COMEBACK DISEASES

Infectious diseases such as cholera, rheumatic fever and
plague–though quite rare–are still threats to
be reckoned with. For example, cholera, Vibrio
comma , is turning up in the shellfish population,
mainly on the U.S. Gulf Coast. It’s usually transmitted to
humans when they eat shellfish that have been undercooked
or improperly stored. Likewise, outbreaks of such maladies
of yesteryear as measles, mumps, diphtheria, tuberculosis
and syphilis are on the rise. That’s partly because
parents, doctors and public health authorities have failed
to mount the effort needed to make sure everyone
susceptible to preventable diseases, regardless of economic
status, is vaccinated. In fact, immunization levels for
preschoolers actually worsened or showed no improvement
between 1980 and 1985 (the latest years for which data are
available).

Even people who have been properly immunized are being
stricken. In the majority of recent cases of measles, the
administered vaccine apparently never took hold. However, a
rise in cases of whooping cough may not be the result of a
failure of a vaccine but, perhaps, failure of the immunity
to last as people grow older. This might not matter as much
if more infants were immunized and there wasn’t so much
whooping cough around to pose a risk. Diphtheria, too, is
striking people who’ve been immunized but whose immunity
levels have fallen. Indeed, tomorrow’s adults may find
themselves as vulnerable as yesterday’s children to this
illness.

Sometimes a bygone infectious disease strikes again because
it suddenly becomes more virulent, as is probably the case
with the Group A streptococcus strains that can lead to
rheumatic fever. What’s more, organisms that “learn”
certain adaptations (such as the ability to adhere more
tightly to a human cell or to resist an antibiotic) can
sometimes pass the traits to cousins through mobile pieces
of DNA, called transposons. For example, Staphylococcus
aureus , which causes toxic shock syndrome, appears to
have passed on its toxin-producing know-how to
streptococci. The result: “toxic strep syndrome.”

Scientists are also speculating that the global warming
trend (a 50-year forecast predicts that temperatures may
rise by up to 9°F) may encourage a dramatic increase in
mosquito breeding, with far-ranging infectious
consequences, such as hemorrhagic dengue fever, which
strikes children. Symptoms usually range from fever and
headache to shock, prostration and internal bleeding.
Already, Aedes albopictus , the mosquito that
carries the dengue virus, has spread to many regions of the
U.S., including cities in Texas, Florida, Louisiana,
Missouri, Indiana and Tennessee.

Many other exotic infections–leprosy (caused by a
relative of the tuberculosis organism), glanders (caused by
a bacterium Pseudomonas mallei ) and
schistosomiasis (a parasitic illness)–have been
imported (and sometimes spread) by travelers and refugees.
There also has been a steady resurgence of bubonic plague
in the U.S., which has been linked to the increasing
numbers of people pursuing recreational activities in the
Southwest, where plague-carrying fleas infest rock
squirrels, other rodents and even cats and dogs.

But we are not helpless against comeback diseases. Here are
eight things you can do to combat them:

1. Ask your doctor whether your immunizations are
up-to-date. Check especially for measles, mumps, tetanus,
diphtheria, rubella, polio and hepatitis B. (If you’re
exposed to a person with such an infection and don’t know
whether you’re adequately immunized, consult a physician.)

2. Make sure your children are immunized on schedule,
especially before they’re placed in a day-care center or
reach school age. (If your child isn’t fully immunized and
contacts someone with measles, whooping cough or chicken
pox, consult your pediatrician immediately.)

3. Before you travel abroad, discuss your itinerary with
your physician, and make sure you receive the proper
immunizations,
immune globulin and preventive medications as indicated.
(When traveling to tick-infested areas, protect yourself
and your pets by using tick repellents and by making
frequent inspections.)

4. Never handle an animal not well known to you. Always
seek medical attention if bitten.

5. Always take a child’s sore throat seriously; consult
your doctor about the possibility of strep.

6. Cook shellfish thoroughly. Before eating raw clams and
oysters, especially in the Gulf Coast region, inquire about
recent cases of cholera.

7. Care conscientiously for hot tubs, humidifiers, contact
lenses and all those other wonderful technological
conveniences. When not kept clean, they’re boons to
microorganisms, too.

8. Keep abreast of community health issues. Tell your
elected representatives if you feel there are inadequate
public health services in your area.

The Laughter Defense

When laughter bursts forth, your metabolism picks up,
muscles are massaged, and neurochemicals stream into the
blood. You feel relaxed–and you raise your guard
against depression, heart disease and pain.

Now researchers think laughter may empower the immune
system as well. New studies indicated that laughter can
increase concentrations of salivary immunoglobulin A
(IgA)–an antibody linked to lower rates of upper
respiratory illnesses. In fact, it’s been found that IgA
levels are naturally high in people who regularly battle
adversity with humor. In addition, laughter decreases
cortisol, an immune suppressor, which has a tremendous
influence on the immune system. This decrease allows
interleukin-2 and other immune boosters to express
themselves.

Overseas Mail-Order Drugs

In a surprise move that has prompted both cheers and jeers,
the Food and Drug Administration has decided that Americans
may now mail-order foreign pharmaceuticals for personal use
even though the drugs are not approved in the U.S. This
means that AIDS patients can now get promising AIDS drugs,
such as Japan’s dextran sulfate, from overseas, and that
mail-ordering of drugs for nearly everything from cancer to
arthritis is permitted. The only banned drugs are some 40
already proscribed by the FDA as fraudulent or dangerous.
Otherwise, almost anything goes–as long as drug
shipments are for personal use and are limited to a
three-month supply or less. In addition (the real trick),
you must specify that a licensed U.S. doctor will oversee
treatment. However, these new guidelines are “on a pilot
basis subject to change or cancellation.”

Right now, the FDA is downplaying the news for anyone other
than AIDS patients and the desperately ill. The truth is
that all Americans now have a world of pharmaceuticals from
which to choose, albeit at their own risk. People with
intractable illnesses might consult Orphan Drugs
(The Body Press, $ 14.9 5) by Kenneth and Lois Ander-son, a
book that describes 192 generic and 1,545 brand-name drugs
available in other countries, gives the foreign trademarks
and addresses of distributors, and tells how to find a
doctor overseas if a prescription is needed.

It should be kept in mind, however, that even when the FDA
does approve a drug in the U.S., it may not be as safe as
you think. In 1986 (the latest year for which data are
available) there were more than 10,500 reports of new drugs
having unexpected side effects, ranging from untoward drug
interactions and nervous system or digestive problems to
fatal reactions. A whopping 24% of reports on new and
established drugs indicated a patient had died or was
hospitalized as a result of the drug.

Too Good for Your Own Good

Those spiffy ultrasonic humidifiers are too good at what
they do. According to the EPA, if you fill one up with tap
water, the ultra-fine mist may contain hazardous levels of
lead, aluminum, asbestos and dissolved organic gases. Even
some “deionized” water actually contains enough impurities
to cause air-quality problems. (Check nearby surfaces for a
fine white powder–evidence your humidifier is
emitting problem particles.)

The solution? Get out the old steam vaporizer. Even used
with tap water, it leaves minerals behind and–unlike
impeller-type (cool-mist) humidifiers–its heat kills
mold or bacteria in the tank.

The Smoking Gum

Nicotine–in cigarettes and smokeless
tobacco–actually alters the gum cells. In lab
studies, researchers found that nicotine prompts gum cells
to grow abnormally, thus encouraging gum disease.
Nicotine-exposed cells also fail to attach firmly to tooth
roots buried under the gum. That’s especially bad news for
smokers going through periodontal surgery. If gum tissue is
slow to attach to the tooth after surgery ,therapy could
fail.

Coming Up Short

It’s no secret that severe malnutrition stunts growth, but
recent evidence suggests that even marginal deficiencies
may also keep some children from reaching optimal heights.

In Ontario, when University of Guelph researcher Rosalind
Gibson gave 10 mg of extra zinc daily for a year to eight
boys marginally deficient in zinc, they grew faster than
eight similarly zinc-deficient boys who did not receive the
supplements.

Since zinc is essential for cell and bone growth, children
and teens–especially boys–need more during
growth spurts. If they don’t get enough, the deficiency can
create a vicious cycle.”

“One of the first symptoms is impaired appetite,” says
Gibson. “So if a child is even moderately deficient in
zinc, his food intake decreases, and he becomes even more
deficient.”
In an unrelated study, Cornell researchers have shown that
iron supplementation significantly improves growth in
mildly anemic children.

Certainly not all short children are deficient in zinc or
iron, but it’s something to be aware of. Fortunately, both
zinc and iron are found in red meat and poultry. Whole
grains, nuts and legumes are also good sources, though zinc
from vegetables is less readily absorbed than that from
animal sources. Iron supplements, on the other hand, can
inhibit the absorption of zinc, so make sure any zinc and
iron supplements are taken in roughly equal amounts.

Cholesterol-Proofing Food

Our nation’s consciousness of the connection between low
cholesterol and a healthy heart has definitely been raised.
Now there may be a natural food additive that would make
cholesterol indigestible. Instead of being absorbed, the
fatty substance would pass right through the body.

According to Iowa State nutrition researcher Donald Beitz,
the magic ingredient is cholesterol reductase, an enzyme
that turns cholesterol into coprostanol, an indigestible
fat. However, it’s not yet known if the coprostanol would
be completely excreted or if it can, indeed, pass
safely through your system. And, even if it does
work well, the anticholesterol additive would not be a
cure-all.

“Saturated fats are four times more likely to raise blood
cholesterol levels than dietary cholesterol itself,”
explains cardiologist John LaRosa of George Washington
University and chairman of the American Heart Association’s
nutrition committee.

Translation: Watch out for saturated fat from the butter in
the pan–not just the cholesterol in the eggs. The
enzyme won’t tame the butter. It’s better to eat a
different breakfast altogether. Oatmeal with skim milk and
fresh fruit, for example, eschews fat, and the oatmeal
itself helps lower cholesterol.