Author: elenaheath16

The human papillomavirus infection (HPV) is the most common sexually transmitted infection present among the current population. According to the CDC, around 79 million Americans are infected with HPV. There are many different types of HPV, each producing distinctively different symptoms, some more severe than others. The most noticeable symptoms of the infection are warts or lesions that occur at the site of infection, which might be in the genital area, anus, or mouth. However, there are only a few types of HPV that cause these symptoms; most types go relatively unnoticed and do not cause long-lasting effects. It is important to note that warts are not the most serious problems associated with this virus. Several types of HPV are known to cause certain cancers in humans, namely cervical cancers, although anal, penal, and oral cancers can also result from the HPV infection. However, there is a vaccination available to help prevent these more serious types of the virus. It is recommended for adolescents of any gender.

Even though there is a vaccination available to help prevent the majority of cervical cancers, some are still skeptical about giving the vaccination to their child. Some believe that the vaccination is too new, meaning it is impossible to gauge what the long-term effects of the vaccination will be. Others have more personal/religious beliefs for choosing to refuse the vaccine for their children, although this will not be discussed as it is not related to the science behind the vaccine. However, it is important to note that the prevention of HPV-associated cancers is a group effort, meaning that everyone needs to be vaccinated to truly eradicate HPV-associated cervical cancers, which consists of most types of cervical cancer. Some lawmakers are even proposing that the vaccination become a required vaccine; however, this idea is facing quite a lot of backlash, so it is uncertain if this will ever become a reality. Another option to help increase the rate of vaccination, which has proven to be successful in Australia, is providing free, easily-accessible vaccinations for adolescents in school. Ever since Australia enacted this vaccination program, they have experienced a “77% reduction in HPV types responsible for almost 75% of cervical cancer.” In fact, Australia is on track to being one of the first countries to eliminate cervical cancer as a public health threat. This seems like it might also be a good option for the US, as it is still optional, but easier to get, meaning more people will hopefully get the vaccination.

Regarding the claims that the vaccine is too new to be considered safe in the long-term, the vaccination has actually been around for quite a long time and has been rigorously studied and tested to examine its effectiveness and safety. The study for the original HPV vaccination, Gardasil, featured a large sample size of 20,000 females in 33 countries and 4,000 males in 18 countries. The researchers were not testing to see if the participants developed cervical cancer, but if any of the participants showed signs of HPV-caused abnormalities in cells of the cervix, which are known to be precursors of cervical cancer. They found that the original vaccination was almost 100% effective in preventing abnormalities in cervical cells caused by HPV types 16 and 18, which are known to be cancer-causing. They also found that the vaccination was largely helpful in preventing genital warts from forming in both males and females. They found no long-term adverse effects, deeming it a safe and beneficial vaccination.

When antibiotics were first discovered, they were considered to be a “miracle drug,” as they were able to treat previously life-threatening infections. They continued to have this reputation for quite some time and as a result, many new antibiotics were developed during this time. However, as people started to become more aware of how useful these drugs were, more people began to overuse them. This includes, but is not limited to, using antibiotics to treat infections not caused by bacteria, feeding livestock antibiotics, and the misuse of antibiotics prescribed to treat bacterial infections. This overuse has produced a variety of negative consequences related to human health. In general, bacteria that were once effectively treated with “safe” antibiotics are now becoming resistant through advantageous mutations and gene transfer. These drug-resistant bacteria must now be treated using antibiotics that pose greater risks to human health. However, some bacteria are now becoming resistant even to the most potent of antibiotics, earning the name “superbug.”

A bacterium that has become increasingly resistant to traditional, first-line antibiotics is Shigella spp. There are four subgroups of Shigella represented by this broad term, each producing different, yet similar effects in humans. In general, Shigella spp. causes dysentery and is a major public health threat due to its low infectious dose and ease of transmission, especially in developing nations where proper sanitation practices might not be available. Traditionally, Shigella spp. is treated using fluoroquinolones as a first-line defense and cephalosporins and B-lactams as a second-line defense. However, many strains are becoming resistant to these preferable treatment options. The mechanisms behind this resistance are an increase in gene expression for efflux pumps, alterations in cell membrane permeability, and the production of drug-inactivating enzymes. For example, some strains of Shigella spp. may start to decrease the production of porin proteins, which function by allowing different types of substances into the cell. Having a loss of porin proteins slows the penetration of B-lactam antibiotics into the cell, meaning that they become less effective, as it takes longer for the antibiotics to reach their target molecule. Another example is the increasing resistance to quinolones due to an increase in the expression of efflux pumps. Efflux pumps are embedded in the cell membrane and help pump substances out of the cell, namely antibiotics. Having more efflux pumps in the membrane helps to remove the antibiotic at a quicker rate, making it less likely to reach its target molecule and less effective. As mentioned previously, fluoroquinolones are used as a first-line defense in the treatment of Shigellosis, so increasing resistance to quinolones poses a great public health problem. When looking to the future of how antibiotic-resistant strains of Shigella spp. might need to be treated, it will be important to understand how these strains are acquiring this resistance to formulate drugs that possibly target these mechanisms.

As more and more bacterial species are becoming resistant to a variety of antibiotics, research needs to continue on the development of new antibiotics. However, there has actually been a decrease in the amount of research being done on the creation of new antibiotics. This is due in large part to the lack of monetary compensation present in the development of new antibiotics. Due to the pathogenicity associated with these multidrug-resistant bacteria, research is highly expensive to conduct. Even if an antibiotic is discovered and is approved for use, it is not likely that the antibiotic will produce a large profit, as it will only be used for short periods of time and on rare occasions. To try and combat this, different governmental agencies have enacted incentives to promote the development of new antibiotics, but even with these incentives in place, many pharmaceutical companies are pulling projects intended to discover new antibiotics. In fact, between 2000 and 2015, only 5 new antibiotics were added to the market. This is incredibly alarming to hear, as it definitely seems as if bacteria are developing resistance faster than humans are creating antibiotics to combat them. As a result, we are looking towards a possible future of a rise in deaths from once easily treated bacterial infections.

Poliomyelitis is a disease caused by the poliovirus. Most people infected with poliovirus have subclinical infections, meaning that they do not develop noticeable symptoms. This is an important factor to consider when discussing poliomyelitis because it allows for the disease to be spread more rapidly. However, people who do develop symptoms will usually have symptoms that resemble the flu. For example, symptoms might include sore throat, fever, tiredness, nausea, headache, and stomach pain. On rare occasions, people might develop symptoms that affect the brain and spinal cord, such as meningitis, paralysis, and paresthesia. Only people infected with the poliovirus that produces CNS-related symptoms are considered to have poliomyelitis. It is a very contagious disease and spreads through human to human contact. There are two types of vaccines available for polio, which include a live, attenuated vaccine and an inactivated one.

The live vaccine, created by Albert Sabin, is administered orally and is thus termed OPV, oral poliovirus vaccine. This form of poliovirus vaccine has not been administered in the US since 2000, due to a variety of reasons. The biggest and most concerning reason is that the mutated, safe form of the virus given to the patient can mutate in the intestine, where it replicates, and cause disease. In fact, in areas where the OPV is still in use, vaccine-derived poliovirus is sometimes more prevalent than wild-type poliovirus. The reason this form of the vaccine is still in use in these countries is because wild-type poliovirus remains an imminent threat for the people that inhabit those regions. While the inactivated form of the disease does provide similar immunity to the virus as the live form, it does not produce antibodies that can neutralize the viral particles before they infect the cell. This is important as it helps reduce the spread of the disease. People who only receive the inactivated form of the vaccine can still infect others, who are unvaccinated, through their feces or through other forms of direct contact. Another related reason why the OPV is no longer in use in the US is the decreased prevalence of wild-type poliovirus in the US. Health officials decided that the risks associated with the live type version of this vaccine did not outweigh its benefits of decreased risk of spread, which would prove to only be beneficial to countries where the vaccine is not as routinely given or the wild-type version still exists at an extensive level. The other form of the vaccine, which was briefly mentioned above, is the inactivated form of the vaccine, created by Jonas Salk, and termed IPV, inactivated poliovirus vaccine. The one downside to this vaccine is that it requires multiple doses to be the most effective at preventing poliovirus. According to the CDC, it requires three doses to provide 99% immunity. However, they suggest that four doses be given to children starting at two months of age to 6 years of age. This can be a problem if children need to travel to areas more affected by wild-type poliovirus. Although, there are much fewer risks associated with IPV, which is why it is now used in replacement of OPV in the US.

In an attempt to eliminate poliovirus in a global setting, an organization entitled the Global Polio Eradication Initiative was launched. This organization partners with different governmental health organizations to promote vaccine practices that will help to eliminate all forms of the poliovirus, including vaccine-derived polioviruses, which as mentioned above, pose a more serious threat to developing regions than wild-type poliovirus. This means that they are working towards slowly eliminating OPV, so as to replace it with IPV. This is not as simple of a task as it seems though, as the production and manufacturing of IPV are extremely expensive and not a feasible option for developing nations, who often have large populations of children. As a result, researchers have begun to test vaccinations that involve somewhat of a combination of the two vaccinations. The reason IPVs are so expensive to manufacture is that they are created using extremely virulent strains of the vaccine, which pose a great biosafety risk, and are thus expensive to create. Researchers want to create a vaccine that uses less virulent strains of the virus, which are known as Sabin strains, in an inactivated form. However, there is still much more progress that needs to be made before IPV alone can be used to prevent poliovirus in nations where it is endemic.

The human microbiome is a complex and diverse community of microorganisms that offers great contributions to human health and disease, whether that be positive or negative. As soon as a baby passes through their mother’s birth canal, they gain vitally important microbes that will help establish the state of their microbiome, which will persist throughout adulthood. In fact, researchers suggest that by the time a child is three years old, their microbiome largely resembles that of an adult, indicating that the first few years of a child’s life are incredibly important in determining their life-long microbial community. However, it is still believed that the microbiome can be changed in adulthood through certain diet practices, or other environmental factors. Establishing a diverse and well-adapted microbiome is important because an imbalance in the microbiota might be linked to certain health issues. Two articles that discuss either how an imbalance in the gut microbiota is related to an increased risk of certain health issues and how this known imbalance might be used to treat disease will be discussed below.

In a literature review titled “Maternal Microbiome and Metabolic Health Program Microbiome Development and Health of the Offspring,” authors Marta Calatayud, Omry Koren, and Maria Carmen Collado discuss how an infant’s microbiome can be altered through different prenatal and postnatal practices and offers an interesting insight into the many different factors of microbial development. According to the authors, an infant’s predisposition for developing diabetes, obesity, and allergies might be influenced before the baby even passes through the birth canal. These increased risks can be associated with certain prenatal practices, such as diet, stress, or chemical products considered foreign to the body, otherwise known as xenobiotics. For example, through multiple studies it was determined that infants are at a higher risk of developing obesity or other metabolic syndromes if the mother is obese or consumes a high-fat diet during pregnancy, indicating that maternal practices can have an influence on her child’s microbiome. However, the authors conclude that while prenatal practices do impact neonatal microbiome development, postnatal practices, such as how the baby was delivered, whether it was breastfed or not, and other environmental influences, have a larger impact on the microbial community of the child. Although, they both make significant contributions to the child’s future microbiome and predisposition to certain diseases or disorders. 

Researchers have also noticed possible links between autoimmune disorders and an imbalance in gut microflora. However, this does not necessarily imply causation, as researchers have yet to establish a singular, universal idea of what a healthy microbiome looks like. For example, people that live in the US have vastly different microbiomes compared to people in other regions of the world, especially less industrialized regions. One possible reason for this difference in microbial communities is the change in diet more industrialized regions experience. As an illustration, researchers noticed that the westernized diet featured a significant lack of fiber, an important nutrient associated with digestive health. As a result, the microbial community of a U.S. resident usually shows a decreased amount of the bacteria genera Prevotella, a bacteria known to help digest fiber, showing that environmental factors can have a significant impact on one’s microbial community. However, even though causation can not yet be established, knowing that this linkage exists can help researchers develop possible treatments for autoimmune diseases. According to a literature review titled “Immunomodulatory and anti-inflammatory effects of probiotics in multiple sclerosis: asystematic review,” probiotics containing bacteria that are present at reduced levels in individuals with multiple sclerosis might offer a treatment option for forms of multiple sclerosis that are difficult to treat. In multiple studies performed on mice inoculated with an animal model of multiple sclerosis, they found that the mice treated with probiotics had less severe symptoms and a significant delay in the onset of the symptoms than the mice that received no treatment, indicating that the human microbiome plays a dramatic role in the health of an individual and can be manipulated to offer treatment for chronic, autoimmune diseases. Looking to the future of probiotic use for treatment of autoimmune disorders, researchers will need to perform more analyses on a wider variety of microbiomes to establish if missing bacteria are due to a potential autoimmune disorder or if this difference is attributed to environmental factors alone.

As discussed in the previous blog post, the new coronavirus is a respiratory infection characterized by pneumonia-like signs and symptoms, including fever, difficulty breathing, cough, and lesions on the lungs. It was proposed that it was spread via human to human droplet transmission, but that the initial infection was spread to a human by an animal. Researchers hypothesized that the primary reservoir for the virus was most likely a bat, although humans most likely obtained the new coronavirus through a mammal, similar to other epidemic-causing coronaviruses in the past. For example, the coronavirus responsible for the 2002-2003 epidemic, severe acute respiratory syndrome (SARS), was transmitted to humans through a civet cat, which is a mammal. After extensive genomic testing, researchers believe that the animal responsible for initiating the infection in humans is the pangolin, a scaled mammal indigenous to China.

Pangolins are animals with elongated snouts that eat ants. They are currently listed as an endangered species, as their population is relatively low from over-hunting. Their meat is viewed as a delicacy in China and their scales are used in traditional Chinese medicine practices. As a result, it is now illegal to kill pangolins and sell their commodities in China. This is important to know, as the new coronavirus originated in a seafood and meat market in Wuhan, China. Pangolins were not listed in the inventory of items solid in the market, but this could easily be explained through the illegal nature of the activity. Researchers believe that the pangolin could have been the source of infection in humans because they found that the coronaviruses in humans and pangolins were 99% similar through genetic sequencing. They also found that the coronavirus in humans uses receptors with similar structures as the coronavirus in pangolins to initiate infection, indicating that the pangolin might, in fact, be the mammal that first transmitted the coronavirus to humans.

Regarding recent news centered on the morbidity and mortality of the new coronavirus, it has now surpassed the previous epidemic-causing coronavirus, SARS. Currently, over 800 people have died from the coronavirus, with most of these deaths occurring in China. However, there have been two reported deaths occurring outside of China, with one occurring in the Philippines and the other in Hong Kong. In addition, the first US citizen to die from the coronavirus has been reported in Wuhan, China. The number of confirmed infections is now 37,198, however, this number could be higher due to discrepancies in medical reporting. Even though these numbers seem alarming, there has actually been somewhat of a stabilization in the numbers. However, WHO officials suggest that this does not mean that the virus has been contained, as outbreaks can be relatively unpredictable.

Influenza is one of the most prevalent and serious infectious diseases plaguing the U.S. It is a respiratory disease that is characterized by a fever, cough, sore throat, runny nose, muscle aches, and fatigue. It is usually spread via respiratory droplets, meaning it is a form of direct transmission. Droplet transmission is most likely to occur if someone directly sneezes or coughs on you, so avoiding close-quarter contact and implementing good coughing/sneezing practices, are a good way to protect yourself and others from contracting the flu, among other things. Peaking around late fall to mid-spring, the flu is a serious threat in the winter. It affects around 8% of Americans each year, however, this number varies depending on the effectiveness of the vaccine and type of influenza going around that year. It causes the most serious health effects in individuals that are immunocompromised, so adults over 65 years of age, children under the age of 5, and patients with compromising diseases. However, the flu infects more children than any other age group. There are several types of influenza, some causing infection in humans, others not. The two types that commonly infect humans are Type A and B, which are differentiated through their surface proteins.

The current flu season has been characterized as a seemingly normal flu season, with hospitalization rates similar to that of recent years. However, there has been an increase in the morbidity and mortality rates of influenza in children. The possible reason for this increase will be discussed further in the last paragraph, which focuses on vaccine efficacy. The predominant type of influenza circulating this flu season is Type B, specifically the Victoria lineage, with 59.3% of people infected with influenza testing positive for the Type B type. However, interestingly enough, more people tested positive for Type A than Type B in this last week. In particular, they mostly tested positive for the H1N1pdm 09 strain. A few tested positive for the H3N2 strain, which is also Type A. So far, there have been an estimated 22 million flu illnesses, 210,000 hospitalizations and 12,000 deaths from flu, which, as mentioned above, is similar statistics when compared to recent years.

A vaccine for influenza is available and is usually administered at the start of the flu season, which is usually in October. Some complain that the vaccine is not effective, or that every time they get the vaccine, they get the flu. This common complaint is riddled with myths, as the vaccine does not cause you to get the flu. The exact statistics regarding the effectiveness of the 2019-2020 flu vaccine have not yet been published, but according to the CDC, the 2018-2019 vaccine was 29% effective for all ages and all types of flu. While this seems relatively low, any protection against the flu is better than no protection. Getting the flu shot may also help reduce the severity of the symptoms of the flu if you do contract it. One problem that the current vaccine does face, however, is that it is not the best match for the Type B version of the virus, which is a problem considering more people have developed Type B rather than Type A. According to one of the top infectious disease professionals, Dr. Anthony Fauci, the vaccine is only around a 58% match for the Type B virus. This is a particularly important problem because children usually are infected with the Type B virus. This discrepancy may help account for the increase in incidence rates among children. However, Fauci reports that the vaccine is a great match to the H1N1 strain of the virus.

test, submitted 2/2/20 10:30 pm.

In December 2019, a group of people that all visited the Wuhan seafood market developed an infection with pneumonia-like symptoms. After extensive testing and genomic sequencing, researchers determined that the causative agent behind this new disease was a new type of coronavirus. Most coronaviruses are relatively nonpathogenic and are responsible for predominantly respiratory infections, such as the common cold. However, there have been a few other instances of epidemic diseases caused by a coronavirus. These infections, known as severe acute respiratory syndrome coronavirus (SARs) and Middle East respiratory syndrome coronavirus (MERS), were considered to be an epidemic and could be quite dangerous if transmitted to an individual that was immunocompromised. In fact, SARS had a fatality rate of 10%, making it a concern for public health officials. While the new coronavirus is not the same virus as SARS or MERS, it is important to understand the mechanisms of these previous viruses to gain an idea of how the new coronavirus might be contained and treated.

Even though the coronavirus has just been identified, researchers have already discovered multiple different aspects to the disease which might be useful when containing the spread of the disease. For example, researchers now know the bat is the primary reservoir for the coronavirus. However, the bat is most likely not the vector for this disease, as it originated in a seafood market. Researchers believe that this coronavirus was most likely spread through a mammal, as SERS and MERS were originally spread through a civet cat and a camel, respectively. Transmission, however, is not limited to human-animal, as healthcare workers in hospitals where patients of the coronavirus were treated also become infected, indicating that human-human transmission was possible. Researchers believe that this virus most likely is transmitted through direct contact, namely droplet transmission. Thus, when considering methods for infection control, it is useful to adopt good handwashing techniques and proper procedures for sneezing or coughing. The estimated R0 value for the virus is around 1.3 to 2.5. According to a news article written by Ewen Calloway and David Cyranoski, any R0 value above one warrants the use of countermeasures to control the spread of the infection. This means that even though the disease can only be spread through direct transmission, it is still important to partake in infection control protocols, such as quarantining and early identification, to prevent the virus from becoming an epidemic. They also know that the virus is a large, enveloped, positive-strand RNA virus, which is useful to know when formulating a possible antiviral medication to treat the infection.

A few questions have arisen surrounding the virality of the virus. One of these questions is if the virus can be asymptomatic. The answer to this question seems to be yes, as a study conducted amongst a Chinese family found that one of the children, who was infected with the virus, did not show any signs of the disease, which include fever, difficulty breathing, cough, and lesions on the lungs. However, these signs are usually not fatal, as the coronavirus has a mortality rate of 3%, meaning that for every 100 people infected, only three die. As stated above, the people at the greatest risk of developing serious complications after becoming infected are immunocompromised people. If the infection is commonly asymptomatic, this could present many problems for infection control procedures. The coronavirus has a relatively long incubation period of 2 to 11 days, which is long enough for a person to accidentally transmit the virus to someone or spread it to a new, unaffected area.

One of the largest and most prevalent controversies surrounding the medical industry is vaccine use and its consequences. This controversy, sparked by gastroenterologist Andrew Wakefield in his 1998 article published in Lancet, has caused some of the public to reconsider the routine vaccinations given to young children, such as the MMR vaccine. In his article, Andrew Wakefield describes a study he performed that seemingly showed a link between regressive developmental disorder, chronic enterocolitis, and environmental triggers, in which he was referring to the MMR vaccine. According to Lauren Kolodziejski in her article “Harms of Hedging in Scientific Discourse: Andrew Wakefield and the Origins of the Autism Vaccine Controversy,” Wakefield purposely uses this ambiguous tone to imply a certain meaning without explicitly stating this conclusion to avoid criticism. This strategy can be seen when Wakefield states that his research does not imply causation or even an association, yet he gives multiple other examples of research that also implies that MMR vaccines have negative consequences. He also goes on to explain that further research needs to be done on the MMR vaccine before an association can be made, inspiring the controversy that was soon to follow the publication of this article.

There are also numerous problems associated with Wakefield’s research. To start with, Wakefield’s cohort only included twelve participants, which is an incredibly small sample size for a cohort-study. While Wakefield does make sure to state that his research does not indicate an association between the MMR vaccine and regressive autism, to even imply that an association might exist using research conducted with only twelve participants is entirely ridiculous. The participants used in the study were also carefully picked to help influence the results of the study in the direction Wakefield wanted. Wakefield, of course, proposes that his sampling was consecutive, yet a panel found this to be untrue. This diminishes the credibility and reliability of his research. The research also does not feature a control group, which is integral in any type of study, as it establishes that a significant difference does exist. The study also heavily relied on parental observations, which often was not able to be supported through the child’s medical records. A majority of the parents were also not supporters of the MMR vaccine, which automatically renders their observations unreliable and biased. Another large controversy surrounding Andrew Wakefield and his research was the fact that Wakefield failed to discuss where he was receiving funding from. Wakefield was being funded by a group of lawyers representing parents that were engaged in a lawsuit with a manufacturer of the MMR vaccine, which is a clear conflict of interest. 

Immediately following the release of this article, rates of immunization started to significantly lower, as the article sparked a media frenzy. This frenzy most likely occurred as a result of rising rates of autism in children, as parents were curious about the cause of the disorder. While the study and article were incredibly flawed, Wakefield did made sure to state that his research did not imply association. However, when the media covered the article, they used more familiar jargon and provided a much too generalized discussion of the article. Thus, for many parents, it seemed as if the article was a credible source of information when deciding whether or not to vaccinate their children, resulting in an all-time low for MMR vaccinations. In fact, the percentage of children receiving the MMR vaccine in 2003 in the UK was only 80%. With 80% immunized astonishingly below the herd immunity threshold of 95%, measles and mumps outbreaks began to plague countries that had nearly eradicated the disease. However, as researchers began to notice this drop in vaccination rate, they decided to perform other experiments to either refute or back up Wakefield’s implied claims. These researchers, who used larger sample sizes than Wakefield and implemented a more rigorous and credible study, were not able to find any link between the MMR vaccine and regressive autism. As a result, the public started to become more informed on the actual mechanisms and effects of the vaccine, and immunization rates have slowly started to increase again. In fact, in 2016, the Americas considered endemic measles eliminated. However, there are still outbreaks that occur, even in areas that are considered above the threshold of herd immunity. Some propose that this is a result of a waning immunity that occurs as people age. A possible solution that has been suggested amongst the scientific community is a third dose of the MMR vaccine, which is said to decrease the attack rate from 14.5 to 6.7 cases per 1000 population. When considering that outbreaks can still happen in well-immunized areas of the world, it is important to understand that herd immunity alone will not protect unvaccinated children from getting the mumps or measles, meaning it’s entirely important to vaccinate your children even in a region where it is considered eliminated.

Hi, my name is Elena Heath and I am a freshman at UNC-Chapel Hill. I am currently a biology major, but I would like to apply to the nursing program next fall, which is why I am taking this class. I would like to pursue nursing as a career because there are so many different avenues that I could take. An avenue that particularity interests me is the certified nurse anesthetist program. I really enjoy sewing, watching films, and taking my miniature dachshund, Scooter, on hikes.