Children's Mysterious Paralysis Tied to New Virus

LiveScienceJuly 7, 2015

A new study suggests that a new strain of a poliolike virus may be responsible for some of the mysterious cases of paralysis in children over the past few years. (Photo: Getty Images) 

Mysterious cases of paralysis in U.S. children over the last year have researchers searching for the cause of the illness. Now, a new study suggests that a new strain of a poliolike virus may be responsible for some of the cases.

So far, more than 100 children in 34 states have suddenly developed muscle weakness or paralysis in their arms or legs, a condition known as acute flaccid myelitis, according to the Centers for Disease Control and Prevention. Previously, researchers linked a virus called enterovirus D68 (EV-D68), which can cause respiratory illness similar to the common cold, with some of these cases.

But only about 20 percent of children with paralysis tested positive for EV-D68, and even in these cases, it wasn’t clear if EV-D68 was the cause of the child’s condition. 

Related: Top 10 Mysterious Diseases

In the new study, researchers say that one case of paralysis, in a 6-year-old girl, is linked with another strain of enterovirus, called enterovirus C105. This virus belongs to the same species (enterovirus C) as the polio virus.

Although the new study doesn’t definitely prove that enterovirus C105 was the cause of the girl’s paralysis, it suggests that there are other viruses besides EV-D68 that are contributing to the outbreak of acute flaccid myelitis.

The study should make researchers aware that “there’s another virus out there that has this association” with paralysis, said study co-author Dr. Ronald Turner, a professor of pediatrics at the University of Virginia School of Medicine. “We probably shouldn’t be quite so fast to jump to enterovirus D68 as the [only] cause of these cases,” Turner told Live Science.

The 6-year-old girl was previously healthy, but she caught a cold from members in her family, and developed a mild fever. Her fever and cold symptoms soon went away, but she was left with persistent arm pain. Then her parents noticed that the girl’s shoulder appeared to droop, and she had difficulty using her right hand, the researchers said.

At the hospital, the girl was diagnosed with acute flaccid myelitis, and a sample from her respiratory tract tested positive for enterovirus C105. This virus was only recently discovered, and the new study is the first report of enterovirus C105 in the United States, the researchers said. The girl tested negative for EV-D68.

Some tests can miss enterovirus C105, because of variation in the virus’s genetic sequence, Turner said. This virus may have gone unrecognized in the current outbreak until now because it is relatively new, and can be hard to detect, he said.

“The presence of this virus strain in North America may contribute to the incidence of flaccid paralysis and may also pose a diagnostic challenge in clinical laboratories,” the researchers said in their study, which will be published in the October issue of the journal Emerging Infectious Diseases.

The researchers noted that enterovirus D68, and now enterovirus C105, have been found in the respiratory tract of children with acute flaccid myelitis, but so far, these viruses have not been found in the spinal fluid of these patients. That’s important because a virus in the respiratory tract would not necessarily cause paralysis.

“You can have a virus in your respiratory tract that’s not doing anything to your nervous system,” Turner said.

In order to more definitively link these cases of paralysis with enterovirus, researchers would need to find the virus in the spinal fluid, he said. But so far, tests have not found the virus there.

How a history of eating human brains protected this tribe from brain disease

By Sarah Kaplan June 11 at 6:57 AM

 

 

A real human brain is displayed in the 2001 interactive exhibit “Brain: The World Inside Your Head” at the Smithsonian’s Arts and Industries Building in Washington. (Andrea Bruce Woodall/The Washington Post)

 

The sickness spread at funerals.
The Fore people, a once-isolated tribe in eastern Papua New Guinea, had a long-standing tradition of mortuary feasts — eating the dead from their own community at funerals. Men consumed the flesh of their deceased relatives, while women and children ate the brain. It was an expression of respect for the lost loved ones, but the practice wreaked havoc on the communities they left behind. That’s because a deadly molecule that lives in brains was spreading to the women who ate them, causing a horrible degenerative illness called “kuru” that at one point killed 2 percent of the population each year.
The practice was outlawed in the 1950s, and the kuru epidemic began to recede. But in its wake it left a curious and irreversible mark on the Fore, one that has implications far beyond Papua New Guinea: After years of eating brains, some Fore have developed a genetic resistance to the molecule that causes several fatal brain diseases, including kuru, mad cow disease and some cases of dementia.
The single, protective gene is identified in a study published Wednesday in the journal Nature. Researchers say the finding is a huge step toward understanding these diseases and other degenerative brain problems, including Alzheimer’s and Parkinson’s.
The gene works by protecting people against prions, a strange and sometimes deadly kind of protein. Though prions are naturally manufactured in all mammals, they can be deformed in a way that makes them turn on the body that made them, acting like a virus and attacking tissue. The deformed prion is even capable of infecting the prions that surround it, reshaping them to mimic its structure and its malicious ways.
The prions’ impact on their hosts is devastating and invariably fatal. Among the Fore, the prions riddled their victims’ brains with microscopic holes, giving the organ an odd, spongy texture. In cattle, prions cause mad cow disease — they are responsible for the epidemic in Britain of the late ’80s and ’90s that required hundreds of thousands of cattle to be destroyed. They have been linked to a bizarre form of fatal insomnia that kills people by depriving them of sleep. And they’re the source of the degenerative neurological disorder Creutzfeldt-Jakob disease (CJD), characterized by rapid dementia, personality changes, muscle problems, memory loss and eventually an inability to move or speak.
The vast majority of prion-diseases are “sporadic,” seemingly appearing without cause. But a lead author of the Nature study, John Collinge, said in an interview with Nature that a portion of cases are inherited from one’s parents, and an even smaller percentage are acquired from consuming infected tissue. Variant CJD, often called the “human mad cow disease,” is caused by eating beef from infected cows.
Prions are especially insidious because there’s no way of stopping them, science writer D.T. Max, author of a book on prions and fatal familial insomnia, told NPR in 2006. In the hierarchy of pathogens, they’re even more elusive and difficult to quash than a virus. They can’t be treated with antibiotics or radiation. Formalin, usually a powerful disinfectant, only makes them more virulent. The only way to clean a prion-contaminated object is with massive amounts of extremely harsh bleach, he said. But that technique isn’t helpful in treating a person who has already been infected.
The study by Collinge and his colleagues offers a critical insight into ways that humans might be protected from the still-little-understood prions. They found it by examining the genetic code of those families at the center of the Fore’s kuru epidemic, people who they knew had been exposed to the disease at multiple feasts, who seemed to have escaped unscathed.
When the researchers looked at the part of the genome that encodes prion-manufacturing proteins, they found something completely unprecedented. Where humans and every other vertebrate animal in the world have an amino acid called glycine, the resistant Fore had a different amino acid, valine.
“Several individuals right at the epicenter of the epidemic, they have this difference that we have not seen anywhere else in the world,” Collinge told Nature.
That minute alteration in their genome prevented the prion-producing proteins from manufacturing the disease-causing form of the molecule, protecting those individuals from kuru. To test whether it might protect them from other kinds of prion disease, Collinge — the director of a prion research unit at University College London — and his team engineered the genes of several mice to mimic that variation.
When the scientists re-created the genetic types observed in humans — giving the mice both the normal protein and the variant in roughly equal amounts — the mice were completely resistant to kuru and to CJD. But when they looked at a second group of mice that had been genetically modified to produce only the variant protein, giving them even stronger protection, the mice were resistant to every prion strain they tested — 18 in all.
“This is a striking example of Darwinian evolution in humans, the epidemic of prion disease selecting a single genetic change that provided complete protection against an invariably fatal dementia,” Collinge told Reuters.
The Fore aren’t the only people to demonstrate prion resistance. More than a decade ago, Michael Alpers — a specialist on kuru who has studied the Fore since the 1960s and was a co-author of the Nature study — conducted similar research on prion protein genes in humans worldwide. In a study published in Science, he found that people as far-flung as Europe and Japan exhibited the genetic protection, indicating that cannibalism was once widespread and that prehistoric humans probably dealt with waves of kuru-like epidemics during our evolution.
But the gene found in the Fore is special because it seems to render mutant prion-producing proteins (the kind that would be passed down from one’s parents, causing inherited prion diseases) incapable of producing any kind of prion whatsoever. It also stops the wild-type protein — the phenotype that most people have — from making malformed prions.
Scientists say that the benefits of this discovery don’t stop at prion diseases, which are relatively rare — only about 300 cases are reported each year in the United States. According to Collinge, the process involved in prion diseases — prions changing the shape of the molecules around them and linking together to form long chains called “polymers” that damage the brain — is probably responsible for the deadly effects of all kinds of degenerative brain illnesses: Alzheimer’s, Parkinson’s and dementia chief among them.
According to the World Health Organization, there are 47.5 million people worldwide living with dementia. An additional 7.7 million are diagnosed each year.
If Collinge and his colleagues can understand the molecular mechanisms by which prions do their work — and how the prion-resistant gene stops them — they might better understand the misshapen proteins that are afflicting millions with those other degenerative brain illnesses.
Eric Minikel, a prion researcher at the Broad Institute in Cambridge, Mass., who was not involved in the study, was impressed by the finding.
“It is a surprise,” he told Nature. “This was a story I didn’t expect to have another chapter.”

'In 1976 I discovered Ebola - now I fear an unimaginable tragedy'

http://www.theguardian.com/us

Peter Piot was a researcher at a lab in Antwerp when a pilot brought him a blood sample from a Belgian nun who had fallen mysteriously ill in Zaire

• The Observer, Saturday 4 October 2014 17.00 EDT
• Jump to comments (536)

 

Professor Peter Piot, the Director of the London School of Hygiene and Tropical Medicine: ‘Around June it became clear to me there was something different about this outbreak. I began to get really worried’ Photograph: Leon Neal/AFP

 

Professor Piot, as a young scientist in Antwerp, you were part of the team that discovered the Ebola virus in 1976. How did it happen?
I still remember exactly. One day in September, a pilot from Sabena Airlines brought us a shiny blue Thermos and a letter from a doctor in Kinshasa in what was then Zaire. In the Thermos, he wrote, there was a blood sample from a Belgian nun who had recently fallen ill from a mysterious sickness in Yambuku, a remote village in the northern part of the country. He asked us to test the sample for yellow fever.
These days, Ebola may only be researched in high-security laboratories. How did you protect yourself back then?
We had no idea how dangerous the virus was. And there were no high-security labs in Belgium. We just wore our white lab coats and protective gloves. When we opened the Thermos, the ice inside had largely melted and one of the vials had broken. Blood and glass shards were floating in the ice water. We fished the other, intact, test tube out of the slop and began examining the blood for pathogens, using the methods that were standard at the time.
But the yellow fever virus apparently had nothing to do with the nun's illness.
No. And the tests for Lassa fever and typhoid were also negative. What, then, could it be? Our hopes were dependent on being able to isolate the virus from the sample. To do so, we injected it into mice and other lab animals. At first nothing happened for several days. We thought that perhaps the pathogen had been damaged from insufficient refrigeration in the Thermos. But then one animal after the next began to die. We began to realise that the sample contained something quite deadly.
But you continued?
Other samples from the nun, who had since died, arrived from Kinshasa. When we were just about able to begin examining the virus under an electron microscope, the World Health Organisation instructed us to send all of our samples to a high-security lab in England. But my boss at the time wanted to bring our work to conclusion no matter what. He grabbed a vial containing virus material to examine it, but his hand was shaking and he dropped it on a colleague's foot. The vial shattered. My only thought was: "Oh, shit!" We immediately disinfected everything, and luckily our colleague was wearing thick leather shoes. Nothing happened to any of us.
In the end, you were finally able to create an image of the virus using the electron microscope.
Yes, and our first thought was: "What the hell is that?" The virus that we had spent so much time searching for was very big, very long and worm-like. It had no similarities with yellow fever. Rather, it looked like the extremely dangerous Marburg virus which, like ebola, causes a haemorrhagic fever. In the 1960s the virus killed several laboratory workers in Marburg, Germany.
Were you afraid at that point?
I knew almost nothing about the Marburg virus at the time. When I tell my students about it today, they think I must come from the stone age. But I actually had to go the library and look it up in an atlas of virology. It was the American Centres for Disease Control which determined a short time later that it wasn't the Marburg virus, but a related, unknown virus. We had also learned in the meantime that hundreds of people had already succumbed to the virus in Yambuku and the area around it.
A few days later, you became one of the first scientists to fly to Zaire.
Yes. The nun who had died and her fellow sisters were all from Belgium. In Yambuku, which had been part of the Belgian Congo, they operated a small mission hospital. When the Belgian government decided to send someone, I volunteered immediately. I was 27 and felt a bit like my childhood hero, Tintin. And, I have to admit, I was intoxicated by the chance to track down something totally new.

 

 

A girl is led to an ambulance after showing signs of Ebola infection in the village of Freeman Reserve, 30 miles north of the Liberian capital, Monrovia. Photograph: Jerome Delay/AP Was there any room for fear, or at least worry?

Of course it was clear to us that we were dealing with one of the deadliest infectious diseases the world had ever seen – and we had no idea that it was transmitted via bodily fluids! It could also have been mosquitoes. We wore protective suits and latex gloves and I even borrowed a pair of motorcycle goggles to cover my eyes. But in the jungle heat it was impossible to use the gas masks that we bought in Kinshasa. Even so, the Ebola patients I treated were probably just as shocked by my appearance as they were about their intense suffering. I took blood from around 10 of these patients. I was most worried about accidentally poking myself with the needle and infecting myself that way.
But you apparently managed to avoid becoming infected.
Well, at some point I did actually develop a high fever, a headache and diarrhoea …
... similar to Ebola symptoms?
Exactly. I immediately thought: "Damn, this is it!" But then I tried to keep my cool. I knew the symptoms I had could be from something completely different and harmless. And it really would have been stupid to spend two weeks in the horrible isolation tent that had been set up for us scientists for the worst case. So I just stayed alone in my room and waited. Of course, I didn't get a wink of sleep, but luckily I began feeling better by the next day. It was just a gastrointestinal infection. Actually, that is the best thing that can happen in your life: you look death in the eye but survive. It changed my whole approach, my whole outlook on life at the time.
You were also the one who gave the virus its name. Why Ebola?
On that day our team sat together late into the night – we had also had a couple of drinks – discussing the question. We definitely didn't want to name the new pathogen "Yambuku virus", because that would have stigmatised the place forever. There was a map hanging on the wall and our American team leader suggested looking for the nearest river and giving the virus its name. It was the Ebola river. So by around three or four in the morning we had found a name. But the map was small and inexact. We only learned later that the nearest river was actually a different one. But Ebola is a nice name, isn't it?
In the end, you discovered that the Belgian nuns had unwittingly spread the virus. How did that happen?
In their hospital they regularly gave pregnant women vitamin injections using unsterilised needles. By doing so, they infected many young women in Yambuku with the virus. We told the nuns about the terrible mistake they had made, but looking back I would say that we were much too careful in our choice of words. Clinics that failed to observe this and other rules of hygiene functioned as catalysts in all additional Ebola outbreaks. They drastically sped up the spread of the virus or made the spread possible in the first place. Even in the current Ebola outbreak in west Africa, hospitals unfortunately played this ignominious role in the beginning.
After Yambuku, you spent the next 30 years of your professional life devoted to combating Aids. But now Ebola has caught up to you again. American scientists fear that hundreds of thousands of people could ultimately become infected. Was such an epidemic to be expected?
No, not at all. On the contrary, I always thought that Ebola, in comparison to Aids or malaria, didn't present much of a problem because the outbreaks were always brief and local. Around June it became clear to me that there was something fundamentally different about this outbreak. At about the same time, the aid organisation Médecins Sans Frontières sounded the alarm. We Flemish tend to be rather unemotional, but it was at that point that I began to get really worried.
Why did WHO react so late?
On the one hand, it was because their African regional office isn't staffed with the most capable people but with political appointees. And the headquarters in Geneva suffered large budget cuts that had been agreed to by member states. The department for haemorrhagic fever and the one responsible for the management of epidemic emergencies were hit hard. But since August WHO has regained a leadership role.
There is actually a well-established procedure for curtailing Ebola outbreaks: isolating those infected and closely monitoring those who had contact with them. How could a catastrophe such as the one we are now seeing even happen?
I think it is what people call a perfect storm: when every individual circumstance is a bit worse than normal and they then combine to create a disaster. And with this epidemic there were many factors that were disadvantageous from the very beginning. Some of the countries involved were just emerging from terrible civil wars, many of their doctors had fled and their healthcare systems had collapsed. In all of Liberia, for example, there were only 51 doctors in 2010, and many of them have since died of Ebola.
The fact that the outbreak began in the densely populated border region between Guinea, Sierra Leone and Liberia ...
… also contributed to the catastrophe. Because the people there are extremely mobile, it was much more difficult than usual to track down those who had had contact with the infected people. Because the dead in this region are traditionally buried in the towns and villages they were born in, there were highly contagious Ebola corpses travelling back and forth across the borders in pickups and taxis. The result was that the epidemic kept flaring up in different places.
For the first time in its history, the virus also reached metropolises such as Monrovia and Freetown. Is that the worst thing that can happen?
In large cities – particularly in chaotic slums – it is virtually impossible to find those who had contact with patients, no matter how great the effort. That is why I am so worried about Nigeria as well. The country is home to mega-cities like Lagos and Port Harcourt, and if the Ebola virus lodges there and begins to spread, it would be an unimaginable catastrophe.
Have we completely lost control of the epidemic?
I have always been an optimist and I think that we now have no other choice than to try everything, really everything. It's good that the United States and some other countries are finally beginning to help. But Germany or even Belgium, for example, must do a lot more. And it should be clear to all of us: This isn't just an epidemic any more. This is a humanitarian catastrophe. We don't just need care personnel, but also logistics experts, trucks, jeeps and foodstuffs. Such an epidemic can destabilise entire regions. I can only hope that we will be able to get it under control. I really never thought that it could get this bad.
What can really be done in a situation when anyone can become infected on the streets and, like in Monrovia, even the taxis are contaminated?
We urgently need to come up with new strategies. Currently, helpers are no longer able to care for all the patients in treatment centres. So caregivers need to teach family members who are providing care to patients how to protect themselves from infection to the extent possible. This on-site educational work is currently the greatest challenge. Sierra Leone experimented with a three-day curfew in an attempt to at least flatten out the infection curve a bit. At first I thought: "That is totally crazy." But now I wonder, "why not?" At least, as long as these measures aren't imposed with military power.
A three-day curfew sounds a bit desperate.
Yes, it is rather medieval. But what can you do? Even in 2014, we hardly have any way to combat this virus.
Do you think we might be facing the beginnings of a pandemic?
There will certainly be Ebola patients from Africa who come to us in the hopes of receiving treatment. And they might even infect a few people here who may then die. But an outbreak in Europe or North America would quickly be brought under control. I am more worried about the many people from India who work in trade or industry in west Africa. It would only take one of them to become infected, travel to India to visit relatives during the virus's incubation period, and then, once he becomes sick, go to a public hospital there. Doctors and nurses in India, too, often don't wear protective gloves. They would immediately become infected and spread the virus.
The virus is continually changing its genetic makeup. The more people who become infected, the greater the chance becomes that it will mutate ...
... which might speed its spread. Yes, that really is the apocalyptic scenario. Humans are actually just an accidental host for the virus, and not a good one. From the perspective of a virus, it isn't desirable for its host, within which the pathogen hopes to multiply, to die so quickly. It would be much better for the virus to allow us to stay alive longer.
Could the virus suddenly change itself such that it could be spread through the air?
Like measles, you mean? Luckily that is extremely unlikely. But a mutation that would allow Ebola patients to live a couple of weeks longer is certainly possible and would be advantageous for the virus. But that would allow Ebola patients to infect many, many more people than is currently the case.
But that is just speculation, isn't it?
Certainly. But it is just one of many possible ways the virus could change to spread itself more easily. And it is clear that the virus is mutating.
You and two colleagues wrote a piece for the Wall Street Journal supporting the testing of experimental drugs. Do you think that could be the solution?
Patients could probably be treated most quickly with blood serum from Ebola survivors, even if that would likely be extremely difficult given the chaotic local conditions. We need to find out now if these methods, or if experimental drugs like ZMapp, really help. But we should definitely not rely entirely on new treatments. For most people, they will come too late in this epidemic. But if they help, they should be made available for the next outbreak.
Testing of two vaccines is also beginning. It will take a while, of course, but could it be that only a vaccine can stop the epidemic?
I hope that's not the case. But who knows? Maybe.
In Zaire during that first outbreak, a hospital with poor hygiene was responsible for spreading the illness. Today almost the same thing is happening. Was Louis Pasteur right when he said: "It is the microbes who will have the last word"?
Of course, we are a long way away from declaring victory over bacteria and viruses. HIV is still here; in London alone, five gay men become infected daily. An increasing number of bacteria are becoming resistant to antibiotics. And I can still see the Ebola patients in Yambuku, how they died in their shacks and we couldn't do anything except let them die. In principle, it's still the same today. That is very depressing. But it also provides me with a strong motivation to do something. I love life. That is why I am doing everything I can to convince the powerful in this world to finally send sufficient help to west Africa. Now!
Der Spiegel

HIV pandemic's origins located: It may have emerged in Congo in 1920s

 Scanning electron micrograph of an HIV-infected H9 T cell. Credit: NIAID

 http://medicalxpress.com/

The HIV pandemic with us today is almost certain to have begun its global spread from Kinshasa, the capital of the Democratic Republic of the Congo (DRC), according to a new study.
An international team, led by Oxford University and University of Leuven scientists, has reconstructed the genetic history of the HIV-1 group M pandemic, the event that saw HIV spread across the African continent and around the world, and concluded that it originated in Kinshasa. The team's analysis suggests that the common ancestor of group M is highly likely to have emerged in Kinshasa around 1920 (with 95% of estimated dates between 1909 and 1930).
HIV is known to have been transmitted from primates and apes to humans at least 13 times but only one of these transmission events has led to a human pandemic. It was only with the event that led to HIV-1 group M that a pandemic occurred, resulting in almost 75 million infections to date. The team's analysis suggests that, between the 1920s and 1950s, a 'perfect storm' of factors, including urban growth, strong railway links during Belgian colonial rule, and changes to the sex trade, combined to see HIV emerge from Kinshasa and spread across the globe.
A report of the research is published in this week's Science.
'Until now most studies have taken a piecemeal approach to HIV's genetic history, looking at particular HIV genomes in particular locations,' said Professor Oliver Pybus of Oxford University's Department of Zoology, a senior author of the paper. 'For the first time we have analysed all the available evidence using the latest phylogeographic techniques, which enable us to statistically estimate where a virus comes from. This means we can say with a high degree of certainty where and when the HIV pandemic originated. It seems a combination of factors in Kinshasa in the early 20th Century created a 'perfect storm' for the emergence of HIV, leading to a generalised epidemic with unstoppable momentum that unrolled across sub-Saharan Africa.'
'Our study required the development of a statistical framework for reconstructing the spread of viruses through space and time from their genome sequences,' said Professor Philippe Lemey of the University of Leuven's Rega Institute, another senior author of the paper. 'Once the pandemic's spatiotemporal origins were clear they could be compared with historical data and it became evident that the early spread of HIV-1 from Kinshasa to other population centres followed predictable patterns.'
One of the factors the team's analysis suggests was key to the HIV pandemic's origins was the DRC's transport links, in particular its railways, that made Kinshasa one of the best connected of all central African cities.
'Data from colonial archives tells us that by the end of 1940s over one million people were travelling through Kinshasa on the railways each year,' said Dr Nuno Faria of Oxford University's Department of Zoology, first author of the paper. 'Our genetic data tells us that HIV very quickly spread across the Democratic Republic of the Congo (a country the size of Western Europe), travelling with people along railways and waterways to reach Mbuji-Mayi and Lubumbashi in the extreme South and Kisangani in the far North by the end of the 1930s and early 1950s. This helped establishing early secondary foci of HIV-1 transmission in regions that were well connected to southern and eastern African countries. We think it is likely that the social changes around the independence in 1960 saw the virus 'break out' from small groups of infected people to infect the wider population and eventually the world.'
It had been suggested that demographic growth or genetic differences between HIV-1 group M and other strains might be major factors in the establishment of the HIV pandemic. However the team's evidence suggests that, alongside transport, social changes such as the changing behaviour of sex workers, and public health initiatives against other diseases that led to the unsafe use of needles may have contributed to turning HIV into a full-blown epidemic – supporting ideas originally put forward by study co-author Jacques Pepin from the Université de Sherbrooke, Canada.
Professor Oliver Pybus said: 'Our research suggests that following the original animal to human transmission of the virus (probably through the hunting or handling of bush meat) there was only a small 'window' during the Belgian colonial era for this particular strain of HIV to emerge and spread into a pandemic. By the 1960s transport systems, such as the railways, that enabled the virus to spread vast distances were less active, but by that time the seeds of the pandemic were already sown across Africa and beyond.'
The team says that more research is needed to understand the role different social factors may have played in the origins of the HIV pandemic; in particular research on archival specimens to study the origins and evolution of HIV, and research into the relationship between the spread of Hepatitis C and the use of unsafe needles as part of public health initiatives may give further insights into the conditions that helped HIV to spread so widely.
More information: The early spread and epidemic ignition of HIV-1 in human populations, Science, 2014. www.sciencemag.org/lookup/doi/… 1126/science.1256739

Ebola virus: 'Biological war' in Liberia

http://www.bbc.co.uk/news/

 

 Ebola robs death of its dignity as victims' bodies are quickly

 burnt with the plastic suits they are wrapped in

Continue reading the main story

Ebola outbreak

• How bad can Ebola get?
• How to avoid Ebola
• Doctor's report
• Why so dangerous?

With warnings from officials that the Ebola virus is "spreading like wildfire" in Liberia, Sarah Crowe, who works for the UN children's agency (Unicef), describes her week on the Ebola front line:

Flights into disaster zones are usually full of aid workers and journalists. Not this time.
The plane was one of the first in after some 10 airlines stopped flying to Liberia because of Ebola, and still it was empty.
When I was last in Liberia in 2006, it was to work on reintegration of child soldiers in a time of peace. Now the country is fighting a "biological war" from an unseen enemy without foot soldiers.
As we enter the airport, an unnerving sight - a team of health workers kitted out with masks and gloves asks us to wash our hands with a chlorine solution and takes our temperatures.

 

Health workers themselves have to be frequently sprayed with disinfectant

It was to be the start of a new routine - the hours and days since, I have had my temperature taken about 15 times and have had to wash my hands with chlorine at the entrance to every building, every office, every store, and every hotel.

Continue reading the main story

“Start Quote

It was a normal pregnancy, but she was turned away by every hospital as staff were too afraid to take her in case she had Ebola”

Even in small villages. And yet ironically, despite all this, few health facilities are properly functioning.

The next morning, the breakfast room at the hotel is buzzing - a large group of scientists from the US Centers for Disease Control and Prevention (CDC) huddle around computers animatedly talking, checking charts and data.
The world's Ebola experts are here - writing the first draft of Ebola history in real time.
The capital, Monrovia, reveals itself as a city branded by Ebola posters shouting out what people know all too well by now - Ebola is deadly, protect yourself, wash your hands.
Human booby traps The talk in the car, on the radio is only about Ebola - people calling in want to know what to do when their child gets sick, they either fear health centres and hospitals or they are not treated.

Ebola virus disease (EVD)

• Symptoms include high fever, bleeding and central nervous system damage
• Spread by body fluids, such as blood and saliva
• Fatality rate can reach 90% - but current outbreak has mortality rate of about 55%
• Incubation period is two to 21 days
• There is no proven vaccine or cure
• Supportive care such as rehydrating patients who have diarrhoea and vomiting can help recovery
• Fruit bats, a delicacy for some West Africans, are considered to be virus's natural host

A colleague tells me she has just lost a family member about to give birth.
It was a normal pregnancy, but she was turned away by every hospital as staff were too afraid to take her in case she had Ebola.
She did not have the virus, but she died because of delivery complications. Her baby at least survived.
News of the US obstetrician in Liberia who contracted the deadly disease while delivering a baby has helped fuel such worries.
So far 169 Liberian health care workers have been affected by Ebola and 80 have died - a massive blow to a fragile health system.
Next I prepare to go up country to Lofa county where more warehouse space was needed - Unicef has delivered tonnes of equipment, including personal protective suits, chlorine and oral rehydration salts to Liberia - and more monitoring was required of those other now-neglected childhood killers like measles, diarrhoea and cholera.
Ebola has turned survivors into human booby traps, unexploded ordinance - touch and you die. Ebola psychosis is paralysing.

 

The workers often look like crop sprayers

Heavy rains lash down over the weekend - I shudder to think of Medecins Sans Frontieres and health ministry workers and patients battling under plastic sheeting in such rains.
Luckily the skies over Monrovia clear for the hour-and-a-half helicopter ride to the hot-zone border between Sierra Leone, Guinea, and Liberia.
In Voinjama, I'm out with a team of social mobilisers who interact and educate communities.
They are playing our song - Ebola Is Here - on a megaphone through the village.

Ebola in Africa: Can we dodge a global pandemic?

By Chris Kilham

Published July 10, 2014

FoxNews.com

CDC/ Cynthia Goldsmith

Right now, a fight for survival is taking place in the West African nations of Guinea, Sierra Leone and Liberia. Ebola, one of the most lethal diseases on the planet, is on a killing rampage.  In Guinea, 303 people have died. In Sierra Leone, 99 have perished, and in Guinea, 65 lives have been claimed.
Within a few days, these figures will be higher. And the disease appears to just be getting warmed up. Spread by contact with bodily fluids, Ebola is flourishing in West Africa, and could be coming soon to a place near you.
When the outbreak began in Guinea in April, the mortality rate was higher than it is now. But the virus is still an extreme hazard, and health workers must work in full bio-hazard suits in order to keep themselves from being infected by the patients they are serving. The protective suits are extremely hot in the sweltering West African climate. They are like little mobile sauna units, slowly cooking the doctors, nurses and aids working inside them.
Named after the Ebola River, the virus was first discovered in 1976 in what was then Zaire and is now the Democratic Republic of Congo. A viral disease, Ebola starts out like a bad flu, exhibiting initial symptoms of fever, weakness, headache and muscle pain – but that’s where the similarities end.
The more severe symptoms commence as early as two days after contact with the virus. Ebola is a hemorrhagic fever, meaning it causes the rupturing of blood vessels throughout the body.  Victims may bleed from the eyes, nose, mouth, ears, anus and genitals, as well as through skin ruptures. The liver, lungs, spleen and lymph nodes can be overcome by Ebola, leading to massive organ failure, and an agonizing death can follow.
There are five strains of Ebola: Zaire, Sudan, Reston, Cote d’Ivoire, and Bundibugyo. Of these, four are known to cause the disease in humans, whereas Reston does not appear to do so.  The disease is transmitted from animals to humans. Fruit bats, monkeys, and wild game may host the virus and spread it to humans, but bats in particular are on the radar of health officials. They are known as reservoir species, carrying the virus without becoming sick from the disease.
Despite urgent, high level attention from the World Health Organization and the Centers for Disease Control and Prevention, Ebola has no specific treatment, no vaccine, and no effective medicines. Bed rest and remaining hydrated appear to be as effective as any course of treatment, with a disease whose mortality rate can be as high as 90 percent. In clinics, Ebola patients are kept isolated as much as possible, and any utensils used to diagnose them must be fastidiously sterilized. Health workers take a huge risk tending to the Ebola infected, and only bio-hazard suits afford enough protection. Still, even one accidental prick from a dirty needle can lead to infection. It is very risky business.
Now, we don’t have to worry, right? Ebola is, after all, over in Africa, far removed from us. Nothing could be further from the alarming truth.
Imagine this scenario: A health worker tends to Ebola patients in Guinea, and remains healthy due to good sanitation practices. Eventually, that health worker needs to travel to the United States or Europe, and he or she boards a plane. Unknowingly, they are infected but symptom-free so far. On the long flight home, they start to feel some aches and chills, and at one point, they sneeze, sending thousands of viruses into the air through the atomized mucus expelled from the nose. Other passengers breathe that air, taking in a few viruses here and there, and they become infected.
And a global pandemic starts to roll.
This is neither a far-off scenario nor science fiction. It is a real possibility. And this is why health officials are so gravely concerned about the current Ebola outbreak. Unlike previous smaller outbreaks which have occurred in rural locations, this one is happening in hot, humid cities where crowds are dense and sanitation is sketchy; where basic hygiene is often hard to manage and many people eat wild game that might be infected. It is a perfect recipe for a massive, uncontrolled outbreak. Infecting another person is as easy as a sneeze, a kiss, cleaning up after someone, making contact with mucus, urine or feces.
The question, then, is what can you do? Except for staying away from anyone infected, you can’t do much. Right now it’s up to the health workers laboring in excessively hot bio-hazard suits, and to officials who are working hard on containment. This situation in West Africa could in fact be the start of a global disaster, or it may be another near-miss. The threat is real, and the disease is on the move. Will we dodge the Ebola bullet? Right now, all we can do is watch and wait.
Chris Kilham is a medicine hunter who researches natural remedies all over the world, from the Amazon to Siberia. He teaches ethnobotany at the University of Massachusetts Amherst, where he is Explorer In Residence. Chris advises herbal, cosmetic and pharmaceutical companies and is a regular guest on radio and TV programs worldwide. His field research is largely sponsored by Naturex of Avignon, France. Read more at MedicineHunter.com.

Doctors Without Borders: Ebola 'out of control'

 http://www.breitbart.com/

DAKAR, Senegal (AP) — The Ebola outbreak ravaging West Africa is "totally out of control," according to a senior official for Doctors Without Borders, who says the medical group is stretched to the limit in its capacity to respond.
The current outbreak has caused more deaths than any other on record, said another official with the medical charity. Ebola has been linked to more than 330 deaths in Guinea, Sierra Leone and Liberia, according to the latest numbers from the World Health Organization.
International organizations and the governments involved need to send in more health experts and increase public education messages about how to stop the spread of the disease, Bart Janssens, the director of operations for the group in Brussels, told The Associated Press on Friday.
"The reality is clear that the epidemic is now in a second wave," Janssens said. "And, for me, it is totally out of control."
The outbreak, which began in Guinea either late last year or early this year, had appeared to slow before picking up pace again in recent weeks, including spreading to the Liberian capital for the first time.
"This is the highest outbreak on record and has the highest number of deaths, so this is unprecedented so far," said Armand Sprecher, a public health specialist with Doctors Without Borders.
According to a World Health Organization list, the highest previous death toll was in the first recorded Ebola outbreak in Congo in 1976, when 280 deaths were reported. Because Ebola often touches remote areas and the first cases sometimes go unrecognized, it is likely that there are deaths that go uncounted, both in this outbreak and previous ones.
The multiple locations of the current outbreak and its movement across borders make it one of the "most challenging Ebola outbreaks ever," Fadela Chaib, a spokeswoman for the World Health Organization, said earlier in the week.
The outbreak shows no sign of abating and that governments and international organizations were "far from winning this battle," Unni Krishnan, head of disaster preparedness and response for Plan International, said Friday.
But Janssens' description of the Ebola outbreak was even more alarming, and he warned that the governments affected had not recognized the gravity of the situation. He criticized the World Health Organization for not doing enough to prod leaders and said that it needs to bring in more experts to do the vital work of tracing all of the people who have been in contact with the sick.
"There needs to be a real political commitment that this is a very big emergency," he said. "Otherwise, it will continue to spread, and for sure it will spread to more countries."
The World Health Organization did not immediately respond to requests for comment.
But Tolbert Nyenswah, Liberia's deputy minister of health, said that people in the highest levels of government are working to contain the outbreak as proved by the fact that that Liberia had a long period with no new cases before this second wave.
The governments involved and international agencies are definitely struggling to keep up with the severity of the outbreak, said Krishnan of Plan, which is providing equipment to the three affected countries and spreading information about how people can protect themselves against the disease. But he noted that the disease is striking in one of the world's poorest regions, where public health systems are already fragile.
"The affected countries are at the bottom of the human development index," he said in an emailed statement. "Ebola is seriously crippling their capacities to respond effectively in containing the spread."
The situation requires a more effective response, said Janssens of Doctors Without Borders. With more than 40 international staff currently on the ground and four treatment centers, Doctors Without Borders has reached its limit to respond, he said.
"It's the first time in an Ebola epidemic where (Doctors Without Borders) teams cannot cover all the needs, at least for treatment centers," he said.
It is unclear, for instance, if the group will be able to set up a treatment center in Liberia, like the ones it is running in in Guinea and Sierra Leone, he said. For one thing, Janssens said, the group doesn't have any more experienced people in its network to call on. As it is, some of its people have already done three tours on the ground.
Janssens said this outbreak is particularly challenging because it began in an area where people are very mobile and has spread to even more densely populated areas, like the capitals of Guinea and Liberia. The disease typically strikes sparsely populated areas in central or eastern Africa, where it spreads less easily, he said.
By contrast, the epicenter of this outbreak is near a major regional transport hub, the Guinean city of Gueckedou.
He said the only way to stop the disease's spread is to persuade people to come forward when symptoms occur and to avoid touching the sick and dead.
"There is still not a real change of behavior of the people," he said. "So a lot of sick people still remain in hiding or continue to travel. And there is still news that burial practices are remaining dangerous."
___
Associated Press video journalist Bishr Eltouni in Brussels and writer Jonathan Paye-Layleh in Monrovia, Liberia, contributed to this report.

West Africa Ebola death toll hits 337: WHO

21 hours ago

Geneva (AFP) - The death toll in west Africa's three-nation Ebola outbreak has risen to 337, the World Health Organization said Wednesday, making it the deadliest ever outbreak of the haemorrhagic fever.

Related Stories

• Guinea Ebola death toll rises above 200 AFP
• West Africa's Ebola death toll rises to 337 Associated Press
• Sierra Leone doubles Ebola death toll AFP
• Death toll from West Africa Ebola hits 337: WHO update Reuters
• Death toll from West Africa Ebola hits 337 -WHO update Reuters

Fresh data from the UN health agency showed that the number of deaths in Guinea, the hardest-hit country, has reached 264, while 49 had died in Sierra Leone and 24 in Liberia.

The new toll marks a more than 60-percent hike since the WHO's last figure on June 4, when it said 208 people had succumbed to the deadly virus.

Including the deaths, 528 people across the three countries have contracted Ebola, one of the deadliest viruses known to man, the WHO said.

A majority of cases, 398 of them, have surfaced in Guinea, where west Africa's first ever Ebola outbreak began in January.

Sierra Leone has registered 97 cases in total, while Liberia has seen 33.

 

Health workers wear protective suits in an isolation center for people infected with Ebola at Donka  …

 

WHO has described the epidemic as one of the most challenging since the virus was first identified in 1976 in what is now the Democratic Republic of Congo.

That outbreak, until now the deadliest, killed 280 people, according to WHO figures.

Ebola is a tropical virus that can fell its victims within days, causing severe fever and muscle pain, weakness, vomiting and diarrhoea -- in some cases shutting down organs and causing unstoppable bleeding.

No medicine or vaccine exists for Ebola, which is named after a small river in the DRC.

Aid organisations have said the current outbreak has been especially challenging since people in many affected areas have been reluctant to cooperate with aid workers and due to the practice of moving the dead to be buried in other villages.

West African authorities have also been struggling to stop mourners from touching bodies during traditional funeral rituals.

News U.S. Officials Keep Close Eye On ‘Miserable’ Mosquito-Borne Chikungunya Virus

CDC: Cases Confirmed In 15 States, Including N.Y., With 25 In Florida Alone June 16, 2014 6:19 PM

 

NEW YORK (CBSNewYork) — First there was West Nile virus. Now health experts are warning about another virus carried by mosquitoes.
The chikungunya virus — or “chik-v” — has sickened tens of thousands of people throughout the Caribbean with high fever and severe pain. Now Americans are coming down with it, too, and there’s fear that it will spread, CBS 2′s Kristine Johnson reported.
“This is not a fatal infection; it’s just a miserable infection,” said Dr. William Schaffner, chairman of Vanderbilt University’s Department of Preventive Medicine.
Cases of the mosquito-borne virus have been confirmed in 15 states, including New York. According to the U.S. Centers for Disease Control and Prevention, 25 cases have been reported in Florida alone.
“The chikungunya fever will last for three, four, five days,” Schaffner said. “You’re miserable. Then you’ll get better. We can treat you symptomatically.”
So far, all of the infected Americans have contracted the virus in parts of the world where it is common. But researchers are worried that mosquitoes in the U.S. could pick up the disease by biting infected people.
“There’s a concern that people from the United States who go to the Caribbean might be bitten by infected mosquitoes and then bring this illness, this virus, back to the United States,” Schaffner siad. “We have the kind of mosquito that will transmit this virus here in the U.S.”
Prior outbreaks have occurred in Africa, Asia, and Europe. Late last year, the virus was found for the first time on the Caribbean islands, where more than 100,000 people have been sickened.
“So far, we have no evidence that there are U.S.-bred mosquitoes that have become infected,” Schaffner said.
There is no vaccine to prevent the virus, which is rarely fatal.

Dengue-like chikungunya virus reported in El Salvador

11 hours ago

Employees of the Dominican Ministry of Public Health stick posters on a wall during an information campaign to prevent the spread of the mosquito which transmits the Chikungunya virus in Santo Domingo on May 30, 2014 (AFP Photo/Erika Santelices)

San Salvador (AFP) - Salvadoran health authorities confirmed Saturday that a dengue-like disease that has been spreading across the Caribbean has now appeared in the Central-American country.

Health Minister Violeta Menjivar said at least 1,200 people have been formally diagnosed with the chikungunya viral disease, although the positive testing must still be confirmed by the US Centers for Disease Control and Prevention.

Menjivar, interviewed by state-run Channel 10 television, said that cases were found on the outskirts of the Ayutuxtepeque municipality just outside the capital San Salvador.

In that area at the end of May, the ministry's epidemiologists and infectious disease specialists detected an outbreak of a rare viral disease that caused fever and skin rash, which they said affected at least 181 people.

She said suspected cases were also found in residents in two other area on the edge of northern San Salvador.

The mosquito that transmits chikungunya -- the Aedes aegypti -- is the same one that spreads dengue.

The health ministry has asked people "to eliminate breeding sites" at their homes.

There is no vaccine or treatment for chikungunya, which has infected millions of people in Africa and Asia since the disease was first recorded in 1952.

It has also spread to southern Europe -- with an outbreak in Italy in 2007 and southern France in 2010 -- and arrived in the Caribbean last year, appearing in Martinique and Saint Martin.

Chikungunya produces symptoms similar to dengue, including high fever, joint pain and skin rash.

The disease's name is derived from an east African word meaning "that which bends up," referring to the way that patients are stooped over in pain.

Whooping Cough Epidemic in California as Cases Surge

  http://www.bloomberg.com/

By Marie French Jun 13, 2014 11:01 PM CT

20 Comments E

California’s whooping cough outbreak has reached epidemic levels, with 800 new cases in the last two weeks, according to the state’s public health agency.
There have been 3,458 cases of the respiratory infection, formally known as pertussis, in California as of June 10, the state’s Department of Public Health reported. That’s more than were reported in all of 2013. Most at risk are newborns, and two have died in California so far this year.
“Our biggest concern is always infants,” Stacey Martin, an epidemiologist with the U.S. Centers for Disease Control and Prevention’s division of bacterial diseases, said in a telephone interview. “There’s a gap in coverage between birth and the first vaccine.”
Whooping cough carries different symptoms at different ages. For children, a case can begin with a cough and runny nose before the cough worsens, characterized by a whooping sound that gives the disease its nickname. Infants don’t always have a cough but their faces may turn red or purple.
More than 900 of California’s cases occurred in April and May, a fivefold increase on the typical number seen in non-peak years, said Corey Egel, a spokesman for state health department.
The high number of cases isn’t unexpected because of the cyclical nature of the disease. California last had a widespread outbreak, or “peak,” in 2010. Martin said the priority is to encourage pregnant women to get the vaccine for pertussis, which the CDC has recommended since 2013.
Vaccinating pregnant women and infants helps prevent the spread of the disease, Ron Chapman, the state’s health department director, said yesterday in a statement.
The CDC recommends infants be vaccinated as early as six weeks after birth, because the effect of a vaccination given to their mother during pregnancy soon wears off, Martin said. The CDC also suggests shots for those spending time with newborns.
Nationwide, there have been three other deaths reported from whooping cough this year, Martin said. In total, 9,964 cases of whooping cough were reported in the U.S. through June 8, compared with 7,573 at the same time last year, the CDC said.

Sierra Leone shuts borders, closes schools to fight Ebola

12 hours ago

FREETOWN (Reuters) - Sierra Leone shut its borders to trade with Guinea and Liberia on Wednesday and closed schools, cinemas and nightclubs in a frontier region in a bid to halt the spread of the Ebola virus.

Sixteen people have died of Ebola in Sierra Leone, a figure that has doubled in the last week, Ministry of Health figures showed.

Authorities will also mount health checkpoints in the eastern Kailahun district and mandated that all deaths there be reported before burial. Anyone who dies of the virus must be buried under the supervision of health personnel, the Information Ministry said.

The decision to close district schools came after a nine-year-old whose parents died of Ebola tested positive for the virus, Deputy Minister of Information Theo Nicol told Reuters.

"There is more contacts between school-going kids than adults hence the closure of schools in the most affected district," he said. The ban exempted churches and mosques but religious leaders should urge anyone with a fever to go to a clinic, he said.
Local groups welcomed the measures given public concern over the virus, which can be transmitted by touching victims or their body fluids.
The virus initially causes a raging fever, headaches, muscle pain and conjunctivitis, before moving to severe phases that bring on vomiting, diarrhoea and internal and external bleeding.
Some 328 cases and 208 deaths are linked to Ebola in Guinea, according to the World Health Organization, making the outbreak one of the deadliest for years.

More than half of new deaths in Guinea were in the southern region of Gueckedou, epicenter of the outbreak which began in February, near the Sierra Leone and Liberian borders. The town is known for its weekly market which attracts traders from neighboring countries.

(Reporting by Umaru Fofana; Editing by Matthew Mpoke Bigg and Janet Lawrence)

Fingers to Ashes: The Millennial Disconnect with HIV

Tyler Curry Become a fan Freelance columnist and fiction writer; creator, The Needle Prick Project

Posted: 06/11/2014 5:17 pm EDT Updated: 06/11/2014 5:59 pm EDT 

http://www.huffingtonpost.com/the-blog

It is hard to imagine that it was only 34 years ago when the first case of HIV was first documented in the United States. Shortly after, the virus seemed to spread like wildfire, burning a path of hysteria, frustration and sadness across the U.S. and throughout the world. In a short period of time, and thanks to a series of political blunders from the Reagan administration and many other political figures across the nation, HIV went from hundreds to millions and became the closest we have ever come to a modern plague.

Although there is still no cure for the virus, this plague is now classified as a chronic illness with those who are HIV positive living long and healthy lives. So the obscene terror that lived in the hearts of every gay man in the world merely three decades ago has all but been erased in the mines of the millennial age. In its place now lives a vague but often-impenetrable fear of those who carry HIV and a diluted sense of safety based on the idea that the transmission of HIV is related to a character flaw of promiscuity. This blind faith that the virus is relinquished to "other" types of people has allowed for this disease to continue affecting the millennial generation at staggering rates.
According to the Center for Disease Control's National Progress Report of 2013, an estimated 1.1 million people are living with HIV in the United States with 50,000 more becoming infected each year. One out of every six people living with the virus are unaware that they are infected, thus continuing the cycle of transmission. And worse, one out of every five gay men are living with HIV, yet the millennial generation often treats the disease as if it is only reserved for the history books.
But beyond the numbers, just what exactly does it mean to live HIV in today's world? For starters, HIV is now officially classified as a chronic disease. Although most people assume that treatment involves a series of toxic cocktails that HIV positive men and women take throughout the day, a person diagnosed today will most likely be on one daily pill to manage the virus. And reports suggest that, given a person is compliant with their medication; they can expect the same estimated lifespan as they did when they were HIV negative.
"A person who is 20-years-old and diagnosed today can expect to live into their 70s, roughly the same lifespan they would expect prior to being diagnosed," says Dr. Gary Blick, HIV Specialist and Founder of World Health Clinicians, an international HIV treatment organization.
However, it isn't all good news. The span of your life may be the same, but your worries certainly are not. People living with the virus run an increased risk of developing other life-threatening diseases such as cancer, heart attack and stroke. Combined with other STI's, these risks are even bigger, making it even more important for a person living with HIV to manage all aspects of their health, not just their pillboxes. However, an HIV positive diagnosis is merely a charge to be drastically more responsible with a person's health instead of an order to make arrangements for a pending funeral.
To many of the people living with the disease, it is also a scarlet branding that induces emotional and psychological symptoms that far outweigh the side effects listed on the side of their medication bottles.
The organizations charged with delivering the message of HIV awareness and prevention have grappled with advancing their messaging with the advancements of modern medicine. Managing HIV is a drastically different animal than it was merely a decade ago, but many still view the virus with the same gravity that they did in the 1990s. The few organizations who have tried to modernize the approach to HIV education have been lambasted for "making light" of the disease, trying to "make HIV cool," or downplaying the severity of living with the virus.
This struggle over messaging has never been more contentious then in the present as institutional juggernauts like the AIDS Healthcare Foundation (AHF) battles with more progressive activists and organizations over the promotion of PrEP, or pre-exposure prophylaxis. This new drug, nicknamed the birth control pill for HIV, now personifies the crux in HIV treatment debate.
PrEP is an Antiretroviral Therapy drug that, if taken correctly by an HIV negative individual, has a 99 percent efficacy rate in preventing the transmission of HIV from someone who is HIV positive. This drug has been on the market since 2012, but several prominent organizations such as AHF, the largest HIV treatment provider in the U.S., have taken an active stance against the HIV prevention pill.
Michael Weinstein, the Executive Director of AHF, has publicly referred to PrEP as a party drug and suggested that the "people who would be taking the drug" could not be trusted to be compliant with their dosage. This stigmatizing rhetoric, combined with the pharmaceutical company, Gilead's, unwillingness to advertise the drug to at-risk populations, has led to a virtual standstill in people seeking a prescription for the prevention pill.
People like J Nick Shirley, a 24-year-old gay man from Dallas, represent the most at risk demographics for HIV transmission, and yet has never heard of PrEP. When asked about the new form of prevention, he was shocked that this was the first time he was hearing about it.
"I just can't believe that we have such a ground-breaking tool at our disposal and so many people don't know about [PrEP]," Shirley said. "I am pretty sure none of my friends know about it. We have never talked about it before."
Long term HIV survivor, activist and former reality T.V star, Jack Mackenroth, is mortified that organizations like AHF have taken on such a damaging approach to PrEP.
"If this were the '90s, people would be lining up down the streets to take PrEP," says Mackenroth. "It is so sad that the fear that we went through has given way to the judgment and stigma from gay men onto other gay men. HIV isn't going anywhere if we don't wake up and realize that condom-only messages don't work."
Which leads us to the use of the problem; organizations using worn out methods of education and prevention, further stigmatizing others looking for prevention methods beyond condoms and leaving the vast majority of millennial, at-risk individuals to believe that HIV is a virus that "other" people get.
Movies like The Normal Heart serve as history lessons, leading young gay men to cry, "Never forget," while failing to realize the dangers they face. LGBT youth are left grappling for connection, because most of the visible reminders of the risk of HIV are only ashes, while the living, more relevant examples prefer to remain in silence for fear of public ridicule and castigation. Sadly, the community that was once unified under the call to fight the virus is now complacent in a pseudo-class system of HIV status that only serves to perpetuate transmission.
But change is on the horizon. Grassroots campaigns such as HIV Equal, The Stigma Project, The Needle Prick and several others have worked to change the climate of HIV stigma for those living with the virus and educate the public on the real vs. perceived danger of HIV transmission. A new wave of young, HIV positive faces, such as Josh Robbins, Cory Lee Frederick and Jake Forth are making their presence known in the public eye, humanizing the virus for the millennial generation while serving as living examples that HIV is still an issue for their age group. And this year, as the Obama Administration unveiled the HIV Care Continuum at the third annual HIV/AIDS Strategy, President Obama's HIV prevention policy recognized Antiretroviral treatment as a valid form of prevention, giving authority to the fact that HIV positive men who achieve undetectable viral load levels are actively preventing the spread of HIV.
While the level of danger has waned over the past three decades, the threat of HIV still remains. Unlike the generations first affected by the virus, the millennial age is now armed a wealth of information and a variety of prevention tools to change the course of HIV for good. And this young generation should take note that these tools came at a very heavy cost.
If you have had sex even once since your last HIV test without a condom, it is worth it educate yourself on PrEP and determine if it is right for you. It only takes one time to transmit the virus, and it only takes one pill a day to stop it. The millennial generation no longer has to face a multitude of limitations when concerning HIV, so there is no excuse to get tested, know your status and pick up the slack in the fight against HIV. After all, most of the heavy lifting has already been done.