HSV-1 infection causing genital infection/Congenital Disease of the Newborn

In the New York Orthodox Jewish communities, circumcision ritual involves removal of the foreskin, then the removal of the blood that accumulates there by the mohel (the performer of the ritual). They do this by sucking the blood from the wound by mouth.

This has led to the infection of four newborn boys with HSV-1, and then possibly causing Congenital Disease of the Newborn. Congenital Disease of the Newborn can lead to mental defects, blindness, deafness and even death. HSV-1 can infect the genitalia as well as the oral mucosa to cause this disease.

The biggest worry is that the Jewish community is protecting the identity of the mohels who performed the procedure. People who are not aware that HSV-1 can cause such a devastating  disease/sequale may be putting their newborn sons at risk for this infection.

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Yellow Fever and the power of vaccination

Yesterday in class we discussed Yellow Fever and its signs and symptoms. Fever,  jaundice black vomit,and death. Today in my inbox there was a notification of an outbreak of Yellow Fever in South America. From December of 2016 until March of this year, there were over 1000 cases of Yellow fever with a 33% fatality rate for confirmed cases.

We also discussed the problem that is are NO antiviral medications that exist for helping someone once they start signs and symptoms of Yellow Fever.  There is nothing that will help stop the virus, nothing but supportive care.

But there IS a vaccine that is good, that will PREVENT infection. In the report, they stressed that vaccination is the most important preventative measure. Quoted from the article:

  • Preventive vaccination can be carried out through systematic immunization in childhood or through unique mass campaigns to increase vaccination coverage in risk areas and also through vaccination of those traveling to at-risk areas.
  • The yellow fever vaccine is safe and affordable and provides effective immunity against the disease in the range of 80 to 100 percent of those vaccinated after 10 days and 99 percent immunity after 30 days.
  • A single dose is sufficient to confer immunity and protection for life, without the need for booster doses. Severe side effects are extremely rare.

This just once again shows the power of vaccination and the ability to prevent life threatening disease.

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It has begun….

China has just modified three normal  human embryos using the CRISPR gene system.

GATTACA may soon be a documentary…..

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The WHO has posted a “Most Wanted” list for the microbial world

Antibiotic resistance continues to march on….

We have known that we are losing the ability to stop bacterial infections for a while now.  Back in 2013, the CDC posted their list of the most dangerous antibiotic resistant bacteria  in an effort to alert the world to the presence of these emerging and dangerous organisms. They arranged these organisms  in terms of hazardous threat levels: Urgent/Serious/Concerning organisms.

It appears that not much has been done towards stopping the continued progression of these organisms (now known as superbugs) in their march towards taking over the world. One such superbug was responsible for the death of a woman in Nevada. The bacteria that caused her death were resistant to 26 antibiotics. Every antibiotic in our arsenal.

Towards this end, the World Health Organization (WHO) has just published their list of the organisms that “pose the greatest risk to human health”. But the World Health Organization is not just trying to educate people as to the  risk of these organisms, but their “Most Wanted” list is to try to get world-wide big pharma to start investing more heavily in R&D to help stop the impending catastrophe these organisms pose for human health.

The WHO posted their list in terms of the need for antibiotics for three groups of organisms (from their website):

Priority 1: CRITICAL

  1. Acinetobacter baumannii, carbapenem-resistant
  2. Pseudomonas aeruginosa, carbapenem-resistant
  3. Enterobacteriaceae, carbapenem-resistant, ESBL-producing (See below!)

Priority 2: HIGH

  1. Enterococcus faecium, vancomycin-resistant
  2. Staphylococcus aureus, methicillin-resistant, vancomycin-intermediate and resistant
  3. Helicobacter pylori, clarithromycin-resistant
  4. Campylobacter, fluoroquinolone-resistant
  5. Salmonellae, fluoroquinolone-resistant
  6. Neisseria gonorrhoeae, cephalosporin-resistant, fluoroquinolone-resistant

Priority 3: MEDIUM

  1. Streptococcus pneumoniae, penicillin-non-susceptible
  2. Haemophilus influenzae, ampicillin-resistant
  3. Shigella, fluoroquinolone-resistant

 

One of the scariest things that is not discussed in general is that #3 on the list (Enterobacteriaceae, carbapenem-resistant, ESBL-producing)  isn’t one organism, but an entire FAMILY of organisms. This family includes such pathogenic bacteria as Shigella, Salmonella, and Yersina pestis. This family of organsims gained their antibiotic resistance through a plasmid that can be transmitted to any non-resistant organisms due to the ability to be spread by conjugation.  So, technically, any pathogenic organism in the presence of one of the “superbugs” could become superbugs in themselves.

We are truly in a world where the “most dangerous are becoming more

 

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The cost of heath care for vaccine preventable diseases

A recent study stated that total cost to the U.S. health care system for vaccine treatable diseases was estimated to be almost 9 billion dollars,  just for 2015 alone. The study also estimated that over 7 billion dollars of that cost was due to people who didn’t get vaccinated, or almost 80% of that total. 80%….

Let’s first of all understand the who, what, and why  of this study.

The who: the study comes from a very reputable source, the UNC Eshelman School of Pharmacy. Since I (and others) believe that this is the best pharmacy school in the nations, I trust their findings. However, I also want to point out that the WHY of this study was that it was funded by Merck, a company who has a finger in the jar, so to speak, of  vaccine revenues. It is Merck’s interest to try to get more people to be vaccinated.

And finally the what of this study: estimating the cost of health care (care, medication and lost productivity) for the unvaccinated. The term vaccine preventable diseases is fairly self explanatory. However, let’s break down the findings farther. The study indicates influenza was responsible for the biggest chunk of the overal expense for vaccine preventable diseases, with about 5.2 billion going to treating patients who have come down with the flu. But let’s investigate the vaccine used to prevent flu. From the CDC:

The updated VE estimate against influenza A H3N2 viruses was 18% (95% confidence interval (CI): 6%-29%).This result is similar to the VE point estimate of 23%, which was reported in a January 16 and confirms reduced protection against H3N2 viruses this season. The VE estimate against influenza B viruses this season was 45% (95% CI: 14% – 65%).

A 45% effectiveness rate is considered good, but 18-23% effectiveness is not. Therefore the cost of treating the flu last year, was not only due to people who were not vaccinated, but also that the vaccine itself was not as capable of preventing infection.

The lack of effectiveness of the flu vaccine wasn’t necessarily due to a bad vaccine, but that but that circulating flu virus had mutated antigenically.  The CDC tested the viruses causing disease and determined that anywhere from 65 to 85% of  all H3N2 viruses tested had drifted antigenically from the vaccine strain used.

And finally, the study did not deduct the cost of the vaccines in the amount of money they estimated. One report indicated that the cost of vaccinating everyone for the flu (with the cheapest vaccine of $14) would have cost roughly 3.57 billion. The cost of Merck’s Gardasil vaccine?  $120 for each shot. So should factoring the cost of the vaccines have been included in the overall monetary numbers indicated?

 

But lastly in Merck’s defense, it has just been published that the Gardasil vaccine is so effect, they are reducing the number of doses needed from three to two (with a final cost of $240 for the two dose series), but also that the vaccine has been amazing good at prevention of actual disease of genital warts but more importantly, human cervical cancer.

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New life forms discovered on earth!

These are not aliens, but a newly recognized type of bacteria found in the deepest regions of earth.

In class, we divide bacteria into categories depending on their growth and energy requirements.  One such division depends on where the bacteria derive their energy. Some bacteria obtain energy from sunlight, and are known as phototrophs (photo: light, troph: obtaining nutrition/energy). Bacteria that utilize organic materials are known as chemotrophs. And we thought that was it…until a recent discovery  found bacteria that derive their energy from the radioactivity produced from uranium!

The name of the organism is Desulforudis audaxviator, and it was found in a gold mine. The bacteria harvest molecules that have been energized by being split by radioactivity.  The bacteria take in the energized molecules, extract the energy and eject the spent molecule back out. So, would this then make this organism a radiotroph?

The scientists in this article are also hypothesizing that life like this could grow on planets without much of an atmosphere where these bacteria could grow on galactic cosmic rays (GCRs). They used Mars as a possible place for these organisms to exist. Some people are calling these alien organisms, but I like to think of them as an example of just how amazing life on earth can get.

Maybe our next search should be for silicon based life forms that grow on radiation? At this point, I think anything is possible!

 

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Watch antibiotic resistance evolve before your eyes!

Thanks to MCRO student Jack Iasiello for sending me a link to a fascinating video of how E. coli can quickly evolve antibiotic resistance. Harvard University and the Technion–Israel Institute of Technology set up a 2 foot by 4 foot “petri dish” of agar with increasing antibiotic gradients of either ciprofloxacin or trimethoprim. Then, set up a video and watched what happened… Link to article and video.

 

(Spoiler alert!! It took only 12 days to evolve resistance to even 1000x the normal dose that inhibited the initial strain). They also were able to track the specific strains that were evolving this resistance.

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More evidence that we live on an Earth that is a literal microbial village.

Antibiotic resistant strains of Shigella sonnei are showing up around the world, US, Australia, Europe and Asia. Researchers in Vietnam have been able to track isolates from a survey of resistant organisms identified around the world to a specific clade of bacteria that appears to have developed  in South Asia. A clade is “a group of organisms believed to have evolved from a common ancestor“. This particular strain of S. sonnei has common mutations in its genetic code that has indicated a common clonal emergence (all the bacteria in the study were investigated using whole genome sequencing).

It appears that 80% of the isolates studied were obtained from travelers to India.  This particular strain of S. sonnei had developed multi-drug resistance but have specifically developed resistance to the type of antibiotics known as fluoroquinolones, with the antibiotic Cipro, being the most notable member. Cipro is the most commonly prescribed antibiotics for a S. sonnei gastroenteritis.

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Cases of syphilis, gonorrhea and chlamydia explode across US

Sexually transmitted diseases (STDs) are making an unwelcome comeback all across the United States. We are seeing especially problematic increases in syphilis, gonorrhea and chlamydia.

What is behind the amazing increase in disease? It is thought to be due to the fact that HIV is now becoming a manageable disease thanks to PReP, and HAART therapies, as well as due to the rise of apps like Grindr and Tinder for quick anonymous hookups.

What kind of increases are we seeing?

  • California:
    • Santa Barbara, reports indicate that there were only 10 cases of syphilis in 2012, and almost 40 cases in 2015. Gonorrhea doubled in 2015 (from 170 in 2012 to 334 cases in 2015).  There were over 2300 cases of Chlamydia in 2015 as well (up 20%).
    • Bakersfield had 28 babies diagnosed with congenital syphilis, with 6 children dying from the infection.
  • Illinois:
    • the number of cases of syphilis rose from 1,682 in 2014 to 1,974 in 2015;
    • chlamydia cases rose from 66,593 in 2014 to almost 70,000 cases in 2015,
    • gonorrhea rose from  15,971 cases in 2014  to 17,130 in 2015.
  • Indiana:
    • Had a 70% increase in syphilis, from 297 cases in  2014 to over 500 in 2015.
  •  Texas:
    • Lubbock County Texas is under a syphilis alert due triple the number of cases as of the end of April of 2016 as there were in all of 2015.
  •  Las Vegas:
    • Saw an increase of  128% in the number of cases of syphilis from 2014 to 2015
  • Maine:
    • There were 3993 cases of chlamydia reported  in 2015 and 422 cases of gonorrhea. Based on numbers in for the first four months of the year,  Maine is on track to surpass both those numbers in 2016.

and finally:

  • Wake County, NC:
    • There was a 40% increase in cases of syphilis from 2014 to 2015.

The main populations where the increase is being detected in the highest percentages is in young adults and homosexual men.  If you think that this is a problem only in America, there are also reports of the same thing happening in the UK, Sweden, Japan and Australia.

The majority of the time, these diseases can be treated with simple antibiotic therapy, but if untreated can lead to serious problems. Gonorrhea and chlamydia can cause pelvic inflammatory disease, and infertility. If untreated, syphilis can cause blindness, neonatal disease and even death.

Word has got to go out. Young people and gay populations CAN control this with simple common sense precautions like condoms or knowing your sexual partner.

Safe sex is not something that should be thought of as only something reserved for HIV.

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Syphillis making a comeback in Japan

There have been over 2000 cases of Syphillis documented in Japan by the end of Oct., 2015. This was up from around 1600 cases in all of 2014.

The main cohort of infected individuals? Females in the 20 to 24 years age group.

One of the main reasons sited for the increase in this demographic is declining risk of contracting HIV.

To read the entire article, click HERE

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