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The Germ Guy: Confessions of a Mercurial Microbiologist

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Infectious Disease

Do You Really Need An Antibiotic?

This week has been filled with controversy. In that vein, I feel it’s a good time to say something equally controversial:

Sometimes the best antibiotic prescription
is no prescription at all.

Okay, if you happen to be in public health, especially in Canada, this might not seem all that troublesome. After all, it’s been a mantra in the medical community for years. Yet, considering we still hear about the abuse and misuse of these life-saving drugs, the guidance hasn’t been accepted universally.

One of the reasons for the lack of compliance is based on a statement I hear quite often when I’m out in the public realm. Maybe you have heard it – or said it – at one time or another:

Prove to me I don’t need an antibiotic.

Admittedly, it’s a difficult request. But over the last few years, researchers have been exploring whether a person can deal with a bacterial infection without the use of antibiotics. The answer is yes but finding a way to show this to the public has been a real challenge. Usually, the information is hidden in statistics, which can be subject to skepticism.

However, I came across something that might demonstrate why forgoing an antibiotic may be worthwhile. It looks something like this…

 (Kinda cool, eh?)

What you’re looking at is a figure that comes from a paper entitled, Symptom response to antibiotic prescribing strategies in acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice. You can click on the title to read the paper.

As you can guess from the graph above and the title of the paper, the researchers examined the progression of the traditional sore throat based on symptoms. They looked at 1512 people who had suffered the illness. The symptom information then was matched with the treatment the individuals received.

  • Some had no antibiotics (the blue);
  • Some had a regular antibiotic prescription (the red);
  • Some had what is known as a delayed antibiotics (green).

Delayed antibiotics is a recent trend going around in which a patient is asked to wait a few days after an initial visit to determine if the infection goes away. This is a great way to determine if the infection is bacterial and may need antibiotics, or viral, in which case antibiotics are useless. This approach also allows the body to fight the infection few days. There’s a good reason for this:

The immune system can handle
many infections on its own.

Based on all the results, the addition of antibiotics resulted in an observed reduction in the length of the worst symptoms. But the extent was far less than anyone might have believed. In fact, once all the numbers were crunched, the benefit ended up being equivalent to a grand total of…

One day.

That’s it. Twenty-four hours of lessened symptoms. Nothing more.

The researchers did happen to point out that those who didn’t take antibiotics had a harder time dealing with the infection throughout the period. But in the end, they recovered just as well as those who had taken the antibiotics.

The results of this study may help add credence to the mantra, but that doesn’t mean forgoing antibiotics is valid for every infection. Just recently, I came across an individual who had a sore throat and decided not to take antibiotics. The person lasted a week before caving in to the pain. The bacterial infection was more troublesome and the immune system needed a boost.

If you are wondering what the best option might be should your throat start to scratch, your urinary tract start to burn, or your eyes begin to turn red and water, let me be perfectly clear:

I can’t tell you.

This is a decision that only can be made between you and your doctor.

What I will advise is that when you do feel those troubles and you make that appointment, don’t be quick to ask for a prescription. Your doctor may want perform some tests first to find out what might be causing the troubles. You may be asked to wait and see if your immune system can pull through. Or, there may be ample evidence to make the prescription immediately.

Just remember, if you are given a prescription and fill it, you need to stick with it until the end, even if you feel better. This way you can be sure that you are clearing your body of the infection and reducing the chances for recurrence down the road.

Finally, I’m curious about the use of antibiotics. So, let me ask a relatively simple question I hope many of you won’t mind answering:

When was your last antibiotic prescription?

 

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Ivanka Trump And A Different MAGA (Mosquitoes Ain’t Gonna Attack)

I don’t know anyone who actually enjoys getting bit by a mosquito. The only exception might be…

(Mosquito Researchers…)

The bites themselves are bad enough with the welts and incessant itching. But when you take into account the potential for disease transmission, a mosquito meal may present more than a mere annoyance. The list of potential infections is getting longer and the impact of these agents on human health is well…

(Staggering…)

There’s one sure way to avoid an infection…don’t get bit. That’s why media stories on mosquitoes and health usually include advice such as wearing long clothing, avoiding prime mosquito meal times, and of course, using a repellent, such as N,N-Diethyl-m-toluamide, which is better known as…

(DEET!)

How DEET works is pretty fascinating. It’s a chemical that gives off a particular odour that repels mosquitoes. The mechanism behind this action took quite some time to figure out but as always, scientists were on the case and eventually figured it out.

Much like humans have the olfactory system, which allows us to detect smells and determine whether we like them or not, mosquitoes have a similar mechanism to recognize molecules in the air. It looks something like this…

(Feel itchy yet?)

That ORN is known as an olfactory receptor neuron and it possesses a number of different proteins capable of recognizing various molecules in the air called odorant receptors. Somewhere within those neurons is a receptor that tells the mosquito to veer away when DEET is around.

Unfortunately, no one knew which one receptor was responsible. This made attempts to study this process any further difficult at best. Then in 2014, a team of researchers examined those odorant receptors and figured out which one detected DEET.  They published the finding in the paper, “Mosquito odorant receptor for DEET and methyl jasmonate,” which you can click on to read.

The receptor is called CquiOR136, which stands for Culex quinquefasciatus Odorant Receptor 136. It’s not a fancy name but the team makes up for this apparent lack of creativity with a cool sense of…

(Style…)

The data reveals CquiOR136, upon sensing DEET, or another molecule known as methyl jasmonate, sends a message to the mosquito’s brain that the environment is threatening and that it’s best to move on to other places. If that area happens to be your skin, you are saved from a bite.

This discovery allowed us to develop a new definition for the now common acronym, MAGA. Instead of Make America Great Again, however, these researchers have found the trick to ensure…

(“Mosquitoes Ain’t Gonna Attack.”)

After the discovery of CquiOR136, researchers tried to find other products capable of triggering that molecule and keeping mosquitoes away. Over the coming year, certain soaps and perfumes were found to repel mosquitoes. Some were even as good as DEET.

With this in mind, a team of Californian and Brazilian researchers decided it was worth looking at a specific perfume to see whether the product also could keep mosquitoes away.

The fragrance they settled on happened to be…

(You could say they were allured…)

Actually, we don’t know the answer as it was never mentioned in the paper. You can check for yourself by reading it here: Ingredients in Victoria’s Secret Bombshell and Ivanka Trump eaux de parfums that repel mosquitoes.

One could surmise, however, the choice was due to presence of an ingredient in the perfume. If you look at the title of the paper from the DEET researchers above, you’ll find a specific name, methyl jasmonate. As you might expect, it’s a molecule found in the jasmine plant, which is included in Ivanka’s fragrance description.

The team went searching to find something that looked like methyl jasmonate and they indeed found it. It was a little different in name – methyl dihydrojasmonate – but the group figured it may have the same effect on mosquitoes.

They performed the tests using another product already shown to repel the insects – Victoria Secret’s Bombshell – and observed whether the mosquitoes found the fragrance alluring or repulsive.

I’ll let the data speak for itself with this graph comparing DEET, Bombshell, and Ivanka’s perfume on how well skin was protected against bites…

(Pretty impressive…)

With this in mind, you might think about making the switch from DEET to Ivanka’s pink potion. But there is a slight issue one should consider. To get an equal level of protection as DEET, the same amount of perfume would have to be used as one would use with a repellent. This would probably mean changing the bottle top from the gentle, mist-forming, atomizer to well, this…

 (You get the point…)

In light of all the concerns we have these days with sensitivities to fragrances, it may not be all that great of an idea.  Not to mention, the cost of Ivanka’s fragrance is about US$30 a bottle. In comparison, that good old fashioned DEET spray will set you back less than $10.

While this study is obviously as much fun as it is science, there is a serious message. In light of the troubles mosquitoes can cause, you can never go wrong with keeping a good repellent around. It’s all about keeping true to MAGA – Mosquitoes Ain’t Gonna Attack.

Whether you go with the usual brands or take a chance on Trump, just be sure to have something to keep those mosquitoes away. Because unlike the other Trump MAGA, this one deals not with society, but your own health. In light of the risks associated with mosquitoes these days, you can never be too safe.

Would You Accept A Hepatitis-C-Infected Liver Transplant?

A few days ago, I came across a news article that intrigued me. It involved the practice of performing liver transplants using donors who are infected with Hepatitis C virus. You can read the article here: Could hep-C-infected livers solve New York’s organ-donor shortage?

Right off the bat, you might think this concept would be described best as…

(Who would do such a thing?)

Up until a few years ago, you would be right. The mere idea of transplanting organs, blood, or other tissues infected with hepatitis C was considered completely unethical. After all, you would be giving a person a potentially lethal disease.

Yet, times have changed. Today, there is a treatment for this viral disease with up to 99% success rate. It’s known as…

(aka “The Cure”)

This drug is a combination of two effective means to prevent Hepatitis C from reproducing in the body. One, known as sofosbuvir prevents the virus from multiplying inside the cell. The other, velpatasvir, blocks the ability to assemble new viruses.

With this in mind, the concept of transplanting an infected liver becomes a little less worrisome. After all, if there’s a cure, then why not give someone a shot at living a longer life? It fulfills the human belief that…

(No one would argue with this…)

But unfortunately, there is a catch. The drug is expensive. We’re talking in the region of US$75,000 per treatment. That’s an incredible amount, particularly those without proper insurance.

Upon hearing this number, the usual approach to pharmaceuticals may come into play, which usually sounds a bit like this…

 (Remember, this is a family-friendly blog…)

But the exorbitant cost shouldn’t cause much surprise. Advanced pharmaceuticals such as this drug combination are going to be expensive. We’re not dealing with run of the mill tetracycline, which can be made for pennies a pill. The process of making these drugs is difficult and maintaining proper quality control requires far more effort. Also, Epclusa is not as pricey as other treatments offered, which can be tens of thousands of dollars higher. So, according to its manufacturer, this drug is a bit of a deal in comparison.

I understand this may seem like a defense of the pharmaceutical industry and that for the sake of public opinion you might suggest…

(Which is usually good advice…)

But when dealing with a serious topic such as transplantation, in which the end result is either life or death, the issue of what is the right cost for a drug becomes secondary to the situation at hand.

I do think the amount is too high. Yet this is the reality as we face it. It’s not what most people – other than perhaps stockholders of the company – would like to hear but as we’ve learned in many health-related issues, we have to…

(It never gets easy…)

Which brings me back to the article. Should we use infected livers for donation? I feel if a system in is place that allows the recipient to receive cost-effective and/or fully covered treatment, it may help to lower the burden of waiting lists.

But what if a person is going to undergo the treatment and then be left to deal with figuring out how to deal with the disease? The individual may be faced with a question of prolonged life in a state of continual debt.

At this point, the decision should be left up to the person to decide which is the better option. Then, when the choice is made, we should all stand with that person and say only…

(Also, “I support you.”)

 

Putting the Poo in Swimming Pools…

Over the last few years, as summer approaches, I tend to receive requests to talk about a phenomenon that might make even the nastiest person go…

(Sorry, Dr. Evil…)

I’m talking, of course, about fecal matter in swimming pools.

I’m sure you may have heard about this occurrence in the news. You may have ignored the story thinking it is another attempt to keep us in the matrix of germophobia. But in this case, the threat is real. Or, to put it another way…

(Thanks, Morpheus)

Feces in pools happens and based on some pretty convincing evidence, it’s more common than you might think. If you don’t believe me, may I suggest you read this wonderful article on the likelihood of finding fecal bacteria and viruses in your local swimming environment.

Assessment of Enteric Pathogen Shedding by Bathers during
Recreational Activity and its Impact on Water Quality

A Microbial Version of Fight Club…

These days, when a scientific article comes out, the title is designed to provide as much information as possible into the specific subject of the study. For those immersed in that branch of science, the words make sense. But for the rest of the population, these titles invoke a rather understandable response…

(What???)

You can’t blame the researchers. They simply are following the rules of what many call the scientific club. Researchers talk in a certain way and title their papers in a scientifically conventional manner. If you don’t follow, you don’t belong.

Unfortunately, when it comes to that wider audience, researchers understand the mere sight of a complex title can leave many thinking…

(I have made a critical mistake…)

But every now and then, someone chooses to fight this convention and come out with a title that is both wonderfully composed and easy to understand. One such article came out recently in the journal PLoS Pathogens.

The article is split into three parts. The first discusses the function of what is known as a Type VI Secretion System, or T6SS for short. It’s a group of proteins assembled together in the form of well…

(A crossbow…)

Not surprisingly, the role of T6SS – as the name implies – is to send out, or secrete, factors from inside the cell to the surrounding area. As to what these factors do, the deliver what can be best described as…

(A vicious punch…)

When a bacterium feels threatened, it uses T6SS to attack other bacterial cells in the hopes of wounding or killing the invader. The authors even provided a lovely visual description of how T6SS is used…

(I couldn’t have drawn it better myself…)

In essence, T6SS is a survival mechanism designed to help ensure bacteria maintain their territory in a diverse environment.

Which brings us to the second part of the paper, where this battle is happening…

 (The gut…)

There are potentially hundreds of different species living in our gastrointestinal tract, especially in the colon. While we might like to think they are all getting along, researchers have shown this is not the case. Instead, there are microcosms in which bacteria are…

(Facing off…)

Many of the bacteria in possession of T6SS are pathogens capable of causing diarrhea and other illnesses such as cholera. The researchers suggest the presence of T6SS gives them an advantage in our guts and can increase the likelihood of symptoms.

Now it’s time for the third part, which the authors magnificently described in the following image…

(Can you guess what is happening here?)

Let’s make this even easier to understand…

  1. The yellow bacterium is a pathogen with a T6SS in place.
  2. The blue bacterium is a friendly species, also known as a commensal.
  3. using genetic engineering, commensals can be given the ability to produce antidotes to T6SS toxins such that they can defend against attack.
  4. Using engineering to give commensals the ability to make T6SS, they also can engage in battle.

The group suggests using these genetically engineered commensal species may be useful in helping to prevent and possibly treat gastrointestinal infections. While this still is little more than a theory, considering the widespread nature of gastrointestinal bacterial infections, and the rise in antibiotic resistance, this strategy may be well worth…

(Further discussion…)

If you’ve been following along, you probably have noticed I haven’t actually given the title of the paper. I first wanted to go through the article and see if you could guess what it would be called.

Based on the science, you might think the article would be called…

“Prospective genetic engineering of commensal bacterial species
as a novel means to prevent T6SS-mediated bacterial gastroenteritis” 

But no.  Instead, the title is one of the best I have seen in a long time. It is simply and brilliantly called…

T6SS: The bacterial “fight club” in the host gut.

When it comes to scientific papers, titles are simply a collection of words designed to match a particular format. Although they may appear challenging and possibly lead you to forego reading on, just remember, the authors probably had no choice. It’s just part of the scientific club.

But, if scientists had the ability to be a little more like the authors of this paper, I can assure you they would. Because while you may think researchers are highly focused, straight-laced, thinking machines devoted to the club of science – and they are – deep inside many of them, there also lies an inner…

(Tyler Durden…)

I would suggest it’s worth going past the title and learning more about what makes these people work and well, fight, as hard as they do.

Why Spring May Tick You Off…

It’s that time of the year when the days last longer than the nights, the temperature warms, and many take a needed breath of relief. Winter has come to an end and we welcome the arrival of…

(Spring!)

From a health perspective, the change of season should signify a slowing down of the hectic pace caused by colds, flu, and other winter-associated illnesses. Yet, over the last decade, the stress has continued although the reason is far different.

Instead of the invisible bacteria and viruses causing all the trouble, another itchy subject has taken over as the public enemy Number 1…

(Ticks…)

As soon as the temperature holds steady at four degrees Celsius, these insects emerge from their hibernation and begin to forage for food. As you can imagine, after months of slumber, they are hungry for blood. They aren’t all that choosy either. If it’s filled with blood and has skin that is easy to penetrate, any animal – including a human – is fair game.

Ticks haven’t always been this troublesome as they used to be only present in woodlands and other rural areas. But they have claimed much more territory and call urban parks and other recreational gathering spaces home. How much you might ask…well, how about this…

(Don’t even ask to see the 2050 or 2080 estimates…)

Of course, the tick itself isn’t really the problem. Much like the mosquito, an invasion is little more than a nuisance that can quickly be remedied. But, inside many of these crawlers are microbes known to cause over a dozen different types of infections.

You may not have heard of some of the pathogens, such as Babesia, which causes anemia, or Powassan virus, which can cause fatal encephalitis. But I’m sure by now you know about the most common worry…

(Needless to say, it’s horrid…)

The mere threat of acquiring one of these infections may be enough to convince you to keep that bare skin covered or use insect repellents containing DEET. Yet, if this concern is not enough to take precautions, perhaps this might offer a good enough reason to keep these insects away…

(Welcome to the microscopic world…)

What you are looking at are the chelicerae (pronounced keh-lees-er-ay) of the tick. If you haven’t guessed what this particular appendage happens to accomplish, you might want to watch a certain video showing what it does. But before I show it, I have two quick notes.

First, this footage was made as a part of a scientific article examining how ticks actually manage to get into the skin. You can read it here:  How ticks get under your skin: insertion mechanics of the feeding apparatus of Ixodes ricinus ticks.

Second, if you happen to be squeamish in any way, you might want to forego watching the video. Although i find it fascinating, some people might consider it a little too um, well…

 (You get the idea…)

If you’re still willing, here’s the video in its entirety. It lasts for a few minutes but for those of you who really want to know how a tick begins its journey into the body, it’s worth the time.

 

Harnessing What Dogs Do Best To Save Lives…

Although I am more of a “cat person,” I concede dogs are incredible creatures. They love attention and return it in their own loving ways. They can be a person’s best friend as well as provide comfort to those who are truly in need.

The only drawback – if you can call it one – to these four-legged companions is their propensity to well…

(You get the idea…)

The reason behind this habit is biological in nature. The most important physiological signals are emitted from two organs known as the anal sacs. As the name implies, they are found in a rather discreet area of the body. When dogs want to learn more information about their counterpart, they attempt to find out using one of their most sensitive environmental detectors…

(The nose knows…)

For most of us, this activity may seem rather odd. But when you realize a dog’s sense of smell is hundreds of times more sensitive than humans (if not more), this is the perfect way to gain valuable information on a potential park mate.

It’s also far more effective than some other routes humans have chosen to acquire details on others such as…

(I spy…)

The olfactory superiority of dogs may be little more than a welcome piece of trivia for those moments when parties and get-togethers tend to drag on. But in 2012, a group of researchers in the Netherlands had a better use for this knowledge. The team wondered if those sensational snouts could be put to good use in a rather unlikely place…

(The hospital…)

The idea came as a result of a rather unfortunate reality occurring in health care. There was a significant rise in the number of infections caused by a pestering pathogen…

(Clostridium difficile…)

I’ve worked with this bacterium and I can tell you it has a rather unique smell. When you get to know the combination of different aromatics, you can identify it almost anywhere.

Now, as you might expect, for a human to pick up on the odour, the population needs to be in the billions, such as in a petri plate culture or from a human stool sample.

I know what you’re thinking…

(Believe me, it is…)

But for a dog, that smell may be picked up from far fewer numbers. Not to mention, the smell might be a whole new type of wonderful. It therefore should not surprise you to know when researchers went out to test their theory, the dog was…

(Happy to oblige…)

The end result was a rather interesting paper revealing a new means to identify C. difficile in healthcare facilities. You can read the study here:

Using a dog’s superior olfactory sensitivity to identify
Clostridium difficile in stools and patients: proof of principle study 

The paper was so warmly received that other institutions decided to use dogs to find the pathogen wherever it may be hiding. This included Vancouver General Hospital who recently added a new staff member to its infection prevention and control team…

(Angus…)

The spaniel has been working since November and has sniffed out dozens of C. difficile hiding spots. In each case, this happy-go-lucky worker has helped to keep hundreds of patients safe from the devious disease. His efforts have been so successful the hospital is looking to add more sniffing staff to its roster.

This is without a doubt one of those feel-good stories although for public health officials, the introduction of canine Clostridium hunters may lead to a different response…


(If you don’t get this, ask your parents…)

Considering this one bacterial species has become one of the greatest threats in healthcare facilities, any help to prevent its impact on patients is welcome news.

This story also offers one more benefit to those dog lovers out there. They finally may have a way to defuse those awkward situations when a cold nose happens to venture a little too close to certain sensitive zone…

(But it saves lives…)

Okay, maybe not…

A Hesitance in (Vaccine) Hesitancy…

If you happen to live in the United States or Canada, you’ve probably heard about the recent rise in cases of mumps or as some people like to call it…

(The Chubby Cheeks Virus…)

I’ve spoken on the virus quite a few times over the last month. Most of what I’ve said is summarized in my recent Huffington Post article, which you can read here:

Here’s The Reason Mumps Has Made A Comeback

As most people know, the best way to stay safe from this infection is vaccination. The mumps vaccine has been around for fifty years and continues to be the most effective means to keep the virus at bay.

But that doesn’t mean I am safe when I talk about these vaccine-preventable diseases. As per usual, I ensure I do my research on the history, the current situation, and any small details that could enrich the message.

Yet I also prepare for…

(A Battle of Words…)

Usually, as soon as I begin to promote vaccines, I can expect to be assailed by a small yet very vocal population of people who are against vaccination as a whole. There are a number of different names associated with these individuals but the most common in today’s scientific lingo is…

(Vaccine Hesitancy…)

The usual argument follows a similar script.

Me: Vaccines are effective.
Them: Vaccines are bad!
Me: Vaccines are safe.
Them: Vaccines are bad!
Me: Vaccines prevent infection
Them: Vaccines are bad!
(Repeat ad nauseum)

No matter what clinical evidence or molecular mechanism I provide, there is simply no room for these valuable medicines in their world. Eventually, the tone gets ugly and at times the attacks change from scientific to personal. At that point, there’s no other option than to…

(Give up the goose…)

As the mumps stories appeared, I readied myself for the assaults. I had all my arguments intact. Although the end result most likely would be a stalemate, I was prepared to go to social media war.

But something strange happened. Instead of flames and vitriol, the response to my efforts could be best described as…

(Crickets…)

There was no push back. There were no accusations of being a shill. The only comments I received shared thanks and appreciation. I even tried to stir the pot a little by spreading the word across different platforms. Yet still, there was no response. It’s as if there was hesitance in the hesitancy.

I know…

(Call it the Vinny Barbarino effect…)

I decided to ask around to find out if there were others feeling the effects of hesitancy but again, there was nothing. Instead, it seemed the advice to seek out vaccination against mumps was being left alone.

While I cannot say for sure what caused this lack of response to the mumps vaccine, I wonder if something else convinced them to stay clear of the issue. If I am right, then it may have something to do with a rather common symptom associated with infection…

(This is an actual ad…)

Maybe the fear of having excruciating pain in certain sensitive areas could overtake the urge to fight unwinnable battles. Perhaps the worry of infertility – for both men and women – could replace the baseless concerns over widespread vaccine harm. Or could it be that when it comes to an actual problem with lasting effects, such as diabetes and brain damage, people will turn to whatever works even if it goes against their principles?

In other words real fear may actually defeat…

(You get the idea…)

If this premise is correct, the result does leave a bitter taste. If the only way to gain the public’s trust is to scare them into acting on recommendations, we will continually need to have greater health threats in order to succeed. Granted, this may do some good in the short term but over the long haul, the efforts will end up hurting everyone. We’ll live in a continually worrisome society, which is as the hesitancy crowd would say…bad.

Not to mention, it may backfire such that we may have to worry about an even greater problem based on irrational fear. If you don’t believe me, let me bring back a word from a few years ago…

 (Need more be said?)

 

A Case of Extreme Vexing…

Every year, an infectious disease spreads like wildfire across North America bringing along with it misery for those who ends up being afflicted. People find themselves rushing to run to the bathroom to relieve that feeling of being sick to their stomachs. Although the condition only lasts a few days, the nightmare is not soon forgotten.

For those wondering, I’m not talking about…

bieber_fever(Although it it quite contagious…)

Instead I’m talking about an illness with many names. Some fifty years ago, it was known as the Winter Vomiting Disease. Then in the 1970s, it was called Norwalk Virus, named after the city in which the virus was originally isolated. Some know it as the cruise ship virus due to its ability to turn a joyful voyage on the sea into a ugly nightmare. Officially, however, it’s known as…

(Norovirus…or noro)

Having studies this organism in the lab, I can tell you it is quite possibly the perfect outbreak pathogen. It has everything going for it…

  1. It can survive for weeks on surfaces – it can be picked up quite easily;
  2. It has a low infectious dose – you only need to ingest a few to develop illness;
  3. It continues to spread after you feel better;
  4. It can resist regular disinfection procedures.

To say the least, this is a true…

eenie-meenie(Eenie Meenie…)

The moment noro finds its way into a confined environment, such as a cruise ship, college dormitory, school, or hospital ward, the situation becomes one of extreme vexing. The virus simply moves its way around from person to person until the entire population has been affected.

To gain any kind of control over this problem, officials need to use equally extreme interventions, such as closing a ward, cancelling the cruise ship trip, or banishing dorm residents for a week. If this were to happen under any other circumstance, it would lead to a massive request for these authorities to say…

sorry(And here’s some money too…)

But when the cause of the conflict is noro, there really is no other recourse.

Although noro hits each year around this time, some seasons end up being far more troublesome than others. The virus seems to affect more people and cause even greater damage. Even more vexing, those who believe they are immune to the virus – because they already had suffered from it – suddenly find themselves back at the toilet again wondering…

mean(What Do You Mean?!)

This happens to be one of those years. It’s not really anyone’s fault, mind you. The trouble is due to the natural ability of the virus to evolve. Much like that other, more famous virus, influenza, noro has several circulating strains, known as genotypes. Just this year alone, the CDC has estimated the number of virus types spreading in the United States is at least six…

norovirus(Although not distributed evenly…)

Unless a person happens to have had come into contact with all of these different genotypes, the risk for infection is always present. This sets up a rather inconvenient truth in which we much admit no matter how many times we may end up with the illness, we must…

neversaynever(No matter how much we would like to…)

There is a small bright side to this situation. Unlike respiratory viruses, noro needs to get into our gastrointestinal tracts in order to harm us. There is only one cell type the virus likes to attack and it’s deep inside the intestines. If we can prevent entry of the invader, we may be able to stay safe.

Granted, this does mean we have to ask one question…

wherenow(Where Are U Now?)

Yet as this image suggests, the answer is relatively easy. Most of the time noro spreads, it’s because it was on someone’s hands. People can pick up the virus from a surface, such as a sink tap or a washroom door handle and readily transfer it to other surfaces or, in the case of self-inoculation, the mouth.

Contamination of objects may not lead to an outbreak. But, when hands come into contact with food, all bets are off. This route usually is the one causing large numbers of infections in restaurants and on cruise ships. Usually, the incident occurs because one or more people simply did not wash their hands properly prior to handling fresh foods not meant for cooking. The end result sadly, is a mass of people disposing of their recent meals from both ends.

This latter situation is exactly why adhering to food safety protocols is so important. It’s also why I feel avoiding even the simplest actions to keep food safe makes…

nosense(No Sense!)

As each year passes and more cases are recorded, I imagine the virus will reach a certain level of infamy. People all over the world may find themselves wanting to avoid the gut-wrenching symptoms and those days of vexation. Granted, it won’t be easy as noro is an able opponent. Yet, as far as I can see, all we need is a combination of purpose, prowess, power and possibly…

bieber-pronger(Pronger!)

With these in place, we can do our best to ensure the virus stays out of our guts for good.

PS: Have you ever had norovirus? If you have, let me know how it felt.

PPS: For the record, I had it and hated it although not as much as when Chris Pronger pretty much did the same thing to the Ottawa Senators during the 2007 Stanley Cup Finals as he did to Bieber yesterday.

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