Podcasts about meningitis b

Meningitis B is a rare but deadly disease. At first, it looks like a case of the flu, but waiting to go to the hospital could prove to be a fatal mistake. Our experts share how this infection has impacted their own lives and the best prevention strategies for you and loved ones. Learn More: https://radiohealthjournal.org/its-not-rare-if-it-affects-your-child-prevention-strategies-for-meningitis-b Learn more about your ad choices. Visit megaphone.fm/adchoices

A mom in the Saint John area is hoping to raise awareness around the risks of Meningitis B, and the fact it's not part of routine vaccinations for kids in New Brunswick after her daughter was hospitalized. We hear from Julie Stewart and her daughter, Lindsay.

Send us a textOn this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole explore the ongoing public health concern of meningococcal disease, focusing on meningitis B outbreaks in Canadian universities. They are joined by Dr. Cristin Muecke, a medical officer of health in Halifax, and Dr. Savita Rani, a public health specialist at the University of Saskatchewan. The episode also features the personal story of Megan Plamondon, a Queen's University student who contracted invasive meningococcal disease.The discussion opens with a look at recent meningitis B outbreaks, including cases at Dalhousie University in 2022 and Queen's University in 2023. The Halifax outbreak led to a targeted vaccination effort offering publicly funded MenB vaccines to students in congregate living environments, such as dormitories and residences.Dr. Muecke provides insights into the Halifax outbreak and the public health response that followed. She discusses the complexities of identifying and controlling meningococcal disease in university settings, where asymptomatic carriers of Neisseria meningitidis can unknowingly contribute to the spread of the infection.Dr. Rani expands on the current state of MenB vaccination, explaining why the vaccine is not included in routine immunization schedules and outlining the challenges of securing broader vaccine coverage across the country. She emphasizes the importance of early detection, given that meningitis can present with nonspecific symptoms which complicates diagnosis.Megan Plamondon's story brings a lived experience perspective to the conversation, highlighting the severe impact of meningococcal disease and the critical need for prevention efforts, particularly among students entering congregated living environments for the first time.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Brian talks with actress, documentarian, and multi-generational icon, Soleil Moon Frye. Best known for her breakout role as the young Punky Brewster, Soleil reflects on Punky's continuing influence, how supportive family and close friends allowed her to have a childhood through the pressures of network success, and how an appreciation of the world brought her behind the camera and lead to the creation of her 2021 documentary film, Kid 90. The pair also cover Soleil's current work with the Ask2BSure campaign to raise awareness about the Meningitis B vaccine. More information can be found at www.Ask2BSure.com See omnystudio.com/listener for privacy information.

Patti Wukovits and Alicia Stillman, two mothers who each lost their young, healthy daughters too soon to a now vaccine-preventable disease, Meningitis B (known as MenB). High school senior Kimberly (Patti's daughter), 17, died one week before her graduation. College sophomore Emily (Alicia's daughter), 19, died just 36 hours after her first symptoms. Both Kimberly and Emily had received the MenACWY vaccine, the MenB vaccine was not yet available to help protect them from MenB.   In 2014, to educate the public about meningococcal meningitis and MenB vaccination, Patti and Alicia each established their own foundations named after their daughters. Both mothers have since joined forces under the Meningitis B Action Project to make sure other parents don't needlessly suffer the same fate.   The objective of the Meningitis B Action Project is to: Empower young adults (and their parents) with information to talk to their healthcare provider about Meningitis B and the vaccine that can help prevent it. Encourage healthcare providers to discuss Meningitis B and the MenB vaccine with their patients. Increase awareness of Meningitis B on high school, college and university campuses Engage policymakers to ensure broader access to the MenB vaccine. :: PODCAST LINKS :: For show notes, guest profiles, photos, blog and more information, visit AmbiguouslyBlind.com and connect on:    Instagram | Facebook | Twitter | Linkedin  Like what we're doing? Support us: Buy Me A Coffee This is a listener supported podcast.  Please consider donating to build and sustain our community  :: EPISODE LINKS :: Guest details:  Patti Wukovits: https://www.ambiguouslyblind.com/guests/patti-wukovits/ Alicia Stillman: https://www.ambiguouslyblind.com/guests/alicia-stillman/ Meningitis B Action Project: https://meningitisbactionproject.org/  The Kimberly Coffey Foundation: https://www.kimberlycoffeyfoundation.org/  The Emily Stillman Foundation: https://www.foreveremily.org/   

Actor / director / producer / documentarian Soleil Moon Frye trades notes with Heather about being a mom of four, sending your kids off to college, letting your kids be actors, the pros and cons of social media, taping her childhood and the creation of her recent Hulu documentary Kid 90, NEPO BABIES, and Soleil's work raising awareness of Meningitis B vaccinations with Ask2BSure.com Check out our great sponsors! Caraway: Visit Carawayhome.com/HDW to get 10% off your next purchase! Peloton: Try Peloton risk free with a 30 Day Home Trial, New Members only. Not available in remote locations. See additional terms at OnePeloton.com/home-trial

September 26, 2022 ~ The return of full college campuses returns the threat of outbreaks of Meningitis B, uncommon but fatal in many cases. Young adults comprise nearly all of Meningitis B cases in the US, and 100 percent of these cases have been on college campuses in the last decade. Our expert is Dr. Rhonda Gumma, a family physician with Trinity Health and the IHA Medical Group in Bloomfield Hills.

September 26, 2022 ~ The return of full college campuses returns the threat of outbreaks of Meningitis B, uncommon but fatal in many cases. Young adults comprise nearly all of Meningitis B cases in the US, and 100 percent of these cases have been on college campuses in the last decade. Our expert is Dr. Rhonda Gumma, a family physician with Trinity Health and the IHA Medical Group in Bloomfield Hills.

September 26, 2022 ~ The return of full college campuses returns the threat of outbreaks of Meningitis B, uncommon but fatal in many cases. Young adults comprise nearly all of Meningitis B cases in the US, and 100 percent of these cases have been on college campuses in the last decade. Our expert is Dr. Rhonda Gumma, a family physician with Trinity Health and the IHA Medical Group in Bloomfield Hills.

Jamie Schanbaum was a University of Texas student when she contracted meningitis in 2008. After two days in the hospital, Jamie was diagnosed with meningitis, and given only a twenty percent chance of survival. Jamie ultimately was faced with the difficult decision to amputate her lower legs and all fingers.Today, Jamie is a passionate advocate for vaccination for meningitis. In 2009, then-Texas Governor Rick Perry signed the Jamie Schanbaum Act, mandating meningitis vaccination for college students. With her mother, Jamie founded the J.A.M.I.E. Group (Joint Advocacy of Meningococcal Information & Education), supporting continued work toward meningitis prevention. In addition to her advocacy, Jamie is an accomplished cyclist, having competed with the U.S. Paralympic Cycling Team. Jamie works in sales and currently lives with her husband, Chris, and their dog, Billie Jean, in Austin, Texas. Dr. Iriny Salib  who is a vaccines researcher and educator, works at GSK as a Field Medical Liaison supporting vaccines. Passionate about immunizations, she uses her vast experience and medical knowledge to educate, inform  and simplify medical concepts. She works towards helping all individuals have access to CDC recommended vaccines and immunization information.  Dr. Salib earned her doctorate of pharmacy degree from Temple University in Philadelphia and has worked in various clinical pharmacy settings before coming to GSK in 2011. Learn more The J.A.M.I.E Group, - Ask2BSure Campaign- CDC Information on Meningitis B

As a child, Soleil Moon Frye became famous for her breakout role in the eighties show Punky Brewster – then in 2021, she released a critically acclaimed documentary called Kid90. Now, the mom of four, who has been an activist her whole life, is a spokesperson for the public health awareness campaign around the Meningitis B vaccine for children and young adults. In this episode, Liz talks to Soleil about why she's always felt a responsibility to make the world a better place, why she always wanted to have a big family, and the questions parents should ask their doctor about the Meningitis B vaccine. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Please note: We partnered with GSK for their Take 5 meningitis campaign for this episode, but my thoughts are my own.)  My kids are getting older and as they get closer to their college years I want to make sure that they are covered when it comes to vaccines to keep them healthy when they leave our home. As mentioned, vaccines are important, and staying up to date on vaccinations is critical. However, as I found out recently, you may not know about all vaccines that your kids should have and that includes getting both sets of shots for meningitis. Take 5 For Meningitis The Take 5 for Meningitis campaign is a campaign that GSK has started that aims to make sure that all parents are aware of the reality of meningitis and the importance of vaccination. I mean, did you know that adolescents and young adults have higher rates of meningitis due to close contact with each other, sharing drinks or eating utensils, coughing or kissing? While meningococcal disease is uncommon, studies have shown that between 2014-2017, the relative risk of contracting Meningitis B was 3.5 to 5 times higher in college students aged 18-24 years compared with peers not attending college. Today we partnered with our friend Christine Koh from the Edit Your Life podcast who recently interviewed Dr. Len Friedland who is a dad, pediatrician, and research scientist, and serves as Vice President, Director of Scientific Affairs and Public Health, for GSK Vaccines. Visit www.meningitisB.com for more information

A university can act as a model or microcosm of a city. What lessons can be learned from how a university manages crises on and off campus? This episode features conversations with Dr. Mary Ferris, former Executive Director of Student Health, and Jim Caesar, Campus Emergency Manager, both of University of California Santa Barbara. They discuss the hazards faced by the university over their tenures including earthquake risk, wildfires, and an infectious disease outbreak of Meningitis B. Technical Level: 3/5 Fear Factor: 2/5

Hey Everyone, Today's topic we discuss the Men B vaccine, and how I apply the NNV/statistics to help add in the shared decision making process.

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Top Stories today: Hampshire County Medical Reserve Corps honored for meningitis outbreak response. Student at Bryan ISD school in Bryan, Texas being treated for Meningitis B. MeningitisNow.org announces call for marathon runners to apply for Team Meningitis for the Virgin Money London Marathoners for 2020. Thanks so much for listening! If you like this episode, please subscribe to “Meningitis News” and rate and review where you get your podcasts: Apple Podcasts Stitcher Spotify Google Play Follow us on Social Media: Twitter: https://www.twitter.com/newsmeningitis Facebook: https://www.Facebook.com/meningitisnews Instagram: https://www.instagram.com/meningitisnews Remember our Disclaimer, the content in this podcast are intended as general information only and may not be considered as a substitution for professional medical advice, diagnosis or treatment. Support our show by visiting us on Patreon, https://www.patreon.com/meningitisnews To learn more about Meningitis News visit our website, http://www.MeningitisNews.org --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/meningitis-news/message Support this podcast: https://anchor.fm/meningitis-news/support

Topic: “World Meningitis Day: Have Your Children Been Vaccinated for Meningitis B?” Guests: Patti Wukovits and Alicia Stillman For more information: www.MeningitisBActionProject.org We’ve heard a lot about the measles outbreak recently. This is a travesty on so many levels because measles is a highly contagious but vaccine preventable illnesses that was declared eliminated in the United States in 2000. Today, in support of World Meningitis Day, we’re going to talk about another vaccine preventable illness starting with M: meningitis. Our guests are both meningitis B advocates for the worst possible reason: they each lost a teenaged daughter to the disease, before a meningitis B vaccine was available in the US. While the meningitis conjugated vaccines have been available for 4 other strains of meningitis since 2005 (Menactra ®  and Menveo ® ), the first meningitis vaccine was available since 1978. The meningitis B vaccine, however, only became available in the US in late 2014 (Bexsero ®  and Trumenba ® ).   Patti Wukovits is a Registered Nurse and meningitis advocate who lost her 17-year-old daughter Kimberly to Meningitis B in 2012. She has since started the Kimberly Coffey Foundation to improve awareness of meningococcal disease and the vaccines available to help prevent it. Patti lives in Massapequa Park, NY, with her husband John. In addition to Kimberly, she has three other adult children.    Alicia Stillman is a meningitis advocate who lost her 19-year-old daughter Emily to Meningitis B in 2013. She has since started the Emily Stillman Foundation to improve awareness of meningococcal disease, the vaccines available to help prevent it, and to encourage organ and tissue donation. Alicia lives with her husband in West Bloomfield, Michigan, where she is the CFO of a multi-state law firm. In addition to Emily, she has two other adult children. Patti & Alicia—and their foundations, the Kimberly Coffey Foundation & the Emily Stillman Foundation—have partnered together to launch the Meningitis B Action Project.

Adrenaline auto injectors are used to treat life-threatening allergies, anaphylaxis, but there are severe supply issues with the brand leader, epipen, particularly with junior epipen and many parents are reporting problems when their children's devices need replacing. It's an anxious time for those caring for severely allergic children and Dr Margaret McCartney reviews the reasons for the shortage and the latest advice for worried parents. At the same time, epipen has come under fire from a UK coroner, who concluded during an inquest into the death of 15 year old Natasha Ednan-Laperouse, that epipens aren't fit for purpose because they don't contain enough adrenaline or have a long enough needle to deliver it properly. Consultant paediatric allergist at St Mary's Hospital, London and a researcher in children's allergies at Imperial College, Dr Robert Boyle, tells Mark there is widespread belief that the companies behind adrenaline auto injectors need to innovate and better designs are needed. Meningitis is every parent's nightmare. It can strike anyone at any age but around half of those with the most serious form, Meningitis B, are toddlers and young children. Two years ago, Ezra, who is now three and a half, contracted the disease. His parents, Cosmin and Serena from Carrick Fergus in Northern Ireland, tell Inside Health how this devastating illness spread so rapidly. Ezra's life was saved but septicaemia meant both of his legs, below the knee, were amputated, followed by the fingers on one of his hands. One of the paediatricians who looked after Ezra at the Royal Belfast Hospital for Sick Children was paediatrician Dr Thomas Waterfield. Inspired by Ezra, Tom worked with colleagues at Queen's University in Belfast to develop a rapid bedside test for Meningitis B. The LAMP test - Loop Mediated Isothermal Amplification test - takes just an hour to identify the Meningococcal DNA and it doesn't need specialists to use it. The current lab test for the disease takes a minimum of 48 hours. Age related macular degeneration, AMD, is the leading cause of blindness around the world, with at least half a million people living with this condition in the UK alone. Treatment has hugely improved in recent decades, with regular injections helping to prevent progressive loss of vision. But intensive monitoring is necessary with monthly trips to hospital for patients for vision tests. Researchers at the Centre for Public Health at Queen's University, Belfast, are trialling ways to avoid these regular hospital visits - saving patients the journey and saving the NHS money. The Monarch Study will assess different ways that patients can monitor their own vision at home, using paper tests or more sophisticated ipad-style eye tests. Mark meets Patricia, who has wet AMD in one eye and dry AMD in the other, who's agreed to be part of the trial and talks to research optometrist Lesley Doyle and Chief Investigator, Dr Ruth Hogg, about the study. Producer: Fiona Hill

  Parents of teens and young adults need to be aware of the risks of meningococcal disease, especially meningitis B, and how to protect your kids from it. According to the CDC, adolescents and young adults are the primary carriers of meningococcal bacteria, even if it doesn’t make them sick. Plus, some of their most […] The post How to Protect Your Kids from Meningitis B appeared first on MomRN.

Hoy toca nuevo episodio de "Diario de una mamá cualquiera" y hoy quiero hablarte de un tema por el que me preguntan mucho las mamis: La vacuna de la Meningitis B llamada Bexsero. He decidido contestar en formato podcast a las preguntas más habituales relacionadas con el Bexsero. Incluso te cuento la decisión que yo tomé con respecto a la vacunación de mis hijas, aunque como te digo la decisión es única y exclusiva de cada padre. Por último te dejo el enlace a un artículo de la Asociación española de Pediatría donde te habla el motivo por el que hasta 2015 no se permitió comprar directamente en farmacias sino que era considerada de uso hospitalario y mucho más. Espero que te resulte de utilidad éste podcast y recuerda que puedes consultarme cualquier duda que tengas en el apartado de contacto del blog. --- Enlaces: - Asociación Española de Pediatría: http://www.analesdepediatria.org/es/vacunacion-frente-al-meningococo-b-/articulo/S1695403314004287/ - Contacto: http://www.nadiecomomama.com/contacto/

Meningitis B Vaccine Recommendations: In light of new recommendations from the AAP, ACIP and CDC surrounding the use of two recently licensed meningococcal B vaccines, Paul Offit, MD, Director of the Vaccine Education Center at Children's Hospital of Philadelphia, sits down to address some common questions related to these recommendations. Published December 2016. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2016 by Children's Hospital of Philadelphia, all rights reserved.

The Chief Executive of Meningitis Now

Up to half a million people in the UK could have it, but it's a condition that hardly anybody has heard about: Charles Bonnet Syndrome. It happens to people who are losing their sight through age-related macular degeneration, cataracts, diabetic eye problems or glaucoma. They see vivid and often frightening visual hallucinations and these images are soundless. Judith Potts' mother Esme was in her 90's when she eventually admitted to her daughter that she was seeing frightening images of goblins and Victorian children all around her. Judith had never heard of the condition and as she tells Dr Mark Porter, neither had any of the health professionals taking care of her mother. Shocked that there was so little awareness about something that is so common, she set up an awareness group, Esme's Umbrella. Dr Dominic Ffytche, Clinical Senior Lecturer at King's College London's Institute of Psychiatry and an expert in visual hallucinations, tells Mark that a key area of research is why some people have Charles Bonnet Syndrome and others don't. Co-proxamol, or Distalgesic as it's better known, was a common drug for mild to moderate pain in the 1990's. But a decade ago, a review by the Medicines and Healthcare Products Regulatory Agency (MHRA) decided that it wasn't a good painkiller and it had very worrying side effects. Its licence was withdrawn and doctors were urged to switch patients onto different medication (although it could still be prescribed on a "named patient" basis). Dr Andrew Green, Chair of the Clinical and Prescribing arm of the GP committee of the British Medical Association tells Mark he's disturbed that nearly ten years after the licence was withdrawn, thousands of patients are still being prescribed co-proxamol at a high cost to the NHS while Bedfordshire GP Dr John Lockley defends continued and careful prescribing for a tiny number of patients who can't get relief from other medication. In a week in which hundreds of thousands of people have signed a petition calling for more children to receive the Meningitis B vaccine, Dr Margaret McCartney talks to Mark about the tricky decisions involved in planning immunisation programmes. Traditional bedside paper charts, which record and monitor patients' vital signs, have been replaced in Oxford hospitals with smart PC tablets. Clinical staff enter patients' blood pressure, heart rate and temperature on the tablet and the new "smart" system provides an early warning traffic light system, alerting them if there's a deterioration in the patient's condition. This means clinicians can prioritise care and another major bonus is that the same information is available, at the touch of a button, to medical staff across Oxford's hospitals. The project is called SEND - System for Electronic Notification and Documentation - and it's a collaboration between the University of Oxford and Oxford University Hospitals NHS Foundation Trust. Mark goes to Oxford and with intensive care consultant and SEND Project Leader Dr Peter Watkinson, sees how the new paperless system is working.

As cars were banned from central Paris this weekend and the health risks of pollution hit the headlines, Mark Porter examines the statistic that pollution kills 29,000 people a year in the UK. And he visits a pioneering clinic at Southampton General Hospital where falls in the elderly are seen as a risk factor for underlying health problems; 'Having a hip fracture is like having a heart attack or stroke' explains Dr Mark Baxter. 50% of people who have a hip fracture will have previously presented with a fall, but once they go on to break a hip, 1 in 10 elderly people may not be alive at the end of the month and up to 25% by the end of the year. Many elderly people are found to be on multiple treatments - blood pressure pills or bladder pills for example - that make people fall over. In recent years there has been much more attention paid to the cumulative burden of the side effects of medicines in the elderly - particularly the group of commonly used drugs known as Anticholinergics. And according to new research by a team at the University of East Anglia, taking Anticholinergics increases the risk of falls too - particularly in men. Following news of the Meningitis B vaccine in children, an Inside Health listener got in touch to ask why it wasn't being given to teenagers in light of data showing that there is a second peak in incidence in the disease among 15 - 19 year olds? Mark talks to Professor Andrew Pollard, Chair of the Joint Committee on Vaccination and Immunisation. And Inside Language: Dr Margaret McCartney and Professor Carl Heneghan demystify the terminology of medicine and research. This week, false positives and false negatives; when is something not what it seems, and when does it seem what it's not?

From this week all UK babies will be vaccinated against that most feared disease, meningitis B, the first country in the world to take this step. But the decision to include Men B in the national immunisation programme has come too late for parents, Freya and Ross. A year ago their baby daughter, Harmonie, nearly died after contracting the infection. Her arms and legs as well as the tip of her nose had to be amputated because of the resulting sepsis. Sue Davie, Chief Executive of Meningitis Now tells Mark that the vaccine is great news and will save many lives. But she hopes in the future that it will be offered to older babies and young children, as well as another at risk group, adolescents. Mental health problems have long been linked to fluctuating hormone levels, at times of menstruation, childbirth and menopause. Dr Michael Craig who runs the Female Hormone Clinic at the Maudsley Hospital in London discusses the role of hormone replacement treatments. Statins are the most commonly prescribed medicines in the UK. They work to lower the level of cholesterol in your blood. There's been considerable debate about when doctors should start prescribing statins and NICE, the National Institute for Health and Care Excellence, had been keen for GPs to be paid to put more patients on the cholesterol-reducing drugs. Dr Margaret McCartney outlines the controversy and NICE Deputy Chief Executive, Professor Gillian Leng, tells Mark that the health advisory body has listened to concerns and why their new statins targets are now to be tested in the field. Young, healthy, sporty people don't get heart attacks. Except when they do. Dr Stuart Miller, Clinical Director of Sport and Exercise Medicine at the University of Bath admits that he was shocked when he had a heart attack, even though he cycles, swims and eats a healthy diet. Sanjay Sharma is professor of cardiology at St George's Hospital in London and he tells Mark how common unexpected heart attacks are. Producer: Fiona Hill.

Diabetes in pregnancy, gestational diabetes, is on the increase, and the risks to mother and baby if this condition is untreated, are very serious. Around one in fourteen pregnant women will develop GD, but the risk is much greater according to age and weight of the mother, whether there's a history of diabetes in the family and in certain ethnic groups. Dr Mark Porter visits The Rosie Maternity Hospital in Cambridge, where Dr Helen Murphy introduces him to the specialist teams that enable 70% of the women diagnosed there to manage their diabetes through diet and exercise, rather than medication. The UK's National Institute for Health and Care Excellence, NICE, has introduced new guidelines for diagnosing gestational diabetes which differ from international thresholds backed by the World Health Organisation. Mark talks to researcher Dr Claire Meek from The Rosie, one of the authors of research published in the journal Diabetologia, which found that up to 4,000 women, at risk of serious birth complications, would be missed under the new UK criteria. The teams at The Rosie are shunning the new NICE guidelines and continuing to follow the WHO thresholds. Professor Rudy Bilous, who runs the Diabetes in Pregnancy Service at the James Cook University Hospital in Middlesbrough and chaired the development group at NICE that produced the new diagnostic guidelines, tells Mark that he's confident that the thresholds, which were drawn up using the latest available evidence, are set at the right level. Weight loss properties and low carbohydrate diets: listener Mark Robins from Southampton describes his success following a low carb diet (he lost nearly four stone in a year) and Inside Health's Dr Margaret McCartney and Susan Jebb, Professor of Diet and Population Health at the University of Oxford discuss the evidence behind weight loss and low carb diets. The number of children who say they are afraid of injections is increasing and Dr Amy Baxter, a paediatric emergency doctor from Atlanta, Georgia and an expert in needle pain, has shown a link between the number of jabs and fear of needles. UK children have up to 15 vaccinations, with the new Meningitis B on the horizon, so managing that fear is important. Dr Baxter tells Mark what parents and health care professionals can do to help, and saying "Sit still, don't move, this will only hurt a bit", isn't recommended! Producer: Fiona Hill.

August issue highlights, including malaria vector control, meningitis type B vaccine, and HPV vaccination targeted at boys and young adults.

Discussion of February highlights, including the link between infection and coronary artery disease.