Friday, April 08, 2016

2016 Cocci Study Group - Fresno CA

I'm in Fresno for the 59th annual Cocci Study Group at the UCSF Fresno Center for Medical Education and Research. We're learning news about research, cures, and funding for Denise's disease. My aunt (the RN) and I attended all the sessions over two days, covering clinical cases, lab research, ecology, epidemiology, environmental, occupational, and other aspects of Valley Fever. Highlights:
  • Viamet is a drug that has received "Orphan Drug Status" for the treatment of cocci.
  • Sertraline (Zoloft) might be an alternative therapy that can be used in addition to fluconazole because it seems to have antifungal properties.
  • Cocci might cause sarcoidosis. This was interesting to me because Gracie recently read Edgar Allen Poe's "Masque of the Red Death" for a class assignment, and sarcoidosis was one of the possibilities for the strange disease in the story.
  • A new drug, APX001-A from Amplyx is active against cocci in vivo and in vitro with mice and warrants further study (however mice metabolize things differently than humans).
  • The very promising drug Nikkomyciz-Z is still moving frustratingly slow to get to market, but now NIH is helping. It's fungicidal in mice, and evidence of activity in mice is highly correlated with activity in human cocci. It's also had good results when used with several pet dogs. Trivia: Nikkomycin study was started up in Nikko, Japan, hence the name.
  • Cocci is on the federal Commerce Control List section 1 dealing with human pathogens AND also on the CDC list of bioterrorism agents. It can be found outside the U.S., so it's pointless to ban it. And if a lab has any students from countries on the list of states sponsoring terrorism, the lab can get into deep trouble. So the professionals attending this conference voted to recommend cocci be removed from both lists so it can be mailed to labs around the country, facilitating research.
  • Several prisons are in cocci-endemic regions, and in recent years the justice system has stopped sending certain inmates at high risk of contracting cocci to ten prisons in endemic regions (particularly Avanal State Prison and Pleasant Valley State Prison outside Coalinga). 
  • There was a study about Valley Fever among Native American Indians and Alaskan natives. Very few cases in these groups, but they are three times more likely to disseminate, four times more likely to need hospitalization, and five times more likely to die compared to whites with cocci. Might be due to environmental exposures rather than genetics. There are lots of Native Americans in endemic regions. But studies can't lump all American Indians together because they're not genetically homogeneous. A point on the hospitalization rate: IHS (Indian Health Services) doesn't take payment, unlike everyone else's hospital/insurance, so American Indians might be more likely to admit themselves since they don't have to pay.
My head is still swimming as I try to digest all the brain-numbing information.
Speaking of digesting we ate a raging-tasty dinner at Diana's Persian Armenian Cuisine. Fresno becomes FresYes when you eat there, look the place up.

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