[HN Gopher] 4th person in US mysteriously stricken with deadly b...
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       4th person in US mysteriously stricken with deadly bacteria from
       South Asia
        
       Author : _Microft
       Score  : 104 points
       Date   : 2021-08-10 15:09 UTC (7 hours ago)
        
 (HTM) web link (arstechnica.com)
 (TXT) w3m dump (arstechnica.com)
        
       | chiefalchemist wrote:
       | As long we have a global economy where goods and consumption move
       | faster than the signals (?) they give off, we're going to be
       | subject to "invasive species" such as this. Add in antibiotic
       | resistance and another collision of natural forces is in the
       | making.
        
         | tg180 wrote:
         | Widespread antibiotic resistance would be a serious turning
         | point for the global economy and the current way of life
        
           | avgDev wrote:
           | It doesn't help that MANY doctors are complete morons and
           | give out antibiotics for "suspected" infection.
           | 
           | The amount of times I had to refuse an antibiotic has been
           | insane. There was a time I had some abdominal pain, got
           | diagnosed with inflammation of the colon.....googled the name
           | doctor said(cant recall now) but the information I found was
           | that antibiotics are completely useless for it. In the end it
           | was a muscle strain lol.
           | 
           | FDA/CDC needs to step in and really crack down on antibiotic
           | usage. If I could report the doctors I would. Documents
           | should be reviewed and warnings issued.
        
             | Zelphyr wrote:
             | Conversely: my wife is a Nurse Practitioner and, when she
             | was practicing family medicine, the number of times she had
             | to refuse people antibiotics for what was obviously not
             | bacterial (muscle strain, viral infection, etc...) was
             | insane. She complained about it regularly.
             | 
             | I agree that the FDA and CDC need to crack down on
             | antibiotic usage. They should also provide better education
             | as to when antibiotics are appropriate.
        
               | chiefalchemist wrote:
               | If you can legally write a script and don't know that
               | antibiotics aren't for virus you shouldn't be allowed to
               | write scripts.
               | 
               | We don't need a crackdown. We need medical professionals
               | to put their education to use.
        
               | Zelphyr wrote:
               | I don't think it is a matter of the provider not knowing
               | that antibiotics aren't for viral infections. They have
               | patient after patient after patient coming in _demanding_
               | to get an antibiotic. At some point, many of those
               | providers give up and give in. I 'm proud of my wife for
               | not being one of them.
        
       | Angostura wrote:
       | Key point from the article- it doesn't generally spread from
       | person to person
        
         | lambdaphagy wrote:
         | Where have you heard that before?
        
           | GavinMcG wrote:
           | Do you actually have reason to doubt it here? Because cynical
           | skepticism isn't a helpful alternative to genuinely doing our
           | best to understand and correcting course when better data is
           | available.
        
             | FabHK wrote:
             | Also, just to flog that old dead horse for the umpteenth
             | time: Nobody said that "COVID-19 does not spread from
             | person to person". What the WHO reported, on January 14
             | 2020, at the very beginning of the pandemic when very
             | little was known, was that "Preliminary investigations
             | conducted by the Chinese authorities have found no clear
             | evidence of human-to-human transmission".
             | 
             | If you read that tweet and conclude that the WHO says that
             | there is no human-to-human transmission, then you have a
             | problem with reading comprehension.
        
               | lambdaphagy wrote:
               | WHO was largely denying the possibility of airborne
               | transmission as late as July 2020.
               | 
               | https://academic.oup.com/cid/article/71/9/2311/5867798
        
             | lambdaphagy wrote:
             | It's simply a matter of applying a prior: when I hear an
             | organization's claim, I consider the base rate at which
             | past claims have proven trustworthy, adjusting for whether
             | past errors were honest mistakes, noble lies, culpable
             | failures to apply medieval-peasant-tier common sense, the
             | fruit of transparently ulterior motives, and so on. I sure
             | hope they're right in this case but it's not clear why in
             | particular I should think so.
             | 
             | What do you do?
        
               | GavinMcG wrote:
               | I consider _all_ my priors, not just a single one about
               | the source.
        
         | adolph wrote:
         | _B. pseudomallei is not considered to be transmitted via air or
         | respiratory droplets in non-laboratory settings. Person-to-
         | person transmission risk is considered extremely low as there
         | have only been a few documented cases of person-to-person
         | transmission; contact of damaged skin with polluted soil or
         | water is the most frequent route for natural infection.
         | Healthcare personnel are generally not at risk if they follow
         | standard precautions. However, laboratory personnel are at
         | increased risk because some lab procedures may aerosolize
         | particles and release B. pseudomallei into the air. Laboratory
         | personnel can reduce their risk of exposure by following good
         | laboratory practices.3 Laboratory staff who may have been
         | exposed to B. pseudomallei should refer to existing CDC
         | guidance._
         | 
         | https://emergency.cdc.gov/han/2021/han00448.asp
        
           | launchaway wrote:
           | https://twitter.com/mims/statuses/1217043229427761152?ref_sr.
           | ..
        
             | SkyMarshal wrote:
             | This isn't the Chinese authorities reporting on this
             | bacteria though.
        
         | tenfourwookie wrote:
         | Also key: All four are known to have had contact. It's not
         | random.
        
           | FabHK wrote:
           | Sure? The article says that the cases are "connected", but
           | not that the individuals have been in contact. (It could have
           | been that they happened to use the same contaminated
           | product.)
           | 
           | > CDC investigators determined that all four cases are
           | connected and they suspect a so-far-unknown imported product
           | may be to blame.
        
             | tenfourwookie wrote:
             | reading comprehension : 1 tenfourwookie : 0
        
           | tenfourwookie wrote:
           | I'm wrong. It does not say this.
        
       | racialfur wrote:
       | Now ars should call covid as virus from china.
        
       | autoexec wrote:
       | > Symptoms can span localized pain or swelling, fever,
       | ulceration, abscess, cough, chest pain, high fever, headache,
       | anorexia, respiratory distress, abdominal discomfort, joint pain,
       | disorientation, weight loss, stomach or chest pain, muscle or
       | joint pain, and seizures, the CDC notes.
       | 
       | This is the first time I've heard of a bacteria causing anorexia
       | or for that matter the first time I've seen anything (apart from
       | possibly genetics) being a direct cause of anorexia
        
         | etrevino wrote:
         | So in this sense they mean a lack of appetite, essentially. As
         | I understand it, what most people think of as anorexia
         | (purposely starving yourself) would be referred to anorexia
         | nervosa.
        
         | ljf wrote:
         | https://en.wikipedia.org/wiki/Anorexia_(symptom)
         | 
         | Quote: Anorexia is a symptom, not a diagnosis. When a
         | healthcare provider states that a patient has anorexia, they
         | are simply referring to a decreased appetite. This means that
         | the provider must find and treat the underlying cause of the
         | anorexia. Anorexia is not to be confused with the mental health
         | disorder anorexia nervosa. Because the terms are often used
         | interchangeably, a provider must clarify to a patient to which
         | they are referring as to avoid confusion. Anyone can manifest
         | with anorexia regardless of their gender, age, or weight.
        
       | NoImmatureAdHom wrote:
       | It'd be great to see more investment in antibiotics, and we need
       | world governments to lead the charge. It'd be even better to see
       | our current drug prohibition regime pivot from recreational drugs
       | to antibiotics. Development of new, fantastic antibiotics is only
       | a matter of time and money. We as a species have the
       | capabilities, we just need to make the move.
       | 
       | Investment is a problem because ABX aren't profitable relative to
       | other opportunities (in biotech / pharma, think cancer or Hep C).
       | ABX cure, rather than treat, which means you have a single
       | revenue event rather than recurring (chronic) revenues. Even in
       | that space, Hep C was way more profitable. And if you're
       | successful with ABX in a public health sense, the number of new
       | cases generally goes _down_. Compare to a cancer drug, or a
       | urinary incontinence drug, where that doesn 't happen. There have
       | been precious few new ABX developed in recent years. One is
       | daptomycin ("Cubicin" in American marketing-speak). It was a few
       | tens of thousands per course of treatment when it came out,
       | pitched (and approved) as a narrow treatment for a very few
       | indications, because that's how you have to sneak a new
       | antibiotic through the system these days--you won't command high
       | enough prices otherwise. It is, in fact, a broad-spectrum drug
       | and I'm sure it's used off-label.
       | 
       | I think what we need to do to fix this is recognize it is a
       | public health problem that the market is not forward-looking
       | enough to fix, and use government power to fix it. We could do
       | this by subsidizing the cost of pushing a new molecule through
       | the FDA. Or we could, you know, fix the FDA and make their review
       | processes more utilitarian and less costly...but that's bigger
       | fish. There are limited government programs trying to do this at
       | the moment.
       | 
       | A lot of the reason we see new, ABX-resistant strains in SE Asia
       | is unrestrained use of our better drugs, which are cheap in
       | generic form (ciprofloxacin, for example). We should be
       | regulating ABX use with the fervor we now reserve for so many
       | low-harm recreational substances. Perhaps we could just pivot
       | that whole industry rather than taking them apart...
        
         | bigbillheck wrote:
         | It's the meat industry that's by far the worst offender in
         | antibiotics, and they've got too much money to do anything
         | about without an awful lot of screaming.
        
         | ipaddr wrote:
         | Research more antibiotics? Let's understand what the current
         | ones do before we introduce new ones.
        
       | pixxel wrote:
       | > South Asia is the southern region of Asia, which is defined in
       | both geographical and ethno-cultural terms. The region consists
       | of the countries of Afghanistan, Bangladesh, Bhutan, India,
       | Nepal, Pakistan, Sri Lanka and the Maldives.
       | 
       | ~Wikipedia
        
         | nopcode wrote:
         | Shouldn't we call it a "Delta Bacteria" before it turns racial?
        
       | Zelphyr wrote:
       | While scary, is this really newsworthy? We're surrounded by
       | bacteria that can be dangerous, but usually isn't.
       | 
       | Five years ago, my dad was admitted to the hospital because he
       | contracted cryptococcus neoformans[1]. The thing is, that
       | bacteria is everywhere. It's just that most people's bodies are
       | able to easily fight it off. Most of the time, when someone
       | becomes infected it is due to low immunity (HIV/AIDS patients and
       | transplant patients, for example) He is neither of them. It turns
       | out, there is a tiny percentage of the population that becomes
       | infected and nobody knows why.
       | 
       | It was scary. Until they finally did a biopsy of his brain they
       | were convinced he had cancer, they just didn't know what form.
       | After the biopsy they were able to easily treat it with a common,
       | over the counter medication they give women for yeast infections.
       | 
       | The bacteria had done enough damage that they had to install a
       | permanent ventricular shunt (basically, a subdural tube that goes
       | from his brain to his stomach to act as an overflow for cerebral
       | fluid his body can no longer properly process in the brain)
       | People die from cryptococcal meningitis like he had. My dad's
       | neurosurgeon even told me that my dad was days away from death,
       | had they not figured out what the problem was when they did.
       | 
       | Still, no news outlets reported on it. So I can't help but
       | wonder, again, the newsworthiness of this mysterious deadly
       | bacteria other than Ars Technica is joining all other media
       | companies in trying to drum up revenue by needlessly scaring
       | people.
       | 
       | 1: https://www.cdc.gov/fungal/cdc-and-fungal/cryptococcal-
       | menin...
        
         | bsder wrote:
         | > While scary, is this really newsworthy?
         | 
         | It is because the strains were genetically linked yet cover a
         | vast disconnected geographic area.
         | 
         | Something is bringing the bacteria in, and they're trying to
         | find it.
         | 
         | In addition, when something like this appears you want medical
         | workers to be thinking about it as an option and adjust their
         | Bayesian probabilities.
         | 
         | The standard "When you hear hoofbeats, think horses not zebras"
         | is fine unless the circus just came to town. At which point,
         | horses is still more likely, but zebras are no longer out of
         | the question.
        
       | noodlenotes wrote:
       | > "Currently, CDC believes the most likely cause is an imported
       | product (such as a food or drink, personal care or cleaning
       | products or medicine) or an ingredient in one of those types of
       | products," the agency said in a statement.
       | 
       | In case anyone was curious and didn't want to read the article.
        
         | Avenger42 wrote:
         | Also, though:
         | 
         | > So far, the CDC has collected and tested more than 100
         | samples of products, soil, and water from the four patients'
         | homes, but none has turned up positive for B. pseudomallei. The
         | agency noted that tracking down a source of B. pseudomallei can
         | sometimes be difficult as the bacteria can take two to three
         | weeks to develop into an infection, broadening the window of
         | possible exposure times and testing patients' memories.
        
       | grafelic wrote:
       | https://www.ajtmh.org/view/journals/tpmd/71/3/article-p360.x...
        
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       (page generated 2021-08-10 23:03 UTC)