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World Health Organization Reports ~14,000 Cases of Swine Flu Worldwide

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Novel influenza A (H1N1) is a new flu virus of swine origin that was first detected in April, 2009. The virus is infecting people and is spreading from person-to-person, sparking a growing outbreak of illness in the United States. An increasing number of cases are being reported internationally as well.

It’s thought that novel influenza A (H1N1) flu spreads in the same way that regular seasonal influenza viruses spread; mainly through the coughs and sneezes of people who are sick with the virus.

It’s uncertain at this time how severe this novel H1N1 outbreak will be in terms of illness and death compared with other influenza viruses. Because this is a new virus, most people will not have immunity to it, and illness may be more severe and widespread as a result. In addition, currently there is no vaccine to protect against this novel H1N1 virus. CDC anticipates that there will be more cases, more hospitalizations and more deaths associated with this new virus in the coming days and weeks.

Country Cumulative total
  		 Newly confirmed since the last reporting period
  Cases Deaths Cases Deaths
Argentina 19 0 14 0
Australia 39 0 20 0
Austria 1 0 0 0
Bahrain 1 0 1 0
Belgium 7 0 0 0
Brazil 9 0 0 0
Canada 921 1 0 0
Chile 86 0 12 0
China 22 0 2 0
Colombia 16 0 0 0
Costa Rica 33 1 0 0
Cuba 4 0 0 0
Denmark 1 0 0 0
Ecuador 28 0 4 0
El Salvador 11 0 5 0
Finland 2 0 0 0
France 16 0 0 0
Germany 17 0 0 0
Greece 1 0 0 0
Guatemala  5 0 1 0
Honduras 1 0 0 0
Iceland 1 0 0 0
India 1 0 0 0
Ireland 1 0 0 0
Israel 9 0 1 0
Italy 23 0 4 0
Japan 360 0 10 0
Korea, Republic of 21 0 0 0
Kuwait 18 0 0 0
Malaysia 2 0 0 0
Mexico 4541 83 367 3
Netherlands 3 0 0 0
New Zealand 9 0 0 0
Norway 4 0 0 0
Panama 76 0 0 0
Peru 27 0 0 0
Philippines 2 0 0 0
Poland 3 0 0 0
Portugal 1 0 0 0
Russia 2 0 0 0
Singapore 1 0 1 0
Spain 138 0 2 0
Sweden 3 0 0 0
Switzerland 3 0 0 0
Thailand 2 0 0 0
Turkey 2 0 0 0
United Kingdom 137 0 0 0
United States of America 6764 10 0 0
Grand
Total		 13398 95 444 3

Chinese Taipei has reported 4 confirmed cases of influenza A (H1N1) with 0 deaths. Cases from Chinese Taipei are included in the cumulative totals provided in the table above.

Cumulative and new figures are subject to revision

Source: WHO, May 27, 2009 (international cases table); CDC (background information)

Swine Flu Information

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Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza that regularly cause outbreaks of influenza among pigs.

Swine flu viruses do not normally infect humans, however, human infections with swine flu do occur, and cases of human-to-human spread of swine flu viruses has been documented.

From December 2005 through February 2009, a total of 12 human infections with swine influenza were reported from 10 states in the United States. Since March 2009, a number of confirmed human cases of a new strain of swine influenza A (H1N1) virus infection in California, Texas, and Mexico have been identified.

Human Swine Influenza Investigation

April 25, 2009 19:30 EDT

Human cases of swine influenza A (H1N1) virus infection have been identified in the U.S. in San Diego County and Imperial County, California as well as in San Antonio, Texas. Internationally, human cases of swine influenza A (H1N1) virus infection have been identified in Mexico.

U.S. Human Cases of Swine Flu Infection
State # of laboratory confirmed cases
California 7 cases
Texas 2 cases
Kansas 2 cases
TOTAL COUNT 11 cases
International Human Cases of Swine Flu Infection
See: World Health Organization

Last Updated: As of April 25th, 2009 7:30 p.m. EDT

Investigations are ongoing to determine the source of the infection and whether additional people have been infected with similar swine influenza viruses.

CDC is working very closely with state and local officials in California, Texas, as well as with health officials in Mexico, Canada and the World Health Organization. On April 24th, CDC deployed 7 epidemiologists to San Diego County, California and Imperial County, California and 1 senior medical officer to Texas to provide guidance and technical support for the ongoing epidemiologic field investigations. CDC has also deployed to Mexico 1 medical officer and 1 senior expert who are part of a global team that is responding to the outbreak of respiratory illnesses in Mexico.

Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people. There are many things you can to do preventing getting and spreading influenza:

There are everyday actions people can take to stay healthy.

  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
  • Avoid touching your eyes, nose or mouth. Germs spread that way.

Try to avoid close contact with sick people.

  • Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
  • If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

Source: Centers for Disease Control (CDC)

Bacterial Infections

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Sometimes, Death Is Good….. For A Vicious Unicellular Microorganism

There are a variety of different types of foreign bacterial infections one can get from many different sources, yet some are more common than others. If they are not beneficial for your physiology, they all should die in order to restore your health.
Bacteria are a simple life form, yet are incredibly productive and efficient. As with other life forms, it exists to reproduce, and does so about every hour, and evolves and adapts to its environment as needed. To do this, it fully utilizes all available resources and energy to develop the protein that is essential for its survival, and bacteria have the ability to adapt as needed to assure this happens.
It needs exactly 7 genes to produce the essential ribosomes for this to occur. Any more or less genes than 7, the bacteria is not maximizing its efficiency to survive and reproduce. Amazing.
Strept infections are caused by what are called gram positive bacteria, and are unique that these bacteria grow in pairs. Staph bacterial invasions are gram positive as well, yet it is the MRSA, Methicillin Resistant Staff Aureous microbes of this type often are very difficult to treat normally when a patient suffers from their damage from being invaded by these bacteria. Another difficult situation is when a patient is infected by VRE, Vancomycin Resistant Enterococci, as well.
These MRSA and VRE pathogenic or disease causing bacteria are the ones that are the most clinically concerning for the health care provider.
Group A strep infections can cause diseases such as strep throat and pneumonia. Since there are several types of bacteria, a diagnostic test called a culture and sensitivity is usually performed to assure the correct antibiotic is selected for treatment, as the bacteria are identified with this method.
Typically, fluid from the area suspected of being infected is obtained from the patient suspected to have an infection and smeared on what is called a petrie dish. And then these dishes are incubated for 2 to 3 days. Gram positive bacteria stain during this process a dark violet or blue. Gram negative bacteria would be pink in color, and are capable of harm as well to a human being.
When the culture is complete, technology offers recommendations on the appropriate class or brand of antibiotic for this bacteria present in another person- presuming the bacteria will not be resistant to the antibiotic recommended, as this happens on occasion.
Usually, classes of antibiotics that are used to treat gram positive strep infections that are not VRE or MRSA are cephalosporins, macrolides, or general penicillins. If the microbe that is causing the infection is resistant to the antibiotic from such classes that are administered to the infected patient, particularly with methicillin and vancomycin, which is the case with VRE and MRSA bacteria, then there are other more aggressive antibiotics that will be chosen for this patient.
Such brands and types of antibiotics for MRSA and VRE bacteria include Zyvox, which has both IV and oral dosage options. There are also other antibiotics, such as Cubicin. However these antibiotics for antibiotic resistant bacteria are given usually due to infections that have progressed to a more serious nature within a patient infected in such a way.
Progressive medical conditions include sepsis, or blood infection, osteomyelitis, or bone infection, or Pneumonia, which is a serious lung infection. A hospital stay is normally required with such patients, as the last antibiotics mentioned for MRSA and VRE bacterial infections are given by IV administration initially for several days, if not several weeks.
There are numerous classes and types of antibiotics available, yet bacterial resistance to most of these antibiotics constantly remains serious concern for the health care provider, and the infected patient, with MRSA at the top of the list of concerns for the health care providers.
Dan Abshear
http://www.cdc.gov/ncidod/dhqp/ar_mrsa_spotlight_2006.html

Experimental Malaria Vaccines to be Tested in FDA and PATH-MVI Collaboration

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The U.S. Food and Drug Administration has announced a collaboration with the PATH Malaria Vaccine Initiative (PATH-MVI) to develop laboratory tests to better predict the level of safety and effectiveness of experimental malaria vaccines before they are used in human clinical trials.

“This collaboration with the PATH-MVI supports the overall mission of the FDA and specifically the Agency’s work under our Critical Path Initiative,” said Jesse L. Goodman, M.D., M.P.H., director of the FDA’s Center for Biologics Evaluation and Research. “We are actively seeking ways to help organizations such as PATH develop safe and effective products that can benefit the public health both in the United States and globally.”

PATH is an international, nonprofit organization that creates sustainable, culturally relevant solutions to improve global health and well-being. PATH-MVI supports the development of malaria vaccines and is expected to spearhead the efforts to ensure their availability and accessibility in the developing world once a safe and effective vaccine becomes available.

The PATH-MVI collaborative project is expected to span about three years and is being conducted under the Cooperative Research and Development Agreement (CRADA) program, which allows federal laboratories and businesses to form partnerships that help expedite research activities. Recent scientific advances suggest that vaccines based on live, weakened (attenuated) malaria parasites may be possible in the future but assessing safety and effectiveness in the early stages of product development is challenging. Under this CRADA, PATH-MVI provides the FDA with about $1.5 million to develop tests for evaluating malaria vaccines early in their development.

To date, there are no approved vaccines to prevent malaria but several vaccines are in development. This CRADA will help develop laboratory tests to assess whether a vaccine candidate is safe enough to begin Phase I clinical trials.

Each year 350-500 million cases of malaria occur worldwide, killing an estimated one million people, most of them young children in sub-Saharan Africa. Travel between the United States and the affected areas, as well as men and women in the U.S. military who are stationed in regions at high risk for malaria, can bring the disease into the United States.

The Center’s Global Vaccine Initiative fosters the development, evaluation and availability of vaccines needed to protect against major global infectious diseases and is part of the Center’s commitment to work with others, including the World Health Organization, in advancing global public health.

The Critical Path Initiative is the FDA’s effort to stimulate and facilitate a national effort to modernize the sciences through which FDA-regulated products are developed, evaluated and manufactured.

Too Few Americans Being Vaccinated Against Serious Diseases

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The Center for Disease Control warns that far too few Americans are being vaccinated against serious, even deadly diseases.

“There’s always been an emphasis in pediatrics on prevention, and immunizations are a big part of that, but adult medicine has not caught up,” says William Sutker, M.D., infectious disease specialist on the medical staff at Baylor University Medical Center at Dallas. Confirming this observation, a study by the Centers for Disease Control (CDC) found that less than five percent of American adults are up-to-date on all of their immunizations.

“I think people don’t realize the number of deaths that occur because of infectious diseases every year,” says Dr. Sutker. It is estimated only 50% of adults over 50 with diabetes or heart disease should receive flu or pneumonia vaccines. “I think the flu and pneumonia vaccine are grossly underutilized,” adds Dr. Sutker.

“All adults over 60 also should be vaccinated against shingles, but just two-percent currently are. And now there’s yet another concern—whooping cough. Because adults haven’t been immunized against whooping cough in years, the illness is now starting to show up in adults and so that’s why there’s been a new emphasis trying to immunize adults again,” says Dr. Sutker.

The whooping cough vaccine is given in combination with the diphtheria and tetanus booster— which should be administered every 10 years. Experts say the results of this CDC study prove not nearly enough emphasis is put on adult immunizations, which can be lifesaving.

“So although it seems we’re more concerned with heart disease and cancer, I think the public needs to know that infectious diseases are still out there and are a potential cause of problems,” says Dr. Sutker.

For more information about vaccinations, talk to your family physician.

Source: Baylor Healthcare Systems

The Dangers of Using Performance Enhancing Drugs

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More than 10,000 athletes from 205 countries will strive to win medals at the 2008 Summer Olympic Games in Beijing, just started. “The heavy preparation for the Olympics puts severe strain on an athlete’s musculoskeletal frame,” said Edward McDevitt, MD, spokesperson for the American Academy of Orthopaedic Surgeons (AAOS) and orthopaedic surgeon specializing in sports medicine.

The dream of every athlete is to win a medal for his or her country,” stated Dr. McDevitt. “This is a great attitude to have, but it can become problematic if the athlete develops the ‘stop-at- nothing mentality’ to win.”

Athletes prepared to go to any lengths to win are known to use PEDs, performance enhancing drugs, which include Human Growth Hormones (hGH or IGF-1), erythropoietin (EPO), and anabolic steroids. The danger of using PEDs is that athletes are only interested in the potential short-term benefits of these drugs and do not consider the important long-term consequences of using them.

The AAOS stresses that severe long-term musculoskeletal, psychological and physiological risks attach to using them, including stunted growth, diabetes, impaired reproductive functioning, the spread of cancerous tumors, early osteoarthritis and accelerated vascular heart disease, heart attack, and strokes. Increased aggressiveness and the possibility of anti-social behavior can also ensue from using these drugs.

Anabolic steroids, growth hormone and other PEDs are readily available through the Internet and local gyms, and Dr. McDevitt recommends that physicians, coaches, trainers and parents maintain constant contact with their athletes to advise on the effects of PEDs.

“All of us who care about the health of our athletes should be aware of the warning signs of PED use for all athletes, not just Olympians,” stated Dr. McDevitt. The following warning signs should be looked for: a sudden increase in am athlete’s height or weight, a shrinking of the male testicles, male-pattern hair loss in men and women, significant acne on the athlete’s back, problems with anger management and increased aggressiveness.

“With the easy availability of these drugs, some athletes are looking to get bigger and stronger as quickly as possible,” stated Dr. enhancing drugs today can lead to life-long medical and musculoskeletal problems down the road.”McDevitt. “It is our responsibility to educate and inform our athletes of all ages that use of performance.

Source: American Academy of Orthopaedic Surgeons (AAOS)

Study Illuminates How Some Bacteria Survive Antibiotic Treatment

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Some bacteria survive antibiotic treatment by activating resistance mechanisms when exposed to antibiotics, according to a recent study in the journal Molecular Cell. The results could lead to more effective antibiotics to treat a variety of infections.

“When patients are treated with antibiotics some pathogenic microbes can turn on the genes that protect them from the action of the drug,” said Alexander Mankin, professor and associate director of the University of Illinois at Chicago’s Center for Pharmaceutical Biotechnology and lead investigator of the study. “We studied how bacteria can feel the presence of erythromycin and activate production of the resistance genes.”

Sensing the presence of an antibiotic in the ribosomal tunnel, some bacteria have learned how to switch on genes that make them resistant to the drug. The phenomenon of inducible antibiotic expression was known decades ago, but the molecular mechanism was unknown. Mankin’s team of researchers include Nora Vazquez-Laslop, assistant professor in the Center for Pharmaceutical Biotechnology, and undergraduate student Celine Thum. assistant professor in the Center for Pharmaceutical Biotechnology, and undergraduate student Celine Thum.

“Combining biochemical data with the knowledge of the structure of the ribosome tunnel, we were able to identify some of the key molecular players involved in the induction mechanism,” said Vazquez-Laslop. “We only researched response to erythromycin-like drugs because the majority of the genetics were already known,” she said. “There may be other antibiotics and resistance genes in pathogenic bacteria regulated by this same mechanism. This is just the beginning.”

Source: Molecular Cell, April 24, 2008

Malaria Protection Provided By Inherited Blood Disorder

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An inherited childrens’ blood disorder called alpha thalassemia can protect children against malaria, according to a new study.

"We made the surprising finding that packaging your hemoglobin in smaller amounts in more cells is an advantage against malaria," says Karen Day, Ph.D., Professor and Chairman of the Department of Medical Parasitology at NYU School of Medicine, who led the research with colleagues at the University of Oxford. Hemoglobin is the oxygen-carrying protein in red blood cells.The study, published in the March issue of the journal PLoS Medicine, proposes an answer to a biological puzzle that first emerged more than 50 years ago.

The study was conducted in Papua, New Guinea, where malaria is endemic, with 800 children participating. 68% of children there have alpha thalassemia. Dr. Day and her then-Ph D. student Freya J.I. Fowkes, and colleagues from the University of Oxford, Papua New Guinea Institute of Medical Research, and Swansea University showed that a severe attack of malaria caused the loss of one third to one half of the total number of red blood cells. However, children with mild thalassemia started with 10% –20% more red blood cells than unaffected children, and could therefore withstand this huge loss.

"It is really remarkable and so simple. Children with alpha thalassemia have adapted to the loss of red blood cells associated with malarial disease by making more of these cells with less hemoglobin," says Dr. Day. "So, these children do better because they end up with more hemoglobin overall when they have a malaria attack compared to normal children," says Dr. Day.
Malaria afflicts hundreds of millions of people, causing up to 2 million deaths every year in Africa and Asia. Many of its victims are young children. In regions of the world where malaria is endemic, mutations have arisen in human populations that allow people to survive. Sickle cell trait, for example, protects against malaria.

Nearly sixty years ago the renowned evolutionary biologist J.B.S.Haldane postulated that the thalassemias were common in human populations because they protected against malaria. Alpha thalassemia is common in Asia, the Mediterranean and Melanesia where malaria is or was prevalent. In the mid 1990s researchers working on the north coast of Papua New Guinea proved that children with mild alpha thalassemia, who inherit mutations in the "alpha" part of hemoglobin genes from each parent, were protected against malaria. These children were 60 percent less likely to get severe malarial anemia than normal children, however the mechanism of such protection was unclear.

Dr. Day and colleagues based their new study on this same population of children. "We are proposing an unexpected mechanism of protection against severe malarial anemia" says Dr. Day. "We show that alpha thalassemia is giving the child a hematological advantage by making more red blood cells.

Source: New York University Medical Center

Active Tuberculosis Prevented by New Drug that Kills Latent Bacteria

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A new chemical that can prevent active tuberculosis in people infected with the latent form of the bacterium has been discovered by researchers. The drug could also shorten the recovery time needed, and suggests new ways of combating bacterial infection, increasingly resistant to traditional antibiotics.

"With each new case of antibiotic resistance, doctors are losing ground against Mycobacterium tuberculosis and other infectious diseases," explains the study’s senior author Dr. Carl Nathan, chairman of Microbiology and Immunology and the R.A. Rees Pritchett Professor of Microbiology at Weill Cornell Medical College. "This new approach fights the pathogen in a way that’s different from conventional antibiotics. For what may be the first time, we have found compounds that only kill M. tuberculosis when they are not dividing. This lack of replication is a characteristic of latent bacteria, which are tough to eradicate with existing antibiotics and ultimately play a huge role in the epidemic’s spread."
The World Health Organization reports 1.6 million worldwide die from the lung infection annually. It is also estimated that as many as one-third of the world’s population is infected with latent or non-replicating M tuberculosis. The latent bacteria begins to replicate in 5% – 10% of these people, resulting in active disease, while experts opinion states that each person with active TB is estimated to infect 9 and 20 other people.
"That means that killing latent M. tuberculosis is one of the keys to curtailing or eliminating TB as a disease," Dr. Nathan says. "Antibiotic research has typically focused on killing rapidly dividing bacteria. But with antibiotic resistance rising, that no longer seems like a winning strategy. The long duration of treatment required for curing TB may reflect the fact that some of the bacteria remain non-dividing even during clinically active disease."
It can take 6 months to wipe out most non-dividing bacteria using present drugs, but if this difficult regime is stopped too early, drug-resistant bacteria can appear. The focus of the Weill Cornell researchers was a bacterial enzyme called dihydrolipoamide acetyltransferase (DlaT).
"DlaT’s main job is to help M. tuberculosis get energy from nutrients. But when the bacterium is under stress, it also uses the enzyme to defend itself against oxidative damage from human immune cells, such as macrophages," explains study lead author Dr. Ruslana Bryk, assistant research professor in the Department of Microbiology and Immunology at Weill Cornell Medical College.
DlaT is vital to initiating active TB disease, the team discovered. "So we screened 15,000 compounds to find chemicals that might inhibit DlaT," Dr. Bryk says. The researchers discovered one such compound from a class of chemicals called rhodanines. Their collaborators at deCODE Chemistry then synthesized over 1,000 different variants until the Weill Cornell team found several that can enter and selectively kill non-dividing M. tuberculosis.
"We believe that these DlaT inhibitors probably target additional mechanisms that non-dividing M. tuberculosis needs to survive, and we are currently investigating that possibility," Dr. Nathan says. "We also believe that these compounds work in synergy with human immune responses and the chemical environment inside the host to kill latent bacteria."
The inhibitors described in the paper are surely not the only ones with the ability to kill non-dividing M. tuberculosis selectively. "This was really a proof-of-principle effort to show that targeting non-dividing bacteria was feasible," Dr. Nathan explains. "In recent work supported by the Bill and Melinda Gates Foundation, we have since found additional compounds that appear to kill non-dividing M. tuberculosis selectively."
"As a parent, a citizen and an occasional patient, I worry about losing the hard-fought gains we’ve made against infectious disease," Dr. Nathan says. "When traditional antibiotics work, treating TB, pneumonia and other bacterial diseases seems routine. When they don’t work — as is happening now with growing frequency — these infections become emergencies. The growing crisis of microbial resistance demands innovative new approaches. We hope this work will encourage more scientists that such innovations are worth seeking."
The new findings are published in the March 12, 2008 online issue of the journal Cell Host & Microbe.

Infection Expert Warns That MRSA May Be Unstoppable

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Dr. Ron Najafi, CEO of NovaBay, describes MRSA (methicillin-resistant Staphylococcus aureus) as a slow-moving hurricane. "Once the ‘superbug’ hits a community or hospital," asks Dr. Najafi, "are populations ready to deal with it?"

His comment was prompted by the untimely death of college student Chris Steden to the disease, which infects 90,000 Americans in our hospitals every year, with 19,000 deaths reported annually.

The company is working on a compound, NVC-422, which may successfully fight many pathogens including MRSA. S. aureua breeds in the nose and on the skin. NovbaBay’s AgaNase formulation of NVC-422 for nasal applications, is an anti-infective, but not a conventional antibiotic. Topically applied to the lower nasal passage to eliminate colonization of S. aureus, including MRSA, AgaNase rapidly destroys a range of pathogens that include bacteria, yeast, and viruses.

Source: NobaBay Pharmaceuticals