What is shigellosis

The city of Flint, Michigan, is seeing a rise in cases of a bacterial illness called shigellosis, and the ongoing water crisis there may be in part to blame, according to news reports.

So far this year, there have been 85 cases of shigellosis in Genesee County, which includes Flint, according to The New York Times. That’s the highest number of shigellosis cases among all counties in Michigan this year.

A statement from Genesee County Health Department in September said that cases of the bacterial illness are up in both the county and the state. In the entire state of Michigan, there were 454 cases of shigellosis this year, and there were 515 cases in 2015. That compares to 175 cases in 2013 and 249 cases in 2012.

Shigellosis is a very contagious gastrointestinal disease caused by the bacteriaShigella. There are about 500,000 cases of the illness each year in the United States, according to the Centers for Disease Control and Prevention (CDC). Symptoms include diarrhea, fever and abdominal pain, and usually last a week, although it may take several months for people’s bowel habits to return to normal after infection, the CDC said.

The Shigella bacteria are spread through contact with fecal matter. People can become infected if they eat food or touch surfaces that have been contaminated with Shigella. Careful handwashing with soap and water can reduce the spread of the disease, the CDC said.

But residents of Flint may have changed their handwashing habits as a result of the city’s water crisis, CNNreported. In 2014, the city changed the source of its water supply, and that change resulted in an increase in the water’s levels of lead. Exposure to this lead may have caused health problems, including rashes, hair loss and neurological issues, The New York Times reported.

Distrust in the city’s water caused people to bathe and wash their hands less frequently, Jim Henry, the environmental health supervisor of Genesee County told CNN. “People have changed their behavior regarding personal hygiene. They’re scared,” Henry was quoted as saying.

Residents have been using baby wipes to wash their hands, but because these wipes aren’t chlorinated, they don’t kill bacteria, Henry said. “It doesn’t replace handwashing,” he said.

You should never be penalized for being a father

images-38As a practicing obstetrician, I always believe that it is fundamentally important to have partners involved with the birth of a child, and for them to participate in all aspects of the delivery— from prenatal care and becoming an advocate for the pregnant patient, to certainly taking part in the birthing experience. The bonding that this brings to the child is of monumental proportions because it provides that family unity and love from the moment of birth, which can translate itself to years of positive experiences for the child.

This is why I was outraged when I heard about a Utah father who says he was billed $39.35 to hold his newborn child during a common skin-to-skin ritual for the mother and child.

As the new dad’s viral Reddit post goes, Ryan Grassley, of Spanish Fork, was surprised to learn when he received his hospital bill that he was charged to hold his newborn on his wife’s neck and chest area. He wrote that the nurse borrowed his camera to take a few pictures of them.

“Everyone involved in the process was great, and we had a positive experience,” Grassley wrote in the post, where he shared a photo of the bill, and a picture of him, his wife and their infant. “We just got a chuckle out of seeing that on the bill.”

Although Grassley said he thought the whole thing was “funny and a bit ridiculous”— and even started a GoFundMe page to raise $39 and pay for the charge, which he met within days— I think this case shows just how absurd hospital bills have become in such crucial medical situations as childbirth and the immediate rituals following.

For mothers who undergo cesarean sections, as Grassley’s wife did, skin-to-skin contact after birth has several benefits for both women and their children. The action involves the baby lying on the mother’s chest, and is meant to help the baby hear his or her mother’s heartbeat and detect her nipple to aid in breastfeeding.

Now, the hospital responded to Grassley’s post, which other parents have met with disgust and outrage, by specifying that the charge wasn’t for the skin-to-skin contact itself, but rather for the additional nurse staff insisted was needed to ensure the baby’s safety during the action.

Regardless, I am sick and tired of patients getting billed to death by hospitals and caregivers, where in some cases, if you look at those crazy itemized bills, they would even charge you for the toilet paper you use when you’re staying in the hospital. Hospitals today charge in such a way that we look like the Pentagon, where we charge $800 for a hammer. And this has to stop.

This case where this father seems to have been billed to simply hold his newborn child is deplorable. There, I said it!

acupressure for morning sickness

For women with morning sickness, a range of remedies may be effective at alleviating mild to severe symptoms, but the evidence on how well they work is lacking, a new review from the United Kingdom finds.

Up to 85 percent of women experience morning sickness during pregnancy, and the symptoms can affect their day-to-day lives, according to the review, published Tuesday in the journal JAMA.

In the review, the researchers, led by Catherine McParlin, an associate researcher at Newcastle Upon Tyne Hospitals NHS Foundation Trust in the United Kingdom, looked at 78 studies on various treatments for nausea and vomiting during pregnancy.

Of the 78 studies, 67 were randomized clinical trials, meaning that the people in the study were randomly assigned to receive either the treatment or a placebo. Randomized clinical trials are considered the gold standard when it comes to determining if a certain treatment is effective.

However, after reviewing the studies, the researchers determined that many of them, including some of the randomized clinical trials, were “low-quality” studies, meaning that the research was imprecise, did not include a wide variety of patients, or didn’t offer enough information from which to draw conclusions, according to the study.

Overall, treatments for morning sickness fell into three main categories, according to the review. First-line treatments were those that included simple lifestyle changes, such as changes to diet, and over-the-counter remedies. Second-line treatments were medicines prescribed by a doctor, according to the review. And third-line treatments were reserved for the women with the most severe morning sickness, and are given in a hospital setting, the researchers wrote.

For women with mild morning sickness, the researchers found that consuming ginger, taking vitamin B6 supplements and using acupressure are all “appropriate initial” approaches. Acupressure is an ancient practice that involves applying pressure to certain points on the body. In the review, the researchers focused on studies that looked at applying pressure on a point on the inside of the wrist, about one-sixth of the way up the arm.

Other options, such as nerve stimulation, which involves applying a mild electrical current to certain parts of the body such as the wrist, may also be considered for mild cases, and although the procedure is safe, “the benefit is unclear,” the researchers wrote. In this case, the researchers looked at a study on nerve stimulation to the same pressure point used in acupressure.

For women with mild to moderate morning sickness, or in those who’ve tried the approaches for mild morning sickness and found they didn’t work, the researchers discovered that antihistamines were associated with improved symptoms. Women are sometimes recommended to take antihistamines in combination with vitamin B6, the researchers said in their review. In the U.S., this combination is available by prescription.

Other prescription drugs, such as promethazine and metoclopramide, which affect dopamine levels in the body, were found to be helpful for women with moderate morning sickness, according to the review.

One study included in the review evaluated psychotherapy as a treatment option for women with moderate to severe morning sickness. However, the researchers concluded that evidence that it worked was not strong enough to recommend it.

Anti-nausea drugs, such as ondansetron, appeared to be beneficial for women with all levels of morning-sickness severity, the researchers wrote. The drug appears to safe for pregnant women, but more research is needed to ensure that it is safe, the researchers wrote.

The dengerous of mercury

We all know the benefits of a daily dose of physical activity by now. Not only does exercise tone your body so you can wear your favorite jeans, it even helps with your memory. But when it comes to retaining new information, working out may not do much for people who were exposed to high levels of mercury before birth, according to a new study that was just published in thejournal Environmental Health Perspectives.

Most adults get exposed to some level of mercury through their diet, especially if they eat a lot of seafood. The metal often gets into water as a result of industrial pollution, and it makes its way up the food chain when fish eat plankton or smaller fish that are already contaminated. Because it accumulates this way, the United States Food and Drug Administration has set a limit on the amount of mercury (1 part per million) that cannot be exceeded in fish intended for human consumption.

Generally, two groups are more sensitive to the effects of mercury — tiny fetuses, and people who are regularly exposed to mercury. That’s because fetuses’ brains are still developing and methylmercury can easily cross their blood-brain barrier and kill neurons. But the long-term effects of mercury exposure once those fetuses grow up to become adults had not been well understood until now.

“We know that neurodevelopment is a delicate process that is especially sensitive to methylmercury and other environmental toxins, but we are still discovering the lifelong ripple effects of these exposures,” Gwen Collman, director of the National Institute of Environmental Health Sciences (NIEHS) Division of Extramural Research and Training said in a statement.

To see if exercise could help improve cognitive function in adults who had been exposed to mercury in the womb, scientists studied nearly 200 people from the Faroe Islands, where fish is a major component of the diet. The researchers kept track of the participants’ health from the time they were in the womb until they turned 22. At the age of 22, the volunteers also took part in a follow-up exam that tested how much they had been exercising by measuring their VO2 max — the rate at which they used oxygen — a statistic that increases with aerobic fitness. Then they did a series of cognitive tests to measure things like short term memory and verbal comprehension and the speed at which their brain processed information.

The researchers found that higher VO2 numbers were associated with better brain function. But participants with higher prenatal exposures did not experience cognitive improvements when their VO2 max and their fitness increased. Brain benefits were limited to those adults who had had levels of less than 35 micrograms per liter in their umbilical cord blood when they were fetuses.

“We know that aerobic exercise is an important part of a healthy lifestyle, but these findings suggest that early-life exposure to pollutants may reduce the potential benefits,” said Collman.

While this doesn’t mean that, if your mom ate a ton of tuna you should give up on exercising entirely, it certainly highlights that we should be even more cautious of the long-term effects of mercury exposure.

MEN SEXUAL DESIRE

They recruited 38 male participants who’d been diagnosed with disorders characterized by a lack of interest in sex. The researchers measured their baseline libido and testosterone, and then divided them into two groups: one got a 30-minute blast of 10,000 lux of white fluorescent light from a box fitted with an ultraviolet filter, immediately upon waking up. The control group got a placebo box with a much dimmer light.

Before the treatment, the men reported their sexual satisfaction at around two out of 10. After two weeks, those who received bright light treatments scored a three-fold increase in their sexual satisfaction, at around six out of 10. The placebo group reported a flaccid 2.7 after staring at their dimmer box.

Testosterone levels also went up, from 2.1 ng/ml to 3.6 ng/ml in the light-treatment group. This boost in testosterone is what jump started their sex lives. “In the Northern hemisphere, the body’s testosterone production naturally declines from November through April, and then rises steadily through the spring and summer with a peak in October,” the study’s lead scientist Andrea Fagiolini said in a press release. “You see the effect of this in reproductive rates, with the month of June showing the highest rate of conception. The use of the light box really mimics what nature does.”

The researchers note that light treatment could offer the benefits of injections or antidepressants typically used to treat lack of sexual desire, without the side effects of medications. But don’t get your pen lights out just yet–this isn’t tabloid, “One Weird Trick” information, but a small study showing potential for larger discussion. For both the more than 30 percent of men and 43 percent of women who experience some sort of sexual dysfunction, light therapy–shown to be helpful in depression and mood disorders–is at least worth a look. Bright light therapy has also shown potential for triggering ovulation in women, so let’s all move to Yuma?

BACTERIAL STDS

There’s little doubt Zika has become the infectious disease of 2016. Since the beginning of the year, public health officials have warned of the two routes of transmission. The first, mosquito bites, is fairly well known although in America has not yet become a major route of spread. The other route, sexual transmission, has become a major focus leading the CDC and other health authorities to sound the alarm.

While the spotlight on sexually transmitted Zika is important to raise awareness, it has distracted from other more prevalent infections. In particular, attention to bacterial causes of disease has waned and for the most part disappeared. Familiar names such as gonorrhea, syphilis, and chlamydia continue to spread without much mention or concern.

While this action may not seem to have any relevance to the general public, one particular statement stands as an ominous outlook for the future. Antibiotic resistance is rising and in the case of gonorrhea, resistance to thelast line of defense has been seen. In other words, some strains of the bacterium can no longer be treated with these drugs.

The announcement is particularly important for Americans. In 2014, more than 350,000 people were diagnosed with gonorrhea. This represents a ten percent increase since 2010. Making this even more troublesome is the age of those most likely to be infected, namely teenagers and those in their early twenties. This suggests the bacterium is spreading in populations generally possessing fewer details on sexual health. Moreover, the potential for resistance to authority makes spreading awareness and recommendations less likely to succeed.

In terms of antibiotic resistance, over one-third of the isolates demonstrate resistance to more than one antibiotic. While the existence of pan-resistant strains has not been seen in the US, the threat is clear. Though there are no time estimates on the arrival of this particular type of gonorrhea, few will doubt it will be all that long if the rate of spread continues to climb.

Gonorrhea may signal the worst of the STDs but the World Health Organization included two other bacteria in the new guidelines. One is the most common bacterial sexually transmitted infection while the other is an old world pathogen resurging today. Like gonorrhea, they too are demonstrating a significant challenge due to increased spread and also the threat of resistance to treatment.

Chlamydia is a hard infection to track as most of the time there are no symptoms. But without treatment, the bacterium can grow and eventually cause significant pain in women. The bacterium can also be transferred to the fetus causing birth defects and pneumonia. It’s one of the reasons why annual screening is important.

In America, more than 1.4 million infections are diagnosed each year. This is over 2.5 times higher than it was just twenty years ago. The rise has meant a greater need for antibiotic treatment and unfortunately, an increase in resistance. While the WHO suggests only a few cases of resistance have been identified in humans, in animals, resistant strains are increasing in prevalence. This means caution is needed to be sure treatment is effective and does not inadvertently lead to troubles.

In contrast to chlamydia, syphilis is well known and is easy to spot. The development of bumps and sores is a telltale sign and should be investigated. However, the real trouble arises later when the bacterium spreads throughout the body. The body becomes covered in a rash, the eyes can be affected, and eventually, the brain may suffer, leading to dementia.

The disease was a scourge centuries ago and in America, was a significant concern in the early 1990s as more than 100,000 people were infected each year. That dropped by almost two-thirds by the turn of the 21st century. However, the bacterium is on the rise again and now affects over 63,000 people per year. This is troubling as the rise suggests a greater risk for infection and also for resistance.

At the moment, there is an effective antibiotic treatment for syphilis. However, there is a shortage of this particular drug in America leaving medical professionals with the need to find alternate options. Thankfully, at the moment, resistance has only been observed against one particular antibiotic type called a macrolide. Yet the potential for wider resistance patterns exists and as such, proper treatment is essential.

The state of STDs in America is without a doubt worsening. Yet, as with many infectious diseases, these three are all preventable. All one needs to do is become aware of the means to safer sex and then follow through on these recommendations. Based on the data at hand, those under 25 years of age are most at risk and need to be sure to stay safe. Figuring out how to convince them to click, read, and heed, however, may be more difficult than dealing with antibiotic resistance.