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September 9, 2016
Has leprosy hit California? Two elementary students 'diagnosed with the rare infectious disease'
Two elementary school students in California have been diagnosed with leprosy, officials claim. The disease, also known as Hansen's, is an
incredibly rare condition caused by slow multiplying bacteria which can destroy sufferers' eyesight and all sensation in their skin. It is most typically
associated with Asia and the Middle Ages, when and where the disease was most prevalent.
But to the horror of parents in Jurupa Valley, an hour's drive from Los Angeles, the infectious condition appears to have reached the West Coast.
It is caused by slow multiplying bacteria (Mycobacterium leprae) which can destroy sufferers' eyesight and all sensation in their skin. The disease is
spread through prolonged or repeated contact with an untreated patient - specifically, contact with their saliva or nasal mucus. It mainly affects the
eyes, the upper respiratory tract, and the skin.
Symptoms can appear as late as 20 years after a person has been infected.
Patients are treated with a combination of antibiotics, and studies suggest antibiotics can protect healthy people from catching the disease.
It is not clear whether the two patients are related, nor whether they recently traveled abroad.
Parents were also issued with fact sheets explaining the disease, how it is transmitted, and how it is treated.
As of 2014, there were fewer than 200,000 cases of the disease globally.
Jurupa Valley District Superintendent Elliott Duchon said classrooms at the school have been disinfected.
Visit the Daily Mail for the story.
UM Zika experts weigh ‘the cost of inaction’
Educational volunteers, “Drain and Cover” posters and insect repellent giveaways don’t prevent the spread of Zika — people do. That’s where
doctors come in, said tropical disease expert Dr. Paola Lichtenberger during a Thursday Zika forum at the University of Miami. Experts need to
hammer home the message that Zika is a big deal.
“This is a problem of all of the citizens of all the cities. It’s what you are doing every time you go outside,” she said. “We have pregnant women to
protect. That is our responsibility and we need to take ownership of it.”
UM experts on tropical diseases, pediatrics, infectious diseases and obstetrics gathered Thursday for a panel on Zika, which has been transmitted
by mosquitoes in two places in Miami-Dade County. The university is creating the Zika Global Network to share information and techniques with
health workers in other countries hit by the virus, including Brazil.
Panelists focused on the science behind possible solutions to the virus. As cases multiply and Miami-Dade plans to start aerially spraying a pesticide
— naled — over Miami Beach, some residents have been vocal with their concerns that the cure is worse than the disease.
The panelists offered a different view: “Everything in life is a risk balance,” said Dr. Christine Curry, a UM obstetrician. For example, she said, driving
to work in a car is a big risk, but the benefit of arriving at the destination makes it worth it. Drivers mitigate risk with safety features like air bags and
seat belts.
In the case of Zika in Miami, officials insist naled is not toxic in small doses.
But protestors have raged at the idea of spraying the controversial pesticide designed to kill adult mosquitoes. The CDC originally dismissed
spraying Miami Beach because of the dense urban area and high-rise buildings but, with cases on the rise, Miami Beach plans to start spraying
Friday at 5 a.m.
But Curry, the UM obstetrician, said, “at this point, protecting pregnant women puts us in a place where using pesticide is a better risk balance.”
When the connection between Zika and microcephaly was first drawn, doctors assumed babies with normal-looking heads weren’t affected by the
virus. Curry said growing evidence suggests infants with regular features can have hidden Zika effects, like calcification and water on the brain or
eye problems.
Doctors will likely learn more in the next few months as the 80 pregnant women with Zika in the U.S. have their babies.
Congress is considering a billion-dollar Zika funding bill that, if passed, would speed up research into a vaccine, testing and treatment — something
UM doctors say they could use.
There are other obstacles to containing the disease, too. Zika tests are expensive, time-consuming and hard to get. Urine tests are easy and the
results come back fast. But they only show whether or not the patient had Zika within the last two weeks.
The most effective test is when a patient’s blood is mixed with Zika antibodies. If the blood fights back, it means the person already had the virus and
the body knows how to attack it now. The backlog in labs statewide means those results can take four to six weeks.
Gov. Rick Scott declared that all pregnant Floridians have access to free Zika testing, but Curry said “a mandate without resources is hollow.”
That’s where a rapid test would come in, said David Watkins, a UM pathology professor. He and Dr. Sylvia Daunert applied for a grant to work on
creating a Zika test that would be as simple, effective and quick as a pregnancy test. They hope to develop an antibody-based test would tell
whether a patient had been exposed to the virus or had it.
A total of 744 people in Florida have contracted Zika this year, according to the health department, including 604 travel-related infections, 56 local
cases and 84 pregnant women.
Visit the Miami Herald for the story.
Zika money is running out across Federal agencies
Another government agency fighting Zika has run out of cash to do it, as Congress fights over whether and how to come up with more. The National
Institute of Allergy and Infectious Diseases has spent all the money it has for work on Zika, says the agency's director, Dr. Anthony Fauci. That
includes money for further work on a Zika vaccine.
The NIAID, part of the National Institutes of Health, had already been using cash borrowed from other projects. The Biomedical Advanced Research
and Development Authority (BARDA), which plans for public health emergencies, is also almost out of money, the Health and Human Services
Department says.
Centers for Disease Control and Prevention director Dr. Thomas Frieden has already said his agency has run through all its borrowed Zika money.
There is no word from Congress on a potential bill to keep work against Zika going, even as the number of affected Americans keeps going up.
Nearly 3,000 travel-related cases have been reported to the CDC. And CDC said Thursday that nearly 16,000 people in U.S. territories — mostly
Puerto Rico — had been infected. These include 671 pregnant women in the 50 states and Washington, D.C. and another 1,080 in the territories.
The CDC says 17 babies have been born with Zika-related birth defects and five have miscarried or been aborted because of severe defects.
And as CDC, NIH and other agencies take money from other disease programs to fight the more time-sensitive Zika battle, they may be shooting
themselves in the foot, says Stephen Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies.
Some members of Congress say the money may need to be included in a continuing resolution — a stopgap bill that would keep the government
running for three months over the volatile election period.
The money's needed for work to develop a Zika vaccine; better tests to help doctors tell if someone's infected or has been infected with Zika and a
better understanding of the birth defects Zika causes. Scientists also want to understand how often Zika causes a paralyzing condition called
Guillain-Barré syndrome and families of babies born with Zika-connected birth defects will also need help.
The federal government is also working to find better ways to control the mosquitoes that spread Zika. The CDC helps local authorities prepare for
and fight Zika, including supplying tests and mosquito repellent.
Fauci says the money crunch is threatening vaccine research. Most experts say a vaccine is the only long-term solution to Zika, which will not go
away so long as the mosquitoes that spread it exist.
Visit NBC News for the article.
Exercise can cancel out the booze, says study
You might want to chase that next beer with a little exercise. Exercising the recommended amount "cancels out" the higher risk of cancer death
brought about by drinking, a new study revealed. Similarly, physical activity lessened any greater risk of death resulting from any cause due to
alcohol.
With its "very high standing" in Western culture, "alcohol will continue to be abused despite the damage it causes to the health of individuals and
society in general," said Dr. Emmanuel Stamatakis, senior author of the study, which appeared in the British Journal of Sports Medicine, and an
associate professor at the University of Sydney's medical school. Yet, policies to regulate consumption have never worked well, explained
Stamatakis.
Since people continue to drink, this realistic researcher and his colleagues decided to see whether the harms of drinking might be offset by the
benefits of exercising.
Stamatakis and his colleagues gathered data from health surveys conducted in England and Scotland. Then the researchers grouped the study
participants -- 36,370 people, all 40 years of age or older -- into three categories: people who are not very active, those who do a moderate amount
of exercising, and those who do the most. Next, the research team looked at alcohol use among the participants.
Calculating 5,735 total deaths over an average follow-up period of nearly 10 years per person, and crunching the numbers, the researchers
discovered that compared with lifelong abstinence from alcohol, drinking at hazardous levels was linked to a heightened risk of death from all
causes. Hazardous drinking is 8 to 20 US standard drinks for women and 21 to 49 for men, as defined by the researchers.
And, the more alcohol units drunk each week, the greater the risk of death from cancer -- even when a person drank less than the recommended
maximum per week. The recommended weekly maximum, as defined, is 8 standard drinks for women and 12 for men.
However, all the numbers changed when Stamatakis and his colleagues factored exercise into their equations.
Specifically, they looked at the impact of the recommended amount of weekly exercise for adults, which is 150 minutes of moderate aerobic activity.
That includes brisk walking, swimming and mowing the lawn, according to the US Department of Health and Human Services. HHS also advises
strength training for all major muscle groups at least twice a week.
Exercising the recommended amount "appeared to wipe off completely" the inflated risk of cancer death resulting from alcohol, said Stamatakis.
Similar physical activity also offset the increased risk of all-cause mortality linked to drinking. Exercising more provided slightly better results.
Visit CNN for the article.
Evidence of Zika virus found in tears
Zika virus can infect the eye, and evidence of the virus has been found in tears, according to a study by researchers at Washington University
School of Medicine in St. Louis. The research, in mice, helps explain why some people with Zika virus develop eye disease and suggests that
contact with infected eyes may play a role in spreading the disease.
Researchers have found that Zika virus can live in eyes and have identified genetic material from the virus in tears, according to a study from
Washington University School of Medicine in St. Louis.
The research, in mice, helps explain why some Zika patients develop eye disease, including a condition known as uveitis that can lead to permanent
vision loss.
The study, published Sept. 6 in Cell Reports, describes the effect of Zika virus infection in the eyes of mouse fetuses, newborns and adults. The
researchers now are planning complementary studies in patients infected with the virus.
“Our study suggests that the eye could be a reservoir for Zika virus,” said Michael S. Diamond, MD, PhD, the Herbert S. Gasser Professor of
Medicine and one of the study’s senior authors. “We need to consider whether people with Zika have infectious virus in their eyes and how long it
actually persists.”
Eye infection raises the possibility that people could acquire Zika infection through contact with tears from infected people. The researchers found
that the tears of infected mice contained Zika’s RNA – the genetic material from the virus – but not infectious virus, when tested 28 days after
infection.
The eye is an immune privileged site, meaning the immune system is less active there to avoid accidentally damaging sensitive tissues responsible
for vision in the process of fighting infection. Consequently, infections sometimes persist in the eye after they have been cleared from the rest of the
body.
Zika researchers are increasingly considering alternative routes of transmission because the virus is spreading more quickly than would be expected
by mosquito-borne transmission alone. Epidemiologists can predict the spread of a disease based on known rates of transmission for related viruses
and the viral level in the bloodstreams of infected people. By those calculations, Zika is moving unusually fast.
Visit EurekAlert for the study.
Competitive bidding program continues to maintain access and quality while helping to save Medicare millions
The Centers for Medicare & Medicaid Services (CMS) announced the new single payment amounts and began sending contract offers to successful
bidders for Medicare’s Round 1 2017 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program.
These new payment amounts and contracts go into effect on January 1, 2017. This program has been an essential tool to help Medicare set
appropriate payment rates for DMEPOS items and save money for beneficiaries and taxpayers while ensuring access to quality items.
Prior to the DMEPOS Competitive Bidding Program, Medicare paid for these DMEPOS items using a fee schedule that is generally based on historic
supplier charges from the 1980s. Numerous studies from the Department of Health and Human Services Office of Inspector General and the
Government Accountability Office have shown these fee schedule prices to be excessive, and taxpayers and Medicare beneficiaries bear the burden
of these excessive payments.
Since implementation of the DMEPOS Competitive Bidding Program on January 1, 2011, CMS has saved approximately $220 million per year in the
nine Round 1 metropolitan statistical areas (MSAs) due to competitive bidding and other CMS fraud, waste, and abuse initiatives. Health monitoring
data indicate that the program implementation is going smoothly with few inquiries or complaints and no negative beneficiary health outcomes.
CMS will now begin offering contracts to winning bidders. CMS expects to complete the contracting process in time to announce the contract
suppliers in the fall of 2016. Bidders that are not offered contracts will be notified of the reasons why they did not qualify for the program when the
contracting process is complete. Suppliers that are not contract suppliers for this round of the DMEPOS Competitive Bidding Program may bid in
future rounds, unless they are precluded from participation in the program.
Additional information on the distribution of contract offers is available at the following Web site: www.dmecompetitivebid.com.
Visit here for additional information about the Medicare DMEPOS Competitive Bidding Program.
Antibacterial ingredients in indoor dust linked to antibiotic resistance
Less than a week after the U.S. Food and Drug Administration announced a ban on 19 chemicals used in antibacterial soaps because they may
pose a risk to rising resistance of bacteria to antibiotics, a new study suggests one of the chemicals is found in indoor dust and contributes to the
problem.
The chemicals triclosan and triclocarbon, as well as four other antimicrobial chemicals, were found in house dust by researchers at the University of
Oregon, Harvard University and Arizona State University, according a study published in the journal Environmental Science and Technology,
suggesting their use in cleaners is contributing to antibiotic resistance.
Researchers in the study analyzed dust samples from an indoor athletic and educational facility, detecting triclosan, triclocarban, and methyl-, ethyl-,
propyl- and butylparaben in the dust samples. The researchers then studied dust microbes, finding antibiotic resistance genes, which can be passed
between bacteria, linked specifically to the six cleaning chemicals detected in the initial analysis.
Samples with higher amounts of triclosan, beyond other chemicals, also had higher levels of genes linked to bacteria resistant to multiple drugs -which they say is contributing to the antibiotic resistance.
The FDA issued a rule on September 2 requiring manufacturers to remove 19 chemicals from antibacterial soaps, but not hand sanitizers or
antiseptics used in healthcare and food handler settings, because of potential health risks.
Among the now-banned chemicals, triclosan is the most widely used. The chemical was widely used primarily by surgeons to sterilize their hands;
however, triclosan started to be added to consumer chemicals, soaps, deodorants and laundry detergents in the mid-1990s.
Visit UPI for the report.
New 2016 AUA/SUO guideline recommends Olympus NBI technology for the diagnosis and treatment of non-muscle invasive bladder
cancer
Olympus, announced that the American Urological Association (AUA), together with the Society for Urologic Oncology (SUO), included the Olympus
Narrow Band Imaging (NBI) technology in its newly released guidelines for diagnosing and treatment non-muscle invasive bladder cancer (NMIBC).
AUA/SUO Guideline includes NBI, the world's only patented endoscopic light technology that, as compared to white light, visualizes lesions in
additional 17 percent of patients, without the use of dyes or drugs.
The AUA/SUO provides in the guideline recommendations on actions that should (or should not) be taken based on risk/benefit. The guidelines,
approved by the AUA Board of Directors, are evidenced-based, meaning that a wide literature search for comparative effectiveness was conducted
and reviewed.
"In a patient with NMIBC, a clinician may consider use of NBI to increase detection and decrease recurrence," the guideline states, adding that
enhanced cystoscopic techniques such as narrow-band imaging (NBI) "seem particularly valuable for diagnosis of urothelial carcinoma in the setting
of positive cytology but negative white light cystoscopy."
NBI is the world's only patented endoscopic light technology that enables effective targeting of biopsies not seen under white light, without the use of
dyes or drugs. NBI is not intended to replace histopathological sampling as a means of diagnosis. NBI enhances visibility of vascular structures on
the mucosal surface. Unlike white light, which uses all colors in the spectrum, NBI uses only blue and green. Blue and green light are strongly
absorbed by blood and appear darker than normal tissue.
Based on a weighted average, the aggregated FDA-reviewed studies show NBI has visualized NMIBC lesions in:
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17 percent additional patients when compared with white light
24 percent additional tumors
28 percent additional carcinoma in situ (CIS or difficult-to-detect flat lesions)
Bladder cancer is the sixth most common cancer in the United States, with the highest lifetime treatment costs per patient of all cancers. White light
cystoscopy misses small papillary tumors or CIS (difficult-to-detect flat lesions) at an estimated rate of 10-20 percent. Fifty-four percent of patients
who go undiagnosed with CIS will progress to muscle invasive disease and require bladder removal (cystectomy) and a urinary diversion or
neobladder, Ninety-six percent of patients diagnosed early will survive five years later. Bladder cancer is known to recur 50 percent of the time.
Visit the AUA for the full guideline.
Olympus has created an informational site for better understanding of NBI technology, at www.simplyseemore.com.