(Roughly) Daily

Posts Tagged ‘epidemiology

“24 hours in a day, 24 beers in a case. Coincidence?”*…

Social distancing makes a soul thirsty– and as the Journal of the American Medical Association reports, that has had consequences…

Alcohol consumption has substantially increased during the COVID-19 pandemic… We examined national changes in waiting list registration and liver transplantation for ALD and the association with alcohol sales during the COVID-19 pandemic. We hypothesized that waiting list registrations and deceased donor liver transplants (DDLTs) for alcoholic hepatitis (AH), which can develop after a short period of alcohol misuse, would disproportionately rise…

This cross-sectional study found that waiting list registrations and DDLTs for AH increased significantly during COVID-19, exceeding the volumes forecasted by pre–COVID-19 trends by more than 50%, whereas trends for AC and non-ALD remained unchanged. While we cannot confirm causality, this disproportionate increase in association with increasing alcohol sales may indicate a relationship with known increases in alcohol misuse during COVID-19. Since less than 6% of patients with severe AH are listed for transplantation, increasing waiting list volume during COVID-19 represents a small fraction of the increase in AH, a preventable disease with 6-month mortality up to 70%.

Pandemic drinking is up– way up. So, it turns out, is serious liver disease: “Association of COVID-19 With New Waiting List Registrations and Liver Transplantation for Alcoholic Hepatitis in the United States.”

And lest we think think that waning COVID-19 pressure will be the end of all of this, a warning: “The Coming Age of Climate Trauma.”

[Image above: source]

* Steven Wright

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As we muse on moderation, we might recall that it was on this date in 2012 that Charles Darwin received about 4,000 write-in votes in the election in Georgia’s 10th Congressional District. Republican Paul Broun, an M.D. who was running unopposed for re-election, had given (the September before) a campaign speech at the Liberty Baptist Church Sportsman’s Banquet in which he said “All that stuff I was taught about evolution and embryology and the Big Bang Theory, all that is lies straight from the pit of Hell.”

In response, radio talk show host Neil Boortz and University of Georgia plant biology professor Jim Leebens-Mack spearheaded a campaign to run the English naturalist and evolutionary theorist against Broun, a young earth creationist. They had no expectation of unseating him (and indeed, Broun carried his district handily) but hoped to draw attention to these comments from the scientific community and to have Broun removed from his post on the House Science Committee– at which they also failed.

Paul Broun [source]

“Let him that would move the world first move himself”*…

In 1930, Indiana Bell, a subsidiary of AT&T, needed a larger building for their headquarters. The problem? The old building needed to stay in operations at all times, providing an essential service to the city. Instead of tearing it down or simply moving to a new building, they decided to move it to a different part of the lot and build on the existing location. Just that.

The massive undertaking began on October 1930. Over the next four weeks, the massive steel and brick building was shifted inch by inch 16 meters south, rotated 90 degrees, and then shifted again by 30 meters west. The work was done with such precision that the building continued to operate during the entire duration of the move. All utility cables and pipes serving the building, including thousand of telephone cables, electric cables, gas pipes, sewer and water pipes had to be lengthened and made flexible to provide continuous service during the move. A movable wooden sidewalk allowed employees and the public to enter and leave the building at any time while the move was in progress. The company did not lose a single day of work nor interrupt their service during the entire period.

Incredibly most of the power needed to move the building was provided by hand-operated jacks while a steam engine also some support. Each time the jacks were pumped, the house moved 3/8th of an inch.

Via Kottke and The Prepared; TotH to @splattne and @mckinleaf

Fun fact: the entire project– including the move– was designed by a leading Indianapolis architect, Kurt Vonnegut Sr., father of the famous novelist (and of the chemist who developed the technique of seeding clouds with silver iodide to produce rain/snow).

Over a month in 1930, the Indiana Bell building was rotated 15 inch/hr– overall, 90°– all while 600 employees still worked there.

* Socrates

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As we change perspective, we might recall that it was on this date in 1915 that Mary Mallon, “Typhoid Mary,” was put in quarantine on North Brother Island, in New York City, where she was isolated until she died in 1938.  She was the first person in the United States identified as an asymptomatic carrier of the pathogen associated with typhoid fever… before which, she inadvertently spread typhoid for years while working as a cook in the New York area.

source

Written by (Roughly) Daily

March 26, 2021 at 1:01 am

“Not with a bang, but with a whimper”*…

 

death

Death Table from Tuberculosis in the United States, prepared for the International Congress on Tuberculosis, September 21 to October 12, 1908. Image: U.S. National Library of Medicine

 

Recent history tells us a lot about how epidemics unfold, how outbreaks spread, and how they are controlled. We also know a good deal about beginnings—those first cases of pneumonia in Guangdong marking the SARS outbreak of 2002–3, the earliest instances of influenza in Veracruz leading to the H1N1 influenza pandemic of 2009–10, the outbreak of hemorrhagic fever in Guinea sparking the Ebola pandemic of 2014–16. But these stories of rising action and a dramatic denouement only get us so far in coming to terms with the global crisis of COVID-19. The coronavirus pandemic has blown past many efforts at containment, snapped the reins of case detection and surveillance across the world, and saturated all inhabited continents. To understand possible endings for this epidemic, we must look elsewhere than the neat pattern of beginning and end—and reconsider what we mean by the talk of “ending” epidemics to begin with…

Contrary to hopes for a tidy conclusion to the COVID-19 pandemic, history shows that outbreaks of infectious disease often have much murkier outcomes—including simply being forgotten about, or dismissed as someone else’s problem: “How Epidemics End.”

* T. S. Eliot, “The Hollow Men”

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As we contemplate the end, we might send insightful birthday greetings to Nettie Maria Stevens; she was born on this date in 1861.  A geneticist– and one of the first American women to achieve recognition for her contributions to scientific research– she built on the rediscovery of Mendel‘s paper on genetics (in 1900) with work that identified the mechanism of sexual selection: its determination by the single difference between two classes of sperm—the presence or absence of (what we now call) an X chromosome.

220px-Nettie_Stevens source

 

“Law; an ordinance of reason for the common good, made by him who has care of the community”*…

 

vaccination

 

In the fall of 1713, measles struck the city of Boston, where Cotton Mather, a Puritan theologian and pastor, lived with his pregnant wife and numerous children. Within a month, his wife, their twin newborn babies, another child, and their maidservant had all died. On November 12, Mather wrote in his journal, “The epidemical Malady began upon this Town, is like to pass thro’ the Countrey. . . . it [might] be a service unto the public, to insert in the News-paper, a brief Direction for the managing of the sick. I will advise with a Physician or two.” On November 21, he wrote, “Lord I am oppressed; undertake for me!” On November 23, he wrote, “My poor Family is now left without any Infant in it, or any under seven Years of Age.”

Eight years later, when an explosive smallpox epidemic threatened Boston’s population of eleven thousand, Mather became an outspoken advocate for a new prophylactic against the virus: inoculation. Dr. William Douglass, one of the few doctors in town with a medical degree, rallied others to oppose Mather, claiming that the method was untested (which was true, at least in the new colony) and that it jeopardized the lives of all those who received it. In young Boston, the fight over inoculation tore at epidemic-addled nerves. In November 1721, a bomb was thrown through Mather’s window. A letter attached to it read, “Cotton Mather, you dog, dam you! I’ll inoculate you with this; with a pox to you.”

Douglass won out, quashing Mather’s plans for a systematic inoculation of the town’s population. Eight hundred and forty-four people died of the virus, accounting for 75 percent of all deaths in Boston that year. The unexploded bomb on Mather’s floorboards disabuses those of us living in 2019 of the impression—generated over the past two years by endless news stories about the current global measles outbreak—that inoculation controversies are a novel feature of our present hyper-mediated, hyper-politicized time.

Measles was considered to be eliminated in the United States in 2000. Still, the virus has regained extraordinary ground—and claimed an increasing number of lives—in recent years. Seven hundred and four cases were reported in the United States in the first four months of 2019, according to the Centers for Disease Control and Prevention. The count reached 1,077 by mid-June, occurring in twenty-eight states. More than six hundred cases have occurred in New York City alone since September of 2018.

In June, the CDC issued a warning to travelers planning to leave the country, by which point outbreaks were occurring in all the places you’d expect, countries beset by depressed economies, poor public health management, war, or extreme poverty, including Ethiopia, Madagascar, Kyrgyzstan, the Democratic Republic of Congo, the Philippines, Sudan, and Georgia (not the U.S. state, although cases have been reported there as well). But also, cases were appearing in countries where entrenched vaccination systems existed and where measles had been thought largely a disease of the past: Belgium, France, Germany, and Italy.

The grand cause for these infections—and for the 300 percent growth of reported measles cases around the world in the first quarter of the year over the same quarter the previous year—is precisely the absence of what Cotton Mather proposed for 1721-era Boston: systematic vaccination of the population. The more interesting question, beyond simple international vaccination logistics, is: What ideological and historical shifts have allowed the reemergence of a disease once believed to be under controlled decline?…

A history of the debates over vaccination that asks, can the social contract be protected from a measles outbreak?: “Herd Immunity.”

* Thomas Aquinas

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As we pull up our sleeves, we might send healing birthday greetings to Giovanni Maria Lancisi; he was born on this date in 1654.  A doctor (he was personal physician to three popes), epidemiologist (he made the correlation between mosquitoes and malaria), and anatomist (his study of the heart resulted in the eponymous Lancisi’s sign), he is considered the first modern hygienist.

He carried out extensive anatomical and physiological studies, also epidemiology studies on malaria, influenza and cattle plague.  Contrary to the then-traditional conception of “mal’ aria ” – literally, “bad air” – Lancisi observed that the lethal fever, malaria, disappeared when the swamps near to the city were cleared.  He concluded that injurious substances transmitted from flies and mosquitoes were the origin of the disease.

250px-Giovanni_Maria_Lancisi source

 

 

Written by (Roughly) Daily

October 26, 2019 at 1:01 am

“Extreme remedies are very appropriate for extreme diseases”*…

 

frog

The Toad Mountain harlequin frog is endangered and at risk from the Bd fungus

 

A century ago, a strain of pandemic flu killed up to 100 million people—5 percent of the world’s population. In 2013, a new mystery illness swept the western coast of North America, causing starfish to disintegrate. In 2015, a big-nosed Asian antelope known as the saiga lost two-thirds of its population—some 200,000 individuals—to what now looks to be a bacterial infection. But none of these devastating infections comes close to the destructive power of Bd—a singularly apocalyptic fungus that’s unrivaled in its ability not only to kill animals, but to delete entire species from existence.

Bd—Batrachochytrium dendrobatidis in full—kills frogs and other amphibians by eating away at their skin and triggering fatal heart attacks. It’s often said that the fungus has caused the decline or extinction of 200 amphibian species, but that figure is almost two decades out-of-date. New figures, compiled by a team led by Ben Scheele from the Australian National University, are much worse.

Scheele’s team estimates that the fungus has caused the decline of 501 amphibian species—about 6.5 percent of the known total. Of these, 90 have been wiped out entirely. Another 124 have fallen by more than 90 percent, and their odds of recovery are slim. Never in recorded history has a single disease burned down so much of the tree of life. “It rewrote our understanding of what disease could do to wildlife,” Scheele says…

The story of an unprecedented pathogen: “The Worst Disease Ever Recorded.” (Lest one rest too easily because this threat seems to target not humans but animals at some distance on the tree of life, see here.)

* Hippocrates

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As we do our best to stave off extinctions, we might recall that on this date in 1981, Nature set the world’s record for “Longest Scientific Name” when it published the systematic name for the deoxyribonucleic acid (DNA) of the human mitochondria; it contains 16,569 nucleotide residues and is thus about 207,000 letters long.

220px-Map_of_the_human_mitochondrial_genome.svg

The 16,569 bp long human mitochondrial genome with the protein-coding, ribosomal RNA, and transfer RNA genes

source

 

Written by (Roughly) Daily

April 9, 2019 at 1:01 am

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