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Archive for the ‘Infectious disease’ Category

By Savannah Keller

When we think about modern pharmaceutical products, we look across the Charles River to the biotech companies that are developing cutting-edge drugs to combat rare clinical diseases. When we think about the burden of bacterial disease, we feel safe that simple antibiotics will keep us protected from such infections. Thus, our fears are averted towards the more complex viruses such as HIV and Malaria; a reasonable mindset due to the higher global death toll attributed to these viruses. But what will happen to us all when the basic antibiotics we so heavily take for granted stop working? (more…)

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By Clarissa Schaffino

Microcephaly is a rare condition where infants are born with unusually small heads and consequently have problems with brain development. This condition has not been widely studied but can have severe ramifications later on in life. Microcephaly is believed to be caused by a number of things but today there is a concern regarding the Zika Virus. This virus is transmitted by a vector mosquito and produces minor symptoms for its host. This virus is believed to have come from Africa in the early 1940’s (Tavernise, 2016). Today, it is affecting many pregnant women in Brazil and other regions of the Americas. Those who have had this virus are now seeing microcephaly in their newborn babies. This is a rising concern due to the large number of incidence. Zika virus has not been proven to cause the condition of microcephaly but there appears to be a strong link among the two and major health players are stepping in.

Little is known about the exact transmission of Zika virus. It was previously thought that this virus was only caused by mosquito bite; however, new cases in different regions suggest that there are other transmission pathways. According to an article in the New York Times, new cases of Zika Virus in the United States suggest that “Zika virus” is “possibly being transmitted by sex” (Tarvernise, 2016). A report from Live Science, confirms this theory by stating that there are cases that “[provide] even more evidence that the virus can be transmitted through sex” (Rettner, 2016). A report on a man who contracted this virus states that “follow-up tests for the virus” were “conducted” and “it could still be found in the semen 62 days after the man’s illness”. This news is alarming because women now have to protect themselves for a period that is longer than 30 days and they may not have access to the proper protection methods such as “condoms or contraception” (Tavernise, 2016). Also, the “testing of semen may be difficult” (Rettner, 2016). This could cause problems because we are not entirely sure how long the virus remains present in fluids; therefore, we do not know when or how long women should refrain from pregnancy.

Another major concern is strict abortion laws in Brazil and in other countries (Romero, 2016). Women who are getting pregnant with Zika virus and do not wish to bring the baby to full term are not being permitted to get abortions. I believe that this will have a big impact on this specific generation of children being born. Women should have the choice in bringing a child into the world. A child with severe developmental problems may not live a life as beneficial as a child without these problems. This condition will also impact the healthcare system due to cost of care for an infant with severe developmental problems.

Treatment methods for this virus are still being researched. A vaccination may prove to be the best preventative option for women who are pregnant. However, there is some stigma against vaccinations and pregnancy. Women may not feel comfortable getting a vaccine during their pregnancy because of fear of hurting the fetus. Eradication may be more difficult than we imagined. Education on safe sex will also be a major tool in fighting the spread of this virus. We have to develop more treatment methods and have more education on safe sex practices. Currently, STI’s are still spread in large numbers.

Ultimately, this problem is going to take time to fix. This virus has the potential to cause major dents in the public health field. There are many different moving parts in regards to this virus and its consequences. Zika Virus is spreading fast through South America, Central America, and now to the United States. If not stopped now, we will be seeing the effects of this virus for years to come. I would recommend this topic to women who are considering pregnancy. This is a major concern because as of now there are little ways to combat the virus. Learning about this topic has opened my eyes to the many different avenues that a virus can impact. Zika Virus is not just a virus that affects a host but it is also a virus that has effects on an infant, on the healthcare system, political system, and global and local public health systems.

 

Below is a video from the New York Times that discusses the Zika Virus:

Video

http://www.nytimes.com/video/world/americas/100000004185544/understanding-zika-virus.html?action=click&contentCollection=world&module=embedded&region=caption&pgtype=article

 

 

Rettner, R. (2016, February 12). Zika Virus in Semen Provides More Evidence of Sexual Spread.           Retrieved February 25, 2016, from http://www.livescience.com/53704-zika-virus-semen-       sexual-transmission.html

 

Romero, S. (2016, February 3). Surge of Zika Virus Has Brazilians Re-examining Strict                          Abortion Laws. The New York Times. Retrieved February 25, 2016, from                                         http://www.nytimes.com/2016/02/04/world/americas/zika-virus-brazil-abortion-                      laws.html

 

Tavernise, S. (2016, February 23). C.D.C. Investigating 14 New Reports of Zika Transmission Through Sex. The New York Times. Retrieved February 25, 2016, from             http://www.nytimes.com/2016/02/24/health/zika-virus-sexual-                                                    transmission.html?ref=health

 

 

 

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By Danielle Taylor

Antimicrobial resistance, a crisis gaining global prevalence, threatens the efficacy of existing treatments for a multitude of diseases and infections. Some projections estimate that by 2050, drug resistance will kill over 10 million people each year1. Doctors and researchers scramble to keep up with these mutating organisms, constantly trying to formulate effective drugs and treatment regimens to prevent and treat the resistance.

Tuberculosis (TB) is a disease susceptible to antimicrobial resistance, and once diagnosed, physicians need to accurately prescribe medications and patients must complete the full regimen. Resistance can occur when medications are stored and distributed improperly or if patients prematurely end treatment2. When tuberculosis is maltreated it can mutate and change within the human body, forming strains difficult to cure known as Multidrug Resistant TB (MDR-TB), or strains almost impossible to cure, called extensively drug-resistant TB (XDR-TB)2, and in 2014 approximately 480,000 people globally were thought to have contracted MDR-TB3. Patients with active MDR-TB are estimated to expose 10-15 other people to the disease in their lifetime4. Those exposed, called contacts, are at risk of developing symptomatic, active TB, or an asymptomatic latent form. Thirty percent of the world’s population has a latent form of TB, and although it is not contagious, they have a 10% chance of the disease becoming active in their lifetime4. Additionally, certain populations such as children and people with HIV or other immuno-compromising diseases are at a much higher risk of becoming ill, and once diagnosed their prognosis is especially bleak4. There are tests that can detect latent TB, however, they are not very specific and cannot predict TB activation5.

There is a fair amount of research in place to combat MDR-TB, primarily aimed at formulating the best treatment regimen for people with the active form6. However, once a treatment for MDR-TB is developed, it can be toxic, causing thyroid dysfunction in around half of treated children, it is expensive, often times cutting into general tuberculosis budgets, and not very effective, as globally only about 50% of patients were successfully treated for MDR-TB1,3. Researchers can keep coming up with new medications and regimens, but the disease can and will continue to form resistances, possibly increasing the number of XDR-TB cases. Ultimately a higher rate of these fairly untreatable cases will result in more deaths. Thus this research approach is not doing much to prevent drug resistant strain incidence and possibly driving the disease to becoming more and more untreatable. Doctors should not have to wait for these cases to become active, and due to the lack of reliability in latent TB testing, it makes sense to forgo this step and treat immediate contacts right away. In theory by treating contacts as soon as possible, the chance that someone who had immediate contact with the MDR-TB patient will contract active or even latent MDR-TB will decrease, eventually reducing MDR-TB incidence.

It is known that treating latent TB patients with some of the same medications used to treat active TB will reduce their risk of developing the disease by 60%5. However little has been done to research this medicating effect specifically in contacts. One observational study in Cape Town, South Africa observed children MDR-TB contacts, and of those given medication, only 5% developed the disease over time. Of those who did not receive any medication, 20% developed the disease1. However, because these studies were not clinical trials legitimizing the direct effect of taking drugs on developing or not developing active MDR-TB in contacts, WHO currently advises no treatment for contacts specifically1. This makes sense, as WHO likely does not want to mandate an allocation of time, money, and medication to treat a potentially large amount of people without tangible evidence of efficacy. However due to the global burden of the disease, researchers would be remiss if they did not further investigate contact treatment.

There is currently an approved clinical trial looking to provide concrete scientific evidence backing the claim that using specific medications is in fact effective in preventing latent MDR-TB activation in contacts7. This study will do this by treating household contacts of MDR-TB patients either with medication or a placebo and following them over time to track MDR-TB status7. Hopefully findings from studies like this will provide the World Health Organization with the necessary information to establish a global protocol for preventive treatment, so that MDR-TB contacts no longer have to live in fear that this disease will one day activate and put them at risk of death.

 

 

 

  1. “Post-Exposure Management of Multidrug-Resistant Tuberculosis Contacts: Evidence-Based Recommendations” Harvard Policy Brief . Number 1. October 2015. Retrieved February 20th 2016 from http://sentinel-project.org/wp-content/uploads/2015/11/Harvard-Policy-Brief_revised-10Nov2015.pdf

 

  1. “What is multidrug-resistant tuberculosis (MDR-TB) and how do we control it?” World Health Organization. Retrieved February 20th 2016 fromhttp://www.who.int/features/qa/79/en/

 

  1. “Global Tuberculosis Report” World Health Organization. Retrieved February 20th 2016 from http://apps.who.int/iris/bitstream/10665/191102/1/9789241565059_eng.pdf?ua=1

 

  1. “Tuberculosis” World Health Organization. Retrieved February 20th 2016 from http://www.who.int/mediacentre/factsheets/fs104/en/

 

  1. “Latent Tuberculosis Infection (LTBI)” World Health Organization. Retreived February 20th 2016 from http://www.who.int/tb/challenges/ltbi/en/

 

  1. “DR-TB Clinical Trials Progress Report” RESIST-TB. Retrieved February 20th 2016 from http://www.resisttb.org/?page_id=1602

 

  1. Australian New Zealand Clinical Trials Registry. Retreived February 23rd 2016 https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369817

 

 

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-By Sarah Esselborn

The consequences of the devastating earthquake in Haiti on January 12, 2010 are still felt today. Specifically, the cholera outbreak brought by U.N. Peacekeepers from Nepal in October of 2010 has had serious effects on the people in Haiti (NBC News 2014). As of March of 2013, more than 650,000 cases had been identified and 7,441 deaths (Grandesso 2014). By contrast, in the United States, the average number of cholera cases per year is 6 (and these are non-fatal). I have spent time in Haiti, my last visit returning the day before this devastating earthquake. These Haitian people getting cholera and dying are people I deeply care for. I want to bring hope to this seemingly devastating situation. (more…)

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-By Samantha Venkatesh

When I traveled to India for the first time in 2005, the last thing I expected to do before my summer vacation was take medication. I distinctly recall my mom handing me a pill box and instructing me to take the medicine daily starting a few days before we left, through the month-long trip, and for a week after we returned. As a ten year old, this seemed overly complicated and unnecessary. In retrospect, I am relieved that my mom remembered this seemingly annoying task, especially considering that my entire body was covered in mosquito bites after the trip. She was able to prevent me from getting malaria, one of the most severe tropical illnesses in the world.

Malaria is a mosquito-borne illness that is caused by species of the parasite Plasmodium and is spread by the bites of the mosquito species Anopheles1. Since 2000, the World Health Organization has been actively attempting to reduce the incidence of malaria worldwide by seventy-five percent as one of its Millennium Development Goals (MDGs)1. To some extent, the WHO has succeeded; estimated malaria mortality decreased by forty-five percent overall in the last decade alone2. But the disease still impacts almost half of the world; more than three billion people are at risk of contracting malaria, and in 2010, there were an estimated 207 million cases globally3. (more…)

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– By Rohit Maruthi

You feel very sick and go to your doctor where you learn that you have a bacterial infection that can typically be treated with antibiotics. Great, problem solved, right? Maybe not… In recent years, there has been a rise in the strains of antibiotic resistant bacteria (ARB) such as methicillin-resistant staphylococcus aureus (MRSA), rendering even the most powerful of our antibiotics ineffective.1 What are the reasons behind this calamity?

The major contributor to ARB has been the excessive use of antibiotics in various aspects of society. For example, “We stuff them into ourselves and our animals; we spray them on crops, [and] dump them in rivers.”1 This is a serious issue due to the high reproduction rate of most bacteria (i.e. some strains reproduce asexually within twenty minutes). Therefore, by natural selection, various strains of bacteria will obtain this resistance, rendering antibiotics – our defense against diseases – futile. The overuse of antibiotics has resulted in some frightening statistics: 70% of bacteria in the world is resistant to at least one antibiotic.1 Furthermore, reports from the Center for Disease Control indicate that at least 2 million Americans become sick and 23,000 die each year as a result of ARB.2

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– By Mirtula Papa

I recently stumbled upon an interesting article on CNN Health titled “CDC: 5 Ways Diseases in Other Countries Can Kill you” by Dr. Tom Frieden (the director of the Center for Disease Control). This article stated that the United States, along with over twenty-five other countries, have launched the “Global Health Security Agenda”, a global effort to purge all populations of infectious diseases. This really sparked my interest, as it is a step in the right direction towards the eradication of infectious diseases worldwide. It is very important that we do not ignore this matter as it can affect us right here at home. (more…)

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