infectious disease
revere | December 5, 2007Indonesian Health Minister, Siti Fadilah Supari, has reiterated her refusal to share isolates of H5N1 virus (it's unclear if this is her decision alone or is the considered decision of the Indonesian government). This came at the current inter-minsterial conference on bird flu on underway in Delhi (how many of these conferences are there, anyway? It seems like every week there's another one.) Her demand is that every isolate have a Material Transfer Agreement (MTA) requiring a statement each time the isolate is shared with another laboratory, stating it is only for diagnostic purposes and not…
revere | December 4, 2007China has just registered its 26th known case of bird flu and its 17th death. I emphasize known, because in a country of over 1.3 billion that has not been able to eradicate this virus from its vast poultry population, it would seem the real number is probably quite a bit higher. But what I want to return to about this case is something I have discussed before regarding the Chinese cases (and pertains to most of the other reported cases as well), but is starkest for the Chinese reports. But first, the pertinent part of the case:
China's first human case of bird flu in six months shows that…
revere | December 3, 2007I'm traveling so I'll let other bloggers do the heavy lifting. And I can always count on flu bloggers of note, Crof and SophiaZoe. Both discuss and link to reports of H5N1 in refrigerated turkey meat sold in stores in Poland (I particularly recommend SZ's excellent summary of the safety issues). While I don't have a lot to add to their coverage, I'd like to inject just one more issue related to finding the virus in meat
An ongoing debate is the relative contributions of migratory (wild) birds and domestic poultry to spreading H5N1 geographically. There is evidence for both mechanisms, and…
tsmith | November 30, 2007Since its discovery, only a few countries have really been affected by Ebola. The virus has surfaced multiple times in the Democractic Republic of Congo, in Sudan, in Gabon, and now in Uganda. This country was last hit (and hit hard) by Ebola in 2000, when an outbreak there caused at least 425 cases, and killed more than half of those it infected. Now it's currently causing yet another outbreak, just weeks after the outbreak in the DRC was confirmed to have ended--and the strain that's causing this one seems to be distinct from the four known types of virus we've seen to date. More after…
revere | November 29, 2007It is not news that the Atlanta lawyer who had/didn't have Extremely Drug Resistant TB early in the year didn't infect anyone when he flew -- against advice or was it against orders? -- from Europe back to the US via Canada and through New York despite a no fly (or not?) order from CDC (or DHS?). Everything about this case was cocked up -- the diagnosis, the communication with the patient, the communication with the public, the communication between federal agencies, state agencies and local health agencies (see our posts here). The fact that no one who sat close to him or further from him or…
tsmith | November 29, 2007Over at Correlations, I have a post up describing the case of a Liberian immigrant who's been jailed in New York for the importation of bushmeat. She's arguing that to punish her for this is in violation of her first amendment right to freedom of religion. More at the link...
tsmith | November 28, 2007 Revere has been covering the situation in Indonesia regarding sharing of influenza viruses with the US and other countries. For those of you who don't follow these issues, Indonesia has been the country hardest hit thus far by H5N1 (113 cases and 91 deaths as of 11/12/07). However, while one might think they would welcome outside help with diagnostics and strain typing, they've been very reluctant to share their viruses. Revere explains:
But Indonesia still refuses to share its human H5N1 isolates, contending they get nothing tangible from an arrangement which is likely to lead to…
revere | November 26, 2007Indonesia's health minister, Siti Fadilah Supari, has answered the question whether the recently concluded Geneva summit on sharing of influenza viruses had produced sufficient agreement to induce that country to begin sharing again. Her answer seems to be "no":
Indonesia's health minister reiterated Sunday that she would not send bird flu specimens to the World Health Organization, saying poor nations needed assurances that any pandemic vaccines developed from the virus would be affordable.
Siti Fadilah Supari made the comments on her return from Geneva, where the WHO held an…
revere | November 24, 2007As you will see from the account below the fold, the flu summit was a contentious and complicated affair. Only time will tell if it was even a qualified success, but there are reasons to be hopeful. Tip of the hat to Ed Hammond, one of the NGO participants, who provided the public health community with his perspective at a time when no one else was talking. This involved late hours for him at the end of long days. We are grateful.
Here's his wrap-up:
Influenza Meeting Ends in Qualified Success
At the end of contentious meetings like the one on policies for sharing flu virus it is tempting to…
revere | November 24, 2007Yesterday was the fourth and final day of the important Geneva summit on sharing flu virus isolates. Like premature news of Mark Twain's death, the Reuters report the meeting had failed was exaggerated. On the contrary, the summit appeared to have moved things forward. We have the latest, below. You can find previous happenings and background here, here, here and here.
Status mid-day, Day 4 (3:26 pm Geneva time, November 23), as reported by Ed Hammond:
Some Things That Happened in the Night Session of Day 3 and Morning Session of Day 4
These sessions were the final negotiations before…
revere | November 20, 2007If a rogue H5N1 virus easiy tansmissible between people is to develop, the most plausible spot for it to happen is Indonesia, the world's fourth most populous with a vast reservoir of infected poultry (and who knows what else) and more human cases (113) and more deaths (91) than any other country. But Indonesia still refuses to share its human H5N1 isolates, contending they get nothing tangible from an arrangement which is likely to lead to vaccines they won't be able to afford. Under the current system, which allows intellectual property rights to cover vaccines developed from WHO supplied…
tsmith | November 19, 2007 It still amazes me sometimes what viruses are capable of doing. I've written a number of times about one virus in particular, the human papilloma virus (HPV). This is the virus implicated in cervical cancer, and it also plays a role in head and neck cancers. There are a number of different strains of HPV--some of them are oncogenic (cancer-causing), while others cause more benign infections, such as warts.
A related virus in rabbits also causes a type of warts, which can replicate out of control and form horny growths (indeed, this is the likely origin of the jackalope myth). Humans…
tsmith | November 15, 2007Two recent stories highlight the good and the bad when it comes to infectious disease prevention.
The good
Death rates for vaccine-preventable diseases are at an all-time low:
The study, by the Centers for Disease Control and Prevention in Atlanta, and published in The Journal of the American Medical Association (link), is the first time that the agency has searched historical records going back to 1900 to compile estimates of cases, hospitalizations and deaths for all the diseases children are routinely vaccinated against.
In nine of the diseases, rates of death or hospitalization…
revere | November 8, 2007Suppose US agribusiness food animals were being fed a poison that killed a few tens of thousands of Americans a year. Would we want them to stop? Maybe we weren't sure but had more than ample grounds for suspicion. Would we want scientists and the government to be looking into it and maybe even halting it until we had a clear answer? I would hope so. But that seems to be the situation with antibiotics and factory farming. Yesterday we posted about the discovery by Dutch scientists that methicillin resistant Stophylococcus aureus (MRSA) had a home and probably an origin in pigs and cattle in…
tsmith | November 8, 2007 Both Mike and Revere have new posts up documenting swine as a new threat to human health (beyond the pork chops and bacon), via carriage of methicillin-resistant Staphylococcus aureus in these animals. Several papers have been published recently documenting high rates of MRSA carriage in swine in the Netherlands, and also have documented transmission of this bacterium from swine to humans. However, even more worrisome to me than the Dutch publications is a new one out in Veterinary Microbiology, showing high rates of MRSA in Canadian swine--and guess where we import about 9 million hogs…
revere | November 7, 2007A pig and a hen are strolling along and they see a sign in a luncheonette window: Ham and Eggs, 99 cents. The hen says, wistfully, "Isn't it great the contribution we are making to the community?" The pig replies, "For you it's a contribution. For me it's total commitment." Now the pig may be having his revenge.
The drug-resistant bug, methicillin resistant Staphylococcus aureus or MRSA, is making headlines now that it has emerged from its old role as a hospital acquired infection to its new, more ominous one as a nasty infectious agent loose in the community, where it can infect infecting…
tsmith | November 6, 2007 I've written a post or two (or a dozen) discussing science journalism--the good, the bad, and, mostly (because they're the most fun), the ugly. There was this story about how blondes "evolved to win cavemen's hearts." Or this one that completely omitted the name of the pathogen they were writing about. Or this one, where a missing "of" completely changed the results being discussed.
I ran across another glaring example yesterday, dealing interestingly enough with one of my favorite topics: chocolate, and bringing in an "omics" prospective to it.
The news story covered a recent…
tsmith | November 5, 2007 I wrote about an emerging mosquito-borne virus with the strange name of chikungunya in a pair of posts last year. This is a virus that was first discovered more than 50 years ago, but as far as arthropod-borne viruses ("arboviruses") go, it's been a minor player for most of that time, as other arboviruses such as yellow fever, dengue, and West Nile caused more disease and death than chikungunya. However, the virus began to rapidly spread beginning in ~2004, causing around a quarter million infections on the island of La Reunion in the Indian Ocean before moving on to cause smaller…
tsmith | November 4, 2007Welcome to this month's edition of Pediatric Grand Rounds! Sit back with a cup of mulled cider and enjoy the best of the past month:
Revere at Effect Measure tells the tale of Streptococcus pneumoniae serotype 19A--a serotype that's not included in the current vaccine, but has increasingly found as a cause of ear aches in children.
Of course, in addition to ear infection, 'tis the season for influenza. As such, it's timely that Highlight Health, Walter emphasizes the importance of influenza vaccination.
My own addition to this month's carnival touches on similar themes: how kids'…