The cost of eliminating Rinderpest

I was still looking for an estimate of the total cost of Rinderpest elimination when I came across this Science article: RINDERPEST: Driven to Extinction from last year, which provided just the estimate I was looking for:

It's impossible to tease out exactly what had been spent in the fight against rinderpest, but Roeder estimates that since 1986, international donors and participating countries spent approximately $610 million on animal health in Africa and Asia, primarily targeting rinderpest but covering other diseases and infrastructure. One FAO estimate puts the benefits of rinderpest eradication at $1 billion annually in Africa alone. The additional $10 million or $12 million needed for the remaining countries to complete the accreditation process "would be a small price to pay for finalizing the eradication of this devastating disease," he says. With just a final push, rinderpest could officially join smallpox as a disease of the past.

The article is a nice, and quite short summary of the elimination program. The link to the article will probably only work from campus computers. Off campus you will need to log on to the libraries proxy server.

Stanley Prusiner

Stanley Prusiner is an American biochemist and neurologist. While he currently works as the director of the Institute for Neurodegenerative Diseases at UCSF, his biggest claim to fame is receiving the 1997 Nobel Prize in Physiology/Medicine for his work and research in Mad Cow Disease and CJD. Prusiner was the first to discover and coin the term "prion." 

An interesting autobiography can be found: ^{http://nobelprize.org/nobel_prizes/medicine/laureates/1997/prusiner-autobio.html}

Where are the germs in your house?

When I saw the CNN headline 'How to germ-proof your home' today I did not have high expectations. When I clicked on the article and saw the accompanying illustration I was expecting the usual 'Arggh!! Germs!! They're everywhere! Kill them all. Kill them!' type of article.

However the article is actually very sensible and cites some interesting studies. Did you know that one-third of women's purses have fecal bacteria on the bottom? Ewww.

(B)e aware that there is such a thing as too clean. Overuse of antibacterial products may lead the microbes to develop mutations that make them resistant to disinfectants and multiply to create a resistant population.

"You don't need to wash yourself with bacterial soap, because you might lose microbes that are beneficial to you," Eichenbaum said.

How to tell if your cow has mad cow disease!

This is a little joke on how to spot mad cow disease......pretty funny, but once again A JOKE.

http://www.niebank.com/madcow.html

South Korea vs. US Beef

Late last year, the major South Korean retailers decided to resume the sale of US Beef after a 5 year ban. This ban was a result of an intense fear of Mad Cow Disease. Many local South Koreans were not very happy about this decision to resume the sale of our beef, so they staged huge protests. The people say that just because the beef is available does not mean that anyone will purchase it.
Before this ban in 2003, US beef accounted for 2/3 of all of South Korea's beef imports. Opening the markets to US beef was tied to a bilateral free trade deal. Watch this news video for more information.

http://www.youtube.com/watch?v=h2CcF-JxwbU

Mad Cow short

Here's a funny little short by Emmy-award winner Seth MacFarlane (creator of Family Guy)!

Ignore the ad for Priceline at the beginning - the actual video starts at 0:23.

And now for something completely different....

The Mosquito and Vector Management District of Santa Barbara County is holding a contest to replace its current logo (shown here) with one that is 'more specifically emblematic of Santa Barbara County and our local issues'. Presumably they would also like one that sucks less than their current one.

The District is inviting local students in high schools and colleges throughout Santa Barbara County to participate in a contest to assist the District in designing its new logo.

The logo should reflect the District’s mission to protect the health and safety of residents and visitors of Santa Barbara County from vectors and vector-borne diseases. Design options could include local geography and local vectors. The design should be limited to four colors for purposes of printing.

Oh, and you can win $300 and, more importantly, a cool line to put on your cv/resume.

Deadly Feasts

There are now a number of books about prions, mad cows and the whole BSE/vCJD issue. One I would recommend is 'Deadly Feasts: the "prion" controversy and the public's health' by Richard Rhodes. It covers all the known prion diseases and tells the story of their discovery and investigation. Richard Rhodes is not a scientist but a journalist and historian (he won the Pulitzer prize for 'The Making of the Atomic Bomb') and I think this gives him a bit more perspective on the issue and an impressive ability to explain scientfific issues to the general public.

Although the subject is a week old, this ad came to me in a forwarded email: I thought it very amusing.

Origin of BSE

A study published in PLoS Pathogens last year, BSE Case Associated with Prion Protein Gene Mutation, elucidates the origin of BSE in cattle. (PLoS stands for 'Public Library of Science' and their Journals are all 'open access' - this reverses the traditional fee structure by charging authors for publication but making the research available to everyone).

The origin of the original case(s) of BSE still remains an enigma. Hypotheses include (i) sheep- or goat-derived scrapie-infected tissues included in meat and bone meal fed to cattle, (ii) a previously undetected sporadic or genetic bovine TSE contaminating cattle feed or (iii) origination from a human TSE through animal feed contaminated with human remains.

The paper describes a novel mutation in a prion protein gene in a cow that is similar to the mutation in the human genome that causes the genetic form of CJD. This suggests that the BSE epidemic could have begun by a random genetic mutation. If that is the case then there are implications for the US beef industry. Concentrating on keeping out infected cows isn't a bad idea but should not be the only strategy since spontaneous cases of BSE will appear. The important point is to prevent the multiplication via cow cannibalism of those spontaneous cases that occur.

4 Types of CJD

Apparently there are four types of Creutzfeldt-Jakob disease: Sporadic CJD, Variant CJD, Genetic CJD, and Iatrogenic CJD.

Starting with the first, and most common type, Sporadic CJD was first discovered in 1921 in Germany by Dr. Creutzfeldt. Unfortunately, we do not know what causes the protein go rogue (it is not linked to Mad Cow or any environmental factors, as of yet). Common symptoms of Sporadic CJD are dimentia, loss of balance/coordination, and hindered speech.

Variant CJD is related to Mad Cow Disease. The first cases occured in 1994, but it wasn't identified until 1996. The cause of Variant CJD is most likely due to human consumption of infected cows. The first symptoms of vCJD are mainly psychological: depression and hallucinations. A few months into the illness, neurological symptoms start to arise: memory loss and loss of muscle control.

Genetic CJD is pretty self-explanatory; the disease is passed from parents to offspring. There is a genetic mutation in the PRNP gene, that causes the protein to be irregular. This form is extremely rare and the symptoms vary from individual to individual.

And lastly, Iatrogenic CJD is acquired through a medical procedure. For example, if a donor suffers from CJD, the recipients of his organs can acquire iCJD. Thus there normal proteins are converted to rogue proteins. The most common procedures resulting in iCJD are the injection of human growth hormone and human dura mater grafts. Other procedures which are less common include corneal transplants, neurosurgery, and organ transplants.

Mad Cow Disease...in Cows

Infected adult cattle may develop signs of the disease slowly. It may take from 2 to 8 years from the time an animal becomes infected until it first shows signs of disease. Symptoms in the animal include a change in attitude and behavior, gradual uncoordinated movements, trouble standing and walking, weight loss despite having an appetite, and decreased milk production. Eventually the animal dies. From the onset of symptoms, the animal deteriorates until it either dies or is destroyed (cattle who cannot stand are called “downers”). This disease process may take from 2 weeks to 6 months.

Scary Squirrel World

Until we know more about TSE's it would seem wise to hold off on all those wild animal brain based delicacies. It seems likely that many organisms may have such TSE's but if the species lifespan is only a few years it may be much shorter than the time it takes the prion protein to multiply up to the level that causes symptoms.

Following the observation of an unusual cluster of Creutzfeldt-Jakob cases in Kentucky, the suggestion was made that these may have arisen due to the consumption of squirrel brains - apparently a regional delicacy.

These observations, together with recent concerns about the transmission of a unique encephalopathy in man believed to be related to bovine spongiform encephalopathy led us to examine the possible association of eating squirrel brains with CJD in rural Kentucky, where eating squirrel and other small game is not uncommon. Culinary preparations include scrambling the brains with eggs or putting them in a meat and vegetable stew referred to as “burgoo”.

Normally I dislike the very dry style of scientific writing but this paper, Creutzfeldt-Jakob Disease and eating squirrel brains, contains the following gem:
'(C)aution might be exercised in the ingestion of this arboreal rodent.'

Following Mike Huckabee's revelation that he ate squirrel (cooked in a popcorn popper!) in college Slate investigated.

Silver Lining

Although most people find diseases scary the real horror is the carnage on the roads. Forgive me if I rant one last time. Over 40,000 dead in the US in an average year. Do you know the total WORLDWIDE death toll in commercial aircraft accidents? It was 692 in 2007 and 502 in 2008. Kind of puts in in perspective. An airplane accident that kills 100 people is major headline news for several days. But more than that number of people die on US roads EVERY DAY. Okay. I'll stop now.

But the point of this post is that when you have a large number (eg 40,000) even a smallish fraction of that number is still pretty big. Over the last year gasoline climbed over $4 a gallon, and then the economy tanked. One consequence of this is that people are driving less and the traffic death toll has fallen. Motor vehicle deaths in the United States totaled 41,059 last year, the lowest level in more than a decade. And the Federal Highway Administration said Americans drove 12.2 billion fewer miles in June than a year earlier, the biggest monthly decrease in a downward trend that began in November.If the trend continues highway deaths this year will drop below 37,000 for the first time since 1961

The number is being pulled down by a change in Americans' driving habits, which is fueled largely by record high gasoline prices, according to the Transportation Research Institute at the University of Michigan.

The institute's study — which covers 12 months ending in April — found that as gas prices rose, driving and fatalities declined. The surprise, said Professor Michael Sivak, author of the study, was the huge decline in fatalities in March and April as gasoline prices surged above $3.20 a gallon.

Experts who have studied motor vehicle fatality trends said one reason for the dramatic decline is that people are reducing their nonessential driving first, which is often leisure driving at night or on weekends. That also happens to be riskier than daylight commuting on congested highways at lower speeds.

Teenage and elderly drivers — who also have higher accident rates — are more likely to feel the pinch of higher gas prices, and thus may be cutting back more than other drivers. Federal data also shows that driving declines have been more dramatic on rural roads, which have higher accident rates than urban highways.

There is no mention of whether drivers with latent toxoplasmosis infections are driving more or less.....

The Carter Center

In 1986, former President Jimmy Carter established the Guinea Worm Eradication Campaign, which since then has reduced the number of guinea worm cases from about 3.5 million cases to less than 5,000, about 99.7 of the cases. Guinea worm could be the first disease to be eradicated without a vaccine or medicine, and the campaign’s efforts have been relatively cost-effective. The Carter Center has received grants from the Gates Foundation, as well as other donor organizations, summing up to a total of about 72 million U.S. dollars. However, the final cases of guinea worm are difficult to track, especially because guinea worm has a one year incubation period. Today, there are only six African nations, Sudan, Ghana, Mali, Ethiopia, Nigeria, and Niger, in which guinea worm cases have been found. If the last case is found and controlled, then guinea worm could become the second disease to be eradicated, after smallpox.

Details can be found here:

Smallpox 2002

I saved this for the weekend because it is a bit of a potential time sink. Smallpox 2002 is a FICTIONAL 'documentary' made in 2001 by the BBC. It was commissioned and largely completed before both the 9/11 attacks and the anthrax attacks that followed. The film has been shown 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 tagline for the movie was, "Drama, until it happens". Good one.

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

For those whose history is shaky, let me repeat, this is fiction. There wasn't a smallpox epidemic in 2002 that killed 60 million people! For reference though, the 1918 influenza pandemic killed somewhere between 20 and 100 million people worldwide.

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

Para(site)phernalia

I really liked an earlier post on the blog that talked about a website that sold cuddly stuffed microbes, so I decided to see if there was anything similar relating to the parasites we have recently been learning about in class.

And, what do you know, I came across a website called Zygote Games that sells parasite paraphernalia. There is a Leucochloridium mug (bottom right) and even a Toxoplasmosis mug (bottom left). I especially like the description of the Leucochloridium mug on the website: This snail is having a much worse day than you are in this image from Parasites Unleashed.

It's amazing what you can buy on the internet these days...

One step closer to a cure...

Researchers from the University of Michigan recently identified several new proteins secreted by Toxoplasma gondii, the protozoan parasite responsible for toxoplasmosis. Among these was TgPLP1, which is related to proteins in the human immune system, and is responsible for helping spread the infection by forming pores in the cell membrane to allow the parasite to escape and cause disease more rapidly throughout the host. This research breakthrough may one day aid in developing drugs or vaccines to treat or prevent toxoplasmosis or related diseases, including malaria. A potential cure may possibly include a component that interferes with the protein’s functions via a selective treatment that disables the TgPLP1 and therefore slows or stops the Toxoplasma gondii’s spread.

The full article may be found:

http://www2.med.umich.edu/prmc/media/newsroom/details.cfm?ID=1028

Zombie Snails

I didn't realize the snail would survive tentacle loss and regrow them. Another thing to think about when considering the selective pressures. It's a nice video but what is with the wavy vision? Is that bird drunk or is it having a flashback?

Here's another video of a fungal parasite I didn't mention. Curiously this manipulates ants in exactly the same way as the Lancet Fluke - making them climb grass stems and then clamp on with their jaws.

Death by Contamination

A University of California, Davis study of dead sea otters collected from 1998 to 2004 found that toxoplasmosis was the cause of death for 13% of the animals. Proximity to freshwater outflows into the ocean were a major risk factor. Ingestion of oocysts from cat faeces is considered to be the most likely ultimate source. According to an article in the New Scientist, the parasites have also been found in dolphins and whales. Researchers Black and Massie believe that anchovies, which travel from estuaries into the open ocean, may be helping to spread the disease. Michael Grigg of the US National Institute of Health mentioned that a new type of T. gondii, type X, has been found which is responsible for the large deaths of sea otters, and may be "poised to sweep the world".

Parasites Lost

In the third season of Futurama there is an episode called 'Parasites Lost' where Fry eats a very old egg sandwich from an interstellar truck stop and becomes infected with parasites. The parasitic worms make him smarter and stronger and cause Leela to become attracted to him. Oh and a bunch of funny stuff happens too but that isn't relevant here.

Here we have a very interesting scenario where a parasite is actually improving its host. If it improved the host's fitness we might have to reconsider whether we should call it a parasite. It is actually quite likely that many currently mutualistic (ie mutually beneficial) interactions between species began as parasitic interactions.

It is fun to speculate on how this might work in humans. Imagine a sexually transmitted disease that causes few or no symptoms but leads to an increased sexual activity in the host. There is no evidence for this in humans but there is some evidence for it in some sexually transmitted diseases of horses. Now imagine the parasite alters host hormones or pheremone levels to make them more attractive to the opposite sex. Hmmm

Medicine for Malaria Treats Toxoplasmosis

“A new drug that will soon enter clinical trials for treatment of malaria also appears to be 10 times more effective than the key medicine in the current treatment for toxoplasmosis.”

This drug is called JPC-2056, and the University of Chicago Medical Center found that this anti-malarial medicine is also extremely effective against Toxoplasma gondii, the causative agent of toxoplasmosis. This drug has the potential to be more effective and less toxic than the current treatment; in fact, it was able to reduce the number of parasites in mice in just a matter of days.

It works by “inhibit[ing] the action of an enzyme DHFR, produced by the family of parasites that includes those that cause toxoplasmosis and malaria.” The drug is strong against this enzyme in malaria and Toxoplasma, but its effect is much less on the human DHFR.

Tests even showed that JPC-2056 was effective against parasites with multiple mutations, suggesting that resistance will not be developed easily. Until more tests can be done, researchers and doctors see this medicine as having “considerable promise” for the future (or lack thereof) of toxoplasmosis.

A Personal Experience in Antibiotic Resistance

Today I went to Student Health with what I believed to be a sinus infection. The doctor on duty confirmed my hypothesis and proceeded to prescribe me amoxicillin, a derivative of penicillin. He said something along the lines of "it's usually a 7-10 day dosage but you are going to take it for 2 weeks." I didn't say anything at the time, but now that I think about it, why do I need to take the drug for and extra 3-7 days? There is no way the doctor could determine that an extended dosage was necessary in my case from just a basic examination. It seems to me that I would have been just fine if I took the normal ammount of amoxicillin for the normal period of time. Extending the term of medication, although probably easier for the kind people at student who have to deal with thousands of students (especially suring flu season), could lead to increased resistance of the bacteria currently infecting me to amoxicillin. If bacteria can survive the regular doseage period AND a few extra days of exposure to the antibiotics, the bacteria will surely be a very resistant strain. Hopefully there will be no long term consequences for me...

Life Straws

My little sister is in the Ecology Club at her middle school and she recently told me about these water purifiers called"LifeStraws"that they are trying to get people to donate to third world countries. The LifeStraw Personals are basically water purifying straws that people can use when they drink to prevent diseases transmitted through contaminated water . Besides the personal straws, people can also donate a LifeStraw Family, which is an "instant microbiological water purifier ".

More information about LifeStraw can be found at: www.vestergaard-frandsen.com/lifestraw.htm
(The website also has other products aimed at fighting disease)

If anyone is interested in donating, let me know!

Who we really are

I think most of us are very uncomfortable with the fact that a parasite in our brain might be altering our personality. Even though this personality change may actually be for the better most of us would like to feel that we are who we are, and are not being influenced by a parasite. For the news report on Toxoplasmosis associated personality changes with the best headline see:
Parasite makes men dumb, women sexy

However I'm not sure how to reconcile this observation with the fact that the most commonly prescribed drugs in the US are antidepressants - well over 100 million prescriptions per year! So on another level people commonly seem to feel they are not 'normal' - despite the fact that there is fairly good evidence that feeling a bit down is perfectly normal and very different to clinical depression. Or maybe we are just vulnerable to the powerful advertising of the drug industry...

It's All in the Wall

Here’s a new way to enhance the cleanliness of hospitals . . . antibacterial plaster! In China, scientists are developing and testing a plaster, which can be mixed into paint, wall coatings, art, etc., that is completely self-sanitizing. This would help sterilize hospitals and reduce the amount of deadly microorganisms that thrive in hospital settings. It is even said to have “more powerful antibacterial effects than penicillin.” This plaster, coined supramolecular plaster, can apparently protect against 5 disease causing bacteria. It can even help control the growth of Staphylococcus aureus and E. Coli better than penicillin. By limiting these deadly bacteria so often found in hospitals, we may be able to reduce and prevent nosocomial infections.

More on Elizabeth R. Griffin

Elizabeth R. Griffin was the 22 year old researcher mentioned in class on Friday that was killed by a drop of virus to the eye. At the Yerkes Regional Primate Research Center, Griffin was moving a monkey infected with herpes B when the primate shot a drop of fluid into Griffin’s eye. The presumed likelihood of risk was very low, and Griffin was wearing gloves, a mask, and the proper lab clothes. It seemed to be a very insignificant event, but two weeks later, the drop of fluid began to cause headaches and an eye infection. With antiviral medication, Griffin was able to go home only to return to the Emory University Hospital ten days later after her legs became weak. Due to the low number of herpes B cases, it was difficult to find a treatment for Griffin’s lethal disease that causes encephalomyelitis, the inflammation of the brain and the spinal cord. Griffin died six weeks after the accident to bacterial infections and respiratory distress. There have only been 40 cases reported since 1933 involving primate-to-human transmission of herpes B. Herpes B is lethal 70 percent of the time.

Details can be found here:

Preventing a Superbug

MRSA will probably give me nightmares tonight, considering I just spent an hour watching videos about it!! Without trying to scare you all, I think this video was quite interesting. I thought MRSA was mostly passed through unhygenic hospital care but apparently it can be found in many places. Sports locker rooms are at high risk and therefore should be cleaned regularly. There is now also a treatment spray that can be applied to the facility. Not only can MRSA be found on inanimate surface objects it can also be found within man's best friend. So everyone call your parents after you watch this video and tell them to get the dog washed before you come home. Enjoy the video, its short and sweet (if you can call it that)!

http://www.nypost.com/video/?vxSiteId=0db7b365-a288-4708-857b-8bdb545cbd0f&vxChannel=General&vxClipId=913022&vxBitrate=300

First Do No Harm

This is part of a four part television series that originally appeared on PBS. "First Do No Harm" is an organization focused on preventing and eliminating hospital spread infections. The beginning shows a few families devastated by these infections. The public is growing very confused and ultimately fearful of hospitals. Many citizens are opting out of hospital care in order to prevent these infections. This is all with very good reason, considering about 2 million people a year become infected with germs passed to them by healthcare workers. In the end, close to 100,000 people die. The leading cause of death is MRSA, methicillin-resistant Staphylococcus aureus. This superbug has become in Epidemic in America and all over the world. This video tries to show citizens as well as healthcare providers that we have the ability to reduce this infection if all healthcare facilitators would participate. Many hospitals do not want to share their statistics of this superbug because they do not want to fall in the ranks of being ranked a better hospital. This epidemic is bigger than the pride of medical workers. It needs to be dealt with now.


http://www.youtube.com/watch?v=5682bhsV1UM

Fleming would be proud

Biophysicist Herbert Levine's Petri dishes look like an exhibit at a modern art museum. His beautiful images are actually made from bacteria similar to the ones that cause deadly diseases.

 You can watch a video and read the story here.

Monitoring HIV

In this video Doctor Charles Farthing discusses the importance of monitoring HIV. The interviewer asks him a series of questions about the virus and he responds with answers that are easy to understand. He suggests that people with HIV have lab tests every 3 months because even if the person is doing well, the virus can change and become more aggressive. This virus is very easily mutated because of the fact that it is a retrovirus and therefore lacks a error-checking system. It is a fairly long video but you can go to the side and choose the section you are most interested in. He touches on CBC, or complete blood count tests as well as chem-screen tests. Watch this video if you are interested in the different ways to monitor HIV, as well as the importance of these tests.

http://www.videojug.com/interview/monitoring-hiv

Attenuated? Ooo, that sounds dangerous....

Spraying scenes from the Aum Shinrikyo headquarters building (photographs taken July 1, 1993, by the Department of Environment, Koto-ward).

Terrorists and microbiology don't seem to mix well. Terrorists seem better suited to explosives and have managed to successfully carry out numerous devastating bombings. But the meticulous and laborious work involved in microbiology seems challenging for the average terrorist who would probably rather be blowing something, someone, or themselves, up.

From the pages of 'epic fail' I bring you the surprisingly little known story of Aum Shinrikyo and anthrax. I am not making this up, everything that follows is fairly well documented (eg. this CDC report), it just isn't very well reported.

Aum Shinrikyo, who have apparently changed their name to Aleph, are a Japanese religious movement, or cult depending on where you draw the line. They are most notorious for their Sarin attack on the Japanese subway in 1995 that killed 12 commuters, seriously injured 54 and affected about a thousand more.

Two years before this, in July 1993, Aum Shinrikyo members dispersed a liquid suspension of Bacillus anthracis (anthrax) from the roof of an eight-story building in Tokyo. Although residents complained of foul odors the spraying went on for at least four days until demands from local residents forced Aum Shinrikyo to stop. There were no known human cases and, at the time, no-one realized an attack had even taken place. The incident was largely forgotten until the 1995 subway sarin gas attacks. Confessions of Aum Shinrikyo members revealed the plot and samples collected in 1993 were eventually analyzed in 1999 and found to be anthrax. The obvious question is why the anthrax attack plot had failed. The consensus seems to be that the would be bioterrorists did just about everything wrong.

• Spraying during the day was a bad move, sunlight inactivates the spores and heat radiating from concrete and asphalt makes the spores rise rather than fall.
• The spore concentration that was sprayed was about 10⁴/mL - many orders of magnitude less than the 10⁹ to 10¹⁰ organisms/mL considered to be optimal.
• The spraying device was very inefficient and apparently the nozzles clogged repeatedly and the device itself broke down several times.
  
• But I saved the best for last. The strain of anthrax used was an attenuated (weakened) strain used to vaccinate animals in Japan. This strain is generally regarded as nonpathogenic for immunocompetent people.

Bioterrorism - it's not as easy as they make it look in the movies.

"Old" Blood - Higher Infection Rate

A study presented at CHEST 2008 (a gathering of the American College of Chest Physicians - read about it by clicking the link) stated that patients who receive transfusions with blood stored for 29 days or more were twice as likely to suffer from nosocomial infections. Federal regulations currently allow blood to be stored up to 42 days - almost two weeks after the 29-day mark.

Cooper University Hospital researchers studied the relationship between the age of the red blood cells and the development of nosocomial infections, testing 422 patients receiving blood transfusions. They found:

• A higher portion of blood is "old": “Previous data indicate that the average age of transfused blood is around 17 days old...[but in] our study, the average age of blood was 26 days, and 70% of all the blood transfused was older than 21 days."
• Not only did over 10% of patients die, but some had multiple nosocomial infections: "The analysis showed that 11 percent of patients died, while 57 patients (13.5 percent) developed NOSO: 32 patients developed one, 21 developed two, and 4 developed three."
• Those who did develop nosocomial infections had older blood: "Patients who developed NOSO had a significantly higher age of the “oldest” unit of blood (28.5 days vs. 32 days)."
• And the final conclusion: "Patients who received transfusions with blood that was 29 days or older were twice as likely to develop NOSO as those receiving transfusions with blood stored for 28 days or less."

Some fear that strict regulations regarding blood donation and storage will result in a dangerous shortage. More research is what is necessary for an answer to this problem.

Good news and bad news

South Africa has an estimated 5.7 million people infected with HIV — the most of any country in the world

South Africa's health minister on Tuesday promised a dramatic increase in treatment for AIDS victims to overcome the legacy of a decade of governmental denial of the epidemic.

People in a number of African countries have suffered badly from the health policies of their governments. Hogan's predecessor promoted the use of garlic and lemons rather than conventional AIDS drugs so this change in policy is very good news for the people of South Africa.

In Zimbabwe the situation continues to deteriorate.

Doctors are leaving Zimbabwe, causing clinics to close, as the health system collapses and Africa’s second-worst cholera epidemic spreads in the countryside, aid groups said. The exodus of medical professionals is compounding a “near total devastation” of Zimbabwe’s health-care system.

Biosafety Issues

The first report of a laboratory-associated infection was published in 1941 and described a case of poliomyelitis most likely acquired through washing and grinding infected tissues in preparation for inoculation into monkeys. Two years later, two laboratory workers were accidentally infected with the prototype Lansing (Armstrong) strain while attempting to infect mice. Two additional reported cases of poliomyelitis in laboratory workers were fatal: one in the United States and the
second in South Africa.
Despite the advances in biosafety over the past 40 years, recent evidence indicates that the potential nevertheless exists for transmission of poliovirus from the laboratory to the community. In 1992, a wild-type 1 strain used for IPV production was documented as being transmitted from a worker in a vaccine production facility to his 18-month-old son, who had received the full IPV series. The boy had been suffering from gastroenteritis when, by chance, the wild IPV seed virus was isolated from his stool. In another incident, a child was reported to be infected with a prototype strain of type 3 commonly used in laboratories for research or vaccine production. The source of this infection was not determined.
you can read more about this by clicking the link: http://www.cdc.gov/od/ohs/who/www9829.pdf

Canadian Quarantine

As SARS cases increased in Toronto, Canada, the government had to find a way to contain it. Quarantine was the answer. On March 25, 2003, approximately 30,000 people in Toronto were detained and quarantined. Prior to this governmental mandate, many hospitals were placed under “Code Orange.” Hospitals were required to limit visitors, suspend some services that were considered non-essential, and create isolation units specifically for SARS (or potential SARS) patients. Unfortunately, many doctors and other health professionals caught the disease. During the second outbreak in 2003, four SARS hospitals were created and all other hospitals were put under “Code Orange.” Much of the quarantine took place in individuals’ homes and work. Those who had come into contact with a SARS victim were required to remain in their home for 10 days in isolation. Surprisingly, screening for SARS at Canadian airports basically consisted of information cards passed out to all passengers. Further assessment were performed as needed. While 6.5 million people were screened, none were suspected to have SARS.

Check this link to see how various countries dealt with SARS.

It all balances out in the long run....

Although I talked about this very issue on Friday I somehow missed the news this week that research at the US Army Medical Research Institute of Infectious Diseases (USAMRIID) at Fort Detrick in Maryland has been suspended following the discovery of four undocumented vials of Venezuelan equine encephalitis. This is a zoonotic viral disease of horses, donkeys etc that can also affect humans. When the U.S. biological warfare program ended in 1969 Venezuelan equine encephalitis virus was one of seven biological weapons it had developed. I have not seen any reports on whether the additional samples are the 'regular' strain or the weaponized strain.

The shutdown, that could last three months, is intended to allow a complete inventory of hazardous bacteria, viruses and toxins stored in refrigerators, freezers and cabinets. The Commander, Col. John P. Skvorak, said there was a high probability that some germs and toxins in storage were not in the database. Whilst this doesn't appear as serious as losing vials, the issue of lax record keeping is worrying. The danger with undocumented samples is that anyone with access could walk out with them and no-one would know they were gone.

Army officials insist there are no missing vials of lethal substances and no danger to the public - but if you don't know what you have how do you know what is missing? What the army should say is that there are no missing samples from their inventory and that their inventory includes x% of all samples - determined after an exhaustive search. New procedures should then be put in place to ensure that all samples are, in future, included in an inventory.

Level 4 Virtual Tour

So today in class Prof. Latto was talking about the different Biosafety levels of labs and how each lab differs. I was curious what it would be like to go into a level 4 lab, but because they have restricted access and so many safety precautions I didn't think I would ever see the inside of one...until I found this virtual tour of one online. It has pictures and details about each aspect of level 4 labs and the steps that workers have to take before they can even enter one. I thought it was interesting that the entire building has to be airtight. It makes sense when you think about it, but I didn't realize the extent to which they take precautions against leaks. The windows cannot be opened, no air flows under doors, the air ducts are welded stainless steel, and the air coming out of the building goes through two filters that remove particles smaller than 0.3 microns. In case you were wondering how small that is, check out the picture on the right. The dust particle is one micron. (That's small!)

It's better to be safe than sorry!

Jon Stewart on missing bubonic plague

I forgot to remind you that Monday is a University Holiday (Presidents' Day). There will be no EEMB40 class on Monday. Enjoy the long weekend.
I think this is worth a repost.

The Daily Show With Jon StewartM - Th 11p / 10c

Bubonic Plague

Daily Show Full Episodes
Important Things With Demetri Martin

Funny Political News
Joke of the Day

Prevent Spreading of Staph or MRSA infections

You can prevent spreading staph or MRSA skin infections to others by following these steps:

1.Cover your wound. Keep wounds that are draining or have pus covered with clean, dry bandages. Follow your healthcare provider’s instructions on proper care of the wound. Pus from infected wounds can contain staph and MRSA, so keeping the infection covered will help prevent the spread to others. Bandages or tape can be discarded with the regular trash.
2.Clean your hands. You, your family, and others in close contact should wash their hands frequently with soap and warm water or use an alcohol-based hand sanitizer, especially after changing the bandage or touching the infected wound.
3.Do not share personal items. Avoid sharing personal items such as towels, washcloths, razors, clothing, or uniforms that may have had contact with the infected wound or bandage. Wash sheets, towels, and clothes that become soiled with water and laundry detergent. Drying clothes in a hot dryer, rather than air-drying, also helps kill bacteria in clothes.
4.Talk to your doctor. Tell any healthcare providers who treat you that you have or had a staph or MRSA skin infection.

Breaking News

Just hitting the news today

Michael Jackson has a severe antibiotic resistant staph infection that he contracted during work to reconstruct his nose. The infection has spread and is inflaming his hands and face, or possibly his entire body, depending which news report you believe

He is currently receiving antibiotics via an IV drip at a Beverly Hills clinic, to treat the severe "staph" infection, similar to MRSA (which may actually be MRSA).

Nosocomial infection in Canada

Clumps of methicillin-resistant Staphylococcus aureus bacteria, magnified nearly 10,000 times.

A similar story in Canada.

Every year, 250,000 Canadians pick up infections while they are in hospitals being treated for something else. That's a staggering one out of every nine Canadians who are admitted to hospital. Every year, those infections kill more than 8,000 people.

That's more than will die of breast cancer, AIDS and car accidents combined. Many of those deaths can be prevented - by simple hand washing.

I'm not sure exactly why this was in the news today but I thought this article on 'The War against Superbugs' from CBCNews was quite nice.

Previous posts of relevance:

• Meet the Clostridiums
• Patients flee, drawing attention to quarantine dilemma
• MRSA infection

The Fight Against Nosocomial Infection

Scientists at The University of Nottingham are leading a major 3 million euro, 3 year study to unravel the genetic code of one of the most lethal strains of hospital acquired infections, Clostridium difficile.

They hope to use gene knock-out technology study the function of genes in this bacteria and hopefully get some answers, like why C.difficile is harder to eradicate and more resistant to antibiotics.

One scientist stated that “worryingly,” there are only two antibiotics still effective against these hypervirulent organisms. The fact that there is a “very real danger that total resistance may arise” is extremely serious.

The scientists hope the studies will point out genome differences between this strain and its less virulent cousins; this way, they can understand its spread and the way it causes disease. If you are interested in reading more about how the study will work, click here.

Baseball Player Sued Iver HIV

Former baseball player Roberto Alomar is being sued by his ex-girlfriend for infecting her with HIV. Not really scientifically relevant but just something that popped up on CNN.

http://www.cnn.com/2009/CRIME/02/11/alomar.aids.lawsuit/index.html

AIDS in Africa most prevalant in married couples

Although this was last weeks topic, I found this discovery very interesting. The article from Scientific American about the evolution of virulence implied that HIV/AIDS spread so much in certain parts of Africa because of sexual promiscuity. This article, however, contradicts that belief; it is now believed that the highest prevalence of AIDS in Kenya and Uganda is in married couples. For a long time, it has been advertised that marriage was a way to help stop the spread of HIV/AIDS, so resources were devoted to educating young, single individuals, who were thought to be most at risk for transmitting and acquiring AIDS and little was done to provide married couples with education or contraception. More information can be found in the following article: http://www.theeastafrican.co.ke/news/-/2558/527926/-/rkspnwz/-/

Fomite Tranmsission

Influenza viruses are mainly spread from person to person through droplets produced while coughing or sneezing. They can also be transmitted by indirect contact by touching a contaminated object or surface and then touching your own mouth, eyes or nose before washing your hands. This is also called fomite transmission.

Different viruses can survive on surfaces for different lengths of time but generally for longer on hard, impermeable surfaces than on porous surfaces. Influenza and cold viruses can still be infective for two hours and maybe up to eight hours. It is easier to catch the common cold than influenza by fomite transmission because some of the cold viruses have much smaller infectious doses than the influenza virus.

Some diseases may be mainly spread via fomite transmission. Examples being cold sores, conjunctivitis, meningitis, strep infections and possibly the common cold itself.

Hospital Acquired Infections

If you go into an intensive care unit in a major Sydney hospital it is almost inevitable that you will get MRSA if you stay long enough."
Richard West, chair of the Royal Australasian College of Surgeons infection control advisory committee.

I doubt that many of you read a Sunday paper any more. I can't say I blame you, most of them are pretty dire. Amongst the worst parts is the awful 'Parade' magazine that is a supplement carried by a large number of papers throughout the country. However it is so bad that it is usually worth reading and it always contains at least one splendidly awful advertisement - many of them from the Franklin mint where parody is indistinguishable from their usual tastelessness. But anyhow I digress, this week's parade (I only read it for the ads) contains a feature article 'Avoiding Hospital Mistakes' with a section on Hospital Acquired Infections:

Hospital-Acquired Infections
The Risk: The Centers for Disease Control and Prevention report that 99,000 patients a year die from hospital-borne infections. Germs are everywhere: on surfaces, doorknobs—even your doctor’s necktie.

What You Can Do:

• Ask anyone who examines you to wash his hands.
• Ask your doctor or nurse to clean her stethoscope before it comes in contact with your skin.
• If you need a urinary catheter, make sure it is kept in for the shortest possible time.
• If you need a “central line” (an IV tube going into a major blood vessel), ask if they have tubes that are coated with antibiotics.
• If you have an IV, make sure it doesn’t stay in place for more than a week. Let the nurses know if it becomes loose.
• Every time a line or regular IV needs to be inserted, ask whether the hospital staff follows sterile procedures before inserting the tube or needle.

Whilst this might all be sound advice my memory of hospitals is that acting like a demanding jerk might incur some risks of its own.

NY Times: Darwinism Must Die So That Evolution May Live

We talked a good bit about evolution last week in section when we discussed the Evolution of Virulence paper. As you've probably heard, Darwin's 200th birthday is this Thursday, and there are all kinds of "Darwin week" events going on right now.

Because of the tremendous influence the idea of evolution via natural selection has had on modern science, we tend to give Darwin a hero's status, both culturally and scientifically. The New York Times had a nice article yesterday that puts Darwin's scientific contributions into perspective, and explains how referring to evolution via natural selection as "Darwinism" may facilitate comparison with "Creationism" and other notions of evolution as a belief system, rather than a well-studied scientific theory. The article is also interesting because it points out some of the previous discoveries and ideas that made Darwin's discovery possible, and even references Louis Pasteur and John Snow.

Finally, if you haven't heard the story of Alfred Russel Wallace, it is a very interesting one as well. He was a naturalist and collector that lived during Darwin's time and hit on the idea of evolution via natural selection right around the time Darwin did. It was Wallace's letter to Darwin that led the theory to be published for the first time (Darwin fearing that he had been scooped, after keeping his idea to himself for twenty years). You can read a cool National Geographic article about Wallace here.

1 in 4 Americans

If any of you are involved with clubs, groups or organizations of any form, from sports clubs, to social groups to the Greek system then here are two events you may want to help promote and publicize.

April each year is STD awareness month to raise public awareness about the impact of sexually transmitted diseases (STDs) on the lives of Americans. The Centers for Disease Control and Prevention (CDC) estimates that there are approximately 19 million new cases of STDs each year, almost half of them among young people ages 15 to 24.

June 27 each year is National HIV testing day. The CDC estimates that 180,000 to 280,000 people nationwide are HIV-positive but are unaware of their status. HIV counseling and testing enables people with HIV to take steps to protect their own health and that of their partners, and helps people who test negative get the information they need to stay uninfected.

Routes of transmission

As we have seen some diseases, like AIDS, may have several routes of transmission. Although I didn't mention it several other diseases may also have sexual transmission as a possible, although not very likely, route of transmission.

Although those suffering from Ebola and related viruses are unlikely to be having sex whilst they are contagious some people do recover from Ebola - 10%-50% depending on the strain. Even though they have recovered from the disease they can still have virus in their semen up to seven weeks after they recovered. Recovered Ebola patients are advised to 'not have sex for 3 months or until tests show that semen is free of the virus.'

A conference presentation from 2001 documents the recovery of Lyme spirochetes by PCR in semen samples of previously diagnosed Lyme disease patients. This, of course, does not necessarily mean active infection is transmitted this way. Some documents state that there are no documented cases of sexually transmitted Lyme disease (eg the CDC here and here) whilst others strike a more cautious note:

The CDC position on sexual intra-human Borrelia burgdorferi (Bb) transmission is that it does not occur. We find no study that addresses sexual transmission of Bb among humans; conversely, we find no study supporting that it does not occur. Inferential data, however, suggest the possibility of human sexual transfer. The data come from sound veterinary studies, the finding of Bb in human semen and breast milk, and by similarity to Treponema pallidum where sexual transfer is abundantly documented. Our clinical experience strongly suggests that predictable, possibly inevitable Bb transfer between sexually active couples occurs.

From: Lyme disease': ancient engine of an unrecognized borreliosis pandemic?
W. T. Harvey, P. Salvato

[This post contains 90% recycled material]

HIV is Real

A young, African-American woman wrote a book entitled "The Naked Truth: Young, Black, and (HIV) Positive." She hopes to raise awareness and acceptance by telling her story as an "unlikely" candidate for the virus.


http://www.cnn.com/2009/LIVING/02/09/Marvelyn.Brown/index.html

The Philippines: Cholera, Ebola

A health official confirmed today that an outbreak of cholera is the cause of the death of at least 240 hogs in the southern Philippine province North Cotabato. The cholera broke out months after health officials found a strain of Ebola virus among hogs at some northern farms in the country. It was the first time in the world that the Ebola virus was found in swine. Last month, the Philippine health authorities also reported that three pig farm workers and a slaughterhouse worker have been found infected with the Ebola-Reston virus.

Outbreak

The 1995 movie 'Outbreak' involves a fictional ebola-like virus known as Motaba which becomes airborne.

Although criticized by some for certain scientific inaccuracies the movie does depict the work of scientists better than most and raises some very important questions about how far a government could, or should go in quarantining an infected area, and how far people might go to escape that quarantine.

Marburg In The US

While looking for my weekly dose of terror this week, I stumbled upon an article about the first confirmed case of the deadly Marburg virus in the US.
Marburg is a hemorrhagic fever that is not unlike Ebola. It is indigenous to Africa, but last I checked no one was certain of where exactly the disease came from. It had been traced back to caves in Africa, which led some to suspect that bats living in these caves are the natural carriers of Marburg.
Apparently this guy went spelunking in a cave in Uganda, looking for pythons, and instead found himself a case of Marburg. The incubation period is about 5-10 days, so he made it all the way back to Denver before he showed symptoms. Tests confirmed that he did indeed have Marburg, and luckily he managed to survive (which is quite a feat considering this disease has a mortality rate over 80%). The CDC was a bit concerned about the health of hospital workers who helped the man, but so far none of them have exhibited symptoms of Marburg. Read the article here.

On a lighter note, I wanted to recommend a few of my very favorite books on the subject or terrifying hemorrhagic fevers. Anyone interested in this macabre subject should definitely check out the author Richard Preston. He writes non-fiction science books that read like exciting action novels. It is hard to come by non-fiction science that reads this well. The Hot Zone is related to Ebola and Marburg, and is full of fascinating stories about the these diseases, and their unfriendly relationships with unlucky humans (and monekys). I love this book! Also look for The Demon in the Freezer and Panic in Level 4, both are also non-fiction books about infectious disease and science. Panic in Level 4 has a few vignettes that touch a lot on disease ecology, so look for it!

Millions for STD prevention in stimulus package

I don't think anyone can be unaware that the House and Senate have been debating an economic stimulus package over the last few weeks. What you may not realize is that both the House and Senate versions contained substantial sums for the prevention of sexually transmitted diseases - $335 million in the House bill and $400 million in STD spending in the Senate bill.

Naturally this funding has faced criticism from Republicans who say the funding makes no sense in bill designed to get the economy back on track.

Republicans say the bill ... has become a vehicle for congressional Democrats to get approval for projects they've been unable to secure in recent years with congressional Republicans and President Bush able to foil their efforts.

Others argue that the money is desperately needed to replace jobs lost in State and local health departments due to the economic crisis.

So it is worth reminding critics of the following: Disease prevention is a job. Reinvestment in the prevention of HIV, STDs, viral hepatitis and TB — after six years of steady decreases in funding that have left our public health systems as "potholed" as any highway — will (re)create thousands of jobs, modernize and strengthen our public health infrastructure, and improve access to health care in ways that will reduce absenteeism and raise productivity at other jobs in our community.

Ryan White and Factor VIII

After Professor Latto talked about the different transmission probabilities of AIDS in class, I remembered the story of Ryan White. He was a young man who was diagnosed with AIDS in 1984, and he helped bring the disease into the public eye as something that could happen to anyone.
White contracted AIDS through a contaminated transfusion of Factor VIII, a blood-clotting agent, which he needed to manage his hemophilia. Since Factor VIII is derived from the blood plasma of hundreds of donated units of blood, the risk of contaminated blood being transfused is much more likely. More about this can be read in TCP pages 311-314.
Although I couldn’t find exact figures for the likelihood of transmission from Factor VIII, the WHO does say that approximately 5-10% of all HIV infections come from contaminated blood and blood products.

Economic downturn threatens global fund

The Global Fund to Fight AIDS, Tuberculosis and Malaria, the main funding body for tackling these diseases, supplies one-quarter of all AIDS funding, two-thirds of tuberculosis funding and three-fourths of malaria funding.

In 2009 it will be $5 billion short of its funding goals as pledges to the fund from donor nations fall short. Some development economists have contrasted this with the $18 billion worth of bonuses taken in 2008 by officials at US banks now receiving public funds to bail them out of the banking crisis.

Active pursuit of HIV infection

From wikipedia I was able to find this unbelievable article. Just thought it was interesting enough to share
Main article: Bugchasing and giftgiving
A subculture of homosexual men desire and actively pursue HIV infection by seeking partners who are HIV-positive and voluntarily having unprotected intercourse with them. In slang terms, those who seek infection are called bugchasers and those who infect them are called giftgivers. This phenomenon should be distinguished from barebacking, which is the preference for unprotected intercourse without the active desire for HIV infection.
The exact extent of practice remains largely unknown. Not all those who self-identify as part of this subculture are actually intent on spreading HIV. Some bugchasers try to connect with giftgivers via the Internet. Other bugchasers organize and participate in "bug parties" or "conversion parties," sex parties where HIV positive and negative men engage in unprotected sex, in hopes of acquiring HIV ("getting the gift").

Infected: a novel

Yesterday I was in Borders looking at their buy one get one 1/2 off table and found this book: Infected: a novel. It looked kind of interesting so I read the back:

A mysterious disease is turning thousands of ordinary Americans into raving, paranoid, murderers who inflict brutal horros on strangers, their own families, and even themselves. And one morning, ex-football star Perry Dawsey awakens to find mysterious welts growing all over his body. Soon Perry finds himself acting and thinking strangely, hearing voices, fighting uncontrollable rage...he is infected. Worse, the disease wants something from him, something that could alter the fate of the human race.

Sounds like a kind of zombie book to me. So I read a couple chapters and ended up buying it. So far the writing isn't that great, but the premise of the book is really interesting. I'm wondering if it will bring up SIR models, how many individuals need to be vaccinated (if there is a vaccine) to protect the community, and issues about quarantines.

HIV/AIDS Awareness Days

Tomorrow, February 7, 2009 is the ninth annual National Black HIV/AIDS Awareness Day.

NBHAAD's mission is to "build the capacity and increase awareness, participation and support for HIV prevention, care, and treatment among Black Americans." There are many activities that take place in various cities around the country, with HIV testing available at almost every location.

More upcoming awareness days are:

National Women and Girls HIV/AIDS Awareness Day: March 10, 2009
National Native (American Indian, Alaska Native, and Native Hawaiian) HIV/AIDS Awareness Day: March 20, 2009

Demand

MTV recently celebrated the tenth anniversary of its AIDS awareness campaign Staying Alive. I don't think this ad was on TV in the US (correct me if you know different) but may have been used in Portugal. The text at the end is in English though and the car license plate looks British so maybe it was used elsewhere?

If you prefer something funnier check out the Staying Alive FurTV videos What is unsafe sex? , Why do I need a condom?, and Do condoms reduce sensitivity?

Previous posts of interest:

• Endogenous retroviruses
• The Lost Children of Rockdale County
• More Sources of HIV infection
• The World as You've Never Seen It