infectious disease
tsmith | August 19, 2006One catchphrase that permeated the conference this past week was "scaling up." I just want to wrap up my posting here with a brief discussion of what that is, and what that means as far as HIV/AIDS prevention and treatment.
Readers who are scientists or who have some kind of science background will probably be famililar with the concept of a "pilot study." This is a study, generally small in scale, where new ideas are tested, and preliminary data are gathered. For example, a pilot study looking at how the ABCs of prevention work may take 100 individuals and split them into two groups: 50…
tsmith | August 18, 2006I mentioned yesterday that one way to help prevent new HIV infections is to treat people who are infected with herpes, another sexually-transmittted virus that infects as much as 20% of the population in the United States. That may seem odd; how does treating one viral infection prevent infection with a second virus?
Studies have shown that, generally, HIV isn't one of the more highly infectious viruses out there. For example, the hepatitis B and C viruses are transmitted via many of the same routes as HIV (such as sexual activity shared needles), but vary in their infectivity. If, for…
tsmith | August 17, 2006 If one thing has been hammered home this week (and, indeed, over the past 25 years) regarding HIV/AIDS, it's that prevention is key. Treatments, while improving, are still a distant second place to preventing primary infection as far as the fight against AIDS goes, and a large portion of the world's HIV-infected population still has no access to these treatments. Prevention, therefore, is critical. And while the condom has become the symbol for HIV prevention, strategies go far beyond that tool.
Over at WebMD, they have a nice summary of many of the key points from this week's…
tsmith | August 17, 2006This week's issue of the New England Journal of Medicine contains two articles on AIDS that are available free of charge.
The first article, Changing the Paradigm for HIV Testing -- The End of Exceptionalism, goes over content I blogged about here, discussing moving toward a more universal testing paradigm. The article focuses on issues specifically in the United States, but certainly many of the points have broad applicability.
The second article, AIDS in 2006 -- Moving toward One World, One Hope? is a broad overview of the lessons learned and problems still faced regarding HIV therapy…
tsmith | August 17, 2006I see he already mentioned this while I was out of town, but I just ran across it: Squid Soap:
More on this and handwashing in general below the fold...
SquidSoap is a fun soap dispenser designed for teaching children healthy hand washing habits.
SquidSoap works by applying a small ink mark on a person's hand when they press the pump to dispense the soap. The ink is designed to wash off after the hands are washed for about15-20 seconds, which is the time recommended by most doctors.
Really clever, actually. There's a little ring of ink on the top of the pump, so kids have to wash long…
tsmith | August 16, 2006Ran across this interesting article in New Scientist on natural resistance to HIV.
Researchers are launching a project to discover how certain people, dubbed "elite controllers", are successfully able to fend off the HIV virus without using drugs.
More and more cases of such people - also known as "elite suppressors" - are coming to light. Unlike the sex workers in Kenya identified a decade ago as being HIV-negative despite their constant exposure to the virus, elite controllers are infected, and do develop antibodies to the virus, but at a very, very low level.
More over at AIDS at 25.
tsmith | August 16, 2006DarkSyde over at DailyKos has his own post up today on the anthrax letters. He asks for "Thoughts, plots, conspiracies?", and gets quite a few in the comments, so be sure to check those out as well.
tsmith | August 16, 2006 In the United States, approximately a third of those who are HIV-positive don't even realize it. Worldwide, that number can be much higher. Because of this, and because those who don't know their HIV status can play a large role in continuing to spread the virus, in recent years, there has been an increased push for more universal HIV testing, in order to decrease this percentage unaware of their HIV status, and theoretically, reduce spread of the virus. But is this a good idea, and how exactly would and should it be accomplished? This was the topic of discussion at a session titled…
tsmith | August 15, 2006I've blogged previously about the massive effect vaccines against the human papilloma virus (HPV) could have. HPV is a common sexually-transmitted virus. Though most strains are harmless, a few have the potential to cause cervical cancer. Therefore, the HPV vaccine will be the first one ever specifically intended to prevent a type of cancer.
This vaccine has recently been approved by the FDA, and is set to roll out shortly. This is already expected to be a rather contentious issue as the vaccine is rolled out in the U.S. and elsewhere, as one target group for vaccination is adolescents…
tsmith | August 14, 2006 To use my earlier post on stigma as a jumping-off point, there was a session today titled Religion and New Leadership: the Challenge to Deliver (video available at the link). Speakers included religious leaders from a variety of religious and cultural backgrounds, discussing the role they play in working to control the AIDS epidemic. It was noted that churches haven't completely come to the reality that people living with HIV/aids aren't just a "they;" but that they're also members of their churches, mosques, synagogues, etc. It was emphasized that this sense of people living with HIV…
tsmith | August 14, 2006 The control and eventual eradication of the smallpox virus from the wild is one of the most heralded success stories in all of public health. Indeed, smallpox has played a central role in the history of vaccination. Even prior to Edward Jenner's use of the related cowpox virus to protect against smallpox disease, it was known that inoculation with materials from an infectious smallpox pustule or scab (dubbed "variolation") could protect an individual from death due to smallpox, generally resulting instead in a mild form of the illness. Jenner's observation that milkmaids seemed to be…
tsmith | August 11, 2006As y'all may or may not be aware, the XVI International AIDS Conference begins this weekend in Toronto. For those of you who read Seed magazine, you've seen that the current issue focuses on "AIDS at 25," and they also have an online summary here. As a matter of fact, myself, a Seed journalist, and a freelance science writer will be blogging the conference at a temporary blog this coming week; myself remotely from Iowa, and the others live from Toronto. So while AIDS will be at the forefront of this blog for a few days, I also have some posts on tap about other issues in infectious disease…
tsmith | August 10, 2006So it would seem.
West Nile is spreading beyond birds, horses and humans. A squirrel has tested positive for the virus and hundreds more are showing the same symptoms
People are finding squirrels in their yards or parks that look like they've been injured because they aren't able to walk. In some cases they're disoriented, running around in circles or shaking. Now it's believed they're suffering from West Nile.
(More below...)
West Nile virus (WNV) is another arbovirus; that is, a virus that's transmitted by an arthropod (in this case, the mosquito). Typically, the virus cycles between birds…
tsmith | August 10, 2006I wrote several posts on mumps outbreak here in Iowa this past spring. However, we aren't the only I-state to have dealt recently with an outbreak of vaccine-preventable disease. An editorial in yesterday's New York Times highlights the dangers of withholding vaccincations.
(Continued below...)
In the spring of 2005, an outbreak of measles occurred in Indiana. The unvaccinated index case had been traveling in Romania on a missionary trip, where she picked up the virus. Measles is one of the most infectious viruses we know of, and when she returned home, she ended up spreading the virus…
revere | August 10, 2006China now admits what everyone knows already knows. It had a death from H5N1 in November of 2003, a full year before its "official" first case (The Guardian). In fact everyone also knows that there was H5N1 in February of that year when the disease was diagnosed in Hong Kong in a family just returned from a visit to Fujian province. That occurred at the outset of China's now infamous SARS cover-up. As interesting, the Chinese explanation for why the case not been reported earlier, was it had been misdiagnosed as a SARS case. This may in fact be what happened but it raises another question:…
tsmith | August 9, 2006The name "dengue" means "breakbone fever" due to the extreme bone pain it causes. The virus is a member of the flavivirus family, which includes the virus that causes yellow fever. Both viruses are arboviruses--viruses that are transmitted by arthropods. In the case of dengue and YF, the arthropod in question is the mosquito; specifically, the Aedes aegypti, an urban mosquito that lives in close contact with humans.
Dengue infections cause an enormous amount of morbidity and mortality in areas where the virus is endemic. It's estimated to infect 50-100 million people each year. Though…
revere | August 8, 2006An astounding 2000 people die of rabies every year in China. There might be a reason why they don't have mandatory vaccination of dogs there, and if some reader knows, tell the rest of us in the comments. Meanwhile the Chinese authorities in Jining are attacking rabid dogs the way we recommend countries deal with bird flu: by killing all dogs within three miles of a rabid one. Jining has had 16 rabies cases in the last 8 months. This is the second mass dog killing to control rabies in China. For those of us with dogs, it is very distressing prospect and I won't try to defend it here except to…
tsmith | August 2, 2006 I mentioned just last month the dearth of research into what really makes an influenza virus easily transmissible from host to host, noting:
If we had a better handle on the factors that caused an avian strain of influenza virus to be more efficiently transmitted among humans, then we could better focus our resources and know when to really sound the alarm--unlike now, when we're flying blind in many ways.
A new paper in PNAS has started to do just that, and the research findings have prompted such headlines as Bird Flu Pandemic may not develop (via Effect Measure). Revere has already…
tsmith | July 31, 2006Good timing. Just Friday we were discussing limits on biological knowledge, particularly in regard to bioterrorism and the potential for information to fall into the wrong hands (or be used for the "wrong" purposes). Today, msnbc.com has an article discussing this exact issue:
Eckard Wimmer knows of a shortcut terrorists could someday use to get their hands on the lethal viruses that cause Ebola and smallpox. He knows it exceptionally well, because he discovered it himself.
In 2002, the German-born molecular geneticist startled the scientific world by creating the first live, fully…
tsmith | July 31, 2006I was busy over the weekend (and disgusted by the hot, nasty weather that will not die), so I don't have a lot on tap for today. Luckily, though, there's some interesting stuff elsewhere that's already written up--thoughtfully saving me some of the trouble.
I discuss the link between infectious and "chronic" disease with some regularity on this site. I think it's a fascinating area; perhaps oversold by some, perhaps over-criticized by others, but certainly a hot topic and an interesting direction for research in microbiology. This weekend's New York Times had a new story that touched on…