The World Health Organisation (WHO) has warned the risk of an epidemic spreading is high after more than 231 cases were identified in Madagascar in just two months.

Madagascar is the most seriously affected country in the world and, although large outbreaks of the disease are rare, it is also endemic in the Congo and Peru.

And there are a surprisingly large number of other nations, including the US, which occasionally experience cases of the deadly disease due to animals carrying the bacteria. In the US, the plague is commonly spread by rats in rural areas and humans can become infected by cats and dogs.

Recently a public health warning was issued in northern Arizona, although there have not been more than a couple of isolated cases. From 2010 to 2015 there were 584 deaths from the plague reported around the world.

However, these were isolated cases, with only a few large-scale epidemics recognised by WHO this century.

The last major emergency was declared in Peru back in 2010 after 17 cases of the plague were reported in the Ascope province of Department La Libertad. And, a year before, a cluster outbreak of pulmonary plague cases were found in the remote town of Ziketan in China’s Qinghai province.

Twelve people were confirmed to have the disease while hundreds more had to be quarantined.

One man died after helping to bury the first victim, a 64-year-old man, as the disease swept through the town. The pneumonic, highly contagious, form of plague - known as the Black Death - is particularly dangerous, and can be passed on through coughing and always proves fatal unless it is caught early. Less contagious, but still dangerous is the bubonic strain of the disease.

It is passed on by a bacteria found in small mammals and their fleas.

Both types contributed to the deaths of more than 50 million people in Europe during the Middle Ages. 

WHO says the number of people dying from plague in Madagascar has risen in recent years even though the total number of infections has not increased.

This has been blamed on a deteriorating health system and rising poverty in the country.

Last week, the WHO delivered 1.2 million doses of antibiotics and released $1.5 million to fight the new epidemic. 

Breathing In (Inhalation)

When you breathe in, or inhale, your diaphragm contracts (tightens) and moves downward. This increases the space in your chest cavity, into which your lungs expand. The intercostal muscles between your ribs also help enlarge the chest cavity. They contract to pull your rib cage both upward and outward when you inhale.

As your lungs expand, air is sucked in through your nose or mouth. The air travels down your windpipe and into your lungs. After passing through your bronchial tubes, the air finally reaches and enters the alveoli (air sacs).

Through the very thin walls of the alveoli, oxygen from the air passes to the surrounding capillaries (blood vessels). A red blood cell protein called hemoglobin (HEE-muh-glow-bin) helps move oxygen from the air sacs to the blood.

At the same time, carbon dioxide moves from the capillaries into the air sacs. The gas has traveled in the bloodstream from the right side of the heart through the pulmonary artery.

Oxygen-rich blood from the lungs is carried through a network of capillaries to the pulmonary vein. This vein delivers the oxygen-rich blood to the left side of the heart. The left side of the heart pumps the blood to the rest of the body. There, the oxygen in the blood moves from blood vessels into surrounding tissues.

(For more information on blood flow, go to the Health Topics how the heart works article.)

Breathing Out (Exhalation)

When you breathe out, or exhale, your diaphragm relaxes and moves upward into the chest cavity. The intercostal muscles between the ribs also relax to reduce the space in the chest cavity.

As the space in the chest cavity gets smaller, air rich in carbon dioxide is forced out of your lungs and windpipe, and then out of your nose or mouth.

Breathing out requires no effort from your body unless you have a lung disease or are doing physical activity. When you're physically active, your abdominal muscles contract and push your diaphragm against your lungs even more than usual. This rapidly pushes air out of your lungs.

The animation below shows how the lungs work. Click the "start" button to play the animation. Written and spoken explanations are provided with each frame. Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames.

Air pollution causes more than 500,000 premature deaths across Europe each year despite 'slowly' improving air quality on the continent, the EU's environment authority.

Although data from the Copenhagen-based European Environment Agency (EEA) reveals some encouraging signs, in large part the result of new technologies, air pollution remains the leading environmental cause of premature death in the region.

In its latest report, the EAA said 520,400 premature deaths in 41 European countries were caused by air pollutants generated by the burning of fossil fuels in 2014, compared with 550,000 in 2013. Of these, four out of five deaths (428,000) were directly linked to fine particulate matter. 

These measure less than 2.5 microns and can enter a person's lungs and even the bloodstream.

Data collected at monitoring stations showed that 82 per cent of the EU's urban population was exposed to these microscopic particulates, known as PM2.5, in 2015.

This is down from 85 per cent in 2013.

Other sources of air pollution linked to the premature deaths include nitrogen dioxide, emitted in the air, and ground-level ozone caused by motor vehicle emissions.

Within the 28 European Union members, fine particulates were responsible for more than three out of four premature deaths (399,000 out of 487,600) in 2014. 'The European Commission is committed to tackling this and help member states make sure that the quality of their citizens' air is of the highest standard,' said Karmenu Vella, the EU commissioner for the environment, maritime affairs and fisheries.

Research in August revealed the number of cases of lung cancer among non-smokers has doubled in the last decade, with experts also blaming air pollution. If the trend continues, the number of deaths from lung cancer among non-smokers will leapfrog those among nicotine users in a decade.

Previously, nine in ten cases of the disease were linked to cigarette use, but this proportion has decreased as more people shun the habit.

China has also seen a sharp rise in the incidence of lung cancer in the past 10-15 years, with many blaming heavy smog in cities. 

Experts at the China Academy of Medical Sciences said they had noticed more cases among non-smokers and women. 

Its study said there had been a rapid increase in a form of lung cancer that develops deep in the lung and is not associated with tobacco use.

China has been waging a battle against air pollution, with concentrations of PM2.5 often topping 300 micrograms per cubic metre.

Last year's national average stood at 47 micrograms, with only a quarter of cities meeting the country's official air quality guideline of 35 micrograms.

The World Health Organisation recommends levels of no more than 10 micrograms. 

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In the development of new drugs, taking something from nature and modifying it has been a successful tactic employed by medicinal chemists for years. Now, with the help of nanotechnology, researchers are turning once-discarded drug candidates into usable drugs.

An estimated 40% of clinical approved drugs fall into the category where either the natural compound itself or a modified version is the approved drug. These include statins (found in bacterial secretions) used to lower cholesterol, quinines (found in cinchona trees) as anti-malarials and paclitaxel (found in yew trees) as anti-cancer medication.

Many of these natural products are toxins produced by plants or animals as a form of defence. And scorpion venom has been gaining interest as a source of new drugs. It contains a mixture of biological chemicals called peptides, some of which are known to trigger cell death by forming pores in biological membranes. Cell death can be useful if we are able to target, say, tumour cells to auto-destruct.

These toxins can have very potent effects. For instance, one particular small peptide, known as TsAP-1, isolated from the Brazilian yellow scorpion (Tityus serrulatus), has both anti- microbial a And anti cancer properties 

However, harnessing this kind of power for clinical good has so far been challenging because these toxins kill both tumours and healthy cells. One method to control such toxicity is through using nanotechnology to build specific anti drug delivery vehicles  If successful, the toxic drug is released to kill only unwanted tissues in a body. 

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A 25-year-old Romanian has been jailed after raping his pregnant 'wife' who he had moved to Britain with. 

The man, of Romany gypsy background, illegally married the girl in their native country before settling in Essex. 

He was imprisoned for six years after admitting having sex with a child under the age of 13.

The man, who cannot be named for legal reasons, has said he wants to 'reignite' the relationship when he has served his prison sentence.

The girl is understood to have returned to Romania and is just weeks away from giving birth, the court heard.

The man's lawyer said he had got 'caught up' in what was a 'widespread practice' and 'tradition' and claimed his 'upbringing' had landed him in court. Jamie Sawyer, prosecuting, said the age of consent in Romania is 16 - the same as in the UK. 

He said: '[The couple] met in Romania and in the victim's view, no one complained about the age gap between them. She has gone back to Romania, and the defendant says how he has a wish to reignite that relationship when he is able.' 

Their illegal marriage was uncovered by police on April 7 this year when their car was stopped at a car wash in Epping while they and two other children were in it.

Detectives later searched their home and found a small room with a double bed the Romanian man and the girl shared. 

Laura Kenyon, defending, told the court the marriage was an 'exceptional' case with very 'unusual circumstances'.

She said: 'There is no grooming, exploitation, force or coercion in this case. This was consent within a marriage, albeit an unlawful marriage.

'This is a widespread practice, an ancient custom that is still used today. The marriage of a young girl and older man is not an extraordinary event in their culture.

'He is following that tradition and is caught up in it.' 

Chelmsford Crown Court was told Romany gypsies are 'badly marginalised' in Romania and the defendant's 'upbringing' had landed him in court. 

But the man was jailed for six years after admitting having sex with a child under the age of 13. 

Sentencing, Judge Patricia Lynch said: 'The issue here is the age of consent and age of lawful marriage in Romania is the same as in this country – it is 16 years of age.

'Sexual activity with children is against the law and we are dealing with a 12-year-old child, no matter what the customs are in another land. She is a child expecting a child I am told in a few short weeks and I am told she will not have an education in Romania.

'This is not a case of informed consent. Children need to be protected from others and from their selves.' 

The man was given full credit for admitting statutory rape and was jailed for six years.

He will also spend 10 years on the sex offenders register. 

Theresa May will today demand an end to racial discrimination in everyday life.

The Prime Minister will publish an analysis showing huge disparities in employment rates and school attainment between white people and those from ethnic minority backgrounds.

She will launch a massive database – the first of its kind in the world – covering 130 areas of life across health, education, employment and criminal justice, all broken down by race.

Mrs May has ordered a review of school exclusions after the audit revealed that some black children were three times as likely to be excluded or suspended as white British ones. The figures show that poorer white children tend to do worse in tests at junior schools, and that black people are less likely to own a house and more likely to be found guilty in court.

The Conservative leader will use the statistics to challenge society to ‘explain or change’ disparities in how people from different backgrounds are treated.

She will tell Whitehall, businesses, police and other institutions that they have ‘nowhere to hide’ and must help ensure race is never a barrier to people achieving their goals in life. 

On a visit to a school in South London, Mrs May told sixth form students: ‘What I hope this audit will bring is a change in attitude so that everyone is treated equally, no matter what their background, and this is never a barrier to getting on in life.

‘By bringing this information together in one place for the first time it will shine a light on the issues we are facing. We must now work together as a society to find solutions.’

Mrs May will launch the new Ethnicity Facts and Figures website today, saying she hopes it will become an ‘essential resource in the battle to defeat ethnic injustice. Among the findings were that the 8 per cent unemployment rate for black, Asian and minority ethnic people is nearly double that of white British adults. 

Mrs May will say: ‘People who have lived with discrimination don’t need a government audit to make them aware of the scale of the challenge.

‘But this audit means that for society as a whole – for Government, for our public services – there is nowhere to hide.

‘These issues are now out in the open. And the message is very simple: if these disparities cannot be explained then they must be changed.

‘Britain has come a long way in my lifetime in spreading equality and opportunity. But the data we are publishing today will provide the definitive evidence of how far we must still go in order to truly build a country that works for everyone. The Ministry of Justice will put in place recommendations from the recent Lammy Review, including performance indicators for prisons to assess how prisoners of different races are treated.

The ministry will also be made to adopt an ‘explain or change approach’ to ethnic disparities and publish all data held on ethnicity by default. Prison chiefs will be urged to improve the recruitment, retention and progress of minority staff.

In education, an external review will look at cases of children excluded from school, with a focus on ethnic groups disproportionately likely to be suspended or expelled.

In 2015/16, Irish traveller pupils were the most likely to be excluded, with a rate of 0.49 per cent. They were followed by gipsy and Roma children (0.33 per cent). Black Caribbean pupils – at a rate of 0.29 per cent – were permanently excluded at three times the rate of white British pupils. 

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