infectious disease

A book review of Dehner’s Global Flu and You

The Spanish Influenza. Chart showing mortality from the 1918 influenza pandemic in the US and Europe. Wikipedia commons.
The Spanish Influenza. Chart showing mortality from the 1918 influenza pandemic in the US and Europe. Wikipedia commons.

In 2009 people globally learned of the appearance of a new strain of influenza named H1N1A or “swine flu” in Mexico. By June the World Health Organization had declared the outbreak to be a pandemic, the U.S. and European governments were spending billions of dollars on vaccines and medications, and the tourism industry in Mexico was devastated. For most Americans, vaccine became available only after influenza had already peaked in their communities. Predictably there was an outburst of anger when the mortality rate proved to be low, as people felt that they had been misled by authorities, and frightened unnecessarily. Conspiracy theories regarding the WHO, pharmaceutical companies, and national governments abounded on Youtube and Twitter. While the mechanisms for communication were new, the problem faced by governments was not. Indeed, the U.S. had faced a similar situation in the 1970s. A historical perspective on influenza can provide some much needed context for policymakers and health authorities. George Dehner’s recent book, Global Flu and You: A History of Influenza, is a concise, well written organized overview of influenza’s history, which can help us to better understand contemporary health issues. …

MERS continues to spread

"Virus" by renjith krishnan at
“Virus” by renjith krishnan at

The news regarding the respiratory virus MERS-COV continues to be worrying. A second case of MERS has now been reported in the United States in Orlando, Florida. This individual is a health care worker from Saudi Arabia who traveled to the U.S., as was the previous case. This fact raises serious concerns about infection control measures in Saudi Arabia’s hospitals, as I discussed in an earlier post. Fortunately, he seems to be recovering. Equally significant, two Indonesians have recently fallen ill with the disease. The first died on April 29th, and the second is seriously sick. This man had gone to Saudi Arabia on pilgrimage. Given that there is no vaccine for MERS, nor is one likely to be developed in the near future, the continued appearance of MERS amongst health care workers from Saudi Arabia, and its spread outside the Kingdom’s borders, is a worrying sign. There are also concerns in the United Kingdom, given that both of the recent cases in the United States arrived after transiting through Heathrow. …

MERS and Saudi Health Care Workers

Historical photo of the 1918 Spanish influenza ward at Camp Funston, Kansas, showing the many patients ill with the flu- U.S. Army photographer
Historical photo of the 1918 Spanish influenza ward at Camp Funston, Kansas, showing the many patients ill with the flu- U.S. Army photographer

The CDC just reported the first case of MERS in the United States. A health care worker from Saudi Arabia recently traveled to the U.S. from Riyadh, Saudi Arabia, and became sick five days ago in Indiana. He has certainly been in contact with other people recently, not only on the flights, but also during a stopover in London.  He also took a bus trip from Chicago to Indiana. As usual, Ian MacKay’s blog has some of the best information on this virus, including a truly chilling chart of case counts. This makes clear the rapid growth of cases over the last month. Recent analyses have not identified any mutations in the virus that might account for this change. Another possibility for the spike in cases may be that infection control measures are breaking down in Saudi Arabia now, much as there were such initial failures with SARS in Canada in 2003. …

MERS, the next pandemic?

"Camel Caravan In A Desert" by m_bartosch at
“Camel Caravan In A Desert” by m_bartosch at

MERS COV (Middle East Respiratory Syndrome Coronavirus) first appeared in Saudi Arabia in 2012. This disease is caused by a corona-virus, much like the SARS epidemic in 2003. A great deal of work was done early in the epidemic to identify the original host for this virus. Although there is a great deal of evidence associating the virus with camels, which are also infected, it now seems that the original host may be the Egyptian tomb bat, an appropriately scary name for a disease vector. Given that many other viruses seem to have bats as their original hosts, this would be unsurprising if true. The disease is a respiratory virus, which causes difficulty breathing, coughing, and fatigue. Roughly 40% of patients die. …

Popular Protest and CKD in Nicaragua

"Burning Sugar Cane" by think4photop at
“Burning Sugar Cane” by think4photop at

I’ve written twice before on this blog about an emerging disease in Central America called Chronic Kidney Disease. In my original post I described how in some communities in the region between a quarter and seventy percent of men may suffer from the disorder, which is a truly staggering number. In a subsequent post, I argued that something mysterious was happening in Central America, because the disease appears to be something new. While some people argue that the illness takes place because of pesticide exposure or dehydration, this argument seems problematic to me. If this is true, why do we not see a similar illness in the Caribbean or the Atlantic coast of Brazil? That is why in this post I suggested changing the name of the disorder to EKD, so as to reflect the disease’s novelty. The fact that the illness focuses on the Pacific Coast of Central America, mainly affects men, but also seems to impact workers outside the sugar cane industry, all seems significant to me. …

Globalization and a new Fungal Disease

"Chest X-rays, 3D Image of lungs, Sagital Plane Image" by Praisaeng at
“Chest X-rays, 3D Image of lungs, Sagital Plane Image” by Praisaeng at

Valley fever (cocci dioides), a fungal disease in the Arizona, New Mexico and California, has received a great deal of media attention lately, with good reason. There have been over 20,000 cases documented, which likely is only a fraction of the total number of people infected. Tom Geoghagen of the BBC has a good piece on the disease, and the video interviews of the affected families are heartbreaking. In late June 2013 a judge in California ordered California to move inmates held in two prisons in San Joaquin in order to reduce their risk of contracting the disease, which made people living in local communities wonder if they should also move.  …

H7N9 Influenza and the WHO’s Pandemic Influenza Plan

Photo courtesy of hyena reality and
Photo courtesy of hyena reality and

Like many of you, I’ve been carefully following the news about H7N9. A few of my favorite blogs or sites for this are Avian Flu Diary, Virology down under, the Center for Infectious Disease Research and Policy, and the Bird Flu Report. A couple of thoughts about what we know so far. First, it is always difficult to make a vaccine for an H7 virus. For this reason, it’s unlikely that sufficient vaccine could be ready in six months, even in the United States. It is true that some newer vaccine technologies are now proving their potential. But we aren’t in a fundamentally different position than in 2009, when most vaccine became available too late for swine flu. …

Mystery Kidney Ailment in Central America: EKD

"Panama Cathedral" by David Castillo Dominici at
“Panama Cathedral” by David Castillo Dominici at

Regular readers of this blog have probably noticed the attention with which I am following the emergence of a new disease in Central America, called CKD or Chronic Kidney Disease. The disease has caused devastation in some rural communities, particularly in both Nicaragua and El Salvador. What is distinct is that it particularly hits men, not women, especially those employed in the sugar cane industry. But the evidence for this is somewhat contradictory, as men employed in other physically demanding jobs also seem to be falling ill with the condition. …

Mystery Epidemic In Central America: CKD

Image of Sugar Cane field from

In an earlier post, I talked about some mystery diseases globally. None, however, may have affected as many people as a strange kidney disease impacting sugar cane workers in Central America. As a recent article states, the suffering in some communities in the region has been immense: “In the past 10 years, it’s believed that hundreds, if not thousands, of residents of Chichigalpa — mostly male sugarcane workers — have died from chronic kidney disease, or CKD. That in a city of nearly 60,000, roughly the size of Ames, Iowa.” One study of a farming community in El Salvador found that one quarter of men were suffering from signs of CKD. In another community, La Isla, Nicaragua, allegedly seventy percent of men have the disease.

At this point people are blaming a host of different factors for the disease: pesticides, dehydration and arsenic. Unsurprisingly, the sugar industry denies that its actions could be responsible in any way for the illness. One spokesperson told Kerry Sanders and Lisa Riordan Seville at NBC News that the root of the problem might be alcohol or volcanoes: …

Avian Influenza and the new SARS

I’ve just returned from a conference at Oxford entitled “Influenza 2012: One Influenza, One World.” The reference to “One World” in the

Avian influenza virus courtesy of dream designs at

title makes the point that human and animal health are intimately interlinked. While at the conference there was discussion of the current avian influenza outbreak in Jalisco, Mexico, and since returning there is now news about the discovery of a new corona virus in Saudi Arabia (this family of viruses covers a diversity of diseases from the common cold to SARS), which has killed one person and gravely sickened another. In this context, it makes sense to talk about the global ethical and scientific problems raised at the conference. …

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