So we are back from L.A. and my husband has had a cough. He didn't go back to work yesterday, and went to the walk in clinic today. He started to describe his symptoms and the walk in clinic was not sure how to handle him. Of course, any coughing person is given a face mask, but they were fearful that he may have contracted coronavirus. Anyway, he has been tested, and we are waiting for public health officials to call with the results.
In the media, we have been seeing a huge increase in deaths by coronavirus now in Italy. Joe Rogan has a podcast that he posts on YouTube and whenever he sees current events with conflicting information floating around online, he brings on an expert for an interview. Today's episode of the Joe Rogan Experience was with Dr. Michael Osterholm who is an expert in infectious diseases at the Center for Infectious Disease Research and Policy (CIDRAP). Have a listen here! In this episode, Joe discusses topics such as the novel coronavirus, chronic wasting disease, a prion type of infectious disease, and the tick-borne Lyme disease.
Dr. Osterholm discusses what is predicted for the coronavirus, due to its novel strain, but also debunks the thoughts about biological warfare (oh you conspiracy theory lovers!).
Influenza and Coronavirus are spread through breathing, and people are infectious before you feel sick - in other words, you will be showing signs of disease after you are already spreading the disease. Dr. Osterholm suggests that coronavirus is likely going to be 10 times worse than the flu virus. Also, that it is not seasonal, so don't think that it will just go away when the seasons change. There is about a 1:1000 mortality rate for influenza, whereas coronavirus has a 2-3% case fatality rate (for every 100 people infected 2-3 people die). There was a short discussion on why healthy adults are getting infected, and that it's likely due to a cytokine storm - an immune response in your body in which the healthier people get more sick.
Lyme Disease: I was in the middle of typing a new blog post on this up-coming tick season! So how convenient that I can talk about it here as well. What Dr. Osterholm briefly mentioned is that we do not fully know how the immune-system works during Lyme disease. What they don't mention is that Lyme disease is a tick-borne bacteria called Borrelia burgdorferi. From what we know about infections in dogs, there is an acute infection with the bacterial organism, the body's immune system can clear the infection without clinical signs, and then there is an antibody response that demonstrates exposure to the bacteria. The antibodies in the animal are detected on a quick assessment test called a SNAP 4Dx - Idexx laboratories, which has a high sensitivity and specificity. I will go into more detail about Lyme disease in my tick awareness post. Dr. Osterholm neglected to say that the Virginia opossum are also great tick consumers (in addition to birds). The chronic form of Lyme disease in dogs is due to the antigen-antibody complexes that form in the blood stream - these clumps of antigen-antibody immune complexes then get trapped in the small capillaries of joints (causing lameness and arthritis), or kidneys (causing Lyme nephritis), and potentially the brain. So far, that we know of, 90% of dogs that test positive for Lyme by a 4Dx snap test (i.e. have been exposed to the bacteria) do not get sick. Also so far, we cannot predict which of those dogs that test positive for Lyme will develop severe disease. The evidence is mixed on whether or not the disease is related to the total amount of antibodies in the blood stream as written in the consensus statement by the American College of Veterinary Internal Medicine (with regards to the Lyme quant C6 test), stating "there is insufficient published evidence that higher titers predict illness or are associated with future illness to advocate routine recommendation of this test in healthy dogs". However, two-thirds of the panelists (4/6) believe that initial testing of C6 prior to the use of antibiotics to treat infection can be helpful when compared to a post-test to see the reduction in the C6 antibody levels. Anyway, that's my brief little intro on Lyme disease - more to come!
For more information on Dr. Osterholm's work and Coronavirus head to the CIDRAP - novel coronavirus.