Are you affected by the NHS stopping gluten-free prescriptions? | Matthew Holmes

The NHS is to stop prescribing gluten free foods to patients suffering from digestive conditions such as coeliac disease as part of its latest budget cuts.

GPs in England will also be told not to prescribe medications such as those for upset stomachs, travel sickness and haemorrhoids in the drive to eliminate waste from the NHS’s £120bn annual budget.

If you have coeliac disease, we’d like to hear from you. Simon Stevens, chief executive of NHS England, said it no longer needs to prescribe some foods as they are on sale in supermarkets, but those who are already struggling for money and are helped with the cost of prescriptions could be hit hard. Are you affected?

Share your stories with us in the form below and we’ll use some of them as part of our coverage.

Are you affected by the NHS stopping gluten-free prescriptions? | Matthew Holmes

What can this Peru slum teach the world about stopping the spread of TB?

For Jasmin Bueno, aged seven, and her brother Aaron, aged six, there is little that can make swallowing chemo-profilactic pills any less bitter. But the tablets they stoically gulp down daily during the next six months are the best protection they can get from contracting tuberculosis.

Just a sheet draped over a washing line separates their sleeping area from that of their 20-year-old brother, Jose, a tuberculosis sufferer. The whole family, their mother and an older sister with an infant baby, live in shack on a hill overlooking the sprawling Carabayllo slum. It is a tuberculosis hotspot where the overcrowded, poorly-ventilated and often damp homes provide a breeding ground for one of the world’s most ancient diseases, which recent research shows claims 1.8 million lives a year globally, not the 1.5 million it was previously thought.

Peru has the highest incidence per capita of tuberculosis in the Americas, including virulent multi-drug resistant (around 2,300 patients per year, 35% of all cases in the region) and extensively drug resistant (around 100 patients per year, 75% of all cases in the region) strains. Its reduction is slow at around 1.5% a year, just short of the global reduction of 1.65% annually, according to the World Health Organisation (WHO). The rate of reduction would need to increase to a 4-5% annually, in order to reach sustainable development goal target 3.3 – ending epidemics of tuberculosis and other infectious diseases by 2030.

The WHO admits this is an ambitious aim. It said in a statement last year: “While there has been significant progress in the fight against TB, with 43 million lives saved since 2000, the battle is only half-won: more than 4,000 people lose their lives each day to this leading infectious disease. Many of the communities that are most burdened by tuberculosis are those that are poor, vulnerable and marginalised.”

We go to the patients’ houses and we find the best way on ensuring they don’t abandon the treatment

Carmen Contreras​,​ Partners in Health

But as well as being one of the hotspots for the disease, Peru has some of the world’s highest cure rates for multi-drug resistant tuberculosis (MDR-TB) at 83% and the extremely drug resistant strain (XDR-TB) at 60%. The global reduction rate for MDR-TB is around 50% and is just 25% for XDR-TB.

“Search, treat, prevent – that’s our approach,” says Carmen Contreras of US-based charity Partners in Health. “We go to the patients’ houses and we find the best way on ensuring they don’t abandon the treatment.” The WHO’s End TB hands-on approach has been implemented since 2015 and it is reaping rewards in Peru.

Decades on the streets as a drug addict smoking unrefined cocaine left 56-year-old Francisco Verastegui’s health in ruins. He became HIV positive then found out he had tuberculosis. Now off the streets in a homeless shelter run by an evangelical church, Verastegui says he has cheated death more than once. “I’ve abandoned the treatment on several occasions in the past but I didn’t die so I know that God must have a purpose for my life,” he says, taking his daily dose of pills.

Francisco Verastegui is HIV positive and has TB after years living on the streets as a drug user. He now lives on a farm for homeless men on the outskirts of Lima. Photograph: Jorge de la Quintana

Partners in Heath works with several thousand patients in Peru and has seen the number of people who abandon treatment reduce from 7-8% to less than 1%. The secret of their success is training local health promoters in the community itself, says Leonid Lecca, the NGO’s director in Lima: “They come from the same community; they know who the coughers are, who has lost weight, who’s hiding because they have problems. They find those people who sometimes never reach the health services.”

The NGO’s aim for 2017 is zero deaths and zero abandonment of treatment. A quick and accurate diagnosis is key to achieving this. So Partners in Health built a state-of-art tuberculosis detection laboratory in an old shipping container in the heart of this deprived community. It’s been operating in Carabayllo, in northern Lima, since 2012.

The lab is the only one of its kind in Latin America and can make 25 diagnoses a day. This is a big boost for Peru’s strained healthcare services, says its head, Roger Calderon: “The diagnosis is very important because the patient often doesn’t know what’s wrong with them. A quick and opportune diagnosis is best way to control tuberculosis but the problem is not just a medical one, it’s a social one. While there’s poor and needy people, there will be tuberculosis.”

Taking patients like Julia Roque, 53, through the lengthy treatment for multi-drug resistant tuberculosis is part of the job for Contreras at Partners in Health as she strolls arm-in-arm with her patient. Roque caught MDR-TB while being treated in hospital for diabetes.

Recovery is arduous. She is too weak to continue her work as a street vendor and lack of money to support herself and her family is constant worry, says Roque. “To recover you have to be determined, strong and have plenty of willpower otherwise you won’t get better,” she says. “If you quit the treatment then only God will gather you up.”

Accompanying patients on the road to recovery with consistent moral support is how Peru is leading by example. Perhaps the rest of the world can follow in its footsteps to make a dent on the global epidemic.

Join our community of development professionals and humanitarians. Follow @GuardianGDP on Twitter. Join the conversation with the hashtag #Dev2030.

What can this Peru slum teach the world about stopping the spread of TB?

If Ebola Arrives In The U.S., Stopping It Could Flip On Controversial Tools

Provided the scope of the Ebola outbreak unfolding in Western Africa, it seems possible that a case will at some point emerge in the U.S.

We could even see an isolated cluster of infections in an American city.

Thinking about the nature of the Ebola virus, and the health-related infrastructure we have to fight its spread, the diagnosis of some circumstances on American soil shouldn’t be reason to panic. We have a plethora of equipment and public overall health practices to readily combat its spread. Nevertheless since the virus is so harmful, and feared, its arrival in America would likely to trigger a robust response from our public health establishment.

For most Americans, it might be the 1st time they glimpse the resources that our government has staked out more than the last decade, as preparation for public well being emergencies like a pandemic flu, or even bioterrorism. Some of these authorities are wholly necessary. Other folks will demonstrate controversial and worthy of closer scrutiny.

Chief between them are authority maintained by the Centers for Illness Control to quarantine Americans suspected of possessing a unsafe, communicable illness. In some cases, this consists of the power to isolate men and women, and hold a healthful person against his will. The CDC’s quarantine authority has been strengthened in recent many years. But we haven’t had sufficient debate about how to stability person rights towards public wellness in these circumstances. And when quarantine is even successful. We ought to revisit these problems ahead of we find ourselves invoking these resources.

What will come about if Ebola arrives in America?

First, there will be a good deal of misplaced panic. But there is no cause for most Americans to worry of Ebola’s wider spread. Although Ebola is extremely infectious, it is not quite contagious.

It is extremely infectious because someone stricken with Ebola is extremely very likely to get sick (and harbors a whole lot of virus particles that they can readily transmit to yet another man or woman, offered the correct circumstances). But the virus itself is fragile, and does not simply spread. So it is not extremely contagious. In quick, Ebola is tougher to contract than a lot of other viruses.

The Ebola virus can only be spread by direct get in touch with (via broken skin or mucous membranes) with the blood, or other bodily fluids or secretions (stool, urine, saliva) of contaminated individuals. Infection can also take place if the broken skin of a healthful man or woman comes into speak to with environments that have become contaminated with an Ebola patient’s infectious fluids (such as soiled clothing).

In addition, individuals generally only grow to be contagious – and can spread the virus — as soon as they begin contracting signs and symptoms. Prior to the onset of symptoms, it is usually harder to spread the virus. But the onset of signs is usually quite serious. So it’s simple to understand that a person is sick. In addition, stricken men and women are significantly less likely to travel about – and spread the virus — offered their debilitated condition.

All of these elements make control of the infection possible. If isolated instances emerge in the U.S., our public wellness apparatus ought to be able to readily incorporate its spread.

However it’s very plausible that a case of Ebola could soon be diagnosed in the U.S.. For a single factor, the virus has a extended incubation period, up to 3 weeks. So an contaminated personal could travel abroad and contract signs and symptoms only properly following arriving at their destination.

Moreover, the identical aspect that is fueling its spread in Africa makes it a lot more likely that Ebola travels abroad. The African outbreak has occurred in urban areas. In the previous, outbreaks have been confined to rural communities, making it simpler to contain. The emergence of Ebola in urban settings has manufactured management harder, and put the virus in closer proximity to individuals who may possibly contract it and unwittingly get on an airplane.

If Ebola appears in the U.S., we have a robust public wellness infrastructure to contain its spread. In the previous decade, five individuals have entered the U.S. with Lassa fever and Marburg, two viral hemorrhagic fevers that are related to Ebola. This includes a situation in March of a Minnesota man diagnosed with Lassa fever right after traveling to West Africa. No a single else contracted the conditions as a outcome of these 5 circumstances.

But provided the deadly nature of the Ebola virus, and the common be concerned it is most likely to engender, a single can anticipate the CDC and well being authorities to pull out all the stops. The response could include invocation of the CDC’s evolving quarantine authorities.

These federal powers comprise a set of guidelines that gives CDC sweeping authority to hold and isolate Americans in a public well being emergency. These authorities haven’t been fully updated in decades. They’ve only been amended in piecemeal style to deal with contemporary threats like SARS and MERS. In advance of what may be a very public test of these powers, the collected scheme deserves closer scrutiny.

If Ebola Arrives In The U.S., Stopping It Could Flip On Controversial Tools

It"s Peak Tick Season: seven Guidelines For Stopping Tick-Borne Illness

Every single yr, amongst 20,000 and 30,000 people are diagnosed with Lyme Illness, says the CDC. That’s a good deal of folks – and many experts feel the CDC’s numbers are way reduced, given that Lyme disease can go unrecognized for a lot of years.

But Lyme is just one particular of a increasing checklist of severe conditions transmitted by ticks. Rocky Mountain spotted fever, babesiosis, erlichiosis and the latest threat, the Heartland Virus, are all on the rise.

And now’s the time to be vigilant – it’s the height of tick season and tick-borne ailments pose a significant chance in many areas. In recent weeks, overall health commissioners in states including Indiana, Missouri, and  New York have issued alerts for a higher-threat season of tick-borne condition.

The blacklegged tick is one of the prime transmitters of Lyme condition in the central and eastern U.S. Deer ticks are one more prime culprit. (Photograph credit: Wikipedia)

So how do you protect oneself, your household, and your pets?

How to Preserve Ticks from Biting:

1. 
   Dress in extended sleeves and extended pants outdoors, even when it’s sizzling. Light-colored, breathable cotton will be most comfortable, but be mindful that ticks can simply crawl inside – and hide beneath – loose pant and sleeve cuffs.


2. 
   Use a strong insect repellent. Yes, there are wellness worries about DEET, no level in pretending there aren’t. But if it is the only point that works towards ticks in your area, use it, as the risk from the ticks themselves is better. (Bear in mind, you can wash the repellent off later on.) Investigation shows most folks overestimate the risk from DEET, frequently perplexing it with DDT. It is toxic only in extremely big quantities and is not a identified carcinogen.


3. 
   If you will not use DEET, use Picaridin. Repellents containing picaridin, an ingredient derived from pepper, could be safer, but it hasn’t been in use as extended so we don’t really know.


4. 
   Do a tick check out. Strip off your clothing and appear for ticks as soon as you get indoors. If someone else is offered to check locations this kind of as the back of your neck and head, enlist their aid.


5. 
   Seem for teensy small ticks. Bear in mind, a lot of tick-borne diseases are carried by ticks even though in the nymph stage, at which point they are smaller than the head of a pin. Be suspicious of any speck that does not brush off.


6. 
   Wash ticks away. Take a shower as soon as attainable, preferably within two hours.


7. 
   Tick-evidence your pets. The systemic flea and tick repellents obtainable from your vet and from pet retailers can help avert ticks from attaching themselves to your canine or cat. They work by means of neurotoxins (most frequently imidacloprid, fipronil, and permethrin that attack ticks’ central nervous programs.)

If you should go au-natural, here’s a recipe for a normal tick-repellent.

For Pets:

In a spray bottle, mix 1 cup water and 2 cups distilled white vinegar. (Ticks loathe the smell and taste of vinegar, supposedly.) Add 2 teaspoons vegetable or almond oil, both of which include sulfur, which ticks also dislike.

For People:

Follow the recipe over, but add eucalyptus oil, an added repellent that at least partially masks the vinegar smell.

Please share your tick-prevention guidelines in the comments below. More suggestions are offered from the FDA on how to protect by yourself towards tick-borne illnesses.

For far more overall health information, follow me here on Forbes.com, on Twitter and Instagram  @MelanieHaiken, and subscribe to my posts on Facebook.

It"s Peak Tick Season: seven Guidelines For Stopping Tick-Borne Illness