Podcasts about melioidosis

Six councils in south-west Queensland have banded together to protest an eye-watering increase in insurance premiums of up to 300 per cent.

As the clean-up from ex-Tropical Cyclone Alfred begins, there could be hazards hidden in the water. Microbiologist at the University of the Sunshine Coast Associate Professor Erin Price told Gary Hargrave on 4BC Drive, "Melioidosis is not very common in South East Queensland, thankfully." "This is an infectious disease that does lurk in the soil, and it loves when there's wet weather, especially flooding events and cyclones." "So we have a perfect storm of conditions for this organism and for this disease right now in South East Queensland." "We want people to just be aware that it is potentially going to be an issue, especially if you've come into contact with flood waters or mud, for instance, during cyclone clean up," Associate Professor Price continued. See omnystudio.com/listener for privacy information.

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Once considered endemic only to tropical and subtropical climates such as Southeast Asia and northern Australia, melioidosis is expanding to non-endemic areas such as the southern US. Climate change is impacting infectious diseases, melioidosis being no exception. Now is the time to inform and prepare: as this Communicable episode's title indicates, melioidosis is going global.Join hosts Angela Huttner and Josh Davis on their in-depth exploration of melioidosis with invited experts Dr. Ella Meumann and Prof. Bart Currie from Royal Darwin Hospital, Darwin, Australia. Topics range from melioidosis discovery, clinical presentation, diagnostic approaches and host risk factors to the disease's expanding endemicity.Melioidosis is an infectious disease caused by the sapronotic agent Burkholderia pseudomallei and contracted by both people and animals through direct contact with contaminated soil, air or waters. Current burden estimates of 169'000 cases and 89'000 deaths per year are thought to be grossly underreported due to limited access to laboratory diagnostics and lack of clinical awareness. Experts call for melioidosis to be recognized as a neglected tropical disease in order to give this disease the urgent attention and resources it deserves.This episode was edited by Kathryn Hostettler and peer-reviewed by Dr. Goulia Ohan of Yerevan State Medical University, Armenia.Literature Meumann EM and Currie BJ. Approach to melioidosis. CMI Comms 2024;1(1). doi: 10.1016/j.cmicom.2024.100008 Savelkoel J, Dance D. Alfred Whitmore and the Discovery of Melioidosis. Emerg Infect Dis. 2024;30(4):752-756. doi:10.3201/eid3004.230693 Limmathurotsakul D, Wongsuvan G, Aanensen D et al. Melioidosis Caused by Burkholderia pseudomallei in Drinking Water, Thailand, 2012. Emerg Infect Dis. 2014;20(2):265-268. doi: 10.3201/eid2002.121891 Petras JK, Elrod MG, Ty MC, et al. Locally acquired melioidosis linked to environment—Mississippi, 2020-2023. N Engl J Med. 2023;389:2355-2362. doi: 10.1056/NEJMoa2306448Howes M and Currie BJ. Melioidosis and Activation from Latency: The “Time Bomb” Has Not Occurred. ASTMH. 28 May 2024;111(1): 156-160. doi 10.4269/ajtmh.24-0007

A vaccine against the bacterium, Burkholderia pseudomallei, that causes melioidosis was tested in a mouse study and found to be highly protective against the disease, according to UCLA researchers. What is Burkholderia pseudomallei? What is melioidosis? And what about this vaccine study? Joining me today to answer these questions and more is Marcus Horwitz, MD. Dr Horwitz is a Distinguished Professor of Medicine, in the division of infectious diseases, and of Microbiology, Immunology and Molecular Genetics at the David Geffen School of Medicine at UCLA. He is also the senior author of the paper on this vaccine in the journal mBio.  

On this episode, Dr. Blair Bigham and Dr. Mojola Omole explore a clinical case involving a rare infection in a returned traveler, highlighting the critical role of travel history in diagnosing unusual diseases. They discuss the case of a woman in her 60s who presented with fever and ankle pain after returning from India. Initial concerns for septic arthritis led to further investigation when standard treatments failed to alleviate her symptoms. Dr. Mara Waters is the lead author of the clinical case entitled “Melioidosis with septic arthritis in a returning traveller,” published in Canadian Medical Association Journal (CMAJ). She details the steps the infectious diseases team took to ultimately identify the infection as caused by Burkholderia pseudomallei.Dr. Waters, an infectious diseases fellow at the University of Toronto, describes the challenges of diagnosing and treating melioidosis, emphasizing the importance of considering travel history and the evolving geography of infectious diseases. She highlights the broader implications of climate change on the spread of infectious diseases and the interconnectedness of human, animal, and environmental health.Following the case discussion, Dr. Jeffrey Pernica, a specialist in infectious diseases and tropical medicine, offers a refresher on common infections in returning travelers, such as malaria, dengue, and typhoid. He stresses the importance of considering these more prevalent conditions when evaluating a returning traveller with fever, providing practical advice on diagnosis and management.This episode serves as a reminder of the complexities of diagnosing travel-related infections and the need for clinicians to be vigilant about travel history, especially in the context of global travel resurgence and the impacts of climate change on infectious disease patterns.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

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In this penultimate episode in the Nobbling the Nonfermentors mini-series, Jame and Callum discuss the regionally important neglected tropical disease Melioidosis, caused by Burkholderia pseudomallei.This episode was based disproportionately on the following article, and we extend our thanks to the authors for thoughfully publishing it so close to us wanting to do a podcast episode on Melioid!Meumann, E.M., Limmathurotsakul, D., Dunachie, S.J. et al. Burkholderia pseudomallei and melioidosis. Nat Rev Microbiol (2023).https://www.melioidosis.info/Link to prep notes here. Support the showQuestions, comments, suggestions to idiotspodcasting@gmail.com or on X/Threads @IDiots_podPrep notes for completed episodes can be found here (Not all episodes have prep notes).If you are enjoying the podcast please leave a review on your preferred podcast app!Feel like giving back? Donations of caffeine gratefully received!https://www.buymeacoffee.com/idiotspod

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Local doctor Sarah joined Pricey on the show to discuss Melioidosis and what we can do to protect ourselves from it. She also mentions how the COVID situation in Townsville is going.  If you want to hear more about infectious diseases in North QLD check out 'Health Chats with Dr Sarah' on the Everything Townsville page now! Link below.  https://www.listnr.com/podcasts/my-town-townsvilleSee omnystudio.com/listener for privacy information.

Jeremy Skillington, CEO of Poolbeg Pharma #POLB outlines the exclusive Licence Agreement with University College Dublin for a late preclinical stage vaccine candidate for Melioidosis, a disease for which there is no currently approved vaccine available. Highlights The vaccine candidate, which is being developed by Poolbeg as POLB 003, was invented following many years of research by Associate Professor Siobhán McClean, UCD School of Biomolecular and Biomedical Science, and was a recipient of a Wellcome Trust Award to aid its development. To read the full RNS click here

Top 5 Most Read RNS's on Vox Markets for Wednesday 21st September 2022 5. Blue Star Capital #BLU - Holding(s) in Company Mark White's holdings have reduced from 10.7% to 8.3%. 4. Dev Clever Holdings #DEV - Launch of Career Success Membership Program Dev Clever will be exhibiting at DIDAC, Asia's largest education conference and exhibition held at Bangalore, India where it will unveil further progress on its Launchmycareer platform with the launch of its Career Success Membership Program. 3. Greatland Gold #GGP - Notice of General Meeting A General Meeting will be held at Salisbury House, London Wall IN London on Friday, 7th October 2022 at 9.30am. 2. EQTEC #EQT - Southport Project Ownership Update The Company has executed with Rotunda Group and certain of its subsidiaries a series of legal agreements to accelerate development of the Southport Hybrid Energy Park. 1. Poolbeg Pharma POLB - Poolbeg licence of Melioidosis vaccine candidate Poolbeg Pharma has signed an exclusive Licence Agreement with University College Dublin (UCD) for a late preclinical stage vaccine candidate for Melioidosis, a disease for which there is no current approved vaccine available.

On episode #8 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the previous two weeks, 7/21/22 – 8/3/22. Hosts: Daniel Griffin and Sara Dong Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of Puscast! Links for this episode Pediatric hepatitis linked to infection with two viruses (BMJ)  Protection duration of Yellow Fever vaccination (CID) Impact of CSF panel on duration of treatment (OFID) Cluster of Parechovirus infections in infants (MMWR) Molecular ecology and risk factors for Escherichia coli (Journal of Antimicrobial Therapy)  Melioidosis endemic in areas of the Mississippi gulf coast (CDC) Early switch from intravenous to oral antibiotics in infections (OFID) Duration of therapy and the use of Quinolone/Rifampin-Based regimens for joint infections (OFID) Efficacy of Doxycycline for mild-to-moderate community-acquired Pneumonia in adults (CID) Effectiveness of a Vancomycin dosing protocol (Cambridge Core) Outcomes of Fungemia in patients receiving extracorporeal membrane oxygenation (IDSA)  Malaria transmission intensity likely modifies RTS, S/AS01 efficacy (IDSA) Ultrashort course antibiotics for suspected pneumonia (CID) Music is by Ronald Jenkees

Jeremy Skillington, CEO of Poolbeg Pharma #POLB discusses their deal with CytoReason, a leading artificial intelligence (AI) company developing computational disease models for efficient drug discovery and development, to provide AI analysis of Poolbeg's influenza disease progression data derived from human challenge study samples. The partnership will harness the insights of Poolbeg's unique repository of influenza human challenge trial* data and is another significant milestone in its strategy to leverage its proprietary databank to identify new pharmaceutical assets using artificial intelligence. CytoReason has built world-class validated AI models which can extrapolate immune cell behaviour based on bulk transcriptomics, making it an ideal partner to maximise the insights of Poolbeg's influenza data. To date, five of the world's top ten pharma companies use CytoReason's technology including Pfizer, Sanofi, Merck KGaA and Roche. Poolbeg's ability to execute a deal of this nature with a company of CytoReason's stature is a testament to the quality of Poolbeg's proprietary databank which will significantly improve the outputs of the collaboration. About Poolbeg Pharma Poolbeg Pharma is a clinical stage infectious disease pharmaceutical company, with a capital light clinical model which aims to develop multiple products faster and more cost effectively than the conventional biotech model. The Company, headquartered in London, is led by a team with a track record of creation and delivery of shareholder value and aspires to become a "one-stop shop" for Big Pharma seeking mid-stage products to license or acquire. The Company is targeting the growing infectious disease market. In the wake of the COVID-19 pandemic, infectious disease has become one of the fastest growing pharma markets and is expected to exceed $250bn by 2025.  With its initial assets from Open Orphan plc, an industry leading infectious disease and human challenge trials business, Poolbeg has access to knowledge, experience, and clinical data from over 20 years of human challenge trials. The Company is using these insights to acquire new assets as well as reposition clinical stage products, reducing spend and risk. Amongst its portfolio of exciting assets, Poolbeg has a small molecule immunomodulator for severe influenza; a first-in-class, intranasally administered RNA-based immunotherapy for respiratory virus infections; a vaccine for Melioidosis, an oral vaccine delivery platform in development and two AI data analysis platforms to help accelerate the power of its human challenge model data and biobank.

Jeremy Skillington, CEO of Poolbeg Pharma #POLB discusses an agreement with OneThree Biotech, a biology-driven artificial intelligence company, to identify new drug targets and treatments for Respiratory Syncytial Virus. Highlights Under the terms of the transaction and as aligned with Poolbeg's strategy, OneThree Biotech's state-of-the-art AI analysis tools will identify drug assets which target immune-response pathways, have a higher probability of clinical success and have the potential to prevent and / or treat infectious diseases. The analysis will prioritise drugs with existing Phase I safety data, reducing spend and risk, which can feed into Poolbeg's rapid, capital light clinical development strategy and its expanding pipeline of assets. The analysis is expected to commence in Q1 2022 with preliminary outputs from this work expected in H2 2022. OneThree Biotech is a clinically validated AI company with a proven technology platform which integrates chemical, biological, and clinical data with cutting-edge computational tools to answer complex questions surrounding disease biology and drug discovery. The team at OneThree will work closely with Poolbeg's scientific team to build a tailored AI analysis model which can leverage the unique insights of human challenge trial data to identify disease-relevant cell signalling pathways which could lead to novel drug targets. OneThree will receive milestone payments based on candidate development and royalties on the sale of products derived from this partnership.  The Company believe that this partnership with OneThree Biotech is the first time that AI analysis has been undertaken on RSV human challenge trial data and samples to identify new drug targets. The unique nature of human challenge trials to produce disease progression data with high precision is expected to revolutionise the insights generated from this analysis. Poolbeg's lead asset POLB 001, which is progressing towards its first human challenge trial in June 2022, was identified using such disease progression data. However, by utilising AI the Company aims to identify more targets, quicker and more cost efficiently than previously possible without this technology.   About Poolbeg Pharma Poolbeg Pharma (AIM:POLB) is a clinical stage infectious disease pharmaceutical company with a capital light clinical model which is developing multiple products faster and more cost effectively than the conventional biotech model. The Company, headquartered in London, is led by a team with a track record of creation and delivery of shareholder value and aspires to become a "one-stop shop" for Big Pharma seeking mid-stage products to licence or acquire. The Company is targeting the growing infectious disease market which has become one of the fastest growing pharma markets and is expected to exceed $250bn by 2025. Poolbeg has access to extensive knowledge, experience, and clinical data from over 20 years of human challenge trials through Open Orphan plc, an industry leading infectious disease and human challenge trials business. The Company is using these insights to acquire new assets as well as reposition clinical stage products, reducing spend and risk.  The Company continues to rapidly expand its portfolio of assets which currently includes POLB 001, a small molecule immunomodulator for severe influenza. POLB 002, a first-in-class, intranasally administered RNA-based immunotherapy for respiratory virus infections and POLB 003, an intramuscular Melioidosis vaccine. The Company is also developing an oral vaccine delivery platform as well as progressing its AI powered drug discovery program to identify drug targets and treatments using its disease progression data.

Welcome to our 2022 season to Aquadocs! We are so excited to kick things off with Dr. Sarah Churgin, veterinarian at Ocean Park in Hong Kong. In this episode, Dr. Churgin discusses the perks and challenges of practicing in a new country such as learning how to do root canals on dolphins and dealing with language barriers. We also discuss Melioidosis, a disease that can cause high fevers and potentially septicemia in dolphins in Asian countries. And stick around until the end for externship and internship opportunities for high school through vet students! If you want to get in touch with Dr. Churgin, feel free to email her at sarah.churgin@oceanpark.com.hk.

Dr. Patrick Dawson, an epidemiologist at CDC in Atlanta, and Sarah Gregory discuss a case of melioidosis from a freshwater home aquarium in the United States.

Cathal Friel, Co-Founder & Chairman & Jeremy Skillington, CEO of Poolbeg Pharma #POLB discuss the Option Agreement they signed with University College Dublin for a Melioidosis Vaccine candidate, MelioVac, and a licence to evaluate 5 other infectious disease portfolio assets. Highlights Poolbeg Pharma , a clinical stage infectious disease pharmaceutical company with a capital light clinical model, has signed an Option Agreement to licence MelioVac, a vaccine for melioidosis, with University College Dublin ('UCD') and its inventor, Associate Professor Siobhán McClean, through NovaUCD, the university's knowledge transfer office.  The Company will continue its due diligence on MelioVac, a preclinical asset and recipient of a Wellcome Trust Award to aid its development, as well as 5 of other potential vaccine candidates discovered by Associate Professor McClean and her team, for the duration of the Option Agreement, prior to signing a 'Licence Agreement'.  Dr McClean is Associate Professor and Head of Biochemistry at the UCD School of Biomolecular and Biomedical Science. Dr McClean completed her BSc in Biochemistry in UCD and received her PhD from Imperial College London. Her research focuses on lung infections which led her to develop a platform technology to identify proteins that bacteria use to attach to human cells. These proteins have proved to be excellent vaccine candidates. Dr McClean completed some of the original research to identify the antigens associated with the Melioidosis Vaccine at TU Dublin. Poolbeg Pharma has identified melioidosis as an infectious disease of interest due to its rising incidence around the world and because there is currently no approved vaccine available. Concerns are growing about global warming contributing to the spread of the disease to traditionally non-tropical areas. Melioidosis, also known as Whitmore's disease, is an infectious disease caused by the bacterium Burkholderia pseudomallei, commonly found in the soil and surface groundwater of many tropical and subtropical regions, with diverse clinical presentations including pneumonia and severe sepsis with multiple organ abscesses. Incidence of the disease is widespread in South-East Asia, Northern Australia and India, with climate change having a substantial impact on the spread of the disease to new areas such as Brazil. There are an estimated 165,000 cases of melioidosis each year, of which as many as 89,000 (54%) are estimated to be fatal.  Other potential vaccine candidates that the Company is evaluating include those for Klebsiella pneumoniae, Escherichia coli (O157), Burkholderia cepacia complex, Pseudomonas aeruginosa and Acinetobacter baumannii. About Poolbeg Pharma Poolbeg Pharma is a clinical stage infectious disease pharmaceutical company, with a capital light clinical model which aims to develop multiple products faster and more cost effectively than the conventional biotech model. The Company, headquartered in London, is led by a team with a track record of creation and delivery of shareholder value and aspires to become a "one-stop shop" for Big Pharma seeking mid-stage products to licence or acquire. The Company is targeting the growing infectious disease market. In the wake of the COVID-19 pandemic, infectious disease has become one of the fastest growing pharma markets and is expected to exceed $250bn by 2025. With its initial assets from Open Orphan plc, an industry leading infectious disease and human challenge trials business, Poolbeg has access to knowledge, experience, and clinical data from over 20 years of human challenge trials. The Company is using these insights to acquire new assets as well as reposition clinical stage products, reducing spend and risk. It already has a Phase II ready repositioned small molecule immunomodulator for severe influenza and a portfolio of other exciting assets. The Company plans to broaden this portfolio further going forward and is in active discussions with AI data analysis platforms to help accelerate the power of its human challenge model data and biobank.

 You may have heard about a recent deadly outbreak related to gemstone-laden room sprays. The culprit in that sad situation is called “Melioidosis,” and this week we've got a history of how humanity tracked down this slippery ailment.

  Vidcast:  https://youtu.be/rVHJSoAkH8g   The CPSC and Walmart are recalling Better Homes and Gardens Essential Oil Infused Aromatherapy Room Spray with Gemstones.  This product contaminated with Burkholderia pseudomallei, a reasonably rare bacterium that causes melioidosis, a nasty infection that may present as a pneumonia, encephalitis, septic arthritis, or dangerous hypotension.  This infection may be fatal.  About 3900 bottles of this aromatherapy room spray were sold by Walmart at stores nationwide and online at walmart.com.     If you bought this aromatherapy spray and it is unopened, do not open it and do not throw the bottle away.  Wear gloves when handling this product.  Double bag the bottle in zip top bags and place in a small cardboard box for return to any Walmart store for a $20 Walmart Gift Card.  Wash any sheets, linens, or clothing with spray on them using normal laundry detergent and dry completely at a hot setting.  Wipe down any surfaces exposed to the spray with an undiluted disinfectant.  Wash your hands after cleaning up.   For more information, call Walmart at 1-800-925-6278.   https://www.cpsc.gov/Recalls/2022/Walmart-Recalls-Better-Homes-and-Gardens-Essential-Oil-Infused-Aromatherapy-Room-Spray-with-Gemstones-Due-to-Rare-and-Dangerous-Bacteria-Two-Deaths-Investigated   #walmart #aromatherapy #infection #melioidosis #recall    

Today we'll look at African swine fever in the Dominican Republic, Is the Delta variant deadlier?, Tularemia infection from crabs, Melioidosis in the US, Another Ebola outbreak and Strongyloides hyperinfection.

Today’s Guests Dr. Bret Nicks – Christian Medical & Dental Association Carmen and Dr. Nicks bring COVID back into conversation, but today related to boosters and also children. They also pivot to a disease virtually none of us may have heard of, Melioidosis, which has made its way into a couple of people in the […] The post COVID Booster Vaccines, Melioidosis and Over-Processed Diets | What the Bible Has to Say About Marijuana appeared first on The Reconnect with Carmen | Engaging Culture from a Christian Worldview.

Christian Medical and Dental Association's Bret Nicks updates us about COVID, as well as about a rare, tropical disease being reported in the US and the problems with the diets of many youth.  Todd Miles, author of "Cannibas and the Christian," addresses the science and the Biblical issues around Marijuana.

Christian Medical and Dental Association's Bret Nicks updates us about COVID, as well as about a rare, tropical disease being reported in the US and the problems with the diets of many youth.  Todd Miles, author of "Cannibas and the Christian," addresses the science and the Biblical issues around Marijuana.

· EU investiga casos de Melioidosis, una extraña enfermedad común en el sur de Asia. · El acoso cibernético durante el regreso a clases. · ¿Qué está pasando en Afganistán? Raúl Paimbert periodista desde Houston nos amplía sobre el tema. · ¿Cómo surgió el Talibán?

Melioidosis en EEUU: CDC lanzan advertencia tras dos muertes por extraña enfermedad.Mató a puñaladas a sus dos hijos en México y lo atraparon al entrar a EEUU.Autoridades de Estados Unidos de la FDA lanzan recall de fórmula para bebés, que ya fue retirado del mercado por no cumplir con los estándares de hierro.Entérate de estas y otras noticias destacadas en el nuevo episodio de MundoNOW.

Melioidosis en EEUU: CDC lanzan advertencia tras dos muertes por extraña enfermedad. Mató a puñaladas a sus dos hijos en México y lo atraparon al entrar a EEUU. Autoridades de Estados Unidos de la FDA lanzan recall de fórmula para bebés, que ya fue retirado del mercado por no cumplir con los estándares de hierro. Entérate de estas y otras noticias destacadas en el nuevo episodio de MundoNOW. Learn more about your ad-choices at https://www.iheartpodcastnetwork.com

This month, in our final excerpt from the “Tropic Medicine” webinar, we look at Rickettsial Diseases with Prof McBride. This is part 3 in a 3 part series. We've discussed Melioidosis and Leptospirosis and Dengue Fever in the previous excerpts.

If you live in FN Queensland and a patient presents feeling unwell with a fever after a flood, on your differential list, you’d need to consider Melioidosis and Leptospirosis.  If you don’t actually live in northern Australia, you may feel you need to brush up on your knowledge of those 2 differentials. And you’re in luck... This month we listen in on a webinar excerpt with Professor John McBride who presented on the topic of “Tropical Medicine”. This is part 1 of a 3 part series, where Prof McBride discusses melioidosis and leptospirosis. 

Pathogenic E. coli are different than lab-grown or commensal E. coli found in the gut microbiome. Alfredo Torres describes the difference between these, the method his lab is using the develop vaccines against pathogenic E. coli, and how this same method can be used to develop vaccines against Burkholderia infections. Julie’s Biggest Takeaways: coli plays many roles inside and outside the scientific laboratory: Laboratory E. coli strains used by scientists to study molecular biology. Commensal E. coli strains contribute to digestion and health as part of the intestinal microbiome. Pathogenic E. coli strains have acquired factors that allow them to cause disease in people The pathogenic E. coli associated with diarrheal disease are the ones named for their O-antigen and flagellar H-antigen, such as O157:H7. There are about 30 E. coli strains with various combinations of O-H factors known to cause diarrheal disease in people.  The E. coli Shiga toxin (though not the bacterium itself) can pass through the epithelial cell layer to become systemic, and eventually the toxin will accumulate in the kidneys. This can lead to patients experiencing hemolytic uremic syndrome (HUS) and kidney failure, leading to lifelong dialysis or need for a transplant. An immune response that prevents the E. coli from attaching will prevent the bacterium from secreting toxin in close proximity to the epithelial cells and decrease likelihood of HUS development. Burkholderia is a bacterial genus whose member species have been weaponized in the past, and which remain potent disease-causing agents around the world.  B. mallei causes glanders, a disease mostly of horses and their handlers. It is a respiratory infection that can become systemic if not treated. B. pseudomallei causes melioidosis, a disease that can manifest in many ways. It is endemic in many tropical regions around the world, found in over 79 countries so far. Coating gold nanoparticles with antigens against which the immune response will be protective is a method Alfredo has used for a number of candidate vaccines, including one against E. coli and one against B. pseudomallei. The nanoparticles can have the gold cleaved off to provide different functional variants of the same vaccine.  Links for this Episode: Alfredo Torres webpage at University of Texas Medical Branch McWilliams BD and Torres AG. Enterohemorrhagic Escherichia coli Adhesins. Microbiology Spectrum. 2013. Sanchez-Villamil JI et al. Development of a Gold Nanoparticle Vaccine against Enterohemorrhagic Escherichia coli O157:H7. mBio. 2019. Wiersinga WJ et al. Melioidosis. Nature Reviews Disease Primers. 2018.  Khakhum N. et al. Evaluation of Burkholderia mallei ΔtonB Δhcp1 (CLH001) as a live attenuated vaccine in murine models of glanders and melioidosis. PLOS Neglected Tropical Diseases. 2019. Torres AG. Common Sense Can Keep You Safe in E. coli Outbreak. Galveston County Daily News. 2020. ABRCMS: Annual Biomedical Research Conference for Minority Students MTM: Burkholderia pseudomallei & the neglected tropical disease melioidosis with Direk Limmathurotsakul HOM Tidbit: Kiyoshi Shiga Biography in Clinical Infectious Diseases  

In Part 2 Matthew talks of his participation on the 4 man commentary team used by the BBC at the Aintree Grand National. He got to call from the commentary position at Becher’s Brook-perhaps the most famous of all the Aintree obstacles. He talks of his love for tennis and his nine year association with Tennis Australia, as a caller and courtside interviewer.  Matt  looks back on the amazing number of sports he’s covered at Summer and Winter olympics. He speaks with great honesty about the lethal virus he contracted during the Beijing Olympics. He recalls the ravages of Melioidosis, a virus present in contaminated soil and water. He looks back on the days when his life hung in the balance. Matt reflects on the decision to leave Sydney and the grand farewell he was given by one special country race club. No Matt Hill podcast would be complete without his tribute to Winx. He called the champion in two of her four Cox Plate wins. This is a review of the first nineteen years of an amazing career. A great listen.  

This podcast presents an interesting internal medicine case of a patient who initially presented to themselves to the clinic with a chief complaint of a cough, and the chain of events that occurred with this particular case.  Joining Dr. John Peitersen, (Internal Medicine) in the case discussion today include: Dr. Barrett Larson, (Pulmonary Medicine), Dr. James Currie (Lakeview Clinic-Infectious Disease), Dr. Matthew Herold (Emergency Medicine), Dr. David Gross (Radiology), Dr. Susan Bowers (Pathology), Dr. Kevin White (Hospitalist), along with various other providers and Allied Health staff.  Enjoy the podcast. Objectives: Upon completion of this CME event, program participants should be able to: Perform a differential diagnosis on cases presented. Identify limitations of certain tests. Discuss the interpretation of lab results on the cases presented. CME credit is only offered to Ridgeview Providers for this podcast activity. Complete and submit the online evaluation form, after viewing the activity.  Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within 2 weeks.  You may contact the accredited provider with questions regarding this program at rmccredentialing@ridgeviewmedical.org. Click on the following link for your CME credit:  CME Evaluation: 2019 Internal Medicine Case Conference (**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.)  The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition.” FACULTY DISCLOSURE ANNOUNCEMENT  It is our intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker’s outside interest may reflect a possible bias, either the exposition or the conclusions presented. Planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event.   Show Notes:      This is the case of a 44 year old woman who initially presents for a cough for about a week. She is obese and has OSA. She is on flonase. She had a low grade fever. Exam doesn’t reveal much besides a serous OM and some mild anterior cervical lymphadenopathy. Conservative care was advised, as well as follow-up in the next couple weeks if not improving. Dr. Peiterson now will tell us the chain of events in this peculiar case. Joining Dr. John Peitersen in the discussion today are: Dr. Barrett Larson from Ridgeview pulmonary medicine, Dr. James Currie, Lakeview Clinic infectious disease, Dr. Matthew Herold, Ridgeview emergency medicine, Dr. David Gross, Radiologist with Consulting Radiologists, Ltd, Dr. Susan Bowers, Pathology, Dr. Kevin White, Ridgeview hospitalist, and various others from the provider and allied health audience.      The initial small segment of this discussion had recording difficulty, so our conversation picks up immediately after the initial presentation of the patient.   CHAPTER 1 REVIEW:      So... let’s recap up to this point. So far we have heard input from Dr. Peiterson, Dr. Larson the pulmonologist, Dr. Gross the radiologist and Dr. Bowers the pathologist. So, initially she was seen for what sounds like a viral URI, and was told to f/u if not improving. Well, we all see this kind of case every day, right? She was then treated by phone with Azithromycin; seen by different providers; Reports “crackling in the lungs’, malaise and subjective fever. She has a Son who had strep 9-days ago. Ears look better today. Cryptic tonsils. VSS. Negative strep test. This was felt to be Viral bronchitis.  CXR offered, patient declined due to $.      Five months later, the patient sees a sleep doctor. Continued cough noted. Pulmonary function tests are likely now indicated. Is there mild asthma? PFTs are able to give us a lot of information. Is the FEV1-FVC ratio acceptable.  Yes, it’s above 80 -  in her case. Chance of asthma markedly low. However the diffusion capacity is low at 83. For some reason, she is not absorbing O2. Nothing really going on with her expiratory loop, or any other major issues with this test. Is the patient’s obesity contributing to her poor lung perfusion? Interestingly, her weight has decreased by 15 lbs since her last visit.       Pulmonary physician recommended a CXR, a 4 week post nasal drip protocol. Additionally is a metacholine challenge needed here? Often a pre- and post-neb peak flow will first be done first. Then the metacholine challenge is done if the clinical picture fits. Is it time to rule-in or out asthma and spare someone years of MDI use. Diffusion capacity should be normal in asthma.       Dr. Peitersen reflects on an often asked board question. When to get a chest xray for the complaint of persistent cough. Barring other obvious reasons such as new chest pain, high fever/shaking chills or focal exam findings, The American College of Chest Physicians recommends that if a cough is present for greater than 8 weeks, a CXR is indicated. This patient’s CXR reveals interstitial changes that bring up a broad list of possibilities on the differential. These include CHF, infection, autoimmune disease.      Chest CT non-contrast was now ordered and shows reticulonodular areas and some regions of consolidation that are almost mass like. Other patchy areas noted throughout. No endobronchial findings. Lymphadenopathy is also noted in various areas of the intra- and extra-thoracic regions. CT with contrast is important to see vascular issues, but also to see small hilar lymph nodes. Sometimes contrast can falsely increase the density of a nodule leading you to call it a granuloma. Hi Resolution chest CT is an older term, but current modern CT scans accomplish this . This involves 1 mm cuts vs. 3 mm cuts. Essentially thinner cuts to see nodules better.      The patient is now seeing a new pulmonologist and has normal vital signs, unremarkable lung exam, which is not totally unusual despite a very abnormal looking xray or CT. A PET CT scan is advised and will show hypermetabolic lesions. Essentially it will help find other areas of concerning activity that would be less risky to biopsy. Radiologist generally avoid biopsy of central lesions that are near important organs and structures. Insurance declines the PET CT, but a node was biopsied in the thigh. Dr. Bowers comments that this biopsy could be a low grade lymphoma, although at this point it would need further assessment, but this is a send-out, looking for B and T cell rearrangement. A hematopathologist would also be good to consult with in this case. For now, this is benign specimen.       Another lymph node specimen was obtained, now axillary. This one shows really no other concerning findings. Tiny granulomas are noted. A variety of staining procedures were performed and all were negative. For Dr. Bowers, Toxoplasmosis may need to be considered.   CHAPTER 2:      Toxoplasmosis seems unlikely because this patient is apparently not immunocompromised. The differential dx does include various other infectious etiologies, such as bartonella, brucellosis and Q-fever. Melioidosis as well. Therefore, a travel history such as to SE Asia should be obtained. So, what now? There are about 20 possible infectious etiologies for this presentation...we need to do more tests. But, the patient was lost to follup for some time.       Now it is 16-months later, and she returns to urgent care with cough, fever, increased respiratory rate, O2 sats are marginal and an abnormal lung exam. Mild leukocytosis noted, and anemia which is new. Dr. White interjects with the following questions: 1. Has she ever been treated with a steroid? 2. Did anyone perform laryngoscopy? In the setting of normal chest imaging, these things should be considered. But of course, since her last CT scan was abnormal, a pulmonary etiology is of highest concern. And indeed a repeat CXR shows worsening overall interstitial change along with increase in the density of the azygoesophageal fissure which was noted on previous CT. The UC provider feels this looks like pneumonia. She was treated for pneumonia and a potpourri of other remedies were tried. Unfortunately, she did not follow-up with her medical doctor. She did see her naturopathologist who resumed drops for bartonella and Lyme disease. As Dr. Currie said, though, Lyme Disease does not present with granulomatous lymph lesions.       She now presents to the Emergency department 18 months after the UC visit. She is SOB, coughing, and states she has “chronic lyme disease”. She is 85% on RA. She has SIRS. Leukocytosis, and a respiratory alkalosis is noted. Her CXR shows Left upper lobe infiltrate that is quite dense. This must be followed to ensure resolution. Lactate and influenza were normal. The commentary from Dr. Herold in the audience was that this patient is not quite meeting sepsis criteria, but quite ill all the same. The decision to initiate broad spectrum antibiotics was made. Further history demonstrates that she was diagnosed with Lyme disease at age 10 and has struggled with health issues ever since. The patient had ongoing frustrations about cost of care and so she continued to see her naturopathologist.       Regarding another good exchange between Dr. Gross and Dr. Herold, involved the discussion of using CT to differentiate this very abnormal CXR for infiltrate vs. empyema. Ultrasound can also be employed for thoracentesis if indeed it is empyema.       Dr. Currie also makes the point that "chronic lyme disease" is not a known condition, so that when patients present with this issue or concern, other underlying disease states must be considered.      While CAP is the leading dx, other considerations in the differential still exist. Dr. Curry also states that azithromycin/Ceftriaxone is a reasonable inpatient treatment regimen going forward. She is feeling better on hospital day 2, but her blood cx come back positive in all 4-bottles. Strep pneumonia is the culprit, and is the current, but certainly not chronic reason for her symptoms. TTE was recommended to rule out endocarditis, especially given her chronic issues. Echo showed high right sided pressures, and a CT PE study was done showing no PE. Dr. Gross discusses the CT reading and notes bilateral signifcant hilar and subcarinal lymphadenopathy. Dense alveolar consolidation around the bronchi and layering left sided pleural effusion. Also noted is a large spleen and some prominent retroperitoneal nodes. Hospital day 3 she has left sided chest pain and had an unchanged repeat chest CT.       Dr. Bowers, the pathologist, discussed the blood cell differential and comments that she is anemic and that is the primary issue. All other counts are normal. Mild rouleaux (stacking of cells) is noted on the morphology and prompts you to think about increased proteins, such as monoclonal and fibrinogen. On hospital day 3, the patient was to go home on levaquin. She is supposed to f/u with pulmonary, but then develops another fever and requires O2 once again. Fever after 40-hours of antibiotics is not entirely unexpected in this patient, especially due to her past history and the likelihood of some underlying etiology that has yet to be discovered.   CHAPTER 3:      Okay, so her immunoglobulins are low. What does that mean? Well, this looks like Chronic Variable Immunodefincy disorder. Does she need IVIG? Yes, it is worth a try per the immunologist. Especially since she is having fevers, rigors and need for increased oxygen. Repeat CXR shows some mild improvement in infiltrate, but a bit more of a CHF pattern, perhaps. ID is involved now and they feel that CVID made sense as a diagnosis. Her symptoms improved and no further IVIG is given. In terms of follow-up, the patient has done quite well. No further hospitalizations to date. There were some barriers in her care involving cost and insurance issues. A repeat CT in 2018 was reviewed by Dr. Gross and she still has some reticulonodular infiltrates. No further dense consolidation in the lung. Lymphadenopathy has improved in general. And the spleen is still enlarged. The patient apparently then was referred to another facility and had another node biopsy after she had yet another scan that showed once again some worsenening. IVIG is helpful for these patients and unfortunately is also very expensive. Many of these patients succomb to cancers of various types, as opposed to infection as they once did many years ago.       According to UpToDate, Common variable immunodeficiency is the most common form of severe antibody deficiency in adults and kids. It is somewhat complex, but in general is due to severe antibody deficiency due to impaired B cell differentiation with defective immunoglobulin production. Recurrent infections, chronic lung disease, GI disease and increased susceptibility to lymphoma are common. Besides having very low IgG, IgA and IgM levels, there is also a poor or absent response to vaccinations.      Feel free to comb through the literature on this one, and while it is not ultra common, it is not unreasonable to consider this in your patients who just can’t seem to avoid getting sick on a regular basis, or who happen to have significantly waned immunity to pathogens they were once immunized for.   Thanks to Dr. Peiterson for bringing this baffling diagnosis to our attention, and to everyone else involved in presenting this case.

Burkholderia pseudomallei is an endemic soil-dwelling bacterium in southeast Asia, where it causes melioidosis. Direk Limmathurotsakul discusses his work to improve the official reporting numbers and how Julie’s Biggest Takeaways: Melioidosis can present in a number of ways, such as sepsis, pneumonia, or abscesses. Because the symptoms are not specific, diagnosis requires isolation of the Burkholderia pseudomallei bacterium. Risk factors for disease include diabetes and exposure to the soil and water in which the bacterium lives. In 2012, only 4 people were officially reported to have died of melioidosis in Thailand, but microbiological records suggest the real number was closer to 696. Scientists like Direk worked with the government to improve reporting requirements and the numbers now reflect a more accurate assessment of the disease burden. More accurate official reporting can lead to more public health campaigns, resources, and support for both scientists and patients. Social media campaigns and a YouTube competition help to raise local awareness of melioidosis. The YouTube competition engages the community by allowing them to enter videos in their own dialect, which then inform others about how to minimize risk factors for melioidosis. The AMR Dictionary gives simple definitions to jargon surrounding the problem of antimicrobial resistance. The definitions are translated into multiple languages in ways that make sense with colloquialisms. For example, in Thai, many people refer to antibiotics as antiseptics or anti-inflammatory drugs, and the dictionary takes local use into consideration in its definitions. Links for this Episode: MTM Listener Survey Limmathurotsakul website at MORU Tropical Health Network Melioidosis.info Melioidosis: the Most Neglected Tropical Disease Antibiotic Footprint AMR Dictionary  

Prof David Dance, senior clinical research fellow and consultant microbiologist, Lao-Oxford-Mahosot Hospital, Vientiane, Laos, gives us a clinical overview of melioidosis. For more information on melioidosis, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/1601 _ The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

Melioidosis is a bacterial infection that quietly causes thousands of deaths each year. Meet the doctor who made it his mission to make the world take notice. Written by Carrie Arnold Read by Michael Regnier Produced by Graihagh Jackson For more stories and to read the text original, visit mosaicscience.com Subscribe to our podcast: Apple Podcasts itunes.apple.com/gb/podcast/mosai…id964928211?mt=2 RSS mosaicscience.libsyn.com/rss If you liked this story, we recommend 'Hunting the silent killer' by Patrick Strudwick, also available as a podcast. 

Premjit Amornchai from our MORU unit in Bangkok, Thailand, tells us about her work as biosafety level 3 lab manager and microbioogy safety officer To prevent relapse or reinfection, melioidosis requires a specific and prolonged treatment. Melioidosis is endemic at least 45 countries, but greatly under-reported, with a microbiological culture required to confirm diagnosis. This can take 2-7 days. In Thailand, up to 40 percent of hospital admitted melioidosis patients die. Premjit works with MORU researchers who have produced a rapid diagnostic test that aims to improve both diagnosis and public awareness of melioidosis. Microbiologist Premjit Amornchai heads MORU's Bio-Safety Level (BSL) 3 Laboratory in Bangkok, Thailand. Safety is very important for Premjit. The BSL3 Lab handles several dangerous materials, most notably, Burkholderia pseudomallei, a highly pathogenic bacterium commonly found in soil and water in Southeast Asia and northern Australia. The pathogen causes the difficult to diagnose, deadly bacterial infection melioidosis.

Premjit Amornchai from our MORU unit in Bangkok, Thailand, tells us about her work as biosafety level 3 lab manager and microbioogy safety officer To prevent relapse or reinfection, melioidosis requires a specific and prolonged treatment. Melioidosis is endemic at least 45 countries, but greatly under-reported, with a microbiological culture required to confirm diagnosis. This can take 2-7 days. In Thailand, up to 40 percent of hospital admitted melioidosis patients die. Premjit works with MORU researchers who have produced a rapid diagnostic test that aims to improve both diagnosis and public awareness of melioidosis. Microbiologist Premjit Amornchai heads MORU's Bio-Safety Level (BSL) 3 Laboratory in Bangkok, Thailand. Safety is very important for Premjit. The BSL3 Lab handles several dangerous materials, most notably, Burkholderia pseudomallei, a highly pathogenic bacterium commonly found in soil and water in Southeast Asia and northern Australia. The pathogen causes the difficult to diagnose, deadly bacterial infection melioidosis.

David Dance from our LOMWRU unit in Laos tells us about his research on bacterial infections in Laos, particularly melioidosis David Dance is a Clinical Microbiologist supporting the work of LOMWRU (Lao-Oxford-Mahosot Hospital Wellcome Trust Research Unit) on bacterial infections of importance to public health in Laos. He is particularly interested in all aspects of melioidosis (Burkholderia pseudomallei) infection, especially gaining a greater understanding of the global distribution of the disease and the environmental factors that underpin its distribution. Laos is seing a growing number of melioidosis, a bacterial infection caused by a bacterium that lived in the environment. Meliolidosis is a disease greatly under-recognised and treatment is specific, making it a major threat to farmers in developing countries. A better understanding of the prevalence of this infection and how it spreads allows us to better target prevention and treatment.

David Dance from our LOMWRU unit in Laos tells us about his research on bacterial infections in Laos, particularly melioidosis David Dance is a Clinical Microbiologist supporting the work of LOMWRU (Lao-Oxford-Mahosot Hospital Wellcome Trust Research Unit) on bacterial infections of importance to public health in Laos. He is particularly interested in all aspects of melioidosis (Burkholderia pseudomallei) infection, especially gaining a greater understanding of the global distribution of the disease and the environmental factors that underpin its distribution. Laos is seing a growing number of melioidosis, a bacterial infection caused by a bacterium that lived in the environment. Meliolidosis is a disease greatly under-recognised and treatment is specific, making it a major threat to farmers in developing countries. A better understanding of the prevalence of this infection and how it spreads allows us to better target prevention and treatment.

Dr Direk Limmathurotsakul's research focuses on the epidemiology of melioidosis, a bacterial infection caused by Burkholderia pseudomallei. Melioidosis is endemic in at least 45 countries, but greatly under-reported. Up to 50% of cases seen in hospital die. Our researchers at MORU have produced a rapid diagnostic test that aims to improve both diagnosis and public awareness. Better coordination between researchers and policy makers is needed to face upcoming emerging infectious diseases.

Dr Direk Limmathurotsakul's research focuses on the epidemiology of melioidosis, a bacterial infection caused by Burkholderia pseudomallei. Melioidosis is endemic in at least 45 countries, but greatly under-reported. Up to 50% of cases seen in hospital die. Our researchers at MORU have produced a rapid diagnostic test that aims to improve both diagnosis and public awareness. Better coordination between researchers and policy makers is needed to face upcoming emerging infectious diseases.

Melioidosis is a neglected tropical disease, and a major infectious killer in South East Asia. Melioidosis particularly affects people with diabetes. Dr Susanna Dunachie works on tropical diseases such as melioidosis, scrub typhus and vivax malaria. Melioidosis is a bacterial disease that results in pneumonia, liver and splenic abscesses and septic shock. The disease can reactivate after a latent period and is inherently resistant to many standard antibiotics. People continue to die around the world from this infection for which there is no vaccine. Understanding the disease is therefore crucial.

Paul Lane, an intensivist from Northern Queensland, gives a lecture about Melioidosis and Leptospirosis in the tropical north of Australia. This was presented at the registrars day at Bedside Critical Care 2012 and credits and slides can be found on Intensive Care Network.

On episode #30 of the podcast, Vincent, Elio, and Michael review how a toxin from Burkholderia pseudomallei inhibits protein synthesis, and the role of the gut microbiome in modulating insulin resistance in mice lacking an innate immune sensor.