Lactose Intolerance in Europe

Tthere's an article about lactose intolerance at Food Reactions, with a map showing the percentage of people with primary lactase deficiency (the genetic inability to produce the lactose-eating enzyme lactase) across Europe.

In a review by Gudmand-Hoyer E in published on The American Journal of Clinical Nutrition (1994), [primary lactose deficiency] is lowest in Scandinavia and Northwest Europe (3-8%) and close to 100% in most of Southeast Asia. In Europe the frequency increases in the southern and eastern directions, reaching 70% in southern Italy and Turkey. There is also a high prevalence of lactose maldigestion in the people of Africa with the exception of cattle-raising nomads. Moreover, studies conducted by Scrimshaw and Murray and Sahi review the prevalence of lactose maldigestion globally. The prevalence is above 50% in South America, Africa, and Asia, reaching almost 100% in some Asian countries.

If you look very carefully at the map, though, you will see that the rate of lactose intolerance reaches not just 70% in Sicily but a pan-European high of 81% just north of Napoli (around the lower calf of Italy, above the spur). This region is called Campobasso, and it's where I get my gene for hypolactasia.

Via ProMED-mail: the South Carolina Department of Health and Environment Control reports on a rabid raccoon that exposed sixteen people to rabies, because they wouldn't let Darwin be Darwin.

Sixteen people who were exposed to rabies by a raccoon are under the care of a physician after the raccoon tested positive for the disease, the S.C. Department of Health and Environmental Control said today.
"The baby raccoon was found in the woods and was being cared for by several people over the past several weeks," said Sue Ferguson of DHEC's Bureau of Environmental Health.
According to Ferguson, many of the exposures occurred when feeding the raccoon, as caretakers came into contact with the animal's saliva. Seven more people are being evaluated for possible exposure risk.

Biolab Follies

Via Universal Hub: the Boston Phoenix reports on BU's ongoing "Biolab Follies."

Throughout the past few years, and particularly during the past 12 months, the biolab’s backers have suffered a string of setbacks: legal, diplomatic, political. Boston University Medical Center (BUMC) may still end up hosting a BSL-4 facility, but this is hardly the sure thing it once was. In fact, given the current momentum of the debate, the smart money might actually be on the biolab not coming to fruition, at least as it was originally conceived.
So what went wrong, exactly? Or, for those who see things differently: what went right?

The story chronicles the political side of the biolab debate, with, perhaps, too much attention to race and too little to zombie protesters.

Heparin Tainting Deliberate

I found this report accidentally in a Parkinson's search, because the CEO of Baxter happens to be one Robert Parkinson. The Chicago Tribune reports that Parkinson called the contamination of its heparin supplies a "deliberate adulteration scheme" by suppliers in China. (PlagueBlog is shocked that such a thing could happen.)

The scale of the scandal over tainted heparin continued to expand. David Strunce, chief executive of Wisconsin-based Scientific Protein, acknowledged that the company has no way of knowing which of 12 different suppliers might have introduced foreign matter into the heparin supply chain. Strunce also claimed Chinese regulators have interfered with his company's efforts to investigate the matter.
The FDA has tallied more than 80 reports of deaths and more than 1,000 adverse events associated with patients in the U.S. who had one or more allergic reactions to heparin products, including those sold by Baxter, since Jan. 1, 2007.

As a result, the Chicago Tribune also reports, Baxter is considering getting out of the heparin business altogether:

The product generates $30 million of Baxter's more than $11 billion in annual sales, and Wall Street analysts asked Parkinson last week whether it was worth the legal risks and liability to remain in the business given that sales are so small.
"We haven't made a decision whether or not we are going to re-enter [the market] with heparin," Parkinson told analysts.

PlagueBlog recommends producing drugs, including their ingredients, domestically.

Rabies on the Cape

Via an unnamed source: the Cape Cod Times reports two cases of rabies in pet cats in the past two weeks.

The discovery of rabies in the cats has dire public health implications, local veterinary and natural resources officials said yesterday. They urged residents to make sure their cats, as well as dogs and ferrets, are vaccinated.
Cats are the "perfect bridge to human health," said Dr. Thomas Burns, president of the Cape Cod Veterinary Medical Association, who treated the Yarmouth cat.
Officials fear an unvaccinated house cat could contract rabies, pass it on to a person before exhibiting symptoms, then wander off and die in the wild. The person might not be aware of the infection, the officials said.

PlagueBlog fondly recalls the days when ferrets were illegal in Massachusetts and continues to recommend fish--the perfect pet and the perfect food.

Heavy Drugs

Via Universal Hub: Xconomy reports on a Lexington (Mass.) company that plans to build better drugs with deuterium.

Concert Pharmaceuticals may have found a way to help established drug substances pack a better punch. By substituting a few normal hydrogen atoms with the heavier form, deuterium, the company believes it is possible to create new chemical entities with greater efficacy and fewer side effects. And since these entities are based on proven drugs, the reasoning goes, it will probably take less time and money to take them to the market.

Magic Finger Powder

Via plime: the BBC reports on an Ohio man who allegedly regrew a severed fingertip using his brother's experimental extra-cellular matrix.

"There are all sorts of signals in the body," explains Dr Badylak.
"We have got signals that are good for forming scar, and others that are good for regenerating tissues.
"One way to think about these matrices is that we have taken out many of the stimuli for scar tissue formation and left those signals that were always there anyway for constructive remodelling."
In other words when the extra cellular matrix is put on a wound, scientists believe it stimulates cells in the tissue to grow rather than scar.

Heparin Update

Via ProMED-mail: The New York Times reported the latest news on the counterfeit heparin scandal this week.

The F.D.A. sent a warning letter on Monday to Changzhou SPL, the Chinese plant identified as the source of contaminated heparin made by Baxter International in the United States. It warned that the plant used unclean tanks to make heparin, that it accepted raw materials from an unacceptable vendor and that it had no adequate way to remove impurities.
Heparin is made from the mucous membranes of the intestines of slaughtered pigs that, in China, are often cooked in unregulated family workshops. The contaminant, identified as oversulfated chondroitin sulfate, a cheaper substance, slipped through the usual testing and was recognized only after more sophisticated tests were used.
The F.D.A. has identified 12 Chinese companies that have supplied contaminated heparin to 11 countries — Australia, Canada, China, Denmark, France, Germany, Italy, Japan, the Netherlands, New Zealand and the United States. Deborah Autor, director of compliance at the F.D.A.’s drug center, said the agency did not know the original source of all the contamination or the points in the supply chain at which it was added.
Officials have discovered heparin lots that included the cheap fake additive manufactured as early as early as [sic] 2006, although a spike in illnesses associated with contaminated heparin began in November and persisted through February, officials said.

China apparently admits to the contamination but denies that it caused any adverse reactions. All PlagueBlog recommendations concerning China still stand.

The Smoking Hamster

Via an unnamed source: WBZ reports that a local woman is suing PetSmart for selling a diseased (Lymphocytic choriomeningitis) hamster to a Rhode Island woman who later passed away and donated her organs. The plantiff's husband received a liver, and also died.

Magee claims her husband died because the liver he received was infected with the rodent-borne disease. Five days after the transplant, which was performed at Mass. General Hospital, Magee's husband developed a high fever and began to bleed internally. According to Magee, one of his lungs collapsed.
He died about one month after the transplant.
The suit filed against PetSmart also alleges two other people also died after receiving organs from the same donor who bought the hamster.

If you must have pets, PlagueBlog recommends fish.

MS, Gout, and Lactose

Via Mathilda37, a paper from 1998 on the inverse relationship between multiple sclerosis and gout:

A possible association between multiple sclerosis (MS), the disease on which EAE is modeled, and uric acid is supported by the finding that patients with MS have significantly lower levels of serum uric acid than controls. In addition, statistical evaluation of more than 20 million patient records for the incidence of MS and gout (hyperuricemic) revealed that the two diseases are almost mutually exclusive, raising the possibility that hyperuricemia may protect against MS.

Here's her analysis:

No-one with MS has gout, no-one with gout has MS[.]
So what? Well, this is really, really important. It means that something about gout effectively puts the brakes on MS, and the causal factor of gout is high uric acid levels in the blood. It turns out that MS sufferers tend to have very low uric acid levels in their blood, and so can’t get gout.
This explains why some of the MS treating diets have worked in the past. They all seem to require ‘no dairy’ . This works because… consumption of dairy products lowers the risk of gout attacks, so you are looking at a factor that lowers blood uric acid levels. The lactose seems to be the real culprit, as cheese and butter didn’t seem to have any effect on the gout sufferers[.]

The Picky Pox

Via Universal Hub: corrections and reflections on the smallpox inoculation scene in the John Adams miniseries from J. L. Bell.

The actual inoculation process shown on screen—scraping pus from an infected person’s sores and inserting it into a cut on the inoculatee—was one of the cruder medical protocols of the time. Physicians also used ground-up scabs and threads dipped in pus to transmit the disease. They looked for infected people who seemed to have mild cases. According to an anonymous commenter on this posting, the series showed pus too thick to be from the early stage of the disease, and thus not contagious. I must confess that I don’t know my pus that well. But I commend the miniseries for including this unattractive but common aspect of eighteenth-century life, even within the confines of its budget.

Intestinal Dysbiosis

Via Henry Bauer: an alternative theory to explain classic AIDS (as opposed to the more widely-defined HIV/AIDS of today), intestinal dysbiosis.

One thing that those who reject the HIV/AIDS hypothesis agree on is that HIV is not the cause of AIDS. But when it comes to alternative theories of causation, disagreement abounds. And some of the most vexing questions surround the earliest cases of AIDS, those that were initially dubbed Gay-Related Immune Deficiency (GRID). Why did it originate in some gay communities? Why did this happen in the late 1970s and early 1980s? Why in the particular form of PCP (Pneumocystis carinii pneumonia), candidiasis, KS (Kaposi’s sarcoma)? And why still do gay men so often test “HIV+”? Why do some “HIV+” people thrive without medication while others get ill?
Here’s a suggestion that answers all those questions in a coherent way. [...]
Inadvertent alteration of these intestinal microflora may eliminate beneficial bacteria while simultaneously promoting the proliferation of harmful microbes. This state, intestinal dysbiosis, can lead to a series of problems, problems which taken together may explain much of what is called AIDS, at least with respect to some groups of gay men.
First, the lining of the gut may become more porous than normal, a condition known as increased intestinal permeability or leaky gut (2). This then allows microbial translocation—a flood of antigens into the blood stream—to occur, which in turn sets off a systemic immune response and the production of large numbers of antibodies to lots of different things. This condition, hypergammaglobulinemia—too many antibodies to too many things—is a known cause of false-positive reactions on the “HIV tests”.

PlagueBlog recommends not delving too deep (i.e., more than three pages) into the PDF if you're squeamish. This is not a pretty theory, and that may be its main disadvantage in the marketplace of ideas.

HIV Dissent

Via a mailing list and three degrees of separation, I came across this recent article: Questioning HIV/AIDS by Henry H. Bauer, in the Journal of American Physicians and Surgeons (Winter 2007). It gives an overview of the history of HIV theory and its discontents:

For more than two decades, dissenters from the assertion that HIV = AIDS have published books and articles and maintained a presence on the Internet, but major media have paid little if any attention; thus most people seem unaware that there are any serious doubts about the matter. The media silence was breached briefly in 2000 when President Thabo Mbeki of South Africa convened a group comprising both HIV/AIDS believers and HIV/AIDS skeptics to advise him on the scientific status of the issue. However, the media coverage gave short shrift to the doubters’ views by comparison to the believers’ Durban Declaration with its 5,000 signatures, which asserted: “The evidence that AIDS is caused by HIV-1 or HIV-2 is clear-cut, exhaustive and unambiguous, meeting the highest standards of science.... It is unfortunate that a few vocal people deny the evidence. This position will cost countless lives.”

The author goes on to point out, as so many HIV dissenters have, that science is backed up with citations, not signatures, and that no such "clear-cut, exhaustive, and unambiguous" connection between HIV and AIDS has been established. You can read much more about it in his blog.

Autism as Diagnostic Substitution

Half Sigma cites a two-year-old paper from Pediatrics to explain the autism "epidemic" as a change in diagnostic categories, rather than any known increase in the incidence of autism. The Contribution of Diagnostic Substitution to the Growing Administrative Prevalence of Autism in US Special Education reported the following results:

The average administrative prevalence of autism among children increased from 0.6 to 3.1 per 1000 from 1994 to 2003. By 2003, only 17 states had a special education prevalence of autism that was within the range of recent epidemiological estimates. During the same period, the prevalence of mental retardation and learning disabilities declined by 2.8 and 8.3 per 1000, respectively. Higher autism prevalence was significantly associated with corresponding declines in the prevalence of mental retardation and learning disabilities. The declining prevalence of mental retardation and learning disabilities from 1994 to 2003 represented a significant downward deflection in their preexisting trajectories of prevalence from 1984 to 1993. California was one of a handful of states that did not clearly follow this pattern.

Counterfeiting Heparin

Via ProMED-mail: the ever-widening counterfeit Chinese heparin scandal doesn't seem to have hit the news very hard compared to the ongoing downers-for-dinner scandal, even though the downer recall is merely punitive in comparison with the recall of half the nation's heparin supply, and especially when you consider that the recall itself was delayed by the FDA because the basic need for heparin outweighed the serious safety concerns.

Heparin is a blood thinner administered to most inpatients, as well as to dialysis patients. It is derived from pig intestines; the raw ingredient is imported from China, before or after processing. Last week the New York Times reported on the discovery of the subtle counterfeit substance intended to pass for real heparin--and no such adulteration in heparin batches known not to cause adverse reactions. This counterfeit ingredient has evidently caused 19 deaths and almost 800 non-fatal adverse reactions so far.

German patients have also suffered adverse reactions leading to a recall, and as a precaution Japan recalled all heparin associated with a suspect Chinese producer late today.

Considering the malice aforethought involved in this sort of counterfeiting and the fact that it's hardly the first time, PlagueBlog recommends cutting off trade relations with China.

Nosocomial Hepatitis C

Via ProMED-mail: everybody is reporting on the multi-incident iatrogenic transmission of hepatitis C at a clinic in Nevada. (Here, for example, is the report from Fox5 News, Las Vegas.) The Southern Nevada Health District site has a FAQ with graphics of the smoking syringe:

Following a joint investigation with the Nevada State Bureau of Licensure and Certification (BLC) and with consultation from the Centers for Disease Control and Prevention, the health district determined that unsafe injection practices related to the administration of anesthesia medication might have exposed patients to the blood of other patients.

Cure Your Own Cancer

Via plime: the AP reports on a Duke University student working to find a cure for his own rare form of cancer:

Chordoma — the cancer Josh learns he has — is a one-in-a million disease. Just 300 people get the terrible news each year, not even one per day. It strikes all ages, at different spots along the spinal column. The tumors can be removed, but the cancer is relentless. Chemotherapy doesn’t work. Life expectancy is around seven years.
The MRI shows Josh’s tumor is in a tough spot, in a bone inside his skull. It extends onto his brain stem and wraps around several arteries. There are two surgeries, then weeks of recovery in the hospital. He and Simone pass the time reading whatever they can about the disease.
There isn’t much. The massive apparatus of medical research — pharmaceutical companies, foundations, universities, government agencies — is utilitarian. High-prevalence diseases are at the front of the line, rare ones like chordoma usually at the back.
But then, a stroke of good fortune. It turns out that the only researcher in the country with a grant to study chordoma happens to be at Duke, working in a VA lab across the street from campus.

Josh later cuts back on his research activities in favor of the Chordoma Foundation which he and his mother founded to better organize research into chordoma. The article also mentions a few other patient-researchers.

Acromegaly in the News

Via pilme: the Daily Mail reports on a chance meeting at a restaurant that led to a diagnosis of acromegaly, a rare condition that affects 3 people in a million.

The life-saving handshake happened on December 6, when lifelong friend Rob Thompson brought Dr Britt to an Italian restaurant Mr Gurrieri runs in Canary Wharf.
"I came out to meet them at the door. My friend, Rob, brought Chris along for the first time," he said.
"We shook hands and I sat them down at the table. He didn't say anything to me at the time but he turned to Rob as soon as he sat down and said 'I'm sure he has acromegaly, I can tell you. I'll stake my career on it.'
"Rob didn't tell me straight away. He came in two days later and was really nervous about telling me.
"I got straight on the internet. I read down the lines and saw the word 'tumour'. That word is frightening, especially when it has to do with the head.
"I went to my GP with everything I could print off from the internet and waved it under his nose.
"He looked it up and said he wasn't sure but would send me off for a blood test and MRI scan. They came back positive for acromegaly."
The condition, in which a tumour grows on the pituitary gland, causes an increase in growth hormones that can cause giantism in children.
In adults, it causes soft tissues to be deposited in the hands and growth of the skull bones.

Pesticide Dumplings

Via plime: the AP reports on the discovery of pesticide in Chinese dumplings imported into Japan:

Officials said Japanese authorities were recalling millions of bags of dumplings and other foods made by Tianyang Food Processing Ltd., the Chinese company that Japanese officials implicated in the earlier incidents.
A day earlier, China's product safety agency announced that tests on the ingredients of Tianyang dumplings — from the same batch sent to Japan — found none of the insecticide cited by Japanese authorities, said the country's General Administration of Quality Supervision, Inspection and Quarantine.
Investigators detected the insecticide methamidophos on the six bags of Tianyang dumplings over the weekend, a Hyogo prefecture (state) police official said on condition of anonymity, citing policy.
The official said that one of the bags had two tiny holes in it, and that investigators were checking whether the dumplings inside were contaminated.
The dumplings were the same type blamed for sickening 10 people, some of them seriously, in central and western Japan in December and January.

Progressive Inflammatory Neuropathy

Via ProMED-mail: the AP reports that the CDC has given a name to the pork-inhalation autoimmune disease contracted by workers at a couple of slaughterhouses:

Minnesota officials said they were broadening their investigation to thousands of former employees at the Quality Pork Processors Inc. plant in Austin, going back a decade to when a powerful compressed air system was installed to remove brain tissue from pig heads.
Investigators have been trying to determine whether pig brain tissue, sprayed into the air as droplets during removal by the compressed air system, was inhaled by workers and made them sick.
If further investigation proves their theories true, they will have identified a rare, new condition that could shed light on a whole family of poorly understood disorders in which the body's immune system attacks the nerves or the sheath that surrounds them, the Star Tribune reported.

You'd think after mad cow, they'd be a little more careful about aerosolizing livestock brains, but no. PlagueBlog recommends avoiding all pork, short or long.