Global successes of NPOs and government organizations can end the vaccine 'debate'

Non-profit organizations (NPOs) along with the World Health Organization (WHO) and other governmental agencies are achieving great strides in improving global health in developing nations through wide spread vaccination campaigns. These formidable NGOs such as the Bill and Melinda Gates Foundation, One World Health, the Malaria Vaccine Initiative (MVI part of PATH) and The Global Alliance for Vaccines and Immunisation (GAVI) are leading the charge to provide lifesaving vaccinations and medications to a major portion of the developing world.  For those who still sit on the fence regarding the risks and benefits of vaccination perhaps stepping back to look at the big picture will make up your mind.

http://www.gatesfoundation.org/

http://www.oneworldhealth.org/

http://www.malariavaccine.org/

http://www.gavialliance.org/

 

The World Health Organization estimates that the immunization campaigns now prevent 2-3 million child deaths each year; however, a further 1.5 million may be saved from preventable diseases by extension and further support of their vaccination programs. The frontrunners in this fight are determined to continue their crusade despite budget cuts in the government portions of their funding. Recently, the first Chinese vaccine, for Japanese encephalitis received WHO approval for use in other countries. The global approval of cheaper Chinese vaccines could make the dispersement of life saving vaccines and more broad ranging vaccine campaigns possible.

http://www.bbc.co.uk/news/health-24519949

http://www.scidev.net/asia-pacific/health/news/china-made-encephalitis-vaccine-gets-who-safety-seal.html

 

Another promising vaccine for malaria developed by GlaxoSmithKline is heading towards regulatory approval and licensing. According to the WHO, malaria infects 219 million people a year killing 660,000 annually. Recent phase III clinical trials conducted on 15,000 children in 11 African countries have shown that three doses on the vaccine can reduce the occurrence of the disease in young children by half and infants by one quarter. This would represent the first successfully commercialized vaccine against a parasitic disease. Due to the complexity of parasitic lifecycles the vaccine does not produce a 100% protection; however, used in conjunction with other control measures such as mosquito nets and antimalarials it will be a powerful tool in the fight against this daunting disease. GlaxoSmithKline who has been developing a malaria vaccine for thirty years has agreed to produce vaccine at cost, plus a 5 per cent profit margin, if it receives regulatory approval.  They would then reinvest the profit margin for further malaria research.

http://www.ctvnews.ca/health/health-headlines/world-s-first-malaria-vaccine-possible-by-2015-1.1488527#ixzz2iahDqzYx

http://www.gsk.com/media/press-releases/2013/malaria-vaccine-candidate-reduces-disease-over-18-months-of-foll.html

 

There have been multiple examples of successful vaccination campaigns throughout recent history with the eradication of small pox in 1980, near obliteration of polio (except in developing/war torn areas) and a virtual wipe out of a number of other serious infections particularly in the developed world.

Further support for the effectiveness of vaccination lays in the resurgence of a number of diseases where there has been a reduction in the rate of the associated vaccination in North America and Europe. Several myths with no scientific merit have surfaced and influenced many people to choose not to vaccinate their children in North America and Europe.

 

One of these myths: that the measles, mumps and rubella vaccine (MMR) may cause or lead to autism has been completely debunked. The original paper from 1998 that reported the results was retracted by the Lancet in 2010. In fact the researcher Andrew Wakefield was found guilty by the General Medical Council of the UK of dishonesty and flouting ethics protocols. Still the myth lives on, often through uninformed public personalities. This dangerous misinformation from uninformed people is a powerful example of how our media culture can be a threat to bona fide science and public health.

http://www.bmj.com/content/340/bmj.c696

 

An outbreak of Pertussis (Whooping Cough) in California in 2010 where 9120 cases of the disease were reported were directly correlated to areas where people could opt out of the vaccination. This outbreak marked the largest number of cases reported in California since 1947.  The researchers found that people in areas where the exemptions existed were 2.5 times more likely to contract the illness. These results show strong evidence that vaccination was the direct cause for absence of the disease. These outbreaks also make the point that choosing not to vaccinate your child is a significant threat to public health and does not affect only your family. This choice affects the community at large.

 

http://pediatrics.aappublications.org/content/early/2013/09/24/peds.2013-0878.abstract

We are all in this life vessel called earth together.  A pandemic is an ominous threat but it can and has happened.  This is not the stuff of science fiction like a zombie apocalypse. Today we face even graver possibilities for rapid circumnavigation of a disease as we humans travel at an ever increasing pace around the world making these tiny pathogens frequent global travellers. Often people may travel prior to any obvious symptoms making detection and screening near impossible. Further, more virulent strains of pathogens are emerging due to evolutionary pressure of antibiotic misuse and an exploding global population.

Vaccines and global herd immunity is one of our best defensive strategies against a global pandemic. Herd immunity happens when a significant enough amount of the population is immune to a disease e.g. through vaccination to prevent effective spread of the disease that could lead to an epidemic. Essentially, it means there are not enough suitable hosts for a pathogen to propagate. The scientific evidence to support the benefits of vaccination are compelling.

The rapid reduction of diseases where NPOs and government organizations are running vaccination programs with the goal of eradication shows a powerful paragon of the effectiveness of vaccines. We are global citizens in a global community and these admirable associations are providing a great service to global health. Vaccines work period.

What is a superbug?

photo credit: www.telegraph.co.uk 

A medical threat loosely termed “superbugs” have been an increasing concern in modern healthcare. These are common bacterial pathogens that have evolved to cause severe and antibiotic resistant infections. Bacteria have naturally occurring mutations during DNA replication. These mutations will often be detrimental to the organism; however, occasionally the mutation may prove to be advantageous. For example, a mutation may alter the target protein of an antibiotic rendering it resistant to that antibiotic. When this occurs in a pathogen that is infecting a host subjected to that antibiotic, the resistant organism may now flourish in the absence of nutritional competitors. Other mutations may contribute to the organism producing factors that cause a more serious infection.

 

Hospitals are a notorious site for the emergence of superbugs for a number of reasons. Hospitals contain susceptible and compromised hosts in close proximity. Patients admitted to the hospital may carry drug resistant or highly virulent strains of bacteria. There are antimicrobial agents being administered to the patients and used for sterilizing equipment and surfaces. These are the agents that place evolutionary pressure on the bacteria that can lead to the development of resistant, hardy strains of the pathogen.

 

Incomplete antibiotic administration is also a major contributor to resistance as it fails to completely eradicate a normally susceptible strain. Low sub lethal levels of antibiotic give the pathogen more time to adapt by allowing for cell division i.e. more cycles of DNA replication and thus a higher chance of acquiring resistance.

 

Finally, many bacteria have developed mechanisms to transfer antibiotic genes to neighboring bacteria through a process called conjugation. They effectively send the DNA coding for resistance over to their neighbor via a tube connecting the two cells. That means if your normal flora that are not harmful carries antibiotic resistance genes there is a chance that they may pass those genes along to harmful strains that cause infection.

 

“Superbugs” can be difficult to treat and often cause more serious disease.  It is crucial that attempts are made to ensure the correct administration and curb the overuse of antibiotics. Alternative treatment such as bacteriophage therapy are in development; however, we must be vigilant as mother nature has proven herself to be highly adaptable to all of our best efforts.

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Scientists develop virus to combat superbug

Scientists develop virus to combat superbug that causes serious diarrhoeal disease

A collaboration of scientists are in the advanced stages of developing a bacteriophage, a type of virus to combat a serious hospital acquired infection caused by the bacteria Clostridium difficile (C. difficile).  Scientists with AmpliPhi BioSciences Corporation have entered a licencing agreement with UK-based University of Leicester to develop bacteriophage viruses to target the infectious agent C. difficile.

C. difficile causes a serious diarrhoeal disease in humans and many strains have become increasingly resistant to antibiotic therapy developing into “superbugs”. C. difficile is one of the most prevalent species of bacteria found in hospital acquired infection. The US Center for Disease Control notes its September 2013 report on antibiotic resistance, that C. difficile is as an urgent threat, causing 250,000 infections in the US every year and costing $1 billion a year in excess medical costs.  Philip J. Young, CEO of AmpliPhi said "C. difficile causes at least 14,000 deaths a year in the US alone.”

Bacteriophages are viruses that can infect and destroy bacteria.  Although bacteriophages have been used in both clinical applications and for genetic manipulation of bacterial species in laboratories for over 100 years they are only recently being commercially developed for therapeutic purposes.  Current studies using bacteriophage in a human colon model of C. difficile infection have shown a significant reduction in bacterial load in addition to a decline of the toxin produced by the bacteria. The bacteriophage is a beacon of hope for new therapies in the grim face of emerging antibiotic resistant bacterial infections. 

The unfortunate fear of biotechnology

The unfortunate fear of biotechnology

"Nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less."• Marie Curie.

There is a marked gap between a technical understanding of biotechnology and how that is translated to layman. In many cases, the negative stigma may be resolved when well summarized facts of the outcomes of scientific research are presented. In the very least, it will allow the masses to make wise, informed decisions about the support or opposition regarding applications of scientific research.

Many layman feel fear towards scientific advancement because they do not understand what has been discovered or achieved. Technical jargon so loved by scientists, make the contents in effect a foreign language to the non-scientist. When explained in simpler terms and common language, the layman does not have difficulty grasping the concepts and most often gets excited, interested and supportive about a topic that they may have previously considered controversial or ethically questionable.  Skewed public misunderstanding fueled by propaganda of motivated groups and based on large amounts of misinformation can stymy some potentially useful scientific progress.

Take for example stem cell research, the biggest controversy seems to lay in the source of the stem cells from embryonic tissues.  In fact, many stem cells may not be derived from controversial sources. Scientists are making great strides to develop techniques to undifferentiated or reprogram cells. They use their knowledge of cell signaling pathways to reverse engineer differentiated cells into stem cells. In 2012 Sir John B. Gurdon, and Shinya Yamanaka were awarded the Nobel Prize in Medicine for the discovery that mature cells can be reprogrammed to become pluripotent. These in vitro (petri dish) derived stem cells hold endless possibilities for spinal cord injury and organ transplant and may in fact reduce less desirable or ethically unpalatable methods in use for these conditions at present.

The flip side of course is that a greater public understanding will also raise well warranted ethical concerns in some areas. This is also a welcome result! Properly educating people on biomedical advancements will ultimately result in appropriate ethics legislation.  The bottom line is that we need to educate the masses so that they can make informed and effective choices. Plus science is fascinating, it is a shame not to share it.

The quandary of personalized medicine-unlocking your personal genome

The quandary of personalized medicine, unlocking your personal genome. By Kristin Tangen-Steffins

It is now accessible for the average person to explore their personal genome to determine potential genetic health risks.  It was not long ago that sequencing a single gene would constitute an entire Ph.D. thesis. Now thousands of genes (or portions of) can he sequenced in a matter of hours.  DNA sequencing has ridden on the coat tails of rapidly advancing computer and nano technology.

Limited genetic testing has been available for some time for a handful of conditions.  People with familial backgrounds may have pondered the conundrum of whether they wanted to know if they were at risk for a disease by possessing a mutation in a particular gene and if they did know how would they react?

Similarly, expectant mothers and fathers are presented with the choice of whether or not to have genetic testing performed on their unborn child. Again apprehension may surface for ethical reasons of what the choice would be if there is a chromosomal abnormality. Would they rather leave it out there for the universe to decide? 

We are now at the point in the genome era where we can ask much more broad stroked questions.  Now the average person can ask “Do I want to know my genetic repertoire or fingerprint?” Many commercial companies now offer these services.  A client simply sends them a sample of a swab from inside their cheek as part of a company produced DNA testing kit. The company uses DNA microchips (laser based DNA sequencing) to test the client’s sample for a variety of characteristics. The results are analyzed based on available scientific findings then send on to the client.  

Scientists can now test for multiple markers (informative regions of targeted genes) representing a plethora of conditions both health specific and curiosity driven.   Below are some well warranted questions that one may ask themselves before considering subscribing to personalized medicine. 

1.      If a client is predisposed to a condition can they do something pre-emptive about it?

2.      What is the chance of disease if there is a particular mutation in their genes? Does the mutation indicate a higher risk (if so how much)? E.g. brca genes in breast cancer or is the condition inevitable e.g. Huntington’s disease.

3.      How serious is the condition? 

4.      If the condition is severe will it negatively affect their life to know they are at risk while they are presently healthy and may be for many years? In fact, the condition may never manifest.  We now know the serious health implications of worry, stress and a negative attitude on our mental and physical health including the immune system.

5.      Will knowing increase someone's risk through self-fulfilled prophecy?  I.e. will they worry themselves sick?

6.      Will it risk their health or life insurance? We hope soon this will not be an issue, as experts and citizens are presently lobbying to make it illegal to discriminate based on genetic predispositions to conditions.

7.      How drastic is the preventative intervention should they prove to be at risk? 

These are all good questions. One must weigh the risks and benefits, then make an informed personal choice. If someone is considering personal genetic testing and has concerns or would like clarifications it would be wise to talk to a genetic counselor.

The choice to use personalized medicine may not be for everyone; however, there already have already been lives saved. For example, disease has been avoided in cases of familial inherited cancers where someone predisposed (possessing the mutated gene) took preventative measures e.g. mastectomy or the disease was caught early due to increased vigilance as a result of knowing they were at high risk. There were cases prior to the availability of testing where people from an affected family had taken drastic irreversible measures such as mastectomy to later find out they did not have the aberrant gene. Here you can see an example where the risk of getting tested would definitely be worth the benefit.

The number of markers (conditions and traits) tested is sure to increase at pace with the new genetic discoveries adding to the personal genome repertoire. If you are interested in further delving into the subject of personalized medicine a fascinating read is a book by Francis Collins, The Language of Life: DNA and the Revolution in Personalized Medicine (HarperCollins, 2010).  Dr. Collins was the leader of the public human genome project and is the presently the director of the National Institutes for Health in Bethesda, Maryland.  This book is informative, factual, based on real case studies and above all entertaining. 

For those who prefer to leave it up to nature, good on you.  And for those who would rather be proactive or are just intensely curious, what seemed to be science fiction a short time ago is now within our grasp.