When the pressure is on

by wwarby
Conducting Research in Disease Outbreaks:
[Via PLoS Neglected Tropical Diseases: New Articles]

Conducting research in an emergency situation, such as an outbreak of disease, poses ethical challenges. These challenges differ according to the type of research: epidemiologic or clinical, and for the latter, whether the disease outbreak can be anticipated in advance. We address these three situations, proposing different potential solutions for each.

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This is a very nice discussion of what must happen in order to carry out research during a disease outbreak. There are many ethical considerations that are under enormous time pressures. Not everyone really thinks about these beforehand.

Obtaining the proper permission, getting regulatory approval, etc. usually take place in a timeframe of weeks and months. But during an outbreak, minutes can be critical. So there needs to be a process for dealing with these questions. I am sure we will see just how much we have prepared for these processes in the next few weeks.

Technorati Tags: Health

Could flies be the difference?

by Opo Terser
CDC Offers Theories on Disparities in Swine Flu Severity:
[Via Medscape Infectious Diseases Headlines]

The acting director of the CDC offered a handful of theories in a press conference today about why the swine influenza outbreak has produced fatalities in Mexico, but not so far in the United States or elsewhere.
Medscape Medical News
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Things are moving really rapidly. The CDC has gotten new kits out to public health officials to check out flu cases. Lots of work being done to create new vaccines. And some of the anti-virals look like they will be effective.

So, why the difference in severity between cases in the US and in Mexico? The CDC provides some of the obvious ones that are likely to be correct.

But, I wonder about a couple of other, more speculative possibilities. Some officials in Mexico say the vector for spreading the disease is a biting fly from the area. Transfer by insects is not a normal route for transmission of influenza and there are not many papers that examine this possibility.

A paper from 2006 found another strain of influenza (an H5N1 rather than H1N1) in blow flies. A more recent paper detailed the identification of mosquitos carrying influenza virus. So insects can harbor the virus.

Not much work has been done to investigate the ability of insects to transmit the virus. But I wonder if blood-to-blood transmission of the virus by biting insects could increase the apparent virulence of an influenza virus. The virus would get directly into the bloodstream rather than have to get in through the lungs.

I’d feel a lot better if there was some more definitive work on transmission of influenza by blood-sucking insects. I figure we will hear more shortly.

Technorati Tags: Environment, Health