Placeholder Content Image

The eye-watering price of Jackie O's opulent Christmas tree

<p>Jackie O is getting in the festive spirit, sharing photos of her and her daughter Kitty in matching plaid pjs posing in front of their opulent Christmas tree. </p> <p>The KIIS FM host, who reportedly earns millions each year on her top-rated radio show, showed off the extraordinary festive decor, with many pointing out just how much she had spent on the tree. </p> <p>Jackie's tree comes from the brand Dancer & Dasher, where prices for their stunning "bespoke" creations start at a whopping $4,000.</p> <p>Those prices are for a 180cm tree decoration package with installation included, but for those looking to splash out on their festive decor, you'll have to join a waitlist. </p> <p>Jackie's tree was decorated with sparkling red baubles and giant bows, as well as sprigs of holly and berries. </p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/DCyQeFPPGbM/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/DCyQeFPPGbM/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Jackie O (@jackieo_official)</a></p> </div> </blockquote> <p>She posed alongside the luxury decoration with her daughter Kitty, the pair in matching seasonal pyjamas. </p> <p>"Christmas ready!!!! Always so in awe of your beautiful trees @danceranddasher," Jackie wrote in her caption on Instagram. </p> <p>"It’s nice to have money haha," joked one fan in the captions while another said, "The best Christmas tree!!"</p> <p><em>Image credits: Instagram </em></p> <p> </p>

Money & Banking

Placeholder Content Image

From eye exams to blood tests and surgery: how doctors use light to diagnose disease

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/matthew-griffith-1539353">Matthew Griffith</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>You’re not feeling well. You’ve had a pounding headache all week, dizzy spells and have vomited up your past few meals.</p> <p>You visit your GP to get some answers and sit while they shine a light in your eyes, order a blood test and request some medical imaging.</p> <p>Everything your GP just did relies on light. These are just some of the optical technologies that have had an enormous impact in how we diagnose disease.</p> <h2>1. On-the-spot tests</h2> <p>Point-of-care diagnostics allow doctors to test patients on the spot and get answers in minutes, rather than sending samples to a lab for analysis.</p> <p>The “flashlight” your GP uses to view the inside of your eye (known as an <a href="https://medlineplus.gov/ency/article/003881.htm">ophthalmoscope</a>) is a great example. This allows doctors to detect abnormal blood flow in the eye, deformations of the cornea (the outermost clear layer of the eye), or swollen optical discs (a round section at the back of the eye where the nerve link to the brain begins). Swollen discs are a sign of elevated pressure inside your head (or in the worst case, a brain tumour) that could be <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/headache/increased-intracranial-pressure-icp-headache">causing your headaches</a>.</p> <p>The invention of <a href="https://openmedscience.com/lighting-the-way-in-healthcare-the-transformative-role-of-lasers-in-medicine/">lasers and LEDs</a> has enabled many other miniaturised technologies to be provided at the bedside or clinic rather than in the lab.</p> <p><a href="https://theconversation.com/whats-a-pulse-oximeter-should-i-buy-one-to-monitor-covid-at-home-174457">Pulse oximetry</a> is a famous example, where a clip attached to your finger reports how well your blood is oxygenated. It does this by <a href="https://www.howequipmentworks.com/pulse_oximeter/">measuring</a> the different responses of oxygenated and de-oxygenated blood to different colours of light.</p> <p>Pulse oximetry is used at hospitals (and <a href="https://theconversation.com/whats-a-pulse-oximeter-should-i-buy-one-to-monitor-covid-at-home-174457">sometimes at home</a>) to monitor your respiratory and heart health. In hospitals, it is also a valuable tool for detecting <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60107-X/fulltext">heart defects in babies</a>.</p> <h2>2. Looking at molecules</h2> <p>Now, back to that blood test. Analysing a small amount of your blood can diagnose <a href="https://theconversation.com/blood-tests-and-diagnosing-illness-what-can-blood-tell-us-about-whats-happening-in-our-body-80327">many different diseases</a>.</p> <p>A machine called an automated “full blood count analyser” tests for general markers of your health. This machine directs focused beams of light through blood samples held in small glass tubes. It counts the number of blood cells, determines their specific type, and reports the level of haemoglobin (the protein in red blood cells that distributes oxygen around your body). In minutes, this machine can provide a <a href="https://www.nuffieldhealth.com/article/inside-the-pathology-lab-what-happens-to-my-blood">snapshot</a> of your overall health.</p> <p>For more specific disease markers, blood serum is separated from the heavier cells by spinning in a rotating instrument called a centrifuge. The serum is then exposed to special chemical stains and enzyme assays that change colour depending on whether specific molecules, which may be the sign of a disease, are present.</p> <p>These colour changes can’t be detected with the naked eye. However, a light beam from an instrument called a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476943/#R88">spectrometer</a> can detect tiny amounts of these substances in the blood and determine if the biomarkers for diseases are present, and at what levels.</p> <h2>3. Medical imaging</h2> <p>Let’s re-visit those medical images your GP ordered. The development of fibre-optic technology, made famous for transforming high-speed digital communications (such as the NBN), allows light to get inside the body. The result? High-resolution optical imaging.</p> <p>A common example is an <a href="https://www.medicalnewstoday.com/articles/153737#risks-and-side-effects">endoscope</a>, where fibres with a tiny camera on the end are inserted into the body’s natural openings (such as your mouth or anus) to examine your gut or respiratory tracts.</p> <p>Surgeons can insert the same technology through tiny cuts to view the inside of the body on a video screen during <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553337/">laparoscopic surgery</a> (also known as keyhole surgery) to diagnose and treat disease.</p> <h2>How about the future?</h2> <p>Progress in nanotechnology and a better understanding of the interactions of light with our tissues are leading to new light-based tools to help diagnose disease. These include:</p> <ul> <li> <p><a href="https://onlinelibrary.wiley.com/doi/full/10.1002/advs.201903441">nanomaterials</a> (materials on an extremely small scale, many thousands of times smaller than the width of a human hair). These are being used in next-generation sensors and new diagnostic tests</p> </li> <li> <p><a href="https://www.nature.com/articles/s41587-019-0045-y">wearable optical biosensors</a> the size of your fingernail can be included in devices such as watches, contact lenses or finger wraps. These devices allow non-invasive measurements of sweat, tears and saliva, in real time</p> </li> <li> <p>AI tools to analyse how blood serum scatters infrared light. This has allowed researchers to build a <a href="https://www.advancedsciencenews.com/powerful-diagnostic-approach-uses-light-to-detect-virtually-all-forms-of-cancer/">comprehensive database</a> of scatter patterns to detect <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/aisy.202300006">any cancer</a></p> </li> <li> <p>a type of non-invasive imaging called <a href="https://www.ncbi.nlm.nih.gov/books/NBK554044/">optical coherence tomography</a> for more detailed imaging of the eye, heart and skin</p> </li> <li> <p>fibre optic technology to deliver a tiny microscope into the body on the <a href="https://www.uwa.edu.au/projects/microscope-in-a-needle">tip of a needle</a>.</p> </li> </ul> <p>So the next time you’re at the GP and they perform (or order) some tests, chances are that at least one of those tests depend on light to help diagnose disease.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231379/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/matthew-griffith-1539353"><em>Matthew Griffith</em></a><em>, Associate Professor and ARC Future Fellow and Director, UniSA Microscopy and Microanalysis Facilities, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/from-eye-exams-to-blood-tests-and-surgery-how-doctors-use-light-to-diagnose-disease-231379">original article</a>.</em></p> </div>

Body

Placeholder Content Image

Rare coin hidden for decades to fetch eye-watering sum

<p>Three sisters from the US who inherited a dime coin kept it in a bank vault for more than 40 years, and while they know it had some value, they didn't know just how much until a few years ago. </p> <p>The rare coin, struck by the US Mint in San Francisco in 1975, could be worth more than $US500,000 ($748,000), according to Ian Russell, president of GreatCollections, the auction house selling the coin. </p> <p>What makes the coin depicting President Franklin D. Roosevelt so valuable is that it is just one of two coins missing the "S" mint mark for San Francisco. </p> <p>The other dime sold for  $US682,000 (over $1 million) at a 2019 auction and then again months later to a private collector. </p> <p>While avid coin collectors have known about the existence of these two extraordinarily rare coins, their whereabouts had remained a mystery since the late 1970s. </p> <p>“They were hidden for decades,” Russell said.</p> <p>“Most major collectors and dealers have never seen one.”</p> <p>The three sisters from Ohio, who want to remain anonymous,  inherited one of the two dimes after the recent death of their of their brother, Russell said. </p> <p>They told Russell that their brother and mother bought the first error coin discovered in 1978 for $27,225, which would amount to roughly $135,000 today.</p> <p>Their parents, who ran a dairy farm, saw the coin as a financial safety net, and it was only until last year that one of the sisters saw the coin first-hand. </p> <p>Russell also said that their brother had reached out to him about seven years ago and told him about the coin, but he too kept it a secret. </p> <p>When Russell told one of the sisters about the potential value of the coin, she told him: “is that really possible?”. </p> <p>The coin, known as the “1975 ‘no S’ proof dime,” will be displayed at a coin show beginning on Wednesday in Tampa, Florida, and before <a href="https://www.greatcollections.com/Coin/1655587" target="_blank" rel="noopener">the auction</a> closes late next month, Russell said.</p> <p>The current highest bidder has offered $US250,000 ($374,000).</p> <p><em>Images: Great Collections/ Professional Coin Grading Services</em></p>

Money & Banking

Placeholder Content Image

The eye-watering salaries of The Voice Australia judges revealed

<p><em>The Voice Australia</em> has revamped the lineup of the judges for the 2024 season, with American music icons Adam Lambert and LeAnn Rimes joining Aussies Guy Sebastian and Kate Miller-Heidke. </p> <p>As the new American talent joins the show, Seven are reportedly paying big buck for the international stars after their salaries were leaked by <a href="https://au.lifestyle.yahoo.com/exclusive-the-voice-australia-coaches-salaries-leaked-amid-pay-row-230921307.html" target="_blank" rel="noopener"><em>Yahoo News</em></a>. </p> <p>According to the publication, an alleged source claims that Adam and LeAnn "are believed to be receiving between $750,000 and $1.2 million" for the single season of the show. </p> <p>Meanwhile, Kate Miller-Heidke "is believed to be receiving upwards of $500,000" for her first season on the show. </p> <p>Veteran judge Guy Sebastian allegedly started on $750,000 per season in 2019, "but this is believed to now be worth $1 million". </p> <p>These new judges are getting "considerably less" than outgoing coaches Rita Ora and Jason Derulo, <em>Yahoo</em> alleges.</p> <p>According to a production insider, the reason for the switch-up of judges was the star's pay cheques, and a desire from producers to keep costs down.</p> <p>The insider said the program has been wanting a change in judges lineup for a quite some time, adding that salary increases are necessary to keep returning stars on the show and the price tag for the former crop was "too expensive".</p> <p>"The company line was that Jessica, Rita and Jason were all too busy, but I don't think anyone is too busy to pick up these sorts of pay cheques. It certainly did have a lot to do with keeping the costs down."</p> <p><em>Image credits: Seven </em></p>

TV

Placeholder Content Image

The eye-watering cost of Karl Stefanovic's "highly secret" 50th birthday bash

<p>Karl Stefanovic had a "highly secretive" birthday party in Saint-Tropez. France, according to <em>Women's Day</em>. </p> <p>The <em>Today </em>host, who was in Paris to cover the Olympic games earlier this month, reportedly booked out an entire hotel for his 50th birthday bash. </p> <p>A source claimed that his party cost a staggering $200,000, with A-listers James Packer and Anthony Bell among the guests. </p> <p>"He'd be thinking you only turn 50 once so let's do this properly and go big!" the insider claimed. </p> <p>"Much like the $50,000 he dropped for (wife) Jasmine's 40th earlier this year, and the rumoured $10,000 birthday parties they have hosted for their four-year-old daughter Harper," they continued. </p> <p>"And then there was their $700,000 lavish Mexican nuptials - Karl has never done anything half-baked!" </p> <p>The party was allegedly 1970s themed, with Stefanovic's wife also showing off her new designer dresses.</p> <p>This comes after it was initially reported that Stefanovic was set to cancel his planned 50th birthday bash in Paris.</p> <p>Earlier this year, the <em>Today </em>host was reported to have spent a whopping $50,000 on his wife's lavish birthday celebrations in Noosa, according to the publication. </p> <p>Jasmine's entire look alone was worth an eye-watering $5,575, with her gown from Zimmermann costing $1,950. </p> <p>The party reportedly lasted for about two days, with a "recovery shindig" allegedly worth $10,000 also taking place. </p> <p>A close friend of the couple said at the time that "Karl is an old romantic" and was more than happy to treat his wife to a lavish birthday. </p> <p><em>Images: Instagram</em></p>

Money & Banking

Placeholder Content Image

Kyle Sandilands finally reveals new eye-watering salary

<p>Kyle Sandilands has stunned listeners after candidly revealing his eye-watering salary live on air. </p> <p>Much speculation has swirled about the KIIS FM radio hosts' salaries after Kyle and Jackie O signed a new 10-year contract with the network, which was rumoured to cost $100 million. </p> <p>This figure would mean that Kyle and Jackie O would see an annual salary of $10 million, but Kyle revealed they are actually getting paid more than that. </p> <p>“I can’t live with the lie, it’s underreported," Kyle admitted on Friday morning. </p> <p>"It’s actually about another $50 million each,” he said, which means the pair will take home $15 million a year each.</p> <p>As Jackie protested at Kyle revealing their personal negotiations, Kyle continued, “I’m just saying, let’s cut through the bulls**t. And we get that because we’re good [at radio].”</p> <p>The new contract, which is said to be the biggest deal in Australian media history, will take <em>The Kyle and Jackie O Show</em> hosts to December 2034.</p> <p>The duo also have a clause in their contract that allows them to broadcast the show “anywhere on earth” at the drop of a hat.</p> <p>After revealing his astonishing salary on air, Kyle and his team began discussing the salaries of other popular radio stars in Australia.</p> <p>The show’s reporter Cooper Johns claimed that Hamish Blake and Andy Lee both make $4 million a year, while Brendan 'Fev' Fevola makes $1.2 million a year for his show on Fox FM in Melbourne.</p> <p>Meanwhile, 2GB’s Sydney breakfast host Ray Hadley is believed to be on a $3.5 million salary, WSFM’s Amanda Keller is reportedly on $2.5 million, and Carrie Bickmore is said to be making $1.5 million a year.</p> <p><em>Image credits: KIIS FM</em></p>

Money & Banking

Placeholder Content Image

Long COVID puzzle pieces are falling into place – the picture is unsettling

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/ziyad-al-aly-513663">Ziyad Al-Aly</a>, <a href="https://theconversation.com/institutions/washington-university-in-st-louis-732">Washington University in St. Louis</a></em></p> <p>Since 2020, the condition known as long COVID-19 has become a <a href="https://www.hhs.gov/civil-rights/for-providers/civil-rights-covid19/guidance-long-covid-disability/index.html">widespread disability</a> affecting the health and quality of life of millions of people across the globe and costing economies billions of dollars in <a href="https://www.oecd.org/en/publications/the-impacts-of-long-covid-across-oecd-countries_8bd08383-en.html">reduced productivity of employees and an overall drop in the work force</a>.</p> <p>The intense scientific effort that long COVID sparked has resulted in <a href="https://pubmed.ncbi.nlm.nih.gov/?term=%22long+covid%22+or+%22pasc%22+or+%22post-acute+sequelae+of+covid-19%22+or+%22postacute+sequelae+of+covid-19%22+or+%22post-acute+sequelae+of+SARS-CoV-2%22+or+%22postacute+sequelae+of+SARS-CoV-2%22+or+%22post+covid+condition%22+or+%22post+covid+conditions%22+or+%E2%80%9Cchronic+covid-19%E2%80%9D+or+%E2%80%9Cpost+covid-19+condition%E2%80%9D+or+%E2%80%9Cpost+covid-19+conditions%E2%80%9D+or+%E2%80%9Cpost-covid+condition%E2%80%9D+or+%E2%80%9Cpost-covid+conditions%E2%80%9D+or+%E2%80%9Clong+covid-19%E2%80%9D+or+%28%22long-term%22+and+%22COVID-19%22%29+or+%28%22longterm%22+and+%22COVID-19%22%29+or+%28%22long-term%22+and+%22SARS-CoV-2%22%29+or+%28%22longterm%22+and+%22SARS-CoV-2%22%29+or+%E2%80%9Cpostcovid+condition%E2%80%9D+or+%E2%80%9Cpostcovid+conditions%E2%80%9D+&amp;sort=date">more than 24,000 scientific publications</a>, making it the most researched health condition in any four years of recorded human history.</p> <p><a href="https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html">Long COVID</a> is a term that describes the <a href="https://www.yalemedicine.org/conditions/long-covid-post-covid-conditions-pcc">constellation of long-term health effects</a> caused by infection with the SARS-CoV-2 virus. These range from persistent respiratory symptoms, such as shortness of breath, to debilitating fatigue or brain fog that limits people’s ability to work, and conditions such as heart failure and diabetes, which are known to last a lifetime.</p> <p>I am a physician scientist, and I have been deeply immersed in studying long COVID since the early days of the pandemic. I have testified before the U.S. Senate as an <a href="https://www.help.senate.gov/imo/media/doc/baf4e4e7-b423-6bef-7cb4-1b272df66eb8/Al-Aly%20Testimony.pdf">expert witness on long COVID</a>, have <a href="https://scholar.google.com/citations?hl=en&amp;user=DtuRVcUAAAAJ">published extensively on it</a> and was named as one of <a href="https://time.com/6966812/ziyad-al-aly/">Time’s 100 most influential people in health in 2024</a> for my research in this area.</p> <p>Over the first half of 2024, a <a href="https://www.nationalacademies.org/our-work/long-term-health-effects-stemming-from-covid-19-and-implications-for-the-social-security-administration#sl-three-columns-afa91458-20e0-42ab-9bd6-55e3c8262ecc">flurry of reports</a> and <a href="https://doi.org/10.1056/NEJMoa2403211">scientific papers</a> on long COVID added clarity to this complex condition. These include, in particular, insights into how COVID-19 can still wreak havoc in many organs years after the initial viral infection, as well as emerging evidence on viral persistence and immune dysfunction that last for months or years after initial infection.</p> <h2>How long COVID affects the body</h2> <p>A new study that my colleagues and I published in the New England Journal of Medicine on July 17, 2024, shows that the <a href="https://doi.org/10.1056/NEJMoa2403211">risk of long COVID declined</a> over the course of the pandemic. In 2020, when the ancestral strain of SARS-CoV-2 was dominant and vaccines were not available, about 10.4% of adults who got COVID-19 developed long COVID. By early 2022, when the omicron family of variants predominated, that rate declined to 7.7% among unvaccinated adults and 3.5% of vaccinated adults. In other words, unvaccinated people were more than twice as likely to develop long COVID.</p> <p>While researchers like me do not yet have concrete numbers for the current rate in mid-2024 due to the time it takes for long COVID cases to be reflected in the data, the flow of new patients into long COVID clinics has been on par with 2022.</p> <p>We found that the decline was the result of two key drivers: availability of vaccines and changes in the characteristics of the virus – which made the virus less prone to cause severe acute infections and may have reduced its ability to persist in the human body long enough to cause chronic disease.</p> <p>Despite the decline in risk of developing long COVID, even a 3.5% risk is substantial. New and repeat COVID-19 infections translate into millions of new long COVID cases that add to an already staggering number of people suffering from this condition.</p> <p>Estimates for the first year of the pandemic suggests that at <a href="https://doi.org/10.1038/s41579-023-00896-0">least 65 million people</a> globally have had long COVID. Along with a group of other leading scientists, my team will soon publish updated estimates of the global burden of long COVID and its impact on the global economy through 2023.</p> <p>In addition, a major new report by the National Academies of Sciences Engineering and Medicine details all the <a href="https://nap.nationalacademies.org/catalog/27756/long-term-health-effects-of-covid-19-disability-and-function">health effects that constitute long COVID</a>. The report was commissioned by the Social Security Administration to understand the implications of long COVID on its disability benefits.</p> <p>It concludes that long COVID is a complex chronic condition that can result in more than 200 health effects across multiple body systems. These include new onset or worsening:</p> <ul> <li><a href="https://doi.org/10.1038/s41591-022-01689-3">heart disease</a></li> <li><a href="https://doi.org/10.1038/s41591-022-02001-z">neurologic problems</a> such as <a href="https://theconversation.com/mounting-research-shows-that-covid-19-leaves-its-mark-on-the-brain-including-with-significant-drops-in-iq-scores-224216">cognitive impairment</a>, strokes and <a href="https://my.clevelandclinic.org/health/diseases/6004-dysautonomia">dysautonomia</a>. This is a category of disorders that affect the body’s <a href="https://my.clevelandclinic.org/health/body/23273-autonomic-nervous-system">autonomic nervous system</a> – nerves that regulate most of the body’s vital mechanisms such as blood pressure, heart rate and temperature.</li> <li><a href="https://www.cdc.gov/me-cfs/hcp/clinical-care/treating-the-most-disruptive-symptoms-first-and-preventing-worsening-of-symptoms.html">post-exertional malaise</a>, a state of severe exhaustion that may happen after even minor activity — often leaving the patient unable to function for hours, days or weeks</li> <li><a href="https://doi.org/10.1038/s41467-023-36223-7">gastrointestinal disorders</a></li> <li><a href="https://doi.org/10.1681/ASN.2021060734">kidney disease</a></li> <li>metabolic disorders such as <a href="https://doi.org/10.1016/S2213-8587(22)00044-4">diabetes</a> and <a href="https://doi.org/10.1016/S2213-8587(22)00355-2">hyperlipidemia</a>, or a rise in bad cholesterol</li> <li><a href="https://doi.org/10.1038/s41590-023-01724-6">immune dysfunction</a></li> </ul> <p>Long COVID can affect people across the lifespan from children to older adults and across race and ethnicity and baseline health status. Importantly, <a href="https://doi.org/10.1126/science.adl0867">more than 90% of people with long COVID</a> had mild COVID-19 infections.</p> <p>The National Academies report also concluded that long COVID can result in the inability to return to work or school; poor quality of life; diminished ability to perform activities of daily living; and decreased physical and cognitive function for months or years after the initial infection.</p> <p>The report points out that many health effects of long COVID, such as post-exertional malaise and chronic fatigue, cognitive impairment and autonomic dysfunction, are not currently captured in the <a href="https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm">Social Security Administration’s Listing of Impairments</a>, yet may significantly affect an individual’s ability to participate in work or school.</p> <figure><iframe src="https://www.youtube.com/embed/9kJ5GWb2wzw?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Many people experience long COVID symptoms for years following initial infection.</span></figcaption></figure> <h2>A long road ahead</h2> <p>What’s more, health problems resulting from COVID-19 can last years after the initial infection.</p> <p>A large study published in early 2024 showed that even people who had a <a href="https://doi.org/10.1038/s41591-024-02987-8">mild SARS-CoV-2 infection still experienced new health problems</a> related to COVID-19 in the third year after the initial infection.</p> <p>Such findings parallel other research showing that the <a href="https://doi.org/10.1016/S1473-3099(24)00171-3">virus persists</a> in various organ systems for months or years after COVID-19 infection. And research is showing that immune responses to the infection are <a href="https://doi.org/10.1126/scitranslmed.adk3295">still evident two to three years</a> after a mild infection. Together, these studies may explain why a SARS-CoV-2 infection years ago could still cause new health problems long after the initial infection.</p> <p>Important progress is also being made in understanding the pathways by which long COVID wreaks havoc on the body. Two preliminary studies <a href="https://doi.org/10.1101/2024.06.18.24309100">from the U.S.</a> and <a href="https://doi.org/10.1101/2024.05.30.596590">the Netherlands</a> show that when researchers transfer auto-antibodies – antibodies generated by a person’s immune system that are directed at their own tissues and organs – from people with long COVID into healthy mice, the animals start to experience long COVID-like symptoms such as muscle weakness and poor balance.</p> <p>These studies suggest that an abnormal immune response thought to be responsible for the generation of these auto-antibodies may underlie long COVID and that <a href="https://doi.org/10.1126/science.zbzipqn">removing these auto-antibodies</a> may hold promise as potential treatments.</p> <h2>An ongoing threat</h2> <p>Despite overwhelming evidence of the wide-ranging risks of COVID-19, a great deal of messaging suggests that it is no longer a threat to the public. Although there is no empirical evidence to back this up, this misinformation has permeated the public narrative.</p> <p>The data, however, tells a different story.</p> <p><a href="https://covid.cdc.gov/covid-data-tracker/#datatracker-home">COVID-19 infections</a> continue to <a href="https://www.cdc.gov/flu/weekly/index.htm">outnumber flu cases</a> and lead to <a href="https://www.cdc.gov/resp-net/dashboard/index.html">more hospitalization</a> and <a href="https://doi.org/10.1001/jama.2024.7395">death</a> than the flu. COVID-19 also leads to <a href="https://doi.org/10.1016/S1473-3099(23)00684-9">more serious long-term health problems</a>. Trivializing COVID-19 as an inconsequential cold or <a href="https://www.theatlantic.com/health/archive/2024/02/covid-anniversary-flu-isolation-cdc/677588/">equating it with the flu</a> does not align with reality.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/233759/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/ziyad-al-aly-513663">Ziyad Al-Aly</a>, Chief of Research and Development, VA St. Louis Health Care System. Clinical Epidemiologist, <a href="https://theconversation.com/institutions/washington-university-in-st-louis-732">Washington University in St. Louis</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/long-covid-puzzle-pieces-are-falling-into-place-the-picture-is-unsettling-233759">original article</a>.</em></p> </div>

Body

Placeholder Content Image

Doctor shares her holy grail tips for overcoming eye sensitivity

<p>As the chill of winter sets in, many people find that their eyes become more sensitive and prone to dryness. This can be particularly challenging for those who already suffer from dry eye syndrome. </p> <p>Dr. Jacqueline Beltz is a leading Australian Ophthalmologist and the founder of <a href="https://www.okkiyo.com" target="_blank" rel="noopener">OKKIYO</a>, a beauty brand that makes PRIORITEYES mascara for people with sensitive eyes.</p> <p>Dr Beltz has shared her insights into dry eye syndrome and how winter can exacerbate symptoms, also sharing her top tips for managing eye sensitivity during the colder months.</p> <p><strong>Understanding Dry Eye Syndrome</strong></p> <p>The surface of the eye is covered by a delicate layer of tears, essential for comfort, vision, protection, and nutrition. The tear film comprises two main layers: an outer lipid (oily) layer and an inner aqueous (watery) layer. The lipid layer, produced by oil glands in the eyelids, prevents tears from evaporating too quickly, while the aqueous layer, consisting of water, electrolytes, and proteins, spreads tears evenly across the eye and helps them adhere to the surface.</p> <p>When the balance of tear production, evaporation, absorption, and drainage is disrupted, it can lead to dry eye syndrome. Symptoms may include redness, irritation, a gritty sensation, tired eyes, itching, excessive watering, and fluctuating vision. In severe cases, dry eye can be painful and significantly impact daily life.</p> <p><strong>How common is dry eye syndrome?</strong></p> <p>Dry eye syndrome is a widespread issue, particularly among older adults. According to the Blue Mountains Eye Study, 57% of adults over the age of 50 experience some degree of dry eye. This condition is notably more prevalent in women, with higher rates observed compared to their male counterparts. The increased prevalence in women is often attributed to hormonal changes, particularly during and after menopause. </p> <p>A more recent study, Optometry Australia’s 2022 Vision index found that over 85% of Australians are estimated to have experienced dry eyes at some point in their lives.  Of those affected, 55% say they only developed the condition following the beginning of the pandemic in 2020.  They reported that almost 1 in 5 (18%) of people experience dry eye symptoms frequently.  </p> <p>These statistics highlight the importance of understanding and managing dry eye, especially as we age.</p> <p><strong>DEWS II Study and Treatment Approaches</strong></p> <p>The DEWS II (Dry Eye Workshop II) study provides a comprehensive framework for understanding and treating dry eye syndrome. According to the study, dry eye is a multifactorial disease characterised by a loss of homeostasis (or balance) in the tear film, accompanied by eye symptoms. Factors such as tear film instability, hyperosmolarity (increased saltiness), inflammation, and neurosensory (altered feelings or sensations) abnormalities play significant roles.</p> <p>There are two primary types of dry eye: aqueous deficient and evaporative. Most individuals have a combination of both. Aqueous deficient dry eye occurs when there is insufficient production of the watery layer of tears, often due to aging, hormonal changes, or certain medications. Evaporative dry eye is typically caused by environmental factors or conditions affecting the lipid layer, such as meibomian gland dysfunction (MGD).</p> <p><strong>Winter's Impact on Dry Eyes</strong></p> <p>Winter poses unique challenges for dry eye sufferers. Cold, dry air, indoor heating, and wind can all exacerbate symptoms. Here's how to combat these winter-specific issues:</p> <p><em><strong>1. Humidify Your Environment</strong></em></p> <p>Indoor heating reduces humidity levels, leading to increased tear evaporation. Consider using a humidifier to maintain moisture in the air, especially in bedrooms and living spaces. This helps keep your eyes hydrated.</p> <p><em><strong>2. Protect Your Eyes Outdoors</strong></em></p> <p>Cold winds can strip away the tear film. When outside, wear wraparound sunglasses to shield your eyes from the elements. This not only protects your eyes from the wind but also from UV rays, which can be strong even in winter.</p> <p><em><strong>3. Stay Hydrated</strong></em></p> <p>Dehydration can worsen dry eye symptoms. Drink plenty of water throughout the day to maintain overall hydration, which supports healthy tear production.</p> <p><em><strong>4. Optimise Your Diet</strong></em></p> <p>Certain foods can promote eye health. Omega-3 fatty acids, found in fish like salmon and flaxseeds, have anti-inflammatory properties that can help manage dry eye symptoms. Incorporate these into your diet for added benefits.</p> <p><em><strong>5. Use a Warm Compress</strong></em></p> <p>A warm compress can help improve the function of the meibomian glands, which produce the oily layer of the tear film. This is particularly helpful for those with meibomian gland dysfunction, or MGD. Gently apply a warm, damp cloth to your closed eyelids for 10-15 minutes, followed by a gentle massage of the eyelids to encourage oil secretion. It is important to avoid rubbing or compressing the eyeballs.</p> <p><em><strong>6. Use Over-the-Counter Lubricant Eye Drops</strong></em></p> <p>Artificial tears can provide temporary relief by supplementing the natural tear film. Choose preservative-free options to avoid further irritation, and use them frequently.</p> <p><em><strong>7.  Remember to have regular eye checks</strong></em></p> <p>In Australia, Optometrists provide our primary eye health check ups. Dr Beltz recommends adults over the age of 40 see their optometrist once a year, but if you’re struggling with symptoms of dry eye in winter, an extra check up might help and your optometrist will be able to help you to come up with an individualised treatment plan.</p> <p><em><strong>8. Invest in Quality Eye Products</strong></em></p> <p>For those who wear makeup, using products designed for sensitive eyes is crucial. <a href="https://www.okkiyo.com/products/protect-and-preserve-mascara" target="_blank" rel="noopener">PRIORITEYES</a> mascara by OKKIYO has been specifically formulated to be gentle on sensitive eyes, avoiding common irritants while providing excellent performance.</p> <p><strong>Managing Dry Eye in Winter: A Recap</strong></p> <p>Winter can be tough on our eyes, but with the right strategies, you can manage dry eye symptoms effectively. Maintain a humid environment, protect your eyes from cold winds, stay hydrated, and incorporate eye-healthy foods into your diet. Regularly use warm compresses and opt for gentle, high-quality eye products like PRIORITEYES mascara.  </p> <p>Dry eye syndrome may be a common condition, but it doesn't have to dominate your life, especially during the harsh winter months. With these tips, you can keep your eyes comfortable and healthy all season long. For personalised advice and treatment, always consult with your eye care professional.</p> <p>Stay warm, stay hydrated and take care of your eyes this winter!</p> <p><em>Image credits: Shutterstock </em></p>

Body

Placeholder Content Image

AFL great's son in induced coma after mystery brain infection

<p>Geelong great Peter Riccardi has revealed his son, Osca, was briefly put on life support after suffering a mystery infection on the brain. </p> <p>Speaking on the podcast Beyond The Boundary, the former AFL player revealed that his son became suddenly ill a fortnight ago. </p> <p>“A couple of Sundays ago (Osca) came home, been out with a few of his mates, he’d been to the beach, went out for dinner, went out to play 10-pin bowling ... and said he was going to bed,” Peter Riccardi said. </p> <p>“Then halfway through the night he was up, he was vomiting, he was feeling a bit crook ... we just thought he was run down.</p> <p>“But come lunchtime, he couldn’t talk, he could hardly walk.”</p> <p>He added that they were extremely lucky his wife Mel worked from home that day and rushed Osca straight to hospital, where they found some "swelling" on his brain following a scan. </p> <p>Doctors also found that he had a sinus and ear infection and glandular fever  all “rolled into one”.</p> <p>“Whether the swim did something with his ears and went into his brain, I’m not 100 per cent sure, yet,” Riccardi said.</p> <p>“They put him an induced coma for three days. He was in ICU (Intensive Care Unit) for four days.</p> <p>“But he’s back home now recovering ... you wouldn’t know that two weeks ago, watching him on life support, and seeing him now, it’s amazing what they do in there.”</p> <p>The podcast hosts then asked how scary the situation was for Riccardi and his wife, and he responded: “It was, yeah ... obviously they have got to prepare you for the worst (outcome)."</p> <p>“That was probably the worst thing to hear, because we didn’t know how he was going to come out of it.</p> <p>“But again, like I said, if Mel had gone to work that day, he wouldn’t be here today.</p> <p>“We’re pretty lucky, we’re pretty lucky.</p> <p>“It must have been a mother’s intuition or mother’s instinct to stay at home that day.”</p> <p><em>Image: Facebook/ Geelong Cats</em></p>

Caring

Placeholder Content Image

Eye infections might seem like a minor complaint – but in some cases they can cause blindness and even death

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a></em></p> <p>When you think of eye infections, what comes to mind? Puffy, swollen bruised feeling eyelids that get glued together with gunk overnight? That feeling of having grit in your eye that can’t be cleaned away? Eye infections may seem like a relatively minor – if unsightly and inconvenient – complaint, but they can also be far more serious.</p> <p>Take the deadly outbreak of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5022785/">antibiotic resistant</a> bacteria <a href="https://www.cff.org/managing-cf/burkholderia-cepacia-complex-b-cepacia"><em>Burkholderia cepacia</em></a> in 2023-24, for example.</p> <p>Between January 2023 and February 2024, contaminated brands of lubricating eye gel were linked to the infection of at least 52 patients. <a href="https://www.independent.co.uk/news/health/contaminated-eye-gel-outbreak-death-b2523446.html">One person died</a> and at least 25 others suffered serious infections.</p> <p>The outbreak has now subsided and products are <a href="https://www.gov.uk/drug-device-alerts/specific-brands-of-carbomer-eye-gel-recall-of-aacarb-eye-gel-aacomer-eye-gel-and-puroptics-eye-gel-potential-risk-of-infection-dsi-slash-2023-slash-11#update-2-april-2024">back on the shelves</a> but it isn’t the first time that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8335909/">medicinal products</a> have led to outbreaks of <em>B cepacia</em>.</p> <p>The bacterium is an opportunistic pathogen known to pose a significant risk to people with cystic fibrosis, chronic lung conditions and weakened immune systems. The infection likely progresses from the mucous membranes of the eyelids to the lungs where it leads to pneumonia and septicaemia causing <a href="https://erj.ersjournals.com/content/17/2/295">death in days</a>.</p> <p>But it’s not just <em>B cepacia</em> that can threaten our health. Something as simple as rubbing our eyes can introduce pathogens leading to infection, blindness and, in the worst case, death.</p> <p>Bacteria account for up to <a href="https://pubmed.ncbi.nlm.nih.gov/16148850/">70% of eye infections</a> and globally <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9032492/">over 6 million people</a> have blindness or moderate visual impairment from ocular infection. Contact lens wearers are at <a href="https://www.aao.org/eye-health/diseases/contact-lens-related-eye-infections">increased risk</a>.</p> <figure><iframe src="https://www.youtube.com/embed/pWsx8i1kaxs?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>The eye is a unique structure. It converts light energy to chemical and then electrical energy, which is transmitted to the brain and converted to a picture. The eye uses about <a href="https://www.ncbi.nlm.nih.gov/books/NBK11556/">6 million cones and 120 million rods</a> which detect colour and light.</p> <p>Eye cells have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8775779/">no ability to regenerate</a> so, once damaged or injured, cannot be repaired or replaced. The body tries its best to preserve the eyes by encasing them in a <a href="https://www.ncbi.nlm.nih.gov/books/NBK531490/">bony protective frame</a> and <a href="https://www.ncbi.nlm.nih.gov/books/NBK482428/">limiting exposure</a> having eyelids to defend against the environmental damage and ensure the eyes are kept lubricated.</p> <p>Despite our bodies’ best efforts to shield the eyes from harm, there are a number of common eye infections that can result from introducing potential pathogens into the eyes.</p> <h2>Conjunctivitis</h2> <p>The outer-most layer of the eye, the sclera, bears the brunt of exposure and to help protect it, it is lined by a thin moist membrane called the <a href="https://my.clevelandclinic.org/health/body/24329-conjunctiva">conjunctiva</a>.</p> <figure><iframe src="https://www.youtube.com/embed/RZ4danuJwd0?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>The conjunctiva is <a href="https://innovations.bmj.com/content/9/4/253">highly vascularised</a>, which means it has lots of blood vessels. When microbes enter the eye, it is this layer that mounts an immune response causing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328962/">blood vessels to dilate</a> in the conjunctiva. This results in <a href="https://www.cdc.gov/conjunctivitis/about/symptoms.html">“pink eye”</a>, a common form of conjunctivitis. Conjunctivitis can be caused by bacteria, allergens or viruses and typically heals by itself.</p> <h2>Blepharitis</h2> <p>Blepharitis is an inflammation of the eyelid and usually affects both sides. It can cause itchy eyes and dandruff-like flakes. It’s most commonly caused by <a href="https://www.tandfonline.com/doi/pdf/10.3109/09273948.2013.870214"><em>Staphylococcus</em> bacteria</a>, or the <a href="https://cks.nice.org.uk/topics/blepharitis/background-information/causes/">dysfunction of the glands</a> of the eyelids. It can be treated by <a href="https://www.nhs.uk/conditions/blepharitis/">cleaning the eyes</a> regularly.</p> <h2>Stye</h2> <p>A stye (also called <a href="https://www.college-optometrists.org/clinical-guidance/clinical-management-guidelines/hordeolum">hordeolum</a>) is a painful infection of the upper or lower eyelid. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5370090/">Internal styes</a> are caused by infection of an oil-producing gland inside the eyelid, whereas <a href="https://pubmed.ncbi.nlm.nih.gov/28723014/">external styes</a> develop at the base of the eyelash because of an infection of the hair follicle. Both are caused by bacteria, typically <a href="https://jamanetwork.com/journals/jamaophthalmology/fullarticle/1874715">the <em>S aureus</em> form of the <em>Staphylococcus</em> species</a>.</p> <figure><iframe src="https://www.youtube.com/embed/INKrGOdy824?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Styes can be treated by holding a clean flannel soaked in warm water against the affected eye for five to ten minutes, three or four times a day. Do not try to burst styes – this could spread the infection.</p> <h2>Keratitis</h2> <p>Keratitis is the inflammation of the cornea, the transparent part of the eye that light passes through. The cornea is part of the eye’s main barrier against dirt, germs, and disease. Severe keratitis can cause ulcers, damage to the eye and even blindness.</p> <p>The most common type is bacterial keratitis; however, it can also be caused by <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7998329/">amoeba</a>, which can migrate to other parts of the body – including the brain – and cause infection and <a href="https://theconversation.com/nasal-rinsing-why-flushing-the-nasal-passages-with-tap-water-to-tackle-hay-fever-could-be-fatal-225811">even death</a>.</p> <p>Noninfectious keratitis is most commonly caused by wearing contact lenses for too long, especially while sleeping. This can cause scratches, dryness and soreness of the cornea, which leads to inflammation.</p> <h2>Uveitis</h2> <p><a href="https://www.nhs.uk/conditions/uveitis/">Uveitis</a> is inflammation of the middle layer of the eye. Although relatively rare, it is a serious condition and usually results from viral infections such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8501150/">herpes simplex</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/29023181/">herpes zoster</a> or <a href="https://link.springer.com/chapter/10.1007/978-3-319-09126-6_40">trauma</a>. Depending on where the inflammation is in the eye, the symptoms can be anything from redness, pain and floaters to blurred vision and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1772296/">partial blindness</a>.</p> <h2>Exogenous endophthalmitis</h2> <p>This is a rare but serious infection caused by eye surgery complications, penetrating ocular trauma (being stabbed in the eye with a sharp object) or foreign bodies in the eye. Foreign bodies can be anything from dirt and dust to small projectiles such as shards of metal from drilling, explosives or soil from farm machinery and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286045/">many other sources</a>.</p> <h2>Dacryocystitis</h2> <p>Dacryocystitis is the inflammation of the nasolacrimal sac, which drains tears away from the eye into the nose. This condition can be <a href="https://pubmed.ncbi.nlm.nih.gov/8443113/">acute</a>, <a href="https://www.nature.com/articles/6700662">chronic</a> or <a href="https://www.jebmh.com/articles/a-study-of-congenital-dacryocystitis.pdf.pdf">acquired at birth</a>. Most cases are caused by <a href="https://bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-020-01792-4"><em>Streptococcus pneumoniae</em> and <em>Staphylococcus aureus</em></a> bacteria.</p> <p>The condition mainly affects newborns and those over 40. Seventy-five per cent of cases are women and it’s most commonly found in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039673/">white adults</a>. It can lead to the stagnation of tears, creating a breeding ground for microbes.</p> <h2>Careful with contacts</h2> <p>Proper eye hygiene reduces the risk of all these conditions – and this is even more important for contact lens wearers.</p> <figure><iframe src="https://www.youtube.com/embed/uENHAntJOIA?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Appropriate hygienic cleaning of lenses is paramount. <a href="https://pubmed.ncbi.nlm.nih.gov/30789440/">Non-sterile water</a>, <a href="https://www.aao.org/eye-health/glasses-contacts/contact-lens-care">spit</a> and other fluids can transfer <a href="https://www.science.org/content/article/bacteria-living-your-contact-lens-solution">potentially dangerous</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482476/">microbes</a> into the eye – a warm, moist environment that makes an ideal breeding ground for bacteria – leading to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9542356/">localised infection</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3972779/">blindness</a> or progress to a more serious <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9835757/">systemic infection or death</a>.</p> <p>Any persistent and painful redness or swelling of eyes should be checked by a registered health professional.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/227252/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, Professor and Director of the Clinical Anatomy Learning Centre, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/eye-infections-might-seem-like-a-minor-complaint-but-in-some-cases-they-can-cause-blindness-and-even-death-227252">original article</a>.</em></p> </div>

Body

Placeholder Content Image

Could my glasses be making my eyesight worse?

<p><em><a href="https://theconversation.com/profiles/james-armitage-399647">James Armitage</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/nick-hockley-1517162">Nick Hockley</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p>So, you got your eyesight tested and found out you need your first pair of glasses. Or you found out you need a stronger pair than the ones you have. You put them on and everything looks crystal clear. But after a few weeks things look blurrier without them than they did before your eye test. What’s going on?</p> <p>Some people start to wear spectacles for the first time and perceive their vision is “bad” when they take their glasses off. They incorrectly interpret this as the glasses making their vision worse. Fear of this might make them <a href="https://www.bbc.com/future/article/20140513-do-glasses-weaken-your-eyesight#:%7E:text=A%20study%20from,they%20are%20right%3F">less likely to wear their glasses</a>.</p> <p>But what they are noticing is how much better the world appears through the glasses. They become <a href="https://www.tandfonline.com/doi/full/10.1080/2576117X.2022.2033588">less tolerant</a> of a blurry world when they remove them.</p> <p>Here are some other things you might notice about eyesight and wearing glasses.</p> <h2>Lazy eyes?</h2> <p>Some people sense an increasing reliance on glasses and wonder if their eyes have become “lazy”.</p> <p>Our eyes work in much the same way as an auto-focus camera. A flexible lens inside each eye is controlled by muscles that let us <a href="https://www.aao.org/museum-eye-openers/how-does-eye-focus">focus on objects</a> in the distance (such as a footy scoreboard) by relaxing the muscle to flatten the lens. When the muscle contracts it makes the lens steeper and more powerful to see things that are much closer to us (such as a text message).</p> <p>From the age of about 40, the lens in our eye <a href="https://theconversation.com/why-we-lose-our-hearing-and-vision-as-we-age-67930">progressively hardens</a> and loses its ability to change shape. Gradually, we lose our capacity to focus on near objects. This is called “<a href="https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/presbyopia">presbyopia</a>” and at the moment there are no treatments for this lens hardening.</p> <p>Optometrists correct this with prescription glasses that take the load of your natural lens. The lenses allow you to see those up-close images clearly by providing extra refractive power.</p> <p>Once we are used to seeing clearly, our tolerance for blurry vision will be lower and we will reach for the glasses to see well again.</p> <h2>The wrong glasses?</h2> <p>Wearing old glasses, the wrong prescription (or even someone else’s glasses) won’t allow you to see as well as possible for day-to-day tasks. It could also cause <a href="https://headaches.org/readers-mail-glasses-causing-headache/">eyestrain and headaches</a>.</p> <p>Incorrectly prescribed or dispensed prescription glasses can lead to vision impairment in children <a href="https://iovs.arvojournals.org/article.aspx?articleid=2126392">as their visual system is still in development</a>.</p> <p>But it is more common for kids to develop long-term vision problems as a result of <a href="https://www.cera.org.au/wp-content/uploads/2021/08/Healthy-Young-Eyes-Guide-ACC.pdf">not wearing glasses when they need them</a>.</p> <p>By the time children are about 10–12 years of age, wearing incorrect spectacles is less likely to cause their eyes to become lazy or damage vision in the long term, but it is likely to result in <a href="https://www.cera.org.au/wp-content/uploads/2021/08/Healthy-Young-Eyes-Guide-ACC.pdf">blurry or uncomfortable vision</a> during daily wear.</p> <p><a href="https://goodvisionforlife.com.au/">Registered optometrists in Australia</a> are trained to assess refractive error (whether the eye focuses light into the retina) as well as the different aspects of ocular function (including how the eyes work together, change focus, move around to see objects). All of these help us see clearly and comfortably.</p> <h2>What about dirty glasses?</h2> <p>Dirty or scratched glasses can give you the impression your vision is worse than it actually is. Just like a window, the dirtier your glasses are, the more difficult it is to see clearly through them. <a href="https://www.optometry.org.au/wp-content/uploads/GVFL/Brochure_PDFs/Care-for-Glasses-2018-A4-single-page-final.pdf">Cleaning glasses regularly</a> with a microfibre lens cloth will help.</p> <p>While dirty glasses are not commonly associated with eye infections, some research suggests dirty glasses can <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0207238">harbour bacteria</a> with the remote but theoretical <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6628431/#:%7E:text=59%2C60%5D.-,S.,39%2C40%2C41%5D.">potential to cause eye infection</a>.</p> <p>To ensure best possible vision, people who wear prescription glasses every day should clean their lenses at least every morning and twice a day where required. Cleaning frames with alcohol wipes can <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0207238">reduce bacterial contamination by 96%</a> – but care should be taken as alcohol can damage some frames, depending on what they are made of.</p> <h2>When should I get my eyes checked?</h2> <p><a href="https://goodvisionforlife.com.au/faqs/">Regular eye exams</a>, starting just before school age, are important for ocular health. Most prescriptions for corrective glasses <a href="https://www.ahpra.gov.au/documents/default.aspx?record=WD16%2F20156&amp;dbid=AP&amp;chksum=676U2aH1QM4XJ6ICVAVaKg%3D%3D">expire within two years</a> and contact lens prescriptions often expire after a year. So you’ll need an eye check for a new pair every year or so.</p> <p>Kids with ocular conditions such as progressive myopia (short-sightedness), strabismus (poor eye alignment), or amblyopia (reduced vision in one eye) will need checks at least every year, but likely more often. Likewise, people over 65 or who have known eye conditions, such as <a href="https://goodvisionforlife.com.au/vision-problems/glaucoma/">glaucoma</a>, will be recommended more frequent checks.</p> <p>An <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6706420/">online prescription estimator</a> is no substitute for a full eye examination. If you have a valid prescription then you can order glasses online, but you miss out on the ability to check the fit of the frame or to have them adjusted properly. This is particularly important for multifocal lenses where even a millimetre or two of misalignment can cause uncomfortable or blurry vision.</p> <p>Conditions such as <a href="https://www.cdc.gov/diabetes/managing/diabetes-vision-loss.html#:%7E:text=Diabetic%20retinopathy%20is%20caused%20when,vision%20or%20stopping%20blood%20flow.">diabetes</a> or <a href="https://www.ncbi.nlm.nih.gov/books/NBK525980/">high blood pressure</a>, can affect the eyes so regular eye checks can also help flag broader health issues. The vast majority of eye conditions can be treated if caught early, highlighting the importance of regular preventative care.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225169/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/james-armitage-399647">James Armitage</a>, Associate Professor in Vision Science, Optometry Course Director, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/nick-hockley-1517162">Nick Hockley</a>, Lecturer in Optometric Clinical Skills, Director Deakin Collaborative Eye Care Clinic, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/could-my-glasses-be-making-my-eyesight-worse-225169">original article</a>.</em></p>

Body

Placeholder Content Image

Why do I keep getting urinary tract infections? And why are chronic UTIs so hard to treat?

<p><em><a href="https://theconversation.com/profiles/iris-lim-1204657">Iris Lim</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>Dealing with chronic urinary tract infections (UTIs) means facing more than the occasional discomfort. It’s like being on a never ending battlefield against an unseen adversary, making simple daily activities a trial.</p> <p>UTIs happen when bacteria sneak into the urinary system, causing pain and frequent trips to the bathroom.</p> <p>Chronic UTIs take this to the next level, coming back repeatedly or never fully going away despite treatment. <a href="https://www.ncbi.nlm.nih.gov/books/NBK557479/">Chronic UTIs</a> are typically diagnosed when a person experiences two or more infections within six months or three or more within a year.</p> <p>They can happen to anyone, but some are more prone due to their <a href="https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-adults">body’s makeup or habits</a>. Women are more likely to get UTIs than men, due to their shorter urethra and hormonal changes during menopause that can decrease the protective lining of the urinary tract. Sexually active people are also at greater risk, as bacteria can be transferred around the area.</p> <p>Up to <a href="https://www.urologyhealth.org/urology-a-z/u/urinary-tract-infections-in-adults#Related%20Resources">60% of women</a> will have at least one UTI in their lifetime. While effective treatments exist, <a href="https://www.health.harvard.edu/bladder-and-bowel/when-urinary-tract-infections-keep-coming-back#:%7E:text=Your%20urine%20might%20be%20cloudy,they%20take%20on%20your%20life.">about 25%</a> of women face recurrent infections within six months. Around <a href="https://sciendo.com/article/10.33073/pjm-2019-048?tab=article">20–30%</a> of UTIs don’t respond to standard antibiotic. The challenge of chronic UTIs lies in bacteria’s ability to shield themselves against treatments.</p> <h2>Why are chronic UTIs so hard to treat?</h2> <p>Once thought of as straightforward infections cured by antibiotics, we now know chronic UTIs are complex. The cunning nature of the bacteria responsible for the condition allows them to hide in bladder walls, out of antibiotics’ reach.</p> <p>The bacteria form biofilms, a kind of protective barrier that makes them nearly impervious to standard antibiotic treatments.</p> <p>This ability to evade treatment has led to a troubling <a href="https://theconversation.com/rising-antibiotic-resistance-in-utis-could-cost-australia-1-6-billion-a-year-by-2030-heres-how-to-curb-it-149543">increase in antibiotic resistance</a>, a global health concern that renders some of the conventional treatments ineffective.</p> <p>Antibiotics need to be advanced to keep up with evolving bacteria, in a similar way to the flu vaccine, which is updated annually to combat the latest strains of the flu virus. If we used the same flu vaccine year after year, its effectiveness would wane, just as overused antibiotics lose their power against bacteria that have adapted.</p> <p>But fighting bacteria that resist antibiotics is much tougher than updating the flu vaccine. Bacteria change in ways that are harder to predict, making it more challenging to create new, effective antibiotics. It’s like a never-ending game where the bacteria are always one step ahead.</p> <p>Treating chronic UTIs still relies heavily on antibiotics, but doctors are getting crafty, changing up medications or prescribing low doses over a longer time to outwit the bacteria.</p> <p>Doctors are also placing a greater emphasis on thorough diagnostics to accurately identify chronic UTIs from the outset. By asking detailed questions about the duration and frequency of symptoms, health-care providers can better distinguish between isolated UTI episodes and chronic conditions.</p> <p>The approach to initial treatment can significantly influence the likelihood of a UTI becoming chronic. Early, targeted therapy, based on the specific bacteria causing the infection and its antibiotic sensitivity, may reduce the risk of recurrence.</p> <p>For post-menopausal women, <a href="https://link.springer.com/article/10.1007/s00192-020-04397-z">estrogen therapy</a> has shown promise in reducing the risk of recurrent UTIs. After menopause, the decrease in estrogen levels can lead to changes in the urinary tract that makes it more susceptible to infections. This treatment restores the balance of the vaginal and urinary tract environments, making it less likely for UTIs to occur.</p> <p>Lifestyle changes, such as <a href="https://journals.lww.com/co-nephrolhypertens/FullText/2013/05001/Impact_of_fluid_intake_in_the_prevention_of.1.aspx">drinking more water</a> and practising good hygiene like washing hands with soap after going to the toilet and the recommended front-to-back wiping for women, also play a big role.</p> <p>Some swear by cranberry juice or supplements, though researchers are still figuring out <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001322.pub2/full">how effective these remedies truly are</a>.</p> <h2>What treatments might we see in the future?</h2> <p>Scientists are currently working on new treatments for chronic UTIs. One promising avenue is the development of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052183/pdf/pathogens-12-00359.pdf">vaccines</a> aimed at preventing UTIs altogether, much like flu shots prepare our immune system to fend off the flu.</p> <p>Another new method being looked at is called <a href="https://link.springer.com/article/10.1007/s12223-019-00750-y">phage therapy</a>. It uses special viruses called bacteriophages that go after and kill only the bad bacteria causing UTIs, while leaving the good bacteria in our body alone. This way, it doesn’t make the bacteria resistant to treatment, which is a big plus.</p> <p>Researchers are also exploring the potential of <a href="https://www.mdpi.com/2079-6382/12/1/167">probiotics</a>. Probiotics introduce beneficial bacteria into the urinary tract to out-compete harmful pathogens. These good bacteria work by occupying space and resources in the urinary tract, making it harder for harmful pathogens to establish themselves.</p> <p>Probiotics can also produce substances that inhibit the growth of harmful bacteria and enhance the body’s immune response.</p> <p>Chronic UTIs represent a stubborn challenge, but with a mix of current treatments and promising research, we’re getting closer to a day when chronic UTIs are a thing of the past.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223008/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/iris-lim-1204657">I<em>ris Lim</em></a><em>, Assistant Professor, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-keep-getting-urinary-tract-infections-and-why-are-chronic-utis-so-hard-to-treat-223008">original article</a>.</em></p>

Body

Placeholder Content Image

Mission: Impossible Sydney mansion sells for eye-watering price

<p>One of Sydney's most iconic properties, known as the Boomerang in Elizabeth Bay, has sold for $80 million. </p> <p>The mansion is featured in the second instalment in the <em>Mission: Impossible</em> franchise, with the 2000 movie starring Tom Cruise being set and filmed in Sydney.</p> <p>It was the first house to officially sell for above $1 million in 1978, before setting another record in 2002 when it fetched $20.7 million.</p> <p>Now, multiple sources have confirmed it has been snapped up by a purchaser, originally from Asia, for four times what it last sold for. </p> <p>The property has long been rated as one of Sydney’s Top 50 homes, and has been in the name of Katrina Fox, the daughter of Melbourne-based billionaire trucking magnate Lindsay Fox, since 2005. </p> <p>The impressive home was put up for sale by Ray White in 2017 with hopes of selling for $60 million and then again with Brad Pillinger of Pillinger for $80 million in 2021 — the last agent to have it listed.</p> <p>Pillinger couldn’t be contacted ahead of publication, but other sources have confirmed the property has sold for the $80m asking price, while speculation from other sources that the result was $105 million have been dismissed.</p> <p>Boomerang sits on 4233 square metres of waterfront land, and features 25 rooms including a private cinema modelled on the State Theatre.</p> <p><em>Image credits: realestate.com.au / Paramount Pictures</em></p>

Real Estate

Placeholder Content Image

Top tips for happy and healthy eyes this Autumn

<p dir="ltr">As the season changes, so do our healthcare needs as many people struggle with irritating allergies. </p> <p dir="ltr">With cooler temperatures, dry air and an increase in pollen often being synonymous with autumn and spring, for many people, leaving the house means having irritated eyes. </p> <p dir="ltr">Luckily, leading Ophthalmologist, Dr. Jacqueline Beltz has shared her essential tips for eye care during autumn with OverSixty, giving you the opportunity to enjoy the change of seasons without jeopardising your vision. </p> <p dir="ltr"><strong>1. Keep your sunglasses handy</strong></p> <p dir="ltr">While the sun is usually not as intense in autumn as it is during summer, Dr Beltz says that using sunglasses can benefit your eyes in many ways. </p> <p dir="ltr">“ Not only do they shield your eyes from harmful UV rays, but they also guard against wind and debris,” she said. </p> <p dir="ltr"><strong>2. Increase your lubricant eye drops</strong></p> <p dir="ltr">Dr Beltz said, “The drop in temperature and the dryer air can contribute to discomfort and dryness in your eyes, so consider increasing the use of lubricant eye drops to keep your eyes moist and comfortable.”</p> <p dir="ltr">By keeping up your eye drops in autumn, you can prevent further damage to your eyes in the long run. </p> <p dir="ltr"><strong>3. Clean your eyelashes daily</strong></p> <p dir="ltr">According to Dr Beltz, keeping up with good health and hygiene along the eyelid margins is essential, especially during the autumn months. </p> <p dir="ltr">“Cleanse your lashes daily and use a warm compress to optimise the quality of your tear film. This helps in preventing irritation and supports overall eye health.”</p> <p dir="ltr"><strong>4. Consider a humidifier</strong></p> <p dir="ltr">To ensure a more comfortable environment for your eyes, Dr Beltz recommends adding moisture to the air can help alleviate dry eyes.</p> <p dir="ltr">She said, “Combat the dry indoor air by using a humidifier in your room, especially while you sleep.”</p> <p dir="ltr"><strong>5. Be proactive with allergies</strong></p> <p dir="ltr">If you are prone to allergies, Dr Beltz said it's best to always be prepared ahead of time. </p> <p dir="ltr">“Autumn allergies are a reality, with triggers like pollen, mould, and dust prevalent during this season,” she said. </p> <p dir="ltr">“If you experience red, itchy, or swollen eyes, consider antihistamine eye drops. Keep your hands clean and avoid rubbing your eyes.”</p> <p dir="ltr"><strong>6. Revitalise your eye makeup</strong></p> <p dir="ltr">While replacing your eye makeup is important all year around, the addition of allergens makes it even more important to Change mascara and non-cleanable products like liquid eyeliner at least every three months. </p> <p dir="ltr">“Especially if you have sensitive eyes, makeup products can harbour bacteria, leading to increased eye irritation.”</p> <p dir="ltr">“Refreshing your eye makeup products to options that are designed to be better suited for dry eyes or eye sensitivity.”</p> <p dir="ltr">If you are <a href="https://oversixty.com.au/lifestyle/beauty-style/embracing-the-art-of-beauty-without-compromise">prone to sensitive eyes</a>, consider trying the OKKIYO <a href="https://www.okkiyo.com/products/protect-and-preserve-mascara#xd_co_f=NzdiNzdlNTctNTA1MS00NTBkLWE1MGEtNjRkMGE2OTI1N2Vj~">Prioriteyes Mascara</a>, which was developed by Dr Beltz to prioritise both style and eye health.</p> <p dir="ltr">While these tips for eye health can seem simple and seemingly unimportant, Dr Beltz assures that by following these tips, you will make a world of difference for your eye health overall. </p> <p dir="ltr">She said, “Implementing these simple tips can make a significant difference in keeping your eyes comfortable and vibrant throughout the season.”</p> <p dir="ltr"><em>Image credits: Getty Images </em></p>

Body

Placeholder Content Image

How long does immunity last after a COVID infection?

<p><em><a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> and <a href="https://theconversation.com/profiles/dr-wesley-freppel-1408971">Dr Wesley Freppel</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p>Nearly four years into the pandemic, Australia, like many other countries, is still seeing large numbers of <a href="https://nindss.health.gov.au/pbi-dashboard/">COVID cases</a>. Some 860,221 infections were recorded around the country in 2023, while 30,283 cases have already been reported in 2024.</p> <p>This is likely to be a significant underestimate, with fewer people testing and reporting than earlier in the pandemic. But the signs suggest parts of Australia are experiencing yet <a href="https://www.abc.net.au/news/2024-01-23/covid-19-case-numbers-from-australia-states-and-territories/103374656">another COVID surge</a>.</p> <p>While some lucky people claim to have never had COVID, many are facing our second, third or even fourth infection, often despite having been vaccinated. You might be wondering, how long does immunity last after a previous infection or vaccination?</p> <p>Let’s take a look at what the evidence shows.</p> <h2>B cells and T cells</h2> <p>To answer this question, we need to understand a bit about how <a href="https://theconversation.com/what-happens-in-our-body-when-we-encounter-and-fight-off-a-virus-like-the-flu-sars-cov-2-or-rsv-207023">immunity</a> to SARS-CoV-2 (the virus that causes COVID) works.</p> <p>After being infected or vaccinated, the immune system develops specific antibodies that can neutralise SARS-CoV-2. B cells remember the virus for a period of time. In addition, the immune system produces memory T cells that can kill the virus, and remain in the blood for some months after the clearance of the infection or a vaccination.</p> <p>A <a href="https://www.science.org/doi/full/10.1126/science.abf4063?rfr_dat=cr_pub++0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org">2021 study</a> found 98% of people had antibodies against SARS-CoV-2’s spike protein (a protein on the surface of the virus that allows it to attach to our cells) one month after symptom onset. Six to eight months afterwards, 90% of participants still had these neutralising antibodies in their blood.</p> <p>This means the immune system should have recognised and neutralised the same SARS-CoV-2 variant if challenged within six to eight months (if an infection occurred, it should have resulted in mild to no symptoms).</p> <h2>But what about when the virus mutates?</h2> <p>As we know, SARS-CoV-2 has mutated over time, leading to the emergence of new variants such as alpha, beta, delta and omicron. Each of these variants carries mutations that are new to the immune system, even if the person has been previously infected with an earlier variant.</p> <p>A new variant likely won’t be <a href="https://www.science.org/doi/10.1126/science.adj0070">perfectly recognised</a> – or even <a href="https://www.cell.com/cell/pdf/S0092-8674(21)01578-6.pdf">recognised at all</a> – by the already activated memory T or B cells from a previous SARS-CoV-2 infection. This could explain why people can be so readily reinfected with COVID.</p> <p>A recent <a href="https://www.thelancet.com/article/S0140-6736(22)02465-5/fulltext#seccestitle10">review of studies</a> published up to the end of September 2022 looked at the protection conferred by previous SARS-CoV-2 infections.</p> <p>The authors found a previous infection provided protective immunity against reinfection with the ancestral, alpha, beta and delta variants of 85.2% at four weeks. Protection against reinfection with these variants remained high (78.6%) at 40 weeks, or just over nine months, after the previous infection. This protection decreased to 55.5% at 80 weeks (18 months), but the authors noted there was a lack of data at this time point.</p> <p>Notably, an earlier infection provided only 36.1% protection against a reinfection with omicron BA.1 at 40 weeks. Omicron has been described as an <a href="https://www.nature.com/articles/s41564-022-01143-7">immune escape variant</a>.</p> <p>A prior infection showed a high level of protection against severe disease (above 88%) up to 40 weeks regardless of the variant a person was reinfected with.</p> <h2>What about immunity after vaccination?</h2> <p>So far almost 70 million COVID vaccines <a href="https://www.health.gov.au/topics/covid-19/reporting">have been administered</a> to more than <a href="https://www.health.gov.au/resources/publications/covid-19-vaccine-rollout-update-12-january-2023?language=en">22 million people</a> in Australia. Scientists estimated COVID vaccines prevented around <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00320-6/fulltext">14.4 million deaths</a> in 185 countries in the first year after they became available.</p> <p>But we know COVID vaccine effectiveness wanes over time. A <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2804451?utm_source=For_The_Media&amp;utm_medium=referral&amp;utm_campaign=ftm_links&amp;utm_term=050323">2023 review</a> found the original vaccines were 79.6% and 49.7% effective at protecting against symptomatic delta infection at one and nine months after vaccination respectively. They were 60.4% and 13.3% effective against symptomatic omicron at the same time points.</p> <p>This is where booster doses come into the picture. They’re important to keep the immune system ready to fight off the virus, particularly for those who are more vulnerable to the effects of a COVID infection.</p> <p>Plus, regular booster doses can provide immunity against different variants. COVID vaccines are constantly being <a href="https://mvec.mcri.edu.au/references/covid-19/">reviewed and updated</a> to ensure optimal protection against <a href="https://www.who.int/activities/tracking-SARS-CoV-2-variants">current circulating strains</a>, with the latest shot available designed to target <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants">the omicron variant XBB 1.5</a>. This is similar to how we approach seasonal flu vaccines.</p> <p>A <a href="https://www.nature.com/articles/s41598-023-50335-6">recent study</a> showed a COVID vaccination provides longer protection against reinfection than natural protection alone. The median time from infection to reinfection in non-vaccinated people was only six months, compared with 14 months in people who had received one, two or three doses of vaccine after their first infection. This is called <a href="https://www.science.org/doi/10.1126/science.abj2258">hybrid immunity</a>, and other research has similarly found it provides better protection than natural infection alone.</p> <p>It also seems timing is important, as receiving a vaccine too soon after an infection (less than six months) appears to be <a href="https://www.nature.com/articles/s41598-023-50335-6">less effective</a> than getting vaccinated later.</p> <h2>What now?</h2> <p>Everyone’s immune system is slightly unique, and SARS-CoV-2 continues to mutate, so knowing exactly how long COVID immunity lasts is complicated.</p> <p>Evidence suggests immunity following infection should generally last six months in healthy adults, and can be prolonged with vaccination. But there are exceptions, and all of this assumes the virus has not mutated so much that it “escapes” our immune response.</p> <p>While many people feel the COVID pandemic is over, it’s important we don’t forget the lessons we have learned. Practices such as wearing a mask and staying home when unwell can reduce the spread of many viruses, not only <a href="https://www.bmj.com/content/375/bmj-2021-068302">COVID</a>.</p> <p>Vaccination is not mandatory, but for older adults eligible for a booster under the <a href="https://www.health.gov.au/news/atagi-update-on-the-covid-19-vaccination-program">current guidelines</a>, it’s a very good idea.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221398/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/lara-herrero-1166059"><em>Lara Herrero</em></a><em>, Research Leader in Virology and Infectious Disease, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> and <a href="https://theconversation.com/profiles/dr-wesley-freppel-1408971">Dr Wesley Freppel</a>, Research Fellow, Institute for Glycomics, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-does-immunity-last-after-a-covid-infection-221398">original article</a>.</em></p>

Body

Placeholder Content Image

I have COVID. How likely am I to get long COVID?

<p><em><a href="https://theconversation.com/profiles/andrew-baillie-646956">Andrew Baillie</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/amelia-gulliver-17440">Amelia Gulliver</a>, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>; <a href="https://theconversation.com/profiles/lena-sanci-523666">Lena Sanci</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/lucette-cysique-1495512">Lucette Cysique</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/philip-britton-1127089">Philip Britton</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>EG.5 or the Eris COVID variant is dominant in parts of <a href="https://www.health.nsw.gov.au/Infectious/covid-19/Documents/respiratory-surveillance-20231202.pdf">Australia</a>. Eris, along with other circulating strains, are descendants of Omicron.</p> <p>While these strains appear less severe than the original Alpha and Delta variants, the risk of long COVID remains.</p> <p>So what does the latest data say about the chance of long COVID? What symptoms should you look out for? And what can be done to support people with long COVID?</p> <h2>When COVID becomes ‘long COVID’</h2> <p>For most people, long COVID means not getting better after a COVID infection.</p> <p>The World Health Organization <a href="https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1">defines long COVID</a> as continuing or new symptoms at least three months from the start of a COVID infection that last at least two months and cannot be explained by an alternative diagnosis.</p> <p>The most <a href="https://link.springer.com/article/10.1007/s10654-022-00962-6">common symptoms</a> include fatigue, brain fog, breathlessness, headaches and abdominal pain. But people with long COVID can experience <a href="https://www.sciencedirect.com/science/article/pii/S1684118222001864?via%3Dihub">a wide range</a> of problems including cardiovascular issues, mental health problems such as depression and anxiety, insomnia, muscle and joint pain, and gastrointestinal problems.</p> <h2>How common is long COVID?</h2> <p>Australian data on long COVID <a href="https://www.mja.com.au/journal/2023/218/10/long-covid-australia-achieving-equitable-access-supportive-health-care">remains limited</a> compared to <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00015-eng.htm">international data</a>, and estimates of its prevalence have varied. A report from Australia’s parliamentary inquiry into long COVID, <a href="https://parlinfo.aph.gov.au/parlInfo/download/committees/reportrep/RB000006/toc_pdf/SickandtiredCastingalongshadow.pdf">published in April</a>, suggested 2%-20% of people may develop long COVID following an infection.</p> <p>A recent Australian study conducted when vaccines were widely available indicates earlier Omicron variants <a href="https://doi.org/10.3390/ijerph20186756">saw 10% of people</a> who caught COVID develop long COVID.</p> <p>Another recent study, yet to be peer-reviewed, found <a href="https://www.medrxiv.org/content/10.1101/2023.08.06.23293706v1">18.2%</a> of those infected went on to have long COVID. The wide-ranging estimates are likely to be because of different COVID variants, differences in vaccination, and different long COVID definitions and assessment methods.</p> <p>The risk is lower in children. One Australian study indicated persistent symptoms in <a href="https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00124-3/fulltext">8% of children</a> who had COVID in 2020, while <a href="https://www.medrxiv.org/content/10.1101/2023.03.14.23287239v1">preliminary research</a> points to a slightly lower risk among children infected in 2021.</p> <p>But more research is needed, especially as the virus continues to evolve. This can be complicated because typical long COVID symptoms are common to many other health problems. As in other countries, more research is now underway <a href="https://www.apprise.org.au/broad-research-area/insights-into-long-covid/">in Australia</a> to determine the accurate prevalence of the condition using a definition and methods that carefully exclude other causes.</p> <p>Although research on long COVID risk factors with new variants is ongoing, we expect being female, having more severe initial disease and having other health conditions will <a href="https://doi.org/10.1001/jamainternmed.2023.0750">increase a person’s chance</a> of getting long COVID.</p> <h2>What’s different this time?</h2> <p>Research shows COVID vaccines offer <a href="https://www.mdpi.com/1660-4601/19/19/12422">protection</a> against long COVID. As well as vaccinations, immunity from previous COVID infections and antiviral treatments are contributing to less severe COVID and potentially <a href="https://theconversation.com/could-antivirals-reduce-your-risk-of-long-covid-where-the-research-is-up-to-on-prevention-and-treatment-216529">less long COVID</a> than we saw earlier in the pandemic.</p> <p>But while the Omicron waves may lead to <a href="https://www.smh.com.au/national/newer-virus-strains-less-likely-to-cause-long-covid-20231123-p5emag.html">fewer cases of long COVID</a> than the earlier Alpha and Delta variants, because so many Australians are contracting COVID, this will still result in a large number of people with long COVID. And each <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00015-eng.htm">repeat infection</a> presents a new risk of prolonged symptoms.</p> <h2>Long COVID can affect all aspects of life</h2> <p>Long COVID can <a href="https://doi.org/10.1093/ije/dyad033">impact</a> a person’s life in many ways. Fatigue following exertion, brain fog and other symptoms can reduce capacity to perform tasks such as concentrating at a computer, manual labour, and even normal household tasks.</p> <p>Many people with long COVID submitted evidence to the recent <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/LongandrepeatedCOVID/Report/Chapter_4_-_Lived_experiences_of_long_COVID">parliamentary inquiry</a> that they were unsupported, stigmatised, isolated, and not taken seriously by health professionals.</p> <p>Evidence suggests many symptoms <a href="https://www.thelancet.com/journals/lanepe/article/PIIS2666-77622200250-2/fulltext">will improve</a> in most people over <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00138-4/fulltext">12 to 18 months</a>, although recovery time can differ between symptoms. Some, including gastrointestinal and respiratory symptoms, tend to <a href="https://www.nature.com/articles/s41579-022-00846-2">resolve sooner than others</a>, such as cognitive symptoms.</p> <h2>I think I have long COVID, what can I expect from my doctor?</h2> <p>Long COVID is the kind of challenge Australia’s <a href="https://dx.doi.org/10.5694/mja2.51950">health system finds most difficult</a>. GPs are stretched and the small number of specialist <a href="https://www.abc.net.au/news/2023-12-12/long-covid-clinics-are-closing-as-us-clinic-expands/103186272">long COVID clinics</a> are struggling to maintain funding.</p> <p>Australia has trailed behind the US, the UK and Europe in rolling out care for long COVID, and in collecting data on the condition.</p> <p>As a result, support for long COVID in Australia is <a href="https://doi.org/10.3389/phrs.2023.1606084">hard to access</a>, expensive and patchy.</p> <p>However, there is consensus on what constitutes good care. Clinicians seeing patients with possible long COVID should:</p> <ul> <li> <p>validate the person’s experience of symptoms and the impact their symptoms are having on their functioning, particularly when the cause is not clear</p> </li> <li> <p>diagnose and treat any other health conditions that are part of the picture</p> </li> <li> <p>support people to minimise the impairment their symptoms cause by pacing of physical and cognitive activities. Importantly, this doesn’t involve pushing through fatigue.</p> </li> </ul> <p>These steps are not a cure but they may improve a person’s ability to function in their day-to-day life, at work and to fulfil their caring responsibilities.</p> <h2>We still need to focus on reducing COVID transmission</h2> <p>The best way to prevent long COVID is to avoid contracting – and spreading – COVID. This means:</p> <ul> <li> <p>getting vaccinated or boosted, if you’re eligible</p> </li> <li> <p>staying home if you feel unwell</p> </li> <li> <p>wearing a mask to protect yourself and vulnerable community members</p> </li> <li> <p>testing for COVID if you have symptoms and if you test positive, taking antivirals (if eligible) and isolating until your symptoms resolve.</p> </li> </ul> <p>Long COVID is not going away, but we all have a role to play in preventing and responding to it.</p> <p><em>Ruby Biezen from the APPRISE Network and the University of Melbourne and Andrew Lloyd from the Kirby Institute at UNSW contributed to this article.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/218808/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/andrew-baillie-646956"><em>Andrew Baillie</em></a><em>, Professor of Allied Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/amelia-gulliver-17440">Amelia Gulliver</a>, Senior Research Fellow, ANU College of Health and Medicine, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>; <a href="https://theconversation.com/profiles/lena-sanci-523666">Lena Sanci</a>, Professor, Department of General Practice and Primary Care, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/lucette-cysique-1495512">Lucette Cysique</a>, Senior Research Fellow, Viral Immunology Systems Program, The Kirby Institute, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/philip-britton-1127089">Philip Britton</a>, Associate Professor, Child and Adolescent Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-have-covid-how-likely-am-i-to-get-long-covid-218808">original article</a>.</em></p>

Body

Placeholder Content Image

Do you really need antibiotics? Curbing our use helps fight drug-resistant bacteria

<p><em><a href="https://theconversation.com/profiles/minyon-avent-1486987">Minyon Avent</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/fiona-doukas-1157050">Fiona Doukas</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/kristin-xenos-1491653">Kristin Xenos</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a></em></p> <p>Antibiotic resistance occurs when a microorganism changes and no longer responds to an antibiotic that was previously effective. It’s <a href="https://thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00502-2/fulltext">associated with</a> poorer outcomes, a greater chance of death and higher health-care costs.</p> <p>In Australia, antibiotic resistance means some patients are admitted to hospital because oral antibiotics are <a href="https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance">no longer effective</a> and they need to receive intravenous therapy via a drip.</p> <p>Antibiotic resistance is rising to high levels in certain parts of the world. Some hospitals <a href="https://www.reactgroup.org/news-and-views/news-and-opinions/year-2022/the-impact-of-antibiotic-resistance-on-cancer-treatment-especially-in-low-and-middle-income-countries-and-the-way-forward/">have to consider</a> whether it’s even viable to treat cancers or perform surgery due to the risk of antibiotic-resistant infections.</p> <p>Australia is <a href="https://www.safetyandquality.gov.au/our-work/antimicrobial-resistance/antimicrobial-use-and-resistance-australia-aura/aura-2023-fifth-australian-report-antimicrobial-use-and-resistance-human-health">one of the highest users</a> of antibiotics in the developed world. We need to use this precious resource wisely, or we risk a future where a simple infection could kill you because there isn’t an effective antibiotic.</p> <h2>When should antibiotics not be used?</h2> <p>Antibiotics only work for some infections. They work against bacteria but <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/do-i-really-need-antibiotics">don’t treat</a> infections caused by viruses.</p> <p>Most community acquired infections, even those caused by bacteria, are likely to get better without antibiotics.</p> <p>Taking an antibiotic when you don’t need it won’t make you feel better or recover sooner. But it can increase your chance of side effects like nausea and diarrhoea.</p> <p>Some people think green mucus (or snot) is a sign of bacterial infection, requiring antibiotics. But it’s actually <a href="https://www.safetyandquality.gov.au/sites/default/files/2023-11/aura_2023_do_i_really_need_antibiotics.pdf">a sign</a> your immune system is working to fight your infection.</p> <h2>If you wait, you’ll often get better</h2> <p><a href="https://www.tg.org.au/">Clinical practice guidelines</a> for antibiotic use aim to ensure patients receive antibiotics when appropriate. Yet 40% of GPs say they prescribe antibiotics <a href="https://doi.org/10.1071/HI13019">to meet patient expectations</a>. And <a href="https://pubmed.ncbi.nlm.nih.gov/35973750/">one in five</a> patients expect antibiotics for respiratory infections.</p> <p>It can be difficult for doctors to decide if a patient has a viral respiratory infection or are at an early stage of serious bacterial infection, particularly in children. One option is to “watch and wait” and ask patients to return if there is clinical deterioration.</p> <p>An alternative is to prescribe an antibiotic but advise the patient to not have it dispensed unless specific symptoms occur. This can <a href="https://doi.org/10.1002/14651858.CD004417.pub5">reduce antibiotic use by 50%</a> with no decrease in patient satisfaction, and no increase in complication rates.</p> <h2>Sometimes antibiotics are life-savers</h2> <p>For some people – particularly those with a weakened immune system – a simple infection can become more serious.</p> <p>Patients with life-threatening suspected infections should receive an appropriate antibiotic <a href="https://www.safetyandquality.gov.au/our-work/clinical-care-standards/antimicrobial-stewardship-clinical-care-standard">immediately</a>. This includes serious infections such as <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/bacterial-meningitis#:%7E:text=What%20is%20bacterial%20meningitis%3F,can%20cause%20life%2Dthreatening%20problems.">bacterial meningitis</a> (infection of the membranes surrounding the brain) and <a href="https://clinicalexcellence.qld.gov.au/priority-areas/safety-and-quality/sepsis/adult-sepsis#:%7E:text=Adult%20patients%20with%20sepsis%20also,adult%20emergency%20department%20sepsis%20pathway.">sepsis</a> (which can lead to organ failure and even death).</p> <h2>When else might antibiotics be used?</h2> <p>Antibiotics are sometimes used to prevent infections in patients who are undergoing surgery and are at significant risk of infection, such as those undergoing bowel resection. These patients will <a href="https://www.tg.org.au">generally receive</a> a single dose before the procedure.</p> <p>Antibiotics may also <a href="https://www.tg.org.au">be given</a> to patients undergoing chemotherapy for solid organ cancers (of the breast or prostate, for example), if they are at high risk of infection.</p> <p>While most sore throats are caused by a virus and usually resolve on their own, some high risk patients with a bacterial strep A infection which can cause “scarlet fever” are given antibiotics to prevent a more serious infection like <a href="https://www.rhdaustralia.org.au/">acute rheumatic fever</a>.</p> <h2>How long is a course of antibiotics?</h2> <p>The recommended duration of a course of antibiotics depends on the type of infection, the likely cause, where it is in your body and how effective the antibiotics are at killing the bacteria.</p> <p>In the past, courses were largely arbitrary and based on assumptions that antibiotics should be taken for long enough to eliminate the infecting bacteria.</p> <p>More recent research does not support this and shorter courses are <a href="https://www.acpjournals.org/doi/full/10.7326/M19-1509">nearly always as effective as longer ones</a>, particularly for community acquired respiratory infections.</p> <p>For <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736742/">community acquired pneumonia</a>, for example, research shows a three- to five-day course of antibiotics is at least as effective as a seven- to 14-day course.</p> <p>The “take until all finished” approach is no longer recommended, as the longer the antibiotic exposure, the greater the chance the bacteria will develop resistance.</p> <p>However, for infections where it is more difficult to eradicate the bacteria, such as tuberculosis and bone infections, a combination of antibiotics for many months is usually required.</p> <h2>What if your infection is drug-resistant?</h2> <p>You may have an antibiotic-resistant infection if you don’t get better after treatment with standard antibiotics.</p> <p>Your clinician will collect samples for lab testing if they suspect you have antibiotic-resistant infection, based on your travel history (especially if you’ve been hospitalised in a country with high rates of antibiotic resistance) and if you’ve had a recent course of antibiotics that hasn’t cleared your infection.</p> <p>Antibiotic-resistant infections are managed by prescribing broad-spectrum antibiotics. These are like a sledgehammer, wiping out many different species of bacteria. (Narrow-spectrum antibiotics conversely can be thought of as a scalpel, more targeted and only affecting one or two kinds of bacteria.)</p> <p>Broad-spectrum antibiotics are usually more expensive and come with more severe side effects.</p> <h2>What can patients do?</h2> <p>Decisions about antibiotic prescriptions should be made using <a href="https://www.safetyandquality.gov.au/our-work/partnering-consumers/shared-decision-making/decision-support-tools-specific-conditions">shared decision aids</a>, where patients and prescribers discuss the risks and benefits of antibiotics for conditions like a sore throat, middle ear infection or acute bronchitis.</p> <p>Consider asking your doctor questions such as:</p> <ul> <li>do we need to test the cause of my infection?</li> <li>how long should my recovery take?</li> <li>what are the risks and benefits of me taking antibiotics?</li> <li>will the antibiotic affect my regular medicines?</li> <li>how should I take the antibiotic (how often, for how long)?</li> </ul> <p>Other ways to fight antibiotic resistance include:</p> <ul> <li>returning leftover antibiotics to a pharmacy for safe disposal</li> <li>never consuming leftover antibiotics or giving them to anyone else</li> <li>not keeping prescription repeats for antibiotics “in case” you become sick again</li> <li>asking your doctor or pharmacist what you can do to feel better and ease your symptoms rather than asking for antibiotics.</li> </ul> <p><em><a href="https://theconversation.com/profiles/minyon-avent-1486987">Minyon Avent</a>, Antimicrobial Stewardship Pharmacist, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/fiona-doukas-1157050">Fiona Doukas</a>, PhD candidate, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/kristin-xenos-1491653">Kristin Xenos</a>, Research Assistant, College of Health, Medicine and Wellbeing, School of Biomedical Science and Pharmacy, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-you-really-need-antibiotics-curbing-our-use-helps-fight-drug-resistant-bacteria-217920">original article</a>.</em></p>

Body

Placeholder Content Image

Drug resistance may make common infections like thrush untreatable

<p><em><a href="https://theconversation.com/profiles/christine-carson-109004">Christine Carson</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a></em></p> <p>We’ve all heard about antibiotic resistance. This happens when bacteria develop strategies to avoid being destroyed by an antibiotic.</p> <p>The consequences of antibiotic resistance mean an antibiotic previously used to cure bacterial infections no longer works effectively because the bacteria have become resistant to the drug. This means it’s getting harder to cure the infections some bacteria cause.</p> <p>But unfortunately, it’s only one part of the problem. The same phenomenon is also happening with other causes of infections in humans: fungi, viruses and parasites.</p> <p>“Antimicrobial resistance” means the drugs used to treat diseases caused by microbes (bugs that cause infection) no longer work. This occurs with antibacterial agents used against bacteria, antifungal agents used against fungi, anti-parasitic agents used against parasites and antiviral agents used against viruses.</p> <p>This means a wide range of previously controllable infections are becoming difficult to treat – and may become untreatable.</p> <h2>Fighting fungi</h2> <p>Fungi are responsible for a range of infections in humans. Tinea, ringworm and vulvovaginal candidiasis (thrush) are some of the more familiar and common superficial fungal infections.</p> <p>There are also life-threatening fungal infections such as aspergillosis, cryptococcosis and invasive fungal bloodstream infections including those caused by <em>Candida albicans</em> and <em>Candida auris</em>.</p> <p>Fungal resistance to antifungal agents is a problem for several reasons.</p> <p>First, the range of antifungal agents available to treat fungal infections is limited, especially compared to the range of antibiotics available to treat bacterial infections. There are only four broad families of antifungal agents, with a small number of drugs in each category. Antifungal resistance further restricts already limited options.</p> <p>Life-threatening fungal infections happen less frequently than life-threatening bacterial infections. But they’re rising in frequency, especially among people whose immune systems are compromised, including by <a href="https://7news.com.au/news/qld/first-heart-transplant-patient-to-die-from-fungal-infection-at-brisbanes-prince-charles-hospital-identified-as-mango-hill-gp-muhammad-hussain-c-12551559">organ transplants</a> and chemotherapy or immunotherapy for cancer. The threat of getting a drug-resistant fungal infection makes all of these health interventions riskier.</p> <p>The greatest <a href="https://www.frontiersin.org/articles/10.3389/fimmu.2017.00735/full">burden of serious fungal disease</a> occurs in places with limited health-care resources available for diagnosing and treating the infections. Even if infections are diagnosed and antifungal treatment is available, antifungal resistance reduces the treatment options that will work.</p> <p>But even in Australia, common fungal infections are impacted by resistance to antifungal agents. Vulvovaginal candidiasis, known as thrush and caused by <em>Candida</em> species and some closely related fungi, is usually reliably treated by a topical antifungal cream, sometimes supplemented with an oral tablet. However, instances of <a href="https://www.theage.com.au/national/victoria/they-can-t-sit-properly-doctors-treat-growing-number-of-women-with-chronic-thrush-20230913-p5e499.html">drug-resistant thrush</a> are increasing, and new treatments are needed.</p> <h2>Targeting viruses</h2> <p>Even <a href="https://theconversation.com/why-are-there-so-many-drugs-to-kill-bacteria-but-so-few-to-tackle-viruses-137480">fewer antivirals</a> are available than antibacterial and antifungal agents.</p> <p>Most antimicrobial treatments work by exploiting differences between the microbe causing the infection and the host (us) experiencing the infection. Since viruses use our cells to replicate and cause their infection, it’s difficult to find antiviral treatments that selectively target the virus without damaging us.</p> <p>With so few antiviral drugs available, any resistance that develops to one of them significantly reduces the treatment options available.</p> <p>Take COVID, for example. Two antiviral medicines are in widespread use to treat this viral infection: Paxlovid (containing nirmatrelvir and ritonavir) and Lagevrio (molnupiravir). So far, SARS-CoV-2, the virus that causes COVID, has not developed significant resistance to either of these <a href="https://www.cidrap.umn.edu/covid-19/low-levels-resistance-paxlovid-seen-sars-cov-2-isolates">treatments</a>.</p> <p>But if SARS-CoV-2 develops resistance to either one of them, it halves the treatment options. Subsequently relying on one would likely lead to its increased use, which may heighten the risk that resistance to the second agent will develop, leaving us with no antiviral agents to treat COVID.</p> <p>The threat of antimicrobial resistance makes our ability to treat serious COVID infections rather precarious.</p> <h2>Stopping parasites</h2> <p>Another group of microbes that cause infections in humans are single-celled microbes such as <em>Plasmodium</em>, <em>Giardia</em>, <em>Leishmania</em>, and <em>Trypanosoma</em>. These microbes are sometimes referred to as parasites, and they are becoming increasingly resistant to the very limited range of anti-parasitic agents used to treat the infections they cause.</p> <p>Several <em>Plasmodium</em> species cause malaria and anti-parasitic drugs have been the cornerstone of malaria treatment for decades. But their usefulness has been significantly reduced by the <a href="https://www.mmv.org/our-work/mmvs-pipeline-antimalarial-drugs/antimalarial-drug-resistance">development of resistance</a>.</p> <p><em>Giardia</em> parasites cause an infection called giardiasis. This can resolve on its own, but it can also cause severe gastrointestinal symptoms such as diarrhea, nausea, and bloating. These microbes have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207226/">developed resistance</a> to the main treatments and patients infected with drug-resistant parasites can have protracted, unpleasant infections.</p> <h2>Resistance is a natural consequence</h2> <p>Treating infections influences microbes’ evolutionary processes. Exposure to drugs that stop or kill them pushes microbes to either evolve or die. The exposure to antimicrobial agents provokes the evolutionary process, selecting for microbes that are resistant and can survive the exposure.</p> <p>The pressure to evolve, provoked by the antimicrobial treatment, is called “selection pressure”. While most microbes will die, a few will evolve in time to overcome the antimicrobial drugs used against them.</p> <p>The evolutionary process that leads to the emergence of resistance is inevitable. But some things can be done to minimise this and the problems it brings.</p> <p>Limiting the use of antimicrobial agents is one approach. This means reserving antimicrobial agents for when their use is known to be necessary, rather than using them “just in case”.</p> <p>Antimicrobial agents are precious resources, holding at bay many infectious diseases that would otherwise sicken and kill millions. It is imperative we do all we can to preserve the effectiveness of those that remain, and give ourselves more options by working to discover and develop new ones.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/213460/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/christine-carson-109004">Christine Carson</a>, Senior Research Fellow, School of Medicine, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/drug-resistance-may-make-common-infections-like-thrush-untreatable-213460">original article</a>.</em></p>

Body

Placeholder Content Image

Eye-watering price tag for "remarkable" first class Titanic menu

<p>A first class dinner menu from the Titanic has been found and sold at an auction in England for £84,000 (around $162,000 AUD) on November 11. </p> <p>The water-stained menu was dated April 11, 1912 just three days before the ship hit an iceberg, ultimately meeting it's ill-fated end causing over 1500 deaths. </p> <p>Wealthy passengers at the time were spoiled with choice, with oysters, salmon, beef, squab (baby pigeon), spring lamb among other dishes on the menu, and that's not including dessert. </p> <p>Auctioneers Henry Aldridge &amp; Son said it was unclear how the menu made it off the ship intact, but the slight water damage suggests that it was recovered from the body of a victim. </p> <p>The rare artefact, which is over 111 years old belonged to amateur historian Len Stephenson, from Nova Scotia, Canada, who passed away in 2017. </p> <p>No one knew he had it, including his family, who only discovered it after going through his belongings following his death. </p> <p>“About six months ago his daughter and his son-in-law, Allen, felt the time was right to go through his belongings,” auctioneer Andrew Aldridge said. </p> <p>“As they did they found this menu in an old photo album.</p> <p>“Len was a very well thought-of historian in Nova Scotia which has strong connections with the Titanic. The body recovery ships were from Nova Scotia and so all the victims were taken back there.</p> <p>“Sadly, Len has taken the secret of how he acquired this menu to the grave with him.”</p> <p>Stephenson worked at a post office and would talk to people, collect old pictures and write letters for them, which might be how he got the rare artefact. </p> <p>According to the auctioneer, no other first class dinner menus dated April 11, 1912 have been recovered from the titanic making this “a remarkable survivor from the most famous Ocean liner of all time”.</p> <p>“There are a handful of April 14 menus in existence but you just don’t see menus from April 11. Most of them would have gone down with the ship,” Aldridge said. </p> <p>“Whereas with April 14 menus, passengers would have still had them in their coat and jacket pockets from earlier on that fateful night and still had them when they were taken off the ship," he added. </p> <p>A few other items recovered from the Titanic were also sold, including a Swiss-made pocket watch recovered from passenger Sinai Kantor which fetched £97,000 (around $187,000 AUD). </p> <p>A tartan-patterned deck blanket, which was likely used during the rescue operation also sold for £96,000 (around $185,000). </p> <p><em>Images: Henry Aldridge &amp; Son of Devizes, Wiltshire</em></p> <p> </p>

Cruising

Placeholder Content Image

From COVID to gastro, why are cruise ships such hotbeds of infection?

<p><em><a href="https://theconversation.com/profiles/thea-van-de-mortel-1134101">Thea van de Mortel</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p>Dual outbreaks of <a href="https://www.abc.net.au/news/2023-11-12/grand-princess-ship-adelaide-covid-19-gastroenteritis/103095704">gastro and COVID</a> on the Grand Princess cruise ship that docked in Adelaide on Monday <a href="https://www.theguardian.com/australia-news/2023/nov/13/grand-princess-cruise-ship-covid-gastro-outbreak-docks-adelaide-south-australia">have now been declared over</a> by the <a href="https://www.canberratimes.com.au/story/8421009/cruise-ship-doctor-declares-dual-virus-outbreaks-over/">doctor on board</a>.</p> <p>A spokesperson for Princess Cruises, which operates the ship, said a number of passengers had presented with symptoms <a href="https://www.9news.com.au/national/grand-princess-no-double-covid19-gastro-outbreak-on-ship-cruise-line-says/5d02d423-3289-4a2b-a580-1ed565b78027">on a previous voyage</a>. But the ship has since been disinfected and the number of people who were ill when the ship arrived into Adelaide was said to be in single digits.</p> <p>While this is positive news, reports of infectious outbreaks on cruise ships evoke a sense of deja vu. We probably all remember the high-profile COVID outbreaks that occurred on cruise ships in 2020.</p> <p>So what is it about cruise ships that can make them such hotspots for infection?</p> <h2>First, what causes these outbreaks?</h2> <p>Respiratory infectious outbreaks on cruise ships may be caused by <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/air-land-sea/cruise-ship-travel">a range of pathogens</a> including SARS-CoV-2 (the virus that causes COVID) and influenza viruses. These can be spread by <a href="https://www.pnas.org/doi/10.1073/pnas.2015482118">respiratory droplets and aerosols</a> released when people breathe, talk, laugh, cough and sneeze.</p> <p>Historically, <a href="https://jmvh.org/article/the-navy-and-the-1918-19-influenza-pandemic/">troop transport ships</a> also helped to spread the lethal 1918 flu virus between continents.</p> <p>Gastro outbreaks on cruise ships are similarly well documented. More than 90% of cruise ship gastro outbreaks are caused by <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/air-land-sea/cruise-ship-travel#infectious">norovirus</a>, which is spread from person to person, and through contaminated objects or contaminated food or water.</p> <p>Gastro can also be caused by other pathogens such as <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/air-land-sea/cruise-ship-travel">bacteria in contaminated food or water</a>.</p> <h2>What is the risk?</h2> <p>In 2020, around 19% of <a href="https://www.bmj.com/content/369/bmj.m1632">Diamond Princess</a> passengers and crew docked in Japan tested positive to COVID. Ultimately, nearly one in four <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739343/">Ruby Princess</a> passengers and crew docked in Sydney tested positive.</p> <p>However, COVID generally presents a lesser risk nowadays, with most people having some level of immunity from vaccination or previous infection. The outbreak on the Grand Princess appears to have been much smaller in scale.</p> <p>A <a href="https://www.sciencedirect.com/science/article/abs/pii/S1477893916300680">three-year study</a> before COVID of influenza-like illness (which includes fever), acute respiratory illness (which <a href="https://www.cdc.gov/flu/about/glossary.htm">doesn’t require fever</a> to be present) and gastro on cruise ships found these were diagnosed in 32.7%, 15.9% and 17% of ill passengers, and 10.9%, 80% and 0.2% of ill crew, respectively.</p> <p>An <a href="https://www.cdc.gov/mmwr/volumes/70/ss/ss7006a1.htm">analysis</a> of data from 252 cruise ships entering American ports showed the overall incidence of acute gastro halved between 2006 and 2019. Passenger cases decreased from 32.5 per 100,000 travel days to 16.9, and crew cases from 13.5 per 100,000 travel days to 5.2. This decline may be due to a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382806/">combination</a> of improved hygiene and sanitation standards.</p> <p>The risk of getting sick with gastro was significantly higher on <a href="https://www.cdc.gov/mmwr/volumes/70/ss/ss7006a1.htm">bigger ships and longer voyages</a>. This is because the longer you are in close contact with others, the greater the chance of exposure to an infectious dose of viruses or bacteria.</p> <h2>Why are cruise ships infection hotspots?</h2> <p>On cruise ships, people tend to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739343/">crowd together</a> in confined spaces for extended periods. These include dining halls, and during social activities in casinos, bars and theatres.</p> <p>The risk goes up when the environment is noisy, as more droplets and aerosols are shed when people are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382806/">laughing, shouting or talking loudly</a>.</p> <p>Passengers may come from <a href="https://www.sciencedirect.com/science/article/abs/pii/S1477893916300680?via%3Dihub">multiple countries</a>, potentially bringing variants from different parts of the world. Influenza, which is usually seasonal (late autumn to early spring) onshore, can occur at any time <a href="https://academic.oup.com/cid/article/31/2/433/295546">on a cruise ship</a> if it has international passengers or is calling at international ports.</p> <p>Human behaviour also contributes to the risk. Some passengers <a href="https://academic.oup.com/jtm/article/15/3/172/1821220">surveyed</a> following cruise ship gastro outbreaks indicated they were ill when they boarded the ship, or they became ill but didn’t disclose this because they didn’t want to pay for a doctor or be made to isolate, or they thought it wasn’t serious.</p> <p>Those who became ill were more likely than those who did not to think that hand hygiene and isolation were not effective in preventing infection transmission, and were less likely to wash their hands after using the toilet. Given <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/norovirus.aspx">faecal contamination</a> is a major source of norovirus transmission, this is concerning.</p> <p>While there are usually a la carte dining options on board, many people will choose a buffet option. From personal experience, food tongs are handled by multiple people, some of whom may not have cleaned their hands.</p> <h2>What can help?</h2> <p>The <a href="https://www.health.gov.au/news/ahppc-statement-advice-to-support-safe-cruising">Department of Health and Aged Care</a> recommends cruise companies encourage crew and passengers to be up-to-date with flu and COVID vaccinations, and encourage anyone who becomes ill to stay in their cabin, or at least avoid crowded spaces and wear a mask in public.</p> <p>They also recommend cruise ships have a plan to identify and contain any outbreaks, including testing and treatment capacity, and communicate to passengers and crew how they can reduce their transmission risk.</p> <p>All passengers and crew should report any signs of infectious illness, and practice good hand hygiene and <a href="https://www.cdc.gov/oralhealth/infectioncontrol/faqs/respiratory-hygiene.html">respiratory etiquette</a>, such as covering their mouth if coughing or sneezing, disposing of used tissues, and washing or sanitising hands after touching their mouth or nose.</p> <p>South Australia’s chief health officer has <a href="https://www.abc.net.au/news/2023-11-13/grand-princess-ship-covid-gastro-docks-in-adelaide/103096836">commended</a> the Grand Princess crew for their infection protection and control practices, and for getting the outbreak under control.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/217534/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/thea-van-de-mortel-1134101"><em>Thea van de Mortel</em></a><em>, Professor, Nursing, School of Nursing and Midwifery, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/from-covid-to-gastro-why-are-cruise-ships-such-hotbeds-of-infection-217534">original article</a>.</em></p>

Cruising

Our Partners