World Antibiotics Awareness Week

The first World Antibiotic Awareness Week 16 to 22 November 2015 aims to encourage best practices among the general public, health workers, policy-makers and the agriculture sector to avoid the further emergence and spread of antibiotic resistance.
The theme of the campaign, Antibiotics: Handle with Care, reflects the overarching message that antibiotics are a precious resource and should be preserved. They should be used to treat bacterial infections, only when prescribed by a certified health professional. Antibiotics should never be shared and the full course of treatment should be completed – not saved for the future.
This information has been included in a short film by the WHO:

What you can do to stop the spread of antibiotic resistance:

1. Only use antibiotics when prescribed by a certified health professional
2. Always take the full prescription, even if you feel better
3. Never use left over antibiotics
4. Never share antibiotics with others
5. Prevent infections by regularly washing your hands, avoiding contact with sick people and keeping your vaccinations up to date.

 

More Edible Plants

Humans use only a mere 200 species of plants for food purposes. This is very meager compared to the possibly 300,000 edible plants, of an estimated 400,000 of the Earth’s plant species. John Warren described the use of these few species of food crops in his book ‘The Nature of Crops: how we came to eat the plants that we do’. This book was published in April 2015 and describes a journey through human history with crop plants. John Warren, Director of Learning and Teaching at Aberystwyth University, writes stories about 50 crops, including cereals, spices, legumes, fruit and ‘cash crops’ such as chocolate, tobacco and rubber. 

I have not actually counted all the plant species that I ate. Imagine trying to write down a list of every plant or part of plant that you ate in your whole life! No problem starting, wheat that was used to make my pasta that I had for dinner tonight, tomatoes that were in the sauce, some garlic and courgette to go in the sauce and some strawberries for dinner. But it would be near impossible to try and figure out if you’ve ever had more than a few of the 10,000 species in the cereal family. And no with that I do not mean Kellogg’s, Fruit-Loops or All-Bran!

According to Wikipedia (the source of all knowledge) only 15 crop plants provide 90% of the world’s food energy intake. I can’t seem to find the source of that information, but the ten staples that feed the world are listed on this page and include maize (corn), rice, wheat, potatoes, cassava, soybeans, sweet potatoes, yams, sorghum and plantain. Except for those last two, I have actually eaten all of them, so I’ve got about 185 more species to go through. Bonne appétit!

Biolace - where science meets art

What if the plants which grow your food also produce the clothes that you wear? Welcome to the world of biodesign.

Strawberry Noir (Fragaria Fusca Tenebris). 

Produces black strawberries with high levels of anthocyanin and Vitamin C, 

and black lace doilies for the fashion market. (C) Carole Collet

This is the field of research in which professor Carole Colett operates. Carole Colett is professor in Design for Sustainable Futures and Director of Design & Living Systems Lab as well as a pioneer of the Textile Futures discipline at Central Saint Martins. Her research focusses on biodesign, biofacturing and high-tech sustainability.

One of her projects is called "Biolace" (2010-2012) which is currently  listed as a fictional project but which might well become reality in 2050. "Biolace" is a series of four plants which are presented in a so called hyper-engineered state. The Strawberry Noir, Bsil n 5, Tomato Factor 60, and GoldNano Spinach plants are shown with an intricate lace pattern as roots. Not only are they aesthetically pleasing, they are also a 'green' alternative to the current textile factories. The plants require only water and sunlight and can create these beautiful lace trimmings for high-end fashion items. What's not to like about them? In her video on Biolace, Design and Biofacture, Horizon 2050, Collett explains the motives and ideas behind this work.


Collet's work is not only beautiful to look at, it also want to encourage the discussion on genetic modification and engineering. How far is ‘too far’ when it comes to controlling living organisms to our benefit? What happens when these plants become a reality? Synthetic biology is well on its way so create new traits in plants and even animals. It is really not that far a leap to these lace doilies made of strawberry roots.
 

Outsmart Ebola Together

Outsmart Ebola Together – a collaboration project using idle computers to search for compounds to cure Ebola

The World Community Grid, a volunteer computing platform developed by IBM that uses the idle computer time of internet-connected computers to perform research calculations, has teamed up with the Scripps Research Institute to help find chemical compounds to fight Ebola Virus Disease.

The aim of this collaboration project called ‘Outsmart Ebola Together’ is to find drugs with high binding affinity with certain of the Ebola virus’ proteins, which can then block the crucial steps in the life cycle of the virus. Currently two targets have been identified: a surface protein used by the virus to infect human cells, and "transformer" proteins which change shape to carry out different functions.

Deadly pathogen

The Ebola virus is a member of the filovirus or Filoviridae family and is shaped like a long, flexible filament. This filament can attach itself to cells and penetrate the cells. The virus then uses the host cell’s mechanisms to replicate itself after which numerous copies of the virus are then released to further infect nearby cells. The result of this repeat infection and replication results in clotting of the blood, leakage from blood vessels, inflammation, organ failure and shock. Infection only occurs by contact with an infected person’s bodily fluids or the body of patient who died from the disease. The virus cannot be transmitted through the air or water. Other members of the filovirus family are Marburg, Sudan and Reston viruses, which are all very virulent and deadly pathogens. These four viruses all have caused outbreaks in 2014 in Africa and Asia (animals only). The Ebola virus has infected over 15,000 people and killed at least 7,500 in West Africa (data of WHO), representing a case-fatality rate of 36%. 

Therapeutic agents under consideration

Currently there are no treatments or vaccines available, but numerous research projects are ongoing, esp. since the 2014 outbreak. This has been confirmed by Marco Cavalari, head of Anti-infectives and Vaccines at the European Medicines Agency (EMA). The EMA has reviewed several potential treatments for Ebola in order to have an overview of data from these treatment and to support decisions on potential emergency use for individual patients. However, they found that evidence for safety and efficacy of the included treatments (which were selected as they have direct virus activity) was not yet sufficient to draw any conclusions.  The therapeutic agents considered by the EMA were three nucleos(t)ide polymerase inhibitors (BCX4430, Brincidofovir and Favipiravir), two oligonucleotide based products (TKM-100802 and AVI-7537), a cocktail of monoclonal antibodies (ZMapp) and polyclonal immunoglobelins derived from immunized horses (Anti-Ebola F(ab’)₂ fragments). These potential treatments are all based on newly developed compounds or compounds currently registered for treatment of other viruses. The WHO has confirmed that two vaccines are in safety trials for use in Ebola affected countries.

Millions of candidate drug molecules

The Outsmart Ebola Together project of the World Community Grid and the Scripps Research Institute however uses a different approach as it is screening the structures of millions of known candidate drug molecules (ligands) against the atomic structure of the target Ebola virus molecule (targets). This screening by using computers, called in-silico screening, uses specific software developed by the Olson Laboratory at the Scripps Research Institute. The target and ligand are evaluated with regard to binding affinity between the molecules. Such screening is traditionally done in a laboratory using test tubes and actual chemicals which have to synthesized first is sufficient quantity, a very laborious and costly business. The screening can however also be done by using software in which the structures of the target and ligands are analyzed and will result in the binding affinity value. The Scripps Research Institute has already solved the structures of the  critical target proteins of the virus and converted these to molecular images. Two of these targets have been identified for inclusion in the Outsmart Ebola Together collaboration project.

Transformer protein

The first target is a surface protein on the Ebola virus that is responsible for injection of new human cells. This target protein is similar for Ebola, Marburg, Reston and Sudan viruses so it could potentially lead to a drug effective against any of these viruses. The second target is a so called shape-shifting ‘transformer’ protein of the Ebola virus, which adopts different forms at different times of the virus lifecycle to achieve different functions.

If a suitable candidate drug molecule, based on a high binding affinity with the Ebola virus protein, has been selected, this can then be tested in the lab. Additional trials will then be necessary to optimize the compound and find a suitable formulation of a drug product. All results from the Outsmart Ebola Together project are shared so that other scientists around the world can use this data as well in their own research to find a cure Ebola. The Scripps Research Institute in La Jolla, California, USA is a non-profit research institution which is on the forefront of such ‘open source’ research in the biosciences. 

On 30 December, the project had already ‘run’ for 132 years, 155 days and 16 hrs, generating 193,870,193 points and returned 491,434 results. This is only 1% of the project. You can help the researchers by donating your computing power to this project. Anyone with a computer, smartphone or tablet can donate their unused computing powder to scientists by installing an application on these devices which runs when they are not using the full capacity of their computer. By connecting all these computers, the World Community Grid is essentially a virtual supercomputer, using its computational power for humanitarian research. Other projects include the Clean Energy Project and the FightAIDS@home project.

Solution to resistance - a lesson in chirality

Jørn Bolstad Christensen, a chemist from the University of Copenhagen has obtained a patent for a drug that can make previously multidrug-resistant bacteria once again responsive to antibiotics. Christensen, together with doctors Jette Kristiansen from the University of South Denmark and Oliver Hendricks from the King Christian X’s Hospital for Rheumatic Diseases in Gråsten, Denmark, discovered that Thioridazin, an antipsychotic drug, was able to kill bacteria without any noticeably harmful effects upon humans.

Thioridazin, who’s chemical name is 10-{2-[(RS)-1-Methylpiperidin-2-yl]ethyl}-2-methylsulfanyl phenothiazine was registered as an antipsychotic drug and used in the treatment of schizophrenia and psychosis, but has also been reported to have antibacterial properties. Due to the many side effects and cardiotoxicity, the drug Thioridazin has been withdrawn from many countries and is no longer used for treatment of schizophrenia and psychosis. The Thioridazine as included in the antiphychotic drug is a so called ‘racemic mixture’, the combination of 50% (S)-thioridazine and 50% (R)-thioridazine. The (S) and (R) indicate the two enantiomers or ‘mirror images’ of each other. Dr Ruben Thanacoody, a physician at the Royal Infirmary Edinburgh, discovered that it was the R-Thioridazine which was responsible for most of the anti-psychotic activity, but that both R- and S-thioridazine were capable of inhibiting bacterial growth. This was further substantiated by the study from Christensen. Hence the idea was born to isolate the separate S-thioridazine and use this as an antimicrobial agent.

(S)-Thioridazine’s own antibacterial properties are not that spectacular, but other researchers from the University of Southern Denmark revealed what the actual effects of Thioridazine on the gene expression and cell wall composition of a drug-resistant bacteria called Methicillin-Resistant Staphylococcus aureus were. Thioridazine acts by blocking the efflux pump of bacteria, which is responsible to pumping any unwanted chemicals out of the bacterial cell. So if another antibacterial agent is given, due to the lack of ‘outflowing’ opportunities , the concentration of the other antibacterial agent within the bacterial cell increases. Jørn Bolstad Christensen has put this idea into practice and obtained said patent to pair (S-)Thioridazine and other antibacterial agents.

If this drug (currently called JEK 47) will become available in Europe, depends on the interest of investors in this substance. “I would rather donate this discovery to an NGO able to use this substance in poor countries that suffer from drug-resistance problems than watch it collect dust in the industrialised world. So, I hope that an investor comes along to develop this ground-breaking substance,” concludes Bolstad Christensen.

Direct to Consumer Genetic Testing (DTC-GT) and the physician’s role

Direct-to-consumer (DTC) genetic testing is a type of genetic test that is accessible directly to the consumer without having to go through a health care professional.  In clinical practice, the health care professionals are the ones requesting for genetic testing and obtain informed consent of the patient. However, for some genetic tests, consumers can obtain such a test themselves. They only have to collect a sample of their saliva in the provided test tube and send it to the DTC-GT company where the laboratory will analyze their DNA. There are a variety of DTC tests, including testing for breast cancer alleles to mutations linked to cystic fibrosis. Although the companies who develop and sell the DTC-GTs promote these tests with slogans like ‘to empower you with genetic insights to help motivate you to improve your health’, it is not expected that consumers themselves can correctly interpret the complex results. In genetic testing, the results are usually expresses as ‘risks’ to certain diseases or disorders and not a simple ‘yes or no’ outcome. In addition, these GT should be fully validated so as not to provide false-positive or false-negative results.

It is therefore not strange that consumers who have bought a DTC-GT then consult their physician for her/him to interpret the results. This provides the primary-health care physicians with quite a few dilemmas. First of all they themselves should be able to understand the type of test performed, the presented outcome and any possible consequences for the patient, which is not usual for non-geneticists. Secondly, they have to make sure the test results are valid and might have to order additional tests though the regular health care system. Thirdly, if the results indicate a high risk for a certain disease but possibly also for other diseases, is the physician obliged to report this to the patient who might not wanted to know this. So DTC-GT also put a burden on the physicians who have the moral obligation to inform patients, to treat them and to protect patient confidentiality.

As the prices of these DTC-GTs are expected to drop (DNA test are currently available for $99), physicians can expect an increase in patients who not only googled their symptoms, but might have gone an extra step and requested genetic testing. Canadian researcher Gillian Bartlett of the Department of Family Medicine of the McGill University in Montreal therefore urgently asks to develop best practice recommendations and identify the ethical, legal and social implications of DTC-GT.

The FDA has recently requested that several companies refrain from providing direct to consumer tests with health-related results, as they have not approved these tests yet.

 

 

 

Pharming for fish oil: Camelina plants produce omega-3 fatty acids

Scientists in the UK have genetically modified the Camelina plant to produce components of fish oils beneficial for cardiovascular health. Omega-3 fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are traditionally sourced from fish, but can also be made in our bodies from another omega-3 acid called alpha-linolenic acid (ALA), found in nuts and vegetable oil. Although the richest source of the omega-3 fatty acids is fish, they themselves get the acids from their diet of smaller fishes that have eaten algae. These algae can synthesize the EPA and DHA. To obtain the EPA and DHA for human consumption, every year around a million tonnes of oil is extracted from ground up fish.

An alternative and more sustainable source of EPA and DHA has now been created by Noemi Ruiz-Lopez, Richard Haslam and Jonathan Napier from Rothamsted Resarch in the UK in the form of genetically modified Camelina sative plants. These plants, of the Brassicaceae family and usually called ‘false flax’, are already rich in ALA but have been ‘boosted’ by inserting seven genes of marine algea and other photosynthetic marine organisms into their genome. The seeds of this modified plant can be extracted and purified and the resulting oil can contain up to 12% EPA and 14% DHA. In addition to these health-beneficial fatty acids, the researchers have developed the plants in such a way that they do not contain undesirable intermediate (shorter) fatty acids. These ‘green factories’ could partially replace the current need for fish oil.

Imaga © rothamsted research

Overview of Measle Outbreak in 2013

The following confirmed cases of Measles have been reported worldwide in 2013:

• Australia (Queensland): 51, as reported by Queensland Health
• USA: 159 up to August 2013, as reported by the CDC
• UK: over 800 cases in the Swansea area, as reported by the NHS
• The Netherlands: 2,543 cases, as reported by RIVM
• Canada (Alberta); 42 cases, as reported by Alberta Health Services

Other notable outbreaks occurred in Indonesia (6,300 confirmed cases), Germany (1,520 cases), Turkey (7,132 cases) and Pakistan (over 30,000).
Most of these cases were in unvaccinated (82%) or incompletely vaccinated (13%) people.

In addition to the current measle outbreak, in Germany two cases of subacute sclerosing panencephalitis (SSPE), a rare, late complication of measles have been reported in 2013. SSPE occurs in general about seven years after having a measles infection. The CDC reports that it SSPE concerns a "progressive deterioration of behavior and intellect, followed by ataxia (awkwardness), myoclonic seizures, and eventually death." There is currently no cure for SSPE or measles, but both can be prevented by vaccination.

Pigs that glow (in the dark)

Scientists from the South China Agricultural University in collaboration with experts from University of Hawaii at Manoa have stated that they were able to raise 10 piglets which will glow green in the dark. As explained in their article in Transgenic Research  Zhenfang Wu, Johann Urschitz, Stefan Moisyadi and others describe the use of a new technology to obtain these transgenic pigs. The scientists were able to insert the gene for Green Fluorescent Protein (GFP) from Aequorea Victoria  jellyfish into the porcine DNA using a new technology is called piggyBAC-mediated transposition of transgenes.

It is not the first time that such green-glowing transgenic pigs have been created. In 2006 researchers from the National Taiwan university also reported to have bred three male pigs which glow in the dark.

The ultimate goal of all this research is to introduce beneficial genes into larger animals to create less costly and more efficient medicines. This has for instance already been tried with the gene of transferrin in cows (Stier Herman of Pharming Group NV in the Netherlands as described by Krimpenfort et al in 1991).

Medical review on the alcohol consumption of Bond, James Bond

A highly remarkable article in the British Medical Journal featured the alcohol consumption of one of the world’s favourite spies. The fictional character Commander James Bond, as created by Ian Fleming, has been seen in many movies to order his trademark Martini ‘Shaken, not stirred’. But the authors of this article went beyond the Martinis and made a detailed inventory of how much Mr. Bond would actually drink in real life, if he were a real person. They read the 14 James Bond books, made notes, compared these notes and came to a conclusion, all very much like regular scientific research. Their conclusion: James would have consumed a staggering 92 units of alcohol a week, which is over four times the recommended amount of alcohol. This high level of alcohol intake would put him at high risk of alcohol related diseases such as liver disease, cirrhosis, impotence and most likely an early death (if not by violence or sexually transmitted diseases first). So he would most likely suffer from alcohol induced tremor, not a good thing if you want to pull a gun and shoot a terrorist. Maybe cutting down on the drinking would be a good thing Mr. Bond!

Measle vaccination

Director of the European Centre for Disease Prevention and Control (ECDC) Marc Sprenger has urged doctors and nurses to provide parents who do not want to vaccinate their children (for political, religious or other reasons) with balanced and evidence-based information  to help make informative decisions regarding vaccination. He did so on the Excellence in Paediatrics conference in Doha last week. The vaccinations are not only to protect the children who are invited for vaccination, but also those who are too young to be vaccinated (younger than 9 months). These children are especially at risk as they can contract the disease if the immunity of the community where they grow up is too low. One of the risks for children infected with measles at that age is subactute sclerosing pan-encephalitis (SSPE), also known as Dawson Disease, which is characterized by progressive psycho-neurological deterioration, seizures and coma.  In the Netherlands, the RIVM (Dutch Institute for Public Health and the Environment) has confirmed 2,439 cases of measles (1 May – 4 December 2013), of which a 17-year old girl who died of measles complications. During earlier outbreaks in 1999/2000, 150 children were hospitalized and 3 died.

There currently is no cure or treatment for infection with measles (Morbilli virus) but a vaccine (MMR) is available.

One Million Deaths - survey in India

The Centre for Global Health Research is conducting an incredible research program, called Million Death Study (MDS). This program had been started 16 years ago and has been set up to document death in India using ‘verbal autopsy’ strategies. The MDS involves in-person surveys of more than 1 million households in India to study premature mortality from 1997 to 2013 which occurred outside the hospital.  Using the verbal autopsy method, the researchers can determine the probable causes of death in cases where there was no medical record or formal medical attention. Families are questioned by field-workers about the events that preceded the deaths. The narratives are then sent to physicians to assign a probable cause of death to each case. The data is valuable for public health experts to monitor disease and assess interventions. That is why the CGHR will be providing the results of the Million Death Study to governments, research agencies and the media.

Nature has published an article on this study which highlights the gathering of the data, the progress of the study and of course the preliminary results on the top causes of deaths. The four most significant causes of death for Indians aged 30-69 are vascular disease, chronic respiratory disease, tuberculosis and cancer. However, the real value of the MSD lies in the observed trends and differences between deaths in hospital and in rural areas. For instance, of the deaths attributed to malaria 90% occurred in rural areas outside of hospital or health-care facilities. These estimates

are much higher than the estimates of the WHO. The use of verbal autopsy to gather the data has been criticized, also by the WHO, as it is not always possible to differentiate malaria from other diseases that cause fever symptoms. However, other teams have also reported higher mortality rates due to malaria.

 (c) CGHR: Million Death Study

The MDS was started by Prabhat Jha, an epidemiologist at the University of Toronto, who wanted to found more information on his grandfather’s death, who had died at home in India. Jha went on to found the CGHR, an independent, not-for-profit organization.

Tuberculosis funding by European Commission

On 2 December, the European Commission (EC) announced that the European Union (EU) institutions will support the Global Fund to fight AIDS, Tuberculosis (TB) and Malaria with €370 million for the period 2014-2016. The pledge was announced by European Commissioner for Development Andris Piebalgs. The Global Fund is the single largest and most important international donor for TB, providing almost 90 percent of all international financing for TB programmes.

Previously, 67 health civil society organizations called on the Global Fund’s continued support to countries with growing HIV, TB and malaria epidemics. One of these societies was the TB Europe Coalition, an advocacy alliance that commits to raising awareness of TB and to increase the political will to control the disease throughout the WHO Europe Region and worldwide. In 2012, it was estimated that 74,000 cases of Multi-Drug Resistant TB (MDR-TB) occurred in the WHO European Region.

Tuberculosis is a contagious airborne disease caused by Mycobacterium tuberculosis, which infects one third of the world’s population.

Image: Drug Discovery

Polio emergency in Syrian Arab Republic

Since October 2013 seventeen cases of polio have been recorded in war-torn Syria, a country which did not record polio for over a decade. Attempts are made to vaccinate all children under the age of 5 years, not only in Syria (1.6 million) but also in its neighbouring countries (estimated to be 23 million).  All countries of the WHO Eastern Mediterranean Region declared the escalating polio situation to be an emergency for the entire Region. The WHO is working with UNICEF, other UN agencies, the Syrian Arab Red Crescent, international and national NGOs, and other local and international groups providing humanitarian assistance to Syrians affected by the conflict to ensure that all children are vaccinated, no matter where they live. It is anticipated that outbreak response activities will need to continue for 6 to 8 months, depending on the area and based on the evolving epidemiology.

Image: WHO

Polio is a highly infectious disease caused by a virus. It invades the nervous system, and can cause total paralysis in a matter of hours. One in 200 infections can lead to irreversible paralysis and among those paralysed, 5% to 10% die when their breathing muscles become immobilized. In 2013, only three countries (Afganistan, Nigeria and Pakistan) remain polio-endemic. However, the Global Polio Eradication Initiative (GPEI) has been proven effective as an almost 40% reduction in cases in these countries were seen compared to 2012.

Currently, there is no cure for polio, it can only be prevented. The polio vaccine, given multiple times, can protect a child for life.

Mosquitos, skin odor and CO2

Scientists of the University of California have studied the mosquito olfactory neurons and receptors required for attraction to skin odor. In their article in Cell, Tauxe et al. discuss that the analysis of the CO2 receptor ligand space provided them a foundation for understanding host-seeking behaviour. It also enabled them to identify potentially safe, pleasant and addordable for use in a new generation of mosquito control strategies world wide. This would hopefully prevent the transmission of many deadly pathogens such as malaria parasites, dengue viruses and filarial worms which are transmitted by mosquitos to hunderds of millions of people every year. One of the most effective repellent candidates the team of scientsts found was ethyl pyruvate, an additive that gives a fruity rum or caramel flavour to breads, white wine, and cocoa.



 


  

Roll Back Malaria - Photo exhibition in Bern

The Swiss Malaria Group organises a photo exhibition on Malaria. Titled 'Swiss Malaria Champions: a photographic exploration' this exhibition illustrates an artistic face to malaria control.

The aim of the Swiss Malaria Group is to raise awareness of malaria and its impacts among decision makers and the public and to increase Swiss support for organisations that are actively involved in the fight against malaria.

December 4–5, 12.00–17.00 : Altstadtkeller Munstergasse 38, Bern

Avian influenza A (H7N9) virus in Hong Kong

According to New Scientist, a 35-year old women has contracted Avian Influenza A (H7N9) virus and is taken in critical condition to a hospital in Hong Kong. Infections with bird flu seemed to have stopped during the summer months, but have now been recurred, including in Hong Kong.  According to the WHO Report, the number of confirmed cases with H7N9 reported to the WHO in 2013 was 137 and 45 deaths (cumulative until 25 October 2013). None of these cases was in Hong Kong, but occured in other areas of China. Hong Kong has now stopped importing Shenzhen chickens and is screening people at its border.

World AIDS Day

A great blog post I read in the Guardian, about how AIDS activists acutally changed the way medical trials were performed.

Welcome

The Global Health, Innovation, Happiness and Inspiration blog (or Global-hihi blog) is all about improving health and happiness by using innovation and providing inspiration to a global population. This blog will contain positive stories on science, public health and social stories with a focus on improving people's lives all over the world. One story at a time.