Sunday, August 22, 2010

New compound shows promise in treating Chagas’ disease

According to a study published in the latest issue of the journal Antimicrobial Agents and Chemotherapy, a new compound has shown promise in treating Chagas’disease in studies.

The compound, Cyclopalladated Compound 7A, was found in studies to inhibit trypomastigote cell invasion and decrease intracellular amastigote proliferation cell division. It was also very effective against T. cruzi even at very low doses. Additionally, it was 340 times more toxic to parasites than mammalian cells as well as more effective than benznidazole in all experiments.

The current drug used to treat Chagas' disease, benznidazole, is effective when treating acutely infected patients, however, it is less so when dealing with chronic infections and poses severe side effects in elderly patients.

Chagas' disease is an infection caused by the parasite Trypanosoma cruzi and it affects approximately 18 million people and causes up to 50,000 deaths per year in tropical regions of the world.

Infection occurs when the triatomine vector defecates during its blood meal and fecal material containing the parasite is inoculated through the bite wound or mucous membranes.

The oral mode of transmission of Chaga’s disease is being increasingly recognized in the region. It is associated with the contamination of fresh food or beverages with intestinal contents of triatomid (kissing) bugs.

Friday, August 20, 2010

Unusual outbreak of salmonella due to contaminated pickles in Illinois

A Niles, Illinois deli has been implicated in a small outbreak of salmonella food poisoning according to a Cook County Dept. of Public Health press release.

At least 6 confirmed cases of salmonella are due to pickles sold at the Assi Market. The pickles are made at the deli and sold in plastic bags.

Of the six cases, 5 people were hospitalized because of their illness.

The batch of pickles was available for purchase July 25, 2010 through July 27, 2010 with a sell by date of August 24, 2010.

The process of pickling typically kills pathogenic bacteria, thus making this case somewhat unusual.

However, other acidic foods have also been implicated in foodborne outbreaks in the past to include orange juice and apple cider.

The manager of the Assi Market suggests that “cross contamination” may be the culprit and the store is fully cooperating with the health department.

Salmonella is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain.

In rare circumstances, infection with salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis.

Greece's West Nile problem could last another month

An 85 year old man from Central Macedonia is the latest victim of a West Nile virus outbreak in Greece.

To date there have been 77 people infected and five deaths according to the Center for Disease Control and Prevention in Greece (KEELPNO).

Health officials in Greece fear the virus could spread until the end of September with an estimated 5-10 new infection daily.

Blood donations have been banned in areas affected by the virus; however the government says there are plenty of reserves.

West Nile virus is a mosquito-borne disease that can cause encephalitis, a brain inflammation. WNV is closely related to St. Louis encephalitis virus (SLEV) which is found in the United States and to Kunjin virus (KV) which is found in Australia, some Western Pacific islands and parts of South East Asia. West Nile virus was first detected in North America in 1999 in New York. Prior to that it had only been found in Africa, Eastern Europe, and West Asia.

According to the Centers for Disease Control and Prevention (CDC), approximately 80 percent of people (about 4 out of 5) who are infected with WNV will not show any symptoms at all.

Up to 20 percent of the people who become infected have symptoms such as fever, headache, and body aches, nausea, vomiting, and sometimes swollen lymph glands or a skin rash on the chest, stomach and back. Symptoms can last for as short as a few days, though even healthy people have become sick for several weeks.

Severe illness with WNV can manifest itself with high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis. These symptoms may last several weeks, and neurological effects may be permanent. Death can occur.

There is no specific treatment for WNV infection. The only real thing that can be done to prevent WNV in humans is avoiding mosquito bites. Horses can be vaccinated.

Thursday, August 19, 2010

The plague found in more wild animals

The deadly bacterium that causes the plague has been found in different animals in different parts of North America this past week.

In the Grasslands National Park, Saskatchewan, Canada, parks officials are warning the public of the finding of dead plague infected prairie dog.

And in the Sierra Nevada, an unspecified rodent was found in the Plumas Eureka State Park which also tested positive for plague.

What is plague?

Plague is an infectious disease caused by the bacterium, Yersinia pestis. It is found in animals throughout the world, most commonly rats but other rodents like ground squirrels, prairie dogs, chipmunks, rabbits and voles. Fleas typically serve as the vector of plague.

Human cases have been linked to the domestic cats and dogs that brought infected fleas into the house.
People can also get infected through direct contact with an infected animal, through inhalation and in the case of pneumonic plague, person to person.

What can you do to protect your cat or dog from getting the plague?

If you must take your pet to an area like the two described above, don’t let your pet go near sick or dead rodents or to explore burrows.

You can also consult your vet about flea treatments and repellents.

What are the symptoms of plague in a pet cat/dog?

Some localized swelling like under the jaw in cats or in the armpit area of your pet. Tiredness, fever and anorexia may also be present. Consult your vet.

Though extremely rare, transmission of plague is certainly possible. What can you do to prevent catching the plague while camping in parks like Grasslands or Plumas?

Avoid contact with rodents and their fleas, dead or alive.

Do not sleep or camp near animal burrows.

Wear long pants tucked into your boots and using insect repellent to reduce exposure to fleas.

Wednesday, August 18, 2010

The stigma of leprosy keeps patients from leaving Ugandan hospital

In the Mayuge district of eastern Uganda is the biggest and best known leprosy hospital, Buluba hospital.

The hospital was started by the Franciscan Missionary Sisters of Africa in 1934.

The stigma surrounding leprosy has been well documented and some patients of the hospital have been at Buluba for decades.

One woman, Dementiria Kagoya, who is nearly 100 years young, was admitted nearly fifty years ago. When she was admitted, she lost all contact with relatives and no one ever checked on her.

Other patients in their elder years have been in the hospital for decades for fear of being discriminated because of their deformities.

They are not infectious because all have been treated successfully, but they have nowhere to go.

Leprosy has a historical precedent of infected people getting rejected by their families and community.

Oyster herpes taking a toll in UK waters

Herpes viruses infect all different types of species with different symptoms for each, whether it is monkeys, humans or oysters.

The United Kingdom has faced a serious outbreak of the herpes strain Ostreid herpesvirus 1 (OsHV-1), which not only attacks oysters but clams and scallops.

The virus is an efficient killing machine where it can wipe out 80 percent of oysters in a bed within a week.

The virus attacks young oysters during breeding season when the oyster’s immune system is down due to expending all its energies on producing sperm and eggs.

OsHV-1 cannot be transmitted to humans.

UK officials are trying to determine where the virus came from. Some suggest the virus traveled from French oyster beds where the virus killed between 20-100% of oysters in some beds. It may be possible that equipment used off the French coast has been used in the British waters.

Others suggest global warming as a culprit. OsHV-1 remains dormant until waters reach a certain temperature.

It does now appear the outbreak has subsided, however experts fear that because of the possibility of latency, the virus could be reintroduced at a later time.

Tuesday, August 17, 2010

"This Wormy World" debuts today

Soil-transmitted helminths like roundworms and hookworms, and schistosomiasis infect hundreds of millions worldwide with a large portion being in Africa.

Today a new tool has been released which is a free, open access source that can be used for planning and setting up deworming programs. It is called the Global Atlas of Helminth Infections or, and it provides information through up-to-date maps of worm distribution.

Soil-transmitted helminths and schistosomiasis are major causes of poor health, malnutrition, failure to thrive and death in many parts of the developing world with children frequently being afflicted.

Currently only the Africa map is in place with other continents to follow. It answers the questions of what communities are most affected, where treatment is needed and how to use scarce resources most efficiently.

Plans for the web site are to eventually include other neglected tropical diseases like trachoma and filariasis.

This Wormy World is produced by the London School of Hygiene and Tropical Medicine and the Partnership for Child Development at the Imperial College London.

Sunday, August 15, 2010

India health officials lash out at NDM-1 study, suggests “sinister design”

With the report in the media last week focusing on a study in the journal The Lancet Infectious Diseases, health officials in India have spoken out saying the study is biased in favor of pharmaceutical companies.

Senior Janata Party member, S.S. Ahluwalia said the timing of the article was suspicious as it comes at a time when India is emerging as a global power in medical tourism.

Health experts from Bangalore find something “sinister” in the report. They say that the Lancet report is an exaggeration and propaganda to kill India’s rapidly growing medical tourism industry and a way for international drug companies to introduce more drugs and antibiotics into the Indian market.

The study was funded by the European Union and the pharmaceutical giants Wellcome Trust and Wyeth. Some have called this a conflict of interest.

Dr. Devi Shetty, Chairman of Narayana Hrudayalaya, believes this is just the beginning. He believes more viruses and superbugs will be attached to India.

Others say the study is inappropriate because of the small amount of patients. Vishali Bali, CEO of Fortis Hospitals, who sees thousands of international patients, suggests that the scientists should have done the study on a wider geographical scale before jumping to their conclusions.

VM Katoch is the Secretary of Health Research said the government will be drafting a reply to the study. He says that “it is unfortunate that this new bug, which is an environmental thing, has been attached to a particular country which is India in this case.”

Even the study’s Chennai, India-based lead author Karthikeyan Kumarasamy took offense to the report and disassociated himself parts of it.

He states that many interpretations in the study were added later without his permission or knowledge.

Some in India have said they are making a much bigger deal out of this than required. PM Bhargava, former director Center for Cellular and Molecular Biology in Hyperabad went on to say, “There are several such (multi-drug resistant) strains found in the US and the UK which may be even deadlier, but it only becomes news because it comes from India.”

The Indians say since this is a scientific report; they are looking for scientific ways to contest it.

When these reports come out, you’ll hear about it here.

CDC: three NDM-1 isolates found in US this year

According to a June 25, 2010 report in the Morbidity and Mortality Weekly Report (MMWR), three isolates of bacteria containing NDM-1 were identified at the CDC.

Three different strains of bacteria (Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae) were implicated. The report also talks of tests that can be used by laboratories to reliably test for NDM-1 production in bacteria.

The report says all three isolates were found in patients who received recent medical care in India.

The CDC has requested that carbapenem-resistant isolates from patients who have received medical care within 6 months in India or Pakistan be forwarded through state public health laboratories to CDC for further characterization.

NDM-1 (New Delhi metallo-β-lactamase 1) is an enzyme that is carried in certain gram negative bacteria like E. coli and Klebsiella, and makes the bacterium resistant to the beta lactam antibiotics, including carbapenems, with the exception of the monobactam agent, aztreonam.

Thursday, August 12, 2010

The WHO says the H1N1 “pandemic” is over…

…and I would like to thank them, the CDC and the media for scaring the crap out the planet for the past 18 months over a mild virus.

I’d also like to preface this by saying I’m not a Monday morning quarterback on this issue. As early as a few weeks into the outbreak, I was criticizing all applicable parties in their over reaction.

The WHO Director-General Margaret Chan declared an end of the “pandemic” on August 10, 2010.

Remember when Dr. Chan declared a global flu pandemic back on June 11, 2009?
At that point there was a mere 141 death attributed to this virus worldwide!

In my opinion the WHO handled this relatively harmless disease quite recklessly and suspiciously.

First and most importantly is when in the middle of the night the WHO changed the definition of a pandemic. This changed everything. When this all started last May the definition of a pandemic on the WHO’s website included the statement “huge number of deaths and sick”.

At some point soon after, the definition changed and that statement was omitted.

What is the outcome of this suspicious act?

Now a flu that costs the lives of several thousand people worldwide is considered a pandemic. Remember that the seasonal flu takes the lives of between 250,000 to 500,000 worldwide annually.

“Pandemics can be either mild or severe…” is now what the WHO website says. So basically every year could be considered a pandemic.

In addition, it makes it easier for global and national health systems to use their emergency powers. Remember, here in the US, President Obama declared swine flu a national emergency.

Also there is the issue of vaccines. Member states are obligated to follow WHO recommendations when a pandemic emergency is declared which forces nations to contract with vaccine companies to purchase vaccines for their citizens.

Interesting seeing that several people in the WHO are connected with these vaccine and drug companies…think there is any financial motivation for declaring a pandemic?

And the CDC is another story…

If you would look at the history of the CDC and their handling of flu “pandemics” in their short history you’d wonder why anyone listens to anything they say.

In 1957 the alarmist CDC warned the nation of an imminent Asian flu epidemic. A half million dollars (a lot of money at the time) were allocated to start a mass vaccination campaign which weren’t available till flu season was over. But though they did absolutely nothing in containing the outbreak, they looked in control in an air of over-hyped flu scare and panic.

Since that time, mass immunization with generally unproven vaccination is the norm.

Then of course is 1976 where 5 soldiers at Ft. Dix, New Jersey contracted the flu. One died from overexertion against his doctors orders, but the CDC considered this the beginning of an imminent flu epidemic in the lines of 1918.

A “war room” was set up with “experts” working 24/7 chasing anything that resembled the flu.

The CDC director at the time convinced Congress and President Ford for the necessity of an immunization crusade. President Ford even went on TV to call for the vaccination against swine flu for every man, woman and child. The only problem was there were no other cases of swine flu.

The vaccine, for those old enough to remember, produced side effects in up to 40% of people and deadly reaction in up to 5 % of people.

And the media…24/7 about this mild virus. They never asked the tough questions and like most that comes out of the WHO or CDC, it is taken as gospel. So the media ran with and surely got fantastic ratings.

So now the Director-General says the pandemic is officially over and we are in the post-pandemic phase. However, the WHO hasn’t completely let go of this by saying pandemics are unpredictable and prone to deliver surprises. No two pandemics are ever alike. This pandemic has turned out to be much more fortunate than what we feared a little over a year ago.

No doubt, pandemics real or imagined are in our future. Now I think we got a real taste for these things will be handled. It’s unfortunate that health has become so politicized and driven by power and greed.

Wednesday, August 11, 2010

World renowned Egyptian folk singer Saed Al Sughair diagnosed with bilharzia

The Egyptian folk singer who dazzled US audiences in 2006 has contracted a severe parasitic infection.

According to the London based Elaph, it is reported that folk singer Saed Al Sughair is suffering from bilharzia or as its also known, schistosomiasis.

The parasitic infection is the cause of recent health deterioration and internal bleeding. Schistosomiasis coincidentally took the life of another lengendary Egyptian singer, Abd Al Halim Hafez back in 1977.

Doctors say that Al Sughair’s disease is still in the initial stages and he will be on prolonged treatment in Germany.

Schistosomiasis is an acute or chronic disease, produced by parasites called Schistosoma. It is not a single disease, but a disease complex initiated by several different species of schistosomes. The three most important human species are Schistosoma mansoni, S. haematobium and S. japonicum.

It is 2nd only to malaria in terms of socioeconomic & public health importance, with 200 million people infected in approximately 75 countries.

NDM-1: is it creating the new “superbug”?

Reports out of the United Kingdom are talking about an enzyme known as NDM-1 (New Delhi metallo-β-lactamase 1), that has found its way from the Indian subcontinent and according to UK researchers could potentially be a major global health problem.

The enzyme is carried in certain gram negative bacteria like E. coli and Klebsiella, and makes the bacterium resistant to the carbapenem class of antibiotics.

The carbapenems are broad spectrum antibiotics used to treat various infections, including difficult to treat infections. They are typically highly resistant to beta lactamases. Beta lactamases are enzymes carried in certain bacteria that make the bacteria resistant to beta-lactam drugs like penicillin.

Beta lactamase is one reason why penicillin is ineffective in treating gonorrhea or Staph aureus today.

According to researchers, NDM-1 has traveled to the UK from British patients that traveled to India or Pakistan for certain medical procedures like cosmetic surgery.

Researchers fear that NDM-1 could also jump to other strains of bacteria which may already be multi-drug resistant.

Currently patients seen with infections with bacteria that are NDM-1, most have been able to be treated with a course of several antibiotics, however scientists have found some strains resistant to all available antibiotics.

Infection experts say the best way to keep this from spreading is good infection control procedures like surveillance, handwashing and disinfecting equipment, rapidly identifying the bacteria and isolation of the patient.

However, there are already reports of hospital acquired transmission from patient to patient in UK hospitals.

Most antibiotics in the pipeline are being developed to treat patients with other antibiotic-resistant organisms like MRSA, and will be ineffective against gram negative bacilli with NDM-1.

The BBC reports that similar infections have been seen in the US, Canada, Australia and the Netherlands and international researchers say that NDM-1 could become a major global health problem.

Tuesday, August 10, 2010

4 Peruvian children likely killed by vampire bats

According to the web site El, 4 children died last week after getting bitten by hematófagos or vampire bats. The deaths were confirmed to be caused by rabies.

The Regional Directorate of Health in Amazonas has confirmed that medical staff has been dispatched to the area with 1300 doses of rabies vaccine to immunize the inhabitants of that locality and nearby small villages.

Most human cases of vampire bat-transmitted rabies have occurred in the Amazon region of Brazil and Peru and in some remote communities of Colombia.

There are three bat species that feed solely on blood: Desmodus rotundus or the common vampire bat, Diphylla ecaudata, the hairy legged bat and the white winged vampire bat, Diaemus youngi. All three species are native to Latin America.

There are currently no new cases of rabies, however, that could change since rabies incubation can vary from days to months.

Clinical trials on dengue fever vaccine begins

A new tetravalent vaccine developed by scientists at the National Institute of Allergy and Infectious Diseases (NIAID) has begun human clinical testing at the Johns Hopkins Bloomberg School of Public Health in Baltimore.

Dengue fever is caused by any of four related viruses — DENV-1, DENV-2, DENV-3 and DENV-4 — which are transmitted to humans by Aedes mosquitoes.

The new vaccine is designed to protect against all four dengue viruses or serotypes. This will provide immunity against all forms of dengue. This is important since when someone gets infected with one serotype of dengue, antibody to that one serotype only is produced. However, this is actually more dangerous because severe dengue hemorrhagic fever can result if infected with a different serotype.

So in essence having some antibody formation can be more dangerous than having none at all. But if vaccinated with this tetravalent vaccine, there will be immunity against all serotypes of dengue eliminating the chance of severe dengue disease like dengue hemorrhagic fever or dengue shock syndrome, both of which can be fatal.

According to the NIH press release, in this Phase I trial, study volunteers who have never been exposed to dengue were randomly assigned to receive one of the candidate tetravalent vaccine formulations or a placebo. The candidate vaccines are live-attenuated, or created by making the live virus harmless or less virulent.

The symptoms of classic dengue usually start within a week after being infected. They include very high fever, up to 105°F, severe headache, pain behind the eye, severe joint and muscle pain, nausea and vomiting and a rash. Some people infected with dengue virus experience no symptoms at all or only a mild fever.

Symptoms of DHF include all the symptoms of classic dengue plus severe damage to the blood vessels. Bleeding from the nose, gums or under the skin are common. This form of dengue can be fatal.

Symptoms of DSS include all of the above symptoms plus; fluid leaking outside of blood vessels, massive bleeding and shock. This form of the disease usually happens in children experiencing their second infection.

Two-third of all fatalities occurs among children.

Monday, August 9, 2010

300 cases of malaria in Rizal province since July according to news report

According to a report in the Manila Bulletin, there have been 300 cases of malaria in the Rizal province since July. The numbers came from Engineer Alberto Piñon, the malaria and dengue coordinator of the Rizal Provincial Health Office (PHO).

Disease carrying Anopheles mosquitoes have been reported in more remote areas of the province to include the Taytay municipality.

However, the news report does not say how the patients are being diagnosed. Clinical symptoms of malaria and dengue do overlap considerably and diagnosis on this alone is difficult.

There was one fatality in this outbreak and interestingly the individual had just returned from Africa.

The Rizal PHO is currently conducting lectures on dengue and malaria prevention in hopes of slowing this down, particularly in more remote regions of the province.

Rizal is located approximately 20 kilometers from the capital city of Manila and is typically considered a low risk area for contracting malaria.

For more information on malaria

For more information on dengue fever

For more information on Rizal province

Sunday, August 8, 2010

The rabies problem in Bali continues

The beautiful resort and formerly rabies-free Indonesian island of Bali is under siege from the deadly virus.

The outbreak that was initially publicized in late 2008 continues to this day with the human death toll up to 78, and probably many other deaths are going unreported.

I initially wrote about this last October 31 when the US Centers for Disease Control and Prevention issued a travel warning for US travelers. At that time the death toll was at 15.

The problem has got to the point where rabies vaccine supplies on the island are running low and may soon not be available.

According to the Jakarta Post, six of Bali's eight regencies - Karangasem, Tabanan, Bangli, Jembrana, Klungkung and Buleleng - had no supplies of anti-rabies vaccines. There was concern that poor patients would not be able to travel to obtain anti-rabies shots.

The Australian-based Bali Street Dog Fund has vaccinated thousands of dogs to help curb the outbreak and the Bali government has even used controversial methods like picking out strays for killing.

Since the beginning of the outbreak, 200,000 dogs have been killed, though many find this an ineffective method to control rabies.

Rabies is an acute viral infection that is transmitted to humans or other mammals usually through the saliva from a bite of an infected animal. It is also rarely contracted through breaks in the skin or contact with mucous membranes.

According to the Control of Communicable Diseases Manual, all mammals are susceptible to rabies. Raccoons, skunks, foxes, bats, dogs, coyotes and cats are the likely suspects. Other animals like otters and ferrets are also high risk. Mammals like rabbits, squirrels, rodents and opossums are rarely infected.

Some infected animals can appear very aggressive, attacking for no reason. Some may act very tame.

The symptoms of rabies are as follows. Initially, like in many diseases, the symptoms are non-specific; fever, headache and malaise. This may last several days. At the site of the bite there may be some pain and discomfort. Symptoms then progress to more severe: confusion, delirium, abnormal behavior and hallucinations. If it gets this far, the disease is nearly 100% fatal.

The only treatment for human exposure to rabies is rabies-specific immune globulin and rabies immunization. Appropriate treatment started soon after the exposure will protect an exposed person from the disease.

Pakistan flood survivors now face a myriad of infectious diseases

With the worst flooding in the country in decades and over 1000 people dead as a result come the next part of the disaster cycle- infectious diseases.

With villages decimated and crops destroyed, thousands of Pakistanis are now flooding rescue centers for many reasons- one being medical assistance.

According to medical personnel on the ground, most patients are suffering from waterborne diseases, gastric problems, chest infections and skin complaints. The cause of these diseases is mainly dirty flood water.

Diseases like cholera, amoebiasis and other diarrheal diseases will likely increase as clean drinking water becomes scarcer.

As crowds of people gather at rescue centers, respiratory diseases like influenza are likely to increase and spread.

And with more rains forecast in Pakistan, these problems may continue for some time.


Saturday, August 7, 2010

New treatment for sleeping sickness could become ineffective according to study

A year ago a new combination drug treatment for African trypanosomiasis was released by the non-profit organization, Drugs for Neglected Diseases initiative (DNDi).

The combination therapy of nifurtimox and eflornithine has been a success story not only in its effectiveness, but it is less toxic, cheaper and easier to administer than the traditional treatments.

However, according to a study in the journal, Antimicrobial Agents and Chemotherapy, UK researchers say their tests show that there is a danger that the parasites' resistance to nifurtimox could increase to the point where the disease is no longer curable with the drug.

This would be unfortunate because the other drugs available are more expensive, have a longer administration time as in the case of eflornithine or in the case of melarsoprol which is arsenic based, much more toxic. Treatment with melarsoprol kills one in 20 people who receive it.

Scientists at the DNDi say that the development of resistance is the norm and said that there are other drugs in the pipeline to treat sleeping sickness.

Click this link for more info on African sleeping sickness

Friday, August 6, 2010

Renowned Colorado restaurant linked to Salmonella outbreak

The Fort restaurant of Morrison, Colorado, famous for its foods from the early west and where then President Bill Clinton dined with world leaders in 1997 is being investigated by the Jefferson County Public Health department about a salmonella outbreak.

Health officials have already confirmed Salmonella enteritidis in 8 people and another 20 are considered probable.

The investigation is concentrating on patrons of the restaurant who dined there between July 10, 2010 and July 16, 2010.

This outbreak is being linked to undercooked eggs. Some think it may be related to rattlesnake cakes, a dish that is similar in appearance to crab cakes which has eggs in the recipe.

Salmonella is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain.

In rare circumstances, infection with salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis.


Thursday, August 5, 2010

Campylobacter outbreak at Montana resort

The Montana Department of Health has confirmed 14 cases of the bacterial gastrointestinal disease, Campylobacteriosis, with another 70 cases considered probable.

Health officials believe the source of the exposure was the water supply near Hebgen Lake and affected the Campfire Lodge Resort.

According to health officials, the owners of the resort are cooperating with the investigation.

What is Campylobacteriosis? It is caused by the various species of the bacterium, Campylobacter. The organism can be found in chicken, in healthy cattle, birds, raw milk, and contaminated water. Most cases of campylobacteriosis are associated with eating raw or undercooked poultry meat or from cross-contamination of other foods by these items.

It doesn’t take a lot of this organism to get you ill. In some studies it showed that as little as 500 organisms can cause disease in some individuals.

Campylobacter jejuni, the species most often implicated in infection causes diarrhea, which may be watery or sticky and can contain blood and white blood cells. Other symptoms often present are fever, abdominal pain, nausea, headache and muscle pain. The illness usually occurs 2-5 days after ingestion of the contaminated food or water. Illness generally lasts 7-10 days, but relapses are not uncommon (about 25% of cases).

There can be complications associated with campylobacteriosis; they include arthritis and neurological disorder Guillain-Barré syndrome. It is estimated that the latter is seen in one out of every 1000 cases of Campylobacter.

Most cases of Campylobacter are self-limiting and do not require treatment. However severe cases can be treated with antibiotics to shorten the length of the disease.


Wednesday, August 4, 2010

2010-2011 seasonal flu shot to include H1N1 strain

The US Food and Drug Administration have announced the three strains that will be included in the 2010-2011 seasonal influenza vaccine.

Of particular interest is the inclusion of the H1N1 influenza virus of 2009.

Each year, federal and global health experts from the FDA, World Health Organization, CDC, and other institutions study virus samples and patterns collected worldwide to identify strains likely to cause the most illness during the upcoming season.

The FDA does stipulate that there is always a possibility of a less than optimal match between the virus strains predicted to circulate and the virus strains that end up causing the most illness. However, even if the vaccine and the circulating strains are not an exact match, the vaccine may reduce the severity of the illness or may help prevent influenza-related complications.

The three strains for the 2010-2011 seasonal influenza vaccine are:

• A/California/7/09 (H1N1)-like virus (pandemic (H1N1) 2009 influenza virus)
• A/Perth /16/2009 (H3N2)-like virus
• B/Brisbane/60/2008-like virus

For more detailed info, read the July 29, 2010 issue of MMWR

Vibrio parahaemolyticus causes Washington State Health officials to close oyster growing areas

Lab tests and several illnesses in two Hood Canal oyster growing areas in Washington State have led state health officials to close these waters to recreational oyster harvesting.

There have been 4 cases of food poisoning due to the bacterium Vibrio parahaemolyticus after eating raw oysters. In addition, lab tests show the bacterium in the waters.

Warm temperatures and high salt water content makes it favorable for the growth of Vibrio parahaemolyticus.

V. parahaemolyticus is naturally present in marine waters and is not necessarily indicative of sewage contamination.

This bacterium, when ingested causes watery diarrhea often with abdominal cramping, nausea, vomiting, fever and chills. Usually these symptoms occur within 24 hours of ingestion. Illness is usually self-limited and lasts 3 days.

Severe disease is rare and occurs more commonly in persons with weakened immune systems. V. parahaemolyticus can also cause an infection of the skin when an open wound is exposed to warm seawater.

Most people become infected by eating raw or undercooked shellfish, particularly oysters.

Treatment is not necessary in most cases of V. parahaemolyticus infection. There is no evidence that antibiotic treatment decreases the severity or the length of the illness. Patients should drink plenty of liquids to replace fluids lost through diarrhea.

Prevention of vibrio infection includes thorough cooking of shellfish. Food safety specialists recommend oysters be cooked to an internal temperature of 145° F to kill the bacteria.


Tuesday, August 3, 2010

An interview with the Blastocystis Research Foundation director, Ken Boorom

The microorganism Blastocystis hominis has been an issue of some controversy for as long as I’ve been in the field, whether it has been over its taxonomic classification or issues of pathogenicity and treatment.

It is an organism that I personally have reported on numerous parasitology stool exams over the years and have always considered it relatively common based on this experience.

Well, I came across the Blastocystis Research Foundation (BRF) through an email and found a whole world of people suffering severe chronic infections that I never knew existed. In addition, I discovered that almost all research on this parasite is coming from overseas scientists with next to nothing happening here in the United States.

I contacted BRF founder and director, Ken Boorom, to ask him some questions on this neglected parasite and some of the work they are doing at the foundation.

Herriman: The Blastocystis Research Foundation (BRF) recently turned four years old. What exactly happened to you to cause you to create this foundation?

Boorom: I got sick in April 2003, with chronic diarrhea and other symptoms, and could not get a reliable diagnosis for over a year. The treatments being prescribed by doctors aren't working in about half the cases, and I'm one of the ones where they didn't work. By 2006, I was so sick I had to go on medical disability. Neighbors and friends in our Oregon community started telling me about their family members who were sick, or that they had gotten sick with the same symptoms, and doctors also started telling me about their other patients. I also found out that every problem I was having had already been reported in the medical literature, either by an NIH scientist in the early 1990's, or by researchers overseas. I started the foundation to get the problem with the diagnostics and treatments fixed.

Herriman: I saw on your web site the battle you are having with the CDC and NIH concerning the lack of research and general neglect to recognize overseas research that specifically identifies that pathogenicity of Blastocystis and its role in gastrointestinal disease. How do you explain their attitudes toward Blastocystis?

Boorom: We're reminding the CDC and NIH of their responsibility, but we aren't expecting much from those agencies. When it comes to GI pathogens, it's rare for either the CDC or the NIH to be a leader in the field. Of the five major microbes identified as GI pathogens identified since 1980 (Giardia, Cyclospora, Cryptosporidium, Enterotoxic E Coli (ETEC), D. fragilis), the CDC played a role only in ETEC, in which Dr. Lee Riley of the CDC did a lot of the early work in the mid-1980's. Giardia and Cryptosporidium were legislated as pathogens by an act of Congress.

There aren't any laws that require federal agencies to take action on disease-causing microbes, as there are for disease-causing chemicals.In Blastocystis, you've got something that can be toxic enough to kill rats in animal studies, but there is no federal response, even though infection rates have climbed to 10-20% in some states. It's important to spell out the law ahead of time, because there are always special interests that will want to do nothing, whether it is a chemical or an infectious disease, even when people are dying. Just read, And the Band Played On (Shilts, 2000)

Herriman: I have worked in parasitology labs here in the US and overseas for over 20 years and have always reported out the presence of Blastocystis with a quantity (rare, few, moderate, many). It shocked me to read in your latest newsletter that physicians may not even be informing their patients that they have Blastocystis in their stools. How long has this been going on?

Boorom: We first heard about this in 2006, and since then it has come up about a half dozen times, but it's probably been going on for a long time. In the 1950's, physicians wouldn't tell patients if they had an incurable cancer (they would tell their families). There is no law requiring doctors to inform patients if their test results come back showing they have an infectious disease like Blastocystis. Some physicians are just too busy to follow-up, and others don't think it's important. At BRF, we think patients should be told so they can take precautions to avoid spreading the infection to others, and so they can be given the opportunity to treat the infection.

Herriman: I also found it interesting that there are so many foreign studies that make a connection with Blastocystis to irritable bowel syndrome (IBS). However, if I go to the NIH site or WebMD for example, there is no indication of this. Why is IBS treated as this elusive syndrome?

Boorom: Most of the people studying IBS in the United States work in groups that are trying to get grants to study "brain-gut" interactions, not infectious diseases. They are often interested in neurology or psychiatry. They have graduate students working on theses, and long-term funding, and the last thing they want to hear is that their patient population actually has an infectious disease.

This is one of the real tragedies of the NIH. The agency is focused on promoting the careers of scientists on the assumption that if scientists are having good careers that will be good for US patients. But there are many cases where something that is great for scientists is terrible for patients. For example, we have almost no parasitology researchers left in the United States, which may explain why research projects for parasitic diseases are going to neurologists.

Herriman: I must admit I was ignorant to many of the assertions your foundation has made. Can you briefly summarize what BRF is doing with the “Gulf War Syndrome” study?

Boorom: The Blastocystis "controversy" started just before the Persian Gulf War, when some physicians at an HMO in Oakland, CA began attacking researchers in at King Faisal Specialist Hospital in Saudi Arabia (and everywhere else) who were saying the Blastocystis was causing symptoms like abdominal pain, diarrhea, headaches, fatigue, depression, and nausea in their patients. The HMO doctors insisted that Blastocystis was harmless, and the patients had IBS, which was thought of as a kind of psychosomatic illness of neurotic women. After the Persian Gulf War, researchers in the Middle East started cranking out papers on Blastocystis - over a hundred so far if you include Turkey - showing the disease is epidemic in the region, and the treatments aren't working. About a third of the medical students in Pakistan are sick.

So who was right? An easy experiment would be to send a bunch of US citizens to the Middle East and see if they get infected with Blastocystis, and to see if a third comes back sick. So we did the experiment with about a million troops, and about 250,000 came back sick, so I say the Saudis are right. But as soon as the troops got back, US researchers insisted it must be a special syndrome due to a toxic exposure, even though the Institute of Medicine kept insisting that the symptoms weren't unique to veterans. The US researchers painted themselves into a corner by being so adamant that the disease was due to a toxicological exposure, they haven't been able to take advantage of any research published in the region since then.

We published the first US study on civilians and veterans with Gulf War Illness symptoms that showed these people had Blastocystis infections that had not been identified. Our veteran had Gulf War Illness, and he spent the war in the United Arab Emirates, hundreds of miles away from any toxic chemicals.
Now we're following up on that study with more vets. We're really just copying the studies the Pakistanis are doing with their sick kids. We're taking fecal samples from veterans with Gulf War Illness and testing them for Blastocystis.

Herriman: The Medical Letter has reported that flagyl, iodoquinol and septra as being effective treatment for Blastocystis infection. What are your thoughts on the effectiveness of the treatment regimens?

Boorom: The only recent study on the effectiveness of metronidazole (flagyl) in European adults put the cure rate at less than 50%. Despite all the talk about the disease, there are very few good treatment studies, and most of the ones we have are on people in the Middle East, or Mexican children. Just because something works in Mexico children doesn't mean it's going to work in adults in the US. Also, the diagnostics available for Blastocystis only identify about a third of infections, so it's difficult to know if the drugs are making patients feel better for a few weeks, or really eradicating the infection.

Mr. Boorom, thank you for taking the time to answer these questions and good luck with your work.


Monday, August 2, 2010

In pursuit of a leprosy vaccine

That’s what scientists at the Seattle-based Infectious Disease Research Institute (IDRI) have been working on for the past several years.

With funding help from the American Leprosy Missions, the IDRI expect to have the newly developed vaccine ready for safety trials by 2011.

In addition, the institute is working on rapid diagnostic tests to be used in the diagnosis of leprosy.

The technique to develop a leprosy vaccine is to identify and produce specific proteins from the Mycobacterium leprae organism and combine these with an effective adjuvant. Adjuvants are substances that enhance the ability of an antigen to stimulate an immune response in the body.

This is the same approach used to successfully develop a vaccine for leishmaniasis.

Leprosy has caused a stigma on infected people for several millennia. Infected people have historically been separated from society in Leprosariums or “lepper colonies”. Now with antibiotics the bacteria can be prevented from disfiguring and destroying the body and preventing transmission.

Leprosy is a chronic infectious disease caused by the bacterium, Mycobacterium leprae. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract and also the eyes, apart from some other structures.

The exact mechanism of transmission of leprosy is not known. At least until recently, the most widely held belief was that the disease was transmitted by contact between cases of leprosy and healthy persons. More recently the possibility of transmission by the respiratory route is gaining ground.

According to the IDRI:
• Leprosy is endemic in 24 countries.
• 1.6 billion people worldwide are exposed to leprosy.
• 300,000 new cases are found each year, that's over 1,300 cases every day.
• It is estimated that four to five million people already suffer from or have deformities due to leprosy.

Sunday, August 1, 2010

Hundreds in West Bengal district afflicted with kala-azar

Reports out of India say that at least 252 people in the West Bengal's Malda district have become affected with kala-azar, a potentially fatal condition caused by the parasite, Leishmania donovani.

According to health officials in the area, hundreds have tested positive for the parasite.

Leishmaniasis is not a single disease, but a group of syndrome due to a variety of species of this parasite. The affect different populations and are related to a characteristic vector, the sandfly.

The disease can range from asymptomatic infections to those causing significant illness and death. Disease can appear on a spectrum from a single skin ulcer to destructive lesions of the face to terminal organ disease.

Kala-azar, an Indian name given to systemic type of the disease due to the grayish appearance of the body, can result in enlarged spleen and liver, diarrhea, emaciation, weakness and death.

3rd Florida fatality due to Eastern Equine Encephalitis. What can you do to protect yourself?

The death of a Brandon, Florida infant is the third fatality from the mosquito borne virus this month in Florida.

This is the second death in Hillsborough County from Eastern Equine Encephalitis (EEE) this month; the other death was from Wakulla County in the Florida Panhandle.

This has prompted health official to issue a public health alert and increase mosquito spraying.

What is Eastern Equine Encephalitis?

It is a mosquito-borne virus that is quite rare in the United States, with only 5-10 cases reported annually according to the Centers for Disease Control and Prevention (CDC). EEE virus is one of several mosquito-transmitted viruses that can cause inflammation of the brain (encephalitis).

It is not transmitted from person to person.

People at highest risk of getting this infection are those who live in or visit woodland habitats, and people who work outside or participate in outdoor recreational activities, because of greater exposure to potentially infected mosquitoes.

Symptoms usually start from a few days to more than a week after getting bit by an infected mosquito. These include a sudden onset of headache, high fever, chills, and vomiting. The disease can progress to disorientation, seizures, and coma. It is fatal in approximately 30 percent of the cases.

There is no specific treatment for this infection and a vaccine is not available for prevention.

What can I do to prevent getting EEE?

The CDC offers the following recommendations:

• Use insect repellent containing DEET, picaridin, IR3535 or oil of lemon eucalyptus on exposed skin and/or clothing. The repellent/insecticide permethrin can be used on clothing to protect through several washes. Always follow the directions on the package.

• Wear long sleeves and pants when weather permits.

• Have secure, intact screens on windows and doors to keep mosquitoes out.

• Eliminate mosquito breeding sites by emptying standing water from flower pots, buckets, barrels, and other containers. Drill holes in tire swings so water drains out. Keep children's wading pools empty and on their sides when they aren't being used.