Minerva
BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7453.1446 (Published 10 June 2004) Cite this as: BMJ 2004;328:1446All rapid responses
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I take my colleague Dr. Levitt to task re. his comment (above)
indicating this report to be "urban legend." Minerva is not so gullible as
to offer a report from other than a peer-reviewed source (certainly that
must be true Madagascar's "La Gazette de la Grande Ile" !!). I have no
doubt Minerva confirmed as reasonable the reported time for both
incubation and mortality due to "fulminating
leptospirosis" (was this Weil's syndrome?). No doubt it was established
that the can was maintained, unexposed to rat urine, from episode of drink
consumption through post mortem investigation. Finally, Minerva certainly
confirmed an appropriate analysis to establish the alleged residue as both
urine and from a rat. A search of the internet finds an ELISA assay for
just such a purpose - NO doubt this was used here.
One could have asked that PCR through cloning and BLAST search to confirm
confirm the presence of Leptospira interrogans DNA in the rat urine
residue, but I'm confident of Minerva's judgement that the data offered
were
sufficient.
Carry on Minerva, the National Inquirer awaits your attention!
Competing interests:
None
Competing interests: No competing interests
Sir:
This is a very interesting selection of Minerva who informs us about
childhood trauma,i.e., trauma before and after age 13 and its linkage to
developmental psychopathology. Besides depression and PTSD and their
comorbidity, there could be two more common psychiatric disorders
preferentially reported among women who were exposed to sexual trauma
before age 13. These psychiatric disorders are borderline personality
disorder and eating disorders. Substance use disorders could also be found
relatively more among those persons who were exposed to trauma after age
13 as compared to control without any history of trauma.
Finally, consulting psychiatrists should explore the history of
exposure of multiple traumata among those who present with one of the
aforesaid psychiatric disorders. This would help in planning delivery of
psychiatric services, which will include drug as well as psychosocial
therapies.
Reference:
Minerva. BMJ 2004; 328: 1446
Competing interests:
None declared
Competing interests: No competing interests
Sir:
Minerva informs us about the effect of chronic, sustained high
systolic blood pressure on teeth which are lesser in number among
hypertensive postmenopausal women as compared to those women with normal
or lower systolic/diastolic blood pressure. This suggest that patients
with high blood pressure should keep their blood pressure readings normal
for keeping their teeth intact by which they can eat delicious foods and
smile well. Of course, there are many other advantages of controlling
blood pressure within normal limtis.
Reference:
Minerva. BMJ 2004; 328: 1446
Competing interests:
None declared
Competing interests: No competing interests
Minerva's report of a case of leptospirosis acquired after drinking a
canned drink contaminated by rat urine is unfortunately just another one
of those urban legends. A visit to the website
http://www.snopes.com/toxins/raturine.htm will show the same story coming
from Belgium. I have in my own collection of slides one of a newspaper
cutting from Dublin warning that rats urinate on beer bottles in pubs and
that drinking beer from the bottle may lead to leptospirosis.
The clue in this story is that the rat urine "had dried on the top"
of the can. Leptospires are delicate organisms which die rapidly when
dessicated. The unfortunate lady in Minerva's tale might well have
contracted leptospirosis during her boat-trip, but it was most certainly
not from a contaminated soft drink can.
Competing interests:
None declared
Competing interests: No competing interests
Leptosporosis
Dear Minerva
Re: Leptospirosis report in Madagascar’s la Gazette
De la Grande Ile
BMJ 328 12.6.04 p1446
I felt that I must write to correct some points of fact in the piece
above which gave the impression that leptospirosis is much more infectious
than it really is.
Firstly, a 2 day incubation period for the illness is very rapid,
although possible. The incubation period is usually more than 5 days.
Secondly leptospires are inactivated very rapidly by drying and also
by stomach acid.
Thirdly, how did they know it was rat urine?
Yours sincerely
Dr AS Johnson
Head of Leptospira Reference Unit
Competing interests:
None declared
Competing interests: No competing interests