[Health] The Infectious Diseases Thread

[Smoove_B]

Yeah, that would have been a treatment scenario, at least according to the NJ manual. If the cat was able to be captured and held for observation (to make sure it didn't exhibit signs and symptoms of rabies), no treatment would be necessary.

Back in 2012 there was a woman in North (?) Carolina that died of rabies after exposure to a bat. When the CDC did their investigation they determined (in part) the failure of local health agencies to educate people about rabies risks contributed. I've had dozens and dozens of phone calls with people and doctors over animal exposures. At certain times of the year it was at least once a week in the one town I worked. People don't realize it, but animal contact happens more frequently than you realize. State, county and local health authorities should absolutely be educating people about rabies.

By way of example, our dog killed a groundhog last year. She's already been vaccinated, so she's low risk. However, protocol indicates she should be evaluated by a vet and then given a booster shot - which she was. She had no signs that she was bitten or scratched by what is a low-risk animal (groundhog). And yet, simply based on the contact, a booster was recommended.

[Ralph-Wiggum]

I've been bitten and scratched by horseshoe crabs more times than I can count; never came down with rabies but I have an intense urge to spawn at high tides.

[Freyland]

I assume you are also at a higher risk for Ring Toss.

[Blackhawk]

Where it becomes more difficult is when you wake up in a room with a bat, let the bat go and are now left wondering if it bit or scratched you while sleeping and you just have no idea.

That is several times a year around here.

[Isgrimnur]

Rubber ducks

Swiss and American researchers counted the microbes swimming inside the toys and say the murky liquid released when ducks were squeezed contained "potentially pathogenic bacteria" in four out of the five toys studied.

The bacteria found included Legionella and Pseudomonas aeruginosa, a bacterium that is "often implicated in hospital-acquired infections," the authors said in a statement.

The study by the Swiss Federal Institute of Aquatic Science and Technology, ETH Zurich and the University of Illinois was published Tuesday in the journal Biofilms and Microbiomes. It's billed as one of the first in-depth scientific examinations of its kind.

They turned up a strikingly high volume — up to 75 million cells per square centimeter (0.15 square inch) — and variety of bacteria and fungus in the ducks.

Tap water doesn't usually foster the growth of bacteria, the scientists said, but low-quality polymers in the plastic materials give them the nutrients they need. Bodily fluids — like urine and sweat — as well as contaminants and even soap in bathwater add microbes and nutrients like nitrogen and phosphorus and create balmy brine for bacteria.

[Isgrimnur]

So what level of breathing protection should I use for a pressure washer?

[Smoove_B]

You shouldn't be putting on anything other than a dust-mask unless you've been fit-tested. Any type of filtration device (even those N95 masks) can potentially put someone into distress.

Also, what are you pressure washing? Getting a giant Dexter face-shield might be enough plus think of all the additional use you'd have for a full-face splatter device.

[Isgrimnur]

Stone tiles in the shower.

[Smoove_B]

I...am not familiar with the use of a pressure washer under those conditions. I'd be hesitant to recommend it, but maybe you have access to information I don't. For reference, when cleaning stone shower tiles, I've used specialized muriatic acid washes that you can purchase retail.

Also, the password is Silicosis.

[Isgrimnur]

Oh, I’m not trying to remove anything tougher than soap scum, but in a quicker manner. And the assorted grunge growing in it.

[Smoove_B]

That's definitely a new one to me. I mean...I understand what you're doing, but it just seems like the X factor for something going horribly wrong is pretty high. To further clarify, it's an electric power washer, right?

I guess in theory what you're suggesting would work. I'd just be afraid of blasting something and causing more of a problem. Your ventilation fan will sure get a work out. I'm also guessing the amount of water vapor that's going to be aerosolized in your home is going to be surprising.

My only other suggestion then I guess is to film it - in case something goes horribly wrong. Still can't recommend a mask, but I would double-down on a face shield. Possibly add a fan to draw moisture and particulates out of the immediate area. As an added bonus that face shield will be helpful if Ebola comes back to your part of the country.

[Isgrimnur]

Well, I did come to you for a worst-case scenario...

[Blackhawk]

You shouldn't be putting on anything other than a dust-mask unless you've been fit-tested. Any type of filtration device (even those N95 masks) can potentially put someone into distress.

You've got my curiosity up. Can you elaborate on this? What sort of distress? I use a painting respirator from time to time.

[Smoove_B]

Respiratory and/or heart distress. Sitting and painting is probably low risk (unless you already have some type of chronic breathing or heart issues). Anything involving physical activity - even just walking around - you need to be evaluated by a medical professional to verify "clearance" to wear those (while working). They also accurately match your face size/shape to the mask and verify the seal. I don;t' have any data on individuals that pick them up retail and wear them for home projects, but if they're working correctly (tight seal, correct filters, etc...) they can absolutely increase risk of some type of cardiovascular event. It's tough because clearly you don't want to be breathing in fumes/dust/shower scum, but on the other hand you also don't want to drop from a heart attack.

I'm still a ton of fun at parties, yes, why do you ask?

[Blackhawk]

Damned if you do, damned if you don't, then?

Smoove Spoils Everything, Episode 84.

[Isgrimnur]

CNN

House mice don't carry door keys, but they can freely enter any residence in New York City, from low-rent studios to penthouse suites.

A yearlong assessment of the city's residential mouse population found that what many of these rodents do carry are previously unseen viruses as well as bacteria capable of causing life-threatening human illness. Some of the bacteria were even antibiotic-resistant.
...
For one of the two papers, [Dr. W. Ian Lipkin, professor of epidemiology at Columbia University's Mailman School of Public Health] and his team searched for and analyzed bacteria in the droppings of the captured mice. Running genetic tests, the researchers defined 235 separate genera and 149 distinct species of bacteria, including the most common causes of gastrointestinal upset: C. difficile, E. coli, Shigella and Salmonella.
...
Further analysis of the identified bacteria showed evidence of genes indicative of antimicrobial resistance to several common antibiotics.

A second paper concerned the viral load of the mouse droppings.

Here, the researchers discovered 36 separate viruses, including six new ones. None of the viruses identified by the researchers is known to infect humans, however, the genetic sequences matched those known to infect dogs, chickens and pigs. This suggests that some of the viruses might have crossed over from other species.

[Isgrimnur]

BBC

A man in the UK who caught the world's "worst-ever" case of super-gonorrhoea has been cured.

Sexual health doctors say he was "very lucky" and the case was a "major wake-up call for everybody".

He picked up the superbug having sex with a woman in South East Asia, despite having a British partner.

It was the first-ever case of the infection being incurable with first choice antibiotics, but now two similar cases have been reported in Australia.

The original case came to light last month and was linked to travel earlier in the year.

The main antibiotic treatment - a combination of azithromycin and ceftriaxone - failed to treat the disease.

A detailed analysis of his infection suggested one last antibiotic might work and he has since been treated with ertapenem.
...
The public health body launched an investigation to track down any further cases - including in his British partner - but says the superbug has not spread in the UK.
...
Dr Olwen Williams, the president of the British Association for Sexual Health and HIV, said the case was a "major wake-up call for everybody".

She told the BBC: "He was very lucky that he still had one remaining antibiotic that was used successfully.

"Our concern is in the future there might be no antimicrobials that will work."

She said people needed to be aware that the risk of picking up superbugs is higher in countries that use antibiotics less carefully.

Antibiotics are available to buy over the counter in many countries around the world, unlike in the UK where a prescription from a doctor is needed.

[Kraken]

Meh, antibiotics are old school. Phages are the future.

[AWS260]

Don't look now, but there's an ongoing Ebola outbreak in the Democratic Republic of the Congo. The good news is that it seems to be petering out, although it's too soon to say for sure.

Since the beginning of the outbreak (on 4 April 2018), a total of 55 EVD cases and 28 deaths have been reported, as of 24 June 2018. Of the 55 cases, 38 have been laboratory confirmed, 14 were probable cases (deaths for which it was not possible to collect laboratory specimens for testing) and three were suspected cases. Of the 52 confirmed and probable cases, 28 died – giving a case fatality rate of 54%. Twenty-seven (52%) confirmed and probable cases were from Iboko, followed by 21 (40%) from Bikoro and four (8%) from Wangata health zones. Five healthcare workers have been affected, with four confirmed cases and two deaths.

The number of contacts requiring follow-up is progressively decreasing, with a total of 1 534 contacts having completed the mandatory 21-day follow-up period. As of 23 June 2018, 172 contacts were under follow up and all (100%) were reached on the reporting date. If no additional cases are confirmed, all contacts will complete the mandatory monitoring on 27 June 2018.

I find the report at that link really interesting. It's dry, but detailed, and it gives confidence that the local health officials and WHO are really on top of this.

[Isgrimnur]

Spoiler:

Science Daily

The highest-resolution image yet of the Zika virus, or any enveloped virus thus far. The scientists used the latest electron microscopy techniques to see the atomic details of the Zika virus structure. They took advantage of Zika virus stability compared to its flavivirus cousins, allowing for a particularly accurate three-dimensional atomic model.
...
"With the higher resolution, it is now possible to efficiently design vaccines and engineer anti-viral compounds that inhibit the virus," says Michael G. Rossmann, a structural biologist at Purdue University.

[Smoove_B]

Remember kids, "dirty bird" isn't just a clever phrase.

Live poultry in backyard flocks are linked to several multistate outbreaks of salmonella infections that have now sickened 212 people in 44 states, federal health officials warned Monday.

...

Raising chickens in urban areas is a growing trend, with Las Vegas one of the latest cities to approve residential coops. A study of 50 of the most populated U.S. cities found 93 percent allow backyard flocks. In 2013, almost 1 percent of all U.S. households surveyed by the U.S. Department of Agriculture reported owning backyard fowl, and 4 percent more planned to start in the next five years.

[Isgrimnur]

Not linking to the CDC?

Owning backyard chickens and other poultry can be a great experience. However, children and other groups of people have a greater chance of illness from handling live poultry or anything in the area where they live and roam. Even handling baby birds displayed at stores can cause a Salmonella infection.
...
Live poultry might have Salmonella germs in their droppings and on their bodies (feathers, feet, and beaks), even when they appear healthy and clean. The germs can get on cages, coops, feed and water dishes, hay, plants, and soil in the area where the birds live and roam. Germs also can get on the hands, shoes, and clothes of people who handle or care for the birds.

People become infected with Salmonella germs when they put their hands or equipment that has been in contact with live poultry in or around their mouth. Young children are more likely to get sick because their immune systems are still developing and they are more likely to put their fingers or pacifiers and other items into their mouths.

People who have contact with items, like coops or water dishes, in the area where poultry live can get sick without actually touching one of the birds. Germs on your hands can spread easily to other people or surfaces, which is why it’s important to wash hands immediately with soap and water after touching poultry or anything in the area where they live and roam.
...
* Don’t kiss your birds or snuggle them and then touch your face or mouth.

[Smoove_B]

Didn't think people would find the source as interesting.

[Pyperkub]

Throwing this in here, to see if our resident health experts can help:

Dutch researchers stopped a clinical trial due to the deaths of 11 babies from a lung disease after their mothers were treated with the drug sildenafil, commonly known as Viagra, while pregnant, Amsterdam University Medical Center announced Monday.

The mothers were part of a clinical trial to evaluate the safety and effectiveness of the drug on unborn babies who had severe fetal growth restriction and who faced significant risk of being stillborn or dying after birth, according to a study that detailed the design and protocol of the clinical trial.

I've done a few click-throughs to see if there was any evidence that this worked in animals first - we were recently giving sildenifil to our cat for a health/lung issue, and eventually had to put him to sleep.

[AWS260]

The Guardian's article on this mentions that it was previously studied in rats.

[Freyland]

Sildenifil is used in lung diseases in which the blood vessels have become constricted, known as Pulmonary Hypertension. Since Sildenifil and it's brethren are profound arterial dilators, they can both improve oxygen transfer and lighten the load on the right side of the heart. I'm assuming in the study mentioned they were trying to improve placental blood flow to fetuses with obviously, and severely, restricted growth.

[Isgrimnur]

New Jersey

Last week, the New Jersey Senate voted unanimously to pass S1729, formally titled “An Act designating Streptomyces griseus as the New Jersey State Microbe, and supplementing chapter 9A of Title 52 of the Revised Statutes,” although don’t worry too much about that last part. The significance of the first part, of course, is that if the bill also passes in the Assembly, New Jersey will become only the second U.S. state to designate an official microbe.

As you know, or should know, Oregon was the first.

To address the question you are surely asking right now, why Streptomyces griseus and not, for example, Azotobacter vinelandii or Acidithiobacillus thiooxidans? Well, my friend, that is indeed a fair question. And those other two were also nominated, in fact. Although, to be honest, I suspect they were nominated only in order to make it appear that Streptomyces was the winner of a free and fair election, the kind of thing our old pal Robert Mugabe used to do. Because it does kind of look like the fix was in.

[Smoove_B]

Streptomycin was discovered at Rutgers. In fact, according to Rutgers it was “discovered in New Jersey soil and … isolated from the gullet of a healthy New Jersey chicken….” So there you have it.

Birds. So dirty. So helpful.

[stessier]

Well this is terrifying.

A vicious species of tick originating from Eastern Asia has invaded the US and is rapidly sweeping the Eastern Seaboard, state and federal officials warn.

The tick, the Asian longhorned tick (or Haemaphysalis longicornis), has the potential to transmit an assortment of nasty diseases to humans, including an emerging virus that kills up to 30 percent of victims. So far, the tick hasn’t been found carrying any diseases in the US. It currently poses the largest threat to livestock, pets, and wild animals; the ticks can attack en masse and drain young animals of blood so quickly that they die—an execution method called exsanguination.

Key to the tick’s explosive spread and bloody blitzes is that its invasive populations tend to reproduce asexually, that is, without mating. Females drop up to 2,000 eggs over the course of two or three weeks, quickly giving rise to a ravenous army of clones. In one US population studied so far, experts encountered a massive swarm of the ticks in a single paddock, totaling well into the thousands. They speculated that the population might have a ratio of about one male to 400 females.

Much more stuff at the link.

[Isgrimnur]

[Smoove_B]

Much more stuff at the link.

I took a class last month about this. I'm glad the media is reporting on it, but there's quite a few unreported infestations they're monitoring in a few different states. Sampling has already started, but to hear the people in charge say they have no idea how this happened is rather disconcerting. I'll share more when I can.

NOTE: This isn't the secret signal to run for the bunker

[coopasonic]

NOTE: This isn't the secret signal to run for the bunker

Some of us never left.

[Isgrimnur]

HPV

Cancers linked to the human papillomavirus have increased significantly over the last 15 years in the United States, with throat cancer now the most common HPV-related malignancy, the Centers for Disease Control and Prevention reported Thursday.

More than 43,000 people developed an HPV-associated cancer in 2015, compared with about 30,000 in 1999, the CDC said.

At the same time, the CDC said, HPV vaccination rates are rising — a trend that could eventually curb the increase in cancer cases. But the vaccine rate rising fast enough, experts say. Nearly half of adolescents ages 13 to 17 in 2017 had received all the recommended doses for HPV vaccination, while two thirds had received the first dose. For both groups, that was a five-percentage-point increase from the previous year.
...
The agency said the inoculations could prevent 90 percent, or more than 31,000 cases, of HPV-associated cases every year. Since the vaccine's introduction a decade ago, HPV infections and cervical precancers have fallen significantly. But it can take a long time to see the vaccine's benefits, because many cancers take several years to develop after HPV infections take hold.

[Smoove_B]

A few things. First, quarantine for an international plane coming in with sick passengers isn't unusual. That being said, I'm going to assume suggesting it was done over "food poisoning" is a PR move to minimize panic.

"CDC is aware of an Emirates flight arriving at JFK this morning with some passengers who are reporting an unspecified illness," Centers for Disease Control and Prevention spokesman Benjamin Hayes said in an emailed statement to NJ Advance Media. "CDC is working with local authorities to investigate and will provide additional information when it is available."

Dozens of ambulances and other emergency personnel have surrounded the plane, video shows.

For the record, there's no foodborne illness that I'm aware of that has "coughing" as a symptom.

[ImLawBoy]

This is likely vampirism, right?

[LawBeefaroni]

Fringe season 1, episode 1 (Pilot).

[Freyland]

I was going Patient Zero for the zombie apocalypse, myself.

[RunningMn9]

[ImLawBoy]

Ice must have been sitting right next to Larry.

[Isgrimnur]