Tag Archives: CDC

Antibiotic resistance infograph.

The CDC thwarted 220 cases of pathogens with ‘unusual’ antibiotic resistance last year alone

Over 220 instances of germs with ‘unusual’ antibiotic resistance genes were reported to the CDC across the U.S., the CDC’s Vital Signs report states.

Bacteria.

Image via Pixabay.

The increasing prevalence of drug-resistant bacteria is, for good reason, one of the most worrying trends in modern medicine. Simply put, we’re developing new treatment options much more slowly than bacteria and their ilk can adapt (read: become immune) to the ones currently at our disposal.

In light of this fact, I’m sure you’ll be comforted to hear that health departments working with CDC’s Antibiotic Resistance (AR) Lab Network throughout the U.S. found more than 220 instances of germs with ‘unusual’ antibiotic resistance genes last year, according to the Vital Signs report. This category includes germs that are impervious to most or all antibiotics we currently possess, are uncommon in one particular geographic area or the U.S. as a whole, or have genetic mechanisms that allow them to spread their resistance to other germs.

To kill a mockinggerm

Antibiotic resistance infograph.

Image credits CDC.

Needless to say, because of the danger they pose to public health, the CDC considers the early detection of these pathogens a top priority. After a threat is identified, the next step in the Centers’ strategy is containment: facilities working with the CDC’s AR Lab try to isolate infected patients as quickly as humanly possible, then initiate special procedures intended to root out any unknown infectees, as well as reduce or stop the pathogen’s spread to new patients.

Luckily, this strategy proved effective in all the reported cases.

“CDC’s study found several dangerous pathogens, hiding in plain sight, that can cause infections that are difficult or impossible to treat,” said CDC Principal Deputy Director Anne Schuchat, M.D. “It’s reassuring to see that state and local experts, using our containment strategy, identified and stopped these resistant bacteria before they had the opportunity to spread.”

The Vital Signs report explains that the CDC’s approach, when faced with such pathogens, calls for rapid identification of resistance, infection control assessments, testing patients who may carry and spread the germ (even those that don’t exhibit symptoms), coupled with continued infection control assessments until spread is stopped. Initial screening is performed within 48 hours of the initial report, and maintain follow-up procedures over several weeks to ensure the threat is neutralized.

CDC prevention strategy.

Image credits CDC.

The CDC estimates that such efforts prevented over one and a half thousand new cases of difficult-to-treat or potentially untreatable infections, including high-priority threats such as Candida auris and carbapenem-resistant Enterobacteriaceae (CRE). The AR Lab Network is crucial for this effort, as it allows for a coordinated response from several healthcare facilities, labs, health departments, and members of the CDC itself.

Other highlights published in the report include:

  • One in four germ samples sent to the AR Lab Network for testing had genetic mechanisms that allow them to spread resistance to other populations.
  • Investigations in facilities that work with unusual resistance pathogens show that about 10% of screening tests on patients without symptoms identified a hard-to-treat strain that spreads easily. This would suggest that germs can spread relatively undetected in such facilities.
  • For CRE alone, estimates show that the containment strategies would prevent as many as 1,600 new infections in three years’ time, in a single state — representing a 76% slash in the total number of cases.

CDme

So what can you do to help the CDC contain such dangerous pathogens in the future? Well, it’s not that much — as you can imagine, tackling populations of drug-resistant bacteria isn’t something you do for fun on a Wednesday evening if you want to be effective. But you can help by being the Center’s scout; its eyes on the ground, if you will. If you want to pitch in, the CDC recommends you:

  • Inform your health care provider if you recently received health care in another country or facility. This lets them tie the dots together and trace down a pathogen’s potential movements in case a threat is determined.
  • Talk to your healthcare provider about preventing infections, taking good care of chronic conditions and getting recommended vaccines. An ounce of prevention beats a pound of cure, as the old saying goes — especially if that pound of cure can’t even kill off the infection.
  • Lastly, practice good hygiene — such as keeping hands clean with handwashing or alcohol-based hand rubs — and make sure you keep cuts and other open wounds clean until healed.

The entire Vital Signs report, as well as more information on the CDC’s containment strategy,  can be accessed on the CDC’s website, here.

Trump administration bans the CDC from using words like “science-based,” “vulnerable,” or “diversity”

The CDC, an organization tasked with using science-based approaches to protect the lives and health of the vulnerable, is banned from using words like “science-based” and “vulnerable” from any documents detailing next year’s budget. The other words from the ban list are “diversity,” “transgender,” “fetus,” “evidence-based,” and “entitlement”.

Words like “diversity” or “science” don’t sit well with this new directive.

When it comes to science and the environment, the current US administration has taken some questionable decisions — to put it mildly. From reversing a much-needed ban on African ivory to supporting the agenda of plastic-making companies, and from denying basic science to lifting protection for endangered sea creatures, the White House has done a lot to disappoint both scientists and the general population. We’ve learned to expect the worse when it comes to science and the environment.

But even so, when the new directives for the CDC were issued, they left everyone stunned, a policy analyst told the media. Other CDC officials confirmed this. It was an unprecedented request: the banning of specific words.

The reaction of people in the meeting was “incredulous,” the analyst said. “It was very much, ‘Are you serious? Are you kidding?’”

“In my experience, we’ve never had any pushback from an ideological standpoint,” the analyst said.

While it’s not the first time this administration has tried to govern what people can and can’t say, doing it when it comes to health policy is a whole different ball game.

With some words, like “transgender,” for instance, it’s clear what they are targeting. Donald Trump himself became the first president to speak at an anti-LGBT hate group summit — so while saddening, it’s not surprising that they want to target transgender policies. “Fetus” shares a similar story, as the administration is trying to ban abortion or make it as difficult as possible. The message is clear: it doesn’t matter what the science says, it doesn’t matter what health recommendations say, we just don’t want you discussing this and that.

It gets even more bizarre with other terms, like “science-based” or “evidence-based”. The current administration is basically forcing the leading national public health institute of the United States to forego, or at the very least rephrase, basic standards of science. The administration recommended replacing those words with “in consideration with community standards and wishes” — a fit replacement, considering that the administration seems determined to replace science and evidence with their standards and wishes.

Here are just two paragraphs from the CDC budget overview, for 2017, which will now have to be rehashed (pdf):

Having evidence-based guidelines and recommendations is important to CDC and the agency’s guideline production is a key component of ensuring the safety of healthcare in the United States.

CDC supports science-based communication campaigns and other efforts to convey the benefits of vaccines to the public to aid individuals in making informed vaccine decisions to protect themselves and their loved ones.

What about “diversity” and “vulnerable”? The CDC has a number of programs in place, designed to protect vulnerable people:

The United States remains deeply committed to safeguarding the American public from terrorists, just as we are committed to providing refuge to some of the world’s most vulnerable people.

The Immunization Program purchases routinely recommended vaccines to protect at-risk and vulnerable populations not eligible for immunizations through the Vaccines for Children (VFC) Program and to meet urgent public health needs such as controlling VPD outbreaks.

The youngest, most vulnerable population in the United States are the approximately 24,000 infants born each year to HBV-infected mothers, because these infants are at highest risk for developing chronic HBV infection.

The CDC also has a Diversity and Inclusion Management program, but that also doesn’t sit well with the new directive either.

The Office of Minority Health and Health Equity, includes the Office of Women’s Health and the Diversity Management Program, provides…guidance and oversight to the agency-wide implementation of the CDC Diversity Plan.

For decades, the CDC has had an impeccable reputation when it comes to responding to infectious disease outbreaks, like Ebola and Zika, as well as studying, tracking, and treating health situations of all sorts, both within the US and outside of it. Impeding with its due process is nothing short of reckless.

“Here’s a word that’s still allowed: ‘ridiculous,’” said Rush Holt, chief executive officer of the American Association for the Advancement of Science, in a statement reacting to the report.

Dr. Sandro Galea, dean of Boston University’s School of Public Health, emphasizes that this is a clear indication of what the current US administration wants: no more science, no more evidence, no more caring about diversity and the vulnerable.

“If you are saying you cannot use words like ‘transgender’ and ‘diversity’, it’s a clear statement that you cannot pay attention to these issues.”

This is also in tune with what President Trump has done with other agencies, most notably the Environmental Protection Agency, which effectively eliminated scientists from its ranks and issued a de facto ban on any climate science initiatives. The CDC is in an equally delicate position, as the White House and some Republican lawmakers have proposed dramatic reductions to the agency’s $7bn discretionary budget. Still, public support for the CDC remains high, and the agency’s leaders remain somewhat optimistic.

 

In an email to agency employees on Saturday night, CDC director Dr. Brenda Fitzgerald noted the media report and wrote:

“I want to assure you that CDC remains committed to our public health mission as a science- and evidence-based institution. As part of our commitment to provide for the common defense of the country against health threats, science is and will remain the foundation of our work.”

But then again, what else could she have said?

Medicine.

The CDC warns that “chronic Lyme” is bogus and the treatments are horrifying and deadly

With summer upon us in earnest, ticks are popping up all over the place. Even so, a growing trend has physicians more preoccupied than the risk of contracting Lyme disease — last Friday, a report published by the CDC warns people about the slew of bogus treatments marketed for the condition.

Medicine.

Image credits Andrea Ajale.

It’s a dark day indeed when the CDC has to protect people from dishonest treatments rather than diseases — but that’s exactly what the center had to do last Friday. Writing in the CDC’s Morbidity and Mortality Weekly Report, a group of doctors from all over the country, including members from the University of Colorado, the CDC, Yale University, Stanford, and the University of California, San Francisco warn that alternative medical treatments for “chronic Lyme disease” are all unproven and very likely harmful — some even deadly.

These doctors recount the experience of five patients who, erroneously or intentionally diagnosed with what’s essentially a made-up condition with no scientific backing, suffered through and from such treatments which in some cases cost them their lives.

Fake Lymes

Now, Lyme disease is a real, well-documented, pretty nasty disease. It’s caused by an infection with Borrelia burgdorferi, a spirochete which uses blacklegged ticks as a vector. Initial symptoms include the appearance of a characteristic “bull’s eye” rash on the skin, fever, headache, and fatigue. If untreated, the infection spreads out through the body causing arthritis, heart inflammation, dysfunctionalities of the nervous system, even brain swelling.

Patients may develop an (actual and recognized) condition called Post-Treatment Lyme Disease Syndrome / PTLDS. Such patients will show lingering symptoms after being cured of Lyme’s, and, while it’s exact cause is unknown researchers suspect it comes down to lingering tissue damage and the way out immune system responds to them — not an infection, and not something which can be cured by antibiotics.

So it’s easy to see why nobody would be thrilled of contacting it. Luckily, its symptoms make Lyme disease pretty easy to spot and two to four weeks of antibiotic treatments usually flushes the spirochetes out of your system.

But capitalizing on that fear are people who advocate for chronic Lyme disease or, as I like to call it, male Bos taurus feces. It’s a wide-net grouping of vague, nondescript symptoms, ranging from fatigue and generalized pain to neurological disorders. Most times, the diagnostic is pinned without performing any FDA-approved lab testing, often without any lab testing at all, for that matter. In fact, it’s not uncommon for the patient to be told he’s suffering from chronic Lyme despite negative lab results for a B. burgdorferi infection. Because what’s a bit of evidence worth in the face of your pseudo-scientific conviction and/or willingness to con people out of money?

Take this pill daily — for years

Blacklegged Tick.

This is what a blacklegged (deer) tick looks like.
Image credits Fairfax County / Flickr.

Many patients, who are confused by their symptoms often fall for these treatments out of sheer desperation to find a cure to their suffering. Self-described “Lyme-literate” doctors, a term which isn’t indicative of any kind of training (if you hear your doctor say this it only means he’s particularly qualified to be replaced,) convince these patients they’re the victims of a chronic infection and put them on these “alternative” treatments.

What followed was exactly what you’d expect to happen when somebody treats you for something you don’t have in a way that doesn’t work — years of pointless suffering, avoidable infections, even death.

“Patients and their health care providers need to be aware of the risks associated with treatments for chronic Lyme disease,” the doctors declare.

Here’s a short recount of what the five patients mentioned by the authors went through.

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One woman in her 30s showed fatigue and joint pain. She was given several rounds of oral antibiotics, and her condition got worse. She was then administered IV antibiotics for several weeks following which she developed a severe catheter-associated blood infection. She ultimately died of septic shock.

Another woman, in her 50s, who had been diagnosed with Lou Gehrig’s disease (amyotrophic lateral sclerosis, or ALS), also got a second diagnosis — chronic Lyme. She was prescribed a course of herbal remedies, and when these somehow, miraculously failed to cure the made-up disease, was put on IV antibiotics for seven months. This mammoth dose of drugs wrecked her intestinal flora and she developed C. difficile colitis, an intractable intestinal infection linked with antibiotic use. After two years battling the infection, she succumbed to ALS-associated complications.

One teenager suffering from headaches and back pain was diagnosed with chronic Lyme and put on a few months of oral antibiotics, followed by five months of IV antibiotics. She developed a severe blood infection as result of the treatment and suffered septic shock. She needed several weeks’ care in the ICU to recover.

A woman in her late 40s was put on several rounds of oral and IV antibiotics to treat her fatigue and cognitive difficulties two years after being treated for Lyme’s. She ultimately developed an infection which spread to her spine, destroying her 9th and 10th thoracic vertebrae.

The final patient, a woman in her 60s with an autoimmune disease, mixed connective tissue disease, and degenerative arthritis, was diagnosed with chronic Lyme and took more than 10 years of alternative therapies. During this time she overcame several catheter-associated blood infections, which eventually caused abscesses to form in her spine that required surgery.

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Regardless of whether you think you may suffer from PTLDS or “chronic Lyme”, you should avoid these alternative treatments at all costs, the CDC report reads. And there’s a lot of them out there. While the most widely-prescribed treatment are prolonged courses of antibiotics, in 2015 internet-listed therapies for Lyme disease and chronic Lyme ranged from simple herbal and vitamin supplements to $13,000 “photon” therapy, heat and magnet therapies, treatments to remove heavy metals such as mercury, bismuth treatments (potentially fatal), or infusions of hydrogen peroxide. That’s not all! The more exotic treatments included bee venom-based remedies, drinking a bleach solution, your own urine, or a coffee and herbal enema.

Delicious.

As you’ve seen earlier, antibiotics can cause a lot of harm. Their overuse destroys beneficial microbe communities in the body, power-level drug-resistant bugs in your body, and increase the chance of you getting a life-threatening, fully-resistant infection. But, since there’s such a bounty of these alternative treatments floating around, we can only imagine what the effects of some of them are — hint: definitely not good.

“These cases highlight the severity and scope of adverse effects that can be caused by the use of unproven treatments for chronic Lyme disease,” the authors conclude.

“In addition to the dangers associated with inappropriate antibiotic use, such as selection of antibiotic-resistant bacteria, these treatments can lead to injuries related to unnecessary procedures, bacteremia and resulting metastatic infection, venous thromboses, and missed opportunities to diagnose and treat the actual underlying cause of the patient’s symptoms.”