Rise of Candida auris embodies a serious and growing public health threat
nytimes.com
nytimes.com
An important takeaway from that article was that it's not too late: agricultural azole usage is actually a fairly recent thing in much of the world and hasn't been in the US for example long. Quoting:
>"Until recently, the United States was exempt from concerns about azole-resistant Aspergillus. Azole use here has historically been low, a small percentage of what happens in Europe—though the numbers that record it, kept by the U.S. Geological Survey, may be incorrect because submitting them is voluntary. Nevertheless, tebuconazole use in the United States rose five times over from 1995 to 2015; the crops that accounted for the most use were wheat and corn. Meanwhile, a Centers for Disease Control (CDC) poll of state health laboratories found no cases of resistance as recently as 2014. But last month, the CDC disclosed that 10 patients treated in the United States have been diagnosed with triazole-resistant Aspergillus bearing the mutations associated with agriculture. In a report in its weekly bulletin, the agency analyzed the records of seven of them. Four of them had never received azoles before they were diagnosed with the resistant strain. Three of the patients died."
It's worth trying to stamp down on it legally ASAP. But it needs more public attention and political pressure, which makes this report that health authorities have been covering up the seriousness even worse.
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1: https://www.theatlantic.com/science/archive/2018/11/when-tul...
Doing that without coming across a jerk, depending on the topic, can be tough.
I follow Hank Green's advice [0] about how to do so. Be specific, be respectful, demonstrate you checked hiso'er past, relevant votes.
They could go to a hospital that isn't having an outbreak. Why isn't that an option for most patients?
> Even the C.D.C., under its agreement with states, is not allowed to make public the location or name of hospitals involved in outbreaks.
This seems like an agreement against the interests of the populations that the C.D.C. is supposed to protect, even if (temporarily) in the interest of hospitals involved in outbreaks ... yet another example of regulatory capture.
On the one hand I can see that this policy would make hospitals more likely to report potential outbreaks and cooperate with the C.D.C. On the other hand the secrecy would result in dead patients who could have gone elsewhere and survived. Or people that need hospital treatment avoiding all hospitals.
Can anyone point to a good argument that such secrecy -- even after the infection has been verified -- is good policy?
[1] https://www.latimes.com/business/la-fi-hospital-outbreaks-se...
And as a consequence of the above, the current system is also likely more beneficial for patients as well because hospitals need not worry about anything other than doing as optimal a job as possible. Something like this sounds like it stands a good chance of eventually spreading everywhere. And so would you be safer at a place that has or has not detected it? Obviously you'd be better off in a place without it, but again once we introduce those unforeseen consequences a place not detecting it is absolutely not the same as a place not having it. By contrast the place that has it has indicated that they are actively screening for it and presumably doing all they can to try to manage it.
Trial lawyers in New York created an organization [0] that systematically maps sidewalks and streets to identify cracks and holes that cause slip-and-fall accidents.
They provide these maps and supporting data to the city for free, and in the process they can prove that the city had constructive knowledge of the risk.
That way the city can't avoid liability by claiming they didn't know.
It seems that a similar "service" could alert hospital managers to the risk of C. auris, and thereby neutralize intentional ignorance as a defense.
[0] https://en.wikipedia.org/wiki/Big_Apple_Pothole_and_Sidewalk...
I agree it'd be extremely useful, but it's a harder problem to get visibility into.
Fortunately for us, antibiotic resistance is maladaptive when antibiotics are not present. Using them intelligently will cause resistant strains to be out-competed.
To actually give a fuck about your nutrition, sleep, and what you do with your body.
As a proponent of a more informed, and introspective society, let's get started.
If the CDC was completely transparent, they'd find a way to spin that into evidence of anti-vax claims.
It's not prima facie irrational to believe that the risks of other vaccines outweigh the benefits. I've never heard of anyone being persuaded by being insulted, so perhaps we should instead approach the anti-vaxxers with hard data showing how yes, their concerns are in fact grounded in fact, but there are also other facts that make vaccination the right decision in most, but not all, cases.
We, on the other hand, will pay for our collective misdeeds.
I realize this is subjective, but to me, biodiversity is obviously far and away the greatest thing in the known universe. It's astounding we (humans in the aggregate) care so little for it.
It's like mostly poisonous gas and water, chill down!
Several billion years of evolution can trump some experts trying to come with a clever solution in a short time. Same way we haven't eradicated the common flu, cancer and tons of other things that still get billions in research every year either after a century of trying...
A "spanish flu" like situation can lead to hundreds of millions dead in this much more interconnected era (cheap flights etc) compared to 1910s...
Easy to say when you only spend 10% of your income on food. Try to convince the people who have to spend between 30% and 50%.
The food companies pocket the extra margins -- and the seed/pesticide companies ensure a constant market for their wares (which they also patent)...
(Add to that that untold tons of perfectly good produce are destroyed every year to keep prices high when production quota are exceeded).
Besides, it's not because of lack of money going around the globe that people have to spend between 30% and 50% of their income for food. It's because of lack of distribution of money (i.e. income inequality).
Most of produce never gets collected in first place for lack of labourers, not destroyed.
Throwing money into fields isn't going to magically produce more food.
That self-interest, and doing things for one's local gains, ends up to the benefit of everybody.
It started with Adam Smith: ""It is not from the benevolence of the butcher, the brewer, or the baker, that we expect our dinner, but from their regard to their own interest. We address ourselves, not to their humanity, but to their self-love, and never talk to them of our own necessities but of their advantages"."
and ended up in ever increased praises of self-interest (Ayn Rand, etc) over communal values and morality.
I find it amusing that so many people read his "Wealth of Nations" and founded edifices on it, while conveniently ignoring his other book: "The Theory of Moral Sentiments"¹
1: Relevant quote: “How selfish soever man may be supposed, there are evidently some principles in his nature, which interest him in the fortune of others, and render their happiness necessary to him, though he derives nothing from it, except the pleasure of seeing it.”
Another looming side effect of mono-cropping — planting huge fields of a single, highly specialized cultivar with very low genetic diversity.
Many of these cultivars are reliant on huge amounts of fertilizer, insecticide and fungicide. They produce high yields when times are good, but come with massive vulnerabilities and large negative externalities.
There has been some movement in recent decades away from typical industrial agriculture toward more diverse planting and sustainable and scientific farming, which in the long run produce healthier soil, crops and environment. Sadly this is still fairly niche and not applied to the millions of acres of single crop areas around the globe, mostly because it’s still super cheap to pump fields for all their worth with cash crops.
Unless we adopt a more difficult path, we’ll be paying for our cheap calories in more ways than just algae blooms and drug-resistant fungus. But I guess the same could be said about everything, climate change et al.
Yes, the greenhouse gases from converted fossil fuels used for transportation and the release of energy to do work, all of which leads to global warming, is of great concern, and in terms of survival of our species, matters very much.
But there are a number of looming adjacent narratives that go hand-in-hand with climate change, but are not necessarily of climate change alone, while human activity beyond the use of fossil fuels is certainly at the heart of the matter.
Fish dying off, colony collapse disorder, birds disappearing, general insect volume depletion throughout zones of historically higher activity, radiological contamination of the ocean by at least one major nuclear incident, the pacific garbage patch and microplastics in general, chemical pollution of waterways, disruptive hydroelectric dams, fracking, slag lagoons (ruptured and unruptured), superfund sites like the gowanus canal as a particular expample of a failure to clean up even one hazardous zone in a major city, pesticides in general (even ignoring insect populations as keystone species and colony collapse). The list goes on.
Beyond just climate change, the grand scope of human activity has some serious detrimental side effects, with deep ramifications for the world around us. Yes it's getting hotter, and the weather patterns are strange, but taken together with other issues, the big picture is that The Anthropocene as a period of time represents itself a challenge of challenges.
That we now can safely call this The Anthropocene is enough to say we have a problem, as we become a force of nature unto itself. This being The Anthropocene is akin to us being the asteroid that killed the dinosaurs. Terrible lizards though they were, we are worse.
We are the asteroid. Don't call is merely climate change. Call it The Anthropocene, and understand that the full scope of human activity is the full scope of the problem.
https://www.gov.uk/government/publications/candida-auris-eme...
This has to be outlawed.
As someone who often gets secondary bacterial infections from initial viral infections, I often have to fight with well-intentioned prescribers in order to get adequate treatment so I don't end up in the hospital a few days later.
> In fact, as many as 60% of all communicable diseases and 75% of emerging infectious diseases of people originated with animals.
60% and not 2/3, but that's memory for you.
https://www.ncbi.nlm.nih.gov/pubmed/15907555
https://mbio.asm.org/content/7/6/e01483-16
https://www.scientificamerican.com/article/radiation-helps-f...
> it is thought that B. pertussis is adapting under acellular vaccine mediated immune selection pressure, towards vaccine escape [1]
> an increase in asymptomatic infection with concomitant increases in transmission and increased selection pressure for Bordetellapertussis variants that are better able to evade vaccine-mediated immunity than older isolates [2]
[1] https://academic.oup.com/femspd/article/73/8/ftv064/2467598
[2] https://www.sciencedirect.com/science/article/pii/S156713481...
I've talked to three doctors about my symptoms, and done various tests, which don't show anything. None of them seemed to accept the idea that it could be caused by Candida. It's interesting to see it getting some media attention, though certainly this particular report makes me a bit nervous.
It caused me a big and risky dehydration of my body as a side effect that I don't known why (nor my doctors), but it eliminated candidiases from my body, and I wasn't using any other medication at that time.
In my own life experience this is common. People bounce around the medical system with varying diagnoses for many ailments, at various levels of confirmation, and sometimes the doctors aren't sure either.
Similarly, cars can have problems that a mechanic can't figure out how to fix. These are generally called undiagnosed problems, but they're still there.
If you've never been in this position yourself, I can understand why you'd be sceptical of the OP's claims, and indeed I'm sure there are lots of people that are convinced they have a particular condition despite what tests say.
For context, I was written off by my NHS neurologist because I didn't match his standard battery of tests. My circumstances and symptoms pointed strongly to a small fiber neuropathy, but he scoffed and said it was very unlikely, and refused to do a skin biopsy to confirm it. Instead he labelled me with fibromyalgia, and hoped I'd disappear - but when questioned it was abundantly clear he literally knew next to nothing about fibromyalgia, and presumably used it as a generic label for "time wasters". Eventually I did get him to do the biopsy - which they fucked up. When the results were negative, he again tried to get rid of me, and I had to fight to get him to redo it properly - lo and behold, it was positive.
I had a very similar experience with endocrinology - I have a rare endocrine condition, but the symptoms point absolutely towards a specific diagnosis - instead, I was basically told to "stop this silly nonsense", and it wasn't until several years later that I was diagnosed. NHS endocrinologists have a terrible reputation for anything that isn't diabetes.
People rave about how wonderful the NHS is, but my (unfortunately substantial) experience has been shambolic. It's my observation that doctors (and consultants and registrars alike) don't update any of their knowledge or training since they left medical school, even if that was 40 years previous; they have no interest in recent medical developments; they have no interest in writing case studies or undertaking research; they could basically be replaced by a flow chart.
/rant
Having spent a lot of time in and around various "health food" type communities, I don't see any reason to believe that so-called Candidiasis is actually a fungal infection. It's some kind of chronic inflammatory condition, that's all we know. Anything beyond that is speculation.
It's a commensal organism that sometimes overgrow and becomes pathologic under opportunistic circumstances: it's quite common to see it rise after an antibiotic treatment which kills the bacteria that keep this fungi in check.
Excessive consumption of bread ord sugar also fuel its proliferation