Patients with feared superbug shed large amounts of it from their skin

New research on a frightening new superbug confirms what scientists have both suspected and feared: Some hospitalized patients who carry the fungus shed large amounts of it from their skin, contaminating the environment in which they are being treated and leaving enough of it to infect others later on.

The bug, called Candida auris, is highly resistant to many existing antifungal drugs. It’s also resistant to regular cleaning methods, making hospital outbreaks incredibly difficult to stop.

C. auris acts more like bacteria than fungi, which do not normally cause hospital outbreaks. Its relatively recent emergence as a hospital-acquired infection has researchers scrambling to find out even the most basic information about it, like how it moves from patient to patient.

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The new work was conducted by scientists from the Centers for Disease Control and Prevention in conjunction with colleagues from the Chicago Department of Public Health. It was presented Sunday at the annual conference of the American Society for Microbiology in San Francisco.

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“As we’re struggling to control this organism, the reality is we don’t know how it’s spreading from person to person. We know that it does. But mechanistically we don’t know how. And so what this study was about was trying to identify the mechanism of how it can get from one person to the other,” said Joseph Sexton, a scientist with the CDC and the lead author of the work. “If we don’t understand how it spreads, we’re not going to be able to intervene.”

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Before members of the team could conduct the study, they had to figure out a way to quantify how much of the fungus was present in any one place — a basic step in studying many pathogens, but not easy to do with C. auris, said Johanna Rhodes, an epidemiologist at Imperial College London. Rhodes, who studies C. auris, was not involved in the CDC research.

“A lot of us have been scratching our heads as to how the heck do you do this?” Rhodes said of the task of trying to devise a way to quantify amounts of the fungus. “It doesn’t have the standard set of genes that you would expect to find. It’s just such a weird bug.”

She was excited to learn of the CDC’s work — both the development of the quantification methods and the findings of the study on transmission of C. auris. Lots of people studying the fungus have assumed what the CDC team found, but it’s critical to actually have data, she said.

“We’ve all kind of said, ‘Yeah, we think this is it. We think this is what happens.’ [But] they’ve done the work,” said Rhodes. “It’s fundamental in our understanding of how this is actually spreading.”

The superbugs are growing in strength and it’s our fault.
Hyacinth Empinado/STAT

The CDC and Chicago scientists studied 28 patients in an outbreak in what is called a ventilator-capable skilled nursing facility in Chicago. Facilities like these offer long-term care to very sick patients who are typically on ventilators, machines that breath for them. These are patients who are bed-bound.

The facility first discovered a patient carrying C. auris in March 2017. But by the time the study was done, 71% of the patients on the floor where ventilated patients are cared for were colonized with C. auris — meaning they carried it on their skin.

C. auris is an infection that is associated with patients with complex medical problems and compromised immune systems; it is generally not considered a risk to the average healthy person. But it can significantly complicate the care of people who are in intensive care units or other areas of hospitals that involve advanced care. About a third of patients who have tested positive for C. auris die, though it’s sometimes unclear if the infection was the cause of death.

The CDC-led team took skin swabs from 28 patients in the Chicago facility, swabbing their armpits and groins, which are among the places bugs that live on human bodies are often found.

They also tested a variety of surfaces in patient rooms — bed railings, doorknobs, and windowsills.

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Their hypothesis was that if patient shedding was responsible for spread, they would find more of the fungus in the rooms of patients who had more of it on their skin. And indeed, they found the rooms inhabited by patients with lots of C. auris on their skin were the most contaminated with the fungus.

All of the railings on beds housing patients with C. auris tested positive for the fungus. Even the railings of two beds that contained patients who didn’t have C. auris were contaminated. Sexton said study of the patient flow on the ward revealed the beds had previously been inhabited by patients who were C. auris-positive. “So we know that they’re not doing a good enough job disinfecting the bed,” he said.

Surprisingly, three-quarters of the windowsills were also contaminated with the fungus. That was unexpected — until the team realized that windowsills were used as de facto shelves in these rooms.

“If there is a takeaway it could be …. ‘Hey, we really need to pay attention to the bed and these other areas that the patient is in contact with,’” said Sexton.

‘White fungus’ just a normal fungal infection, black fungus more dangerous: Doctors

At a time when states are witnessing a rise in black fungus (mucormycosis) cases, a disease primarily affecting immunocompromised Covid-19 patients, reports of another fungal infection, called “white fungus” have caused a stir.

However, experts Indiatoday.in spoke to say there is no such disease as “white fungus”. The infection that is being reported is nothing but candidiasis, they said.

The first reports of ‘white fungus’ came from Patna, Bihar. However, the government-run Patna Medical College and Hospital (PMCH) dismissed these reports.

Now, a fresh case of so-called white fungus has been detected in Uttar Pradesh.

“White fungus is just a myth and misconception. It is basically candidiasis, a fungal infection caused by a type of fungus called Candida. It is the most common fungal infection,” said infectious diseases specialist Dr Ishwar Gilada.

READ | Black fungus: Top doctors answer all FAQs about new threat in Covid times

The experts also said there was no basis to reports that “white fungus” is more dangerous than black fungus.

Dr Kapil Salgia, pulmonologist at the Bombay Hospital, who has been treating black fungus patients, said mucormycosis was more invasive and might cause lot of damage to sinuses, eyes, brain and requires extensive surgery.

“Mucormycosis is more dangerous because it is normally not found in the human system, and we normally do not see many cases. Candidiasis is easily diagnosed and easily treated. Most of the times, it is not life threatening, unless you miss treatment or symptoms completely and it becomes invasive,” Dr Kapil Salgia said.

ALSO READ | Black fungus: Tracing existence of rare disease to pre-Covid times

Those with frail immunity, suffering from diabetes and have been on steroids during Covid-19 treatment for a long period are vulnerable to candidiasis.

“When Covid-19 becomes severe in patients and they become hypoxic, steroids are one of the mainstays of treatment besides antivirals and antibiotics. That predisposes the development of a fungal infection depending on the dosages of steroids given and how long they have been given. Steroids cause suppression of immunity,” said Dr Ishwar Gilada.

Experts said the most common candidiasis infection is oral thrush. “This infection generally affects areas or parts of the body that have a thin lining, mucocutaneous junctions like lips, nose, or inside the mouth and genital area,” Dr Gilada, known to be the first person to raise the alarm against AIDS in India, said.

He said the warning signs to look out for are headache, pain in one side of the face, swelling, loss of vision or diminishing vision and ulcer in mouth. A simple microscopic examination under 10 per cent KOH (potassium hydroxide) can be done to detect the infection, Dr Gilada said.

Dr Kapil Salgia said simple infection due to candida is more easily manageable clinically that black fungus. “For candidiasis there are many drugs. The most common is fluconazole and it settles down quite easily,” he said.

Top Fungal Infections of the Skin

The hot humid weather in India serves as a rich fertile medium for fungi to thrive and multiply. Fungal infections of the skin, hair and nails are extremely common in India, especially during the monsoons and along the coastal regions due to high humidity levels. Certain internal conditions like diabetes and impaired immunity further increase the risks of fungal infections. Here we look at some common fungal infections, what we can do to prevent them and how we can manage them effectively.

*Images courtesy: Shutterstock and Thinkstock/Getty Images

The hot humid weather in India serves as a rich fertile medium for fungi to thrive and multiply. Fun… Read More

The hot humid weather in India serves as a rich fertile medium for fungi to thrive and multiply. Fungal infections of the skin, hair and nails are extremely common in India, especially during the monsoons and along the coastal regions due to high humidity levels. Certain internal conditions like diabetes and impaired immunity further increase the risks of fungal infections. Here we look at some common fungal infections, what we can do to prevent them and how we can manage them effectively.

Read LessThe hot humid weather in India serves as a rich fertile medium for fungi to thrive and multiply. Fun… Read More

The hot humid weather in India serves as a rich fertile medium for fungi to thrive and multiply. Fungal infections of the skin, hair and nails are extremely common in India, especially during the monsoons and along the coastal regions due to high humidity levels. Certain internal conditions like diabetes and impaired immunity further increase the risks of fungal infections. Here we look at some common fungal infections, what we can do to prevent them and how we can manage them effectively.

Read LessPityriasis Versicolor:
This scary sounding name is a very common fungal infection that has minimal … Read More

Pityriasis Versicolor:

This scary sounding name is a very common fungal infection that has minimal symptoms and is very easy to treat. It appears as tiny white spots on the back and chest but sometimes it spreads to the face and lower body as well. The spots are initially 3-4 mm in size and may join up to form large areas of white-looking skin. This is a very common infection in coastal areas, but it is also seen in central and northern India. Men, women and children of any age can be affected. Sometimes the white spots become prominent after a beach holiday when the surrounding normal skin gets tanned. 

For More on Skincare: How to Get Soft Skin

Read LessTreatment
Treating this infection is very simple. The selenium sulphide present in certain shampoos… Read More

Treatment

Treating this infection is very simple. The selenium sulphide present in certain shampoos can be used, or ketoconazole-containing shampoos can also be used. Dermatologists usually prescribe anti-fungal creams or lotions, which need to be used for 6 weeks. Sometimes, in case of an extensive spread, tablets may also be prescribed. After the treatment is complete, it may take up to 9 months for the skin to return to its normal colour. It is very important to be patient and not panic during this stage.

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Read LessRingworm (Tinea):
This is also a very common fungal infection. It occurs most commonly in body fold… Read More

Ringworm (Tinea):

This is also a very common fungal infection. It occurs most commonly in body folds like the groin, armpits, between the fingers or toes, or in the fold beneath the breast tissue. It tends to be very itchy and may look red or dark in colour. This is extremely common in people with diabetes, especially during the monsoon season. 

For More on Skincare: Common Skin Rashes during Summers

Read LessTreatment
Treating this involves the use of anti-fungal creams for six weeks. Antifungal tablets ma… Read More

Treatment

Treating this involves the use of anti-fungal creams for six weeks. Antifungal tablets may be used in case of extensive involvement. Ringworm has a high tendency to recur however so it is important to keep the affected areas dry and moisture-free, during and after the healing phase. One needs to wear loose clothes of a breathable fabric, keep the body folds dry, use anti-fungal dusting powder in the body folds and in case of diabetes, get one’s blood sugar under control. All of these can be used as precautionary measures throughout the monsoon season for people who are prone to get repeated attacks of ringworm.

For More on Skincare: Lifestyle Factors Affecting Your Skin Health

Read LessThe same fungus can also cause infections in the scalp. This appears as a patch of hair loss with or… Read More

The same fungus can also cause infections in the scalp. This appears as a patch of hair loss with or without swelling in pre-pubertal kids. Treating this area requires anti-fungals for a long period and creams and ointments have very minimal benefit.

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Read LessA fungus of the same family can also infect the nails. Usually one or more nails may start to appear… Read More

A fungus of the same family can also infect the nails. Usually one or more nails may start to appear yellow or dark, usually starting from the tip and moving towards the body. The nail may appear to sit loosely on the nail bed and there may be accumulation of some powdery dust between the nail and the nail bed. This fungal infection of the nail is notoriously difficult to treat and requires long courses of anti-fungal tablets. It is advisable to get a nail clipping examined for fungal elements prior to initiating treatment and to ensure that the long course is completed.

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Read LessThrush:
This is an infection caused by a yeast called candida albicans. The most body part to get a… Read More

Thrush:

This is an infection caused by a yeast called candida albicans. The most body part to get affected is the genital area. It presents as a red or whitish itchy rash around the body openings. The itch is unbearable. It can be easily managed by using anti-fungal creams and ointments. In cases of very severe itching, a mild steroid cream may be added initially to give relief from the itching. In men, it can present as an area of redness with slight irritation on the penile skin. The area needs to be washed off with water, dried adequately and then an anti-fungal cream may be used.

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Read LessSometimes, thrush may also be seen in the mouth. This is quite uncommon and is usually seen in diabe… Read More

Sometimes, thrush may also be seen in the mouth. This is quite uncommon and is usually seen in diabetics, people with suppressed immunity or in people using inhalers containing steroids for managing their asthma. In this area, it may be associated with pain and difficulty in eating and swallowing. This needs dermatologist consultation for effective management.

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Read LessNappy rash in babies is also a form of thrush. The ammonia in the soiled nappy coupled with moisture… Read More

Nappy rash in babies is also a form of thrush. The ammonia in the soiled nappy coupled with moisture in the area due to occlusion with the nappy results in growth of this yeast. It appears as redness and the baby cries incessantly, especially during a nappy change. It is important to change nappies frequently, use a barrier cream liberally prior to using the nappy and try and minimise use of nappies to prevent this infection. Once the infection has occurred, in addition to the above measures, an anti-fungal cream will need to be used.

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Read Less

Google Pixel 6 and Pixel 6 Pro Review: Return of the Camera King

Stereo speakers flank the screen, and while they don’t sound as rich as the drivers on the iPhone 13 Pro, they’re still pretty darn good and loud. As on most of today’s high-end phones, there’s no headphone jack, MicroSD card slot, or charging adapter in the box, but there’s wireless charging, fast wired charging, 5G, Wi-Fi 6E, and water resistance. All the marquee features are here.

I’m happy to say the Tensor chip’s day-to-day performance is excellent. I’ve yet to see any slowdowns or stutters launching and switching between apps, and if it helps for reference, benchmark tests put it only slightly behind Samsung’s Galaxy S21 Ultra. 

I only ran into some resistance with the most graphically demanding game I could think of, Genshin Impact. I had to drop the graphics settings to low to be able to play it at around 60 frames per second (medium at 30 fps). The iPhone 13 Pro Max had trouble with the same title and needed some fiddling with the settings too, but Apple’s top-end phone is certainly more powerful than the Pixel, and gameplay wasn’t as choppy. The vast majority of games I tried, like Pokémon Unite, Hyperburner, and Dead Trigger 2, all ran flawlessly on the Pixels. 

I just have a few gripes. Most importantly, the fingerprint sensor: The physical, capacitive sensor on the back of the phone is gone, and now biometric authentication is handled by a fingerprint sensor built into the screen. It’s not very good. Sometimes it unlocks on the first try, but most of the time you need to tap your finger twice. I also have very rarely noticed some choppiness in Twitter specifically, but this isn’t always the case. Usually, the phone scrolls very smoothly. 

Then there’s the OLED screen. It’s readable outdoors, but it doesn’t get as bright as competing flagships, so you might find yourself squinting on sunny days. Also, the Pixel 6 is 6.4 inches and the Pixel 6 Pro is 6.7 inches, but they feel very similar because the latter has slimmer bezels and curved glass edges, maximizing the display’s real estate. That’s all well and good if you’re a fan of big-screen phones, but it would’ve been nice to have a noticeably smaller Pixel. 

Hot Pix

Photograph: Julian Chokkattu

Google Pixel 6, main camera. The perfect fall photo. The Pixel 6’s main camera delivers a sharp pumpkin and basks the whole patch in this wonderful golden yellow, while maintaining the moody sky and vibrant colors. 

Google’s phones have always taken excellent photos. But the hardware hasn’t changed much over the years, and that’s allowed competitors to sail ahead of the Pixel with regards to photo quality. Things will be different now that the Pixel’s camera has finally gotten a major overhaul. Both new models have a 50-megapixel main camera with a large sensor joined by a 12-megapixel ultrawide. The Pro adds its own 4X optical zoom telephoto for a versatile triple-camera array and optical image stabilization on all its lenses.

I’ve taken more than 300 photos over the past two weeks in an effort to compare photos from these two Pixels against their predecessor and competitors like the iPhone 13 Pro Max and Galaxy S21 Ultra. It’s tough to say the Pixels are the best camera phones around, only because they’re competing with the iPhone 13 Pro for that top spot. There are times when the iPhone pulled ahead and times when the Pixel came out on top. 

Rare fungal infections that destroy eyeballs and kill are on the rise in India

Enlarge / A health worker exits an ambulance outside a quarantine center in the Goregaon suburb of Mumbai, India, on Tuesday, April 27, 2021.

Covid-19 Coverage

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As the pandemic coronavirus continues to ravage India, doctors are reporting a disturbing uptick in cases of a rare, potentially fatal fungal infection among people recovered or recovering from COVID-19.

The infection is called mucormycosis, or sometimes “black fungus” in media reports, and it appears to be attacking COVID-19 patients through the nose and sinuses, where it can aggressively spread to facial bones, the eyes, and even the brain (rhinocerebral mucormycosis). In other cases, the fungus can also attack the lungs, breaks in the skin, and the gastrointestinal system or spread throughout the body in the blood stream.

A classic feature of mucormycosis is tissue necrosis—the death of flesh, essentially—which in the rhinocerebral form of the disease can lead to black, discolored lesions on the face, particularly on the bridge of the nose and the roof of the mouth. Mucormycosis is fatal in around 50 percent of cases.

If the fungus is able to spread to the eyes, patients may develop blurred vision, drooping eyelids, swelling, and vision loss. Patients may even need to have their eyes surgically removed to prevent the infection from spreading further, according to doctors who spoke to the BBC.

Dr. Akshay Nair, a Mumbai-based eye surgeon, told the BBC that he treated 40 patients with mucormycosis in April. Eleven of them needed to have an eye surgically removed.

The total number of mucormycosis cases in India is unclear, but media reports have tallied dozens to hundreds of cases. Dr. Renuka Bradoo, head of the ear, nose, and throat wing of Sion Hospital in Mumbai, told the BBC that doctors there have seen 24 cases of mucormycosis in the past two months. Usually, they see only about six cases in a whole year.

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Worse for diabetics

A report in The New York Times out of New Delhi relayed that local news media in the western state of Maharashtra, which includes Mumbai, had tallied around 200 cases. In the western state of Gujarat, state officials have reportedly ordered 5,000 doses of amphotericin B, an antifungal medicine used to treat mucormycosis.

The startling increase in cases may be explained by India’s high number of people with diabetes, coupled with poor hygiene amid the critical COVID-19 surge, doctors speculate. Mucormycosis is known to strike people who have compromised immune systems, especially people with diabetes—and those with poorly controlled diabetes in particular.

Not only does diabetes dampen immune responses, welcoming invasive fungi, it also provides a comfortable environment for the infections. Mucormycosis is caused by mucormycetes, a ubiquitous group of molds that live in soil and decaying organic matter, like wood, leaves, and compost. These molds love iron-rich, acidic environments, and diabetic ketoacidosis—a complication of diabetes that causes the blood to become acidic—is a key risk factor for developing mucormycosis. A literature review published in the New England Journal of Medicine in 1999 estimated that about 50 percent of all cases of rhinocerebral mucormycosis occur in people with diabetes.

India doesn’t have exceptionally high rates of diabetes compared with other countries. But because of its population of over 1.36 billion people, the country has one of the highest raw totals of diabetes cases in the world, estimated to be around 77 million people, second only to China. India also has some of the highest estimated levels of death and disability from diabetes, according to a study published in the journal Scientific Reports last year.

“Triple whammy”

Adding to this problem is the current COVID-19 crisis crippling India’s healthcare system. With hospitals overwhelmed, experts who spoke with the Times noted that many COVID-19 patients are being treated with oxygen at home without proper hygiene. Moreover, many COVID-19 patients are given powerful steroids—which further tamps down the immune system.

“You’ve got a high rate of mucormycosis, you’ve got a lot of steroids—maybe too much—being used, and then you’ve got diabetes, which is not being well controlled or managed,” David Denning, an expert in fungal infections at Manchester University, told the Associated press. It’s a “triple whammy,” he said.

Dos and don’ts to treat fungal skin infections

Suffer from fungal skin infections? Read this and follow the tips to treat the condition.

Written by Bhavyajyoti Chilukoti | Published : January 18, 2018 12:07 PM IST

Fungal infections are more common in people who use public transport and keep moving in crowded places as these infections are contagious. Fungal infections of the underarms, waistline in women and the groins are very common in the winters and summers because of humidity and heat. But if you get one, then what are your supposed to do to prevent the spread of the infection and treat it? Dr Rinky Kapoor, Consultant Dermatologist, Fortis SL Raheja Hospital, Mahim shares few dos and don’ts you need to follow to treat fungal skin infections. Here are few highly contagious skin diseases that you should be aware of.

Dos

1. Keep your hands clean. This is because hygiene and sanitation play an important role in treating and preventing fungal infections. You can use a hand sanitizer if washing your hands regularly is not a feasible option for you at your workplace.

2. Use anti-fungal powders in the body folds as they can help treat the infection and soothe pain and itching. If you are suffering from diabetes, you need to take special care as diabetics are more prone to fungal infections due to the uncontrolled blood glucose levels.

3. Using natural remedies to treat a fungal infection at home is not a bad idea. In fact, most people try to opt for home remedies. However, if using anti-fungal powders, home remedies and even maintaining hygiene and sanitation fails to show any sign of improvement in your condition, then consult a dermatologist.

4. There is a high chance of recurrence of fungal infections if proper guidelines are not followed. Hence, treat all infected contacts in the family or workplace or else you might be at a high risk of recurrence. It includes keeping your washroom clean, washing your clothes with disinfectant and using sanitizer to wash your hands.

Don’ts

1. Avoid wearing tight clothes like jeans and tight underwear as it decreases breathability and traps heat and moisture in your vagina. This becomes a feasible environment for yeast and bacteria to thrive and hence, further worsen the condition. Hence, wear loose clothes as it helps to prevent sweating and keep the area dry as much as possible.

2. Avoid using swimming pools if you have fungal infections as it not only moistens the skin and aids in the fungal growth but can also increase the chances of spreading it to others. Also, if the pool is not properly disinfected you can even get fungal infections from using it. Here are skin infections your razor can give you (and how to avoid them).

3. If you have fungal infections in the groin region or in the underarms, it is wise to prevent shaving. This is because any cuts in the skin can further make the condition worse and increase the risk of other infections as well.

4. Avoid overcrowded areas, if possible. And if you have to travel every day than ensure you take a shower once you reach home with an antibacterial soap

Image Source: Shutterstock

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What To Do When Earwax Becomes a Problem

Give your ears a gentle cleansing each day. The best approach: After washing your face or stepping out of a steamy shower, cover one finger with a damp washcloth and wipe around your outer ear. “De-clogging the most external exit will help with that natural migration,” Ying says.

People who tend to produce an abundance of earwax may try using a softening agent, to help the wax leave the ear or to remove it more easily. If you prefer to go the natural route, try baby oil or mineral oil. Using an eyedropper, apply a drop or two into your ear, tilting your head so that the opening of the ear is pointing up toward the ceiling. Stay in that position for a minute or two to let the fluid flow down to the waxy buildup. Then tilt your head in the opposite direction to let the fluid and wax drain.

Or try an over-the-counter product to loosen small amounts of wax. These solutions may contain oil or hydrogen peroxide. (Ying recommends the Debrox Earwax Removal Kit.) Some include a bulb syringe that you squeeze to flush your ear with warm water, if needed. Irrigation, however, isn’t always appropriate, particularly if you have a damaged eardrum or a middle ear infection. “You’re doing it blind,” says Ying. “You go, ‘Let me go in a little bit deeper,’ but you have no way to gauge that. What’s more, if you get it into the ear canal and it doesn’t come out, it can create a moist environment, and that can lead to an outer ear infection. “

It might be tempting to poke a cotton swab, bobby pin, pencil or finger into your ear to get the gunk out, but don’t go digging. Yes, it’ll remove some of the wax, but it may also push the rest deeper into the ear canal. There’s also a risk of injuring the eardrum. “You might look at your Q-tip and think, Look at this stuff I got out of my ear,” says Vaughan, who has seen plenty of this “pushy” behavior in his practice. “But that’s actually wax you got from the sides of the ear canal, after you’ve pushed most of the wax further inside the ear canal.”

When to get medical help

You’ll need assistance to remove a blockage. If the buildup is fairly close to the opening of the ear canal, a general practitioner can do the job. In fact, earwax removal is one of the most common otolaryngological procedures performed in a primary care setting. There are two common techniques doctors employ to remove impacted wax. One involves using a curette, a slender instrument designed to fit into the narrow ear canal, with a curved tip to scrape or scoop out wax. The other method is to use an irrigation device, like a rubber bulb syringe or a water pick filled with warm water (the flow of water is directed toward the sides of the canal to soften and dislodge accumulated wax).

There are risks to both methods, though. Scraping away with a curette can nick the skin in the ear canal, and sending a force of water into the canal can damage the eardrum or lead to infection if some of that liquid gets stuck behind the eardrum and isn’t able to drain properly.

If the ear is impacted with a hard, stubborn chunk of wax that’s really lodged in there, it’s time to bring out the big guns — namely, an ear, nose and throat doctor (that is, an otolaryngologist). This specialist has an arsenal of precise tools at his disposal to go deep, without harming the delicate eardrum. One method Ying uses involves a suspended surgical microscope, which lets her see deep inside the ear canal as she works; she dilates the ear canal with a speculum, then uses suction to dislodge the wax.

And a clean ear canal can make a world of difference. One study found that 35 percent of hospitalized patients over age 65 had impacted earwax and 75 percent of those had improved hearing after it was removed. Some experts estimate that removing an earwax plug can improve hearing by 10 decibels. (The difference between whispering and normal conversation is around 20 decibels.) Better hearing isn’t the only benefit. “There may be an improvement in your balance,” Vaughan says. “Some patients actually feel as though their lives have changed.”

90,000 Treatment of fungus in the ears (otomycosis) in children and adults

Fungal otitis externa is successfully treated in ENT clinic №1

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The problem of fungal infection of the external auditory canal (otomycosis) is growing every decade.This is due to the problem of a decrease in immunity, the frequent and uncontrolled use of antibiotic therapy, the dietary habits of a modern person, who consumes large quantities of food rich in carbohydrates, often leading to type 2 diabetes mellitus and an increase in blood glucose levels. All these reasons lead to an increased risk of developing fungal infections, including in the ear canal.

If we add to the overall picture the bad habit of “cleaning” or “scratching” the ears with all available items, naturally non-sterile (including the so-called “ear” sticks, which are also non-sterile), which helps to remove from the ear canal a natural defense factor – earwax and seeding at the same time with all conceivable and inconceivable bacterial and fungal microflora – we get the ideal soil for the formation of otomycosis.

What should be feared with otomycosis?

Fungal otitis externa has a tendency to chronicity of the process, the formation of a sluggish, constantly persistent process of fungal inflammation. At the same time, an increase in symptoms is provoked either by taking antibiotic therapy or by changes in the diet: an abundance of “fast” sugars – when the mushrooms begin to grow “by leaps and bounds.”

A long-lasting fungal process leads to sensitization (allergization) of the body, a decrease in immunity, and the presence of itching often leads to scratching and the danger of secondary purulent infection.

What can be troubling with fungal otitis externa

• Itchy ears
• Pain in the external auditory canal
• Wetness, “squelching” sensation in the ears
• Detachable more often ashy or moldy, with an unpleasant odor
• Peeling of the skin of the external auditory canal

What to do if you suspect otitis media?

First of all, immediately contact a specialized ENT clinic or ENT office. In Moscow, for example, in the ENT clinic number 1, where the otorhinolaryngologist will conduct an endoscopic examination of the ear, to clarify the diagnosis, he will take the discharge from the ear (smear) for mushrooms and prescribe a complex therapy for this disease, which includes local therapy, general therapy and physiotherapy.

One of the important elements of treatment is washing the ear canal with a medicinal solution in order to remove the mycelium of the fungus and inflammatory discharge, after which an ointment or drops with a therapeutic effect is injected on the turunda, it is necessary that the drug acts on the cleaned ear canal.

Red laser therapy is very effective for antifungal, anti-inflammatory and immunomodulating effects. The course of such treatment is 8-10 procedures.

After a course of complex therapy, it is recommended to give up the bad habit of “cleaning” your ears in order to enable earwax to protect you from such diseases in the future.

90,000 10 terrible diseases that destroy entire species of animals

• Shreya Dasgupta
• BBC Earth

April 10, 2015

Photo author, Getty

Epidemics of terrible diseases threaten not only humans.Our smaller brothers sometimes literally mow down about the same serious diseases – from Ebola and anthrax to cancer and plague, says the correspondent of

BBC Earth .

Outbreaks of fatal diseases can kill thousands of animals in a very short time. The situation becomes especially dangerous when it comes to rare or endangered species.

Over the past decades, many new animal diseases have arisen, and already known diseases have appeared in new territories.”The reason is, to some extent, the increase in trade and human migration, which contributes to the spread of pathogens in different regions,” – says Merm Kilpatrick of the University of California, Santa Cruz. Infections are transmitted between humans, domestic animals and wild animals.

The most serious threat to fauna continues to be the decline in habitat, often caused by the expansion of agricultural land. But disease can also lead to a significant decrease or even extinction of wildlife populations, emphasizes Richard Cock of the Royal Veterinary College in Hatfield, England.

In this article, we will focus on ten diseases that cause great harm to animals in the wild. Let’s start our list with the infamous ailment.

1. Ebola

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The Ebola virus is very dangerous for both chimpanzees and gorillas. It kills about 95% of infected individuals

We perceive Ebola as a human disease, and there is an obvious explanation for this: the outbreak of this fever last year claimed about 10 thousand lives.But she also walked through the populations of our closest relatives, great apes.

In the early 1990s, Ebola mowed flocks of chimpanzees in Tai National Park in Ivory Coast, Africa. In the next decade, several outbreaks of the disease in the Republic of the Congo severely thinned the gorilla population there: in 2002-2003, a fever killed about 5,000 endangered primates in the Lossi Reserve, and then, in 2003-2004, hundreds of gorillas in Ozala National Park were destroyed.

The Ebola virus is very dangerous for both chimpanzees and gorillas. It kills approximately 95% of infected individuals, causing severe fever and bleeding.

This threat becomes even more serious when it is superimposed on other factors dangerous for great apes – poaching and deforestation. Uncontrolled hunting has reduced the number of gorillas and chimpanzees so much that Ebola has the potential to completely wipe out some populations, says Julia Jones of Bangor University in the UK.

One of the solutions to the problem could be the Ebola vaccine. By 2014, scientists had tested this drug on a group of captive chimpanzees, and it proved to be safe and effective.

2. Chytridiomycosis

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Over the past 30 years, the deadly fungus has caused a catastrophic decline in the number of more than 200 species of amphibians.Over the past 30 years, it has caused a catastrophic decline in the number of more than 200 species of amphibians, and some of them have even become extinct.

For example, an epidemic in Panama’s El Copé National Park in the early 2000s destroyed 30 species. Five of them were not previously known to science.

This fungus with the Latin name Batrachochytrium dendrobatidis is found on all continents except Antarctica. It affects the outer layer of the skin of amphibians. Because frogs and salamanders absorb nutrients and water through their skin, infection kills them over time.

However, this fungus has not always been so harmful. For more than 100 years, it has not caused any harm to amphibians in some of their habitats, for example, in the US state of Illinois and in Korea.

Not all infected species die from infection. Some of them, such as the American bullfrog and the African smooth clawed frog, are resistant to the dangerous fungus. These species are thought to have contributed to the spread of the disease, although the international amphibian trade also played a role, Kilpatrick notes.

3. West Nile encephalitis

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Mosquito-borne virus infected and killed millions of birds in the United States, Mexico and Canada

In 1999, the American city of New -York has become the epicenter of the outbreak of a dangerous disease. People went to hospitals with encephalitis: their brains were inflamed. Around the same time, several city crows and other birds from the Bronx Zoo were found dead. In all these cases, the West Nile encephalitis virus, which at that time was found mainly in Africa and Asia, was the culprit.

This mosquito-borne virus has since infected and killed millions of birds throughout the United States, Mexico and Canada. The virus has been found in 48 species of mosquitoes and 250 species of birds, and is sometimes transmitted to humans and horses.

In some areas, due to this disease, the number of American ravens has decreased by 45%. The virus has also led to significant declines in the numbers of other bird species such as the wandering thrush, eastern sialia, tufted tit and titmouse. Nevertheless, according to Kilpatrick, they are not threatened with complete extinction from West Nile encephalitis.

However, other, rarer species are under threat. Scientists have developed an antiencephalitis vaccine for the California condor and for the island bush jay, which is found only on Santa Cruz Island off the southwest coast of the United States. Vaccines are now being tested for other species of birds.

4. White Nose Syndrome

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Almost six million bats have died as a result of the White Nose Syndrome epidemic, and some species have declined by 99%

In 2006, an amateur caver took a photograph of a bat in a cave near Albany in the US state of New York.The bats’ nose was covered with a white fungus. This image was the first photographic evidence of a dangerous epidemic hitting bats in North America. The disease, dubbed “white nose syndrome”, quickly spread throughout the United States and Canada.

As a result of the epidemic, almost six million bats have died, and the number of species – for example, the North Queensland smoothnose – in the northeast of the continent has declined by 99%. “White nose syndrome is seriously affecting the bat populations of North America,” says Kok.

The disease causing fungus is called Pseudogymnoascus destructans. It disrupts the hibernation of bats. Instead of sleeping in their caves, bats fly too far from their den, even in the daytime. They quickly deplete their stores of subcutaneous fat and starve to death.

The infection may have come from Europe, where it does not have any noticeable dangerous effect on local bats. Restricting human access to caves and protecting bats’ habitats are considered as possible measures to combat the epidemic.

5. Anthrax (anthrax)

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In 2004, in the Malilangwe Reserve in Zimbabwe, anthrax destroyed about 90% of the local population of wild herbivores

Anthrax as a weapon of bioterror. However, this disease has threatened the fauna from time immemorial. It mainly affects herbivores, but it can also be transmitted to other mammals, including some predators, great apes and humans.

Anthrax infection can have different consequences, and they depend on the type of animal and the ecosystem in which this species lives. In areas such as Etosha National Park in African Namibia, the disease is considered a natural component of the environment, and attempts to control it were abandoned in the early 1980s, says ecologist Wendy Turner of the University of Oslo in Norway.

Occasionally, however, anthrax outbreaks become deadly.For example, in 2004 in the Malilangwe Nature Reserve in Zimbabwe, anthrax destroyed about 90% of the local population of wild herbivores. In 2010, a similar outbreak in Uganda killed more than 80 hippos.

Anthrax spores (Bacillus anthracis) can live in the soil for several years and infect grazing livestock and, through it, people. It is worth vaccinating domestic herbivores regularly to fight the disease, Turner said.

6. Tasmanian devil facial tumor

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For the first time a facial tumor in Tasmanian devils was noticed in 1996, and since then it has destroyed up to 90% of some populations of these animals

A strange epidemic of contagious cancer has broken out among the Tasmanian devils in Australia.This cancer is passed from one animal to another when they bite each other. And they often do this, fighting for food or for sexual partners.

This disease is often fatal. Large cancerous tumors appear on the muzzles of infected devils, which subsequently spread throughout the body and kill the animal within several months.

According to scientists, initially the disease appeared in the so-called Schwann cells of the nervous tissue in only one animal.However, then cancer cells began to spread from one Tasmanian devil to another, which was facilitated by the tendency of these animals to fight.

Genetically, all Tasmanian devils differ very little from each other, and, as a result, their immune systems are not able to provide strong resistance to cancer. The disease was first noticed in 1996, but since then it has wiped out up to 90% of some populations of these animals.

To protect the species, scientists have created in captivity “reserve populations” of about 500 healthy Tasmanian devils.Within these populations, 98% of the genetic diversity of the entire species is represented.

7. Canine plague

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In the late 2000s, canine plague destroyed 49 of 52 captive hyena dogs in Tanzania – in just two months

Canine virus plague, which has appeared in domestic dogs, destroys wild predators around the world. This virus is very similar to the causative agent of human measles, it affects the respiratory, nervous and digestive systems of animals.

In 1985, canine plague struck black-footed ferrets in the US state of Wyoming. Then, in the early 1990s, it killed many hyena dogs in Africa, as well as about 1000 lions. And in the late 2000s, the virus killed 49 of the 52 captive hyena dogs in Tanzania in just two months.

As the number of domestic dogs grows, the disease spreads to new territories and is transmitted to an increasing number of predatory animal species. In particular, the rare Amur tigers living in the Russian Far East have suffered from it.

Vaccination of domestic dogs can limit the spread of the virus to some extent. However, this is not quite enough, as other animals can also carry it. To save rare species, it may be necessary to undertake targeted vaccination.

8. Chlamydia

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Chlamydia has reduced the number of koalas in some parts of Australia from 60 thousand in the mid-1990s to 10 thousand in 2012.

Australian koalas suffer from a sexually transmitted disease, chlamydia, which also occurs in humans. This disease can deprive an infected koala of the ability to reproduce, lead to infections of the genitourinary and respiratory systems, blind or even kill the animal.

Overlapping with drought, chlamydia has reduced the number of koalas in parts of Australia from 60,000 in the mid-1990s to 10,000 in 2012. The populations were hardest hit in the states of Queensland and New South Wales.

In order to detect infection in time, some veterinarians resort to ultrasound scanning of animals instead of traditional smears. In addition, scientists have begun sequencing the genes of koalas, including those that play a key role in their immune system. Experts hope to understand how the disease affects these genes.

The situation is complicated by another disease – the koala retrovirus, similar to the human immunodeficiency virus. It suppresses the immune system, making animals less resistant to chlamydia.

These two diseases, as well as the destruction of the habitat of koalas and the threat from other species, have put these cute animals on the brink of extinction. However, there have already been successful tests of a vaccine that may be able to save them.

9. Itchy scabies

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It is believed that all foxes on the Danish island of Bornholm have died of scabies

Itchy scabies, as the name suggests, causes severe itching and an overwhelming urge to itch, which can lead to infections and even death.It is caused by a microscopic parasite – itch mite.

This disease affects over 100 species of animals, from Australian wombats to European foxes and lynxes and North American wolves. A close relative of the animal scabies mite causes scabies in humans.

The tick bites under the skin and the scabies it leaves behind becomes inflamed. The infection spreads with constant scratching. Over time, the animal can lose hair, begin to suffer from dehydration, hypothermia and hunger, and in some cases even die.

In many stable populations, scabies does not have a long-term effect on animal numbers. But the disease can prove fatal to populations that are already endangered or living in isolation. For example, it is believed that all foxes on the Danish island of Bornholm have died out from scabies.

To get rid of scabies in certain groups of animals, veterinarians use antiparasitic drugs such as ivermectin.

10. Plague

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In parts of North America, plague has destroyed entire colonies of prairie dogs.The mortality rate from it is over 90%.

The same bacterium that caused devastating plague epidemics in human civilization (including the European “black pestilence” of the mid-14th century) also mows down representatives of the animal world. This is the plague stick of Yersinia pestis.

Animal plague was first observed in North America in the early 19th century. Perhaps the ships that came from the plague-affected regions of Europe and Asia brought with them infected fleas and rats, which transmitted the plague bacillus to the local fauna, which had not previously encountered the plague.

Plague has wiped out entire colonies of prairie dogs in parts of North America. The mortality rate from it in these animals was more than 90%.

The disappearance of prairie dogs has in turn led to a decrease in the number of black-footed ferrets. This is one of the rarest species of North American animals, they feed mainly on prairie dogs and raise offspring in their burrows. Therefore, ferrets depend on prairie dogs, not to mention the fact that the plague is also deadly for them.

Endangered ferrets have begun to be bred in captivity and re-released into the wild, and their numbers are now slowly increasing. Vaccination of ferrets and prairie dogs with vaccine baits can also help stop the spread of plague.

Science: Science and technology: Lenta.ru

Leprosy has left a deep mark on the history and culture of mankind. Until now, lepers are perceived as people who carry a threat and from whom you need to stay away. In the past, the disease was very common, and the only effective control was the expulsion of the sick from society, which is still practiced in some countries.”Lenta.ru” tells about leprosy, which became the scourge of Europe before the plague and cholera and continues to terrorize the poor, despite the efforts of international health organizations.

Compared to cholera and plague, lepra is a silent and latent disease. After infection, it can take ten or even twenty years before the first symptoms appear. First, pain-insensitive spots appear on the skin, the arms and legs begin to go numb. It is very important to start treatment as soon as possible, because a few months after the disease manifests itself, irreversible damage to the peripheral nerves occurs.The person loses control of the muscles and becomes paralyzed. But even earlier, the body is attacked by secondary infections that affect the eyes, skin, mucous membranes and articular cartilage in the hands and feet. The fingers are deformed and shortened due to the death of the phalanges, facial features are distorted, trophic ulcers are formed.

By itself, the causative agent of leprosy – mycobacterium Mycobacterium leprae – is not a deadly killer like the plague bacillus or Vibrio cholerae. It is an obligate parasite that cannot live outside human cells, so it is in its interest not to kill the host quickly.But it destroys the body’s primary protective barrier, leaving a person vulnerable to many other pathogens. Secondary infections are the leading cause of death in patients with leprosy.

Affected areas of the skin

A person with leprosy becomes a carrier of mycobacteria, infecting other people. The risk group includes people living in poor countries suffering from malnutrition and reduced immunity. Although it is still not entirely clear how M. leprae enters the body, it is believed that infection occurs through the upper respiratory tract.It is now known that one-time close contact with someone with leprosy, such as shaking hands or being near an infected person, rarely leads to infection. M. leprae is not sexually transmitted or passed into the unborn child when the carrier is a pregnant woman.

Lepra is one of the oldest diseases that was known in ancient China, India, Egypt, Greece and Rome. The first mentions of it date back to 600 BC. At the same time, other fungal skin diseases were often confused with leprosy.The word “leprosy” itself comes from the ancient Greek Λέπος, which means “scales”, and literally translates as “a disease that makes the skin scaly.” This word was used to refer to any skin disease leading to peeling, but then it became associated with leprosy.

Before the advent of modern medicine in Africa and Eurasia, the fungus Trichophyton Trichophyton schoenleinii was common, causing favus, or scab, in which a hard crust forms on the skin. Patients with favus or psoriasis were also declared lepers, expelled from society, or ended up in leper colony.Syphilis was sometimes confused with leprosy.

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00:01 – May 6, 2020

In the Middle Ages, in the XI century, a major epidemic of leprosy broke out in Europe. Among the experts, there is still no single picture of where the disease came from. Many experts believe that the outbreak was caused by the Crusades, as a result of which M. leprae arrived in Europe from Palestine. Leprosy could get to England with the Vikings, who brought the fur of infected squirrels from the continent.According to an alternative hypothesis, leprosy originated in Europe itself and existed for several thousand years. In any case, the disease spread widely in the XII-XIV centuries, reached its peak in the XVI century, and then suddenly retreated, turning into a “forgotten disease”. It is now found only in poor countries.

The medieval epidemic led to the emergence of leper colony – treatment and isolation centers for the care of the sick. Leprosaria have become the main means of containing the disease. Leprosy was so widespread that in some regions it affected about three percent of the population.Naturally, all the sick leper colony could not accommodate, so often lepers were declared “untouchable”, they were forced to wear recognizable closed clothes and carry bells, which warned others about the approach of the patient with their ringing.

Picture of a leprosy patient

The myths about leprosy, popular at that time, made the disease worse than it is. It was believed that leprosy is a divine punishment, which means that the patient carries evil in himself, is sinful and is able to harm others.The infected were perceived by society as damned and unclean in spirit, they were expelled from the city, and experts on sins – priests – were engaged in diagnostics and “treatment”.

Lepra put the stigma of curses on people, they were considered almost dead and arranged a “live” funeral for them, after which they were forever expelled from society. There are also known cases of reprisals against the sick, when lepers were buried alive in the ground, burned at bonfires like sorcerers, thrown into gorges or drowned.

Leprosories were created at monasteries where the sick could feel relatively safe, and the healthy citizens felt relieved that the lepers stayed away from them.By the 13th century, up to twenty thousand leper colony appeared in Europe, including hospitals under the Order of Saint Lazarus, later called infirmaries.

Although leper colony limited the spread of the disease to some extent, the main reason for the end of the epidemic, as shown by recent studies, was the development of resistance among the population of Europe. Reconstruction of the genome of mycobacterium showed that the causative agent of leprosy has hardly changed genetically, and modern strains are identical to the ancients. This means that the epidemic is not over because the pathogen itself has somehow changed.The high prevalence of leprosy has led to the fact that among Europeans, more and more people are resistant to the disease. This was influenced by natural selection, including the lifelong social isolation of the sick, who lost the opportunity to continue their race.

Hansen’s wand

A breakthrough in understanding the disease was made in the 19th century, when the Norwegian doctor Gerhard Hansen discovered the true culprit of leprosy – M. leprae . He showed that the disease was not inherited, as some of his colleagues believed.Hansen demonstrated that the isolation of patients had a strong scientific basis: the disease was caused by microorganisms that could be transmitted from person to person. On the recommendations of a doctor in Norway, patients were prohibited from free movement around the country, they were required to be isolated in hospitals or stay at home. Such measures have shown high efficiency, because as a result, the incidence of leprosy fell sharply. The Norwegian experience was then adopted by other European countries.

There was no effective treatment for leprosy until the 1940s, when promin was synthesized – at that time the only known drug with bactericidal activity against M.leprae . However, already in the 60s, mycobacteria developed resistance to it, so doctors switched to other compounds: clofazimine and rifampicin. Then doctors began using all three drugs as combination therapy, which prevented the emergence of resistant strains of the bacterium.

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Now around the world there are about 200 thousand cases of leprosy per year, but with timely diagnosis, the disease is completely curable.