Archive for the 'Lung Disorders' 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


Many Long-Term Smokers have Chronic Lung Disease, But Don’t Know They Have It

the lungsLong-term smokers are at high risk of developing a chronic lung condition called COPD (chronic obstructive pulmonary disease), but many are not even aware they have it during the early stages.  In a recent Canadian study of long-term smokers, about one in five were found to have COPD, but only a third of them knew they had the condition.

COPD causes a slow damage to the lungs. The destruction is irreversible, making it the leading cause of death and illness worldwide.

COPD develops slowly, and it may be many years before symptoms become noticeable. The severity of the following symptoms depends on how much of the lung has been destroyed. If you continue to smoke, the lung destruction will be more extensive than if you stop smoking.

  • Shortness of breath, especially with exercise
  • Chest tightness
  • Cough (A cough that doesn’t go away and coughing up large amounts of mucus are common signs of COPD)
  • Sputum (mucous) production
  • Wheezing

Most COPD is caused by long-term smoking and can be prevented by not smoking or quitting soon after you start. Damage to your lungs can’t be reversed, so treatment focuses on controlling symptoms and minimizing further damage.

Breathing in other kinds of lung irritants, like pollution, dust, or chemicals over a long period of time may also cause or contribute to COPD.

If you think you might be at risk of having COPD, ask your doctor to order a simple breathing test called spirometry.

More Information: Quitting Smoking, About COPD

Source:  Hill K, et al “Prevalence and underdiagnosis of chronic obstructive pulmonary disease among patients at risk in primary care” CMAJ 2010. DOI: 10.1503/cmaj.091784. 

Source: “Undiagnosed COPD Common”, MedPage Today, April 6, 2010  

More Severe Asthma Linked to Low Vitamin D Levels

LungsLow levels of vitamin D are associated with greater asthma severity, report researchers in the American Journal of Respiratory and Critical Care Medicine. In their recent study, low levels of vitamin D correlated with poorer lung function, increased airway reactivity, and reduced response to steroid treatment in adult asthmatics. As a result of these findings, the researchers suggest that vitamin D supplements might improve symptoms in some asthma patients, but this particular study did not specifically prove that vitamin D supplements would reduce asthma symptoms.

The importance of Vitamin D is considered to be one of the top 10 medical breakthroughs of 2007 and researchers are continuing to find evidence of its critical importance in immune function and many other systems in the body.

In recent years, low Vitamin D levels have been linked with a number of  serious, chronic diseases such as weak bones and muscles, mental decline in elderly, diabetes, gum disease, multiple sclerosis, peripheral neuropathy, osteoporosis, and possibly cancer, stroke, and heart disease have all been found to be associated with low levels of Vitamin D.

Yet despite the importance of this vitamin, a deficiency of Vitamin D remains widespread. 

The National Academy of Sciences’ Institute of Medicine (IOM) has set the Upper Limits (UL) for vitamin D at 2,000 IU for children, adults, pregnant, and lactating women, and 1,000 IU for infants up to 12 months of age.  A simple blood test can measure the circulating Vitamin D levels in your blood. Many doctors have recently been drawing blood levels of Vitamin D to to make sure patients are getting enough vitamin D to optimize good bone health and prevent chronic disease. Ask your doctor about this.

Read more about Vitamin D 

Source: Sutherland E, et al “Vitamin D levels, lung function and steroid response in adult asthma” Am J Respir Crit Care Med 2010; DOI: 10.1164/rccm.200911-1710OC.

Source: “Low Vitamin D Worsens Asthma”, MedPage Today, January 28, 2010

Electronic Cigarettes Contain Chemical Used in Antifreeze

Electronic cigarettes are loaded with carcinogens and addictive nicotine Readily available on the internet and shopping malls, electronic cigarettes are marketed to teens and touted as a healthy substitute for cigarettes.  E-cigarettes, which are often made to look like real cigarettes, are far from healthy.

The FDA has recently analyzed the ingredients in a small sample of cartridges from two leading brands of e-cigarettes. A chemical used in antifreeze that is toxic to humans was found, as well as other  known carcinogens, such as nitrosamines, were detected.   

These products have never been submitted to the FDA for evaluation or approval, so at this time the agency has no way of knowing, except for the limited testing it has performed, the various levels of nicotine or the different amounts or kinds of other chemicals that these products deliver to the user. In fact, little is known about the devices.

The devices, known as e-cigarettes, are battery operated and contain nicotine, flavors, and other chemicals that are converted into a vapor that the user inhales.  Flavors such as chocolate, cola and bubble gum provide a youthful appeal.  Manufacturers provide no health warning on the product and claim that they are a safe alternative to cigarettes because they do not burn tobacco.  

The FDA said it has been examining and detaining shipments of e-cigarettes at the borders since Summer 2008, and is currently involved in a lawsuit challenging its jurisdiction over certain e-cigarettes.
Source: “E-Cigarettes Subject of FDA Warning”, MedPage Today, July 23, 2009

Zicam Nasal Products Linked with Loss of Smell

The FDA has reported serious problems with three Zicam Nasal Gel/Nasal Swab products sold over-the-counter as cold remedies.  

The Agency has received more than 130 reports of loss of sense of smell associated with the use of these products.  In these reports, many people who experienced a loss of smell said the condition occurred with the first dose; others reported a loss of the sense of smell after multiple uses of the products.

The loss of sense of smell may be long-lasting or permanent, according to the FDA, and can adversely affect a person’s quality of life.  The loss of ability to smell can also limit the ability to detect the smell of gas or smoke or other signs of danger in the environment.

Anyone using one of these products should discontinue use immediately. People who have experienced a loss of sense of smell or other problems after use of the affected Zicam products should contact their health care professional.

Source: FDA, MedWatch 2009 Safety Summary for Zicam 

Vitamin D Deficiency Linked with Increased Colds

Upper Respiratory InfectionVitamin D deficiency appears to weaken the body’s defenses against upper respiratory infections such as colds, according to researchers from Massachusetts General Hospital. 

A simple blood test can measure the circulating Vitamin D levels in your blood. Many doctors are now drawing blood levels of Vitamin D to make sure patients are getting enough vitamin D to optimize good bone health and prevent chronic disease. This recent study underlines yet another reason to be sure a Vitamin D deficiency is not present. 

Learn about ways to make sure you and your family are getting enough Vitamin D

Source: Ginde A, et al “Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey” Arch Intern Med 2009; 169: 384-90.

33 people banned from flying due to TB infections

In June of 2007 the United States government instituted a Do Not Board list for people thought to have contagious, and possibly drug-resistant, strains of tuberculosis.  Since that time, they have received 42 requests and added 33 names to the list.  Those not added either agreed not to fly or were not contagious. 

The US instituted the list after an Atlanta lawyer, Andrew Speaker, managed to return to the US after being asked not to fly and was quarantined by the CDC upon returning to the country. 

Eighteen of the original 33 have been removed from the list: 16 because they were no longer contagious and two because they didn’t have TB.

Broccoli may slow progression of COPD

A recent study has indicated that  an anti-oxidant found in broccoli, sulforaphane, may help slow the progression of COPD.  The work is preliminary and conducted solely on mouse cells, but this research may hold the key to determining why some people develop emphysema while others don’t. 

While eating broccoli may be good for your lungs, if you’re a smoker, the best thing to do for them is put down the cigarette.

via MedPageToday

Sleep apnea patients may need oxygen during air travel

A new small study finds that about half of people with obstructive sleep apnea may need supplemental oxygen during a commercial airline flight, even if they are otherwise healthy. Australian researchers from the Concord Repatriation General Hospital in Sydney undertook this study because of the rising rate of obesity, which is increasing the number of people with obstructive sleep apnea.  

In this study there were 2 groups of participants who underwent an airline cabin simulation while their blood-oxygen saturation levels were measured.  One group consisted of 22 patients with severe sleep apnea but no history of lung disease, and the other group was made up of 10 normal volunteers.  During the simulation of commercial airline travel, both groups experienced a significant drop in oxygen saturation from normal, but the sleep apnea patients had a significantly lower oxygen saturation at all simulated heights.  In fact, 11 of the 22 patients experienced a drop low enough to warrant the use of supplemental oxygen.

According to one of the researchers Leigh Seccombe, M.Sc., in MedPage Today, ”It’s too early to say what the clinical implications of the findings are. Many people fly, many people get hypoxic, but not many have adverse events.”  One implication might be that the airlines may need to allow people with obstructive sleep apnea to use supplemental oxygen at a physician’s request, as they now do for people with chronic obstructive pulmonary disease.

Via MedPage Today May 2008
Seccombe LM, et al “Effects of commercial flight simulation in patients with obstructive sleep apnea” Am J Respir Crit Care Med 2008; 177: A220.