This week I had a chance to have a discussion via Skype with a class in Ithaca, New York, which had read my book on the AIDS Pandemic in Latin America. The class asked what had changed with the epidemic since I wrote my book, as well as what would I change if I were to write it now? The good news is that there has been a great deal of progress in the fight against HIV in the region. More people are receiving appropriate therapy, fewer babies are being born with HIV, and the rate of condom use is up in many nations. At the same time, the number of people living with HIV is slowly increasing, in part because people are now living longer with the infection, thanks to better therapy. …
Bayeux Tapestry Scene 44, taken from Wikipedia Commons
Over the last ten years there has been a lot of discussion about the post-antiobiotic era, as increasing numbers of drugs lose their efficacy. One of the key problems has been the practice of using antibiotics as a growth enhancer in agriculture. Recently, researchers at Texas Tech discovered that antibiotic resistant bacteria from feedlots are airborne. Now there may be a new alternative to addressing antiobiotic resistance discovered in England, where researchers at the University of Nottingham tested a recipe to treat infections from the 9th century. There cannot be too many medical researchers willing to work with directions that have to be translated from early Anglo-Saxon. If you’re curious, you can click here to see the strengths of a medieval approach to the problem of infection. What the researchers found was that a recipe based on cow bile, garlic and wine successfully killed MRSA in the lab, even when it had developed biofilms, which make it difficult to treat. Of course, this study took place in testtubes and mice rather than in a clinical setting. It will be some time before we know if these results can be replicated in people. Still, it raises the point that the modern age does not have a monopoly on medical knowledge.
When Chinese scientists needed to find a treatment for drug-resistant malaria during the Vietnam War, they turned to sweet wormwood, which was an age-old treatment found in classic Chinese medical texts. It soon became the standard treatment for malaria, although resistance is again emerging in South East Asia. Who knows what other remedies may be hidden in old formularies that have not been used in centuries, not only in Europe, but also in many other nations?
Two outstanding journalists in the area of infectious disease, Helen Branswell of Canada Press and Martin Enserink with Science, have teamed up to create an online “course” on Ebola. Although it was designed (with support from the U.S. Department of State) to help journalists preparing to cover Ebola, the website will give anyone a good introduction to basic facts about the disease. Another good source for information is the CDC Ebola website, for more in depth coverage.
Mercator Map of the Congo, 1595, from the Northwestern University Library Maps of Africa collection, accessed through Wikipedia.
I have done work for much of the last 15 years in global health, and wrote a book about the AIDS Pandemic in Latin America. I’ve returned to thinking about HIV recently because I’ve just given a lecture on the Global AIDS pandemic, during which I discussed media coverage of not only the new gene therapy to fight HIV, but also the discovery of an HIV strain in Cuba that seems to lead to AIDS more rapidly than is typical. Behind these news stories remains the fact that over 35 million people are now living with HIV. It is true that impressive advances in both medicine and public health now mean that there is more hope concerning the epidemic than at any time before. Still, despite the merited attention given to the Ebola outbreak in West Africa, it’s worth remembering that over a million people died of AIDS last year, far more than all the Ebola outbreaks in recorded history combined. How did this outbreak begin? Since I first began to study the virus a great deal has been learned about its evolutionary history, and the circuitous path that the virus took from an unknown individual in Cameroon to become a global pandemic. …
Climatologists and social scientists have been debating whether a severe drought in the MIddle East may have led to the outbreak of war in that country for at least two years. I discussed this topic in a blog post published in 2013. A new study in the Proceedings of the National Academy of Sciences is now receiving a lot of attention for its detailed study of the question. So far, the best coverage that I have seen of the topic has been Andrew Freeman’s article, “The Seeds of War,” which combines text with photographs and graphics. I highly recommend this piece. You can also read the abstract for the original article here. Of course, few questions are trickier than the causation of a war, which are multi-factorial. The anniversary of the outbreak of World War One last year led to a plethora of academic studies about that war’s causation. By its nature, it’s almost impossible to do counter-factual history; that is, to demonstrate what would have happened if something had not taken place. Nonetheless, the causal link in Syria between the collapse of the agricultural economy, the explosive growth of urban populations, and the breaking of social bonds, is a persuasive one. …
I know that people may be tired of hearing about Ebola, which is a painful topic. Still, I have to strongly recommend a new storyboard by NPR reporters called “Life after Death,” which describes one village’s experience with the outbreak. The storyboard combines audio interviews and stunning photographs to create an account that is moving, informative and beautiful. It illustrates the the human reaction to the outbreak, and the toll that the disease continues to take from the community after people stop dying. I think that this storyboard shows the potential of new media, which combine the content of text-based journalism, with the artistic expression of photo-journalism. One alert- if you are viewing this at work, you probably should put on your headphones before you click on the link above.
The French website Sentiweb tracks disease prevalence in the country. This winter the map of influenza-like illness in France has been a sea of red, which documents a particularly bad year. The situation in Germany is no better. Influenza viruses mutate over time, which means that every year vaccine makers must guess which strain of the virus is most likely to cause illness in the coming season. Sadly, this year’s vaccine was poorly matched with the strain of H3N2 that has caused the most illness. According to a study in the U.S. it was only 23% effective, while one study in Canada found that people were actually more likely to become ill if they had been vaccinated. You can’t have a much worse vaccine that that. This situation has meant that more people in the United States went to the hospital with an influenza-like illness than in most years, particularly amongst the elderly. At least in the United States the influenza season is now waning. In my home state of Oregon, influenza cases peaked last month. This sadly does not seem to be the case in France as this map suggests. As in the United States, the majority of cases in France have been the H3N2 strain.
People tend not to treat influenza with sufficient respect. Years ago I had a phone call from someone who wanted to drive to Portland to meet me in my role as the Director of International Studies. The morning of the meeting I woke up and knew right away that I had the flu. It felt as though somebody had turned up the gravity in my room. I had a high fever and could barely stand. But not wanting to disappoint them, I dragged myself to the office. They didn’t show up, and after an hour I went home. I consoled myself that it was for the best, because they last thing that they needed was to catch my flu. …
European Centre for Disease and Infection Control map of MERS, November 2014
I’ve discussed MERS before in this blog, but this virus has faded from public attention as Ebola has become a major health crisis in West Africa. This recent map by the European Centre for Disease and Infection Control, however, makes clear why MERS remains a global health challenge.
Map of outbreaks of the Ebola virus in Africa by strain and confirmed contractions. Created by: Zach Orecchio, University of South Florida Geography Dep, Obtained from Wikipedia, Creative Commons.
One of the major questions that international agencies and governments have been wrestling with is the likely future of the Ebola epidemic in Africa. Perhaps the best website for these predictions is the Columbia Prediction of Infectious Diseases site. Unfortunately, despite the heroic efforts currently being made in West Africa, the curve towards mid-November shows a steady increase. Of course, there are success stories as well, as Nigeria has recently been declared Ebola-free. But this site indicates the scale of the challenge that world currently faces. The website is also useful for tracking yearly influenza epidemics.
At this date, a great deal rides on the outcome of Ebola vaccine trials. The Canadian government yesterday sent 800 vials of experimental vaccine to the WHO, for this organization to distribute as it sees best. The world is also increasing the supplies and manpower provided to West Africa. It is now clear that everyone underestimated the dangers of this outbreak, because Ebola had been controlled before. What has been different has been that this outbreak is taking place in an urban setting.
Like this blog? You can subscribe to the RSS feed in the upper left corner. Or subscribe to the blog by e-mail by clicking the “subscribe” tab on the right of the page. Want to see more on global health or infectious disease? Click on these words in the word cloud on the right.
