Category Archives: Health

Researchers: Improving Eyesight May Help Prevent Dementia

July 3, 2022 Admin Leave a comment

Dementia cases are climbing along with an aging world population, and yet another much-anticipated Alzheimer’s medication, crenezumab, has proved ineffective in clinical trials — the latest of many disappointments. Public health experts and researchers argue that it is past time to turn our attention to a different approach — focusing on eliminating a dozen or so already known risk factors, like untreated high blood pressure, hearing loss and smoking, rather than on an exorbitantly priced, whiz-bang new drug.

“It would be great if we had drugs that worked,” said Dr. Gill Livingston, a psychiatrist at University College London and chair of the Lancet Commission on Dementia Prevention, Intervention and Care. “But they’re not the only way forward.”

Emphasizing modifiable risks — things we know how to change — represents “a drastic change in concept,” said Dr. Julio Rojas, a neurologist at the University of California, San Francisco. By focusing on behaviors and interventions that are already widely available and for which there is strong evidence, “we are changing how we understand the way dementia develops,” he said.

The latest modifiable risk factor was identified in a study of vision impairment in the United States that was published recently in JAMA Neurology. Using data from the Health and Retirement Study, the researchers estimated that about 62 percent of current dementia cases could have been prevented across risk factors and that 1.8 percent — about 100,000 cases — could have been prevented through healthy vision.

Though that’s a fairly small percentage, it represents a comparatively easy fix, said Dr. Joshua Ehrlich, an ophthalmologist and population health researcher at the University of Michigan and the study’s lead author.

That’s because eye exams, eyeglass prescriptions and cataract surgery are relatively inexpensive and accessible interventions. “Globally, 80 to 90 percent of vision impairment and blindness is avoidable through early detection and treatment, or has yet to be addressed,” Dr. Ehrlich said.

The influential Lancet Commission began leading the modifiable risk factor movement in 2017. A panel of doctors, epidemiologists and public health experts reviewed and analyzed hundreds of high-quality studies to identify nine risk factors accounting for much of the world’s dementia: high blood pressure, lower education levels, impaired hearing, smoking, obesity, depression, physical inactivity, diabetes and low levels of social contact.

In 2020, the commission added three more: excessive alcohol consumption, traumatic brain injuries and air pollution. The commission calculated that 40 percent of dementia cases worldwide could theoretically be prevented or delayed if those factors were eliminated.

“A massive change could be made in the number of people with dementia,” said Dr. Livingston. “Even small percentages — because so many people have dementia and it’s so expensive — can make a huge difference to individuals and families, and to the economy.”

In fact, in wealthier countries, “it’s already happening as people get more education and smoke less,” she pointed out. Because the odds of dementia increase with age, as more people reach older ages, the number of dementia cases keeps rising. But the proportions are dropping in Europe and North America, where the incidence of dementia has fallen by 13 percent per decade over the past 25 years.

Dr. Ehrlich hopes the Lancet Commission will add vision impairment to its list of modifiable risks when it updates its report, and Dr. Livingston said it would indeed be on the commission’s agenda.

Why would hearing and vision loss contribute to cognitive decline? “A neural system maintains its function through stimulation from sensory organs,” explained Dr. Rojas, a co-author of an accompanying editorial in JAMA Neurology. Without that stimulation, “there will be a dying out of neurons, a rearrangement of the brain,” he said.

Hearing and vision loss could also affect cognition by limiting older adults’ participation in physical and social activity. “You can’t see the cards, so you stop playing with friends,” Dr. Ehrlich said, “or you stop reading.”

The link between dementia and hearing loss, the single most important factor the Lancet Commission cited as a modifiable risk, has been well established. There is less clinical data on the connection to impaired vision, but Dr. Ehrlich is a co-investigator of a study in southern India to see whether providing older adults with eyeglasses affects cognitive decline.

Of course, this approach to reducing dementia is “aspirational,” he acknowledged: “We’re not going to eliminate low education, obesity, all of these.”

Some efforts, like raising education levels and treating high blood pressure, should begin in youth or at midlife. Others require major policy changes; it’s hard for an individual to control air pollution, for example. Altering habits and making lifestyle changes — like stopping smoking, reducing drinking and exercising regularly — are not simple.

Even fairly routine medical practices, like measuring and monitoring high blood pressure and taking drugs to control it, can be difficult for low-income patients.

Moreover, older Americans will be likely to notice that routine vision and hearing care are two services that traditional Medicare does not cover.

It will pay for care related to diabetic retinopathy, glaucoma or age-related macular degeneration, and it covers cataract surgery. But for more common problems correctable with eyeglasses, “traditional Medicare is not going to help you out much,” said David Lipschutz, associate director of the nonprofit Center for Medicare Advocacy. Nor will it cover most hearing aids or exams, which are much higher expenses.

Medicare Advantage programs, provided through private insurers, usually do include some vision and hearing benefits, “but look at the scope of coverage,” Mr. Lipschutz cautioned. “They might apply $200 or $300 or $500 towards hearing aids” — but at a typical $3,000 to $5,000 a pair, “they still might be far out of reach,” he said.

Expanding traditional Medicare to include hearing, vision and dental benefits was part of the Biden administration’s Build Back Better Act. But after the House passed it in November, Republicans and Senator Joe Manchin III, a Democrat, scuttled it in the Senate.

Still, despite the caveats and cautions, reducing modifiable risk factors for dementia could have enormous payoff, and the Centers for Disease Control and Prevention has incorporated that approach into its National Plan to Address Alzheimer’s Disease.

A focus on these factors could also help reassure older Americans and their families. Some important risks for dementia lie beyond our control — genetics and family history, and advancing age itself. Modifiable factors, however, are things we can act on.

“People have such fears of developing dementia, losing your memory, your personality, your independence,” Dr. Livingston said. “The idea that you can do a lot about it is powerful.”

Even delaying its onset can have a great effect. “If, instead of getting it at 80, you get it at 90, that’s a huge thing,” she said.

Eye and hearing exams, exercise, weight control, stopping smoking, blood pressure medications, diabetes care — “we’re not talking about expensive interventions or fancy surgery or seeing specialists who are hours away,” Dr. Ehrlich added. “These are things people can do in the communities where they live.”

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Sure Signs Your Blood Sugar is Too High — Eat This Not That

July 3, 2022 Admin Leave a comment

High blood sugar may not get as many headlines as health concerns like COVID, heart disease and cancer. But chronically high blood sugar—commonly known as diabetes—is a silent epidemic in the U.S., a condition that can cause serious health consequences and can even be fatal. To protect yourself, have your blood sugar checked regularly and be aware of the potential signals that it’s elevated. These are some sure signs that your blood sugar is too high. If you notice any of them, it’s worth giving your doctor a call. Read on to find out more—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.

One of the most common signs of high blood sugar is urinating more than what’s normal for you. That happens because when sugar (glucose) builds up in the bloodstream, the body tries to flush it out through urine. If you’re urinating more frequently than usual, it’s a good idea to check in with your doctor.

Another common symptom of high blood sugar is frequent thirst. Increased urination can cause dehydration on two fronts—urinating more often deprives the body of fluids, and blood sugar actually leaches fluid away from tissues as it leaves the body. That can result in increased thirst, and drinking more water may not satisfy it.

Blood sugar often becomes chronically elevated because the body has become resistant to insulin, the hormone that helps cells use sugar for energy. Lacking that energy source, someone with high blood sugar might feel frequently fatigued.

People with high blood sugar may feel hungry more frequently, and they might lose weight despite eating more. That’s because the body, deprived of energy from glucose, demands more food to use as fuel. Chronically high blood sugar may also result in unexpected weight loss, as the body may start to burn fat stores for energy.

Chronically high blood sugar levels can damage nerves throughout the body, a condition called diabetic neuropathy. The most common form is peripheral neuropathy, which affects the feet, legs, hands and arms. It can produce tingling, burning, numbness, decreased sensitivity to pain or temperature or sharp pains or cramps in the affected areas. The symptoms tend to get worse at night.

High blood sugar levels can swell and distort the lenses of the eyes, causing blurry or double vision. Diabetes can cause blood vessels in the retina to leak, or abnormal new blood vessels to grow, leading to vision problems. This is called diabetic retinopathy. According to Johns Hopkins Medicine, diabetic neuropathy is the leading cause of blindness in American adults. And to protect your life and the lives of others, don’t visit any of these 35 Places You’re Most Likely to Catch COVID.

Michael Martin

Michael Martin is a New York City-based writer and editor whose health and lifestyle content has also been published on Beachbody and Openfit. A contributing writer for Eat This, Not That!, he has also been published in New York, Architectural Digest, Interview, and many others. Read more

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The #1 Best Drink To Keep Your Brain Young, New Study Suggests — Eat This Not That

July 3, 2022 Admin Leave a comment

While it’s understandable why some people who feel overly dependent on a cup of java might want to give up coffee despite—or perhaps because of—their desperate need for it, there are plenty of benefits that you can enjoy if you drink a reasonable amount of coffee on a regular basis.

Along with coffee habits that can help with inflammation, coffee can even increase your lifespan. Beyond that, you’re surely aware of the fact that it can give both your brain and body a boost by amping up your alertness and energy level. At the same time, it turns out that coffee can also keep your brain younger.

In a study that was recently published in Nutritional Neuroscience, information was collected from National Health and Nutrition Examination Surveys that took place from 2011 to 2014. The data focused on the relationship between caffeine and cognitive function in the 827 participants who were all 60 years old or older. The results showed that caffeine helped to prevent cognitive function from getting worse over time.

“The more that coffee is studied, the more often health benefits are elucidated from coffee,” Dana Ellis Hunnes, PhD, MPH, RD, senior clinical dietitian at UCLA medical center, assistant professor at UCLA Fielding school of public health, tells Eat This, Not That!.

When it comes to how coffee benefits the brain beyond the mere boost from caffeine, Hunnes explains that the beverage “has a lot of polyphenols and antioxidants in it that are anti-inflammatory and likely play a role in reducing the risk of cognitive impairment.”

As for how much coffee you might want to drink to see this kind of potentially positive effect, Hunnes says “most studies on coffee benefits point to three to four cups per day as the optimal dose.” However, she adds that “these are six to eight-ounce cups of coffee, not 20-ounce ventis.” It’s also important to note that “benefits occur most” when you opt for coffee that’s “taken black or with minimal additives.”

To find out more about how to keep your cognitive function super sharp, be sure to read The #1 Best Eating Habit for Your Brain, Says Science.

Desirée O

Desirée O is a freelance writer who covers lifestyle, food, and nutrition news among other topics. Read more

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Viral Infection Might Attract Mosquitoes to Humans

July 3, 2022 Admin Leave a comment

This article was originally published in The Conversation.

Mosquitoes are the world’s deadliest animal. Hundreds of thousands of deaths a year are attributed to mosquito-borne diseases, including malaria, yellow fever, dengue fever, Zika, and chikungunya fever.

How mosquitoes seek out and feed on their hosts are important factors in how a virus circulates in nature. Mosquitoes spread diseases by acting as carriers of viruses and other pathogens: A mosquito that bites a person infected with a virus can acquire the virus and pass it on to the next person it bites.

For immunologists and infectious-disease researchers like me, a better understanding of how a virus interacts with a host may offer new strategies for preventing and treating mosquito-borne diseases. In our recently published study, my colleagues and I found that some viruses can alter a mouse’s, and perhaps a person’s, body odor to be more attractive to mosquitoes, leading to more bites that allow a virus to spread.

Mosquitoes locate a potential host through different sensory cues, such as your body temperature and the carbon dioxide emitted from your breath. Odors also play a role. Previous lab research has found that mice infected with malaria have changes in their scents that make them more attractive to mosquitoes. With this in mind, my colleagues and I wondered if other mosquito-borne viruses, such as dengue and Zika, can also change a person’s scent to make them more attractive to mosquitoes, and whether there is a way to prevent these changes.

Read: Shazam for mosquitoes

To investigate this, we placed mice infected with the dengue or Zika virus, uninfected mice, and mosquitoes in one of three arms of a glass chamber. When we applied airflow through the mouse chambers to funnel their odors toward the mosquitoes, we found that more mosquitoes chose to fly toward the infected mice than toward the uninfected mice.

We ruled out carbon dioxide as a reason for why the mosquitoes were attracted to the infected mice, because though Zika-infected mice emitted less carbon dioxide than uninfected mice, dengue-infected mice did not change emission levels. Likewise, we ruled out body temperature as a potential attractive factor when mosquitoes did not differentiate between mice with elevated or normal body temperatures.

Then we assessed the role of body odors in the mosquitoes’ increased attraction to infected mice. After placing a filter in the glass chambers to prevent mice odors from reaching the mosquitoes, we found that the number of mosquitoes flying toward infected and uninfected mice were comparable. This suggests that there was something about the odors of the infected mice that drew the mosquitoes toward them.

To identify the odor, we isolated 20 different gaseous chemical compounds from the scent emitted by the infected mice. Of these, we found three to stimulate a significant response in mosquito antennae. When we applied these three compounds to the skin of healthy mice and the hands of human volunteers, only one, acetophenone, attracted more mosquitoes compared with the control. We found that infected mice produced 10 times more acetophenone than uninfected mice.

Similarly, we found that the odors collected from the armpits of dengue-fever patients contained more acetophenone than those from healthy people. When we applied the dengue-fever-patient odors on one hand of a volunteer and a healthy person’s odor on the other hand, mosquitoes were consistently more attracted to the hand with dengue-fever odors.

These findings imply that the dengue and Zika viruses are capable of increasing the amount of acetophenone their hosts produce and emit, making them even more attractive to mosquitoes. When uninfected mosquitoes bite these attractive hosts, they may go on to bite other people and spread the virus even further.

Next, we wanted to figure out how viruses were increasing the amount of mosquito-attracting acetophenone their hosts produce. Acetophenone, along with being a chemical commonly used as a fragrance in perfumes, is also a metabolic by-product commonly produced by certain bacteria living on the skin and in the intestines of both people and mice. So we wondered if it had something to do with changes in the type of bacteria on the skin.

To test this idea, we removed either the skin or intestinal bacteria from infected mice before exposing them to mosquitoes. Though mosquitoes were still more attracted to infected mice with depleted intestinal bacteria compared with uninfected mice, they were significantly less attracted to infected mice with depleted skin bacteria. These results suggest that skin microbes are an essential source of acetophenone.

Read: Two ways of making malaria-proof mosquitoes

When we compared the skin-bacteria compositions of infected and uninfected mice, we identified that a common type of rod-shaped bacteria, Bacillus, was a major acetophenone producer and had significantly increased numbers on infected mice. This meant that the dengue and Zika viruses were able to change their host’s odor by altering the microbiome of the skin.

Finally, we wondered if there was a way to prevent this change in odors.

We found one potential option when we observed that infected mice had decreased levels of an important microbe-fighting molecule produced by skin cells, called RELMα. This suggested that the dengue and Zika viruses suppressed production of this molecule, making the mice more vulnerable to infection.

Vitamin A and its related chemical compounds are known to strongly boost production of RELMα. So we fed a vitamin-A derivative to infected mice over the course of a few days and measured the amount of RELMα and Bacillus bacteria present on their skin, then exposed them to mosquitoes.

We found that infected mice treated with the vitamin-A derivative were able to restore their RELMα levels back to those of uninfected mice, as well as reduce the amount of Bacillus bacteria on their skin. Mosquitoes were also no more attracted to these treated, infected mice than uninfected mice.

Our next step is to replicate these results in people and eventually apply what we learn to patients. Vitamin-A deficiency is common in developing countries. This is especially the case in sub-Saharan Africa and Southeast Asia, where mosquito-transmitted viral diseases are prevalent. We will investigate whether dietary vitamin A or its derivatives could reduce mosquito attraction to people infected with Zika and dengue, and subsequently reduce mosquito-borne diseases in the long term.

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Are the Covid mRNA Vaccines Safe? ⋆ Brownstone Institute

July 3, 2022 Admin Leave a comment

A new scientific study entitled “Serious adverse events of special interest following mRNA vaccination in randomized trials” provides the best evidence yet concerning the safety of the mRNA Covid vaccines. For most vaccines in common use, benefits far outweigh risks, but that may not be the case for the mRNA covid vaccines, according to this study by Joseph Fraiman and his colleagues. It depends on your age and medical history.

The randomized controlled clinical trial is the gold standard of scientific evidence. When regulators approved the Pfizer and Moderna mRNA vaccines for emergency use in December 2020, two randomized trials showed that the vaccines reduced symptomatic covid infection by over 90% during the first few months after the second dose.

Pfizer and Moderna did not design the trials to evaluate long-term efficacy or the more important outcomes of preventing hospitalization, death, or transmission.

The randomized trials did collect adverse event data, including the presence of mild symptoms (such as fever) and more serious events requiring hospitalization or leading to death. Most vaccines generate some mild adverse reactions in some people, and there were considerably more adverse such reactions after the mRNA vaccines compared to the placebo.

That is annoying but not a major issue. We care about severe health outcomes. The key question is whether the vaccine’s efficacy outweighs the risks of severe adverse reactions.

The Fraiman study uses data from the same Pfizer and Moderna-sponsored randomized trials presented to the FDA for vaccine approval, but with two innovations that provide additional information.

First, the study pools data from both mRNA vaccines to increase the sample size, which decreases the confidence intervals’ size and the uncertainty about the estimated harms.

Second, the study focuses only on the severe adverse events plausibly due to the vaccines. Serious adverse events such as gunshot wounds, suicide, animal bites, foot fractures, and back injury are unlikely to be due to a vaccine, and cancer is unlikely to be due to a vaccine within a few months after vaccination. By removing such random noise, the ability (statistical power) to detect genuine problems increases. If there is no excess risk, shorter confidence intervals bolster confidence in the safety of the vaccines.

Classifying adverse events into the two groups is not a trivial task, but Fraiman et al. do an excellent job to avoid bias. They rely on the pre-defined Brighton Collaboration definitions of adverse events of special interest (AESI). Founded in 2000, the Brighton Collaboration has two decades of experience using rigorous science to define clinical outcomes for vaccine safety studies.

Moreover, Fraiman and colleagues blinded the process where they classified the clinical events as AESIs. Adjudicators did not know whether the individual had received the vaccine or the placebo. Hence, any criticism of so-called p-hacking is unwarranted.

So, what are the results? There were 139 AESIs among the 33,986 people vaccinated, one for every 244 people. That may sound bad, but those numbers mean nothing without comparison against a control group. There were 97 AESIs among the 33,951 people who received a placebo. Combining these numbers implies 12.5 vaccine-induced AESIs for every 10,000 people vaccinated, with a 95% confidence interval of 2.1 to 22.9 per 10,000 people. To phrase it differently, there is one additional AESI for every 800 people vaccinated (95% CI: 437-4762).

That is very high for a vaccine. No other vaccine on the market comes close.

The numbers for the Pfizer and Moderna vaccines are 10 and 15 additional events per 10,000 people, respectively, so both vaccines contributed to the finding. The numbers are similar enough that we cannot confidently say that one is safer than the other. Most excess AESIs were coagulation disorders. For the Pfizer vaccine, there was also an excess of cardiovascular AESIs.

While these safety results are concerning, we must not forget the other side of the equation. Unfortunately, the study does not calculate composite estimates that also included the reduction in serious covid infections, but we have such estimates for mortality.

Dr. Christine Benn and her colleagues calculated a combined estimate of the effect of vaccination on all-cause mortality using the same randomized trial data as Fraiman et al. They did not find a mortality reduction for the mRNA vaccines (relative risk 1.03, 95% CI: 0.63-1.71).

One important limitation of both Fraiman’s and Benn’s studies is that they do not distinguish the adverse reactions by age, comorbidities, or medical history. That is not their fault. Pfizer and Moderna have not released that information, so outside researchers do not have access.

We know that the vaccine benefits are not equally distributed among people since covid mortality is more than a thousand times higher among the old. Thus, risk-benefit calculations must be done separately for different groups: with and without prior covid infection, by age, and for the first two doses versus boosters.

Covid-recovered people have natural immunity that is stronger than vaccine-induced immunity. So, the benefit of vaccination is – at best – minimal. If the risk of adverse reactions is the same as in the randomized trials, there is a negative risk-benefit difference. Why are we mandating people in this group to be vaccinated? It is both unethical and damaging to public health.
While everyone can get infected, children have a minuscule risk of covid mortality. There is very limited safety data from the trials on children. If the risk of adverse reactions is the same as for adults, the harms outweigh the risks. Children should not receive these vaccines.
Older people above 70 have a much higher risk of covid mortality than the population in the Fraiman study. If their risk of adverse reaction is the same, then the benefits outweigh the harms. Hence, older people who have never had covid and are not yet vaccinated may benefit from these vaccines. However, we do not know if they are better than the Johnson & Johnson and Astra-Zeneca vaccines.
It is unclear from the clinical trial data whether the benefits outweigh the risks for working-age adults who have not been vaccinated and who have not already had covid. This is true both historically, for the original covid variants, and currently for the newer ones.
The Fraiman study analyzes data after the first and second doses. Both risks and benefits may differ for booster shots, but no randomized trial has properly evaluated the trade-off.

These results concern only the Pfizer and Moderna mRNA vaccines. Fraiman et al. did not analyze data on the adenovirus-vector vaccines marketed by Johnson & Johnson and Astra-Zeneca. Benn et al. found that they reduced all-cause mortality (RR=0.37, 95% CI:0.19-0.70), but nobody has used trial data to analyze AESIs for these vaccines.

Critically, the Fraiman and Benn studies had a follow-up of only a few months after the second dose because Pfizer and Moderna, unfortunately, terminated their randomized trials a few months after receiving emergency use authorization. Of course, a longer-term benefit can provide a basis to tolerate negative or neutral short-term risk-benefit differences. However, that is unlikely since we know from observational studies that mRNA vaccine efficacy deteriorates a few months after the second dose.

There may also be long-term adverse reactions to the vaccine regarding which we do not yet know. Since the randomized trials ended early, we must look at observational data to answer that question. The publicly available data from the Vaccine Adverse Event Reporting System is of low quality, with both under- and over-reporting. The best observational data is from CDCs Vaccine Safety Datalink (VSD) and FDA’s Biologics and Effectiveness Safety System (BEST), but there have only been limited reports from these systems.

Fraiman and colleagues have produced the best evidence yet regarding the overall safety of the mRNA vaccines. The results are concerning. It is the responsibility of the manufacturers and FDA to ensure that benefits outweigh harms. They have failed to do so.

Martin Kulldorff, Senior Scholar of Brownstone Institute, is an epidemiologist and biostatistician specializing in infectious disease outbreaks and vaccine safety. He is the developer of Free SaTScan, TreeScan, and RSequential software. Most recently, he was professor at the Harvard Medical School for ten years. Co-Author of the Great Barrington Declaration. [email protected]

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Monkeypox cases more than double in California and the Bay Area

July 3, 2022 Admin Leave a comment

Monkeypox cases have more than doubled over the past week in California and the Bay Area, where health officials are joining a global scramble to contain the outbreak while the virus still circulates in limited social networks.

California had reported 95 monkeypox cases as of Friday, up from 40 the week before, according to the Centers for Disease Control and Prevention. About 460 cases have been reported nationwide as of Friday, up from 150 the week before.

In the Bay Area, more than two dozen confirmed or suspected cases have already been reported, with 16 in San Francisco alone as of Friday, though that number is updated only once a week and is almost certainly higher by now, health officials said.

The infectious disease, a cousin of smallpox, manifests itself as skin lesions and is spread by intimate, person-to-person contact. Most people recover fully without treatment, but monkeypox can cause severe illness in children and some other vulnerable groups. Even for those who aren’t seriously sick, it can take weeks to get over and cause discomfort and pain.

Almost all cases so far have been reported among gay or bisexual men, most of whom are believed to have been exposed through sexual or other close contact with someone who was infected. The risk to the general public remains very low, local and federal health officials say.

Monkeypox is nothing like COVID, and is not currently — and almost certainly never will be — a threat at the same crisis level, experts say. But the outbreak is at a critical stage where health officials have an opportunity to stamp it out before cases spread further and potentially affect more vulnerable people.

“Monkeypox is not the same scale of a problem (as COVID). That said, if there’s an opportunity to control an emerging disease, it’s important we try to do it,” said Dr. Seth Blumberg, an infectious disease expert at UCSF. “We can’t blow this off. We need the political and societal will to control the disease now.”

It’s possible that monkeypox, if allowed to widely circulate, could become endemic in the United States and threaten the general population, though many health experts said that outcome is unlikely given the nature of the virus and how it spreads, plus the existence of effective vaccines to stop it.

Monkeypox also could establish itself as a recurring threat that triggers fresh outbreaks every few years, especially if it becomes embedded in U.S. animal populations. Or it could join the ranks of sexually transmitted infections, including syphilis and gonorrhea, that affect certain communities and have proved stubborn to control.

“It will suck if monkeypox joins the list of STIs that people have to worry about,” said San Francisco Supervisor Rafael Mandelman, who has called for a hearing this month to discuss the city’s public health response to monkeypox. “We need to be moving quickly on vaccination and stopping the spread now.”

In the Bay Area, pressure is mounting on health officials to make vaccines — which for monkeypox, can work before and after exposure to the virus — more broadly available, and to conduct more widespread surveillance to quickly determine whether the disease spreads beyond the communities currently affected.

Most testing is being done by state laboratories, which confirm results with the CDC. Stanford began providing laboratory testing for monkeypox two weeks ago in anticipation that the outbreak and demand for surveillance could grow quickly, said Dr. Benjamin Pinsky, head of the Stanford Clinical Viral Laboratory.

Vaccination efforts around the country are currently held up by lack of supply. Two vaccines are authorized for prevention of monkeypox, though the preferred product — called Jynneos — is in much shorter supply. The second vaccine, called ACAM2000, has side effects that for some people could be worse than the illness itself.

The U.S. last week announced plans to rapidly ramp up its vaccination efforts with Jynneos. So far, about 66,000 doses have been delivered to states with monkeypox cases; an additional 240,000 doses are expected to go out in the coming weeks, and at least 1.6 million total doses should be available by the end of the year, according to the CDC. On Friday, the U.S. Health and Human Services Agency said it had ordered an additional 2.5 million doses, which will be available at the end of this year and in 2023.

California, which has about a quarter of all cases in the U.S., expected to receive about 15,000 doses by the end of last week or early this week. Jynneos is administered in two doses given 28 days apart.

Bay Area counties reported receiving anywhere from 10 doses to more than 500, in San Francisco. That’s not enough to offer vaccination to everyone who might want it, so local health officials say they are targeting only those with a known exposure at the moment. That includes people identified through contact tracing of reported cases, people who hear informally that a partner was recently diagnosed, or those who attended an event or venue associated with one or more monkeypox cases.

“We don’t have enough for everybody,” said Frank Strona, the incident management lead for the San Francisco Department of Public Health’s monkeypox response. Strona said more than 200 doses had been administered in the city as of Friday morning. “We anticipate more batches every few days,” he said.

Once more vaccine becomes available, officials said, they hope to offer it to people at risk of becoming infected but who don’t necessarily have a known exposure. The vaccine may not ever be needed for the general public if the outbreak is contained.

Monkeypox tends to cause flu-like symptoms and a trademark rash, with dense, fluid-filled lesions. Most people are sick for two to four weeks and don’t need treatment, though a few drugs are available for severe cases. Worldwide, a handful of deaths have been reported this year, but none in the U.S.

This year’s global outbreak, which has so far infected more than 5,000 people, has baffled infectious disease experts who have never seen the virus spread much beyond the West African countries where it’s endemic. The United States would typically see a few travel-associated cases every few years, but previously had reported only one outbreak: In 2003, 47 cases were identified, all linked to rodents imported from Ghana.

It’s not clear why monkeypox suddenly took off, though experts suspect it may be a combination of the virus mutating to become more transmissible and finding traction in groups where it could spread quickly and easily.

Monkeypox transmits primarily through direct, sustained contact. People are most at risk if they are exposed to the fluid inside lesions, for example by touching the rash of an infected person or sharing bedding or towels with someone who’s infected. The virus can also pass from person to person through respiratory droplets, but only at close range — it doesn’t spread through the air of restaurants and grocery stores.

In the U.S., 271 of the first 305 cases were in men, and more than 70% were men who have sex with men, according to the CDC. Several large clusters have been traced to events or venues — including private sex parties and clubs or bathhouses — where people had sex with multiple partners.

“A small number of people have a large number of sexual contacts, and that can cause very rapid and early spread,” said Dr. Jason Andrews, an infectious disease expert at Stanford. “But it doesn’t necessarily mean it will be sustained that way.”

Health officials note that unlike with HIV and some other sexually transmitted infections, there’s no connection between particular sexual practices and the spread of monkeypox — the virus just happens to have taken root first in gay networks. It can spread as easily among heterosexual partners, or among close household contacts.

Andrews said he suspects the global outbreak may be starting to slow after weeks of explosive growth. He and other infectious disease experts noted that because of a long incubation period for monkeypox, cases being diagnosed now are probably from exposure one or two weeks earlier.

The possibility remains for the virus to get a foothold in the broader population. “The most concerning outcome would be if it spreads more broadly as an endemic infection across all ages, or through casual contact routes,” Andrews said. “I don’t think we have strong evidence of that happening right now, but we have to prepare for it.”

Erin Allday is a San Francisco Chronicle staff writer. Email: eallday@sfchronicle.com Twitter: @erinallday

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4 Worst Drinks Slowing Your Metabolism, Say Dietitians — Eat This Not That

July 3, 2022 Admin Leave a comment

Age, hormone shifts, and natural changes in muscle mass are just some of the factors that could be causing your metabolism to slow. While we can’t do much about some of these natural progressions, there are several lifestyle factors that could be causing a slower metabolism, too. Many lifestyle habits, like what you eat, drink, and how much you sleep can influence your metabolism, and the good news is you have a say in improving these factors.

When it comes to what you’re drinking, here are the four worst drinks slowing your metabolism. Read on, and for more, don’t miss 4 Eating Habits That Slow Your Metabolism After 50, Say Dietitians.

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Whether soda, sweetened coffee or tea, juice, or your afternoon energy drink, beverages loaded with refined sugar could be causing your metabolism to slow. Not only can these types of drinks make weight loss more challenging, but they are also linked to several chronic conditions, like diabetes, fatty liver disease, obesity, heart attack, and stroke, according to Harvard Health.

While there is some mixed data on how sugary drinks impact metabolism, one study found when overweight and obese participants consumed 25% of their total calories from fructose-sweetened beverages, resting energy expenditure decreased significantly from baseline. It is important to note the fructose that naturally occurs in fruit is different than the fructose sweetener used in drinks, like high fructose corn syrup. While the fructose in fruit is not in question here, the processed fructose sweetener used in many beverages appears to be a factor leading to reduced metabolism.

Drink This! Tip: Try cutting out at least one of your sweetened drinks each day. Over time, you can reduce your intake more, and replace the sugary drinks with more healthful options, like water, unsweetened carbonated water, and unsweet tea.

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This one gets a little tricky, but there is reason to think alcohol may be slowing your metabolism. First off, research indicates in small amounts, alcohol may actually increase metabolism for a short period of time after having a drink. However, outside of that acute period, alcohol may be impacting several factors that could potentially slow your metabolism.

For example, alcohol has been linked to poor quality sleep and duration, which can slow your metabolism. Additionally, alcohol can impair digestion and absorption of essential nutrients which may impact metabolism. Lastly, alcohol is dehydrating and may lessen your likelihood of participating in regular exercise, two factors that can individually impact your metabolism.

Drink This! Tip: Drink alcohol in moderation which is defined as two drinks or fewer per day for males, and one drink for females. Ensure you are well hydrated before having an alcoholic drink and try to limit added sugar in your beverages as well.

RELATED: 6 Incredible Effects Of Giving Up Alcohol for One Month

While this may be a necessary adjustment for certain health concerns, decaffeinated drinks don’t provide the same “jolt” to your metabolism. Caffeine is a natural stimulant, which can acutely increase your metabolism. If your body is used to caffeine on a regular basis, switching to decaf may naturally lead to a slower metabolism. Caffeine is found in a variety of drinks, from soda and coffee to energy drinks and tea, and frequent consumption of these drinks can boost metabolism throughout the day.

However, if you have cut caffeine for health reasons, you’re doing the right thing for your body! Sure, the short metabolism boost following a cup of caffeinated coffee sounds like a perk, but if your caffeine consumption is impacting your overall health, swapping it for decaf is the right choice.

Drink This! Tip: To create a metabolism boost without caffeine, stay well hydrated, get frequent exercise, plan movement throughout the day and avoid long periods of sitting, avoid sugary drinks and excessive alcohol consumption, and make your sleep environment conducive to good quality sleep.

Sure, all beverages contain liquid that can aid in your hydration, but nothing is quite like drinking plain ol’ water. If you find yourself loading up on non-water beverages, and you’re only getting a sip or two of water by the end of the day, your lack of water could be causing your metabolism to slow. Water recommendations vary from person to person and depend on many different factors, like gender and physical activity. However, it is a good goal for women to consume at least 80 ounces of fluid per day, while men should have over 100 ounces.

Drink This! Tip: Match ounces of water to non-water ounces if you find yourself coming up short on your fluid targets. Eventually, you can aim to drink more water than other beverages combined. Also, try starting your day with a large glass of water to help hydration, and after each non-water drink you have, enjoy equal ounces of water and alternate throughout the day.

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The Similar Stories Of COVID Long-Haulers And Chronic Lyme Sufferers

July 3, 2022 Admin Leave a comment

Ask Rebecca Niziol, 34, about life before Lyme, and she remembers bounding around with infinite energy. A life coach and yoga instructor, she packed her schedule with hikes, Pilates workouts, client calls, meet-ups with friends, and weekend getaways. Then, in July 2020, she felt something change.

It started with neck pain and headaches. At first, she brushed them off as side effects of sitting in a car for hours on a road trip from Chicago to Colorado to visit family. Over the next few weeks, though, she continued to develop flu-like symptoms. It was the early months of the pandemic, so her immediate thought was COVID. But tests kept coming back negative.

She couldn’t practice yoga for a month. “I was in bed 20 hours a day,” she says. Her doctor suspected loneliness and pandemic-related anxiety, but her gut told her this was different. Something more physical, never-ending. She wouldn’t learn that she was battling Lyme disease for more than a year, when she connected with a “Lyme-literate” doctor and her labs confirmed it.

Brittany Barry, of Utah, faced a similarly confusing crisis last summer. Given that she was a self-described “healthy, fit, 32-year-old woman” at the time, doctors chalked up the muscle aches, fatigue, and shortness of breath to long COVID—a term for the phenom of health problems continuing long after someone tests positive for the virus. (She had COVID in February 2021.) One MD blamed post-pregnancy changes, while another told her to see a counselor.

Fast-forward to January 2022, when she found a doctor who did blood work that pointed to Lyme that had likely gone undetected for years.

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Parallel Experiences

A coincidence that these women’s diagnoses came when they did? Maybe. But just like Niziol and Barry, many who’ve been impacted by long COVID, Lyme, or even both in the past few years are realizing they’re telling a similar story. There’s been a shift in empathy for chronic-illness and autoimmune patients who are stuck in a cycle of nonspecific symptoms that medical experts don’t totally know what to do with, says Niziol, who is still managing Lyme today.

Despite many yet-to-be-solved mysteries (we’ll get into those!), physicians and patients alike can agree the suffering is real—as is the serious change in perspective, says Robert Kalish, MD, a rheumatologist and the director of the Lyme Disease Clinic at Tufts Medical Center. “The pandemic helped people grasp the idea that you can get an infection, kill the initial cause, and still suffer lasting consequences from damage that’s been done—even if it’s difficult to detect or understand,” he says.

Up to 20 percent of Lyme patients report that their symptoms come back or never truly go away.

When you’re sick, you crave validation. Recognition gives you a better chance at care, not to mention dignifies your reality. “There’s a lot of similarity in experience between long-haulers and folks with chronic illnesses like mine being misunderstood or misdiagnosed,” Niziol says. “I might not have what you have, but I relate and deeply empathize.”

Diagnosis Dilemma

More compassion is huge. But it doesn’t erase the fact that Lyme is the most common tick-borne infection in the U.S., with an estimated 476,000 new cases each year (although only an estimated 35,000 get reported annually because of how difficult it is to diagnose). Since 1991, the prevalence of Lyme has nearly doubled as deer ticks, the main carriers of the disease, have expanded their territory. What’s more, increasing temps are expected to up Lyme cases by more than 20 percent between 2036 and 2065, a recent study found.

So, yes, a very real and growing threat, yet Lyme has been steeped in controversy pretty much since it was discovered in the ’70s. For one thing, there’s no perfect test: False negatives and positives happen often, which makes getting a correct diagnosis a challenge. Not every positive person shows the one telltale symptom—a bull’s-eye–shaped rash—either. (Niziol and Barry have no recollection of one.)

Further complicating the path to an accurate diagnosis is that Lyme, nicknamed “the great imitator,” can look like a bunch of other conditions, such as multiple sclerosis, depression, fibromyalgia, or a general viral infection. Niziol faced multiple misdiagnoses as her symptoms escalated to brain fog, blurry vision, bouts of numbness in limbs, and gaps in memory, as the months rolled on without answers. “I felt like a shell of a human,” she says. “My vibrancy was gone; joy left my body.”

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Long-Haul Life

If and when you get a definitive read? The fight doesn’t necessarily stop there. With speedy detection and treatment (typically a four-week or longer course of antibiotics), the infection is usually easy to resolve at first. But for many, including Niziol, symptoms live on.

In August 2021, just over a year after her symptoms first emerged, and still desperate to find a doctor who really understood, she searched online for specialists in her area. This time, she visited Casey Kelley, MD, a family and integrative medicine physician. Dr. Kelley ran a slew of tests and diagnosed Niziol with chronic Lyme. (Just when you thought things couldn’t get trickier!)

The diagnosis most commonly given is post-treatment Lyme disease syndrome, or PTLDS. But some doctors go so far as to use the term “chronic Lyme disease,” though this is not a diagnosis recognized by the National Institutes of Health. That’s because in one camp, you have pros who question the legitimacy of this term that indicates an ongoing infection, citing human studies that show meds are effective in killing bacteria that cause Lyme. On the other side are docs like Dr. Kelley who believe chronic Lyme is real even if it’s unclear why it happens. (She points to studies that suggest a long-term infection remains.)

Whatever you call it, “This much is not controversial: There’s no proven effective treatment for persistent Lyme,” says Linden Hu, MD, a professor of immunology at Tufts University School of Medicine. Depending on your doctor, solutions could involve meds, supplements, and/or an anti-inflammatory diet. “A two-steps-forward, one-slide-back kind of situation,” Niziol says.

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Health On The Horizon

The reassuring news is that real advancement is underway. In the past few years, tens of millions of dollars have been dedicated to combating Lyme. Researchers at Columbia University are working on brain imaging studies to better understand symptoms like chronic fatigue and pain that come with the infection.

Game-changing innovations to defeat the disease are also in the pipeline. A vaccine being tested in guinea pigs (thank you, Yale researchers) triggers an immune reaction to a tick bite that helps get the bug to detach, inhibits its ability to feed from you, and reduces transmission of the pathogen. Another candidate, from Valneva and Pfizer, works by killing bacteria in the bloodsuckers. Early studies indicate the prick is safe, and you might be able to get it as soon as 2025.

Researchers at Tufts University also set the lofty goal of eradicating Lyme by 2030. “The best chance for making sure no one gets Lyme is to hit it where it lives—in the mice, birds, and ticks in the wild,” says Dr. Hu, who is co-director of the initiative. His team is testing a bait-delivered drug that targets Lyme in wild mice in Massachusetts, followed by sites in other states, to have all key target areas covered within the next five years.

And progress for one chronic illness means progress for others. Long COVID patients are being treated with many of the same interventions that have worked for persistent Lyme symptoms. The similarities in how these diseases impact the immune system are becoming evident, Dr. Kelley says. “The patient awareness and advocacy will continue to grow from here,” she says. “We’re going to see new preventive measures to help people get their lives back faster.”One-on-one connections with people with a persistent illness (Lyme, long COVID, MS, you name it) can be a saving grace, adds Niziol. She exchanged DMs via Instagram with people who helped her find podcasts and advocacy groups. Months into treatment, Niziol is pushing herself to stay active again and remains optimistic. “I’m not going to ignore the hard parts or minimize them,” she says. “But with more understanding, more empathy, there is hope.” Right on.

This article originally appeared in the July/August 2022 issue of Women’s Health.

Lauren Krouse
Lauren Krouse is a freelance writer who covers health, domestic violence, and self-advocacy.

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Covid vaccines: how can immune imprinting help experts to rethink jabs?

July 3, 2022 Admin Leave a comment

A surge in Covid-19 hospital admissions driven by the BA.5 subvariant of Omicron, accompanied by the inability of vaccines to prevent reinfection, has prompted health policymakers to rethink their approach to boosters.

US regulators last week recommended changing the design of vaccines to produce a new booster targeting Omicron — the first change to the make-up of shots since their introduction in late 2020. Research into immune imprinting, whereby exposure to the virus via either infection or vaccination determines an individual’s level of protection, is now driving the debate over the make-up of Covid-19 vaccines.

Immunologists say that, more than two years into the coronavirus pandemic, people have acquired very different types of immunity to the Sars-Cov-2 virus, depending on which strain or combination of strains they have been exposed to — leading to big differences in Covid-19 outcomes between individuals and countries.

“The effect is more nuanced than ‘more times you have it, less protection you get’,” said professor Danny Altmann of Imperial College London, who is investigating the phenomenon with colleagues. “It’s more helpful to consider it as progressive fine-tuning of a huge repertoire. Sometimes this will be beneficial for the next wave, sometimes not.”

What is immune imprinting?

After someone encounters a virus for the first time, through infection or vaccination, the immune system remembers its initial response in a way that usually weakens the response to future variants of the same pathogen but may sometimes strengthen it. Proteins on the “spike”, which the virus uses to bind with human cells, play a key role.

“Our first encounter with the spike antigen, either through infection or vaccination, shapes our subsequent pattern of immunity through immune imprinting,” said professor Rosemary Boyton of Imperial College.

The pattern has been observed for many years in flu and dengue virus, when it was usually called original antigenic sin. Studies are now demonstrating that it applies to Sars-Cov-2 too, although the effects are hard to pin down, according to Altmann, who prefers the term “immune imprinting” to the biblical connotations of original sin.

A study of 700 UK healthcare workers by the Imperial team, published last month in the journal Science, found that Omicron infection had little or no beneficial effect of boosting any part of the immune system — antibodies, B-cells or T-cells — among people who had been imprinted with earlier Sars-Cov-2 variants.

“Omicron is far from a benign natural booster of vaccine immunity, as we might have thought, but it is an especially stealthy immune evader,” said Altmann.

Vaccines currently in use were designed to target the virus as it first emerged from Wuhan, China, more than two years ago. They retain high protection against severe disease and hospital admissions but their efficacy against transmission and mild infection wanes quickly, especially against Omicron.

Understanding the effect of immune imprinting will help health officials to decide which vaccines to use in future booster campaigns. Boyton said immune imprinting has “important implications for future-proofing vaccine design and dosing strategies”.

Does immune imprinting help to explain breakthrough infections?

Most people in the industrialised world have been infected or vaccinated against Covid — or both. England’s Schools Infection Survey, run by the London School of Hygiene and Tropical Medicine, last week released data showing that 99 per cent of secondary schoolchildren tested positive for Covid antibodies from natural infection.

By this stage of the pandemic, the vast majority of Covid cases are reinfections in people whose immune defences acquired from vaccines or earlier infections do not hold up against Omicron BA.4 and BA.5.

Nor are these “breakthrough” infections necessarily as mild as many people believe, said Ziyad Al-Aly, a clinical epidemiologist at Washington University in St Louis. He analysed the health records of 34,000 people with breakthrough Covid infections in the database of the US veterans administration, which provides healthcare services for retired soldiers. The cumulative risk of serious damage to heart, brain and lungs rose significantly with each repeated infection.

In another study, Al-Aly and colleagues found that, while vaccines are good at preventing acute Covid-19, they were just 15 per cent effective at preventing long Covid, which is defined as suffering symptoms for 12 weeks or more after a Covid-19 diagnosis. “Getting Covid, even among vaccinated people, seems almost unavoidable nowadays,” he said.

Has immune imprinting influenced vaccine debates?

Some anti-vaxxers have enlisted immune imprinting in their arguments, on the grounds that vaccines become less effective as the virus evolves — an objection that immunologists reject forcefully.

“While our latest findings highlight clear concerns about the nature of Omicron infection, vaccination remains effective against severe disease,” said Altmann. “Those who are eligible to receive a booster should be encouraged to do so.”

Professor Christian Drosten, a leading German virologist, said in an interview with Der Spiegel that extending the interval between jabs could help reduce the impact of immune imprinting.

“I suspect the effect [of vaccination] will get better, the greater the interval from the previous vaccination,” he said. “[But] it is not yet known how long the interval between vaccinations should actually be.”

How has differing immunity affected decisions on vaccines?

The World Health Organization last month said Omicron-based jabs may be beneficial as boosters because they would broaden protection against different variants.

And, on Tuesday, the US Food and Drug Administration advisory committee voted 19 to two in favour of incorporating genetic material from Omicron into new booster jabs.

“We’re trying to use every last ounce of what we can from predictive modelling, and from the data that is emerging, to try to get ahead of a virus that has been very crafty,” said Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research.

On Thursday, the FDA recommended including a component of the BA.4/BA.5 Omicron subvariants in a new shot for autumn booster campaigns. But the agency has not advised a change to the existing vaccine for first doses.

Moderna and BioNTech/Pfizer, the leading manufacturers of mRNA vaccines, have submitted laboratory data showing that their latest versions, targeted at Omicron, produce a potent antibody response against BA.4 and BA.5. But some immunologists remain uncertain whether they will be more effective than receiving another dose of the original Wuhan vaccine.

“Due to immune imprinting, patterns of anti-spike immunity in different people and populations have become heterogeneous, complex and unpredictable,” said Boyton. “This makes the argument for moving forward in a careful, considered and evidence-based way.”

“The challenge for next-generation Covid vaccines is to design vaccines that broaden the immune response to protect against future variants of concern.”

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5 foods to manage bad cholesterol naturally

July 3, 2022 Admin Leave a comment

There are certain foods that lower LDL cholesterol levels in your blood naturally and must be added to your diet.

Updated On Jul 01, 2022 08:11 PM IST

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