The Mould Show

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

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 have 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 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
medRxiv 2021.02.07.21251322; 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 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 where HEPA air purifiers fail, and some of the common mistakes that can occur when people are trying to match 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 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

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 is considered a 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 a 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, by 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:

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