Sequelae of World War II: An Outbreak of Chronic Cutaneous Nontuberculous Mycobacterial Infection among Satowanese Islanders

Lillis, Joseph V.; Ansdell, Vernon; Ruben, Kino; Simpson, Eric L.; Tumbaga, Gloria; Ansdell, David; Bremmer, Samuel; Kurtz, Stephen E.; White, Clifton R.; Blauvelt, Andrew; Winthrop, Kevin

doi:10.1086/598928

Cited by 13 publications

(7 citation statements)

References 12 publications

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“…The recognition of NTM as opportunistic pathogens began in the 1950’s with a number of patients suffering from underlying pulmonary disease being reported in the literature [ 5 ] Chronologically, three distinct phases could be drawn: in the pre-HIV era, the majority of patients with NTM pulmonary infection were men, whose risk factors included lung damage from other conditions (e.g., emphysema, cystic fibrosis, TB), smoking and occupational dust exposure [ 6 ], or World War II veterans with smoking and alcohol abuse habits; in a second stage, the infections became associated with patients with concomitant human immunodeficiency virus infection and loss of T-cells. Afterwards, reports describe taller, slender, and elderly women (and some men) as being more affected [ 7 ].…”

Section: Introduction: Mycobacteria and The Hostmentioning

confidence: 99%

Non-Tuberculous Mycobacteria: Molecular and Physiological Bases of Virulence and Adaptation to Ecological Niches

et al. 2020

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Non-tuberculous mycobacteria (NTM) are paradigmatic colonizers of the total environment, circulating at the interfaces of the atmosphere, lithosphere, hydrosphere, biosphere, and anthroposphere. Their striking adaptive ecology on the interconnection of multiple spheres results from the combination of several biological features related to their exclusive hydrophobic and lipid-rich impermeable cell wall, transcriptional regulation signatures, biofilm phenotype, and symbiosis with protozoa. This unique blend of traits is reviewed in this work, with highlights to the prodigious plasticity and persistence hallmarks of NTM in a wide diversity of environments, from extreme natural milieus to microniches in the human body. Knowledge on the taxonomy, evolution, and functional diversity of NTM is updated, as well as the molecular and physiological bases for environmental adaptation, tolerance to xenobiotics, and infection biology in the human and non-human host. The complex interplay between individual, species-specific and ecological niche traits contributing to NTM resilience across ecosystems are also explored. This work hinges current understandings of NTM, approaching their biology and heterogeneity from several angles and reinforcing the complexity of these microorganisms often associated with a multiplicity of diseases, including pulmonary, soft-tissue, or milliary. In addition to emphasizing the cornerstones of knowledge involving these bacteria, we identify research gaps that need to be addressed, stressing out the need for decision-makers to recognize NTM infection as a public health issue that has to be tackled, especially when considering an increasingly susceptible elderly and immunocompromised population in developed countries, as well as in low- or middle-income countries, where NTM infections are still highly misdiagnosed and neglected.

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Section: Introduction: Mycobacteria and The Hostmentioning

confidence: 99%

Non-Tuberculous Mycobacteria: Molecular and Physiological Bases of Virulence and Adaptation to Ecological Niches

et al. 2020

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“…Recently, the offending agent has been identified as Mycobacterium marinum, and prolonged courses of doxycycline have been shown to be effective against it. Japanese medaka fish, introduced to control mosquitoes in Pacific War bomb craters and taro patches, are thought to be an intermediate host (Lillis, Winthrop, White, and Simpson, 2008;Lillis, Ansdell, Ruben, et al, 2009).…”

Section: Hansen's Diseasementioning

confidence: 99%

Micronesian Migrant Health Issues in Hawaii

Yamada

Pobutsky

2009

CALIF J HEALTH PROMOT

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Increasing numbers of people from the Federated States of Micronesia and the Republic of the Marshall Islands are presenting for clinical and public health services across the U.S., especially in Hawaii. We review the impact of historical and contemporary relationships between the U.S. and these Freely Associated States on the health status and health care access of these migrants. We draw upon both epidemiological evidence and clinical experience to suggest measures to assure health care access and appropriate clinical care for these populations. We also point to potential public health measures, and indicate directions for future research.

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“…Mycobacterium marinum (M. marinum), belonging to non-tuberculous mycobacteria (NTM), is an important causative agent of infectious granulomas [2] . The disease is prevalent worldwide, with an incidence of 0.27/10 5 in the United States and 0.04/10 5 in France, as high as 6% on the island of Satowan in Cronesia [3][4][5] . But the incidence of M. marinum is still increasing rapidly and it has become a serious public health problem [6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

5-aminolevulinic acid-photodynamic therapy ameliorates cutaneous granuloma by killing drug-resistant Mycobacterium marinum

Yang

Feng

Pang

et al. 2021

Preprint

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Although 5-aminolevulinic acid photodynamic therapy (ALA-PDT) has been extensively used to treat to various skin disease, the application of ALA-PDT on cutaneous infection caused by Mycobacterium marinum (M. marinum), especially by drug-resistant M. marinum is still not clear. We evaluated the therapeutic efficacy of ALA-PDT on M. marinum in a mouse infection model and tested its killing effect on M. marinumin vitro. Finally, we investigated the clinical effect of ALA-PDT in treating cutaneous granuloma caused by drug-resistant M. marinum. We isolated total 9 strains of M. marinum from patients and confirmed by morphological and molecular approaches. The strains were identified by anti-mycobacterial susceptibility. Then we evaluated the killing effect of ALA-PDT on M. marinum in vitro and in a mouse model to observe the antimycobacterial effect of ALA-PDT. Therapeutic efficacy was further assessed in patients with cutaneous granuloma caused by drug-resistant M. marinum. We demonstrated that the ALA-PDT directly killed M. marinumin vitro. The paws cutaneous lesions of mice caused by M. marinum were fully recovered 2 weeks after ALA-PDT treatment. However, there was no significant difference for immune cells in peripheral blood before and after ALA-PDT therapy. Finally, ALA-PDT proved to be effective in treat two patients with cutaneous infection caused by drug-resistant M. marinum. The results suggest that ALA-PDT is effective in treating M. marinum cutaneous infections by killing M. marinum directly, independent of systemic immune responses. The data highlight the ALA-PDT as a promising therapeutic choice for M. marinum infection, especially for drug-resistant strains.

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Sequelae of World War II: An Outbreak of Chronic Cutaneous Nontuberculous Mycobacterial Infection among Satowanese Islanders

Abstract: "Spam disease" is a chronic, progressive skin disease of high prevalence on Satowan and is associated with taro farming and contact with World War II-era bomb craters. Histopathological and PCR data demonstrate a nontuberculous mycobacterial infection as the cause.

Cited by 13 publications

References 12 publications

Non-Tuberculous Mycobacteria: Molecular and Physiological Bases of Virulence and Adaptation to Ecological Niches

Non-Tuberculous Mycobacteria: Molecular and Physiological Bases of Virulence and Adaptation to Ecological Niches

Micronesian Migrant Health Issues in Hawaii

5-aminolevulinic acid-photodynamic therapy ameliorates cutaneous granuloma by killing drug-resistant Mycobacterium marinum

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