Sunday, June 15, 2014

That Which Bends Up

 Just before leaving for my trip to Costa Rica, I purchased a some Ultrathon insect repellent and an insect repellent bracelet. This trip was going to be my first time traveling in Central America, and I had heard that the mosquitoes were "no joke". This was also my first international trip with a group, and I had to give myself time to adjust to the fact that I would have no control over our itinerary at all (which is a big deal, because I enjoy planning everything about my trips).

I'm usually not a major target for mosquitoes here in the states. I honestly cannot remember ever really getting a mosquito bite in the past, but if you are a regular reader, you'll remember that I've had my fair share of ticks and other things. I'm sure it wont surprise you to hear that I did my research before going, and made sure I was aware of any infectious disease-related hazards. Giant spiders and venomous snakes don't really worry me, but I did my research for everything else. There's a giant list of illnesses that are prevalent in Central America, but you can research those on your own. The only real possibility of exposure was Dengue fever. I've traveled to areas that have had outbreaks of Dengue fever before, without any insect repellent, so I was already doing a better job of being prepared.

I was traveling with a group of field biologists, and I learned right away that most field biologists have absolutely no time or motivation to worry about infectious diseases. Yes, they were all prepared with their massive spray bottles of OFF! and some with their insect repellent shirts and hats. But, I've never seen so many people willingly jump after poisonous frogs, handle venomous snakes, catch bats, and handle potentially dangerous insects without a bit of hesitance. Most of it was traumatic for me (I'm more of a "let's be as unobtrusive as possible and observe from afar" type of biologist), but seeing their childlike excitement was kind of inspiring.

Speaking of excitement, here's me at a beautiful waterfall near La Fortuna.

We brought microscopes with us and stayed at the Texas A&M Soltis Research Center during a majority of our trip. The microscopes we were able to pack weren't anything fancy, just two Leica dissecting scopes and three Primostars for fluorescence work. Here are some of the images I took (the primostars didn't have cameras, so these are all taken through the oculars with my iphone):

Clockwise from the upper left:
 tree moss autofluorescing under a DAPI filter, the wing of a fly under a FITC filter, 
floral structure under FITC filter, plant structure under DAPI filter.

Anyway, the point of this blog post was not to showcase my vacation photos, but to talk about what I experienced afterward. Upon returning to work the very next day (mistaaaaake!), some interested colleagues asked if I had "brought anything back" from my trip. They weren't asking if I bought coffee or chocolate, but if I had contracted any diseases while gallivanting through the rainforest. Sure, I might have made some jokes about wanting to get myself a pet botfly larvae, but I wasn't serious. I mentioned that there was a chance I could be in an environment with mosquitoes carrying Dengue fever, and one of my colleagues said, "but there's a new one, right? It's like Dengue, but not?"

That, my friends, is Chikungunya. Chikungunya, which means "that which bends up", has been an issue since the 1950s, but reached epidemic proportions in 2004. Since 2004, Chikungunya has spread rapidly in Africa, Asia, the Indian subcontinent, Europe and the Americas. Recent spread of Chikungunya through the Caribbean islands has caused isolated incidents to show up in North America, thanks mainly to tourism.

Chikungunya is a mosquito-borne RNA virus that shares initial symptoms with Dengue fever, which often results in misdiagnosis. Most regions affected by Chikungunya don't have clinics or labs with the capability to test for both Chikungunya and Dengue fever. 

While Chikungunya doesn't have a high mortality rate, the symptoms can be excruciating. Much like Dengue fever, fever, muscle pain, headache, nausea, and fatigue are common, but joint pain and rashes are the distinguishing symptoms. Dengue has been called "bone breaking" fever for the muscle and bone pain associated with infection, but Chikungunya, or "that which bends up" was named for the contorted posture associated with the debilitating joint pain. 

Via El National

The emergence of the Chikungunya epidemic and the warnings against Dengue fever at the World Cup bring up an interesting question: in the age of synthetic biology, should we try to wipe out mosquitoes once and for all? We've been down this road with malaria and using insecticides to reduce mosquito populations, and...well, malaria is still a problem. But, if you are interested in what's being done to control mosquito populations in specific areas, I highly suggest you listen to the Kill 'Em All episode of Radiolab.

By the way, the CDC has a map tracking cases and local transmission of Chikungunya that is updated as reports of cases come in.

Check back soon for my next blog post on a disease that causes self-cannibalism!

Tuesday, March 18, 2014

New Beginnings: Spring Edition

My life has completely changed since my last post, seven months ago. I wanted to write, in fact, I had a list of topics going for a while, but I just couldn't find a spare hour or two to really iron out the details. In the time since my last post, I got married, traveled to Europe (specifically Paris and London) for my honeymoon, had a birthday, got some new science-specific tattoos, published some papers, was asked to teach a few classes in the fall, took some steps to better myself in my career and my personal life, and got a cat. I have a hard time fitting in time for the gym, or even really breathing!

Here's my husband, on our honeymoon, in a Medical History Museum in Paris (I'll blog about that later). 
I have ideas for new blog posts every day, and I'm going to do my best to start catching up. Be warned, though, my ability to write somewhat blog posts may have decreased, since I've been working on writing three papers simultaneously in the last few months. Maybe you're a distinguished scientist, maybe you're a student, or maybe science is just a hobby to you, but I don't think I need to explain that scientific writing is not the most flavorful of writing styles.

The weather is getting warmer, especially for those of us in California (It was 80 degrees this weekend!). This means gardening, hiking, a general increase in "outdoorsiness". There are two things that I want you to be aware of as you start enjoying the warm weather: Lyme Disease and soil-transmitted parasites! I'll cover soil-transmitted parasites in my next blog post.

One of my dear friends, Kristen, has been trying to dig her heels into some research on Lyme Disease, and I promised I'd post something about it. Since I am stupid, I forgot that I had already written about ticks! Not necessarily Lyme Disease, but a tick-borne virus. Actually, maybe I should try to convince her to write a little guest-blog post for us about what she's learned!? I can imagine myself asking her to do that, and can clearly picture the mixed emotion of extreme excitement and annoyance that would wash over her face. Kristen, if you are reading this, I won't make you do it!

The Tick, via PopGunChaos
Lyme Disease is a bacterial infection that is quite weird, in that you have the ability to be successfully treated with the use of antibiotics within the first few weeks, but it can become chronic if left untreated. Lyme disease has been reported in 80 countries worldwide, and is especially concentrated on the east and west coast of the United states in regions with wooded areas and areas with tall grasses.

Lyme Disease rash variations, via bayarealyme

The bacteria responsible for Lyme Disease is Borrelia burgdorferi, which is a spirochete that has a double membrane, instead of being gram positive or negative. B. burgdorferi is an obligate parasite that uses ticks (Ixodes pacificus) as a vector to infect their mammalian hosts, like rodents, deer and humans. Transmission of B. burgdorferi to smaller mammals doesn't typically result in Lyme Disease (although the rash has been seen in many domesticated dogs that live in rural areas), making that complication specific to human hosts. Ticks transmit B. burgdorferi to humans while taking a blood meal. A simple "bite" doesn't usually do the trick. Transmission is dependent on the length of time the tick has been present on the host (usually 36-48 hours minimum), and on the level of infection within the vector (is the bacteria just in the midgut? or is it present in many different organs, like on the mouth parts and throughout the digestive tract?).

Also, according to samples studied from the Pacific Northwest (California and Oregon), only about 1-1.5% of ticks are infected with B. burgdorferi. With increases in tick populations, the probability of transmission increases. This is one of the reasons warmer seasons lead to more infections.

Ixodes pacificus, via Riekes Nature Blog
Tick size comparison before and after a blood meal, via WA Department of Health
Many studies are trying to determine the proliferation and survival mechanisms of B. burgdorferi because it lacks common pathogenic factors, like lipopolysaccharide, toxins, and specialized secretion systems. Researchers think this may be because B. burgdorferi did not evolve to cause disease in mammals. Not only is there a wide range of variation between bacterial strains of B. burgdorferi, but the analysis of the DNA has shown that it is rapidly evolving.

So why don't you want Lyme Disease? If you are one of the lucky ones that has a resident tick for more than 36 hours, and doesn't identify the symptoms within the first few weeks of infection (meaning you probably wouldn't seek treatment either), then you could experience a wide range of chronic symptoms. Initial symptoms are classic "flu-like" symptoms, such as fever, chills, muscle aches, stiff neck, and just feeling like crap (clinical phrase). To be fair, unless you see a rash with these symptoms, I don't know why you would seek treatment. We've all been sick before, and usually flu-like symptoms aren't severe enough to run to the doctor. A lot of people miss the rash because it's on their scalp/under hair, or somewhere they can't see, like on the back of their neck and trunk areas.

Most people who have chronic Lyme Disease and are being actively treated still feel exhausted all the time. But, without treatment, B. burgdorferi can spread to your brain and heart, resulting in major organ damage and failure. The most common and alarming symptoms are numbness, paralysis, and muscle weakness. It's pretty awful, and you don't want it.

My family has many stories that involve ticks. As you probably know, I am a huge hypochondriac. My poor husband, Peter, has to put up with text messages from me saying things like "AM I HAVING A STROKE?" and "MAYBE ITS CANCER". (Whatever, he knew what he was getting himself into...). I'm also pretty outdoorsy. I'm a runner and love to hike. I hike year-round, but that doesn't stop me from asking Peter to check me for ticks every time I come home from a hike.

My first run in with a tick was in elementary school, on a class hike. My mom, a nurse, was one of the chaperones, and saw it crawling on the back of my neck. I don't remember it actually biting me, but every time we bring that story up, she gets very serious. She hates bugs.

After a hike with my mom, I had the fun opportunity of getting a tick to back out of her skin by using a hot matchstick. She thought it was a mole on her back that was being irritated by her running bra. Sorry mom. Luckily we caught it and she escaped sans Lyme Disease.

Another awesome tick story: my sister is an amazing athlete, and signed up to do her first triathlon a few years ago. She felt sluggish and terrible a few weeks before, was diagnosed with early Lyme Disease despite not seeing a rash (there are diagnostic tests that are done, too), and started treatment immediately. She still competed in the triathlon and finished with a great time. See what I have to live up to? Ugh.

Tuesday, August 20, 2013

Programmed Cell Death

I know education is a unique experience for everyone, but for me, I LOVE being in school. It keeps me stimulated and challenged, which is something that I think goes away when we start working, sometimes even if you work in a challenging environment. A part of me died a little when I graduated and started working full time. Honestly, it took me a long time to adjust to not having to study, and to all the free time I suddenly had (I can read for fun? Psh! Yeah, okay pal. Whatever you say.).

It effected me so strongly that I've found myself desperately searching for classes to take for free online. We live in an amazing time where education is starting to become more available, and I think everyone should take advantage of it. There are sites like Coursera and EdX, that both have a number of scientific classes (some of which overlap) that are taught by leading professors and professionals from major universities... and it's all FREE.

I'm plugging these websites because I recently published a paper, and when I posted the abstract on facebook for my family and friends to read, if they wished (ok fine, it was to brag, whatever.), I found a number of people actually saying "Wow, cool, but I don't understand it", which, to be terribly honest, really bugged me. I've found that the trend among my peers is to veer away from scientific literature, and instead, read articles that are easier to digest (things on huffington post, reddit, etc.). The truly sad thing about this is that most people just don't believe in themselves enough to try and read these scientific articles. They don't want to put in the effort to look up words that they don't understand, or concepts that are foreign to them.

Sure, I'm a bit hypocritical because I use this blog to make the science of diseases fun and interesting to my peers. But the way I see it, these posts should be the gateway to higher learning. Reading only minor articles that skip over some of the most important facts in a study or paper and ignoring the true publications is like subsiding only on 100-calorie snack bags instead of entire meals.

With that being said, I've really jumped into these sites because I think it's important to keep learning. One of my favorite courses that I've taken so far was Programmed Cell Death taught by Dr. Barbara Conradt at LMU.

In 6 weeks, Dr. Conradt simply explains the pathways involved in apoptosis, which is a process practically all living organisms rely on. Apoptosis is the way our body destroys infected or diseased cells, avoids tumorigenesis (the development of tumors via uncontrolled cell proliferation), and controls tissue and system development. While it's used ubiquitously throughout living systems, my favorite use is in our immune systems. Without apoptosis, our bodies wouldn't be able to stop the proliferation of infectious diseases that take over our immune system. Without apoptosis, some viruses and chronic diseases wouldn't be able to evade our immune system responses. Really, it's quite fascinating.

Towards the end of the course, she posted a link to a video (imbedded below for your viewing pleasure) that summarizes the actions of apoptosis (aka Programmed Cell Death) in a little over 4 minutes. The only words used are labels, and the entire video is a computer animation of the steps our bodies take to destroy diseased cells.

This is what I love about science. You might skip the video (if you do, you are really missing out), or you might watch it, but either way, apoptosis is happening inside of you RIGHT NOW. Sure, studying pathways can be tedious, and is not for everyone, but this video summarizes it beautifully. The soundtrack is perfectly eerie, as well.

My point is, when I see things like this video, I know I'm in the right field. It weirds me out that apoptosis is occuring inside of me while I watch the video explaining it, but it also fascinates me. It makes me want to learn even more. I don't know, maybe I'm crazy.

So, without further rambling, here is "Apoptosis" by The Walter and Eliza Hall Institute of Medical Research.

Side note: I apologize for the absence of my posts lately. I've been completely consumed with work, publishing the paper I mentioned, presenting it at an international conference, and also I'm getting married in 2 months. Please excuse my absence.

Friday, March 1, 2013

Still alive, still kicking, and so are viruses, too.

The last few months for me have been a total whirl-wind, and have caused me to neglect my blog! I feel terrible! I'm sure that, since then, all of my (not so) dedicated readers have turned to bland multi-topic science quick-fixes, like those posted by the "I fucking love science" page on Facebook, or io9, who tried to say that NASA was covering up knowledge of alien existence a few months ago. Laughable! Anyway, we'll just forget I abandoned my blog as I planned out the next few steps in my life. It's not important!

Let's jump right in, shall we?

The hottest topic in virology these days is the sudden reemergence of the age old "are viruses alive?" debate. The basic properties used to describe something as "living" are:
  • Does it have the ability to grow? 
  • Does it have the ability to reproduce? 
  • Can it maintain an internal homeostasis
  • Can it respond to stimuli, and carry out various metabolic processes? 
  • Has it, and can it evolve over time?
 Such criteria make sense when you apply them to things that we've already determined to be alive, but when it comes to viruses, we're still searching for some solid answers. The most common quest to find an answer to whether or not viruses can be classified as living things is to consider the origin of viruses.

There are three theories for the origin of viruses that have been respectfully agreed-upon: (1) the progressive hypothesis, (2) the regressive hypothesis, and (3) the virus-first hypothesis. Let's discuss, shall we?

The progressive hypothesis:
The progressive hypothesis states that mobile genetic elements found the ability to leave one cell and enter another, progressively picking up additions as they traveled, forming infectious agents. The progressive hypothesis is supported by the existence and they behaviors of retrotransposons. Retrotransposons are the essence of the progressive hypothesis, as they are genes that move along the genome with the aid of RNA intermediates. While transitive within a single cell's genome, retrotransposons are currently limited to the confines of that cell. We've seen retrotransposons in many eukaryotic genomes, and attribute them to assisting with evolution.

The progressive hypothesis, which leans so heavily on retrotransposons for support, also has a viral example: retroviruses (which as you know, are some of my favorites). The single stranded RNA genome of a retrovirus utilizes a number of enzymes to fuel reverse transcription and integration into the host's genome. But, while retrotransposons are limited to one cell, retroviruses are able to bud from the host cell and move to another.

The regressive hypothesis:
The regressive hypothesis states that the formation of viruses occurred due to reductive evolution. Regressive evolution is not as common, but is supported. On a singular cell level, the best example of regressive evolution is that of the mitochondria. Mitochondria are organelles in eukaryotic cells that are responsible for the generation of most of the cell's energy. Mitochondria are comprised of multiple layers and membranes, and have their own set of DNA that is handed down through maternal ties. Due to their complex structure and their individual set of DNA, researchers believe that mitochondria were once bacteria that devolved to become an organelle.

The virus-first hypothesis:
The virus-first hypothesis takes a completely different approach to the origin of viruses, as it suggests that viruses originated before other cellular life. This hypothesis is really hard for some people to grasp, since we currently identify viruses by their dependency on a host for continued replication and existence. But what if viruses existed first? The simplistic design of a virus and the high rate of mutations that occur within viral replication are both promising reasons for the virus-first hypothesis.

Why am I talking about this?

A study published in Nature seems to have illustrated an adaptive quality in bacteriophages, wherein they begin to express somewhat of an "immune response" to the host's innate immune response. Researchers have shown that specific short palindromic repeats and associated proteins (CRISPR/Cas, for those who are interested) protect vital regions of the bacteriophage genome when exposed to potential threats, like invading amino acids or other bacteriophages.

Now, this article on Discovery News jumps the gun a little bit in the headline alone. "Viruses Pass Major Test to Enter Ranks of Living"? Now just hold on a gosh darned second.

Well, actually, I think I might let you decide. What do you think? Does this mean viruses are living things? Additionally, how do you think people will react to hearing that viruses may be living?

Or do you even care?

Wednesday, October 31, 2012

Eaten Alive!

-->Since it’s Halloween, let’s discuss the fact that you are being eaten alive, every second of every day.

It’s common knowledge that the average human body consists of more microorganisms than it does human cells, but no one ever talks about the symbiotic relationship that we’ve developed with each species that inhabits our tissues. Surely, when you think about bacteria and other microbes living on (or in!) you, your first thought is the microbes that live in your guts. But, this symbiotic relationship we’ve developed with other microbes extends much farther than your digestive tract. In fact, your human microbiome covers your entire body, from your skin to your inner digestive tract, in your mouth, on your scalp, everywhere!

Here’s a list of some of the most common human-inhabiting microbes that live amongst your tissues, day in and day out.

1. Demodex folliculorum

Demodex folliculorum is a type of parasitic mite that lives ON YOUR FACE. As we know with other species, mites love to have something on which to cling, so Demodex folliculorum will most likely be found around the hair follicles on your face. If you are thinking “but I wax my entire face!”, here’s a list of where Demodex folliculorum love to live:
  • nose hair
  • eyebrowns
  • eyelashes
  • the tiny hair that covers your entire face, but is most commonly on your cheeks and forehead (which my mom used to lovingly call “peach fuzz”).
Demodex folliculorum also like to live in your pores. They can be found on other parts of your body, too, but the face region is the most common. Now, don’t hurry to the nearest sink to wash your face. Demodex folliculorum are mostly harmless, and is classified as commensal, which means they benefit from consuming your dead skin and sebaceous gland tissue cells. Since Demodex folliculorum infestation is relatively common, they are considered a part of your normal skin fauna.

In the last 10 years or so, dermatologists have theorized that a heavy infestation of Demodex folliculorum may be the cause of rosacea in later years in life. 

2. Spirochaetes spp.
I can’t tell you how many times I’ve heard someone say “…but a dog’s mouth is supposedly really clean!” as a dog licks their face. First off, did you know that dogs consider cat feces a delicacy? Secondly, I’d love to believe that dogs have some secret antimicrobial property that allows them to cure all ailments, but let’s be realistic. We know that magical property only exists in unicorns.

Mouths are pretty disgusting places, regardless of what species you are. For humans with periodontal diseases (such as gingivitis or other oral inflammatory infections), Spirochaetes spp. are levels are elevated. 

The Spirochaetes spp. belong to a bacterial phylum that have double membranes (diderm). They are most commonly long coils, and live in those hard-to-reach areas of your mouth. To reproduce, they undergo asexual transverse binary fission, producing two identical cells.

If you have good oral hygiene practices, then you should have nothing to worry about with Spirochaetes spp. They will be found in your mouth no matter what. The only time Spirochaetes spp. can become a problem is if you have periodontal diseases, which can lead to an active infection.

3. Candida albicans
Candida albicans is a common species of yeast that lives in and on your body. You depend on Candida albicans for digestion, as it exists as a part of our normal gut flora.  Yet, sometimes overgrowth can occur, causing candidiasis. 

Candidiasis can rear its ugly head in many anatomical locations. We most commonly hear about yeast infections affecting the female reproductive system, but yeast can inhabit your body in many different areas. 

Yeasts like to live in warm moist areas, so oral tissues are another common location to see a yeast infection. Extreme cases can cause thrush on the tongue. Candidaisis can also occur in your ocular tissues (eyes), and occasionally on the skin. 

I'm keeping this post short because it's my favorite day of the whole year. Halloween is a great time for scientists because we get to put our creative nature into costumes!  If this post wasn't scary enough for you, feel free to check out my post from last Halloween

Happy Halloween!

Sunday, June 17, 2012


I worked as a health educator on a college campus for a few years, and the stories some students told me about their experiences with sex ed in high school were classic. Sadly, about 1/3 of the students I encountered had never had proper sex education; either their parents opt-ed out of having their children be a part of such classes, or their educational institution failed to offer such crucial lessons. What I'm saying is 1/3 of the incoming freshman I taught had no knowledge of basic sex 101, no knowledge of their bodies, and no knowledge of the sex-crazed world they were about to be thrust into (was that pun intended?). I don't know about you, but this makes me scared and sad. But it also made me love my job (my boss, however, was an entirely different story). 

I was raised in the public school environment, and I am proud to say that I experienced too much sex education. No, I don't mean that in a sleazy way. The first time I remember being mandatorily immersed in proper school-run sex education was in the 4th grade. Being from a genetically-strong Italian family, you'd think I would be close to "blossoming into a woman" (barf.), like the other awkwardly prepubescent girls in my class, but that was a gene that was not active in my little bean-pole of a body. I was built like the boys in my class, and I had no intention of that ever changing. But, despite my ignorance to "the change" which would later ruin my teen years and cause me to discover feminism, I found myself learning anyway. To this day, one particular story continues to haunt me. 

It was an overcast day on the playground of this California public elementary school ground. My class was outside, proudly displaying our homemade solar ovens, and anxiously waiting for the magic of science to cook the little nuggets of hot dogs that were rationed out between groups. My teammate and I constructed our solar oven out of cheap construction paper that seeped green ink into the hot dogs that sat idly in our little oven (elementary school teachers of the world: HOW IS THIS SANITARY?! Answer: it's not). One of the boys in my class dared me to eat one of the green hot dogs, and even though i had given up meat years before on my own will, I succumbed anyway, because I was not, and would never be afraid of science. Upon eating the green nugget of slimy meat, our teacher blew a whistle and instructed the boys to play while the girls came into the classroom to watch a movie. "Was it a Disney movie? were we being rewarded? Those boys are so smelly," we all giggled, because that was before girls knew how to be catty and mean. 

To our horror, we discovered that it was not a Disney movie and we were actually being punished. While the boys ran around on the playground and farted on each other, we were being forced to watch short films with such titles as "Your first period" and "Accepting Change: A Puberty Story" (I made those up). I sat in the back of the class, and began to feel my palms get sweaty as I heard the glorious benefits of using pads. But then, things turned bad. 

I was going to barf. 
Was I going to barf because I was scared of puberty? 
I'm going to barf. 
Was I going to make it to the bathroom in time?
Am I going to barf?

My first act of defiance against an authority figure was running out the door as my teacher yelled that I could not be excused. I ran to the first garbage can I saw, and promptly threw up. When I was finished spewing my guts out, I realized that all of the boys from my class had stopped running to watch me. One boy yelled "She's puking 'cause they are watching movies about people doing it!" and everyone laughed. I had no idea what "doing it" meant, but I didn't care because I was going to be excused for the rest of the day to lay around and watch Aladdin, so clearly, I had won.

In fifth grade, after we were segregated by gender and taught about using tampons and having crushes, the boys all asked if I puked again. 

I would like to take this moment to say that, thanks to Facebook, I now know that I am one of the few remaining people from my middle school and high school classes that does not have kids. That's the benefit of throwing up in front of boys at a young age: no one wants to knock you up.

Anyway, why am I telling you this incredibly awkward tale from my childhood? Well, not only has congress been sprinting to restrict access to care for females in the United States, but one particular STI has been all over the news lately. 

Gonorrhea, caused by gram-negative bacteria Neisseria gonorrhoeae, is here to stay, and it's not taking no for an answer. N. gonorrhoeae are motile bacteria which use type IV pili, which work to retract to pull the attached substrate towards the organism (kinda like the "hookshot" that Link uses to reach distant ledges in Legend of Zelda games). Additionally, some strains of N. gonorrhoeae extracellularly express Opa proteins, which can competitively bind to certain immune response receptors and down regulate the development of an adaptive immune response.

People who recognize the hookshot reference have probably spent more time playing Zelda than actually having sex. This may possibly be another reason why I didn't get knocked up during college.

Incidence of drug-resistant infections of gonorrhea have risen (as have drug-resistant infections of everything lately), and apparently the American public is SHOCKED. This particular article states that "the [World Health Organization] blames the misuse of antimicrobial medicines like antibiotics, antivirals, and antimalarials for the formation of new types of bacteria, viruses, and parasites that resist current treatments", and while I know that's part of the case, I am also convinced that this particular issue of drug-resistant gonorrhea, especially in the United States, could have been prevented with adequate education. 

Not only is gonorrhea one of the most prevalent bacterial STIs in the United States (309,314 cases in 2010, which is actually down 16% from 2006), second only too Chlamydia (1.3 million cases in 2010, which has risen 24% since 2006), its also incredibly easy to prevent with safer sex techniques. When I say safer sex techniques, I'm not only referring to the use of a barrier method (condoms, dental dams, gloves, etc.), but to getting tested (and treated, if necessary) regularly and talking openly with your partners about sexual history and test results. If more people got tested regularly, the appropriate treatments would be administered at earlier stages of the infection, making it easier to treat, and the probability of transmission would drop dramatically. If more people were honest with their partners about getting tested, the number of cases each year would also decrease dramatically. But, that's too difficult.

A public health attempt at reducing gonorrhea infection rates during WW2. Doesn't she look like Carmen Sandiego?
Here's another link that's not usually made: since cases of undetected and untreated gonorrhea and chlamydia are rampant, its no surprise that a lot of couples are finding it hard to become pregnant. Thanks to the lack of education at early ages, a lot of people think gonorrhea is "no big deal", but it can cause infertility if an infection is left untreated. 

The tricky fact of gonorrhea is that an infection can be present without showing the tell-tale symptoms of burning during urination, vaginal discharge, fever, having a "cold" that never seems to go away, or a sore throat. Females, due to our internal organs, have the special ability to present symptoms internally, which makes them harder to detect (especially if you are afraid to look at your own vagina). 

So, if some infections don't show any symptoms, why is this a problem if some strains of gonorrhea are now drug-resistant? There are a few answers to this question:

1. People will continue to spread it, and those few individuals who are responsible enough to get tested and treated regularly will have a harder time finding effective treatment options. This is especially sad since current gonorrhea incidence rates have been reported at historically low levels.

2. Treatment regimens will start to become pretty intense, and much more costly. The days of gonorrhea being considered treatable with a regular antibiotic are coming to an end, and some health care providers may start to consider antibiotic cocktails, which are not only annoying but also costly. 

3. Symptoms that are rarely seen, with the exception of severe infections that are left untreated, will start to become more common. Infertility is one, caused by salpingitis (scarring of the fallopian tubes) and Pelvic Inflammatory Disease (PID). Other symptoms can include spreading of the infection to the joints and heart valves, as well as meningitis. 

4. If pregnancy does occur in infected women, it can be passed to the baby during birth, which will raise the rates of infections in younger populations. 

Now, before I end this incredibly lengthy post, I'd also like to bring your attention to the fact that THE PLAGUE IS BACK!

Oh shit, wrong sign. (Credit Denver Westword Blogs)
I have to admit, I'm pretty excited about this since I'm heading to Oregon this weekend. Who knows, maybe I'll get lucky (with the plague, that is)!

Let it be known that 100% of the credit for the title of this blog post goes to my partner, who is actually funnier than I am. 

Sunday, May 20, 2012

The Interlude Continues

Boy howdy, if I haven't received loads of encouragement! As I stated in my last entry, I've had to take some time away from writing blog entries so I could wrap up a few major projects. Since that post, I've received tons of emails wishing me luck, and others saying "I hope you will return to writing when you finish!" So, a gigantic thank you to everyone who wished me well in my time away from Under the Microscope.

Yet, my time apart is not completely over. I'm currently in San Diego for a collaborative work project with The J. Craig Venture Institute, and when I return to the Bay Area, I will be quickly hopping on a plan for a few weeks for a much needed vacation. I will try to write in the meantime, but promises are always futile.


I drove to San Diego instead of flying, partially because I wanted to bring my bike with me, and partially because I wanted some time alone to think. I spent a lot of time listening to old podcasts from Radiolab, which got me thinking about future blog posts. Trying to decide what to write about next is troubling for me, believe it or not. Writing is not a natural habit for your truly, unless its in a lab notebook. I can remember all of my major writing accomplishments throughout my personal history, as they were few and far between. In the seventh grade, I chose to write my literary research paper on the bubonic plague, narrated by the only unaffected living thing in the town: a tree. Oh, twelve-year-old me, you were so dark, so profound! I had clearly been listening to too many records by The Cure. The next was my Advanced English research paper that I chose to do on Bram Stoker, and other historical works which focused on vampires. If I would have known, at age sixteen that Twilight would be a thing in future times, well, I would have been a rich little idiot.

Anyway, I struggle with deciding on future topics for Under the Microscope. There are too many species, too many diseases, too many, too many, too many! But listening to one old Radiolab podcast in particular reminded me of why I write. I highly suggest you dedicate an hour to listening to this show, titled Parasites, from 2009.

Carl Zimmer has always been a role model of mine (ok, I'll admit it, I have a crush), as he often takes the side of the parasite. Not only is this rare, but it's exactly the standpoint that I've always taken. Think about it: humans are, without a doubt, the most advanced life form of which we know, yet we can easily be challenged and occasionally defeated by "lesser" life forms. Parasites, some of which are even single celled organisms, bacteria, and viruses, which aren't even considered to be "alive"! Sure, we've evolved and developed habits and methods to limit our exposure and risk of such encounters, but they don't always work.

This show about parasites always makes me laugh when I listen to it because people always ask me if I've ever heard of Jasper Lawrence, or "that guy that sells worms". I never really know how to react, because I do applaud Mr. Lawrence for taking his medical care into his own hands (or should I say gut?) and I am totally happy that shows like Radiolab have made that sort of science accessible to everyone... but starting your own business off of it is a little sketchy. Mr. Lawrence keeps a blog associated with his business, wherein he describes his family life and his allergies. There is one entry where he discusses the risks associated with obtaining hookworms in the wild (ie, naturally), but it's basically just a review of wikipedia pages.

So, maybe I should talk about hookworms? I've written previous entries on tapeworms and other types of parasitic nematodes, but I can't recall an entry that specifically focused on hookworms.

Ascariasis and infections by Ancylostoma duodenale and Necator americanus are pretty harmless, and while uncommon in the United States, it is highly prevalent in other regions of the world. You often find prevalent hookworms in areas where modern plumbing is unavailable, and human feces is used in fertilizers. Poop everywhere!

The filariform larvae of A. duodenale and N. americanus cause infection by burrowing into the skin, typically around the feet or ankles when exposed in shallow waters or muddy areas where infected feces is present. In instances where feces is used for fertilizer, Ascaris eggs can be ingested with fruits and vegetables that are not thoroughly washed.

Once in the body, the adults attach to the lining of the small intestine and feed on blood and protein sources. There are very few symptoms associated with a hookworm infection, and many people are unaware of infections that they've had for years! If an infection is particularly heavy, the individual can experience anemia and protein deficiency.

What's amazing about these creatures is that they've phenotypically adapted to their ideal environments. They may be blind and deaf, but there are many different types of hooks and "teeth" that allow them to anchor themselves to one tissue surface for years. I've always imagined the following nerd references when studying hookworms and tapeworms, but what can I say, I'm totally unprofessional.

Credit: Dan Meth

In the real world (sighhhhh), hookworm "mouths" usually have one row of teeth, like this:

This photo is entirely not scary if you imagine it's singing opera.

I should say that I've always approved of the Hygiene Hypothesis, as I was raised in an area where many people suffer from seasonal allergies, and I do not! Maybe I'm just biologicaly supreme, or maybe it's because I did have my own run-ins with a few parasites at young ages. Either way, this theory is commonly centered around the ability of your system to produce a specific types of antibodies (IgE) that are associated with allergic reactions and helminth diseases (parasitic worms).

While that is all I have time for today, I want to end by saying, once again, that I will update as much as possible. Also, I'd like to send out magical vibes to Carl Zimmer, in hopes that he might agree to have lunch or dinner (or tea!) with me when he is in San Francisco in October. Maybe?