The ASM folks did an excellent job editing the first video episode of “This Week in Virology.” We did this show on a stage in the ASM conference press room in Philadelphia last week. The actual live audience didn’t exactly pack the house, but she was very attentive. Meanwhile, about 50 people watched the streaming video online. Now, if you have unreasonable amounts of time to kill, you can catch the rerun.
Gerald Weissmann, editor-in-chief of the FASEB Journal, has a good editorial in the journal’s current issue. While it doesn’t break any new ground, it does provide an excellent history of the vast “dietary supplement” industry:
If our economy tanked because of subprime mortgages, perhaps the time has come to look at subprime drugs. (I’d call drugs “subprime” if they affect bodily functions without having undergone tests of safety and efficacy by the FDA.) Unfortunately, the $24 billion/year “dietary supplement” industry peddles subprime concoctions that can only be recalled after someone blows a whistle. Case in point: A class-action law suit filed in Atlanta by the Falcons’ Grady Jackson finally led the FDA to recall StarCaps slimming capsules and over 60 other dietary supplements because of unlisted and/or dangerous ingredients. Among the covert ingredients of these over-the-counter nostrums was bumetanide, a potent diuretic (5).
This was not the first time a court in Atlanta has heard accusations of hidden ingredients in a patent medicinal. In 1902, an Atlanta courtroom heard evidence that a medicinal “stimulant,” Coca-Cola, was liberally laced with caffeine and undetermined amounts of cocaine. The ensuing uproar over secret components, especially cocaine, in patent medicines led to passage of the Pure Food and Drug Act of 1906, provisions of which still guide the FDA. Follow-up litigation ensured that today’s Coke no longer contains coke (6)
Weissmann goes on to trace how this legislation evolved, and how hucksters and quacks continue to circumvent it. My prediction: the editorial will draw intense fire from the hucksters and quacks, who will continue to use their political leverage to block meaningful regulation. It’s a good read, though.
As you already know if you’ve come within 100 meters of any radio, television set, newsstand, or computer in the past week, there’s a flu pandemic underway. My TWiV colleagues and I will be talking about it tomorrow, when we record the next episode of the show, but I want to toss out a few thoughts on the issue here as well. TWiV, by the way, will be focusing on the very interesting virology behind this story, which hasn’t gotten much coverage, so tune in to the podcast when you’re sick of hearing about border closings, travel restrictions, pork slaughters, and other completely pointless activities.
What has gotten a lot of coverage, of course, is the growing number of cases of the new H1N1 influenza. Yes, I’m calling it H1N1, not “swine flu,” because the latter term, and the politically-charged alternatives to it, are clearly incorrect at this point.
What’s also incorrect is the constant refrain that this virus contains a mixture of bird, pig, and human viral genes. We can’t really blame the 24-hour blogospheric echo chamber for repeating this error – repeating things is what our modern news system does, and the original claim came from a highly credible source. For reasons nobody seems to understand, CDC spokesperson Anne Shuchat’s 23 April press statement claimed that “the viruses contain genetic pieces from 4 different virus sources … North American swine influenza viruses, North American avian influenza viruses, human influenza viruses, and swine influenza viruses found in Asia and Europe.”
Now that the viral sequences are being released to the public, though, virologists see no trace of avian or human flu genes in them. It’s a virus reassortant of entirely swine origin, which has now made the leap to humans. Shuchat’s previous statement was simply wrong. So let’s stop repeating it, okay? Seriously. Stop.
Next, we should probably back off a bit on speculating why the fatality rate is so high in Mexico. I’m guilty of some of this myself, but the more I compare the news reports to the actual data, the more I wonder whether this observation is real. Every mainstream news story mentions how many cases and fatalities there have been, but only a few make a clear distinction between the suspected and confirmed cases. We hear about almost 200 deaths in Mexico (so far), but digging a bit further reveals that only a handful of those have been confirmed as having had H1N1 flu. Meanwhile, US authorities are being more careful about the figures they release, focusing on confirmed cases rather than suspected ones. The upshot is that news stories are often comparing suspected cases and deaths in Mexico with confirmed cases and death (1 so far) in the US. It’s apples vs. pears. Until we have solid numbers to compare apples to apples, we don’t actually know whether Mexico’s fatality rate is higher.
Finally, it’s amusing, but unsurprising, to see that the finger-pointing has already started. Mexicans are blaming their government for not acting fast enough, Americans are trying to decide who to sue, Europeans are blaming the Americans, and everyone is casting a suspicious glance at big pork producers. When a major crisis like this occurs, though, we really should be asking who benefits. In this case, I think it’s pretty clear.
It seems that snakehead fish aren’t the only aquatic invaders worth frying up. Lionfish (Pterois spp.), an imported species originally from the Pacific, are now thriving in North Carolina waters. As the Charlotte Observer explained yesterday:
The lionfish population has exploded at a pace unlike anything scientists have ever seen from an invasive fish species in this part of the world. They are appearing in huge numbers from here southward into the Caribbean and are so plentiful that divers off the North Carolina coast routinely find up to 100 on a single shipwreck.
“If you go deeper than 100 feet, they’re ubiquitous now,” said Paula Whitfield, a researcher with the National Oceanic and Atmospheric Administration in Beaufort. “They’re absolutely everywhere.”
Fortunately, Southerners are once again turning to a favorite regional solution for critter problems:
Lionfish, it turns out, have a sweet, white meat similar to the tasty groupers and snappers they are threatening.
Discovery Diving Co. in Beaufort and Olympus Dive Center in Morehead City are recruiting sport divers for a series of “lionfish rodeos” during the summer dive season, the first May 18-19. Later ones likely will also involve researchers and representatives of the culinary school, said Debby Boyce, owner of Discovery Dive Shop.
The scientists and divers hope to persuade restaurants in the area to start serving lionfish.
I went wreck diving out of Morehead City a few years ago. On that trip, I learned that Olympus runs an excellent dive charter operation, and that some restaurants in the Morehead City area could frankly use some cooking tips, so this looks good all around. The article also offers useful advice on cleaning the catch:
Rodeo divers will gently shoo the fish into a net while wearing the kind of puncture-proof gloves worn by workers who handle used hypodermic needles and other medical waste, Boyce said.
The venom is in the ribbon-like flesh along the shaft of the spines, and a simple, safe way to clean them is to hold them with pliers and use wire cutters to snip off the spines.
Then they can be cleaned like a typical fish, Boyce said.
The podcast This Week in Virology has now reached the “featured” page at the front of the “Science and Medicine > Medicine” category on iTunes. Apparently, there are a lot of folks out there who love to hear a few microbiologists (Vince Racaniello, Dick Despommier, and me) ramble on about viruses for an hour a week. Check it out – that’s us in the lower right corner:
If you don’t subscribe to the podcast yet, perhaps you should. That way, when we’re world-famous and you’re standing in the throng of fans waiting for an autograph, you can tell people that you were listening to us when we first hit the charts.
The Associated Press is still investigating pharmaceutical pollution. Now they’ve actually gone beyond what I originally reported for Nature Medicine, and it seems they’ve uncovered a trove of interesting data in the process:
U.S. manufacturers, including major drugmakers, have legally released at least 271 million pounds of pharmaceuticals into waterways that often provide drinking water — contamination the federal government has consistently overlooked, according to an Associated Press investigation.
Yes, when you aren’t looking for something, you tend to overlook it. On the other hand, maybe the government really is looking, and just not seeing:
Federal and industry officials say they don’t know the extent to which pharmaceuticals are released by U.S. manufacturers because no one tracks them — as drugs. But a close analysis of 20 years of federal records found that, in fact, the government unintentionally keeps data on a few, allowing a glimpse of the pharmaceuticals coming from factories.
Gotta love that data mining software.
As part of its ongoing PharmaWater investigation about trace concentrations of pharmaceuticals in drinking water, AP identified 22 compounds that show up on two lists: the EPA monitors them as industrial chemicals that are released into rivers, lakes and other bodies of water under federal pollution laws, while the Food and Drug Administration classifies them as active pharmaceutical ingredients.
Of course, this doesn’t prove a) that the compounds really came from pharmaceutical manufacturers, or b) that they pose any real danger in the minute concentrations found in drinking water. Still, it seems worth looking into – deliberately this time.
Flies are wonderful for genetics research, but it’s hard to say whether their scientific contributions as a model system can ever outweigh the Dipteran order’s crimes against humanity. Here’s another reason to hate them:
Researchers at the Johns Hopkins Bloomberg School of Public Health found evidence that houseflies collected near broiler poultry operations may contribute to the dispersion of drug-resistant bacteria and thus increase the potential for human exposure to drug-resistant bacteria. The findings demonstrate another potential link between industrial food animal production and exposures to antibiotic resistant pathogens. Previous studies have linked antibiotic use in poultry production to antibiotic resistant bacteria in farm workers, consumer poultry products and the environment surrounding confined poultry operations, as well as releases from poultry transport.
“Flies are well-known vectors of disease and have been implicated in the spread of various viral and bacterial infections affecting humans, including enteric fever, cholera, salmonellosis, campylobacteriosis and shigellosis,” said lead author Jay Graham, PhD, who conducted the study as a research fellow with Bloomberg School’s Center for a Livable Future. Our study found similarities in the antibiotic-resistant bacteria in both the flies and poultry litter we sampled. The evidence is another example of the risks associated with the inadequate treatment of animal wastes.”
“Although we did not directly quantify the contribution of flies to human exposure, our results suggest that flies in intensive production areas could efficiently spread resistant organisms over large distances,” said Ellen Silbergeld, PhD, senior author of the study and professor in the Bloomberg School of Public Health’s Department of Environmental Health Sciences.
Housefly. Image courtesy yimhafiz.
Some of this is still conjecture, as the researchers have not connected the contaminated flies with specific epidemiological outcomes. This study was just traditional environmental microbiology:
Graham and his colleagues collected flies and samples of poultry litter from poultry houses along the Delmarva Peninsula—a coastal region shared by Maryland, Delaware and Virginia, which has one of the highest densities of broiler chickens per acre in the United States. The analysis by the research team isolated antibiotic-resistant enterococci and staphylococci bacteria from both flies and litter. The bacteria isolated from flies had very similar resistance characteristics and resistance genes to bacteria found in the poultry litter.
Still, it’s more than enough justification to swat the little buggers whenever you see them.
This is pretty amusing. A few days ago, I got a press release from an Institutional Review Board (IRB) contractor called Coast IRB. IRBs are the organizations that monitor human clinical research to make sure everything is done in accordance with modern ethical standards, so ideally these folks would take their jobs pretty seriously. Apparently Coast IRB does:
On Friday, March 6, 2009, Coast IRB, an Independent review board, discovered that a protocol submitted to it for review of a medical device called Adhesiabloc by a Device Med Systems of Clifton, Virginia, was in fact fraudulent in violation of federal and state law. Upon receipt of proof of the fraud, Coast IRB and its CEO, Daniel Dueber, ordered the immediate termination of the clinical trial, referred evidence to federal and state authorities for investigation and prosecution, and instituted measures to prevent a recurrence.
So far, so good. They found out that someone was trying to set up a shabby clinical trial, and they called shenanigans. Today, though, Coast IRB felt the need to issue a new press release:
In a press release issued on March 10, 2009, Coast IRB informed the public that it had discovered what appeared to be a fraudulent clinical trial submitted to that Independent review board for evaluation. Coast IRB has since learned that the fraudulent trial was apparently commenced as part of a congressional “sting” operation. Apparently at the behest of the U.S. House Subcommittee on Oversight and Investigations of the House Committee on Energy and Commerce, agents submitted false credentials and clinical trial data to Coast IRB and possibly other IRBs to induce them to perform reviews. Evidence of the progress of the trials could then form the basis for arguments critical of the FDA and in favor of greater regulatory oversight.
So they stung the sting operation, and by sending out a press release about it, blew the cover off the whole thing. Was that wrong? Well, the folks at Coast aren’t taking any chances – they’re going on the offensive:
Unless pursuant to a court order or under the auspices of the Department of Justice, the sting could be illegal, violating wire fraud, mail fraud, and state laws against fraud and false credentialing.
First you bust an apparent fake clinical trial, then you out a Congressional sting operation, and now you’re arguing that Congress actually broke the law by initiating the sting. Is this really the right tone to take? At least the parties will have an opportunity to discuss the matter further:
Coast IRB CEO Daniel Dueber had been asked by subcommittee staff to submit to an informal interview prior to giving testimony before the committee on March 19. Following notice from Coast IRB that the fraud had been detected, committee staff informed Coast that the hearing would be postponed until March 26, 2009 and that the chairman of Coast IRB and possibly another Coast official would now have to appear for a “transcribed interview” with committee staff.
Um, did we do something wrong? Did you? Let’s not take any chances – try reminding everyone that we’re on the same side:
“We are doing our level best to ensure protection for subjects of clinical trials under our review, an objective we share with the Food and Drug Administration,” said Daniel Dueber, CEO of Coast IRB.
Honestly, I wish the folks at Coast IRB the best of luck. They’ll probably need it.
I’m a bit peeved with science journalist Leslie Roberts. She’s a fine writer, but as my graduate school mentor and current TWiV co-host Vince Racaniello has reminded me, she continues to screw up the story of polio eradication.
Vince has an excellent post on his blog today about the main story. In a nutshell, it seems that the World Health Organization (WHO), still struggling through an interminable campaign to wipe out polio, has had a shocking realization: they might need to consider switching to a different vaccine. To understand the sarcasm in the previous sentence, take five minutes to read Vince’s post, then come back here.
Okay, now that you’re back, let’s go to the Science news story that set me off. The full text requires a subscription, but this paragraph is the biggest problem:
The first big complication came in 1999 when scientists realized that the weakened virus used in the live oral polio vaccine (OPV) could revert to its neurovirulent form in rare cases and spark an epidemic. Thus was born the “OPV paradox”: OPV was necessary to eradicate the virus, but as long as OPV was in use, eradication could never be achieved. As a solution, World Health Organization (WHO) scientists proposed a plan: After the world was certified polio-free, all countries would stop using OPV simultaneously, as if at the stroke of midnight.
Actually, the scientific realization that OPV can throw off neurovirulent mutants came about thirty years earlier – it just took the WHO until 1999 to admit that this was a problem for their plan. Furthermore, the mutations don’t seem to be restricted to “rare cases.” There’s good evidence that OPV-vaccinated individuals routinely excrete virulent poliovirus in their stools.
Nor was this some obscure finding that had to be rediscovered from a dusty archive. In 1997, just two years before the big OPV-associated outbreak in the Dominican Republic that highlighted the issue, Vince and I warned of precisely that outcome, and argued that the WHO’s endgame strategy was absurd. Our paper, incidentally, was published in Science.
Roberts picked up the eradication story for the same journal in 2004, profiling the leaders of the WHO campaign in a long news piece and discussing some of the problems they were encountering. It was good reporting, but it ignored some critical history and fumbled some important facts, so I wrote a letter about it. I can certainly understand a reporter not trolling the archives for every prior publication on the issue, but I assumed she’d at least read the published letter correcting her, and not make the same errors in the future.
That obviously didn’t work, so here’s another shot at it. Maybe this blog post will turn up in Leslie Roberts’s next Google search for polio eradication. Leslie, if you have any questions after reading this, you can contact me through this site, or reach Vince (a genuine virologist who’s much more credible on this issue) through his blog.
I can’t let Darwin Day pass without a post, but I’m also a) on deadline for some paying work and b) dreadfully lazy by nature, so I’ll take the blogger’s easy way out. Reaching back into the Dovdox archives, I’ll blow the dust off this one:
Recently, I was talking to a researcher about a particular virus, and he mentioned that it has infected us “since fish.” Yes, fish have a time dimension. In two words, he had communicated reams of information: this virus has infected vertebrates ever since the divergence of the common ancestors of fish and mammals – somewhere around 395 million years ago. That implies that all of the species descended from those ancestors should have their own strains of the virus, which will have co-evolved alongside their host species. “Since fish” is a point in time, a testable prediction about present conditions, and a suggestion of how things might change in the future.
The immensely powerful organizing framework that makes that kind of shorthand possible is, of course, Charles Darwin’s theory of evolution. Besides spawning an argot that includes phrases like “since fish” (which would be a great name for a band, by the way), Darwin built one – or perhaps two – of the most useful conceptual structures in all of science.