1. The New York Times published an update about a “Life of Struggle and Scares” for young families afflicted with Zika virus in Brazil. This well-composed piece includes videos and interviews, and documents the cases of several specific children. Doctors are finding later onset complications of Zika even for children not immediately diagnosed with gross morphological abnormalities. The impact of this disease is still truly unquantifiable.  https://nyti.ms/2mwjn68
  2. The US is in the midst of a Seoul Virus Outbreak:
    https://www.cdc.gov/hantavirus/outbreaks/seoul-virus/index.html
    This virus, transmitted through the bodily fluid of non-symptomatic rat carriers, cannot be transmitted human-to-human. However, it seems, rodents distributed from a centralized rattery (a rat distribution and breeding center, not a battery powered by rats on a wheel*) may have reached 15 states and Canada. Seventeen individuals in 7 states were diagnosed with the hemorrhagic fever caused by the hantavirus.
    After cases began appearing in February, the CDC opened an investigation, defining cases and seeking overlooked cases, identifying a common source, tracking shipments, and making recommendations to prevent further spread of infection – executing the steps we outline in class to investigate an outbreak.
  3. Recently, I met a 6-year-old boy at swimming physical therapy who had come down with a fever and now mysteriously suffers from near-complete paralysis. In 2016, 136 individuals in 37 states were diagnosed with Acute Flaccid Myelitis (AFM), mostly children. Some research shows these cases may be linked to a certain Enterovirus (C105), but in general the cases have very little in common. A similar 2014 outbreak corresponded to a national outbreak of Enterovirus D68.For reference, this is essentially the pathogenic mechanism of Poliovirus (an enterovirus which affects the spinal cord). Testing of individuals from the recent outbreak has identified no consistent pathogen. It is unclear if a single pathogen or the immune response itself is chiefly responsible for lesions in the spinal cord.
    Further research is included here: https://wwwnc.cdc.gov/eid/article/21/10/15-0759_article

     afm-cases-reported
  4. Scientists and NPR predict 2017 will be a bad year for Lyme disease. NPR made the same prediction in 2012 based on the same body of research. The research from 2005, in short, uses correlative data to predict Lyme incidence, and the best predictors they say are weather, mice, and acorns. However, according to the group:

    We found that acorns and mice were strong predictors of Dutchess County Lyme disease incidence, but their predictive power appeared to be weaker spatially. Moreover, evidence was weak for causal relationships between Lyme disease incidence and the weather variables that we tested.

    So the question good students should ask is, “were they right in 2012?” Thanks to the CDC, who made the data of Lyme incidence available publicly by county in the US, I was able to check both for the US and for Connecticut and the case count was not up:

    Year 2008 2009 2010 2011 2012 2013 2014 2015
    CT Cases 1788 3058 3896 4156 3068 3039 2657 2925
    National Cases 35198 38468 30158 33097 30831 36307 33461 38069

    Now this could be due to better education and prevention or any number of other factors; always be smart when hiking and spending time in tick habitats and areas where mice live. Our final point today (6) addresses the dangers of drawing conclusions from correlations.

  5. Have you had it with drug-resistant bacteria? Good! Because the US is reporting cases of a new, disgusting, drug-resistant fungal infection in hospitals.
    Last year, 7 cases of Candida auris infection had been reported in Morbidity and Mortality Weekly Report published in November – 6 more were under investigation. Now, 34 cases have been reported in New York state alone in this outbreak. The CDC has recommendations and protocols published for preventing the spread and infection of this disease, as well as treatment. However, the CDC openly admits more data is needed to get a better grasp on this potentially devastating international infection.
  6. Last but not least – ever see a correlation so strong with an R value so good you just knew it had to be true? Think again. Below is a favorite example from a list compiled by Tyler Vigen, curated and called “Spurious Correlations.”

    In an examination of real, publicly available data, Tyler sought correlations and graphed them using questionable but not even egregiously bad axes. The graphs here are well labeled and border on convincing, which in this case is fun, but it speaks to a greater issue with the presentation of data.

    untitled.png

    Enjoy these correlations, read up on other health threats, and if you see anything I’ve missed that you think is important shoot me an email.

Be Well!
P.S.
Follow-Up and Updates
From Last Month
  • Two cases were reported in Gobabis region of Namibia last month, however only one appears to have been truly CCHF. A second case is now confirmed but with no epidemiological link.
  • While this has been developing, three are dead after an outbreak in Oman. While both outbreaks seem to be contained, CCHF is considered a high-risk pandemic disease.
  • The disease is endemic in Afghanistan and is FAR more widespread than I had initially thought.
* and a “rattery” in this form already exists
rat
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