By BY ELIZABETH PRESTON from NYT Health https://ift.tt/tGpu0Ho
Thursday, March 2, 2023
Florida man dies after contracting brain-eating infection from rinsing sinuses with tap water
March 02, 2023
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A man in south Florida died from a brain-eating infection last month after using tap water during sinus rinses, according to FOX 4.
The man, who has not been named but was identified as a resident of Charlotte County, died on Feb. 20, three days before the county health department issued a public alert about the infection.
DOH-Charlotte reported one case involving Naegleria fowleri, a microscopic single-celled living amoeba, on Feb. 23. The department said infection is rare and can only happen when water contaminated with the amoeba enters through the nose, stressing that it cannot be contracted by drinking tap water.
The amoeba can cause an infection of the brain known as primary amebic meningoencephalitis (PAM) – a condition that does not have any known effective treatments.
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In a statement to FOX 4, the CDC said this is the first case ever in Florida where a person was infected through tap water, and the first ever case reported in winter months in the U.S. It's also the first reported case of Naegleria fowleri infection this year.
According to the CDC, the infection kills over 97% of the people who contract it. Out of 154 known infected individuals in the United States from 1962 to 2021, only four confirmed patients have survived the infection.
Last summer, then 13-year-old Caleb Ziegelbauer contracted a possible brain-eating amoeba while swimming at Port Charlotte Beach Park, which is in Charlotte County, Florida.
Though his case has not been confirmed by the CDC as the Naegleria fowleri infection, his medical team reportedly believes that's what it was. As of last week, he is still alive and remains on the road to recovery.
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The CDC said the amoeba typically lives in warm, freshwater bodies like lakes, rivers and hot springs. It is also likely to be found living in sediment at the bottom of lakes, ponds and rivers, so the agency advises against digging in or stirring up soil in shallow, warm fresh water.
It is extremely rare for Naegleria fowleri to be found in swimming pools, splash pads, surf parks, or other recreational venues, but it is possible if they're poorly maintained or don’t have enough chlorine.
In the U.S., most infections have been linked to swimming in southern states, with Texas and Florida reporting the most cases at 39 and 37, respectively.
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Following the death, DOH-Charlotte said it is "continuing to investigate how this infection occurred and is working with the local public utilities to identify any potential links and make any necessary corrective actions."
In the public alert, the department said Charlotte County residents should be extra cognizant while bathing, showering, washing faces, swimming, jumping into water and playing with hoses/sprinklers to avoid water going up the nose. It's also recommended to keep plastic and blow-up pools disinfected, and to avoid slip-n-slides.
It added that sinus rinse solutions should always be made with distilled or sterile water, which can be made by boiling tap water for at least one minute then letting cool.
The department urged residents to seek medical assistance immediately if any of the following symptoms are experienced after swimming in warm lakes or rivers or getting water up the nose: headache, fever, nausea, disorientation, vomiting, stiff neck, seizures, loss of balance and hallucinations.
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Wednesday, March 1, 2023
Eye drops and safety issues: Here’s what you need to know now
March 01, 2023
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In light of recent news that a brand of over-the-counter eye drops may have caused bacterial infections that led to vision loss and even death, consumers may be wary of using them at all.
Thomas Stokkermans, OD, PhD, director of optometric services for University Hospitals Cleveland Medical Center in Cleveland, Ohio, said that eye drops are generally completely safe to use.
"Reported infections from eye care products are extremely rare," he told Fox News Digital in an email.
"It is much more likely that the wrong use of eye care products causes injury."
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The Centers for Disease Control and Prevention (CDC) on Jan. 20 called for people to stop using EzriCare Artificial Tears after 50 patients reported eye infections associated with the product.
The bacteria, Pseudomonas aeruginosa — which is resistant to many antibiotics — was linked to respiratory infections, urinary tract infections, permanent vision loss, hospitalization and even one death.
Dr. Stokkermans saw one of the affected patients in the ophthalmology department at UH Cleveland Medical Center.
The person lost almost all her vision in the affected eye.
On Feb. 23, the Food and Drug Administration (FDA) urged consumers to avoid purchasing or using another product, Delsam Pharma’s Artificial Eye Ointment, due to possible bacterial contamination.
Long before the EzriCare and Delsam Pharma incidents, other eye products had been recalled due to ocular infections, Dr. Stokkermans pointed out.
In previous cases, the infections apparently came from contact lens solutions.
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"In May 2007, the CDC linked AMO Complete MoisturePLUS contact lens solution to reports of Acanthamoeba keratitis, a rare parasite that can cause a serious and potentially blinding eye infection," he said.
"And in May 2006, the FDA issued a recall for B&Ls ReNu Moisture Loc after several users reported fungal keratitis infections, which are serious and hard to treat. B&L ended up settling 600 lawsuits of people affected by this infection."
Dr. Stokkermans called the EzriCare-related infections "very unfortunate."
He and said they have degraded consumers’ trust in having access to safe, healthy medications and supplements.
"Often, there is no way to know beforehand that a manufacturer has produced a tainted product until a number of consumers have been affected and it is advertised in the news," he said.
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"It’s important to remember that it is extremely rare for eye drops to be recalled due to microbial infections."
He added that the best safeguard against infection or eye disease is to only treat the eye with drops that have been prescribed or recommended by a doctor.
Optometrist Juanita Collier, MS, OD, FCOVD, offers vision therapy at her 4D Vision Gym office in Cromwell, Connecticut.
She said that eye drops containing preservatives are generally safe to use, as the preservatives extend the life of the drop safely and protect against pathogens. However, she recommends using caution with preservative-free brands.
With allergies and other medical conditions often causing red, itchy and watery eyes, it may be difficult to determine when the symptoms indicate an infection.
"Bacterial infections are often associated with goopy discharge and redness, along with a feeling like there is sand in the eye, which is known as foreign body sensation (FBS)," Dr. Stokkermans explained.
Viral infections will most likely just involve tearing and FBS, while allergies are more associated with itching, watering and swelling, the doctor said.
Infections can also affect the conjunctiva, the thin, clear membrane that protects the eye. When this becomes inflamed or infected, it can cause a condition called conjunctivitis, more commonly known as pink eye.
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When the infection affects the cornea (the surface of the front of the eye), it can cause a condition called keratitis, where the cornea becomes inflamed, said Dr. Stokkermans.
"The Pseudomonas aeruginosa infections [associated with EzriCare Artificial Tears] caused a type of keratitis where the infection broke the surface of the cornea," the doctor said. "This is called a corneal ulcer, which is the most dangerous of the discussed types of infections and can lead to blindness."
Given that infections, allergies and general sensitivities can share some of the same symptoms, it’s always best to consult an eye doctor.
"One of the most important signs of a serious problem is when the red eye is associated with blurred vision or vision loss," Dr. Stokkermans said.
In that case, he recommends going to the emergency room.
Many eye drops will sting slightly when they're first inserted, which isn’t usually a cause for concern, said Dr. Collier.
"If an eye drop burns excessively, discontinue use and call your eye doctor right away," she said.
Before using any type of eye drop, Dr. Stokkermans said it’s important to make sure the tamper-proof seal has not been broken.
Next, check the expiration date and verify that you’re using the correct product.
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"I have personally had patients who thought they were using their regular eye drops and instead placed super glue in their eyes," he said.
Dr. Collier advises her patients to never touch the tip of the bottle to their eye — no matter what type of drops they’re using — as that is a major entryway for pathogens and can also scratch the eye.
Also, Dr. Stokkermans recommended this safety advice: "When using preservative-free drops, discard the container after use. The contents of preservative-free products do not kill or slow the growth of microbes and can easily become tainted with an infectious agent."
For best results when putting in an eye drop, Dr. Stokkermans said to sit in a chair, tilt the head back and look up.
Pull the lower eyelid down and dispense a single drop into the pocket that is created between the eyeball and the lower lid.
If using different types of eye drops, he recommends waiting 15 minutes between each application.
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Between uses, eye drops should be stored at room temperature or in the refrigerator as instructed on the label.
"Drops that are exposed to high temperatures may lose the ability to retard the growth of microbes," Dr. Stokkermans said. "I had a patient who acquired Acanthamoeba keratitis [a rare but serious infection of the eye] after forgetting his contact lens solution in the clothes dryer."
Those who are unsure about the safety of an eye drop product can check the FDA’s website for any recall notices or alerts.
"Most importantly, check with your optometrist before starting any drops," said Dr. Collier.
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Colorectal cancer is showing up in younger people and at more advanced stages: study
March 01, 2023
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Advanced stage colorectal cancer (CRC) cases are on the rise and the disease is being discovered among younger patients more frequently, according to Colorectal Cancer Statistics 2023, a new report on cancer facts and trends by the American Cancer Society (ACS), which is headquartered in Atlanta.
Although deaths related to CRC are continuing to decline, the report indicated the disturbing trend within the landscape of fighting this disease.
Notably, this includes the advanced stage of cancer at the time of diagnosis and the patient’s age at which it's diagnosed.
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The incidence of advanced stage CRC disease now occurs in three out of five people, while one out of every five CRC diagnoses are made in people under 55 years old, according to the study's investigators.
Also, people who are natives of Alaska had the highest rate and mortality — almost four times higher than those of non‐Hispanic White individuals, according to the report.
It was published on Wednesday, March 1, in the journal CA: A Cancer Journal for Clinicians and in the publication Colorectal Cancer Facts & Figures 2023-2025 on cancer.org.
"We know rates are increasing in young people, but it’s alarming to see how rapidly the whole patient population is shifting younger, despite shrinking numbers in the overall population," Rebecca Siegel, senior scientific director, surveillance research at the American Cancer Society and lead author of the report said in a news release.
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"The trend toward more advanced disease in people of all ages is also surprising and should motivate everyone 45 and older to get screened," Siegel said in the release as well.
The researchers collected data from 50 states and the District of Columbia.
The data was available through 2019 from the Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute and the National Program of Cancer Registries of the Centers for Disease Control and Prevention, as provided by the North American Association of Central Cancer Registries.
The researchers also looked at national mortality data available through 2020 that was provided by the National Center for Health Statistics, according to the report.
Overall, CRC mortality declined by 2% annually from 2011 to 2020, yet there was an 0.5%–3% annual increase in mortality in individuals younger than 50 years old and in Native Americans under 65 years of age, according to the study.
Despite these overall declines, a diagnosis of CRC is being seen more frequently in those of a younger age and at a more advanced stage.
The investigators noted that individuals in the U.S. diagnosed with advanced-stage colorectal cancer increased from 52% in the mid-2000s to 60% in 2019.
The number of CRC cases in individuals under 55 years old nearly doubled from 11% in 1995 to 20% in 2019.
That is a jump from 1 in 10 people to 1 in 5, according to the release.
"We have to address why the rates in young adults continue to trend in the wrong direction," Dr. Ahmedin Jemal, senior vice president, surveillance and health equity science at the American Cancer Society and senior author of the study, said in a news release.
"We need to invest more in research to uncover the causes of the rising trends and to discover new treatment for advanced-stage diseases to reduce the morbidity and mortality associated with this disease in this young population, who are raising families and supporting other family members."
Colorectal Cancer Awareness Month is observed in March to stress the importance of screening for this form of cancer.
The researchers said an estimated 153,020 people will be diagnosed with CRC in the U.S., and that some 52,550 people will die from the disease in 2023.
"These highly concerning data illustrate the urgent need to invest in targeted cancer research studies dedicated to understanding and preventing early-onset colorectal cancer," Dr. Karen E. Knudsen, CEO of the American Cancer Society, said in a news release.
"The shift to diagnosis of more advanced disease also underscores the importance of screening and early detection, which saves lives."
The report revealed that CRC cases declined rapidly in people 50 and older during the 2000s. This was attributed to increased screening with colonoscopy, which experts say can help prevent cancer by removing precancerous growths or polyps.
The study authors found, however, that progress has slowed over the past decade, which could be in part due to the trend in rising cases in younger individuals, the study noted.
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The report found that the 65 and older age group showed a decline in incidence rates since 2011 and that those rates stabilized in the 50-64 year old cohort.
However, a disturbing trend showed an increased incidence rate by 2% per year in people younger than 50 years of age, as well as in people ages 50 to 54 years old.
Cancer experts said they're concerned that the diagnoses being made are for more advanced disease stages, in which the cancer has spread to lymph nodes and other organs.
When it comes to preventing colorectal cancer, "one of the simplest tools to tell people is to get a colonoscopy when they're young," Dr. Paul Oberstein, M.D., a medical oncologist at NYU Langone Perlmutter Cancer Center in New York City, told Fox News Digital.
Oberstein was not involved in the study but commented on the findings.
Colonoscopies were typically recommended at age 50, he said, but in recent years, that number was changed to age 45 in average-risk individuals and earlier if there was family history or other risk factors.
While colonoscopies are the main standard used to diagnose CRC, new ways to screen for this type of cancer are needed, said Oberstein, especially based on these findings of more aggressive forms diagnosed in a younger population.
"We don't actually know why rectal cancer is increasing in younger people," he told Fox News Digital.
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He added, "There are a lot of hypotheses. People think it might have to do with diet, or with antibiotics, or with exposure to other foods, [such as] processed foods — or you can make a list of anything. We don't know the answer. And so the challenge is that until we know that answer, it's really hard to turn it around if you don't know what we're targeting."
In addition to obtaining a colonoscopy, patients should be aware of signs of CRC.
They should speak to their health care provider, he said, especially if they see blood in their stool or have intestinal issues that don't resolve.
CRC is the third most commonly diagnosed cancer and the third leading cause of cancer deaths in both men and women in the U.S., according to the study.
The American Cancer Society Cancer Action Network (ACS CAN) is continuing to advocate for the implementing of policies in each state to help cover the cost of colonoscopies and eliminate barriers to colorectal cancer screening.
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