Wednesday, October 22, 2014

Viruses 

As I reflected in my article on Ebola virus, on my blog at www.leadmyworld.blogspot.com , I thought that a scientific and a layman’s definition of viruses needed more explanation. We often hear that a person’s computer was affected by a virus or that someone lost data due to a virus. Computer viruses attack computers by inserting themselves into files that were downloaded as attachments (host). They have the ability to replicate themselves as they are malware programs. These virus program writers prey on the vulnerability of the security of your computer (immune system in the world of biology) It can virtually kill your computer for good if antivirus software has not been installed to detect and destroy the malware before it does its job.
Biological viruses operate in the same way. Computer science has borrowed the term ‘Virus’ from the world of microbiology. Dr. Janet S. Butel[1] defined viruses as, “the smallest infectious agents (ranging from about 20 nm to about 300 nm in diameter) and contain only one kind of nucleic acid (RNA or DNA) as their genome. The nucleic acid is encased in a protein shell, which may be surrounded by a lipid-containing membrane. The entire infectious unit is termed a Virion. Viruses are inert in the extracellular environment; they replicate only in living cells, being parasites at the genetic level.”
Once viruses find a host, they are pretty independent and active in their tasks of destruction. They have command centers, genome organization, launch a self-replicating strategy, interact with the surface receptors of their targets and can neutralize antibodies, attack and fight a type of guerrilla warfare by playing hide and seek before eventually killing their host.
The world is becoming a global village, so viral infections are also becoming global. As we travel from continent to continent within hours, so do viral diseases. Human are not the only carriers of viral diseases. Animals and their meats that we eat can also harbor viruses. Some of the factors we ignore too easily are:
1.      Water pollution caused by changes to ecosystems and deforestation.
2.      Human to human transmissions caused by careless social and sexual behaviors.
3.      Bad hygiene caused by poverty, wars and lack of education.
4.      Disease migration due to travelling, trade and rapid transportation systems.
5.      Poor food processing, packaging, storing and shipping methods.
6.      Disease transmission by blood transfusion, contaminated medical devices and medical wastes.
7.      Virus propagation by organs and tissue transplantation.
8.       Lack of diligence due to budget cutbacks or the commercialism of healthcare.
Some of the emerging viral infections are Ebola, Nipah, Dengue fever, West Nile Virus, Rift Valley fever, Bovine Spongiform Encephalitis, SARS and MERS.
Safety precaution:
Some of the reasons why the Ebola virus has become such a monster is because we have not taken lab safety precautions seriously. Governments, so far, have taken this particular virus and its deadly disposition too lightly. Had we taken the Ebola virus as seriously as we did with HIV or SARS, we would have been in control of the situation.
Here are a few tips and precautions for lab safety. The major places of transmission of viruses are labs, hospitals, healthcare facilities, schools and universities.
·         Laboratory acquired infections can occur from human pathogens, so extra precautions have to be taken into account in and around the lab environment.
·         Ingestion by mouth is a major cause. Eating in the lab should be prohibited.
·         The most common transmissions are due to the pricking of skin by needles and the careless handling of contaminated, bio-hazardous materials.
·         Splashing into eyes or nostrils and even chapped lips or micro-lesions can also cause transmission.
The best safety precautions use common sense. For example:
1.      Proper washing/scrubbing of hands
2.      Quality training on handling bio-hazardous materials like used syringes, bandages, gloves, waste and lab equipment
3.      No eating, drinking, smoking, chewing or using make up, aerosol hair sprays or inhalers in the lab
4.      Keep safety gear only in the lab in designated sanitized places and nowhere else
5.      Sterilize everything; create and follow checklists for sterilization and carefully follow all other bio-safety procedures
Spread goodness, it’s worth it.




[1] Reference: Dr. Janet S. Butel in Medical Microbiology, 25th Edition

Thursday, October 16, 2014

Common Cold vs. Flu

How often do people ignore signs of the flu? The answer is, very often. Stuffy nose, sinus, and sniffling are symptoms associated with the common cold. However, it may very well be the early signs of influenza. It comes as a shock to hear that in the USA, some “36,000 people die each year from flu related complications”. (RAND Corp. survey)

Differences between Flu and Cold

Influenza is a respiratory virus which is caused by a viral infection. The cold is also a viral infection caused by, the adenovirus or coronavirus. Flu is preventable with vaccination, whereas the common cold has to run its course. Flu season in the United States is generally between November and January. It commonly spreads from person to person. Seasonal influenza cannot be taken as lightly, since it can become an out of control epidemic. Healthcare experts have categorized seasonal influenza into 3 groups A, B and C; it is further classified as H1N1 and H3N2. Symptoms can include: sudden high fever, sore throat with dry cough, and muscle pains; some people may feel joint pain, and runny nose. Constant and severe fever can be fatal if not treated. Before discussing scientific facts, let us learn what The Center for Disease Control Atlanta (CDC) and The World Health Organization (WHO) recommends for preventing or dealing with the common cold and flu.

Prevention and handling

·        Proper hygiene and keeping yourself germ-free.
·        Wear protective clothing at the changing of seasons.
·        Getting flu shots ahead of time, unless you have an egg allergy.
·        Get plenty of rest and do not compromise your immunity.
·        Stay hydrated by drinking beverages that contain electrolytes.
·        Keep an eye on fever and your body temperature.
·        Gargle salt water to sooth your sore throat.
·        Use cough medicine, chicken broth and other OTC comforting medicines to keep your body well rested and strong enough to fight infection.
·        People with a weak immune system or chronic illness, infants and elderly, or people with medical conditions are at a higher risk to be affected, faster than healthy people. Use precautions, know your health history.
·        According to medical experts, antibiotics are weapons to fight bacterial infection. Unless, one has developed a bacterial infection alongside a viral one. Then antibiotics are not recommended, but let your family physician determine this. 
·        Antiviral medications are the most effective at the earliest stage. The moment you first feel the symptoms.
·        Consult your family physician for professional advice.
·        Viruses are known to develop resistance to antiviral medicines. Therefore, it is better to play it safe and stay conscious of your environment and the changing weather.
The World Health Organization (WHO) regularly updates its recommendations in the light of the latest research and development in disease prevention and control. Visit www.who.org or www.ced.gov to stay updated of health issues and disease prevention.  This article is written as a public service announce (PSA) on behalf of Lead My World’s academic development department. Lead my World USA’s mission is, “Spread Goodness, It’s worth it”.  For more information, please contact Najam@Leadmyworld.com





Thursday, October 2, 2014

Understanding EBOLA Virus Disease EVD  

A strange virus has appeared but it is no stranger to medical professionals. This is effectively the third major coming of Ebola. It’s shaped like a serpent with Mickey Mouse’s face but this time with a lot more venom, making a mockery of unprepared healthcare professionals as they take on it’s challenge in the battlefield of epidemiology and disease prevention. Ebola first appeared in 1976 in Nzara, Sudan, and in Yambuku, Democratic Republic of Congo. Yambuku is situated near the Ebola River.

Its first appearance did not get Ebola much attention as a major threat to human civilization. Surely, some professionals began their research work but, unfortunately, unless a virus gets a lot of bad press, healthcare professionals cannot do their jobs because, generally, the people who control research and development funds are not scientists, but rather politicians and bureaucrats.  The World Health Organization reported on September 14, 2014 that there is “No early end to Ebola outbreak in West Africa”. This did not make it as headline news in the world media, as usual.  The reported numbers of cases have now reached nearly 2000 with a close to 1100 deaths caused by the virus. By the time we have a handle on this epidemic; the numbers will be staggering and still elevating. The disease has spread from Liberia to Guinea, and Sierra Leone to Nigeria. Along with the World Health Organization (WHO), The Center for Disease Control and Prevention (CDC), UN World Food Program and many other organizations are monitoring and coordinating the efforts to keep the lid down on this fast spreading epidemic that could potentially engulf the World. It’s important to convey the facts surrounding this or any health threat but, more often than not, information gets lost in the translation from Medical Terminology, statistical data, and scientific lingo. Let’s understand what Ebola is;

 Ebola EVD definition by World Health Organization and CDC;

·         Ebola virus disease (EVD), formerly known as Ebola hemorrhagic fever (VHF) is a severe, often fatal illness in humans.
·         EVD outbreaks have a case fatality rate of up to 90%.
·         EVD outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests.
·         The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.
·         Fruit bats of the Pteropodidae family are considered to be the natural host of the Ebola virus.
·         Severely ill patients require intensive supportive care. No licensed specific treatment or vaccine is available for use in people or animals.
·          
Genus Ebola virus is 1 of 3 members of the Filoviridae family (filo virus), along with genus Marburg virus and genus Cueva virus. Genus Ebola virus comprises 5 distinct species:
1.      Bundibugyo Ebola virus (BDBV)
2.      Zaire Ebola virus (EBOV)
3.      Reston Ebola virus (RESTV)
4.      Sudan Ebola virus (SUDV)
5.      Taï Forest Ebola virus (TAFV).
BDBV, EBOV, and SUDV have been associated with large EVD outbreaks in Africa, whereas RESTV and TAFV have not. The RESTV species, found in Philippines and the People’s Republic of China, can infect humans, but no illness or death in humans from this species has been reported to date.

Symptoms

·        Sudden onset of fever, intense weakness, muscle pain. Headache or sore throat with fever.
·        This viral illness is further confirmed by nausea, vomiting diarrhea and skin rash. 
·         Internal and in some cases external bleeding & impaired renal functions are also a symptom.
·        Disorderly platelet counts and elevated liver enzymes, determined by lad tests
·        The incubation period can last between 2 to over 21 days. In other words, in some cases the symptoms may not appear for that long of a period.  



Known Transmission of Disease;

 

·        Ebola is introduced to human through close contact of blood and secretion from human and animals like bats, monkeys and pigs.
·        Contact or transplantation of other bodily fluids of infected organs of human and animals
·        Direct contact between the patients and their care takers through open/ broken skin in mucous membranes.
·        Indirect contact through the environment like the affected personal items of and the body of deceased or living human who have recovered from Ebola can be a potential cause.
·        It has been reported that even 7 weeks after recovery, a person can affect his partner through unprotected sexual contact.

Preventive measures

·        According to the professional opinion of Dr. Stephen Monroe, Deputy Director of CDC, National Center for Emerging & Zoonotic Disease, Ebola does not get transmitted by a casual contact.
·        Avoid sharing needles and sexual contact
·         "Avoid blood transfusion, touching open skin or secretions of the affected persons
·        If you are a caretaker of the patient, take all necessary and professional precautions, using protective gear like gloves and covering face and eyes.
·        EVD is a bio-safety level 4 virus, testing should be done following the protocols of controlled testing environment.
·        Upon the confirmation of diagnosis, healthcare professional should begin the “contact trail” process to further warn, test and protect other possible victims.  Contact tracing protocol mandate that at least 140 people be contacted who were in contact with the patient.
·        Last but not least- Common sense rules. Use good personal and environmental hygiene. Follow health rules not your sentiments when you come in contact with an EVD affected person in the family. Isolation of a patient is a necessary step that has to be taken to protect from spreading the disease.
·        Always keep your health check records and advise people in your sphere of influence the same. Always rely on facts from the professional sources and not the media.
·        For information contact me at the International School of Capital Medical University, Beijing; Najam@ccmu.edu.cn