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Pneumocystis pneumonia is a fungal infection caused by Pneumocystis jirovecii which is one of the most common opportunistic fungal infections. Symptoms can include fever, dry cough, shortness of breath and fatigue. In individuals with HIV or weakened immune systems the infection presents sub-acutely and they will have a low-grade fever. In HIV-unifected patients the symptoms will include a high fever and the infection will develop more quickly.
Transmission
Transmission is unknown but there is some evidence to suggest that transmission in humans in airborne.
A combination of immunotherapy and a virus could treat aggressive breast cancer, an 'absolutely amazing' study has revealed. Breakthrough research showed the pairing cured up to 90 per cent of mice plagued by triple negative breast cancer - deemed the deadliest form.
Canadian scientists are hopeful the findings will lead to a potential cure, as survival depends on how early the disease is caught.
The trial, led by Ottawa University scientists, comes as a separate study found that an injection of a virus could also treat aggressive brain tumours. Dr Marie-Claude Bourgeois-Daigneault, lead author of the Canadian study, was full of praise for the findings, which may apply to humans.
She said: 'It was absolutely amazing to see that we could cure cancer in most of our mice, even in models that are normally very resistant to immunotherapy.
'We believe that the same mechanisms are at work in human cancers, but further research is needed to test this kind of therapy in humans.'
Every year 11,400 people die from breast cancer in the UK. In the US, the figure is around four times higher.
Charities estimate around 15 per cent of all cases of breast cancer are triple negative - but death rates are proportionally higher.
The study, published in Science Translational Medicine, adds to the growing body of evidence that shows the vast benefits of immunotherapy.
All of the mice in the study were resistant to the checkpoint inhibitor, which blocks proteins on cancer cells to stop them from growing, that was used. This type of drug - made famous by nivolumab, which Sunday Times food critic referred to as the weapon of choice for 'every oncologist in the first world' before he died, is already used to treat some forms of cancers, including lung and kidney.
Separate trials showed an oncolytic virus called Maraba boosted the immune system of the mice, attacking the cancerous cells.
However, it had little effect on their survival of mice on its own. The rodents were engineered to be in a state of metastasis - when the cancer has spread from the original location.
When it was used alongside the checkpoint inhibitor it cured between 60 and 90 per cent of the mice.
This was compared to a 0 per cent cure rate for the immunotherapy alone and 20 to 30 per cent for just a dose of the virus.
The new treatment, which backs up older trials using the same technique, saw the virus given before surgery and the drug after.
Dr John Bell, co-author, added: 'Our immune system is constantly trying to recognize and kill cancer cells, but the cancer cells are always trying to hide from it.
'When you infect a cancer cell with a virus, it raises a big red flag, which helps the immune system recognize and attack the cancer.
'But in some kinds of cancer this still isn't enough.
'We found that when you add a checkpoint inhibitor after the virus, this releases all the alarms and the immune system sends in the full army against the cancer.'
Researchers recently confirmed oncolytic viruses and checkpoint inhibitors have potential for treating melanoma.
The new study was the first to test viruses and checkpoint inhibitors in a surgery and metastasis model, which is particularly relevant for patients.
Aspergillosis is a fungal infection caused by Aspergillus, a common mold that lives indoors and outdoors. Most people breathe in Aspergillus spores every day without getting sick. However, people with weakened immune systems or lung diseases are at a higher risk of developing health problems. The types of health problems caused by Aspergillus include allergic reactions, lung infections, and infections in other organs.
Transmission
People can get aspergillosis by breathing in microscopic Aspergillus spores from the environment. Aspergillosis can’t spread between people or between people and animals from the lungs.
Lab Tests & Specimen Info
Test*
Specimen
Microscopic examination
Respiratory Specimen
Culture
Sputum, Bronchial Aspirate, Lung biopsy
Galactomannan Antigen Test
Serum, Bronchoalveolar Lavage
IgG Serology
Serum
PCR
Bronchoalveolar Lavage, Tissue
Isolation Precautions
Standard precautions are recommended in healthcare settings.
Prevention for Patients
It’s difficult to avoid breathing in Aspergillus spores because the fungus is common in the environment. For people who have weakened immune systems, there may be some ways to lower the chances of developing a severe Aspergillus infection. It’s important to note that although these actions are recommended, they have not been proven to prevent aspergillosis.
Try to avoid areas with a lot of dust like construction or excavation sites. If you can't avoid these areas, wear an N95 respirator while you're there.
Avoid activities that involve close contact to soil or dust, such as yard work or gardening.
To reduce the chances of developing a skin infection, clean skin injuries well with soap and water, especially if they have been exposed to soil or dust.
Microsporidiosis is a disease caused by infection with microscopic organisms called microsporidia. Microsporidia are eukaryotic parasites that must live within other host cells in which they can produce infective spores. Microsporidiosis can cause infection of the intestine, lung, kidney, brain, sinuses, muscles, and eyes.
Intestinal symptoms that are caused by microsporidia infection include chronic diarrhea, wasting, malabsorption, and gallbladder disease. Symptoms of microsporidiosis primarily occur in people with immune-system deficiency, such as HIV-infected individuals and organ-transplant recipients.
Lung symptoms may include cough and difficult, labored breathing.
Transmission
Microsporidia spores are released from the stool and urine of infected animals. A number of animals, including insects, birds, and mammals, can serve as reservoirs of infection for microsporidia. These spores are then consumed or inhaled by humans.
Histoplasmosis is a type of lung infection. It is caused by inhaling Histoplasma capsulatum fungal spores. These spores are found in soil and in the droppings of bats and birds. This fungus mainly grows in the central, southeastern, and mid-Atlantic states.
Most cases of histoplasmosis don’t require treatment. However, people with weaker immune systems may experience serious problems. The disease may progress and spread to other areas of the body. Skin lesions have been reported in 10 to 15 percent of cases of histoplasmosis that has spread throughout the body. What Should I Watch For?
Most people who are infected with this fungus have no symptoms. However, the risk of symptoms increases as you breathe in more spores. If you are going to have symptoms, they generally show up about 10 days after exposure.
Possible symptoms include:
fever
dry cough
chest pain
joint pain
red bumps on your lower legs
In severe cases, symptoms may include:
excessive sweating
shortness of breath
coughing up blood
Widespread histoplasmosis causes inflammation and irritation. Symptoms may include:
chest pain, caused by swelling around the heart
high fever
stiff neck and headaches, from swelling around the brain and spinal cord
Blastomycosis is an infection caused by a fungus called Blastomyces. The fungus lives in the environment, particularly in moist soil and in decomposing matter such as wood and leaves. Blastomyces mainly lives in areas of the United States and Canada surrounding the Ohio and Mississippi River valleys and the Great Lakes. People can get blastomycosis after breathing in the microscopic fungal spores from the air. Although most people who breathe in the spores don’t get sick, some of those who do may have flu-like symptoms, and the infection can sometimes become serious if it is not treated.
Blastomycosis is a caused by the fungusBlastomyces dermatitidis. The fungus lives in moist soil and is associated with decomposing organic matter. Some individuals can have lung infections after inhaling airborne fungal spores although many do not become ill. The symptoms of blastomycosis are similar to those of influenza.
Blastomyces in generally found in the midwestern, south-central, and southeastern states.
There has not been a case of Blastomycosis reported in Arizona in the past 10 years.
Transmission
Transmission occurs through inhalation of the Blastomyces dermatitidis spores from the environment.
Incubation period may be weeks to months. In symptomatic patients the median incubation period is 45 days.
Lab Tests & Specimen Info
Test*
Specimen
Culture (the specimens are in order of usefulness)
Serum, CSF (Test can measure prior exposure to the fungus)
Isolation Precautions
Blastomycosis is not a communicable disease.
Standard precautions are recommended in healthcare settings.
Prevention for Patients Anyone can become infected with the Blastomyces dermatitidis spores but individuals with underlying medical conditions may be at increased risk for infection. Individuals with weakened immune systems may consider avoiding wooded areas where they might come in contact with the fungus.
Sporotrichosis is a fungal infection caused by Sporothrix schenckii. Cutaneous infections are the most common form of infection but pulmonary infections can occur. The symptoms of a cutaneous infection can include a small painless nodule that may appear on the fingers, hands, or arms where the fungus entered the body. The nodule may become larger and look like an open sore or ulcer. Infections may become disseminated to other parts of the body include bones, joints, and CNS but this usually only occurs in individuals with weakened immune systems.
The fungus lives in sphagnum moss, hay or other plant materieral.
Transmission
Transmission occurs when the fungus enters the skin through a cut or puncture in the skin.
Sporotrichosis is not spread person to person.
Incubation period is 7 to 30 days.
Lab Tests & Specimen Info
Test*
Specimen
Culture
Drainage (pus), Abscess Drainage, Skin Biopsy
Isolation Precautions
Standard precautions are recommended in healthcare settings.
Prevention for Patients
Wearing protective clothing such as gloves and long sleeves when handing wires, rose bushes, bales of hay, pine seedlings or other material that may cause minor cuts
Kawasaki disease is an acute febrile illness primarily affecting children 5 years of age or younger. The most common symptoms are: fever, rash, swelling of the hands and feet, desquamation of the hands and feet, and irritation and inflammation of the tongue and mouth. Approximately 20% of children who do not get treatment develop coronary artery abnormalities, including aneurysms.
Arizona 5 year median: 20 cases
Transmission
Unknown, but there is no evidence of common source or person-to-person transmission.
Lab Tests & Specimen Info
No tests available.
Isolation Precautions
Standard precautions are recommended in healthcare settings.
St. Louis encephalitis is a viral disease caused by St. Louis encephalitis virus (SLEV). Most individuals that are infected will have no signs of illness. Symptoms can include:
fever
headache
nausea
vomiting
tiredness
Some individual may go on to have a severe neuroinvasive disease which will most commonly include encephalitis. This severe disease occurs most commonly in older adults.
St. Louis encephalitis virus is endemic in Arizona.
Transmission
Transmission occurs when an individual is bitten by an infected mosquito.
Incubation period is 5 to 15 days.
Isolation Precautions
Standard precautions are recommended in healthcare settings.
Prevention for Patients
The best way to prevent infection is to avoid being bitten by mosquitoes. Methods include:
Wearing long pants and long-sleeved shirts
Using insect repellent
Using screens in windows or doors
Public Health Actions
Public health will conduct an epidemiological investigation on a case or suspect case.
