BIOL 368: Blog

BIOL 368 (NJIT) and 28:120:368 (Rutgers) — Fall 2016

Ecology and Evolution of Disease

This is a blog associated with the course above. Students are asked to post, in the comments section below, short vignettes of related news items that come up while the course is in session.

 

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92 thoughts on “BIOL 368: Blog”

  1. Infectious, vector-borne diseases have always been an issue, especially one known as dengue fever. Transmitted by mosquitoes, it is the most prevalent mosquito-borne disease in the whole world, and the Philippines faces some of the worst cases. Approximately 200,000 inhabitants are infected with dengue every year in this country, which has led to immunization programs implemented in schools using the Dengvaxia vaccine. However, through post-vaccination surveillance programs, a detrimental trend with this vaccine use has been identified; for unknown reasons, those who have never been infected with dengue prior to Dengvaxia have a higher risk for severe health problems following introduction of the disease . Thus, the immunization programs in schools have been halted for the time being, now that the complex nature of dengue infection has been brought to light. For those who have been infected prior to Dengvaxia, they have chances of severe hemorrhaging upon infection with another strain (dengue has 4 serotypes, with the person building immunity to each strain it is infected with). Because of this new information about how the disease might work, the Philippine government is issuing a pause in the program in order to recollect the facts, but it is detrimental not only economically but medically because without any dengue treatment on the market, there are children completely vulnerable to the attack of vectors and the diseases they carry with them.

    More information here: https://www.nytimes.com/2017/12/01/world/asia/philippines-dengue-vaccine.html?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health&region=stream&module=stream_unit&version=latest&contentPlacement=2&pgtype=sectionfront

  2. Author James Gallagher makes a profound connection between the gut microbiome and cancer therapy in his article titled “Gut bacteria ‘boost’ cancer therapy”. Gallagher sites a study conducted in Paris at the Gustave Roussy Cancer Campus that took 249 cancer patients and examined their response to immunotherapy. It was found that the tumors in those who had taken antibiotics in the past, were more likely to grow. This is due to the fact that antibiotics damage the gut microbiome. In addition to this, a particular strain of bacteria, Akkermansia muciniphila, was found to be linked to patients who responded to the immunotherapy. In a separate study, a trans-poo-sion was conducted where fecal matter of humans was transferred into mice, who then faced a slower growth in their tumors as opposed to those mice without the transfer. This was linked to the mice having a “good” mix of bacteria from the human fecal matter. Using these two studies, this article highlights an interesting benefit of maintaining a healthy gut microbiome, that some may not realize at first glance.

    http://www.bbc.com/news/health-41848461?intlink_from_url=http://www.bbc.com/news/topics/c1038wnxy50t/medical-research&link_location=live-reporting-story

  3. This article discusses the possible connection between the air pollution that women are exposed to and low birth weight for newborns. Researchers found that average air pollution levels were 14 micrograms per cubic meter of PM 2.5 in London. PM 2.5 refers to air pollutant particles. The EPA recommends that 12 micrograms per cubic meter should be the limit for PM 2.5 levels, while other organizations suggest even less, which indicates that the levels in London are significantly higher than recommended. One epidemiologist said that a 10% reduction in PM 2.5 levels can potentially lead to a 90% decrease in low birth weight in London.

    This article signifies how environmental causes can lead to certain conditions. In this case, it is air pollution with regards to low birth weight for newborns. Low birth weight is associated with diseases such as diabetes and heart disease later in life, which signifies the importance of reducing air pollution.

  4. The U.s. Environmental Protection Agency (EPA) has authorized a biotechnology start up to implement the use of lab developed mosquitoes to get rid of the Zika and Dengue-transmitting Asian tiger mosquito. The goal is aimed at the Asian tiger mosquito Aedes albopictus, which is a vector for the Zika virus that began to circulate in the U.S. last year. The MosquitoMate was created with “killer” tiger mosquitoes by infecting males with the Wolbachia pipientis bacterium. When these manipulated males mate with wild female mosquitoes that don’t carry the same Wolbachia strain, the resulting eggs die.

    This article relates to our topic on disease transmission and transmission rate. By releasing altered insects into the enviornment, we would utimately be able to drive these Asian tiger mosquitoes into extinction. I thought this was a really clever way to go about things. If you can get rid of the vector, a vector-borne disease will have to way to transmit onto other hosts and will ultimately die out. They should consider this technique when administering vaccinations. If we can alter mosquitoes to carry vaccinations, whenever we would get stung, we would be getting a treatment.

  5. This article highlights how antibiotic-resistant gonorrhea is an issue that is becoming increasingly worse. Earlier this year, the World Health Organization (WHO) released a statement saying that data from 77 countries show that gonorrhea is evolving antibiotic resistance. This problem has gradually been becoming more prevalent over the years. A study conducted in 2015 found that efforts to inhibit the increased resistance of Neisseria gonorrhoeae to antibiotic treatment appeared to be failing. More specifically, the antibiotic ceftriaxone became even less effective with its growing popularity, which researchers found through studying bacteria samples. As with all antibiotics, when they are used, bacteria begin to evolve defenses upon interacting with them. This interaction causes resistance to spread more quickly. For this reason, antibiotic use should be limited and saved for when it is really needed in order to prolong the effectiveness of the drug.
    The Centers for Disease Control and Prevention referred to gonorrhea as an “urgent threat” in 2013. The suggested treatment was ceftriaxone and another drug, which decreased resistance for some time, but resistant strains later became common yet again. The WHO suggested using new antibiotics to defend against this infection, but there are only three such drugs being developed. Since antibiotics do not produce much profit for pharmaceutical companies, investing millions of dollars in developing a drug proves to be difficult. The WHO hopes a vaccine can be created to treat gonorrhea because antibiotic resistance is a serious problem and other ways to treat bacterial infections must be found.

  6. Here is an article about an interesting study that examined the effects antibiotics can have on the immune system which was similar to our discussion on the positive and negative effects that antibiotics can have on the gut microbiota. In this study, a mouse infected with E. coli was given antibiotics which ended up changing the metabolites being released by the mouse. These metabolites were found to actually inhibit immune cell activity and increased the antibiotic resistance of the E. coli.
    https://www.sciencedaily.com/releases/2017/11/171130141100.htm

  7. Here is an article that kind of follows up on our discussion about the HIV levels in African countries and the role of different public health organizations. The study showed a 42% reduction in new infections in a Ugandan district after the implementation of different HIV prevention strategies. This is a very important finding as it provides credence to the idea that such prevention strategies can be effective in large populations. The strategies implemented involved promoting medical circumcision for uninfected males, antiretroviral therapy for those infected, and general safe practices such as having a single sexual partner.
    https://www.sciencedaily.com/releases/2017/11/171130090106.htm

  8. The influenza virus kills about 12,000 to 56,000 people in the United States per year. Recently, researchers from the University of Colorado Boulder and University of Texas at Austin have found a mechanism by which the human immune system attempts to fight against the influenza A virus. This mechanism was previously unknown and its discovery could potentially result in new and effective treatment options. The seasonal flu virus typically originates in birds and later makes its way to humans. The recent findings could lead to the development of antivirals to hinder several influenza strains. This article mentions how there are two key molecules involved with influenza infection. One of these molecules is a human protein, TRIM25, which plays an essential role in the response of humans to flu infection. The second molecule is NS1, which is present in all strains of the influenza A virus and binds to TRIM25 to inhibit it from playing its role.
    There were two main discoveries from analyzing these molecules: TRIM25 latches on to the unique structure of the flu virus resembling a “molecular clamp” that prevents the virus from replicating when detected. In addition, NS1 that is produced by the flu virus is able to block the function of TRIM25, thus causing infection. The article discussed how the study conducted involved researchers infecting transgenic cell lines with primate versions of TRIM25 with human influenza A virus. They found that these cells combatted the virus better than the human versions of the protein. This reflected how TRIM25 can destroy influenza, but the human form is not as active. It was also found that TRIM25 is present in the nucleus of the cell, which is where flu replication occurs. Further studies are necessary, but it is possible that new methods of therapy may be developed to block the NS1 protein, which would prevent the flu virus from acting against the human immune system.

    https://www.sciencedaily.com/releases/2017/11/171108151614.htm

  9. Research of flies’ resident bacteria suggests that the insect can transfer microbes via their legs from one spot to another. Scientists analyzed the whole genomes of 116 houseflies and blowflies, including all of their native microbes. These meta genomes reveal that flies are likely to transfer potentially pathogenic bacteria. This method for pathogen transmission has been unnoticed by public health officials. Flies can add to the already rapid transmission of pathogens in epidemic incidents.
    After breaking down the blowfly microbiome, the limbs and wings were apparent/ distinct for the existence of Helicobacter species, including H. pylori, which can lead to ulcers. The authors suspect the flies picked up the bacteria from sewage. Another experiment showed that flies could pick up E. coli after walking on a dish covered in the bacteria, and then spreading the colonies to sterile plates they later landed on.

    This article also relates to our topic about pathogen transmission. Essentially, bacteria can “fly” by catching a ride from common flies. Flies could be a vector for many infectious diseases and responsible for the transmission of many diseases. I thought it was a really interesting article because I never thought of flies being responsible for disease transmission. They pick up the microbioime on their feet, spread them across their wings and disperse them when they land on different surfaces.

  10. Mosquitoes have, by far, been the animal to cause the most human deaths throughout history. There is nothing uniquely dangerous about the mosquito itself, instead the danger lies in it’s role as a vector for numerous diseases, particularly Malaria. Currently, public attention has been focused on Zika, a mosquito transmitted disease circulating around Central and South America which lead to birth defects in the offspring of infected women. A researcher by the name of Omar Akbari at the University of California, Riverside has utilized gene drives in mosquitoes to attempt to eliminate diseases such as malaria, dengue, and Zika. The gene drive technology utilizes CRISPR/Cas9 and guide RNA to influence the likelihood of specific genes being passed on i.e. genes making mosquitoes unable to carry the malaria parasite. Akbari’s lab is considering many questions and options regarding how to engineer mosquitoes that could be released to the larger population and mitigate the frequency of disease transmission, but they face a large problem in that they don’t know how wild mosquitoes behave and are unsure of how successful mutant mosquitoes will be in altering the gene pool. Furthermore, even if an answer were reached the lab still faces many restrictions as the public is reticent to accept such technology and their contract with DARPA prevents them from releasing any gene drives.

    Full article here: https://www.statnews.com/2017/12/13/gene-drive-mosquitoes-darpa/

  11. This article examines a new method for monitoring Zika virus that will happen more cost efficiently and swiftly. The assay is based on loop-mediated isothermal amplification (LAMP) and can distinguish between Asian and African strains of the virus. The LAMP assay proceeds at a constant temperature of 63 degrees centigrade unlike that of the reverse transcription PCR. By eliminating the reverse transcription step by using a cost effective heat block and is powered by the battery of a truck. This method will make the assay cheaper and more accessible to remote locations.
    This new method do determine the presence of zika in humans and mosquitos would lessen the economic burden of testing in underdeveloped places and turn increase the spread of awareness and hopefully decrease the vertical transmission of the virus.

    Full Article: https://www.the-scientist.com/?articles.view/articleNo/49333/title/Quick-and-Cheap-Zika-Detection/

  12. According to a study on mice published in Nature , gut bacteria can mediate the effects an infection dying pregnancy can have on the offspring. Researchers found that mice pups developed autistic abnormal behaviors when their mothers were exposed to an infection while pregnant if certain strains were present. These specific strains prompted the activity of T helper cells causing an immune response to produce interleukin-17a, a previously identified contributor to behavioral dysfunction in mouse pups. The region in the brain responsible for this behavior was pinpointed in another study.
    Women infected with viruses during pregnancy are at a higher risk of having children with behavioral problems. The connection between irregularities of the brain and viral ingestion still need to be confirmed in humans. This research gives new perspective on a disease that was not previously thought to have no connection to an infectious cause.

    Full Article :https://www.the-scientist.com/?articles.view/articleNo/50318/title/Infection-During-Pregnancy-Tied-to-Autism-in-Mouse-Model/

  13. Researchers have found that obesity can be prevented in mice when the Hedgehog protein pathway was activated in mice, despite eating a high fat diet. Mice who did not have their Hedgehog protein pathway activated became obese after consuming a high fat diet for eight weeks. The Hedgehog pathway essentially prevents fat cells from becoming bigger, thus potentially becoming a potential target for humans to combat obesity. However, too much activation of the Hedgehog pathway has been associated with some cancers, hence more research needs to still be done on this pathway.

    https://www.sciencedaily.com/releases/2017/12/171205115946.htm

  14. In his article titled “Migraine therapy that cut attacks hailed as ‘huge deal’”, James Gallagher presents a study that explores a way to combat migraines. The administration of an antibody that neutralizes calcitonin gene-related peptide or CGRP in the brain has been shown to greatly reduce the effects of a migraine. CGRP is involved in light and sound sensitivity during a migraine and an antibody, such as erenumab or frenamezumab, targets CGRP resulting in a decrease in migraines in patients over time. A study conducted using erenumab resulted in 50% of people who took the antibody having half the number of migraines they usually have per month. A separate study conducted with frenamezumab resulted in 41% of people who took the antibody having less migraines. This article, therefore, presents a new way to combat migraines and provides the reader with two studies on two antibiotics that do this.

    http://www.bbc.com/news/health-42154668?intlink_from_url=http://www.bbc.com/news/topics/c1038wnxy50t/medical-research&link_location=live-reporting-story

  15. This article discussed how researchers created a form of stainless steel that had many microscopic sharp bumps that made the steel uninhabitable for bacteria; the steel killed and repelled the bacteria. The steel was tested against gram-positive bacteria, which has been hard to kill because of its antibiotic resistance. The “nanotexturing” could help sensory devices to better detect diseases.

    Article here: https://gizmodo.com/a-new-type-of-steel-kills-bacteria-with-nanospikes-1821270726

  16. This article discussed how a blood test designed by researchers at Georgia State University came up with a blood test that was able to detect non-Hodgkin’s lymphoma and melanoma (in mice). The blood test used infrared spectroscopy, which allows for rapid screening. Currently, biopsies are conducted in the diagnoses of these cancers; biopsies can be a lengthy and costly process. A blood test would allow for more rapid and widespread screening, and could be tested for in regular checkups.

    Article here: http://www.nydailynews.com/life-style/health/simple-blood-test-diagnose-types-cancer-article-1.3696467

  17. This article introduces the idea that an antidepressant called clomipramine could also help take away symptoms for Multiple Sclerosis patients. The research has moved on to the clinical phase of experimentation, which is extremely ground breaking because soft far there is no treatment available for MS patients. The therapy has been proven effective in mice and the symptoms of MS including paralyzation were reduced. The biggest advantage researchers have going into the clinical phase of trying this drug for MS patients is that they are already fully educated and aware of the possible side effects, essentially allowing them to skip the entire phase 1 trial.

  18. This article explains how those suffering from one of the most fatal cases of skin cancer should possibly also try rheumatoid arthritis medication in combination with their existing medication to see better results. It was observed that when the two drugs were combined, the growth of the melanoma tumor almost completely stopped. The explanation which is provided states that combining both drugs attacks the cancers the from several angles therefore minimizing the impact and making it harder to develop resistance. The current drugs which are being testing together are leflunomide and selumetinib, and they are being texted on mice now. The major issue researchers are facing right now is that the tumor is growing resistant the drugs that are being introduced very quickly.

    https://www.sciencedaily.com/releases/2017/12/171219092956.htm

  19. A recent study found that exposure to common housecleaning products with disinfecting qualities can lead to a higher risk in obesity in infants. Canadian researchers studied the gut flora of 757 infants at the age of 3-4 months and took note of their weights when at the ages of 1-3 years. The infants exposed to disinfectants were found to have the microbiome in their guts altered- there was a decrease of the bacteria Haemophilus and an increase in Lachnospiraceae at 3-4 months. At the age of 3, their body masses were larger compared to infants not exposed to disinfectants. However, exposure to detergents and/or eco-friendly cleaners did not produce the same result. Rather, their gut microbes had a lower level of enterobacteriaceae. Although it could not be proven that the microbiomes of infants exposed to eco-friendly housecleaning products reduce the risk of obesity, it was concluded that those infants had a healthier diet, overall. The question as to why and exactly what part of disinfecting cleaning products produced these results was not answered in this study and the researchers call for more studies to be conducted in order to fill in these gaps.

  20. With the rise of the prevalence of syphilis in adults, there was also been a subsequent rise in the number of babies born with congenital syphilis from infected mothers. The number of babies born with syphilis has increased by more than two times in the last four years, and last year it was the highest it has been in 20 years. In pregnancy, syphilis can cause miscarriages and stillbirths; babies born with it can suffer from a wide range of health issues that can affect them for the rest of their lives. Therefore, the CDC’s recommendations instruct all pregnant women to be screened for syphilis during the first prenatal exam. However, this upward trend comes after many believed that syphilis had been close to being completely eliminated in 2000. Since then though, progress has “unraveled,” says the report, which is very saddening to think about. In order to combat syphilis, it will take the public health field and communities working together with industry and people.

  21. On October 1, 2018, the Nobel Prize in Physiology or Medicine was awarded to Dr. James P. Allison of the United States and Dr. Tasuka Honjo of Japan for their work on using the body’s immune system to attack cancer, a breakthrough that has led to an entirely new class of drugs that are helping cancer patients who had previously run out of options. Previously, cancer treatments consisted of surgery, radiation, chemotherapy, and hormonal treatments. With the new breakthroughs in Dr. Allison’s and Dr. Honjo’s research, a new class of drugs called checkpoint inhibitors are being used to treat cancers of the lung, kidney, bladder, head, and neck. They are also used to treat the aggressive skin cancer melanoma and for Hodgkin lymphoma.

    The first breakthrough for Dr. Allison and Dr, Honjo came in the 1990s when both of them, working separately, discovered there were certain proteins that act as “brakes” on the immune system’s T cells and limit their ability to attack cancer cells. T cells are a type of white blood cell that are deployed to fight to fight infections and cancer. These T cells carry molecules called checkpoints that the body uses to shut down the cells when it needs to. Cancer cells target these checkpoints to cripple the T-cells and prevent them from fighting the disease. Both Dr. Allison and Dr. Honjo discovered two different checkpoints, CTLA-4 for Dr. Allison and PD-1 for Dr. Honjo. This allowed both researchers to develop drugs called checkpoint inhibitors that can physically block the checkpoint, which frees the immune system to attack the cancer cells.

    However, with all the success these checkpoint inhibitors bring in the battle of cancer, there are many side effects and downsides of checkpoint inhibitors. These treatments can also turn the fury of the immune system against the patient’s own tissues, leading to side effects such as the lungs, intestines, and even the heart becoming inflamed, thyroid gland turning sluggish, the pancreas getting damaged which could lead to diabetes, the risk of developing rheumatoid arthritis, and sometimes even death. These drugs are also very expensive, costing over $100,000 a year. However, with the continuing research that are being done with these checkpoint molecules, including more research from Dr. Allison and Dr.Honjo, many are confident that these checkpoint inhibitors are the step in the right direction in the war against cancer.

    Dr. Honjo, 76, is a longtime professor at Kyoto University. Dr. Allison, 70, is a chairman of immunology at the University of Texas M.D Anderson Cancer Center. He did the work recognized by the Nobel committee while working with the University of California at Berkeley and Memorial Sloan Kettering Cancer Center in New York.

    Learn more at: https://www.nytimes.com/2018/10/01/health/nobel-prize-medicine.html

  22. One of the most daunting world health issues faced today is the ineffectiveness of antibiotics due to rapid evolution of bacteria against them. It has been noted that evolution in bacteria, which have the ability to horizontally transfer genes, showcases how natural selection can give rise to medical conditions and also be an unfortunate by-product of medical practice. Antibiotic resistance from unpredictably fast pathogen evolution has lead to the inability of even the most last resort medications to prevent infection, such as Carbapenem.

    Recent scientific breakthroughs have shown the promising ability of CRISPR gene editing with respect to halting pathogen evolution. In a published paper in Communications Biology with lead author Dr. Peter Otoupal, it showed how researchers changed one gene at a time in bacteria. Observations established that decreases in pathogen fitness were found after multiple genes’ expressions were altered. Thus, the impact of one gene at a time was less significant and allowed the bacterial generations to still rapidly adapt. Researchers explain that since this type of gene editing treatment would understandably be expensive, it is likely to be among the last resort options. The biggest claims of researchers on this project is that new routes of disease resistance should be sought out as antibiotic resistance in pathogens like superbugs still has significant fatal consequences in thousands across the country every year.

    Link for more information:
    https://www.contagionlive.com/news/crispr-technology-could-help-thwart-evolution-of-antibiotic-resistant-superbugs

  23. The US Center of Disease Control has noted 155 current cases of acute flaccid myelitis (AFM) which is a disorder associated with polio-like conditions. It has lead to paralysis and most patients are affected children (90% under the age of 18). One of the biggest concern of health officials is that is it unknown why the virus impacts different children differently. One patient highlighted had contracted the virus at the same time as her siblings but she was the only one to become paralyzed from the pathogen.
    This disease has been followed by the CDC since 2014 and it has been noted that the highest influx of cases occur during fall. AFM is still a relatively unstudied disease and most public health professionals are not sure why susceptibility and recovery time are so variable per patient.

  24. Science author, Carl Zimmer, presents the findings of Dr. Inigo Martincorena, a geneticist at the Wellcome Sanger Institute in Cambridge, England. Dr. Martincorena examined samples of human skins cells and found that “about one of every four [healthy] epithelial cells carried a mutation on a cancer-linked gene, speeding up the cell’s growth.” When Dr. Martincorena performed a similar analysis of esophageal tissue, he found “rogue” mutant colonies that, while “these clones aren’t cancer, they do exhibit one of cancer’s hallmarks: rapid growth.”
    As we discussed in class, this perspective of clonal evolution has many implications regarding the detection of and the treatment for cancer.

  25. A viral outbreak has been reported at the Wanaque Center for Nursing and Rehabilitation in Northern NJ. This adenovirus has left 6 children dead at the pediatric center while infecting another 12. The virus presents itself with symptoms of mild respiratory illnesses such as those of a mild cold or bronchitis. The virus spreads through contact of contaminated surfaces and/or water for which it is commonly associated with communal facilities. This specific communal center has been associated with health violations in the past, however, they have not been sanctioned.

    Update: As per CNN, a total of 10 children have died as a result of the initial viral outbreak at the center.

  26. A new study has been conducted looking into the eventual possibility of a universal flu shot. Most antibodies attack the surface proteins of a virus and the variation of these proteins causes these antibodies to have to be specific to a certain strain. However, some antibodies are able to attack a part of the virus that is found in many different strains. Researchers took four of these antibodies from llamas because their antibodies small size makes them relatively easy to work with, and created a gene that would manufacture one mega-antibody as a combination of all four. In order to get mice to start producing the mega-antibody, the researchers added the gene to a less virulent virus and sprayed the virus into the noses of mice. These mice were then infected with 60 different flu strains and only one of those strains was able to replicate within the mice. They are hoping to use this finding and translate it to humans.

  27. The NYT published an article about the flu shot: who should get it, why its important to get, what the flu shot does, if its effective, the future of flu vaccinations, how to prevent getting the flu.

    Two interesting points made by the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, Dr. Michael T. Osterholm:
    – he stated that November is the best time to get the flu shot so that an individual’s immunity will be the strongest during the height of flu season in December. He explains that the immunity gained from the flu shot is transient and that it “tends to wane by 20 percent a month.”
    – he explains the efforts being made towards developing a “‘universal’ flu vaccination.” “The goal, Dr. Osterholm said, is ‘a vaccine that can handle many new changes in the virus and that needs to be given only once every five or 10 years.'”

  28. This article discusses how deforestation is allowing monkey malaria (P. knowlesi) to spread and infect human hosts. A Malaysian woman on July 23, 2018 tested positive for monkey malaria, and monkey malaria has become an increasingly prevalent disease in humans. While Malaysia has been focused on working towards decreasing the cases of human malaria, monkey malaria has spiked over the past ten years. Most cases of monkey malaria in humans are found in those that reside or work near cut forests. This is believed to happen because monkeys prefer to live near human communities that provide food and have less natural predators around. New conventional methods are being explored for mosquito control in areas prone to P. knowlesi transmission by these mosquitos. This study shows how important it is to consider the effects of big projects such as deforestation and other environmental changes on human health.

  29. NBC released an article this week regarding 90 children coming down with acute flaccid myelitis (AFM). These symptoms are very similar to polio’s symptoms in that patients suddenly develop weakness in their arms or legs as well as respiratory symptoms. Doctors are now trying to find the source of these symptoms. Although they have only found traces of viruses in samples of spinal fluid from 2 of the patients, doctors believe the symptoms are being caused by viruses and likely different viruses within each patient. However, they are still checking other possible causes like toxins to make sure nothing is overlooked.

    https://www.nbcnews.com/health/health-news/polio-syndrome-caused-several-viruses-cdc-says-n935721

  30. For the first time in almost 2 decades, cases of measles have shown up in Brazil. This once-eradicated disease crossed Brazilian borders from Venezuela and have also spread to countries such as Argentina, Colombia, Ecuador, and Peru. Brazil’s patient zero was a 1-year-old Venezuelan child. More than 10,000 patients contracted measles in Brazil within 8 months and 170 new cases appear every week. So far, 2 adults and 4 infants have died. Venezuela had also eradicated malaria in sections of their country decades ago, but in the past 3 years, the number of malaria cases have tripled and have lead to an increase in malaria cases in Brazil and Peru. The last time Colombia had a case of diphtheria was in 2005. In 2018, they have had 8 cases recorded in regions with high Venezuelan immigrant populations. The reemergence of these once-eradicated diseases are the result of the failing government infrastructure. Economic and political problems have been continually deteriorating Venezuela’s health care system. The government has tried to launch vaccination programs, but issues such as compromised containment efforts, inappropriate vaccination storage, and inability to deliver vaccinations, have made it difficult to reach everyone. Additionally, the spread of measles and other diseases shows a weakness in vaccination programs in countries like Brazil, where 1/3 of Brazilians were unvaccinated when measles came from Venezuela.

    https://www.washingtonpost.com/news/world/wp/2018/10/31/feature/as-venezuelas-health-system-collapses-disease-spreads-beyond-its-borders/?noredirect=on&utm_term=.ed08aaba1537

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