International Day of Older Persons 2017, 1 October 

Health services must stop leaving older people behind – WHO
The theme of the International Day of Older Persons 2017 is; 

“Stepping into the Future: Tapping the Talents, Contributions and Participation of Older Persons in Society.”

This year’s day is about enabling and expanding the contributions of older people in their families, communities and societies at large. It focuses on the pathways that support full and effective participation in old age, in accordance with old persons’ basic rights, needs and preferences.
This year’s theme underscores the link between tapping the talents and contributions of older persons and achieving the implementation of the 2030 Agenda and the Madrid International Plan of Action on Ageing, which is currently undergoing its third review and appraisal process.

Between 2015 and 2030, the target date for the Sustainable Development Goals, the number of older persons worldwide is set to increase by 56 per cent — from 901 million to more than 1.4 billion. By 2030, the number of people aged 60 and above will exceed that of young people aged 15 to 24.

Stepping into the future with pledges that no one will be left behind, it is starkly evident that the need to tap into the often overlooked and under-appreciated contributions of older persons is not only essential to older persons’ well-being, but also imperative for sustainable development processes.
The 2017 theme will explore effective means of promoting and strengthening the participation of older persons in various aspects of social, cultural, economic and civic and political life. UN.ORG

Health services must stop leaving older people behind – WHO

29 SEPTEMBER 2017 | GENEVA – On the International Day of the Older Person – 1 October – WHO calls for a new approach to providing health services for older people. WHO highlights the role of primary care and the contribution community health workers can make to keeping older people healthier for longer. The Organization also emphasizes the importance of integrating services for different conditions.
“By the year 2050, 1 in 5 people in the world will be aged 60 and older,” says Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “It’s our goal to ensure that all older people can obtain the health services they need, whoever they are, wherever they live.”
Yet, even in the rich world, people may not be getting the integrated services they need. In a survey of 11 high-income countries, up to 41% of older adults (age ≥65 years) reported care coordination problems in the past two years.
WHO’s new Guidelines on Integrated Care for Older People recommend ways community-based services can help prevent, slow or reverse declines in physical and mental capacities among older people. The guidelines also require health and social care providers to coordinate their services around the needs of older people through approaches such as comprehensive assessment and care plans.
“The world’s health systems aren’t ready for older populations,” says Dr John Beard, Director of the Department of Ageing and Life course at WHO.
“Everyone at all levels of health and social care, from front-line providers through to senior leaders, has a role to play to help improve the health of older people. WHO’s new guidelines provide the evidence for primary care workers to put the comprehensive needs of older people, not just the diseases they come in to discuss, at the centre of the way they provide care.”
Older adults are more likely to experience chronic conditions and often multiple conditions at the same time. Yet today’s health systems generally focus on the detection and treatment of individual acute diseases.
“If health systems are to meet the needs of older populations, they must provide ongoing care focused on the issues that matter to older people – chronic pain, and difficulties with hearing, seeing, walking or performing daily activities,” adds Beard. “This will require much better integration between care providers.”
Some countries are already making smart investments guided by WHO’s Global Strategy on Ageing and Health.
Brazil has implemented comprehensive assessments and expanded its services for older adults; Japan has integrated long -term care insurance to protect people from the costs of care; Thailand is strengthening the integration of health and social care as close as possible to where people live; while the Ministry of Health in Vietnam will build on its comprehensive health care system and the large number of elderly health care clubs to better meet the needs of older people in their communities. In Mauritius, the Ministry of Health provides universal health coverage for older adults including a network of health clubs and primary care clinics with more sophisticated services in hospitals. The United Arab Emirates are meeting the health needs of older people by creating more age-friendly cities. In France, a new WHO Collaborating Centre called Gerontopole, located in the Toulouse University Hospital, is helping to advance research, clinical practice and training on Healthy Ageing.
“Integrated care can help foster inclusive economic growth, improve health and wellbeing, and ensure older people have the opportunity to contribute to development, instead of being left behind,” concluded Dr Beard.

News release (WHO Media Center)

Scale up prevention of heart attack and stroke- World Heart Day 2017 

Scale up prevention of heart attack and stroke- World Heart Day 2017 : World Heart Day on 29 September is the world’s biggest platform for raising awareness about cardiovascular disease (CVD). World Heart Day is the World Heart Federation’s biggest global awareness raising platform for cardiovascular disease. Since it was launched in 2009, it has grown rapidly and now enjoys huge global participation and support. 
Cardiovascular diseases (CVDs) take the lives of 17.7 million people every year, 31% of all global deaths. Triggering these diseases – which manifest primarily as heart attacks and strokes – are tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol. These in turn show up in people as raised blood pressure, elevated blood glucose and overweight and obesity, risks detrimental to good heart health.

Key messages to protect heart health

• Tobacco use, an unhealthy diet, and physical inactivity increase the risk of heart attacks and strokes.

• Engaging in physical activity for at least 30 minutes every day of the week will help to prevent heart attacks and strokes.

• Eating at least five servings of fruit and vegetables a day, and limiting your salt intake to less than one teaspoon a day, also helps to prevent heart attacks and strokes.

  
  

What can I do to avoid a heart attack or a stroke?

(WHO: Online Q&A Updated September 2015)

Q: What can I do to avoid a heart attack or a stroke?

A: WHO estimates that more than 17.5 million people died of cardiovascular diseases such as heart attack or stroke in 2012. Contrary to popular belief, more than 3 out of 4 of these deaths occurred in low- and middle-income countries, and men and women were equally affected.
The good news, however, is that 80% of premature heart attacks and strokes are preventable. Healthy diet, regular physical activity, and not using tobacco products are the keys to prevention. Checking and controlling risk factors for heart disease and stroke such as high blood pressure, high cholesterol and high blood sugar or diabetes is also very important.
Eat a healthy diet: A balanced diet is crucial to a healthy heart and circulation system. This should include plenty of fruit and vegetables, whole grains, lean meat, fish and pulses with restricted salt, sugar and fat intake. Alcohol should also be used in moderation.
Take regular physical activity: At least 30 minutes of regular physical activity every day helps to maintain cardiovascular fitness; at least 60 minutes on most days of the week helps to maintain healthy weight.
Avoid tobacco use: Tobacco in every form is very harmful to health – cigarettes, cigars, pipes, or chewable tobacco. Exposure to second-hand tobacco smoke is also dangerous. The risk of heart attack and stroke starts to drop immediately after a person stops using tobacco products, and can drop by as much as half after 1 year.
Check and control your overall cardiovascular risk: An important aspect of preventing heart attacks and strokes is by providing treatment and counselling to individuals at high risk (those with a 10 year cardiovascular risk equal to or above 30%) and reducing their cardiovascular risk. A health worker can estimate your cardiovascular risk using simple risk charts and provide the appropriate advice for managing your risk factors.

• Know your blood pressure: High blood pressure usually has no symptoms, but is one of the biggest causes of sudden stroke or heart attack. Have your blood pressure checked and know your numbers. If it is high, you will need to change your lifestyle to incorporate a healthy diet with less salt intake and increase physical activity, and may need medications to control your blood pressure.
• Know your blood lipids: Raised blood cholesterol and abnormal blood lipids increase the risk of heart attacks and strokes. Blood cholesterol needs to be controlled through a healthy diet and, if necessary, by appropriate medications.
• Know your blood sugar: Raised blood glucose (diabetes) increases the risk of heart attacks and strokes. If you have diabetes it is very important to control your blood pressure and blood sugar to minimize the risk.

WORLD HEALTH ORGANIZATION

HAPPY HEART DAY (NEPALI)

Rabies: Zero by 30, World Rabies Day 2017: 28 September is World Rabies Day

Rabies: Zero by 30, World Rabies Day 2017: It is celebrated annually to raise awareness about rabies prevention and to highlight progress in defeating this horrifying disease.
28 September also marks the anniversary of Louis Pasteur’s death, the French chemist and microbiologist, who developed the first rabies vaccine.

Rabies: Zero by 30
At the global conference on rabies elimination in 2015, a common goal of zero human deaths from canine
 rabies by 2030 was agreed by the World Health Organization, World Organisation for Animal Health,
UN Food and Agriculture Organization and GARC.  In support of this goal, the 2017 World Rabies Day
theme is Rabies: Zero by 30.
https://rabiesalliance.org/world-rabies-day

 
Today, safe and efficacious animal and human vaccines are among the important tools that exist to eliminate human deaths from rabies while awareness is the key driver for success of communities to engage in effective rabies prevention.

Key facts

• Rabies is a vaccine-preventable viral disease which occurs in more than 150 countries and territories.
• Dogs are the main source of human rabies deaths, contributing up to 99% of all rabies transmissions to humans.
• Rabies elimination is feasible through vaccination of dogs and prevention of dog bites.
• Infection causes tens of thousands of deaths every year, mainly in Asia and Africa.
• 40% of people bitten by suspect rabid animals are children under 15 years of age.
• Immediate, thorough wound washing with soap and water after contact with a suspect rabid animal is crucial and can save lives.

Rabies is an infectious viral disease that is almost always fatal following the onset of clinical symptoms. In up to 99% of cases, domestic dogs are responsible for rabies virus transmission to humans. Yet, rabies can affect both domestic and wild animals. It is spread to people through bites or scratches, usually via saliva.
Rabies is present on all continents, except Antarctica, with over 95% of human deaths occurring in the Asia and Africa regions.
Rabies is one of the neglected tropical diseases that predominantly affects poor and vulnerable populations who live in remote rural locations. Although effective human vaccines and immunoglobulins exist for rabies, they are not readily available or accessible to those in need. Globally, rabies deaths are rarely reported and children between the ages of 5–14 years are frequent victims. Treating a rabies exposure, where the average cost of rabies post-exposure prophylaxis (PEP) is US$ 40 in Africa, and US$ 49 in Asia, can be a catastrophic financial burden on affected families whose average daily income is around US$ 1–2 per person.
Every year, more than 15 million people worldwide receive a post-bite vaccination. This is estimated to prevent hundreds of thousands of rabies deaths annually.

Prevention

Eliminating rabies in dogs

Rabies is a vaccine-preventable disease. Vaccinating dogs is the most cost-effective strategy for preventing rabies in people. Dog vaccination reduces deaths attributable to rabies and the need for PEP as a part of dog bite patient care.

Awareness on rabies and preventing dog bites

Education on dog behaviour and bite prevention for both children and adults is an essential extension of a rabies vaccination programme and can decrease both the incidence of human rabies and the financial burden of treating dog bites. Increasing awareness of rabies prevention and control in communities includes education and information on responsible pet ownership, how to prevent dog bites, and immediate care measures after a bite. Engagement and ownership of the programme at the community level increases reach and uptake of key messages.

Preventive immunization in people

Human rabies vaccines exist for pre-exposure immunization. These are recommended for people in certain high-risk occupations such as laboratory workers handling live rabies and rabies-related (lyssavirus) viruses; and people (such as animal disease control staff and wildlife rangers) whose professional or personal activities might bring them into direct contact with bats, carnivores, or other mammals that may be infected.
Pre-exposure immunization is also recommended for travellers to rabies-affected, remote areas who plan to spend a lot of time outdoors involved in activities such as caving or mountain-climbing. Expatriates and long-term travellers to areas with a high rabies exposure risk should be immunized if local access to rabies biologics is limited. Finally, immunization should also be considered for children living in, or visiting, remote, high-risk areas. As they play with animals, they may receive more severe bites, or may not report bites.

Symptoms

The incubation period for rabies is typically 1–3 months but may vary from 1 week to 1 year, dependent upon factors such as the location of virus entry and viral load. Initial symptoms of rabies include a fever with pain and unusual or unexplained tingling, pricking, or burning sensation (paraesthesia) at the wound site. As the virus spreads to the central nervous system, progressive and fatal inflammation of the brain and spinal cord develops.
There are two forms of the disease:

• People with furious rabies exhibit signs of hyperactivity, excitable behaviour, hydrophobia (fear of water) and sometimes aerophobia (fear of drafts or of fresh air). Death occurs after a few days due to cardio-respiratory arrest.
• Paralytic rabies accounts for about 30% of the total number of human cases. This form of rabies runs a less dramatic and usually longer course than the furious form. Muscles gradually become paralyzed, starting at the site of the bite or scratch. A coma slowly develops, and eventually death occurs. The paralytic form of rabies is often misdiagnosed, contributing to the under-reporting of the disease.

Diagnosis

Current diagnostic tools are not suitable for detecting rabies infection before the onset of clinical disease, and unless the rabies-specific signs of hydrophobia or aerophobia are present, clinical diagnosis may be difficult. Human rabies can be confirmed intra-vitam and post mortem by various diagnostic techniques that detect whole viruses, viral antigens, or nucleic acids in infected tissues (brain, skin, urine, or saliva).

Transmission

People are usually infected following a deep bite or scratch from an animal with rabies, and transmission to humans by rabid dogs accounts for 99% of cases. Africa and Asia have the highest rabies burden in humans and account for 95% of rabies deaths, worldwide.
In the Americas, bats are now the major source of human rabies deaths as dog-mediated transmission has mostly been broken in this region. Bat rabies is also an emerging public health threat in Australia and Western Europe. Human deaths following exposure to foxes, raccoons, skunks, jackals, mongooses and other wild carnivore host species are very rare, and bites from rodents are not known to transmit rabies.
Transmission can also occur when infectious material – usually saliva – comes into direct contact with human mucosa or fresh skin wounds. Human-to-human transmission through bites is theoretically possible but has never been confirmed.
Contraction of rabies through inhalation of virus-containing aerosols or through transplantation of infected organs is rare. Contracting rabies through consumption of raw meat or animal-derived tissue has never been confirmed in humans.

Post-exposure prophylaxis (PEP)

Post-exposure prophylaxis (PEP) is the immediate treatment of a bite victim after rabies exposure. This prevents virus entry into the central nervous system, which results in imminent death. PEP consists of:

• extensive washing and local treatment of the wound as soon as possible after exposure;
• a course of potent and effective rabies vaccine that meets WHO standards; and
• the administration of rabies immunoglobulin (RIG), if indicated.

Effective treatment soon after exposure to rabies can prevent the onset of symptoms and death.

Extensive wound washing

This involves first-aid of the wound that includes immediate and thorough flushing and washing of the wound for a minimum of 15 minutes with soap and water, detergent, povidone iodine or other substances that kill the rabies virus.

Recommended PEP

Depending on the severity of the contact with the suspected rabid animal, administration of PEP is recommended as follows (see table):

All category II and III exposures assessed as carrying a risk of developing rabies require PEP. This risk is increased if:

• the biting mammal is a known rabies reservoir or vector species
• the exposure occurs in a geographical area where rabies is still present
• the animal looks sick or displays abnormal behaviour
• a wound or mucous membrane was contaminated by the animal’s saliva
• the bite was unprovoked
• the animal has not been vaccinated.

The vaccination status of the suspect animal should not be the deciding factor when considering to initiate PEP or not when the vaccination status of the animal is questionable. This can be the case if dog vaccination programmes are not being sufficiently regulated or followed out of lack of resources or low priority.
WHO continues to promote human rabies prevention through the elimination of rabies in dogs, dog bite prevention strategies, and more widespread use of the intradermal route for PEP which reduces volume and therefore the cost of cell-cultured vaccine by 60% to 80%.

Integrated bite case management

If possible, the veterinary services should be alerted, the biting animal identified and quarantined for observation (for healthy dogs and cats). Alternatively, the animal may be euthanized for immediate laboratory examination. Prophylaxis must be continued during the 10-day observation period or while awaiting laboratory results. Treatment may be discontinued if the animal is proven to be free of rabies. If a suspect animal cannot be captured and tested, then a full course of prophylaxis should be completed.

WORLD HEALTH ORGAINIZATION