Tag Archive | medicine

Brucellosis: My New Bacterial Tenant

Brucellosis hotspot?

Brucellosis hotspot?

Though the tests aren’t back yet, I am certain that I have been infected with one (or more) species of a bacteria in the genus Brucella. In humans, Brucella is usually transmitted by drinking unpasteurized milk, or through contact with the saliva, nasal excretions, urine of fecal matter of infected livestock. There are only 100-200 cases a year in the US, but it’s common in developing countries.

For those keeping up, you may remember that I spent the summer in Kenya, working with a team extracting blood samples from camels, cows, goats and sheep. We were in contact with all of these animals on almost a daily basis. We weren’t wearing any protection at all, but it’s inconceivable to wear a full hazmat suit while taking blood from goats in a Maasai community. You’d get laughed out of town.

My days right now are running in a fairly predictable pattern. I wake up, feel pretty good, eat breakfast and drink some coffee. At about 10-11 a.m. I begin to feel dizzy, sweat somewhat, a low grade fever kicks in and a horrible taste develops in my mouth. My peripheral vision is limited and I have trouble focusing on distant objects. It gets progressively worse throughout the day, but improves before dinner. After dinner, I feel worse than before. I’m positive that the brunt of the physical symptoms are associated with anemia. It’s like a low grade malaria.

The psychological effects are fascinating. Again, in the morning, I feel fine. As the day progresses, I am less and less able to string coherent sentences together (not that I’m good at it in the best of times), lose thoughts in mid sentence and can’t remember important vocabulary words. I’m stuck in an existential funk where the thought of tomorrow is dark, I’ve forgotten the past and the present isn’t all that meaningful. I often find myself staring into space and time passes quickly.

Though I have no other negative physical effects and am able to leave the house and move around, I’m finding this incredibly debilitating. Even writing this blog post is a challenge.

From the pathogen’s standpoint, this situation is ideal. It doesn’t immediately kill the host, and the bacteria tends to incubate in cells so that it can avoid the body’s immune response. If I were a herd animal, eating and defecating in the same space, I would be able to transmit for, conceivably, the rest of my life. The low grade anemia keeps the animal mobile, yet impedes its ability to evade predators, allowing transmission to occur from herbivorous ungulates to carnivorous animals.

Again, because the bacteria hides out in cells, it’s a bear to kill. I have two months of two types of antibiotics to look forward to, both with different schedules and dietary requirements. One causes awful nightmares (doxycycline).

If left untreated brucellosis can include abscesses in the joints, spinal problems, blindness and inflammation of the testicles. It is anecdotally associated with elevated rates of suicide in veterinarians. I’m wondering how much chronic brucellosis there is in pastoralist communities in Sub-Saharan Africa. The burden must be quite severe.

This is going to be rough, but it’s better than a lifetime of these symptoms. I’m certainly finding this scientifically interesting, though I will be happy to have it gone for good.

A Visit to the Local Witch Doctor

The Healer holding a diarrhea medication and wearing a medicinal herb which alleviates joint pain.

The Healer holding a diarrhea medication and wearing a medicinal herb which alleviates joint pain.

I’ve seen survey after survey which show that a large percentage of Africans rely on traditional healers (witch doctors, medicine men) as a first choice when symptoms of disease appear. It’s pretty easy to dismiss them outright, but they have to be taken somewhat seriously when so many people rely on them for help.

My friend, Gabriel, though, knowing I’m into weirdness, took me to one tonight. By sheer coincidence, we happened to run into him on the way walking with a young gentleman. After a brief exchange, he was kind enough to agree to see us and led us back to his house.

Through Gabriel (my Luo is beyond poor), I asked him what the young man was doing there. The healer told me that someone had stolen some items from the guy. He had come to the healer to ask him to use his magic to reveal the identity of the thief and purchase some medicine with with to curse the man who had stolen his property. I asked him if people came to him often with such troubles. He replied that yes, indeed, many people do.

I tried to be snide and ask him what he would do if the thief came to him to try and get the curse removed and put on the guy that cursed him (fueling a never ending cyclic hell of cursing), but he didn’t really get what I was after.

The Healer's house, complete with waiting patients.

The Healer’s house, complete with waiting patients.

The healer then turned to me and asked me what my troubles were. I tried to tell him my knee hurts (which it does), but he kept insisting that my stomach hurt (it does not). Finally, I had to cave and just tell him that I was suffering from stomach pain. When he was describing the pain, he kindly tried to include the knees.

The healer learned his trade from his parents. He claims that his particular magic is strong because he learned it from his mother (rather than his father). I was told that that was a secret but I guess I’ve let it out. I’m sure it’s still a secret here. (My readership numbers show that it’s a secret anyway.)

He took us back to his house, a shack in a fishing compound on the edge of town, which usually smells of weed. He took us inside and had us sit down on his couch while he started pulling out various bottles and bags of powders. I was sitting next to him. Suddenly he jumped up and insisted that the medicines wanted me to move to the far side of the couch. I asked him if the medicines talked to him to which he replied yes, indeed, they do. I figured out pretty quickly that he’s half deaf and wanted Gabriel closer to him so he could hear.

Medicines

Medicines

He went about mixing up some medications. The first was a small amount of powder that I thought was going to cure my alleged stomach problems, but instead was intended to get me a job. In fact, this medicine is so powerful, that I will never get fired from the job once I get it. I guess this means I’ll get a tenured faculty position any day now.

Next, he produced a number of bags of what looked like Indian spices and proceed to mix a heaping amount of what could be easily mistaken for garam masala. This medicine is what’s supposed to cure my diarrheal ills (which he also insisted I had). He poured some in my hand and told me to taste some. I hesitated but did it anyway. Definitely chili peppers in there. My mouth immediately went numb and my head started to spin a bit. Could be something like kava, definitely not weed. I have no clue what’s in this stuff, but there’s most certainly some active ingredient in it. I suspect that he produces it to emphasize his powers.

Magical items

Magical items

He gave me very specific instructions on how to mix it, and when to use it. I am only supposed to use it between the hours of 8 and 9 p.m. All of my diarrhea and abdominal pains will immediately disappear. I am to go back to see him after two days (presumably to buy more).

Finally, he recognized that my knee hurts. He asked me if I had time to wait. I said yes, and he left the house to go and get some herbs. We could hear him pounding it into a powder outside. He returned, and said that I should mix the power with Vaseline and cover my entire body with it. I would need a partner to do it. After covering my entire body with the vaseline/powdered grass mixture, I should shake my limbs a bit. After two days, all of my pain would cease. I was to see him again (and again buy more, presumably).

We asked him how much it would be. “This is very expensive. 2,000 Schillings ($24.00).” to which we both balked. Eventually, we talked him down to 500 (about $6.00). Gabriel wanted to talk him down to 100, I just let it go figuring it was a small price to pay for such a weird experience.

Eventually, we had to go. Patients were lined up outside waiting.

The Healer with patients

The Healer with patients

“Crowded” Vaccine Schedule Deemed Safe….

as one would expect. The Institute of Medicine within the National Academies of Sciences recently produced a 230 page report addressing the concerns of parents that the current recommended vaccine schedule is too “crowded” and thus puts children at excessive risk.

Upon reviewing stakeholder concerns and scientific literature regarding the entire childhood immunization schedule, the IOM committee finds no evidence that the schedule is unsafe. The committee’s review did not reveal an evidence base suggesting that the U.S. childhood immunization schedule is linked to autoimmune diseases, asthma, hypersensitivity, seizures, child developmental disorders, learning or developmental disorders, or attention deficit or disruptive disorders.

Existing mechanisms to detect safety signals — including three major surveillance systems of FDA-approved products maintained by the CDC and a supplemental vaccine safety monitoring initiative by the FDA—provide further confidence that the current childhood immunization schedule is safe.

It’s quite a tempting narrative. Small defenseless children are jabbed multiple times, allowing harmful foreign substances to enter the body, all with the nefarious intent of making profits for large pharma giants. However, children are assaulted by pathogens from the second they exit the birth canal, and continue to be throughout the course of their lives.

The inactivated versions of the pathogens they might otherwise come into contact with should present no extra burden to an immune system that already anticipates invasion. Of course, coming into contact with a dead version of a pathogen is far preferable to coming into contact with the live version. The assertion that the schedule is “crowded”, given daily attacks on the immune system, is completely absurd.

Moreover, the report found that States with loose vaccine policy, have higher incidence of disease, in this case Pertussis:

While parents generally worry about children’s health and well-being, and their concerns about immunization safety can be viewed in that context, delaying or declining vaccination has led to outbreaks of such vaccine-preventable diseases as measles and whooping cough that may jeopardize public health, particularly for people who are under-immunized or who were never immunized. States with policies that make it easy to exempt children from immunizations were associated with a 90 percent higher incidence of whooping cough in 2011.

Of course, we are experiencing record numbers of Pertussis cases. It must be noted, that like influenza, most cases of Pertussis are asymptomatic. In fact, it is estimated that 5 out of 6 cases of Pertussis come without symptoms, yet transmission occurs. (2 out of every 3 influenza cases are asymptomatic. Next time someone tells you they never get the flu, don’t believe them.) Unvaccinated people may still contract the disease, not experience symptoms, and still pass it one to an unvaccinated person, who, of course, could very well die.

Many of the diseases on the vaccine schedule are very much still in circulation. One excellent example is tetanus, a bacteria which lives happily in soil (not rust, as commonly believed). Tetanus passes through our digestive tract regularly through food, but when the bacteria enter the other parts of the body, particularly the low-oxygen environment of the muscles, the usual outcome is to suffer for months and often die a truly horrible death. Nearly all cases of tetanus in the US occur in unvaccinated individuals.

Given tetanus’ ubiquity in the environment, I often scratch my head when parents tell me they don’t vaccinate their children as the risks of the disease far outweigh the risks of the vaccine. Here, of course, it isn’t the vaccine that’s killing kids, but politics and self-serving conspiracy hacks.

Follow

Get every new post delivered to your Inbox.

Join 1,586 other followers

%d bloggers like this: