Wednesday, September 4, 2013

The Never Ending War on Pathogens

The war on emerging pathogens isn’t like any others. The war on drugs might well end with a new approach. The war on terrorism might eventually wind down. But the war on emerging pathogens is different. It will never end.
Morens and Fauci wrote: “While it has become possible to eradicate certain infectious diseases (smallpox and the veterinary disease rinderpest), and to significantly control many others (dracunculiasis, measles and polio, among others), it seems unlikely that we will eliminate most emerging infectious diseases in the foreseeable future.”
In “Emerging Infectious Diseases: Threats to Human Health and Global Stability,” published by PLOS, the authors from the National Institutes of Health paint a serious, if not scary, picture that the world faces from emerging pathogens: “The inevitable, but unpredictable, appearance of new infectious diseases has been recognized for millennia, well before the discovery of causative infectious agents.
The ease of world travel and increased global interdependence has made it more complex to containing these infectious diseases that affect not only the health but the economic stability of societies.”
Not all emerging pathogens will use food and waterborne transmission sources, but enough do to make emerging pathogens every bit as important a food-safety issue.
Emerging pathogens includes any bacteria, virus or parasite that, through rapid mutation, overwhelms human defenses to cause illness or death. E. coli O157:H7 was an emerging pathogen for the 20 years before it busted out and began causing dozens of outbreaks each year. A new Pathogen E coli Oio 4:H3  hit Europe last year killing 50.
And, just like then, there is now a new list of emerging pathogens being tracked by the National Institute of Allergy and Infectious Diseases. Pathogens that have been newly recognized in the past two decades are: Acanthamebiasis, 
Australian bat lyssavirus, Babesia, atypical, 
Bartonella henselae, 
Ehrlichiosis, Encephalitozoon cuniculi, Encephalitozoon hellem, 
Enterocytozoon bieneusi, Hendra or equine morbillivirus, 
Human herpesvirus 8, 
Human herpesvirus 6 and
Parvovirus B19. And those on the re-emerging list include Enterovirus 71, Clostridium difficile, 
Mumps virus, Streptococcus, Group A 
and staphylococcus aureus.
Acanthamebiasis is found in freshwater and soil, Australian bat lyssavirus is a lot like rabies, and Babesia is a blood parasite. As for the re-emerging pathogens, a vaccine could eliminate mumps, but doctors tell patients they may not ever shake Clostridium difficile, which is often acquired during hospital stays.
Yet for thousands of scientists that work on emerging pathogens, both at the elite institutions and on research campuses across the country, most of the research sounds fairly normal. Take Dr. Anita Wright’s research, for example.
She is an associate professor at the University of Florida’s Emerging Pathogens Institute. Wright is among those in academia working to help the oyster industry in Apalachicola, FL, in the aftermath of hurricane Katrina.
Her research involves the species of Vibrio that makes people sick when they eat raw or undercooked oysters. Wright is looking for a post-harvest treatment for reducing or eliminating Vibrio without killing the oysters. She is also working with oysters in their natural estuarine habitat to find out how Vibrio infects shellfish in the first place.
Some astounding research occurs at these institutions, and it often goes virtually unnoticed. For example, after 9/11, the virus that caused the flu pandemic of 1918 was right up there with smallpox and anthrax as possible biological agents that could be weaponized.
But that’s not been a concern since 2009 because the annual flu vaccine now protects against the virus that killed 675,000 Americans in 1918, thanks to the work of Adolfo Garcia-Sastre, the institute director at Mount Sinai.

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