Sep
01
2004

Epstein-Barr Virus Linked With MS

By | Infectious Disease, Multiple sclerosis

MS, the debilitating and at times fatal disease which affects about 50,000 Canadians continues to be a puzzle to medical researchers. New findings are shedding new light on this illness and may help to unravel its complexities and bring more effective treatment to patients.

Dr.Brenda Banwell from the Department of Pediatrics and the Pediatric MS Clinic at The Hospital For Sick Children in Toronto found that 83 % of children with a diagnosis of MS showed evidence of a previous Epstein-Barr virus infection. (Healthy controls only showed a rate of 42 %). No differences were found for other viruses (like herpes, parvovirus, chicken pox). Researchers have yet to determine, whether there is a link between Epstein-Barr virus infections and MS, or whether MS patients are more susceptible to Epstein-Barr infections.

With regard to MS treatment amazing improvement has been demonstrated on MS patients who were treated with the cholesterol-lowering drug simvastatin. A reduction of MS induced brain lesions by 44 % was achieved in patients treated with the drug, and animal experiments show similar results. Researchers are cautioning MS patients that more investigations will be needed, till this treatment will become a new standard in the treatment of MS.

Epstein-Barr Virus Linked With MS

Epstein-Barr Virus Linked With MS

Link to more information on multiple sclerosis.

Reference: Parkhurst Exchange, Vol.12, Nr.8, August 2004,page26

Last edited December 8, 2012

Jul
01
2004

Flu Shots For Young Children And Pregnant Moms

By | Asthma, Diabetes, Infectious Disease, Lung Disease

It may be summer, but next winter will be there and along with it the threat of flus.
Flu shots are offered in fall, and especially people with health problems (like asthma or diabetes, just to name a few) and seniors have been the primary target groups for public vaccination programs. U.S. health authorities now have also added young children under 2 to the program.

This step has been taken, as babies and young children are at a substantially increased risk for influenza-related hospitalizations.
The U.S. Centers for Disease Control has just release a new recommendation, that all women who are pregnant during the influenza season should get flu shots. Pregnant women who contract influenza frequently have an increased rate of complications, including pneumonia, tachycardia (rapid heart beat), and contractions.
Even though most pregnant women are young and healthy, their hospital admission rate during the flu season is similar to what you see in the elderly.
Statistics show that generally only 12% of women with uncomplicated pregnancies get vaccinated. With the threat of a severe strain of influenza A, which showed its aggressive and widespread activity last winter, it can be expected that there will be an increased demand for flu shots this year.

Flu Shots For Young Children And Pregnant Moms

Flu Shots For Young Children And Pregnant Moms

References: The Medical Post, May 18, 2004, pg. 8 and 9

Last edited December 8, 2012

Apr
01
2004

Sucking Bite Does Not Remove Venom

By | Health, Infectious Disease, Pain

How often have you heard the story that you should suck out the venom from a snakebite or insect bite. Researchers at the University of California at San Francisco have put this to the test. They injected a “mock venom”, which mimicked the composition of a venom without the poisonous effect, into eight male volunteers. This mock venom was radioactively labelled, so it could be traced. A vacuum pump, which simulated the sucking out of the wound, was applied after a few minutes and the amount of venom extraction was calculated by measuring the radioactivity of the extracted mock venom. To the surprise of the researchers only 2% of the mock venom had been sucked out on average.

Venom alert: Attempting to suck out a bite wound will not remove enough venom to make any difference for the total body venom load. It is much more important to not waste any time by applying a tight tourniquet above the bite wound (between the bite and the heart) and to call for an ambulance to rush the patient to the nearest Emergency Department where antitoxin for the venom treatment is available. To suck out a wound would only add mouth bacteria to the wound and could result in serious infections in addition to the poison.

Sucking Bite Does Not Remove Venom

Sucking Bite Does Not Remove Venom

Medical Post, Vol.40, No.12, March 23, 2004 (page 66).

Last edited December 8, 2012

Feb
01
2004

Worldwide Alert For Avian Influenza (Bird Flu)

By | Infectious Disease, Lung Disease

There is a new strain of avian influenza that in the beginning was confined to transmission among birds only. However, with 8 deaths in humans reported in Asia by the end of January 2004 (7 children and one adult) there is a fear that the virus is possibly genetically adapting towards transmission between humans, which could cause a worldwide flu epidemic similar to the flu in 1918 where more than 40 million people died.

Presently the avian flu has killed a high percentage of chickens and ducks in Vietnam, China, Thailand, Indonesia, Pakistan, Cambodia, and Laos. Recently Japan, South Korea, and Taiwan have also been added to the countries where the avian flu has arrived in birds. The governments are busy killing chickens off by the millions in an attempt to stop transmission to man.

All of the human cases were found in people who lived close to chicken farms or who handled diseased chickens.
The virus strain has been characterized as the type A, H5N1 strain (= the H5N1 flu), of the avian influenza. This strain has surfaced in the past on two occasions. First, it hit 18 persons in Hong Kong in 1997 of which 8 persons died. With the help of strict isolation methods an epidemic was prevented. Secondly, in March of 2003 a father and son from Hong Kong had traveled to southern China and they returned sick with the flu. The father died, the son recovered. Disease investigation showed that the source of infection in all of these cases was contact with diseased birds or with live, infected poultry in open markets.

Worldwide Alert For Avian Influenza (Bird Flu)

Worldwide Alert For Avian Influenza (Bird Flu)

Unfortunately the present flu vaccines will not give protection against this strain. WHO officials had an emergency meeting at the end of January 2004 to discuss the strategy for preventing a worldwide epidemic with
this new influenza strain. Production of a new vaccine will take several months (up to 6 to 8 months), if it is done in the conventional way. The cheaper antiviral antibiotics such as amantadine and rimantadine that normally would cover an A type influenza are ineffective against this new flu strain. There are newer antiviral antibiotics, which are effective, but they are more expensive. With mass production they could become more affordable and this could interfere with the spread between humans, if the virus should adapt to this transmission behavior.

At the present time migratory birds that are infected with the flu virus are spreading the avian flu to birds in other neighboring countries. In the meantime farmers who are not satisfied with only a 10% reimbursement by their governments for forcefully killed chickens are selling chickens on open meat markets, some of which harbor the avian flu, and this is another possible mode of transmission. David A. Halvorson, a veterinary medicine doctor from the University of Minnesota in Saint Paul stated that the risk for avian flu in the US at the present time is low as the US is not importing any live poultry from Asia.

In an interview between Doug Kaufman from MD Consult and the CDC director Dr. Julie Gerberding on Jan. 29, 2004 it was learnt that 10 patients had died so far in Vietnam and Thailand. Six WHO scientist in Vietnam are working with officials to contain the avian flu in Asia so that it won’t migrate similar to another outbreak of the same type of avian flu strain in Hong Kong in 1997. It appears that the killing of chickens has made some difference. On the other hand the spreading of the disease among wild ducks is of some concern.

The CDC and WHO are working together on this and are pushing for accelerated production of live and of inactivated vaccines against avian flu. This is a type of vaccine, which would make it impossible for future avian flu strains to cross into human hosts. The mass production of antiviral drugs is also being pursued. Dr. Gerberding stated that oseltamivir (brand name: Tamiflu), one of the newer antiviral drugs, would be effective in treating this type of avian flu (cited in Medscape Medical News Jan. 29, 2004).

Dr. Neill, an infection specialist and professor of medicine at the Brown University School of Medicine in Providence, Rhode Island, said that in case of a future human breakout of an epidemic with this flu the following instructions should be followed: 1. cover your mouth and nose with paper tissue when you sneeze or cough 2. frequently wash your hands with soap and water 3. use designated containers for disposal of the used paper tissues 4. symptomatic patients should use face masks to prevent the spread of the flu.

This article is based on the Lancet (The Journal) Vol. 363, Vol. 9406 (Jan. 31, 2004), on news stories from MD Consult and on Medscape news stories.

More info about the Flu: http://nethealthbook.com/infectious-disease/respiratory-infections/flu/

Link to Centers for Disease Control and Prevention on avian (bird) flu

Last edited October 26, 2014

Jan
01
2004

Flu Season Not Over Yet

By | Health, Infectious Disease, Lung Disease, Prevention

Influenza type A is the cause of many flu epidemics including the one that recently affected the northern hemisphere. It is known to change its surface characteristics from time to time. This has occurred in the southern hemisphere (Australia and New Zealand) during the summer of 2003 and the same new type has caused the recent epidemic in Canada, the US and Europe.

Prior strains of flu viruses in recent years were variants of the Panama strain, that’s why the infection specialists decided in the beginning of 2003 to suggest a Panama strain type vaccine to be used for protection for this flu winter season. However, 70% of the cases tested in Canada by the end of November turned out to be influenza type A/Fujian,full name A/Fujian/411/2002(H3N2), different from type A/Panama, full name A/Panama/2007/99(H3N2), according to Dr. Theresa Tam. She is a specialist in the division of respiratory diseases at the Health Canada Centre for Infectious Disease Prevention and Control. Similar observations regarding a shift from the type a/Panama to the type A/Fujian strain of the flu virus has also been reported in the US and in Europe. It appears that those who have been vaccinated with the type A/Panama vaccine have had partial protection from this new flu as some of the flu virus characterisitics (e.g. the H3N2 determinants) are the same.

Dr. Tam mentioned that the recent deaths in children from the flu in the US, England and Canada would likely be explained by the fact that in the last 3 years there have not been any H3 type flus and the flus that did circulate were relatively mild. This means that children have not developed enough background resistance to fight a flu when it comes. Most adults have background resistance, but older people are loosing some of the resistance due to aging. Dr. Tam explained that not too many children have had the flu vaccination. One would expect that children are most vulnerable for the flu and this explains why these deaths would have occurred.

Flu Season Not Over Yet

Flu Season Not Over Yet

Production of flu vaccines that protect from flus: One of the problems with getting the best match for an upcoming flu season is the lag period between the decision to produce a certain type of flu vaccine and the mass production of the vaccine to serve a world population. This can take 6 to 8 months. A new technique of vaccine production is being investigated, called “reverse genetics”, where the lag period may only be a few weeks.

Dr. Webster, an infectious disease specialist at the St. Jude Children’s Research Hospital in Memphis, has produced a vaccine with this method against an avian flu with the characteristics H5N1(different from the others mentioned above). This is an older flu transmitted by birds that has resurfaced earlier in 2003 again. However, this vaccine that has been produced in cell culture and not in egg cultures, has only been tested in animal models, not in humans yet. Both Dr. Webster and Dr. Tam agree that human trials under FDA guidelines are needed to test these newer vaccines utilizing reverse genetics. Regulatory and patent issues need to be settled for this to happen.

Use of antiviral drugs: Another issue is that type A influenza can be treated with antiviral antibiotics, but every flu season these types of drugs tend to run short. Each country should have a national stockpile of these antiviral drugs (such as Tamiflu) so that enough stock is available in case of a serious epidemic where the vaccine may not fit the flu strain that comes around. This is not happening at the present.

What is needed is that international discussions take place through the Global Health Security Network (right now consisting of the G7 countries and Mexico), Dr.Tam said.

Conclusion: The flu season has started early this season. Many people have died because of a lack of vaccination. Some of those who were vaccinated against the flu may have caught the flu as the fit this year with regard to the vaccine was not the best. However, they likely survived the flu, whereas those who did not have the vaccine were more likely to have experienced the flu more severely and some of these have died. It is not too late to get the flu vaccine before the spring season. Typically there is another peak of the flu between February and April.

Based in part on The Medical Post, Dec.9, 2003 (p.1 and 73).

Last edited December 8, 2012

Oct
02
2003

Flu Shot Cuts Death Rate Into Half

By | Infectious Disease, Lung Disease, Prevention

An earlier publication in the New England Journal of Medicine in March 2003 has shown that the death rate of people 65 years or older who were vaccinated against the flu, dropped into half when they were exposed to the flu and were compared to non-vaccinated controls. On Oct. 9, 2003 Dr. Megan Wren, associate director of the internal medicine residency at Barnes-Jewish Hospital and Washington University School of Medicine, reminded physicians that with the upcoming flu season it is important to include everybody who is healthy at age 50 or older (as the CDC has suggested now for 3 years) with influenza vaccination . Many physicians are still not aware that the rules have been changed to incude younger persons.

Below are recommendations of who should get a vaccination (in table form).

Dr. Wren pointed out that the risk from a flu vaccination is minimal. Contrary to public belief the flu vaccine does not cause fever, unwellness or muscle aches. The only effect is a mildly sore arm at the site of injection.

Flu Shot Cuts Death Rate Into Half

Flu Shot Cuts Death Rate Into Half

This year the FDA has approved a live flu vaccine that is administered as a nasal spray. This is a live modified flu virus that has been “trained” to only multiply in the colder nasal cavity, but not in the warmer airways. Like with all live viral vaccines pregnant women are not allowed to take this.

Who should get the flu vaccine ?
Group of people:
Comments:
all people age 50 or over the immune system weakens with age, that’s why complications of the flu are more common in this age group
women who will be in the 2nd or 3rd trimester of a pregnancy during November through to March protects the fetus from the flu virus in the most vulnerable period of the  development of the fetus
chronic heart disease or lung disease (including asthma) the flu affects the lungs and the heart most readily
chronic kidney or liver disease these chronic diseases weaken the immune system
people without a spleen and cancer patients the immune system is weak in these patients
children and adults with any chronic disease including diabetes chronic illnesses weaken the immune system in young and old
people on imunosuppressive medications the immune system is weak in these patients
all close family members of any of the above people the CDC hopes that this stops the spread of the flu into this vulnerable group of patients

Dr. Wren also mentioned that people with chronic illnesses, with immune deficiencies (e.g. AIDS and cancer patients) and healthy patients over the age of 50 cannot take this live vaccine. All others from age 5 to 49 can take it, but presently this is still very costly (one nasal mist application in 2003 is about 50.00$ US).

Last edited December 9, 2012

Sep
01
2003

West Nile Virus (WNV) Vaccine Being Tested In Humans

By | Infectious Disease, Prevention

According to Dr. Tom Monath, the scientific officer of the Acambis pharmaceutical company, human trials on a new vaccine for West Nile virus (WNV) can begin as soon as the FDA will give the green light (likely in October of 2003).

At the 2003 World Vaccine Conference in Montreal/Canada this summer Dr. Monath explained that Acambis has been doing research for a new vaccine against WNV since 1999 when this virus arrived in New York. The virus belongs into the same group of flaviviruses as dengue fever, yellow fever and Japanese encephalitis.

Yellow fever has been successfully prevented by vaccination with a live vaccine that has been modified considerably (called 17D attenuated vaccine). This strain is basically a harmless virus, which will induce a strong immune response in 100% of vaccinated people. If this is repeated every 10 years, a vaccinated person would be safe to travel in yellow fever infested areas. Based on this knowledge the researchers of Acambis have created a chimera virus where the yellow fever vaccine (attenuated virus 17D) is used as a vehicle in the center while the surface has been modified by incorporating parts of the WNV into its envelope. As this new vaccine virus has qualities of both the yellow fever vaccine virus and the WNV, it is called a chimera virus. The same technology has already been successfully applied to two other flavivirus vaccines, namely the dengue fever vaccine and the Japanese encephalitis vaccine.

West Nile Virus (WNV) Vaccine Being Tested In Humans

West Nile Virus (WNV) Vaccine Being Tested In Humans

The new WNV vaccine has been tested extensively in mice and monkeys and has been found sofar to be very safe and it is mounting a very good immune response. It is timely that human trials are being done now starting this fall as WNV seems to be expanding rapidly throughout the United States and Canada. The vaccine would be needed particularly for older people as in them the WNV disease presents much more violently with a higher death rate. However, visitors from Europe to the US and Canada will likely want to protect themselves as well before they travel.

Comment in July 2012: A vaccine for humans is still not available, for horses it is.

Last edited December 9, 2012

Sep
01
2003

SARS Due To SARS-Associated Coronavirus (SARS-CoV)

By | Infectious Disease, Lung Disease

A comprehensive paper was recently published online July 22, 2003 (Lancet 2003; 362: 263-70) regarding the causative microorganism of SARS.

Several investigators have collaborated in this study from viral laboratories of Rotterdam/The Netherlands, Hong Kong Special Administrative Region/China , Singapore, London/UK, Hamburg/Germany, Paris/France and Geneva/Switzerland.

This study involved isolation of the SARS-associated coronavirus (SARS-CoV) from SARS patients who died from the disease, propagation of the virus in an experimental animal model (cynomolgus macaques) and causing SARS again with an injection of the isolated virus back into a healthy experimental animal.

This, according to the authors (Dr. Thijs Kuiken et al.), fulfils the Koch’s postulates, which is one of the fundamental laws in microbiology that has to be fulfilled in order to claim a new infective organism. Dr. Robert Koch was a German physician who had detected the causative organisms of anthrax, tuberculosis and cholera and won the Nobel price for physiology and medicine in 1905. He developed the four original Koch’s postulates that were subsequently modified to a total of six. Here is a run down of the postulates and how it relates to SARS:

SARS Due To SARS-Associated Coronavirus (SARS-CoV)

SARS Due To SARS-Associated Coronavirus (SARS-CoV)

1. The specific organism should be present in all cases of animals suffering from a specific disease, but should not be found in healthy animals.

For SARS this was fulfilled as this study, which was based on a thorough analysis of 436 patients in six countries, showed. 75% of the suspected cases were found in postmortem studies to contain the SARS-associated coronavirus (SARS-CoV). In some patients other infectious agents could also be isolated, but the primary causative agent was SARS-CoV.

2. The specific organism should be isolated from a diseased animal and grown in pure culture on artificial laboratory media.

Using an experimental animal model, the virus was able to be isolated from a diseased person and injected into a healthy animal that turned sick with SARS. From this animal the virus could be isolated again from cells of the infected airways and grown in tissue culture.

3. This freshly isolated microorganism, when inoculated into a healthy laboratory animal, should cause the same disease as in the original animal.

As already explained under point 2 above, this has been shown with SARS.

4. The microorganism should be able to be isolated again in pure culture from the experimental infection.

This was proven in this paper regarding SARS. It was even done with genetic markers that were still present after passage from postmortem human tissue into an experimental animal and from the final respiratory tissue isolate of this newly infected animal.

5. The infective agent can be filtered and the filtrate contains the infective agent.

This was proven for SARS and the exact classification of the virus was possible because of the advanced genetic knowledge that is now available.

6. When the virus enters the body or the experimental animal, there are signs of the immune system attempting to rid the body of the infectious organism.

Sophisticated immune tests were performed that showed in more than one way that the immune system attempted to rid the body of SARS, but was eventually overwhelmed in the cases that did not survive.

Summary: This paper has conclusively proven that SARS is caused by a new type of coronavirus, SARS-associated coronavirus (SARS-CoV). In about 12% of cases there was another virus type present, such as human metapneumovirus. This occasionally was also present in lethal SARS cases as a secondary virus. Some other flu-type viruses were also found in the non-SARS cases. However, this paper has shown that SARS-associated coronavirus (SARS-CoV) is what causes SARS.

Link to SARS chapter of Dr. Schilling’s Net Health Book: http://nethealthbook.com/infectious-disease/infectious-disease-infections/severe-acute-respiratory-syndrome/

Last edited October 26, 2014

Jun
01
2003

Effect Of Smallpox Vaccination Lasts Much Longer

By | Infectious Disease, Prevention, Skin Disorders

Introduction

A study found that the effect of smallpox vaccination lasts much longer than previously thought. In the age of bioterrorism Americans worry about what would happen in the case of an attack with smallpox. Due to concentrated efforts worldwide through the WHO for many years, smallpox could be declared eradicated in the US in 1949 and worldwide in 1972. American children since then did not receive a smallpox vaccination. However, 95% of Americans over the age of 35 have been vaccinated and according to a recent study have been shown to still have a very good immune response that likely would make them immune to a bioterrorism attack with smallpox virus.

Review article in the British Medical Journal 

A review article in the British Medical Journal (BMJ 2003;326:1164) on May 31, 2003 reports about a study by Oregon researchers from the Departments of Molecular Microbiology and Immunology in Portland. Dr. Mark Slifka and Dr. Erika Hammarlund (Oregon Health Sciences University) collected blood samples from 306 previously smallpox vaccinated volunteers to check for antibody levels as well as T cell responses against smallpox antigens. The volunteers were of different ages and included people who were vaccinated against smallpox as recently as last year and as long as 75 years ago. All of them showed a very good response due to high antibody levels and their serum was able to neutralize the smallpox vaccinia virus in Petri dishes.

Good T cell responses after 35 years of smallpox vaccination

The T cell mediated cellular immune response showed some slowing down in the older age group. However, another study done by a North Carolina research group and also presented at a meeting from the American Society for Microbiology in Washington, DC. and published recently (New England Journal of Medicine 2002;347:689-90) found that T cell responses lasted a very long time. A group of people vaccinated 35 years earlier, so the North Carolina group reported, had perfect T cell responses to the smallpox vaccinia virus. The conclusion of these studies is that the effect of smallpox vaccination lasts much longer.

Effect Of Smallpox Vaccination Lasts Much Longer

Effect Of Smallpox Vaccination Lasts Much Longer

Conclusion

There is no point of vaccinating more often than two times in a lifetime.  Even one-time vaccinated people often have good immunity against smallpox. People born after 1972 and never  vaccinated against smallpox should consider vaccination and discuss this with their doctors. There are, however, some known complications of the vaccine such as a myopericarditis (a heart condition). Next, generalized vaccinia can occur, a skin condition common in people with skin problems like acne or psoriasis. 1 in 10,000 immunizations will get viral encephalitis, which often leads to brain damage. There is presently a campaign to vaccinate 500,000 frontline healthcare workers in the US against smallpox. This is a government plan to prepare for a smallpox bioterrorism attack. Due to the possible complications so far only 35 000 healthcare workers have volunteered for vaccinations. Link to overview regarding history of smallpox from the CDC.

Incoming search terms:

May
01
2003

Early SARS Treatment In Hong Kong Reduces Death Rate Dramatically

By | Infectious Disease, Lung Disease

Dr. Loletta Kit-Ying So from the Pamela Youde Nethersole Eastern Hospital in Hongkong reported on May 10, 2003 in the medical journal The Lancet (Lancet 2003;361:1615-1617) about their experience with early SARS treatment. Key to the success of this group is early recognition and early treatment of SARS. They found that high doses of corticosteroids to control the inflammatory reaction of the airways coupled with the antiviral antibiotic ribavirin has meant a breakthrough in the treatment of SARS. They have treated 50 patients with the new combination protocol.

Medication protocol:

Initially the patient is started on the fluoroquinolone antibiotic levofloxacine 500 mg once per day. This has an immunomodulating effect and keeps the virus at bay. Methylprednisolone at 1 mg per kg of body weight given three times per day is the corticosteroid used for 5 days, the gradually tapered to nothing over 16 days. The virus itself is treated with the antiviral drug ribavirin 400mg three times daily intravenously for three days or until the patient becomes stable, followed by tablets (1200mg twice per day) by mouth.

Outcome:

The good news with this protocol is that 70% of patients have left the hospital and are recovered; 27% are treated and are stable; three patients are mechanically ventilated (on a respirator), but stable. One patient who was an elderly diabetic patient has died of a heart attack.

Early SARS Treatment In Hong Kong Reduces Death Rate Dramatically

Early SARS Treatment In Hong Kong Reduces Death Rate Dramatically

There are no major side-effects of the treatment protocol. Some modifications are made with patients who have tuberculosis and with patients who are pregnant.

Here is an overview of SARS with links to the CDC.

Last edited October 26, 2014