Man"s best friend, bacteria"s worst enemy: dog sniffs out superbug in Canada hospital

Hospital ID badge dangling from his neck, Angus considered the empty bed in front of him. After a few strong sniffs, he moved on.

Nearing the next bed, his floppy ears perked up before he stopped dead in his tracks, tapping his paw and eyeing his handler expectantly.

The two-year-old English springer spaniel is believed to be the only canine hospital employee in the world trained to sniff out the notorious superbug Clostridium difficile, or C difficile.

The seeds of Angus’ unlikely career were planted three years ago, after Teresa Zurberg, a Vancouver resident, suffered a C difficile infection. Her bout with the bacteria – which attacks people whose immune systems have been weakened by antibiotics – left her in the hospital for five days and she lost 20 pounds.

“It was awful. I almost died,” Zurberg said.

Her husband, Markus, a nurse who works in patient safety and quality care, stumbled across an article on a beagle in the Netherlands who had been specially trained to check patients for C difficile.

Could Zurberg – a canine handler who trains bomb- and drug-detecting dogs – do the same thing in Vancouver? he wondered. “I told him, ‘If it’s got a smell, I can teach a dog to find it,’” Zurberg said. Their new beagle pup might be perfect for the job, she suggested.

The pair approached Vancouver Coastal Health, the health authority that oversees the city’s general hospital – and were surprised by the enthusiastic reaction they received. “I was expecting them to laugh at us but they were like: ‘Hey, that’s really cool.’”

Once Angus detects the bacteria, the area is cleaned with a robot that uses ultraviolet light to disinfect 99.9% of the C difficile spores. Photograph: Vancouver Coastal Health

Working with the health authority, Zurberg and Angus became part of a one-of-a-kind pilot program. The hope, said Nancy Desrosiers of Vancouver Coastal Health, was to find an innovative approach to address what has become a global concern.

“It really is one of those vicious cycles,” she said, pointing to a steadily rising number of infections that result in longer hospital stays and increase the likelihood of further infections. “In Canada, 64% of all of our C difficile cases are hospital-acquired.”

Unlike the patient-sniffing beagle in the Netherlands – who is now retired – Angus, it was decided, would focus exclusively on searching for C difficile in the hospital environment.

Hospitals normally use ultraviolet light to find the bacteria, but Angus can move much more quickly and efficiently through rooms. Once he detects the bacteria, the area is cleaned with a robot that uses ultraviolet light to disinfect 99.9% of the C difficile spores.

The decision to have him work on environments rather than patients minimised the chances of Angus triggering patients who may have allergies or sensitivities to dogs.

With the dog’s role in the hospital now clearly laid out, Zurberg began training Angus, mimicking the techniques used to train dogs to detect bombs or drugs.

“All of the detection work for the dogs, it’s just a game. To them, it’s just a way to get what they really want, which is their toy or their food, depending on what they’re rewarded with.”

As she taught him to associate the scent with a food reward, researchers from the hospital kept her stocked with a steady supply of the scent of C difficile – isolated from the bug – on cotton swabs.

Angus, the C difficile-sniffing dog. Photograph: Vancouver Coastal Health

The training took about 10 months. After passing a series of detection tests in a local nursing college with mock patient wards, Angus was brought into the hospital this summer.

Easily excitable when he’s not focused on work, Angus is accompanied by Zurberg at all times during the four days a week he spends at the hospital.

“It’s a very multi-ethnic health authority and I have to be really conscious of who’s around me and what issues they may have with dogs,” she said. “That’s part of the reason we chose a floppy-eared dog as opposed to a pointy-eared dog, because he’s not so intimidating-looking.”

Like any other member of the hospital staff, Angus faces a slight risk that he could be infected by C difficile. “He’s young and he’s not autoimmune compromised, so his risks are extremely low,” Zurberg said. His health is carefully monitored through regular veterinarian visits, she added.

His stint at the hospital has attracted global attention, and health authorities from Finland to Chile have contacted Zurberg with questions about replicating the idea. The aim, said Zurberg, is to develop a program that would train other dogs to sniff out C difficile and make them available to hospitals around the world.

Zurberg’s voice raises with excitement as she contemplates the possibility that Angus might hold the key to regaining control over a superbug that has affected so many people around the world.

“So many people come up to me and say: ‘My dad died of C diff,’ or ‘This person in my family has C diff,’ and they thank me for what we’re doing,” she said. “It opens the doors to other possibilities – what else can we have a dog detect? We’re only really limited by our imagination.”

Man"s best friend, bacteria"s worst enemy: dog sniffs out superbug in Canada hospital

Jeremy Hunt has got it wrong: junior doctors are not the enemy within | Diane Abbott

The first ever all-out strike in the NHS took place under David Cameron’s Tory government. The very first five-day strike in the NHS is now set to take place under Theresa May, unless the government sees sense. This is the Tory record on the NHS.

Jeremy Hunt says there is always tension between health secretaries and NHS staff. Tension is one thing, strike action is unprecedented. The government is attempting to portray this entirely as a result of unreasonable, militant or even out-of-touch and overpaid junior doctors flexing their muscles. Nothing could be further from the truth.

In psychology, this is known as projection. The government is blaming NHS workers for its own failings. It is flexing its own muscles. It’s possible that junior doctors are just the first group of workers who will be targeted for the unreasonable imposition of contracts without negotiation. The Conservative government is also out of touch with public opinion. Of course the public dislikes the disruption, and may even be fearful of its consequences. But people are clear that the blame for this lies with the government itself.

The government’s anti-doctor propaganda campaign should not be allowed to obscure a central truth about the crisis. Far from being able to deliver a seven-day NHS it is clear the existing procedures of the NHS are not sustainable because of government underfunding. On virtually all measures NHS performance is deteriorating, and waiting lists are growing across the board. Hospital trusts are racking up enormous debts because they are being asked to do more with less, and the waste of PFI. Targets for ambulance waiting times, A&E consultations, GP access and cancer referral times are all being missed.

Jeremy Hunt: junior doctor strike will be ‘worst in NHS history’

The target for elective surgeries is that they should be performed within 18 weeks. According to the Patients Association the target was missed for 92,739 people in 2015, a rise of more than 40,000 in a single year. This should be borne in mind when Hunt points the finger at junior doctors and blames them for postponed operations. Patients are already waiting inordinate periods of time for operations, often suffering painful or debilitating conditions.

This throws into sharp relief the central cause of the dispute, the attempt to impose seven-day working without the resources to fund it. Current resources are insufficient to adequately fund the so-called five-day NHS. The mantra that the NHS must do more with less has become “the NHS must do much, much more with less”. It is infeasible.

As the junior doctors point out, most NHS services are available at the weekend and most doctors work weekends as part of their rotas. The government is not introducing something wholly new, just something wholly unworkable without resources. The danger is that the changes to the rotas will increase risk to patients. Doctors might end up working even longer hours.

All of this is avoidable. The BMA junior doctors committee is willing to enter talks about the contract. The government could approach the aim of creating a seven-day NHS in a collaborative way.

Our health service relies above all on the skill and professionalism of its staff. They are the key asset in preserving and improving the NHS to meet new needs. Nothing useful can be achieved by this government treating hard-working junior doctors like “the enemy within”.

Jeremy Hunt has got it wrong: junior doctors are not the enemy within | Diane Abbott

South African stories: "My hope is that we can remove our largest enemy"

On Christmas Eve 2010 my outlook on daily life changed significantly when I was diagnosed with multi drug-resistant tuberculosis (MD-R TB).

I was admitted to hospital, isolated and started on 7 diverse very toxic drugs. I in no way realised the troubles drug-resistant TB patients face when they have to comply with therapy. I in no way recognized the terrible side results of the medicines, such as irreversible side results like hearing reduction, that I however experienced. I couldn’t work as a physician anymore and with my hearing broken, I wondered if I would ever be in a position to choose up my stethoscope yet again.

I was incredibly lucky in gaining compassionate accessibility to the first new TB drug in in excess of 40 years. I managed to maintain the rest of my hearing and comprehensive treatment method right after 18 months. I was then capable to start off operating yet again as a medical doctor, but at this time I also began to dedicate time to TB advocacy. I co-founded an advocacy group referred to as TB Proof and grew to become a vocal advocate for others suffering from TB.

At the end of 2012 a prominent TB researcher heard my story and imagined it would be worth telling at the yearly International TB Conference. I did not have funding to go on the journey, even so thankfully the advocacy organisation Therapy Action Group made the decision to sponsor my trip. That presentation changed my daily life. I met international leaders in the discipline of TB and was invited to share my story on international platforms.

Back house in South Africa I also became mindful of the incredible threat healthcare employees face operating in our hospitals on a daily basis. Collectively with other occupational TB survivors and TB activist medical students we commenced an advocacy group with the aim to TB Proof our wellness care employees (similar to bulletproof vests for policeman). Our perform rapidly grew we commenced getting invitations to share these sessions with hospital and clinic staff all above the Cape Town area.

We saw that our TB Evidence sessions began to alter people’s attitudes and behaviours in direction of TB. Sharing our very own stories broke down the stigma, and encouraged an ever-rising quantity of wellness care workers and students to share their very own experiences of TB. This was exceptionally inspiring, and a vital 1st stage in acknowledging the extent of the problem and offering necessary care and help for TB sufferers.

It is critical to remember that TB is a social illness, preying on the disadvantaged and the marginalised. Till we deal with inequality, poverty and discrimination we will not achieve TB elimination, so these continue to be broader focal factors for our nation.

My biggest hope for South Africa is that we can get rid of our greatest enemy, the biggest killer in our country, and certainly in the background of mankind, mycobacterium tuberculosis.

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South African stories: "My hope is that we can remove our largest enemy"

Sugar is the actual enemy, not unwanted fat itself, says movie targeting weight problems

A new documentary appears into the website link in between sugar and obesity? Photograph: Jose Luis Pelaez/Getty Pictures/Mix Photos

Very first came An Inconvenient Reality. Then Quick Food Nation. Then Blackfish. Every single showed the energy of critically acclaimed, productive documentaries to alter perceptions about controversial troubles ranging from international warming to mistreatment of animals in captivity and the behaviour of food industry giants.

Now comes Fed Up, a film that appears at the worldwide problem of surging human weight problems costs and obesity-related ailments. The movie, developed by Laurie David, former wife of Seinfeld creator Larry David, and narrated by Television journalist Katie Couric, seeks to challenge decades of misconception and food industry-sponsored misinformation about diet regime and physical exercise, excellent and poor calories, excess fat genes and lifestyle. When it comes to obesity, excess fat may not be our friend but it is not the enemy that sugar is, says the film’s scientific advisor Robert Lustig, a neuroendocrinologist, writer and president of the Institute for Accountable Nutrition. It is a view that is gathering support from doctors.

A US government study lately found that 17% of kids and younger individuals aged in between two and 19 are considered obese. An additional predicted that today’s American children will lead shorter lives than their mother and father. Laurie David, who produced the climate adjust movie An Inconvenient Truth, calls that statistic “sobering and tragic”.

According to Lustig, however, neither obesity nor body fat is the problem. “The meals business would like you to emphasis on three falsehoods that hold it from dealing with problems of culpability. A single, it really is about obesity. Two, a calorie is a calorie. Three, it really is about personalized accountability.”

If obesity was the issue, metabolic illnesses that normally show up in the obese would not be displaying up at prices discovered in the regular-excess weight population. Far more than half the populations of the US and Uk are experiencing results typically linked with obesity. If a lot more than half the population has problems, it can not be a behaviour issue. It must be an publicity issue. And that publicity is to sugar.”

The film claims that quickly-meals chains and the makers of processed food items have additional a lot more sugar to “minimal unwanted fat” food items to make them a lot more palatable.

The sugar surge adds up to a difficulty not only for minimal-income groups that are usually associated with diet-related well being issues, but for all ranges of society, say the film-makers. The film says big company is poisoning us with food marketed underneath the guise of well being advantages.

Early-onset diabetes, a situation related with exposure to cane sugar and corn syrup, was nearly unknown a few years in the past. If recent prices carry on, 1 in 3 Americans will have diabetes by 2050. “Weight problems expenses extremely tiny and is not dangerous in and of itself,” says Lustig, who operates with the UK’s Action on Sugar campaign. “But diabetes charges a entire whole lot in terms of social evolution, decreased productivity, healthcare and pharmaceutical charges, and death.”

But while the battle towards weight problems is championed by 1st lady Michelle Obama, efforts to curb the sugar business have largely failed. In 2003 the Bush administration threatened to withhold US funding to the World Overall health Organisation if it published dietary tips advocating that no more than ten% of calories in a everyday diet plan should come from sugar. Furthermore, Washington has sweetened the profits of the companies of corn-primarily based sweeteners by awarding billions of bucks in trade subsidies.

The film-makers say it is not in the curiosity of meals, beverage or pharmaceutical businesses to decrease sugar content. “It really is too worthwhile,” says Lustig. The pharmaceutical business talks of diabetes treatment, not prevention. “The food business helps make a ailment and the pharmaceutical business treats it. They make out like bandits whilst the rest of us are becoming taken to the cleaners.”

Lustig says laws are required. The model for regulation is alcohol given that alcohol metabolises as sugar and produces a lot of of the identical persistent ailments whilst excess fat metabolises differently.

But Lustig believes that education or government guidelines alone are inadequate to tackle substance abuse problems. “What’s necessary is to restrict availability to decrease consumption and minimize alcohol-relevant health problems,” he says.

Proposals contain placing overall health warnings on soft-drinks cans, giving equal advertising time to advertising fresh fruit and vegetables and voluntary agreements to decrease sugar articles.

Lustig says: “If the food business continues to obfuscate, we will by no means resolve this and by 2026 we will not have healthcare since we will be broke. Meals producers are going to have to be forced. There’s only one group that can force them, and that’s the government. There’s one group that can force the government, and which is the folks.”

Sugar is the actual enemy, not unwanted fat itself, says movie targeting weight problems

Sugar is now enemy amount one in the western diet | Dr Aseem Malhotra

Spoonfuls of sugar are most likely to lead to spoonfuls of medication Photograph: Rob Stark/Alamy

In 2012, the United Nations Globe Health Assembly advocated a significant new overall health goal: to lessen avoidable deaths from non-communicable diseases (NCDs) by 25% by 2025. Cardiovascular condition, diabetes, cancer and respiratory illness destroy 35 million per yr. The UN has recognized tobacco, alcohol and poor diet regime as central threat elements. The initial two have been regulated by governments in purchase to protect public overall health, but bad diet regime is in fact accountable for much more condition than smoking, alcohol and bodily inactivity combined.

But what element of the western diet plan should be targeted? The proof suggesting that additional sugar need to be the target is now overpowering. Unlike unwanted fat and protein, refined sugars supply no dietary value and, contrary to what the meals sector want you to feel, the physique does not demand any carbohydrate from additional sugar for energy. As a result it is a source of entirely pointless calories.

Sugars are extra to the majority of processed foods in the United kingdom. However disturbingly, several customers are unaware of its presence in such huge quantities. In the Uk and Europe guideline every day amounts for sugar have not been up to date since 2003. These obsolete tips even now suggest a single can eat a staggering 22 teaspoons of sugar day-to-day.

The Planet Overall health Organisation has lately been recommended by scientific specialists that added sugar or, a lot more particularly, non-milk extrinsic sugar must constitute no far more than 5% of energy. That would give a limit to the regular guy of a optimum of eight teaspoons a day and the regular lady to 6 tea spoons a day. And that would include sugars from fruit juice and honey.

The misleading labelling and well being claims on “lower unwanted fat” foods that truly have shocking amounts of sugar extra is a scandal. Worse nonetheless, it has designed the excellent storm for public overall health. Therefore, last Thursday, a group of United kingdom and worldwide professionals, such as myself, launched Action On Sugar. The primary aim is to strain the foods industry to decrease added sugar in foods by forty% above 4 years. That would mean one hundred fewer calories per man or woman, which according to the United kingdom Department of Wellness would reverse the obesity epidemic.

However, the market stays in denial. Barbara Gallani, director of regulation at the Meals and Drink Federation, made a statement of immediate resistance, denying sugar’s part in weight problems and failing to acknowledge the multitude of scientific research to the contrary. We mustn’t overlook that it took 50 years from when the 1st scientific studies between smoking and lung cancer were created ahead of any effective legislation was launched by means of regulation. Why? Because Massive Tobacco really efficiently adopted a corporate method of denial. By planting doubt, puzzling the public, bribing political allies and even buying the loyalty of rogue scientists.

The comparisons with the sugar business are quite chilling. Leader of the Commons Andrew Lansley’s aggressive intervention in parliament on Thursday was therefore intriguing. He attempted to rubbish respected public well being professional Professor Simon Capewell’s statement that sugar is the new tobacco. Lansley then compounded his mistakes by ignorantly asserting in the Home that “sugar is important to food”. It is not. He would have been more accurate in saying “sugar is important to meals industry revenue and lining the pockets of its co-opted partners”. Lansley was a paid director of marketing firm Profero to the end of 2009. Profero’s clients have included Pepsi, Mars, Pizza Hut and Diageo’s Guinness.

Throughout his unhappy time as overall health secretary, Lansley promoted his brainchild, the Obligation Deal. There, he invited quick-food firms in for cosy discussions on how to tackle weight problems, cynically generating the impression of progress, but only attaining weak and meaningless voluntary calorie reduction pledges.

The foods business spends billions in junk meals and sugary drink advertising, targeting the most vulnerable members of society, such as youngsters. Worse, the business cynically associates fitness and sport with junk food and sugary drinks. As a result Mars is a single of the official sponsors of the England football crew. Nevertheless one normal sized bar includes eight teaspoons of sugar, practically triple the volume advised as a limit for a four- to eight-yr-old little one by the US Department of Health and Human Services’ dietary suggestions. The commonest cause of continual pain in young children is tooth decay with sugar as the amount one particular threat factor. Standard physical activity has a multitude of wellness positive aspects even so, its result on sustained fat reduction is frequently weak. Furthermore, activity amounts have altered little in the previous 30 many years as obesity has rocketed.

We are all vulnerable, since you never have to be obese to be impacted by diet-associated ailment. Of all the persistent illnesses, kind two diabetes, which is fully preventable, is perhaps the most damaging. Diabetes increases the threat of heart attack, stroke, kidney failure, eye ailment and leg amputations. Up to half of all diabetic patients go on to suffer acute or persistent ache, and two-thirds will eventually produce dementia. The direct and indirect costs to the United kingdom of diabetes is in excess of £24bn and projected to strategy £40bn by 2030. If we do absolutely nothing, this will cripple the NHS.

How does sugar examine to tobacco? A teaspoon of sugar or a single cigarette will not harm you. But more than time, the habit can be fatal. As opposed to Big Tobacco, Large Sugar deliberately targets young children. And added sugar has grow to be so pervasive inside the food surroundings that we can not avoid it even if we wished to. It is hence not merely a matter of individual decision. But possibly most disturbing of all the similarities is the fiscal and political muscle that each industries have exerted to consider and shield their earnings, at the cost of our wellness. It’s time to wind back the harms of also considerably sugar, reverse the “diabesity” epidemic and the unspeakable suffering it causes. It is time for Action On Sugar.

Dr Aseem Malhotra, a London cardiologist, is the science director of Action on Sugar

Sugar is now enemy amount one in the western diet | Dr Aseem Malhotra