Stopping Malaria with a Sugared Mousetrap
When I was an active clinician I saw several people die of malaria and it’s one of those things that you don’t forget. Nobody likes losing a patient, particularly to a potentially preventable disease. I would often think of the millions of people infected by this parasite. There are 300 million clinical cases of malaria each year, and around the world over one million people die of the illness each year. It has been calculated that a child dies of malaria every 30 seconds, with the largest number of deaths occur among young children in Africa.
We know that cleaning up water supplies and appropriate insecticides would make a huge dent in that terrible clinical toll, and hats off to the Bill and Melinda Gates Foundation for its massive attempts to do things that make sense for helping eradicate malaria and a score of other problems.
There are academics and some pharmaceutical companies that are working on malaria vaccines, and I wish them well. But I wonder about the practicality of paying for vaccines for hundreds of millions of people, when for a fraction of the cost, clean water would do a much better job, and without all the potential problems that might be associated with vaccination.
Global climate change will likely make the range of malaria-carrying mosquitoes much greater in the years to come: it was recently suggested that malaria might in our lifetimes spread as far North as England.
I was very interested to read of an entirely new approach to targeting malaria that could be cheap and easy. It’s also so obvious that I’m sure that there are scientists the world over who are slapping their foreheads this weekend.
I a study reported in the International Journal for Parasitology a team from Hebrew University was able to devastate a local mosquito population by spraying acacia trees with a sugar solution spiked with an insecticide.
The Plasmodium parasites that cause malaria are spread by female Anopheles mosquitoes. The female mosquitoes need blood to develop their eggs, but they also need large amounts of sugar to support their metabolism, so they need large amounts of sweet plant nectar.
What the Israeli team did was to spray acacia trees in an oasis in Southern Israel with a sugar solution containing the insecticide Spinosad. This area was chosen because there were few other plants from which the mosquitoes could obtain sugar. After spraying, the mosquito population was decimated.
Clearly this technique is going to be most valuable in areas with limited plant growth, so the mosquitoes aren’t just going to be able to go next door for food. Though that being said, Anopheles mosquitoes are fussy eaters and only visit a limited number of plant species. So now one suggestion is to plant mosquito attracting plants and spraying them with insecticide. Naturally enough, one worry is that the mosquitoes will learn to go to plant sources that they normally wouldn’t touch, or that they will develop resistance to the pesticides. And though Spinosad is supposed to be an environmentally friendly insecticide that doesn’t effect other insects, birds or animals, we have to keep an eye on the possibility that it may not be all that benign.
This work is going to need to be replicated, but it is an encouraging new approach to a horrible illness that is second only to tuberculosis in the number of people that it kills each year.
It’s Not Just Spinach!
The news yesterday of E. coli contaminated spinach must have been enough to make Popeye weep.
According the Centers for Disease Control and Prevention in Atlanta, as of today, 102 people have been infected with the outbreak strain of E. coli O157:H7 have been reported to CDC from 19 states, and one person in Wisconsin has perished.
Just to re-iterate what you’ve probably heard on the news already: E. coli is often a nasty resistant little bug that is not always killed by cooking. So the best advice is to throw away any spinach that may be suspect. The bacterium can make you very sick. You may have heard that one person has already died and at least a dozen more are in the hospital.
Several years ago there was an egg-borne Salmonella outbreak in the United Kingdom, and we’ve heard of several outbreaks of hepatitis A related to food contamination. There are outbreaks of food poisoning every now and then. And then there is the constant worry about “Mad cow disease,” that led to the wholesale slaughter of animals in the United Kingdom a couple of years ago.
Overall, Secretary Johanns and his team at the United States Department of Agriculture are doing a good job of protecting us.
Be aware, though, that apart from food, there are many other places that bacteria and occasionally viruses can lurk:
- Makeup: the ingredients in makeup can make good breeding grounds for some bacteria. Don’t keep makeup for too long, particularly if it’s been in a hot damp place
- People carry a lot of bugs. That doesn’t mean that you have to become worried about being around them, but it’s best not to get in an elevator is someone’s coughing or sneezing. I’d like to say the same thing about planes, but that’s usually not practical. I’ve many times had to use homeopathic remedies after a flight to prevent a cold – or worse – from emerging. Others have even taken antibiotics after a long flight next to someone nursing a cold. A bit illogical in my view: most upper respiratory tract infections are viral.
- Many bacteria and a few viruses get transferred to hands and doorknobs. You cannot spend your life being terrified of such things: it ruined the life of Howard Hughes, and in real life Adrian Monk would really be suffering. But you can wash you hands – with soap – in warm water for one minute whenever you get the chance. Studies have shown that most people don’t wash their hands properly. And I like those little sterilizing towels that you can carry with you.
- Change your toothbrush every 2-3 weeks.
- If you can afford them, those Ionic Breeze devices do seem to help keep the air cleaner.
- And I’m sure that I do not need to remind you, gentle reader, of the importance of carefully washing your hands after visiting a rest room.
Plague: A Follow Up
I’ve had a lot of very positive feedback about my article about global warming and the risk of Plague.
One person said that he didn’t want to think about something scary like that. Which reminded me a bit of our new kitten, who has still not worked out that if she can’t see you, then maybe you can still see her. She hides her head in a large stand of Pampas grass and assumes that she’s now invisible….
As the conversation with Mr. Head-In-the-Sand continued, I had a sudden flashback to the Hitchhiker’s Guide to the Galaxy, in which the "Ravenous Bugblatter Beast of Traal" was described as "so mind-bogglingly stupid that it assumes that if you can’t see it, then it can’t see you."
I just received this report from the Centers for Disease Control (CDC) in Atlanta.
As you will see, there have been very few cases of Plague in the United States and the CDC keeps a close watch for us. The article also lists some of the key clinical featres of the illness.
Climate Change and Plague
I’ve talked before about one of the reasons that I worry about climate change: it’s the potential for it to unleash illnesses that have been rarely seen in recent centuries. In the Middle Ages, the Black Death, killed a third of the population of Europe, or more than 25-30 million people. The most widely held theory is that the Black Death was Plague: a disease caused by the bacterium Yersinia (Pasteurella) pestis that is most often carried by fleas. In recent years one scholar has suggested that the Black Death was actually caused by anthrax, and in 2001, two epidemiologists raised the possibility that the Black Death was caused by an Ebola-like virus rather than a bacterium.
A paper in today’s Proceedings of the National Academy of Sciences, was written by an international team of scientists, who focused their research on Kazakhstan. Why look in central Asia? This seems to be the original center of the illness. The desert regions of Central Asia are known to contain natural foci of plague where the great gerbil (Rhombomys opimus) is the primary host of the Yersinia-carrying fleas.
The first epidemic originated in Asia and was apparently transmitted to Europeans in 1347. A Turkish army besieging a Genoese trading post in the Crimea allegedly catapulted plague-infested corpses into the town. The Plague spread from the Mediterranean ports and ravaged all of Europe between 1347 and 1351. Those outbreaks coincided with both warmer and increasingly wet weather. There were renewed outbreaks in 1361–63, 1369–71, 1374–75, 1390, and 1400. For more than two centuries, everything remained quiet, but then there were further outbreaks in Italy in 1629-1631, London in 1665, and Vienna in 1679. There was another Pandemic in Asia from1855-1870 that claimed the lives of millions, and again coincided with wetter and increasingly warm weather.
Fleas become active when the temperature exceeded 10C (50F), so a warm, frost-free spring has led to an early start to breeding. Over the last two years, the flea population has continued to grow when the spring was followed by a wet, humid summer.
We don’t need to be unnecessarily alarmist, but the evidence indicates that climatic changes could lead to more outbreaks of bubonic plague among human populations. And who knows what other illnesses are waiting in the wings as our climate changes, we travel more and our physical resilience declines?
“Humankind has not woven the web of life. We are but one thread within it. Whatever we do to the web, we do to ourselves. All things are bound together. All things connect.”
–Chief Seattle (Native American Leader of the Suquamish and Duwamish Tribes who became a Roman Catholic and Cooperated in Creating Peaceful Relations with European Settlers, c. 1786-1866)
Toxoplasmosis, Behavior and Mental Illness
This title may seem odd, but this item may actually turn out to have enormous implications for all of us.
A couple of years ago I read a fascinating book: Parasites and the Behavior of Animals, in which the author – Janice Moore from Colorado State University – cataloged some of the extraordinary ways in which parasites can impact the behaviors of a vast array of animals. As difficult as it is to interpret studies of parasites in humans, I kept coming back to some odd observations about an illness with which I’ve been involved for more than 30 years: schizophrenia. I kept wondering if some of the odd observations made over the years could be explained by the parasites?
What kind of odd observations?
- Reports of mental illness have been found throughout history, yet this strange illness that we now call schizophrenia seems to have been very rare until about 1750, when it increased dramatically throughout Western Europe. I have had the privilege of working at the Bethlem Royal Hospital from which got the word “bedlam.” I know of the incredible records kept there. Something began to change in some of the types of patients being admitted at that time. I have also had the opportunity to look at some of the records at the Philip’s Hospital in Southern Germany, which has been in existence since 1533. Again the records show the sudden appearance of many cases of something that had been quite rare until then. 1750 marked the early years of the industrial revolution in Europe and the mass migration of people from the countryside to the new and very crowded cities
- There has been recent evidence that being born and raised in a city increases your chance of developing schizophrenia.
- There is increasing evidence that acute episodes of psychosis, mania and depression are associated with increases in circulating inflammatory mediators. There is also intriguing new data that both psychosis and depression can be improved by giving people COX2 inhibitors.
- There has also been the strange observation that bipolar disorder may have been becoming more common in recent years, over and above our greater ability to recognize the illness.
Several years ago the well-known psychiatrist E. Fuller Torrey first suggested that a small protozoal parasite called Toxoplasma gondii might be responsible for all of these observations. Cats can carry it, which is why pregnant mothers are advised not to pet their cats during pregnancy.
The idea that such a complex disease as schizophrenia might sometimes be caused by a parasite caught the media’s attention, but in recent years the story – but not the ongoing research – died down a bit.
There was an excellent and provocative blog item by Carl Zimmer about this almost three weeks ago, but I wanted to check everything out before responding. He gave a brief review of a new paper published in the Proceedings of the Royal Society, by Kevin Lafferty from the University of California in Santa Barbara. Lafferty has attempted to correlate the varying rates of Toxoplasma in different countries with predominant personality traits and therefore – since our societies are aggregates of all our personalities, cultural characteristics.
That may all sound far-fetched, but I don’t think that it is. And I don’t think that the Proceedings would have taken a completely half-baked proposition.
I have also found a report published in the journal the Proceedings of the Biological Society. Four eminent authors, including Torrey, revisited the while issue of Toxoplasmosis and mental illness. When the parasite gets into the nervous system it can alter behavior: Rats are normally programmed to avoid cats, but once infected they are attracted to cats. Over the last few days I’ve been plowing the world literature, and I’ve learned some very interesting things that support the idea that Toxoplasma may be playing a role in several different types of psychiatric illness.
There is strong evidence that schizophrenia, bipolar disorder and major depressive disorder lie on a spectrum. The illnesses are not the same, but people often switch from one type of clinical presentation to another. The precise type if illness would be determined by the interaction of genes, physical and Intrapsychic environment. Nobody would be sufficiently naïve to try and reduce the whole of psychiatric illness to a single bug. Mental illness is a great deal more than just a physical problem, and apart from anything else, the rates of Toxoplasma infections show remarkable variations around the globe, while the rates of major mental illness are much the same everywhere.
So what have I learned?
- There are a remarkable numbers of studies showing that many people with schizophrenia have antibodies to Toxoplasma, including people having their first attack of the illness
- Blood donors infected with Toxoplasma have decreased levels of novelty-seeking
- In women who become infected, there are some marked changes in personality.
- Toxoplasma affects the dopamine systems of the brain that we know are intimately involved in mood, cognition, movement and motivation.
- Some drugs used to treat psychosis (haloperidol) and mood disorder (valproic acid) inhibit the replication of Toxoplasma gondii. The valproic acid already does it at concentrations lower than we normally aim for when treating humans.
- There is some intriguing work going on into the use of antibiotics to kill Toxoplasma and reverse its behavioral effects.
In the last few years, so many illnesses have turned out to have infectious origins, from peptic ulcers to arteriosclerosis and some cancers. Perhaps some mental illnesses will be next.
Last year Barry Marshall and Robin Warren were awarded the Nobel Prize in Physiology or Medicine for their pioneering work on Helicobacter. I have a strong sense that there are more prizes to come on the interaction between infectious agents, inflammation, genes, the psyche and the environment.
Perhaps the reason that some antipsychotics and mood stablizers can reverse some of the neurological damage associated with schizophrenia and bipolar disorder is becuase they are killing off the causative agents and allowing the brain to repair itself.
I shall keep you posted!
Global Warming
My interest in global warming is three-fold: the first is scientific: is this all just a political bandwagon, driven by a misunderstanding of normal climatic cycles? Secondly, if it is a real phenomenon, then we have a responsibility to future generations: a part of what we refer to as a central philosophical plank: “Legacy.” Third is the impact of global warming on patterns of illness, in particular infectious and environmental pathogens, and how we can build resistance and resilience to them.
Some of the more recent evidence had a good airing on the Scientific American website.
My own view is that global is now clearly proven: I have just seen too much evidence, from walking the balmy streets of Stockholm in dead of winter when the temperatures should have been tens of degrees lower to an analysis of changing patterns not just of temperature, but of disease. The warming is a consequence of a lack of balance and harmony: too much Yang activity overwhelming the Yin necessary to stabilize the world. Or, in the language of spiral dynamics, too many people and social structures being stuck at the levels of the Red and Orange Memes.
The only thing that I find a little irksome is the number of people who lecture us about global warming while continuing to engage in all kinds of activities that contribute to the problem. Your humble reporter first became interested in installing solar panels while still living in England. Not practical in a country where once the sun rarely shone very much, and where the panels used to be prohibitively expensive.
We plan to install some next year, while continuing drastically to conserve other resources. And to try and anticipate the impact of global climate change on illness.
Cranberries and the Inflammation Associated With Severe Gum Disease
There is an interesting study from a team of researchers from Quebec, Canada. The findings, published in the Journal of Antimicrobial Chemotherapy, reveal that natural compounds in cranberries may help ward off periodontitis, or severe gum disease, by serving as a powerful anti-inflammatory agent. This anti-inflammatory effect may be attributed to unique compounds in the fruit that prevent the bacterium P. gingivalis from adhering to the teeth below the gum line. Though it is early days, this new research offers promise for the estimated 67 million Americans affected by periodontitis, the primary cause of tooth loss in adults.
The reason for the study was that cranberries have what are known as "anti-adhesion" activity. This helps guard the body from certain harmful bacteria that cause urinary tract infections (UTIs), gastric ulcers and gum disease. This anti-adhesion activity is primarily due to molecules called proanthocyanidins (PACs) found naturally in cranberries and other foods. Cranberry PACs contain a unique A-type structure that is responsible for this anti-adhesion mechanism of action, while most other foods contain only the more-common B-type PACs.
Researchers discovered that cranberry compounds can reduce the growth of P. gingivalis and subsequent plaque development — the initial step in the development of periodontitis. Periodontitis occurs when inflammation or infection of the gums is left untreated or treatment is delayed. Infection and inflammation spreads from the gums to the ligaments and bones that support the teeth and eventually leads to tooth loss.
In a paper in the Journal of Dental Research the same researchers had previously shown that cells treated with cranberry juice showed significantly less inflammation than cells that were not treated.
Not only can cranberry compounds decrease the growth of P. gingivalis, they may also prevent certain oral bacteria from directly destroying gum tissue itself — another major factor contributing to periodontitis. This may have more widespread implications as recent studies have also linked severe gum disease with an increased likelihood for heart disease and stroke.
The study was part funded by the Ocean Spray agricultural cooperative that sells cranberry juice.
Brushing, flossing and regular professional cleaning reduces the risk of developing periodontitis by helping to prevent the onset of gingivitis, or gum infection. Cranberries may provide an interesting ingredient in the development of new therapeutic approaches for treatment of periodontitis.
Technorati tags: Cranberries Dental disease Heart disease Urinary tract infection Inflammation
Brushing Your Teeth is Good for Your Heart
This was the title of an article in Time magazine and something that I’ve been meaning to discuss for a while now.
We have known for some years now that there can be a link between periodontal bacteria and heart disease, but a new study from the Department of Health Sciences in Kristianstad University, in Sweden and published in the Journal of Periodontology.
The researchers found the presence of specific bacteria in periodontal pockets, which are those areas of tissue surrounding teeth, that might be an explanation for the relationship between periodontal disease and acute coronary syndrome (ACS). ACS is the term used to describe insufficient blood supply to the heart muscle that results in heart disease.
The investigators compared 161 subjects diagnosed with ACS with a control group of people who did not have cardiovascular disease. They found that the bacterial burden – the amount of oral bacteria –was twice as high in the ACS group for the combination for the bacteria streptococci, and three less common bacteria: P. gingivalis, T. forsythia and T. denticola. These findings suggest that this combination of bacteria is the link between periodontitis and ACS.
The periodontal bacteria cause an inflammatory response that elevates the white blood cell count and increases one of the key inflammatory markers: high sensitivity C-reactive protein levels in the blood, a factor which has been linked in past studies to heart disease.
Alveolar bone loss—atrophy of the bones that support your teeth—was also found to be significantly greater among subjects with ACS. The extent of bone loss was more severe in the ACS group than in the non-ACS group with 77%of the participants in the ACS group afflicted with periodontitis versus 42% in the control group.
The study highlights the importance of routine periodontal examinations and at-home dental care, particularly if you have a personal or family history of heart disease.
Technorati tags: Periodontal disease Heart disease Inflammation Dental hygiene
Homeopathy as a Part of a Comprehensive Treatment Plan
I have been using homeopathic remedies for over 25 years, and I have often found them to be extremely helpful.
I part company from many of my friends who are classical homeopaths who insist that using any form of conventional medicine "suppresses" illnesses, rather than curing them, and so should all be avoided like the plague.
As we started rolling out the new integrated model of healthcare, which integrated conventional medicine, lifestyle changes and homoeopathy, many people objected violently on the grounds that ANY use of other, non-homeopathic treatments would prevent the homeopathic remedies from working.
This has come up recently with several common problems: using homeopathic "vaccinations" in place of the real thing; using homeopathic remedies for influenza, to the exclusion of conventional treatments. And now we hear of people being advised to use homeopathy for malaria prohylaxis. This worries me: I have seen people die of malaria, and it isn’t pretty. Homeopathy may be a useful adjunctive treatment and it may also help with any side effects of conventional treatment.
Please don’t play Russian Roulette with your health.
I thought that it would be a good idea to reproduce the following brief article:
Alternative malaria treatment may not work from PhysOrg.com
British health authorities are urging tourists not to rely on alternative treatment such as homeopathy to fight malaria.
[…]
Technorati tags: Homeopathy Integrated medicine Malaria
A New Way of Looking at – and Treating – Inflammation
Diseases of both large and small blood vessels are two of the biggest problem facing people with diabetes. Not only is it a huge clinical challenge, but also nature sometimes does our experiments for us. The high rates of coronary and peripheral vascular disease in diabetes can be seen as a kind of experiment of nature: a recognizable set of chemical abnormalities that might shed light on vascular diseases in general. It was those twin factors: a huge clinical problem, and an experiment of nature, that lead me to pick the topic of my research doctorate.
When I was working on my research doctorate in the mid 1980s, I came across a lot of old research that seemed to show links between inflammatory and autoimmune conditions like systemic lupus erythematosus and rheumatic fever, and the eventual development of coronary artery disease. There was also a lot of old and largely forgotten research about the link between some viral infections and the development of coronary artery disease and acute coronary artery occlusions, because some infections can make blood more “sticky.” Inflammation evolved as one of the body’s defence mechanisms.
So I made the proposal – revolutionary at the time – that diabetes, coronary artery disease and a range of other illnesses might be inflammatory rather than degenerative. I soon found inflammatory markers in people with diabetes, that helped predict when someone was running into trouble with their eyes, kidneys or heart. Even with stacks of data, I had to spend a lot of time defending that position, because it also implied that some illnesses thought to be irreversible might not be.
With the passage of time, it has tuned out that I was probably correct. Chronic inflammation, wherever it starts, mat have long-term effects on the body and on the mind. Chronic inflammation increases the risk of diseases of many blood vessels, as well as causing anemia, organic depression and cognitive impairment. Here is a partial list of common conditions in which inflammation is a prominent factor:
1. Rheumatoid arthritis
2. Systemic lupus erythematosus
3. Fibromyalgia
4. Chronic infections
5. Insulin resistance or metabolic syndrome
6. Arteriosclerosis
7. Diabetes mellitus
8. Hypertension
9. Asthma
10. Inflammatory bowel disease
11. Psoriasis
12. Migraine
13. Peripheral neuropathy
14. Alzheimer’s disease
15. Autism
16. Gingivitis
17. Cystitis
The reason for raising the issue is not to say “told you so!”
It is instead that we need to think about inflammation a little differently. There is a mountain of information about the physical aspects of inflammation. We can stop at the simple description of inflammation as a condition in which part of the body becomes reddened, swollen, hot, and usually painful, or we can look below the surface: we can examine inflammation not only as a physical problem, but also as a psychological, social, subtle and spiritual problem. Why bother? Because the deeper approach allows us to understand and to treat and transcend inflammation as never before.
I am going to write some more about specific ways to address inflammation and what it means in future articles. I would also like to direct you to the book Healing, Meaning and Purpose, in which I talk about specific approaches in more detail.
But I would like to start with this.
In Ayurvedic and homeopathic medicine, inflammation is a sign of an imbalance in the vital forces of the body, and the traditional Chinese system agrees: here inflammation is usually a manifestation of an excess of Yang Qi, or a deficiency of Yin Qi. Most of our lives are seriously out of balance: Yang Qi is like a rampaging lion that has been stimulated by:
Acidic foods;
Environmental toxins;
Unwanted sexual stimulation:
Noise;
Discordant music:
Constant demands from others:
Toxic relationships;
Years spent in front of television sets and limitless multi-tasking.
It should be no surprise to learn that all of these inflammatory conditions are increasing rapidly throughout the Western world. Not because we are getting better at identifying them, or we are living longer, but genuinely increasing.
It is wrong to put all the blame on poor diets or inadequate exercise. The problem is more subtle and is a reflection of distorted Information being fed to our bodies, minds, relationships, subtle systems and spiritual relationships.
The great news is that this simple conceptual shift gives us a whole load of new tools for handling these problems, and for using them as catalysts to growth.
In the next few weeks, I am going to drill down and give you some specific guidance that ties into the material in Healing, Meaning and Purpose and the next two that are on the launch pad.
Fasten your seat belt!
Technorati tags: Inflammation Aging Alzheimer’s disease Arteriosclerosis Neuropathy Autism Arthritis Systemic lupus erythrmatosus Fibromyalgia Inflammatory bowel disease Gingivitis
