Saturday, March 24, 2012

another flu post

This pathogenic flu thing is still all over the news, even after all of winter quarter has come and gone. This article expresses the author's desire for either the NIH or the WHO to come out with a clear statement concerning the safety surrounding publishing potentially dangerous scientific articles, as well as rules concerning what is acceptable to publish and what is not. All of the articles I've read on this topic express the sentiment that everyone knows this is a potentially extremely dangerous and important question, the right to publish research that might be dangerous, and everyone seems to want someone to be in charge of the situation and make a statement, but that role has not been filled satisfactorily (says the author of this article). The WHO did decide that the flu articles in question should be published in full, but that hardly addresses the full scope of the issue.


The danger of amateur biologists

This interesting article from the New York Times ponders the threats that amateur biologists might pose to public health. With the falling costs of biotech and lab equipment, and the possibilities of outsourcing DNA synthesis and other processes to companies who don't pass judgment on the safety of various sequences, someone in a garage lab could theoretically produce a more pathogenic flu strain, says this article. There exist such things as "community biotech labs," which seems like a bad idea unless there is a very stringent safety and security protocol in place. Trained virologists/biologists who read the papers about the most recent flu pathognization uproar could make pathogenic flu viruses several different ways on their own.

The main point of this article is that 1) it's worryingly easy to make dangerous biological agents, whether on purpose or accidentally, to those who have access to the right technology and 2) we really need a flu vaccine that works for all flu strains.

--Sarah Kaewert

Breakthroughs in Ebola and Marburg treatment

It looks as though there are several new promising treatments for Ebola and Marburg viruses. Apparently the leukemia medications
Gleevec and Tasigna prevented the virus from replicating in a colony of kidney cells in the lab. Also, antibodies to the viruses taken from monkeys can keep other monkeys from getting seriously sick if administered within two days of exposure. Finally, multiple doses of siRNA have prevented monkeys from dying of the viruses as well.

All of these treatments are promising in terms of immediate applications and future research, though the article mentions that the (thankfully) rare nature of these diseases means that testing them in real situations will be difficult.

--Sarah Kaewert

Dengue Lipid Manipulation May Be a Target for Inhibition

Research published in PLoS has indicated that the synthesis of new virions in a cell infected by dengue virus depends on specific manipulations of cellular lipids in order to create proper structures for viral assembly and prevent an immune system response to the infection. This is of unique interest because, as we've seen in class, any process uniquely performed by a virus that is critical for replication is a potential target for treatment since it differentiates infected cell processes from normal cell processes so that a chemical agent will inhibit the virus while ignoring regular cells.

Researchers primarily at Purdue University used hihg-resolution mass spectroscopy to probe the 'lipidome', the full array of all unique lipid components, of healthy cells in comparison to those infected by dengue. They found that the infected cells contained ratios of lipid classes that were distinctly different from those of normal cells. Further research indicated that several signaling pathways were manipulated in order to effect this change. Not only does this research improve our basic molecular biology understanding of dengue, but it also has implications for potential treatment. Because much of the lipid synthesis used in dengue's manipulation is a result of the enzyme fatty acid synthase, inhibitors of this enzyme have already been shown to reduce viral replication. It may be too early to say for sure, but this could represent a new way of developing anti-viral medication specifically for dengue.

-Zachary Herrera

The Paper:
The Article:

Wednesday, March 21, 2012

Marijuana and HIV treatment

A study by the Mount Sinai School of Medicine showed that a Marijuana-like chemical trigger a cellular receptor to inhibit HIV in late stage AIDS. The receptor is called cannabinoid receptor CB1 an CB2. This is possibly the first study that shows the biological mechanism of how medical marijuana works. This discovery is very exciting because it proposes new targets for HIV drugs. CB1 is associated with the "high" of taking marijuana, so research focus should be on CB2. Study found that treating HIV-infected cells with CB2 agonists reduced infection.

I think this article is super cool because in addition to targeting different steps of the HIV life cycle, there is the possibility of new drug target. I'm excited to see how this turns out!


Wednesday, March 14, 2012

Less HPV Screening Recommended

Based on data from the past 30 years, the United States Preventitive Agency has released new guidelines recommending pap smears to occur no more than every three years. The data indicate that no significantly greater amount of cervical cancer cases were discovered by pap smears, as explained by the American College of Obstetricians and Gynecologists. One reason for the recommendations was the reducing the number of false-positives, and therefore preventing unnecessary painful biopsies and pregnancy difficulties.

Many have accused the task force of altering their recommendations based on the cost of the tests, but they insist that this is not the case.

The relevant part of this is also the recommendation to avoid testing women under the age of 30 for Human Papilloma Virus (HPV). They say that even though women under 30 can get HPV, they can almost all clear the virus from the body themselves and need no treatment. It will not affect the rates of diagnosis, since so many positives are currently false positives.


Monday, March 12, 2012

Tracing Rabies in Europe

This article provides an exemplary account for en epidimiological tracing. While this is particularly about a rabies case in the Netherlands, this process and study can and should be applied to any sort of epidimiological investigation.

At the end of January, a rabid dog was imported from Morocco to the Netherlands. The puppy was acquired by a Dutch couple, who give an account for the progressive behavior change in the puppy. On February 14th, they contacted their local veterinary agency, explaining that they had both been bitten by the dog. A few days later, the puppy's behavior became uncontrollable, and it was euthanized by officials. Post-exposure prophylaxis was arranged for both of them, and all 43 contacts were informed and categorized into degree of exposure.

Why did this puppy manage to get imported, adopted, given a pet passport, etc. without any single person checking its rabies status? Illegal animal imports and bad veterinary practices continue to be the major cause for rabies showing up in Europe, where it is a common practice to adopt animals.


Clinical Trials for Dengue Vaccine

Another Dengue vaccine is about to move from monkeys to humans! The vaccine, developed by the Genetic Engineering and Biotechnology Center in Cuba (Centro de Ingeniería Genética y Biotecnología) and the Pasteur Institute, acts on all four serotypes. Clinical trials will begin later this year. Interestingly, the drive for a dengue vaccine in Cuba was lead by Fidel Castro after the 1981 outbreak that killed hundreds.

There are also at least five other vaccines in the pipeline, all of them tetravalent for reasons we all know. There's one by Sanofi Pasteur, GlaxoSmithKlein, the NIH, Inviragen (CDC), and Merck. The Sanofi Pasteur vaccine is probably entering Phase III trials and can possibly be licensed as early as 2015; the others are entering Phase I or II. There are live attenuated chimeric and genetically modified vaccines, purified subunit vaccines, vaccina-recombinant vaccines, and even DNA vaccines. Reference.

Let's hope at least one of them can make it out and become a much-needed, internationally useful vaccine.


Prospects of HIV - treatment, prevention, challenges

One of the greatest hindrances in HIV treatment is the fact that these viruses remain in latent stages, making them hard to target by drugs. At the Conference on Retroviruses and Opportunistic Infections, Dr. De Cock (director of the Center for Global Health at the CDC) stated the necessity of drugs to trigger viruses to come out of their latent state in order for treatments to be effective in killing the virus.
The article also talked about the difficulty of developing a HIV vaccine. In order for a vaccine to be effective, the body must recognize aspects of the vaccine and mount an immune system stimulating production of memory lymphocytes that would recognize the wild type virus. However, HIV is integrated into the host genome and avoid antibody response.
A new drug developed by Merck, Zolinza (vorinostat) can disrupt latent HIV infection and may aid in HIV treatment. However, it seems like we are far from curing HIV since only one provirus is needed to maintain infection.
I'm most interested in the development of HIV vaccine - it seems like the largest road block in developing a vaccine is the integration feature of HIV. If we use a integrase inhibitor in combination with vaccine, would that make the vaccine more effective? Wonder if anyone experimented with the use of prophylactic integrase inhibitor.

-Michelle Jin

Sunday, March 11, 2012

AIDS Drug Re-Evaluation

In April of 2011, an AIDS drug- Truvada- was pulled from clinical trials after several African women participants were getting infected with the virus. These participants were in relationships where their male partners were infected with the virus.

This week, however, scientists at the Conference on Retroviruses and Opportunistic Infections showed that the results may not have come from a lack of efficacy on the drug's part. Blood samples taken from the participants revealed that only one in four women who had gotten infected during the trials had any trace of Truvada in their blood- suggesting the pills were never taken. This new information leaves researcher and physicians alike with conflicting feelings- on one hand, the use of pre-exposure prophylaxis may decrease one's probability of viral infectivity, on the other, even if the stated case is true, behavioral choices may prevent these forms of preventative care from working. The behavioral choices may be influenced by social norms and stigmas- the presence of AIDS medication in several African regions (as well as regions worldwide) have negative stigma associated with them.

In the United States, incidence rates have plateaued at approximately 50,000 annual cases with a good portion of these cases being identified as black women from lower socio-economic statuses. New efforts have been implemented aimed at proper screening and diagnostics for "at-risk" groups including the Center for Disease Control's new "Take Charge. Take the Test." initiative.

-Angela Ceseña


HIV among Black Women

At a recent conference on retroviruses, Dr. Hodder presented a study on the prevalence of HIV among American black women. In "HPTN 064 Women's HIV Seroincidence Study (ISIS)", it was found that among a study of 2,099 adult females (88% of whom were African-American), 0.24% of participants were HIV positive; this rate is 5 times higher than the rate predicted by the CDC for the general population of African-American women.

This study is getting a high amount of press because this infection rate is comparable to developing countries known for their burgeoning HIV rate - for instance, Congo at 0.28% and Kenya at 0.53% HIV-positivity.

Although the study focused on areas known to have high HIV rates and prevalent poverty, this is still a very concerning statistic for even a subpopulation. On the whole, 66% of new HIV infections among women in the US occur among African-American women, while only 14% of US women are actually African-American. This disparity is alarming and begs to be addressed by behavioral interventions. Hopefully the attention of the HIV-aware community can be directed toward black women just as intensely as it has been directed toward homosexual men in the past.


- Elena Higuchi

Boceprevir approved for use by Britain's state health service.

Merck’s new hepatitis C drug, Boceprevir (Victrelis) has won recommendation for use in Britain’s state health service. It was widely discussed especially because the drug is especially expensive. This an important drug because unlike previous INV +Ribavirin combination therapy, Boceprevir can be used in the treatment of hepatitis due to HCV genotype 1, the most common form of hepatitis C. It will be used in combination with Pegylated Interferon and Ribavirin for genotype 1 hepatitis C.

Boceprevir is an NS3/4A protease inhibitor. This drug stops viral replication by binding to a protease that would work to cleave the polyprotein. Thus this drug prevents the production of functional viral protein. Pegylated interferons are used to moderate the immune system. Ribivirin is a nucleoside analog and when given with IFN, it can reduce viral replication.

Original Article from Reuters:

More info on HCV Medications:

--Elena Jordan

Monday, March 5, 2012

Potential for Long-Term Flu Vaccination

Princeton University researchers have recently developed what could be a "universal" vaccine protecting against all influenza strains. The vaccine is designed to target the relatively unchanging parts of the virus and hamper its ability to evolve rapidly. Currently, flu vaccines target the virus' most adaptable parts.

So far, the researchers have only been able to demonstrate success on a computational model, given that no humans have received their designed vaccines. James Lloyd Smith from UCLA says, "This is the first study that looks at the population consequences of the next generation of vaccines, both in terms of epidemiological impact and evolutionary impact on the virus."

Current flu vaccine focuses on the hemagglutinin proteins protruding on the cell surface. Small mutations in this area are the cause of the rapidly evolving virus family. The universal vaccine, however, ignores the hemagglutinin area, and target more commonly conserved proteins.


Leukemia drugs can treat ebola

Ebola is known for its terrifyingly rapid and unstoppable death. But at the National Institute of Allergy and Infectious Diseases, Mayra Garcia's lab has shown that two leukemia drugs, notlitinib and imatinib, can slow the progression of the virus. It does this by stopping the function of the oncogene Abl (a tyrosine kinase), which is necessary for viral budding through the activity of the matrix protein VP40.

This is a really weird overlap of two very different fields! And very cool! The drug can stop rapidly replicating cells and rapidly replicating viruses, though the mechanism is somewhat different. I wonder why viral budding needs Abl? The research hasn't left cell plates yet, but it sounds promising to me. The drugs are kind of toxic, but nothing beats the toxicity of ebola... Anyhow, Its a good reminder to learn everything we can about viral processes, because apparently we can use drugs we've already developed to stop them!



Sunday, March 4, 2012

HIV Infection Rate Down Amongst IV Drug Users In United States

Felt this was relevant considering we've talked a lot about HIV testing and infection rates during class and in the pset.

The CDC announced the results of a survey conducted in 2009 among 10,000 individuals from major urban areas that concluded that the rate of HIV infection among intravenous drug users (IDUs) fell from 18 to 9 percent as compared to 1990s. While this appears to be solid progress in the fight against HIV, the CDC cautions that the report also indicates several negative signs as well. The study shows a significant decline in testing rates(to 49%) and knowledge of one's seropositive status( half of those infected didn't know they were infected) and a large rate of high-risk behaviors such as needle-sharing(1/3 participated), unprotected sex(the majority), and multiple sex partners.

This study comes at an interesting time in our class since it's implications forces us to think about the complexities of epidemiology, especially with such a life-long infection and in these high-risk populations. Does this report mark a step forward due to the fall in prevalence, or a lack of gain/step back due to the decrease in testing and the perpetuation of high-risk behaviors that guarantee high incidence?

-Zachary Herrera

New influenza in bats

A new strain of influenza A virus was identified in 316 yellow-shouldered bats. It's the first time that an influenza virus was found in bats. Given the history of bat-origin emerging infectious diseases, the possibilities of this virus crossing over to humans is frightening. However, authorities believe that it's not transmissible to humans. The yellow-shouldered bats in which the virus is identified in do not bite humans, feed on fruits, and is native to Central and South America.

Reading this article reminded me of the beginning of a new "Contagiou-like" movie. Because the short time since the identification of this virus hasn't permitted a comprehensive study to be done on the transmissbility potential of the virus, I am skeptical in the authorities' claim that the virus would not transmit to humans. Only time will tell!

Michelle Jin


The latest update on the genetically modified H5N1 virus was released a few days ago with the original research team claiming that the virus was not as contagious or as infectious as the media portrayed it- new data has prompted for a re-evaluation of the government's recommendation to not reveal specific steps involved in the project.

These new recommendations were submitted to the National Science Advisory Board for Biosecurity, which will convene in March. The head of the National Institute for Allergy and Infectious Diseases, Dr Anthony Fauci stated that " THere is a gross, pervasive misunderstanding out there," and the danger of this genetically modified virus may have been overstated.

Dr. Fouchier, the head of the research team that undertook this modification, was able to reveal a few of the research's results this past week at a convention for the American Society for Microbiology. Dr. Fouchier stated that the mutated H5N1 virus was not as lethal as the media claimed- not all of the healthy ferrets that were exposed to the virus contracted the infection, and those that did become infected did not necessarily show symptoms or die. In addition to this, the healthy ferrets that had been exposed to the seasonal flu prior to the H5N1 infection gained immunity to the mutated H5N1 virus.

Genetically modified flu viruses are a definite threat to public health if used as a bioterrorist weapon.

The National Science Advisory Board for Biosecurity re-evaluation will be covered here in the upcoming weeks. Stay tuned :)

-Angela Cesena


Chikungunya in the US?

The Pan American Health Organization (PAHO) recently issued a warning that the Americas may be at risk for Chikungunya virus. According to the CDC, the virus is currently responsible for a number of pandemics in Africa and Asia - and recently, in parts of southern Europe. From 2006 to 2010, there have been 106 cases of registered chikungunya virus in the US from travelers returning from pandemic areas.

Clinically, chikungunya is most often characterized by a fever, headache, fatigue, nausea, vomiting, muscle pain, rash and joint pain (the last of which can be sustained for weeks or months). It is an arbovirus transmitted through the species Aedes aegypti and Aedes albopictus. Travelers carrying chikungunya have been quickly quarantined by US health authorities, but PAHO is concerned that the infected mosquitoes themselves may soon begin to spread the virus to the entire Western Hemisphere.

This story stood out to me because so many people are currently concerned about influenza and smallpox - specifically, viruses that can be scientifically engineered to be more lethal. It is often forgotten that there are a number of viruses and diseases endemic in developing countries that US health officials take wide precautions to protect us against. Hopefully people continue to remember that they should be giving their full-fledged support to infectious disease prevention. It's much easier to keep chikungunya out of the US than it would ever be to eliminate it once present.


CDC on Chikungunya:

- Elena Higuchi

Saturday, March 3, 2012

Foreign Nationals to Begin Getting Free HIV Treatment Under Britain’s NHS

Foreign nationals are about to begin getting treatment for HIV through the NHS in the UK, people who would usually not be covered under NHS. This, campaigners say, is a step in the right direction to reduce the risk of HIV transmission for all British residents.

Estimates say up to 25,000 people are currently undiagnosed and living with HIV in Britain and many were born abroad (the group includes failed asylum seekers, students, and tourists). However, if these people are HIV+ they could potentially spread the disease to UK citizens.

The proposed bill extends free treatment to people who have been living in Britain for 6 or more months. As we learned in class, treating people with HIV can drop the blood virus titers low enough that they are a lot less likely to pass on the infection to others.

According to the public health minister Anne Milton, “This measure will protect the public and brings HIV treatment in to line with all other infectious diseases. Treating people with HIV means they are very unlikely to pass the infection on to others.”

There is also a financial argument for the NHS to treat all HIV+ people. That is that it is a lot cheaper to treat HIV early than to treat someone who comes into the hospital with a very serious and complex condition.

From what we’ve learned in class, I would say, on the part of the NHS, this is a very forward thinking bill that in the long run will help the population of th uK stay healthier!

Elena Jordan
The original article can be found on the BBC at:

Monday, February 27, 2012

Hepatitis C Death Rate Exceeds AIDS Rate

In the United States, the death rate from Hepatitis C is now greater than that of AIDS. The Centers for Disease + Control produced a recent report detailing how more than 3 million people are currently infected with Hepatitis C. The death rate of Hepatitis C is about 5 for every 100,000 now, despite rates being only 3 out of 100,000 about 10 years ago. During this same time frame, the HIV/AIDS death rate fell from 6/100,000 to 4/100,000.

Hepatitis C primarily infects people between the ages 45 to 64. The director of Viral Hepatitis at the C.D.C., Dr. John Ward, exclaimed how a treatment exists for Hepatitis C that is capable of clearing more than 70% of the viral load from the body, so the lack of education and awareness for the disease is clearly the major problem causing this increased death rate.

Using the H.I.V. death rate decline as a model, Ward hopes to apply a similar program in raising awareness for Hepatitis C.


Discovery of Hepatitis C vaccine

The University of Alberta has its very own Li Ka Shing center (like us!) where a potential Hepatitis C vaccine, developed from a single strain of the virus over a period of 10 years, by researcher and chairman Michael Houghton, has shown to be effective against all known strains of the virus. The main challenge in the development of the vaccine had to do with a particular feature of HCV, whose very high level of virulence made it very difficult to come up with a vaccine that could neutralize all the different strains effectively. The vaccine that has been developed by Houghton and his coworkers is capable of generating broad cross-neutralising antibodies against all the different major strains, which is very good news for all the areas where HCV is prevalent.
Nevertheless, there remain a few critical but unanswered questions regarding this vaccine: Did the recipients actually produce antibodies that could neutralize the actual infectious virus? If they could, how broad was the neutralizing response?
Further experiments performed with this newly developed vaccines are needed to not only answer these questions but also ensure of its efficacy against multiple HCV strains.
At the same time, at Oxford University, significant progress has been observed in the development of a vaccine that would have effective targeting ability - by targeting the "inner engine" of the HCV virus instead of the surface markers/proteins.

Looks like we're on the right track!

- Julie

Sunday, February 26, 2012

Koala retrovirus

That tree-climbing bundle of cute , the koala, is suffering from loss of habitat, urbanization, global climate change, and…Chlamydia? Not the human kind, but a different species that is transmitted during birth, mating, and fights and causes blindness, respiratory infections, and infertility. The Queensland population is especially devastated, with a little less than half the population disappearing from 2001 to 2008—why?

The answer is—koala retrovirus! The HIV-like virus is widespread in the area, and immunocompromises the koalas, leaving them open to severe Chlamydia infections. Researchers are looking for a vaccine to halt the decline of our furry friends, which would involve wild koala captures followed by vaccination and release.

It’s a bit surprising to me that we can produce effective vaccines against animal retroviruses but haven’t yet made an effective one against HIV. It may have something to do with different receptors or low viral loads, but I hope that each successful animal vaccine might bring us closer to a human one.



Indian Teen Mother Infected With HIV Through Blood Transfusion

This is a very sad story - we're all aware of the early HIV incidences that occurred in the 70s and 80s due to infected blood transfusions. Today, however, blood banks are required to screen all donations for a number of viruses, including HIV. Or at least, that is supposed to be the case - not so for Sheikh Hasina in Andhra Pradesh, India. Sheikh was tested for HIV and other communicable diseases during her pregnancy and immediately prior to C-section, and both turned up negative for HIV.

Following the birth, she was administered a blood transfusion (3 units) due to significant blood loss. Specifically, the blood was bought from a nearby Red Cross Society blood bank. Roughly 3 months later, Sheikh experienced a fever and vomiting; she was tested again and this time found to be HIV positive. At this time, both her husband and infant were similarly tested and found to be HIV negative.

Sheikh's complaints to local authorities led to a series of media reports and subsequent closure of the blood bank, accompanied by a formal investigation. Sadly, no follow-up care was provided for the mother, Sheikh. According to this article, she is terrified of breastfeeding her infant (viral titers have been found in breast milk, to varying degrees). Hopefully following this secondary wave of media response, people will reach out and provide her with some support.

This is obviously just such a backward occurrence, but will hopefully act as a cautionary tale to all blood banks, and those in developing nations in particular (where contamination can be more likely). The transmission of HIV is high enough that we really don't need it to be parenteral, as well...

- Elena Higuchi

Indian is polio-free!!

India is polio-free! WHO waited 2 years after the last case of polio in India before announcing the eradicaition of polio in India. India’s speed and efforts to eradicate polio was very impressive: in 1985, 150,000 cases of polio were reported and even as recent as 2009, 741 cases of cases were reported in India. Hindrances of polio eradication in India included its large population size, lack of universal immunization, high migrant community, poor sanitation, and resistnce to oral polio vaccine in many high-risk populations. The success of the eradication was dependent on collaboration between the government, religious eaders, pulic health officials, and increased immunization. The success of polio eradication in India has monumental implications of global public health efforts in removing polio in the natural environment worldwide.

-Michelle Jin


Lawsuits Related to Las Vegas Hepatitis C Outbreak Settled

Earlier this week, one more chapter of the extensive fallout of 2008’s infamous Las Vegas hepatitis C contamination fiasco, which was actually reported on this blog, came to a close. In case you don’t remember, the case involved one Dr. Dipak Desai who exposed possibly a hundred patients to bloodborne disease in his 3 endoscopic clinics by re-using propofol vials and encouraging their re-use as policy. Several patients who contracted hepatitis C have subsequently launched a massive lawsuit campaign against the clinics and the manufacturers and distributors of the drug, propofol.

In all of the cases against the 3 companies, the lawyers for the plaintiffs have argued that they implicitly encouraged the re-use of their medication by supplying propofol in bulk, 50 mL vials when they knew that endoscopic procedures performed by Dr. Desai usually take 10-20 mL. Through these practices, Teva and by association the distributors of propofol, Baxter and Mckeeson, sought to increase their profits while ignoring the ethical implications of what they were shipping and how it was being used. While the drug companies argue that they aren’t liable because nothing was defective in their product, which could have been used safely for different procedures, courts have disagreed and all 3 have lost a number of cases with verdicts in the hundreds of millions of dollars.

Realizing defeat, the three companies have decided to settle 41 of these cases for a currently undisclosed sum of money, though Teva alone has apparently set aside $285 million for settlements. This entire case raises some interesting questions, in particular “Who is to blame for this outbreak?” Clearly Dr. Desai and his colleagues performed the most flagrant ethical violations and blame rightfully belongs with them, but are the drug companies at fault for turning a blind eye, or is such irresponsible abuse unpredictable by a product manufacturer?

-Zachary Herrera
(Recent settlement –February 24, 2011)
(Sort-of recent article about Dr. Desai’s trial)

Food-borne Outbreaks in Ohio

When over thirty students and faculty fall ill and experience common symptoms in weeks time, it is appropriate to assume the pathogen responsible was transmitted either through fecal-oral or respiratory routes. In the case of Denison University's 36 students and 2 faculty, the culprit was transmitted through the former. Licking County Health Official, Joe Ebel, in a statement to a Columbus Dispatch representative declared the importance of sanitary precautions- “hand washing, using hand sanitizers, staying home when sick, cleaning and sanitizing surfaces, and not preparing food when sick can help reduce your risk of acquiring or spreading norovirus.”
Norovirus is the leading cause of food-borne illnesses in the United States.
Along with the University outbreak, the Licking County Health department also attended to a similar outbreak that occurred at a dinner hosted by the Columbus Museum of Art. In this situation, 41 of 78 attendees dell ill with symptoms that included diarrhea and vomiting.
Despite the two outbreaks' proximity, the Ohio Department of Health has claimed that there is no current connection and the outbreaks are being treated as two isolated events. There was one Denison University student working at the Columbus Museum of Art dinner- he, however, was not involved in food preparation or distribution and was not one of the norovirus victims on campus.
It is essential to note that diarrhea is an underreported symptom and this lack of reporting factors into the degree of outbreaks that occur.
Please wash your hands regularly :).



Smuggled bushmeat confiscated in airports shown to harbor potentially harmful viruses.

Bushmeat seized in several US airports recently has been shown to harbor both retroviruses and herpesviruses. Bushmeat has long been known to act as a “conduit for disease emergence”, especially in terms of certain retroviruses. With international trade what is scary, is that easier than ever, these products can be moved around the world increasing pathogen spread.

Wildlife importations have been shown to introduce such diseases to the US as exotic amphibian chytridiomycosis, Newcastle disease and monkeypox (through pets). It has also been shown that the hunting/butchering of bushmeat (especially non human primates) has led to zoonotic transmission of retroviruses including SIV, STLV, and SFV. It is thought that these viruses were than able to mutate allowing them to be transmitted from human to human.

The US CDC prohibits the importation of bushmeat from various species but greater surveillance is needed to fully stop the practice as it poses a threat to health.

Article from:

--Elena Jordan

Saturday, February 25, 2012

H5N1 more common, less deadly than previously thought

(another flu post!)

Data published by the WHO states that the H5N1 bird flu has a mortality rate of almost 59% (out of a total of 586 cases since 2003)--a rate that is more than worryingly high. However, a new study from the Mount Sinai School of Medicine has found evidence that perhaps this rate is incorrect. In their study, they screened blood samples from more than 12,000 people in Europe, Asia, and Africa, and found that 1-2 percent of the samples showed signs of bird flu infection, but that none of the individuals died from bird flu, and most never even sought treatment. This data suggests that many more people have been infected with bird flu than according to the WHO, and thus that the bird flu mortality rate could be much lower than previously thought.

This discrepancy in numbers makes sense when you consider that in order for the WHO to classify someone as sick, they have to have a fever and be sick enough to go to a hospital and be tested specifically for the virus. Individuals who are already that sick are more likely to die, which raises the mortality rate as a result.

Takeaway: the article suggests a population-wide study of infection rates and symptoms in order to find out exactly how serious this still-dangerous virus really is.

--Sarah Kaewert

Flu season is mildest in years

According to the New York Times, the beginning of this year's flu season was announced this last Friday. Flu season is announced after three consecutive weeks of at least 10% of all respiratory infections are found to have been caused by influenza. Especially with all this gorgeous weather we've been having, this seems like a late start of the flu season, and in fact it is--this is the latest start to the flu season in 24 years. This could be because of the mild winter, allowing people to get outside and not be cooped up with each other for long periods of time, or because viruses can't survive on fomites as well in warmer weather.

So far only (only?) 3 children have died from flu-related reasons this year, which still seems like a lot, but compared to last year's 122 and the year before's 200+ is small. There have been far fewer hospitalizations this year, and only two states (California and Colorado) have been widely affected. Additionally, the majority of the infections have been of the H3N2 strain, as opposed to the more severe and more common, at least at the beginning of the season, H1N1.

--Sarah Kaewert

Monday, February 20, 2012

Bird Flu Remains A Menace in South Asia.

(Sorry for the late post! I meant to post this like 2 weeks ago! Woops...)

Though relatively forgotten by the mainstream press outside of the latest news about the modified version, bird flu remains enzootic in South and Southeast Asia. While the fervor over a possible pandemic has died down considerably as efforts have been stepped up to regionally contain the virus, elimination from key areas, much less eradication, has proven extremely tricky. Bird flu doesn't fit all of the requirements for a true human virus and despite or because of this, bird flu is a very serious, potentially fatal virus of humans. Though the odds of catching it from an infected bird are low, it can carry a nearly 50% mortality rate.

In South Asia, the past two months have been one long series of setbacks and embarrassments, as India's announcement of the elimination of all wild bird flu in December 2011 has been followed by a total loss of containment along the India-Bangladesh border. Even though India DID eliminate the virus, it couldn't change the infected status of birds in Bangladesh, who subsequently broke through containment, spreading an outbreak that traveled into Nepal. Along the way, the mere presence of the virus in any bird has led to mass cullings and the swift erection of new containment barriers enforced by vaccines and cullings of wild birds. While the government's ability and will to enact these measures gives this story a positive outlook, one cannot ignore that the outbreak began because of a failure to take such measures across borders. Until this can be done, the region can never be truly safe from a new outbreak. Just like with a human virus, complete eradication remains the only option to ensure that any given region is truly safe.

In conclusion, this story should serve to remind us that bird flu remains a real and endemic infection. It should also inform us of the difficulties in controlling and eliminating an epizootic infection. Unlike humans who can tell their doctor if they are sick or who can be easily vaccinated en masse, animals need to be controlled with much stricter options, such as culling, and have no respect for human borders.

-Zachary Herrera
Nepal Outbreak + Response
Indian Outbreak
More Recent News from Vietnam:

Baby boomer injection use increases number of hepatitis related deaths

hepatitis-associated deaths increased dramatically in the past decade, exceeding the number of HIV-related deaths. Hepatitis C alone caused 13,000 deaths between 1999 and 2007, compared to 13,000 due to HIV. Just as significant as the related mortalities are the related morbidities - 1.4 million people are living with chronic hepatitis B and 3.2 with HCV.

One group particularly represented in the hepatitis-related mortality group is the baby boomer generation. This group is more susceptible to injection drug use, therefore at higher risk for hepatitis infection. It's estimated that 75% of all hepatitis related deaths can be attributed to this group. This group is also at high risk because the HBV vaccine was not developed while they were youths.

The article provided a fairly accurate background on the latency of hepatitis virus, how it's transmitted, and potential treatment using nucleoside analog. I was very surprised that Hepatitis caused more deaths than HIV since there seems to be so much attention concentrated on HIV research. Hopefully, with the development of HBV vaccine, we can reduce the number of hepatitis related deaths and move onto developing a vaccine for HIV!

-Michelle Jin
Article source:

Sunday, February 19, 2012

Doctors drop vaccine-refusing families

Great article by WSJ: More Doctors "Fire" Vaccine Refusers!

It's kind of horrible I know—doctors refusing to treat families who refuse vaccination. Because really, the doctor's duty to society should include those who are disillusioned by vaccines, and should treat illnesses other than MMRV. But apparently, 30% of pediatricians in Connecticut and 21% in the midwest asked families who refused vaccinations to find another doctor. The trend has only climbed in the last decade, perhaps owing to increasing frustration as these parents refuse to believe scientific studies, the medical internet (where I personally diagnose myself with everything...), the risk of infections spreading from unvaccinated children in the waiting room (new type of nosocomial spread!!) or the fact that a large part of a pediatrician's job is actually providing vaccines.

Interestingly, this has created a group of families who can't really get pediatric care. That's quite sad, and a consequence I really had no idea was coming. I really appreciate that we don't blindly follow whatever our doctors tell us but take the time to become informed. However, there are definitely times where it's probably better to just listen to the doctor, despite how smart we think we are/how well we know our own bodies. I suspect I'd be a bad patient one day when I'm overprotective of my kids and haven't kept up on medical findings. Plus, I'll be one of those med students who comes in claiming they have cancer every 3 weeks.


Norovirus Vaccine in the works

With all of the news about Norovirus lately, it is nice to hear of a positive development in this field.

According to the Huffington Post a vaccine for Norovirus is being worked on at Arizona State University. It will be an inactivated vaccine in the form of a powder puff which will be administered nasally.

So maybe in the future when you are planning your next cruise vacation the packing list will look something like this: Swimmsuit (check), sunglasses( check), sunscreen, shorts, shirt, etc (check), and lastly Norovirus vaccine (check).

Right now the vaccine is having about a 50% success rate which will need to be increased but the vaccine looks promising. Immunity to noroviruses tends to be similar to influenza viruses so the vaccine would likely need to be administered annually.

In the meantime, while we wait for an effective vaccine, the best precautions are to wash your hands before eating/preparing food and to stay home from work/school if you are sick.

--Elena Jordan

Monday, February 13, 2012

Flu Scare in New Zealand

In what seems to be a pretty comical story, New Zealand health authorities ordered the immediate isolation of a plane that touched down in Auckland. It was believed that dozens of Japanese students on this flight were carrying a strain of unknown flu virus, and so 73 of these homestay students were kept on the plane hours after it hit the tarmac.

According to the passengers, a pretty frantic investigation ensued, with paramedicals erratically taking temperatures and pulses of the students, and no clear explanation being given from the authorities to the passengers. While it seems funny, about 40 students were found to exhibit mild respiratory symptoms.

The passengers were released approximately 4 hours after landing, and given health services. The whole flurry began when one non-Japanese passenger saw a few Japanese passengers with respiratory symptoms, and thus reported it to the captains on the plane, who then called medical services.

While the Auckland authorities admitted to overreacting, it was much better than underreacting, especially given that 300,000 cases of flu have been reported in Japan in the last week alone.


Germany leads the way in centralizing infectious disease data

Germany has just finished testing an electronic reporting system for infectious disease. The system was only tested in the Rhein-Kreiss Neuss district, but theoretically all districts of the country would gather information from local hospitals, doctors, and labs, and forward all information about infectious diseases on to the central federal authority, the Robert Koch Institute in Berlin.

This test not only sets up a data structure for reporting, but also set up secure and confidential ways to submit patient information, as well as set doctors up with the proper computer systems for this kind of networking. This means that it will be faster and easier for German doctors to share information with the Robert Koch Institute in Berlin, which is increasingly important in given the current climate of infectious disease and the necessity of fast response. This would be important in every country, and hopefully the world is moving in that direction.

--Sarah Kaewert

The Speed of Viral Evolution

Researchers recently studied how genetic manipulation of a the virus known as Phage Lambda (noninfectious to humans) affected transmissibility among host bacteria e. coli cells. Downregulation of the typical receptor protein resulted in the viral evolution of a new tropogen that utilized the receptor protein OmpF - a receptor protein that until now had never been recorded as the receptor protein for Phage Lambda. The development of this new tropogen occurred within just 15 days! Upon molecular examination, it was revealed that this mutation required four individual point mutations within the viral genome.

This research could shed some light on the idea of viral evolution. The primary researcher, Justin Meyer, estimates that the probability of four such point mutations occurring simultaneously is around "one in a thousand trillion trillion" (a slightly nonspecific estimate but still...). Contrary to what might be expected, however, in a number of different trials the virus always acquired the function mutation over the course of several weeks.

Is viral evolution more pointed than pure probabilistic mutations? So it would seem.

- Elena Higuchi



Sunday, February 12, 2012

Nanotechnology and future antiviral therapies

Recently, research has been done on the interactions of nanoparticles on the surface structure of viruses (see interaction of silver particles on G120 of HIV) and there's been interest in developing nanoparticles capable of neutralizing viruses or delivering drugs to specific targets. A company called NanoViricides Inc has developed 'polymeric micelles' that contain ligands normally specific to viral tropogens. This viricide's mechanism of action involves binding to viral-specific proteins (multiple types, if available) and engulfing the virion. In vitro, it has been shown to disassemble the virus in many cases, but researchers have been unable to explain why this happens.

This new type of antiviral therapy is slated to have no adverse metabolic effects, significantly higher effectiveness than chemical drugs, a short R/D period (3-6 weeks), and is biodegradable. It is touted to be a good, rapid counter to bioterror because micelles containing target proteins specific to the virus can be created quickly and cheaply. Unfortunately, the research summary did not include possible disadvantages, of which I can imagine many: host immune response may inactivate the drug, finding effective tropotopes is a severe limiting factor, targeting latent or intracellular pathogens may be difficult, etc.

Possible applications include control of viremia via injection into blood, topical applications on sores (ex. Herpes) and lesions, nasal sprays, and immune-globulin-like therapy/prophylaxis. Also, given that they can be specific to certain cell/viral receptors, these micelles can be used to deliver drugs to areas of the body that need it most.

protective protein against HIV

A protein called SAMHD1, produced by dendritic cells, provides resistance of immune cells against HIV. Researchers are currently investigating the mechanism by which SAMHD1 resists HIV infection, but it's been proposed that this protein destroys the free flowing dNTPs, thus depleting virus infected cells of building blocks to replicate the viral genome. This process is termed Nucleotide pool depletion. Or in the words of Dr. Landau "SAMHD1 essentially starves the virus." But the viruses have their own escape strategies - they evolved to not infect SAMHD1 producing cells, but to infect CD4 T-cells, which do not produce such protective proteins. In addition, HIV and related viruses have developed Protein X that directly attacks SAMHD1, allowing it to infect dendritic cells.

I found this article interesting because it has profound therapeutic implications. If we could develop a drug to increase SAMHD1 production in naturally non-producing cells, such as CD4 T cells, therefore counter-attacking HIV's immune evading strategies. In addition, understanding how viral protein X interacts and destroys SAMHD1 could pave the way to developing drugs that prevent viral destruction of these crucial genes.

Michelle Jin

WNV competent mosquito returns to UK

Culex modestus has been found in the marshland of the Thames Estuary. This mosquito has not been seen in the UK since 1945. It is worrisome because it can carry and transmit West Nile Virus.

Scientists are now using satellite imagery to locate habitats where the mosquito is most likely to be found. They will then work on the ground to study the mosquito more and determine whether there is any risk to human health.

WNV has been transmitted to humans occasionally in southern Europe but so far has no human has contracted the disease in the UK.

Elena Jordan

Study Linking Chronic Fatigue Syndrome to Viral Infection Has Been Retracted

In 2009, a study published in Science by Dr. Judy Mikovits linked chronic fatigue syndrome to a viral infection with XMRV. Two years later, in December of 2011, this original study along with one study that supported the findings were retracted within days of each other, and the viral association was discredited. After the study was published, a number of studies failed to confirm the association, and a critical part of the scientific process, replication, was unable to occur.
Chronic fatigue syndrome is defined by a number of symptoms, the most common being profound exhaustion, swollen lymph nodes, sore throat, and cognitive dysfunction. Up until the publication of Mikovit's study, there was no known cause for CFS. The Center for Disease Control even classifies the syndrome as a psychological disease or a stress-related condition. According to a paper by the CDC, patients' who suffer from CDC tend to disproportionately have "paranoid, schizoid, obsessive-compulsive, avoidant, and depressive personality disorders."
On a side note, following the study's retraction, a legal plague hit the institution and researcher associated with the XMRV study. The main researcher, Dr. Mikovits was jailed for stealing from the lab and charged with being a fugitive. At the same time, the Whittemores, from the Whittemore Peterson Institute for NeuroImmune Disease (the research institution where the original study was performed) are being sued for embezzlement.
The XMRV-CFS association was not the only viral-associated connection that Mikovits proposed. At several conferences, Dr. Mikovits offered the idea that the murine leukemia virus (MLV) is associated with autism.

-Angela Cesena


Thursday, February 9, 2012

Super Bowl Measles!

Oh man, this story is horrifying but also hilarious.

Someone who mingled with over 200,000 people at the Super Bowl village in Indianapolis has come down with the measles, aka the most infectious disease ever.

There's a chance that he wasn't infectious at the event, which was held on Friday—measles is infectious around 4 days before it becomes a visible rash, and if he's just come down with measles, the people he interacted with should be safe. But who knows what the speed of the news reporting is. Since there's a 10-day incubation period, if he really did spread it, we should see a ton of new cases popping up soon.

The public health department alerted the CDC, but the officials don't seem too worried. This faith in good vaccine coverage may be misplaced, but we can hope that there weren't a large number of kids who attended the party, because the children born in the last decade or so aren't as well immunized as the rest of the population because of parental worries (coughJennyMcCarthy).

Anyways, I look forward to the imminent measles outbreak that will hopefully spur more parents into getting their kids vaccinated!


Monday, February 6, 2012

Fatal Rabies Case in Italy

A 40-year old man in Mantova, Italy was admitted to the hospital a day ago exhibiting symptoms of rabies including fever, myalgias, and respiratory distress. His rabies infection was confirmed and he died soon after. On September 28, 2011, the man was attacked by an aggressive dog and received pretty severe bite injuries in the arm in the north part of India. Despite receiving immediate post-exposure prophylaxis, his rabies was not cured.

He scored a 17 on the Glasgow Coma Score, which is a diagnostic tool used in rabies diagnosis. It questions eye response, verbal response, and motor response. More information is here:

Approximately 36% of the rabies cases worldwide occur in India, or about 20,000 deaths. Though rabies is known well throughout India, immunoglobulin protecting against the disease is the major constraint in protection as it is in extremely short supply.

Viral Valentines

In researching for the blog post this week, I must have come across 6 different articles highlighting the infectious dangers of Valentine's day. Valentine's day conveniently coincides with the height of cold-flu season, and since that's coming up and conveniently showcases many of the viruses we've been talking about in class, it's worth a mention.

Among the viral diseases mentioned in just one article are mononucleosis, colds, the flu, and cold sores. This particular article delicately steers clear of any sexually transmitted diseases, but it's Valentine's day so those should probably be included in this list as well. The families represented here might include Herpes, Paramyxo, Picorna, Corona, Papilloma, and Retro, and methods of transmission include direct contact, respiratory, and sexual. Basically, Valentine's day is pretty cool for a virology student.

This particular article shares helpful tips such as "keep your chopstick [and other utensils] to yourself" and "Do Give and Get a Flu Shot – 'It’s the gift that keeps on giving – you protect yourself, your loved one and you stop the virus from spreading to others,” said Parada. “If that isn’t sexy, and say ‘I love you’ I don’t know what does.'"

So enjoy Valentine's day everyone!

--Sarah Kaewert

All noro on board!

3 cruise ships set sale this weekend after having docked in Florida and Louisiana with norovirus outbreaks. Not too much info is known on whether any passengers were infected (guess we'll have to wait the 72 hours of incubation period!). The spokesperson for the cruise ship said that the ship was cleaned and shouldn't cause the symptoms of upset stomach, vomiting, and diarrhea.

I wish the article provided more information on the cleaning measures, how many patients went onboard, how many patients were affected by the outbreak, and how many other cruise ships will be docking in the oubreak area.

The spokesperson for the cruise line also said the passengers were warned - this somehow seems like blaming the victim.

But we'll see in a few days what happens! dun dun dun...


-Michelle Jin

Canadian HIV vaccine SAV001 to be tested in humans


A genetically engineered live attenuated HIV vaccine has been developed at the University of Western Ontario, and US FDA approval was announced in mid-December of 2011. The vaccine has already been proven to stimulate immune response in animal subjects, and Phase I testing in HIV-infected human subjects began in January. The efforts of UWO and Sumagen Canada were also recently bolstered by a $728,000 boost from the Bill and Melinda Gates Foundation.

I'll try and dig up more information on how exactly this vaccine works, and what the genetic modification entails. I'm sure we all remember the Sabin vaccine controversy...

-Alan Le

Sunday, February 5, 2012

The reservoir of Foot and Mouth disease in Mongolia

In Mongolia, outbreaks of food and mouth disease, caused by the foot and mouth disease virus, in the family picornaviridae, affects a wide range of mammals and cloven-hooved animals including: domestic sheep, goats, cattle, camels and Mongolian gazelles. This is a fatal disease, both economically and resource-wise, as about a third of the Mongolian population relies directly on livestock for survival.
Until recently, it was thought that the Mongolian gazelles were the main reservoir of this virus, however, the results of a recent study, entitled "Serosurveillance for Foot-and-Mouth Disease in Mongolian Gazelles (Procapra gutturosa) and Livestock on the Eastern Steppe of Mongolia", proved otherwise. The researchers involved in the study collected blood samples from 36 gazelle calves and 57 adult gazelles to identify the existence and quantity of antibodies to the virus in their blood. They also collected more blood samples from other domestic animals that were kept in areas frequented by gazelles. These included: 138 sheep, 140 goats, 139 Bactrian camels, and 138 cattle and were used as a comparison. They found that in general, the pattern of antibody prevalence in the blood of these gazelles reflected the dynamics of foot and mouth disease outbreaks: for instance, they saw that during 1998-1999, which was free of foot and mouth disease outbreak, no antibodies were to be found in the blood samples of these gazelles, whereas during an outbreak in 2001, there was about 67% prevalence of antibodies in these animals. The study further analyzed following outbreak-free periods, during which the level of antibodies in the gazelle population continued to decline.
Based on these results, the researchers concluded that the Mongolian gazelles were not the natural reservoir for the foot and mouth disease virus, but instead, become infected after spillover from livestock during the sporadic outbreaks.

- Julie

Norovirus Hits Close to Home: San Francisco High School Shut Down

Last week, a norovirus outbreak suddenly and dramatically hit St. Ignatius High School in San Francisco. School authorities and health professionals have scrambled to explain the source of the outbreak, but so far tests run to check possible contamination of the food or water supply, which would be the easiest way for the fecal-orally transmitted norovirus to spread so quickly, have come back negative. As of now, the school's population has been devastated with a 20% infection rate(!!). 300 students and 30 teachers all got acutely sick on last Wednesday with many vomiting at school. Because of the high infection rate and norovirus' extremely contagious nature, officials shut down the school and declared a 5-day weekend while testing was done and the entire school cleaned to eliminate any residual viral particles. As with the case of most norovirus outbreaks in America, all those affected are expected to recover in a matter of days even though several cases at the school resulted in trips to the hospital due to severe dehydration, likely so they could be treated by ORT.

Interestingly, one of the investigators relayed an anecdote that may explain the outbreak. Supposedly, a sick student vomited on one of the door handles in a main hallway and the janitors didn't disinfect the mess completely. Though the cause of this incident may never be known, the possibility that a single sick patient and a single vomiting could lead to over 300 ill speaks volumes about the incredibly contagious norovirus. We should be so lucky that such a virus is not more dangerous, and that all of these students will recover with no chronic infection.

-Zachary Herrera

Pediatric Rabies Patient in California Recovers

An eight year old girl with a history of paroxysmal supraventricular tachycardio (occasional rapid heart rate) was seen by her pediatrician for a sore throat and vomiting on April 25th, 2011. A week later, she was taken to the emergency department on accounts of poor oral intake and dehydration. Two days after that incident, she returned to the emergency room for non-localized abdominal pain, neck and back pain and was discharged. The next day she returned with the previous days' symptoms, a rapid pulse, respiratory distress and acidosis. All infectious disease tests were negative with the exception of a positive rhinovirus PCR. As time progressed, she suffered from ascending flaccid paralysis, a fever, and decreased level of consciousness.
This patient was tested for west nile virus and enterovirus which both came back negative. Then, the Californa Department of Public Health Viral and Rickettsial Laboratory suggested testing for rabies based on the clinical syndromes. The tests came back positive for rabies-specific antibodies IgG and IgM . She was later sedated, received advanced supportive care and was placed in therapeutic coma. She, however, was not administered rabies immunoglobin or the post-exposure rabies vaccine. (why?)
A few weeks after the combined treatments and therapeutic coma, the patient was transferred to a rehabilitation center where she regained fine motor skills as well as her cognitive skills.
A public health investigation in this rural county in California ruled possible exposure to the rabies virus through means of suspicious animal contact in school- the girl was apparently scratched by two cats in school weeks before the onset of the symptoms. Of all the cats tested, none came back positive for rabies. Nevertheless, precautions were taken and 27 people that came in contact with the girl were given post exposure prophylaxis.

-Angela Cesena


Suing over STDs

Just had to share this funny story with you all, though it's a month old. It's about Michael Brown, a high-profile surgeon who went to court for beating his wives and paying ridiculous amounts of money for strippers among other things. The first line of this article reads: "Like herpes, Michael Brown is the gift that keeps on giving. And apparently one of those gifts is...herpes."

Basically, he gave one of his ex-girlfriends vaginal and anal herpes and lied about his STD status. Bad luck in terms of virus shedding and generally poor manners, but what's the problem?

Apparently, it's actually a misdemeanor in New York (also in other states, including CA) to knowingly withhold information from a partner and/or intentionally spread an infectious disease such as an STD. This is based in the person's right to know and the harm done to them, and constitutes a form of assault/battery. Plus, if the person's rich and already in a ton of trouble, you can sue for emotional damages and add fire to the scandal.

It seems to me that this could make fights about who-gave-who-what and taking revenge messier, but I think it's cool that the courts have this kind of protection for those who were taken advantage of and contracted a life-long, stigmatizing, and limiting disease. I'm trying to imagine living with herpes—its painful outbreaks and the constant risk you'd put a sexual partner in even if they consented. Not fun. So, I hope people who have it know about this law!


Viruses on Cruise Ships!

In Fort Everglades, Florida, 2 cruise ships (of Princess Cruises) were forced to return to port after experiencing gastrointestinal sickness outbreaks among passengers and staff. The Crown Princess had nearly 150 sick people aboard when it returned to port, and the Ruby Princess had 92 infected passengers and 13 infected crew members.

A spokesperson for the cruise line said that the two outbreaks were unrelated, but let's be honest: the food may have very well been contaminated. Proper steps were taken once reports of gastrointestinal illness became common: disinfection of surfaces (railings, door handles, elevator buttons), encouraged hand-washing, and placement of hand sanitizer around the ship.

I was simply entertained by the fact that these simultaneous "cruise ship illnesses" occurred directly following our Humans&Viruses journey into the world of norovirus and diarrhea. It reminded me of my own experiences at Stanford Sierra Camp (where I worked 2 summers) and the constant dread of a norovirus outbreak among staffers there. I'll never forget the phrase "no noro" that would be uttered before sharing drinks or similar... probably not the overall best virus prevention...


- Elena Higuchi

Saturday, February 4, 2012

The New Official Recommendations for Vaccinating Boys Against HPV Are Finally Here

Recently there has been a new wave of studies on oral HPV. Just last week, the New York Times reported on a study which found that there are actually now more men with oral HPV than Women. In fact Pooja even posted about it.

Historically the HPV vaccine has been recommended for girls and only encouraged for boys. This was because it was thought that boys were not nearly as susceptible to disease from HPV as girls. Of course it was encouraged to prevent genital warts and certain cancers however it was usually thought that the cancers were rare and could be somewhat looked over.

However, with the recent concern over oral HPV and its link to throat cancer the CDC has published a brand new recommendation. A footnote has been added to the HPV schedule which includes a “recommendation of the quadrivalent human papillomavirus (HPV4) vaccine for males aged 11 or 12 years and catch-up vaccination for males 13 to 21 years of age. Males aged 22 to 26 years may be vaccinated with HPV4 vaccine.” (Annals of Internal Medicine).

From Human and Viruses we of course know that this is an important step in reducing the disease prevalence within society. While the fact that men are also susceptible to cancer from HPV not good news, a push to get everyone (male or female) vaccinated will be an important step to reducing overall infection.

Which reminds me, I suppose it’s time for me to get my vaccine.

--Elena Jordan

The original article Recommended Adult Immunization Schedule: United States, 2012 found in Annals of Internal Medicine can be viewed at
The New York times article can be viewed at

Monday, January 30, 2012

Oral HPV More Common in Men Than Women

A new study talked about in the New York Times Vital Signs blog shows that about 1/15 Americans is infected with oral human papilloma virus. Of these numbers, more are men than women. The disease is a virus of the throat and can cause throat/larynx/pharynx cancers. Specifically, HPV Type 16 has tripled in prevalence over the last 20 years, a fact that is becoming more known in the public given the rise in throat cancer reports.

Aout 6.9% of adults and teenagers in the country are affected with any kind of strain of Human Papilloma Virus. The study also narrowed down behavioral practices that could make one more susceptible to oral HPV: increased age, sexual activity, and smoking cigarettes. Oral HPV can come about from engaging in oral sex.

Given the controversial political debate about whether or not men should also receive the HPV vaccine is likely to be affected by this new study. The fact that men had triple rates of throat cancers than women had until now been unexplained.


Could avoiding raw date juice and sap reduce Nipah infection?

Well experts in Bangladesh seem to think so. According to the Bb News (a Bangladeshi Newspaper) five deaths have already been reported this year in a recent outbreak in Bangladesh. Health department officials fear that more outbreaks of this Fruit babo virus loom on the horizon . However, experts are calling for a simple measure to reduce disease: “not drinking raw date juice.”

The link of date juice/sap to nipah is the fear that fruit bats can infect the dates while feeding. Consuming raw juice from infected dates could pass the virus onto unsuspecting victims, posing a serious threat to their health.

Once infected, there is no cure for Nipah infection and the disease is serious. Symptoms can include encephalitis and coma .(CDC)
Interestingly enough, at least according to this article, Nipah virus is currently only found in Bangladesh…I’ll have to look up that fact to make sure it is indeed true.

The original article can be found here:
And the CDC page can be found here:

--Elena Jordan

Sunday, January 29, 2012

Study Finds 7 Percent of People in United States Have Oral Infection of HPV.

A new study, published in the Journal of the American Medical Association and reported on in the New York Times, has determined that 6.9% of the American population, aged 14 to 69, has detectable levels of some serotype of HPV in their mouths/throats. The study was performed by PCR analysis of lysed cell extracts retrieved by a simple gargle-and-spit method using mouthwash.

The study also yielded numerous correlations between independent factors and rates of HPV infection. These ranged from the predictable, positive correlations with age and sexual activity since both increase the likelihood of exposure, to the thought-provoking, such as a tripled rate of infection for men vs. women(10.1%/3.6%) and a positive correlation between smoking and chances of infection. Of the serotypes tested, HPV-16, a type linked to both cervical and oral cancers, was the most prevalent of any given type but was still relatively minor at a 1% infection rate. Even so, if these numbers can be expanded for the entire population, that means ~2 million people are infected with an oral oncovirus.

Ultimately, this study alternately raises and calms fears at the same time. While the burden of dealing with potential oral cancers in the future appears grim, for now the numbers retrieved by the study pale in comparison to the rates of genital HPV infection and the chance of contracting cervical cancer. Still, investigations into the efficacy of vaccines to stop oral HPV transmission will likely be performed sometime in the future if the United States gets serious about reducing HPV infection rates.

-Zachary Herrera

Plantibodies in the fight against HIV?

Dr. Deborah Anderson, professor of obstetrics, gynecology, and microbiology at Boston University, is currently developing a form of prophylaxis against HIV and HSV that uses plant-grown human antibodies to neutralize these viruses in the female genital tract. Anderson has been working closely with the industry to develop a system of producing antibodies to HIV cheaply and massively in tobacco plants. The so-called "plantibodies" are then hoped to be applied to numerous other viruses, perhaps even influenza and rhinovirus.

Trials for another anti-HIV gel were cancelled in November because they appeared to be ineffective at preventing infection. Here's hoping that this one shows happier results.


-Alan Le

How young adults handle epidemics

A study from the University of Michigan recently outlined how young adults handle epidemics such as the H1N1 influenza. The study was a survey of 3,000 people and focused mostly on people in their 30s, finding that only 20% of those surveyed had been vaccinated during the 2009-10 H1N1 scare. However, about two thirds of them said that they were following the issue closely and "moderately concerned, " which apparently is not concerned enough to be vaccinated (come to think of it, I can't think of one person I know in my age group who got the vaccine either). Even though they felt "well-informed" or even "very well-informed" on the topic, the average scores on an influenza knowledge test were "moderately informed."

The study went on to break down the behavior of this group further: adults with young children at home were the most likely to pay attention to news concerning the epidemic. Most people got news from friends, family, and coworkers (but where did the friends, family and coworkers get their news from?) They most trusted doctors and most mistrusted Wikipedia. Overall, this generation was said to have done "reasonably well in their first encounter with a major epidemic" by the author of the report, Jon D. Miller.

--Sarah Kaewert

Viruses outrun us..and bacteria

A recent study published in Science invested gated viral replication in E.coli. The bacteriophage, lambda, attach via specific receptors and attack glycoproteins on E.coli. Scientists generated a bacteria that lack the virus-specific receptor required for viral entry and insertion of genome into host genome. However, within 15 days, the virus evolved to utilize a different receptor to gain entry into its host.

I think this article is interesting because bacteriophages are good models for human viruses. The speed of viral evolution to facilitate infection is impressive but threatening to our health. It would be interesting to learn more about how the virus evolved that fast and I wonder if there's a way for our immune system to adapt faster.

-Michelle Jin


Wisconsin-Madison Flu Study Censored for Security Measures

Dr. Yoshihiro Kawaoka's recent flu study at the University of Wisconsin-Madison and the University of Toronto is under review after his lab created a more contagious form of the H5N1 avian flu. This study has been compared to that of Dr. Fouchier's H5N1 study at the Erasmus Medical Center in the Netherlands. The main difference being that Dr. Fouchier's lab created a more contagious and a super-lethal strain of H5N1 that killed over 50% of the ferrets it infected. Dr. Kawaoka's strain is highly contagious, but has not been shown to be lethal- not to mention, the current flu vaccine remains effective against his mutated strain. This contagious H5N1 virus strain is a result of four point mutations that occurred after the team of researchers attached the hemagglutining gene of the H5N1 virus to seven genes of the H1N1 2009 virus.
In opposition to research involving genetically engineered flu viruses, Richard Ebright, a chemistry professor at Rutgers University stated, "this virus will not be the endpoint; the first experiment that will be done with it will be an effort to enhance its lethality." Many researchers are concerned that the gene-manipulation techniques as well as intermediate mutations are potentially as dangerous as the end products, which is why certain aspects of this research should be censored.
Censoring this research will make the reproduction of these studies difficult (if not impossible)- which brings into question the importance of reproducing studies in order to validate their results.

-Angela Cesena


Ross River Fever outbreak in Australia

Okay, I just have to report on this because the symptoms are so...not what I would expect from a Togavirus.

There's been an outbreak of Ross River virus in Australia that has hit hundreds of humans! This is a mosquito-borne togavirus, and the breeding season has been prolific, especially in the southwest. (For a island nation, Australia sure suffers a lot of weird disease outbreaks).

But what's fascinating to me is that Ross River virus causes a fever that used to be known as "epidemic polyarthritis." Because it causes arthritis/arthralgia in 95% of symptomatic infections!! (also flu-like fever, of course) This can last for months in chronic infections—hooray for feeling like your fingers, wrists, back, elbows, and knees are 80 years old instead of 20. Based on Bio230 last quarter, I'd suspect that this is probably caused by immune complexes (small batches of virus tied up with antibodies) getting stuck in joints, which causes a local inflammatory response that causes joint discomfort. Ouch.


Sindh Polio Campaign Begins Today

Sindh, one of Pakistan's four provinces, launches its polio campaign today, with hopes of immunizing 7.4 million children against the virus. 22,000 teams of vaccinators (primarily volunteers assisted by local paramedics) have as their goal to vaccinate every child under 5 in every part of the province. To avoid any vaccine shortage, the teams have been provided with 7.4 million orally-administered (Sabin) doses as well as an additional 10 million as back-up.

Although there was not too much information listed in the article, this seems to be a very positive note in the step of worldwide polio eradication. Pakistan recorded a total of 198 cases in 2011 (as compared to just 1 in 2010); there have already been 5 cases recorded since the start of 2012. Numbers certainly point to the start of an epidemic in the region, and it is likely that there are far more people actually harboring the virus who haven't displayed any symptoms yet. It's too late for a vaccine to be able to help those who are already infected, but it would certainly help inhibit the spread of the virus. Selection of Pakistan to receive this high number of vaccine seems like a good application of typical outbreak containment strategy (high dosages of vaccine administered in the surrounding area of an emerging outbreak).

Article here

- Elena Higuchi

Saturday, January 28, 2012

Prion diseases hide out in the spleen!!

Since we are going to be looking at prions, which are composed of misfolded forms of a protein called PrP, later on, I thought that this study presented an interesting set of facts regarding recent discoveries made about prion diseases.
It was recently found that Prion diseases such as bovine spongiform encephalopathy (BSE) and variant Creutzfeldt–Jakob disease (vCJD) are able to jump across species much more easily than previously thought; in fact, it seems that they can start replicating in the spleen without necessarily affecting the brain. This would mean that thousands of people could be silent carriers of a prion infection and not realize it! It also increases the risk of transmission of the prion infection to more people through surgery, organ donations or blood transfusions.
This also relates back to the question that we had in our problem set this week - do prions have a wide host range and is that why they are able to jump from one species to another easily, according to this new study? Is that why they are called the "barrier breakers"? Apparently, these pathogenic agents are not only able to replicate in the brain, but can also affect lymphoid tissue, such as the spleen, tonsils and appendix. Do these findings match the original assumption that species barriers are very difficult to cross?

- Julie

Thursday, January 26, 2012

Looks like HCV is losing!

A receptor called NPC1L1, or Niemann-Pick C1–like 1, present in the membrane of our liver cells has been known to aid in cholesterol absorption. For a long time, a few studies had hypothesized its potential role in also facilitating the entry of the Hepatitis C virus and thus allowing infection - however, the results of these studies had not been confirmed until now.
Researchers have shown that knocking down the NPC1L1 receptor completely prevents the virus from entering and infecting the liver cells, since this receptor is 'necessary' for infection. Thus if a drug that uniquely targeted NPC1L1 (a NPC1L1 antagonist) could be manufactured, imagine the number of lives that could be saved! This would be especially useful for patients who have received a liver transplant and who are at a high risk of infection (i.e. the virus infecting their new liver). The promising news is that such a drug does exist, and it is called ezetimibe! It has been approved by the FDA, is recognized as safe, and has been used for a long time to control cholesterol levels - now we know that it will kill two birds with one stone!

Here's the Nature article!

- Julie

Monday, January 23, 2012

Effective drug management could save lives

According to a study published in Clinical Infectious Diseases, the shortage of anti-infective drugs pose a great threat to clinical care and disease outcomes. Anti-infectives were shown to reduce the prevalence of multidrug-resistant pathogens. These drugs are able to treat syndromes such as encephalitis, neurosyphilitis, tuberculosis and many others. The shortage of these key drugs may result in loss of many lives of patients with such diseases. While the source of such drug shortage is hard to determine, several possibilities are "red tape" factors such as regulation, processing, distribution, and other factors that could be avoided with effective management. I think this article is interesting because it points to the necessity of effective non-medical actions to increase medical treatment. By increasing oversight of such processes, many people's lives could be saved.

Article source:

-Michelle Jin

Sunday, January 22, 2012

CCHF in Bangladesh

On Thursday a Bangladeshi man was admitted into the hospital and treated for Congo Crimean hemmorhagic fever, and sadly died, despite medical treatment. The bite of a single tick resulted in his infection and death, the closure of several restaurants, and has mobilized an entire hospital, the Ministry of Health, an infectious disease team, the Ministry of Agriculture and Fisheries, and the Ministry of Regional Municipalities and Water Resources. Though CCHF is transmitted by ticks, it has been known to spread to healthcare workers and nurses, possibly through exposure to blood. There are unconfirmed reports of several other individuals undergoing treatment for CCHF as well.

The aforementioned ministries are taking actions to prevent any other infections through ticks or infected animals, but control of an organism so small as ticks will no doubt prove extremely difficult, as control efforts with mosquitoes for mosquito-borne diseases have proved. Bad meat was also implicated in the infection, and though this connection is unconfirmed, several restaurants have been shut down and people have been told to avoid eating meat that was bought a week before the incident.

--Sarah Kaewert

Murray Valley Encephalitis in Australia!

Recent flooding in Australia (don't forget that it's summer there) has been followed by a spike in the number of Murray Valley encephalitis cases. MVEV is an arbovirus of flaviviridae (genus flavivirus, along with Yellow Fever, West Nile, and Dengue) and is transmitted by mosquitoes. In addition, MVEV persists in the bird population year round as a reservoir.

MVEV appears to cause no clinical presentation in the vast majority of infected individuals; however, a very small number of individuals develop encephalitis. According to the Health section of the New South Wales website, very young infants, travelers, and immigrants to Australia are at greatest risk of developing MVE, due to their lack of immunity and greater chance of becoming infected. Still, the vast majority of infected individuals exhibit no symptoms, and only a very small fraction present with MVE.

Some of you might remember the concerns over West Nile several years ago, when it was first spreading across the U.S. . While many infected individuals exhibited no symptoms, others would suffer from encephalitis and experience severe health problems. I'm not entirely sure what causes the discrepancy in how people react to the virus, but it might be an exciting topic for future reading.

-Alan Le

Mosquito-borne brain-swelling virus on the rise (ABC Australia)

NSW Health Factsheet for MVEV

Aerial Baiting

Texas has annually taken to the air to fight the ground war on rabies. Over the last 18 years planes were loaded with hundreds and thousands of packets of rabies vaccines that are dipped in fish oil and fish meat. They will deploy 1.8 million packets this year over a larger area of rural south and west Texas.

The goal of this eradication effort is to vaccinate the foxes and coyotes in the rural areas to create a natural buffer zone from rabies that maybe passing into Texas from Mexico and surrounding areas. This program targets only fox and coyote transmitted rabies but is good start to keep enzootic levels down within these animals since they often have contact with livestock and humans. With the success of this program they will move onto skunk rabies.

The vaccination occurs when the animals eat the fish oil covered packets. January is the optimal time for this operation because food is in short supply because of the winter months and the bait becomes very enticing. Texas scientists got the idea for this aerial baiting system for the distribution of rabies vaccines from a program that was occurring in Canada. This method along with laws that mandate pet rabies vaccines keep rabies levels at an all time low.

Through the 18 years of running this program canine associated rabies fell from 122 to 0, and fox strain rabies fell from 244 to 0. Since the air drop began there have been no human cases of rabies in that region. This immunity circle is really doing its job in keeping rabies from spreading in wildlife and ultimately in the human population.

To read more click here

-Victoria Anikst

Polio Cases Triple in Afghanistan

Polio is currently pandemic in three countries- among them, the one posing the greatest world threat is Afghanistan. Even with the political and military unrest, vaccination teams have been allowed to fulfill their work by the government as well as the Taliban. Th Global Polio Eradication Initiative has stated a near eradication, but this year the cases in Afghanistan tripled- from 25 cases in 2010 to 76 in 2011. This three-fold rise is of international concern since the new cases appeared in regions that were previously believed to be polio-free.

The Afghanistan Ministry of Public Health has indicated that the new cases are of a polio strain seen in Pakistan. This strain has been imported by refugees from endemic areas in Pakistan as well as travelers and tourists. Cases in Pakistan also increased from 80 to 192 in 2011. But not all regions with endemic polio have had similar trends- India, on the other hand, saw a year with no new polio cases.

The World Health Organization and Unicef have devoted $32 million dollars to aid in the effort to eradicate polio. This week, WHO is declaring the three-fold rise in Afghanistan a global public health emergency.

-Angela Cesena


Can HIV Be Eradicated Without Vaccines?

I read an article recently that discussed the potential for eradicating HIV using prophylaxis and anti-retroviral drugs. It's a curious idea since we are taught in class that having a good vaccine is a dominant reason why eradication efforts have worked in the past. Given the nature of HIV spread, the effectiveness (in preventing transmission) and diversity of anti-retroviral drugs, and the lack of a capable, licensed vaccine, suppressing HIV and preventing it's spread may be the best solution; theoretically, it would take a few generations if our only option was to stop spread and wait until the last person with HIV dies, but people are banking on the possibility of reactivating latent HIV reservoirs--a popular area of HIV research--and flushing the virus out of an individual completely, leading to eradication within decades; it won't come cheap though (est. $24 billion a year) and drugs that change the chromatin environment in latent HIV infected cells would need to be developed and approved. One thing that might hamper the effort would be latency in in Hematopoetic Stem Cells!. If eradication through antivirals is successful, it might change the vaccine-centered paradigm. (Original Article)

- NGUyen

Other Cool Stuff:
*In 2006, CDC recommended routine HIV screening for everyone 13-64 years.

*Below: How the Oraquick test works. The way antibodies and enzymes are represented in the picture makes me chuckle.

Ethics of Bird Flu Research

As was discussed in class, the research surrounding H5N1 avian influenza could have benefits in helping understand the microbiology of influenza zoonoses (and thus any possible predictors), but it also carries with it implications of bioterrist weaponization.

On Friday, Ron Fouchier (the premier virologist involved engineering in the virulent strain of H5N1) and a group of other premier flu-ologists issued a letter announcing a suspension of this research, to allow for more discussion by public officials and academics of its possible benefits versus its possible threats. Such a moratorium is extremely rare - the last one having occurred from 1974 to 1976 following safety concerns in recombinant DNA research.

What I found particularly interesting was Fouchier's statement regarding the parallel debate in the Netherlands - where similar research was also taking place. Scientists seem to have taken much more active steps in the Netherlands throughout their research to keep politicians and citizens much more updated and aware of the research. As such, a heated debate as found in the US does not exist in the Netherlands. This strongly indicates that, in the future, any similarly controversial scientific research would really benefit from publicizing itself more than is typically necessary for other research.


Fouchier's letter

- Elena Higuchi

Bird Flu in China

Two people in China have died from H5N1 in less than a month. This is according to an article run in the New York Times today. China is a country known for agricultural practices that make perfect “breeding grounds” for bird flu and transmission to humans, namely the close proximity and mixing of birds and pigs. Still, these deaths come as a surprise.

The latest victim’s case was worrisome as the patient didn’t report any contact with poultry before falling ill. The concern was that H5N1 might have finally begun to be transmitted human-to-human. However they didn’t rule out other reservoirs that could spread the disease to humans and based on close relatives not becoming ill, it seems that no human-to-human transmission occurred.

However, with bird flu’s high mortality rate it’s no wonder people are so concerned. According to the WHO, bird flu has killed 343 out of 582 people who have reported being infected. This is a worrisome disease and 2 fatal cases in less than a month is a cause for alarm.

The original article can be located for further review at:

--Elena Jordan


Since we didn't really get around to Nipah and Hendra...

Hendra virus (a paramyxo) is an Australian BABO zoonotic virus (found in "flying foxes") that most commonly kills horses. Since discovered in 1994, many horses and 4/7 people have died from infection, but human-to-human transmission has not been recorded. Symptoms in horses include respiratory and neurological symptoms. The fatality rate is ~75%. Symptoms in humans can range from mild influenza-like illness to fatal pulmonary, neurologic, or systemic failure.

Most recently, a horse died from Hendra in Australia in early January, marking the 18th outbreak in a year. Some people are calling for the nearby bats to be killed or at least their population thinned, but others argue that this could distress the bats and lead to behavior that infects more horses.

It's interesting to me that we group Hendra and Nipah together in our panic about zoonotic viruses. Yes, they share many characteristics: structure, disease symptoms, spread by bats, and infection of local livestock. However, Nipah has killed many more people, infects a wider range of livestock (commonly pigs, our favorite mixing vessels), and can be transmitted from human to human (nosocomial spread!!). It has hit Malaysia, Singapore, Bangladesh, and India, making it more geographically important than Hendra. Currently, we don't have to worry much about Hendra virus, but perhaps we ought to worry about Nipah...