How SARS CoV-2 kills
Please folks, stay home, hunker down, the enemy is time, the weapons are distance and soap. New Orleans let the good times roll and now it’s our Italy. US Doubling Time today, down to 2.2 days from 3.2 days. 100,000 cases in 22 days, 1 Million in 44.
First Bedside test
0.8/M vs 34.8/M Wow. Causation or Correlation?
"When comparing crude case fatality rates (CFR) of COVID-19 between countries with active BCG vaccination programs to those that do not routinely vaccinate, differences exist between incidence of disease and CFR.8 For instance, the daily incidence of COVID-19 was 0.8/million in countries with a BCG vaccination program compared to 34.8/million in countries without such a program as of March 22, 2020.8 Additionally, based on rough estimates and available data, CFR was estimated to be 4.1% in countries with a BCG vaccination program compared to 5.1% in those without.8 "
Okay Folks, work in process…Not complete…Reultnof last 48hrs.
Draft Procedure Home Sterilization of N95 type conformal face mask respirators.
You can’t just keep wearing the face respirators without real fear of introducing contamination by either touching the surface or inadvertantly placing the masks on a clean surface contaminating your house or office.
Recent data has shown SARS CoV2 remains on cloth for 2 days and surgical masks for up to 7 days!!!
Research has shown Microwave Generated Steam (MSG) is effective in mask decontamination.
From the CDC, " The microwaves produced by a “home-type” microwave oven (2.45 GHz) completely inactivate bacterial cultures, mycobacteria, viruses, and G. stearothermophilus spores within 60 seconds to 5 minutes depending on the challenge organism.
Another study confirmed these resuIts but also found that higher power microwaves in the presence of water may be needed for sterilization. Complete destruction of Mycobacterium bovis was obtained with 4 minutes of microwave exposure (600W, 2450 MHz)"
“Moist heat, consisting of 60°C and 80% RH caused minimal degradation in the filtration and fit performance of the tested FFRs [3, 9, 10]. Heimbuch et al. disinfected FFRs contaminated with H1N1 using moist heat, of 65°C and 85% RH, and achieved a minimal of 99.99% reduction in virus [14]. One limitation of the moist heat method is the uncertainty of the disinfection efficacy for various pathogens”
“Steam treatment and liquid hydrogen peroxide are promising methods with some limitations”
"Decontaminate six FFR models and achieved 99.9% inactivation of MS2 bacteriophage. Filtration performance of all tested FFRs scored above NIOSH certification requirements. Three FFRs were further evaluated for three cycles of steam exposure and demonstrated no change in filtration performance [15]. Bergman et al. also demonstrated acceptable filtration performance after three cycles of exposure to microwave generated steam [3].
Microwave generated steam had little effect on FFR fit after exposure to up to three cycles of steam [9, 10].
Using microwaves to produce steam to decontaminate FFRs is not without limitations. Not all microwaves are constructed the same and some are more powerful than others. The effect of higher power microwaves on FFRs is unknown. Furthermore, the metal nosebands of FFRs may cause arcing, sparks inside the microwave oven, during exposure to microwaves."
My experiment to disinfect respirator masks…will let you know!
YOU MUST REMOVE THE METAL STRIP!
- Wash
- Gloves
- Remove Mask by strings and deposit on disposable paper toweling or paper.
- Cut slot at top of mask and Remove Metal strip using tweezers or needle nose pliers. Separately sanitize strip.
- Wrap mask with heavily moistened paper towel to generate consistent steam heating of mask surface
- Place in Paper Sack to prevent contamination of Microwave surfaces and contain steam
- Nuke per CDC instructions. Goal is 68 C at 85%RH for several minutes
- Wash and Change Gloves
- Recover Nuked Respirator Mask to “clean” paper towel and dispose of moist HOT towel in covered sanitary waste bag. WARNING HOT!!!
- Reinsert 70% alchohol or 0.05% bleach sanitized metal strip
- Allow to dry
- Seal mask in disposable plastic Bag Respirator for “2??” days
- Wipe down microwave surface with approved virucide.
- Cycle respirator back into service on third day.
- Be aware of cross contamination in handling exposed mask surfaces…
The non-sterilized tip of a needle, seeded with bacteria.
‘Micro’ in words like microorganism and microalgae comes from the Greek word mikros, which means ‘small’. In our language, we use ‘micro’ to refer to very small things. Like organisms that are so small, we can’t see them without a microscope.
Microorganisms are many times smaller than insects like lice and ants. They aren’t measured in centimetres or millimetres, but in micrometres (µm, one-thousandth of a millimetre) or even in nanometres (nm, one-millionth of a millimetre). Microbes are often only a few micrometres in size. For example, around 50 bacteria fit in the diameter of a single strand of hair. And viruses are many times smaller than bacteria.
How do Surgical and Respirator P95/99 masks work?
Information and FAQs on the Performance, Protection, and Sterilization of Face Mask Materials
Peter Tsai UT
The masks have outer protective layers and an inner layer of polypropylene (PP) non woven fiber filter media.
"Both medical masks and N95 respirators are made of three plies of media: an outer veil made of spunbond (SB) PP facing outward; a filtration layer made of charged Melt Blown (MB) PP electret in the middle; and an inner veil in contact with the face made of needled or thermal bond nonwovens for the N95 and SB thermal bond or paper tissue for medical masks. Medical masks have only one ply of the filtration layer for medical masks while the N95 is composed of two plies of MB PP electret each having a higher FE than the filtration layer of the medical masks.
The filter layer, is a random orientation tangled jungle of polypropylene fibers about x microns in diameter. They may be treated with a salt type material to help kill viruses…The material picks up an electrical static charge, to attract and capture virus particles much much smaller than the fiber diameter."
"The filtration layer of these masks is made of meltblown (MB) PP (polypropylene) nonwoven electret, an electrostatically charged media.
Bacterial filtration efficiency (BFE) is a measure of the effectiveness of a material to filter bacteria 3.0 µm in size, whereas filtration efficiency (FE) is a measure of the effectiveness of a material to filter submicron (median diameter of 0.075 µm) particles of NaCl.
Medical masks have a BFE of >95–99% and a >78–87% FE. The N95 respirator has an FE of >95% and a BFE of >>99% along with a perfect edge seal and contour structure that conforms the human face, preventing particles from entering between the face and the respirator edge.
Medical masks play a critically important role in preventing large-sized saliva droplets, some of which may carry airborne diseases, from entering by direct inertial impaction on the mask surface. However, some particles in aerosol form may enter from gaps between the mask edge and the face without going through the mask body.
Sterilization using ionizing radiation such as gamma irradiation may decompose the PP materials, while using alcohol will erase the charges. However, exposing the masks to air at elevated temperatures such as 70℃ for 30 minutes allows the charges to be retained. With this method, it is important to suspend the masks in air without contacting or approaching a metal surface because the metal temperature is much higher than that of the hot air leading to a severe charge decay or damage of the mask material.
Because the surface tension of alcohol is lower than that of PP, alcohol can penetrate into the MB PP fabric and erase the charges. Therefore, face masks cannot be sterilized using alcohol because the charges are erased by either liquid or vapor alcohol. "
"There are three general mechanisms that N95 masks have to pull particles from the air stream: inertial impaction, diffusion, and electrostatic attraction.
Inertial impaction sounds like a dance move or a dental procedure. But it is when the tortuous path makes it difficult for particles that are 1 μm and larger to continue on their straight paths. Such particles are too large to weave through the mask fibers and end up running into one the fibers."
"The second mechanism, diffusion, helps keep particles that are 0.1 μm and smaller from proceeding. The design of the mask filter creates a situation in which these very small particles move in random directions, colliding with each other and with filter fibers. When these particles are bouncing against each other as if they were in a mosh pit, it less likely that they will get though the maze.
The third mechanism, electrostatic attraction, sounds like something someone would say on a Tinder conversation. The filter material for N95 doesn’t just physically block viruses and other small particles. As the song goes, you can’t see it, it’s electric. During the manufacturing process, the fibers receive an electric charge. “This electrostatic charge then attracts the virus so that it gets stuck on the fibers.” This is one case where forced attraction is a good thing.”
“Picture below is from a Field Emission Scanning Electron Microscope (FE-SEM). If you’re not sure what that is, it’s a really powerful microscope that can make things look up to 80,000 times larger. Dirt particles (lighter grey) being captured by an N95 Mask Filter.”
How do Surgical and Respirator P95/99 masks work?
Information and FAQs on the Performance, Protection, and Sterilization of Face Mask Materials
Peter Tsai UT
The masks have outer protective layers and an inner layer of polypropylene (PP) non woven fiber filter media.
"Both medical masks and N95 respirators are made of three plies of media: an outer veil made of spunbond (SB) PP facing outward; a filtration layer made of charged Melt Blown (MB) PP electret in the middle; and an inner veil in contact with the face made of needled or thermal bond nonwovens for the N95 and SB thermal bond or paper tissue for medical masks. Medical masks have only one ply of the filtration layer for medical masks while the N95 is composed of two plies of MB PP electret each having a higher FE than the filtration layer of the medical masks.
The filter layer, is a random orientation tangled jungle of polypropylene fibers about x microns in diameter. They may be treated with a salt type material to help kill viruses…The material picks up an electrical static charge, to attract and capture virus particles much much smaller than the fiber diameter."
"The filtration layer of these masks is made of meltblown (MB) PP (polypropylene) nonwoven electret, an electrostatically charged media.
Bacterial filtration efficiency (BFE) is a measure of the effectiveness of a material to filter bacteria 3.0 µm in size, whereas filtration efficiency (FE) is a measure of the effectiveness of a material to filter submicron (median diameter of 0.075 µm) particles of NaCl.
Medical masks have a BFE of >95–99% and a >78–87% FE. The N95 respirator has an FE of >95% and a BFE of >>99% along with a perfect edge seal and contour structure that conforms the human face, preventing particles from entering between the face and the respirator edge.
Medical masks play a critically important role in preventing large-sized saliva droplets, some of which may carry airborne diseases, from entering by direct inertial impaction on the mask surface. However, some particles in aerosol form may enter from gaps between the mask edge and the face without going through the mask body.
Sterilization using ionizing radiation such as gamma irradiation may decompose the PP materials, while using alcohol will erase the charges. However, exposing the masks to air at elevated temperatures such as 70℃ for 30 minutes allows the charges to be retained. With this method, it is important to suspend the masks in air without contacting or approaching a metal surface because the metal temperature is much higher than that of the hot air leading to a severe charge decay or damage of the mask material.
Because the surface tension of alcohol is lower than that of PP, alcohol can penetrate into the MB PP fabric and erase the charges. Therefore, face masks cannot be sterilized using alcohol because the charges are erased by either liquid or vapor alcohol. "
"There are three general mechanisms that N95 masks have to pull particles from the air stream: inertial impaction, diffusion, and electrostatic attraction.
Inertial impaction sounds like a dance move or a dental procedure. But it is when the tortuous path makes it difficult for particles that are 1 μm and larger to continue on their straight paths. Such particles are too large to weave through the mask fibers and end up running into one the fibers."
"The second mechanism, diffusion, helps keep particles that are 0.1 μm and smaller from proceeding. The design of the mask filter creates a situation in which these very small particles move in random directions, colliding with each other and with filter fibers. When these particles are bouncing against each other as if they were in a mosh pit, it less likely that they will get though the maze.
The third mechanism, electrostatic attraction, sounds like something someone would say on a Tinder conversation. The filter material for N95 doesn’t just physically block viruses and other small particles. As the song goes, you can’t see it, it’s electric. During the manufacturing process, the fibers receive an electric charge. “This electrostatic charge then attracts the virus so that it gets stuck on the fibers.” This is one case where forced attraction is a good thing.”
“Picture below is from a Field Emission Scanning Electron Microscope (FE-SEM). If you’re not sure what that is, it’s a really powerful microscope that can make things look up to 80,000 times larger. Dirt particles (lighter grey) being captured by an N95 Mask Filter.”
Any one hear of this anti parasitic? In Australia? Monash Univ.?
Ivermectin influence on the mast cell activity in nodules of onchocerciasis patients
Wildenburg, Korten, Mainuka, Büttner
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Abstract
Summary Onchocercal nodules were stained immunohistochemically using antibodies specific for human mast cells and IgE to elucidate the localization and frequency of mast cells after a single oral dose of 150 μg/kg ivermectin. Tryptase‐and chymase‐positive mast cells occurred predominantly in mixed inflammatory infiltrates and perivascularly, and never adhered to adult worms or microfilariae. Up to three days after ivermectin, mast cells and IgE‐positive cells were markedly increased in the capsular area of nodules containing female worms with embryos and microfilariae compared to untreated nodules. In the centre of these nodules, around the adult Onchocerca volvulus, we found many tryptase‐positive cells. More mast cells were IgE‐positive than in untreated nodules, equalling the number of tryptase‐positive mast cells. There was a clear correlation between the appearance of mast cells and the attacks on damaged microfilariae by eosinophils and macrophages and in the vicinity of adult worms by neutrophils that occur soon after ivermectin treatment. Onchocercomata harbouring female worms with oocytes only revealed, after all treatment intervals, the same mast cell numbers as untreated nodules. In conclusion, during the first three days after administration, ivermectin produces increased numbers of mast cells in nodules harbouring females with embryos and microfilariae, probably as part of an allergic reaction to the attacked microfilariae. Four to 19 days after ivermectin the number of mast cells in the entire nodule is no longer elevated.
Introduction
Ivermectin, an orally effective microfilaricidal agent, is the current drug of choice for treating patients infected with the nematode Onchocerca volvulus. Onchocerciasis is one of the major filarial diseases affecting humans and a leading cause of blindness in Africa. The adult worms, inducing the formation of subcutaneous nodules (onchocercomata), release thousands of microfilariae which migrate to the skin and cause dermatitis.
Mast cells (MC) are normally distributed throughout connective tissues, where they are placed near parasites and other pathogens that come into contact with the skin or mucosal surfaces ( 11). Infections with helminths are often associated with the proliferation and activation of MC in parasitized tissues. Although the contribution of the MC to the pathogenesis of allergic diseases is well known, the MC‐dependent recruitment of leucocytes at sites of parasitic infection may be important to host defence, especially if one takes into account that MC are potential sources of several inflammatory mediators that could promote leukocytic infiltration.
Information about MC in human onchocerciasis ( 2; Mackenzie CD, Williams JF & Guderian RH (1986) The onchocercal nodule: its structure and composition. In ) was scarce until 27) found that the frequency of MC depends on the distribution of stromal and effector cells, whereas the latter is contingent on the vitality and productivity of the worms and therefore, indirectly and directly on the release of O. volvulus antigens. Treatment with ivermectin is anticipated for most endemic areas and understanding in detail its effects on the host’s immunological responses may have implications for treated patients. Therefore our aim was to investigate the localization and frequency of MC in nodules with a defined worm population at various intervals after ivermectin treatment using antibodies specific for human MC.
Materials and methods
Parasites and light microscopy
Onchocercomata were extirpated at various time intervals after treatment with a single oral dose of 150 μg/kg ivermectin in Liberia, Ghana and mainly Uganda as described previously ( 1) and were examined using conventional histology. From these series of nodules, 45 onchocercomata from 25 patients with generalized onchocerciasis were selected for an immunohistochemical study of MC ( Table 1). Some of these patients had been treated repeatedly at 6‐ and 12‐monthly intervals. Fifty‐five nodules from untreated patients with generalized onchocerciasis were used for immunohistological comparison ( 28). Nodulectomies for research purposes were approved by the Ethics Commission of the Medical Board Hamburg. We selected mainly nodules with single worms for this study. Adult females were classified according to the presence of oocytes only or the presence of embryos and microfilariae in their uteri and in the nodular tissue ( Table 1). A few nodules also contained a live male worm. Not all nodules belonging to the different categories came from different patients, we also selected several from one patient to examine the influence of the host’s immune status. The macrofilariae and their productivity status were histologically assessed as described by 3).
Table 1. Oncghocercomata (n= 45) from 25 ivermectin‐treated patients selected for immuno‐histochemical examination
Onchocercomata were fixed mainly in 80% ethanol, in 4% buffered formaldehyde or in modified Karnovsky’s fixative containing 1% paraformaldehyde and 0.025% glutaraldehyde in 0.1 m cacodylate buffer. Paraffin sections were routinely stained using Pappenheim, Giemsa, Movat, haematoxylin and eosin, and toluidine blue stains. A large number of nodules after ivermectin treatment were examined using conventional histological methods.
Immunohistochemistry
For immunostaining the alkaline phosphatase‐antialkaline phosphatase (APAAP) technique was applied according to the recommendations given by the manufacturer (Dako Diagnostika, Hamburg, Germany) and after 5). The monoclonal antibodies (mab) specific for human MC tryptase (Dako Diagnostika) served as primary antibodies at a dilution of 1:200 and human MC mab specific for chymase (Chemicon, Temecula, USA) at a dilution of 1:1000. The neutral protease tryptase is located fully active in the secretory granules of MC, bound to and stabilized through heparin. A rabbit polyclonal antibody (pab) against IgE (Dako Diagnostika) was applied at a dilution of 1:2000. Anti‐mouse pab and anti‐rabbit mab (Dako Diagnostika) were used as secondary antibodies. Fast Red TR salt (Sigma, Deisenhofen, Germany) was applied as the chromogen and haematoxylin functioned as counterstain.
For the primary pab against histamine (Chemicon) (1:250), and partly for the above mentioned antibodies, the peroxidase‐anti‐peroxidase (PAP) complex with a secondary swine anti‐rabbit pab (Dako Diagnostika) was used as recommended by the manufacturer. The peroxidase activity was demonstrated by exposure of the sections to a fresh solution of 3.3’‐diaminobenzidine (Walter, Kiel, Germany) and hydrogen peroxide (Merck, Darmstadt, Germany). Antibodies specific for eosinophils (mab against eosinophil cationic protein ECP EG2, 1:150; Kabi Pharmacia, Uppsala, Sweden) and neutrophils (mab against defensin, 1:4000; Dianova, Hamburg, Germany) were also applied.
Estimation of mast cell numbers
The MC frequency in the nodules was estimated. Sections stained with the mab against MC tryptase were examined using the computer aided image analysing system VIDAS (Zeiss, Oberkochen, Germany). Areas with worm tissue were not included. The frequency of MC in the nodules was estimated in six zones at 64‐fold magnification for five representative sectors. For the final comparison the nodules were divided in the two main areas ‘capsule’ and ‘nodule centre’, as described in 28).
Results
Whereas staining properties of MC and general features of MC distribution in the examined nodules of patients after ivermectin treatment followed principally the description of 28) for untreated nodules, the MC density differed after ivermectin. After treatment MC were attracted by adult worms and by microfilariae, but never localized directly at their cuticle ( Figures 1, 2e) while neutrophils ( Figure 2d) and macrophages were often attached.
Figure 1
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Immunohistochemical staining of onchocercoma sections containing live female worms after different intervals of ivermectin treatment and without treatment. a. 4 h after ivermectin numerous mast cells (MC, arrowhead) are already visible in the capsule (ca) of a nodule containing a female with embryos and microfilariae (arrow). mab tryptase, PAP, ×145. b. Centre of a nodule containing a female with microfilariae (arrow) revealing many IgE‐positive MC 6 h after ivermectin. Note the typical ring‐shaped appearance (arrowhead). pab IgE, APAAP, ×145. c. Strong infiltration of MC (arrowhead) in the capsular area (ca) of a nodule containing a female with microfilariae‐filled uteri (ut). 1 d after ivermectin, mab tryptase, APAAP, ×90. d. In contrast to (c), a poorly infiltrated capsule (ca) of a nodule with a female with oocytes only revealing only few MC (arrowhead) between collagenous fibres. 1 d after ivermectin, mab chymase, APAAP, ×145. e. Lower MC (arrowhead) frequency in the capsule (ca) of an untreated nodule containing a female with embryos and microfilariae (arrow). Compare with (a) and (c). mab tryptase, APAAP, ×210. f. Many activated, chymase‐positive MC (arrowhead) lie in a nodule centre mainly in association with infiltrate islands. 2 d after ivermectin, mab chymase, PAP, ×90.
Figure 2
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Details of onchocercoma sections showing the mast cell (MC) reaction around damaged or live microfilariae, 1 or 2 d (Figure 2f) after ivermectin treatment. a. Several MC (arrowhead) are visible in the capsule around microfilariae (arrows) attacked by eosinophils and macrophages. mab tryptase, APAAP, ×145. b. Serial section to (a) showing several eosinophils (arrowhead) attacking a damaged microfilaria (arrow) in the capsule. mab ECP EG2, APAAP, ×575. c. Nodule centre showing MC (arrowhead) in the vicinity of neutrophil infiltrates (arrow) around damaged microfilariae near to a female (F). mab defensin, APAAP, ×145. d. Serial section to (c) revealing a damaged microfilaria (arrow) enclosed by defensin‐positive neutrophils (arrowhead). mab defensin, APAAP, ×575. e. Tryptase‐positive, partly degranulated (arrowhead) MC are present among a mixed infiltrate with neutrophils attacking a damaged microfilaria (arrow) in the nodule centre, but do not adhere to its cuticle. mab tryptase, APAAP, ×575. f. Deposition of histamine on a dead microfilaria (arrow) and surrounding histamine‐positive cells. mab histamine, APAAP, ×670. g. MC (arrowhead) without affinity to live, intact microfilariae (arrow), assumed to be motile in the nodule centre. mab chymase, PAP, ×170.
At the early intervals after treatment, between 4 h and 3 days, the capsule area of onchocercomata containing female worms with oocytes only generally revealed a strikingly low cellular reaction ( Figure 1d). Few round to ovoid, only partially stretched, nondegranulating MC were situated between collagenous fibres and perivascularly. Even with more MC distributed among the mixed perivascular infiltrates in the capsule, the number of MC was low. In the area around the worm loops, the MC frequency was clearly increased ( Figure 1d), but often, especially in nodules with young nulliparous females, a low cellular reaction correlated with few scattered MC. IgE was rarely detected on MC in these nodules.
In nodules containing females with embryos and microfilariae, differences in the MC frequencies were observed in the capsule and in the worm centre in comparison with untreated nodules ( Figure 1e). Beginning 4–6 h after ivermectin ( Figure 1a) as well as 1 and 2 days after treatment ( Figure 1c), a strong girdle‐shaped infiltration of MC was observed in the capsule, indicating more MC in the capsule than in the centre. This was particularly evident in patients who had been treated previously at 6‐and 12‐monthly intervals. A correlation of MC distribution with the occurrence of eosinophilic attacks on damaged microfilariae was observed in the capsular area ( Figure 2a,b). MC accumulated around these microgranulomata formed by eosinophils and macrophages. This concurrent infiltration of the nodular tissue by MC, eosinophils and macrophages was detected in the early phases of cellular attack, i.e. one day after treatment, as well as in the more advanced phases after two and three days.
In the zones around the female worms tryptase‐ as well as chymase‐positive MC concentrations revealed a clear relation with other inflammatory cells ( Figure 1f), particularly where neutrophils were accumulated around damaged microfilariae or in perivascular infiltrates ( Figure 2c,d). Together with some macrophages the neutrophils formed microabscesses surrounded by MC ( Figure 2c). In these abscesses the attack appeared advanced and the dead microfilariae lay in the centre of free neutrophil granular material, many neutrophils and some macrophages ( Figure 2d). Other damaged microfilariae were surrounded by only few neutrophils which deposited defensin on their surface. This participation of neutrophils in the attack was only detected in nodules of patients after treatment. MC accumulating in the central infiltrates often displayed signs of cell activation such as partial or complete emptying of granules and irregular cell shapes ( Figure 2e), elongated cytoplasmic protrusions and extracellular proteases in the vicinity of the cell. Numerous cells in the central and in the capsular area, showing the characteristic histological appearance of MC, were labelled with the antibody against IgE ( Figure 1b). These cells displayed characteristic ring‐shaped staining on the surface. Although activated MC were gathered in the vicinity of degenerating microfilariae attacked by eosinophils and macrophages or by neutrophils ( Figure 2b,d), they showed no obvious connection to the cuticle of damaged microfilariae ( Figure 2e). Histamine release and deposition on microfilarial fragments was observed ( Figure 2f). MC showed no affinity to live, intact microfilariae, assumed to be mobile ( Figure 2g).
Later, 4–19 days after the ivermectin dose, there no longer were more mast cells in entire nodules harbouring females with embryos and microfilariae than in untreated nodules: few or no microfilariae were seen in the tissue of most nodules. Neither did nodules with females oocytes only show any peculiar features in the MC reaction at these intervals after treatment.
Overall the MC density after ivermectin treatment was significantly lower in the capsular area of nodules containing females with oocytes only than in those harbouring females with embryos and microfilariae. The MC reaction was stronger in onchocercomata from patients with repeated treatments and seemed to occur earlier, i.e. 4–6 h after ivermectin. The numbers of MC in the worm centre were similar in both groups, with nodules containing females with embryos and microfilariae tending towards increased numbers of MC in the centre. More IgE‐positive MC were detected in nodules containing females with embryos and microfilariae than in those with females with oocytes only after treatment, especially in the centre. Thus, the strongest cellular reaction was observed in the nodule capsule during the first 48 h after treatment.
Discussion
We studied the influence of ivermectin on the MC activity in onchocercomata at different intervals after ivermectin treatment. Ivermectin has achieved widespread acceptance for the treatment of human onchocerciasis. Its mode of action is not fully understood but a number of possibilities have been proposed, including a direct toxic effect with consequent inhibition of motility, possibly mediated by potentiation of the inhibitory neurotransmitter GABA, and paralysis of the microfilariae ( 21; 31). It has been suggested that although ivermectin may only slightly reduce microfilarial motility, this may be sufficient to allow cytotoxic host cells to adhere to their surface with subsequent clearance by lymphatic drainage ( 6; 27; 15). More damaged and dead microfilariae were discovered in the nodules of ivermectin‐treated patients than in the untreated samples, located in microgranulomata and microabscesses as described in previous studies ( 3; 16). This pronounced attack comprises infiltrating neutrophils, macrophages and densely packed masses of eosinophils, indicating a role in parasite clearance for these cells ( 2729, 1996; 14). The presence of numerous MC close to these attacks confirms that MC are very likely to be attracted and activated by somatic antigens ( 3028, 1998; 16) released from damaged or dead microfilariae and in even greater numbers after the microfilaricidal action of ivermectin. MC can also be activated by eosinophil granule constituents such as ECP, major basic protein (MBP) and eosinophil peroxidase (EPO) ( 7), which are released during the eosinophil‐parasite adherence reaction ( Gleich GJ & Ackerman SJ (1986) The eosinophil and inflammation: an overview. In ; 27); these proteins were abundant in the eosinophil‐rich infiltrates mixed with MC in the nodule periphery. This may in part account for the strong MC infiltration in the capsule. On the other hand, MC through TNF‐α Il‐5 and Il‐4 might enhance recruitment of eosinophils and other inflammatory cells ( 11; 23). The ability of Il‐5 to promote the growth, differentiation, survival and priming of eosinophils is particularly noteworthy in connection with the finding of simultaneously occurring MC and eosinophils.
The strong MC infiltration in the capsule areas of nodules harbouring female worms with embryos and microfilariae that occurs 4–6 h after ivermectin treatment is consistent with the peak plasma ivermectin concentration of about 50 ng/ml approximately 4 h after dosing ( 13). Ivermectin seems to have a relatively large apparent volume of distribution (46.9 ng/ml), indicating wide tissue distribution ( 10). 9) found ivermectin in the nodular tissue 6 h after treatment (14 ng/g), remaining high for 24 h and persisting for 3 days (12 ng/g). The apparent terminal elimination half‐life was between 16 and 28 h after oral administration ( 8; 9). This is in agreement with the increased MC numbers up to three days after treatment.
IgE‐positive cells were detected with a higher incidence in nodules containing female worms with embryos and microfilariae up to three days after treatment than in untreated nodules. MC may be sensitized by antigen‐specific IgE adhering to their high affinity receptors (FceRI) and could therefore be involved in IgE‐dependent allergic reactions. On these sensitized MC the cross‐linking of IgE by microfilarial antigens might have led to a pronounced release of preformed mediators such as histamine, tryptase and chymase ( 11). Continuous cytokine production by chronically activated MC ( 23) could augment the inflammation; tryptase and chymase could even cause a local autocrine expansion of the MC population by enhancing the endothelial adherence not only of leucocytes, but also of MC precursors ( 19; 4). It is widely thought that much of the pathology associated with adverse reactions to parasites reflects the adverse effects of the leucocytes that are recruited to the sites of reaction ( 22). Wakelin D (1984) Nematodes which invade tissues. The cuticle as target for effector mechanisms. In ) proposed that MC, free microfilarial antigens and IgE initiate the skin reactions of onchodermatitis. Our findings confirm the proposed concept of a stronger MC‐ and IgE‐dependent allergic inflammatory reaction to microfilarial antigens in onchocercomata of ivermectin‐treated patients in contrast to the untreated generalized form.
Neutrophilic attacks on microfilariae in the vicinity of a female worm were observed after ivermectin treatment of patients with the generalized form, similar to skin reactions after administration of diethylcarbamazine ( 14) and in agreement with neutrophil activation in ivermectin‐treated onchocerciasis described by 20). Many MC occurred close to these attacks. MC induce neutrophil influx via the release of TNF‐α on activation with IgE ( 2625, 1996). The findings show a positive correlation of MC with eosinophils and macrophages, and with neutrophils after treatment with ivermectin.
In conclusion, MC are initiating the inflammatory process elicited by nongravid filariae as described from other inflammatory reactions ( 18) but the microfilaricidal effect of ivermectin leads to the strong increase of MC during the first three days after treatment in nodules containing female worms with embryos and microfilariae, probably as part of an allergic reaction to the attacked microfilariae and the released O. volvulus antigens.
"The strong relationship between the onset and severity of ivermectin-associated adverse reactions and the release of mast cell tryptase into the peripheral circulation supports a role for mast cell hyperplasia and/or degranulation in the early inflammatory response to O. volvulus microfilariae that are killed or damaged after treatment.
Mast cells may have a role in the initiation of the inflammatory cascade, leading to eosinophil recruitment in the tissues. Such an initiating event might be the release of parasite antigens from ivermectin-damaged microfilariae, leading to IgE-dependent mast cell degranulation. Our observations of a transient increase in mast cell numbers (at 24 h after treatment) before development of dermal eosinophilia and significant clinical inflammation (e.g., lymphedema) would suggest that mast cells play a role as initiators of treatment-associated inflammation.
The increase in mast cell density may have followed recruitment of circulating precursor cells, local proliferation of resident mast cells, or migration of mature cells from adjacent tissues [20]. The rapid decrease in mast cell numbers by 36 h after treatment may have resulted from apoptosis or from failure to detect degranulated mast cells (depleted of tryptase) [2].
Failure to detect basophils in these
treatment-associated skin lesions contrasts with late-phase responses to intracutaneous allergen administration [21, 22], which suggests that the inflammation occurring after antiparasite treatment is not a classic IgE-dependent late-phase response."
Bilastine: a lifetime companion for the treatment of allergies
Martin K. Churcha, Marysia Tiongco-Rectob, Erminia Ridoloc and Zoltan Novakd
“Bilastine is a selective, second-generation H1-antihistamine. It was first approved in the European Union in 2010 for the symptomatic treatment of allergic rhinoconjunctivitis (seasonal and perennial) and urticaria in patients aged 12 years or older, and is now available in approximately 100 countries worldwide8. More recently, it has been approved in Europe for use in children aged 6 to <12 years8. This narrative review summarizes available data on the use of bilastine in the treatment of allergic disorders in different age groups, including younger and older adults, and school-age children and adolescents.”
https://www.tandfonline.com/doi/pdf/10.1080/03007995.2019.1681134?needAccess=true
Three randomized studies have found surgical masks are just as effective as N95 masks at preventing virus transmission. They hypothesize the main reason for this is that any mask can reduce the hand-to-face contact, although we don’t know this for sure.
https://jamanetwork.com/journals/jama/article-abstract/2749214
Testing the Efficacy of Homemade Masks: Would They Protect in an Influenza Pandemic?
July 2013
Disaster Medicine and Public Health Preparedness 7(4):413-418
Homemade Masks vs. Viruses
The test above used bacteria that were 1 micron large, yet the coronavirus is just 0.1 microns – ten times smaller. Can homemade masks capture smaller virus particles? To answer this question, the scientists tested 0.02 micron Bacteriophage MS2 particles (5 times smaller than the coronavirus).
On average, the homemade masks captured 7% fewer virus particles than the larger bacteria particles. However, all of the homemade materials managed to capture 50% of virus particles or more (with the exception of the scarf at 49%).
Posting some DIY mask info for the crafty and less so. No evaluation on these so up to you to look at your own and previously posted resources as to efficacy.
Stolen from good guys at Smartairfilters.com. Per other posts use your own sources and previous posts as to efficacy for your purposes.
Can DIY Masks Capture Viruses?
Scientists from the University of Cambridge asked this exact question in the aftermath of the 2009 H1N1 flu pandemic. They thought that in a global pandemic scenario, we might run out of N95 masks. Their predictions have come true during the coronavirus outbreak.
Efficacy of Homemade Masks Viruses Pandemic
The researchers asked volunteers to make their own masks using cotton t-shirts and a sewing machine, using a simple protocol they’d devised. Then the researchers shot tiny 1-micron size bacteria (called “Bacillus atrophaeus”) at the masks and measured what percentage the homemade masks could capture. These particles are roughly the size of the particles behind the plague and anthrax.
The DIY masks captured fewer particles than the surgical mask, but they still managed to capture 69% of 1-micron particles.
But is that the smallest particle homemade masks can capture? The researchers stepped it up a notch by shooting .02-micron “Bacteriophage MS2” particles at the masks. These are even smaller than coronavirus particles.
DIY Cloth Mask Virus Capture Surgical Mask
Again, the surgical mask captured more particles, but the homemade cloth mask captured 51% of these nanoparticles.
OK, But They’re Leaky, Right?
At this point, smart skeptical readers are probably thinking, “sure, cloth can capture particles, but they probably don’t seal around the face, so they’re ineffective.”
Fortunately the researchers fit-tested the DIY masks too. In fit-tests, scientists measure the number of particles inside the mask versus outside the mask while someone is actually wearing the mask.
Mask Fit Test Procedure
The fit-test machine measures particles from .02 to 1 microns, which includes the size of the coronavirus.
DIY Mask Fit Test Effectiveness Virus
Across 21 volunteers, the homemade cotton masks captured 50% of 0.02-1 micron particles, compared with 80% for the surgical mask. Thus, DIY masks still managed to capture particles while people were actually wearing them. Based on this data, the researchers concluded that homemade masks would be better than nothing.
Are Two-Layered DIY Masks More Effective?
If the problem is filtration effectiveness, would the masks work better if we doubled up with two layers of fabric? The scientists tested virus-size particles against double-layered versions of the dish towel, pillow case, and 100% cotton shirt fabrics.
Overall, the double layers didn’t help much. The double-layer pillowcase captured 1% more particles, and the double-layer shirt captured just 2% more particles. Yet the extra dish cloth layer boosted performance by 14%. That boost made the tea towel as effective as the surgical mask.
Looking at the data, the dish towel and vacuum cleaner bag were the top-performing materials. However, the researchers didn’t choose these as the best materials for DIY masks:
Instead, they concluded the pillowcase and the 100% cotton t-shirt are the best materials for DIY masks. Why?
The Importance of DIY Mask Breathability
The answer lies in breathability. How easy it is to breathe through your mask is an important factor that will affect how comfortable it is. And comfort isn’t merely a luxury. Comfort will influence how long you can wear your mask.
Fortunately, in addition to particle effectiveness, the researchers tested the pressure drop across each type of fabric. This gives us a good indication of how easy it is to breathe through each material. As a benchmark, they compared breathability of each DIY mask material to the surgical mask.
Although the tea towel and the vacuum bag captured the most particles, they were also the hardest to breath through. With two layers, the tea towel was over twice as hard to breathe through as the surgical mask. In contrast, the pillow case, t-shirt, scarf, and linen were all easier to breathe through than the surgical mask.
Researchers’ Pick for Best-Performing Homemade Mask Material
Based on particle capture and breathability, the researchers concluded that cotton t-shirts and pillow cases are the best choices for DIY masks.
Making DIY Masks with Household Materials
Bottom line: Test data shows that the best choices for DIY masks are cotton t-shirts, pillowcases, or other cotton materials.
These materials filter out approximately 50% of 0.2 micron particles, similar in size to the coronavirus. They are also as easy to breathe through as surgical masks, which makes them more comfortable enough to wear for several hours.
Doubling the layers of material for your DIY mask gives a very small increase in filtration effectiveness, but makes the mask much more difficult to breathe through.