Hugh Pennington

As a student at St Thomas’s Hospital, I used to walk the long ‘Nightingale’ wards – Florence Nightingale had not only founded its school of nursing but was influential in the design of the building – and learned to avoid prayer-time because the way out was obstructed by the line of ‘Nightingales’ kneeling at the door in order of seniority. And...

Cyclone Nargis struck Myanmar (let’s use the place names used by the World Food Programme) on 2 and 3 May, blasting the Ayeyarwady delta and the capital, Yangon. The population of the declared disaster areas – much of it the country’s granary – is about 13 million. About 1.5 million have been seriously affected. In many places houses, farming assets and food stores have been destroyed and the land ruined by saltwater.

The arrival of bluetongue in eastern England in the late summer of last year was not a surprise. There were large outbreaks of the virus among farm animals in Belgium and the Netherlands, close enough to Norfolk, Suffolk and Essex for these counties already to be designated at risk because it was known that the infection could be carried by wind over the sea for hundreds of kilometres. An...

Diarrhoea diminishes dignity. In the Western world most people don’t bother to seek medical advice for it, because they are embarrassed and because they expect it to go away soon. They are often right: most community-acquired intestinal infections are self-limiting and get better more quickly if left untreated. This is true even for E. coli O157. Taking antibiotics or antispasmodics is thought to increase the risk of developing the complications of kidney failure, brain damage and cardiac death. But Clostridium difficile is different. Treatment with special antibiotics often works well, but about 7 per cent still die. E. coli O157 outbreaks have much lower mortality rates and infections caused by it are much rarer. In England and Wales in 2005 there were 950 laboratory-confirmed cases; in that year Clostridium difficile caused 51,690 cases of disease and was mentioned on 3807 death certificates.