Rabies: 9 years and nothing gets better

 rabid dog
For about nine years now, I have been traveling to Baltimore on a semi-annual basis. I go to the Johns Hopkins Bloomberg School of Public Health and deliver, more or less, the same talk, year after year,  about rabies.
9 years, and more deaths.
It’s part of the vector-borne section of the course. While not a vector-borne disease (unless we wish to think of dogs as a vector between us and bats–a bit of a stretch, if you ask me), rabies is considered one of the Neglected Tropical Diseases (NTDs), and because it’s a preventable cause of horrific and needless suffering it needs to be somewhere.
Opening Salvo
I always preface my talk with two informal survey questions:
  1. Does anyone know what the OIE is?
  2. Does anyone know what One Health is?
Answers:
  1. OIE stands for Office International des Epizooties, or World Organisation for Animal Health (yes, they use the British spelling of “organization, which I think is a political statement, but that’s another post). It’s kind of like the WHO for animals, and it is based in Paris.
  2. One Health is a concept advanced by the American Veterinary Medical Association, the CDC, and other organizations. The CDC states “One Health recognizes that the health of people is connected to the health of animals and the environment. The goal of One Health is to encourage the collaborative efforts of multiple disciplines-working locally, nationally, and globally-to achieve the best health for people, animals, and our environment.”
I think that over the years, I’ve had maybe three ‘yes’ answers to these questions, combined. The conclusions are obvious:
  1. The OIE is failing in its mission to educate the other health professions, as well as the general public, on the importance of animal health, both as it relates to animals alone and to human health as well.
  2. The One Health concept is a failed attempt by the veterinary profession to assert its presence into discussions of public health. It represents the profession’s inability to move itself from the general world of agriculture (where it is also clearly important) and place itself among the disciplines of other health sciences.
(As a veterinarian, we are used to being the red headed stepchild of the medical professions, so this doesn’t really surprise or irk me. Sometimes, we even create brilliant concepts, like One Health, so we can pretend that it’s really a thing for those outside of our bubble.)
So, what’s the problem here, specifically regarding rabies?
Let me preface this by saying that , I don’t really trust rabies statistics. The latest updates I’m reading estimate the annual number of rabies deaths at 59,000.  Given that most of these deaths come from rural areas in Africa and Asia with poor access to treatment and prevention, I’m not sure how they come up with that number. (On my to-do list: contact a rabies epidemiologist.) What I do know is that when I first started giving the talk, the number was 25,000 – 50,000. The range itself, varying by 100% of the low number, inspires doubt in and of itself.
That noted, the trend over the past nine years is at best level, and at worst shows an increase of 18%. Rabies does not get a lot of attention. Most diseases of the poor—Chagas’ disease, cysticercosis, leishmaniasis, hydatid disease, and others—get little attention. AIDS/HIV, tuberculosis, and malaria are the exceptions, but two of those are not restricted to poor areas overseas. Rabies kills “only” 59,000 people a year, a number that pales in comparison to the other diseases listed here. But working on one disease does not preclude working on another.  Rabies is low hanging fruit. The numbers of rabies deaths are skewed towards children.  Rabies is not a medical mystery. The bottom line is that no one should die the horrible death that comes with rabies infection.
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New post on PAZ blog

http://www.pazonehealth.org/single-post/2017/06/13/Hydatid-Disease-in-Ayacucho-Peru-Our-next-project-Part-I-Gross-picture-alert

New Post on the Meta-Bug

 

Click on Monica to read about parenting, divorce, baseball, politics, etc.
MONICA-VITTI

New Post on The Meta-Bug

Just because. 

And this picture has nothing to do with it.

And this picture has nothing to do with it.

New post on The Meta-Bug

Have you found LInkedIn to be a useful resource? I’m going to be a naysayer. http://themetabug.com/2014/08/29/is-linkedin-good-for-anything/

Mental Health Monday, either early or late

From Nursing Mental Diseases, by Harriet Bailey, RN

MS. BAILEY WROTE IN 1929:

In the prevention of mental deficiency segregation is recognized as a most important measure, for these individuals have not the mental qualities which make them valuable to society, and economically they are a partial or a total loss. Furthermore, it is an established fact that this type of defective family increases at about double the rate of the general population, that feeblemindedness is inherited, for parents cannot transmit to their children nervous and mental strength which is not theirs to give. From some recent studies made of the feebleminded, it has been shown that not all mental defectives are a social menace, and therefore in need of segregation. Thees studies have also shown that when properly educated and specially trained in the manual and industrial arts, many of them become quiet, law-abiding, useful citizens. Experience also shows that only through education and supervision may they be saved from lived of inefficiency, failure, dependency, and misery.

feebleminded table

 

New Post on the Meta-Bug

I’ve been writing more over there lately. In this post I take up the fight against the greedy maw of MLB.

 

 

Arsenic Poisoning and Child Development

Our friends over at PAZ (Pan American Zoonotic Research and Prevention) are looking into the negative effects of heavy metals on infant and child health.

Arsenic

While arsenic levels in breast milk are low even in the face of exposure by ingestion, prenatal arsenic exposure increases the risk for spontaneous abortion and stillbirth. Surviving infants whose mothers have exposed are more susceptible to pneumonia and diarrhea in infancy. Children exposed themselves to arsenic via drinking water have 10 times greater risk of developing fatal liver cancer while young. Susceptibility to arsenic poisoning is thought to be enhanced by poor nutritional level, especially low folic acid levels.

The concern of PAZ is that in Peru–where the extraction of metals is one of the main drivers of the economy–that mining will increase the exposure of children and pregnant moms to toxic levels of arsenic.

Heavy Metal Toxicity

Heavy Metal Toxicity

 

] Arsenic dust is produced during copper and gold smelting, and coal combustion – See more at: http://www.miningfacts.org/Environment/What-is-the-role-of-arsenic-in-the-mining-industry/#sthash.ExbqmZnR.dpuf
] Arsenic dust is produced during copper and gold smelting, and coal combustion – See more at: http://www.miningfacts.org/Environment/What-is-the-role-of-arsenic-in-the-mining-industry/#sthash.ExbqmZnR.dpuf

] Arsenic dust is produced during copper and gold smelting, and coal combustion – See more at: http://www.miningfacts.org/Environment/What-is-the-role-of-arsenic-in-the-mining-industry/#sthash.ExbqmZnR.dpuf
] Arsenic dust is produced during copper and gold smelting, and coal combustion – See more at: http://www.miningfacts.org/Environment/What-is-the-role-of-arsenic-in-the-mining-industry/#sthash.ExbqmZnR.dpuf

 

 

Mummies, Chagas’ Disease, Drinks, and Dishes

YOU HAVE TO WONDER about the minds of Incas and scientists.

The mummified remains of a  young woman from Peru have been analyzed. According to radioactive carbon dating, the woman died around 600 years ago. They know that she was Incan by the way that her skull was modified. (I can talk about pretty much any sort of disease or bodily fluid, even while eating, but this enforced body distortion absolutely creeps me out. Not fond of looking at the faces of mummies, either, for that matter.)

Why was this particular woman sacrificed? The researchers, guessing from DNA found in her, believe that she had Chagas’ disease and that her poor health probably made her a likely candidate. We therefore have another reason not to get Chagas’ disease: you will be more likely to be the one chosen to get tossed into the volcano or offered up à la Fay Wray, albeit to smaller primates and ones with prehensile tails.

THE CHILCANO

We haven’t put a drink recipe on here in a while, and if you are relying on us  that you are feeling either pretty thirsty or are sick to death of algorobina cocktails and pisco sours.

The Chilcano was invented in honor of Robinson Canó’s attempt to bring béisbol to Chile, a typically fútbol-mad country. MLB, in the face of waning enthusiasm for baseball, was hoping that the Caribbean locura for the beauty of the diamond would spread to the rest of Latin America, and lead a resurgence in what they hope will be not just America’s pastime, but the  Americas’ pastime. Canó, as MVP,  was sent as an ambassador. Peru, of course, was in principle opposed to this gesture, not because of any dislike for baseball, but what they saw as yet another attempt by their southern neighbors to appropriate pisco as their own, when everyone (including the EU)  knows that Pisco es Peruano.

I like the chilcano because it is easy and it is refreshing.

Into a tall glass filled with ice:

  • 1-2 oz. Pisco
  • 4 oz. ginger ale, ginger beer, or other fizzy mixer.
  • Squeeze the juice of 1/4 lime
  • Garnish with a slice of lime.

chilcano-8277-750x500

AND NOW, for the dish:8full-sylva-koscina
Sylva Koscina was an Italian movie actress, born in the Kingdom of Yugoslavia (now Croatia). She had a successful career in the ’50s and ’60s, and men of a certain age might remember her playing opposite Paul Newman in the The Secret War of Harry Frigg. She invested all of her wealth in a luxurious villa in Rome, but as her income dwindled, she was forced to sell it in order to avoid a charge of tax evasion.

Ms. Koscina died in 1994, at the age of 61, due to breast cancer.

Sylva_Koscina

From the Army’s deck of “Freedom Cards”

During the Iraq and Afghanistan wars,  US Army issued a deck of playing cards with various messages on them.

suicide  6 of clubsFreedom cards suicide warnings