August 30, 2015
By
HOUSTON - A 14-year-old Houston teen (click here) who has been battling a rare brain-eating disease for more than a week has passed away.
Michael Riley got sick after swimming in a lake at Sam Houston State Park. Doctors say the amoeba is typically found in warm freshwater and that it entered through Riley's nose and swam to his brain.
Only 35 Americans have suffered from the disease in the past ten years.
Cooling the body below normal temperatures creates a hostile environment for the parasite. Texas has standards for public lakes, were the inspections daily to these sources of infection. Are the Texas standards adequate to provide early detection of parasites in the public waters?
After 35 years (click here) without a Naegleria survivor in the United States, during the summer of 2013, 2 children with Naegleria fowleri infection survived. The first, a 12-year-old girl, was diagnosed with PAM approximately 30 hours after becoming ill and was started on the recommended treatment within 36 hours. She also received the investigational drug miltefosine 7-9 and her brain swelling was aggressively managed with treatments that included cooling the body below normal body temperature (therapeutic hypothermia). This patient made a full neurologic recovery and returned to school. Her recovery has been attributed to early diagnosis and treatment and novel therapeutics including miltefosine and hypothermia 5.
A second child, an 8-year-old male, is also considered a PAM survivor, although he has suffered what is likely to be permanent brain damage. He was also treated with miltefosine but was diagnosed and treated several days after his symptoms began. Cooling of the body below normal body temperature was not used....
August 30, 2013
Infections caused by free-living amebae (FLA) (click here) are severe and life-threatening. These infections include primary amebic meningoencephalitis (PAM) caused by Naegleria fowleri* and granulomatous amebic encephalitis caused by Balamuthia mandrillaris† and Acanthamoeba species.§ Although several drugs have in vitro activity against FLA, mortality from these infections remains >90% despite treatment with combinations of drugs.
Miltefosine is a drug used to treat leishmaniasis and also has shown in vitro activity against FLA (1), but as an investigational drug, it has not been readily available in the United States. With CDC assistance, however, miltefosine has been administered since 2009 for FLA infections as single-patient emergency use with permission from the Food and Drug Administration. Although the number of B. mandrillaris and Acanthamoeba species infections treated with a miltefosine-containing regimen is small, it appears that a miltefosine-containing treatment regimen does offer a survival advantage for patients with these often fatal infections (2). Miltefosine has not been used successfully to treat a Naegleria infection, but the length of time it has taken to import miltefosine from abroad has made timely treatment of fulminant Naegleria infections difficult...
Hot air leads to hot water which leads to the growth of pathogens. There should be regular testing of any public waters. States should consider the danger of the climate crisis in relation to public health and public waters. This problem will not go away. Not now it won't.
An increase in pathogens has always been part of the expectations of the climate crisis. Pathogens are opportunistic. There is no other way of dealing with this than regularly testing waters known to have temperatures of that of bathwater or higher.
This pathogen and others needs to be clearly understood. Research of these pathogens is very dangerous to the people conducting the studies. These require all kinds of precautions including anti-rooms to don and doff personal protective equipment. The public exposure is important to prevent.
These organisms need to be understood to the environmental conditions that spawn their growth to help decide some states when to begin testing and when to end. Other states will just consider this a routine no matter the environmental conditions.
The methodology of testing on a continual basis will add another layer of safety to the public in that mutant strains can occur. There is nothing more effective than placing drops of water under a microscope and looking for parasites and their numbers.
For all fifty states that seek to conduct daily accounting of public waters, the CDC would have guidelines and recommendations. With this death of a very precious child the CDC might consider a bulletin to conducting testing to prevent exposure to the public.
...The states are required (click here) under the Clean Water Act to review their water quality standards at least once every three years and revise them, if appropriate. States review standards because new scientific and technical data may be available that have a bearing on the review. Further, environmental changes over time may also warrant the need for a review....
This single event can trigger an evaluation of Texas water quality standards. I strongly suggest Texas do exactly that.
By
HOUSTON - A 14-year-old Houston teen (click here) who has been battling a rare brain-eating disease for more than a week has passed away.
Michael Riley got sick after swimming in a lake at Sam Houston State Park. Doctors say the amoeba is typically found in warm freshwater and that it entered through Riley's nose and swam to his brain.
Only 35 Americans have suffered from the disease in the past ten years.
Cooling the body below normal temperatures creates a hostile environment for the parasite. Texas has standards for public lakes, were the inspections daily to these sources of infection. Are the Texas standards adequate to provide early detection of parasites in the public waters?
After 35 years (click here) without a Naegleria survivor in the United States, during the summer of 2013, 2 children with Naegleria fowleri infection survived. The first, a 12-year-old girl, was diagnosed with PAM approximately 30 hours after becoming ill and was started on the recommended treatment within 36 hours. She also received the investigational drug miltefosine 7-9 and her brain swelling was aggressively managed with treatments that included cooling the body below normal body temperature (therapeutic hypothermia). This patient made a full neurologic recovery and returned to school. Her recovery has been attributed to early diagnosis and treatment and novel therapeutics including miltefosine and hypothermia 5.
A second child, an 8-year-old male, is also considered a PAM survivor, although he has suffered what is likely to be permanent brain damage. He was also treated with miltefosine but was diagnosed and treated several days after his symptoms began. Cooling of the body below normal body temperature was not used....
August 30, 2013
Infections caused by free-living amebae (FLA) (click here) are severe and life-threatening. These infections include primary amebic meningoencephalitis (PAM) caused by Naegleria fowleri* and granulomatous amebic encephalitis caused by Balamuthia mandrillaris† and Acanthamoeba species.§ Although several drugs have in vitro activity against FLA, mortality from these infections remains >90% despite treatment with combinations of drugs.
Miltefosine is a drug used to treat leishmaniasis and also has shown in vitro activity against FLA (1), but as an investigational drug, it has not been readily available in the United States. With CDC assistance, however, miltefosine has been administered since 2009 for FLA infections as single-patient emergency use with permission from the Food and Drug Administration. Although the number of B. mandrillaris and Acanthamoeba species infections treated with a miltefosine-containing regimen is small, it appears that a miltefosine-containing treatment regimen does offer a survival advantage for patients with these often fatal infections (2). Miltefosine has not been used successfully to treat a Naegleria infection, but the length of time it has taken to import miltefosine from abroad has made timely treatment of fulminant Naegleria infections difficult...
Hot air leads to hot water which leads to the growth of pathogens. There should be regular testing of any public waters. States should consider the danger of the climate crisis in relation to public health and public waters. This problem will not go away. Not now it won't.
An increase in pathogens has always been part of the expectations of the climate crisis. Pathogens are opportunistic. There is no other way of dealing with this than regularly testing waters known to have temperatures of that of bathwater or higher.
This pathogen and others needs to be clearly understood. Research of these pathogens is very dangerous to the people conducting the studies. These require all kinds of precautions including anti-rooms to don and doff personal protective equipment. The public exposure is important to prevent.
These organisms need to be understood to the environmental conditions that spawn their growth to help decide some states when to begin testing and when to end. Other states will just consider this a routine no matter the environmental conditions.
The methodology of testing on a continual basis will add another layer of safety to the public in that mutant strains can occur. There is nothing more effective than placing drops of water under a microscope and looking for parasites and their numbers.
For all fifty states that seek to conduct daily accounting of public waters, the CDC would have guidelines and recommendations. With this death of a very precious child the CDC might consider a bulletin to conducting testing to prevent exposure to the public.
...The states are required (click here) under the Clean Water Act to review their water quality standards at least once every three years and revise them, if appropriate. States review standards because new scientific and technical data may be available that have a bearing on the review. Further, environmental changes over time may also warrant the need for a review....
This single event can trigger an evaluation of Texas water quality standards. I strongly suggest Texas do exactly that.
