Category Archives: Immunology

Marijuana Allergies on the Rise – Medscape

March 7, 2020 medical

"Cannabis sativa is a weed and it causes reactions just like any other pollen allergy," said William Silvers, MD, from the University of Colorado School of Medicine in Aurora.

Silvers' clinic began to see people with allergic reactions to the plant after the increase in direct exposure that accompanied the legalization of recreational marijuana in Colorado. For people with allergic tendencies, first- and second-hand exposure to C.sativa will increase "classic responses," such as allergic rhinitis, sneezing, wheezing, itching, and asthma, he told Medscape Medical News.

Smoking the weed, direct exposure to the plant, contact with others who have touched plants, and breathing air in a grow operation "can all cause reactions," he said. "And the more exposure they had, the greater the reaction, especially those who have allergic tendency," he said.

The type of exposure to C.sativa is also a factor. Smoking the plant can induce typical allergic responses, the ingestion of hemp seed has been known to induce anaphylaxis, and "working with the plant can lead to dermatitis or contact urticaria," he explained.

The health risks and benefits associated with C.sativa will be discussed at the upcoming American Academy of Allergy, Asthma and Immunology (AAAAI) 2020 Meeting in Philadelphia. The new AAAAI cannabis working group will also meet during the event to discuss the next steps for patient care.

Edibles made with C.sativa have led to overdoses because dosing is difficult to determine. "It takes an hour or so to have an effect, so you don't have as much control as inhaling it," Silvers explained.

A 2018 case report describes a 24-year-old daily marijuana smoker who experienced anaphylaxis after ingesting hemp seed. He had a history of allergies to stoned fruits, nuts, crustaceans, and aeroallergens. It was his first known exposure to hemp seed.

The patient developed urticaria on his arms after contact with C.sativa leaves and flowers, but had no reaction when smoking marijuana. This case indicates how important mode of exposure is.

"There are only a few cases of anaphylaxis known from ingestion of hemp seed," Silvers said, "but the 'stoned fruit, stoned patients' cross-reactivity looks to be a real thing."

People allergic to ragweed and sage are more likely than others to have a reaction to cantaloupe and other fruits in the melon family, he explained. There is a common antigen in the C.sativa pollen and in certain foods with cross-reacting proteins, such as tomato, peach, and hazelnut. "We see a pollen and food cross-reactivity via nonspecific lipid transfer proteins."

A 2017 review of C.sativa allergy points out that few reports of IgE-dependent allergic reactions have been published because of the illegal status of cannabis. However, it is becoming more prevalent as a potential allergen. For example, in Nebraska, C.sativa pollen accounts for 36% of the total pollen count.

People with IgE-mediated cannabis allergy can have a sensitization to the nonspecific lipid transfer protein of C.sativa, Cans3, which might explain the secondary plant-derived food allergies seen in European patients with a cannabis allergy, according to the review. Cans3 cross-reacts with various plant homologues.

"This is the sort of information that allergists need to have," Silvers said.

The fact that federal law prohibits cannabis use in the United States has made research difficult.

A strain distributed by the University of Mississippi can be used for research, "but it's potency is very low, at 5% or 7%," Silvers explained. At medical marijuana dispensaries, the potency of the flower can be as high as 25%, and in other forms, the THC content can be above 80%.

The legal status makes cannabis allergy difficult to diagnose and impossible to treat. Immunotherapy is out of the question. "With federal illegality, we need to stay out of trouble in that regard," said Silvers, adding that, currently, avoidance is advised.

But research is emerging from Canada, where medicinal and recreational marijuana use is legal. Results from a survey showing the prevalence of response in marijuana-exposed allergic patients will be reported at the meeting by Ryan Lo, MD, from the University of Toronto.

The impact of cannabis exposure on human respiratory health will be addressed by several speakers, including Angela Lemons, from the National Institute for Occupational Safety and Health in the United States.

Stigma around cannabis is still high. "Nobody wants to be seen as a 'pot doctor'," said Silvers. But after it became legal in Colorado in 2015, he was asked to give a talk and decided to speak up.

"I have never written a medical prescription for marijuana," he said, explaining that he is involved with the Center for Bioethics and Humanities at the University of Colorado. "I try to take a societal as well as a medical perspective, looking at the value and concerns for abuse and misuse."

"As it becomes more available, more legalized, patients are having more reactions," he said. "Allergists need to get in the game."

Attitudes need to change. Physicians and allergists need to understand what's happening in the population "and be open-minded about it so they know what to do," he added.

Users of medical marijuana can become dependent, said Ellen Burnham, MD, also from the University of Colorado.

"Patients want a blessing from care providers that it's okay to use," she told Medscape Medical News. "We're in a state where people are really interested in holistic approaches to health, and cannabis is a natural product, but it may exacerbate allergies."

Some components of cannabis might have bronchodilator properties but there are so many unknowns at this time. "I don't think allergists should be recommending or condoning cannabis as part of a patient's therapy," she said. "It's not okay for everybody."

As business flourishes for operators in the cannabis industry and for the legal profession, Burnham said she worries that there isn't enough protection for workers. "Do workers exposed to plant material on a daily basis have adequate workplace protection," such as masks and gowns? "There's a downstream effect that impacts people that nobody has really thought about," she pointed out.

If the cannabis industry becomes driven by money, with a lobby like the tobacco industry, there will be no way to keep people who are vulnerable from using cannabis.

Is an occasional joint, much like an occasional glass of wine, okay? "We don't know," said Burnham. "We just don't have enough information about it."

Research is needed to develop medicinal strains of cannabidiol, cannabigerol, and cannabinol, which offer "medicinal and anti-inflammatory relief without the psychologic affects," Silvers added.

American Academy of Allergy, Asthma and Immunology (AAAAI) 2020 Meeting.

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Marijuana Allergies on the Rise - Medscape

Immunology

Busting the Myths of Coronavirus and Goods Imported from China – Grainmart News

March 7, 2020 medical

With increasing deaths and the number of infected individuals, coronavirus has left the worlds economy dwindling. This calls for busting myths of coronavirus, food and imported goods from China.

Several experts stated that there is no chance that virus could be transmitted from touching any surface of packaged shipped product. Further, they declared that no type of active delectable virus could travel via surface. David Evans, a professor in the Department of Medical Microbiology and Immunology at the University of Alberta states that coronavirus has a lipid bilayer a fatty membrane. Also, it is fragile and damaged easily. If it disperses on a surface, it dries and gets inactive stuck on that surface. However, the myths of coronavirus spread faster than the actuality.

India imported raw and powdered garlic from China in huge quantities. However, the coronavirus fears have stopped the supply of Chinese garlic, which were in great demand until now. Despite its toxicity levels due to bleaching, people prefer to use it over Indian variety because of its easiness to peel. However, the news of coronavirus outbreak has vanished Chinese garlic from the markets.

Ongoing myth about spreading of coronavirus by consuming chinese garlic is false. The conflicting misinformation out there resulted in digital platforms tightening the noose. Further, platforms like Twitter, Google and Instagram have started redirecting users to their home countries health authorities.

The widespread circulation of myths regarding the Coronavirus (Covid-19) has resulted in decreasing sales of chicken and meat. Citing this, the Poultry Farm Association organized chicken mela in Uttar Pradesh where it provided cooked chicken meals at a very low cost. Also, the top chicken companies have declared on their social media handles that properly cooked meat is safe for consumption.

The increasing myths of coronavirus are making people careless towards the threat. Also, the rumors about homeopathic medicines preventing the virus have spread. So, to clear out the doubts, the Ministry of AYUSH has issued an advisory that there is no medicine to prevent the coronavirus. Hence, people must take precautions rather than popping pills to boost their immunity. People have fallen prey to the misinformation on social media platforms. Thus, people need to identify the source of information before taking action.

In conclusion, Washing hands, wearing masks in public, staying away from public events and keeping distance from sick people is the right approach.

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Busting the Myths of Coronavirus and Goods Imported from China - Grainmart News

Immunology

Hepalink Announces the Appointment of Healthcare Senior Executive Mr. Frank Sun as Executive Director and Vice Chairman of the Board – Financial Post

March 7, 2020 medical

SHENZHEN, China Shenzhen Hepalink Pharmaceutical Group Co., Ltd. (SZSE: 002399), a China-based global pharmaceutical company targeting high-mortality diseases with significant unmet medical needs, announced the appointment of Mr. Frank Sun as Executive Director and the election of Mr. Sun as the Vice Chairman of the Board. Mr. Sun will work with the Board on strategy design, enhancement and implementation, and lead the efforts in strategic investment, capital markets, and the development of Hepalinks innovative businesses globally.

We are thrilled to have an industry veteran such as Frank joining us, said Mr. Li Li, Hepalinks co-founder and Chairman. He brings 20 years of experience in top global companies, and a broad set of expertise in the healthcare industry, investment, corporate finance and management. This is an exciting time for Hepalink, as we accelerate value realization driven by continued focus on innovation and global expansion. Franks leadership and expertise will be critical to helping Hepalink reach the next stage of growth.

Mr. Sun joins Hepalink from Yunfeng Capital, one of the largest China-based private equity funds, where he served as Managing Director responsible for global healthcare investment. Prior to Yunfeng, Mr. Sun worked at UBS AG, and served as Managing Director and Head of Asia Healthcare Investment Banking. Previously, he was a pharmaceutical sector equity research analyst with Morgan Stanley based in New York, and a research scientist at Bristol-Myers Squibb.

Mr. Sun graduated with distinction and received his MBA from NYU Stern School of Business. He has a Masters degree in pharmacology from Columbia University. Mr. Sun is a director of the China Healthcare Investment 50 Forum (H50).

About Hepalink

Founded by a group of seasoned polysaccharide-chemists with scientific insights and profound understanding of immunology, Hepalink is a leading China-based pharmaceutical company with global businesses in pharmaceutical, innovative biotech and CDMO sectors. We have built up a portfolio of both leading drugs in the anticoagulant and antithrombotic therapeutic areas and innovative drug candidates focusing on diseases with an immune system disorder axis, including oncology, autoimmune, metabolic and other areas.

View source version on businesswire.com: https://www.businesswire.com/news/home/20200306005009/en/

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Media Shenzhen Hepalink Pharmaceutical Group Co.,Ltd. Peiyu Wang Peiyu.wang@hepalink.com (86) 755-2698 0200 ext. 2103

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Hepalink Announces the Appointment of Healthcare Senior Executive Mr. Frank Sun as Executive Director and Vice Chairman of the Board - Financial Post

Immunology

School of Medicine physicians, researchers tackle coronavirus Washington University School of Medicine in St. Louis – Washington University School of…

March 7, 2020 medical

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Clinical teams ready; research for vaccines, drugs underway

Postdoctoral researchers Brett Case, PhD, (left) and Adam Bailey, MD, PhD, wear full personal protective equipment to study the COVID-19 virus. Washington University School of Medicine in St. Louis physicians and researchers are preparing for COVID-19 cases and working on drugs and vaccines to fight the disease.

Soon after a novel coronavirus first appeared in China in late 2019, researchers, doctors and staff at Washington University School of Medicine in St. Louis began preparing for the possibility of an outbreak. Infectious disease physicians started planning how to respond if a person with suspected exposure to the virus arrived on campus, and researchers set to work finding drugs or vaccines to treat or prevent COVID-19, the name given to the illness caused by the virus.

New infectious diseases emerge every so often, and we have to be vigilant, said Steven J. Lawrence, MD, an associate professor of medicine. Over the last few decades weve had HIV, Ebola, SARS, Zika and now COVID-19. Such diseases usually arise when an animal virus manages to jump into people because of close contact between people and animals. The chance of preventing that happening anywhere in the world is probably zero. What we can do is be prepared to respond as rapidly as possible when it happens.

In December, China reported the first cases of a mysterious illness characterized by fever, a dry cough and difficulty breathing. Within weeks, Chinese scientists had identified the cause as a never-before-seen member of the coronavirus family. Coronaviruses typically cause mild infections such as the common cold. But in 2002, a newly emerged strain of coronavirus caused an outbreak of severe acute respiratory syndrome (SARS) that killed nearly 1,000 people before it was contained.

It quickly became evident that the 2019 coronavirus strain, named SARS-CoV-2, was more like SARS than the common cold. By late January, tens of thousands of people in China were infected. At the time, the only cases in the U.S. were believed to be in people who had been infected while traveling in China.

In January and February, we had a brief moment of opportunity to contain this outbreak in the U.S. by knowing where people had traveled, Lawrence said. Thats why the efforts to identify and isolate people with the virus were so robust, even though we had such few cases. Once the virus started spreading from person to person in the U.S., it became much, much more complicated.

Washington University infectious disease physicians (from left) Stephen Y. Liang, MD, Steven J. Lawrence, MD, Hilary M. Babcock, MD, and David K. Warren, MD, are preparing for the possibility of COVID-19 cases in St. Louis. Pictured is the team, in 2014, discussing emerging infectious diseases.

Hilary M. Babcock, MD, a professor of medicine and medical director of the Infection Prevention and Epidemiology Consortium for BJC HealthCare, and David K. Warren, MD, a professor of medicine and the medical director for infection prevention at Barnes-Jewish Hospital, did not wait for the virus to start spreading in the U.S. In January, they established a virtual incident command center at BJCHealthCare and called twice-weekly meetings to develop a coronavirus outbreak response plan for all BJC hospitals, including hospitals and clinics staffed by Washington University physicians. The team started by dusting off a plan developed in 2002 for SARS and adapting it to COVID-19 as more information emerged.

The data on mortality for COVID-19 remains a moving target and continues to be assessed. So far, people who are older and those with underlying health conditions, such as heart disease, lung disease or with compromised immune systems, have a higher risk of death. Early data suggests that the illness is more deadly than seasonal flu. Like SARS and the flu, COVID-19 spreads easily through droplets released when infected people cough or sneeze. The viruss contagiousness means that proper use of personal protective equipment is crucial to protect health professionals caring for coronavirus patients.

Communication is one of the most important tools at a time like this, Babcock said. We needed to make sure that our front-line clinicians can very quickly recognize that someone might be infected, and that they know what to do if a potentially infected person presents at their clinic. We also developed guidance regarding which personal protective equipment to wear when working with a patient suspected of having COVID-19 mask, gloves, eye shield, respiratory equipment, and gown how to put it on so it is most effective, and, most importantly, how to take it off without contaminating yourself.

Babcock and Warren also are keeping a close watch on outbreaks in other countries and implemented new travel screening recommendations across the university as the virus has spread to other countries, notably South Korea, Italy and Iran.

We are ready, Babcock said. Weve been ready for weeks. Its only a matter of time before we get our first case.

Building the toolkit to fight COVID-19

Across campus, a team led by Sean Whelan, PhD, the Marvin A. Brennecke Distinguished Professor and head of the Department of Molecular Microbiology, and Michael S. Diamond, MD, PhD, the Herbert S. Gasser Professor of Medicine, is looking for ways to treat COVID-19 or reduce its spread.

We had a discussion in early January and decided then to work on advancing therapeutics and vaccines for coronavirus, because it had the potential to be a significant problem, said Whelan, who took over as head of the molecular microbiology department on Jan. 1. It is our responsibility as part of the biomedical research community to do this. The consequences of this virus in places where there isnt a good health-care system could be dire.

Whelan called weekly meetings to coordinate the School of Medicine coronavirus research effort. He and Diamond have special expertise in emerging viral infections. Diamond led the School of Medicine response to Zika virus, during which he and others developed a mouse model of Zika infection and identified an antibody that is now used as part of a diagnostic test. While on the faculty at Harvard, Whelan studied Ebola and identified a critical protein that the virus exploits to cause deadly infections.

Whelan and Diamond built a research team including influenza experts Jacco Boon, PhD, an associate professor of medicine, and Ali Ellebedy, PhD, an assistant professor of pathology and immunology, who provided advice and scientific tools for studying respiratory viruses; structural immunologist Daved Fremont, PhD, a professor of pathology and immunology, who has begun studying the interactions of coronavirus proteins with antibodies and other human proteins to facilitate vaccine design and improved diagnostics; David T. Curiel, MD, PhD, the Distinguished Professor of Radiation Oncology,who began designing a potential vaccine; and Siyuan Ding, PhD, an assistant professor of molecular microbiology, who is investigating whether the virus also can be transmitted through the fecal-oral route.

The team is analyzing the structure of the viruss proteins to find possible targets for drugs or vaccines, looking for antibodies that might protect against disease, creating potential vaccines using multiple strategies, and developing a mouse model that can be used to test potential drugs and vaccines.

In addition, geneticist Ting Wang, PhD, the Sanford and Karen Loewentheil Distinguished Professor of Medicine, and members of his lab built a genome browser to help researchers study the genetics of the COVID-19 virus and compare different strains. Greg Bowman, PhD, an associate professor of biochemistry and molecular biophysics whose work focuses on how proteins take their shape, has mobilized his crowdsourced Folding@home Consortium to find the shape of coronavirus proteins to inform drug and vaccine development.

The speed of research on coronavirus has been extraordinary, Diamond said. Chinese scientists identified the virus, sequenced its genome, identified the probable animal source, and released the genomic sequence to the public in a matter of weeks. Groups around the world have been creating and sharing the tools we need to interrogate this virus. But even so, these things take time. Every day, the U.S. is seeing new cases. We are racing against the clock.

Washington University School of Medicines 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Childrens hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Childrens hospitals, the School of Medicine is linked to BJC HealthCare.

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Immunology

Allergan and AbbVie Turn Eyes to the FTC for Approval of their $63 Billion Merger – BioSpace

March 5, 2020 medical

AbbVie and Allergan have cleared a major hurdle in completing the merger of the two companies that began in June of 2019. On Tuesday, the European Commission gave the green light to the merger following the divestiture of an investigational autoimmune treatment.

With the nod from the European Commission, all eyes are now on the U.S. Federal Trade Commission as it continues to review the pending merger. The FTC does not have a set timeline, but AbbVie and Allergan said they have a timing agreement with the agency that could result in a decision early in the second quarter of this year. AbbVie and Allergan said they continue to fully cooperate with the FTC during its review and intend to close the transaction at the earliest possible date.

The European Commissions approval of the $63 billion merger was contingent on the divestiture of brazikumab, an investigational IL-23 inhibitor in development for autoimmune diseases, to AstraZeneca. In January, AbbVie and Allergan announced their intentions to divest some assets in order to avoid regulator concerns over a monopoly. In addition to the deal with AstraZeneca for brazikumab, which is currently in Phase IIb/II development for Crohn's Disease and in Phase II development for ulcerative colitis, the companies sold the approved Zenpep (pancrelipase), a treatment for exocrine pancreatic insufficiency due to cystic fibrosis and other conditions, and Viokace, a pancreatic enzyme preparation, to Nestle.

With clearance from the European Commission, share prices for both companies are climbing this morning. AbbVie is up 3.57% to $90.70 per share as of 10:27 a.m. and Allergan is up % to $194.74 per share, as of 10:27 a.m.

While the news is positive for investors, particularly after a tumultuous week in the stock market, some consumer groups have been trying to stop the merger of AbbVie and Allergan. The groups opposed to the merger of the companies have raised concerns over the creation of a monopoly that will stifle competition in the immunology market. The organizations, which includes American Federation of State, County, & Municipal Employees, Public Citizen, Service Employees International Union, Doctors for America and Prescription Justice, argue that even with the divestiture of brazikumab, AbbVie dominates the immunology market through a variety of exclusionary tactics to hamper rivals.

In a letter sent to the Federal Trade Commission, the group said even with the divestiture to AstraZeneca, there is a chance that drug will not increase competition in the market since its still an investigational medication.

In January, AbbVie and Allergan announced plans for a new, stand-alone company called Allergan Aesthetics that will include Allergans blockbuster aesthetics treatment Botox as a tent pole.

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Allergan and AbbVie Turn Eyes to the FTC for Approval of their $63 Billion Merger - BioSpace

Immunology

BEYOND LOCAL: Sniffles and itchy eyes in winter? It could be allergies – TimminsToday

March 5, 2020 medical

Bad news, allergy sufferers winter wont necessarily give you a break.

There are what we call perennial allergens that never really go away, said Dr. Anne Ellis, professor and chair of the division of allergy and immunology at Queens University.

Things like house dust mites, which are microscopic spider-like insects that live in our mattress and pillow, certain moulds can live indoors in homes, and obviously if people have pets cats and dogs they usually allow them in the house and theyre not leaving, because its wintertime.

Mice also like to come inside during the winter, said Dr. Paul Keith, an associate professor in McMaster Universitys division of allergy and clinical immunology. These rodents can also be an allergy trigger for many people, he said, if they get into the house.

Part of the problem is that we spend more time indoors during the winter, Ellis said, which is not a great environment for allergy sufferers.

In winter, people usually keep their houses closed up and dont have air conditioners running or windows open which means allergens can build up in the closed area, she said. Heaters can make the air drier, which is also irritating for some.

These arent the same as seasonal allergies though.

Theres no pollen in the air right now, she said. Its tempting to think that theres something in the air when you have these intermittent mild melts. But usually whats happening there is that people who have allergies, they have hypersensitive airways anyway and so any changes in climate can trigger irritant-type symptoms in the nose.

Winter is also cold season, she said, and it can be tricky to tell the difference between an allergy and an infection.

Allergies typically would not cause you to have a fever, and you wouldnt get a sore throat.

Swollen lymph nodes and a general icky, not-great feeling are also probably a cold of some kind, not an allergy, she said.

If you do have allergies, there are things you can do to help lessen your symptoms, starting with trying to eliminate the allergen in your home.

With pets, you want to try to keep the pet out of the bedroom, so that [in] the room where you spend at least eight hours a day, youre not exposed to a higher level [of allergens], Keith said.

For dust mite allergy, we recommend covering the pillow and mattress to reduce your exposure, he said.

You should also change your sheets and pillowcases every week and wash them in hot water, Ellis said.

Similarly, Keith said, many people dont wash their winter coats very often, and these can also attract dust mites.

Air purifiers can make a difference, Ellis said, but they must be certified allergy-asthma friendly.

You may also want to try tackling your symptoms with medication. Saline nasal sprays can help wash allergens out of your nose, Keith said.

Pharmacies sell lots of very effective non-sedating antihistamines, Ellis said. She strongly recommends second-generation antihistamines, sold under brand names like Claritin and Allegra, over older antihistamines like diphenhydramine (Benadryl), because they have fewer side-effects and are more effective.

Nasal steroid sprays can also be effective, she said, though people need to be aware it can take a few days for the effect to kick in. You need to use it every day for at least a week to notice a significant improvement in your symptoms.

And, she said, if you find over-the-counter options dont work, you should consult a primary care provider or an allergist.

Allergy specialists love to see patients even with minor concerns, because we really like helping people for things that we know can be a burden to the patients who experience them.

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BEYOND LOCAL: Sniffles and itchy eyes in winter? It could be allergies - TimminsToday

Immunology

Vir Biotechnology and Alnylam Join the Fight Against COVID-19 – Motley Fool

March 5, 2020 medical

Yet another biotech has joined the fray against the novel coronavirus: Alnylam Pharmaceuticals (NASDAQ:ALNY) andVir Biotechnology (NASDAQ:VIR) on Wednesday announced they were expanding their ongoing collaboration to include an attempt to develop RNA interference (RNAi) treatments for SARS-CoV-2.

According to the American Society for Microbiology, coronaviruses are everywhere. They are the second-leading cause of the common cold, after rhinoviruses. In an article on the society's website, Dr. Rodney Rhode wrote, "Coronaviruses ... mutate and change at a high rate, which can create havoc for both diagnostic detection as well as therapy (and vaccine) regimens."

Image source: Getty Images

The two companies have been collaborating since the 2017 founding of Vir, which specializes in using immunology to fight and prevent infectious diseases. Vir CEO George Scangos was the CEO ofBiogenbefore he took control of the start-up.

"Given the scope and speed of the COVID-19 outbreak," Scangos said, "Vir is seeking multiple approaches that combine our expertise in infectious disease with that of current and new partners to respond rapidly. Alnylam has been an excellent partner, and our complementary capabilities made this a compelling opportunity..."

As Alnylam CEO John Maraganore said, "We believe RNAi therapeutics represent a promising approach for targeting coronaviruses, like SARS-CoV-2. As the leader in RNAi therapeutics, we at Alnylam are committed to doing our part in joining other biopharmaceutical companies, like Vir, to address this emerging outbreak."

Vir will lead all development and commercialization of any selected drug molecules. Alnylam retains the option to share in the profits and losses associated with the effort. Shares of Vir were up 14% in early trading Wednesday, while Alnylam was up 3%.

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Immunology

Dr. David Gottsegen: Coronavirus and the dangers of a president with no concern for science – GazetteNET

March 5, 2020 medical

Last week in my office, I had the first case where I questioned whether a patient could have Covid-19, or coronavirus.

The young person had traveled abroad and returned with flu-like symptoms. I discovered that it is not easy for physicians to make this diagnosis. I first called Baystate Medical Center and was directed to the Department of Public Health in Boston, where a person took my number; an epidemiologist called me back. The epidemiologist told me that this patient was low risk and did not require testing.

If she had, then I would have had to fill out a 17-page questionnaire, which changes daily, then collect a nasal and oral viral swab, and send it to Baystate, where, once a day, a courier brings them to Boston for testing, where until this week, it would be then sent to the Centers for Disease Control and Prevention in Maryland.

Many people I speak with, including other doctors, are not aware of this process, thinking that there are special collection kits out there. The collection requires only an ordinary viral culture, but the process is very special.

Adding to the confusion is that President Donald Trump has said that all information about Covid-19 would come from Vice President Mike Pence, not health experts within the administration.

Hes used his bully pulpit to take aim at Democrats for creating a hoax around this new epidemic, even as public health experts like Anthony Fauci, director of the National Institute of Allergy and Immunology, said that the new coronavirus has adapted very well to humans and seems now to lead to a higher mortality rate than influenza.

In addition, budget cuts by the Trump administration have severely hampered the public health communitys efforts to protect American people from the novel coronavirus and other exotic infections. There has been controversy about his proposed reduction in funding to the CDC, since many of the cuts were not supported by Congress.

But this much is well documented: Trump eliminated the position of senior director for global health security and biodefense in the National Security Council, established after the first Ebola virus outbreak. He terminated epidemic prevention efforts in 39 out of 49 countries, including the Congo and China.

The Obama administration maintained a tiered epidemic response approach, created after the 2014-2016 Ebola epidemic, with 10 advanced facilities and 60 centers located one tier below. The Trump administration continued funding for the 10 advanced facilities, but eliminated the 60 intermediate treatment centers.

His administration also got rid of a U.S. Agency for International Development program called PREDICT, established in 2009 to detect new zoonotic viruses (originating in animals, like Covid-19).

For the first time in its history, the CDC is headed by a physician with no expertise in public health. In the meantime, budget cuts to public health departments meant that until this week, only three health departments across the country were able to test for coronavirus.

Then of course, are the Trump administration cuts to health care in general, to pay for the $2 trillion in tax cuts for Americas wealthiest individuals: $1.4 trillion eliminated from Medicare, Medicaid and the Affordable Care Act, disproportionately affecting the poor, seniors, families and children. How will this affect care for patients who have Covid-19?

Under the ACA, the number of uninsured Americans fell from 40million to about 27.5million, but because of the Trump administrations withering attacks on the Obama-era program, the number of uninsured Americans increased last year to 29.5 million. Do you think that an uninsured waitress, like my sister-in-law, who cares for her wheelchair-bound husband, can skip work if she is sick?

The same is true for millions of Americans who are the sole wage earner for their families and, thanks to the continued erosion of the labor unions in this country, have no job security. How do you think that will affect efforts to control this emerging epidemic?

This new virus, along with sickening nearly a 100,000 people, and killing thousands of them, has highlighted the dangers of having a president with no concern for science or public health, a tax structure that cripples funding for vital health services and a nation alone among modern industrialized nation which does not guarantee health care for all.

Despite all the bad news, the risk of Covid-19 to children is very low: Fewer than 1% of diagnosed cases have occurred in those less than 18 years old, and they have tended to be mild cases, many without fever.

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Dr. David Gottsegen: Coronavirus and the dangers of a president with no concern for science - GazetteNET

Immunology

AAAAI Urges Patients on Montelukast to Contact Their Healthcare Provider – PR Web

March 5, 2020 medical

MILWAUKEE (PRWEB) March 04, 2020

With the U.S. Food and Drug Administration (FDA) today announcing it is requiring a boxed warning for montelukast due to the risk of neuropsychiatric events, such as agitation, depression, sleeping problems, and suicidal thoughts and actions, the American Academy of Allergy, Asthma & Immunology (AAAAI) is stressing the importance of contacting your healthcare provider if you are on this drug.

If you are taking montelukast and this is helpful for your symptoms, you should speak with your healthcare provider first prior to making a decision to suspend this medication, said AAAAI President David M. Lang, MD, FAAAAI, who is also Chair of the Allergy/Immunology Department in the Respiratory Institute at Cleveland Clinic.

Alternatively, if you begin taking montelukast, or if you have been taking montelukast, and you feel sad, experience mood changes, or vivid dreams, you should suspend montelukast and contact your healthcare provider, added Dr. Lang.

Montelukast, which is sold under the brand name Singulair and in generic form, is frequently prescribed. For asthma, montelukast can be used as the sole medication taken regularly for treatment of mild persistent asthma, or in combination with other medications (e.g., inhaled corticosteroids) for management of moderate or severe persistent asthma. Patients with asthma frequently also have allergic rhinitis.

Montelukast was initially FDA approved for management of asthma, and then was also approved for seasonal and perennial allergic rhinitis and for prevention of exercise-induced bronchospasm. FDA approval is as young as 12 months in asthma, two years in seasonal allergic rhinitis, six months in perennial allergic rhinitis, and six years in exercise induced bronchoconstriction.

The boxed warning that the FDA is now requiring strengthens an existing warning about the risk of neuropsychiatric events associated with the drug, and it advises healthcare providers to avoid prescribing montelukast for patients with mild symptoms, particularly those with allergic rhinitis.

You can learn more about asthma and allergic rhinitis on the AAAAI website, aaaai.org.

The American Academy of Allergy, Asthma & Immunology (AAAAI) represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has over 7,000 members in the United States, Canada and 72 other countries. The AAAAIs Find an Allergist/Immunologist service is a trusted resource to help you find a specialist close to home.

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Immunology

Can the Weather Make You Sick? – FOX 15

March 5, 2020 medical

We have all heard the phrase put a jacket on or youll catch a cold. well there might be some truth to this. It turns out that the weather can actually help you get sick but not in the way that you might think. According to UL Assistant Professor of Immunology Ritwij Kulkarni, while the colder temperatures of this time of year might not directly make you sick they can help viruses survive longer.

Generally the way these viruses are transmitted transmitted through Aerosols so while you are speaking a little bit of spit comes out, sneeze a little bit of spit comes out. You can imagine that aerosol falls on the surface and surface is hot then it will get dried out quickly the viruses will not survive that you can imagine that all these things are going to happen more if if there is cold weather like it will take longer for these droplets to dry out.

On top of this, during the colder months we tend to stay inside more and with this the transmission of viruses and illnesses does increase.

Why we see these viruses are more common during cold months is because we are indoors. We are more in contact with each other in that time. Chances of transmission are higher and so thats why we get those infections at that time.

No matter the weather though there is one thing that you should always be doing to help keep yourself safe and that is to wash your hands.

Hand washing is the best thing that is going to clean your hands washing hands with warm water and soap; what we learn in elementary school singing happy birthday to you and making sure that youre washing hands.