Monday, October 20, 2014

Gain of Function or Loss of Funding?

Hey everyone!

I was just looking through some news articles today and came across this one talking about the White House's decision to stop funding research that involves "gain-of-function" viruses, specifically the influenza, SARS, and MERS viruses. 

For reference, gain-of-function viruses are those that feature increased pathogenicity or transmissibility; these viruses are particularly useful for experimentation regarding disease pathogenesis and understanding the specific pathways of disease. Specifically, studies that propose protocols that would increase viral pathogenicity will not be funded. Naturally found viral experiments involving influenza, MERS, and SARS are not subject to these constraints. 

This isn't the first time that research related to gain-of-function viruses has been under fire; in 2011, the US National Science Advisory Board for Biosecurity asked Nature and Science to not public studies about mutated strains of the bird flu virus because this information could be used inappropriately for bioterrorism. 

I'd love to hear everyone's thoughts about whether this is an appropriate step to take at this point! How can those researchers who are working hard to understand the effects of increased viral pathogenicity take precautions to avoid mistakes and severe consequences? Where is the line between conducting important research and developing potentially dangerous pathogens, and how can this be effectively be regulated by the US government and other research and funding entities? Do scientists have the power to create mutant viruses with such harmful negative impact in order to "predict" future strains and how to combat them? There are a ton of associated ethical questions, and I'm looking forward to our discussion in class about it!

Happy Monday!

Nicole

You can see the news brief here from the White House:
http://www.whitehouse.gov/blog/2014/10/17/doing-diligence-assess-risks-and-benefits-life-sciences-gain-function-research

Other sources:
http://www.businessinsider.com/r-white-house-halts-funding-on-risky-flu-studies-2014-10
http://gizmodo.com/the-u-s-will-stop-funding-research-into-making-mutant-1647865903


Screening for Ebola at Airports - Effectiveness?

As many of us are starting to make travel plans back to our hometowns for Thanksgiving, one thing that may be on our minds is how safe is it to travel on airplane these days. With Ebola still making many media headlines, the thought of potential infection is still a scary one that many of us have. Airplanes are particularly a source of concern, with recycled air and oftentimes lack of thorough sanitation.

Professor James Barbaree of Auburn University has long studied bacteria on airplanes. From what he has discovered, when improperly cleaned, many of the airplane surfaces, such as chairs, tray tables, toilets, etc, can all harbor bacteria pathogens for sometimes more than a week. When it comes to Ebola though, the CDC has said that at least on surfaces, Ebola is only able to survive for a few hours. However, if the virus is in some sort of bodily fluid, the virus survival time is extended to several days.

The CDC also claims that Ebola can only transmitted to another person if the infected person is exhibiting symptoms, such as fever. The viral titer in a patient drastically increases as the patient becomes more and more ill, and experiences more symptoms, making their bodily fluids that much more infectious. The spread of Ebola only happens through direct contact with bodily fluids containing the virus. By properly disinfecting with hospital grade disinfectants, such as bleach, it is possible to inactivate Ebola virus.

Given all this information, the CDC supports that the chances of being infected by an Ebola carrier who has no symptoms is low. Given this information, should we be screening people who board planes for fever and other symptoms? Director of the National Institute of Allergy and Infectious Diseases, Anthony Fauci, believes it is worth our time to continue screening. While screening patients for Ebola might not help curb the spread of the virus to other countries, as intended, if the patient doesn't develops symptoms after they exit the plane, perhaps what the screen can be useful for is preventing the spread of disease to people on the airplane itself. At least if nothing else, screening people may reduce any panic people may have about contracting Ebola while traveling home for Thanksgiving!

 http://www.zerohedge.com/news/2014-10-18/why-airport-screening-wont-stop-ebola-economist-explains

http://www.cdc.gov/media/releases/2014/faq1017-ebola-investigation-frequently-asked-questions.html

-Anna Duan


Nigeria Ebola Virus Free

The World Health Organization (WHO) has now officially declared Nigeria free of Ebola virus transmission.  The first Ebola case in Nigeria was reported on July 23rd in Lagos.  The greater community was alarmed because Nigeria has the population size of Guinea, Liberia, and Sierra Leone combined.  Furthermore the unsanitary and crowded conditions of this country and of Lagos in particular provides an optimal environment for Ebola virus transmission.  The US consul in Nigeria Jeffery Hawkins, said " The last thing anyone in the world wants to hear is the 2 words, 'Ebola' and 'Lagos' in the same sentence."  Despite these facts, Nigeria has proven to be a success story that many countries can learn from.  Earlier this year Nigeria also eradicated guinea worm disease.  So is Nigeria just lucky or is there a secret weapon?

This success story can be attributed to the strong and united leadership and cooperation that followed this epidemic.  The Nigerian response to the outbreak was quick and coordinated.  Within days an Emergency Operations Center was established by the CDC and accepting patients.  The government and other economic entities were able to provide resources and financial support to different organizations and hospitals.  Another important factor to consider is Nigeria's premiere virology lab under the Lagos University Teaching Hospital.  The lab was prepared and stocked to respond to Ebola virus disease; this response included diagnosis and treatment by competent staff members.  In addition there was efficient contract tracing conducted by WHO, the CDC, and other health organizations.  These different parties found 100% of known contacts, which is a feat in itself.  Another factor that contributed to this success story is Nigeria's success with trying to eradicate polio.  For quite some time the President Goodluck Jonathan has pushed polio eradication; with his support the country is expected to eradicate wild type polio by the end of the year. When the first case of Ebola virus was reported the country switched their polio eradication techniques over to the Ebola virus; the foundation for viral eradication was already in existence.  GPS assisted real time contract tracing, and daily mapping of transmission were two techniques used by epidemiologists to study the epidemic.  


What most health officials and government leaders in Nigeria want the world to know is that if an African country with it's own set of issues can eradicate the Ebola virus, then it is possible for another African country to do the same.

-Nalani Wakinekona

References

http://www.who.int/mediacentre/news/ebola/20-october-2014/en/index2.html

http://www.bbc.co.uk/news/world-africa-29685127

Sunday, October 19, 2014

The Hot Zone: Why We Are in the Midst of a Critical Opportunity to Improve Scientific Literacy

Twenty years ago, author Richard Preston published The Hot Zone, a non-fiction thriller about the Ebola virus.  Even back then, before thousands of people had died from the virus and before its name was splashed across news headlines around the globe, the book sold like hotcakes.  It was rhetorically engaging, scientifically interesting, and downright terrifying.  In the context of the current Ebola outbreak, there has been an understandable spike in purchases of Preston's book.  According to the New York Times, today the book is ranked the 23rd most popular on Amazon and its publisher, Anchor Books, has released 150,000 new copies for sale in anticipation of renewed public interest and purchases.

Popular media coverage of the current Ebola outbreak has been widely criticized for its inaccuracies and inflammatory language that exacerbate challenges to epidemic control by encouraging and misdirecting public fears.  However, many of these criticisms fail to address the deeper underlying crisis:  a deplorable lack of public scientific literacy.  According to a report published by the National Science Foundation on February 14th of this year, one in four Americans do not know that the earth orbits the sun, only 39% think the universe began with a big explosion, and the majority struggle when asked to provide a rationale for the use of a control group or to explain what makes a fact scientific.

The Hot Zone offers a perfect gateway to this conversation because while it is marketed as a non-fiction book---in fact, its subheading reads "The Terrifying True Story of the Origins of the Ebola Virus"---it is somewhat outdated (having been published 20 years ago to elucidate a field that is evolving almost as fast as its subject matter) and includes inaccuracies of imaginative language and description.  Preston himself acknowledged in an interview with the New York Times published today, "In the original Hot Zone, I have a description of a nurse weeping tears of blood. That almost certainly didn’t happen. When a person has Ebola, the eyes can turn brilliant red from blood vessels leaking and blood oozing out of the eyelid. That’s horrifying, but it’s not someone with tears of blood running down their face."  With book purchases on the rise, a new host of readers are being misled.  Preston says he is, in a slightly inappropriate and surely unintentional double entendre, "dying to update the book."  But when his corrections and planned contextualizing preface will be incorporated remains unclear.

It would be unfair to criticize this author on his use of colorfully descriptive language, for not only does it make the book engaging but also imagination and creativity play an important role in scientific thought.  The generation of new ideas that revolutionize scientific paradigms is an inherently creative process and utilizing curiosity and imagination to encourage public interest in science can be quite effective.

Fortunately, while scientific literacy remains low scientific interest is high.  The same National Science Foundation report that published the aforementioned worrying statistics on public knowledge of science also released statistics on how many Americans reported having visited a zoo, aquarium, natural history museum, or museum of science and technology in the previous year:  the majority!  The Ebola outbreak has further garnered public interest in scientific phenomena and constitutes a critical opportunity for increasing scientific literacy.  If Preston can correct the inaccuracies of The Hot Zone, if the families who visit zoos and museums can come away with an understanding of how science happens and not just the knowledge it produces, and if we can channel the current public curiosity about Ebola into positive learnings rather than fear-mongering, perhaps we can capitalize on widespread public scientific interest to improve scientific literacy.

If public interest in science was high even before the Ebola outbreak why are we not generally more well-informed about scientific subject matter?  The problems lie in our approaches to science education and science communication.  One misconception, even among some educators, is that the content must be embellished to elicit excitement---that tears of blood would be interesting whereas explaining that a tiny questionably-living thing that contains only a few genes can cause leaky blood vessels and wreck a human population might not be enough to keep readers engaged.  We need a structured way to support our innate scientific inquisitiveness and channel it into an understanding of the scientific method and how it has been applied to reveal principles that describe natural phenomena.  One strategy would be to employ the scientific method earlier and more deeply in science education by empowering students to make discoveries themselves, in the context of a scaffolded learning environment.  Another element of the disconnect between our pubic scientific interest and scientific literacy could be a dehumanization of scientific discovery.  Though scientific experiments themselves are necessarily structured and employ carefully-crafted controls and manipulations, the overarching process of scientific discovery is often more disordered, more frustrating, more explorative and more exhilarating.  We tend to detach the facts from the people---apart from giving credit where it is due---and lose rich opportunities for scientific storytelling:  sharing the compelling narratives of the humans behind the scientific discoveries.  (As a relevant aside, if you haven't yet, read Microbe Hunters.)

This brings us back to The Hot Zone, an effective piece of scientific literature (despite a few outdated facts and mild hyperbole) because it couples the science with the human experience.  Scientific storytelling and young science students participating in the scientific process rather than simply memorizing facts would both be attempts at the same.  It is a beautiful thing that our minds run wild with imagination, propelled by a natural curiosity!  It is precisely that curiosity that must be harnessed productively through scientific education and science communication to improve scientific literacy.  With the word "Ebola" whispered and shouted by so many mouths these days, we are in the midst of a critical opportunity to channel public concern into meaningful learnings and bridge the gap between science and the populous.

(I apologize for the long post---this subject matter is close to my heart!)
--Laurie Rumker

P.S. You can read the full NSF report on scientific literacy here (http://www.nsf.gov/statistics/seind14/index.cfm/chapter-7/c7h.htm)
and the full interview with Richard Preston, author of The Hot Zone here (http://nyti.ms/1Fny11X).

Ebola may save lives in the US

            The media coverage on the sparse cases of Ebola in Texas and other areas of the United States have prompted fear among the public for a virus that is ultimately not very contagious and a minuscule health risk in the United States compared to other diseases.  However, perhaps the Ebola epidemic in Africa will save thousands of lives stateside as the awareness and willingness to get a flu vaccine increases in tandem with curiosity and fear of Ebola.
            Frank Bruni, a columnist for the New York Times, wrote a controversial op-ed article describing Americans’ inconsistency with risk management. He discusses the well-known dangers of the flu, skin cancer, and car accidents, yet millions of Americans decide to not get vaccinated, wear sunscreen, nor wear a seatbelt. While such criticisms come as no surprise, perhaps the Ebola outbreak in Africa is increasing the number of flu vaccinations in the US.
            Infectious disease experts attribute deaths in the US at up to 50,000 a year due to the flu. However, flu vaccines are on the rise as well in counties across the United States attributed to an increased awareness and conversation around both Ebola and EV-68 a severe respiratory virus with polio-like symptoms spurred by media.  Walgreens alone saw an increase in 10% in revenue from flu-shot administration and doctors report an uptick in patients getting the vaccine. GP magazine, what I can only imagine is the GQ for general practitioners, attributes the rise to a general increase in flu campaigns and free shots. Either way, I’m about to head to the pharmacy to get one myself.

-Will St. Amant

Sources:

Ebola Philanthropy

With the largest Ebola epidemic on hand ever, the realm of humans and viruses has never been more exciting. For some, this outbreak has caused enough damage and terror to motivate them to give incredible sums of money towards organizations battling against the filovirus on the front lines. Billionaires across the United States have started to make enormous monetary pledges towards fighting the international spread of Ebola.

Bill Gates may have started the trend of massive private philanthropic donations towards Ebola on September 30, 2014 when he pledged 50 million dollars through the Bill & Melinda Gates Foundation that will be directly utilized by organizations like the WHO, UN, and CDC curbing the epidemic.

Soon after making this pledge, Bill Gates talked with ABC News about his donation, mentioning how excited he was about others getting involved in philanthropy, particularly focusing on the the young and rich of the world stating that people shouldn't wait until they are "on their deathbead" to start giving away their money.

Interestingly, after this article was published, Mark Zuckerberg donated 25 million dollars to the CDC to be used directly in the fight against Ebola. Whether or not the young Bay Area Billionaire decided to give to the Ebola outbreak before Gate's call to action is besides the point, as the money will be actively utilized by the CDC immediately.

As an aside, after Humans and Viruses class on Thursday, I attempted to contact Mark Zuckerberg via email in order to get him to talk with our class about his philanthropic actions. He has not responded to me yet. I'll let you all know when I get an email back from mark.zuckerberg@fb.com.


- Marcus Munoz

Friday, October 17, 2014

Mosquito Triad Plaguing Pacific


Dengue, Zika, Chikungunya. 

The names sound exotic and many probably have not even heard of the last two. They could be the names of primitive south American tribes, or names of towns in Papa New Guinea. What they actually are is a trimer of really dangerous, mosquito borne diseases. Frighteningly, there has been an increasingly high uptick of these viral disease in the Pacific since 2012. 

Mosquitoes are the vector of transmission ot humans for all 3 of these diseases, and all three can cause horrible complications including encephalitis and hemorrhagic fever syndromes.  While Zika was only identified in 2007 and Chikungunya in 2011,  dengue has been around for a long time but all three are seeing some alarming new trends. 

For dengue, usually outbreaks are seen in sporadic, explosions of 1 form of dengue (there are 4 main serotypes or strains that usually infect humans). However, in 2012 scientists saw epidemics involving all 4 serotypes of dengue. Multi-sera circulation of dengue virus is a particularly troublesome event because studies have shown that having antibodies to one strain of dengue significantly increases your chances of coming down with the most serious complications associated with dengue virus--Dengue shock syndrome and hemorrhagic fever. 2013 also saw the largest ever recorder outbreak of dengue. 

Zika virus produces slightly more mild response than west Nile or dengue, but is also a newer and less understood pathogen. However, in addition to much high case instances being seen in places like New Caledonia (as well as a reports of cases outside the observed scope of area that could not be counted) the virus is presenting in new ways. One concerning hallmark of the 2013-2014 outbreaks has been the high incidence of neurological complications--encephalitis and Guillain-Barre syndrome. 

Since Chikungunya virus's (CHIKV) identification in New Calendonia in 2011, it is now nearly endemic to the area. However, in 2012-13 the largest even epidemic was recorded in Papua New-Guinea. CHIKV does not frequently cause death, but it can cause severe fever, joint pain and sometimes debilitating  complications. While it does not seem as deadly as dengue, it has a much wider host range that includes rodents, monkeys and livestock. 

It is not known why the sudden increase in these diseases, but since these viruses are mosquito-borne, it seems possible that warmer climates causing larger mosquitoes populations could be a factor. 

--Lauren Sweet

SOURCES: 
http://wwwnc.cdc.gov/eid/article/18/11/11-1036_article
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20929
http://www.ncdc.noaa.gov/sotc/global/