Infectious Diseases Challenge Medical Community––

The World Is Changing, And So Are The Viruses

By Dottie Evans

Dr Paul Nee of the Danbury Office of Physicians’ Services, Infectious Diseases Program, spoke Monday evening, November 24, to a group assembled in the Monsignor Conroy Room of St Rose School. His topic was “The Infection Connection and Triumphs of Your Immune System,” and his talk was illustrated by slides.

After an introduction by Sally O’Neil, who represented the St Rose Parish Nurse Program, Dr Nee examined eight infectious diseases that he said were “hot topics” in today’s medical community.

These included SARS (Severe Acute Respiratory Syndrome), HIV-related illness and AIDS, Lyme disease, TSS (Toxic Shock Syndrome, which he noted has largely disappeared) Erlichia, tuberculosis, hospital viruses, and influenza.

Many of the most stubborn and persistent viruses have arisen as the result of change, Dr Nee pointed out. Change in the health care system, change in technology, and change in the natural and social environment.

For example, he said the deer tick that carries Lyme disease has multiplied along with the explosion of the deer population, which has occurred in Connecticut because farmland has been replaced by forest and the suburban landscape –– all places where deer thrive.

“We can partially attribute the spread of AIDS to social change,” he noted, as well as to change in technology that allows people to travel widely.

“It was airplane travel that contributed to the spread of SARS from China to Taiwan to Toronto, Canada. SARS broke out in March 2003 and was contained within six months, but not before a total of 8,422 contracted the disease resulting in 916 deaths,” he said.

Demographic change is another contributing factor to the spread of infectious diseases.

The Hispanic immigrant population pouring into the United States during the past decade has resulted in a rise in the incidence of tuberculosis, and AIDS, which originated in Africa, has spread worldwide.

“The greatest incidence of AIDS is now occurring in the black population south of the Sahara Desert –– especially in the children of those who are infected. AIDS may be passed on from mother to child at birth or through breast feeding,” Dr Nee said.

Influenza Vaccine

Recommended

When battling infectious diseases, there is a constant struggle on the part of the medical community to keep up with viruses that mutate or change their genetic code in response to antibiotics currently in use.

“This year’s influenza, for example, had already mutated by the time the vaccine was prepared and shipped –– a process that takes nine months.”

Dr Nee cautioned anyone who has had this year’s flu shot not to become alarmed, however, since he or she would still be much more likely to fight the disease off. Or they would likely not get as bad a case of the flu as they would have otherwise.

“There are approximately 30,000 influenza deaths in the United States each year. Flu symptoms are exacerbated when there is an underlying chronic illness.

“Companies realize that vaccinating their employees is a cost-effective measure,” Dr Nee said.

Despite the fact that the current flu vaccine may not be 100 percent effective in warding off the disease, it is still recommended by the medical community, and the best time to get the flu shot would be right now, or before the New Year.

“Many hospitals and clinics are offering shots free of charge to those at risk,” Dr Nee said.

The flu shot is recommended for any child between the ages of 6 to 23 months, for pregnant women, for those with chronic medical conditions, for those working in nursing homes or other health care facilities, and for anyone over the age of 50.

Erlichiosis And Lyme

Connecticut has the highest rate of Lyme disease infection, Dr Nee said, and the disease is spreading south into Maryland and Virginia.

Another tick-borne disease is Erlichiosis, which causes a low white blood cell count and mild hepatitis.

“Erlichiosis is on the rise in northern Fairfield County. There were two cases in 1999, and so far this year, we’ve counted 60. Unlike Lyme disease, there is no presenting rash associated with Erlichiosis. A diagnosis can only be made after blood work is done showing a lowered number of platelets and an elevated liver function.

“We’re seeing Erlichia more often in adults than in children, and the disease may be accurately diagnosed by looking at slides of the blood cells where we can identify specific granulocytic markers,” Dr Nee said.

Once diagnosed and treated with antibiotics, a patient usually recovers from Erlichiosis within 24 to 48 hours, he added.

As for pneumonia, Dr Nee said the medical community is working round the clock to find a new antibiotic that is as effective as penicillin.

“The race is on! Resistance to penicillin is rising. Children tend to be the reservoirs for the bacterium, and children are often overtreated.”

A similar problem is found in the hospital environment. Staph infections may spontaneously arise and spread. In our current ambulatory care system, Dr Nee noted, long-term care patients may be admitted to hospitals for acute care, and then be discharged relatively quickly back into long-term care. The patient may be harboring a virus that was contracted in either of the two facilities, and the infection may spread before it can be detected.