Infectious disease

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Critics Call for Large Sepsis Study to be Shut Down

September 25, 2018

Sepsis is a very serious illness — of the million Americans who get the disease each year, up to 30 percent will die. A large, National Institutes of Health (NIH)-funded government trial of sepsis treatments, called Clovers, is currently under attack. According to the New York Times, "In a letter to the federal Office for Human Research Protection, representatives of Public Citizen’s Health Research Group compared the study, called Clovers, to 'an experiment that would be conducted on laboratory animals.” The Times recounts, "At issue is whether patients participating in Clovers are being given treatment that deviates from usual care — so much so that lives may be endangered by the research. Participants are only enrolled for 24 hours, but the first hours of treatment are critical for survival. . . . Scientists leading the study note that treatment is not hard and fast, and insist that all participants are getting medical care that 'falls within the range of usual care.'” The Consortium is nationally recognized for its work on patient rights and research ethics in clinical trials; among our contributions are major, national conferences bringing together top policymakers, scholars and researchers to grapple with thorny issues of consent, capacity and conflicts of interest. To learn more and view videos from these conferences, visit our YouTube channel.

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Mike Osterholm

Osterholm Appointed an International Science Envoy

June 12, 2018

Michael T. Osterholm has been honored with the position of Science Envoy by the US Department of State. Through the Science Envoy Program, eminent scientists and engineers leverage their expertise and networks to forge connections and identify opportunities for sustained international cooperation, championing innovation and demonstrating America’s scientific leadership and technical ingenuity. Osterholm is an international leader regarding preparedness for a global pandemic as well as the growing threat of antimicrobial resistance. As a Science Envoy for Health Security, he will combat biological threats by working with priority countries on infectious disease preparedness and antimicrobial stewardship. Osterholm is Director of the Center for Infectious Disease Research and Policy (CIDRAP), a Consortium member, and currently serves on our Executive Committee. Read an interview with him about his appointment here

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Romaine lettuce

E. Coli Outbreak Illustrates the Limits of US Food Traceability

May 2, 2018

The recent cluster of E. coli contamination, which is linked to romaine lettuce and has sickened people in 22 states, has just caused its first fatality. We don't yet know the source of the infection. The outbreak demonstrates gaps in the systems used to track food pathways in the US. According to an article in ​Wired, compared to Europe and Japan, "the procedures that might make [the US] food supply more traceable have been caught in a tug of war between federal officials, who want to solve outbreaks more quickly, and growers and shippers, who are resistant to investing in technology they don’t think they need." Amy Kircher, director of the Food Protection and Defense Institute​, a Consortium member, is interviewed for the piece. She notes that "when there are records, they aren’t necessarily granular enough to be useful." Referring to a typical four-pack of tomatoes, Kircher explains that "'we assume those tomatoes come from the same source.' But because tomatoes from many farms get commingled at packing houses and then sorted for similarity of ripeness, size and color, that four-pack could contain tomatoes from four different farms." The article notes it's possible that blockchain – a "distributed, encrypted ledger that supports cryptocurrency such as Bitcoin​ – could also be used to build a record of every transaction that affects a piece of produce."

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Ramanan Laxminarayan

Global Antibiotic Use Rises, Fueled by Economic Growth

April 2, 2018

A large-scale international study has found that the use of antibiotics is increasing around the world, largely driven by improving living standards in low- and middle-income countries (LMIC). An article from the Center for Infectious Disease Research and Policy (CIDRAP), a Consortium member, describes the paper published in the Proceedings of the National Academy of Sciences, which shows that overall global antibiotic use "rose by 65% from 2000 through 2015, while the antibiotic consumption rate increased by 39%. Over that period, antibiotic consumption in LMICs more than doubled, with some LMICs having consumption rates that surpassed those of high-income countries (HICs). The increase was correlated with growth in per capita gross domestic product." One of the authors of the study is Ramanan Laxminarayan of the Center for Disease Dynamics, Economics and Policy (CDDEP), who was scheduled to be the third speaker in our lecture series on Antibiotic Resistance: Policy Challenges & Solutions; that talk was canceled because of extreme weather. A recent CIDRAP-sponsored webinar by Prof. Laxminarayan, "What Can the United Nations Do about Antimicrobial Resistance," is available for viewing here

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H. Morgan Scott

Video Available for Lecture on Agricultural Use of Antimicrobials

March 13, 2018

A lecture delivered on Feb. 28 by H. Morgan Scott, DVM, PhD, is now available for viewing via the Consortium's YouTube channel. In his talk, Prof. Scott discussed antimicrobial stewardship in the production of food animals. An article published by the Center for Infectious Disease Research and Policy (CIDRAP), a lecture co-sponsor and Consortium member, describes Scott's proposal of "an ethical framework for defining judicious use of antibiotics in animals." Last November, the World Health Organization (WHO) called for a major reduction in the use of medically important antimicrobials in food animals; according to Scott, that is "where things start to get a little tricky," since it indicates a pullback from preventive practices. Prof. Scott provided a nuanced consideration of the values shared by both sides in this contentious debate — for instance, both agree that "antibiotics enhance the health and well-being of animals and humans, that there is overuse and misuse of antibiotics in animals and humans, and that protecting the efficacy of antibiotics for future generations is a good thing." Scott was joined by Jeff Bender and Tim Johnson of the University of Minnesota College of Veterinary Medicine. In addition to CIDRAP, this lecture was co-sponsored by the Microbiota Theraputics Program. The next lecture in the series will be held on April 3, 2018 and will feature Ramanan Laxminarayan, PhD, MPH of the Center for Disease Dynamics, Economics & Policy (CDDEP) and the Princeton Environmental Institute. He will discuss policies that can increase global access to effective antimicrobials.

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CDC bar graph of positive flu tests Feb 2018

Current Flu Season Sparks Discussion of Prevention, Vaccines

February 21, 2018

Minnesota Public Radio (MPR) host Mike Mulcahy interviewed two experts yesterday about this year's unusually strong — and deadly — outbreak of influenza. Patsy Stinchfield of Children's Minnesota focused on steps to prevent the illness. Michael Osterholm, director of the Center for Infectious Disease Research and Policy (CIDRAP), a Consortium member, outlined the challenges to developing effective vaccines. Osterholm co-authored a New York Times op ed in January, with Mark Olshaker, sounding the alarm on our lack of preparedness for a flu pandemic. They write: "A worldwide influenza pandemic is literally the worst-case scenario in public health — yet far from an unthinkable occurrence. Unless we make changes, the question is not if but when it will come."

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C difficile bacteria

Research Reveals Exciting New Possibilities for Microbiome Therapies

February 22, 2018

A major paper just published in Cell Host & Microbe sheds light on a question that has puzzled scientists for years: while we know fecal microbiota transplantation (FMT) works for people suffering from recurrent Clostridium difficile infection, how exactly does it work? The research team behind the paper includes Alexander Khoruts and Michael J. Sadowsky, the director of the Biotechnology Institute, a Consortium member center. They used clinical experiments and statistical modeling to uncover the "rules" for how donor bacteria grafts itself to existing gut microbes in the host. One of the outcomes of the research is Strain Finder, a method to predict which types of bacteria will best colonize a microbiome being treated via FMT. An article in the Star Tribune further describes the work of Sadowsky and Khoruts’ Microbiota Therapeutics Program, which is on the cutting edge of developing remedies for various microbiome-related illnesses. You can also read a Star Tribune op ed by Khoruts and Sadowsky, in which they express their concerns about the article's focus on a for-profit model for developing such therapies. 

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Martin J. Blaser

Blaser Shares Groundbreaking Research on Antibiotics and Microbiome Health

February 7, 2018

Today, Martin J. Blaser of New York University's School of Medicine spoke to a standing-room-only crowd on "The Dark Side of Antibiotics." Prof. Blaser provided an overview of what we've learned about changes to the human microbiome over the past 70+ years. His talk focused on obesity, diabetes, asthma and other harms that appear to be linked to the aggressive use of antibiotics. Prof. Blaser also outlined research indicating that microbiome characteristics can be passed from mother to child, leading to ever more limited microbiotic diversity over generations. He looked at global differences in the human microbiome related to the number of antibiotics prescribed, and discussed the more judicious use of these drugs in countries like Sweden, where antibiotics are prescribed less frequently but health measures are still strong. Finally, he described some possible approaches to microbiome restoration. James R. Johnson, an infectious disease specialist, provided a commentary in which he discussed the various ways antibiotics have been viewed by medical professionals since coming into wide usage in the early 1940s. Prof. Johnson offered a clinical perspective on the challenges of limiting their use. A video of the entire talk can be viewed here.  

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MERS virus

NIH Lifts Ban on Making Lethal Viruses

December 21, 2017

The National Insitutes of Health (NIH) has ended "a moratorium imposed three years ago on funding research that alters germs to make them more lethal," according to the New York Times. The goal of such research is to better understand the mechanisms that drive pathogens to mutate and become deadly; the new guideline requires the germ pose a "serious health threat" and that the research be done in a highly secure lab. The Times article notes, "There has been a long, fierce debate about projects — known as 'gain of function' research — intended to make pathogens more deadly or more transmissible." The ban on such reseach was put in place after an incident in which lab workers at the Centers for Disease Control (CDC) were accidentally exposed to anthrax. Michael T. Osterholm, Director of the Center for Infectious Disease Research and Policy (CIDRAP), a Consortium member, is quoted in the article. He believes this type of work could be done safely, but wanted restrictions on what would be published, noting "if someone finds a way to make the Ebola virus more dangerous, I don’t believe that should be available to anybody off the street who could use it for nefarious purposes. . . . We want to keep some of this stuff on a need-to-know basis."

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World Health Org logo

WHO Recommends Against Antibiotic Use for Healthy Animals

November 8, 2017

New guidelines from the World Health Organization (WHO) recommend farmers and the food industry stop using antibiotics routinely to promote growth and prevent disease in healthy animals. According to the WHO, "Over-use and misuse of antibiotics in animals and humans is contributing to the rising threat of antibiotic resistance," a serious danger to global health that's the subject of the Consortium's 2018 lecture seriesDr Kazuaki Miyagishima, Director of the Department of Food Safety and Zoonoses at WHO, states "The volume of antibiotics used in animals is continuing to increase worldwide, driven by a growing demand for foods of animal origin, often produced through intensive animal husbandry.” However, H. Morgan Scott, DVM, PhD (Texas A&M University), who will be delivering the second lecture in the Consortium series, emphasizes that veterinarians and producers must work to achieve reductions in the need for preventive use of antimicrobials. In his talk, he'll explore the social norms, moral imperatives (to both humans and animals), and ethical features that should frame future antimicrobial stewardship practices. To register for the lectures, which are free and open to the public, click here

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Andres Perez

Leadership Change at Center for Animal Health and Food Safety

October 11, 2017

Prof. Andres Perez, DVM, PhD, is the new director of the Center for Animal Health and Food Safety (CAHFS), an interdisciplinary team at the University of Minnesota. The Center is coordinated by the College of Veterinary Medicine, and is a Consortium member. Perez takes over for Dr. Scott Wells, who is stepping down after serving as director and co-director for the past six years. Prof. Perez joined the College in 2014 and is a veterinary epidemiologist specializing in the prevention and control of food animal diseases. He also holds the Global Animal Health and Food Safety endowed chair. Prof. Perez notes, “CAHFS has been an effective catalyst for lasting change in the animal health and food safety sectors, and I hope to continue that success. . . . The goal is to increase CAHFS’ portfolio in areas such as policy, online education and outreach, quantitative data analysis, aquatic health, and antimicrobial resistance.”

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1960s photo of public health workers examining little girl's smallpox vaccine scar

Smallpox Cousin Synthesized in Lab, Raising Bioterrorism Concerns

July 17, 2017

The Washington Post reports that scientists in Alberta have "used commercially available genetic material to piece together the extinct horsepox virus, a cousin of the smallpox virus that killed as many as a billion human beings before being eradicated." While the lead researcher's efforts are "aimed at developing vaccines and cancer treatments," his achievement led the former head of the Centers for Disease Control (CDC), Tom Frieden, to assert "the need to monitor more closely 'dual-use' experiments — research that could be used either for protective purposes or, in theory, to create a deadly pathogen." Consortium collaborator Alta Charo, who currently serves on the National Working Group for the LawSeq project, says "we are still struggling with how to manage the dual-use dilemma. How do we get the benefit of the research without the risk of it being turned against us?" Meanwhile, other researchers emphasize the greater threat of naturally evolving pathogens such as Zika and Ebola. Michael Osterholm, director of Consortium member the Center for Infectious Disease Research and Policy (CIDRAP), notes another aspect of the horsepox synthesis: “How many other people have done it[?] We never thought or expected it to come from a place like Alberta. It's not one of the leading universities in the world for microbiology and synthetic biology. If it came out of there, how many other places like this are also doing the same work right now?” Osterholm continues, "This has been the storm coming for years. We’ve known about it, but unfortunately, we’re not ready."

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Ilhan Omar

Minnesota Measles Outbreak Result of Anti-vaccine Efforts

May 18, 2017

More than 60 Minnesota children, mostly from the state's large Somali-American community, are infected with measles. The outbreak is a direct result of efforts by anti-vaccine activists such as Andrew Wakefield, the discredited researcher behind the film Vaxxed, who has visited Minneapolis and met with Somali parents. According to the Minneapolis Star Tribune, the rate of measles immunization among Somali-American children has plummeted from rates as high as 92% in 2004 to just 42% today. Alarms were sounded in 2008, when it was reported that a disproportionate number of Somali-American children were participating in a preschool program for those diagnosed with autism. Some members of the Somali-American community have been alarmed by claims that autism can result from the measles-mumps-rubella (MMR) vaccine, concerns shared by a significant portion of the general public despite efforts by public health workers to combat that perception. An article in Snopes details how one discredited anti-vaccine study was recently published, then unpublished, by two academic journals, digging into the "suspect statistics and devil-may-care attitude toward methodological design" in the paper. Meanwhile, Ilhan Omar, the first Somali-American legislator in the US, is working with the Minnesota Department of Health to encourage vaccination and rebut myths about autism, an effort that is showing results.

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Julie Gerberding

All-star Panel Charts a New Course for Disaster Preparedness

April 17, 2017

Last week, the Consortium hosted the final of three lectures on Emerging Diseases in a Changing Environment, featuring Dr. Julie L. Gerberding, MD, MPH, FACP. Dr. Gerberding is Executive Vice President at Merck and the former Director of the Centers for Disease Control and Prevention (CDC). In her talk, she described what she's learned about emergency preparedness through responses to anthrax, SARS and other biothreats, and proposed steps that should be taken to improve such responses. Dr. Gerberding was joined by Prof. Amy KircherDrPH (Director, Food Protection and Defense Institute) and Prof. Michael T. Osterholm, PhD, MPH (Director, Center for Infectious Disease and Policy). In a lively conversation, they discussed pandemic threats and responses and from the perspectives of their disciplines, ultimately arriving at the importance of advance planning by collaborations such as the United Nations Central Emergency Response Fund (CERF) to contain crises before they balloon out of control. A video of the entire event can be viewed here. Videos of the first lecture in the series, "Finches, Dogs, Lions and Zika: An Ecologist Looks at Emerging Disease" by Prof. Andrew Dobson, DPhil, can be viewed here. The second, "Ending the Pandemic Era: Science at the Animal-Human-Environmental Interface" by Jonna Mazet, DVM, MPVM, PhD, can be viewed here

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Book cover -- Deadliest Enemy

New Book by Consortium Colleague Offers Strategies for Emerging Diseases

March 22, 2017

Renowned epidemiologist Michael T. Osterholm, PhD, MPH, director of Consortium member the Center for Infectious Disease Research and Policy (CIDRAP), has published a new book laying out how humanity can protect itself against catastrophic infectious disease and pandemic. In Deadliest Enemy: Our War Against Killer Germs, Prof. Osterholm and co-author Mark Olshaker apply knowledge and strategies acquired during fights against bioterrorism, pandemic influenza, Ebola and other public health emergencies. The book's goal? To describe "the latest medical science, case studies, policy research, and hard-earned epidemiological lessons. . . we need to develop if we are to keep ourselves safe from infectious disease." You can view a lecture delivered by Prof. Osterholm on the subject of the book here. He moderated a lecture on a closely related topic, Combating Microbial Terrorists, by former head of the Centers for Disease Control Julie Gerberding, MD, MPH, on April 13; view a video of that event. 

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Turkey

Poultry DNA Sequencer a Powerful Tool in Antibiotic Resistance Research

December 21, 2016

A state-of-the-art genetic analysis tool has been deployed to Willmar, Minnesota, the heart of the state's burgeoning turkey business. According to an article in Agweek, beginning in 2017 the Food and Drug Administration (FDA) is implementing new restrictions that change how livestock producers use antibiotics in feed to promote growth. The action is being taken to address growing concerns that antibiotic resistance could threaten public health. Veterinary science professor Tim Johnson is leading the project, which is housed at the U's Mid-Central Research and Outreach Center. According to Johnson, the DNA sequencer "will improve the speed and the resolution of our ability to detect pathogens of the bad bacteria and the bad viruses" by helping researchers understand how pathogens travel and examining "emerging diseases of poultry and other animals to be able to quickly identify what's causing problems." The Consortium is hosting a three-part series on a related topic, Emerging Diseases in a Changing Environment, starting on Jan. 24; learn more and register here

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HPV microbe

Research Shows HPV Antibodies Influence Head, Neck Cancer Prognosis

December 8, 2016

A new study led by a researcher at Consortium member the Masonic Cancer Center (MCC) provides important new information about the connection between human papillomavirus (HPV) antibodies and five-year survival rates for some types of cancer. The paper, "Immune Response to HPV16 E6 and E7 Proteins and Patient Outcomes in Head and Neck Cancer,” was published in JAMA Oncology; it demonstrates that measuring a patient’s immune response to HPV provides a robust prognostic signal, suggesting that in the future a blood serum test for two specific HPV antibodies may replace traditional pathology testing. Lead author Heather Nelson, PhD, MPH, is co-leader of the Screening, Prevention, Etiology and Cancer Survivorship (SPECS) Program at MCC. 

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HIV cell

Vindication of "Patient Zero" Highlights Power of Disease Narratives

November 21, 2016

In the early 1980s, during the initial throes of the AIDS epidemic, a flight attendant named Gaetan Dugas came to be identified as "Patient Zero" because he was represented in popular culture as the person who brought HIV to North America. A recent study published in Nature used genomic data to map the spread of HIV during that time, demonstrating conclusively that Dugas was not the North American index case as previously depicted. An analysis of the case by Greg Clinton explores "the spectacle of disease narratives, not only what they emphasize, but what they tend to obscure." Drawing on the groundbreaking work of Priscilla Wald and others, Clinton describes how epidemiological narratives, most famously that of Typhoid Mary, are "typically bound up with literary concerns, such as the assignment of 'hero' and 'villain' status to a person or group." He argues for consumers to apply "critical consciousness" to such media-driven spectacles, resisting the all-too-human temptation to passively absorb narratives that assign meaning, "even if that meaning is false and only serves to perpetuate fear of the Other." Read the entire article here

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Flock of turkeys

UN Tackles Antibiotic Resistance

September 22, 2016

A new declaration by the UN General Assembly is intended to slow the spread of antibiotic-resistant organisms. According to National Public Radio, the resolution "requires countries to come up with a two-year a plan to protect the potency of antibiotics. Countries need to create ways to monitor the use of antibiotics in medicine and agriculture, start curbing that use and begin developing new antibiotics that work." While concerns about "superbugs" are widespread in public health circles, it took data showing the potentially catastrophic economic implications of antibiotic resistance to spur this action. One expert, Ramanan Laxminarayan, is optimistic about the outcomes of this campaign, comparing this effort to a similar one begun by the UN about the HIV pandemic; the article notes, "since 2004, there has been a 45 percent drop in AIDS-related deaths in countries supported by global HIV campaigns."

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