Category: Infection

AMSTERDAM: According to European Society of Cardiology (ESC) Guidelines on Infective Endocarditis, patients with specific cardiac conditions, such as valvular heart disease and congenital abnormalities, or those needing pacemakers, should practice good dental and skin hygiene to help prevent uncommon but potentially fatal infections of the heart’s inner lining and valves.The findings were published in European Heart Journal.“Infective endocarditis is an uncommon but very serious disease that can present with many different symptoms, and thus may be challenging to diagnose,” said Guidelines task force chairperson Professor Michael Borger of Leipzig Heart Centre, Germany. “Patient education is therefore paramount to early diagnosis and treatment. Those with valvular heart disease or previous heart valve surgery should be particularly diligent with regards to prevention and recognizing symptoms.”An infection of the heart’s inner lining, most usually the heart valves, is referred to as infectious endocarditis. It happens when germs or fungus enter the bloodstream, such as after surgery, dental work, or skin diseases. Fever, night sweats, unexpected weight loss, cough, disorientation, and fainting are among the symptoms. The infection may result in the valve being destroyed, abscesses, and cell and microbe clusters that can fragment into smaller pieces and spread to other regions of the body (a process known as embolization). Also possible are heart failure, septic shock, and stroke.Worldwide each year there are nearly 14 new cases of infective endocarditis for every 100,000 individuals and more than 66,000 patients die. “The mortality rate is extremely high and therefore preventive strategies in patients at high risk are pivotal,” said Guidelines task force chairperson Dr. Victoria Delgado of the Germans Trias i Pujol University Hospital, Badalona, Spain.Those at highest risk include survivors of previous episodes of infective endocarditis and patients with prosthetic heart valves, congenital heart disease (not including isolated congenital heart valve abnormalities) or a left ventricular assist device. In these patients, prophylactic antibiotics are recommended before oral or dental procedures. Patients at intermediate risk are those with pacemakers, severe valvular heart disease, congenital heart valve abnormalities (including bicuspid aortic valve) and hypertrophic cardiomyopathy, a disease where the heart muscle is thickened. In these patients, the need for antibiotic prophylaxis prior to dental procedures should be evaluated on an individual basis. Antibiotic prophylaxis is not needed in those at low risk.The main targets for antibiotic prophylaxis are oral streptococci. The document states that “the emerging and increasing antibiotic resistance among oral streptococci is of concern”. Dr. Delgado said: “Streptococci are naturally present in the mouth but can enter the bloodstream when oral hygiene is suboptimal and during dental procedures. Rises in antibiotic use for infectious diseases have led to resistance, meaning that antibiotics become ineffective. Caution in the use of antibiotics is therefore needed and self-medication should be avoided.”The Guidelines recommend other preventive measures for patients at intermediate and high risk including twice daily tooth cleaning, professional dental cleaning (twice yearly for high risk and yearly for intermediate risk patients), consulting a general practitioner for fever with no obvious reason, strict skin hygiene, treatment of chronic skin conditions, and disinfection of wounds. Piercings and tattoos are discouraged.Recommendations are provided for diagnosis, treatment, and management of complications. Diagnosis is based on clinical suspicion, blood cultures, and imaging. Echocardiography is the first-line imaging technique, and new diagnostic criteria include findings on other imaging techniques. There are new recommendations on the use of computed tomography, nuclear imaging and magnetic resonance imaging plus novel diagnostic algorithms when the infection involves native heart valves, prosthetic heart valves, and implanted cardiac devices such as pacemakers and defibrillators.Treatment aims to cure the infection and preserve heart valve function. The Guidelines recommend appropriate antibiotics, determined from blood cultures, as the mainstay of therapy, with duration depending on the severity of infection. Surgery to remove infected material and drain abscesses is indicated for patients with heart failure or uncontrolled infection, and to prevent embolisation. Surgery should generally occur earlier than previously recommended because of improved survival.One of the worst complications of endocarditis is stroke. Decisions about the timing of surgery in patients who have suffered a stroke must balance the risk of neurological deterioration during the procedure against that of delaying surgical therapy. Novel recommendations are to proceed with urgent heart valve surgery in patients with ischaemic stroke due to embolism but delay surgery in patients with haemorrhagic stroke. In addition, thrombectomy (removal of the embolus through a catheter) may be considered in very select patients with stroke.A new section in the Guidelines is devoted to patient-centred care and shared decision-making. Professor Borger said: “Infective endocarditis is a life-threatening condition with lengthy treatment and can be emotionally distressing for patients and families. Patients must be at the centre of care to achieve the best physical and mental outcomes.”

KARACHI: The metropolis has witnessed a surge in viral eye infections during the ongoing rainy season, with dozens of cases being reported on a daily basis. Public and private hospitals across the city have been grappling with the mounting cases of conjunctivitis, commonly known as red eye. Jinnah Hospital, a prominent medical facility in the city, has recorded 50 instances in its Outpatient Department (OPD) each day. Of these, 25 cases pertain specifically to the red eye infection, afflicting both children and adults alike. Leading Consultant Ophthalmologist, Dr Muhammad Moizuddin, has attributed this sudden surge to the transmission of the infection through direct contact with the ocular discharge of affected individuals. The infection, known to linger for a period of 8 to 10 days, manifests with a reddening of the eye, accompanied by moisture and discomfort. Dr Moizuddin advises the affected individuals to maintain strict hygiene practices, including separating their personal items such as towels and toiletries. In the midst of this growing concern, the afflicted are advised to employ prescribed eye drops and clean tissues for the cleansing of their eyes. Cold water, it is noted, brings relief to the affected eyes, offering a temporary reprieve from the discomfort. The consensus remains that adherence to cautionary measures and impeccable cleanliness are pivotal in stemming the transmission of this highly contagious eye infection. Detailing the symptoms of conjunctivitis, Dr Rabia Chaudhry, Assistant Ophthalmologist at Jinnah Hospital Karachi, emphasised the emergence of redness, itching, and inflammation of the eyes. She further noted the formation of lumps near the ears and, in some instances, the involvement of the cornea, potentially affecting the visual acuity of the individual. Read also: Treatment of genetic diseases stressed While a swift recovery is anticipated if the infection confines itself to the white part of the eye, instances where the cornea is compromised demand a longer healing timeline, spanning two to three weeks. Dr Chaudhry highlighted the significance of precautionary measures, given the infection’s propensity for person-to-person transmission. Unlike common misconception, she asserts that the infection isn’t contracted through mere eye contact; rather, it is facilitated by direct exposure to the infected individual’s ocular fluids. Notably, many cases have shown a co-occurrence of red eye with cold, flu, and cough symptoms. Dr Chaudhry further imparted crucial advice on how to mitigate the risk of transmission within households and workplaces. By maintaining personal hygiene and avoiding shared items, individuals can considerably reduce the chances of spreading the infection. Proper hand washing before administering eye drops, coupled with careful application, forms a vital line of defence. The sting of light often accompanies the infection, for which sunglasses and cold compresses can provide respite. Children have not been spared by this contagion; therefore special attention is urged to their well-being.

COVID-19 was never just another cold. We knew it was going to stick around and keep changing to try to get the upper hand on our immune systems.Related video above: New EG.5 COVID-19 variant spikes in parts of the U.S.But we’ve changed, too. Our B cells and T cells, keepers of our immune memories, aren’t as blind to this virus as they were when we first encountered the novel coronavirus in 2020. The U.S. Centers for Disease Control and Prevention has screened blood samples and estimates that 97% of people in the U.S. have some immunity to COVID-19 through vaccination, infection or both.Then there’s science: We have updated vaccines and good antivirals to lean on when cases start to rise. Masks still work. Rapid tests are in stores. We now know how to filter the air and to ventilate our spaces.Those strategies, plus our hard-won immunity, had helped bring our national numbers of infections, hospitalizations and deaths down to levels that felt almost forgettable.Almost.Now that COVID-19 infections have started to rise again, it feels like people all over the country are testing positive, and it’s hard to know how to react. The government has been dialing back its response since the end of the public health emergency in May. Good COVID-19 data is hard to come by and harder to interpret.So if people are less likely to be hospitalized or die from a COVID-19 infection now, has the danger passed? Is there still reason to worry if you do catch the infection for a second, third or fourth time?Experts say it’s less risky to catch COVID-19 than it used to be, but there are still good reasons not to treat it casually.”At this point, the risk is lower because of our prior immunity, whether for severe outcomes or for long COVID,” said Dr. Megan Ranney, an emergency physician and dean of the Yale School of Public Health.”COVID is still more dangerous than the flu, but its level of danger is becoming less,” she said, noting that we’re still very early in our human experience with the coronavirus, even four years in, and there are still things we don’t know.”But for it to behave like other respiratory viruses in terms of seasonality and surges is entirely expected,” she added.It would be “really weird” for COVID to disappear or for it not to cause illnesses, hospitalizations and deaths. “It is still a virus,” Ranney said.But a somewhat predictable waxing and waning of infections doesn’t make COVID-19 something to turn our backs on.Our immune systems are better at spotting dangerAfter more than three grueling years, nearly all Americans have some immunity against COVID-19.That means our immune systems – as long as they’re healthy and working as they should – will remember most forms of the coronavirus when it next comes our way.That process takes some time to get going, however. That lag may give the virus enough of a window to get a foothold in our nasal passages or lungs, and we get sick. We may feel crummy for a few days, but then our B cells and T cells get their antibody production up and running. Eventually, they shut the virus down, and we get better.That’s what should happen. But for many, their immune system just doesn’t kick in as quickly or as vigorously as it should.Immune function drops off naturally with age. About 1 in 4 Americans is over the age of 60, according to census data. Then there are certain medications and health conditions that suppress immune function. About 3% of the U.S. population – 7 million people – is severely immunocompromised, according to the National Institutes of Health. This is a group taking medications to protect organ transplants or who are getting powerful drugs for cancer treatment, for example.Then there’s individual variability. Through genetic bad luck, some people may just be at higher risk of serious reactions to COVID-19 infections, and they probably wouldn’t know it.Taken together, that’s a sizeable pool of people who benefit greatly from having antibodies at the ready to take on the coronavirus as fast as possible. Vaccines get those antibodies in place and ready to work as soon as they’re needed.Sometimes, people are so immunocompromised that vaccines can’t help them much, either. They benefit from preventive shots containing COVID-fighting antibodies that are built to stick around the body for a few months. Until this year, there was such a preventive product available, Evusheld. But the virus has evolved so much that Evusheld lost its potency, and in January, the FDA revoked its authorization.Since then, people who have very low immune function haven’t had anything to protect them from infection or severe disease. But that could change. The government announced this week that it’s funding the development of a new preventive antibody through the drug company Regeneron. Trials of that drug are expected to start this fall, according to the U.S. Department of Health and Human Services.While nearly all of us have immune systems that can recognize key parts of the virus now, even that memory to the infection fades over time. The longer it has been since you’ve been infected or vaccinated, the more forgetful your immune system becomes.Those B cells and T cells, “they’re going to be a little slower to respond. They’re not they’re not as primed and ready to go,” Ranney said.Your strongest immunity will be in the two weeks to two months after you get your vaccines. That means it’s smart to try to get your shots shortly before COVID is expected to be on the upswing. Just like for flu, experts expect the worst of COVID to hit in the fall and winter.CDC Director Dr. Mandy Cohen said that even though cases are going up now, most people will be better off waiting a few weeks to get the newly updated COVID-19 vaccines rather than trying to get one of the older bivalent vaccines right now. But this is dependent on personal risk, so if you’re concerned, talk

(CNN) — Liam Payne is taking a step back from professional commitments for health reasons. The former One Direction member announced on his Instagram on Friday “with a heavy heart” that he has “no other choice but to postpone” his upcoming tour in South America, since he has been in the hospital “with a serious kidney infection.” He added in the caption to the video post that the ordeal is “something I wouldn’t wish on anyone, and doctors orders are that I now need to rest and recover.” “I was beyond excited to come play for you guys. To all of you who have bought tickets: I’m so sorry. We’re working to re-schedule the tour as soon as we possibly can, but for now we will be refunding the tickets,” Payne added. In his video address, he concluded that once he’s well again, “hopefully we’ll put on an even bigger, better show.” According to the singer’s official website, Payne was slated to play six dates in early September, in Peru, Colombia, Chile, Brazil, Argentina and Mexico. Last month, the crooner shared that he was six months sober after spending 100 days in a rehabilitation facility. “I just needed to take a little bit of time out for myself actually because I kind of became somebody who I didn’t really recognize anymore,” Payne said in the video, adding “And I’m sure you guys didn’t either.” He continued of his rehab experience, “I was in bad shape up until that point and I was really happy more than anything after I arrived to kind of put a stopper to life and work.” “Ever since then, I’ve just been trying to learn to get to know this new guy,” he added. Thanks for reading CBS NEWS. Create your free account or log in for more features.

By Soonia Fernandez, UC Santa Barbara Indigenous peoples suffered disproportionately from the COVID-19 pandemic, experiencing a lack of sovereignty, limited infrastructure and discrimination in local healthcare systems that make them particularly vulnerable to infectious diseases. Yet little research exists to guide interventions and public health efforts tailored to remote-living Indigenous populations during pandemics. In Bolivia, for example, a team of researchers including UC Santa Barbara’s Tom Kraft and Michael Gurven, and local collaborators, attempted to mitigate SARS-CoV-2’s impact on the Tsimané, a small-scale Indigenous society living in remote areas of the Amazon. The effort centered on a strategy of voluntary collective isolation, in the hopes that remoteness, coupled with self-sufficiency in food production and a culture of resilience, would act as a buffer against disease. A new study by the same team, now published in the journal PLOS Biology, set out to test whether voluntary collective isolation was likely to be effective at preventing rapid spread of COVID-19 transmission among Tsimané. The authors used 20-plus years of data on Tsimané population structure, movement patterns and social networks to build a computer model to assess Tsimané vulnerability to COVID-19. The simulation predicted that without any intervention, approximately four out of every five Tsimané would be infected during an outbreak, and that even the most remote communities (more than 100 km from the nearest market town) would be affected. It also revealed that without severely curtailing travel, voluntary collective isolation was likely to fail. Sadly, the researchers confirmed their model’s predictions, observing a nearly identical rate of infection in the real world across Tsimané communities, based on serological testing of individuals after a first wave of COVID-19 infections. “Remote-living, small-scale populations are highly vulnerable to global diseases,” said Kraft, an anthropologist from both UC Santa Barbara and the University of Utah, and the lead author of the study. “We can’t rely on remoteness and voluntary isolation alone to mitigate risks — we need to plan to direct medical resources to these communities.” The Tsimané are one of several Indigenous tribes who hold collective title for much of the Estación Biologica del Beni and Pilón Lajas Biosphere Reserves and Indigenous Communal Lands, protected areas on the eastern flank of the Andes Mountains. They share characteristics common to many small-scale Indigenous societies, making this case study a useful reference for understanding infectious disease dynamics and public health interventions in other populations globally. The researchers designed their model to simulate the introduction of SARS-CoV-2 from the closest urban market town, and its spread among Tsimané communities. The idea for the study began at the outbreak of the pandemic. Many of the authors have worked with the Tsimané through theTsimané Health and Life History Project, which operates a mobile medical team that travels between villages to provide aid, while also conducting biomedical and anthropological research. Senior author Gurven, a professor of anthropology at UC Santa Barbara, co-founded the project back in 2002. For this work amidst the pandemic, the team wanted to understand how best to direct public health messages and deploy their limited medical resources. “At the time, there was great concern about what COVID might do if it reached the remote Amazon,” Gurven said. “So we shut down our normal operations and went into full COVID prep, hoping it wouldn’t spread. When COVID hit anyway, we then went into full surveillance mode, poised to help lessen the spread, and to help treat severe cases.” The Tsimané are mostly self-sufficient by small-scale farming of plantains, manioc, rice and corn, and by hunting and fishing. But with better roads and outboard motors, they now come into greater contact with Bolivian merchants, colonists and others in local towns. About 18,000 Tsimané live in over 95 villages spread along rivers and logging roads — the farthest requires a multi-day boat trip to the market town. Multiple generations live together in large extended households. The close-knit community is quite social, and individuals travel frequently between villages to visit friends and family. The authors evaluated how these characteristics would influence the extent and trajectory of disease spread, the community- and individual-level risk factors for susceptibility of infection and the effect of various intervention scenarios. “The Beni region of Bolivia is pretty remote, and medical facilities are hard to come by,” said Dr. Daniel Eid Rodriguez, a physician and medical coordinator for the Tsimané project based in Bolivia. “Any information that can help us make informed choices to best direct limited health resources is a blessing.” “We can’t rely on remoteness and voluntary isolation alone to mitigate risks — we need to plan to direct medical resources to these communities.” To the researchers’ surprise, the remoteness of the Tsimané communities made little difference in preventing the spread of COVID-19, both in computer simulations and observed infections. Once introduced, the disease spread in a chain reaction to even the most isolated villages, as predicted by the model. The timing and magnitude of infection differed in the short term, with communities closest to market towns getting infection peaks earlier than remote villages. Yet the smaller, more isolated villages experienced the largest outbreaks proportionally, challenging the intuition that epidemics are likely to be limited in remote, low-density populations. The authors suggest that for maximum impact, public health efforts in the future should focus on dispersing limited medical and messaging resources across remote communities, rather than concentrating efforts solely on denser communities closer to urban centers. Michael Gurven – Professor Gurven’s research links the evolved life history of humans with high levels of intragroup cooperation. He has conducted fieldwork for two decades with South American indigenous populations, and his work takes an evolutionary perspective on behavior, health, physiology and psychology. (Photo: Matt Perko) Simulations of different intervention strategies had mixed effectiveness. Restricting travel to market town alone slowed transmission, but made essentially no difference in the final outbreak size. Even extreme travel restrictions showed limited efficacy; simultaneously reducing 90% of travel to town and between villages substantially slowed transmission but was predicted to reduce

ByParmita Uniyal, New Delhi Aug 28, 2023 08:50 PM IST Share Via Copy Link Give a boost to your immune system by including seasonal foods, drinking plenty of fluids and avoiding roadside food. Here are expert tips to prevent dengue. Dengue cases have been increasing at an exponential rate this year across the country due to incessant rains, waterlogging and floods. It is important to build immunity against the disease by doing regular exercise, sleeping adequately and eating a nutritious diet. Experts recommend seasonal fruits and vegetables, adequate fluids, nuts, proteins, vitamins to stay healthy and prevent infections. One should also avoid consuming sugary drinks, junk food, deep-fried foods, baked and processed foods. (Also read: Dengue outbreaks: 9 reasons why dengue cases are getting more severe; what role does global warming play) Practising mindful eating behaviours, choosing seasonal foods, staying physically active and being positive is the best way to maintain good health status(Freepik) “Dengue season is here. Bolstering the immune system is the key mantra in the current scenario, which helps the body to build resistance and combat infections. Practising mindful eating behaviours, choosing seasonal foods, staying physically active and being positive is the best way to maintain good health status,” says Deepti Khatuja, Head – Clinical Nutritionist, Fortis Memorial Research Institute, Gurgaon. Food groups to be added in the diet regimen during this season and in dengue to boost immunity and keep infections at bay are as follows: • Fluids Plenty of fluids, potable water is as vital as consuming warm, concoctions, herbal teas, broths, and soups should be consumed to build immunity. Along with these hot liquids, cold liquids like lemon water, buttermilk or lassie, coconut water etc. are also beneficial. These drinks are rehydrating that maintain electrolyte balance, detoxifies the system and essential for building a robust immune system. • Fruits Adding seasonal fruits like jamun, pears, plum, cherries, peaches, papaya, apples, and pomegranates supports meeting the increasing demands of nutrients like vitamins A, C, antioxidants, and fibre. These fruits aids to improve digestion, maintain gut flora and triggers the immune response. • Vegetables Seasonal and different coloured vegetables should be made part of your regular diet to foster good gut health and immune activity. Various vitamins present in different coloured vegetables like Vitamin A, C along with minerals like Zinc, magnesium etc. are good antioxidants and provide the immunity. • Spices Spices and herbs like turmeric, ginger, garlic, pepper, cinnamon, cardamom, and nutmeg are bestowed with anti-inflammatory, antifungal, antiviral, antimicrobial, anti-bacterial and immune-boosting activities. They work amazingly well to support the immune system by regulating immune cells like T-cells that helps the body to defend off the pathogens. Add these spices generously in your regular cooking during this weather and uplift your overall health. • Nuts Nuts and seeds are loaded with proteins, healthy fats, vitamins, minerals, and antioxidants. Proteins and amino acid are the basic building blocks of body and helps keep the GI tract and immune system healthy. They support immune functions by activation of immune cell functions, multiplication of immune cells and production of antibodies. • Probiotics Include probiotics in the diet: Opt for yogurt, buttermilk, cheese kefir, kombucha, and soybeans. Probiotics are packed with good bacteria that act on our digestive system and boost immunity. Prachi Jain, Chief Clinical Nutritionist & HOD (Nutrition & Dietetics), CK Birla Hospital, Gurgaon says to Strengthen our immune system adequate nutrition is the key. To attain strong immunity, one needs to modify the lifestyle as it cannot achieved in one day. Jain suggests the following foods: Indian food plate which contains all the food groups in proper proportion i.e.– healthy and balanced diet. Eat enough proteins – 0.8 to 1 gm per kg body weight at least. In case of any deficiencies, protein intake can be increased to 1.2 to 1.5 gm after consulting nutritionist or doctor as proteins help in muscle building, maintaining, repairing body tissues, healing and speeding up recovery. E.g., milk and milk products, paneer, soya, tofu, lentils, nuts, boiled egg etc. Vitamins and minerals – Include properly washed fresh seasonal fruits and vegetables as they are rich in antioxidants. You can boost your immune system by including these nutrients: Vitamin A: Carrot, sweet potato, papaya, apricots Vitamin C: All citrus fruits like lemon, amla, tomatoes, oranges, sweet lime etc Vitamin E: Sunflower seeds, saf flower seeds, almonds & pistachios Vitamin D: Fortified milk and milk products, exposure to sunlight, mushrooms, egg, fish Zinc & selenium: Seeds like chia seeds, pumpkin seeds, sunflower seeds, whole pulses, whole cereals, black til, eggs, fish Include probiotics and prebiotics like curd, yoghurt, and fermented foods. Indian herbs & spices – These have anti-inflammatory, anti-microbial and anti- bacterial properties. Examples are tulsi, dry ginger, lemongrass, garlic, turmeric, black pepper, and coriander etc. Omega 3 include nuts and seeds, almond, walnut, chia seeds, flax seeds, pumpkin seeds, sunflower seeds. Hydration – Stay hydrated by including coconut water, lemonade, fresh homemade soups, buttermilk, green tea. Maintain 2- 2.5 litre of fluid intake on a daily basis. Foods to avoid: 1. Avoid carbonated drinks, cold drinks, squashes etc. 2. Avoid roadside, raw, stale food to prevent infection. 3. Avoid fried, deep fried food. 4. Avoid bakery food, maida which includes junks – pizza, pasta, burgers & fries. 5. Avoid processed foods like cheese, mayonnaise etc. 6. Avoid alcohol. 7. Quit smoking and tobacco. Topics Dengue

Ooceraea biroi. Credit: Daniel Kronauer, The Rockefeller University In a new study in Nature Communications, an international research team including scientists at the Max Planck Institute for Chemical Ecology reports that, given the same genetic makeup, individual behavior alone determines whether or not an individual in a social group will contract a disease. Clonal raider ants of the species Ooceraea biroi that forage outside the nest are more likely to be infected by parasitic nematodes than conspecifics in the nest. The research team also observed that diseases in the colony altered the behavior of all ants: sick and healthy ants alike remained in the nest and the division of labor was reduced, affecting the overall social organization in the ant colony. The social role determines the risk of infection The COVID-19 pandemic made it quite obvious that not all people were equally at risk of catching the new virus. The elderly, the sick, and people with health problems needed special protection because the risk of contracting a life-threatening illness or dying from the virus was greatly increased. Apart from this, the risks of contracting the virus were also unequally distributed due to our occupational activities. By no means was everyone able to protect themselves from contact with infected persons by working at home. So-called “system-relevant” occupations were often those in which there were particularly large numbers of encounters with potential virus carriers: jobs in nursing and the medical sector, in child care and teaching, and providing the everyday necessities. “Division of labor, the fact that different members of a social group perform different tasks, has long been thought to result in different disease exposure. A frequent assumption is that the division of labor can lead to an unequal exposure of group members to pathogens or parasites,” explains study leader Yuko Ulrich of the Max Planck Institute for Chemical Ecology. She heads the Lise Meitner Group Social Behavior. However, it is not easy to test this assumption experimentally, as other factors, such as diet, age and personal susceptibility, often also play a role. In her postdoctoral work in Daniel Kronauer’s group at The Rockefeller University, Yuko Ulrich was involved in establishing the clonal raider ant Ooceraea biroi as a model for studies of the effects of individual behavior on social organization. Workers of this species have no queen and reproduce asexually via unfertilized eggs that develop into genetically near-identical individuals. As a consequence, all members of the ant colony are genetically identical and researchers can observe colonies of the same age under exactly the same conditions—the ideal model system to test the assumption. Automated tracking. Credit: Yuko Ulrich, Max Planck Institute for Chemical Ecology Parasitic nematodes are more likely to infect foraging ants The cause of disease in the focus of the current study are parasitic nematodes. They infect a particular gland on the ants’ heads. The behavioral studies were conducted using automated behavioral tracking, which allows computerized analysis of the behavior of each individual ant in a colony using videos. This tracking of individuals is done simultaneously in many ant colonies. This sophisticated system generates far more data than human observations and manual evaluations would create. “We observed that individual behavior alone affects their risk of infection. For example, ants that spend more time outside the nest foraging are more likely to become infected than individuals that have the same genotype and age but spend more time inside the nest,” first author Zimai Li summarizes key findings from the behavioral assays. As the research team found out, infection with the parasites significantly reduces the survival rate of the ants. Genetic analyses showed that infected ants exhibited altered gene expression patterns. In addition, the scientists used gas chromatography analyses and found that the odor profile of infected ants had changed. The ants’ cuticle is covered by a waxy layer of various hydrocarbons. “Our chemical analysis showed that infections altered the relative abundance of all cuticular hydrocarbon classes on the cuticle of clonal raider ants: both n-alkanes and methyl-branched alkanes had lower relative abundance in infected individuals. These substances are thought to be associated with desiccation resistance and communication among ants,” says Zimai Li. Infections in the colony change the behavior of all ants, even healthy ones The behavioral observations also revealed a quite surprising result: the division of labor within the colony not only affects the risk of infection of individual ants, but an infection also controls the behavior of the ants. Not only did infected animals spend more time in the nest, but also their healthy nestmates did. “We were surprised to find that the presence of infection reduced activity outside the nest in not only the direct host but also the uninfected nestmates. Since the nestmates are not infected, we did not expect that their behavior would also change; their behavioral changes were not directly induced by infection. This observation raises new questions that we need to investigate further. We would like to find out whether ants recognize the infection status of their nestmates and whether this induces some kind of care-taking behavior expressed by the healthy ants staying close to the sick ones,” says Zimai Li. Another explanation would be that the parasites cause these behavioral changes in order to be able to reproduce further. This is because parasite infection causes healthy and sick ants to come together more frequently in the nest, which should increase the likelihood of transmission. The altered odor profile of infected ants, which the researchers identified, may also play a role. “This study has raised many questions that we hope to answer in follow-up studies. For example, we want to know why the nematodes infect this one gland in the ants’ heads. We are also interested in how the ants’ chemical communication changes when some individuals are infected. And finally, we want to find out whether the changes in the ants’ behavior benefit their own colony or the parasites,” says Yuko Ulrich. More information: Zimai Li et al, Behavioural individuality determines infection

Credit: Unsplash/CC0 Public Domain White-tailed deer across Ohio have been infected with the virus that causes COVID-19, new research has found—and the results also show that viral variants evolve about three times faster in deer than in humans. Scientists collected 1,522 nasal swabs from free-ranging deer in 83 of the state’s 88 counties between November 2021 and March 2022. More than 10% of the samples were positive for the SARS-CoV-2 virus, and at least one positive case was found in 59% of the counties in which testing took place. Genomic analysis showed that at least 30 infections in deer had been introduced by humans—a figure that surprised the research team. “We generally talk about interspecies transmission as a rare event, but this wasn’t a huge sampling, and we’re able to document 30 spillovers. It seems to be moving between people and animals quite easily,” said Andrew Bowman, associate professor of veterinary preventive medicine at The Ohio State University and co-senior author of the study. “And the evidence is growing that humans can get it from deer—which isn’t radically surprising. It’s probably not a one-way pipeline.” The combined findings suggest that the white-tailed deer species is a reservoir for SARS-CoV-2 that enables continuing mutation, and that the virus’s circulation in deer could lead to its spread to other wildlife and livestock. The study is published in Nature Communications. Bowman and colleagues previously reported detection of SARS-CoV-2 infections in white-tailed deer in nine Ohio locations in December 2021, and are continuing to monitor deer for infection by more recent variants. “We expanded across Ohio to see if this was a localized problem—and we find it in lots of places, so it’s not just a localized event,” Bowman said. “Some of the thought back then was that maybe it’s just in urban deer because they’re in closer contact with people. But in rural parts of the state, we’re finding plenty of positive deer.” Beyond the detection of active infections, researchers also found through blood samples containing antibodies—indicating previous exposure to the virus—that an estimated 23.5% of deer in Ohio had been infected at one time or another. The 80 whole-genome sequences obtained from the collected samples were represented groups of viral variants: the highly contagious delta variant, the predominant human strain in the United States in the early fall of 2021 that accounted for almost 90% of the sequences, and alpha, the first named variant of concern that had circulated in humans in the spring of 2021. The analysis revealed that the genetic composition of delta variants in deer matched dominant lineages found in humans at the time, pointing to the spillover events, and that deer-to-deer transmission followed in clusters, some spanning multiple counties. “There’s probably a timing component to what we found—we were near the end of a delta peak in humans, and then we see a lot of delta in deer,” Bowman said. “But we were well past the last alpha detection in humans. So the idea that deer are holding onto lineages that have since gone extinct in humans is something we were worried about.” The study did suggest that COVID-19 vaccination is likely to help protect people against severe disease in the event of a spillover back to humans. An analysis of the effects of deer variants on Siberian hamsters, an animal model for SARS-CoV-2 studies, showed that vaccinated hamsters did not get as sick from infection as unvaccinated animals. That said, the variants circulating in deer are expected to continue to change. An investigation of the mutations found in the samples provided evidence of more rapid evolution of both alpha and delta variants in deer compared to humans. “Not only are deer getting infected with and maintaining SARS-CoV-2, but the rate of change is accelerated in deer—potentially away from what has infected humans,” Bowman said. How the virus is transmitted from humans to white-tailed deer remains a mystery. And so far, even with about 30 million free-ranging deer in the U.S., no substantial outbreaks of deer-origin strains have occurred in humans. Circulation among animals, however, remains highly likely. Bowman noted that about 70% of free-ranging deer in Ohio have not been infected or exposed to the virus, “so that’s a large body of naive animals that the virus could spread through rather uninhibited.” “Having that animal host in play creates things we need to watch out for,” he said. “If this trajectory continues for years and we have a virus that becomes deer-adapted, then does that become the pathway into other animal hosts, wildlife or domestic? We just don’t know.” Martha Nelson of the National Library of Medicine was co-corresponding author of the study. Ohio State co-authors Dillon McBride, Steven Overend, Devra Huey, Amanda Williams, Seth Faith and Jacqueline Nolting worked on the study with co-authors from St. Jude Children’s Research Hospital; the University of California, Los Angeles; the National Research Center in Giza, Egypt; PathAI Diagnostics; the Ohio Department of Natural Resources; the U.S. Department of Agriculture; Columbus and Franklin County Metroparks; and the Rega Institute for Medical Research in Belgium. More information: Accelerated evolution of SARS-CoV-2 in free-ranging white-tailed deer, Nature Communications (2023). DOI: 10.1038/s41467-023-40706-y Provided by The Ohio State University Citation: COVID-19 virus is evolving rapidly in white-tailed deer, new research finds (2023, August 28) retrieved 29 August 2023 from https://phys.org/news/2023-08-covid-virus-evolving-rapidly-white-tailed.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.

A Tough Mudder competition in California’s Sonoma County may have sickened hundreds, according to an updated report on the event, where participants claimed they smelled cow manure on the muddy, wet field. “There was a few times during the race where I could smell cow manure,” Nicole Villagran, who developed a rash after participating in the event, told ABC News. “You wake up the next day and you’re like, ‘What is all this on my arm? Like, what is going on here?’ And it’s on both arms. That’s where I was digging and doing army crawls and it’s on the inside of my knees where I was pushing off of as well,” said Villagran. A Tough Mudder race is a collaborative obstacle course challenge, where participants attempt Boot Camp-style hurdles in mud and muddy water. TikToker Lindsay Sirmon, who participated in the Tough Mudder challenge, shared a video of rash-covered knees, writing, “Had a blast at Tough Mudder Sonoma but…..little did we know that chills, fever, body aches (headache) and infection would follow.” “We hosed off, changed clothes then showered well after,” Sirmon wrote in the TikTok caption. “After drs. visits, we are on antibiotics and topicals.” But as Sirmon pointed out, “I mean, it is in the mud, I get that.” ABC News reports that now at least 350 people who participated in the August 19-20 event have become sick. Their symptoms were so severe, ranging from skin rashes to vomiting, that it prompted the county health department to issue an advisory. “The Tough Mudder race involved extensive skin exposure to mud. Most affected persons have pustular rash [rashes with pus-filled blisters], fever, myalgias [muscle pain], and headache,” the August 23 advisory from the Sonoma County Department of Health Services said. However, the advisory continued that the symptoms could have a wide range of causes — some potentially deadly, although there have been no reports of fatalities from the Sonoma County event. “These symptoms could be indicative of a minor illness called Swimmers’ Itch, but they can also indicate a staph infection or other more serious bacterial infection such as Aeromonas.” Swimmer’s Itch is caused by microscopic parasites in water, according to the CDC, and while uncomfortable, can usually be treated at home with corticosteroid cream. Some participants in the Sonoma County Tough Mudder experienced rashes and fevers. Tayfun Coskun/Anadolu Agency via Getty Staph infections, however, can turn deadly, the Mayo Clinic says. While symptoms vary, staph usually presents with pus-filled boils, impetigo (a painful rash), and cellulitis. If the staph bacteria enters the bloodstream, it can cause a deep infection known as bacteremia, which can impact internal organs, and muscles. While staph is generally treated with antibiotics, the Mayo Clinic points out that antibiotic-resistant strains of staph may require intravenous antibiotics. And according to the National Institute of Health, Aeromonas is caused by “opportunistic bacteria” that generally live in water, and possess a “wide spectra of antibiotic resistance.” The CDC says California is the first state to mandate reporting of Aeromonas infections. “Bloodstream infections caused by Aeromonas tend to be very severe and progress rapidly,” the National Institute of Health has said. “While the overall frequency of Aeromonas as a cause of … bacteremia is low, Aeromonas bacteremia has a high fatality rate.” The Sonoma County health department also advised: “If you participated in the race and have a rash with fever or other symptoms, please see your medical provider or, if you do not have a medical provider, your local emergency department. You may wish to take this Advisory with you. Incubation period is 12 to 48 hours.” A representative for Tough Mudder said in a statement to PEOPLE that all participants and spectators from the event have been contacted and urged to seek medical attention if they are experiencing any symptoms. Additionally, they are working closely with the County of Sonoma Health Services to investigate the matter. “As it has been for the thousands of races we have put on for millions of racers across the globe, the health and safety of the Tough Mudder community is always our top priority,” the statement said. “All necessary protocols were followed in preparation for, and during, the event. Our thoughts are with those affected and we are actively investigating to understand exactly what occurred.” PEOPLE has reached back out to Tough Mudder for further comment.

The CDC reports that syphilis cases have increased among males and females, in all regions of the United States, and in all age groups, including congenital syphilis. In 2021, there were 176,713 cases, representing a 28.6% increase from 2020.1 Intramuscular benzathine penicillin G (BPG) is widely recommended2-3 as the first-line treatment for primary, secondary, latent and tertiary syphilis without CNS involvement, with reported success rates of 90-100%.4 Although not mentioned by the World Health Organization (WHO) and CDC guidelines, oral amoxicillin is included in the Japanese and United Kingdom guidelines. For early syphilis, amoxicillin 500 mg three times daily is a first-line option in the Japanese guidelines5, whereas amoxicillin 500 mg four times daily plus probenecid 500 mg four times daily is an alternative in the United Kingdom guidelines.6 Ando et al conducted an open-label, randomized controlled trial to assess the non-inferiority of two amoxicillin-based regimens for the syphilis treatment at a single center in Japan. Patients with HIV, age ≥20 years, and diagnosed with syphilis by positive Treponema pallidum hemagglutination (TPHA) and a positive rapid plasma regain (RPR) test were included. Positive RPR titers were defined as the following: an RPR titer greater than 8, an RPR titer equal to 8 with clinical symptoms compatible of primary or secondary syphilis, or at least a 4-fold rise in RPR titer. Pregnant and lactating individuals and patients with neurosyphilis were excluded from the study. Patients were randomized 1:1 to receive amoxicillin 500 mg three times daily (Japanese guideline dosage) or amoxicillin 1000 mg plus probenecid 250 mg three times daily. In both groups, patients with early syphilis received a 14-day course while patients with late syphilis received a 28-day course. Follow up visits were conducted at 3,6,9 and 12 months after treatment. The primary outcome was serological cure rate at 12 months, defined as a four-fold decrease or negative conversion in RPR titer by the conventional test, using per protocol analysis. The non-inferiority margin was 10%. Self-reported medication adherence and adverse effects including nausea, diarrhea, vomiting, drug allergy, Jarisch-Herxheimer reactions were assessed at the second visit. Between August 2018 and February 2022, a total of 112 patients were enrolled. All study participants identified as male, the median age was 39, and 97% of participants were Asian. The majority of patients took antiretroviral therapy (91%) and had HIV viral load <200 copies/mL (84.8%). The median RPR titer at diagnosis was 64 (IQR 32-128) and the majority of patients had early syphilis. Four patients that missed follow up appointments due to COVID-19 stay-at-home orders were excluded from analysis at the applicable timepoints. Amoxicillin monotherapy did not demonstrate non-inferiority to amoxicillin/probenecid for serological cure rate at 12 months (Table). Similar trends were confirmed with automated RPR testing. No significant differences between adverse effects or medication adherence were observed; 105 participants (93.8%) reported taking more than 95% of the regimen. Advertisement This study describes the effectiveness of amoxicillin-based regimens with similar observed effectiveness to first-line syphilis therapies including BPG and doxycycline. 4.8 As a low-cost oral regimen, amoxicillin with probenecid may provide advantages for select patients. Medication adherence to a multiday amoxicillin regimen is crucial, compared to single-dose or weekly intramuscular BPG administered by a healthcare professional. Alternative treatment options are particularly vital when managing medication shortages and as of April 2023 there is an ongoing shortage of BPG in the United States due to increased demand for the medication. The CDC has issued guidance to prioritize BPG supply for patients with no alternative treatment options: pregnant people with syphilis and babies with congenital syphilis.3 Of note, the probenecid dose used in this study varies from recommendations in the UK guideline and package insert. 6,7 Probenecid inhibits tubular secretion of penicillin and subsequently increases penicillin serum concentration.7 While treponemicidal amoxicillin serum concentrations have been described6, this study did not assess medication concentration levels in participants. Further prospective studies of amoxicillin/probenecid regimens for syphilis treatment in people without HIV and women should be conducted to optimize the dosing regimen and demonstrate safety and effectiveness in a diverse patient population. Article Citation: Ando, N., Mizushima, D., Omata, K., et al. Combination of Amoxicillin 3,000 mg and Probenecid versus 1,500 mg Amoxicillin Monotherapy for Treating Syphilis in Patients with HIV: an Open-Label, Randomized, Controlled, Non-Inferiority Trial. Clin Infect Dis. 2023 May 9;ciad278. doi: 10.1093/cid/ciad278. Online ahead of print. References Centers for Disease Control and Prevention. (2023, May 16). National Overview of STDs, 2021. Centers for Disease Control and Prevention. https://www.cdc.gov/std/statistics/2021/overview.htm#Syphilis Workowski, K. A., Bachmann, L. H., Chan, P. A., et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187. doi: 10.15585/mmwr.rr7004a1 Guidelines for the management of symptomatic sexually transmitted infections. (2021). World Health Organization. Clement ME, Okeke NL, and Hicks CB. Treatment of syphilis: a systematic review. JAMA. 2014 Nov 12;312(18):1905-17. doi: 10.1001/jama.2014.13259. Japanese Society for Sexually Transmitted Infections. The Japanese STI diagnosis and treatment guidelines [in Japanese]. 2016. http://jssti.umin.jp/pdf/guideline-2016_v2.pdf Kingston, M., French, P., Higgins, S., et al. UK national guidelines on the management of syphilis 2015. Int J STD AIDS. 2016 May;27(6):421-46. doi:10.1177/0956462415624059. Epub 2015 Dec 31. Probenecid [package insert]. Lannett Company Inc; Philadelphia (PA): July 2012 Dai T, Qu R, Liu J, Zhou P, Wang Q. Efficacy of Doxycycline in the Treatment of Syphilis. Antimicrob Agents Chemother. 2016 Dec 27;61(1):e01092-16. doi: 10.1128/AAC.01092-16.