Thursday, May 29, 2008

Let's Look at This Closely

If I could perform a magic trick and have the ability to do something over, here is how I would and would not spend that gift:

I don't really care that the Wings have no chance of a sweep. I wouldn't want them to win the cup on the Penguin's ice. Suffice it to say, I was thrilled to see Johan Franzen (who gets his meatballs at Ikea too) get one in the net. It was a beautiful goal.


The Penguin's wanted this win more and it showed. It was a great game but the Wings didn't come to life until the third period and by that time, it was too little, too late. I wouldn't spend my redo gift here.

Looking back on my life, I'd want a major redo in my career. When I went to nursing school, it was microbiology that captured my heart. I have a love of things minuscule and tedious. This is a branch of science complete with formalities like the nomenclature or naming of organisms. It's quite formal. I love the study of microscopic critters and find their images beneath a lens that magnifies their sizes thousands of times, quite stunning. Had it been financially feasible back then, I'd have changed direction and become a bug hunter of some sort: bacteriologist, virologist, epidemiologist or immunologist. I'd probably like viruses. I've always been enamored of the study of viruses. All organisms look so amazing when under the microscope:

Here is the star of the movie (and book) And the Band Played On.
HIV on a macrophage-it looks like a photo of the universe.

This spirochete is Treponema pallidum or more commonly, syphilis. One nursing school instructor I had always gave good advice: before you say yes, turn on the lights. I can't believe that stuck in my head lo these many years later. I know I've never had it but working in this business, I've seen it. Baltimore is the #1 city for occurrence of syphilis. Detroit is 6th.

This is an absolutely stunning photo of gram positive cocci arranged in clusters. Yes, it's Staphyloccus (genus) epidermidis (species). It resides on our skin and can be a normal finding. Ordinarily this organism is not pathogenic (disease causing) but don't be mislead; this beautiful bug can infect a person and is usually resistant to penicillin and methacillin. That's not a good thing. This bug can enter the body through a catheter and produces a biofilm (slime) that adheres to the catheters and thus causes infection in the immune compromised "host".

I love the red stain used on this virus. I am captivated by the story of this bug. It's the spanish flu which was a particularly deadly Influenza A Virus strain of subtype H1N1. The irony of the Spanish flu is that it was first discovered here in the U.S and then spread to Europe. It's thought that maybe up to as many as 100,000,000 people world wide were killed by this virus. Thats a lot of zeros. It was fascinating to read The Great Influenza by John M. Barry. I'd recommend this book to anyone who is even remotely concerned about the emerging strains of influenza (H5N1-avian flu) that the scientific community is concerned about. I'd recommend it as well to people who love bugs as much as me.

This bug is the reason you really shouldn't abuse or use antibiotics you don't need (antibiotics don't kill viruses or fungi.) This is Clostridium difficile. It causes horrific colitis and even death and once again, it's in the news. I dread taking care of patients with this bug. I have to gown, glove and wash everything all day long. It takes a toll on patients and can lead to severe skin issues as well. This is one I worry I'll catch too and thats why I'm so careful. The new data coming out indicates that newer strains of this bacteria are more deadly than in the past.

So this is how I'd spend my redo. If only.


Rositta said...

C-diff has been in the news here a lot over the last week. Seems that a couple of hundred people have died recently in hospitals and not reporting it to the government. It is the talk of Question Period (Brit parliamentary system) almost daily, with the opposition parties up in arms. Bugs look pretty on pictures but I wouldn't want to catch one...ciao

Rudee said...

This infection and MRSA are pretty big problems. MRSA can now be acquired quite easily in the community (used athletic equipment,gyms,schools,etc.) Given that history, can C-Diff be far behind? Don't eat at buffets.

Dipl.-Ing. Wilfried Soddemann said...

Spread of avian flu by drinking water:

Proved awareness to ecology and transmission is necessary to understand the spread of avian flu. For this it is insufficient exclusive to test samples from wild birds, poultry and humans for avian flu viruses. Samples from the known abiotic vehicles also have to be analysed. There are plain links between the cold, rainy seasons as well as floods and the spread of avian flu. That is just why abiotic vehicles have to be analysed. The direct biotic transmission from birds, poultry or humans to humans can not depend on the cold, rainy seasons or floods. Water is a very efficient abiotic vehicle for the spread of viruses - in particular of fecal as well as by mouth, nose and eyes excreted viruses.

Infected birds and poultry can everywhere contaminate the drinking water. All humans have very intensive contact to drinking water. Spread of avian flu by drinking water can explain small clusters in households too. Proving viruses in water is difficult because of dilution. If you find no viruses you can not be sure that there are not any. On the other hand in water viruses remain viable for a long time. Water has to be tested for influenza viruses by cell culture and in particular by the more sensitive molecular biology method PCR.

There is a widespread link between avian flu and water, e.g. in Egypt to the Nile delta or Indonesia to residential districts of less prosperous humans with backyard flocks and without central water supply as in Vietnam: See also the WHO web side: .

Transmission of avian flu by direct contact to infected poultry is an unproved assumption from the WHO. There is no evidence that influenza primarily is transmitted by saliva droplets: “Transmission of influenza A in human beings” .

Avian flu infections may increase in consequence to increase of virus circulation. In hot climates/the tropics flood-related influenza is typical after extreme weather and floods. Virulence of influenza viruses depends on temperature and time. Special in cases of local water supplies with “young” and fresh H5N1 contaminated water from low local wells, cisterns, tanks, rain barrels, ponds, rivers or rice paddies this pathway can explain small clusters in households. At 24°C e.g. in the tropics the virulence of influenza viruses in water amount to 2 days. In temperate climates for “older” water from central water supplies cold water is decisive to virulence of viruses. At 7°C the virulence of influenza viruses in water amount to 14 days.

Human to human and contact transmission of influenza occur - but are overvalued immense. In the course of influenza epidemics in Germany, recognized clusters are rare, accounting for just 9 percent of cases e.g. in the 2005 season. In temperate climates the lethal H5N1 virus will be transferred to humans via cold drinking water, as with the birds in February and March 2006, strong seasonal at the time when drinking water has its temperature minimum.

The performance to eliminate viruses from the drinking water processing plants regularly does not meet the requirements of the WHO and the USA/USEPA. Conventional disinfection procedures are poor, because microorganisms in the water are not in suspension, but embedded in particles. Even ground water used for drinking water is not free from viruses.
Ducks and rice [paddies = flooded by water] major factors in bird flu outbreaks, says UN agency
Ducks and rice fields may be a critical factor in spreading H5N1
26 March 2008 – Ducks, rice [fields, paddies = flooded by water! Farmers on work drink the water from rice paddies!] and people – and not chickens – have emerged as the most significant factors in the spread of avian influenza in Thailand and Viet Nam, according to a study carried out by a group of experts from the United Nations Food and Agriculture Organization (FAO) and associated research centres.

“Mapping H5N1 highly pathogenic avian influenza risk in Southeast Asia: ducks, rice and people” also finds that these factors are probably behind persistent outbreaks in other countries such as Cambodia and Laos.
The study, which examined a series of waves of H5N1 highly pathogenic avian influenza in Thailand and Viet Nam between early 2004 and late 2005, was initiated and coordinated by FAO senior veterinary officer Jan Slingenbergh and just published in the latest issue of the Proceedings of the National Academy of Sciences of the United States.
Through the use of satellite mapping, researchers looked at a number of different factors, including the numbers of ducks, geese and chickens, human population size, rice cultivation and geography, and found a strong link between duck grazing patterns and rice cropping intensity.

In Thailand, for example, the proportion of young ducks in flocks was found to peak in September-October; these rapidly growing young ducks can therefore benefit from the peak of the rice harvest in November-December [at the beginning of the cold: Thailand, Viet Nam, Cambodia, Laos are situated – different from Indonesia – in the northern hemisphere].

“These peaks in congregation of ducks indicate periods in which there is an increase in the chances for virus release and exposure, and rice paddies often become a temporary habitat for wild bird species,” the agency said in a news release.

“We now know much better where and when to expect H5N1 flare-ups, and this helps to target prevention and control,” said Mr. Slingenbergh. “In addition, with virus persistence becoming increasingly confined to areas with intensive rice-duck agriculture in eastern and south-eastern Asia, evolution of the H5N1 virus may become easier to predict.”

He said the findings can help better target control efforts and replace indiscriminate mass vaccination.
FAO estimates that approximately 90 per cent of the world’s more than 1 billion domestic ducks are in Asia, with about 75 per cent of that in China and Viet Nam. Thailand has about 11 million ducks.

Dipl.-Ing. Wilfried Soddemann - Epidemiologist - Free Science Journalist

Rudee said...

It would seem that anything that mentions the influenza strain that is of concern right now, brings attention from all over the world. I had many hits on my site from everywhere imaginable. Although the previous comment is quite long, I find it fascinating. Thanks for the enlightenment.

Ruth said...

From the lady awaiting the "petite" socks ... take your time, please! I find the bugs most interesting, and very far afield from my legal profession. Although, I have heard that some attorneys are slime personified, or cockroaches of the first order, I have enjoyed most of the folks I have encountered.

But ... I do believe that I will be washing my hands and watching my intake a whole lot more, thank you my friend.

Rooting for the Red Wings (even though I grew up with the Boston Bruins). Interesting Blog!

Rudee said...

Awww. Tell the truth Ruth. You may have grown up rooting for the Bruins but it's really Don Cherry who holds the keys to your heart.

I am taking my time on your socks. You'll not die a quick death though I am hoping I will! Only 50% of us remain.