PracticalDermatology

2015 Nobel Prize in Physiology or Medicine: Ivermectin Discoverer Recognized

Diseases caused by parasites have plagued humankind for millennia and constitute a major global health problem. In particular, parasitic diseases affect the world’s poorest populations and represent a huge barrier to improving human health and wellbeing, says the Nobel Prize committee. This year’s Nobel Laureates have developed therapies that have revolutionized the treatment of parasitic diseases.

William C. Campbell and Satoshi ŌOmura discovered the drug, Avermectin, the derivatives of which have radically lowered the incidence of River Blindness and Lymphatic Filariasis, as well as showing efficacy against an expanding number of other parasitic diseases. Youyou Tu discovered Artemisinin, a drug that has significantly reduced the mortality rates for patients suffering from Malaria. These two discoveries have provided humankind with powerful new means to combat these debilitating diseases that affect hundreds of millions of people annually, the committee says.

The discoveries of Avermectin and Artemisinin have fundamentally changed the treatment of parasitic diseases. Today the Avermectin-derivative Ivermectin is used in all parts of the world that are plagued by parasitic diseases. Ivermectin is highly effective against a range of parasites, has limited side effects, and is freely available across the globe. The importance of Ivermectin for improving the health and wellbeing of millions of individuals with River Blindness and Lymphatic Filariasis, primarily in the poorest regions of the world, is immeasurable, a statement says. Treatment is so successful that these diseases are on the verge of eradication, which would be a major feat in the medical history of humankind.

AAP Updates Treatments for Head Lice

With the school year well underway and news about super lice spreading, it’s important to be aware of updated treatment recommendations. An updated clinical report by the American Academy of Pediatrics (AAP) in the May 2015 issue of Pediatrics provides information on safe and effective methods for treating head lice, including new products and medications.

Most cases of head lice are acquired outside of school. In the report, the AAP continues to recommend that a healthy child should not be restricted from attending school because of head lice or nits (eggs). Schools and communities should be educated that no-nit policies are unjust and should be abandoned. Children can finish the school day, be treated, and return to school. Unless resistance has been seen in the community, physicians and parents should consider using over-the-counter medications containing 1% permethrin or pyrethrins as a first choice of treatment for active lice infestations. The best way to interrupt a chronic lice problem is with regular checks by parents and early treatment with a safe, affordable, over-the-counter pediculicide. After applying the product according to the manufacturer’s instructions, parents should follow with nit removal and wet combing. The treatment should be reapplied at day 9, and if needed, at day 18. In areas with known resistance to an over-the-counter pediculicide, or when parents’ efforts on their own do not work, parents should involve their pediatrician for treatment with a prescription medication such as spinosad or topical ivermectin.

ANTIBIOTIC RESISTANCE CONSIDERATIONS

When considering treatment options for acne, should antibiotic resistance be a concern? Lawrence F. Eichenfield, MD, FAAD says, “Yes”—each patient treatment decision influences the individual and collective microbiome and microbial ecology.
“One of the questions that very commonly comes up in relation to treating patients with acne is ‘Do I need to worry about antibiotic and antibiotic resistance?...Yes, you should.”

To watch the full interview, visit dermtube.com.

Once a family member is identified with head lice, it should be recommended that all household members be checked. The AAP does not recommend excessive environmental cleaning, such as home pesticides. However, washing pillow cases and treating natural bristle hair care items that may have been in contact with the hair of anyone found to have head lice are reasonable measures.

While it is unlikely to prevent all cases of head lice, children should be taught not to share personal items such as combs, brushes, and hats. Regular observation by parents can also be an effective way to detect and quickly treat head lice infestations.

CDC Names Six New Medical Research Centers to Help Fight Infectious Disease

New funding from the Centers for Disease Control and Prevention (CDC) has more than doubled the number of CDC Prevention Epicenters. Six new American academic institutions joined the five existing Epicenters working to discover new ways to protect patients from dangerous germs. The CDC awarded a total of $11 million to the six academic institutions to identify possible new and improved ways to prevent the spread of infectious diseases like Ebola in health care facilities. The goal is to help doctors and nurses better protect the health and safety of their patients, and each other, from high-risk disease threats.

The additional institutions funded to identify infectious disease-related innovations from 2015 to 2018 are Emory University, The Johns Hopkins University, University of Illinois, Chicago, University of Iowa, University of Maryland, Baltimore, and University of Utah.

The new Prevention Epicenters will focus on projects that:

• Prevent the spread of infectious germs in health care facilities
• Evaluate best approaches to using personal protective equipment
• Study novel approaches to minimizing the role of the health care environment in germ transmission

CDC’s existing Prevention Epicenters are Cook County Health & Hospital System and Rush University Medical Center, Duke University, Harvard Pilgrim Health Care and University of California, Irvine, University of Pennsylvania, and Washington University.

Spread of infectious diseases in health care settings is a problem in the US, adding billions of dollars to health care costs. Infectious diseases like influenza, antibiotic-resistant bacteria, and C. difficile (C. diff) can spread when infection control measures are insufficient or if recommendations are not followed. 

“Through the Prevention Epicenters Program, academic leaders in health care epidemiology can work together and with CDC to innovate and stay ahead of the spread of germs,” said John A. Jernigan, MD, MS, director of the Office of Prevention Research and Evaluation within CDC’s Division of Healthcare Quality Promotion. “This program allows us to work closely with leading academic researchers to find out how to better reduce the risk of health care-associated infections and improve patient safety.” n