Sunday, October 31, 2010

The risks of drinking raw milk; bacteria, parasites and theoretically rabies

The Minnesota Department of Health (MDH) reported additional cases of infectious organisms being transmitted through consumption of raw milk.

Raw milk consumed from Hartmann dairy farm in Sibley County has several people sick from two different infectious organisms, the bacteria Campylobacter jejuni and the parasite Crytosporidium parvum. These organisms were laboratory confirmed.

But these cases are only been the tip of the iceberg this year from raw milk consumption from this particular farm. So far this year there have been 47 documented cases of foodborne illness from ingesting raw milk with the most recent outbreak being this summer with E.coli O157:H7 from raw milk.

As MDH Foodborne Diseases Unit Supervisor Kirk Smith wisely notes, “While we are very concerned about the ongoing illnesses associated with this one farm, this isn’t just about one farm selling raw milk and making people sick, this also is about the inherent risk of any raw milk. People need to think carefully about those risks before consuming raw dairy products from any source, and people need to know that the risks are especially high for young children.”

And he is absolutely correct.

In a paper titled, “Milk of Nonhuman Origin and Infectious Diseases in Humans”, John Leedom from USC points out the many risks of drinking raw or unpasteurized milk. The list is a cornucopia of infectious agents: Salmonella species, Campylobacter species, Listeria monocytogenes, Brucella abortus, Brucella melitensis, Mycobacterium bovis,Tick-borne encephalitis, Yersinia enterocolitica and he discusses the theoretical possibility of rabies transmission:

“In 1996 and 1998, there were 2 episodes involving rabid cows that occurred in Massachusetts. Milk from rabid cows can contain rabies virus, and transmission via unpasteurized milk is theoretically possible. Temperatures reached during pasteurization kill the virus. Eighty persons consumed unpasteurized milk that was collected from the 2 cows, and 9 more had contact with saliva from the cows. All 89 persons received postexposure rabies prophylaxis, and no human cases of rabies eventuated. A similar report in Oklahoma of possible rabies exposure associated with the consumption of raw milk or cream from a rabid cow was circulated in 2006.”

As Kirk Smith also notes in the news release, "Whatever is in cow poop is going to wind up in raw milk. It is impossible to produce raw milk without those kinds of things happening."

Saturday, October 30, 2010

Did Lyme disease originate out of Plum Island?

Many in the Lyme disease community and so-called “conspiracy theorists” have been making this claim for a long time. While no surprise, the Department of Homeland Security has unequivocally denied it. On their web site “About Plum Island Animal Disease Center” (PIADC), they state; “the PIADC does not and has not performed research on Lyme disease.”

What is Plum Island Animal Disease Center?

According to their web site, “The Plum Island Animal Disease Center is a Biosafety Level 3 (BSL-3) facility designed and constructed to work with the most dangerous animal diseases in the world, such as foot-and-mouth disease (FMD), Rinderpest, and African swine fever. In fact, by federal law, Plum Island is the only place in the U.S. where FMD and Rinderpestviruses can be studied.”

Located about off the tip of Long Island, New York, it was opened in 1954 during the Cold War with a “goal” of protecting livestock from animal diseases.

Some say it was opened under “Project Paperclip”. This was a top-secret government program to recruit Nazi scientists who were working on animal diseases during WWII. It has been suspected that more than 2000 scientists were brought here and offered employment contracts and US citizenship. One of the areas of expertise they had was experiments with disease-infected ticks.

It is suspected that Dr. Erich Traub, a physician once in charge of the Third Reich's virological and bacteriological warfare program in World War II, was involved with biological warfare research at Plum Island.

From the Belarus Secret it states; …"Even more disturbing are the records of the Nazi germ warfare scientists who came to America. They experimented with poison ticks dropped from planes to spread rare diseases. I have received some information suggesting that the U.S. tested some of these poison ticks on the Plum Island artillery range off the coast of Connecticut during the early 1950s…"

Plum Island is coincidentally within miles of the place where Lyme disease “originated”, the epicenter of Lyme, Connecticut.

People who place blame on Plum Island for Lyme disease clearly demonstrate that infected ticks from Plum Island could have easily been transported to the mainland via the hundreds of different birds that would nest there.

Is Lyme disease considered a biowarfare agent?

After years of denial that this was the case, a few years ago the Centers of Disease Control admitted when opening Margaret Batts Tobin Laboratory Building in Texas that facility would be used to study such diseases as anthrax, tularemia, cholera, lyme disease, desert valley fever and other parasitic and fungal diseases. The Centers for Disease Control and Prevention identified these diseases as potential bioterrorism agents.”

The causative agent of Lyme disease, Borrelia burgdorferi (Bb) has been used in biowarfare studies before. During WWII, the infamous and murderous Japanese Unit 731 has used Bb in some of their barbaric studies according to scientist Barclay Newman.

Have the researchers at Plum Island actually ever done any experiments with tick-borne diseases?

The answer to this is an unequivocal yes. Numerous studies were done with tick diseases and the published papers are available. Here is a list of some of the papers:

“African swine fever virus multigene family 360 genes affect virus replication and generalization of infection in Ornithodoros porcinus ticks”

“Heartwater disease of domestic and wild ruminants”

“Experimental transmission of African swine fever virus by the tick Ornithodoros (Alectorobius) puertoricensis (Acari: Argasidae).”

And this is just a short list. However, this does not prove that Lyme disease originated at Plum Island, but disease-infected ticks were certainly present there.

However, the deeper you look into this issue it’s like peeling back the layers of an onion.

Whether it is the shady beginnings with Nazi scientists or later the Iraqi biowarfare scientists that have worked there, the denials and secrecy of the facility, the fact that every land area around Plum Island is endemic for Lyme disease and now Plum Island is requesting fund for upgrading the facility to a BSL-4 laboratory, questions abound.

Though we may never know if indeed Lyme disease originated out of tick-borne and biowarfare research at Plum Island, questions need to be answered and maybe an investigation is warranted.

Guatemalan syphilis experiment: in the name of public health?

Of course everyone has heard by now the appalling discovery unearthed by Wellesley College professor, Susan Reverby on how the US Public Health Service (a medical branch of the US government) conducted clearly unethical and dangerous syphilis experiments in Guatemala in the mid-40s.

And all of Washington from President Obama to Secretaries Hillary Clinton and Kathleen Sebelius to NIH director, Francis Collins has come out condemning the experiments and apologized to the country of Guatemala.

So what did Professor Reverby find? From 1946 to 1948, a Public Health Service (PHS) physician, Dr. John C. Cutler, ran a syphilis inoculation project on Guatemalan soldiers and prisoners to determine the prophylactic capabilities of penicillin against this infamous spirochete.

Cutler, the government physician, would also take part in the equally abhorrent US government sponsored Tuskegee Syphilis Study.

Do you think Cutler was just a rogue doctor performing dangerous experiments on unsuspecting foreigners in another land? Though clearly Cutler agreed with the goals of the experiments he certainly wasn’t alone in this. At least two agencies under the Truman administration were direct co-sponsors in this dastardly deed; in addition to the PHS, the National Institutes of Health (NIH) was involved and the global health organization, Pan American Health Organization.

And it was not only the US government either. Guatemala’s President Alvaro Colom came out saying, “What happened all those years ago is a crime against humanity and the government reserves the right to lodge a formal legal complaint over it.”

What Mr. Colom fails to acknowledge here is that parts of the Guatemalan government at that time also consented to the experiments. It seems the only ones who didn’t consent were the human guinea pigs in Guatemala.

And a statement I personally find extremely abhorrent comes from then US Surgeon General Thomas Parran: “You know, we couldn’t do such an experiment in this country”.

Let me preface these next statements by saying I do not consider this case exactly equal to the atrocities that came out of Germany and Japan with human experimentation on prisoners during World War II however some things overlap and some are just plain ironic.

In the name of public health, the US government (PHS) in 1946 to 1948 goes to a foreign land (Guatemala) to do human experimentation on prisoners of that foreign land without their consent.

Didn’t just a few short years earlier, Mengele, et al do similar types of experiments on prisoners to test malaria treatments where more than 1000 prisoners were purposely exposed to malaria infected mosquitoes, or purposely infecting prisoners with tetanus and other agents to test the effectiveness of the antibiotic, sulfonamide ?

And not to mention the human experimentation that was performed by the Japanese on Chinese soldiers and others in their infamous Unit 731.

And now the irony…

While our good doctor, John Cutler was conducting these government-condoned “experiments” in Guatemala, the Doctor’s Trials (United States of America v. Karl Brandt, et al) were going on in the Palace of Justice in Nuremburg in front of a panel of US judges.

Friday, October 29, 2010

Is there an association between intestinal parasites and fecal occult blood?

This was a question researchers at the King AbdulAziz University-Jeddah, Saudi Arabia set out to answer.

Intestinal parasites include nematodes (roundworms) like hookworms and Ascaris lumbricoides, cestodes (tapeworms) like Taenia, trematodes (flukes) like the schistosomes and intestinal protozoa such as Entamoeba histolytica and giardia.

Some of the above parasites like Entamoeba histolytica are well known for causing bloody stools like in dysentery.

A fecal occult blood test checks for nonvisible blood in feces. The classic guiac test was developed for screening colon cancer.

In this study lead by Majed Wakid, over 1200 workers from western Saudi Arabia had stools collected and examined for intestinal parasites and for fecal occult blood. All the enrolled participants were males aged 17 to 70.

Six hundred and fifty six cases (53%) with out intestinal parasites were designated as the control group for the study.

The other 47% of cases (582) were infected with one or more of the following parasites: hookworms, Trichuris trichiura, Ascaris lumbricoides, Hymenolepis nana, Schistosoma mansoni, Strongyloides stercoralis, Enterobius vermicularis, Taenia saginata, E. histolytica, Giardia lamblia, Blastocystis hominis, and several nonpathogenic intestinal protozoan parasites (Entamoeba coli, Endolimax nana, Entamoeba hartmanii, Iodamoeba butschlii, and Chilomastix mesnili).

Of the 582 positive workers, there were 130 cases that were positive for fecal occult blood (22.43%). In the control group of 656 workers, 170 men had a positive fecal occult blood (25.91%).

Based on this study of male workers in western Saudi Arabia, there is not a significant association between infection with intestinal parasites and the presence of fecal occult blood.

Thursday, October 28, 2010

Handwashing: the Dyson Airblade proves superior to warm air hand dryers

A study was performed by researchers at the University of Bradford, UK to compare efficacy of hand drying in two areas: (A) the bacterial transfer after drying and the (B) impact on numbers of bacteria when rubbing hands.

The comparison was between the ultra-rapid hand dryer, the Dyson Airblade and regular warm air dryers.

If you are not familiar, the Dyson Airblade uses two air “knives” that strip water from still hands while as everyone knows, a conventional dryer uses warm air to evaporate moisture while rubbing hands together.

In the first study (A), the volunteers handled meat and washed their hands in the conventional manner. After drying their hands, their fingers were tested for bacterial transfer. After a drying time of 10 seconds, the use of the Airblade resulted in a significant drop in bacterial transfer as compared to warm dryers. This is due to the difference in residual moisture left on the hands after using each machine. At times of 30 seconds the Airblade was still better, but the differences were less significant.

In the (B) study where hand rubbing was evaluated, drying was performed with and without hand rubbing. When the hands were still there was little difference between dryers. However, when rubbing hands while using warm air dryers actually inhibited the overall reduction of bacteria on the skin.

Of course handwashing is critical in preventing infection and hand drying is an important component. In this study, two main conclusions were reached: 1) The Airblade was clearly superior in reducing bacterial transfer and 2) rubbing hands while using warm air dryers can counteract the reduction in bacterial numbers accrued during handwashing.

VITEK 2 susceptibility cards incorrectly report Pipericillin/Tazobactam

Microbiology products manufacturer bioMerieux, Inc. issued a worldwide product correction last month for some of its clinical microbiology products.

The products in question are the VITEK 2 Gram Negative Susceptibility Cards which contain the antibiotic Piperacillin/Tazobactam (TZPv). 112 different VITEK 2 susceptibility panels manufactured after March 10, 2009 are affected.

Clinical microbiology laboratories using cards with Pipericillin/Tazobactam to test E.coli and Klebsiella pneumoniae resistant results were notified to test this antibiotic using an alternative method.

A bioMerieux investigation confirmed that the VITEK 2 Gram Negative Susceptibility Cards may report susceptible E.coli and K. pneumoniae isolates as resistant to Pipericillin/Tazobactam. In addition, E.coli strains that were resistant to Pipericillin/Tazobactam may be incorrectly reported at susceptible.

According to the press release, incorrect results could potentially lead to patients being inappropriately treated with Piperacillin/Tazobactam when infected with a resistant E. coli isolate. There have been no reports to date of treatment failures associated with either falsely-resistant or falsely-susceptible E. coli results for Piperacillin/Tazobactam (TZPv), or for falsely-resistant K. pneumoniae results.

Wednesday, October 27, 2010

Vibrio cholerae demonstrates ability to kill salmonella and E. coli

Vibrio cholerae, the causative organism of the serious diarrheal disease cholera is making the news with increasing frequency as of late with outbreaks in Haiti that has killed hundreds, and in Nigeria over 1500 people have succumbed to the infection.

Well it appears that not only in the cholera bacterium lethal to humans but according to researchers at the University of Alberta, also to other competing bacteria.

The study published in the Proceedings of the National Academy of Sciences describes the researcher’s findings.

The cholera bacteria compete with other gram negative bacteria for food and nutrients in the environment.

V. cholerae’s secretion system known as type VI secretion system (T6SS) is structurally similar to the bacteriophage cell-puncturing device has been known protect the bacteria from phagocytic eukaryotes and amoebas.

Now researchers have discovered the T6SS to be pathogenic to several Gram negative bacteria like E.coli, S. Typhimurium and others. As a matter of fact in the study it was demonstrated to produce a 100,000 fold reduction in E.coli.

This killing mechanism against competing bacteria could explain why cholera epidemics reoccur months or years after the last reported case of the disease.

V. cholera is a water-borne organism and exists there in a free-living state. People get infected with the bacteria through ingesting contaminated food or water.

Cholera is an acute bacterial intestinal disease characterized by sudden onset, profuse watery stools (given the appearance as rice water stools because of flecks of mucus in water) due to a very potent enterotoxin. The enterotoxin leads to an extreme loss of fluid and electrolytes in the production of diarrhea. It has been noted that an untreated patient can lose his bodyweight in fluids in hours resulting in shock and death.

Tuesday, October 26, 2010

Dried seafood from Vietnam recalled due to botulism risk

Foremost Foods International of Pomona, California issued a voluntary recall of some Tomi brand dried seafood products because of the potential risk of Clostridium botulinum, the agent of the life-threatening disease botulism.

The dried seafood was manufactured in Vietnam by Kien Long Seafood Company Ltd.

The products which include Tomi brand dried baby squid and dried shrimp fry (see complete list here) were distributed in the States of California, Nevada, and Washington through Seafood City and Manila Seafood retail stores. The recall involves products sold between September 23, 2009 and October 20, 2010.

Food borne botulism is a severe intoxication caused by eating the preformed toxin present in contaminated food. Botulinum toxin is one of the most potent neurotoxins known.

Typically in a few hours to several days after you eat the contaminated food you will start to show the classic symptoms; blurred vision, dry mouth, and difficulty in swallowing. Gastrointestinal symptoms may or may not occur.

If untreated, the paralysis always descends through the body starting at the shoulders and working its way down. The most serious complication of botulism is respiratory failure where it is fatal in up to 10% of people. It may take months before recovery is complete.

If the disease is caught early enough it can be treated with antitoxin.

Monday, October 25, 2010

Health officials in UK warn about Hepatitis E being transmitted by raw pork

Hepatitis E virus (HEV), a relatively rare, waterborne disease has been implicated in the deaths of 3 people and at least 55 illnesses across the United Kingdom.

This form of hepatitis is generally associated with contaminated water and poor sanitation and generally afflicts younger aged people. But health officials are seeing the infections in middle aged and elderly people with no history of overseas travel.

Dr Harry Dalton, a consultant gastroenterologist at Royal Cornwall Hospital Trust believes the infections are a result of eating raw pork. It is acknowledged that pigs and pork can harbor the virus and that this may be the cause of the disease in cases where there has not been any foreign travel.

There have been several cases of hepatitis E infection in France in the past due to eating raw figatellu, which is made with pig liver.

It has recently been shown that HEV is present in both domestic pigs and wild boar in various parts of Europe and the high genetic similarity between HEV isolates from pigs and humans confirm previous inferences of possible zoonotic transmission of HEV.

Most outbreaks are associated with contaminated water or shellfish where people get infected primarily through the fecal-oral route.

The clinical course of hepatitis E is similar to that of hepatitis A with no chronic form of the disease. Jaundice, fever, loss of appetite and lethargy are common symptoms.

Typically like hepatitis A, the fatality rate is low with the exception of pregnant women where it can reach 20% among those infected in the third trimester. Liver failure is a frequent outcome with pregnant women.

Hepatitis E is found endemically in countries that have inadequate environmental sanitation. It is most frequently seen in Asia, Africa, Central America and the Middle East.

Saturday, October 23, 2010

Syphilis tops gonorrhea as top STI in large Chinese cities

The sexually transmitted infection which was once almost non-existent in China has become a burgeoning problem in at least two large metropolitan areas, so much that syphilis has surpassed gonorrhea in at least two cities.

I reported in May that the mega city of Shanghai the epidemic of syphilis has spread so far that it surpassed all other sexually transmitted infections (STI).

Now syphilis has passed gonorrhea as the most common STI in the city of Beijing. According to a report released by the Beijing Municipal Health Bureau, reported syphilis cases in the city increased by 21% last year alone.

Syphilis cases have grown by an average of 17.51 percent every year from 2004 to 2009. The most affected age groups are 20 to 39-year-olds, followed by 50-plus years of age.

To combat the syphilis problem the city will soon provide free checkup and treatment of syphilis at community clinics.

One of the most tragic things about this burgeoning epidemic is that there is no mandatory screening for STI’s like syphilis for pregnant women. The result is that every hour a baby born in China is born with syphilis.

According to the official report from the Beijing Municipal Health Bureau, the three high-risk groups based on sentinel surveillance results of clinics in the capital city: prostitutes, male homosexuals and drug users.

In the United States, syphilis ranks behind both gonorrhea and Chlamydia as the most common STIs.

Syphilis is a sexually transmitted infection (STI) caused by the bacterium, Treponema pallidum. The most common way to get syphilis is by having sexual contact (oral, genital or anal) with an infected person. The secondary lesions are also infective and contact with them could transmit the bacteria. It can also be transmitted from an infected mother to her baby (congenital transmission). It can also be transmitted through blood transfusion, though extremely rare because of testing of donors.
http://www.examiner.com/infectious-disease-in-national/50-years-ago-it-was-practically-non-existent-now-china-facing-explosion-of-syphilis

Friday, October 22, 2010

CDC websites: contradictions on the association between Lyme disease & the lone star tick

Lyme disease is a bacterial infection caused by the spirochete Borrelia burgdorferi and according to the American Lyme Disease Association; the vectors that transmit the bacteria are the deer tick (Ixodes scapularis) in the eastern United States and its close relative the Western black-legged tick (Ixodes pacificus) on the Pacific Coast.

This has been widely accepted by most in the medical and entomology communities.

So it surprised me when I saw this in my email box this morning from the Georgia Lyme Disease Association:

“CDC website notes the aggressive Lone Star tick; Amblyomma americanum, the tick most commonly found biting southeastern humans, transmits Lyme disease. GA Lyme has documented human Lyme cases from Lone Stars. As one researcher told us, even if only 1% of Lone Stars are infected, because they bite humans so often and are so widespread, it poses a TREMENDOUS health threat. This information changes the Lyme disease prevalencemap, as Lone stars are found from Florida to Canada and halfway across the country. Your chances of getting Lyme in these areas are far greater than previously calculated, when they used "deer ticks" alone. This again raises the question: How many people are being misdiagnosed due to the medical myth that "we don't have Lyme here"? We call upon public health officials to promptly educate the medical community and public.”

I thought Wow; Lyme disease advocates in the south have been saying this for a while. So I checked the link that was provided in the email: http://www.dpd.cdc.gov/dpdx/HTML/ImageLibrary/Ticks_il.htm

This is in fact part of the CDC’s Division of Parasitic Diseases and Malaria section, and there is an image gallery for ectoparasites such as ticks.

With the images of Amblyomma americanum is the following statement: “In North America, A. americanum transmits Francisella tularensis (tularemia), Ehrlichia chaffensis (ehrlichiosis), Borrelia burgdorferi (Lyme disease), and Rickettsia rickettsii (Rocky Mountain spotted fever, or RMSF).“

However, upon further examination of the CDC’s websites, in the section for the Division of Vector-Borne Infectious Diseases they have a whole piece on how Lone Star ticks DO NOT transmit Lyme disease. They go on to talk about how the lone star tick causes a condition called southern tick-associated rash illness (STARI). However, it is not caused by Borrelia burgdorferi.

Read the CDC article “Lone Star Tick a Concern, but Not for Lyme Disease”.

Read more about Lone Star ticks and Southern Tick-Associated Rash Illness

So my question is; which is correct? Why are different sections of the CDC contradicting each other?

Thursday, October 21, 2010

SIGA Technologies gets tentative contract for smallpox antiviral

SIGA Technologies, Inc. announced that the Department of Health and Human Services (HHS) intends to award a contract to the company to deliver 1.7 million courses of its novel smallpox antiviral drug, ST-246 for the Strategic National Stockpile.

The contract is currently pending because of a protest from competitor Chimerix.

If and when the contract is finalized, the revenues generated for SIGA would be up to $2.8 billion.

SIGA specializes in drugs to combat bio-warfare agents like smallpox. ST-246 is SIGA’s groundbreaking smallpox antiviral.

It works by blocking the variola virus (smallpox) from spreading to other cells, essentially preventing the disease. ST-246 has prophylactic, post-exposure, therapeutic and adjuvant to vaccination uses.

The Strategic National Stockpile (SNS) is the United States’ national repository of antibiotics, vaccines, chemical antidotes, antitoxins and other critical medical equipment and supplies. In the event of a national emergency involving bioterrorism or a natural pandemic, the SNS has the capability to supplement and re-supply local health authorities that may be overwhelmed by the crisis, with response time as little as 12 hours. The SNS is jointly run by the CDC and the Department of Homeland Security.

Though no longer found in the human population smallpox is considered a bio-warfare threat. There were two types of smallpox recognized in the 20th century; variola minor which had a fatality rate of less than 1%, and variola major which had a fatality rate of around 30%.

Initially after infection with the virus, prior to getting the rash, there was a period of sudden onset of high fever, headache, backache and malaise. After 2-4 days, the rash would begin to appear.

The rash progressed through several stages; from raised bumps to fluid- filled, hard and firm vesicles with a depressed center resembling a belly button.

The lesions appear on the face and extremities, including the palms of the hands and the soles of the feet. The lesions are at the same stage of development in a given area.

Rarely, in 5-10% of smallpox patients, variola major would take a fulminant, hemorrhagic course where it was rapidly fatal. In such patients, the lesions are so densely confluent that the skin looks like crepe rubber; some patients' exhibit bleeding into the skin and intestinal tract.

Smallpox is extremely contagious via respiratory secretions or direct contact with fluids with an incubation period of 12 days average. The illness usually lasts 4 weeks and the person would be contagious until all the lesions scabbed over and fell off in 3-4 weeks leaving pitted scars.

It is exclusively a human disease with no known animal or environmental reservoir hosts.
http://www.examiner.com/infectious-disease-in-national/siga-technologies-gets-tentative-contract-for-smallpox-antiviral

Tuesday, October 19, 2010

Iowa man gets a rare case of raccoon roundworm in the eye | video

Though he may never know exactly how he contracted it, John Matthews of Cedar Rapids knew something was terribly wrong with his left eye; dark spots appeared in his vision and things appeared hazy like looking through a muddy lens.

Then Dr. James Folk at the University of Iowa Hospitals and Clinics recognized what the problem was: a worm was seen right in the middle of his retina.

The worm was Baylisascaris procyonis, a roundworm found in raccoons. B. procyonis is the most common and widespread cause of clinical larva migrans in animals. In the case of John Matthews it is called ocular larval migrans as the parasite larvae ended up in the eye.

Baylisascaris procyonis is a roundworm found in the small intestines of raccoons. They excrete the eggs of this parasite in their feces. The eggs can survive in the environment for years under favorable conditions. There can be millions of eggs shed by the raccoon, with high densities in the feces and the soil surrounding it.

The raccoon roundworm is pretty indiscriminate in what animals it can infect; rabbits, woodchucks, squirrels, and birds among others. Many times these animals get infected by getting the eggs in their fur and ingest the eggs during grooming.

Humans also get infected by accidentally ingesting eggs from the environment, from raccoon feces, contaminated water or fomites. Raccoons typically defecate in favored areas called latrines. Common latrines include the bases of trees, raised forks of trees, fallen logs, rooftops, woodpiles and decks.

In animals and humans, the eggs hatch in the intestine and the larvae migrate through the body. The three most common disease manifestations are larval migrations through the tissues, to the eyes (blindness) and the central nervous system (brain damage). Young children and persons with pica, (an abnormal desire to eat strange things like dirt) and those who are exposed to areas where raccoons defecate are most likely to get infected.

Treatment of Baylisascaris is generally unsatisfactory and the infection can be life threatening if the central nervous system is involved. As in the case of John Matthews, ocular baylisascaris has been treated successfully using laser photocoagulation therapy to destroy intraretinal larvae.

Read more about Baylisascaris in this journal article I wrote.

Monday, October 18, 2010

The association between stunting and soil-transmitted nematodes in school kids

Moderate-to-heavy intensity infections of the three major soil-transmitted helminthes is the main predictor of stunting in a study among Chinese schoolchildren (rural areas of southern China) according to researchers from the National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (China CDC).

Stunting, or a reduced growth rate in human development is a main manifestation of malnutrition in early childhood in many developing countries. The association between parasitic infections and a reduced rate of growth in young children is also well documented.

In this study, researchers set out to determine the prevalence of stunting for children and its association with three major soil-transmitted helminths (Ascaris, Trichuris and hookworm) in rural areas of southern China.

Over 1000 children from 15 primary schools, aged 9-12 years old took part in the study. The following things were part of the study: a questionnaire, a physical examination, determination of the presence and load of the three parasites in their stools and blood hemoglobin concentrations.

The results of the study show that based on the WHO Child Growth Standards there was over a 25% prevalence of stunting among the children.

Risk factors for stunting were moderate-to-heavy intensity infections with the three soil-transmitted helminths, anemia and the educational level of the mother.

The overall prevalence of the three soil-transmitted nematodes was nearly 37% with moderate-to-heavy intensity infections seen in 16.7% of the children.

The overall prevalence of ascariasis, trichuriasis, hookworm and co-infection were 18.5%, 11.2%, 14.7% and 9.1% respectively.

The prevalence of anemia among the schoolchildren was over 13% (based on a hemoglobin level of less than 12g/dl).

Based on the data produced, stunting was highly prevalent among study population and soil-transmitted helminth infections are one of the important risk factors for stunting, especially moderate-to-heavy intensity infections was the main predictor of stunting.

Researchers note that to reduce stunting among this population, measures such as deworming the children and education to improve hygiene and sanitation are needed.
http://www.examiner.com/infectious-disease-in-national/the-association-between-stunting-and-soil-transmitted-nematodes-school-kids

Saturday, October 16, 2010

Cutaneous leishmaniasis cases increase dramatically in Afghanistan

The non-fatal but physically disfiguring parasitic disease has been surging in Afghanistan during the past decade, so much that the World Health Organization (WHO) has dubbed the capital Kabul is the “largest center of cutaneous leishmaniasis in the world”.

In Kabul alone the number of cases jumped from an estimated 17,000 a year in the early 2000s to 65,000 in 2009. In Afghanistan as a whole the disease threatens more than 13 million Afghans, many who are living in extreme poverty and cannot afford expensive treatments.

And according to Peter Graff, WHO representative for Afghanistan, the numbers are likely underreported due to the stigma associated with such a disfiguring disease.

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.

Cutaneous leishmaniasis goes by a number of pseudonyms; "Aleppo boil," "Baghdad boil," "Bay sore," "Biskra button," "Chiclero ulcer," "Delhi boil’, "Kandahar sore" among others. There are numerous species responsible for cutaneous leishmaniasis with Leishmania tropica being one common example.

The vector for this parasite is a phlebotomine sandfly. There are a few different species implicated depending on the part of the world.

Sandflies are very small (about 1/3 the size of a mosquito) and make no noise when flying. There bites can sometimes be painless; because of these reasons, many people have no idea they were bitten.

According to the WHO, most victims are women and children. They are more vulnerable because they mostly live indoors at night, where the sand flies prefer to bite, and are therefore more susceptible than men who are generally outside the home.

When the female sandfly takes a blood meal it injects the parasite into the wound. Macrophages pick up the parasite and here they multiply until the cell bursts from overcrowding. The parasite goes on to infect more macrophages.

After getting bitten by a sandfly, disease may manifest itself from a week to many months later.

It starts out as a papule that enlarges. The ulcer can give the appearance of a volcano crater. Lesions may appear singly or multiple; many heal spontaneously within weeks to months to years.

The sand flies proliferate from June to September. They thrive in unsanitary conditions such as piles of garbage and debris, though bed nets offer protection from their bites. As the disfiguring sores grow larger, many suffer social stigmatization.

Cutaneous leishmaniasis is treatable, however the expense of anti-leishmanial drugs make it out of reach for most Afghans. Check this link for treatment guidelines.

http://www.examiner.com/infectious-disease-in-national/cutaneous-leishmaniasis-cases-increase-dramatically-afghanistan

Friday, October 15, 2010

Shigella dysentariae vaccine Phase I clinical study results look positive


Vaccine developer GlycoVaxyn AG announced positive data from the Phase I clinical study on its Shigella dysentariae bioconjugate vaccine. According to the company the results from the study show that the vaccine demonstrated safety and good immune response.

The study conducted at the Institute for Social and Preventive Medicine of the University of Zürich, Switzerland, under the supervision of principal investigators Professors Hatz and Steffen.

In the study, 40 healthy volunteers were assessed for antibody response and safety to the vaccine candidate. Subjects of both genders were randomly given vaccine in ascending antigen dose with and without adjuvant. The vaccines were given in two doses, 60 days apart.

As far as the issue of safety, no significant adverse reactions were noted among all volunteers.

The vast majority achieved excellent antibody response with 80% achieving a four-fold increase in antibody level as compared to their own pre-vaccination levels. Both antibodies IgG and IgA were elicited in all vaccine dose levels.

Shigellosis is an acute bacterial disease of the intestines caused by several species of the bacterium, Shigella. It is typified by loose stools, frequently containing blood and mucus (dysentery), accompanied by fever, vomiting, cramps and occasionally toxemia.

It can cause bacillary dysentery because of the invasive ability of the organism that may result ulcerations and abscesses of the intestines.

It rarely spreads to the bloodstream.

More severe complications may include convulsions in children, Reiter's syndrome and hemolytic uremic syndrome depending on the species of Shigella implicated.

It is transmitted primarily by fecal-oral person to person means. It can also occur through contaminated food or water. Those that are primarily responsible for transmission are those that fail to wash their hands thoroughly after defecation.

Because Shigella is resistant to gastric acid, a person can get infected with as little as 10 organisms.

After getting infected symptoms usually appear 1-3 days later. It can be transmitted during the acute phase of infection till approximately four weeks after illness when the organism is no longer present in the feces. Asymptomatic carriers can also infect others.

Diagnosis is confirmed through bacteriological culture of feces. Treatment of shigellosis may include fluid and electrolyte replacement if there are signs of dehydration.

Antibiotics can shorten the course of infection, the severity of illness and the period of time a person may excrete the pathogen. Because of some antibiotic resistance, a antibiotic susceptibility test should be performed to determine which antibiotic will be effective.

Thursday, October 14, 2010

Woman miscarries, infection from mite bite suspected


According to a report found on the Chinese news source dayoo.com, a woman who was 8 months pregnant miscarried and is in critical condition from an infection caused by the bite of a mite.

Health officials from Foshan No.1 People’s Hospital in Foshan, Guangdong province, China suspect the miscarriage may have been caused by an infection with the organism Orientia tsutsugamushi.

The woman was taken to the hospital with a high temperature and stomach ache. Doctors at the hospital determined at that time the embryo had died due to a lack of amniotic fluid.

What is Orientia tsutsugamushi?

Orientia tsutsugamushi or as it is formerly known, Rickettsia tsutsugamushi, is a gram-negative obligate intracellular bacterium that causes the disease scrub typhus.

People get infected with this bacterium through the bite the Leptotrombidium deliense mite, the larval form is also known as a chigger.

Symptoms of scrub typhus include fever, headache, muscle pain, cough, and gastrointestinal symptoms. More virulent strains of O. tsutsugamushi ("summer-type scrub typhus") can cause bleeding and hemorrhaging.

One characteristic of this disease is the formation of an eschar at the site of the bite.

Scrub typhus is found in Asia, parts of Russia and Australia.

Diagnosis of scrub typus is by serological methods and immunofluorescence.

The treatment of choice is doxycycline, with chloramphenicol, rifampin and azithromycin as alternatives especially if there is doxycycline resistance. Without treatment, scrub typhus is frequently fatal.

Wednesday, October 13, 2010

Could clove oil be a future treatment for scabies?

Clove oil and its main ingredient eugenol showed high levels of toxicity against two types of scabies mites, permethrin-sensitive S. scabiei var suis mites harvested from pigs and permethrin-resistant S. scabiei var canis mites harvested from rabbits, according to a study published by Queensland Institute of Medical Research (QIMR) in Australia and Wright State University in Dayton, Ohio.

According to Dr Cielo Pasay of QIMR's Clinical Tropical Medicine Laboratory, "Essential oils and their active chemical components have long been proven to be effective against animal parasites such as cattle ticks, sheep ticks, and rabbit mites. Our research is applying this theory to the human scabies mite."

Researchers tested 3 types of oils; clove, nutmeg oil and ylang ylang oil on the two different species of scabies mites to see it effects.

The clove oil according to researchers killed all the mites within 15 minutes. Nutmeg oil had moderate toxicity and ylang ylang oil was the least toxic.

The main ingredient in clove oil, eugenol, which makes up 80% of clove oil, showed toxicity comparable to the topical solution, benzyl benzoate which is used as a treatment for scabies.

Dr Pasay goes on to say the following about the research, “our research aims to identify naturally occurring compounds that can combat scabies and prevent resistance from occurring."

Scabies is caused by an infestation by the eight-legged “itch mite”, Sarcoptes scabiei.

Transfer of this mite from person to person typically occurs through prolonged direct contact with infested skin and also during sexual contact. In fact, sexual contact is the most common form of transmission among sexually active young people.

Transfer from undergarments and bedclothes occur only if these have been contaminated by an infested person immediately beforehand.

Outbreaks have happened in nursing home and similar institutions, albeit rare.

It may take up to two months for symptoms to appear after initial infestation. Scabies produces skin rash composed of small red bumps and blisters and affects specific areas of the body.

Lesions are prominent around finger webs, wrist and elbows, armpits, belt line, thighs and genitalia of males and nipples, abdomen and buttocks are frequently affected in women. In infants; the head, neck palms and soles may be involved.

Itching is intense, especially at night and complications due to secondary bacterial infections with staph and strep are possible.

A more severe form is called Norwegian scabies, or crusted scabies. There seems to be a problem with the immune response to the mites, allowing for the infestation of an individual with hundreds of thousands of the mites.

Crusted scabies almost always affects people with a compromised immune system and is observed most frequently in the elderly, those who are mentally or physically disabled, and in patients with AIDS, lymphoma, or other conditions that decrease the effectiveness of the immune response.

The lesions of this distinctive form of scabies are extensive and may spread all over the body.

Some current treatments for scabies include: 5% permethrin, 10% Crotamiton or 1% lindane.

Monday, October 11, 2010

The Schistosomiasis Control Initiative: doing fantastic work in Africa

Today I would like to spotlight an organization that are doing some real important and necessary work in sub-Sahara Africa battling some of the most debilitating infectious diseases known. Let’s look at the Schistosomiasis Control Initiative (SCI).

With 500 million people in Africa alone infected with two or more of the Neglected Tropical Diseases (NTDs) (ascariasis, hookworm infection, trichuriasis, lymphatic filariasis, onchocerciasis, schistosomiasis, and trachoma) at any one time, one would think that more health officials worldwide would be screaming “crisis”.

And especially with treatments for these diseases costing literally pocket change to treat one person per year, this is a fight worth fighting. Fortunately there are organizations like the SCI.

Based out of the Imperial College London in the UK, the SCI has been working with governments from some of the most affected African nations to set up or expand disease control programs within these countries (Burkina Faso, Burundi, Mali, Niger, Rwanda, Tanzania and Uganda).

A major part of the SCI’s mission is mass drug administration, which can often treat multiple infections simultaneously, at an extremely low cost. The latest numbers offered by the SCI show that by 2007, 40 million doses of the anti-parasitic drug, praziquantel, to treat schistosomiasis were delivered to those in need. Other drugs like albendazole, which is used to treat a number of intestinal worms, have also been distributed in large quantities to those in need.

In addition to drug treatments, the SCI also creates support for these NTD programs, assist governments in operating their NTD programs and creating global awareness about the problems Africa is facing with NTDs. And that’s only scratching the surface of the great work they do.

The SCI was started in 2002 thanks to a multi-million dollar grant from the Bill and Melinda Gates Foundation at the Imperial College London. The SCI is under the direction and leadership of Professor Alan Fenwick, Professor of Tropical Parasitology at the College.

Keep up the good work.

If you would like to donate to the SCI to help them continue their work in Africa, donate here.

http://www.examiner.com/infectious-disease-in-national/the-schistosomiasis-control-initiative-doing-fantastic-work-africa

Sunday, October 10, 2010

Maine lobsterman suffering from difficult to treat MRSA skin infections

During the past two summers, at least 30 lobsterman and their families from the Maine island of Vinalhaven have been battling difficult to treat, painful and persistent skin infections caused by the multi-drug resistant bacterium, Methicillin Resistant Staphylococcus aureus (MRSA).

This infection which has resulted in outbreaks in military recruits, prisoners and athletes is now affecting the men and their families of this important occupation on an island across Penobscot Bay.

Because of the nature of their work, lobsterman frequently end up with abrasions and other trauma from handling lobsters, traps and tools as part of their trade. The resulting trauma to the hand can create a portal of entry for the MRSA bacteria.

The infections are reported to be quite painful and often take multiple courses of antibiotics to effectively treat it. If left untreated, these types of infections could spread becoming systemic and potentially deadly.

What about the lobsters, are they safe to eat?

Yes. The manner in which lobsters are prepared, either boiling or steaming, would certainly kill any bacteria left on the large crustacean.

Staphylococcus aureus is a bacterium found colonizing (without causing infection) the skin and nose in one quarter to one third of people.

Methicillin –resistant Staphylococcus aureus is a highly resistant type in which beta-lactam antibiotics (penicillins and cephalosporins) are useless in treatment.

What was once restricted to hospital infections, MRSA is becoming increasingly common in community acquired infections.

MRSA is primarily spread person to person via close skin contact, through cuts and abrasions and poor hygiene.

MRSA was first seen in the United Kingdom in 1961. Today there are approximately a million cases seen in the U.S. annually.

For MRSA skin prevention recommendations see the link from the CDC

1st indigenous case of malaria in Spain in nearly 50 years

The last time the country of Spain had seen an indigenous case of malaria was 1961, until last month. A patient with no travel history from the Huesca province has been confirmed with an infection with the parasite, Plasmodium vivax.

Spanish health authorities call this an “epidemiological curiosity” and say the case poses no risk to the public.

Health officials say that the individual contracted the through the bite of an Anopheles atroparvus mosquito.

Reports say that the patient has been treated and is recovering.

Malaria is not rare in Spain with upwards of 500 cases seen annually, however all cases are attributed to traveling abroad and are considered “imported”.

The specific species of malaria in this case, Plasmodium vivax, typically is a relatively mild form of the disease and is not usually fatal.

Malaria was officially declared eradicated in Spain in 1964.

Saturday, October 9, 2010

Watching his back: Campylobacter’s survival relationship with Pseudomonas

I have written about the organism Campylobacter numerous times on this site as it is a very common cause of gastrointestinal and foodborne illness.

Campylobacter does have some unique atmospheric oxygen requirements that most bacteria don’t have; it is a real microaerophilic bacterium, meaning it requires just a little oxygen for growth and survival and will not survive in atmospheric oxygen for very long periods of time.

Campylobacter survives inside the animal or bird host in large numbers without afflicting disease on these creatures. However, how does it survive on the outside surface of meats like chicken in which we consume all the time?

Well, researchers at the University of Veterinary Medicine, Vienna may have solved this mystery. Published in the Journal Applied and Environmental Microbiology, the theory is maybe the Campylobacter is able to withstand the increased oxygen tension with a little help from a spoilage organism. A spoilage organism does just that, it spoils meat, milk and other foods but aren’t really the cause of human gastrointestinal disease.

The study by Friederike Hilbert and colleagues was to use in vitro survival assays by interacting over 100 strains of Campylobacter jejuni isolates found on chicken meat, broiler feces and in human samples with a variety of food spoilage organisms to include Pseudomonas spp.,Proteus mirabilis, Citrobacter freundii, Micrococcus luteus,and Enterococcus faecalis.

When incubated alone or together with bacteria such as Proteus mirabilis or Enterococcus faecalis, Campylobacter survived atmospheric oxygen levels for no longer than 18 hours. However, when incubated together with strains of Pseudomonas putida, Campylobacter were found to survive for much longer, in some cases over 48 hours.

Using scanning electron microscopy, Hilbert and the team were able to visualize the source of the commensalism; the developmentof fiberlike structures braiding P. putida and C. jejuni cells.Hence, it seems that microaerophilic C. jejuni is able to surviveambient atmospheric oxygen tension by metabolic commensalism with Pseudomonas spp. There was no evidence in the study that the Pseudomonas species benefited at all from this relationship.

The result of this study could have implications on the control of chicken meat destined for our dinner tables. As Hilbert goes on to say, "On the basis of this study it should be possible to elucidate new mechanisms for limiting the level of Campylobacter on chicken meat and thus the incidence of food poisoning could be much reduced."

Friday, October 8, 2010

Philippine actress Kris Aquino, sons, suffer from hand, foot and mouth disease

TV hostess, actress, daughter of the former president and sister of the current Philippine president, Kris Aquino and her two sons are afflicted with the viral disease, hand, foot and mouth disease (HFMD).

This according to a Twitter post: “We r all sick. Josh caught foot & mouth disease. Nahawa Bimby & me. I don’t have the sores around the mouth or the rashes sa hands & feet but my fever went up to 40 last night. We r all taking Zoverax & Immunosin. Ang tibay the 3 yayas, Yaya A, Gerbel & Ruby. Di sila nahawa. Rare daw for an adult to get hawa but u know me -- lapitin ng sakit. Naka isolate kami for at least 1 week.”

What is HFMD?

HFMD is a common viral illness in children and infants which is commonly confused with the animal disease foot-and-mouth (also called hoof-and-mouth) disease. Foot and mouth disease is a disease of cattle, sheep, and swine; however, the two diseases are not related—they are caused by different viruses. Humans do not get the animal disease, and animals do not get the human disease.

Hand, foot and mouth disease is caused by a group of viruses called the enteroviruses. The Centers for Disease Control and Prevention (CDC) warns that HFMD outbreaks occur regularly in the spring and summer in China. Other countries in Asia have also reported cases of HFMD. Coxsackievirus A16 is the most common cause of HFMD in the United States.

Infection of HFMD is spread from person to person by direct contact with infectious virus. The virus is found in the nose and throat secretions, saliva, blister fluid, and stool of infected persons. The virus is most often spread by persons with unwashed, virus-contaminated hands and by contact with virus-contaminated surfaces.

Symptoms of HFMD may include fever, headache, vomiting, fatigue, malaise, ear pain, sore throat, non-itchy body rash, sores with blisters on palms of hands and soles of feet, oral ulcer, sores or blisters, loss of appetite, and diarrhea.

Infected persons are most contagious during the first week of the illness. The viruses that cause HFMD can remain in the body for weeks after a patient's symptoms have gone away. This means that the infected person can still pass the infection to other people even though he/she appears well.

There is no specific treatment for HFMD, only symptoms are treated.

Wednesday, October 6, 2010

Raw clams implicated in Campylobacter outbreak in Syracuse

The Onondaga County Health Department is investigating an outbreak of Campylobacter in which at least 7 people have become sick after attending a clambake in North Syracuse.


Health officials say those affected attended a clambake at Hinerwadel’s Grove on West Taft Road last month. Though the exact cause of the outbreak has yet to be determined, Commissioner of Health, Dr. Cynthia Morrow is leaning towards the ingestion of raw clams as the culprit.

The clambake was sponsored by the Syracuse Builders Exchange and there were approximately 3800 people in attendance. Because of the large crowd health officials are expecting the outbreak to grow.

According to reports, this is not the first time an outbreak of gastrointestinal disease happened due to a clambake at Hinerwadel’s. More than 200 people got sick from the same bacteria after eating raw clams at Hinerwadel’s in 2008.

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.

Dr. Morrow requests anyone who ate at this facility on or after September 15 and who became ill to contact the Health Department at 435-6607.

Monday, October 4, 2010

The Hajj: the infectious disease risks and what can you do to protect yourself

The annual pilgrimage to Mecca is an obligation for Muslims to do at some point in their lifetime if they have the means to. The annual pilgrimage is huge as far as numbers of people participating every year. In 2009, the Saudi Arabian government estimates that more than 2.5 million people from all corners of the globe. This year the Hajj begins the week of November 14th.

With such a large amount of people in one place, the issue of overcrowding always becomes a safety issue. In addition to accidental injury due to people getting trampled or crushed, this intense overcrowding is prime breeding grounds for a number of infectious diseases. Also, many people that come to Saudi Arabia to participate in the Hajj come from countries where certain infectious diseases are endemic and the infections may travel with the person.

According to Eurosurveillance, the Kingdom of Saudi Arabia has installed many preventive measures and health care facilities to care for pilgrims. First, they provide free health care to all Hajj pilgrims.

Last year 24 hospitals with nearly 5000 beds were prepared fully staffed with medical personnel to treat sick or injured pilgrims.

In addition, all ports of entry in the country have teams of public health personnel to pilgrims arriving for the Hajj has met immunization and other medical requirements.

For a list of the health requirements for visitors coming to Saudi Arabia for the Hajj, check the following link:
http://www.moh.gov.sa/english/modules/mysections/article.php?lid=21

There are a plethora of infectious diseases that have in the past or have the potential to infect people in overcrowded conditions such as seen at the Hajj. Here is a short list:

Due to the intense overcrowding and high humidity, the deadly meningococcal meningitis disease can spread throughout pilgrims. The history of meningococcal meningitis and the Hajj has demonstrated numerous large outbreaks throughout the years (1987, 2000, and 2001).

To combat this, the Saudi government requires pilgrims to be immunized against this form of meningitis. According to the CDC web site, the requirements are as follows:

All pilgrims over 2 years old must get a vaccine to protect against meningococcal disease. This requirement means that you:

1.Need to have had your vaccine no more than 3 years and no less than 10 days before you arrive in Saudi Arabia.
2.Must show proof of meningococcal vaccination on a valid certificate of vaccination (International Certificate of Vaccination or Prophylaxis) before you can enter the cities of Mecca and Medina to perform the Hajj. If you do not have this proof of vaccination, you may not be allowed to enter.
3.Note for clinicians: This vaccine MUST be a quadrivalent (A/C/Y/W-135) meningococcal vaccine.
In addition, your routine vaccinations should be up to date to include measles/mumps/rubella, tetanus, diphtheria, pertussis and polio. If you are arriving from a country where yellow fever is endemic such as those from the continents of Africa and South America, proof of yellow fever vaccination is required.

In addition to meningococcal meningitis vaccine, the Saudi government also requires vaccination against H1N1 influenzae.

There are numerous acute respiratory infections that are common with the Hajj. Overcrowding and close sleeping quarters contribute to the spread of viral infections to include: respiratory syncytial virus (RSV), parainfluenza, influenza and adenovirus.

The combination of crowding and people coming from countries which are endemic for tuberculosis make TB a potential serious problem among pilgrims.

The Saudi Arabian Ministry of Health encourages pilgrims to wear surgical face masks when they are in crowded areas.

A ritual among Muslim men at the end of Hajj is shaving their heads. However, because some barbers who operate around the Hajj reuse shaving equipment on multiple men, the risk of blood borne infections like hepatitis is a risk. Male pilgrims should ensure only using licensed barbers at the Hajj. Avoid sharing razors with others.

Besides respiratory infections, overcrowding such as what is seen at the Hajj is associated with diarrheal diseases. Diseases such as cholera have been implicated in outbreaks in the past and even with much improved water and sewage systems, the concern about imported cholera and other enteric diseases are always a concern.

The CDC recommends you do the following to prevent diarrheal diseases:

1.Drink only beverages that have been bottled and sealed.
2.Avoid tap water, fountain drinks, and ice cubes.
3.And of course handwashing, not only for diarrheal disease prevention but also for prevention of respiratory infections.
In addition to the numerous infections possible in such a crowded environment, you should also protect yourself from non-communicable illness and injury such as protecting yourself from the sun, heat and keep yourself properly hydrated.

Hajj requirements for a visa

Sunday, October 3, 2010

How does Salmonella spread in humans?

This is a question that scientists at the National Institutes of Health have answered in the latest issue of the Proceedings of the National Academy of Sciences.


In the study they describe finding a reservoir of rapidly replicating salmonella inside epithelial cells. These bacteria are primed to infect other cells and are pushed from the epithelial layer by a new mechanism that frees the salmonella to infect other cells or be shed into the intestine.

Epithelial cells line the outer and inner surfaces of the body, such as the skin and gut, and form a continuous protective tissue against infection. But salmonella have learned how to live inside epithelial cells and use them for their benefit. Salmonella protect themselves within special membrane-bound compartments, called vacuoles, inside gut epithelial cells.

Scientists using special high-resolution microscope were looking at epithelial cells infected with salmonella when they saw a population of the bacteria not confined to a vacuole but instead moving freely inside the cell.

Unique features of this reservoir of bacteria was more rapid replication, long flagella and an ability using a needle complex to pierce cells so they could inject proteins. These attributes allowed this reservoir of Salmonella to invade new cells. ( To see video:  http://videocast.nih.gov/wmv/salmonellaReplication.wmv)

This rapidly replicating, invasive bacteria push out of the intestinal tissue setting the bacteria free. This resembles the natural way humans shed dead epi cells from the gut.

Well, this doesn’t trick the immune system, which senses that these are just normal dying cells and releases interleukin-18. The interleukin-18 is a protein that sets off inflammation and has been associated with autoimmune disorders like inflammatory bowel disease. This could explain the inflammation with salmonella infections.

More research will be needed to find a treatment that could prevent the spread of Salmonella.

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.

Friday, October 1, 2010

Get your Giardia intestinalis merchandise at Giardia in Black and White

http://www.cafepress.com/giardiainblackandwhite

Genital herpes vaccine fails clinical trials, GlaxoSmithKline will abandon

The experimental vaccine known as Simplirix which was designed to block the transmissions of herpes from men to women has failed a major clinical trial that would prevent manufacturing approval. As a result, pharmaceutical giant GlaxoSmithKline has announced they will not pursue any further attempts to develop the vaccine.


The vaccine, Simplirix, was designed to protect against the two major herpes simplex viruses, HSV-1 and HSV-2.

The National Institute of Allergy and Infectious Diseases, which co-sponsored the trial with GlaxoSmithKline, announced Thursday that the vaccine provided no more than 20% protection against infection, a level that was not statistically different from zero. Researchers do not yet know why the vaccine failed.

They are 2 different serotypes that infect humans. HSV type 1 most commonly infects the mouth and lips, causing sores known as fever blisters (95%). It is also an important cause of genital infection.

HSV type 2 is the usual cause of genital herpes, but can also infect the mouth.

Estimates of up to 90% of adults possess antibody against HSV-1. Initial infection with HSV-1 usually occurs before 5 years of age.As far as HSV-2; in the U.S., there are 45-50 million people over 12 years of age infected. HSV-2 antibody occurs in 20-30% of American adults. According to the Centers for Disease Control and Prevention (CDC), HSV-2 is more common in women (about 1 out of 4 women) than men (about one out of eight).

With HSV-1 contact with the virus in saliva of carriers is probably the most important mode of spread.

Most people get HSV-2 by sexual contact with someone who is shedding the virus either during an outbreak or during a period with no symptoms. People who do not know they have herpes play an important role in transmission of the virus.

Both types 1 and 2 may be transmitted to various sites by oral-genital, oral-anal or anal-genital contact. It can also be transmitted by close skin to skin contact.

There is no cure or vaccine available for herpes. There are antivirals that can prevent or shorten outbreaks.