Healthsifter by mary desmond pinkowish, since 2003

Licking Listeria in Your Kitchen

You know about the cantoloup-related Listeria outbreak, but melons aren't the only possible sources of this dangerous organism. What's even stranger is that unlike many food-borne pathogens, Listeria can thrive in the fridge. So please cast your eyes over this latest guidance from the FDA on keeping your kitchen, and especially your refrigerator, clear of this bacterial menace. 

Lookin' good

How Could Loneliness Make You Sick?

According to this report in The Economist, loneliness may harm your health. I bet you can't guess why, though. Here's a hint, it has something to do with the way that lonely people defend against viruses, as opposed to bacteria. Wild stuff. I urge you to read this really short report about the work by Dr. Steven Cole of UCLA. 

Wild stuff!

More on Whooping Cough: Why Are We Still Talking About This Infection?

It should be a distant memory. Read this excellent article by Paul Howard and James R. Copland in City Journal that explains why we may be hearing more, not less about pertussis in the future. Why did nearly 8,000 little California kids get pertussis in 2010--and 10 of them die? Lack of access to vaccine? Not quite. Howard and Copland explain here:

Last October, the National Committee for Quality Assurance issued a report finding that vaccination rates among privately insured two-year-olds declined by nearly 4 percent in 2009—even as rates among enrollees in Medicaid, the government-run insurance program for low-income families, increased. In fact, 91.2 percent of children in Medicaid received the measles-mumps-rubella vaccination, compared with 90.6 percent of children in private plans. In California’s wealthy Marin County, public health official Fred Schwartz reports that parents are “signing waivers to opt out of immunizing kindergarten-bound children.” About 7 percent of all children entering kindergarten in Marin County are unvaccinated, the seventh-highest percentage among California’s 58 counties. It isn’t surprising, then, that Marin County accounts for 15 percent of all California whooping-cough cases, despite having just 0.67 percent of the state’s population.

 Breathtaking. In the same issue, you might also enjoy Theodore Dalrymple's review of Deadly Choices: How the Anti-Vaccine Movement Threatens Us All, by Paul A. Offit.

Another Look At the Shingles Vaccine

The back story: The risk of shingles, a painful and often debilitating reactivation of chickenpox, can be lowered by a vaccine with the trade name Zostavax. It's not perfect: the vaccine lowers the risk of shingles by about 50% in older adults and reduces the risk of a nasty complication--postherpetic neuralgia (terrible persistent pain after the skin symptoms go away)--by close to 70%. Result: The CDC recommends that everyone age 60 and older get vaccinated. 

Now the story: For ages, doctors have thought that shingles was a one-time deal and that one episode protected you from subsequent episodes unless your immune system was punky. But according to a study in the current issue of Mayo Clinic Proceedings, the risk of shingles appears to be the same whether you've already had it--or not. Investigators looked at data from 1700 people who had a first episode of shingles and followed them for an average of 8 years. They found that 5% had a second episode; if they had been looking at a similar population of folks who had never had shingles, they would have expected about the same percentage to get shingles. The risk of a second episode was higher among women and in people who'd had pain for 30 or more days after the first one. You can read the summary of the original article or read the story at ScienceDaily.

Should people who've had shingles should get the vaccine to protect against another shingles outbreak?To my knowledge, no one has looked at the effectiveness of the vaccine when given to people who've already had shingles, so there's no data on which to base that decision. I hope my mother is reading. Stay tuned.

No Raw Milk

Raw milk is unpasteurized. Pasteurization is a simple process: heating milk for 20 seconds at just over 160 degrees F does the trick. This is enough to kill potentially deadly bacteria including some you've heard of: Campylobacter, Salmonella, and E coli. The development of pasteurization is one of the big success stories in food safety of the past couple hundred years. Even if the farmer or store selling raw milk assures you that the milk has been tested and is free of bacteria, stay clear. The tests are not reliable, according to the CDC. Click here for access to more sources of information about raw milk. Hear first-hand stories from people who got sick from raw milk here. Listen to an NPR story on this topic by clicking here, and read here why some New Yorkers are unpersuaded by the safety arguments.

Dr. Drew Pinsky is Sick with Leptospirosis: Get Better!

According to Today Celebrities web site, Drew Pinsky, MD, got sick with leptospirosis somewhere in the West Indies and is currently hospitalized. Leptospirosis is caused by exposure to the spirochete bacteria Leptospira, to which humans and animals are susceptible. Leptospirosis is quite common in warm/tropical areas and among people who work outside and with livestock, a fact that's reflected in some of the other names it goes by, like Swineherd's disease, Rice-field fever, Cane-cutter fever, Swamp fever, and Mud fever. (What kind of a vacation was Dr. Drew on?? :-))

Some people are symptomless and never know they are infected with Leptospira, while others get a high fever, aches, fatigue, and severe vomiting and diarrhea. Left untreated, the infection can lead to liver or kidney problems, and even meningitis, according to the CDC.  Interestingly, leptospirosis is not transmitted person-to-person. That means the good folks (patients and staff) at the Pasadena Recovery Center, Sober House, and Celebrity Rehab are in the clear. The infection usually responds to common antibiotics.

Get better fast!

Smallpox Virus: Destroy All of It--or Save Some for Research?

Later this year, a decision-making body at the WHO will vote on whether to destroy all remaining samples of the smallpox virus (variola) now being held by medical researchers or to allow some supply to be kept for research. Only two labs in the world, one in the U.S., the other in Russia, have the virus. One fear is that someone, somewhere, has a secret stock of variola that could be used in a bioterror escapade. In that situation, researchers would need their stock to make vaccines. Those want the stock destroyed say that we know all there is to know about the diagnosis and treatment of smallpox. But an editorialist writing this week in the British journal Nature writes, 

"...further study of the virus could still reveal a huge amount, both on the specifics of what makes it such a formidable foe and on human immunology and viral pathogenesis in general."

The author goes on to say that destruction of the remaining viral stocks has less to do with science and public health than it has to do with political gesturing. Looks that way here, too.  

Shingles: Look at the Photos, Get the Vaccine

Thanks to WebMD for posting this excellent slide show about shingles. Many people (those who haven't had it) underestimate the pain and suffering caused by shingles, which is a reactivation of the chickenpox infection you had as a kid.  The good news is that a shingles vaccine is available. It cuts the risk of shingles by about half and the risk of prolonged, severe nerve pain after the initial shingles outbreak by two-thirds.  The vaccine is recommended for people age 60 and older and others who may be at higher-than-average risk because of another illness or immune condition. 

UPDATE Jan 24th: See this article/listen to the report about the shingles vaccine at NPR.org.

Pertussis, aka the 100-Day Cough, is Up

Pertussis rates are increasing, and under-vaccination is not the culprit according to Tara Parker-Pope's article in today's New York Times. Her description of devastating coughing fits in her fully vaccinated 11-year-old daughter is enough to send you packing to the doctor for a booster shot. Pertussis (also known as whooping cough) rates are up 7-fold from last year in California and are also up in Pennsylvania. Overall, as many as 3 million Americans may get the infection this year. 

It's bad enough that adolescents and adults may experience pertussis as "the 100-day cough" (it just doesn't go away), but babies can die of the infection. Many of them become infected before they're old enough to get the vaccine and are exposed to adults or teens with pertussis.

And why are an increasing number of adults, and especially teens getting sick? The problem seems to be waning immunity even after getting all the recommended immunizations. And you know all the warnings we get about not demanding antibiotics from our doctors for head colds? Well, it's possible that back in the day when doctors did hand out antibiotics for what appeared to be colds, they were actually treating early pertussis. No way should we routinely take antibiotics for colds, but we could get tested for pertussis more often. Unfortunately, lab tests for pertussis are pretty sketchy right now. 

As I wrote earlier this summer, my doctor gave me a Tdap (tetanus, diphtheria, and acellular pertussis) vaccine this spring. You can ask about it too. To hear what whooping cough sounds like, check out WhoopingCough.net, a site maintained by a British doc who recommends that if necessary you record your cough so your doctor can hear it (in case there's a problem with diagnosis). Think your cough doesn't matter? This baby probably caught the infection from an adult, maybe even a parent or grandparent:

Teen Girls: Lots of Sexually Transmitted Infections

The current issue of the journal Pediatrics has the results of a survey of a representative sample of more than 800 girls aged 14 to 19 years who were interviewed, had physical exams, and were tested for five sexually transmitted infections (STIs): Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, herpes simplex virus type 2, and any of the high-risk types of human papillomavirus (HPV).  The findings as presented in the article's summary:

"Prevalence of any of the 5 STIs was 24.1% among all and 37.7% among sexually experienced female adolescents. HPV (23 high-risk types or type 6 or 11) was the most common STI among all female adolescents (prevalence: 18.3%), followed by C trachomatis infection (prevalence: 3.9%). Prevalence of any of the STIs was 25.6% among those whose age was the same or 1 year greater than their age at sexual initiation and 19.7% among those who reported only 1 lifetime sex partner."

So about one-quarter of adolescent girls have at least one STI, and the risk is significant even if the girl has had just one sex partner. She may have had just one partner, but he's infected, she soon will be. The word should get out. This research was conducted at the CDC.