health

New Mosquito-Borne Diseases Grab Headlines

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | August 26th, 2019

Dear Doctor: I just read that there’s a new mosquito virus being found in Florida that can harm the brain. What is it? I thought Zika was the one we’re worried about.

Dear Reader: Mosquitoes aren’t your typical predators, but they can be deadly. Mosquitoes carry and spread an array of diseases that result in more than 700,000 deaths worldwide annually. With 3,000 known mosquito species -- about 175 of them here in the U.S. -- it’s no surprise that new mosquito-borne illnesses keep making news.

The virus you’re asking about is the Eastern equine encephalitis virus, or EEEV. In July, health officials in Florida reported finding the virus in horses, chickens and other animals across the state, prompting a statewide alert.

Symptoms, which appear from three to 10 days after infection, come on quite suddenly. They include headache, which becomes progressively more severe, fever and body aches. The virus is fatal in about one-third of patients and puts survivors at risk of ongoing neurological problems. The virus can lead to encephalitis, which is inflammation and swelling of the brain.

Signs that the virus has begun to affect the brain include loss of muscle control, weakness or paralysis; changes to sensation, including tingling or numbness; decline in cognitive function; and the onset of seizures. There is no human vaccine for the virus at this time, and medical treatment focuses on managing symptoms and offering supportive care.

In the past, the number of reported cases of EEEV, which was first recognized in humans in 1938, has been extremely low. According to the Centers for Disease Control and Prevention, the number of reported cases of EEEV annually is fewer than 10. The actual number of EEEV cases may be higher because it’s likely that some cases of the rare disease are undiagnosed or misdiagnosed.

Zika virus, which is linked to severe birth defects in infants whose mothers became infected while pregnant, is still a problem. The only thing that has disappeared are the headlines addressing it. In the U.S., widespread use of screens, air conditioning and the presence of mosquito control districts have sharply limited the Zika threat. So far in 2019, there have been five confirmed cases of Zika in the U.S., each acquired during international travel. There have been no known cases due to local mosquito-borne transmission.

Limit exposure to mosquitoes with the use of screens, mosquito repellent and by covering bare skin. Remove standing water near your home. Be aware of the times of day the specific mosquitoes in your area are active. Mosquitoes are frail and fly best in still air. A fan can stir enough breeze to keep them from reaching their target.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

health

Acupuncture Gaining Popularity as Treatment Option

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | August 23rd, 2019

Dear Doctor: What do you think about acupuncture for lower back pain? What is it, and how does it work?

Dear Reader: Acupuncture is a key component of traditional medicine in China, but until recently, it was viewed as alternative therapy here in the United States. Then, in 1997, the National Institutes of Health issued a pro-acupuncture consensus statement, acknowledging acupuncture as an effective tool for managing pain and nausea. The agency also recommended that acupuncture be taught in medical schools. As doctors, we both see a role for acupuncture in our practices. Dr. Ko recently finished her training in acupuncture and uses this treatment.

Acupuncture is a centuries-old practice that builds on the premise that the human body contains energy pathways, known as meridians, which are comprised of more than 2,000 specific points. During an acupuncture treatment, a practitioner stimulates certain groups of points by inserting hair-thin sterile needles. The feeling is more of a distinct sensation than actual pain. Acupuncture needles may also be heated during a treatment, or they can be stimulated to conduct a mild electric current. A usual course of treatment typically includes multiple sessions that can continue for weeks or months.

Despite centuries of use, modern medicine doesn’t really understand how this ancient technique works. One theory ties the stimulation of acupuncture points to the release of specific biochemicals, which play a role in healing, as well as physical and emotional well-being.

A study published in 2014 used advanced 3D imaging techniques to examine acupuncture points at the cellular level. The researchers found that, unlike neighboring tissues, acupuncture points contained a high density of micro-vessels and other vascular structures. Not a definitive answer to the mysteries of acupuncture, but certainly an intriguing start.

Clinical studies have shown the value of acupuncture for pain relief, nausea, headache and osteoarthritis. A growing number of medical insurance plans cover acupuncture treatments. The U.S. armed services now use acupuncture as a form of pain management. And the Centers for Medicare & Medicaid Services is considering a proposal to cover acupuncture treatments for patients with chronic lower back pain participating in certain clinical trials.

If you do decide to try acupuncture, please be sure to find an experienced practitioner. As with many integrative therapies, licensing requirements vary from state to state. If you live in an area that doesn’t have licensing requirements or oversight for acupuncturists, consider looking for a practitioner certified by the National Certification Commission for Acupuncture and Oriental Medicine, a national oversight and advocacy organization. You can find more information at nccaom.org.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

health

Pig Ear Treats Connected to Latest Salmonella Outbreak

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | August 21st, 2019

Dear Doctor: Is it true that dog treats made from pigs’ ears are giving humans a dangerous infection? I don’t buy them because, honestly, they look kind of gross, but our dogsitter brings them over sometimes. Should we be worried?

Dear Reader: You’re referring to a series of alerts issued by the Centers for Disease Control and Prevention about an outbreak of salmonella infections, which have been identified as being resistant to several different antibiotics. These infections have been tied to dog chews made out of pig ears.

As of the CDC’s latest update on July 17, a total of 93 people living in 27 states have become ill, including 20 individuals who had to be hospitalized. No deaths have been reported at this time. If you have these dog treats in your home, the CDC recommends wrapping them securely and disposing of them. Use hot, soapy water to wash anything that came into contact with the treats, including surfaces, containers and, of course, your hands.

Salmonella is a group of bacteria that cause about 1.2 million people to become sick each year. They can cause an illness known as salmonellosis, which develops as soon as 12 hours and up to three days after ingesting the bacterium. The infection often occurs when feces infected with the bacteria comes into contact with food or water and is unknowingly consumed. Symptoms, which include fever, abdominal pain and diarrhea, last from four to seven days. Although the majority of people recover without medical treatment, in some cases the diarrhea can be severe enough to require hospitalization.

The danger is that a salmonella infection can move from the intestines into the bloodstream, and then spread to other areas of the body. The infection is particularly risky for children under age 5, for the elderly, for individuals who are medically frail and for those with weakened or suppressed immune systems. Treatment typically focuses on managing diarrhea and pain, preventing dehydration and, if the infection has spread via the bloodstream, the use of antibiotics.

Pig ear treats are just the most recent source of a salmonella outbreak. In recent years, sources as diverse as pet guinea pigs, pet hedgehogs, dog food, papayas, sprouts, nut butters, backyard chickens, small turtles and chicken salad have been linked to outbreaks. In response to the current outbreak, Pet Supplies Plus, a distributor of bulk pig ears, which are stored in large, open bins, has agreed to a voluntary recall of the treats. At this time, pre-packaged pig ear treats from individual brands are not part of the recall.

Pets can also become ill from a salmonella infection. Their symptoms can include lethargy, diarrhea that may be bloody, vomiting and fever. Pets with salmonella infections may be sluggish, run a fever, begin vomiting and have diarrhea that may contain blood or mucus.

For the latest information on the current outbreak, visit cdc.gov/salmonella.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

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