Center for Health Security
Center for Health Security
News Article | May 16, 2017
A recent measles outbreak that has thus far sickened dozens of Somali-Americans in Minnesota — nearly all of them children — can be traced to anti-vaccination campaigns that targeted Somali-Americans and suggested that vaccines are linked to autism, health officials said. On Friday (May 12), the Minnesota Department of Health (MDH) announced that it had confirmed 54 measles cases, 51 of which were in children age 17 or younger — and the majority of those infected were unvaccinated, according to an MDH report published online. These figures are particularly high when compared to the number of measles cases reported in the state of Minnesota in previous years: a total of 56 cases reported between 1997 and 2016, according to MDH. [5 Dangerous Vaccine Myths] Measles is highly contagious; if one person is sick, an estimated 90 percent of unvaccinated people who are physically near that individual will also get sick, the Centers for Disease Control and Prevention (CDC) explains on its website. And while the current outbreak is spreading in a matter of days, its origins can be traced back nearly a decade — to 2008, to be exact, Kristen Ehresmann, director of Infectious Disease Epidemiology, Prevention and Control at MDH, told Live Science. In 2008, local news agencies reported that Somali-American children were accessing special education services in Minnesota school districts more than children in other ethnic demographics. That caught the attention of anti-vaccine groups, who erroneously link immunization to autism (a group of developmental brain disorders), Ehresmann said. Anti-vaccine activists promptly flooded Minnesota's Somali-American communities with misinformation about links between developmental difficulties in children and vaccination, Ehresmann said. Prominent anti-vaccine spokesperson and discredited doctor Andrew Wakefield met with Somali-American groups in Minnesota "on at least two different occasions," Ehresmann told Live Science. When MHD set up community meetings to talk about immunization, anti-vaccine groups were there, handing out incendiary literature. "They have been very aggressive in taking advantage of concerns about autism in this community," Ehresmann said. "Before 2008, Somali immunization rates [in Minnesota] were at or above the rate in the rest of [the] state. Starting in 2008, we saw a dramatic decline — now we're at 41 percent." In 2016, measles was declared to be eliminated from the Americas, in an announcement by the Pan American Health Organization (PAHO). However, this meant only that cases no longer originated in the Americas; measles could still appear in the U.S. if they were imported, infectious disease specialist Dr. Amesh Adalja, a senior associate at the Johns Hopkins University Center for Health Security, told Live Science in September 2016. Measles outbreaks are also a growing source of unease in Europe, particularly in areas where immunization coverage is low. More than 500 cases emerged in the World Health Organization's (WHO) European region in January 2017, and the disease continues to spread, WHO representatives announced in a statement published online March 28. "With steady progress towards elimination over the past two years, it is of particular concern that measles cases are climbing in Europe," Dr. Zsuzsanna Jakab, WHO regional director for Europe, said in the statement. "Today's travel patterns put no person or country beyond the reach of the measles virus. Outbreaks will continue in Europe, as elsewhere, until every country reaches the level of immunization needed to fully protect their populations," Jakab said. As health officials in Minnesota race to contain the outbreak, they continue to work closely with Somali-Americans to address concerns about autism and to improve access to resources for children who have developmental needs. Officials are also collaborating with a health advisory group, made up of leaders in the Somali-American health care community, to further promote awareness of the importance of vaccinations — particularly in children, Ehresmann told Live Science. In fact, it appears that the outbreak has spurred a backlash among Somali-Americans against the anti-vaccine groups, Ehresmann said. "The community is really starting to push back and say, 'We don't want this,'" she said. "Physicians and other health care leaders in the community are speaking out, which makes a big difference. We're really seeing the community step up and take action."
News Article | September 11, 2016
This x-ray of the hands of someone with leprosy was taken in Thailand. The disease causes deformities and contractures, seen here. Two schoolchildren in California are suspected of having leprosy, but where might they have caught the disease? This week, officials in Riverside Country (which is near Los Angeles) said they are investigating the suspected cases of leprosy, now usually called Hansen's disease, at an elementary school in the area. Nursing staff at the school first notified officials about the possible infections on Sept. 2, but it will take several weeks to confirm them, according to the Los Angeles Times. Cases of Hansen's disease in the United States are rare, but they do occur, with about 100 to 200 cases typically reported each year, according to the Centers for Disease Control and Prevention. In 2014, there were 175 new cases of Hansen's disease diagnosed in the United States, and nearly three-quarters of these cases were reported in seven states: Arkansas, California, Florida, Hawaii, Louisiana, New York and Texas, according to the U.S. National Hansen's Disease (Leprosy) Program. "There's a lot of stigma and a lot of misunderstanding about leprosy," said Dr. Amesh Adalja, an infectious-disease specialist and a senior associate at the University of Pittsburgh Medical Center's Center for Health Security. "In the United States, there are thousands of people" who have the disease, Adalja told Live Science. It's estimated that, overall, about 6,500 people in the United States have Hansen's disease, and about half of these require active medical treatment, according to the National Hansen's Disease Program. [Top 10 Stigmatized Health Disorders] There's currently not enough information provided about these two suspected case to know where they might have originated, Adalja said. But armadillos in the United States are known to harbor the bacteria that cause the disease, and it's possible for people to become infected through contact with the animals, Adalja said, although the risk of this is low. People can also become infected with leprosy through prolonged close contact with patients who have leprosy, Adalja said. Because the disease is not very contagious, people are unlikely to become infected through casual contact, he added. In addition, a sizable number of the people who have Hansen's disease in the United States (about 60 percent) were born in another country, Adalja said, and so it's possible they contracted the disease in another country, but this is not certain. Countries with more widespread leprosy transmission include Angola, Brazil, Central African Republic, Democratic Republic of Congo, Federated States of Micronesia, India, Kiribati, Madagascar, Mozambique, Nepal, Republic of Marshall Islands and the United Republic of Tanzania, according to the CDC. The disease is caused by a bacterium known as Mycobacterium leprae. It mainly affects the skin, peripheral nerves, upper respiratory tract, eyes and lining of the nose, according to the National Institutes of Health. The bacteria multiply very slowly, so it may take two to 10 years before a person who is infected with the bacteria has any symptoms, the CDC says. Left untreated, the bacteria can cause permanent damage to the skin, nerves, limbs and eyes (including paralysis and blindness), according to the World Health Organization. But the disease is easily treatable with antibiotics, according to the CDC. And patients are unable to transmit the disease to other people after taking just a few doses of antibiotics. Hansen's disease is not easily spread between people, and it's unlikely that people would catch the disease in a school or work environment, Barbara Cole, of the Riverside County Department of Public Health, told the Los Angeles Times. One reason that the disease doesn't appear to be very contagious is that most people are naturally immune to the disease — it's estimated that about 95 percent of people are not able to contract leprosy, Adalja said. The school with the suspected cases said it has disinfected a few classrooms as a response to the news, according to the Los Angeles Times. But Adalja said that this action was probably overdoing it relative to the risk that the cases pose. "Almost all of it will be overkill because this disease is not that contagious," Adalja said. Copyright 2016 LiveScience, a Purch company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
News Article | November 5, 2016
Zika Virus - What You Should Know A deadly fungus has reportedly reached U.S. hospitals where it is said to have killed a few patients. Federal health officials said the yeast known as Candida auris has already infected 13 patients and killed four. "It appears that C. auris arrived in the United States only in the past few years," said Dr. Tom Chiller, who heads the U.S. Centers for Disease Control and Prevention's branch of fungal diseases. According to the CDC, the disease was first identified in 2009 in a Japanese patient who had an ear ailment. The fungus C. auris has caused a global outbreak and has been detected in countries such as Britain, India and Israel. Making the appearance as bloodstream infections, it has defied treatment from antifungal drugs. An alert was issued by the CDC in June asking U.S. laboratories to report suspected cases of the fungus to federal, state and local healthcare departments. It is likely that the outbreak may compound the task of healthcare authorities worldwide, who are already struggling to control bacteria that are resistant to most antibiotics. The toll from drug-resistant superbug bacteria is already too high, with 23,000 Americans and 700,000 people worldwide dying from superbug strains annually. According to experts, C. auris is an ascomycetous species of fungus and grows as yeast. It causes candidiasis infections with a display of symptoms such as difficulty in swallowing, a burning sensation, genital itching, and discharge of white fluids. The CDC reports that all patients affected in the U.S. had become very sick. They included a paraplegic in Illinois whose catheter was attacked by C. auris and four more from New Jersey, New York and Maryland. According to CDC officials, all these patients had severe medical conditions, including cancer, and had been in the hospital for 18 days when they tested positive. However, doctors are still unsure if the killer fungus was the main reason for their death or their underlying health problems were to be blamed. One of the major challenges of C. auris, including finding a cure, is the difficulty in identifying the fungus. It needs special laboratory facilities. Otherwise, most samples go misidentified as other fungal species, the CDC said. Meanwhile, Amesh Adalja, senior associate at the Center for Health Security at the University of Pittsburgh Medical Centre warned that C. auris carries high mortality threats. The CDC appealed to all stakeholders to ensure the thorough cleaning of hospital rooms and a strict check of facilities to confirm whether patients admitted had this infection. "We need to act now to better understand, contain and stop the spread of this drug-resistant fungus," said CDC director Dr. Tom Frieden. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.
News Article | September 13, 2016
Hillary Clinton's doctor diagnosed the presidential candidate with pneumonia on Friday, according to The New York Times. But while the illness may evoke images of cold weather, experts told Live Science that a late summer case of pneumonia is nothing surprising. Pneumonia, which is characterized by inflammation in the lungs, can be caused by bacteria, a virus or a combination of both, said Dr. Amesh Adalja, an infectious-disease specialist and a senior associate at the University of Pittsburgh Medical Center's Center for Health Security. Adalja has not treated Clinton. [7 Absolutely Horrible Head Infections] There is some seasonality to many infectious diseases, Adalja told Live Science. For example, certain viruses which can cause pneumonia are more common in summer than they are in winter, Adalja said. Pneumonia can be caused by a number of other things, including fungal infections, parasites or reactions to certain medications. With any disease, seasonality represents only one common pattern of infection. That means it is possible for a person to get a certain illness outside of that season, he added. Dr. Len Horovitz, a pulmonologist at Lenox Hill Hospital in New York City, who has not treated Clinton, agreed. Just like there are winter colds and summer colds, caused by different viruses, a person can get pneumonia in the summer or the winter. Although The New York Times reported that Clinton is currently taking antibiotics for the pneumonia, Horovitz said that he suspected the candidate's pneumonia was caused by a virus, rather than bacteria. Antibiotics would not treat a viral infection, he said. When people have bacterial pneumonia, they're a lot sicker than people with viral pneumonia, Horovitz told Live Science. Bacterial pneumonia often requires hospitalization and intravenous antibiotics, Horovitz said. Still, it's not uncommon for a doctor to start a patient on oral antibiotics, especially when the patient has walking pneumonia, Horovitz said, referring to the type of pneumonia that involves not being stuck in bed. Doctors prescribe antibiotics in case a patient does turn out to have a bacterial infection. Although such infections can be confirmed by testing a person's sputum (a mixture of saliva and mucus) for bacteria that could cause pneumonia, it can take several days for the test results to come back, and by then, a person could be quite ill, he said. Walking pneumonia is very common, Horovitz said. He noted that in his practice, he sees it all the time. Because the illness is not serious, doctors don't need to report it to the Centers for Disease Control and Prevention (CDC), Horovitz said. When the CDC talks about the nation's pneumonia cases and statistics, they're talking about the more serious cases that require a person to be hospitalized, he said. "There's no obligation to report walking pneumonia [to the health department] any more than you'd have to report a common cold," Horovitz said. The condition is about as contagious as a cold, he added. Walking pneumonia is like a "chest cold [that's] gone a step further," Horovitz said. The treatment for a viral version of pneumonia includes staying hydrated, getting rid of mucus from the throat and lungs (by coughing it up, for example) and getting enough sleep, he said. Copyright 2016 LiveScience, a Purch company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
News Article | May 13, 2016
Scientists who use computer models to forecast future events often receive punishing criticism for getting it wrong. (Just ask Hillary Clinton’s polling team.) So here’s a ScienceInsider shoutout to some modelers who appear to have gotten it right: the meteorologists and entomologists who joined forces last May and predicted where local transmission of Zika in the continental United States was most likely to occur. As of today, the only documented cases of viral transmission from a mosquito to a human in the continental United States have taken place in southern Florida and Brownsville, Texas. That’s precisely what the best models indicated. And, if history repeats itself, as winter approaches and cold weather reduces populations of the Aedes aegypti mosquito—Zika’s main vector—this transmission likely will stop and resurface late next spring. The so-far narrow U.S. outbreak is certainly no consolation to those struck by the virus, but offers some relief to public health officials bracing for the worst. And it gives modelers some confidence that their virtual crystal balls are working. Andrew Monaghan, a modeler at the National Center for Atmospheric Research in Boulder, Colorado, says his team hasn’t updated the Zika forecast it did in 2016, but suggests that next year the virus may transmit locally in U.S. locales that now have local dengue transmission. "So, in addition to continued high risk for Zika virus transmission in Brownsville and metropolitan Miami[, Florida,] next year, there may be elevated risk in communities in central Florida, the Florida Keys, as well as border communities in the Rio Grande Valley in south Texas,” Monaghan says. But he stresses that he could be wrong. “It's always difficult to forecast virus transmission due to the complex dynamics of these systems,” he says. Here’s our story from this past May, which mapped out the modelers’ thinking: If history repeats itself, the U.S. media will make a whoop dee doo out of the first confirmed case of Zika virus transmission that takes place in the United States from a mosquito to a person. So far, such “autochthonous” transmission hasn't happened, but scientists believe it’s very likely to occur in the next few weeks. Given the attention that each imported case of Zika has triggered so far—see here and here and here and here and here—expect the U.S. media to go full-throttle. Politics will further increase the clamor: Just 2 days ago, White House Press Secretary Josh Earnest at his daily briefing pointed to a map that appears to show the virus blanketing half the continental United States by mid-summer. “The map behind me is a graphic illustration of the need for immediate congressional action,” said Earnest, urging Congress to heed President Barack Obama’s 3-month-old request to pump $1.9 billion in emergency aid to fight Zika. But researchers who have studied Zika and the mosquitoes that transmit it say that the country is currently in the calm before the calm. Damaging as Zika is to fetuses, they predict that autochthonous transmission will only affect a small swath of the country that stretches from Florida along the Gulf Coast to Texas. And the dynamics of mosquito-borne disease in the United States are so different from those in Latin America that the number of confirmed cases probably will be in the hundreds, if that, before autochthonous spread sputters out. There are many mysteries about Zika and how, in particular, it behaves in pregnant women, triggering some to miscarry and others to give birth to babies with brain disorders like microcephaly. There also are questions about how much spread occurs without a mosquito vector: Zika can persist in semen and be transmitted sexually, and there’s an outside chance that viral RNA in saliva, which never has been linked to an infection, might pose a risk. But when it comes to the mosquito species that harbor the virus and the transmission cycle with humans, a great deal is known. Experience with two other diseases spread by the same mosquitoes, dengue and chikungunya, offer insights as well. The United States simply doesn’t have the ingredients for the type of explosive, autochthonous transmission seen in Latin America, says Thomas Scott, an entomologist and epidemiologist at the University of California, Davis. “I don’t want to blow this off and leave people with the impression that you don’t need to worry about it—who knows where this is going,” he says. “But I don’t think we’re going to have sustained transmission in the U.S., primarily because of our lifestyle. We also don’t have enough mosquitoes.” The temperature-sensitive Aedes aegypti, the main mosquito vector, only lives in high numbers in a small portion of the United States, and mainly thrives in summer months when the temperature is between 25°C and 32°C. There are many more A. aegypti to spread Zika in Brazil—which saw up to an estimated 1.3 million infections in 2015 alone—than in the United States. There’s also a feast of human skin available, as people in warmer climes often wear tank tops, flip-flops, and shorts. Poverty explains some of Zika's success in Latin America as well. Window and door screens are uncommon in many locales, and houses often have stagnant tubs or pools of water in dark places that provide breeding grounds for the homebound A. aegypti, which Scott calls “the cockroach” of mosquitoes. “They don’t fly very far from where they emerge,” he says. “It’s mostly people moving the virus around.” Add to this mix Latin culture: “A lot of places where Zika is common the people are incredibly social, and they go all over the city to see family and friends,” he says, while in the United States, "people often come home and go inside and there’s air conditioning and they watch TV.” As of 11 May, the U.S. Centers for Disease Control and Prevention (CDC) had confirmed 503 “travel-associated” cases of Zika in the United States, 10 of which involved sexual transmission. No evidence exists that a mosquito has yet bit any of these people and then spread the infection to another person in the country. Scott recently collaborated on a global Zika modeling project led by Simon Hay, head of the geospatial science division at the Institute for Health Metrics and Evaluation in Seattle, Washington. The team mapped the environmental suitability for Zika based on annual rainfall, temperature, areas where A. aegypti persists, and conditions where Zika has already occurred. The researchers also included data for A. albopictus—better known as the Asian tiger mosquito—which can harbor the virus. In the United States, A. albopictus has a greater range than A. aegypti. But Scott doubts it can keep the transmission cycle going because, unlike A. aegypti, it can bite a human as an appetizer and then turn to several other species to complete its blood meal. “Little changes in biting frequencies on an appropriate host can make a big difference” for transmission, Scott says. The model, published online 19 April by eLIFE, calculated that 2.17 billion people in the world live in areas that are environmentally suitable for Zika. High-risk areas include more than half of Latin America—where the virus is now circulating—as well as parts of South and Southeast Asia, Northern Australia, and a broad swath of Africa around the equator. But Zika's potential for spread in the United States is limited. The only “highly suitable” regions are Florida and portions of nearby states to the west, including coastal regions of Alabama, Mississippi, Louisiana, and Texas. The map shown at the White House press briefing came from another paper, published online 16 March in PLOS Current Outbreaks. The White House presents it as a "month-by-month look at the prevalence of the mosquitoes that can carry the mosquito virus," visible as a wave of yellow, orange, and red circles washing over the country as 2016 progresses. (The White House Zika website has an even more alarming map prepared by CDC “from a variety of sources.”) In the paper in PLOS Current Outbreaks, however, the figures indicate the "potential abundance" of the mosquito population—that is, how big it could be—based on a model that uses climate data. That potential range vastly exceeds the actual area where the mosquito is known to live. The map includes places as far north as Denver and Salt Lake City, where A. aegypti has never been seen. “I don't have any explicit comment on the use of the graphic by the White House,” says Andrew Monaghan, a meteorologist at the National Center for Atmospheric Research in Boulder, Colorado, who led the team that made the map. Monaghan stresses that “we were clear that our map primarily shows seasonal climatic suitability for Aedes aegypti, and is not meant to be a precise indicator of where the mosquito will be found.” Monaghan and his colleagues from NASA and North Carolina State University in Raleigh agree that A. aegypti is most abundant in the region that stretches from Florida to the Gulf Coast of Texas. The map includes another variable that likely will fuel autochthonous spread: the number of travelers (shown as circles) arriving in the United States from Latin American and Caribbean countries that have local spread of Zika now. Monaghan says that the places where Zika will most likely start spreading in the United States are those where dengue and chikungunya have done so as well. Those areas, colored dark brown on the map, are Brownsville, Texas, which abuts Mexico and has a busy land border crossing, and southern Florida. If history repeats itself, these may be the only places Zika virus transmits in the continental United States. Dengue was detected in the United States as far back as 1780 in Philadelphia, Pennsylvania, but autochthonous transmission stopped in 1945 and did not surface again until 1980 in Texas, when a 5-year-old girl in Brownsville became infected. In 1986, Texas had nine more documented autochthonous cases, four of which were in Brownsville, and the city again had three indigenous cases in 2005. Hawaii had 122 confirmed dengue cases in 2001–02. There, the vector was not A. aegypti, but A. albopictus. Florida first had dengue autochthonous transmission in 2009–10, with the Department of Health tallying a total of 88 cases “associated with Key West,” the southernmost part of the state. There have been other sporadic local transmissions since, all in the southern and central part of the state, with one serious outbreak in 2013 that involved 28 people. Chikungunya has, so far, been equally easy on the United States. The first confirmed indigenous transmission occurred in Florida’s Miami-Dade County on 27 June 2014. Only 10 other cases followed, as CDC reported in December 2014. All of these occurred in southern Florida counties, too. A third map, published in The Lancet 14 January, seals the deal that southern Florida is prime Zika real estate. These researchers analyzed passengers arriving in the United States who left airports in Brazil located within 50 kilometers of areas that potentially could transmit Zika year-round. They additionally highlighted U.S. regions that had the most hospitable climes for both Aedes species that transmit Zika. Miami and Orlando turn out to be the best airports of entry for the virus. (Brownsville does not get a mention, because it does not have a major airport.) D.A. Henderson, an epidemiologist who helped lead the program that eradicated smallpox and has advised the U.S. government on several other infectious diseases, says the threat of Zika to the United States does not warrant the degree of fear and concern that it has triggered. “I can’t get very excited about this whole affair,” says Henderson, who now is at the UPMC Center for Health Security in Baltimore, Maryland. Although he’s all for stepped-up mosquito control efforts, he stresses that the virus causes few, if any, symptoms in most people it infects and doesn’t transmit well between people. “We do not see smashing big epidemics,” he says. Henderson, who is 87 and has seen many epidemics come and go, says the U.S. Zika media coverage is driven in part by the comparatively recent surge in laboratories that now work on viral diseases. “Their inclination, in good faith, is to say, ‘This could be a real problem’ to keep their money flowing to their laboratories,” Henderson says. “It’s not evil and I don’t want virologists bereft of funds, but you have to keep in perspective what some of these things mean. It’s gotten a little out of hand.” [Editor's note: Henderson died in August 2016, after this story was published.]
News Article | March 29, 2016
Newer isn't always better — some researchers are proposing to bring back an older version of the whooping cough vaccine, because multiple studies show that today's version doesn't protect as well as the earlier kind. In a new study, researchers suggest vaccinating children with one dose of the older whooping cough vaccine — called the whole-cell pertussis vaccine — and then giving them four doses of the current whooping cough vaccine in early childhood. (Whooping cough is also known as pertussis.) Currently, children are given five doses of the new vaccine. Using a mathematical model, the researchers found that this "combined" vaccination strategy could reduce the rate of whooping cough infections by up to 95 percent, and save millions of dollars in health care costs. Researchers from The Santa Fe Institute, a nonprofit research center in New Mexico, conducted the study. The older, whole-cell pertussis vaccine is linked with a higher rate of side effects, such as fever, than is the newer version. But because improved vaccines against whooping cough are likely years away, "in the interim, switching to the combined strategy is an effective option for reducing the disease and mortality" from whooping cough the researchers wrote in their findings, published today (March 28) in the journal JAMA Pediatrics. [5 Dangerous Vaccine Myths] But even though the new study found that the benefits the combined strategy would outweigh the risks, questions remain about whether parents would accept a higher rate of side effects, especially among those parents who are already hesitant to vaccinate their children, experts said. The whole-cell pertussis vaccine was used in the United States from the 1940s until the 1990s, when doctors switched to a new version called the acellular pertussis vaccine, which was linked to fewer side effects. But studies soon found that, unlike the older version, the acellular pertussis vaccine did not produce long-lasting immunity against pertussis; the protection offered by the acellular vaccine wanes after a few years. Researchers have attributed the rise in whooping cough cases in recent years in part to the inferior protection offered by the acellular vaccine. In 2012, there were more than 48,200 cases of whooping cough in the United States, the most in any year since 1955. The current vaccine schedule calls for five doses of the acellular vaccine, with one dose occurring at each of the following times: ages 2 to 4 months, 4 to 6 months, 6 to 8 months, 18 to 24 months, and 4 to 5 years. In the new study, researchers compared using that schedule with a "combined" vaccine strategy, of giving an initial dose of the whole-cell pertussis vaccine followed by four doses of the acellular pertussis vaccine. The combined strategy would reduce symptomatic whooping cough cases by 95 percent, and would reduce cases in infants by 96 percent, compared with the current strategy, the models predicted. With the combined strategy, there would also be a 96 percent decrease in hospitalizations from whooping cough and a 95 percent decrease in infant deaths from the disease, compared with the acellular strategy. However, the combined strategy would have higher rates of vaccine side effects: There would be about 10 more cases of fever for every 100,000 vaccinations, and seven more cases of seizures for every 10 million vaccinations, compared with the acellular vaccine strategy. Overall, the combined strategy would lead to a 96 percent decrease in hospitalizations due to either whooping cough or vaccine-related side effects, the study found. Based on the new study, it seems the combined strategy would lead to better outcomes overall, said Dr. Amesh Adalja, an infectious-disease specialist and a senior associate at the University of Pittsburgh Medical Center's Center for Health Security. "When you look at the way they've modeled this, it seems to be, on balance, a better strategy than what we're doing currently," Adalja said. And giving just one dose of the whole-cell vaccine "maybe somewhat more palatable to people" than giving children five doses of this vaccine, Adalja said. The findings also support the idea that "the strategy we're using currently against pertussis is not the optimal model, and children are needlessly contracting pertussis because we're using an inferior vaccination strategy," Adalja said. Still, some experts were skeptical that parents would accept bringing back the whole-cell pertussis vaccine. "The problem is that you cannot model public perception," Dr. Mark Sawyer, a pediatric infectious disease specialist at the University of California, San Diego School of Medicine, wrote in an editorial accompanying the study in the journal. "Many in the vaccine-policy world cringe at the idea of re-introducing whole-cell pertussis vaccine." Sawyer noted that parents today are intolerant of any adverse side effects related to vaccines, even if such effects are rare. In the past, the public reaction to these side effects played a role in the rise of the anti-vaccine movement, Sawyer said. "Although bringing back whole-cell pertussis vaccine for a priming dose … makes sense from an immunologic perspective, other considerations will make this challenging," Sawyer said. Because the study used a mathematical model and was not conducted in the real world, more studies will need to validate the findings before policy would be changed, Adalja said. 5 Viruses That Are Scarier Than Ebola Copyright 2016 LiveScience, a Purch company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
News Article | December 19, 2016
About 9,600 first responders including paramedics, firefighters, and other students in Federal Emergency Management Agency have been mistakenly exposed to deadly ricin for the last five years. FEMA, which has been exposing the emergency responders to a deadly toxin since 2011, blames one of its suppliers for the blunder. The ricin powder made of castor beans, which was used in FEMA training classes, is lethal even in small doses. FEMA claims that the ricin powder the agency has been ordering is a less toxic one, but Toxin Technology, which supplies the said product, as reported by USA Today, has been wrongly shipping the more toxic ricin for years. However, the toxin suppliers noted that the nine shipments made since 2011 were the more toxic version, and they were clearly labeled with the scientific name "RCA60," indicating they are lethal. Meanwhile, FEMA administrator W. Craig Fugate has called the Department of Homeland Security Office to investigate on the issue. The agency has also stopped providing training classes using the biological agents, including a less potent strain of anthrax. Fortunately, nobody in FEMA was affected by the toxin, which has no antidote. FEMA spokesperson Alexa Lopez noted that students wore protective gears when they were in training to identify the presence of biological agents, and the workers at the training center who prepared the ricin powder for experiments were also not exposed to the toxin since they were inside special biosafety cabinets. Tom Ridge, former Homeland Security secretary who was shocked about the issue, noted that it is outrageous that the agency hasn't verified the product they have been using for a period of five years. "It's beyond careless and outrageous. It's almost malfeasance," Ridge said. Meanwhile, Richard Ebright, a biosafety expert from Rutgers University, noted that the ricin issue at FEMA is another incident that shows the "incompetence" of a federal agency in mixing up between biological agents, believing that they were attenuated or killed when in fact they weren't. Ebright also noted that unless concerned people are held "accountable" for such mistakes, the federal agencies wouldn't understand the seriousness of the issues. "These kinds of things are continually going to happen until biosafety gets elevated to a major level," said Amesh Adalja, a senior associate from UPMC Center for Health Security. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.
News Article | November 8, 2016
Ebola - What You Should Know Ticked Off! Here's What You Need To Know About Lyme Disease Zika Virus - What You Should Know Scientists have yet to develop a cure for the mosquito-borne Zika virus, but a new mice study has shown promise in protecting pregnant females and their fetus from the infection. One of the most devastating consequences of Zika is the development of microcephaly or an abnormally small head in newborn babies who were infected in utero. Now, for the first time, a human antibody has been found to shield mice fetus from being infected with Zika. Researchers believe the existence of the antiviral means Zika virus during pregnancy is treatable. The study, which was conducted at Washington University School of Medicine and Vanderbilt University School of Medicine, involved the screening of 29 anti-Zika antibodies from patients who recovered from Zika virus infection. Michael Diamond and James Crowe Jr., both senior authors of the report, discovered one antibody known as ZIKV-117, which efficiently neutralized five Zika strains in the laboratory. Diamond, Crowe and colleagues tested whether the antibody would be effective in animals. They gave the Zika antibody to pregnant mice either one day after or one day before they were infected. During both trials, the treatment significantly decreased the levels of virus in pregnant female mice and their fetuses as well as in the placenta compared with pregnant mice that did not receive the antibody. Researchers said the antibodies protected the fetus 95 to 100 percent of the time. Indira Mysorekar, a coauthor of the study, explained that the antibodies keep the fetus safe by blocking the Zika virus from crossing the placenta. In fact, the placenta from treated female mice appeared healthy and normal, while those of the untreated female mice revealed damage on the placental structure. Such damage can hinder fetal growth, and in some cases, can lead to fetal death, which are both markers of Zika among humans. Statistics from the World Health Organization reveal that more than 2,000 children with microcephaly or birth defects in the central nervous system were born in Brazil since the outbreak, making the development of an effective treatment against Zika urgent. Amesh Adalja, a senior associate at the UPMC Center for Health Security, believes that if the mice study can be replicated in human models, it could be an important way to curb the damage caused by Zika. Meanwhile, Crowe, Diamond and the rest of the research team are working with private companies and the government about ways to support further studies and the production of the antiviral treatment. "[N]ow we want to know whether it can clear persistent infection from those parts of the body," added Diamond. The findings of the report are published in the journal Nature. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.
News Article | August 22, 2016
CHICAGO (Reuters) - The Obama administration on Friday declared a public health emergency in the U.S. territory of Puerto Rico, saying the rapid and widespread transmission of the Zika virus threatens the health of infected pregnant women and their babies. The Caribbean island of about 3.5 million people has recorded 10,690 laboratory-confirmed cases of Zika, including 1,035 pregnant women, but the actual number of infections with the mosquito-borne virus is likely higher, the U.S. Department of Health and Human Services said in a statement. Among U.S. states and territories, Puerto Rico is expected to see the worst of the Zika outbreak due to its tropical climate and a lack of infrastructure for mosquito control. The only local transmission of the virus so far reported in the continental United States has been in South Florida. The virus can cause microcephaly, a birth defect marked by abnormally small head size and developmental problems in babies. It also can also be spread by sex, prompting public health officials to advise that people who have been infected refrain from unprotected sex for several months. "This administration is committed to meeting the Zika outbreak in Puerto Rico with the necessary urgency," HHS Secretary Sylvia Burwell said in a statement. The public health emergency declaration is a tool for the federal government to provide fresh support to Puerto Rico's government to tackle the outbreak and grants access to certain federal funds. The last time HHS declared such an emergency was in 2012 in the wake of Superstorm Sandy, which slammed into the New Jersey shore and flooded parts of New York City. It was the second important step to fight Zika that the federal government has taken in as many days. The administration said on Thursday it had shifted $81 million in funds from other projects to continue work on developing vaccines to fight Zika in the absence of any funding from U.S. lawmakers. HHS made the declaration at the request of Puerto Rico Governor Alejandro García Padilla. It allows Puerto Rico to apply for funding to hire and train unemployed workers to assist in mosquito control efforts, as well as for outreach and education efforts. It also allows Puerto Rico to temporarily reassign public health workers to assist in the Zika response. "The declaration will allow access to more funds, the waiving of certain regulatory procedures to speed response, reassign key personnel, allow temporary personnel appointments, and provide the authority to take necessary actions to combat the outbreak," said Dr. Amesh Adalja, an infectious disease expert and senior associate at the UPMC Center for Health Security in Baltimore. Also on Friday, Florida said three more people had become infected with Zika by local mosquitoes, bringing the total to 28. Zika was first detected last year in Brazil, where it has taken its heaviest toll so far, and has spread rapidly through Latin America and the Caribbean. "The threat of Zika to future generations of Puerto Ricans is evident, and I feel a responsibility to do everything that is within my reach to make sure we fight the spread of the virus," Garcia Padilla said in a statement. The Obama administration in February requested $1.9 billion to fight Zika, but the Republican-led Congress has approved no money. A bill providing $1.1 billion was blocked by Democrats after Republicans attached language to stop abortion-provider Planned Parenthood from using that government funding for healthcare services, mainly in U.S. territories like Puerto Rico. The Republican legislation also would siphon off unused money under Obama's signature 2010 healthcare law to combat Zika.
News Article | March 5, 2016
The most obvious symptom of microcephaly is that the child has a smaller head than others of the same age and gender. More Pregnant women who become infected with Zika virus may be at risk for not only having a child with microcephaly, but also having a fetus with other serious health issues, including problems with the nervous system and even fetal death, according to a new study from Brazil. The study — which provides some of the strongest evidence that Zika virus causes microcephaly — found that nearly one-third of women who had Zika infections during their pregnancy had an ultrasound that showed fetal abnormalities. These abnormalities included problems with growth, such as microcephaly (meaning an abnormally small head), problems with the placenta and lesions in the brain or spine. "Zika definitely causes the problems. We think microcephaly is only the tip of the iceberg," said study co-author Dr. Karin Nielsen-Saines, a professor of clinical pediatrics at the David Geffen School of Medicine at UCLA. [Zika Virus FAQs: Top Questions Answered] Infants and fetuses in the study showed a variety of problems, including calcification (or hardening) of brain tissues, problems with the amniotic fluid and an abnormally small body size. There were two stillbirths in the study. Usually, viral infections don't cause only one problem, and because of the array of problems now linked with Zika, the researchers suggest using the term congenitial Zika virus syndrome, Nielsen-Saines said. The new study provided a stronger type of evidence than previous studies of the effects of Zika during pregnancy because it was prospective, meaning that women who came into the clinic in Brazil were tested for Zika and then followed over time (regardless of whether or not they tested positive for the virus). In addition, the researchers tested the women for Zika by looking for the virus's genetic material – which is more reliable than looking for antibodies, or proteins produced by the immune system in response to a Zika infection, Nielsen-Saines said. The new study is "what people have been waiting for," in terms the type of evidence needed to prove that Zika infection in pregnancy causes microcephaly, said Dr. Amesh Adalja, an infectious disease specialist and a senior associate at the University of Pittsburgh Medical Center's Center for Health Security, who was not involved in the study. That's because the researchers compared pregnant women infected with the Zika virus with pregnant women who were not infected with Zika virus and lived in the same area — a so-called "case control" study. "This is the closest we've gotten to [proving] causation," Adalja said. Although more studies are still needed to solidify the link, "for all intents and purposes, this justifies the concern raised early on," that at least a proportion of the microcephaly cases in Brazil were caused by Zika virus, Adalja said. The Zika virus is currently spreading rapidly in Central and South America. Health officials became concerned about a link between the virus and microcephaly after there was a dramatic rise in cases of this birth defect in Brazil last year. The study involved 88 pregnant women in Rio de Janerio who were tested for Zika virus because they had recently developed a rash — one of the symptoms of the infection. Of these women, 72 tested positive for Zika virus, and they were at various stages of pregnancy – anywhere from 5 to 38 weeks pregnant. The researchers performed ultrasounds on 42 women who had a Zika infection and 16 women who did not have a Zika infection. (A number of women in the study who tested positive for Zika did not agree to have ultrasounds, Nielsen-Saines said, and in some of those cases, were due to women not wanting to know whether the fetuses they were carrying potentially had health problems.) About 30 percent of the Zika-infected women showed a fetal abnormality on their ultrasound, compared to none of the women without a Zika infection. The Zika-infected women were all previously healthy and did not have other risk factors for adverse pregnancy outcomes, the researchers said. [Zika Virus News: Complete Coverage Of The Outbreak] Five of the Zika-infected women (12 percent) had fetuses with microcephaly, but in most of these cases, the fetus also had a condition called intrauterine growth restriction, meaning the whole fetus was abnormally small, and not just the head. Seven women (16 percent) had fetuses with lesions on the brain or spinal cord, or other central nervous system problems, and 7 women appeared to have placental insufficiency, when the placenta doesn't work as it should so that the fetus does not receive a sufficient amount of oxygen and other nutrients. Two women infected with Zika had stillbirths at 36 and 38 weeks of pregnancy, respectively. In previous studies, there was some speculation that Zika infections may be more damaging if they strike earlier in pregnancy. But in the new findings, the stillbirths both happened in women who were infected late in their pregnancies, Nielsen-Saines said. And in another case, a baby had to be "urgently delivered" from a woman with a later Zika infection, because the baby would have died otherwise, she said. None of those three cases involved microcephaly or other problems with the central nervous system, but rather, these cases had other problems such as placenta or amniotic fluid abnormalities, she said. There "may be a high risk of fetal demise with infections in the last trimester," she said. The finding that nearly 30 percent of Zika-infected women had an abnormality on their ultrasound is "worrisome," the researchers said. They note that the rate of fetal death in women with Zika was 4.8 percent, which is about twice the rate of fetal death among women infected with HIV living in the same area. However, Adalja said that because the new study was small and in a single area, more studies are needed before researchers know the true rate of Zika-related pregnancy complications. In addition, there were 30 women in the study who were infected with Zika but did not have an ultrasound. It will be important for future studies to perform ultrasounds on all Zika-infected women in order to generalize the findings, Adalja said. [The 9 Deadliest Viruses on Earth] In Brazil, fears about Zika are running very high, Nielsen-Saines said. "People are very worried, there is a lot of fear and concern" she said. Some pregnant women who become infected with the virus are coming to doctors and requesting to have their labor induced right away – some in the third trimester, but also some still in their second trimester -- in hopes of minimizing the damage to their fetus, she said. The study is published today (March 4) in the New England Journal of Medicine. 5 Things to Know About Zika Virus Copyright 2016 LiveScience, a Purch company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.