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HEALTH

First baby in Europe with Zika defects born in Spain

A baby has been born in Spain with Zika-caused microcephaly, the first to be born in Europe with the condition.

First baby in Europe with Zika defects born in Spain
The Zika virus is spread by mosquitos. Photo: Yuri Cortez/AFP
The child was born by caesarean section at the Vall D’Hebron hospital in Barcelona.
 
The hospital’s chief neonatal physician Felix Castillo confirmed that the baby had been born with a small head circumference, a typical symptom of the Zika virus.
 
The pregnancy had gone to term, the hospital confirmed.
 
The baby, which was born by Caesarean section at the end of pregnancy, “is stable and has not required any specific resuscitation,” Castillo stated. Obstetrician Elena Carreras said that the mother “had been accompanied by the father the whole time, and they are very excited and happy.”
 
This is Spain's first case of Zika-related microcephaly, a severe form of brain damage where babies are born with abnormally small heads. The mother had been infected with Zika and dengue during a trip to Latin America.
 
It is the first known case of its kind in Europe in a baby that has gone to term. Traces of Zika were found in the brain of an aborted foetus in Slovenia that had severe microcephaly.
 
“The anomalies were identified between the 19th and 20th weeks of pregnancy,” a Catalonia health official told reporters in June, confirming that the foetus had shown “several anomalies, including microcephaly”.
 
Authorities declined to identify the woman in order to protect her privacy, but local media said she had decided against an abortion.
   
“These symptoms cause serious difficulties, but do not usually lead to the death of the foetus,” said gynaecologist Elena Carreras.
 
A total of 105 people in Spain have been infected with the mosquito-borne Zika virus, according to official statistics from May 3.
 
Spanish authorities have said all the infection cases – including 13 pregnant women – are “imported cases” found in people either “from, or who have visited affected countries” in Latin America.
 
More than a fifth of foreign residents in Spain are of Latin American or Caribbean origin, the area hit by the epidemic.
 
The current Zika outbreak began in early 2015 in Brazil, where some 1.5 million infections have been reported. Since then, the epidemic has spread to several other countries in the Americas.
 
Scientists believe the virus to be responsible for a surge in Brazilian infants born with microcephaly.
 
There is no vaccine or treatment for the virus, which in most people causes only mild symptoms — a rash, joint pain or fever.
 
Despite a flurry of research, very little is known about Zika, including the full list of diseases and disorders it may cause.
 
Recent scientific consensus is that the virus causes microcephaly in babies and adult-onset neurological problems such as Guillain-Barre Syndrome, which can cause paralysis and death.
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HEALTH

When can doctors in Denmark refuse to continue treating patients?

General Practitioners in Denmark have the right to break off a patient-doctor relationship in specific circumstances.

When can doctors in Denmark refuse to continue treating patients?

Although doctors in Denmark have the right to decide not to continue treating a patient – requiring them to find a new GP – the circumstances in which this can happen are limited, and must be approved by health authorities.

The frequency in which the circumstances arise is also low. A doctor decided to no longer receive a patient on 375 occasions in 2016, according to the medical professionals’ journal Ugeskrift for Læger. The following year, newspaper Jyllands-Posten reported the figure at 458.

There are two main categories of circumstances in which a doctor can choose to take this step. The first is in instances of violent or threatening behaviour from the patient towards the doctor. 

The second (and most common) is when the doctor considers the relationship to have deteriorated to the extent that confidence has broken down, according to Ugeskrift for Læger.

It should be noted that patients are not bound by any restrictions in this regard, and can decide to change their GP without having to give any justification.

A patient also has the right to appeal against a doctor’s decision to ask them to find a new GP. This is done by appealing to the local health authority, called a Region in the Danish health system.

In such cases, a board at the regional health authority will assess the claim and if it finds in favour of the patient may order the doctor to attempt to repair the relationship.

Doctors cannot end a relationship with a patient purely because a patient has made a complaint about them to health authorities. This is because patients should have the option of making complaints without fear of consequences for their future treatment. 

However, if this is accompanied by the conclusion on the doctor’s part that there is no longer confidence in them on the part of the patient, they can remove the patient from their list.

The right to no longer see patients in the circumstances detailed above is provided by doctors’ collective bargaining agreements, the working conditions agreed on between trade unions and employer confederations under the Danish labour market system.

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