The Real Charlie

Strep and Mexican Cheese

Last Friday I started to feel really run down at work. I thought that I was having a Lyme disease relapse - I get this from time to time - but I powered on through the day and got home. We celebrated Stella's birthday (yay two years!) and after that I collapsed. I didn't even eat dinner. I woke up on Saturday with a 102 temperature and a sore throat. My sister spent most of her childhood with strep or recovering from it (and eventually got her tonsils out, which ended the problem forever), so I knew the signs. I went to urgent care (my doctor doesn't swab on Shabbos), got the throat culture and the penicillin, and went home. I am 80% better today, but bizarrely, my culture came back negative! The doctor said to keep taking the penicillin, the test was probably incorrect. Maybe I have stealth strep? As usual, I blame my two little petri dishes for bringing me this little gift from one of their play dates.

In other news, MMWR warns us, again, of the dangers of unpasteurized cheese. This time, drug-resistant salmonella from Mexican-style cheese. Not cheddar. But eating cheese from your local corner market is still safer than eating a dead beached whale. In the same issue: fishing fatalities. To the fisherman, not the fish. That wouldn't be news.

Guinea Worm, Bad Tuna and Abby

A good MMWR this week. The lead story talks about the effort to eradicate the truly disgusting disease of dracunculiasis, or Guinea Worm Disease. It is disgusting (think meter long worms in the skin) and totally preventable. It still exists because it is a difficult to treat disease of poor African people. If people in Brookline caught it it'd have been cured 100 years ago. We seem to be slowly getting rid of it, and not a moment too soon. Another piece talks about scombroid, a kind of food poisoning that one gets from tuna or mackerel that has gotten too warm. Also gross, and easily preventable by keeping fish cold after it is caught. My years working at Harvard School of Public Health taught me that prevention is the key to good health so often as in these cases. Or as my old t-shirt from HSPH says, what didn't you die from today?

And on a happier, less wormy note, congratulations to my darling Abby, whose work in a group exhibit at the Three Graces Gallery in Portsmouth, New Hampshire (Live Free Or Die!) is featured in the local paper this week. Check it out here, and check out the show if you have a chance. And buy, please, so I can be supported by my wife's art in an opulent lifestyle to which I will rapidly become accustomed. It's that or Stella becomes a starting pitcher, or Roxanne starts a successful hedge fund. Um, scratch that last idea. I better keep my day job.

Save me from the wee turtles!

Classic MMWR article this week. It combines a dangerous disease, an unusual vector, illegality and good old fashioned hectoring. The disease? Salmonellosis. The vector? Small pet turtles. Illegality? You're not supposed to sell small turtles as pets, but they are easily purchased at flea markets, etc. Hectoring? Dig in.

The best part about the article is that I get to quote Groundskeeper Willie.

Antibiotics

Three recent readings/events have me thinking about antibiotics:

1) This article on WBUR (via Universal Hub) about the easy and illegal access to antibiotics over the counter in grocery stores in many immigrant communities.

2) This week's MMWR article on gonorrhea, which has grown so resistant to antibiotics that only one widely available drug is effective against it in the United States.

3) My recent visit to the pediatrician with Roxanne for her third (!) ear infection of the winter. She is sort of allergic to one antibiotic, another we just used and may or may not have worked, and there is only one other that they can use anymore due to resistance.

Very scary. Anytime my categories are MMWR and Real Real Daddy it is not a good scene.

Springtime, Drivetime, Salmonella Time

Spring is coming. It is definitely not here. In New England, there is a long period that is not really spring, but not winter anymore either. We are in it right now. So today was fairly warm, but tonight is quite chilly, for example. I track it with birds, too, and it was nicely illustrated on my drive into the office this morning.

Winter: I saw Juncos in my yard this morning. Classic winter bird. Once they're gone, it is spring.
Spring: The song sparrows are singing up a storm behind my office.

Winter: There is nothing to eat in the woods, so the wild turkeys in Chestnut Hill were marching along on the newly capped ash dump off Hammond Pond Parkway today, eating something in the grass.
Spring: There are robins everywhere, pulling worms out of the damp, thawing lawns.

You get the picture.

In other avian news, MMWR has a nice report this week on salmonella outbreaks caused by handling baby chicks. This is not a new problem, it is a well known problem, yet it seems to persist. The article describes three outbreaks. In one, the reason why people bought the chicks is not described. In another, most of the people bought the chicks as a source of food or eggs (a reasonable enough reason to buy chickens, I reckon). In the third case, some person brought baby chicks to a daycare for the children to play with and nine kids got sick. My daughter would love to play with baby chicks, and she'd have a blast, and it would be adorable, but I'd love to fly an F-22, break the sound barrier and fire off a few missiles, and that isn't happening either, for the same reason: the Man won't let me. Wait, that has nothing to do with baby chicks. What was I talking about again? Oh, baby chicks. Don't touch 'em.

Dirty Milk and Dirty Work

Last week's MMWR (I promised a weekend update, I know, but Roxanne was all out of sorts over Purim and her upcoming birthday and just sort of suck the wind out of my sails) had a good piece on people getting e. coli infections from milk. The milk in question is unpasteurized milk bought from a "cow share" program on an unlicensed and uninspected farm. There are like five kinds of wrong going on here. While I am not so foolish as to assume that all of my industrial food is pure and clean, I do like knowing that some of the basics of modern animal husbandry and food chain management, like pasteurization, are going on, especially in the milk that I feed to my children. Why take the chance, especially with milk, which is basically just cow juice anyway?

In related news, my workplace is experiencing an outbreak of a gastrointestinal illness among our patients and clinical staff. I'll be vague about the details due to Ground Rule #2 and the delicate stomachs of you, the reading public. Suffice to say: not a good scene. It is oddly quiet on the halls, with most people confined to their rooms or floors, few visitors and most events canceled. And I. like most of my colleagues, have become an obsessive hand washer. I don't even touch the elevator buttons with my hands - perversely, I use a spare black yarmulke that I keep in my briefcase in the not rare event that I need to attend a funeral on short notice as a prophylactic -  and I have a big canister of Clorox wipes on my desk, leftovers from Roxanne's days on the little potty. Just charming. 

Lions Rampant

One nice things about having a very bright, very inquisitive young child is that her interests make me do things and see things that I would not ordinarily do or so. Two examples this weekend: on Saturday morning Roxanne and I visited the library in search of books on Hopi Katsinas. I have several in my house and she is just obsessed with them: she knows their names in Hopi and English, makes up stories about them and loves to look at pictures of other Katsinas as well. Feeling like it was all a bit decontextualized and vaguely culturally imperialistic (see that Amherst education at work?) I wanted her to learn about the people who made the Katsinas and their way of life. The nice children's librarian helped us find some great books, a little above her level but  appropriate and interesting.

Later, we went to temple for an end of Shabbat Havdalah service and at one point Roxanne pointed up and squealed "Look, daddy, dere day are! Lions rampant!" Sure enough, a silver menorah displayed in a case by the coat room was graced with a pair of lions rampant. Roxanne knows that lions rampant "stand up and say roar" while lions passant "just walk by." Maybe this is all about what I've chosen to teach my child, actually.

In other news, a friend of The Real Charlie has suggested (in so many words) that on weak MMWR weeks (such as this one) I run "clips shows" of classics from the past - people getting staph from weights at the gym, trichnosis from eating raw bear liver, anything about getting sick from eating whales or fermented seal flipper, etc. I am undecided. Meanwhile, let me note that norovirus (aka "winter vomiting") is rampant ("roar!") in Boston these days, so hit the Purell, folks.

Goodbye, Rubella

A very interesting MMWR this week. A scary piece about little babies accidentally poisoned to death by parents giving them too much cold medicine sent me running to check my medicine cabinet and to give my sniffly little girls some kisses. But more interesting is the announcement that the main chart in the weekly disease tables will no longer show the variances in reports of rubella. There is now too little rubella in the U.S. to make the charts meaningful. It is being replaced by the more common and very nasty (as I learned in 1988 after brushing my teeth in Leningrad) parasitic disease giardiasis. I mentioned this to Abby and she pointed out that careful surveillance for Rubella clearly played a role as she was tested for Rubella immunity no less than four times from 2002-2005 (prior to marriage, at her first ob visit during her pregnancy with Roxanne and upon admission to the hospital for both deliveries) despite having documented immunization from her childhood. So score one for vaccination.

I am trying very hard to focus on one topic per post these days, so stay tuned for news on the securities that I sold and bought last week sometime in the next few days.

Slander, De Koninck and the Moose

I am the subject of slander over at White She Naps, where the implications is made that while Abby draws Roxanne's attention with her beautiful crafts, I am known to my daughter primarily as a drinker of beer. It is true that Roxanne asks me, often at breakfast, if I am going to have a beer that night. But this is because she likes to collect the bottle caps (inspired by a Laurie Berkner song), not because she is my little enabler. Hmmph.

On the subject of beer, my beloved Publick House in Brookline is preparing to expand, adding another bar and forty seats next door to its current locations (replacing its previous neighbor, a "health clinic" that promoted colonics with a creepy display of a person buried in sugar packets). I visited for lunch yesterday and was delighted to find one of my all time favorite beers, De Koninck, in stock. This is the beer of Antwerp, milder (in alcohol) than most Belgian beers, with a sweet and malty flavor. A good beer to enjoy one or two of with lunch, a business-like beer. It is hard to find in these parts (and I have never seen it in the bottle), so I was glad to enjoy it yesterday, and to see a place that I like doing well.

MMWR this week has an interesting piece on moose vs. human auto accidents in Maine. One way of spotting a Maine driver in these parts (other than Maine tags) is the "Slow Down For Moose: It May Save Your Life" bumper sticker. Turns out that's good advice. So in this festive season, go easy on the beer and watch out for Bullwinkle.

Shots in the Dark

Regular readers know that I am very much a fan of vaccines. My daughters are fully vaccinated against whatever the pediatrician thinks they should be vaccinated against. This week's MMWR is all about vaccines, including the "controversial" HPV vaccine. Controversial because the vaccine protects against a sexually transmitted disease, and we like to pretend that young people don't have sex. But if they are, shouldn't they be protected against one aspect of risk in a way that is very passive, doesn't require sneaking into CVS and buying condoms praying that you don't run into your mother's friends (or, in my case, my freshman Russian professor) and seems effective? I say yes, but then again ask me when Roxanne is sixteen. Remember the old cliche of the dad sitting on the porch with a shotgun? I have daughters and a porch. All I need is the gun.

Ironically, my workplace tested me for various immunities and claims that I lack sufficient immunity to mumps, rubella and varicella (chicken pox). I just got my varicella shots a few years ago, so that's bull, but I guess Dr. Stein (of blessed memory) was doling out some weak serum back in the 70s. I got re-vaccinated for measles right before college so that's why I was okay there, but I guess I need some boosters. I am in the process of changing doctors, so it will have to wait. In the meantime, the employer reserves the right to suspend me with pay if there is an outbreak of mumps or rubella in the building. Sob.