Dr. Buttery's Public Health BLOG

Those With A Specific Gene Mutation, and cat exposure at birth, may increase a child's risk of developing eczema during their first year according to a new study by researchers from University Hospital, Copenhagen, Denmark. Eczema runs in families and evidence suggests it is caused by genetic and environmental factors. The same researchers recently discovered that two common "loss-of-function" variants in the gene encoding filaggrin (FLG) predispose people to eczema. Filaggrin is a protective protein normally found in skin. It acts as a physical barrier to potentially harmful substances in the environment.

Posted by at 10:31 AM | Permalink | Comments (1)

A potential vaccine against malaria in children in Mali, Africa (where malaria is the major cause of death among chlidren under 10 years of age) is being tested by researchers from the University of Maryland School of Medicine and the University of Bamako ..

Posted by at 10:51 AM | Permalink | Comments (3)

World Rabies day is on Spetember 28th. Rabies in humans is 100% preventable through prompt appropriate medical care. Yet, more than 55,000 people, mostly in Africa and Asia, die from rabies every year - a rate of one person every ten minutes.

Posted by at 11:52 AM | Permalink | Comments (0)

During 2004, an unvaccinated Wisconsin patient received a new medical treatment and became the first documented survivor of rabies who had not received preexposure vaccination or postexposure prophylaxis. In today's MMWR is a report of three additional cases treated with the 'Wisconsin protocol' who failed to survive. Rabies should still be considered deadly and after any unprovoked bite, specially from a bat, rabies prophylaxis should be started immediately.

Posted by at 9:57 AM | Permalink | Comments (5)

Yesterday the The Food and Drug Administration (FDA) urgently reminded the public that contact with baby turtles can pose a serious health risk to infants, small children, and adults with impaired immune systems as they can be natural hosts to Salmonella, a group of bacteria that can cause severe illness and death. Recently, a four-week old infant in Florida died of infection traced to Salmonella pomona, a bacteria that was also found in a pet turtle in the home

Posted by at 10:01 AM | Permalink | Comments (0)

Travellers continue to import rare diseases. The MMWR reports 12 imported cases of Chikungunya fever in the March 30 edition. Chikungunya virus (CHIKV) is a mosquitoborne alphavirus indigenous to tropical Africa and Asia, where it causes endemic and epidemic chikungunya (CHIK) fever, an acute illness characterized by fever, arthralgias, and sometimes arthritis, commonly accompanied by conjunctivitis and rash. Although symptoms of CHIKV infection usually last days toweeks, joint symptoms and signs usually last for months and occasionally for 1 year or longer; deaths from CHIKV infection are rare.

Posted by at 1:32 PM | Permalink | Comments (0)

Easter will be here shortly and some families will buy chicks and baby rabbits for their children. In today's [March 30] MMWR the lead feature concerns Salmonella outbreaks among people in contact with baby birds. Ths is preventable and purchases of small animals for Easter should be forgone

Posted by at 1:27 PM | Permalink | Comments (0)

In this week's BMJ is a paper describing increased resistance to treatment by head lice. This suggests the need for better preparation to provide advice to schools and parents this coming fall. Around 80% of 316 lice tested were resistant to the treatment, equating to resistance to four out of five head lice affecting primary schoolchildren in Wales, say the authors. The experiment needs repeating in the US.

Posted by at 10:45 AM | Permalink | Comments (0)

However, when you go to a petting zoo where do you wash your hands? The advice is good, the practicality leaves much to be desired. Is there a role here for local health departments?

Posted by at 11:58 AM | Permalink | Comments (0)

The death from rabies of a British woman, bitten by a dog in Goa, reported in the news and in an article in this week's BMJ, highlights the issue of rabies prophylaxis for people who travel to and live in endemic areas.
Around 90% of deaths from rabies occur in the developing world, with more than half in the Indian subcontinent, where dogs that roam freely are largely responsible.
The probability of contact with an infected animal depends in part on anticipated activities, locality, and length of time spent in the country. For example, hiking in a rural area of the Indian subcontinent where dogs commonly roam free carries a sufficient risk of exposure—combined with potential difficulties in obtaining early, safe, and effective post-exposure prophylaxis—to warrant vaccination before travelling.

Posted by at 2:11 PM | Permalink | Comments (9)

This reminds us of the long incubation period of rabies. Travellers need reminding of the dangers of stray animals when overseas.
A British woman just died of rabies, after being bitten by a stray dog while on holiday in Goa.
Alison Dwerryhouse, 39, a shop assistant from Bury, near Manchester, became ill on her return to England and died at the Walton Centre, a specialist neurology and neurosurgery hospital in Liverpool, on Saturday (July 16).
She was bitten on April 9 and is the 23rd Briton to die of rabies, in all cases contracted overseas, since 1946. No one has contracted rabies in Britain since 1902.

Posted by at 11:43 AM | Permalink | Comments (0)

There are very few records of survival from rabies. The following extract from the NEJM of June 16,Vol 352:2508-2514 (read in TMK) reported:
"survival of a 15-year-old girl in whom clinical rabies developed one month after she was bitten by a bat. Treatment included induction of coma while a native immune response matured; rabies vaccine was not administered. The patient was treated with ketamine, midazolam, ribavirin, and amantadine. Probable drug-related toxic effects included hemolysis, pancreatitis, acidosis, and hepatotoxicity. Lumbar puncture after eight days showed an increased level of rabies antibody, and sedation was tapered. Paresis and sensory denervation then resolved. The patient was removed from isolation after 31 days and discharged to her home after 76 days. At nearly five months after her initial hospitalization, she was alert and communicative, but with choreoathetosis, dysarthria, and an unsteady gait."
We will have to wait and hope to hear if her recovery improves.

Posted by at 10:35 AM | Permalink | Comments (0)

This season’s first human case of West Nile virus reminds us of the importance of taking precautions to avoid becoming ill, said Dr. Lyle Petersen, director of CDC’s Division of Vector- borne Infectious Diseases. "It’s impossible to predict what this year’s season will hold. So everyone who spends time outdoors should take steps to protect themselves from mosquito bites and West Nile virus. Simple measures can help prevent infection:avoid mosquito bites by using insect repellents and protect your home by emptying standing water and installing screens. People can also help their communities by supporting community-based mosquito control programs. In many places, people can report dead birds to local health authorities to help with disease monitoring
CDC recently expanded the list of active ingredients it recommends for protection against mosquito bites. In addition to DEET and permethrin, repellents containing picaridin and oil of lemon eucalyptus have recently been found to provide reliable and long-lasting protection from mosquito bites.

Posted by at 1:15 PM | Permalink | Comments (0)