Infectious disease

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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 speaking at podium

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 applies knowledge and strategies acquired during his fights againt bioterrorism, pandemic influenza, Ebola and other public health emergencies. His 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 yesterday by Prof. Osterholm on the subject of the book here. He will be moderating 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; register to attend or view the webcast here

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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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Gaetan Dugas

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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Olympic logo made out of mosquito silhouettes

Despite Zika's Spread, Experts Caution Against Overreaction

August 5, 2016

The confluence of the Zika outbreak in Latin America and the Rio Olympic games has led some athletes to make a tough decision: forgoing competition to avoid the disease. This week, the Centers for Disease Control (CDC) confirmed homegrown transmissions of the virus in the US. These developments lead to questions about how significant Zika is as a public health hazard, and whether the Olympics will increase its spread into countries that don't currently have it. An article in FiveThirtyEight explains why the latter isn't a major concern: despite Brazil being the origin of the current Zika outbreak, there are a lot more tourists to the entire outbreak area than people traveling to the Olympics. In other words, "a 30-person Olympic delegation and 100 spectators don’t present much additional risk to a country that’s already seeing 50,000 visitors a year from areas with Zika." For countries like the US, which already have an active, mosquito-borne outbreak, experts like Michael Osterholm of Consortium member the Center for Infectious Disease Research & Policy (CIDRAP) emphasize the importance of basic public health measures. In an interview on the Diane Rehm Show, Osterholm recommended focusing on "eliminating the breeding sites – the water sources, the garbage. We now live in a plastic garbage world where one bottle cap sitting in a ditch is more than enough, is a great breeding site for this mosquito." CIDRAP maintains a Zika website that's a up-to-date, scientifically accurate, and global in scope; here's a link.

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Poo lookalike ice cream sundae from Beijing

Consortium Lecturers Discuss Fecal Transplant Pill

August 2, 2016

An article by Ed Yong in The Atlantic describes attempts to create effective stool substitutes to replace fecal transplants used to treat Clostridium difficile, which kills almost 30,000 Americans each year. One such substitute, from Seres Therapeutics, recently failed during a phase 2 drug trial. Yong quotes Dianne Hoffmann, who spoke last spring during the Consortium's Microbiome Therapeutics lecture series: she notes that "whole stool" is clearly more effective than bacterial pills. "Something in there is working. We just don’t know what it is, and it might be hard to deconstruct.” Another speaker in the lecture series, Alexander Khoruts, adds "The full spectrum of microbes harvested from donors has been designed by nature, and has a proven safety track record in the original host. That’s a very hard benchmark to improve upon with any kind of synthetic." You can view Diane Hoffmann's lecture on regulating microbiome therapeutics here; Alex Khoruts' talk, The Evolving Human Microbiome, is here.

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C. difficile bacterium

Scientists Seek Answers: Why Do Fecal Transplants Work?

July 18, 2016

An article in the New York Times features recently published research by Alexander Khoruts, MD (Microbiota Therapeutics Program) and Michael J. Sadowsky, PhD (Director, Consortium member the Biotechnology Institute). They are among the scientists trying to understand the mechanisms enabling transplanted fecal matter to fight potentially fatal Clostridium difficile infections. While Khoruts and Sadowsky are currently focusing on the chemistry of the human gut, specifically bile acids, other researchers are looking at microbes known as archaea, and still others are considering the role of bacteria-infecting viruses. Understanding the human microbiome is notoriously complex; as Prof. Khoruts notes, it's "something nature put together over millions and millions of years.” View Prof. Khoruts' recent lecture on the human microbiome here.  

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Aedes aegypti mosquito that carries Zika virus

Human Role in Proliferation of Zika Mosquito Examined

June 21, 2016

The implacable nature of evolution means attempts to eradicate Aedes aegypti mosquitoes – the species that carries Zika virus and other diseases – are doomed to fail, according to an opinion piece in the LA Times by Prof. Marlene Zuk, PhD, of the College of Biological Sciences. Zuk describes the complex interaction between mosquitoes, humans and ecological systems that have led to emergence of a bug that's been "domesticated" to thrive in urban environments. Michael Osterholm, director of Consortium member the Center for Infectious Disease Research and Policy (CIDRAP), is quoted in the article on past, failed efforts to eliminate Aedes aegypti, noting "'evolutionary biology is the gravity' – the force – that underpins the progress and control of Zika."

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White Tuskegee researcher drawing blood from Black man

Legacy of Tuskegee Syphilis Experiment Revelations: Reduced Life Expectancy for Black Men

June 14, 2016

Since it was revealed in 1972, the Tuskegee Study of Untreated Syphilis in the Negro Male has been considered among the most egregious violations of research ethics during the 20th century. The study began in 1932; for 40 years, researchers passively monitored hundreds of adult black males with syphilis, despite the availability of effective treatment. The study was funded by the US Public Health Service (PHS), and only concluded when PHS employees alerted journalists, having been ignored or rebuffed by their employer. A newly published paper outlines the tragic legacy: "the historical disclosure of the study in 1972 is correlated with increases in medical mistrust and mortality and decreases in both outpatient and inpatient physician interactions for older black men." The authors of the study estimate "life expectancy at age 45 for black men fell by up to 1.4 years in response to the disclosure, accounting for approximately 35% of the 1980 life expectancy gap between black and white men." At last December's Consortium-sponsored Research with Human Participants conference, Prof. Vanessa Northington Gamble, MD, PhD (George Washington University) discussed her work as Chair of the federal committee that obtained an official apology for the study from President Bill Clinton in 1997 -- view her talk here

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Petrie dish with MCR-1 superbug

MCR-1 Superbug Found in US for the First Time

June 1, 2016

Health care providers have long been concerned about the overuse of antibiotics; each year, the CDC estimates more than 23,000 people die after being infected with bacteria that have developed resistance to currently-available drugs. These worries have been heightened by the discovery that a Pennsylvania woman is harboring a strain of E. coli that is resistant to colistin, the antibiotic of last resort. An article from Consortium member the Center for Infectious Disease Research and Policy (CIDRAP) describes the discovery of the MCR-1 resistance gene by a team of Chinese researchers last November. In a Washington Post opinion piece, health policy scholar Ezekiel Emanuel proposes novel approaches to addressing antibiotic resistance, including the development of drug stewardship programs to reduce inappropriate prescriptions and the creation of financial prizes to motivate researchers and companies to develop new antiobiotics.  

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C difficile bacteria

Probiotics Regulation Talk Concludes Microbiome Lecture Series

April 21, 2016

The 2015-16 Microbiome Research & Microbiota Therapeutics lecture series wrapped up today with a talk by Prof. Diane Hoffmann, JD, MS, of the Law & Health Care Program at the University of Maryland. Prof. Hoffmann discussed her work leading an NIH-funded working group charged with identifying regulatory gaps and recommending solutions to ensure the safety and efficacy of probiotic products. She also described a project currently underway to perform a similar audit of fecal microbiota transplantation (FMT) regulations and those for other microbiome transplants. Prof. Francisco Diez-Gonzalez, PhD (Dept. of Food Science and Nutrition, University of Minnesota) offered a commentary from his perspective as a food safety expert and microbiologist. Videos are available of the two previous lectures in the series, one on the evolving human microbiome by Prof. Alexander Khoruts, MD (University of Minnesota) and the other on pediatric uses of FMT by Prof. Stacy Kahn, MD (University of Chicago). Video of the lecture by Prof. Hoffmann will be posted soon; please check back. 

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Turkey

The Looming Threat of Avian Flu

April 13, 2016

An article in this week's New York Times Magazine outlines the challenges of protecting the U.S. agricultural system from devastating diseases. Last year's avian flu outbreak was particularly destructive, with more than 21 states reporting cases of the H5 virus and more than 50 million birds killed. The article outlines some reasons for the growing seriousness of these outbreaks, despite a post-9/11 presidential directive to better protect "the agriculture and food system against terrorist attacks, major disasters and other emergencies." Prevailing wisdom at that time "was that farms, deep in thinly populated rural areas, would not be a danger to one another." University of Minnesota professor of avian health Carol Cardona, DVM, explains: "The food system responded to 9/11 with changes further up the food chain.” she notes, leading to the establishment of organizations like Consortium member the Food Protection and Defense InstituteNow, the USDA is working directly with farmers and trade organizations to better protect farms from the flu and one another. The most thorough, up-to-date resource for information on avian flu and other epidemics can be found at the website of Consortium member the Center for Infectious Disease Research and Policy (CIDRAP). 

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