Killer smile: Link between mouth microbes and systemic disease

I will, from now on,  blame my early on-set dementia not on booze, or pucks to the head, many, many concussions. or gaslighting, but on the bacteria in my mouth.

Technology Networks reports the healthy human oral microbiome consists of not just clean teeth and firm gums, but also energy-efficient bacteria living in an environment rich in blood vessels that enables the organisms’ constant communication with immune-system cells and proteins.

A growing body of evidence has shown that this system that seems so separate from the rest of our bodies is actually highly influential on, and influenced by, our overall health, said Purnima Kumar, professor of periodontology at The Ohio State University, speaking at a science conference earlier in Feb.

For example, type 2 diabetes has long been known to increase the risk for gum disease. Recent studies showing how diabetes affects the bacteria in the mouth help explain how periodontitis treatment that changes oral bacteria also reduces the severity of the diabetes itself.

Connections have also been found between oral microbes and rheumatoid arthritis, cognitive abilities, pregnancy outcomes and heart disease, supporting the notion that an unhealthy mouth can go hand-in-hand with an unhealthy body.

“What happens in your body impacts your mouth, and that in turn impacts your body. It’s truly a cycle of life,” Kumar said.

When the American Association for the Advancement of Science (AAAS) themed this year’s annual meeting around dynamic ecosystems, Kumar saw an opportunity to put the mouth on the map, so to speak, as a vibrant microbial community that can tell us a lot about ourselves.

“What is more dynamic than the gateway to your body – the mouth? It’s so ignored when you think about it, and it’s the most forward-facing part of your body that interfaces with the environment, and it’s connected to this entire tubing system,” she said. “And yet we study everything but the mouth.”

Kumar organized a session at the AAAS meeting today (Feb. 8, 2021) that she titled “Killer Smile: The Link Between the Oral Microbiome and Systemic Diseases.”

The oral microbiome refers to the collection of bacteria – some helpful to humans and some not – that live inside our mouths.

Though there remains a lot to learn, the basics of these relationship between the oral microbiome and systemic disease have become clear.

Oral bacteria use oxygen to breathe and break down simple molecules of carbohydrates and proteins to stay alive. Something as simple as not brushing your teeth for a few days can set off a cascade of changes, choking off the oxygen supply and causing microbes to shift to a fermentative state.

“That creates a septic tank, which produces byproducts and toxins that stimulate the immune system,” Kumar said. An acute inflammatory response follows, producing signaling proteins that bacteria see as food.

“Then this community – it’s an ecosystem – shifts. Organisms that can break down protein start growing more, and organisms that can breathe in an oxygen-starved environment grow. The bacterial profile and, more importantly, the function of the immune system changes,” she said.

The inflammation opens pores between cells that line the mouth and blood vessels get leaky, allowing what have become unhealthy bacteria to enter circulation throughout the body.

The real-life diseases that spread the vampire myth

Whenever I talk about Kansas, I think of a couple of times Amy and I went off the regular roads, and saw all kinds of pioneer homesteads, long abandoned but probably built about the 1820s.

finger-of-godGiven the weather of Kansas, I would speculate, it’s no wonder so many crazy religions came from this place, because the finger of god – tornadoes – would descend without warning, super heat, super cold, and it wasn’t like anyone could go to Wal-Mart and restock.

It was probably terrifying.

I also recall how an astounding professor who’s class I got to TA for a couple of years – genetics for arts students – would begin every semester by citing Christian scripture and then describe the genetic ailment (he also said the Christian bible was a fairytale, because a woman – XX – could only have a female offspring and still be a virgin).

Vampires are the same way.

Stephen Dowling of the BBC writes diseases were frightening things before the age of medical science. Plagues and epidemics could appear without warning and cause death and misery (I’m thinking Jesus time and Kansas, 1820).

It wasn’t just plagues. Other diseases – perhaps passed on by animals or from genes lying dormant in their own bodies – could cause ailments that defied explanation.

People turned instead to the supernatural. Some of these diseases helped spawn one of the most enduring and widespread monster myths in civilisation – the vampire.

The vampire – an undead figure who rises each night from his unquiet grave to feast on the blood of the living – has appeared since the time of the Ancient Greeks. While some of the sage old philosophers we still admire today might have lived into their 70s, life expectancy in Ancient Greece was thought to be around 28; centuries before sanitation, refrigeration and antibiotics, diseases were more prevalent and were far more likely to take people to an early grave.

But without a microscope to study these tiny assailants, communities in older times saw the hand of the supernatural in many diseases.

Author Roger Luckhurst, who edited Oxford World’s Classic’s reprint of Bram Stoker’s Dracula, has researched the conditions which spread the belief in vampires, showing that the myth began to gain popularity in the early 18th Century. “The first mention of the word vampire in the English language is in the 1730s, in newspapers which carry reports from the edge of Europe, of bodies being dug up and looking bloated, and having fresh blood around their mouths. They report that these stories have come from peasants, but they make them sound very plausible.”

When calamity struck these rural areas – plague, cattle dying – many would point the finger at an undead spirit preying on the living. Often the first act would be to dig up the last person who had died in the village. And that leads us to another problem – medical science was in such infancy, that even telling if a person had died wasn’t exactly foolproof. Diseases such as catalepsy, which put people into a catatonic state so deep that their pulse was hard to detect, meant some were buried alive. If they awoke, some were driven so mad with fear and hunger that they would bite themselves – an explanation, perhaps, for some of the corpses found with fresh blood.

Most people in these communities kept animals; the villages themselves were usually close to forests and woodlands home to many other animals. Before vaccination was discovered, rabies, now virtually unknown in the European wild, was common. Once symptoms – which include aversion to light and water, aggression, biting and delirium – developed, death was inevitable. There is no cure.

“Rabies is obviously where we get the link to the werewolf, too,” says Luckhurst. “People were turned feral by this contact with animals. There is a degree of folk wisdom in the werewolf myth, a warning for people not to connect yourself too much to the natural world. You had to remember your humanity.”

There are many cultures around the world – in different continents and at different times – that share the myth of the bloodsucking undead. There are manananggal in the Philippines, and the peuchen of Chile; the Baobhan Sith of Scotland and the Yara-ma-yha-who of indigenous Australian tribes.

Essentially, the vampire myth comes from more than just disease, says Luckhurst. The vampire always seems to come from somewhere outside of the comforts of our own homes – be that a rural Transylvanian cottage, an English stately home or Ancient Athens.

“It always comes from somewhere else; in Ancient Greece the barbarians from beyond the Greek world were cannibals and bloodsuckers, and able to do all sorts of black magic that they were weren’t. In other places, it was the pagan tribes.” Even in South America, he says, the vampiric creatures the Incas believed in were from the wilds beyond their cities.

The vampire seems to be a vehicle not just for the diseases that we were not able to comprehend, but for all those strange, unmapped places and the people that live in them too.

Data analysis allows researchers to predict disease outbreaks

Researchers tracking social media and Web searches have, according to USA Today, detected outbreaks of the flu and rare diseases in Latin America by up to two weeks before they were reported by local news media or government health agencies.

Working at a series of universities and companies around the country, the researchers are part of a program led by the Intelligence Advanced Research Projects Agency (IARPA) that is aimed at anticipating critical events, such as disease outbreaks, violent uprisings or economic crises before they appear in the news.

“The goal is to use publicly available information to predict events, such as political violence, disease outbreaks and economic crises,” said Jason Matheny, program manager of IARPA’s Open Source Indicators program. “We’re using leading indicators like social media, Web search trends, Wikipedia in order to identify the events. We’re looking at flu outbreaks or other signs of unrest in a population.”

IARPA’s goal, Matheny said, is to inform U.S. policymakers about major events early enough to make more of a difference. Too often, he said, public announcements of disease outbreaks come too late. Intelligence analysts with access to a system able to eliminate the clutter that’s common in open source data may be able to get a jump on disease outbreaks or other problems.

IARPA is the intelligence community’s version of the Defense Advanced Research Projects Agency (DARPA), which performs much of the military’s research into technology to make better weapons or improve medical treatments. 

UN agency says surge in diseases of animal origin means new approach to health needed

Holistic is a term academics and those on the conference circuit like to toss around when they have no idea how to actually improve things.

Or sometimes it’s just the PR types who write the fluff.

According to a new report from the Food and Agriculture Organization of the United Nations, population growth, agricultural expansion, and livestockthe rise of globe-spanning food supply chains have dramatically altered how diseases emerge, jump species boundaries, and spread,

A new, more holistic approach to managing disease threats at the animal-human-environment interface is needed, it argues.

Seventy percent of the new diseases that have emerged in humans over recent decades are of animal origin and, in part, directly related to the human quest for more animal-sourced food, according to the report, World Livestock 2013: Changing Disease Landscapes.

The ongoing expansion of agricultural lands into wild areas, coupled with a worldwide boom in livestock production, means that “livestock and wildlife are more in contact with each other, and we ourselves are more in contact with animals than ever before,” said Ren Wang, FAO Assistant Director-General for Agriculture and Consumer Protection.

“What this means is that we cannot deal with human health, animal health, and ecosystem health in isolation from each other – we have to look at them together, and address the drivers of disease emergence, persistence and spread, rather than simply fighting back against diseases after they emerge,” he added.

FAO’s new study focuses in particular on how changes in the way humans raise and trade animals have affected how disease emerge and spread.

“In response to human population growth, income increases and urbanization, world food and agriculture has shifted its main focus from livestock-img01the supply of cereals as staples to providing an increasingly protein-rich diet based on livestock and fishery products,” World Livestock 2013 notes.

While livestock production provides a number of economic and nutrition benefits, the sector’s rapid growth has spawned a number of health-related challenges, it says.

The risk of animal-to-human pathogen shifts varies greatly according to the type of livestock production and the presence of basic infrastructure and services.

While intensive production systems are largely free from high-impact animal and zoonotic diseases, they do present some pitfalls, particularly in developing countries and countries in transition, according to the report.

The report also states, however, that disease emergence in livestock is not specific to large-scale, intensive systems.

Smallholder livestock systems – which tend to involve animals roaming freely over large areas, but still in relatively high densities – often facilitate the disease spread, both among local animal populations and over broad distances.

It’s like unprotected sex; many vets sickened by animals they treat

Erstwhile veterinarian Gonzalo starts a year of clinical rotations today.

This is the time when veterinary students mysteriously diagnose themselves with whatever ailment the animals have.

ace-venturaApparently in some cases it’s true.

Almost one in two vets contract infections from animals they treat because of bad hygiene practices, a study has found.

Research by the University of Sydney’s Veterinary Science department shows poor infection control has led to 44.9 per cent of vets contracting an infectious disease during their career.

More than 75 per cent of the 344 veterinarians questioned used masks, gowns or gloves when performing surgery, dental work and post-mortem examinations.

However, about half (40 to 70 per cent) didn’t use adequate protection when treating animals with respiratory, neurological, gastrointestinal and dermatological disease.

“Our profession appears to have a complacent attitude towards the use of personal protection,” said the study’s author, Dr Navneet Dhand.

“Not using appropriate protection when necessary is just like having unprotected sex with a stranger and thinking that it will be alright.”


Why is meat inspected? And why is change so difficult?

 Why is meat inspected?

Why does it have to be overseen by veterinarians?

Does inspection result in fewer sick people?

Do inspectors have pathogen-seeking goggles?

The Washington Post reports this morning that every day, inspectors in white hats and coats take up positions at every one of the nation’s slaughterhouses, eyeballing the hanging carcasses of cows and chickens as they shuttle past on elevated rails, looking for bruises, tumors and signs of contamination.

It’s essentially the way U.S. Department of Agriculture food safety inspectors have done their jobs for a century.

But why? Today’s meat inspection seems grounded in repetition and historical precedent rather than science.

In 1184, city leaders in Toulouse, France, introduced some of the first documented measures to oversee the sale of meat: profit for butchers was limited to eight per cent; the partnership between two butchers was forbidden; and, selling the meat of sick animals was forbidden unless the buyer was warned.??By 1394, the Toulouse charter on butchering contained 60 articles, 19 of which were devoted to health and safety.?

As outlined by Madeleine Ferrières, a professor of social history at the University of Avignon, in her 2002 book, Sacred Cow, Mad Cow: A History of Food Fears, the goal of regulations at butcher shops — the forerunners of today’s slaughterhouse — was to safeguard consumers and increase tax revenues.

Primarily increase tax revenues.

Animals from the surrounding countryside were consolidated at a single spot — the evolving slaughterhouse, originally inside city walls — so taxes could be more easily gathered, and so animals could be physically examined for signs of disease.??It’s no different today: slaughterhouses are common collection points to examine animals for signs of disease and to collect various levies.

Bernard Vallat, Director General of the World Organisation for Animal Health (OIE), said a couple of years ago that veterinary legislation is the foundation of any efficient animal health policy.

??”Veterinary legislation is a critical infrastructure element for all countries. In many OIE Member countries, the veterinary legislation has not been updated for many years and is obsolete or inadequate in structure and content for the challenges facing veterinary services in today’s world. Dr Vallat said that it is important that the veterinary services have the authority to enter livestock premises and other establishments and take the actions needed for early detection, reporting and rapid and effective management of any animal diseases as soon as they are detected. Such actions include the capacity to seize animals and products, to impose standstills, quarantine, testing and other procedures; to control animals and products at frontiers; and to require the destruction and safe disposal of animals and all articles considered to present a risk of disease transmission and to public health. These activities represent the core activities of veterinary services in the field of animal health control and veterinary public health and the legislation must provide the necessary authority as a minimum.”

That’s an attempt to answer the why-inspect-meat question, but it won’t be found in the Post story.

The Post story does explain that in some large slaughterhouses, USDA inspectors must regularly shave slices off the surface of different pieces of meat and send them to labs to test for E. coli.

But science has done little to thin the ranks of traditional inspectors. The law requires that they be present whenever animals are slaughtered and that they visit meat processing plants at least once a day. The USDA has more than 7,500 people doing the job.

The USDA launched an initiative in 1997 that would have shifted some responsibility for identifying carcass defects on slaughter lines to food company employees so that inspectors could focus more on microbial contaminations, USDA officials said. But a year later, the American Federation of Government Employees, some federal inspectors and a public-interest group sued to block the plan, alleging that it scrapped the carcass-by-carcass inspections required by the 1906 law.

As a result of the court battle, the USDA was forced to keep at least one inspector on each slaughter line.

Richard Raymond, a former USDA undersecretary of food safety, tried another approach in 2005. He worked to reallocate the time inspectors spend in meat processing plants based on the facilities’ safety record and the risk posed by the foods processed: Ground-beef plants, for example, would get more attention than a canned-ham operation.

But after two years of discussion with the food industry, consumer groups and unions, Congress barred the USDA from using funds to pursue the initiative. Raymond said he suspects that unions, fearful for their members’ jobs, blocked the effort.

In Canada, the years following the 2008 listeria-in-Maple-Leaf-deli-meat outbreak that killed 23, the federal inspectors’ union has had the public discussion volume set to shrill.

Canadian union president Bob Kingston said in the past few days (months, years) that any cuts to Canadian Food Inspection Agency inspector staffing would “be devastating.”

He doesn’t say why.

Would more federal government inspectors have prevented the Maple Leaf mess? No. Do Canadian inspectors possess Superman-style listeria detection goggles? No. Do more inspectors make food safer? No.

In January, the USDA unveiled a proposal that would keep one inspector on each poultry slaughter line while the rest focused on what the agency considers higher risks, such as testing poultry for pathogens. Much of the responsibility for spotting obvious problems with the carcasses would fall to the plant’s employees.

The voluntary proposal would save taxpayers more than $90 million over three years, lower production costs for the industry by $257 million a year and better protect the public against contaminants, USDA officials say.

But these days, the bulk of what Americans eat — seafood, vegetables, fruit, dairy products, shelled eggs and almost everything except meat and poultry — is regulated by the Food and Drug Administration. And the FDA inspects the plants it oversees on average about once a decade.

These radically different approaches are a legacy from a time when animal products were thought to be inherently risky and other food products safe. But in the past few years, the high-profile and deadly outbreaks of foodborne illness linked to spinach, peanuts and cantaloupe have put the lie to that assumption.

The FDA’s approach is partly by necessity: The agency lacks the money to marshal more inspectors.

But it also reflects a different philosophy about how to address threats to the nation’s food supply: an approach based on where the risk is greatest.

“We have two extremes in the inspection programs,” said Michael Doyle, a nationally known microbiologist who directs the Center for Food Safety at the University of Georgia. “Neither system is working very well. They both need to be updated and upgraded.”

At the USDA, tight federal budgets and scientific advances over the past century make the case for new ways to manage risk, one that relies less on basic observation by an army of inspectors. But bureaucratic politics and union power have blunted these initiatives.

“I’m sure the resources can be allocated better,” said Michael Batz, a University of Florida researcher who studied the risks posed by different foods. “But each agency has a mandate. USDA, because of its mandate, has very little discretion about how it can use its resources. FDA has a broader mission, but, I think it’s fair to say, not enough resources.”

Regardless of whether local, state or federal, inspection are present to hold producers accountable, as part of a tax collection scheme, or to make food safer, the best slaughterhouses, processors, retailers and restaurants will go above and beyond the minimal standards of government.

And stop whining about it.

Because none of this chatter among the, err, chatting classes means fewer people are barfing from the food they consume.

Webidemiology: disease sleuths surf for outbreaks online

 Most folks who wake up feeling crummy will sit down with a computer or smartphone before they sit down with a doctor.

They might search the Web for remedies or tweet about their symptoms. And that’s why scientists who track disease are turning to the Internet for early warning signs of epidemics.

Philip Polgreen, an epidemiologist at the University of Iowa, told NPR’s Adam Cole, "Surveillance is one of the cornerstones of public health. It all depends on having not only accurate data, but timely data."

The current system requires the Centers for Disease Control and Prevention to compile reports about from physicians and labs all over the country — and that can take a while. There’s typically a week-long delay between an outbreak and the release of an official report.

To get an early read on things, epidemiologists look for the first clues of illness — a rise in thermometer sales or increased chatter on hospital phone lines. Now, they’re tapping into the Internet.

A team of researchers at Johns Hopkins wanted to see if Google’s estimates would prove accurate and useful in the everyday operation of a hospital.

They compared Google searches originating in Baltimore to the number of patients who showed up with flu-like symptoms at a local emergency room.

"It seems like a stretch, but what we found — amazingly — is that there’s a really high correlation between these searches in the community and what we’re seeing in hospitals," says Richard Rothman, the study’s co-author.

Online disease surveillance — or "Webidemiology" — is a cool new tool, and researchers are eagerly testing it out and double-checking the data they collect. But it won’t be used by itself to make important public health decisions anytime soon.

"The Internet is just one additional stream of information," Polgreen says. "It’s certainly not going to replace traditional forms of surveillance."

While the Internet may not be a perfect predictive tool, researchers and public health officials agree that it is great for one thing: communication.

Social networking allows officials to easily reach the public and enter into a conversation. Tweets, searches and Facebook posts can give officials a sense of public reaction to vaccines, or their attitude towards an epidemic.

"It’s a quick and easy barometer for public anxiety," Polgreen says.
And in a public health emergency, that can be just as useful as cold, hard numbers about cases.

Sandra Bullock smuggles sausage

Sandra Bullock wouldn’t stand a chance against the AQIS beagles.

Australia has an impressive quarantine and inspection service for folks arriving to the island. So do lots of countries. The reason is that people want their nostaligic food, but have no concept of the consequences of disease introduction; think foot and mouth disease in the UK, which was ultimately linked to some overseas food eventually fed to pigs.

People magazine, for those who can’t get enough of celebrities, artists and athletes who should focus on their craft instead of speaking, reports that Sandra Bullock’s Christmas dinner involves illegally importing sausages from Germany to continue a meal tradition started by the actress’s mother.

"Since my mother passed, we break the law, because we have to manage to smuggle German sausages into the country, and apparently bringing meats across the waters is against the law," Bullock, 47, told Jay Leno during an appearance on The Tonight Show. "You fry ’em up with some sauerkraut and potato salad, but they have to be the right ones."

Bullock said her family sends out an "SOS" to a handful of loved ones overseas to send the meats over to the U.S.

"We just have to break the law a little bit, but eventually someone’s package gets through," she told Leno.

When pressed about the method, Bullock said with a smirk: "I’m not at liberty to divulge how we smuggle the sausage."

Like watching South Park: why feeling disgust can be good (or fart jokes)

Feelings of disgust help humans avoid, or at the very least recognize, the things that cause disgust like sick people, dirty water, vomit, body fluids and all the other stuff that makes us react "Yuck."

BBC News reports that in a paper published in Philosophical Transactions for the Royal Society B, Dr Val Curtis, from the London School of Hygiene and Tropical Medicine, argues that avoidance behavior is essential to prevent the spread of all the major current and recent infectious diseases which present a threat to humans.

Washing hands and food can prevent diseases like cholera and hepatitis A, avoiding sex with others who are infected helps prevent the spread of HIV, while keeping a distance from people with influenza or measles is a sensible move to reduce the risk of infection.

"The idea of contacting or consuming infectious substances such as saliva, feces or vomit, or of intimate contact with those known to be carrying infection is deeply uncomfortable to even contemplate," writes Dr Curtis.

"Self-limitation of such behaviour is so automatic and intuitive that it is often ignored as the front-line in our defense against disease.

Something as simple as handwashing with soap could save over a million lives a year globally, the paper says, just by stopping the transmission of disease.

Disgust is often used to get this message across in public health campaigns.

Stephen Fry, who has declared himself celibate in the past, is quoted in Dr Curtis’s paper describing how disgust played a part in his decision to abstain from sex.

"I would be greatly in the debt of the man who could tell me what would ever be appealing about those damp, dark, foul-smelling and revoltingly tufted areas of the body that constitute the main dishes in the banquet of love.

"Once under the influence of drugs supplied by one’s own body, there is no limit to the indignities, indecencies and bestialities to which the most usually rational and graceful of us will sink."

Why disgust matters
Philosophical Transactions of the Royal Society B, vol. 366, no. 1583, 3478-3490
Valerie Curtis
The new synthesis about disgust is that it is a system that evolved to motivate infectious disease avoidance. There are vital practical and intellectual reasons why we need to understand disgust better. Practically, disgust can be harnessed to combat the behavioural causes of infectious and chronic disease such as diarrhoeal disease, pandemic flu and smoking. Disgust is also a source of much human suffering; it plays an underappreciated role in anxieties and phobias such as obsessive compulsive disorder, social phobia and post-traumatic stress syndromes; it is a hidden cost of many occupations such as caring for the sick and dealing with wastes, and self-directed disgust afflicts the lives of many, such as the obese and fistula patients. Disgust is used and abused in society, being both a force for social cohesion and a cause of prejudice and stigmatization of out-groups. This paper argues that a better understanding of disgust, using the new synthesis, offers practical lessons that can enhance human flourishing. Disgust also provides a model system for the study of emotion, one of the most important issues facing the brain and behavioural sciences today.

Kids can go back to the pool in Kentucky as shigella wanes

As the temperature climbed to 105F today in Manhattan (Kansas) I was once again thankful for City Park, down the street, with it’s groovy new splash and water park.

Two-and-a-half-year-old Sorenne hasn’t had an accident – yet – but who knows if she will.

It’s a tough balancing act for city types – public health versus cool relief.

WLWT repots that children who are not toilet trained can again swim in public pools in Northern Kentucky, under revised guidelines issued by the Northern Kentucky Health Department on Thursday.

The restriction, in place since June 3, has been part of an effort to stop the spread of shigella. More than 100 cases of shigella have been reported in Boone, Campbell, Grant and Kenton Counties since April. Typically, about 25 cases are reported for the entire year.

"When faced with a shigella outbreak, a big concern is that the bacteria, and other similar illnesses, could infect a larger population through local swimming pools," said Dr. Lynne M. Saddler, District Director of Health, in a news release.

"The restriction on diapers in pools was an effective strategy. In past shigella outbreaks, when restrictions were not in place, we saw a significant increase of shigella cases and other recreational water illnesses in June. This June, with restrictions in place, we have not seen as many cases of shigella, or other illnesses, including cryptosporidium."

Other efforts to contain the Shigella outbreak will continue, focusing on child care centers and swimming pool facilities, officials said.

And keep those chlorine levels up.