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Skeptical Thoughts – acupuncture, Dr Oz & ‘aboriginal’ medicine Siouxsie Wiles Nov 26

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I now have a regular radio slot, called Skeptical Thoughts, with Graeme Hill on his RadioLive Weekend Variety Wireless show. Here are links to a few of my recent editions:

Here, I do my bit for Acupuncture Awareness Week (revealing my own sordid history with acupuncture), talked about Dr Oz’s bad week on Twitter and was disgusted by a story from Canada about a woman’s right to refuse to allow her child’s leukemia to be treated with chemotherapy in preference for ‘aboriginal’ medicine. Did you know high dose vitamin C was ‘aboriginal’? Me neither.

Here I talk about drinking bleach and a rather fantastic way of spotting ghosts.

Feedback welcomed, as are suggestions for future slots.

Is Starbucks the USA’s “ground zero” for Ebola? Um, no. Siouxsie Wiles Nov 24

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With the abundance of very serious news stories about the ongoing Ebola outbreak in west Africa, time for a little light relief in the form of “Dr”* James David Manning. “Dr” Manning is pastor of the ATLAH Worldwide Missionary Church in New York. He also presents ‘The Manning Report’ on YouTube which bills itself as “the news behind the headlines”. When it was revealed that New Yorker Dr Craig Spencer, recently returned from treating Ebola patients in Guinea, had visited coffee shops and a bowling alley (all while asymptomatic and hence posing no threat to the public) it seems to have prompted Manning to fall for a hoax about Starbucks using semen to give it’s lattes more flavour. He’s recorded several rants, including one declaring that Starbucks was New York’s “Ground Zero” because of all the “sodomites” frequenting it, and another about the semen flavoured lattes.

Watch those if you must, but more amusing is Adam Reakes parody interview for his Herd Mentality podcast. Enjoy!

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*”Dr” Manning has a “PhD” from his own unaccredited ATLAH Theological Seminary.

Monday Micro – glowing bugs return to the park! Siouxsie Wiles Nov 10

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biolumination2

This Thursday, bioluminescent bacteria will once again be making an appearance at Auckland’s Art in the Dark festival. ‘Biolumination‘ is the result of my second collaboration with artist Rebecca Klee. This year sees our glowing bacteria being displayed in custom-built glass vessels which remind me a lot of the fishing lines our native glow worm Arachnocampa luminosa uses to snare its food.

The lovely people at Gather and Hunt made a neat little video about Rebecca and I which will give you a little teaser of Biolumination in action. And for those of you in Auckland, come along to Western Park, 8pm-midnight, Thursday 13th – Sunday 16th November and look for the shipping container down at the bottom of the park.

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If you are curious about last year’s piece – Living Light – check out the project blog here.

Naturopathy vs Science Siouxsie Wiles Nov 03

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Today Wellington’s Dominion Post newspaper ran a piece of (in my opinion..) misleading propaganda they passed of as a cartoon which can be summed up as naturopathy vs science.

I assume it is in response to the bad press that homeopathy received last week after Green Party MP Steffan Browning signed a petition calling for the World Health Organisation to start using homeopathy to treat people in west Africa with Ebola. I had the pleasure of explaining what homeopathy is on breakfast TV.

Inspired by the fantastic @WieldARedPen on twitter, I fixed the cartoon. Enjoy!

Dom Post Naturopathy cartoon - Nov14a

Monday Micro – frozen poop pills! Siouxsie Wiles Oct 13

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It’s still Monday so time for a very quick post about a paper just out in the Journal of the American Medical Association. I’ve blogged before about faecal transplants – giving a patient a dose of faeces from a healthy donor to resolve infection with the diarrhoea-causing bacteria Clostridium difficile.

One of the problems with faecal transplants is the way they are delivered – either by a tube through the nose and into the colon, or the more direct route of up the bum. Researchers at Massachusetts General Hospital in Boston have tried something a little more palatable. They took faecal material, blended it to make a suspension, removed all the particulate matter, added glycerol as a cryoprotectant and then froze it in small amounts inside of capsules that could withstand transit through the acidic environment of the stomach. If you are interested, apparently 48 grams of faecal matter makes 30 capsules.

Next the researchers gave the frozen poop capsules to 20 people with C. difficile infection. This involved patients fasting for 4 hours and then taking 15 capsules each day for 2 days. Nobody suffered any serious side effects and that 2 day course of frozen poop pills cured the diarrhoea of 14 of the 20 patients. Of the 6 people who didn’t respond, 4 of them got better after another course of the poop pills, giving an overall success rate of 90%. This is quite promising data, although the study was small and there was no placebo control group.

It will certainly make things easier if the poop needed for faecal transplants doesn’t need to be fresh, and people are definitely more likely to prefer popping pills to tubes up their noses!

Reference:
Youngster et al. Oral, Capsulized, Frozen Fecal Microbiota Transplantation for Relapsing Clostridium difficile Infection. JAMA Preliminary Communication, October 11, 2014.

The threats of antibiotic resistant superbugs to New Zealand Siouxsie Wiles Sep 26

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In this week’s New Zealand Medical Journal is a paper by Deborah Williamson and Helen Heffernan on antimicrobial resistance in New Zealand (1). This comes hot on the heels of the WHO report which gave a global picture of antibiotic resistance (2), and highlights what the big challenges are for New Zealand.

So what are the antibiotic resistant superbugs that pose a risk to the health of New Zealanders?

According to the authors, there are four main superbugs we need to be watching:
1. Methicillin Resistant Staphylococcus aureus also known as MRSA
2. Extended-spectrum B lactamase (ESBL) producing Enterobacteriaceae, especially E. coli and Klebsiella pneumonia
3. Mycobacterium tuberculosis which causes the lung diseases tuberculosis (TB)
4. Neisseria gonorrhoeae which causes gonorrhoea

What are the key factors driving antibiotic resistance in New Zealand?

The authors highlight three main drivers which they believe are contributing to the problem:
1. The use and overuse of antibiotics in people and animals
2. Transmission of antibiotic resistant microbes in both the community and within healthcare facilities, including rest homes
3. Increasing globalisation – we are importing many of our antibiotic resistant superbugs from abroad

MRSA – a problem of our own making

Over the last few years there has been a huge increase in the number of skin and soft tissue infections caused by S. aureus in New Zealand. Alongside this, there has been a huge increase in prescriptions for a topical antibiotic called fusidic acid. As a consequence, one of the major clones of S. aureus now causing disease in New Zealand is an MRSA clone called AK3 which is resistant to fusidic acid (3).

Importation of resistant superbugs

Some of the superbugs of worry, notably extremely resistant strains of E. coli, K. pneumonia and M. tuberculosis are mainly being imported into New Zealand from countries like India, China and those in south-east Asia. This is going to be an area to watch, especially given the importance of countries like China for trade and tourism in New Zealand.

Gonorrhoea – the tip of the iceburg for sexually transmitted diseases

In New Zealand, sexually transmitted infections (with the exception of HIV) are not notifiable. This means that the data we have on these diseases is based on the voluntary provision of the numbers of diagnosed cases from laboratories and sexual health and family planning clinics. What’s crucial to this is that many people can have no symptoms, hiding the true burden of disease. Gonorrhoea is one of these. While most men will have symptoms when they have the disease, half of women can be asymptomatic. Importantly, untreated infection can lead to infertility in women.

In 2013 there were 3,334 cases of gonorrhoea in New Zealand (4). What is shocking is that 1,145 of these cases were in young people under the age of 19. In fact, there has been a 43% increase in the rate of gonorrhoea in 15–19 year old women between 2009 and 2013. Less than half of sexually active young people report using condoms (5) which goes some way to explaining why our rates are rising. If we end up with a completely untreatable strain of N. gonorrhoeae taking hold in New Zealand this could have a huge impact on our future fertility.

References:
1. Williamson DA & Heffernan H (2014). The changing landscape of antibiotic resistance in New Zealand. New Zealand Medical Journal.
2. World Health Organisation (2014). Antimicrobial resistance: global report on surveillance 2014. ISBN: 978 92 4 156474 8.
3. Williamson DA et al (2014). High Usage of Topical Fusidic Acid and Rapid Clonal Expansion of Fusidic Acid-Resistant Staphylococcus aureus: A Cautionary Tale. Clin Infect Dis. pii: ciu658.
4. Sexually transmitted infections in New Zealand 2013. Institute of Environmental Science and Research Limited.
5. Clark TC et al (2013). Youth’12 Overview: The health and wellbeing of New Zealand secondary school students in 2012. Auckland, New Zealand: The University of Auckland.

Fighting antibiotic resistance: from Obama to TV3! Siouxsie Wiles Sep 25

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Ascomycetes
Ascomycetes“. Licensed under CC BY-SA 2.5 via Wikimedia Commons.

Last week President Obama signed an Executive Order aimed at combating antibiotic resistant superbugs. The order establishes a task force and a Presidential Advisory Committee which will look at how the US can implement a national strategy to deal with antibiotic resistance. The order covers areas such as surveillance, antibiotic use (now being called antibiotic stewardship) as well as promoting new and next generation antibiotics and diagnostics.

Speaking of which, Massey University’s Dr Heather Hendrickson and myself featured in a recent TV3 3rd Degree episode on antibiotic resistance in New Zealand, showcasing the work that we are doing in our labs. You can watch our clip from the episode here.

In my lab we are starting to collaborate with researchers at Landcare Research to screen the thousands of species of New Zealand and Pacific fungi that have never been mined for new antibiotics. We are currently writing lots of grants to try to get some money to support this work but if you’d like to help get started and are a New Zealand-based user of Facebook then please consider voting for our project for the People’s Choice Award for an AMP scholarship. And tell all your friends!

Monday Micro II – lockdowns, manslaughter and murder Siouxsie Wiles Sep 22

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The Ebola outbreak in west Africa continues. According to the CDC’s website, as of the 14th September the number of reported cases was up to 5,347 including 2,630 deaths. The virus is now in five countries. Here’s the latest:

Guinea (942 cases/601 deaths)

A team of health care workers, journalists and local officials have been reported to have been killed by villagers while on a drive to raise awareness of the symptoms of Ebola and how to seek help. Clearly suspicion that health care workers are spreading the disease is still widespread.

Sierra Leone (1673 cases/562 deaths)

Sierra Leone has been in lockdown since Friday with a three day curfew in place so that officials could try to get to grips with the numbers of people infected. There are reports of burial teams being attacked.

Liberia (2710 cases/1459 deaths)

There are reports that Liberia has run out of beds for all but the sickest Ebola patients and the healthcare system is collapsing.

Senegal (1 case/0 deaths)

So far there has been just one case of disease in Senegal, a Guinean man who was under surveillance for having had contact with an Ebola patient but who escaped by road to Dakar to stay with relatives. He arrived on the 20th of August and sought medical treatment on the 23rd when he started to have fever, diarrhoea, and vomiting. He was treated for malaria and went back to stay with his relatives. He was hospitalised on the 26th August and finally diagnosed with Ebola. Question is, how many family members and healthcare workers did he infect? The incubation period is almost up so we should know soon.

Nigeria (21 cases/8 deaths)

Ebola spread to Nigeria via American-Liberian Patrick Sawyer, who contracted Ebola from his sister and then travelled by air to Nigeria. He collapsed at the airport and died 5 days later. For a little while it looked like Nigeria might have managed to put a lid on Ebola, but human nature appears to have thwarted that. Nigeria’s Daily Post reports that a diplomat who contracted Ebola from Mr Sawyer, and survived, may be facing manslaughter charges. He evaded quarantine and travelled from Lagos to the city of Port Harcourt where he was secretly treated in his hotel room. The doctor who treated him contracted Ebola and has now died, but not before having contact with a lot of people while symptomatic.

Reading the WHO report, it sounds like he either didn’t know the diplomat he was treating had Ebola, or was in complete denial. Read this and weep:

After onset of symptoms, on 11 August, and until 13 August, the physician continued to treat patients at his private clinic, and operated on at least two. On 13 August, his symptoms worsened; he stayed at home and was hospitalized on 16 August. Prior to hospitalization, the physician had numerous contacts with the community, as relatives and friends visited his home to celebrate the birth of a baby. Once hospitalized, he again had numerous contacts with the community, as members of his church visited to perform a healing ritual said to involve the laying on of hands. During his 6 day period of hospitalization, he was attended by the majority of the hospital’s health care staff. On 21 August, he was taken to an ultrasound clinic, where 2 physicians performed an abdominal scan. He died the next day.The additional 2 confirmed cases are his wife, also a doctor, and a patient at the same hospital where he was treated. Additional staff at the hospital are undergoing tests. Given these multiple high-risk exposure opportunities, the outbreak of Ebola virus disease in Port Harcourt has the potential to grow larger and spread faster than the one in Lagos.

Several hundred people are now under surveillance so it’s a case of ‘watch this space’. Judging by the number of close contacts the doctor had with people while symptomatic, it’ll be amazing if there aren’t many more cases.

Skeptical Thoughts – gendered marketing Siouxsie Wiles Sep 22

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I’ve started a new radio slot called ‘Skeptical Thoughts’ on Sunday evenings on Graeme Hill’s Weekend Variety Show on Radio Live. A couple of weeks ago we talked about what a scam gendered marketing is – when companies repackage the same product and market it specifically for men or women, often charging different amounts. Australian show The Check Out did a great piece on the topic:

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Speaking of gendered marketing, Nanogirl and fellow Sciblogger Dr Michelle Dickinson tweeted this monstrosity (“for working men”) a few days ago:

mans hand sanitisor

WTF?! Perhaps unsurprisingly, Michelle’s tweet thanking Mitre 10 for removing the sexist product from their shelves was met with a cry of “PC gone mad” by some.

sexism

Which is sad, as it misses the point that products like that in places like a DIY store perpetuate the myth that women can’t do DIY and make women feel excluded. Also sad is the fact that tweet was from the CEO of a tech company.

*sigh*

Lighting up Wellington’s waterfront Siouxsie Wiles Aug 31

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For the last week, Wellington has been positively glowing thanks to the lux festival. This year I collaborated with artist Brittany Byrne to bring a touch of bioluminescence to the proceedings – rather appropriate given the genes that encode bacterial bioluminescence are known as the lux operon.

Previously Brittany created Nimbus – a work involving hundreds, if not thousands, of wooden pegs, suspended in the air and which made a very satisfying sound when touched.

Our piece was called Vibrio Nimbus, and from the outside looked like a boring old shipping containing.

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But on the inside, Nimbus’ wooden pegs had been replaced with hundreds of plastic conical tubes and the sonic nature of Brittany’s previous work exchanged for light, provided by trillions of glowing bacteria. When the tubes were gently jostled, they glowed a little brighter for a brief time, thanks to the little extra oxygen being supplied. Here’s a picture I took – Vibrio Nimbus was a bit like bringing one of Waitomo’s glow worm caves to the Wellington waterfront.

vibrio nimbus

A huge thanks has to go to the Bioluminescent Superbugs Lab and Una Ren for preparing all the media needed to keep Vibrio Nimbus glowing – the bacteria needed replacing with a fresh batch every other day. Brittany and her team became quite adept at growing microbes this week! And if you need reminding about the glowing Vibrio and where it is normally found, check out the Astrosquid animation below.

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