Health: Button batteries pose 'deadly' risk to toddlers

Surgeons are warning of the potentially deadly risk posed to young children by button batteries.

If accidentally swallowed, the small, round batteries can get lodged in the oesophagus and burn a hole through its lining.

London's Great Ormond Street Hospital has seen a big increase in cases in the past year.

Surgeon Kate Cross said: "Button batteries should be treated like poison and kept out of reach of children."

Three-year-old Valeria, from Northern Ireland, has been left with permanent damage to her throat after she swallowed a watch battery in April 2015.

The battery became stuck in her food pipe and she began being sick and refusing food.

It was not until five days later that an X-ray showed she had swallowed a battery, by which time it had burned a hole through her oesophagus and windpipe.

Lasting injuries

Since then she has spent nine months at Great Ormond Street Hospital receiving specialist treatment and still needs to visit every few weeks.

Valeria has undergone dozens of surgical procedures, including having part of her oesophagus removed.

Her mother Jelena said: "Because she now can't eat or drink properly, the doctors have made a hole in her neck and attached a bag so that all her saliva and anything she drinks goes straight in to it.

"Without this, water would go in to her lungs, which would be very dangerous. She also has a special button on her tummy that that liquid food goes through.

"In many ways Valeria is now a normal three-year-old who likes Play-Doh and playing doctors, but she still needs a lot more operations to help her recover."

Doctors are planning to put a metal support, called a stent, into what is left of her oesophagus and they may eventually lift her stomach into her chest to create a new food pipe.

Caustic soda

Great Ormond Street Hospital says a decade ago they rarely treated button battery injuries, but there has been a dramatic rise recently, and now are seeing about one child a month.

Kate Cross, consultant neonatal and paediatric surgeon said: "If the battery gets enveloped in the mucosa of the oesophagus it creates an electrical circuit and the battery starts to function, releasing an alkali which is like caustic soda, which can erode through the wall to the windpipe.

"If the battery is facing a different way it can burn into the aorta, a major blood vessel, and there have been cases in Britain where the child has bled to death.

"That is why it is important to get the message out to parents but also other health professionals because this is a time critical problem."

Complex surgery

Catharina Santos, aged 18 months, swallowed a button battery that she removed from some bathroom scales at her home in Surrey.

Her mother Jessika said: "I saw Catharina playing with the scales and a moment later realised she had removed the battery cover - I took her to hospital straight away."

Doctors removed the battery about three hours after it had been swallowed, but it had already burned through to her windpipe.

Catharina is being tube fed, and will need complex surgery to try to repair the damage.

Jessika said "My message to other parents is to make sure they keep any of these batteries, or the items which contain them, far away from children."

Children's hospitals in Birmingham, Sheffield and Manchester are also trying to raise awareness of the potential dangers after a steady stream of cases.

Ray Clarke, consultant surgeon at Alder Hey Children's Hospital in Liverpool said: "We have also had a few cases of children putting them into the nose with nasty consequences, including perforation of the nasal septum (a hole in the partition between the nostrils) or putting them into their ear causing serious inflammation."

Katrina Phillips, Chief Executive of the Child Accident Prevention Trust, said: "Button batteries are everywhere in our homes, in many products that appeal to children.

"But very few parents know about the danger they pose, especially those containing lithium.

"We want to join forces with the battery industry to raise awareness and help keep children safe."

In 2014, engineers in the US produced button batteries with a special coating which conducts electricity only when squeezed, such as when it is in a spring-loaded compartment.

However, the technology has yet to be incorporated by manufacturers.

The British and Irish Portable Battery Association (BIPBA) said it was investigating such designs.

BIPBA said it "takes the safety of consumers very seriously", adding that warning notices are placed on batteries and packaging is child resistant.

Source: http://www.bbc.com/news/health-37410343

Health: Zika: The key unanswered questions

The infection has prompted the World Health Organization to declared a global health emergency due to the link to thousands of suspected cases of babies born with small brains - or microcephaly - in Brazil.

But there are still many, crucial, unanswered questions.

How many people have been infected in the Americas?

The best estimate of Zika infections is between 500,000 and 1.5 million - which is quite a wide margin of error. What percentage of people in an affected area are getting infected? Is it everyone? We don't know.

Why the explosive outbreak?

One theory is that the virus has mutated to become more infectious. Alternatively, some experts argue it could simply be a case of the virus reaching areas where people are densely packed together and there are huge numbers of mosquitoes.

Who is infectious?

Around 80% of people have no symptoms when they get the virus - although this figure needs further investigation. It's not known if they can also spread the virus or even why they are asymptomatic.

Does it cause microcephaly?

It's the biggest health concern in the outbreak, yet the link with Zika and birth defects is still only "strongly suspected". Parts of Brazil that have seen cases of Zika have, several months later, also seen a surge in microcephaly. However, the trials to prove the link have not finished.

How risky is infection?

If the virus does cause microcephaly, how often does this happen? Does every infection lead to birth defects? Or is it one-in-100? One-in-10,000 perhaps? At the moment it's not clear how worried pregnant women should be.

Is there a risky period in pregnancy?

If the virus causes microcephaly, does it matter when you are infected? There have been some suggestions that the first trimester (the first 12 weeks) is key, but other doctors have hinted there might be risks as late as 29 weeks. And those risks could change over time.

How could it damage the brain?

Some infections, such as rubella, can damage the brains of developing babies during pregnancy. But it is not known how Zika could be crossing the placenta and damaging brain growth.

Does developing symptoms change the risk?

Around four-in-five people infected will not develop symptoms. Do silent infections carry the same risks of microcephaly as those which result in a fever or a rash? There is also the rare neurological disease Guillain-Barre syndrome that has been linked to Zika infection and we don't know which patients are most a risk.

What's going on in Africa and Asia?

The virus was first detected in Africa and then parts of Asia until it reached Brazil and then spread. So do these continents represent giant vulnerable populations susceptible to Zika outbreaks? Or has Zika been around and undetected there for years, so that most of the population are immune? It is hard to establish the global threat without knowing the answer.

How big is the surge in microcephaly really?

There are big questions about the quality of the data, both before the outbreak of Zika and now. The figures for previous years may be underestimates, and the number of suspected cases is an overestimate. Of the 4,783 reported cases of microcephaly - 404 have been confirmed, 709 have been disproved and 3,670 are still being investigated.

Can it be spread by other mosquitoes?

The Zika virus is spread by the Aedes aegypti mosquito, but it is confined to tropical and sub-tropical countries. There is concern that Zika could be spread by other mosquitoes too such as the Asian tiger mosquito. This species prefers more temperate climes such as parts of Europe.

How big a risk is sex?

It seems likely that the overwhelming majority of cases are spread by the Aedesmosquito where the insect bites a person with the virus and passes it onto the next person it bites. But sexual transmission has been implicated in a couple of infections. It's unknown how common this is.

What about immunity?

Are you infected once and then protected for life, like measles? Or does it take multiple infections to achieve immunity? How long does immunity last? These answers will tell us how long the outbreak could last and indicate whether a vaccine would be effective.

Source: http://www.bbc.com/news/health-35493892

How does honey kill bacteria?

Professor Rose Cooper, from the Centre for Biomedical Sciences at Cardiff Metropolitan University, has been at the forefront of research into the antibacterial properties of honey since the late 1990s.

Using electron microscopy, which can reveal the structure of bacteria, she has shown even low concentrations of Manuka honey stops bacteria including MRSA growing, meaning cells cannot divide and therefore are unable to form infections.

Combining honey with oxacillin and other antibiotics has also been shown to be more effective against antibiotic resistant bacteria.

She is currently investigating how different bacteria seems to be affected in different ways by Manuka honey, believing it to have a wider application than just killing bugs.

Here, Professor Rose Cooper explains how honey can cause holes in some types of bacteria, and help prevent infection.

Read more: When will we take medicinal honey seriously?

Source: http://www.bbc.co.uk/nature/28401509

Helath: Dilute honey 'may fight urine infections'

Honey and water might be a useful weapon against urine infections in hospital patients, say UK researchers.

Patients often have a catheter fitted, either to drain urine stuck in the bladder or to monitor urine output.

But these flexible tubes can harbour nasty bugs and cause infection.

Scientists at University of Southampton have shown in the lab that diluted honey stops some common bacteria from forming sticky, hard-to-remove layers on surfaces such as plastic.

In theory, a honey solution might be useful for flushing urinary catheters to keep them clean while they remain in the bladder.

Many more trials would be needed to check it would be safe to use in humans, however.

Nature's medicine

Honey has been used for centuries as a natural antiseptic. People have used it to treat burns and wounds and many companies now sell a range of "medical grade" honey products that comply with regulatory standards.

The laboratory work, published in the Journal of Clinical Pathology, looked at two common bacteria that can cause urine and bladder infections - E. coli and Proteus mirabilis.

Even at low dilution - about 3.3% - the honey solution appeared to stop the bacteria from clustering together and creating layers of known biofilm.

Dr Bashir Lwaleed's team used Manuka honey (made by bees that feed on the nectar of the manuka tree) in their study because this dark-coloured honey from Australia and New Zealand is known to have bacterial-fighting properties.

They say other types of honey might work too, but they have not tested this.

Dr Lwaleed said: "Nobody knows exactly how or why honey works as an antibacterial. And we don't know how well honey would be tolerated in the bladder. We are the first to propose this."

Prof Dame Nicky Cullum is an expert in wound care and has looked at the evidence around honey as a treatment.

She said: "This work from Southampton is at a very early stage so we shouldn't get too excited. But it is an interesting avenue that is worth pursuing.

"Obviously, we'd need more studies to check that it wouldn't irritate the bladder or cause any other problems.

"People like things that are natural but they are not always more effective."

Source: http://www.bbc.com/news/health-37471076