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.

http://www.nytimes.com/2012/03/04/opinion/sunday/the-truth-about-the-doomsday-virus.html?scp=2&sq=virus&st=cse

--Sarah

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.

http://www.nytimes.com/2012/03/06/health/amateur-biologists-are-new-fear-in-making-a-mutant-flu-virus.html?pagewanted=2&sq=virus&st=cse&scp=3

--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.


http://www.nytimes.com/2012/03/20/health/advances-suggest-possible-cures-for-ebola-and-marburg-virus.html?_r=1&scp=1&sq=virus&st=cse#

--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:
http://www.plospathogens.org/article/info%3Adoi%2F10.1371%2Fjournal.ppat.1002584
The Article:
http://www.purdue.edu/newsroom/research/2012/120322KuhnDengue.html

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!

-Michelle
Source: http://www.sciencedaily.com/releases/2012/03/120320195252.htm

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.

http://news.yahoo.com/hpv-testing-recommended-women-over-30-223201980.html

Pooja

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.

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20112


Pooja

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.

-Annelise

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
-Source: http://www.mb.com.ph/articles/354072/progress-no-big-breakthrough-hunt-hiv-cure

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

Source:
http://www.nytimes.com/2012/03/09/health/research/setback-on-aids-pill-is-re-evaluated.html?_r=1&ref=health

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.

Article: http://www.medicalnewstoday.com/articles/242762.php

- 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: http://www.reuters.com/article/2012/03/09/merck-britain-idUSL5E8E8AH120120309

More info on HCV Medications:
http://emedicine.medscape.com/article/177792-medication#2

--Elena Jordan

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.

Pooja
http://www.sciencedaily.com/releases/2012/02/120227111536.htm

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!

Article.

-Annelise

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?

http://www.reuters.com/article/2012/03/02/usa-hiv-drugs-idUSL2E8E205R20120302

-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
Source: http://www.brecorder.com/general-news/172/1161773/

H5N1 GIFT

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

Sources:
http://www.nytimes.com/2012/03/01/science/maker-says-bird-flu-virus-not-as-dangerous-as-thought.html?_r=1&ref=health

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.

Article: http://www.dnaindia.com/health/report_virus-may-infect-america-warns-health-group_1658238

CDC on Chikungunya: http://www.cdc.gov/ncidod/dvbid/Chikungunya/index.html

- Elena Higuchi

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: http://www.bbc.co.uk/news/health-17187179