Could Yellow Fever Return to the United States?

Peter Hotez and Kristy Murray from Baylor College of Medicine highlight the potential for yellow fever to return to the southern cities of the United States

Endemic regions of yellow fever in Africa (Image Credit: CDC)

Endemic regions of yellow fever in Africa (Image Credit: CDC)

In the summer-fall of 1878 an epidemic of yellow fever destroyed the city of Memphis, Tennessee.  Likely introduced into the Caribbean by trade from the West Coast of Africa and later brought up the Mississippi River by a steamer ship (the Emily B. Souder) with sick and dying sailors, yellow fever killed an estimated 5,000 Memphis residents, almost one-third of its population who did not flee the city that August [1].   According to Molly Caldwell Crosby in her detailed account, the summer-fall 1878 yellow fever epidemic in the Mississippi Valley was possibly “the worst urban disaster in American history” [1].

Among the factors responsible for the 1878 tragedy were an unusually warm winter and spring that year, which helped Aedes aegypti mosquitoes  to flourish in the Mississippi Valley, together with a lack of adequate urban drainage and a functioning sewer system, and a susceptible (non-immunized) population – the yellow fever vaccine would not be developed for another 50 years.
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Category: General, Neglected Diseases | 1 Comment

This Week in PLOS NTDs and PLOS Pathogens: New Insights Into P. vivax Genome, How Viruses Protect Themselves Against RNA Decay Machinery, Imaging Schisotosomiasis Eggs with Cell Phone Cameras, and More

The following new articles are publishing this week in PLOS NTDs:

Hester J, Chan ER, Menard D, Mercereau-Puijalon O, Barnwell J, et al. (2013). PLoS Negl Trop Dis 7(12): e2569. doi:10.1371/journal.pntd.0002569

Hester J, Chan ER, Menard D, Mercereau-Puijalon O, Barnwell J, et al. (2013). PLoS Negl Trop Dis 7(12): e2569. doi:10.1371/journal.pntd.0002569

P. vivax malaria is poorly understood as the parasite is difficult to study in vitro. In this study James Hester and colleagues use sequence data generated from a field isolate to reconstruct long DNA sequences without relying on the reference genome, revealing many P. vivax DNA sequences that are absent from the reference genome and contain 792 predicted genes. One of these novel genes encodes a predicted protein similar to known Plasmodium proteins involved in red blood cell invasion.

There is a need to develop diagnostic methods for parasitic infections specifically designed for use in resource-deficient situations, and with the proliferation of mobile phones, data transfer networks and digital imaging the stage is set for a new era of field microscopy. Here Ewert Linder and colleagues aim to show, as proof of concept, that it is possible to achieve point-of-care diagnostics by an inexpensive mini-microscope for direct visualization on a display and remote diagnostics by computer vision.
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PLOS & DNDi launch a new Collection celebrating a Decade of Open Access and NTD R&D

In the second post in celebration of the 10th Anniversaries of PLOS and the Drugs for Neglected Diseases initiative (DNDi), PLOS Medicine Senior Editor, Rhona MacDonald, discusses the new PLOS Collection highlighting the valuable work of DNDi published in PLOS throughout the years.

This special DNDi anniversary will also be celebrated at the Institut Pasteur from the 4th December.

As part of a collaborative initiative, PLOS and the Drugs for Neglected Diseases initiative (DNDi) are delighted to launch a special Collection—PLOS & DNDi: a decade of Open Access and Neglected Tropical Diseases R&D—to coincide with a joint event at the Institut Pasteur in Paris celebrating the 10 year anniversary of DNDi.

Tsetse Fly (Top Left): Tam Nguyen, Wikimedia Commons; Hand (Top Right): cosmo flash, Flickr; Petri Dish (Bottom Left): Microrao, Wikimedia Commons; Hookworm (Bottom Right): CDC’s Public Health Image Library, Wikimedia Commons.

Tsetse Fly (Top Left): Tam Nguyen, Wikimedia Commons; Hand (Top Right): cosmo flash, Flickr; Petri Dish (Bottom Left): Microrao, Wikimedia Commons; Hookworm (Bottom Right): CDC’s Public Health Image Library, Wikimedia Commons.

In addition to being the same age, PLOS and DNDi have much in common. Both organisations have broken convention, both have pushed boundaries, and both have successfully combined the pursuit of quality scientific research and its publication with a strong advocacy.

In a recent blog, DNDi describe their history and their drive to prioritise the R&D of neglected diseases by putting it on the international health agenda and by facilitating networks of scientists from around the world. DNDi has shown that a new model in which public and private actors share knowledge and work together towards a common purpose can work.
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Category: MSF, Trachoma | Comments Off

This Week in PLOS Medicine: Insufficient Antimalarial Dosing in Children, Completeness of Trial Reporting, and Increases in Journal Retractions

This week PLOS Medicine publishes the following new articles:

Image credit: Karunakar Rayker, Flickr

Antimalarial drug resistance has hampered malaria control programs for almost 60 years. A key factor in combating this threat is to ensure that all antimalarial drugs are deployed in a way that ensures that the maximum number of patients are completely cured. Ric Price and colleagues pool individual patient data from efficacy trials coordinated by the WorldWide Antimalarial Resistance Network (WWARN). The results show that, while treatment of malaria with dihydroartemisinin-piperaquine generally results in excellent patient recovery, young children are at higher risk of treatment failure and this may be due to their receiving an insufficient dose of the drug. The study also highlights that one third of children aged 1–5 years received a dose of piperaquine below that recommended by the World Health Organisation. Furthermore, patients receiving a lower dose were slower to respond to treatment and had a greater risk of getting malaria again. In a linked Perspective, Paul Garner further discusses dosing issues for artemisinin combination therapy.
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Is the Global Fund Heading Backwards on Access to Medicines?

Suerie Moon from the Harvard School of Public Health warns against falling back on stale solutions for ensuring access to essential medicines. 

For nearly a decade, a bright spot on World AIDS Day has been steady growth in the number of people in developing countries accessing lifesaving HIV treatment, which increased 40-fold from 2002-2012. But this year, Board discussions at the Global Fund to Fight AIDS, Tuberculosis and Malaria have set off alarm bells about a potential retreat from the time-tested pro-generic policies that enabled such progress. At issue is a proposed “blue-ribbon Task Force” on tiered-pricing of medicines for middle-income countries (MICs), spearheaded by the Global Fund together with the GAVI Alliance, UNDP, UNICEF, UNITAID, and the World Bank.

Data sources: UNAIDS and MSF (http://utw.msfaccess.org/)


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Category: General, HIV | 3 Comments

Less Neglect, More Openness: Two ‘Grand Experiments’ in Health Innovation

Commemorating the 10th Anniversaries of PLOS and the Drugs for Neglected Diseases initiative (DNDi), Bernard Pécoul, Executive Director of DNDi, discusses the innovative journeys of the organisations.

This is the first of two posts which will culminate in a new PLOS Collection launching on December 4th, highlighting the valuable work of DNDi published in PLOS throughout the years. This special DNDi anniversary will also be celebrated at the Institut Pasteur from the 4-5th December.

Tsetse Fly (Top Left): Tam Nguyen, Wikimedia Commons; Hand (Top Right): cosmo flash, Flickr; Petri Dish (Bottom Left): Microrao, Wikimedia Commons; Hookworm (Bottom Right): CDC’s Public Health Image Library, Wikimedia Commons.

Tsetse Fly (Top Left): Tam Nguyen, Wikimedia Commons; Hand (Top Right): cosmo flash, Flickr; Petri Dish (Bottom Left): Microrao, Wikimedia Commons; Hookworm (Bottom Right): CDC’s Public Health Image Library, Wikimedia Commons.

For those of us who experienced first-hand what it meant as doctors, working in very remote areas of developing countries, to be simply unable to appropriately treat patients with life-threatening conditions, the anger we felt at the dearth of R&D a decade ago changed us and led us to act, notably through the MSF Access Campaign. In 2001, a publication that analysed a 25-year period (1974 to 1999) showed that only 1.1 % of new drugs were approved specifically for neglected diseases, and this against the background of a global disease burden of 12%. In the neglected disease R&D community we referred to this as the ‘fatal imbalance’, rooted in market and policy failures. The foundations of DNDi and PLOS – two ‘experiments’ in innovation initiated 10 years ago – were part of what we can call today, with hindsight, a paradigm shift.
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PLOS Medicine & MHTF issue Call for Papers: ‘Integrating Health Care to Meet the Needs of the Mother–Infant Pair’

This week, PLOS Medicine and the Maternal Health Task Force (MHTF) at the Harvard School of Public Health announce the third year of an Open Access Collection on maternal health by issuing a call for papers on the theme, Integrating Health Care to Meet the Needs of the Mother–Infant Pair.

Image credit: Jack Zalium, Flickr

Image credit: Jack Zalium, Flickr

The Year 3 Collection builds on the successful first and second years of collaboration between the MHTF and PLOS. In the first year, the Quality of Maternal Health Care Collection included 18 original articles and the second year’s Collection, Maternal Health Is Women’s Health, to date comprises 30 original articles.

In a joint editorial, the MHTF team and the PLOS Medicine Editors state: “This year, under the theme, Integrating Health Care to Meet the Needs of the Mother–Infant Pair, we aim to strengthen the evidence for approaches to providing integrated care from pre-conception, throughout pregnancy, childbirth, and the postnatal period, to the child’s early days and years of life.
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Category: Collections, Maternal Newborn and Child Health | Comments Off

This Week in PLOS Medicine: Maternal Health Collection, Pharmaceutical Industry, Burden of the 2009 Influenza Pandemic, & Poverty and HIV Stigma

This week PLOS Medicine publishes the following new articles:

Image credit: Jack Zalium, Flickr

The Maternal Health Task Force (MHTF) and PLOS Medicine issue the call for papers for Year 3 of the MHTF-PLOS Collection: Integrating Health Care to Meet the Needs of the Mother–Infant Pair. The MHTF-PLOS collaboration is looking for research and commentary papers that fit the theme. All papers should be submitted to PLOS Medicine, with a clear statement in the cover letter that they are intending to submit to the MHTF-PLOS Collection.

In a systematic review of 15 studies of interactions between non-physician clinicians and industry, Quinn Grundy and colleagues found that many of the issues identified for physicians’ industry interactions exist for non-physician clinicians (Registered Nurses, advanced practice nurses with prescriptive authority, physicians’ assistants, pharmacists, dieticians, and physical or occupational therapists). Most non-physician clinicians across disciplines held favorable views of interactions with sales representatives and industry interactions in general. A minority perceived that industry marketing influenced their own practice, but more felt their colleagues would be influenced. Preparation for industry interactions generally was not a part of professional training.  In a related Perspective, James Yeh and Aaron Kesselheim discuss the steps needed to address the conflicts of interest posed by contact between non-physician providers and the medical products industry. They suggest that because current programs intended to provide transparency about the prevalence of pharmaceutical industry marketing may not reach the non-physician clinician population, institutional policies should be constructed to apply to all providers of patient care.
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This Week in PLOS NTDs and PLOS Pathogens: NTD Elimination in a Shifting Policy Landscape, the Biology of Microbial Amyloids, Duplication of the Duffy Binding Protein Gene in P. vivax Strains

The following new articles are publishing this week in PLOS NTDs:

Hufnagel DA, Tükel Ç, Chapman MR (2013). PLoS Pathog 9(11): e1003740. doi:10.1371/journal.ppat.1003740

Hufnagel DA, Tükel Ç, Chapman MR (2013). PLoS Pathog 9(11): e1003740. doi:10.1371/journal.ppat.1003740

The concept of NTDs was established in the aftermath of the Millennium Development Goals. Here, Dr. Peter Hotez summarizes the emergence of several new post-2010 global health documents and policies, and how they may alter the way we frame the world’s major NTDs since they were first highlighted. These documents include a new Global Burden of Disease Study 2010 that identifies visceral leishmaniasis and foodborne trematode infections as priority diseases, a London Declaration for access to essential medicines, and a 2013 World Health Assembly resolution on NTDs.

Over the past five years, researchers are reporting with increasing frequency that Duffy-negative individuals are infected with P. vivax, raising new questions as to how P. vivax infects the red blood cells when the Duffy blood group antigen is not available. In this paper Didier Menard and colleagues show that the parasite’s Duffy binding protein gene has been duplicated in multiple P. vivax strains, especially at high prevalence in Madagascar.
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Category: General, HIV, Malaria, Vectors | Comments Off

This Week in PLOS Medicine: AIDS Treatment in Children, Influenza Vaccination Strategies, Patient Safety, and Antimicrobial Resistance in China

This week PLOS Medicine publishes the following new articles:

Image credit: NIAID

Image credit: NIAID, Flickr

Using observational data collected in cohort studies in Southern Africa, Michael Schomaker and colleagues estimate the mortality associated with starting Antiretroviral Therapy (ART) at different CD4 thresholds among children aged 2–5 years. Recent changes to World Health Organization guidelines for starting anti-AIDS drugs in young children are unlikely to improve death rates but may increase the numbers of children receiving ART by simplifying access to treatment. The findings suggest that, among southern African children aged 2–5 years at HIV diagnosis, there was no difference in three year death rates between children in whom ART was started immediately and those in whom starting ART was deferred until their CD4 count and percentage (markers of progression of HIV infection) fell below 750 cells/mm3 and 25% respectively.
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