Hosts on a viral planet: When Herpes infects the eye

In the summer of 1985, I was working in a cool lab, and about to enter the final year of my undergraduate degree in molecular biology and genetics.

And I was living with a girl.

In Aug. 1985, we got tickets to go see Neil Young and the International Harvesters at the CNE (the Canadian National Exhibition, or the Ex) and I fell ridiculously ill.

I was in bed for two weeks, barfing, and in agony – a great way to start a new relationship that would bear four beautiful daughters.

I made it out of bed to see Neil and the Harvesters.

The next day I went home to Brantford, Ontario, Canada.

I was really, really sick, my eye really, really hurt, and my parents suggested I go see the eye doctor.

Within 5 minutes, he diagnosed eye Herpes, prescribed a retroviral cream, and I was quickly cured.

Yeah, science.

I have been exceedingly public about this story in the fantastical hope that others may be spared some of the pain, or at least have it contained.

Sarah Zhang of The Atlantic writes – 33 years later – that Herpes simplex virus type 1 is best known as the culprit behind cold sores. When it’s not causing itchy, crusty sores on the mouth, it hides in the bundle of nerves that run through the face. And it’s super common. An estimated 50 to 90 percent of people harbor lifelong infections of HSV-1—largely without incident.

But in some cases, HSV-1 can run through that bundles of nerves in the face and erupt in the eye. Or maybe it gets into the eye from the outside. No one is really sure. In any case, HSV-1 can definitely infect the eye. (In case you’re wondering: HSV-1 can also cause genital infections, though it’s herpes simplex virus type 2 that is more commonly associated with genital herpes.)

Herpes in the eye is as bad as it sounds. The virus infects the cornea, forming tree-like branching ulcers across the eye. It can cause irritation, pain, sensitivity to light, and ultimately blindness if untreated. Herpes in the eye is a leading cause of blindness in the world. The cornea, after all, is a transparent layer of tissue at the front of the eye, whose job is essentially to let in as much light as possible. Infection can turn the cornea cloudy—permanently.

In most cases, herpes infections in the eye can be treated with antiviral drugs like Zovirax, but the herpes viruses are becoming increasingly resistant to these drugs. Scarred corneas can also be replaced with a transplant, but past infection makes the eye more likely to reject the new tissue. Plus, once you get herpes in the eye, it can keep coming back—just like cold sores. “For some patients that experience this, there’s absolutely nothing we do,” says Dan Carr, an HSV-1 researcher at the University of Oklahoma. “Essentially they’re going to go blind if something else doesn’t happen”—if new treatments don’t become available.

Enter now a surprising new study about herpes. Deepak Shukla, a virologist at the University of Illinois at Chicago, and colleagues have identified a molecule called BX795 that clears HSV-1 infections in human cells and in mice—with few side effects, it seems.

It’s a surprise because Shukla’s team originally threw BX795 onto HSV-1-infected cells thinking it would make the viruses grow better in the lab. (They were trying to study the virus’s basic functions.) That’s because BX795 is known to inhibit a enzyme called TBK1 that turns on the human immune response. Dampen the immune response, and you should get more viruses, right?

“We saw the opposite,” says Shukla. BX795 appears to play another role in yet another human enzyme that viruses hijack to synthesize their own viral proteins. Shukla’s team tested BX795 in cultured human cells, human corneas, and mice with herpes eye infections. It worked to suppress the herpes virus in all those cases—and often at lower concentrations than existing antiviral drugs.

Most exciting of all, BX795 could represent an entirely new class of drugs for herpes. Existing drugs generally work by inhibiting the virus’s DNA (or RNA) replication, blocking it from making more copies of itself. Since the drugs work in such similar ways, it’s easy for the virus to evolve resistance to all of them. “A second class is almost nonexistent. That’s where I think our discovery is really important,” says Shukla. BX795, remember, prevents protein synthesis instead. Shukla is now testing it to see if BX795 offers broad protection against other related viruses like those causing chicken pox and mono.

I spent the weekends of 1979 bagging rock, and while I thought I was just really bored, I had mono.

 

Woman’s rare eye infection highlights (low) risk of parasite spread by flies

Susan Perry of the Minnesota Post reports an Oregon woman is the first known person to become infected with a tiny parasitic worm that lives in the eyes of cattle, according to a case study report published Monday by researchers at the Centers for Disease Control and Prevention (CDC).

Although common in animals, eye-worm infections in humans are extremely rare. And, if caught and treated early, they don’t cause any permanent damage to the eye.

“This is only the 11th time a person has been infected by eye worms in North America,” lead author Richard Bradbury, who heads the CDC’s Parasite Diagnostics and Biology Laboratory, told CNN. “But what was really exciting it that it is a new species that has never infected people before. It’s a cattle worm that somehow jumped into a human.”

The woman, 28-year-old Abby Beckley, was working on a salmon boat in Alaska two summers ago when her left eye became irritated and inflamed. A week later, when the symptoms didn’t go away, she decided to investigate.

BuzzFeed reporter Nidhi Subbaraman, who interviewed Beckley, describes what happened next:

Standing at the mirror in the galley, [Beckley] plucked at her eyeball, as if extracting a contact lens. 

“I put my fingers in there in kind of a picking motion and I pulled out a worm,” Beckley [said]. “I looked at my finger and it was moving and I was shocked.” 

Beckley said she woke up her bunkmate to show her the worm, a piece of tangled white fluff wriggling at the end of her index finger. “She confirmed I wasn’t crazy,” Beckley said.

Over the course of the next few days she pulled out about a half dozen more worms. “I was living with these things, and I’d just keep pulling them out when I’d feel them,” Beckley said. 

Beckley flew home and went to see specialists at the Oregon Science and Health Laboratory in Portland. They extracted two more worms, and sent one to the CDC for analysis. It was identified as being the nematode Thelazia gulosa, which commonly infects the eyes of cattle, but had never been found in humans.

The case report was published online in the American Journal of Tropical Medicine and Hygiene, where it can be read in full.

But what does gastro mean? Outbreak hits University of Queensland students

I don’t know what it is about Australians, whether it’s some pseudo-inherited British culture of hierarchy, or just dumbness, but lately, any outbreak of barfing and pooping is called a gastro outbreak.

As in gastroenteritis.

There are microbiology labs in Australia, so figure it out, and let people know.

Janelle Miles of The Courier Mail reports 20 students at two University of Queensland residential colleges have fallen ill with gastroenteritis in the middle of orientation week.

The students are residents of King’s College and Grace College at UQ’s St Lucia campus in Brisbane’s west.

They have been quarantined separated from other students to avoid the infection spreading.

Was it foodborne? Are there any epidemiologists in Australia? Is anyone investigating?

Australian student who sold monkey skull to ‘people from Pirates of the Caribbean’ fined

A few years ago, one of those Johnny-Depp-pirate movies — it may have been 5 — was filming down the highway at the Gold Coast.

The set was plagued by drama when it was discovered Depp and then wife Amber Heard had illegally brought two dogs into the country.

This prompted deputy premier Banaby-the-bloody-carp Joyce (right, not exactly as shown) to question Depp’s acting ability after the couple apologized, which shows how small Australia is because now Joyce is embroiled in his own scandalous activities, involving humans, not pets.

Behind the sideshow of movie making, divorce and apologies, a Canberra university student was on Thursday fined for illegally possessing and importing exotic animal remains into Australia, in a case that has shed some light on the shadowy world of wildlife trade.

Alexandra Back of the Canberra Times reports that for years, avid collector Brent Philip Counsell, 28, dealt in what a magistrate described as a “macabre” trade of skulls and animal specimens, once selling a primate skull to the people making the Pirates of the Caribbean movie in Brisbane.

In 2016 authorities from the department of environment raided Counsell’s home in Deakin where they found and seized about 100 animal specimens from the living room and bedroom.

Australian environment law makes it illegal to either possess or import protected exotic animal specimens without a permit.

Over several years, Counsell either illegally imported or possessed a small primate skull threaded on a necklace, the skulls of a brown bear and a gibbon, a taxidermy buzzard, water monitor lizard, and teeth from a bear and a hippopotamus tooth.

When he spoke to investigators, Counsell admitted possessing and selling species from his website wulfe.com.au, which he had since shut down.

One of the charges stemmed from an admission Counsell made to authorities after they had searched his home, that he had sold a primate skull to the “people” behind the Pirates of the Caribbean movie that was filming in Brisbane.

He tried to avoid detection, and prosecutors found on his phone articles that offered tips about how to send skulls overseas without being noticed by customs.

Rabies (maybe) from bats living in a sorority house, Indiana, 2017

In February 2017, the Indiana State Department of Health (ISDH) was notified of bat exposures at a university sorority house. The initial complaint was made to ISDH because of concerns for food sanitation. Bats had been routinely sighted in shared living areas and hallways. ISDH, in consultation with the U.S. Centers for Disease Control, collaborated with the university and sorority to assess residents and staff members for potential rabies risk. In 2016, 4.3% of all bats tested in Indiana were positive for rabies. The longest incubation period recorded for indigenously acquired bat rabies is 270 days (1); therefore, out of an abundance of caution, ISDH conducted interviews with 140 students and eight employees who resided or worked in the sorority house during the preceding 12 months, all of whom were considered to have possibly been exposed. A web-based survey was administered in February to collect information about bat exposures, which was used to categorize all respondents into having a low, medium, or high risk for rabies exposure per CDC guidance (2).

Persons who reported a bite, scratch, or direct skin contact with a bat were categorized as having a high risk. Persons were categorized as having moderate risk if they reported waking and finding a bat in the same room where they were sleeping. Persons who reported no bat exposure were categorized as having a low risk. Respondents categorized as having a high or moderate risk had follow-up interviews in person or by telephone.

Among the 148 possibly exposed persons, 100 (68%) responded to the questionnaire, including 92 (66%) students and all eight employees; 94 respondents reported ever having seen a bat in the sorority house. Among those 94 persons, 70 (74%) reported having seen a bat within the previous 12 months, and 34 (36%) reported seeing a bat ≤1 month ago. Among respondents who reported ever having seen a bat in the sorority house, 13 (14%) were identified as having a moderate or high risk for rabies exposure, including 11 sorority members, one university employee, and one nonsorority member student. After follow-up interviews, nine of these 13 persons were reclassified as having a low risk for rabies exposure. The remaining four persons were considered to have a high (three persons) or a moderate (one) risk. All four persons received a recommendation for postexposure prophylaxis (PEP), which consists of human rabies immune globulin and a series of 4 doses of rabies vaccine. Two persons completed the PEP series during March 20–April 18, and two declined PEP because of a perceived lack of risk. No respondent had developed clinical rabies as of February 2018.

ISDH learned that bats had been roosting in the building for approximately 30 years. Commercial wildlife operators conducted an environmental investigation in March and identified multiple small openings between the house’s exterior wall and doorframe, which can serve as points of ingress or egress for bats. In addition, certain students reported hearing scratching behind a wall inside the house’s common space. This wall was scheduled to be removed as part of a house remodel during summer 2017. A commercial wildlife control operator repaired the openings and completed building remediation during this time. Students returned to the house in August 2017. No bat sightings have been reported since students returned.

This is the first reported instance of a mass bat exposure in a fraternity or sorority house. Multiple high-risk rabies exposures occurred in this sorority house, attributable to bat colonization of the building. The initial complaint to ISDH related to concerns for food sanitation, rather than rabies, is consistent with previous reports indicating an underappreciation of the health risks associated with indoor bat exposures (3). ISDH communicated the risk for rabies exposure at meetings with students and university housing directors. All bat exposure events should be reported immediately to public health officials, who can provide advice about rabies risk assessments and determination of the need for PEP.

Notes from the Field: Assessment of Rabies Exposure Risk Among Residents of a University Sorority House — Indiana, February 2017

Morbidity and Mortality Weekly Report; February 9, 2018; 67(5);166

Betsy Schroeder, DVM; Alex Boland, MPH; Emily G. Pieracci, DVM; Jesse D. Blanton, PhD; Brett Peterson, MD; Jennifer Brown, DVM

https://www.cdc.gov/mmwr/volumes/67/wr/mm6705a4.htm?s_cid=mm6705a4_e

Corresponding author: Betsy Schroeder, BSchroeder@cdc.gov, 814-248-5774.

1Epidemic Intelligence Service, CDC; 2Indiana State Department of Health; 3Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

References

De Serres G, Dallaire F, Côte M, Skowronski DM. Bat rabies in the United States and Canada from 1950 through 2007: human cases with and without bat contact. Clin Infect Dis 2008;46:1329–37. CrossRef PubMed

CDC. Assessment of risk for exposure to bats in sleeping quarters before and during remediation—Kentucky, 2012. MMWR Morb Mortal Wkly Rep 2013;62:382–4. PubMed

DeMent J, Trevino-Garrison I. Investigation of potential rabies exposure while attending a camp, Barton County, June 2010. Topeka, KS: Kansas Department of Health and Environment; 2010. http://www.kdheks.gov/epi/download/Bats_at_Camp_Final_Report.pdf

It’s all about the cross-contamination: But isn’t there a better way to describe how bugs spread and make people puke?

Ever since Sorenne got diagnosed with a shellfish allergy, the shrimp on the barbie are for when she’s at school.

Woman’s hands cleaning prawns at table

The video clip is exactly what weekly faculty meetings were like at Kansas State University, while they ate raw sprouts on Jimmy John’s subs, with about $2 million in annual salaries sitting around the table, chatting about what to do with a 45K staffer.

This study aimed to qualify the transfer of Vibrio parahaemolyticus during the shrimp peeling process via gloves under 3 different scenarios. The 1st 2 scenarios provided quantitative information for the probability distribution of bacterial transfer rates from (i) contaminated shrimp (6 log CFU/g) to non-contaminated gloves (Scenario 1) and (ii) contaminated gloves (6 log CFU/per pair) to non-contaminated shrimp (Scenario 2). In Scenario 3, bacterial transfer from contaminated shrimp to non-contaminated shrimp in the shrimp peeling process via gloves was investigated to develop a predictive model for describing the successive bacterial transfer.

The range of bacterial transfer rate (%) in Scenarios 1 and 2 was 7% to 91.95% and 0.04% to 12.87%, respectively, indicating that the bacteria can be transferred from shrimp to gloves much easier than that from gloves to shrimp. A Logistic (1.59, 0.14) and Triangle distribution (-1.61, 0.12, 1.32) could be used to describe the bacterial transfer rate in Scenarios 1 and 2, respectively. In Scenario 3, a continuously decay patterning with fluctuations as the peeling progressed has been observed at all inoculation levels of the 1st shrimp (5, 6, and 7 log CFU/g). The bacteria could be transferred easier at 1st few peels, and the decreasing bacterial transfer was found in later phase. Two models (exponential and Weibull) could describe the successive bacterial transfer satisfactorily (pseudo-R2 > 0.84, RMSE < 1.23, SEP < 10.37). The result of this study can provide information regarding cross-contamination events in the seafood factory.

PRACTICAL APPLICATION:This study presented that Vibrio parahaemolyticus cross-contamination could be caused by gloves during the shrimp peeling process. The bacterial transfer rate distribution and predictive model derived from this work could be used in risk assessment of V. parahaemolyticus to ensure peeled shrimp safety.

Modeling transfer of vibrio parahaemolyticus during peeling of raw shrimp

February 2018

Journal of Food Science

Xiao X, Pang H, Wang W, Fang W, Fu Y, Li Y

DOI:10.1111/1750-3841.14064 

http://geenmedical.com/article/29411873

Botulism in France, 2013-2016

Human botulism is a rare but severe neurological disease which is submitted to the French Public Health. The biological diagnosis is performed by the National Reference Center of Anaerobic Bacteria and Botulism (CNR), Institut Pasteur, Paris.

This study carries the status of human botulism in France During the 2013-2016 period based on the epidemiological data of Public Health France and the biological investigation of CNR. episodes

Thirty-nine of confirmed botulism and 3 suspected episodes involving 68 and 4 persons, respectively were Identified: 6 Type A episodes (10 cases), 26 type B episodes (47 boxes), type 2 F episodes (5 cases), and 5 undetermined type episodes (6 boxes). The source of botulism was foodborne in 36 outbreaks (66 cases) and 6 cases were infant botulism. All type A and F botulism cases were severe forms

The incriminated food was identified in 15 of the 36 episodes of foodborne botulism. Homemade preparations of pork meat, especially raw ham, were responsible for 13 type B episodes, including 3 due to imported meat. Homemade pork meat was suspected in 12 other outbreaks. Other included pheasant pie and home canned asparagus. One of the two type F episodes was caused by industrial ground meat contaminated with Clostridium baratii F7 . No food has been identified in infant botulism and environmental contamination has been suspected in three cases. Penicillin and metronidazole resistant C. botulinum A2 strain was isolated from an infant botulism case with relapses.

Human botulism is rare in France. However, botulism surveillance is required for early identification of emerging novel botulinum toxin types, such as in the two C. baratii type F outbreaks in 2014 and 2015. Botulism surveillance also helps addressing recommendations to industrialists and consumers regarding hygiene and food preservation practices. Finally, this surveillance allows to quickly identify contaminated food in order to withdraw it from the market or from family’s homes.

Human botulism in France, 2013-2016

BEH

Christelle Mazuet 1 , Nathalie Jourdan-Da Silva 2 , Christine Legeay 1 , Jean Sautereau 1 , Michel R. Popoff 1

http://invs.santepubliquefrance.fr/beh/2018/3/2018_3_1.html

Hygiene hypothesis: We’re not smart enough, but go ahead, the importance of infants’ exposure to microorganisms

In the 25 years I’ve been doing the food safety thing, the most frequent question is, don’t bugs make us stronger? Aren’t we too clean.?

These are referrals to the hygiene hypothesis, that the Western world has become too clean for our infants, a little dirt won’t hurt you, throw knowledge out the window, because nature is true (my grandson announced the impending birth of a sibling this morning on facebook; my daughter does not buy into this shit).

Jane Brody of The New York Times writes that many studies have strongly suggested that the trillions of microorganisms that inhabit the human body influence our current and future health and may account for the rising incidence of several serious medical conditions now plaguing Americans, young and old.

The research indicates that cesarean deliveries and limited breast-feeding can distort the population of microorganisms in a baby’s gut and may explain the unchecked rise of worrisome health problems in children and adults, including asthma, allergies, celiac disease, Type 1 diabetes and obesity. These conditions, among others, are more likely to occur when an infant’s gut has been inadequately populated by health-promoting bacteria.

A growing number of researchers and consumers are now paying more attention to where it all begins, especially how this huge population of microbes in our bodies, called the microbiome, is affected, for good or bad, by how babies are born and nourished.

As this still-evolving information trickles down to prospective mothers, it could — and perhaps should — lead to profound changes in obstetrics, pediatrics and parenting. The two most important would be fewer scheduled cesarean deliveries and more mothers breast-feeding exclusively for six months to enhance the kinds and amounts of bacteria that inhabit an infant’s gut.

(The daughter mentioned above was breast-fed for something ridiculous like 17 months.)

These organisms perform important functions that include digesting unused nutrients, producing vitamins, stimulating normal immune development, countering harmful bacteria and fostering maturation of the gut.

The story and the studies cited have lots of anectodal information – Sorenne and I had a brief chat about the difference between anectode and science over breakfast this a.m. – but do nothing to advance the germs-are-good-for-you-theory, other than it feels right.

Until one of your kids is the genetically susceptible one to succumb.

Science can do better.

It’s just not there yet.

Chlorine works: 12 dead, 87 sick from Legionnaires’ linked to Michigan water supply 2014-15

An outbreak of Legionnaires’ disease that killed 12 people and sickened at least 87 in Flint, Mich., in 2014 and 2015 was caused by low chlorine levels in the municipal water system, scientists have confirmed. It’s the most detailed evidence yet linking the bacterial disease to the city’s broader water crisis.

Rebecca Hersher of NPR reports that in April 2014, Flint’s water source switched from Lake Huron to the Flint River. Almost immediately, residents noticed tap water was discolored and acrid-smelling. By 2015, scientists uncovered that the water was contaminated with lead and other heavy metals.

Just months after the water source changed, hospitals were reporting large numbers of people with Legionnaires’ disease.

“It’s a pneumonia, but what’s different about it is, we don’t share it like we do the flu or common cold,” explains Michele Swanson of the University of Michigan, who has been studying Legionnaires’ for 25 years. “It’s caused by a bacterium,Legionella pneumophila, that grows in water.”

The bug can enter the lungs through tiny droplets, like ones dispersed by an outdoor fountain or sprinkler system, or accidentally inhaled if a person chokes while drinking.

“If you don’t have a robust immune system, the microbe can cause a lethal pneumonia,” she says. In a normal year, the disease is relatively rare — about six to 12 cases per year in the Flint area, according to Swanson. During the water crisis, that jumped up to about 45 cases per year.

Although the outbreak of Legionnaires’ happened at the same time as the Flint water crisis, it was initially unclear how the two were connected. After earlier research suggested that chlorine levels might be the key, Swanson and colleagues at the University of Michigan in Ann Arbor, Sammy Zahran of Colorado State University and a team of researchers at Wayne State University in Detroit, began analyzing detailed water and epidemiological data from the six-year period before, during and after the crisis.

“We know that Legionella is sensitive to chlorine in the laboratory,” says Swanson. The chlorine makes it difficult for the bacteria to replicate, which is one reason water companies often add chlorine to their systems. But when Flint’s water source changed, the chlorine level dropped and cases of Legionnaires’ disease spiked. “It was the change in water source that caused this Legionnaires’ outbreak,” Swanson says.

The new research was published in a pair of studies in the Proceedings of the National Academy of Sciences and the journal mBio on Monday. The conclusion may bolster parts of the case being brought against Nick Lyon, the former Michigan Department of Health and Human Services director, who is being tried for involuntary manslaughter in connection with the Legionnaires’ deaths.

From April 2014 to October 2015, the Flint River served as Flint’s water source. During the same period, cases of Legionnaires’ disease increased from less than a dozen per year to about 45 per year, and 12 people died of the waterborne disease.

The new studies also suggest that a complex set of factors may be responsible for low chlorine levels during the crisis. In addition to killing microbes, chlorine can react with heavy metals like lead and iron, and with organic matter from a river. That means lead and iron in the water may have decreased the amount of chlorine available to kill bacteria.

400 sick: Now the water is chlorinated in Nousis, Finland

(Something may be lost in translation; thanks to our Scandanavian correspondent for passing along these stories.)

About 400 people in Nousis, Finland — a town of 4,800 — fell as a result of contaminated drinking water.

The municipality’s health authorities state that the situation was worst 23-27 January when more than 50 cases were recorded every day. The number of new cases has decreased steadily.

Last weekend, a ban on drinking water was introduced.

A leakage has been found to be behind the epidemic; the leak caused sewage and drinking water to mix.

Last night, chlorination of the water pipeline began. Day care centers, schools, retirement homes and health centers are in the first place in a hurry for redevelopment, and on Tuesday the chlorination of the water to households begins.

In tests taken by people who have fallen ill after drinking the municipality’s water pipeline, at least noro, sapo and astroviruses have been found.

Some of the patients had had two different viruses.

Individual cases of ETEC and EHEC bacteria and of the bacterium Plesiomonas shigelloides were also found in the patient samples.

In water analyzes only sapovirus has been found, and therefore it has not been possible to confirm that the other disease have come from the water.

“I contacted the municipality when the water was grayed out, but they then certified me that it was safe to drink,” said resident Jutta Holmevaara.

“Then it started coming out ‘from both ends.’ It continued as long as I drank the water.

“It took five days before I noticed that they had announced that it was worth boiling the water. I had fever for several days. I still do not feel completely healthy.”