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2006/10/24-26 [Health/Disease/AIDS] UID:44952 Activity:high |
10/24 Is this the end of antibiotics? http://www.laweekly.com/news/news/the-scourge-of-skid-row/14810 (Warning, some of the pictures are really nasty.) \_ In short, yes. And this plague of staph is starting exactly like AIDS. First, it gets the drug-users and other societal rejects. Then, it comes for everyone else. When it's an expensive killer of "normal" people, it's seen as a crisis, and it is, rather than being nipped in the bud. Like all our other infrastructure, public health is in a state of near-total neglect. Drug-resistant staph, tuberculosis, malaria, and a host of others are coming at us, spread in part by insecticide resistant bugs. Idiots in Washington spend trillions combating threats to thousands of us and ignore the threats which will kill millions of us. Write your congressman, please. --PeterM \_ How do you figure AIDS could have been "nipped in the bud" in this country? I recall at the time some were advocating enforced \_ That was just Lyndon LaRouche \_ No, it was a lot of people. Either way, the question remains: what would you have done at the time to "nip AIDS in the bud"? \_ Um, mounted effective research and prevention efforts early on instead of not worrying about the "gay plague", for starters? early on instead of not worrying about the "gay plague", for starters? \_ So with billions of dollars of research and education efforts since then, what has happened? People who wanted to engage in risky activity continued to do so despite knowing the dangers and still get AIDS today. There was no magic bullet that would have done anything of note. After 20+ years of public education there are still new cases even though the number of new cases *should* be near zero. People are dumb. \_ HIV isn't easy to transmit. If we'd had clean needle and condom campaigns early we could have lowered transmissability to the point where the infection might have died out in the US, especially with very focussed targeting on the initial high risk groups. Further, there WAS NO CURE at the time and a campaign of persuasion, "do this or die" might have been more effective. To this day, dirty needles are responsible for much spread of HIV and hepatitis because politicians would rather moralize than take effective action (needle exchange) for public health. Convinced now? --PeterM \_ Convinced? Of what? No. I'll repeat my main point: to this today everyone *should* be aware that certain activity will get you HIV/AIDS yet they still choose not to use condoms or use clean needles even in places where they are given free. People are dumb. And btw, there is still no cure, so I'm not sure why you mention there wasn't one then either but thats not the point. \_ Convinced that early vigorous action could have greatly reduced the impact of HIV on the US. HIV isn't very transmissible: maybe 1.1 new cases per existing case, or even less thanks to public health campaigns. Even if early vigorous action reduced transmission by 20%, there would be .9 new cases of HIV per existing case and the infection would die out. I'm saying that if we'd had vigorous prevention and needle campaigns early on, HIV would have had negligible impact on the US and we would not have needed the *billions* now required for treatment and research. --PM \_ So now that we have spent billions in research and the public is as educated as possible, is the rate .9 or 1.1? If you can show me something that says .9 then I'm fully convinced. Of course there would still be people coming from outside the country but I'm not going to push that as I'm sure it's a small number. Either way, people are still dumb. ;-) \_ http://csua.org/u/hb7 (Entrez PubMed) This is an NIH site. The number today isn't .9, it seems, but lower, .05/yr. That is, for every existing case, there is 1 new case in 20 yrs. That is actually more successful than I had thought. Just under 1M in USA have HIV. Oh, and yes, people are dumb, I fully agree on *that*. But remember, those *billions* spent have mostly been spent treating the sick, not on prevention/education. Early prevention efforts would have yielded a huge ROI, especially since at that time AIDS victims were dying relatively fast. --PeterM \_ Ok, I'll buy that. Just one last thing to keep in mind is that by the time HIV/AIDS was recognised and diagnosable there were already a lot of people who already had it since it has such a long infection -> symptoms period. It may be the case that after the initial death toll, the level of education was appropriate since new cases are determined based on test date, not the unknowable infection date. So the high initial rates were unstoppable and then people who were uninfected then more or less did do the right things to stay safe(r). It also may be the case that since H/A transmission is more likely with certain activity that the virus was already mostly isolated to those populations, thus without *any* education it might have had low rates after the initial deaths. No one can say with certainty how many more, if any, might have remained uninfected if there had been earlier education (IIRC it was about 2 years that it was believed to be a 'gay disease'). isolation a la Typhoid Mary. What do you figure 'they' should be doing about all these other diseases right now? \_ Spend money on better public health and research. This isn't exactly rocket science. -ausman \_ And how would that have done anything at the time when AIDS first became known in the US to stop it from spreading? Billions of dollars of research have gone into AIDS, medical science has advanced, and there was a lot of money going into public education, but no one really knew what AIDS was, some *still* dispute what it is and we are still are the very early stages of being able to deal with viruses of any sort. What was going to happen in the 80's to stop AIDS? \_ Politicians and public health officials ignored AIDS because most initial victims were gays and drug users. If it had been, say, children or middle-aged white males there would have been a much more effective prevention campaign. Similarly with this new drug-resistant staph in LA. Right *now* it's afflicting homeless, prisoners, and drug users. Very soon, like AIDS, it's going to be mainstream, and dealing with it is going to cost a lot more in lives and in money. Tuberculosis is back in many countries with a drug-resistant vengeance. Malaria's returning, too, also in drug-resistant glory. Remember when life expectancy was 50 years or less? Continued neglect of public health and medical research will bring those days back. --PeterM \_ On a related note, all those anti-bacterial soaps may not be so good for us after all: http://tinyurl.com/yxa9cw (motherearthliving.com) |
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www.laweekly.com/news/news/the-scourge-of-skid-row/14810 -> www.laweekly.com/news/news/the-scourge-of-skid-row/14810/ E-mail The Scourge of Skid Row A staph infection threatens the lives of cops, firefighters and homeless people. But don't expect any help from county health officials By CHRISTINE PELISEK Wednesday, October 18, 2006 - 6:00 pm The plague boils over: When will the county health department step in? She wondered if it had anything to do with an ankle fracture she suffered on vacation in Mexico a few months earlier. Within a half hour, the warm feeling turned into pain so excruciating that her leg went numb. Unable to walk, the 39-year-old burglary-investigations supervisor was carried to a patrol car and rushed by her partner to an emergency room. Later that day, a surgeon cut into her foot and removed an abscess. The diagnosis: Skid Row staph, or, more technically, a strain of methicillin-resistant Staphylococcus aureus that is sickening dozens of police officers, firefighters, health-care workers and homeless people. These cases pose a new challenge to county health officials, who so far have refused appeals by Skid Row care providers to step up help to the city's most down-and-out population. Cops are so accustomed to seeing people with oozing boils that they call them Skid Row cooties. Doctors inserted tiny tubes in Hauck's foot to drain the curdled white pus. Finally, on September 27, doctors prescribed the antibiotic of last resort -- vancomycin, which she takes intravenously at home, where she spends most of the day in bed. Twice a week, Hauck's nurses come to her home to change her IV lines. Doctors fear the infection is eating at her bones, and that her ankle may become so overtaken with bacteria that they will be forced to fuse together the bones in her ankle, rendering her unable to walk without help. Right now, the least of her worries are the medical bills; Hauck believes that she caught the highly contagious bug at her station on Skid Row, which has become a giant petri dish for Skid Row staph. Nearly 1,500 homeless people living and sleeping on the streets, with little or no access to proper hygiene, soap or warm water, make it an ideal breeding ground for the bacteria. "We work in a filthy environment with people who don't practice good hygiene and are in and out of jail," Hauck says. These wounds were exposed to my environment, which is as dirty as it could be." In 2005, staph infections hit at least 20 Los Angeles city firefighters, many of whom work on Skid Row. A staph infection landed a deputy city attorney, who works out of the Central Division police station, in the hospital for two weeks. An LAPD helicopter pilot, who helped a homeless man across the street, almost had to have his leg amputated. Two doctors working at a wound-care clinic got infected. A chaplain and a night manager working at the Union Rescue Mission got it. So did the director of public affairs and two other employees at Midnight Mission. Besides Hauck, a deputy chief and a rookie officer at LAPD's Central Division have been diagnosed with Skid Row staph. A giant petri dish full of Skid Row staph "It is very seldom discussed down here, but it is a big fear for my officers every day," says Captain Andrew Smith. "There are a lot of things that have been swept under the table, and we are really trying to shine a light on what is happening in Skid Row. I don't think there is a lot of public awareness of this infection. We convened a meeting with the county one year ago and told them what our concerns are with the virus. Staph survivor: Midnight Mission's Orlando Ward The Los Angeles County Department of Health Services is doing little to address Skid Row staph. Health officials rejected Midnight Mission's request for a mobile health unit to monitor and treat homeless people. Instead, the health department gave homeless advocates fliers to pass out. "The response was nowhere near what we expected," says Orlando Ward, Midnight Mission's director of public affairs, who contracted Skid Row staph, along with his wife and a co-worker. People who are sleeping outside -- wearing the same clothes with untreated wounds. Staph came on the scene in the 1960s, infecting nursing homes and hospitals, where some 12,000 people nationwide die from infections every year. Health officials do not track the number of staph-related deaths in LA County because, like the flu, cases do not need to be reported. The hospital version mutated into a community version that the Centers for Disease Control calls USA 300, dubbed Skid Row staph in this story. In the mid-1990s, the community strain started creeping into nurseries, correctional facilities, homeless shelters, locker rooms and military bases. It was also popping up among drug users, gay men and children under 2 It was generally affecting people living in crowded conditions and dirty environments who had no access to good cleaning supplies. Around the county, a spot check of hospitals shows a half dozen or more cases being diagnosed in some emergency rooms every week. "It is now the single most common cause of skin infections, which is remarkable, because five years ago it was close to zero," says Dr. Gregory Moran, clinical professor of medicine in the department of emergency medicine and the Division of Infectious Diseases at Olive View-UCLA Medical Center. "It has quickly emerged as a cause of these infections in regular people out in the community. We now have showed that it is not just limited to people in specific risk groups. Moran says he sees one or two fatal cases of Skid Row staph annually. Health officials do not even keep track of staph cases -- unless they amount to an outbreak, where many people are infected in a short amount of time. Such an epidemic rages in LA County's seven jails, where up to 300 cases are diagnosed every month. Eleven months ago, the infection claimed its first known jail inmate, a 53-year-old Los Angeles man. The bacterium that transmits staph can be passed through touch, shared surfaces and personal items like razors or towels. The infection often is dismissed as a large pimple, ingrown hair or a spider bite, but it comes on quickly and is extremely painful. in rare instances, staph can cause blood, bone and lung infections. The increase in cases acquired outside the jail has unsettled some city officials, who believe that the city and county are not doing enough to monitor it, and that they are downplaying its seriousness, especially on Skid Row. More and more of the cases seen in the jail system originated on the streets. "It is hard to believe that nobody has died from it when I have two people in my station who are at death's door because of it," says Smith. If I have two people out of 335 who nearly died from it, and these are young, healthy people with health insurance, I shudder to think of the people who are living in cardboard boxes and on the street that may be dying because of it." Emma (not her real name), 24, is sitting on an old wooden school chair with her right arm propped up on a small exam table at Homeless Health Care LA's needle exchange and wound-care clinic on Fourth Street in the heart of Skid Row. Her young face is streaked with dirt and peppered with impetigo, a highly contagious form of Skid Row staph that causes blisters and itchiness. Unlike most of the clients, Emma, who is wearing a filthy yellow hoodie, a tank top, jeans and slip-on slippers, has returned to have her bandages changed. She gets infections regularly, mainly around the marks left by needles. She whimpers and clutches the big red ski hat that covers her coarse yellow hair as Dr. Susan Partovi discards the dirty bandage from her wrist and drains the abscess that is bleeding and oozing pus. Partovi gently cleans the wound and chats amiably to Emma, who is getting more squeamish. In between gasps, Emma briefly talks about her husband, who is in jail, and her infant daughter, who is being taken care of by her mother. Partovi quickly tackles the wound on Emma's left thigh, then gives her a brown paper bag full of Q-Tips, gauze, packing, bandages and a pair of scissors -- just in case Emma doesn't come back. Partovi operates the wound-care clinic three days a week. It opened two years ago inside t... |
csua.org/u/hb7 -> www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14707798&dopt=Abstract Rollins School of Public Health, Center for AIDS Research, Emory University, 1518 Clifton Road NE, Room 540, Atlanta, GA 30322, USA. edu The HIV/AIDS epidemic in the United States generally has been characterized by AIDS case incidence and AIDS-associated death rates; in a more limited fashion, the epidemic has also been described by AIDS prevalence; However, HIV transmission rate information (ie, the rate of transmission from persons living with HIV to HIV-seronegative persons) has received relatively little attention. The purpose of the present paper is to estimate the annual HIV transmission rate (from HIV-seropositive to HIV-seronegative persons) in the United States for the time period 1978-2000 and to discuss the practical utility of the findings. This implies a programmatic success in that for more than roughly 95% of persons living with HIV in any given year, no HIV transmission occurs. Research is urgently needed to fully understand the circumstances that allow the remaining instances of HIV transmission to take place; moreover, serostatus-appropriate HIV-related services are needed to disrupt these remaining instances of transmission. |
tinyurl.com/yxa9cw -> www.motherearthliving.com/issues/motherearthliving/nature/Antibacterial-Soap-Wipes_286-1.html?CMP=OTC-RSS antibacterial soap, antibacterial, antibacterial wipe, antimicrobial, antimicrobial soap MATTEW T STALLBAUMER Antibacterial products aren't any more effective than soap and water, and they can actually be harmful. If you choose "antibacterial" products because you trust them to kill germs, you might want to reconsider. According to recent studies, antiseptic ingredients added to numerous products are not effective and may actually be harmful. In 2005, a US Food and Drug Administration (FDA) panel concluded that there is "no added benefit" from using antimicrobial products over plain soap and water. Researchers at Johns Hopkins Bloomberg School of Public Health discovered that one of the most popular antimicrobials, the pesticide triclocarban (TCC), defies water treatment methods after we wash our hands of it. Once it's flushed down drains, about 75 percent of TCC makes it through treatments meant to break it down, and ends up in our surface water and in the biosolids known as municipal sludge. This sludge is regularly applied to US crop fields as fertilizer, so the chemical could potentially accumulate in our food, too. Rolf Halden, assistant professor in the Department of Environmental Health Sciences at Johns Hopkins and lead author of the study, estimates that TCC contaminates 60 percent of US streams. He says it is known to cause cancer and reproductive problems in mammals, and blue-baby syndrome in human infants. Introducing an antimicrobial into the environment in this way also has the unwanted effect of increasing pathogens' resistance to clinically important antibiotics. The antiseptic triclosan -- related to TCC in structure, function and usage -- is known to promote the growth of resistant bacteria, including E coli. In fact, the American Medical Association (AMA) took an official stance in 2000 against adding antimicrobials to consumer products. Since then, the AMA has repeatedly urged the FDA to better regulate these chemicals, advising that they should be avoided "until the data emerge to show antimicrobials in consumer products are effective at preventing infection and have no detrimental effect on public health." Currently, TCC is not required to be monitored, but about 1 million pounds of it are released annually in the United States. Since 2000, about 1,500 new antibacterial products have hit store shelves. Halden says the irony of his research is two-fold: "First, to protect our health, we mass-produce and use a toxic chemical which the FDA has determined has no scientifically proven benefit. Second, when we try to do the right thing by recycling biosolids, we end up spreading a known reproductive toxicant on the soil where we grow our food." He emphasizes the importance of considering the full life cycle of the chemicals we manufacture. We'll send our next tip directly to your e-mail address. submit Comments on "Why You Don't Need "Antibacterial" Soap" I agree with this article, what products do you recommend to use that are not antibacterial? Posted by: SAuvil | October 21, 2006 A variety of washing products free from antibacterials are produced under the trade name "Ecover"; put this name into Google and it will list web sites in the USA, UK and several other countries. Posted by: JParfitt | October 21, 2006 Another company that offers safe, nontoxic and effective cleaning products is Seventh Generation. Their products can be purchased in most health food stores. Plus, many of the companies that make "antibacterial" products offer non-antibacterial counterparts as well. Posted by: TALTERMAN | October 24, 2006 Share Your Comments on "Why You Don't Need "Antibacterial" Soap" You can use this comment form to enter your personal experiences, or additional information and resources that you'd like to share with Mother Earth Living readers. I would like to be notified of any new comments Write Your Comment (Offensive materials and/or spam will be removed, no HTML allowed) Please Note: Your sign-up must be verified via e-mail before your comment is published. |