hckrnws

I've been saying this for years! Almost everyone I know scoffs, "bah, there's no known case of a human ever catching it!" To which I've said, "That's what they said about BSE, too! Do you want to win the lottery of having a disease named after you?"

And the authorities have become very reluctant to do testing due to the expense -- I've got meat from multiple untested animals in the freezer.

Also, if they don’t test for it, it clearly doesn’t exist. :s

Another good argument to reintroduce apex predators. Lyme and prion disease are nasty, and the US deer population is riddled with it.

Apex predators can help, but in places like New Jersey (and hell, the entire Accela corridor) deer are incredibly overpopulated in places too dense with humans for apex predators to tolerate. In those places, we need aggressive bow hunting and culling. But the very noisy and politically powerful "don't shoot Bambi" crowd prevents this. You get sick deer and forests entirely devoid of saplings, and therefore at risk.

Hear hear. Hunting is ethical management. There are people willfully ignorant to that.

Screw the bow. Get a suppressed bolt action .300 blackout or 8.6 blackout.

The bow will make about as much noise.

Good luck with that suppressor in New Jersey [1].

Regarding the cartridge, while I generally prefer high velocity projectiles for whitetails without the silencer, when hunting suppressed I'm on board with subsonic, but IMO the best cartridge for that is big-bore (I personally use .44 magnum, bolt action like you suggest, 300 grain hollow-point at around 1050 fps). At that low velocity, you don't get much hydrostatic shockwave, so might as well make the biggest hole possible for an ethical kill. That lumbering freight train won't stop for anything, smashes right through bones. But even subsonic, it's a lot louder than a bow -- movie pew-pew just won't consistently put down something as big as a whitetail. Also note that at those low velocities, it's difficult to get bullets to consistently expand, so I do lots of terminal ballistics testing to find the optimal projectile and load.

For grandparent comment, too bad you have those hunting restrictions -- where I hunt, while this year's regs aren't out yet, for the last couple of years, anyone who wants to can shoot 12 deer per year (of which at most 2 can be bucks). They're trying to put a dent in the population, for various reasons including CWD, although I frankly think it's excessive.

[1]: https://www.silencershop.com/blog/post/suppressor-laws-by-st...

I shot a suppressed 308 with subs last weekend. The firing pin was louder that the report.

I seriously think a bow twang is louder

Shooting healthy bucks does nothing for disease management. How often do you choose the sickly ones? Predators are so helpful for this.

As the days get shorter, signs go up in Rock Creek Park saying that people should stay away at night, for hunters will be at work. I don't know how many deer they get every season.

Somebody on the neighborhood listserv has advertised candle-light vigils for the deer at an adjoining field, but I haven't seen that in a few years.

That makes a lot of sense, except for the possibility of infecting the predators. What if they end up as a stepping stone to infect humans as well?

If deer to human transmission is truly possible, then I would be worried about the possibilities here.

How would the wolves infect the humans though?

Lycanthropic vector.

Testing is hard because it only becomes evident once a month.

Canis lupus to Canis lupus familiaris transmission is pretty much guaranteed to be easy.

Sorry if this seems dumb, but how can apex fix cjd?

Perhaps what they meant was that CWD makes the infected animals more likely to be eaten. Then the apex would, over time, kill the affected subpopulation.

Not sure that this was meant and if that even makes sense.

Culling is vital to healthy populations and balanced ecosystems.

Animals don't have medicine, so the sick or diseased amongst them can spread susceptibility to illness more readily, over time making groups more genetically or immunologically prone in a way that could lead to destabilization, become vectors for contamination (some cancers are contagious, like in dogs, and prions don't break down easily, making them true ecohazards), or end up as vectors as they contact other animal populations (HIV and swine flu were non-human origin).

Predators also encourage migration of herds, so deer won't consume an environment to depletion, including crops.

Predation is nature's free labor!

Kill and eat the sick, reducing the spread of the disease.

There's a study that showed mountain lion (puma) can eat and digest CWD infected deer meat resulting in > 95% removal of prions. Don't quote that number though, some googling should find the study.

What a shame, I used to hunt quite a bit but have all but stopped because I'd be covered in ticks each time.

We've been told recently of deer infected with CWD found near my grandparents farm (where I hunt). So I don't see myself going out much at all anymore, never was a trophy hunter, I do really like the taste of venison.

Might be for the best. A family friend died not that many years ago after a seemingly sudden onset of progressive neurological deterioration. The decade before, he'd become much more religious, describing to me what he felt as "grace" - short, intense emotional periods where he saw the world like a newborn and was overcome with wonder. If only we'd realized.

He was a lifelong deer hunter, lived in the woods for a few weeks every year, field dressing, butchering, and eating his kills the traditional way. Our area has CWD cases, and while he was going through it, I asked if he'd ever tested or been tested, and he said no, he'd been told it wasn't contagious to humans.

Can do what my dad does to mitigate risk. He has a dedicated outdoor freezer, only thing is to hold dead deer (BEFORE processing). Has the deer tested by a lab before processing. Then processes himself.

Acronyms are a scourge. Neurology.com can get away with using acronyms, since they're talking to specialists. But people also use them when talking to a public who doesn't know what the fuck the letters refer to. It's sloppy.

I'm a medical professional and I read medical journals regularly. Abbreviations and acronyms are a scourge, a single article can have dozens of cryptic abbreviated names. There's a good chance some are used that I don't immediately recognize and decipher. Some journals print a list of the articles abbreviated forms along with the "long" form which is quite helpful.

Of course, authors are supposed to given the long form and abbreviated form in parentheses. The trouble is in printed journals it can be difficult to find the first use of the abbreviation. Fortunately viewing articles in an electronic medium it's usually possible to do a search which is a real time-saver.

Furthermore, an abbreviation can have multiple meanings, especially across disciplines. For example, PSA can stand for prostate specific antigen, pressure-sensitive adhesive, public service announcement and probably some others too. Anyway I try to be mindful of the ambiguity abbreviations can produce. By all means, spelling out the term(s) abbreviations refer to should be considered mandatory.

"PSA" can also be probabilistic sensitivity analysis. I do health economic evaluations for prostate cancer screening -- which leads to interesting ambiguities:).

Yeah, sorry about "CJD" and "CWD" - it was hard to fit the title in with the Hacker News 80-character limit.

Is there a reason we believed that other prion diseases won't transmit? BSE -> CJD is already established, right? Seems like our base-case belief should be that these transmit, but I don't know the field.

It is a known risk:

> To date, there have been no reported cases of CWD infection in people. However, some animal studies suggest CWD poses a risk to certain types of non-human primates, like monkeys, that eat meat from CWD-infected animals or come in contact with brain or body fluids from infected deer or elk. These studies raise concerns that there may also be a risk to people. Since 1997, the World Health Organization has recommended that it is important to keep the agents of all known prion diseases from entering the human food chain.

https://www.cdc.gov/prions/cwd/index.html

I did not realise monkeys eat meat. Which species is that?

Plenty of monkeys will opportunistically consume things, and some groups like the baboons and mandrills are gleefully omnivorous and have been known to take down small antelopes. Take a look at those canines and wonder not.

Even horses eat the odd bird.

I don't think it's about believing one way or the other. Hunter ed warns you about this and recommends precautions.

But also consider that millions of deer are hunted and consumed in the US every year, and that hunters don't seem to be developing prion diseases at an elevated rate. We know relatively little about prions, but it seems likely that humans are fairly resilient to this, perhaps except for some predisposed individuals. Genetic factors are suspected, but there's no smoking gun. Acquired vCJD is exceedingly rare too.

There were 5882 cases of CJD between 2007 and 2020 in the United States (not specific to CWD though). Nonetheless, when I learned of that tally a few weeks ago I didn't expect the tally to be so high. Public health messaging had conveyed to me that CJD was an extremely rare occurrence in the US.

A larger-than-expected percentage of people Dxed with CJD are elderly (mid-70s to mid-80s) women which leads me to wonder if medical equipment was used when delivering babies exposed many women? I wonder if their children (who were being delivered) were also infected? In deer the mother-offspring infection route's quite well studied, but I'm not well informed about the human offspring route.

--- Full paper here (not free): https://jamanetwork.com/journals/jamaneurology/article-abstr...

The article in JAMA, above, has been summarized on this page: https://www.neurologyadvisor.com/topics/neurodegenerative-di... I'll paste the summary text below:

The incidence of Creutzfeldt-Jakob disease (CJD) has risen considerably from 2007 to 2020, particularly among older women, according to a research letter published in JAMA Neurology.

The progressive, universally fatal prion disease CJD has been stable in the United States (US) between 1979 to 2006. The most common subtype of CJD, sporadic CJD, tends to affect older individuals. As the global population ages, the epidemiology of CJD may be evolving.

To evaluate recent trends in CJD in the US, the researchers sourced data for this cross-sectional study from the Wide-Ranging Online Data for Epidemiologic Research multiple cause of death database. Death certificates between 2007 and 2020 for CJD were assessed for volume and decedent demographics.

The incidence of CJD increased consistently between 2007 and 2020, in which there were 5882 total cases and 51.2% occurred among women.

[article continues on the Neurology Advisor page]

A couple of caveats about the article: First, there were only two cases. Second, the article notes: "Based on non-human primate and mouse models, cross-species transmission of CJD is plausible. Due to the challenge of distinguishing sCJDMM1 from CWD without detailed prion protein characterization, it is not possible to definitively rule out CWD in these cases." I'm not a biologist, so if someone knows more please correct me, but I read this to mean that they definitely found CJD in the patients but could not establish the presence of the CWD prion. So they say "is plausible" and "not possible to definitely rule out".

In PA, CWD has been detected in a lot of areas (https://pagame.maps.arcgis.com/apps/dashboards/b3c0fd44cc594...) but the prevalence seems low: The dashboard is showing 102,933 CWD samples with 1857 cases of CWD detected. (It's not clear how representative this is, or how the samples were acquired.)

"only two cases" from the same hunters lodge is significant enough to warrant suspicion inuo the deer/human prion pathway. Two cases in the same location like that is actually significant. One case matters. Two really matter. Three and it's pretty serious.

Is there more to the article? All I see is one paragraph of results and one paragraph of conclusions. Would love some more details.

Chronic wasting disease sounds ominous. Is it difficult to tell if a deer is infected or is this a mistake any hunter could make?

It is a published abstract from a conference, not a complete article. Journals don’t make it obvious but if you click on the link to view the issue you’ll see that the issue title refers to an annual meeting.

Here's a different source https://www.fieldandstream.com/conservation/study-cwd-fatal-...

You have to take the deers head to a lab. The university where I live will test it for free.

The three scariest afflictions to me are: Cancer, Rabies, and Prions

Sorry to ruin your afternoon but ALS is the terror that slowly cripples

...and MS

But of all those listed, cancer is far and away the most common and thus most likely to kill you in practice.

I do not think that is true anymore about MS. For most cases it is pretty manageable these days.

It’s better than it would have been in the early 90s by a huge margin, but it’s not that great. It’s very scary.

[dead]

It's even technically guaranteed that you get cancer if get old enough.

Not a biologist, but if I got that correctly, every time your body replicates your DNA a bit of the end is cut of. There is a section of "garbage" at the end, but once that is gone the "functional" parts of the DNA are cut of.

Once that happens you are guaranteed to develop tumors sooner or later.

The "garbage" at the end protects against cancer.

It prevents cells from multiplying uncontrollably (and accumulating mutations in the process) by shortening the fuse at each generation.

There's a hierarchy with stem cells at the top that live long, rarely divide, and have few mutations, and the children of the children ... of their children at the bottom divide often, but have a short fuse and a limited lifetime, so they don't keep accumulating mutations as much

We’re just talking to ourselves at the moment but wait until they learn about p53 and how unless you have 2 copies you will get cancer before you’re 10

Naegleria fowleri (aka brain-eating amoeba)

Vibrio vulnificus! (Flesh eating bacteria found in warm waters like Florida)

Never swim in southern US waters.

Fresh water.

IIRC it hits the salt water down there as well… more often on the gulf side, maybe?

Really? I wonder why, if it's pollution or something that cases the amoeba to be so present. I have never heard of cases in the Caribbean and that water is warm also.

Is there any significant chance of catching it without getting hot water from a freshwater source up your nose or being immunocompromised?

Deadly brain amoeba infects US tap water (2013)

https://www.nbcnews.com/healthmain/deadly-brain-amoeba-infec...

It's on the rise as well (2022)

https://www.theguardian.com/environment/2022/sep/21/brain-ea...

Contact lenses and tap water will do it. From your eye, it can travel to your lungs or brain. https://my.clevelandclinic.org/health/diseases/21560-acantha...

I went wakeboarding in a freshwater lake a few years ago.

On the first wipeout, my face smashed into the water, and it went very far up my nose.

On getting up, I remembered "Naegleria fowleri", and wondered, hmmmm this might have killed me.

Luckily no symptoms appeared over the next few days.

I feel like wakeboarding should be banned in warm freshwaters.

lol ban wakeboarding? Ah yes let’s ban fun because…

> The risk of Naegleria fowleri infection is very low. There were 29 reported infections in the United States in the 10 years from 2013 to 2022, despite millions of recreational water exposures each year. By comparison, in the 10 years from 2011 to 2020, there were an estimated 4,012 unintentional drowning deaths each year in the United States.

https://www.cdc.gov/parasites/naegleria/general.html

You’re 150x more likely to drown. And even that is exceedingly unlikely - like 0.05% or something per year.

OK then add in all of the suspect bacterial or viral meningitis that was actually N fowleri because it's "so rare".

Having read Laurie Gannet’s The Coming Plauge the possibility of air transmissible Ebola is on my list after Prions.

I sometimes ponder that if HIV were airborne, there would be very few people alive right now. It would have travelled far and wide and infected practically everyone before we even knew what was happening, and long before there were any real mitigations, and there still isn't really a cure.

It's only a matter of time before nature invents a virus that will work around our defenses and spread silently and then wham, 90% of humanity is gone.

We’d work harder on finding ways to reduce spread and extend the lifespan of the infected.

I think we’d manage. Already HIV and AIDS are highly treatable, and lifespans are measured in years and decades rather than days and weeks.

Already HIV and AIDS are highly treatable

Doesn't it cost something like $100k/yr? And if so do insurance companies keep people on their policy for long after they contract it?

I am not sure.

In a lot of countries, access to healthcare is not dependent on the wealth of the recipient, or the goodwill of an insurance company.

I think you're missing the point of my comment. When HIV and AIDS were first spreading, nobody knew what it was and it took quite a long time before there was even any acknowledgement that something was wrong. There simply wouldn't be time to invent countermeasures if HIV were airborne, because all the scientists would be dying/dead already, because AIDS doesn't kill the patient immediately, or quickly. If it had been airborne in the early 1980s, it would have spread far and wide quickly, and practically everyone on the planet would have had it within a few months or a year. And we didn't have the same medical tech back then that we do now.

That’s a fair point. However, I did a quick search and it seems that untreated, the average prognosis for someone with HIV is 8-10 years.

With the right motivation, a lot could be accomplished in that time.

You're still missing the point. If HIV were airborne, it would have 8 to 10 years to spread to every part of the world, everyone would have it, and then suddenly people start dying, not just a few but practically everyone everywhere would fall ill, including the scientists you're expecting that would find a cure.

AIDS started being noticed in 1981 when a lot of gay men started falling ill and dying. It took until 1983 before scientists figured out it was a virus causing it. By the early 1990s, HIV was the No. 1 cause of death among Americans ages 25 to 44. There weren't any real mitigations until around 1995. So be glad that it wasn't airborne, because there simply wouldn't have been any scientists left to work out how to keep people alive, because an airborne AIDS would have infected literally everyone and killed off almost all before we'd have time to work out how to prevent it from killing people.

A lot of the delay in finding a cure was due to a lack of interest in finding a cure because of social stigma around HIV. You say it took 14 years for the first mitigations after HIV started to be noticed, but we could like move much faster than that if we tried harder.

8-10 years is an average. Some people would start dying earlier, setting the alarm bells ringing, but you have a point that 1981 doesn’t represent the point where the clock starts ticking for global survival. Airborne transmission doesn’t guarantee 100% infection rates, and so there’s likely some extra time built in there as the virus spreads. For sure it would be a crisis much worse than COVID, but I dont think the picture would be as bleak for the species as you paint it.

The HIV retrovirus was first discovered in 1983, and the first antiretroviral drug began trials 2 years later in 1985. That's how long it takes to discover and develop a new class of drugs. HIV researchers said at the time, "we're getting all the money we ask for; there are no delays in funding". But you think the researchers were being held back by something?

https://www.lauriegarrett.com/the-coming-plague

It kills too quickly. You would have to hole up for 10-20 days and the infection will wipe itself out.

Anyone who played this virus game on their phone knows how difficult it is to wipe out all of humanity! You have to have the optimal mix of lethality and spread velocity.

Post Covid what do you think the chances are of that happening now?

Once people started seeing folks disintegrate in public I don't think it would be too much of an issue. In fact, I'd bet people would willingly hole up so they didn't catch that new plague that causes you to rot from the inside out.

Irrelevant I think. This is going to be brutal and very visible. Good riddance to the denialists at that point.

I would agree, except that I just watched a How To Cook That episode featuring rat lung worms transmission from slugs.

That's treatable though. And easy to avoid if you just wash your veggies properly before eating them.

Ah. There is so much more… luckily chances of getting anything terrible outside cancer (which you will get if you get to be old enough) are slim. And cancer at old age is usually slow and fighting with other stuff that will kill you faster; bad heart, bad blood vessels, dementia, slipping in the bathtub etc.

What about COPD. Non-smokers can get it, too, eg from silica dust exposure (also other materials).

HIV is still very much a scary disease. Sure you can take pills that extend your life but your remaining years will be filled with dread for which opportunistic disease is going to get you.

Edit: I was wrong about rabies.

> Rabies isn’t really a risk. Nearly everyone is vaccinated

Oh my this is very very very false. People are rarely vaccinated for rabies. Only high risk people such as veterinarians are vaccinated. People who are bitten can be given PEP, but the vast majority of people are completely unprotected against rabies.

If you live in the US there absolutely are many areas that have rabies infected wildlife.

Rabies is 10000x worse to get than HIV.

Well, it's worse if you don't realize you got it.

I'd rather be infected with rabies, and receive a vaccine/cure immediately, than be infected with HIV, which I'd need to deal with chronically for the rest of my life.

if you're exposed to HIV and take post-exposure prophylaxis quickly enough, you can avoid lifelong infection. the trick is realizing you need it, which is why PrEP (pre-exposure) can be a good idea if you're at risk.

HIV PEP is only about 80% effective, which is good but still a 1 in 5 chance of getting it.

Not true - most people are not vaccinated against rabies. Vaccination should be done ASAP after suspected infection, it's still effective.

You're also still wrong about modern HIV

Not really. Even with post 2016 ART, opportunistic infections are very common. TB is a massive killer even if you’re on medication. The rate of cancers go up by like 2000% in some cases. Yes your life expectancy is going to be close to the normal life expectancy but you’re going to be sick a lot.

[dead]

[dead]