infectious disease
revere | April 24, 2009Late yesterday we summarized a CDC media briefing about the developing investigation of cases of influenza in California and Texas with a previously unknown flu virus with genetic components from pigs ("swine flu", humans and birds). At the same time reports were surfacing of an especially virulent respiratory disease outbreak in central and southern Mexico that had resulted in 20 deaths and hospitalizations with acute respiratory failure. 137 cases have been reported, including health care workers. When asked yesterday, CDC said they were in close touch with their Mexican counterparts but at…
revere | April 23, 2009This afternoon CDC held a "media availability" on the evolving swine flu cases. Evolving is an understatement. There are now more recognized cases, although not all cases are "new," with some cases retrospectively recognized now that more intense investigation is occurring. The total is now seven cases. Two occurred in San Antonio, Texas, two sixteen year old boys in the same school. Three more were found in California (in addition to the initial two cases), including a father - daughter pair. All California cases are in San Diego and neighboring Imperial counties, the location of the initial…
revere | April 22, 2009Late yesterday afternoon a Morbidity and Mortality Weekly Report (MMWR) Dispatch appeared on CDC's website that is unique in my experience. MMWR is usually heavily vetted and edited and nothing gets out of there fast. Indeed, in recent years, nothing at all got out of CDC very fast. And yet here is this Dispatch, with text referring to the same day of issue (April 21), reporting on two young patients with febrile respiratory illnesses, one of whose cases CDC only learned about on April 13, 8 days earlier. April 17 CDC determined that the two children, both from the San Diego, California area…
revere | April 20, 2009When a small body of water, say a slow flowing creek or water in a drainage ditch, "goes septic" it starts to stink, often giving off a rotten egg odor (hydrogen sulfide, H2S). This isn't a sign that the water is polluted in the chemical sense of toxic materials. It means that so much organic matter has entered the water that the bacteria there have gone on a food orgy. The initial gluttons are aerobic bugs that need oxygen as a final electron acceptor to generate energy for their needs. When the feasting aerobes use up all the oxygen they die and are replaced by a new set of diners, the…
revere | April 17, 2009This year's flu season isn't over, but it's almost over, and it was fairly typical and much better than last year, which was nasty. It began at the end of September but didn't take off until early January, peaking in mid Februrary. New cases are still appearing but much less frequently and they are mainly influenza B, which tends to be milder than influenza A. Most of flu/A this year was also of the milder H1N1 sort, which probably contributed to the better outcomes. Here's where we are (source for all charts here):
Comparing this year with previous years shows it to be relatively typical of…
revere | April 12, 2009Fomites are inanimate objects that act as modes of transmission for infectious agents. You know. The doorknob or airplane armrest handled by someone who coughs on his hand or blows her nose. We know that some agents, like influenza viral particles, can remain viable (i.e., retain their ability to replicate in a host cell) for days or weeks. This doesn't automatically mean that fomites are an important mode of transmission, however. There is evidence those same viral particles lose their ability to replicate after only a few minutes on your hand. The apparent paradox is probably related to the…
revere | April 9, 2009A tantalizing Reuters story yesterday called attention to the uptick in human bird flu cases in Egypt, the African country with more cases than any other (although far behind Asian countries like Indonesia). The observation prompting renewed expressions of concern are that new cases seem to be in the very young (toddlers) but adult cases have almost disappeared. So where are these toddlers picking up the virus? A possibility that is consistent with the observations is that adults are giving it to the toddlers but are themselves symptomless carriers. It's not impossible, because we know that…
purepedantry | March 29, 2009It's amazing what the kids are up to these days.
This one comes live from Mount Sinai (my present educational residence). Hubner et al., publishing in Science, use an infectious, fluorescent strain of HIV to watch the virus move from one cell to another. Their results are fascinating and may help us develop better ways to treat the disease.
(Full disclaimer: This research was performed in the Chen lab at Mount Sinai where my roommate presently works.)
It's funny how my biases work. I mean, I am not a microbiologist, but here is the bias that I had about how infections like HIV work: I…
revere | March 25, 2009"The Stupid. It Burns!" I don't know where this Simpson-esque phrase comes from, but The Stupid burns pretty bright in the brains of Republican Governors Mark Sanford and Bobby Jindal who are refusing stimulus money for unemployment compensation even though their states have some of the highest unemployment rates in the nation. That's stupid. Like refusing help with avian influenza even if you have more cases of the disease than anywhere in the world. The Stupid isn't just an American disease.
Take Indonesian Health Minister Siti Fadillah Supari. Please.
Source: plognark
Indonesian Health…
purepedantry | March 16, 2009If you work in infectious diseases in a hospital -- or frankly if you work anywhere in a hospital -- the emergence of antibiotic resistant bacteria is a serious problem. You have to be constantly aware of what the right drug is to prescribe to ensure its maximum effectiveness, and -- though rare -- there are some bacterial infections for which we have no good drugs.
This is why I was very intrigued about researchers trying to design antibiotics that would not create resistant bacteria:
Vern L. Schramm, Ph.D., professor and Ruth Merns Chair of Biochemistry at Einstein and senior author of the…
revere | March 13, 2009I'm just getting around to reading the Brief Report by Blachere et al., "Measurement of airborne influenza virus i a hospital emergency department" (Clinical Infectious Diseases 2009:48:483-440) but it's quite interesting. We've noted fairly often here that we still don't know for sure what the main modes of transmission of influenza are, something that surprises many people. We "know" that flu can be passed from person to person via the respiratory secretions from runny noses, coughs and sneezes but we often don't think more deeply about this. We know that viral material can remain viable…
revere | March 3, 2009The United States has an influenza surveillance system composed of five overlapping parts. You can get an overview of each here. In 2004 laboratory confirmed deaths from influenza in children (persons less than 18 years old) was made a notifiable cause of death by the states and through this we have been able to get a statistical snapshot of this most tragic kind of influenza mortality. There were 8 such deaths in four states reported this past week, occurring from February 1 to February 18, making the total for this flu season 17. Bacterial co-infection with Staph was seen in 10 of the 17…
revere | March 1, 2009The scientific literature is full of specialized papers that on their face would seem to be of little interest. Here's a title like that: "Prevalence and seasonality of influenza-like illness in children, Nicaragua, 2005-2007" (Gordon et al., Emerging Infectious Diseases 2009 Mar). Over 4000 Nicaraguan children, aged 2 to 11 years old and living in the capital of Managua were followed for 2 years, April 2005 to April 2007 and observed for development of ILI (influenza-like illness). We know a lot about influenza in major industrialized countries in the northern and southern temperate zones,…
revere | February 19, 2009Like a lot of people I am more inclined to believe research that is in accord with my prior beliefs. Put another (Bayesian) way, I don't have to change my beliefs much on the basis of evidence. That means I don't question the evidence rigorously. So with that warning, here's a story I instinctively believe because it accords with my prior beliefs -- and preferences. It has to do with washing your hands after using a public bathroom.
To be clear at the outset: I always wash my hands after using the bathroom. I'm not sure what the actual evidence for disease transmission is but I consider it an…
tsmith | February 8, 2009Last fall, I wrote about a new research paper which tried to replicate some of Andrew Wakefield's original results, which not only claimed a correlation between MMR vaccination and autism, but also the presence of measles virus in intestinal tissue. Wakefield had suggested that an inappropriate response to the presence of measles virus in this tissue may trigger conditions such as bowel disease and autism. The more recent study was unable to replicate any of Wakefield's findings--not surprising, since so many papers in the last decade have found no connection between vaccination and autism…
amillikan | January 29, 2009A notorious bacterial foe has made its first documented appearance in the U.S. and is jumping species around the farm scene. First, MSRA—methicillin resistant Staphylococcus aureus— was found in chickens. Just recently, research conducted by ScienceBlogger Tara Smith from Aetiology found that ST398, a strain found in pigs, was also found in many of the humans who came into contact with the pigs at a large food production farm in Iowa. While this strain seems to spread readily between animals and humans, its potential for lethal infections is still unclear.
Related ScienceBlogs Posts:
Swine…
revere | January 29, 2009Getting a good night's sleep is supposed to boost your resistance so you don't get sick as easily. Or put another way, not getting enough sleep puts you at risk of colds and other nuisance infectious diseases. Is this just an old wives' tale? Apparently not. Or at least, now we can say there's some evidence to back it up:.
BACKGROUND: Sleep quality is thought to be an important predictor of immunity and, in turn, susceptibility to the common cold. This article examines whether sleep duration and efficiency in the weeks preceding viral exposure are associated with cold susceptibility. METHODS…
revere | January 27, 2009On Sunday my friend and colleague from Fluwiki, DemFromCT, did me the honor of interviewing me on the front page of DailyKos. That's a pretty tall platform, being the most visited blog in the known universe (and beyond), so it's best to be absolutely clear when saying things there. I"m not sure I quite met that standard, but I'll let you judge for yourself, as I am cross-posting the interview below the fold. But this also gives me an opportunity to clarify one point that drew some justified comment. Here's something I said in the interview:
In the past I downplayed individual prepping for a…
revere | January 26, 2009The peanut butter/peanut paste ingredient based salmonella outbreak has been in the news lately and we've discussed it here (and here, here, here, here, here). There are now about 500 reported cases and six deaths. That's a case fatality ratio of just over 1%. So what if there were a disease outbreak of 100,000 cases with a case fatality ratio of 20%? I think we'd be pretty alarmed. But it happened in 2005. And it happened in 2006 and 2007 and last year, 2008 And it's happening, now, too. It isn't salmonella or or even HIV/AIDS, although it is estimated to kill more people in the US than both…
revere | January 25, 2009From a colleague who knows I am interested in prophylactics for flu:
Miss Beatrice, the church organist, was in her eighties and had never been married. She was admired for her sweetness and kindness to all.
One afternoon the pastor came to call on her and she showed him into her quaint sitting room.
She invited him to have a seat while she prepared tea. As he sat facing her old Hammond organ, the young minister noticed a cut-glass bowl sitting on top of it. The bowl was filled with water, and in the water floated, of all things, a condom! When she returned with tea and scones, they began…