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.

Pooja

http://www.nytimes.com/2012/02/28/health/research/hepatitis-c-deaths-creep-past-aids-study-finds.html?_r=1&ref=health

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.

Article!

-Annelise

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

Source: http://www.livemint.com/2012/02/26223206/How-India-fought-the-wild-poli.html?atype=tp

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
References:
http://www.claimsjournal.com/news/west/2012/02/24/201689.htm
(Recent settlement –February 24, 2011)
http://www.8newsnow.com/story/16616132/former-dr-desai-to-have-fitness-hearing-in-las-vegas-hep-c-case
(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 :).


-Angela

Source: http://www.dispatch.com/content/stories/local/2012/02/24/granville-on-guard-after-viral-outbreaks.html

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: http://jama.ama-assn.org/content/307/8/769.full.pdf+html

--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.




http://www.redorbit.com/news/health/1112481349/bird-flu-more-common-than-previously-believed/

--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.



http://www.nytimes.com/2012/02/25/health/start-of-winter-flu-season-in-us-is-announced.html?ref=health



--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
References:
Nepal Outbreak + Response
http://www.google.com/hostednews/afp/article/ALeqM5j7xEcYCva8ncWPDqGc3qKPBJCxzw?docId=CNG.d7502e631fd80bd9b27d505006b05b64.41
Indian Outbreak
http://www.worldpoultry.net/news/bird-flu-prompts-mass-poultry-cullings-in-india-9972.html
More Recent News from Vietnam:
http://www.washingtonpost.com/world/asia-pacific/what-happened-to-bird-flu-deaths-continue-new-strain-outsmarts-poultry-vaccine-in-vietnam/2012/02/17/gIQAEGmAJR_story.html

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: http://news.businessweek.com/article.asp?documentKey=1376-LZK4GQ6K50XU01-0B4FE2IEUNK9I8BNJICBH7EOEQ

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.

-Annelise

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
http://www.huffingtonpost.co.uk/2012/02/17/powder-puff-vaccine-for-norovirus-vomiting-bug_n_1284886.html

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.


http://tvnz.co.nz/national-news/health-scare-auckland-airport-4717991


Pooja

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.


http://epractice.eu/en/news/5332231

--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

Article: http://www.nytimes.com/2012/01/27/science/in-real-time-a-virus-learns-a-new-way-to-infect.html

Study: http://www.sciencemag.org/content/335/6067/428.abstract

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
Source:http://www.news-medical.net/news/20120212/Study-reveals-how-SAMHD1-works-to-protect-dendritic-cells-from-HIV-virus.aspx?page=2

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

http://www.bbc.co.uk/news/uk-england-16988183

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

Source:
http://www.nytimes.com/2012/02/07/health/fallout-from-fatigue-syndrome-retraction-is-far-and-wide.html?pagewanted=1&_r=2&ref=health#

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!

-Annelise

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: http://www.trauma.org/archive/scores/gcs.html

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.

http://www.promedmail.org/

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!

http://www.newswise.com/articles/valentine-s-day-is-the-worst-time-to-kiss-says-loyola-infectious-disease-specialist

--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...

Source:http://www.boston.com/news/nation/articles/2012/02/06/3rd_us_cruise_ship_sails_after_virus_outbreak/

-Michelle Jin

Canadian HIV vaccine SAV001 to be tested in humans

Source

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

Source:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6104a1.htm?s_cid=mm6104a1_w

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!

-Annelise

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...

Article: http://www.local10.com/news/Passengers-become-sick-on-2-Princess-cruise-ships/-/1717324/8595618/-/15hew72/-/

- 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 http://www.annals.org/content/early/2012/01/30/0003-4819-156-3-201202070-00388.full
The New York times article can be viewed at http://well.blogs.nytimes.com/2012/02/02/new-vaccine-recommendations-hpv-for-boys-hepatitis-b-for-diabetics/?ref=health