Friday, January 31, 2020

A deadly virus is spreading from state to state and has infected 15 million Americans so far. It's influenza

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The novel coronavirus that's sickening thousands globally -- and at least five people in the US -- is inspiring countries to close their borders and Americans to buy up surgical masks quicker than major retailers can restock them.
There's another virus that has infected 15 million Americans across the country and killed more than 8,200 people this season alone. It's not a new pandemic -- it's influenza.
The 2019-2020 flu season is projected to be one of the worst in a decade, according to the National Institute of Allergy and Infectious Diseases. At least 140,000 people have been hospitalized with complications from the flu, and that number is predicted to climb as flu activity swirls.
    The flu is a constant in Americans' lives. It's that familiarity that makes it more dangerous to underestimate, said Dr. Margot Savoy, chair of Family and Community Medicine at Temple University's Lewis Katz School of Medicine.
    "Lumping all the viral illness we tend to catch in the winter sometimes makes us too comfortable thinking everything is 'just a bad cold,'" she said. "We underestimate how deadly influenza really is."
    Even the low-end estimate of deaths each year is startling, Savoy said: The Centers for Disease Control predicts at least 12,000 people will die from the flu in the US every year. In the 2017-2018 flu season, as many as 61,000 people died, and 45 million were sickened.
    In the 2019-2020 season so far, 15 million people in the US have gotten the flu and 8,200 people have died from it, including at least 54 children. Flu activity has been elevated for 11 weeks straight, the CDC reported, and will likely continue for the next several weeks.
    Savoy, who also serves on the American Academy of Family Physician's board of directors, said the novelty of emerging infections can overshadow the flu. People are less panicked about the flu because healthcare providers "appear to have control" over the infection.
    "We fear the unknown and we crave information about new and emerging infections," she said. "We can't quickly tell what is truly a threat and what isn't, so we begin to panic -- often when we don't need to."

    The flu can be fatal

    Dr. Nathan Chomilo, an adjunct assistant professor of pediatrics at University of Minnesota Medical School, said that the commonness of the flu often underplays its severity, but people should take it seriously.
    "Severe cases of the flu are not mild illnesses," Chomilo said. "Getting the actual flu, you are miserable."The flu becomes dangerous when secondary infections emerge, the result of an already weakened immune system. Bacterial and viral infections compound the flu's symptoms. People with chronic illnesses are also at a heightened risk for flu complications.
    Those complications include pneumonia, inflammation in the heart and brain and organ failure -- which, in some cases, can be fatal.
    Chomilo, an internist and pediatrician for Park Nicollet Health Services, said this flu season has been one of the worst his Minnesota practice has seen since the H1N1 virus outbreak in 2009. Some of his patients, healthy adults in their 30s, have been sent to the Intensive Care Unit, relying on ventilators, due to flu complications.

    The virus is always changing

    Influenza is tricky because the virus changes every year. Sometimes, the dominant strain in a flu season will be more virulent than in previous years, which can impact the number of people infected and the severity of their symptoms.
    Most of these changes in the virus are small and insignificant, a process called antigenic drift. That year's flu vaccine is mostly effective in protecting patients in spite of these small changes, said Melissa Nolan, an assistant professor at the University of South Carolina's School of Public Health.Occasionally, the flu undergoes a rare antigenic shift, which results when a completely new strain of virus emerges that human bodies haven't experienced before, she said.
    Savoy compares it to a block party: The body thinks it knows who -- or in this case, which virus -- will show up, and therefore, which virus it needs to keep out. But if a virus shows up in a completely new getup, it becomes difficult for the body's "bouncers" -- that's the immune system -- to know who to look for and keep out. The stealthy virus can infiltrate easily when the body doesn't recognize it.
    This flu season, there's no sign of antigenic shift, the most extreme change. But it's happened before, most recently in 2009 with the H1N1 virus. It became a pandemic because people had no immunity against it, the CDC reported.

    Get your flu shot, experts say

    To avoid complications from the flu, Savoy, Chomilo and Nolan have the same recommendation: Get vaccinated.
    It's not easy to tell how flu vaccination rates impact the number of people infected, but Savoy said it seems that the years she struggles to get her patients vaccinated are the years when more patients end up hospitalized with the flu, even if the total number of infections doesn't budge.
    The CDC reported at least 173 million flu vaccine doses have been administered this flu season so far -- that's about 4 million more doses than the manufacturers who make the vaccines projected to provide this season.
    Still, there are some who decide skipping the vaccine is worth the risk. A 2017 study found that people decline the flu vaccine because they don't think it's effective or they're worried it's unsafe, even though CDC research shows the vaccine effectively reduces the risk of flu in up to 60% of the population.
    Chomilo said some of his most frustrating cases of the flu are in patients who can't be vaccinated because of preexisting conditions or their age (children under 6 months old can't be vaccinated).
      There are two important reasons to get the flu vaccine, he said -- "Protecting yourself and being a good community member."
      credit: CNN.

      Tuesday, January 28, 2020

      Differences Between E.Coli & Salmonella

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      We have all heard of E-coli and Salmonella contaminating our food, but have never been too fussed to find out what they actually are. Are they the same thing or are they even similar to each other? Let’s find out!
      Salmonella and E.coli are similar in the sense that they are both bacteria, but are in fact completely different types of bacteria. Salmonella is the name of the group of over 2,500 types of bacteria that most commonly causes food poisoning in humans and animals. Salmonella is spread by ingesting foods that are contaminated by salmonella such as raw eggs, raw meat, eggs, fruits, vegetables, and contaminated water. Contamination takes place when these foods come into contact with animal or human feces and are not cooked properly. Symptoms of Salmonella are diarrhea, vomiting, fever, cramps, headache, and lasts around 4-7 days. Symptoms can get more serious in infants and the elderly but overall will go away by themselves.

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      E-coli is the name of the bacteria that lives in the intestines without (Most of the times) causing any problems. However, several strains of E-coli can cause food poisoning and result in serious issues where bleeding and hemorrhaging occurs. You can get E-coli by eating foods that have been improperly processed or harvested that may have come into contact with animal or human feces. The most common symptom of E-coli is recognized by symptoms which involve a bloody stool, which should be taken to immediate hospital care.
      Salmonella and E-coli outbreaks are both rooted by the contamination of feces, but are different bacteria that pose different risks. Now that you have educated yourself on the differences, it is most important to keep yourself healthy and free from these bacteria.

      How to protect yourself

      The best way to avoid any infection from E-coli and Salmonella is to maintain hygiene. Always thoroughly wash your vegetables and fruits as they may have come into contact with dirt which may have been contaminated by feces. In fact, E-coli and Salmonella can be passed by a simple shake of a hand from someone who has hasn’t washed their hands after relieving their bowel. Thus, always wash your hands before eating.
      Secondly, it is always important to cook your meat thoroughly, especially chicken. Those who crave their meat nice and rare, pose a risk to catching one of these infections. Lastly, it is important to maintain clean drinking water in your household so that your family does not consume E-coli or Salmonella from your water source. Bottled water or a purified drinking water system will be your best bet to safe water!

      Wuhan Coronavirus has killed 106 and infected 4,515 people, Chinese health authorities say

      GP: Coronavirus China's Wuhan Coronavirus Spreads To South KoreaChinese health authorities said Tuesday that the coronavirus outbreak has killed 106 people and infected 4,515.
      The officials also said 60 people had been discharged.
      The majority of the reported cases are in mainland China, where local authorities have quarantined several major cities and canceled Lunar New Year’s events in Beijing and elsewhere.
      The U.S. Department of State on Monday raised its travel advisory for China from Level 2 to Level 3 asking Americans to “reconsider travel to China due to the novel coronavirus.” They added that some areas have “added risk.”
      President Donald Trump addressed the matter in a tweet Monday, saying the U.S. is “in very close communication with China concerning the virus.”
      Multiple cases of the virus have been confirmed in Hong Kong, Macao, Taipei, Thailand, Vietnam, South Korea, Singapore, Malaysia, Japan, Australia, France and the United States.


      On Monday, local authorities in Germany confirmed the country’s first case. Nepal has confirmed one case. Cambodia confirmed its first case on Monday, according to Reuters, citing Health Minister Mam Bunheng. Sri Lanka also confirmed its first case on Monday, Reuters reports.
      Several companies, including Walt Disney with its Shanghai Disney, are suspending operations until further notice during the normally festive weeklong Lunar New Year holiday to prevent the outbreak from spreading. Starbucks and McDonald’s also closed stores in Hubei province.
      The Centers for Disease Control and Prevention confirmed Sunday a fifth U.S. case of the coronavirus — a patient in Maricopa County, Arizona, who recently traveled to Wuhan, China, the epicenter of the disease’s outbreak and where the majority of cases have been reported.


      U.S. health officials warned that the flu or other respiratory illnesses could complicate identifying more cases. They recommend that people call a health-care provider before seeking treatment so the appropriate measures can be put in place. The CDC is trying to speed up testing and to get the tests in the hands of state health officials. It currently takes the CDC about four to six hours to make a diagnosis once a sample makes it to its lab.
      CDC officials said Monday that the number of “patients under investigation” in the U.S. has almost doubled since Thursday to a total of 110 across 26 states. The disease is not spreading through human-to-human contact in the U.S. and the risk to the public right now is still considered low, Dr. Nancy Messonnier, the director of the National Center for Immunization and Respiratory Diseases, told reporters on a conference call Monday.
      Coronaviruses are a large family of viruses that usually infect animals but can sometimes evolve and spread to humans. Symptoms in humans include fever, coughing and shortness of breath, which can progress to pneumonia. Physicians have compared it to the 2003 outbreak of SARS, which had a short incubation period of two to seven days. U.S. officials said Friday that symptoms from the new virus, temporarily named 2019-nCoV, may take up to 14 days to appear.
      The WHO’s director-general, Dr. Tedros Adhanom Ghebreyesus, is traveling to Beijing to meet with government and health officials. According to the organization, more data needs to be collected before the virus, which can spread through human-to-human contact, is declared a global health emergency. WHO declined at two emergency meetings last week to say it was a worldwide emergency.
      China stepped up efforts to increase medical supplies to Wuhan that includes transferring 14,000 protective suits and 110,000 pairs of gloves from the central medical reserves, according to the State Council. Emergency supplies of 3 million masks, 100,000 protective suits and 2,180 pairs of goggles were also made available.


      More than 1,600 medical staff are said to be sent to the Hubei province, where Wuhan is located, to assist in containing the virus. The central government previously said it allocated 1 billion yuan, or $145 million, to support the province — Wuhan is building a 1,000-bed hospital to treat the infected and plans to have the facility operational by the end of the week.
      The incubation period is between two and 14 days, Messonnier said. There’s been some debate over how contagious the disease is, and she said it may take a while before researchers can figure that out.
      “This outbreak is really unrolling in front of our eyes,” she said. The so-called R naught, a mathematical equation that shows how many people will get an illness from each infected person, is somewhere around 1.5 to 3, she said. Measles, which is one of the most contagious infections in the world, has an R naught of around 12 to 18, by comparison, she said.
      China’s National Health Commission Minister Ma Xiaowei said on Sunday the incubation period could range from one to 14 days and that researchers in China now believe the virus is infectious during that time. Messonnier said the CDC hasn’t seen any evidence that shows it’s contagious before symptoms appear.

      Coronavirus: 110 people in 26 states 'under investigation' for disease; 5 U.S. cases confirmed so far

      More than 100 people in 26 states are being monitored for the new coronavirus that has killed 81 people in China, a U.S. health official said Monday.
      The news comes as the CDC on Monday raised its travel alert level for China to level 3, meaning Americans should avoid nonessential travel to the entire nation.
      Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, said 110 people are "under investigation" for the virus but added that human-to-human transmission of the virus has not been documented in the U.S.

      READ ABOUT: Coronavirus: 110 people in 26 states 'under investigation' for disease; 5 U.S. cases confirmed so far
      "This is a rapidly changing situation, both here and abroad," Messonnier said. "However, the immediate risk to the general U.S. public is low at this time."
      Still, she said a program for screening travelers entering the U.S. from Wuhan could be expanded in the coming days to include other parts of China. President Donald Trump tweeted Monday that U.S. officials are in "very close communication" with China and offered aid to President Xi Jinping as his nation grapples with the coronavirus.
      China's confirmed cases have ballooned to more than 2,800 since the coronavirus was discovered last month. The epicenter of the outbreak is Wuhan, a city of 11 million people, but more than 40 cases have been confirmed in a dozen other countries, including five in the U.S.
      "All US cases traveled from Wuhan," the Centers for Disease Control and Prevention said in a statement. "More cases may be identified. However, risk to US general public is still considered low."
      In the U.S., two cases have been confirmed in California, one in Arizona, one in Illinois and one in Washington state. Dozens of cities and states continue to screen patients whose symptoms are consistent with the virus.
      Drug companies are racing the clock to develop a vaccine.
      "Very few cases reported in USA, but strongly on watch," Trump tweeted. "We have offered China and President Xi any help that is necessary. Our experts are extraordinary!"

      Halting the outbreak remains a challenge, however. China’s National Health Commission says it appears the virus is infectious before symptoms show, an alarming characteristic that could complicate containment efforts.

      READ ABOUT: China confirms new cure after successful trial on nurses
      That could make this outbreak more ominous than severe acute respiratory syndrome, SARS, a virus that was not contagious during incubation. SARS killed more than 600 people across mainland China and Hong Kong along with more than 100 other people around the world in 2002-2003. 
      Ogbonnaya Omenka, an assistant professor and public health specialist at Butler University's College of Pharmacy and Health Sciences, says the revelation makes the coronavirus "more problematic and more difficult to contain."
      "It poses additional challenges," Omenka told USA TODAY. "Now we’re looking at both the identified cases and the traced contacts needing to be isolated to ensure the contacts do not keep spreading the virus unwittingly."
      In China, the government extended its Lunar New Year holiday period by three days, until Sunday, to ease crowds as tens of millions of Chinese return home from visiting family and tourist sites. At least 17 Chinese cities have imposed lockdowns affecting 50 million people.
      Chinese Premier Li Keqiang arrived Monday in Wuhan to take charge of the effort to curb its spread, the South China Morning Post reported.
      “You are trying every means to save lives,” Li told medical staff at Jinyintan hospital, one of the designated institutions for coronavirus patients. “When you are putting your efforts to save lives, you have to protect yourselves, too.”


      CREDIT: USA TODAY

      Monday, January 27, 2020

      The Wuhan coronavirus is now in Australia – here’s what you need to know

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      New South Wales Health has confirmed three men in their 30s, 40s and 50s in Sydney have tested positive to the new Wuhan coronavirus after returning from China.
      This follows Australia’s first case of the virus in a patient treated at Melbourne’s Monash Medical Centre – a man in his 50s who spent two weeks in Wuhan.This brings the total number of Australian cases so far to four.
      The outbreak is still in its early days, but the early identification and isolation of people suspected of having the virus will go a long way to preventing local transmission in Australia.
      There are now 1,323 confirmed cases of the Wuhan coronavirus worldwide, mostly among people in China.
      The virus has also claimed 41 lives, including the youngest victim, a 36-year-old man in Wuhan.
      Cases have also been identified in Japan, South Korea, the United States, France, Thailand, Singapore and Vietnam.
      The epicentre of the outbreak seems to be a seafood and live animal market in Wuhan. It was initially thought transmission had been from infected animals to those people at the market, with no or limited person-to-person spread.
      However, we’ve since learnt there has been person-to-person transmission in people who haven’t visited live animal markets, including the Melbourne case.
      The person infected in Vietnam had not been to China at all, but was a family member of someone infected in Wuhan.
      This means an animal infection has probably learnt to jump to humans and then spread within our species.
      Of the cases in China, 21% have been reported as severely ill and, on earlier estimates, 3% of those infected had died.
      The ages of the first 17 people who died from the virus range from 48 to 89, with an average age of 73. Thirteen (76%) were men and four (24%) were women.

      READ ABOUT:Researchers trace coronavirus outbreak in China to snakes (CHINESE FOOD)

      Most of those who have died from the virus appear to have underlying health conditions, and we know for sure in the case of ten people whose health information has been released.
      These people suffered from a range of chronic conditions, including high blood pressure (41%), diabetes (29%), stroke (18%), as well as chronic obstructive pulmonary disease, coronary artery disease, chronic kidney disease and Parkinson’s disease.
      If this pattern continues with the mounting death toll, older men with underlying health problems are at highest risk of dying.
      If the Wuhan coronavirus behaves like the other human coronaviruses such as SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome), droplets of saliva, urine, faeces and blood could all be infectious.
      Contact with these substances – directly from people while they’re infectious, or indirectly from surfaces contaminated with these body substances – could lead to infection.
      This is why prompt isolation of suspected cases and good infection control practises are so important, especially if a person turns into a “super spreader”. This means they produce large amounts of virus and are unusually infectious.
      The World Health Organisation estimates the coronavirus has a reproduction number (R0) of 1.4-2.5. This means one infected person has the ability to infect 1.4-2.5 susceptible people. But this figure could be revised as the outbreak evolves.
      In comparison, SARS had a suspected reproduction number of of 2-5. This meant one infected person could infect up to five susceptible people.
      So the Wuhan coronavirus appears less infectious than SARS.
      The risk of transmission for SARS was highest five to ten days into the illness. If people were isolated early on in their illness, after showing symptoms, they were unlikely to infect anyone else.
      But one study showed it was possible to be infectious with the Wuhan coronavirus without showing symptoms. This raises the possibility of an infected person transmitting the virus to others without knowing they’re sick. This would make it much harder for health authorities to identify and isolate the infectious people and to control the outbreak.
      State and territory guidelines advise GPs and hospitals to insist people suspected of the virus wear masks and are isolated as soon as possible. They should also call ahead to their GP practice or hospital, so precautions can be in place before their arrival.
      If the virus started to spread in Australia, which is unlikely, health authorities would likely advise people to avoid large gatherings and ensure they washed their hands frequently.
      There is a role for masks when going to public places but their effectiveness depends on the type of mask, the duration it’s worn, and how well it’s fitted.
      Researchers are currently working to develop a vaccine, but it’s likely to be many months before an approved vaccine is available.

      Life serving fecal transplant

      Poo transplant illustration
      The faecal transplant, also known as trans-poo-sion, surely has the title of medicine's most disgusting procedure.
      It is pretty much what you are imagining - part of a faecal stool is taken from one person and given to another.The purpose is to introduce new beneficial microbes to the receiving patient's digestive system.And it can be life-saving.It shows just how important microbes, which colonise nearly every surface of our body, are to our health.The gut is an exceptionally rich world with many different species of micro-organisms interacting with each other and our human tissue.Down in the dark, oxygen-deprived depths of your bowels is an ecosystem as rich as a rainforest or coral reef.But a bacterium called Clostridium difficile (C. difficile) can take over and dominate the bowels.
      It is an opportunist and normally takes hold after patients have been treated with antibiotics.Antibiotic drugs are one of the miracles of the modern age, but they kill good and bad bacteria alike.They are like a forest fire burning through the gut's microbiome - the collected micro-organisms living down there - leaving behind a scorched microbial earth on which C. difficile flourishes.

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      The microbiome


      Bacteria

      • You are more microbe than human - if you count all the cells in your body, only 43% are human
      • The rest is our microbiome and includes bacteria, viruses, fungi and single-celled archaea
      • The human genome - the full set of genetic instructions for a human being - is made up of 20,000 instructions called genes
      • But add all the genes in our microbiome together and the figure comes out at between two million and 20 million microbial genes and is known as the second genome


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      Performing the transplant

      The problem with C. difficile is that patients will have multiple bouts of watery and even bloody diarrhoea every day, tummy cramps, fever and in the most severe cases the infection is fatal.
      The best that medicine has to offer is more antibiotics; it is the definition of a vicious circle.A stool transplant - or to give it its full title "a faecal microbiota transplant" - aims to repopulate the patient's gut with the microbes from a healthy person.A relative is often used as they would have had similar gut bacteria.After a "sample" is produced, it is mixed with water.Some techniques break the poo up by hand while others blitz it in a household blender.There are two routes for getting the sample into the required location - down through the mouth or up through the rectum.

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      Listen to The Second Genome on BBC Radio 4.
      The next episode airs 11:00 BST Tuesday April 24, repeated 21:00 BST Monday April 30 and on the BBC iPlayer

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      Dr Janet Jansson, a microbial ecologist from Pacific Northwest National Laboratory in Washington State in the US, was part of the team trying to prove trans-poo-sion works.The patient was a 61-year-old woman who had had chronic diarrhoea for around eight months and had lost 27kg in weight."It was really a desperate plea for some kind of solution, she was at risk of dying from this C. difficile infection, all of the antibiotics were ineffective," said Dr Jansson.
      A sample of healthy stool was transplanted from her husband.Dr Jansson told the BBC she was very surprised at its success."Amazingly two days after that she was able to have normal stools, normal bowel movements, she was basically cured," she said."As a microbial ecologist, this is very unusual."We saw she went from a very diseased state, when you look at the microbial species, to a healthy microbiome that was very similar to her husband's," Dr Jansson added.

      Body bacteria illustration

      Trials have suggested the procedure is around 90% effective.
      The excitement in the field has led to some people even performing their own DIY faecal transplants with groups like OpenBiome in the US - essentially a public stool bank - being set up.But will trans-poo-sions mean anything for medicine beyond C. difficile?
      The interaction between our human and microbial selves is being investigated in nearly every disease you can think of the microbiome has been linked to diseases including inflammatory bowel disease, diabetes, Parkinson's, whether cancer drugs work and even depression and autism.But this means there could be unintended consequences of a faecal transplant.
      There was a report in 2015 of a woman gaining 36lb (16kg) and being classed as obese after a transplant from her daughter.It is possible to make mice thinner or fatter by transplanting into them the microbiome from either a lean or obese human, although the jury is still out on whether the same rules apply in people.

      Scales illustrations

      There is also the more obvious risk of transferring dangerous disease-causing microbes.It is why scientists are trying to move on from donating faeces to donating cocktails of bacteria.Dr Trevor Lawley, from the Wellcome Sanger Institute, said future treatments had to be more refined and targeted ,"Faeces is an undefined community, and when you develop a drug first and foremost you have to consider the safety of the patient," he said.
      "We have an idea of what bugs to put in now, so if you have a defined mixture that's proven safe, we can overcome that." And that is likely to be the future of microbial medicine - knowing what is the problem in an individual patient's microbiome and being able to address that.
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