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Contagion,” the extraordinary film portraying the outbreak of lethal virus that spreads rapidly around the world, may seem eerily familiar: from the medieval plague to the Spanish flu of 1918-19 to more recent fears of avian influenza, SARS, and H1N1 “swine flu”, contagions have long characterized the human condition. The film captures almost perfectly what a contemporary worst-case scenario might look like, and is eerily familiar because it trades on realistic fears. Contagion, the transmission of communicable infectious disease from one person to another (either by direct contact, as in this film — sneezing or coughing or touching one’s nose or mouth, then a surface like a tabletop or doorknob that someone else then touches

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by Cassie, Associate Publicist

Michael B. A. Oldstone is a Member (Professor) at the Scripps Research Institute, where he directs a laboratory of viral immunobiology. He is also the author of Viruses, Plagues, and History: Past, Present, and Future, a look at viruses from smallpox to ebola to West Nile to the flu. In this excerpt, Oldstone explains how pigs, dogs, and ferrets help scientists discover that the flu was a virus, not bacteria.

Although suspected influenza epidemics occurred during several decades of the 1700s, Robert Johnson, a physician from Philadelphia, is generally credited with the first description of influenza during the 1793 epidemic. With his description available and improved public health statistics, epidemics were documented in 1833, 1837, 1847, 1889–90, and 1918.

However, the identity of the infectious agent that caused influenza remained debatable. In Germany, Richard Pfeiffer discovered “bacteria” present in great numbers in the throats and lungs of patients with influenza. Because of this agent’s large size, it could not pass through a Pasteur-Chamberland-type filter, causing many observers to speculate that influenza originated from a bacterium and not a virus.

Only by serendipity was the true nature of influenza as a virus discovered. This is a tale of pigs, hounds, foxes, and ferrets—all of which played decisive roles in the determination that influenza was a virus…

The story begins with J. S. Koen of Fort Dodge, Iowa, an inspector for the U.S. Bureau of Animal Husbandry. In 1918, he observed in pigs a disease that resembled the raging human influenza plague of 1918–19:

Last fall and winter we were confronted with a new condition, if not a new disease. I believe I have as much to support this diagnosis in pigs as the physicians have to support a similar diagnosis in man. The similarity of the epidemic among people and the epidemic among pigs was so close, the reports so frequent, that an outbreak in the family would be followed immediately by an outbreak among the hogs, and vice versa, as to present a most striking coincidence if not suggesting a close relation between the two conditions. It looked like “flu,” and until proved it was not “flu,” I shall stand by that diagnosis.

Koen’s views were decidedly unpopular, especially among farmers raising pigs, who feared that customers would be put off from eating pork if such an association were made. Ten years later, in 1928, a group of research veterinarians in the U.S. Bureau of Animal Husbandry, led by C. N. McBryde, reported the successful transmission of influenza infection from pig to pig by taking mucus and tissue from the respiratory tracts of sick pigs and placing it into the noses of healthy pigs. However, these investigators were unable to transmit the disease after passing the material through a Pasteur-Chamberland-type filter. Therefore, no evidence was yet available that a virus caused influenza. That situation changed when Richard Shope, working at the Rockefeller Institute of Comparative Pathology at Princeton, New Jersey, repeated McBryde’s experiments within a year of the negative report. By reproducing influenza disease in healthy pigs after inoculating them with material taken from sick pigs and passed through the Pasteur-Chamberland filter, Shope provided the first evidence that viruses transmitted influenza of swine.

…Initially, dogs were used for research on the [canine distemper] virus and for studies to develop the vaccine, but problems soon surfaced. Among the difficulties was the issue that some dogs had become immune because of a previous encounter with canine distemper virus so did not contract the disease when exposed; additionally, antivivisectionists and some pet owners objected to using “man’s best friend” as a research tool. These problems vanished when ferrets were substituted for dogs. Hound keepers on the English country estates had noticed that ferrets also developed distemper, presumably transmitted from dogs. Soon ferrets replaced dogs in canine distemper studies at both the Wellcome and the MRC laboratories.

In 1933, the first epidemic of influenza since 1919 struck London and, as before, spread quickly. Among the many humans infected were several members of the research staff at Wellcome and MRC laboratories. However, unexpectedly, ferrets kept at the Wellcome laboratory also became ill, with symptoms of wheezing, sneezing, and coughing reminiscent of human influenza infection. When Wilson Smith, a senior researcher at the MRC unit, recognized the situation, he infected ferrets with nasal washings from influenza-infected patients. As the ferrets came down with the influenza-like syndrome, both Smith and Christopher Andrewes examined them. A story soon told was that a sick ferret sneezed in Christopher Andrewes’ face. A few days later, Andrewes came down with influenza. Smith obtained washings from Andrewes’s throat, passed the material through a Pasteur-Chamberland-like filter, then injected the filtrate into healthy ferrets. Soon they too began sneezing and coughing, discharging phlegm from the nose and eyes and spiking a temperature. Here was the first evidence that a virus caused human influenza, at the same time fulfilling Koch’s postulates.

Following his studies with tuberculosis, Robert Koch formalized the criteria eventually called Koch’s postulates to distinguish a microbe causing disease from one that is a happenstance passenger. According to the postulates, a link between agent and disease is valid when the organism is regularly found in the lesions of the disease; the organism can be isolated in pure culture on artificial media; inoculation of this culture produces a similar disease in experimental animals, and the organism can be recovered from the lesions in these animals. These postulates require modification for viruses, however, because they cannot be grown on artificial media (viruses require living cells for their replication), and some are pathogenic only for humans. Nevertheless, these experiments with ferrets, humans, and influenza virus filled the bill for a modified Koch’s postulate. Considering the role serendipity played in the use of ferrets and the initial isolation of human influenza virus, one agrees with Pasteur: “Chance favors the prepared mind.”

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Be kind to the swine. Don’t give them the blame.
Treat all pigs with kindness. Shake a hoof, ask their name!

As a gesture of kindness, consider biscuits and tea.
I’ve heard roast beef and pound cake makes a pig squeal with glee!
Or…
You could take a piggy to market and buy some new shoes…
add some bloomers, some stockings and a handbag or two!

Yes be kind to the pig. Turn his gray skies to blue.
But first wash your hands. Please don’t give him Swine Flu!

Achoo!

_R.Baird

Three more days to vote…. Won’t you please help us win the ABC Children’s Picture Book Competition?  Voting Link:

http://www.abcbookcompetition.org/5th_comp/SorryDoesntCleanItUp.html

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Be kind to the swine. Don’t give them the blame.
Treat all pigs with kindness. Shake a hoof, ask their name!

As a gesture of kindness, consider biscuits and tea.
I’ve heard roast beef and pound cake makes a pig squeal with glee!
Or…
You could take a piggy to market and buy some new shoes…
add some bloomers, some stockings and a handbag or two!

Yes be kind to the pig. Turn his gray skies to blue.
But first wash your hands. Please don’t give him Swine Flu!

Achoo!

_R.Baird

Three more days to vote…. Won’t you please help us win the ABC Children’s Picture Book Competition?  Voting Link:

http://www.abcbookcompetition.org/5th_comp/SorryDoesntCleanItUp.html

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Today's Youth Advisory Board post comes from Bryan Spencer, one of our newest board members (look for more YAB updates next week!), Ypulse Insights intern and among the many unfortunate college students to find himself a victim of the H1N1 virus.... Read the rest of this post

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That’s right. The Swine Flu toy is for sale, and it’s a big hit! The CDC (Centers for Disease Control) have created this plush, pink toy to give your child hours of entertainment, available to buy now in their Atlanta gift shop! (who would have even thought the CDC had a gift shop?!)

This may be the perfect gift for children actually infected with Swine Flu and stuck in bed with nothing to do.

But if the toy based on the Swine Flu (aka H1N1 virus) isn’t what you’re looking for, than might I suggest the gonorrhea toy? How about the chlamydia toy? This is not a joke. These toys are for real!

Each toy comes with a tag that describes the illness, along with “fun facts” about it. Turns out people are buying these toys for various reasons. Some parents and doctors are getting these plush toys to help explain certain diseases to children, while some people are buying them because this is just about one of the funniest gag gifts there is!

And for you sophisticated types looking for something a little less childish, do not fret. There are disease-themed scarves and ties for sale, too. According to the CDC, the microbes of some very deadly diseases can make a very “stylish pattern” (Ooh! I know what will be on my Christmas wish-list this year!)

All images from giantmicrobes.com

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A wolf, a tiger and a pig congregate around a campfire one bizarre evening. One thing leads to another, and they inevitably begin to boast. The wolf says “every time I howl, the whole forest is scared”. The tiger says “that’s nothing. Every time I roar, the whole jungle is terrified!” The pig snorts (derisively) and says “Well every time I sneeze, the whole world craps itself.”

A global pandemic. A threat to modern civilisation. A hundred billion lives in danger (?) What will be reported next on Swine flu? As far as my number crunching has led me to believe, 4 of 100,000 cases have resulted in death unaided by any other illness. That’s 1 in 25,000. You have a better chance of being struck by lightning than dying if you get it. (1)

Does normal flu not result in a similar amount of deaths each year? Tell me if I’m missing something. Is an intolerable phobia of pig-flu the latest craze to sweep the globe ever since the constant threat of terrorism became auspiciously quiescent?

In a society becoming ever more bacteria-o-phobic (for lack of a knowledge of ancient greek), where will we get our immune systems from? Babies are sheltered from germs, kids aren’t going out and getting filthy and… well… teenagers I suppose are (allegedly) rife with STDs and fresher’s flu but that’s not the point.

Give your immune system some exercise- go outside without a facemask on! If you end up in bed for 2 weeks, sure, it’s crap but it’ll be character building or something…

I’d never heard that pigs could fly, until swine flu…

(1) - http://wiki.answers.com/Q/What_are_the_odds_of_being_struck_by_lightning

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Swine Flu:
One death in Guam and 2 confirmed cases in Saipan. Like everywhere else in the US, swine flu makes headline news. Since I've been in Ohio this summer for vacation, visiting family, I've been hearing about swine flu here, too. Ohio also had its first death from swine flu this month.

Swine flu is a pandemic. More than half of the deaths have been in the U.S. It is NOT the most virulent form of flu the world has seen, but it is the current strain and it's causing plenty of harm. Symptoms being talked about here in Ohio are fever, sore throat, vomiting and diarrhea. Best to take precautions.

What's scary in Saipan, though, is how small the population is, how close contact may be unavoidable, and especially how weak our health system is, despite the protestations of CHC and the health department that everything is fine.


Tim Villagomez:
His lawyers are begging for leniency. His family and friends are flooding the court with letters begging for mercy. The newspapers publish only snippets of the requests, but some of them show that the community is also part of the problem.

The comment that gets first place imho in the "you're clueless" category goes to Diego Benevente for this:

“Villagomez has been and remains a respectful and modest public servant in spite of the predicament he found himself in.”

Excuse me? He didn't find himself in a predicament. He committed a crime. He is to blame for his own action. It's about personal responsibility.

I still haven't seen Tim Villagomez own up to his own responsibility in this matter. Yes, he quit his job as lieutenant governor. But that was not until after he was convicted of federal crimes.

I'm guessing he can't say a lot, because he's probably following the advice of counsel to remain silent. But that's a far cry from finding himself in a predicament.


Another comment winner for passing the buck goes to his wife, Margaret Keene Villagomez, who, as his wife, is understandably blinded by loyalty and love. But really, think before you write something like this:

“One of the biggest mistakes that he has ever made, in my opinion, was that he entered the uncertain world of politics where some of the people that he helped would one day be the cause of his demise.”

This just shows it's all about getting caught, in the thoughts of his family. Never mind that there was evidence that he scammed the public through fraudulent rydlime sales to CUC before he went into politics... And those people he helped! How dare they cause him trouble. (Surely she doesn't mean his sister and brother-in-law; it's the snitch who testified against him and those people in the public auditors office and who else?)


I'm not sure what the Bishop hoped to convey with his comment.

“They have strived to live up to the Christian ideals of living out the Gospel message in their day-to-day living. They recognize their mistakes and they are keen on making conscious efforts to correct them. Overall, I see the goodness in their hearts despite their shortcomings.”

I don't remember the Gospel saying anything good about cheating people by enriching your own pockets with a scam, under cover of high status and public power.

And then there are the heartfelt pleas for the sake of the children. I do feel for the children, who are innocent in this matter; who no doubt love their father; who no doubt need their father in their lives. But what are we teaching those children with comments like this?

“Please give them leniency on sentencing day. Please don’t take our families apart. It’s all in your hands.”

“I don’t know how any parent could find the strength to explain to their young children the logic of why their daddy will not be with them much longer, or that soon he may not be coming home at all."

Both of these comments (one from a nephew, one from the wife) again show that denial of the reason why Tim Villagomez is facing jail time. It is not the JUDGE breaking up the family. And what you tell your children is that daddy is a human being who made a big mistake and now must pay for it.

I understand loyalty and wanting someone you love to be given a second chance; be shown mercy. I think Kay Delafield's comments, as reported in the newspaper, help protray that best.

According to the Tribune, "She said Villagomez has no past record of bad acts and he has young children, a wife, a mother and a family who need him in their lives." Okay. Facts. This is an effective plea; simple, direct, not too emotional.

And Sasamoto's comment:

“He has lost credibility in the public eye and I believe that he is truly despondent regarding what he has put his family through.”

Okay, fact and opinion stated as an opinion. Effective.

Lots of people convicted of crimes have wives and children. The judge can't seriously even consider that when sentencing someone convicted of crimes. Many people get despondent when they are caught.

And let's be honest, Tim did some serious harm, despite the denials of his family.

I think Rob Torres' comment sums up the "support:"

Villagomez's counsel, Robert Torres, said his client is no different than other offenders in public corruption cases who have denied their gifts and talents in pursuit of brazen, if not blind, ambition.

“But Tim remains to me someone whom I care for and whom I support unequivocably and without hesitation. I stake my name and reputation as an officer of this court in writing this letter,” he said.

Tim screwed up but we love him anyway. Okay. Now let's get back to logical considerations for sentencing.


Judiciary debt to the Retirement Fund:
This one is good: the CNMI judiciary owes a heck of a lot of money to the NMIRF.

Let's order them to go get second jobs to pay this off, okay? Sic Mike White on them? Threaten them with jail for non-payment?

That's what they do every day to poor debtors without the education and opportunities they all have!

Oh, they want the public to pay from the general fund? That was part of the deal. Okay. They want to work this out. No problem.

Well, there is a problem as there is no easy solution. Oh-oh.

Really, I hope they consider how unreasonable debt happens to the best of us the next time a poor person can't pay in an ordinary debt collection case.

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Dororthy H. Crawford is Professor of Medical Microbiology and Assistant Principal for Public Understanding of Medicine at the University of Edinburgh. She is the author of several books and papers, most recently for OUP, Deadly Companions: How Microbes Shaped our History. In the post below she compares the current swine flu outbreak with previous flu pandemics, and asks why this one is apparently more serious in Mexico than elsewhere and how it might develop.

She has previously written for OUPblog on the UK Foot and Mouth Disease outbreak in 2007.

Ironically, while all those trying to predict the next flu pandemic are monitoring the antics of bird flu in Asia and North Africa, swine flu escapes from a pig farm in Mexico and goes global. This unpredictability is typical of flu virus which is constantly mutating and recombining its genes, eventually producing a ‘new’ strain that can infect and spread in humans unrecognised by our immune system.

This unruly behaviour gives an average of three pandemics (defined as a spreading infection in more than one continent at once) per century. In the 20th century we had Hong Kong flu in 1968, Asian flu in 1957, and the post WW1 Spanish flu in 1918 that killed around 40M people.

Within days of Mexico reporting a flu epidemic, now with some 985 infections and 25 deaths, cases appeared in around 20 countries, including the UK, all directly seeded from Mexico thanks to our efficient trans-global airliners. Scientists at the Centre for Disease Control, Atlanta, US, quickly identified the virus as H1N1; a common subtype in humans. But the ‘Mexican’ pig virus, which has been traced to one that has been circulating in pigs since the 1930s, is very different from the human H1N1 strain. It has occasionally jumped to humans before but until now it has never succeeded in spreading between humans.

Flu viruses have RNA genomes with eight separate gene segments that mutate and recombine rapidly. The ‘Mexican’ virus has six genes derived from North American swine flu and two from Eurasian swine flu; a combination that has never been found infecting humans before. It is not clear how or why it jumped species, but given that it is now spreading between humans, and most of us are likely to be non-immune, this is a recipe for a pandemic.

At present events are moving so fast that whatever I write will not only be out of date, but may even be proved wrong, by tomorrow, so I will restrict myself to speculating on the following: why is ‘Mexican’ flu apparently more serious in Mexico than elsewhere’? and: ‘how might the pandemic develop’?

Traditionally, respiratory infections like flu are a threat to the very young, the very old and those with chronic diseases, causing thousands of deaths in these groups in the UK every year. Generally the death rate from flu is less than 1%, so the rate of around 2.5% reported from Mexico (985 cases of flu and 25 deaths) is high. But outside Mexico cases seem to be mild, with the only death reported being a child in the US where over 160 cases have been diagnosed. So what is the explanation?

In all flu outbreaks those who seek help represent the tip of the iceberg, with many more infections being too mild to require medical attention. It is likely that the Mexican figures represent only those sufferers who consulted a doctor and are therefore distorted towards the severe end of the spectrum. More research is needed to uncover the actual prevalence of the disease in the community before a reliable death rate can be calculated.

Reports of deaths among young adults in Mexico are worrying as this is reminiscent of the 1918 H1N1 virus with its high death rate in the young. The explanation may be that the older generation are partially protected by having met a similar strain of H1N1 in the past, but again we need more details from Mexico before specific risks can be assessed.

In the Northern hemisphere flu epidemics usually strike in the winter when the virus transmits more easily between people who are huddled inside trying to keep warm. But in the UK the 1918 pandemic began with a small outbreak in the Spring which receded in the Summer only to take off again in the Autumn, causing thousands of infections and deaths. Given the present pattern, we may now be witnessing the equivalent of the 1918 Spring outbreak, heralding a full pandemic in the Autumn. If so this could be good news as it gives us a 6 month breathing space – time enough to prepare a vaccine to protect our vulnerable groups.

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John Playfair’s short book Living with Germs: In Health and Disease takes the reader through the essentials of infectious organisms - bacteria, viruses, protozoa and the rest - and of our defences against them, the immune system with its powerful weapons and occasionally dangerous side effects. The alternatives - antibiotics and public health measures - are also considered and there is a look ahead at some of the significant problems to come in the future. In the post below, John Playfair reminds us that infectious diseases don’t stand still for long.

The death of two sumo wrestlers last year from a new strain of herpes gladiatorum (’scrumpox’ to rugby players) is not only bad news for Japan’s number one sport but a reminder that infectious diseases do not stand still for long.

MRSA, drug-resistant tuberculosis, malaria, and the permanently shifting AIDS viruses have been for years at the very top of the list of world health problems, and now a new hybrid flu virus from pigs, containing additional genes from both avian and human strains has unexpectedly leapfrogged all these to potential pandemic status (WHO threat level 5). With global warming already introducing ‘tropical’ insect-borne diseases such as malaria, leishmaniasis, and dengue to temperate zones such as Europe and North America, and with vaccines still lacking for all fungal, protozoal, and worm infections, it is no longer thinkable to say, as the US Surgeon-General rashly did 40 years ago, that ‘it is time to close the book on infectious diseases.’

Three problems stand out. Drugs - loosely known as ‘antibiotics’ - have been very successful against some bacterial infections but much less so against viruses, where years of expensive research have been needed to identify those few weak spots where a drug can damage the virus but not its host (bacteria have far more of these). Vaccines, on the contrary, have a better record against viruses than against bacteria, and if any more infections are to follow smallpox into oblivion they will probably be viral - polio and the common childhood viruses being the most likely candidates. There remains the stumbling block of the immune system, our main protection against infection and the point at which successful vaccines operate. Almost a century ago it was discovered that with ‘toxic’ diseases like diphtheria and tetanus, all you needed for protection was a sufficient level of antibody in the blood.

But unfortunately this is not true of many infections: antibody may be ineffective, or directed at the wrong target, or actually harmful. Sometimes immune cells must go into action, killing viruses or releasing messenger molecules known as cytokines. But even cytokines can be dangerous; in fact they may account for the curious fact that swine flu appears to be more deadly in younger victims with active immune systems. So we must be prepared for more surprises.

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Elvin Lim is Assistant Professor of Government at Wesleyan University and author of The Anti-intellectual Presidency, which draws on interviews with more than 40 presidential speechwriters to investigate this relentless qualitative decline, over the course of 200 years, in our presidents’ ability to communicate with the public. He also blogs at www.elvinlim.com. In the article below he looks at “swine flue”. Read his previous OUPblogs here.

“Swine flu” or a strand of influenza A subtype “H1N1?” Try as federal officials might, the media continues to resist their call to term the “swine flu” the new strain of “H1N1″ virus.

At a press conference last Tuesday, Agriculture Secretary Tom Vilsack was at pains to say, “This really isn’t swine [flu], it’s H1N1 virus.” He also explained why: “and it is significant because there are a lot of hard-working families whose livelihood depends on us conveying this message.” (At least ten countries have placed bans on the import of pork even though the World Health Organization has attested that H1N1 is an air-borne and not a food-borne virus.)

The hegemony of “swine flu” over “H1N1″ is even more peculiar given that the World Organization for Animal Health (OIE) reports that the particular strand of H1N1 virus (which typically infect pigs) that is causing the current epidemic has not previously been reported in pigs and actually contains avian and human components. It was only on May 2, long after “swine flu” had gained rhetorical currency that the strain was found in pigs at a farm in Alberta, Canada. Even there the story has a twist - the pigs had gotten infected because of their contact with a farm worker who had recently returned from Mexico, and not the other way around - prompting some to suggest that the proper nomenclature ought to be “human flu” or “Mexican flu.”

But the media’s job is to transmit the news in the best way that rolls of one’s tongue, not deal with the fallout of their infelicitous use of words. To be fair, administration officials were slow to catch on. As late as April 26, two days before Vilsack’s press conference, the White House and Richard Besser of the Center for Disease Control (CDC) were still referring to the “swine flu.” Clearly, the pork lobbyists aren’t going to win this battle and the malapropistic epidemic will continue. Administration officials should know that if they really wanted a working alternative to “swine flu,” they would have to do a lot better than a robotic scientific abbreviation.

Our current malapropism has an ancient pedigree. The 1918-1920 H1N1 pandemic called the “Spanish Flu” didn’t start in Spain (and probably started in Kansas). This is ironic, because the “Spanish Flu” acquired its name only because Spain was a neutral country in WW1 and with no state censorship of news of the disease, was offering the most reliable information about it. This ended up generating the impression that the disease originated and was particularly widespread in Spain. Even when the media is not trying, it defines and shapes our reality.

Why does any of this matter? Because words characterize an issue in such a way as to insinuate a cause and to frame our reactions. Sometimes, words can even drive mass hysteria. Consider the “swine flu” outbreak in 1976, which claimed a single life at Fort Dix, NJ. Because this particular strain of virus looked a lot like the one that caused the “Spanish Flu” of 1918-1920 (also misleadingly named), public health officials convinced President Gerald Ford to commence a mass immunization program for all Americans. The use of a sledgehammer to crack a nut was not without consequences. Of the 40 million Americans immunized, about 500 developed Guillain-Barré syndrome, a paralyzing neuromuscular disorder.

So let us pick our words carefully, lest our slovenly words presage our slovenly deeds.

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