Learn about parasitic disease! Fun Fun Fun!
http://www.pazonehealth.org/single-post/2017/09/27/Hydatid-Disease-Part-IV
New Post at a site we watch, pazonehealth.org.
Rabies: 9 years and things are not getting better
For about nine years now, I have been traveling to Baltimore on a semi-annual basis. I go to the Johns Hopkins Bloomberg School of Public Health and deliver, more or less, the same talk, year after year, about rabies.
9 years, and more deaths.
It’s part of the vector-borne section of the course. While not a vector-borne disease (unless we wish to think of dogs as a vector between us and bats–a bit of a stretch, if you ask me), rabies is considered one of the Neglected Tropical Diseases (NTDs), and because it’s a preventable cause of horrific and needless suffering it needs to be somewhere.
Opening Salvo
I always preface my talk with two informal survey questions:
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Does anyone know what the OIE is?
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Does anyone know what One Health is?
Answers:
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OIE stands for Office International des Epizooties, or World Organisation for Animal Health (yes, they use the British spelling of “organization, which I think is a political statement, but that’s another post). It’s kind of like the WHO for animals, and it is based in Paris.
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One Health is a concept advanced by the American Veterinary Medical Association, the CDC, and other organizations. The CDC states “One Health recognizes that the health of people is connected to the health of animals and the environment. The goal of One Health is to encourage the collaborative efforts of multiple disciplines-working locally, nationally, and globally-to achieve the best health for people, animals, and our environment.”
I think that over the years, I’ve had maybe three ‘yes’ answers to these questions, combined. The conclusions are obvious:
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The OIE is failing in its mission to educate the other health professions, as well as the general public, on the importance of animal health, both as it relates to animals alone and to human health as well.
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The One Health concept is a failed attempt by the veterinary profession to assert its presence into discussions of public health. It represents the profession’s inability to move itself from the general world of agriculture (where it is also clearly important) and place itself among the disciplines of other health sciences.
(As a veterinarian, we are used to being the red headed stepchild of the medical professions, so this doesn’t really surprise or irk me. Sometimes, we even create brilliant concepts, like One Health, so we can pretend that it’s really a thing for those outside of our bubble.)
So, what’s the problem here, specifically regarding rabies?
Let me preface this by saying that , I don’t really trust rabies statistics. The latest updates I’m reading estimate the annual number of rabies deaths at 59,000. Given that most of these deaths come from rural areas in Africa and Asia with poor access to treatment and prevention, I’m not sure how they come up with that number. (On my to-do list: contact a rabies epidemiologist.) What I do know is that when I first started giving the talk, the number was 25,000 – 50,000. The range itself, varying by 100% of the low number, inspires doubt in and of itself.
That noted, the trend over the past nine years is at best level, and at worst shows an increase of 18%. Rabies does not get a lot of attention. Most diseases of the poor—Chagas’ disease, cysticercosis, leishmaniasis, hydatid disease, and others—get little attention. AIDS/HIV, tuberculosis, and malaria are the exceptions, but two of those are not restricted to poor areas overseas. Rabies kills “only” 59,000 people a year, a number that pales in comparison to the other diseases listed here. But working on one disease does not preclude working on another. Rabies is low hanging fruit. The numbers of rabies deaths are skewed towards children. Rabies is not a medical mystery. The bottom line is that no one should die the horrible death that comes with rabies infection.
Another Old News Clipping: How We Are Just Not Getting Afghanistan
While we hate to serve as mere aggregators, one of our editors came across this article from 2012, courtesy of The Daily Beast.
I Reenlisted to Return to Afghanistan, Only to Find Myself in Kuwait.
I wanted to do the right thing, to go back to the winding-down war to bring the rest of the guys back home.
by Jonathan Raab
The soldier who wrote the article–five years ago–reenlisted so he could help with the “winding-down” of the war. He was sent to Kuwait instead, and we don’t need to point out that the war shows no sign of winding down.
Meta-Bug readers like cute doggie stories, less motivated by calls for the Trumplets (Ivanky, Ericky, and Donny Jry) to join the military.
So few people read this virtual rag that statistics are probably useless. However, we did go over 100 views for ENTIRE WEEK! I realize that more millions more people than that will watch a cute cat video in the time it takes to read this paragraph. I can live with that.
And I’m glad that you’re interested in the thrilling story about Genius Mutt defying death after eating a chocolate cake.
But people! In all of this political talk flying around, NO ONE is talking about the proper use of the military. It would be nice to have this discussion before we get stuck in another stupid quagmire that costs the lives and health of those willing to sign on that line.
It is the unanimous view of the Meta-Bug editorial staff that the draft needs to be reinstated. We don’t like the draft. We don’t like the fact that having a large standing army tends to get overused. We wouldn’t like the increased military spending that would accompany a universal draft. We don’t like the possible militarization of society that could occur with a universal draft. We don’t like having permanent military bases in places where they are not wanted or not necessary. We think that young Americans should be supported in becoming the adults they want to be, and that it should be done through education, that the money would be better used paying for universities and trade schools rather than uniforms, food supplied by contractors, and weapons.
Above all, I don’t want my children in the military.
But we are in love with our military might. For a large number of Americans, being big and powerful is part and parcel of our patriotism. We stand astride the globe, ready to go anywhere at a moment’s notice (damn the exit strategies!).
If that is going to be the case, everyone needs to take part. Senators’ sons. Kids of Congressmen. The President’s Progeny. Especially the President’s Progeny. And they shouldn’t be dragged off to the draft board kicking and screaming. They should be at the recruiter’s office, waiting at the door ten minutes before opening time. (On time in the military is 10 minutes early.)
Will they answer the call?
More Life Lessons, In Which The Totally Useless Dog Eats My Son’s Chocolate Birthday Cake, and Lives to Annoy Other Day.
I really didn’t want another dog.
Y’know that old joke, the one where various people are having a discussion about when life begins (conception, etc), and the old couple has the punchline about life beginning when the kids move out and the dog dies. At this point in my life I’m still not looking forward to when the kids move out, nor do I want the current canine to croak, but when my previous dog died, I have to admit that I was in no hurry to get her replaced.
I had had my own dogs since my junior year in college. After around 35 years of owning various hounds, arctic breeds, retriever crosses, herding dogs, my 16 year-old Australian Cattle Dog, Maddie, was euthanized on a 4th of July. This was just slightly less than a month before my best friend died after a bout with a cancer caused by the radiation that had cured his previous cancer around 20 years earlier. When Mike died, we had been friends for nearly 4o years.
It’s not an astounding revelation that you don’t get to go back to sixth grade and make another decades-long best friendship. You’re just stuck with that permanent sense of loss that occurs when you realize nothing can ever be the same again. I will never have a best friend who was around since I was 10. I suppose that this isn’t astounding. We all know it will happen. Everyone gets to this point, some reach it quite early in life.
Mike had just turned 50, and I was just about to do the same. Plain and simple, I didn’t want another dog. As a veterinarian, I had usually counseled clients to get back into the saddle (more often than not a new pet helps ease the pain of the loss of the old one), and although I had always followed that advice myself, when my best friend died I decided that I was done. I wasn’t in the mood for any more loss. Life brings enough loss without going out and purposely adding to it.
But Jolee bugged me. And bugged me. And then bugged me some more. And went after this the way that only a child who wants a dog can. Then she started finding dogs on PetFinder.com. She worked on my guilt about the divorce. And then I broke. I should’ve known better. I’m a veterinarian, the guy who is on the other side of the exam table when the exasperated parent–usually a mother–comes in and says, “I told them they could have a dog if they would help take care of him!” To which I usually answer, “And you had what evidence to actually believe this claim?”
The truth is that no matter how much kids promise, they are going to fall short. Usually they are going to fall way short. And then they will probably leave for college before the dog dies, which means you’re stuck with the difficulties of caring for the old dog, with his arthritic joints, incontinent bladder, bad eyesight, and failing cognitive abilities. The kids are alright: they do have good intentions. They just have really poor followthrough combined with an inability to accurately assess their desires and capacities. There are a lot of stories about the strong bond between a child and a dog. But no one writes stories about when a child’s interest in the dog gets hijacked for interest in something else (sports, hormone-induced wackiness, cars, music, delinquent behavior. . .) The problem is that it takes forever to say no, but just a few moments of delusion or weakness to say yes. And in general, parents love to say yes.
But I’m digressing. This is about my son’s birthday, my dog Kaleb, who is a total maroon, and the chocolate cake. Every 16 year-old should have a chocolate cake for breakfast on this momentous occasion. Took it out of the refrigerator, put it on the counter, put the 17 candles on (one for good luck), and went upstairs to brush my teeth. Return downstairs, and Genius Mutt is licking the last bits of crumbs off of the floor.
To be continued. . .
The Case Against Bulldogs (Gross Picture Day)
I’m packing today, so I don’t have time for any deep thoughts.
But if you’re thinking of getting a bulldog (or a Cocker Spaniel, for that matter), feast your eyes on this:
This poor guy just had what is called a Total Ear Canal Ablation (TECA), because his ears were chronically inflamed and infected. Imagine a circle around the ear canal, deepened all the way to the level of the skull.
The Meta-Bug 