Mosquitoes can spread the flesh-eating Buruli ulcer. Here’s how you can protect yourself
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Each year, more and more Victorians become sick with a flesh-eating bacteria known as Buruli ulcer. Last year, 363 people presented with the infection, the highest number since 2004.
But it has been unclear exactly how it spreads, until now. New research shows mosquitoes are infected from biting possums that carry the bacteria. Mozzies spread it to humans through their bite.
What is Buruli ulcer?
Buruli ulcer, also known as Bairnsdale ulcer, is a skin infection caused by the bacterium Mycobacterium ulcerans.
It starts off like a small mosquito bite and over many months, slowly develops into an ulcer, with extensive destruction of the underlying tissue.
While often painless initially, the infection can become very serious. If left untreated, the ulcer can continue to enlarge. This is where it gets its “flesh-eating” name.
Thankfully, it’s treatable. A six to eight week course of specific antibiotics is an effective treatment, sometimes supported with surgery to remove the infected tissue.
Where can you catch it?
The World Health Organization considers Buruli ulcer a neglected tropical skin disease. Cases have been reported across 33 countries, primarily in west and central Africa.
However, since the early 2000s, Buruli ulcer has also been increasingly recorded in coastal Victoria, including suburbs around Melbourne and Geelong.
Scientists have long known Australian native possums were partly responsible for its spread, and suspected mosquitoes also played a role in the increase in cases. New research confirms this.
Our efforts to ‘beat Buruli’
Confirming the role of insects in outbreaks of an infectious disease is achieved by building up corroborating, independent evidence.
In this new research, published in Nature Microbiology, the team (including co-authors Tim Stinear, Stacey Lynch and Peter Mee) conducted extensive surveys across a 350 km² area of Victoria.
We collected mosquitoes and analysed the specimens to determine whether they were carrying the pathogen, and links to infected possums and people. It was like contact tracing for mosquitoes.
Cameron Webb (NSW Health Pathology)
Molecular testing of the mosquito specimens showed that of the two most abundant mosquito species, only Aedes notoscriptus (a widespread species commonly known as the Australian backyard mosquito) was positive for Mycobacterium ulcerans.
We then used genomic tests to show the bacteria found on these mosquitoes matched the bacteria in possum poo and humans with Buruli ulcer.
We further analysed mosquito specimens that contained blood to show Aedes notoscriptus was feeding on both possums and humans.
To then link everything together, geospatial analysis revealed the areas where human Buruli ulcer cases occur overlap with areas where both mosquitoes and possums that harbour Mycobacterium ulcerans are active.
Stop its spread by stopping mozzies breeding
The mosquito in this study primarily responsible for the bacteria’s spread is Aedes notoscriptus, a mosquito that lays its eggs around water in containers in backyard habitats.
Controlling “backyard” mosquitoes is a critical part of reducing the risk of many global mosquito-borne disease, especially dengue and now Buruli ulcer.
You can reduce places where water collects after rainfall, such as potted plant saucers, blocked gutters and drains, unscreened rainwater tanks, and a wide range of plastic buckets and other containers. These should all be either emptied at least weekly or, better yet, thrown away or placed under cover.
Cameron Webb (NSW Health Pathology)
There is a role for insecticides too. While residual insecticides applied to surfaces around the house and garden will reduce mosquito populations, they can also impact other, beneficial, insects. Judicious use of such sprays is recommended. But there are ecological safe insecticides that can be applied to water-filled containers (such as ornamental ponds, fountains, stormwater pits and so on).
Recent research also indicates new mosquito-control approaches that use mosquitoes themselves to spread insecticides may soon be available.
How to protect yourself from bites
The first line of defence will remain personal protection measures against mosquito bites.
Covering up with loose fitted long sleeved shirts, long pants, and covered shoes will provide physical protection from mosquitoes.
Applying topical insect repellent to all exposed areas of skin has been proven to provide safe and effective protection from mosquito bites. Repellents should include diethytolumide (DEET), picaridin or oil of lemon eucalyptus.
While the rise in Buruli ulcer is a significant health concern, so too are many other mosquito-borne diseases. The steps to avoid mosquito bites and exposure to Mycobacteriam ulcerans will also protect against viruses such as Ross River, Barmah Forest, Japanese encephalitis, and Murray Valley encephalitis.
Cameron Webb, Clinical Associate Professor and Principal Hospital Scientist, University of Sydney; Peter Mee, Adjunct Associate Lecturer, School of Applied Systems Biology, La Trobe University; Stacey Lynch, Team Leader- Mammalian infection disease research, CSIRO, and Tim Stinear, Professor of Microbiology, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Surgery won’t fix my chronic back pain, so what will?
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This week’s ABC Four Corners episode Pain Factory highlighted that our health system is failing Australians with chronic pain. Patients are receiving costly, ineffective and risky care instead of effective, low-risk treatments for chronic pain.
The challenge is considering how we might reimagine health-care delivery so the effective and safe treatments for chronic pain are available to millions of Australians who suffer from chronic pain.
One in five Australians aged 45 and over have chronic pain (pain lasting three or more months). This costs an estimated A$139 billion a year, including $12 billion in direct health-care costs.
The most common complaint among people with chronic pain is low back pain. So what treatments do – and don’t – work?
Opioids and invasive procedures
Treatments offered to people with chronic pain include strong pain medicines such as opioids and invasive procedures such as spinal cord stimulators or spinal fusion surgery. Unfortunately, these treatments have little if any benefit and are associated with a risk of significant harm.
Spinal fusion surgery and spinal cord stimulators are also extremely costly procedures, costing tens of thousands of dollars each to the health system as well as incurring costs to the individual.
Addressing the contributors to pain
Recommendations from the latest Australian and World Health Organization clinical guidelines for low back pain focus on alternatives to drug and surgical treatments such as:
- education
- advice
- structured exercise programs
- physical, psychological or multidisciplinary interventions that address the physical or psychological contributors to ongoing pain.
Pain education is central. Monkey Business Images/Shutterstock Two recent Australian trials support these recommendations and have found that interventions that address each person’s physical and psychological contributors to pain produce large and sustained improvements in pain and function in people with chronic low back pain.
The interventions have minimal side effects and are cost-effective.
In the RESOLVE trial, the intervention consists of pain education and graded sensory and movement “retraining” aimed to help people understand that it’s safe to move.
In the RESTORE trial, the intervention (cognitive functional therapy) involves assisting the person to understand the range of physical and psychological contributing factors related to their condition. It guides patients to relearn how to move and to build confidence in their back, without over-protecting it.
Why isn’t everyone with chronic pain getting this care?
While these trials provide new hope for people with chronic low back pain, and effective alternatives to spinal surgery and opioids, a barrier for implementation is the out-of-pocket costs. The interventions take up to 12 sessions, lasting up to 26 weeks. One physiotherapy session can cost $90–$150.
In contrast, Medicare provides rebates for just five allied health visits (such as physiotherapists or exercise physiologists) for eligible patients per year, to be used for all chronic conditions.
Private health insurers also limit access to reimbursement for these services by typically only covering a proportion of the cost and providing a cap on annual benefits. So even those with private health insurance would usually have substantial out-of-pocket costs.
Access to trained clinicians is another barrier. This problem is particularly evident in regional and rural Australia, where access to allied health services, pain specialists and multidisciplinary pain clinics is limited.
Higher costs and lack of access are associated with the increased use of available and subsidised treatments, such as pain medicines, even if they are ineffective and harmful. The rate of opioid use, for example, is higher in regional Australia and in areas of socioeconomic disadvantage than metropolitan centres and affluent areas.
So what can we do about it?
We need to reform Australia’s health system, private and public, to improve access to effective treatments for chronic pain, while removing access to ineffective, costly and high-risk treatments.
Better training of the clinical workforce, and using technology such as telehealth and artificial intelligence to train clinicians or deliver treatment may also improve access to effective treatments. A recent Australian trial, for example, found telehealth delivered via video conferencing was as effective as in-person physiotherapy consultations for improving pain and function in people with chronic knee pain.
Advocacy and improving the public’s understanding of effective treatments for chronic pain may also be helpful. Our hope is that coordinated efforts will promote the uptake of effective treatments and improve the care of patients with chronic pain.
Christine Lin, Professor, University of Sydney; Christopher Maher, Professor, Sydney School of Public Health, University of Sydney; Fiona Blyth, Professor, University of Sydney; James Mcauley, Professor of Psychology, UNSW Sydney, and Mark Hancock, Professor of Physiotherapy, Macquarie University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Kiwi vs Lime – Which is Healthier?
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Our Verdict
When comparing kiwi to lime, we picked the kiwi.
Why?
Looking at the macros first, kiwi has more protein, more carbs, and more fiber. As with most fruits, the fiber is the number we’re most interested in for health purposes; in this case, kiwi is just slightly ahead of lime on all three of those.
In terms of vitamins, kiwi has more of vitamins A, B2, B3, B6, B9, C, E, K, and choline, while lime has a tiny bit more vitamin B5. As in, the vitamin that’s in pretty much anything and is practically impossible to be deficient in unless you are literally starving to death. You may be thinking: aren’t limes a famously good source of vitamin C? And yes, yes they are. But kiwis have >3x more. In other big differences, kiwis also have >6x more vitamin E and >67 times more vitamin K.
When it comes to minerals, kiwi has more calcium, copper, magnesium, manganese, phosphorus, potassium, and zinc, while lime has more iron and selenium. Another easy win for kiwis.
In short: enjoy both; both are good. But kiwis are the more nutritionally dense option by almost every way of measuring it.
Want to learn more?
You might like to read:
Top 8 Fruits That Prevent & Kill Cancer ← kiwi is top of the list; it promotes cancer cell death while sparing healthy cells
Take care!
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The Top Micronutrient Deficiency In High Blood Pressure
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High blood pressure is often considered a matter of too much sodium, but there’s another micronutrient that’s critical, and a lot of people have too little of it:
The Other Special K
Potassium helps regulate blood pressure by doing the opposite of what sodium does: high sodium intake increases blood volume and pressure by retaining fluid, while potassium promotes sodium excretion through urine, reducing fluid retention and lowering blood pressure.
Clinical studies (which you can find beneath the video, if you click through to YouTube) have shown that increasing potassium intake can reduce systolic blood pressure by an average of 3.49 units, with even greater reductions (up to 7 units) at higher potassium intakes of 3,500–4,700 mg/day.
Potassium-rich foods include most fruit*, leafy greens, broccoli, lentils, and beans.
*because of some popular mentions in TV shows, people get hung up on bananas being a good source of potassium. Which they are, but they’re not even in the top 10 of fruits for potassium. Here’s a non-exhaustive list of fruits that have more potassium than bananas, portion for portion:
- Honeydew melon
- Papaya
- Mango
- Prunes
- Figs
- Dates
- Nectarine
- Cantaloupe melon
- Kiwi
- Orange
These foods also provide fiber, which aids in weight management and further lowers risks for cardiovascular disease. Increasing fiber intake by just 14g a day has been shown not only to reduce calorie consumption and promote weight loss, but also (more importantly) lower blood pressure, cholesterol, and overall health risks.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
What Matters Most For Your Heart? Eat More (Of This) For Lower Blood Pressure ← this is about fiber; while potassium is the most common micronutrient deficiency in people with high blood pressure, fiber is the most common macronutrient deficiency, and arguably the most critical in this regard.
Take care!
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Small Pleasures – by Ryan Riley
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When Hippocrates said “let food be thy medicine, and let medicine be thy food”, he may or may not have had this book in mind.
In terms of healthiness, this one’s not the very most nutritionist-approved recipe book we’ve ever reviewed. It’s not bad, to be clear!
But the physical health aspect is secondary to the mental health aspects, in this one, as you’ll see. And as we say, “mental health is also just health”.
The book is divided into three sections:
- Comfort—for when you feel at your worst, for when eating is a chore, for when something familiar and reassuring will bring you solace. Here we find flavor and simplicity; pastas, eggs, stews, potato dishes, and the like.
- Restoration—for when your energy needs reawakening. Here we find flavors fresh and tangy, enlivening and bright. Things to make you feel alive.
- Pleasure—while there’s little in the way of health-food here, the author describes the dishes in this section as “a love letter to yourself; they tell you that you’re special as you ready yourself to return to the world”.
And sometimes, just sometimes, we probably all need a little of that.
Bottom line: if you’d like to bring a little more joie de vivre to your cuisine, this book can do that.
Click here to check out Small Pleasures, and rekindle joy in your kitchen!
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You’re Not Forgetful: How To Remember Everything
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Elizabeth Filips, medical student busy learning a lot of information, explains how in today’s video:
Active processing
An important thing to keep in mind is that forgetting is an active process, not passive as once believed. It has its own neurotransmitters and pathways, and as such, to improve memory, it’s essential to understand and manage forgetting.
So, how does forgetting occur? Memories are stored with cues or tags, which help retrieve information. However, overloading cues with too much information can cause “transient forgetting”—that is to say, the information is still in there somewhere; you just don’t have the filing system required to retrieve the data. This is the kind of thing that you will try hard to remember at some point in the day when you need it, fail, and then wake up at 3am with an “Aha!” because your brain finally found what you were looking for. So, to avoid that, use unique and strong cues to help improve recall (mnemonics are good for this, as are conceptual anchors).
While memory does not appear to actually be finite, there is some practical truth in the “finite storage” model insofar as learning new information can overwrite previous knowledge, iff your brain mistakes it for an update rather than addition. So for that reason, it’s good to periodically go over old information—in psychology this is called rehearsal, which may conjure theatrical images, but it can be as simple as mentally repeating a phone number, a mnemonic, or visually remembering a route one used to take to go somewhere.
Self-perception affects memory performance. Negative beliefs about one’s memory can worsen performance (so don’t say “I have a bad memory”, even to yourself, and in contrast, find more positive affirmations to make about your memory), and mental health in general plays a significant role in memory. For example, if you have ever had an extended period of depression, then chances are good you have some huge gaps in your memory for that time in your life.
A lot of what we learned in school was wrong—especially what we learned about learning. Traditional (vertical) learning is harder to retain, whereas horizontal learning (connecting topics through shared characteristics) creates stronger, interconnected memories. In short, your memories should tell contextual stories, not be isolated points of data.
Embarking on a new course of study? Yes? (If not, then why not? Pick something!)
It may be difficult at first, but experts memorize things more quickly due to built-up intuition in their field. For example a chess master can glance at a chess board for about 5 seconds and memorize the position—but only if the position is one that could reasonably arise in a game; if the pieces are just placed at random, then their memorization ability plummets to that of the average person, because their expertise has been nullified.
What this means in practical terms: building a “skeleton” framework before learning can enhance memorization through logical connections. For this reason, if embarking on a serious course of study, getting a good initial overview when you start is critical, so that you have a context for the rest of what you learn to go into. For example, let’s say you want to learn a language; if you first quickly do a very basic bare-bones course, such as from Duolingo or similar, then even though you’ll have a very small vocabulary and a modest grasp of grammar and make many mistakes and have a lot of holes in your knowledge, you now have somewhere to “fit” every new word or idea you learn. Same goes for other fields of study; for example, a doctor can be told about a new drug and remember everything about it immediately, because they understand the systems it interacts with, understand how it does what it does, and can compare it mentally to similar drugs, and they thus have a “place” in that overall system for the drug information to reside. But for someone who knows nothing about medicine, it’s just a lot of big words with no meaning. So: framework first, details later.
For more on all this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
How To Boost Your Memory Immediately (Without Supplements)
Take care!
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The Vagina Bible – by Dr. Jen Gunter
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The vagina is mysterious to most men, and honestly, also to a lot of women. School education on this is minimal, if even extant, and as an adult, everyone’s expected to “just know” stuff. However, here in reality, that isn’t how knowledge works.
To remedy this, gynecologist Dr. Jen Gunter takes 432 pages to give us the low-down and the ins-and-outs of this remarkable organ that affects, and is affected by, a lot of the rest of our health.
(On which note, if you think you already know it, ask yourself: could you write 432 pages about it? If not, you’ll probably still learn some things from this book)
Stylistically, this book is more of a textbook in presentation, but the writing is still very much easy-reading. The focus is mostly on anatomy and physiology, though she does give due attention to relevant healthcare options; what’s good, what’s bad, and what’s just plain unnecessary. In such cases, she always has plenty of science to hand; it’s never just “one woman’s opinion”.
If the book has a downside, it’s that (based on other reviews) it seems to upset some readers with unwelcome truths, but that’s more in the vein of “she’s right, of course, but I didn’t like reading it”.
Bottom line: if you have a vagina, or spend any amount of time in close proximity to one, then this is a great book for you.
Click here to check out The Vagina Bible, and upgrade your knowledge!
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