I just saw this during my daily internet browsing. Long story short, it blocks HIV entry into T cells multiple ways. If the virus can’t get into the cell, it cannot further replicate and will die out. I’ll write more about HIV later this week!
Louisiana has some of the highest rates of HIV/AIDS in the United States, both per capita and in total case numbers. A vaccine like this would have drastic effects here, for the better.
First off, my apologies for being so inconsistent with posting since I’ve been back home. Now that school is out there is absolutely no excuse! I’ll be keeping the posts coming as best as I can.
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Rubella has been eradicated from the western hemisphere:
On April 29th, the World Health Organization declared Rubella, known more commonly as German Measles, eradicated from the Americas. What was once a fairly common disease of childhood is no longer in this portion of the world. Rubella virus, if contracted during pregnancy, can have serious complications for both mother and fetus.
Liberia is declared Ebola free following 42 days without any new cases:
On May 9th, the WHO determined that Liberia was free of Ebola. The last reported death from Ebola was on March 27th. Routine vaccinations for other diseases, which had been on halt due to the outbreak, are now proceeding as usual.
Hey… the news isn’t talking about Ebola non-stop 24/7 recently. That means it’s gone away, right?
Definitely not.
While we have been hearing less about Ebola currently than in previous months this Fall, Ebola certainly hasn’t gone away. At the end of 2014, over 20,000 cases of Ebola were reported, with nearly 8,000 fatalities. The current data (as of March 13, 2015) indicate 24,509 cases and over 10,000 deaths. The outbreak has still been very much contained to the three original countries: Sierra Leone, Guinea, and Liberia.
For citizens of these countries, life has been disrupted for many, many months. Children have been unable to go to school, go to to the local healthcare clinic to get vaccinated. This interactive report from NPR documents the physical and emotional hardships Ebola has caused to the heavily-hit village of Barkedu, Liberia. While this report only highlights one area, the story remains the same throughout the region.
While the number of cases may be starting to drop, the aftermath is just beginning. Due to decreased vaccination rates this year (healthcare workers simply couldn’t get there), many officials are concerned for a measles outbreak in these disease-stricken areas. And unlike EBV, measles is spread through aerosol, making it much easier to contract. With gaping holes in measles vaccination, many more children will be susceptible than in previous years. Some reports estimate over 225,000 additional cases and 16,000 deaths because of measles. UNICEF has reported increased malnutrition rates, which can affect the child for the rest of its life.
Speaking of vaccinations, several Ebola treatments and prophylactic measures are in the works. One uses survivors blood to extract Ebola antibodies to give to sick patients, while a vaccine will soon be undergoing wide-scale clinical trials to see if a proper immune response can be generated from the vaccine. The problem with currently facing these clinical trials is fewer cases of Ebola means fewer people can be recruited for testing.
So why have we been seeing less and less coverage about the Ebola outbreak? Has the media turned a blind eye, maintaining an “out of sight, out of mind” mentality? Or is it because we are fighting our own measles outbreak and the news only has room for one viral story at a time? I’m not a sociologist. I can’t answer these questions. But I can tell you that the fight is far from over.
The last thing anyone wants on their well-earned vacation is to become sick. It’s even worse if that illness was entirely preventable. Yet, this is exactly what is happening in Disneyland, to the horror of parents nationwide. While many tend to disregard measles just a virus of childhood, it can lead to life-threatening consequences and death for those who develop complications.
The measles virus (MeV) is a highly infectious, airborne virus. Typical symptoms onset within a few days and include fever, head cold, conjunctivitis (red-eye), and the characteristic spotted red rash that spreads over the entire body. In severe cases, pneumonia and brain inflammation can occur. While no direct treatment for measles exists, it is almost ENTIRELY preventable with proper vaccination.
The measles vaccine is combined with the vaccine for mumps and rubella (MMR) or mumps, rubella, and varicella (MMVR); the first dose is given around 1 year of age. Infants younger than one year are susceptible to contracting the disease and are dependent on the effect of herd immunity to keep them safe.
The US has taken considerable steps to eradicating the measles virus (MeV). A major vaccination program against measles in the 1970’s lead to a considerable decrease in the number of cases. This trend continued for the next two decades. In 2000, measles had been effectively eradicated from the US. This is a major accomplishment and testament to the power of vaccines and public health.
However, measles is still present in other parts of the world, and travelers coming into the US may still carry the virus. When a large enough portion of the population (read: all that are physically able) is vaccinated against the virus, the virus has no where to go and will die out. This is a key concept of herd immunity. Due to the recent trend in some communities against vaccines, the virus has been able to spread like wildfire. This particular outbreak of measles, as well as every other outbreak in the US since 2000, can be linked to unvaccinated individuals being exposed to the virus from an overseas traveller carrying the virus. Even those who have been vaccinated can still contract measles, although at much lower rates. While measles has not been detected in Louisiana yet, it is only a matter of time- 14 other states have reported measles outbreaks.
If you haven’t had your child (or yourself) vaccinated yet, do so! Not only are you protecting your loved ones, you’re protecting everyone around you. The Greater New Orleans Immunization Network provides the vaccine free of charge for those who are eligible. Here is a schedule of sites they will be at in February.
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Sources:
AP Red Book Online Visual Library (www.aap.org)
http://www.cdc.gov/measles/about/signs-symptoms.html
http://www.cdc.gov/measles/about/history.html
http://www.cdc.gov/measles/cases-outbreaks.html
In honor of Ochsner Hospital in New Orleans being recognized as the number one hospital in the nation for liver transplants and the fact that I’m studying Hepatitis C in France, I decided to make a post on the virus that got me interested in virology in the first place. Most recently, Hepatitis C viral treatments have been in the news several times over the past year, mainly focusing around a new drug called Sofosbuvir that has shown a nearly 100% cure rate for those with certain genotypes of HCV. But did you know there are four other types of hepatitis viruses, each functioning in their own special way? With over 500 million people worldwide suffering from a Hepatitis virus, it has become a major public health problem.
There are five different types of viral hepatitis. While initial thinking may lead you to believe that they are all closely related, the truth is far from that.
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Before I dive into the ABC’s of viral hepatitis, I also want to give a few definitions that are frequently used throughout this post.
Kb: Kilobases; the number of base pairs (AT, GC) that the virus has x 1000.
Polyprotein: A large amino acid sequence consisting of many different protein sequences. Once the viral genome is translated by the host cell’s machinery, post-translation modifications cleave the translated polyprotein into different structural and non-structural proteins.
Non-Structural Proteins: Proteins found in the viral genome that are used to help with replication and other viral processes inside the cell, but do not contribute to the shape of the virus.
Structural Proteins: Proteins they surround the viral genome and give the virus its shape. They also can help viruses enter host cells by interacting with surface proteins on the host cell. Think of structural proteins as the “scaffolding” of the virus.
Chronic vs Acute Infection: To summarize, an acute infection is the infection that initially develops after exposure to the virus. A chronic infection is an ongoing infection that lasts six months or longer.
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Hepatitis A Virus
HAV is a non-envelopped, positive sense RNA virus ~7.5kb long. It is a member of the Picornaviridae family. Like other picornaviruses, it is spread through the fecal-oral route. After about 28 days of incubation, those who exhibit symptoms often show signs of jaundice, fever, general malaise, and dark urine, among others. HAV has not been shown to develop into a chronic infection. A vaccine is available against HAV and is often included in normal vaccination schedules.
Hepatits B Virus
HBV is a partially double-stranded DNA virus about 3.2 kb long. Unlike HAV and other RNA viruses, HBV uses a different mechanism to convert make an RNA copy of its genome which the infected host cell then translates. As a member of the Hepadnavirus family, it has high levels of genetic variability. HBV is spread through mucosal contact with bodily fluids or through cuts in the skin exposed to infected bodily fluids. About 25% of all infections will become chronic; HBV is also one of the leading causes of Hepatocellular Carcinoma (HCC) , a form of liver cancer. There are 8 human genotypes of HBV, and three other possible genotypes found in apes. The HBV vaccines protects against all known genotypes.
Hepatitis C Virus
HCV is an enveloped, positive sense RNA virus about 9.6 kb long. Its family Flaviviridae and genus Hepacivirus includes viruses like west nile virus and yellow fever. The seven different genotypes of HCV, the difficulty of studying HCV in vitro and in vivo, and high mutation rate of the virus has made it impossible thus far to develop a vaccine, though developments are underway. While it is an RNA virus like HAV, in most individuals (75-80%) it develops into a chronic infection and can cause HCC like HBV. The current treatment for HCV includes a cocktail of anti-viral drugs designed to inhibit further HCV synthesis. As HCV is spread through contact with infected blood, intravenous drug users are at a high risk for HCV.
Hepatits D Virus
HDV is a negative sense RNA virus about 1.7 kb long. It relies on the HBV viral envelope to form complex in order to assemble and infect. Only about 5% of HBV patients have a HDV co-infection, yet those with HDV are more likely to develop serious liver disease. While no vaccine is available against HDV, HBV vaccination prevents HDV.
Hepatitis E Virus
HEV is a non-enveloped, positive sense RNA virus about 7.2 kb long. Is is spread through the fecal-oral route and causes acute hepatitis. There are four different genotypes of HEV in the Hepeviridae family. While HEV is not much of an issue in the US, it is endemic in many countries around the world. In particular, mortality rates of up to 30% have been cited in pregnant women who contact HEV. No vaccine is currently available, and treatment focuses on relief of symptoms over treating the infection.
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The easiest and most effective ways to avoid viral hepatitis transmission is to follow standard hygiene practices. As with other sexually transmitted diseases, safe sex practices reduce the risk of transmission. Regular STD testing is important, as viral hepatitis can be asymptomatic. Those in healthcare and other high-risk settings are vaccinated against Hepatitis B; the vaccine is available to others who desire it.
The viral hepatitis viruses are not the only viruses that can cause liver inflammation and disease. Cytomegalovirus, Epstein-Barr Virus, Herpes Simplex Virus, and Yellow Fever have all been shown to cause liver inflammation.
Sources:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360271/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3294142/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2517704/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897199/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3782269/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3823334/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3630916/
I often rely on the New York Times to keep me updated on what’s happening at home while I am studying in France. I knew it was time to make another post when the only articles in the US section were on Ebola!
Many people have wondered why they haven’t just “banned all flights from there”. To start, no direct flights from the US to Liberia, Guinea, or Sierra Leone exist. The last direct flight between the US and Liberia was on August 31, 2014. If you don’t believe me, go to any airline search engine and pick a city in the US and either CKY, ROB, or FNA as the final destination. It’ll take you at least two planes to get there. To get to these countries, one must connect through major European hubs such as Paris, London, or Brussels. The feasibility of stopping all flights from three of the worlds busiest airports for an extended period of time is nearly impossible. While many airlines have suspended service through these routes, there are several that still operate.
More Ebola for the US (and other countries too):
Two nurses involved in the care of Mr. Thomas Duncan, the first person in the US to die of Ebola, have contracted Ebola. These are the first cases of Ebola being transmitted in the US. Other healthcare workers volunteering in West Africa have also been receiving treatment in the US, though the healthcare officials in charge of their care have not showed any signs of disease. In Spain, a nurse has died tending to an patient who had contracted Ebola working as a missionary. There are several other countries in Europe who are also caring for Ebola patients.
Louisiana to Refuse Remains of Ebola Patient:
Some personal artifacts of Mr. Thomas Duncan, were scheduled to be disposed of at a hazardous waste facility in Calcasieu Parish. An order to block this transport was issued and has been by the upheld by the state court.
New CDC Guidelines on Protective Measurements for Healthcare Professionals:
Great graphics and videos on the changes to protective wear for healthcare workers. The CDC has recently come under fire for not providing consistent information about what should be worn, and many hospitals are reporting that they have received inconsistent or little additional training on how to properly remove contaminated garments.
Ebola Training Drills in New Orleans:
Staff at the Interim LSU Hospital went through a training exercise as a reminder of how easily germs can spread, even when taking proper precautions. They also have stated that they will be asking every patient will be asked if they have travelled to West Africa.
Over 8,000 cases and 4,000 deaths have been reported as of 10/13/14. The WHO is reporting that there could be up to 10,000 cases a week in West Africa by the end of the year.
Links to remember:
The American Association for the Advancement of Science (AAAS) has given free access to a host of research and news articles related to the Ebola outbreak.
Don’t forget about the CDC’s continual updates on the Ebola outbreak.
Did we put away our iron lungs too quickly? A cousin virus of polio called Enterovirus 68 has been cropping up around the country over the past few months, causing severe respiratory distress, paralysis, and even death in young children. While previous outbreak clusters have been few and far between since the virus was first identified in 1962, this mysterious virus has now appeared in nearly every state. With no vaccine available and the sudden onset of severe symptoms, Enterovirus 68 rightfully induces panic in many parents.
As I said earlier, Enterovirus 68 is a “cousin” virus of the infamous poliovirus responsible for the Polio outbreak of the 1940’s and 1950’s. They are both members of the Enterovirus family of viruses. Other members of this family include Coxsachie viruses A and B, and echoviruses, all which can cause a variety of viral gastrointestinal diseases. All members of the Enterovirus family are single stranded RNA viruses that can easily be replicated by the host cell’s machinery. Unlike other members of the enterovirus family that spread through the fecal-oral route, Enterovirus can also spread through respiratory secretions like saliva, mucus, or sputum (the nasty yellow/green stuff you cough up when you have a cold).
Most enteroviruses, including EV68, only cause mild illness often indistinguishable from a mild cold or general malaise. Although related to polioviruses, enteroviruses are not known to cause polio-like symptoms. What makes EV68 so peculiar is that it can suddenly cause these polio-like symptoms such extreme difficulty breathing (similar to an asthma attack or whooping cough) and partial paralysis. These symptoms have never been seen before in other enterovirus infections, and leaves researchers asking wondering the mechanism and reason behind this. It is unknown whether the paralysis caused by EV68 is permanent or not as it’s too early to tell. At the time of publication, there have been 780 cases reported, including at least two cases in East Baton Rouge Parish, and four deaths.
As with other enteroviruses, EV68 mainly affects children, though there have been cases of adults with EV68 as well. Children with asthma appear to be most at risk. While no specific treatment or vaccine exists for EV68, standard hygiene practices are advised keep the virus from further spreading. These include washing your hands frequently and covering your mouth before coughing or sneezing. If only this could be done to keep our abysmal football seasons from getting worse…
Additional sources:
http://www.cdc.gov/non-polio-enterovirus/about/ev-d68.html
http://health.heraldtribune.com/2014/10/14/enterovirus-68-evolving-serious-threat/
I can’t keep these posts coming fast enough! It seems that all we see and hear on the news is Ebola, Ebola, Ebola. Here are some of the highlights of what has happened in the past week.
First case of Ebola in the US in Dallas, Texas:
The man had flown in from Liberia to visit family in Texas was admitted to Texas Health Presbyterian Hospital on September 28th after exhibiting signs of the Ebola virus. After arriving in the United States on September 20th, he had first sought medical care on September 26th but was sent home. Separate tests by the hospital and a CDC lab confirmed the Ebola virus on September 30th. All persons who have been in contact with him are currently being monitored by the CDC.
The CDC has stated that even hospitals without special containment isolation units are well-equiped to handle Ebola or other infectious diseases. Governor Bobby Jindal has stated that Louisiana is ready to handle any possible Ebola cases.
The last reported case of Ebola in Nigeria was on August 31st. Since then, all people being monitored for symptoms have not fallen ill. Unlike other the other West African countries affected by the outbreak, Nigeria has a significantly more structured healthcare system that was able to handle the situation.
Increased production of ZMapp:
Production of ZMapp, a cocktail of monoclonal antibodies that has been experimentally shown to neutralize the Ebola virus in the body, is set to increase. The antibodies are to be produced by in genetically-engineered tobacco plants that have the genetic code necessary to produce the antibodies. There are concerns over whether the increased production will occur fast enough; industrial-scale engineering of these and other similar products can take nearly a year to get fully up to speed.
New Statistics:
The WHO has announced that the 2014 West Africa Ebola outbreak has already caused over 3,000 deaths.
New predictions indicate there could be over 20,000 total cases of Ebola by the end of November.
Links to remember:
The American Association for the Advancement of Science (AAAS) has given free access to a host of research and news articles related to the Ebola outbreak.
Don’t forget about the CDC’s continual updates on the Ebola outbreak.
Did you know that New Orleans had one of the deadliest outbreaks of Flu during the Influenza epidemic of 1918-1919? What started as a few sick men on a ship became a full-fledged epidemic throughout the city. With vigorous quarantine measures and experimental vaccinations, the city was able to quell the outbreak in a few months. Almost a full one hundred years later, Influenza still remains a prevalent disease throughout the world.
There are three different types of Influenza: A, B, and C. Types A and B are responsible for seasonal flu epidemics. Type A can be broken down into different subtypes that depend on the type of proteins they exhibit. Type B has multiple strains arising from two different lines. Over time, the virus can mutate as it replicates. Eventually, these small mutations accumulate to the point where a new strain of virus has been made. In Influenza type A, major mutations can occur in short periods of time that change the makeup of its marker proteins. This dramatic shift is what caused the H1N1 pandemic (swine flu) in 2009.
The all too familiar symptoms of the flu include aches, chills, a sore throat, fatigue, and fever. It’s certainly enough to keep you out of school or work for a few days. At the other end of the spectrum, complications such as pneumonia can arise from the flu and cause life-threatening illnesses or death. Thankfully, decades of research has given us a powerful tool to prevent or lessen the symptoms caused by the virus – the flu shot!
A flu shot contains three (trivalent) or four (quadrivalent) different strains of the influenza virus. To determine which strains go into the flu vaccine, scientists study epidemiological data and influenza samples throughout the year to determine which strains are most likely to be prevalent in a given year. The results from this monitoring are released twice a year, and individual countries determine which virus strains are to be put into the vaccines. All flu shots in the US protect against the two most common subtypes of Influenza A, and a selected strain or two of Influenza B. Even if the strains don’t perfect match up with those in the vaccine, the vaccine still offers protection against other strains. That said, you can still get the flu after a flu shot. But the immune response built up from the vaccine lessens the severity of symptoms, getting you back on your feet faster than if you hadn’t gotten the shot.
Advancements in science have lead us to creating ouch-less flu shots. In fact, a nasally inhaled flu vaccine is the preferred method of vaccination for children 2-8 years old, and is approved for adults up to 50 years of age. For those who were previously unable to get flu shots due to egg allergies, new types of flu vaccines are developed in cell culture, providing a safe alternative for those unable to take the traditional vaccine.
Like any other vaccine, all people who are eligible to get it should get it. There are few people who should not get it; your doctor will determine if this is the case. To reiterate a point I have made previously: VACCINES DO NOT CAUSE AUTISM. The more people who get the vaccine, the more the community benefits. Certain groups of people should make getting a flu shot a priority; scroll to the bottom to learn more.
October typically marks the beginning of flu shot season. One ouch of prevention pays for itself not only for you, but for those around you. Many insurance companies completely cover the cost or only require a small co-pay. If you are uninsured, fear not! Walgreens is offering free flu shots for those who qualify. Of course, if you feel ill, please consult your physician.
Sources:
http://www.influenzaarchive.org/cities/city-neworleans.html#
http://www.cdc.gov/flu/protect/keyfacts.htm
http://www.cdc.gov/flu/professionals/vaccination/virusqa.htm
I think I can speak for everyone when I say that mosquitos are one of life’s greatest little annoyances. From the irritating buzzing to the itchy welts after a bite, no one I know looks forward to an encounter with a mosquito. Something far more serious than a little bite, however, is the fact that mosquitos can also carry deadly diseases that can affect many species. The most pertinent of these diseases to us in Louisiana is the West Nile Virus (WNV), which can cause fever, neurological disease, and even death.
The first identified case of the virus was in the West Nile region of Uganda in 1937, giving the virus its name. Outbreaks were small and localized until the 1990’s when the two different strains of WNV began to spread around the world. The first known cases of WNV in the United States were New York City in 1999 after an unknown disease was killing both birds and humans. The disease was later identified to be WNV.
WNV is a small, spherical RNA virus that can penetrate the blood-brain barrier, where it can then cause neurological disease. That said, about 80% of cases remain asymptomatic and clear up on their own. In the remaining 20% of the cases, a majority develop West Nile Fever, whose symptoms mimic that of the flu. Very few individuals (less than 1%) will develop neuroinvasive diseases such as meningitis, encephalitis, paralysis. In severe cases, these complications arising from the viral infection can cause death. The elderly, men, those with hypertension, and diabetes are more at risk for neurological complications.
As I’ve said earlier, WNV is a mosquito-borne virus. The virus itself is often carried in birds, though it has been shown to be carried in other mammals. Female mosquitos that carry the disease bite birds, which in turn infects the birds. The infected mosquitos go on to bite more birds and other mammals (like us).
While West Nile Virus is commonly associated with summer heat and humidity, it can present itself at any time in the year, in any state. Recently, several new cases of West Nile Virus have been reported in Louisiana. There have been over 700 cases of West Nile Virus, and 25 deaths caused from it so far this year.
There is currently no vaccine available for WNV. Community management of mosquitos (i.e. the trucks that spray that awful smelling fog around your neighborhood) help keep the overall number of mosquitos down. In addition, emptying stagnant pools of water, wearing mosquito repellent with DEET, and wearing protective clothing are all things that you can to do protect yourself from potentially getting the WNV. If you feel sick after receiving a mosquito bite, seek medical care. It takes several days for symptoms to arise.
The Louisiana Department of Health and Hospitals offers an extensive report on the West Nile Virus.
Sources:
Roehrig JT. West nile virus in the United States – a historical perspective.
Viruses. 2013 Dec 10;5(12):3088-108. doi: 10.3390/v5123088. Review. PubMed PMID:
24335779; PubMed Central PMCID: PMC3967162.
Hayes EB, Sejvar JJ, Zaki SR, Lanciotti RS, Bode AV, Campbell GL. Virology,
pathology, and clinical manifestations of West Nile virus disease. Emerg Infect
Dis. 2005 Aug;11(8):1174-9. Review. PubMed PMID: 16102303; PubMed Central PMCID:
PMC3320472.
VINO Presents: Virology in the News 