Medicine Man

India's latest bird flu outbreak has been further complicated by poultry farmers in the country's northeast attempting to smuggle flocks of chickens out of a quarantine zone.

The outbreak of the H5N1 strain of the bird flu virus in Manipur is causing concern and although no humans have been infected to date state health officials say blood samples taken from workers on the affected farm in the western city of Pune are being tested.

Health workers have culled almost 40,000 poultry and destroyed thousands of eggs and a 10 km surveillance zone around Imphal is expected to be extended to other districts following reports that a large number of chickens has been smuggled out of the affected zone.

Authorities say in all 150,000 poultry will be culled within the quarantine zone and it is the prospect of losing their livelihood which is prompting the smuggling operations.

Local residents are said to be alerting the police to people trying to sneak chickens and poultry products out of the quarantine area.

A veterinary worker in Manipur who died suddenly during the culling operations was not a bird flu victim but died after consuming formalin issued by the government for spraying at the burial sites of culled birds.

His death created some panic amongst workers in the rapid response teams sent to deal with the outbreak.

Officials have revealed that they have detected poultry smuggled out of Imphal in Thoubal and Bishenpur and authorities have seized 1,500 chickens smuggled out of the affected zone.

So far more than a dozen farmers have been detained by the police but the state government has promised farmers compensation to the tune of 40 rupees ($1) for every one of their chickens it has to cull.

The northeastern region of India has Bangladesh, Myanmar and China on it's borders and all have also been hit by the H5N1 strain.

Indian troops on the state's border with Myanmar have now begun extra patrols to prevent poultry smuggling.

Last year, India faced two major outbreaks of the H5N1 strain in chickens in the west of the country.

According to the World Health Organization since 2003, almost 200 people have died out of more than 300 people infected by the virus around the world and the fear remains that the virus will ultimately mutate into a form which is easily passed between humans.

Doctors in Britain are warning that offering all men over 50 and all women over 60 a pill to protect them against heart disease and stroke, will only serve to encourage an unhealthy lifestyle.

The 'polypill', a combination of cholesterol-lowering statin, aspirin and drugs to cut blood pressure, is being promoted as an all-purpose cure for heart disease, but critics say laziness and over-confidence about diet and fitness could result in the polypill becoming a killer.

A surge in the numbers of people leading unhealthy lifestyles could be the unwanted result of offering the pill to protect the middle-aged against heart disease and stroke, doctors have warned.

Many experts support moves to increase the numbers taking the 'polypill' but they too warn that it should not be viewed as a magic cure.

Professor Roger Boyle, the national director for heart disease and stroke, has suggested that the mass-prescription to the drugs could be a means of preventing premature deaths.

It is estimated that cardiovascular disease kills more than 200,000 people each year and three million Britons, considered to be at high risk, currently take the drugs.

Some experts say, though in principle the idea is sound, there is a concern that the responsibility for health is taken away from the person and the pill could be seen as a magic cure and lifestyle issues ignored.

They say some people on statins believe they can eat whatever they like and do little exercise.

It is thought that giving the drugs to everyone over a certain age would reduce cases of diabetes as the statins are effective and safe; offering one pill instead of three or four also meant people were more likely to take them.

Advocates say however that such a move must be accompanied with an education program which encourages people to think about their diet and to stay fit.

Professor Peter Weissberg, medical director of the British Heart Foundation says there is a risk of creating a culture where lifestyle issues are resolved by taking a pill which is an inappropriate message.

Experts say the best advice to reduce the risk of heart attack remains to not smoke, not get over-weight, eat well and exercise and statins are not a substitute for the lifestyle message but rather a welcome addition.

The National Institute of Clinical and Health Excellence (NICE) recommend all adults with a 20% risk of developing cardiovascular disease in the next 10 years be offered a statin.

This recommendation means in effect that six million people in the UK are eligible for the drugs on the NHS.

Globe trotting tuberculosis victim, American lawyer Andrew Speaker, has been released from hospital and has returned home.

Speaker triggered an international health panic when he flew to Europe despite supposedly being told he had a rare and contagious form of tuberculosis (TB).

Speaker has flown home but this time in an air ambulance in order to avoid 'public alarm' and though no longer contagious he will have to take antibiotics for two more years.

At the time of the scare officials say he was advised against travelling but Speaker and his family maintain this was not the case.

After zigzagging across Europe on various airlines Mr. Speaker and his wife eventually returned to the U.S. by slipping through the Canadian border in a car.

Since his return he has been in isolation in a Denver hospital where it was found that he actually had a less serious form of TB than first thought.

Mr Speaker was initially diagnosed with extensively-drug-resistant, or X-DR, tuberculosis but further tests found he had the multi-drug-resistant strain, which is still severe but easier to treat.

Doctors at the National Jewish Medical and Research Center in Denver, say Mr Speaker was healthy enough to return home to Georgia on a commercial flight and they expect him to return to a full and active life.

Speaker has spent eight weeks in the hospital where he underwent surgery to remove part of a lung with a tennis-ball-sized lump of infection.

Dr. Gwen Huitt, director of the hospital's adult infectious disease care unit says Mr Speaker was not completely cured and they believe some TB bacteria remain in his lungs, which ongoing antibiotic therapy should kill.

TB is rare in the United States and last year there were 13,767 recorded cases or 4.6 cases per 100,000 Americans.

Genome detectives have done it again by revealing at least three genes which are implicated in the incurable nerve disorder Multiple Sclerosis (MS).

Three team of scientists who have screened the entire human genome also suspect that a dozen more genes might be involved.

MS is caused by the breakdown of the fatty sheath surrounding portions of nerve cells that carry messages from one cell to another; this sheath, known as myelin, is rather like the plastic coating insulating an electrical cord.

Symptoms of the disease include muscle weakness, cognitive impairment, difficulties with balance and coordination and speech and vision problems.

MS is most common in young adults and women are more likely to develop the disease, which affects about 350,000 patients in the United States.

Scientists believe the autoimmune response is triggered as the result of a complex interplay between genetic and environmental factors, and one study suggests subtle changes in the immune system might spur the disease.

The three studies, two published in the journal Nature Genetics and one in the New England Journal of Medicine represent hope to 2.5 million people worldwide with MS, a disabling disease that progressively damages the nervous system.

The researchers say they detected tiny variations in people's genomes by using new tools, called 'snip chips'.

The New England journal study involved teams from the University of California at San Francisco, the University of Miami, Vanderbilt University and the University of Cambridge in the United Kingdom, who led the collection of multiple sclerosis populations.

Their combined efforts resulted in the screening of more than 7,000 DNA samples from patients with and without confirmed multiple sclerosis and they were able to determine which genetic variations occurred most often in people with the disease.

Their research supports earlier work which suggested that two of the three genes were implicated in MS and bolsters the connection to the two DNA sequences with the new one; the researchers also found a dozen more that showed some signs of linkage.

The researchers say this is the first major genetic advance in MS in 30 years and they believe their discoveries may lead to novel treatments for the disease or the identification of targets for new therapies.

Finance from the MS Society, the NIH and other organizations, allowed the scientists to use the 'snip chips' and the researchers say they are now planning another, larger study to look for more MS-linked genes.

The World Health Organisation (WHO) says millions of children die each year because of environmental hazards and one in five children in the poorest parts of the world will not reach their sixth birthday, mainly because of environment-related diseases.

According to a new WHO report the deaths of 4 million children under the age of five each year can be attributed to such hazards as polluted air or water, or exposure to chemicals.

The report highlights in particular the susceptibility of children to harmful chemical exposure at different periods of their growth and says their age at the time of exposure may be just as important as the magnitude of the exposure.

The report by an advisory group of 24 scientific experts, representing 18 countries says that poisonings, acute respiratory infections, diarrhoeal diseases and malaria carried by mosquitoes which thrive in dirty water are the culprits in the majority of the deaths.

The new study has focused on the child, including the developing embryo, fetus, infant and adolescent, and on the need to have a good understanding of the interactions between exposure, biological susceptibility, and socioeconomic and nutritional factors at each stage of a child's development.

Worst hit are children living in poor and degraded environments where neglect and malnourishment render them particularly vulnerable.

Children living in unhealthy housing, lack clean water and sanitation services, and have limited access to health care and education.

The report reveals that lead is more toxic to children whose diets are deficient in calories, iron and calcium and more than 30% of the global burden of disease in children can be attributed to environmental factors.

Many other environmental threats such as pesticides in food alter the delicate organism of a growing child and may cause or worsen disease and induce developmental problems.

Fresh evidence now suggests that exposure to certain environmental chemicals during childhood results in an increased risk of certain diseases in adults such as cancer and heart disease.

Dr. Terri Damstra, WHO's team leader for the Interregional Research Unit says children are not just small adults and are especially vulnerable and respond differently from adults when exposed to environmental factors, and this response may differ according to the different periods of development they are going through.

Dr. Damstra says their lungs are not fully developed at birth, or even at the age of eight, and lung maturation may be altered by air pollutants that induce acute respiratory effects in childhood and may be the origin of chronic respiratory disease later in life.

Damstra says Africa is the region with the most environmental-related diseases, followed by parts of south east Asia.

The WHO says the scientific principles proposed in the document for evaluating environmental health risks in children will help the health sector, researchers and policy makers to protect children of all ages through improved risk assessments, appropriate interventions and focused research to become healthy adults.