Monday, October 31, 2011

Dengue outbreak in Lahore, Pakistan

There's a huge dengue (fever) outbreak in Lahore, Pakistan. The monsoon season hit early and hard, so the temperature and amount of standing water is ideal for mosquito breeding. Over the past month and a half-ish, more than 30,000 people have gotten sick. Hospitals are crammed, and individual health workers sometimes test more than 1000 patents a day. Many have recovered, but 323 people have died. (Interestingly, the only day no one's died is Sunday: the 9th, 23rd, and 30th.) That's pretty amazing, even in a population of 6 million.

It's amazing to me that epidemics can be spread through mosquitos. I think of epidemics as being spread by coughing, but in this case if you're sick and a mosquito bites you and then bites the person next to you in bed, you've effectively infected the other person. Thus, sick patients aren't wearing masks, but are shrouded in mosquito nets! I think they're spraying and sucking viruses up in an effort to contain the mosquito population. See pictures.

The other article.


Nonlytic Escape of Poliovirus

It is assumed that for most naked viruses, the egress of newly formed virions involves only cell lysis, but a study by Karla Kirkegaard, formerly of Stanford, show that nonlytic release via phagosomes was also possible.

A important link to understanding this other method of viral exit is the fact that all eukaryotic +ssRNA viruses replicate genetic material on membranes in the cytoplasm (e.g. mitochondrial, ER, Golgi).

Kirkegaard postulates that polioviruses and some other nonlytic viruses can induce and be ecapsulated by cytoplasmic double-layered membranes, in which they mature and are eventually shipped out to the extracelluar fluid.

Despite the normal use of this autophagy pathway to degrade intracellular components, the digestive properties of said double-layered membranes seem to be ineffective or inhibited by nonlytic viral invaders.

Inhibition of cellular autophagy resulted in a lower yield intracellular viruses (because they are dependent on these membrane surfaces) but an even lower yield of extracellular virus; this is consistent with the non-lytic escape hypothesis.
Furthermore, experiments in which cells were polarized such that vesicles would only exit in one direction and infected with poliovirus showed virion emergence from the predicted side of the membrane.



Hantavirus in India

A case of hantavirus infection has been discovered in the Karimnagar District of Hyderabad, India. This is considered the first reported case of hantavirus in the state, and Yashoda Hospital specialists are apprehensive of future cases to come. The man, Bhagavan Rao, was admitted to the hospital with cough and shortness of breath, only to fall into intense cardiac arrest the day afterwards. He was revived, placed on a ventilator, and appears to be slowly recovering. He is non-responsive and probably blind.

His physician, Dr. M V Rao, sent samples to Mumbai under suspicion of hantavirus. They came back positive, and Dr. Rao presence of rodents in the area, especially deer mice. This poses interesting questions in relation to the 1993 outbreak in the Four Corners Area of the United States. Should precipitation increase in the Karimnagar District, should the hospital take precautions in preparation of more hantavirus cases?


Act supporting research into antibacterial-resistant solutions introduced to Senate

The GAIN Act (Generating Antibiotic Incentives Now) was introduced into Senate last week. It's currently supported by both democrats and republicans in the House and the Senate, however, so far it has taken a backseat to the overshadowing issues of economic crisis.

This act seeks to make research into solutions for antibiotic-resistant bacteria profitable enough to attract pharmaceutical companies to devote their resources to the problem. Pfizer and Johnson&Johnson, both large pharmaceutical companies, have recently shut down some or all of their antibacterial resistance research, because the profits are miniscule when compared to other drugs they manufacture. The mot profitable drugs for large pharmaceutical companies are those that have to be taken for years and even decades. Drugs that would fight antibiotic-resistant bacteria would only need to be taken for a few days.

These shutdowns come at a bad time, as deaths from anti-biotic resistant diseases have reached a high this last year, causing about 70,000 deaths in the United States. These infections are mostly hospital-acquired, and are often MRSA or vancomycin-resistant enterococci. Additionally, these infections cost the U.S. healthcare system up to $34 billion a year.

The author of this article was pessimistic that the incentives offered by the GAIN Act would be enough to encourage pharmaceutical companies to continue their research. Until this issue becomes a crisis, it's just more profitable to make other drugs.

--Sarah Kaewert

Flu Vaccines Aren't Up to Par

Researchers from Johns Hopkins recently analyzed several studies of flu vaccination efficacy and concluded that while the vaccines are said to protect 70-90% of the population, in reality, they are only effective in 59%. They analyzed 17 randomized controlled trials and 14 observational studies from 1967-2011. Their conclusions include: efficacy of TIV in only 59% of adults aged 18-65 no such trials for children ages 2-17 or people over 65 fit the criteria for their study; efficacy of LAIV in 83% of children 6months - 7 years and no such trials for ages 8-17; no LAIV studies demonstrated significant protection in healthy adults under 60

One of the researchers argued for reduction of regulatory barriers, stating that,
"'The difference between 69% effectiveness and 90% effectiveness will have a major public health effect in any pandemic that causes serious morbidity or increased mortality.'"

An interesting note is that the researchers only deemed 31 out of 5,707 studies screened as eligible to analyze. They chose to only include studies that used highly specific tests like RT-PCR to confirm the presence of flu and excluded studies on the basis of study design. It is admirable that they had such stringent requirements for their analysis, but that also means they looked at less than 1% of the available studies that have been done in the past 40 years. Are they skewing theirs numbers by being too picky?
-Emily Mitchell

No more cold sores?

Researchers at Utah identified a gene linked to Herpes Simplex labialis (Cold sore). This type of herpes infection results in fluid-filled blisters on the tips and the virus remains in the body throughout the infected person's life time. In a study with 618 participants who had cold sores, the researchers identified a gene called C21orf91 that is responsible for cold sores. Researchers suggest that the gene will be remained as the Cold Sore Susceptibility Gene 1 (woo so much easier to remember!). This discovery has important implications for drugs for the treatment of cold sores and future research on whether it's linked genital herpes.

I think this is a very interesting finding because although cold sores are not as severe as other herpes infections, it is very annoying to have to deal with them. Having had cold sores my whole life, I'm very excited to hear that there might be new long lasting treatments that might prevent future outbreaks.

-Michelle Jin

Sunday, October 30, 2011

Successful Application of Sterile Insect Technique to Aedes Aegypti Mosquitoes, But Concerns Raised Over Public Reception

Today, the New York Times reported on the publication of a paper in the journal Nature Biotechnology that reports success in the release of large numbers of effectively sterile, male mosquitoes in the Cayman Islands to control the population of the Aedes Aegypti mosquito. Using genetic modification to make the male mosquitoes and any subsequent offspring dependent on doses of tetracycline, researchers working for the company Oxitec hoped that their modified crop would compete with natural males and give rise to a generation of new mosquitoes that would die before birth. Since female mosquitoes only mate once, this technique has to potential to seriously curtail mosquito population and, by association, the risk of spreading diseases such as dengue that use these mosquitoes as vectors.
The same technique has already been used successfully in multiple cases to limit or even eradicate entire insect populations, such as the screw-fly in most of North America. Those cases relied instead on ionizing radiation to sterilize males and/or female flies with the rest of the protocol unchanged. Unfortunately, such techniques can't be applied here since irradiated flies maintain their ability to compete with natural males, something not seen in Aedes aegypti mosquitoes. Indeed, researchers were pleased to attain a 50% competition rate in the studies conducted so far, with the release of enough males to approximate 16 % of the total population having the lethal gene resulting in 10% of larva dying in one example.
Unfortunately, numbers like this form one point of possible controversy. Like with the screw-fly program, an eventual program to eradicate or seriously control the mosquito will have to rely on 'over-kill', with tremendous amounts of modified mosquitoes being released. Given a 3.5% rate of offspring mutating to survive the presence of the gene and a 0.5% rate of females accidentally released alongside the males, programs such as this carry the risk of unintentionally making the situation worse if major errors occur. What may influence public perception the most is that this program involves “genetic modification” and the introduction of vast numbers of modified organisms into the environment. Even if similar programs have been performed with incredible success for decades, these projects needs to be handled with care, lest a public backlash prevent the control of such a deadly pest.

New York Times Article:
Concerns Are Raised About Genetically Modified Mosquitoes
Sterile Insect Technique:
Screwworm Eradication in North and Central America(1987)

-Zachary Herrera

Saturday, October 29, 2011

Antibody Vaccine Shows Promise for Nipah and Hendra

A new monoclonal antibody vaccine that protects against two paramyxoviridae viruses - Nipah and Hendra - has shown promise in clinical trials involving monkeys. The NIH stated that in all 12 trials, the monkeys received lethal doses of the Hendra virus and were subsequently given the antibody vaccine, and all 12 monkeys recovered.

Nipah is a deadly disease that has killed 251 of the 475 people known to have been infected with it (most of whom worked with pigs); the movie Contagion was based upon the Nipah virus. Hendra has only been known to have infected 7 people (4 cases were fatal), but this preliminary vaccine may also have saved the lives of an Australian mother and daughter who were sick with the virus. Antibodies are relatively expensive to produce, however, so scientists are also looking into the possibility of peptide vaccines for the two diseases - an option which has shown promise among hamsters.

I find this an interesting progress because it's vital that we research vaccines for not only the traditional headliner viruses (HIV, ebola, etc), but even those that occur less commonly. Nipah and Hendra may not be household names, but given how quickly swine flu mutated from an infection among pigs to one that could be readily transmissible among humans, it's quite possible that these deadly diseases could quickly mutate to become much more widespread. If such a scenario ever occurs, it would be hugely beneficial to already have a template vaccine available to work with.

Original article:

- Elena Higuchi

Wednesday, October 26, 2011

Herpesvirus as breast cancer treatment

Sloan-Kettering Cancer Center: A herpesvirus engineered to specifically target triple-negative breast cancer cells is showing promise in in vitro studies. This type of breast cancer causes 20% of cases but isn't estrogen-receptor dependent, and thus can't be targeted by those drugs. However, these cancers have high levels of pMAPK, a phosphorylated signal cascade protein. The herpesvirus attacks these cells, shown up to 90% effective in petri dishes and in mouse models.

This is pretty cool, especially if it's replicable in humans. I'm not sure I understand the biology (how does the intracellular levels of pMAPK make a difference to the virus? I would have thought that the virus would be targeted to a specific cell surface receptor for entry). However, a few key properties will probably be interesting clinically, based on what we know about these viruses.
1. Herpesvirus causes local infection. That means that it can be specifically targeted to the cancer site, but also that it may not work for metastases.
2. Herpesviruses are latent. Does this mean that they'll stick around to screw up the patient later, or perhaps provide lasting protection against recurring cancer?

In any case, it's been an exciting time for herpesviruses—Alzheimer cause, cure for cancer? Also, we need a new "chemotherapy" term for viruses. "Vironcotherapy?"

Article here.)

-Annelise Mah

Breakthrough that may help combat viral infections like HIV

After a whole week on the cells of the immune system, it is exciting to come across an article that describes the use of our own Natural Killer cells' properties to combat serious infections such as HIV.
Natural Killer cells are a type white blood cells or lymphocytes that are an important component of our innate immune system. They are not activated by molecules found on a tumor or a pathogen unlike most other cells, but are rather "shut down" by proteins, called Human Leukocyte Antigens (HLA) found on our healthy cells. Since tumor cells and pathogens lack these HLAs, they are immediately killed by Natural Killer cells, (since they are not shut down like with our healthy cells.)

Natural Killer cells recognise the HLA molecules on our cells using a system called "Killer cell immunoglobulin-like receptors" (KIR). This pairing is known to play a role in limiting viral replication in people with HIV, slowing the progression of the disease to AIDS. The exact mechanism is unknown, but it has been suggested that a better understanding of the structure of the KIR proteins may help to develop new ways of using Natural Killer cells against viral infection.

This is another promising piece of good news for the fight against HIV!

- Julie Saffarian

Monday, October 24, 2011

Hearth Trouble Linked to HPV?!!

A study of 2,450 women by Dr. Kenichi Fujise of University of Texas is making yet another claim against the highly talked about HPV. His study has produced findings that suggest women infected with HPV are two to three times more likely to have a heart attack or stoke.

Earlier we talked about how HPV is a known cause of cancer of the cervix, anus and throat. It can also cause cancer of the vulva and penis. While this study does not prove that HPV is linked to heart disease it shows a strong link between the two. The researcher suspect that HPV, with its ability to sabotage the P53 gene, could possibly lead to inflammation and thickening of the arterial walls.

Clearly, more research needs to be done to determine if this link between HPV and heart disease is really causative and also if it is causative in men as well. If it is, this would lead to ever more reason for more people (men and women) to get the HPV vaccine. It also might signal that a paradigm shift about the vaccine is needed as more health concerns become linked with this virus.

Read more at:

--Elena Jordan

Rabies Virus Infection Linked to Fear of Water and Increased Sex Drive in Human

A 28-year-old lady in India stumped her doctor when she came in to clinic complaining of increased libido. Four days later she died of rabies. It was determined that she had been bitten by a dog some 2 months earlier but had not sought treatment because it had been a puppy.

While fear of water (hydrophobia) is a commonly known symptom of rabies, hypersexuality can also be caused by the virus. Other symptoms of the disease include fever, headache, and general tiredness, discomfort, numbness or pain at the site of the bite. Later infected people may experience insomnia, anxiety, confusion, paralysis, excitability, hallucinations, agitation, hyper-salivation and difficulty swallowing.

It would be interesting to learn the mechanisms for such a change as hypersexuality. Could rabies be spread sexually? How might behavioral alteration benefit the virus itself?

Read more at:

Published Date: 2011-10-24 20:04:45
Subject: PRO/AH/EDR> Rabies - India (16): (TN) canine, human 
Archive Number: 20111024.3169

--Elena Jordan

Growing vaccines to the world's diseases in lettuce?

Henry Daniell, a microbiologist at the University of Central Florida, is working on creating vaccines for a broad range of diseases that he hopes will prove more effective than traditional vaccines.

Vaccines can be problematic in developing regions because they often need to be refrigerated, they expire, and it takes health personnel to administer shots. Daniell is working with lettuce leaf proteins to create oral vaccines that won't go bad or require training to administer. Basically, with a little bioengineering, a lettuce leaf becomes an antibody pill. While this sounds a little far fetched, he has successfully tested vaccines for malaria, TB, polio, cholera, anthrax, black plague, and dengue fever. There's even potential for his vaccines to work on genetic diseases, like diabetes I. Now his lab is working out the final kinks, testing appropriate dosage and longevity of the vaccines. If this new kind of vaccine proves to be as great as it sounds, it will change the future of vaccination.

--Sarah Kaewert,0,3523908.story

Gel for HIV AND Herpes protection

Researchers at the NIH recently discovered that a gel that has been tested to protect women from HIV (successfully) is even more successful in protecting against genital herpes. The gel, called tenofovir, reduced HIV infection by 39% and herpes infection by 51%. When it enters tissue of the vaginal wall, tenofovir converts into a form that blocks an enzyme which is necessary for herpes replication. Tenofovir effectively prevents HIV when taken as a pill as well but not against herpes because the drug must enter the vaginal tissue to stop the viral replication.

The makers of Tenofovir are now debating whether or not it is worth it to spend the millions of dollars that is necessary to get the gel approved for selling in America. How popular would a gel that protects against HIV and herpes be in the States? I wonder if people would go through with the hassle of buying it or not?

-Emily Mitchell

Hepatitis B Vaccination Policies in the US

A Los Altos, CA paper explained the growing liver cancer epidemic in the United States, centered mostly around the Bay Area in Asian immigrants, mostly caused by Hepatitis B Virus. For instance, Asians and Pacific Islanders make up 4.5 % of the US population but account for more than 50% of chronic hepatitis B cases.

The problem is that while this vaccination will surely prevent you from getting Hepatitis B-related liver cancer, most of the individuals who have Hepatitis B acquire it in Asia as opposed to when they come to the United States. While one doctor argues that the challenge is to educate and motivate Asian immigrants to get vaccinated, another one says that recent increase in vaccination rates in the U.S. has no correlation with rates of HBV infection. The latter doctor justifies his argument with this graph:

HBV is transmitted via similar routes as HIV (blood & semen) but is much more infectious.

This of course raises the question of whether or not our public health spending is allocated properly and intellectually. If our education of Asian immigrants is indeed useless scientifically, how has this gone unnoticed?


Sunday, October 23, 2011

(see previous robins post)

Forgot to give out the link to the article:

- Elena Higuchi

Venereal Disease on the Rise in Women

According to the New York Times, pre-cancerous genital growths are becoming significantly more common in women -especially those in their 40s. A medical group reported a fourfold increase in women from 1973 to 2000. Human Papilloma Virus is the cause of most of the growths and is known to cause cancers of the cervix, penis, anus and parts of the throat. The growths, called vulvar intraepithelial neoplasia, can be removed by surgery, lasers or drugs. Dr. Massad, a professor at WashU-St. Louis and a spokesperson for the American College of Obstetricians and Gynecologists (the aforementioned medical group) says that most specialists are seeing more cases than the past- at least one a week. But Massad is also concerned with over-treatment - many of the genital abnormalities are just non-cancerous warts, and don't need to be aggressively removed.
Some doctors think that the increases in pre-cancerous growths are due to people having more sexual partners and giving themselves more opportunities to get infected to HPV. According to the researchers, more than 50% of sexually active men and women become infected and 80% of women have been exposed by the time they are 50. While more people are developing growths, rates vulvar cancer are not increasing, according to the National Cancer Institute. It is possible that the growths are being appropriately treated, or that not enough time has passed to the cancer to develop.
It will be interesting to watch HPV-related cancer rates in the future - and this article really puts into perspective how important getting the HPV vaccine in childhood/early adulthood can be. The vaccine, Gardasil, was made to prevent cervical cancer, but can also help precent the growths (cancerous and non-cancerous alike) from developing, although only the growths caused by HPV. Those caused by herpes viruses are another can of worms, so to speak.

read the article.

-Emily Pollock

Robins Discovered to Be "Super-Spreaders" of West Nile Virus

Marm Kilpatrick, a researcher at UC Santa Cruz, has been studying patterns in West Nile transmission and has identified robins as being particularly influential in the spread of West Nile virus. Although a variety of species can be infected with the virus, in a given location, the majority of viral transmission was found to be dependent on a few key species of mosquitoes and birds - one of those being robins. Apparently, mosquitoes prefer feeding upon robins to other species of birds.

I feel like this information could be particularly useful in studying viral epidemiology when examining changing environments. It's important to keep an entire ecosystem in mind when examining either natural or human-induced changes on an environment, but knowing the key species that could in turn impact infectious disease is especially important in measuring the effect that these changes will have on human populations.

young doctors are more skeptical about vaccines than older doctors

A study suggests that young doctors are more reluctant to believe vaccine effectiveness and safety than older doctors. The study was down on 551 doctors through survey on their believes of childhood vaccines such as polio, measles, mumps, rubella, and varicella. Young doctors were defined by those two just graduated medical school. This group was 15% less likely to believe in vaccine effectiveness than older doctors, possibly because of difference in views of risk-benefit analysis of vaccines.
One possibility for the age-related difference is the fact that younger doctors did not witness disease epidemics such as as those that were included in the survey since vaccines were already in place and prevented many cases before the doctors were born. Older doctors, in contrast, witnessed the epidemics of these diseases before vaccinations were available and are thus more likely to believe in vaccine safety and efficacy.
The article also talks about another study on parental opinion on childhood vaccinations. Results suggest that parents are most likely to reject MMR, HPV, and flu vaccine. Top reasons for deferring vaccines included belief that vaccines could lead to autism, too many shots, and fear of side effects.

I think this article is interesting because it focuses on both doctors' views on vaccines and the parents' beliefs about vaccines. I think it's particularly interesting that the older age group is more likely to believe in vaccine efficacy and safety than the younger generation because I thought since the young doctors just graduated medical school, they would have a fresh memory of vaccines and know that Wakefield's study on vaccine and autism has been long discredited. I feel like based on the results of the two studies mentioned in this article, there should be more public education programs to teach the public about the accurate pros and cons of vaccines. I'm also curious to know if there is correlation between the parents' opinion on vaccines and the age of their doctors (whether seeing younger doctors would make the parents less likely to agree to having their kids vaccinated)

Article source:

-Michelle Jin

HSV1 as risk factor for Alzheimer's?

The University of Manchester scientists have shown that the herpes simplex virus type 1 (HSV1) is a risk factor for the neurodegenerative disorder Alzheimer's when it is present in the brains of people who have a specific genetic risk to the disease. In other words, HSV1, together with the host genetic factor, is a major risk for the disease. The herpes virus has been shown to cause the accumulation of two significant AD proteins: β-amyloid (Aβ) and abnormally phosphorylated tau (P-tau), known to be the main components of plaques and tangles. Both proteins are thought by many scientists to be involved in the development of AD.
According to Prof. Itzhaki, the team leader in the University's Faculty of Life Sciences, "the viral DNA in AD brains is very specifically located within amyloid plaques. This, together with the production of amyloid that the virus induces, suggests that HSV1 is a cause of toxic amyloid products and of plaques." These results therefore suggest that a possible effective treatment of AD (to slow disease progression at least) would be to use antiviral agents to target the replication of HSV1 DNA. This would be successful only if the accumulation of β-amyloid and P-tau caused by the virus occurs at or after the stage at which viral DNA replication occurs.

- Julie Saffarian

Saturday, October 22, 2011

Double Trouble: Vaginal Gel Protects Against HIV and HSV Replication

Since we have spent a significant amount of time this week discussing viral modes of transmission and the molecular biology behind it, I find it suiting to discuss a new study that was recently published in the Cell Host and Microbe journal and covered by the New York Times entitled “Topical Tenofovir, a Microbicide Effective Against HIV, Inhibits Herpes Simplex Virus-2 Replication.” A longitudinal study conducted by Caprisa (Durban-based AIDS research center) involving 889 women showed a positive correlation between the use of a vaginal gel- Tenofovir- and a reduction in the probability of infection. Women who used this vaginal gel were 54 percent less likely to acquire an HIV infection. Surprisingly, the benefits of the gel did not stop there. It was also shown that these women had a protection rate against herpes-simplex virus 2 of 62 percent.
These benefits though are only effective against herpes when tenofovir is taken as a vaginal gel and not when it is ingested in the form of a pill. As a gel, the active tenofovir metabolite directly inhibits the herpes simplex virus DNA polymerase, thus inhibiting its ability to replicate. Not to mention, the tissue concentrations of the drug are approximately 100 times higher in the gel than in its pill counterpart.
The benefits of this gel are more than physiological, there are also behavioral and economical factors that weigh into the pros. Financially, this product as a combination of an anti-HIV and anti-herpes drug increases its targeted population, especially in the United States where almost 21 percent of sexually active women are infected with the herpes simplex virus. In regards to behavioral benefits of this form, since the use of the vaginal gel is controlled by the woman herself, she can ensure a level of protection from infection by sexual transmission that is not offered by certain forms of contraception. Further studies need to be conducted in order to test the reliability of the gel as well as its effectiveness if used on a daily basis rather than being used prior to and following sexual intercourse.

McNeil, Donald G "Gel Cuts Women's Risk of Herpes, Study Finds"

Andrei, Graciela et al. "Topical Tenofovir, a Microbicide Effective against HIV, Inhibits Herpes Simplex Virus-2 Replication." Cell Host and Microbe. Vol 10,4. October 1011. pp379-389

-Angela Ceseña

Thursday, October 20, 2011

Initial Spread of HIV Strongly Accelerated and Influenced by Non-Sexual Routes of Transmission

The New York Times reports on a newly released book, The Origin of Aids by Dr. Jacques Pepín that investigates the initial outbreaks of HIV and tries to explain how different strains of the virus broke out of a localized state and became global while others remain endemic to certain regions. Using a back of the envelope calculation, at least how the article explains it, Dr. Pepín found fault with the idea that after an initial species cross-over of SIV from chimpanzees into humans, the disease spread primarily through sexual transmission. According to the article, this wouldn't have allowed for the explosion in cases and the unique nature of certain strains. Instead, Pepín theorizes, with medical records of patients treated for various tropical diseases to back his claims, that aggressive efforts by colonial doctors to treat diseases with injections of antibiotics, coupled with contamination of plasma and blood banks, played a significant role in creating a large enough population of infected people in Africa to create a sustained reservoir.
These “amplifiers” inadvertently allowed the virus to become the pandemic that it is today, and Pepin argues that evidence for their strong role in HIV's spread can be seen in the geographic diversity of current strains. For instance HIV M subgroup B, which is an obscure strain in central Africa, is endemic to Haiti and much of the Western Hemisphere. Pepín argues that the likely number of infected Haitians returning from the Congo, the cradle of the disease, could not have sustained the virus on their own, but instead that a plasma bank notorious for poor practices amplified the virus, creating a foothold for the epidemic seen today.
Though cliché, it's true that hindsight is 20/20 and there's a certain degree of irony that in trying to save patient's lives, doctors may have accidentally created the HIV pandemic. Whether or not this is how it actually happened, this possibility should serve as a warning for the future and a cautionary story of how quickly human factors can exponentially increase a virus' threat to global health.

New York Times Article:
" Chimp to Human to History Books- The Circuitous Path of AIDS"

-Zachary Herrera

Wednesday, October 19, 2011

Link between Swine Flu and Stillbirths

BBC news has just published an article regarding a new study showing that babies born to mothers who have contracted the flu virus faced a greater risk of being stillborn or premature.
In mothers who were infected with the 2009 (H1N1) strain of the flu virus, baby deaths were almost 5 times as normal between September 2009 and January 2010: In these 256 women, seven of the babies were stillborn, and three died shortly after birth - this is equivalent to approximately 39 babies dying out of 1000 before and after birth, which is a drastic difference compared to 7 deaths in 1000 in uninfected mothers.
This article primarily aims to send an important message to pregnant women biased against getting the flu shot during pregnancy and encourages them to get vaccinated in order to avoid the harmful effects on the virus on their unborn babies. Since pregnant women are likely to develop more complications if they get the flu virus, getting vaccinated should definitely be on their "to-do" list, especially at this time of the year. Contrarily to what most people believe, the vaccine can be given very safely at any stage of pregnancy, and studies have even shown that some of this protection from the vaccine can actually be passed on to their baby and last for the first few months of their lives.

Pregnant or non-pregnant, get your flu vaccine!

- Julie Saffarian

Monday, October 17, 2011

NIH awards $150 million to bioterror defenses

The NIH will be awarding up to $150 million over 5 years to four companies who are developing drug treatments that could be effective against bioterrorist attacks.

United Therapeutics is working on a broad-spectrum drug called UV-4 for dengue and the flu, which might also combat the issue of drug resistance.

The drug company CUBRC is developing a tetracycline that could treat community-acquired pneumonia and other respiratory diseases. There are also plans on testing this drug against Bacillus anthracis and Yersinia pestis, which cause anthrax and the plague, respectively, and are bioterror possibilities.

Entana Pharmaceuticals is working on broad-spectrum antibiotics called bicyclolides. These are effective against both gram positive and gram negative strains of bacteria, and have shown promise against anthrax, plague, and tularemia.

XOMA LLC (from Berkeley!) is contracted to develop an intravenous botulism poisoning treatment.

--Sarah Kaewert

Rubella in Hong Kong

There has been a small outbreak of Rubella in Hong Kong in 3 Indonesian women. Epidimiological evidence shows that all three of them attended the same church earlier. A quick reaction was mounted, and all the attendees received a talk, questionnaires were handed out, and immunization was offered to all those who had not been immunized before. Close to 11 of those people were found with symptoms, further increasing the likelihood that the church was the source of the women's infection. The women are stable.

Rubella is a highly infectious disease that is caused by rubella virus and transmitted via respiratory tracts. The women were of young age, which is problematic considering that rubella can do irreversible damage to developing fetuses. While the women are stable, it raises the numerous and well-versed questions of why groups of people choose not to get vaccinated against preventable diseases.


Genetically modified viruses used to treat cancer patients...

The article posted for the last question of our problem set this week really motivated me to look more into the concept of viral therapy for cancer treatment. While the recent breakthroughs in this field do not involve naturally-occurring viruses, they indicate very promising results through the use of genetically modified viruses.
This article that I came across described the use of engineered herpes viruses used to treat patients with head and neck cancer. The modified viruses had the unique ability to multiply inside the cancer cells, but not the patient's healthy ones, thus making it the perfect agent to target and kill (through bursting), the tumor cells, and to also stimulate the patient's immune response. This also meant that since the herpes virus wasn't able to enter the patient's healthy cells, it also couldn't cause its usual symptoms, including cold sores. The study leader Dr Kevin Harrington, further added: "The genes that normally allow the virus to hide in the body and pop out later - called latent infection - have been removed so the virus can no longer do that."
Wouldn't this kind of genetic modification make any virus the perfect cure to cancer?
This virus was injected into 17 patients’ cancer-affected lymph nodes, in combination with chemotherapy and radiotherapy treatment. About 93% showed successful results since no trace of cancer was observed after their tumour had been surgically removed. This is truly remarkable...

Julie Saffarian

The Importance of Listening to Viral Chatter

In this essay published in the Wall Street Journal, Nathan Wolfe (small world! He's the Lorry Lokey Visiting Professor in Human Biology here at Stanford, and he's been mentioned a couple times in class) shares his dream of pandemic preparedness. He hopes for a well-developed network and communications infrastructure in rural Africa, a hotspot for emerging viruses. He imagines a constant inflow of viral data from across the continent (in a colleague's words, "viral chatter"), and he hopes to see teams of bright young minds absorbing and analyzing this information, hoping to see patterns of viral emergence in the mountains of data.

I do think his dream is worthy of serious consideration, taking into account the increasing number of lives that could be claimed by a pandemic. However, Wolfe's proposal is essentially an early warning system. If the virus emerges quickly and spreads rapidly, then we won't be able to respond quickly enough to stop it.

Still, Wolfe's vision of the future of infectious disease reveals a multidisciplinary field that requires all sorts of skillsets and knowledge. It's exciting, and it reminds me why I am a HUMAN Biology major. :]


WSJ: Nathan Wolfe on How to Stop the Next Pandemic

Viral Exportations- International Measles Outbreak

Measles incidence rates have fallen to under 1% of the population under the age of 30 in regions where the vaccination is readily available. Even though the MMVR (measles, mumps, rubella, varicella) vaccine has been available in the United States since 2005, there have been recent outbreaks of the corresponding infections. In Berkeley, there have been over 40 cases of confirmed mumps.

On an international scale, the World Health Organization recently published a report regarding measles outbreaks worldwide which affected regions of the Americas, Europe, and Africa. Regions in the Americas suffered from several outbreaks that were linked to importation of the measles virus from other regions- primarily Europe, Malaysia (outbreaks in the US and Chile) and Kenya (outbreak in Ecuador). In Europe, 40 of 53 member states of the WHO reported over 26,000 confirmed cases of measles with 11 of these cases being lethal. The last region that was affected this year was Africa, with the most confirmed cases- over 103,000. The Democratic Republic of Congo have also reported over 1100 measles-associated deaths this year.

The Americas had not had a measles endemic since 2002. In Europe, they’ve responded to the outbreaks by adapting their vaccination schedule accordingly including lowering the cost (offering free vaccinations in school) in order to increase accessibility. This report reinforces the dangers of international trade and travel and the possibility of tourists or foreigners introducing new viral strains to a susceptible population. Control and preventative measures should be implemented to avoid viral exportations.

Original Source:

-Angela Cesena

Sunday, October 16, 2011

Measles epidemic?

There have been two suspected cases of measles in Wellington. The cases are believed to be associated with a gelato cafe. The suspected cases involed one adult and one pre-schooler. Health officials believe that it's possible that the cases are transmitted by a visitor from Auckland, where measles cases have been reported since May. Dr. Nesdale warn against traveling with sickness or related symptoms and that even when someone presents a "minor" symptom like cough and red eyes, it could still be measles and very infectious. To date, no secondary cases have been identified.

I think the fact that a pre-school is infected should be taken seriously, especially if the pre-schooler went to school after being exposed. The article does not talked about the potentially exposed population size, and I feel like that kind of information would help with the epidemiological investigation of the measles cases.

-Michelle Jin

Discovery of New Huge Virus

Earlier this week, researchers announced the discovery of a distant cousin of Mimivirus, an unusually large viruses of amoebas and possibly of humans discovered in 2003, in the waters of the Pacific Ocean. Named Megavirus chilensis, the virus is notable for its extremely large size and genome, with scientists comparing both to that of a rudimentary bacteria. Genes of note include those encoding for tRNA synthases not seen in Mimivirus, which itself contained the first seen outside of cellular life. This, in combination with a great deal of homology with the complex genome of Mimivirus, lead researchers to speculate that this virus is one of the closest found to approach autonomy and resemble typical life.

The paper announcing this find, which was published in PNAS, goes on to speculate that these properties offer further proof of a reductive evolutionary theory of viruses. This theory postulates that viruses were all once cells themselves that, after falling into an evolutionary niche of exploiting other cells, slowly lost their resemblance to and autonomy from cells in order to streamline their proliferation and cut away all functions that couldn't be taken over from the host. While the complex genome of mimivirus itself could be explained as a fluke of horizontal gene transfer, the paper argues that the homology seen between mimivirus and megavirus in combination with their unique genes points to a common viral ancestor, a cellular organism.

Sorry if this is too broad of a topic seeing as how megavirus was found by proliferating samples through amoebas, but this presents an interesting development in theories about the evolution of viruses.

-Zachary Herrera

WIRED article:

PNAS paper:
Distant Mimivirus Relative with a larger genome highlights the fundamental nature of Megaviridae

Viruses that love bacteria

Speaking of defeating the immune system (problem set 3)...
Scientists are undergoing research on viruses such as polio and a reovirus that use normally useful bacteria found in the human gut to get past the body's immune defense using lipopolysaccharides on the surface of the bacteria. As a test, they removed these bacteria from the gut of a mouse, inoculated the mouse with polio, and found that the virus was hardly able to replicate.
This finding challenges the reputation of many previously-classified "benign" bacteria in the gut, but overall the researchers believe that the help these bacteria provide to the body outweighs the increased risk of viral infection.

-Emily M

Twitter as an Epidemiological Tool

For some of us in Humans and Viruses, class tweets may be our first exposure to Twitter. This online social networking and microblogging service site might bring to mind 14-year-olds expressing complaints mid-adolescent crises, but could Twitter may turn out to be the great tool for tracking epidemics and how people respond to them?

This week, NPR posted an article about a group of scientist doing just that. Using Twitter data they are comparing vaccine estimates published by the CDC to look at patterns between perception of vaccines and whether or not people are getting sick. In fact there is an increasing number of scientists using twitter information in research.

According to the article, the use of twitter is particularly interesting because "You can observe how people feel about certain things in a real-world context". It is a huge amount of data and one challenge is to sort out the misinformation and false alarms and bias from the good information. The scientists using it feel that it is a helpful tool in their work.

Elena Jordan

The article can be found at:

Mumps at Cal

A ProMed post early last week indicated that the mumps outbreak at Cal is continuing to spread to new individuals - 44 suspected cases in total, 7 of which have already been confirmed by lab results. The outbreak is thought to have originated from one individual who was exposed to the virus in Britain, who thereafter developed mumps and spread it to a number of others at the college campus. Although 2 doses of MMR (measles, mumps, and rubella) vaccine were previously thought to be sufficient protection against the respective viruses, health officials are recommending a third dose - particularly for the immunocompromised. The university is also encouraging students to wash hands thoroughly and frequently, not share food or drinks, etc.

I find this article interesting because it is an example of just how easily a virus can be spread in a college setting. Dorm life provides a veritable cesspool of infectious possibilities (as evidenced by the number of freshmen who quickly become sick after entering college). Even with hand-washing, omnipresent antibacterial gel, and End-Bac, so many students are still bound to get sick. It really is necessary to be up to date on vaccinations, as well as to take proactive measures for a healthy immune system (sleep, exercise, healthy diet, not sharing cups at parties...) to keep viruses away.

Let's not end up like Cal.

-Elena Higuchi

Saturday, October 15, 2011

Innovation Needed For Polio Eradication

In 1988, there were 350,000 reported cases of poliomyelitis globally. According to the independent monitoring board formed by WHO Director General Margaret Chen, in 2010 there were just 1294 reported cases. And although in 2010 the number of polio cases decreased significantly in India and Afghanistan (90% and 34%, respectively), Pakistan has seen an increase from 89 cases in 2009 to 144 cases in 2010. And for the first three months 2011, Chad, the DRC, and Pakistan all had more cases than reported for that period in 2011.

The take-away point from this article was that although we are making significant steps to eradicate Polio, we are going to have to do much better in terms of vaccinating the isolated communities, vaccination education, and creating a more reliable vaccine. In Pakistan, almost 44% of the 144 patients had previously been given more than one dose of OPV (oral polio vaccine). The article mentions studies that have had the highest seroconversion levels combine OPV and an inactivated poliomyelitis vaccine into one cocktail - but doesn't cite these studies.

Read the full article here

Emily Pollock

Thursday, October 13, 2011

Powerful, multi-strain anti-HIV antibody

Antibody treatments for HIV have been around for a while, but the technology just got better. A newish anti-HIV antibody, PGT 128, has been shown to powerfully neutralize 70% of known HIV strains. The La Jolla Institute recently showed how: this antibody not only binds to the sugars surrounding gp120 that usually provide a slippery surface that the immune system can't target very well, but also to conserved part of gp120 itself. This explains why the antibody can target so many strains of HIV. X-ray crystallography and EM structures also hint that the antibody can bind two separate gp120 molecules at the same time, making it's hold on the virus that much more powerful than other antibodies.

I always find it really cool when we can harness the body's capability like this—making antibodies as drugs. One problem with this treatment is that it can't target viruses that are already hiding inside DCs or T cells. However, it could stop the disease from progressing farther or perhaps provide an effective way to passively immunize people most at risk. Antibodies are super expensive, but PGT 128 is powerful enough that very little is required, so this might actually be a possible solution (in the first world at least—maybe for inclusion with blood transfusions?).

-Annelise Mah

Monday, October 10, 2011

HPV in Men?!

We are familiar with the debate, men health does not depend on getting the HPV vaccine because men don't suffer the pathogenetic effects of the virus. Women hae cervixes and women get cervix cancer caused by HPV. This teaching has been falsely used to argue that men don't need to get the HPV vaccine because they don't get sick from the virus.

Obviously this is a flawed argument because even if men didn't suffer the effects of the virus, they are carriers and pass it onto the female population. The only way to eradicate the disease would be to vaccinate all women and men! Not to mention the fact that this argument does not include men who have sex with men who can also be effected by the HPV.

However it is now being shown that heterosexual males are also at risk for diseases linked to HPV. On October 3rd The San Francisco Chronicle reported on a study that shows "More males may get throat cancer from having oral sex with women than from smoking as the result of a virus linked to the malignancy, a study suggests."

By looking at samples of throat tumors from the past 20 years, scientists have determined that the percentage of throat tumors linked to HPV have increased from 16% to 72% and that throat cancers from HPV predominantly effect men. They think that by 2020 HPV linked throat tumors will become more common that HPV linked cervical cancer and that there will be a large shift from affecting women to affecting men.

Elena Jordan

Read more:

Alzheimer's Shows Some Prion-like Qualities

In a new study published in the journal Molecular Psychiatry, researchers have found that Alzheimer's Disease shares some qualities with prion diseases. Most of the negative effects of Alzheimer's start with an accumulation of misfolded amyloid-beta proteins. When those same misfolded proteins are injected into a healthy test animal, the animal would start to exhibit the symptoms of Alzheimer's Disease as the misfolded proteins accumulated. In this way, the disease is similar to a prion disease, where exposure to even a small amount of prion results in an accumulation of prions, leading to a disease. These findings will allow for more research on the mechanisms and treatment of Alzheimer's Disease.

--Sarah Kaewert

HIV Found to Infect Cerebral Macrophages

A study from the University of North Carolina at Chapel Hill has been studying HIV-associated dementia (HAD), a common neurological disease that accompanies AIDS. In their study, they realized that many patients who have this disease have not one but two genetically different strains of HIV infecting their cerebrospinal fluid (only one strain was found circulating in the blood of these patients).
One of these types of HIV reproduces normally in T cells, like the virus in the blood, but the other was found to reproduce in macrophages, marking the first time that HIV has been observed replicating in anything besides a T cell.
Macrophages have a longer half-life than T cells, and so HIV infecting these cells last a lot longer in the body. But infected macrophages can be detected years before the onset of CNS-related disease, so this discovery may help in targeting and preventing HAD before it starts in many patients.

-Emily Mitchell

Sunday, October 9, 2011

DNA Avian Flu Vaccine Helps Make Universal Antibodies

In 2010, researchers at the Vaccine Research Center showed that in mice, ferrets, and monkeys, when a DNA primer vaccine for avian flu, H5N1, regimen was injected, the treatment elicited hemagglutin (HA) - directed antibodies. This is important because while influenza strains change seasonally, it is thought that the HA stem is relatively constant across many of the strains and a vaccine could be more universal if it was directed at this conserved head region of a protein. A few says ago Lancet Infectious Diseases published results from phase 1 clinical trails of the treatment in humans- with very similar results. Those who had the DNA vaccine primer were more protected against the virus, and some volunteers produced broadly neutralizing antibodies directed at the HA stem.

This is good news to those threatened by H5N1, for developing an effective vaccine with an inactivated virus. But while this is nothing definite, the larger picture of the study is actually very exciting. If we can create a vaccine like this DNA vaccine that spurs immune systems to produce antibodies for widely conserved proteins in the influenza virus strains, then we are one step closer to developing a longer lasting vaccine and protecting more people for longer.


-Emily Pollock

Depo-Provera Is Said to Increase the Risk of HIV Transmission

A recent prospective cohort study published in the Lancet Infectious Diseases found a correlation between forms of hormonal contraceptives and the risk of HIV contraction and transmission. The longitudinal study was composed of 3,800 heterosexual couples in which one of the members was HIV-positive and was positive for the herpes simplex virus type 2. The couples were monitored for rates of HIV transmission and acquisition (in respect to the female member of the couple) from 2004 to 2010. In this time, they found that women who were initially HIV-negative and were taking either birth control pills or the Depo-Provera shots had a probability of contracting HIV from their HIV-positive partners that was two-fold higher than HIV-negative women that were not taking birth control or were taking a different form of birth control. Similarly, women who were initially HIV-positive and were on the birth control pill or Depo-Provera shot were twice as likely to transmit the viral infection to their HIV-negative partner. Furthermore, when the women who were HIV positive and were taking the Depo-Provera shots had significantly higher levels of the virus in their genital tract but normal levels of the virus in their blood.

Even though further studies need to examine the correlation of certain hormonal contraceptives, specifically Depo-Provera, and rates of HIV-transmission and acquisition in order to take definitive action, I believe that women who are at high-risk of contracting the virus should be properly counseled on this study’s findings and the need for protection. The World Health Organization has recently released a similar statement, saying that, “We want to make sure that we warn when there is a real need to warn, but at the same time we don’t want to come up with a hasty judgment that would have far-reaching, severe consequences for the sexual and reproductive health of women… This is a very difficult dilemma.” WHO will convene in January in order to review this study’s findings (as well as others) to recommend action that should be taken concerning the use of Depo-Provera in regions characterized by a high-risk of HIV transmissions.

-Angie Ceseña

AIDS Beacon-


How Far Do We Go to Protect Ourselves From disease? (from ProMed)

A resident of Massachusetts has been confirmed as infected with Eastern Equine Encephalitis (EEE) somewhere in Raynham, Missouri. The woman spent an extended period in Missouri. The disease is a vector-borne disease that is transmitted via mosquitos. This causes concern, especially since about a month ago on September 5th, a major political member of Raynham passed away from EEE as well. The newly infected woman is thankfully alive and recovering, but this pushes the need for anti-mosquito spraying in Missouri. Politically, this has been a divisive issue, and the Raynham selectman vows to improve spraying.

I find this to be a really interesting, as it is an intersection of multiple routes of health. For instance, extended spraying against mosquitos could protect individuals from acquiring EEE, but it could also decrease the quality of food and crops grown. It truly is the intersection of the human world, the virus world, and the evolution of both of those.

-Pooja Desai

Can Hormonal Contraception Increase Risk for HIV?

Interestingly, both of my posts thus far will have been about risk factors for HIV that most people might not immediately think about: male non-circumcision (see last week), and now hormonal contraception? A study was just published by University of Washington researchers that explored a correlation between the use of female hormonal contraception among heterosexual couples, and the incidence of HIV transmission from one partner to the other.

The study followed 3800 heterosexual couples throughout Botswana, Kenya, Rwanda, South Africa, Tanzania, Uganda, and Zambia. Among each couple, either the man or the woman was already diagnosed as HIV-positive at the start of the study. Researchers measured the number of couples who after 2 years had both members test as HIV-positive, and their corresponding (self-reported) contraceptive use. Condom use was found to be roughly equivalent for both groups of couples (those using hormonal contraceptives and those not). The study found that for couples that used a popular injectable hormonal contraceptive, the rate of transmission to the uninfected partner almost doubled.

WHO (the World Health Organization) will be discussing the issue at a meeting in January, and reevaluating current clinical recommendations on contraceptive use - whether they should be advising female patients more about HIV risk when they prescribe contraceptives.

Personally, I find this study to simply reinforce the importance of condoms. While hormonal contraceptives provide an important tool to help lower unwanted pregnancies, condoms act as a 2-1 barrier against both pregnancy and infection. Most of the confounds I could think of for this study were already controlled for: that women on hormonal contraceptives were not having sex with more partners (because the study only looked at couples), and the fact that condom usage was not more prevalent among couples without hormonal contraception (which would have accounted for their lower rates of HIV transmission). I'm hoping that this will spark research into the field to perhaps look for a biological/chemical mechanism behind the correlation. In the meantime: condoms, condoms, condoms.

Could HIV ever be reduced to a "minor" infection?

As Michelle's post indicated last week, there has been a lot of debate concerning the new HIV vaccine that is currently being developed by Spanish scientists at the National Biotech Centre in Madrid. According to an article that appeared in "The Telegraph" about two weeks ago, researchers working on this vaccine, the MVA-B, claim that HIV could be reduced to a minor chronic infection comparable to Herpes if the vaccine proves to be successful in future clinical trials. Problem is, could we risk testing this new product on many more healthy individuals to prove its efficacy?
Let's look at its composition:
MVA stands for Modified Vaccinia Ankara virus, a very attenuated strain of the vaccinia virus, engineered to function as a vaccine delivery system for antigens and previously used to treat, and eventually eradicate, smallpox. The MVA-B, a variation of MVA, has been designed to work against the most common subtype of HIV in Europe, indicated by the letter "B". Its composition differs from the original MVA strand by 4 extra HIV genes, called Gag, Pol, Nef and Env, inserted into MVA's genetic sequence. These genes are able to stimulate B and T lymphocytes, and lack the ability to self-replicate, which makes them rather safe candidates for this type of vaccine. Could this be sufficient proof for their safety?
In addition, this study led by Professor M. Esteban showed that over three-quarters of the 24 treated volunteers had developed HIV-specific antibodies 48th weeks after vaccination. 38.5% of these participants also demonstrated the production of lymphocytes T CD4+ (a type of T helper cell that fights HIV), while 69.2% had produced the T cell receptor CD8+ in comparison with a total of 0% in the control group.
While the robust results of this small-scale study illustrate the potential success of a world-changing solution, they do not tell us anything about the therapeutic aspect of the vaccine. How will the four genes act in the immune system of a patient already infected with HIV?
The need for many more clinical trials (preferably large-scale!) in the future is evident. What is more unclear, however, is whether more participants will be willing to take part in testing a vaccine that may not even hit the production phase.
For more information, here is a very detailed Science Daily Article with more recent results (6th October 2011): MVA-B Spanish HIV Vaccine Shows 90 Percent Immune Response in Humans

- Julie Saffarian

Thursday, October 6, 2011

In New York, 9 cases of West Nile virus infections, including one virus-related fatality, were reported. Queens and Staten Island had the most number of mosquito pools, 88 and 51, respectively. The Department of Health is spraying down the mosquito pools in effort of reducing spread. The mosquitoes that carry the virus are most active during the months August through October and the virus is believed to affect older people and immuno-compromised people the most. Health officials believe that the mosquitoes were brought into the United States by international flights. They suggest people use insect repellents and protective clothing when going outside.

I think this article is very interesting because it is an example of what we learned in class of how the immuno-compromised population is especially susceptible to infection. The article didn't mention the timeline of mosquito pool spraying or the amount of funding and manpower the state dedicates to it, but I'm curious to know how seriously NY is taking the presence of West Nile Virus. Also, I would like to read more about how the mosquitoes were brought into the United States, where it came from, and if this strain of WN virus is similar or different from its parent strain.

-Michelle Jin

Wednesday, October 5, 2011

Rotavirus Roll-Out: GAVI's New Program in Africa.

The second biggest killer of childhood illnesses is diarrhoeal diseases, coming close after respiratory illnesses. Around 40% of these diarrhoeal diseases are caused by rotaviruses. So therefore it makes sense that the Global Alliance for Vaccines and Immunization has commenced a roll-out of the virus throughout Africa (where around half of the deaths from rotavirus occur). The roll-out involves immunizing 50 million children in the top 40 poorest countries in the world in an attempt to diminish the high child mortality rate.

Although rotavirus infections are common globally, they are particularly deadly to those living in poorer countries due to insufficient medical care and inability to get the child on a rehydration regiment in time. The new Rotavirus Vaccine protects against multiple, fast mutating strains of rotavirus alleviating the need for many different reformulations and boosters.

This effort follows the December 2010 pneumococcus vaccine effort, and now has been expanded to 19/37 developing countries. GAVI's new programs now target the two largest killers of children worldwide and will hopefully reduce the high mortality rates of these diseases in developing countries.

Read the full article here.

-Victoria Anikst

Tuesday, October 4, 2011

West Nile Deaths in CA

The first deaths this year in the US from West Nile were reported yesterday in Kern County, CA. So far this year, CA has had 88 cases. Last year, we had 6 deaths out of 111 cases.

Two men, ages 86 and 37, died from WNV infections in their brain tissue, known as West Nile encephalitis/meningitis. Normally West Nile is asymptomatic or takes a milder, fever-like form in people with healthy immune system, but these two men had other chronic health problems that left them susceptible.

WNV is a flavivirus that naturally resides in birds and is transferred by mosquito bites. It arrived in the US in 1999, supposedly from birds at the Bronx Zoo, and has since spread all across the US and to our neighboring countries. WNV reminds me of how scary some viruses can be: they're hiding invisibly in so many unavoidable things like food, friends, air, and mosquitos. We can only hope that our body can handle whatever gets inside of us, which it does grandly most of the time.

It's also pretty amazing that WNV can be deadly in birds, horses, and humans, so being the molecular biologist I am, I looked up its cellular "tropotope". It's still unknown, but possible suspects include well-conserved receptors such as Toll-like receptor 3, usually used to recognize and combat infection by dsRNA viruses, and Integrin, used to secure the cell to the extracellular matrix.

Article and the more interesting PubMed page on WNV.

-Annelise Mah

Human Papillomavirus and Rising Oropharyngeal Cancer Incidence in the United States

Even as osopharyngeal cancer rates due to smoking are declining, the incidence of HPV-related cancer is on the rise.

For your reading pleasure (full text also available):

Human Papillomavirus and Rising Oropharyngeal Cancer Incidence in the United States


Monday, October 3, 2011

Circumcision as HIV Prevention in Africa

While a vaccine against HIV is being hotly researched in the United States and other scientifically advanced countries, a major source of HIV prevention in Africa could be as simple as wider implementation of male circumcision. The foreskin is more likely to harbor the HIV virus and transmit it to the bloodstream than is the rest of the penis; currently, circumcisions in Africa have been cited to be 60% effective as a vaccine in men. Because sexual activity is acknowledged as a leading factor in HIV transmission, circumcision has the potential to act as a major preventative barrier amongst a new population of uncircumcised African males.

Given that this procedure has a minimal ground cost, and a high relative effectiveness, it is somewhat surprising that it has yet to be implemented among many African countries. Currently, only 3% of the African sexually active male population is recorded as being circumcised. Leading authorities - including such leaders as the World Health Organization, and the Bill and Melinda Gates Foundation - hope to implement a new program that would have as a goal circumcision of 80% of the 15-49 yr old male population among 14 African countries. Right now, major barriers lie among lack of support from local governments, often due to cultural misconceptions - also, the dilemma that in some areas only physicians (rather than nurses or other medical professionals) would be considered adequately trained enough to perform the procedure.

Right now, as so often seems to be the case, the major solution seems to be education: education of the population regarding the benefits of circumcision, education of medical officials as to the procedure itself, and the recurring education of safe sex practices. Another promising approach is the implementation of new plastic rings (the Shang Ring and PrePex) which, when attached around the foreskin of the penis for a week, cuts off its blood supply and therefore allows for its removal sans suture. The promise of a circumcision that wouldn't require anesthesia is a more appealing option to many sexual active African men, and is therefore expected to increase circumcision rates. Hopefully, this combination of both new and old practice will help to definitely decrease the rate of HIV overall in Africa.

- Elena Higuchi

Sunday, October 2, 2011

Revolutionary Exams

Liver damage is a potential side effect of virtually any medication that is metabolized by the liver. The risk of acquiring this damage is even greater in patients that are required to take cocktails of drugs- one prime example being HIV positive patients. These high-risk populations should be closely monitored for liver damage in order to avoid death as a result of liver failure. AIDS patients in Africa, however, are 12 times more likely to die from liver failure than their American counterparts largely due to a lack of proper resources needed for diagnosis. This may soon change.

A new diagnosis test created by a Harvard professor, Dr. Whiteside, has the potential to diagnose liver damage for less than a penny. This device is smaller than a postage stamp and is composed of a sheet of paper, wax, and reagents that are used to measure the level of aspartate aminotransferase (AST) in a patient’s blood. With a single drop of blood placed into the center of the layered paper, the plasma is filtered through a porous membrane allowing it to seep into the second layer. At this stage, the plasma comes in contact with two chemicals. If AST is present in the plasma, it will bind to these two chemicals and sulfite ions will be released. These sulfites trigger a chemical reaction with the blue methyl dye on the last layer of the diagnostic test that turns the dye colorless. Since this layer contains a pink background, the blue dye forms an initial purple spot on the sheet. If, however, the sulfites cause the dye to undergo the chemical reaction, the spot will be light pink by the end, signifying high levels of AST in the blood, which indicate liver damage.

This new form of diagnostic testing can have drastic effects in international health care. The low cost and feasible manufacturing of the exams can potentially lead to an increase in diagnosis a decrease in death attributed to liver failure. Not to mention, antibodies can potentially replace the two chemicals in the second layer in order to diagnose viral infections.

Original Article:

-Angela Ceseña

One scientist works on a product that costs cents but has the potential to save millions!

In Boston Dr Whiteside of Harvard University has created a postage stamp sized diagnostic test for liver damage. Instead of the usual method of creating a diagnostic lab in miniature with small instruments, test tubes, and the like that fits into a small case and can be used in remote locations, Dr. Whiteside's lab is putting aside the glass and aluminum and settling instead for paper.

His laboratory devised a model which uses paper etched with tiny channels "mined with proteins and chemically-triggered dyes proteins”. All of this fits within a square of paper about the size of a postage stamp. To use the diagnostic tool, only a drop of blood needs to be placed on the square and as it runs through the channels the dyes respond to enzymes in the blood and light up different colors. Based on the colors, the health care provider can determine if liver damage is occurring or not.

The great thing about such a test is that, while it cost a great deal to create a working prototype, mass producing a small paper model is particularly cheap. Patients who suffer from AIDs and tuberculosis (in combination) take high doses of powerful drug cocktails run a high risk of liver damage and failure which can be even more deadly than the diseases they are trying to control. This makes it imperative to test on a regular basis to see how the drugs are affecting the organ. However, regular testing is far too expensive for many patients.

Dr. Whiteside's test has the ability to revolutionize the way people are being treated for HIV with tuberculosis. If it could really be made for fifty cents, that could be affordable even for impoverished populations which could be a wonderful tool for trying to reduce liver failure associated with treatment of these combined illnesses.

The original article is at:

-Elena Jordan

Chicken Culling in India in an Effort to Slow the Spread of Avian Influenza

A mutant strain of H5N1 Avian Influenza has been spreading through parts of Asia including China and Viet Nam and India, causing Indian authorities to commence the culling of all poultry, feeding material, and eggs. Places like West Bengal, which are prone to virulent outbreaks of bird flu, have stepped up surveillance, even considering stopping the movement of all poultry. It is not entirely clear that the outbreaks in China and Viet Nam are related to the outbreak in India.

This recent outbreak in Asia is of particular concern, due to its mutation and the lack of any vaccine against this particular strain. The UN Food and Agricultural Association has warned of the outbreak moving beyond the continent. H5N1 Avian Influenza is relatively virulent, and the high rates of exposure between people and poultry in villages in East India could mean major danger for humans not just in the area, but far beyond the country's borders.

In 2006, a major outbreak of bird flu occurred in India, and since then multiple mini-outbreaks have resurfaced.,F2400_P1001_PUB_MAIL_ID:1000,90356

-Pooja Desai

Smallpox Stocks: Keep or Kill?

As we examined the complex, brick-shaped structure of the Smallpox virus in class, and observed a photo of a Somalian man known as one of the last natural cases of this infectious disease, the recent controversy over keeping the last stocks of the Variola virus came up to my mind. About four months ago, on May 24th, the World Health Organization announced that it will defer any decisions regarding the destruction or maintenance of the two last stocks of the virus to 2014, mainly due to an opposition lead by Iran.
These two stocks, located in the US Centers for Disease Control and Prevention in Atlanta, Georgia, and the Russian State Research Center of Virology and Biotechnology in Kosovo, are "believed" to be the last existing sources of the virus since its successful eradication in 1980. The word "believed" here is especially important: It is still unclear to many whether all the forgotten stocks and collections of the Variola virus were completely destroyed after the World Health Organization (WHO) requested of all nations to do so in 1980. Additionally, as the US secretary of health Kathleen Sebelius fears in her article "Why We Still Need Smallpox", it is evident that any geneticist with cruel intentions and incredible resources could recreate the virus, since its full sequenced genomic information are now available online. All these questions remain unanswered.
The article below, by BBC News, offers great insight into this controversial yet significant issue. Should the stocks be kept for more research, the generation of newer vaccines in case of an accidental outbreak, or simply for preventing the extinction of a species? If all the genomic characteristics of the virus are known, and if it would be completely possible to perform research without the stocks, then is there really a solid reason for keeping them?
I guess we would have to wait until 2014 for further clarification.

Should the US and Russia destroy their Smallpox stocks?, BBC News Health, 16 May 2011

Why We Still Need Smallpox, US secretary of health Kathleen Sebelius, 25th April 2011

Smallpox Decision Deferred Again, article posted exactly a month after the one above as a response to the WHO's decision, BBC News Health, 24th May 2011

- Julie Saffarian

2 million infants and young children may not be fully protected against preventable diseases

A recent online survey revealed that more than 1 in 10 parents do not vaccinate their children according to the vaccine schedule advised by the U.S. government. The reasons cited indicated general mistrust of the government because of safety concerns circulating through erroneous online and media reports about the vaccines.

This puts close to estimated 2 million toddlers and infants at risk for deadly and disabling diseases. A larger federal survey showed that 1 in 10 toddlers and preschoolers delayed or did not have important vaccines like those for chickenpox and MMR.

Not only does this have repercussions today this various outbreaks of easily preventable diseases like mumps and measles among the general population but means that more and more people (including the misinformed parents) are not getting the vaccinations they need and therefore are themselves not protected against typically vaccine-preventable diseases.

Altogether, this survey puts the spotlight on the CDC, American Academy of Pediatics and American Academy of Family Physicians to re-evaluate their vaccine information communication to the general public and their patients. They ultimately need to revise their strategy and focuse on directing parents to valid sources in order for the parents to become fully informed before making decisions about their child's health.

-Victoria Anikst

Targeting Cholesterol to Prevent Negative Effects of HIV

Past research has indicated that white blood cells with lower-than-normal levels of cholesterol are unable to be infected by HIV. Knowing that the protective coat that surrounds an HIV virion also happens to contain cholesterol, a team at Johns Hopkins decided to explore the inverse of what was previously known: they wanted to see if altering the amount of cholesterol in an HIV virion would then prevent it from being able to infect host cells.

Normally, HIV infections produce an overwhelming immune response that leads to system shut down. HIV cells with altered levels of cholesteral initiated a normal immune response, however, allowing the immune system to more effectively detect and combat HIV.

This discovery probably can’t provide much in terms of a solution for people whose immune systems are already dealing with the effects of HIV, but, as the article concludes, it could help people who are newly infected with HIV better detect and successfully fight the virus before it wreaks havoc on their immune system. Three cheers for prevention efforts.

-Emily Mitchell