World's worst mouse plague

Rodent-phobes may want to avoid clicking the above video. A couple of times tomorrow I will refer to population explosions of rodents. This video really puts this into perspective - rodents can, and do, reach some incredible densities unless we are careful to keep them in check. Cities have always been magnets for rodents but rural areas, as the video shows, can have their own problems.

Attack of the Lone Star

Being a native New Yorker, I found today's presentation about geographic prevalence of ticks especially interesting.  Growing up on Long Island we are told all our lives to avoid tall grass and always check your legs after spending time in the woods.  Ticks are basically an expected but accepted annoyance because people assume that they can avoid catching Lyme disease with rather simple measures.  This article in the local news says that these steps will no longer be effective with a new species of tick that has migrated to New York.  The new tick can sense respiration and seek out a host rather than simply come across one by chance.  The ticks can also move at a much faster speed which gives it the potential to do much more damage as it spreads out across the Lyme Disease region.

Now THAT'S what I call an ecosystem service.

Okay listen up endangered species. Do you want to get noticed? Do you want some protection? Well how about you start performing some useful service..... Can't filter water or cycle nutrients? Well how about lowering the prevalence of disease? Take a tip from the Western Fence Lizard and start asking not what mankind can do for you but what YOU can do for mankind.

I'm guessing some of you have come across the idea of ecosystem services before. It is becoming more and more widely used as an argument for the conservation of species and ecosystems. Personally I have to admit I find the reliance on this argument to be increasingly disturbing since there may be a great many species whose presence cannot be justified based on the services they provide. Do we really need 3,500 species of mosquito? What about species that are neither harmful nor beneficial but some people just find 'ikky'?

There was a nice article in the San Francisco Chornicle in 1998 describing the lizard-tick-cleansing story.

Solver for the SIR Model of the Spread of Disease

Here's a link if anyone is interested in more of the SIR model. It's the exact same model we talk about in class. You can plug in any number you want and see for yourself how fast a disease can spread. Here's the link

Lyme Disease and President Bush

Although not disclosed until nearly a year afterward, President George W. Bush was treated for Lyme Disease in late August of 2006. Apparently, the public was failed to be made aware of his treatment because he did not catch the disease until after his annual physical on August 1st. The disease was caught in its early stages before any serious or long lasting symptoms arose. The President is obviously still deemed, overall a healthy person-- At least healthy enough to bike with Lance Armstrong. For more on this story: CLICK HERE.

HPV and cervical cancer

I was just looking for a good source of some basic information on the Human Papillomavirus vaccine I mentioned right at the end of lecture when I found this wonderful PBS site from a show just under a year ago on this very subject. You can watch the whole show at the site and also read an interview with a 'vaccine expert' that raises interesting issues and find out the basic facts about HPV and the vaccine. If you can't see what all the fuss is about take a deep breath and read some of the posted comments.

Vaccine safety

The CDC website has a helpful section on some of the myths and some of the facts about the risks associated with various vaccinations.

Some parents wonder why their children must receive shots for diseases that do not seem to exist. Myths and misinformation about vaccine safety abound and can confuse parents who are trying to make sound decisions about their children's healthcare.

An additional problem with vaccination rumors is that they spark lawsuits which in turn dissuade manufacturers from marketing and investing in vaccines. Consider the whole thimerosal-autism issue. There are some links to this issue on the CDC website and a couple of interesting editorials from the Wall Street Journal here and here.

Avian Cholera

For one reason or another quite a few diseases have rather confusing names. A prime example of this is Avian Cholera which has been in the news lately. The bacteria which cause avian cholera (Pasteurella multocida) and cholera in humans (Vibrio cholerae) aren't closely related. Humans generally only acquire Pasteurella multocida as a zoonotic infection as a result of bites or scratches from pets such as cats and dogs and even this is relatively rare.

This headline from the New York Times last week could have been a little clearer:
Birds in Great Salt Lake Felled by Cholera by the Thousands
If you'd like to read more about this disease in birds the USGS National Wildlife Health Center has a frequently updated news page on the outbreak.
We will be talking more about wildlife diseases in week 9 but this caught my eye.

Interesting clips

Here's a funny clip of how Bubonic Plague was spread in China.
http://www.youtube.com/watch?v=TgC49_7Bm3s


Also, this is a cartoon of how germs are spread. Pretty funny
http://www.youtube.com/watch?v=jdONxsUkXRg&NR=1

Plague a growing but overlooked threat

Experts from the journal Public Library of Science journal PloS Medicine are concern that the Bubonic Plague are on the rise again with the general population being unaware. "Although the number of human cases of plague is relatively low, it would be a mistake to overlook its threat to humanity, because of the disease's inherent communicability, rapid spread, rapid clinical course, and high mortality if left untreated." Globally the World Health Organization reports about 1,000 to 3,000 plague cases each year, with most in the last five years occurring in Madagascar, Tanzania, Mozambique, Malawi, Uganda and the Democratic Republic of Congo, while the United States sees about 10 to 20 cases each year. The most recent large pneumonic outbreak comprised hundreds of suspected cases in the Democratic Republic of Congo in 2006.

For more info here's the link.

Dengue fever

In a strange crossing of interests, Amazon.com just recommended the latest release by a band called Dengue Fever to me. Usually I disregard these e-mails but this one obviously caught my eye. On further investigation I am happy to report that Dengue Fever are not only not a heavy metal band but play 'Southeast Asian pop, Vietnam-war-era lounge music, klezmer, ska, surf rock, and Ethiopian jazz' AND one of the band apparently caught Dengue Fever which is where the band got their name. I suspect Anthrax, Cholera, Bubonic Plague and Ebola can't say that.

Dengue fever is a hemorrhagic fever caused by a virus found primarily in the tropics and Africa, with a geographical spread similar to malaria. Dengue is transmitted to humans by mosquitos. Although it is a hemorrhagic fever the mortality rate, especially with medical care, is much lower than other hemorrhagic fevers such as Ebola hemorrhagic fever.

(Sorry the video isn't actually a video but I like this track - One Thousand Tears Of A Tarantula.)

The Bubonic Plague and Imperialism in Africa

As I was researching topics related to the Bubonic Plague I continually landed on sites referencing this book which I thought looked quite interesting. The book, "Black Death, White Medicine: Bubonic Plague and the Politics of Public Health in Colonial Senegal, 1914-1945 (Social History of Africa)" by Myron J. Echenberg, looks into the effects of imperialism on the ecology of the Bubonic Plague in Africa, more specifically Senegal. Echenberg examines the conflict between western medicine and African healing methods as well as the segregationist practices (and the resistance to them) that emerged during the 1914 to 1945 Plague period in Senegal. The book looks quite fascinating. For more information: Click Here.

'Plague-infected lab mice missing in New Jersey'

The post below reminded me of this news item from 2005. If any of you are planning a career in politics you might want to think how you could possibly have spun this story, about some missing plague infected mice. That's a tough press release to write - there's just no good way to combine 'Plague infected' and 'missing' in the same sentence.

The Plague as a Biological Weapon

For some fun Jon Stewart Commentary on the dangerous nature of the Bubonic Plague, CLICK HERE.

As far back as in the Ancient Chinese Empire, the plague has been used as a weapon in warfare. The Huns, the Mongols, and the Turks are just a few of the many groups said to have used the plague as weaponry--whether by contaminating water supplies with the carcasses of infected animals or even catapulting the bodies of plague victims into enemy cities. (However, given the fact that the bubonic plague is only transmitted to humans through animals, these warfare techniques may not have been very effectual). More effectively perhaps, in World War II Japan released large numbers of infected fleas in designated enemy territories as well as intentionally infected many of their prisoners of war. Since World War II, the United States is said to have developed biological weapons involving the pneumonic plague.

For more about the plague as a weapon: Click Here.

Flagellation in German rock video

I am a big fan of Wikipedia and have no hesitation in recommending it to students with the caveat that for complete information on a subject, especially in science, it is rarely sufficient. However it is almost always worth checking out as one starting point and if you make a habit of looking up almost everything there you learn a surprising amount. I also find it sometimes more useful than Google because at the end of articles they often have some excellent links - it's like a pre-screened set of Google links.

So for those who wish to know more about the flagellants of the middle-ages we mentioned today here's the Google article, the rather interesting Catholic Encyclopedia entry on the flagellants it links to and, above, a demonstration, albeit not from the middle ages, by German rock band Rammstein also courtesy of Google. That's the band beating themselves there and they seem to be really putting some effort into it.

The Great Chinatown Fire

There's a fascinating series of articles from the Honolulu Star-Bulletin about an outbreak of Plague in Honolulu's Chinatown and how a controlled burn to contain the epidemic rapidly became an uncontrolled burn.

'During the first weeks of November, dock workers on the Pacific Mail pier noticed that rats were behaving strangely, venturing into the light, dying in apparent agony. Not just a few. Hundreds of rats littered the pier. Workers shrugged and swept the dead animals off into the harbor water. Good riddance.'

A Very Provocative Clock

Here is a link to a clock (see poodwaddle.com) which, among other things, keeps track of the incidence of a few major infectious diseases: malaria, TB, HIV and others.

Kind of a depressing pile of information. Except for the fact that more bicycles are being produced than cars.

More on Pharmaceuticals in the Environment

In lecture, we briefly touched on how antibiotics can be 'salvaged' from urine, and Maggie's post "Pollution and Antibiotics" notes the release of antibiotics into the environment.

The United States Geological Survey (USGS) has done studies (click here for one example) describing organic compounds, which include antibiotics, which were found in water that has been treated in U.S. wastewater treatment facilities and is subsequently deemed 'potable.'

I have also heard that researchers at UC Merced are examining surface waters of the Sierra Nevada for evidence of pharmaceutical contamination. This might occur, for example, around upscale backpacking hotspots (like the High Sierra Camps or Yosemite Valley in Yosemite National Park) where large numbers of people using caffeine, male 'enhancements,' birth control medications, pain relievers, and antibiotics would be excreting large amounts into the watershed. The Sierra watersheds are the source of all of the drinking water for San Francisco and a number of the other Bay Area cities, as well as for the irrigation and drinking in the Central Valley and southern California.

In light of this information, I am reflecting on the two weeks I spent backpacking in the upper Tuolumne River watershed of Yosemite National Park, all the while completing a course of antibiotics (Doxycycline) to treat my Lyme disease.

I have to wonder what Laurie Garret, author of The Coming Plague, would say to the scientists mentioned in this article.  Researchers from the Universities of Michigan and Minnesota claim to have made a major step toward the development of new antibiotics in the family of macrolides.  After successfully crystalizing a bacteria in the process of making a macrolide ring, scientists believe they will better understand how these antibiotics work and how they can create more of them.  There is already a growing resistance to macrolide antibiotics, but these researchers claim that their new findings has the potential for bacteria to create thousands of new compounds which can then be tested for antibiotic activity.  One interesting thing about this discovery is that it requires less chemical manipulation of the bacteria and could provide a greener way to produce antibiotics.

Vietnam meets WHO’s tuberculosis treatment target

A few days ago, the World Health Organization released the latest statistical findings of TB in Vietnam. the newly-contracted case rate per 100,000 people was 175 in Vietnam, with the mortality rate per 100,000 people being 23. Vietnam now ranks 13 th among the 22 countries with the highest number of TB patients in the world. It has been reported that Vietnam has (over the last 9 years) been constantly obtaining the WHO's targets of detecting 70% of TB cases and curing 85% of the patients. Here's the link to the article.

Expecting the unexpected part 2

An update to an earlier post about the norovirus outbreak in the UK. Now that the hysterical news reports have died down there are some more serious and questioning reports. The Times Online has a fairly sensible Q&A on whether there is an epidemic or not and the Guardian has a brief article asking whether the epidemic is a myth.

An Impatient Patient Role Play info

howdy

as you prepare for the Role Play exercise next week you may run into a few links on the info sheets that I handed out in discussion which do not work. I've tried to track them down, find substitutes, and maybe add a few:

On the CEO Pharmaceutical Company sheet, I think this is the updated link to the penicillin story.

The rest seem up to date (at least, in the last 5 years). The CDC based information all seems to have links/references to the primary literature too.

For more information on how microbes work, try this University of Wisconsin web page, or this "MicrobeWorld" Website, who seem to be friends with the folks selling the stuffed animal microbes.

I will try to add some more as I find it. Feel free to leave good sites you find in the comments.

XDR-TB in South Africa

I didn't have time in class to tell you the story behind the discovery of XDR-TB. Only discovered in 2006 it was was first reported as a cluster of 53 patients in a rural hospital in South Africa - 52 of whom died. The strain of TB they had did not respond to any of the drugs then available in South Africa for first- or second-line treatment of TB. In addition it killed patients very quickly, something TB does not usually do. This was the epidemic for which the acronym XDR-TB was first coined. Over the next few months there were 314 cases reported, with 215 deaths. The story of the discovery of the resistance in these cases and the interaction between HIV and TB is told in this fascinating article.

Nesri Padayatchi, deputy director of the Centre for the AIDS Programme of Research in South Africa, tells of 35 patients treated with a second-line drug that causes intense nausea. Eight of them, she says, "tried it and said, 'I would rather die.'"

Doctors whose patients face resistant TB can't turn to "third-line" drugs: none exists.

There's a link below to some recent cases of XDR-TB in Botswana.

Basket Full of Puppies

What do Cholera, Anthrax, Bubonic Plague and Ebola all have in common apart from being potentially deadly diseases? They are all the names of bands. Ahh, deadly diseases, beloved of metal bands everywhere. Until they start killing people close to home of course. I remembered this funny article from the New York Times in 2001 during the anthrax attacks in the US. The media, desperate for something to write about, started contacting members of the band Anthrax for their opinion! The band eventually sent out a fake press release announcing that they were changing their name to Basket Full of Puppies.

Streptomyces

Remember the soil bacteria Streptomyces I mentioned as being the source of several of our antibiotics? You will probably not be surprised to find that this bacteria is also the source of resistance genes. A paper from the end of 2006 shocked many people though when it was discovered just how many antibiotics Streptomyces was resistant to.

In the paper, they isolated 480 different strains of the bacteria and then exposed them to 21 different antibiotics to see if they could survive. The average strain was resistant to between seven and eight antibiotics and two particularly hardy ones were resistant to 15 drugs. The danger is that these genes will pass from harmless soil bacteria such as Streptomyces into more deadly bacteria. This is known to happen, for example the genes that allow some harmful bacteria to resist vancomycin, one of the last lines of antibiotic defense, originally came from soil-dwelling bacteria.

"The chances that these genes will end up in a disease-causing organism at some future point is high," microbiologist Abigail Salyers, University of Illinois at Urbana-Champaign.

Pollution and Antibiotics

When discussing the third world and antibiotic drugs, most people focus on the misuse that commonly leads to the rising dilemma of antibiotic resistance in these countries. The fact that third world countries are often major manufacturers of United States generic pharmeceuticals is often overlooked. In fact, pharmeceutical imports from China and India make up 40 percent of all bulk drugs used in the United States. This figure is predicted to rise to as high as 80 percent within the next 15 years.

So how does this drug manufacturing affect the third world? While I assumed that such production may be beneficial to these countries and there ability to supply antibiotics to their own populations, such is not the case. Mishandling and a lack of effective antibiotics in these countries is still prevalent but now is accompanied with another major problem: toxic waste.

Lets look at India, the United States' largest importer of pharmeceuticals. Toxic waste from drug production plants is polluting their rice paddies and hindering agriculture, infectecting their water and killing livestock, and has been blamed for the higher rates of cancer that exist in villages surrounding such plants. The discharge found in water supplies from pharmeceutical production plants, "in one Indian region show concentrations of antibiotics and other drugs at 100 to 30,000 times the levels considered safe".

For more about the pollution problems in third world countries due to antibiotic production Click Here. It is pretty ironic to think that not only do antibiotics create stronger and smarter strains of disease, but that their production commonly leads to pollution that is further detrimental to health.

Minié balls and infection before penicillin

"Hospital Gangrene of an Arm Stump" painted by Edward Stauch.

A misconception that I had for years was the the Minié ball rifle bullets used in the Crimean War (1853-1856) and then by both sides in the US Civil War (1861-1865) were 'mini-balls' and were therefore small. They are actually named after their inventor, a French Army Captain named Claude-Étienne Minié. And they are very far from small, being mainly in 0.58", and 0.69" caliber sizes. That's more like the size of a paintball (0.68") than a modern rifle bullet (0.30" or 0.22"). There are now military reasons to favor the smaller bullet such as reduced recoil with greater accuracy and range.

The huge Minié ball, with its high muzzle velocity and soft lead composition, that flattened out on entering the body, produced terrible wounds. The heavy rounds would completely shatter bones they struck and in many cases the surgeon would amputate the limb rather than risk an infection that was invariably fatal. In fact the most common operation during the Civil War was amputation. Most amputations were necessary because when a Minié Ball struck a soldier, it carried dirt and bacteria into the wound. Despite the amputations many soldiers died of infection. With our knowledge of bacteria and infection it seems like a wonder that anyone survived but amputation, if done quickly, was a life saver. If the amputation was done within 24 hours of the injury then there was a 50% chance of survival. Because of this necessity to amputate, and to amputate quickly, civil war surgeons acquired a reputation for being too hasty with the saw. I'm happy to do my part in correcting this misconception for there is little doubt the surgeons saved many lives whilst working in conditions so appalling that I really don't want to think about it. You can read more about civil war surgery and some misconceptions about it here.

First 2 cases of TB in Botswana

This is an interesting article that I read on TB today. Botswana confirmed 100 cases of multi-drug resistant TB. According to a report released in November 2007 by the HIV Research, about one-third of the approximately 40 million HIV-positive people worldwide also are living with TB. From the report about 10% of people living with HIV/AIDS develop TB annually, according to the report. Approximately 90% of people living with HIV/AIDS will die within months of contracting TB. Here's the link if anyone is interested on this article.

http://www.kaisernetwork.org/daily_reports/rep_index.cfm?hint=4&DR_ID=49876

More vampire

For vampires in the US here's a research paper looking at 'Bioarcheological and Biocultural Evidence for the New England Vampire Folk Belief' from The American Journal of Physical Anthropology.

Tuberculosis is not the only candidate for the origin of vampirism, rabies has been suggested as well - for example in 'Rabies: A possible explanation for the vampire legend' in the journal Neurology.

Given the incredible number of vampire myths from around the world (the Wikipedia article on vampires is a good starting place) it is entirely possible that different diseases were the origin of vampire myths in different places.

I love the picture in the post below. It's so perfectly Gothically vampire.

Incidentally cult actress and TV horror-movie host Vampira aka Maila Nurmi died yesterday at the age of 85. Her visual appearance with jet black hair, pale powdered face and blood-red lipstick and nail varnish undoubtedly influenced the Morticia Addams character on The Addams Family, Elvira, Mistress of the Dark, and a whole generation (or two) of Goths. Rest in peace, or not......

Tuberculosis and Vampirism

Dracula and Tuberculosis? Surely enough the lack of information concerning the disease and its transmission led the pre-Industrial Revolution population to use their imagination and link Tb to vampirism. Symptoms such as pale complexions and the coughing up of blood were some reasons for this commonly held belief. Furthermore, people did not connect the fact that numerous members of a given household would often die to contagion, but instead they believed that this occurred because the first death (of the vampire) would drain the life out of the other family members. This is a great example of just how much knowledge was gained about Tb from the late 18th century to the early 20th century--when the first Tb vaccine was produced.
For more about this folklore: Click Here

Scrofula

In the first week I showed this cartoon from 1858 where Father Thames presents his 'offspring' to the fair city of London. The offspring are labeled 'Diptheria, Scrofula and Cholera.' I know you've all heard of Cholera, most of you have probably heard of Diptheria but I'm guessing that few of you have heard of 'scrofula'.

Scrofula is an old term for a variety of diseases that affected the lymph nodes in the neck. In children Tuberculosis can have this effect. In the Middle Ages it was believed that the touch of the sovereign of England or France, could cure the disease. Scrofula was therefore also known as the King's Evil. Some particularly benevolent Kings are believed to have touched hundreds of people to 'cure' them of the disease. King Henry IV of France is reported as often touching and healing as many as 1,500 individuals at a time. Charles II of England is said to have touched more than 90,000 victims between 1660 and 1682. The last royal healer in England was Queen Anne, who touched 200 victims in 1712. In France the ceremony persisted for another century and was even briefly revived by Charles X between 1824 and 1830.

Given what we now know about infectious disease it's a wonder that none of these monarchs died of an infectious disease they contracted with all that close contact and touching but thanks to the wonders of Wikipedia we have:
King Henry IV of France - assassinated
Charles II of England - probably died of kidney dysfunction
Queen Anne of England - died of gout (a type of arthritis) at age 49
Charles X of France - died from cholera in 1836 (long after he'd stopped bestowing the 'Royal Touch' on the sick.)

Disclaimer: despite being British I have never touched a monarch

Epidemiology and virtual virus part 2

'For days carpets of skeletons riddled the highest populated towns and were rendered uninhabitable by the persistent plague.'

Just following up on the post below. I found the following article in the Lancet (a leading medical journal) that answers many of my questions. This has a great many connections to this class.
'The untapped potential of virtual game worlds to shed light
on real world epidemics'.

Epidemiology and Virtual Virus

This is an article that I found interesting that relates to our discussion on Epidemiology. Since last August, this was the first time that a virtual virus has infected a virtual human being in a manner resembling an actual epidemiological event. This has open up the field of Epidemiology with scientists now perhaps able to use certain virtual models to answer questions such as How many people will run away from a quarantine? Will they become more or less co-operative if they are scared? instead of being limited to punching in numbers in math models. Here's the link to the article is anyone is interested.
http://www.news.com.au/dailytelegraph/story/0,22049,22281585-5012895,00.html

Week one roundup

The glossary and the lecture slides are now available online via a link section I added to right hand side of this page. The glossary will be updated occasionally, I'll think of some way of making it obvious whether it is new or not (like maybe putting the date at the top....). Lecture slides will not, unfortunately be available ahead of time this year but I'll put them up on the Friday of each week. I think it was useful to spend 5 minutes reviewing terminology and important historical events and people at the end of todays lecture so I'll continue to do that in future weeks. Honors students - don't forget to sign up and start posting here. If you are unsure how to do this you are welcome to come to office hours (W and Th 12-1 in 4324 LSB) and I'll give you a quick tutorial. If you are not an honors student and would like to post here just send me your e-mail and I'll send you an invite. Everyone is welcome to post comments on any posts and you don't need to be signed up to do that. As I mentioned in the first lecture this is a new class so any and all feedback is welcome - your comments really do make a difference. As an instructor the most annoying thing is to get feedback on the end of term evaluations that could easily have been fixed during the class ('spoke too quietly', 'text on slides was too small' etc). If you let me know of any problems by e-mail I'll try to fix them. Finally, I am going to be teaching this class this coming summer, in summer session 2008, and in future years in the winter semester. If you are enjoying the class I'd appreciate it if you could help spread the word. I really DO believe this class will cover a lot of material everyone should know so I'd like to continue the class and grow it a little. Finally, thanks to you all for signing up this year for the inaugural event. See you in class next week for Tuberculosis aka TB aka The White Plague aka Consumption.

The Ghost Map

If you'd like to read more about John Snow and the London cholera epidemic there is a nice book by Steven Johnson that came out in 2006 called 'The Ghost Map: The Story of London's Most Terrifying Epidemic--and How It Changed Science, Cities, and the Modern World.' As part of the publicity for the book they made an amusingly educational (or educationally amusing) animated video that is well worth 3 minutes of your time.




This graphical approach to depicting to disease has been adopted by a recent website Who is Sick? Here you can find out just what is going around in your community. I'm not sure they've really reached critical mass yet but if a lot of people reported their sickness on the website it would be a very useful tool. Currently you have to look at relatively large urban areas such as LA or the Bay Area to see its potential.

Giant Microbes

This is just something fun I thought I would post.
It is a link to the Giant Microbes online store where you can buy stuffed animals of various microbes such as Herpes, Ebola, and TB. I have about 10 that I have collected over the years and they are sitting on my desk with me right now. My stuffed Ebola actually inspired me to write one of my papers on Ebola last quarter. They provide interesting information on the tags and are really cute stuffed animals. Also, when you give one of them as a gift you get the opportunity of saying "I gave my roommate Chlamydia for Christmas!".

www.giantmicrobes.com

Cholera in Baghdad, Iraq

This is an interesting article on Cholera that I read last quarter in late November about the fear of a possible large outbreak of Cholera in Baghdad. Baghdad accounts for 79% of all new Cholera cases with up to 101 cases with the majority reported within the last 3 week of when this article was written. Currently the United Nations Children's Fund (UNICEF) is providing water purification tablets and rehydration salts for families and safe water to the most affected areas while asking Iraq's government to clean water storage tanks.

Here's the link if anyone is interested.

Cholera and 19th Century European Politics

Check out this New York Times Archive article concerning the political reaction to Cholera in Italy and France during the late 19th century. This article was published in August of 1884 during the midst of the 1881-1896 Cholera pandemic that began in Europe. This article highlights the lack of knowledge that was still present in the late 1800's concerning Cholera and disease in general. These dominantly Catholic countries' reliance on religious figures for help may have only prolonged the pandemic as a focus on higher standards of sanitation may have been made a secondary concern.

Reassuringly expensive

Infectious Disease Podcast

For news and reviews in the realm of infectious disease, check out "Persiflagers Infectious Disease Podcast" (or look in the Science Podcasts section of iTunes). It is provided by a doctor from Oregon (who spells out MRSA rather than calling it mersa), so some of it is a bit 'doctory.' But not surprisingly, a cast from mid-December highlighted several of the themes John touched on in Monday's lecture, and which we will be discussing throughout the quarter. Examples include antibiotic resistance, recent Ebola outbreaks and the virus' possible trend towards lower virulence (that's bad), TB, effects of climate change on Dengue, etc.

This might be a good source of relevant and tangential topics for the blog and for discussion. Plus, when you tell friends what you are listening to, they'll know just how nerdy you really are (or how nerdy your TA is).

Expecting the unexpected

'Doctors estimate that more than 100,000 people a week are catching the bug.' Wow. That has to be quite an epidemic.

When is an epidemic not an epidemic? When you can see it coming. Lots of diseases, such as the common cold and influenza, are somewhat seasonal but we wouldn't necessarily refer to the peak each year as an epidemic because it is not unexpected based on past patterns. On the other hand sometimes we get a larger peak than normal, such as a new strain of influenza, and it is then appropriate to call it an epidemic. The press doesn't always make this distinction but it is an important one.

There is currently a potential epidemic of norovirus in England. The press seem to prefer to call it the 'vomiting bug' eg. on the BBC website Many wards closed by vomiting bug. However even though you may not have heard of norovirus before it is actually very common, causing about half of all cases of viral gastroenteritis (stomach pain, diarrhea, and vomiting). Viral gastroenteritis is second only to the common cold as a cause of illness in the U.S. The graph at the top of this page shows the seasonal nature of norovirus outbreaks over the past few years. It looks like there was an increase from2001-2006 compared to 1998-2000 but whether the 2008 outbreak will become an epidemic is complicated by the fact that the press reports on it will themselves increase the number of people seeking medical advice. Cases are apparently at a 5-year high with between 100,000 and 200,000 cases a week and an estimated 2 million in total. This raises a couple of interesting points about the definition of an epidemic:

• We can see epidemics on different time scales. There may be an ongoing, longer term epidemic of norovirus since 2001, AND there may be an epidemic this year.
• Epidemics can be confused by publicity. More cases are reported when a disease hits the headlines - this does not always mean there is a real increase in the disease. For example Ronald Reagan's Alzheimer's diagnosis led to a huge press coverage and an apparent outbreak of Alzheimer's in the US. In reality it was almost certainly just due to the reporting and the increased awareness led to improved and earlier diagnosis of existing cases.
  

Norovirus fun true fact: The Norwalk virus was named after Norwalk, Ohio, where an outbreak of acute gastroenteritis occurred among children at an elementary school in November 1968. Noroviruses are named after the Norwalk virus.

Norovirus dubious fact: according to the Daily Mail 'newspaper' in England norovirus 'is 100,000 times more infectious than salmonella.' Hmmm, that is interestingly precise. I wonder what scientific morsel is behind that statement.

Welcome

Welcome to the blog for eemb40: Ecology of Disease. its main function is to provide links of relevance to the class that will allow you to explore topics of interest to you.

If you would like to make postings here then just send me an e-mail and I'll send you an invite to join. Otherwise, please note that all readers are able to make comments - it just looks like you need to have a google account but you can change that option to 'anonymous' after you click on the 'comments' section at the end of each post.

I will also use this blog in place of a class website to post various items. For example I will make a glossary of all the terminology available to you. Because this is a new class and all the lectures aren't written yet I don't want to make copies of an incomplete document for everyone for week 1 but I do want to make it available to you. So here it is, most of the terminology for the first three weeks should be there, plus some from other weeks.