Syphilis rates in the U.S. and Western Europe has increased significantly, according to a recent review article. “As in other high-income settings, rates of primary and secondary syphilis reported in the U.S. decreased during the 1990s, and by early 2000, the rate was the lowest since reporting began in 1941. The resurgence of primary and secondary syphilis in the U.S. began in late 2000 and has continued unabated.”

Dr. Kevin Fenton, Centers for Disease Control and Prevention, Atlanta, and colleagues, authors of the article, say, “In many high-income countries, successes in syphilis prevention and control were accelerated during the early and mid-1990s, with many countries approaching or achieving elimination of endemic disease transmission. However, since the beginning of the 21st century, syphilis incidence has started to rise in high-income settings, in part driven by increases in cases among men who have sex with men, although more recent increases among heterosexual people have also been reported.”

Syphilis, which infects some 12 million people worldwide every year, is caused by the bacteria Treponema pallidum.

The paper goes on to report that “we can differentiate social determinants of syphilis epidemiology into three broad categories: (1) general populations of developing countries, (2) low socioeconomic status minority populations of developed countries, and (3) homosexual men.”

The increase in syphilis is marked “by high rates of HIV co-infection, high-risk sexual behavior, and the use of drugs such as methamphetamines,” the authors report. Sexually Transmitted Disease (STD) is an expensive health proposition. The economic impact costs the U.S. health care system as much as $15.5 billion annually.

The Centers for Disease Control (CDC) says “novel” approaches are being undertaken to control and to prevent the disease. It is a given that with the new rise in cases, health care professionals must renew their training and efforts in dealing with the significant increase in cases.

The CDC calls for the following actions to be taken by the medical community:

• Development of a revised formula for allocating federal syphilis elimination funding to states and cities, allowing CDC to respond more rapidly to emerging geographical trends in syphilis cases.
• Creation of a new program evaluation approach to more rapidly modify prevention programs to meet the changing epidemic.
• Production of a new surveillance tool designed to capture behavioral data which provides local and national information to direct our responses to the syphilis epidemic.

The CDC is addressing the amazing rise of Internet use in connecting partners for sex. This is especially true for gay men. The Internet, itself is used to combat the problem by more effectively reaching at-risk populations with prevention approaches, such as health communication to increase community awareness and outreach to encourage testing and partner services.

The study was supported by a grant from the National Institutes of Health and the National Institute of Allergy and Infectious Diseases. The review was published in The Lancet Infectious Diseases.

– by Peter Menkin, San Francisco Correspondent

Posted: May 30th, 2008 under Diseases, Sexually Transmitted Diseases.
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There is an alarming increase of Chlamydia cases globally with almost 12 percent of the world’s population infected, experts are telling Infection Protection.  In China, nearly 30 percent of young adults have been treated for the disease. The bacterium Chlamydia trachomatis is sexually transmitted.

Typical symptoms of the disease include a urethra irritation and abnormal discharge from the opening of the reproductive organs. This often evolves to become a urinary tract infection in men and pelvic inflammatory disease in women. In cases where newborns are born by infected women, Chlamydia leads to eye infections, blindness and subclinical pneumonia.

Dr. J. Wanjoike Gachuhi, a gynecologist at Upper Hill Medical Center in Nairobi, Kenya, claims to have diagnosed more than three hundred cases of the disease since 2007. He says that “Chlamydia is highly contagious and leads to ectopic pregnancy in women. The infection is high in young women aged between 15 and 25 years of age most of which are college students. This age bracket is sexually active and prone to STD’s.” Due to the infection’s mild symptoms most of these young women rarely seek medical consultation, so they suffer from scarring of the fallopian tubes and chronic pelvic pain.

In China, the sharp increased infection in students is “alarming,” according to health experts. Dr L. Ziping a gynecologist at Guangdung Women’s hospital in China, tells Infection Protection “there is a sharp increase in ectopic pregnancies cases in this age bracket due to Chlamydia. This is due to poor empirical research on how to increase awareness about sexually transmitted diseases and the basic infection protection methodologies.”

According to a report by Dr. John Douglas, an official at the Division of Sexually Transmitted Disease Prevention, at the Centers for Disease Control, more than 3 million Americans are infected with Chlamydia.

The increase constitutes a 62 percent jump in women and a 56 percent jump in men within two years. Other contributing factors to the increase to Chlamydia are new strains of the bacterium. Chlamydia is also increasingly common in gay and bisexual men.

In Europe, concern over the spread of Chlamydia is rising. Dr. Roy Lawrence, a Manchester based practitioner, says there are psychological barriers for many patients, who are fearful of reporting that they are infected with a sexually transmitted disease  “They are ashamed to explain the symptoms since they are physiologically impaired hence spend months without seeking medical respites,” says Lawrence.

– by David James, East Africa Correspondent

Chlamydia can spread throughout the body.

Posted: May 30th, 2008 under Developing Diseases.
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Doctors have discovered that North American avian influenza viruses of the H7 subtype are becoming “more like human flu viruses” in their ability to attach to host cells, suggesting that the viruses are evolving to bolster their capacity to infect humans, according to The Proceedings of the National Academies of Science.

Scientists determined that several recent North American H7 viruses have an increased ability to bind to a type of receptor molecule that is abundant on human tracheal cells.

The finding”underscores the necessity for continued surveillance and study of these  viruses as they continue to resemble viruses with pandemic potential,” says the report.

The study was completed by scientists from the U.S. Centers for disease Control and Prevention (CDC), Emory University in Atlanta, and the Scripps Research Institute in La Jolla, Calif.

H7 viruses have caused a number of disease outbreaks in poultry in Europe and North America in recent years.  H7 viruses also have occasionally infected humans, typically causing conjunctivitis. But a veterinarian died of an H7N7 infection during the devastating poultry outbreaks in the Netherlands in 2003.

Previous research has established the fact that avian flu viruses like to link up with cell receptor molecules known as alpha 2-3 glycans, whereas human flu viruses, such as H1N1 and H3N2, prefer to attach to receptors called alpha 2-6. The terms refer to the nature of the link between sialic acid (SA), which forms the tip of the receptor molecule, and galactose, an adjoining sugar unit.

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

Posted: May 29th, 2008 under Avian Flu, Developing Diseases.
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The Irish Health Protection Surveillance Center is warning students that they should have the measles, mumps, rubella (MMR) vaccine following outbreaks of mumps in a number of third-level colleges.

This year, health authorities said, there have been over 150 cases of mumps among Irish students, and five were admitted to hospital.

Seven centers of learning have been affected - the Institutes of Technology in Waterford and Limerick and at Universities in Cork, Limerick, Galway, Maynooth and Dublin City University.

The mumps is a contagious acute viral illness, which until recently has been on the decline.

Complications with the mumps are usually mild but it can cause meningitis and deafness.

In years past there was major concern about the MMR vaccine after a study in 1998 linked it with autism.

That research has only recently being found to be untrue but in the intervening years it led to a major declikne in the number of children availing of the vaccine.

Now around 86 percent of children are getting the vaccine but health experts say 95 percent should be covered in order to prevent against a major outbreak.

– by Gene J. Koprowski, Editorial Director

Nearly 20 percent of Irish children do not recieve the MMR vaccination. Source: Vaccine Ireland.

Posted: May 29th, 2008 under Diseases, Measles, Mumps, Rubella.
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The rate of hospital-acquired infections has increased in New York state, according to a new study. The 2008 New York State Hospital Report Card, created by the Niagara Health Quality Coalition, rates the state’s 243 acute care hospitals on 31 common procedures, treatments, ailments and in some cases, likelihood of death, using a three-star scale.

The report found that about 3,200 of 1.45 million hospitalizations resulted in a hospital-acquired infection in the state. That’s an increase from about 2,900 out of 1.48 million hospitalizations a year earlier.

Coalition President Bruce Boissonnault said that the number represents “a small fraction of the infections. For example, many people do not show symptoms of an infection until they’re discharged, and those patients would not be in that sample used in the study.” This is the first year a health trend has worsened since the coalition began conducting the study six years ago.

The report also found that the overall likelihood of dying from a hospital procedure dropped from 8.5 percent for eight inpatient procedures in 2002 to 7.4 percent in 2006. State Health Department spokesman Jeffrey Hammond said, “while it may be possible that infection rates are getting worse, it may also be true that hospitals are more vigilant at reporting infections, and that’s good news for patients.”

– by Gene J. Koprowski, Editorial Director

Germs overrun typical  health care workers’ hands.

Posted: May 28th, 2008 under Clostridium difficile, Developing Diseases, Impaired Immunity, MRSA.
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A new study shows that the administration of post-operative antibiotics is increasing patients’ risk of infection with C. difficile, Canadian researchers say. The report is published in the online edition of the journal Clinical Infectious Diseases. The antibiotic Cefoxitin was most likely to be associated with the contraction of a C. difficile infection, the study said.

A result of the use of the prophylactic antibiotic is a modification in normal flora of the human intestine, which allows the bacterium C. difficile to flourish, which can cause severe diarrhea, often leading to death.

In the past, doctors thought the benefits of preventing surgical site infections outweighed the risk of C. difficile infections. But that’s changing, rapidly. A mega-virulent strain of C. difficile has emerged, causing a dramatic increase in the number and severity of infections. This is especially so in the elderly.

Dr. Louis Valiquette of the University of Sherbrooke calculated the risk of contracting a C. difficile infection when a sole antibiotic was given accompanying surgery and “found a 21-fold increase in the risk — from 0.07 percent of patients to 1.5 percent.”

The study found that of the 40 patients who developed a C. difficile infection after peri-operative antibiotic, five died or developed septic shock.

– by Gene J. Koprowski, Editorial Director

Antibiotics after surgery are quite risky.

Posted: May 28th, 2008 under Clostridium difficile, Developing Diseases, Impaired Immunity.
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North Korea has greatly reduced malaria infections throughout the communist enclave, but mosquitoes carrying the deadly disease are crossing the border and infecting hundreds each year in the South, a provincial governor said this week.

Malaria was “eradicated” on the Korean peninsula about 30 years ago but re-emerged in the poverty-stricken North in the 1990s due to poor sanitation.

Kim Moon-soo, governor of Gyeonggi province, which includes Seoul and shares a border with North Korea, visited the north this month to discuss food aid and ways to keep malaria under control.

“Based on the statistics that we have access to, it seems that the malaria cases in North Korea have been significantly reduced,” Kim said at a news briefing with reporters.

Kim said there were about 60,000 civilian infections in North Korea in 2003 while in 2007 the number was reduced to an estimated 7,430.

– by Gene J. Koprowski, Editorial Director

Mosquitos invading South Korea carry the deadly malaria bug, according to news reports.

Posted: May 27th, 2008 under Diseases, Malaria.
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Statistics show that nosocomial infections are burgeoning at U.S. hospitals. Nearly one out of every 20 hospital patients contracts an infection during their hospital stay unrelated to the primary condition. That’s close to 2 million people each year. According to estimates from the U.S. Centers for Disease Control and Prevention, HAIs claim the lives of approximately 90,000 patients annually, a number greater than breast cancer and auto accident deaths.

According to a report in the Nashville Tennesseean newspaper, online edition, the most common and deadly nosocomial infection is catheter-related blood stream infections or CRBSIs. CRBSIs occur when a bacterium enters a patient’s blood stream through a central venous catheter (CVC), which is usually inserted in patients in need of frequent injections of medications, or fluids for nutritional support. These infections are typically the most dangerous HAI and are expensive to treat, costing upwards of $35,000 per patient.

Several interventions that hospitals can implement to help lower the incidence rates of CRBSIs. These consist of using evidence-based guidelines such as those from the CDC to comply with protective measures. These steps include the following:

* Proper hand hygiene.

* Moving unneeded items out of the sterile environment.

* A collaborative approach to catheter insertion, where by someone is always present to document compliance.

* Guidelines for employing caps, gowns, gloves and sterile barriers when inserting CVCs.

It’s crucial to note is that these steps are quite simple, but compliance with the rules is not routine among health care professionals.

With nearly 2 million infections each year, the CDC estimates that HAIs result in approximately $4.5 billion in excess costs.

– by Gene J. Koprowski, Editorial Director

Posted: May 27th, 2008 under Clostridium difficile, Developing Diseases, Impaired Immunity, MRSA.
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Lyme disease is growing at four times the rate of AIDS and is becoming America’s fastest-proliferating and most poorly diagnosed disease, according to a report in the online edition of The San Francisco Chronicle. The disease is also known as Neuroborreliosis.  

For the 50 percent of people who develop the characteristic bull’s-eye rash immediately after being bit, treatment can be relatively simply. For those who don’t, the disease takes a silent toll over the years, harming different bodily systems, including the central nervous system.

Preventive measures include: using insect repellent with DEET, donning white clothing to make any ticks visible, tucking in loose clothing and avoiding tick-infested areas like tall grass and brush near deer trails. If bitten by a tick, immediately remove the tick and save its dead carcass to assist doctors in possible future diagnoses.

This disease has become highly politicized, as insurers, federal health agencies and academia, are battling against Lyme doctors and patients. After seeing five respected doctors and receiving four misdiagnoses, one patient, Robert Bueltman, of Montara, Calif.,  learned that he was infected not only with Lyme disease but with another tick-borne infection as well.

Connecticut Attorney General Richard Blumenthal is probing the the Infectious Disease Society of America (IDSA), which developed the guidelines that most doctors use to diagnose the disease, according to the report in the paper.

– by Gene J. Koprowski, Editorial Director

Ticks spread Lyme Disease and bacteria, according to the National Institutes of Health (NIH).

Posted: May 26th, 2008 under Diseases, Lyme disease.
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A significant number of hospitals in Canada are reusing “single-use medical devices” and most of those that do so are sterilizing or “reprocessing” the devices in-house, according to the May issue of the journal Infection Control and Hospital Epidemiology. The practice increases the risk of infection for patients, greatly.

There appears to be consensus that a new national policy is needed and that the practice of “in-house reprocessing” ought to be prohibited, clearly, parts of the country hospitals can do as they wish when it comes to reuse of single-use medical devices, researchers say.

Amongst the devices being reused are “biopsy forceps” used in stomach and bowel surgery, “membrane scrapers” used in eye surgery, “breast pump kits and blades, burrs and drill bits” used to bore through bone.

“I’m absolutely appalled,” says Dr. Mark Miller, head of infection prevention and control with Montreal’s Jewish General Hospital.

Of 398 hospitals that responded to a questionairre, 28 percent admitted to reusing single-use devices. Though some of the reprocessing is farmed out to U.S. companies certified by the U.S. Food and Drug Administration, 85 percent of the hospitals that admitted to reprocessing said they did the work in-house.

The senior author of the study, Dr. Michael Gardam, says the numbers are probably even higher. “I doubt that we’re underestimating the problem.”

– by Gene J. Koprowski, Editorial Director

Disposable forceps being reused in surgery in Canada, study says.

Posted: May 26th, 2008 under Developing Diseases, Impaired Immunity.
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