“This is a fivefold increase in less than 1 month,” said Duane Gubler, ScD, MS, former director of the US Centers for Disease Control and Prevention’s (CDC’s) Division of Vector-Borne Infectious Diseases. “That’s an unusual number for sylvatic yellow fever.”
The gene, known as MCR-1, was first identified in China in November 2015 in Escherichia coli samples from pigs, pork products, and a handful of human cases. It has since been detected in more than 30 countries, including the United States. The emergence of the resistance gene was believed to be connected to widespread use of colistin in Chinese agriculture. China banned use of the drug in animal feed in 2016, based in part on the findings of that study.Though there have been few cases so far of human infections involving the gene—which has mostly been found in animals—MCR-1 has become a significant public health concern because colistin is one of the few antibiotics left that can be used to treat multidrug-resistant infections. And because the gene is carried on mobile pieces of DNA called plasmids, it can be passed not only to different strains within a single family of bacteria—such as E coli—but also to different types of bacteria.Among the most worrisome scenarios is the emergence of bacteria that harbors the MCR-1 gene along with other antibiotic-resistance genes. If the superbug carbapenem-resistant Enterobacteriaceae (CRE) were to acquire the gene, for example, it could present clinicians with infections that are nearly impossible to treat with current antibiotics.
Crook also acknowledged that reducing fluoroquinolone use by 50%—as has been done in England—will be very difficult to do in the United States, since fluoroquinolones are used widely in the US healthcare system.Brad Spellberg, MD, an infectious disease specialist at University of Southern California, agrees.”We massively overuse quinolones in the US, and, unfortunately, national guidelines have helped propagate the overuse by promoting these drugs as first line for diseases where other drugs can also be used,” Spellberg said.Spellberg said fluoroquinolones should be reserved for broad-spectrum gram-negative infections, which tend to be more resistant and harmful to humans, and should be used for less harmful gram-positive infections only when other options can’t be used.”This should become a focus of change in national guidelines, in [Food and Drug Administration] approving and labeling, and in payer, regulator, and professional expected practice,” Spellberg added.
In Latin America and the Caribbean 360 million people are overweight, and 140 million are obese, warned the United Nations Food and Agriculture Organisation (FAO) and the Panamerican Health Organisation (PAHO).“The rise in obesity is very worrying. At the same time the number of people who suffer from hunger has diminished in the region. We need to strengthen our efforts and have food systems with improved nutrition based on sustainable production methods to reduce those figures,” Eve Crowley, FAO acting regional representative, said Thursday at the organisation‘s headquarters in Santiago.
The results of this new study, which are published in Genome Biology, identified a small number of genes whose expression accurately predicts patient survival, independent of viral load.
My note: This would be somewhat limited, perhaps, to this particular version of Ebola but should be an entry point to any new versions and a test to see who needs how much of new vaccine that has been developed.
My prognosis is not good, but Obamacare gets me the treatment I need so that I can be myself as long as possible. Without this insurance, my illness would progress more rapidly, until I died.Early on Thursday morning, the Senate voted to begin the process of repealing Obamacare. On Friday, the House followed suit. A repeal of Obamacare — without even knowing what the replacement would be — obviously makes me very scared. I used to be the one helping people as a social worker. Now I’m the one who needs help.17COMMENTSIt’s not too late for Republicans in Congress to change their minds and see reason. It will be at least a few weeks before Congress formally votes on the question of repeal.If one of the last meaningful things I can do is help even one person understand how important it is for millions of people to keep their Obamacare, then my illness will have served its purpose. For that I will be grateful.
An aggressive infectionThe patient was a 70-year-old resident of Washoe County, Nevada who was admitted to an acute care hospital in August 2016 after an extended trip to India. She was given a primary diagnosis of systemic inflammatory response syndrome, likely resulting from an infected right hip seroma. The infection was serious; none of the 14 antibiotics physicians used to treat the woman worked. After the CRE—identified as Klebsiella pneumoniae, one of the more common types of CRE—was confirmed by lab testing, an isolate from a wound specimen was sent to the CDC for further susceptibility testing and to determine the mechanism of resistance. That testing confirmed the presence of New Delhi metallo-beta-lactamase (NDM-1), an enzyme that directly breaks down carbapenems, a powerful class of antibiotics that are often used to treat multidrug-resistant infections.In addition, the CDC’s antimicrobial testing showed the isolate was resistant to 26 different antibiotics, including all aminoglycosides and polymixins—another class of last-resort antibiotics. It was also intermittently resistant to tigecycline, an antibiotic developed specifically to overcome drug-resistant organisms. Essentially, there were no treatment options.
There is a major though silent global threat to human and animal health, with implications for both food safety and food security and the economic well-being of millions of farming households. It is so-called anti-microbial resistance.The problems arises from the indiscriminate, excessive use of synthetic products, such as anti-microbial medicines, to kill diseases in the agricultural and food systems, which may be a major conduit of the anti-microbial resistance (AMR) that causes 700,000 human deaths each year and has the potential to raise this number to up to 10 million annually.AMR is a natural phenomenon of micro-organisms such as bacteria, viruses, parasites and fungi that are no longer sensitive to the effects of antimicrobial medicines, like antibiotics, that were previously effective in treating infections.Nevertheless, commercial practices meant to increase benefits have been leading to the dramatic fact that these drugs are more and more used to practically solely promote animal growth.
On 6 December 2016, the Ministry of Health (MoH) in Madagascar alerted WHO of a suspected plague outbreak in Befotaka district, Atsimo Atsinanana region in the south-eastern part of the country. The district is outside the area known to be endemic area in Madagascar. No plague cases have been reported in this area since 1950.As of 27 December 2016, 62 cases (6 confirmed, 5 probable, 51 suspected) including 26 deaths (case fatality rate of 42%) have been reported in two adjacent districts in two neighbouring regions of the country. 28 cases, including 10 deaths have been reported from Befotaka District in Atsimo-Atsinanana Region and 34 cases including 16 deaths have been reported from Iakora district in Ihorombe Region.
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