Archive for February, 2013

Take More Weather With You

26 mm of rain! That’s what I call a sensational day!

Dr. F. Bunny

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Take The Weather With You

“We’re expecting a top temperature of 32oC,” announced the radio. “Another sensational day.”

“Another sensational day!? Look at me flamin’ trees! Look at me flamin’ grass! Look at me flamin’ plants!” cried Wal, waving the radio at the desiccated vegetation.

“Don’t be silly, Wal” thought the Dog. “Radio can’t see.”

That’s about as close as I can get to remembering one of my favourite quotes from one of my favourite comic strips, Footrot Flats. It highlights the gap between the urban dweller, who lives a life divorced from reality, and the farmer trying to make a living off the land who doesn’t necessarily think that two months of sunshine with almost no rain makes for “another sensational day.”

Having just recorded the driest January on record, with February likely to follow, all our grass is dead, the trees are looking decidedly droopy and wilted and our water tanks are all but empty. For me “another sensational day” involves a torrential downpour, or at least some steady rain. Unfortunately that would cause our urban friends to complain because they had to cancel their cricket match. They would give no thought to the lack of rain until they turned their kitchen tap on and the water they took for granted was no longer there.

Dr. F. Bunny

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Some Like It Hot

As I emerged from the aerobridge into the Manila terminal I noticed a woman pointing a weird device at me. It was a thermal camera, a gizmo used to measure skin temperature. High temperature areas show up yellow or red while low temperature areas are blue or purple. Given the current paranoia about things like bird flu and SARS this camera was being used to screen passengers in case someone had a fever, which could be indicative of an infection with one of these diseases. If you read the literature put out by the company that produces it (http://www.flir.com/cs/apac/en/view/?id=42362) they would have you believe that this is an effective screening process. But is it?

Thermal cameras have been used in veterinary medicine to detect lameness and abscesses by the heat they generate. You will no doubt have sprained something at some point and noticed how warm the area became, because of the inflammatory process. This is different to the central fever that is generated by infectious agents. According to the company’s literature the temperature in the corner of the eye most closely approximates core body temperature. The literature also states that “glass and plastic do not transmit infrared radiation, so people need to remove their glasses in order to be examined.” That’s me slipped through the net. The recommendation is also to scan individual passengers at a distance of 1 to 1.6 metres so that the face fills the screen. How this is possible for the mass of humanity streaming off the plane, where some people are looking ahead, others are looking to the side and still others are looking at the ground, is beyond me. However, this is more an operational fault than a fault with the camera per se.

A recent study attempted to objectively evaluate the effectiveness of thermal cameras in detecting fever. In this study all subjects that wore them removed their glasses and stood still in front of the device for two to three seconds, very different to the moving people at the airport. Using this method the thermal camera had a 90% sensitivity (10% of the people who had a fever were not detected) and an 80% specificity (20% of the people who were detected as having a fever did not actually have one) (Nguyen et al 2010). These figures were deemed to be acceptable even though it meant that some people escaped the surveillance net while others would be falsely detained. Still no system is 100% fool-proof.

What also puzzles me is what the authorities would have done if they had registered a positive. Presumably that person would have been asked to stand aside for further investigation, but what of the other passengers? Would all the previous passengers, who had by now dispersed through the terminal, be rounded up? Would all the passengers yet to emerge from the plane be detained? Surely if one person had a fever then all the passengers and crew would need to be regarded as infected, as we had all been breathing the same air for the past however many hours? Veterinary medicine is much more straightforward and logical. Any animals shipped overseas need to have a defined set of vaccinations beforehand (e.g. rabies if coming from a rabies endemic country) and they enter a period of isolation after arrival at their destination. If they are healthy at the end of this quarantine period they are free to go. This is of course completely impractical for people, who like to jet-set around the world on a daily basis. However, it certainly does enhance the potential for diseases to spread rapidly around the world as we saw with SARS, which travelled at the speed of flight from Asia to Canada.

The other problem with thermal imaging is that it only detects infected people who have a fever. Many diseases, such as bird flu, have an incubation period of several days during which the infected person displays no clinical signs but is still potentially infective.

I don’t know what the solution to averting a pandemic is, possibly a combination of individual country surveillance of people and animals coupled with vaccination. Infrared thermography has a potential role to play but only if used properly and not in the haphazard manner I saw in Manila. Unfortunately this would add to passenger inconvenience, which would, however, be a small price to pay if it might avert or mitigate a pandemic.

Dr. F. Bunny

Reference

Nguyen, A.V., N.J. Cohen, H. Lipman, C.M. Brown, N.A. Molinari, W.L. Jackson, H. Kirking, P. Szymanowski, T.W. Wilson, B.A. Salhi, R.R. Roberts, D.W. Stryker, and D.B. Fishbein. 2010. Comparison of 3 infrared thermal detection systems and self-report for mass fever screening. Emerging Infectious Diseases 16: 1710-1717.

 

 

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Pants On Fire

We like to mark milestones and remember anniversaries. Some anniversaries celebrate a joyous moment in our lives, such as a wedding or birthday, but many seem to commemorate a tragedy. As the fourth anniversary of the Black Saturday bushfires is upon us and the weather is once again stinking hot and we have once again had almost no rain, I wonder about the need to have public remembrance ceremonies and at what arbitrary point they are deemed to be unnecessary. Presumably the Ash Wednesday fires of 1983 were commemorated for some years after, but no longer.

Those of us that were involved in the events of Black Saturday will carry them with us until the day we die and need no reminder, especially when it is hot and the wind comes up. That never fails to elevate my heart rate and blood pressure. For those that were not involved it is probably just an abstract concept that happened to someone else, much like Anzac Day.

I suppose a day of public remembrance is meant to be cathartic, a day to remember the people that died and show they are not forgotten, as if the friends and relatives of the dead could ever forget them. For me it is anything but cathartic. All it does is open all the old wounds again and bring everything back to the forefront of my consciousness. We were lucky in that no one we knew died and we managed to save our house, so our losses were minor compared with many, but I do wonder if anything positive comes from these sorts of public remembrances. Does it aid the healing process or does it prolong it, especially the way the media likes to sensationalise everything? I would be more than happy to mark the day privately with my family, preferably in the snow somewhere far from here, but I would also never begrudge anyone their public ceremony if it might help them heal. I just wish I was not part of that public.

Dr. F. Bunny

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So Sue Me

It is hard to believe that the following cases could be true but since the internet only contains factual information I guess they must be:

The Stella Awards

For those unfamiliar with these awards, they are named after 81-year-old Stella Liebeck who spilled hot coffee on herself and successfully sued the McDonald’s in New Mexico, where she purchased the coffee. You remember, she took the lid off the coffee and put it between her knees while she was driving. Who would ever think one could get burned doing that, right? That’s right; these are awards for the most outlandish lawsuits and verdicts in the U.S.

Here are the Stellas for this past year:

Seventh Place: Kathleen Robertson of Austin, Texas was awarded $80,000 by a jury of her peers after breaking her ankle tripping over a toddler who was running inside a furniture store. The store owners were understandably surprised by the verdict, considering the running toddler was her own son.

Sixth Place: Carl Truman, 19, of Los Angeles, California won $74,000 plus medical expenses when his neighbour ran over his hand with a Honda Accord. Truman apparently didn’t notice there was someone at the wheel of the car when he was trying to steal his neighbour’s hubcaps.

Fifth Place: Terrence Dickson, of Bristol, Pennsylvania, who was leaving a house he had just burglarized by way of the garage. Unfortunately for Dickson, the automatic garage door opener malfunctioned and he could not get the garage door to open. Worse, he couldn’t re-enter the house because the door connecting the garage to the house locked when Dickson pulled it shut. Forced to sit for eight, count ’em, EIGHT days and survive on a case of Pepsi and a large bag of dry dog food, he sued the homeowner’s insurance company claiming undue mental anguish. Amazingly, the jury said the insurance company must pay Dickson $500,000 for his anguish.

Fourth Place: Jerry Williams, of Little Rock , Arkansas, garnered 4th place in the Stella’s when he was awarded $14,500 plus medical expenses after being bitten on the butt by his next door neighbour’s beagle – even though the beagle was on a chain in its owner’s fenced yard. Williams did not get as much as he asked for because the jury believed the beagle might have been provoked at the time of the butt bite because Williams had climbed over the fence into the yard and repeatedly shot the dog with a pellet gun.

Third Place: Amber Carson of Lancaster, Pennsylvania because a jury ordered a Philadelphia restaurant to pay her $113,500 after she slipped on a spilled soft drink and broke her tailbone. The reason the soft drink was on the floor: Ms. Carson had thrown it at her boyfriend 30 seconds earlier during an argument. What ever happened to people being responsible for their own actions?

Second Place: Kara Walton, of Claymont, Delaware sued the owner of a night club in a nearby city because she fell from the bathroom window to the floor, knocking out her two front teeth. Even though Ms. Walton was trying to sneak through the ladies room window to avoid paying the $3.50 cover charge, the jury said the night club had to pay her $12,000….oh, yeah, plus dental expenses. Go figure.

First Place: This year’s runaway First Place Stella Award winner was Mrs. Merv Grazinski of Oklahoma City, Oklahoma City, Oklahoma, who purchased a new 32-foot Winnebago motor home. On her first trip home, having driven on to the freeway, she set the cruise control at 70 mph and calmly left the driver’s seat to go to the back of the Winnebago to make herself a sandwich. Not surprisingly, the motor home left the freeway, crashed and overturned. Also not surprisingly, Mrs. Grazinski sued Winnebago for not putting in the owner’s manual that she couldn’t actually leave the driver’s seat while the cruise control was set. The Oklahoma jury awarded her $1,750,000 PLUS a new motor home. Winnebago actually changed their manuals as a result of this suit, just in case Mrs. Grazinski has any relatives who might also buy a motor home.

I have certainly heard the last story many times before. Hopefully they are just urban myths that give us a good laugh, rather than actual incidents. If the latter is the case I cannot really blame the claimants because people are greedy and will seize any opportunity to make some easy money. The real blame lies with the courts that handed out these ridiculous awards. If the cases were rejected and the claimants fined for wasting the court’s time I suspect these sorts of events would disappear overnight.

Dr. F. Bunny

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