Gastroenteritis

• “Over the past year, we made significant progress with HIL-214, our vaccine candidate for the prevention of moderate-to-severe norovirus related acute gastroenteritis.
• As of October 2023, HilleVax has completed enrollment of subjects in all three clinical trials.
• As of December 31, 2023 and December 31, 2022, the company had cash, cash equivalents and marketable securities totaling $303.5 million and $279.4 million, respectively.
• Other income for the fourth quarter 2023 was $3.3 million, compared to $1.9 million for the fourth quarter 2022.

• More than 700 cases of this gastrointestinal disease were reported in Queensland in January, which is 13 times more than in January last year.
• Read more:
  What lies beneath: the bugs lurking in your swimming pool

What causes cryptosporidiosis, and who is affected?

• Cryptosporidum hominis only affects humans and is the major cause of recent outbreaks in Australia, while Cryptosporidium parvum can also affect animals.
• The infection is spread by spores called oocysts in the stools of humans and animals.
• Cryptosporidiosis is more prevalent in young children, particularly those under five, but the disease can affect people of any age.

So how do we catch it?

• The largest recorded outbreak occurred in Milwaukee in 1993 where 403,000 people were believed to have been infected.
• As few as ten oocysts can cause infection, making it possible for contaminated drinking water to affect a very large number of people.
• Oocysts have been found in foods such as fresh vegetables and seafood but these are not common sources of infection in Australia.

What about chlorine?

• Young children and in particular children in nappies are known to increase the potential for disease transmission in recreational water.
• Proper nappy changing, frequent bathroom breaks and showering before swimming to remove faecal residue are helpful ways to reduce the risk.

Some sensible precautions

Other measures you can take to reduce yours and others’ risk of cryptosporidiosis include:
avoid swimming in natural waters such as rivers and creeks during and for at least three days after heavy rain
avoid swimming in beaches for at least one day after heavy rain
avoid drinking untreated water such as water from rivers or springs. If you need to drink untreated water, boiling it first will kill the Cryptosporidium
avoid swallowing water when swimming if you can
if you’ve had diarrhoea, avoid swimming for at least two weeks after it has resolved
avoid sharing towels or linen for at least two weeks after diarrhoea has resolved
avoid sharing, touching or preparing food that other people may eat for at least 48 hours after diarrhoea has resolved
wash your hands with soap and water after going to the bathroom or before preparing food (Cryptosporidium is not killed by alcohol gels and sanitisers).
Not all cases of diarrhoea are due to cryptosporidiosis. There are many other causes of infectious gastroenteritis and because the vast majority of the time recovery is uneventful you don’t need to see a doctor unless very unwell. If you do suspect you may have cryptosporidiosis you can ask your doctor to refer you for a stool test.
Vincent Ho does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

• From the sizzling suya snack in Abuja to the aromatic jollof rice in Lagos, street food has become an integral part of Nigerian life.
• However, beneath these enticing flavours lies a critical question of public safety and health regulation.
• Other studies have focused on the microbiological safety of street foods (for example, soy wara, a Nigerian curdled soy milk product), and the risk factors in street food practices.
• While street food vendors provide affordable and accessible meals, the lack of regulation poses significant health risks.

Why street food can be unsafe

• Inadequate access to clean water, inappropriate waste disposal, temperature abuse and lack of food safety knowledge are common challenges seen among street food vendors.
• Generally, street food preparation in Nigeria mirrors traditional approaches to food preparation at home.
• Similarly, many street food vendors operate in less than perfect environments for food processing: many street food vendor stands have flies, rodents and open waste bins which are risk factors for the contamination of foods.

Checking unsafe practices

A multifaceted approach to these issues must be adopted.
Training: First, basic food safety training for vendors is crucial. This training should cover essential hygiene practices, safe food handling and storage procedures. It can be done through local health departments and community organisations. This recommendation draws on established principles of hygiene and safe food handling. Continuous training on food safety has proved effective in promoting food safety.

• This requires a balance between ensuring public health and not stifling the livelihoods of the vendors.
• Supplying vendors with hygienic materials has proved to be valuable for preserving and enhancing food safety in low- and middle-income nations.

Inspection: Regular inspections should be conducted to ensure compliance with these regulations. These should not be punitive but rather supportive, helping vendors to meet the required standards. A food hygiene rating scheme should be put in place to identify vendors complying with food safety standards as this could motivate them to improve their sanitary conditions.
Awareness: Public awareness also plays a vital role. Consumers should be educated about the importance of food safety and how to identify vendors who adhere to hygiene standards. Consumer awareness can create a demand for safer practices, encouraging vendors to comply with regulations.
Research and development: Finally, research and collaboration with food scientists and public health experts can lead to innovative solutions that are tailored to the Nigerian context. For instance, exploring low-cost preservation techniques or developing mobile apps for health inspection ratings could revolutionise the way street food is regulated.

Regulations will save lives and livelihoods

Regulating street food in Nigeria is not just about preventing disease; it is about preserving a way of life in a safe and sustainable manner. At the heart of this issue are the vendors and consumers, whose lives and well-being are interconnected with the very essence of street food culture.
Helen Onyeaka does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

• Patient acceptance of self-administration using the ambulatory pump for lenalidomide delivery has been confirmed in this study.
• Remarkably, there were no hematologic toxicities greater than Grade 1 observed to date.
• Only a single drug-related adverse event was reported -- subcutaneous induration at the injection site which resolved within two weeks.
• Up to 30% of patients discontinue use of Revlimid® and roughly 70% dose reduce as a result of these adverse effects.