UK gives superbug alert outside of the hospital environment

The BBC reports that experts are warning that bugs such as MRSA have been spreading in the wider community environment. They want doctors to be alert to the most dangerous form of MRSA that can attack the lungs and may strike young people in particular.

 

Panton Valentine leukocidin (PVL) strains of community-acquired MRSA can cause a condition called necrotizing pneumonia, which destroys lung tissue.

This only affects a minority of those infected, but can be deadly.

“These new strains of bacteria appear to be able to stick to damaged skin and airways better than the hospital MRSA strains, and they can also multiply at a faster rate,” says Dr Marina Morgan, of the Royal Devon and Exeter Foundation NHS Trust.

So far these strains are mainly spreading in the US, where 12% of all MRSA cases are community-acquired, but the UK has seen an increasing number of cases.

It is unclear why children seem to be at particular risk, but the speculation is that older people in the community have fewer cuts and abrasions – a key transmission route – and have less contact with other people.

 

Nursing home threat

Meanwhile, Irish researchers are examining a new breed of bacteria which carry enzymes called extended spectrum beta lactamases (ESBLs), which are capable of destroying a many common antibiotics.

They include a strain of E. Coli, which is spreading into nursing homes and communities across Europe.

This was held responsible for a severe outbreak of cystitis, a bladder infection, in the UK between 2003 and 2004.

“Although cystitis is not life threatening, it is the most common form of urinary tract infection, and the economic consequences of failing to treat an outbreak quickly and properly are considerable,” said Dr Dearbhaile Morris, of the National University of Ireland.

“In severe infections, patients may suffer serious complications if the first antibiotic given to them does not work.”

Mark Enright, professor of molecular epidemiology at Imperial College, said he was “not surprised” by the findings.

“The emergence and spread of ESBL E. Coli does give physicians problems in providing proper initial care for some patients especially those with urinary tract infections.”

He added: “The control of infections in many nursing homes is inferior to hospitals despite the medication and specialist care required by some residents.”

 

AIDS study indicates that it arrived in USA in 1969

Aids study shows it arrived in US in 1960s – Telegraph

This is a very interesting reporting regarding the transmission of the AIDS virus from Africa and the sub Sahara regions to the USA. Initially, a Canadian airline steward was credited with the spread of HIV in the USA, however, the team of researchers from the University of Edinburgh, basing their claims on genetic analysis have shown that the probable route from Africa is through Haiti.

 

The team, which includes Andrew Rambaut at the
University of Edinburgh, based on the conclusion on genetic analyses.
The team analysed blood from five of the first Aids patients identified
in the US, all of whom were recent immigrants from Haiti. The team also
analysed genetic sequences from another 117 AIDS patients from around
the world.

 

The team used statistical methods to
investigate all the family trees that were consistent with the genetic
data. For the hypothesis that, from Africa, HIV went to the US first,
the probability is 0.003 percent — virtually nil. For the hypothesis
that HIV went from Africa first to Haiti in around 1966 and then on to
the US, the probability is 99.8 percent, almost 100 percent.

The advantage of this study is that by learning more about the genetic make-up of the various strains of HIV could help vaccine development.

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A Responsible approach to MRSA

By JEFFERSON WEAVER
Staff Writer

Health
officials hope encouraging better hygiene and following strict
protocols can prevent the MRSA virus from becoming more of a problem in
Columbus County.

Columbus Regional already has close
enforcement of hand hygiene and patient isolation rules to avoid spread
of the drug-resistant bug. The infection has been blamed for several
deaths across the country in recent weeks, and is turning up in
previously unaffected portions of the population.

Methicillin-resistant
Staphylococcus aureus, better known as MRSA or simply staph, was
previously rare outside of hospitals and nursing homes, but in recent
years the virulent strain of MRSA has begun appearing in schools,
prisons, and the general population.

Miranda
Dufour, who is in charge of Infection Control and Employee Health at
Columbus Regional, said the hospital was already on a prevention
platform for the disease, which has no vaccination of cure.

“We’ve
been monitoring it closely,” Dufour said. “That’s been the case since
2005, when we became aware this could be a growing problem.”

Community-related
MRSA, according to the state Department of Health, can be treated with
medicines. Hospital-associated MRSA, the more virulent strain, is the
one doctors are worried about.

The disease became a
major concern to health officials in the 1990s, when people with no
connection to medical facilities began showing signs of HA-MRSA.

The
variation of the disease was noticed in 2005 in North Carolina. Day
care centers and schools have been the hardest hit by the disease,
which the Centers for Disease control estimates will kill more people
than the AIDS virus next year.

MRSA infections can appear as a spider or infected insect bite.

This
changes into a “red hot pimple,” Dufour said, and may be followed by
flu-like symptoms. The disease usually causes powerful infections to
the rest of the body.

MRSA is carried by many people who never exhibit symptoms or get sick.

“A lot of people can be colonized in their skin, nose or armpits,” Dufour said, “and never show an active infection.”
The disease is spread through skin-to-skin contact, or by extended
contact with articles that carry the germ, like towels, washcloths and
razors. MRSA can also be transmitted through the handles of shopping
carts, telephones and athletic equipment.

Dufour
said medical professionals are eyeing the bug because it is appearing
in greater numbers in the general population. The hospital has taken a
strong preventative stance on the disease, Dufour said.

“We
are concerned,” she said. “MRSA has always been there, especially in
hospitals and nursing homes, but when it started moving out into other
places it became even more serious.”

The hospital already checks nursing home or long-term care patients for MRSA, Dufour said.

If
a patient tests positive for the bug – either through an active case or
by being colonized, or carrying the disease – he or she is isolated
from other patients. Staff members also wear gowns and other protective
gear whenever they treat a colonized patient.

“We also
practice strict handwashing hygiene throughout the hospital,” Dufour
said, “and we encourage anyone visiting the hospital to do the same.”

Dispensers
with alcohol-based sanitizers are set up throughout the hospital, and
some members of the staff carry individual bottles.

It’s a habit Dufour said health officials encourage for the general population, too.

“You
can get the personal size bottles almost anywhere,” she said. “There
are small ones that fit perfectly in a child’s lunchbox or bookbag, and
everyone should have some available if they go to a store or other
public place where contact is likely.”

The germ commonly turns up in infants with skin abcesses, Dufour said, and children who spend time in close quarters.

The
state Department of Health has issued special advisories on MRSA for
schools and athletic organizations, since a 17-year-old Virginia youth
contracted the disease while playing high school sports.

Several members of a North Carolina high school team were also infected recently and are being treated.
Health clubs and gyms have also been put on notice, Dufour said,
because the germ can be spread through sweat from an infected person.

Others
at risk are people with poor general hygiene, anyone who lives in a
confined space, intravenous drug users, and people with chronic
illnesses such as renal failure or diabetes.

“If you’re in generally good health, “ Dufour said, “just keep an eye on anything suspicious.”

While there is no antibiotic that can treat the disease, Dufour said there is a simple way to prevent it.

“Good
handwashing hygiene is the best preventative,” she said. “Washing your
hands in warm soapy water for 15 to 20 seconds will eliminate much of
the danger.”

Dufour said there has been a rise in calls
to area doctors about the disease, especially from concerned parents
and people who notice insect bites.

“Not every bite or
pimple is MRSA,” Dufour said. Keep any suspicious wound clean, dry and
covered, Dufour said, and if there is no improvement in a few days,
“call your doctor.”

The wound will then be drained and
the infection tested to determine if the patient has staph, Dufour
said. Sometimes the problem can be treated with draining by a doctor.

The disease has historically struck older people, Dufour said, but the
new strain is increasingly taking aim at young people, especially
children.

To
avoid spreading the disease, the hospital has also asked that parents
not allow young children to crawl into hospital beds with patients.

“You
hate to have to say something like that,” Dufour said, “but if a person
is infected, and a little one crawls into bed with grandma – then you
have two infected people, not just one.”

Both the U.S. Centers for Disease Control and the state Department of Health have set up a special website on MRSA.

For more on diagnosing and preventing the spread of the disease, go to
the state site at www.epi.state.nc.us/epi/gcdc/ca_mrsa, or the federal
site at www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.html.

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4 infants died – the police case against the mother collapses because of inadmissible evidence

Has Justice been served for this mother, who had 4 children and lost all of them for an unknown reason?

 

CAROL Matthey entered the Supreme Court yesterday charged with murdering her four small children, one by one, over five years.

Police said she deliberately suffocated them, partly in order to sustain her troubled relationship with her husband, Stephen Matthey, the children’s father.

But yesterday, the criminal case against Mrs Matthey, who has always denied she harmed her children, collapsed.

Fifteen minutes after she arrived, Mrs Matthey left the court free, cheerfully accepting congratulations. In an extraordinary end to one of the most dramatic cases in Victorian legal history, prosecutors dropped the charges because much of the evidence gathered against her was ruled inadmissible.

A case that involved a three-year police investigation, thousands of pages of statements and 160 witnesses — and a case that dominated four years of Carol Matthey’s life — was suddenly over before it reached trial.

After she left the court, Mrs Matthey walked along William Street smiling, declining to answer reporters’ questions until this one: “Are you not guilty, Carol?”

“No,” she said firmly.

The reporter pointed out the double negative and asked for clarification. Did she mean she was innocent? “Yes,” she said, chuckling, amused at the misunderstanding. Then she walked off the public stage and into the rest of her life.

The Supreme Court case against Mrs Matthey ended as a result of pre-trial hearings before Justice John Coldrey. In a complex 94-page judgement on October 12, he found most of the proposed evidence inadmissible under the law.

In legal terms, this is not an acquittal. A defendant against whom charges are withdrawn is not protected by double jeopardy and, theoretically, faces the prospect of another trial if new evidence emerges.

Mrs Matthey, 27, of Geelong, lost four children between 1998 and 2003. Jacob was seven months old, Chloe nine weeks old, Joshua three months and Shania three years and four months. At her committal hearing in March 2006, Mrs Matthey’s defence argued there was no physical evidence of harm done to any of the children. Her lawyers said it was possible the children shared an as-yet-undiscovered gene that caused a medical condition, such as a fatal cardiac arrhythmia, that led to their deaths.

Police yesterday declined to comment. The acting director of public prosecutions, Jeremy Rapke, QC, said the case was irreparably damaged when the judge deemed inadmissible much of the medical evidence.

Initially, Jacob and Chloe Matthey were found to have died from Sudden Infant Death Syndrome, and Joshua of klebsiella septicaemia. A police investigation began after the death of Shania, who was too old to have died of SIDS, and for whom no cause of death could be found. At the committal hearing, experts acknowledged SIDS was a “diagnosis of exclusion” — the cause of death used for babies when no other cause can be found. They said there were often no forensic clues that would differentiate natural SIDS from deliberate suffocation.

This left much of the expert medical evidence at the committal heated and contradictory. Four local forensic pathologists strongly argued the autopsies revealed no scientific evidence of harm to any of the children.

But a pediatrician from South Australia who specialized in SIDS, Dr Susan Beal, and a forensic pediatric pathologist from the US, Dr Janice Ophoven, were equally vehement homicide was the most likely explanation.

They argued that “scientific” evidence included the lack of risk factors for SIDS in some of the children; the rarity of four such deaths in one family; the troubled marriage; and the fact that the children had experienced “ALTEs” — apparent life-threatening episodes in which they stopped breathing or were found unconscious.

Dr Beal said: “ALTEs are not a predictor for SIDS; they’re a predictor for (homicide).”

Justice Coldrey ruled out most of the evidence of these two witnesses.

The conflict between the experts meant the Crown case relied on other evidence, such as Mrs Matthey’s relationship with her husband and children.

Justice Coldrey said the Crown had submitted that, particularly at times of ALTEs or deaths among the children, the marriage was under severe strain.

“Moreover, it is asserted that the relationship of Mrs Matthey to her children, evinced by unwanted and unplanned pregnancies, mediocre parenting and indifference to their deaths, would enable a jury to infer they were the unfortunate pawns in this strategy to bolster her marital situation,” he wrote.

Justice Coldrey found there was no discernible link between the timing of marital crises and the ALTEs or the deaths: “There is no foundation for the contention that the killings were designed to win back Stephen Matthey’s love and affection.”

While there was evidence of poor mothering, the judge wrote, other reports painted a picture of a woman “who was a concerned, caring and loving mother during the children’s lives, and a distressed and grieving one when they died”.

Mrs Matthey’s lawyer, Paul Lacava, SC, said there were no winners in the case. “Mrs Matthey and her husband have lost their children and their sadness is profound and ongoing.

 

I find it very strange that it used to be accepted if one baby died from SIDS then there was a chance that further babies could die from SIDS, yet these two women “experts” on a mission claim that it is impossible and that the deaths must be homicide. If this mother did in fact kill her children, then both of these “experts” have done a lot of harm to the prosecution case. The local pathologists, who had more than likely examined the bodies of the babies indicated that there was no scientific evidence of harm being done to the children. Why then should the Prosecution be allowed to build a case based upon the evidence of “experts” who had not performed any forensic pathology on the children. The Judge did the right thing striking down the charges. Carol Matthey does not walk away from the court as a totally free woman, because she could be charged again, but at least justice is seen to be done when a case that is not based upon fact, but upon “experts with a mission” has been struck down because of the lack of real evidence that would lead to a conviction.

Cleaning products linked to adult asthma?

A Spanish study involving more than 3500 people has determined that there is an increased risk of adults developing asthma from the use of household cleaning products (now that is the truth!). The study was published in the American Journal of Respiratory and Critical Care Medicine.

The study found that using household cleaning sprays and air fresheners as little as once a week raised the risk of asthma in adults. The risk of developing asthma increased with frequency of cleaning and the number of different sprays used.

The report from the BBC News indicated that the heavy use of such products has already been linked with occupational asthma, but this study indicates that the occasional use of chemical sprays in the home is also a threat for those who are susceptible to respiratory illness.

The type of products that tend to cause these problems include furniture polish (such as Mr. Sheen) and window sprays (such as Windex).

Personally, I would also add the use of mould killers and fly sprays because these can also have an effect upon the development of asthma within the home.

At this stage it is not known what irritants are the cause of the development of respiratory symptoms.

Chemicals at home and at work can have an effect upon anyone who has respiratory sensitivity. This is something that to me is not new, since I have had reactions to Mr. Sheen, Windex, and Mortein fly spray, as well as to the most popular mould killer. In the case of the mould killer it was the strength of the chlorine in the product and the fact that it was being sprayed in tiny droplets that was the cause of my distress. When this happened to my, my upper airway passages would block off, and I could not breathe unless I had something over my face. I have also reacted to paint fumes, methylated spirits and similar products. On the other hand, I have not had such a severe reaction when using the pump sprays. Another product that I would add to the mix is hair spray, since this can also cause allergy in a highly sensitive person.

Obviously there is work to be done in identifying the irritants, but at least now there is a study that proves what I have said for more than 30 years regarding cleaning products and other chemicals in the home – they are responsible for my respiratory reactions.

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Drugs and mental illness ‘go hand in hand’ | NEWS.com.au

Drugs and mental illness ‘go hand in hand’ | NEWS.com.au

Former rugby Newcastle Knights player, Andrew Johns has admitted his drug habit on national television. A few days later, the psychiatrist treating Andrew Johns stated that Johns has Bipolar disorder and that “he is not to blame” for his condition. However, I am not certain that the psychiatrist is seeing what is obvious to most people – that there appears to be a connection between the Bipolar Disorder of Andrew Johns and his drug taking habit.

Today I saw this article which is a report on a conference that is dealing with the twin problem of substance abuse and depression. There are at least 500,000 Australians who suffer from depression and at the same time they have a drug problem. One woman at the conference spoke about the problems of getting treatment for her son because the “system” has not been able to cope with treating both conditions at the same time:

“SUBSTANCE abuse and mental illness go hand-in-hand for hundreds of thousands of people and more options are needed to treat the problems together, a conference was told today.

The Anex Illegal Drugs and Mental Health Conference in Melbourne was told that separating drug use and mental health treatment put lives at risk.

Jo Buchanan, whose son Miles had depression and substance abuse problems, said that for more than 15 years Miles was shunted from psychiatric wards to drug rehabilitation units, never able to be treated for both problems at once.

“One after another, one they would deal with depression, the next one would deal with the drugs, but never at the same time,” Ms Buchanan told the opening day of the conference which is being conducted by Anex – the Association for Prevention and Harm Reduction Program.

“Usually he was released prematurely from the hospital psychiatric wards before the effects of the anti-depressants had taken place, so he would come out and as soon as he succumbed to the depression, he turned to the drugs again, so next thing he’d be in rehab.

“But you could not go into any rehab place if you were on anti-depressants. They would not accept you, so he had to go off the anti-depressants to be treated for his drug problems.”

She said that during this period, Miles attempted to kill himself several times.

Mental Health Council of Australia chief executive David Crosbie said 500,000 people were facing mental illness and drug problems together.”

I suspect that this is an extremely common problem and it has not been taken seriously for many years. One of the difficulties in getting the right treatment stems from the propaganda of the pro-marijuana crowd who refuse to acknowledge and accept that smoking pot can in fact cause mental illness in some patients. As a result of that propaganda pot was portrayed as a harmless social drug. The truth that was avoided for so long is that for some people with a highly addictive personality any drug of addiction is harmful. The person craves a high, and he or she might start with pot, but inevitably that person ends up on something harder, including heroin and ecstasy.

Andrew Johns was caught with one ecstasy tablet. He has admitted that he intended to take the tablet. This does not make sense because ecstasy is known to be harmful, and it can kill, and yet Andrew Johns was prepared to ignore the fact that ecstasy is a killer drug. After the psychiatrist came out with details of Andrew Johns having Bipolar Disorder, Matthew Johns admitted that his mother had been concerned about her son’s behaviour when he was still a teenager. In hindsight, the behaviour could have been a clue that Andrew Johns was taking drugs since his teen years.

Without doing the necessary research on Bipolar Disorder, I cannot be 100 per cent certain that I am on the right track but I certainly think that there is possibly a real link between the taking of recreational drugs and this form of mental illness. Not all people who are diagnosed with Bipolar Disorder have been on recreational drugs, but I would like to see the statistics on what percentage of patients affected have a history of drug taking. This would open up further questions as to what came first: Bipolar Disorder or drug taking. I suspect that the drug taking came first.

There are many causes for depression and most of the causes are traceable to personality traits and attitudes towards daily life. People who have unrealistic expectations are more likely to end up being depressed. The stressors of life can cause mental illness, especially if the person does not have a fully developed coping mechanism, i.e. a positive mental attitude. Bipolar Disorder is the more serious form of depression because the individual suffers highs and lows. It is not difficult to see that a rugby player of the stature of Andrew Johns had difficulties with the highs and lows of the rugby game. Without a doubt, his drug taking habit has contributed to his mental illness. From this point of view, I do believe that Andrew Johns is responsible for his current condition.

Without a doubt, people with these problems need a treatment that takes both factors into account, and that includes not going soft on the drug taking habit. Nothing is achieved by telling the patient that his mental condition is not his fault. It is for this reason that I believe that the incorporation of a 12 step program in the rehabilitiation process is very necessary. The mentally ill patient needs to admit responsibility for past actions and without the admitting of responsibility the patient is not capable of moving forward or being cured. Perhaps Mr. Johns has taken that first step, by going on TV and admitting that he has a drug habit and that he was taking drugs over the period of his rugby career. However, this is only the first step on the road to recovery. If Andrew Johns can move forward to the point that he can prove that he has been cured, then perhaps he really will become a good example to others who are struggling with Bipolar Disorder and a drug habit.

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