DDT - or not...

'The U.S. and WHO encourage African countries to use DDT to fight the spread of malaria, but some Ugandans are protesting. The pesticide DDT, long banned in the United States, has made something of a comeback in Africa. DDT can be an effective weapon against malaria. The U.S. government, and the World Health Organization are encouraging African countries to use the insecticide, and say it is safe when handled properly. But in the East African nation of Uganda, DDT has provoked a fierce political battle. And the experience has taught a hard lesson: effective malaria control involves more than just fighting mosquitos.'

Read the rest of the story here on Public Radio International. It's interesting and maybe not what you expect.

Alex Fokkens is a Dutch organic cotton buyer. He's worried the spraying would mean he'd no longer be able to sell the cotton to his European customers, "If they find out there are any traces of DDT, it would be sent back, and it would be a very big claim on us."

So proponents of organic agriculture mounted a vocal campaign to thwart the government's DDT plan.

Summer re-runs - part 6

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

Some nosocomial infection and antibiotic resistance favorites:

• Almost inevitable
• Patients flee, drawing attention to quarantine dilemma
• Meet the Clostridiums
• XDR-Tb in California

Behind Ebola/Marburg

Chris forwarded this interesting trailer/promo for an as yet unmade documentary about Ebola and Marburg virus.

Summer re-runs - part 5

From the abundance of HIV posts here are a few favorites. I still don't know quite what I think about the ad above. Alarmist? Yes. Too alarmist? Maybe. Effective? Possibly.

• AIDS awareness
• Perverse is not using condoms
• 1 in 4 Americans
• The end of AIDS?
• AIDS in South Africa

Viral Chatter

Virus hunter Nathan Wolfe is outwitting the next pandemic by staying two steps ahead: discovering deadly new viruses where they first emerge -- passing from animals to humans among poor subsistence hunters in Africa -- before they claim millions of lives.

Check out Nathan Wolfe's talk at the TED conference earlier this year. TED (Technology, Entertainment, Design) invite some of the world's most fascinating thinkers and doers, and challenge them to give the talk of their lives (in 18 minutes). The best talks and performances are available on their website. You should all check out this talk, it is very interesting, very well presented and hugely relevant to this class.

Midterm

Raw scores from the midterm. Two people scored the full 300. Most people were in the B to A range or close to it. Enjoy the weekend.

Moldy Food: When to Use, When to Discard

Tired of having your food stolen by sticky-fingered coworkers or roommates? Bullies taking your kid's lunch? Well, worry no more . . . Anti-Theft Lunch Bags are sandwich bags that have green splotches printed on both sides, making your freshly prepared lunch look spoiled. Don't suffer the injustice of having your sandwich stolen again! Protect your lunch with Anti-Theft Lunch Bags.

Okay this is barely relevant but since it is a potential health issue (albeit not an infectious disease issue) I thought I'd mention that I just discovered that the USDA has a helpful chart on 'Moldy Food: When to Use, When to Discard'. Hmm, I rather wish I'd known this some decades ago....

When Zombies attack

A strange increase in Zombie related news lately. First, a number of news outlets have picked up on the publication of a paper entitled 'When zombies attack!: Mathematical Modelling of an Outbreak of Zombie Infection.' For example there's a BBC article entitled 'Science ponders 'zombie attack' and a CBC Canada artcile entitled 'Zombie attack would be the death of us'. Venturing into the blogosphere reveals some criticisms of the model eg here and here. The model, by the way, should look familiar to you since it's a pretty basic SIR model.

I like the fact one of the authors is named Professor Robert Smith? - the question mark is part of his surname and not a typographical mistake.

Also making headlines, in the LA Times at least is the success of 'Pride and Prejudice and Zombies', a surprise bestseller with '85% Austen's original text and 15% brand-new blood and guts'. I bumped into this in Goleta library the other day. I must admit the premise is amusing and the cover is excellent but I found the joke wearing a bit thin after a few pages. Maybe I'll wait for the sequel: Sense and Sensibility and Sea Monsters (no, really, that is the title of the next book).

Even Austen purists admit a grudging admiration for the "Zombies" concept.
"In publishing terms, it's brilliant," said Claire Harman, a Columbia University professor and author of "Jane's Fame: How Jane Austen Conquered the World."
"Why did I spend three years writing a critical book on Austen? Why didn't I just think of that?"

Mice Invasion

There's a longer version with an annoying voice-over ('Armies of frenzied wild rodents ran amok') but I think the silent version is enough.

Lyme disease cases rising

"The number of ticks is so much more than we've seen in the past," Arias said. "It could be the humidity; it could be the moisture; it could be some biological factor out there."

A number of states are reporting another increase in the number of new cases of Lyme disease. For example the increase in Virginia was reported in the Washington post last month, and cases are also on the increase in Minnesota and Maryland.

The picture shows a device that attracts deer to corn and then uses paint rollers to apply a pesticide that kills ticks. When they lean down to get the corn, the rollers on either side touch their heads and necks, applying the pesticide. Although invented and perfected by U.S. Department of Agriculture scientists to protect cattle from lone star ticks in the Southwest it has been adapted to help reduce the number of black-legged ticks on deer in Maryland.

Summer re-runs part 4

Some Lyme disease favorites:

• Bad tick, no nail varnish for you
• Under Our Skin
• Amy Tan
• Sexually transmitted Lyme Disease ?
• Now THAT'S what I call an ecosystem service.

Tb trivia

I was listening to the radio today and hadn't realized that Cat Stevens had suffered from tuberculosis in 1968. Near death he spent months recuperating in hospital and a year recovering. During this time Stevens began to question aspects of his life, and spirituality which, eventually, led to his conversion to Islam.
"(t)o go from the show business environment and find you are in hospital, getting injections day in and day out, and people around you are dying, it certainly changes your perspective. I got down to thinking about myself. It seemed almost as if I had my eyes shut."

Plague Years

The Black Death, one of the deadliest pandemics in human history, occurred between about 1348 and 1351.

In the centuries following the Black Death there were several further devastating outbreaks of hemorrhagic plague, particularly in European Cities. I briefly mentioned one of these, the Great Plague of London, that occurred between 1665 and 1666, and killed an estimated 100,000 people - about 20% of London's population at the time. This was the last widespread outbreak in England.

Between the 1350's and the 1660's something had happened that greatly changed our ability to understand and interpret the past - the invention of the printing press in the 1400's and the appearance and spread of books.

So our record of the Great Plague of London is much better. Perhaps the most widely known book from the period is Daniel Defoe's 'A Journal of the plague year'. However this was probably written just prior to publication in 1722 and Defoe was only 5 years old in 1665. Other books were however written at the time, such as Loimologia, or, an historical Account of the Plague in London in 1665, With precautionary Directions against the like Contagion by Dr. Nathaniel Hodges (1629–1688).

Hodges investigated several possible cures for the plague and does not seem impressed by any, not even unicorn horn:

'The powder also of a Unicorn's horn, so much cried up for an antidote, never answered any good expectation, although I have several doses of it given me by a merchant, on purpose to try its virtues: but that which would cure pidgeons, fowls, cats and dogs, as the worthy Gentleman assured me that did, had yet no efficacy against the pestilential virulence.'

The funny pages

I don't suppose many people read the comics in the paper anymore now that no-one is reading the newspaper. Some of them will probably continue with a healthy internet life but the fate of the interminable soap opera strips such Mary Worth or Apartment 3-G must be in doubt. One of the more bizarre soap opera strips was always 'Mark Trail' - combining outdoor folksy wisdom with a series of bizarre ongoing plots. One of the recent stories involved Sneaky, the adorable raccoon bandit.

Perhaps it was more than a coincidence that a recent Sunday nature strip set readers straight about raccoons and their rabid ways.

Panic in the Streets

There are a number of interesting disease movies (apart from zombie movies). I bumped into a reference to 'Panic in the streets' the other day and think I'll have to watch it again. It must be 30 years since I saw this on late night tv. Apparently the original title was 'Outbreak'

From Amazon's editorial review:

An amazingly effective film noir action movie, shot on location in New Orleans in 1950, that has twists of plot and explosions of violence that can still make audiences gasp. Elia Kazan, of all people, directed this story of a public health worker (Richard Widmark) and a police detective (Paul Douglas) who have only a few hours in which to capture some fleeing felons who may be infected with bubonic plague. The bad guys are played, with enormous relish, by Jack Palance and Zero Mostel, the latter only a few years before Kazan ratted him out to the House Un-American Activities Committee. In retrospect, this modest crime picture looks like a crucial turning point in the formation of Kazan's distinctive style, a clear precursor to the blistering location work of landmark films like On the Waterfront, Baby Doll, and America, America. --David Chute

From DVD verdict:

The trailer for Panic in the Streets promotes the film as an action/suspense thriller about preventing the spread of a nationwide biological epidemic. Reading between the lines, however, Panic in the Streets can be seen as an allegory about stopping the threat of Communism in the United States at the beginning of the Cold War.

and finally, from epinions.com

The Moral of the Story Is?

Cooperating with authorities is shown as not only a civic duty, but as necessary to self-preservation, though there are officials who are more concerned about keeping the public ignorant than about keeping it safe, and even this imperative is muddied by the movie's siding with the heroes keeping a newspaperman from reporting what is going on.

Summer re-runs part 3

Some Bubonic Plague favorites:

• A little speculation
• The Triumph of Death
• The Plague as a Biological Weapon
• Flagellation in German rock video

Plague outbreak in China

If you have been reading or watching the news lately you may have heard about an outbreak of the pneumonic form of Bubonic Plague in Ziketan, China.

The outbreak was first reported on August 1st, and the Chinese government has been much more open about this incident than previous diseases outbreaks (eg SARS).

The town of Ziketan, with more than 10,000 people was sealed off.

A spokeswoman for the World Health Organization, Vivian Tan, said an outbreak such as this was always a concern, but praised the Chinese for reacting quickly and for getting the situation under control.

Rapid action appears to have helped stop the outbreak in its tracks and there were only three deaths - possibly due to delayed treatment. Today there comes news that the source of the outbreak may have been a marmot. A dog that ate the plague infected marmot died and the first human victim was infected by fleas as he buried the dog.

Although this story is a good example of how rapid action can halt potential disease outbreaks there was a somewhat worrying story in the Times about how some taxi drivers have been earning a small fortune by sneaking residents around roadblocks and out of the cordoned off town.

Quote

Here's a quote I skipped in lecture for time. Nothing new, but it really brings home to me exactly how unpleasant the side effects from some second line Tuberculosis drugs are:

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.'"

Just a Bill

Although unanimously endorsed by public health and medical organizations, federal bills aimed at phasing out the non-therapeutic use of antibiotics in US food animal production have repeatedly failed to make it out of committee. The current version is still in committee - the 'Preservation of Antibiotics for Medical Treatment Act of 2009'.

Govtrack.us is a pretty neat site for tracking legislation. If you click on 'related legislation' you can see that legislation with the same title was introduced to the previous 3 Congress's but has never made it out of committee despite having bipartisan support (at least the sponsors include both Republicans and Democrats).

110^th Congress: S. 549Dead

110^th Congress: H.R. 962Dead

109^th Congress: S. 742Dead

109^th Congress: H.R. 2562Dead

108^th Congress: S. 1460Dead

108^th Congress: H.R. 2932Dead

You can read the FDA's Statement before the House Committee on Rules on July 13th this year, here. A statement read into Congressional record by Rep. Jerry Moran (The expanding power of the federal government and its intrusion into America's business) gives some idea of why this Bill has trouble getting anywhere.

Other countries have, however, acted, the European Union banned the use of antibiotics as growth promotional agents in 2003.

Mmmmm Chocolate-covered bacon

Someone asked me at the start of the course once whether it was going to be a scary class. My answer was then, and is now, no. Of all the diseases we will cover I think only a single one merits being scared of (more of that in week 4 - and no it isn't AIDS or Ebola). The answer might be different if you lived in a poorer country of course....

But in the good old US of A infectious diseases are responsible for barely 5% of all deaths. If you compare that to other preventable deaths then it is dwarfed by smoking and poor diet/lack of exercise that each lead to over three times as many deaths as all infectious diseases combined in the US. The so called 'diseases of affluence'.

I'll talk about this more in the very final lecture but I was reminded of it today when I read in the news that the Wisconsin State Fair has introduced two new food items: Chocolate covered bacon, and deep fried peanut butter and jelly sandwiches.

So have a good weekend, drive/cycle/walk safely, maybe get some exercise and a nice salad......

Summer re-runs part 2

Some Tuberculosis favorites:

• Got TB? Have some heroin...
• Running Footmen
• Patients flee, drawing attention to quarantine dilemma
• Tuberculosis and Vampirism

BCG

'Given the variable protective efficacy provided by Mycobacterium bovis bacillus Calmette-Guérin (BCG), there is an urgent need to develop new vaccines against tuberculosis. '

The BCG vaccine was the first vaccine developed for Tuberculosis. Originally developed in 1921 it is still the only vaccine available.

With the recent increase in the prevalence of Tuberculosis there are now a number of possible new vaccines in development. Since commercial firms have shown little interest in developing such drugs support has largely come from private philanthropists. The Bill and Melinda Gates foundation have a strong commitment to Tuberculosis and recently gave a $200 million grant to the Aeras Global TB Vaccine Foundation, a non-profit Product Development Partnership dedicated to the development of effective TB vaccines.

There have also been some recent developments in improving the efficacy of the BCG vaccine. A paper in the Journal of Leukocyte Biology earlier this year described the use of interferon to boost the immune response produced by the BCG vaccine and led to some inevitable headlines 'New Discovery Gives Tuberculosis Vaccine A Shot In The Arm'

Crimean War Photographs

I mentioned that there were photographs of the Crimean War. These are in fact some of the earliest photographs of war and were taken by Roger Fenton in 1855 He was sent to the Crimea by Prince Albert in an attempt to alter public opposition to the war and was told before he departed for the frontline: "No dead bodies."

Conveniently, the Library of Congress has a set of 263 of the 360 photographs Fenton took and you can view these at their website. Fenton's photograph of the 'Valley of the Shadow of Death' is probably the most famous but if you scan through all the images one thing really strikes you - the amazing facial hair!

I looked it up and a mustache was compulsory in the British Army until 1916! Actually that's not strictly true - army regulations forbade the shaving of the upper lip which isn't quite the same as making mustaches compulsory even though the outcome is very similar!

Summer re-runs part 1

Because not everyone has the time and patience to wade through the three hundred posts already on the blog I thought I'd highlight some of the most relevant or interesting posts for each disease we cover. Here are some Cholera favorites:

• The Ghost Map
• Preventives of Cholera
• Cholera Exhibition
• A lion in the village

Choose your own apocalypse

Slate online magazine has been having an entertaining series of articles on how America might end - 'a week long though experiment on the United States' demise.'

This is quite entertaining and one article contains an impressively thorough list of 144 possible scenarios - several of which are disease related.

They also have a 'Choose your own Apocalypse' interactive feature that lets you select your most likely scenarios. This is all (vaguely) relevant to class because once you pick your scenarios you get to see what the top apocalypse scenarios are. Antibiotic resistance - our next topic is one of the top picks. Of course this is all very unscientific and most people probably picked the entertaining options (my top pick was 'Robot Overlords') but there is some food for thought there. Nevertheless I think I'll tag this 'humor'.

Topical

Even for a topical subject there were a surprising number of disease stories in the news today.

Briefly the lead item on the CNN home page was a report on a PNAS paper abut the origin of Malaria:

Today scientists reported that they have discovered the origin of malaria, one of the deadliest diseases of humanity. Chimpanzees, native to equatorial Africa, have been identified as the original source of the parasite that likely moved from them to humans via mosquitoes.

Also in the news today was a story based on a Nature Medicine paper this week that describes a new strain of HIV:

These findings indicate that gorillas, in addition to chimpanzees, are likely sources of HIV. The discovery of this novel HIV lineage highlights the need to better monitor the emergence of new HIV variants, particularly in western central Africa from where existing HIV groups have originated.

Finally, the cholera outbreak in Zimbabwe I mentioned has finally been declared over:

Zimbabwe's Health Minister yesterday said a cholera epidemic has ended, after more than 4200 deaths and 100 000 cases since last August, but gave warning new outbreaks remain a threat.

"The nation experienced the worst cholera outbreak between August 2008 and June 2009, but the epidemic has successfully been contained and has ended," Health Minister Henry Madzorera said.

International aid organisations said the cholera epidemic was the worst to hit Africa in 15 years and gave warning the disease had now entrenched itself as endemic in Zimbabwe.