drcameronjones

Science is all about observation and forming hypotheses to answer questions. For scientists like myself, I’m interested in how the environment affects health, and specifically, how water damaged buildings and exposure to poor indoor air quality can affect quality of life. For this week on The Mould Show we're going to be talking about fungal mycotoxins and myalgic encephalomyelitis termed ME for short and chronic fatigue syndrome (ME/CFS). The reason I've chosen this topic is that I've met a family whom I've now done three separate mould inspections for. Why this is unusual is that the symptoms experienced by the female occupant and her daughter are classic ME/CFS symptoms. Across all 3 of the different properties hidden mould problems were discovered. That information in itself was useful for this family and helped them to break their lease due to the fact that there was verified mould present. However, that's not the point of this podcast and even the positive mould confirmation as an environmental trigger didn’t help the mother and daughter from understanding why they reacted so strongly when indoors. They thought they were going crazy, since how could 3 different properties cause them so much trouble? They couldn’t understand why some buildings caused no issues, and the 3 they’d chosen to rent all set them off? This has bothered me all year. I know mould is a huge issue for some people – but what exactly might be going on for THIS family? On a side note, I'm an avid reader and through the COVID pandemic I've enjoyed the increasing number of authors who choose to publish on a newsletter type subscription service termed Substack. One of these authors published a very interesting article in May this year focusing on his experience with chronic pain and ME/CFS and how after 25 years of suffering, he discovered by chance, following a recommendation from a friend to read a book that talked about the connection between ME and chronic fatigue syndrome and mitochondrial dysfunction. So that is the true focus of the topic today. • Could exposure to fungal mycotoxins be the reason why they were tired and experiencing pain? • Could this be the reason you’re tired? Is this another aspect to environmental illness? • And could this be classified as Myalgic Encephalomyelitis or Chronic Fatigue Syndrome (ME/CFS)? • Are there any patient-specific tests to verify ME/CFS or mould exposure and what can be done to alleviate the symptoms? Firstly, let's define what ME/CFS is. There are three core symptoms + at least one or more other symptoms which include: 1. an inability to participate in routine activities that would have been possible before becoming ill and that lasts for greater than six months. 2. the fatigue which is also a primary symptom tends to worsen after physical, mental or emotional effort. 3. and does not resolve after sleep, termed ‘unrefreshing sleep’. Other problems include: a) an inability to concentrate or memory impairment and/or b) something called orthostatic intolerance. Which means that when people stand up, they feel lightheaded or dizzy and can even faint. The family that moved into those three different properties all complained that after a few days of occupying the mould contaminated building the wife especially experienced episodes of unexpected fainting and collapsing into her husband's arms. Those 3 inspections coupled with reading the Substack article led me to investigate further whether there was any published literature, focusing on exposure to fungal cells or their mycotoxins in the ME/CFS literature. Very recently a publication appeared in the International Journal of Environmental Research and Public Health that has looked at exactly this topic. These scientists looked at the levels of Aspergillus toxins like aflatoxin, ochratoxin, and gliotoxin in the urine of 236 ME/CFS patients who had a known exposure to mould from water damaged buildings. The evidence from two types of urine mycotoxin testing from Real Time Laboratories as well as from the Great Plains Laboratories revealed that 92.4% of ME/CFS patients who had exposure to water damaged buildings had mycotoxin evidence in their urine, with ochratoxin being the most prevalent. This study is extremely important because it validates what many of us mycologists and microbiologists have known for many years - that exposure to water damaged buildings leads to mould exposure and that it is the mycotoxins and not just the intact cell which contribute to adverse health. In this Livestream, I'll also be extending on the concept of mitochondrial dysfunction and we'll be looking at three additional publications which have looked at how the individual can improve their mitochondrial activity for better health. Watch the Livestream or listen to the podcast for further information on how nutritional supplements like cocoa flavanols or astaxanthin, resveratrol and even functional phenolics like quercetin, curcurmin, melatonin and even selected tea’s can be used to improve cellular mitochondrial activity. Examples are cited from the exercise literature and from contemporary anti-ageing research. It looks like ME/CFS is strongly influenced by not just bacterial, fungal or viral infections or from toxic man-made chemicals – but that commonly encountered mycotoxins should be added to the list of triggers. From an integrative perspective, functional foods and targeted use of nutraceuticals, together with healthy lifestyle choices, may help support mitochondrial biology and in turn promote better health. REFERENCES: Rogers, T. (2022). Chronic pain, ME/CFS, "post exertional malaise", what is killing the mitochondria, wrong theories of the case, and the slide into the metaverse. Retrieved 26 June 2022, from https://tobyrogers.substack.com/p/chronic-pain-mecfs-post-exertional Wu, T.Y.; Khorramshahi, T.; Taylor, L.A.; Bansal, N.S.; Rodriguez, B.; Rey, I.R. Prevalence of Aspergillus-Derived Mycotoxins (Ochratoxin, Aflatoxin, and Gliotoxin) and Their Distribution in the Urinalysis of ME/CFS Patients. Int. J. Environ. Res. Public Health 2022, 19, 2052. https://doi.org/10.3390/ijerph19042052 Daussin FN, Cuillerier A, Touron J, Bensaid S, Melo B, Al Rewashdy A, Vasam G, Menzies KJ, Harper ME, Heyman E, Burelle Y. Dietary Cocoa Flavanols Enhance Mitochondrial Function in Skeletal Muscle and Modify Whole-Body Metabolism in Healthy Mice. Nutrients. 2021 Sep 29;13(10):3466. doi: 10.3390/nu13103466. PMID: 34684467; PMCID: PMC8538722. https://pubmed.ncbi.nlm.nih.gov/34684467/ Lewis Luján LM, McCarty MF, Di Nicolantonio JJ, Gálvez Ruiz JC, Rosas-Burgos EC, Plascencia-Jatomea M, Iloki Assanga SB. Nutraceuticals/Drugs Promoting Mitophagy and Mitochondrial Biogenesis May Combat the Mitochondrial Dysfunction Driving Progression of Dry Age-Related Macular Degeneration. Nutrients. 2022 May 9;14(9):1985. doi: 10.3390/nu14091985. PMID: 35565950; PMCID: PMC9104458. https://pubmed.ncbi.nlm.nih.gov/35565950/ Gonçalves AC, Gaspar D, Flores-Félix JD, Falcão A, Alves G, Silva LR. Effects of Functional Phenolics Dietary Supplementation on Athletes' Performance and Recovery: A Review. Int J Mol Sci. 2022 Apr 22;23(9):4652. doi: 10.3390/ijms23094652. PMID: 35563043; PMCID: PMC9102074. https://pubmed.ncbi.nlm.nih.gov/35563043/ Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of High-Consequence Pathogens and Pathology (DHCPP). June 1, 2022. https://www.cdc.gov/me-cfs/index.html What is ME/CFS?. ME/CFS Australia Ltd. https://mecfs.org.au/about-mecfs/what-is-mecfs/ Myhill, S. (2018). Diagnosis and Treatment of Chronic Fatigue Syndrome and Myalgic Encephalitis, 2nd ed. - Chelsea Green Publishing. Retrieved 26 June 2022, from https://www.chelseagreen.com/product/diagnosis-and-treatment-of-chronic-fatigue-syndrome-and-myalgic-encephalitis/ Pizzorno J. Mitochondria-Fundamental to Life and Health. Integr Med (Encinitas). 2014 Apr;13(2):8-15. PMID: 26770084; PMCID: PMC4684129. https://pubmed.ncbi.nlm.nih.gov/26770084/

This week on The Mould Show we're going to be looking at the gut microbiome and in particular some emerging research that is showing that the diversity of microorganisms found in the gut may be linked to different immune responses and may even affect the pathogenesis of conditions like multiple sclerosis, MS. I'll be reviewing two of the dominant papers in the MS literature around gut microflora and looking at this concept of species diversity. In these papers the scientists looked at the number of different microorganisms between healthy controls and MS patients. Multiple sclerosis is a neuro inflammatory autoimmune disease known to affect two and a half million people worldwide with most patients experiencing what is termed relapsing remitting Multiple Sclerosis which as the name suggests shows periods of stasis punctuated with symptoms but overwhelmingly moves towards more frequent symptoms as the disease progresses. There are currently no known treatments for MS. However, there is an abundant literature showing that healthy lifestyle factors such as no current smoking, a healthy diet regular exercise and maintaining a low body mass index all help reduce symptoms. The two papers we're looking at today ask the question: Are there some fungi that can be measured in the gut that are correlated with MS and healthy controls? Essentially, what is the role that microbiology plays in MS?. These two papers strongly suggest that bacterial and fungal diversity is indeed connected and can differentiate healthy controls from MS patients. This research is exciting because it offers the opportunity not only for individualized testing as a risk predictor, but also the opportunity for individualized dietary modifications to be made to change the composition of the gut microflora. Both papers determined that fungi like Candida, Epicoccum, Malassezia and Saccharomyces all seem to show statistical relationships that could be a value to predict or at least classify individuals into different risk categories. Interestingly, when we drill into the literature and look at the species diversity for Saccharomyces which is a typical yeast found in breads and grains there is another set of literature that has looked at the gut microbiota and the day 28-day mortality for critically ill patients admitted to hospital. Of course, many of the underlying reasons for hospital admission includes chronic lung disease, chronic heart disease, immunosuppression, active cancer and acute kidney injury. Nevertheless, when sampling was performed, they found clear evidence that species diversity in the gut was predictive for which patients survived versus those that died? So, what to make of these facts? Well, there is opportunity to look at what readily available compounds might be used nutritionally or therapeutically, to mitigate, delay, or reverse these diseases? One of the compounds being actively researched is called Astaxanthin and is commonly found in shellfish and lobsters and green micro algae. It’s been shown to not only possess anti-microbial or antibiotic type activity but there is emerging research it can be used for a range of neurodegenerative diseases, including stroke, multiple sclerosis, Alzheimer’s and even conditions like chronic fatigue syndrome. This research into use of astaxanthin suggests that even if it cannot be used as a topical anti-microbial (due to high dosage), it may exert its beneficial effect by altering the composition of the gut microflora at lower dosage. Other elegant research has looked at how astaxanthin has been able to protect the myelin sheath in Multiple Sclerosis models in rats. This research strongly suggests that astaxanthin exerts its effect because they help reduce inflammation and oxidative stress. We can only hope that more research into the therapeutic effects of natural compounds like astaxanthin may lead towards wide-spread use of targeted dietary modifications. This could result in near term benefit for a range of people suffering immune mediated neurodegenerative conditions and that’s a win for all. Yadav, M., Ali, S., Shrode, R. L., Shahi, S. K., Jensen, S. N., Hoang, J., Cassidy, S., Olalde, H., Guseva, N., Paullus, M., Cherwin, C., Wang, K., Cho, T., Kamholz, J., & Mangalam, A. K. (2022). Multiple sclerosis patients have an altered gut mycobiome and increased fungal to bacterial richness. PloS one, 17(4), e0264556. https://doi.org/10.1371/journal.pone.0264556 Shah, S., Locca, A., Dorsett, Y., Cantoni, C., Ghezzi, L., Lin, Q., Bokoliya, S., Panier, H., Suther, C., Gormley, M., Liu, Y., Evans, E., Mikesell, R., Obert, K., Salter, A., Cross, A., Tarr, P., Lovett-Racke, A., Piccio, L. and Zhou, Y., 2021. Alterations of the gut mycobiome in patients with MS. EBioMedicine, 71, p.103557. https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(21)00350-9/fulltext

Imagine that at your workplace - you move to new offices and these offices are sited partially below ground level. Within three months of moving into the new offices, every person who works there has started to suffer from symptoms that consistent with exposure to a water damage buildings and are reacting to the microbes and moulds that are commonly found in these environments. When the symptoms became unbearable, the office staff started looking for answers. This week on The Mould Show, I'm going to be reviewing the research results that carefully examined each of those office workers to work out two things: Firstly, was the building contributing something toxic that the workers were being exposed to? And secondly, how could this be best measured by the medical doctors who were involved? This publication looks at whether or not immunosuppression and adverse events can be measured. And if so, how does one go about doing this? This publication appeared on the 21st of January 2022 in the Journal of Fungi: Toxic Indoor Air Is a Potential Risk of Causing Immuno Suppression and Morbidity-A Pilot Study. What the scientists did was examine both the patient (that is the occupants of the workplace), and they also looked at the building to see what type of toxins and microbes could be detected. The purpose of the research was how to prove causality between the symptoms experienced by the workers and exposure to the toxic indoor air. But the scientists weren't satisfied with just using microbiological technique to measure for mould, because it's well recognized that even though these tests are very sensitive and accurate to measure mould spore levels in the air - they can often miss the breakdown fragments of microbes that grow on water damaged buildings. And therefore, this very exciting research from Finland has implemented a new method to assess toxicity indoors, which looks at collecting condensed indoor air water vapour and test that. Now what does this mean? Well, essentially, they have devised and patented a method of rapidly collecting water vapor out of the air but again, how did they do this? The Finnish scientists used three toxicity test methods to see how the indoor air might be compromised. The first one was to use THP-1 macrophages. The next type of test they used to assess for toxicity in vitro wants to use baby hamster kidney cells or BHK-21 cells. These are commonly used to study viral infections, but they can also be used to determine the sensitivity to a drug or to a virus. the third type of toxicity assessment the Finnish scientists used was boar sperm. And this is a bio sensor-type test for detecting toxins in indoor dusts and bioaerosols. The reason it works is because sperm are highly dependent on mitochondria for energy, and therefore any drug that can be tested for how it might interfere with motility sheds light on interference with mitochondria. If we drill into one of the key tables in the Finnish research, we find that of course, various different toxins picked up in the mycotoxin screening panel, like Ochratoxin were present in each of the workers who worked in this new office location. But of extreme interest is a new biomarker called Mycophenolic acid, and this also was present in almost all of the individuals who worked in this particular office. Now, you need to remember that because large volumes of indoor air are inhaled every day, this air contains water vapor. And when the relative humidity indoors and temperature increases, the levels of mycotoxins that are inhaled will also increase. So this type of research is contributing cutting edge new knowledge about the different toxins that are being inhaled, along with the more common fungal particulates, like mould spores together with the PM2.5 and PM10 cell wall fragments from fungi. But what about all those people who are working in water damage building interiors? We know if they're being exposed to particulate matter, like mould spores and cell fragments, from typical indoor air quality tests like spore traps, biotape lifts or direct microbiology from the air or surfaces onto Petri plates. But many of the mycotoxins can also be measured in urine? Thanks to this breaking research, there are other, new biomarkers like mycophenolic acid – which is tested from the water vapour indoors. In turn, what do you think the contribution is to adverse health from mycophenolic acid exposure? The Finnish data shows that mycophenolic acid reduces immune function and the other types of in vitro tests showed that macrophages activity is reduced and that mitochondrial activity is increased, but also that bore sperm motility is interfered with. Vaali K, Tuomela M, Mannerström M, Heinonen T, Tuuminen T. Toxic Indoor Air Is a Potential Risk of Causing Immuno Suppression and Morbidity-A Pilot Study. J Fungi (Basel). 2022 Jan 21;8(2):104. doi: 10.3390/jof8020104. PMID: 35205859; PMCID: PMC8877819. https://pubmed.ncbi.nlm.nih.gov/35205859/

If you're dealing with water damage building interiors, or just wondering what is the best way to clean textiles and clothing that might have become mould contaminated - you might be thinking, why can't I just put them all into the washing machine? Your next question might be: is there something I can do to the washing cycle that will help reduce the population of any germs that might be on those textiles? The answer is yes, there is an optimal way of washing your clothing to remove specific germs like classes of fungi that cause skin and nail infections. These fungi are termed dermatophytes and are superficial fungal infections that colonize the skin, hair or nails. This group of fungi thrive in moist areas of the skin and are easily transferred to clothing and towels and they are also found in soil. The statistics around dermatophytes report that 20 to 25% of the world's population is currently infected with a dermatophyte fungus. A paper that was published in late May 2022, looked at whether you could freeze material contaminated with dermatophyte fungi, or heat them up in a laundromat or domestic dryer, or whether it was best to wash them – and if so, what’s the best way to reduce the viability of these dermatophytes? This is an interesting question because although dermatophyte fungi are specific causative agents of skin, hair and nail infections they nevertheless represent a class of fungi that if we understand how they respond to the washing cycle - then this could extend to other types of fungi found in the home, on the floor, or on porous personal items of personal property that might benefit from being washed. So the central question of this live stream is: hot cycle versus cold cycle versus heat drying versus freezing - which is better? To answer this question, I'm going to summarize the key findings of a paper that came out in the Journal of Fungi which looked at how to test between these different treatments. What the scientists did was deliberately contaminate gauze pads with three of the most common fungi that affect humans (Trichophyton tonsurans, Trichophyton rubrum and Trichophyton interdigitale). We know the effects of these fungi when they attack feet and other moist skin areas and cause, for example, Athlete's Foot. We should also respect the fact that these fungi are easily transmitted. Think – of contact with infected individuals or even skin contact with inanimate objects like flooring. And so what the scientists did was they deliberately infected small gauze pads and then cleaned them in different ways. The. They looked at the recovery rate for the dermatophyte fungi. Successful cleaning meant there were no fungi recovered. The first treatment looked at how temperature and cleaning time impacted on fungal recovery. The next question for the washing machine method was whether adding detergent helps? Another cleaning method looked at whether freezing the textile gauze pad could kill the fungi? The results are compelling: • Low temperature washing for example, at 40 degrees Celsius for 100 minutes with or without detergent did not reduce the viability of Trichophyton fungi. • Increasing the temperature to either 60 degrees Celsius or 90 degrees Celsius for either 100 minutes or 150 minutes resulted in the loss of viability for Trichophyton fungi. • The higher temperature was effective with or without detergent. • Unfortunately, heat drying the contaminated material in either a domestic machine or a laundromat machine for anywhere from 10 minutes to 150 minutes, did not reduce the population viability of Trichophyton fungi. • And somewhat counter-intuitively, it was not possible to freeze the fungus and cause it to stop growing even if freezing was carried out for one day, two days, or even seven days – the persistent viability of the Trichophyton fungi was preserved. The take-home message, therefore, was that domestic washing machines with or without detergent are highly effective at removing dermatophyte fungi like Trichophyton. Furthermore, despite the purported case for the energy-saving and environmental protection benefits of cold water washing, the science says that cold water is not effective at eradicating dermatophytes and may increase the risk of cross-contamination. Overall, the most up-to-date research suggests there are no differences between laundering with or without detergent but you need to use the hot cycle set to at least 60 degrees Celsius to eliminate dermatophyte fungi like Trichophyton. REFERENCES: Akhoundi M, Nasrallah J, Marteau A, Chebbah D, Izri A, Brun S. Effect of Household Laundering, Heat Drying, and Freezing on the Survival of Dermatophyte Conidia. J Fungi (Basel). 2022 May 23;8(5):546. doi: 10.3390/jof8050546. PMID: 35628801; PMCID: PMC9143173.

Remembering how exactly the SARS-CoV-2 virus causes harm is easy with the 4 horsemen metaphor borrowed from the old testament, Book of Revelation. See how infection, inflammation, vascular and renal impacts and hypercoagulation fit together using the 4 horsemen.

I'm often asked whether mould affects children's health? I thought this would be an appropriate topic to kick off the new year for The Mould Show in 2022. In approaching this topic, I'm going to review some of the key symptoms associated with exposure to mould and then provide you with an easy visual guide that you can use to not only remember the typical mould symptoms, but the causes and effects but that may be helpful when describing indoor air quality issues in your home or workplace. We all know that unexpected weather increasingly contributes to mould problems indoors in addition to water leaks and home dilapidation problems. In turn, most of us understand that moulds grow on wet surfaces and release their spores into the air. It’s important to remember that mycotoxin levels inside water damaged buildings are sometimes 1000-fold higher than the mould count. It's also known that 50% of fungal growth can be hidden and is missed by mould testing according to the EPA. To look at the health effects of mould on children, I’ll draw your attention to the first paper The authors review a study from Harvard University looking at 13,369 children aged between 8 and 12 years where they found that mould was growing in up to 50% of the homes and between 3 and 11% of children had asthma. By comparison, a Russian study showed that for 5951 children having mould in the home and water damage, there was a positive association with symptoms of asthma, dry cough wheezing and bronchitis. Another important paper in titled The Brain and Mycotoxins by Dr. Andrew Campbell. He talks about how mycotoxins can affect the brain and how research supports a connection with autism spectrum disorder, multiple sclerosis, and dementia and Alzheimer's. Dr. Campbell stresses the importance of talking with your medical practitioner about blood serum testing for mycotoxin antibodies using the ELISA test. He stresses that urine testing for mycotoxins does not mean the person is suffering from any disease or disorder linked to mould or mycotoxins. The third paper I want to talk about is examining the impact of mould contamination in early, gestational and postnatal periods. I will be reviewing a paper from Poland that looked at the association between mould exposure and IQ. To do this, we first need to define what the odds ratio is and how this is connected with the confidence interval, which simply means the span where 95% of the observation data points fall on either side of the population mean. The OR is a way to present the strength of association between risk factors/exposures and outcomes. If the OR is <1, odds are decreased for an outcome; OR >1 means the odds are increased for a given outcome. OR=1 Exposure does not affect odds of outcome OR>1 Exposure associated with higher odds of outcome OR<1 Exposure associated with lower odds of outcome The Polish research was looking at what the exposure effect for living with mould was on the cognitive development in children. They examined the cognitive function of 277 babies at 6 years of age. A survey was conducted to evaluate the extent of visible mould on indoor walls monitored at different intervals over the postnatal stages after birthing and up to 5 years. This was assessed using the Wechsler Intelligence Scale for children. They determined that where mould exposure to indoor moulds occurred for greater than two years. children scored significantly lower on the IQ scale with an odds ratio of 3.53 which more than tripled the risk of low IQ scoring. Put another way: “The odds of having a lower IQ is 3.4 times higher if the child experienced mould during early life for more than 2 years as opposed to not experiencing mould”. This paper demonstrates the harmful effects of early pre- and postnatal exposure to indoor moulds on children's cognitive development and emphasizes the importance of the living environment on human cognitive development. REFERENCES: Campbell AW, Watson P. Mold, Mycotoxins, and their Effects in Children. Altern Ther Health Med. 2021 Jan;27(1):8-10. PMID: 33609089. Campbell AW, Decena K. The Brain and Mycotoxins. Altern Ther Health Med. 2020 Nov;26(6):8-11. PMID: 33609092. Campbell AW. Molds and Mycotoxins: A Brief Review. Altern Ther Health Med. 2016 Jul;22(4):8-11. PMID: 27548484. Theoharides TC. Mold and Immunity. Clin Ther. 2018 Jun;40(6):882-884. doi: 10.1016/j.clinthera.2018.05.005. Epub 2018 May 30. PMID: 29859636. Spengler JD, Jaakkola JJ, Parise H, Katsnelson BA, Privalova LI, Kosheleva AA. Housing characteristics and children's respiratory health in the Russian Federation. Am J Public Health. 2004 Apr;94(4):657-62. doi: 10.2105/ajph.94.4.657. PMID: 15054021; PMCID: PMC1448314. Jedrychowski W, Maugeri U, Perera F, Stigter L, Jankowski J, Butscher M, Mroz E, Flak E, Skarupa A, Sowa A. Cognitive function of 6-year old children exposed to mold-contaminated homes in early postnatal period. Prospective birth cohort study in Poland. Physiol Behav. 2011 Oct 24;104(5):989-95. doi: 10.1016/j.physbeh.2011.06.019. Epub 2011 Jul 8. PMID: 21763705; PMCID: PMC3758954. Szumilas M. Explaining odds ratios [published correction appears in J Can Acad Child Adolesc Psychiatry. 2015 Winter;24(1):58]. J Can Acad Child Adolesc Psychiatry. 2010;19(3):227-229. Wong CT, Wais J, Crawford DA. Prenatal exposure to common environmental factors affects brain lipids and increases risk of developing autism spectrum disorders. Eur J Neurosci. 2015 Nov;42(10):2742-60. doi: 10.1111/ejn.13028. Epub 2015 Sep 19. PMID: 26215319.

Fungi grow everywhere, including the soil, in water and on plants on us, and in other organisms and of course inside our homes. Back in the 1990s people thought there were about 1.5M fungi on earth because only some of them had been described. However, more recent genetic sequencing tools put the total number of fungal species on Earth at over 5 Million. When we think about research on fungal diversity it’s a bit like the concept of the microbiome in our gut and similarly is referred to as the mycobiome. The purpose of today's talk is to discuss the relationship that we have with fungi in the built environment or the mycobiome of our homes. To do this, I want to focus attention on a groundbreaking pre-print paper that came out on the 16th of December 2021 on medRxiv. This looked at the relationship between specific types of fungi and how Species diversity can be used to predict the seriousness of influenza type infections like COVID-19 mortality. When you think about the over 5M fungal species that exist on the planet and juxtapose this against the approximate 2000 mushrooms species we might eat as food - there really are a lot of chance and probable possibilities for us to come into contact with these microorganisms in our everyday lives. This new paper that came out from the Lawrence Berkeley National Laboratory is quite an eye-opener because it looked at how fungal communities inside 1135 homes in the United States is connected with something called the Infection Fatality Ratio (IFR) which describes the number of deaths caused by COVID-19 per 1000 coronavirus infections. Their research showed that an increased fungal diversity especially for specific Species of indoor fungi versus outdoor fungi (Beta diversity) was associated with a reduced infection fatality ratio. Their hypothesis was premised on the known fact that (i) humans probably have an evolutionary adaptation to maintaining semi-stable close contact with microbes such as fungi without major adverse impact. As well, (ii) it’s known that early life exposure to certain types of bacteria, yeasts, and fungi actually stimulates the immune system. In their paper, they looked at whether there was a correlation between certain Species of fungi and adverse outcomes from COVID? And amazingly they found that “yes” there is! They found that something called the beta diversity assessed from a comparison between fungal spore types collected outdoors and then inside the home living environment was of fundamental importance. To understand this concept, I need to explain what beta diversity is because this is a basic principle needed to understand this publication. [This presentation and the references in the show notes below detail exactly how to do this]. However, the key result is that: high diversity of outdoor fungi when also present indoors is associated with a suppression effect for COVID-19 mortality. This means that collecting spore trap measurements from the outdoors and indoors is very important for predicting adverse events like mortality from COVID-19 and emphasizes the importance of the environment on human illness. Now it’s not just the raw numbers of fungi, but the overlap of which types are present outdoors and also found indoors which defines different aspects of Species richness and diversity. The research showed that at least four of the following seven fungal genera have a key role in suppressing coronavirus infections. These were: Alternaria, Aspergillus, Epicoccum, Eurotium, Toxicocladosporium and Wallemia as well as a novel Mycosphaerellaceae fungus. You could argue that simply airing out your property will naturally bring fresh outdoor air containing mould spores indoors. So, wouldn’t that automatically select for the correct beta diversity ratio that’s better for your health? On the surface, you'd be right to conclude this. However, I've personally done 1000s of indoor air quality inspections over the years and many homes have hidden mould problems that contribute to poor indoor air quality. This is often caused by water damage and dampness and in most of these cases, there is a skewed distribution of fungi indoors that’s very different to the outdoors. This publication is extremely important because it shows a correlation effect between bioaerosol counts especially mould spores and respiratory disease outcomes. The key takeaway here is that COVID-19 mortality is suppressed inside homes where the outdoor fungi occur indoors at very similar levels. When the skewness or difference between the outdoor: indoor diversity changes, or when the indoor fungi are significantly different to the outdoors, then COVID-19 mortality increases. These researchers found that fungal beta diversity was a much stronger correlate for adverse COVID-19 outcome as age. For example, older persons have worse COVID-19 outcomes, and this paper says that fungal beta diversity in the wrong direction is also bad for your health. The authors stress the method is unlikely to be restricted only to coronavirus but could extend to surveillance of other allergic and viral diseases. This research, therefore, underscores the importance of fungal biosurveillance in the built environment to improve public health outcomes. REFERENCES: The impact of environmental mycobiomes on geographic variation in COVID-19 mortality. December 16, 2021. Joshua Ladau, Katrina Abuabara, Angelica M. Walker, Marcin P. Joachimiak, Ishan Bansal, Yulun Wu, Elijah B. Hoffman, Chaincy Kuo, Nicola Falco, Jared Streich, Mark J. van der Laan, Haruko M. Wainwright, Eoin L. Brodie, Matthias Hess, Daniel Jacobson, James B. Brown medRxiv 2021.12.14.21267549; doi: https://doi.org/10.1101/2021.12.14.21267549 Blackwell M. The fungi: 1, 2, 3 ... 5.1 million species? Am J Bot. 2011 Mar;98(3):426-38. doi: 10.3732/ajb.1000298. Epub 2011 Mar 2. PMID: 21613136. Li, H., Tian, Y., Menolli, N., Ye, L., Karunarathna, S., & Perez‐Moreno, J. et al. (2021). Reviewing the world's edible mushroom species: A new evidence‐based classification system. Comprehensive Reviews In Food Science And Food Safety, 20(2), 1982-2014. doi: 10.1111/1541-4337.12708 Koenigsberg, A. (2021). How to Calculate Species Evenness. Retrieved 23 December 2021, from https://sciencing.com/calculate-species-evenness-2851.html Bezerra JDP, Sandoval-Denis M, Paiva LM, et al. New endophytic Toxicocladosporium species from cacti in Brazil, and description of Neocladosporium gen. nov. IMA Fungus. 2017;8(1):77-97. doi:10.5598/imafungus.2017.08.01.06 Sandoval-Denis M, Sutton DA, Martin-Vicente A, Cano-Lira JF, Wiederhold N, Guarro J, Gené J. Cladosporium Species Recovered from Clinical Samples in the United States. J Clin Microbiol. 2015 Sep;53(9):2990-3000. doi: 10.1128/JCM.01482-15. Epub 2015 Jul 15. PMID: 26179305; PMCID: PMC4540897. Videira, S., Groenewald, J., Nakashima, C., Braun, U., Barreto, R., de Wit, P. and Crous, P., 2017. Mycosphaerellaceae – Chaos or clarity?. Studies in Mycology, 87, pp.257-421. Baselga, A., 2015. What is Beta Diversity?. [online] Methods Blog. Available at: [Accessed 23 December 2021].

This week on The Mould Show, I'm going to be talking about censorship of mould illness. And to do this, we’ll be reviewing a paper that came out earlier this year that focused on the situation in Finland. Essentially, this is a battle between free democracy and socialism and the impact that politics has on contemporary scientific thinking and the dissemination of applied science into the wider community. So, what's this all about? Well, most of us understand the connection between bad indoor air quality and water damage and how this can impact our health. However, I'm always amazed when people try to negate this connection between environmental exposure and illness or outright deny the scientific facts. This is very perplexing because on the one hand, when the mainstream media is considering carbon credits, or net-zero, they seem to have no trouble linking the slightest change in the environment with some type of consequence to someone somewhere. In certain socialist, corporatist European countries like Finland, mould related illness has become highly politicized. And today we're going to be reviewing a paper put out by Professor Tamara Tuuminen in May/June 2021. She is a very courageous scientist and doctor who discusses the fact that even though the epidemiological literature shows an overwhelming consensus that mould induces a multi-organ symptomology way beyond just the sniffles - that many government and corporate institutions in her country of Finland deny this link. She discusses the Government Department of Health and Welfare as well as the Finnish Institute of Occupational Health as two of the key institutions that aim to deny mould as a real environmental illness. Her paper discusses how this is achieved using corporatist special interest groups and educational bodies who often position themselves as independent opinion leaders. In many cases, they are far from unbiased and can demonstrate corruption by not disclosing hidden conflicts of interest or selectively quoting only those academic works of literature that support the government or corporate agenda. In the Livestream, I'm going to present evidence as far back as 1964 showing that this approach is patently false, and any non-brainwashed person can easily verify these facts for themselves. DYOR and it quite easy then to connect environmental illnesses connected with mould and the many very real physiological problems that can ensue. I'll also discuss how the Finnish attempt to use mindfulness exercises and referrals to psychologists or psychiatrists, instead of addressing the fundamental problem of indoor air quality and building damage. Contemporary, mainstream narrative protocols instead blame the person for the sickness and from a clinical perspective, attempt to retrain the patient’s brain to remove the stressful situation. I hope you'll join with me and watch the live stream or download the podcast which touches on multiple areas of contemporary #FollowTheScience and #Censorship of science and how this has become politicized. I’ll conclude with some recommendations that you can follow to minimize this bias to get at the ground truth and let the science help rather than hurt you. REFERENCES: Tuuminen T. Dampness and Mold Hypersensitivity Syndrome, or Mold-related Illness, Has Become Highly Politicized and Downplayed in Finland. Altern Ther Health Med. 2021 May;27(3):59-64. PMID: 33882029.

You might not know it but there is an increasing incidence of mould related illness worldwide due to changes in building practices and efforts to cut heating energy losses. This has led to building construction of homes that don't breathe as effectively, the use of lightweight construction practices, often using risky and poorly tested building materials. This combination of poor building practices and attention to detail, means that errors in the construction process often lead to a series of unwanted building defects that conspire to make water management problems turn into mould problems that are often hidden behind wall, floor or ceiling linings. These problems can lead to mould related disease and the defining hallmark of this is chronic exposure of the respiratory system to bioaerosols, like mould. In this presentation, I want to review something called salt therapy, which is considered a complementary method for the treatment of respiratory tract illnesses. This will have a special focus on mould related disease. Clinical practice referrals my Company receives revolve around exposure to indoor air dampness and mould, usually in the home. When this is prolonged, it can cause problems including: vocal cords irritation, rhinitis, cough, wheezing and recurrent infections of the upper and lower respiratory tract. Breathing in bioaerosols might also make existing asthma worse or bring on new asthma in children or adults. Many of the client and patient referrals we receive complain that their doctor does not truly understand their symptoms or may even consider some of these to be psychosomatic. Apart from focussing on fixing the building, what can you do to ‘get well’ if you’re mould affected? To this end, an important paper recently came out in the Journal: Alternative Therapies in June 2021 (https://pubmed.ncbi.nlm.nih.gov/34726628/). Salt therapy is put forward as a treatment for mould related illness. But what is it and why does it work? Salt therapy has developed into a holistic complementary therapy available in day spa-like environments based on observations made by a 19th century Polish doctor, Feliks Boczkowski. He noticed that salt mine workers had far fewer skin and respiratory health symptoms compared with other mine workers. Later during World War II in Germany, people who sheltered during bombing in salt caves were observed to experience relief from respiratory problems. Salt therapy exploits or mimics the microclimate of natural salt caves. People who spend time in these caves are take advantage of what is called Spleotherapy in the literature. This involves inhaling pure sodium chloride, NaCl along with other aerosolized elements including magnesium and calcium. A different version termed Halotherapy allows people to experience the benefits of salt therapy by spending time in a room that has salt coated walls and floor. Halotherapy may also use a generator (termed a halogenerator) to produce fine sodium chloride aerosols (1-5-micron diameter) which are aerosolized in the ‘salt room’. The salt easily penetrates into all parts of the respiratory tract and has antibacterial and anti-inflammatory properties. Salt particles also promote ciliary transport in the lung, allowing mucus plugs to be coughed up and it also reduces IgE inflammatory levels. Doctors have used salt therapy in the treatment of allergic rhinitis, asthma, COPD, bronchitis for cystic fibrosis and for viral bronchiolitis. There is even research support linking the use of salting of face masks to neutralize the SARS-CoV-2 virus in an effort to combat COVID-19. Salt therapy is known to be 100% natural and it's generally safe because it improves the clearance of particulates from the lung, often provides relief from coughing and reduces bronchial inflammation. It’s easily experienced by spending time in a salt room (30-60 min. sessions) repeated 10 to 20 times. If your home might be mouldy, then consider salt your new ally for health promotion. REFERENCES: Wasik AA, Tuuminen T. Salt Therapy as a Complementary Method for the Treatment of Respiratory Tract Diseases, With a Focus on Mold-Related Illness. Altern Ther Health Med. 2021 Oct;27(S1):223-239. PMID: 34726628. https://pubmed.ncbi.nlm.nih.gov/34726628/ Preeti Shah. (2019). A Review of Salt Therapy as a Complementary Treatment for Enhancing Respiratory Wellness and Skin Ailment. The Indian Practitioner, 72(5), 28-32. Retrieved from https://articles.theindianpractitioner.com/index.php/tip/article/view/34 Tuuminen T. Dampness and Mold Hypersensitivity Syndrome, or Mold-related Illness, Has Become Highly Politicized and Downplayed in Finland. Alternative Therapies in Health and Medicine. 2021 May;27(3):59-64. PMID: 33882029. Quan, FS., Rubino, I., Lee, SH. et al. Universal and reusable virus deactivation system for respiratory protection. Sci Rep 7, 39956 (2017). https://doi.org/10.1038/srep39956 Rubino, I., Oh, E., Han, S. et al. Salt coatings functionalize inert membranes into high-performing filters against infectious respiratory diseases. Sci Rep 10, 13875 (2020). https://doi.org/10.1038/s41598-020-70623-9

Black fungus disease can have a devastating impact for people who contract COVID 19 and even for those who are recovering from COVID-19 and who are more properly classed as COVID long haulers. My purpose in presenting this live stream is really to bring about awareness to every person about the potential impact of black fungus and explore some of the reasons why everyone should be aware of post-COVID infection co-infection with black fungi. It is my hope that this live stream prevents unnecessary illness, infection and even death. So, what are the common types of black fungus and why is this connected with COVID? To answer this question, I need to focus on two of the most common fungi that are implicated in mucormycosis and they are from the Genus that includes Rhizopus sp. and Mucor sp. These are typically fast-growing fungi that produce copious spores. The problem is that these black coloured fungi in the immunocompromised hosts such as those recovering from COVID can utilize the iron in blood as a food source. It must be remembered that the pre-COVID infectious period includes the one to two weeks prior to symptoms. The next month is the acute phase of COVID infection. And after five weeks, this is the post-COVID-19 period. Those admitted to hospital are commonly offered steroid medications. These steroids like dexamethasone work by dampening down the body's immune system, but at the same time they also increase the levels of iron in the blood, which the black fungi use as a food source. Although dexamethasone does work and is a relatively inexpensive medication, it is a problem for treatment, especially when this has become widespread due to the fact that although it produces an anti-inflammatory effect, this property is at the same time, immunosuppressive in action. These mean this steroid has two contrasting properties as a treatment. There are many ways in which black fungus can enter the body. Depending on where it enters, this determines the impact of the severity of the fungal infection. So, what is the takeaway from this particular livestream? Number one, it's very important that you know whether or not you are at risk. Just because you've recovered from COVID 19 does not mean that your body is capable of neutralizing invading pathogens like the black fungi. Everyone should be mindful of the fact the indoor living environment has an effect on your overall health and predisposition to infection. Therefore, inadequate hygiene, high humidity, and water damaged materials can cause an already compromised immune system to become susceptible to various diseases. REFERENCES: Pushparaj K, Kuchi Bhotla H, Arumugam VA, Pappusamy M, Easwaran M, Liu WC, Issara U, Rengasamy KRR, Meyyazhagan A, Balasubramanian B. Mucormycosis (black fungus) ensuing COVID-19 and comorbidity meets - Magnifying global pandemic grieve and catastrophe begins. Sci Total Environ. 2022 Jan 20;805:150355. doi: 10.1016/j.scitotenv.2021.150355. Epub 2021 Sep 16. PMID: 34818767; PMCID: PMC8443313. https://doi.org/10.1016/j.scitotenv.2021.150355 Lukács, G., Papp, T., Nyilasi, I., Nagy, E., & Vágvölgyi, C. (2004). Differentiation of Rhizomucor species on the basis of their different sensitivities to lovastatin. Journal of clinical microbiology, 42(11), 5400–5402. https://doi.org/10.1128/JCM.42.11.5400-5402.2004 Zupančič, J., Novak Babič, M., Zalar, P., & Gunde-Cimerman, N. (2016). The Black Yeast Exophiala dermatitidis and Other Selected Opportunistic Human Fungal Pathogens Spread from Dishwashers to Kitchens. PloS one, 11(2), e0148166. https://doi.org/10.1371/journal.pone.0148166. Air Quality and Mould Inspection Report: Nauru Regional Processing Centre. https://www.homeaffairs.gov.au/foi/files/2020/fa-191000441-document-released.PDF

According to a new study just published on November 17, by the American Thoracic Society, there is a misalignment between available clinical mould antigen extracts and the actual levels and types of airborne fungi found in water-damaged homes. What does this mean? According to the paper, there are five key reasons why indoor air sampling is used. These include (1) health concerns by occupants, (2) visible fungi, (3) known water damage or dampness, (4) smelling a mould or musty odour or (5) proactive evaluations. Proactive evaluations include pre-purchase inspections or quarterly or annual preventative air samplings. Common health concerns from mould include asthma, allergic rhinitis, wheeze, cough, shortness of breath, or hypersensitivity pneumonitis, headache, eye and skin problems and other health issues. It is reasonably well known, at least by the integrative health community, that exposure to moulds and other fungi is correlated with a range of allergic and pulmonary diseases in susceptible individuals. Allergy is often tested using antigen extracts. The paper we're discussing today shows that the available antigen extracts are not well matched to the types of fungi that are commonly found indoors. Allergic sensitization is measured in vivo by something called the skin prick or intradermal testing method or by serological testing against a panel. Fungal antigens are therefore used to determine reaction and it is an important clinical diagnostic that supports environmental inspections. It is also known that environmental remediation is correlated with improved outcomes of hypersensitivity pneumonitis and asthma. But linking these conditions with buildings relies on either the environmental inspection or the clinician being able to prove the allergy using fungal antigens. This important paper shows that the actual spore counts in the air reveal exactly which fungi are most likely to induce allergy. The research reviewed nearly 25,000 indoor air samples from over 7,500 mould affected or complaint homes and compared them against nearly 30,000 outdoor air samples. It was found that the Penicillium fungus was the dominant Genus in water-damaged homes and was more common than Aspergillus. Overall five important Penicillium Genus fungi and three Aspergillus Genus species were identified as the predominant indoor water damage related fungi. Notably, none of the Penicillium species and only one of the Aspergillus species has a clinical antigen extract available for skin testing or serum testing. The conclusions show variously that commercial production of additional antigen extracts are required and that air spore count measures are fundamentally important to determine the risk level of the indoor air versus the outdoor air. So, what is healthy air versus unhealthy air? The researchers review the recommendations put forward by the American Industrial Hygiene Association (AIHA) who state that higher indoor versus outdoor mould levels, determined using either viable Petri plate culture or spore trap air sampling should be considered as unhealthy. This new research also introduces a new quantitative minimum threshold risk level: Where the combined concentration level of Penicillium/Aspergillus fungi in the indoor air is greater than 200 colony forming units per cubic meter of air (CFU/m3) higher than in the outdoor air. This may be an appropriate evidence-based benchmark. This research concludes by stating that the accuracy of clinical detection of mould sensitivity can be significantly improved by (1) adding new antigen extracts for the predominant species of Penicillium and Aspergillus commonly identified in damp and mould affected homes and that (2) this will lead to improved outcomes for individuals who suffer from mould related conditions so that (3) timely environmental interventions such as (4) patient relocation and or (5) mould remediation when required can be implemented as a (5) critical component of disease management to improve the outcomes of asthma and hypersensitivity pneumonitis in the built environment. REFERENCE: Misalignment between Clinical Mold Antigen Extracts and Airborne Molds Found in Water-Damaged Homes. William M Sothern, Sarah L O'Beirne, Michael Berg, Daniel Devine, Nasrin Khandaker, Christopher Mikrut, and Robert J Kaner Published online: November 17, 2021as DOI: https://doi.org/10.1513/AnnalsATS.202101-096OC

Summer is approaching, at least for us here in Australia and for some of us, looking down at our toes might bring on a "yuck" reaction. Why are those nails cracked, fragile or showing discoloration? Are you embarrassed by this? What's causing it? How do I stop it? Is this a sign of something worse? That's the topic of this week's show. And importantly, we're going to be talking about how the health of your toenails and even the health of the nails on your fingers can be used as an indicator of overall health. To do this, we're going to go through some of the most common questions around nail fungus including symptoms and which groups of people are most likely to get fungal nail infections? What are the terms about this microbial infection and what are the typical fungi that cause this? We'll also talk about some of the environmental hazards for foot fungus as well as how it's diagnosed at the lab and then move on to how you can prevent fungal nail infections and discuss some of the treatments from the research literature. With this foundation we'll then move on to the central topic of today's presentation, which is looking at the association between foot and nail fungus and COVID 19 clinical outcomes and we'll be discussing what the scientists discovered and why it's very important to deal with fungal nail infections because they do have an impact on the clinical outcomes of respiratory illnesses like COVID-19. REFERENCES: Rakita U, Kaundinya T, Guraya A, Nelson K, Maner B, Manjunath J, Schwartzman G, Lane B, Silverberg JI. Associations between onychomycosis and COVID-19 clinical outcomes: a retrospective cohort study from a US metropolitan center. Arch Dermatol Res. 2021 Nov 12. doi: 10.1007/s00403-021-02299-8. Epub ahead of print. PMID: 34773138. https://link.springer.com/article/10.1007%2Fs00403-021-02299-8 Elewski B. E. (1998). Onychomycosis: pathogenesis, diagnosis, and management. Clinical microbiology reviews, 11(3), 415–429. https://doi.org/10.1128/CMR.11.3.415 Robres P, Aspiroz C, Rezusta A, Gilaberte Y. Usefulness of Photodynamic Therapy in the Management of Onychomycosis. Actas Dermosifiliogr. 2015 Dec;106(10):795-805. English, Spanish. doi: 10.1016/j.ad.2015.08.005. Epub 2015 Oct 1. PMID: 26427737.

Have you ever wondered whether there's a connection between the seasons and flu like epidemics? Well, this week on The Mould Show, we're going to be looking at two recent pieces of evidence, which focus on the fact that current models for flu-like epidemics are not sufficiently explained by the seasonality effect. Now, most of us would think to ourselves that colds and flus are often more frequent in the cooler winter months, and that gives rise to the seasonality effect. However, two papers have recently provided some stunning evidence suggesting that there is a strong statistical association between exposure to pollen and mould and the infection potential of flu-like illnesses. We know that pollen is allergenic and that it's linked to immune-activation and defence against a range of different respiratory viruses. But, interestingly, it seems to create a bioaerosol that when inhaled, seems to lower the reproduction number of flu-like viruses. These results for pollen were quickly followed up on by another research group that decided to look at whether or not there was a correlation with mould spore exposure. And that's the main focus of this live stream. The follow-on paper and results show again, a statistically strong correlation between the total bioaerosol count, the total pollen count, and the total mould spore count and presentations to hospital emergency departments for influenza-like illnesses. The final part of the presentation will review how the authors have used mould spore counts and pollen counts to show that COVID-19 presentations and hospitalizations are correlated with the airborne mould spores and pollen counts. This data has significant implications for how we understand disease transmission of flu-like illnesses and chosen interventions against. I look forward to you joining me for this exciting episode. References: Confirmation of an Inverse Relationship between Bioaerosol Count and Influenza-like Illnesses, Including COVID-19. On the Contribution of Mold Spores Richa B.Shah,Rachna D.Shah,Damien G.Retzinger,Andrew C.Retzinger,Deborah A.Retzinger,Gregory S.Retzinger medRxiv2021.02.07.21251322;doi:https://doi.org/10.1101/2021.02.07.21251322 Pollen Explains Flu-Like and COVID-19 Seasonality Martijn J. Hoogeveen, Eric C.M. van Gorp, Ellen K. Hoogeveen medRxiv 2020.06.05.20123133; doi: https://doi.org/10.1101/2020.06.05.20123133 Now published in Science of The Total Environment doi: 10.1016/j.scitotenv.2020.143182 https://www.medrxiv.org/content/10.1101/2020.06.05.20123133v4

If you've ever found yourself having trouble explaining to someone why you just don't feel right inside that room or building, then you'll want to watch this. Ok, you might just sneeze a little over springtime when exposed to pollen...but what if those types of symptoms happened to you every time you clocked in at work? How do you make sense of this? Sick building syndrome is a catch-all term that is often used to describe the constellation of symptoms that may occur if you react to this "something" indoors. There's also the problem of long-term exposure. If you're constantly exposed to a challenging environment, your symptoms may get worse. That's the topic of the show today and will focus attention on what clinicians know lies beyond sick building syndrome. I'll go over what they know about multiple chemical sensitivity, hypersensitivity and chronic fatigue. The research shows that the duration of exposure along with other co-morbidities leads to a worsening of symptoms and an expansion on the clinical definitions of illness. I conclude with commentary on the important role of site testing and the need for microbiology data. There's a self-serving reason why your insurance-led occupational hygienist or landlord or rogue builder might want to dismiss your claims about health and water damage and mould exposure. There's also a simple argument against such self-serving claims. That's called "Lege artis:" and is Latin for the need to sample the environmental microbiology and toxicology in the same way any other diagnostic specimen is taken. Don't allow any authority to rely on a visual inspection or say that no visible mould was seen and hence there is no problem. Use and be aware of the "Lege artis" and the fact there are multiple Standards and Guidelines for indoor air quality and water damage and microbial assessment. Don't led no data or poor data compromise your health or the lie that mould isn’t a problem as long as we dry out your building. Remember there’s an industry who want your money for works that are all too often poorly implemented or unverified for source removal. If you’ve ever been sold the snake oil that “we’ll just fog to treat the mould” recognize that that’s not removing the microbial risks and dead mould can still cause a serious immune challenge. This livestream is for all those that need that one publication to help explain and support how they feel and where the science is at around this topic of risk and exposure to water damage and mould. Reference: Tuuminen T. The Roles of Autoimmunity and Biotoxicosis in Sick Building Syndrome as a "Starting Point" for Irreversible Dampness and Mold Hypersensitivity Syndrome. Antibodies (Basel). 2020 Jun 22;9(2):26. doi: 10.3390/antib9020026. PMID: 32580407; PMCID: PMC7345570. https://www.the-sun.com/news/3981683/son-scared-home-mould-missed-school/ https://www.abc.net.au/news/2021-10-13/condobolin-aboriginal-tenants-houses-mould-termite-faults/100530342

Asthma is a common respiratory condition causing an attack or spasm of the bronchioles or airways that carry air to the lungs. Asthma makes it difficult to breathe and in Australia affects one in nine people equivalent to 2.7 million Australians. In the period between 2017-2018, nearly 40,000 hospitalisations occurred. It's known that 80% of asthma hospitalisations are preventable. Now it's not just the hospital costs - asthma affects the quality of life. Asthma sufferers self report their wellbeing as "fair" or "poor" compared with other people without asthma. Some interesting research was recently published in the journal, Indoor Air in September 2021. It looked at what household features contribute to biocontamination and that are linked with asthma. What are some of the typical biocontaminants that might cause asthma-type health effects? Most of us can recall images of pollution haze and coughing, but different types of microorganisms, dusts and pollens and household behaviours are also likely suspects. The paper I'm highlighting is from Canada and the scientists collected dust from people's homes to determine the concentrations of: house dust mite allergens, cat allergens, cockroach allergen, beta-(1,3)-D-glucan and endotoxin levels. They also used a questionnaire as part of home inspections to ask about features and behaviours in the home. What did they find? They discovered that the age of the home and whether or not carpets were present along with the history of water damage and mould odour were https://www.rev.com/all positively associated with the presence of multiple indoor contaminants linked to asthma. They also found that high floor cleaning frequency and the use of dehumidifiers were negatively associated with the presence of multiple indoor contaminants. This live stream will review this data and list the Top 8 asthma and allergy triggers. I've also created a free survey so you can measure your own home for risk factors linked to asthma and allergic disease. You can find the survey here: https://drcameronjones.checkboxau.com/asthma-and-allergy-triggers REFERENCES: Sun L, Miller JD, Van Ryswyk K, et al. Household determinants of biocontaminant exposures in Canadian homes. Indoor Air. 2021;00:1–11. https://doi.org/10.1111/ina.12933

On the 22nd October 2021, Victoria, Australia begins our own Freedom Day. But is this really freedom? State-wide vaccine mandates are in force and there's a need for vaccine passports to enter retail. For many, significant restrictions remain. The State is still under a form of medical apartheid. Strict coercion around freedom of choice has forced many to choose vaccination just to re-enter society or keep their job. The censorship around therapeutic options and facts and figures and open debate have largely been silenced across the mainstream media. This short Livestream discusses a very recent publication that came out (20th October 2021) on the preprint server, medRxiv. This paper serves as a warning around the very real risks of transmission among the vaccinated. Please read it for yourself and consider the results and conclusions. REFERENCE: Evidence of transmission from fully vaccinated individuals in a large outbreak of the SARS-CoV-2 Delta variant in Provincetown, Massachusetts https://www.medrxiv.org/content/10.1101/2021.10.20.21265137v1

This Week in Victoria and New South Wales and many other parts of Australia we're reopening and a lot of the lockdown restrictions are being lifted. So what does that mean? Well, many of our children will be returning to school - so this week I want to be focusing on a very important non-pharmaceutical intervention, which revolves around indoor air quality. And this is a particularly relevant and topical, because if you've picked up any of the news media over the last couple of weeks, you may have noticed a range of different stories focusing on both the Victorian announcement regarding the $190 million package for air purifiers to be put into all public schools. Similarly, in New South Wales people are calling for stronger ventilation Standards, and this is shining a spotlight on a very important engineering control step to address public health concerns around respiratory viruses. And so today we're going to be focusing on HEPA which stands for High Efficiency Particulate Air, and I'm going to be reviewing and answering the following questions: - Are portable air purifiers effective? - What to look for in an air purifier? - What are some of the definitions you should be aware of when you look online, if you want to purchase one of these HEPA air purifiers for your own home or office? - Do portable air purifiers work against covid? - Is there research showing HEPA is of benefit for particulate matter and in turn bacteria, fungi, pollen and even viruses when they are put to the test? - What are the best portable air purifiers according to science? And this should help you out when you return to your High street retailer and look on the box for specifications or DYOR online. I also want to talk about some of the scientific evidence that is the premise for why HEPA is a valuable intervention. Then, what is the evidence for whether they work or not against the SARS-CoV-2 virus? I'll also be reviewing some of the writings from expert panels, such as OzSage, and their recommendations regarding carbon dioxide, and ventilation standards for buildings. Importantly, I will review were HEPA air purifiers fail, and some of the common mistakes that can occur when people are trying to matching a portable HEPA air purifier for a particular space. Finally I'll round out with some of the benefits that are validated from the literature, such as improving the or reducing the probability of hospital acquired infections, specifically around fungal pathogens. Then, I'll conclude with some very recent research looking at the benefits of HEPA air quality and depression. REFERENCES: 1. Hammond A, Khalid T, Thornton HV, Woodall CA, Hay AD (2021) Should homes and workplaces purchase portable air filters to reduce the transmission of SARS-CoV-2 and other respiratory infections? A systematic review. PLoS ONE 16(4): e0251049. https://doi.org/10.1371/journal.pone.0251049 2. Rodríguez, M., Palop, M., Seseña, S. and Rodríguez, A., 2021. Are the Portable Air Cleaners (PAC) really effective to terminate airborne SARS-CoV-2?. Science of The Total Environment, 785, p.147300. https://doi.org/10.1016/j.scitotenv.2021.147300 3. Protecting children from COVID-19 and making schools and childcare safer. https://www.burnet.edu.au/news/1523_ozsage_advice_on_protecting_children_from_covid_19 https://www.burnet.edu.au/system/asset/file/4947/OzSAGE_Children_and_Schools_and_Childcare.pdf https://ozsage.org/ventilation-and-vaccine-plus/ 4. Tamana, S., Gombojav, E., Kanlic, A., Banzrai, C., Batsukh, S., Enkhtuya, E., Boldbaatar, B., Lanphear, B., Lear, S., McCandless, L., Venners, S. and Allen, R., 2021. Portable HEPA filter air cleaner use during pregnancy and children's body mass index at two years of age: The UGAAR randomized controlled trial. Environment International, 156, p.106728. 5. Curtis L. HEPA Filters and Airborne Viruses, Bacteria, and Fungi. Otolaryngology–Head and Neck Surgery. July 2021. doi:10.1177/01945998211035104 6. Liu DT, Phillips KM, Speth MM, Besser G, Mueller CA, Sedaghat AR. Portable HEPA Purifiers to Eliminate Airborne SARS-CoV-2: A Systematic Review. Otolaryngology–Head and Neck Surgery. June 2021. doi:10.1177/01945998211022636 7. Enkhbat, U., Gombojav, E., Banzrai, C. et al. Portable HEPA filter air cleaner use during pregnancy and children’s behavior problem scores: a secondary analysis of the UGAAR randomized controlled trial. Environ Health 20, 78 (2021). https://doi.org/10.1186/s12940-021-00763-6 8. Liu X, Qian X, Xing J, Wang J, Sun Y, Wang Q, Li H. Particulate Matter Triggers Depressive-Like Response Associated With Modulation of Inflammatory Cytokine Homeostasis and Brain-Derived Neurotrophic Factor Signaling Pathway in Mice. Toxicol Sci. 2018 Jul 1;164(1):278-288. doi: 10.1093/toxsci/kfy086. PMID: 29688525.

According to the World Health Organization, cardiovascular disease is the leading cause of death globally. In 2019, it was estimated that 17.9 million people died from cardiovascular disease. This represents 32% of all global deaths with 85% being caused by heart attack and stroke. It is further reported that 75% of cardiovascular disease deaths, take place in low and middle-income countries. Heart disease and mortality are considered premature death. This is because most cardiovascular diseases can be prevented by focusing on behavioral risk factors. These include tobacco use, unhealthy diet, obesity, a lack of physical activity, and harmful use of alcohol. It's therefore important to detect cardiovascular disease, as early as possible so it can be managed with lifestyle, counseling, and medication as required. So what can Danish nurses tell us about the risk of heart failure? A lot, actually. A recent paper published in the Journal of the American Heart Association has conducted original research and made some profound discoveries that all of us should be aware of. So what exactly do I mean when I talk about the Danish nurses in Denmark? A study was begun in the early 1990s, which was looking at 22,189 Danish nurses to determine whether or not there were environmental risk factors connected with heart failure. The study goals were premised on the fact that millions of people die from heart failure, and those that live are frequently hospitalized, have poor quality of life, and experience multiple comorbidities. The researchers already knew that risks like smoking, excess alcohol consumption, and obesity were linked to pre-existing conditions like hypertension, coronary artery disease, diabetes, and myocardial infarction. They also knew that air pollution is a recognized risk factor for cardiovascular disease. Scientists define heart failure, as the reduced ability of the heart to pump or fill with blood. This is a subcategory of cardiovascular disease. The question they were looking at was whether air pollution might induce oxidative stress and inflammation and in turn, cause an imbalance to the autonomic nervous system. The trial tracked a large number of female Danish nurses, from 1993 and 1999 which was the baseline, all the way up until the end of 2014. Over this nearly 2 decade period, they found some fascinating associations between heart failure and exposure to environmental pollutants. The key takeaway from the data is that heart failure was strongest when the nurses were exposed to very fine particulate matter (PM2.5) having a diameter of less than 2.5 microns. The researchers also found that road traffic noise was also associated with the incidence of heart failure. Over 2% of the nurses suffered heart failure. These nurses were most likely to have been exposed to PM2.5, traffic noise, and NO2 pollution. The heart failure nurses were also more likely to be former smokers and to have high blood pressure. You don't have to be a Danish nurse to recognize that the clinical implications of this research are that air pollution and road traffic noise are correlated with an increased risk of heart failure. Targetting public health interventions to former smokers or those with high blood pressure, as well as those who live with exposure to air pollution is warranted. All of us should be aware of the silent risks to heart health from fine particle air pollution and road traffic noise. REFERENCES: Who.int. 2021. Cardiovascular diseases (CVDs). [online] Available at: <https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)> [Accessed 13 October 2021]. Lim, Y., Jørgensen, J., So, R., Cole‐Hunter, T., Mehta, A., Amini, H., Bräuner, E., Westendorp, R., Liu, S., Mortensen, L., Hoffmann, B., Loft, S., Ketzel, M., Hertel, O., Brandt, J., Jensen, S., Backalarz, C., Simonsen, M., Tasic, N., Maric, M. and Andersen, Z., 2021. Long‐Term Exposure to Air Pollution, Road Traffic Noise, and Heart Failure Incidence: The Danish Nurse Cohort. Journal of the American Heart Association, https://www.ahajournals.org/doi/10.1161/JAHA.121.021436

This is the video to accompany an OpEd I wrote for TrialSiteNews.com. The article is available here: https://trialsitenews.com/could-tucker-carlsons-nicotine-gum-habit-stop-covid/ ALL REFERENCES & HYPERLINKS IN THE ORIGINAL ARTICLE AT TrialSiteNews.com Could Tucker Carlson's Nicotine Gum Habit Stop Covid? by Dr. Cameron Jones, Ph.D. Tucker Carlson of Fox News fame is not a cigarette smoker but is known to chew nicotine gum throughout the day. He once told Gavin McInnes, the far-right political commentator that he spends $300 per week on the gum saying it provides "a deep sense of satisfaction" and "it forms the basis of your joy". Tucker also claims "it cures unhappiness" while insiders say he only stops chewing to film segments for his show. However more recent reports claim he has given up the nicotine chews after 36 years. Could it be time for Tucker to take up the habit again? Early in the pandemic researchers were scrambling to make sense of the data, much of this from China which has a high smoking prevalence. One review showed that current smokers were less likely to have an adverse COVID-19 outcome compared with former smokers. A groundbreaking pre-print from France in mid-2020 then examined if nicotine replacement therapy (NRT) given to smokers split into two groups (those with and without major smoking-related disease) would have an effect on hospitalization with COVID-19. In people without comorbidities from smoking-related diseases, nicotine replacement therapy was associated with a decreased risk of hospitalization. The ratio of NRT versus no NRT for patients hospitalized with COVID-19 was 151:496 while the ratio of death or intubation was 13:73. However, these trends did not carry over for patients having known smoking-related diseases. Continuing research then suggested that nicotine, not smoking, could offer some protection against COVID-19. There are even five clinical trials underway at the Hôpitaux de Paris,,, and at the Central Hospital, Nancy, France. They are investigating the potential protective effect of nicotine patches to prevent adverse outcomes like the need for mechanical ventilation or transfer to intensive care and even as a preventative. According to ClinicalTRials.gov these studies are active or recruiting or show as complete, but as yet, no new results have been published. Since the coronavirus pandemic began, doctors and scientists have observed that daily active cigarette smokers are less likely to become severely infected or hospitalized despite the fact the virus targets the lungs. Reformed puffers aren't so lucky and are more likely to become ill due to smoke-damaged respiratory or cardiovascular systems, or because of immune compromise. Ultimately, COVID-19 is an inflammatory syndrome illness. Current thinking is that the principal receptor allowing the SARS-CoV-2 virus to infect cells is through the angiotensin-converting enzyme 2 (ACE2) found in the lungs, small intestine, colon, kidney, brain, and heart. However, there is some doubt this is the only way the virus causes infection since high ACE2 levels may be beneficial rather than harmful, especially in people with lung injury, like smokers. When lungs are infected by bacteria, fungi or viruses a strong inflammatory response occurs. Illness severity depends on lung macrophages which switch between pro-inflammatory and anti-inflammatory modes by releasing high levels of inflammatory cytokines. This signals other cells to challenge the infection and helps with healing. Severe COVID-19 symptoms and mortality are related to an over-responsive immune system leading to the cytokine storm effect. What if other receptors or activators control whether the coronavirus can successfully gain entry into cells? This paradox is explained by the nicotine hypothesis where the addition of this alkyloid drug exerts its protective effect via the nicotinic acetylcholine receptor (nAChR) by modulating ACE2 expression and preventing a hyperinflammatory response. By increasing ACE2 expression in cells, lung injury and kidney damage can be limited. Nicotine may also help reduce platelet aggregation and stop clot formation since it has known antioxidant and anti-inflammatory properties. Even though pharmaceutical nicotine products are intended as smoking substitutes, their safety in non-smokers has been established. For example, nicotine replacement therapy has been used to treat multiple sclerosis, attention-deficit hyperactivity disorder (ADHD), Tourette syndrome, Parkinson's disease, Alzheimer's, arthritis, and ulcerative colitis. I reached out to Professor Bertrand Dautzenberg who reviewed the design of the French nicotine clinical trials for comment. He confirmed that although transdermal nicotine is being tested as a preventative against COVID-19 for up to 82 days it is "not in general practice and only in the prospective randomized trial" where they're watching for outcomes. The next part of the trial looked at treating patients already in the hospital for the duration of their stay (7-35 days). Dautzenberg commented that "because of vaccination, the accrual of patients dramatically dropped a few weeks after initiation, and we had to stop the trial". So, what about the potential of nicotine treatment of patients in intensive care (up to 30 days) which was another component of the latest trial? The good news from Professor Dautzenberg is that "the study is closed with the expected number of patients" and "we are cleaning the database and we plan to have results at the end of 2021". Although no published clinical results are available at this time to supplement the earlier work, a review of over forty international studies shows clear differences between smoking history and non-severe and severe COVID illness; with smokers being more than twice as likely to suffer severe illness. But there are numerous contradictory studies from China, South Korea, and India showing protection from SARS-CoV-2 infection from smoking. I asked Professor Dautzenberg about the importance of therapeutics like nicotine compared with vaccines and their role in public health messaging. He is of the view that the "vaccine is much more active but it's important to understand everything about COVID-19 including the interaction of nicotine with COVID". So even though we'll have to wait for the results from these trials, we all want to know whether nicotine might work as a preventative or to limit hospitalization or severity. To this, Prof. Dautzenberg commented "the only practical recommendation is to offer complete nicotine substitution in all hospitalized COVID" patients. I also reached out to Dr. Joe Kosterich, Chairman of the Australian Tobacco Harm Reduction Association (ATHRA) for comment but he was “not in a position to comment on the issues” since “the focus of ATHRA is tobacco harm reduction and use of alternate nicotine delivery systems to assist smokers to quit combustible tobacco”. Based on the scientific research alone, repurposing already available and approved nicotine products like gum or patches could help restore the compromised function of the nicotinic cholinergic system under coronavirus attack. This could be a valuable, low-cost therapeutic option for treating COVID-19 by reducing inflammation and suppressing the cytokine storm. Whether it’s lockdowns or mandates or infection itself, COVID-19 had undeniably altered the life plans for many of us. Even though it’s been said that not every disease is also an illness, quality of life is strongly linked with health and happiness. Philosophers call this beneficence in healthcare and is where medical interventions are meant to benefit the patient. At the same time, there’s a moral and ethical requirement for the patient to understand the risks and benefits before making an independent decision. As this pandemic evolves and we all look for our own personal protections against the virus, perhaps the final word fittingly is had by Tucker Carlson who said about nicotine, “the question really is – are you ready to be happy?”

- Many high-income countries including Australia have been playing vaccine roulette with our public health. Lockdowns and personal restrictions have been applied while institutions wait for the vaccine effect to kick in. - I’m not here to question the principle of immunisation that prevents disease transmission and infection which in many areas of application is effective. BUT - The problem is that the majority narrative for vaccine safety has not adequately looked at complementary strategies like: other treatments, strengthening the health system, non-pharmaceutical prevention, promotion of safe infection control practices and perhaps above all, a healthy lifestyle. - This talk will look at another complementary strategy and is a follow-on from my OpEd paper and talk on the potential benefits of nicotine against COVID infection. - A comment on this video suggested I should make a video on some outstanding University of Michigan research just published at the end of August 2021. I was curious and looked into this. WOW…important research and I want to bring you an overview of this and how you can take advantage of this yourselves. - Despite vaccination there is a need for antiviral compounds that can (i) control local outbreaks, (ii) be used for home-based management and (iii) be used for immunocompromised people for whom vaccination is not suitable and this is required to (iv) slow the spread of variants of concern that may escape vaccine neutralisation. - Repurposing already FDA-approved drugs is a good place to start to look for drugs that could be deployed as treatments for COVID-19. - The U. Of Michigan research has developed a way to quantitatively screen actual SARS-CoV-2 infection in human cells and screen for drugs that show in vitro antiviral activity. - The scientists screened 1425 drugs and found 17 that inhibited coronavirus infection. - I’m focussing on the top #1 = Lactoferrin (bovine lactoferrin) - They screened the drugs using African Green monkey kidney cells called Vero E6 as well as several cancer cell lines to see how the virus and drugs worked together. This provided additional insight into the impact of underlying co-morbidity and cancer treatment protocols on infection status. - We’re going to only focus on coronavirus infection in normal healthy cells in this talk. - They screened the 1425 FDA-approved compounds at 5 concentrations and looked for antiviral activity. - The best performing drug was a nutraceutical called Lactoferrin. This is a protein found in colostrum and milk. It was able to block SARS-CoV-2 replication at the entry level. - It was also found to be effective as a post-entry inhibitor - They also found that a common asthma inhaler (ipratropium bromide) used in the treatment of asthma and COPD curbed infection and reduced severe bronchial symptoms. - How does lactoferrin work? It controls the up-regulation and down-regulation of the immune response. - It decreases the production of IL-6 which is produced by the white-bloc cell macrophages which respond to infection. By reducing the levels of IL-6 this can reduce the cytokine storm effect. - Lactoferrin is known to be a safe nutritional supplement anyone can buy online from the pharmacy. - Lactoferrin is also found in cheeses, specially hard cheese like Swiss cheese. - Lactoferrin is cheap, widely available and according to research can be rapidly deployed for both prophylaxis and management of COVID-19 - Lactoferrin is known to be: anti-microbial, antifungal, antiviral, and anti-parasitic. It possesses an anti-inflammatory, immunomodulatory, and anti-cancer molecule. It is also a fundamental regulator of cellular iron homeostasis. - In healthy conditions, Lf concentration in blood is rather variable yet always relatively low. - To use lactoferrin for it’s anti-inflammatory and anti-cancer benefit, higher concentrations are needed to be effective, therefore, exogenous lactoferrin must be administered in vivo to overcome this drawback - Nutraceuticals like lactoferrin are natural compounds having potent antiviral activity, anti-inflammatory and anti-microbial activity and anti-cancer activity - A great candidate for combination therapies Mirabelli, C., Wotring, J., Zhang, C., McCarty, S., Fursmidt, R., Pretto, C., Qiao, Y., Zhang, Y., Frum, T., Kadambi, N., Amin, A., O’Meara, T., Spence, J., Huang, J., Alysandratos, K., Kotton, D., Handelman, S., Wobus, C., Weatherwax, K., Mashour, G., O’Meara, M., Chinnaiyan, A. and Sexton, J., 2021. Morphological cell profiling of SARS-CoV-2 infection identifies drug repurposing candidates for COVID-19. Proceedings of the National Academy of Sciences, 118(36), p.e2105815118.

Severe weather is becoming increasingly common as the effects of climate change bring wetter and warmer summers, along with more freak events such as cyclones and flash flooding. In Australia, the effects of El Niño and La Niña are a combination of ocean and atmosphere frictions. Amidst this, properties are at risk of costly damage, yet it may not be a monsoon or lightning that causes you or your property harm - it could well be mould. Water damage and the potential for subsequent mould is something that many of us have had to deal with at one time or another, but water damage from a storm or flooding raises a whole host of additional problems. Primarily, the source of the water can determine how much of a health risk the mould can pose to us. Category 1 water is clean, such as from a leaky pipe or overflowing bathtub. It is unlikely to produce unexpected mould growth, however the longer it is left untreated, the higher the risk becomes. Category 2 water contains a greater amount of chemical, biological or physical contaminants, such as water from an empty toilet bowl or a dishwasher. Often called grey water, it has microorganisms and nutrients that can facilitate the growth of potentially harmful moulds. Category 3 water, often called black water, is unsanitary and unsafe. It contains harmful bacteria and fungi comes from sewage, seawater, drains, rising water from rivers or streams, ground surface water or toilet backflows. These can all be caused by severe weather. The vast quantity of microorganisms naturally present in black water means that any kind of contamination within the home is likely to result in microbial growth, which poses a serious risk to health. Additionally, mould can often grow in the places we do not suspect or can’t easily reach, such as hidden behind plasterboard or in wall or roof voids where there is water damaged insulation. It can also easily grow under leaky bathroom or shower bases or underneath breached waterproofing on balconies. Because of this, identifying mould growth is hugely important, so it’s a good idea to inspect your property after severe weather. Other than visibly seeing it, one of the best ways to know if you have mould within the home is by its smell. Fungi give off characteristically pungent odours called microbial volatile organic compounds (mVOC’s), and having an expert investigate is a fast-track way to get the mould under control. So, what’s the best course of action to take after a spell of severe wet weather? Getting fresh air flowing throughout the property is a great start, as this will help remove any moisture from the air. Open doors and windows, but mechanical ventilation offers better control of the location and can dehumidify at the same time. Check the age of any filters for better particle filtration as this will ensure that any equipment is working at its best. Similarly, removing any standing moisture from surfaces and carpets as soon as possible will help to prevent mould growth. If any mould patches do emerge, then treat them quickly using a chemical disinfectant and regularly maintain mechanical ventilation if possible. Monitor and inspect for any odours from hidden mould or water-damaged areas that may need drying or remediation. Moreover, improving drainage inside and outside your property will help to remove any lingering water more quickly, reducing the chances of mould to begin growing. Performing regular building maintenance by checking the guttering and all wet areas, including bathrooms and kitchens, will ensure that your home is as mould safe as possible, and may even spare you an expensive repair bill further down the road. By being vigilant and knowing what to look out for you, can make sure that your home and your health can weather even the wettest of summers.

Pathogen. Germ. Bug. Infection. Virus. Plague. Today, more than ever, it seems like we are constantly surrounded by an invisible world of hidden dangers. These words are synonymous with our times, but we are not the first generation who have had to contend with a dangerous pathogen. So, what is a pathogen, and how has history shaped the relationship between them and humans? Pathogens, defined as an organism that causes a disease to its host, are spread across our planet on an unbelievably vast scope. They occupy every known environment, from nuclear waste sites to rocks buried thousands of metres beneath the surface of the Earth. Moreover, they are numerous as well as widespread. Scientists estimate the number of viruses on earth to be about 10 to the power of 31. That’s 10 billion times the number of stars in the universe. For over 1.5 billion years, viruses and other microorganisms have been seeking biological hosts in which they can manifest, and humans have been in an evolutionary brawl with pathogens including prions, viruses, bacteria and fungi for as long as we have existed. However, only about 1 in a billion microbes is a human pathogen, meaning we have identified around 1400 unique pathogens that can harm us, but as we’ve discovered with COVID-19, there is a huge amount of undiscovered threat. Pathogens have, of course, brought havoc and suffering to countless human populations throughout our history. They do this by colonising a host growing and manifesting inside us. They can enter us through our food or drink, and as we’ve seen with COVID-19, some can be airborne in water droplets. Once contaminated by the pathogen, they begin producing toxins which are often waste-products of the microbial cell life cycle. These toxins are often extremely poisonous. Anthrax, for example, has been exploited as a biowarfare agent. Our history is littered with the effects of such pathogens and their devastating effects. The Justinian Plague (541-549) claimed the lives of 100 million Europeans and brought about the fall of the Roman Empire. Fast forward 800 years and the Black Death is terrorizing Europe and Asia. One in three people in Europe were killed by the disease. To this day, building projects in London have to conduct investigation work to see if the ground underneath them is littered with the remains of medieval Londoners, tossed into one of the cities many plague pits. And to this day there are emerging threats. COVID-19 is the third serious coronavirus we’ve had to confront in recent history, succeeding the Spanish Flu and SARS. On top of this, there is influenza, and it’s ever-mutating strains that cyclically return to claim an estimated 389,000 lives annually, disproportionately affecting those with a lower level of access to basic health care and sanitation. Drug-resistant germs can also cause a serious health impact, especially within hospitals and nursing home patients. Candida auris, a drug-resistant infection, was only discovered in 2009 and causes problems for already immunocompromised people. Those who are already unwell face a serious risk from such infections, as treatment options are limited. Infectious diseases beyond COVID-19 have, and will, cause a major burden globally. They are responsible for up to one-third of all deaths and half of all deaths in people under the age of 45. There are steps we take to help, including good hand hygiene and cough etiquette, regular environmental cleaning and disinfection and the use of PPE like masks and gloves. Perhaps the best action we can all take is to be mindful of others and our own environment by cleaning regularly, as it is the number one method of infection control. This is something we must be mindful of in our daily lives. Improved attention to infection control will benefit society and should become part of our daily lives as we proceed into 2021.

Bathtime wouldn’t be the same without a rubber duck. For children, and maybe some adults too, the main attraction of a scrub in the tub is the chance to play with rubber or plastic bath toys, watching them bob amongst the bubbles and submerge amongst the suds. But beneath the cheery exterior of bright wide eyes and chirpy beak exists a hidden danger - one that could make you or your children very unwell. The best way to investigate this is to chop them open (sorry, ducky), revealing the microbial growths that manifest inside. The initial findings are startling, showing a significant build-up of dark, murky slime, known as a biofilm. Biofilms are, in fact, a whole host of different microorganisms, including bacteria, fungi and moulds, that stick to each other and form a slimy substance to help them survive and multiply. What’s shocking is that this is not just a one-off or a particularly old toy. Research found that 70% of bath toys contained the same black, slimy biofilm, and it could potentially be very harmful. So, why does this biofilm grow inside of bath toys? One reason is the materials used. Plastic polymers leach biodegradable plasticizers and stabilizers which are used as a food source by microbes, giving them the fuel they need to multiply. On top of this, a combination of microbes from the building’s plumbing as well as additional nutrients and microbial contamination from the person bathing promotes microbial growth and biofilm formation inside the toys. All of these factors combine to create an environment in which the biofilm can survive and grow. As unpleasant as biofilm sounds, the harm it can cause someone is even more severe. Because of the variety of microbes within the biofilm, there exists a range of dangers it can pose. Pseudomonas aeruginosa, one of the microbes found in the biofilm, can cause inflammation and sepsis as well as urinary tract, skin and gastrointestinal infections. Exophiala, also known as Black Yeast, can cause skin infections and is particularly dangerous to those who suffer from cystic fibrosis Enterococcus faecalis, rather unpleasantly, is found in faeces. They can colonize the intestines and can cause fever, chills, urinary tract infections, gastrointestinal upset and meningitis. Of course, environmental exposure to these microbes is very normal, but the danger lies in coming into contact with them in high concentration or ingesting them. One of the best ways to keep bath times fun, yet safe, is to disinfect toys. However, disinfecting toys once will not prevent microbes from returning and growing again. It is still worth being vigilant, and maintaining a routine of drying the toys after use, boiling them, and then using a disinfectant product on them will help to ensure they stay clean and safe. Additionally, closing up any holes with a glue gun will stop any moisture from getting inside. Perhaps most important is to use some common sense. Keep things as clean as possible, be aware of potential dangers even if they are hidden, and replace toys that are looking past their best, even if it is your favourite ducky. Neu, L., Bänziger, C., Proctor, C.R. et al. Ugly ducklings—the dark side of plastic materials in contact with potable water. npj Biofilms Microbiomes 4, 7 (2018). https://doi.org/10.1038/s41522-018-0050-9 Neu, Lisa. (2020). Predicting and managing biofilm growth on flexible polymeric materials in contact with drinking water. Doctoral Thesis. https://doi.org/10.3929/ethz-b-000440713 Stauber CE, Walters A, Fabiszewski de Aceituno AM, Sobsey MD. Bacterial contamination on household toys and association with water, sanitation and hygiene conditions in Honduras. Int J Environ Res Public Health. 2013;10(4):1586-1597. Published 2013 Apr 18. doi:10.3390/ijerph10041586 Zupančič J, Novak Babič M, Zalar P, Gunde-Cimerman N (2016) The Black Yeast Exophiala dermatitidis and Other Selected Opportunistic Human Fungal Pathogens Spread from Dishwashers to Kitchens. PLoS ONE 11(2): e0148166. https://doi.org/10.1371/journal.pone.0148166 Davies MW, Mehr S, Garland ST, Morley CJ. Bacterial colonization of toys in neonatal intensive care cots. Pediatrics. 2000 Aug;106(2):E18. doi: 10.1542/peds.106.2.e18. PMID: 10920174. Strong, E. (2020). Yahoo is now a part of Verizon Media. Retrieved 24 November 2020, from https://www.yahoo.com/lifestyle/mom-warns-parents-hidden-dangers-bath-toys-son-nearly-loses-vision-145625143.html Mitchell, A. (2020). Expert cuts open children's toys and shares horrifying results as warning to parents | The Morning Show. Retrieved 24 November 2020, from https://7news.com.au/the-morning-show/expert-cuts-open-childrens-toys-and-shares-horrifying-results-as-warning-to-parents-c-1633226?utm_campaign=share-icons&utm_source=facebook&utm_medium=social&tid=1606090947121&fbclid=IwAR134s5nSuPUGOtAEhFalrpfvXGoAoQsVW2IWx6VUQG5qS9XnhuN3_gcuno