In a briefing to reporters in Geneva, WHO Communications Officer Oliver Rosenbauer said that out of 22 reported cases of acute flaccid paralysis (AFP), 10 had been confirmed as being the result of Wild Polio Virus Type 1. The remaining 12 cases are still being investigated.

The cases were initially reported on 17 October in the Deir Al Zour province in the north-east region of Syria. Due to the protracted conflict, which has displaced millions, Syria had already been considered at high-risk for vaccine-preventable diseases. However, the country has not experienced a case of polio since 1999.

Polio, whose virus enters the body through the mouth and multiplies in the intestine attacking the nervous system, is highly infectious and can cause total paralysis in a matter of hours.

Initial symptoms are fever, fatigue, headache, vomiting, and stiffness in the neck and pain in the limbs. One in 200 infections leads to irreversible paralysis and among those paralyzed, five to 10 per cent die when their breathing muscles become immobilized.

Rosenbauer said the next step was to look at the isolated viruses and identify where they came from, to shed light on the source of the outbreak.

The 22 people who have been tested are children, mostly toddlers less than two years old. All of them appeared to be under or unimmunized, with some having received one dose of a vaccine and others not receiving any vaccination at all. Rosenbauer said the children came down with fever and were then paralysed.

WHO spokesperson Glenn Thomas added that health authorities in Syria and neighbouring countries had already begun the planning and implementation of the comprehensive outbreak response.

Meanwhile, a UN spokesperson in New York reported yesterday that Anthony Lake, the Executive Director of UNICEF, ended a two-day visit to Damascus, in which he said that the Syrian Government and agency had agreed on the importance of reaching hundreds of thousands of children in some of the worst-affected parts of the war-torn country with life saving vaccines, including those against polio.

Lake said that immunizing children is in its very nature non-political and has no connection to any military considerations. Lake also said that, with cases of polio now emerging in Syria for the first time since 1999, vaccinating children against polio is an urgent and critical priority for Syria and for the whole world.

“This trend is a positive one. Millions of lives have been saved,” said Anthony Lake, UNICEF Executive Director. “And we can do still better. Most of these deaths can be prevented, using simple steps that many countries have already put in place – what we need is a greater sense of urgency.”

The leading causes of death among children aged less than five years include pneumonia, prematurity, birth asphyxia, diarrhoea and malaria. Globally, about 45% of under-five deaths are linked to undernutrition.

About half of under-five deaths occur in only five countries: China, Democratic Republic of the Congo, India, Nigeria, and Pakistan. India (22%) and Nigeria (13%) together account for more than one-third of all deaths of children under the age of five.

Newborn children are at particularly high risk

“Care for mother and baby in the first 24 hours of any child’s life is critical for the health and wellbeing of both,” says Dr Margaret Chan, Director-General at WHO. “Up to half of all newborn deaths occur within the first day.”

The lives of most of these babies could be saved if they had access to some basic health-care services. These include skilled care during and after childbirth; inexpensive medicines such as antibiotics; and practices such as skin-to-skin contact between mothers and their newborn babies and exclusive breastfeeding for the first six months of life.

While the global average annual rate of reduction in under-five mortality accelerated from 1.2% a year for the period 1990–1995 to 3.9% for 2005–2012, it remains insufficient to reach Millennium Development Goal 4 which aims to reduce the under-five mortality rate by two-thirds between 1990 and 2015.

“Continued investments by countries to strengthen health systems are essential to ensure that all mothers and children can get the affordable, quality care they need to live healthy, productive lives,” said Keith Hansen, Acting Vice President of Human Development at the World Bank Group.

Sub-Saharan Africa, in particular, faces significant challenges as the region with the highest child mortality rates in the world. With a rate of 98 deaths per 1000 live births, a child born in sub-Saharan Africa faces more than 16 times the risk of dying before his or her fifth birthday than a child born in a high-income country.

However, sub-Saharan Africa has shown remarkable acceleration in its progress, with the annual rate of reduction in deaths increasing from 0.8% in 1990–1995 to 4.1% in 2005–2012. This is the result of sound government policies, prioritized investments and actions to address the key causes of child mortality and reach even the most difficult to reach populations.

“Nearly all mothers are physically able to breastfeed and will do so if they have accurate information and support,” said Carmen Casanovas, breastfeeding expert with the Department of Nutrition for Health and Development of the UN World Health Organization (WHO).

“But in many cases, women are discouraged from doing so, and are misled to believe that they are giving their children a better start in life by buying commercial substitutes,” Dr. Casanovas said in a news release.

Breastfeeding, WHO stressed, is “the best source of nourishment” for infants and young children and one of the most effective ways to ensure child health and survival. People who were breastfed as babies are less likely to be overweight or obese later in life, less prone to diabetes and may perform better in intelligence tests.

However, globally, only an estimated 38 per cent of infants are exclusively breastfed for six months, the agency noted.

Concerned that breast-milk substitutes were being marketed to mothers too aggressively, the 27th World Health Assembly in 1974 urged member States to review sales promotion activities on baby foods and to introduce appropriate remedial measures, including advertisement codes and legislation where necessary.

This led, in 1981, to agreement on the International Code of Marketing of Breast-milk Substitutes, and the adoption of several subsequent resolutions on the matter. The new report, published ahead of World Breastfeeding Week, found that only 37 countries, or 19 per cent of those reporting, have passed laws reflecting all the Code’s recommendations.

For example, 69 countries (35 per cent) fully prohibit advertising of breast-milk substitutes; 62 countries (31 per cent) completely prohibit free samples or low-cost supplies for health services; and 64 countries (32 per cent) completely prohibit gifts of any kind from relevant manufacturers to health workers.

In addition, 83 countries (42 per cent) require a message about the superiority of breastfeeding on breast-milk substitute labels, and only 45 countries (23 per cent) report having a functioning implementation and monitoring system.

The report stated that mothers are often inundated with incorrect and biased information both directly, through advertising, health claims, information packs and sales representatives, and indirectly through the public health system.

For example, distribution of “educational materials” on breastfeeding produced by manufacturers of infant formula have a negative impact on exclusive breastfeeding, as does the distribution of samples of infant formula.

For this year’s World Breastfeeding Week, which runs from 1 to 7 August, WHO and partners are calling for more support for breastfeeding mothers. It noted, among other things, that health facilities that support breastfeeding – by making trained breastfeeding counsellors available to new mothers – encourage higher rates of the practice.The agency also pointed out that breast milk gives infants all the nutrients they need for healthy development. It is safe and contains antibodies that help protect infants from common childhood illnesses such as diarrhoea and pneumonia, the two primary causes of child mortality worldwide. Breast milk is readily available and affordable, which helps to ensure that infants get adequate nutrition.

Infant formula, WHO said, does not contain the antibodies found in breast milk. There are also risks arising from the use of unsafe water and unsterilized equipment or the potential presence of bacteria or other contaminants in powdered formula.

Breastfeeding also benefits mothers, the agency added, noting that exclusive breastfeeding is associated with a natural (though not fail-safe) method of birth control (98 per cent protection in the first six months after birth). It also reduces risks of breast and ovarian cancer later in life and helps women return to their pre-pregnancy weight faster.

The Emergency Committee is made up of international experts to provide technical advice to the WHO Director-General in the context of a “public health emergency of international concern” (PHEIC). Depending on the circumstances, the Emergency Committee may advise on whether or not a PHEIC is occurring . If the Director-General determines that the event constitutes a PHEIC, the Emergency Committee will then provide advice on appropriate Temporary Recommendations of health measures to be implemented by States Parties. As a PHEIC proceeds, the Emergency Committee continues to provide advice to the Director-General on termination of the PHEIC, and the modification and termination of Temporary Recommendations. All decisions on these issues are taken by the Director-General.

Coronaviruses are a large family of viruses that includes viruses that may cause a range of illnesses in humans, from the common cold to SARS. Viruses of this family also cause a number of animal diseases.

The Middle East respiratory syndrome coronavirus (MERS-CoV) has not been previously identified in humans. There is very limited information on transmission, severity and clinical impact with only a small number of cases reported thus far.

Since April 2012, there have been 64 laboratory-confirmed cases of human infection with Middle East respiratory syndrome coronavirus (MERS-CoV); 72% have been male. Thirty-eight of the confirmed cases have died. Affected countries in the Middle East include Jordan, Saudi Arabia, the United Arab Emirates (UAE), and Qatar. Cases have also been reported by four countries in Europe, France, Germany, the United Kingdom (UK) and Italy, and by one country in North Africa, Tunisia. All of the European and North African cases have had a direct or indirect connection to the Middle East. However, in France, the UK, Tunisia and Italy, there has been limited local transmission among close contacts who had not been to the Middle East.

Among the new laboratory-confirmed cases of MERS-CoV reported since the last update on 31 May 2013, three have been reported by Italy. In this cluster, the index case, a 45-year-old Italian resident, travelled to Amman, Jordan in mid-April. He developed mild respiratory symptoms one day before returning home to Italy in late May. He was admitted to hospital with pneumonia 3 days after returning home. Nasopharyngeal (NP) and throat swabs taken on the day following admission were positive for MERS-CoV. He had no underlying chronic medical conditions, but was noted to be obese. He recovered and was discharged home after a week in hospital. Contact monitoring was conducted in Italy, and two developed respiratory symptoms: a 42-year-old co-worker and a 14-month-old close relative. Both tested positive for MERS-CoV. The two contacts had each been exposed to the 45-year-old man on a single day, and their illnesses began 3 and 4 days, respectively, after that exposure. Both had mild illnesses and recovered uneventfully. Follow up was also done on close contacts in Amman, Jordan. Four symptomatic and six asymptomatic contacts had NP swabs collected for testing; all were negative for MERS-COV.

The Ministry of Health in Saudi Arabia has also notified WHO of additional laboratory-confirmed cases of MERS-CoV with onset in late May and early June. These include cases from the Ta’if Governorate, Wadi Al-Dawaser, and Hafar Al-Batin; the first reported from these areas. The more recent cases were similar in age and sex to previously reported cases, except for a 2-year-old with chronic pulmonary disease from Jeddah.

Although the exact timing and nature of exposures that result in infection is usually unknown, for those cases for which exposure is known or strongly suspected, the incubation period for laboratory confirmed cases of MERS-CoV is generally less than one week. However, in at least one case the known exposure occurred 9 to 12 days prior to onset of illness. Further evidence in cases exposed over a range of time suggests that, at least in a minority of cases, the incubation period may exceed one week but is less than two weeks.

Evidence is also accumulating to suggest that nasopharyngeal swabs are less sensitive for detecting infection with MERS-CoV than specimens taken from the lower respiratory track. Currently, no head-to-head comparisons are available on the two approaches to diagnosis. However, in a number of patients, NP swabs have been negative at one point during the course of illness while lower respiratory specimens were positive at another time during the same illness. In addition, in several clusters, patients who were strongly suspected of having MERS-CoV infection because of direct exposure and severe respiratory illness had NP swabs that tested negative, while other confirmed cases in the cluster had lower respiratory track specimens that tested positive.

“Tobacco use is one of the top threats to human health, killing half the people who use it,” Secretary-General Ban Ki-moon said, marking World No Tobacco Day, observed annually on 31 May.

“When we reduce people’s exposure to tobacco advertising, we reduce the likelihood that they will start to use tobacco,” he said.

Tobacco is a major risk factor for non-communicable diseases such as cancer, cardiovascular disease, diabetes and chronic respiratory diseases. By 2030, the World Health Organization (WHO) estimates that it will kill more than 8 million people every year, with four out of five of these deaths occurring in low and middle-income countries.

Most users start consuming tobacco before the age of 20, making young people a key target of tobacco advertising. Worldwide, 78 per cent of young people aged 13-15 report regular exposure to some form of tobacco promotion.

“Tobacco use ranks right at the very top of the list of universal threats to health yet is entirely preventable,” said WHO’s Director-General Margaret Chan. “Governments must make it their top priority to stop the tobacco industry’s shameless manipulation of young people and women, in particular, to recruit the next generation of nicotine addicts.”

WHO research has shown that bans on tobacco advertising are one of the most effective ways to reduce smoking, with countries that have already introduced these measures showing an average 7 per cent reduction in tobacco consumption.

While bans are highly effective, WHO stressed that legislation needs to be comprehensive, as there are multiple ways to target potential smokers including placement of tobacco products in films and television, engaging trendsetters to influence people, handing out branded products that attract youth, and using media such as pro-smoking mobile applications and online discussions with tobacco industry members posing as consumers to sway conversations.

WHO’s report on the global tobacco epidemic 2011 shows that only 19 countries have reached the highest level of achievement in banning tobacco advertising, promotion and sponsorship, and that more than one third of countries have minimal or no restrictions at all.

Mr. Ban and Ms. Chan urged countries to live up to their commitments under the WHO Framework Conventions on Tobacco Control (FCTC) and implement comprehensive bans on all tobacco advertising promotion and sponsorship.

The FCTC requires parties to introduce a comprehensive ban of all forms of tobacco advertising, promotion and sponsorship within five years of the entry into force of the Framework Convention for that party. Adopted in 2003, the FCTC now has 176 Parties, covering 88 per cent of the world’s population.

The report, entitled Progress on sanitation and drinking-water 2013 update, warns that, at the current rate of progress, the 2015 Millennium Development Goal (MDG) target of halving the proportion of the 1990 population without sanitation will be missed by 8% – or half a billion people.

While UNICEF and WHO announced last year that the MDG drinking water target had been met and surpassed by 2010, the challenge to improve sanitation and reach those in need has led to a consolidated call for action to accelerate progress.

“There is an urgent need to ensure all the necessary pieces are in place – political commitment, funding, leadership – so the world can accelerate progress and reach the Millennium Development Goal sanitation target” said Dr Maria Neira, WHO Director for Public Health and Environment. “The world can turn around and transform the lives of millions that still do not have access to basic sanitation. The rewards would be immense for health, ending poverty at its source, and well-being.”

The report echoes the urgent call to action by United Nations Deputy Secretary-General Jan Eliasson for the world community to combine efforts and end open defecation by 2025. With less than three years to go to reach the MDG deadline WHO and UNICEF call for a final push to meet the sanitation target.

“This is an emergency no less horrifying than a massive earthquake or tsunami,” said Sanjay Wijesekera, global head of UNICEF’s water, sanitation and hygiene (WASH) programme. “Every day hundreds of children are dying; every day thousands of parents mourn their sons and daughters. We can and must act in the face of this colossal daily human tragedy.”

“Health care-associated infections are a major burden around the world and threaten the safety and care of patients,” said UN World Health Organization (WHO) Envoy for Patient Safety, Liam Donaldson. “I urge the health care and patient communities to take firm and decisive action to save lives from this preventable harm.”

The WHO global campaign “SAVE LIVES: Clean Your Hands” recommends that people wash their hands during five key moments: before touching a patient, before cleaning and aseptic procedures, after contact with body fluids, after touching a patient and after touching patient surroundings.

Since its launch in 2009, more than 15,700 health facilities with more than 9 million health workers in 168 countries have registered with the campaign, according to WHO.

“Health care-associated infections usually occur when germs are transferred by health-care providers’ hands touching the patient,” the UN agency said, often leading to significant physical and psychological suffering and sometimes death of patients, and financial losses for health systems.

Of every 100 hospitalized patients, at least seven in developed and 10 in developing countries will acquire a health care-associated infection, according to UN figures. Among critically ill and vulnerable patients in intensive care units, that figure rises to around 30 per 100.

Hundreds of millions of patients every year are affected by health care-associated infections, WHO reported. The most common include urinary tract and surgical site infections, pneumonia and infections of the bloodstream.

“More than half of these infections could be prevented by caregivers properly cleaning their hands at key moments in patient care,” according to the Geneva-based agency.

According to a new survey conducted by WHO and its Collaborating Centre on Patient Safety, the University of Geneva Hospital, patient participation is considered a useful strategy for improving hand hygiene and creating a positive patient safety climate in the facilities implementing it.

Patients and their family members can participate by asking health workers who are about to touch them to clean their hands and thanking them when they do, and asking for information about any existing initiatives that involve patients at the health facility.

“Patient participation can be a powerful tool to achieve improvements in health care,” said Dr. Benedetta Allegranzi, team lead in the WHO Patient Safety Clean Care is Safer Care programme. “Although the ability of patients to be involved will vary in different cultures and situations, family members of patients often help with caregiving and they are some of the best advocates for their loved ones. That makes them good allies in this process.”

According to the World Health Organization (WHO), pedestrian casualties account for 22 per cent of the total 1.24 million road traffic deaths. To draw attention to the needs of pedestrians and generate action to protect them, WHO organized the Second UN Global Road Safety Week, which kicks off on 6 May with events in 70 countries.

“The Second United Nations Global Road Safety Week offers an opportunity to highlight the myriad challenges that pedestrians face around the world each and every day,” said WHO Assistant Director-General of Noncommunicable Diseases and Mental Health, Oleg Chestnov.

“We are all pedestrians, and Governments should put in place measures to better protect all of us. This will not only save lives, but create the conditions needed to make walking safe. When roads are safe, people will walk more, and this in turn will improve health and protect the environment,” he said, echoing the theme of Road Safety Week, “Make Walking Safe.”

Pedestrians are among the most vulnerable road users. Studies indicate that males, both children and adults, make up a high proportion of pedestrian deaths and injuries. In developed countries, older pedestrians are more at risk, while in low-income and middle-income countries, children and young adults are often affected. Children and adults with disabilities suffer higher rates of injury as pedestrians compared to their non-disabled peers.

“More than 5,000 pedestrians are killed on the world’s roads each week. This is because their needs have been neglected for decades, often in favor of motorized transport,” said the WHO Director of the Department of Violence and Injury Prevention and Disability, Etienne Krug. “We need to rethink the way we organize our transport systems to make walking safe and save pedestrian lives.”

WHO and its partners also released a road safety manual for decision-makers and practitioners, which promotes a combining enforcement, engineering and education measures such as: adopting new laws to reduce speeding, curb drinking and driving, decrease mobile phone use, improve roadway lighting and put in place infrastructure that separates pedestrians from traffic.

The agency also contributes to achieve the goal of to the Decade of Action for Road Safety 2011-2020. Launched in May 2011 by Governments across the world, the Decade of Action aims to save 5 million lives and seeks to build road safety management capacity in countries, improve the safety of roads and vehicles, enhance the behavior of all road users and strengthen post-crash care.

At least 63 people have been infected by the virus also known as H7N9.

WHO says more than 1,000 people who have been in contact with the confirmed cases are being closely monitored, although there has been no confirmation that the virus was spreading from one person to another.

The source of the virus remains unknown although some birds including chickens have tested positive for the virus.

An international team of scientists is expected in China later this week to assess the situation and advise on the way forward.

Glenn Thomas is a spokesperson for WHO.

“China has invited a team of international experts to carry out a one week joint assessment of the H7N9 situation in the country. The team will assess the outbreak and response to guide further prevention and control measures. Members include Chinese experts on epidemiology, laboratory tests and clinical treatment as well as experts and officials from the US, the EU, Australia and WHO.”

WHO says until the source of infection has been identified, it is expected that there will be further cases of human infection with the virus in China.

The UN health agency is currently not recommending that any travel or trade restrictions be applied to China.

Patrick Maigua, United Nations Radio Geneva.

“Too often, strategies to tackle pneumonia and diarrhoea run in parallel,” said Elizabeth Mason, Director of Maternal, Newborn, Child and Adolescent Health at the UN World Health Organization (WHO), which launched the campaign together with the UN Children’s Fund (UNICEF).

“But as countries like Bangladesh, Cambodia, Ethiopia, Malawi, Pakistan and Tanzania are already showing, it makes good health sense and good economic sense to integrate those strategies more closely,” she added of the initiative, which could reach its annual target of two million lives saved as early as 2015.

The Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea is premised on the fact that richer countries have already shown that common elements, such as good nutrition and a clean environment, are crucial in reducing infections and deaths from both diseases.

New vaccines are also being introduced to protect children from both and good access to health services and the right medicines can ensure they get the treatment they need, but existing efforts in low- and middle-income countries have yet to capitalize on these common elements.

“This is a question of equity. Poor children in low-income countries are most at risk of death from pneumonia or diarrhoea but much less likely to get the interventions they need,” said Mickey Chopra, global head of UNICEF’s health programmes. “We know what to do. If, in the 75 countries with the highest death rates, we apply to the entire population the same coverage of essential interventions enjoyed by the richest 20 per cent of households, we can prevent the deaths of two million children even as soon as 2015, the deadline for the Millennium Development Goals (MDGs).”

The MDGs, adopted at the UN Millennium Summit in 2000, seek to slash a host of social ills, including global poverty and hunger, disease, and lack of access to health and education, all by 2015.

The Action Plan sets clear goals to achieve by 2025: a 75 per cent reduction in incidence of severe pneumonia and diarrhoea from 2010 levels among children under five, and the virtual elimination of deaths from both diseases in the same age-group. It also aims for a 40 per cent reduction in the global number of children under five who are stunted.

The Action Plan’s targets are significantly higher than current levels. For example, it calls for 90 per cent of all children to have access to antibiotics for pneumonia and oral rehydration salts for diarrhoea, up from current levels of 31 and 35 per cent respectively.

As an interim target, at least half of all children under six months should be exclusively breastfed, against 2012 levels of 39 per cent. All children should have access to improved sanitation and safe drinking water, from 63 and 89 per cent respectively; and, building on the progress already made in some countries in introducing new vaccines against pneumococcal bacteria and rotavirus, it aims for 90 per cent coverage by the target date.