General Epidemiology
tsmith | September 11, 2007I mentioned in this post on Marburg virus that another outbreak of hemorrhagic fever had been reported in the Democratic Republic of Congo (DRC, formerly Zaire). It's now been officially reported by labs in Congo and Gabon that, indeed, this new outbreak is due to the Ebola virus. More on this after the jump.
As I've written previously, the DRC has been especially hard-hit by filovirus outbreaks. This was one of the places where Ebola first made its appearance in the human population, and was also the site of large outbreaks of the virus in 1995 and 2001 (with another Marburg outbreak…
tsmith | September 10, 2007 September 8th was world rabies day. In the United States, this was celebrated with the news that the canine rabies strain appears to be eliminated from this country. In the U.S., rabies in both humans and domestic animals remains rare, though the virus remains endemic in several species of wildlife (especially raccoons, skunks, and bats). However, worldwide, rabies remains a significant public health problem, causing an estimated 50-60,000 deaths per year worldwide--one death every ten minutes. More after the jump...
First, the news about the U.S. and dog rabies. Like most viruses,…
tsmith | September 4, 2007Denial has real consequences-- MMR plea by doctors as measles cases treble in 11 weeks:
Parents have been urged to give their children the MMR vaccine as it was revealed Britain is in the middle of the worst measles outbreak for 20 years.
The unprecedented warning from the Health Protection Agency came as the number of children suffering from the disease trebled over the last 11 weeks.
This is the worst outbreak since the controversial MMR vaccine was introduced in 1988.
Take-up of the triple jab - which also protects against mumps and rubella - plummeted to 80 per cent after Dr Andrew…
tsmith | August 31, 2007 As I mentioned in the introductory post, we know incredibly little about the very basics of Marburg virus ecology and epidemiology. The sporadic nature of outbreaks of illness, their occurrence in remote areas of Africa lacking established medical research capabilities, and often in countries experiencing governmental strife and instability, compound the difficulty of determining the ecology of this particular virus. Often, the primary case (the first person in an outbreak known to be infected, and who likely acquired the virus from its wild reservoir) died before questions could be…
tsmith | August 31, 2007Those familiar with the history of influenza probably know about the 1918 outbreak of swine influenza in Cedar Rapids, Iowa. In the fall of that year, the National Swine Show and Exposition in Cedar Rapids opened, bringing people and their hogs from miles around. Soon after it opened its doors, people noticed their swine were becoming sick--and the symptoms looked suspisciously like those of human influenza. When the virus was characterized years later, it was indeed found to be the influenza virus--and it was very similar to ones that were isolated from humans.
This characterization of…
tsmith | August 30, 2007As I've noted before, filoviruses are some of my favorite pathogens. I don't work on them myself--though in the pre-children era I certainly thought about it--but I find them absolutely fascinating to read about and follow the literature. Mostly, I think, this is because after knowing about them for so many years (Marburg was discovered in 1967), and so much research (over 1500 papers in Pubmed, or roughly a paper for every person these viruses have killed), we still know relatively little about the most basic questions--such as where there viruses are maintained in nature, and how they…
tsmith | August 24, 2007...and that's not just a comment on the weather here. The past few days have been packed. In addition to the work stuff, I've been gearing up for classes next week and getting my kids off to their new school year (and my son in kindergarten). It's always nice when hard work pays off, but it would be even nicer if it didn't all pay off in the same week. But of course, when it rains, it pours. In addition to the publicity for the HIV article, a Reuters story on my Streptococcus suis talk in Wisconsin came out earlier this week, and was mentioned in the ProMed email alerts yesterday:…
tsmith | August 22, 2007Seems like just yesterday that I was watching (from afar) Ewen head off to grad school in journalism. Well, now he's making a splash in the latest issue of Nature, with a story on the potential for a dengue vaccine, and why there may be more of a market for it currently--largely because it's becoming a disease of the wealthy. Check out his Nature article, and read more over at Complex Medium.
tsmith | August 21, 2007Since there are already several threads on HIV running, and I'm loathe to have another, I'll post this up for consumption but leave the comments for one of the other threads. While I was in New York over the weekend, PLoS Medicine published an article authored by myself and Steven Novella (also of the Skeptics' Guide to the Universe): HIV Denial in the Internet Era.
tsmith | July 27, 2007XDR-TB has been in the news quite a bit lately, largely thanks to Andrew Speaker's notoriety. Even though his TB was later re-classified as "just" multi-drug resistant (MDR-TB) instead of the initial extremely drug resistant (XDR) type, it did serve to raise awareness about the issues public health authorities face when dealing with something like tuberculosis--and where the gaps are in the control of its spread. (Indeed, a breaking story out of Taiwan shows how difficult it can be to enforce a travel ban).
However, while XDR-TB is rather new on the radar of the general public (and even…
tsmith | July 18, 2007The strange and tragic case of the Tripoli Six, a group of 5 Bulgarian nurses and one Palestinian doctor working in Tripoli, Libya, is finally drawing to a close. The six health workers had been found guilty of infecting up to 400 children in the hospital where they worked with HIV, and had previously been sentenced to death--even though the science had shown that the epidemic began prior to the arrival of the workers. This saga has been dragging on for the better part of a decade (Declan Butler at Nature has a very nice story here discussing the various twists and turns along the way), but…
tsmith | July 6, 2007Over at Neurotopia, Evil Monkey has been busy writing up a series on hormone therapy.
Part One: history and basics. (Be sure to check out the 1960s-era ads for hormone replacement therapy too...be warned that they might raise your blood pressure).
Part Two: types of HRT and consequences, including material on the Women's Health Initiatives that have received a lot of press over the past several years.
Part Three: cognitive consequences.
tsmith | July 4, 2007I know many of the HIV threads here get very tedious and repetitive, but occasionally interesting things come out of them. Believe it or not, I've learned a lot about HIV denial over the past year and a half or so. I've long been familiar with Duesberg's objections, but it wasn't until more recently that I realized there still were active denial groups around, and even wholesale germ theory deniers. So to me, the threads aren't all wasted.
Anyway, in one of the ongoing threads, there was discussion of one commenter's "natural" remedies, and her claim that "Germs cannot get a strong-hold in…
tsmith | June 29, 2007Last year, I mentioned some ongoing research suggesting a link between exposure to light and the development of breast cancer. As I mentioned then:
While we know a good deal about factors that can contribute to breast cancer risk--including genetics (such as mutations in the BRCA1 and BRCA2 genes) and lifestyle choices (late or no childbearing, high fat diet, lack of exercise), many environmental risks for breast cancer remain controversial. Even the effect of cigarette smoking on breast cancer development remains uncertain, as does the environmental light idea.
For a nice update and…
tsmith | June 26, 2007 Women do some rather insane things to achieve modern standards of beauty. We wear shoes that do terrible things to our feet. We don bras that dig into our chest and push our breasts into strange conformations. We slide on pantyhose to firm our stomachs, makeup to hide our imperfections, and hair dye to diminish our grays. And we have this strange habit* of yanking other body hair out from the root, be it our eyebrows, underarms, legs, or pubic hair.
Yes, I do have a point here (besides making men squirm). The August issue of Clinical Infectious Diseases has a forthcoming article…
tsmith | June 13, 2007 Over at The Examining Room of Dr. Charles, the good doc brings up another instance of quackery from an unexpected source: Dr. Henry Heimlich, originator of the Heimlich maneuver for choking. While that procedure has clearly saved many lives, Dr. Heimlich doesn't stop there--he advocates using his maneuver for drowning victims and asthmatics, neither of which have been scientifically proven (and indeed, major medical associations have spoken out against them). Dr. Charles also reveals that Heimlich also carries out other questionable research, including deliberately infecting HIV+…
tsmith | June 12, 2007 One of the most famous stories in all of epidemiology revolves around the very birth of the science, in the midst of a London cholera outbreak in 1854. At the time, the scientific community was divided over the cause of cholera and other diseases. The majority of them accepted the miasma theory, the idea that disease was due to corrupted air ("all smell is disease," noted sanitation commissioner Edwin Chadwick). This idea dates back to antiquity, and increased in popularity in the Victorian era. It's a great example of something that logically made sense, even though it was wrong.…
tsmith | June 8, 2007I keep saying I'm going to update my blogroll, and really, one of these days I'll get to it. In the meantime, I'll keep highlighting a few of the sites that I'll be adding. One of these is Epidemiologic Inquiry, kind of one-stop-shopping for epidemiologists. The site includes updates on epi and research matters and links to other sources of information (such as a list of textbooks), and also has job and fellowship boards.
tsmith | June 4, 2007 Syphilis is a disease frequently shrouded in many levels of mystery. It appeared suddenly in Europe in the late 1400s as a highly virulent and often fatal disease, a disease that could give Ebola a run for its money when it comes to sheer grotesque-ness. Victims may be covered with pustules from head to toe, diseased flesh peeled from their bodies, and patients may be in agonizing pain for weeks or months prior to death. However, after this inauspicious beginning, syphilis seems to have become less virulent, and instead shifted in presentation to more of the chronic disease that we know…
tsmith | May 30, 2007I blogged earlier about the Georgia man who globe-trotted while infected with XDR-TB. I wrote that post late Tuesday evening, and since then, a number of other details about his case have come to light--and they're not encouraging. In fact, this serves as a nice example of a convergence of a number of areas I've written about before--obviously, the evolution of antibiotic resistance and the terrible position it leaves us in, the politics and policies of quarantine/isolation (and how they'd be enforced), and the global spread of infectious disease, so I figured this would warrant another…