Johns Hopkins Gazette: May 28, 1996

In Brief:
Medical News

Test to enhance study of new tick-borne disease

Johns Hopkins researchers have developed a new test that may help probe potential links between Lyme disease and a recently discovered tick-borne illness, granulocytic ehrlichiosis.

Because both diseases are spread by the same tick, the deer tick, and because granulocytic ehrlichiosis symptoms can be mistaken for a flu or Lyme disease, Hopkins investigators say unrecognized ehrlichiosis may be complicating the treatment of some Lyme disease patients.

They say the new test also should help researchers developing better ways to treat and prevent ehrlichiosis, which can be fatal. In one study of Midwesterners with ehrlichiosis, 56 percent of patients were hospitalized and 2 percent died. In serious cases, the body's defense systems weaken and opportunistic viral, fungal and bacterial infections cause fatal complications.

"Patients with ehrlichiosis start with very general, flulike symptoms--fever, headaches, muscle aches, and most doctors say, 'It's a virus! Go home and get some rest,' " says J. Stephen Dumler, a Hopkins associate professor of pathology. "That's scary because there's a special antibiotic that can cure patients in 24 to 48 hours if the infection is caught early." Dumler was a member of the research team that developed the new test and discovered the human form of granulocytic ehrlichiosis.

"We have only isolated human granulocytic ehrlichia from six patients," Dumler says. "By allowing us to isolate more sam-ples of the bacteria, this test should help us identify which forms can cause serious illness and study how they are different from the forms that cause almost no symptoms." These findings could aid development of ehrlichiosis vaccines for persons at risk, such as outdoorsmen, hikers and campers.

The new test, described by Dumler at this week's meeting of the American Society for Microbiology in New Orleans, cultivates the bacteria by making it reproduce in a tissue culture.

"Ehrlichia can't be grown on lab dishes like most bacteria," he explains. "They belong to a class of organisms that are so highly adapted that they can't grow outside of cells. The new technique solves that problem, and could help us study this whole class of organisms."

Funding for development of the new test was provided by various sources at the University of Maryland.

Other News

Asbestos removal to be done in three stages

The renovation of the Milton S. Eisenhower Library is scheduled to begin on June 17. The first stage of the renovation will involve the removal of the asbestos-containing plaster ceiling on M-Level. Unlike other asbestos abatement projects done in the library in the past--small, after-hours projects in mechanical rooms--this is a large-scale project, which will be done during normal library operating hours.

The M-Level abatement will be undertaken in three stages, starting at the south end. Before any removal begins, the contractor builds a containment whose purpose is to isolate the work area from the rest of the building. All asbestos fibers released during the abatement stay within the walls of the containment area.

The ventilation system for the contained area is disconnected, and all air supply and return vents are sealed off. Before work begins, a representative from the Office of Safety and Environmental Health will inspect the containment to make sure that the work area is securely sealed off from the outside.

The contained area is also placed under negative pressure. This is done by means of high-powered HEPA filtration units. The purpose of the filtration units is two-fold.

One, the filters remove asbestos fibers from the air inside the containment to provide a safer environment for the abatement workers.

Two, because the containment is under negative pressure with respect to the area outside the containment, the air flow is from the clean area outside the containment into the work area. Accordingly, in the event of a containment breach, air flow is from outside to inside the containment, which ensures that contaminated air will remain inside the containment.

As part of the project, an outside environmental consulting firm will conduct air monitoring for the duration of the asbestos project. In addition to monitoring the abatement workers, they will also conduct air sampling for asbestos fibers outside the containment. This sampling information, along with interpretation, will be posted in the library.

After the abatement is complete, the outside consultant will sample the air inside the containment. The containment will be taken down only if the asbestos fiber concentration is below the state of Maryland clearance level of 0.01 fiber/cubic centimeter.

If anyone has questions or concerns about the asbestos abatement phase of the library renovations, call OSEH at (410)516-8798.

'The Gazette' summer schedule

This is the last weekly issue of the 1995-96 academic year. The Gazette will be published on June 10 and 24, July 12 and 26, and August 5 and 19.

Weekly publication will resume on Tuesday, Sept. 3.

Have a great summer.

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