The untapped power of LGBTQ+ blood drives

Reflecting on this summer experience, one of the ways in which I have noticed that the COVID-19 pandemic and the HIV epidemic have crashed into each other, is how the United States has recently handled its blood supply. In a state of emergency, the American Red Cross declared its first ever blood shortage crisis in January 2022 due to a decrease in blood donations because of COVID-19 lockdown restrictions. Yet during this time, United States regulations held onto an FDA policy that was instated in 1983: the gay blood ban.

This ban for gay men donating blood was established two years before HIV diagnostic testing was widely available in 1985, and during a time when HIV stigma towards the LGBTQ+ community was elevated. In 2020, the U.S. Food and Drug Administration (FDA) rule changed from a lifetime ban on gay men to a three-month deferral from the last time a gay man was sexually active. Though changes have been made, the HIV stigma remains for the LGBTQ+ community. What if the behavior was safe and with a longtime partner? What about risky heterosexual behavior? It is hurtful to many knowing these rules only apply to homosexual relationships. The FDA’s message remains clear: sexually active, homosexual men are prone to HIV infection regardless of safety measures.

A lot has changed in two years with rules and regulations regarding the COVID-19 pandemic, so one can imagine how outdated a rule from 40 years ago could now be on the HIV epidemic. Current HIV testing has proven accurate. In fact, the residual risk of the test failing to identify HIV in a unit of blood is one in every 2.3 million units of blood. The Red Cross website “recognizes the hurt this policy has caused to many in the LGBTQ+ community and believes blood donation eligibility should not be determined by methods that are based upon sexual orientation.” The forms of eligibility referred to are individual risk assessments to determine if a person’s behavior is more prone to HIV infection, regardless of sexual orientation. Countries that have implemented these new measures during the COVID-19 pandemic include Canada and the United Kingdom. It is my opinion that the United States should do the same.

This ban only applies to homosexual men, who are just a part of the LGBTQ+ community (e.g., gay men, bisexual men, men who have sex with men), but it has also prevented the community from mobilizing to host blood drives together—something that is much needed during the COVID-19 pandemic. End the gay blood ban. Let LGBTQ+ blood drives happen. I’ve been waiting to donate blood for years.

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From evolution to microbiology: A journey to understand the tuberculosis pandemic

My sophomore year at Loyola University Chicago, I took an Evolution of Human Disease course with paleopathologist Anne Grauer, PhD. Her class served as an in depth introduction into the evolution of the Mycobacterium family, and why m. Tuberculosis (Mtb) is such a fascinating yet complex bacterium to study. For some initial context, Mtb is a bacteria that can cause the tuberculosis (Tb). It is transmitted when a healthy individual inhales a cough droplet from an infected Tb individual. The bacteria typically lodges itself within the lungs, causing numerous respiratory symptoms that left untreated are fatal. It is a major global health concern because it can become resistant to life saving antibiotics.

From an evolutionary perspective, Mtb evolved to persist in a wide spectrum of environmental conditions. It can lay low in healthy individuals for years, and if a person eventually becomes immunocompromised, it can trigger rapid growth causing Tb. This is due to its incredibly slow growth rate. On the other hand, Mtb can adapt to its current conditions by mutating against antibiotics necessary to treat it. Mtb should not be able to do the latter given its slow growth rate. This is why some consider it “an extraordinary bacteria”. It has successfully co-evolved with humans pointing to its remarkable adaptability in any given environment.

This insight was why I jumped at the opportunity to apply to the Institute for Public Health Summer Research Program – Public & Global Health Track and, despite having minimal microbiology knowledge, I am pleased to work in the mycobacterium lab of Professor Christina Stalling, PhD.

My initial goal was to connect my evolutionary based understanding of Mtb to microbiology. I have always been fond of connecting details together to to create a bigger picture. Those details being Mtb evolution and microbiology lab work and the bigger picture being tuberculosis as a major global health concern. I wanted to understand at a molecular level why Mtb was exceptional at evading antibiotics. To put it another way, as Dr. Grauer had said on numerous occasions “why is it such a smart bacteria?” I wish I had an answer.

What I’m finding is that there are a lot of theories but much of the work revolves around figuring out how the bacteria works. What I mean is that there are many systems in Mtb that either promote growth of the bacteria, or virulence (referring to its ability to infect). Often times, microbiologists know what systems and genes are involved but they are unaware of how that system works or what a gene is acting on. This has made meeting my primary goal difficult, and to be honest I am more confused finishing this program than when I arrived. But I do not view this as a negative because working in the Stallings Lab at Washington University in St. Louis has shown me how complex and fascinating Mtb is.

I have made one major connection: Given Dr. Grauer’s evolutionary perspective on Mtb, it has historically adapted very well to many environments. Therefore, it is not shocking to me that microbiologists are having an incredibly difficult time finding a universal answer to solving the tuberculosis pandemic.

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MRSA

MRSA stands for methicillin-resistant Staphylococcus aureus. It causes a staph infection (pronounced "staff infection") that is resistant to several common antibiotics. There are two types of infection. Hospital-associated MRSA happens to people in health care settings. Community-associated MRSA happens to people who have close skin-to-skin contact with others, such as athletes involved in football and wrestling.

Infection control is key to stopping MRSA in hospitals. To prevent community-associated MRSA:

• Practice good hygiene
• Keep cuts and scrapes clean and covered with a bandage until healed
• Avoid contact with other people's wounds or bandages
• Avoid sharing personal items, such as towels, washcloths, razors, or clothes
• Wash soiled sheets, towels, and clothes in hot water with bleach and dry in a hot dryer

If a wound appears to be infected, see a health care provider. Treatments may include draining the infection and antibiotics.

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Yeast Infections

Yeast infections can occur in various parts of the body, but they are most commonly associated with vaginal yeast infections in women. However, men can also get yeast infections, typically on the penis. Other areas where yeast infections can occur include the mouth (oral thrush), skin folds, and nail beds.

Some factors that can contribute to the development of yeast infections include:

Antibiotic use: Antibiotics can disrupt the natural balance of bacteria in the body, allowing yeast to overgrow.

Hormonal changes: Hormonal fluctuations during the menstrual cycle, pregnancy, or menopause can increase the risk of yeast infections.

Weakened immune system: People with weakened immune systems, such as those with HIV/AIDS or undergoing chemotherapy, are more susceptible to yeast infections.

Diabetes: Uncontrolled diabetes can create an environment favorable for yeast overgrowth.

Poor hygiene: Not maintaining proper hygiene, such as not changing damp clothing or staying in wet swimwear for extended periods, can increase the risk of yeast infections.

The symptoms of a yeast infection can vary depending on the affected area, but common signs and symptoms may include:

*Vaginal itching and irritation
*Thick, white vaginal discharge
*Burning sensation during urination or intercourse
*Redness and swelling of the vulva
*In men, itching or a rash on the penis
*In oral thrush, creamy white patches on the tongue and inside the mouth

If you suspect you have a yeast infection, it's important to see a healthcare professional for an accurate diagnosis. They may perform a physical examination and may take a sample for laboratory testing to confirm the presence of yeast.

Treatment for yeast infections typically involves antifungal medications, which can be applied topically or taken orally, depending on the location and severity of the infection. Over-the-counter antifungal creams and suppositories are available for treating vaginal yeast infections. It's important to complete the full course of treatment, even if symptoms improve, to ensure the infection is fully cleared.

In addition to medication, some preventive measures can help reduce the risk of yeast infections. These include practicing good hygiene, avoiding douching and using scented feminine products, wearing breathable cotton underwear, avoiding tight-fitting clothing, and maintaining a healthy diet and lifestyle to support a strong immune system.

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Hemorrhagic Fevers

Viral hemorrhagic fevers (VHFs) are a group of illnesses caused by four families of viruses. These include the Ebola and Marburg, Lassa fever, and yellow fever viruses. VHFs have common features: they affect many organs, they damage the blood vessels, and they affect the body's ability to regulate itself. Some VHFs cause mild disease, but some, like Ebola or Marburg, cause severe disease and death.

VHFs are found around the world. Specific diseases are usually limited to areas where the animals that carry them live. For example, Lassa fever is limited to rural areas of West Africa where rats and mice carry the virus.

The risk for travelers is low, but you should avoid visiting areas where there are disease outbreaks. Because there are no effective treatments for some of these viral infections, there is concern about their use in bioterrorism.

*Transmission: Hemorrhagic fevers are typically transmitted to humans through contact with infected animals or through direct contact with the bodily fluids of infected individuals. In some cases, mosquitoes or ticks may also play a role in transmitting these viruses.

*Symptoms: The symptoms of hemorrhagic fevers can vary depending on the specific virus, but they commonly include high fever, fatigue, muscle aches, headache, dizziness, and weakness. As the disease progresses, more severe symptoms may develop, such as bleeding from the nose, mouth, and other body orifices, as well as internal bleeding.

*Diagnosis: Diagnosing hemorrhagic fevers can be challenging due to the similarity of symptoms with other infectious diseases. It often requires specialized laboratory tests to confirm the presence of the specific virus causing the infection.

*Treatment: There is no specific antiviral treatment for most hemorrhagic fevers. Supportive care is provided to manage symptoms and complications. This includes maintaining fluid balance, managing bleeding, and addressing any organ dysfunction or failure. In some cases, experimental treatments or investigational antiviral drugs may be used, but their effectiveness is limited and varies depending on the virus.

*Prevention: Prevention of hemorrhagic fevers primarily focuses on reducing exposure to the viruses. This includes practicing good hygiene, avoiding contact with infected animals, using protective measures such as gloves and masks when caring for infected individuals, and implementing appropriate infection control measures in healthcare settings.

*Outbreaks: Hemorrhagic fevers have caused several outbreaks in different parts of the world, particularly in regions where the viruses are endemic. These outbreaks can be challenging to control due to the high mortality rates, lack of specific treatment, and the potential for rapid spread within communities.

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Zika Virus

Zika is a virus that is spread mostly by mosquitoes. A pregnant mother can pass it to her baby during pregnancy or around the time of birth. It can spread through sexual contact. There have also been reports that the virus has spread through blood transfusions. There have been outbreaks of Zika virus in the United States, Africa, Southeast Asia, the Pacific Islands, parts of the Caribbean, and Central and South America.

Most people who get the virus do not get sick. One in five people do get symptoms, which can include a fever, rash, joint pain, and conjunctivitis (pink eye). Symptoms are usually mild, and start 2 to 7 days after being bitten by an infected mosquito.

A blood test can tell whether you have the infection. There are no vaccines or medicines to treat it. Drinking lots of fluids, resting, and taking acetaminophen might help.

Zika can cause microcephaly (a serious birth defect of the brain) and other problems in babies whose mothers were infected while pregnant. The Centers for Disease Control and Prevention recommends that pregnant women do not travel to areas where there is a Zika virus outbreak. If you do decide to travel, first talk to your doctor. You should also be careful to prevent mosquito bites:

• Use insect repellent
• Wear clothes that cover your arms, legs, and feet
• Stay in places that have air conditioning or that use window and door screens

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Animal Diseases and Your Health

Animal diseases that people can catch are called zoonoses. Many diseases affecting humans can be traced to animals or animal products. You can get a disease directly from an animal, or indirectly, through the environment.

Farm animals can carry diseases. If you touch them or things they have touched, like fencing or buckets, wash your hands thoroughly. Adults should make sure children who visit farms or petting zoos wash up as well.

Though they may be cute and cuddly, wild animals may carry germs, viruses, and parasites. Deer and deer mice carry ticks that cause Lyme disease. Some wild animals may carry rabies. Enjoy wildlife from a distance.

Pets can also make you sick. Reptiles pose a particular risk. Turtles, snakes and iguanas can transmit Salmonella bacteria to their owners. You can get rabies from an infected dog or toxoplasmosis from handling kitty litter of an infected cat. The chance that your dog or cat will make you sick is small. You can reduce the risk by practicing good hygiene, keeping pet areas clean and keeping your pets' shots up-to-date.

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Acute Bronchitis

Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It causes a cough that often brings up mucus. It can also cause shortness of breath, wheezing, a low fever, and chest tightness. There are two main types of bronchitis: acute and chronic.

Most cases of acute bronchitis get better within several days. But your cough can last for several weeks after the infection is gone.

The same viruses that cause colds and the flu often cause acute bronchitis. These viruses spread through the air when people cough, or though physical contact (for example, on unwashed hands). Being exposed to tobacco smoke, air pollution, dusts, vapors, and fumes can also cause acute bronchitis. Less often, bacteria can also cause acute bronchitis.

To diagnose acute bronchitis, your health care provider will ask about your symptoms and listen to your breathing. You may also have other tests.

Treatments include rest, fluids, and aspirin (for adults) or acetaminophen to treat fever. A humidifier or steam can also help. You may need inhaled medicine to open your airways if you are wheezing. Antibiotics won't help if the cause is viral. You may get antibiotics if the cause is bacterial.

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Abscess

An abscess is a pocket of pus. You can get an abscess almost anywhere in your body. When an area of your body becomes infected, your body's immune system tries to fight the infection. White blood cells go to the infected area, collect within the damaged tissue, and cause inflammation. During this process, pus forms. Pus is a mixture of living and dead white blood cells, germs, and dead tissue.

Bacteria, viruses, parasites and swallowed objects can all lead to abscesses. Skin abscesses are easy to detect. They are red, raised and painful. Abscesses inside your body may not be obvious and can damage organs, including the brain, lungs and others. Treatments include drainage and antibiotics.

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Aspergillosis

Aspergillosis is a disease caused by a fungus (or mold) called Aspergillus. The fungus is very common in both indoors and outdoors. Most people breathe in the spores of the fungus every day without being affected. But some people get the disease. It usually occurs in people with lung diseases or weakened immune systems.

There are different kinds of aspergillosis. One kind is allergic bronchopulmonary aspergillosis (also called ABPA). Symptoms of ABPA include wheezing and coughing. ABPA can affect healthy people but it is most common in people with asthma or cystic fibrosis.

Another kind is invasive aspergillosis, which damages tissues in the body. It usually affects the lungs. Sometimes it can also cause infection in other organs and spread throughout the body. It affects people who have immune system problems, such as people who have had a transplant, are taking high doses of steroids, or getting chemotherapy for some cancers.

Your doctor might do a variety of tests to make the diagnosis, including a chest x-ray, CT scan of the lungs, and an examination of tissues for signs of the fungus. Treatment is with antifungal drugs. If you have ABPA, you may also take steroids.

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Eye Infections(Pink Eye)

Your eyes can get infections from bacteria, fungi, or viruses. Eye infections can occur in different parts of the eye and can affect just one eye or both. Two common eye infections are:

• Conjunctivitis - also known as pink eye. Conjunctivitis is often due to an infection. Children frequently get it, and it is very contagious.
• Stye - a bump on the eyelid that happens when bacteria from your skin get into the hair follicle of an eyelash.

Symptoms of eye infections may include redness, itching, swelling, discharge, pain, or problems with vision. Treatment depends on the cause of the infection and may include compresses, eye drops, creams, or antibiotics.

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West Nile Virus

West Nile virus (WNV) is an infectious disease that first appeared in the United States in 1999. Infected mosquitoes spread the virus that causes it. People who get WNV usually have no symptoms or mild symptoms. The symptoms include a fever, headache, body aches, skin rash, and swollen lymph glands. They can last a few days to several weeks, and usually go away on their own.

If West Nile virus enters the brain, however, it can be life-threatening. It may cause inflammation of the brain, called encephalitis, or inflammation of the tissue that surrounds the brain and spinal cord, called meningitis. A physical exam, medical history, and laboratory tests can diagnose it.

Older people and those with weakened immune systems are most at risk. There are no specific vaccines or treatments for human WNV disease. The best way to avoid WNV is to prevent mosquito bites:

• Use insect repellent
• Get rid of mosquito breeding sites by emptying standing water from flower pots, buckets or barrels
• Stay indoors between dusk and dawn, when mosquitoes are most active
• Use screens on windows to keep mosquitoes out

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Hepatitis B

Hepatitis B is an infectious disease caused by the Hepatitis B virus (HBV) that affects the liver; it is a type of viral hepatitis. It can cause both acute and chronic infection.

Causes:

Hepatitis B is caused by the hepatitis B virus (HBV), which belongs to the Hepadnaviridae family of viruses.
The most common modes of transmission include unprotected sexual contact with an infected person, sharing needles or syringes contaminated with infected blood, mother-to-child transmission during childbirth, and exposure to infected blood or bodily fluids through needlestick injuries or other accidents.
It is important to note that hepatitis B is not spread through casual contact like hugging, kissing, or sharing utensils with an infected person.

Symptoms: 

Many people with hepatitis B may not experience any symptoms and may unknowingly carry the virus. This is known as chronic hepatitis B.
Acute hepatitis B infection can cause symptoms that include fatigue, loss of appetite, nausea and vomiting, abdominal pain, dark urine, clay-colored stools, joint pain, jaundice (yellowing of the skin and eyes), and fever. However, these symptoms may not be present in all cases.

Treatments: 

Acute hepatitis B infection does not usually require specific treatment, as the body's immune system can often clear the virus within a few months. However, medical monitoring and supportive care are important.
Chronic hepatitis B infection may require long-term treatment to reduce the risk of complications such as liver cirrhosis and liver cancer. The treatment options include antiviral medications, such as interferon and oral antiviral drugs like entecavir, tenofovir, or lamivudine.
Regular monitoring of liver function, viral load, and screening for liver cancer are crucial for individuals with chronic hepatitis B.
In some cases, a liver transplant may be necessary for individuals with advanced liver disease caused by chronic hepatitis B.

Prevention:

The best way to prevent hepatitis B is through vaccination. The hepatitis B vaccine is safe and effective and is typically given as a series of three or four doses.
Practicing safe sex by using barrier methods like condoms and avoiding sharing needles or other drug paraphernalia can also help prevent the transmission of hepatitis B.
Infants born to mothers infected with hepatitis B should receive the hepatitis B vaccine and hepatitis B immune globulin (HBIG) shortly after birth to prevent transmission.

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Hepatitis A: Causes, Symptoms And Treatment

Hepatitis A is more common in places where the sanitation is poor, it spreads via contaminated food or water and close contact with an infected person. Mild cases of hepatitis settle down on its own and don’t require any treatment, patients recover without any damage to the liver. Also Check Out: Protect Yourself From Hepatitis Infections!

Symptoms:

The signs and symptoms of hepatitis A does not show until a person has the virus for a few weeks. Some of the common symptoms include;

Tiredness

Nausea and vomiting

Pain in the stomach, specifically in the upper right side beneath your ribs (by the liver).

Poor appetite

Low- grade fever

Dark-tinted liver and pale stool

Yellowing of the skin and whites of the eyes.

Itching and rashes

The symptoms will be fairly mild and settle within a few weeks, but if the infection is very severe then it may last for months.

Causes:

A person suffering from HAV will excrete the virus in the stool. It generally, passed on when a normal person consumes food or water that has been contaminated with stool of an infected individual.

Some of the ways HAV spread include:

Eating food handled by an infected person who doesn’t thoroughly wash his or her hands after using the toilet.

Having contaminated water

Consuming raw shellfish from water polluted

A sex partner who has the virus

From close contact with an infected person

Diagnosis And Treatment:

The doctor recommends certain blood and urine tests to check for the presence of hepatitis A virus. For people without any visible symptoms, it is difficult to diagnose hepatitis even with a complete physical examination.

There is no specific treatment for hepatitis A, the body in most cases, will flush out the virus on its own and the liver heals within six months without any side effects. Treatment mainly aims at keeping the patient comfortable and avert complications like dehydration and fatigue. This includes:

A proper diet that helps to replenish nutrition and fluids

Avoiding alcohol

Adequate rest, with time off work

Taking over the counter pain relievers, if needed and recommended by the physician

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 Hepatitis A

What is hepatitis A?

Hepatitis A is a type of viral hepatitis. It causes an acute, or short-term, infection. This means that people usually get better without treatment after a few weeks.

Thanks to a vaccine, hepatitis A is not very common in the United States.

What causes hepatitis A?

Hepatitis A is caused by the hepatitis A virus. The virus spreads through contact with an infected person's stool. This can happen if you:

• Eat food made by someone who has the virus and did not properly wash their hands after using the bathroom
• Drink contaminated water or eat foods that were rinsed with contaminated water
• Have close personal contact with someone who has hepatitis A. This could be through certain types of sex (like oral-anal sex), taking care of someone who is ill, or using illegal drugs with others.

Who is at risk for hepatitis A?

Although anyone can get hepatitis A, you are at higher risk if you:

• Travel to developing countries
• Have sex with someone who has hepatitis A
• Are a man who has sex with men
• Use illegal drugs
• Are experiencing homelessness
• Live with or care for someone who has hepatitis A
• Live with or care for a child recently adopted from a country where hepatitis A is common

What are the symptoms of hepatitis A?

Not everyone with hepatitis A has symptoms. Adults are more likely to have symptoms than children. If you do have symptoms, they usually start 2 to 7 weeks after infection. They can include:

• Dark yellow urine
• Diarrhea
• Fatigue
• Fever
• Gray- or clay-colored stools
• Joint pain
• Loss of appetite
• Nausea and/or vomiting
• Abdominal pain
• Yellowish eyes and skin, called jaundice

The symptoms usually last less than 2 months, although some people can be ill for as long as 6 months.

You are at a higher risk of getting a more severe infection from hepatitis A if you also have HIV, hepatitis B, or hepatitis C.

What other problems can hepatitis A cause?

In rare cases, hepatitis A may lead to liver failure. This is more common in adults over age 50 and in people who have another liver.

How is hepatitis A diagnosed?

To diagnose hepatitis A, your health care provider may use many tools:

• A medical history, which includes asking about your symptoms
• A physical exam
• Blood tests, including tests for viral hepatitis

What are the treatments for hepatitis A?

There is no specific treatment for hepatitis A. The best way to recover is to rest, drink plenty of liquids, and eat healthy foods. Your provider may also suggest medicines to help relieve symptoms. In more severe cases, you may need care in a hospital.

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