Archive for the 'Infectious Disease' Category

Concerns are Mounting Over Deadly Fungus in Northwest U.S. and British Columbia

Trees and soil in the Pacific Northwest are thought to be the source of the fungusA new deadly strain of an airborne fungus, called Cryptococcus gattii, is infecting both animals and people in the Pacific Northwest and British Columbia, according to Duke researchers. 

Although rare so far, this airborne fungus has been highly virulent with a mortality rate of about 25 percent. It typically only infects immunocompromised patients, but this new strain is genetically different and is a threat to healthy people as well.

Treatment of this highly lethal infection requires months to years of antifungal medications. Surgery is often necessary to remove the large masses known as cryptococcomas that can develop in various parts of the body.  There is no known method of prevention or vaccination at this point.

C. gatti has historically been a tropical fungus normally found in South America, Australia and Papua New Guinea. In these areas, it tends to favor eucalyptus trees with rates of infection among people being relatively low.

However, in 1999, the fungus emerged as a new strain on the east side of Vancouver Island where it is thought to have infected certain areas of soil, water, and local trees. From 1999 through 2003 the outbreak was confined to the island, but since 2003 the infection has also been found in the mainland of British Columbia, Washington state, California and Oregon.   Given this path, as well as the fact that C. gattii potentially can be dispersed through export of trees and woody products, air currents, water currents, and biotic sources, such as birds, animals, and insects, the researchers predict further spread of the fungus into the U.S. 

The disease is not contagious from person to person or person to animal.  It is thought to spread through the air to both humans and animals by inhalation of spores released by the fungus from the trees, soil, water or air.  

“The primary site of infection is the lung; C. gattii can lead to pneumonia or formation of cryptococcomas. The infection can disseminate to most other organs, notably the central nervous system (CNS), where it causes meningoencephalitis or brain cryptococcomas”, according to a February 2010 article in Emerging Infectious Diseases.

Most people never develop symptoms, but the spore-forming fungus can cause symptoms in people and animals two weeks or much longer after exposure.  Symptoms in people include a cough that lasts for weeks, sharp chest pain, shortness of breath, headache, fever, nighttime sweats and weight loss. 

 Cats, dogs and a wide range of both domestic and wild animals have been infected.  In animals the symptoms are a runny nose, breathing problems, nervous system problems and raised bumps under the skin.

Although the occurrence of this infection is rare, the CDC warns residents and even tourists in these areas to be aware of suspicious symptoms such as those described above, which should be reported to their physicians. 

SOURCE: “Emergence and Pathogenicity of Highly Virulent Cryptococcus gattii Genotypes in the Northwest United States”, PLoS Pathogens 2010.

SOURCE: “Potentially deadly fungus spreading in US, Canada”, Reuters Health, April 23, 2010

SOURCE: “Cryptococcus gattii Risk for Tourists Visiting Vancouver Island, Canada”, Emerging Infectious Diseases, Vol 13, No. 1, January 2007

SOURCE: “Epidemiology of Cryptococcus gattii, British Columbia, Canada, 1999–2007″, Emerging Infectious Diseases, Volume 16, Number 2–February 2010 

SOURCE: “Projecting Global Occurrence of Cryptococcus gattii”, Emerging Infectious Diseases, Volume 16, Number 1–January 2010

 

Beware of this Super Bug in the Sand at the Beach

Sand at the beach can harbor dangerous bacteriaSand at the beach may harbor the super bug MRSA (methicillin-resistant Staphylococcus aureus), according to researchers from the University of Washington.  Recently, public beaches in Seattle were tested by the researchers and nearly all of them contained staphylococci in the sand at the shoreline, with MRSA in half of the staph bacteria.

It is well known that staphylococci are frequently found in sand and salt water, but the more dangerous MRSA strain of staphylococci was unexpected by the researchers. 

As a result of these findings, the investigators are recommending caution for beechgoers, especially those who have exposed cuts or abrasions, or those who are ”medically fragile”.  Covering up with sand or digging down into the sand appears to increase the chance of coming in contact with a dangerous strain of staph, and a break in the skin provides the portal of entry for the super bug. 

A thorough shower with lots of soap and water immediately after the beach is always a good idea, and any signs of infection, nodules, ulcerations, persistent rash, or fever are important signs that should be brought to the attention of your doctor.    

Read more about MRSA

Source: Soge OO, et al “Methicillin-Resistant Staphylococcus aureus (MRSA) and Methicillin-Resistant Coagulase-Negative Staphylococcus spp. (MRCoNS) from West Coast Public Marine Parks” ICAAC 2009; Poster C2-146.
Source: “MRSA Found on Beaches in Washington”, MedPage Today, September 2009

 
 

Rare Strain of Super Bug Emerges in the USA

The super bug, MRSA, is being monitored closely by scientistsA rare strain of the Super Bug, MRSA, has been found by researchers at the Henry Ford Hospital in Detroit.  The drug-resistant strain of Staphylococcus aureus is about five times more deadly than other strains, say researchers. In fact, half of the patients with bloodstream infections caused by this rare strain of methicillin-resistant S. aureus (MRSA) died within 30 days of diagnosis.

At this point, the strain of MRSA, referred to as USA600, has been more common in Europe than the U.S.

See photos and read more about MRSA

Source: Moore CL, et al “USA600 Methicillin-resistant staphylococcus aureus bacteremia (MRSA-b) Associated with reduced vancomycin susceptibility and significant mortality” IDSA 2009; Abstract LB-40.
Source: “Rare MRSA Strain Deadlier than Others”, MedPage Today, November 3, 2009

 
 

Can You Get Bad Germs From a Toilet Seat?

A toilet seat can harbor a variety of germsYes, a toilet seat can harbor a variety of germs. MRSA, pinworms, and viruses that cause diarrhea and vomiting are just some of the pathogens that can be transmitted to you by the toilet seat.   

Researchers are now describing a new wave of irritating and itchy rash on the upper thighs and buttocks of children.  Harsh chemical cleaners on toilet seats and/or exotic wooden toilet seats appear to be the main culprits causing this problem.  A recent study from Johns Hopkins Children’s Center documents recent cases of toilet seat dermatitis in children, some of whom suffered for years before being diagnosed.

Toilet seat dermatitis was first documented and described in 1927 when varnish, lacquers, and paints were used on wooden toilet seats.  In the 1980s and 1990s, plastic toilet seats replaced wooden ones and sanitary seat covers came into use.  These changes were associated with a dramatic decline in the condition.

Recently, however exotic wooden toilet seats, as well as harsh toilet seat detergents have made a resurgence in popularity.  Cleaners with ingredients such as didecyl dimethyl ammonium chloride and alkyl dimethyl benzyl ammonium chloride, are being used as toilet seat cleansers although they have previously been documented to cause severe skin irritation.

To prevent any of these conditions, avoid sitting directly on a toilet seat or use a protective barrier in public restrooms.  Avoid harsh cleansers at home and replace all wooden toilet seats with plastic ones.

Read more about the Super Bug, MRSA 

Source: “Toilet Seat Dermatitis Making a Comeback”, MedPage Today, January 2010
Source: Center for Disease Control
 

 

Locate Swine Flu and Seasonal Flu Shots

An office that provides flu shotsA flu vaccine finder service is being provided by Google at google.com/flushot, which is designed to locate facilities that offer H1N1 and seasonal flu shots. 

The flu-shot finder service will soon be available at flu.gov, as well as the website of the American Lung Association. 

Don’t Give Cough or Cold Remedies to Children Under Four

Cough syrupParents should always consult their pediatrician before giving any medication to their child, but the labels on cough and cold remedies have historically stated that these medicines should not be given to children under age 2. 

Cough and cold remedies are coming under fresh scrutiny and drug manufacturers have voluntarily decided to change their labels stating that cough and cold medicines should NOT be given to children younger than age 4. Products with the old labels will not be removed immediately from store shelves but will be gradually replaced with newly-labeled products.

A booming, and rapidly growing, multimillion dollar industry, herbal drugs as well as other over-the-counter drugs, line the shelves of grocery stores and pharmacies. People often assume that they are safe if they are sold in their neighborhood grocery store.  This is not necessarily true.  Every year, thousands of children under age 12 end up in emergency rooms after taking over-the-counter cough and cold medicines. Most of these children were unsupervised when they took the medicine.

Read more:

Source: CDC, October 2009 http://www.cdc.gov/Features/PediatricColdMeds/

Interactive Tool for the Swine Flu

An elderly man using the InternetAre you wondering if you have the swine flu and need to see a doctor?  Microsoft has recently unveiled an interactive Web site which may help you decide.

Go to http://www.h1n1responsecenter.com . Type in your age and answer questions about your current symptoms and general health.  

Swine Flu Rapid Test Not Always Accurate

Rapid tests for swine flu deliver results in 15 minutes but are not always accurate if negativeThree major, commercially available, rapid test kits for the swine flu accurately identified only 40% to 69% of 45 clinical specimens known to contain the H1N1 flu strain, according to the CDC. However, there was an 89% accuracy if a tested specimen had a high level of the virus. But as the level of virus in the specimens fell, the accuracy of the tests declined, the CDC reported in the Aug. 7 issue of Morbidity and Mortality Weekly Report. Viral titers are highest in the first 3 days of illness.

These rapid tests are widely used and only require 15 minutes to deliver a result, but a negative result is not always accurate.  A positive result, on the other hand, is more reliable and can be very helpful.

Source: CDC, “Evaluation of rapid influenza diagnostic tests for detection of novel influenza A (H1N1) virus — United States, 2009″ MMWR 2009; 58: 826-29.
Source:  “Rapid Tests Miss Mark for Pandemic H1N1 Flu”, MedPage Today, August 6, 2009

WHO Says H1N1 Swine Flu “Unstoppable”

Young woman in bed with the fluThe new H1N1 swine flu virus is “unstoppable”, according to the World Health Organization, who has given drug makers full authorization to manufacture vaccines against the circulating strain of influenza. Healthcare workers are to be the first to receive the vaccine.

The H1N1 virus appears to attack people differently than seasonal influenza.  It tends to affect younger people, the severely obese and often healthy adults. 

The elderly seem to have some immunity to this H1N1 swine flu virus which is a very distant cousin of the H1N1 swine flu virus that caused the 1918 pandemic which was the most devastating epidemic in recorded world history. People born before 1920 have been found to have the antibodies to the 1918 viral strain. 

The H1N1 swine flu virus is also different from the seasonal flu in that it causes disease deep in the lungs and does not infect the nose and throat.  It also tends to cause gastrointestinal effects, whereas most seasonal influenza viruses affect the nose and throat, and usually do not cause gastrointestinal symptoms.  

Source: Journal of Nature, July 2009
Source: Reuters, July 2009
Source:  World Health Organization, July 2009

 

New Strain of Swine Flu Found in Brazil

Scientists have found a new strain of Swine FluScientists in Brazil report discovery of a new strain of the swine flu virus. This new strain was found in a 26-year-old man who had been hospitalized in Sao Paulo in April. He reportedly came down with flu symptoms after returning from Mexico and has since made a full recovery,  

It’s not yet clear if the newly discovered strain is any more dangerous than the original strain that first surfaced in Mexico in April which has killed 108 people worldwide, but this is a concerning discovery.

While the swine flu doesn’t yet seem any more lethal than the regular flu that each winter kills 36,000 people in the United States alone, scientists fear it could mutate as it circulates around the world, become more virulent and then return to the Northern Hemispere with a vengeance in the fall, as did the swine flu virus of 1918.

The virus that caused the the epidemic of 1918 was the most devastating epidemic in recorded world history.  It is thought to also be caused by a swine flu virus which was an exceptionally virulent strain. It started with cases in the spring, seemingly disappeared over the summer, and then returned with a vengeance in the fall ultimately infecting 28% of all Americans and a fifth of the world’s population. During the worst of the epidemic, the virus moved quickly, killing young and healthy people within hours of the onset of symptoms.  

Experiences with the 1918 swine flu pandemic have been the driving force behind the heightened concern over the most recent outbreak. 

Source: CDC, June 19, 2009