Microbiology for Smarties

The Walking Dead may not just be a fictional TV show. Turns out, the Rabies Virus can cause humans to demonstrate zombie like symptoms, spaz out, and die. This very unfortunate virus is a zoonosis that is transferred to humans from rabid (carrier) animals– most commonly dogs, raccoons, coyotes, and bats. This disease, once signs and symptoms develop in the patient, is always fatal. As unfortunate as this is, rabies has always been one of the most intersting and mind-blowing diseases to me.

According to a recently reviewed article by KidsHealth, rabies will not kill the person if treated before signs and symptoms develop. Foaming at the mouth, confusion, aggressiveness, headaches, and twitching (literally a zombie) symptoms appear after the virus replicates at the site of the bite and goes to cranial nervous tissue. The article mentions that if someone even slightly thinks they were bit by a rabid animal, they should be treated. 2 shots are available for the prevention of the disease: rabies immuno globulin (provides immediate protection) and the rabies vaccine (not really ideal for immunocompromised people but taken in a series of doses). So luckily, there is a way to treat rabies and prevent death in the patient, if treated early enough.

Domestic animals can also be routinely vaccinated to prevent them from becoming rabid. However, as more people around the world are domesticating pets, improper vet care has raised rabies prevalence world-wide. According to an article by The Himalayan Times, this issue is occurring in Nepal. The South Asian country has lost 6 citizens in the last 2 months due to rabies. These cases have been linked to the fact that more and more people in Nepal have gotten pets, unaware of the potential for fatal zoonosis diseases. The article also mentions how many people in Nepal take an animal bite or small scratch very lightly, improper education has led them to not even get these bites/scratched checked in a medical facility. Due to these recent incidents, Nepal has introduced new guidelines for the rabies vaccine (requiring 4 doses of the vaccine to all potentially infected individuals) and is overall taking the virus more seriously.

Unfortunately, we all most likely know at least one person who has suffered from cancer. The scary disease of Cancer causes a great amount of deaths world-wide due to the uncontrolled division a patient’s cells undergo. A tumor develops as a result of this uncontrolled cell division and, if cancerous, can lead to further inconvenient, costly, and life-threatening concerns. According to a recent article published by Cancer Treatment Centers of America, cancer is not necessarily categorized as an autoimmune disease. Cancer is usually a result of the immune system not properly doing its job of eliminating harmful cells while an autoimmune disease results from the immune system falsely attacking healthy cells. Either way, both cancer and autoimmune diseases lead to fatal consequences for the individual. The good news is that cancer treatment and autoimmune disease research has skyrocketed over the past century with scientists now able to pinpoint the exact cause and possible effective treatments or preventions of cancer.

According to an article by the American Cancer Society, different methods of treating cancer including vaccines are currently being studied. While vaccination is not currently considered a treatment for cancer, researchers have been able to pin-point what should be included in a cancer vaccine. The article specifically mentions four specific types of possibly effective cancer vaccines: Tumor Cell Vaccines, Antigen Vaccines, Dendritic Cell Vaccines, and Vector-based Vaccines. All these types aim to defeat cancerous tumors by either introducing one type of antigen, or removing and altering actual cancer cells from the patient then reintroducing them to the body. The most effective one, as noted by the article, is the Dendritic Cell Vaccine. As we discussed in class, dendritic cells are cells in the immune system that detect cancerous cells and “flag” them for an immune response to occur. This vaccine essentially works by exposing dendritic cells to cancer cells in a lab setting, then when DCs are injected into the patient, they cause a healthy immune response rapidly and efficiently. This process, as effective as it is, is noted to be very costly. It required the extraction of dendritic/immune cells from the specific patient, which is obviously a process. Another downside to this is that it has only been approved to treat prostate cancer. The reason why it is most effective against this type of cancer as oppose to any other was not mentioned in this article, but I assume there is a valid reasoning behind this. Nevertheless, there is hope. In the next few years, we will hopefully defeat cancer altogether!

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Ovarian cancer vaccine overview from https://medicalxpress.com/news/2018-04-personalized-ovarian-cancer-vaccine-trial.html

I’ve said this before and I’ll say it again- vaccines are incredible! I think we as a human race are pretty awesome for developing something to combat deadly diseases. Unfortunately, some diseases are just too complex for us to make an effective vaccine for. Syphilis and Gonorrhea, both sexually transmitted diseases with virulent drug-resistant strains, do not currently have an effective vaccine developed. As you can imagine, this makes incidence of these infections that much more prevalent, dangerous, and alarming.

You may have heard of Gonorrhea, but did you know that about 100 million cases of the STD is reported each year world-wide?! That number is insane and just goes to show the extreme prevalence of Gonorrhea. According to a recent article by Healio, the cases of the fatal STD has increased 67% (think about that number for a second) from 2014 to 2017. Gonorrhea, caused by the bacterium Neisseria gonorrhoeae, used to be treated easily through the use of antibiotics. Over time, this STD has developed antibiotic-resistant strains that has become increasingly difficult to fight. The article mentions that there is no current vaccine for Gonorrhea but discusses a potential candidate. A study by researchers in New Zealand is currently examining the effectiveness of B meningococcal vaccine, or MeNZB against Gonorrhea. According to the article, this study is the first successful attempt at determining a possible vaccine for Gonorrhea! MeNZB evoked an anti-gonococcal response in immunized rabbits and when given to people under the age of 20, showed promising outcomes. Granted, the estimated vaccine effectiveness was only 31%, I still see that as a win against N. gonorrhoeae.

Unfortunately, the list of diseases without a proper vaccine preventative goes on and on. According to a recent article by The Conversation, a Syphilis infection, caused by spiral shaped Treponema pallidum, is easily treated by inexpensive antibiotics. Great. So, what makes Syphilis so dangerous? As easy as it is to treat Syphilis, prevention is almost not possible through medicine. The fact of the matter is, a Syphilis infection almost always leads to other medical issues. Ulcers appear with an infection although they are typically painless and in an unnoticeable place. Also, Syphilis is typically asymptomatic which makes its transmission from person to person veerryy easy; syphilis is typically not diagnosed for a long time after the infection because of this reason. It also has the potential to go into a latent phase and remain in the body/reemerge in years down the line causing further issues like tissue damage, pregnancy issues, and even infertility. According to the article, there is no vaccine for Syphilis. Although this article (nor any other one I came across) did not mention the reason why there is no Syphilis vaccine yet, it can be assumed that the complexity of the bacterium, it’s many strains, and its infectious course (latency and all) are the reason. I do have hope for a Syphilis vaccine in the future because of how good of a candidate Syphilis is: many people world-wide get Syphilis each year and with the medical innovation occurring everyday, I’m certain that researches studying this disease will soon develop and effective vaccine.

The takeaway message here is to know your partner’s medical history and get tested! Stay safe, kids.

As much as vaccines have proven to save lives time and time again, there will always be skeptics. Recently, I discussed vaccine hesitancy in detail (check out that blog post!). The reason for hesitancy basically comes down to the fact that some people think vaccines have a higher chance of doing bad than good. The fabricated study of Andrew Wakefield raised the notion that vaccines may be positively correlated to autism. Other studies later on showed this correlation to be very insignificant aka super duper unlikely; nevertheless, anti-vaxers stand their ground.

The controversy behind Thimerosal-containing vaccines is no different than what I’ve been discussing thus far. Thimerosal, according to the Center for Disease Control‘s website, is an ingredient in many vaccines and other medicine; Thimerosal works by preserving the vaccine and preventing the growth of harmful bacteria and fungi. Imagine getting vaccine contaminated with tons of bacteria. Yikes. That is exactly what Thimerosal helps prevent- which sounds great, right? But the reason why some people are against vaccines with Thimerosal is because Thimerosal contains a type of Mercury called ethylmercury; the most common routine vaccines don’t contain Thimesosal, but the ones that do (like some flu vaccines) are being resisted. Mercury has a bad reputation for being toxic to the body (in high amounts) so it’s understandable why many people don’t want to be injected with a vaccine that contains mercury. The thing to understand is that ethylmercury is much less likely to cause any harm to the human body because its essentially eliminated by the immune response very quickly- much more quickly than the commonly-known harmful mercury found in fish. Another page on the CDC‘s website mentions that Thimerosal does not cause autism, a concern by many anti-vaxers. For example, a peer-reviewed article published on NCBI‘s website concluded that there is not a strong correlation between autism and Thimerosal, in fact there really is not correlation. The article references a few studies, all of which conclude that Thimersosal is safe to use in vaccines. The article also discusses that the ethylmercury in Thimerosal has different pharmacokinetic properties than the kidney and cognitive-impairing methylmercury found in fish. However, this article and the CDC mention that this lack of correlation between Thimersosal and cognitive damage is not 100% certain to be true. As with all things in the medical field, there are uncertainties and exceptions seen in all cases. I think further testing needs to be conducted because as of right now, there does not seem to be enough convincing evidence for the skeptics.

Haters gonna hate but I don’t see anything wrong with Thimerosal. I understand the controversy behind it and why some people don’t want to take any chances with Thimerosal-containing vaccines, but this is a matter of weighting costs versus benefits. The benefits of preventing a possibly lethal infection through vaccination heavily out weights the costs of possibly maybe not really developing autism or any other developmental issue.

We all know about the glories of the human gut microbiota, but did you know that the condition of one’s gut microbiota can suggest the onset of fatal diseases? Thats right– respect the gut. Recent studies have been trying to identify the role of the human microbiota in Parkinson patients. Parkinson’s disease is an inhibiting and crippling disease of the brain, according to a recently updated article by the U.S Department of Health and Human Services. As the often-deadly disease progresses, symptoms of shaking, difficulty walking, and stiffness increase. This inhibiting disease has been the topic of many health reform conversations world-wide with questions as to how and why exactly this disease develops; this recent study may lead to more answers.

The study, written in a post by Medical News Today, suggests that understanding the gut will help researches understand the origin of the disease– something that is not 100% clear yet. According to Dr. Scheperjans from Helsinki University Hospital, “…the origin of the disease may lie in the gut with possible involvement of abnormal protein aggregates, local inflammation, and the gut microbiome.” Simply put, this study of his identified that by looking at gut composition before and after diagnosis, there is a link between certain proteins in the gut microbiome and nerve abnormalities that trigger the disease. Other factors like hyper-permeability of the gut and the presence of high amounts of alpha-synuclein (a protein) in Parkinson patients also were found to play a role in the link between the gut microbiota and Parkinson’s; there is a belief that this protein is playing a role in the onset of Parkinson’s due to the findings of high amounts of it in the enteric nervous system of patients, which would have originated from the gut. The article mentions that this study is just barely scratching the surface and more studies need to be conducted to further analyze these beliefs. The article also mentions how hard it is to study a disease like Parkinson’s; it is often diagnosed long after the patient actually has it, making it difficult to study that patient’s microbiota beforehand. Basically, there is no way to truly predict if someone will develop Parkinson’s, which obviously makes it hard to gather information on a patient before they get the disease and compare.

I will honestly say that I am disappointed this study did not answer all the questions it intended to. But that’s what a good study should do- answer some questions but bring rise to new ones that ought to innovate and change the way we view the medical world. Suggesting a possible connection between gut bacteria and a disease of the brain is actually very innovative and deserves some credit (@me). My hope is that future studies will expand upon this one so someday we can accurately understand, predict, and maybe even prevent Parkinson’s disease using knowledge of gut microbiota. One thing’s for sure- happy gut, happy life. 🙂

If you’ve ever been in a hospital or doctor’s office (props to you if you can’t relate), you may have noticed posters of sepsis awareness including signs, symptoms, and ways you can help prevent shock. Sepsis has been an increasing concern in the healthcare community and here’s why. According to a recently reviewed page on Medicinenet‘s website, sepsis is deadly blood poisoning typically caused by health-care related bacterial infections. To put it simply, any localized bacterial infection that spreads to the bloodstream is sepsis. The treatment of sepsis is a long and tiresome one typically requiring a few weeks of hospitalization (depending on the severity of the case) and intense antibiotic treatments. Most cases, unfortunately, lead to death due to organ failure and septic shock, or super duper high blood pressure.

As I discussed in my previous post, new research and studies frequently conducted in the healthcare field are helping us win our fight against the microscopic world of pathogens! Luckily, many studies are being conducted on sepsis and ways to better treat the condition to help save lives. According to a recent MedicalNewsToday post, a new drug compound of cilengitide- generically called InnovoSep- has been researched and shown evidence of inhibiting the progression of organ failure in septic patients. According to the article, InnovoSep was successfully used by researches at the Royal College of Surgeons in Ireland and showed to prevent S. aureus and E. coli from binding to Endothelial cell barriers; by preventing damage to endothelial cells, sepsis can ultimately be controlled, and that is exactly what this research of InnovoSep aimed to justify. The article mentions that the drug appeared to prevent bacteria going into the bloodstream by “stabilizing the blood vessels so that they cannot leak bacteria and infect the major organs”. The thing that gets me most excited about this drug is the fact that its not an antibiotic! I’ve discussed the severity of antibiotic resistance in past blog posts and obviously, antibiotic resistance is a concern with sepsis treatment. The article mentions this benefit of the drug as being very promising.

Of course, as with any new study, many more clinical trails and approvals must be met before the whole world can accept the new idea. Considering the Royal College of Surgeons in Ireland is the only institution I could find that thoroughly studied this drug, I personally need a little more to fully be convinced that InnovoSep is the answer. The fact that this is not non-antibiotic treatment for sepsis is highly innovate and highly amazing, but makes me wonder how effective it can really be on any given patient. Nevertheless, this research is great step forward for us.

The amazing thing about the healthcare community is that it is constantly evolving, revamping, and discovering new ideas. Even you can someday be the founder of a life-changing discovery or magical cure that alters the state of the world! Dream big, folks.

In recent years, immunologists have been working to further improve a malaria vaccine, and they just might have struck gold. As we all know from class, malaria is transmitted to humans via infected Anopheles mosquitos and is a life-threatening, possibly deadly disease that damages red blood cells. There is currently no recommended malaria vaccine as the only one available to get, RTS,S, is kind of crappy. RTS,S, according to recent reviewed Precision Vaccination post, has a very low effectiveness rate, especially in children (towards whom malaria is most fatal). Malaria, can however, be avoided somewhat by antimalarial medication before exposure.

According to an article by Oregon Health and Science University, a new type of vaccine combating malaria has surfaced and is currently being studied. Cytomegalovirus (CMV) vaccines are being studied to determine their effectiveness in vaccinating for malaria, HIV, and TB, and so far, results have been promising. According to the article, a paper published by PLOS ONE journal indicates that CMV-based vaccines reduce the malaria parasite’s “release from the liver and into the blood of infected rhesus macaques by 75 to 80 percent”. This is great news because if it worked so well on monkeys it should on humans too. The article mentions that the CMV vaccine is a great improvement from the short lifespan (aka not very effective) of the RTS,S malaria vaccine. What I found especially interesting about this newly studied vaccine is that it is a weakened form of CMV, a common herpes virus, and it does not cause sickness to those vaccinated. According to the same Precision Vaccination post mentioned previously, CMV-based malaria vaccines are really getting the health community (and myself) excited because of its long lasting effects, which is always highly sought after. As promising as this research may sound, I highly encourage further testing and development before getting too convinced; perhaps this vaccine could cause health problems years after getting vaccinates, or could lead to further complications in currently healthy individuals.

Perhaps the reason why we don’t have a solid malaria vaccine yet is because malaria is caused by a protozoan parasite, Plasmodium. Most common vaccines you may know of (chickenpox, flu, or MMR) are viral. Maybe protozoans infections are that much harder to make into an attenuated/inactive/protein/etc vaccine, and still ensure optimum effectiveness. Nevertheless, the effectiveness and creativeness of this innovative CMV-based vaccine gives me hope that we are on the right track to eliminating malaria before it eliminates us.

According to the Center for Disease Control‘s website, polio is a severe and inhibiting disease that can be prevented almost entirely by one simple measure. You guessed it. Vaccination. What’s interesting about the polio vaccine is that different forms of it, either oral or inactivated, can be given to a person. Even more interesting is that different vaccines are used in different countries. Lets investigate further.

The poliovirus causes the disease polio (aka Poliomyelitis) and is a single-stranded RNA virus. According to a recently updated post by the World Health Organization, the inactivated polio vaccine (IPV) uses a killed version of the virus while the oral polio vaccine (OPV) uses three live attenuated virus serotypes. Regardless of the type of vaccine, they both perform the same function of allowing the host to make memory cells and antibodies for the virus in order to stay healthy if they do again come in contact with the virus. Basically, as we learned in class, vaccines allow the host’s body to mimic a response to an infection, without the actual getting sick part. This is why vaccines are amazing. As I mentioned earlier, different forms of the polio virus are used in different countries. The same article mentions that over the course of a few centuries, new forms of vaccines have been researched and developed to accommodate for different countries. According to the same post, Scandinavia and the Netherlands are two notable counties that have successfully eradicated polio through IPV use. Other countries use OPV simply because it is easy to administer an oral vaccine and it does not require much (or any) medical training. Injected vaccines, on the other hand, require training, proper aseptic technique, and is overall just easier to mess up. Because of this, oral polio vaccines are much more practical and used mainly in unwealthy or medically underdeveloped countries that need a quick and simple way to vaccinate the population.

As you know if you’ve read my previous posts regarding vaccines, I am a clear and strong advocate for them. Vaccines save people and those around them from many harmful, deadly, and preventable diseases like polio. The persistent issue of poor healthcare in third-world countries that lead to constant spread of disease is something that must be combated. Perhaps oral vaccines are the answer? If we can get more unwealthy countries vaccinated without worrying about proper administrative technique or training, how great would that be? Of course issues of financing these vaccines and getting them distributed to the needy population arise but overall in my opinion, this is big win-win situation.

Mycobacterium tuberculosis is the bacterium responsible for tuberculosis disease. You may have heard of tuberculosis, but you may not have known that it is one of the top 10 causes of death worldwide, according to the World Health Organization as referenced by a recent Health Essentials post. M. tubercolosis is an airborne pathogen that infects the lungs and causes chest pain, fever, chills, loss of appetite and death. The Health Essentials post also mentions that tuberculosis, or TB, is only really prevalent in developing countries because of lack of proper healthcare. In America and other developed nations, the TB vaccine and antibiotics are effective enough to prevent a strong prevalence of tuberculosis. Here comes the bad news. Recently, there has been a rise of antibiotic-resistant TB that has increased the number of cases, spread, and fatality rates of the disease. This is yet another example of the dangers that can arise with antibiotic use.

A few blog posts ago, I discussed antibiotic resistance in general terms (go read that post if you haven’t already!) and its effects on the healthcare industry. The emerging threat of multi drug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) is an issue that could potentially have no true cure. Lets backtrack a little. Tuberculosis is almost always treated with the antibiotic Isoniazid, according to a recently updated article by the American Lung Association. According to the article, TB treatment ranges from 6 to 9 months and typically encompasses a few different drugs like rifampin or ethambutol (along with isoniazid) which, as you can imagine, is a lot of coins. Considering today’s rising price of healthcare and insurance, most people can literally not afford to get a disease like this. So, why might MDR-TB arise? Well, taking multiple drugs at a time for a long period of time can result in accidentally taking the medicine incorrectly or simply having resistant bacteria survive the treatment and replicate-all things discussed in my antibiotic resistance blog post.

An article by the European Respiratory Journal notes that recent antibiotic resistance in strains of M. tuberculosis suggests the need for a revamped treatment regimen. The article mentions that this resistance is not only affecting patient’s chances of survival, but treatment for MDR-TB and XDR-TB is costly and could potentially permanently damage the sight or hearing of patients. I appreciate that disclaimer because I think it’s very important to get the message of RISKS across. Perhaps if more people truly knew about the life-changing risks associated with most diseases and their treatment, vaccines and prevention would be taken more seriously. Just sayin…

To combat MDR-TB he World Health Organization suggests strictly oral (as oppose to injectable) regimes, according to a recent article by the World Health Organization. Based on recent studies, the WHO also suggests treatment with Fluoroquinolones and Bedaquiline drugs for longer periods of time. What I got from this article is that the WHO basically recommends longer and more indirect treatment to prevent or combat antibiotic resistant tuberculosis. The article also notes the importance of closely considering the patient’s age and condition prior to putting them on any regimen as well as closely monitoring the patient throughout the treatment. I think this is very important because each case of any disease effects people different; monitoring and assessing is crucial along with drug treatment.

Human papilloma virus, or HPV, is fun to pronounce but not fun to get. As we learned in class, HPV is a potentially cancer-causing naked DNA virus. There are at least 100 different strains of HPV with 40 of them associated with gross genital warts. An HPV infection can be deadly but do not fear, vaccines are here!

I’ve been seeing so many news articles and TV ads on HPV lately, which is great because more people should be informed about this potentially deadly (but preventable) virus. There are a few reasons why HPV is so dangerous; as we discussed in class, some strains of HPV can cause cervical or oral cancer because of oncogenic genes they possess, symptoms of an HPV infection are often asymptomatic (like you literally don’t know you have i), and the fact that HPV can infect any mucosal tissue in the body. I don’t know about you, but I’ve aways thought HPV was a sexually transmitted disease only, but surprisingly it doesn’t just end there. You can get HPV through merely coming in contact with lesions and if thats not good enough, HPV can affect pretty much any mucosal tissue (genital, mouth, throat, or pretty much any lining in the body), which means condoms won’t cut it and forget about oral sex with an HPV positive partner. Yikes.

The Vaccine!

Lucky for us, there is a preventative measure we can take to protect ourselves and our lovers from HPV– vaccination! The HPV vaccine (Gardasil) should be administered before an individual comes in contact with the virus in order to prevent the evil virus from causing much harm to the person. This vaccine, like many others, saves lives

Unfortunately, there has been a lot of talk and hesitancy toward the HPV vaccine in the news lately by parents. According to a recent article by Johns Hopkins Medicine, many parents are hesitant to allow their children this vaccine. The article mentions that according to the American Sexual Health Association, up to 80 percent of sexually active Americans will be infected with HPV sometime in their lives. That’s why researches are curious to understand why parent’s are hesitant and what can be done to combat this. The article mentions a study in which parents were asked open-ended questions regarding this vaccine. The top concern of all parent’s was that this vaccine would “encourage or support youth sexual activity”. While I highly agree with the idea that this vaccine may encourage sexual activity in youth, I also think that its better to be safe than sorry. In all cases with vaccines, the benefits outweigh the harms and administering it can prevent many cases of the infection. Even having youths/adolescents take part in clinical trials studying this vaccine is hesitated by parents. According to a 2017 NCBI article, studies found that most parents of adolescents are not willing to have their teens involved in an HPV vaccine clinical trial with many predictors of this hesitancy including the parent’s age and their number of sexual partners. . In a 2013 JAMA Network article, a trial was administered the asses the ideal dosage of the vaccine in young adolescence and young women. In short, this trial found that based on antibody durability, more doses (3 as oppose to 2) should be given but still, more studies should be conducted to ensure this conclusion. This trial is yet another justification for getting the HPV vaccine; nevertheless, all clinical trials that have been done on this vaccine that I’ve read about have shown that the vaccine does more good than harm to any given group of people. AKA get vaccinated people!