Author: elenaheath16

Listeriosis is a food-borne illness that is known as being one of the causes of bacterial meningitis. It normally produces mild symptoms in healthy individuals; however, it can be life-threatening if the immune system is compromised. It can also present a problem to pregnant women, as the bacteria can cross through the placenta through their actin tails (Textbook) they formed inside host cells. The mother will usually only have flu-like symptoms and will be fine, but pregnant women infected with listeriosis often experience stillbirths or miscarriages, making it important for pregnant women to avoid foods that might be contaminated with this bacterium. These are most often soft cheeses, cold cuts, or smoked seafood. Listeriosis can be sporadic, but it is also associated with outbreaks if the contamination is sourced from a factory.

Recently, an outbreak of Listeriosis originating from contaminated Enoki mushrooms has affected a few states throughout the US. The companies that sell these mushrooms, H&C Food Inc., Guan’s Mushroom Co., and Sun Hong Foods, Inc. have all issued recalls to warn consumers about the possible contamination. The CDC advises that people that are at a particularly high risk of developing serious complications from listeriosis, to avoid all Enoki mushrooms labeled “Product of Korea,” as they are not yet sure where exactly the contamination originated from and what other brands might be affected. They also suggest that any Enoki mushrooms already bought, should be returned to the retailer or thrown out. It is also important to decontaminate any surface the Enoki mushrooms might have come into contact with to make sure that the bacterium does not spread to other foods.

As mentioned above, Listeriosis is one of the causes of meningitis, a disease characterized by the inflammation of the meninges. In healthy individuals, symptoms will be mild and might include diarrhea, fever, headache, and muscle pain. In immunocompromised individuals, symptoms could be life-threatening and include fever, stiff neck, and head and muscle aches. In fact, the mortality rate of meningitis caused by Listeriosis is around 20-30%. The current outbreak has affected 36 individuals and has killed 4. There have also been 6 cases associated with pregnant women, 2 of which resulted in the loss of the fetus. Thus, it is very important to follow guidelines set out by the CDC regarding this outbreak, especially if you are pregnant or immunocompromised.

Monoclonal antibodies are a form of treatment options for individuals suffering from autoimmune diseases, cancer, or allergies, among other things. They are unique to other antibody treatments in that all the antibodies given to the patient are specific (Textbook) to one epitope on one antigen. Normally, antibody treatments may be specific to an antigen but are not specific to an epitope on that antigen. This allows for greater specificity in whatever disease you are trying to target. Monoclonal antibodies are created in an animal vessel. The animal is injected with the specific antigen researchers are trying to treat so that the animal will make antibodies to it. B cells produced by the animal are isolated and mixed with a form of cancer cell, known as a myeloma cell. These are important because they allow for uncontrolled cell growth and are susceptible to aminopterin, an immunosuppressive drug. The two cells are mixed and incubated on a plate containing aminopterin, forcing the cells to fuse together and become hybridoma cells. The hybridoma cells combine the wanted traits from both cells; the B cell provides the genes necessary for antibody production, while the myeloma cells provide the mechanism for uncontrolled cell growth.

One type of monoclonal antibody, omalizumab, is given to patients who suffer moderate to severe asthma. Asthma, which is a Type 1 hypersensitivity reaction (Textbook), involves spasms of the muscles that line the bronchial tubes and an increase in mucous production. Type 1 hypersensitivity reactions are characterized by IgE antibodies bound to Fc receptors on mast cells or basophils. When these antibodies recognize their specific antigen, they bind the antigen and the mast cells will degranulate, releasing chemicals that induce inflammation. When this type of reaction occurs in the lower respiratory tract, muscle spasms occur, causing the known signs and symptoms of asthma. Omalizumab helps to prevent this reaction by binding to free IgE antibodies, which keeps them from binding to the Fc receptors on basophils and mast cells. As they are bound to an antibody, IgE can not induce the mast cells to degranulate, reducing the number of asthma attacks affected individuals experience. Numerous clinical studies also seem to suggest that a decrease in the amount of free IgE antibodies causes downregulation of IgE Fc receptors on basophils, further preventing future attacks. However, this treatment is meant to be an additional form of therapy for asthma patients, as it is not intended to treat attacks while they are happening, so corticosteroid inhalers are still recommended for use in combination with omalizumab.

As with any immunosuppressive drugs, there are a few serious side effects associated with omalizumab. More serious, but rare side effects include cancer, inflammation of the blood vessels, parasitic infections, and heart and circulation problems. Omalizumab works by binding to IgE, preventing it from exerting its effects. While this is helpful in preventing asthma attacks, it also puts the patient at an increased risk of developing a parasitic infection, as IgE’s main function is to destroy parasitic worms. If the patient lives in an area where parasitic worms are common, the patient should be closely monitored. In a study to see how omalizumab is associated with cancer, researchers found that 0.5% of the participants who were taking omalizumab developed cancer, compared to the 0.2% that were taking a placebo. Researchers explained that the relationship is most likely not causal, especially since the participants developed different types of cancers. However, they did suggest that further research should still be done before a conclusion can be made concerning omalizumab and cancer. Other more common side effects for patients over 12 include leg and arm pain, dizziness, fatigue, skin rash, bone fractures, and ear pain. One other problem that occurs in a very small percentage of patients (less than 0.1%) but needs to be recognized, is anaphylactic shock upon receiving the injection of omalizumab. Because of this, patients are required to be monitored 2 hours after the injection, as this is when anaphylaxis shock is most likely to occur. However, it can still happen up to 24 hours after the injection, so patients might be given epinephrine pens in case this happens.

As a result of the fear of spreading the coronavirus, many countries and agencies have halted their mass vaccination programs in an effort to meet social distancing guidelines. While this is great in the initiative for stopping the coronavirus, this opens up a very serious problem in the eradication of other diseases. In these mass vaccination events, children in developing nations are given vaccinations for measles and poliovirus. Already in many of these countries, outbreaks of measles and poliovirus are commonplace, making the need for vaccination so important. Thus, if mass vaccination programs decide to halt their services, it is entirely likely that citizens of these nations will begin to face an increasing number of serious outbreaks of the virus, pushing the dates of eradication of these viruses way into the future.

Some infectious disease experts even suggest that eradication will never occur unless a better method for vaccination is created. However, this is a problem because funding is often lacking for these projects. For example, a skin patch containing the vaccine for measles was created to help reduce the difficulties surrounding administering the vaccine and make it easier for more children to be vaccinated. However, this project has not really left the ground due to a lack of funding. This will be an important initiative to take because the vaccination has to be prepared and administered by a qualified health care worker, stored in a 2-8℃ climate, and can be expensive to administer. In fact, in the DRC, a nation with mass vaccination programs in place, only 57% of children are receiving the vaccine. For herd immunity to be effective and control the spread of the virus, at least 92-95% of the population needs to be vaccinated. Most children are also only given a single dose of the vaccination, which is more effective than receiving nothing, but the greatest level of immunity is given by a second dose. Considering how infectious measles is, eradication efforts are nowhere near where they need to be to actually eradicate the virus. This is a problem because measles poses significant risks to the population in developing nations. The mortality rate is often around 3-6%, and can even reach 30% in a bad outbreak. Measles also leaves children at risk of a variety of other problems due to clearing of the memory of the immune response.

While it is definitely important to help halt the spread of the coronavirus, especially in nations with underdeveloped healthcare programs, it is important to realize what consequences these actions might impose in the future. In the next year or so, as the coronavirus begins to slow, other dangerous infectious diseases, such as poliovirus and measles, could begin to pick back up. It is understandable why these mass vaccination programs are beginning to stop, but instead of completing pulling these programs, perhaps it could be beneficial to develop other ways to administer these vaccines on a large scale. Otherwise, eventual eradication of these diseases seems almost impossible. If these efforts stop, poliovirus and measles will continue to kill hundreds of thousands of people. In 2018 alone, measles killed an estimated 140,000, which will most likely see an increase due to the pandemic. Thus, it is entirely important to remain aware and continue to make efforts to reduce the effects of these viruses.

An important step towards reducing social distancing guidelines and allowing individuals to return to work is to determine what type of immunity previously infected individuals are gaining against COVID-19. To help figure this complex situation out, researchers and governmental agencies, such as the FDA, are suggesting the use of immunoglobulin tests. These tests determine if the serum of the blood contains antibodies, specifically IgM and IgG, against COVID-19. While this form of testing would not be beneficial in diagnosing, it is helpful to epidemiologists in creating a more accurate picture of how the virus is affecting the overall population. It also helps them gain an idea of what form of immunity is given to individuals that have been infected with COVID-19. This is extremely useful in determining the overall timeline for social distancing.

As mentioned above, these immunoglobulin tests determine if IgM and IgG antibodies against COVID-19 are present in the serum of the blood. IgM antibodies are the first form of antibody to be produced against an infection and are a more general form of protection. They are usually less effective than other antibodies in binding to antigen, but they are important in creating an initial response. Thus, if a person tests positive for IgM antibodies alone, they would most likely be in the initial stages of infection. IgG antibodies, on the other hand, are generally produced a few days after the initial infection, peaking 28 days after. These antibodies provide a more specific and effective response, as they are better able to bind antigen, which is why it takes several days for them to start being produced. Thus, if an individual tests positive for IgG alone, they are most likely in the later stages of infection, or are past the infection period of the virus. These antibodies also have a long half-life, providing lasting infection to the virus. If a person tests positive for IgG, this could mean possible immunity to the virus, at least for a short amount of time. If a person has these antibodies, it is unlikely that they could carry and transmit the virus, due to quick opsonization and phagocytosis of the virus, although there is still much research that needs to be conducted before a blanket statement regarding immunity can be made.

One important factor researchers need to focus on before this “certificate of immunity” can be given to individuals, effectively allowing them to return to their job and society, is how much immunity these antibodies really give. According to leading immunologists, different viruses can be placed on an immunity spectrum based on how long-lasting the immunity to that virus is. On one end are viruses like varicella-zoster, which produce antibodies that provide life-long immunity. At the other end are viruses like HIV, which seem to produce antibodies that have almost zero effect on the virus. By looking at other novel coronaviruses and common cold-associated coronaviruses, it seems that immunity should last for at least a year, but will most likely not provide immunity for longer than a few. The longest known immunity for a coronavirus is 8 years, although it is unlikely that this strain will provide that long of an immunity.

In order for social distancing measures to become less severe, a more effective form of treating COVID-19 needs to exist. There have been several claims made by different scientists/public figures regarding what drug might be able to treat the coronavirus. Here are a few that have been mentioned and what actual scientific evidence there is to back them. Another important method that will be integral in controlling the pandemic is the creation of a vaccine, although this is at least a year or two in the works, so for the time being, only current drugs available will be discussed.

One of the most talked-about potential drug options for COVID-19 is hydroxychloroquine. This drug, which has already been on the market for several years for the treatment of lupus and the prevention of malaria, has shown in multiple studies to block the coronavirus from entering cells. However, there is currently no proof to show that it will help treat the coronavirus in humans. Many trials are being conducted on this drug, but none have yet to produce substantial results. When asked for his opinion on whether hydroxychloroquine could be considered as a treatment option for COVID-19, leading immunologist expert, Dr. Anthony Fauci, stated that “The answer is no, and the evidence that you’re talking about…is anecdotal evidence.” Thus, it’s hydroxychloroquine is a long way from being considered a treatment option for COVID-19.

Another potential drug for the treatment of COVID-19, Remdesivir, shows good potential as a treatment option. Remdesivir, which has been in the works for around a decade now, was initially created as a possible treatment for SARS and MERS, two other infectious coronaviruses that have circulated in the past. It was also thought to be effective against Ebola, although it never got brought into the market because it was not as effective as other antivirals were at treating Ebola. However, researchers hope that this drug might be more effective at treating COVID-19 and have already undergone numerous clinical trials. The results of these trials should hopefully be produced with the next few upcoming weeks.

For many years, researchers have been looking for new, more effective ways to treat cancer. One of these new ways is through the use of genetically altered T-lymphocytes. One type of cancer that might possibly be treated with this new therapy is large B-cell non-Hodgkin lymphoma. Another type of lymphatic cancer, lymphoblastic leukemia, can also be potentially treated using this method, but less will be discussed about this type of cancer. B-cell non-Hodgkin lymphomas are tumors that develop in the lymphatic system. As such a characteristic sign of this cancer is the presence of enlarged lymph nodes, where the tumors often develop. Other signs and symptoms may include abdominal pain or swelling, chest pain, persistent fatigue, fever, night sweats, and unexplained weight loss. The cause of this form of cancer remains relatively unknown, but it is thought to be linked to the production of abnormal lymphocytes, in particular B-lymphocytes. There are forms of non-Hodgkin lymphomas that are caused by T-cells, but this form is not currently treated using T-cell therapy. Researchers suggest that a problem occurs in the body that interrupts the normal life cycle of the B-lymphocytes, prohibiting the old ones from dying in a timely manner. As a result, a build-up of lymphocytes occurs, causing a tumor to form. Researchers are not sure why this happens, although they noticed that this form of cancer occurs primarily in immunocompromised or older individuals, so there may be some link.

As mentioned above, T-cell therapy involves the use of genetically altering T-cells to provide enhancing cancer cell killing ability. This is performed by taking a sample of blood from the patient and separating the T-lymphocytes from the blood. The T-lymphocytes are then taken to a laboratory, where they are genetically modified to have chimeric antigen receptors (CAR), which help the T-cells to better recognize the specific cancer cells they are designed to fight. When the T-cells recognize the antigen on the cancer cell (usually CD19), they become activated and release toxins and cytokines to eliminate the cancer cells. However, this poses a few problems in the body. For example, this massive release of cytokines can cause cytokine release syndrome, which is marked by headache; fever; chills; severe nausea, vomiting, diarrhea; severe muscle or joint pain, shortness of breath, low blood pressure, and fast heart rate. These symptoms have shown to be relatively mild, but they can be life-threatening in severe cases. Some neurological events could also take place after treatment. One of the reasons why this treatment is still used is because it is better at preventing the return of cancer after remission than other forms of treatment, such as chemotherapy or radiation. This is because the CAR-T cells remain active in the body for a prolonged period of time, ready to recognize and activate at any given moment. However, this is also one of the reasons why the side effect can be so severe.

Researchers at the Ludwig Institute for Cancer Research might have found a possible solution to this problem. They suggest that the best possible way to prevent cytokine release syndrome is to genetically alter the chimeric antigen receptors so that they can be inactivated by small molecules. There are three main parts to the chimeric antigen receptor. The external part of the receptor recognizes the antigen. The two internal parts are CD3-zeta, which is necessary for activation, and CD28, which supports the proliferation of the cell. To make the CAR-T cell become able to inactivate, researchers found that they could put the CD3-zeta portion of the receptor on one molecule and the antigen-recognizing portion on another, with a chain that could link the two molecules together and make them functional. If a certain molecule was introduced to the system, it would prevent the two molecules from binding, effectively inactivating the T-cells. Due to the potentially dangerous side effects of this therapy, it seems that the best option would be to restrict use until absolutely necessary, meaning when other treatments have failed. If used as a treatment, it would also be beneficial to implement the molecule-inhibiting option of the CAR-T cells.

March 24 is known as World Tuberculosis (TB) day. Its creation is an effort to make people more aware of what TB actually is and how serious of a problem it is. TB is the leading cause of death of infectious diseases, killing around 1.5 million people last year and infecting a total of 10 million. As a result of the coronavirus pandemic, this year it is expected that around 4 million will die from tuberculosis. In the US, TB is not as prevalent of a problem, making it entirely important for awareness events such as World Tuberculosis Day to exist. The theme for this year’s World TB Day is “It’s Time,” referring to the increasingly important need to end tuberculosis, which officials hope to do by 2030.

Tuberculosis is caused by the bacterium Mycobacterium tuberculosis. Discovered by Robert Koch in 1882, tuberculosis has continued to cause a plethora of problems throughout its discovery. Tuberculosis infects the lungs, and as such causes respiratory-related symptoms, such as cough, fatigue, fever, chills, loss of appetite and weight. A bloody sputum is often produced. However, these symptoms only appear if the infected individual has an active TB infection, meaning that it is actively replicating throughout the body. Tuberculosis is unique in that it can hide inside macrophages, evading the immune response. The immune response can usually keep the bacterium contained and non-replicating, causing a latent infection with no noticeable signs or symptoms. However, in immunocompromised individuals, the immune system is not able to keep the bacteria contained, allowing it to spread and replicate. This is what occurs when a person has an active infection, and can oftentimes be deadly if the bacteria are multidrug resistant or the disease is not caught early enough.

Mycobacterium tuberculosis is a very slow growing bacteria. As such, when treating tuberculosis, it is often necessary to use more than one antibiotic for an extended period of time, such as 6 months or even more. This is to make sure that the bacterium does not develop a resistance to the antibiotics used, as it would be more difficult to randomly produce two separate mutations that make them resistant to both antibiotics. However, more and more strains of tuberculosis are becoming increasingly antibiotic resistant. These strains require the use of even more antibiotics that are oftentimes more costly, more dangerous, and are usually less effective. As treatment of tuberculosis becomes more and more difficult, initiatives are being taken to help further along disease prevention, rather than disease treatment, although disease treatment is still entirely important. These efforts might include more extensive diagnostic testing, isolating infected individuals from at-risk individuals, and making people more aware of what the disease is and how it is spread.

When news first started circulating that the coronavirus might possibly move classes online and restrict access to campus, I, like many others, failed to realize the seriousness behind the upcoming pandemic. At that point in time, I thought online classes would only last a short amount of time and actually had plans to come back to campus because I thought it would be fully functional at the time of my return. A few days into the extended spring break, a friend and I went back to Chapel Hill to pick up a few things from our dorms. When we were getting ready to leave, we received the email that UNC campuses were closing and that we would have to move out. A few hours after I received the email, I was pretty upset about the whole situation. I kept making jokes about how this was an overreaction, about how I should just buy cheap plane tickets to Mexico, really just embodying the “Gen Z” attitude of making light out of everything. Even though this was kind of a selfish attitude to embody, it helped me feel better about losing all the things that I loved that I had gained in college.

After a few days of extended spring break and countless hours of TikTok, it became easier to accept this new situation we were all forced into by knowing that others were also facing a similar situation. I also started to become more aware of how important social distancing was, making it a bit easier to grow more accustomed to the situation. During this time, I kept busy by rewatching a few of my favorite shows on Netflix. I also started watching Narcos on Netflix, which I entirely recommend, if only for its amazing theme song. I also became motivated to start working out more and eating healthier, which I was able to maintain for a few days before I gave up entirely on that endeavor. It is definitely something I would like to get back into after the first week of online classes, which has been actually pretty stressful.

To be completely honest, the first week of online classes did not go as great as I thought it might. Ever since they announced that classes were becoming remotely instructed, I became worried that it would be difficult to keep my attention on my work and not get distracted. I have taken online community college classes before and I was the worst at procrastinating my work to the final due date, which was often Sunday, and having the worst time that day trying to get all my work in order. The first few days went well and I remained fairly motivated. However, as it started getting closer to the end of the week and more and more due dates started popping up, I became a little overwhelmed and started to procrastinate again. I kept getting distracted by niche powerpoint TikToks and Twilight memes on Twitter, of which I have included examples. I am hoping that these next few weeks go a little more smoothly as I start to get more accustomed to this new format.

Actually, I am not able to upload videos with the free account, so here is a link to a niche powerpoint TikTok on why baby Grinch is the best baby character: https://vm.tiktok.com/GumuuW/

What once started off as a seemingly non-threatening, flu-like virus, COVID-19 has radically impacted almost every aspect of the world. Now classified as a pandemic, COVID-19 poses a significant public health risk, causing local and national governments to implement severe, but important restrictions for its citizens. The purpose of this exercise is to limit and slow down the spread of the virus, which can be highly contagious if preventive measures are not taken, such as frequent handwashing, safe coughing/sneezing practices, and avoiding highly congested areas. As mentioned in previous blog posts, COVID-19 presents with symptoms similar to that of the flu, including fever, cough, and shortness of breath. This means that for younger, healthy individuals, COVID-19 will not usually pose a significant risk. However, for older or immunocompromised individuals, COVID-19 can be fatal, which is one of the reasons why it is such a pressing health issue. Another factor important when considering the spread of infection is its relatively long incubation period. According to the CDC, an infected individual may not develop symptoms until 14 days after they initially contracted the infection, meaning that that individual could have been unknowingly spreading the virus for up to 2 weeks. While this infected individual will most likely develop a mild infection and will make a full recovery, they could have easily given it to someone that will not have the immune capacity to defend against the virus. This is one of the main reasons why so many preventative measures are being taken against COVID-19.

The main initiatives being taken to help prevent the spread of the coronavirus are geared towards promoting social distancing. This means that it is recommended for individuals to remain at least 6 feet away from each other at all times. COVID-19 is spread through direct contact and droplet transmission, meaning that when individuals maintain this social distancing, the spread of infection greatly reduces. However, as these efforts are intended to slow the spread of infection, it will take a longer period of time for the virus to circulate out of the public population. This idea of social distancing is not to reduce the overall number of people who get infected, alternatively, it is to keep the number of infected individuals at a manageable rate. In countries where social distancing practices were not implemented in a quick enough manner or were not effective enough, hospitalization rates quickly increased past the capacity level. Healthcare workers ran out of supplies and did not have enough equipment for infected individuals, meaning that the fatality rate of patients would increase. Already in the US, shortages of personal protective equipment, ventilators, and important drugs have been reported. This is incredibly scary to think about, as the US has not even reached the peak of the virus, which is why “flattening the curve” is so important.

Another reason why flattening the curve and social distancing is so important is that there is currently not an effective treatment for COVID-19. When patients are hospitalized for the coronavirus, treatment includes strategies to help relieve the symptoms of the infection. This might include drinking fluids, taking pain relievers, or the use of ventilators to help patients breathe. There is currently no antiviral medication recommended for use for the coronavirus. However, researchers might have a promising antiviral medication in the works. The drug remdesivir was created during the Ebola pandemic; however, it was never approved by the FDA because it was deemed to be less effective than other antiviral medications available. When researchers began testing for medications effective against the coronavirus, they noticed that remdesivir helped to mitigate the symptoms of coronavirus in multiple lab studies. Researchers are now undergoing clinical trials to test if the medication is just as effective in humans. However, it is still unclear when, or if at all, the drug will be approved for the treatment of COVID-19.

Gonorrhea is a sexually transmitted disease caused by the gram-negative bacterium Neisseria gonorrhoeae. This bacterium requires a moist, warm environment, so it will usually only infect and colonize in the mucosal membranes of the genital area, throat, eye, or anus. Given this, the primary method of transmission for gonorrhea is sexual contact. Neisseria gonorrhoeae cannot survive for long periods of time in the outside environment, so transmission is almost directly limited to sexual contact. The symptoms for gonorrhea are often fairly mild, with some not developing noticeable symptoms at all. For men, the symptoms include a burning sensation when urinating, painful or swollen testicles, and a discharge from the penis (white, yellow, or green in color). For females, the symptoms include a burning or painful sensation when urinating, an increased amount of vaginal discharge, non-menstrual bleeding, pain in the belly, and pain when having sex. The people at highest risk for developing gonorrhea are younger individuals who have multiple sex partners, are having sex with an individual with multiple sex partners, or those that have unprotected sex. The risk for developing gonorrhea will also increase if the individual has had a previous case of gonorrhea or another STD.

As gonorrhea is a bacterial infection, it is treated using antibiotics. Traditionally, gonorrhea was easily cleared using penicillin and tetracycline. It did not pose any significant threats to the infected individual if discovered early enough. However, as time progressed and the incorrect use of antibiotics increased, Neisseria gonorrhoeae developed resistance to many of these first-line antibiotics, requiring researchers to consistently develop new methods for treating and controlling the disease. Currently, most cases of gonorrhea are treated using azithromycin and ceftriaxone. However, Neisseria gonorrhoeae will most likely continue to develop increased resistance to a greater number of antibiotics, making it an extremely important item of concern for researchers and public health officials.

As mentioned above, gonorrhea poses little risk to infected individuals if diagnosed early enough and if it can be adequately treated using antibiotics. If, however, gonorrhea goes untreated, it can pose significant risks to the long-term health of that individual, especially in women. When Neisseria gonorrhoeae is left to its own devices, it may not stay contained within the mucosal membranes of the affected area. In both men and women, it may rise from the infected area to cause a more serious problem. For men, the bacterium may rise and infect a tube called the epididymis that carries and stores sperm. This causes the tube to become inflamed in a condition known as epididymitis, which may cause infertility if not treated. The ascension of gonorrhea in women may cause pelvic inflammatory disease (PID), which occurs when the fallopian tubes and uterus are infected. PID is a serious problem because it can result in chronic pelvic pain, infertility, and ectopic pregnancy. Babies born to mothers that have gonorrhea are also at risk for developing serious complications, making it important for every individual to be aware and educated about their sexual health.