Quick diagnostic test for the coronavirus from Wuhan in development

According to an article in the January 31, 2020 issue of the San Francisco Chronicle, Dr. Charles Chiu, an infectious disease expert at UCSF, is trying to develop a quick diagnostic test for the coronavirus that originated in Wuhan, China. He is partnering with Mammoth Biosciences, a San Francisco company, to develop a test that could diagnose the coronavirus in a matter of hours. The only current way to diagnose the virus is through a six-hour molecular test conducted at the CDC, but turnaround time could take up to 24 hours. The test that Chiu is working on could potentially be able to diagnose the presence of the virus in two hours in doctor’s offices and emergency rooms without needing to send samples to a central location. Nasal swabs would be collected, placed in a tube, mixed with a reactant, and then exposed to a testing strip which would react to the presence of the virus. The technique uses CRISPR technology which has already been used to detect other viruses, such as Zika.

UCSF is also working on two other issues. First, Dr. Chiu is hoping to develop a faster method of genome sequencing, a process that might sequence a virus’s genome in as little as 3-4 hours. Second, UCSF is also working on another diagnostic tool based on host response biomarkers. This test would be useful for diagnosing infected individuals who do not show any symptoms, in which case the nasal swab might not contain enough of the virus to produce a positive test.

~~ Steve Blasberg

Monkeypox in the Democratic Republic of the Congo

After having done my presentation on smallpox last week, I was disturbed to see on the CDC website that monkeypox has made an appearance in the Democratic Republic of the Congo. A most unpleasant illness involving fever, headache, muscle aches, swollen lymph nodes, exhaustion, and a rash, monkeypox lasts for 2-4 weeks, and is fatal in up to 10% of victims. I looked up photos of monkeypox to see if it looked as horrendous as smallpox, and it certainly does look miserable.

Monkeypox is a zoonotic disease, which can spread from infected rodents and primates to other animals (including humans) when they bite or scratch. People can also become infected by touching the meat of infected animals. The virus spreads from person to person through coughing, sneezing, and talking, and the body fluids and skin sores of an infected person are infectious.

Monkeypox is a rare disease, usually occurring near tropical rain forests in remote parts of Central and West Africa. The DRC is in the midst of an outbreak, so travelers should protect themselves by avoiding contact with wild animals, including wild animal products such as meat, washing hands often and thoroughly with soap and water, and avoiding touching the eyes, nose, or mouth when possible.

The CDC advises that if a resident or traveler in the DRC thinks he or she may have contracted monkeypox, he or she should stay home and avoid contact with others, with the exception of seeking prompt medical care. As always, people are advised to cover their mouths and noses with a tissue or sleeve (not the hands) when coughing or sneezing.

The CDC also provides information for clinicians, advising that if a patient arrives at a health care facility with a fever and vesicular or pustular rash, strict infection control precautions should be applied. If an airborne infection isolation room is not available, the website suggests that the patient should be placed in a private room with the door closed. If monkeypox is suspected, infection control personnel and the local health department should be notified immediately.

~~ Amy McPhie Allebest

https://wwwnc.cdc.gov/travel/notices/watch/monkeypox-democratic-republic-of-congo

How does it even work? Uncovering AAV entry mechanisms

Adeno-associated viruses (AAV) - our multi-functional, harmless parvovirus friend - is the most commonly used virus vector in gene therapy. However, we still largely do not know how the virus actually works, beginning with the first step of the dynamic phase: Cell entry. Recently, a research team discovered GPR108, a G-protein coupled receptor, and by knocking out the receptor in cells, they found that it is necessary for cell entry in most strains of AAV. They propose that the receptor acts like a “lock” that helps the virus gain access into its target cell. The discovery is an important first step in describing AAV mechanisms, and by understanding how the virus vector works, scientists could potentially create more effective and specific gene vectors. Gene therapy is already being used to treat many diseases and poses many potential possibilities for combating cancer and other genetically based maladies.

~Avi Kaye 

Article: Dudek et al. GPR108 Is a Highly Conserved AAV Entry Factor. Molecular Therapy, 2019. doi: 10.1016/j.ymthe.2019.11.005.

We Made the Coronavirus Epidemic

David Quammen’s article titled, We Made the Coronavirus Epidemic reveals mankind can be blamed for the current coronavirus epidemic that plaguing the world today. For example, he blames the use for “wildlife for food” which caused animal markets that sold bats, civets, porcupines, turtles, rats and more to exist in Wuhan, the epicenter of the virus. Furthermore, by invading the tropical forests and cutting their trees down we essentially “shake viruses loose from their natural hosts.” He also blames governments for lying to conceal bad news and lack of funding for public health and research. The author poses a bigger statement, which is mankind caused the virus through our actions.

This article relates directly to our “Virus in the News” class because it covers the current epidemic, we are facing with the coronavirus spreading to the United States. The author offers an uncomfortable insight, which focuses on blaming mankind for the current situation. This article sheds light on the unintentional consequences from mankind’s travel, destruction of the rain forests for profit and attempt to feed mankind through “wildlife animals.” I believe some of the blame can be placed on mankind but would rather see us search for solutions rather than place blame. 

~~ John Sikora

 https://www.nytimes.com/2020/01/28/opinion/coronavirus-china.html

Antivirals for High-Risk Flu Patients

High risk flu patients should be treated take antivirals.

High risk flu patients are people with age or health factors that are known to increase the patient’s risk for serious complications from the flu. Such patients include people with respiratory diseases, including Asthma and Chronic Obstructive Pulmonary Disease (COPD). Patients with Neurological and Neurodevelopment disorders are considered high risk, as are patients with blood disorders such as Sickle Cell disease, and endocrine disorders like Diabetes Mellitus. Patients with heart, kidney, or liver disorders are considered high risk. Patients who have metabolic disorders, may be obese, or who have a weakened immune system are also considered high risk. Adults 65 and older, as well as infants under 2 years old should also take antivirals.

Antivirals should be taken within 2 days of getting sick and should continue for 5 days. The CDC recommends 4 prescription antivirals for the treatment of flu:

• oseltamivir phosphate (available as a generic version or under the trade name Tamiflu®),
• zanamivir (trade name Relenza®)
• peramivir (trade name Rapivab®), and
• baloxavir marboxil (trade name Xofluza®).

Antivirals are most effective when taken soon after the onset of the flu. Taken soon enough, antivirals can reduce fever and flu symptoms, and shorten the course of the sickness by about a day or so. Antivirals lower the chances for complications like ear infections, respiratory infections, and hospitalization.  Studies have shown that early antiviral treatment can reduce the risk of death in adults hospitalized for flu complications.

~~ Pete Dailey

Why R0 Matters

Who wouldn’t want to know “how infectious is it?” about a scary new infectious disease?   If someone comes down with it in Las Vegas today, am I likely to catch it in San Francisco tomorrow?

Epidemiologists have this question dialed in.   They call it “R0” (“R-zero”), which is the average number of secondary infections produced by an infected individual in an otherwise susceptible host population.

R0 is a really key number.  It determines whether a pathogen can persist in a host population.

Here’s the really key point to understand:

When R0 is less than 1, on average each infectious individual infects less than one other individual, and the pathogen will die out in the population.
In contrast, when R0 exceeds 1 there is an exponential rise in the number of cases over time, and an epidemic results.

Not sure you’ve got it?   I’ll make an analogy.   How many babies do humans need to produce, on average, to make sure the population doesn’t grow or shrink?   This number would be a kind of R0=1.   Well, the number is intuitive:   it takes a male and female to reproduce, so that’s two in the parent generation, so, if the population is to stay steady, it stands to easy reason that they should produce two children who themselves are able to reproduce.  Since some of their offspring will die before reproducing, they in fact need to produce a bit more than 2…  in fact, it was 2.33 children per woman in 2003.

~~ Robert Carr

CVM Global One Health Expert Discusses Coronavirus Outbreak

From an article posted on the Texas A&M website, Jan. 27, 2020 (https://vetmed.tamu.edu/news/press-releases/cvm-global-one-health-expert-discusses-coronavirus-outbreak/)

Dr. Gerald Parker, associate dean at the Texas A&M College of Veterinary Medicine & Biomedical Sciences (CVM), is following the fast-changing coronavirus and looking at the response to SARS as a model.

 “Lessons learned from SARS included significant shortfalls in early disease reporting, transparency, global disease surveillance systems, collaboration, and leadership,” Parker said. “SARS was a wake-up call that an outbreak anywhere can quickly become a risk everywhere and catalyzed global health public health preparedness efforts.”

 “We still have many unanswered questions in the early phase of this emergency that unfortunately require more time to evolve.

“Several reports are largely positive regarding improved transparency, disease reporting, and response in China and from the World Health Organization (WHO),” he said. “But there are also concerns that transparency and sharing of viral isolates and other data from China needed for research, vaccine development, and public health guidance are not where it needs to be to enable a more effective international response.

“Our scientific and public health understanding of the underlying science will evolve daily, maybe hourly, and public health authorities at all levels will have to react to new facts, take appropriate action, and communicate effectively to the public,” Parker said.

Texas A&M announced on Thursday that a student was being quarantined for a suspected case of coronavirus, though it was announced on Sunday that the student had tested negative.  While this outbreak is concerning, the current risk to the Texas A&M community is low.

“Regarding the suspect case in College Station, we should take reassurance that public health guidance to front-line health care providers is working in our community,” Parker said.

There is no declared public health emergency of international concern for the coronavirus outbreak from WHO, but it is a serious emergency in China despite not yet having reached the level of a global emergency.

There are currently over 2,800 confirmed cases and at least 81 reported deaths worldwide; more than 8,000 people are under observation.

~~ Steve Blasberg

Fear Influenza More Than Coronavirus

The headline of a January 27, 2020 Slate article by Matthew Davis reads, “Is This Year’s Flu More Fearsome Than Coronavirus?” While still too early to definitely know so far the answer appears to be yes. Normally during the flu season influenza A strains hit first followed by influenza B strains. Yet, this year the influenza B strain has hit especially early and especially hard.

An early strike of influenza B is problematic for a few reasons. First, influenza B is notably impactful on the young. By hitting so early in the flu season, influenza B now has that much longer to infect people when compared to its normally late arrival. Second, the influenza B strain that is currently impacting the United States is not a good match with the flu vaccine that was administered this year.

The second bit of bad news is there is still time for two other influenza A strains to significantly impact the human population of the United States. The first is H3N2, a common but harsh strain of the virus and, H7N9, a rare strain of influenza A but one that has killed over a third of the 1,500 people who have been infected with it the last few years. While the “H7N9 virus is not well suited for human to human transmission,” if the virus mutates and maintains its lethality while improving its ability to go from human to human the results could be devastating. To put things into perspective, “the last time the U.S. had a bad flu season, in 2017–18, about 61,000 people died, including 643 children (that’s some 20,000 more than die each year from breast cancer). Yet even a bad season like that generates nowhere near the all-hands-on-deck action like we are seeing with the coronavirus.”

Citation: Davis, Matthew. “Is This Year’s Flu More Fearsome Than Coronavirus?” Slate, 27 January 2020. https://slate.com/technology/2020/01/flu-season-a-strain-b-strain-deadly.html. Accessed 27 January 2020.

Post by Richard Hackmann

The Recent Coronavirus Outbreak Underlines the Need for Global Thinking

The recent outbreak of Corona Virus thought to have been originated in Wuhan, highlights the complexity of dealing with infectious diseases in the modern world. Today, more than any other time in history, the world is interconnected. An individual infected in a remote forest in Africa can be in the middle of New York City or Los Angeles in less than 24 hours.

According to the Washington Post, additional screening procedures have been put in place in several major US airport to screen passengers arriving from Wuhan both directly and indirectly.[1] Shortly after news of the outbreak, additional screening was established in John F. Kennedy, Los Angeles, and San Francisco international airports. According to the article, now Chicago’s O’Hare and Atlanta’s Hartsfield-Jackson airports will join the list, bringing the total number of airports with additional security procedures to five. Moreover, passengers who have direct or connecting flights from Wuhan who are arriving in other US airports will be redirected to one of these five airports for additional screening. Once they are cleared, they will be flown back to their original US destination. Needless to say, the complexity of setting up such procedures is staggering.

While the CDC believes that there is not a high risk to the public in this particular outbreak, this is a case that shows the need for a change of attitude among both people and politicians. National borders become increasingly transparent and meaningless, and therefore policies that focus on local solutions and local progress, while neglecting global issues and naively believing that those global problems can be simply kept outside the borders for others to deal with, are mistaken. Humanity lives in one single World, and this calls for global thinking. Real issues do not recognize arbitrary human made borders.

~~ Moe Azadeh

[1] U.S. screenings for the coronavirus expanded to airports in Atlanta and Chicago

Plague, Inc. Tops Video Game Charts in China during Wuhan CoV Epidemic

Just saw this headline on CNN: "Video game company urges players to avoid Plague Inc. game for information on coronavirus."

Apparently there's a video game called Plague, Inc. in which players learn about how infectious diseases spread across the globe. The player creates, deploys, and evolves a pathogen in an effort to infect everyone and "destroy the world." As morbid as that sounds, I think it's a brilliant concept - it takes into account factors like transmission mechanism, why islands are so interesting epidemiologically, and teaches the difference between pathogens like viruses and bacteria, as well as prions and biological weapons.

Interestingly, in 2019 the company announced they would add an in-game scenario about vaccine hesitancy after a petition was signed by over 10 thousand players.

The developer of the game was invited back in 2013 to visit the CDC. After his visit, the CDC said it was interested in Plague Inc. as "it uses a non-traditional route to raise public awareness on epidemiology, disease transmission, and diseases/pandemic information. The game creates a compelling world that engages the public on serious public health topics".

The game has garnered new attention as the current (as of Jan 2020) highest selling app in China, corresponding to the epidemic phase of the Wuhan CoV outbreak.

For more info on the game, you can find its official website here.

~~ Brian Smith

Wild Game Markets Once Again Believed to be Source of Exposure to Virus

As has been widely reported, the live animal “wildlife” markets in Huanan, Wuhan, is believed to be the source of the recent outbreak of coronavirus in China.   Wildlife markets, which are especially prevalent in southern China,  are part vanity and part homeopathy, enabling affluent customers to “show off” by consuming rare and exotic wildlife, procured at great expense. and other customers to obtain alleged healing benefits from the consumption of not-widely-available wildlife.   The markets are also very profitable and market owners, driven by the lure of the premium pricing they obtain on the sale of wildlife, tout their products as sources of protein and as revenue generators in impoverished regions. 

These markets, which sometimes sell live snakes, turtles, bamboo rats, guinea pigs, palm civets and other unlikely species for human consumption,  continue to thrive notwithstanding well established findings of pathogenic risk, most prominently, that they were also the source of the SARS outbreak, some 17 years ago.  SARS affected thousands of people around the world, ultimately leading to more than 800 deaths.  While researchers have not been able to casually link the new coronavirus to a specific wildlife transmission route, they believe that it originated in bats and then jumped to a mammal (they have not identified the mammal in the chain yet).   In the aftermath of SARS, the authorities banned the sale of the illness-causing civets but, within months of the epidemics peak, the ban was lifted and sales began anew.   

While researchers investigate the causal chain, the new coronavirus epidemic is rapidly worsening in China and around the world, with the New York Times reporting at least 1370 cases and 56 deaths.  The economic damage of the outbreak continues to mount, as well.   Wuhan’s 11 million residents are on “lockdown,” tourism is at full stop and the municipal government is racing to build a second temporary hospital (expected to be operational by February 3).  Temples, Shanghai’s Disneyland, and even the Forbidden City were closed over the Lunar New Year holiday. 

~~ David Walsh

An AI Epidemiologist Sent the First Warnings of the Wuhan Virus

The use of AI to predict the spread of the new flu outbreak in China highlights how technology can help lessen the effects of pandemics. While the WHO and the CDC must rely on Chinese officials to notify the public of the outbreak, BlueDot, through their machine learning, beat both organizations by nearly a week. The health monitoring platform notified its customers on Dec. 31, compared to Jan. 6 for the CDC, and Jan. 9 for the WHO. These organizations are dependent on an untrustworthy government to provide them with accurate information, while BlueDot’s algorithm scours news reports, animal and plant disease networks, and official proclamations to provide advance warning. Compiling lots of data quickly, AI can fill the void when governments are not cooperating. However, it is important to note that the human and scientific element remain. Epidemiologists on staff check to make sure the algorithm’s conclusions still make sense from a scientific standpoint.

-          Patrick Moynahan

https://www.wired.com/story/ai-epidemiologist-wuhan-public-health-warnings/

A Perfect Storm? The Timing of the 2019-nCoV Virus (Wuhan coronavirus)

Saturday January 25, 2020 is Chinese New Year. The weeks prior (i.e. now) and after see the largest wave of people movement in world history. Chinese government estimates that Chinese people will take three billion trips to visit families via trains, planes, automobiles, and boats (2). Wuhan, a city with a population of 11 million is a major transportation hub. The city sits at the convergence of the Yangtze River and Han River. The central location of Wuhan, the timing of Chinese New Year, and bustling population make the Wuhan coronavirus outbreak an historical event in the making. It will also test the control system Chinese government put in place since the SAR epidemic.

On the morning of Wednesday January 22 at 10:00 am, China’s State Council (i.e. the Chinese government) held its first press briefing since the first patient was admitted to the hospital on December 8, 2019 (1). The next day, January 23, Wuhan, a city bigger than Belgium in population and London in area, is in lock down (4). In an effort to control the outbreak, the officials have asked people not to leave the city and not to come to the city. The government also issued the “Quick Guide to Diagnosis and Treatment of New Coronavirus Pneumonia 新型冠状病毒肺炎诊疗快速指南” (3).

The “Quick Guide” identifies the reservoir of the virus as bat. “经过病毒序列比对分析，推测新型冠状病毒病的自然宿主可能是蝙蝠。在从蝙蝠到人的传染过程中很可能存在未知的中间宿主媒介。根据对SARS-CoV和MERS-CoV的研究，冠状病毒对热敏感，保持56℃30分钟、乙醚、75%乙醇、含氯消毒剂、过氧乙酸和氯仿等脂溶剂均可有效灭活病毒。氯己定不能有效灭活病毒。From the result of viral sequencing, it is believed bat is the natural host. There might be other vectors between bat and human. Based on previous studies of SARS-CoV and MERS-CoV, Coronavirus is sensitive to heat. It is already known that chlorhexidine does not inactive the virus. Lipid solvent of diethyl ether, 75% ethanol, chlorine disinfectant, peracetic acid, chloroform kept at 56℃ for 30 minutes can effectively inactive the virus” (3).

~~ You Jia Zhu

1. 《专家解读不明原因的病毒性肺炎最新通报》”Experts Explain the Latest Viral Pneumonia in Wuhan”, People.cn, January 11, 2020. (in Chinese)

2. 《30亿人次出行！2020年春运大幕开启》“3 Billion Trips! 2020 Chun Yun Begins”, www.gov.cn, January 10, 2020. (in Chinese)

3.  《新型冠状病毒肺炎诊疗快速指南》出炉 “ ‘Quick guide to diagnosis and treatment of new coronavirus pneumonia’ Released”, bjnews.com.cnhttp://bjnews.com.cn/, January 23, 2020. (in Chinese)

4.  Cissy Zhou, “China coronavirus: as travel ban is issued for Wuhan, many in city rush to escape,” South China Morning Post, January 23, 2020.

How accurate is the Wuhan coronavirus count?

As of Wednesday, January 22, officials from China indicate that 470 people have been infected by the virus and 17 have died. But how accurate are these numbers?

The Washington Post reports that some recent deaths attributed to “severe pneumonia” are not included on the official list of those who have died for the viral infection. Family members of those recently deceased shared stories that indicate a striking resemblance to the coronavirus outbreak.

In one example, a healthy 65-year-old woman boarded a train station in Wuhan in late December and then developed a cold with persistent cough and fever. On January 15th, she was hospitalized in the infectious diseases unit of a Wuhan hospital and died within six hours. Her body was quickly cremated and her death certificate indicated “severe pneumonia.”

Similarly, a 72-year old woman hospitalized for a heart problem in mid-December died on January 12th after admittance to the respiratory department. Her husband, who had visited her in the hospital,  developed shortness of breath and a lung infection died this past Tuesday. The deceased wife and husband were created immediately. Relatives told the Timesthat neither are included in the count for coronavirus victims.

~~ Janette Canare

https://www.washingtonpost.com/world/as-families-tell-of-pneumonia-like-deaths-in-wuhan-some-wonder-if-china-virus-count-is-too-low/2020/01/22/0f50b1e6-3d07-11ea-971f-4ce4f94494b4_story.html

Illness, the Great Democratizer: President Abdo of Paraguay Contracts Dengue Fever

In my study of smallpox last week, I was sobered to learn the story of King George III, who lost two young sons to the smallpox vaccination. Pathogens have no respect for rank or fame, and today’s story on Paraguay’s President Abdo demonstrates the humbling randomness of virus transmission.

In the January 22, 2020 edition of Reuters, Mariel Cristaldo writes that the dengue fever outbreak affecting thousands in Paraguay has reached the president himself. The 48-year-old president began feeling ill while traveling to the east of the country, and upon his return to the capital, a blood test confirmed that Abdo had contracted dengue fever.

Feeling in “good general condition,” according to the minister of health, President Abdo has been ordered to rest for 2-7 days, after which he will be able to fulfill his tasks in the presidential residence with some restrictions. In a post on Twitter, the president thanked Paraguayans for their support. “I am fine, thank god. Getting some rest. We must be conscious that dengue can attack us all.”

Paraguay has the second highest incidence of dengue in South America after Brazil; an outbreak in 2013 killed 250. Cases typically peak in the summer months, when the Aedes Aegypti mosquito proliferates and transmits the virus from human to human. The government announced that Paraguay anticipates a strong epidemic this year, peaking in the late-summer month of February. So far this year two people have died from the disease. 1,800 cases of dengue have been confirmed, and about 10,000 suspected cases have been reported.

The World Health Organization says the incidence of dengue has been on the rise in recent years. There is no treatment or cure for the disease, which causes high fever and joint pain.

~~ Amy McPhie Allebest

https://www.reuters.com/article/us-paraguay-health-dengue/paraguays-president-abdo-contracts-dengue-fever-amid-outbreak-idUSKBN1ZL1U3

Wuhan Coronavirusssss

Several New & Hots have already been posted on this emerging infection, but I wanted to call attention to a recent report from CNN that asserts snakes, like the Chinease krait and the Chinese cobra, could be the zoonotic origin behind the newly-human Coronavirus.

As the death toll continues to rise (17 reported as of this posting), understanding the natural reservoir of the virus will be key. That there have been over 500 cases of confirmed infection hints that this virus may be able to spread from person to person as well.

A zoonotic origin for Wuhan CoV would not be surprising given that bats, camels, and civet cats have been implicated in the SARS CoV and MERS CoV outbreaks of recent times. 

The author of this particular report states that the snakes may have been bitten by, or eaten, infected bats.

Until further notice, the market that seems to be the source of the initial human infection - perhaps where an infected snake was purchased for later consumptions - has been closed.

This virophile thinks that's a good call.

~~ Brian Smith

Community Immunity Has a Good Ring to It

The bad human viruses, the ones that are proven killers, typically spread easily and quickly from human-to-human, threatening the entire community, especially these weak members such as infants, the elderly, and people with weakened immune systems.

These viruses spread like wild-fire because they infect most people they invade and they turn those people into machines to manufacture more virus and infect yet more people. The wild-fire metaphor is apt, because the most effective way to stop a wild-fire is with a fire-break. It’s the same with human viruses, except in humans the way to make a ‘fire break’ against a virus is to vaccinate humans so they are immune against that virus. That way, when the virus invades an immunized human body, the virus cannot replicate, and cannot turn that human into its next agent to spread another 10 billion copies of itself.

Scientists call a fire-break against viruses ‘herd immunity.’ I’ve also seen it called 'community immunity' or 'herd protection.’ But I like to call it ‘community immunity.’

To achieve community immunity you need a very high percentage of humans in the community to be immune. But not everyone, because, if say 95% of the population is immune, then the virus will almost always run into human firebreaks (i.e., immune humans) and it will stop in its dead tracks. If 5% of humans are still not immune, the changes are very good the virus will never ‘find’ them.

This community immunity principle is essential because it not only protects the entire community, it also protects our weakest members: infants, the elderly, and people with weakened immune systems. These weakest members cannot be vaccinated because vaccines, like all medicines, can have side effects. The side effects are negligible for everyone except these weak members, but they can hurt these weak members. So their doctors will not be able to protect your 90-year old grandmother or your 3 month-old niece by immunizing them, but if the community around them are almost all immunized, they will form a human fire break around them. And that’s a good idea for all of us.

~~ Robert Carr

One Size Fits All Cancer Therapy

A group of researchers at Cardiff University in Wales have published an article in the journal Nature Immunology concerning the discovery of a new kind of T-cell which appears to be able to recognize and attack a wide variety of cancers. Among the cancers it can recognize are lung, skin, leukemia, colon, breast, prostate, bone, kidney, cervical, and ovarian cancers. The researchers believe that the T-cells can detect cancer through their interaction with MR1, a molecule which exists on the surface of all human cells. The researchers believe that the MR1 molecule may be signaling to the T-cells the change in the cell’s metabolism due to the effect of cancer. Like penicillin, this new T-cell was found by accident -- the researchers were looking for something else entirely.

The researchers believe that these newly identified T-cells might be modified to recognize even more (perhaps even all) cancer cells. This could lead to a “one-size-fits-all” immunotherapy to treat cancer, one of the holy grails of cancer researchers.

~~ Steve Blasberg

Lassa Fever in West Africa

The West African outbreak of Lassa Fever that began on December 9 with 2 reported cases has grown to more than 20 confirmed cases with 3 deaths reported.The case-fatality rate among recently confirmed cases in the region has been 36% (9 deaths out of 25 confirmed cases since August 2019). Males are mostly affected by the disease (56%) of confirmed cases as compared to females.

Lassa fever virus is contracted from contact with infected rodents and their excreta, or contact with the blood or secretions from infected human patients. Health facilities must use personal protective equipment properly and insure lab biocontainment procedures meet standards to protect staff from blood and secretions of infected patients.

Lassa fever virus transmission to humans results from contact with the reservoir rodent host, the multimammate mouse (Mastomys natalensis and M. erythroleucus) and the African wood mouse (_Hylomycus pamfi_) or their excreta. Rodent control is part of the public health response to contain and avoid outbreaks.

Source: ProMED
https://promedmail.org/promed-post/?id=20200120.6901139

Using Mosquitoes to Fight Mosquitoes: A Novel Approach Against Dengue

The aedes aegypti mosquitoes are notorious for spreading viral diseases such as yellow fever, Chikungunya, Zika and Dengue. But could they also be the solution to the inexorable proliferation of the pathogenic virome? Researchers identified and isolated a series of human antibodies that can be used to suppress all four known strains of Dengue (thereby avoiding antibody dependent enhancement). They proceeded to breed a female mosquito population that synthetically expresses these antibodies. Then, once the ‘skeeter bites and draws blood, the antibodies inside it are activated and prevent viral replication. Subsequently, in a process similar to “gene drives,” the antibody expression can spread within the mosquito population and quell Dengue expansion. For a viral disease that still lacks a specific treatment, controlling aedes aegypti and preventing Dengue from infecting and burgeoning in the first place is the best tactic to save lives in susceptible geographic areas. Transgenic mosquitoes appear to be a viable method to control Dengue and potentially other ARBOviruses in the future.

~Avi Kaye

Article: Buchman et al. Broad dengue neutralization in mosquitoes expressing an engineered antibody. PLOS Pathogens, 2020. https://doi.org/10.1371/journal.ppat.1008103

Zika virus: checking its progress and harnessing its power

Research scientists believe they have figured out how the Zika virus, which scourged Latin America in 2015-2016, can be fenced off from infecting brain cells and, even more extraordinary, used to help fight brain cancer.  One of the most devastating impacts of Zika virus infection is microcephaly—a condition where babies of infected mothers are born with abnormally small heads.  As reported in Medical Xpress (January 16, 2020), two teams of researchers at UC San Diego are conducting complementary investigations into how the Zika virus gains access to brain cells.  Both teams have preliminarily concluded that one molecule, avb5 integrin, is singularly essential to the virus’s ability invade brain stem cells.  Integrin molecules, embedded in cell surfaces, are believed to be critical to cell adherence and communication; they are also associated with cancer progression and metastasis.

The first team, led by Tariq Rana, Ph.D, focused on figuring out how the Zika virus gains entry to certain brain cancer cells (glioblastoma).    After isolating 92 different human brain stem genes necessary to Zika infection and replication in a brain cell, researchers determined that the gene for the one that encodes avb5 integrin was uniquely necessary to the process.  Other viruses have multiple points of entry; Zika appears to have just the one. 

The second investigation team, led by Jeremy Rich, M.D., took the identification to the next step: trying to determine if blocking or inhibiting avb5 would prevent Zika infection.  The results were impressive.  Rich’s study found that, by using antibodies or deactivating the gene, they “almost completely blocked the ability of the virus to infect brain cancer stem cells and normal brain stem cells.”

Rana’s team conducted similar testing using two experimental cancer drugs that target avb5 with similarly positive results.   Rana plans a further confirmatory study using an engineered mouse model that lacks the avb5 integrin altogether. 

Building on a study he helped to complete in 2017 which demonstrated the Zika virus’ highly selective preference for glioblastoma stem cells (over healthy brain stem cells) and capitalizing on the virus’ ability to shrink brain tissue, Rich hopes to use the Zika virus to aid in the battle against glioblastoma.  Working with other UC San Diego researchers, including Alysson Muotri, Ph.D. and Pinar Mesci, Ph.D., Rich was able to generate a new brain tumor laboratory model that confirmed that the Zika virus selectively eliminates the brain cancer stem cells.   Rich concludes that “we would likely need to modify the normal Zika virus to make it safer to treat brain tumors, we may also be able to take advantage of the mechanisms the virus uses to destroy cells to improve the way we treat glioblastoma.”  Rich points to the potential surrounding viruses noting that they are “very good at targeting and entering specific cells in the body.” 

~~ David Walsh

Zika May Help In The Fight Against Brain Cancer

New information suggests that the Zika virus may help humans fight brain cancer. In a story published by Live Science, research shows that humans may be able to help themselves in the fight against brain cancer by harnessing the brain cell attacking ability of Zika. Zika uses a unique molecular key to access brain cells. Researchers are hopeful that they can utilize that access key to attack specific brain cancer cells without impacting the entire brain. The focus right now is on fighting glioblastoma, a specific form of brain cancer that is particularly aggressive and difficult to treat.

Zika negatively affects humans “by targeting neural stem cells and stunting their proliferation.” Researchers began to wonder if they could utilize this impact for good through targeted attacks on brain cancer cells. Researchers are now using CRISPR technology to try and modify the Zika virus so it only impacts cells related to glioblastoma and not the entire brain. The research is promising. Even better “the Zika virus actually prefers to infect glioblastoma stem cells over normal brain cells.” This breakthrough is especially significant because of how aggressive glioblastoma is. For example, patients usually live less than two years from the time they are diagnosed with glioblastoma. Researchers are also intrigued by what other viruses may help in the fight against brain cancer.

Citation: Lanese, Nicoletta. “Could Scientists 'Hack' the Zika Virus to Kill Brain Cancer?” Live Science, 20 January 2020. https://www.livescience.com/using-zika-virus-to-treat-brain-cancer.html. Accessed 20 January 2020.

Post by Richard Hackmann

Yada yada … scientists name new virus after Seinfeld catch phrase

How do you separate your work in a crowded and over-saturated marketplace? You use 90’s nostalgia as a marketing ploy of course. Jana Batovska and her team at Agribio, the Centre for AgriBioscience, wrote a short paper in the January 9^th issue of Microbiology Resource Announcements detailing the discovery of their new virus – the Yada Yada virus. They named the virus after the famous 1997 Seinfeld episode, and it signifies the lack of excitement their discovery ought to generate.

Extracting RNA from mosquitoes in Australia’s Victoria state, Batovska found a new alphavirus that only infects mosquitoes. While a “new alpha virus” sounds menacing, it is not all that unusual. This discovery is the fourth one since 2012 that the article notes. Yada Yada, while not as newsworthy, is not without utility. Mosquito-specific viruses help scientists better understand how viruses evolved, and help with vaccine production.

          Patrick Moynahan

https://www.sciencemag.org/news/2020/01/yada-yada-scientists-name-new-virus-after-seinfeld-catchphrase

170 people sickened at Yosemite National Park after likely norovirus outbreak

Faith Karimi’s article titled, "170 people sickened at Yosemite National Park after likely norovirus outbreak" reveals that park employees and visitors are suffering from a mysterious gastrointestinal illness. According to a park statement, two people have been confirmed of having norovirus. Norovirus is extremely common and is synonymous to the “stomach bug.” The virus causes inflammation to the stomach and intestines causing stomach pain, nausea and diarrhea. It can be caught through direct contact of a contaminated person, surface, object, food or drink. Using soap and water or alcohol bases hand sanitizer to keep your hands clean can help prevent the virus. The author also reported that the cases have been on the decline over the past few days.
~~ John Sikora

https://www.cnn.com/2020/01/17/health/yosemite-national-park-norovirus/index.html

Gastrointestinal Illness at Yosemite Linked to Norovirus

An outbreak of gastrointestinal illness has affected 170 people at Yosemite National Park this January. To date, Norovirus has been confirmed in two of these reported cases. Those affected include park employees and visitors. Most of the cases spiked during the first week of the month, with a slight decline of new cases in recent days, according to Park officials.

The National Park Service Office of Public Health (OPH) has sent medical professionals to work with Yosemite National Park to investigate the cause of the outbreak. According to nps.gov, the Park continues to undertake “extensive cleaning and enhanced sanitation protocols.” This includes reminding visitors and employees to wash their hands “frequently with soap and water for at least 20 seconds. If soap and water are not readily available, an alcohol-based hand sanitizer containing at least 60% alcohol can be used.

The CDC describes Norovirus as a very contagious disease causing vomiting and diarrhea, in addition to nausea and stomach pain. Recommended prevention includes: washing hands often, rinsing fruits and vegetables, cooking shellfish thoroughly, staying home when sick and for two days after symptoms stop, and avoid preparing food for others when sick and for two days after symptoms stop. The disease spreads from infected people as well as contaminated food surfaces. Most outbreaks occur between November-April.

~~ Janette Canare

https://www.nps.gov/yose/learn/news/yosemite-national-park-reports-multiple-cases-of-gastrointestinal-illness.htm?fbclid=IwAR1E3kpvuRnhXzA5tP7QClb-dcyambs3Tzc7jr1zGegHc7rDCoVYhaTxdAU

https://www.cdc.gov/norovirus/index.html 

War, Rumor, and Ebola in Democratic Republic of Congo (DRC): what’s the role of social media?

It is the tenth Ebola outbreak in forty years, and it is the worst DRC is experiencing. As of January 11, 2020, there has been 3,395 reported cases and 3,277 confirmed cases. So far, 2,235 people have died since the outbreak began in August 2018 (1). The fatality rate is 68%.

To compound the tragedy, the outbreak zone is also a war zone. This means aids workers are often caught in the crossfire between various groups fighting for resources and powers. Recently aids workers have become targets due to misinformation and mistrust in the government because the aids workers are seen as doing the government’s job. The fact that the previous minster of health was accused for pocketing aids funding only adds to the wariness and fuels the rumor mills. Many in the West blame social media, the tool that is giving the old-fashioned word-of-mouth gossip more mileage than ever (3,4). According Statista, the number of cellular subscription in DRC is about 40%; high enough to create an eco-system necessary for circulating canards that exploit fear, anger, and helplessness of the Congolese in the war zone (5).

In early December there was a spike in Ebola epidemic in DRC due to confluence of factors. Rumors spread through social media that foreign powers are using Congolese as tools in the vaccination and the West is profiting from the crisis by creating an epidemic. One woman says, “Westerners wanted to kill Africans and sell(s) vaccines for a disease that can be cured.” Another man says, “… during last night, helicopters flew low over the city of Lubero [a town in the North Kivu Province of DRC where fighting is happening] to inject its population with Ebola.” (2). The effectiveness of social media can’t be discounted; the question is how to use the power of social media to dispel misinformation and to convince people to vaccinate and to protect those who are healthy.

~~ You Jia Zhu

1. “DRC Ebola Outbreaks: Crisis Update – January 2020”, Medecins sans Frontieres, January 13, 2020.

2. Monica Villamizar, “How war and misinformation are complicating the DRC’s Ebola battle”, Publica Broadcasting Service, January 15, 2020.

3. Vittoria Elliott, “Ebola Responders in Congo Confront Fake News and Social Media Chatter,” The New Humanitarian, May 2, 2019.

4. Patrick Vinck, and Phuong N Pham, Kenedy K Bindu, Juliet Bedford, Eric J Nilles, “Institutional trust and misinformation in the response to the 2018–19 Ebola outbreak in North Kivu, DR Congo: a population-based survey,” The Lancet, vol. 19, May 2019, pp. 529-536.

5. David P. Fidler, “Disinformation and Disease: Social Media and the Ebola Epidemic in the Democratic Republic of the Congo,” Blog Post for Council for Foreign Relations, August 20, 2019.

Evidence of Correlation between Virus Infection and Incidence of multiple sclerosis

According to The Scientist, (1) researchers have found strong evidence for the hypothesis that there is some correlation between multiple sclerosis and a variant of herpes virus infection in humans.(2) The hypothesis itself is not very new: in fact as early as 1990’s scientists had suspected that a common form of herpes virus, known as human herpesvirus 6 (HHV6), could be related to the development of multiple sclerosis in humans. However, subsequent tests had failed to establish this correlation conclusively as the results of various tests were not consistent.

Now Researchers think they know why. It turns out that the HHV6 virus itself actually consists of two related but distinct variants: HHV6A and HHV6B. Very likely, the inconsistencies in the results of previous tests has been due to not distinguishing the two variants. However, researchers have now found ways to distinguish the two types by distinguishing their antibodies. By doing so, they have shown that high levels of HHV6A antibodies strongly correlate with multiple sclerosis, while HHV6B antibodies actually correlate to lower risk of multiple sclerosis. Their conclusions are based on studying more than 16000 people, comprising 7842 individuals with multiple sclerosis and 7215 healthy individuals used as control. Whether this correlation signifies causation or not is still a matter of debate, but the sheer number of participants makes these findings statistically very strong. At the very least, this work draws attention to the need for more studies on the HHV6 virus.

~~ Moe Azadeh

1. https://www.the-scientist.com/news-opinion/type-of-herpes-virus-tied-to-multiple-sclerosis-66949
2. E. Engdahl et al., “Increased serological response against human herpesvirus 6A is associated with risk for multiple sclerosis,” Frontiers in Immunology, doi:10.3389/fimmu.2019.02715, 2019.

Measles In Palestine

The World Health Organization reported this week that a total of 124 cases of measles were reported in the Gaza Strip in 2019, including two deaths. Of the confirmed cases, 57 cases (46%) were unvaccinated, of which 28 (23%) were infants between 6 months and 1 year old. 29 patients (23%) were among age groups higher than 30 years old. Between 2009 and 2018, 97% of the population completed their second measles-containing vaccine (MCV2). Prior to last year’s outbreak, no measles cases had been reported in the Gaza Strip since 1986, except one isolated case in 2000.


In response to these recent cases, the Ministry of Health in Gaza has continued to administer both doses of the Measles/Mumps/Rubella (MMR) vaccine, including following up with health workers in hospitals where Measles patients had been admitted. Approximately 900 health care workers received these vaccinations on December 13, 2019. In addition, the MOH has strengthened surveillance systems for patients exhibiting fever and rash and initiated the early notification of suspect cases by the Central Preventive Medicine. The World Health Organization (WHO) is supporting the MOH in many ways, including the following: procuring 10 kits (for 9,000 tests) for measles after the first two confirmed Measles cases, printing and distributing Measles awareness materials among health care workers and the public, training health care workers on measles diagnosis and clinical management, and transporting samples from Gaza to a Ramallah referral laboratory.

Gaza Strip maintains a high level (97%) of immunization, but socio-economic decline, political conflict with Israel, and closure to the outside put Gaza at risk. WHO recommends strong surveillance on the district level to control transmission of the disease.

~~ Amy McPhie Allebest

The next SARS? A new coronavirus in China now spreads to Japan

On January 16, 2020, the New York Times shared a report that a case of the new Chinese coronavirus occurred in Japan just days after another traveler brought the disease to Thailand. The current ‘outbreak’ evokes memories of the 2003 SARS epidemic that killed more than 800 people, raising fear over the emergence of another coronavirus that could spread globally. Health officials initially tracked the origin of the virus to a seafood market in Wuhan, China where birds and other animals are sold. However, the Japanese patient never went to the market itself, raising a whole host of concerns: Has the virus infected animals beyond the market? Was the patient ever in direct contact with an animal? And if not, was the virus transmitted from another human? Nonetheless, at this point in time, scientists do not think that the virus can transmit between humans. And the clinical manifestation is significantly less virulent than SARS as only one of the 41 cases in China was fatal, and that individual already had other health complications. There are still numerous questions that remain unanswered: We still do not know the animal responsible for transmitting the virus to humans and it is still very unclear the extent that the virus has spread beyond the alleged source in the Hunan Seafood Wholesale Market in Wuhan. 

~Avi Kaye

Sources: “Japan Confirms First Case of New Chinese Coronavirus.” The New York Times.

https://www.nytimes.com/2020/01/15/world/asia/coronavirus-japan-china.html

“World on alert for potential spread of new SARS-like virus found in China.” Science Mag. https://www.sciencemag.org/news/2020/01/world-alert-potential-spread-new-sars-virus-found-china