public health
tsmith | October 10, 2006As Revere notes, this week is Pandemic Influenza Awareness Week. I'll have some posts on this after today (still swamped, with no end in sight, unfortunately); in the meantime, check out all the info already available at the Flu Wiki.
mikethemadbiologist | October 6, 2006According to Time Magazine's Christine Gorman, China and Japan are trying to bribe the voters who will decide the next W.H.O. president. It's disgusting that an organization which can be critical in saving lives and combatting infectious disease can be so easily corrupted. Gorman writes:
It's been an open secret for years that the race for Director-General at the World Health Organization is subject to a lot of horse-trading among the so-called member states of the United Nations. But this year's election-in which there are now 13 candidates-is shaping up to be the most unseemly to date.…
tsmith | October 3, 2006I write on a somewhat regular basis on here about vaccines: new research, new shots, addressing skepticism about how well they work or if they're related to autism, etc. Recently, several vaccine stories have been in the news that I've not gotten to yet, so consider this a vaccine meta-post. More after the jump.
The first story is timely in that it discusses the influenza vaccination (and we're heading into that season). Allow me to share an anecdote first. When I was pregnant with my daughter in 1999, I was in graduate school and the lab I worked in was affiliated with a hospital. So…
tsmith | October 3, 2006Orac has a post up on this new JAMA paper as well. He brings up some better examples than the one I gave:
Does anyone in this day and age still believe that smoking doesn't cause lung cancer? The epidemiological evidence of the association is bulletproof. However, the majority of smokers don't get lung cancer. In fact, there are complex statistical models that allow a pretty accurate calculation of risk in populations based on how long and how much a smoker has been smoking. For example, if you start smoking at age 18 and smoke two packs a day, by age 55, you have about a 5% chance of dying…
mikethemadbiologist | October 3, 2006Inspired by this excellent post by Revere about the evolution of influenza, I've delved deep into the archives of the Mad Biologist, and summoned up some evolutionary thoughts of my own about influenza:
I meant to post something about evolution and influenza before my travels up north, but I was swamped by work and couldn't get to it. Thankfully, two colleagues, Carl Bergstrom and Marc Lipsitch, have decided to deal with Wendy Orent's faith-based virology. Orent writes (italics mine):
Indeed, a strictly enforced quarantine could do more harm than good. Herding large numbers of possibly…
tsmith | October 2, 2006Ah, another day, another paper for the anti-HIV establishment to glom onto and misrepresent.
Last week's issue of the Journal of the American Medical Association published this paper examining the relationship between HIV load and CD4 T-cell decline:
Context Plasma human immunodeficiency virus (HIV) RNA level predicts HIV disease progression, but the extent to which it explains the variability in rate of CD4 cell depletion is poorly characterized.
Main Outcome Measures The extent to which presenting plasma HIV RNA level could explain the rate of model-derived yearly CD4 cell loss, as…
tsmith | September 29, 2006Nina Plank, the author of the NY Times article I commented on in this post, stopped by to comment. Rather than just having this lost in the comments to a week-old post, I wanted to take a moment and quickly address two of her points (with potentially a follow-up post next week when I have a bit more free time).
First, to Nina, thanks for stopping by. I'll just say that I very much disagree with your stance on raw milk and dairy. Indeed, contamination can also happen after pasteurization and nothing replaces vigilance, but having seemingly healthy cows is no guarantee of healthy milk.…
tsmith | September 26, 2006I was travelling over the weekend and I'm incredibly busy up through Wednesday, so new material from me will have to wait until later in the week. In the meantime, I'll point you to a stellar post I wanted to highlight last week, from Revere on H5N1 and the evolution ov virulence, and another excellent one from Mike regarding the importance of surveillance when it comes to detecting and containing outbreaks (such as the recent O157 outbreak). He also describes a timeline for how long many of the common procedures take; quite a bit different from what you get watching CSI or similar shows…
mikethemadbiologist | September 25, 2006Do you want to know how to stop, or at least, lessen the next E. coli 0157:H7 outbreak? Improve our surveillance and public health infrastructure.
If we improve the infrastructure, we can speed the response time, making it easier to contain an outbreak.
Let's walk through each of the steps the CDC outlined in its response.
1. Incubation time: The time from eating the contaminated food to the beginning of symptoms. For E. coli O157, this is typically 3-4 days.
There's not much we can do to 'improve' this step. While random testing could be an option, when it comes to produce, I don't see…
mikethemadbiologist | September 25, 2006Most microbiologists, you know, the experts , are not very thrilled with the emphasis being placed on bioterrorism. Inspired by Tara's post on the Bioshield initiative, I'm reposting this from the old site.
This week, leading microbiologists are sending an open letter to NIH stating that the politically-based emphasis on bioterrorism is starving other areas of research. For some time now, I've thought that we've been too concerned with bioterrorism, particularly when good ol' influenza regularly kills 32,000 37,000 people per year (that's one World Trade Center per month for those of you…
mikethemadbiologist | September 21, 2006 In the November general election, South Dakota will have a referendum that could overturn its law that bans abortions, even where the woman has been raped, is the victim of incest, would suffer long-term medical problems, or would be unable to have future children. The first of the political ads are running, so I thought this post would be appropriate (and certainly in the style my readers have come to expect....). From the archives:
Well, that got your attention, didn't it?
Of course, I realize that it's utterly inappropriate to introduce religion into the abortion debate.
(Thankfully,…
tsmith | September 21, 2006 That's certainly the claim in a new New York Times editorial (via The Frontal Cortex). The author, Nina Planck (author of Real Foods: What to Eat and Why), claims that it's as easy as just feeding cattle grass, and poof!--E. coli O157 will vanish.
More on this and why organic farming won't necessarily stop such outbreaks after the jump.
Planck writes:
Where does this particularly virulent strain come from? It's not found in the intestinal tracts of cattle raised on their natural diet of grass, hay and other fibrous forage. No, O157 thrives in a new -- that is, recent in the history of…
tsmith | September 21, 2006I write a lot here about science denial, and it's been pointed out previously that denying that HIV causes AIDS, for instance, is deadly quackery. Now, via Nature write and blogger Declan Butler and Nature magazine comes news of another form of science denial revolving around HIV: the 7-year imprisonment and torture of six medical workers in Libya (the "Tripoli six"), falsely accused of deliberately infecting more than 400 children with HIV. In his blog post, Butler asks, "Can the blogosphere help free the Tripoli six?"
(More below...)
This mess began back in 1999, and now the six face…
mikethemadbiologist | September 20, 2006A CDC website lays out how we actually identify an outbreak of O157:H7. Guess what? It doesn't happen like it does in the movies or on TV. This is why keeping these networks fully functional (i.e., adequately funded) matters: time is critical and delays in processing due to inadequate resources or personnel can be deadly. For kicks, imagine if this were something far more contagious than a food-borne pathogen.
Here's the timeline:
1. Incubation time: The time from eating the contaminated food to the beginning of symptoms. For E. coli O157, this is typically 3-4 days.
2. Time to…
mikethemadbiologist | September 20, 2006Geneticists often use the phrase wild type to describe the dominant allele--genetic variant--of a gene. In microbiology, we typically assume that the wild type of a bacterium is sensitive to antibiotics, and that the rare mutants (and recombinants) are antibiotic resistant.
My colleague, Susan Foster, at the end of a seminar she presented to clinicians in Southern California, asked her audience to anonymously write down the percentage of methicillin-resistant Staphylococcus aureus (MRSA) at their hospitals.
The result?
The median percentage of methicillin resistance was 60% (the average was…
tsmith | September 19, 2006From the New York Times:
The last of the anthrax-laced letters was still making its way through the mail in late 2001 when top Bush administration officials reached an obvious conclusion: the nation desperately needed to expand its medical stockpile to prepare for another biological attack.
The result was Project BioShield, a $5.6 billion effort to exploit the country's top medical and scientific brains and fill an emergency medical cabinet with new drugs and vaccines for a host of threats. "We will rally the great promise of American science and innovation to confront the greatest danger of…
tsmith | September 18, 2006And who said spinach was boring?
If the ongoing E. coli outbreak due to spinach has done one thing, it's highlight the mystery that revolves around Salinas, California:
The sunny Salinas Valley holds a dark mystery: Why, in the past decade, have nine Escherichia coli outbreaks been linked to produce grown here?
It's still unknown why this fertile land has been hit by what an FDA official calls "significant" crop contamination.
Throughout the picturesque terrain here, questions swirl.
Has cattle waste contaminated irrigation water? Does contaminated soil blow in the wind? Do birds feeding on…
tsmith | September 18, 2006It seems like every other story that comes out about H5N1 contradicts the previous one. I've blogged previously about some reasons to think that the diagnosed cases of H5N1 are only the tip of the iceberg (see here, here, and here, for instance). Though there I present some evidence to suggest that we may be missing asymptomatic or mild influenza cases, other stories have come to the opposite conclusion. For example, a recent news story from Cambodia reports that no mild or asymptomatic cases of H5N1 infection were found:
Researchers who tested 351 Cambodian villagers after they had…
mikethemadbiologist | September 16, 2006After reading this Washington Post article about the Iraq War reconstruction effort, I've stumbled across the epitaph of the Bush Administration:
Bush Administration appoints political cronies and ideological wackjobs to important positions. Said appointees pandimensionally clusterfuck everything sideways. People suffer and die due to avoidable ineptitude.
Let's document the idiocies.
Jim O'Beirne was the gatekeeper for hiring in the Coalition Provisional Authority (CPA). Because most of these jobs were classified as temporary, provisional jobs, they were exempt from the federal…
tsmith | September 15, 2006 E. coli outbreak traced to tainted spinach
An outbreak of E. coli in eight states has left at least one person dead and 50 others sick, federal health officials said Thursday in warning consumers nationwide not to eat bagged fresh spinach.
The death occurred in Wisconsin, where 20 others were also sickened, said Dr. David Acheson of the Food and Drug Administration's Center for Food Safety and Applied Nutrition. The outbreak has sickened others -- eight of them seriously -- in Connecticut, Idaho, Indiana, Michigan, New Mexico, Oregon and Utah.
FDA officials do not know the source of the…