May
02
2016
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bacteriophage

Photo courtesy of Shutterstock

Treatment of Legionnaires’ disease typically involves a series of antibiotics that seek out and kill the present bacteria in a person’s system. This type of treatment is generally very effective, but as discussed in previous posts on this blog, there is concern about overuse of antibiotics leading to drug-resistant bacteria. However, a new potential treatment method has emerged as a secondary effect of specific cancer drugs.

BH3-mimetic drugs target and switch-off BCL-XL proteins inside cells. This helps with cancer treatment because it prevents the cancer cells from surviving apoptosis – programmed cell death. Coincidentally, the BCL-XL protein is a very important part of the Legionella bacteria and is dubbed the “survival protein” in an article from LaboratoryNews. BCL-XL is the only protein that has the function of keeping the bacteria alive, so when it is switched off by BH3-mimetic drugs, the bacteria in the macrophages and lung epithelial cells die. Macrophages and other cells that do not contain the BCL-XL protein are not affected by the drugs, so this successfully destroys the bacteria without damaging the hosts normal cells.

Of course cancer medications should not be given to someone who is suffering only from Legionnaires’ disease, so there is some work that needs to be done to isolate the specific compounds. However, any breakthrough in the medical field (even accidental ones) are generally considered a success and can lead to the development of more effective medicine.

Posted by jzacher">jzacher at 5:47 pm
Apr
27
2016
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Garston Lane hospital in Wantage, a town in Oxfordshire, is closing due to plumbing issues.  According to the hospital trust, the “old and corroded” pipes present a threat of Legionella bacteria to the public.

Wantage residents, however, are fighting to keep it open.  The campaign was launched this past Saturday and the petition already has over 1,600 signatures.

The hospital is currently set to close in the early summer and has plans to “set aside” funds for repairs.  No work will begin until it can be determined how the hospital will be renovated.

However, the trust also said in a recent statement “Given the high cost of the works required the trust is concerned that the future use of the building should be determined before undertaking an expensive building project which may then need to be changed as a result of the consultation.”

Mayor StJohn Dickson believes that Legionella “will give them an excuse to close the hospital down,” but that the residents of Wantage will “demand better or equal services in the area.”

To read more about this story, please click here.

Posted by jzacher">jzacher at 5:42 pm
Mar
30
2016
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     Mike Glasgow

Mike Glasgow, Flint laboratory and water quality supervisor,

 is shown in this Flint Journal file photo.

     An interesting piece of information about the Flint water crisis emerged yesterday at an open hearing where members of the Flint community could testify before a Joint Committee. A water treatment plant official, Mike Glasgow, testified that he had tried to increase his staff number and the protection measures being taken as the switch to the Flint River occurred. However, he was blocked from doing so by officials at the  Michigan Department of Environmental Quality (MDEQ). Glasgow became well known during the investigation into the Flint water crisis due to his correspondence with the MDEQ in April of 2014 in which he explicitly said that the water treatment center he operated was not ready to service the water from the Flint River. However, orders were given to begin treatment, so Glasgow obeyed to save his job. Though he did write to the MDEQ saying that the operations were “against my direction”.

Based on Glasgow’s testimony and the mounting evidence, it is clear that the negligence shown by the MDEQ was not circumstantial, but instead deliberate. This means that the MDEQ officials and possibly Governor Snyder knew that the switch could potentially cause harm to citizens, but chose not to rectify the situation. As time goes on, it will become clearer who is really culpable in this matter, but for now it is good that the people of Flint have the opportunity to speak publicly about how it has affected their lives.

For more details about the hearing, please see the Detroit Free Press article located: Here

Posted by jzacher">jzacher at 4:59 pm
Mar
29
2016
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   Flint makes us sick

Protestors march along Saginaw Street

 demanding clean water outside of Flint 

City Hall in Flint, Mich. on Wednesday 

Oct. 7, 2015. Christian Randolph | MLive.com

     Summer is approaching quickly, and with it, warmer weather. Generally this is a pleasant transition from a cold winter, but the residents of Flint, Michigan may have a reason to dread the upcoming season. The transition to Spring may see an uptick in the number of cases of Legionnaires’ disease. Bacteria thrive in warmer water, and Flint has had a terrible problem with bacteria in the past year. Second to lead exposure, Legionella bacteria has been the most pressing issue during the Flint water crisis; over 80 people have contracted the disease and more than 10 people have died. The government of Flint has since changed the water source back to Lake Huron, but the damage has already been done. Corrosion in the pipes from the Flint River extricated dangerous chemicals and organisms and flushed them into the water systems of residents and businesses in the city.

Danger is still present even after remediation measures were taken. This doesn’t mean that contaminated water from the Flint River is still being pumped into the city; it means that some small cultures of Legionella trapped in the pipes of the city may proliferate and spread to potable water systems during warmer months in the year. Due to the complexity and scale of the water systems within cities, it is nearly impossible to fully police all of the pipes, so techniques such as hyper-chlorination of the entire system are used to create a safer environment. Flushing water systems with biocides is effective and generally kills most bacteria, but in many cases there are sections that don’t have continuous flow and allow the buildup of stagnant water. Inspectors can’t tear up every installment of pipe to check these stagnant areas, so the best option is to use the methods we have and focus on preventative measures for future residents.

Prevention is just as important as remediation. If we can stop a problem before it occurs then remediation is unnecessary. Prevention is a thankless job because it is much harder to see the results from prevention efforts than it is to see the results of remediation efforts. In a sense, if you hear no news, it means that prevention measures are working. It isn’t until an event occurs that prevention efforts get thrown into the spotlight. In the case of Flint, the switch from Lake Huron to the Flint River was an act that deliberately defied the preventative measures set in place by the government. That is why the Flint water crisis has had such a negative impact on people such as Governor Snyder. There has been a lot of finger pointing because it’s clear that the Flint water crisis was not the result of some force of nature, but instead an act of negligence by many levels of government. Preventative measures can stop occurrences that endanger millions of people, but they only work if we abide by their standards. When people get greedy, or don’t have the funds to make that happen, disasters happen.

 

For further information please see the following articles: CBS DetroitMLive

For information about preventative measures being taken by other cities, please see the following articles: News 13RT Article

Posted by jzacher">jzacher at 4:56 pm
Mar
23
2016
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Kyaira Donald, 6, of Flint, gets her finger poked to test her blood for lead levels, while at Freeman Elementary School in Flint, Mich., Tuesday, Jan. 12, 2016. The Flint Community Schools, the Genesee County Health Department and Molina Healthcare held a family fun night at the school to get children ages 0 to 6-year-olds tested for lead levels in their blood. (Jake May/The Flint Journal-MLive.com via AP) MANDATORY CREDIT NYTCREDIT: Jake May/The Flint Journal-MLive.com, via Associated Press

Kyaira Donald, 6, of Flint, gets her finger poked to test her blood for lead levels, while at Freeman Elementary School in Flint, Mich., Tuesday, Jan. 12, 2016. The Flint Community Schools, the Genesee County Health Department and Molina Healthcare held a family fun night at the school to get children ages 0 to 6-year-olds tested for lead levels in their blood. (Jake May/The Flint Journal-MLive.com via AP) MANDATORY CREDIT NYTCREDIT: Jake May/The Flint Journal-MLive.com, via Associated Press

Before understanding the steps being taken to amend the crisis, one must first understand the causes and circumstances. The water supply for the city of Flint was switch from the Detroit city water inlet to the Flint River  from April 25th, 2014 until October 16th, 2015. This switch was an effort to reduce costs for the municipal system while maintaining a constant water supply. However, during that period many levels of the Flint government either did not see, or intentionally disregarded clear evidence that the water from the Flint river was damaging to the city. This negligence has resulted in numerous deaths from Legionnaires’ disease as well as an increase in lead levels for many children in the area which can cause permanent neurological damage and hamper proper development.

While the situation looks grim, the good news is that the government of Flint has begun to implement new policies and remediation techniques to restore order after the devastating water crisis. A plan was released Monday that details the areas that the government intends to focus on including water infrastructure shortcoming, well being of children exposed to lead, Flint schools, and economic development. To address these areas, the government has proposed the following initial actions:

  • Professional support from state health officials for children under 6 with high levels of lead
  • Opening three additional health centers in the city
  • Replacing drink water faucets and fixtures in public facilities
  • Replacing lead service lines
  • Training residents

     It is difficult to fully measure the scope of the crisis in Michigan. It’s clear that many people got sick, but finding an accurate number of how many and the severity of their sickness is an incredibly difficult process. Additionally, many people who were exposed to lead will not show any symptoms and will not be reported as having high levels of lead unless they voluntarily get tested. It will be a very long process to rectify this situation, and we may see the effects of this crisis for eons to come. 

 

For more information on remediation planms see the TeleSur article: Here

For a timeline of the Flint River crisis, visit the New York Times article: Here

 

Posted by jzacher">jzacher at 2:46 pm
Mar
22
2016
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Empty Hospital Bed in a Ward

88 people contracted Legionnaires’ disease from June 2014 to November 2015. Until recently, nine of those 88 had died due to the illness, but health officials have added another individual to the list of those who succumbed to Legionnaires’ disease bringing the total to 10. The outbreak in Flint, MI has been one of the worst outbreaks in history, breaking the top ten in number of deaths recorded.

While a conclusive link between the Flint River and the water crisis in Flint has not been fully established, the circumstances strongly suggest that oversights by both the Flint government and the EPA led to a disastrous situation in which many people were permanently affected or died. Many Michigan families have filed lawsuits against the government of Flint, but it doesn’t not look as though any retribution will be occurring in the near future. In situation such as these, court proceedings can last decades due to the number of parties involved.

The Governor Snyder and the Michigan representative for the EPA have admitted that the “system failed” and that multiple levels of government did not function properly which resulted in the crisis, but what implications do those statements have for the future? What new policies can be implemented that would prevent situations like this from occurring?Only time will tell, and hopefully we won’t hear about any disasters like this one anytime soon.

 

For more information about the 10th death, please visit Local 4 Michigan News’ site: Here

 

 

Posted by jzacher">jzacher at 5:44 pm
Mar
17
2016
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   Snyder

  Image Credit: Zach Gibson/The New York Times

     Michigan Governor Rick Snyder and Environmental Protection Agency (EPA) head Gina McCarthy attended a house hearing today regarding the water crisis in Flint, MI. The hearing was intended to clarify some of the circumstances surrounding the water crisis, and give both the governor and EPA a chance to publicly speak about their perspective.

While appearing before the House Oversight and Government Reform Committee, Governor Snyder admitted that the Flint water crisis was a result of a “failure of government at all levels”. This statement served two purposes for Governor Snyder: it showed humility by accepting at least part of the blame for the situation, but it also indicated that he was not solely responsible and that all levels of the government in Flint failed the protect the people.

Without naming names, Governor Snyder suggested that the “so-called experts” and “career bureaucrats” he worked with continually reassured any qualms that Snyder had regarding issues with the water. However, it is clear from the emails between staff members, that were later exposed as part of the investigation, that many were aware Flint’s water supply had major issues.

Gina McCarthy was also harshly criticized at the hearing, but tended to stand behind her belief that the state of Michigan’s government had failed the EPA. However, when asked if she was partly responsible she responded by saying “the system failed” and “we were part of that system”.

As Dyson and McCarthy suggested, it is hard to point the finger at one particular person in a situation like this. However, in the next year(s) we will eventually find out the circumstances that led to such a terrible crisis.

 

For further information, please read the New York Times article: HERE

Posted by jzacher">jzacher at 5:52 pm
Mar
15
2016
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Governor Rick Snyder called for an investigation of the Michigan Department of Health and Human Services to look into the way that the Legionnaires’ disease outbreak and water crisis were handled in Flint, Michigan.

Spokesman Ari Adler said that up to $800,000 will be spent on research sifting through “large quantities” of emails and documents.  No health department personnel are suspended at the moment.

Michigan Attorney General Bill Schuette is also hoping that the state will grant his office $1.5 million to investigate the water crisis as well.

Much remains unclear about the water crisis in Flint, Michigan, but it is known that between 2014-2015, nine people died due to Legionnaires’ disease in Genessee County and dozens of others were sickened with the illness.

To read more about this story, please click here.

Posted by jzacher">jzacher at 6:33 pm
Mar
10
2016
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   Bacteria resistance

     The marvel of modern medicine has drastically changed the way society functions on an everyday basis. Obviously the benefits of the advancements from the past century outweigh the drawbacks, but some issues have arisen from our progress that threaten the very purpose for which the advancements were made. For instance, the discovery of the first antibiotic, Penicillen, in 1928 by Alexander Fleming was one of the most groundbreaking advancements in modern history, and has allowed for the treatment of bacterial infections since. This greatly reduced the death rate and pioneered a new realm of medicine that has been evolving to this day. However, times have changed and the mentality about medicine has as well.

Now, antibiotics are widely available, but the general population is not necessarily knowledgeable about their intended use. A World Health Organization (WHO) survey which indicated that ~66% of people thought antibiotics could be used to treat the common cold and flu, but this is not the case as the common cold and flu are viral infections and not bacterial. This mindset found in the population is probably due to the fact that many bacteria infections can present symptoms similar to those of viral infections. It also helps to explain the major issue with modern antibiotics: overuse. The overuse of antibiotics is slowly leading to frightening future in which antibiotics will no longer be effective.

Every time a sick person uses antibiotics, he or she increases the likely-hood that a few of the surviving bacteria will form resistances against the associated antibiotic. In short, this is making antibiotics less and less effective. In the long run, the overuse of antibiotics and the continual adaptation of bacteria may make it impossible to fight any bacterial infection. There is hope, however.

Many pharmaceutical companies have recognized the danger of antibiotic overuse. Some have dropped out of the market because it is becoming an increasingly hard field to garner funding for, and the return on investment is typically poor. However, other organizations are working to implement policy changes and create incentive for continuing development of  newer antibiotics. For example the leaders of the drug industry in Switzerland all agreed on a plan to change funding for new antibiotics from quantity to quality. This creates incentive to develop new, better drugs rather than creating a ton of mediocre drugs for profit. Although development of new antibiotics is an important industry, there are other preventative measures that governments are taking.

     The US federal budget allocated an additional $375 million last year to a few different agencies to better understand antibiotic resistance, the best prevention measures, and development of new antibiotics. Developing drugs to treat bacterial infections is important, but developing preventative measures to avoid those infections in the first place is just as crucial. Vaccines, public health measures, and managing antibiotic use can generally eradicate many of the issues with bacteria before they occur. It is important for the population to understand what they’re putting into their body and how it can effect them. Our future may depend on it. 

 

For more information and a New York Times source article written by Aaron Carroll please click : here

Posted by jzacher">jzacher at 6:06 pm
Mar
08
2016
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   ASHRAE 12-2000

    Most occupations adhere to standards of safety or quality that are developed over many years, and designing interior building systems is no exception. The American Society of Heating, Refrigeration, and Air-Conditioning Engineers, Inc. (ASHRAE) is an organization that produces updated standards and guidelines for jobs involving central systems in buildings. The guidelines are not guaranteed to prevent accidents or eradicate risks, but are generally considered the best ways to prevent undesirable occurrences.

The ASHRAE 12-2000 Guideline, entitled Minimizing the Risk of Legionellosis Associated with Building Water Systems, focuses on what architects, construction companies, and maintenance employees should do to maintain a safe environment for their patrons and ensure that their water is free of Legionella bacteria. Guidelines like these are very important because they set a standard of accountability that might otherwise be unknown or disregarded. For example, if these guidelines didn’t exist and a group of people contracted Legionnaires’ disease at a Shopping Mall, the owners of the Shopping Mall could say that it wasn’t their fault because they were unaware of how to prevent such an occurrence.  Standards not only help to maintain a safe environment, they also hold those in charge responsible for making sure that the standards are met.

In the 15 page report, the authors cover a group of topics ranging from the ecology of Legionella to the proper design and maintenance of potable and emergency water systems, heated spas, decorative fountains, cooling towers, and humidifiers. Below are some excerpts that demonstrate the wealth of valuable knowledge that can be found in the Guideline:

  • Ecology of Legionella – The risk of transmission of infection to humans depends on the presence of several factors: conditions favorable for amplification of the organism, a mechanism of dissemination (e.g., aerosolization of colonized air), inoculation of the organism at a site where it is capable of causing infection, bacterial strain-specific virulence factors, and the susceptibility of the host.
  • Transmission of Legionnaires’ Disease – The first event [needed to occur for Legionella to infect is], survival in nature, is generally outside the scope of building engineering and management practices. The next three events – amplification, dissemination, and transmission – can be influenced by engineering design and maintenance practices.
  • Recommended Treatment/Design – New shower systems in large buildings, hospitals, and nursing homes should be designed to permit mixing of hot and cold water near the showerhead. The warm water section of pipe between the control valve and showerhead should be self-draining.

 

These are just some small segments of this document, and the rest is just as informative. If you have the chance, read the guidelines and see if they can apply to your own situations.

Download link: ASHRAE 12-2000 Download

Posted by jzacher">jzacher at 5:47 pm