Netflix and…worry?

An ex-student on study abroad in Spain sent me an email about a new documentary on Netflix called “Resistance.”

I watched it, and it is a thoughtful overview on antibiotic resistance that may help people who don’t really understand (or care about) what is happening in the world of antibiotic resistance to see the full implications of what is happening due to our haphazard handling of these miracle drugs.

It not only talks about our terrible squandering of these drugs, but also details a number of cases of people who have had  infections with resistant organisms. It also has stunning visual images of bacteria and other microbes.

I think it is something everyone should see.

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Fun fact for the day: Humans are 8% retrovirus

In class, I used the incorrect statistic (remember: 73.6% of statistics are made up) and have come here to clarify.

Over the course of evolution, we have been bombarded (read: infected) by viruses that integrate their genome into OUR chromosomes.  Sometimes the virus would infect a sperm or an egg, or maybe even a fetus that is only 8 cells old.

This new DNA becomes integrated into our genome. We fight back by inactivating their genes (by mutation or epigenetic changes). This is a great review article by Carl Zimmer, a scientist writer, and National Geographic contributor.

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Carolina, we are looking at you….study investigates inappropriate prescriptions

A study conducted by the Carolinas HealthCare System investigated almost 449,000 visits to  urgent care, family medicine, internal medicine and pediatric practices. They focused on “outpatient visits for common upper respiratory conditions that should not require antibiotics.”

The take-home:

  1. There were over 400 prescriptions per 1000 visits. Remember NONE of these cases should have required a prescription.
  2. In treating adults, white patients were more likely than any other race to receive antibiotics.
  3. In treating children, older providers (aged 51-60) were 4x more likely to prescribe antibiotics to children than younger providers (< 30 years).
  4. Physician’s assistants and nurse practitioner’s were 15% more likely to prescribe antibiotics over a physician.

 

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I am not the only one who can get snarky about handwashing.

I love Katherine Smith Lockler.

She is the Florida ER nurse who Has. Just. Had. It. Up. To. Here… with people who don’t understand how the flu is spread, or how to prevent themselves from getting the flu.

News agencies around the country are reposting this video because it is a great example of an expert (someone who deals with the flu AND flu patients on a daily basis) discuss the flu.

I especially love the replay at the end…

 

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We don’t deserve antibiotics

First isolated and produced by Chain and Florey in 1942 , penicillin was used in 1943 to save tens of thousands of lives in World War II. Tens of thousands of lives. Antibiotics are wonder drugs.

We have grown complacent of these wonder drugs, and now think of them as everyday medications.

What is worse, we think so little of them in today’s society that our main use for them is to feed them to farm animals to “promote growth and improve feed efficiency.” 75 to 80% of all antibiotics are given to farm animals. Report after report detail the problematic overuse of antibiotics in farm animals.

It has just been reported by the Bureau of Investigative Journalism that thousands of tons of the antibiotic colistin are being shipped and fed to chickens in India.

What is colistin? It is considered the antibiotic of last resort for use against Enterobacteriaceae , a family of bacteria that contain organisms that we interact with every day: E. coli, Salmonella, and Klebsiella. Many of these organisms have become superbugs. A superbug is named so, not because they are super hero’s but because they  have become resistant to a large number of antibiotics. So, essentially, they are super villains. These most elite of the superbug/super villains carry a small piece of DNA known as the NDM-1 plasmid (New Delhi Metallo-beta-lactamase-1). ANY bacteria containing this plasmid is resistant to almost all known antibiotics. With the exception of colistin. Colistin is the only antibiotic in our arsenal that can stop these superbugs.

But instead of protecting this weapon of last resort, that has to be used as a last resort to save human lives, we are feeding tons of this antibiotic to chickens in India. What happens is our antibiotic of last resort will be decoded by the bacteria encountered in the animals, and then inactivated.

I guess this is what happens when you just leave weapons laying around for anyone or any thing to misuse.

Soon, we will lose this wonder drug,bacteria will know how to inactivate it and superbugs may just end up ruling the world.

This chart from the CDC tells the story of how this happens better than I can:

 

 

 

 

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Really great website on how herd immunity works and DATA on Vaccines

This is taken from NOVA and PBS regarding how herd immunity works to protect. This is a great article discussing vaccines and vaccination.

But most importantly is the accumulated evidence compiled by the American Academy of Pediatrics. This lists study after study of evidence based research that concludes that autism is not caused by vaccines.

Lastly, I want to discuss, Andrew Wakefield, the former doctor (he had his license revoked) who described the so-called link to vaccines:

  • His published study has never been able to be reproduced by scientists who tried to verify his findings.
  • All of his fellow authors on the papers have removed their names from the paper, and the paper was retracted from the Lancet, and cited as having information that was deliberately falsified.
  • It was proven that the children in his study (a total of 12 children), and none of them actually had inflammatory bowl disease.
  • Wakefield had established a:

 venture “was to be launched off the back of the vaccine scare, diagnosing a purported — and still unsubstantiated — ‘new syndrome,'” BMJ reported Tuesday. A prospectus for potential investors suggested that a test for the disorder Wakefield dubbed “autistic enterocolitis” could produce as much as 28 million pounds ($43 million U.S.) in revenue, the journal reported, with “litigation driven testing” of patients in the United States and Britain its initial market.

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For the people who believe that Measles is not dangerous…

I present the heartbreaking data coming in from Bangladesh. There has been an extensive outbreak in a remote village, where 88 children were infected with measles. Of those, 53 required hospitalization and nine children have died. The outbreak started just a week ago.

For the doubters: yes, death is much higher in underdeveloped countries. This is thought to be primarily due to malnutrition. Also, death would have probably been prevented if proper hospitalization had occurred earlier. But regardless, measles is not a “this will strengthen my child’s immune system” infection. It is a “this could kill my child” infection. Hospitalization is routine even in developed countries, where pneumonia and encephalitis are sequelae to the infection.

None of the children in the village were vaccinated. Actually, no one in the village was vaccinated due to oversight on the part of the government.  The local council is stating that no more infections will  happen, because they are “starting an immunization program now”. But measles is one of the most infectious viruses known. Infectious virus can remain hanging in the air as particles (called droplet nuclei) for hours. There are 85 families in this village and anyone who has NOT been vaccinated will probably be dealing with this infection. Without vaccine, there is no treatment but supportive care to stop a measles infection. Antibiotics will not help. There is no antiviral drugs to help. There is nothing to do but watch your child go through the pain and the agony of a preventable (possibly lethal) infection.

These horrific outcomes do not have to happen. Vaccinate your children now.

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Dirt is good- New book detailing why you should NOT be worried about microbes

Great article from NPR on new book by Jack Gilbert, a microbiologist from the University of Chicago. Click here to read article.

In short, don’t worry about being so clean. The hygiene hypothesis-being too clean inhibits your immune system’s ability to see and recognize small threats. Dealing with small threats trains your immune system so that you are better prepared when large threats happen!

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Thank you John Oliver

I have lectured on this for the last decade, but thank you for John Oliver for summing up and explaining why vaccines are safe will save lives and what herd immunity is.

Please watch John Oliver’s Vaccine summary on YouTube

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HSV-1 infection causing genital infection/Congenital Disease of the Newborn

In the New York Orthodox Jewish communities, circumcision ritual involves removal of the foreskin, then the removal of the blood that accumulates there by the mohel (the performer of the ritual). They do this by sucking the blood from the wound by mouth.

This has led to the infection of four newborn boys with HSV-1, and then possibly causing Congenital Disease of the Newborn. Congenital Disease of the Newborn can lead to mental defects, blindness, deafness and even death. HSV-1 can infect the genitalia as well as the oral mucosa to cause this disease.

The biggest worry is that the Jewish community is protecting the identity of the mohels who performed the procedure. People who are not aware that HSV-1 can cause such a devastating  disease/sequale may be putting their newborn sons at risk for this infection.

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