Livingstone Chishimba specialises in aspergillosis (amongst other things) and works at the National Aspergillosis Centre, Manchester, UK. This is a regular monthly support meeting held at the NAC for patients living with aspergillosis.

1. LED BY GRAHAM ATHERTON SUPPORTED BY GEORGINA POWELL, MARIE KIRWAN & DEBBIE KENNEDY NAC CENTRE MANAGER CHRIS HARRIS TALK GIVEN BY LIVINGSTONE CHISHIMBA CLINICAL FELLOW AT THE NATIONAL ASPERGILLOSIS CENTRE NATIONAL ASPERGILLOSIS CENTRE UHSM MANCHESTER Support Meeting for Aspergillosis Patients Fungal Research Trust

3. Patient meeting -Q &A Dr Livingstone Chishimba University Hospital of South Manchester

7. CAUSES OF ASPERGILLOUS LUNG DISEASE

9. Fungi are in the air

10. Exposure in the garden

11. The tsunami and Sakseniae vasiformis

12. Source of Aspergillus

13. Hospital demolition Hansen et al. JHI 2008; 70: 259-264.

14. Heavy excavation! Nihtinen et al. 2007 BMT

15. ASPERGILLOSIS

17. EU caseload of aspergillosis Immune dysfunction Frequency of aspergillosis Immune hyperactivity Frequency of aspergillosis Subacute Invasive Aspergilloma Chronic cavitary Chronic fibrosing Locally invasive . After Casadevall & Pirofski, Infect Immun 1999;67:3703 30,000 - 70,000 cases ~7,500 cases ABPA Severe asthma with fungal sensitisation Allergic sinusitis Acute Invasive

19. Incidence of Cryptococcus gattii infection British Columbia, Canada Source: BC Centre for Disease Control 2007 Cases per 100,000 population Average incidence 1999–2006: Vancouver Island: 2.8 cases per 100,000 Mainland: 0.65 cases per 100,000

20. Likely ABPA caseload 1%+ of adult asthmatics attending clinic have ABPA In UK - ~5,000,000 with asthma, >3M adults In Europe - >17,000,000 adults with asthma ~ 150,000 adults with ABPA in Europe ~12% of those with CF have ABPA EU CF population ~150,000 = ~ 17,500 patients

22. INVESTIGATIONS AND DIAGNOSIS

31. TREATMENT

35. side effects of medication

41. Thank you for your attention

42. Heavy excavation! Nihtinen et al. 2007 BMT

43. Himalayan Challenge

44. Himalayan Challenge The Himalayan 100 Mile Stage Race has been describe as the 'most beautiful' and the 'toughest' marathon in the world. The Runners Times magazine ran an article on the marathon. Their opening line was: "There are lots of good reasons not to do the Himalayan 100 Mile Stage Race. The first three are that it’s really, really, really hard."

45. The Location

47. Donations so far www.everestendurance.co.uk

50. Manchester Carers

51. http://www.nhs.uk/carersdirect/Pages/CarersDirectHome.aspx

56. Nursing Times Award – did we win???

69. PATIENT-DOCTOR RELATIONSHIP