Argentina Train Crash Kills Dozens and Injures 600

The train, which runs from the ring of urban areas that surround greater Buenos Aires, crashed at about 8:30 a.m. at its final stop at the Once Station, not far from downtown Buenos Aires.

The train was carrying more than 800 passengers and traveling at an estimated 16 miles per hour when it entered the station, slamming into the barrier of the platform, destroying the engine.

“It is a very serious accident,” Juan Pablo Schiavi, the national secretary of transportation, said in his initial assessment of the crash during a televised press conference outside the Once Station. Mr. Schiavi said brake failure was the suspected cause.

“The train hit the bumper,” Mr. Schiavi said, “causing one car to crumple into another.”

He said one car pierced into another by nearly 20 feet.

The injured were taken to hospitals in the vicinity, Dr. Alberto Crescenti, head of the state emergency medical system, said on Argentine television on Wednesday. He said around midday that about 30 people were trapped in the wreckage.

Passengers told the local news media that the train, which is operated by the private company Trenes de Buenos Aires, was traveling faster than normal and had struggled to slow down when braking at stations ahead of Once Station.

Trenes de Buenos Aires said in a statement that the reasons for the crash had not been determined, though the company acknowledged that the train “wasn’t able to stop.”

Video footage of the crash taken by people at the scene showed people walking along the platform, with screams audible. People were pulling others out of the wreckage.

“I saw a lot of people bleeding and some who were trapped,” said one survivor, a 23-year-old woman, quoted by the newspaper Clarín.

Last September, a commuter train on the same line crashed into a passenger bus and hit a second train at the Flores Station, killing 11 and injuring more than 200. The bus had crossed the tracks when the barrier was down. In February 2011, four people were killed in a collision of two trains.

The newspaper La Nación said the accident was the third-deadliest in Argentina’s history, surpassed only by a 1972 collision that killed 142 people and a 1978 accident involving trains and other vehicles that left 55 dead.

Charles Newbery reported from Pinamar, Argentina, and Simon Romero from Rio de Janeiro.

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Hepatitis C Now Kills More Americans Than HIV

MONDAY, Feb. 20 (HealthDay News) -- Deaths from hepatitis C have increased steadily in the United States in recent years, in part because many people don't know they have disease, a new government report says.

More Americans now die of hepatitis C than from HIV, the AIDS-causing virus, according to 1999-2007 data reviewed by the U.S. Centers for Disease Control and Prevention (CDC). And most of those dying are middle-aged.

"These data underscore the urgent need to address the health threat posed by chronic hepatitis B and C in the United States," said investigator Dr. Scott Holmberg, chief of the Epidemiology and Surveillance Branch in CDC's Division of Viral Hepatitis.

About 3.2 million Americans are infected with hepatitis C, a major cause of liver cancer and cirrhosis, the CDC authors said. An estimated one-half to three-quarters of infected adults are unaware they have the disease, which progresses slowly.

Hepatitis C is spread through injection drug use, from blood transfusions received before routine blood-screening began in 1992, and through sexual contact. In some cases, it passes from mothers to infants.

"Chronic hepatitis is a leading and preventable cause of premature death in the United States," Holmberg said. "Over time, leaving viral hepatitis untreated can lead to costly care and treatments, and lifetime costs can total hundreds of thousands of dollars. However, early detection and intervention can be cost-effective and save lives."

The new study highlights the need to increase hepatitis awareness and the critical importance of testing, Holmberg said. Screening will increase diagnoses and treatment, thereby reducing hepatitis-related deaths, he said.

The report is published in the Feb. 21 issue of the Annals of Internal Medicine.

Using death records from 1999 to 2007, researchers collected data on some 22 million Americans, looking for those who died from hepatitis B, C and HIV.

The investigators found deaths from hepatitis C surpassed deaths from HIV (15,000 from hepatitis C versus 13,000 from HIV). They also found that deaths from hepatitis C and B are mostly among the middle-aged.

"Seventy-three percent of hepatitis C deaths were reported among those 45 to 64 years old," Holmberg said. "As the population living with hepatitis C in the United States -- 66 percent of whom were born between 1945 and 1964 -- has aged and entered a high-risk period of life for hepatitis C-related disease, deaths associated with hepatitis C have increased substantially."

Vaccines exist for hepatitis B, but not for hepatitis C. If current trends continue, by 2030 deaths from hepatitis C are expected to reach 35,000 a year, researchers say.

According to Dr. Eugene Schiff, director of the Center for Liver Diseases at the University of Miami Miller School of Medicine, "the study is important because it documents and authenticates what we knew." But, "what we need right now, particularly for hepatitis C, is routine screening," noted Schiff, who was not involved with the study.

Dramatic changes are under way in the treatment of hepatitis C, he pointed out. Current treatment involves a cocktail of drugs, including antivirals and interferon, which many people cannot tolerate.

In about two years, interferon-free treatment will be available, Schiff said. This means higher cure rates with fewer side effects, which will make treatment tolerable by most patients, he explained.

"What's going to happen is what happened with HIV -- test and treat," Schiff said. "Patients will be given an interferon-free regimen with cure rates approaching 100 percent," he predicted.

Another study in the same journal issue found that the most up-to-date treatment for hepatitis C can cost $60,000, but may be cost-effective, according to Stanford University health policy researchers.

In a study led by Jeremy Goldhaber-Fiebert, an assistant professor of medicine at the School of Medicine, investigators developed a computer model to assess the cost-effectiveness of a new treatment for hepatitis C. Their model showed that for people with advanced disease the cost was justified in terms of results.

The treatment involves use of two drugs called protease inhibitors -- boceprevir (brand name Victrelis) and telaprevir (brand name Incivek) -- in addition to interferon and an antiviral.

While the new treatment is expensive and may cause side effects, it could reduce patients' risks for cancer and liver transplants, thereby avoiding those costly events and possibly helping patients live longer, better lives, the researchers pointed out in a journal news release.

Yet another study in the journal recommends one-time screening of all those born between 1945 and 1965, instead of waiting until symptoms appear.

More information

For more information on hepatitis, visit the U.S. Centers for Disease Control and Prevention.

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In Mexico, Prison Riot Kills at Least 44 People

The authorities in Mexico’s Nuevo León State said a confrontation between inmates in two cellblocks broke out around 2 a.m. Sunday and lasted a few hours before the state and federal police could bring the prison, in Apodaca, under control.

Jorge Domene, a spokesman for the state government, said it appeared that members of Los Zetas and the Gulf Cartel, two of Mexico’s most powerful criminal groups, started the fight as part of a power struggle, using sharp objects, stones and clubs. He said firearms were not used.

The riot was the deadliest in a recent series of prison riots, including those in which 31 people died last month in Tamaulipas State and 20 were killed there in October. In Durango State, 23 people were killed in 2010.

Deadly rioting is commonplace in Mexican and Central American prisons as a drug war rages among criminal groups and government forces, filling prisons and jails well beyond their capacity. Local news reports said that the prison in Apodaca held 3,000 inmates but was built for 1,500.

Harsh overcrowding played a role in the fire last week that killed 359 people at a prison in central Honduras; it was one of the deadliest prison fires anywhere in decades. Officials were investigating the cause, including the possibility that an inmate had set fire to a mattress.

That prison held more than 850 inmates, twice its capacity. As in Mexico, many prisoners were being held on drug charges in a country overrun by drug-trafficking gangs shipping cocaine to the United States and beyond.

Supervisors at the prison in Mexico were being held as part of the investigation, which Mr. Domene said would also determine whether guards took part.

In other prisons, inmates have been known to bribe guards for parties, drugs, prostitutes, cellphones, TVs, even their freedom.

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Prison Fire Kills More Than 300 in Honduras

Outside the fence, hundreds of relatives rushed the gates of the burned-out prison on Wednesday, anguished and anxious for any word, clashing with soldiers and the police when they could not get in. As a prison officer stood on a balcony, reading out a roll call of the dead and survivors from a handwritten list, faces in the crowd turned away in tears.

It was one of the worst prison fires in recent years in Latin America, with a death toll surpassing 300, most of the victims choking to death in their cells awaiting a rescue that never came. Guards with the keys were nowhere to be found, rescuers said. Some inmates bashed their way through the roof to escape, and kept running. They are now fugitives.

Honduran prisons are rife with overcrowding, rioting and abuse on a normal day, but on Tuesday night, when officials say an inmate set fire to his mattress, things turned unimaginably worse, and this nation, already sinking into turmoil from a wave of drug trafficking, was staggered by yet another crisis.

Honduras has the highest murder rate in the world, according to the United Nations. The country’s institutions are still recovering from a 2009 coup. The police are committing assassinations. Criminal groups are extorting and kidnapping almost at will. The Peace Corps has withdrawn over concerns about crime. And the nation’s prisons are so overwhelmed that in 2010 the government declared a state of emergency in the system, acknowledging that nearly half of its prisons did not meet the minimum requirements for penitentiaries.

“This horrendous tragedy is the result of prison conditions that are symptomatic of the country’s larger public security crisis,” said José Miguel Vivanco, director of the Americas division of Human Rights Watch. Given the violence gripping the nation, he added, “there’s huge pressure to lock up real and suspected criminals, and unfortunately almost no concern for these prisoners’ well-being.”

Survivors recounted horrific scenes of companions ablaze and people trapped in their cells after the fire, the third major prison disaster in the country since 2003, broke out and burned out of control for 40 minutes before the first rescuers arrived around 11:30 p.m.

“We were asleep when we suddenly heard the screams of people on fire,” said a survivor interviewed on the Televicentro television network outside the prison, where a proverb over the entrance reads, “Let justice be done even if the world perishes.”

Family members, many of whom rushed to the prison in their pajamas, agonized throughout the day. The eight children of José Alejandro Morales gathered in a circle outside the prison’s gates early Wednesday waiting for an answer. Mr. Morales, who was sent to the prison two years ago on an armed robbery charge, was not on the list of survivors, nor had he been confirmed dead.

Then, around 2:30 p.m., a fresh list of the dead began to circulate, and the children fell to their knees.

“Our lives are ruined,” said Doris Morales, a daughter, after hearing his name. “He may have deserved to be punished, but he did not deserve this.”

The bodies of many other prisoners had been incinerated, making identification nearly impossible. Inside the prison’s gates, the thud of hundreds of black body bags being dropped at the entrance by military personnel broke the afternoon air. The bags screeched as they were dragged along a gravel road, then heaved into the back of a truck, ready to be taken to the morgue.

Honduran prisons, like many in Central America, are notorious for overcrowding and violence, a problem made worse as drug gangs have overrun the nation and set up staging grounds to move cocaine from South America to the United States.

A United Nations report in October said that Honduras had the highest murder rate in the world, at 82.1 per 100,000 residents, far ahead of the worldwide rate of 6.9. President Porfirio Lobo last week accepted a technical adviser on security sent by the United States government to help control the violence and impunity.

While Latin American prisons in general are susceptible to fires and rioting, the problem in Honduras is particularly serious, according to human rights groups and other monitors.

Karla Zabludovsky contributed reporting.

This article has been revised to reflect the following correction:

Correction: February 17, 2012

A picture supplied by Reuters for an article on Thursday about a deadly fire in a Honduran prison was published in error. The news agency said on Thursday that it had removed from circulation the photograph showing two rows of prisoners’ bodies lying on the ground because it believed the picture was taken in 2004 after another prison fire in Honduras, and not after the fire on Wednesday. (Reuters also recalled four other pictures thought to be from the 2004 fire. The Times did not publish any of those.)

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Malaria kills twice as many as thought: study

LONDON (Reuters) - Malaria kills more than 1.2 million people worldwide a year, nearly twice as many as previously thought, according to new research published on Friday that questions years of assumptions about the mosquito-borne disease.

Past studies had overlooked hundreds of thousands of deaths because they had wrongly assumed malaria overwhelmingly killed babies and focused their findings on under-fives, said the study by the Institute for Health Metrics and Evaluation (IHME) in the United States.

The new study, published in The Lancet medical journal, found 42 percent of deaths were actually among older children and adults.

The higher number of victims showed the need to increase funding to fight malaria, even as governments came under pressure to cut their aid budgets amid the global economic crisis, said the researchers.

"You learn in medical school that people exposed to malaria as children develop immunity and rarely die from malaria as adults," said Christopher Murray, who led the study as IHME Director. "What we've found in hospital records, death records, surveys and other sources shows that just is not the case."

In their work, which used new data and computer modelling to build a historical database for malaria between 1980 and 2010, they found that more than 78,000 children aged five to 14, and more than 445,000 people aged 15 and older died from malaria in 2010. This means more than four in 10 of all malaria deaths were in people aged fives years and older.

Overall, malaria deaths worldwide rose from 995,000 in 1980 to a peak of 1.8 million in 2004, before falling again to 1.2 million in 2010, the study found.

The World Health Organisation's (WHO) latest global report said the estimated number of malaria deaths fell to 655,000 in 2010, almost half the number in the IHME study.

The WHO, a United Nations agency, said on Friday it stood by its figures and said that much of the data used in the Lancet study had been based on verbal testimony by relatives of how people had died, not on laboratory diagnosis of samples.

"So we would say that again the great majority of deaths would be in children under five and we stand by our estimates," WHO spokesman Gregory Hartl told a news briefing in Geneva.

Both studies showed a downward trend in deaths in recent years, thanks largely to the use of anti-malaria drugs and insecticide-treated bed nets.

The new findings are part of an ongoing series generated by the Global Burden of Diseases, Injuries and Risk Factors 2010 Study. Global trends in child deaths, maternal deaths, breast cancer, and cervical cancer were released last year

and more will be released in coming months.

Malaria is endemic in more than 100 countries worldwide but can be prevented by the use of bed nets and indoor spraying to keep the mosquitoes that carry the disease at bay.

Effective malaria drugs known as artemisinin-based combination therapies, or ACTs, can cure the infection but access to these medicines is often hampered in poor countries, where funding is limited and health services are patchy.

The IHME researchers said much of the decline in deaths was down to efforts by the Global Fund to Fight AIDS, Malaria and Tuberculosis, which was launched in 2001, and other anti-malaria organisations such as the WHO's Roll Back Malaria campaign.

"We have seen a huge increase in both funding and in policy attention given to malaria over the past decade, and it's having a real impact," said Alan Lopez of the University of Queensland and one of the study's co-authors.

"Reliably demonstrating just how big an impact is important to drive further investments... This makes it even more critical for us to generate accurate estimates for all deaths."

The researchers also warned, as the WHO did in its December 2010 malaria report, that recent gains in the fight against the disease malaria could be reversed if global economic troubles stifle funding efforts.

It said an announcement by the Global Fund in November that it would cancel its next round of funding "casts a cloud over the future of malaria programs".

"If the Global Fund is weakened, the world could lose 40 percent of all the funding dedicated to fighting malaria," said Stephen Lim, also at IHME and a co-author on the study.

View the original article here

Malaria kills twice as many as thought: study

LONDON (Reuters) - Malaria kills more than 1.2 million people worldwide a year, nearly twice as many as previously thought, according to new research published on Friday that questions years of assumptions about the mosquito-borne disease.

Past studies had overlooked hundreds of thousands of deaths because they had wrongly assumed malaria overwhelmingly killed babies and focused their findings on under-fives, said the study by the Institute for Health Metrics and Evaluation (IHME) in the United States.

The new study, published in The Lancet medical journal, found 42 percent of deaths were actually among older children and adults.

The higher number of victims showed the need to increase funding to fight malaria, even as governments came under pressure to cut their aid budgets amid the global economic crisis, said the researchers.

"You learn in medical school that people exposed to malaria as children develop immunity and rarely die from malaria as adults," said Christopher Murray, who led the study as IHME Director. "What we've found in hospital records, death records, surveys and other sources shows that just is not the case."

In their work, which used new data and computer modelling to build a historical database for malaria between 1980 and 2010, they found that more than 78,000 children aged five to 14, and more than 445,000 people aged 15 and older died from malaria in 2010. This means more than four in 10 of all malaria deaths were in people aged fives years and older.

Overall, malaria deaths worldwide rose from 995,000 in 1980 to a peak of 1.8 million in 2004, before falling again to 1.2 million in 2010, the study found.

The World Health Organisation's (WHO) latest global report said the estimated number of malaria deaths fell to 655,000 in 2010, almost half the number in the IHME study.

The WHO, a United Nations agency, said on Friday it stood by its figures and said that much of the data used in the Lancet study had been based on verbal testimony by relatives of how people had died, not on laboratory diagnosis of samples.

"So we would say that again the great majority of deaths would be in children under five and we stand by our estimates," WHO spokesman Gregory Hartl told a news briefing in Geneva.

Both studies showed a downward trend in deaths in recent years, thanks largely to the use of anti-malaria drugs and insecticide-treated bed nets.

The new findings are part of an ongoing series generated by the Global Burden of Diseases, Injuries and Risk Factors 2010 Study. Global trends in child deaths, maternal deaths, breast cancer, and cervical cancer were released last year

and more will be released in coming months.

Malaria is endemic in more than 100 countries worldwide but can be prevented by the use of bed nets and indoor spraying to keep the mosquitoes that carry the disease at bay.

Effective malaria drugs known as artemisinin-based combination therapies, or ACTs, can cure the infection but access to these medicines is often hampered in poor countries, where funding is limited and health services are patchy.

The IHME researchers said much of the decline in deaths was down to efforts by the Global Fund to Fight AIDS, Malaria and Tuberculosis, which was launched in 2001, and other anti-malaria organisations such as the WHO's Roll Back Malaria campaign.

"We have seen a huge increase in both funding and in policy attention given to malaria over the past decade, and it's having a real impact," said Alan Lopez of the University of Queensland and one of the study's co-authors.

"Reliably demonstrating just how big an impact is important to drive further investments... This makes it even more critical for us to generate accurate estimates for all deaths."

The researchers also warned, as the WHO did in its December 2010 malaria report, that recent gains in the fight against the disease malaria could be reversed if global economic troubles stifle funding efforts.

It said an announcement by the Global Fund in November that it would cancel its next round of funding "casts a cloud over the future of malaria programs".

"If the Global Fund is weakened, the world could lose 40 percent of all the funding dedicated to fighting malaria," said Stephen Lim, also at IHME and a co-author on the study.

View the original article here

Malaria kills twice as many as thought - study

LONDON (Reuters) - Malaria kills more than 1.2 million people worldwide a year, nearly twice as many as previously thought, according to new research published on Friday that questions years of assumptions about the mosquito-borne disease.

Past studies had overlooked hundreds of thousands of deaths because they had wrongly assumed malaria overwhelmingly killed babies and focused their findings on under-fives, said the study by the Institute for Health Metrics and Evaluation (IHME) in the United States.

The new study, published in The Lancet medical journal, found 42 percent of deaths were actually among older children and adults.

The higher number of victims showed the need to increase funding to fight malaria, even as governments came under pressure to cut their aid budgets amid the global economic crisis, said the researchers.

"You learn in medical school that people exposed to malaria as children develop immunity and rarely die from malaria as adults," said Christopher Murray, who led the study as IHME Director. "What we've found in hospital records, death records, surveys and other sources shows that just is not the case."

In their work, which used new data and computer modelling to build a historical database for malaria between 1980 and 2010, they found that more than 78,000 children aged five to 14, and more than 445,000 people aged 15 and older died from malaria in 2010. This means more than four in 10 of all malaria deaths were in people aged five years and older.

Overall, malaria deaths worldwide rose from 995,000 in 1980 to a peak of 1.8 million in 2004, before falling again to 1.2 million in 2010, the study found.

The World Health Organisation's (WHO) latest global report said the estimated number of malaria deaths fell to 655,000 in 2010, almost half the number in the IHME study.

The WHO, a United Nations agency, said on Friday it stood by its figures and said that much of the data used in the Lancet study had been based on verbal testimony by relatives of how people had died, not on laboratory diagnosis of samples.

"So we would say that again the great majority of deaths would be in children under five and we stand by our estimates," WHO spokesman Gregory Hartl told a news briefing in Geneva.

Both studies showed a downward trend in deaths in recent years, thanks largely to the use of anti-malaria drugs and insecticide-treated bed nets.

The new findings are part of an ongoing series generated by the Global Burden of Diseases, Injuries and Risk Factors 2010 Study. Global trends in child deaths, maternal deaths, breast cancer, and cervical cancer were released last year [ID:nL5E7KF0NP] and more will be released in coming months.

Malaria is endemic in more than 100 countries worldwide but can be prevented by the use of bed nets and indoor spraying to keep the mosquitoes that carry the disease at bay.

Effective malaria drugs known as artemisinin-based combination therapies, or ACTs, can cure the infection but access to these medicines is often hampered in poor countries, where funding is limited and health services are patchy.

The IHME researchers said much of the decline in deaths was down to efforts by the Global Fund to Fight AIDS, Malaria and Tuberculosis, which was launched in 2001, and other anti-malaria organisations such as the WHO's Roll Back Malaria campaign.

"We have seen a huge increase in both funding and in policy attention given to malaria over the past decade, and it's having a real impact," said Alan Lopez of the University of Queensland and one of the study's co-authors.

"Reliably demonstrating just how big an impact is important to drive further investments... This makes it even more critical for us to generate accurate estimates for all deaths."

The researchers also warned, as the WHO did in its December 2010 malaria report, that recent gains in the fight against the disease malaria could be reversed if global economic troubles stifle funding efforts.

It said an announcement by the Global Fund in November that it would cancel its next round of funding "casts a cloud over the future of malaria programs.

"If the Global Fund is weakened, the world could lose 40 percent of all the funding dedicated to fighting malaria," said Stephen Lim, also at IHME and a co-author on the study.

(Additional reporting by Stephanie Nebehay in Geneva; Editing by Andrew Heavens)

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