Balance, Fall 2013 by Lewiston Tribune

Balance Volume 5 – Issue 3 – Fall 2013

CANNERS BEWARE Follow established recipesor face the consequences

The health magazine for Body, Mind & Motivation Published quarterly by the Lewiston Tribune and the Moscow-Pullman Daily News

MOLD MADNESS

It’s everywhere but experts say quick action can keep it at bay

GET-FIT GUY

Spokane’s Ben Greenfield makes a name for himself

FASTING FEARS

Those in the know warn it’s not worth the risk

Fall 2013

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Contents

Balance – volume 5, issue 3 – Fall 2013

COVER STORY

Even in drier climates, mold is present and can lead to health concerns

when customizing recipes

THE GET-FIT GUY Lewiston native Greenfield making

a name for himself in the field of fitness

ALSO | GERMS 10 4

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HEALTH & WELLNESS

MOLD MATTERS

CANNERS BEWARE Experts warn of consequences

FITNESS

NUTRITION

FASTING FEARS

Experts warn of downfalls for popular weight-loss method

FOOD ALLERGIES 18

ALZHEIMER’S 20

LOCAL CONTRIBUTORS

JoeL Mills

Lewiston Tribune staff writer

Joel Mills lives with his family in Lewiston. He’s currently enjoying the growing abundance of fresh, local foods available in the Valley and turning them (with some success) into good, healthy meals.

Kerri Sandaine

Lewiston Tribune staff writer

Kerri covers the southeast corner of Washington for the Tribune. Her favorite activities are tennis, running marathons and chasing news stories.

Elaine Williams

Lewiston Tribune staff writer

Elaine started reporting at the Tribune in 1991 and has covered the business beat since 2000. She’s an aspiring distance runner who completed the Lewis-Clark Half Marathon in 2 hours, 25 minutes and 23 seconds, her best time yet.

Jesse Hughes Graphic designer

Jesse has worked for the Daily News and Lewiston Tribune since 2008 in the advertising department. He and his wife try to eat a healthy, well-balanced diet and stay active by walking, hiking, and being kept on their toes by two boys.

Kevin Gaboury

Oregon native Kevin Gaboury formerly covered education for the Tribune.

Elizabeth James

Elizabeth James is a freelance who contributes occasionally to the Lewiston Tribune.

Balance is published quarterly by the Lewiston Tribune and Moscow-Pullman Daily News and printed at the Tribune Publishing Co. Inc.’s printing facility at 505 Capital St. in Lewiston. To advertise in Balance, contact the Lewiston Tribune advertising department at (208)848.2216 or Advertising Director Kim Burner at kburner@lmtribune.com, or the Moscow-Pullman Daily News advertising department at (208)882.5561 or Advertising Manager Craig Staszkow at cstaszkow@dnews.com. Editorial suggestions and ideas can be sent to Tribune City Editor Craig Clohessy at cclohessy@lmtribune.com or Daily News City Editor Murf Raquet at murf@dnews.com.

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Fall 2013

Mold matters Even in drier climates, mold is present and can lead to health concerns By Elizabeth James

old is everywhere. Some 70,000 species of mold surround us constantly and are impossible to keep out of homes. They enter through windows and doors, through heating and cooling systems, or are transported on the bodies and clothing of humans and pets. Mold and mildew might seem prevalent in humid climates like the Eastern U.S., but dry regions such as north central Idaho and eastern Washington are by no means immune. Ed Marugg, environmental health director for the Lewiston office of Public Health-Idaho North Central District, said mold is more of an irritant in the region than a major problem. Sensitivities to mold vary tremendously, but for most healthy individuals, the mold that routinely exists in homes is not dangerous. Some people may experience mild upper respiratory symptoms; vulnerable populations, including the elderly, pregnant women, those with compromised immune systems, and highly allergic individuals may have more severe reactions. Marugg’s office receives 15 to 20 calls per month about mold in homes during the fall, winter, and spring months, but the health department does not consider it to be a major health concern. Extensive mold growth, however, can

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epa.gov

(Top Left) Mold grows inside a wall where it’s dark and damp. (Above) A common growth area for mold is the shower where moisture abounds. (Left) A heavy growth of mold on a poorly stored suitcase.

also become a significant financial problem and any home can experience mold growth. “The key is air management,” said Bruce Prindle, general manager of CTR Cleanup and Total Restoration in Lewiston. He agrees that it is not a major problem in the region, but it can and does happen in homes throughout the area. Moisture — water intrusion — is the

source of mold growth, and any place with improper ventilation is susceptible. Basements and crawl spaces are especially at risk when a building’s foundation cracks or is otherwise compromised and moisture is regularly present. Roof leaks are another source of mold problems, especially on foreclosed or partyear homes where residents are not necessarily present to detect and repair the leaks.

epa.gov

A heavy growth of mold on a sheet rock wall and molding.

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for instance, might involve excavation, sealing the foundation, and even repairing the home’s landscape. While homeowners can never eliminate mold and moisture from their homes, financial and physical health warrant caution and care to keep them to a minimum. Whether heating or cooling a home, ensuring proper air circulation is the first and most important step to mold prevention, Prindle said.

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Newer homes tend to have more efficient air circulation but, Prindle warns, new homes can also create mold problems by being too tightly closed, which allows condensation to build up. That, in turn, encourages mold growth. It usually happens in windows and siding, where outdoor and indoor temperatures often compete and collide. Mold is detected by sight and smell. A musty odor in the basement, for example, is a sure sign of mold growth. The true extent of the problem can only be determined by an indoor environmental test, which is performed before an abatement program begins. Depending on the degree of the problem, remediation can run into thousands of dollars. Removing mold from a basement,

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On the Net:

http://www.cdc.gov/mold/stachy.htm#Q1 http://idahopublichealth.com/environment/ files/mold-homes.pdf http://idahopublichealth.com/environment/ files/mold-in-rentals-fact-sheet.pdf http://www.epa.gov/mold/moldguide.html

Mold prevention tips

l Keep humidity levels as low as you can — no higher than 50 percent all day long. An air

conditioner or dehumidifier will help you keep the level low. Bear in mind that humidity levels change over the course of a day with changes in the moisture in the air and the air temperature, so you will need to check the humidity levels more than once a day. l Be sure your home has enough ventilation. Use exhaust fans that vent outside your home in the kitchen and bathroom. Make sure your clothes dryer vents outside your home. l Fix any leaks in your home’s roof, walls, or plumbing so mold does not have moisture to grow. l Clean up and dry out your home thoroughly and quickly (within 24 to 48 hours) after flooding. l Add mold inhibitors to paints before painting. l Clean bathrooms with mold-killing products. l Remove or replace carpets and upholstery that have been soaked and cannot be dried promptly. Consider not using carpet in rooms or areas like bathrooms or basements that may have a lot of moisture. Source: Centers for Disease Control

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Fall 2013

Tribune/Kyle Mills

Lewiston-Clarkston Valley nearly disappears from the view point atop Lewiston Hill from smoke from area fires and other pollution.

Smoke: A visible threat Wildfire season is winding down, but experts say air quality is a year-round concern By JOEL MILLS

ildfire season is winding down and air quality is trending up, but there are plenty of other pollutants floating around that can harm sensitive populations. “The biggest issue we deal with every year is wildfire smoke,” said Ed Marugg, environmental health director for Idaho North Central District Public Health. “It’s hard to avoid it because it’s so ubiquitous.” Smoke is an obvious, visible prob-

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lem. But those sensitive to air quality activities like cooking, bathing and can also be affected by more insidicleaning. And if that moisture is introous culprits: mold, pets, plants, radon, duced into a poorly insulated environformaldehyde, pesticides, asbestos and ment with cold walls, condensation can secondhand smoke. form. Mold, especially, can pose a respi“Because it stays moist, it’s a perfect ratory threat during the three cooler environment for mold and mildew seasons, Marugg to get growing,” “Even though this year it looks said. Marugg said. like fire season is pretty much over, “You get the And that can when people see really smoky, hazy pose short- and colder conditions conditions, that means that there’s outside, and the long-term probprobably something in the air and way buildings are lems for what you should avoid heavy exertion built these days, Public Health out there.” there’s not a lot of defines as “sensiEd Marugg air exchange betive groups.” Air Environmental health director for tween the indoor quality is imporIdaho North Central District Public Health and outdoor air,” tant to everyone, he said. but it can have a pronounced effect on Humans produce humidity naturally pregnant women, children, the elderly, by breathing, and through regular daily people with respiratory issues and peo-

ple with conditions like heart disease or diabetes. Marugg said mold isn’t a huge problem in the region, but Public Health gets multiple calls about its occurrence every year, especially during the fall, winter and spring when it starts to cause allergic reactions. Controlling humidity and insulating exterior walls can help prevent it from growing. Formaldehyde is another common irritant because the chemical is present in glues used to assemble cabinets and lay carpeting. The vapors emitted from those products can be especially potent in new construction, Marugg said. People who breathe too much formaldehyde complain of bad smells and headaches. Vapor emissions usually diminish over time, but those affected should try to keep their homes wellventilated, he said. Asbestos remains an issue, even though people have been aware of its harmful effects for years. Marugg said

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it was used as a construction material for so long that it continues to pop up everywhere. “A lot of those old buildings are still standing,” he said. And when people or businesses remodel, they can stir up some nasty particles. The best way to avoid asbestos exposure is to have it removed by a licensed contractor. So while other threats are abundant,

Marugg said wildfire smoke poses one of the biggest dangers. But he said the best point to remember is to take it easy. “Even though this year it looks like fire season is pretty much over, when people see really smoky, hazy conditions, that means that there’s probably something in the air and you should avoid heavy exertion out there,” he said. “That’s the biggest thing that people should know about with air quality.”

Some simple and effective measures to breathe a little easier during wildfire season:

l Stay inside with the doors and windows closed as much as possible to limit exposure when wildfire smoke is present. l Wash or change filters on air conditioners and furnaces frequently, and use the “recycle” mode in the home or car to keep the filtered air inside. l Avoid heavy work or exercise outside, and wear an appropriate mask if it is unavoidable. l Stay with someone else if the home does not have air conditioning and temperatures are extreme. l Call a doctor if shortness of breath, uncontrolled coughing, sneezing, choking or chest discomfort develop. l Have at least a five-day supply of medications for a heart or lung condition. l Drink plenty of water to keep airways moist. Breathing through a warm, wet washcloth can also relieve dryness.

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Fall 2013

Germs 101 When it comes to bacteria-related ailments, the best prevention is wash your hands

The only most effective way to keep bacteria to a minimum, according to health experts, is to wash your hands regularly. Olson calls the practice an integral part of health. While a certain amount of bacteria on human skin is completely normal, she said, hand washing will substantially reduce the BY ELIZABETH JAMES numbers of bad germs that make people sick. Sandra McCurdy, Extension food safety our cellphone is a breeding ground specialist at the University of Idaho, agreed, for bacteria. So is your kitchen sink. adding simply that hand washing is “really And your desktop. Public places like important.” restaurants and hotel rooms are full of germs But even if you faithfully and conscienas well. tiously wash your hands after using the restDisinfectants help sanitize surfaces, said room, not everyone necessarily does. A 2007 Anna Olson, staff epidemiologist at the North study observing public restroom behavior Central Public Health District in Lewiston. of 6,000 adults showed that only 77 percent But, she cautions, in order to be effective, washed their hands after using the facilifollowing manufacturer directions is paraties. The study, reported by WebMD, also mount. And not every disinfectant will kill uncovered a gender disparity: 66 percent of every germ. the monitored men washed their hands while

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TRIBUNE/STEVE HANKS

A thorough hand washing prevents the spread of germs.

88 percent of women did so. In contrast, in a concurrent telephone survey asking individuals about their hand-washing behavior, 92 percent of 1,000 people surveyed claimed to always wash their hands when using a public restroom. The single most reliable way to keep yourself and others from getting sick with the cold, flu, or worse infections, is to wash your hands. Mere touch spreads bacteria, viruses, fungi, and parasites to everything we touch — cellphones, ATM machines, door knobs and handles, grocery carts, desktops, and more. According to the blog, “Learn About Germs,” by Kelly Reynolds, associate professor of public health at the University of Arizona, some germs can live for up to two hours on hard surfaces, and other bacteria can grow and divide every 20 minutes. At the end of a single day, that single cell multiplied to 8 million germs.

No matter how reliably and often we wash our hands, there are still some surprising places that can expose us to unpleasant germs. The website Prevention.com lists the “8 Germiest Public Places” and “10 Worst Germ Hot Spots.” Restaurants are high on the list, but not just the public restrooms. Menus and condiment bottles have been found to harbor millions of germs. Held and perhaps coughed and sneezed on by up to a dozen people in the course of a single day, these items are not usually cleaned or disinfected. In addition to the other customers, we rely on the good faith of food preparers and servers to wash their hands regularly. The lemon wedges served with your ice tea can harbor microbes such as E. coli. The good news is that most food service facilities are clean. Neither Olson nor McCurdy recall any recent major outbreaks in the region due to food-borne pathogens. McCurdy points out that from a marketing standpoint, it only makes sense for vendors to serve safe food, whether in a restaurant, farmers market, or county fair. Nonetheless, even in homes, germs thrive in unexpected places. News stories in

recent years have reported some surprising studies. The mere act of flushing a toilet, for example, sends an aerosol of fecal bacteria throughout your bathroom. In the kitchen, sponges and cutting boards are known to be virtual petri dishes of bacteria and viruses. But some places we might not think about include jewelry, according to Prevention.com. Our bling can harbor millions of germs, holding them next to your skin when you wear your favorite necklace, bracelet, or earrings. (Silver is a natural antimicrobial, however, so silver jewelry tends to shelter less bacteria than other materials.) Purses and backpacks are other germ condominiums — they get tossed about and set just about anywhere, including bathroom floors. When was the last time anyone sanitized a purse? The list of places where germs hide and multiply is endless. The bottom line is that it is impossible to avoid being exposed to them. But people can take control of how much they spread germs, and counter the exposure they do get, Olson said, simply by completely and frequently washing their hands.

What is the right way to wash your hands? l Wet your hands with clean, running water (warm or cold) and apply soap. l Rub your hands together to make a lather and scrub them well; be sure to scrub the backs of your hands, between your fingers, and under your nails. l Continue rubbing your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice. l Rinse your hands well under running water. l Dry your hands using a clean towel or air dry them. Source: www.cdc.gov/handwashing

31 Places That Germs Love 1. Toothbrushes 2. Yoga mats 3. Desk tops 4. Kitchen sponges 5. Restroom door handles 6. Grocery carts 7. Jewelry (except silver) 8. Pillows 9. Purses 10. Gas pumps 11. Communal buttons (elevators, ATMs, vending machines, debit card touchscreens) 12. Reusable grocery bags 13. Kitchen faucet 14. Garbage disposal 15. Welcome mat 16. Vacuum cleaner 17. Dish towel 18. Car dashboard 19. Soap dispensers 20. Restaurant condiment bottles/dispensers 21. Refrigerator seal 22. Restaurant menus 23. Lemon wedges 24. Airplane bathrooms 25. Doctor’s office 26. Stair and escalator railings 27. Backpacks 28. Gym machines 29. Cellphones and covers 30. Television remote 31. Kitchen knobs and handles Source: Center for Disease Control and Prevention

When should you wash your hands?

l Before, during, and after preparing food l Before eating food l Before and after caring for someone who is sick l Before and after treating a cut or wound l After using the toilet l After changing diapers or cleaning up a child who has used the toilet l After blowing your nose, coughing, or sneezing l After touching an animal or animal waste l After handling pet food or pet treats l After touching garbage Source: www.cdc.gov/handwashing

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Fall 2013 11

The Get-Fit Guy Lewiston native Greenfield making a name for himself in the field of fitness By KERRI SANDAINE

ewiston native Ben Greenfield is the go-to guy when it comes to triathlons, exercise and nutrition. He’s only 31, but Greenfield is already a highly respected author, speaker and consultant in the fitness and nutrition industry. He owns a successful home-based business called Pacific Elite Fitness and provides training plans, books, DVDs and custom coaching programs on his website, BenGreenfieldFitness.com. His two podcasts — “the Get-Fit Guy” and “the Ben Greenfield Fitness Podcast” — have been rated No. 1 on iTunes in the fitness category. Greenfield, who has a master’s degree in exercise physiology from the University of Idaho, is also an endurance athlete who competes internationally. He and his wife, Jessa, are the parents of twin 5-year-old boys gyms, and now I primarily coach and consult named River and Terran, and currently live in online, and speak and put on training clinics the Spokane Valley. around the world. With a resume like that, Greenfield was B: What is your fitness philosophy? asked to share some of his tips with our BG: I love getting fit, feeling good about Balance readers. He recently competed in the way my body looks, and fulfilling my IronMan Canada and was headed to London deep-seeded drive to live life to the fullest by when we caught up achieving difficult “I love getting fit, feeling good with him via email. feats of physical perabout the way my body looks, Balance: How did formance. But I was and fulfilling my deep-seeded you get started in this fed up with feeling drive to live life to the fullest by line of work? like crap from all the achieving difficult feats of physical Ben Greenfield: extreme exercising, performance.” All five years of strange foods, feeling Ben Greenfield university, I worked of constant stress and Lewiston native and owner of Pacific Elite Fitness as a personal trainer soreness, and worry and wellness consultant, and aside from a about the toll my hectic lifestyle was taking brief four-month stint working in surgical on my body. So I created a way of training, sales for Biomet straight out of college, all I’ve eating and living that is perfectly healthy and ever done is help people achieve better bodies natural, but still allows me to look, feel and and higher performance. Until my kids were perform at my peak capabilities. born, I ran personal training studios and B: What does your daily training schedule

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look like? BG: I exercise for 60 to 90 minutes a day — typically with some morning stretching and yoga, and then an afternoon of highintensity cardio or weights workout. Once a week, I take a rest day that simply includes playing a new sport, doing yoga or simply

(Above) Ben Greenfield leads a class at IMPAX World - Transformation Expo 392763i2_13

hanging out with my family. B: What fitness accomplishment are you most proud of? BG: I just completed my ninth Ironman triathlon and fifth time qualifying for Ironman Hawaii, which will be my 10th Ironman triathlon. I’m proud of getting each of those big races under my belt. B: Any quick and easy advice for our readers when it comes to diet and exercise? BG: Lots. My biggest three tips are: 1. Write down exactly what you want to accomplish and how you are going to do it. If it’s not in writing you probably won’t do it. 2. Sleep and de-stress as much as humanly possible. This will keep you healthy, which allows you to consistently exercise and get the body you want. When given the choice to beat yourself up or to relax, then relax. 3. Fuel your body with real food. The best exercise program on the face of the planet is useless if it’s fueled by fake foods. For more information and tips, readers can check out BenGreenfieldFitness.com.

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Fall 2013 13

Fasting: Benefits not worth the risk Experts warn of downfalls for popular weight-loss method By Kevin Gaboury Fasting, the willing abstention from food or drink for a period of time, has been around for centuries. A number of religions, including Islam, practice fasting as a means of demonstrating faith or spiritual reflection. The historical figure who often comes to mind at the mention of fasting is Ghandi, who used fasting as a non-violent form of protest against British rule in India. In recent years, fasting or similar diets

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have emerged as a quick, easy way to lose weight. It seems simple enough: Just stop eating, and watch the pounds melt away. But most nutrition experts agree that when it comes to fasting, the risks outweigh the benefits and it can cause more harm than good, said Courtney Goff, an outpatient dietician at St. Joseph Regional Medical Center in Lewiston. “Generally, nutrition experts agree that fasting is potentially dangerous and not an effective way to lose weight,” she said. When someone initially loses weight while fasting, it’s primarily water weight, not fat, she said. When a person doesn’t eat for a period of time, a number of things happen. As they continue fasting and the body uses up its stores of glycogen, a substance stored in the liver and muscles, the muscles begin to break down and the body goes into conservation mode, where the metabolism slows down so calories are burned more slowly.

“It can result in health problems, like muscle loss,” she said. “The body starts to eat itself, or lose muscle.” There’s also a higher rate of fat breakdown, which can result in ketosis. When fat is broken down, it yields ketone, which can act as a substitute energy source for the body, although not a preferred one, Goff said. Ketosis can cause fatigue, headaches and mental dullness. “It can put a strain on the kidneys,” she said. “I get very concerned about folks with diabetes. It’s very dangerous for someone who has diabetes.” Once they’re done fasting, most people quickly gain the weight back, and can become distraught or discouraged, she added.

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“Generally, nutrition experts agree that fasting is potentially dangerous and not an effective way to lose weight.” Courtney Goff

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Some people also fast to rid the body of toxins, but this is also a myth, Goff said. “It does sound logical that it could cleanse your body, but there is no scientific evidence that fasting can cleanse the body of toxins,” she said. “When someone is fasting, toxins can increase because you become dehydrated.” The liver, kidneys, skin and lungs are all perfectly capable of removing toxins on their own, she added. Rather than take a drastic weight-loss approach like fasting, Goff recommends working with a dietician to find a healthy eating plan that they can stick to over the long term. This, done in conjunction with regular physical activity, is the only effective way to lose weight and keep it off. As for fasting, Goff said there really are no positives. “It’s a quick fix, and that’s what attracts people,” she said. “This type of approach does not work over the long term.”

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Canners beware Experts warn of consequences when customizing recipes By ELAINE WILLIAMS

ustomizing your home-canned salsa could produce disastrous results. Salsa is one of the most popular foods for amateurs to can and it can also be one of the trickiest to get right because of acidity levels, said Sandy McCurdy, extension food safety specialist at the University of Idaho in Moscow. Understanding a little food science is important even for the growing number of first-time canners since the price of a mistake can be drastic. “People are interested in where their food comes from and having control over their own food,” McCurdy said of why so many folks are turning to canning. But the pH level in any food needs to be at or below 4.6 for it to be canned in a water bath. At 4.6 and below it’s safe for anyone other than very young infants to consume foods with spores of clostridium botulinum, the bacteria that causes botulism, McCurdy said. If the pH reading is higher, the food contains less acid and needs to be preserved in a pressure canner so the temperature reaches 240 degrees and kills the spores, McCurdy said. The problem with salsa is it contains a mixture of ingredients with lower acidity, such as onions and peppers, and ones that have higher acidity, like tomatoes, McCurdy said. Recipes from credible sources like the National Center for Home Food Preservation carefully calibrate the mixtures to keep them at the right acidity level. (See related information.) But if a home cook tinkers the same way they might if they’re making spaghetti sauce, and, say, adds an extra onion, it could push the acidity too low, McCurdy

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said. “It’s one area that worries me a little, that people get too creative.” Salsa isn’t the only potential place that canners stumble. Vegetables with low acidity, such as green beans, need to be processed in a pressure canner unless they’re

being pickled using a credible recipe, McCurdy said. Using the right cook times and adjusting the pressure at altitudes of more than 1,000 feet are just two of the key steps, McCurdy said. “It’s very specific on how you need to do it. You need to vent your canner

(Opposite) The green beans should be washed and drained, their ends removed and then cut to a desired length. (Above Left) After the cut green beans have been blanched, they are transferred to the sterilized canning jars. (Above Right) After the jars have been filled with green beans and the lids put in place, they go into the pressure canner, where they will eventually be sealed.

The basics of safe canning

l Use recipes only from credible sources such as the following websites: http://www.cals.uidaho.edu/edComm/catalog.asp?category1=Family%20and%20Consumer%20Issues&category2=Food%20and%20Nutrition http://uga.edu/nchfp/publications/publications_usda.html http://extension.usu.edu/htm/publications/index.cfm (Click on food and health. Then go to food preservation.) l Check the elevation of where you live before you start canning, because it makes a difference in canning times and pressure. In places such as the Lewiston Orchards, where the elevation is 1,000 feet or higher, for example, five minutes needs to be added to the times of water bath canning recipes. Google Earth provides the exact elevation of any home. l Have the dial pressure gauge on your canner tested annually, something that can be done at extension offices. l If you purchase a used pressure canner, look for the Universal Underwriters Laboratory symbol. That’s an indication it was manufactured after 1970 when safety features became standard. Take the canner to an extension office before you use it to check its safety. l Use bottled lemon juice in recipes that call for it. The acidity of it is standardized. l Add a small sliver of butter to jam and jelly recipes while they cook. It reduces the foam. l Be sure to get rid of air bubbles and wipe the lids of the jars before screwing on the lids. l Monitor the canning process. If the water stops boiling in your canner before the specified amount of time in the recipe has passed or the pressure on a pressure canner falls below the level specified in the recipe, you have to start the time over. l Allow the jars to cool overnight at room temperature before taking off the rims, wiping the tops of the jars again, labeling the jars with the date and contents and storing them. l Make sure there’s absolutely no give in the top of the lid. If there is, put it in the refrigerator and use it in the same length of time as something that wasn’t preserved.

properly.” Dial gauges for pressure canners should be calibrated annually by experts at places like county extension offices since they can get thrown off easily in a number of ways, including being dropped, McCurdy said. Even jam, long considered one of the safest forms of canned food, can get complicated.

Often jam is made from acid fruit like apricots and peaches grown on trees where it’s less vulnerable to clostridium botulinum than vegetables raised on the ground, McCurdy said. Beside the fruit, recipes used to have two other ingredients: sugar and pectin to thicken the mixture, McCurdy said. Just like salsa, what people put in jam is

growing more diverse, creating new hazards. Sometimes people will add herbs or they’ll experiment with a sweetener other than sugar, McCurdy said. Those methods can be safe as long as the person who created the recipe did so following the right food safety principles, McCurdy said. “These days we have a lot more alternatives.”

Fall 2013 17

Kids’ food allergies cost U.S. nearly $25 billion a year, study finds By Karen Kaplan Los Angeles Times LOS ANGELES — Children’s allergies to peanuts, dairy and other foods cost the U.S. nearly $25 billion a year, according to the first survey to come up with a comprehensive price tag for a condition that affects 8 percent of American kids. Researchers led by Dr. Ruchi Gupta, a pediatrician at Ann & Robert H. Lurie Children’s Hospital of Chicago and a professor at Northwestern University’s Feinberg School of Medicine, surveyed 1,643 parents around the country who have at least one child with a food allergy. The parents’ responses were weighted to match the actual distribution of children with food allergies in the United States. Here’s what they found: Doctors’ appointments, hospital stays, trips to the emergency room and other direct medical expenses accounted for $4.3 billion of the tab, researchers reported. The lost productivity of parents who had to take their children to these appointments added $773 million. Then there were the expenses associated with buying special allergen-free foods, placing children in allergy-sensitive schools and making special arrangements for child care in facilities that are willing to banish peanuts. These costs totaled $5.5 billion. The biggest cost by far was the money parents gave up by staying out of the workforce, taking lesser jobs or otherwise restricting their careers to accommodate their children’s medical condition. Among the parents surveyed, 9.1 percent said they had incurred some type of work-related opportunity cost. (Some parents even said they’d been fired as a result of dealing with their kids’ allergies.) Altogether, these costs added up to $14 billion a year. The grand total for these expenses came

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to $24.8 billion a year, or $4,184 per child, the researchers found. After excluding medical expenses that would be covered by health insurance, the costs borne by families was $20.5 billion. To make sure their number was in the ballpark, the researchers asked parents to consider this hypothetical question: How much would you pay each month for a medicine that would cure your child’s allergy? The average response, annualized, was $3,504. When extrapolated across every single kid with a food allergy in the entire country, the parents’ total willingness to pay to

be rid of allergies was $20.8 billion per year. That was surprisingly close to the $20.5 billion per year that food allergies actually cost them, and seemed to validate the high price parents pay in their careers (or lack thereof). Parents “often need to be at school, social events, or camp to educate and affirm the seriousness of their child’s condition,” the researchers noted in their report, which was published online in the journal JAMA Pediatrics. “In case of an emergency, caregivers may not be able or willing to take a job that requires travel or many hours away from their child.”

Runner touts chocolate milk All that would have been news to Zanecosky back in the 1980s and ’90s when she participated in about PHILADELPHIA — Althea Zanecosky 10 Philadelphia Distance Runs. At takes her chocolate milk seriously. the time, Zanecosky typified the When she traveled to watch her daugh- competitive element of the running ter, Rebecca, run in the Pittsburgh Maracircuit. Her best marathon time is 3 thon, she didn’t leave anything to chance. hours, 5 minutes, and she completed Zanecosky packed a cooler with chocolate the Boston Marathon. milk, carted it across the state, stowed it in In the 30 years since, running a hotel room refrigerator and then hauled it has exploded into a mass participato the finish line. tion sport. Races designed for fun have “I am both the sports nutrition mom drawn weekend warriors focused more and the dairy mom,” Zanecosky said. “Evon finishing than a fast time. For eryone in the party knows that I carry the those non-elite runners, proper chocolate milk.” recovery is all the more important. A former sports nutrition professor at “How much do people spend on Drexel and registered dietitian who represhoes? $120?” Zanecosky said. “We sents the Mid-Atlantic Dairy Association, know that it’s important to have Zanecosky used to get funny looks when the right equipment. Part of that she trumpeted the recovery benefits of equipment is your food.” chocolate milk. Zanecosky said the first 30 minutes to two hours after the race is the most important time “Chocolate milk is the one to refuel. She suggests ditching delicious thing that all of us can the traditional, carb-heavy have no guilt about because it’s pancake breakfast for a doing the body this wonderful meal balanced between good.” carbs and protein, like Althea Zanecosky cereal in milk with yogurt Former sports nutrition professor at Drexel and registered dietitian who represents the and fruit. Mid-Atlantic Dairy Association And of course, she has an idea about what to drink: “There seems to be this disconnect: “We’ve got exactly what you need.” If it tastes good it can’t be good for me,” Zanecosky said. “Chocolate milk is the one delicious thing that all of us can have no guilt about because it’s doing the body this Located wonderful good.” inside After a long race, Zanecosky said, Rosauers runners need carbohydrates and protein in roughly a 3 to 1 ratio. Chocolate milk Certified Organic Foods provides that naturally, along with the necessary fluids and electrolytes. Zanecosky Natural Body Care Products said the trend toward chocolate milk began www.huckleberrysnaturalmarket.com in the cycling community and migrated to 322 Thain Road, Lewiston • 411 North Main, running.

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Rising Alzheimer’s creates strain on caregivers By LAURAN NEERGAARD Associated Press WASHINGTON — David Hilfiker knows what’s coming. He was diagnosed with Alzheimer’s so early that he’s had time to tell his family what he wants to happen once forgetfulness turns incapacitating. “When it’s time to put me in an institution, don’t have me at home and destroy your own life,” said the retired physician, who is still well enough that he blogs about the insidious progress of the disease. “Watching the Lights Go Out,” it’s titled. Nearly half of all seniors who need some form of long-term care — from help at home to full-time care in a facility — have dementia, the World Alzheimer Report recently reported. It’s a staggering problem as the global population ages, placing enormous strain on families who provide the bulk of that care at least early on, and on national economies alike. Indeed, cognitive impairment is the AP Photo/Cliff Owen strongest predictor of who will move into a Retired physician David Hilfiker, of Washington, leaves the National Press Club on his bike after talking about his life care facility within the next two years, 7.5 with Alzheimer’s in Washington. Hilfiker, was diagnosed in September 2012, and has been writing about the experience times more likely than people with cancer, of losing his mental capacity in his blog “Watching the Lights Go Out.” Nearly half of all seniors who need some form of heart disease or other chronic ailments of long-term care, from help at home to full-time care in a facility, have dementia, according to the World Alzheimer Report. older adults, the report found. “It’s astonishing,” said Marc Wortmann, Global Coalition on Aging. or at least delay the devastating disease. The executive director of Alzheimer’s Disease “Very shortly there will be more of us Obama administration had hoped to invest International, which commissioned the over 60 than under 15,” he noted. $100 million in new Alzheimer’s research report and focused on the problems of care Today, more than 35 million people this year, a move blocked by the budget cuts giving. “What many worldwide, includ- known as the sequester. Overall, the nation “When it’s time to put me in an countries try to do ing 5 million in the has been investing about $400 million a year institution, don’t have me at home is keep people away U.S., are estimated in Alzheimer’s research. and destroy your own life.” from care homes to have Alzheimer’s. But the disease’s financial toll is $200 bilDavid Hilfiker because they say Barring a medilion a year in the U.S. alone, a tab expected retired physician and author of the blog that’s cheaper. Yes cal breakthrough, to pass $1 trillion by 2050 in medical and “Watching the Lights Go Out, it’s cheaper for the those numbers are nursing home expenditures — not counting government or the health system, but it’s not expected to more than double by 2050. unpaid family care giving. The world report always the best solution.” The U.S. National Institutes of Health puts the global cost at $604 billion. And dropping birth rates mean there are announced recently that $45 million in Families affected by Alzheimer’s and agfewer children in families to take care of ag- new Alzheimer’s research, with most of the ing advocates say it’s time for a global push ing parents, too, said Michael Hodin of the money focused on finding ways to prevent to end the brain disease, just like the world’s

20 Balance

governments and researchers came together to turn the AIDS virus from a death sentence into a chronic disease. “We need a war on Alzheimer’s,” said Sandy Halperin, 63, of Tallahassee, Fla., who was diagnosed with early stage Alzheimer’s three years ago. He now finds himself stumbling for words, but still visits lawmakers to urge more funding. Meanwhile, the world report focuses on care giving, stressing how the needs of people with dementia are so different than those of other ailments of aging, such as cancer and heart disease. People with dementia begin needing some help to get through the day early on, to make sure they don’t leave the stove on or get lost, for example. Eventually, patients lose the ability to do the simplest activities of daily life, and can survive that way for a decade or more. Often family members quit their jobs so they can provide round-the-clock care, and the stress can harm their own health. The world report said families need early education about what services are available to help before they’re in a crisis, plus training in how to handle the behavioral problems of the disease — such as not to argue if their loved one thinks Ronald Reagan is still president, or how to handle the agitation at dusk known as sundowning, or how to react when the patient hits someone. Two-thirds of the calls that Home Instead Senior Care, which provides in-home personal care services, receives are from families that did no planning until the patient had a crisis, such as wandering or a fall, said its president, Jeff Huber. Hilfiker, the blogger with early Alzheimer’s, takes that education idea a step further. He tells everyone he knows that he has Alzheimer’s as a way to break some of the stigma, “so when I make dumb mistakes, I don’t need to be embarrassed,” he said. He urges other patients to plan their endof-life care early, while they’re still cognitively able to participate. He believes that telling his wife no extraordinary care — no feeding tubes, for example — will ease her burden. Hilfiker’s big unanswered question: “If I’m at peace with my disease, does that make it easier to care for me later?”

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Fall 2013 21

Study ties higher blood sugar to dementia risk By MARILYNN MARCHIONE Associated Press igher blood-sugar levels, even those well short of diabetes, seem to raise the risk of developing dementia, a major new study finds. Researchers say it suggests a novel way to try to prevent Alzheimer’s disease — by keeping glucose at a healthy level. Alzheimer’s is by far the most common form of dementia and it’s long been known that diabetes makes it more likely. The new study tracked blood sugar over time in all sorts of people — with and without diabetes — to see how it affects risk for the mind-robbing disease. The results challenge current thinking by showing that it’s not just the high glucose levels of diabetes that are a concern, said the study’s leader, Dr. Paul Crane of the University of Washington in Seattle. “It’s a nice, clean pattern” — risk rises as blood sugar does, said Dallas Anderson, a scientist at the National Institute on Aging, the federal agency that paid for the study. “This is part of a larger picture” and adds evidence that exercising and controlling blood pressure, blood sugar and cholesterol are a viable way to delay or prevent dementia, he said. Because so many attempts to develop effective drugs have failed, “It looks like, at the moment, sort of our best bet,” Anderson said. “We have to do something. If we just do nothing and wait around till there’s some kind of cocktail of pills, we could be waiting a long time.” About 35 million people worldwide have dementia; in the United States, about 5 million have Alzheimer’s disease. What causes it isn’t known. Cur-

22 Balance

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New research published in the Aug. 8 New England Journal of Medicine suggests a possible way to help prevent Alzheimer’s disease: Keeping blood sugar at a healthy level. A study found that higher glucose levels, even those well short of diabetes, seemed to raise the risk for dementia.

rent treatments just temporarily ease symptoms. People who have diabetes don’t make enough insulin, or their bodies don’t use insulin well, to turn food into energy. That causes sugar in the blood to rise, which can damage the kidneys and other organs — possibly the brain, researchers say. The new study, published in the

New England Journal of Medicine, just tracked people and did not test whether lowering someone’s blood sugar would help treat or prevent dementia. That would have to be tested in a new study, and people should not seek blood-sugar tests they wouldn’t normally get otherwise, Crane said. “We don’t know from a study like

Study: http://www.nejm.org/doi/full/10.1056/NEJMoa1215740 Alzheimer’s info: http://www.alzheimers.gov Alzheimer’s Association: http://www.alz.org Warning signs: http://www.alz.org/10signs

this whether bringing down the glucose level will prevent or somehow modify dementia,” but it’s always a good idea to avoid developing diabetes, he said. Eating well, exercising and controlling weight all help to keep blood sugar in line. The study involved 2,067 people 65 and older in the Group Health Cooperative, a Seattle-area health care system. At the start, 232 participants had diabetes; the rest did not. They each had at least five blood-sugar tests within a few years of starting the study and more after it was underway. Researchers averaged these levels over time to even out spikes and dips from testing at various times of day or before or after a meal. Participants were given standard tests for thinking skills every two years and asked about smoking, exercise and other things that affect dementia risk. After nearly seven years of followup, 524, or one quarter of them, had developed dementia — mostly Alzheimer’s disease. Among participants who

had the apoE4 gene, which raises the risk for Alzheimer’s. At least for diabetics, the results suggest that good blood-sugar control is important for cognition, Crane said.

For those without diabetes, “it may be that with the brain, every additional bit of blood sugar that you have is associated with higher risk,” he said. “It changes how we think about thresholds, how we think about what is normal, what is abnormal.” Follow Marilynn Marchione on Twitter at http://twitter.com/MMarchioneAP

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“We don’t know from a study like this whether bringing down the glucose level will prevent or somehow modify dementia,” Dr. Paul Crane

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started out without diabetes, those with higher glucose levels over the previous five years had an 18 percent greater risk of developing dementia than those with lower glucose levels. Among participants with diabetes at the outset, those with higher blood sugar were 40 percent more likely to develop dementia than diabetics at the lower end of the glucose spectrum. The effect of blood sugar on dementia risk was seen even when researchers took into account whether participants

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Deaths of wandering autistic kids prompt action By DAVID CRARY Associated Press

he 3-year-old girl wandered away from her grandmother’s home in Wareham, Mass., in mid-April. A frantic search began almost immediately, and within an hour little Alyvia Navarro was found unresponsive in a nearby pond. She was pronounced dead the next day. A month later, across the continent, a larger search unfolded over three days as hundreds of emergency service personnel and volunteers fanned out around Clearlake, Calif., looking for 9-year-old Mikaela Lynch after she vanished from her backyard. The outcome grimly echoed the Wareham search: A dive team found Mikaela’s body in a muddy creek. The two girls were the first of at least 13 children with autism known to have died this year after slipping away from their caregivers. Twelve of them drowned, evidence of a fascination that many autistic children have with water. The tragic phenomenon goes by various names — wandering, elopement, bolting — and about half of autistic children are prone to it, according to research published last year in the journal Pediatrics. That would be a huge number. A federal survey this year estimated that one of every 50 U.S. schoolchildren is on the broad autistic spectrum — more than 1 million children in all. Wandering has led to the deaths of more than 60 children in the past four years, and the fear of it can make daily life a harrowing, never-let-your-guard-down challenge for parents. “We take steps at home — locks on every door, gates, alarms,” said writer Jo Ashline Online Resources:

of Orange, Calif., whose 11-year-old son has autism. “But there’s always, in the forefront of our minds, the thought that one tiny mistake could prove fatal.” Groups that advocate for autism-affected families, including the National Autism Association and Autism Speaks, are now making it a priority to increase awareness of wandering — among parents, professionals who deal with autistic children, and first-responder agencies that handle missing-children cases. The study in Pediatrics found that half of parents with autistic children had never received advice or guidance from a professional on how to cope with wandering. Among those trying to change that is Sheila Medlam of Colwich, Kan., whose 5-year old son, Mason, drowned in a pond in July 2010 after squirming out of the family home through a window that had been raised about 8 inches because the air conditioner went out. Medlam was at work; her adult daughter was at home but didn’t see Mason’s getaway. “It only takes a second of inattention and they’re gone,” Medlam said in a telephone interview. “They’re fast, they’re quiet. They can disappear in an instant.” Medlam now works with autistic children, operates a website that keeps track of wandering-related deaths, and lobbies for a national alert system that would improve emergency responses. On her website, she has written a wrenching account of the day Mason died — blaming herself for leaving the window open and for omitting potentially helpful details when she called 911, and blaming the first responders for lack of knowledge about how to search for autistic children. “If only I could redo that day and just

National Autism Association: http://www.autismsafety.org/wandering.php Fact sheet: http://www.missingkids.com/en—US/publications/SpecialNeeds—Addendum.pdf Study on wandering: http://bit.ly/Sy7klg

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change one thing. But I can’t,” Medlam wrote. “All I can do is point out the mistakes I made, the mistakes others made, and the lack of resources that claimed my child’s life and ripped him from my arms forever.” Boys and girls with autism aren’t the only children who stray from caregivers, of course, but their wanderings pose distinctive challenges. While autism encompasses a spectrum of disorders, posing a range of developmental challenges, experts say the wanderers are often among the more severely affected. They often have minimal concept of danger, don’t readily absorb safety lessons, and have limited ability to communicate with others. And once on the loose, they often make a beeline for a destination of interest that proves fatal: a busy highway or a body of water. Lori McIlwain, executive director of the National Autism Association, says about 90 percent of the wandering fatalities in recent years have been drownings, and most of the other victims were struck by cars. McIlwain, who lives in Cary, N.C., says her own son, Connor, wandered away from his school in 2007 and might well have ended up in danger had a concerned motorist not stopped and picked up the boy after getting no response to some questions. In the ensuing years, McIlwain said, it’s been a constant challenge to teach her son how to keep himself safe. Still, the fear that he’ll bolt remains “what we live with — it doesn’t go away,” she said. Precautionary measures recommended by experts include locks and alarms on doors and windows, “Stop” signs placed in key locations in the home, and ID bracelets or tracking devices worn by the child. Other recommendations from the National Autism Association include: —enrolling the children in swimming lessons, such as those offered by the YMCA for special-needs pupils.

â&#x20AC;&#x201D;developing a family emergency plan to be used in the event of a wandering incident. â&#x20AC;&#x201D;informing local emergency services, trusted neighbors and staff at the childâ&#x20AC;&#x2122;s school or day-care center about details of the childâ&#x20AC;&#x2122;s interests and wandering patterns. Even after taking such steps, many parents nonetheless sleep in their autistic childâ&#x20AC;&#x2122;s room to avert a nighttime getaway. McIlwain knows a mother who takes away her daughterâ&#x20AC;&#x2122;s shoes when theyâ&#x20AC;&#x2122;re home as a deterrent. Lauri Dupree of Lumberton, Miss., says she and her husband, who are raising their 6-yearold grandson, Boo, have resorted to using a harness during outings and even sometimes at home because of his daily attempts to bolt. â&#x20AC;&#x153;He has always done this since he learned to walk and has come close to losing his life on several occasions,â&#x20AC;? Dupree said. Jo Ashline describes her home in California as resembling Fort Knox with its array of security measures. â&#x20AC;&#x153;Thereâ&#x20AC;&#x2122;s always that state of worry â&#x20AC;&#x201D; is he going to get out,â&#x20AC;? Ashline said of her son Andrew. â&#x20AC;&#x153;As he gets older and taller, are we going to be able to outsmart him? It only takes one time for him to outsmart us.â&#x20AC;? She and her husband â&#x20AC;&#x201D; like many other parents in their situation â&#x20AC;&#x201D; shy away from travels and vacations that might expose Andrew to new opportunities to get away. â&#x20AC;&#x153;The world itself became our greatest nemesis,â&#x20AC;? Ashline wrote on her blog. â&#x20AC;&#x153;Places most families treasure such as parks, beaches, backyard swimming pools and campsites became staging grounds for our imaginationsâ&#x20AC;&#x2122; worst nightmares.â&#x20AC;? Indeed, several of this yearâ&#x20AC;&#x2122;s wandering victims were on vacations or family outings

â&#x20AC;&#x201D; including a camping trip in Ohio and a beach vacation in Florida. Even festive gatherings at home can be dangerous, according to Bob Lowery, executive director of the missing children division of the National Center for Missing and Exploited Children. â&#x20AC;&#x153;The backyard barbecue is probably the most unsafe place to be,â&#x20AC;? he said. â&#x20AC;&#x153;Everyone assumes someone else is watching that child, and they slip away unnoticed.â&#x20AC;? To avoid that outcome, he said, some parents develop elaborate hand-off systems to try to ensure an adult always has their eyes on the child. Over the past few years, Loweryâ&#x20AC;&#x2122;s organization has intensified efforts to increase awareness of the wandering phenomenon and improve the way emergency services and search-and-rescue teams respond. For example, the people who field 911 calls are being encouraged to obtain specific information from the caller such as whether the child is attracted to water, so that searchers can immediately deploy to local ponds or rivers. â&#x20AC;&#x153;We know that if thereâ&#x20AC;&#x2122;s a tragedy with a child with autism, it probably will occur very quickly,â&#x20AC;? Lowery said. â&#x20AC;&#x153;They have a tendency to head straight to water if thatâ&#x20AC;&#x2122;s what they want â&#x20AC;&#x201D; you need every able-bodied person available to get to water as soon as possible to head them off.â&#x20AC;? Lowery and his colleagues, as well as many advocates for autism-affected families, have been exploring ways of developing a national alert system tailored to deal with wandering incidents. He said the existing Amber Alert system is not an option â&#x20AC;&#x201D; itâ&#x20AC;&#x2122;s limited to

cases where a child is believed to have been abducted by someone who poses a danger to them. One option being looked at is Project Lifesaver, launched in 1998 to help searchand-rescue teams find missing people with Alzheimerâ&#x20AC;&#x2122;s disease, dementia, autism and Down syndrome. Funding is an issue, however: For the program to function, the people at risk of wandering must wear transmitter bracelets and emergency services must have appropriate tracking equipment. The driving force behind the recently published research on wandering was the Interactive Autism Network, a program headed by Dr. Paul Law at the Kennedy Krieger Institute in Baltimore. Law says he is encouraged that people in the autism community and beyond are now talking about the phenomenon. â&#x20AC;&#x153;Up until now itâ&#x20AC;&#x2122;s been a silent problem,â&#x20AC;? he said. â&#x20AC;&#x153;Everyone was expected to deal with it on their own. They didnâ&#x20AC;&#x2122;t talk to their doctor; parent groups didnâ&#x20AC;&#x2122;t talk about it.â&#x20AC;? He said parents coping with the challenges of a wandering child deserved public understanding and support. For many parents, thereâ&#x20AC;&#x2122;s damned-if-youdo, damned-if-you-donâ&#x20AC;&#x2122;t aspect to the nonstop need for vigilance. Some are criticized for turning their homes into fortresses and minimizing their autistic childâ&#x20AC;&#x2122;s contacts with new environments. Yet when a wanderingrelated death occurs, the parents can incur harsh criticism in social media, including aspersions that they were negligent. Follow David Crary on Twitter at http://www.twitter.com/craryap

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New test aims to better detect viral infections By LAURAN NEERGAARD Associated Press WASHINGTON — It happens too often: A doctor isn’t sure what’s causing someone’s feverish illness but prescribes antibiotics just in case, drugs that don’t work if a virus is the real culprit. Now Duke University researchers are developing a blood test to more easily tell when a respiratory illness is due to a virus and not a bacterial infection, hoping to cut the dangerous overuse of antibiotics and speed the right diagnosis. It works by taking a fingerprint of your immune system — how its genes are revving up to fight the bug. That’s very different from how infections are diagnosed today. And if the experimental test pans out, it also promises to help doctors track brand-new threats, like the next flu pandemic or that mysterious MERS virus that has erupted in the Middle East. That viral “signature could be quite powerful, and may be a game-changer,” said Dr. Geoffrey Ginsburg, Duke’s genomic medicine chief. He leads the team that on Wednesday reported that a study involving 102 people provided early evidence that the test can work. Today, when symptoms alone aren’t enough for diagnosis, a doctor’s suspicion guides what tests are performed — tests that work by hunting for evidence of a specific pathogen. Fever and cough? If it’s flu season, you might be tested for the flu virus. An awful sore throat? Chances are you’ll get checked for strep bacteria. A negative test can

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(AP Photo/Duke Medicine, Shawn Rocco)

In this image provided by Duke University, lab research analyst Marshall Nichols does research relating to developing a blood test to more easily tell when a respiratory illness is due to a virus and not a bacterial infection, hoping to cut the dangerous overuse of antibiotics and speed the right diagnosis.

leave the doctor wondering what germ to check for next, or whether to make a best guess. Moreover, rapid in-the-office tests aren’t always accurate and can miss infections. So patients may have blood or other samples sent to labs to try to grow any lurking bacteria and tell if it’s to blame, additional testing that can take days. “This is something we struggle with every day,” said Dr. Octavio Ramilo, infectious disease chief at Nationwide Children’s Hospital in Columbus, Ohio, who wasn’t involved in the new study.

Particularly with children, a respiratory virus and a bacterial infection “in the beginning look completely alike,” he added. Hence researchers at a number of universities are trying to harness a fairly recent discovery: As your immune system detects an invading bug, different genes are activated to fend off a viral infection than to fight a bacterial or fungal one. Those subtle molecular changes appear to be occurring even before you feel any symptoms. And they form distinct patterns of RNA and proteins, what’s called a genomic

added. In Ohio, Ramilo is exploring a more immediate need: When young infants have high fevers, they’re often hospitalized while doctors run a battery of tests to find the fraction who have a serious bacterial infection. He is leading a study involving 22 pediatric emergency rooms to see if a genomic fingerprint approach could separate which babies really need all that testing.

But the virus-or-not question is just the beginning, Ramilo said. His research suggests genomic fingerprints also can distinguish a flu strain from other common viruses. And the Duke team is analyzing a huge study of students living in dormitories, to see if the genomic test detected who was incubating the flu before their first sniffle — and thus might be useful in stemming outbreaks.

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fingerprint. The Duke team discovered 30 genes that are switched on in different ways during a viral attack. The test essentially is a freeze-frame to show “what those genes are doing at the moment in time that it’s captured,” explained Duke lead researcher Dr. Aimee Zaas, an infectious disease specialist. Small studies spotted that viral signature in people who volunteered to be infected with different influenza strains for science. For a more real-world simulation, the researchers then analyzed blood samples stored from feverish people who had come to the emergency room — and who were eventually diagnosed, the old-fashioned way, with either some type of virus or a bacterial infection. The genomic test proved 89 percent accurate in sorting out who had a virus, and did even better at ruling out those who didn’t, Zaas reported Wednesday in the journal Science Translational Medicine. It took 12 hours to get results. The researchers hope to speed that up so that it might work as quickly as some in-office tests. Still, “it’s a promising tool,” said Ramilo, an Ohio State University professor who is doing similar research. He called the Duke study an important step toward creating a commercial test, and predicts one might reach the market within five years. Why would a doctor want to know merely that a virus is present and not which virus? That’s enough information to rule out antibiotics, Zaas said. Unnecessary antibiotic use is one factor in the growing problem of drug-resistant germs, which the government blames for more than 23,000 deaths a year. Plus, if a dangerous new virus begins spreading, like MERS, this approach could help avoid quarantining people unnecessarily by telling right away which ones are virus-free, Ginsburg

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Silver used as a type of antibiotic thousands of years before discovery of microbes protective membrane that prevents antibiotic against multi-drug-resistant microbes. drug molecules from penetrating and killing Researchers who were not involved in them. the study said it was timely, given the rising LOS ANGELES – Thousands of years beIn a series of experiments, Collins and concern over the dwindling power of antibifore the discovery of microbes or the invencolleagues from BU and Harvard University otics. The World Health Organization warns tion of antibiotics, silver was used to protect examined the effects of a simple solution of that “many infectious diseases risk becoming wounds from infection and to preserve food silver nitrate salt on Gram-negative bacteria untreatable and uncontrollable.” and water. like Escherichia coli. “This is exciting data and should help The alluring metal, which was fashioned What they found was that even small pave the way for clinical trials into the use into a multitude of curative coins, sutures, amounts of silver ran roughshod over some of silver,” said Wilmore Webley, an assistant foils, cups and solutions, all but vanished of the toughest bacteria around. professor of microbiology at the University of from medical use once physicians began us“It did two things,” Collins said. The Massachusetts, Amherst. “The investigators ing anti-bacterial drug agents to fight sickness positively charged silver ions degraded the covered a lot of ground.” in the 1940s. bacteria’s protective layer, giving the antibiotWhile the precise mechanisms by which But now, as bacteria grow increasics easier access to the pathogens’ innards. It silver kills germs remain something of a mysingly resistant to these medications and new also messed with the bugs’ metabolism and tery, the element’s medicinal and preservative pathogens invade hospitals, some doctors are their ability to manqualities have been “This is exciting data and should recorded throughout turning once again to the lustrous element age their iron levels. that Hippocrates prescribed for patients in The second effect help pave the way for clinical trials history. ancient Greece. led to the creation of into the use of silver,” Silver has been Wilmore Webley In a study published in Science Translamolecules that can used variously to treat assistant professor of microbiology at the tional Medicine, researchers found that by kill bacteria, includskin ulcers, comUniversity of Massachusetts, Amherst adding trace amounts of silver to common ing oxygen molpound fractures and antibiotics, the medications became up to ecules that are prone to chemical reactions even bad breath. 1,000 times more effective in fighting infecthat can damage cells, Collins said. In his “History of the Medical Use of tions in mice. In one experiment, researchers induced Silver,” Dr. J. Wesley Alexander wrote that Also, study authors said they were peritonitis in mice by injecting them with E. North American pioneers routinely dropped surprised and excited to find that the silvercoli cells. Of the mice treated with silver and silver coins into vessels of drinking water antibiotic combo was able to “re-sensitize” vancomycin, 90 percent survived. during long journeys to ward off infection. In bacteria that had developed a resistance to Mice treated with just silver or just vanaddition, privileged families benefited from the drugs. It even extended the effectiveness comycin fared much worse. Half of the mice using silver eating utensils that often caused of the commonly used antibiotic vancomycin that got silver died, along with 90 percent of “a bluish-gray discoloration of the skin, thus to a class of bacteria that was previously imthe mice treated with antibiotics. becoming known as ’blue bloods.’” mune to its effects. The researchers also observed that silver Argyria, an irreversible condition in which “We went from basically no killing to was effective against biofilms – colonies of the skin turns blue or gray due to the buildsubstantial killing,” said senior author James slime-protected bacteria that create stubborn up of silver particles, is the result of consumCollins, a professor of microbiology at Boston infections on medical implants, heart valves ing silver solutions or flecks of the metal over University. and hospital equipment. long periods of time. The study is one of the first comprehensive Although experiments combining silver examinations of the ways that silver affects and antibiotics have yet to be performed on ©2013 Los Angeles Times bacteria that are known as Gram-negative. humans, the study suggests that the metal Visit the Los Angeles Times at www.latimes.com Distributed by MCT Information Services These bacteria are equipped with an extra may become a powerful helper in the fight By Monte Morin Los Angeles Times

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