Like the Rest of Us: Celebrities Getting Superbug Infections

It will be interesting to see what happens now -- now that celebrities are getting antibiotic-resistant infections like everyone else. Unfortunately, it often takes a famous person's suffering to focus the media's blinding light on a medical problem (think Christopher Reeve and paralysis, Michael J. Fox and Parkinson's or Ronald Reagan and Alzheimer's).

Now that US baseball star Barry Bonds has developed a potentially career-ending bacterial infection (MRSA? they're not saying), and UK pop singer Edwyn Collins has acquired MRSA following brain surgery, it won't be long till the TV news magazines cover these stories -- not from the medical viewpoint, but the celebrity viewpoint. As we know, that's where the public's attention is focused. It might not be long before anyone visiting an ER or ICU will ask about their infection rates, which they will have discovered from the pop media.

Update 19 May 2005: It's now been made public that Bonds is indeed fighting a staph infection, and that he is now off an intravenous antibiotic regimen but still on antibiotics. Read this post for commentary on the likely impact of Bonds's steroid use on this infection.

Also, regarding stubborn staph infections, Giant-turned-Oriole slugger Sammy Sosa has been on the disabled list due to a foot abcess and staph infection. The AP ran a brief but informative article on the growing incidence of such infections outside the hospital environment.

Are Intestinal Bacteria Making Us Fat?

Could it be that it's not just genes, diet and exercise that determine our amount of body fat? Jeffrey Gordon and Fredrik Backhed -- microbiologists at the Washington University School of Medicine in St. Louis -- think so. Their experiments with mice show them that certain types of gut bacteria secrete a chemical that messes with the hormone responsible for fat storage.

Even when fed a "moderate" diet, mice with a normal mix of intestinal bacteria got fat. Gordon and Backhed compared this group with mice raised & kept in a germ-free environment. Despite having a higher-calorie diet than the normal mice, these isolated mice actually had 40+% less fat -- until they were exposed to the gut bacteria found in the fat mice. Then they, too, gained weight.

"Killing off the gut bacteria is not a viable option," concludes an article in Discovery Magazine "it would trigger opportunistic infections long before it would yield meaningful weight loss—but Gordon is targeting the fat-promoting hormone itself in hopes of developing a better diet drug." [More detail on the study is here.]

Dr. Gordon and a team of WU researchers are also using a $1.45 million grant to sequence and analyze the genomes of friendly (probiotic) bacteria that live in human intestines. Says Gordon, "Our objective is to understand how the human body functions as a carefully woven fabric of interacting species. Ultimately, such understanding promises to provide new ways of fortifying health and preventing or treating a variety of diseases both inside and outside of the gastrointestinal tract."

More MRSA Infections When ICU Nursing Staffs Overburdened

Researchers announced at the Intensive Care Society’s annual Spring meeting that patients are more likely to develop MRSA superbut infections in intensive-care units (ICUs) experiencing a shortage of nurses.

Dr Stephanie Dancer, a consultant microbiologist from Scotland, who conducted the study, said the results came as a surprise.

“I have studied the acquisition of MRSA for several years now, and have previously focused on levels of hygiene.

“These results show that MRSA acquisition is caused by the culmination of a number of different factors.

“In this study, understaffing was a significant factor, exacerbated by poor ward hygiene and further studies are required to explore this in more detail.

“It is assumed that when nurses are particularly busy due to understaffing, they do not have time to wash their hands.”

[Hat tip: Dave Roberts]

Salmonella and Pet Mice, Hamsters, Rats etc.

I have happy childhood memories of our pet red-eared turtle, who swam around in a clear-plastic aquarium and caught some rays under a plastic palm tree. (Like most of his petshop and dimestore colleagues, he likely died from neglect or accident and was ignominiously flushed down the toilet -- though my memory is hazy at this point.) Once the authorities discovered those turtles can carry dangerous Salmonella bacteria, it became impossible to buy the little fellas in the local petshop.

Now the alarm is being raised about people getting sick from salmonella picked up from pet rodents, including mice, hamsters and rats. Solution: wash hands after handling these and other exotic pets, including birds.

Nigerian Polio Spreads to Indonesia; Urgent Vaccination Campaign Underway

Nearly a year ago I wrote about the roadblocks to polio vaccination erected by Nigerian Muslim leaders, which were preventing the eradication of the disease. As a result of their believing and spreading conspiracy theories, polio has become epidemic in Nigeria. It has also spread to several other African nations that had been on the verge of eliminating the disease. [More about polio vaccination progress in 2004 and early 2005.]

Now it appears, say news reports, that Nigerian polio has crossed the world to Indonesia (a Muslim nation).

A total of four cases of polio have been confirmed in young children in Indonesia, and health officials fear the outbreak will escalate; several additional possible cases are being investigated.

Polio was believed to have been eradicated in Indonesia more than 10 years ago. An emergency campaign is underway to vaccinate children in a district near Jakarta on May 5-6 in an attempt to halt the spread of the disease.
...
The virus is related to the West African virus currently causing an epidemic across Africa. The ongoing outbreak so far has re-infected 15 formerly polio-free countries and re-established transmission in six of them.

According to Afrol News, Muslims traveling on pilgrimage or business likely transmitted the disease from Africa to Indonesia:

Health officials assume that the spread from northern Nigeria to Indonesia could have happened as a result of the Hajj, where Muslim pilgrims from all over the world visit holy cities in Saudi Arabia. Alternatively, transmission could have passed through the many migrant workers staying in Saudi Arabia, including Nigerians and Indonesians.

Practical Tips for Treating Early-stage MRSA Infections

The Houston Chronicle, noting an increase in community-acquired MRSA (CA-MRSA) infections, writes a helpful article. Below are some quotes, but I recommend reading the whole thing.

[Pediatrician Dr. Paula Schlesinger has] begun advising parents with youngsters with repeated skin infections to add two tablespoons of bleach to their bath water.

"It seems to me we're seeing more skin infections than we used to," Schlesinger said. "We're seeing children of all ages with boils and abscesses. They don't respond to the usual antibiotics."
...
As Houston approaches summer, when the most severe cases of MRSA start appearing , experts are warning parents and others to be on the lookout for unusual-looking insect bites, or red and swollen spots following minor injuries.
...
The infection, once seen only in hospitals, may start with something as simple as a mosquito bite or scratch.

In one fatal case reported by TCH in 2003, a 13-year-old boy developed the infection after stumbling on carpet and getting a rug burn.

Often, MRSA infections can be treated with topical antibiotics....[P]arents should pay close attention to scratches and insect bites on their children. Keep fingernails clean and trimmed short to cut down on germs spread by scratching.

Another newspaper article published today adds this detail about the appearance of CA-MRSA infections: "The community infections typically start as red, angry, itchy bumps and are often confused -- by patients and doctors -- with spider bites."

London Hospital Attacks VRE Superbug with Vaporized Hydrogen Peroxide

Local London reports that Kingston Hospital's ICU was decontaminated over the weekend, following infection of three patients with vancomycin-resistant enterococcus (VRE), a relatively rare superbug that is still confined to hospital and nursing-home settings. What's significant, however, is the response:

A [Kingston] hospital spokeswoman said: "Over the weekend the area underwent full bio-decontamination using the latest technology, tested and approved by the new rapid review panel for NHS technology." [see this PDF on the Bioquell process used at Kingston, and this Bioquell news release; go here for info on other NHS-approved decontamination technologies.]

The unit was sprayed with hydrogen peroxide vapour which creates a fog that covers the whole area, killing any germs. The hydrogen peroxide was then extracted by a machine that ensures that the environment is safe for immediate re-use.

This new decontamination method amounts to "going nuclear" against dangerous bacteria. Like the use of diatomaceous earth against insect pests, hydrogen peroxide attacks bacterial cells at such a basic level that there is no way for them to develop resistance against it. And while the peroxide vapor is poisonous to humans while hanging in the air, it breaks down into water vapor and oxygen, with no poisonous byproducts, and does not harm equipment or other furnishings.

Look for vaporized hydrogen peroxide (VHP) to be deployed frequently in the future against superbugs that have taken up residence within hospitals. The treatment also is effective against anthrax spores.
[Hat tip: MRSA Watch]

The Patient as Blogger

Laura Landro writes the column, The Informed Patient, in The Wall Street Journal. Her latest offering (subscription req'd] discusses the growth of blogging by people suffering from a variety of illnesses.

The ubiquitous personal Web sites known as blogs have become a significant new forum for health-care consumers. Easily created with free Web-based services or software programs that let you instantly post information and reader feedback, blogs allow Web-savvy patients like Ms. [Amy] Tenderich to chronicle their experiences with everything from Alzheimer's and cancer to gastric-bypass surgery and childbirth, often providing links to the latest medical studies and news.

For the legions of Web users who go online for health information each year, blogs present a new and more personal alternative to the plethora of disease-related Web chat rooms, message boards and email discussion groups, which typically let hundreds or even thousands of registered users send emails to each other through a central server.

This article suffers from the typical back-n-forth of its genre: blogs are good for sharing personal info, but on the other hand, the audience doesn't know for sure the bona fides of the writers [who am I, anyway, right?], and what about them dang ads?

Ms. Tenderich identifies herself as a San Francisco resident on her blog. "I'm not going to be posting my credit-card information, but I want it to be personal -- the whole point of being an advocate is to use your experience to help someone else," she says. She posts a small picture "so people can see I'm relatively fit and living with this thing, and not a 400-pound diabetic." Her blog features some links to ads for diabetes products and services, but she contends that won't affect any reviews or comments she makes.

The Association of Cancer Online Resources, which sponsors email discussion groups on various forms of cancer at its acor.org site, is now weighing a plan to help subscribers set up blogs. ACOR founder Gilles Frydman predicts there will be password-protected blogs to protect people's privacy in the future. That would be similar to the strictures placed on many email lists and message boards. ACOR and other groups typically require subscribers to their email lists to register and use passwords; list managers oversee the traffic and attempt to filter out any curiosity-seeking interlopers, commercial emails or anyone making unsupported claims of a cancer cure.

In the end, though, she reckons blogs are good after all (whew!):

While many blogs are meant to reach a broad audience, they can also be used to keep friends and family members informed during a long or difficult treatment. When his wife Donna was diagnosed with breast cancer, requiring a lumpectomy, radiation and chemotherapy, Harvard Medical School associate clinical professor Charles Safran says they were overwhelmed with calls and inquiries, so he asked friends at work to help start a blog so he could post weekly updates and friends could post messages to Donna.

Within a week more than 50 people he had notified via email logged on to the site he created. "The blog helped us form a community of concern and support for Donna," says Dr. Safran. "It certainly was therapeutic for me." While still new to health care, he predicts, "blogs will become one of the tools that help families cope with serious illness."

Cockfighting is Spreading Bird Flu in Asia

The traditional sport of cockfighting is helping spread avian flu in Asia, due to the close contact between the birds and their owner/handlers.

Meantime, international health officials are calling on Asian farmers to vaccinate their poultry rather than kill the fowl -- as the birds most likely to have avian flu are wild ones that are the hardest to catch and kill. That doesn't quite make sense to me (if you can't catch them to kill them, how can you catch them to vaccinate them?), but then I'm not an international health official.
[Hat tip: BirdFluReport]

Antibody Injections Reduce Alzheimer's Plaques in Mice

HealthCentral reports that researchers have successfully reduced Alzheimer's-related, beta-amyloid plaques in the brains of mice. The research performed at the Rush University Medical Center in Chicago used injections of antibodies against the beta-amyloid protein plaques, which are associated with the development of Alzheimer's dementia.

The mice in this study were genetically engineered to develop both early and late-stage Alzheimer's disease, characterized by a build-up of protein plaques in the brain.

A single intraventricular (into the brain's ventricles) injection of antibodies against beta-amyloid reduced the amount of amyloid in mice brains by about 70 percent, even in mice with a fairly severe stage of Alzheimer's, the researchers found.

There was no sign of serious inflammatory problems in the brain, they added. This type of antibody-linked inflammation had occurred in earlier studies, when injections were delivered into the bloodstream outside the brain.

According to the researchers, their results suggest periodic antibody injections may prove an effective means of rapidly reducing pre-existing amyloid plaques and associated inflammation. They hope such a treatment might someday yield a new means of preventing or successfully treating Alzheimer's.

Legionnaires' Disease Killing Patients in New York Hospital

The New York Daily News reports that Columbia Presbyterian Hospital in New York has discovered a number of patients have died from Legionnaire's bacteria. An investigation by state health inspectors is underway.

Victor Yu, a Pittsburgh doctor and one of the nation's top experts on Legionnaires', said Columbia Presbyterian brought him to New York in January to advise the hospital on how to keep the bacteria out of its water.

"I believe they had some intermittent cases, all of whom - or most of whom - survived," he said. "I'm going to guess that even though they had everything in place, something slipped through, and I would say that's almost impossible to stop."

Legionnaires' bacteria [Legionella pneumophila] are commonly found in water pipes and are not usually harmful. But in a hospital setting they can attack elderly patients or those with compromised immune systems, giving patients a form of pneumonia.

Experts say Legionnaires' is almost certainly underreported in hospitals, which can often find the bacteria or the infection if they look hard enough.

New Zealand Staph Superbug Kills Newborn & Sickens 15 Hospital Workers

In a global community, sickness spreads as quickly as communications. News comes today that in New Zealand's Wellington Hospital, six-day-old Alexandra Hunt has died of staph-induced blood poisoning.

Since the hospital realized last October it was harboring the antibiotic-resistant bacteria, some 37 infants and 15 hospital workers have been infected. Alexandra, a prematurely born baby, was the third newborn to die from staphylococcus infection.

Despite the two previous deaths caused by staphylococcus in the unit, Hunt says she was told nothing of the risk the bacterium posed to her baby.

The first she heard of staph was when the initial autopsy results came back.

"I wasn't aware of staph. It wasn't discussed - I wasn't even thinking about that sort of thing," she said. "But I would have thought they would have mentioned it."

But Hunt has no plans to take action against the hospital, saying her daughter always faced a struggle to survive and that the staff did their best. "(Laying a complaint) won't bring my baby back," she said. "I'm just hoping they can learn more from it and stop any more babies dying."

Update 03 May 2005: "Experts are confident a bacteria strain that has killed three babies at Wellington Hospital's neonatal unit has been contained."