Feeling Inspired

Hello Old Friends!

I just read an article in the New York Times and thought of you all, so I thought I'd post it, even though no one is actually reading this blog anymore.....

The title: China's Tough Measures on Flu Appear to be Effective
The blurb: They quarantined foreigners and it worked! H1N1 is being contained!....it reminds me of Atlantic Storm and Germany's threat to Poland that we'd quarantine any Polish outsiders who came into Germany. I guess the plan would have worked.
: o )

http://www.nytimes.com/2009/11/12/world/asia/12chinaflu.html?_r=1&hp

Review-- Assessment of Future Scientific Needs for Live Variola Virus

In 1999, the government (specifically the U.S. Department of Defense, the U.S. Department of Energy, and the U.S. Department of Health and Human Services) requested that the Institute of Medicine convene an independent scientific panel to investigate future scientific needs for live variola virus. That committee, the “Committee on the Assessment of Future Needs for Variola (Smallpox) Virus,” produced a report “The Assessment of Future Scientific Needs for Live Variola Virus” chronicling their conclusions. The report outlines six major scientific needs for the smallpox virus, the first and most convincing being the need for further research into the creation of novel vaccines fit for immunocompromised populations.

The assessment is particularly interesting in light of the World Health Organization’s upcoming debate as to whether or not to retain the world’s existing stocks of live variola virus. Dr. Ann Arvin (Stanford University School of Medicine), who served on the committee both in 1999 and on a recent committee to revisit the issue, commented on the differences between the two assessments, claiming that the 2009 study was far less political than charged debates of 1999. I found this to be interesting, as both reports were intended to be (and appear to be) completely independent—obviously being unbiased is tough, even in science.

The 1999 assessment is well written, providing a clear outline of the major scientific motives for the retention of variola stocks, and well as a broad overview of smallpox epidemiology, eradication, and bioterrorism threat. It is informative and accessible to the general public, and although it is very technical, I did enjoy reading it.

The Avian Flu of 1957: Ghost of What's to Come

Throughout our course, we have repeatedly referenced the flu epidemic of 1918-1919 as a lesson for the upcoming swine flu pandemic. We never fully examined the similarities between H1N1 and the Avian Flu of 1957. After reading an article about it in The Washington Post, I am convinced that the epidemic of 1957 provides valuable lessons for the trajectory of swine flu and how to handle it.

The Avian Flu (H2N2) broke out during the normally flu-free summer in the Northern Hemisphere, and attacked many group-living situations such as summer camps and military bases. The current strain infected over 80 summer camps during the summer. Like H1N1, the 1957 virus had an overwhelming effect on younger people as compared to the elderly population that flu normally effects. Additionally, the 1957 Avian Flu was briefly harsh but rarely fatal, as H1N1 has thus far. As the article details, these similarities suggest that the pandemic of 1957 may be an instructive model for what is to come with H1N1.

Overall, the 1957 pandemic created 60,000 “excess deaths” in the U.S, which would be the equivalent of 107,000 people today. This is a substantial amount, and with such large similarities between the two epidemics, the Avian Flu of 1957 should be studied in order to prepare for the major outbreak of H1N1.

http://www.washingtonpost.com/wp-dyn/content/article/2009/08/24/AR2009082402431_4.html?sid=ST2009082401811

Review-- The Demon in the Freezer

The first two books that I read for Smallpox Safari, Smallpox—The Death of a Disease and Scourge, were both fascinating and incredibly informative. Looking back, however, I realize that it is Richard Preston’s The Demon in the Freezer that is the perfect introduction to smallpox. First, Preston’s story is informative, as he gives a detailed overview of the history and eradication of smallpox, along with the potential future threats of the disease. Second, the subject matter is timely. As Preston weaves the story through both smallpox and anthrax, he taps into the fears of the reader; both in 2002 soon after when the anthrax attacks occurred and in 2009 in a world where science and military are growing ever more connected. (Although I do agree that the presence of anthrax in the storyline did unnecessarily complicate the book). Finally, The Demon in the Freezer is simply exciting, due to the subject and the author’s gift for impressive storytelling.

Herein lies the beauty of The Demon in the Freezer, in its ability to combine a significant amount of academic information with an exhilarating literary adventure. The excitement is only compounded by the reality that Preston presents. Like most readers, Preston’s concluding words struck me: “We could eradicate smallpox from nature, but we could not uproot the virus from the human heart.” The Demon in the Freezer provides perfectly both the introductory information and the incentive to dive into the study of smallpox.

Book Review : Jenner's Publication on Vaccination against smallpox

This book is a useful compilation of Jenner’s work concerning inoculation against smallpox. With Jenner’s three articles is one place you easily see how he developed his ideas and tested his observations surrounding smallpox. It is important to note that the scientific approach to thinking that is evident in these pages was somewhat of an anomaly in this 18^th century era. Jenner provides a lot of evidence to support his theories connecting cowpox and smallpox. He describes in sufficient detail for the numerous case studies which he performed. Although it is a scientific set of papers, it reads like a simple, logical story unlike today’s scientific literature laden with specific jargon. In addition to the scientific aspect, Jenner also finds ways to make reference to those who are skeptical of his work. It is interesting to have a glimpse into the mind of a man who developed a novel way to prevent the “severest scourge of the human race”. Jenner seems to have had an inkling about the magnitude of his work as he was “ encouraged by the hope of its becoming essentially beneficial to mankind.” For anyone studying medical or scientific history, these original texts are a must read as the development of vaccines is key to preventative medicine today.

Stanford testing for H1N1 vaccine & FREE seasonal flu vaccine at Vaden

Hey Pox Stars! If there’s any practicable lesson we could have taken from Bob’s class (aside from the skillful timing and technique it takes to jump in the air with 15 other people), it was that vaccines are a lifesaver. If you haven’t received a seasonal flu vaccine yet, there is no excuse because Stanford will be giving away FREE vaccines to employees and students. I saw this on the Vaden website, and I had to tell all of you!

http://vaden.stanford.edu/medical/index.html#flu

And now, for my final New and Hot . . .

After Roz Diane Lasker’s simulation and Bob’s re-simulation on the “what-ifs” of a biological attack, I thought that these scenarios could be brought down to earth a bit more. As I see it with the H1N1 pandemic, these scenarios are already happening. There are some definite parallels between some of the suggestions our class gave to solving the hypothetical biological outbreak and the H1N1 pandemic happening in real time.

At Stanford Medical School, trials have been underway to test the H1N1 influenza vaccine. The National Institutes of Health (NIH) is sponsoring the phase-2 trial at six sites around the country. At Stanford, there is a call for 130 volunteers, with 2/3 of this number in the 18-64 age category (I believe our very own Josh Wong is among this group!) and the rest from 65+ above.

The government response stemming from the NIH to disperse resources and mobilize university, intellectual, and volunteer efforts is a common theme among any outbreaks, viral or biological.

As we go back to school soon, the spread of the H1N1 flu strain is expected to diffuse itself among the school-age population more as we have seen happening at several universities. And as much as our class talked about mass vaccination vs. ring containment, decisions like these are happening at this very moment! The federal government is waiting to hear from trials already under way before making a final decision about whether to proceed with a large-scale national immunization program.

But there’s a problem . . .

Stanford Medical School reports: “The government, which had hoped to have 120 million doses of the H1N1 vaccine on hand by Oct. 15, announced on Aug. 18 that, because of delays in the manufacturing process, it now expects only 45 million doses to be available by then.”

Does this predicament remind anybody of the same problem us delegates faced during Atlantic storm? A huge debate we had was whether the smallpox vaccine should be diluted or not. This controversy may be placated with some of the experiments taking place at Stanford Medical School. Trial is underway for the introduction of a novel vaccine that contain an adjuvant: “a substance that stimulates the immune system so that it attacks the virus more vigorously.” With the use of the adjuvant, it may be possible that the dose of vaccine could be lowered, allowing for more people to be immunized.

Hopefully, this will be a great breakthrough to help placate any tense relations forming between Germany and Poland. Way-to-go for friendly mediating efforts from the nearby Sweden!

http://med.stanford.edu/ism/2009/august/flu-trial.html

How to Improve Vaccines

How can scientists engineer a disabled vaccine to make it as potent as a “live” vaccine but as safe as a “killed” vaccine?

Disabled viruses have been effective in the production of vaccines for smallpox and polio. However, for non-viral diseases like tuberculosis and malaria, the immune system is able to recognize that the viruses in these vaccines are disabled, and hence, the immune system will not trigger the anticipated antibody response.

The co-author of a study that suggests a solution to this problem, Daniel Portnoy, a UC Berkeley professor of molecular and cell biology and of public health, explains, “What this says is that the immune system knows the difference between a live bug that's virulent and a dead one that is harmless." Furthermore, Portnoy says that not only is there no immune response, immunity is also suppressed.

To solve this problem, the study suggests getting the microbes to act as if they’re alive. The strategy is to select new bacterial strains that induce the right kind of immune response.

The pathogen seems to take on a personality and these mannerisms within the cell affect how the immune system will respond — “where it goes in the cell, what pathways it interferes with, and how disruptive it is.” A vaccine against these pathogens would need to have an effect of inducing T cell response, a condition that does not happen with currently available vaccines.

http://www.sciencedaily.com/releases/2009/09/090904071654.htm

(Biochemistry . . . so awesome!)