The end

Well it's all over, except for the final exam thing. I hope you enjoyed the class. If you have additional feedback on the class then you can post a reply to this message, anonymously if you wish, or e-mail me if you prefer.

I'd like to thank Maggie and David for their posts to the blog. I hope you enjoyed reading all the posts and that it provided you an opportunity to explore and think beyond the class.

John

ProMed

A little more specialized but worth knowing about is the Program for Monitoring Emerging Diseases (also known as ProMED-mail). Although there are now a number of sites like this one, this is by far the oldest and is probably the largest. Sites such as this make it very hard for any government to remain quiet about a disease outbreak indefinitely. Because of the importance of animal diseases to human health ProMED-mail also reports on emerging animal diseases.

Keep Up Your Knowledge of Disease on the CDC Website

Checked out the Center for Disease Control and Prevention's webpage yet? It is great site that shares various aspects of health concerned information. From everyday healthy living facts to environmental health issues to healthy travel tips to upcoming CDC initiatives and plans and their status in Washington, this site has it all. I was even able to look up exactly how the CDC Funds for State and Local Health Organizations were divided up in the state of California in 2007 (Click Here for the Chart). I was surprised to find that above the $54, 721,262 spent on AIDS and HIV related programs and the $52,577,481 spent on Immunization programs, Terrorism Preparedness and Emergency Response with $79, 458, 396 in funding in 2007 was the category that received the most financial support. Secondly, in comparison to those previously mentioned, the mere $527,948 spent on Heart Disease organizations was also quite a surprise.
The CDC website has much more great information and links so check it out and feed your interest in disease after the end of this course!

Informative information on Influenza

These clips explain the mechanism of influenza transmission.

Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO

Here is the latest number of people infected with the avian flu, H5N1, link

11 March 2008

Country	2006		2007		2008		Total
	cases	deaths	cases	deaths	cases	deaths	cases	deaths
Azerbaijan	8	5	0	0	0	0	8	5
Cambodia	2	2	1	1	0	0	7	7
China	13	8	5	3	3	3	30	20
Djibouti	1	0	0	0	0	0	1	0
Egypt	18	10	25	9	4	1	47	20
Indonesia	55	45	42	37	12	10	129	105
Iraq	3	2	0	0	0	0	3	2
Lao People's Democratic Republic	0	0	2	2	0	0	2	2
Myanmar	0	0	1	0	0	0	1	0
Nigeria	0	0	1	1	0	0	1	1
Pakistan	0	0	1	1	0	0	1	1
Thailand	3	3	0	0	0	0	25	17
Turkey	12	4	0	0	0	0	12	4
Viet Nam	0	0	8	5	4	4	105	51
Total	115	79	86	59	23	18	372	235

House grills meat packing chief

Westland/Hallmark Meat Co. President Steve Mendell and attorney Asa Hutchinson, left, wait to testify on Capitol Hill in Washington, Wednesday, March 12, 2008, before the House Oversight and Investigations subcommittee hearing on federal regulations for food and food safety.

When faced with video showing sick cattle being illegally slaughtered the head of the Southern California slaughterhouse at the center of the largest beef recall in U.S. history was forced to acknowledge that his earlier statement, made under oath, that no ill cows from his plant entered the food supply was incorrect. Although the video was widely circulated and available at many sites on the internet Mendell avoided a perjury charge by claiming he had never seen it. This is the video that led to his plant's shutdown and last month's recall of 143 million pounds of beef and he had never bothered to watch it?

This story was all over the news today. Best headline goes to the Chicago Tribune:
House grills meat packing chief.

Morbidity and mortality

Morbidity and Mortality Weekly Report (MMWR) is a weekly epidemiological digest for the United States published by the Centers for Disease Control and Prevention.

You can sign up to receive it in your e-mail weekly or access the current version and the archives at the website. There's often something interesting there that isn't getting picked up by the mainstream media and when something does hit the media it's a good place to go for the plain facts.

Mixed messages

Top federal health authorities Thursday reiterated that vaccines do not cause autism after government health officials acknowledged that a vaccine, by worsening an underlying genetic condition, may have triggered autismlike symptoms in one girl. The case is viewed as an important milestone by autism groups that maintain that vaccinations are connected to autism.

ABC News, 7 March 2008

This was a very important Government decision, the federal government conceding that vaccines may have triggered brain deterioration with symptoms like autism in the case of one young girl. Although this wasn't headline news in most papers this was a tremendously important decision. If want to see the nitty gritty of the legal documents then there's a column at The Huffington Post entitled 'The Vaccine-Autism Court Document Every American Should Read'.

New Scientist magazine has an editorial about the decision that reflects the surprise most scientists felt about this decision. Scroll down the page though to read a fascinating discussion between a number of well informed and passionate readers, on both sides of the debate.

Malaria control for the 21st century

Before I post something more serious here's a Dutch comedy sketch. I thought the Dutch version was funnier but there is an English version too. The huge blood stain on the wall made me laugh. But then again I'm easily amused....

H5N1 in India

In the news this week are reports of a fresh H5N1 avian influenza outbreak in India:

Veterinary workers in India have begun culling tens of thousands of chickens in an attempt to combat a fresh outbreak of bird flu in West Bengal. The disease surfaced in the region in January. More than one million birds were slaughtered. But about a month ago officials said the situation was under control. Both outbreaks involve the potentially fatal H5N1 virus, although so far there have been no reports of humans being infected in India. (BBC News 10 March 2008)

The more outbreaks the strain has in poultry the more likely it is that a reassortment will occur and a major pandemic will occur in humans - especially during 'flu season' when human influenza strains are most prevalent. A Google news search on H5N1 will throw up almost daily reports of new outbreaks. In the 24 hours there have been reports of outbreaks in India, Vietnam and Iraq and a human case in Egypt.

Spanish flu

There have been a few press reports about the last surviving veterans of World War 1 as the numbers dwindle. Worldwide there are now 14 surviving veterans who are aged between 107 and 111. There is also a declining number of people who remember the 1918 flu pandemic and CNN had this interesting report on a 98 year old survivor's recollections in 2005: Witness to 1918 flu: 'Death was there all the time'.

For more information on the 1918 Influenza pandemic you should check out the PBS website for their 'Secrets of the Dead' program on 'Killer Flu':
Where did this particular flu strain come from and what made it so deadly? "Killer Flu" will show how 85 years later, virologists and epidemiologists are still hunting down the answers to those two critical questions.

Polio eradication

–Polio eradication will hopefully happen within the next few years. You can track developments at the WHO website. The eradication of polio will be a big step for global healthcare: it will demonstrate that smallpox was not a unique case, and that with cooperation, funding and willpower diseases can be defeated. More importantly the eradication of polio will then free up resources to tackle other diseases. There are only a limited number of resources, and hopefully when polio is gone they can be directed towards other diseases like measles, guinea worm and trypanosomiasis.

As I mentioned, a polio vaccine was only available in the 1950's. The World Health Organization estimates that there are 10 to 20 million polio survivors worldwide and, as one of the largest disabled groups in the world, polio survivors helped to advance the modern disability rights movement. Wikipedia has an interesting list of famous polio survivors.

Some more on that Nigerian Polio Vaccination Ban...

The map to the left displays the territory size as a proportion of the worldwide polio cases from 2000 to 2005. The reason for the overwhelming amount of polio cases in Nigeria? The Nigerian Muslims boycott of the Polio Vaccine. The boycott began in the northern Islamic state of Kano in Nigeria and other Nigerian states quickly followed suit. Kano state officials have insisted that the vaccine is unhealthy based on the fact that in 2003, Nigerian health experts found estrogen and other female sex hormones in the vaccine. They claim this vaccination effort to be a U.S. plot to spread AIDS and infertility. As the boycott continues, polio cases have been reported in 7 other African countries where it was previously believed to be eradicated.

Heroes and Villains

To follow up on the post below.....
In the last few years Rachel Carson was named as one of the '100 most influential people of the last century' by Time magazine and then her book Silent Spring, was named as one of the 'Most Harmful Books of the 19th and 20th centuries' by a panel of 15 Conservative Scholars.

But this is nothing compared to the reception Carson got when the book came out. From the Time magazine article:

Carson was violently assailed by threats of lawsuits and derision, including suggestions that this meticulous scientist was a "hysterical woman" unqualified to write such a book. A huge counterattack was organized and led by Monsanto, Velsicol, American Cyanamid - indeed, the whole chemical industry - duly supported by the Agriculture Department as well as the more cautious in the media.

You may wonder, as I did, what is so dangerous about Carson's book? Many of her companions on the list of 'harmful books' are more predictable (Karl Marx, Adolf Hitler and Mao Zedong are the top three). The argument, presumably, is that by starting a campaign that ultimately led to the banning of DDT in many countries, Carson's book led, indirectly, to increased rates of disease as a major tool in the war against insect transmitted diseases was removed.

But what is interesting is that if you actually read the book, nowhere does it call for the banning of DDT. For example at the end of her section on DDT she says:

Practical advice should be "Spray as little as you possibly can" rather than "Spray to the limit of your capacity."

Sound advice.

But if you are ready to have some of your preconceptions about DDT challenged you might want to read this article from the New Yorker magazine about Fred Soper...

...one of the unsung heroes of the twentieth century. With DDT as his weapon, Soper almost saved the world from one of its most lethal afflictions. Had he succeeded, we would not today be writing DDT's obituary. We would view it in the same heroic light as penicillin and the polio vaccine.

DDT: The Environmental Side

Beginning in 2003, the Bush Administration has made some monumental changes to the way in which the United States contributes to the fight against Malaria. Funding has been somewhat diverted from the research of this disease and has been directed towards making mosquito nets, combination drugs, and DDT readily available. While without a doubt the Bush Administration's contributions to the fight against malaria have been much more effective than the poorly executed aide programs of the past and has created a great example for programs in the future, it seems rather strange that the use of DDT is such a large component of the U.S. aide program when the majority of its uses were outlawed in the U.S. in 1972.

The ban of DDT in the early 1970's followed the release of biologist Rachel Carsen's Silent Spring. In this book, Carsen questions the widespread use of a toxic chemical of which the total effects are largely unknown. She claimed that DDT was a cause of cancer in humans and posed a major threat to many different species of wildlife. This book was extremely monumental. Beyond spreading knowledge about the dangers of DDT use and triggering public outcry and ultimately its ban, she jump started the environmental movement as a whole.

While DDT has been a very effective means of halting the spread of malaria, its links with breast cancer, danger to many bird species, and reproductive problems are important consequences to keep in mind.

Gates foundation

Philanthropy is nothing new but we seem to be entering an era where it is occurring at a scale we haven't seen before. The Bill and Melinda Gates Foundation was only established in 2000 and is the largest charitable foundation the world has ever seen. The value of the endowment was doubled by a donation by Warren Buffet, the world's richest man, in 2006. Buffet, known for his frugality, uncanny investment sense and philanthropy plans to give virtually his entire $62 billion fortune to charity before he dies. Instead of creating a new foundation he has, very wisely in my opinion, decided to funnel the money through existing foundations - primarily the Bill and Melinda Gates foundation.

At their website you can read about their programs against malaria, details from the Malaria forum they sponsored in October 2007, and details of the ongoing search for a Malaria vaccine.

As someone who has cursed Bill Gates numerous times in the long and buggy road from MS-DOS (fond memories) to Windows 1.0 (I never had a machine powerful enough to run it!) to Windows 95 (I remember using this one for quite a long time) to Windows 98 (2nd edition is still my favorite), to Windows 2000 (what a piece of crap!) to Windows XP (well it was better than 2000) to Vista (so far I'm underwhelmed) I am delighted that some of the money I have overspent on lousy software packages and operating systems (personal opinion so not libelous) is going to do some good.

Relevant Podcasts on NPR

Just happened to start listening to last week's NPR Environment Podcast, and lo and behold, they are talking about Yellow-fever in the U.S., and cholera in Peru, and how both may be affected by climate change. The first story in the podcast is all about the XDR-TB isolation case in AZ...

actually, even though I listened to it, I cant seem to relocate the bit about Yellow-fever. anywho, good stuff.

Thoughts as to why Global eradication of Malaria Fail

Researchers from London suggested that the World Health Organization and the Global Fund for Aids, Tuberculosis and Malaria, in particular, should make a better effort to implement newer and more efficient treatments. The traditional treatments for Malaria are chloroquine and Fansidar because they are cheap but, these drugs are ineffective since they often fail to fight against resistant strains of the disease. Drugs that do not work result in patients coming back to the clinic again with greater complications, such as a more severe form of the disease that often lead to death. Research has shown that a new treatment derived from a 1,500-year-old Chinese medicinal plant Artemisinin, called artemisinin-class combination therapy (ACT), is the most effective drug to treat malaria since no resistance to the drug has been recorded to date. ACT costs ten times as much as chloroquine and Fansidar at $1 to $3 per treatment. The cost of the switch from old malaria drugs to ACT should not be an issue since as more manufacturers produce the drug, the price will drop significantly as it did with AIDS drugs. With AIDS we saw what can be done when people start paying enough attention to a disease -- prices of AIDS drugs dropped from $15,000 to under $200. Link to article.

Smallpox 2002

Smallpox 2002 is a fictional docudrama. The film originally aired on BBC Two in the UK as "Smallpox 2002 - Silent Weapon." It aired in the US as "Smallpox", on FX. Although the program has some flaws, on the whole I thought it was well done. If it gets people to think in advance about what will happen in the next pandemic, whether it is influenza or bioterror, then that's a good thing. What parts of the program did you find unrealistic? Do you think events would have played out differently? Do you think this program is unnecessarily fear-mongering or do you think it is a valuable warning?

The program is rather addictive and lasts 90 minutes so don't start watching if you have other things to do!

Part 2
Part 3
Part 4
Part 5
Part 6
Part 7

Bush promotes U.S. role in war on malaria

President Bush promotes U.S. role in anti-malaria program. President, first lady visiting five nations during six-day visit in Africa. The public mission of his travels is to improve health on an impoverished continent. The underlying one is to preserve his initiatives beyond his presidency and cement humanitarianism as a key part of his legacy. Bush launched a plan in 2005 to dramatically reduce malaria deaths in sub-Saharan Africa, the worst affected region in the world. More than 80 percent of malaria cases happen here. The disease kills at least 1 million infants and children under five every year. Bush's initiative has helped more than 25 million people. It is one of several global efforts that have combined to sharply reduce malaria deaths in African countries. Congress so far has put $425 million toward Bush's $1.2 billion, five-year program. Tanzania is one of 15 countries that benefit through the distribution of live-saving medicines, insecticide spraying and bed nets that keep mosquitoes away at night. Those bed nets, which cost about $10, have long-lasting insecticide. The Bushes are touring a plant where nets are woven, hung on hooks for inspection and bagged for shipment. Here's the link to the article.

SIDE NOTE: The RED CROSS club at UCSB is also having a Malaria prevention program call "Fight the Bite." We are fund-raising to help provide bed nets, each costing $10.00. There will be flyers coming out sometime this week and it would be great if everyone can help support our cause. More info later this week.

Perfect timing

After being starved of funds for many years, the efforts of the Gates Foundation and others have raised the stakes in the war against malaria, still a major killer, especially in Africa. This week's Nature looks at the prospects for progress. See also the Editorial and the online malaria special.

Flu season

I love science. It's like an irritating kid that won't stop asking 'why'? Just when you start getting really annoyed you realize that the kid has a good question.

Why is winter 'flu season'? Well the conventional explanation is that it's because we all crowd together inside buildings in winter and so pass the virus around more easily. Except that clearly isn't the case in places like California and there isn't much evidence for it in many other places although it may be a factor sometimes.

It turns out that until recently we really didn't have a good explanation. Until this week.

Influenza viruses coat themselves in fatty material that hardens and protects them in colder temperatures -- a finding that could explain why winter is the flu season, U.S. researchers reported on Sunday.
In warmer outdoor temperatures this protective coating melts, and unless it is inside a living person or animal, the virus perishes.
"Like an M&M in your mouth, the protective covering melts when it enters the respiratory tract," said Joshua Zimmerberg of the National Institute of Child Health and Human Development (NICHD), who led the study.

I should have saved this for week 10 when we cover influenza but I know I'd forget.