Global cyber-attack: NHS services among victims – live updates

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• This is not targeted at the NHS, it’s an international attack, says Theresa May

• NHS England declares major incident after ransomware blocks access to patient records, internal phones and emails

8.34pm BST

More than half of Scotland’s health boards have been affected by a large-scale cyber attack on NHS computer systems. GP surgeries and dental surgeries were among some of the locations hit by the ransomware attack on IT networks, the Press Association reports.

NHS Lanarkshire said only those patients requiring emergency treatment should attend hospital while they dealt with the issue on Friday.

7.50pm BST

The Agence France-Presse news agency reports that, in Spain, employees at the telecom giant Telefónica were told to shut down their workstations immediately through megaphone announcements as the attack spread.

Forcepoint Security Labs said that “a major malicious email campaign” consisting of nearly 5m emails per hour was spreading the ransomware.

7.44pm BST

Some more quotes from the prime minister. She has told reporters:

I think what is important is that we have recognised that increasingly we need to be aware of the need to address cyber security issues, that’s why the National Cyber Security Centre has been set up. It is now able to work with the NHS to support the organisations concerned and to ensure that patient safety is protected.

7.36pm BST

After the prime minister said she was “not aware of any evidence that patient data has been compromised”, Ross Anderson, a professor of security engineering at Cambridge university, advises caution.

The NHS are saying that patient privacy hasn’t been compromised, but if significant numbers of hospitals have been negligently running unpatched computers for two months after the patch came out, how do they know?

7.24pm BST

Some more on that statement from the prime minister, Theresa May, who says:

We are aware that a number of NHS organisations have reported that they have suffered from a ransomware attack.

This is not targeted at the NHS, it’s an international attack and a number of countries and organisations have been affected.

7.21pm BST

There are reports around that as many as 40 NHS organisations have been hit by the cyber-attack. NHS Digital says it is not going to confirm the number until tomorrow.

7.08pm BST

The cyber-attack that has hit the NHS is part of a wider international attack, the prime minister Theresa May has confirmed.

She said there is no evidence that patient data had been compromised.

7.02pm BST

One expert who has worked closely with law enforcement says this would be seen as an attack on critical national infrastructure. He says investigators will be examining systems affected by the ransomware to see how badly they are affected and whether they, in turn, can or already have infected other computer systems connected to them.

He adds that the fear is that the ransonware cannot be broken and thus data and files infected are either lost or that the only way to get them back would be to pay the ransom, which would involve giving money to criminals.

7.00pm BST

One question arising from the attack on a sector of critical national infrastructure is whether the government has a policy on paying ransom to cyber hackers.

British government policy in the case of a terrorist attack or of the taking of a person hostage is clear: ransom will not be paid. But it is not clear if a policy exists for the 21st-century cyber equivalent. The lead agency dealing with the attack on the NHS is the National Cyber Security Centre, an arm of GCHQ.

6.57pm BST

The New York Times is reporting that 12 countries, including the UK, have been affected.

It reports that the attack struck “computers across a wide swath of Europe and Asia”, saying that Japan, Russia, Turkey, Vietnam and the Philippines are among those affected.

6.51pm BST

Prof Alan Woodward, a security expert from the University of Surrey, says the attackers appear to have taken advantage of a chink in the armour of Microsoft XP that was exposed in a recent leak of CIA hacking tools.

He says the problem may have been exacerbated because organisations have not updated their software with the fixes made available, or are using outdated versions.

From what we can see, it is a piece of ransomware called wanna decryptor. It goes by other names but it emerged in February 2017. Since then, it has been modified and there is evidence that it is spreading using a flaw in the Microsoft network protocol called SMB, which was exposed in the recent dump of exploits that were allegedly from US intelligence agencies.

It is not just the NHS affected: reports suggest it is a global problem. The virulence is likely to be because some organisations have either not applied the patch released by Microsoft, or they are using outdated operating systems (such as XP) that are no longer supported by Microsoft and hence no patch exists.

6.34pm BST

NHS England have released an updated statement. Dr Anne Rainsberry, the NHS incident director, said:

We’d like to reassure patients that if they need the NHS and it’s an emergency that they should visit A&E or access emergency services in the same way as they normally would and staff will ensure they get the care they need.

More widely, we ask people to use the NHS wisely while we deal with this major incident, which is still ongoing. NHS Digital are investigating the incident and across the NHS we have tried and tested contingency plans to ensure we are able to keep the NHS open for business.

6.31pm BST

Here’s a little background from my colleagues Damien Gayle, Alexandra Topping and Sarah Marsh. They report the situation as it stood at about 5pm today:

Hospitals across England have been hit by a large-scale cyber-attack, the NHS has confirmed, which has locked staff out of their computers and forced many trusts to divert emergency patients.

The IT systems of NHS sites across the country appear to have been simultaneously hit, with a pop-up message demanding a ransom in exchange for access to the PCs. NHS England has declared a major incident. NHS Digital said it was aware of the problem and would release more details soon.

6.25pm BST

The NHS has declared a major incident after it was hit by a cyber attack that is thought to have affected services across England and Scotland. Staff have been locked out of their computers and many trusts have been forced to divert emergency patients.

We’ll be updating you here as this story develops.

Continue reading…

Global cyber-attack: NHS services among victims – live updates

Loneliness among older people: a new epidemic

A weekly phone call or visit from a volunteer are among the solutions to help ease the loneliness epidemic affecting 1.2 million older people in England, according to campaigners.

Age UK, says that 1.2 million older people are chronically lonely and that this has an adverse impact on mental health, and the challenge will increase as our population ages. In the next 20 years, England’s over-85 population is set to rise from nearly
1.3 million people to just under 2.8 million.

Caroline Abrahams, Age UK charity director says: “Loneliness can have an impact on older people’s health and wellbeing. And this is particularly true when it comes to mental health, with older people’s depression often brought on by, or exacerbated by loneliness.”

NHS figures reveal that depression affects around
22% of men and 28% of women aged over 65 in England, but, according to the Royal College of Psychiatrists,
85% of older people with depression receive no NHS help at all. The spotlight on older people initiative – a group of nine older people’s organisations led by the Jo Cox Commission on Loneliness – says that more than half the users of over-50s social networking site Gransnet who say they are lonely have never discussed loneliness with anyone.

But solutions do exist, says Abrahams: “There is no quick fix or single policy solution to eradicate loneliness but there are reasons to hope that we can change things for the better.” An Age UK and Campaign to End Loneliness 2015 report, Promising Approaches to Reducing Loneliness and Isolation in Later Life, reveals good practice. For example, it says interventions involving help with transport or technology “can be the glue that keeps people active and engaged”.

The report highlights successes such as face-to-face or telephone befriending projects, including the Royal Voluntary Service’s Dorset Befriending Service, offering home visits to older people. The project began after a local GP’s concerns that older patients would visit the doctor primarily because they were isolated. Another initiative, The Silver Line, is a 24-hour, free helpline for information and companionship. In addition, British Red Cross community connectors are volunteers who identify and attend local activities with lonely older people.

The Campaign to End Loneliness is developing a national initiative to tackle loneliness through community collaboration. Laura Alcock-Ferguson, the campaign’s director, adds: “At a local level across the UK, health authorities should be developing clear plans to reduce loneliness and social isolation in their local areas.”

Dr Amanda Thompsell, chair of the old age psychiatry faculty at the Royal College of Psychiatrists, says organisations developing support projects must also include older people and carers as well as psychiatrists, GPs, and the social care sector. Thompsell suggests awareness of loneliness could also be incorporated into the school curriculum: “Inter-generational contact has been shown to be particularly effective in combating loneliness and we often forget how much children can learn from older people.”

Ignoring the challenge is not an option, as Thompsell says: “Failure to tackle loneliness will lead to more pressure on services which are already overwhelmed.”

Roy Warman: ‘I met the daughter I never had through a telephone befriending service. It changed my life’

Warman credits Age UK with helping to turn his life around Photograph: Amanda Searle

Roy Warman’s wife, Phyllis, died in January 2015. Buoyed by well-wishers in the first few weeks of bereavement, the visits and telephone calls gradually dwindled, and he felt increasingly alone. Many of his friends have passed away, he does not have any family nearby and the couple never had children. He explains: “The longer it goes without speaking to someone, the harder it gets.” He describes loneliness as “one of the hardest things that you will encounter in life”, likening feeling low to “living in a void”.

The 84-year-old from Wiltshire spotted information about Age UK in a local magazine a few months after Phyllis’s death. He got in touch and was referred to an Age UK telephone befriending service that matches older people with like-minded volunteers for friendship or phone calls.

He recalls the first time he spoke to a companion on the phone: “It opened a new door. It was so nice to think that someone might listen … a voice at the other end who could sympathise.” Today he has weekly phone calls with a volunteer he describes as “like the daughter I never had” and he also has regular visits from another volunteer as part of Age UK’s face-to-face befriending scheme.

The impact has been extraordinary, says Warman, describing the experience of support as “like being in a desert and coming across an oasis”. He has joined a singing group and developed his IT skills: “I think it partly affected my decision to join a local choir. And Age UK introduced me to the tablet, it’s like a giant library.” Crucially, he senses his self-confidence has returned: “I feel good about myself and feel able to cope now.” SS

Loneliness among older people: a new epidemic

Suicide rate among defence veterans far higher that for those currently serving

The rate of suicide among current serving Australian Defence Force members is much lower than the general population, but higher for those who have left the force, particularly if under 30 years of age.

The National Mental Health Commission says the reason for this phenomenon needs to be better understood, requiring further investigation.

It says the ADF must improve the preparation it gives personnel for life beyond the ADF, and then provide support services from the moment of discharge for the duration of post-service life.

The final report of the Commission’s review of the suicide and self-harm prevention services available to serving and ex-serving ADF members and their families was released on Thursday.

It relied on interviews with more than 3,200 serving and ex-serving ADF members, family members, and experts. It found current and former ADF personnel could access a range of suicide services, and a survey conducted for the review found 80% of current ADF members described their experience of those services as fair, good, very good or excellent.

But it heard a range of poor experiences of services, and feelings of cynicism, distrust, frustration, abandonment and loss, with many ADF members unaware that services existed, and barriers preventing some from accessing services.

According to the Australian Institute of Health and Welfare, the suicide rate among current serving ADF members is much lower than the general population.

When adjusting for age, when compared with all Australian men, it says the suicide rate is 53% lower for men serving in the ADF full time – a statistically significant difference.

But the suicide rate is 13% higher for men who have left the force.

The commission says this suggests the Australians recruited for military service may be at lower risk than the general population, and features of military service may also protect against the risk of suicide.

But it says more needs to be done to ensure suicide and self-harm is prevented among current and former ADF personnel.

Peggy Brown, chief executive of the National Mental Health Commission, said barriers still existed that prevented some ADF members from accessing suicide services, including stigma attached to mental health issues, the culture within the ADF, and the perception that seeking mental health treatment could have a negative impact on career progression.

“I guess what’s interesting about this is that, if that’s the reason why people are deferring seeking help then it’s more likely that their mental health state will actually deteriorate, and then it will actually impact on their career, rather than if they seek help early,” she said on Thursday.

Brown said the report identified no glaring gaps in services, but found the ADF and government ought to engage better with families.

The Commission has made 23 recommendations, including that the government specifically engage former members of the ADF aged 18–29 years, who have left the service in the last five years, and who could be at risk of suicide or self-harm.

It says further investigation is required to understand why ex-ADF members under 30 face a higher risk of suicide than the general population.

More support needs to be provided to families of current and former members, it says.

Dan Tehan, the minister for veterans’ affairs, said new data will be released later this year that provides greater insight into the welfare of current and former-ADF members.

Regarding suicide rates among current and ex-personnel, he said initial figures showed there was no correlation between those who had served overseas and those who had committed suicide.

“As a matter of fact, it shows those who have stayed here, the incidence is slightly higher,” he said. “But we really need to do a lot more work in this area, and that’s why we really are now beginning to drill down [into new data].”

Statistics from the Australian Institute of Health and Welfare

A recent study found 292 certified suicide deaths among serving and ex-serving personnel between 2001 and 2014.

The total included 84 suicide deaths in the serving full-time population, 66 in the reserve population and 142 in the ex-serving population.

Men accounted for more than nine in 10 suicide deaths (272 deaths, 93%) over that period, while women accounted for 20 deaths (7%).

Nearly three in five suicide deaths among serving and ex-serving personnel were of people aged 18–34 (170 deaths, 58%).

Of these, 66 deaths (23%) were among people aged 18–24; 58 (20%) were people aged 25–29; and 46 (16%) were aged 30–34.

• For information and support in Australia call Lifeline on 13 11 14, Mensline on 1300 789 978 or Beyond Blue on 1300 22 4636
  

Suicide rate among defence veterans far higher that for those currently serving

Tooth extractions rise among under-fours

The number of tooth extractions on children aged four and under in English hospitals has risen by almost a quarter over the past decade.

NHS data obtained by the faculty of dental surgery at the Royal College of Surgeons (RCS) shows there were 9,206 extractions within the age group in 2015-16 compared with 7,444 in 2006-07 – a 24% rise.

The figures prompted calls for parents, the government and the food industry to take action to reverse the alarming trend.

Prof Nigel Hunt, dean of the RCS’s faculty of dental surgery, said: “When you see the numbers tallied up like this it becomes abundantly clear that the sweet habits of our children are having a devastating effect on the state of their teeth.

“That children as young as one or two need to have teeth extracted is shocking. It’s almost certain that the majority of these extractions will be down to tooth decay caused by too much sugar in diets.”

The rise came as the number of children aged four and under in England rose by 16% over the same period.

Hunt said people should not be complacent about the removal of baby teeth as they “set the pattern for adult teeth, including tooth decay”.

He said 90% of tooth decay is preventable through reducing sugar consumption, regular brushing with fluoride toothpaste and routine dental visits, but that 42% of children did not see a dentist in 2015-16 despite treatment being free for under-18s.

“We’d like to see a significant proportion of the money raised through the government’s sugar levy spent on oral health education,” he said. “Sugar has an almost immediate damaging impact on teeth and if we teach parents and children to cut down on sweet treats and look after their teeth properly, there will be a positive knock-on effect for childhood obesity rates too.”

The British Dental Association (BDA) said that ministers in England had offered a “collective shrug” to the problem compared with dedicated programmes run by the Scottish and Welsh devolved governments “which have had transformative effects on children’s oral health”.

The BDA chair, Mick Armstrong, said there were deep inequalities which “require real commitment from government, not just token efforts”.

Katharine Jenner, campaign director at Action on Sugar, lamented the rise of added sugar but also called for a change in culture.

“Added sugar has found its way into almost all food and the use of sugar as a means to calm, entertain or reward children has become normalised, whereas sugar should be an occasional treat,” she said.

“Sugar-sweetened drinks are the biggest contributor of sugar in the diets of children and teenagers and, unless they are reduced, these drinks will still contribute to the high levels of obesity, type 2 diabetes and tooth decay – all of which are preventable and cost the NHS billions of pounds each year.”

The latest national diet and nutrition survey showed that, in 2012-2014, children aged one-and-a-half to three years old consumed 63g of sugar-sweetened soft drinks a day on average.

The RCS figures also show more than 34,000 extractions were performed on children aged nine and under in each of the past two years, compared with 27,760 in 2005-06.

A government spokesman said: “We are introducing a soft drinks levy, as well as a broader sugar reduction programme, to encourage food and drink companies to reduce the amount of sugar that is in popular products in the first place.”

Public Health England advised parents to ensure their children follow good dental hygiene, including limiting sugary food and drink.

Tooth extractions rise among under-fours

Screentime linked to greater diabetes risk among children

Children who are allowed more than three hours of screentime a day are at greater risk of developing diabetes, new research suggests.

The study found that children who were glued to their screens for three or more hours a day scored higher on measures of body fat and had higher levels of resistance to the hormone insulin than their peers who spent an hour or less watching TV, videos or playing computer games.

But the authors cautioned that the research does not show that increased screentime itself results in raised levels of risk factors for the disease.

“Screentime could be capturing something about your behaviours – how much sedentary time you have and how much you break that up [or] what your dietary habits [are], potentially,” said Claire Nightingale, a medical statistician at St George’s, University of London and co-author of the research.

Writing in the journal Archives of Disease in Childhood, Nightingale and colleagues described how they sought to probe whether for children, as is known for adults, screentime is linked to an increase in risk factors for type 2 diabetes. To do so, they analysed data from the Child Heart and Health Study in England – a survey carried out between 2004 and 2007 of almost 4,500 children, aged between nine and 10, from primary schools in three UK cities: London, Birmingham and Leicester.

Among the questions asked, data was collected on the length of time the children spent watching TV, video games or playing computer games. A host of physical measurements were also taken including measures of the children’s body fat and resistance to insulin – a hormone that controls blood glucose levels. In addition, levels of physical activity were monitored for 2,031 of the children.

The results revealed that while 37% of children reported that they spent an hour or less watching TV or playing computer games a day, 18% reported spending three or more hours in front of a screen.

Comparing the groups, researchers found the children who reported three or more hours of screentime scored higher on various measures of body fat. What’s more, these children had 10.7% higher levels of insulin after fasting, 10.5% higher levels of estimated insulin resistance and 9.3% higher levels of leptin – a hormone involved in controlling appetite – all of which are risk factors for type 2 diabetes.

The associations held even when factors such as socioeconomic status and levels of physical activity were taken into account.However the study did not not follow up on the children to see whether they actually went on to develop diabetes.

While the data was collected a decade ago, before electronic devices such as smartphones became ubiquitous, the team believe the link between screentime and diabetes risk is likely to remain. But Nightingale said it is difficult to offer advice to parents. “Potential decreases in screentime could be beneficial, but we can’t really say a cut-off point,” she said.

Dan Howarth, head of care at Diabetes UK said that the study highlights a worrying trend.

“The rising number of type 2 diabetes in children is an alarming statistic and addressing the nation’s childhood obesity issues should be the responsibility of us all,” he said.

“Encouraging physical activity over a sedentary lifestyle, such as that relating to screen time, and a healthy balanced diet clearly plays a significant part.”

Screentime linked to greater diabetes risk among children

Roving clinics tackle TB among Myanmar"s poorest people – in pictures

Tuberculosis is among the leading causes of death for people aged 15-49 in Myanmar, but the cost of reaching a hospital for a diagnostic X-ray is often prohibitive for those in isolated communities. A scheme that sends mobile teams out to test and give medication is helping people get much needed treatment

All photographs by John Rae/UN Office for Project Services

Roving clinics tackle TB among Myanmar"s poorest people – in pictures

Smoking and drinking among young people at lowest level on record

Young people in England born since the turn of the century are the most clean-living generation in recent times, with the rates of those choosing to smoke cigarettes and drink alcohol the lowest on record.

Fewer than 5% of children aged eight to 15 have smoked, down three-quarters since 2003, while only about 17% admitted ever drinking alcohol, a fall of two-thirds, according to an annual survey of health trends.

At the same time, the proportion claiming to eat five portions of fruit and veg has almost doubled in the same period to a fifth. Despite that, 28% of children aged two to 15 were overweight or obese in 2015, and only one in five were as physically active as they ought to have been.

Nine in 10 mothers and eight in 10 fathers of overweight children did not recognise the problem, according to the Health Survey for England 2015, published by NHS Digital on Wednesday, with charities warning that obesity is still an urgent public health epidemic.

The dramatic fall in the number of young smokers follows a cultural shift in the perception of smoking, as well as significantly tighter restrictions on tobacco sales.

In the past decade, the government raised the legal age for buying tobacco from 16 to 18, banned smoking in enclosed public spaces, introduced graphic health warnings and introduced rules that hide tobacco products from view in shops.

At the same time, off-licences have become far stricter about sales to teenagers, and bars and clubs have introduced stringent ID requirements for entry.

Gillian Prior, the head of health at the National Centre for Social Research, which carried out the survey of 8,034 adults and 5,714 children on behalf of the NHS, said: “Changes to the law mean that under-18s are prohibited from buying cigarettes and the Challenge 25 policy adopted by many retailers has meant that these laws are more rigorously enforced than they have been in the past.

“But we should not underestimate the importance of changes in the nature of childhood; changes in technology and society mean that teenagers in particular spend their time in a very different way compared to teenagers 15 years ago.”

A Department of Health spokesperson said: “We are committed to helping people lead healthier lives so it is encouraging to see a decline in smoking rates and fewer children drinking alcohol.

“However, this survey reaffirms that we can’t let up in our efforts to tackle childhood obesity – and we are confident our world leading plan will make a real difference in the long term.”

Smoking and drinking among young people at lowest level on record

Risk of poverty and suicide far higher among transgender people, survey finds

Transgender people are substantially more likely to have attempted suicide, to be unemployed, and to be living in poverty than the broader US population, according to a landmark new survey by the National Center for Transgender Equality (NCTE).

The survey of more than 28,000 trans individuals by the Washington DC-based advocacy organization suggests that along with a battery of health and economic indicators, transgender people face persistent discrimination and a litany of other challenges.

“Responses revealed pervasive mistreatment, harassment and violence in pretty much every facet of life whether that be in the schools, the workplace or family life,” said survey project manager Sandy E James.

The results on mental health were of particular concern. Thirty-nine percent of respondents said they had experienced “serious psychological distress” in the past year, compared with 5% of Americans.

Forty percent of those surveyed said they had attempted suicide in their life, almost nine times the US overall attempted suicide rate. Seven percent said they had made an attempt within the last year, more than 10 times the national prevalence.

“We have already known that these are issues … in the trans community but now we actually have a tool that we can reference to [say] these are the numbers,” said NCTE executive director Mara Keisling. “That can be a useful instrument for creating transformative change in the lives of transgender people.”

Nearly one third of respondents said they were living in poverty, about twice the rate of Americans nationwide. Respondents also reported an unemployment rate of 15%, three times higher than than the national rate. Trans people of color were the most likely to experience high rates of unemployment. Researchers said they intentionally shaped survey questions to be comparable to survey data regarding the broader US public.

A quarter of those employed over the last year said they had experienced discrimination in the workplace, and more than three quarters of those who were “out” or perceived as transgender during school recall experiencing “some form of mistreatment”, including sexual assault and verbal and physical harassment.

James said NCTE plans to repeat the effort every five years to keep tabs on the challenges that transgender individuals face over time. The study released this week is the second such report, following a less expansive effort in 2011.

This year’s study also looked at what could be considered the most visible aspect of the battle for trans rights in the US today, public restroom accommodations. Legislation like North Carolina’s HB2, which restricts individuals to using only the bathroom reflective of the biological sex listed on their birth certificate, has turned the issue into a flashpoint for transgender rights.

The most visible recent debate over transgender rights has surrounded North Carolina’s so-called ‘bathroom battle’. Photograph: Mandel Ngan/AFP/Getty Images

“I can speak first hand for how critical [it is] for transgender people to have safe and private bathroom access just like everyone else”, said Sharron Cooks, a trans woman and activist. Cooks added that when she was in high school, she was banned from the women’s room, calling the experience “crushing”.

“It made it impossible to learn and it severely delayed my academic career,” Cooks said.

The study found that Cook’s experience is far from unique. More than half of survey respondents said they had avoided using a public restroom in the past year because they “were afraid of confrontations or other problems they might experience”. 32% said they had limited the amount they ate or drank in the previous year specifically to avoid using the bathroom.

But Keisling cautioned that while the bathroom issue is important, “we have a lot of issues … that are missed when all we talk about is bathrooms.”

Keisling added: “Every minute we spend talking about it, we’re not talking the problems in real people’s lives. We’re not talking about the economic marginalization and we’re not talking about people being alienated from their faith communities and families.”

Risk of poverty and suicide far higher among transgender people, survey finds

Doctors see a new condition among immigrant children: fear of Trump

At doctors’ offices across the United States, a new diagnosis has been popping up in the medical files of immigrant children, their friends and their families: fear of Trump.

Since the 8 November election, pediatricians and clinics serving undocumented immigrants and other low-income patients have reported a spike in anxiety and panic attacks, particularly among children who worry that they or their parents might now face deportation.

One little boy in North Carolina has been suffering crippling stomach aches in class because he’s afraid he might return home to find his parents gone. In California, many families are reporting that their children are leaving school in tears because their classmates have told them they are going to be thrown out of the country.

Children are showing up in emergency rooms alone because their parents are afraid of being picked up by Immigration and Customs Enforcement if they show their faces. Even American-born children are suffering – one boy in the south-east asked a doctor for Prozac because he was worried about his undocumented friend.

“It’s as though a volcano erupted. It’s been awful,” said Mimi Lind, director of behavioral health at the Venice Family Clinic, one of the largest providers of healthcare to low-income families in southern California. “People who don’t have a history of anxiety and depression are coming forward with symptoms they’ve never had before. And people who had those symptoms already are getting much worse.”

It’s too soon to put precise figures on the wave of Trump-related anxiety, but health professionals and immigrant rights groups say it is unmistakable. “People worry their families will be broken up, that parents will be deported and children will end up in foster care, on a scale that we’ve never seen before. The feeling out there is one of great fear,” said Marielena Hincapié of the National Immigration Law Center.

People who don’t have a history of anxiety and depression are coming forward with symptoms they’ve never had before

Mimi Lind, Venice Family Clinic

Some of the Trump-related anxiety was evident even before the election, especially in states where Republican-dominated legislatures have pushed through measures to make it harder for immigrants to access education, healthcare and other basic services. Trump’s election, however, turned the abiding worry into a full-blown crisis – not least because his victory was unexpected.

Julie Linton, a pediatrician from Winston-Salem, North Carolina, who also serves on the American Academy of Pediatrics’ immigrant child health special interest group, started receiving panicked calls from patients at 6.30am on the morning of 9 November, and she has been deluged since.

Many undocumented parents with sick children born in the United States are now making contingency plans in case they are deported, she says, and in so doing have to face an agonizing choice: whether to leave their children behind, or to risk losing access to the care they need in their home countries. She sees Syrian refugees as well as patients from Mexico and Central America, where it may be difficult or impossible, for example, to find devices to enable children with neuromuscular disorders to walk.

“Parents are asking me: ‘What do I do? How do I set up a power of attorney in case I’m deported?’” Linton said. “It’s hard enough to care for a child with special healthcare needs without having to worry about the threat of deportation.”

A group of immigrants and attorneys gather outside Trump Tower on 22 November to draw attention to Donald Trump’s proposed immigration policies. Photograph: Justin Lane/EPA

It is not just families and children that have felt the impact. Many patients who are vulnerable anyway – alcoholics, drug addicts, those with degenerative diseases or mental health struggles – have been knocked backwards. “To them, it feels that another part of their power has been taken away when they’ve just started to build themselves up again,” said Eileen Garcia, a therapist who looks after HIV and Aids patients at the Venice Family Clinic.

One of her patients, a middle-aged undocumented immigrant who wanted to be called Maria (not her real name), said that while she had been shocked when she received her initial HIV diagnosis she took it in stride because she knew help was available. “But this,” she said, “feels like a death sentence.”

As Maria sees it, she may lose access to treatment if the Trump administration scraps President Obama’s Affordable Care Act, and she may lose it, too, if she is deported and cannot find similar services back in her home country (which she did not want to name). “It’s a double worry,” she said.

The fear felt by many patients is reflected in the protective instincts of their caregivers. For this story, doctors and therapists were extremely careful not to give away patients’ names, or more than the most basic details of their medical profiles, or even in some cases the state where they live for fear of providing clues to authorities pursing an anti-immigrant crackdown.

They also struggle to know what to say to address their patients’ concerns, especially at this early stage.

“Many of us feel pretty helpless right now,” Linton, the North Carolina pediatrician, agreed. “We try to remain nonpartisan but we’re unabashedly pro-child and that’s a hard place to sit right now. For me, as a pediatrician and as a mom, it’s heart-breaking to think that a child is worth less based on conversations happening at the local, regional or national level.”

“This waiting time is the most anxiety-provoking,” Lind, the behavioral health specialist said. “No one can say anything. We have no way of allaying people’s anxiety with concrete facts.”

Doctors see a new condition among immigrant children: fear of Trump

Cancer deaths among women to rise 60% by 2030, new reports warn

Two reports have warned of an explosion in cancer deaths among women, with a toll, mainly from breast cancer, of around 5.5 million a year by 2030 – roughly the population of Denmark.

This represented a near 60% increase in less than two decades, said an analysis conducted by the American Cancer Society (ACS), released on Tuesday at the World Cancer Congress in Paris.

As the global population grows and ages, the highest toll will be among women in poor and middle-income countries, it said, and much of it from cancers which are largely preventable.

“Most of the deaths occur in young and middle-aged adults”, placing a heavy burden on families and national economies, said Sally Cowal, senior vice-president of global health at the ACS, which compiled the report with pharmaceutical company Merck.

A second report, published in the Lancet medical journal on Wednesday, said the number of women diagnosed with breast cancer alone could almost double to 3.2 million a year by 2030 from 1.7 million in 2015.

For cervical cancer, the number of diagnoses could “rise by at least 25% to over 700,000 by 2030”, mainly in low- and middle-income countries, said a statement from the Lancet.

Cancer is already killing one in seven women around the world, said the ACS report – the second highest cause of death after cardiovascular disease.

All four of the deadliest cancers – breast, colorectal, lung and cervical cancer – are mostly preventable or can be detected early, when treatment is more successful.

In poorer countries, a much smaller proportion of cancer cases are diagnosed and treated than in rich ones, while a much bigger group dies. The relative burden is growing for developing countries as people live longer due to better basic healthcare.

Women in these countries are also increasingly exposed to known cancer risk factors “associated with rapid economic transition”, said Cowal, “such as physical inactivity, unhealthy diet, obesity, and reproductive factors” including postponing motherhood.

“Due to these changes, cancers that were once common only in high-income countries are becoming more prevalent,” said the report entitled The Global Burden of Cancer in Women.

Beth Vyse: A breast cancer appointment is like Deal or No Deal

According to the International Agency for Research on Cancer, there were 6.7 million new cancer cases and 3.5 million deaths among women worldwide in 2012. Of these, 56% of cases and 64% of deaths were in less developed countries.

“These numbers are expected to increase to 9.9 million cases and 5.5 million deaths among females annually by 2030 as a result of the growth and ageing of the population,” said the ACS report.

The biggest concentration is in eastern Asia, with 1.7 million cases and a million deaths in 2012, mainly in China.

The highest ratio of cancer cases per population group are still reported in high-income countries in Europe, the Americas and Asia, but this was partly due to better access to screening and detection.

Deaths, however, were proportionally much higher in low- and middle-income countries with reduced access to diagnosis and treatment. The countries with the highest death rate were Zimbabwe, Malawi, Kenya, Mongolia and Papua New Guinea.

Breast and lung cancer are the two most common types in both rich and poor nations, with colorectal cancer the number three killer in developed countries and cervical cancer in less developed ones.

Cervical cancer can be staved off by vaccination against the cancer-causing human papillomavirus (HPV) and can be detected through regular Papanicolaou (pap) smear tests.

The Lancet report, comprised of three research papers, said a basic cancer control package could be introduced in low- and middle-income countries for as little as US$ 1.72 (£1.40) per person – the equivalent of just 3% of current health spending in these countries.

Universal HPV vaccination of all 12-year-old girls could prevent 420,000 deaths worldwide over their lifetime.

“The global community cannot continue to ignore the problem – hundreds of thousands of women are dying unnecessarily every year,” said Richard Sullivan of King’s College London, who co-authored the Lancet report.

“Not only are the costs of essential cancer services for women lower than expected, but scale-up of diagnostic, surgical and treatment services are a highly effective investment compared the devastating economic cost to countries, communities and families.”

Cancer deaths among women to rise 60% by 2030, new reports warn

NHS figures show "shocking" rise in self-harm among young

The number of children and young people self-harming has risen dramatically in the past 10 years, new NHS figures obtained by the Guardian show.

The sharp upward trend in under-18s being admitted to hospital after poisoning, cutting or hanging themselves is more pronounced among girls, though there have been major rises among boys, too.

Experts say the rise is “shocking” confirmation that more young people are experiencing serious psychological distress because they are under unprecedented social pressures.

The number of girls under 18 who have needed hospital treatment after poisoning themselves has gone up from 9,741 in 2005-06 to 13,853 – a rise of 42% – figures collated by NHS Digital show. The numbers of boys ingesting a poisonous substance have stayed almost unchanged; 2,234 did so in 2005-06 and 2,246 did so in 2014-15.

Poisonings among girls were 42% higher in 2014-15 than 10 years previously

However, the number of girls treated as inpatients after cutting themselves has almost quadrupled over the same period, from 600 to 2,311 – a 385% rise. The number whom A&E teams have treated after hanging themselves has also risen during that decade, from 29 to 125.

While far fewer boys end up in hospital after cutting themselves, the numbers went up from 160 in 2005-06 to 457 in 2014-15 – a rise of 286%. Similarly, the numbers of boys who hanged themselves also doubled from 47 to 95 over the same period, the figures show.

“This is a depressing confirmation of the clinical experience of child and adolescent psychiatrists’ experience on the ground,” said Dr Peter Hindley, chair of the Faculty of Child and Adolescent Psychiatry at the Royal College of Psychiatrists.

“It is also shocking because it appears to confirm our clinical experience that levels of distress are rising, though not all young people who self-harm have mental health problems, and [that] mental health disorders are rising, for both girls and boys,” he said.

Experts said the rises were likely to be due to a variety of factors, including pressure to succeed at school, the damaging effects of social media, family breakup, growing inequality in recent years, children’s body-image fears, a history of abuse, including sexual abuse, and increasing sexualisation.

The NHS’s most senior doctor responsible for young people’s health said the “distressing” figures underlined that greater improvements were needed to boost support for troubled children.

“It’s clearly distressing that more young people are causing harm to themselves and we know that the problems facing children are growing,” said Dr Jackie Cornish, NHS England’s national clinical director for children, young people and transition to adulthood.

“In common with most experts, we believe this is due to increasing stress and social pressure on young people, including to succeed at school, and emerging problems with body image leading to eating disorders and self-harm.

Poisoning accounts for 88% of all self-harm admissions among under-18s

She added: “We recognise that vital care for children and young people’s mental health is an area where more work needs to be done.”

Jeremy Hunt, the health secretary, severely criticised NHS care of troubled young people last week. Child and adolescent mental health services (CAMHS) were the “biggest single area of weakness in NHS provision” and beset by “big problems”, including failure to intervene early enough when problems such as eating disorders emerged, which meant that “too many tragedies” were occurring, he said.

Hindley added: “The rise is likely to be as a result of many factors but the most important ones are likely to be: growing inequality in the age of austerity, the negative impact of the digital age, increasing sexualisation – this is particularly important for girls – and the impact of abuse and sexual exploitation, and increased pressure to succeed.”

Sarah Brennan, the chief executive of Young Minds, said that troubled young people were harming themselves partly because help for them is so inadequate that some do not receive specialist support once it is obvious they have psychological problems. “It’s extremely worrying that the number of young people needing hospital treatment for self-harm has risen so sharply. There needs to be far more investment in early intervention, so that problems are dealt with when they first emerge.”

Budget-driven local council cuts to social workers, educational psychologists, parenting classes and mental health services in schools had reduced care and support for under-18s in distress, she said. CAMHS teams were responding to rising demand by rationing care.

“The pressure on CAMHS has forced services to raise the bar for access to treatment. Consequently, about a quarter of young people are being turned away, and this will include many who self-harm. At the moment too many vulnerable children end up going to A&E because no other help is available,” Brennan added.

Young Minds is concerned that children who self-harm and then turn to the internet for help could come across unhelpful information about, and even encouragement to continue, their behaviour. Young people who self-harm are most likely to go online for information and few to seek their parents’ support, according to a survey it conducted in March with Childline, Self-Harm UK and The Mix. While 76% of youngsters said they would search the web, just 16% would look to their mother or father, while 61% would ask a friend, and 27% cited a GP and 17% a teacher.

The government has promised to put an extra £1.4bn into care of troubled children during this parliament to ensure that at least 70,000 more under-18s get high-quality care. However, NHS England chief executive Simon Stevens has admitted that even if that target is met, it will still only increase the proportion of young people being helped from a quarter to a third.

Hunt last week pledged to make children’s mental health a top priority. Cornish added that NHS England has created 56 extra beds in specialist inpatient units for children and young people in the last two years and is putting £30m into improving services for those suffering from an eating disorder such as anorexia nervosa. Earlier this month, it allocated £25m to help cut young people’s waiting time for treatment and reduce the backlogs of those awaiting urgent care.

NHS England collated the figures it shared with the Guardian from those covering self-harm and self-poisoning from its Hospital Episodes Statistics datasets from the past decade.

• In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.

NHS figures show "shocking" rise in self-harm among young

ABC"s Man Up tackles the tragedy of male suicide – but only among blokey blokes

According to figures released last month, Australia’s suicide rate is increasing, and death among men from intentional self-harm is three times greater than that for women.

In Man Up, a three-part ABC-TV series which aired its second episode on Tuesday, radio presenter Gus Worland is spurred by the 2006 suicide of a friend, Angus – and, more recently, conversations with his widow and daughter – to challenge stoic, self-reliant stereotypes of masculinity, and instead champion emotional vulnerability and communication as signs of strength.

It’s a well-meaning, heartfelt show, but flawed: Man Up spends too much time trying to entertain and not enough time challenging the normalised, constructed identities of Australian manhood – white, heterosexual, masculine – which continue to alienate anyone who falls outside them.

Worland jackhammers concrete on a worksite, talking to men in the construction industry about their particularly high risk of suicide. He goes yachting with returned military servicemen dealing with trauma. He takes part in male nude yoga – all in an attempt to get beneath the skin of men.

Gus Worland and farmer John Harper at the Mate Helping Mate country man organisation meeting, featured in Man Up. Photograph: ABC

He poses for a GQ shoot, while we learn about commercial, fluffy categories of manhood: metrosexuality, retrosexuality and, I kid you not, lumber-sexuality (some sort of mix of lumberjack and hipsterism). He tries to craft a media campaign to appeal to men to talk, even consulting one advertising guru who was responsible for reinforcing the stereotype that the social world of men revolves around booze and barmaids with big boobs.

All of this is watchable, but it leaves less than a minute for discussion of the high rate of suicide among Aboriginal and Torres Strait Islander men. That task falls to Wiradjuri man Joe Williams, a former National Rugby League Rabbitohs player who doesn’t appear on screen but whose voice is heard as a radio talkback caller.

There is no explicit mention of gay and bisexual men, or those whose identity falls outside normalised gender binaries. If, as the Man Up manifesto states, the “pressure to be an Aussie man is fuelling a suicide crisis”, then we must acknowledge the groups of men who are the most at risk of depression, anxiety and suicidal feelings.

This show cannot be all things to all people, of course – yet it doesn’t even seem interested in trying to speak to the spectrum beyond blokey blokes. Man Up’s reliance in Tuesday’s episode on UK-born Australian psychologist and author Steve Biddulph – whose opinion is unquestioningly sought in on-the-road interviews – makes me wonder if the series is coming from a very conservative view of male identity.

Steve Biddulph, author of Raising Boys. Photograph: David Levene for the Guardian

Biddulph’s 1997 book Raising Boys is described in Man Up as “the handbook on how we can better raise Australia’s sons” – but I remember it differently.Biddulph’s glib, blithe discussion of homosexuality in an early edition distressed my own mother, making her fear she was at fault for my orientation – even though I’ve been living happily as a gay-identifying man for some time. It was in Biddulph’s book, so it must be true, right?

Now in its fourth edition (2013), Biddulph has made a few palatable tweaks to his bestseller, but it still raises dubious “mounting evidence” that sexuality may be determined by “certain hormonal settings” in the womb – without citing an actual scientific reference. The book still makes the outdated, sloppy suggestion that having a teenage gay son “demolishes” parents’ “fond hopes” of a “rewarding career, marriage and grandchildren”. And it still says that “some dads fear that cuddling their son will turn him into a ‘sissy’. In fact, the reverse is probably true.” (To his credit, Biddulph has deleted the subsequent line of earlier editions: “Many gay or bisexual men I have spoken to say a lack of fatherly affection was part of what made male affection more important to them.”)

As Flinders University psychologist associate professor Damien Riggs wrote in 2008: “[Biddulph’s] inference is that if fathers gave more affection the sons wouldn’t grow up to be gay, which is thus constructed as the preferable option.”

The most affecting scenes in Man Up involve Worland’s own teenage son, Jack. In the second episode, facilitator Tom Harkin runs a special workshop on masculinity, in which Jack and fellow students apply nail polish. “Not a guy thing to do,” says Harkin, who then asks: “Who wrote that rule?”

The workshop encourages these teenagers to rethink what it means to be a man, to talk, to listen and to show emotion. To cry, which they do, openly and cathartically. This would have been the ideal point to say: it’s OK to be straight, bisexual, gay, queer; it’s OK to question your identity or gender. But the show is too timid to make that important leap, instead relying uncritically on Biddulph as a barometer of all men’s emotional lives.

Gus Worland and his son Jack. Photograph: ABC

There are other missed opportunities. Man Up vaguely links suicidal ideation among men to financial pressures. What these pressures are is not spelled out, but surely there is a great deal to say about the growing inequity between rich and poor. The rising costs of rent and mortgages under a government unwilling to change investment policies. The burden many men take on to be primary breadwinners, and where that burden comes from.

We are told in Man Up that women attempt to take their lives more often than men, but men are more likely to die. We are told this is because women reach out for help more often, but other factors – such as the preference among women for drugs as a means of suicide – would have been worth discussing.

My hopes for Man Up clearly overreached its narrowly focused aims. But in its sincere efforts to find a new vocabulary for men, the series is a step in the right direction.

• Man Up continues on 25 October on the ABC; for information and support in Australia call Lifeline on 13 11 14, Mensline on 1300 789 978 or Beyond Blue on 1300 22 4636

ABC"s Man Up tackles the tragedy of male suicide – but only among blokey blokes

Self-harm, PTSD and mental illness soaring among young women in England – survey

Rates of self-harm, post-traumatic stress disorder (PTSD) and chronic mental illness are soaring among young women in England aged 16 to 24, according to the biggest NHS survey of mental ill-health and treatment since 2007.

One in eight young women (12.6%) within that age group has PTSD, according to the study. That is three times the 4.2% rate found when the government-funded adult psychiatric morbidity survey was last conducted in 2007.

PTSD graphic

Researchers found a similarly worrying upward trend for the number of 16- to 24-year-old young women who self-harm – almost one in five. That has risen three-fold from 6.5% in 2000 to 11.7% in 2007 to the 19.7% found in 2014.

The same age group also has the highest rates of common mental disorders such as anxiety and depression of any group in the population. Overall 28.2% of young women told researchers they had some form of mental health condition, almost three times higher than the 10% of men from the same age group who did so.

Mental health graphic

Experts said that violence and abuse, including rape, as well as near-death experiences such as car crashes, and a loved one being killed or committing suicide were part of the explanation for the sharp rise in PTSD.

Although the definition of what constitutes trauma has remained unchanged since the survey was last conducted in 2007, the researchers said that their use for the latest survey of a new screening tool for PTSD, which is thought to be more accurate than its predecessor, may help explain the big jump in those with that disorder.

Sally McMahon, the lead researcher behind the survey, said: “We know that there are things like violence and abuse that are strongly associated with mental illness.”

Graphic

But, she added: “This is also the age of social media ubiquity. This is the context that they [young women] are coming into and it warrants further research.”

She described 16-25 year olds as the “first cohort to come of age in social media ubiquity”.

She pinpointed mobile phone use as another potential driver if the alarming trends revealed in the report, published on Thursday by NHS Digital.

Self-harm, PTSD and mental illness soaring among young women in England – survey

Self-harming among British military personnel up by a third

The number of UK armed forces personnel deliberately self-harming has jumped by more than a third over five years.

Figures released by the Ministry of Defence revealed a 36% increase in servicemen and women who self-harmed at least once between 2010/11 and 2014/15.

There were 383 recordings of deliberate self-harming (DSH) – including self-injury and self-poisoning – for navy, army and air force personnel in 2014/15, up from 339 in 2010/11.

The data excludes servicemen and women who had thoughts of DSH or suicide.

Women, army personnel and those aged under 24 were most at risk, the figures suggested.

Those aged under 20 were around 10 times more likely to self-harm than those aged 45 and over, while women were around twice as likely as men to be at risk.

The MoD said the risk groups in the armed forces were in line with those in the general population.

Improved methods of capturing DSH data could have attributed to the reported rise in incidents, the MoD added.

The data included regular armed forces personnel, mobilised reservists, full-time reservists and non-regular permanent staff alongside trained and untrained personnel.

Self-harming among British military personnel up by a third

Bishop campaigns to highlight issue of body image among children

Rachel Treweek, the bishop of Gloucester, has said she is highlighting the issue of body image among children to challenge perceptions that physical appearance determines self-worth.

On Monday, Treweek – the first female bishop to sit in the House of Lords – will visit All Saints Academy in Cheltenham to talk to a group of 13- to 16-year-olds in the first of a series of school visits in her constituency to discuss the issue.

It follows a report from the Children’s Society last month that found one out of three girls aged 10 to 15 was unhappy with her appearance and felt ugly or worthless.

The study highlighted the growing pressure of social media with regard to body image. The proportion of girls with negative feelings about their bodies increased from 30% to 34% over five years; among boys it remained unchanged at 20%.

Treweek told the Guardian the issue urgently needed addressing. “When I talk to girls, it strikes me how much of how they view themselves and their self-worth is caught up with appearance and the way that society sees them,” she said. “Issues of health and mental health are more and more linked with how people are viewed by others, and much of that begins with external appearance.”

The bishop plans to listen to the concerns of teenagers over the coming months before considering what action can be taken.

“I want to challenge the subconscious messages we’re giving,” she said. “We need to look at the language we use as adults and how it shapes our culture. For example, when adults engage with girls, nearly always the first thing we say is a comment on appearance. We need to find out who they are, what they enjoy, what they’re good at, what makes their souls sing.”

She added: “I don’t want to say to girls: ‘Don’t worry about hair or nails or fashion’ – I want them to enjoy those things. But I want these things to be an expression of who they are, not their starting place.”

Treweek acknowledged that as one of a handful of female bishops she had a different perspective on society than her male colleagues. “The church doesn’t always appear in touch with people’s everyday lives. This faith stuff has got to connect with people’s lives – and if this is shown to be an issue affecting girls’ mental health and happiness, then we have to be listening to that, the church needs to engage with it.”

The Children’s Society report found that 14% of girls aged 10 to 15 were unhappy with their lives as a whole. Another study last month by the Department for Education found an increase in psychological distress among 14-year-olds in 2014 compared with similar research in 2005.

Bishop campaigns to highlight issue of body image among children

Brain cancer now deadlier among US children than leukemia

Brain cancer is now the deadliest childhood cancer in the US, now ahead of leukemia, a result of improved leukemia treatment and a frustrating lack of progress on brain cancer.

Government statisticians reported the change in rankings on Friday, drawing from a review of 15 years of death certificates.

“I think most people, when they think of childhood cancer, think of leukemia,” said Sally Curtin of the Centers for Disease Control and Prevention. “This is kind of a changing of the guard.”

Cancer is the fourth leading cause of death for children overall, accounting for about 1 in 10 childhood deaths in 2014. About a quarter these cancer deaths, or 534, were due to brain cancer. There were 445 leukemia deaths.

Accidental injuries remained the leading cause of death for those under 19, followed by suicide and murder, according to the report.

There are still more new cases of leukemia each year than new cases of brain cancer, but it no longer accounts for the most deaths. That’s due to advances in leukemia treatment over the past few decades and because leukemia is easier than brain cancer to treat, experts said.

“Some types of leukemia that a generation ago were almost universally fatal are now almost universally treatable,” said Curtin, a statistician who worked on the report.

But the rate of death from brain cancer for children has held at about the same level for at least 15 years, according to the CDC report.

The trends are similar for adults too, according to the American Cancer Society.

Leukemia is a type cancer that affects the blood. That makes it easier for doctors to get to it and fight it with treatments like chemotherapy.

The brain is protected by a barrier which helps keeps many dangerous chemicals – including many cancer drugs – from getting to brain tissue or brain tumors. Surgery is difficult and sometimes impossible, depending on where the tumor is located in the brain. Radiation treatment can damage the development of a child’s brain.

“There’s survival, and then there’s survival at a price,” said Dr Katherine Warren, an expert in pediatric brain tumor research at the National Cancer Institute.

Another factor is that scientists have only recently begun to understand that pediatric brain cancers may be biologically different from adult versions, and could require different approaches to treatment.

In 2014, the brain cancer death rate was about 0.7 per 100,000 children ages 1 through 19. The leukemia death rate was about 0.6. The overall pediatric cancer death rate dropped by about a fifth between 1999 and 2014, the CDC reported, helped by the reduction in leukemia deaths.

Brain cancer now deadlier among US children than leukemia

Measles outbreak among Amish in Ohio hazards spreading at buggy showcase

Guests from around the planet to two approaching occasions in Ohio’s Amish nation could come away with a lot more than they bargained for, well being officials fear – a situation of measles from the nation’s largest outbreak in two decades.

The outbreak, with more than 360 situations, started out following Amish vacationers to the Philippines contracted measles this 12 months and returned house to rural Knox County, the place it spread thanks to a reduce rate of vaccination amid the Amish and the issues public overall health authorities had in receiving the word out to largely rural communities, where phones are couple of and the net is nonexistent.

Overall health officials think the outbreak is slowing in Ohio thanks to vaccination clinics and door-to-door visits by public health nurses. But Horse Progress Days, an worldwide showcase of horse-drawn gear scheduled for Friday and Saturday, is anticipated to draw a lot more than 20,000 Amish and other folks from all around the globe. A big annual auction that raises money to aid Amish families pay out healthcare bills for children with birth defects is scheduled for Saturday.

Authorities are trying to spread education – and vaccination.

“Quite effortlessly an individual could come for these occasions, be exposed to somebody who didn’t know that they were sick, and travel property, and start yet another outbreak in an additional community someplace in the United States or overseas,” explained Dr DJ McFadden, well being commissioner in Holmes County, web site of Horse Progress Days and house to 1 of the country’s biggest Amish populations.

The county has 54 instances of measles and 1 hospitalization. Most of its Amish have been currently vaccinated ahead of the outbreak, McFadden stated.

Richland public wellness nurse nurse Renee Blankenship offers Daniel Martin, an Amish guy from Holmes County his measles, mumps and rubella vaccination. Photograph: Tom E. Puskar/AP

Signs and symptoms of measles, which is induced by a virus, incorporate fevers, coughs, rashes and pinkeye. Just before widespread vaccinations in the US beginning in the 1950s, 450 to 500 folks died each 12 months, 48,000 had been hospitalized and practically a thousand individuals suffered brain harm or deafness. Though virtually eradicated in the United States, measles remains common in numerous parts of Asia, the Pacific and Africa.

The Amish eschew several conveniences of present day daily life. Their religion does not avert them from in search of vaccinations, but due to the fact their kids do not attend conventional public schools, vaccinations are not required and therefore not program.

For Amish who aren’t vaccinated, Ohio wellness officials say, motives consist of religious objections, unwillingness to shoulder the expense due to the fact they do not have insurance, and not seeing the need for a ailment that is not typical.

Outreach efforts to supply vaccinations and schooling have been hampered by communication – handful of Amish have phones – transportation and the strapped resources of rural counties with out huge wellness departments, said Richland County public wellness nurse Sue McFarren.

But when they’re contacted, most Amish have cooperated, she stated. Officials have distributed about ten,500 vaccines in Ohio, about half in Holmes County in central Ohio. The other impacted regions are mostly, but not all, nearby — in Crawford, Ashland, Coshocton, Highland, Holmes, Richland, Stark and Wayne counties.

“They have been excellent about quarantining themselves,” McFarren said. “If they have a case, they remain home until it is run its program.”

Young Mennonite girls gather at the well being and safety clinic Photograph: Tom E. Puskar/AP

Amish dairy farmer Daniel Weaver got a vaccination throughout a clinic at a pole barn near Shiloh in northern Ohio on 25 July, concerned due to the fact he travels usually.

“The Amish in basic are not reacting that much differently than the rest of the population,” stated Weaver, 48, of nearby Shreve. “It’s just simply because of our tight proximity, it generates a distinct effect.”

Several Mennonite households visited the exact same clinic, arriving a single right after the other in horse-drawn buggies with fluorescent orange triangles affixed to the rear. These “horse-and-buggy” Mennonites reside a lifestyle equivalent to some Amish, even though several have phones and other modern conveniences.

Mennonite dairy farmer Samuel Zimmerman, who got his vaccine after hearing about the outbreak, mentioned he’d never ever actually had an viewpoint about vaccines before.

“I guess when I was expanding up we had been hale and hardy, and we did not feel about vaccinations,” stated Zimmerman, 36, of Blooming Grove.

Organizers of Horse Progress days said they are distributing letters to worldwide guests warning them of likely measles publicity. Previous events have drawn non-Amish from nations like Australia, Colombia, Germany, Mexico, South Africa, Sweden and New Zealand.

Posters will give info about measles and motivate people with signs and symptoms to go residence, and a hospital will give totally free vaccinations Friday, standard coordinator Daniel Wengerd stated.

Saturday’s auction for the Ohio Crippled Children’s Fund is getting held at the Kidron Auction Property in Wayne County. An auctioneer there mentioned he wasn’t familiar with officials’ worries.

The Ohio outbreak is the biggest in the US because 1994. Total, the Centers for Disease Handle and Prevention are monitoring 529 situations in twenty states, with the subsequent largest outbreaks in California and New York, none of which involve the Amish.

Measles outbreak among Amish in Ohio hazards spreading at buggy showcase