CABI Blogs: hand picked... and carefully sorted

Theft! A new threat to glaciers

Argentina passed a law back in September 2010 aiming at preserving their glaciers on the grounds that they are important as: "strategic hydrological resource for human consumption; for agricultural use; to recharge hydrographic basins; to protect biodiversity; a scientific information source; and a touristic attraction.” The law imposed a requirement for a prior evaluation of any planned allowed activities. This is quite an important law, when considering the latest threat to glaciers – theft! A news article from the UN News Centre reported recently that criminal gangs might have become a more immediate threat to glaciers than climate change.

Tuberculosis treatment- end of an era?

The 1940s saw the beginning of the era of effective drug therapy for TB with the discovery of streptomycin. At the beginning of the 21^st century we are seeing its end. Last month doctors in India reported an outbreak of a strain of TB that was termed totally drug resistant. It could be a false alarm because as it turns out the strains were not tested against all known drugs for TB but they were resistant to all 12 of the most common first and second line drugs.

Unfortunately India wasn’t the first place to report totally drug resistance such strains were reported in Italy in 2007 and Iran in 2009. Its presence in India is a concern, say experts because of the large poor population living in crowded conditions and government funded treatment of only simple TB cases.

TB develops drug resistance readily, probably aided by the long treatment times needed. Drug resistant strains followed very soon after the development of the first anti TB drugs and multiple drug resistant (MDR) forms heralded the resurgence of TB globally in the 1980s.

In response the World Health Organization developed the DOTS strategy, where adherence to the drug regime is ensured by observing the patient each time they take a drug dose. But despite this half a million cases of MDR TB occur each year because of poor adherence, poor quality drugs or erratic supply of drugs.

In 2006 the next step on the slippery slope to an incurable TB was the appearance of extremely drug resistant TB in an outbreak in South Africa. This was resistant to first and some secondline drugs.

This increasing drug resistance puts recent progress in decreasing the number of worldwide TB cases in jeopardy.

What can be done? Early diagnosis and testing and a better vaccine would go a long way to getting cases early and giving the right drugs. Treating early and accurately will stop the spread of TB.

TB diagnosis is antiquated - requiring use of microscopy in low resource settings. Matters are complicated by unreliable blood tests on the market which are attractive, quick to do and cheap. WHO issued a warning about those last year.

Progress is being made towards a rapid test. The Xpert MTB/RIF assay is a real-time PCR assay that is fully automated, and that has demonstrated high performance and could be deployed in a range of low- and middle-income settings. The World Health Organization (WHO) has publicly backed it.

World TB day is on 24^th March 2012. Join the campaign against this disease of poverty here.

CABI is publishing a book about tuberculosis this year: Tuberculosis diagnosis and treatment.

See Global Health Knowledge Base for access to Global Health abstracts on tuberculosis

Photo credit: Janice Haney Carr

Come on in, the water’s lovely……

Among the full text records recently loaded to Environmental Impact is one which examined the water quality of spa waters at Polish health resorts.

Specifically the paper [1] examined the composition of the healing waters. Iron seems to be an important component present in 37 of 160 waters tested from 39 health resorts. Fluoride is also another important constituent of spa waters with 12 waters tested containing more than 2 mg/dm³. Some 28 of the waters contained sulphides in concentrations of >1 mg/dm³ while 64 waters contained iodide in similar concentrations. Even more alarming is the fact that waters which contain radon in an amount corresponding to the radiation of 74 Bq (2 nCi) in 1 dm³ are classified as radon waters. Ten of the analysed waters were found to contain this element.

A search of the database using the descriptor health resorts gave an interesting mix of papers which examined the bacteriological quality of the spa waters, health problems caused by using spa waters (hot tub lung) and tourism impacts of spa resorts. One paper [2] reported the death of a previously healthy 49-year-old woman from pneumonia came after she visited a wellness hotel for a spa holiday. Water samples contained bacteria that matched samples taken from the patient and revealed severe deficiencies in hygiene maintenance of the hot tubs at the hotel.

The presence of radon in Polish spa waters is not unique and a Hungarian study [3] examined uranium concentrations in spring, therapeutic and tap waters. The authors found that spring waters contained the highest concentrations of uranium while the lowest were found in tap waters. The calculated doses for the analysed samples of spring water are in the range 0.07-32.39 µSv/year with an average 4.32 µSv/year. This is well below the 100 µSv/year reference level of the committed effective dose recommended by WHO and the EU Council.

Traditionally, geothermally heated therapeutic spa waters widespread across Europe are not disinfected. This has led to sporadic outbreaks of legionellosis. The effectiveness of disinfection using UV and hyperchlorination was examined by Portuguese researchers [4]. They found that using UV light was an effective disinfection method and had the advantage of not affecting the physicochemical composition of the spa waters.

So a trip to the spa may not necessarily be the healthiest of options after all.

 

[1] The elements of specific biological activity in therapeutic waters in Polish health resorts. Drobnik, M.; Latour, T.; Sziwa, D.; Journal of Elementology, 2011, 16, 4, pp 525-533, 21 ref.

[2] Fatal Pseudomonas aeruginosa pneumonia in a previously healthy woman was most likely associated with a contaminated hot tub. Huhulescu, S.; Simon, M.; Lubnow, M.; Kaase, M.; Wewalka, G.; Pietzka, A. T.; Stöger, A.; Ruppitsch, W.; Allerberger, F.; Infection, 2011, 39, 3, pp 265-269, 20 ref.

[3] Radioanalytical investigations of uranium concentrations in natural spring, mineral, spa and drinking waters in Hungary. Jobbágy, V.; Kávási, N.; Somlai, J.; Dombovári, P.; Richárd Kardos, K. T.; Journal of Radioanalytical and Nuclear Chemistry, 2010, 286, 2, pp 417-422, 25 ref.

[4] Colonization of a therapeutic spa with Legionella spp: a public health issue. Costa, J.; Costa, M. S. da; Veríssimo, A.; Research in Microbiology, 2010, 161, 1, pp 18-25, 37 ref.

Phosphorus – essential nutrient, pollutant and limited resource

The world's phosphorus (P) reserves are almost peaking! Yet excess P is polluting our water resources! What is going on with the phosphorus cycle and what can be done about it?