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.

  • I have a PhD in Microbiology and Immunology, and I am currently a Principal Scientist.
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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.
  • Follow me on Twitter or connect on LinkedIn.
  • 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
  • Follow me on Twitter or connect on LinkedIn.