Issue link: http://www.e-digitaleditions.com/i/176094
H i s to r y a n d T r e n d s o f H e a l t h C a r e travel readily throughout the world, disease can spread much more rapidly from individual to individual. The World Health Organization (WHO) is concerned about influenza pandemics occurring in the near future. Throughout history, influenza pandemics have killed large numbers of people. For example, the 1918 Spanish flu pandemic killed approximately 2.6 percent of individuals who contracted it, or about 40 million people. Researchers recently identified the virus that caused this epidemic as an avian (bird) flu virus, or H5N1, that was transmitted directly to humans. The H5N1 viruses, which are present in Asia and other countries, today pass readily from birds to birds and have devastated bird flocks. The infection has appeared in humans, but most cases have resulted from contact with infected poultry or contaminated surfaces. The spread from one person to another has been reported only rarely. In 2009 a new virus, H1N1, was discovered. The respiratory infection is commonly called the swine flu. Swine flu is an influenza in pigs and it can occasionally be transmitted to humans, mainly those in close contact, such as hog farm workers. H1N1 spreads quickly and easily between humans when they cough or sneeze and others breathe in the virus or come in contact with a contaminated surface. H1N1 cannot be acquired by eating pork. H1N1 spread to almost all parts of the world and the WHO declared it to be Today's Research Tomorrow's Health Care 23 a global pandemic in 2009. The concern is that flu viruses can mutate quickly and may create a new even more lethal virus. Even if the H1N1 viruses do not mutate, WHO is still concerned about many other viruses. Examples include the hantavirus spread by rodents, severe acute respiratory syndrome (SARS), monkeypox, and filoviruses such as the Ebola virus and the Marburg virus that cause hemorrhagic fever. Because viruses are prone to mutation and exchanging genetic information, the creation of a new lethal virus can occur at any time. WHO estimates that 2 to 7 million people worldwide could die from infections by this type of virus. Other estimates are that tens of millions of people could die. Many governments are creating pandemic influenza plans to protect their populations. Components of most plans include the following: • Education: information about the pandemic and ways to avoid its spread must be given to the entire population • Vaccine production: more research must be directed toward producing effective vaccines in larger quantities and in a shorter period of time • Antiviral drugs: drugs that are currently available must be stockpiled so they will be ready for immediate use, and more research must be done to develop and produce effective antiviral drugs The Food and Drug Administration Regulating Maggots and Leeches as Medical Devices? Throughout the history of health care, maggots and leeches have been used to treat infection and encourage blood flow. Maggots clean festering, gangrenous wounds that fail to heal. They eat the dead tissue and discharges to clean the wound and promote the growth of new tissue. Leeches drain excess blood from tissue and encourage new circulation. Microsurgeons, physicians who specialize in reattaching fingers, hands, and other body appendages, have come to rely on the assistance of leeches. When microsurgeons reattach or transplant a body part, they can usually connect arteries that bring blood to the appendage. They find it more difficult to attach veins, which carry blood away from the appendage, because veins are smaller and are fragile. Without a good venous supply, blood tends to collect in the new attachment, clot, and in some cases, kill the tissue. To allow time for the body to create its own veins to the new appendage, physicians apply leeches. The leeches naturally inject the area with a chemical that includes an anticoagulant (a substance that prevents clotting), an anesthetic, an antibiotic, and a vasodilator (a substance that dilates or enlarges blood vessels). This chemical encourages the blood to flow quickly. The leeches drain this blood to reduce pressure and allow veins to form. Now, researchers are evaluating the use of maggots to treat burns and skin cancer. Surgeons are determining if maggots can decrease the risk of infection after surgery, especially since so many infectious agents are antibiotic-resistant. German scientists are evaluating the use of leech therapy to lessen pain and decrease the inflammation associated with osteoarthritis and other inflammatory diseases. Many other alternative uses of this biotherapy (including using living animals to aid in diagnosis or treatment) are possible in the future. Even though many individuals are squeamish about the use of maggots and leeches, they have proved to be an effective method of treatment for chronic infections and microsurgery. The FDA has classified maggots and leeches as medical devices and regulates how maggots and leeches are grown, transported, sold, and disposed of after use. This provides a safe source for this unique method of treatment and encourages future research on the use of maggots and leeches as methods of treatment.