India, a country on which polio has always had a terrible impact, has not reported a single polio case in over 200 days. The country's only polio case reported this year was on January 13 from West Bengal. Along with the absence of new cases, the program responsible for detecting polioviruses in the sewage systems (The National Polio Surveillance Project, or NPSP) in three main areas of the country isn't detecting any either. The sewage surveillance is considered an extremely important component of the early warning system. When polioviruses are found to be circulating in sewage, cases of paralytic polio often follow up.
According to Hamid Jafari, project manager of WHO-NPSP, "Both Type 1 and Type 3 polio viruses were detected in the sewage samples from Delhi during 2010," but since August 2010, when viruses were last seen in the sewers of New Delhi, and early November 2010, when they were last found in the sewers of Mumbai, no more cases of sewage-circulation poliovirus have been detected. Despite these promising news, India is still at a high risk of being a victim of the importation of viruses from elsewhere, especially its neighboring countries such as Pakistan.
Pakistan has recently been confirmed by the World Health Organization (WHO) as a main "exporter" of poliovirus, something that could really be destroying all of India's efforts to remain polio-free if not controlled properly. A cautious New Delhi has therefore intensified surveillance at the India-Pakistan border in Wagah to minimize the import of the virus as efficiently as possible since September 13. In the past month, India has reported the vaccination of 115 children, all below five years of age, who entered the country from Pakistan with the bivalent polio vaccine. Dr. Balwinder Singhm, one of Punjab's immunization officers, reported to "Times of India" about a month ago that "active searching operations" are being carried out at the borders and that "all hospitals near the border have confirmed that there has not been one missed case of acute flaccid paralysis (AFP) to spot any signs of polio being imported. Information boards at Wagah and Attari in three languages - English, Hindi and Urdu - are asking all those coming from Pakistan to immediately contact the health booth if their children aged below five years feel sudden weakness in any part of the body or have been feeling it over the past six months."
Currently, the Global Polio Eradication Initiative (GPEI) says that about 16 countries are facing outbreaks owing to the import of the poliovirus, which is a significant number. Pakistan is amongst the top exporters, having a recorded 136 total cases of paralytic polio to date this year, with over 100 cases caused following the transmission of the P1 strain. It is also the only Asian country this year to have reported the P3 virus, which is on the verge of elimination elsewhere on the continent.
On another sad note, earlier this fall, China reported that viruses from Pakistan had triggered China's first polio outbreak in over 10 years. To date, China has reported 18 cases. (For more information, visit the Global Polio Eradication Initiative website, which provides great information and the most recent updates on the number of polio cases)
The WHO has said: "travelers to and from Pakistan should be fully vaccinated, and travellers to the country who in the past have had three or more doses of oral polio vaccine (OPV) should have another one before they travel. Some countries require travelers from Pakistan to be fully immunized against polio before they grant an entry visa."
Similarly to the WHO's recommendations, the UK has required all travelers coming from countries where polio is endemic to show proof of having received the oral polio vaccine at least 6 weeks prior to travel, and the Kingdom of Saudi Arabia has issued vaccination requirements for travelers of all ages undertaking the Umrah and the Hajj pilgrimages. This should be an effective contradiction to what a great number of Muslim populations believe of the vaccine (especially in Pakistan where so many people refused immunization), as Elena has described in detail below, and will hopefully act as an effective message to increase the number of vaccinations in countries such as Pakistan.
Read more at: http://www.ctv.ca/CTVNews/Health/20111103/india-polio-transmission-111103/#ixzz1cwu1YgNN
- Julie Saffarian
Sunday, November 6, 2011
Saturday, November 5, 2011
Polio Vaccine Myths Affecting Vaccination Campaign in Pakistan
This past Friday, the guardian printed an article about potential reasons for a rise in polio cases in Pakistan. Here is a summary:
In the federally administered tribal areas (Fata) of Pakistan, polio is on the rise. Within the Kyber Agency (a region within Fata) alone, it is estimated that more than 200,000 children have regularly missed immunization since 2009 and nationally 84 cases of polio have been reported so far this year.
What is causing so many people to not get their immunizations for polio, a potentially life threatening and crippling disease? While there is an inaccessibility problem due to security concerns, another huge reason for lack of immunization it seems is reluctance from parents perhaps related to beliefs in rumors about the negative health impacts the vaccine has.
The rumors often start when religious leaders launch campaigns against the polio vaccination through sermons and radio broadcasts. A very influential rumor begun by Maulana Fazlullah, a leader of a banned militant organization and important religious cleric, said that the polio drops cause impotency and infertility and it is an American conspiracy to sterilize and reduce the population of Muslims. Another rumor says that the polio drops are made out of pig fat and therefore forbidden by Muslims. In the past sermons have declared children who died or became paralyzed by the virus martyrs for not falling for western conspiracy.
It doesn’t help that most polio vaccines used in Pakistan are manufactured in WHO laboratories around the world including the USA. Furthermore, news reports about the fake vaccination campaign used by the CIA to track down Bin Laden only help strengthen misconceptions about the polio vaccine.
However, with the resurgence of polio, now religious leaders have joined the campaign led by the National Research and Development Foundation and Unicef to get rid of myths about the polio vaccine. About Five thousand scholars of the Deobandi sect (a school of religious thought which the majority of the people of the tribal belt belong to) have joined the campaign.
Clerics have helped resolve vaccine refusal cases, over 8,000 in Fata in one week of march alone. Religious scholars have issued Fatwas in favor of vaccinations. Health workers rely on working with religious scholars to successfully accomplish their education and vaccination campaigns. In some cases a scholar accompanies the health-worker in their rounds. Before parents would not even allow the health-workers to enter their homes. Now, the partnership with religious scholars and proving make the campaign a lot more successful.
Interestingly, clerics and religious scholars who support the vaccination campaign often take a quote from the Qur’an that sounds very similar to a possible modern public health mission statement. The quote talks about the importance of healing a single human being equal to healing human kind.
--Elena Jordan
Read more at: http://www.guardian.co.uk/commentisfree/belief/2011/nov/04/polio-vaccination-pakistan?newsfeed=true
In the federally administered tribal areas (Fata) of Pakistan, polio is on the rise. Within the Kyber Agency (a region within Fata) alone, it is estimated that more than 200,000 children have regularly missed immunization since 2009 and nationally 84 cases of polio have been reported so far this year.
What is causing so many people to not get their immunizations for polio, a potentially life threatening and crippling disease? While there is an inaccessibility problem due to security concerns, another huge reason for lack of immunization it seems is reluctance from parents perhaps related to beliefs in rumors about the negative health impacts the vaccine has.
The rumors often start when religious leaders launch campaigns against the polio vaccination through sermons and radio broadcasts. A very influential rumor begun by Maulana Fazlullah, a leader of a banned militant organization and important religious cleric, said that the polio drops cause impotency and infertility and it is an American conspiracy to sterilize and reduce the population of Muslims. Another rumor says that the polio drops are made out of pig fat and therefore forbidden by Muslims. In the past sermons have declared children who died or became paralyzed by the virus martyrs for not falling for western conspiracy.
It doesn’t help that most polio vaccines used in Pakistan are manufactured in WHO laboratories around the world including the USA. Furthermore, news reports about the fake vaccination campaign used by the CIA to track down Bin Laden only help strengthen misconceptions about the polio vaccine.
However, with the resurgence of polio, now religious leaders have joined the campaign led by the National Research and Development Foundation and Unicef to get rid of myths about the polio vaccine. About Five thousand scholars of the Deobandi sect (a school of religious thought which the majority of the people of the tribal belt belong to) have joined the campaign.
Clerics have helped resolve vaccine refusal cases, over 8,000 in Fata in one week of march alone. Religious scholars have issued Fatwas in favor of vaccinations. Health workers rely on working with religious scholars to successfully accomplish their education and vaccination campaigns. In some cases a scholar accompanies the health-worker in their rounds. Before parents would not even allow the health-workers to enter their homes. Now, the partnership with religious scholars and proving make the campaign a lot more successful.
Interestingly, clerics and religious scholars who support the vaccination campaign often take a quote from the Qur’an that sounds very similar to a possible modern public health mission statement. The quote talks about the importance of healing a single human being equal to healing human kind.
--Elena Jordan
Read more at: http://www.guardian.co.uk/commentisfree/belief/2011/nov/04/polio-vaccination-pakistan?newsfeed=true
Thursday, November 3, 2011
And we have yet to discover so much more about our amazing immune system...
We all know that when the human body becomes infected with a new virus, the immune system is rapidly activated in order to build a response to the intruding pathogen. In the case of the Influenza viruses, a sort of "inborn" protective mechanism is generated by the immune system that helps to fight the virus. Very recently, a new component of this mechanism, a protein called "Mx" (which stands for Myxovirus resistance), has been added to the definition of this immune response.
As we have seen with new strains influenza viruses in the past, such as with the H5N1 bird flu virus or the swine flu virus, these types of viruses have the property of "jumping" from humans to animals at a surprising pace, making it very difficult to control their spread. Although as humans we do not possess any sort of pre-exisiting immunity to these viruses, our immune system is able to rapidly generate a defense mechanism to prevent influenza viruses to replicate and proliferate uncontrollably in the body.
The protein Mx has been described as playing a crucial role in this process, through maintaining the spread of the viruses under control. The exact mechanism through which this protein accomplishes this task was previously unknown, but has recently been described by virologists from the Institute of Medical Microbiology at the Freiburg University Medical Center and biochemists from the Max Delbrück Center for Molecular Medicine (MDC) in Berlin-Buch, Germany. These researchers have, through building a molecular and atomic-level model of the protein, discovered that Mx is a molecular machine that develops its power when all the individual molecules have joined each other to form a ring-like network. A central element of the formation of these ring structures is the special part of Mx known as the stalk, which functions similarly to a "clamp", restricting and deactivating the components of the influenza virus in the infected cell. How are these Mx proteins activated in the first place? Their production has been linked to signals received from interferons, which as we know, are proteins released by cells upon infection with a pathogen. Thus under normal conditions, the protective Mx protein is not found in our healthy, virus-lacking cells.
These new findings about the Mx protein could revolutionize the treatment against influenza viruses, and researchers truly believe that they will form the basis for the formation of new antiviral drugs and for the understanding of other members of this family of proteins.
Read more here! http://www.sciencedaily.com/releases/2010/04/100428085843.htm
- Julie Saffarian
As we have seen with new strains influenza viruses in the past, such as with the H5N1 bird flu virus or the swine flu virus, these types of viruses have the property of "jumping" from humans to animals at a surprising pace, making it very difficult to control their spread. Although as humans we do not possess any sort of pre-exisiting immunity to these viruses, our immune system is able to rapidly generate a defense mechanism to prevent influenza viruses to replicate and proliferate uncontrollably in the body.
The protein Mx has been described as playing a crucial role in this process, through maintaining the spread of the viruses under control. The exact mechanism through which this protein accomplishes this task was previously unknown, but has recently been described by virologists from the Institute of Medical Microbiology at the Freiburg University Medical Center and biochemists from the Max Delbrück Center for Molecular Medicine (MDC) in Berlin-Buch, Germany. These researchers have, through building a molecular and atomic-level model of the protein, discovered that Mx is a molecular machine that develops its power when all the individual molecules have joined each other to form a ring-like network. A central element of the formation of these ring structures is the special part of Mx known as the stalk, which functions similarly to a "clamp", restricting and deactivating the components of the influenza virus in the infected cell. How are these Mx proteins activated in the first place? Their production has been linked to signals received from interferons, which as we know, are proteins released by cells upon infection with a pathogen. Thus under normal conditions, the protective Mx protein is not found in our healthy, virus-lacking cells.
These new findings about the Mx protein could revolutionize the treatment against influenza viruses, and researchers truly believe that they will form the basis for the formation of new antiviral drugs and for the understanding of other members of this family of proteins.
Read more here! http://www.sciencedaily.com/releases/2010/04/100428085843.htm
- Julie Saffarian
Monday, October 31, 2011
Dengue outbreak in Lahore, Pakistan
There's a huge dengue (fever) outbreak in Lahore, Pakistan. The monsoon season hit early and hard, so the temperature and amount of standing water is ideal for mosquito breeding. Over the past month and a half-ish, more than 30,000 people have gotten sick. Hospitals are crammed, and individual health workers sometimes test more than 1000 patents a day. Many have recovered, but 323 people have died. (Interestingly, the only day no one's died is Sunday: the 9th, 23rd, and 30th.) That's pretty amazing, even in a population of 6 million.
It's amazing to me that epidemics can be spread through mosquitos. I think of epidemics as being spread by coughing, but in this case if you're sick and a mosquito bites you and then bites the person next to you in bed, you've effectively infected the other person. Thus, sick patients aren't wearing masks, but are shrouded in mosquito nets! I think they're spraying and sucking viruses up in an effort to contain the mosquito population. See pictures.
The other article.
-Annelise
It's amazing to me that epidemics can be spread through mosquitos. I think of epidemics as being spread by coughing, but in this case if you're sick and a mosquito bites you and then bites the person next to you in bed, you've effectively infected the other person. Thus, sick patients aren't wearing masks, but are shrouded in mosquito nets! I think they're spraying and sucking viruses up in an effort to contain the mosquito population. See pictures.
The other article.
-Annelise
Nonlytic Escape of Poliovirus
It is assumed that for most naked viruses, the egress of newly formed virions involves only cell lysis, but a study by Karla Kirkegaard, formerly of Stanford, show that nonlytic release via phagosomes was also possible.
A important link to understanding this other method of viral exit is the fact that all eukaryotic +ssRNA viruses replicate genetic material on membranes in the cytoplasm (e.g. mitochondrial, ER, Golgi).
Kirkegaard postulates that polioviruses and some other nonlytic viruses can induce and be ecapsulated by cytoplasmic double-layered membranes, in which they mature and are eventually shipped out to the extracelluar fluid.
Despite the normal use of this autophagy pathway to degrade intracellular components, the digestive properties of said double-layered membranes seem to be ineffective or inhibited by nonlytic viral invaders.
Inhibition of cellular autophagy resulted in a lower yield intracellular viruses (because they are dependent on these membrane surfaces) but an even lower yield of extracellular virus; this is consistent with the non-lytic escape hypothesis.
Furthermore, experiments in which cells were polarized such that vesicles would only exit in one direction and infected with poliovirus showed virion emergence from the predicted side of the membrane.
Nguyen
Sources:
http://www.stanford.edu/group/kirkegaard/pdf/Kirkegaard_Autophagy_2005.pdf
http://www.stanford.edu/group/kirkegaard/pdf/Kirkegaard%202009.pdf
A important link to understanding this other method of viral exit is the fact that all eukaryotic +ssRNA viruses replicate genetic material on membranes in the cytoplasm (e.g. mitochondrial, ER, Golgi).
Kirkegaard postulates that polioviruses and some other nonlytic viruses can induce and be ecapsulated by cytoplasmic double-layered membranes, in which they mature and are eventually shipped out to the extracelluar fluid.
Despite the normal use of this autophagy pathway to degrade intracellular components, the digestive properties of said double-layered membranes seem to be ineffective or inhibited by nonlytic viral invaders.
Inhibition of cellular autophagy resulted in a lower yield intracellular viruses (because they are dependent on these membrane surfaces) but an even lower yield of extracellular virus; this is consistent with the non-lytic escape hypothesis.
Furthermore, experiments in which cells were polarized such that vesicles would only exit in one direction and infected with poliovirus showed virion emergence from the predicted side of the membrane.
Nguyen
Sources:
http://www.stanford.edu/group/kirkegaard/pdf/Kirkegaard_Autophagy_2005.pdf
http://www.stanford.edu/group/kirkegaard/pdf/Kirkegaard%202009.pdf
Hantavirus in India
A case of hantavirus infection has been discovered in the Karimnagar District of Hyderabad, India. This is considered the first reported case of hantavirus in the state, and Yashoda Hospital specialists are apprehensive of future cases to come. The man, Bhagavan Rao, was admitted to the hospital with cough and shortness of breath, only to fall into intense cardiac arrest the day afterwards. He was revived, placed on a ventilator, and appears to be slowly recovering. He is non-responsive and probably blind.
His physician, Dr. M V Rao, sent samples to Mumbai under suspicion of hantavirus. They came back positive, and Dr. Rao presence of rodents in the area, especially deer mice. This poses interesting questions in relation to the 1993 outbreak in the Four Corners Area of the United States. Should precipitation increase in the Karimnagar District, should the hospital take precautions in preparation of more hantavirus cases?
http://articles.timesofindia.indiatimes.com/2011-10-29/hyderabad/30336211_1_hantavirus-deer-mice-rodent
Pooja
His physician, Dr. M V Rao, sent samples to Mumbai under suspicion of hantavirus. They came back positive, and Dr. Rao presence of rodents in the area, especially deer mice. This poses interesting questions in relation to the 1993 outbreak in the Four Corners Area of the United States. Should precipitation increase in the Karimnagar District, should the hospital take precautions in preparation of more hantavirus cases?
http://articles.timesofindia.indiatimes.com/2011-10-29/hyderabad/30336211_1_hantavirus-deer-mice-rodent
Pooja
Act supporting research into antibacterial-resistant solutions introduced to Senate
The GAIN Act (Generating Antibiotic Incentives Now) was introduced into Senate last week. It's currently supported by both democrats and republicans in the House and the Senate, however, so far it has taken a backseat to the overshadowing issues of economic crisis.
This act seeks to make research into solutions for antibiotic-resistant bacteria profitable enough to attract pharmaceutical companies to devote their resources to the problem. Pfizer and Johnson&Johnson, both large pharmaceutical companies, have recently shut down some or all of their antibacterial resistance research, because the profits are miniscule when compared to other drugs they manufacture. The mot profitable drugs for large pharmaceutical companies are those that have to be taken for years and even decades. Drugs that would fight antibiotic-resistant bacteria would only need to be taken for a few days.
These shutdowns come at a bad time, as deaths from anti-biotic resistant diseases have reached a high this last year, causing about 70,000 deaths in the United States. These infections are mostly hospital-acquired, and are often MRSA or vancomycin-resistant enterococci. Additionally, these infections cost the U.S. healthcare system up to $34 billion a year.
The author of this article was pessimistic that the incentives offered by the GAIN Act would be enough to encourage pharmaceutical companies to continue their research. Until this issue becomes a crisis, it's just more profitable to make other drugs.
--Sarah Kaewert
http://www.theday.com/article/20111030/OP01/310309941
This act seeks to make research into solutions for antibiotic-resistant bacteria profitable enough to attract pharmaceutical companies to devote their resources to the problem. Pfizer and Johnson&Johnson, both large pharmaceutical companies, have recently shut down some or all of their antibacterial resistance research, because the profits are miniscule when compared to other drugs they manufacture. The mot profitable drugs for large pharmaceutical companies are those that have to be taken for years and even decades. Drugs that would fight antibiotic-resistant bacteria would only need to be taken for a few days.
These shutdowns come at a bad time, as deaths from anti-biotic resistant diseases have reached a high this last year, causing about 70,000 deaths in the United States. These infections are mostly hospital-acquired, and are often MRSA or vancomycin-resistant enterococci. Additionally, these infections cost the U.S. healthcare system up to $34 billion a year.
The author of this article was pessimistic that the incentives offered by the GAIN Act would be enough to encourage pharmaceutical companies to continue their research. Until this issue becomes a crisis, it's just more profitable to make other drugs.
--Sarah Kaewert
http://www.theday.com/article/20111030/OP01/310309941
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