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Expert Perspective: CDC decides on permissive recommendation for strain B meningococcal vaccination

The Center for Disease Control (CDC) chose not to mandate a newly-developed vaccine for a meningitis substrain Neisseria meningitidis, but to leave the decision to vaccinate up to parents and children with physician recommendations. Meningococcal meningitis is a serious condition which can be incredibly dangerous if not treated quickly. Vaccines for the strains A, C, Y and W-135 have been a part of vaccination requirements for over 10 years, while the vaccine for the serogroup B strain, Neisseria meningitidis, was developed last year. Questions about the vaccination requirements were raised amidst growing concerns linked to recent B-strain outbreaks.

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New grant will allow U of M researchers to advance new diagnosis & treatment methods for meningitis

Researchers from the University of Minnesota Medical School’s Division of Infectious Diseases and International Medicine have received a $3.2 million grant to examine new cost-effective approaches for diagnosing and treating meningitis. The University will partner with Uganda’s Makerere University on the effort.

In the first of two programs supported by the new grant, University of Minnesota researchers will employ a tiered approach to diagnosing meningitis, employing a strategic approach that eliminates a full battery of testing when a more limited panel of stepwise testing can confirm infection.  The project will also explore new diagnostic tests for meningitis due to tuberculosis (TB).

The grant will also support a new clinical trial to test the antifungal properties of sertraline (Zoloft), an antidepressant with possible anti-fungal properties in mouse models. Because Zoloft went off patent in 2006, the medication could present a cheaper alternative in the fight against cryptococcal meningitis.

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Health Talk Recommends: “How a wimpy, ubiquitous black mold turned to the dark side.”

Yesterday, Laurel Herold wrote about the fungal meningitis outbreak that has killed 29 people to date while sickening 377 others.

Today, Dr. Craig Bowron, a Twin Cities physician and contributor to MinnPost takes an editorial approach we thought would interest Health Talk readers.

In his article “Fungal meningitis: How a wimpy, ubiquitous black mold turned to the dark side,” Bowran profiles Exserohilus rostratum, the black mold which made its way from the reportedly-unsanitary environment of the New England Compounding Center (NECC) into steroid injection compounds bound for customers across the country with disastrous results.

According to Bowran, up until this point human infections traced to black mold have been fairly rare or unconcerning.  “Although Exserohilus is a ubiquitous mold, found commonly in soils and on plants, it doesn’t find humans to be particularly appetizing or easily boarded, and so human infections are rare,” he writes.

But if that’s true, how has the fungus wreaked havoc on the American populace?

To find out, Bowran talked to University of Minnesota microbiologist Kirsten Nielsen, Ph.D.  Here’s what she told him:

“Because the primary source of exposure to fungi is through the lungs, most of our immune defenses are poised for action at the pulmonary level,” Nielsen explained. “If the fungus does manage to move through the lungs and deeper into the body, at least we’ve already been alerted to their presence, and the body is able to escalate its immune response to the invader.”

But according to Neilsen, providing a fungal infection a back-door entry into the central nervous system (CNS) can cause profound problems for the human body.  The CNS isn’t adequately prepared to immediately mount a meaningful immune system response. In the resulting war with an invading fungus, the CNS is completely outmatched.

To read more, click over to MinnPost and read the full piece by Dr. Bowran. It’s a fascinating article and worth the read.

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Unprecedented meningitis contamination causes major concern

The recent outbreak of fungal meningitis from contaminated steroid shots linked to New England Compounding Center (NECC) has caused a major stir across the country and garnered considerable interest from the public and media looking for an answer as to how to control and prevent contaminations like this from happening again.

As of this post, more than 180 people have been infected in 10 states (including Minnesota), and 14 people have died. With the toll of those infected growing by the day, public health officials are looking to find a way to curtail the threat and restore faith in pharmaceutical safety.

According to David Polly, M.D., a University of Minnesota Physicians orthopaedic surgeon, this outbreak of aspergillosis meningitis is due to contamination of medicine, and in that respect is similar to other such contaminations where physicians and health officials sharing information with the public becomes critical.

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In the fight against cryptococcal meningitis, U of M researcher recommends a shorter, more cost-effective therapy regimen

The most cost-effective course of treatment for cryptococcal meningitis is different than current World Health Organization (WHO) recommendations according to University of Minnesota researchers, and as a result, current policies need to be reviewed.

David Boulware, M.D., M.P.H., Associate Director of Global Health Programs in Internal Medicine, Division of Infectious Diseases & International Medicine, Department of Medicine, recommends a shorter, more cost-effective therapy regimen option for cryptococcal meningitis.

Cryptococcal meningitis is a serious fungal infection of the brain, usually occurring in people with immune system deficiencies such as organ transplantation or HIV/AIDS. Cryptococcal meningitis affects approximately 1 million people per year worldwide and is currently the most common cause of meningitis in Africa.

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