Scourge Review

With Scourge: The Once and Future Threat of Smallpox, Jonathan Tucker presents an entertaining overview of the history of the variola virus, one of humanity’s most ruthless killers, and the target of its only successful infectious disease eradication campaign.  The first chapters provide an abbreviated early history, highlighting the notable aspects of the virus’s epidemiology, cultural impact, and lethality. Tucker even provides anecdotes about smallpox as a primitive biological weapon, the fear of which is an undertone throughout the latter chapters.  These first few chapters sufficiently set the stage for the rest of the book, acquainting the reader with smallpox as it used to be: a terrifying, powerful, and mysterious human adversary.  Tucker also gives sufficient nods to the pioneers of the modern vaccine, who paved the way for humanity’s victory over the virus—Lady Wortley Montagu, Dr. James Waterhouse, and Edward Jenner—before he launches into the body of his work.

Scourge focuses primarily on the cooperative international campaign for global eradication of smallpox, begun in 1966. Tucker spends the majority of the book describing the country-by-country difficulties and triumphs of eradication, as well as the heated political debate in the decades following the last human case of smallpox.  Although sometimes at the price of chronological clarity, Tucker does a remarkable job of maintaining the reader’s interest by following the efforts of the major players in the eradication campaign (notables include the effort’s leader D.A. Henderson, the young maverick Larry Brilliant, and former Soviet biological weapons scientist Ken Alibek).  This technique helps Scourge turn pages like a work of fiction, so we feel the weight of Henderson’s determination, the spark of the young Larry Brilliant’s enthusiasm, and the paranoia inspired by Alibek’s first-hand accounts of the Soviet biological weapons program—all without sacrificing historical accuracy or validity. The result is an entertaining, informative overview of the eradication effort and the drama of its aftermath. Of course, this comes at the expense of total depth in any particular subject, but as an introduction to the history and future of smallpox, Scourge is a must-read. 

-Andrew Beck

Swine Flu and the Economy

Having read article after article about swine flu in the Health section of the NY Times webite, I clicked on the Economics section, looking for a little relief. But just in case I had forgotten how interconnected our world is (thank you, Humbio!), I found headlines about swine flu dominating the Econ section as well. The first article (http://www.nytimes.com/2009/04/29/business/economy/29trade.html) had to do with the pork industry. Several countries have closed their barriers to Mexican and American pork, and others are likely to follow suit. In addition, analysts have predicted a decline in pork sales in grocery stores, and consumers in the US have confirmed that they are steering clear of pork. Understandably, the pork industry is frustrated, as there is currently no evidence that swine flu can be contracted by eating pork. Reading about the pork industry's losses reminded me of the Mad Cow epidemic, when the beef industry in the US and the UK suffered severe losses. However, in that case the disease could in fact be acquired from cows, who harbored the deadly prion, while in the case of swine flu the association between pork and swine flu is tenuous at best.

Nevertheless, this message has either not reached the American public or is currently being ignored amidst a growing climate of fear. The name "swine flu" may have something to do with the avoidance of pork; as another article (http://www.nytimes.com/2009/04/29/world/asia/29swine.html?ref=health) discusses, the name "swine flu" may not be entirely appropriate; in addition to genetic sequences from swine influenza, the virus also contains sequences from avian and human influenza. Others have suggested calling the virus by its scientific name, H1N1, or naming it "Mexican Influenza."

The BBC Business Section, too, ran a headline article today (http://news.bbc.co.uk/1/hi/business/8021974.stm) about the economic impacts of swine flu, noting losses in the markets worldwide and a particular loss in shares for travel firms and airlines. The article also included an entertaining quote: analyst Tsuyoshi Segawa of Shinko Securities said, "We had finally begun to see a bottom for the global economy, and that has been ruined by pigs." Segawa's statement is not entirely correct, but she raises an interesting point: how will the swine flu affect global economic recovery plans in the coming months? What kinds of reverberations will the flu have beyond the pork, travel, and airline industries?

A final article reminded me of the huge economic costs associated with combatting an epidemic (http://www.nytimes.com/2009/04/29/health/29flu.html). Yesterday, Obama asked Congress for $1.5 billion in supplemental funding. The UK, too, is facing huge costs, as it stockpile face masks and plans an extensive information campaign that includes the delivery of an informational leaflet to every home in Britain (BBC, http://news.bbc.co.uk/1/hi/uk/8023977.stm). Funding must also go toward vaccine research and potential production on a mass scale and public health and prevention efforts. Finally, the Mexican economy is at present the hardest hit; Mexico City currently resembles a ghost town, and the impending decision to shut down public transportation may freeze almost all economic activity in the capital city.

Perhaps the hype and concern over swine flu is overstated, but it seems important to me to recognize the reverberations that the virus is already having on economies worldwide.

-Cooper

Finally - a health secretary to be confirmed!

In the midst of the recent swine flu outbreak, you may have noticed that there has been no words of advice or even input from the Secretary of Health and Human Services, the head of the CDC, or the surgeon general. Well, that's because no one held those positions.

In the midst of the recent outbreak of swine flu, the U.S. government finally realized that those positions might exist for a reason. Early this morning at 6:30 AM, the Senate scheduled a morning debate and an afternoon vote to confirm Kathleen Sebelius, a two-term Democratic governor of Kansas, as the Secretary of Health and Human Services. Although she is expected to get the 60 votes needed to be confirmed, many Republican senators are lobbying against the candidate for her stance on abortion and the substantial donations she received from a late-term abortion doctor.

An interesting and completely unrelated tidbit about Governor Sebelius - she has a 30-year streak of annually attending the New Orleans' Jazz Fest. Thank you, Wikipedia!

-Elizabeth

Universal Cold or Flu Vaccine?

We are getting closer to developing a universal cold or flu vaccine...how great would that be!!! 

Here's a quick summary on the most recent finding along with videos! 

http://www.emaxhealth.com/1020/90/30709/universal-flu-vaccine-closer-reality.html

-C. Paula de los Angeles

To Vaccinate or Not to Vaccinate?

By C. Paula de los Angeles 

In my smallpox travels online, I found this interesting list of quotes and facts compiled by the Chapter President of "Vaccination Liberation", an organization whose motto is "The Right to Know. The Freedom to Abstain", arguing against smallpox vaccination. Is smallpox vaccination even a realistic/desired possibility now? Also, check out that good old George W. Bush wisdom...question mark?  

http://www.rense.com/general32/20r.htm

20 Reasons Not to Take

Smallpox Vaccine

  By Ingri Cassel

DrCarley.com

12-14-2

1. George W. Bush has said of smallpox vaccination: "One of my concerns if we were to have universal vaccination, some might lose their life." ~The Times (in London), November 09, 2001.

 

2. For each million people vaccinated with the smallpox vaccine, as many as 250 could die, according to the American Medical Association. Multiply 250 times 285 (millions of Americans) and the possible deaths from universal smallpox vaccination could equal 71,250. ~ Journal of the American Medical Association, June 9, 1999, Vol. 281, No. 22, p. 2132.

 

3. "The American Medical Association said on Tuesday it was not in favor of an immediate mass U.S. smallpox vaccination program, saying the potential threat of a bioterror attack did not warrant inoculating every American against the disease." ~Reuters, December 12, 2001.

 

4. "Right now the risk of getting the vaccine is higher than the benefit. You could get a secondary infection, a full-blown systemic infection." ~Marie Rau, Panhandle Health District nurse, quoted by The Spokesman-Review, November 20, 2001.

 

5. CDC director Jeffrey Koplan has admitted that universal smallpox vaccination could unleash a significant number of side-effects. He said that because many parts of our population do not have a "robust immune system," a fair number of people could have serious reactions. ~Koplan speaking on the PBS special "Bioterror Propaganda" aired by WETA, November 14, 2001.

 

6. If the entire nation were to receive a smallpox vaccine, several thousand people would likely develop encephalitis, an inflammation of the brain. ~Washington Post, Dec. 26, 2001.

 

7. Roger J. Pomerantz, chief of the infectious disease department at Thomas Jefferson University in Philadelphia, said that doctors have no idea what the smallpox vaccine might do to people at the extremes of life--less than 2 and older than 65. He said that an even greater concern would be its effect on people with weakened immune systems from HIV infection, chemotherapy or transplants. ~Washington Post, Dec. 26, 2001.

 

8. "Researchers have been reluctant to recommend a new vaccination program which would use the smallpox vaccine for the local population because the vaccine can cause disease and death in persons with inadequate immune systems." ~Science, Vol. 277, July 18, 1997, pp. 312-13.

 

9. Routine smallpox vaccination in the United States ended in 1972. Officials are hesitant to resume the immunizations because the vaccine is the most reactive of all and has been linked to serious side effects, including death. ~ Reuters, November 29, 2001.

 

10. Eight printed pages of medical studies documenting the many serious side effects of smallpox vaccination can be obtained at www.whale.to/vaccines/smallpox.html. See "smallpox vaccine adverse reactions 66-76." [Note: go to the home page above and put "smallpox vaccine adverse reaction" in the search engine.] Repercussions include serious brain and heart diseases, autism, abnormal chromosomal changes, diabetes, various cancers and leukemias, plus demyelination of nerve tissue years after vaccination.

 

11. The U.S. Supreme Court has ruled that vaccination must not be forced on persons whose physical condition would make such vaccination "cruel and inhuman." In other words, the state has no right to command that an individual sacrifice his life in the name of public health. ~Jacobsen V. Massachusetts, 197 U.S. 11 (1905).

 

12. By the 1920s, several British medical researchers documented that smallpox was not only more common among the VACCINATED, but that the DEATH RATE from smallpox was actually higher among those who had been vaccinated. This indicates that the vaccine was ineffective and predisposed vaccinated persons to more lethal disease. ~Vaccination, Dr. Viera Scheibner, Australia, 1993, pp. 205-220.

 

13. Getting a vaccination does not guarantee immunity. ~CDC, January 28, 1994.

 

14. By 1987, scientific evidence indicated that the World Health Organization's 13-year global smallpox vaccination campaign may have awakened dormant HIV infection in many vaccines. ~Times (in London) May 11, 1987.

 

15. Vaccines made from animal substrate contain animal viruses that are impossible to filter out. By 1961, scientists discovered that animal viruses in vaccines, including smallpox, could act as a carcinogen when given to mice in combination with cancer-causing chemicals, even in amounts too small to induce tumors alone. They concluded that vaccine viruses function as a catalyst for tumor production. ~Science, December 15, 1961.

 

16. Some of the new smallpox vaccine doses will be created with animal substrate. Because the vaccine will incorporate vaccinia, the cowpox virus, many wonder about possible mad-cow contamination. Fifty-five million doses of the new vaccine will be created using a cell line dating back to 1966 and cultured from the lung tissues of an aborted human fetus. ~World Net Daily, December 4, 2001.

 

17. The new smallpox vaccine will be genetically engineered. Many scientists believe that genetically engineered vaccines may be responsible for the global epidemic of auto-immune disease and neurological dysfunction. ~American College of Rheumatology, annual meeting, Nov. 8-12, 1998. Merck's genetically engineered hepatitis B vaccine, Recombivax HB, is a classic example. According to Dr. Bonnie Dunbar of Baylor College of Medicine, many thousands of reported adverse reactions to the hepatitis B vaccine include: chronic fatigue, neurological disorders, rheumatoid arthritis, lupus and MS-like disease.

~Testimony of Dr. Dunbar to Texas Dept. of Health, March 12, 1999. Over 15,000 French citizens sued the French government to stop mandatory hepatitis B injections for school children because of resulting auto-immune diseases. ~Science, July 31, 1998. Dr. John Classen has published voluminous data showing that the hepatitis B and other vaccines are closely linked to the development of insulin dependent diabetes. ~Infectious Diseases in Clinical Practice, October 22, 1997.

 

18. The British vaccine manufacturer Medeva has a horrendous record of contamination and blunders. In 2000, the FDA found that Medeva was making vaccines in conditions of filth, resulting in contaminated products. Medeva had been illegally using bovine medium to culture its polio vaccines, then lied about it. Medeva also used the blood of a Creutzfeldt-Jakob victim (mad cow) to manufacture 83,000 doses of polio vaccine used for (against?) Irish children. Nevertheless, the FDA allowed the USA to accept Medeva's flu vaccine (Fluvirin) for the year 2000. ~London Observer series: October 20-26, 2000.

 

19. In 2001, the British socialized health care system was reported to be in a state of collapse, with many hospitals and labs operating in abysmal filth. Five thousand people die each year from infections contracted in British hospitals; 10,000 become deathly ill from such infections. Sterilization procedures are barely adequate and said to be risking the spread of mad cow disease. Government ministers are reportedly trying to hush up the scandal. www.itn.co.uk/Jan 06, 2001; The Sunday Times of London, November 12, 2001.

 

20. The U.S. government apparently intends to conduct NO double blind studies on the safety and efficacy of the new smallpox vaccine. It has ordered 286 million doses, one for every man, woman and child in America at a cost of $428 million. At least half of this vaccine will be delivered by Acambis PLC of great Britain.

 

Tip of the Week: Keep all vaccine needles away from your body! 

Swine Flu at the FARM?! The On-Campus Response So Far...

As we are talking about lovely infectious diseases and how humans have (or should have) reacted to them in the past, I thought it might be interesting to look at the current response to swine flu back at Stanford. 

Below is the flyer being circulated by PHEs (Peer Health Educators) via dorm email lists, etc.

What do you think: 

Is this an acceptable response to the threat of swine flu on a college campus? Too much/too little? 

How is it similar to the efforts to contain other virulent diseases, and how is it different?

-Molly

In the spirit of media hysteria: Whale Flu - The next great plague???

Check out the Discovery Channel's top ten animals that carry the influenza virus.

Maybe you'll think twice before reaching for that juicy whale filet the next time

you're in Tokyo.  

Source: http://dsc.discovery.com/news/top-10/top-10-flu-animals.html

Cheers,

Khang

New & Hot - Measles

Measles - totally preventable, but popping up again as a big issue in Wales & Virginia

Elaine Su

New & Hot - Preventing the Flu

This article in NEJM identifies the current method of prioritizing recipients of flu vaccines as ineffective, insofar as they do not prevent epidemics. Currently, those who are more susceptible to death from flu, i.e., the elderly, are encouraged to receive vaccinations before young adults, who have stronger immune systems. However, according to this article, flu vaccinations are recommended for groups that make up approximately 85% of the American population. The author of the article is in favor of universal vaccination, arguing that the resources are available, and a minimal increase in expenditures will prevent unexpected deaths in unlikely age groups.

Elaine Su 4/27/09
http://content.nejm.org/cgi/content/full/359/24/2579

Making Molecules and History

BBC News Science and Environment- "World First for Strange Molecule"

Scientists at Stuttgart University have "created" the Rydberg molecule, a theorized molecule that was impossible to create because of the incredibly low temperatures needed to work with the molecule's two electrons. The molecule was originally theorized by Enrico Fermi in 1924, but it was solely a theorized example because of the lack of technology to make the incredibly cold environment needed to "make" the molecule. The creation of the bond has confirmed "long-held fundamental atomic theories".

http://news.bbc.co.uk/2/hi/science/nature/8013343.stm

Kaitlyn

The Speckled Monster - Elaine Su

The Speckled Monster by Jennifer Lee Carrell
Reviewed by Elaine Su 27/4/09

Jennifer Lee Carrell’s account of Lady Mary Wortley Montagu and Dr. Zabdiel Boylston is well-researched and delves into the personal lives of two prominent figures in the history of smallpox. Carrell channels their personalities, achieving a psychological depth in her characters that brings history to life. The text is an easy read and provides a cursory view of the early history of smallpox as the virus ravaged the cities of London and Boston in the early 1700’s. Despite Carrell’s propensity for one-word sentences and occasional lapses into melodrama, the novel is not without its shining moments; the townhouse debate between Boylston and his intellectual adversary, Dr. Douglass, is both probing and vibrant. Ambitious in its attempts to compress a complicated time period into two mini-biographies, The Speckled Monster nonetheless succeeds in painting an engrossing picture of an era that is utterly preoccupied with the treat of smallpox and the controversy of variolation.

I'd rather be in Hong Kong: where to go in the event of an epidemic

Crystal Zheng

As Swine Flu begins to appear in more and more places across the globe, the city most prepared for it may be Hong Kong. With lessons learned from the not so distant SARS legacy, which killed almost 300 people, Hong Kong has since instituted reforms and created a system incredibly ready to prevent and mobilize action against any epidemic. Can anyone not be impressed by its facial-temperature readers built into the security gates at the airport, designed to detect fevers? Anyone passing through with a fever will immediately be quarantined until swine flu tests (which take two days) are confirmed negative. Health centers have been established to accommodate a potential large influx of patients due to epidemics, and funding has been appropriated to disease research.
Think back to Hong Kong of 2003: a horribly disjunct system with no communication between government departments, the public health services sector, and the private health sector; no plan in place to respond to a sudden epidemic; covering up of information and non-cooperation from the central Chinese government; insufficient capacity to respond to an overflow of patients. (for more info: http://www.bmj.com/cgi/content/full/327/7419/832-b)
I am relieved to see that Hong Kong has learned its lesson from SARS, and as a result has become one of the safest cities to be in during an epidemic. I’m surprised that more nations did not take Hong Kong as a warning to begin developing their own disease control programs. If in 2003 Mexico City had started to do so, then perhaps today’s events would not be happening.

See http://www.nytimes.com/2009/04/27/world/asia/27kong.html for more info

Book Review: Biohazard by Ken Alibek

By Crystal Zheng

When I first started reading Biohazard, I thought I had picked up a sci-fi novel and almost forgot that I was reading non-fiction. Easy and quick reading, the story is a narrative of Alibek’s work with the secret Soviet bio-weapons program. Written for the un-technical reader, Alibek provides friendly explanations of immunology and virology suitable to the layman.
The most redeeming part of the book is the perspective it gives the reader to make more informed assessments of the current security climate and our nation’s ability to respond to potential threats. The most chilling part is that these threats could still exist in unknown hands; whereas the enemy of Alibek’s time was the single Soviet Union, today’s enemies are non-traditional and numerous rogue states and terrorist groups.
If you’re looking for just the facts, prepare to read through a good deal of personal memoir material. The main complaint I have about this book is that it tends to drag on and give too many details. The author could easily have gotten his point across in a 150 pages, but instead takes over 300 pages. The main points tend to become bogged down by personal details. It’s difficult to separate credibility from sensationalism. For example, the first page describes a scene of viral particles descending upon an island of African monkeys. Do not choose this book if your criteria is literary merit.
Overall, the book brings up some very interesting and little-known events. I just wish that an abridged version could come out soon. Unless you’re very interested in this man’s personal life, a Wikipedia article may suffice.

In celebration of World Malaria Day (which was on Saturday)!

http://edition.cnn.com/2009/HEALTH/04/23/world.malaria.day/index.html

First, a semi-relevant quote by Samuel Clemens:
"History doesn't repeat itself, but it rhymes."

   Today, the malaria virus strongly rages, reportedly causing sickness in 250 million people each year and killing around one million. If the WHO had their way in 1955, malaria would have joined the ranks of smallpox as the only diseases to have been eradicated. However, despite the substantial reduction of its presence, the malaria eradication effort fell short of full success. The article points to lack of public support as the main cause for past failure, with help from overconfidence and complacency in medical treatments available back then. For many top researchers and scientists, fully eradicating malaria persists is an impossible goal. In case you didn't know (because I didn't), malaria is a dynamic virus, able to develop resistance to medicines designed to combat it as well as rapidly proliferate through migrant populations of mosquitos. It requires constant and vigilant research and development of treatments. However, despite the apparent challenges, the notion that full eradication is possible is held by the National Institute of Allergy and Infectious Disease as stated by its director, Dr. Anthony S. Fauci.
   Regarding Clemens' quote as the beginning, even though previous eradication efforts failed, Fauci believes the past provides valuable insight into how to succeed in the present and future. Efforts for eradication were rekindled by none other than our favorite entrepreneurial, technocratic philanthropists, Bill and Melinda Gates.
   It is interesting to note that drugs aren't described in the article to be the key to successful malaria eradication; rather, wide-spread community education is the critical component of our second round fight against malaria. With better technology and newfound information on malaria, the public can be made more knowledgeable and aware of the disease's capabilities and dangers and thus, create more incentives to invest in the necessary biomedical research towards eradication.

In conclusion, I'll end with a quip because I started with a quote from the quip master.

Let's keep up the anti-malaria hysteria and sustain our pro-eradication sensation!

-teresa

Two TED talks

For anyone who hasn’t yet become addicted to TED—these two are a good place to start:

(1) http://www.ted.com/index.php/talks/larry_brilliant_wants_to_stop_pandemics.html

This award-winning talk by Dr. Larry Brilliant, who oversaw the last cases of smallpox in the world, discusses its eradication as well as remaining public health challenges such as blindness and pandemic flu.

Brilliant portrays Smallpox as an equalizer of sorts: being rich or strong “cannot protect you from dying of Smallpox…we are all in this together.” (However, we know this is not entirely, or at least not historically, true: during the American epidemic in the 17 and 1800’s, the wealthy, who could afford to be inoculated, often put the poor at risk from the disease). (According to Pox Americana).

One segment of the talk goes into the strategies his team used to eliminate the disease in India: they realized mass vaccination was beyond their abilities for the size and population of the country, and because more un-vaccinated babies would constantly be being born. Instead, they got a massive number of people to go door-to-door with the picture we saw in class, creating “circles of immunity” around each case they discovered.

Some families didn’t want to report Smallpox because they believed it meant (as we discussed in class) they were being visited by a God, and were not supposed to let strangers in while she was there. This was true in a number of countries.

Brilliant also discusses the great potential of web-based epidemic tracking systems—using webcrawlers and Internet searches for early detection of disease.

(2) http://www.ted.com/index.php/talks/nathan_wolfe_hunts_for_the_next_aids.html

This talk by Nathan Wolfe, the head of the Global Viral Forecasting Initiative (GVFI), discusses identification of human diseases via monitoring of “viral chatter” in animal populations. He works specifically with bushmeat hunters in Cameroon. They frequently come into direct contact with animal (particularly primate) blood, and thus, if infected by an animal they kill, could make great “mixing vessels” for a new human virus. He believes that by monitoring this chatter we can prevent new pandemics before they start. HIs research so far has identified several new retroviruses and poxviruses in humans.

Wolfe is currently a visiting Humbio Professor at Stanford, and a really friendly guy (I and some other Smallpox students took his class fall quarter). I’m sure he’d be open to any student inquiries about his work (although he might be hard to reach)—his email is nwolfe@gvfi.org.

Anne

-(Anne)

And you thought the Swine flu posts were over...

http://healthmap.org/en

Site tracking its progress...

More Swine Flu

Hey guys,
There is also a great article about it on BBC.com
http://www.facebook.com/ext/share.php?sid=76497222059&h=9AH6m&u=iRNBD&ref=nf

Katie

Swine Flu Update!

Swine Flu Update!

http://www.guardian.co.uk/world/2009/apr/26/swine-flu-pandemic

The front page of guardian.co.uk this morning reports that 20 people have died from “swine flu” in Mexico City, with 48 more deaths possibly attributable to the outbreak. 11 cases have been reported in the US.

A Kansas couple with a mild form of the illness has been allowed to stay at home because, according to their doctor, they “understood the gravity of the situation and are very willing to isolate themselves.”

Such an individual public health consciousness is something that was rarely seen during past smallpox outbreaks in the Americas (when, for example, recently-inoculated and likely contagious carriers continued to go about their daily lives), and is still sometimes breached in important circumstances today—for example, in the case of the man who boarded a plane with multidrug-resistant TB.

A British Airways flight attendant is believed to have come down with the disease en route from Mexico to London, and is currently being isolated in London’s Northwick Park hospital.

According to the Guardian, “People in Mexico City were being ordered not to kiss or shake hands. Football matches went ahead without spectators, theatres, shops and museums were closed, staff were inside locked schools scrubbing classrooms with disinfectant, and health workers patrolled buses, ordering sickly looking people home.

“…Any doubts over the extent of the emergency were dispelled last night by the sight of soldiers handing out blue surgical masks to pedestrians and motorists along Mexico City's central boulevard, Paseo de la Reforma.”
It’s rare to see a modern-day epidemic change the face of a city so drastically. The Guardian’s description recalled the “empty city” scenes described in Pox Americana during the smallpox epidemics in the Americas during the 17 and 1800’s.

The virus has been classified as A/H1N1, a mix of human, bird, and pig viruses. Unlike avian flu, this strain appears to be transmissible from human to human, and thus has sparked WHO fears of a pandemic.

The cases have ranged from mild to severe, and it’s interesting to note that all of the US cases have been mild. Could this have to do with genetic differences? And, in that case, could it maybe shed light on the reasons why smallpox or other past epidemics had such varying effects in different populations? Or is it more likely (because of the small sample size) simply chance? A difference in the virus, itself? Differences in access to health care?

The CDC has already created a vaccine “seed stock” genetically matched to the new virus, which could be used to get started producing vaccine if they decide it is necessary.

Anne

Book Review: Edward Jenner’s Cowpox Vaccine: The History of a Medical Myth By Peter Razzell

Crystal Zheng
Peter Razzell argues, in a very dry and tedious way, that the traditionally accepted story of Jenner’s discovery of cowpox as a vaccination against smallpox was nothing more than variolation, a practice which had been going on for centuries; in other words, the “cowpox” strain he was using was actually smallpox. He presents evidence from Jenner and other colleagues’ notebooks as well as historical epidemiological evidence.
His evidence does raise some questions and might prompt one to revisit this page in history, but is not enough to convince me of his argument. Although I commend him for taking a counter-approach to history, I think he does a lackluster job of convincing the reader of its significance. I want to know, other than as an interesting fact for the medical history book, why is it important for us to resolve this issue? The side cover gives a few hints into implications for the eradication of smallpox, but it is not discussed by Razzell in the text. The back cover claims that if Razzell is right, then Jenner is not such a big hero after all. Perhaps it is because I do not have the necessary background or appreciation, but the book leaves me with a big , “So what?”.
While the material is mostly historical, Razzell provides a refreshing last chapter about scientific discoveries that corroborate the observations of Jenner and early physicians working on smallpox. However, the 1977 book seems to be quite outdated, and anyone seeking information about recent research in smallpox should look elsewhere.
The material is fairly dense and technical, as it mostly uses primary material for evidence. I would suggest that anybody reading this book do so only after having a fair background to the material. This book presents a counter-interpretation of history; thus it is only logical that readers should first understand the accepted interpretation. Without this background, it is difficult for a reader to critically assess Razzell’s argument.
The most redeeming part of this book is that it reminds us to read history with a grain of skepticism. History is not truth written in stone, but is only transmitted to us as recorded through the eyes of people with ulterior motives. We should keep those motives in mind and critically assess any interpretation of history that we are presented with.

New and Hot- Swine Flu

Sorry. The swine flu post was by Katie Ridley

New and Hot- Swine Flu

http://news.yahoo.com/s/ap/20090425/ap_on_re_la_am_ca/med_swine_flu

Above is a link to an article about Mexican swine flu, which is a newly discovered disease discovered in Mexico and linked to pigs. The symptoms are much like a normal flu, but the virus can be deadly, capturing the attention of WHO and the CDC. Large gatherings such as concerts in Mexico City have been shut down and people have been warned against crowds( such as being in a movie theatre). A few cases have crossed into California and Mexico but so far none have been fatal.

Check it out.

Book Reviews

Biohazard by Ken Alibek

Chillingly compelling and wildly gripping, Ken Alibek’s Biohazard is a good read for anyone interested in the secret world of biological warfare. This true story reads as one part biography, one part historical account, one part scientific journal, and one part thrilling suspense novel. The author is a former Soviet scientist whose life work was the creation of biological weapons capable of taking the lives of millions. He weaves personal experience, research, and scientific explanations together in such an artful web that the reader can’t help but be caught in the story. The science in this book is approached in an intelligent but simple way; even a person with no background in biology would have no problem understanding Alibek’s explanations. However, this book is not for the squeamish reader as some parts are quite gruesome. This novel serves as Alibek’s atonement for a career in killing, and he is sympathetic despite the horrors he creates. The true strength of this book comes from the author’s sincerity and honesty, however when he makes conjectures and predictions based on policy he has no personal experience of, the book loses some of its force and clarity. Luckily these lapses in technique are few and far between and most of the story is believable and engaging. Overall it is well written and delivers the frightening message that what we don’t know might kill us.

The Smallpox Slayer by Alan Brown

The Smallpox Slayer by Alan Brown is a good overview on Dr. Jenner’s life and work, but it is oddly graphic for a children’s book. I appreciated how Brown tried to make the smallpox story more relatable to kids by looking at it from the boy Jenner first vaccinated’s perspective. However, there is the one blaringly obvious flaw; mainly that this is a children’s book on a deadly infectious disease. It seems a strange topic for a children’s book and might be upsetting to kids with big imaginations. The book features such doomsday phrases as “ If you had lived [in 1796] one of your brothers or sisters would probably have died of smallpox. It might have been two. It might have been you”. The book is well written and does a good job summing up Jenner’s work and describing the scientific method used to defeat smallpox. However, it is imperative not to give this book to a child who is too young or upset by graphic descriptions of diseases. After the first ten pages or so the book is fairly light and positive, but getting through the first few pages poses some problems. All in all, for the right child, this could be a very informative and interesting book.

Katie Ridley

More on Malaria...

In continued celebration of World Malaria Day--

http://www.nytimes.com/2009/04/18/world/18malaria.html?_r=1&scp=2&sq=malaria&st=cse

On April 17, nytimes.com covered a new campaign--Affordable Medicines Facility for Malaria-- that aims to substantially cut Malaria drug costs for the developing world. 

The campaign plans to pressure (and help subsidize) drug companies currently manufacturing Artemisinin combination drugs (see http://en.wikipedia.org/wiki/Artemisinin) until the drugs are affordable to developing-world consumers over less-effective, but cheaper, alternatives like Choloroquine, to which many malaria strains have become resistant. Currently, Artemisinin combination drugs cost 10 to 40 times more than Chloroquine.

The Global Fund, the Roll Back Malaria Partnership, and Unitaid; along with Norway, Britain, and the Netherlands, are spearheading the effort. 

The US has not yet given its support, arguing that "the advocacy [has gotten] out ahead of the evidence." The deputy coordinator of the President's Malaria Initiative, Dr. Bernard Nahlen, called for more studies showing that this type of effort would work before the US would join the campaign.

I understand why the US is reluctant to put money into something relatively new and unknown. As the article points out, better and more widespread Malaria diagnostics may be a key issue to deal with before turning to treatment: there's evidence that, in many parts of the world, fearful patients overdiagnose malaria and end up using drugs when they may not actually need them. (If this were to happen with new multi-drug therapies, could it contribute to increased resistance?). 

On the other hand, If Obama truly means to meet his ambitious 2015 goal, I'm not sure he has time to wait around. He may need to accept this bolder effort (and many more like it) as a real-world laboratory for the "further research" he seeks; and let go of plans for more cautious study.

-Anne

Happy World Malaria Day

Tomorrow marks the second annual World Malaria Day, dedicated to raising awareness of the worldwide campaign to fight malaria.  President Obama recently stated his commitment to ending malaria deaths by 2015, and he has some valuable allies in the fight; Bill Gates announced his dedication in 2007.

The cause is noble, since approximately 250 million people contract malaria every year, and a million of the cases lead to death.  But malaria differs in some key ways from smallpox, and thus global eradication would be a very different process.  First and foremost, we still haven't developed a reliable vaccine for the disease (which is caused by protozoan parasites), although the search is on (various treatments and preventive drugs do exist, though).  Second, while variola only affected humans, and thus could only be transmitted from human to human, malaria is spread by mosquitoes, which means an eradication campaign may even require the eradication--or at least containment--of mosquitoes.  

Despite these difficulties, many argue that global eradication is possible--just look at the U.S. and other countries where malaria no longer exists--but there still exist doubts as to whether total eradication similar to that of variola is even possible, since the parasite could theoretically reappear with the right conditions (hence the potential need for eliminating mosquitoes).  Vigilant vaccination and treatment might thus be a more prudent approach than a worldwide eradication campaign.

Loads of information on the debate is easily accessible, and it's a pretty interesting one. Here's the brief article that spurred my interest.

http://www.google.com/hostednews/ap/article/ALeqM5iD0C8OsOU8jCRHT3osRuyarYP2jgD97OG8K00

-Andrew Beck

Book Review: Pox Americana

   Pox Americana: The Great Smallpox Epidemic of 1775-82 by Elizabeth A. Fenn insightfully follows the spread of smallpox throughout the entire North America between the titled years by compiling and analyzing various primary documents. Using sources ranging from Catholic Mission archives to personal diaries, Fenn paints a illustrative portrait of the suffering smallpox creates and the vital role it played during the US's formative years. In fact, the book strongly asserts smallpox's spread as a concise and telling documentation of both Natives-Americans' and settlers' development. Each chapter focuses on a specific location during the period and explores how smallpox arrived there. Short narratives mark the beginning of each chapter, providing vignettes that enable the book's anthropological and scientific facts to possess the appeal of a historical fiction book. That said, Pox Americana is as informative as it is easy to read.
   The book's strengths lie in Fenn's talent in weaving together a multitude of primary documents to create a detailed historic tapestry; it is undeniably well-researched. She not only offers several scenarios for how smallpox reaches and disperses in a certain region but also finely argues the one she believes most plausible. She carefully explores the virus's impacts in various sectors of society, from politics and economy to biology and technology. Furthermore, Fenn compares and contrasts how different cultures reacted to the Variola virus. For example, Fenn dedicates one chapter on the mandates General George Washington passed when he lead the Continential Army in the Revolutionary War and another chapter on how the entry of guns and horses in the Central Plains altered tribal relations and produces an environment perfect for Variola to proliferate. After reading Pox Americana, readers will be able to vividly see how the Variola virus shaped the development of the US.
   However, I must warn readers that the weakness of the book exists within the strengths-- sometimes, there simply is too much information. In one paragraph alone, readers can find up to (and sometimes more than) five distinct dates and incidents. I occasionally feel as if Fenn is cramming all the information in there. Throughout the book, I'd think to myself, “Okay, I get the point” after reading a semi-exorbitant number of accounts that leaves readers confused and annoyed. Other than that, Pox Americana is a thoroughly good read for historians, biologists, and the general curious population alike.

HIV Research and the "Humanized Mouse"

One significant challenge of HIV research is that the HIV virus infects only humans and chimpanzees -- not dogs, cats, rodents, or any other normal lab test animals. As a result, testing hypotheses about HIV transmission has been extremely difficult; infecting humans with HIV is unethical, and infecting chimpanzees with HIV is not feasible because of their protection as endangered species. However, Dr. J. Victor Garcia-Martinez of the University of Texas Southwestern has come up with a clever research technique that circumvents these constraints. This week, Garcia-Martinez gave a presentation describing new developments in his use of the "humanized mouse" to study HIV.

The mouse model is a chimera, meaning its cells are taken from two (or more) sets of genetically distinct cells. Fetal human liver and thymic tissue cells were used to repopulate the bone marrow, from which new cells were then created. The mouse thus develops a human immune system and can be infected with HIV. Garcia-Martinez previously used the mouse model to show that antiretroviral drugs given before and after HIV transmission can prevent vaginal transmission. This research implies, according to Science Daily, that high risk women might one day be able to take a regular pill to prevent HIV infection.

Having begun by studying male-to-female transmission, Garcia-Martinez is now using the humanized mouse to study male-to-male transmission. In my opinion, his work is extremely creative and his concept important -- even if I do have a hard time wrapping my head around the idea of a mouse that is part human!

The article can be found at: http://www.sciencedaily.com/releases/2009/04/090420103740.htm

-Cooper

Some humbling statistics from my hometown: DC highest HIV rate in nation

As a lifelong Washingtonian (having been born in Crystal City), there is no lack of material for me be proud of. We believe that the whole world revolves around our demure, yet dignified, city, and I am constantly finding myself holding my nose up when surrounded by the less politically cognizant. Sometimes the Redskins have a pretty good season too..

However, while doing reading for my New and Hot, I stumbled across some surprising news in the New York Times that hit quite close to home (literally): Washington D.C. has the highest rate of HIV/AIDS in the country (I always assumed it was San Francisco). According to the D.C. 2007 Annual AIDS Report, 1 in 50 D.C. residents are living with HIV/AIDS; compare that with 1 in 7000 nationwide. Heterosexual transmission, especially among adolescents, is increasing, underscoring the need for for effective sex education. Meanwhile, MTC (mother-to-child) transmission has increased as well, which is especially disconcerting considering that these cases are easily preventable with routine testing and drugs. Even though blacks account for 51% of the DC population, of the 12,400 PLWHA (people living with HIV/AIDS), 81% are black.

Concurrently in the Times, Tom Friedman laments racial disparity in our schools and economy (link). The disproportionate infection rate among blacks is a sad and brutal reminder that in a city with the most powerful people in the country, racial inequality still plagues its neighborhoods, and the consequence is life or death. It also warns that the problem is not as easy to solve as the superficial "Free Condoms for Everyone!" approach, but that much deeper social issues need to be resolved in order to truly address HIV/AIDS.

Changes need to happen and they need to happen fast. Fortunately, HIV/AIDS has become a more pressing item on the political agenda; as Elizabeth brought up, Obama's first days brought some sorely needed change to this country's AIDS policy, including allowing federal funding for clean needle programs and comprehensive sex education. We will see if America can clean up its act -- for my hometown and for America, I will keep my fingers crossed.

--Crystal Zheng

New and Hot: HIV Vaccines are Hard to Make: One Reason

http://mr.caltech.edu/media/Press_Releases/PR13252.html

Researchers have been trying for nearly 25 years to develop an HIV vaccine, but the development of a vaccine has proven extremely elusive. Yesterday two Caltech scientists presented a report that provides one reason for the difficulties. Many antibodies work by intercepting the virus with a two-pronged receptor before the virus can infect the cell. This is effective for the influenza virus, for instance, because it has 450 "spikes" protruding from it, so the likelihood of two of these spikes bumping into the two prongs of the receptor are fairly high. The Caltech scientists found that using two-pronged receptors was less effective than predicted because an HIV virus might have fewer than 15 spikes--decreasing the likelihood that a receptor will bind to the virus with both prongs. This is important, because when both arms of an antibody bond to a virus, "there can be a hundred to thousandfold increase in the strength of the interaction, which can sometimes translate into an equally dramatic increase in its ability to neutralize a virus."

Another difficulty in designing an effective HIV vaccine is the mutability of the HIV virus. Apparently HIV mutates quickly, so a vaccine would have to produce a wide variety of antibodies to bind with many variations (NY Times, Altman, "Gateses to Finance H.I.V. Vaccine Search").

-Elaine Chang

Polio Eradication Effort Facing Reversal in Central Africa

Like smallpox in the past, polio is a vaccine-preventable disease facing a decades-long global eradication effort, much of which is detailed on the website of the Global Polio Eradication Initiative: http://www.polioeradication.org/. But according to an April 20, 2009 article in the New York Times, 15 countries in Africa previously polio-free have found the disease within their borders since January 2008. Some of these countries, like Uganda, had been free of the disease for over a decade. While Nigeria, India, Pakistan, and Afghanistan are the only four countries in which polio has never been eradicated, the new cases found in central to southern Africa have prompted fears of a greater outbreak, especially since the disease has reached Port Sudan again, a stop on the way to Mecca, the Muslim pilgrimage site believed to have helped the disease spread quickly to Yemen, Somalia, Indonesia, and Saudi Arabia between 2004 and 2006.

Something I found particularly interesting about this report was that many newly reinfected areas are those with high concentration of Muslims, many of whom have resisted vaccination "because of rumors that vaccine efforts are a Western plot to sterilize them," according to the NYTimes article. While (hopefully) untrue here, the virility of this rumor underscores both the politics, perceived or real, of such an eradication effort on a global scale.

Click for NYTimes article.
Link to original WHO article: http://www.who.int/wer/2009/wer8416/en/index.html

-Molly

Obama ends ban on federal funding for needle-exchange programs

President Obama recently ended a decades-old ban on federal funding for needle-exchange programs. Needle-exchange programs are based on the idea of harm reduction; they provide hypodermic needles to injection drug users to prevent the spread of HIV, hepatitis B and C, and other infectious diseases. They are, of course, controversial since many argue that giving clean needles to drug users will increase drug addiction. To me, the claim is eerily reminiscent of the argument used against condom distribution or comprehensive sex education in HIV prevention. But numerous studies have found that needle-exchange programs do NOT increase drug addiction and that they are very effective in decreasing the prevalence of HIV among injecting drug users. In one study, HIV infection rates decreased by 5.8% in one year in cities with needle-exchange programs while they increased by 5.9% in cities without the programs. President Obama has yet to reverse former President Bush's ban on the use of U.S. foreign aid money to finance needle-exchange programs. Perhaps that should be his next step considering the fact that 30% of global HIV infections outside of sub-Saharan Africa are caused by injecting drugs!

Link to article: http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=58166

An interesting side note on Teresa's article about the 2 cases of swine flu: there is a theory that pigs are potential "mixing vessels" (or some call them "cocktail shakers") since they can harbor both human and avian flu viruses. Inside the pigs, the human and avian flu viruses could exchange genetic material to mutate into a super virus that could be easily transmitted from human to human. As of now, avian flu H5N1 has not shown sustained human to human transmission, but there have been increasing reports of pigs infected with H5N1 in east and southeast Asia.

-Elizabeth

Viruses as batteries?

A group of researchers at the Massachusetts Institute of Technology in Cambridge are betting that viruses could be the key to making low-energy, 'green'-friendly batteries. The researchers replicate the inner workings of a battery using biological processes. In their series of studies working with the M13 virus, they were able to engineer both an anode and a cathode within the virus, with the outer shell acting as the anode and the virus' carbon nanotubes as the cathode. Tests found the resulting battery to have performance comparable to commercial lithium-ion batteries. However, since the virus battery offers no performance gains compared to current battery technology, further inroads must be made before viruses can be a viable source of battery technology. In my opinion, it will only be a matter of time before this technology is properly optimized; the prospects of an low-energy, environmentally-friendly battery are just too attractive in this green-conscious era.

link to article: http://sciencenow.sciencemag.org/cgi/content/full/2009/403/1

-Andrew Plan

Book Review & Update

The Demon in the Freezer, Richard Preston, 2002

Preston ambitiously aims to chronicle a recent history of smallpox in layman’s terms, and generally succeeds in painting a comprehensible picture of viral infection. Demon is filled with comparisons that make Preston’s subject accessible, but as can be expected, excerpts are sometimes hindered by cumbersome extended analogies and misleading metaphors. As he attempts to write about a scientifically complicated phenomenon with a poetic slant, Preston is occasionally impeded by his own language, as he (poetically, but inaccurately) describes trans-species virus jumps as “random yet full of purpose,” and refers to viruses as “pickpockets” (51). Much of the book is concise and descriptive, but some pages read like the drafts of a feature writer who has been assigned to cover a front-page news story; at times, the book is muddled by a self-consciousness that is out of place given its narrative goals. Preston’s scope also widens unannounced, as he moves from discussions of smallpox to details of anthrax scares. Among the book’s merits are a descriptive style that lends itself easily to film adaptations, if not a science textbook. Preston offers glimpses into the personalities of big names such as DA Henderson and Peter Jarhling. As a whole, Preston succeeds in capturing his reader’s attention, but at the expense of occasionally glossing over the gritty scientific details.

Elaine Su

As far as other crazy stuff going on in the world, avian flu might be silently circulating in Egypt: http://www.nytimes.com/2009/04/21/health/21flu.html?_r=1&ref=science

The Swine Flu Virus Redux

http://www.medscape.com/viewarticle/701738

Though they showed no severe symptoms and have recovered since, the two recent cases of Swine Flu should incite alarm. Both victims had no contact with pigs yet the virus infected them-- suggesting, as the article reports, that the virus can now be transmitted from human to human. Furthermore, the CDC reports how the current influenza vaccine and antiviral treatments proved useless against the swine viruses. These development provide current evidence of virus' resilient survival traits as they advance their biological capabilities. We touched on this topic of virus formidability briefly in class on Tuesday.
On a lighter note, though the number of swine flu cases have increased in recent years, we can take this as success of the public influenza surveillance programs in California (hooray for us).
The article also introduced me to the CDC's Morbidity and Mortality Weekly Report (MMWR); its title suggests the nature and frequency of its reports. For anyone interested in official real-time developments of infectious diseases and treatment, you can find it at the MMWR website http://www.cdc.gov/mmwr/ .

My final thought: I think I'll pass on pork chops for the time being.

-Teresa Tarn

Book Review! "Scourge"

Book Review- “Scourge: The Once and Future Threat of Smallpox” by Jonathan B. Tucker

In Tucker’s “Scourge”, attention is heavily focused on the global eradication efforts of smallpox and the “final inch” in the campaign to rid the world of the variola virus. Though a history of the magnitude of the virus is presented in the first few chapters, Tucker relies on the names of the various actors that played roles in the WHO’s eradication campaign, the CDC’s contribution to the efforts in West Africa, and the revealing of the Soviet Union’s multiton bioterrorist activities that revolved around the dispersion of aerosolized smallpox laced bomblets. If you are more interested in the history of the development of the vaccine, or the devastating effects of smallpox throughout the centuries, then another book might fit those needs better. Tucker gives the Jenner and Lady Montagu story scant space in this book, choosing to focus more on the ongoing controversy regarding the destruction of the few stores of smallpox virus samples left in the world (Moscow, Atlanta) and the bioterrorist dangers that could arise from the variola virus. All in all, “Scourge” gives a very generalized view of the complex history of the human-specific smallpox virus, yet is rich in the post-1950s activities of smallpox eradication efforts, USSR bioterrorist threats, and the debate over destruction of the live samples of the virus.

ALSO: A new species of lichen has been named after Obama. Just a fun trivia fact-

http://news.mongabay.com/2009/0415-hance_lichen.html

Kaitlyn

Is your house feeling a bit gray and dreary? Redecorate with broad-spectrum anti-microbial paint!!!

Scientists at the University of South Dakota's Biomedical Research Program have recently incorporated a new N-halamine monomer (N-chloro-2,2,6,6-tetramethyl-4-piperidinyl methacrylate) into a polymer which can easily be used in paints.  This new isoform of N-halamine, a compound which has already been used as a disinfectant to a limited extent, shows signs of being able to kill off the dreaded “superbugs,” or drug-resistant bacteria.  This polymer also demonstrates the ability to destroy some viruses and fungi.  Other advantages to this polymer include its retained potency for a relatively long duration, ease of monitoring with a simple potassium iodine/starch test, and it’s “rechargeable” with a straightforward chlorination process.  Plus, it doesn’t interfere with the quality of latex paints, so hospitals can finally get fun, colorful paint schemes instead of that morbid, death-inducing white they always use.  

Cheers,

Khang

Source: http://pubs.acs.org/doi/abs/10.1021/am800157a