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Maryn McKenna has an unsettling and sobering article at Nature examining the the emergence of carbapenem-resistant Enterobacteriaceae. Since 2002, this large family of bacteria, gram-negative organisms that include many symbionts as well as the gut-dwelling Escherica coli and Klebsiella species that cause hospital infections, are increasingly in possession of a carbapenem-resistance gene rending our best antibiotics useless.
A map of the United States showing states with carbapenemase-producing CRE that promote resistance to carbapenem antibiotics as confirmed by CDC as of September 2012.
Microbial Misadventures is a recurring series on Body Horrors looking at instances and incidents where human meets microbe in novel and unusual circumstances that challenge our assumptions about how infections are spread.
Conjunctivitis is spread through particularly artful and gross means – the contamination of objects with eye gunk, smeared inadvertently hither and thither as a person wrestles with the itchy, gritty misery that defines what is commonly known as pinkeye. Many of us know that infectious diseases inevitably come from someone, some one, but we don’t often know from whom. Conjunctivitis is easy enough for the amateur Sherlock or epidemiologist-in-training – find the disconsolate soul with red, dripping eyes and follow the (sticky) trail.
An illustration of the Hippelates pusio eye gnat. H. pusio derive nourishment from eye secretions and are most prevalent during the warm, summer months. Eye gnats are mechanical vectors in the transmission of species of Haemophilus bacterial organisms that are responsible for causing outbreaks of seasonal infective conjunctivitis. Image: CDC.
“During her hospital stay, a total of 142 larvae were manually extracted, aided by the application of raw bacon which served as an attractant and petroleum jelly occlusion.”
You might be surprised to know that finding interesting articles on infections and infestations is a thankless and occasionally banal job. It is rare, as you find yourself trawling through the dusty and dense annals of Pubmed and Jstor, that you stumble upon a really good paper, the true gold twinkling among the pyrite of multisyllabic articles on viral proteomics, immunology and dull epidemiological trends in diseases. When you discover a treasure that renders you mute, like the one I recently discovered on a screwworm infestation that was wrangled by physicians with processed pork products, it’s like chancing upon a chupacabra in your backyard. The sight is both rare and awful, but also mesmerizing to behold. Also, you need to tell everyone about the chupacabra that you found.
A dorsal view of the New World screwworm fly, Cochliomyia hominivorax, a member of the family Calliphoridae. Adult flies are the size of a housefly with a greenish-blue metallic body color and an orange face. The larvae are obligate parasites of living flesh in warm-blooded animals including humans, and can cause a parasitic illnes known as myaisis. Image: CDC.
Japan is in the midst of a rubella outbreak that has already infected over 5,000 people in just the first four months of this year. Since the early 2000s, the country has undergone cyclical five-year rubella epidemics, with community-wide outbreaks cresting in the spring and summer. But in the past two years the number of infections has surged dramatically from a hundred-odd cases every year into the thousands, and a weird epidemiological pattern has emerged thanks to a quirk in Japan’s vaccination policy in the 1970s: 77% of cases in the rubella outbreak have occurred in men over the age of 20 (1).
A transmission electron micrograph (TEM) showing an assemblage of rubella virions. Image: Dr. Erskine Palmer, CDC.
Rabies is one of mankind’s long-feared diseases. And rightfully so: for centuries, a bite from a crazed, slavering animal was almost always a guarantee of a slow warping of the mind and a pained, gruesome demise. A death sentence.
This past May I had the pleasure to chat with Desiree Schell of the radio and podcast show Skeptically Speaking about how infectious diseases and parasites can shape society for an episode examining the impact of science and medicine on specific communities. Over at their website, you can download the hour-long episode “Community Specific Science” featuring myself, Danielle Lee and Dr. Joe Henrich and hear more about how science journalism and the social sciences are investigating the ways in which the livelihoods and health of certain groups - delineated by ethnicity, culture or religion - are affected by scientific research and medicine. Lee speaks for the first third of the episode on the state of science coverage in media that serves minority audiences, while Henrich finishes the show with his research on cultural outliers, those societies not generally considered Western, Educated, Industrialized, Rich, or Democratic – what Dr. Henrich refers to as WEIRD – and the state of behavioral research.
Earth! Fire! Wind! Water! Heart! “Captain Planet and Planeteers” is a classic of 1990s television and may soon appear on the big screen as a live-action movie. The animated television series featured five earnest teenagers equipped with magical powers fighting eco-villains intent on destroying the ozone, rainforest and the wetlands and guided by the sage wisdom of Gaia, the spirit of Earth, and Captain Planet. Today, the program is recognized for its environmental “edutainment” pitch and the emerald-mulleted, square-jawed appearance of its titular superhero.
Today in The New York Times coverage of a report published yesterday on a Saudi hospital-borne outbreak of Middle East respiratory syndrome released by The New England Journal of Medicine, a potential epidemiological phenomenon was briefly addressed: men have made up the majority of infected cases and the low rates of infection among women may be due to an emphasis on the wearing of the face veil, known as the “niqab,” in Arab culture.
Spears. Bows and arrows. Swords. Guns. Bombs. Drones. Microbes. The evolution of weapons and forms of warfare shadows our technological advancements, from the field of metallurgy to that of microbiology.
A 1942 American propaganda poster derived from President Roosevelt’s “Day of Infamy” speech following the Pearl Harbor attacks. The poster, and other forms of PSAs that followed, are exemplary of the domestic sacrifices asked of Americans in the face of war – even with the possibility of nuclear and biological warfare after WWII. Image: Library of Congress. Click for source.
Parasites and viruses once thought to make their homes exclusively in exotic locales beyond America’s borders are now gaining a foothold in the country and they are exacting significant economic tolls and placing heavy burdens on health care systems. Neglected tropical diseases such as cysticercosis, echinococcus, toxocariasis, dengue, West Nile virus and Chagas have found their way into the country due to a synergistic combination of factors, including globalization, migration, trade and climate change.
Two recent studies that shed light on the inner workings of our bacterial ecosystems, otherwise known as our microbiota, have me musing on the nature of disease and pathology, of harmony and balance.
The Wall Street Journal has a superb write-up of a Nepalese man infected with extremely drug resistant tuberculosis (XDR-TB) who is currently detained at the US border in South Texas. XDR-TB is resistant to four of the major types of antibiotics that are used to treat and control TB infections and this man is the first person with this particularly dangerous strain of TB to cross the border and be quarantined in this country (1).
Just two months ago, I had the distinct pleasure of acting not as a science scholar but as a research participant. Instead of having my face in a book, I willingly offered it to a woman who diligently scraped my forehead in search of Demodex mites. I know that it’s everyone’s humble dream to contribute their own exquisite arachnological flora to Science with an S and so, yes Reader, I can feel your oozing envy.
If you ever find yourself working in an infectious disease laboratory, whether it’s of the diagnostic or research variety, the overarching goal is not to put any microbes in your eye, an open wound or your mouth. Easy enough, right? Wear gloves, maybe goggles, work in fume hoods and don’t mouth pipette. When working with pathogenic bacteria and viruses, priority number one is Do Not Self-Inoculate.
Former Centers for Disease Control (CDC) parasitologist, Dr. Mae Melvin (Lt), examines a collection of test tubes while her laboratory assistant mouth pipettes a culture to be added to these test tubes. Source: David Senser/CDC.
Much of the United States is mesmerized by the belligerent squawks from North Korea’s Kim Jong-un and the volatile tension straddling the Korean peninsula, but I’m more concerned about what is happening in China right now and the troubling trickle of news on a new bird flu strain H7N9.
Hey ya’ll! Welcome to Body Horrors at Discover! My name is Rebecca and I am a microbiologist-epidemiologist-public health scholar, your modern Renaissance lady. For my graduate dissertation two years ago, I began Body Horrors as an experiment in writing about the public health of infectious diseases and parasites – an experiment that is still running today, a carefully cultured organism that’s constantly evolving and growing. I am delighted to have been invited by the lovely people at Discover to join a crew of great science bloggers and to see what becomes of this fanciful blogging organism.
April! We’ve passed the vernal equinox and spring is springing, flowers are blooming, we’re shedding our sweaters and jackets and all will be warm once again. We can put our winter blues to rest and bask in the knowledge that summer will soon be upon us.
One of the hardest questions to answer in an infectious disease outbreak investigation is “Why?”
Why then? Why there? These questions can be almost impossible to answer – not only because of their heady metaphysical nature but also because of the difficulty of assessing the minute interactions between microbe, environment and human host. Public health officials are often left shrugging their shoulders, half-heartedly admitting to an unsatisfied public that they just don’t know and indeed may never know, later drowning their sorrows in dark and smoky bars with cup after cup of the metabolic waste products of unicellular fungi.
An epidemiologist decked out in personal protective equipment (PPE) while conducting field work on the Nipah virus outbreak in Malaysia. Source: CDC, Public Health Image Library.
Everyone has their own collecting quirk. I myself collect animal skulls, inconveniently large earrings and unusual stories of infectious disease cases and outbreaks. To each their own, yes? I’ve decided that, instead of stockpiling these stories away in some recess of my brain, I’ll be sharing them online in a new recurring series on Body Horrors called Microbial Misadventures.
A gram stain of cerebrospinal fluid showing the characteristics rods of B. anthracis. Source: JA Jernigan et al. (2001) Bioterrorism-Related Inhalational Anthrax: The First 10 Cases Reported in the United States. EID. 7(6): 933-44.
Click image for source.
A recently published paper in Scientific Reports has found that climate variability in the form of the North Atlantic Oscillation (NAO) has had a significant impact on the occurrence of disease outbreaks in Europe over the past fifty years. Researchers in France and the United Kingdom studied 2,058 outbreaks occurring in 36 countries from 114 infectious diseases from 1950 to 2009 and found that climatic variations and seasonal changes in air pressure across the continent attributed to the NAO influenced the outbreak occurrences of eleven diseases. Every conceivable route of transmission – by air, food, water and vector – was influenced by NAO conditions.
The year 2018 has recently been declared our new target year for eliminating polio from the world by the World Health Organization, the Gates Foundation and Rotary International. It is clear that the next five years will pose no small challenge; we have spent over 60 years vaccinating millions of children and adults since Salk and Sabin’s discovery of viable polio vaccines, and we have long struggled in particular with three countries where the virus is endemic: Afghanistan, Pakistan and Nigeria.
Photograph of a man receiving the smallpox vaccination by jet gun injector during the Smallpox Eradication and Measles Control Program in Niger, W. Africa in February of 1969. Image: Dr. JD Millar/CDC.
This week, I was honored with a Best Life-In-Science Award from ScienceSeeker for my article on the earliest known cases of HIV/AIDS, “The Sea Has Neither Sense Nor Pity: the Earliest Known Cases of AIDS in the Pre-AIDS Era.” There were some serious heavyweight contenders in this inaugural contest and I am beyond delighted that this fascinating story was recognized. It’s nice to be acknowledged (and rewarded!) for work that is largely spent in loud cafes while drinking bitter espresso long gone cold and staring helplessly at my computer keyboard. Thank you to the judges - Fraser Cain, Maggie Koerth-Baker, and Maryn McKenna and to ScienceSeeker for this distinction and award. 
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Microbial Misadventures is a recurring series on Body Horrors looking at instances and incidents where human meets microbe in novel and unusual circumstances that challenge our assumptions about how infections are spread.
I am partial to the odd tipple and, as a resident of the licentious, enabling city that is New Orleans, I’m fortunate to be adequately supported in my booze-seeking ways by the high number of bars and restaurants within stumbling distance of my front porch. But what to do for those of us prohibited from indulging in one of the world’s greatest mood modulators, for those of us, say, incarcerated in America’s prison-industrial complex? In that case, American ingenuity and tenacity wins, always: become a smalltime craft brewer and make your own.
A Gram stain of Clostridium botulinum type A. The spore-forming, soil-dwelling bacterium produces a nerve toxin, causing the rare, paralytic illness known as botulism. There are seven types of botulism toxin, classified alphabetically A through G; only types A, B, E and F cause illness in humans. Image: CDC/ Dr. George Lombard.
It is the 161th birthday of the German microbiologist Julius Richard Petri, whom we can thank for those low-tech but indispensable tools of the microbiology lab: the petri dish. Google honors Petri‘s birthday today with their lovely Google Doodle riffing on his invaluable discovery.
The Google Doodle for May 31, 2013 in honor of Julius Richard Petri. Image: Google.
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