Rabies Hero, Dr. George Baer

There are some people who accomplish so much in life, they shine like beacons for the rest of us. Dr. George Baer is one such figure who contributed so much.

Although he passed from this life on June 2nd, he is immortalized as a ‘Rabies Hero’ – a pioneer in the field.

I first ‘discovered’ who he was after picking up a copy of his book ‘The Natural History of Rabies‘. That book was part of my introduction to rabies, after having learned firsthand about that horrible disease on a clinical rotation in the Philippines – see my blog “My first patient with rabies“. I read everything I could find about rabies and I learned what an important figure he was.

Dr. Baer had a long and productive scientific career. He worked for the public good out of a genuine compassion and concern for humanity. He served as head of the CDC rabies laboratory for a number of years. He went on to work in Mexico, where his efforts led to dramatic improvements in reducing rabies transmission.

Among his great contributions was the development of an oral rabies vaccine. That led to eradication of wildlife rabies in most of Europe. Even up-to the time of his passing, he was busy working on an improved vaccine for influenza.

Dr. Baer influenced so many people around the world. He is an inspiration we will never forget.

RW

Miracles Needed! White Nose Syndrome hurting bats in the U.S.

In the past few years, a strange disease has been devastating bats across the Northeastern United States. Dubbed ‘White Nose Syndrome’ for the characteristic finding of a thin white fungus growing on the faces and wing membranes of the bats, this illness causes a high mortality.

Experts are worried, since the disease seems to be spreading and the death rates are so high. In some areas, more than 95% of bats have died. Some endangered bat species, such as the Indiana bat, could get pushed close to extinction if the disease cannot be stopped. No one knows for sure what is causing the disease – if it’s the white fungus or some other germ weakening the bats and allowing the fungus to grow.

Bats are important in the environment. Many bat species eat insects– such as moths and beetles which can damage crops. If large proportions of bats die off, there could be a greater reliance on harmful chemicals and pesticides to protect those crops.

Bats live in a different ‘world’ which might seem strange and frightening to some. Most bat species however are highly social – living in colonies for years. One bat researcher told me some bats can live up to 25 years! Bats make up 20% of all known mammal species, so there’s more of them than you might think. Mother bats usually just have one baby a year, and feed them milk to drink.

Bats don’t attack people or get tangled in someone’s hair. A healthy bat will try to avoid contact with humans if at all possible. A sick bat may have trouble flying and could be found on the ground. Like all wildlife, a bat should be respected and never handled without the proper equipment including durable gloves. A very small percentage of bats (usually 1% or less) might carry rabies. A scratch or a bite from a bat is a reason to see a doctor who would know about bat diseases – such as an Infectious Diseases specialist. The CDC rabies website gives some general advice on ‘What to do’ if a bat is found in your home.

So far experts don’t know exactly what is causing WNS or how to stop it. We’re hoping for some miracles soon to help these small but wonderful creatures.

Released to the Angels of Hospice Care

I cannot sleep. My mind reverberates with the discussions I had today with the family of the Child. It was my job to reveal the truth, the awful truth of what was to come, there would be no miracles here. None, at least, that they were expecting.

The sister became lightheaded and pale. She had to sit down hurriedly. Wild were her eyes, searching. Tears flooded down, she was overcome.

The Child resided inside the twisted form. Crippled since birth with spina bifida, her existence altered, unknown to many. No childhood games. No running in the playground. Life in a wheelchair.

She would not be getting better. She had fought bravely for months, but now she was giving up. The exhaustion, the tiredness was there. How could one fight for so long? Now, her condition degraded. Osteomyelitis, a destructive disease of the pelvic and hip bones, savaged onwards, sapping the life from her. The Child’s eyes showed the fatigue.

‘Why’? ‘What should we do’? ‘What is right‘?

I spent time with them. I explained the pathology, the disease, the nature of the germs responsible. I told them the truth.

Then, a faint light off in the distance. Hospice. Hospice care. With darkness all around, moving closer was the right thing to do. An angel would carry her.

My dad passed on with hospice. It was the best thing that could have happened. Faced with a terminal cancer, he wanted to die peacefully at home. No halogen lights glaring, no surgical masked figures probing, no ribs cracking. No anxiety, no pain, no suffering. Just sleep in the hand of God.

Now, her angel was here. “Tonight, I am here beside you. You might not see me, but if you listen you will know. It is going to be okay.”

Farewell Child. We will see you again.

RW

A medical marvel – the influenza vaccine

I like to think there are many small miracles going on right now, as the influenza virus tries to invade North America. I imagine families and friends together, keeping warm from the cold. The flu virus hovers outside, looking in through frosted windows, hoping for a victim to enslave with its sinister viral machinery. Every year, the virus plots and schemes for a way to slip past our defenses and cause disease. Although it seems just a simple virus, it has an evil intelligence behind it.

Flu has ravaged human populations before. In 1918 for example, the Spanish flu was responsible for killing over 50 million people! Many of the victims were young and otherwise healthy. In 2009, we are much more interconnected, creating new opportunities for the virus.

Luckily we have tools to fight it- primarily the influenza vaccine. A flu shot could save your life and protect your family. Anyone who doesn’t get the flu shot should at least know the facts. Unfortunately some fear the vaccine and as a result, miss out on protective immunization.

The flu shot cannot ‘make’ you sick with influenza. There is nothing ‘alive’ in this vaccine – just inactivated proteins. Sometimes we don’t feel 100% after the shot because the immune system is activated. It’s supposed to be like that – so that when the ‘real’ flu comes along, sickness is prevented. It’s like going to the gym: after a work out, your muscles are sore the next day. If you give the immune system a ‘work out’, you might feel lousey for a day or two. These symptoms shouldn’t be that terrible — think of what the ‘real’ flu would do!

The other scenario is when a different virus comes along at about the same time as when the shot was administered. It might appear as if the flu shot caused an infection, but technically it is impossible. An egg allergy or a history of Guillan-Barre syndrome (a very rare neurological disorder) would be the only valid reasons for declining the flu shot.

There are a few other things to know about the flu shot. It is a purified collection of proteins that are the three ‘best guesses’ for which strain of flu will attack this year. Because it takes about 6 months to make a vaccine, flu experts have to pick the most likely candidates in advance of the flu season. Sometimes they are wrong, but each year we get immunized, we add to our immune system’s library of information to keep us healthy. A flu shot actually lasts for several years, but because the flu comes out as a different strain each year, it is best to get a new shot each season.

According to the CDC, about 10% of us this year will catch the flu, whether it’s recognized or not. How much suffering or missed days from work could this mean? What about those deaths that could have been prevented? We can shield our families and friends by getting immunized. February is actually the peak month of flu activity in North America, so it isn’t too late.

For those who are afraid of needles, there is a ‘Flumist’ which can be given up the nose as a spray. This is especially nice for children – since there is less anxiety than with an injection. This vaccine is a ‘live’ vaccine so caution is recommended as with other live vaccines. Your doctor will help decide which vaccine is best for you.

Learn more about influenza from the CDC website.

Be smart, get vaccinated, and save a life!

RW