BIOL 368 (NJIT) and 28:120:368 (Rutgers)
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.
Structural Ecology Lab @ NJIT 
A sobering professional editorial on the moral responsibility of physicians, which at the end touches on public health issues such as environmental damage.
https://jamanetwork.com/journals/jama/fullarticle/2665004
And here is a media article linking economic distress to a variety of ailments. The (somewhat obvious) conclusion is that a lot of public health issues require not medical but economic/political solutions.
https://www.citylab.com/equity/2017/12/economic-inequality-and-health-inequality-are-inextricably-linked/547349/
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®ion=stream&module=stream_unit&version=latest&contentPlacement=2&pgtype=sectionfront
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
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.
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.
Dalia’s link is hidden in her name at the top of the post: click on it to go to the article.
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.
https://www.popsci.com/antibiotic-resistant-gonorrhea-getting-worse#page-3
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
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
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
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.
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/
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/
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/
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
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
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
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
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.
https://www.sciencedaily.com/releases/2017/12/171220121839.htm
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
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.
For more information:
https://www.sciencedaily.com/releases/2018/09/180917082435.htm
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.
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
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
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.
https://www.cnn.com/2018/10/22/health/acute-flaccid-myelitis-cdc-stats/index.html
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.
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.
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.
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.'”
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.
https://www.sciencenews.org/article/malaysia-ground-zero-monkey-malaria-deforestation
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
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
Although this year’s flu vaccine will reduce the odds of getting the flu significantly, it is still not the most effective. The flu shot has helped to reduce the odds of getting sick, but because of how difficult and time consuming it is to develop an effective flu shot, scientists are searching for other methods of flu prevention. Researchers have created a potential alternative to the seasonal flu shot by using immunotherapy and gene therapy to create an artificial antibody that has protected mice from various flu strains. Researchers discovered a rare antibody called broadly neutralizing antibodies that do not target the specific surface proteins of the flu virus the way the current flu shots do. These antibodies target other parts of the flu virus that are nearly identical between different viral strains. These broadly neutralizing antibodies that the researchers used came from llamas, and they were formed into ‘mega-antibodies’. Although these antibodies are effective in mice, human trials are still needed to determine how effective and safe these new antibodies are.
The New York Times recently published an article regarding a “rapid” cure that has just been approved for Sleeping Sickness. Sleeping Sickness, also called African trypanosomiasis, is caused by protozoan parasites that are transmitted through the tsetse fly vector, as it sucks human blood. The parasites travel to the host’s brain, causing paranoia, hallucinations, rage, and eventually death. A new drug, fexinidazole, comes in the form of a pill and was recently approved by Europe’s drug regulatory agency on Friday, November 16th for use in Africa. As there are less than 2,000 cases per year, the new, rapid treatment is to make Sleeping Sickness a disease that can soon be eradicated. The new drug is supposed to cure any stage of the disease within a span of 10 days, which is much shorter than previous forms of treatment. Before, anyone with the parasite found in their blood would have to undergo a spinal tap to determine if the parasite invaded the brain. If it did, patients had to undergo long hospital stays and intravenous treatment of eflornithine, which could weigh about 125 pounds. The most common form of Sleeping Sickness, caused by Trypanosoma brucei gambiense, occurs in west and central Africa and can be cured by the pill. However, a less common form of Sleeping Sickness occurs in southern Africa and still requires older treatments.
The salmonella outbreak began last year, November 2017 and continues to spread this year. There is no clear source of the outbreak but the US Department of Agriculture’s Food Safety and Inspection Service found a link between turkey products and the outbreak. According to lab results, salmonella pathogen strains was found in ground turkey, turkey patties, live turkey, and pet food. The symptoms include fever, diarrhea, and stomach cramps that usually last for a few days and up to a week. Very rarely will it lead to death, though there have been cases. This can occur if the patient is not treated with antibiotics. There are approximately 1.2 million cases of salmonella infections in the US per year. The US centers for Disease Control and Prevention encourage people to take precautions when handling turkey products by washing hands after touching it, ensuring that the turkey is cooked well before consumption, and defrosting the turkey in the refrigerator, not outside on the counter.
https://www.cnn.com/2018/11/16/health/salmonella-raw-turkey/index.html
The CDC has issued a warning about a new E. coli outbreak found in romaine lettuce and has advised all individuals to stop the sale and consumption of all romaine lettuce immediately. The source of the current outbreak is under investigation, but an earlier outbreak in June of this year was traced back to a contaminated irrigation canal near a factory farm in Arizona consisting of animal waste. The water from the canal was used to dilute pesticides which were applied to the farmlands. Animal feces contains E. coli and their application to soil as fertilizer makes leafy greens and vegetables susceptible to contamination with E. coli. Foodborne transmission of E. coli to humans occurs through leafy greens such as romaine lettuce since they are generally eaten raw. Cooking them would destroy the bacteria and greatly reduce the risk of E. coli infection. Furthermore, many E. coli strains are harmless because they have long been present in our guts and intestinal tracts. Some strains, which we have not been exposed to before, are likely to cause symptoms of infection such as diarrhea, stomach cramps, and vomiting. The current outbreak has affected 32 individuals across 11 states in the US and 18 people in Canada.
Link:
https://www.usnews.com/news/news/articles/2018-11-20/citing-e-coli-outbreak-us-officials-say-dont-eat-romaine
This article is about a Chinese scientist, who used the gene-editing tools to make two twin baby girls resistant to HIV by eliminating a gene called CCR5. Gene editing is deleting or changing troublesome coding in embryos which can be serve as a potential method to prevent heritable diseases for future generation. However, interfering with the genome of an embryo can cause harm not only to the individual but also future generations that inherit these same changes. Gene editing is considered experimental and is still linked with off-target mutations, causing genetic problems early and later in life, including the development of cancer. An expert in stem cell science at King’s College London argues that HIV is highly treatable and that if the infection is kept under control with drugs, then there is almost no risk of the parents passing it on to the baby anyway. Therefore, this experiment exposes healthy normal children to risks of gene editing for no real necessary benefit. Other scientists call this act of experimentation on humans for an avoidable condition just to improve knowledge morally and ethically unacceptable. The institute linked to the case has launched an investigation.
Link: https://www.bbc.com/news/health-46342195
The article talks about how the scientists in the US are trying to develop a new flu treatment using a new antibody therapy produced by llamas. Antibodies are defenses of the immune system and they bind to the proteins that stick out from the surface of a virus. Llamas produce extremely tiny antibodies in comparison to humans. Human antibodies attack the tips of those proteins, which can be altered by influenza easily. However, llama antibodies are so small that move a little bit deeper and attack the parts that flu cannot change. A group of researchers at the Scripps Institute in California infected llamas with multiple types of flu to trigger an immune response. 4 synthetic antibodies were made using elements from Llama’s antibodies that could attack a wide range of flu strains, which tested on mice with deadly doses of influenza. One of the researcher told BBC that the antibodies are effective, there were 60 different viruses that were used in the challenge and only one wasn’t neutralized and that’s a virus that doesn’t infect humans. However, there is still work being done, and it depends how well these things work, how easy it is to produce and also how costly it will be.
Link: https://www.bbc.com/news/health-46078989
https://www.sciencedaily.com/releases/2018/11/181126093211.htm
A new study discusses how obesity may be the reason some children have asthma. The article claims that about 10% of kids from 2-17 with asthma or about 1 million children could have potentially avoided this illness if they had maintained a healthy weight. Potential differences in lung and airway development and inflammatory changes in the body due to obesity could be the cause of childhood asthma. Further exploration will be completed to determine whether there is a causal relationship between asthma and obesity. However, there is a definite significant increase in asthma in obese children. This article highlights how trade-offs and effects of one disease can potentially cause the rise of a seemingly unrelated disease.
Earlier this week, NPR released an article regarding potential treatments for Ebola. The Democratic Republic of the Congo has had another outbreak of Ebola spanning the last four months. This wave is close to becoming the largest outbreak on record. In hopes to better contain future outbreaks, they are launching the first multidrug clinical trial in search for the most effective treatments. The focus of the trial is on mAb114, Regeneron, Remdesivir, and ZMapp, the four leading treatments for Ebola. The World Health Organization has revised a protocol they had previously created for Ebola treatment to suit the needs of these trials. It is called “Monitored Emergency Use of Unregistered and Investigational Interventions”. This protocol allows health care providers to use unapproved treatments on Ebola patients due to the urgent characteristics of the disease. The WHO’s director general is very optimistic towards the study and believes this to be the beginning of saving many lives down the road.
https://www.npr.org/2018/11/27/670913385/ebola-treatment-trials-launched-in-democratic-republic-of-the-congo-amid-outbrea
The article examines the lack of progress made in reducing worldwide polio over the past year. The poliovirus transmits through the fecal-oral route. It mainly affects children and can lead to fatigue, fever, vomiting, and even permanent paralysis. Currently, the wild poliovirus is only endemic to Pakistan, Afghanistan, and Nigeria, as opposed to the 125 countries it was endemic to 30 years ago. However, in Afghanistan, the number of cases has almost doubled in the past year, and in Pakistan, the number of new cases has remained constant. There have been 27 of these wild poliovirus cases recorded by the WHO, compared to 22 last year. In addition to the wild virus, there are also outbreaks of vaccine-derived polio, which is caused when the weakened virus from the oral vaccine is excreted and is transmitted to other people. The WHO attributes this problem to “‘gaps in population immunity.’” Many countries are vulnerable to outbreaks because in nations that have eradicated polio, fewer people are getting vaccinated. The WHO predicts that if polio is not eradicated completely worldwide in the next few years, then it might have a worldwide resurgence, like measles, which, in 2017, caused around 110,000 deaths.
https://www.cnn.com/2018/11/30/health/polio-who-bn/index.html
Sources:
1. https://www-m.cnn.com/2018/11/23/health/listeria-outbreak-vietnamese-pork-roll-recall/index.html?r=https%3A%2F%2Fwww.google.com%2F
2. https://www.foxnews.com/health/vietnamese-pork-rolls-recalled-after-4-hospitalized-with-listeria
If asked by friends, family, or other acquaintances whether or not you would like to try any Vietnamese pork from Long Phung Food Products, politely decline the offer and inform them of this important news. As a result of four people developing listeriosis and subsequently being hospitalized after eating Long Phung anchovy-marinated pork patty rolls, the Center for Disease Control has released an advisory urging vendors not to sell or serve the recalled Long Phung pork products (manufactured between May 21st and November 16, 2018). Additionally, Long Phung Food Products issued a recall of its pork products that were shipped nationwide. Listeria is a bacterial infection that is caused by consuming products contaminated with Listeria monocytogenes. Listeria is dangerous for anyone over the age of 65, pregnant women, or anyone with a weakened immune system. Typically, the first signs of infection include diarrhea or other gastrointestinal issues. A listeria infection can cause headaches, stiff necks, fever, muscle pains, confusion, loss of balance, and/or convulsions. Symptoms usually occur within four weeks of infection but can take as long as 70 days to appear.
The four illnesses occurred in different states: Texas, Louisiana, Tennessee, and Michigan, but the US Department of Agriculture’s Food Safety and Inspection Service said that it is concerned that families and businesses may have stored frozen products. Health officials urge customers that purchased these items to either discard these items or return them to the stores the items were purchased from for a refund and to sanitize any shelf or drawer where the food was stored.
The CDC has reported an outbreak of a polio-like disease called acute flaccid myelitis (AFM) this fall. There have been 116 confirmed cases of AFM across 31 states, including six in New Jersey, thus far. There is mystery surrounding this illness because it seems to flare-up every two years since 2014 at around the same time of year and primarily affects children. Its symptoms such as muscle weakness and sudden-onset paralysis are very similar to those of polio. It is characterized by a lesion in the spinal cord which affects gray matter of the central nervous system and causes asymmetric paralysis of limbs on one side of the body. Researchers are working to identify direct causes of AFM and definitive treatment options, but this has been met with challenges because distinguishing AFM from other similar illnesses has been difficult. Initial symptoms such as a viral fever, cough, and other respiratory problems are very similar to other illnesses. In order to diagnose AFM, an MRI must be taken to identify the lesion in the spinal cord and asymmetric paralysis needs to be observed. AFM appears to progress relatively fast and infection is seen in the early stages of illness. The pathogen causing AFM has been isolated in only a few cases, however. Potential pathogens identified so far include enterovirus D68/A71, adenovirus, and mycoplasma. Treatment for AFM currently involves only supportive care such as breathing and feeding support for patients. Therefore, more studies involving children with AFM must be done to identify the direct cause of AFM and develop the most appropriate treatment plans.
Links:
https://www.cnn.com/2018/11/26/health/acute-flaccid-myelitis-afm-numbers/index.html
https://www.forbes.com/sites/tarahaelle/2018/11/30/what-do-we-know-about-the-polio-like-acute-flaccid-myelitis/#7a69995af589
This article details how a specific gene mutation linked to protecting people from the Bubonic Plague in Europe has also been found to prevent fatal liver scarring in HIV patients co-infected with hepatitis C. This gene, called CCR5, is a receptor for chemokines and is found on the surface of white blood cells. People can have a mutation of this gene called the CCR5-Delta 32 mutation and it has been studied to be passed down by survivors of the bubonic plague. The reason why this information is of interest is because mutations in CCR5 genes can prevent HIV from infecting immune cells or slow down inflammation as the proper functioning CCR5 gene is what regulates the entry of HIV into the cells. Furthermore, slowing down the scarring of the liver can prolong a life.
Researchers from UC Division of Digestive Disease, the University of Maryland, and Research Triangle Institute conducted studies with two groups of people. The first group included hemophilia patients who were accidentally infected with HIV and Hepatitis C through contaminated blood. The second group included HIV patients with no initial liver disease who were also in a clinical trial for a drug called Cenicriviroc. With the first group, the results showed that those with the mutation had less fibrosis progression (scarring) than those without the mutation. Researchers concluded that the CCR5 mutation led to decreased rates of fibrosis progression.
Cenicriviroc is a drug that blocks CCR5 and CCR2 receptors. The second group in the study received varied doses of this drug. Those with higher doses of the drug had less scarring through the course of one year with HIV. These results have a lot of potential as other HIV treating drugs can have harmful side effects such as fatal liver damage and creating medicine that blocks these CCR5 receptors could be key in preventing liver damage and prolonging the life of HIV patients. It is quite interesting to see how the mutation of a gene, which protected people from one of the deadliest disease outbreaks in our history, can also be useful in treating other diseases in modern society.
Source: https://www.uc.edu/news/articles/2018/12/n2052180.html
A new report from the European Center for Disease Prevention and Control and the the World Health Organization (WHO) indicates that there is an alarmingly higher rate of new HIV cases in eastern Europe, compared to Western Europe where rates are declining. In 2017, 130,000 of 160,000 of new HIV diagnoses in Europe came from the eastern region. As a result, the initial WHO target of diagnosing 90% of HIV positive individuals in Europe, providing antiretroviral therapy for 90% of the individuals diagnosed, and suppressing viral infection in 90% of the individuals treated by 2020 will most likely not be reached based on these new developments. Furthermore, the WHO goal of eliminating HIV worldwide by 2030 will also likely not be reached. There are several reasons behind the elevated HIV rate in eastern Europe including a lack of prevention and late diagnoses of HIV. Needle exchange programs have shown to be effective methods of prevention in populations with injecting drug users, but they have not been implemented on a large scale in the eastern European region, which has a significant population of injecting drug users. Social stigma around HIV has also prevented early testing practices from taking hold in this region. The fact that many individuals are being diagnosed late indicates that they have already transmitted HIV to other members of the population prior to beginning treatment. Currently, drug injections account for 48.8% of new HIV diagnoses, according to the article, but this will soon be overtaken by heterosexual transmission, so these countries must be prepared to deal with this as well. Therefore, early diagnosis and treatment will help suppress HIV and reduce the rate of new infections. Cooperation from governments in eastern Europe is essential to curb the increasing rates of HIV moving forward by investing in preventative measures as well as frequent testing and treatment of HIV.
Link:
https://www.cnn.com/2018/11/27/health/hiv-eastern-europe-study-intl/index.html
The article is about a tick that is spreading widely across the USA. There are nine states, which reported finding the Asian long horned tick, which carries a range of pathogens. New Jersey was the first state to report the tick in August 2017. Since then, eight other states have reported finding the tick on animals, people and in environmental samples including Arkansas, Connecticut, Maryland, North Carolina, New York, Pennsylvania, Virginia and West Virginia. These Asian long horned ticks are a bit rare in that a single female tick can reproduce up to 2,000 eggs without mating. Hundreds to thousands of ticks can be found on a single person or animal. There are no official results declared whether the long horned tick is able to transmit Lyme disease, but in Asia, it spread other serious diseases such as SFTS virus and the pathogen that causes Japanese spotted fever, along with many diseases in animals. It can hurt livestock, reducing production in dairy cattle by 25 percent, and can cause blood loss and death in calves. Unfed ticks can live nearly a year.
Link: https://www.usatoday.com/story/news/nation/2018/12/03/cdc-asian-longhorned-ticks-spreading-across-us-may-spread-diseases/2189393002/
This article examines how essential oils could potentially be a possible solution to fight off a certain type of Lyme disease. Lyme disease is a bacterial infection, which is caused by B. burgdorferi, and is transmitted by ticks. The Centers for Disease Control and Prevention estimates that there are approximately 300,000 cases of Lyme disease every year in the United States, while only 30,000 cases are reported. In most of these cases, antibiotics are the most effective therapy and can treat the bacterial infection within a couple of weeks. Nevertheless, 10-20% of Lyme disease cases are capable of persisting for months and, possibly, even for years. Scientists are unsure of what causes these cases of Lyme disease. However, they are aware that the bacterium that causes Lyme disease is capable of becoming dormant, which is believed to allow it to resist these antibiotics more effectively. In these cases of persistent Lyme disease, Dr. Zhang from the Department of Molecular Microbiology and Immunology at Johns Hopkins Bloomberg School of Public Health found that essential oils could eliminate the bacterium. Dr. Zhang’s findings show that thirty-five oils from sources, such as garlic bulbs and allspice berries, killed the antibiotic-resistant B. burgdorferi in the lab dishes, in 7 days, and there was no regrowth for 21 days, as well. Additional studies need to be performed, especially on animals and humans, but, if these findings are found to be significant, then essential oils could be used as an alternative to antibiotics in this particular situation.
https://www.medicalnewstoday.com/articles/323881.php
This article discusses how at least 36 students at a private school in North Carolina have contracted chickenpox. This school only has 152 children in attendance, which means that about a fourth of the student population contracted the disease. The school has the one of state’s highest rates of religious exemptions for vaccination and this is now the largest outbreak the state has seen since the chickenpox vaccination became available. While every state in the US has laws that require school immunizations, like almost all states, North Carolina allows exemptions from the vaccinations for medical or religious reasons. Last school year, about two thirds of the kindergartners at this school received religious exemption of the required vaccinations. This story provides an important illustration of the importance of adhering to vaccination guidelines.
Link to article: https://www.nytimes.com/2018/11/20/health/chicken-pox-vaccine-asheville.html?rref=collection%2Fsectioncollection%2Fhealth
Sickle Cell Disease is a very prevalent illness in the continent of Africa where they account for approximately 75% of the 300,000 total annual cases reported worldwide. This illness currently has no treatment in Africa and most children with the disease die before the age of 5 years old. The present situation took a turn for the better when hydroxyurea (a cheap and effective oral treatment) was approved to be administered in the country. This pill treatment has been available to wealthy countries for decades, was approved for american adult use to treat Sickle Cell Disease in 1998 and was approved for pediatric use last year, giving the opportunity for trials in African children.
The treatment could not have been assumed to work in the past and was held off due to the malaria, malnourishment and vitamin deficiency in Africa, however, the treatment proved to be a success for the children. In terms of success it not only decreased their symptoms and increased their life expectancy but it also surprisingly decreased their risk of contracting malaria. The drug is commonly used to treat leukemia and certain neck cancers for which patients are left in observation to ensure regular WBC counts. Like any other drug, hydroxyurea has side effects which may limit its use and researchers have stated that further experimentation is needed to determine adequate pediatric dosing to lower risks of side effects and complications with the treatment.
Link to article: https://www.nytimes.com/2018/12/01/health/sickle-cell-hydroxyurea-africa.html?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health®ion=stream&module=stream_unit&version=latest&contentPlacement=7&pgtype=sectionfront