Month: August 2023

Summary: Researchers found a live eight-centimeter Ophidascaris robertsi roundworm in the brain of a 64-year-old Australian woman. The parasitic roundworm, typically found in carpet pythons, was successfully extracted following brain surgery. The patient likely contracted the parasite from touching or consuming a type of native grass, Warrigal greens, contaminated with the python’s fecal matter. This alarming case raises concerns about the increasing risk of zoonotic diseases as human and animal habitats continue to overlap. Key Facts: This is the first-ever human case of Ophidascaris robertsi roundworm, which is common to carpet pythons. The roundworm was found in the woman’s brain, a first for any mammalian species. The patient likely contracted the parasite from Warrigal greens beside a lake where the python had shed the parasite through its feces. Source: Australian National University The world’s first case of a new parasitic infection in humans has been discovered by researchers at The Australian National University (ANU) and the Canberra Hospital after they detected a live eight-centimetre roundworm from a carpet python in the brain of a 64- year-old Australian woman. The Ophidascaris robertsi roundworm was pulled from the patient after brain surgery – still alive and wriggling. It is suspected larvae, or juveniles, were also present in other organs in the woman’s body, including the lungs and liver. “This is the first-ever human case of Ophidascaris to be described in the world,” leading ANU and Canberra Hospital infectious disease expert and co-author of the study Associate Professor Sanjaya Senanayake said. “To our knowledge, this is also the first case to involve the brain of any mammalian species, human or otherwise. “Normally the larvae from the roundworm are found in small mammals and marsupials, which are eaten by the python, allowing the life cycle to complete itself in the snake.” Ophidascaris robertsi roundworms are common to carpet pythons. It typically lives in a python’s oesophagus and stomach, and sheds its eggs in the host’s faeces. Humans infected with Ophidascaris robertsi larvae would be considered accidental hosts. Roundworms are incredibly resilient and able to thrive in a wide range of environments. In humans, they can cause stomach pain, vomiting, diarrhoea, appetite and weight loss, fever and tiredness. The researchers say the woman, from southeastern New South Wales in Australia, likely caught the roundworm after collecting a type of native grass, Warrigal greens, beside a lake near where she lived in which the python had shed the parasite via its faeces. The patient used the Warrigal greens for cooking and was probably infected with the parasite directly from touching the native grass or after eating the greens. Canberra Hospital’s Director of Clinical Microbiology and Associate Professor at the ANU Medical School, Karina Kennedy, said her symptoms first started in January 2021. “She initially developed abdominal pain and diarrhoea, followed by fever, cough and shortness of breath. In retrospect, these symptoms were likely due to migration of roundworm larvae from the bowel and into other organs, such as the liver and the lungs. Respiratory samples and a lung biopsy were performed; however, no parasites were identified in these specimens,” she said. “At that time, trying to identify the microscopic larvae, which had never previously been identified as causing human infection, was a bit like trying to find a needle in a haystack. “In 2022, she began experiencing subtle changes in memory and thought processing and underwent a brain MRI scan which demonstrated an atypical lesion within the right frontal lobe of the brain.” The patient was first admitted to a local hospital in late January 2021 after suffering three weeks of abdominal pain and diarrhoea, followed by a constant dry cough, fever and night sweats. By 2022, the patient was experiencing forgetfulness and depression, prompting an MRI scan. A neurosurgeon at Canberra Hospital explored the abnormality and it was then that the unexpected eight-centimetre roundworm was found. Its identity was later confirmed through parasitology experts, initially through its appearance and then through molecular studies. Associate Professor Senanayake said the world-first case highlighted the danger of diseases and infections passing from animals to humans, especially as we start to live more closely together and our habitats overlap more and more. “There have been about 30 new infections in the world in the last 30 years. Of the emerging infections globally, about 75 per cent are zoonotic, meaning there has been transmission from the animal world to the human world. This includes coronaviruses,” he said. “This Ophidascaris infection does not transmit between people, so it won’t cause a pandemic like SARS, COVID-19 or Ebola. However, the snake and parasite are found in other parts of the world, so it is likely that other cases will be recognised in coming years in other countries.” Associate Professor Karina Kennedy said the important message from this case is about general food safety, particularly when gardening or foraging for food where there may be other wildlife in close proximity. “People who garden or forage for food should wash their hands after gardening and touching foraged products. Any food used for salads or cooking should also be thoroughly washed, and kitchen surfaces and cutting boards, wiped downed and cleaned after use,” she said. The patient continues to be monitored by the team of infectious disease and brain specialists. “It is never easy or desirable to be the first patient in the world for anything. I can’t state enough our admiration for this woman who has shown patience and courage through this process,” Associate Professor Senanayake said. The researchers’ findings have been described in the journal Emerging Infectious Diseases. The research team included scientists and infectious diseases, immunology and neurosurgical doctors from ANU, Canberra Health Services, CSIRO, the University of Melbourne and the University of SydneyThe world’s first case of a new parasitic infection in humans has been discovered by researchers at The Australian National University (ANU) and the Canberra Hospital after they detected a live eight-centimetre roundworm from a carpet python in the brain of a 64- year-old Australian woman. The Ophidascaris

A new COVID-19 variant may be more likely to cause breakthrough infection, according to the Centers for Disease Control and Prevention (CDC). The CDC released a risk assessment Wednesday, breaking down information regarding the new variant. “BA.2.86 may be more capable of causing infection in people who have previously had COVID-19 or who have received COVID-19 vaccines,” the assessment read. Meaning, it may be more likely to cause breakthrough infections than previous strains of the virus. The CDC also broke down where the variant has been spotted, how severe an illness it may cause, and whether current treatments are effective against it. Here’s what experts currently know about BA.2.86. Getty Images / AzmanL Nicknamed “Pirola,” BA.2.86 was first identified on July 24, 2023. The World Health Organization recently added the new variant to its list of “currently circulating variants under monitoring,” noting that the strain has a “large number of mutations identified.” So far, nine cases of BA.2.86 have been detected—three in Denmark, two in South Africa, two in the U.S., one in the U.K., and one in Israel. One of the cases in the U.S. was a person in Michigan, with the Michigan Health Department noting in a statement on X (formerly known as Twitter) that the patient who contracted the strain is an older adult with “mild symptoms” who hasn’t been hospitalized. BA.2.86 is a subvariant of Omicron, which has been the dominant strain in the U.S. since late 2021, but “it has many, many more mutations than the mutations of each of the variants before,” Timothy Murphy, MD, senior associate dean for clinical and translational research at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences, told Health. Specifically, BA.2.86 has more than 35 amino acid changes to its spike protein than the recently circulating XBB.1.5, which the fall COVID-19 booster was based on, Murphy said. The CDC pointed out that this change is “roughly of the same magnitude” as the switch between the Delta strain of COVID-19 and the initial Omicron variant, BA.1. It’s the spike protein mutations that make this variant likely to cause breakthrough infections. “The virus uses the spike protein to bind the disease to cells,” Murphy said. “That’s what the vaccines are directed against.” With so many mutations in the spike protein, there is a greater chance that the vaccine and having previously been infected with COVID-19 won’t offer as much protection against BA.2.86 as prior strains of the virus, William Schaffner, MD, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, told Health. “Initially, officials thought that BA.2.86 was not all that much different but, now that they’ve noted there are many mutations, they’ve at least raised the question about whether there may be some immune evasion on the part of this strain,” Schaffner said. The CDC said it’s “too soon to know the real-world impacts on immunity” of BA.2.86. However, the agency noted that many people have immunity, either from previous infection, the vaccine, or both. “It is likely that these antibodies will continue to provide some protection against severe disease from this variant,” the CDC said. While testing for COVID-19 is highly encouraged, new variants can be tricky to accurately test for. “We have no lab data or experimental data whatsoever to say how this will impact immunity,” Murphy said. “It simply hasn’t been studied at this point, but likely will be soon.” Samples of the new strain aren’t broadly available for reliable lab testing at this point, but are expected to happen eventually. Meanwhile, existing treatments for older COVID-19 strains can most likely provide relief for patients who are infected with BA.2.86. According to the CDC, the mutation profile of BA.2.86 suggests that treatments like Paxlovid, Veklury, and Lagevrio will be effective against the variant. “The medications don’t target the spike protein—they go after different proteins in the virus and those do not appear to be any different,” Murphy said. Schaffner agreed. “The treatments for sure ought to work, but we’ll see whether over-the-counter tests continue to be able to detect this new variant as we go forward,” he said. Overall, it’s hard to say how different BA.2.86 is from other variants. The CDC stressed that there have just been nine cases, making it hard to know how infectious this variant is and how severe of an illness it may cause. “There’s really zero information here,” Murphy said. “With nine cases, it’s just not enough to know anything.”

Credit: CC0 Public Domain For centuries, we have known that tuberculosis is a social disease. It thrives on poverty and social factors such as malnutrition, poor housing, overcrowding, unsafe work environments and stigma. Globally in 2021 an estimated 2.2 million cases of TB were attributable to undernourishment, 0.86 million to HIV infection, 0.74 million to alcohol use disorders, 0.69 million to smoking and 0.37 million to diabetes. But knowledge about social determinants alone does not always translate into tangible action and progress. A new trial in India, called RATIONS, aimed to determine the effect of nutritional supplementation on new cases of tuberculosis in households of adults with pulmonary TB. The research found that providing food baskets to people with TB and their households could go a long way to prevent and mitigate the disease. No easy silver bullets The TB community has typically looked for biomedical solutions, or “silver bullets”, for a social pathology, and we are struggling to make progress. Since the COVID pandemic, TB mortality and incidence have increased globally, putting TB back on top as the single most deadly infectious killer of humankind. In 2021, 1.6 million people died of TB. In Africa, TB incidence is high (212 per 100,000 population) with a high case fatality rate because of the HIV epidemic. Undernutrition is the most important cause of TB. This has been shown in studies in many countries, including South Africa, where researchers found poor levels of nutrition in patients admitted to a specialized TB hospital. Malnutrition refers to all forms of deficiencies in nutrition, including over-nutrition and obesity. Undernutrition refers more specifically to a deficiency of nutrients. While we know that many patients with TB have poor nutrition, the latest evidence is that undernutrition also plays a key role in TB within households. The results of the Reducing Activation of Tuberculosis by Improvement of Nutritional Status (RATIONS) trial show that improved nutrition in family members of patients with lung TB reduced all forms of TB by nearly 40%, and infectious TB by nearly 50%. This trial recruited 10,345 household members of 2,800 patients with lung TB. All TB patients received a monthly 10kg food basket (rice, pulses, milk powder, oil) and multivitamins for six months. In one group family members received 5kg rice and 1.5kg pulses per person per month, while the other group of family members did not get food baskets. Food worked like a vaccine in this trial, cutting the risk of household members developing TB. Nutrition could also protect against other conditions such as anemia, diarrhea and respiratory infections, but these were not not the main focus of the trial. An accompanying paper, based on the results of the RATIONS trial, showed that severe undernutrition was present in nearly half of all patients. An early weight gain in the first two months was associated with 60% lower risk of TB mortality. The other benefits were higher treatment success and better weight gain. During the six-month follow-up period, a remarkable treatment success rate of 94% was achieved. Getting food to patients How expensive was the intervention? The cost of a food basket was US$13 per TB patient per month and US$4 per household member per month and could be delivered, even in rural areas, using field staff. Even before the RATIONS trial, the Indian government had recognized the need for nutrition support for people with TB, and in 2018 launched “Nikshay Poshan Yojana”, a direct benefit transfer scheme. Under this scheme, each TB patient receives a financial incentive of US$6 per month for the duration of the anti-TB treatment (typically, six months for people with drug-sensitive TB). Emerging data suggests that while the scheme improves the treatment completion rates among patients with TB in India, they often receive their payments late. There is a need to improve the efficiency and provide timely payments. The new RATIONS trial suggests that directly providing food baskets may be another effective strategy. Many countries, including India, have other social security programs, including public distribution systems to provide food grains at subsidized prices. Using existing channels to provide extra food rations to people with TB, and expanding the menu to include proteins such as pulses and millets, is a strategy worth exploring. This could also have positive effects on other diseases such as diabetes. Implications for South Africa South Africa is one of the countries labeled by the World Health Organization as a “high TB burden country”. What does this latest research mean for South Africa? Statistics South Africa reported that in 2021 2.6 million people had inadequate access to food and a further 1.1 million stated they had “severe” inadequate access to food. More than 683,000 children five years and younger experienced hunger. This toxic mix requires prevention of TB by nutritional support, drugs to prevent TB infections and early diagnosis with molecular tests and treatment. With high levels of food insecurity and undernutrition in South Africa, fueled by the highest levels of inequality, it is critical that South Africa includes social benefits for people with TB and those in their households to reduce the prevalence of TB in the country and to meet the Sustainable Development Goals for 2030. Regardless of how social benefits are distributed, action must be based on evidence. We need better tests, cures and vaccines for TB, but they alone cannot end the epidemic. TB patients must be provided with the social benefits that they need and deserve, as a basic human right. Provided by The Conversation This article is republished from The Conversation under a Creative Commons license. Read the original article. Citation: TB research shows a good diet can cut infections by nearly 50% (2023, August 28) retrieved 28 August 2023 from https://medicalxpress.com/news/2023-08-tb-good-diet-infections.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.