Monday 27 July 2015

Disease, the Ecology and Climate Change in North America

Texas City Waits Hours Before Issuing E.Coli Warning
Officials in the city of Corpus Christi, Texas, did not warn its residents of an E.coli contamination in their water supply until several hours after confirming it.

25 July, 2015

According to the Texas Commission on Environmental Quality, the city released the information at 9 a.m. on Friday – 7.5 hours after establishing the bacteria’s presence. Under state law, the city had until 9 a.m. to issue the warning.

At 10 a.m., the city asked if it could issue a water boil in the Flour Bluff only, but TCEQ declined the request because the city could not confirm that Flour Bluff was the only area at risk.

Dangerous enterohemorrhagic bacteria E. coli
Dangerous enterohemorrhagic bacteria E. coli

According to TCEQ, the city limited the scope of the danger in order to keep as many businesses and restaurants open.

Dr. Keith Rose, a local doctor, said the city should have taken the risk more seriously.

"It seems to make sense to me, common sense, that you would let everyone know there's a chance that this could be out there,” Rose said. “We'd like you to start boiling your water now. We'll confirm it and let you know later, because the downside to this is you're going to have a lot of sick people, and you can overload the emergency rooms, the healthcare system."

However, the doctor did not condemn the city’s actions entirely.

"It's easy to be an armchair quarterback, and I don't have all the information, but I can tell you that from a medical standpoint, we'd like to know. And I'm sure the folks of Corpus Christi would want to know as soon as possible," Rose said.

This is not the first time municipal officials have faced controversy surrounding the city’s water supply. In 2007, TCEQ fined the city for waiting two days before alerting residents of an E.coli contamination. That event led to the resignation of a former water director

Deadly Brain-Eating Amoeba: Naegleria Fowleri Found In New Orleans Suburb’s Water Supply

16 September, 2013

A horrifying announcement was made Wednesday by the Louisiana Department of Health and Hospitals. 

 The deadly brain-eating Naelgeria Fowleri Amoeba has once again been found in the water supply in two of the seven water sites that supply St. Bernard Parish, a New Orleans suburb that was devastated by Hurricane Katrina 10 years ago. 

In 2013, a 4-year-old Mississippi boy became infected while playing on a slip ‘n slide – he didn’t survive. 

Three people have perished over the years in St. Bernard Parish due to this insidious amoeba which has led to two lawsuits against the treatment facilities, according to the Daily Mail. 

The water is safe to drink, however officials are urging residents to not get the water into their noses. 

The deadly amoeba enters through the nose and for reasons not yet clear, can attach itself to nerves that send smell signals to the brain. It then multiplies causing brain swelling and infections which is said to be deadly 97 percent of the time. 

NBC News reports that while both stations tested positive for the amoeba, only one is suspected to have been from contaminated ground water which may have leaked in after a car hit the station, causing damage. 

The DHH Safe Drinking Water Program staff has said that “The second positive test occurred at 948 Angela Street,” and “Chlorine levels at the site of the positive sample did meet the 0.5 mg/l requirement.” 

One positive test was at a site at the water treatment plant before the water was treated. The second positive test occurred at 948 Angela Street, which may have been contaminated by ground water due to a leak at the sampling station. 

Chlorine levels at the site of the positive sample did meet the 0.5 mg/l requirement. 

The St. Bernard Parish population has never return to its numbers since Hurricane Katrina, which has led to the less-used water supply to become warm and stagnant; a perfect breeding ground for the Naegleri Fowler. 

Olivia Hwang, a health department official, says “Use is good because it pushes new water through the system.” There are a number of parts of St. Bernard parish that still don’t have the same levels of population since Hurricane Katrina. 

Use is good because it pushes new water through the system. And while Hwang says they’re putting extra chlorine into the water – chlorine kills the amoeba – there are several steps you can take to protect yourself in the mean time: 
  • DO NOT allow water to go up your nose or sniff water into your nose when bathing, showering, washing your face or swimming in small hard plastic/blow-up pools.

  • DO NOT jump into or put your head under bathing water (bathtubs, small hard plastic/blow-up pools); walk or lower yourself in.

  • DO NOT allow children to play unsupervised with hoses or sprinklers, as they may accidentally squirt water up their nose. Avoid slip-n-slides or other activities where it is difficult to prevent water going up the nose.

  • DO run bath and shower taps and hoses for five minutes before use to flush out the pipes. This is most important the first time you use the tap after the water utility raises the disinfectant level. And in other water related news, watch out for beach fecal contamination.
High Levels Of Antidepressant Meds In US Water Making Wildlife Sick
New research suggests that one of the most commonly prescribed antidepressants in the United States, Prozac, is altering the behaviour and physiology of birds.

22 July, 2015

With 9% of all Americans taking the antidepressant, wastewater in the US is contaminated with the drug, and has subsequently been exposed to animals. reports:

The study in question concluded that wild starlings, when fed wax worms injected with levels of fluoxetine (the generic name for Prozac) equivalent to what the birds might be exposed to by “feeding on invertebrates at a wastewater treatment plant,” showed “conspicuous changes in foraging behavior.”

That’s right—birds are getting dosed with Prozac by eating worms in your poo.
Pretty gross, yes; but why does it matter? According to Dr. Kathryn B. Arnold, one of the researchers involved in the study, wild starlings that ingest too much fluoxetine alter their instinctual feeding patterns from two large meals a day to continuous “snacking.” Arnold told The Guardian that this change in feeding habits could affect the species’ ability to dramatically modify its weight in accordance with the seasons—fat for winter, trim for summer. Continuous ingestion throughout the day generally makes for heavier birds all year round, which also makes it more difficult for individuals to escape predators. Prozac, in effect, might wipe out populations of starling in and around waste-treatment plants, which could be devastating to local ecosystems, given that starlings are such avid insectivores.

Birds aren’t the only creatures at risk for Prozac-induced problems. In 2010, National Geographic reported on a study in Aquatic Toxicology which linked high fluoxetine levels in coastal waters with erratic behavior in shrimp. “Shrimp normally gravitate toward safe, dark corners. But when exposed to fluoxetine, the animals were five times more likely to swim toward a bright region of water,” the study found; leaving them at abnormally high risk for predation. Shrimp are a staple of coast-water ecosystems, particularly in fragile estuary zones. A drop in population would be devastating—and all too likely if shrimp continue to get hopped up on dissolved Prozac.

Trace aquatic levels of other drugs—particularly endocrine disruptors like birth control pills, steroids, and tamoxifen (for hormone therapy)—are contributing to a population-rise in “intersex fish,” disrupting mating patterns and unbalancing populations of breeding-age adults. According to a 2013 article in Nautilus, “In studies done all over the world, normally male fish downstream of wastewater plants appear to be growing ovary tissue in their testes, while female fish have been found with sperm-producing nests in their ovaries instead of eggs. The chemicals also affect sexual differentiation in the womb, tilting the balance of male to female fish dramatically. In one study conducted downstream of Boulder’s wastewater treatment plant, researchers found a 10 to 90 ratio of male to female fish.”

An upset in the sex-ratio of breeding-age fish could contribute to massive population decline; affecting everything from the smaller fish and microbes they feed on (overpopulation), to pescavores like the American grizzly bear (starvation). So how do we head this problem off? What can we do? We’re not going to ask nearly half of all Americans to suddenly stop taking any and all environment-altering drugs—we need a practical alternative.

One such alternative might entail an update to our wastewater treatment plants. The World Health Organization (WHO) has identified a number of technologies and chemical processes (pdf) than can effectively remove up to 99% of pharmaceutical traces from wastewater—nanofiltration, reverse osmosis, ozonation, and advanced oxidation (pdf).

We can also modify how and where we treat wastewater. WHO suggests: “Preventive measures, such as policies promoting or regulations governing disposal practices at concentrated point sources (e.g. health-care and veterinary facilities), can reduce the amount of pharmaceutical waste entering water bodies. In addition, take-back programmes, guidance and enhanced consumer education will support efforts for the proper disposal of medicines and reduce the impact of pharmaceuticals entering our water sources.”

It’s worth noting that an excess of substances like fluoxetine in bodies of water isn’t all doom-and-gloom, however. A 2013 article in National Geographic cited a study conducted in Lake Erie which found that concentrations of dissolved Prozac was killing off E. coli-carrying bacteria.

But it’s nevertheless important to weigh the benefits of pharmaceutical intervention—not only in how they affect our personal bodies, but how they affect the environment once they leave them. Shrimp and birds, and other animals, are happiest when their habitat and planet is as undisturbed as possible. save the happy pills for making people happy.

Correction: A previous version of this post claimed that 48.9% of Americans used antidepressants at least once a month between 2009 and 2012. That figure refers to all prescription drugs. Nine percent of Americans reported using prescription antidepressants at least once a month during those years.

Not Just Lyme Disease Anymore': 7 New Reasons To Fear Ticks This Summer

10 July, 2015

BOSTON A father of four boys, Michael Vitelli of Marshfield Hills, Mass., lives a high-energy, outdoor and active life when he’s not at work. He fishes, he hikes, he golfs, he can even boast a running streak of 642 days in a row.

But last month, on what would have been day 643 of running, a tick brought him to an excruciating halt.

After feeling achey for a few days, Vitelli suddenly got too sick to get out of bed, as if with a summer flu — fever, sweats and chills, headache. Then he got even sicker. His test results looked dire: protein and bile in his urine;  liver function gone haywire; platelets, red and white blood cells down so low that his chart looked like he had leukemia, a doctor told him.

The diagnosis, after three days in the hospital: anaplasmosis, an infection borne by the same deer ticks that carry Lyme disease. It’s up dramatically in Massachusetts: About 600 confirmed and probable cases statewide last year, compared to closer to just 100 in 2010.

Never heard of it? Neither had Vitelli. Naturally, he’d heard of Lyme, which has spread across much of the country in recent decades and now infects an estimated 300,000 Americans a year at least, mainly in New England and the Midwest.

But like most people, he didn’t know that ticks can carry a whole array of nasty bugs — with obscure names like babesiosis and Borrelia miyamotoi — and that, though much less common, they, too, are on the rise, following more slowly behind the inexorable march of Lyme diseчase.

(Source: Massachusetts Department of Public Health)
(Source: Massachusetts Department of Public Health)

In worst-case scenarios, some of these infections can kill people, usually those who are old or have an underlying condition. Deaths are very rare; what’s not rare is for patients to get much more acutely, severely ill than is typical for Lyme disease.

Those little ticks,” Vitelli says with the voice of bitter experience. “They can really wreak havoc with the body.”

It’s peak season for Lyme disease right now, and for these other infections as well. If the risk of Lyme hasn’t been enough to prompt you to take the recommended measures against ticks — repellent, tick checks — perhaps awareness of these rising new risks will add impetus. Public health officials also call for vigilance about persistent summer fevers with no other obvious explanation, and for greater awareness that they can be caused by bugs other than Lyme.

If you live in an area where there’s Lyme disease, you should be aware of these other agents,” says Dr. Peter Krause, a tickborne disease expert at the Yale School of Public Health. “And that’s true throughout the United States.”

It’s also true for doctors. “If you’re thinking about Lyme disease, you should think about these other diseases, too,” says Dr. Larry Madoff, director of epidemiology and immunization at the Massachusetts Department of Public Health, who recently helped treat a case of anaplasmosis in central Massachusetts. “And even if you don’t see Lyme disease, if you have a patient who reports tick exposures or lives in an area where there’s a high prevalence of these diseases, you should think about these as well. And they are treatable,” with antibiotics.

At the risk of being accused of scaremongering, here are seven new reasons to fear, loathe and avoid ticks more than ever this summer, based on news about these more acute infections:

1. Pronounced me-ya-moe-toe-eye: 

Researchers keep finding new tickborne bugs, like Borrelia miyamotoi, which was first reported in 2013 and causes flu-like feverish illnesses so severe that a recent study found that about one-quarter of patients who tested positive for it had landed in the hospital.

About 14 percent of patients who had it also tested positive for the bacterium that causes Lyme disease. The findings suggest that Borrelia miyamotoi “may not be a rare infection in the northeastern United States,” the authors write.

2. No Relaxing In August

An editorial co-authored by Dr. Krause that accompanies that study begins with this punch: “It’s not just Lyme disease anymore.”

It notes that “the peak incidence of positive assay results for B. miyamotoi was in August, with probable onsets of illness continuing into September, which is about a month after the peak incidence of Lyme diseчase.”

That timing suggests that ticks still in the larval stage are the culprits: “Bites from larval deer ticks have not been considered as a health threat, but this needs to be reevaluated.”

In other words, even tick babies are bad. And the period of peak tick vigilance may need to be extended from summer into fall. (Already, some ecologists are calling for heightened tick vigilance in the Northeast earlier in the spring, starting in April.)

3. Going Where Lyme Goes, But Later

The ecological backstory of the rise of tickborne bugs, Dr. Krause explains, is this: As the forests returned to New England in the 20th century, so did the deer, and with the deer came infected ticks. Lyme disease is transmitted more readily than the other infections, and it can be carried by birds, he says, so it spreads faster.

Dr. Alfred DeMaria, medical director for the Bureau of Infectious Disease at the Massachusetts Department of Public Health, singles out the white-footed deer mouse as another culprit in the infections’ spread. In the springtime, he says, young “nymph” ticks are out infecting the mice with the bacteria, and the rodents amplify the infection rates.

There are more and more of these mice in the fragmented forest environment that we’ve created,” he says, “through the suburbanization of the state. And now we’re seeing the consequences of that.”

Bottom line: If you’re in an area with Lyme — and that means all of Massachusetts and much of the Northeast from Virginia to Maine — other infections are likely.

4. In The Blood

Also to be filed under “tick infections that are not so rare anymore”: babesiosis. The rise in its prevalence looks very similar to anaplasmosis:

(Source: Massachusetts Department of Public Health)
(Source: Massachusetts Department of Public Health)

It is the No. 1 infection spread by blood transfusion in the United States, Dr. DeMaria says, to the point that the FDA is expected to recommend screening blood from high-prevalence states like Massachusetts for it, and possibly the entire national blood supply.

5. Climate Change

You knew this was coming. Among the countless other problems it’s creating, climate change is extending the habitats of ticks and thus of the infections they carry. Case in point: The Vineyard Gazette on Martha’s Vineyard cites multiplying reports of Lone Star ticks on the island this year. Lone Star, that is, as in Texas. Under the headline “Lone Star rides into town,” it reports:
While it’s premature to say if the Lone Star tick has colonized on the Vineyard, anecdotally and on social media, many Islanders have reported finding them for the first time this year…Unlike deer ticks and dog ticks, the Lone Star tick is an aggressive predator. “They’re nasty; they have eyes, unlike deer ticks that are blind,” [tick biologist Sam] Telford said. “They can see you and come after you.”

Until recently, the Lone Star tick was primarily found south of the Mason-Dixon Line. But as the climate has warmed, the infectious insect has spread its range. The Lone Star tick has now colonized on Cuttyhunk, Nashawena, and Prudence Island.
Lone star ticks carry quite a few diseases, Dr. Madoff notes, among them Ehrlichiosis, tularemia, and Rocky Mountain spotted fever. (Massachusetts just had a case of Rocky Mountain Spotted Fever, he says, though it’s not known which tick spread it.)

6. Scariest Of All

I recently asked Dr. Harriet Kotsoris, chief scientific officer of the Global Lyme Alliance, what scares her most in the world of tickborne infections. Her reply: Powassan Virus.

It remains exceedingly rare — only about 60 confirmed cases nationwide over the last decade — but, she says, it’s like equine encephalitis in that it “has a predilection for the central nervous system, and it carries a 10 percent mortality rate.”

And unlike anaplasmosis or babesiosis, which respond well to antibiotics, it has no treatment.

There have been about five cases in Massachusetts since 2013, the Worcester Telegram reports.

And here’s the worst part: It’s generally thought that the Lyme disease bacterium infects a person only if the tick has been feeding on them for at least 24 hours; Powassan is believed to need only 15 minutes.

7. Even The Healthiest

Dr. David Katz (courtesy)
Dr. David Katz (courtesy)

Though the more acute tickborne infections tend to kill people who are older or physically weaker, they can hammer even the healthiest.

The ultimate cautionary tale comes from Dr. David Katz, director of the Yale University Prevention Research Center and president of the American College of Lifestyle Medicine. He’s one of the country’s leading voices on the medical importance of healthy behaviors like good diet and plenty of exercise, and he practices his preachings in his personal life in woodsy Connecticut, from horseback riding to hiking to gardening.

So it was a shocking departure from his usual wellbeing when he fell desperately ill last month. “I became so sick that I couldn’t lift my head off the bed, I could barely turn my eyes,” he recalls. “I had shaking chills, drenching sweats, crushing headache.”

Like Michael Vitelli, Dr. Katz was diagnosed with anaplasmosis. He writes about the experience here, and he says that though he had long practiced Lyme disease prevention, “this was a bracing reality check for me, too, because this was a serious infection. I haven’t been this sick — well, I never have been this sick, frankly, and I don’t want to experience it again any time soon.”

Dr. Katz sees multiple lines of anti-tick defense — covering up outdoors, showering when he comes indoors, checking for ticks –but he says it’s also important “to recognize that those defenses are imperfect, a tick may slip through, and if you start to get characteristic symptoms, get checked out.

Michael Vitelli, too, emphasized the importance of knowing your body and seeking prompt help when something feels really off. And his experience made him wonder, he says, what’s being done to eradicate ticks.

Not much, according to a report this April by the New England Center for Investigative Reporting: “Despite Spread of Lyme Disease, Mass. Dedicates No Money To Prevention.

It remains to be seen whether the rise of potentially fatal tickborne infections will affect that policy — or rather, that lack of policy.

Doctors concerned, cases of Lyme disease increase in Ontario

25 July, 2015

Saturday, July 25, 2015, 3:28 PM - Eastern Ontario has seen a surge in cases of Lyme disease over the past few years.

Lyme disease is a bacterial infection transmitted by ticks infected with borrelia bacteria. Woodland animals like white-footed mice, raccoons, skunks, foxes, or deer pick up the bacteria, and ticks contract it by biting infected animals.
An infected tick then passes it on to humans by burying its head into our skin.
But not all ticks carry Lyme, and most people with tick bites don't necessarily contract the disease.
The illness is commonly spread through the bite of blacklegged ticks. And the longer the tick is attached to the body, the higher the risk for contracting the disease.
Now, doctors worry about how people are getting rid of ticks after being bitten.
Anne Marie Allart, a doctor with the University of Ottawa health services, tells the CBC she's seen many people who don't know what to do with ticks, post-bite. Allart says about 90 per cent of her patients have removed the bug incorrectly..
"I've seen it all. Lighting a match, pencils, fingernails, needles, everything they shouldn't be doing," Allart says, adding that she finds these reactions surprising, especially with the rapid increase of reported cases of Lyme disease.
"[I]f they leave body parts in, or if they squeeze, that can release the bacteria in the skin and make them sick.
 photo Ticks embed_zps4k44c5vu.jpg

So what's the right way to dispose of a tick? Allart tells the CBC that the key is a pair of tweezers.
"Grab the part of the tick that's closest to the surface of your skin and pull up gently without twisting. And make sure to wash your skin with soapy water immediately after.
According to veterinarians, pet owners know how to dispose of ticks better than others. Doctor Kevin McIntosh at Algonquin Animal Hospital says so far, his team has pulled two dozen ticks off pets this year, the CBC reports.
The animal hospital is currently handling 17 cases of animals with Lyme disease. McIntosh recommends that pet owners give their animals a "good rub down" from head to tail after walks in bushy areas.
"Behind the ears, around the face, anywhere where its east to bite is where the ticks will be signoff," McIntosh tells the CBC.
Here is a list of some common symptoms of Lyme disease, along with preventative measures to stay safe from infected ticks this season, courtesy of the Canadian Lyme Disease Foundation.
  • Flu-like symptoms: headaches, fever, nausea, jaw pain, light sensitivity, muschle aches
  • Large, bulls-eye type rash
  • Diarrhea, upset stomach
  • Bone or joint pains
  • Shortness of breath
  • Poor balance, dizziness
Prevention and Protection
  • Wear light-coloured clothing to spot ticks.
  • Avoid low-lying brush or long grass, walk on pathways and trails.
  • Check clothing regularly for ticks -- they climb upwards towards exposed skin.
  • Wear long-sleeved shirts and long pants when possible.
  • Apply insect repellent to skin and clothing, covering all areas of open skin (e.g. ankles, wrists, neck.)

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