Wednesday, January 6, 2010

HIV: 250-500 African Patients Infected Daily

For many people suffering from colossal blood loss, anaemia, hemophilia, or various other blood diseases, blood transfusion is crucial for survival. The article "HIV Transmission Via Transfusions in Continent Remains High," by Alison Walkley, relays a negative outcome due to blood transfusion in Africa; the contraction of HIV, a highly contagious disease, most often contracted through blood transmission or sexual activity. Many unlucky patients are being injected with HIV-tainted blood during the transfusion process. This practice is often fatal, occurring throughout Africa, due to limited amounts of healthy blood to transfer. Currently, the World Health Organization (WHO), estimates that between 5% and 10% of recently documented HIV cases are the outcomes of infectious blood used for transfusions.

Sadly, approximately 87% of African counties do not have the healthy blood required to meet blood donation standards. That being said, eight-million units of blood are to be collected annually for donation, but because the majority of African countries do not have sufficient blood, only three-million units were collected. Not only are blood clinics lacking hale blood, they are also lacking adequate equipment and money to thoroughly test the blood units for HIV contamination. This causes a nearly 95% to 100% (250-500 people daily!) chance of contracting infected blood.

Now, in order to halt unhealthy blood transfusion, more and more African countries are constructing policies, making it mandatory for clinics to screen all blood units for infection. Dr. Neelam Dhingra, the blood transfusion safety coordinator for the WHO, states that this policy is nearly impossible, because many countries are not able to supply healthy blood, proper blood testing material, and substantial clinics. Dhingra believes that more blood donations, and appropriate testing are essential in making sure that patients in Africa are getting acceptable transfused blood.

There is no evident author bias present in this article. The article does not contain opinion, it consists of alarming issues, facts, and statistics regarding the HIV transmission due to blood transfusion. The article does, however, contain quotes from Dr. Neelam Dhingra, who is the WHO blood transfusion safety coordinator. Dhingra is concerned for the health of African citizens, and he is trying to create ways to make the blood transfusion system safer, positive, and more effective.

In my opinion, this article was very organized and informative. It successfully relayed an alarming message of what is happening in Africa, due to their poverty and obsolete equipment. A main reason why I chose this article, is because I feel that it is informative and necessary to be aware of infectious disease evident in other parts of the world. During reading and summarizing this article, I connected the HIV contraction in Africa to the Swine Flu scare here. While the United States has been caught up in the current phenomenon of Swine Flu, Africa is in a tangled mess to prevent the rapid spread of HIV. In the United States, we are lucky to have advanced medical technology and knowledge to assist us in finding ways to stop the Swine Flu from spreading. We can't take this for granted, because this article allows us to see that Africa is far behind us in essential gear to prevent a much bigger health issue than Swine Flu. For the full article, visit here: http://allafrica.com/stories/201001050140.html

Tuesday, January 5, 2010

Drug-Resistant Diseases: First Case of Contagious Form of TB

Martha Mendoza is a writer for the New York Times and has recently published an article about a special, highly drug-resistant case of Tuberculosis. The article focuses on the story of the man that acquired the disease, while providing innumerable details and examples about drug-resistance. This was published on December 27, 2009 and is titled, “First Case of Highly Drug-Resistant TB Found in US”. This article can be accessed from this link: http://www.nytimes.com/aponline/2009/ 12/27/health/AP-AS-MED-When-Drugs-Stop-Working-Killer-TB.html?pagewanted =3&_r=1&sq=Infectious%20Disease&st=cse&scp=11.
Bacteria resisting treatment is a growing problem and one of great concern. One cause for drug resistance is the overuse of drugs. For example, antibiotics are prescribed for almost every little thing. Because bacteria reproduce rapidly, it can evolve quickly to build up immunity towards these drugs. Another cause is the misuse of medication. If the infected does not complete its treatment, not all of the bacteria will be killed. In this case, the bacteria will multiply, mutate and reemerge as a stronger, tougher strain. Drug-resistant diseases are showing up all over the word. For instance, Cambodia is seeing new forms of Malaria and Africa is trying to fight against new forms of HIV. Now tuberculosis in the Americas has augmented this list of drug-resistant diseases by one more. It has recently been discovered that tuberculosis has built up immunity to treatment and now can be highly contagious.
A man named Oswaldo Juarez contracted a rare form of tuberculosis that most of his doctors had never even seen before, never mind know how to cure. His strain was named XXDR, which means extremely drug resistant TB. He was sent to special facilities to receive treatment and had tests done. Juarez is 19 years old and lived in Peru his whole life. He came to America as a student to study English. He was told that if he returned home, you would die within a month. He experienced many symptoms from this disease. He vomited blood, experienced wheezing fits, and every breath he took was accompanied with labor and pain. The worst part about his situation, Juarez claimed, was that he was contagious. The disease could be spread every time he coughed, sneezed, or even talked. His doctors pumped significant doses of drugs into him, hoping to find a cure. He suffered for a year and a half, living in the isolation of a tiny hospital room. Finally, he received the news that the black dot on the x-ray of his lungs was gone and he was cured. At age 21, he left the hospital and went back home to Peru.
This article provides a lot of information about why diseases are becoming more drug resistant and I agree that the public should ascertain all of the facts. Tuberculosis has been reported on all seven continents and is rapidly increasing. TB has the highest mortality rate of adults than any other infectious disease. Unfortunately, in one year, MDR (multi-drug-resistant) TB infects the bodies of 500,000 people over the planet. Drug-resistance is a growing problem and with not enough funding it is hard for scientists to come up with a new cure. I think Juarez’s case was horrible and unbelievable. Doctors said that he was one of two people to ever obtain that strain of TB and the other died. Hopefully the evolution of infectious diseases slows down in time for doctors to find new cures and new forms of diseases don’t continue to spread on a global scale.

Cholera Devastates Zimbabwe

In "Beyond Cholera: Zimbabwe's Worsening Crisis", it talks about how the economic collapse and deteriorating infrastructure in Zimbabwe has led to a major outbreak in Cholera. Zimbabwean's must flee from their country and risk their lives by crossing the Limpopo River in order to seek refuge in Southern Africa. Cholera is not the only crisis in Zimbabwe, HIV, political problems, and malnutrition also plague the country. Cholera has been an ongoing problem, however, in the last few months it has continued to worsen. MSF, also known as Medicines Sans Frontiers has some teams stationed in Zimbabwe and others helping refugees seek immediate medical treatment, so far they have treated more than 75% of the infected population but the Cholera outbreak continues. Lack of access to clean water and blocked or burst sewage can be pinpointed as reasons for the outbreak of Cholera, but these all point back to the break down of the economy and government. Increases in Cholera cases have been seen because of the shutting down of many medical centers due to lack of supplies, money, and staff. This is a national problem in Zimbabwe but not much international attention has been shed on this issue of Cholera, the MSF program is one of the only groups trying to help resolve this. It's impact on Zimbabwe is that so far only 45,000 patients have been treated for Cholera and the problem still continues to worsen with the downfall of the economy and government. This paper was written in February of 2009 and was written by a team of MSF workers, the link to this paper is http://www.msf.org.uk/beyond_cholera_zimbabwe_20090217.news.
The writer's attitude toward the subject is not really positive or negative, it is more factual. The writer is trying to stress how important this Cholera outbreak is and show how it is affecting so many people and we should try to do more to help Zimbabwe resolve this. Also, the author shows sympathy for the people of Zimbabwe and the struggle they must go through to get medical treatment for Cholera. " It is a constant challenge to keep up with increasing patient numbers. We are running out of ward space and beds for the patients.", this quote shows the anxiety of the MSF team trying to help the Zimbabwean's and it shows how more support is needed. No, the article does not give an author's name just that it was writte by some members of the MSF staff. Yes, the article provides much factual details to support the thoughts and ideas of the MSF staff on the Cholera outbreak in Zimbabwe. No, different viewpoints are not expressed in the article, it is all viewed from a staff member's perspective, at no point is the Cholera outbreak talked about through a Zimbabwean's view. Yes, the article is very informative and convincing because it gives so much in depth descriptions about the problem's in Zimbabwe and what has led to the Cholera outbreaks as well as what the people must do to get treatment.
A connection between this article and History of Epidemic Disease class is the transfer of the infectious disease Cholera, for example, Cholera is transferred through unclean water and anywhere that hygiene and sanitation are not very good as is HIV with sharing unclean needles. I have learned that more time should be spent on helping the important crises in other nations and that they should be publicized better. I thought the article was very interesting because I had no idea that there was even a Cholera outbreak going on in Zimbabwe and it opened my eyes as to what some people have to do in order to get medical attention.

Monday, January 4, 2010

Scary Sexual Practices in Uganda

Scary Sexual Practices in Uganda:
This article is found on Times Online, the article is written by Tristan McConnell who is an international correspondent that currently resides in Nairobi. The article titled “Ugandan MPs debate Bill proposing death sentence for gay sex” was published on December 18, 2009. Here is a link for the article : http://www.timesonline.co.uk/tol/news/world/africa/article6960920.ece

Shocking. That is the one word that comes to mind after being ambushed by this article. I was caught totally off guard by this article and the bill that was being proposed in it. In Uganda there is in the process draft legislation for a law that will enact the death penalty for any citizen caught in a homosexual act. The bill goes even further by citing the consequences of individuals known to be aiding and abetting individuals partaking in such acts. The bill has come to light in Uganda for multiple reasons both of which are very notable and important on a global level. The first reason, main reason why Ugandan politicians are pushing the bill is because of the evangelical Christianity push in Uganda. The bill as one unnamed politician says is aimed too, ““strengthening the nation’s capacity to deal with emerging internal and external threats to the traditional heterosexual family”. Although the evangelical Christianity is an important factor in the radical and by some considered “inhumane” bill it is not the whole side. How this article relates to History of Epidemic Diseases has to do with not only Uganda’s but Africa’s HIV/Aids population. Over the course of the last 30 years a lot has been learned about HIV/Aids and a lot of stereotypes have been formed about the topic. A very common stereotype that has been associated with HIV/Aids individuals is their sexuality; particularly their sexual orientation. The Bill calls for mandatory testing for HIV and forced disclosure of HIV status of infected individuals. The Bill proposes the death penalty as a possible punishment for the “willful transmission of HIV to others”.

Overall as an article I find it informative if not mostly because I was completely unaware that it was happening. The article cites people from both sides of the argument and really cements the fact that evangelical Christians are a big part of the debate. Personally I find the idea inhumane and think that it is just flat out wrong. On a world level the law is seen in a similar light with some countries expressing such distaste that they are threatening to cut foreign aid to Uganda. I choose this article for shock value and that it is a subject that is very radical, or at least from an American point of view seems so. I also choose the article because it not only highlights HIV/Aids but does it in an area where the disease is problematic. Not only problematic, but I feel as though to a degree the disease is almost associated with Africa unfortunately. Furthermore HIV/Aids has been easily one of the biggest players as far as epidemic diseases since its arrival in the early 1980’s, in retrospect to history it is a very new and still puzzling disease. Is Uganda right about this law? If the law eventually passes how will other countries that currently give Uganda aid react to it? What about the thousands of homosexuals living in Uganda, is this an invasion of right? Basic sexual orientation? I’m curious of any and all points of view

-Tim O’Sullivan

The Secret Weapon Against Viruses: Evolution

Rose Barrett

A recent article in The New York Times, Using a Virus’s Knack for Mutating to Wipe It Out, written by Carl Zimmer and published on January 4, 2010, offers new information on the eradication of viruses. It is available online.

This article discusses recent developments regarding the concept of “lethal mutagenesis.” This is a potential new method of treating viruses with drugs that increase the rate of mutation. Although current treatments are often effective, scientists are always in search of improved techniques. The article states, as we know from class, that viruses mutate very quickly in comparison with other living things. These mutations can enable the virus to evolve so that it can infect its host more effectively. However, while some mutations result in increased strength, most are fatal or at least slow growth. The idea behind lethal mutagenesis is that increased mutations will result in the defeat of the virus, as the number of harmful mutations also increases. A geneticist at the University of Washington has already shown that this method can be successful, eliminating an HIV infection in vitro ten years ago. However, concerns about negative side effects on patients have slowed any growth in support this method might have had. Viruses affect people universally, but with the help of lethal mutagenesis, it is possible that more effective treatments can be developed.

This article is extremely optimistic about the future of lethal mutagenesis. Zimmer chooses to cite Dr. Domingo, who is also hopeful, saying, “Dr. Domingo, who has been studying mutation rates in viruses for more than three decades, the latest results suggest lethal mutagenesis will become a medical reality—at least someday.” His choice to end the article on the confidence of Dr. Domingo shows his faith in the method. Zimmer does recognize other bias, however, covering the negative aspects of the treatment, but he seems to believe that these will be overcome at some point.

The author of this article, Carl Zimmer, is a science writer who has contributed to numerous reputable sources, including The New York Times, National Geographic, Time, and Popular Science. He also lectures at Yale University. Zimmer supplies numerous quotes and citations of factual material to support his statements. Although he seems to be in favor of advance in the treatment, he presents views opposing it as well. There is bias present in favor of lethal mutagenesis, but it is not an editorial, as Zimmer chooses to use the words of other scientists rather than his own opinions. The article is informative and engaging, and presents a balanced view of arguments for and against further testing.

I found this article to be very interesting because the treatment could completely revolutionize the way viruses are treated. I appreciated the heavy integration of quotes and data to support the information. The article was especially interesting because we have learned so much about antibiotics. Antibiotics slow growth of pathogens directly, while mutation-increasing drugs cause pathogens to eliminate themselves through a process that is meant to make them more powerful. Lethal mutagenesis seems to be a promising new field, and I believe scientists should proceed with caution to test it.

Sunday, January 3, 2010

Swine Flu May Be Less Contagious Than Feared

The article I found on-line which was very interesting was published by The Boston Globe. The article was written by Marilynn Marchione titled Swine Flu May Be Less Contagious Than Feared and the tagline read, "Most households with illness keep it to one patient". This article can be found at this link: http://www.boston.com/news/health/articles/2009/12/31/swine_flu_may_be_less_contagious_than_feared/

The overall review of this article would be that through recent research it has been determined that this is not the most contagious of many recent diseases. It will not have such a devastating effect world-wide as other diseases. After this first study of how contagious h1n1 flu is in a family setting and it has been determined that the odds of catching the flu are 1 in 8 (far less than the Bubonic Plague we recently studied) the study also showed that children are more likely. This is the first time one such survey was taken.

This article is actually a summary of a resent publication in the New England Journal of Medicine. The research was done by the American Centers for Disease Control and Prevention and the Imperial College London specialists. A lot of interesting statistics were assembled, such as this: Swine Flu has infected one sixth of all Americans since it was identified in April. Also, around 60% of the people effected with Swine Flu have been children. What these researchers specifically did was follow 216 people with H1N1 and the 600 people they live with. It turns out that only around 10% developed flu-like symptoms. This shows a very low spreading rate than flus of the past. In an ordinary flu season (like, the seasonal flu) shows a spreading rate 5 - 40% in households. It was also discovered that children were twice as likely to be infected as older family members. This would be even more prevalent if they are under years of age. There was a lot of good news from this study the article said, "
Nearly three-fourths of households in the study managed to avoid spreading the illness to any family members." It did not show a high level of children as super-spreaders which is a misconception often attached to how germs are spread.

As you can see, a lot of helpful information has been assembled because of this survey.

This article was written in a straight forward, informative way. It was easy to understand and very clear. I picked this article because it is very good in summing up our Swine Flu unit by bringing together some current research on this disease. I found it very informative and I hope you did too.

U.S. Reaction to the Swine Flu

The article I read was "U.S. Reaction to Swine Flu: Apt and Lucky".This article is from The New York Times and was written by Donald G. McNeil Jr. and was published on January 2, 2010. http://www.nytimes.com/2010/01/02/health/02flu.html?ref=health . This article is about how the reaction to H1N1 by Americans was better than expected and even though we reacted excellently, luck played a huge part. This article talks about the national reaction by Americans and the good and bad decisions made by federal officials during the outbreak of H1N1. Back in August, an estimate was made that at least 30,000 to 90,000 people would die from the swine flu. Since August, only 10,000 people have been killed by H1N1. This shows our country that swine flu was not as bad as we believed it would be and that we did a good job of keeping everyone healthy and vaccinated. But we did make some mistakes and these mistakes let Americans know what are weaknesses were during the H1N1 outbreak. One mistake was that we should have been able to spot H1N1 earlier than we did but we did not have good cooperation with Mexico. Another mistake made by the government was making only 30 million vaccine doses by October, when we were told there would be 160 million doses. The government did make a lot of good decisions involving the swine flu. There were many rumors evolving around the Swine Flu, but the C.D.C. and the World Health Organization were always on the top of their game. They were able to shut down every rumor, which helped stop fears about the Swine Flu from Americans.

Donald McNeil wrote this article in a positive way. He agrees with the fact that America did a good job of handling the Swine flu. This article shows readers that things could have been a lot worst if we had not responded to H1N1 in the ways we did. He is very informal and uses mostly quotes and facts from different people to get the message across. The message is that America reacted to H1N1 in many good ways and that the ways we reacted showed us a little about our country. He says, "The outbreak highlighted many national weaknesses." He goes on to list the weaknesses but then he goes into detail with quotes from many health experts on the things that we did right. I do not think that there is any bias of the author. He is simply giving information on how we reacted to the Swine Flu. McNeil gives many quotes and statistics from both sides of the Swine Flu. He shows the ways in which we reacted to the Swine Flu excellently and how we reacted to it badly. I believe that this article is informative and I was convinced that we did do a good job reacting to H1N1.

This article is centered around Swine Flu and that is why I decided to choose it. We did public health announcements on Swine Flu and many of the things that we focused on were talked about in this article. Back in the summer and early fall, I remember watching the news and learning about the Swine Flu. I feared it, like many people did, since all of the information we were being told about H1N1 made it seem like a lot of people were going to die. This article showed me that the Swine Flu did not turn out to be what we all thought it was going to be. I also learned that our government did a very good job in reacting to the Swine Flu. Overall, I think this is a really good article to read because it shows people the things that we did wrong in reacting to the Swine Flu and the things we did right and we can learn from our reactions.