Monday, 25 March 2013

Dirty Conditions in Argentinian Dairy's Introduces Aspergillus into Milk

The presence of human pathogens and mycotoxin in milk for human consumption is routinely monitored prior to allowing into the food chain in most developed parts of the world, so safeguards are in place but no study has looked in any detail at the potential for contamination of milk by Aspergillus when the cows are being milked.

This new study which looks at the dairy industry in Argentina finds that 61.4% of bulk milk stocks are contaminated by Aspergillus with more contaminated by other moulds and Aspergillus was isolated from 30% samples taken from individual cows.

The animals concerned belonged to 44 dairy establishments located in Cordoba province, in the central region of Argentina during March to September, 2009. Cordoba province produces 37 % of the country’s total milk and is the main milk production area with 3,000 dairy establishments.
To make matters more concerning one third of those strains of Aspergillus found were capable of producing the mycotoxin Gliotoxin which is an immunosuppressive poison that is strictly controlled in food. The presence of this toxin correlated with poor quality of the milk as measured by high SCC (Somatic Cell Count).

The study revealed that the highest levels of Aspergillus correlated with those dairies that had the poorest hygiene - this is perhaps not the most surprising of findings but it is the first to demonstrate the potential severity of consequence for lack of good hygiene amongst workers, poor work practices, equipment that had been inadequately cleaned and the surrounding environment where milking is carried out.

Wednesday, 13 March 2013

Legal-Medical Assistance for Damp Home-owners - A Powerful Study

Poor living conditions in New York
There is a wealth of evidence that people living in damp homes are more prone to respiratory illness, asthma, sinusitis and where present they are likely to worsen (WHO guidelines for indoor air quality: dampness and mould WHO/Europe, 2009). There is less certainty over what is causing the health problems though dust, volatile organic compounds, increase in the numbers of micro-organisms present, pet dander, insects & rodents are all implicated to a greater or lesser extent.

It is clear then that people should not be forced to live in damp homes. The next difficulty we face however is that damp homes are plentiful, partly because older properties were not built for modern living or have been adapted to save expensive heat by cutting ventilation, and partly because of poor maintenance and the need for cheap housing in areas of economic deprivation.

Landlords can be unwilling to spend money on a property that raises little money and will often do the minimum required to keep letting it - this is in spite of government laws (UK and USA) that now place a duty of care on the landlord to ensure the good health of their occupants. Landlords often blame the way their occupants are failing to ventilate and are carrying out activities that will push a lot of moisture into the air of the house e.g. drying laundry inside the home, occupants are regularly ill-informed on how to ventilate effectively or are forced to minimise ventilation to keep heat within their home or for security purposes. Disreputable landlords may let properties they know to be damp and once occupants move out cover up the mould prior to letting the home to new, unsuspecting people - but how much of this goes one, what effect does it have on the health of the occupants?

This recent paper studies only a small sample of families living in damp homes in New York - 22 patients were enrolled suffering from poorly controlled asthma - all were adults aged over 18.

Environmental improvements brought by the legal interventions in the homes of poorly controlled inner-city adult asthmatic patients: a proof-of-concept study

All of those patients were granted legal assistance to help improve their homes. 10 failed to take up the offer which left a group of 12 who used the legal system to force their landlords to carry out work. Work carried out included fixing leaks (mould growth was visible in 50% of the properties), painting, structural repairs, pest extermination and so on (see table 1 in the paper).

The results with regard to living conditions must have been marked but the results with regard to their asthma are remarkable.
Improved asthma control was also accompanied by decreased ED visits and hospital admissions by over 90%, implying significant health and financial benefits. The use of systemic steroids, associated with a myriad of adverse effects, was eliminated in 73% of the patients.

This is the first paper showing that improving living conditions has a direct impact on improving the health of adult occupants. Its small sample size weakens its acceptance as a result we can apply generally but the strength of the result tends to argue that there is something we can all take from this. Further work will follow.

Monday, 11 March 2013

Bagpipers - Take Care to Clean Your Pipes!

Keep your pipes clean
The Scotman newspaper describes a case where a bagpipe player fell ill with respiratory difficulties that failed to respond to antibiotic therapy. He was admitted to hospital for more intensive antibiotic treatment but continued to deteriorate until his bagpipes were tested for clues as to what the problem might be.

Large quantities of moulds were found in the bag of his pipes and no doubt antifungal drugs were quickly brought into action and his infection gradually improved, though it took a month before he could leave hospital.

Occupational exposures such as this can be extremely dangerous. We have seen reported gardeners (1, 2) and a deep sea diver who have died after inhaling large quantities of spores. In the latter case the diver failed to clean his plastic buoyancy bag thoroughly and subsequently inhaled the air contained within the bag.  He used to inflate the bag by mouth so of course he introduced moisture & saliva into the bag and this was enough to promote lush mould growth. Once this had happened the next gulp of air he took formt he mouldy bag would have been full of mould spores. Sadly the diver ultimately succumbed to the consequences of his infection.

There are clear similarities between the diver and the bagpipe player. Both have inhaled from a mouldy bag that must have stored many millions of spores. The bagpipe player was lucky to survive the infection and may well not have done if his doctors had not been so effective in identifying a rare type of infection.

This is a clear warning to anyone who finds themselves breathing in or blowing into plastic bags that have been filled with air via mouth or any other non-sterile source, but in particular bagpipe players should take great care to ensure that their pipes are well cleaned after use every time, especially if they use the non-traditional instruments that use a plastic bag rather than natural alternatives - they are not low maintenance!

Friday, 8 March 2013

A New Screening System for the Identification of New Antifungal Drugs

A patent application for a new testing device is under review that provides a more efficient method of identifying new anti-fungal drugs.

Infections acquired in hospitals are the 4th largest cause of death in the U.S, contributing an extra $5 billion in medical cost each year and can add several weeks to the length of stay in hospitals for those infected. A large number of these are due to fungal infections which have a high mortality rate compared with bacterial infections e.g. cases of some types of aspergillosis have a 90% mortality rate.

Current treatments are not very effective because fungi are made up of 3-D structures that made it difficult for drugs to act upon and so can resist the treatment. These structures are known as 'biofilms' and there is a need for new drugs that can prevent or control these 'biofilms'.

Figure 1. 96-well plate assay

This new development is a testing device that allows for a more effective way to analyse new drugs and see how well they act against fungi that could lead to the replacement of the existing 96-well plate assay (fig. 1), which is time consuming and costly. See patent here.

Thursday, 7 March 2013

Cancer-Causing Milk Detected in Germany

Aflatoxin B, one the the strongest naturally occurring carcinogens, was found to be double the levels that national standards allow in the milk of a farm in Germany. The cause has been found to be contaminated feed that was delivered to over 1000 farms. In some cases levels were over 30 times the guidelines..

Quoting from the original German news website 'The Local'

Before being pasteurised, milk from the farm had twice as much aflatoxin – produced by the Aspergillus species of mould – than national standards allow. 
There was a possibility that the contaminated raw milk had already been sent to dairies for processing, the state Consumer Protection Ministry said. Until the milk has levels below 50 nanogrammes of aflatoxin per kilogramme of milk it may not be sold. Current levels were around 100 nanogrammes. 
Milk from cows which have ingested aflatoxin – one of the strongest naturally occurring carcinogens – is “particularly dangerous,” said Udo Paschedag from Lower Saxony's Agriculture Ministry.
At the weekend, hundreds of farms in Lower Saxony were banned from selling milk after the same fungus was discovered in feed from Serbia. Certain instances saw the raw milk containing 30 times the acceptable limit of aflatoxin.
The source was traced back to 10,000 tonnes of a Serbian shipment of contaminated maize which found its way into animal feed delivered to 3,560 farms in Lower Saxony, including 938 dairy farms.
The NRW farm obtained its livestock feed from a supplier in the Lower Rhine region, which had sold 200 tonnes of contaminated Serbian maize. Although this is not thought to be connected with the maize in circulation in Lower Saxony.
Aflatoxin-riddled feed was also identified in three other farms in NRW, the milk from which all fell just under the acceptable limit. Around 70 farms likely bought feed from the Lower Rhine supplier. 
This story emphasises the need to have an efficient and effective food toxin screening program, even in the more highly develped parts of the world! 

Friday, 1 March 2013

Aspergillus Newsletter for February

The Aspergillus Website Newsletter is now available

International warning issued on drug-resistance from agricultural fungicides

The European Centre for Disease Control has today announced it is examining current evidence for the possible environmental origin of drug resistance in a group of diseases known as Aspergillus infection, following Manchester research.

The EDCD report was prepared with the support of European and US experts, including a team at The University of Manchester.
In its risk assessment, ECDC examines current evidence for the environmental origin of resistance to medical triazoles - a drug used to treat Aspergillus infectionAspergillosis is usually an incurable disease of the lungs caused by the fungus Aspergillus. It is treated using antifungal antibiotics called triazoles but researchers at Manchester have found that the fungus has been able to mutate making treatment ineffective.  
The ECDC’s report now makes recommendations for further steps to assess the risks and consequences of the environmental usage of triazole fungicides – which are widely used in crop protection and material preservation in Europe. Over 90% of plant diseases are caused by fungi.
ECDC estimated that 2,100,000 patients may be suffering from allergic aspergillosis and 240,000 from chronic aspergillosis across Europe each year. In addition, an estimated 63,250 cases of invasive aspergillosis, annually complicates the management of other diseases including leukaemia, transplantation, chronic obstructive pulmonary disease and medical intensive care.   
Triazole therapy has become the established treatment for human Aspergillus diseases. However, triazole resistance appears to have been increasing in several European countries in recent years. If present, such resistance can severely limit treatment options. The inability to treat patients with triazole antifungals due to resistance has a significant impact on patient management (88% mortality) and associated health costs.
Results from published studies suggest that triazole resistance has evolved in the environment and could be driven by the selective pressure of triazole fungicides routinely sprayed on numerous crops. Although evidence supporting this hypothesis is growing, the link between the environmental use of azole fungicides and the development of triazole resistance in patients with Aspergillus infection is not yet proven.
The report concludes on the importance of improved surveillance and diagnosis of resistance in Aspergillus, as well as the development of further environmental and laboratory studies to confirm the environmental hypothesis.
Professor David Denning, Professor of Medicine and Medical Mycology, and Dr Paul Bowyer, a senior lecturer in Molecular Biology, from The University of Manchester were involved in the research. The Manchester researchers, who are based at the University Hospital of South Manchester, have published several papers on azole resistance. Professor Denning, described this phenomenon for the first time in 1997, and is Director of the National Aspergillosis Centre.
Professor Denning welcomed the ECDC’s report. He said: “The medical and public health communities need to be alerted to this resistance problem and look at possible means of dealing with it. Resistance rates continue to be problematic in patients.”

Notes for editors

Notes for editors:
European Centre for Disease Prevention Control (ECDC) issued its report today. To view the report, click here.
For further information contact:
Alison Barbuti
Media Relations Officer for the Faculty of Medical and Human Sciences
0161 275 8383

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