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News Tests to Identify Brain-Eating Amoeba

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By Nicholas Weiler, UCSF News

 

Last summer, a 74-year-old resident of San Francisco’s Chinatown was admitted to San Francisco General Hospital and Trauma Center with fever and disorientation, which rapidly degenerated into a coma.

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Her symptoms screamed that she was suffering from encephalitis, an infection of the brain, but a series of tests and drugs – for tuberculosis, bacterial and fungal infections, even Toxoplasmosis – could neither identify the cause of infection nor do anything to resuscitate her.

 

She died 16 days later, her illness still a mystery to her clinicians.

 

Sadly, this outcome is all too common in cases of brain infection, which go unsolved six times out of 10 in California, according to a 2006 UC San Francisco study.

 

Joseph DeRisi, PhD

Joseph DeRisi, PhD

Biochemist Joe DeRisi, PhD and neurologist Michael Wilson, MD, of UCSF want to change that statistic, and they think they have the tools to do it.

 

When the researchers learned of last summer’s case of mystery encephalitis, they turned to cutting-edge genomic tools to track down the cause of the woman’s disease.

 

They used rapid next-generation genomic sequencing to search the patient’s spinal fluid for non-human DNA, then compared what they found against databases of genes of every known invasive microorganism or virus.

 

This “metagenomic” approach rapidly found a match: a common soil-dwelling amoeba called Balamuthia mandrillaris, as the researchers reported last month in the journal Annals of Neurology.

 

The researchers and their colleagues have recently set up a new Center for Next-Gen Precision Medicine Diagnostics to help hospitals make genome-based screens for the root causes of encephalitis part of their standard of care.

 

The technology could save money as well as lives. Over her two-week hospitalization, care for last summer’s Balamuthia victim cost more than $100,000.

 

The metagenomic screen, by comparison, costs a mere $2,000 – and typically takes two days.

 

Michael Wilson, MD

Michael Wilson, MD

One of the center’s first priorities will be a study to determine when in the course of an encephalitis patient’s care the technique would have the greatest clinical impact. Researchers will comb through databases of encephalitis cases to identify when cheap, existing treatments like a $100 blood draw are effective at diagnosing a patient’s disease and when it’s time for clinicians to turn to the center’s big genomic guns.

 

“We all agree these metagenomic screens are happening too late,” said UC Berkeley health economist Brent Fulton, PhD, MBA, part of the center’s team who is leading the study. “When UCSF gets the call, doctors have already tried everything under the sun and it’s a bad situation.”

 

But how early should the test be done? It’s still an open question, according to Fulton. “A $2,000 test is nothing to sneeze at if it turns out to not change the usual course of care,” he explained. “But balanced against a multi-week, half-million dollar hospitalization, it’s nothing.”

 

Through the new center, DeRisi hopes to make such screening a hospital’s go-to test for mystery brain infections rather than a last resort. Currently, doctors need to track down DeRisi and his peers directly to request help, he said. “We need to make this into an actual clinical diagnostic so a doctor who doesn’t know my phone number can just order up this test.”

 

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Rest in Peace: A.M.E. Pastor and L.A Civil Rights Icon Cecil “Chip” Murray Passes

The Rev. Dr. Cecil L. “Chip” Murray, former pastor of First African Methodist Episcopal Church (FAME) in Los Angeles, died of natural causes April 6 at his Windsor Hills Home. He was 94. “Today, we lost a giant. Reverend Dr. Cecil Murray dedicated his life to service, community, and putting God first in all things. I had the absolute honor of working with him, worshiping with him, and seeking his counsel,” said Los Angeles Mayor Karen Bass of the dynamic religious leader whose ministry inspired and attracted millionaires as well as former gang bangers and people dealing with substance use disorder (SUD).

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The Rev. Dr. Cecil L. “Chip” Murray, former pastor of First African Methodist Episcopal Church (FAME) in Los Angeles, died of natural causes April 6 at his Windsor Hills Home. He was 94.

“Today, we lost a giant. Reverend Dr. Cecil Murray dedicated his life to service, community, and putting God first in all things. I had the absolute honor of working with him, worshiping with him, and seeking his counsel,” said Los Angeles Mayor Karen Bass of the dynamic religious leader whose ministry inspired and attracted millionaires as well as former gang bangers and people dealing with substance use disorder (SUD).

Murray oversaw the growth of FAME’s congregation from 250 members to 18,000.

“My heart is with the First AME congregation and community today as we reflect on a legacy that changed this city forever,” Bass continued.

Murray served as Senior Minister at FAME, the oldest Black congregation in the city, for 27 years. During that time, various dignitaries visited and he built strong relationships with political and civic leaders in the city and across the state, as well as a number of Hollywood figures. Several national political leaders also visited with Murray and his congregation at FAME, including Presidents George W. Bush and Bill Clinton.

Murray, a Florida native and U.S. Air Force vet, attended Florida A&M University, where he majored in history, worked on the school newspaper and pledged Alpha Phi Alpha Fraternity.  He later attended Claremont School of Theology in Los Angeles County, where he earned his doctorate in Divinity.

Murray is survived by his son Drew. His wife Bernadine, who was a committed member of the A.M.E. church and the daughter of his childhood pastor, died in 2013.

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Court Throws Out Law That Allowed Californians to Build Duplexes, Triplexes and RDUs on Their Properties

Charter cities in California won a lawsuit last week against the state that declared Senate Bill (SB) 9, a pro-housing bill, unconstitutional. Passed in 2021, SB 9 is also known as the California Housing Opportunity and More Efficiency Act (HOME). That law permits up to four residential units — counting individual units of duplexes, triplexes and residential dwelling units (RDUs) – to be built on properties in neighborhoods that were previously zoned for only single-family homes.

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Charter cities in California won a lawsuit last week against the state that declared Senate Bill (SB) 9, a pro-housing bill, unconstitutional.

Passed in 2021, SB 9 is also known as the California Housing Opportunity and More Efficiency Act (HOME). That law permits up to four residential units — counting individual units of duplexes, triplexes and residential dwelling units (RDUs) – to be built on properties in neighborhoods that were previously zoned for only single-family homes.

A Los Angeles Superior Court Judge ruled in favor of the cities, pointing out that SB 9 discredited charter cities that were granted jurisdiction to create new governance systems and enact policy reforms. The court ruling affects 121 charter cities that have local constitutions.

Attorney Pam Lee represented five Southern California cities in the lawsuit against the state and Attorney General Rob Bonta.

“This is a monumental victory for all charter cities in California,” Lee said.

However, general law cities are excluded from the court ruling as state housing laws still apply in residential areas.

Attorney General Bonta and his team are working to review the decision and consider all options that will protect SB 9 as a state law. Bonta said the law has helped provide affordable housing for residents in California.

“Our statewide housing shortage and affordability crisis requires collaboration, innovation, and a good faith effort by local governments to increase the housing supply,” Bonta said.

“SB9 is an important tool in this effort, and we’re going to make sure homeowners have the opportunity to utilize it,” he said.

Charter cities remain adamant that the state should refrain from making land-use decisions on their behalf. In the lawsuit, city representatives argued that SB 9 eliminates local authority to create single-family zoning districts and approve housing developments.

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Funds for Down Payments and Credit Repair Given to Black First Time Homebuyers

The California Civil Rights Department (CRD) won a $10,000 fair housing settlement last November against a property management company, CIM Group LP, a global real estate company headquartered in Los Angeles, and property owner, RACR Sora, LLC, for implementing a blanket ban on renting to tenants with criminal histories at Sora Apartments in Inglewood. Three months earlier, the department, which enforces California’s civil rights laws, won another $20,000 civil rights settlement against a Lemon Grove property manager, who had targeted a Black tenant with a series of racist actions and threats of violence.

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By McKenzie Jackson, California Black Media

The California Civil Rights Department (CRD) won a $10,000 fair housing settlement last November against a property management company, CIM Group LP, a global real estate company headquartered in Los Angeles, and property owner, RACR Sora, LLC, for implementing a blanket ban on renting to tenants with criminal histories at Sora Apartments in Inglewood.

Three months earlier, the department, which enforces California’s civil rights laws, won another $20,000 civil rights settlement against a Lemon Grove property manager, who had targeted a Black tenant with a series of racist actions and threats of violence.

CRD Director Kevin Kish said the department investigates cases of apparent racial bias in housing and sometimes more subtle acts of prejudice like nuisance-free or crime-free housing policies or holding tenants to different standards based on their race.

Kish said, “People will get evicted if they call the police. This can negatively impact victims of domestic violence. We also see these no-crime ordinances, or no-crime policies, used in racially discriminatory ways. If there is some kind of incident, and the police are called and it involves a Black family, then they get evicted, but other folks aren’t necessarily evicted.”

On April 11,1968, a week after Rev. Dr. Martin Luther King, Jr. was assassinated, President Lydon B. Johnson signed the Fair Housing Act, which prohibits discrimination in the sale, rental, and financing of housing based on race, color, religion, and nationality.

Kish noted that William Byron Rumford, the first Black California State Assemblymember, who represented Berkley and Oakland, spearheaded the passing of the Rumford Act in 1963. That law sought to end discriminatory housing practices in the Golden State, five years before the Fair Housing Act became law.
Real estate agent and housing advocate Ashley Garner is the director of the CLTRE Keeper Home Ownership program. That organization gave 25 Black, indigenous, and people of color $17,500 each in down payment and credit repair support to purchase a home in Oak Park, a traditionally Black neighborhood in Sacramento, last fall. CLTRE obtained a $500,000 grant from the city of Sacramento to award the funds to the residents after they completed an eight-week homeownership program.

In 2021, the California Housing Finance Agency (CalHFA) noted that around four in 10 Black California families owned homes, which trails that of White, Asian-American and Latinos.
According to Forbes, the median price for a home in California is over $500,000, which is double the cost of a home in the rest of the country.

Black lawmakers recently introduced their Reparations Priority Bill Package that includes support for Black first-time homebuyers, homeowners’ mortgage assistance and property tax relief for neighborhoods restricted by historic redlining.

California Housing Finance Agency (CalHFA) spokesperson Eric Johnson said CalHFA helps prospective low-income and moderate-income Californians purchase homes by offering down payment and closing cost aid. “There are lots of people who have steady jobs, good credit scores, constant income, but they haven’t been able to save up the money that traditional banks need or want to see for a down payment,” Johnson stated. “We help those folks out. We give a loan for the down payment to get them over that hurdle.”
CRD and the Department of Real Estate hosted “Fair Housing Protections for People with Criminal Histories” Zoom call on April 10.

On April 25, CRD will also hold Zoom seminars focused on advocating for fair housing for people with disabilities.

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