How cholera affects the body

WE ARE CLOSER TO CURING ALL DISEASES THAN WE THINK

Anne Weston, Wellcome Images

Breast Cancer Cell

Color-enhanced shot of a breast cancer cell

FOR CANCER CARE, ACCESS TO TREATMENT MAY BE THE BIGGEST OBSTACLE

By Susmita Baral

Last week, Facebook CEO Mark Zuckerberg and his wife Priscilla Chanannounced an ambitious project—to “invest in basic science research with the goal of curing disease.” The couple started by donating $3 billion over 10 years in this initiative, which target four major groups of illnesses: cancer,infectious diseases, as well as heart and neurological diseases.

The desire to ‘cure all disease’ is laudable, and $3 billion is a nice, albeit small amount of money in the grand scheme of medical research funding. However, a really important question we should all be asking is can we really find cures for all diseases? Well, according to scientists, it depends on which ones you’re talking about. But in general, while we might not be there yet, we may be closer in our understanding of the causes of disease than we think.

In the case of infectious disease, the objective to "cure, prevent, and manage” is trickier than it looks. Eric Rubin, an immunology and infectious diseases researcher at Harvard's T.H. Chan School of Public Health, says that pathogens—which are any infectious disease-causing bugs like bacteria, viruses, or other microorganisms—evolve at different rates. The ones that evolve at a slow rate, like the bacterium that causes leprosy or the one that causes Guinea worm disease can be cured. But addressing rapidly evolving pathogens like the flu is far more challenging.

“The influenza virus that infects us every year is different from the influenza virus from last year,” says Rubin, who is “optimistic” about the $3 billion project. “In fact, it’s different from multiple different [flu] viruses circulating at any given time.” Some of those changes are small Rubin says, and in those cases, the immunity we have still protects us. But if the changes are large, then our pre-existing immunity isn’t very good.

That’s not to say rapidly evolving pathogens cannot be moderated, says Rubin. He says that as a pathogen evolves to resist something, it becomes less fit to grow and cause illness.

According to Francis S. Collins, the Director of the National Institutes of Health, while it’s hard to imagine a world where there are no infectious diseases, we can certainly create one where they can be controlled.

“We will not banish infectious disease from Earth but we will have strategies to quickly combat them if they do emerge,” says Collins. “I do think what we can do is to develop an increasingly nimble system to identify the emergence of new infectious disease problems and quickly put in place the kind of prevention and treatment strategies that will be needed. We are already accelerating that pace.”

When it comes to cancer, things are a bit different. With over 100 different types of cancer—each of which impacts individuals differently based on an array of factors including age, sex, racial/ethnic group, and geographic location—the progress being made is significant.

“Even though it’s 200 plus diseases, with the trajectory we are on now, in the next couple of decades, we are going to have a tremendous amount of progress being made in managing [cancer] and for an increasing large number of patients, curing [it],” says Ronald DePinho, president of The University of Texas MD Anderson Cancer Center.

DePinho says he is optimistic in progress being made in preventing, detecting, and treating cancer, but the largest obstacle is the disparity in access in areas of the world where there is a “disparity gap” in access and quality care.

The biggest issue we’re going to face in cancer is not so much the blueprint to prevent, detect, or manage disease, but the access.

“Cancer will always be with us because advancing age is the most important instigator for the development of cancer. It’ll be with us,” says DePinho. “The biggest issue we’re going to face in cancer is not so much the blueprint to prevent, detect or manage disease, but the access.”

Ultimately the notion of curing disease varies from condition to condition, but Collins says it is a feasible one.

“It’s a bold audacious goal, but I like audacious goals, and I think developing cures for all diseases is certainly something that we could imagine happening in the course of this century,” says Collins. “Whether we would successfully apply those to every person who is afflicted is another question but research ought to be able to tackle everything we see in front of us with all the vigor that we got.”

How Germy Are Airplanes?

By Susanne Rust

Plane: My Good Images/Shutterstock. Bacteria from left: National Institute of Allergy and Infectious Diseases; CDC/Janice Haney Carr; CDC/Melissa Brower

Viruses and bacteria can persist on airplane surfaces for days, researchers find.

Missed connections and lost bags might not be your biggest worry when traveling. Researchers have found that nasty, contagious bacteria can last for days on airplane surfaces.

James Barbaree, a pathologist at Alabama’s Auburn University, and colleague Kiril Vaglenov were curious about how long bacteria could last under typical air travel conditions. They applied smears of methicillin-resistant Staphylococcus aureus(MRSA) and the virulent E. coli strain O157:H7 to six airplane surface types — armrests, plastic tray tables, metal toilet buttons, window shades, seat pocket cloths and leather — which were supplied by an unnamed major airline.

What they found was disturbing. MRSA lasted for 168 hours, or seven days, on seat pockets (where travelers reach for magazines and store their iPads), while E. coli samples thrived for up to four days on armrests. Barbaree and Vaglenov rubbed pig skin on the tainted surfaces to mimic contact with human flesh. They found that the less porous the surface, the more transmissible the bug.

Bacteria survived longer, however, on more porous surfaces, such as seat pockets, though they were much less transmissible than those on, say, a tray table.

The researchers are now performing the same tests on Streptococcus pyogenes, which causes strep throat. They also are testing cleaning agents that might help prevent bacterial stowaways.

For now, Barbaree says regular hand-washing is probably the best way to prevent the spread of disease. He says he and his wife now take alcohol wipes with them on flights.

And the next time you’re waiting to get on a plane, ponder this: There are no federal cabin-cleaning regulations.

Post-antibiotic era draws closer as new resistant bacteria discovered

GEORGE UNDERWOOD



The world is drawing closer to a “post-antibiotic era” after bacteria resistant to last-resort drugs are discovered in China.

The report in the Lancet Infectious Diseases identified bacteria resistant to the antibiotic colistin in patients and livestock.

Most worryingly, the new mutation is able to be easily shared between bacteria. There is already evidence that it has spread to Laos and Malaysia.

Professor Timothy Walsh from the University of Cardiff, who collaborated on the study, told the BBC: "If this mutation becomes global, which is a case of when not if, and the gene aligns itself with other antibiotic resistance genes, which is inevitable, then we will have very likely reached the start of the post-antibiotic era.”

In a statement to coincide with European Antibiotic Awareness Day on November 18, the EMA reinforced its strategy to fighting resistance.

“To advise policy makers on the best way to tackle antimicrobial resistance, robust scientific data on how antimicrobials are used across the EU and how resistance emerges and transfers are needed,” the regulator said. “This requires close cooperation between the various European agencies that have responsibilities in this area.”

The regulator hopes to create an environment that stimulates and facilitates the development of innovative antimicrobials through the use of guidance and workshops.

The latest results on antimicrobial resistance (AMR) published by the European Centre for Disease Control (ECDC) show that the situation is worsening for most bacteria and antibiotics under surveillance.

In at least 3 countries (Italy, Greece and Malta) the resistance to last-line antibiotics has become an “endemic problem”, meaning their hospitals are unable to treat patients infected with resistant bacteria.

But for the first time data shows a significant decrease in antibiotic consumption in the local community in five European countries (Denmark, Luxembourg, Slovenia, Spain and Sweden), even if antibiotic consumption in the hospital sector is still increasing.

Commenting on the report, EU Commissioner for Health and Food Safety Vytenis Andriukaitis said: "The ECDC results show the threat of antibiotic resistance is increasing day by day. If left unchecked, it has the capacity to turn the clock back on medicine by a hundred years."

In Europe alone, infections caused by multidrug-resistant bacteria are estimated to kill 25,000 people every year.

Colour-changing dressing 'fights antibiotic resistance'

A medical dressing that changes colour when it detects infection could cut the unnecessary use of antibiotics, say scientists at Bath University.

It works by releasing fluorescent dye from tiny capsules when toxins are given out by bacteria in a wound.

This allows doctors to identify bacterial infections and treat them more quickly, particularly in children with burns.

Researchers said it could help to save lives.

Children with burn wounds are particularly susceptible to bacterial infections because of their immature immune systems.

These infections can slow the healing of wounds, leading to longer stays in hospital and sometimes permanent scarring. In severe cases, infections can kill.

Major health concern

Doctors find it very difficult to diagnose infections quickly and easily without removing the dressing, which can be painful and create more scarring.

Because of this, antibiotics are often prescribed as a precaution before the infection is confirmed.

However, treatment with antibiotics when there is no infection can lead to bacteria becoming resistant to antibiotics - and antibiotic resistance is a major health concern.

Dr Toby Jenkins, reader in biophysical chemistry at Bath, leading the project, said "it could really help to save lives."

The team has been awarded almost £1m by the Medical Research Council to test the responsiveness of the prototype dressing to samples taken from the wounds of burns victims.

Infectious cancer found in clams

1. Erik Stokstad

Soft-shell clams along North America's east coast suffer from a fatal leukemia-like condition. Researchers report this week that the cancer is transmissible, a phenomenon previously known only in dogs and Tasmanian devils. The finding suggests that transmissible cancers may be more common than was thought. Following up on the discovery of retrotransposon, called Steamer, the researchers found genetic similarities among the cancer cells in clams from various parts of the coast. The cancer cells' DNA did not match the genomes of the clams they afflict, further suggesting that all the cancer cells derive from one primordial immune cell gone rogue, which then spread from clam to clam. Questions remain about how the disease is transmitted and how the cancer cells escape the clams' immune systems.