Infectious Disease Blog

Get your flu shots!

As if we haven’t heard that from the government every season.

On Wednesday, a federal panel recommended that all children older than 6 months old receive a yearly influenza vaccine, according to the Chicago Tribune.

While the current recommendation calls for 6-month-olds to 5-year-olds to get the vaccine, the new proposal would expand the age range to 18.

Thirty million more children would get the flu vaccine under the committee’s recommendation, according to the New York Times.

The proposal could be adopted by the CDC as early as 2009. Experts and doctors are confident that the vaccine industry would be able to provide enough doses to match future demands.

Expanding the age range of children who should get the vaccine came from a wish to keep children healthy and to defend parents and adults who come into contact with kids with the flu, according to the Tribune article.

“Kids are not just transmitters, they’re amplifiers,” said Dr. James King, a professor of pediatrics at the University of Maryland School of Medicine. “If you’re going to catch the flu, you’re much more likely to get it from a child.”

While preventing cases of influenza is a noble cause, it seems like the panel neglected to consider a simple truth: kids hate needles.

Evette from Babies & Kids blog brought up this practical point:

“That’s a lot of confrontations with needles. Not sure how many kids would like hearing this.”

Scientists drafted the first map of emerging infectious disease hot spots in the world, according to a study published last week in the journal Nature.

Unfortunately, the hot spots, designated in red, tend to have the least resources for infectious disease prevention.

Researchers from the U.S. and Britain assembled a database of 335 infectious diseases marked as a threat between 1940 and 2004. They then compared the frequency of unique outbreaks with possible environmental factors, such as population density and growth, geographic latitude and diversity of wildlife.

MedicineNet.com gives the following definition of an emerging infectious disease:

Emerging infectious disease: An infectious disease that has newly appeared in a population or that has been known for some time but is rapidly increasing in incidence or geographic range.

Examples of emerging infectious diseases include:

• Ebola virus (first outbreaks in 1976 and the discovery of the virus in 1977),

• HIV/AIDS (virus first isolated in 1983),

• Hepatitis C (first identified in 1989, now known to be the most common cause of post-transfusion hepatitis worldwide),

• Influenza A(H5N1) virus (well known pathogen in birds but first isolated from humans in 1997),

• Legionella pneumophila (first outbreak in 1976 as Legionnaire disease and since associated with similar outbreaks linked to poorly maintained air conditioning systems),

• E. coli O157:H7 (first detected in 1982, often transmitted through contaminated food, has caused outbreaks of hemolytic uremic syndrome), and

• Borrelia burgdorferi (first detected in 1982 and identified as the cause of Lyme disease).

According to Popular Science, the researchers discovered:

In the end, they discovered that emerging infections in developing nations tended to be novel pathogens, encountered as humans squeeze further into previously uninhabited regions and have more contact with the wildlife found there. Conversely, the emerging infections in the developed world were primarily drug-resistant pathogens, bred by widespread antibiotic use in the human and livestock populations.

An infectious disease expert discussed the possible implications of the study with Scientific American:

This study and others before it increasingly show “that there are patterns which can be used for the forecasting of novel pandemics,” says infectious disease specialist Nathan Wolfe of the University of California, Los Angeles, who was not part of the study. “It helps to inform the kind of monitoring that’ll have to be in place to take this to the next step, to really prevent the next pandemic.”

To read the abstract in Nature, click here.

To many, tuberculosis is a dead disease.

To be safe though, just about everyone in the U.S. gets tested for tuberculosis, or TB. Few of us really believe that we will get the disease.

But, in Toronto, Canada, there’s a growing chance of a tuberculosis outbreak. The current system would not be ready to handle an outbreak because it lacks a centralized system of TB clinics, according to United Press International. Ontario is the only Canadian province without a centralized TB system.

Toronto’s growing immigrant population is the reason some experts say there may be an increase in cases of deadly, contagious tuberculosis, according to the Toronto Star.

About one-fourth of Canada’s TB cases originate in Toronto, according to the Star. Of the 1,600 active cases of TB in Canada, 400 come from Toronto. Experts say that any country where TB is epidemic should expect to see a higher incidence of the disease as immigration rates rise in the country.

According to the article, Toronto will face tuberculosis problems as long as the city is an immigration center:

“It seemed like infectious diseases would disappear from the planet,” says Dr. Elizabeth Rea, an associate medical officer of health for Toronto Public Health’s TB prevention and control program. “They haven’t. Particularly for Toronto. Our rates are driven by what is happening outside the city … TB is not going to disappear from Toronto as long as we are an immigration centre. We need to plan for cases to continue to arrive here and to be able to deal with them at the highest level of care.”

Canada Immigration Blog writer Sergio R. Karas, a lawyer and certified specialist in Canadian citizenship and immigration, gave insight on allowing immigrants with TB into Canada:

I fail to see why potential immigrants with active TB should be admitted to Canada. Public safety demands that they should not be admitted. In my view, it is a “no-brainer”.

I thought that the world had matured and become better informed since the ’80s and early ’90s, when people with HIV and/or AIDS were stigmatized for having the disease. Apparently, I was wrong.

Eight Egyptian men who were suspected of having HIV were arrested and forced to undergo HIV tests, sparking a massive controversy in the country, according to FOX News.

The men were charged for allegedly accepting money for sex in late 2007, according to PlusNews, which provides HIV/AIDS news and analysis. They were then forced to take HIV tests. Two of the men who tested positive were allegedly chained to their hospital beds.

The arrests may affect more than just the eight men detained, according to the BBC:

In a joint press release, Amnesty International and HRW warned that Egypt’s efforts to prevent the spread of the deadly virus could be seriously damaged by the arrests.

“This not only violates the most basic rights of people living with HIV. It also threatens public health, by making it dangerous for anyone to seek information about HIV prevention or treatment,” said Rebecca Schleifer, who works on HIV/Aids issues at HRW.

The BBC article also discusses how some of the men were allegedly beaten after they refused “homosexuality tests.”

The blogger of The Largest Minority said that homosexual acts can be punished in Egypt:

While not specifically referred to in Egypt’s legal code, homosexual acts can be punished under laws covering obscenity, prostitution, and habitual debauchery. With this authority, Egyptian police are targeting suspected homosexuals in a campaign to crack down on HIV.

Instead of tackling the disease itself, Egypt is arresting people suspected of being HIV-positive. Part of the problem is that the country still knows very little about HIV/AIDS, according to the PlusNews article:

“You can find people who know what you are talking about when you talk about AIDS, but I could say that most people who live here don’t know the difference between a person with HIV and a person with AIDS,” said UNAIDS Country Officer Wessam El-Beih. “They will say that this is not something that exists in Egypt.”

Anyone who watched the hit children’s show “Sesame Street” while growing up may remember some of the helpful songs that taught us a thing or two:

“What do we do before we eat? We wash our hands and we wash our feet.”

Hand washing not only clears our hands of the grime and germs that we come across, but it also helps to prevent the spread of infectious diseases.

One community in Nigeria has seen a drop in cases of diarrhea due to efforts teaching the importance of hygiene and regular hand washing, according to magazine The East African.

About 1.5 million children worldwide die from inadequate water and poor sanitation and hygiene each year, the article said. Also, about 42,000 people die each week from the diseases related to low water quality.

Learning the importance of hand washing would yield a large impact for Nigeria, according to the article:

“Over 10 million productive days would be gained (in Nigeria) if access to both water and sanitation rose to 100 percent,” UNICEF country representative for Nigeria, Ayalew Abai, said recently.

Diarrhea remains one of the main causes of child mortality, “yet it is so simple to avoid it by washing hands before eating,” UNICEF spokesperson in Abuja, Christine Jaulmes, noted.

National health organizations stress the importance of hand washing in preventing the outbreak of infectious diseases.

The CDC runs a campaign to promote hygiene and hand washing called An Ounce of Prevention. The Mayo Clinic also discusses the dangers of not washing hands and provides tips for how to properly wash.

Scientists get access to all sorts of crazy organisms and chemicals. We trust them with these sometimes deadly substances. What happens when a scientist with a promising career steals bacteria and tries to do the unthinkable with it?

A biomedical researcher from the United Kingdom took potentially-deadly germs from a hospital lab in a plan in a plan to end her life, according to Britain’s Daily Mail.

Jennifer Bainbridge acted in despair after suffering from depression for months. But, she stopped herself before administering a bacterium she had removed from the hospital.

Bainbridge told the Daily Mail:

“I was basically going to give myself septicemia. I just took what was available in the lab, but I made sure they were organisms which were not going to put anyone else at risk.

“I didn’t go through with it in the end because it was silly and a few days later I told staff.

“Even thinking about it all now makes me upset.”

Septicemia is a bacterium found in MRSA – a strain of staph resistant to the antibiotic methicillin – and E. coli germs.

MedicineNet.com gives the following definition:

Septicemia: Systemic (body wide) illness with toxicity due to invasion of the bloodstream by virulent bacteria coming from a local seat of infection. The symptoms of chills, fever and exhaustion are caused by the bacteria and substances they produce. The disorder is treated with massive doses of antibiotics. Also known as blood poisoning.

Bainbridge confessed everything to her boss and was taken off the health professions council register for 18 months, according to the Daily Mail.

About.com’s Infectious Disease blogger Anna Spector weighed in on the issue:

“Lab life leaves people very isolated and it wouldn’t surprise me to hear she isn’t the only one who has taken germs home, on purpose that is.”

Well said. I wonder if Spector is right about this. If so, I hope there are caring coworkers out there who notice when something is wrong and do their part to help.

I had the privilege of chatting with Dr. Michael Barza on Friday about what’s going on in the field of infectious diseases. Barza is the Chief of Medicine and Program Director for Internal Medicine at Caritas Carney Hospital and also Vice Chairman for Operations and Associate Chief of Medicine at New England Medical Center, both of which are in Boston, Mass. Barza also serves as the Deputy Editor of the journal Clinical Infectious Diseases.  

Click below to hear the interview.

Interview with Dr. Michael Barza

Here’s the transcript:

Christina Zdanowicz: How long have you been working in the field of infectious disease and what specifically is your specialty?

Dr. Michael Barza: For 40 years. At least I began my fellowship in 1968 at New England Medical Center. And my specialty is probably antibiotics, pneumonia, fevers of unknown origin. Those would be my main areas of interest.

CZ: What’s you affiliation with the Clinical Infectious Diseases journal?

MB: I’m the deputy editor of that journal. My main duty is to take the first look at virtually all of the unsolicited manuscripts, which is most of the manuscripts – about 2,500 a year. I take the first look at those and decide if I think we should be interested in sending them out for review or declining them without review.

CZ: What is the exact scope or what are some of the topics in that journal?

MB: It’s very broad reaching. It covers all aspects of infectious disease ranging from hospital epidemiology to immunization practices to infections by virtually any kind of pathogen: viruses, bacteria, fungi, parasites. As well as sometimes dealing with issues of ethics, of efficiency of consultations of sort of general topics like that. So, virtually all aspects of infectious disease but the emphasis is upon clinical infectious diseases, not so much in basic research, or if its basic research, it must be something applicable more or less now.

CZ: What are some of the hot topics relating to infectious diseases that the journal has been publishing about more recently? 

MB: In terms of viruses, influenza, both influenza A and B that we have in this country already as well as H5N1. Influenza has been a big topic. Other viral infections, of course HIV is always an important topic. Lately, we’ve actually had quite a few studies of treatment issues in HIV in developing countries – Africa, southeast Asia and so on.

In terms of bacterial infections, the biggest issue is probably been MRSA, which is an acronym for Methicillin-resistant Staphylococcus aureus. We’ve also had quite a bit on resistant bacteria, especially resistant Gram-negative bacteria, especially in intensive care units and elsewhere in hospitals, multi-resistant organisms, which have been an increasing problem in mot countries. Sticking with bacteria, tuberculosis continues to be a major killer and in particular now, there’s been a great deal of concern about multi-drug resistant tuberculosis. So called XDR, extended drug resistant TB. These organisms are actually resistant to virtually every antimicrobial that we can throw at them.

Then, a number of parasitic infections, malaria continues to be a major killer and cause of morbidity in a lot of countries, so we continue to have an interest in trials of new anti-malarial agents. 

CZ: And anything coming up in the new issue of the journal that is really groundbreaking or something that the community will really latch onto?

MB: Well, I haven’t looked yet at what’s on. I see these things usually several weeks in advance and I can’t remember what’s on for the next issue. I don’t remember anything that’s earth shattering. There is, in a few weeks, we’re going to have expedited publication, which we hardly ever do, of an article describing a kind of outbreak of a kind of E. coli in the United Kingdom. A kind of E. coli infection that can sometimes cause serious damage to the kidneys, it’s called the hemolytic uremic syndrome. In fact that manuscript is going to be the basis of an inquiry by some judicial commission in the United Kingdom. So we have been considering releasing that in expedited form.           

CZ: That sounds like something really explosive potentially if it’s going to a judicial committee. 

MB: It does have public health implications in part because mostly because there’s some evidence that these infections could be transmitted from child to child, I guess from adult to child too, or vice versa, but there have been some cases of transmission, so they want to alert the public that if one child has some of these symptoms, they should be kept separate from other children. So, I think that, in part, will be the subject of the inquiry. 

I was reading a book entitled “The Chicago ‘L’” when I stumbled upon a photo of a “fresh air car” from 1915. Chicago was doing its best to stave off an influenza outbreak, so the “L” would run one car with most of its windows opened to maximize air circulation. At the time, many people believed that fresh air from the lakefront would promote good health. The open-air car would only run on certain trains between Jackson Park and north suburban Evanston.

Advertisements inside the car read:

“Too much fresh air is just enough.”

“Get the fresh air habit; dress warm enough to enjoy it.”

“The Chicago ‘L’” by Greg Borzo details the history of the “L” with photographs. Check out the book on Amazon.

The Chicago History Museum houses the first passenger car to operate on the “L” back in 1892. The museum also gives four different “L” tours of the city on Sundays: Brown Line, Green Line south, Green Line west and Blue Line.

Today and on March 30, Greg Borzo, the author of the aforementioned book, will lead a tour of the Loop “L.” Information and tickets are available at the Chicago History Museum by clicking here.

San Diego County officials reported Friday that five more children have come down with measles, bringing the total number of cases to 11, according to San Diego TV station FOX 6.

Five of the cases are thought to be linked to an 8-year-old who may have got measles at a San Diego charter school. Three other cases may be connected to an infant who may have contracted the disease at a La Jolla children’s clinic.

According to the San Diego Union-Tribune,

All of the 11 confirmed patients, from 10 months to 9 years old, were not vaccinated either because they were younger than 1 – the minimum age for measles inoculation – or because their parents objected to having them vaccinated, county officials said.

The FOX 6 story includes links to three video interviews with Dr. Richard Halverson, all posted on YouTube. He covers the danger of measles, if the disease can be good for you and how it can be a killer disease in underdeveloped countries.

Remember spending the day after your 21^st birthday running to the bathroom and vomiting? Most people were probably doing so because they had a little too much fun the night before. In my case, it was because I had caught the stomach flu.

Wouldn’t it be nice if there was a way to prevent the peril caused by a norovirus, commonly called the stomach flu?

Researchers from the University of North Carolina discovered that the virus mutates genetically, much like the influenza virus, according to Medicine World’s Infectious Disease blog. As there are influenza vaccines, there’s a chance a stomach flu vaccine could be possible.

Noroviruses are extremely contagious, as I can attest – I caught the bug by drinking from a glass and eating with utensils belonging to a friend who had the stomach flu.

Here is the CDC’s list of ways a person can become infected with the stomach flu:

• eating food or drinking liquids that are contaminated with norovirus
• touching surfaces or objects contaminated with norovirus, and then placing their hand in their mouth
• having direct contact with another person who is infected and showing symptoms (for example, when caring for someone with illness, or sharing foods or eating utensils with someone who is ill)

Lisa Lindesmith, one of the study’s authors, told UPI:

“What we’ve found is that the GII.4 arm — of the noroviruses — keeps changing,” one of the study’s authors, Lisa Lindesmith, said in a statement. “Whenever we’re seeing big outbreaks of norovirus, we’re also seeing genetic changes in the virus.

“A vaccine may have an important role, too, especially among the elderly and other people particularly vulnerable to the effects of the illness,” Lindesmith said.