Pandora Report 12.4.2015

This week, Washington, DC hosted the Summit on Human Gene Editing, where the ethical and legal implications of gene editing technologies, like CRISPR-Cas9, were heavily discussed. In this week’s report, Greg Mercer works his magic, revealing the internet and social media trends following the shootdown of a Russian SU-24 on November 24th. We’re also reporting updates in the Zika virus and dengue fever outbreaks as well as the Harvard-LSHTM Panel Report on Global Response to Ebola. France is currently experiencing an increase of highly pathogenic avian influenza cases while a Black Angus beef cow in Alberta was discovered to have bovine spongiform encephalopathy (BSE). Fun history fact Friday – on December 3, 1967, the first human heart transplant was performed in Cape Town, South Africa and on December 4, 1945, the Senate approved US participation in the UN. Before we start our weekly roundup, make sure to mark your calendars to attend GMU’s seminar on Ebola surveillance and laboratory response this Monday, December 7th from 4:30-6pm at our Fairfax campus (details below!).

Zika Virus Outbreak – Updates
The growing outbreak of Zika virus has now seen locally acquired cases reach ten countries, causing the Pan American Health Organization (PAHO) to issue an alert, “urging countries in the region to be on the lookout for the disease and to watch for unusual patterns in newborn.” Brazil has been hit hard with a rise from 739 on November 27th, to 1,248 cases reported on November 30th. Six of the ten countries saw cases occur in November, hinting that the outbreak could just be starting. The growing concerns regarding the outbreak are also related to the newest evidence linking microcephaly and maternal cases. Zika virus genome was found in the amniotic fluid of two pregnant women and fetal diagnosis of microcephaly was performed via ultrasound. Even more so, French Polynesian health officials reported an unusual spike in nervous system malformations in babies that were born during a Zika virus outbreak in the region from 2014 to 2015. The concern regarding neurological conditions raises red flags as Brazilian health officials are reporting neurological complications, like that of Guillain-Barre syndrome, in Zika virus patients. The WHO reported 739 Brazilian microcephaly cases in newborns and while there is only ecological evidence linking the virus and microcephaly, investigations are ongoing. The outbreak first started in February 2014, on Easter Island (Chile) and has seen been identified in Colombia, Guatemala, Brazil, El Salvador, Mexico, Paraguay, Panama (confirmed cases as of December 4, 2015), Suriname, and Venezuela. Spread by Aedes mosquitoes, this vector-borne organism has similar symptoms to dengue fever and illness tends to last between four and seven days.

Event: Ebola Surveillance & Laboratory Response – Lessons for Global Health SecurityScreen Shot 2015-12-03 at 9.34.57 AM
Time/Location: Monday, December 7, 2015 from 4:30pm-6pm in Robinson A-203 at George Mason University.
As the recently released Harvard-London School of Hygiene and Tropical Medicine Independent panel on the Global Response to Ebola indicates, the West African Ebola epidemic highlighted
many gaps in national and international health and response systems that are critical for protecting global health security.  Join leaders and experts who helped to lead the U.S. response for Ebola to discuss the international response to the epidemic, the importance of robust biosurveillance systems, and how the experience with Ebola influences our approach to Global Health Security. Speakers:

  • Dr. Matthew Lim, Senior Policy Advisor for Global Health Security, HHS, fmr Civil-Military Liaison Officer to WHO
  • May Chu, Ph.D. fmr Assistant Director for Public Health, Office of Science Technology and Policy, White House; Senior Science Advisor, CDC
  • Jeanette Coffin, Manager U.S. mobile laboratory deployment, MRIGlobal

It’s Definitely Maybe World War 3
GMU’s Greg Mercer breaks down the November 24th Turkish shootdown of a Russian SU-24. Greg reviews the media attention following the event and the “immediate buzz about declarations of war, what exactly NATO owes Turkey vis-à-vis Russia, and the possibility of military confrontation between Russia and the West.” Through his use of google trends and Twitter, Greg shows just how much hype and concern the notion of WWIII got during this time. Take a look at his recap and debunking of the WWIII buzz and how quickly it caught like wild fire.

Reporting from the Panel on the Final Report of the Harvard-LSHTM Independent Review of the Global Response to Ebola
If you missed the Center for Strategic & International Studies (CSIS) Global Health Policy Center’s Launch of the final report of the Harvard-LSHTM Independent Panel on the Global Response to Ebola, don’t worry! I was fortunate to attend and a great deal of the report (we reported on last week) heavily emphasized “on the ground” capacity. Dr. Peter Piot, Director and Handa Professor of Global Health, London School of Hygiene and Tropical Medicine (LSHTM), joined via video link and started by saying that this would not be a WHO-bashing event. As one of the original researchers on Ebola during its 1976 discovery, he mentioned that the Democratic Republic of Congo (DRC) is a great example of local capacity in their success of ridding themselves of the disease within a few months of the outbreak starting. Dr. Piot heavily emphasized the work of several countries and how the WHO brought together multiple ethicists to review research during such a terrible outbreak. Lastly, Dr. Piot noted that “we risk focussing too much on global and not enough on local” in our future efforts. Dr. Suerie Moon, Research Director and Co-Chair of the Forum on Global Governance for Health at Harvard Global Health Institute, then spoke on the “weak coordination of global response” and how it severely aided the spread of Ebola. Dr. Moon highlighted the need for a global strategy to ensure adequate funding (external financing for the poorer countries and transparent tracking of financing) and the necessity for external assessment of country capacity. She pointed to the need for political and economic incentives and disincentives to not only report cases but also discourage the hiding of outbreaks. Reviewing each recommendation, the panel noted that “human health is a vital part of human security”. In one of her closing comments, Dr. Moon stated that “there are many unanswered questions regarding ebola response and we need to address a number of aspects that went wrong” and “a major theme is accountability at all levels, across all types of players.” Dr. Moon pointed out that the necessity of so many reforms shows just how much work is needed and that now is the time to see political support occur. Muhammad Pate, former Nigerian Minister of State for Health, expressed that “one of the lessons, at the national level, in terms of surveillance and accountability to respond, was missing and something that national leaders need to own up to is building their own public health systems.” Dr. Sophie Delaunay, Doctors Without Borders/MSF, then discussed the role of medical innovations and how the outbreak provided us with a unique opportunity to collect data. Dr. Delaunay said it will “be a complete nightmare to connect all the dots” in this outbreak and there is a desperate need for better R&D regarding disease outbreaks and response. “We ask for governments and policy makers to support collaboration on R&D to demonstrate their willingness to be more effective in the next outbreak” noted Dr. Delaunay. She heavily pushed for global financing efforts to facilitate investment in R&D and response. After the initial panel, there was a secondary group that shared their thoughts on the report, including Dr. Tom Frieden (CDC Director), Julie Gerberding (Exec. VP for Strategic Communications, Global Public Policy and Population Health, Merck) and Ron Klain (Former US Ebola Response Coordinator, White House and General Counsel, Revolution LLC). Ron Klain pointed to the failure of the WHO and “if institutions failed us, individuals shined. We did see extraordinary compassion from the rest of the world and tremendous outpouring of support. ” Mr. Klain mentioned that “the scariest thing about Ebola is the warning signs of how badly we failed this when the threat could’ve been worse and the epidemic we face could be much much more dangerous in the future.” Dr. Frieden emphasized the need of human resources management improvement at the WHO and how global outbreak response could work to support each other better. Lastly, Dr. Frieden emphasized a topic near and dear to my heart; infection control and it’s necessity in global disease prevention. Overall, the panel touched on several key points to the outbreak, emphasizing the need for the biggest players (including MSF) to lead by example via data sharing, etc. The push for political support on incentives and local capacity/accountability was perhaps one of the biggest recommendations and points emphasized from this event.

Gene Editing and CRISPR!
This was a busy week in the biotech world. The International Gene Editing Summit kicked off in Washington, DC. Bringing together experts from around the world, the summit touched on the newest technical innovations, ethical and legal concerns, and even social implications of genome editing advances. Genome Web has provided a great overview of the summit. Nature also published their Four Big Questions related to genome editing, touching on points related to editing the human germline and the ethical implications for technology that “researchers are still grappling with the known unknowns”. Recently, biologist, Emmanuelle Charpentier, discussed CRISPR-Cas9 and that it’s simply too early to begin gene editing as “the tools are not ready” and “as of today, I’m in favor of not having the manipulation of the human germlines. As long as they’re not perfect and ready, I think it’s good to have this ban against editing the germline.” Buzzfeed noted that over the course of the conference, there was a substantial push for a delay in the use of genetic engineering in fertility clinics due to the risk of making “designer babies”. Given the heavily debated nature of this topic it’s not surprising that the US National Academy of Sciences, Engineering and Medicine, the UK’s Royal Society, and the Chinese Academy of Science, all agreed that it “would be irresponsible to proceed with any clinical use of germline editing.” While the future is left open to gene editing on humans, there was heavy accentuation throughout the conference on the ethics and societal views of these scientific breakthroughs and the necessity to revisit their applications on a regular basis.

Dengue Fever Outbreak in Hawaii 
The Dengue fever outbreak on Hawaii Island is still growing. Now at 122 confirmed cases, this is one of the biggest outbreaks they’ve seen with local transmission. As of 12/2, the confirmed cases involved 106 Hawaii Island residents and 16 visitors. The Hawaii Department of Health (HDOH) has published information, hoping to aid prevention efforts, regarding the Aedes aegypti and Aedes albopictus mosquitos that are responsible for spreading the disease. There have been 313 reported potential cases and you can even find a map of the case distribution here!

Stories You May Have Missed:

  • 2015/2016 Flu Season- Where Are We?– The CDC 2015/2016 influenza activity showed a bit of a spike during the November 15-21 week. Influenza A (H3) is still the predominant species in laboratory confirmed cases. If you’re looking to keep an eye on seasonal flu, Google Flu Trends may no longer be operational, but you can still keep an eye on Flu Near You or the CDC’s page.
  • MERS-CoV Severity and Incubation Period– The CDC & Emerging Infectious Diseases published a report regarding the association of severe MERS-CoV illness and a shorter incubation period. Analyses of 170 patents in South Korea revealed a longer incubation period associated with a decreased risk for death while “patients who died had a shorter incubation period.” This mirrors the results of a previous study that had similar results with SARS coronavirus.
  • Salmonella Outbreak Associated With Recalled Nut Butters – The CDC is currently investigating 11 illnesses across nine states that may be linked to recalled nut butters. The Salmonella serotype is Paratyphoid B variant L (+) tatrate (+) (previously called Salmonella Java) and has caused illness in California, Colorado, Georgia, Hawaii, Idaho, Illinois, North Carolina, and New Jersey.
  • Taiwan CDC Holds Bioterrorism Drill – Involving 70 participants, the course utilized a subway union station to allow people to simulate first responders and real-life operations. “CDC bioterrorism teams are tasked with the investigation and identification of biological threats and attacks. Members take on containment and mitigation of damage for any individuals that are harmed during and as a result of an attack.” Go Taiwan!

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It’s Definitely Maybe World War 3

It’s Definitely Maybe World War 3
By Greg Mercer

The Washington Post
The Washington Post

On November 24, Turkish F-16s shot down a Russian SU-24 bomber which had been flying over Syria, after an alleged violation of Turkish airspace.[1] Needless to say, the details are still emerging and the facts are still highly contested. The New York Times has an excellent comparison of claims made by Turkish and Russian officials, including the radar maps released by each country showing the airspace violation (or lack thereof).[2] Russian President Vladimir Putin called the shootdown a “stab in the back” and promised harsh consequences. Turkey called for an emergency meeting of NATO.

This incident and its bellicose rhetoric sparked immediate buzz about declarations of war, what exactly NATO owes Turkey vis-à-vis Russia[3], and the possibility of military confrontation between Russia and the West.  One particular phrase was cautioned against by reputable folks and seriously considered by less-than-stellar[4] sources: World War 3. I think this is really interesting, so I turned to good old search analytics to see how the internet reacted:
Screen Shot 2015-12-03 at 9.59.08 AM







Continue reading “It’s Definitely Maybe World War 3”

Just in Time for Thanksgiving: Fowl Cholera

By Jonathon Marioneaux

Let’s finish the series on birds this week with one of the most ubiquitous diseases that affect our distinguished guests on Thanksgiving: fowl cholera.  First, we will look at what cholera is including a general overview of its structure and transmission.  We will then explore the clinical symptoms and if there are any treatments to protect birds.  We will then conclude with a farewell to our series on turkeys and introduce our next topic: plant diseases.

Pasteurella multocia was first characterized in the 1880’s by Louis Pasture as the causative agent of fowl cholera.  It was soon recognized that P. multocia had three distinct subspecies multocida, spetica, and gallicida with gallicida being the most common.  All birds are susceptible to cholera to varying degrees with waterfowl and turkeys being more susceptible than chickens or other land birds.  P. multocia is a gram negative coccobacillus that stains with Wright stain on its variable carbohydrate surface.  It resists phagocytosis by macrophages and neutrophils with a lipopolysaccraccharide capsule covering a highly hydrated polysaccharides cell wall (Chung et al. 2001). No single virulence toxin has been shown to cause virulence, however several proteins are suspected: capsule endotoxin, outer membrane proteins, iron binding systems, heat shock proteins, neuraminidase, antibody cleaving enzymes, and P. multocida exotoxin (Chung et al. 2001).  The bacterium is highly motile in water and can transfer hosts without direct contact when in close proximity.

The disease is spread primarily by feces or nasal fluids, however it can also be spread by contaminated water, food, bedding, humans (shoes and clothes), and other animals, primarily pigs.  P. multocia causes explosive greenish diarrhea and nasal and oral discharges that can directly infect new hosts (Overview, 2014).  Infected birds can also pass the bacterium by touching feed with open lesions, distended wattles and combs, and contaminated feathers.  Introducing new or wild birds that have not been properly quarantined can introduce the infection to otherwise healthy flocks.  Reservoirs such as pigs and dogs are known to harbor the pathogen as asymptomatic carriers and can spread it to flocks if allowed to mingle with the birds.  Transmission is also a problem with humans when moving between flocks because contaminated feces can stick to boots or other clothing and then be picked up by birds through open cuts or mucus membranes.  Finally, transmission is very common with asymptomatic carriers in large flocks such as factory farms and is less of a problem in free range birds because the bacterium is susceptible to heat and drying out (PM-Onveax,).

Cholera is known for its high morbidity and sudden mortality in large numbers of birds.  Symptoms of infection anorexia, ruffled feathers, oral and nasal discharge, and depression, so careful observation of animals should be carried out routinely.  Other signs might include fibrous contents in distended waddles and excessive red blood cells in livers in post mortem autopsies.  Treatments with penicillin and proactive bacteria can be effective against P. multocia, however caution should be used because antibiotic resistance has been shown to occur rapidly (Fowl cholera, 2014).  A new cholera vaccine is being developed using a highly pathogenic attenuated isolate while an established vaccine uses a mild variant administered under the wing (Hertman et al. 1979).

In conclusion, turkeys are susceptible to bacterial infections primarily by fecal-oral transfer and open lesions.  The most common treatment is oral penicillin or live attenuated vaccination injected under the wing.  With Thanksgiving tomorrow, remember to take extra care of our feathered friends—they can get sick just like us, but with the proper treatment we can take care of them.

This concludes our session on diseases that affect birds; birds are all around us and their diseases deserve to be studied more in-depth because they can teach us a lot about diseases that affect mammals.

Our next series will cover fungal plant diseases in preparation for the winter festivities.


Image Credit: Plainville Farms

Chung, J. (2001, January 1). Role of Capsule in the Pathogenesis of Fowl Cholera Caused by Pasteurella multocida Serogroup A. Retrieved November 22, 2014.

FOWL CHOLERA – Diseases of Poultry. (n.d.). Retrieved November 22, 2014, from

Hertman, I., Markenson, J., Michael, A., & Geier, E. (1979). Attenuated Live Fowl Cholera Vaccine I. Development of Vaccine Strain M3G of Pasteurella multocida. Avian Diseases, 24(4), 863-863. Retrieved November 22, 2014.

PM-ONEVAX-C®. (n.d.). Retrieved November 22, 2014, from

Overview of Fowl Cholera. (n.d.). Retrieved November 22, 2014, from

Turkey Brooder Pneumonia

By Jonathon Marioneaux

This week we continue our series on bird diseases by diving into a fungal bird disease: Aspergillus fumigatus. We will begin by characterizing the physical and genetic qualities of Aspergillus fumigatus and move into a more detailed analysis of how it is spread. Finally we will wrap up by discussing what precautions you can take to keep our favorite holiday bird safe and healthy for the days to come.

Aspergillus fumigatus is a type of fungus that is commonly found in decaying matter and produces spores from the conidiophores during asexual reproduction that are 2-3 microns in size. Its optimal growth range is 37-50 degrees Celsius which is critical for the carbon and nitrogen cycle for breaking down plant and animal matter. It has a filamentous structure under the microscope and its fruiting bodies appear grey during spore release. A study in Nature found 29.4 million base pairs and 5,000 noncoding regions in its genome (Galagan et al., 2010).

A. fumigatus is an opportunistic pathogen that typically attacks immunocompromised individuals, such as those suffering from previous infections, or the very young. The most typical route of infection is pulmonary where the spores germinate in the warm moist areas of the lungs. The fungi evade immune systems attack through macrophages and lactoferrin (iron scavenger molecule) by overwhelming macrophages and lactoferrin production (Ben-Ami et. al., 2005). After successful germination, the fungi penetrate the pulmonary cell walls and in severe cases spread in the blood system for nutrient acquisition. The nutrients include iron, nitrogen, polypeptides, and byproducts, including gliotoxin, that suppress neutrophil activation through superoxide and apoptosis (Ben-Ami et. al., 2005).

In birds, A. fumigatus is spread principally through contaminated feed products or in unsanitary bedding conditions, however, it has been documented that spores can come through improperly cleaned air vents. Air sampling techniques have found seasonal variation among the types of Aspergillus with variations being significantly higher in the winter than the summer (Ben-Ami et. al., 2005). This may be a result of more spore production in drier conditions—there is an inverse relationship between humidity and spore production. Additionally, poults can be exposed to asymptomatic adult carriers and contract it through mechanical interaction. It typically attacks poults 5 days to 8 weeks of age, however, it has been found in birds with underlying genetic or other disease related conditions. Because the fungus mainly attacks the lungs, symptoms can include heavy or rapid breathing and yellow or grey nodular lesions in the respiratory tract, especially lungs and air sacs.

Currently there are no vaccinations or cost effective cure for A. fumigatus infections, therefore once an infection has been identified the bird must be isolated and culled. Vaccine trials have shown no immunity and in some cases a second exposure has proven fatal. The best protection against A. fumigatus infection is delivered through the preparation of clean bedding, food, and air and the prompt culling of infected animals (Ben-Ami et. al., 2005). In addition, increasing the humidity levels and a light spraying of germicide when the poluts are of sufficient size will also keep the risk of contracting the spores lower (Larson et al., 2007).

In summary, there is a lot of work that goes into creating healthy turkeys but with some simple steps and proactive work flocks will not be overrun by pathogenic A. fumigatus. The fungus is very necessary in the carbon and nitrogen cycle and only causes opportunistic disease in immunocompromised birds. So, enjoy your holiday turkey and next week we will continue our series and investigate more illnesses that plague our avian friends.


Image Credit: Champoeg Farm

Ben-Ami, R., Lewis, R. E. and Kontoyiannis, D. P. (2010), Enemy of the (immunosuppressed) state: an update on the pathogenesis of Aspergillus fumigatus infection. British Journal of Haematology, 150: 406–417. doi: 10.1111/j.1365-2141.2010.08283.x

Galagan, J. (2005, October 5). Sequencing of Aspergillus nidulans and comparative analysis with A. fumigatus and A. oryzae. Retrieved November 16, 2014, from

Larson, C., Beranger, J., Bender, M., & Schrider, D. (2007). Common Diseases and Ailments of Turkeys and Their Management. In How to Raise Heritage Turkeys on Pasture (pp. 35-52). American Livestock Breeds Conservancy.

Characterization of Turkey Pox

By Jonathon Marioneaux

This week we start a new series of articles about the diseases of birds. We will start with viruses and then progress to bacterial and fungal later in the month.   In celebration of the next major holiday, we will cover turkeys and the threats to both our feathered friends and to their handlers.  To begin our series will look at fowl pox, more specifically turkey pox.  We begin with a short characterization of the virus, how it works in hosts, and the general routes of transmission.  Then we progress to a short case study of turkey pox in Europe where it is becoming an endemic problem among breeders.  Finally, we wrap up with a discussion of how our feathered friends help us in the wild (and on the plate.)

Pox viruses belong to two major families—Chordopoxvirinae, which infects vertebrates including mammals and birds, and Entomopoxvirinae, which infects invertebrates including beetles, butterflies, and flies.   Both of these families share similar characteristics including large genomes, early RNA’s made in the virion core, and an internal envelope formed de novo, not during budding.  Mature particles of Chordopoxvirinae attach to the target cell membrane glycosaminoglycans during the first uncoating stage and release enzymes ready to begin DNA replication (Acheson, 2011).

Pox viruses are unlike many other viruses because they replicate solely in the cytoplasm and therefore they must carry all of the genes coding for DNA replication proteins with them.  These early genes code for proteins that break down the viral core and expose intermediate genes that code for DNA replication.  As theses intermediate genes are activated by compound promoters they produce intermediate mRNA which code for intermediate proteins.  These intermediate RNA’s are unique because they have 5’ terminal poly(A)heads added, facilitated by a TAAA sequence, which allows for a slippage mechanism adding the AAA head (Acheson, 2011).  These proteins are created in viral factories and set the stage for late gene activation.  The late genes code for structural proteins used in the encapsulation process.  The process includes the packaging of completed DNA (incomplete viruses) and enzymes (mature viruses); the final step is dependent on the infection route of the virus.

If the host cell ruptures before the virus escapes then it is left with an extra protein layer and is called an extracellular virus, which can infect cells easier.  If the virus is able to escape the cell then it sheds its protein shell during the budding process and is left with only its envelope. One difference between these viruses is their stability in the external host environment.  These enveloped viruses are extremely stable in the environment and are found in the scabs and mucus of infected individuals (Acheson, 2011).  Poxviruses have several means to evade host immune systems including TNF-binding proteins and soluble IFN-γ proteins which diminish inflammatory cytokine activity.  Finally, the general routes of transmission include contact with abraded epithelium of mucosal membranes or skin and physical inoculation of epithelial tissues either by pecking or blood feeding arthropods (Kindt et al, 2007).

In 2010 a turkey farm in Austria experienced an outbreak of fowl pox in the cutaneous form (Hess et al, 2011).  The farm had 11,680 birds spread over six flocks in stages ranging from polts to mature birds.  The effect on the birds included “nodular red-brown wart-like growth” and encrusted lesions on the head and neck region.  Samples were taken a plated on Columbia agar, McConkey agar, Schaedler agar, and Sabouraud-gentamicinchloramphenicol agar and included at 37 ͦC in aerobic conditions. Other tissue samples were used to isolate the virus using pathogen-free-Gallus gallus domesticus embryos.  PCR DNA replication was performed by using tissue samples and fowl pox base pairs were isolated by gel electrophoresis.  These isolates were reconstituted and sequenced with the original fragments and compared to the GenBank database using BlastN algorithm.

The results included antibiotic Staphylococcus aureus which is common on most skin surfaces but can become problematic when entered into the blood stream.  The tissue isolates showed hyperplasia and hypertrophy as well as distended eosinophilic inclusion suggestive of excessive dissolved lipids.  The GenBank search yielded 100% matches to avipox-AY530304 and turkeypox-DQ873808.  Interestingly no lesions were reported on internal organs, however, no septicemia test was done so a blood infection could not be excluded.

In contrast to other outbreaks the morbidity rate was very low due to a lack of perceived aggressiveness among the birds.  It was noted that a large number of flies were observed in heavy litter suggesting an initial route of exposure and a persistent route of infection to other individuals (Hess et al, 2011.)  Both flies and mosquitoes are known transmitters of fowlpox (Larson et al, 2007).

In conclusion, there are many types of fowl pox ranging from pigeons and turkeys to ducks and chickens however it is generally assumed that the pox viruses that effect each are unique to that species.  These pox viruses have commonalities among birds and generally affect the non-feathered regions of the neck, feet, and head.   In many cases the disease is spread by pecking/scratching or by blood feeding arthropods and covers most of the southeastern part of the USA. In general, wild turkeys are less affected by the virus than domesticated turkeys, however that could be in part due to a lack of recorded data and the predation of sick individuals (Davidson and Doster).

No need to worry, though, as all farm raised stocks are vetted by the USDA and are disease free so the risk of contracting fowl pox by eating a farm raised turkey is very slim. So this Thanksgiving eat lots of turkey and remember the complex interactions that happened to get it to your plate.


Image Credit


Acheson, N. (2011). Poxviruses. In Fundamentals of Molecular Virology (2nd ed., pp. 312-323). Hoboken: John Wiley & Sons.

Davidson, W., & Doster, G. (n.d.). Avian Pox – A disease that can affect any bird. NWTF Wildlife Bulletin, 24:1-24:4.

Hess, C., Maegdefrau-Pollan, B., Bilic, I., Liebhart, D., Richter, S., Mitsch, P., & Hess, M. (2011). Outbreak of Cutaneous Form of Poxvirus on a Commercial Turkey Farm Caused by the Species Fowlpox. Avian Diseases, 714-718.

Kindt, T., Goldsby, R., & Osborne, B. (2007). Immune Effector Mechanisms. In Kuby Immunology (6th ed., p. 314). New York: W. H. Freeman and Company.

Larson, C., Beranger, J., Bender, M., & Schrider, D. (2007). Common Diseases and Ailments of Turkeys and Their Management. In How to Riase Hertigae Turkeys on Pasture (pp. 35-52). American Livestoock Breeds Conservancy.