Category: Infection

Emergency departments at Calgary hospitals have been flooded with children following an infectious disease outbreak at daycares across the city. Alberta Health Sevices (AHS) confirmed that multiple children arrived at the Alberta Children’s Hospital with bloody diarrhea over the Labour Day long weekend, and that they are dealing with an E.coli outbreak. The outbreak is believed to have originated at a central kitchen that is shared by six locations of Fueling Brains, a daycare that operates multiple locations in Calgary, as well as five additional institutions, AHS said in its statement. CBC News has reached out to Fuelling Brains. The company said they will respond on Tuesday with more information. 12 patients hospitalized In its statement, AHS said that there are 17 lab-confirmed cases that have been linked to the outbreak, as well as 12 individuals hospitalized. Up to 50 children have come to hospitals, AHS said. “A lot of these kids, unfortunately, have to be admitted for 24 hours,” said Dr. Arun Abbi, president of Emergency medicine with Alberta Medical Association, told CBC News in an interview. “They’ll have to make sure there’s no kidney damage.” All of the sites linked to the central kitchen where the outbreak came from have been issued a closure order until the situation is resolved. They include: Fueling Brains Braeside. Fueling Brains West 85th. Fueling Brains New Brighton. Fueling Brains Centennial. Fueling Brains Bridgeland. Fueling Brains McKnight. Braineer Academy. Kidz Space. Little Oak Early Education (formerly Mangrove). Almond Branch School. Vik Academy in Okotoks, Alta. Katie Mclean, whose daughter goes to the McKnight location of Fuelling Brains, said she started noticing symptoms late last week. “She was sent home with a very low fever and then over the next couple of days, there was blood in her diarrhea and that was the thing that tipped us off to call Health Link,” she said, referring to a phone line that provides health information and advice. “We went to the ER on Sunday. It was filled with parents and toddlers …I overheard some other parents talking about an outbreak and their daycare.” Mclean said that she has not heard anything from the location her daughter attends about an outbreak yet. In a letter addressed to parents of the New Brighton location obtained by CBC News, the daycare asks parents and guardians to make sure their children “urgently” seek medical attention if they display any symptoms of gastrointestinal outbreak symptoms. Symptoms include nausea or vomiting, diarrhea, stomach cramps or pain, bloating or gas, loss of appetite, fever or fatigue. More serious problems Some forms of a E.coli cause a common illness, such as traveller’s diarrhea. But Dr. Stephen Freedman, a professor of pediatrics and emergency medicine at the University of Calgary, says that what AHS is seeing in this outbreak — shiga-toxin positive e.coli — can lead to more serious issues. In addition to causing mild diarrhea when people are first infected, Freedman explained that after a couple of days, those infected can experience significant abdominal pains, cramping and frequent bloody diarrhea anywhere from 10 times a day up to 40 times a day. The biggest concern however, he said, is that this bacteria that secretes a toxin that can damage other parts of the body. “The toxin gets absorbed into the bloodstream and then circulates to other organs and can lead to impacts on on the kidneys,” Freedman said. “Only about 15 to 20 per cent of children who have this … type of infection developed these complications at all. The other 80 to 85 per cent really have very uncomfortable, bothersome, and concerning diarrhea, abdominal pains and can have dehydration.”

NEW JERSEY — Health officials are warning consumers in New Jersey and across the nation about potential contamination in two brands of eye drops, which could lead to a serious and even fatal infection. Last week, the Food and Drug Administration issued a warning to consumers not to purchase “and to immediately stop using” Dr. Berne’s MSM Drops 5 percent Solution and LightEyez MSM Eye Drops – Eye Repair. The eye drops could potentially be contaminated with bacteria, fungus, or both, according to an Aug. 22 consumer warning. Both companies sell the drops online. “Using contaminated eye drops could result in minor to serious vision-threatening infection which could possibly progress to a life-threatening infection,” said the FDA. Health officials also said these products contain an active ingredient that is unapproved, and is “illegally marketed” for sale in the United States. The FDA warning said that microbial contaminants were found in both products. The Dr. Berne’s MSM Drops were found to have both bacterial and fungal contamination, while the LightEyez MSM Drops were found to have four different bacterial contaminants. On Aug. 26, Dr. Berne’s issued a voluntary recall of several lubricating eye drops (see below). The Food and Drug Administration did not indicate that this recall is connected to a deadly strain of highly drug-resistant bacterial infections from contaminated eyedrops, which has been linked to four deaths nationwide. That particular bacteria, P. aeruginosa, was not on the list of contaminants found in the Dr. Berne’s and LightEyez products. Health officials also said these two products also contain methylsulfonylmethane (MSM) as an active ingredient, which is not approved in the U.S. “These products are unapproved drugs and illegally marketed in the U.S.,” the FDA said. “There are no legally marketed ophthalmic drugs that contain MSM as an active ingredient.” Dr. Berne’s Whole Health Products issued a nationwide recall of these eye drops and several others on Aug. 26. Two people reported adverse reactions to using the drops, the company said, but did not provide further details. The Dr. Berne’s-issued recall is for all lots of MSM DROPS 5 percent and 15 percent Solution, Dr. Berne’s Organic Castor Oil Eye Drops, and Dr. Berne’s MSM MIST 15 percent Solution. LightEyez Limited had not responded to the FDA as of last week’s warning, and does not appear to have issued any recall. Dr. Berne’s consumers with questions about the recall can contact Dr. Berne’s Whole Health Products at (877) 239-3777 or by e-mail at [email protected] Mon-Fri 9-5 pm Mountain time. Anyone who has quality problems, or who experiences an adverse reaction to using the eye drops, is advised to contact their physician or healthcare provider. Consumers can also report to the FDA’s MedWatch Adverse Event Reporting program either online, by regular mail or by fax: Complete and submit the report Online Regular Mail or Fax: Download form or call 1- 800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178 This recall comes amid a growing number of cases linked the deadly and “extensively drug-resistant” P. aeruginosa bacteria found in eye drops, which health officials as EzriCare Artificial Tears. According to the most recent Centers for Disease Control update, 81 patients with the rare strain have been identified in 17 other states. Those states are: California, Colorado, Connecticut, Delaware, Florida, Illinois, North Carolina, New Mexico, Nevada, New York, Ohio, Pennsylvania, South Dakota, Texas, Utah, Washington and Wisconsin. Related article:

Researchers have found an unusual immune response in unvaccinated, critically ill COVID-19 patients that could inform future vaccines. A study by teams from the University of Sydney and UNSW, published in the journal Clinical & Translational Immunology, found cytotoxic T cell responses in critical COVID-19 cases were far greater than those in mild or asymptomatic cases. Cytotoxic T cells – also known as killer T cells or T lymphocytes – are specialised white blood cells that identify and eliminate other malfunctioning or infected cells in the body, including those from viral or bacterial infections, or even cancer. SARS-CoV-2 viruses and immune cell. Conceptual image illustrating antiviral immunity and vaccination. Credit: Science Photo Library There are two classes of T cells: Usually, these cells carry CD8 receptors, but some helper T cells, which prime cells to fight off pathogens (rather than killing problems directly) have a CD4 receptor. The team, led by Professor Jamie Triccas, a microbiologist who is acting deputy director of Sydney University’s Infections Diseases Institute, has found an unusually high number of cytotoxic CD4 cells occur in patients with critical COVID-19 (basically, they’re in ICU) who weren’t vaccinated prior to infection. Triccas’ team wanted to take an agnostic approach to analysing these samples – waiting to see if there were any associations of particular cell types with disease severity. When their computer analysis was complete, it was the CD4 cell types that surprised them. “Most of the time, it’s what we’d call those CD8 T cells that are cytotoxic, and the CD4 type that are the helper [cells]. In this case we see it’s cytotoxic CD4 T cells, which is a little bit unusual,” Triccas tells Cosmos. “You had this class of T cells that you don’t normally associate with being cytotoxic, that were now having this cytotoxic [characteristic].” While it’s unusual to see a lymphocyte more commonly known for playing a ‘helper’ role in immune responses suddenly pick up its spear and activate its ‘seek and destroy’ mode, it’s not unheard of. Previously, cytotoxic CD4s have been seen in patients with viral infections like HIV, Epstein Barr and dengue. The concern for patients is that a particularly strong immune response could cause excessive tissue damage. “Those cells, if they’ve been turned on to have a lot of this cytotoxic type ‘killing’ function, the consequence of that could be that you might get some sort of off-target effect,” says Triccas. “Because these cells are highly activated, they’re making a lot of molecules that activate the immune system and … you get too strong an immune response and you wind up causing excess damage.” Compare this to patients with more mild and even severe (but not yet critical) cases: their average percentage of more cytotoxic CD4s was markedly lower. In critical cases, they suggest the findings of cytotoxic CD4s in critically ill COVID-19 patients might contribute to tissue damage and systemic inflammation associated with death. Triccas suggests that while these findings offer little to people at an individual level, they give vaccine manufacturers valuable data when developing next-generation therapies. “If we want to make new vaccines, or better vaccines, do we have to think about the balance of these types of cells?” he says. “We know that … generally the goal of the vaccines is to make a lot of antibodies and I don’t think anyone thinks that too many neutralising antibodies is a problem. But I think you can envisage that too many highly active T cells could be a problem. “Our paper is saying is that you probably should look quite closely at the different types of cells that are made if you’re making a new vaccine, and then decide: am I generating an immune response that’s that is balanced enough to not cause any problems?”

By the edhat staff The U.S. Food and Drug Administration (FDA) has issued a warning regarding the use of two eyedrop products due to bacterial and fungal contamination. The affected products are Dr. Berne’s MSM Drops 5% Solution and LightEyez MSM Eye Drops Eye Repair. The contamination involves drug-resistant bacteria Pseudomonas aeruginosa, Mycobacterium, Mycolicibacterium, and Methylorubrum in LightEyez, and Exophiala fungi in Dr. Berne’s product. Both products claim methylsulfonylmethane (MSM) as their active ingredient, which is not authorized for use in any legally marketed eye drugs in the U.S. So far, no adverse effects have been reported by consumers who have used these products, according to the FDA. This warning comes as the U.S. Centers for Disease Control and Prevention (CDC) revealed an outbreak of Pseudomonas aeruginosa infections linked to several brands of artificial tears and eyedrop products. The CDC identified the bacteria strain in 81 individuals, with four deaths reported between May 2022 and April 2023. Notably, the most common product associated with the infections was Ezri Care Artificial Tears, which the FDA warned against purchasing in February. The CDC confirmed the presence of the matching Pseudomonas aeruginosa strain in open bottles of Ezri Care Artificial Tears, leading to further investigation to determine if contamination occurred during the manufacturing process. The FDA attributed the lack of appropriate microbial testing and the use of inadequate, tamper-evident packaging to the manufacturer, Global Pharma Healthcare, an India-based pharmaceutical provider. Global Pharma also voluntarily recalled another product, Delsam Pharma Artificial Eye Ointment, for similar reasons. In February, two other companies, Apotex Corp. and Pharmedica USA, recalled their eyedrop products. At that time, those products had not been linked to infections. However, as of May, infections related to the outbreak were reported in 18 states across the U.S., including California, Texas, New York, and Florida. Symptoms of the bacterial infection include eye discharge, redness, blurred vision, light sensitivity, and eye pain. In severe cases, the infection can spread to other parts of the body, including the bloodstream, leading to potential vision loss or surgical removal of the eyeball. Treatment typically involves antibiotics, but the increasing resistance of the bacteria to multiple drugs poses a challenge. The CDC currently recommends testing for infection only in individuals exhibiting symptoms. In recent years, drug-resistant strains of Pseudomonas aeruginosa have caused thousands of infections among hospitalized patients, prompting concerns about the need for effective measures to address this ongoing issue. As the FDA urges consumers to cease the use of the affected products and investigates the contamination, vigilance and caution when choosing eyedrop products are paramount.

The BA.2.86 strain, now known as Pirola, has been identified in three states: Michigan, Virginia, and Ohio. The Michigan case, the first in the US, was an older woman who had recently returned from Japan. “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 CDC said in a Risk Assessment Summary. “Scientists are evaluating the effectiveness of the forthcoming, updated COVID-19 vaccine. “CDC’s current assessment is that this updated vaccine will be effective at reducing severe disease and hospitalization. “At this point, there is no evidence that this variant is causing more severe illness. That assessment may change as additional scientific data are developed. CDC will share more as we know more.” At a World Health Organization (WHO) news briefing on Friday, Aug. 25, authorities said they consider BA.2.86 to be part of the Omicron variant family, but that could change if the strain spreads more widely even though Pirola’s 30 mutations are from the BA.2 lineage, which was the dominant Omicron strain in 2022. More data on the strain is expected later this week. The Pirola strain was first detected in Israel, and cases have also been identified in several other countries, including the US, United Kingdom, South Africa, and Denmark. Currently, a new Omicron subvariant known as Eris, whose official name is EG.5, is accounting for most COVID cases nationwide, just ahead of the XBB.1.16 strain, according to estimates by the CDC. Arcturus is also an offshoot of the highly-contagious Omicron strain. Check back to Daily Voice for updates. Click here to follow Daily Voice Nassau and receive free news updates.

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In Tanzania, researchers are unlocking the mysteries of a mold (fungus) that infects patients who have already contracted the bacterial disease tuberculosis. According to World Health Organization statistics, tuberculosis is the leading cause of death globally from infectious disease, with over a quarter of TB deaths occurring in Africa. Fungal lung disease, particularly chronic pulmonary aspergillosis is significantly under-diagnosed, under-treated and a common cause of death in Africa: a 2022 study found the Aspergillosis mold develops in the lesions caused by TB, worsening them and resulting in a deteriorating clinical situation. Dr Martha F. Mushi, a lecturer consultant medical mycologist, at the Catholic University of Health and Allied Sciences (CUHAS) and Bugando Medical Centre in Mwanza, Tanzania, explaines that her research explores the prevalence, risk factors, and clinical outcomes of CPA among patients with smear-negative (lower bacterial load) TB, contributing to improved patient care in vulnerable populations. “The fact that approximately 45% of clinically diagnosed pulmonary TB cases have negative-smear or PCR test results highlighted the need of this project,” she says, adding that while CPA is documented as the major cause of smear negative TB, the mortality rate of untreated CPA is estimated at 75% to 80% over five years. “Africa’s capacity to diagnose lung fungal infection is still very low,” she says, “This calls for the global attention in increasing awareness of fungal infection among clinicians and training of technical staff (radiology and clinical laboratory) on the WHO essential diagnostic tests, to attain the sustainable development goals.” Mushi explained that the project is a result of collaboration with Prof David Denning, the founder and retired executive director of Global Action Fund for Fungal Infections (GAFFI), which partially funds and supports the project. Dr Martha Mushi reading gram stain results all in in microbiology laboratory of CUHAS with taken on … [+] 30th June 2023 Martha Mushi Importance of Mycology Mushi grew up in in Kilimanjaro region Northeastern part of Tanzania. “As a university student I was very much inspired by my microbiology professor, who interested me in this field that explores the intricate world of microorganisms,” she says, adding that the neglect of mycology as a whole result in limited research funding, making it challenging to generate evidence-based data for teaching and to foster interest among junior researchers. “Despite these obstacles, mycology plays a crucial role in understanding and addressing fungal infections, which have significant impacts on public health,” she says. According to Mushi, addressing public health issues requires more than just medical interventions. “Scientists from the Global South understand the local healthcare systems, traditional healing practices, community dynamics, and social determinants of health,” she says, “This understanding enables them to design interventions that are sensitive to cultural beliefs and practices, promote community engagement, and enhance the likelihood of successful implementation. Mushi explains that scientists from the Global South can shed light on ethical dilemmas specific to their contexts and ensure that research is conducted in a way that respects the dignity, autonomy, and rights of individuals and communities. “This not only enhances the relevance and applicability of the solutions but also promotes a sense of ownership and empowerment among the communities affected by the global challenges,” she says. Mwanza, Tanzania. getty Phage Approach Another researcher from the region interested in tuberculosis is 20-year old Rutendo Kahari. Kahari, from Zimbabwe, is already on a path to use viruses that infect bacteria to fight some of sub-Saharan Africa’s deadliest infectious diseases. The budding biomedical researcher interested in bacteriophages (viruses that whose hosts are bacteria) and genetic engineering as potential tools for fighting TB and other infectious diseases. Recent studies have focused on phage-based treatments as a solution to treating multidrug-resistant tuberculosis. After hearing a podcast on bacteriophages, Kahari delved into how phages could potentially combat the spread of antibiotic-resistant bacteria. “I was intrigued by the idea of using viruses to control populations of pathogenic bacteria,” she says.

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.