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The number of people diagnosed with the infection Valley fever is increasing. According to a CDC (Centers for Disease Control and Prevention) report released this week, individuals diagnosed with the infection called Valley fever or Coccidioidomycosis has increased 74% since 2014.

Valley Fever is an infection caused by the fungus Coccidioides spp., which is typically found in the soil of warm, arid regions of the southwestern US (Arizona, California). It is found in a lesser degree in Nevada, New Mexico, Utah, and Texas, but has even been found as far north as central Washington. The fungus is inhaled and goes to the lungs, where it can cause a respiratory illness, but sometimes can also lead to disease throughout the body.

The CDC says on the Valley fever page: "People can get Valley fever by breathing in the microscopic fungal spores from the air, although most people who breathe in the spores don’t get sick. Usually, people who get sick with Valley fever will get better on their own within weeks to months, but some people will need antifungal medication. Certain groups of people are at higher risk for becoming severely ill. It’s difficult to prevent exposure to Coccidioides in areas where it’s common in the environment, but people who are at higher risk for severe Valley fever should try to avoid breathing in large amounts of dust if they’re in these areas."

What are the symptoms? Many people infected don't have any symptoms, while others (about 40%) may have flu-like symptoms lasting weeks to months, which may go away on their own. Valley fever can include symptoms such as: fatigue, cough, fever, shortness of breath, headache, night sweats, muscle aches or joint pain, and perhaps a rash on the upper body or legs. There is usually a 1 to 3 week incubation period. Unfortunately it may look like pneumonia, but typical pneumonia treatment with antibiotics does not help.

Much is still unknown in how to treat the illness, including whether antifungal medications lessen symptom duration or intensity in patients with uncomplicated Valley fever. [Antifungal medications are used to treat complicated cases.] About 5 to 10% of patients develop life-threatening severe lung (pulmonary) disease and in about 1% of people the infection spreads from the lungs to other parts of the body (e.g. brain and spinal cord, skin, or bones and joints). Some people may need lifelong treatment. While anyone can get Valley fever, the CDC says some risk factors include: immunosuppression (e.g. have had an organ transplant, have HIV, are on corticosteroids), being pregnant, having diabetes, people who are black or Filipino. The CDC lists some tips in preventing getting this fungus.

From Medscape: Valley Fever on the Rise and Spreading, CDC Says  ...continue reading "Valley Fever Infections Are Increasing In the United States"

The issue of antibiotic resistance, that is, of antibiotics no longer working for bacterial infections in humans is a huge concern. So why are we squandering the antibiotic oxytetracycline on orange trees sickened with the disease citrus greening when a recent study by University of Florida researchers says it doesn't work?

The US Environmental Protection Agency gave permission for large-scale agricultural use of 2 antibiotics (streptomycin and oxytetracycline) to try to combat the bacterial infection that is destroying vast numbers of orange trees in Florida, Texas, and other states. However, the 2 antibiotics are also used to treat a number of bacterial infections in humans. And the latest development is that a study found that when oxytetracycline was sprayed on citrus trees for 6 months according to manufacturer's directions, it was no more effective than spraying water against the harmful bacteria (Candidatus Liberibacter asiaticus). 

Public health advocates, the FDA (Food and Drug Administration), and the CDC (Centers for Disease Control and Prevention) were all opposed to the EPA's antibiotic approvals for the citrus tree disease. They are very concerned that such large scale use could result in the development of antibiotic resistant bacteria, thus making these antibiotics useless in treating human illnesses. The CDC states that each year in the U.S., at least 2 million people get an antibiotic-resistant infection, and at least 23,000 people die.

Keep in mind that the European Union has banned the agricultural use of both oxytetracycline and streptomycin. Brazil has also banned these 2 antibiotics for agricultural use, and there citrus growers are battling the same citrus greening bacteria in citrus groves.

Steven Roach, a senior analyst for the advocacy group Keep Antibiotics Working has said:  “To allow such a massive increase of these drugs in agriculture is a recipe for disaster. It’s putting the needs of the citrus industry ahead of human health.”

From the NY Times: Spraying Antibiotics to Fight Citrus Scourge Doesn’t Help, Study Finds   ...continue reading "Time to Reassess Spraying Antibiotics On Orange Trees"

The evidence is growing. Another recent study found that exposure to dirt and animals in the first year of life is beneficial for development of a a rich and diverse gut microbiome - that is, for greater species "richness" as well as more beneficial microbes. This is linked to lower levels of allergies and asthma in children.

So don't worry about children being exposed to animal "germs" and getting dirty! Instead, consider the microbes as having health benefits, such as developing a "robust immune system". In summary, it now appears that in the first year of life the immune system needs lots of exposure to all sorts of microbes (e.g. from pets, animals, dirt)  to "train it" to develop normally.

The Ohio State University researchers compared 5 healthy rural Amish infants to 5 healthy non-Amish urban infants in Ohio, also found that all of the rural (Amish) children were breastfed, while 2 of the urban (non-Amish) children were only formula fed (some microbial differences there). The Amish households had farm animals (cattle, sheep, and/or horses) and pets (dogs and/or cats), while the non-Amish households had no contact with livestock, but did have a pet dog or cat. Just like in other studies, one pet doesn't seem to be enough - even more animal exposure in early childhood is best for the gut microbiome. [One study found a dose-dependent effect with exposure to 5 furry pets in early childhood was needed to prevent all allergies.]

Studies find that rural (Amish) children have a low incidence of allergies and asthma, while urban children have a high incidence of allergies and asthma. In this study, an example of microbial differences in the 2 groups of children was that Bifidobacterium bacteria were "enriched" in non-Amish (urban) infants, while Roseburia species were "enriched" in Amish (rural, farm-raised) infants. Similar gut microbe differences have been observed in other studies comparing rural and urban children, and both dietary differences (e.g. farm raised children eat lots of homegrown produce) and environmental differences (animal exposure) are thought to be responsible for the differences.

From Science Daily: Keeping livestock in the yard just might help your baby's immune system  ...continue reading "Children, Animals, and Gut Microbes"

The Paleo diet has been around for years and yet it continues to be controversial. The debate is whether following the Paleo diet long-term has health benefits or not? Supporters of the Paleo (Paleolothic) diet say it promotes gut health and is good for gut microbes, but recent research findings are a strike against this claim. The Paleo diet is based on the hypothesis that humans have not adapted to eating products of agricultural farming such as grains, dairy products, or legumes (beans), as well as all processed foods, so they should be avoided. Instead it stresses eating meat, fish, eggs, nuts, (some) fruits, and vegetables.

So what were the new research findings?  Australian researchers found that people who had been on a Paleo diet for more than a year ate lower amounts of resistant starch, and so had a different bacteria profile in the gut - with lower levels of some beneficial species. They also had high levels of a biomarker in the blood (trimethylamine-n-oxide or TMAO) that is linked to heart disease.

The problem seems to be the lower intake of resistant starch - which is a carbohydrate that resists digestion in the small intestine and ferments in the large intestine. As the fibers ferment they act as a prebiotic and feed the beneficial bacteria in the gut. More than one type of resistant starch can be present in a single food. And what foods contain resistant starches? Precisely some foods avoided in the Paleo diet: grains, rice, beans, peas, lentils, plantains, and green bananas. A number of studies find health benefits (e.g. gut health) from eating foods with resistant starches.

From Medical Xpress: Heart disease biomarker linked to paleo diet

People who follow the paleo diet have twice the amount of a key blood biomarker linked closely to heart disease, the world's first major study examining the impact of the diet on gut bacteria has found.  ...continue reading "Problems With Paleo Diet?"

New research once again confirms that raw fruits and vegetables result in a person ingesting lots of microbes. Millions of bacteria. Which is considered beneficial for our gut microbiome! What's interesting in the latest study looking at bacteria in both conventionally and organically grown apples is that organic apples are a better source of bacteria - that their bacteria are more diverse, distinct, and balanced (when compared to conventionally grown apples).

The Austrian researchers (Wassermann et al) wrote in the Frontiers In Microbiology: "Our results suggest that we consume about 100 million bacterial cells with one apple. Although this amount was the same, the bacterial composition was significantly different in conventionally and organically produced apples."

Interestingly, there were a lot of beneficial Lactobacillus species in the organic apples, but not conventionally grown ones. The researchers thought that the diverse microbiome of organic apples probably limits or hampers harmful microbes (human pathogens). The researchers also wrote: "The described microbial patterns in organic apples resemble the impact of apple polyphenols on human health, which have not only been shown to alleviate allergic symptoms (Zuercher et al., 2010), but also to promote growth of Lactobacillus and Bifidobacterium in the human gut and to reduce abundance of food-borne pathogens."

Another bonus of eating organic apples is that it means avoiding pesticides that are routinely sprayed on conventional fruit. So eat away! Microbes, fiber, and nutrients all in one small fruit!

Fun fact: The researchers write that apples are the most consumed fruit world-wide. Excerpts from Science Daily: An apple carries about 100 million bacteria -- good luck washing them off  ...continue reading "Excellent Reason To Eat Apples: The Bacteria"

Want to prevent your children from having allergies or asthma? A recent study adds support to increasing evidence that growing up on a farm, or living among multiple pets in the first year of life is protective against developing allergies and asthma. This is because exposure to lots of animal and outdoor soil bacteria in early childhood is good for the developing immune system. The study, which was conducted by Finland's National Institute  of Health and Welfare, carried this line of work further and found that this type of beneficial farm microbial exposure could be duplicated in non-farm homes.

They found that children's risk of developing asthma decreased as the similarity of their home's bacteria became more similar to that of farm homes. The researchers analyzed living room dust from homes and found that certain types of outdoor soil microbes were beneficial for preventing asthma. They found higher levels of these bacteria (and archaea, another microbe) in homes where people wore their outdoor shoes in the house, as well as 3 or more children, and increased moisture in houses. The types of fungi found in the dust of farm and non-farm houses didn't seem to matter. The researchers mention that the same kind of protective (for asthma) results of soil microbes has also been shown in mice.

Additional thoughts reading this: The study results can be interpreted as playing and crawling outdoors is definitely beneficial to children's health, especially young children. Exposure to soil microbes! And, of course, having pets. But wearing outdoor shoes indoors is problematic in areas with high lawn and garden pesticide use (e.g. suburban NY and NJ!) because studies show the pesticides get tracked indoors. This same problem occurs in areas with high lead levels (around older homes) or other heavy metals.

From Science Daily: Farm-like indoor microbiota may protect children from asthma also in urban homes   ...continue reading "Outdoor Soil Microbes In the Home and Asthma"

New research is raising questions about the role of gut bacteria in how people react to medications and whether the medicines are effective, at least some medications such as L-dopa treatment for Parkinson's disease. Why do medicines work for some people and not others? Perhaps the gut microbes are playing a part by interacting with the medicines! The gut microbes may actually be breaking down medicines and preventing them from reaching their target.

Researchers from Harvard University and University of California found that the composition of the gut microbes has an effect on whether the medicine L-dopa is effective or becomes ineffective as a Parkinson's disease treatment. They found that some bacteria can inactivate the medicine. Definitely research that needs following up on. Also, which medications is this true for?

Excerpts from Science Daily: Gut microbes eat our medication    ...continue reading "Gut Bacteria Has An Effect On Some Medicines?"

Study after study is finding that having pets in early childhood or living on a farm with lots of exposure to animals is associated with a lower incidence of allergies. Pets with all their "germs" (bacteria and other microbes) appear to have beneficial effects on children's developing immune systems. One study from the Univ. of Gothenburg (in Sweden) actually found that the more pets a child lives with in the first year of life, the lower the incidence of later allergies in children. The results were dose-dependent - with each additional pet, the incidence of allergies is a little lower.

The numbers are amazing - allergies decreased from 49% in those with no pets to zero in those with five or more pets. The researchers suggest that there is  a “mini-farm” effect, with exposure to a number of cats and dogs protecting against all allergy development (animal, food, and pollen allergies). What an about face in medical views in a few decades! It used to be viewed that if you wanted to prevent allergies in children, then avoid pets such as dogs and cats. Hah!

From Medical Xpress: Pet-keeping in early life reduces the risk of allergy in a dose-dependent fashion

A team of researchers at the University of Gothenburg has found that when infants live with pets, they grow up to have fewer allergies and other diseases. In their paper published on the open access site PLOS ONE, the group describes their study of datasets that held information on children's health and whether they had lived with pets as infants, and what they found.  ...continue reading "Exposure to Pets in Infancy Reduces the Risk of Allergies"

Many, many people wind up taking numerous courses of antibiotics at some points in life. Think of recurrent sinus infections or urinary tract infections or other infections. Or some conditions (e.g. dental or skin conditions) are treated with really long courses of antibiotics  New research (from 36,429 women participating in the long-running Nurses' Health Study)  found that women who take antibiotics over a long period of time during middle-age (40 to 59 years old), but even more so in late adulthood (60 years and over), are at increased risk of heart attack or stroke within the next 8 years.

How increased a risk for cardiovascular diseas? 28% or higher risk (compared to those who didn't take antibiotics)! But looking at the actual numbers it means: Among women who take antibiotics for two months or more in late adulthood, six women per 1,000 would develop a cardiovascular disease, compared to three per 1,000 among women who had not taken antibiotics.

Eight years was the length of the study, so it is unknown if the increased risk persists longer. The authors give a number of possible reasons for these results, but think it might be because antibiotic use results in gut microbial alterations. And the longer the antibiotic use, the more persistent the gut microbiome (microbial community) alterations. Other research studies supports this link (antibiotic use - gut microbe disruptions - increased cardiovascular disease). Another reason to eat in as healthy a manner as possible to feed beneficial gut microbes: a diet rich in fruits, vegetables, whole grains, seeds, and nuts.

From Medical Xpress: Antibiotic use linked to greater risk of heart attack and stroke in women

Women who take antibiotics over a long period of time are at increased risk of heart attack or stroke, according to research carried out in nearly 36,500 women. The study, published in the European Heart Journal today, found that women aged 60 or older who took antibiotics for two months or more had the greatest risk of cardiovascular disease, but long duration of antibiotic use was also associated with an increased risk if taken during middle age (aged 40-59). The researchers could find no increased risk from antibiotic use by younger adults aged between 20-39.  ...continue reading "Link Between Antibiotics, Heart Attacks, and Stroke Risk In Older Women"

Today's post expands on the problem of superbugs in hospital rooms. Superbugs are microbes that resist many antibiotics and drugs, and are called multidrug-resistant organisms (MDRO) in the medical literature. According to the Centers for Disease Protection (CDC): Each year in the U.S. at least 2 million people get an antibiotic-resistant infection, and at least 23,000 people die as a direct result of antibiotic resistant infections. Multidrug-resistant microbes are a continuing problem in hospitals and nursing homes.

The last post was on the contamination of privacy curtains around beds in hospitals and nursing homes. A recently published study (by the same Univ. of Michigan Medical School researchers) goes further in looking at microbes in hospital rooms. They looked at 3 main multidrug resistant organisms: vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA),  and resistant gram-negative bacilli (RGNB). And yes, they found them in many rooms and on some patients' hands and nostrils.

In the study, a total of 399 patients (average age 60.8 years) were followed as they entered 2 hospitals in Michigan during 2017. Fourteen percent of patients were already colonized with an MDRO when sampled within 24 hours of admission to the hospital - with 10% already having an MDRO on their hands, 7.5% in their nostrils, and 3.5% on both hands and nostrils. Room surfaces were sampled within the first 24 hours of a patient arriving at the hospital room - twenty-nine percent of rooms harbored an MDRO on the surfaces sampled. Six percent of the patients acquired an MDRO on their hands during their hospital stay. Luckily there were no deaths during the study.  

These microbes are frequently shed by patients and staff, and then they contaminate surfaces for days - which means that other people (patients, visitors, and hospital staff) are at risk of getting (acquiring) these microbes when they touch these surfaces. Surfaces that patients and staff frequently touch are: bed control and bed rail, call button, television remote, bedside tray table top, phone, toilet seat, and bathroom door knob.

The researchers stated that their study shows that patient hands are an "important reservoir" of microbes and play a "crucial role in the transmission of pathogens in acute care hospitals". Thus there is a need for "patient hand hygiene protocols" - in other words, wash the hands frequently.

From Medical Xpress: 'Superbugs' found on many hospital patients' hands and what they touch most often

For decades, hospitals have worked to get doctors, nurses and others to wash their hands and prevent the spread of germs. But a new study suggests they may want to expand those efforts to their patients, too.  ...continue reading "Patients Both Spread and Acquire Multidrug Resistant Microbes In Hospitals"