Isolated spider monkeys (Ateles geoffroyi) likely lower the pitch of their calls to improve the chances of re-establishing contact with their group, according to a study published April 3, 2019 in the open-access journal PLOS ONE by José D. Ordóñez-Gómez from the German Primate Center, Germany, and colleagues.

Untreated tuberculosis (TB) during pregnancy poses a significant threat to both mother and child. The aim of World Tuberculosis Day, which was observed recently, was to promote the prevention of infection, as well as the destigmatisation of treatment.

“A woman’s health is more important than ever during pregnancy. By taking care of your own health, your baby is taken care of as well,” says Dr Howard Manyonga, the Head of The Birthing Team, an affordable maternity care programme available in Johannesburg, Pretoria and Durban.

More hazardous if left untreated

Midwives and doctors stress the importance of adhering to TB treatment during pregnancy because newborns can also contract TB from their infected mother’s placenta. Treatment options during pregnancy consist of several oral drugs as well as injectable agents, depending on the susceptibility of the bug. Women are also encouraged to take vitamins, including B6 supplements, to ensure that the foetus receives the necessary vitamins and to prevent drug-related side effects.

“Many consider the treatment of TB dangerous during pregnancy, but it is far more hazardous if left untreated,” says Manyonga. “It is important to be screened for TB as early in the pregnancy as possible. If TB is suspected, be completely transparent with your healthcare professional regarding your diagnosis.”

The total treatment time can take up to nine months and it is important to consult with medical professionals postpartum regarding the continuation of treatment, if necessary, and how it will affect nursing infants.

According to the Donald Gordon Medical Centre, South Africa has the fifth highest burden of TB in the world. South Africa has more than 880 new TB infections each day, with close on 1.5 million people dying from the disease every year.

The Birthing Team, supported by healthcare management company PPO Serve, provides affordable private maternity care to women who are uninsured. Their all-inclusive fee covers all necessary scans, tests, medication, services and assessments based on their patient’s first consultation at 12 weeks of pregnancy. Screening for TB will be done in this initial assessment. The programme’s focus on antenatal care and patient education ensures that the mother-to-be will be given the treatment best suited to the situation.

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For the first time scientists have found an organism that can produce chlorophyll but does not engage in photosynthesis.

The damage caused to the Great Barrier Reef by global warming has compromised the capacity of its corals to recover, according to new research published today in Nature.

Eileen McAdie died after being given blood-pressure medication instead of pain relief drugs.

Less than 10 minutes a day of brisk walking can help prevent disability in people with arthritis pain in their knee, hip, ankle or foot, researchers report.

Just one hour a week of brisk physical activity “is less than 10 minutes a day for people to maintain their independence. It’s very doable,” said lead study author Dorothy Dunlop. She’s a professor of preventive medicine at Northwestern University’s Feinberg School of Medicine in Chicago.

Four years of data

“This minimum threshold may motivate inactive older adults to begin their path toward a physically active lifestyle with the wide range of health benefits promoted by physical activity,” Dunlop added in a university news release.

She and her team analysed four years of data from more than 1 500 older adults in Baltimore, Pittsburgh, Columbus, Ohio, and Pawtucket, Rhode Island, who had pain, aching or stiffness in their lower joints from osteoarthritis but were initially free of disability.

The participants’ levels of physical activity were monitored using a wearable device.

An hour a week of moderate-to-vigorous physical activity reduced their risk of disability, the study found. Specifically, the activity reduced the risk of walking too slowly to safely cross a street by 85%, and their risk of not being able to do daily living activities – for example, morning routine tasks such as walking across a room, bathing and dressing – by nearly 45%.

By the end of the four years, 24% of participants who did not get a weekly hour of brisk physical activity were walking too slowly to safely cross the street, and 23% had difficulty performing their morning routines, according to the study.

One hour a week

About 14 million older Americans have symptomatic knee osteoarthritis, the most common type of osteoarthritis. About two in five people with osteoarthritis – most of whom have it in their lower joints – develop disability.

Federal guidelines recommend low-impact physical activity for older adults with arthritis, and recommend that older adults do at least 2.5 hours a week of moderate-intensity activity.

But that amount of activity can be too much for inactive older adults with lower extremity pain, according to Dunlop.

“We hope this new public health finding will motivate an intermediate physical activity goal,” she said. “One hour a week is a stepping stone for people who are currently inactive. People can start to work toward that.”

The study was published in the American Journal of Preventive Medicine.

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One morning late last year, 4-year-old Joey Wilcox woke up with the left side of his face drooping.

It was the first sign of an unfolding nightmare.

Three days later, Joey was in a hospital intensive care unit, unable to move his arms or legs or sit up. Spinal taps and other tests failed to find a cause. Doctors worried he was about to lose the ability to breathe.

“It’s devastating,” said his father, Jeremy Wilcox, of Herndon, Virginia. “Your healthy child can catch a cold – and then become paralysed.”

Joey, who survived but still suffers some of the effects, was one of 228 confirmed victims in the US last year of acute flaccid myelitis, or AFM, a rare, mysterious and sometimes deadly paralysing illness that seems to ebb and flow on an every-other-year cycle and is beginning to alarm public health officials because it is striking more and more children.

Fearsome epidemics

Dr Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, said it may bear similarities to polio, which simmered among humans for centuries before it exploded into fearsome epidemics in the 19th and 20th centuries.

Fauci, who published a report about the disease Tuesday in the journal mBio, said it is unlikely AFM will become as bad as polio, which struck tens of thousands of US children annually before a vaccine became available in the 1950s.

But he warned: “Don’t assume that it’s going to stay at a couple of hundred cases every other year.”

Other countries have reported cases, including Canada, France, Britain and Norway. But the size and pattern of the US outbreaks have been more pronounced. More than 550 Americans have been struck this decade. The oldest was 32. More than 90% were children, most around 4, 5 or 6 years old.

Most had a cold-like illness and fever, seemed to get over it, then descended into paralysis. In some cases it started in small ways – for example, a thumb that suddenly wouldn’t move. Some went on to lose the ability to eat or draw breath.

Many families say their children have regained at least some movement in affected limbs, but stories of complete recovery are unusual. Health officials cannot say how many recovered completely, partly or not at all, or how many have died, though the Centers for Disease Control and Prevention says deaths are rare.

Mutated virus

Scientists suspect the illness is being caused chiefly by a certain virus that was identified more than 55 years ago and may have mutated to become more dangerous. But they have yet to prove that.

And while doctors have deployed a number of treatments singly or in combination – steroids, antiviral medications, antibiotics, a blood-cleansing process – the CDC says there is no clear evidence they work.

Many parents say that when they first brought their child to the emergency room, they quickly realised to their horror that the doctors were at sea, too.

“Everyone is desperate for some magical thing,” said Rachel Scott, a Tombal, Texas, woman whose son Braden developed AFM in 2016 and has recovered somewhat after intensive physical therapy but still cannot move his right arm and has trouble swallowing and moving his neck.

A growing number of experts agree that physical therapy makes a difference.

“These kids can continue to recover very slowly, year over year… It’s driven by how much therapy they do,” said Dr Benjamin Greenberg of UT Southwestern Medical Center in Dallas, one of the nation’s foremost experts on the condition.

Wilcox, Joey’s father, said his son made huge improvements that way. Joey can run and use his arms. Still, muscle tone is weak in his right leg and shoulder, and he still has left-side facial paralysis. “He can’t completely smile,” his dad said.

Other stories are more tragic.

Shouldn’t be happening

Katie Bustamante’s son Alex developed AFM in 2016. The suburban Sacramento, California, mother realized something was wrong when she asked the boy, then 5, why he wasn’t eating his yogurt. Alex replied that his thumb had stopped working and he couldn’t hold his spoon.

That morning was the start of 17 months of hospital stays, surgeries, therapy, and struggles with doctors and insurers to find a way to restore his ability to breathe. It ended one morning last May, when the Bustamantes woke up to find Alex had died.

Government officials need to step up, Bustamante said.

“I want them to research it and find the cause, and I want them to find a way to prevent it,” she said. “This is growing. This shouldn’t be happening.”

More and more experts feel certain the main culprit is an enterovirus called EV-D68, based on the way waves of AFM have coincided with spikes of respiratory illnesses caused by EVD-68. Enteroviruses are a large family of viruses, some of which, such as polio, can damage the central nervous system, while many others cause mild symptoms or none at all.

In the US, doctors began reporting respiratory illnesses tied to EV-D68 in 1987, though usually no more than a dozen in any given year.

Then, in what may have been one of the first signs of the AFM waves to come, a 5-year-old boy in New Hampshire died in 2008 after developing neck tenderness and fever, then weakened arms and deadened legs. The boy had EVD-68, and in a report published in an obscure medical journal, researchers attributed his death to the virus.

The first real burst of AFM cases hit in 2014, when 120 were confirmed, with the largest concentrations in California and Colorado.

What ensued was an even-year, odd-year pattern: Cases dropped to 22 in 2015, jumped to 149 in 2016, and fell again, to 35 in 2017. Last year they reached 228, a number that may grow because scores of illnesses are still being investigated.

In keeping with the cyclical pattern, just four cases have been confirmed this year so far.

Greater focus

CDC officials consider an illness AFM based on scans and other evidence showing a certain kind of damage to the spinal cord. Proof of an enterovirus infection is not required for a case to be counted, mainly because such evidence has been hard to come by. So far, CDC investigators have been able to find evidence of enteroviruses in the spinal fluid of only four of 558 confirmed cases.

Scientists are using more sensitive spinal-fluid tests in hopes of establishing the connection between AFM and EV-D68 more firmly. That, in turn, could spur more focused work on treatments and maybe even a vaccine.

Meanwhile, Fauci’s agency has put out a call for researchers to apply for federal funds, and is tapping a University of Alabama-anchored network of pediatric research centres to work on the illness.

The CDC is pledging a greater focus, too. Parents have accused the agency of doing little more than counting cases and have complained that when they tried to contact CDC, they encountered only automated phone trees and form responses.

CDC officials have begun holding meetings and calls with families, set up a scientific task force and working to monitor cases more closely.

Fauci suggested it would be a mistake to assume that surges will take place every other year forever. The next one “may be in 2019, for all we know”, he said.

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Female doctors complain of sexism and crude behaviour as the GMC warns of a culture of bullying and rudeness.

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