Are we alone?

Welcome WASP-117b! NASA has announced confirmation of the detection of another exoplanet bringing the number to 1,743 planets and 452 multi-planetary systems (such as our Solar system). This always bears the question: With all of these planets orbiting other stars, are we alone? My answer has always been a quote from the brilliant Carl Sagan, "If it's just us, seems like an awful waste of space".

Way back when humans enjoyed the stars without knowledge or understanding of how truly vast the universe is, this question never occurred to them. It wasn't until the 1920s that astronomers began to understand how big our Milky Way Galaxy was let alone the distance to our nearest galaxy and the hundreds of billions of galaxies spanning the ~14 billion light years of the observable universe.

As observations of the universe continued the question started to emerge, are there non-terrestrial life forms out there. Science fiction writers (who often turn out to be prophetic) tell us there are many. In 1961, Frank Drake wrote out a formula to determine the statistical likelihood for the existence of intelligent life other than on Earth. There are many debates about the validity of the measurements and assumptions for the values of the Drake equation. However, even with the most conservative estimates for all the values, I think it is conclusively NON-ZERO. If it's not zero then there is always the chance. With the discovery of more and more exoplanets, the chance that some of those planets harboring some form of life is not zero. The chance that some harbor life we would recognize is not zero. The chance that some harbor intelligent life we could interact with is not zero.

So, are we alone...I highly doubt it. Will we ever meet our neighbors? Only time will tell. But, with continuation of NASA's space exploration program we might knock on their door before they knock on ours.

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This is a personal blog. The views expressed herein may not represent those of my employer.

Vaccine-Associated Paralytic Poliomyelitis and BCG-osis

This week's MMWR published by the CDC reports a case of vaccine-associated paralytic poliomyelitis and disseminated BCG infection in a vaccinated child brought to a San Antonio hospital. This case is important for the general public to be aware of for two reasons, and it's not to avoid vaccinating children.

The first complication here is that the child did not have the appropriate immune system to handle vaccination with a live vaccine, of which both BCG and the OPV received are. This child lacked an essential enzyme required to make both cells of the immune system and protective antibodies. The absence of this enzyme meant that the child lacked the ability to fight infections and resulted in the child and siblings suffering from recurrent infections. There exist certain conditions, such as SCID or lack of an immune system, that preclude one from being vaccinated. It is important that our physician know of any and all possible complications and that you yourself are award of those complications as well.
        For you altruists, because there are people that cannot get vaccinated, it is essential to maintain a high level of immunized people in the population surrounding those unfortunate individuals. This provides a strong pressure to keep infections out of the general populace and away from individuals who cannot be vaccinated.

The second important point to consider here is that this child, from India, was vaccinated with the live BCG vaccine (against tuberculosis which is still rampant in the developing world) and OPV (the live oral poliovirus vaccine). Neither of these vaccines are used in the United States. With the last case of natural polio occurring in 1979. Since 2000, the US has switched from vaccinating individuals with the live OPV to vaccinations with the safer inactivated (or dead) poliovirus vaccine (IPV). This vaccine cannot grow and so there is no risk of developing polio from this dead vaccine.
       In addition, the US no longer routinely vaccinates against tuberculosis. The only, mildly, effective vaccine is the live, related BCG strain. However, this vaccination interferes with surveillance, turning all vaccinees positive. The US has decided to monitor for infections (PPD skin test many receive) instead of vaccinating the populace with a questionably effective vaccine. However, in developing countries where tuberculosis still kills many children, something is better than nothing.

In conclusion, don't let reports such as these scare you away from vaccinating children. Talk with your doctor about any potential complications or risks.



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This is a personal blog. The views expressed herein may not represent those of my employer.

Vaccination satires...be careful

I recently read a satirical posting about why a particular person didn't vaccinate their child. I would ask that posters be careful when doing so. Those people looking for reasons not to vaccinate their own children may not fully read those and get the point that "of course we will" and just stick with the reasons that they are too young or none of those diseases are around. Many of the terrible diseases present today can move through the population very quickly and can spread around the world faster than you might think. 

Don't joke about vaccinations they are very important and your jokes can be misconstrued, particularly in print with no facial or voice tone cues.

Outbreak of Pertussis at a school in Florida re-enforces the need to vaccinate!

Well, I was trying to hold off longer but it is August (National Immunization Awareness Month) and vaccine preventable diseases are in the news again. As reported in this week's Morbidity and Mortality Weekly Report (MMWR) from the CDC, pertussis (aka whooping cough) has broken out in a charter school in Florida where only about 10% of the students have been immunized claiming religious exemption. CDC reports that 30% of the 316 students have suspected or confirmed pertussis.

Envision now, my ascendency onto the proverbial soapbox as I address the following questions.

Why should students, faculty & staff make it important to take care of immunizations?

Vaccinations save lives and prevent suffering. It may sound like a simple cliche but that doesn't mean it isn't true. Vaccines save an estimated 4.9 million people from suffering every year. Life is a gamble, whether or not you will get infected, whether or not you will be the 1 in however many to die from that disease, why not stack the deck in your favor. Vaccinate!

You know those shingles vaccine commercials where “the shingles virus is already inside you”, that’s why you get vaccinated. If it freaks you out to think about these diseases cruising around inside of you, get vaccinated. Most of the available vaccines are designed, yes designed, to keep you from getting infected. All of the viruses and most of the bacteria that infect humans require growth inside of you in order to reproduce and spread. By getting vaccinated you are not only protecting yourself from getting infected but preventing the disease from spreading to others. It is particularly important for those who cannot get vaccinated for medical reasons that others are. This is called herd immunity and helps to keep the diseases out of the population. How altruistic of you, pat yourself on the back if you got vaccinated! If you didn’t keep reading and hopefully you will change your mind.

With all of these reasons to get vaccinated, why are fewer people vaccinating themselves and their children? Mainly, I think, for two reasons. First, they don’t understand how it works so they don’t bother or are easily dissuaded. Let me solve that problem by telling you exactly how they work. Cells of your immune system recognize parts of these diseases as not belonging in you and they attack; then remember those pieces in case they encounter it again. Vaccines make use of this memory by showing these same parts of the disease to your immune cells in a safe manner without all of the nasty symptoms or potential death from the disease. Then, when the real disease tries to invade, your cells are ready and kill off the disease before it can infect and reproduce. Think of it as studying hard for an exam. It may cause a little pain to study, but it sure makes the exam easier because the more you’ve studied the more you know.

The second reason fewer people vaccinate is actually a testament to the success of vaccinations. The collective populace, particularly in industrialized countries, like the US, no longer encounters these diseases and has forgotten how devastating they are. When most people think of a vaccine, they think of the seasonal flu vaccine they might get every year. For most of the population, getting the seasonal flu is an inconvenience and not much more. So, if this is all that vaccines do, why should they bother with the other vaccinations or watch their baby cry as they get stuck with a needle. They haven’t witnessed kids with polio living their meager lives in an iron lung because they’re muscles won’t work to let them breathe, or babies with neonatal tetanus rigid as a board screaming in pain, or tetanus patients with muscle spasms so strong it breaks their backs, or kids with pertussis coughing so long and hard they faint or vomit, or the disfiguring scars left by smallpox. The corollary to these unobservable diseases is that people think these diseases are gone. WRONG; the only disease that no longer persists in the human population is smallpox. All those other diseases that our parents and grandparents fought so hard to force out of the population still lie in wait for enough people not to be vaccinated that they can regain a foothold and return with a vengeance.

What are some repercussions if we don’t take care of these immunizations? 

            The repercussions implied by the statements above are that we lose more than 130 years’ worth of beating back these diseases. Already we are seeing resurgences of measles, a disease for which the vaccine is nearly 100% effective at preventing. Moreover, while these diseases are multiplying inside an infected person they can change to become more lethal. Failure to maintain vaccinations, allows adaptation of the disease to spread efficiently in the human population, potentially to the point where the current vaccine is no longer effective. This is currently happening with pneumococcus, the vaccine is less and less effective at preventing infection against the circulating pneumococcus.

So, do we just give up and say it’s inevitable? NO, we continue to fight. We develop new vaccines against the new strains, like the devastating avian and swine influenza. We protect ourselves from new diseases, like SARS. By continuing to vaccinate, we have almost eradicated polio from the human population. In March of this year, the World Health Organization announced that only 3 countries in the world, Nigeria, Pakistan, and Afghanistan, still have cases of polio. The others have been polio-free for at least 3 years. Only 3 more countries and polio goes the way of smallpox.

Does this mean that the rest of the world can stop polio vaccinations? NO! Ask yourself, how quickly can someone or something get from one of those countries to where you live. With global transit and commerce as rapid as it is today, 24-48 hours. The time between when a person contracts polio and starts showing symptoms is usually 6 DAYS. That means an infected person can hop on a plane not knowing they’re infected and end up anywhere in the world. Along the way, they can be transmitting the disease before they know they’re sick. Polio is so contagious that a single infected child can result in 200,000 each year, infecting the entire world in 10 years. Oh yeah, there’s no cure for polio once infected. So, should we avoid everybody all the time? Don’t be ridiculous, get vaccinated. The vaccine against polio, and all of these childhood diseases, is really, REALLY good.

What are some facts that you would share with the public about immunizations?

1.      Vaccines prevent more than 2.5 million deaths each year.

2.      3 million people die each year from vaccine-preventable diseases.

3.      There is ZERO data that vaccines cause autism. Unfortunately, people pay more attention to the internet than their highly trained doctor.

4.      You can’t argue with crazy, but neither should you listen to it. Seek sound advice.

5.      Scientists DO know exactly how these vaccines work.

6.      Vaccines strengthen your immune system’s memory against nasty diseases.

7.      Yes, there are a lot of vaccinations. We are fighting 18 different diseases.

8.      Yes, children get a lot of shots when they’re young. That’s because: 1) we are fighting a lot of childhood diseases and want to protect them before they get the disease, and 2) these vaccines last for a long time so start early.

9.      Not all vaccines are given as injections, ask about alternatives.

10.  The injection might hurt, but it’s not nearly as painful as the actual disease.

11.  Yes, vaccines may have side effects and contraindications, but most are mild, headache or muscle ache. But would you rather risk a complication from the vaccine or a life of paralysis from polio?

12.  93% of doctors vaccinate themselves and their own children.

13.  Vaccines work!!! They prevent deadly diseases!!! (Forbes: How Vaccines have changed the world)

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This is a personal blog. The views expressed herein may not represent those of my employer.

Ebola outbreak demonstrates need for continued research on dangerous diseases

The recent outbreaks of Ebola in West Africa highlight the importance of continued research into such dangerous pathogens. We still do not understand how Ebola is transmitted and how humans respond to the Ebola and Marburg viruses. Researchers continue to how these and other deadly microbes work. With international air travel as rapid as it currently is, this disease could easily escape west Africa and end up in any country around the world.

The recent errors resulting in the accidental, potential exposure of workers to anthrax and smallpox have undermined the public's confidence for the need to investigate these dangers. However, with Ebola and its relative Marburg having death rates between 50-90%, it is therefore most critical that this research continues despite the dangers of using these and other deadly microbes. Just imagine the chaos and death if half or more of the world's population were to succumb to these and other deadly diseases. Medical research must continue to seek therapeutics and vaccines in order to treat or prevent these diseases.

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This is a personal blog. The views expressed herein may not represent those of my employer.