Pale Rider: The Spanish Flu of 1918 and How It Changed the World
by Laura Spinney
Describes the enormous-scale human disaster caused by the 1918 Spanish Flu and uses the latest findings in history, virology, epidemiology, psychology and economics to show how the pandemic permanently changed global politics, race relations, medicine, religion and the arts.
Pandemic 1918: Eyewitness Accounts from the Greatest Medical Holocaust in Modern History
By Catherine Arnold
Describes the outbreak of the Spanish Flu 100 years ago that killed more than 50 million people around the world, including 550,000 in the United States, right in the middle of World War I.
Immune: How Your Body Defends and Protects You
By Catherine Carver
Explains how the immune system works, likening it to a well-fortified castle, and notes how new drugs are being designed to harness its power to treat illness.
Children’s
Germs: Fact and Fiction, Friends and Foes
By Lisa Cline-Ransome
An introduction to the world of good and bad bacteria is told from the perspective of Sam the Salmonella and reveals fascinating facts about the role of germs in everyday life, how germs were discovered and the invention of important germ-fighting practices and medicines.
Fever Year: The Killer Flu of 1918: A Tragedy in Three Acts
By Don Brown
The award-winning creator of The Unwanted and Drowned City presents a graphic novel history of the devastating Spanish Influenza epidemic and its violent impact on World War I.
A lab analysis of plastic balls from play areas found bugs responsible for pink eye, urinary tract infections, bloodstream infections, heart inflammation and more. (Courtesy Spectrum Health Beat)
If the cacophony of children screaming and throwing tiny plastic balls everywhere hasn’t prompted you to forgo ball pits, a new study may just send you scurrying for the door.
The research found that ball pits were awash in microbes, some potentially quite dangerous.
The study team found 31 bacterial species and one species of yeast. Some of those bugs are responsible for pink eye, urinary tract infections, bloodstream infections, heart inflammation and more.
“Be aware of this if you take your child to a physical therapy clinic, especially if the child has a compromised immune system,” said senior study author Dobrusia Bialonska, assistant professor of environmental microbiology at the University of North Georgia.
“You might consider asking for no treatment in the ball pit. We definitely showed that there are things on the balls that can potentially hurt a child who is immune-compromised,” she said.
Does that mean all kids need to steer clear of ball pits in fast food restaurants or other play spaces?
No, Bialonska said.
“We’re talking about pediatric physical therapy patients that may have some immune problems and may be more fragile. If kids are healthy, let them go and play. It may help build their immune system,” she said.
But kids should wash their hands when they jump out of the pit, especially if they’re going to eat after playing, Bialonska quickly added.
Ball pits became popular in the 1980s when they began popping up in commercial restaurant chains across the United States. But these play areas are often contaminated with visible dirt, vomit, urine and feces, researchers said. Numerous bacteria had already been identified in ball pits, but researchers wanted to learn how those used for physical therapy for children might compare.
The study team collected samples from six ball pits in Georgia physical therapy clinics. They randomly selected nine to 15 balls from each location, then swabbed the whole surface of each ball to find any microbes.
There were microorganisms on all of the balls, though some had very few. The researchers said it’s not unusual or concerning to see microbes anywhere humans are present. There should be concern when there are a lot of microbes, however.
Researchers noted a significant variation in the extent of microbial contamination from clinic to clinic. That suggests a need to develop guidelines for cleaning the balls and the pit area when they are used for physical therapy in potentially vulnerable kids, researchers said.
Bialonska said there are no standards or directions for cleaning these areas. She said someone had used a commercial washing machine to clean the balls. Others have tried using ultraviolet light to disinfect the balls.
Dr. Maryann Buetti-Sgouros, chair of pediatrics at Northern Westchester Hospital in Mount Kisco, N.Y., was not involved with the research, but reviewed the study.
“Common sense has to dictate how you address risks as a parent,” she said. “If there’s somewhere germy, what will you do to decrease the risk? A little bit of germs isn’t awful. Carry antibiotic wipes.”
Another expert agreed.
“Many of the microbes isolated are part of our normal flora,” said Dr. Salman Khan, an infectious disease physician at Lenox Hill Hospital in New York City. “However, some of these have the potential to cause disease in patients with immunocompromising conditions and open wounds.”
Buetti-Sgouros said she doesn’t think ball pits are inherently worse than other places where kids play, but the balls cannot be sterilized between uses and are going to get covered in bacteria.
If you’re taking a child for physical therapy where there is a ball pit, she suggested asking how the balls are sterilized. “In this study, one of the clinics didn’t have as much bacteria. What were they doing differently?” she said.
Buetti-Sgouros also pointed out that injuries are a concern at ball pits and other kid play areas, such as those with multiple indoor trampolines.
“Again, let common sense dictate. But, I’d rather see kids outside where there’s ventilation and air,” she said.
The study was recently published in the American Journal of Infection Control.
Electronic cigarette products play host to bacterial toxins and fungi that have unknown effects on the growing number of people who use these items. (Courtesy Spectrum Health Beat)
You might need to worry about inhaling more than just nicotine when you vape: New research warns that many electronic cigarettes appear to be contaminated with fungi and bacteria.
The finding stems from a close look at the contents of 75 popular vaping products.
About half of the e-cigarettes examined were of the single-use cartridge variety, while the other half were refillable products. Both contained liquid laced with nicotine, along with other chemicals. Once a user takes a puff, a battery-powered heating device vaporizes the liquid, turning it into inhalable vapor.
But nicotine was not all that was found in the vapor of many products.
Study author Dr. David Christiani said 23% of the electronic cigarette products they examined contained bacterial toxins, while 81% tested positive for a substance called glucan, which is found on the cellular structures of most fungi.
“The contamination took place in electronic cigarette liquid and in the cartridges,” Christiani said, although the cartridge e-cigarettes contained more than three times more glucan than the refillable liquid e-cigarettes.
Christiani, director of the environmental and occupational medicine and epidemiology program at Harvard’s T.H. Chan School of Public Health, characterized the findings as “surprising.” But when asked if the identified contaminants actually pose a danger to vapors, he suggested the jury is still out on that question.
Potentially, “they are toxic,” Christiani said.
That means that, over time, exposure to high amounts of such contaminants can prompt the onset of progressive lung illnesses such as emphysema, chronic bronchitis and asthma.
But as a practical matter, Christiani noted that the contaminant levels his team found in e-cigarettes was actually “considerably lower” than levels “that have been shown to cause lung disease” in workplace environments where manufacturing chemicals abound.
What’s more, such contaminants are also found in standard cigarettes, where levels “are (also) generally higher than what we measured here,” he added.
The bottom line: “At this time, we do not have scientific evidence that the levels we see in these electronic cigarette products raise health concerns,” Christiani concluded.
Still, he cautioned that “we do not know what the risk is with long-term usage, with increasing cumulative dose and with the interaction between these contaminants and other potentially toxic agents we and others have found in electronic cigarette products, such as flavorants or industrial solvents.”
Christiani’s team noted that the popularity of e-cigarettes has exploded in just a few years, particularly among young users. For example, the authors pointed out that while just 220,000 high school students vaped in 2011, last year that figure hit more than 3 million.
And though many experts take the position that vaping is probably a safer option than smoking standard cigarettes, as its use has grown, so has public health scrutiny.
As to what might cause contamination, the study team said it could happen at any point during the production process. But they also pointed a finger at the cotton fiber wicks found in e-cigarette cartridges, given that such fibers are known to host both bacteria and fungi.
Regardless of whether such contaminants ultimately pose a significant risk, “vaping is potentially harmful to your health, and (it’s best) not to do it,” Christiani said. “More study is needed to determine whether vaping can be made safer by removal of all contaminants and adulterants.”
The study was published online recently in the journal Environmental Health Perspectives.
Victoria Stevens is scientific director of epidemiology research with the American Cancer Society. She agreed that “a more complete understanding of what’s in e-cig products and what their users are exposed to would help define some of the potential risk of vaping.”
Stevens pointed out, for example, that the bacterial and fungal property that the study team found in e-cigarettes “are common contaminants and are found in things like household dust.”
So she suggested that until more research clarifies exactly how much exposure vapers face—in terms of both what is found in vaping devices and what users actually inhale—”it is unclear whether this contamination is a cause for concern.”
