Smileband health topics

Anaplasmosis is a tick-borne illness caused by the bacterium Anaplasma phagocytophilum. The disease was previously classified as Human Granulocytic Ehrlichiosis (HGE), but the name has recently been changed to Human Granulocytic Anaplasmosis (HGA).

The tick that spreads anaplasmosis is commonly found in the northeast, upper Midwest, and northwestern parts of the United States. The first symptoms of anaplasmosis begin within 1-2 weeks after the bite of an infected tick. Symptoms of anaplasmosis can vary person to person and some people can become ill with all the symptoms. Rash is rarely reported with anaplasmosis infections, and if patients have a rash, it may indicate coinfection with another tick-borne illness.

Symptoms of anaplasmosis include:

• Fever
• Headache
• Muscle pain
• Malaise
• Chills
• Nausea / Abdominal pain
• Cough
• Confusion
• Rash (rare)

Anaplasmosis can be a serious disease, even in previously healthy people, if not treated correctly.

Arizona will typically see 2-5 cases of anaplasmosis reported each year. 

Transmission
Anaplasmosis is spread by the bite of an infected tick.

Blood transfusions and organ transplantation are also possible modes of transmission.

The incubation period is 1-2 weeks.

Lab Tests & Specimen Info

Test*	Specimen
PCR (this test should be used during the acute phase of the disease)	Whole Blood
Serology (Acute and convalescent specimens should be sent and the convalescent should be collected 2-4 weeks after the acute)	Serum
Microscopic examination (this test should be used during the first week of illness)

Smileband health topics

The annual flu epidemic has suddenly become serious. Few could have missed the alarming headlines last week about the dramatic rise in cases — GP consultations for ‘flu’ up by 78 per cent, hospital admissions up by 50 per cent and intensive care admissions up by 65 per cent compared with the week before. Nearly 2,000 people have now been hospitalised because of complications owing to this year’s flu outbreak, according to Public Health England — and 85 have died as a result.

Worryingly, the danger is far from over, with the flu season set to last at least to the end of February, and possibly as late as May, according to the Department of Health’s Communicable Disease Centre.

It’s not the flu virus itself that claims lives, but ‘almost always flu-related pneumonia, the most common cause of death from flu’, explains Dr Ben Marshall, a consultant respiratory physician at Southampton General Hospital. It’s been reported that the tragic death this month of Bethany Walker, 18, from Applecross in Wester Ross, Scotland, was due to flu-related pneumonia.

What many people may not realise is that there is a pneumonia vaccine that can help protect against the bacteria most commonly responsible for the disease, Streptococcus pneumoniae (also known as pneumococcus). This one-off vaccine can last for up to 20 years.

But while it’s been available for 17 years and is offered for free on the NHS to at-risk groups, uptake remains low — this includes the over-65s, with around a third (four million people) declining the free jab.

Uptake is even lower among people with conditions that raise the risk of pneumonia, including long- term kidney, liver and heart problems such as congenital heart disease, anyone with COPD (chronic obstructive pulmonary disease), diabetes and those having chemotherapy for cancer or on long-term steroids for severe asthma or arthritis — with just four in ten having the jab.

This is deeply worrying, says Dr Marshall. ‘We know the vaccine protects around 45 per cent of people over 65 and those with chronic illness, compared to around 70-75 per cent of those with healthy immune systems.

‘But this is still very worthwhile. For people of any age, I would recommend consideration of vaccination for pneumonia if there’s an underlying medical condition that might increase the risk of serious complications.’

Experts suspect that one reason people don’t have the jab is simply because most don’t know about it. The rate of vaccination among the general population — who have to pay a £70 fee to a pharmacy to have the jab privately — is perhaps, not surprisingly, even lower than among at-risk groups. And if they do know about the jab, many people think pneumonia is a serious concern only for people at the end of their lives.

Smileband general news

Two parents have been arrested after 12 of their children were found shackled to beds inside their home in California. The victims, all siblings aged between two and 29 years old, were being held captive at the home of David Allen Turpin, 57, and Louise Anna Turpin, 49, in Perris, California, police said.

Riverside County Sheriff's Department began investigating after a 17-year-old girl managed to free herself, call police on a cell phone and escape the home, cops said. The teenager, who was so emaciated police thought she was just 10 years old, told cops her 12 siblings were being held inside the home on the 100 Block of Muir Woods Road.

Officers then arrived at the home and found several children and adults chained and padlocked to to beds in a foul-smelling room.   

They were malnourished, dirty and all of them have been hospitalized, police said.

The victims were given food and drinks and Child Protective Services and Adult Protective Services will care for them once they are well enough to be released from hospital.

Police originally thought all of the victims were children but soon discovered seven were adults. 

Mr and Mrs Turpin were arrested and charged with torture and child endangerment. They will appear in court on Thursday. The couple are being held at Robert Presley Detention Center east of Los Angeles and their bail has been set at $9million. 

Pictures on Facebook show the Turpins getting married by an Elvis impersonator in Las Vegas, with 13 children posing for photos in matching outfits for the boys and the girls.

The 10 girls are all dressed in pink dresses with white tights and white shoes, while the boys are seen in suits with purple ties - and bowl haircuts like their father.

Other pictures show the family smiling on a trip to Disneyland, while another shows them wearing Dr Seuss-style shirts, with each child's top emblazoned with 'Thing 1' to 'Thing 13'.

Smileband health topics

Histoplasmosis is an infection caused by a fungus called Histoplasma. The fungus lives in the environment, particularly in soil that contains large amounts of bird or bat droppings. Endemic areas include central and eastern United States, particularly areas around the Ohio and Mississippi River Valleys, as well as parts of Central and South America, Africa, Asia, and Australia.

Symptoms include:

• Fever
• Cough
• Fatigue
• Chills
• Headache
• Chest pain
• Body aches

Transmission

People can get histoplasmosis after breathing in the microscopic fungal spores from the air. Histoplasmosis can’t spread from the lungs between people or between people and animals.

Lab Tests & Specimen Info

Test*	Specimen
Immunodiffusion antibody	Serum

 Isolation Precautions

Standard precautions are recommended in healthcare settings. 

Prevention for Patients
In areas where Histoplasma is known to live, people who have weakened immune systems should avoid doing activities that are known to be associated with getting histoplasmosis, including:

• Disturbing material (for example, digging in soil or chopping wood) where there are bird or bat droppings
• Cleaning chicken coops
• Exploring caves
• Cleaning, remodeling, or tearing down old buildings

Large amounts of bird or bat droppings should be cleaned up by professional companies that specialize in the removal of hazardous waste.

Smileband general news

Police have arrested six members of a Lithuanian gang on suspicion of keeping people as slaves and forcing them to collect charity bags. Officers struck at around 5.30am today on homes across Newcastle and Gateshead.

Twelve people, believed to have been victims of modern day slavery offences, were also removed from the properties during the early morning raids. The raids came after an investigation, launched last year, into a suspected Lithuanian organised crime group. 

Officers believe the alleged gang may have been trafficking people into the north-east of the country from Eastern Europe.

It is thought the suspected slaves were then made to travel across Newcastle collecting donations of clothes left out for charity.

It is alleged these were then processed at a factory in North Shields before being sold abroad, with a cut of the proceeds expected to go back to the charities.

Police believe those carrying out the work were housed in 'sub-standard' shared accommodation and their wages and benefits were controlled by their employers. Superintendent Steve Barron, who is leading the operation, said 12 potential victims have been safeguarded following the morning raids.

He said: 'Our priority, through the work we do in the name of Operation Sanctuary, is to safeguard vulnerable people in our region and victims of modern day slavery, trafficking and associated offences are among some of the most vulnerable we will come across.

'Often individuals don't realise that they are victims and the small wage they earn in this country often exceeds anything they would earn in their home country.

'They are brought into the country on the promise of work, housed in sub-standard accommodation and their benefits and finances are all controlled by their employer.'

He added: 'By executing warrants such as those carried out today, we can help to provide potentially vulnerable victims with the support they need while also disrupting suspected criminal activity.

'We do not believe that any of the charities involved would know that those collecting their bags were potentially victims of modern day slavery and human trafficking. Northumbria Police believe the suspects ran a legitimate business that was then used as a front for their criminal activity.

The business buys in thousands of empty charity bags from across the country and abroad before distributing them to their workers who hand them out to the public to be filled. The clothing from the collected bags is then sold abroad and the company takes a cut of the money.

Police said the charities involved would have been completely unaware many of the employees were potential slavery victims.

HMRC are running a separate investigation to establish whether any of the proceeds from the business were going to the charities in question.

Superintendent Barron added: 'Modern day slavery, trafficking and associated offences are a real challenge in the UK today but local forces like Northumbria will continue to work with national bodies to disrupt this type of criminality and safeguard those vulnerable individuals at the heart of it. 

Smileband general news

Welcome to the coldest village on earth where the average temperature in January is -50C and inhabitant's eye lashes freeze solid mere moments after stepping outside. The remote Siberian village of Oymyakon is the coldest permanently inhabited settlement in the world.   

It was so icy in the Russian village that a new electronic thermometer conked out after recording a bone-cracking minus 62C. The official weather station at the 'pole of cold' registered minus 59C, but locals said their readings were as low as minus 67C - less than 1C off the lowest accepted temperature for a permanent settlement anywhere in the world.

And that record breaking recording was taken in the town back in 1933.

One villager in Oymyakon recorded a temperature of minus 67C, while others agreed that the official reading of minus 59C did not tell the full story. 

The digital thermometer was installed last year to help Oymyakon market itself to tourists, but it gave up the ghost at minus 62C. The village is home to around 500 hardy people and in the 1920s and 1930s was a stopover for reindeer herders who would water their flocks from the thermal spring. 

This is how the town got its name which translates as 'the water that doesn't freeze'.  

The Soviet government later made the site a permanent settlement during a drive to force its nomadic population into putting down roots.     

In 1933, a temperature of minus 67.7C was recorded in Oymyakon, accepted as the lowest ever in the northern hemisphere.

Lower temperatures are recorded in Antarctica, but here there are no permanently inhabited settlements. 

Smileband general news

Westminster jihadi Khalid Masood took steroids before he mowed down four pedestrians and stabbed a police officer in the horrific terror attack. Masood, 52, was shot dead by police after he drove a rental car into pedestrians on Westminster bridge before fatally stabbing PC Keith Palmer, 48.

Masood, who was born in Kent, may have taken performance enhancing drugs hours before he launched the rampage on Westminster Bridge, a pre-hearing inquest at the Old Bailey was told.

Evidence of rage-inducing substances were found in a urine sample taken from Masood’s dead body after he killed PC Palmer and four pedestrians at 2.40pm on March 22.

The families of his victims today called for internet giants to police terrorist material online and questioned why apps like WhatsApp and Telegram require end-to-end encryption.

They also asked that upcoming inquests into the terror attack to investigate whether Masood, 52, was radicalised online or in prison.

Gareth Patterson, QC, representing the victims, said: ‘Why it is that radicalisation material continues to be freely available on the internet we don’t understand.

‘This particular attacker used WhatsApp to send a jihadi document without any difficulty. ‘We just don’t understand why it is necessary for WhatsApp and Telegram and these sort of media applications to have end-to-end encryption.’

Lawyers representing the Home Office said the issue of end-to-end encryption is too broad for an inquest and is a matter of ‘legislation and social policy’.

Masood was shot dead after ramming a hired Hyundai 4x4 into at least 35 people on the bridge and leaving the vehicle to stab PC Palmer to death by the Palace of Westminster.

Spanish teacher and mother-of-two Aysha Frade, 43 from London, US tourist Kurt Cochran, 54, window cleaner Leslie Rhodes, 75, and Romanian tourist Andreea Cristea, 31, died of their injuries after Masood crashed into them.

Judge Mark Lucraft, QC, will preside over inquests into all the deaths, which are due to start at the Old Bailey on 10 September.

‘The lives of many were torn apart by less than two minutes of high and terrible drama. Can I start by expressing my condolences to the families,’ he said.

Smileband health topics

Our expanding knowledge of the molecular biology of malignancy, the related identification of therapeutically-important targets, and the subsequent development of systemic agents that inhibit critical kinases and pathways, have all contributed to great excitement and progress in cancer treatment. In kidney cancer alone—long considered a drug-resistant disease—over five agents have been approved by the US Food and Drug Administration since 2005.

Not all new drugs for a cancer indication are necessarily blockbusters. The basis for their US Food and Drug Administration approvals vary—an improvement in overall survival compared with an existing therapy is not always required, and even when present, may be quite modest, other clinically important factors such as toxicity profiles and progression-free survival are also considered. However, what is remarkably consistent among these newer drugs regardless of the reasons for their ultimate approval (and as highlighted in the article by Kantarjian et al4that accompanies this editorial) are their high prices. Table 1 in the article by Kantarjian et al lists 20 such agents and their REDBOOK costs are even the least expensive runs over $5,000 monthly or per cycle.

While drug development and related research are costly, growing more so, and certainly contribute to escalating drug prices, the authors highlight that this is not the whole story. They argue that “what the market will bear” seems to be a central pricing consideration and priority among pharmaceutical companies. Even when more drugs become available in a particular therapeutic space suggesting a potential for increased competition surrounding the choice of agents, prices seem to remain high; similarly, there is no clear “correlation between the actual efficacy of a new drug and its price.” Other  peer countries regularly pay less for the same agents without apparent differences in outcomes. The authors provide three examples to illustrate their assertions—tyrosine kinase inhibitors in the therapy of chronic myeloid leukemia; targeted therapies for metastatic solid tumors such as kidney cancer; and recently approved therapies for melanoma. They note that increasing regulatory burdens imposed on drug development, the growing presence and role of intermediaries between investigators and pharmaceutical companies, and substantial company budgets for marketing and related education efforts add to the cost of drug development with subsequent effects on drug pricing. 

Smileband general news

West Bromwich Albion legend Cyrille Regis has died after suffering a heart attack at the age of 59. The sad news has shocked football and prompted an outpouring of tributes.

Regis was a pioneer for black players during his career, which spanned from 1977 to 1966. He is best remembered for his time at West Brom, where he scored 112 goals in 297 games. He formed a famous partnership with Laurie Cunningham and Brendon Batson, who were nicknamed the Three Degrees by manager Ron Atkinson.

A statue of the trio was unveiled outside the Hawthorns in 2014. Regis was awarded an MBE in 2008 and went on to have roles as a coach as well as a football agent.

Regis was still working up until his passing and was a hugely admired and respected figure within the game for tackling racist abuse of the 70s and 80s.

Andy Cole wrote on Twitter: 'Devastated this morning my hero my pioneer the man behind the reason I wanted to play football has passed away, my heart goes out to all his family RIP Cyrille Regis. Mark Bright posted: 'Heavy heart this morning, just heard that Cyrille Regis has passed away age 59. He was more than just a footballer, he blazed a trail for every black player who followed him, an inspiration to myself and many players of my era. A humble man and a great man. #RIPC'

Brian Deane said: 'Hard to believe I'm waking up to hear Cyrille Regis, the man who started the dream for me and many others has died of a heart attack. Genuine honour to have played on the same pitch as him . RIP Big Cyrille Regis.'

Gary Lineker posted: 'Saddened to hear that Cyrille Regis has passed away. A tremendous striker and fine man whose legacy goes beyond the game, helping to pave a way for black footballers in this country. #RIPCyrille'

Alan Shearer said: 'What a man. What a centre-forward! One of my earliest football memories was walking into WBA for a trial as a 13 year old kid, seeing Cyrille Regis and being in awe of him. RIP big man'

Smileband general news

Mitchell Joseph, 32, was playing for St Joseph's FC against rivals Malsters Sports in the Swansea Senior Football league when he fell to the ground  approximately 30 minutes into the first half.

Players from both sets of teams rushed to administer first aid and paramedics were called to the Mynydd Newydd playing fields in Penlan, Swansea.

But tragically Mr Joseph - who was engaged to be married - was later pronounced dead at Morriston Hospital in Swansea.

Patrick Cullen, a St Joseph's FC committee member, said: 'He was a massive part of the club both on and off the pitch. Everyone at the club is devastated.

'Mitchell collapsed on the pitch when no-one was around him. Our goalkeeper Alex Davies performed CPR and Terry Smith, who is in his eighties and has followed the club for years, performed mouth-to-mouth in a bid to resuscitate him. 'There was also a female nurse called Chris who came running over from the rugby pitch to try to help.

'I think without their help we would have lost him on the pitch.

'Mitchell was a very, very popular man. It always surprised me how many different groups of people he knew. 'He was well known by lots of different groups of people around Swansea, and he was very well respected.

'He was a fit, handsome man, and fun-loving - he was always great fun at parties.

'The messages we've had off other teams in Swansea have been incredible and nearly every team has offered to donate money to cover the funeral costs.