Monday, January 2, 2017

cdc on Zika, Goats and Chronic fatigue


not much new except they go into the guideline stuff for docs and public health folk.

And yes, spraying should help.

Successful control of Aedes aegypti, the primary mosquito vector of Zika virus, has proven extremely difficult using existing control methods. CDC’s technical assistance during the Zika response has therefore included support for improved mosquito control infrastructure, novel mosquito control techniques, and integrated vector management that uses existing control methods. During the Zika virus outbreak in the Wynwood neighborhood of Miami-Dade County, Florida, aggressive ground-based integrated vector management was supplemented by sequential aerial applications of adulticide and larvicide, which rapidly reduced adult mosquito counts in surveillance traps by approximately 90% and helped to end this local outbreak (36). A similar approach in Miami Beach, Florida, using aerial applications of adulticide and ground-based applications of larvicide, also substantially reduced adult mosquito counts. Recent advances in aerial insecticide application methods, and the fact that, in the continental United States, Aedes aegypti lives primarily outdoors, likely contributed to the success of the aerial approach in Miami-Dade County. Public opposition to aerial pesticide application in Puerto Rico precluded a similar approach there; instead, lethal mosquito traps have been deployed as part of large community trials that aim to evaluate this method of preventing future outbreaks of mosquito-borne disease on the island (37).

unless you are pregnant, the disease only is minor (yes, Guillian Barre, but that is rare). I had to groan at a yuppie who wrote an essay on one of the left wing magazine type sites bragging they got and survived Zika, and used this to brag you don't really need to use precautions like DEET or insect repellant when traveling in third world countries.


but never mind. Dengue is not a big thing: Only Zika, which can be hyped to push contraception, or Ebola, which is really bad, are in the news.


a bad strain of EColi causing bloody diarrhea has been linked to a goat farm...


Chronic fatigue syndrome discussion here.

The cause or causes of ME/CFS remain unknown. Patients often report an acute onset after a flu-like illness that does not go away, and some patients have a history of frequent infections before their illness. This suggests that an infection can trigger the illness, though it is less clear that the ongoing chronic illness is perpetuated by an infection. Investigators have looked for, and failed to find, a single etiologic agent. However, chronic fatiguing illnesses have long been described in the medical literature following infection with several different agents. For example, a syndrome with similarities to ME/CFS occurs in approximately 10% of patients with a variety of viral and nonviral pathogens, such as Epstein-Barr Virus, Ross River Virus, Coxiella burnetti (Q fever), or Giardia (12). The severity of the acute infection was most predictive of subsequent illness, and there is no evidence of unusual persistence of infections in those who remain ill; baseline psychological profile and socioeconomic status did not predict who would become chronically ill (12). Other studies have found that, compared with healthy controls, persons with ME/CFS have had exposure to significantly more stressors (trauma and other adverse life events) and are more likely to have metabolic syndrome, as well as higher physiologic measures of neuroendocrine response to stress (allostatic load) (13). These associations are not specific to ME/CFS, because stress is a factor in many chronic illnesses.
I have found patients with this who tested positive for Mononucleosis/EBV infection, post viral pneumonia (PPLO/Mycoplasm) and various forms of hepatitis. Often "tincture of time", and reassurance will work. Some were depressed, and counseling with a decent diet/exercize program will help, but the real puzzling cases are when you have a person who just loses their ability to work due to fatigue, and they don't fit into any of these boxes.

So it is a syndrome (a combination of symptoms): whether or not it has one cause is not certain.

But it is not "all in your head", and like fibromyalgia and other vague syndromes, the approach is to try to keep the patient functioning rather than a magic shot to cure it.

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