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In December 2019, there was a listeria outbreak in the United States, and I found this article to explain what happened. Seven people were infected with listeria across five states and one person died from the infection. The source of listeria was hard boiled eggs from a company called Almark Foods. These eggs were used by other companies to make products that contained hard boiled eggs, so it was difficult for people to know for certain whether or not they had consumed any of the contaminated food. The CDC recommended that people avoid all pre-packaged hard-boiled eggs until they could properly trace the outbreak.

               Another article about this specific outbreak explained the recalls that occurred following this outbreak. Trader Joe’s recalled many of their prepared foods, such as their potato salad, that contained potentially-contaminated eggs. The eggs that were distributed were sold under many different brand names, so the list of recalled products was long. In fact, 88 different products were recalled. This is alarming to me because it would be easy to unknowingly purchase contaminated food. The eggs were produced in Georgia, but they were distributed across the country.

               Listeria infections are uncommon, but they do have a high mortality rate. Some of the symptoms that you should look out for if you are worried that you may have eaten contaminated food include headache, stiff neck, confusion, loss of balance, and fever. Listeria infections are particularly dangerous for pregnant women. An infection can result in miscarriage, stillbirth, or premature delivery. Also, patients on dialysis have a significantly higher chance of getting a listeria infection than other people. These chances are also increased for pregnant women and people with cancer.

One example of a drug that uses antibody therapy is adalimumab, which is also known commercially as Humira, which you may have seen advertised on TV a few times. Before we start talking too much about Humira specifically, let me explain what a monoclonal antibody even is. According to Wikipedia, monoclonal antibodies all bind to one identical epitope, and they can be engineered to bind to virtually any epitope. Monoclonal antibodies are all produced by identical plasma cells that stem from a single B cell. The ability for scientists to design a specific monoclonal antibody to attach to a particular epitope makes them a useful tool in medicine. Monoclonal antibody therapies can treat many conditions, ranging from cancer to autoimmune diseases.

Humira is used to treat a wide variety of autoimmune diseases, such as rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn’s disease, hidradenitis suppurativa, ulcerative colitis, and plaque psoriasis. In patients with arthritis, Humira can prevent further joint damage, but it is not designed to repair damage that has already been done. As explained by Medicine Net, adalimumab is an antibody that works by binding to tumor necrosis factor (TNF), and thereby inhibiting its ability to cause inflammation. This action prevents the inflammatory response that is often responsible for some of the signs and symptoms associated with autoimmune disorders. This antibody was approved for treatment by the FDA in December of 2002, and I did not realize that our biotechnology was advanced enough back them to be able to develop this type of drug.

Like with any medicine, several side effects are associated with the use of adalimumab. Some of the more serious side effects include infections, nervous system problems, blood problems, heart failure, liver problems, and psoriasis. More common side effects include upper respiratory infections, headaches, rash, and nausea. Taking Humira can also weaken your immune system, which can lead to reactivation of a latent TB infections or reactivation of a chronic hepatitis B infection. With that said, it is important for patients to be tested for both of these diseases before beginning treatment with Humira. Cancer may be associated with the use of adalimumab, but the connection is unclear because people with rheumatoid arthritis have higher rates of developing cancer anyway.

              For this blog post, I wanted to talk about this year’s flu season because it has been overshadowed by COVID-19 in the media. It was quite difficult to find any articles just discussing the flu, but I did find some interesting information about the flu in a context alongside COVID-19. In my opinion, the measures taken against COVID-19 will help and hurt the numbers of people affected by other diseases this month. Immunocompromised individuals who are taking the precautions seriously should benefit from the decreased interactions between people. This lack of interaction will help them avoid falling ill from other infectious diseases as well, such as the flu. Many businesses are also doing their part to help people be able to stay home. On the other hand, crowded hospitals will make hospital visits more dangerous for immunocompromised people who do happen to fall ill during this time.

              According to a recent article, 32 million people have gotten the flu in America since flu season began in September. In comparison, fewer than 600,000 cases of COVID-19 have been confirmed in the US. With that being said, more people have died from COVID-19 (21,000) than from the flu (18,000) since flu season began in America. We have much less fear surrounding the flu because there are vaccines and treatments available. Also, we have had a lot more time to research the influenza virus, so we know more about how our body reacts to it and how it spreads. Another concern with the novel coronavirus, there is no natural immunity because no one had been exposed to it previously.

              I found another article that highlighted the similarities and differences between the flu and COVID-19. Many of the symptoms of these 2 diseases overlap, such as fever, dry cough, fatigue, and shortness of breath. Both the flu and COVID-19 can be spread through droplets and fomites, so similar precautions should be taken to avoid transmission of either. An important difference between the two if that COVID-19 has a much higher hospitalization rate than the flu, and it causes a higher percentage of serious cases. If precautions are not followed for COVID-19, the numbers will quickly surpass those of the flu because it is more contagious and more deadly.

Before jumping into the specific relationship between antibodies and the novel coronavirus, let me explain the basics of antibody response from what I have learned in class. As soon as B cells are activated by an antigen, they produce plasma cells, which will produce antibodies. In the very beginning, before they know a whole lot about the invader, these plasma cells just start to produce IgM antibodies. Therefore, someone who has high levels of IgM coronavirus antibodies is at the beginning of their infections. Once a plasma cell begins to go through class switching, it will begin to produce IgG antibodies, which will be better at fighting against viruses. A patient with both IgM and IgG antibodies is in the process of fighting off the disease, but they have not completely cleared out the infection. A patient who only has IgG antibodies already fought off the infection and is prepared to eliminate the antigen if it came back into contact with it. These people would be less likely to infect others.

              However, scientists are still researching the novel coronavirus to figure out how it will be effected by antibodies, and this article discusses many of the uncertainties that still need to be researched. We develop varying levels of immunity to different viruses after exposure, depending on several characteristics of each virus. If the virus behind COVID-19 behaves similarly to the coronaviruses that cause the common cold, then people will not gain lasting immunity after infection. If this is the case, it may not be safe for people with high levels of IgG to return to work or stop social distancing. On the other hand, if this coronavirus is similar to the one that causes SARS, people who were infected will develop immunity that lasts for a few years, and it would be safe for them to return to normal activities.             

  I found another article that explained the practical applications of an antibody test if one was able to be used after the aforementioned research was completed. Many people who are infected with the novel coronavirus remain asymptomatic, so these antibody tests would be the only way to know if they have been exposed and are now immune. This test would be useful to figure out which healthcare workers could safely go to work without risking their own health or the health of their patients. A healthcare worker (or any worker) who is asymptomatic but still has IgM antibodies should not interact with others because they could still spread the virus. National Institutes of Health is planning on testing 10,000 health volunteers to see if they can safely continue to work and risk being exposed.

As the numbers of cases and deaths from COVID-19 continue to rise at an alarming rate, many people are hoping that a vaccine or treatment of some sort will soon be available to protect us. There is a pharmaceutical company called Moderna that is at the front of this race to develop a vaccine, and this article explains where they are right now. The first phase of human trials for this vaccine began in mid-March, and they are hoping to enter phase 2 in the spring or early summer. Phase 1 is only testing 45 people, split into groups that will receive different doses, so we still have a while to go until it is on the market. A fun side note about Moderna is that my brother’s ex-girlfriend’s dad is the head of manufacturing there! I found this out when she posted an article on Instagram where her dad was interviewed for an article about developing a vaccine in record time after a new pathogen was identified.

              I found another article that explained more of the science behind Moderna’s vaccine. They developed an mRNA vaccine which causes the recipient’s body to make the viral spikes so that their immune system will be able to recognize it in the future. An mRNA vaccine has never even made it to Phase 3 of clinical trials, so this is definitely a new strategy that we are trying to figure out. Even if an effective vaccine is developed, it would not help us get out of our current situation right away. Instead, it would make us prepared for future recurrences of the coronavirus, like the annual flu season. We will also need to wait for results from the clinical trials to see if this vaccine would provide lasting immunity once it was administered.

              Some sort of treatment would provide more immediate relief than a vaccine, and many treatment options are also being developed at the moment. According to the FDA website, one type of treatment that is being tested in the US is the use of convalescent plasma. This method would take plasma from people who have already recovered from COVID-19 and give it to patients with an active case of COVID-19. This convalescent plasma would contain antibodies for the virus behind the disease and should provide passive immunity to the recipient. Although it still needs to go through several trial phases before it is a commonly used treatment, it is being tested in some severe cases in which the patient’s life would otherwise be at risk.

If you are like me, then you have never heard of dendritic cell therapy, and even if you have, then you probably don’t know a whole lot about it. During my research, I stumbled across an analogy that helped me better understand the basics of dendritic cell therapy from this article. In this article, the author explains that our immune system has to fight against tumors in our body, but sometimes, the cells of our immune system are not able to handle this “enemy” on their own. Under natural conditions, many cells in the immune system are unable to effectively target tumor cells, and some may even aid the growth of the tumor. Therefore, scientists are developing ways to equip our immune system cells, such as T cells, natural killer cells, and dendritic cells, with better “weaponry” so that they can fight against the tumor cells more successfully. To make this possible, scientists extract some of a patient’s immune system cells, modifies them, and then inserts them back into the patient.

              This article went on to explain a few specific ways that scientists can help tumor-infiltrating cells be better at their job. One of these methods addressed the issue that many tumor cells can hide from immune system cells, so scientists extract some of the patient’s cells, stimulate them with IL-2 and modifies them in other ways to make them more active, and then re-inserts them into the patient. Some cancers mutate rapidly, giving them the ability to present different antigens, and this can make it difficult for a single drug to effectively treat a patient’s cancer. Using and enhancing a patient’s immune system can be more effective than drugs because our immune system can detect many different antigens. From personal experience, my grandma has cancer and her treatment changes every few months because one stops being effective as the cancer cells adapt to it, so I am hopeful that further development o this type of treatment would prevent this issue in treating other cancer patients.

              Once I understood the basics of this type of therapy, I felt prepared to tackle this scientific article that discusses the use of dendritic cell therapy to treat glioblastoma patients, which is a common and aggressive form of brain cancer.  Trials of this treatment have not been completely effective, but scientists remain hopeful that they will be able to fine-tune this type of therapy so that it becomes a more effective option for treat glioblastoma patients. However, according to this article, this treatment comes with a hefty price tag of nearly $375,000, so it may not be worth the cost to many patients when its success rate is not extremely high yet. I could not find an article from the last six months explaining the side effects, but I did find this article from 2018 that presented the side effects of this type of treatment. Some of the side effects include cytokine release syndrome (which results in flu-like symptoms), neurologic events that vary in severity, neutropenia, and anemia. Fortunately, most of these side effects are easily treated and will likely go away on their own following treatment.

Sooo, let’s slow down a bit and I’ll catch you up on what has been going on in my life recently. It has been pretty crazy for the past few weeks, as I’m sure most people’s lives have been. My dad’s last day of work was Friday, and he is now retired (yay!), but that means my parents are moving to our beach house for retirement. And since my brother and I are home from college, that means we get to help them move… We are moving from Greensboro, NC to Myrtle Beach, SC, so my extended spring break consisted of packing boxes, loading them into cars or U-Hauls, and driving 4 hours to Myrtle Beach. Over and over and over. We just finished clearing all of our stuff out of the house, leaving behind furniture to make the house look nice, and it is now on the market! Hopefully, that will make some things slow down now and we can just work on settling into our beach house, which is still a challenge because we have to incorporate junk from two houses into one.

Now let’s move on to how all of this isolation/quarantine craziness is impacting my life. The home photographer came to our house on the last day that they legally could in NC, so our house went on the market just in time. People are not allowed to come see the house in person, but hopefully seeing it online will be enough for the house to sell. We can finally stay in South Carolina for a while without needing to go back and forth to North Carolina, so a lockdown won’t be too detrimental for us. My second brother is in Clemson still because he had to get to wrap up his research and wants to write his masters thesis without us distracting him, but I am guessing he will come to stay with us in Myrtle Beach soon when he starts to get bored all alone. Our house is right on a pond/lake thing with a walking path around it that has been super busy, so I shouldn’t go too stir crazy because I can just people watch from the safety of our balcony and walk my dogs whenever I get tired of the house.

Classes online will certainly require an adjustment period. I am having a hard time staying focused and motivated with all of the distractions of my home, but I am hoping that I will get used to it. I am thankful that I have reliable internet access and I am in the eastern time zone, so I am not too worried about logistical issues. I am not the best at using technology, so that could become a problem at some point, but it will be a learning experience. I have one midterm that was somehow moved to be a week earlier than originally planned, so that it interesting to me. I do love that my dogs can keep me company during class! I am also glad that I get to cook and bake in my own kitchen and don’t have to go to the dining hall for every meal.

What felt like a distant fear to Americans not too long ago is now affecting the daily lives of millions of people across the country. The pandemic started in China, where over 80,000 people fell ill with COVID-19. Since the first case in November, the virus has spread all over the world, resulting in 335,000 cases and nearly 15,000 deaths worldwide. China is seeing fewer and fewer cases each day as it seems they have gotten past the worst phase of their outbreak. On the other hand, the United States is still at the beginning of their outbreak, and unfortunately, the worst is yet to come. So far, America has had over 33,000 cases and over 400 deaths. All of these numbers came from this website, and you should check it out to see how that numbers have changed since this blog was posted.

              To prevent as much devastation as possible in the United States, many states are implementing strict orders to keep people at home to slow down transmission of the disease. According to a CNN article, eight states have banned their citizens from leaving their homes for any nonessential activities. Under these orders, grocery stores, pharmacies, and medical centers remain open, and restaurants can still sell food through pick up orders, delivery, and drive thru. In many other states, restaurants are similarly closed for dine in service and non-essential stores are closed. Businesses are asking as many people as possible to work from home, and schools and universities are closed for the foreseeable future. I would be surprised if anyone claimed that this pandemic is not affecting their lives, even if it is something as simple as making it more difficult to find toilet paper!

              As various authorities take drastic measures to prevent transmission, it can be easy to become fearful about the situation. While it is something that needs to be taken seriously, it is important that people do not panic. Stay in your home as much as possible and avoid unnecessary contact with people. Wash your hands frequently and practice some commonsense hygiene. If you do begin to fell unwell, contact your doctor beforehand so that they can keep you isolated from other patients. Also on a more positive note, several manufacturers are beginning to use their factories and resources to produce important medical supplies, such as Rolls-Royce producing ventilators, according to this article .

When I read this week’s prompt, I was a bit skeptical about how easy it would be to find articles that discuss changes regarding STDs in the last 6 months, but I was wrong. I was delighted when I found a recent article that explained a correlation between rates of chlamydia and gonorrhea and, believe it or not, fracking in Texas. According to this article, Texas counties where fracking was common reported rates of gonorrhea 15% higher than other counties, and chlamydia rates were 10% higher in fracking counties than other counties. The article went on to explain that this increase in STD rates is caused by the influx of young men that come to work on the fracking sites. New young men bring STDs into the fracking counties, and they transmit these diseases to other sexually active people in the community. The researchers behind this study emphasized the importance of educating community members and nonlocal workers on how to prevent transmission of STDs where they will likely be comingling of people from different regions.

              On a more serious note, I also found an article discussing a potential cure for gonorrhea in women that may be available in the near future. N. gonorrhoeae can quickly develop antibiotic resistance, so previous attempts at treating infections with antibiotics are not effective long term. To treat infections that can rapidly acquire resistance to antibiotics, scientists may target host cells in a way that prevents the bacteria from establishing an infection. Carbamazepine and methyldopa are two drugs used to treat two different conditions, but scientists believe that they me be an effective treatment for gonorrhea when used together. These drugs bind to CR3 receptors on the cell surface to block N. gonorrhoeae from binding to these receptors and establishing an infection in humans. However, CR3 receptors are not present in animals used in laboratory tests, so it is difficult for scientists to test this treatment in lab.

              To develop this possible treatment without being able to test it in animals, scientists are using primary epithelial cervical cells to simulate a human infection. In previous tests, this treatment has completely cleared infections of multi-drug resistant N. gonorrhoeae infections in the primary epithelial cells. After writing about the rapid increase in multi-drug resistant bacteria in previous blog posts, I think that it is important for scientists to continue researching treatments that do not rely on antibiotics. The success of treatments that target host cells will not depend on the rapidly mutating bacteria that cause many infections. While these types of treatments may present a promising future for healthcare, prevention is still extremely important regarding STDs. Remember, the most effective ways to prevent the spread of STDs are abstinence, monogamy, and condoms.

The HPV vaccine is a relatively new vaccine that is recommended for all children and young adults to prevent cervical and other types of cancer. I remember when this vaccine was first gaining popularity, a nurse came to my middle school and all of the girls received the vaccine at school. I found a recent article that explained the current status of the HPV vaccine. This vaccine took 21 years to develop and it is commonly known by its commercial name of Gardasil. The vaccine causes the body to make antibodies against 7 different strains of HPV. Since the vaccine’s introduction, countries are already reporting a decline in the number of cases of HPV and related cancers.

              This article also went on to explain some of the side effects of the HPV vaccine, which are simply the side effects associated with any type of injection. These include injection site redness and swelling, and possible dizziness and lightheadedness. However, these symptoms quickly dissipate and the lasting benefits of the vaccine far outweigh the temporary mild discomfort. Some people claim that the HPV vaccine causes chronic fatigue syndrome, but there is no substantial evidence to support a causal relationship between the two. The HPV vaccine prevent the chances of cervical cancer by 75-85%, so these mild side effects should not prevent someone from getting the potentially lifesaving protection from the vaccine.

              I also found an older scholarly article that discussed the trial stages of the HPV vaccine. One of the main purposes of these trials was to show that the vaccine itself would not cause HPV infections. Since letting the patients in the trial develop cancer would be unethical, they were instead monitored for precancerous lesions as the endpoint. Cancer could also not be used as the “endpoint” because it is a relatively uncommon result of an HPV infection. The vaccine was particularly effective in younger girls because they had not had as much prior exposure to HPV. This vaccine is also recommended for men because of its efficacy against anal cancer.