Alzheimer’s Disease – Alternate View for Pathology

A new paper from researchers at the Case Western Reserve University School of Medicine challenges the classic theory that
the nerve tangles seen in the brains of Alzheimer’s disease (AD) victims are the cause of the disease, but rather proposes
that they are a protective response to the disease. Their paper appears in the April issue of the journal Trends in Molecular

The tangles, called neurofibrillary tangles (NFTs) by scientists, are one of the major features seen in brains of people with
AD. The major component of NFTs is a protein called tau which has undergone a biochemical reaction called phosphorylation,
and it is widely assumed that NFTs are central to the progression of AD and nerve cell death. Yet these tangles also occur to
some extent in all brains with age although typically there are a lot more in the brains of people with AD.

“However, the correlation between the presence of NFTs and incidence of disease does not necessarily dictate a causal
relationship” said lead author, Hyoung-gon Lee, Ph.D., a research associate in the Department of Pathology at Case. “In fact,
since NFTs are produced in response to a variety of disease conditions, there is the distinct possibility that tau
phosphorylation has an alternate role in disease – one that proceeds rather than precedes it.”

So, what evidence is there to support a non-pathogenic role for NFTs in AD?

First of all, according to the researchers, tau phosphorylation or fibril formation itself is unlikely to be the harbinger of
neuronal death since NFT-bearing neurons appear to survive for decades. In fact, one study found that neurons containing NFTs
can survive for as long as 20 years.

Senior author, Mark A. Smith, Ph.D., professor of pathology at Case, noted, “These findings are in accord with our own
published findings showing that NFTs are not only a relatively late event in the chronology of the disease, occurring decades
after oxidative stress, but might also represent a response aimed at reducing oxidative damage.”

There is growing evidence that oxidative stress is a significant factor in the development of AD. Free radicals and reactive
oxygen species oxidize tissues. Rusting metal is a process of oxidization, for example. In tissue, oxidization damages
membranes and DNA, disrupting normal cell function and leading to nerve cell death.

“Since oxidative stress is decreased in neurons bearing NFTs,” Smith added, “we suspect that the accumulation of tau proteins
might actually be a protective, antioxidant response that serves as a mechanism for cells to defend themselves.”

While such a “good” role for tau phosphorylation goes against the grain of current dogma, Lee noted, “A protective role of
tau phosphorylation is further supported by the fact that embryonic neurons that survive after treatment with oxidants have
increased tau phosphorylation relative to those that die. It is also apparent that NFT-like tau phosphorylation occurs during
hibernation, a neuroprotective phenomenon.”

“Therefore, Smith added “the regulation of tau phosphorylation in the adult mammalian brain appears to represent a naturally
occurring process associated with neuroprotective mechanisms.” In support of this, previous work by Smith’s group found that
cellular antioxidant induction and tau expression are opposing, suggesting that the reduced oxidative damage in neurons
showing tau accumulation may be a direct consequence of an antioxidant function of phosphorylated tau.

This group’s alternate view of protein aggregation in AD is not limited to NFTs. Lee, Smith and colleagues also believe that
amyloid-beta, another aggregated protein found in AD, could play a key role in protecting neurons and, like NFTs, be an

And they are not alone. Recently, it was reported by another research group that the protein aggregates associated with
Huntington’s disease are associated with increased cell survival.

“After nearly a century of viewing pathology as pathogenic, our accumulating data called for a paradigm shift where pathology
is protective,” said Lee. “If proven correct, this will not only change current dogma but, more importantly, reveal key
insights to accelerate the development of new therapeutic inroads.”

In addition to Lee and Smith, co-authors represented the key contributions and insights of a decade-long team-effort by
current (George Perry, Ph.D., Matthew R. Garrett, Paula Moreira, and Xiongwei Zhu, Ph.D.) and former members (Quan Liu,
Ph.D., Atsushi Takeda, Ph.D., and Akihiko Nunomura, Ph.D.) of the Institute of Pathology at Case.

Contact: George Stamatis
Case Western Reserve University

Mediterranean Diet May Help Alzheimer’s Patients Live Longer

A Mediterranean diet may help people with Alzheimer’s disease live longer than patients who eat a more traditional Western diet. The study is published in the September 11, 2007, issue of Neurology, the medical journal of the American Academy of Neurology.

The study followed 192 people with Alzheimer’s disease in New York for an average of four and a half years. During that time, 85 of the people died. Researchers found that those who most closely followed a Mediterranean diet were 76 percent less likely to die during the study period than those who followed the diet the least.

“The more closely people followed the Mediterranean diet, the more they reduced their mortality,” said study author Nikos Scarmeas, MD, MSc, of Columbia University Medical Center in New York, and member of the American Academy of Neurology. “For example, Alzheimer’s patients who adhered to the diet to a moderate degree lived an average 1.3 years longer than those people who least adhered to the diet. And those Alzheimer’s patients who followed the diet very religiously lived an average four years longer.” Previous research by Scarmeas and his colleagues demonstrated that healthy people who eat a Mediterranean diet lower their risk of developing Alzheimer’s disease. Studies have also shown that healthy people who follow a Mediterranean diet live longer than those who eat a more traditional Western diet, higher in saturated fat and meats and lower in fruits and vegetables.

“New benefits of this diet keep coming out,” said Scarmeas. “We need to do more research to determine whether eating a Mediterranean diet also helps Alzheimer’s patients have slower rates of cognitive decline, maintain their daily living skills, and have a better quality of life.”

The Mediterranean diet includes a high intake of vegetables, legumes, fruits, cereals, fish, monounsaturated fatty acids; a low intake of saturated fatty acids, dairy products, meat and poultry; and a mild to moderate amount of alcohol.

The study was supported by grants from the National Institute on Aging and the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain at Columbia University.

The American Academy of Neurology, an association of more than 20,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer’s disease, epilepsy, Parkinson’s disease, and multiple sclerosis.

American Academy of Neurology

Rheumatoid Arthritis Doesn’t Hinder Computing Skills

A recent study by researchers from the University of Pittsburgh found that workers with rheumatoid arthritis (RA) were comparable to non-impaired individuals in keyboarding speed. Individuals who were trained in touch typing demonstrated faster typing speeds than those using a visually-guided (“hunt and peck”) method, regardless of impairment. Researchers also noted slightly impaired mouse skills in workers with RA. Results of this study appear in the February issue of Arthritis Care & Research, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology.

According to the U.S. Census Bureau the number of workers using computers increased from 46% in 1993 to 56% in 2003 with figures expected to continue climbing higher. For workers with RA the capacity to use computers may be limited by impairment in hand range of motion (ROM) and strength caused by inflammation of their joints due to the disease. Prior studies have shown that workers with RA have higher rates of work disability, premature work cessation, and reduced hours on the job.

“With more arthritic workers using computers, understanding the associations between hand function impairment and peripheral device (keyboard and mouse) limitations is essential and the focus of our current study,” said lead author Nancy Baker, Sc.D., MPH, OTR/L. Researchers recruited 45 participants from the University of Pittsburgh Medical Center (UPMC) Arthritis Network Registry for the study. Those subjects enrolled had an average age of 55, were primarily white females, and had RA for 17 years. Half of all participants worked full or part-time, with 100% of this group using computers at work.

Hand function was assessed using the Keitel Hand Function Index (KHFI) and the Arthritis Hand Function Test (AHFT). The KHFI included 11 performance test items to measure active ROM of the thumb, fingers, writs, forearms and elbows. The AHFT consisted of 10 test items to evaluate pure and applied strength and dexterity in a variety of hand tasks. Participants’ abilities to use a standard keyboard and mouse were measured using the Assessment of Computer Task Performance (ACTP).

The research team found that 73% of participants were trained in touch typing and used the computer an average of 18 hours per week. Regression models suggested that keyboarding speed was significantly associated with touch typing training and age. Mouse speed was significantly associated with age only, with younger participants demonstrating faster speeds than older subjects. Impairments in hand function were associated with 2 of 7 keyboarding tasks and no mouse tasks. “Our research suggests that if individuals with motor impairments have the capacity to learn touch typing it may increase their overall speed,” noted Dr. Baker.

Researchers further compared the current study group results with an impaired and non-impaired subject group from a normative study by Dumont et al to benchmark ACTP. “We found that our RA workers had similar keyboarding speed compared with the non-impaired sample,” Dr. Baker stated. “However, we found that mouse speed was much slower in some participants in our RA sample.” Task-specific training for mouse use is not available and the reduced productivity with this device has the potential to place computer using workers with RA at risk for work disability. “Further research is needed to identify effective strategies to maintain productivity in computer users with RA,” concluded Dr. Baker.

Article: “Association Between Computer Use Speed and Age, Impairments in Function, and Touch Typing Training in People With Rheumatoid Arthritis.” Nancy A. Baker and Joan C. Rogers. Arthritis Care and Research; Published Online: January 28, 2010 (DOI: 10.1002/acr.20074); Print Issue Date: February 2010.

Dawn Peters

USDA To Assess Impact Of Midwest Flooding On 2008 Crop Acreage

The U.S. Department of Agriculture’s National Agricultural Statistics Service (NASS) is taking several steps to assess the impact on the 2008 crop acreage from the impact of the extraordinary rainfall and flooding in the Midwest.

NASS will release the 2008 Acreage report as scheduled on June 30 at 8:30 a.m. EDT. However, NASS collected most of the acreage data during the first two weeks of June, before the majority of the flooding occurred.

In the Acreage report, NASS will use standard procedures to estimate planted area. But in an effort to more accurately determine how much of the planted area will actually be harvested for grain, NASS will re-interview producers during the week of June 23 in affected areas of Illinois, Indiana, Iowa, Minnesota, Missouri and Wisconsin. This will provide additional information about producers’ harvesting intentions for corn, soybeans and sorghum.

However, because some producers might be difficult to contact or still could be assessing their options, NASS will conduct a more extensive update of planted and harvested acreage in July in the impacted areas. This information along with data normally collected from across the country during this time will be reflected in the August 12 Crop Production report.

For more information about USDA’s response and efforts in the Midwest, go to usda/safety.


Educational Home Visits Can Improve Asthma In Children, Study Suggests

A few home visits by a health care specialist to educate children with asthma about basic strategies for earlier symptom recognition and improving medication use can lead to fewer flare-ups and less frequent trips to the ER, according to research from Johns Hopkins Children’s Center published in the December issue of Pediatrics.

An estimated 6.5 million children in the United States have asthma, which is the leading pediatric chronic illness in this country and disproportionately affects minorities.

“We compared several strategies to improve asthma control among children and, much to our delight, we found that taking a few simple steps can go a long way toward doing so,” says senior investigator Kristin Riekert, Ph.D., a pediatric psychologist at Hopkins and co-director of the Johns Hopkins Adherence Research Center.

Researchers say the key is providing regular asthma education that includes:

– in-the-home demonstration and training on the proper use of inhalers by an asthma specialist and a discussion with the family about regular access to a pediatrician, ensuring they have access to one

– an asthma action plan specifically tailored to each child with a list of must-take daily controller medication to keep inflammation at bay, a checklist of what to do when symptoms start and when to seek emergency care.

Researchers compared the effectiveness of three different strategies in 250 African-American children with asthma who ended up in the ER with an asthma attack. One group received a booklet with basic asthma information the standard and usual care. The other two groups received educational home visits by asthma educators, with one group receiving education only, and the other receiving education plus feedback on how well the patient was following their medication instructions, which researchers determined by a monitoring device on the child’s inhaler to record each use, as well as coaching on how to improve adherence.

Follow-ups at six, 12 and 18 months showed that:

Children in the two groups that received home visits and whose medication use was monitored had 15 percent fewer trips to the ED compared to children who got the standard care. They also had a 52 percent faster rate of refill of inhaled corticosteroids, daily controller medication that helps keep inflammation at bay.

Children who got educational home visits reported on average fewer symptoms per month compared to children who received the informational booklet.

Children who got the informational pamphlet the standard of care had 12 percent more ED visits and 17 percent higher use of oral corticosteroids, a marker of an asthma flare-up, when compared to children from the other two groups.

There was no added value in providing medication monitoring and feedback above providing at-home educational visits alone.

There was no significant difference in the number of hospitalizations among the three groups.

The National Heart, Lung and Blood Institute funded the research.

Lead author Michiko Otsuki, Ph.D., a Hopkins behavioral medicine fellow at the time of the study, is currently at the University of South Florida St. Petersburg. Other Hopkins investigators in the study included Michelle Eakin, Ph.D.; Arlene Butz, Sc.D.; Cynthia Rand, Ph.D., Jean Ogrborn, M.D., and Andrew Bilderback, M.S. University of Maryland co-investigators: Van Doren Hsu, Pharm.D., and Illene Zuckerman, Pharm.D.

Source: Johns Hopkins Medicine

More Frequent Check-Ups Urged For Urban Kids With Asthma

Because even mild asthma among young inner-city children appears to be more unpredictable than ever, four or more check-ups a year after diagnosis is a wise move as a hedge against dangerous flare-ups of wheezing and trips to the emergency room, according to a study from the Johns Hopkins Children’s Center. Current asthma guidelines call for follow-up of one to six months after diagnosis, but six months may be too long for many patients, researchers report in the November issue of Pediatrics.

Hopkins Children’s researchers studied 150 Baltimore City asthmatic children 2 to 6 years of age and were “surprised” to find that nearly half of those with the mildest asthma at their first visit had worsening symptoms as early as three months later. The changes were so serious that they required either new drugs or new doses.

“We know asthma is an unstable disease, but we underestimated just how unpredictably it could behave over time, especially in inner-city kids,” said researcher Hemant Sharma, M.D., a pediatric allergist at Hopkins Children’s. “Doctors and parents need to be more vigilant and schedule at least three-month check-ups even if the child appears to be doing fine.”

The findings also suggest that pediatricians should shift their focus away from disease severity at diagnosis to disease control.

“Asthma control appears to be a better barometer of a child’s risk for a flare-up than is initial assessment of symptoms, a staple that many doctors use as their yardstick for treatment and follow-up,” said lead investigator Gregory Diette, M.D., M.H.S., a lung specialist at the Johns Hopkins School of Medicine.

Asthma is the most common pediatric chronic illness, affecting 6.2 million children in the United States. Severe illness is most prevalent in inner-city children, doctors say, because of pollution, poor access to regular health care and disproportionate exposure to allergens like mice and cockroaches as well as to dust, cigarette smoke and automobile fumes.

In the study, researchers found that children with poorly controlled disease were two to three times more likely than those with good control to end up at the doctor’s office or in the emergency department with bad asthma symptoms in the three months following diagnosis.

The Hopkins scientists defined four levels of asthma control — mild intermittent, mild persistent, moderate persistent and severe persistent — determined by the frequency of coughing, wheezing, shortness of breath, waking up at night, use of rescue medications to stop an asthma attack and limitations on physical activity.

How often children needed medical attention for their symptoms varied greatly from one level to the next, researchers found, and each higher level of severity doubled a child’s risk of emergency medical care.

The study was funded by the Environmental Protection Agency and the National Institutes of Health. Other investigators, all from Hopkins: Elizabeth Matsui, M.D. M.H.S.; Peyton Eggleston, M.D.; Nadia Hansel, M.D., M.P.H.; and Jean Curtin-Brosnan, M.A.

Founded in 1912 as the children’s hospital of the Johns Hopkins Medical Institutions, the Johns Hopkins Children’s Center offers one of the most comprehensive pediatric medical programs in the country, treating more than 90,000 children each year. U.S. News & World Report ranks Hopkins Children’s among the top three children’s hospitals in the nation. Hopkins Children’s is Maryland’s only state-designated Trauma Service and Burn Unit for pediatric patients. It has recognized Centers of Excellence in 20 pediatric subspecialties including cardiology, transplant, psychiatric illnesses and genetic disorders. For more information, please visit: hopkinschildrens/

Source: Katerina Pesheva

Johns Hopkins Medical Institutions

Asthma many children may not grow out of it as has previously been assumed

Many children may not simply ‘grow out’ of asthma when they become teenagers, as has previously been widely assumed, according to a US study.

Doctors at the University of Arizona studied 781 children in the ‘Tucson Respiratory cohort’ – a group of children born at approximately the same time whose respiratory health has been tracked from birth by researchers.

They found that wheezing symptoms continued during adolescence in over half of the children who had asthma diagnosed before puberty. ‘Our findings challenge the commonly held view that asthma usually remits during adolescence,’ said Dr Stefano Guerra, who led the research. ‘Only 42% of children with asthma reported no wheezing in the first four years after the onset of puberty.’

Looking more closely at their results, the researchers found that obesity and the age at which puberty starts may play a part in determining whether a child ‘grows out’ of asthma or not in their teen years. Among the children who continued to experience asthma symptoms as adolescents, a disproportionate amount were overweight or had been younger to enter puberty. Being obese doubled the likelihood of a child having persistent asthma, said the scientists. ‘These findings expand our understanding of the relationship between obesity and asthma,’ said Dr Guerra.

‘This study reminds us that we shouldn’t assume that a child’s asthma will disappear as they grow up, but the link between asthma and obesity may not be quite so simple,’ said Kate Webb, Senior Policy & Information Officer at Asthma UK.

‘Asthma isn’t limited to overweight children,’ she added. ‘It would be interesting to know whether the teenagers in this study are obese as a result of their condition, which may be due to less exercise, or whether their obesity has caused their asthma,’ she added.

The research was published in the American Journal of Respiratory and Critical Care Medicine.

For advice and information on asthma, call the Asthma UK Adviceline (08457 01 02 03) or email an asthma nurse specialist.


Contact Lens Wearers Seek Relief From Spring Allergies

For millions of Americans, the arrival of Spring brings with it ocular allergy symptoms such as itching, tearing, and redness. Ocular allergies affect 1 in every 5 individuals and are among the most common reasons that people consult various health care professionals for advice on possible treatment and management. It is estimated that 50 percent of individuals with seasonal and indoor allergies also experience some degree of eye allergies.1,2

While eye allergy symptoms are a year-round problem for many, about 67 percent of allergy sufferers, say that Spring is the time of year when eye allergy symptoms are worst, according to a recent survey conducted by the Asthma & Allergy Foundation of America (AAFA), the leading patient advocacy organization for people with asthma and allergies. For respondents who wear contact lenses, Spring is particularly frustrating as nearly half (45%) say that their eye-related allergy problems often prevent them from wearing their contacts, and one in ten (12%) admits to having to stopped wearing their contacts because of allergies.

The majority of respondents report that they wear their lenses two weeks, one month or longer. In a recent study presented at the 87th annual meeting of The American Academy of Optometry, researchers reported that only about one-third (36%) of wearers of contact lenses prescribed for monthly replacement said that they replaced their lenses as prescribed. Over half (55%) replaced them within five weeks, 23 percent at eight weeks or more, and 14 percent at ten weeks or more.3

“As contact lenses age, they accumulate deposits that may impact the ocular surface,” explains Paul Karpecki, O.D., F.A.A.O., Clinical Director, Koffler Vision Group, Lexington, Kentucky. “Factor in the research that shows these patients are not being compliant with their wearing and replacement schedule, and it’s no surprise that many are experiencing ocular discomfort and distress. Certain care systems contain preservatives which may further exacerbate discomfort for some allergy sufferers.”

According to Dr. Karpecki, the use of one-day lenses can help minimize the discomfort of the contact lens-allergy combination. One study found that 67 percent of ocular allergy sufferers who switched to one-day lenses reported improved comfort while only 18 percent of those who simply replaced their conventional two-week daily wear soft contact lenses reported improvement.4

“Studies have shown that one-day contacts, such as 1???day acuvue® MOIST® Brand Contact Lenses can be a healthy and more comfortable option for any lens wearer, including those with eye allergies,” he explains. “By putting in a clean, fresh lens every day, one-day contacts minimize the potential for accumulation of allergens and irritants that can often accumulate with repeated use of the same pair of lenses.”

To help allergy sufferers better understand and manage their condition, AAFA offers a free educational brochure titled “Eye Health and Allergies.” The brochure, which also includes smart allergy season strategies for contact lens wearers, can be viewed or downloaded at aafa/eyeallergies. The brochure, along with a free trial-pair certificate* for 1???day acuvue® MOIST® Brand, is also available at acuvue/seasons.

ACUVUE® Brand Contact Lenses are indicated for vision correction. As with any contact lens, eye problems, including corneal ulcers, can develop. Some wearers may experience mild irritation, itching or discomfort. Lenses should not be prescribed if patients have any eye infection, or experience eye discomfort, excessive tearing, vision changes, redness or other eye problems. Consult the package insert for complete information. Complete information is also available from VISTAKON®, Division of Johnson & Johnson Vision Care, Inc., by calling 1-800-843-2020 or by visiting acuvue.

Clinical research has shown when worn on a daily disposable basis, 1???DAY ACUVUE® Brand Contact Lenses and other daily disposable etafilcon A contact lenses such as 1???DAY ACUVUE® MOIST® Brand Contact Lenses may provide improved comfort for many patients suffering from mild discomfort and/or itching associated with allergies during contact lens wear compared to lenses replaced at intervals of greater than 2 weeks.

*Professional exam and fitting fees not included. Valid only while supplies last.

1 Katelaris CH, Bielory L. Evidence-based study design in ocular allergy trials. Curr Opin Allergy Clin Immunol. 2008;8(5):484-488.

2Bassett C. Ocular Allergies. Asthma & Allergy Advocate. Summer 2007. American Academy of Allergy Asthma & Immunology Web site. aaaai/patients/advocate/~. Accessed November 3, 2008.

3 Hickson-Curran, Sheila, Chou, Patricia, Gardere, Jill, “Longer Prescribed Replacement Intervals leads to More Stretching of Frequent Replacement Contact Lenses”, presented at American Academy of Optometry Meeting, November 2009

4 “Hayes, VY, Schnider, CM and Veys, J. “An evaluation of 1-day disposable contact lens wear in a population of allergy sufferers,” CL & Ant Eye, 26 (2003) 85-93

ACUVUE® and 1???DAY ACUVUE® MOIST® are trademarks of Johnson & Johnson Vision Care, Inc.

The Asthma and Allergy Foundation of America

New Therapy For Asthma Is A Breath Of Fresh Air

Glucocorticoids, the treatment of choice for many people with asthma, boost production of the molecule IL-10, which helps decrease airway inflammation. However, some asthmatic patients are resistant to glucocorticoid therapy because their T cells do not produce IL-10 in response to these steroids. In a study appearing online on December 8 in advance of print publication in the January 2006 issue of the Journal of Clinical Investigation, Catherine Hawrylowicz and colleagues from King’s College London investigate IL-10-producing T cells in the context of human allergic and asthmatic disease.

The authors show that pre-treatment of patient T cells with IL-10 and vitamin D3 can overcome this defect and greatly enhance glucocorticoid-induced IL-10 synthesis by T cells from asthmatic patients who were resistant to glucocorticoid therapy. These manipulations increase IL-10 production to levels comparable to those observed in patients who do respond well to therapy. IL-10 increases glucocorticoid receptor expression, and the authors propose that this is the mechanism by which IL-10 overcomes the glucocorticoid-resistant patient defect in IL-10 synthesis. Therefore, this population of IL-10-producing T cells may help treat human allergic diseases and reverse glucocorticoid resistance in asthma.

TITLE: Reversing the defective induction of IL-10-secreting regulatory T cells in glucocorticoid-resistant asthma patients

View the PDF of this article at:

Brooke Grindlinger
Journal of Clinical Investigation – Dec 8th

UNICEF: Children And Women Displaced By Conflict In Pakistan Need Urgent And Ongoing Support

UNICEF is deeply concerned about the condition of thousands of children who have been displaced by conflict, or who remain in affected areas, in north-western Pakistan. Nearly 50 per cent of the estimated 2 million displaced are children, many of whom are in urgent need of health and educational services, nutritional support, access to clean water and sanitation as well as protection. Their situation has been compounded by the harsh summer temperatures.

UNICEF is especially concerned that some 700,000 children are due to start the new school year in September in 3,700 schools that are currently occupied by 150,000 IDPs. If these schools are not vacated and rehabilitated soon, the education of all these children will be interrupted. Some of these children could even drop out of the education system permanently.

The speed and magnitude of the crisis has stretched the capacity of the government, host communities and humanitarian actors to the limit. Though fighting is reported to have subsided in Swat and Buner, IDPs continue to seek refuge in camps and communities in northern parts of North West Frontier Province (NWFP) and new displacements are being recorded into southern parts of the province due to military operations in South Waziristan.

“In Pakistan we face a unique humanitarian challenge, since the vast majority of the displaced are seeking shelter in host communities which are far more difficult to reach with basic services than in the camps,” said UNICEF’s Director of Emergency Programmes, Louis-Georges Arsenault.

While basic needs are being met in camps, the situation is critical for the vast majority of IDPs living in host communities. In the thousands of school buildings that have been converted into IDP shelters and other spontaneous camps that have sprung up throughout parts of NWFP to cope with the influx of people from conflict-affected areas, children and families are living in cramped conditions with limited to negligible access to safe drinking water and sanitation – and are difficult to reach with basic hygiene materials and education to decrease the likelihood of water borne diseases. At equal risk are host communities who are shouldering the burden with limited resources and fragile infrastructure in the aftermath of food prices spikes that took root in 2007.

UNICEF is working closely with the government of Pakistan and other partners to provide services and information to displaced children and women. To prevent the outbreak of diseases, over 200,000 children have been vaccinated against measles and 230,000 people receive safe drinking water and hygiene education in IDP camps and communities. To date, 47,400 children and 20,400 mothers have been screened for malnutrition, and the 11,000 moderately malnourished have received care within their own communities. While malnutrition rates are presently low, the vulnerability of the population requires sustained support to prevent the situation from deteriorating rapidly.

The Pakistan Humanitarian Response Plan, revised in May to cope with new displacements caused by the military operations in Swat and Buner, has so far raised less than a third of the $543 million required to support 1.7 million IDPs for six months. As part of the Appeal, UNICEF requested $52 million. To date $22.5 million has been received from donors and is in hand -and another $9.3 million has been pledged.

“Without sufficient funding, it will be impossible to ensure that thousands of children and families affected by the conflict have the services and support they require in the time of their greatest need. Equally important is support to the host communities who are struggling to cope with their new found burden,” said Arsenault.