#Infectious Diseases

[gumjrop]

This year’s flu shot will be missing a strain of influenza it’s protected against for more than a decade.

That’s because there have been no confirmed flu cases caused by the Influenza B/Yamagata lineage since spring 2020. And the Food and Drug Administration decided this year that the strain now poses little to no threat to human health.

Scientists have concluded that widespread physical distancing and masking practiced during the early days of COVID-19 appear to have pushed B/Yamagata into oblivion.

This surprised many who study influenza, as it would be the first documented instance of a virus going extinct due to changes in human behavior, said Dr. Rebecca Wurtz, an infectious disease physician and epidemiologist at the University of Minnesota School of Public Health.

“It is such an interesting and unique story,” Wurtz said, adding that if it were not for COVID, B/Yamagata would still be circulating.

One reason COVID mitigation efforts were so effective at eliminating B/Yamagata is there was already a fair amount of immunity in the population against this strain of flu, which was also circulating at a lower level, said Dr. Kawsar Talaat, an infectious disease physician at Johns Hopkins Bloomberg School of Public Health.

In contrast, SARS-CoV-2 was a brand new virus that no one had encountered before; therefore, masking and isolation only slowed its transmission, but did not stop it.

The absence of B/Yamagata won’t change the experience of getting this year’s flu shot, which the Centers for Disease Control and Prevention recommends to everyone over 6 months old. And unvaccinated people are no less likely to get the flu, as B/Victoria and two influenza A lineages are still circulating widely and making people sick. Talaat said the disappearance of B/Yamagata doesn’t appear to have lessened the overall burden of flu, noting that the level of illness that can be attributed to any strain varies from year to year.

The CDC estimates that between 12,000 and 51,000 people die every year from influenza.

However, the manufacturing process is simplified now that the vaccine is trivalent — designed to protect against three flu viruses — instead of quadrivalent, protecting against four. That change allows more doses to be produced, said Talaat.

Ultimately, the costs of continuing to include protection against B/Yamagata in the flu shot outweigh its benefits, said Talaat.

"If you include a strain for which you don't think anybody's going to get infected into a vaccine, there are some potential risks and no potential benefits," she said. "Even though the risks might be infinitesimal, the benefits are also infinitesimal."

Scientists and public health experts have discussed for the past couple years whether to pull B/Yamagata from the flu vaccine or wait for a possible reemergence, said Kevin R. McCarthy, an assistant professor at the University of Pittsburgh's Center for Vaccine Research. But McCarthy agrees that continuing to vaccinate people against B/Yamagata does not benefit public health.

Additionally, there is a slight chance of B/Yamagata accidentally infecting the workers who manufacture the flu vaccine. The viruses, grown in eggs, are inactivated before being put into the shots: You cannot get influenza from the flu shot. But worker exposure to live B/Yamagata might occur before it's rendered harmless.

That hypothetically could lead to a reintroduction of a virus that populations have waning immunity to because B/Yamagata is no longer making people sick. While that risk is very low, McCarthy said it doesn’t make sense to produce thousands of gallons of a likely extinct virus.

It is possible that B/Yamagata continues to exist in pockets of the world that have less comprehensive flu surveillance. However, scientists aren’t worried that it is hiding in animals because humans are the only host population for B lineage flu viruses.

Scientists determined that B/Yamagata disappeared in a relatively short period of time, and this in and of itself is a success, said McCarthy. That required collaboration and data sharing from people all over the world, including countries that the U.S. has more tenuous diplomatic relationships with, like China and Russia.

“I think the fact that we can do that shows that we can get some things right,” he said.

Sarah Boden is an independent health and science journalist based in Pittsburgh.

[reasonsforhope]

"Since it was first identified in 1983, HIV has infected more than 85 million people and caused some 40 million deaths worldwide.

While medication known as pre-exposure prophylaxis, or PrEP, can significantly reduce the risk of getting HIV, it has to be taken every day to be effective. A vaccine to provide lasting protection has eluded researchers for decades. Now, there may finally be a viable strategy for making one.

An experimental vaccine developed at Duke University triggered an elusive type of broadly neutralizing antibody in a small group of people enrolled in a 2019 clinical trial. The findings were published today [May 17, 2024] in the scientific journal Cell.

“This is one of the most pivotal studies in the HIV vaccine field to date,” says Glenda Gray, an HIV expert and the president and CEO of the South African Medical Research Council, who was not involved in the study.

A few years ago, a team from Scripps Research and the International AIDS Vaccine Initiative (IAVI) showed that it was possible to stimulate the precursor cells needed to make these rare antibodies in people. The Duke study goes a step further to generate these antibodies, albeit at low levels.

“This is a scientific feat and gives the field great hope that one can construct an HIV vaccine regimen that directs the immune response along a path that is required for protection,” Gray says.

-via WIRED, May 17, 2024. Article continues below.

Vaccines work by training the immune system to recognize a virus or other pathogen. They introduce something that looks like the virus—a piece of it, for example, or a weakened version of it—and by doing so, spur the body’s B cells into producing protective antibodies against it. Those antibodies stick around so that when a person later encounters the real virus, the immune system remembers and is poised to attack.

While researchers were able to produce Covid-19 vaccines in a matter of months, creating a vaccine against HIV has proven much more challenging. The problem is the unique nature of the virus. HIV mutates rapidly, meaning it can quickly outmaneuver immune defenses. It also integrates into the human genome within a few days of exposure, hiding out from the immune system.

“Parts of the virus look like our own cells, and we don’t like to make antibodies against our own selves,” says Barton Haynes, director of the Duke Human Vaccine Institute and one of the authors on the paper.

The particular antibodies that researchers are interested in are known as broadly neutralizing antibodies, which can recognize and block different versions of the virus. Because of HIV’s shape-shifting nature, there are two main types of HIV and each has several strains. An effective vaccine will need to target many of them.

Some HIV-infected individuals generate broadly neutralizing antibodies, although it often takes years of living with HIV to do so, Haynes says. Even then, people don’t make enough of them to fight off the virus. These special antibodies are made by unusual B cells that are loaded with mutations they’ve acquired over time in reaction to the virus changing inside the body. “These are weird antibodies,” Haynes says. “The body doesn’t make them easily.”

Haynes and his colleagues aimed to speed up that process in healthy, HIV-negative people. Their vaccine uses synthetic molecules that mimic a part of HIV’s outer coat, or envelope, called the membrane proximal external region. This area remains stable even as the virus mutates. Antibodies against this region can block many circulating strains of HIV.

The trial enrolled 20 healthy participants who were HIV-negative. Of those, 15 people received two of four planned doses of the investigational vaccine, and five received three doses. The trial was halted when one participant experienced an allergic reaction that was not life-threatening. The team found that the reaction was likely due to an additive in the vaccine, which they plan to remove in future testing.

Still, they found that two doses of the vaccine were enough to induce low levels of broadly neutralizing antibodies within a few weeks. Notably, B cells seemed to remain in a state of development to allow them to continue acquiring mutations, so they could evolve along with the virus. Researchers tested the antibodies on HIV samples in the lab and found that they were able to neutralize between 15 and 35 percent of them.

Jeffrey Laurence, a scientific consultant at the Foundation for AIDS Research (amfAR) and a professor of medicine at Weill Cornell Medical College, says the findings represent a step forward, but that challenges remain. “It outlines a path for vaccine development, but there’s a lot of work that needs to be done,” he says.

For one, he says, a vaccine would need to generate antibody levels that are significantly higher and able to neutralize with greater efficacy. He also says a one-dose vaccine would be ideal. “If you’re ever going to have a vaccine that’s helpful to the world, you’re going to need one dose,” he says.

Targeting more regions of the virus envelope could produce a more robust response. Haynes says the next step is designing a vaccine with at least three components, all aimed at distinct regions of the virus. The goal is to guide the B cells to become much stronger neutralizers, Haynes says. “We’re going to move forward and build on what we have learned.”

-via WIRED, May 17, 2024

[thecrashcourse]

Premiering today at 12 pm ET: the first ever Crash Course Lecture! Join us and guest lecturer John Green in the live chat as we learn about the history and science of #tuberculosis and how we can #StopTB

Crash Course Lectures are individual long-form videos that dive deep into a topic in a multidisciplinary way. As always at Crash Course, we embrace curiosity. We hope learners of all kinds enjoy these lectures, and that you are inspired to continue learning about the topic even after the video ends!

[nando161mando]

COVID denialism and misinformation has led to Olympic athletes not even washing their hands because they wrongly think it will help them become more resistant against disease.

There is no evidence handwashing weakens your immune system. There is no evidence that adopting unsanitary practices makes your immune system stronger. But there is a lot of evidence that handwashing and other precautions protects you and others from infectious diseases, especially in risky environments like bathrooms.

https://www.reddit.com/r/HermanCainAward/

https://www.sorryantivaxxer.com/

[x-x-angel]

What if I just.. yes this is a new Handplates infection au called Necrophobia (The fear of corpses and dead things), in this au the skele brother’s encounter these 2 doppelgängers roaming around the lab while testing, there is a gaster doppelgänger that is unidentified,

Handplates by @zarla-s

[chronicsheepdeprivation]

There's a possible effective treatment for the Amphibian Chytrid Fungus!

This fungus has been the cause of devastating mass deaths and extinctions in several frog species but now we have a way to help combat it!

[wikipediapictures]

Rabies vaccine

“Vaccine for oral vaccination in foxes.” - via Wikimedia Commons (original description translated from Bulgarian using Google Translate)

[spearslug-box]

Hey!! Rainworld infection AU!!!! (Body horror warn under cut)

:3

[heardatmedschool]

Resident: Finally! The results of the urine culture are in. Let’s send this patient home!

Intern: Could you imagine if it’s contaminated and we can’t adjust the antibiotics?

Resident: No way, that’s not going to… It’s polymicrobial.

[flyonthewallmedstudent]

Q Fever

Aka, Query fever. What a weird name for a disease. Imagine telling people that's what you got.

in the 30s-40s, an Australian pathologist in QLD/Brisbane, came across an outbreak of the same or similar illness among abbatoir or slaughterhouse workers.

At the time, he called the disease "Q" fever or query as a temporary name until the pathogen could be identified. Unfortunately it stuck.

decades later, now nobel prize winner and virologist, MacFarlane Burnett isolated and identified the microbe responsible. I think this discovery contributed to his prize. i forget already.

Microbe responsible: Coxiella burnetti. Named for Burnett and HR Cox, the American bacteriologist who found the genus Coxiella where C burnetti falls under.

Initially they felt it was related to Rickettsia, responsible for Rocky Mountain Spotted Fever, but as science progressed, this was disproven.

Now for a Case Report

A 55 yo Italian man with a history of aortic valve replacement was diagnosed with pyrexia of unknown origin twice. Further signs included myalgias/splenomegaly/night sweats. The 2nd time he was admitted for PUO he deteriorated rather dramatically and was put on meropenem and teicoplanin.

A host of organisms was tested for on serological testing based on the man's travel and epidemiological history, all negative. Even a rheumatological panel was done, also less revealing. He also had a history of MGUS (a haem disoder), which is kind of a red herring here.

Cultures were negative, no vegetations were seen on a TTE - so they did consider IE. Which is an important differential for PUO.

Eventually a PET-CT was done (often favoured when investigations do not yield much for a sick patient with fevers), finally revealing a focus of infectious on his ascending aorta, where he'd also had previous surgery done. And in a round about way, they also further identified Coxiella Burnetti. He was treated doxycycline and hydroxychloroquine. As it's so rare in Italy, it wasn't really considered even though he mentioned rural travel.

Bottomline: Q Fever is an important consideration in the work up for culture negative IE. Further to this, always consider IE in the differentials for PUO particularly if they're at increased risk for IE (prosthetic valves, damaged valves, select congenital heart issues, previous IE). IE can present with night sweats, fevers, weight loss and splenomegaly. It can be insidious and chronic in nature. other risk factors can be more suggestive as we'll get into below.

Causative organism

Coxiella burnetti, it's a zoonoses - i.e. transmissible from animals. Special powers: very tough/hardy, can survive extreme environments (high temps and UV light etc.) over prolonged periods and is resistant to many common disinfectants/surface cleaners.

It's an intracellular pathogen and gram negative coccobacilli (PINK!)

name coccobaccili reminds me of cocopuffs.

it's mainly associated with farm animals, which the CDC so wholesomely displays on its website on Q fever (wtf).

goats, sheep, cattle typically (but many other animals, even birds, dogs and horses can be reservoirs)

in particular bodily fluids - amniotic fluid, placenta, faeces/urine, milk etc.

you can get it through unpasteurized milk and through inhaling it if it lands on dust in the area

ever visit a farm or petting zoo lately? OMG WASH YOU HANDS.

That said, it's typically inhaled in inorganic dust. You inhale it, it goes to the lungs, and then the bloodstream.

Increased risk for Coxiella burnetti (What to take on history of exposures and when to strongly consider it)

live on a farm or near one

exposure to a farm

work as a vet on a farm

farm worker, dairy workers, researchers on these animals/facilities

slaughterhouse/abbatoir

Also from CDC:

Clinical presentation

Most won't get sick after exposure and remain asymptomatic, a very small minority does. even though it is highly infectious.

incubation time is 2-3 weeks (consider this time in your history of exposure, did they work on the farm 2-3 weeks ago as opposed to yesterday).

Nonspecific acute infectious symptoms:

nonspecific systemic fevers/malaise/arthralgias/myalgias--> key is high fevers though and can be associated with headache and photophobia.

non specific GI - N/V/diarrhoea

respiratory ones - SOB or cough, consider it as atypical cause of community acquired pneumonia.

rare: hepatitis and jaundice (granulomatous) or encephalitis with neurological complications such as demyelinating disease or CN palsies, also haemolytic anaemia and HLH (yikes)

really it's the history of exposure that will lead you down the garden path to Q fever.

Chronic Q fever is perhaps worse, and can present as culture negative IE/PUO. Months/years later, as B symptoms as above above + LOW/LOA, night sweats. More likely to occur if you are predisposed for IE as above, have a weakened immune system for any reason, including pregnancy.

Chronic Q fever has a mortality of 10% if left untreated. About <5% of those with acute Q fever develop this if left untreated. Speculation is that it's more of an autoimmune process or abnormal immunological response to the bacteria.

To be honest, most who walk in the door with community acquired pneumonia get treated empirically for atypicals anyway, (standard course of doxycycline), so we hardly really ponder the question of Q fever in every patient. But if they present chronically and did not have atypical cover at the onset of acute symptoms, then it's something important to consider.

Other important conditions - can cause complications in pregnant women and 20% will get post Q fever syndrome. like chronic fatigue.

investigations

Serology! nice and easy. Look for IgG antibodies in the chronic presentation. Or PCR. Down side to serology - can take 2-3 days for the body to make said antibodies to the bacteria for detection. PCR can be done on any fluids/tissue sent.

Cultures useless, hence it fall under the umbrella of culture negative (hard to grow outside a host cell, it is an obligate intracellular pathogen).

Other hints on bloods (as serology/PCR takes time to return) - elevated or low platelet's, transaminitis with normal bili, opacities in CXR with hilar lymphadenopathy, CSF will show raised protein levels if done when encephalitis is suspected.

imaging can also support the diagnosis.. as illustrated by the case report.

Treatment

Acute disease - as standard for atypical bugs, doxycycline 100 mg BD for 14 days. Alternatives - TMP SMX or Clarithromycin.

Chronic Q fever or IE:

native valves: doxycycline and hydroxychloroquine (200 TDS) for 18 months

prosthetic: same but 24 months

why hydroxy: enhances the action of doxycycline (increases the pH of the phagolysosome)

Follow-up: look for 4 fold decrease in IGG

Sources:

CDC

Stat Pearls

Wiki as linked above

[gumjrop]

Make your voice heard and ask the CDC to:

Recommend COVID vaccines for all ages and health statuses at least twice a year (spring vaccine access for all) AND

Support more frequent updates to the vaccines, adjusted for the latest variants.

Submit a public comment using our sample language below.

The committee is anticipated to vote on the following topic on day 1 of the meeting (October 23): “Use of additional doses of COVID-19 vaccine in immunocompromised individuals and older adults following an initial dose of 2024–2025 vaccine”

Your comments make a difference. At this committee’s June 2024 meeting, public comments from our community led to the committee’s decision to make fall COVID vaccines available to people of all ages, rather than limiting eligibility to specific risk groups. Please join us in making your voice heard for spring COVID vaccine access for all, and at least twice a year access going forward.

Submit Written Comment

You can also register to give Oral Public Comment at the upcoming online CDC ACIP Meeting October 23-24 at: https://www2.cdc.gov/vaccines/acip/acip_publiccomment.asp 

Submit written comments and/or register to make oral comments at the meeting by Friday October 18 at 11:59pm Eastern Standard Time.

It’s important to submit a personalized comment, which can be brief. Ideas for a personalized comment:

How you, your family, or your community would be impacted by spring vaccine eligibility being restricted to only high risk groups (such as older age or immunocompromised status)

Barriers to vaccination your have faced, particularly if your eligibility was questioned or misinterpreted by a vaccine provider

How out-of-pocket costs are a barrier to getting the latest vaccines

Also feel free to take inspiration from or borrow the language in our sample public comment below.

Step-By-Step Submission Instructions:

Step 1. Go to the Regulations.gov to submit your comment.

Step 2. Type in your comment under the field, “Comment.”

Step 3 (optional). Submit a PDF or Word version of your comment under, “Attach Files.”

Step 4. Select either “Individual” or “Anonymous” depending on if you want to share your personal identifiable information that will be publicly available on the Federal Register.

Step 5. If selecting “Individual,” minimally provide your first and last name. If selecting “Anonymous” you can directly submit the comment without sharing your personal identifiable information. Click “Submit Comment.”

Example Comment:

Docket No. CDC-2024-0072-0001 COVID vaccination at least twice a year (at least every six months) must be recommended for people of all ages, regardless of health status. A restrictive approach to eligibility creates undue barriers for vulnerable people and discourages high risk people from getting needed vaccine boosters. People of all ages, including those who are aged 65 and older or immunocompromised, should have the opportunity to receive another COVID vaccine in the spring of 2025. The vaccine schedule should address waning efficacy in the months following vaccination [1-3] as well as emergence of new SARS-CoV-2 strains by recommending updated vaccination for all ages, at least every six months. Waning efficacy is seen with all COVID vaccine types, and recent research into the biological mechanisms of waning [4] supports that this effect occurs regardless of age or immunocompromised status. Recent vaccination is associated with a lower risk of developing Long COVID following a COVID infection [5] as well as a lower risk of Multisystem Inflammatory Syndrome in children (MIS-C) [6].  The CDC’s clear and unequivocal recommendation of COVID vaccination at least twice a year for all ages will influence recommendations by healthcare providers, and coverage by health insurance. Moreover, it will improve public awareness in people of all ages about the importance of recent vaccination (within the last six months) to provide the best protection as part of a multilayered approach to preventing illness. The CDC must ensure equitable and affordable access to updated vaccines and prevent limited access because of financial constraints or demographics. The CDC’s Bridge vaccine access program ended in August 2024 [7], leaving many uninsured and underinsured adults without COVID vaccine access. We ask you to advocate for free COVID vaccine access for all of us to reduce barriers and hesitation to vaccination. References: 1. Link-Gelles R. Effectiveness of COVID-19 (2023-2024 Formula) vaccines. Presented at: FDA VRBPAC Meeting; June 5, 2024. Accessed June 12, 2024. https://www.fda.gov/media/179140/download 2. Wu N, Joyal-Desmarais K, Vieira AM, et al. COVID-19 boosters versus primary series: update to a living review. The Lancet Respiratory Medicine. 2023;11(10):e87-e88. doi:10.1016/S2213-2600(23)00265-5 3. Menegale F, Manica M, Zardini A, et al. Evaluation of Waning of SARS-CoV-2 Vaccine–Induced Immunity: A Systematic Review and Meta-analysis. JAMA Netw Open. 2023;6(5):e2310650. doi:10.1001/jamanetworkopen.2023.10650 4. Nguyen DC, Hentenaar IT, Morrison-Porter A, et al. SARS-CoV-2-specific plasma cells are not durably established in the bone marrow long-lived compartment after mRNA vaccination. Nat Med. Published online September 27, 2024:1-10. doi:10.1038/s41591-024-03278-y 5. Fang Z, Ahrnsbrak R, Rekito A. Evidence Mounts That About 7% of US Adults Have Had Long COVID. JAMA. Published online June 7, 2024. doi:10.1001/jama.2024.11370 6.  Yousaf AR. Notes from the Field: Surveillance for Multisystem Inflammatory Syndrome in Children — United States, 2023. MMWR Morb Mortal Wkly Rep. 2024;73. doi:10.15585/mmwr.mm7310a2 7. https://www.cdc.gov/vaccines/programs/bridge/index.html 

Full instructions for written and oral comment and meeting information can be found at: https://www.cdc.gov/acip/meetings/

You can also register to give Oral Public Comment at the upcoming online CDC ACIP Meeting October 23-24 at: https://www2.cdc.gov/vaccines/acip/acip_publiccomment.asp 

You must register by October 18 at 11:59pm Eastern Standard Time

CDC’s ACIP meeting information on the Federal Register: https://www.federalregister.gov/documents/2024/09/30/2024-22357/meeting-of-the-advisory-committee-on-immunization-practices 

Full Statement:

Vaccination with the latest updated vaccines continues to be foundational to a multilayered approach to COVID, providing protection against both acute disease and Long COVID. Far too few Americans have received the latest vaccines. As of October 11, 2024, only 11.2% of all adults and 26.7% of adults aged 65 and older had received an updated 2024-2025 COVID vaccine. Data for children were unavailable at the time of this writing (October 15, 2024). COVID vaccination rates continue to lag behind influenza vaccination rates. As of July 27, 2024, only 9% of adults aged 65 and older received the recommended two doses of last year’s 2023-2024 vaccine.

Vaccine efficacy wanes significantly four to six months following vaccination, making updated vaccination important for all people as COVID continues to spread in our communities. Vaccine approaches that restrict access based on age or risk status put all of us at risk and leave those at high risk of severe consequences of COVID infection confused about whether they qualify to receive additional doses. These high risk patients may also face barriers as vaccine providers misunderstand the guidelines. A more frequent vaccination approach providing vaccination at least every six months as well as frequent updates to match current variants is needed to better protect all of us amid year-round COVID spread.

Recent vaccination is associated with a lower risk of developing Long COVID following a COVID infection as well as a lower risk of Multisystem Inflammatory Syndrome in children (MIS-C). Waning efficacy is seen with all COVID vaccine types, and recent research into the biological mechanisms of waning supports that this effect occurs regardless of age or immunocompromised status. 

The CDC’s Bridge Access Program, which previously provided COVID vaccines to uninsured and underinsured adults free of charge, ended in August 2024. The end of this program without replacement coverage puts people at risk, and public health officials must advocate for free vaccine access for all of us, including those who are uninsured and underinsured.

Submitted written comments or registration to make oral comments at the meeting must be received by the CDC no later than October 18 at 11:59pm Eastern Standard Time

[reasonsforhope]

Cancer

“Starting at home, a study last year found that US cancer deaths had declined by 33% since 1991. This is equivalent to around 3.8 million people alive thanks to various efforts to combat the disease family.

The report was authored by the American Cancer Society, and published in the journal CA. American Cancer Society CEO Karen Knudsen called the drop “truly formidable,” while the report attributed the fall to the development of better treatments, the reduction in smoking habits, and earlier detection methods.

Just between 2019 and 2020, cancer death rates dropped 1.5%, while the deployment of the HPV vaccine was correlated with a 65% drop in cervical cancer rates from 2012 through 2019 among women in their 30s.

The report also found that not only are death rates falling, but 5-year survival rates for detected cancers have increased 68% among all diagnoses made between 2012 and 2018.

Guinea Worm Disease

Cancer research often involves cutting edge medical research, but across West Africa and India where cutting edge medicine is not widely available, human determination has succeeded in nearly eradicating Guinea Worm disease.

There are records of this truly unpleasant parasite affecting human health going back thousands of years, and in 1989, there were nearly 1 million cases globally.

But in 2022, this unwelcome waterborne guest created just 15 cases worldwide—a decline of 99.998%, and almost all 15 of those cases occurred in Chad.

This monumental turnaround was not the result of some experimental vaccine, but simple education, teaching people how to avoid drinking contaminated water, when and where this mostly seasonal parasite is likely to be found, and how to treat water to purify it of the Guinea worm.

Ebola

Other than Chad, Guinea Worm disease was also found in Uganda, which produced another medical milestone with the successful eradication of a recent Ebola outbreak.

The outbreak began in September, driven on by the incurable Sudan strain of the virus. It was the worst outbreak in 20 years, but even though there is no vaccine for the Sudan strain, the health authorities managed to contain it to just two administrative districts, and 142 confirmed cases.

“The magic bullet has been our communities who understood the importance of doing what was needed to end the outbreak, and took action,” said health minister Dr. Jane Ruth Aceng Ocero last Wednesday.

Vaccine trials involving Oxford University are currently underway for the Sudan strain, but until that time, health authorities received congratulations for their swift actions, and were thanked for the “lessons learned.””

-via Good News Network, 1/19/23

[plumbits]

Leptospirosis: What it is, what it does, and how you can protect yourself and your pets.

People always have questions about leptospirosis (lepto) when they come into the clinic, especially in regards to the vaccine. This post will hopefully clear up those questions or any confusion regarding lepto and its vaccine, and why it's so serious. The information in this post comes from my formal education as a LVT, as well as other sources including the CDC, PAHO, and AVMA. If I missed anything or you see something that's incorrect, please let me know!

First and foremost: What is leptospirosis?

Leptospirosis is a bacterial disease that effects human and non-human animals. It's caused by bacteria in the genus Leptospira. In humans, it can cause a wide range of symptoms that can be very general. This leads to misdiagnoses. Animals such as dogs, livestock, and certain wildlife are all susceptible to infection.

How is leptospirosis spread?

Lepto is most often spread through contact with the urine of an infected animal. This is especially the case (but not the only case) with wild rodents. Infected dogs can seem healthy, but still pass the bacteria on in their urine. In urine-soaked soil, the bacteria can survive for weeks to months.

Dogs typically become infected when their mucous membranes or open wounds come into contact with urine or urine contaminated surfaces (like soil or water). Infection can also be spread through urine-contaminated bedding or food, or the tissues from the carcass of an infected animal. There have been rare instances where lepto has been transmitted by bite or breeding. A pregnant dog who is infected may pass the bacteria to her puppies through the placenta.

Humans contract lepto pretty much the same way: through contact with urine from an infected animal or urine-contaminated surfaces.

What are the signs and symptoms?

In humans:

High fever

Headache and muscle aches

Chills

Jaundice

Vomiting and diarrhea

Redness of the eyes

Abdominal pain

Rash

Humans can also be asymptomatic, which is particularly concerning. It usually takes anywhere from 2 days to 4 weeks post-exposure to the infection source before any symptoms are displayed. The illness begins abruptly and it may occur in 2 phases. The first phase is where you will see a lot of the general symptoms listed above. The person infected may recover for a period of time, but become ill again. The second phase is more severe, leading to kidney or liver failure, and possible meningitis. The illness can last a few days to 3 weeks or longer.

Without treatment, recovery can take several months.

In dogs:

Signs and symptoms may vary slightly depending on the strain of the infected bacteria. The signs are also very general in dogs, but the most common ones include:

Loss of appetite

Vomiting and diarrhea

Lethargy

Abdominal pain

Jaundice

Dehydration

Increased thirst and urination

Weight loss

Stiffness or muscle pain

The disease can also progress to kidney and liver failure in dogs, with damage to other organ systems also noted in the literature. Lepto can also cause bleeding disorders, which can lead to blood in urine, vomit, feces, or saliva, and petechiae on the mucous membranes or light colored skin.

Who is most at risk?

For humans, those who are most at risk include those who work with animals or outdoors where you come into contact with wildlife. The Pan American Health Organization (PAHO) also mentions that sewer workers and military personnel are at-risk populations. Farmers (and generally people who work with livestock) also make the list, as do veterinarians, veterinary technicians, and veterinary assistants.

For dogs, it's all of them. "All dogs are at risk of leptospirosis, regardless of age, breed, lifestyle, geographic location, time of year, and other factors." (source: AVMA)

Situations that can increase the risk of your dog contracting leptospirosis are listed below:

Exposure to drinking from slow-moving or stagnant water sources (this includes puddles)

Roaming on rural property

Exposure to wild animals or farm animals, even if it's only in the yard

Contact with other dogs (such as in urban areas, dog parks, boarding, or training facilities.

How is leptospirosis treated and diagnosed?

Disclaimer: I am NOT a medical doctor or DVM, but I am an LVT. If you think you're experiencing these symptoms, PLEASE go see your doctor. If you think your dog or any of your other animals are experiencing these symptoms, PLEASE take them to your vet.

Diagnosis in non-human animals:

Unfortunately, routine blood tests alone cannot diagnose leptospirosis. That's why it's important for your vet to use all information available to them (i.e. diagnostics, signs and symptoms, lifestyle, etc). There WILL be abnormal results for blood work, most likely high liver and/or kidney values and high white blood cell count. There are specific tests available for diagnosing lepto, such as the DNA-PCR and MAT tests. Both may be needed to reach or confirm a diagnosis. False negatives are possible, so your pet may be treated as if they have leptospirosis, even if the test results are negative. False positives are exceedingly rare.

Diagnosis in humans:

Leptospirosis is diagnosed in a similar fashion in humans. A physical exam, blood work, and urinalysis will likely be run. The same style of tests are used: DNA-PCR and MAT.

Treatment in non-human animals:

Leptospirosis is treated with antibiotics and supportive care. Doxycycline is most commonly used, and will likely be prescribed for 2 weeks or more. Supportive care includes hospitalization with IV fluids and management of electrolyte levels. Additional medications and procedures may be necessary.

Treatment in humans:

The treatment is similar in humans, with antibiotics (usually doxycycline). Your doctor may also suggest to take ibuprofen and monitor yourself at home for less severe cases. If the case is severe, then you'll likely spend time in the hospital. Additional medications or procedures may also be necessary.

Outcomes:

In non-human animals:

Leptospirosis is responsive to treatment with antibiotics. Complete recovery is possible, but some animals that survive may be left with chronic kidney and liver disease. Some animals may not survive if the infection has gotten to the point where it causes severe organ damage or the ability of blood to form clots.

In humans:

You can survive leptospirosis. Most cases have either very mild symptoms that go away on their own, or none at all. Without treatment, leptospirosis can cause kidney damage, meningitis, liver failure, trouble breathing, and even death. PLEASE go see a doctor if you think you're experiencing any of these symptoms, especially together.

Prevention

How can you prevent infection and protect your pets?

For dogs, there's the leptospirosis vaccine. This is an annual vaccine that vaccinates against multiple strains of Leptospira. If you're worried about your dog having a vaccine reaction, let your vet know and they can administer an injection of diphenhydramine (generic benadryl) beforehand, OR you can ask them what the appropriate dose is for your dog and give them the respective amount at home (in tablets or liquid). Vaccine reactions are uncommon, but if they do happen, it's usually immediately after exposure to the vaccine. You can ask to stick around in the lobby/waiting area of your vet clinic for a few extra minutes if you're still concerned.

Limit your dog's access to standing water. Don't let them drink from it. Prevent rodent problems where you can by properly storing food items in appropriate containers, securing your garbage, and patching up any access points into your house if you see them. Try to avoid contact with wildlife, when possible.

For humans, the recommendations remain similar. Don't wade or swim in stagnant water, ESPECIALLY if you have open wounds. Avoid contact with wildlife. WASH YOUR HANDS, often and appropriately. USE PPE if you work in a veterinary setting and properly clean and disinfect surfaces and equipment. Make sure you know or research the area that you're in if you like swimming and boating. Check to see if there have been any recent lepto infections. Cover your scrapes and wounds with waterproof bandages and wear water shoes if possible.

I hope this post answered a lot of your questions! Thanks for reading.

Sources under the cut.

Sources:

[nando161mando]

Most of you are going as this for Halloween. And it doesn't even require a costume.

https://www.reddit.com/r/HermanCainAward/

#COVID #COVIDisNotOver #COVIDisAirborne #COVID19 #eugenics #ableism

[pink-link-lemonade]

I put together a couple “Signs & Symptoms” info images for Infected Home-verse :)

Edit: I seem to forgotten a very obvious sign! Since the body is still given ‘orders’ to mutate in Type 2’s, the body is most likely to respond in height change; something less drastic than what Type 1’s go through.

Check below for the separate sketches: