Friday, October 24, 2014

MUENCHHAUSEN, Oct. 24, 2014



MUENCHHAUSEN
AN ELECTRONIC NEWSLETTER ABOUT ENVIRONMENT,
RENEWABLE RESOURCE TECHNOLOGY,
AND RELATED TOPICS
By BOOTSTRAP PRESS, INC.
BETHESDA, MD
JJGREENBARON(at)VERIZON.NET
OCTOBER 24, 2014
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WELCOME!
The Green Baron (TGB) welcomes one and all who take the time to read Muenchhausen. He aims to “tell it like it is” as much as possible, and avoid advocacy and ideological positions. There are enough of those to go around in other publications.

The Green Baron also welcomes comments from anyone who may read Muenchhausen. Please send comments to the e-mail address above.

NOSOCOMIAL INFECTIONS
On September 24, TGB had the honor of making (or actually remaking) the acquaintance of Tom Frieden, who leads the federal Centers for Disease Control and Prevention (CDC, Atlanta, GA), on the occasion of a National Press Club (NPC) luncheon. During his presentation, he asked those assembled what the biggest human infectious disease threat might be (1). Among the choice of sources were zoonotic (vectored from animals, including invertebrates) and nosocomial (contracted during hospital care). TGB raised his hand and guessed zoonotic. Yes, zoonotic-vectored diseases do present a major threat, but TGB guessed wrong. The answer Frieden had in mind was nosocomial. One reason nosocomial-source infections present what he deems to be the greatest threat is that such infections may well be caused by bacteria that have developed resistance to one or more antibiotics. Salient examples are methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE). Moreover, some of these “bugs” become resistant to multiple drugs, so the physician’s armamentarium may be much diminished.

 Thomas Frieden official CDC portrait.jpg
Frieden. Warned of nosocomial infection dangers.

There may be some hope for a “pushback” against such resistance, dim and distant though it may currently be. Some researchers at the Hebrew University Medical Faculty (Jerusalem, Israel) and other laboratories may be in the process of revealing the molecular/genetic means by which some bacteria develop drug resistance (2). Much work remains to be done, but it is good to learn that perhaps a start in this direction has been made. TGB plans to follow the progress of this work diligently.

THE EBOLA SCARE
Often, when one sees the word “scare”, one perceives exaggeration. In this case, however, the Ebola scare is indeed a scare, at least potentially. Ebola is a hemorrhagic fever by which, generally, the patient loses all one’s bodily fluids and his/her organs fail. The mortality rate for this disease is pegged at 50% to 90%; TGB prefers to consider the latter figure. The peer-reviewed literature and the popular press contains mountains of information and commentary on Ebola for those who wish to delve deeper.

Ebola fever is named after the River Ebola, a river in what is now the Democratic Republic of Congo, which flows into the Congo River. Reputedly the disease was discovered in the vicinity of that river; however, it also is told that the discoverer(s) were a bit hazy about their geography, and the disease actually was first detected in humans near another river mistaken for the Ebola. The disease is zoonotic, said to be vectored by fruit bats, and from those bats, to primates that customarily were sources of “bush meat” that is widely consumed in many regions of sub-Saharan Africa. Given that bush meat sometimes is smuggled into the United States by some travelers from Africa, TGB is astonished that Ebola has not appeared in the US until recently, and even then by travelers from West Africa already so afflicted.

The virus—a filovirus shaped like a string or wire—looks like a string which contains a knot that resembles simple knots one learns to tie if one is a boy scout or a beginning military trainee. The race is on to develop vaccine(s) to immunize humans against Ebola. This effort is on fast track and appears promising, with some scientists positing that an effective vaccine might be marketable by late 2015. There also exists a medication—currently in very short supply—known as “ZMAPP”, that seems to be effective against Ebola in its earlier stages. ZMAPP is said to be synthesized from a species of tobacco (Nicotiana tabaka). ZMAPP apparently helped cure two missionary physicians who had contracted the disease in Liberia, one of three countries in which Ebola has spread widely. The other two countries are Guinea (Conakry) and Sierra Leone. Another approach to attacking the disease in its earlier stages is to transfuse into the patient antibodies from a person with compatible blood type who has recovered from Ebola. One of the cured physicians contributed such antibodies to a nurse in Dallas, TX, who had contracted Ebola from a patient (who subsequently died) who had traveled to Dallas from Liberia. The current news is that the nurse has recovered at the National Institutes of Health (Bethesda, MD), who is to return to Dallas to regain her strength. Perhaps an antibody “bank” can be developed from blood contributions from recovered Ebola patients.


Ebola virus. Note the knot at one end.

Ebola currently is transmitted by direct contact with human body fluids and wastes. The virus does not seem able to travel from human to human by passage through air. However, medical science fears the possibility that the Ebola virus might mutate so that it would be transmissible via coughing and sneezing much as colds and influenza are spread.

BOOTSTRAP PRESS
Bootstrap Press is located in Bethesda, MD. TGB is its current president, although given his advancing age (he is now 80), he may seek a responsible person to take it over one day. Bootstrap Press is a nonprofit entity that concerns itself with environmental, energy, and (more recently) health topics.

REFERENCES:
1. Frieden, T. Presentation at National Press Club (Washington, DC), Sept. 24, 2014.
2. Siegel-Itzkovich, J. Health scan: How stubborn bacteria avoid antibiotics. Jerusalem Post online, Jan. 25, 2014. http://www.jpost.com/Health-and-Science/Health-scan-How-stubborn-bacteria-avoid-antibiotics-339349.

 






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