BOSTON — On September 8, Nantucket’s newspaper, The Inquirer and Mirror, reported the number of confirmed cases of Lyme disease had reached 262 for 2008. This represented an increase of almost 40% over all of 2007. In 2006 there were only 23 cases confirmed.

It was only 33 years ago that Lyme disease was recognized as the cause of a mysterious cluster of juvenile arthritis cases in the town of Lyme, Conn. In 1982 the causative agent, a bacteria named Borrelia burgdorferi, was isolated from the mid-gut of deer ticks. Since that time Lyme disease has become the most common vector-borne disease in the U.S. and has vaulted into the top ten of all infectious diseases. The Massachusetts Department of Public Health reports the incidence of Lyme disease as confirmed cases per 100,000 population. In 2005 there were 36.3 reports per 100,000 statewide compared to the national average of 8.2 cases. At the current rate Nantucket will surpass 1,000 cases per 100,000 giving it one of the highest incidences in the world.

According to Massachusetts native Constance Bean, former coordinator of health education at MIT and author of Beating Lyme: Understanding and Treating This Complex and Often Misdiagnosed Disease, the Lyme disease problem on Nantucket is just the tip of the iceberg. “The higher numbers are not due to improved diagnosis, “she tells Infection Protection. “By all estimates only one in ten cases is reported. We don’t have true numbers on the Lyme epidemic because we don’t have reliable tests. It is estimated that 1.7 million Americans are infected. We have more ticks. The ticks have no natural enemies and more of the ticks are being infected.”

Dr. Dan Cameron is an epidemiologist and an expert in Lyme disease. He is board president of the International Lyme and Associated Disease Society. “Yes”, he tells Infection Protection, “Lyme disease is certainly the epidemic of our time”. He agrees that Lyme disease is under-reported and under-treated. “The most effective way to address Lyme disease is to foster greater understanding of the disease within the medical community. Increased incidence of Lyme disease can be attributed to several factors, including the continued spread of human populations into wooded habitats with increased exposure to ticks, global warming that has increased survivability of ticks, and the geographic spread of infested tick populations to all 50 states.”

– by Dr. Chris Iliades, MD,  Boston Correspondent, Infection Protection

Posted: November 29th, 2008 under Developing Diseases, Diseases, Impaired Immunity, Lyme disease.
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An HIV-1 vaccine designed to stimulate cell-mediated immunity is “no better than placebo” in preventing HIV infection in individuals at high risk of contracting the disease, according to a study published this week in The Lancet.

The Lancet is one of the world’s leading medical journals.

Dr. Susan P. Buchbinder, MD, from the San Francisco Department of Public Health, and colleagues randomly assigned 3,000 HIV-negative individuals to three injections of the MRKAd5 HIV-1 vaccine made in adenovirus type 5, Ad5, and designed to elicit cell-mediated immunity, or placebo.

Doctors found that among patients with low Ad5 antibody titers at baseline, 24, or 3 percent, of 741 vaccine recipients and 21, 3 percent, of 762 placebo recipients became infected with HIV-1.

Plasma HIV-1 RNA levels were similar in the placebo and vaccine groups, according to Dr. Buchbinder’s research.

– by Gene J. Koprowski, Editorial Director, and Nancy Bruening, Executive Editor

Image courtesy of 3DScience.com.

Posted: November 14th, 2008 under Developing Diseases, Diseases, HIV, Impaired Immunity.
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The death of a 12-year-old boy from a tooth infection — which spread to his brain – has sparked outrage and forced the state of Maryland to launch a new, public health project.

Family, friends, and even some public health officials gathered yesterday at the school he attended to announce the Deamonte Driver Dental Project, which will bring a mobile dental office to needy children at elementary schools in Prince George’s and Montgomery counties.

The boy died from a tooth infection that spread to his brain in February 2007 after his mother could not find a dentist to treat his infectious illness.

Maryland Office of Oral Health Director Harry Goodman says Driver’s death spurred officials to act.

The project’s director, Dr. Hazell Harper, says the goal is to serve about 2,000 students at nine schools in the first school year.

The state has given Prince George’s County more than $288,000 to fund the first year of the project.

Driver’s mom, Alyce, who has just graduated from the dental assistant program at Prince George’s Community College, did not speak at the ceremony, but she was moved tears.

– by Gene J. Koprowski, Editorial Director, and Nancy Bruening, Executive Editor

Posted: November 14th, 2008 under Developing Diseases, Impaired Immunity, Meningitis.
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A local judge in the Dutch city of Groningen has handed down sentences of nine and five years to the two of the accused men in what has become known as the Groningen HIV case.

The trial of these men centered on charges that they drugged, then raped and deliberately infected other men with HIV - the virus that leads to AIDS - at a number of  outlandish “sex parties” in the Netherlands.

One of the defendants was jailed for nine years, another to five years, while a third man will be released immediately.

The trial began a month ago, and the court ruled there was dispositive evidence of the two main suspects having attempted to cause grievous bodily harm.

According to the court, the criminals injected five men with HIV-infected blood at sex parties hosted by the accused. They did so, according to the court “even though they themselves had personally experienced what the far-reaching consequences of infection are.”

The prosecutor had asked for terms of 15 years against the main two suspects and one of eight for the third man.

– by Gene J. Koprowski, Editorial Director and Nancy Bruening, Executive Editor

Assault with a deadly weapon — HIV.

Posted: November 13th, 2008 under Diseases, HIV, Impaired Immunity.
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Antibacterial drug use appears to have soared at academic medical centers between 2002 and 2006, driven primarily by increased use of broad-spectrum agents and the antibiotic vancomycin.

Use of antibacterial drugs dramatically increases the risk that pathogens will become resistant to their effects.

Infection with drug-resistant bacteria is linked with greater illness and death and higher health care costs than infection with bacteria susceptible to antibiotics. “Many professional societies and national agencies have recommended monitoring antibacterial use and linking patterns of use to resistance,” the authors of the new study, funded by Bayer.

Amy L. Pakyz, Pharm.D., of Virginia Commonwealth University, Richmond, and colleagues measured antibiotic use documented in claims data from university teaching hospitals between 2002 and 2006.

Statistics available from 35 hospitals in 2006—that year, a total of 775,731 patients were discharged, with 492,721, 63.5 percent, receiving an antibacterial drug.

The average total antibacterial use at the 22 hospitals providing five-year data increased from 798 days of therapy per every 1,000 days patients were in the hospital to 855 per 1,000 patient-days in 2006.

When doctors examined the drugs by class, fluoroquinolones were the most commonly used, and their use remained constant. “The other change contributing to the increase in total use was the marked increase in the use of vancomycin,” the authors write. “During five years, the mean [average] vancomycin use increased by 43 percent.”

“With few new antibacterials in development, antimicrobial stewardship programs in concert with aggressive infection control efforts represent the best chance for control of resistant pathogens,” the authors write.

– by Gene J. Koprowski, Editorial Director, and Nancy Bruening, Executive Editor

Doctors, nurses and other personnel at academic medical centers continue to dole out antibiotics.

Posted: November 12th, 2008 under Clostridium difficile, Developing Diseases, Impaired Immunity, MRSA.
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A new study shows that Clostridium difficile (C.-diff.) infections rates at hospitals are soaring, and an increasing number of patients have developed antibiotic-resistant strains of the infection that are more difficult to treat.

The study, released by the Association for Professionals in Infection Control and Epidemiology (APIC), found that 13 out of every 1,000 patients or approximately 7,178 inpatients on any one given day were infected or colonized with C.-diff. That’s a total of 94.4 percent who were infected.

The rate is 6.5 to 20 times higher than previous incidence estimates that were based on more limited data. The study shows that on any given day these infections cost between $17.6 million to $51.5 million and kill between 165 and 438 patients.

The report is based on a survey of infection control professionals from 648 health care facilities throughout the country who collected data about all of their patients with C.-diff. infections on one day between May and August 2008.

“C-diff. infections are much too common in our nation’s hospitals and threaten the health of thousands of patients every year,” said Lisa McGiffert, director of Consumers Union’s stop hospital infections campaign, at www.StopHospitalInfections.org . “Most hospitals aren’t doing enough to protect patients from these deadly, preventable infections.”

The group called on hospitals today to take more aggressive steps to protect patients.

– by Gene J. Koprowski, Editorial Director, and Nancy Bruening, Executive Editor

C. Difficile infections.

Posted: November 12th, 2008 under Clostridium difficile, Developing Diseases, Impaired Immunity.
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Swiss scientists report that bacteria in the human mouth play a role in creating the distinctive flavors of certain foods. Doctors found that these bacteria actually produce food odors from components of food, allowing eaters to savor fruits and vegetables.

Their study appears in the November 12 edition of the ACS bi-weekly Journal of Agricultural and Food Chemistry.

Christian Starkenmann and colleagues point out that some fruits and vegetables release characteristic odors only after being swallowed.

Though doctors have reported that volatile compounds produced from precursors found in these foods are responsible for this retroaromatic effect, the details of this transformation were not understood.

The scientists performed sensory tests on 30 trained panelists to evaluate the odor intensity of volatile compounds – known as thiols – that are released from odorless sulfur compounds found naturally in grapes, onions, and bell peppers.

When given samples of the odorless compounds, it took participants 20 to 30 seconds to perceive the aroma of the thiols – and this perception persisted for three minutes. The researchers also determined that the odorless compounds are transformed into the thiols by anaerobic bacteria residing in the mouth – causing the characteristic ‘retroaromatic’ effect.

“The mouth acts as a reactor, adding another dimension to odor perceptions,” they explain.

– by Gene J. Koprowski, Editorial Director, and Nancy Bruening, Executive Editor

Posted: November 11th, 2008 under Anti-Bacterial Resources, Developing Diseases, Diseases, Impaired Immunity.
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New research by doctors at the University of Michigan is eyeing the problem of infected blood at its most basic level, in hopes of finding new and more effective methods to treat bacteremia and sepsis.

In a research paper published in the November issue of the learned journal Shock, and recent reports in the journals Bulletin of Mathematical Biology and Academic Emergency Medicine, the doctors describe new computer-based models of bloodstream infection that may help guide the creation of new treatments.

These models use complex mathematical techniques, but have also been validated by laboratory experiments in mice and in bloodstream models.

These new findings give more information than ever before about how bacteria act within the blood vessels of the body, as well as how they might be filtered out of the blood and into organs where the immune system can kill them.

This model of how bacteremia occurs in “real world” of the fast-moving bloodstream - rather than a placid Petri dish or test tube - is now being put to work to study how best to combat or prevent bacteria in the blood.

Dr. John Younger, an associate professor of emergency medicine at the U-M Medical School, leads the team, which includes members with training in medicine, mathematics, and chemical engineering. He reckons the team’s model reveals that a bacterial bloodstream infection can be thought of a high-speed police chase in heavy traffic.

“The bacteria are each a micron across - a thousandth of a millimeter - and they’re traveling at the same fast speeds - up to three feet per second - as other cells in the bloodstream, like red and white blood cells and platelets,” he said. “The white blood cells, which are the police of the body, are stuck in the same flow and can’t ‘change lanes’ in the fast-moving traffic to capture and kill them.”

– by Gene J. Koprowski, Editorial Director, and Nancy Bruening, Executive Editor

Posted: November 11th, 2008 under Developing Diseases, Diseases, Impaired Immunity.
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A new study shows that there is a secret pathway used by disease-causing bacteria to escape the host immune system and survive within the cells meant to kill them.

This breakthrough research may lead to new treatments and vaccines for tuberculosis (TB) and certain other chronic bacterial and parasitic infections.

The research is the work of the laboratories headed by Peter Murray, Ph.D., at St. Jude Children’s Research Hospital in Memphis, Tenn., and Thomas Wynn, Ph.D., of the Laboratory of Parasitic Diseases at the National Institute of Allergies and Infectious Diseases (NIAID).

Clearing the body of disease-causing bacteria is the job of specialized white blood cells called macrophages.

The word “macrophage” means “big eater” in Latin and that is just what these cells do–they chomp up cell debris, infected cells and disease-causing bacteria found.

However, some harmful bacteria, known as intracellular pathogens, live inside cells and can even survive and replicate within macrophages.

“The bacteria designed to live inside the cell are highly adapted to their environment,” says Dr. Murray.

– by Gene J. Koprowski, Editorial Director

Image courtesy of McGill University.

Posted: November 3rd, 2008 under Developing Diseases, Diseases, Impaired Immunity, Tuberculosis.
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A new study suggests that eating dried plums slows the development of atherosclerosis, commonly known of as hardening-of-the-arteries. An inflammatory disease, the condition leads to cardiovascular disease and stroke, and is the leading cause of death in western society.

The study is published in this month’s edition of the British Journal of Nutrition.

There are many studies on the effects of fruit and vegetables on serum cholesterol, but few reports exist on the reduction of atherosclerosis.

This study is the first studying the effect of a fruit, in this case dried plums, on this type of disease.

“This study breaks new ground by showing a significant reduction in the development of a major inflammatory disease,” says researcher Dan Gallaher, PhD, a professor of nutrition in the department of food science and nutrition at the University of Minnesota. “It also strengthens the notion of eating fruit, in particular dried plums, as a preventive measure against heart disease.”

The dried fruit has many nutrients, including potassium, magnesium and boron, as well as a high antioxidant score, giving dried plums numerous health benefits from helping maintain desirable blood sugar levels to possibly reducing skin wrinkles.

The study was conducted over a five-month period on a strain of mice that develop atherosclerosis more quickly than normal. The amount of dried plum powder shown to significantly reduce the area of atherosclerotic lesion was equivalent to eating 10 dried plums a day.

The study shows a reduction in the area of atherosclerotic lesions in the entire arterial system as well as the aortic arch.

– by Gene J. Koprowski, Editorial Director and Nancy Bruening, Executive Editor

Dried prunes reduce arterial inflammation.

Posted: October 29th, 2008 under Developing Diseases, Diseases, Impaired Immunity.
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