[Health] The Infectious Diseases Thread

[Jeff V]

Wow, potentially good news for my wife -- The Philippines vaccinates against TB, but then again, so many of her friends here have had it that anecdotal evidence might indicate it's not all that affective. Or else maybe The Philippines use a different vaccine.

It likely depends on her age. According to Wikipedia, BCG vaccination started in the Philippines in 1979 with the Expanded Program on Immunization.

She was born in 1984. Most of her friends probably were born after 1979, but not all of them. Meanwhile, her mother has contracted TB several times.

[Daehawk]

[gilraen]

Wow, potentially good news for my wife -- The Philippines vaccinates against TB, but then again, so many of her friends here have had it that anecdotal evidence might indicate it's not all that affective. Or else maybe The Philippines use a different vaccine.

When I worked for a hospital, we were required to be tested for TB once every other year or so. Filipinos always got a pass because the vaccine made the skin test false positive. When she immigrated here, she had to get chest x-rays.

USSR has been vaccinating everyone with the BCG vaccine since early 1960s, and most of Eastern and Central Europe still do. So immigrants could never pass a TB test, sometimes they would get a knowledgeable tech who would know not to even try. Our family got some idiot who insisted we must all have TB and should take medication. I ended up filling out a form saying I refuse to take it due to severe side effects, which was enough to satisfy the bureaucracy.

There's now a blood test (IGRA) that they can do regardless of your prior vaccination status, it doesn't react to the BCG.

[Jeff V]

Is there a reason they don't vaccinate Americans who travel to TB-lousy parts of the world? When I went to the Philippines the first time, I only got a Hep-C vaccine (and a follow-up after I returned). It must have worked since my liver is still passing it's daily stress test.

I imagine that when my wife succeeds in relocating us to the Philippines, I should probably get vaccinated, as much of her family has had it (TB, not the vaccine).

[gilraen]

Is there a reason they don't vaccinate Americans who travel to TB-lousy parts of the world?

Doesn't work on adults.

[Jeff V]

Ah, okay then! Never mind! I suppose my kids would get it then. Would it be recommended if they even just visit?

[gilraen]

I'm not a doctor, nor do I play one on TV (I work in medical software specializing in hospital employee health, so I read CDC materials for work)
From what I understand, you may have trouble finding a pediatrician stateside who stocks it, since CDC doesn't consider it to be sufficiently effective, so they "don't recommend" it. UK recommends it only if the kids will be staying in a TB-prevalent country for 3 months or more. So...your call, really.

[Jeff V]

So not for a travel visit probably, but if we wind up emigrating there. I'm rather more worried about dengue there, though.

[Daehawk]

This was a sad but good read. About COVID in a small indian reservation hospital.

Covid Upends a Rural Hospital, Where Staff Know All the Patients

[Jeff V]

Major breakout at my wife's old job, many of her former coworkers are infected along with patients. She got a job offer the other day for 30% raise to care for infected residents somewhere, that would be a 90% raise over the past year. I think the only way she does that is if she happens to get it, then trust in some form of immunity after recovery.

[Sudy]

Two of the neighbouring municipalities, including the city of Toronto, are going back into a minimum 28-day lockdown for the first time since July. My region isn't far behind. So restaurants will be closed for dine-in, non-essential retail will be closed, etc. Yet... schools remain open. So I'm really not sure what the point is. I mean, every little bit helps. But I feel like the government's really having trouble committing.

There are stories of stores being packed over the weekend, both for essential and non-essential shopping. Some people are just trying to get their Christmas shopping done while stores are still open. (Obviously, this is truly apocalyptic for the B&M retail industry.) Others admit they're stocking up on essentials such as toiler paper. (Why?? This lockdown shouldn't affect toilet paper production or availability at all.)

Ontario's seeing about 1,200-1,500 new cases a day. So's South Dakota (where Mrs. Nym's family lives). This really makes me worry considering Ontario has more than 15x SD's population.

[Kraken]

In Boston, we track "thresholds for concern."

The new way the city is using to calculate the percent positive rate has the number moving up to 5.6% from 5.4% earlier in the week, with data too sparse from the past several days to product meaningful numbers. That’s above the 5% threshold for concern.

The number of daily positive tests too has continued to climb, hitting a seven-day average of just over 250 last Sunday, the most recent date for which sufficient info is available. That continues to rise every day, but remains below the threshold of 339.7.

...

The number of occupied intensive-care-unit beds in Boston hospitals slid back down from a recent high of 85% at the start of the month to 81%. The city says 95% is the threshold for concern.

But the overall number of free beds has crept down slightly to 26% from 27% the previous week, continuing a slow decrease from October. The threshold is 20%.

Thanksgiving's aftermath will most likely make us concerned within a couple of weeks.

[dbt1949]

Arkansas and Oklahoma are getting record numbers. I don't understand why.

[Blackhawk]

We're at 585 cases per 100,000, and 17.27% positivity rate. Pesky hoax.

[Max Peck]

When you look at per capita data, the current hot spot in Canada is Nunavut. Until recently, the northern territories have been spared, but once the virus arrives, it's obviously going to quickly spread within isolated communities which also have limited healthcare infrastructure.

[coopasonic]

My wife actually suggested masking up when we go to her parents house for T-Day. I really want to suggest passing on it altogether, but I just know that won't fly. I think I might suggest we limit the time e spend there to minimize risk. It's a long shot, but worth a try. We'd normally be there for 5-6 hours. Practically speaking they are in our bubble, but we aren't entirely sure how big THEIR bubble is.

[Jeff V]

Practically speaking they are in our bubble, but we aren't entirely sure how big THEIR bubble is.

That kind of defeats the purpose of a "bubble." It's like being in a committed relationship -- one cannot be in a multiple committed relationships.

[Lorini]

Yeah we aren't doing Thanksgiving because of the eating part of it. If it was just socializing, I think we could manage with open windows and masking, but eating means you have to take off your mask and that's not good.

[coopasonic]

Practically speaking they are in our bubble, but we aren't entirely sure how big THEIR bubble is.

That kind of defeats the purpose of a "bubble." It's like being in a committed relationship -- one cannot be in a multiple committed relationships.

Yeah I was going to say something about "and their bubble *IS* our bubble so..." but I had to get on a call and I wasn't sure what to do what the "so..."

Basically, I wanna go into isolation, but nobody else in my life is on board. I don't have Smoove's credentials to flash around and I am not volunteering to make my kids do their school work either, which woul dbe rwquired if we wanted them to do school from home, so I am more or less powerless.

[Blackhawk]

Basically, I wanna go into isolation, but nobody else in my life is on board. I don't have Smoove's credentials to flash around

Pfft. I don't need credentials. I've actually flashed Smoove's credentials to get people into line. "I have a friend who..." It's enough to take it out of the abstract talking heads and into the real world for the few people I talk to about it.

[Jeff V]

Basically, I wanna go into isolation, but nobody else in my life is on board. I don't have Smoove's credentials to flash around and I am not volunteering to make my kids do their school work either, which woul dbe rwquired if we wanted them to do school from home, so I am more or less powerless.

With a wife on the front lines, we are in total agreement when it comes to isolating, although she's more inclined to get stir crazy than I am and cheat here and there.

My son has been in school since August, but this week (only a 2 day school week) the school district decided to close for cleaning so for the first time we are doing full day remote learning. It's better than when he was in kindergarten, and there was just a 30 minute Zoom and a table of links for online things to do. He's in his second of 5 scheduled Zoom sessions right now. He also started early, so he's finished a lot of between-class things already. He's more self-sufficient now too. When he had summer school, he rarely lasted as long as an hour after Zoom before yelling that he wanted to be done. We might actually get through 2 days of this, but I wouldn't want to have to do this daily.

[ImLawBoy]

Two of the neighbouring municipalities, including the city of Toronto, are going back into a minimum 28-day lockdown for the first time since July. My region isn't far behind. So restaurants will be closed for dine-in, non-essential retail will be closed, etc. Yet... schools remain open. So I'm really not sure what the point is. I mean, every little bit helps. But I feel like the government's really having trouble committing.

I think there's a case to be made that you can keep schools open if do a good enough job in locking down non-essential functions. You're doing the balancing act there - value of in-person learning (which is not inconsiderable) vs. risk of infection. Some schools have been doing a good job with it. I'm more of the mind that you need to have pretty good local control to get to the point where I'd be comfortable sending kids to school (and we don't have that here). It's not a bonkers strategy, though.

[Sudy]

The more I think about it the more reasonable it seems, but if you want to have the biggest reduction in transmission, you have to shut down every possible avenue, don't you? Disruptions to education may not be insignificant... it causes a childcare crisis as well. But we're talking about saving lives (or hospital beds, or whatever). But then, they're still not mandating masks for office buildings that can't physically distance either, so I dunno.

[Lorini]

Basically, I wanna go into isolation, but nobody else in my life is on board. I don't have Smoove's credentials to flash around

Pfft. I don't need credentials. I've actually flashed Smoove's credentials to get people into line. "I have a friend who..." It's enough to take it out of the abstract talking heads and into the real world for the few people I talk to about it.

I'm so fortunate. My friends and family all wear masks all the time and are not doing Thanksgiving. I don't have to convince anyone or discuss it.

[ImLawBoy]

The more I think about it the more reasonable it seems, but if you want to have the biggest reduction in transmission, you have to shut down every possible avenue, don't you? Disruptions to education may not be insignificant... it causes a childcare crisis as well. But we're talking about saving lives (or hospital beds, or whatever). But then, they're still not mandating masks for office buildings that can't physically distance either, so I dunno.

If the focus were solely on reducing transmission, then yes, you'd shut down schools, too. The problem is that there are also definite, real negative consequences to not having kids in schools. That's why there's the balancing act. If you can get community transition down enough, there's a strong argument that you can then also limit the negative impacts of remote learning by sending kids back to school.

[Torfish]

My parents have always hosted Thanksgiving. Usually around 20-25 of us. They cancelled and said Christmas is probably also cancelled. I support their decision 100%, so does my wife.

[LordMortis]

My parents have always hosted Thanksgiving. Usually around 20-25 of us. They cancelled and said Christmas is probably also cancelled. I support their decision 100%, so does my wife.

I'd love to +1 this but my parents and aunt and uncle are thinking about XMas. I won't be going but that doesn't mean it won't happen. Of course, my parents already spend time with my aunt and uncle whom have no regard for virus safety and I swear to pancake if they get my parents sick I will never speak to them again.

[Kraken]

Fortunately, we got disinvited from family holidays 5-6 years ago because one of us somehow insulted our host (my BIL's wife) -- I wasn't surprised to learn that it was me; I have a history of offending people without meaning to. That was fine with me, since I never liked spending time with them anyway...although she's a good cook, and I did miss getting the traditional annual feast. Since then, Wife patched things up with them, but then they moved to FL, so that's still the end of holidays.

My offense? I made a Facebook post complaining that my garden hadn't done well that year, "probably because of inconsistent watering." My BIL had been watering it while we were on vacation and took it personally, even though I hadn't meant to accuse him.

Anyway, we've spent our holidays alone ever since the year my garden didn't get enough rain. That suits me especially fine this year.

[LordMortis]

I would love to spend an evening with family and holiday time gaming with friends but not yet....

[Jeff V]

Last year on Football and Turkey Day I actually had some family members (sister, her 2 kids, and a brother) come and by all appearances, they enjoyed it. We had a 2-bird feast that included traditional American and Filipino foods, probably 30 people altogether.

This year, my wife and I might split a pork rib roast with my wife if I can even find one (3 supermarkets checked Saturday, none to be had). Barring that, I have a rack of ribs in the freezer, it's supposed to be nice enough to grill outside. The kids aren't really into feasting, we're lucky if we can them to eat a mouse-sized portion of anything not Mac and Cheese or pizza. Wife is working that night, so she'll be looking to something she can eat quickly and go back to bed.

[stimpy]

It's shit like this that will keep the virus around for a long time.
Are we supposed to feel bad for them?
I love this line: “We really truly have been following CDC guidelines with the exception of gathering,”
Ummmmm......no....you really truly weren't. Idiots that only care about themselves until something bad happens then they want everyone else to take it serious. F-em. You get what you deserve.

https://www.yahoo.com/lifestyle/texas-f ... ccounter=1

[Daehawk]

Caught the tail end of a news story about a vaccine that is 90% effective if the first does is a half dose and the second dose is a full dose. But its only 60% effective if given as two full doses. Shrug.

[Sudy]

This year, my wife and I might split a pork rib roast with my wife if I can even find one (3 supermarkets checked Saturday, none to be had).

I'm not sure whether you're a bigamist and/or if your grocery stores have a more interesting selection than mine.

[Isgrimnur]

CNN

Nearly a third of the nurses who've died of coronavirus in the US are Filipino, even though Filipino nurses make up just 4% of the nursing population nationwide.

A recent report from the largest nurses' union in the country revealed the disproportionate number of deaths. It's a jarring statistic researchers are working to understand and a tragedy families across the US and around the world are living with every day.
...
The union's latest analysis of nurses' deaths for which race and ethnicity data was available found that 74 of 245 nurses who'd died were Filipino, or roughly 30%. The toll includes nurses who were born in the Philippines and immigrated to the United States, and Filipino American nurses born in the US.

[Daehawk]

From the stuff Im reading and some pics Ive seen of the way they are handling Santa pics this year is pretty ridiculous and sad. I know they have too but its still sad to see it. Those kids will look back and tell their grand kids about the COVID Christmas.

[The Meal]

It's shit like this that will keep the virus around for a long time.
Are we supposed to feel bad for them?
I love this line: “We really truly have been following CDC guidelines with the exception of gathering,”
Ummmmm......no....you really truly weren't. Idiots that only care about themselves until something bad happens then they want everyone else to take it serious. F-em. You get what you deserve.

https://www.yahoo.com/lifestyle/texas-f ... ccounter=1

It's like having peeing and no-peeing sections in the pool.

[Isgrimnur]

Alaskapox

In 2015, a novel poxvirus was isolated from a resident of Alaska. Diagnostic testing and limited sequence analysis suggested this isolate was a member of the Orthopoxvirus (OPXV) genus but was highly diverged from currently known species, including Akhmeta virus.
...
The nine genes of the Alaska isolate exhibited notable divergence from both New World and Old World OPXVs, with higher sequence similarity to Old World OPXVs [30], which was unexpected given its isolation in the New World.

The divergence of the Alaska isolate and the seeming disagreement between its isolation in the New World and sequence similarity to Old World OPXVs highlighted a need for further investigation.
...


Figure 1. Phylogenetic analysis of the conserved central region of the Alaskapox virus (AKPV) genome with representative OPXVs, Murmansk poxvirus, NY_014 poxvirus, and Yoka poxvirus (YPV). Twenty-seven poxvirus sequences (Table S1) were aligned using MAFFT. Old World OPXVs are highlighted in blue; New World OPXVs are highlighted in green; AKPV is highlighted in pink. Phylogenetic tree was estimated using BEAST v. 2.5.1 using the GTR+G+I model under a relaxed lognormal molecular clock. Posterior probability is shown next to each node.

[Freyland]

I'm still holding on to the impression that if something out of Alaska kills me, it will be a moose.

[Isgrimnur]

The orca might pass on the moose for you instead.

[Smoove_B]

It's a mystery!

There are now 39 people confirmed sick in one of three mystery E. coli O157:H7outbreaks currently under investigation by federal agencies. Leafy greens are under particular scrutiny.

Since the most recent update from the Centers for Disease Control and Prevention, which was on Oct. 28, there have been 16 people added to the patient tally. The sick people span 18 states. No states have confirmed any deaths in this outbreak. The new numbers are current as of Nov. 19, according to the CDC’s Nov. 23 update.

For those old enough to remember O157:H7 and thinking it sounds familiar - you're right.

Regardless, for this particular outbreak it's seemingly being linked to "leafy greens":

“State and local public health officials are interviewing ill people to determine what they ate and other exposures in the week before they got sick. Of the 22 ill people interviewed to date, all reported eating a variety of leafy greens, like spinach with 16, romaine lettuce with 15, iceberg lettuce with 12, and mixed bag lettuce with 8. No single type or brand of leafy greens or other food item has been identified as the source of this outbreak. CDC is not advising people to avoid any particular food at this time,” according to the outbreak update.