The Ebola Vaccine and the Ethics of Drug Trials

By Greg Mercer

The World Health Organization recently announced that a trial of the VSV-EBOV Ebola virus vaccine in Guinea has been “highly effective,” and that randomization in the trial would be stopped to allow for expansion of the range of subjects and protection of more people against the virus.  The trial began in March, and until recently, randomized subjects so that some received the vaccine immediately, while others received it later, after the virus’ gestation period.

A paper published in The Lancet details the study, and finds that the vaccine is highly effective and likely safe to use in the affected population.  The “recombinant, replication-competent vesicular stomatitis virus-based” vaccine is administered in a single dose via the deltoid muscle.  4,123 people received the vaccination immediately, while 3,528 people received the delayed vaccination (more on the study methodology in a moment). The researchers found that no subjects developed a case of Ebola after receiving the immediate or delayed vaccination, meaning that the vaccine proved 100% effective (with p=0.0036 at 95% CI).  These findings are excellent news for researchers, government officials, and those in the affected counties, and are fascinating from a scientific standpoint.

At The New Republic, Timothy Lahey, of Dartmouth, argues that these results, while promising, aren’t necessarily confirmed.  He notes that the lack of a placebo (because of the study’s particular methodology) makes it difficult to determine effectiveness, the vaccine could have failed to protect subjects from infection in a way that the study didn’t detect, and that a statistical aberration could mean that while the vaccine is not actually 100 % effective.  Regardless of whether these potential pitfalls affected the study or not, Lahey raises an important issue in drug testing for a disease like Ebola.  He is concerned that a lower standard for vaccines could mean that lower-income countries might not receive drugs of the same quality as rich countries, and points to past failed vaccines to illustrate the fallacy of believing that all vaccines work as intended.

The ethical dilemmas of drug testing have been front and center in the Ebola crisis.  Back in November, 2014, Nature reported on public health officials weighing the question of whether to use control groups when testing treatments for a disease with 70% mortality.  At the time, some advocated for applying experimental treatments (like the ZMapp antiviral cocktail, which had been used in patients but whose effectiveness was not entirely determined) to all patients, while others argued that these treatments might not be more effective than standard care, and that randomized trials guard against harmful side effects and provide a clearer picture of a drug’s effectiveness.

The VSV-EBOV vaccine was tested in the “ring” method that was previously used in the eradication of Smallpox.  This method eschews the double-blind placebo treatments commonly associated with drug trials.  Instead, this method creates a “ring” around new cases.  Contacts and contacts of contacts were identified by Guinea’s tracking system, and eligible adults were entered into randomization blocks, and received either the immediate or delayed vaccination.  This way, all of the subjects received the treatment, but in varying circumstances to establish effectiveness.  The full study is available via The Lancet.

Ethical drug testing is a crucial consideration, and has an imperfect past.  The National Institutes of Health’s own ethics guide cites a study that led to the United States’ ethics rules: a study that withheld syphilis treatment from 400 African-American men.  And for many, there’s good reason to be concerned about the actions of international organizations and multinational corporations.  In 1996, Pfizer conducted a study of an experimental drug on children with meningitis in Nigeria. While Pfizer maintained that the study was philanthropic, allegations arose from Nigerians and international organizations that children and parents were not informed that they were part of a study, and that Pfizer withheld treatment without consent or administered dangerous drugs.  The incident spawned a series of lawsuits and a panel of Nigerian medial experts condemned Pfizer’s actions in 2006, as reported by The Washington Post.

Epidemics and drug testing present a multitude of practical and ethical concerns, but careful consideration of the issues and sound methodology can, as they did in Guinea, produce exciting scientific and humanitarian results.

Image Credit: Psychonaught

Pandora Report 6.14.15

I’ve got brunch reservations this morning so the big story about the coming egg shortage is hitting close to home. We’ve also got a story about ISIS’ WMD and a bunch of stories you may have missed.

As a final reminder, the Early Registration Deadline for the Pandemics, Bioterrorism, and International Security is tomorrow, Monday, June 15. For more information and registration, please click here.

Enjoy the rest of your weekend!

Egg Shortage Scrambles U.S. Food Industries

The unprecedented outbreak of avian influenza in the U.S. has meant massive losses in the domestic poultry industry which has left experts warning that U.S. consumers are very likely to see an increase in egg prices. Cases of avian flu have been reported in 15 states, with Iowa and Minnesota being some of the hardest hit. “In Minnesota, the number of lost turkeys represent about 11 percent of our total turkey production…of the chickens we’ve lost that are laying eggs, 32 percent… have been affected by this” In Iowa, about 40 percent of the state’s egg-laying chickens and 11 percent of its turkeys have been affected. All these losses will mean a shortage of whole eggs and other egg-based products.

U.S. News and World Report—“Consumers haven’t felt the pinch too much just yet, but they are unlikely to emerge with their pocketbooks unscathed, [Rick] Brown [Senior VP at Urner Barry, a food commodity research and analysis firm]. He says two-thirds of all eggs produced in the U.S. remain in a shell, many of which are placed in cartons and sold in grocery stores. This stock of eggs has been hit significantly less by the avian flu outbreak than those used in the egg products industry, which Brown says encompasses “everything from mayonnaise to salad dressings to cake mixes to pasta to bread.”

Australian Official Warns of Islamic State Weapons of Mass Destruction

You may have already seen this, since this story was everywhere this week. Julie Bishop, Australia’s Minister for Foreign Affairs, said the Islamic State (ISIS) already has and is already using chemical weapons. Bishop made these comments in an address to the Australia Group—a coalition of 40 countries seeking to limit the spread of biological and chemical weapons. In a follow-up interview, Bishop also said that NATO was concerned about the theft of radioactive material and what that could mean for nuclear weapons proliferation.

The Washington Post—“‘The use of chlorine by Da’ish, and its recruitment of highly technically trained professionals, including from the West, have revealed far more seriou­s efforts in chemical weapons development,” Bishop said, using an alternate name for the Islamic State in a speech reported by the Australian. She did not specify the source of her information.  “… Da’ish is likely to have amongst its tens of thousands of recruits the technical expertise necessary to further refine precursor materials and build chemical weapons.’”

Stories You May Have Missed

 

Image Credit: Hannahdownes

Pandora Report 4.19.15

Sunday has to be the biggest brunch day of the week, so it is only fitting that our lead story looks at the many (delicious and nutritious) uses of maple syrup. We also look at Dengue fever in Brazil, missteps in the U.S. fight against Ebola, and other stories you may have missed.

Once you’re updated, get out there and enjoy the rest of your weekend and the beautiful weather! Have a great week!

Syrup Extract Found to Make Antibiotics More Effective Against Bacteria

It seems like we look at growing antibiotic resistance every week here at Pandora Report. This week, researchers at McGill University in Montreal reported that a “concentrated extract of maple syrup makes disease-causing bacteria more susceptible to antibiotics.” This finding suggests that combining the extract with antibiotics could increase their effectiveness and lead to lower antibiotic usage overall. Honestly, is there anything maple syrup can’t make better?!

Infection Control Today—“‘We would have to do in vivo tests, and eventually clinical trials, before we can say what the effect would be in humans,” [Professor Nathalie] Tufenkji says. “But the findings suggest a potentially simple and effective approach for reducing antibiotic usage. I could see maple syrup extract being incorporated eventually, for example, into the capsules of antibiotics.’”

Brazilian Teams on Alert because of Dengue Fever Outbreak

Brazilian soccer teams are on high alert because of a dengue fever outbreak that has already affected some of the country’s top teams. This week three players were diagnosed with the mosquito borne disease, which normally takes about two weeks to recover from. Players have been forced to use insect repellent during games and practices and health officials have been asked to check fields and training centers for mosquito breeding sites.

USA Today—“Cases of dengue fever have increased significantly across Brazil this year, with most of them reported in Sao Paulo state. Brazil’s health ministry said there have been more than 460,000 cases of the disease in the country in 2015, which accounts for almost 5,000 cases a day. More than 130 people have died so far this year, the ministry said.”

Empty Ebola Clinics in Liberia Are Seen as A Misstep in U.S. Relief Effort

After spending hundreds of millions of dollars and deploying 3,000 U.S. troops to build Ebola treatment centers (E.T.C.) in Liberia, the facilities have largely sat empty. Only 28 Ebola patients have been treated at the 11 E.T.C.s built by the U.S. military. Nine of the centers never had a single Ebola patient. Looking back, the emphasis on building E.T.C.s had far less of an impact than the “inexpensive, nimble measures taken by residents to halt the outbreak.”

The New York Times—“Had the Americans and other donors been more flexible, critics and some officials contend, the money could have been put toward rebuilding Liberia’s shattered health care system—or backing the efforts of local communities—instead of focusing on treatment centers that would scarcely be used.”

Stories You May Have Missed

 

Image Credit: Dvortygirl

Pandora Report 4.5.15

I love when the stories find me, so we’ve got some big ones this week including the nuclear deal with Iran and the arrival of multi-drug resistant Shigella in the United States. We’ve also got an Ebola update and other stories you may have missed.

Enjoy your (Easter) Sunday, have a great week and see you back here next weekend!

An Iran Nuclear Deal Built on Coffee, All-Nighters and Compromise

For months—many, many, months—there has been discussion of potential for Iranian nuclear weapons and what the U.S. planned to do about it. This week, those questions were finally answered as a nuclear agreement between American and Iranian officials was reached in Lausanne, Switzerland.

New York Times—“The agreement calls for Tehran to slash its stockpile of nuclear materials and severely limit its enrichment activities, theoretically bringing the time it would take to produce a nuclear weapon to a year — a significant rollback from the current estimate of two to three months.

Both sides made significant compromises. For the United States, that meant accepting that Iran would retain its nuclear infrastructure in some shrunken form. For Iran, it meant severe limits on its production facilities and submitting to what Mr. Obama has called the most intrusive inspections regime in history.”

Drug-Resistant Food Poisoning Lands in the U.S.

Before I travelled to China in 2012, my doctor prescribed me ciprofloxacin. It was, in his opinion, almost guaranteed I would come into contact with some sort of bacteria that would result in the dreaded “travel tummy.” Now, Cipro-resistant Shigella (a bacterial infection of the intestines) is becoming a growing problem in Asia and around the world. Over the past year, the resistant strain has shown up in 32 U.S. states and was linked with international travel to India, the Dominican Republic, and Morocco. However, in many instances, people who got sick hadn’t travelled outside the U.S. meaning the strain has already started to circulate unrelated to international travel. This could be a real problem.

NPR—“‘If rates of resistance become this high, in more places, we’ll have very few options left for treating Shigella with antibiotics by mouth,” says epidemiologist Anna Bowen, who led the study. Then doctors will have to resort to IV antibiotics.

Shigella is incredibly contagious. It spreads through contaminated food and water. “As few as 10 germs can cause an infection,” Bowen says. “That’s much less than some other diarrhea-causing germs.’”

This Week in Ebola

It’s been awhile since we’ve had an Ebola update, which should mostly be interpreted as a good sign. And there are good signs, like the two experimental trials of Ebola vaccine candidates have proven to be both safe and effective. However, during a three-day countrywide shutdown in Sierra Leone, 10 new cases of Ebola were found. The good news is that there were not hundreds of hidden cases, as some feared, and the Head of Sierra Leone’s Ebola Response has said the small figures indicate that the country is now at the “tail end” of the epidemic. If things are going relatively well in Liberia and Sierra Leone, Ebola still remains entrenched in Guinea. This week Guinea closed its border with Sierra Leone as an effort to stamp out the virus. Even those who aren’t sick, or have recovered, must still deal with the after effects of the disease. This week, the Liberian government recommended that all Ebola survivors practice “safe sex indefinitely” until more information can be collected on the length of time the virus may remain present in bodily fluids. All these stories should serve as a reminder that even though Ebola may not be as present in the news, the disease is still affecting people around the world.

Stories You May Have Missed

Image Credit: Zeynel Cebeci

Pandora Report 3.28.15

This week we’re covering a new treatment for inhalation anthrax, Russian nuclear threats, chlorine accelerating antibiotic resistance and other stories you may have missed.

Have a great week and see you back here next weekend!

FDA Approves Emergent BioSolutions’ Inhaled Anthrax Treatment

Considered one of the most likely agents to be used in biological warfare, Anthrax now has a new enemy—Anthrasil. This treatment, developed by Emergent BioSolutions Inc., neutralizes toxins of Bacillus anthracis and requires only two doses to confer immunity, versus the three of BioThrax (the current treatment for inhaled anthrax).

Reuters—“The company developed the treatment, Anthrasil, as part of a $160 million contract it signed in 2005 with the Biomedical Advanced Research and Development Authority (BARDA), a part of the HHS. Anthrasil, which is approved in combination with other antibacterials, is already being stored in the U.S. Strategic National Stockpile, the company said on Wednesday. The drug is made using plasma from healthy, screened donors who have been immunized with Emergent Bio’s Anthrax vaccine, BioThrax, the only FDA-licensed vaccine for the disease. Anthrasil has an orphan drug designation and qualifies for seven years of market exclusivity.”

Russia Threatens to Aim Nuclear Missiles at Denmark Ships if it Joins NATO Shield

Denmark has said that in August it will contribute radar capacity on some of its warships to NATO’s missile defense system. Russia has now threatened to aim nuclear missiles at Danish warships if Copenhagen goes through with its actions. Moscow opposes the system arguing that it reduces the effectiveness of the Russian nuclear arsenal and could lead to a new Cold War-style arms race.

The World Post—“‘We have made clear that NATO’s ballistic missile defense is not directed at Russia or any country, but is meant to defend against missile threats. This decision was taken a long time ago, so we are surprised at the timing, tone and content of the statements made by Russia’s ambassador to Denmark,” [NATO spokeswoman Oana Lungescu] said. “Such statements do not inspire confidence or contribute to predictability, peace or stability.’”

Chlorine Treatment Can Accelerate Antibiotic Resistance, Study Says

Research presented at the American Chemical Society meeting last week shows that chlorine treatment of wastewater may actually encourage the formation of new antibiotics—rather than eliminating the drug residues. While scientists are looking for new antibiotics, this isn’t good news. ACS says that upon re-entering the environment, the new drugs—in theory—can promote the growth of antibiotic resistant bacteria. In a test, doxycycline was exposed to chlorine; the results are described below.

Gizmodo—“The study evaluated the changes in the antibacterial activity of the products that form in the reaction between doxycycline and chlorine using antibiotic resistance assays. The results showed that some of the transformation products have antibiotic properties. The products of chlorination were also examined…and several chlorinated products were detected. These transformation products may still select for antibiotic resistant micro-organisms in the environment even in the absence of the parent doxycycline molecule. This suggests that re-evaluation of wastewater disinfection practices may be needed.”

Stories You May Have Missed

Image Credit: The U.S. Food and Drug Administration

Pandora Report 3.8.15

This whole “spring forward” thing is the worst, right? We won’t get that hour of sleep back until November! No matter, we must press on. This week we’ve stories about engineering TB-resistant Cows, McDonald’s chicken, Ebola vaccine strategy, and loads of other stories you may have missed.

Have a great week, enjoy the warm weather, and we’ll see you back here next weekend!

Tuberculosis-Resistant Cows Engineered in China

We often talk of tuberculosis as a problem for humans, but the bacterial disease also affects animals—from circus elephants, to badgers, and cows. This week, scientists in China announced production of a heard of genetically modified cattle capable of resisting bovine tuberculosis. This was done through the insertion of a TB resistant mouse gene, into the cow’s genetic makeup. Though the work is still in the early stages, a genetically modified cow could have massive benefits for farmers who could minimize the overuse of antibiotics within their herds.

Popular Science—“Many countries have tried unsuccessfully to get rid of the disease, often slaughtering thousands of cattle per year to try to stem the disease’s spread. The United Kingdom in particular is waging a war against the disease. In 2013, the government announced that it would wipe the disease out of the country in 25 years. But even a timeline of a quarter century a tricky proposition, as cattle aren’t the only host for the disease. Bovine TB can also thrive in wildlife like badgers, elk, and even deer, which can pass the disease to cattle and vice versa.”

Your McNuggets: Soon Without a Side of Antibiotics

First Chipotle, then Chick fil-A, now McDonalds. The fast food giant announced this week that within two years the company will stop buying chicken raised with certain antibiotics for its U.S. stores. This move doesn’t stop the overuse of antibiotics on farms, however, McDonald’s is the largest food-service buyer of chicken in America, so the decision could affect other restaurants and the production of other meats.

Wired—“The reason this announcement is so important is that, for decades, researchers have been linking the use of antibiotics in livestock-raising (and to a lesser extent in fish farming and fruit production) to the rise of antibiotic-resistant infections in humans. Multiple pieces of research show that low-dose antibiotic use on farms — use that doesn’t cure animal illness, but promotes growth and prevents infections — creates resistant bacteria that move off farm properties in water, dust and the meat that animals become. Those bacteria infect humans directly — via meat or because the bacteria contaminate a home or restaurant cooking surface — and they pass their resistance DNA to other bacteria as well.”

Guinea Ebola Vaccine Trial Uses Smallpox Strategy

Two different vaccines are being tested in the three West African countries affected by the recent Ebola outbreak. As the last Ebola patient in Liberia heads home, and the Vice President of Sierra Leone has put himself in voluntary quarantine after the death of one of his security personnel, Guinea looks to the successful eradication of smallpox as their model for their Ebola vaccination plan, which began on March 7. This, of course, was the use of “ring vaccination” in the 1970s.

NBC News—“Ring vaccination involves finding all the direct contacts of new Ebola cases and vaccinating them, creating a “ring” of immunity around patients.

“An effective vaccine to control current flare-ups could be the game-changer to finally end this epidemic and an insurance policy for any future ones,” said WHO assistant Director-General Marie-Paule Kieny.”

Stories You May Have Missed

Image Credit: Christopher Michel

Pandora Report 1.18.15

For those who’ve been reading for awhile, you’ve probably surmised that one of my personal health interests is seasonal and pandemic flu. There were plenty of stories about that this week, so that’s what we’ll focus on. We’ll also look at Ebola and other stories you may have missed. My apologies for posting delays this week, I’m dealing with some rotator cuff and carpal tunnel issues in my right arm, and let me tell you, it is HARD to type with your dominant arm in a sling!

Enjoy your holiday Monday (if you have one) and have a safe and healthy week!

Texas Health Experts Say Universal Flu Vaccine Could be a Reality

The CDC has said that this year’s seasonal flu vaccine was only 23% effective due to unanticipated antigenic drift—meaning the predicted strains in the vaccine didn’t match the dominant strains of the virus that are currently circulating. In order to combat this in the future, scientists at Mount Sinai health system in New York are in the process of testing a universal flu vaccine which will go into clinical trials this year.

KLTV.com—“‘There is work going on to see if, perhaps a different kind of vaccine could be developed maybe against a different part of the flu virus, one that is not so subject to this antigenic drift or to change as readily from one year to the next,” [Dr. Levin of UT Health Northeast] says.”

Scientists Find Brain Protein Aids Influenza Recovery

Scientists at Washington State University in Spokane have found a brain protein that boosts the healing power of sleep and speeds recovery from the flu in mice. Professor James M. Kruger said this discovery could lead to alternative treatments for flu and other infectious diseases by stimulating production of the brain protein called AcPb. This discovery comes at a time where avian influenza is prevalent in Taiwan, Japan, Nigeria, China, Egypt, Canada, the U.S. and Mexico.

Washington State University—“Krueger showed this recovery involves AcPb and an immune system signaling chemical called interleukin-1. AcPb links up with interleukin-1 to help regulate sleep in healthy animals. It also prompts infected animals to spend more time sleeping during an illness.

In the study, mice who lacked the gene for AcPb slept less after being infected with influenza virus. They also became chilled, grew sluggish, lost their normal circadian rhythms and ultimately died in higher numbers than the mice who slept longer.”

This Week in Ebola

As GMU students return to classes, so do students in Ebola affected Guinea. Schools in Guinea will re-open Monday, and schools in Liberia are set to re-open “next month.” No date has been set for schools in Sierra Leone. Despite this, the President of Sierra Leone has declared that there will be zero new confirmed Ebola cases by the end of March the country will be Ebola-free, by WHO standards, by May. These announcements come at a time when Dr. Thomas Frieden, Director of the CDC, has said he was “very confident we can get to zero cases in this epidemic if we continue the way we’re going and nothing unexpected happens” and the outbreak appears to be slowing down. Last week brought record low numbers—for Guinea, the lowest total since mid-August; for Liberia, the lowest total since the first week of June; for Sierra Leone the second week of declines and the lowest level since the end of August. However, there are still “at least 50 micro-outbreaks” underway throughout West Africa.

Pauline Cafferkey, the Scottish nurse infected with Ebola, is “showing signs of improvement” and an American soldier who was found dead in Texas after his deployment in West Africa reportedly showed no signs of Ebola leaving officials to remark that there was “no evidence of a public health threat.”

A seemingly large amount of good news this week left space for new ruminations on Ebola and outbreaks in general. Wired  had an interesting piece on Nanobiophysics and how it could stop future global pandemics while The Chicago Tribune looked at bats and their likely role in Ebola outbreaks and CNBC looked at the price of protection from global pandemics—would you believe $343.7 billion?

Stories You May Have Missed

 

Image Credit: NBC News

Pandora Report 1.4.15

Happy 2015! I hope all of you enjoyed a safe, happy, and healthy holiday season. As we get back into things, this week we will look at Seasonal Flu, 1980s Chemical Weapons, and, of course, Ebola. Please also enjoy a wrap up of other stories from the last two weeks in the Stories You May Have Missed section.

Have a fabulous week!

This Season’s Flu Activity Has Reached the Epidemic Threshold, the CDC Says

On the heels of the announcement that this year’s flu vaccine is not as effective as hoped, the Centers for Disease Control and Prevention has announced that they are seeing elevated activity in all their influenza surveillance systems and that this year’s seasonal flu has reached epidemic levels. The Virginia Department of Health has called the flu “widespread” in our state. The CDC urges it is still too early to determine if this season will be worse than others but preliminary data seems to reflect that it may be.

The Washington Post—“The influenza season reaches an epidemic level when the proportion of deaths attributed to pneumonia and influenza reaches a certain threshold: 6.8 percent. According to the CDC’s latest available information on the flu season, the percentage is currently at the threshold.”

Secret Papers: UK Studied Chemical Weapons Buildup in the 1980s

Newly released, formerly secret, documents show that in the early 1980s former Prime Minister Margaret Thatcher’s government considered rebuilding Britain’s chemical weapons arsenal in the face of a perceived looming threat of the Soviet Union. Thatcher’s defense chiefs were worried that the country would have only nuclear weapons in order to respond to a possible Soviet chemical attack.

ABC News—“In the papers, Thatcher states that it might be considered “negligent” of the government not to develop a credible response to a Soviet chemical attack short of using nuclear weaponry. She also suggests urging the Americans to modernize their chemical arsenal.

The lack of a chemical capacity was called a “major gap” in NATO’s military capacity by Defense Secretary Michael Heseltine in a secret 1984 document. He said the threat of a nuclear response lacked credibility.”

This Week in Ebola

While we were celebrating and enjoying the holidays, Ebola, of course, didn’t take a break. In the spirit of the season the UK’s Queen praised the selflessness of those fighting the ongoing epidemic in West Africa. And while Christmas gatherings were cancelled in Sierra Leone and Guinea, those in Liberia made sure their Christmas spirit was on full display. As 2014 came to an end, there were many looks back at the year in Ebola and the possible source of the start of the outbreak. The first case of Ebola was diagnosed in Britain by a nurse who contracted the disease in West Africa and there were reports of a possible lab error exposure to the virus at the CDC.

There are some reasons for optimism as 2015 begins, including survival rates increasing for cases in Sierra Leone and promising news on the vaccine front. Vaccines tested in Uganda against Ebola and the related filovirus Marburg have proven to be safe and effective in generating an immune response to the deadly viruses  and the U.S. Department of Health and Human Services has awarded contracts worth $43 million to develop two possible Ebola vaccines more quickly. According to the UN’s Anthony Banbury, 2015 should see the number of Ebola cases brought to zero by the end of the year and Al Jazeera America argues that this year should be focused on immunization and investment in West African health systems.

The last two Ebola updates are entirely unrelated and include the unverified possibility that ISIS militants have contracted Ebola and interesting coverage by NPR of how Ebola has affected love and sex.

Stories You May Have Missed

 

Image Credit: The Washington Post

Pandora Report 12.7.14

I hope all of you had a wonderful Thanksgiving! There were a lot of stories to consider for this extra long (extra late) week in review. We cover the AIDS pandemic, Avian Influenza, Polio in Pakistan, and, of course, Ebola. For those of you in school, I hope your papers and exams aren’t too overwhelming! For everyone else, have a wonderful week, hopefully paper and exam-free week!

AIDS Campaigners Say Pandemic Has Finally Reached Tipping Point

A report released by the ONE campaign to mark World AIDS Day on December 1 said that “the world has finally reached “the beginning of the end” of the AIDS pandemic that has infected and killed millions in the past 30 years.” What is the tipping point? The number of newly infected HIV patients is lower than the number of HIV positive patients who have access to retroviral medications that keep AIDS at bay. However, this doesn’t mean the fight is over.

Reuters—“‘We’ve passed the tipping point in the AIDS fight at the global level, but not all countries are there yet, and the gains made can easily stall or unravel,” said Erin Hohlfelder, ONE’s director of global health policy.”

FAO, OIE Warn of Avian Influenza’s Rapid Spread

The Food and Agriculture Organization of the United Nations and the World Organization for Animal Health have warned that the new avian flu strain detected in Europe is similar to those found in Asia and pose a significant threat to the poultry sector. Evidence of H5N8 has been found in Germany, the Netherlands, and the United Kingdom, as well as China, Japan, and South Korea. So far, it doesn’t appear this strain is infecting people, however, this week there were reported human cases and deaths from H5N1.

The Poultry Site—“The new virus strain provides a stark reminder to the world that avian influenza viruses continue to evolve and emerge with potential threats to public health, food security and nutrition, to the livelihoods of vulnerable poultry farmers, as well as to trade and national economies. Therefore extreme vigilance is strongly recommended while progressive control efforts must be sustained and financed.”

Pakistan Polio Outbreak ‘Will Probably be Fixed Next Year’ says WHO Official

So far this year there have been 262 cases of polio detected in Pakistan, which is the highest number of cases in 14 years. Pakistan is one of only three countries in the world, including Afghanistan and Nigeria, where the virus remains endemic. Despite these numbers, a WHO official in Pakistan says the disease will “most probably be fixed in the first half of 2015.” Military campaigns around the country have not only made vaccination more difficult but have faced tribal militants who banned all vaccinations.

The Guardian—“Persistent public awareness campaigns have not fully quashed popular fears that the drops given to children – a solution of highly weakened polio virus – are part of a western conspiracy to make Muslims infertile.

The Pakistani Taliban have attacked and killed health workers who conduct door-to-door campaigns, forcing the government to mount massive security operations during major vaccination drives.”

This Week in Ebola

We’ve got a lot of news from the last two weeks, so today, let’s start stateside.

The CDC says you can stop worrying because it is very unlikely that Ebola will become airborne, so you can stop cancelling your African safaris. Ebola anxiety has left the U.S. buying up all the PPEs leaving little for workers in West Africa, while the Director of the Harvard School of Public Health Emergency Preparedness has said that U.S. quarantine policy could discourage volunteers from going to help the outbreak. However, recently, no one has been caught in quarantines entering New York and New Jersey airports. 35 American hospitals have been designated as Ebola centers and already the U.S. government is looking past Ebola for the next health disaster. Meanwhile, the first human trial of an experimental vaccine for the virus has produced promising results.

Overseas, the German airline Lufthansa adapted an A340-300 to transport Ebola patients. In Liberia, the President has banned election rallies and mass gatherings under the reasoning that they risk worsening the spread of the virus and Ebola moves out of the cities, it is ‘pingponging’ into rural areas. In Sierra Leone there are approximately 80-100 new cases of Ebola daily, they are running out of beds, and in protest of non-payment, burial workers are dumping bodies in public in the city of Kenema. One piece of good news coming out of this outbreak that has affected more than 16,000 people is that female genital mutilation is on the decline. Also, a new 15-minute test for Ebola is being tested in Guinea, which, if it works, will help medical staff identify and isolate Ebola patients sooner.

The UN warns that the longer the disease is allowed to spread unchecked in West Africa, the more likely it is that Ebola will appear in new places in the world but EcoHealth journal notes that closer study of zoonotic diseases could help prevent Ebola and other diseases from affecting humans. Don’t worry though, according to North Korea Ebola isn’t a zoonotic disease, it is a bioweapon created by the U.S.

Stories You May Have Missed

 

Image Credit: Free Internet Pictures

Pandora Report 9.20.14

We are introducing a new feature for the news round up—“Stories You May Have Missed.” This final section consists of fascinating articles I’ve found throughout the week that couldn’t fit in the report. This week the round up includes the UN Security Council’s resolution about Ebola, ISIS using chemical weapons in Iraq, a surprising source to combat antibiotic resistance, and of course, an Ebola update.

Lastly, you know what time of year it is, flu season is starting…don’t forget to get your flu shot!

Have a great weekend!

With Spread of Ebola Outpacing Response, Security Council Adopts Resolution 2177

On Thursday, the United Nations Security Council met to discuss the Ebola outbreak in West Africa and unanimously adopted resolution 2177 (2014). 2177 established the United Nations Mission for Ebola Emergency Response (UNMEER) and calls on Liberia, Sierra Leone, and Guinea to speed up establishment of national mechanisms to deal with this outbreak and to coordinate efficient utilization of international assistance, including health workers and relief supplies. The resolution also calls on other countries to lift their border and travel restrictions saying that isolation of the affected countries could undermine efforts to respond to the outbreak.

The United Nations—“United Nations Secretary-General Ban Ki-Moon said that the Ebola crisis had evolved into a complex emergency, with significant political, social, economic, humanitarian and security dimensions.  The number of cases was doubling every three weeks, and the suffering and spillover effects in the region and beyond demanded the attention of the entire world.  “Ebola matters to us all,” he said.”

ISIS Uses Chemical Weapons Against Army in Iraq

There were reports this week that the IS terrorist group has used chemical weapons in an attack on the Iraqi army in Saladin province. The reported attack took place Wednesday and Thursday in Dhuluiya, which has been under control of the group for more than two months. The attack affected approximately a dozen people.

One India—“Iraq’s Ambassador to the UN, Mohamed Ali Alhakim said in a letter that remnants of 2,500 chemical rockets filled with the deadly nerve agent sarin were kept along with other chemical warfare agents in a facility 55 km northwest of Baghdad. He added that the site’s surveillance system showed that some equipment had been looted after “armed terrorist groups” penetrated the site June 11.”

Vaginas May be the Answer to the Fight Against Drug-Resistant Bacteria

A naturally occurring bacterium found by scientists from the University of California, San Francisco, School of Pharmacy might be the key to addressing the threat of a post antibiotic future. Found in the female vagina, Lactobacillus gasseri is the basis for Lactocilin, a possible antibiotic alternative. This discovery comes at a time where the WHO has declared antimicrobial resistance as “an increasingly serious threat to global public health.”

Medical Daily—“This isn’t the only implication for the L. gasseri bacteria. Researchers are also hopeful to find similar-acting bacteria in different parts of the human body. “We think they still have bacteria producing the same drug, but it’s just a different bacterial species that lives in the mouth and has not yet been isolated,” lead researcher Micheal Fischbach told HuffPost. Even though the bacteria were harvested in females, researchers are confident it will have equal results when used in men.”

This Week in Ebola

It was a terrible week for Ebola, absolutely terrible. Above, we already learned that the UN Security Council declared the virus a threat to international peace and security, but that wasn’t all that happened. President Obama pledged 3,000 troops to fight Ebola in West Africa. The WHO said that the number of Ebola cases could begin doubling every three weeks and expressed concern about the black market trade of Ebola survivors’ blood. Eight aid workers and journalists were murdered in Guinea leaving many to fear that violence could stymy relief efforts and in Sierra Leone, the government instituted a three-day lockdown in order to help health care workers find and isolate patients.

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