Mosquito repellant nanotechnology clothing against Chikangunya

     As I wrote on a previous post, Chikangunya virus is spreading quickly in the Caribbean and has been transmitted in the U.S. in Florida, now.  I am currently visiting Dominica in the Eastern Caribbean, a region particularly hit by the virus.  In addition to the old standby, #SkinSoSoft by Avon, I discovered new insect repellant nanotechnology for clothing sold at #Cabela's and made by #BurlingtonLabs. Reasonably priced, I have attached a photo of the labels showing the fabric contains 0.52% permethrin, an insecticide, on one of the shirts. 

    We ventured into the Central Rain Forest, a national park and encountered no problems. I think it really repelled mosquitoes and other insects. Only after I removed the clothing after returning to the hotel (albeit with the windows open) did I get a mosquito bite in #Dominica.  Now I will wait and see what happens.

China Provinces Implement Broad Quarantine

            One person, Wang, of unknown gender, died in Yumen of pneumonic plague on Wednesday, July 16, 2014 and 151 people had close contact with him have been contacted and isolated. Conflicting reports say he was in close contact with a marmot or with rats.
            The National Health and Family Planning Commission has gone to Yumen to implement control measures.  It is not clear on whose authority quarantines were issued, but reports say that authorities in the city of Juiquan, Gansu Province, implemented quarantine in four areas on Thursday, July 17, 2014: Yuman City, Chijin Tow, Xihu Village and an unnamed rural area.  In addition, roads have been closed into and out of Jiuquan, including Lianhuo Expressway that lings east Jiangsu Province with the Xinjiang Uygur Autonomous Region and it is being enforced by local police officers.

According to reports, the third-highest in a four-tier quarantine law was implemented in these areas and roads going in and out of the area.

           “As a result of the emergency alert -- the third-highest in a four-tier system - four quarantine areas have been set up: in Yumen City, Chijin Town, Xihu Village and an unnamed rural area, the government said. Several roads into and out of Jiuquan have also been closed, including the Lianhuo Expressway that links east Jiangsu Province and the Xinjiang Uygur Autonomous Region, local traffic police said. "We don't know when the road will reopen," said Meng Guanghui, a police officer who patrols the expressway, adding that drivers have been told to find alternative routes.”
            China’s Law on the Prevention and Treatment of Infectious Diseases categorizes plague as a Class A infectious disease, the highest level.
            During the SARS outbreak, China’s quarantine laws included individual and area quarantines such as the one described in these recent news accounts.  Area quarantines are unusual in the United States and are typically reserved for agriculture quarantines, not people.  Quarantining a region or town for a human disease would be a highly unusual action and is not a measure provided for in most state public health emergency laws, although it has been recommended in model legislation as an important tool for managing infectious disease outbreaks.

First thing we do, let's purge all the advisors!

    My title is a play on the Shakespearean quote from his work, “Henry VI”, “First thing we do, let’s kill all the lawyers!” uttered by Dick the Butcher in hopes that if he could do away with law and order, he could become king. This title seems apropos for the purging of the institutional memory of the NSABB yesterday with the wave of dismissals of 11 of the 23 member FACA (Federal Advisory Committee). Yesterday’s news of the purge of the NSABB in the wake of the CDC and NIH incidents with anthrax and smallpox, raises questions about the reason for making an exception to the charter’s length of service of membership appointments and the very purpose of the NSABB. The NSABB Charter provides that members will be appointed “for overlapping terms of up to four years; . . .”

               The purpose of the NSABB is explained in the charter “. . . is to provide, as requested, advice, guidance, and leadership regarding biosecurity oversight of dual use research, defined as biological research with legitimate scientific purpose that may be misues to pose a biologic threat to public health and national security. The NSABB will provide advice on and recommend specific strategies for the efficient and effective oversight of federally conducted or supported dual use biological research. . .”  This is a very narrow charge, and the NSABB has historically worked in this narrow area.  The scope of authority for the NSABB does not include advice on the proper regulation of federal conducted research --- only that research in the context of its “dual use” implications.  Even a new array of advisors will have no further authority than the existing and purged membership, so it is unclear what the expectations are for this exceptional overturn of membership.

      The Pandemic and All-Hazards and Preparedness Act, 42 U.S.C. 217a, sec. 222, is the authority for the NSABB.  The NSABB is a Federal Advisory Committee which means it is made up of non-government members with government members and is advisory, only.  The NSABB advises the Secretary of Health and Human Services.

CDC's anthrax accident and the problems of self-regulation

The CDC’s most recent incident with the discovery of a strain of anthrax that was not what they thought it to be, that is, an attenuated or weakened strain, raises the same red flag that has been raised in previous incidents.  CDC is regulating itself, and it is apparent from their own internal investigation of the incident that they were not complying with their own requirements for experiment plans and specific protocols for each experiment, for response protocols or for biosafety standard operating procedures (SOPs) required for each experiment, point of contact (Responsible Official), etc.

But some of the more obvious problems with the regulatory structure in which biosafety and biosecurity should be achieved are evident in their own investigative report.  The CDC reported that it had “ceased operations” which is not what the regulating body should have done in this case.  The CDC should have at a minimum “suspended” its registration (42 CFR §73.8) which would not allow them to resume operations until a complete review of their biosafety and biosecurity plans and procedures and compliance had been verified by --- well, by them.  But there is more.  An incident such as this, resulting in a potential occupational exposure requires a reporting protocol, and a form completion within seven days of the incident (the incident was June 13):

 42 CFR §73.11(b) Upon discovery of a release of an agent or toxin causing occupational exposure or release of a select agent or toxin outside of the primary barriers of the biocontainment area, an individual or entity must immediately notify CDC or APHIS.

 (1) The release of a select agent or toxin must be reported by telephone, facsimile, or e-mail. The following information must be provided:

(i) The name of the select agent or toxin and any identifying information (e.g., strain or other characterization information),

                          (ii) An estimate of the quantity released,
                          (iii) The time and duration of the release,
                          (iv) The environment into which the release occurred (e.g., in building or outside
                          of building, waste system),
                          (v) The location (building, room) from which the release occurred,
                         (vi) The number of individuals potentially exposed at the entity,
                         (vii) Actions taken to respond to the release, and
                         (viii) Hazards posed by the release.

(2) A completed APHIS/CDC Form 3 must be submitted within seven calendar days. 

   The Freedom of Information Act should allow anyone to see how well they complied with this provision, but my experience with CDC was three years before a response to our FOIA request – another problem for another post.

   The CDC’s investigation report dated July 11, 2014 makes little attempt to cite any regulation that is violated and only references to needed improvements that are actually regulatory requirements are made without citing to any regulation.  It suggests that CDC’s investigation had little to do with the regulation or being regulated.  “Arrogance” is the word I am trying to avoid using too quickly, but it is becoming the elephant word in the room as I read the report. 

   The self-regulation in this case, bears review, and perhaps another department, like the Dept of Homeland Security, would be best suited to review the biosecurity compliance aspect, at least.  NIH, the sister agency of CDC within DHHS has more knowledge of biosafety than any other agency, even CDC, because they do more of the biodefense research than any other agency, and they would be well suited to be an advisory source for compliance.  But because NIH is regulated by CDC, this also sets up a conflict of interest where “mutual regulation” would be created. An external body could review the biosafety compliance if it was made up of conflict-free members who were not on the CDC payroll as consultants, but again, it is hard to find an expert who is not contracted with CDC to do inspections of laboratories.  Regulating CDC is not an easy problem to solve, but perhaps when a private accrediting association eventually emerges to accredit laboratories independent of CDC, they would be the place to seek a regulator of CDC’s own BSL facilities. 

    But my final word is that the real hero in this story is the scientist who discovered the unexpected growth of the anthrax on the discarded plates, and averted what could have been a biodisaster. 

    Congratulations and thanks to the individual scientists at CDC who are working to protect public health and safety, every day.  They are not the problem, it is the regulatory framework in which they work.

Chicken Pox Parties Gone Global

    In 2011, Reuters reported a Nashville U.S. District Attorney was warning parents not to mail chicken pox infected lollipops or other materials through the mail.  The mailing of infectious diseases through the U.S. mail is a federal crime.  They also caution that tampering with consumer products such as a lollipop is also a federal crime.  These warnings came after news of a multi-state ring of anti-vaccination parents were sharing lollipops licked by their infected children and mailing them to parents who wanted to intentionally infect their child with chicken pox to give them what they hoped was a mild case of it.
    The test for whether you have committed a federal crime is not whether the lollipop was mailed across state lines, but whether it had "a substantial effect on interstate commerce," which could be potentially achieved by having investigators travel to the area to investigate and spend money on a hotel and food.
    The parents were also hosting chicken pox parties.  Information for parents hunting for infected children was shared on Facebook at one page called "Find a Pox Party in Your Area".  I since located other Facebook pages, "Pox Party-USA", Pox Party in the Gulf South, Chicken Pox -- Greater New York Area".
     Not only is this illegal, it is dangerous.  CDC reports more than 100 children a year were killed by chicken pox before the childhood vaccine became available about a decade ago.  Shingles is also caused by the presence of the chicken pox virus, so once you have the disease you may be looking forward to shingles in the future.  The chicken pox vaccine allows your child to miss that opportunity.
     Troubling is the evidence that this is become a global phenomena, not just an American one.  The United Kingdom as well as New Zealand have had reports of chicken pox parties.
     The First Amendment provides for Americans to gather in their homes without government interference, but when those gatherings have a serious impact on public health, state governments should consider making these contamination rituals at parties, illegal.

The New York Times Review by Gopnik recognizes a new genre of biohorror/biothriller

Adam Gopnik, fantasy author in his own right, reviewed Chris Weitz's new children's book, "A Young World," in this Sunday's New York Times Book Review section.  The book is about a pandemic that leaves the teens in charge of the world.  But of most interest is that Gopnik begins to see an emerging genre when he writes,

"What is the deep appeal of this kind of fantasy right now? That it is a well-developed — even an overdeveloped — genre is disarmingly acknowledged by Donna: “Even when it was happening, all I could think was, this is just like ‘Contagion.’"

I recommend The Things That Keep Us Up At Night --Reel Biohorror --the first book to identify and explore biohorror and biothriller as a new subgenre.   

Anti-Vaccine Believers and Scientific Studies

When The Economist, Hollywood, Jon Stewart, Scientists, Children and Scientific Fraud Collide

In 1989, Meryl Streep warned us away from apple juice because it contained a “pesticide” called alar.  It has since been shown first, that it is not a “pesticide” and second, that the upshot to omitting alar from apple growing – which causes the apple to stay on the tree longer, thus less need for pesticides – was that more pesticides will have to be used. (All of this happened as I was graduating with a Ph.D. in Environmental Sciences with a focus on risk communication, so it was indeed a memorable event that told me I had a lot of work ahead of me.) This is the way not to do science, and did we learn a lesson from taking scientific advice from Hollywood stars? No.  Apparently, the California hipsters in Napa, Sonoma, etc. have heeded the warning of another Hollywood “star” with no expertise.

On June 28, 2014, The Economist wrote a scathing commentary on the connection between Hollywood stars and the affluent areas of California which have seen a rise in childhood diseases correlated with resistance and refusal to get vaccinations. .

Jon Stewart, in June, did his usual comedic-style treatment of the subject. Samantha Bee did a nice job of hitting some key points, despite her abrasive biases against conservatives.

But none of these high profile, attention-grabbing presentations pointed the finger where it really deserved pointing – to the researcher who was cloaked with scientific credibility when he misrepresented his studies and claimed there was correlation between autism and the MMR vaccine for children. Scientists who falsify data are more to blame than Hollywood. A credible scientist, Wakefield, published in a prestigious medical journal the findings that correlated autism with vaccines, but on closer examination the funding for the study was in anticipation of litigation against vaccine manufacturers and came from lawyers involved in the case according to a report in CNN in 2011.  Reporter, Brian Deer, said Wakefield "chiseled" the data before him, "falsifying medical histories of children and essentially concocting a picture, which was the picture he was contracted to find by lawyers hoping to sue vaccine manufacturers and to create a vaccine scare." According to BMJ, Wakefield received more than 435,000 pounds ($674,000) from the lawyers. Godlee said the study shows that of the 12 cases Wakefield examined in his paper, five showed developmental problems before receiving the MMR vaccine and three never had autism.

Did the retracted article make it clear that the science was falsified and there is no correlation between autism and the MMR vaccine? Unfortunately, Dr. Andrew Wakefield (a British scientist) has played on the sensitivities of parents with children with autism who would like to find a reason. Undeterred, he has found safe haven for his anti-vaccine message in Austin, Texas where he is founder of an autism research center, Strategic Autism Initiative (SAI), and Director of the Autism Media Channel. With that in mind, it may be very relevant here to mention that one of the most frequently seen bumper stickers for Austin is “Keep Austin Weird.”

If a poll could be taken of parents asking them whether it was true that autism is caused by childhood vaccines, would they still remember the hype around the now discredited study or would they remember the retraction of that article? My hypothesis is that the parents who heard the scientifically reported article would number at least 3 to 1 the parents who knew  about (and understood) the retraction.  

Both FDA and CDC should join forces to develop an information campaign to tell parents the truth and help guide them through the collision of information bombarding them from every corner of the social media milieu to protect children and to protect public health in America.  The effect of this leadership could have a global impact as well, and the world's leader in science, education and discovery could save millions of lives by that one, simple campaign.