Vape smoke has ‘toxic chemical fumes’
A Mayo Clinic study of vaping-related lung injuries has found “toxic chemical fumes”, not oils, may be to blame for the illnesses.
The findings, published in the New England Journal Of Medicine, was based on the biopsies of 17 people with confirmed or possible cases of vaping-related lung injuries, including two patients who died.
All of the subjects had a history of vaping, with 71% of them having used marijuana or cannabis oils.
The US Centers for Disease Control and Prevention reported more than 805 people have been diagnosed with vaping-related lung injuries since April. Twelve deaths linked to e-cigarette use have been confirmed in 10 states.
Early symptoms of the lung injuries include coughing, shortness of breath, fatigue, chest pains, nausea, vomiting and diarrhoea.
Despite speculation by some researchers that the injuries might be linked to an accumulation in the lungs of fatty substances known as lipids, the Mayo Clinic study said none of the cases showed any evidence of lipoid pneumonia.
“While we can’t discount the potential role of lipids, we have not seen anything to suggest this is a problem caused by lipid accumulation in the lungs,” said Dr Brandon Larsen, a surgical pathologist at the Mayo Clinic in Scottsdale, Arizona, and the senior author of the study. “Instead, it seems to be some kind of direct chemical injury, similar to what one might see with exposures to toxic chemical fumes, poisonous gases and toxic agents.”
Studies have also shown that products containing THC — the principal psychoactive compound in marijuana — or other cannabis oils, such as cannabidiol or CBD, may play a role in the outbreak.
“This is a public health crisis, and a lot of people are working frantically around the clock to find out what the culprit or culprits could be — and what chemicals may be responsible,” Larsen said. “Based on what we have seen in our study, we suspect that most cases involve chemical contaminants, toxic byproducts or other noxious agents within vape liquids.”
Brazilian mosquitoes fight dengue
Dengue-resistant mosquitoes are breeding in a Rio de Janeiro laboratory, producing offspring infected with bacteria packing a punch in the fight against the deadly virus, which is exploding across Brazil this year.
Scientists are using Wolbachia, a bacteria common among insects except the dengue-transmitting Aedes aegypti mosquito, to dent the spread of the debilitating virus and other illnesses including Zika and chikungunya.
Since 2015, the Fiocruz institute in Rio has been producing mosquitoes infected with Wolbachia and releasing their dengue-hardened offspring into the densely populated city and neighbouring Niteroi. The hope is they will spread the bacteria by reproducing with wild mosquitoes.
Wolbachia works in two ways: it boosts a mosquito’s immune system, making it less likely to contract dengue. But if the mosquito does get dengue, Wolbachia makes it harder for the virus to grow inside the insect and be transmitted to humans. So far, results are promising.
Scientists involved in the trial report a “significant reduction” in cases of dengue and chikungunya in targeted neighbourhoods.
Tests show more than 90% of mosquitoes in areas where the first infected insects were released more than three years ago have the bacteria.
But Wolbachia is not the silver bullet for eliminating dengue, said Luciano Moreira, head of the project in Brazil.
“Where there are people, there are mosquitoes,” Moreira explains, surrounded by hundreds of tubes holding thousands of Wolbachia-infected mosquitoes. “We always say we are not the solution, it has to be an integrated process done together.
“People still have to destroy breeding sites at home. You want to have less mosquitos, but mosquitoes with Wolbachia. If there is a vaccine you can use it in conjunction with that ... it has to be a combination.”
Edible sensor helps TB patients
An ingestible sensor that allows doctors to remotely monitor tuberculosis patients’ intake of medication has the potential to save millions of lives and revolutionise treatment for the world’s most deadly infectious disease, researchers said last week.
A randomised trial of 77 patients in California, published in the journal PLOS Medicine, found that 93% of patients using the sensor were taking their daily treatment doses, compared with 63% who did not.
Around 10 million people contract tuberculosis annually, and in 2017, 1.6 million people died from the chronic lung disorder.
Poor adherence to treatment regimes has long been associated with continued transmission and the emergence of drug-resistant strains of the disease.
The so-called Wirelessly Observed Therapy (WOT) involves a patient swallowing a small, pill-sized sensor and wearing a paired patch on their torso which transmits medication levels via Bluetooth.
Their physician can then track in real-time their medication intake using a phone app.
“If we are serious about eliminating TB then we have to get some fundamental things right such as increased support for patient care that efficiently helps patients complete all of their treatment,” said Sara Browne, Professor of Clinical Medicine at the University of California San Diego, who led the trial.
The vast majority of TB deaths occur in developing nations, led by India.
Mark Cotton, professor of paediatrics and child health at Stellenbosch University, said the technology could have a profound effect on tuberculosis rates and deaths in highrisk countries.
“We must urgently evaluate the applicability of WOT in high-prevalence countries such as India and South Africa where adherence rates are often poor due to geographical barriers, stigma and poverty,” Cotton said. “WOT could potentially be a lifesaver for millions.”