Meet
Your Doctor
By Chris Motola
Emil Lesho, D.O. Rochester Regional infectious diseases physician warns of rapid increase in insect-borne illnesses — in certain cases incidence has tripled in the last decade
Could Time in a Sauna Lower Stroke Risk?
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lder adults who like to bask in the heat of a sauna may be less likely to suffer a stroke, a new study suggests. The study, of more than 1,600 Finnish adults, found that those who hit the sauna at least four times a week were about 60 percent less likely to suffer a stroke over the next 15 years versus people who had only one weekly sauna session. Finland is the birthplace of the traditional sauna which involves sitting in a room filled with dry heat at temperatures that top 160 degrees Fahrenheit. Sauna bathing is ingrained in the Finnish culture, and most people do it at least weekly, according to the researchers on the new study. So it’s not clear whether the results would extend to other types of heat therapy from steam rooms to hot tubs that are more common in other countries, said lead researcher Setor Kunutsor. But the findings do build on evidence that traditional saunas benefit people’s cardiovascular health, said Kunutsor, a research fellow at the University of Bristol in England. Past studies have found that frequent sauna users have lower rates of heart disease and dementia, compared to infrequent users. There’s also evidence the sessions lower people’s blood pressure, and make the blood vessels less stiff and more responsive to blood flow. It’s those effects, said Kunutsor, that might explain the lower stroke risk seen in this study. The findings are based on 1,628 adults who were between the ages of 53 and 74 at the outset. None had a history of stroke. The findings were published online May 2 in Neurology.
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Q: You’ve been talking about insect-borne illnesses lately. Is that your specialty. A: I’m a health care epidemiologist for Rochester Regional Hospital. I look at communicable diseases, focusing on preventable infections that patients can get when they go to the hospital. But some diseases we take care of are borne by insects like Lyme disease, West Nile virus, etc. Q: Have the incidences of these diseases been increasing? A: According to reports from the CDC, yes. Over the last 10 to 12 years, the rates have doubled or tripled. Q: I grew up in downstate, which was kind of ground zero for Lyme disease. Has it become a major concern in Western New York? A: Yeah, it’s pretty prevalent up here. As the climate gets warmer, a lot of diseases that were isolated to more southern regions are spreading northward. Q: Has the medical strategy for these diseases been more preventive or treatment-oriented? A: It’s both. It’s hard to prevent every mosquito bite, especially since you won’t always know if you’re getting bitten by one. But you can wear bright clothing, wear insect repellant, and those things also help prevent tick bites. With ticks, you can check yourself or have family members check you for bites. The tick needs to be imbeded for a day or two before it can transmit Lyme disease. I would also encourage people not to feed deer or encourage them to
come into their yard, since they carry a lot of ticks. I would say both treatment and prevention are important. Some types of mosquito-borne illnesses, particularly those that affected the brain, have no treatments. In those cases it’s just supportive care. Q: How are medical institutions like Rochester Regional preparing? A: That same report says that not enough resources are being put toward surveillance and that our current procedures need bolstering. We’re talking about studying ticks and mosquitos, seeing what species are out there, and whether they’re carrying these diseases. We are, however, pretty familiar with these diseases. Q: With regard to your research into antibiotic resistant bacterial strains, is that mostly hospital-based? A: It is primarily hospital-based, but more research and reports are showing that they’re found throughout the community, especially in places where sanitation is poor. But it’s mostly hospital-based. If you’re having a lot of surgeries, you’re more vulnerable. A lot of those strains used to be sensitive to antibiotics, but those same strains are sometimes resistant to some antibiotics. Sometimes they’re resistant to all antibiotics.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • June 2018
Q: What do you do when you have a strain that’s resistant to all antibiotics? A: There’s not much you can do. You hope and pray. You use combinations of antibiotics. You use the highest dose you can use without causing toxicity. You administer it more slowly, over a longer period of time. You basically are trying to weaken the bac-
In The News “Disease cases from mosquito, tick, and flea bites tripled in the US from 2004 to 2016.” CDC report teria enough for the body’s immune system to be able to finish it off. That’s one of the components of the resistant crisis, but there’s another: the lack of new antibiotics coming to market. Bacteria develop resistance pretty quickly, so the drug companies are disincentivized to make new ones. So we have what we call a dry pipeline. Q: Is there any attempt being made to fix the pipeline? A: Yes, there has been, but the current administration isn’t prioritizing it. The previous administration had a plan to address antibiotic resistance. Q: I understand the challenge isn’t just with bacterial, but fungal infections as well. A: The technical name is Candida auris that’s emerged in the U.S. since 2016. The vast majority of cases in the U.S. are in New York state, and the vast majority of those are in New York City. There was a patient transferred from a New York City hospital to our hospital carrying the fungus but, through a series of best practices, we were able to keep it from spreading. It can easily spread through hospitals and has a substantially high mortality rate. Q: What sort of practices help? A: We were aware of the early reports from around the world about this fungus. So, the first best practice is awareness and vigilance. We were very diligent about sending any suspect-looking organisms to the lab for confirmation. The next step is, for lack of a better term, locking down the patient and equipment. You don’t share any equipment until its cleaned. The next step is cleaning services and using a powerful disinfectant on the equipment. We then swab hospital surfaces and disinfect them again until we no longer detect the organism. It’s teamwork, feedback, communication and using the right chemicals.
Lifelines Name: Emil P. Lesho, D.O. Position: Infectious diseases specialist at Rochester Regional Health Hometown: White Haven, Pa. Education: Philadelphia College of Osteopathic Medicine Certification: American Board of Internal Medicine Affiliations: Rochester Regional Health Organizations: Infectious Diseases Society of America; Society of Healthcare Epidemiologists of America; American College of Physicians; Rochester Academy of Medicine Family: Wife; dog Hobbies: Mountain climbing, gardening, piano, guitar