Conspiracies and Coincidences
Tuberculosis Outbreak and the LAM-ELISA Test
LAM-ELISA Tuberculosis Test
Detection of mycobacterial lipoarabinomannan with an antigen-capture ELISA in unprocessed urine of Tanzanian patients with suspected tuberculosis. [Original]
1. Trans R Soc Trop Med Hyg. 2005 Dec;99(12):893-900. Epub 2005 Aug 31. Detection of mycobacterial lipoarabinomannan with an antigen-capture ELISA in unprocessed urine of Tanzanian patients with suspected tuberculosis.
Boehme C(1), Molokova E, Minja F, Geis S, Loscher T, Maboko L, Koulchin V, Hoelscher
M. Author information: (1)Department of Infectious Diseases and Tropical Medicine, LMU, University of Munich, Leopoldstr. 5, 80802 Munich, Germany. firstname.lastname@example.org
A direct antigen-capture ELISA based on the detection of mycobacterial lipoarabinomannan (LAM) in unprocessed urine was evaluated for its usefulness in clinical practice. In Tanzania, 231 patients with suspected pulmonary tuberculosis (TB) and 103 healthy volunteers were screened with standard TB tests and with the new LAM-ELISA. Of 132 patients with confirmed pulmonary mycobacterial disease (positive sputum culture), 106 were positive using the LAM-ELISA (sensitivity 80.3%). In comparison, the sensitivity of acid-fast bacilli (AFB) sputum microscopy was 62.1% (82 of 132 confirmed cases). Of the 231 patients, 17 were both culture- and AFB-negative, but had typical radiographic signs of pulmonary mycobacterial infection and did not respond to antibiotic treatment. Of these 17 patients, 13 (76.5%) had positive LAM-ELISA test results.
To define the specificity of the assay, urine samples from 103 healthy volunteers were also screened using LAM-ELISA. All but one had an optical density below the cut-off (specificity 99%). Of interest was a significant correlation between level of microscopic density of mycobacteria in sputum and LAM antigen concentration in urine (chi2=8.44). The LAM-ELISA is a field-adapted tool that can improve screening standards in countries with a high incidence of TB.
PMID: 16139316 [Indexed for MEDLINE]
Tuesday, February 19, 2013 – Elisa Lam’s body discovered at the Cecil Hotel near Skid Row in Los Angeles, CA.
Friday, February 22, 2013 – Los Angeles health officials concerned about TB outbreak on skid row. [Original]
(Reuters) – Los Angeles County health officials have asked for federal assistance to analyze and contain an outbreak of tuberculosis within the city’s homeless population, a spokeswoman for the county agency said on Friday.
Los Angeles County Health Department spokeswoman Mabel Aragon said the agency is still in the process of confirming the number and type of TB cases in the county.
“The CDC is helping us with surveillance and statistic gathering,” she said. CDC spokesman Scott Bryan confirmed that the federal health agency has been asked by local and state TB officials to assist with the outbreak investigation. Bryan said the CDC plans to dispatch staff to the state in the next two weeks.
The Los Angeles Times reported that health workers have identified about 4,650 people who were probably exposed to a persistent outbreak of the contagious disease on downtown Los Angeles’ skid row. The newspaper said that over the past five years, county officials have identified 78 cases of a unique strain of the contagious disease, including 11 deaths. Sixty of those cases were homeless individuals leaving in the skid row area.
In an interview posted on the Los Angeles health department’s website, Kiren Mitruka of the U.S. Centers for Disease Control and Prevention said: “Although progress has been made toward eliminating TB in the U.S., TB outbreaks continue to occur and remain a challenging issue.” The United States had about 10,528 cases of tuberculosis in 2011 and there were 529 deaths from the disease in 2009, according to the latest full year CDC statistics.
The CDC responds to TB outbreaks only when state and public health departments exceed their surge capacity to control it, Mitruka said. “We don’t go in unless we’re asked,” she said in the online interview. Typically, the CDC will conduct an onsite investigation lasting two to three weeks, working closely with state and local public health partners, Mitruka added.
The cluster of TB cases going on in Los Angeles follows a pattern of infection. A review of 51 TB cases which the CDC investigated between 2002 and 2008 published in Emerging Infectious Diseases found substance abuse was the most common risk factor, with 58 percent of outbreak patients reporting substance abuse.
Tuberculosis infection destroys lung tissue, causing patients to cough up the bacteria which then spreads through the air and can be inhaled by others.
Most cases can be cured with a six-month cocktail of antibiotics, but rates of drug-resistant TB have been spreading fast, causing alarm among public health officials and prompting calls for more research into new treatments. “I think it’s a wakeup call that highlights the fact that this is still a major, major problem,” said Dr Mel Spigelman, chief executive of the TB Alliance, a nonprofit research group based in New York.
“Even in the U.S., where we have one of the lowest rates in the world, we still have over 10,000 patients every year who get TB.”
Spigelman said that number pales in comparison to the 9 million people globally who get TB.
“It’s still in the U.S., we just don’t recognize it.”
(This story corrects spelling of TB Alliance chief executive’s last name to Spigelman, not Spiegelman, fourth paragraph from bottom)
Reporting by Deena Beasley and Julie Steenhuysen; editing by G Crosse
Centre for Tuberculosis Research; University of British Columbia, Vancouver Campus [Website]
DYNASTY OF DARKNESS Lyrics
Morbid, the founding member, singer, and guitar player for “Dynasty of Darkness” uploaded a video of himself in his room at the Cecil Hotel in 2010-2011. A few days after Elisa Lam’s body was discovered, Morbid posted a link to a teaser video for his side-band “Slitwrist.” In the video, a girl appears to be chased down and killed. She’s found dead and bloody in the forest.
He issued several statements:
- “Well apparently some strange coincidences are making people believe that I murdered a girl named Elise Ham. Last year I posted a video while chilling at the Cecil Hotel in Los Angeles. Apparently some time after I was there someone killed a girl in that same place..”
- “I posted this music video preview of my band Slitwrist where a girl appears to be dead, and now people are playing Detective and trying to tie me into the murder case…
- “This is ART. I am not a murderer. It’s impressive how people’s insanity can make them believe in so much stupid shit. But I guess this proves my video very effective. \m/”