MMR Vaccine Protecting you in Multiple Ways

A recent study has shown that the MMR vaccine can help lower your risk of being infected by other serious infections and not just measles, mumps, and rubella. The recommended vaccines that one should get along with the MMR vaccine are diphtheria, tetanus, pertussis, polio, and Haemophilus influenza. Researchers found that when people were vaccinated with these shots at the appropriate time along with the MMR vaccine they were at a lower risk of attaining an infection. 

This research proves a point that you should be getting vaccinated and it also shows that parents should be listening to what the public health is recommending. Being vaccinated takes away the risk of getting infected with other diseases. If you simply follow what the public health doctors are saying then your chances of staying healthy are at a greater percent. 

Pictured above is a baby getting her MMRvaccine 

This article really tries to drive across the importance of sticking to scientific evidence and how germs spread. They really want people listening to suggested medical procedures to keeping you and others around you safe from infections. A shocking statistic shows that there were 115 more cases last year than the annual average. Along with that, a California epidemiologist stated that nearly half of the patients had parents who opted out of the state's immunization schedule. 

The reason I chose this article is because it talked a lot about public health and in class we do talk a lot about it. When studying Cholera people listened to what the public health was saying and it was important to keeping the community safe from infection. Even if it wasn't the right thing they were directing people to do, they were looking out for them and giving them the most reasonable actions to try and prevent the spread of a disease. It is important I think for people to do as directed by public health to help keep you and the people around you safe from infection and starting an epidemic. 

http://www.medicaldaily.com/mmr-vaccine-linked-overall-reduction-hospitalizations-infections-especially-lower-respiratory-tract

Multiple Cases of Children in California Having a Polio-like Illness

According to the article, “’About 20’ cases of polio-like illness found in California” by Jacque Wilson and Ashley Hayes of CNN, neurologists have identified five patients who developed paralysis in one or more of their limbs between August 2012 and July 2013. However, all five of the children had been vaccinated for the poliovirus and the treatment did not help the children to regain their motor skills. Samples were taken from two of the five children and the results were that they tested positive for entervirus 68, which is a rare virus that is linked to severe respiratory illness.  The children have not recovered use of their affected limbs and have “severe weakness” according to Dr. Emmanuelle Waubant, a neurologist at the University of California. She claims that “it’s not just dropping a toy; it’s more like not being able to move your arm at all."

  

This phenomenon is not new according to Dr. Carol Glaser, chief of Encephalitis and Special Investigation Section at the California Department of Public Health, who says that there are similar outbreaks all across the world. Enterovirus 68 was first identified in a California lab in 1962, and since 2000 the government has kept a close watch and has seen 47 cases. However, outbreaks have occurred over the years in both Asia and Europe. Enterovirus 71 is more concerning to health officials, and it is associated with severe neurological issues such as aseptic meningitis, polio-like paralysis and encephalitis. Enterovirus 71 has circulated in Europe, Malaysia, Taiwan, Southeast Asia, Sydney, Australia, and in the United States. Dr. Steven Oberste, chief of the Polio and Picornavirus Laboratory Branch at the CDC, said, “That’s the really odd thing, we see cases from time to time in the United States. Occasionally there’ll be severe. Basically it’s identical to what’s circulating in Asia….but it doesn’t cause the same big outbreak in disease. And we really don’t know why.”
 

I chose this article because it is happening in the United States and has been happening recently. Also, I chose this article because in class we are going to learn about polio, which in the article was stated has been eradicated in the United States for 30 years, and this is article is about a polio-like illness and how there is still symptoms of polio. The CDC does not know what the connection is between the disease in Asia and in the United States and why we are not having as large of an outbreak. I thought this article gave a lot of information of what was going on in California and also around the world and how they’ve been following Enterovirus  68 and 71 cases for quite some time. I hope that doctors and the CDC can soon discover what is causing this illness and they are able to treat it and help those who lost their motor functions because of it.

 

http://www.cnn.com/2014/02/25/health/california-mystery-disease/

Disease Hits Close to Home

Nobody wants to hear that a disease was found in a grocery store. Especially in a grocery store so close to home. In Framingham Massachusetts at a local Trader Joe's, employees are said to have contracted measles. In the more recent news just found out last night about this outbreak. 

In this article Trader Joe's may be the source of the Measles outbreak, by foodsafeguru on the US Safety Food Blog,a local Trader Joe's located in Framingham is said to be the source of two recent cases of measles. It is said that if you were in the store between the dates February 15 and February 19 between the hours of 9 am to 5 pm, you could be at risk of infection. 

Of the two cases in the metro west, one of the infected persons is said to work at this Trader Joe's. The public health organization of Massachusetts set up clinics in the store on the 22nd and the 24th to help educate staff on measles. Most employees were said to already have their vaccinations. 

 If they weren't in the store, the risk is minimal,” this being said by the chief public nurse of Framingham, Kitty Mahoney. This is mostly saying that if you weren't in the store you are not likely going to contract the virus. It is more of a "Don't worry about it" statement. This is probably stated so that many people don't panic and rush to a clinic to get vaccinated so they can vaccinate the ones that were exposed to the disease. 

It is amazing that such an infectious disease can be this close to home. Living in Massachusetts you would never believe that something like this could happen. Measles is one of the  most infectious diseases that has a large spread rate. The window of the ten day incubation period is up and people are waiting now for symptoms to set in.

A force of public health figures went in with such rapid force it is amazing. Many people are now getting vaccines and watching out for the symptoms of measles. With setting up those clinics at Trader Joe's, it spread awareness. 




http://blog.usfoodsafety.com/2014/02/25/trader-joes-may-be-the-source-of-measles-outbreak/

Black Death Left A Mark On Human Genome

Recent studies of the human genome have found that people who's ancestors were exposed to the Black Plague have a change in their genome. Mihai Netea, an immunologist at Radboud University Nijmegen Medical Centre in the Netherlands, and evolutionary biologist Jaume Bertranpetit of Pompeu Fabra University in Barcelona, Spain, and their colleagues looked for differences at more than 196,000 places in the genomes of 100 Romanians of European descent and 100 Rroma. The researchers also cataloged the differences in 500 people who lived in Northwestern India, where the Rroma had come from. Next, they analyzed which genes changed the most so they could see which were favored by selection.

 

The research was done to figure out why some Europeans respond to different diseases and have different susceptibilities. A thousand years ago, Rroma people (commonly called gypsies) migrated from North India to Europe. They still have very different genetic backgrounds, as they did not often marry outside of their race. However, both of these groups were hit by the Black Plague. Researchers went looking for genes that were favored by natural selection by finding similarities in the Rroma people and in European Romanians that are not found in Northern Indians. 

What they found were 20 genes in the Rroma and Romanians that could not be found in Indian's genes. The genes included skin pigmentation, inflammation, autoimmune diseases, and three immune system genes that can be found on chromosome 4. They code toll-like receptors, and are thought to be directly related with the Black Plague because when they were tested with Yersinia Pestis, they found that the strength of the response had to do with the receptor genes.

Other Europeans who's ancestors have been exposed to the Black Plague do have similar changes. But people who are from places that were not reached by the disease, such as China, do not show these changes. This shows how the Black Death bacterium does change the protein coded for certain genes and has a lasting effect on the population.

This relates to our work in class because we studied the Black Death and what it did to the population during that time period, but now we know the long term effects on people during the present day. Those these changes in genes may not be major, they are significant and a big step in research on disease. These discoveries will probably prompt other labs to see if other bacterial infections could also alter peoples genetic makeup.

http://news.sciencemag.org/biology/2014/02/black-death-left-mark-human-genome

A Fatal Mistake May Mean Death for Innocent Patients

A recent outbreak of disease in the Forsyth Medical Center has forced 18 families to potentially deal with a rare but fatal degenerative brain disorder. The disease, known as the Creutzfeldt-Jakob Disease, affects one in 1 million patients worldwide annually, or about 300 Americans a year, and has no known cause or treatment. Symptoms often don't appear for year, and even decades. Unfortunately, death typically occurs within a few weeks after the onset of symptoms.

Brain infected by Creutzfeldt-Jakob

The disease is spread by iatrogenic and variant exposure. Iatrogenic exposure is illness caused by medical examination or treatment, and the risks include ontaminated surgical instruments, dura mater transplant, corneal transplant and human growth hormone. Variant risks include eating contaminated beef or being exposed to contaminated blood or a blood plasma transfusion.

The outbreak of Creutzfeldt-Jakob began with a neurosurgical procedure on a patient that was later confirmed to have the disease. The other 18 neurosurgical patients were all exposed within about 20 days of the first procedure. The exposure occurred because the instruments used in the surgery were sterilized in the standard way, but did not receive the enhanced sterilization process that is necessary for Creutzfedlt-Jakob.

The disease can remain on equipment that is not properly sterilized. This was an oversight on behalf of the Center. There are only a few laboratories across the United States that test for this disease, so this makes it even more difficult for the patients who potentially contracted it.  Jeff Lindsay, the hospital’s president, said “any exposure is simply unacceptable.”

The reason behind this outbreak occurred is rather difficult to fathom. Patients go to hospitals and special doctors expecting their needs to be taken care of, and not contracting a more serious and fatal illness. Other reports of malpractice and haphazard procedures that have caused outbreaks of disease in patients have come up recently and I think it brings into question if hospitals and public health services are really doing all they can to protect the patient. I wonder how these families are planning on responding to the exposure of disease.

This relates to our work with epidemic disease in terms of germ contraction through simple things such as hand washing. Although this is on a much larger scale of sterilization and is about a very complicated disease, it still holds the same basic idea of being healthy. One doctors unintentional mistake can cause fatal problems for other people.

Not all of the 18 cases have been confirmed, but the fact that it is even a concern is rather unsettling. The Center is currently under quarantine until the situation is resolved.  

Read full article at: http://www.news-record.com/news/local_news/article_6badfe68-928f-11e3-811b-001a4bcf6878.html

Is Polio the Next Come Back King?

In Kabul, Afghanistan, the first polio case reported in over twelve years. Three-year-old Sakhina recently contracted the disease. The people of Afghanistan believe that the reason polio is making a come back is because of the interaction they have with Pakistan. Besides being their next-door neighbor, Pakistan has more polio cases throughout the country. There have been 93 recorded polio cases in Pakistan in the last year, which makes the cases in Afghanistan traceable to Pakistan. 

Although numerous vaccinations were distributed throughout Afghanistan, Military attacked and invaded the health workers trying to cure the disease. An speaker from the United Nations in Afghanistan said, "The C.I.A. has a lot to answer for in setting back polio eradication years." They believe that because of the invasion, polio is going to be more prevalent in years to come. Although the army was blamed, the Taliban militants, International and Afghan-government worked together to reduce the number of cases to 14 in 2013. Unfortunately, the 3-year-old girl was not treated enough because in November she became paralyzed. Afghanistan plans to increase the rate of immunizations in children so that they can try and conquer the disease that currently is an incurable viral infection. The country plans to try and eradicate the disease by 2015, and the way things are going the leaders believe they will achieve the goal. 

Since the 3 year olds case, their are plans to vaccinate over 73,000 children that are living in the same area as the girl. They believe that since there was only one case in over 12 years that the immunity of the area is pretty good. A Unicef official said, "It meant the population, in terms of immunity, is well protected." He says that the security of the rest of the people is intact because there were no other polio cases found. 

Polio, to me is one of the most devastating diseases because there is not much you can do to stop it from paralyzing the victim. The people of Afghanistan and Pakistan were infected with numerous cases of polio over the years, and after 12 years of having no cases it arises again in Afghanistan. Luckily there was only one case reported, but who knows what's in store for them in the future. I think that they are on the right tract by providing immunization for thousands of children. They are trying to be as preventative and safe as they can be. Out of all the diseases we have studied, I think that polio is one of the worse. Yes, smallpox and typhoid were bad, but at least there was something that could be done to prevent it from spreading further. Hopefully in the future, someone will find a way to eradicate the disease completely. 

website: http://www.nytimes.com/2014/02/12/world/asia/rare-afghan-polio-case-tied-to-pakistan.html?_r=0

picture: https://www.nytexaminer.com/wp-content/uploads/2012/01/Polio-Vaccination-Given-in-Afghanistan.jpg

Drug Resistant TB on a Rampage

Image from: http://atlantablackstar.com/2013/10/03/vitamin-d-may-treat-tuberculosis/

On January 17, 2014 Honor Whiteman posted an article titled “Patients with untreatable tuberculosis ‘are spreading infection’” on the Medical News Today website, which discussed the problem of drug resistant Tuberculosis. South Africa many patients with drug resistant Tuberculosis are being released back into communities to spread the very infectious disease after doctors failed attempts at treating patients with this type of TB. TB is spread through airborne particles and therefore is extremely contagious from one person to another.

Since so many people in South Africa are sick with TB the hospitals do not have enough beds to keep patients with long term drug resistant TB and therefore let them out into the community. Unfortunately, what this is ultimately doing is causing more cases of drug resistant TB in the area since the disease is so contagious amongst people. According to Honor Whiteman, “The disease primarily affects the lungs, but it can also affect other organs. Typical symptoms of the disease include persistent coughing (in which a person can bring up blood), weight loss, night sweats, a fever, tiredness and fatigue, and loss of appetite.” These symptoms are without a doubt very painful for a patient and can have an affect on a person’s quality of life, especially if the patient has a form of drug resistant TB, making their case very hard to treat.

Tuberculosis has a very personal connection to my family. When I was doing genealogy for my history class last year I learned from my great grandmother who is ninety- three that both her mother and a few of her sisters had tuberculosis when she was growing up. She told me that the reason her father bought their house in Stoneham on Curve Road was because their house sat up on top of a hill and that the doctor told him that higher elevation would be good for his wife and daughters condition. Also, she told me that her father used to carry the very weak girls outside into the sun during the day to let them get some fresh air. Unfortunately despite her father’s great efforts both her mother and some of her sisters died of Tuberculosis.

This article was very interesting to read and really brought into the light for me what an issue TB truly is in South Africa. It is so sad that just because a patient has drug resistant TB they are sent back out into the community to fend for themselves and ultimately to continue spreading the disease because the hospitals do not have enough beds to accommodate all the people with TB in South Africa. This year in History and Science of Epidemic Disease we have learned a lot about how different infectious diseases spread. Tuberculosis is extremely contagious because it is spread through airborne droplets from one person to another. Unlike other diseases that we have learned about that are spread from people from a vector, feces, or something else this disease is truly infectious person to person. Tuberculosis is a huge issue around the world and this article truly highlights just how devastating the disease is, especially in South Africa.

Link to Article: http://www.medicalnewstoday.com/articles/271338.php

New Bird Flu Threat?

This article discusses the first ever reported cases of H10N8 avian influenza found in humans. Before December 2013, this strain of flu was only found in animals, mostly birds. 

On December 17th, 2013, Chinese authorities contacted the World Health Organization after finding strands of H10N8 influenza in a 73-year-old woman from Jiangxi Province in China. The patient was reported to be hospitalized around November 30th with pneumonia and high fever. She would unfortunately pass away after multiple organ failures on December 6th. This patient was said to gave visited a poultry farm four days before becoming ill. Though there were no traces of this strain of flu at the farm one can not infer that she fell ill due to the poultry from that specific farm. 

Another case was found also in Jiangxi Province China around January 30th, 2014. The World Health Organization reported a second case of the H10N8 influenza within a 55-year-old women, although she is now in stable condition. 

“A genetic analysis of the H10N8 virus shows a virus that is distinct from previously reported H10N8 viruses, having evolved some genetic characteristics that may allow it to replicate efficiently in humans.”

-Yuelong Shu of the Chinese Center for Disease Control and Prevention in Beijing

However, the case numbers for H10N8 influenza remain low in humans many scientists and doctors are more concerned with other influenza strains such as H7N9 and H5N1.

I found this article very interesting in many ways. First, both victims of this strain of flu were from the same city in China. Coincidence? Maybe… Also, I found it very interesting how doctors are thinking that this strain of flu newly found in humans is just an outlier. Even though there are not as many cases, this type of flue has never been found in humans before, wouldn't one think if it is now appearing in humans it should be looked at in some what greater detail? Should doctors pay more attention to "the new bird flu", or should they stay devoted to more serious and deathly forms of influenza?

I chose this article because it was so open ended. There is so much more we can learn and research about this type of disease and even then all of our questions won't be answered. It also relates somewhat to the unit about Typhoid Mary. In some ways these two victims struck with the H10N8 strand of influenza are outcasts, no one else has gotten this illness before in history (at least humans in that case). Just like Mary, even though others were asymptomatic carriers none were treated the way Mary Mallon was treated. Comparing the two is in a way a stretch but we can see how the influenza patients will be treated maybe differently than others that have gotten different strands of influenza because no one has paved the path in how to cure this flu. 

http://www.the-scientist.com/?articles.view/articleNo/39092/title/New-Bird-Flu-Threat-/

The Next Big Epidemic?

The article I chose is titled "Counting the Costs of a Global Epidemic" by Anmar Frangoul, from CNBC on Wednesday February 5th. This article focuses on past outbreaks of different strains of flu in history, and poses the question of when the next one will happen. For example, SARS in 2002 and Swine flu in 2009. The article talks about how planning is really the best thing to do, quoting former Secretary of the U.S. Department of Health and Human Services Michael O.  Leavitt:

"Ultimately, the key to preparing for a pandemic is to develop, stockpile, and prepare to distribute vaccines and antivirals – vaccines to prevent people from becoming infected by a virus, and antivirals to treat them if they are infected."

The conclusion is that there's really no perfect way of planning for a disease, just controlling it once it strikes. 

My first reaction to this was that this idea is very scary. Reading about the costs and devastation that epidemics and pandemics in the past have caused makes me slightly worried. Knowing that there is no perfect cure except to plan for the worst seems to be helpless. Knowing the history of many other pandemics that we have studied in class such as the plague or smallpox, there is a light at the end of the tunnel, so to speak. Diseases spread and people die, but time keeps going. The crisis eventually ends, as we have seen before. 

I really enjoyed this article. Reading about the swine flu makes me remember getting my shot in the auditorium of Parker Middle School. It was a crazy time to think that we were vaccinating ourselves for an epidemic. I read the article and started getting worked up about the next epidemic, and then I had to remind myself that I've actually lived through one, which was pretty cool to me.  

Photo: "Reported Fatalities from Pandemic Influenza." Map. Nature.com. Nature Publishing Group, 2009. 

The "Silent" Epidemic of America's Southwest

 Nodules caused by Coccidioides immitis fungus.

There is a serious epidemic going on in the American Southwest which has been remarkably overlooked by the rest of the country.  A fungal disease termed "Valley Fever" is currently endemic to several southwestern states, prominently Arizona, New Mexico, and Southern California.  However, while endemic, this disease is ruthless and has very little funding to aid treatment due to its apparent obscurity.  Here is a quote that really caught my attention:

" The impact of valley fever on its endemic populations is equal to the impact of polio or chicken pox before the vaccines”

-John Galgiani, an infectious-disease physician who directs the Valley Fever Center for Excellence at the University of Arizona in Tucson

 

A nodule of Coccidioides immitis filled with infected spores.

It is crucial to understand the confusing severity of the Valley Fever fungal disease.  The way that it enters our bodies is through breathing in its spores.  The spores are the small spherical whitish objects within the nodule pictured above.  The fungus has adapted in a way such that when humans breathe in the spores, they latch onto the inner lining of the lungs and cannot be breathed back out.  Therefore, if you happen to live in an area that the fungus is endemic, and you can walk down the street and breathe these into your lungs, you are at risk of a serious condition.  Once breathed in, the spores multiply within a protective nodule, which then breaks open and allows the spores to spread throughout your body.  In many unfortunate cases they reach the brain and cause large amounts of damage.  

The disease is hard to combat because in the least severe cases symptoms appear to be much like the flu: cough, fever and exhaustion that eventually go away by themselves.  However, in more severe cases, the spores spread to other tissues inside the body including the skin, bones, and brain. The fungus has even been linked to a form of meningitis, termed "Cocci meningitis", which can be treated, but the treatment includes extremely painful injections into the skull of amphotericin B (an antifungal medication).

One case study of a young woman who started with a seemingly mild case of Valley Fever is described here:

"One patient, a twenty-six-year-old white woman who caught valley fever four years ago, told me that the medicine made her vomit non-stop on a negative incline. She was temporarily paralyzed, underwent three brain surgeries, and has had twenty-two spinal taps. Not long after her diagnosis, the doctors told her mother to make funeral arrangements. Now they tell her she will be on anti-fungals, funnelled through a shunt in her brain, for the rest of her life."

 

-Dana Goodyear, Author of Article discussing a previously conducted interview. 

Overall, Valley Fever is a huge problem in the desert southwest that is being ignored due to its endemic state.  This is concerning because there is no vaccine against it, and when cases become potentially fatal there is usually no way to cure them without significant pain for the patient.  In addition, this disease is non-discriminating in its victims; anyone can breathe in the fungi if they are in an infected area.  

I chose this article because it brings up the ideas of ethics and governmental involvement in epidemics that we've been talking about in class.  Should the government not fund research and treatment surrounding a disease just because it isn't a "big name" infection that we hear about every day in social media?  Should patients be subjected to harsh treatments such as cranial injections if they barely know anything about the disease that they have? What if someone went to Arizona and brought the fungus back to the northeastern US, how would the CDC and the government react if at all?  All big questions that apparently are yet to be answered.  It will be interesting to see how (and if) this disease makes it into the news as we approach the warmer vacationing summer months.  

Link to the Main Article:

http://www.newyorker.com/reporting/2014/01/20/140120fa_fact_goodyear

Picture Links:

http://www.virginmedia.com/images/rift-vallery-fever-431x300.jpg

http://en.wikipedia.org/wiki/File:Mature_spherule_with_endospores_of_Coccidioides_immitis_PHIL_480_lores.jpg

H1N1 Wreaking Destruction in California

Last year, during the 2012-2013 flu season, there were 106 recorded flu-related deaths in California. This year, there were as many cases in just one month. The number is currently at 147 so far, not including the 44 deaths currently under investigation to see if they were indeed flu-related. All of these deaths were of people under the age of 65, and each death was either a direct result of the H1N1 virus or complications that came about because the person was infected with the virus.

H1N1 virus

It's uncertain whether or not California is an outlier with such a high statistic, since states are not required to report flu deaths to the Centers for Disease Control, or if this is a disturbing premonition of what's to come. The CDC does say that this season has seen the widest circulation of H1N1 since the pandemic in 2009. It was that pandemic that made it required for counties in California to report any and all deaths caused by the flu in those under 65 years of age.

A possible explanation for the large number of deaths among younger people comes from Sacramento Health County Health Officer Dr. Olivia Kasirye, who says that H1N1 is a different strain of flu virus because it targets those who are young and healthy. Scientists also think that those over the age of 65 have a higher immunity as a result of similar outbreaks that had occurred decades ago, whereas younger people may have never been exposed to it before, and the H1N1 vaccine is not a mandatory vaccine for everyone.

There is some good news. Influenza cases in Los Angeles County seem to be leveling off and even declining recently. However, cases of flue-like symptoms at doctors' offices around the country are 50% higher than normal, which means that the United States is still smack in the middle of flu season. Health officials are urging those at the greatest risk to see their doctors as soon as they start developing flu-like symptoms, and California is encouraging its residents to get vaccinated, since it doesn't seem like flu season will be over any time soon.

For me, it's pretty disturbing to hear of 147 people dying as a result of the flu. In today's world, things like this always surprise me, and I keep having to remember that, despite all of our advances in health care and medicine, we still have no cure for viruses. Once you get a virus, your immune system is on its own, with maybe some marginal help from medicine. It is, for me, one of the failures of modern medicine, and one of the things that makes viruses so fascinating.

This outbreak reminded me of the Mary Mallon case and the question of individual rights versus public well-being that we have been studying. What if the spread of H1N1 got worse? What would the state of California do if faced with a critical situation? Would the rights of individuals be an afterthought in the face of such a danger to the general population? I think a big difference between now and Mary Mallon's time, however, is that people are much less shy of suing if they think they have a case, which could change the way the government would approach such a situation.

For more information on the H1N1 vaccine: http://www.webmd.com/cold-and-flu/features/h1n1-swine-flu-vaccine-faq

The original article, from Liberty Voice: http://guardianlv.com/2014/02/h1n1-flu-hits-hard-with-147-dead-so-far-in-california/