Sunday, May 10, 2020

Rare inflammatory syndrome linked to Covid-19 kills 3 kids in New York, says governor Andrew Cuomo

Three children in New York have died from a rare inflammatory syndrome believed to be linked to the novel coronavirus, governor Andrew Cuomo said on Saturday, a development that may augur a pandemic risk for the very young.

Both Cuomo and his counterpart in the neighbouring state of New Jersey also spoke on Saturday about the pandemic’s growing toll on mental health, another factor on the minds of governors as they weigh the impact of mounting job losses against health risks in moving to loosen restrictions on daily life.

Nearly all of the 50 US states will have taken steps to relax lockdown measures by this weekend, including states like Arizona and Mississippi, which are reporting increasing infections of Covid-19, the disease caused by the virus, highlighting the risk of a new wave of outbreaks.

Cuomo told a daily briefing that he was increasingly worried about a syndrome that shares symptoms with toxic shock and Kawasaki disease, which he said included inflammation of the blood vessels and potentially fatal damage to the heart.

He said three children - including a five-year old disclosed on Friday - have died from such symptoms while also testing positive for Covid-19 or related antibodies, suggesting a link that was still not fully understood.

Cuomo, who has emerged as a leading national voice on states’ response to the coronavirus crisis, said state health officials were reviewing 73 similar cases, which have rattled a prior assumption that children were largely not susceptible to the novel coronavirus.

“We are not so sure that is the fact anymore. Toddler, elementary school children are presenting symptoms similar to Kawasaki disease or toxic shock-like syndrome,” Cuomo said. “It’s very possible that this has been going on for several weeks and it hasn’t been diagnosed as related to COVID.”

Cuomo said state health officials had partnered with the New York Genome Center and the Rockefeller University to look at whether there is a genetic basis for the syndrome and have been asked by the federal Centers for Disease Control and Prevention to develop national criteria for identifying and treating cases.

The syndrome shares symptoms with toxic shock and Kawasaki disease, which is associated with fever, skin rashes, swelling of the glands, and in severe cases, inflammation of arteries of the heart. Scientists are still trying to determine whether the syndrome is linked with the new coronavirus because not all children with it have tested positive for the virus.

At a separate briefing, New Jersey Governor Phil Murphy said the death of a four-year old disclosed on Friday was not related to the syndrome. “This is a very specific situation with this blessed little kid and we are going to leave it at that.”

‘TOXIC MIX’

New York and New Jersey are at the epicenter of the pandemic in the United States, accounting for nearly half of the 77,737 American deaths from Covid-19, according to a Reuters tally, and the two states have among the strictest lockdown rules still in place.

They are also at the center of a devastating economic toll underscored in government data released on Friday showing the US unemployment rate rose to 14.7% last month, up from 3.5% in February and shattering the post-World War Two record of 10.8% set in November 1982.

Cuomo said his state has seen increasing reports of mental health issues, substance abuse and domestic violence, all tied to the economic stress and isolation of the lockdowns.

On Friday a study released by the Well Being Trust and the American Academy of Family Physicians estimated an additional 75,000 people could lose their lives to suicide, drugs and other contributors to “deaths of despair” stemming from the crisis.

Murphy echoed those concerns.

“The cure for the health crisis is keeping people isolated,” Murphy told his briefing. “You add to that job loss, small businesses that have been crushed. It’s a toxic mix.”

Cuomo said 226 New Yorkers died from Covid-19 on Friday, up from 216 a day earlier, but less than half the levels recorded two weeks ago. He said hospitalizations and intubations continued their downward trend, further evidence the state has gained a measure of control over the virus.

Murphy said an additional 166 residents of his state had died over the past 24 hours from Covid-19, bringing its total fatalities to 9,116, while total cases rose by 1,759 to 137,085.

On a positive note, Murphy said the number of people hospitalized for the disease continued to fall, with the 422 patients discharged over the past 24 hours outpacing the 364 newly admitted for treatment.

Yet Murphy warned against complacency and said his constituents should continue to practice social distancing.

“We are not out of the woods, folks. Let’s not forget that,” he said.


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Thursday, April 30, 2020

What is Kawasaki disease? The rare child syndrome might have link to Covid-19

UK paediatrics specialists have warned that a small but rising number of children are becoming ill with a rare syndrome that could be linked to coronavirus.

On Sunday the Paediatric Intensive Care Society UK (PICS) warned about a small rise in the number of cases of critically ill children, some who had tested positive for Covid-19, presenting "overlapping features of toxic shock syndrome and atypical Kawasaki disease with blood parameters."

In a statement sent over the weekend to medical professionals who look after critically ill children, PICS said "abdominal pain and gastrointestinal symptoms have been a common feature as has cardiac inflammation."

So what is Kawasaki disease and how worried should parents and carers be?

What is Kawasaki disease?

Kawasaki disease, also known as Kawasaki syndrome, is a rare childhood illness that causes the walls of the blood vessels in the body to become inflamed.

According to the UK's National Health Service (NHS), the condition -- also known as mucocutaneous lymph node syndrome -- mainly affects children under the age of 5, although it can affect children of any age. 

Symptoms include a high temperature lasting for five days or longer, alongside a rash, swollen glands in the neck, dry cracked lips, red fingers or toes and red eyes, according to the healthcare provider.
If treated, the symptoms usually become less severe, the NHS said, adding that the disease is not contagious.

"Thankfully Kawasaki-like diseases are very rare, as currently are serious complications in children related to Covid-19, but it is important that clinicians are made aware of any potential emerging links so that they are able to give children and young people the right care fast," Professor Simon Kenny, NHS national clinical director for children and young people said in a statement sent to CNN on Monday.

A condition that can lead to heart complications

Kawasaki disease is a leading cause of acquired heart disease in the United States, and serious complications can include aneurysms and coronary artery dilations, according to US healthcare company the Mayo Clinic.

Standard treatment, which involves intravenous immunoglobulin and aspirin, can substantially decrease the development of coronary artery abnormalities, the US Centers for Disease Control and Prevention (CDC) says.

According to the NHS, around 25% of children with the disease who do not receive treatment go on to experience heart complications, which can include conditions such as heart attacks and heart disease.

However, the health care provider says that most children with Kawasaki disease make a full recovery if they receive prompt treatment.

What causes Kawasaki disease?
Experts admit that the causes of Kawasaki disease are not fully understood, but think that children who develop it could be genetically predisposed to it, having inherited certain genes from their parents.

The disease itself is not contagious, according to the NHS, meaning that it is unlikely to be caused by a virus alone.

The disease is more common in children from Northeast Asia, especially Japan and Korea, the NHS said.

What is the link to Covid-19?
The link between Kawasaki disease and Covid-19 is unclear, but health care professionals have reassured parents that the risk of children becoming severely ill with the virus remains low.
In a report released in April, the CDC said that children diagnosed with coronavirus in the US typically have mild cases of the virus.

The number of Covid-19 cases among children remains small and while some children and infants have been sick with Covid-19, adults make up most of the known cases to date, according to the CDC.
Professor Rosalind Smyth, director and professor of child health, UCL Great Ormond St Institute of Child Health, said current evidence suggests that most children with Covid-19 who receive medical attention have mild symptoms, with about half having a fever, around 40% having a cough and less than 10% of reported cases having gastrointestinal symptoms.

"However, our understanding of this condition in children is limited. Covid-19 does present, in adults, as an inflammatory disease affecting a number of organs. We should investigate fully these children, with SARS-CoV-2, who present with a multi-system inflammatory disease to assess whether this is a presentation of Covid-19," Smyth said in a statement Monday.

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Sunday, October 20, 2019

Study discovers enzyme that may prevent streptococci infection

Researchers have found an enzyme that could prevent a deadly streptococci infection that causes around 500,000 deaths worldwide each year.

Group A streptococcus can lead to illnesses such a s strep throat, scarlet fever, sepsis, and toxic shock syndrome as well as several long-term autoimmune diseases with high mortality rates.


Working with colleagues, the researchers found an enzyme that is required to produce a carbohydrate on the surface of the streptococcal bacterium which enables it to infect humans and animals.


Their research reveals new opportunities to inhibit this enzyme and ultimately, fight Group A Streptococcus infections.


The fact this enzyme works through a novel mechanism of action that can also be found in other streptococcal species increases the impact and relevance of this finding.


Strep throat is the most common Group A Streptococcus infection and can often be fought by the body's immune system. Unfortunately, the very same bacterium also causes a plethora of severe and potentially fatal illnesses, such as sepsis and toxic shock syndrome, said one of the researcher.


We knew that the carbohydrate coating was an essential component of Group A Strep, but we wanted to find out more about how this worked. What we've shown is that the enzyme initiates the synthesis of the bacterial coating, continued the Dr.


Surprisingly, we also found that this enzyme fulfills the same function in many other types of streptococci. This includes Group B Streptococci, that can cause severe infections in newborns, and Group C and G Streptococci that cause similar disease as Group A, including bacteraemia and endocarditis, in humans and animals, added the Dr.

The newly discovered enzyme is not present in humans or animals, therefore providing a novel,opportunity for drug discovery programmes, reported the study published recently.

Antimicrobial resistance is a global problem and existing antibiotics fail to work in around 20 % of cases of strep throat. The long term aim of the Dundee team is to aid the development of a new class of antimicrobial drugs that could completely inhibit or reduce the enzyme's activity.


The next step towards this goal will see them work with others to develop compounds that could target this enzyme.


The research was jointly led by PhD student and another researcher explained, in our study, we show how this protein initiates the production of this carbohydrate through a mechanism never described before.


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Sunday, April 22, 2018

Organic tampons, cups no safer against toxic shock

Organic cotton tampons are often advertised as safer alternatives, but a study Friday said they are not better than regular tampons at preventing toxic shock syndrome.     

Menstrual cups can also raise the risk of toxic shock, and should be boiled in between uses, said the report in  a journal .     

Women have long been advised to change tampons regularly to avoid the risk of toxic shock syndrome, a rare but life-threatening condition that arises from a bacterial infection. Symptoms may include fever, vomiting, rash, muscle aches and organ failure.
 
In recent years, a number of new female hygiene products have hit the market, including tampons made from organic cotton and menstrual cups that can be rinsed between uses. To see how they measured up, researchers tested 11 kinds of tampons and four menstrual cups in the lab to study their effect on growth of a pathogen called Staphylococcus aureus, and also toxic shock toxin 1 (TSST-1) production.     

They inserted the tampons and cups into plastic bags, injected a liquid and a trace of bacteria isolated from a patient who had toxic shock in 2014, then sealed the bags and left them for eight hours. They found it didn't seem to matter what kind of material was in the tampon, rather it was the amount of air in between the fibers that seemed to raise the risk of bacterial growth.  

"Our results did not support the hypothesis suggesting that tampons composed exclusively of organic cotton could be intrinsically safer than those made of mixed cotton and rayon," said a professor of microbiology. "We observed that space between the fibers that contributes to intake of air in the vagina also represents the major site of S. aureus growth and TSST-1 production."

Meanwhile, menstrual cups seemed to allow even more bacteria to grow than tampons, again likely due  to the additional air involved. At least one case has been documented in scientific literature of a woman coming down with toxic shock after using a menstrual cup.

"Over the years, it was postulated that perhaps if tampons were made from natural materials, toxic shock would be averted. The new research recently published clearly illustrates that this is not true," said a director of gynecology and robotic surgery, who was not involved in the study. "Toxic shock can occur with any tampon material and even more frequently with the menstrual cups."    

According to the co-chief of the division of ambulatory care , a network of medical providers, women should change tampons frequently. "If tampons and menstrual cups are used be sure to see your doctor at the first sign of any fever, chills or rash, and of course, remove the cup or tampon immediately."

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