically died before he had the chance to go.
Yet Asthma UK's annual report - which surveyed 7,611 people - found that only 35% of patients with asthma in the UK are receiving the most basic level of asthma care.
Basic care involves three key elements, as set out in national guidelines. They are:
a yearly asthma check-up
a written asthma action plan
a lesson in how to use an inhaler

There are 5.4 million asthma sufferers in the UK, including 1.1 million children.

Based on the proportion of people in the survey who responded - and applied to the UK's asthma population as a whole - the charity believes 3.5 million asthma sufferers are not receiving basic care.
A lack of basic care can be fatal. NHS data from the past four years shows, on average, someone is admitted to hospital for an asthma attack in the UK every eight minutes.

'Postcode lottery'

Tiernan, was 20 when he died.

"Tiernan came to my bedroom door, having an asthma attack, gasping for breath. He was pale, his lips had turned blue and he was taking his inhaler but it wasn't helping," said Donna.

"I called an ambulance and was on the phone when he turned to me and said, 'mum I'm going to die tonight'. It was the most frightening moment of my life.

"Tiernan collapsed on the floor and stopped breathing and I gave him CPR while my daughter continued talking to the paramedics, but he died before he got to hospital.

"Losing Tiernan has left a big hole in our lives."

Donna has joined forces with Asthma UK to campaign for better care.

"Mums often tell me that doctors are brushing aside their worries about their children's asthma and they aren't being given what they need."

Statistics show that asthma patients are four times more likely to be admitted to hospital for asthma if they don't have an asthma action plan.

The use of written action plans has increased year on year since the Asthma UK's first annual survey in 2013, with nearly half of those surveyed in 2017 (43.9%) saying they now have have a written plan for managing their or their child's asthma.

However, the 2017 survey found annual asthma reviews and inhaler technique checks have dipped.

My miracle daughter died from asthma
Grieving father's plea after asthma death
Girl dies of asthma after being turned away by GP

One in six people (15%) with asthma - an estimated 800,000 - said they received poor care, with wide variations geographically.

While Northern Ireland recorded good figures, only 27% of sufferers in London and 26% in Wales received basic care compared, to the UK figure of 35%.

The survey also found marked generational differences. A quarter of people aged 18 to 29 (25.1%) received basic asthma care, compared to 41.7% of people aged 70 to 79.

Dr Samantha Walker, from Asthma UK, said: "There's a postcode lottery with millions not getting basic asthma treatment, despite the fact it is proven to save lives.

"It shouldn't matter where you live - people with asthma should get a written plan to help them manage their asthma, a yearly review to check their medicine is working and help to ensure they are taking it properly."
Dr Imran Rafi of the Royal College of GPs said: "This report recognises that we need better information sharing between primary and secondary care to improve the outcomes of patients with asthma, and we agree that this process needs to be more seamless to ensure patients are receiving the best possible care throughout.

"It is also vitally important that patients understand their treatment and how to properly use equipment, such as inhalers, and we support any measures that encourage patients to feel more confident to manage their condition effectively and appropriately."

An NHS England spokeswoman said: "GPs are best placed to provide appropriate asthma treatment and we are rolling out support to help them improve the diagnosis and treatment of the condition, including the development of local hubs that will make testing more effective."

Source: http://www.bbc.com/news/health-42773538

Cervical Cancer Trust: embarrassment makes women avoid smear tests charity says

The charity Jo's Cervical Cancer Trust surveyed 2017 British women.. Young women are avoiding getting smear tests because they are embarrassed by the look and smell of their pubic areas, a survey suggests.A third said embarrassment caused them to delay getting a smear test, which can prevent 75% of cervical cancers.The charity said cervical cancer is the most common cancer in women under 35, yet almost two-thirds of those surveyed weren't aware they're most at risk.A total of 220,000 British women are diagnosed with cervical abnormalities each year.

'Naive and uneducated'

Lauren Bennie said she put off having her smear test until the age of 30 because she was "naive, embarrassed and uneducated about the female body".

"So many silly things stopped me from going for my smear test," she said.

"I worried about the nurse being able to take one look at my bits and have some magic skill to be able to determine the number of sexual partners I'd had. I thought a lot about what kind of underwear and clothes to wear."

While at university in Dundee, she thought she might know the medical students who could be asked in to observe.

Lauren Bennie said she put off having her smear test until the age of 30

"I didn't know it at the time, but the embarrassment I felt around going for a smear was actually doing my body damage," said the 33-year-old Glaswegian.

WATCH: Is there really scraping in a smear test? The truth about what it really involves

When she did eventually get a test she was told she needed further examination.

"It was when I was faced with words such as dyskaryosis (abnormal cells), high-grade and colposcopy that I realised the severity of the situation."

Hospital results later confirmed she had severely abnormal cells that were pre-cancerous on her cervix.

"It was terrifying," she said. "I felt angry rather than sad that I had left it so long to go for a smear test."

Lauren's story isn't unique.

'Waxed or shaved'

The survey found young women are embarrassed to attend smear tests because of their body shape (35%), the appearance of their vulva (34%) and concerns over smell (38%).

A third said they wouldn't go if they hadn't waxed or shaved their bikini area.

About 15% also said they would miss their smear tests for a gym class or a waxing appointment.

Robert Music, of Jo's Cervical Cancer Trust, said: "Please don't let unhappiness or uncertainty about your body stop you from attending what could be a life-saving test.

"Nurses are professionals who carry out millions of tests every year, they can play a big part in ensuring women are comfortable."

Datapic with stats about smear tests, showing 72% of eligible women were tested last year, 94.8% of tests were negative but coverage has declined since 2011

Of the five million women in the UK invited to cervical screening each year, one in four do not attend.

This rises to one in three among women aged 25 to 29 and is particularly bad in some geographic areas, such as Glasgow.
Mr Music said: "Every area has different demographics, pressures and geography," with the charity finding a third of local healthcare providers and councils haven't made any action in the past year to increase uptake of smear tests.

"There is already so much great work being done across the UK, however, if this is not amplified and prioritised, we will continue to see a decline in cervical screening coverage and ultimately lives lost."
Smear test 'saved my life'

Lauren's smear test allowed her to catch the pre-cancerous cells before they developed into cancer.
She said: "I had to have surgery to have a piece of my cervix removed.

"Luckily I received the all-clear but if I had delayed my smear test any longer it could have been much worse.
"My smear test could have saved my life, please don't put yours off."

Source: http://www.bbc.com/news/health-42747892

No safe level of smoking one cigarette a day increases heart disease and stroke risk

No safe level of smoking, study finds, Smokers need to quit cigarettes rather than cut back on them to significantly lower their risk of heart disease and stroke, a large BMJ study suggests.People who smoked even one cigarette a day were still about 50% more likely to develop heart disease and 30% more likely to have a stroke than people who had never smoked, researchers said.

They said it showed there was no safe level of smoking for such diseases.
But an expert said people who cut down were more likely to stop.
Why young people are now less likely to smoke
Quit smoking campaign backs e-cigs
'One smoke leads to daily habit for most'
'Stop completely'

Cardiovascular disease, not cancer, is the greatest mortality risk for smoking, causing about 48% of smoking-related premature deaths.

While the percentage of adults in the UK who smoked had been falling, the proportion of people who smoked one to five cigarettes a day had been rising steadily, researchers said.

Their analysis of 141 studies, published in the BMJ, indicates a 20-a-day habit would cause seven heart attacks or strokes in a group of 100 middle-aged people.

But if they drastically cut back to one a day it would still cause three heart attacks, the research suggests.
The researchers said men who smoked one cigarette a day had about a 48% higher risk of developing coronary heart disease and were 25% more likely to have a stroke than those who had never smoked.
For women, it was higher - 57% for heart disease and 31% for stroke.

Prof Allan Hackshaw at the UCL Cancer Institute at University College London, who led the study, told the BBC: "There's been a trend in quite a few countries for heavy smokers to cut down, thinking that's perfectly fine, which is the case for things like cancer.

"But for these two common disorders, which they're probably more likely to get than cancer, it's not the case. They've got to stop completely."

The researchers said it might be expected that smoking fewer cigarettes would reduce harm in a proportionate way as had been shown in some studies with lung cancer.

However, they found that men who smoked one cigarette per day had 46% of the excess risk of heart disease and 41% for stroke compared with those who smoked 20 cigarettes per day.
For women it was 31% of the excess risk of heart disease and 34% for stroke.

Prof Hackshaw said the increased risks of cardiovascular illness were over the course of a lifetime but damage could be done in just a few years of smoking.

But he said the good news was that those who quit smoking could also quickly reduce their risk of cardiovascular disease.

Cutting down not 'useless'

Paul Aveyard, professor of behavioural medicine at the University of Oxford, said the "well conducted" study confirmed what epidemiologists had suspected - that light smoking created a "substantial risk for heart disease and stroke".

But he said it was wrong to conclude cutting down smoking was useless.

"Those who try to cut down with the aid of nicotine, whether from nicotine replacement treatment or an e-cigarette, are more likely to stop eventually and thus really reduce their risks from smoking," he said.
Martin Dockrell, tobacco lead at Public Health England, said: "This study adds to the growing body of evidence which tells us that cutting down to just one cigarette a day still leaves a substantial risk of heart attack and stroke. The best and safest thing you can do is to quit completely for good."

Deborah Arnott, chief executive of health charity ASH, said: "It's addiction to nicotine that keeps people smoking but it's the tar in cigarette smoke that does the serious damage.

"Vaping is much less harmful, but only if you quit smoking altogether."

Simon Clark, director of the smokers' group Forest, said discouraging people from cutting down smoking could be "counter-productive".

Source: http://www.bbc.com/news/health-42802191