Sunday, January 8, 2017

Bird to Cat to Human Influenza Transmission

A couple weeks ago, there was a report of a veterinarian who worked in a Manhattan shelter with sick cats, who was infected with a strain of avian influenza (H7N2). Pretty weird stuff really, it's only been documented twice in humans and never related to cats, and it prompted an unusual health emergency that has public health advocates sending out warnings to pet owners.
Image result for cat with bird
Cat - Bird Influenza - Possible transmission method
The veterinarian in question ended up with a very mild illness for a short period of time and has recovered, according to a letter from Corinne Schiff, acting deputy commissioner of the NYC Department of Health and Mental Hygiene. 
This is a pretty rare situation (at least not documented previously) but it is confounded by the fact that the cases of seasonal influenza are currently increasing.
More than likely, if you have flu-like symptoms and have cats or exposure to cats, you have normal influenza or a common cold. However, if you have contact with a sick cat of any kind, and then develop an illness, I would recommend mentioning it to your physician.
Currently, H3N2 is peaking (hopefully) in Canada and in the US. H3N2 is the most popular strain representing about 99% of the cases this year. H3N2 is a little bit rougher, typically on the elderly. If you haven't gotten the flu vaccine yet this year, WTF are you waiting for! But seriously, better late then never.


Monday, December 12, 2016

Traveling Observations

Recently, I saw an article published in the online publication "Quartz", about being an American and traveling abroad. Like most lists on the internet, it is about 10% useful and interesting, and 90% garbage. But I wanted to comment, since the past year (and this upcoming year) I have spent traveling through Sierra Leone, Uganda, Belgium, France, The Netherlands, and Germany. In those countries, I have interacted with many different nationalities from all walks of life as part of the Ebola response, etc.

1. Calling myself an American
From Canada all the way down to the tip of Argentina and Chile, residents of North America, Central America, and South America are all Americans. If you want to get into a heated debate and make an enemy in less than a minute, tell anyone in Latin America that you’re more American than they are. You’ll land yourself in a political discussion about hierarchies of money and power that will make you want to apologize for your very existence. Nowadays, I just say that I’m from the US. I don't fully understand this. I still call myself American. Most people know that I am from the USA. Even the most remote, uneducated West African can take one look at me and usually guess correctly. I have never met anyone that assumes I am from Central America or Korea, or Mexico or Germany, etc. Now, mainly that is because I am white and speak English. If I was mixed ethnicity or non-white in any way, then I am sure it would be more confusing. I don't see the issue here. At least with most of the interactions that I have had, no one really cares.

2. Believing that I have to sit down, alone in the stall, to go to the bathroom

Before I left the United States, the term “popping a squat” wasn’t even in my vocabulary. I couldn’t imagine not having a porcelain seat, elevated properly off the floor, to do my business—and do it alone, at that. But when you find yourself with nowhere else to go but next to a one-foot-tall bush in the expanse of the Andean desert, with all of your tour buddies waiting in the bus, you use those weak quad muscles and let it all go. You get used to bidets, hoses, spaced slats of wood, communal bathrooms with no dividers, and flushing your waste with dirty bucket water. You plant your feet carefully on either side of the eastern toilet (a ceramic hole), grasping a rail while the train sways back and forth, and hope not to splash yourself. Let's be clear. A toilet is important, and from a public health standpoint, one of the most important improvements we can make worldwide. Sure, there are going to be some cases when you are out hiking, or in the jungle, or whatever that you won't have a toilet. However, most of the time a decent toilet is available if you look. I was at a football match a few weeks back in a poor part of Freetown. Even the football "stadium" had a public toilet. It wasn't pretty, or clean, but it was a toilet. This just seems ridiculous. It is no different than all the "world-travelers" that talk about the time they got malaria, or yellow fever, or typhoid, WHICH ARE ALL PREVENTABLE! Sometimes people glamorize the "wilderness" and just act stupidly. Find a toilet if you can.

3. Liberally using hand gestures

When you don’t speak the language in another country, your first resort might be to use hand gestures. Make sure to do your research beforehand. While giving the middle finger is a universally understood American signal, others are not. The A-OK sign, with the index finger forming a circle with the thumb, is equivalent to “asshole” in Brazil. If you point at a picture of the king in Thailand, you could land yourself in jail. Sometimes, it’s better to keep your hand movements to yourself. I have never had a problem with this, however I try to avoid it and am conscious of it. I would include other "ticks" like whistling, which can sometimes be viewed negatively.

4. Clinging to forks and spoons

Over the years, I’ve come to observe how other people eat and follow suit, using chop sticks, tortillas, bread, or simply my hands to eat. There’s no one right way to do anything, and there’s also no better place to acquaint yourself with a new culture than around the dinner table. True, bring hand sanitizer or alcohol wipes.

5. Having a personal bubble

In the US, when it comes to personal space, most of us grow up feeling entitled to an area around our bodies that we feel is ours. It depends on the person, but I think it’s safe to say that we require at least five to 10 inches around us, free from other people or objects, to feel comfortable. After traveling a bit, you quickly realize that the personal bubble is not a universal concept. Whether it be the mandatory cheek kiss in Europe, waiting in line in Asia with people pressed up on all sides, or sleeping in a dorm room with 11 other people, the illusion that you own any of the air surrounding you evaporates like the cigarette smoke just blown in your face. During an Ebola outbreak, this obviously changes. Touching is a big no-go. It does hold up most other times though. On that note though, be safe. Continue to think safety. If you don't feel comfortable, don't just accept being surrounded by 200 people. Stampedes, pick-pocketing, assault, etc. are not uncommon in some places. Keep your wits.

6. Over-planning everything

If you grew up in the States, most of your friends had their whole lives planned out by the time they entered high school. They’d graduate college at 22, obtain their dream career in a year, get married at 25, have kids at 26, and so on. If there’s one thing I roll my eyes at, it’s thinking that you can strategically plot your entire life’s trajectory. When you travel, it’s a must that you embrace uncertainty. When you’re on the road, you come to understand that the unthinkable—whether good or bad—could happen at any time. Because of this, you learn to let go, live in the moment, and let life guide you to where you’re supposed to be. Plan for the best, prepare for the worst. Planning still results in a better probability of success. I can't imagine coming into any travel whether for work or pleasure and not being prepared. By reading this, you are preparing. Yes, you have to be flexible, but that doesn't mean don't plan.

7. Thinking that luxuries are necessities

When you’re wrapped up in the perspective of your own world, it’s easy to think that you “need” a better car, a new wardrobe, or a drink at the end of a hard day. After you start to travel—especially throughout developing countries—you begin to see how others live, forcing an immediate re-evaluation of what a necessity is. When you see children digging through garbage to find their next meal, families of 10 sharing a one-room shack, people without access to clean water, electricity or education, you just might feel ashamed that you once thought you needed a $350 haircut with highlights. 100% this. I can't stand entitled people. 

8. Equating money to happiness

The culture in the United States is undoubtedly capitalistic. We are taught that if we work hard enough, we’ll eventually have enough money to buy the car, house, and life of our dreams. We’ll be able to dress like celebrities and vacation on yachts with champagne fountains overflowing. At that point, once we’re millionaires, we can finally smile with our bleached teeth and know that we’ve obtained success. After over a decade of travel, I’m more than ever convinced that happiness has nothing to do with money. You can live in a mansion, using cash for Kleenex, and still wake up lonely and desolate. Or you can dance in rags alongside your family, knowing you’ll eat nothing but rice and beans for the next week, yet grateful for the love surrounding you. Travel has taught me that there are a multitude of ways to live, and many more ways to find happiness. Yup.

9. People from the USA are loud.

This is my own addition. Because after having sat in restaurants, airports, cars, casinos, boats, etc. I have come to the realization that Americans are damn loud. Sure, sometimes some other group of people are loud. And I will say that in Africa, EVERYTHING is loud. There is yelling, and just a lot of noise everywhere. What I mean is mostly conversation. Americans don't yell a lot or make a lot of noise or have the radio up loud, but just general conversations at dinner, they are always more loud than everyone else. I still haven't really figured out why.

Sunday, December 11, 2016

Herpes Monkeys in Florida


Somewhere in Florida, there is an island. A monkey island, if you will. Or maybe herpes island is a better name?

Rhesus macaque - "I tested positive for what?"
There are over 130 documented types of herpes virus and they infect a wide range of animal species including mammals, birds, fish, reptiles, amphibians, and mollusks. 

In some cases these infections are relatively harmless. The "cold-sore" lesions humans get are a result of herpes virus infection. However, sometimes herpes infections can be very problematic; in the case of elephant endotheliotropic herpesviruses (EEHV) which can cause a fatal hemorrhagic disease in elephants or oyster herpes virus (OsHV-1) which leads to high mortality rates in shellfish farms.

Ask me questions using the comments section below!

There is however a herpes virus strain, found in monkeys, that can be fatal to humans. B virus or monkey B virus, which causes minor disease in macaques (thought to be the natural hose) can cause very serious disease in humans.

So why are there macaques in Florida you might ask? You could probably guess. Someone brought them in as a novelty and they flourished. Without any natural predators (we hunted and killed most of them) they spread. However, recently with the increase in large snakes (another invasive species) maybe they will start feeding on the monkeys and limit the population.

Stories like this are pretty fascinating and seem weird, however I think it highlights the One Health concept and how zoonosis is such a curious, and important idea in public health.

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  • Saturday, December 10, 2016

    Herpes from a Virtual Reality Headset?

    After I completed my undergraduate degrees at North Dakota State University, I was interested in an MPH in global health type stuff. After being accepted to the University of Pittsburgh Graduate School of Public Health, I took a bit of a detour and did my MS in a lab that primarily looked at the link between herpes virus and cancer.

    Pittsburgh, is where I learned to love herpes. And we all know, that herpes love lasts forever.

    There are many ways we have learned you can get herpes, various styles or methods of sexual intercourse being the main way, but for other types of herpes virus (Epstein-Barr) it is often vertical transmission or normal close human-human contact.

    Now, there seems to be a new way to spread herpes simplex and it is related to a new technology.

    Ask me questions using the comments section below!

    Recently, a panic went through the virtual reality (VR) community about an ocular herpes outbreak due to a shared VR headset at a technology convention. There is no confirmation of this in any public health reports, but the possibility is real.

    Herpes is quite contagious, as are other possible infections (bacterial in nature as well) that could cause pink-eye or conjunctivitis. 

    Now, the odds of this happening are quite slim. But, I think it is a legitimate concern, enough so that it might not be a terrible idea to have an alcohol disinfectant spray or pad if you plan on using these devices after a large number of people at a convention.

    Reports like this are always interesting to me. The way that bacteria and viruses spread (herpes is a virus) is and always will be important, but the way that technology aids in their transmission is also extremely useful. I doubt a lot of design people think about how their products will aid the spread of disease, it just isn't something that most people consider. 

    VR headsets are another in the long line of developments. Razor blades for shaving, tattooing, etc. all have been inventions that inadvertently can spread disease.

    However, as with most everything, someone is already doing work on this subject. Curtis Brandt at UW-Madison is an expert in ocular herpes. The Brandt lab was one I was interested in doing my PhD at. However, fate took me elsewhere.


  • I have a PhD in Microbiology and Immunology, and I am currently a Principal Scientist.
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  • Sunday, December 4, 2016

    Back in the Saddle

    As I write this, I am sitting in my hotel room in Sierra Leone. It has been an interesting 18 months. Not that many posts ago, I was lamenting job hunting, and dreaming of assisting with the current (at that time) outbreak of Ebola that was occurring in West Africa.

    And then, it happened.

    I was hired for the job I had dreamed about for as long as I can remember; International Lab Capacity Building and Diagnostics, Viral Special Pathogens Branch (VSPB), CDC. And it was AMAZING!
    • Team lead for CDC Ebola diagnostic lab in Bo, Sierra Leone (three teams)
    • Ecology and molecular diagnostics training instructor at Njala University, Sierra Leone
    • Acting lab supervisor for VSPB at Uganda Virus Research Institute, Entebbe Uganda (twice)
    • BSL-4 work at "the mothership"
    And on top of all of that, the people were incredible. Our branch chief, program manager, my supervisor and my teammates were wonderful. The branch was full of great scientists and most of those were also great people. It is hard to imagine ever having a better situation...and then I quit.

    Sigh, that last part was hard, but I got an offer from a group that needed someone to oversee their work in Sierra Leone, and guess what? Not many people want to live in Sierra Leone for a year. So here I am.



  • I have a PhD in Microbiology and Immunology, and I am currently a Principal Scientist
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  • Sunday, March 1, 2015

    Hiatus

    Just a quick note that I will probably not be posting for a while. Moving to D.C., job hunting, house hunting, and a variety of other things (biotech startup, NPO startup) keeping me busy lately.

    Aloha!

    Saturday, January 31, 2015

    NDSU Microbiology Part 2

    In an earlier post I had a little fun with the Hektoen agar plates. I figured I would try my hand at a bit more art work this week. Below is the North Dakota State University logo. Again, the school colors are yellow and green, so the Hektoen plates are perfect. Enjoy!
    
    NDSU Logo with slightly sloppy lettering.
    NDSU Logo without lettering
    And the original:


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  • I have a PhD in microbiology and immunology, and I am currently a clinical/public health laboratorian.
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  • Saturday, January 17, 2015

    North Dakota State University - The Bacteria Love a 4-Peat!

    Hektoen enteric agar with fermenter.
    North Dakota State University beat Illinois State University in the FCS Championship game 29-27 in a thriller in Frisco, TX to capture its fourth straight FCS national championship.

    To commemorate this momentous occasion, I decided to have a little fun with the Hektoen enteric agar (NDSU's colors are yellow and green) in the lab. Enjoy!

    • I have a PhD in microbiology and immunology, and I am currently a clinical/public health laboratorian.
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    Monday, January 5, 2015

    Book Reviews and Suggestions

    I wanted to cover a few books that I have read and liked. Obviously this isn't an all inclusive list and I will try to add to it when I read something good and "sciencey".

    The Hot Zone - Richard Preston: This book has taken a bit of a beating over the past few weeks by certain members of the science community. While I understand that it takes literary freedoms, this really shouldn't be interpreted as a true historical account. Preston is an Ebola expert like Michael Crichton was a dinosaur expert. I don't know what good it does to get upset at Preston's book. He is an author, not a scientist, and I have heard extremely well-respected scientists saying much more ignorant, stupid, and dangerous things than Preston. If an Ebola outbreak happens to bump the sales of his book, and CNN and Fox have him on to interview him, why would he turn it down?

    I am far more upset at the people who read this book and interpret it as some supremely accurate historical account. I feel like the ven diagram of those who believe Preston's book is scientifically accurate and those who believe professional wrestling is real has a lot of overlap.

    Beating Back the Devil - Maryn McKenna: This book is basically about the Epidemic Intelligence Service at the CDC and provides a very thorough description of life as an EIS officer. At this point in time I have applied to the EIS 3-4 times (I lost track). Naturally, I love this book.

    The Coming Plague - Laurie Garrett: This book is the most detailed book on major outbreaks I have read. Meticulous and amazing. There is so much information in this book you would have to read it 20 times to get everything out of it. A must read for any one interested in public health.

    Inside the Outbreaks - Mark Pendergrast: Another book about a select few EIS investigations and the EIS program in general. I love this book, and it is fairly recently released.

    Arrowsmith - Sinclair Lewis: An inspiration. Anyone interested in public health or medicine, research or clinical should read this book. Fictional, but speaks volumes to the career choices, ups and down, and is still relevant today. Lewis won the Pulitzer and really was the first to address medicine and medical education in the 20th century and he predicted many issues and successes of medicine and research. I've only read it once, but it is on my own personal list of books to read this year.

    Biography of a Germ - Arno Karlen: This book is a little more "cute" kind of an interesting read of the biography of a germ. I liked it, it was mostly scientifically accurate. Something different from the more realistic or heavier stuff on this list.

    Virus Hunters - C.J. Peters: C.J. Peters is an icon. This book as well as "Level 4 Virus Hunters of the CDC" tell first person accounts of Ebola hunting in Africa. Both are CDC legends and C.J. Peters also mentions his time at USAMRIID. Both are biographical in nature, campfire tales and read as such.

    Level 4 Virus Hunters of the CDC - Joseph McCormick: See above. And I will make one more note. I actually have met Joseph McCormick and he signed this book for me. I was lucky enough to be able to attend a talk he gave at NDSU while I was in undergrad there. I double majored in biotechnology and microbiology and this was the point where the public health side of me took a majority and it hasn't swung back to biotech since (although it is still close, maybe 60/40 split)

    And the Band Played On - Randy Shilts: Do you remember when AIDS was called Gay-Related Immune Deficiency (GRID)? This is an absolute masterpiece of literary work by Shilts detailing the AIDS epidemic from political, social, and medical angles. As always, the book is better than the movie (although the cast is amazing; Alan Alda, Phil Collins, Richard Gere, Steve Martin, Ian McKellen, Lily Tomlin, BD Wong etc.)

    Concerning the Origin of Malignant Tumors - Theodor Boveri: Classic. It's like reading the Odyssey. It might be a bit of a slog, but you can be the one guy at the party that can say he has read it.

    The Plague - Albert Camus: Existentialist or absurdist, whatever he categorized himself as, it's an interesting read. If only to make you look a little differently at things in the world.


    Books I have not Read, but will in the Future

    The Viral Storm: The Dawn of a New Pandemic Age - Nathan Wolfe

    Spillover: Animal Infectious and the Next Human Pandemic - David Quammen

    A Planet of Viruses - Carl Zimmer


    • I have a PhD in microbiology and immunology, and I am currently a clinical/public health laboratorian.
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    Friday, December 26, 2014

    Look What I Found! - Smallpox and Friends Edition

    
    
    I don't want to spend a lot of time on this post because most everything that can, has been said about the situation. However, there is a particular point that I really want to make and some venting that I feel like doing.
    
    

    On 01 July 2014, the National Institutes of Health (NIH) notified the Division of Select Agents and Toxins (DSAT) and the Center for Disease Control and Prevention (CDC) (When are they going to change their name to the CDCP? Branding nightmare.) that employees discovered vials labeled "variola" in an unused portion of a storage room (how can part of a storage room be unused? I get what they are trying to say, but calling the place where they found smallpox "unused" sort of undercuts the fact that THERE WAS SMALLPOX IN THE ROOM!) at the FDA lab on the NIH campus which was opened in 1972. The vials appear to date from the 1950's.

    This here is my main point. How the hell did this happen?!? I can't f'ing stand dirty, unorganized lab space. Most of this is my personality, but part of it is training. The first lab that I worked in was at Aldevron, a biotechnology start up in Fargo, ND. They had just moved into a warehouse at the time so they were still in the process of setting up lab space and organizing. Then I worked in some labs on campus at NDSU, mostly new faculty which again were clean and organized. Fast forward to my PhD again with a new faculty member in a new lab space.
    Point being, most of the time I was a large part of the initial setup and organization, and there wasn't a lot of old junk to worry about throwing out, organizing, or worrying about.

    Then I worked at a public health lab and it was a completely different story. They kept everything; it was a science hoarders dream. A single drawer in some cases could outfit a science museum. And it was there I understood. People save stuff, all the time. I was zero surprised when they found smallpox, and I will be zero surprised in 20 years when they find polio, or rinderpest, or whatever other eradicated disease is out there. Dirty little secret is that scientists are not clean and organized. Maybe their data, maybe their desk, but certainly not the lab. Very few of them clean the lab space, and keep it organized and most of it is rationalized as a time issue, or "this is taxpayer money so we can't throw it out".

    Human nature is definitely something to consider when discussing the "should we destroy the remaining vials or not" topic. Not only is there the potential for it to be used as a weapon (which I think is extremely small) but there is the more likely chance that someone wasn't careful and has it stashed somewhere forgotten. I personally don't think we should destroy the stocks until we can reliably reproduce the virus from DNA sequence, but even if the decision to destroy the last remaining stocks occurs, it probably won't be "the last remaining stocks".
     
    The other thing I find fascinating is the idea that an invasion of another country was justified by selling the idea Iraq had weapons of mass destruction. My guess is 99% of all the other countries in the world have less bioweapons than what has been lost in storage rooms at the NIH and other labs around the country.

    Another amazing aspect of this whole ordeal, is the discovery of multiple other substances including ricin, yersinia pestis, staphylococcal enterotoxin, burkholderia pseudomallei, and francessella tuleremia. As if smallpox wasn't bad enough. Ugh. I hate the idea that people can't even be held responsible for knowing what is in their lab. It's YOUR lab. You work with smallpox, etc. how do you not know exactly what is in the lab, and where? It isn't that hard people. But clearly it is.

    Last but not least was the string of tweets that occurred once the story broke. I won't go into them here, but I would highly recommend visiting the link.
    • I have a PhD in microbiology and immunology and I am a clinical/public health laboratorian.
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