tag:blogger.com,1999:blog-48472834252879859162024-03-14T00:21:23.799-07:00Under the Microscopeunderthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.comBlogger62125tag:blogger.com,1999:blog-4847283425287985916.post-60369926605259495082018-06-30T12:52:00.002-07:002018-06-30T12:56:30.572-07:00Herpes and the BrainAs with everything else, there are trends in scientific research. Concepts like sustainability blossomed with climate change, and studies of the human microbiome exploded a decade ago.<br />
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The same can be said about disease research, driven by the number of diseases, both noncommunicable and infectious, that are currently lacking effective treatments options. It is easy to see "finding a cure" as the main goal of disease research, but that future-focused vision excludes individuals suffering in the present. A common trend in disease research now is long-term effects of disease, as in, what will happen when we are exposed to such pathogens or experience a disease for an extended period of time? Additionally, how do one-off infections change our health down the road, after the symptoms have come and gone?<br />
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<tr><td style="text-align: center;"><a href="https://4.bp.blogspot.com/-Pj8MaooPwZQ/WzfNBpO56hI/AAAAAAAABOc/ohuK2uwlbyoQeaLn_PAQQwXn9GTomqeVwCLcBGAs/s1600/brain-healthy-brain-ad-best.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="450" data-original-width="600" height="240" src="https://4.bp.blogspot.com/-Pj8MaooPwZQ/WzfNBpO56hI/AAAAAAAABOc/ohuK2uwlbyoQeaLn_PAQQwXn9GTomqeVwCLcBGAs/s320/brain-healthy-brain-ad-best.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image borrowed from <a href="https://alzheimersdiseasebiol2095.wordpress.com/">https://alzheimersdiseasebiol2095.wordpress.com/</a></td></tr>
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It is especially interesting when pathogens overlap or influence noncommunicable diseases, as seen with HPV and cancer, just to name one example. Recently, <a href="https://www.cell.com/neuron/fulltext/S0896-6273(18)30421-5" target="_blank">a relationship between specific Human Herpes Virus (HHV) strains (6A and 7) and Alzheimer's disease was "accidentally" discovered by researchers at Mt. Sinai's Icahn School of Medicine</a>. Twice as much HHV was detected in brain tissue from individuals with Alzheimer's compared to brain tissue of those without Alzheimer's.<br />
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Although a direct link isn't clear, this is still an interesting finding. Yet, not a surprising one...<br />
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HHV-6 is a neurotropic virus, meaning it can invade nervous system. There are many viruses that are neurotropic, so it would be interesting to see if any of the others, like Japanese encephalitis virus, polio, and rabies (just to name a few) have similar influence on chronic disease down the road.<br />
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<tr><td style="text-align: center;"><a href="https://4.bp.blogspot.com/-5hQhN4DFjKc/WzfNMgkfgMI/AAAAAAAABOg/sAp5ozbFBLk-HO0kd5X9zZvYkWQ0QcltgCLcBGAs/s1600/ds00452_im03111_ans7_roseolathu_jpg.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="370" data-original-width="468" height="252" src="https://4.bp.blogspot.com/-5hQhN4DFjKc/WzfNMgkfgMI/AAAAAAAABOg/sAp5ozbFBLk-HO0kd5X9zZvYkWQ0QcltgCLcBGAs/s320/ds00452_im03111_ans7_roseolathu_jpg.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image from <a href="http://www.mayoclinic.org/" target="_blank">Mayo Clinic Foundation for Medical Education and Research</a></td></tr>
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HHV-6 is often acquired at a young age, producing a non-specific febrile illness and a rash, called "roseola". HHV-6 is spread through saliva droplets, similar to how a cold or flu are spread, so it is easy to imagine how so many young children acquire the infection. For many, the symptoms can look a lot like a seasonal flu infection with a rash, but it can<span class="st"> also cause febrile seizures, encephalitis or intractable seizures.</span> Many also suspect symptoms of chronic fatigue and extreme malaise. <br />
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The interesting thing about many herpes viruses is that after the initial infection, which may or may not cause symptoms, the virus experiences a period of latency, where it hides in a specific type of cell, before reactivation later in life. The type of cell that supports latency of the virus depends on the type of herpes virus, as they all have their own favorite. Some prefer nervous system cells, whereas others prefer cells of the immune system. According to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3809354/" target="_blank">Bjørn Grinde</a>, HHV-6 prefers leukocytes, which play a large roll in inflammatory pathways and immune system function. Leukocytes can be trafficked across the blood brain barrier and into the central nervous system, which may be the way latent HHV-6A found its way into the brains of the Alzheimer's disease study at Mt. Sinai.<br />
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HHV-7 is also considered a roseola virus and causes similar symptoms in infants. HHV-7 prefers T-cells for latency (also according to Bjørn Grinde's paper... I am not a herpes researcher!), which are also critical cells for immune response. Similarly to HHV-6A, T-cells can cross the blood brain barrier, which may expose the central nervous system to latent HHV-7 virus.<br />
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Regardless of the molecular methods used, these viruses may contribute to the activation or progression of Alzheimer's disease. Pretty interesting!<br />
<br />underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com7tag:blogger.com,1999:blog-4847283425287985916.post-5386353219192084132017-12-21T17:05:00.001-08:002017-12-21T17:05:42.351-08:00'Tis the season to see everything destroyedHappy Winter Solstice! Wait, can I say that? Do we get to enjoy it?<br />
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Honestly, I can't. I am having a hard time enjoying anything anymore, because I'm watching everything around us quickly crumble and decay. This year brought a lot of destruction that may not have been able to be prevented (see: massive hurricanes, earthquakes, wild fires, volcano eruptions), but could have been tempered with the simple belief in climate change. The scientific community's throats are sore from yelling "PLEASE BELIEVE US", and our eyes our tired from writing grant after grant after grant begging for adequate funding to find ways to minimize the destruction and better our outcomes.<br />
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In this season of light, everything is dark. There is no hope left for the new year, because we are being told to shut our mouths and follow the rules set by people who don't have the proper training, expertise, or even a hint of interest in anything but themselves.<br />
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Let's talk about the utter travesties for the sake of watching the avalanche unfold one more time:<br />
<ul>
<li>From the day of his inauguration, He Who Shall Not Be Named began stripping credibility from the scientific community within the US. The climate change section of the white house website was removed entirely, not to show change, but to show complete erasure of progress. The "leaders" of this country fail to see that the health and wellness of your environment is the new space race, the new cold war. Everyone is racing to undo the damage of decades of ignorance, yet here we are, stuck at the starting line because we can't even agree on a common goal.</li>
</ul>
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<tr><td style="text-align: center;"><a href="http://www.slate.com/content/dam/slate/articles/health_and_science/science/2016/10/blaming_natural_disasters_on_climate_change_will_backfire/499920398-an-indian-man-carries-gas-canisters-through-floodwaters.jpg.CROP.promo-xlarge2.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://www.slate.com/content/dam/slate/articles/health_and_science/science/2016/10/blaming_natural_disasters_on_climate_change_will_backfire/499920398-an-indian-man-carries-gas-canisters-through-floodwaters.jpg.CROP.promo-xlarge2.jpg" data-original-height="571" data-original-width="800" height="285" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image from <a href="http://www.slate.com/articles/health_and_science/science/2016/10/blaming_natural_disasters_on_climate_change_will_backfire.html">Slate.com</a></td></tr>
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<ul>
<li>Quickly after, in January, <a href="https://www.scientificamerican.com/article/trump-signs-orders-advancing-keystone-dakota-pipelines/" target="_blank">the Keystone XL and Dakota Access pipelines were approved</a> to proceed, out of chosen blindness to the fact that the systems would fail. Approving these pipelines sent a message, saying "Have faith, it will work". By November, <a href="http://www.cnn.com/2017/11/16/us/keystone-pipeline-leak/index.html" target="_blank">the keystone pipeline leaked 210,000 gallons of oil into South Dakota</a>. The message wasn't rewritten, and the spill wasn't even acknowledged by our blind leaders. </li>
</ul>
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<tr><td style="text-align: center;"><a href="https://www.usnews.com/dims4/USNEWS/d254ab9/2147483647/resize/1200x%3E/quality/85/?url=http%3A%2F%2Fmedia.beam.usnews.com%2Fa6%2Fa0%2F308573cb4328be92712ee0a83555%2F93203017-10.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="511" data-original-width="800" height="255" src="https://www.usnews.com/dims4/USNEWS/d254ab9/2147483647/resize/1200x%3E/quality/85/?url=http%3A%2F%2Fmedia.beam.usnews.com%2Fa6%2Fa0%2F308573cb4328be92712ee0a83555%2F93203017-10.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image of Keystone pipeline spill via <a href="https://www.usnews.com/news/articles/2016-04-08/keystone-pipeline-leak-worse-than-thought">USNEWS</a></td></tr>
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<ul>
<li>We knew republicans were gunning to repeal Obamacare (aka the ACA), but we didn't see the complete disregard with which they would write their replacement bill. The worst riot of the passing of the ACA was that the healthy and wealthy were nervous about having to "wait in line" as the rest of us were magically insured. That was nothing. <a href="http://time.com/4956397/graham-cassidy-republican-health-care-protests/" target="_blank">This year we saw people fighting for their basic needs to be met, people being violently removed from their wheelchairs, and chronically ill individuals begging for the dignity of being acknowledged</a>. You know that sexist, old fashioned saying, "happy wife, happy life"? The 2017 version should be "healthy citizens, healthy nation", and can only be said with a similar amount of irony.</li>
</ul>
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<tr><td style="text-align: center;"><a href="https://www.denverpost.com/wp-content/uploads/2017/06/gardner_protest_008.jpg?w=620" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="413" data-original-width="620" height="266" src="https://www.denverpost.com/wp-content/uploads/2017/06/gardner_protest_008.jpg?w=620" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Arrested protesters via the <a href="https://www.denverpost.com/2017/06/30/disabled-protesters-cory-gardner-sit-in/">Denver Post</a></td></tr>
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<ul>
<li>Access to reproductive health care was a constant battle this year, as many of the female-forward initiatives tied into Obamacare would have been threatened with the repeal. On top of that, immigration and reproductive rights overlapped with <a href="https://www.aclu.org/news/after-month-obstruction-trump-administration-jane-doe-gets-her-abortion" target="_blank">cases of state and federal attempts to deny patients access to their choice of care</a>. Brigitte Amiri of the ACLU commented “With this case we have seen the astounding lengths this
administration will go to block women from abortion care. We will not
stop fighting until we have justice for every woman like Jane.” Unfortunately, history always tells us that this issue in particular will be a never-ending battle, especially with <a href="https://www.nytimes.com/2017/07/14/opinion/donald-trump-women-reproductive-rights.html" target="_blank">disrespectful trash leading the way</a>. </li>
</ul>
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<tr><td style="text-align: center;"><img border="0" data-original-height="571" data-original-width="800" height="228" src="https://i.pinimg.com/originals/18/fb/61/18fb61a61a04fe77bce0dded9e9a1d2b.jpg" style="margin-left: auto; margin-right: auto;" width="320" /></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="color: #0000ee;">Planned Parenthood representation at the Women's March 2017, <a href="http://www.hercampus.com/school/kenyon/womens-march-washington-my-10-favorite-moments-will-fill-you-hope">via HerCampus</a><br /><u></u></span></td></tr>
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<ul>
<li>US citizens that inhabit Puerto Rico were simply told <a href="https://www.nytimes.com/2017/10/12/us/politics/trump-warns-puerto-rico-weeks-after-storms-federal-help-cannot-stay-forever.html" target="_blank">to help themselves</a> after being hit by <a href="https://www.scientificamerican.com/report/the-monster-hurricanes-of-2017/" target="_blank">two unbelievably massive hurricanes, one right after the other</a>. This response, after the outpouring of love for Houston, which was also hit extremely hard, was the white house's way of saying "you're brown, so you don't count". Let's do ourselves a favor and NEVER LET THAT SENTIMENT BE SAID OR IMPLIED EVER AGAIN.</li>
</ul>
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<tr><td style="text-align: center;"><a href="http://a.abcnews.com/images/US/puerto-2-ap-er-170926_12x5_992.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://a.abcnews.com/images/US/puerto-2-ap-er-170926_12x5_992.jpg" data-original-height="334" data-original-width="800" height="166" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Damage in Puerto Rico via <a href="http://abcnews.go.com/US/san-juan-mayor-people-gasping-air-maria-cripples/story?id=50106214">ABC News</a></td></tr>
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<ul>
<li>Science funding was a ridiculous mess, with He Who Shall Not Be Named and Congress not agreeing, and <a href="http://www.sciencemag.org/news/2017/05/how-science-fares-us-budget-deal" target="_blank">the outcome being...kind of all over the place</a>. The biggest laugh comes from He Who Shall Not Be Named trying to cut NASA's funding, and then stating later that immediate future initiatives will be <a href="https://www.nytimes.com/2017/12/11/science/trump-moon-space-directive.html" target="_blank">to go back to the moon</a>, instead of previous calls for Mars in 2020.</li>
</ul>
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<tr><td style="text-align: center;"><a href="https://2.bp.blogspot.com/-zqsy4zNiIEY/WjxYI3dqY3I/AAAAAAAABJk/Q8IwHFlup5Abc2JZpj_GdBOlOWanlt2WgCLcBGAs/s1600/trumpeclipse.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="298" data-original-width="530" height="179" src="https://2.bp.blogspot.com/-zqsy4zNiIEY/WjxYI3dqY3I/AAAAAAAABJk/Q8IwHFlup5Abc2JZpj_GdBOlOWanlt2WgCLcBGAs/s320/trumpeclipse.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">An idiot looks directly at the solar eclipse that happened earlier this year.</td></tr>
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<ul>
<li>Oh wait, there was a response to the Keystone XL pipeline spill: <a href="https://www.nytimes.com/2017/11/07/climate/syria-joins-paris-agreement.html" target="_blank">The US is now the only nation to oppose the Paris Climate Accord</a>. Please, continue to embarrass us. </li>
</ul>
<ul>
<li>Also in November, we are allowed to give thanks to those who stole the land that this country was built on by celebrating the proposal of national monument land reduction -- the largest in US history. Nothing is sacred, everything will be doused in oil and profits. The future of our national parks includes drilling and mining.</li>
</ul>
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<tr><td style="text-align: center;"><a href="https://snowbrains.com/wp-content/uploads/2017/12/24296606_10159854711605457_5361958554974318602_n.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="800" data-original-width="800" height="320" src="https://snowbrains.com/wp-content/uploads/2017/12/24296606_10159854711605457_5361958554974318602_n.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><a href="http://www.patagonia.com/home/">Patagonia</a>'s web-protest over the land reduction</td></tr>
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<ul>
<li>Also in November, we were shown another side of the completely horrifying terror that's running the country, as He Who Shall Not Be Named <a href="https://www.nytimes.com/2017/11/20/us/politics/trump-elephants-trophy-hunting.html" target="_blank">threatened to lift the ban on the importation of trophy hunted elephants and ivory</a>, but <a href="https://www.washingtonpost.com/news/animalia/wp/2017/11/15/trophies-from-elephant-hunts-in-zimbabwe-were-banned-in-the-u-s-trump-just-reversed-that/?utm_term=.717e3dd82515" target="_blank">then decided to not change anything</a>...for now. </li>
</ul>
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<tr><td style="text-align: center;"><a href="http://beta.latimes.com/resizer/zZr8VYQO6eTBGETMKejzXiBm2t0=/1400x0/arc-anglerfish-arc2-prod-tronc.s3.amazonaws.com/public/NE342XA5MNEZJBZNHWCYGDPSWM.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://beta.latimes.com/resizer/zZr8VYQO6eTBGETMKejzXiBm2t0=/1400x0/arc-anglerfish-arc2-prod-tronc.s3.amazonaws.com/public/NE342XA5MNEZJBZNHWCYGDPSWM.jpg" data-original-height="450" data-original-width="800" height="225" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Kenya Wildlife Services ranger guards illegal ivory, via <a href="http://beta.latimes.com/world/africa/la-fg-south-africa-elephants-ivory-ban-20161230-story.html">LA Times</a></td></tr>
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<ul>
<li>The latest GOP tax cuts, passed in December, initially threatened to tax graduate student tuition fees that are waived as a part of their programs agreements, but didn't end up in the final, passed version. That's not to say most students seeking higher education wont have a harder time accessing and paying for it. </li>
</ul>
<ul>
<li>As far as public health is concerned, how can we lead preventative efforts if we may not be able to say certain words? A flood of news stories claimed that the CDC had a list of banned words that they are not allowed to use, which includes "fetus", "vulnerable", "diversity", "entitlement", "transgender", "evidence-based", and "science-based". <a href="https://www.npr.org/sections/thetwo-way/2017/12/20/572242449/as-cdc-denies-banning-words-hrc-projects-disputed-terms-on-trumps-d-c-hotel" target="_blank">That claim has since been denied</a>, but we'll see how things change. </li>
</ul>
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<tr><td style="text-align: center;"><img border="0" data-original-height="420" data-original-width="800" height="210" src="https://assets2.hrc.org/files/images/blog/WeWillNotBeErased-HRCProjection-TrumpHotel-1200x630.jpg" style="margin-left: auto; margin-right: auto;" width="400" /></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="color: #0000ee;">Protest of banned words via the <a href="https://www.hrc.org/blog/hrc-projects-cdcs-banned-words-onto-trump-hotel-in-washington">Human Rights Campaign</a></span></td></tr>
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<ul>
</ul>
I'm clearly skipping over a lot of stuff just to highlight the science-heavy hits of this year. We can also tie a nice bow on this list with <a href="http://www.who.int/csr/don/archive/year/2017/en/" target="_blank">all the outbreaks that occurred this year</a>. You'll notice many of the diseases on that list are vector-borne diseases, the spread of which has been proven repeatedly to be influenced by changes in climate.<br />
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With each passing day, the situation worsens. I can link Betsy DeVos to the destruction of scientific and technological advancements in the future because STEM education will wither under her care. Challenges with our changing climate will continue to worsen, because we are not training the minds of the future to think creatively about how to tackle such problems -- or even that such problems exist, as many science textbooks don't include sections realistically representing climate change.<br />
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Everything feels like its crumbling right now, and I already feel like I know what's coming in the new year.<br />
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Happy holidays, whatever you believe in or celebrate or do this time of year.<br />
Find some hope for science somewhere, please.<br />
<br />underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com7tag:blogger.com,1999:blog-4847283425287985916.post-54287194901778726892017-11-11T14:51:00.001-08:002017-11-11T14:55:39.578-08:00Cats, Bats, and Rats: Harbingers of Diseases of DisparityOn Monday, I attended a symposium, titled "One Health: Interface of Human Health/Animal Diseases", at the American Society for Tropical Medicine and Hygiene (ASTMH) annual meeting (aka #TropMed17). This was one of many sessions I attended, but one of the few that really stood out to me.<br />
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I love the concept of One Health, which emphasizes the interwoven nature of the environment, animals, and humans, where a change to one aspect of the world will affect the other surrounding environments and populations. This is a vital concept when it comes to global health, as we often focus on human disparities without working to improve the person's environment for sustainable health and change. As you can imagine, One Health is a critical component when describing the lifecycles of zoonotic diseases, which infect both animals and humans. I wrote a magazine article for The Biochemist about the impacts of One Health on disease emergence. You can find that <a href="http://www.biochemistry.org/393/index.html" target="_blank">here</a> (e-zine) or <a href="http://www.biochemistry.org/Portals/0/Biochemist/June%202017%20Biochemist-FINAL_correction.pdf" target="_blank">here</a> (PDF), for free.<br />
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Within the One Health symposium, each speaker outlined an important animal exposure for each infection, whether parasitic, viral, or bacterial. For example, the first speaker discussed an outbreak of hantavirus in Peru during the creation of a <a href="https://www.aracari.com/interoceanic-highway-peru-rainforest/" target="_blank">new interoceanic highway</a> that runs across Peru and Brazil. Deforestation and construction created a new opportunity for exposure to hantavirus for construction workers and residents in the area. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4979164/" target="_blank">Here's some more info on that</a>, if you are interested.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://www.researchgate.net/profile/Christoph_Zoeckler/publication/235953145/figure/fig1/AS:299835656818690@1448497799551/Figure-1-Short-tailed-bats-emerging-from-the-Shwedagon-Pagoda-in-Yangon-Myanmar.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="522" data-original-width="696" height="240" src="https://www.researchgate.net/profile/Christoph_Zoeckler/publication/235953145/figure/fig1/AS:299835656818690@1448497799551/Figure-1-Short-tailed-bats-emerging-from-the-Shwedagon-Pagoda-in-Yangon-Myanmar.png" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image of bats emerging from the Swedagon Pagoda in Myanmar, borrowed from <a href="https://www.researchgate.net/publication/235953145_Mass_exodus_of_bats_and_dragonflies_the_measurement_and_conservation_of_biodiversity" target="_blank">an article on Biodiversity via ResearchGate</a></td></tr>
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Another speaker spoke about emerging pathogens in Myanmar due to exposure to bats through the use of caves for economic (mostly the creation of tours for tourists) or religions purposes (think shrines in caves). Myanmar apparently has 22% of world's species of bats, meaning it has a diverse population of bats, and they are everywhere.<br />
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The two talks that I really enjoyed covered parasitic infections that are a global issue affecting primarily low income populations, even those in the United States.<br />
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<tr><td style="text-align: center;"><a href="https://media.newyorker.com/photos/593e9bb1dd7c6e19ee4b1600/master/w_1298,c_limit/Greenberg-Rat-Lungworm-Tropical-Parasite-Hawaii.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="414" data-original-width="800" height="165" src="https://media.newyorker.com/photos/593e9bb1dd7c6e19ee4b1600/master/w_1298,c_limit/Greenberg-Rat-Lungworm-Tropical-Parasite-Hawaii.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Beautiful illustration borrowed from <a href="https://www.newyorker.com/tech/elements/rat-lungworm-the-tropical-parasite-that-took-hawaii-by-surprise" target="_blank">The New Yorker</a></td></tr>
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<i>Angiostrongylus cantonensis, </i>or "rat lungworm",<i> </i>is a parasitic nematode that is found throughout Southeast Asia and the Pacific basin. Rat lungworm causes eosinophilic meningitis in humans. Humans are exposed to <i>A. cantonensis</i> through ingestion of infested foods, like undercooked or seafood, fish, frogs, vegetables, or snails.<br />
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<tr><td class="tr-caption" style="text-align: center;">An apple snail, image borrowed from <a href="https://lflank.wordpress.com/2017/03/30/floridas-invaders-the-apple-snail/" target="_blank">Hidden History</a></td></tr>
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Apple snails act as a reservoir for <i>A. cantonensis</i> throughout Southeast Asia. Upon investigation, the larval stage of the nematode can be found invading the lungs of the snail. Adult <i>A. cantonensis</i> live in the pulmonary arteries of rats, and larvae migrate to the pharynx, where they are swallowed by the rat and dispelled in the rat's feces. The larvae are then ingested by the apple snail, or other specific mollusk species.<br />
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The apple snail can be purchased to eat from stands along the road in Laos, Cambodia, and Thailand, or the larvae can infest other aquatic animals. Once ingested by a human, the nematode travels to the brain through the blood stream, and then dies shortly after. The presence of a foreign body in the central nervous system causes a flood of white blood cells, specifically eosinophils, which triggers inflammation of the meninges. While this can clear on its own, some people have been seen with significant neurological dysfunction, some of which are lifelong, or death. This parasite is most commonly associated with Southeast Asia, in the past few years, has popped up in Hawaii. <br />
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Another speaker detailed a project focusing on parasitic load in public parks throughout New York. <i>Toxocara</i> spp. can infect dogs (<i>Toxocara canis</i>) and cats (<i>Toxocara cati</i>), and can also infect humans if the eggs are ingested. I think a lot of people in the US believe that parasites are a problem in other countries, but there are many types of parasites that can infect (and infest) people in urban and rural areas of the US.<br />
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<tr><td style="text-align: center;"><a href="https://www.cdc.gov/dpdx/toxocariasis/images/2/toxocara_larva.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="300" data-original-width="480" height="200" src="https://www.cdc.gov/dpdx/toxocariasis/images/2/toxocara_larva.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Toxocara roundworm image from the CDC</td></tr>
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<i>Toxocaraisis</i>, or an infection caused by <i>Toxocara spp., </i>is a roundworm infection that causes symptoms depending on where the larvae migrate in the body. Visceral toxocariasis occurs when the larvae migrate to various organs, most commonly the liver or central nervous system, causing fever, fatigue, coughing or wheezing, or abdominal pain. When in the central nervous system, psychological symptoms and neurological dysfunction can occur. Ocular toxocariasis occurs when the larvae migrate to the eye, causing symptoms relating to the eye, such as vision loss, inflammation of the ocular tissues, or damage to the retina that can cause permanent blindness. The CDC estimates that up to 70 people are blinded each year from Toxocariasis. Many people clear a <i>Toxocara</i> infection without experiencing any symptoms, and have a strong immune response.<br />
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This particular project tested soil and sand samples from parks because children are frequently exposed by ingesting soil and sand from parks, and from putting contaminated hands in their mouths. Infection during childhood can affect childhood development, and most people are never diagnosed if they don't present with severe symptoms. Many psychological symptoms aren't linked to parasitic infection, so they aren't treated appropriately!<br />
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<tr><td class="tr-caption" style="text-align: center;">Some random kid from the internet eating dirt.</td></tr>
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More importantly, the presenter emphasized how this is an infection that is more common in low income communities. For example, out of all the areas tested throughout New York, parks in the Bronx had significantly high contamination levels (something like 67% of parks tested in the Bronx had positive samples!). The CDC estimates that ~14% of people in the US have antibodies against <i>Toxocara spp.</i>, suggesting that tens of millions of Americans have been exposed to these parasites at one or more points in their lives.<br />
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The presenter's data, combined with the CDC's estimates of exposure in the US, suggests that a majority of those exposed to <i>Toxocara</i> are from disadvantaged communities, where public health initiatives fall short. This means that health services are not doing their jobs to protect all people within a community. We can't just protect select groups. All people have a right to be informed of what they may be exposed to in their local environment, and what local organizations (whether nonprofits, government organizations, or research initiatives) are doing to minimize risk!<br />
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If you are interested in this specific project, here is an older youtube video of the speaker describing her research:<br />
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Its important to remember that the concept of global health affects people around the globe, especially children, no matter where they live or how developed their environment is. Public health interventions have helped reduce the number of diseases that many people in developing countries would be exposed to, but no one lives in a sterile environment!underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com4tag:blogger.com,1999:blog-4847283425287985916.post-75643932682800777842017-06-26T07:57:00.000-07:002017-06-26T07:57:06.763-07:00The Bite of SummerIt’s starting to get really hot as summer sets in for many regions of the world. Even in the last weekend, we had temperatures of 100F throughout the Bay Area (where’s my “June Gloom”?). Over the last decade, we have seen record-breaking temperatures and drastic changes in seasonal climate, in which only some people believe are actually real and worthy of concern. When we think of summer, many people try to make the most of the longer hours of daylight and more palatable temperatures by spending more time outdoors. This simple act of migrating towards wilderness, combined with shorts and tank tops, makes for a memorable “meet-cute” scenario, only instead of casually encountering the love of your life, you’re mingling with vectors that harbor disease.<br />
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My husband often calls me a buzzkill because I can’t help but interject when friends, relatives, or acquaintances tell me that they are planning a summer trip to a location that I know is endemic for one, two, or many vector-borne diseases. “I hope you are bringing some DEET,” I say, explaining that all of the information you need is conveniently located on the <a href="http://travel.state.gov/">travel.state.gov</a> and <a href="https://www.cdc.gov/" target="_blank">CDC</a> websites. People often get pissed off when I suggest they take precaution instead of flaunting the new swim suit they’ve purchased just for this trip. Whether they take my advice or not is completely their choice, but I can’t help but feel like I’d be partially liable if I didn’t at least warn them.<br />
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Many people are still afraid of traveling to tropical islands and throughout South America, as Zika is still in recent memory, and many parts of Europe, for fear of being attacked by a terrorist. Instead, people are opting to explore the natural wonders in their own “back yard”, stating that it’s not only “cheaper, safer, and less of a hassle”, but also that they are afraid <a href="http://donaldtrump.org/" target="_blank">He Who Shall Not Be Named</a> might start selling off our National parks for industrial use and that they’ll miss the Instagram photo-op forever if they don’t go now.<br />
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Are we really safer in the United States? Sure, there are many reasons to believe that, from an infectious disease standpoint, we are. We haven’t had autochthonous malaria here since the days of our founders, and most people have access to and choose to get vaccinated.<br />
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But people die or suffer from chronic conditions as a result of infectious diseases here all the time, many of which can be prevented with basic action.<br />
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I write about tick-borne diseases almost every summer, and for good reason. Tick-borne diseases are spread by ticks, and come in the variety of flavors. Many are treatable if caught before chronic illness sets in, as with Lyme disease, but there are still some that cannot be treated. In all cases, the tantamount risk lies with getting bitten by a tick. Without the tick, you can’t get an infection. It’s as simple as that.<br />
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<tr><td class="tr-caption" style="text-align: center;">Beautiful image of a blacklegged tick from coppelabs.com</td></tr>
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But we all do things that we shouldn’t. I’m guilty of it too! I run my local trails in a t0shirt or tank top, risking tick bites every time I do it. Why do we refuse to let these vectors take control of our lives? Confidence, maybe? Blissful ignorance associated with a “that won’t happen to me” attitude? I’m not sure.<br />
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With that little diatribe, let’s talk about Powassan virus, or “POW” for short. POW is an RNA virus from the genus flaviviridae, meaning it is related to many well-known mosquito-borne viruses like dengue virus, West Nile virus, and yellow fever virus. POW is definitely a lesser-known tick-borne disease, because I think most people only have space for Lyme disease in their cerebral storage. There have only been 75 confirmed cases of POW infection in the US in the last decade, so it’s not as sexy to the news as larger outbreaks. Yet, it’s one to note, because there are no treatments available, aside from symptomatic treatment. <a href="https://www.cdc.gov/powassan/statistics.html" target="_blank">According to the CDC</a>, POW neuroinvasive disease cases have been reported in Maine, Massachusettes, Minnesota, New Hampsire, New Jersey, New York, Pennsylvania, Virginia, and Wisconsin between 2006 and 2015.’’<br />
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That’s right, it’s a neuroinvansive disease, which means after being bitten by an infected tick, the virus can infect the central nervous system, causing encephalitis and meningitis. Upwards of 10% of cases are fatal, and the CDC reports that approximately half of those infected suffer from permanent neurological symptoms.<br />
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<tr><td class="tr-caption" style="text-align: center;">Image from webmd.com</td></tr>
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Not only does the warmer weather drive humans outside, it also expands the territories where many vectors, like mosquitoes and ticks, can survive and thrive. As temperatures increase and stay warmer longer, tick populations have expanded, increasing the likelihood of being bitten. <a href="http://www.cnn.com/2017/05/03/health/powassan-tick-virus/index.html" target="_blank">Many predict </a>that there will be a dramatic increase in the number of POW infections this year, as weather continues to warm.<br />
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There is no treatment available for POW infection, aside from symptomatic treatment. Since POW is a virus, the antibiotics used for Lyme disease won’t work on a POW infection. Yet, most people who are infected are asymptomatic, and won’t experience any of the symptoms of POW disease. POW isn’t transmitted from person to person, so there’s risk of unknowingly infecting others if you are infected.<br />
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If you’re planning a camping or hiking trip, or you’re an avid trail runner like me (and by avid, I mean, I’m amateur at best), I suggest reading over <a href="https://www.cdc.gov/ticks/avoid/on_people.html" target="_blank">these tips on preventing tick bites</a>, and remember that POW cases have only been detected in the northeastern states, and around the Great Lakes.<br />
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If you do find a tick on you, here’s a video that shows how to remove a blacklegged tick:<br />
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<br />underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com6tag:blogger.com,1999:blog-4847283425287985916.post-22407872344205378412017-02-26T11:29:00.004-08:002017-02-26T11:29:56.457-08:00Give us a kissI know I'm a little late to the Valentine's-themed blog update game this year (and, like, every year? Let's be honest), but I was busy celebrating a general feeling of love in my life by grading midterm exams all night long. But, in honor of St. Hallmark (har har), I'd love to tell you about an unforgettable kiss.<br />
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South America is famous for romance and religion; two concepts that seem to overlap regularly throughout history. Given the tropical climate that engulfs Central America and most of South America, and the common built environments (housing structures, etc.) in rural areas, South and Central America are also endemic for a number of neglected tropical diseases. For example: despite the fact that a <a href="https://www.cdc.gov/vaccines/vpd/yf/public/index.html" target="_blank">yellow fever vaccine exists</a>, there is a huge <a href="https://wwwnc.cdc.gov/travel/notices/alert/yellow-fever-brazil" target="_blank">yellow fever outbreak</a> happening in Brazil right now. This just shows that with the right environment, if preventative measures (like vaccines) aren't required, then the disease will prevail. <br />
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Aside from our well-known and beloved mosquito vector, Central and South America are also home to an incalculable abundance of other insects that have the ability to spread many different diseases. One of my favorites (so to speak), is the triatomine bug, AKA the "kissing bug" or the "assassin bug".<br />
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<tr><td class="tr-caption" style="text-align: center;">Triatomine bug on a knuckle. Image borrowed from <a href="http://www.ticotimes.net/2015/10/24/national-university-spread-chagas-disease" target="_blank">The Tico Times</a></td></tr>
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These relatively large insects are bloodsuckers, meaning they take a blood meal from mammals. Due to their need for blood, land clearing, and human encroachment into heavily forested areas, many species of triatomine have adapted to living in and around housing structures. This environmental cross-over helped our friend, the triatomine bug, to start transmitting a number of diseases. The most common disease they spread is the protozoan parasite <i>Trypanosome cruzi</i>, which causes Chagas disease.<br />
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<tr><td class="tr-caption" style="text-align: center;"><i>Trypanosome cruzi</i> next to a red blood cell. Image (c) to Pearson Education.</td></tr>
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Triatomine bugs, known for the unforgettable kiss I mentioned earlier, are nocturnal and attracted to carbon dioxide, which we emit constantly as we exhale. Humans exhale the highest concentration of carbon dioxide in one location while they are sleeping, because most people don't move around as much while they are out cold.<br />
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After biting an infected animal or human, the bug now contains the parasite and is able to transmit it to another being. The infected bug bites and draws blood for a blood meal while defecating on the surface of the skin. The bite is usually painless and doesn't wake the latest victim.<br />
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By including the act of defecating during feeding, the triatomine bug deposits <i>T. cruzi</i> onto the skin. A combination of the irritation of the bite, and a mild allergic response to the feces, causes the skin to feel itchy. Scratching the itch helps move the feces and parasites into the bite wound, and infection ensues. After scratching, the parasite can also make their way into the body via mucosal tissues in the eyes, nose, and mouth, reaching the bloodstream through penetration of the delicate tissues. The parasite needs the triatomine bug to break the skin, since it is too thick for the parasite to penetrate on its own. <br />
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<tr><td class="tr-caption" style="text-align: center;">This amazing image is from <a href="https://www.researchgate.net/publication/259152699_Design_Synthesis_and_Evaluation_of_Hydroxamic_Acid_Derivatives_as_Promising_Agents_for_the_Management_of_Chagas_Disease" target="_blank">this publication</a>.</td><td class="tr-caption" style="text-align: center;"><br /></td></tr>
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<tr><td class="tr-caption" style="text-align: center;">This complete life cycle diagram is courtesy of the <a href="https://www.cdc.gov/parasites/chagas/biology.html" target="_blank">CDC</a>.</td></tr>
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Fever and swelling of the lymph nodes kick off the presentation of symptoms. A sore may develop at the site of the infection, and if the person was bitten on the face, a presentation called Romaña's sign causes distinct swelling around the eye. Romaña's sign occurs in approximately 50% of infected individuals, and is often considered one of the tell-tale signs of infection.<br />
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<tr><td class="tr-caption" style="text-align: center;">Romaña's sign in the left eye, image from the WHO and the CDC</td></tr>
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If not treated during the acute phase of infection, after initial symptoms subside, the chronic phase of Chagas disease sets in. Chronic Chagas disease can cause major complications to organs and entire organ systems, such as irreversible damage to the heart, intestines, and liver. Its estimated that over 25% of infected individuals develop potentially fatal damage to the heart.<br />
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Treatment for Chagas disease is usually a combination of benznidazole and nifurtimox, anti-parasitic medications that attack <i>T. cruzi</i>. This treatment must be given during the acute phase, when the parasite can be found in the circulatory system. In endemic regions, treatment is typically available. Yet, in the US, you must have a confirmed diagnosis of Chagas disease in order to obtain the treatment from the CDC, because it is otherwise not available. Diagnosis is performed by a blood smear viewed with a microscope to identify the parasite in the blood. Other tests, such as PCR, can be performed, but the blood smear is the gold standard in identification and diagnosis.<br />
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<tr><td style="text-align: center;"><a href="https://www.cdc.gov/parasites/images/chagas/triatomine_map_sm.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="193" src="https://www.cdc.gov/parasites/images/chagas/triatomine_map_sm.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Triatomine bug populations reported in the US, via the CDC</td></tr>
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The vector, triatomine bugs, are found throughout a large part of the southern US. <a href="https://www.scientificamerican.com/article/bed-bugs-kissing-bugs-linked-to-deadly-chagas-disease-in-u-s/" target="_blank">A small number of locally-acquired cases have been reported</a>, but not enough to cause huge alarm. Also, there are a number of ways this parasite can fail to infect you.Without the presence of the vector, the parasite cannot infect you. The parasite cannot penetrate the skin on its own, so unless a triatomine bug successfully bites you, or you have an open wound that is exposed to the feces of triatomine bugs, you are not at risk. Additionally, triatomine bugs don't always defecate when they feed.<br />
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The best way to limit exposure to Chagas disease is by reducing your exposure to the triatomine bugs, since there is no available vaccine, and treatment can be difficult to obtain in the US. Monitoring your house for triatomine bugs, cleaning away debris to reduce environments for their ideal hiding places, and if you are truly worried, regular insecticide spraying can all reduce your risk of exposure. While most insecticides have not been approved for use in the US against triatomine bugs, long lasting insecticides have been shown to kill them.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://3.bp.blogspot.com/-8Psr5AiJLZ8/WLMsjddgrTI/AAAAAAAABBg/K3AHh-bbXh4ACyu0irFxljDgadsnzFjugCLcB/s1600/ciclo-de-trasmicion-del-chagas.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="https://3.bp.blogspot.com/-8Psr5AiJLZ8/WLMsjddgrTI/AAAAAAAABBg/K3AHh-bbXh4ACyu0irFxljDgadsnzFjugCLcB/s400/ciclo-de-trasmicion-del-chagas.jpg" width="290" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image from <a href="http://www.chagasiniciative.com/home.php" target="_blank">Chagas Initiative Argentina</a></td></tr>
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<br />underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com2tag:blogger.com,1999:blog-4847283425287985916.post-4289856037497833642017-01-20T14:31:00.002-08:002017-01-20T14:32:47.326-08:00A Sense of UrgencyI haven't posted anything in a while, simply because the last few months have been occupied with self-reflection and constructing a plan of action for 2017. After the US Presidential election results were released, it seemed like a waste of time and energy to write about some disease that most people in the US will never even learn about, let alone be exposed to.<br />
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I was caught in an ambiguous fog of wondering whether the work that I do (my research, not necessarily this blog) is truly worth it, or if I'm just contributing to the unsustainable aspects of "global health". It can be frustrating when your subjects are on another continent, in another time zone, and will never interact with you face-to-face. Its also frustrating when you realize that you are just another white lady that claims a passion for global health/"wanting to make a difference". What does that mean, really? And frankly, what does that mean now that our government is lead by someone who believes in business over, well, everything else?<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://2.bp.blogspot.com/-6feooWhqAdI/WIKNmBCFEsI/AAAAAAAAA-g/7YPb5df4dbw_5OtqmdaYo3UJDGtR2R-wgCLcB/s1600/k4.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="213" src="https://2.bp.blogspot.com/-6feooWhqAdI/WIKNmBCFEsI/AAAAAAAAA-g/7YPb5df4dbw_5OtqmdaYo3UJDGtR2R-wgCLcB/s320/k4.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Community health workers in Madagascar (photo from <a href="http://atlantablackstar.com/2015/03/26/8-black-panther-party-programs-that-were-more-empowering-than-federal-government-programs/" target="_blank">K4Health</a>)</td></tr>
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How do you cope with being a person of the scientific community who wants to help initiate positive change, such as expanding the development and access to treatment and vaccinations for neglected diseases, improving access to clean water and sanitation technologies, or expanding educational and economic opportunities for young women in developing countries (just to name a few popular and reoccurring themes in global health), but also realizing that you may be forcing a very biased view on communities that are rarely empowered, but instead labeled has victims? (example: Many journalists claimed the cause for the last, explosive ebola outbreak was initially due to "<a href="https://www.theguardian.com/world/2014/jul/02/-sp-ebola-out-of-control-west-africa" target="_blank">ignorance</a>" of the affected communities). Similarly, how do you prioritize issues abroad when there is so much happening in your local communities? <br />
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I recently finished reading <a href="https://www.amazon.com/Sometimes-Brilliant-Impossible-Adventure-Spiritual/dp/0062049232" target="_blank"><i>Sometimes Brilliant</i>, by Dr. Larry Brilliant</a>, which details his journey through being a hippy MD with a passion for social justice and civil rights, and how he managed to find a spiritual connection to India while working to eradicate smallpox. On a number of occasions in this story, Dr. Brilliant (lovingly nicknamed "Dr. America" by his guru) questions his actions and whether his efforts are actually helping people in the long term, or if he's contributing to immediate yet unsustainable aid. This obviously spoke to me on a number of levels, but didn't help guide me to a solution (the answer isn't always broad and right in front of you, I guess).<br />
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<a href="http://www.marketplace.org/2016/12/21/world/smallpox-eradicator-and-rock-doc-larry-brilliant-beingsometimes-brilliant" target="_blank">Here's a great interview with Dr. Brilliant on Marketplace.</a><br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://4.bp.blogspot.com/-aJW8yv4cADQ/WIJ9fPhDWWI/AAAAAAAAA9I/4S_EB5kjr204VwH-ogd6eMfcyATkmdJGwCLcB/s1600/CNN%2Blarry%2Bbrilliant.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="180" src="https://4.bp.blogspot.com/-aJW8yv4cADQ/WIJ9fPhDWWI/AAAAAAAAA9I/4S_EB5kjr204VwH-ogd6eMfcyATkmdJGwCLcB/s320/CNN%2Blarry%2Bbrilliant.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Dr. Larry Brilliant (center) in India in the 1970s, working to educate communities and eradicate smallpox.</td><td class="tr-caption" style="text-align: center;"></td><td class="tr-caption" style="text-align: center;"><br /></td></tr>
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The beginning of the year coincides with my birthday, and instead of setting resolutions, I try to revisit the actions I've taken in the last year, and reflect on whether I'm having enough of an impact, giving enough of myself (energy, time, money, values, etc.) to others. This year, I wasn't feeling great about it, because I feel like there isn't enough time in one day, or even one year, to give enough of oneself to a cause (or causes) that will result in a true impact, a change, an improvement.<br />
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This dilemma is amplified by the fact that I spend a majority of my time and effort working in a lab at one of the most well known, private universities in the world, wherein I primarily interact with other white people, and everything sparkles with privilege and ongoing gifts from wealthy donors. Despite being in such an environment where low-income students get to attend for free, or where new and extensively valuable discoveries are made regularly, I'm not working in the hospital directly, where I could leave my workday feeling like I had a direct impact on someone's quality of life, or interacting with the students, who will go on to spread their expert educational experiences to many parts of the world with their future careers. When you work in such an environment, it is not clear who is "on your side" politically, or who is there to make a difference versus for the prestige of working with such a well known university. Its easy to feel isolated in a well-off environment when you are aware of inequalities.<br />
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Earlier this week, I attended a Global Health Symposium. It was a great event last year, but I wasn't expecting anyone to speak about the real issue at hand: How can we navigate global health issues with the new switch in government? It is typically not talked about, because you never know who voted for which party, or who actually believes <i>the wall</i> should be built. But without discussing such issues, it can make you feel like you are a part of the problem just by going to work.<br />
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The opening keynote address was given by Diana Chapman Walsh. Dr. Walsh was president of Wellesley College until 2007, and currently serves on the board of the Broad Institute of MIT and Harvard. She is also on the board of directors for the Mind and Life Institute, where she gets to work with the Dalai Lama. At first look, admittedly, I stereotyped and judged her. I thought, "she appears to be another 'rich white lady' who will talk about working together and doing good things for people of the world, but her talk will be empty and uninspired", because that's how jaded I've been feeling about everything lately. I was clearly desperate for inspiration and guidance.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://2.bp.blogspot.com/-_INzmTdmuek/WIKBPfDZ2iI/AAAAAAAAA9c/BZw_EdAjJ0kHXwLuczWAdphnJiRXu9QEQCLcB/s1600/Diana-Chapman-Walsh-2013-GoldLab-Symposium.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="213" src="https://2.bp.blogspot.com/-_INzmTdmuek/WIKBPfDZ2iI/AAAAAAAAA9c/BZw_EdAjJ0kHXwLuczWAdphnJiRXu9QEQCLcB/s320/Diana-Chapman-Walsh-2013-GoldLab-Symposium.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Diana Chapman Walsh. Image borrowed from <a href="http://goldlabfoundation.org/presenters/diana-chapman-walsh/" target="_blank">GoldLab</a></td></tr>
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She proceeded to talk about the urgency of collaboration and navigating our resources while we still have access to them. Stating "they told me I could be political", she spoke outwardly about how <b>white supremacy has put us in our current position, and how it is a danger for the future of global health.</b> Frankly, white supremacists do not value the health and wellness of other, non-white/non-(North) Americans. How does that view impact the health of our nation, and the health of people around the world? <b>Negatively</b>. This new administration is not going to value the federal organizations that perform research and provide aid that benefits people worldwide, as 'they should be able to take care of themselves'. Statements like these do not acknowledge that there is a monopoly on resources that are a fundamental human right. Instead, these resources are traded strategically, doled out as bribes for economic advantage (example: mining natural resources in Africa, trading access to such resources strategically for money and power). Don't even get me started on the white supremacist view of developing countries through the narrow lens of tourism and hospitality industries (Dr. Walsh didn't touch on this, but I bet she has thoughts about it). <br />
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Dr. Walsh spoke of climate change as a vital component of global health, which is not a view you hear regularly. You hear of polar bears losing their habitat, and small island villages being swallowed by rising sea levels, but with the polarized nature of climate change, no one likes to talk about the increased spread of disease, how it is affecting animal populations, or how it is going to get extremely difficult for some regions to access basic resources, like clean water and food. <b>Why would you allocate funds for research and innovation to combat these problems if you don't believe in climate change?</b> Also, why would you believe in climate change when you cant see past your own bubble?<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://4.bp.blogspot.com/-aPmHMSap_U0/WIKDKVzyN6I/AAAAAAAAA9o/AeChT_UE2nsNJcKJm6BRyvi9K1U58NqtgCLcB/s1600/DCW%2BBLM.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://4.bp.blogspot.com/-aPmHMSap_U0/WIKDKVzyN6I/AAAAAAAAA9o/AeChT_UE2nsNJcKJm6BRyvi9K1U58NqtgCLcB/s320/DCW%2BBLM.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">A bad photo of an inspiring talk.</td></tr>
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What especially surprised me was how Dr. Walsh openly expressed her support for <b>Black Lives Matter</b>. I have never heard anyone at our university (outside of my immediate lab group) express such views openly. It hit me like a punch in the face, because I thought she was going to be someone who wouldn't take a stand, and who would most likely be an expert at straddling the fence. But, no, I was wrong! What a refreshing surprise! She used her position of power to say that <b>we need to consider our local communities as a part of our global health initiatives</b>. What that showed me is that we can be an example, and we shouldn't keep quiet. <b>Also, maybe if we start listening more, we can learn how to get things done?</b> Here's an article that details <a href="http://atlantablackstar.com/2015/03/26/8-black-panther-party-programs-that-were-more-empowering-than-federal-government-programs/" target="_blank">"8 Black Panther Party programs that were more empowering than federal government programs"</a>, just as one example.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://3.bp.blogspot.com/-VvUIniP8N6M/WIKLwusohSI/AAAAAAAAA-c/TIlf_K2F5jgBV3pmpe-5yIGgMOkH_fLvACLcB/s1600/black-panther-free-food-program-600x861.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://3.bp.blogspot.com/-VvUIniP8N6M/WIKLwusohSI/AAAAAAAAA-c/TIlf_K2F5jgBV3pmpe-5yIGgMOkH_fLvACLcB/s320/black-panther-free-food-program-600x861.jpg" width="222" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Amazing photo from the <a href="http://atlantablackstar.com/2015/03/26/8-black-panther-party-programs-that-were-more-empowering-than-federal-government-programs/" target="_blank">Atlanta Black Star</a></td></tr>
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A few people referenced the latest <a href="https://www.oxfam.org/en/pressroom/pressreleases/2016-01-18/62-people-own-same-half-world-reveals-oxfam-davos-report" target="_blank">Oxfam report on inequality</a> that states "62 people own the same as half of the world", and 53 of them are men (surprised?). Only until the end of the day was the concept of engaging these powerful few for philanthropic endeavors. I mean, look at what a tremendous impact Bill and Melinda Gates have had on research, innovation, and impacting global health. It just has to be seen as a priority. <br />
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So where do we go from here? Which causes are you passionate about? How do we harness these ideas for fuel for our activist fire? I hesitated to use the word "activist", but then realized that standing up for global health means being an activist for social justice, no matter where your efforts are targeted.<br />
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In a specifically memorable moment of Dr. Brilliant's book, he tells a story about being caught in the middle of a dilemma: to play the game of corruption that may lead to long-term support for their smallpox eradication mission, or to stand up for noble action and do what is immediately right for the cause. He sought guidance from another spiritual leader and was told to consider the question "how are my actions affecting the children who are sick and dying from smallpox?" with every move. Truly how do you navigate these situations when there is a business side to global health? We cannot always only lead with our hearts, because funding will run out in a flash.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://2.bp.blogspot.com/-DqcGIebxito/WIKIZXNz0UI/AAAAAAAAA-I/nuEkm-4sXs0rd94mtDOub8M5p-5H57rPwCLcB/s1600/rsz_775x775-global-goals.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="https://2.bp.blogspot.com/-DqcGIebxito/WIKIZXNz0UI/AAAAAAAAA-I/nuEkm-4sXs0rd94mtDOub8M5p-5H57rPwCLcB/s320/rsz_775x775-global-goals.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Global Goals taken from <a href="https://www.one.org/us/2015/07/14/30-innovations-that-could-transform-global-health/" target="_blank">One.org</a></td></tr>
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I'll still cover infectious diseases, but the tone of my blog may change. There will be more calls to action, for sure. Global health is not only up to the righteously motivated or the extensively educated, especially when we consider global health as all encompassing. <b></b><br />
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Thanks for the much needed inspiration, Diana Chapman Walsh and Larry Brilliant. I'll see you on the front lines.<br />
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This one's for you, Trump:<br />
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<iframe allowfullscreen="" frameborder="0" height="315" src="https://www.youtube.com/embed/lstDdzedgcE" width="560"></iframe><br />
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Note: I've received a number of requests to do a series of posts about vaccinations: how they are developed and manufactured, how they work, etc., so I will be dedicating my next few updates to that subject. underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com2tag:blogger.com,1999:blog-4847283425287985916.post-89158927095064068382016-09-16T12:07:00.000-07:002016-09-16T12:07:13.655-07:00CCHF: The Western European TourIn 1944, a tick-borne virus characterized in Crimea was name "Crimean hemorrhagic fever virus", yet 25 years later, the vector was identified in the Congo. Hence, Crimean Congo Hemorrhagic Fever, or CCHF for short, was born (in the "I've given this naturally existing thing a name so it shall be seen as new" sense). As all vector-borne diseases are limited by the regional distribution of their vectors, it is no surprise that news outlets are currently describing CCHF as a "new" viral disease. Spread primarily by the <i>Hyalomma </i>species of tick, CCHF has been historically limited in spread, with cases primarily showing up in certain regions of Africa, the Middle East, Eastern Europe, and some parts of China.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://4.bp.blogspot.com/-b4x_XDy55lM/V9wpeSRnEwI/AAAAAAAAA6A/sFScHxKYP30_Uz_G0e_Q-jgHRzqnW_vBgCLcB/s1600/cchf-distribution-map-2014.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="308" src="https://4.bp.blogspot.com/-b4x_XDy55lM/V9wpeSRnEwI/AAAAAAAAA6A/sFScHxKYP30_Uz_G0e_Q-jgHRzqnW_vBgCLcB/s400/cchf-distribution-map-2014.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Map borrowed from the <a href="https://www.cdc.gov/vhf/crimean-congo/outbreaks/distribution-map.html" target="_blank">CDC (2014 version)</a>.</td></tr>
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Let's look at some older maps that contrasts the distribution of the <i>Hyalomma</i> species and historical cases of CCHF:<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://1.bp.blogspot.com/-alfUXe19N5Q/V9wqNmc_7WI/AAAAAAAAA6E/5w1Q_Rlqiz8h535zt7udhmJdRIYGEQPawCLcB/s1600/Global_CCHFRisk_20080918.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="267" src="https://1.bp.blogspot.com/-alfUXe19N5Q/V9wqNmc_7WI/AAAAAAAAA6E/5w1Q_Rlqiz8h535zt7udhmJdRIYGEQPawCLcB/s400/Global_CCHFRisk_20080918.png" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Map from the <a href="http://www.who.int/csr/disease/crimean_congoHF/Global_CCHFRisk_20080918.png?ua=1" target="_blank">WHO in 2008</a></td></tr>
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://1.bp.blogspot.com/-b934Rc_3Qgg/V9wqO1THbUI/AAAAAAAAA6I/0CcYE0IGSHkOzL2KmNi9zj-nfI0xDbhmQCLcB/s1600/tick%2Bdist.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="https://1.bp.blogspot.com/-b934Rc_3Qgg/V9wqO1THbUI/AAAAAAAAA6I/0CcYE0IGSHkOzL2KmNi9zj-nfI0xDbhmQCLcB/s400/tick%2Bdist.jpg" width="327" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image from <a href="http://www.afrivip.org/sites/default/files/Ticks_identification/ixod_hyal.html" target="_blank">AFRIV<span id="goog_304822614"></span><span id="goog_304822615"></span>IP.org</a></td></tr>
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There are a number of factors that have contributed to the spread of CCHF virus. CCHF virus is a zoonotic virus, meaning animals, such as livestock and domesticated animals, may also be infected. Many species of birds appear to be resistant to CCHF virus, with the exception of ostriches. Outbreaks have been linked to ostrich abattoirs (or slaughterhouses) in South Africa, but the animals do not present with disease symptoms or consequences. Primarily cattle, goats, sheep, camels, and hares or rabbits are susceptible, and act as the amplifying host. Humans can become infected as a result of contact with an infected animal tissue or blood, so it is easy to see why herders and abattoir workers are at high risk for exposure. Human-to-human transmission is possible through contact with infected bodily fluids, which puts health workers at risk as well. Cases have been traced back to exposure through contaminated medical equipment, although that is fairly rare.<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://2.bp.blogspot.com/-aAHhqSMLIqc/V9wtbe_rVzI/AAAAAAAAA6c/NdqeIozA5TwjxeL2vmtOgXyDJ07LSdtEQCLcB/s1600/cchf_life_cycle_poster.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="305" src="https://2.bp.blogspot.com/-aAHhqSMLIqc/V9wtbe_rVzI/AAAAAAAAA6c/NdqeIozA5TwjxeL2vmtOgXyDJ07LSdtEQCLcB/s400/cchf_life_cycle_poster.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Viral life cycle image via the CDC</td></tr>
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So why are we seeing <a href="http://www.express.co.uk/life-style/health/708622/Crimean-Congo-Hemorrhagic-Fever-CCHF-vaccine" target="_blank">CCHF virus labeled as "new"</a>? "New" is the media's historically ignorant term for "emergent", meaning these infectious diseases have been around for a while (some for centuries, even), but environmental and civil factors are influencing spread to new regions. Even the slightest change in seasonal climate or average annual temperature can create a hospitable environment in places that were inhospitable to these disease vectors. We also have a very developed view of the world, where it is hard to see that human actions, such as spillover into forests regions for industrial purposes (extracting natural resources or large-scale plantations for the production of resources), and development purposes (houses, houses, everywhere), can influence the introduction of these diseases to new populations. Not only are the vectors moving into our developed areas, but we are constantly invading and inhabiting natural habitats and contributing to the zoonotic nature of these viruses (and other infectious diseases). After all, we are animals, too.<br />
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Forbes, with their obnoxious refusal to let you view articles on their website while using an adblocker plugin,<a href="http://www.forbes.com/sites/judystone/2016/09/08/should-you-worry-about-tick-borne-crimean-congo-hemorrhagic-fever-in-spain/#138d4594202a" target="_blank"> says that you should be worried about CCHF</a>. The first local transmission of CCHF virus was reported in Spain this year, and the patient died. <a href="http://www.nytimes.com/2016/09/06/health/crimean-congo-hemorrhagic-fever-spain.html" target="_blank">A nurse was also exposed as a result of this case, which lead to close monitoring of many people from the medical team and local community</a>. The presence of CCHF virus in Spain has been known since 2011, <a href="http://promedmail.org/post/20111028.3209" target="_blank">when the West African strain of CCHF virus was isolated from ticks in Caceres province</a>. Up until that point, the Balkans were the western-most region known with reported cases of CCHF.<br />
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Onset of CCHF is quick, with sudden onset of high fever, severe headache, back and joint pain, stomach pain and vomiting. Patients may appear flushed with red eyes, face and throat, with a patchy red palate. Jaundice and the onset of neurological complications can arise.The hemorrhagic nature of the disease begins with severe bruising and frequent, severe nose bleeds, or uncontrollable bleeding at the site of injection. Outbreaks generally have a case fatality rate of <a href="http://www.who.int/mediacentre/factsheets/fs208/en/">40</a> - <a href="https://www.cdc.gov/vhf/crimean-congo/symptoms/index.html">50</a>%. Treatment is limited to supportive care, and there are currently no vaccines available to humans or for use in livestock populations. <br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://2.bp.blogspot.com/-qWOUF2bOgLI/V9w3wMHyxcI/AAAAAAAAA6s/tRZU9B7NK2cTX6--2brYuoiTGzQqT_82QCLcB/s1600/crimean%2Bhemorrhagic%2Bfever%2Bpatient%2B1.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="221" src="https://2.bp.blogspot.com/-qWOUF2bOgLI/V9w3wMHyxcI/AAAAAAAAA6s/tRZU9B7NK2cTX6--2brYuoiTGzQqT_82QCLcB/s320/crimean%2Bhemorrhagic%2Bfever%2Bpatient%2B1.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image from <a href="http://www.microbiologybook.org/parasitology/ticks.htm">Microbiologybook.org</a></td><td class="tr-caption" style="text-align: center;"><br /></td><td class="tr-caption" style="text-align: center;"><br /></td></tr>
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://3.bp.blogspot.com/-tgmBpx7U914/V9w4I3L_bNI/AAAAAAAAA6w/0t2ujQRAr64QwXnmMKAtF_56duR4geuPgCLcB/s1600/Crimean-Congo_Hemorrhagic_Fever%2Bpatient%2B2.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="215" src="https://3.bp.blogspot.com/-tgmBpx7U914/V9w4I3L_bNI/AAAAAAAAA6w/0t2ujQRAr64QwXnmMKAtF_56duR4geuPgCLcB/s320/Crimean-Congo_Hemorrhagic_Fever%2Bpatient%2B2.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image from <a href="https://en.wikipedia.org/wiki/Crimean%E2%80%93Congo_hemorrhagic_fever">Wikipedia</a></td></tr>
</tbody></table>
There are many other hemorrhagic fevers, including Ebola virus (EBOV), Marburg
virus (MBGV), Lassa virus (LASV), Rift Valley fever virus
(RVFV), dengue
virus (DENV), and yellow fever virus (YFV). Differential diagnosis, how we determine which virus is causing the hemorrhagic disease, is very difficult, as many of the symptoms overlap and rapid testing is not always available. In all of these viral hemorrhagic diseases, infection can impact liver cells and liver function. Impairment of liver function can decrease synthesis of protein that initiate clotting. This most likely occurs due to the body's response to severe disease and shock, as more liquid/unclotted blood can disseminate faster to all organs. Infection of liver cells can also cause an increase in clotting proteins, causing small clots to form, blocking blood flow. Hemorrhagic fevers also effect the permeability of blood vessels, causing the severe bruising and bleeding in tissues and orifices, like the nose, gums, or vomiting blood as a result of severe internal bleeding. <br />
<br />If you are following the advice from Forbes, and deciding to worry about CCHF, take action. Check yourself for ticks after spending time outdoors in wooded areas, places with tall grass, or wild animal exposure. Wear long sleeves and pants while spending time outdoors to limit your skin exposure to ticks (you can even treat your clothing with repellent; <a href="http://www.cdc.gov/ticks/avoid/on_people.html">learn how here</a>). Lastly, if you find it a tick on yourself, be sure to remove it carefully without pulling the head off or smashing the blood-filled body. If you are worried about disease exposure from said tick, do your doctor a favor and save the tick! It can be sent to a lab and tested, but act quickly as these viruses can be difficult to isolate from old material. underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com5tag:blogger.com,1999:blog-4847283425287985916.post-58353370292738191402016-08-10T19:43:00.001-07:002016-08-10T19:43:17.521-07:00Beasts Aplenty<br />
The world is on fire about arthropod-borne viruses, or "arboviruses". The simple mosquito bite can transmit a battery of diseases, including the currently popular West Nile virus, dengue virus, and zika virus. While these viruses are not new, the emergent nature has taken our media by storm, and is illuminating the universe of zoonotic diseases.<br />
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There's one virus, though, that for me, was the original. This virus has infected history and popular culture alike, but still hasn't achieved the level of fear that we see with some of these other, more emergent viruses. The fact that more people aren't absolutely terrified of this virus is beyond me, considering that it is the most deadly virus in the world, whereas dengue and zika have relatively low mortality rates.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://3.bp.blogspot.com/-Xbvl6W19lZQ/V6vM9R0bkcI/AAAAAAAAA20/nwZ4fSn1-VQWkOXo4UTMTYU3iXMOF4YAACLcB/s1600/werewolf1.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://3.bp.blogspot.com/-Xbvl6W19lZQ/V6vM9R0bkcI/AAAAAAAAA20/nwZ4fSn1-VQWkOXo4UTMTYU3iXMOF4YAACLcB/s320/werewolf1.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image from <a href="http://moviepilot.com/posts/2910101" target="_blank">7 Bloodcurdling Werewolf Tales That Will Keep You Up at Night</a></td></tr>
</tbody></table>
The rabies virus is a unique, non-segmented, negative stranded RNA virus of the <i>Rhabdoviridae</i> family. Unlike most diseases that hijack the circulatory system for dispersal through the body, rabies attacks the nearest nerve. The virus actually replicates in the nerve cell, slowly moving up to the brain.<br />
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The
rabies virus is quite literally shaped like a bullet. The lipid
envelope is lined with glycoproteins that help with viral attachment. <br />
The slow progression is part of the issue, because most people don't know they've been exposed to the virus until much later, when the symptoms start to set in. By the time symptoms occur, the virus has replicated and multiplied significantly, so a large amount of virus hits the brain.<br />
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The first symptoms are nonspecific and mild, with fever, weakness, headaches, and malaise. Some patients report a tingling and itching sensation at the site of the bite. After the nonspecific symptoms, confusion, anxiety, and agitation set in. Cerebral dysfunction leads to fits, and the body starts to lose the ability to sense temperature, pain, and pressure. These fits lead to erratic behavior.<br />
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It is common for patients to experience a phobia of water, too. As the virus is most commonly transmitted by bite, the fear of water is an evolutionary advantage for the virus. Without water, the virus is concentrated in saliva, without being diluted by water, making it more likely to be transmitted.<br />
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It is also possible for patients to experience "dumb rabies", with lethargic and comatose-like symptoms prior to death.<br />
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Once these symptoms start, recovery and survival is extremely rare. Disease progression usually lasts between 1 and 3 weeks, from start to finish. There have been only a small number of people who have survived a rabies infection, some from experimental treatments, and others for unknown reasons. Post-exposure prophylaxis of human anti-rabies antibodies needs to be administered before the onset of these symptoms, otherwise death is guaranteed.<br />
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Given its intense lethality, rabies has inspired a significant
amount of medical development. Louis Pasteur developed the first rabies
vaccine in 1885. Pasteur achieved successful development of the vaccine
by serial attenuating, or weakening the virus in rabbits. <br />
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Rabies kills approximately 60,000 people a year, worldwide. We don't typically worry about it here in North America, due to pet vaccination and local animal control, so most of the deaths occur in poor, rural, and developing regions of the world. <a href="http://www.berkshireeagle.com/local/ci_30217603/watch-your-pets-sheffield-worst-rabies-outbreak-two" target="_blank">In the last two weeks, though, Sheffield, MA has been experiencing the worst rabies outbreak in decades</a>. Residents of Sheffield have reported rabid foxes, skunks, and even a RABID WOODCHUCK.<br />
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Rabies has played an integral part in the development of some of the most horrific monsters. The concept of man morphing into a wild beast evolved from human exposures to animal diseases. The best examples of this are the werewolf and Dracula (or, vampires in general).<br />
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It all starts with a bite.<br />
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<br />underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com3tag:blogger.com,1999:blog-4847283425287985916.post-18874794438249335992016-05-17T20:38:00.001-07:002016-05-17T20:38:48.044-07:00Brought to you by the letters HBVMay is Hepatitis Awareness Month (according to the CDC), so I'm going to focus on something I get inquiries about all the time.<br />
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Hepatitis is a viral disease that can cause liver damage that can progress to liver inflammation, scarring (fibrosis), cirrhosis, or liver cancer. Disease progression depends on the virus, and other existing health issues (excessive use of alcohol and other substance abuse, autoimmune disease, etc.). <br />
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There are 5 viral types of hepatitis, aptly named A, B, C, D, and E (or HAV for Hepatitis A Virus, HBV for Hepatitis B Virus, and so on). We don't usually hear about hepatitis A and/or E here in the US, because they are transmitted by ingesting contaminated food or water (you're more likely to get <a href="http://www.cdc.gov/listeria/" target="_blank">listeriosis</a> here!), which is mostly associated with developing countries and poor sanitation. If your an avid traveler, you've probably already received a HAV vaccine.<br />
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Hep B and C, though, are common in the US, and worldwide, and this is where the the inquiries come in. Hep B, C, and D are spread by contact with contaminated bodily fluids, such as blood and semen. The most common methods of transmission are through unprotected sex, and through sharing or using contaminated needles (drug use, tattoos, piercings, birth, and medical procedures). There are vaccines available for Hep B and D, but not C. Actually, the HBV vaccines also protect against HDV! Since most people do not know they are infected with a hepatitis virus, and HBV, HCV, and HDV are prevalent worldwide, the HBV vaccine is recommended for all newborns in the US.<br />
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Hep B and C kill more than 1 million people every year, and its not an easy death. Liver disease is painful, and the treatments few treatments for hepatitis can be incredibly expensive. So, to answer everyone's question all at once: <b>Yes, I do believe the recommended vaccine schedule is necessary and important for your child, and all children for that matter. </b><br />
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Before I go on, let me just say that, as someone doesn't have kids of my own, I can't imagine how scary it must be at the beginning. The dichotomy of wanting to protect your kids from everything while not having them undergo a ton of procedures and get a bunch of shots because they are fragile little beings must be scary. It's ok to try to figure out what is right for you and your child, because some things <i>are</i> unnecessary (baby yoga? I don't know)! But, I believe vaccines are not one of those unnecessary things.<b> </b><br />
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The following are most common things I hear about the HBV vaccines from concerned parents.<b> Just a note</b>: my language in this section is referencing people who do have access to regular medical care, and may or may not be taking advantage of it. This is something that all parents should have access to for their children, but sometimes it just isn't possible (for a number of reasons). Most often, people who are questioning the use of the HBV vaccine (and others) do have access to quality medical care, yet choose not to follow the guidelines. <a href="http://news.discovery.com/human/psychology/anti-vaccination-parents-richer-better-educated-151231.htm" target="_blank">Descriptive demographics of the people who are chosing not to vaccinate their children include white, upper middle class or upper class, and college graduates.</a><br />
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So, with that being said, here are the most common things I hear about the HBV vaccine:<br />
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<b>1. "Why would I give my baby a shot (3 to 4, actually!) for something you can only get from having sex?"</b><br />
There are so many assumptions being made here. First of all, you should be glad that you have access to, and are benefiting from the privilege of having access to vaccines for your child and yourself. Most kids don't get vaccines, because they aren't mandated or they are too expensive or not available to them based on where they live. The fact that you and your child get to benefit from that is not something at which to scoff! Many children don't even live past the first few years of life because they don't have access to quality medical care and treatments.<br />
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Secondly, over 2 billion people have been exposed to hep B, and as I stated above, most people don't know that they are infected. That means there are many opportunities for your child to unknowingly be exposed. There are even opportunities for family members who don't know that they are infected to expose your kid during infancy. This vaccine will protect your child through their exploratory stages, when you might not always be around. I can't even tell you how many kids at my middle school thought blood pacts weren't serious (I think we can mostly blame that on 90s movies, right?), or in high school when everyone experimented with making their own tattoo guns. Or even had unprotected sex because they were too embarrassed to buy condoms or felt <i>too </i>invincible because "well, I'm not going to get AIDS from you, right?" Let's face it, pretty much every kid, teenager and young adult makes odd choices when they are figuring everything out, and that exploration really shapes who they become as adults. So, if there is a vaccine available to them that may offer some protection throughout their lives, why would you deny that?<br />
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<b>2. "It just seems like a lot for a newborn to handle." or, alternatively, "That's a lot of chemicals to put into a newborn."</b><br />
The hep B vaccine has actually gone through a few iterations before arriving at it's currently available form. In 1986, manufacturing switched to using recombinant DNA, which is significantly more safe (see: 100% safer, because<a href="http://www.hepb.org/professionals/hepatitis_b_vaccine.htm" target="_blank"> it is physically impossible to get hepatitis from the vaccine</a>) than the original product. The vaccine has been clinically tested (on many animals and humans) and approved for use in children. The recommendations set for these vaccines are based on a) the earliest safe and effective usage of the vaccine by the immune system (i.e. - <i>will my immune system even respond to it?</i>), how long the immune system response will last (<i>will I need a booster shot in the future, or will this one time vaccine protect me for life?</i>), and the need (<i>will I potentially be exposed to the pathogen at this stage in my life?</i>). There are many vaccines that kids in the US don't get, because they won't need them (see above where I explain that the hep A vaccine is mostly given to travelers headed to regions with poor sanitation). But, as stated above in #1, there are a lot of opportunities for people to be exposed to HBV and HDV.<br />
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<b>3. "I'll just give it to them later in life."</b><br />
Sure, do that, but they will hate you for it. I remember having to get my hep B vaccines. It hurt really badly! And I remember it hurting because I wasn't a newborn. Also, I don't say this as a scare tactic, but every day without the vaccine (or other ones, for that matter), are days that your child's immune system isn't primed and ready to go. So, for that reason, its really silly to wait, <a href="http://cid.oxfordjournals.org/content/53/1/68.full" target="_blank">especially since most people don't need boosters</a>.<br />
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<b>4. "Why does anyone care what I do to my child?"</b><br />
Every child without the vaccine is at risk of being exposed to the virus. If your child is infected at any point in their life, they have the ability to transmit (or spread) the virus to others, especially if they do not know that they are infected and do not take precautionary measures (using condoms, not sharing needles, etc.). Some people with compromised immune systems cannot get certain vaccines, and are therefore at a higher risk of getting infected, and developing chronic or severe disease. If you do not vaccinate your child, your child may be responsible for unknowingly spread the HBV or HDV to someone with a compromised immune system. <br /><b> </b><br />
<b> 5. "Most people only have an acute infection that goes away on its own."</b><br />
No, most ADULTS experience acute disease. Only 2-6% of adults develop severe or chronic hepatitis, whereas <b>90% of infected infants become chronically infected</b>. The risk of pre-mature death due to liver disease and chronic complications from hepatitis (mostly liver failure and liver cancer) is increased by up to 25% if a child is infected in their first 5 years of life. <b>Three shots can completely eliminate this risk for your child.</b> The hep B vaccine can also eliminate the risk of hepatitis-linked treatments, like invasive surgeries, transplants, or cancer treatments, which increase the risk of premature death even more, and are just not easy for a child to endure.<br />
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<b> </b><br />If you are still questioning whether to vaccinate your child for hepatitis B, I recommend you talk to your pediatrician about the statewide mandated guidelines and federal recommendations. As I stated earlier, I'm sure having a child is scary. There is a lot of information out there, and it is hard to know what to believe. But, vaccinations are not something that should be questioned. It has been proven time and time again that they are safe to your child, and safe for the community, and have effectively eradicated some diseases. It is okay to be cautious, but it is also okay to trust science.<br />
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Happy Hepatitis Awareness Month!<br />
<br />underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com6tag:blogger.com,1999:blog-4847283425287985916.post-7362738588876791682016-03-20T20:27:00.004-07:002016-04-07T20:46:18.945-07:00Elizabethkingia: The Bacteria That Kicks You While You're DownWhat's your biggest fear? Sharks? Heights? Cancer?<br />
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Compared to exciting threats like sharks, or falling to your death when your bungee cord snaps on your honeymoon bungee jumping excursion, infectious diseases fall pretty low on the list for most Americans. We've eradicated a number of diseases through rapid urbanization/industrialization (<i>did you know that malaria was endemic in North America in the early decades of the union?</i>), large-scale waste management (<i>bye, cholera!</i>), and widespread use of vaccinations (<i>see: smallpox, polio, etc.</i>).<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://1.bp.blogspot.com/-T7ksv5bWUTA/Vu9ZLyiG4kI/AAAAAAAAAyQ/7L3cjRRIwWIzDFT1gokFbmGYOh5jncNLw/s1600/halomonas%2Bplate.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="213" src="https://1.bp.blogspot.com/-T7ksv5bWUTA/Vu9ZLyiG4kI/AAAAAAAAAyQ/7L3cjRRIwWIzDFT1gokFbmGYOh5jncNLw/s320/halomonas%2Bplate.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">An agar plate of bacteria and mold, from <a href="http://nationswell.com/bacteria-oil-eating-halomonas-illinois-basin/" target="_blank">NationWell</a></td></tr>
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There's a number of things to which Americans are not immune, and a large category of them is bacterial infections. I say "category", because the variety of pathogenic bacteria in the U.S. can be broken into a number of subdivisions, such as: sexually transmitted infections (those which are caused by bacteria), antibiotic/antimicrobial resistant bacteria, those spread by environmental exposure (like <i>Borrelia</i> <i>spp.</i> that causes Lyme Disease, which is transmitted by ticks), and nosocomial bacterial infections (also known as hospital-acquired infections), just to name a few.<br />
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The most well-known subdivision I mentioned above is antibiotic/antimicrobial resistant bacteria. In fact, over two million people in the U.S. are infected with antibiotic/antimicrobial resistant bacteria each year. You can dig deeper into the world of antibiotic/antimicrobial resistant bacteria on<a href="http://www.cdc.gov/drugresistance/biggest_threats.html" target="_blank"> the CDC website, which rates bacterial species based on the severity of the threat they pose</a>. <br />
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Nosocomial infections, specifically, caused approximately 1.7 million infections and resulted in 99,000 deaths in 2002 (according to an estimate report from the National Nosocomial Infections Surveillance System). A similar surveillance survey by the CDC in 2011 reported over 720,000 nosocomial infections in acute care hospital facilities.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://4.bp.blogspot.com/-dDJ9OQWKfKE/Vu9RHRK1ReI/AAAAAAAAAx8/xjDmRf89hJ8vV9L0NGNJ0cP6bKN_vgKYg/s1600/HAIs%2Bin%2Bthe%2BUS.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="113" src="https://4.bp.blogspot.com/-dDJ9OQWKfKE/Vu9RHRK1ReI/AAAAAAAAAx8/xjDmRf89hJ8vV9L0NGNJ0cP6bKN_vgKYg/s320/HAIs%2Bin%2Bthe%2BUS.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Get more information on the <a href="http://www.cdc.gov/hai/surveillance/" target="_blank">CDC's Hospital-Acquired Infection Data and Surveillance Report here</a>.</td></tr>
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<span class="_Tgc"></span><br />
I bring this up because in the span of 4 months, a bacterial infection called <i>Elizabethkingia anophelis</i> has killed 18 people in Wisconsin and 1 person in Michigan. <br />
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<i>Elizabethkingia </i>is the phylogenetic genus of 4 related species of gram negative bacteria:<br />
<ul>
<li><i>E. anophelis</i>, which causes respiratory infections in humans, and was originally isolated from the midgut of Anopheles mosquitoes</li>
<li><i>E. endophytica</i>,<i> </i>which is a plant pathogen that mostly infects <i>Zea Mays</i>, or sweet corn</li>
<li><i>E. meningoseptica</i>, which causes severe meningitis and sepsis in newborns and infants (premature newborns are particularly susceptible)</li>
<li><i>E. miricola</i>, which was miraculously (pun!) isolated from condensation water on the Russian Space Station, Mir.</li>
</ul>
The genus is named after Elizabeth Osborne King, a clinical microbiologist (and a #WomanInSTEM!) who worked for the CDC in the 1940s through the 1960s, and studied meningitis in newborns. <i>E. anophelis</i> is common in environmental reservoirs, such as water and soil, bu<span style="font-size: x-small;"><span style="font-size: small;">t rarely causes infections in humans. The CDC logs only a handful of reported cases in the US each year. </span></span><br />
<br />
<span style="font-size: x-small;"><span style="font-size: small;">Yet, in Wisconsin, approximately 54 people have been infected since November of 2015. </span></span><span style="font-size: x-small;"><span style="font-size: small;"><span style="font-size: x-small;"><span style="font-size: small;">The outbreak is mostly affecting people who are 65 years or older, most of which had underlying health conditions.</span></span><i><span style="font-size: x-small;"><span style="font-size: small;"> </span></span>E. anophelis</i> infects the bloodstream and occasionally the respiratory tract, causing nonspecific symptoms, including fever, chills, shortness of breath, and cellulitis. Death is usually a result of sepsis.</span></span><br />
<br />
<span style="font-size: x-small;"><span style="font-size: small;">The current outbreak has been tracked across 12 counties, but has not specifically been labeled as a hospital-acquired infection.</span></span><span style="font-size: x-small;"><span style="font-size: small;"> Infections of the current outbreak have been centered in the southeastern quarter of the state, including the Milwaukee area and surrounding suburban counties. <a href="http://wwwnc.cdc.gov/eid/article/21/2/14-0623_article" target="_blank">One case in Hong Kong illustrated that the infection can be spread from mother to child</a>. <i>E. anophelis</i> is an antibiotic resistant species, which is why the magnitude of the current outbreak is causing such alarm for medical professionals. Transmission from person-to-person is highly unlikely without blood-to-blood contact, meaning there must be another common source within the community. The transmission route for the most recent outbreaks that occurred prior to the current one in Wisconsin, one in Central Africa and the other in Singapore, was not determined. </span></span><br />
<span style="font-size: x-small;"><span style="font-size: small;"><br /></span></span>
<span style="font-size: x-small;"><span style="font-size: small;">So, how does this factor into our biggest fears? The infectious disease world is constantly discussing the concept of "emerging diseases", meaning rare infections that are suddenly migrating to naive populations (meaning, the population of that geographical region has never been exposed to the pathogen before) or are infecting new populations. Antibiotic resistant bacteria, like <i>Elizabethkingia anophelis</i>, are sometimes included in the description of emerging diseases because the acquired or developed resistance poses new problems for treatment and infection control. </span></span><br />
<span style="font-size: x-small;"><span style="font-size: small;"><br /></span></span>
<span style="font-size: x-small;"><span style="font-size: small;">Say you go to the hospital because your appendix has ruptured. This is a routine surgery that shouldn't take much time or effort. But being in the hospital puts you at risk for infection, especially when you are in the process of recovering from a routine, but intensive, procedure. If the infection is rare, it will take your doctor a longer time to identify the culprit. If the infection is resistant to common treatments, you will have to endure more extensive treatment programs. If you are recovering from a surgical procedure, or have other open and exposed wounds, you're immune system may be otherwise preoccupied. So, a short hospital stay that should have been routine, might end up being more extensive, or putting you at a higher risk for death. </span></span><br />
<span style="font-size: x-small;"><span style="font-size: small;"><br /></span></span>
<span style="font-size: x-small;"><span style="font-size: small;">If you would like to follow the outbreak in Wisconsin, <a href="https://www.dhs.wisconsin.gov/disease/elizabethkingia.htm" target="_blank">the Department of Health Services website </a>is updated every Wednesday regarding developments in the investigation. </span></span><br />
<br />underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com2tag:blogger.com,1999:blog-4847283425287985916.post-77084511665289826222016-02-17T19:17:00.001-08:002016-02-17T19:28:16.627-08:00On to the Next One<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://3.bp.blogspot.com/-3rstqEeXFcg/VsUbhfY2iwI/AAAAAAAAAwQ/r530S7NVyjc/s1600/hova.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="213" src="https://3.bp.blogspot.com/-3rstqEeXFcg/VsUbhfY2iwI/AAAAAAAAAwQ/r530S7NVyjc/s320/hova.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Jay Z, image from <a href="http://www.newsweek.com/hova-load-tidal-announces-exclusive-jay-z-concert-326756" target="_blank">Newsweek</a></td></tr>
</tbody></table>
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<br />
<br />
<br />
Isn't it phenomenal that there's always a newer, more pressing issue on the horizon? In the words of Jay Z:<br />
<br />
<blockquote class="tr_bq">
<h4>
<i>"Ya'll should be afraid of what I'm gonna do next"</i></h4>
</blockquote>
Now that the <a href="http://nypost.com/2016/01/15/ebola-is-back-in-west-africa/" target="_blank">WHO has declared the ebola outbreak completely over</a> (with a new case reported the very next day, whoops!)... <br />
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://4.bp.blogspot.com/-x9s9_rPzTp0/VsUfMLO_OJI/AAAAAAAAAwg/QKP_xWOSHTU/s1600/idiot%2Baccomplished.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="193" src="https://4.bp.blogspot.com/-x9s9_rPzTp0/VsUfMLO_OJI/AAAAAAAAAwg/QKP_xWOSHTU/s320/idiot%2Baccomplished.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">This is the first thing I thought of when I saw the declaration of the end of the ebola outbreak.</td><td class="tr-caption" style="text-align: center;"><br /></td><td class="tr-caption" style="text-align: center;"><br /></td></tr>
</tbody></table>
The new focus is on the Zika virus (ZIKV) outbreak in South and Central America. I've been waiting to write this post for weeks because the news coverage is so heavy, and I didn't feel like being redundant. Everyone has heard about this "new" virus, the "new" link to microcephaly, and most recently, <a href="http://www.telegraph.co.uk/news/worldnews/zika/12157747/Zika-virus-Brazil-dismisses-link-between-larvicide-and-microcephaly.html" target="_blank">the anti-GMO tie to Monsanto</a>. But, what do we really know about ZIKV? Let's break it down:<br />
<br />
<b>ZIKV is not a new virus.</b><br />
ZIKV is a single-stranded RNA virus of the <i>Flaviviridae</i> family. It is related to dengue virus (DENV), West Nile virus (WNV), yellow fever virus (YFV), and Japanese encephalitis (JE) virus. <br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://1.bp.blogspot.com/-5851_XlG6GY/VsUxV61qFpI/AAAAAAAAAxA/LyU7r3hNzdQ/s1600/zikvstruc.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://1.bp.blogspot.com/-5851_XlG6GY/VsUxV61qFpI/AAAAAAAAAxA/LyU7r3hNzdQ/s1600/zikvstruc.jpg" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">ZIKV structure, thanks to St. George's University in Grenada</td></tr>
</tbody></table>
While newly introduced to South and Central America, ZIKV has been endemic in specific regions of Africa and Asia for quite some time. ZIKV was first discovered in Uganda in 1947, yet phylogenetic analysis of the viral genome estimate that ZIKV originated sometime between 1892 and 1947 (most likely in the 1920s). Early reports stem back to the 1950s, but with evolution of arthropod-borne viruses (arboviruses), the general and non-specific symptoms reported may have been caused by a similar virus (more on that later). Both urban and sylvatic, or rural/forest-based, transmission has been reported, and ZIKV is also seen in monkeys.<br />
<b><br /></b>
<br />
<div class="firstHeading" id="firstHeading" lang="en">
Yet, the recent and substantial outbreak in South and Central America (most notably in Brazil, which reported more than 14,000 cases in a matter of months) is new and a big deal. Prior to outbreak in 2015, ZIKV was wreaking havoc on islands like <a href="http://www.worldatlas.com/webimage/countrys/oceania/pf.htm" target="_blank">French Polynesia</a> (2013-2014) and <a href="http://www.worldatlas.com/webimage/countrys/samerica/easterisland/easterfacts.htm" target="_blank">Easter Island</a> (2014-2015). In fact, the outbreak in French Polynesia illustrated the link between ZIKV infection and chronic neurological conditions, specifically <a href="http://www.ninds.nih.gov/disorders/gbs/detail_gbs.htm" target="_blank">Guillain-Barr</a><span style="font-weight: normal;"><a href="http://www.ninds.nih.gov/disorders/gbs/detail_gbs.htm" target="_blank">é Syndrome</a>. </span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><br /></span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><b>Pregnant women are always seen as an "at risk" or "high risk" group.</b></span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;">The human body goes through a plethora of changes and adaptations when pregnant, mostly because survival of the mother is imperative for survival of the fetus. Development of the fetus is directly dependent on the numerous resources that the mother's developed body provides. The most relevant to this blog is "immunological priming", that continues after birth through <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3110651/" target="_blank">contact with the mother's microbiome during the birthing process</a> and during breast feeding. </span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><b> </b></span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;">Given the sensitivity of this relationship, pregnant individuals are always seen as a high risk group, as some pathogens can travel across the placenta, exposing the fetus during development and before birth. Trans-placental transmission/exposure to ZIKV is currently being investigated by a number of different institutions. With the increase in microcephaly cases during the ongoing ZIKV outbreak in South and Central America, it is understandable why a potential link would cause alarm. </span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><br /></span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;">One important thing to note is that Brazil is one of the few places that already had baseline incidence and prevalence data for microcephaly, making the increase in cases easier to identify. That type of data hasn't been readily available during previous outbreaks in other regions, which makes it difficult to determine whether or not ZIKV is the immediate cause. </span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><br /></span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><b>A mosquito bite does not guarantee disease.</b></span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;">Unlike it's relative, dengue virus, it is estimated that only 20% of people infected with ZIKV will become ill and experience symptoms. That means 80% of people infected are asymptomatic (meaning, they do not have any symptoms and often do not know they are infected). Symptom of ZIKV are, much like the symptoms of other arboviruses, general and non-specific. This means you experience fever, headache, rash, and joint or muscle pain. ZIKV also commonly causes conjunctivitis, or redness and swelling of the eye and skin around the eye. </span><br />
</div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><b> </b></span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><b> Arboviruses have been threatening to spread to North America with increasing persistence for years.</b></span></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://3.bp.blogspot.com/-NkD_q9qxtJ8/VsUt6Uc25CI/AAAAAAAAAw0/sOfX3igxI6U/s1600/NAM%2BEmerging%2BInfectious%2BDisease%2BOutbreaks%2B2002-2015.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://3.bp.blogspot.com/-NkD_q9qxtJ8/VsUt6Uc25CI/AAAAAAAAAw0/sOfX3igxI6U/s320/NAM%2BEmerging%2BInfectious%2BDisease%2BOutbreaks%2B2002-2015.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Graphic from the <a href="http://iom.nationalacademies.org/Activities/PublicHealth/ZikaResearch/2016-FEB-16.aspx" target="_blank">Institute of Medicine's presentation on Zika by Dr. Victor Dzau (2/15/2016)</a></td></tr>
</tbody></table>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;">North America is an anomaly in the infectious disease world. Since clearing most of the natural forests to favor rapid urbanization and industrial usage of land and resources, most hosts and vectors for many infectious diseases just won't survive in these areas. Part of that is because a majority of infectious diseases are perpetuated by tropical climates that are hospitable to the hosts and vectors (think jungles and warm/wet environments). But, some of the hosts and vectors are durable, and have taken advantage of changes in climate and global travel. </span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><br /></span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;">Many of the mosquito species that are required to spread these viruses have already established residency in California and Florida. So, as these viruses come closer to our geographical borders, and travel to/from endemic regions becomes more frequent, we <i>may </i>see some locally-acquired cases. But, the spread of a virus into a new region is a complicated process and so many factors have to overlap.</span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><br /></span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><b>Sexual Transmission can occur, but is not common.</b></span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;">There have been isolated cases of sexual transmission, but the uptick in news coverage is only a result of the ZIKV madness people have seen to caught, and is most likely the mass media's way of "helping" figure out whether microcephaly is linked to ZIKV infection. Despite what you've heard, having sex with someone that has ZIKV on the head of their penis will not cause microcephaly in all of your future children. Thanks, internet.</span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><b> </b></span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;">It is common sense, from an evolutionary standpoint, if you think about it. If you are in a region where mosquitoes are plentiful and looking for a bloodmeal, you are more likely to be exposed to ZIKV by a mosquito. Yet, these viruses "survive" when they are passed from one person to the next. Without transmission, our immune systems would clear the infection or we would die, and that would be the end of the story. Your mucosal membranes are a perfect environment for transport from one human to the next, especially when small tears may occur, giving access to blood. </span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<br /></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;">Just because there is a statistical possibility for sexual transmission to occur doesn't mean it can be considered a main method of transmission. There have only been 3 confirmed cases to date of male to female transmission through unprotected sexual contact. </span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><br /></span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><b>When babies are at risk, money is dedicated to the cause.</b></span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;">In hearing that there may be a link between ZIKV infection and an increased risk for microcephaly, President Obama dedicated $1.8 billion to ZIKV research. This funding will go to the development of faster, cheaper, and more specific and sensitive diagnostic tests, vaccine development, immune profiling and characterization of ZIKV disease, and studies to definitively determine whether microcephaly in newborns can result from ZIKV infection in pregnant women.</span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><b> </b></span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><b> If you are traveling to an endemic or high-risk area, you can protect yourself.</b></span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;">Arboviruses are some of the least feared diseases, from what I can tell based on my friends' reactions when I tell them to pack DEET and other mosquito repellents when traveling. Basically, if they are not at risk of getting malaria, they aren't worried. </span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><b> </b></span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;">If you are worried and have travel scheduled, there is <a href="http://www.cdc.gov/zika/prevention/" target="_blank">a page dedicated just to the prevention of ZIKV</a> exposure and transmission on the CDC website.</span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><b> </b></span></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://1.bp.blogspot.com/-zjXyVlRts2U/VsU2yKYlJOI/AAAAAAAAAxY/wHznLvfCHCk/s1600/zika%2Bat%2Bthe%2Bolympics%2B2016.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="227" src="https://1.bp.blogspot.com/-zjXyVlRts2U/VsU2yKYlJOI/AAAAAAAAAxY/wHznLvfCHCk/s320/zika%2Bat%2Bthe%2Bolympics%2B2016.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Cartoon by <a href="http://editorialcartoonists.com/cartoon/display.cfm/148333/" target="_blank">Rob Rogers and (c) the Pittsburgh Post-Gazette</a></td></tr>
</tbody></table>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><b> </b></span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;">Now, let's all hold our breaths and see what happens during the 2016 Summer Olympics, which are being hosted in Brazil. </span></div>
<div class="firstHeading" id="firstHeading" lang="en">
<span style="font-weight: normal;"><b></b><br /></span></div>
underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com2tag:blogger.com,1999:blog-4847283425287985916.post-66336123322826018672015-12-31T12:59:00.002-08:002015-12-31T12:59:34.465-08:00End of a Year, End of Another DecadeEveryone is posting these elaborate "BEST OF 2015" lists and photos, but for me, the end of 2015 marks another big milestone: the end of my 20s. In celebration of my 30th year in existence, I thought it would be fun to look back to what was happening in science 30 years ago.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://www.sciencemag.org/content/231/4733/local/cover-enclosure.gif" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://www.sciencemag.org/content/231/4733/local/cover-enclosure.gif" height="320" width="244" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><a href="http://www.sciencemag.org/content/231/4733.cover-expansion" target="_blank">Cover page of Science </a><span class="issue-meta"><a href="http://www.sciencemag.org/content/231/4733.cover-expansion" target="_blank">vol 231, issue 4733, released on January 3rd, 1986</a> - one day after I was born.</span></td><td class="tr-caption" style="text-align: center;"><span class="issue-meta"></span><br /></td><td class="tr-caption" style="text-align: center;"><span class="issue-meta"><br /></span></td><td class="tr-caption" style="text-align: center;"><span class="issue-meta"><br /></span></td></tr>
</tbody></table>
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<br />
The 1980s were a decade of fearlessness in science, where there were still so many unknowns, yet everyone was excited about all of the possibilities. There were two major scientific pushes in the 1980s: space travel and deciphering the AIDS epidemic, and as you may remember (or have guessed), there were many tragedies in 1986. Let's take a look:<br />
<br />
<b>January 12th: STS-61-C Space Shuttle Columbia is launched. </b><br />
Among the crew was Dr. Franklin Chang D<span class="irc_su" dir="ltr" style="text-align: left;">í</span>az, the first Latino astronaut. Dr. Franklin Chang D<span class="irc_su" dir="ltr" style="text-align: left;">íaz is an engineer and physicist of Chinese and Costa Rican descent.</span><br />
<span class="irc_su" dir="ltr" style="text-align: left;"><br /></span>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://upload.wikimedia.org/wikipedia/commons/9/9f/Changdiaz.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://upload.wikimedia.org/wikipedia/commons/9/9f/Changdiaz.jpg" width="240" /></a></div>
<span class="irc_su" dir="ltr" style="text-align: left;"><br /></span>
<span class="irc_su" dir="ltr" style="text-align: left;"></span><br />
<b><br /></b>
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<b>January 24th: The Voyager 2 space probe made its first encounter with the planet Uranus.</b><br />
Launched in 1977, <a href="http://voyager.jpl.nasa.gov/" target="_blank">Voyager 2</a>'s primary mission was to study distant planets. Voyager 2 visited the Jovian system in 1979, Saturnian system in 1981, Uranus and the Uranian system in 1986, and Neptune in 1989.Now in it's 39th year since launch, Voyager 2 is on an extended mission to study the outer reaches of the Solar
System. <a href="http://voyager.jpl.nasa.gov/imagesvideo/imagesbyvoyager.html" target="_blank">Check out some of the images taken by Voyager 1 and Voyager 2 here.</a><br />
<sup class="reference" id="cite_ref-5"></sup><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-0oUhL7wWD6I/VoWCEZAcqAI/AAAAAAAAAvA/A3sFHOYcylQ/s1600/voyager2enroute.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="247" src="http://1.bp.blogspot.com/-0oUhL7wWD6I/VoWCEZAcqAI/AAAAAAAAAvA/A3sFHOYcylQ/s320/voyager2enroute.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Voyager 2, photo credit: NASA</td></tr>
</tbody></table>
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://voyager.jpl.nasa.gov/gallery/images/uranus/15bg.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://voyager.jpl.nasa.gov/gallery/images/uranus/15bg.jpg" height="320" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Uranus, taken by Voyager 2 in 1986. Photo credit: NASA</td></tr>
</tbody></table>
<b><br /></b>
<b>January 28th: Space Shuttle Challenger (STS-51-L) explodes on launch.</b><br />
On its 10th flight, Challenger exploded 73 seconds into mission launch, due to an explosion. All <a href="http://history.nasa.gov/Biographies/challenger.html" target="_blank">seven crew members</a> and the Challenger shuttle were lost as a result of the malfunction. The shuttle and the bodies of the crew members were found mostly intact on March 9th by the US Navy.<br />
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<iframe width="320" height="266" class="YOUTUBE-iframe-video" data-thumbnail-src="https://i.ytimg.com/vi/j4JOjcDFtBE/0.jpg" src="https://www.youtube.com/embed/j4JOjcDFtBE?feature=player_embedded" frameborder="0" allowfullscreen></iframe></div>
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<b>February 21st: Nintendo releases the first game in the Legend of Zelda series in Japan.</b><br />
Nerds everywhere have no idea how their lives are about to change. This may not seem directly scientific, but if we think about how far computer science and gaming science has come in 3 decades, it is revolutionary.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-CiRdSuxx8NM/VoWSDOiV54I/AAAAAAAAAv0/oQHFk7ee9Go/s1600/legendofzelda_1986.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="262" src="http://4.bp.blogspot.com/-CiRdSuxx8NM/VoWSDOiV54I/AAAAAAAAAv0/oQHFk7ee9Go/s320/legendofzelda_1986.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Legend of Zelda, 1986</td></tr>
</tbody></table>
<br />
Here's the trailer for the upcoming release in the Legend of Zelda series:<br />
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<iframe width="320" height="266" class="YOUTUBE-iframe-video" data-thumbnail-src="https://i.ytimg.com/vi/XZmxvig1dXE/0.jpg" src="https://www.youtube.com/embed/XZmxvig1dXE?feature=player_embedded" frameborder="0" allowfullscreen></iframe></div>
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<br />
<b>March 3rd: The first paper on Atomic Force Microscopy is published.</b><br />
Atomic Force Microscopy (AFM), or Scanning-Force Microscopy, allows for very high-resolution with demonstrated resolution on the order of fractions of a nanometer, more than 1000 times better than the optical diffraction limit.<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://upload.wikimedia.org/wikipedia/commons/5/5e/AFMsetup.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="252" src="https://upload.wikimedia.org/wikipedia/commons/5/5e/AFMsetup.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Setup of AFM, image from Wikipedia.</td></tr>
</tbody></table>
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<br />
<br />
<br />
<b>April 3rd: IBM releases the first laptop computer.</b><br />
It weighed 13 pounds, and looked like a little robot.<br />
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://upload.wikimedia.org/wikipedia/commons/9/9a/Ibm-convertible.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://upload.wikimedia.org/wikipedia/commons/9/9a/Ibm-convertible.jpg" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">IBM "PC-Convertible", photo via Wikipedia</td></tr>
</tbody></table>
<b>April 13th: The first child born to a non-related surrogate mother is born.</b><br />
Produced by gestational surrogacy, this revolutionary human pregnancy resulted from the transfer of an embryo created by <i>in vitro</i> fertilization (IVF), in a manner so the resulting child is genetically unrelated to the surrogate.<br />
<br />
The
surrogate and biological mother, Mary Beth Whitehead, refused to cede
custody of Melissa (otherwise known as "Baby M", born 4/13/86) to the couple with whom she made the surrogacy
agreement. The courts of New Jersey
found that Whitehead was the child's legal mother and declared
contracts for surrogate motherhood illegal and invalid. However, the
court found it in the best interest of the infant to award custody of
Melissa to the child's biological father, William Stern, and his wife
Elizabeth Stern, rather than to Whitehead, the surrogate mother.<br />
<b> </b><br />
<br />
<br />
<b>April 25th: The Chernobyl Nuclear Power Plant exploded, causing the worst nuclear power plant disaster in history.</b><br />
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<b> </b><br />
<br />
<b>May: The first method to create part-human, part-mouse monoclonal antibodies was published. </b><br />
The development of humanized monocolonal antibodies lead the way for many medical therapeutics being used today. There are currently more than 30 FDA-approved monoclonal antibody therapies available for a wide range of diseases, including (but not limited to) cancers, autoimmune disorders like rheumatoid arthritis, severe psoraisis, Crohn's disease, transplant rejection, and cardiovascular diseases.<br />
<b><br /></b>
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<tr><td style="text-align: center;"><a href="http://media-2.web.britannica.com/eb-media/39/21139-004-1BC93D10.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://media-2.web.britannica.com/eb-media/39/21139-004-1BC93D10.jpg" height="175" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image from <a href="http://www.britannica.com/science/monoclonal-antibody/images-videos/Artificial-production-of-monoclonal-antibodies-The-technique-involves-fusing-certain/17648" target="_blank">Britannica: Monoclonal Antibodies</a></td></tr>
</tbody></table>
<b></b><br />
<b><br /></b>
<b>May: HIV is named.</b><br />
The International Committee on the Taxonomy of Viruses said
that the virus that causes AIDS will officially be called HIV (human
immunodeficiency virus) instead of HTLV-III/LAV.<br />
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-0mLKdvgK_hQ/VoWOh_fw8yI/AAAAAAAAAvk/MylLozeXKqk/s1600/LevyHIV.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="http://4.bp.blogspot.com/-0mLKdvgK_hQ/VoWOh_fw8yI/AAAAAAAAAvk/MylLozeXKqk/s320/LevyHIV.jpg" width="222" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Dr. Jay Levy of UCSF, who discovered the "AIDS-related virus", or ARV, which would eventually be named Human Immunodeficiency Virus (HIV). Photo via UCSF archives.</td></tr>
</tbody></table>
<br />
<b>July: FDA approves the first genetically engineered vaccine for Hepatitis B.</b><br />
Prior to the development of recombinant Hepatitis B vaccines, all Hep B vaccines were plasma-derived. Now, with the synthetically prepared vaccine, it is impossible for you to get Hepatitis B from the vaccine. <br />
<br />
<br /><b>November 3rd: TIME magazine releases an issue on viruses, specifically discussing new research surrounding the HIV/AIDS epidemic. </b><br />
By the end of 1986, 85 countries had reported 38,401 cases of AIDS to the World Health
Organization, including Africa (2,323), Americas (31,741), Asia
(84), Europe (3,858), and Oceania (395).<br />
<br />
From TIME: "
It would be another year before the first antiviral drug against HIV,
AZT, is developed, but scientists are learning more about the biology of
the AIDS virus, and testing new treatments, including gene therapy."<br />
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-m1DWGofIVMQ/VoWKyoz8reI/AAAAAAAAAvU/pcWSvq42Ytw/s1600/TIME%2B1986%2BNov3.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="http://3.bp.blogspot.com/-m1DWGofIVMQ/VoWKyoz8reI/AAAAAAAAAvU/pcWSvq42Ytw/s320/TIME%2B1986%2BNov3.jpg" width="242" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Cover Image, credit TIME Magazine.</td></tr>
</tbody></table>
<br />
So there you have it: 30 years ago in science history. I hadn't really thought about it before, but my scientific career has been very representative of science in 1986. I've worked for NASA, studied HIV, and, for many years as a lying, idiot teenager, told my peers that I was the first "test tube baby".<br />
<br />
Any guesses as to what the next 30 years will hold for science?<br />
<br />underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com1tag:blogger.com,1999:blog-4847283425287985916.post-12643226236947373642015-12-01T20:02:00.002-08:002015-12-01T20:02:47.354-08:00World AIDS Day 2015: Did you even notice?<br />
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<a href="http://2.bp.blogspot.com/-O3DYBEKMzFo/Vl5npWoTuTI/AAAAAAAAAuQ/aivij5mrDTQ/s1600/WAD121.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="182" src="http://2.bp.blogspot.com/-O3DYBEKMzFo/Vl5npWoTuTI/AAAAAAAAAuQ/aivij5mrDTQ/s400/WAD121.jpg" width="400" /></a></div>
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December 1st is World AIDS Day. It has been for decades, and will continue to be for decades to come. Yet, did you even notice?<br />
<br />
Years ago, I was venting to my dad about how I wish people used social media for intelligent conversation and to spread important information instead of posting pictures of their outfits and arguing over inaccurate news stories. He looked at me and said "make Facebook what you want it to be", suggesting that I ignore all my boring acquaintances and follow organizations that I believe in, instead. So that's what I did. Twitter, Facebook, and eventually Instagram. I follow government organizations relating to public and global health, nonprofit organizations, scientists, museums, etc.<br />
<br />
But, today, I found myself frustrated again. I was looking forward to seeing posts about World AIDS Day, but I saw TWO posts on facebook, and only FIVE quick tweets (80% of which were from US government organizations like Health & Human Services or the CDC).<br />
<br />
So, why don't we care about HIV and AIDS anymore? Why has HIV and AIDS turned into a docile disease?<br />
<br />
I have a few theories about this:<br />
<br />
<b>1. We're inundated with articles about how "A CURE IS RIGHT AROUND THE CORNER" or about "ONE MAN: CURED OF AIDS".</b><br />
Don't get me wrong, I have complete faith in the scientific research community and the medical community, but I'm tired of things being announced or declared in a way that isn't really all that true. We are already in an age where there is a huge distrust of science, so when breakthroughs are made, results are expected immediately. When we talk about "curing AIDS", I imagine the general masses imaging taking a huge red marker and checking a box. But, we've seen with every drug trial (I'm especially thinking of cancer drugs and the public outcry as a result of some of the waiting periods), results aren't immediate. We don't go from test tube to mass production of a perfectly effective drug. Even with animal trials, many times there are unforeseen side effects or changes in dosage efficacy.<br />
<br />
Not to mention, the "curing" or "clearing" of HIV has not had a lasting effect. The incredibly invasive, extensive, and expensive procedures that lead to the initial news stories are simply not feasible for everyone (and even most people!). But the realistic side of the story is often not included.<br />
<br />
I don't say this in any way to minimize the great advancements we've seen with antiviral treatments. We are in an age where many people who are infected with HIV are living long, healthy lives as a result of treatment options and lifestyle changes.<br />
<br />
<b>2. HIV isn't as scary as other emergent diseases and infections.</b><br />
How can we take HIV seriously as an ongoing threat if we hear about something new, unknown, and terrifying every week? There are many factors that go into viruses breaking out of a small region and spreading to previously unaffected areas. But, we are in an age of emergent diseases. Ebola has been around for decades, but up until last year, most people had never heard of it. Zika virus was isolated in specific regions of sub-Saharan Africa and Southeast Asia, and suddenly, this year, more than 14,000 people have been infected in Salvador, Brazil. Kissing bugs are in 26 states, and <i>Aedes</i> mosquitoes have been moving in to California for a few years now. Chikungunya is in the Caribbean and certain parts of Europe.<br />
<b> </b><br />
With scientific distrust, comes fear. Everyone is too busy fearing new viruses to remember that HIV is still here.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-v7AAp4FKlFQ/Vl5oWaCc9oI/AAAAAAAAAuY/ud8K018AQZY/s1600/HIV%2BTEM.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="http://4.bp.blogspot.com/-v7AAp4FKlFQ/Vl5oWaCc9oI/AAAAAAAAAuY/ud8K018AQZY/s320/HIV%2BTEM.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="color: #0000ee;"><span style="color: #0000ee;">TEM <span style="color: #0000ee;">micrograph of budding HIV virions</span></span></span></td></tr>
</tbody></table>
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<b>3. Young generations haven't experienced death from HIV and AIDS. Young generations haven't experienced the disease revolution.</b><br />
The largest recorded ebola outbreak in human history happened (is still happening, albeit slower) happened in an area of the world with which most people are still not familiar. The cases that caught the most media attention were Americans that received experimental treatment.<br />
<br />
Younger generations aren't familiar with the fear and death associated with HIV in the 80s and 90s. They aren't familiar with the imagery of that time. They aren't familiar with the huge and devastating number of children that have HIV.<br />
<br />
This lack of realistic knowledge and awareness of HIV and AIDS has lead to incredibly sad facts, such as: <b>60% of HIV positive youths are not aware of their HIV status. </b><br />
<br />
<br />
Speaking of statistics, its estimated that <b>34 million people worldwide are living with HIV.</b><br />
I recently attended the American Society of Tropical Medicine and Hygiene (ASTMH) annual conference, and I collected some really devastating statistics. As of 2013, it was estimated that 3.2 million children were living with HIV worldwide, and less than 25% of them were receiving antiretroviral therapy (ART). That was almost 3 years ago.<br />
<br />With the bleak statistics of the number of people living with HIV who don't know their status and the number of children with HIV, we are not in the position to say that HIV is not a threat, or that "we can see the end of AIDS by 2030". If we aren't even acknowledging World AIDS Day anymore, then how can we see a future without HIV and AIDS?<br />
<br />
Take this matter into your own hands. Get tested regularly. <br />
<br />underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com1tag:blogger.com,1999:blog-4847283425287985916.post-25840713456483351862015-11-20T21:34:00.002-08:002015-11-20T21:34:32.621-08:00Giving Thanks to ChimpsSomething special happened this week that, I feel, isn't getting the attention it deserves. With Thanksgiving (US) next week, I felt it was fitting to highlight this event, because to me, it is representative of who and what we forget to be thankful for on a regular basis.<br />
<br />
In 2013, the NIH announced it would start to phase out all research and trials involving chimpanzees, sparing only 50 chimps for support of research with very specific needs involving chimps as a model system. <a href="http://www.nih.gov/about-nih/who-we-are/nih-director/statements/nih-will-no-longer-support-biomedical-research-chimpanzees" target="_blank">As of this week, the NIH has announced that they will no longer support biomedical research on chimpanzees.</a> The NIH will no longer retain the 50 remaining chimpanzees, and they will be moved to a chimpanzee sanctuary.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-S1Ug4DRIFFU/VlAA6MZzxdI/AAAAAAAAAtc/-RKaa9a-jck/s1600/chimpNG.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="255" src="http://2.bp.blogspot.com/-S1Ug4DRIFFU/VlAA6MZzxdI/AAAAAAAAAtc/-RKaa9a-jck/s320/chimpNG.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Photo from <a href="http://www.dailymail.co.uk/news/article-3123040/Government-agency-acknowledges-chimpanzees-endangered-places-restrictions-using-biomedical-research.html" target="_blank">National Geographic/Getty Images</a></td></tr>
</tbody></table>
Part of the reason this is happening is because the <a href="http://www.fws.gov/endangered/what-we-do/chimpanzee.html" target="_blank">U.S. Fish and Wildlife Service has designated chimpanzees, including those in captivity, as endangered species</a>. The original placement of wild chimpanzees on the endangered species list occurred in 1990, after being on the "threatened" list since 1976. This is a tragic reason, but the response from the NIH is absolutely the right move. A small move, but a valuable one.<br />
<br />
I bring this up, not only because it is a personal issue for me, but because we benefit from products and technologies that have been tested on chimpanzees and many other animal species often without thinking about it. Historically, chimpanzees have been used for a wide range of biomedical research subjects and topics, including psychological research, and an endless list of health and medicine-related topics. Private institutions in the US started using chimpanzees in laboratory research in the 1920s, while the NIH waited until 1960 to establish the first government-operated non-human primate research center. If you want to learn about the first 100 chimpanzees brought from Africa specifically for research purposes, I highly encourage you to visit the <a href="http://first100chimps.wesleyan.edu/" target="_blank">First 100 Chimps website</a>, from Lori Gruen.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-Gy50vS37KgU/VlACBLqfOGI/AAAAAAAAAtw/dbORsOgRY04/s1600/researchimpNG.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="215" src="http://1.bp.blogspot.com/-Gy50vS37KgU/VlACBLqfOGI/AAAAAAAAAtw/dbORsOgRY04/s320/researchimpNG.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Photo from Corbis Bettmann and <a href="http://news.nationalgeographic.com/news/2014/09/140912-chimpanzee-haven-retired-research-animals/" target="_blank">National Geographic</a></td></tr>
</tbody></table>
<br />
Long before their use in biomedical and psychological research, many species of non-human primates were a source of heavy fascination during the height of colonialism in Africa. The two most popular past times were trying to capture live orangutans in the wild, and capturing smaller primate species to keep as pets. <br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-dM1iFQ-4Myk/Vk__cAneXvI/AAAAAAAAAtQ/1VsRXWOWpgE/s1600/fongoli-chimps-hdr.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="220" src="http://1.bp.blogspot.com/-dM1iFQ-4Myk/Vk__cAneXvI/AAAAAAAAAtQ/1VsRXWOWpgE/s320/fongoli-chimps-hdr.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Photo from the <a href="http://www.expandedenvironment.org/call-of-the-wild/" target="_blank">Expanded Environment</a></td></tr>
</tbody></table>
One of the most well known research areas was the use of chimpanzees for HIV research, starting in the mid-1980s. Chimpanzees are the most genetically-related species to humans, but that doesn't necessarily make them good models for research. It took almost a decade for the NIH to realize that chimpanzees are poor models for HIV research, which ceased breeding programs for federally-owned chimpanzees in 1995. At this time, there was a surplus of chimpanzees in research-associated captivity as a result of the rapid increase in HIV research, and the assumption that chimpanzees were the best animal model. Thus, <a href="http://www.chimphaven.org/" target="_blank">Chimp Haven</a> was founded to support the retirement of chimpanzees from biomedical research facilities, the entertainment industry, and pet trade. <br />
<br />
Speaking of HIV research, I just had the opportunity to see <a href="http://www.med.upenn.edu/apps/faculty/index.php/g275/p8418831" target="_blank">Dr. Beatrice Hahn</a> of the University of Pennsylvania speak about her non-invasive research that has answered many questions about the origin of HIV-1 and HIV-2. By using sequencing technologies to analyze fecal samples from wild primates in Africa (that her team literally collects from the ground in the jungle), she has been able to find the missing pieces of viral origin and evolution. You can find a summary of Dr. Hahn's work on her website (click her name above), or by <a href="http://www.uphs.upenn.edu/news/News_Releases/2015/03/hahn/" target="_blank">reading this article</a> from earlier this year.<br />
<br />
In 2010, the NIH tried to transfer more than 200 government-owned chimpanzees to the National Primate Research Center in Texas for invasive research studies. Yes, 2010. This was more than a decade after many countries, such as New Zealand, Australia, Sweden, and the Netherlands, started to place strict bans on great ape research. Jane Goodall pressured the NIH to rethink their decision to make more chimpanzees available for invasive research, which lead to a year-long investigation into the necessity of the use of chimpanzees for research purposes. In 2011, the NIH declared that chimpanzees are "largely unnecessary for biomedical research".<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-UOabc36hRkk/Vk_-JMcCApI/AAAAAAAAAtE/z2_hjcuifFU/s1600/1351830.large.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="192" src="http://3.bp.blogspot.com/-UOabc36hRkk/Vk_-JMcCApI/AAAAAAAAAtE/z2_hjcuifFU/s320/1351830.large.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Photo from the<a href="http://www.janegoodall.org/" target="_blank"> Jane Goodall Institute</a></td></tr>
</tbody></table>
Yet, while legislation is in place to protect chimpanzees and other species from unnecessary use and cruel treatment during research, many private companies (note: not getting government funding) still have and maintain chimpanzee research facilities. <a href="http://www.humanesociety.org/issues/chimpanzee_research/tips/companies_chimpanzee_policies.html" target="_blank">Some companies in the US have already ceased using chimpanzees, or have declared that they will phase out their use of chimpanzees by 2020 (click for list of companies)</a>. If you'd like to follow the periodic retirement and movement of chimpanzees into sanctuary facilities, I encourage you to visit the <a href="http://www.last1000chimps.com/" target="_blank">Last 1000 website</a>, also maintained by Lori Gruen. <br />
<br />
Here's the important part from the NIH's statement from the director regarding the retirement of the last 50 chimps:<br />
<h4>
"These decisions are specific to chimpanzees. Research with other
non-human primates will continue to be valued, supported, and conducted
by the NIH."</h4>
Don't be fooled. This ends the use of chimpanzees in government facilities and government-funded research, but the use of chimpanzees has not been banned in the US. Private companies can still use chimpanzees and other non-human primates, as long as they adhere to the strict "humane usage" guidelines. <a href="https://awic.nal.usda.gov/research-animals/laboratory-animal-species" target="_blank">Here is a website that will give you more information about animal species currently used in laboratory research.</a> <br />
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-LrZqKJOMXXQ/VlABjVOj3NI/AAAAAAAAAtk/ZdKQc4k325A/s1600/chimppbs.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="220" src="http://1.bp.blogspot.com/-LrZqKJOMXXQ/VlABjVOj3NI/AAAAAAAAAtk/ZdKQc4k325A/s320/chimppbs.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Photo from <a href="http://www.kpbs.org/news/2010/jun/18/nature-chimpanzees-unnatural-history/" target="_blank">KPBS</a></td></tr>
</tbody></table>
<br />
Chimpanzee research originated before many of us were born, and other than the amazing Jane Goodall, there are not many champions bringing this issue to light. When I decided to pursue biological sciences -- specifically infectious disease research -- as a career, I decided I would never take a job that would require me to do anything with animals directly, and I didn't want to be involved with projects that relied on animal research. In the time that I've been working as a scientist, the number of technologies and discoveries that minimize the need for animal research has exploded. In my opinion, we are moving towards a time in science where animal models wont be necessary anymore. There are many people that don't agree. I encourage you to look at the available facts, and decide for yourself.<br />
<br />
But before you do that, think about the animals, and specifically the chimpanzees, that have been involved in research. Think about the animals that have been breed specifically for research purposes. Think about the biomedical advances we've had thanks to animal models. If you are going to spend some time next week thinking about what you are thankful for, consider being thankful for chimpanzees, and for the sanctuaries that are dedicated to caring for them.<br />
<br />
Has this made you wonder what brands you use that currently test on animals? <a href="http://www.crueltyfreekitty.com/companies-that-test-on-animals/" target="_blank">Here's a good, comprehensive list.</a><br />
<br />
For a good visual guide of the history of the use of chimpanzees for research, <a href="http://www.cbc.ca/natureofthings/features/a-history-of-chimps-in-medical-research" target="_blank">check out this site</a>. underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com2tag:blogger.com,1999:blog-4847283425287985916.post-41111251269885978142015-10-02T21:39:00.002-07:002015-10-02T21:39:34.085-07:00Myth CampaignI've been wanting to write this post all month, but every few weeks I'd see more examples I wanted to include, and my frustration increased exponentially. I should start by saying that I consider myself somewhat of a "political radical" of sorts. By that, I mean that, while I have a lot of respect for the idea of a true democracy, I have a low tolerance for the amount of actual representation of the average American citizen. I try not to talk about my political opinions on this blog, because frankly, that's not why I started this blog.<br />
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But, science and politics are very intertwined. From federal grants and funding initiatives for research, to government institutions and committees, there is no separation between "lab and state". Sometimes, that's a good thing. Some of the federal regulations that mandate safety and procedural guidelines for research ensure that working in research environments (labs, fieldwork, etc.) are <i>safer</i> for the people doing the work. Also, there have been a lot of scientific exploration and advancements due to federal funding.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://41.media.tumblr.com/7603ac0dca8a876294eb3b17b26156b3/tumblr_nl4jvtMfN81s9dnijo1_1280.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://41.media.tumblr.com/7603ac0dca8a876294eb3b17b26156b3/tumblr_nl4jvtMfN81s9dnijo1_1280.jpg" height="180" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image courtesy of the<a href="http://whitehouse.tumblr.com/post/113474477248/big-news-were-hosting-the-5th-annual-white-house" target="_blank"> Official White House Tumblr</a></td></tr>
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<br />
While some presidents have taken a marked interest in science (some recent examples: <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1011403/" target="_blank">G. H. W. Bush's "Decade of the Brain"</a>, and <a href="https://www.whitehouse.gov/science-fair" target="_blank">Obama's White House Science Faire</a>), most of their actual involvement comes in the form of spewing talking points prior to being elected. How many US presidents have championed scientific innovation and research initiatives? Science has never really been on the forefront of any presidency since the moon landing. <br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://www.aaas.org/sites/default/files/Budget_1.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://www.aaas.org/sites/default/files/Budget_1.jpg" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">"R&D as a Percent of the Total Federal Budget, 1962-2016" via the American Association for the Advancement of Science (AAAS), May 2015</td></tr>
</tbody></table>
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Think about how political attitudes about science directly affect the public. The 10th anniversary of Hurricane Katrina was just a couple of months ago. Its estimated that the hurricane and flooding killed over 1,830 people and caused over $108 billion in damage. Scientists continually warn about the increasing severity of future storms and weather conditions, rising temperatures and pH changes in the ocean, and major reductions in natural resources. While no one could have anticipated the number of fatalities or the severity of the damages brought on by Hurricane Katrina, government initiatives to protect communities from future natural disasters (like, planning and response measures, zoning to recognize emergency response for <i>all</i> <i>communities</i>, etc.) may be more successful if scientists were acknowledged and involved. Instead, Senator Ted Cruz, the chairman of the United States Senate Commerce Subcommittee on Space, Science and Competitiveness, is a science denier.<br />
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Scientists and medical professionals have worked tirelessly to eradicate many diseases in the US and around the world, through the development of vaccinations and therapeautics with increased effectiveness, lasting power, and fewer side effects. Government agencies have been directly involved in funding and spearheading such initiatives. Unfortunately, some presidential candidates (whether we consider them serious or not), have decided that the subject of vaccinations are now appropriate debate material (I'm looking at you, Donald Trump, an idiot, and BEN CARSON, a retired neurosurgeon).<br />
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There's <a href="http://www.cnn.com/2015/09/17/opinions/graham-cnn-debate/" target="_blank">a clip in this article that shows the specific section of the republican debate where vaccines come up</a>. Ben Carson and Donald Trump will actively talk about vaccines, but refuse to even acknowledge an important question from the moderator: "as president, you will be in charge of the Centers for Disease Control and the National Institutes of Health, both of which say you are wrong. How will you handle this situation as president?"<br />
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Meanwhile, <a href="http://www.healthmap.org/site/diseasedaily/article/why-223-cases-polio-still-matter-4313" target="_blank">polio is still an issue in some parts of the world</a>, among other serious diseases that are preventable by vaccination. <br />
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You'll also notice, if you watch that clip (and others featuring Trump talking about vaccines), that Trump is also great about reinforcing stigma around disease. Sometimes, he's blatant about it, like when he said this about ebola patients:<br />
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<a href="http://4.bp.blogspot.com/-UhggHN_fjYI/Vg9UeGBPcNI/AAAAAAAAAsU/B8peEptAbII/s1600/donnyt.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="185" src="http://4.bp.blogspot.com/-UhggHN_fjYI/Vg9UeGBPcNI/AAAAAAAAAsU/B8peEptAbII/s320/donnyt.jpg" width="320" /></a></div>
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Other times, he's sneaky about it. During the debate, he said that "beautiful babies" are injected with huge amounts of vaccinations ("it's meant for a horse", he says, describing the supposedly cartoon-sized syringe that would never actually be used on children), and then goes on to say that the child eventually (1 week later) develops autism. Sure, no one wants their child to develop autism or any disorder, developmental or otherwise. But its clear from Trumps wording that he wouldn't consider a child with a disability as beautiful. <br />
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With the fiscal year ending, <a href="http://www.reuters.com/article/2015/09/30/us-usa-plannedparenthood-idUSKCN0RU2QJ20150930" target="_blank">the House of Representatives has repeatedly voted on a measure to "defund" Planned Parenthood</a>. Speaking of an issue that directly affects the all people in the US, women's health issues are always debated by presidential candidates.<a href="http://www.washingtonpost.com/news/the-fix/wp/2015/08/04/how-planned-parenthood-actually-uses-its-federal-funding/" target="_blank"> Even though federal funds totaling $528.4 million went to Planned Parenthood in the 2013-2014 fiscal year, the organization is not allowed to use federal funds to provide abortion services.</a> So, by removing federal funding, 96% of the medical services Planned Parenthood provides, such as STD testing and treatment, contraceptive prescriptions and education, cancer screenings, routine check ups and gynecological exams, and prevention services, would be severely reduced. Yet, not eliminated entirely. In the 2013-2014 fiscal year, only 41% of Planned Parenthood's funding came from federal sources (through standard MediCal reimbursements, etc.). I wont go into how these services, regardless of how you feel about abortion (which only makes up 3% of Planned Parenthood's procedures), have an influence on the health and overall quality of life for many people -- not just women, not just low-income communities, and not just sexually active teens. <br />
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By the way, <a href="http://www.theatlantic.com/national/archive/2015/10/planned-parenthood-arson/408511/" target="_blank">a Planned Parenthood clinic in Thousand Oaks, CA was set on fire this week. </a><br />
<br />So, while you listen to presidential candidates ramp up their campaign circuits, and recycle talking points that don't actually address any of the serious questions asked of them, think about where science and medicine fall into play. What do these issues actually mean for the future of the American economy? How do politicians navigate these issues for the American public? Just think about it. underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com0tag:blogger.com,1999:blog-4847283425287985916.post-85648690016510025072015-08-30T12:20:00.001-07:002015-08-30T12:20:33.379-07:00Jail-house CoughWhen the world of somewhat rare infectious diseases collides with prison and inmate issues, it causes an uproar of excitement in my house. Education and advocacy are large themes in my marriage. It's obvious that STEM education is my driving force, but my husband focuses his efforts on issues associated with significantly skewed stigma and underrepresented topics, such as advocacy for mental health patients and inmates. He actually teaches a class on prison issues at UC Berkeley, and leads a volunteer group that takes UC Berkeley students into San Quentin Prison to tutor inmates that are working towards obtaining a GED. Its not uncommon that he will have to cancel volunteer shifts due to prison-wide lockdowns (most often due to fog), but Thursday night's lockdown had us talking.<br />
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As I've mentioned before, prisons are an epidemiological hotbed for infectious diseases. Sticking a large number of people in small, confined communal living quarters with inadequate medical care is one of the fastest ways to allow diseases to spread. So, hearing that the lockdown on Thursday and Friday were due to the potential spread of disease, we were not alarmed. When we heard <a href="http://www.nbcbayarea.com/news/local/San-Quentin-Prison-Officials-Confirm-Legionnaires-Disease-in-1-Prisoner-323245341.html" target="_blank">it was Legionnaires' Disease and that one case had been confirmed with 30 other inmates presenting symptoms</a>, we were surprised.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-atoSZRz2wNc/VeNFzYL3gxI/AAAAAAAAAq8/PM-TdAnz4jo/s1600/l.%2Bpneumophila.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="http://2.bp.blogspot.com/-atoSZRz2wNc/VeNFzYL3gxI/AAAAAAAAAq8/PM-TdAnz4jo/s320/l.%2Bpneumophila.jpg" width="320" />`</a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image from <a href="http://www.primewater.be/legionella-en.html" target="_blank">PrimeWater Membranes</a></td></tr>
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Legionnaires' Disease, or "legionellosis", is a bacterial infection caused by <i>Legionella spp.</i> (most commonly <i>Legionella pneumophila</i>) and leads to the development of atypical pneumonia. Legionnaire's disease is most well known for its debut in 1976, when a<i> L. pneumophila </i>epidemic was traced back to the Philadelphia Convention of the American Legion. More than 30 people died as a result. Yet, <i>L.micdadei</i> had already been isolated from human blood in the mid 1940s. As usual, only a handful of disease nerds care about a disease <i>before</i> an epidemic occurs.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-Pao8VtJXO9I/VeNUeWcprBI/AAAAAAAAArQ/jIoxFykW7RA/s1600/Gorman_and_Feeley.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="250" src="http://2.bp.blogspot.com/-Pao8VtJXO9I/VeNUeWcprBI/AAAAAAAAArQ/jIoxFykW7RA/s320/Gorman_and_Feeley.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">These two, specifically. (Credit: <a href="https://upload.wikimedia.org/wikipedia/commons/8/8e/Gorman_and_Feeley.jpg" target="_blank">Wikipedia</a>)</td></tr>
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Legionnaire's Disease is spread through droplets of water containing the bacteria, especially in warm environment that cause steam and aerosolization, like showers, hot tubs, wet saunas, humidifiers, and faucets.The CDC also lists "decorative fountains" as a potential source, which, I have to admit, made me laugh. I mean, think about all the major hospitals that have massive decorative fountains in their entrance/courtyards! Double threat!<br />
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<i>Legionella spp</i>. have developed a somewhat symbiotic relationship with larger protozoae, such as amoebas, that create large biofilms that can protect the <i>Legionella</i> bacteria. Outbreaks are most common in places that house lots of people for extended periods of time, like hotels, office buildings, retirement homes and convalescent facilities, hospitals, cruise ships, and prisons. <i>Legionella spp.</i> also like to live in wet soils. Despite the dependency on aerosolization for transmission,
Legionnaires' Disease is not spread from person to person. A reservoir,
like water or soil, is required for the transmission of the disease. <br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-qwn8m7JUJm8/VeNVOl5x-bI/AAAAAAAAArY/PabC8DIfRHc/s1600/scientific-info-drinking-water-img4.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="90" src="http://3.bp.blogspot.com/-qwn8m7JUJm8/VeNVOl5x-bI/AAAAAAAAArY/PabC8DIfRHc/s400/scientific-info-drinking-water-img4.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Amoeba engulfing and releasing bacteria. (Via Pall Corp.)</td></tr>
</tbody></table>
If you inhale contaminated water, the bacteria travel through your respiratory tract and into your lungs. This triggers your immune system, and trolling macrophages engulf the bacteria. While engulfing the bacteria through phagocytosis is one method (of many) your immune system uses to identify and destroy invaders, many infectious agents have learned to exploit this mechanism. Once in the macrophage, the bacterium will multiply, causing tons of bacterial cells to explode out of the macrophage and continue spreading the infection throughout your tissues.<br />
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While your body is working to fight off the rapidly replicating <i>Legionella</i> bacteria, you'll start to experience symptoms, such as fever, chills, and a cough. Depending on the severity of your infection, you can cough up blood, sputum, or a combination of the two. Chest pains are common, and some people can also experience diarrhea and vomiting. A combination of chest x-rays and bacterial culturing will land you with a diagnosis of Legionnaires' Disease. Since this is mostly rare form of pneumonia, it is incredibly important to get an accurate diagnosis. Since Legionnaires' Disease is caused by a bacterial infection, there are specific antibiotics that can be used to treat your infection. As always, when left untreated, the disease will get significantly worse, and may be fatal. Pneumonia is a significant cause of death for those who have compromised immune systems, and for children without access to medical care.<br />
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So, San Quentin Prison has shut off their water supply (with the exclusion of toilets, that have now been deemed okay), but this still raises the question of how extensive the contamination is. If only one person was affected, it may have been an isolated incident from an isolated source. Yet, with 30 potential patients, this is a larger issue that most likely stems from the prison's water source.<br />
<br />underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com0tag:blogger.com,1999:blog-4847283425287985916.post-80551399095438312192015-07-19T18:40:00.004-07:002015-07-19T19:21:28.759-07:00Gendered STEM Stereotypes <table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-tChEGvkKTF4/Vaw0B9vweTI/AAAAAAAAApI/ZLHh21FPtNY/s1600/pri%2Blaura%2Bgrover%2Bcartoon.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="232" src="http://4.bp.blogspot.com/-tChEGvkKTF4/Vaw0B9vweTI/AAAAAAAAApI/ZLHh21FPtNY/s320/pri%2Blaura%2Bgrover%2Bcartoon.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Cartoon credit: Laura Grover via <a href="http://www.pri.org/" target="_blank">Public Radio International</a></td></tr>
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I saw this on my facebook feed the other day, and at first I thought, "oh, just another cartoon about gender gaps and recruiting women and girls into STEM fields..."<br />
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But, then I realized that a) my disenchanted reaction is a result from the overwhelming amount of media attention that has been dedicated to the subject of women in science lately (always?), and b) this cartoon pissed me off. In the 5+ years that I've been running this blog, I've maybe covered 3 political topics because that's not my main goal. There are enough blogs out there that overlap personal opinions and science or STEM (science, technology, engineering, and math) topics, and really, who cares? But I'm going to talk about the issues of gender in science today, because there are some issues that aren't being discussed by most popular news and media outlets.<br />
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Let's address each of my reactions separately, shall we?<br />
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<b>a) My disenchanted reaction due to the overwhelming amount of media attention that has been dedicated to women in science:</b><br />
Everyone is eager to tell you that women are underrepresented in STEM fields. In a lot of places, women are still treated as diversity hires. There are societies for women in science, scholarships given to encourage young women to major in STEM degrees, organizations to help young girls find the path to STEM careers, and <a href="http://www.google.com/doodles/marie-curies-144th-birthday" target="_blank">Google doodles dedicated to Marie Curie</a>.<br />
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I think people love to believe that women are minorities in STEM because everyone hates statistics. I know, I am not a fan of statistics (exception: when you work super hard on some statistical analysis and get really satisfying results), but I can break some recent statistics down for everyone:<br />
<br />
According to <a href="https://s3.amazonaws.com/s3.documentcloud.org/documents/1350163/women_education_workforce.pdf" target="_blank">this economic briefing</a> released in October of 2014 by the Council of Economic Advisers to the President of the United States, women are <a href="http://www.usnews.com/news/blogs/data-mine/2014/10/31/women-more-likely-to-graduate-college-but-still-earn-less-than-men" target="_blank">"now more likely than men to earn a bachelors degree and attend graduate school"</a>.<br />
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In fact, women 25-34 years old were 21% more likely to graduate from college than men, and 48% more likely to attend graduate school.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-cqx3sUqpDG0/Vaw8x-fC8OI/AAAAAAAAApc/cqLmcFwXf14/s1600/women1-graphicUS2014.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="238" src="http://3.bp.blogspot.com/-cqx3sUqpDG0/Vaw8x-fC8OI/AAAAAAAAApc/cqLmcFwXf14/s320/women1-graphicUS2014.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image credit: <a href="http://www.usnews.com/news/blogs/data-mine/2014/10/31/women-more-likely-to-graduate-college-but-still-earn-less-than-men" target="_blank">US News</a></td><td class="tr-caption" style="text-align: center;"></td><td class="tr-caption" style="text-align: center;"></td><td class="tr-caption" style="text-align: center;"></td><td class="tr-caption" style="text-align: center;"></td><td class="tr-caption" style="text-align: center;"></td></tr>
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Speaking of minority populations, I'm happy to report that this trend of women being more likely to attend college and graduate with an undergraduate degree <a href="http://www.pewresearch.org/fact-tank/2014/03/06/womens-college-enrollment-gains-leave-men-behind/" target="_blank">has been shown across Hispanic, Black, Asian, and Caucasian populations</a>.<br />
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Statistics associated with women obtaining degrees in STEM fields are EVEN BETTER, according to an NSF study released this year. <a href="http://www.nsf.gov/statistics/2015/nsf15311/digest/theme2.cfm" target="_blank">According to the report</a>:<br />
<blockquote class="tr_bq">
"<b>Women have earned 57% of all bachelor's degrees and about half of all
science and engineering (S&E) bachelor's degrees since the late
1990s</b>. However, women's level of participation in S&E fields varies,
and within fields it tends to be consistent over every degree level. In
most fields, the proportion of degrees awarded to women has risen since
1993. The proportion of women is lowest in engineering, computer
sciences, and physics. Women earn about one-third of the doctorates in
economics and slightly more than one-fourth of doctorates in mathematics
and statistics."</blockquote>
I'm curious, would you have guessed that women earn approximately half of the science and engineering undegraduate degrees conferred in the US?<br />
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My point is HELLO WE ARE HERE. WE ARE DOING SCIENCE RIGHT NOW. Women are represented in STEM fields. We are in the lab, in the field, in the workshop, in space, published in leading scientific journals, on computers, on advisory boards, at conferences, and in classrooms and lecture halls. Quite frankly, every time an article comes out about the need to recruit women into STEM, a young girl gets discouraged and decides that science hates women.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-9zw1AOkrIFM/VaxRUWMh0fI/AAAAAAAAApw/DHGCZ67g2mI/s1600/ella_tyree.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://2.bp.blogspot.com/-9zw1AOkrIFM/VaxRUWMh0fI/AAAAAAAAApw/DHGCZ67g2mI/s400/ella_tyree.jpg" width="338" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Ella Tyree, image credit: <a href="http://cliotropic.org/blog/2010/03/early-african-american-women-in-math-science/" target="_blank">cliotropic</a></td></tr>
</tbody></table>
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Also, every time an article comes out about the need to recruit women into STEM careers, someone of an actually underrepresented population in STEM fields loses hope. Example: <br />
<blockquote class="tr_bq">
Despite considerable progress over the past two decades, <b>the gap
in educational attainment separating underrepresented minorities from
whites and Asians remains wide</b>. In general, underrepresented minorities
are less likely than whites and Asians to graduate from high school,
enroll in college, and earn a college degree. Among underrepresented
minorities who do graduate from college, the overall degree patterns are
similar to those of whites. Asians are more likely than whites and
underrepresented minorities to earn a college degree in a science and
engineering (S&E) field. Although whites' share of S&E degrees
has declined over the past 2 decades, they continue to earn a majority
of degrees in all broad S&E fields.</blockquote>
This example is from the same NSF survey cited above. When I worked for NASA, I worked in a building that was full of white men and women. There were a ton of women (in fact, our lab was 75% women!), but I can't say that I ever interacted with any Black or Hispanic researchers, primary investigators, or division chiefs. When I started working at Stanford, I went weeks until I saw a black person on campus -- not just my building, but on the entire campus. I have other examples, but they all seem redundant. I attended a college where Black students were the majority, yet the halls of the science buildings were mostly white.<br />
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If you really want to continue talking about women in science, maybe our attention should be diverted from recruiting and instead, focus on fixing the anti-women culture that surrounds STEM fields. Actually, we shouldn't be recruiting women into fields where a majority of them feel they need to leave because they are repeatedly sexually harassed or verbally discredited. Its not sustainable, and its not safe. We shouldn't have to laugh at things like the #distractinglysexy hashtag. We should laugh because we can laugh at ourselves, not because its an uncomfortable situation that no one really wants to talk about.<br />
<br />
<br />
<b>b) The above cartoon pissed me off.</b><br />
When I was a young girl, I played with barbies and cabbage patch dolls. I acted out my ridiculous dreams by "playing Ninja Turtles" with my best friend, a young boy that lived across the street. I was a gymnast and I loved birds. I built furniture while listening to AC/DC with my dad. My favorite color was purple, not pink. As a teen, I found punk rock and would go into mosh pits. I wore men's pants one day and a mini skirt the next. I played water polo on a co-ed team and drew anatomically-correct cadavers in art class. I loved math until I hated it. I helped one of my high school boyfriends work on his '72 chevelle malibu and drove it more than he did. I shaved my legs and armpits, or I didn't. I dyed my hair every color imaginable. I dressed like a pin-up girl sometimes, and other times I'd be mistaken for a man (well, a young man).<br />
<br />
I wasn't a stereotypical girl, but to be honest, I don't know many women who ever followed a stereotypical path. Maybe that's because the roles and actions expected of women have changed rapidly with each decade, thanks to our ever growing ability to collectively stand up for the things we don't like. But, really, what does feminine mean anymore? Does it mean pink? Does it mean being a mom? Does it mean working, not working? Does it mean wearing skirts and high heels all the time? Does it mean feeling bad about yourself and your body, or living by the rules of magazines like Cosmopolitan, or any other magazine that's actually owned and funded by a group of men?<br />
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I'm going to have to say I don't actually know, but I do know that my heart didn't always lead me to science. I found it eventually, but I wasn't actively recruited. Science found me. I think that's what really makes me mad about cartoon above, actually. I did like dolls (and no, I never ripped the heads off of any of my barbies), and I also liked to do fun things. I liked to do things that made me feel smart, and challenged what I understood about the world. Science is about exploration, and when you are young, so is playing with dolls! I like science because its gross and beautiful at the same time, which is oddly how being a women makes me feel most of the time. <br />
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The cartoon really makes me mad because I don't see the point in trying to emphasize gender in science. It's an issue if you are harboring an unsafe culture full of harassment, but it shouldn't be an issue when recruiting kids into science. We're hearing about more kids deciding to transition between genders, and who is to say what they'll be interested in doing as adults? No one, because its 2015 and your gender shouldn't define what you can and cannot do.<br />
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If we educate girls and boys and everyone in between on an equal level, then people will find their own path. We shouldn't be forcing science, but showing everyone why it is awesome and for everyone. Saying women who aren't stereotypically feminine are better suited for careers in STEM is like saying you have to be quirky, rude, and somewhere "on the spectrum" to be a scientist (like the Big Bang Theory leads many people to believe). Also, can we please talk about other women in science instead of only praising Marie Curie all the time? Yes, she was great, but <a href="http://www.smithsonianmag.com/science-nature/ten-historic-female-scientists-you-should-know-84028788/?no-ist" target="_blank">other women in STEM were/are great too</a>.<br />
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I currently work in a lab with two other women. Both of them wear lipstick and dresses all the time. I don't ever, unless its required of me. One of them loves the color pink so much that I ordered her a hot pink ice bucket and tube racks for the lab. She also has a PhD. We both bleach our hair. At NASA, our analytical chemist was (is still) a mom, a runner, and someone who volunteers with her church every weekend. Another chemist at NASA, a researcher with her PhD, looked like a Puerto Rican version of Taylor Swift and ruled everything just the same. Just because I have tattoos, and choose to wear jeans and no makeup every day doesn't mean I'm more or less qualified to be a scientist than any of these other women, or any of the men in STEM fields either. <br />
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We all attack our lives differently, and our interests or career choices shouldn't have anything to do with the gender we prefer for ourselves. What should matter is what you bring to the table, or the lab, or the field, or the operating room, or wherever it is that you want to work. Science isn't (always) about putting things in boxes, it's about discovering what makes things unique. <br />
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and that's all I have to say about that. <br />
<br />underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com0tag:blogger.com,1999:blog-4847283425287985916.post-3103607174925149292015-07-07T09:51:00.001-07:002015-07-07T09:51:07.175-07:00Cat! Scratch! Fever! bowwnownow wowww<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-TKuNrjbRtX8/VZvxQ_DrxzI/AAAAAAAAAn0/92zrwbaXsq8/s1600/IMG_2872.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="300" src="http://1.bp.blogspot.com/-TKuNrjbRtX8/VZvxQ_DrxzI/AAAAAAAAAn0/92zrwbaXsq8/s400/IMG_2872.JPG" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Sunset and moon over the Atacama desert (photo by me)</td></tr>
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I apologize for missing my June update, but I was traveling through Chile. I have to admit, I didn't know <i>that much</i> about Chile before going there. The famous government coup occurred before I was born, and wasn't "resolved" until I was 4. High school history classes in the US don't really pay any attention to Chile whatsoever.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-bm1Px0FZl4o/VZvxNZm430I/AAAAAAAAAnc/ji14D9tHSLQ/s1600/IMG_2740.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="300" src="http://1.bp.blogspot.com/-bm1Px0FZl4o/VZvxNZm430I/AAAAAAAAAnc/ji14D9tHSLQ/s400/IMG_2740.JPG" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Lincanbur volcano (left) and desert vegitation (photo by me)</td></tr>
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My itinerary centered around the northern regions of Chile, specifically the Atacama desert. The Atacama desert is the driest desert in the world, and is known for its abundance of copper and lapiz lazuli, a rare blue stone that you can really only get in Chile and Afghanistan. The Atacama desert is also a great place for meteorites, because the super dry atmosphere preserves them in their natural "space-state" (scientific term), and the flat neutrally-colored desert make them easy to find.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-RWpaw1F3gqQ/VZvxRF6kJ0I/AAAAAAAAAno/UhBUuK-jmOk/s1600/IMG_2849.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="300" src="http://2.bp.blogspot.com/-RWpaw1F3gqQ/VZvxRF6kJ0I/AAAAAAAAAno/UhBUuK-jmOk/s400/IMG_2849.JPG" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Valle de la Muerte (photo by me)</td></tr>
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Disease-wise, Chile's had pretty excellent luck compared to its
neighbors of the South American continent. Of course, after booking my
flights, the first thing I did was hit the books (err..internet) to look
for diseases in Chile. Its winter there right now, so mosquitoes and other disease-spreading
insects aren't really an issue until the warm months return. Actually, the Atacama desert environment isn't all that great for mosquitoes, since it's dry and at a higher altitude than they generally enjoy. Sandflies, on the other hand, are the perfect candidates to spread certain infections.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-ma1qZfVgcZY/VZv0ZI2xoHI/AAAAAAAAAoE/ktqsAELicy4/s1600/lutzomyiasf.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://3.bp.blogspot.com/-ma1qZfVgcZY/VZv0ZI2xoHI/AAAAAAAAAoE/ktqsAELicy4/s1600/lutzomyiasf.jpg" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><i>Lutzomyia </i>genus Sandfly, responsible for transmitting Bartonellosis and Leishmaniasis.</td></tr>
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Bartonellosis is an disease caused by <i>Bartonella baciliformis</i>, and has many manifestations. Oroya Fever, also known as <a href="https://www.blogger.com/null" title="Carrion's disease">Carrión's disease</a>, is mainly found in Peru, Ecuador and Columbia, but with vector migration, movement and spread of the disease is possible. Some travel books about Chile have warnings about Bartonellosis when traveling to the north.<br />
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Oroya Fever occurs when <i>B. baciliformis</i> infects endothelial cells and red blood cells. Acute phase (Carrión's disease) occurs when the infection persists in the bloodstream, causing sustained fever, malaise, hepatomegaly, jaundice, lymphadenopathy, splenomegaly, and severe hemolytic anemia. Fatality rates are high, up to 40% of patients, when acute phase infections go untreated. Risks of fatality increases dramatically by the presence of opportunistic infections, specifically by <i>Salmonella </i>species, as a result of transient immunosuppression. <br />
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Chronic phase, or "Verruga Peruana" or "Peruvian Warts", is an eruptive phase that occurs when endothelial cells are involved. In addition to fever, malaise, arthralgias (joint pain), myalgias (muscle pain), lymphadeopathy (lymph node involvement), hepatomegaly (enlarged liver), and splenomegaly (enlarged spleen), patients develop a
cutaneus rash produced by a proliferation of endothelial cells.The cutaneous rash involves raised lesions that can rupture and bleed. <br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><img border="0" src="http://www.scielo.org.pe/img/revistas/amp/v31n1/a06fig02.jpg" height="320" width="303" /> <span id="goog_1235471234"></span><span id="goog_1235471235"></span></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Illustration of verruga peruana from 1926, via <a href="http://www.scielo.org.pe/scielo.php?pid=S1728-59172014000100006&script=sci_arttext" target="_blank">Sci ELO Peru</a></td><td class="tr-caption" style="text-align: center;"></td></tr>
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-EGwV2IVoxN0/VZv8f8Fuw5I/AAAAAAAAAoc/_G7rvJRjcWY/s1600/VerrugaChild.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="http://3.bp.blogspot.com/-EGwV2IVoxN0/VZv8f8Fuw5I/AAAAAAAAAoc/_G7rvJRjcWY/s320/VerrugaChild.jpg" width="211" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Verruga peruana on a child</td></tr>
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Cat Scratch Disease, also known as "Cat Scratch Fever", on the other hand, occurs worldwide, and is caused by <i>Bartonella henselae</i>. I couldn't help thinking of Ted Nugent while writing this post. I like to think <a href="https://www.youtube.com/watch?v=nW8S58CYQqs" target="_blank">this song</a> is about Bartonellosis.<br />
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Cat Scratch Disease is usually spread by fleas and ticks. Cats, being the scrappy beings that they are, can develop an immunity after being exposed at a young age. Dogs present severe symptoms. Humans are susceptible to Cat Scratch Disease infection if they are scratched by an infected cat or bitten by a flea or tick carrying <i>B. henselae</i>. Antibiotics can successful treat Bartonellosis.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-n4cze2GqD3E/VZwAS_V0e3I/AAAAAAAAAoo/iTx4mpTRO5Y/s1600/bartcats.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="243" src="http://4.bp.blogspot.com/-n4cze2GqD3E/VZwAS_V0e3I/AAAAAAAAAoo/iTx4mpTRO5Y/s320/bartcats.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image "borrowed" from <a href="http://www.galaxydx.com/web/2013/medical-webinars-on-bartonella-infection/" target="_blank">Galaxy Diagnostics Webinars</a></td><td class="tr-caption" style="text-align: center;"></td><td class="tr-caption" style="text-align: center;"><br /></td><td class="tr-caption" style="text-align: center;"><br /></td><td class="tr-caption" style="text-align: center;"><br /></td></tr>
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While I was in Chile, I discovered the abundance of stray animals that inhabit every city. It was really shocking and sad, especially to see so many stray dogs in urban cities. Santiago and San Pedro de Atacama had primarily stray dogs, while Valparaiso had some stray dogs and a TON of stray cats (that could have been outdoor pets without collars...but...). <a href="http://www.economist.com/news/americas/21603436-state-orders-sterilisation-stray-mutts-spay-you-go" target="_blank">This article from last year claims there are initiatives for mass sterilization of stray dogs</a> to help stop the growth of homeless dog populations in Santiago, but there weren't any signs of progress when I visited last week.<br />
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That's all I have for you today. Check back in a few weeks for a new update (I'm going to do two for July since I skimped out on my blogging responsibilities in lieu of vacation!).<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-GXFdrYjDs4A/VZvxQ5OOOZI/AAAAAAAAAn4/GDpUIyIcIB4/s1600/IMG_2833.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="300" src="http://3.bp.blogspot.com/-GXFdrYjDs4A/VZvxQ5OOOZI/AAAAAAAAAn4/GDpUIyIcIB4/s400/IMG_2833.JPG" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Valle de la Luna (photo by me)</td></tr>
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<br />underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com0tag:blogger.com,1999:blog-4847283425287985916.post-90842282811400058502015-05-16T14:35:00.000-07:002015-05-16T14:35:04.997-07:00Sentenced to Death by SporesOne of the things I find most irritating about social media is that a lot of people post articles that they either didn't read before linking to them, or when you see them in person, they can't have a follow up conversation about the subject matter. If we aren't exploiting the hyperaccessibility of information with which the internet has graced us, then what's the point? (Don't get me wrong, I love videos of cute animals, too.)<br />
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The hot topic this week that was really reminiscent of this personal irritation of mine was the sentencing of <a href="http://www.nytimes.com/2015/05/16/us/dzhokhar-tsarnaev-death-sentence.html?_r=0" target="_blank">Dzhokhar Tsarnaev</a> for his role in bombing the 2013 Boston Marathon finish line. Tsarnaev, only 21, was given the death penalty.<br />
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As you can imagine, the internet started to stir with articles about the history of the death penalty in the U.S., and infographics about how the U.S. is the only developed country that still uses the death penalty. I'll admit, the people I associate with tend to lean towards a specific side on the political scale, so I didn't really see anyone posting relief or word art of "JUSTICE" in red, white, and blue. I didn't really go looking for it either.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-ZRbfJpWncPI/VVeumMipc1I/AAAAAAAAAlc/WN6iw6zmvtY/s1600/justice-american-eagle-flag.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="320" src="http://3.bp.blogspot.com/-ZRbfJpWncPI/VVeumMipc1I/AAAAAAAAAlc/WN6iw6zmvtY/s320/justice-american-eagle-flag.jpg" width="277" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">I couldn't find any word art, but this is clearly the next best thing. Thank you, internet.</td></tr>
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I did see a lot of people posting about the broader concept of execution, whether or not it is moral, or representative of justice. Obviously an age-old issue that I'm not really going to discuss in this blog. But, I will ask: if you post these articles, is that enough? I mean, especially for an issue like this, where someone's life is at stake. Is it ok to say you are pro-choice, but to never donate to a clinic that provides full-scale reproductive health services? Are you standing up for what you believe in if you say you love children and want them all to be happy and healthy, but refuse to vaccinate your own child?<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://www.newyorker.com/wp-content/uploads/2014/01/140120_a17976-600.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://www.newyorker.com/wp-content/uploads/2014/01/140120_a17976-600.jpg" height="221" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image courtesy of <a href="http://www.newyorker.com/wp-content/uploads/2014/01/140120_a17976-600.jpg" target="_blank">The New Yorker</a></td></tr>
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I'll admit, standing up for the rights of incarcerated people can be a tricky subject, especially if you don't live near a prison (there are a lot of them, but they tend to usually be in the middle of nowhere), or if you have no knowledge of the legal issues involved. Our society is very quiet when it comes to talking about prisoners, regardless of their sentencing current. But so many of these issues that communities are so polarized about have to do with life versus death. <br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://api.ning.com/files/Ltz8IQUQkiLoeyhFG2iqZZwkVjfV8lXPwSZ0ptlvjLHJzBK142qrZksmAWedBjQLb*Yukcu6mUU57GcUWDnkHNUrYENF5a7y/CaliforniaPrisonsexhibitc.jpg?width=500" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://api.ning.com/files/Ltz8IQUQkiLoeyhFG2iqZZwkVjfV8lXPwSZ0ptlvjLHJzBK142qrZksmAWedBjQLb*Yukcu6mUU57GcUWDnkHNUrYENF5a7y/CaliforniaPrisonsexhibitc.jpg?width=500" height="289" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Photo courtesy of <a href="http://www.afropunk.com/profiles/blogs/feature-manifestjustice-art-exhibit-in-los-angeles" target="_blank">Afro Punk</a> and their coverage of the <a href="http://manifestjustice.org/" target="_blank">#ManifestJustice exhibit</a>.</td></tr>
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The prison system is a weird in-between. Are you really still living life in prison? Even if you are sentenced to death, you usually aren't executed the very next day, either. I know, you're probably thinking "why is she writing about this? what does this have to do with disease at all?"<br />
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The answer to that is EVERYTHING. Most people don't think about how diseases spread rapidly through the prison system, just like they do with agricultural livestock and in refugee camps. Any environment with a lot of living beings in small, enclosed spaces is a hotbed for communicable diseases. Also, many prisons have inadequate health care and clinics to properly serve all of the inmates accordingly.<br />
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There's one infectious disease that specifically targets incarcerated people that hasn't received enough attention as it should (I wonder why...): <b>Coccidioidomycosis</b>.<br />
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Coccidioidomycosis, or "<a href="http://www.cdc.gov/fungal/diseases/coccidioidomycosis/definition.html" target="_blank">Valley Fever</a>", is a fungal infection that is really tricky to diagnose, and is often fatal because of that fact. <i>Coccidioides immitis, </i>the causative agent for Coccidioidomycosis, is a soil fungus that loves warm, dry climates because it's spores can be carried far distances by the wind. It's usually found in the southwestern U.S., Mexico, and some parts of South America.<br />
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<i>C. immitis</i> spores are carried from dry soil patches, through the air and dust, making it really easy to inhale. Most people inhale these spores and never have any complications or present any symptoms. This is most likely because they were exposed to small amounts of spores that weren't successful at mounting an infection, but it was enough exposure for their immune systems to recognize the treat and prepare a response for future exposures. Some people may also have <a href="http://www.ncbi.nlm.nih.gov/pubmed/10338499" target="_blank">genes that influence their resistance to Coccidioidomycosis</a>.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-WRRqlcdF-YI/VVezavur4sI/AAAAAAAAAmE/TsRV4pWQQRQ/s1600/sphercocimmitis.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="209" src="http://1.bp.blogspot.com/-WRRqlcdF-YI/VVezavur4sI/AAAAAAAAAmE/TsRV4pWQQRQ/s320/sphercocimmitis.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Spherules of <i>C. immitis</i>, courtesy of <a href="http://www.scpr.org/news/2015/01/11/49218/california-spends-5m-to-screen-inmates-for-valley/" target="_blank">University of Utah School of Medicine</a>.</td></tr>
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<a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3702223/" target="_blank">But some people aren't as lucky.</a> People who have compromised immune systems (HIV/AIDS, autoimmune disease, organ recipients, etc.), people with diabetes, and people who are Black or Filipino are at higher risk for successful infection with complications. <a href="http://www.npr.org/sections/health-shots/2013/05/13/181880987/cases-of-mysterious-valley-fever-rise-in-american-southwest" target="_blank">Children are at risk, too.</a><br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-qxMSkaeihTM/VVewh30khgI/AAAAAAAAAlw/qfUFr484nM0/s1600/cimmitus%2Borgan.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="219" src="http://1.bp.blogspot.com/-qxMSkaeihTM/VVewh30khgI/AAAAAAAAAlw/qfUFr484nM0/s320/cimmitus%2Borgan.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Pulmonary Cavitary Lesions caused by chronic <i>C. immitis</i> infection. Image courtesy of <a href="http://path.upmc.edu/cases/case211/dx.html" target="_blank">University of Pittsburgh Department of Pathology</a>.</td></tr>
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Symptoms are almost always non-specific, including fatigue, cough, fever, headaches, night sweats, shortness of breath, muscle and joint pain, and rash. Yet, 5-10% of people have severe symptoms, wherein the develop long term respiratory problems due to high fungalemia (which means there's a ton of fungus in your lungs). Approximately 1% of Coccidioidomycosis cases spread to other organ systems, including the central nervous system. This can cause seizures, coma, or death.<br />
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Treatment for Coccidioidomycosis involves antifungal medication and symptom-specific management to help ease the illness and stop the spread to other organ systems. As always, treatment depends on how severe the infection is, and what organ systems it is affecting. <br />
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There is a huge problem with inmates getting Coccidioidomysis and not getting proper treatment. Many <a href="http://www.sacbee.com/news/politics-government/article2605061.html" target="_blank">lawsuits have been filed against the California prison system</a> specifically, because many inmates in the 18+ prisons in the Bakersfield area have contracted Coccidioidomysis, many of which were misdiagnosed or not given proper treatment. California has even <a href="http://www.scpr.org/news/2015/01/11/49218/california-spends-5m-to-screen-inmates-for-valley/" target="_blank">dedicated funding to routine inmate screening</a> for Valley Fever.<br />
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The dedicated funds for screening came as a result of the lawsuits and the inmates' families advocating for better care. When I say advocating, I'm referring to writing letters to their elected government officials, working with prison system administrators, and encouraging doctors and wardens to listen to the inmates that they care for as a part of their jobs (that are paid for with state taxes)... not posting about it on facebook, per say. <br />
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If you want to read a long, drawn out story about Valley Fever, <a href="http://www.newyorker.com/magazine/2014/01/20/death-dust" target="_blank">the New York Times published one </a>about a year and a half ago. They even hyphenate "Valley Fever", which is cute?<br />
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If you think about a lot of the controversial issues we are constantly arguing about in the U.S., they can all be linked to health and disease in some way. Access to adequate housing reduces the spread of seasonal infections, some parasitic infections, and bacterial infections. Access to proper sanitation reduces the spread of countless infections. Access to education can help limit the spread of all diseases, because sometimes we aren't aware of the risks we are subjecting ourselves to, or ones that may be avoided with some extra steps (hand washing, condom usage, etc.). Access to reproductive rights can help people detect infections or other diseases and get the treatment they need. These are only a few.<br />
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What issues are you passionate about?underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com0tag:blogger.com,1999:blog-4847283425287985916.post-85406292217046316392015-04-19T18:17:00.002-07:002015-04-19T18:17:59.796-07:00Get the Rift of itLast Friday, I was showing some of the work I've done to my fellow Stanford School of Medicine Pediatrics Department-ites, and no one had heard of the virus I've been working with lately, so I decided to turn it into a blog post!<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-1-k7z-qkhJc/VTRTpkxMd_I/AAAAAAAAAk0/xTbU-WX8kkA/s1600/rfvfpost.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://3.bp.blogspot.com/-1-k7z-qkhJc/VTRTpkxMd_I/AAAAAAAAAk0/xTbU-WX8kkA/s1600/rfvfpost.jpg" height="242" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Heyyyyyy.</td></tr>
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Since I've only been with my lab for a short time, I started working on a project that wouldn't take a lot of time to complete (you know, to prove myself to my lab -- "look, I've already finished a project!", ha!) before sinking my metaphorical teeth into some more substantial work. Luckily, it's turned into something I can present and publish.<br />
<br />
So, let's talk about Rift Valley Fever!<br />
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The Great Rift Valley is a massive crack in the earth's crust (a.k.a. - "rift") that basically splits Kenya in two, from north to south. Rumor has it that the Great Rift Valley was discovered by a woman, but no one believed her.<br />
<br />
In 1910, Kenya's Rift Valley region started seeing cases of pregnant livestock spontaneously aborting their offspring. This disease was the start of a long history with <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111045/" target="_blank">Rift Valley Fever Virus (RVFV)</a>, a <i>Phlebovirus</i> of the <i>Bunyaviridae</i> family. RVFV was eventually identified as a zoonotic agent, infecting people with contact with infected livestock. Mosquitoes were eventually identified as the vector for RVFV when incidence spiked after rainy seasons, as flooding increases potential breeding areas for mosquitoes.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-bRJIEPhr5Qw/VTROcsSU6CI/AAAAAAAAAkg/0fXu0h2lzS4/s1600/cows-in-park.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://3.bp.blogspot.com/-bRJIEPhr5Qw/VTROcsSU6CI/AAAAAAAAAkg/0fXu0h2lzS4/s1600/cows-in-park.jpg" height="214" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Cows in Kenya - photo from <a href="http://baraza.wildlifedirect.org/2009/08/11/kenyan-drought-cattle-invade-parks/" target="_blank">Wildlife Direct</a></td></tr>
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RVFV infections has been restricted to the African continent, primarily in western Africa, with a small outbreak reported in Egypt in 1977. In 2000, an RVFV outbreak was reported in Saudi Arabia and Yemen. The spread is usually a result of trading infected livestock and/or climate conditions that support the migration of mosquito populations.<br />
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<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.who.int/csr/disease/riftvalleyfev/Global_RVF_20090908.png?ua=1" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://www.who.int/csr/disease/riftvalleyfev/Global_RVF_20090908.png?ua=1" height="267" width="400" /></a></div>
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RVFV is an enveloped, single-stranded RNA virus. The RVFV genome is divided into 3 segments of differing sizes (small, medium, and large), all of which are circularized. Host cells targeted during infection include macrophages, hepatocytes, and endothelial cells.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-dNMMVxdfmzo/VTRSUytPLgI/AAAAAAAAAks/bXRM9c2-tyE/s1600/rvfv3d.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://2.bp.blogspot.com/-dNMMVxdfmzo/VTRSUytPLgI/AAAAAAAAAks/bXRM9c2-tyE/s1600/rvfv3d.jpg" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">A computer modeled 3D structure of RVFV - image from<a href="http://www.ndm.ox.ac.uk/principal-investigators/researcher/juha-huiskonen" target="_blank"> Dr. Juha Huiskonen</a></td></tr>
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Pathophysiology of RVFV in humans includes the standard headache, high fever, weakness, back pain, fatigue, and dizziness. Most people with these flu-like symptoms recover in about a week, and that's it. In severe cases, though, patients can develop encephalitis, retinitis, and hemorrhagic fever.<br />
<br />
Given the severe affects on livestock reproductive viability, RVFV outbreaks can have devastating affects on the economy. Not only can you lose a large amount of your livestock population through death of the infected animal, and future generations by abortion, but once infected animals are identified, you are banned from trading livestock for an extended period of time. This process has been very effective in containing RVFV to the continent, but not all infected animals present symptoms prior to trade or breeding. With a large enough outbreak, severe economic collapse could follow.<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-mhvyLa_JbKA/VTRNlirMrmI/AAAAAAAAAkY/kcl-dc8Idzk/s1600/riftvalleyfetus.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://1.bp.blogspot.com/-mhvyLa_JbKA/VTRNlirMrmI/AAAAAAAAAkY/kcl-dc8Idzk/s1600/riftvalleyfetus.jpg" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">An unfortunate casualty - Image from<a href="http://www.the-travel-doctor.com/" target="_blank"> The Travel Doctor</a></td></tr>
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There is a <a href="http://www.ars.usda.gov/research/projects/projects.htm?accn_no=422108" target="_blank">vaccine </a>available to herders, but it can also cause the vaccinated animal to spontaneously abort developing offspring, although at a lower rate. Yet, it's difficult to convince herders to vaccinate their animals if they are (maybe) damned if they do and (likely) damned if they don't. There are also <a href="http://www.ars.usda.gov/is/pr/2007/070216.htm" target="_blank">models that have successfully predicted RVFV outbreaks</a> in the past.<br />
<br />
The United States Department of Agriculture (USDA) has listed RVFV as a major threat to the U.S. because of the large economic dependency we have on livestock. Even though the virus has only started to leave Africa, the U.S. does have the vectors to support spread to North America. underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com0tag:blogger.com,1999:blog-4847283425287985916.post-81112821624980784492015-03-21T15:42:00.003-07:002015-03-23T08:24:35.409-07:00Taenia solium and the leaky brain cystFor <a href="http://thevegansweetbeat.blogspot.com/" target="_blank">my other blog</a> (warning: not a scientific blog), I wrote a little thing about why Spring is one of my favorite seasons (I mean, second to Autumn of course!) because it brings an abundance of cute baby animals to the world. One of my absolute favorites is the pig! Domesticated, wild, big, small, it doesn't matter.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://i.dailymail.co.uk/i/pix/2013/11/17/article-2508856-19775C2E00000578-847_634x241.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://i.dailymail.co.uk/i/pix/2013/11/17/article-2508856-19775C2E00000578-847_634x241.jpg" height="151" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image from<a href="http://www.dailymail.co.uk/news/article-2508856/Thats-tired-mum-Daisy-sow-gives-birth-27-piglets-just-months-including-litter-16.html" target="_blank"> Daily Mail</a>.</td></tr>
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So, in honor of all the piglets being born this season, let's talk about a classic parasite with some new research twists. <i>Taenia solium</i> is a type of tapeworm that is specifically linked to pigs. <i>T. solium</i> is related to the "beef tapeworm of man" (<i>Taenia saginatum, </i>tapeworm associated with cows), but can cause some much more severe symptoms. <br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-jBvpa6MWgvM/VQ3XysnUBFI/AAAAAAAAAik/uNOE_vG3bxg/s1600/Tsaginata%2BSEM%2Bscolex.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://4.bp.blogspot.com/-jBvpa6MWgvM/VQ3XysnUBFI/AAAAAAAAAik/uNOE_vG3bxg/s1600/Tsaginata%2BSEM%2Bscolex.jpg" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><i>T. saginatum</i> scolex imaged using electron microscopy. Image taken from<a href="http://www.phsource.us/PH/HELM/PH_Parasites/taeniasis.htm" target="_blank"> the internet</a>.</td></tr>
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<i>T. saginatum</i>, the beef worm, is what everyone thinks of when they think "tapeworm": adult worms have a head, neck, and proglottids, and causes intestinal obstruction and discomfort. Oh, and it can live inside of you for up to 25 years!<br />
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In order to get your own tapeworm infection, all you have to do is consume poorly cooked beef which contains <i>T. saginatum</i> eggs. When the eggs "hatch", oncospheres (infective larva) migrate to the small intestine, where they will take 3 months to mature into an adult worm. Adult worms are typically 2 to 10 meters in length. Usually only one worm is found, unless you've consumed a heavily contaminated piece of meat or ate fecal matter that's full of gravid proglottids (the end pieces of the tapeworm). Fun fact: eggs can survive for months once they've left the body. Beware of old poop!<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-fgEInlbkorA/VQ3oN6hdJuI/AAAAAAAAAjA/6LhuFqBdcpw/s1600/taenia_lifecycle.gif" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://3.bp.blogspot.com/-fgEInlbkorA/VQ3oN6hdJuI/AAAAAAAAAjA/6LhuFqBdcpw/s1600/taenia_lifecycle.gif" height="315" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Taeniasis life cycle for T. saginatum and T. solium, via the CDC</td></tr>
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Patients infected with a beef tapeworm (clinically described as "Taeniasis") may complain of non-specific abdominal symptoms, such as nausea, general pain and discomfort, or weight fluctuations. I say weight fluctuations because most people experience extreme weight loss (often misdiagnosed as anorexia), especially those affected in developing countries (where these parasites are most prevalent), but there have been a number of people who have infected themselves, by choice, and have reported it being "no big deal" or that they gained weight (see my favorite example: <a href="http://www.bbc.com/news/science-environment-25968755" target="_blank">Michael Mosley of the BBC News</a>). So, while most people experience weight loss, I suppose you could say that depends on your socioeconomic status, and whether or not you've had a choice to become infected.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-y3IRCFPNFKE/VQ3obiMSH6I/AAAAAAAAAjI/owyp1fKea-0/s1600/tsolium%2Blife%2Bcycle.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://2.bp.blogspot.com/-y3IRCFPNFKE/VQ3obiMSH6I/AAAAAAAAAjI/owyp1fKea-0/s1600/tsolium%2Blife%2Bcycle.jpg" height="320" width="210" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">T. solium life cycle from the <a href="http://www.fao.org/docrep/003/t0756e/t0756e05.htm" target="_blank">Food and Agriculture Organization of the United Nations (fao.org)</a></td></tr>
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<i>T. solium</i> can also cause all the same intestinal symptoms, and can live out a life cycle similar to that of <i>T. saginatum</i>. But, in some cases, <i>T. solium</i> can cause something called Neurocysticercosis (cue scary music). <i>T. solium</i>'s life cycle and pathophysiology usually looks very similar to that of <i>T. saginatum</i>, only with smaller worms (4-7 meters in length). Neurocysticercosis occurs when you've ingested the eggs directly, such as ingesting contaminated feces. This happens to pigs when their food is contaminated with human feces (pretty ironic, right?).<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-JVtbncggGuU/VQ3pUoC9ZPI/AAAAAAAAAjQ/B2lGeFytXqM/s1600/tsolium%2Bscoliex.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://2.bp.blogspot.com/-JVtbncggGuU/VQ3pUoC9ZPI/AAAAAAAAAjQ/B2lGeFytXqM/s1600/tsolium%2Bscoliex.jpg" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">T. solium scolex. Image from<a href="http://www.facmed.unam.mx/deptos/microbiologia/parasitologia/taeniosis.html" target="_blank"> UNAM</a>.</td></tr>
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The consumed eggs hatch in the small intestines and the oncospheres are released. Oncospheres penetrate the intestinal mucosa and make their way to the blood. Once in the blood, they travel throughout the body and migrate to different tissues, where they will mature into cysticeri. The cysticeri really like skeletal and cardiac muscle, subcutaneous tissue, and lungs, but they can also get lodged in the central nervous system (CNS), including the brain and the cerebral ventricles. Once the cysticeri have chosen a tissue which to lodge themselves, they become calcified granulomas.<br />
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<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-df7hJit6uXo/VQ3qOWT9X3I/AAAAAAAAAjY/hPnd5ryyQ7k/s1600/tsolium_escolex.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://1.bp.blogspot.com/-df7hJit6uXo/VQ3qOWT9X3I/AAAAAAAAAjY/hPnd5ryyQ7k/s1600/tsolium_escolex.jpg" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">T. solium adhering to the epithelial cells of the intestine. Image from<a href="http://www.facmed.unam.mx/deptos/microbiologia/parasitologia/taeniosis.html" target="_blank"> UNAM</a>.</td></tr>
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The most common location for cysticercosis to occur is the cerebral hemispheres, at the gray-white matter junction, but they can also be found in the cerebellum, the brainstem, the subarachnoid space, the basal cisterns, and the spine.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-K-NXL4tQWI8/VQ3rsGfWhxI/AAAAAAAAAjg/aMswZk7YucE/s1600/brainTsolium%2Bcysts.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://1.bp.blogspot.com/-K-NXL4tQWI8/VQ3rsGfWhxI/AAAAAAAAAjg/aMswZk7YucE/s1600/brainTsolium%2Bcysts.jpg" height="181" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">T. solium cysts in a human brain. Image from <a href="http://discovermagazine.com/2012/jun/03-hidden-epidemic-tapeworms-in-the-brain" target="_blank">Discover Magazine</a>.</td></tr>
</tbody></table>
Obviously, having a 1-2 cm cyst calcifying in your brain will cause some damage. Neurocysticercosis is one of the leading causes of epilepsy in developing countries. It can also cause severe headaches, hydrocephaly and eosinophilic meningitis. <br />
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The <a href="http://www.niaid.nih.gov/topics/tropicalDiseases/Pages/neurocyst.aspx" target="_blank">National Institute of Allergy and Infectious Disease (NIAID) just released an article</a> about the treatment-induced inflammatory response in pigs with neurocysticercosis. The current treatment of Praziquantel is apparently causing inflammation, blood vessel leakage, and damage to the blood-brain barrier. This means that new drugs need to be developed that can reduce inflammation at the site of the cyst(s) while maintaining the integrity and functionality of the blood-brain barrier and blood vessels. <br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-PA-viLLxuJU/VQ3l4ujfkpI/AAAAAAAAAi0/wcLczlXXkmg/s1600/BrainNCC.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://1.bp.blogspot.com/-PA-viLLxuJU/VQ3l4ujfkpI/AAAAAAAAAi0/wcLczlXXkmg/s1600/BrainNCC.jpg" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span id="ctl00_formatCtrl1">Photo of the surface of the brain of a pig
treated with the antiparasitic drug praziquantel showing blue-dyed (blue
arrows) and clear (white arrows) cysts. The blue dye indicates
disruptions in the blood-brain barrier. Image from <a href="http://www.niaid.nih.gov/topics/tropicalDiseases/Pages/neurocyst.aspx" target="_blank">NIAID/</a></span><a href="http://www.niaid.nih.gov/topics/tropicalDiseases/Pages/neurocyst.aspx" target="_blank"><br /></a><span id="ctl00_formatCtrl1"><a href="http://www.niaid.nih.gov/topics/tropicalDiseases/Pages/neurocyst.aspx" target="_blank">Dr. Cristina Guerra-Giraldez</a>.</span></td></tr>
</tbody></table>
This research only focuses on pig subjects, and has not yet been performed on humans infected with neurocysticercosis. <br />
<br />
<br />
Want to avoid tapeworms and neurocysticercosis? The best way to do that is either to avoid eating meat, or to make sure your meat is cooked properly. Cooking meat properly is the best way to inactivate or kill most infectious diseases associated with meat consumption.<br />
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One of the major reasons diseases are so rampant in livestock is because a lot of treatments (mainly antibiotics) are used as prophylactics instead of at the onset of infection and symptom presentation. Animals that are raised in small, confined areas are more likely to be exposed to illnesses. When you are raising animals on a large scale and rely on them for income (whether through livestock trade, meat or dairy production), it can be really scary when one of your animals gets an infection, because you risk losing some of your income. It's obviously unethical to sell/trade sick animals, but it happens all the time, and is one of the main causes for the spread of disease to other regions. When prophylactic treatments are used, resistant infections are more likely to occur, which is an even larger problem (as I'm sure you can imagine).<br />
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Even if the meat you consume came from a healthy cow/pig/lamb/goat/chicken/turkey/etc., it might have been slaughtered in the same environment as a sick animal, which still puts you at risk. So, if you have a tendency to order your meat "rare", be sure you know the risks associated with that choice.<br />
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<i>Edited to add:</i><br />
I want to be clear that, even though I'm vegan, I believe choosing to be vegan is a very personal choice and no one should ever be bullied in to it. But, I also feel the need to add some information about the environmental impacts of eating meat to this post, since we are talking about risks associated with consuming meat. Considering the risks to yourself is very important, so you can actively minimize your risk of getting an infection or other serious health disparity (mostly through the long-term, excessive meat consumption), but considering the long-term risks for the environment (ie- everyone on earth) is also really important. Here are some articles that you might want to consider reading before making a definitive decision about your dietary habits:<br />
<br />
<div class="entry-title">
<a href="http://science.time.com/2013/12/16/the-triple-whopper-environmental-impact-of-global-meat-production/" target="_blank">The Triple Whopper Environmental Impact of Global Meat Production: TIME</a></div>
<div class="entry-title">
<br /></div>
<div class="entry-title">
<a href="http://www.scientificamerican.com/article/meat-and-environment/" target="_blank">How does meat in the diet take an environmental toll?: Scientific American</a></div>
<div class="entry-title">
<br /></div>
<div class="entry-title">
<a href="http://www.theguardian.com/environment/2014/jul/21/giving-up-beef-reduce-carbon-footprint-more-than-cars" target="_blank">Giving up beef will reduce carbon footprint more than cars, says expert: The Guardian</a></div>
<br />
<a href="http://www.earthsave.org/environment/water.htm" target="_blank">2500 gallons all wet?: EarthSave</a><br />
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<br />underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com1tag:blogger.com,1999:blog-4847283425287985916.post-46839771462236971592015-02-28T17:01:00.002-08:002015-02-28T17:01:54.220-08:00ToxoplasmosisI was inspired to write this entry because I have a number of friends who have recently crossed over into that place in your life where you suddenly want tons of kids. Some of them have just recently birthed their first child (congrats to you), and some are just starting to feel that warm glow of constant nausea that will stick with them for the next few months. This is an awkward time for me, personally, because I fall into the category of "never, no, not interested" when it comes to babies. I've always kind of been that way, and yes, I fully acknowledge that my feelings <i>could </i>change in the future. I also want to point out that it would be fine if my feelings didn't change, because it's not an obligation that all women have (to have children, that is). I should also say that I like kids, and I think that they are amazing little creatures.<br />
<br />
I wanted to bring this up for two reasons:<br />
1. being pregnant has to do with the parasite I'm going to discuss later in this post, and<br />
2. the Washington Post published <a href="http://www.washingtonpost.com/news/energy-environment/wp/2015/02/27/the-rock-star-female-scientist-who-put-shark-research-on-the-map/?tid=sm_tw" target="_blank">an article about Eugenie Clark</a>, who just passed away on Wednesday. The article is a great little summary of her life, but this is one of the most important parts (in my opinion):<br />
<blockquote class="tr_bq">
"Professors at Columbia University told her it would be a waste of their
time to admit her to their graduate program because she’d end up as a
housewife..."</blockquote>
Granted, this was in the 50s, but it struck me to see that so boldly stated. I've had mentors make comments like that to me within the last FIVE YEARS. While it's really important to state that women like Eugenie Clark have paved the way for women scientists, we still have a lot of work to do. I've had a lot of really incredible mentors, but it's hard to move past comments that one or two bad apples may have made, especially in such early and exploratory years of my career. If we strip away all the statistics about women and minority populations in science/STEM, we can still come to the same conclusion about comments that assumingly discourage someone from doing what they want to do with their lives: it's mean. It's really mean to do that to another human being, no matter what population they do or do not fit into.<br />
<br />
I know that was more into my personal life that I usually divulge, but that article really inspired me.<br />
<br />
So, back to my friends and their pregnancies!<br />
A majority of my friends that are getting pregnant/having babies also have cats. I know, I know, you know where I'm going with this because its old news and everyone should already know about it. Well, not everyone does.<br />
<i><br /></i>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-dTYjbr1dmUM/VPJdt1AmXEI/AAAAAAAAAhc/3PIb8L4MLiE/s1600/Toxoplasma-gondii.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://4.bp.blogspot.com/-dTYjbr1dmUM/VPJdt1AmXEI/AAAAAAAAAhc/3PIb8L4MLiE/s1600/Toxoplasma-gondii.jpg" height="184" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Toxoplasma gondii. Image from <a href="http://phenomena.nationalgeographic.com/2013/04/26/mind-bending-parasite-permanently-quells-cat-fear-in-mice/" target="_blank">National Geographi</a>c.</td></tr>
</tbody></table>
<i><br /></i>
<i>Toxoplasma gondii </i>is a parasite that can infect all warm-blooded animals and birds (as intermediate hosts), but is primarily centered around the definitive host: cats. Actually, over 200 mammalian species can act as an intermediate host for <i>T. gondii</i>, which makes the prevalence in humans pretty high.<br />
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As you can see below in this terrifyingly hilarious life cycle image (thanks, internet), the life cycle of <i>T. gondii </i>(sexual development) is completed in the intestines of a cat (even if it is a cross-eyed Halloween caricature of a cat like the one in this image).<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-zbdInPdsMKE/VPJc5z1uNZI/AAAAAAAAAhU/cMiLsVztUJ0/s1600/toxogondii%2Blife%2Bcycle.gif" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://2.bp.blogspot.com/-zbdInPdsMKE/VPJc5z1uNZI/AAAAAAAAAhU/cMiLsVztUJ0/s1600/toxogondii%2Blife%2Bcycle.gif" height="340" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image discovered somewhere online, although I couldn't find a clear source which to give credit. Sorry.</td></tr>
</tbody></table>
Infection in humans is usually asymptomatic, meaning a non-infective (dormant, non-pathogenic) stage of <i>T. gondii</i> could be in you right now, and for most of your life without you even knowing! Most infections are triggered by a state of immunodeficiency. There have been some studies that have looked at the possible correlation between <i>T. gondii</i> infection and schizophrenia (a few years ago, you may have seen a bunch of sarcastic articles about how your cat is trying to control your mind, etc.). If you do develop acute Toxoplasmosis, you'll usually only experience non-specific symptoms, such as malaise, fever, and other flu-like symptoms that can resolve themselves within a few weeks or months. A lot of times, Toxoplasmosis isn't diagnosed correctly because proper diagnosis is really dependent on the organ system that is infected (heart, eyes, brain, etc.), and depends on the pathology lab to identify the organism in your tissue samples. <br />
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The biggest issue with Toxoplasmosis comes when you are pregnant, because it can cause spontaneous abortion, or if you carry to term, can be passed congenitally causing hydrocephaly, mental retardation, cerebral calcification, and chorioretinitis.<br />
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If you are pregnant and have an indoor/outdoor cat that uses a litter box in your house, I'd suggest avoiding any contact with it for the time being. You can be exposed to infectious fecal particles while emptying the litter box, that can be ingested accidentally. I'm not really sure why you wouldn't wash your hands thoroughly after handling an animals wastes, but that might be another thing you'd want to start doing, especially now that you are pregnant and all.<br />
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Another fun thing about <i>T. gondii</i> is that you can become infected through organ transplantation! Organ recipients can get Toxoplasmosis from the new organ, or from self-activation (if you've already been infected with a dormant, non-pathogenic stage, but go into immunodeficiency after surgery). This is pretty rare, but it is possible.<br />
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Here's a picture of my cat, Milo (aka "Beef"), who usually helps me write these blog posts, and made it known that she does not appreciate this particular entry.<br />
underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com2tag:blogger.com,1999:blog-4847283425287985916.post-29085596305144211522015-01-25T13:10:00.004-08:002015-01-25T13:10:51.165-08:00A two'ferJanuary: the peak of flu season, the aftermath of the holidays, and my birthday month. To celebrate all of those things, you get a two'fer today. Two subjects, one post. <br />
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Before I dive in to my two topics for today, I wanted to remind you that the Ebola outbreak is, unfortunately, still going strong. Just because the news no longer finds it new, doesn't mean it's over. Just because someone made "Ebola patient" Halloween costumes and oh, Halloween was so long ago, doesn't mean it's over (also, you should be ashamed of yourself if you donned that, or any version of that costume). As of yesterday, the outbreak has killed more than 8,600 people. I encourage you to stay informed via the <a href="http://www.healthmap.org/ebola/#timeline" target="_blank">Ebola Map</a>.<br />
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Anyway...back to our regularly scheduled program:<br />
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Let's play GUESS THE DISEASE!<br />
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In 1757, a Scottish physician by the name of Francis Home proved that ___________ was caused by an infectious agent in the blood of afflicted patients.<br />
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In 1912, __________ became a "nationally notifiable" disease in the US, meaning that all health care workers were required to report all cases, as approximately 6,000 deaths were caused by _________ per year.<br />
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In the 1950s, nearly all children got __________ by the time they were fifteen years of age, causing scientists and the federal government scrambling to find a solution. In 1963, a vaccine was finally available. Thanks to the development and approval of the vaccine, the US government aimed to eradicate _________ by 1982. While this didn't completely happen, cases were decreased by 80% from 1980 to 1981.<br />
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In 2000, _________ was declared eliminated in the US.<br />
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Have you figured it out yet? Better yet, have you <i>caught it</i>, yet? (haha I'm so funny)<br />
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Still stumped? Here's one last hint:<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-oNox1wx_Bi8/VMVG_zy8X1I/AAAAAAAAAgo/WNNBGE4VL4I/s1600/measles.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://4.bp.blogspot.com/-oNox1wx_Bi8/VMVG_zy8X1I/AAAAAAAAAgo/WNNBGE4VL4I/s1600/measles.jpg" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Photo courtesy of the <a href="http://cdc.gov/" target="_blank">Centers for Disease Control and Prevention</a></td></tr>
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It's Measles! The famous <i>Morbillivirus</i> is back in a big way, and is<a href="http://www.cdph.ca.gov/Pages/NR15-008.aspx" target="_blank"> running rampant at one of the happiest places on earth</a>. Measles (or Rubeola) is a highly contagious negative-sense single strand RNA virus of the paramyxoviridae family that is illustrated by symptoms in the respiratory tract, skin, and immune system. The obvious rash (seen above) is often accompanied by a hacking cough, <a href="http://www.nlm.nih.gov/medlineplus/ency/imagepages/2558.htm" target="_blank">Koplik's spots</a>, red eyes, and high fever. Measles is an airborne virus and is dependent on aerosolization (coughing, sneezing) in order to spread properly. The virus can "live" in aerosolized droplets for up to two hours on a surface. Assuming there are no complications, measles usually runs its course in about 7 to 10 days (like a gross case of the flu).<br />
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So, why do we care? Why was the US government in a rush to eradicate such a disease?<br />
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Measles is really prominent in children, and children usually don't have an immune system that can withstand stubborn viruses with a history. A lot of children (actually one out of every 20 kids infected) end up developing pneumonia as a result of a measles infection, which is actually the leading cause of death from measles in young children. About one out of every 1,000 children that are exposed to measles can develop encephalitis, which can cause permanent brain damage due to excess swelling. Ear infections associated with measles (affecting 10% of infected kids) can result in permanent hearing loss.<br />
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It's estimated that over <a href="http://www.travelandleisure.com/articles/worlds-most-visited-tourist-attractions/16" target="_blank">16 million people visit Disneyland every year</a>, with attendance fluctuations based on holidays and common school schedules (like summer break). <b>That's almost 45,000 people PER DAY</b> in a place were everyone is touching everything from handrails to harnesses, from interactive displays to the bric-a-brac in all of the shops.<br />
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In the latest measles outbreak, that officials are saying started at Disneyland, a handful of employees were also infected. I bet a lot of those employees were vaccinated as children, but since Disney hires people from around the world (I say this as a fact that I applaud because everyone should be able to live out their dream of working at Disneyland... and because I desperately want to be Maleficent), I bet a good chunk of their employees didn't grow up in areas that enforce strict vaccination requirements for school-aged kids. Vaccination requirements vary by state, by country, and some are better enforced than others. Plus, school-based vaccination requirements don't usually include home-schooled kids. <br />
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I'm not going to launch into some diatribe on how I feel about vaccinations (I'm sure you know already if you read my blog regularly), but I will say that the MMR vaccine (that's Measles, Mumps, and Rubella in a combination vaccine) has lead to a 99% reduction in infections, compared to the pre-vaccine era (prior to 1963). If you aren't sure about your vaccine history, I heavily encourage you to go get an <a href="http://www.nlm.nih.gov/medlineplus/ency/article/003333.htm" target="_blank">Antibody Titer Test</a> done. A titer will tell you what antibodies you have the ability to produce, whether from vaccines or direct exposure, and will tell you which ones your body isn't able to currently make, meaning you haven't been exposed, or you need an additional vaccination or booster. Not only could this simple test save your life, but it could also save the lives of others that may not be able to fight off diseases. If you're vaccinated, it's like saying "Hey disease! You'll have to get through me first before you can infect this baby, that old lady, or that person with a compromised immune system. OH WAIT, YOU CAN'T!"...and suddenly you're a hero.<br />
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I also want to remind you that its not just Disneyland, and its not just measles. Think about how many people you encounter every day, and how many people your family members encounter. Who knows what you've touched! I take the bus every day to work, and I can't tell if it's making my immune system stronger, or taking years off of my life.<br />
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Speaking of taking the bus, here's your second subject!!<br />
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I've been reading a lot since I've started taking the bus to work. I mean, reading for fun. This is the first time in probably 20 years that I've really had time to read for fun, to read for ME, and I love it. In fact, I've already finished my first book of the year, and while it wasn't science-related, there were some topics that really interested me.<br />
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The book I just recently finished (because I seriously couldn't put it down) was <a href="http://www.amazon.com/Unbroken-World-Survival-Resilience-Redemption/dp/0812974492" target="_blank">Unbroken by Laura Hillenbrand</a>, which details the life of Louis Zamperini and his experiences during World War II. It is heartbreaking and amazing. I cried multiple times on the bus while reading this book (what, Zamperini reminded me a lot of my late grandfather, so it was extra emotional for me).<br />
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I won't spoil the book, but there are a number of chapters that talk about the life of American and Allied men that were caught and held as POWs in Japan. One of the most prominent health issues that was seen in these camps was beriberi. Beriberi is an illness that occurs as a result of severe thiamine (vitamin B1) deficiency, without infectious agent, and presents in two ways: wet beriberi and dry beriberi.<br />
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Wet beriberi affects the cardiovascular system, causing shortness of breath, increased heart rate, and swelling of lower extremities. Dry beriberi, or Wernicke-Korsakoff syndrome, affects the nervous system, and can cause loss of feeling, paralysis, difficulty walking, mental confusion, strange eye movements, pain and vomiting. Both wet and dry beriberi can become severe very quickly, and can lead to permanent damage and death. <br />
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Thiamine deficiency is common in developing countries, especially regions with restricted access to food due to war, severe economic conditions, and environmental conditions that make it difficult to grow or access food. I bring this up because it's easy to read a book like Unbroken, and think about beriberi as an issue that only hurt POWs during WWII, because you stop hearing about it once you finish the book. I encourage you, as you read books or whatever you're looking a online, to do further research and teach yourself something new. LeVar Burton would be proud of you.<br />
<br />underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com0tag:blogger.com,1999:blog-4847283425287985916.post-58058526481176286812014-12-01T20:28:00.001-08:002014-12-01T20:28:45.191-08:00World AIDS Day 2014<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-5peFtq8soFQ/VH04Nuw0EPI/AAAAAAAAAf4/5Hu-4YHnxXY/s1600/Library_WAD_poster_web.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://3.bp.blogspot.com/-5peFtq8soFQ/VH04Nuw0EPI/AAAAAAAAAf4/5Hu-4YHnxXY/s1600/Library_WAD_poster_web.jpg" height="400" width="258" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">World AIDS Day 2014 Poster from CDC.gov</td></tr>
</tbody></table>
This morning I scrolled through the last few years of entries on this blog, looking for a World AIDS Day post to which to link. I then realized that I am lazy and less empowered than my younger self. My whole world used to be consumed by HIV, so to speak.<br />
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While in high school, I learned that one of my most honored relatives was HIV positive, and I instantly changed my path to learn everything about the unknown. They didn't stress how scary this virus can be, and usually is, while I was young. It was a monster from the 80s that wasn't scary anymore, which is entirely inaccurate (well, not the 80s part). All of the sudden, someone I knew had been infected, and by the time I went to college, that number had exploded.<br />
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I ran the free HIV testing clinic in college, and advocated for a better educated, a more empowered sexually active youth culture. I volunteered and then later worked for Planned Parenthood, and supported every client without judgement. As a health educator, I taught college freshman, whom had never had any exposure to sex ed, about the basics: everything from basic anatomy, dispelling menstruation myth, STIs, etc. I even researched HIV for my graduate thesis. There was a time in my life where I felt like I was talking about HIV every day. But people still weren't concerned.<br />
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<a href="http://www.cdc.gov/vitalsigns/HIV-AIDS-medical-care/" target="_blank">New statistics</a>
show that only 4 out of 10 people in the US who are infected in HIV in
2011 were receiving HIV-specific medical care (meaning regular
monitoring, access to medication, viral suppression, etc.).
Approximately 3 in 10 people with HIV in the US had achieved viral
suppression, which is a critical factor in continuing to live and thrive
with the infection. According to the CDC, 76% of people who receive HIV medical care achieve viral suppression. That means 46% (yes, almost half) of people with HIV in the US either don't have access to adequate care, don't know about it, don't know that they have HIV, or are refusing care. I shouldn't have to point out that these are only statistics for the US, and access to care on a global scale is much worse. <br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-3zkV19PMPgM/VH0_R0J6DuI/AAAAAAAAAgI/HkHOGXgN058/s1600/infographic_570px.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://2.bp.blogspot.com/-3zkV19PMPgM/VH0_R0J6DuI/AAAAAAAAAgI/HkHOGXgN058/s1600/infographic_570px.jpg" height="400" width="308" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">via CDC.gov</td></tr>
</tbody></table>
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Now that I've made my way back into my field (after my 3 year stint with NASA), I find myself getting really frustrated and feeling really helpless about HIV. It wasn't until this year that I realized how distanced I've become. Honestly, I'm a little embarrassed, because this is such an important topic for me.<br />
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So, I'm going to strive to reinvent my commitment to advocating for patients, for access to care, for continued funding, and for access to real education. We need to be frank about this subject, because it's not going away anytime soon. As far as I'm concerned, we probably wont find a cure within the next 10 years (as some people are claiming), and even if we do, the focus needs to shift to continuing to support those who are infected, and those who are at risk of becoming infected.<br />
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Even though World AIDS Day is coming to an end for this year, make it a point to start talking about HIV, and get empowered to <a href="https://gettested.cdc.gov/" target="_blank">get tested regularly</a>. Use the resources that are available in your community, and learn how you can protect yourself. AIDS is everywhere, and we need to stop pretending that it's a thing of the past.<br />
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<br />underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com0tag:blogger.com,1999:blog-4847283425287985916.post-7856385699721410302014-11-25T20:46:00.001-08:002014-11-25T20:46:23.115-08:002014 Outbreaks: Plague EditionThis is the time of year where you are supposed to feel thankful for all the things you have in your life, whether its family, friends, stability, purpose, faith, or maybe even physical things. But, honestly, this year has been hard to feel truly thankful, scientifically speaking. There's been a lot of distrust, a lot of fear-mongering, and a lot of really terrible journalism that has made people (primarily Americans) really hate any scientist (or doctor, or medical professional) that isn't Neil DeGrasse Tyson. But guess what: we aren't lying to you, and we are doing the best we can to figure things out thoroughly and efficiently. Funding is at an all time low, support for major research is very political, and there is a surplus of newly graduated PhDs that aren't being utilized. Science is simultaneously really hard and really amazing right now.<br />
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Now that I've said all that, we can focus on what's happening right now in science: the plague.<br />
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You may remember learning about the bubonic plague in middle school, when your history classes were covering the middle ages, and it was the perfect time to talk about disease in science class (because let's face it, the middle ages were gross). I'm guessing you learned about it and immediately let yourself forget about it because you figured "well, that's over and done with so I'm safe."<br />
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Surprise! Approximately <a href="http://www.who.int/csr/don/21-november-2014-plague/en/" target="_blank">40 people have died from the plague in Madagascar</a> this month, and there have been approximately 120 cases reported.<br />
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But, look, this isn't shocking. In 2012,<a href="http://microscopicblog.blogspot.com/2012/06/never-gonorrhea.html" target="_blank"> I even wrote about how there was a confirmed plague case in a rodent in Los Angeles</a>. But, it is shocking in the sense that we haven't seen anything near "outbreak" proportions since the middle ages (and you have public health to thank for a majority of that!). <br />
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<i>Yersinia pestis, </i>the bacteria that causes the plague, is most often (not really often, per say) seen in animals, and is rarely transmitted to humans anymore. The middle ages were different, though. Animals (and fleas!) lived in very close quarters with families. Since hygiene wasn't really a fad yet, diseases like the plague would spread incredibly rapidly. In some countries, 50% of the population was wiped out.<br />
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<a href="http://3.bp.blogspot.com/-5sf7sPn_7w8/VHVa0APeTuI/AAAAAAAAAfo/Px5JPW41wlc/s1600/buboes.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/-5sf7sPn_7w8/VHVa0APeTuI/AAAAAAAAAfo/Px5JPW41wlc/s1600/buboes.jpg" height="215" width="320" /></a></div>
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There are three different forms/presentations of the plague:<br />
<ul>
<li>Bubonic plague, which is transmitted by fleas and causes bulbous swelling ("buboes") around the lymph nodes</li>
<li>Pneumonic plague, which is respiratory, and spreads between humans via aerosolization and contact with fluids</li>
<li> Septicemic plague, which is an infection of the blood</li>
</ul>
The bubonic plague can be treated with antibiotics, but pneumonic plague is incredibly deadly. In some incredibly severe cases, it can kill you after only <a href="http://www.nlm.nih.gov/medlineplus/ency/article/000596.htm" target="_blank">1 day of infection</a> (not including the incubation period).<br />I am particularly nostalgic for the plague because it was the first real disease that caught my attention. Not only do I remember becoming completely infatuated with diseases, but I still have the report I wrote about the plague in 7th grade. Maybe if you really hope for it, I'll scan it and post it for you to laugh at. Tis the season for miracles, after all... right?<br />
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So, while you are sitting around, eating ridiculous amounts of food, try to be thankful for the advancements that have been made in science and health. If you have access to potable water and a waste treatment system, then you should be extra thankful. If you've had access to education, whether you've taken advantage of it or not (no judgement either way), then be overjoyed. Think of all the things that have changed since the middle ages, and be thankful.<br />
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<br />underthemicroscopehttp://www.blogger.com/profile/17827816127207787947noreply@blogger.com1