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The appearance of the Swine Flu aka H1N1 last spring not only created a worldwide panic, it demonstrated to Albert Osterhaus, head of virology at the Erasmus Medical Center in the Netherlands how uninformed the lay public was about viral outbreaks, epidemiology and public health. This prompted Dr. Osterhaus and his colleagues to create a free, online video game called the “The Great Flu” which challenges players to control a new viral pandemic.

As the virus has spread worldwide, countries have tried different methods to slow it down and pharmaceutical companies are now racing to produce a swine flu vaccine (sound familiar?). To fight the emerging outbreak, players use public health measures including setting up surveillance systems, stockpiling antivirals and vaccines, and closing schools and airports. Players also have a limited budget and are warned that "your actions to control the virus cost money, so keep an eye on it." In other words, while the goal is to control the pandemic, there may not be sufficient funds and resources to accomplish those goals!

A running tally of the numbers of people infected and those who have died are displayed above the budget. Newspaper stories about the deadly virus and the global response to it — like riots breaking out worldwide — pop up to help players monitor the outbreak and plan their next moves. Messages from governments mirror the difficulties faced by international agencies like WHO that are responsible for containing worldwide epidemics. For example, when players set up costly surveillance systems, sometimes participating governments will send a message "we will comply with your directions...but we must inform you that the political support for this action is low in this region. Therefore, the effectiveness of the system to control the outbreak may differ from your expectations."

The goal of the game is make the lay public aware of the difficulties that public health officials encounter during pandemics and the tight rope they sometimes must walk to insure that the virus is contained and doesn’t continue to spread. To test your skill level at controlling pandemics, you can choose different viruses (which range from easy to difficult to manage) at the beginning of the game.

I think “The Great Flu” is a great way to educate the public about infectious diseases and epidemiology and have fun at the same time. If you are interested in more sinister online swine flu games check this out.  Who said learning science has to be tedious and dull?

Until next time...

Good Luck and Good Virus Hunting!!!!!

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Do you lie awake a night overwhelmed by the possibility of another infectious disease outbreak? Well, if you want to get a good night’s sleep, I highly recommend that you take a look at a brief history of American epidemics that was published in this past Sunday’s New York Times. According to the article, history shows that the number of American epidemics has been relatively small. In fact, the author suggests that there were only nine major epidemics in the US since 1892. 

While there were several major outbreaks in the early to mid 1900s (Spanish flu, 1918; smallpox, 1947 and polio, 1952), the US has been relatively unscathed in recent years—with the possible exception of the HIV/AIDS epidemic and possibly the herpes and HPV epidemics. This is because of America’s outstanding infectious diseases surveillance networks, its comprehensive vaccination programs and modern medical and hospital infrastructures.

However, no matter how vigilant we are, there is no way to prevent infectious disease outbreaks unless the pathogens that cause the diseases are eradicated from the planet as was the case for the smallpox virus. That said, the best way to manage infectious disease epidemics is to be prepared for all contingencies.  In my opinion, the recent swine flu outbreak—this was its second appearance, the first taking place in 1976—was a practice run. And I think the world did “pretty, pretty good” as Larry David, my former NYC softball teammate and co-creator of Seinfeld would say!

Until next time...

Good Luck and Good Job Hunting

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Salmonella enteriditis, an organism dear to my heart (luckily not my posterior small intestine) is a common cause of food poisoning. As some of you may know, I did my PhD thesis work on Salmonella gastroenteritis (aka food poisoning) and I like to think that I am something of an expert on the topic. 

Typically, Salmonella food poisoning outbreaks are localized and rarely reach epidemic proportions. However, there have recently been two major nationwide Salmonella outbreaks in the US —one in 2007 and now in early 2009.

The current outbreak has afflicted 388 people in 42 states and may be caused by the same strain (Saint Paul) that was responsible for the 2007 outbreak. Ultimately, the 2007 outbreak was linked to contaminated tomatoes. The jury is still out on the cause of the most recent outbreak. Needless to say, CDC scientists are scurrying to quickly identify the source of the current outbreak because it took the agency over 5 months to conclusively identify the culprit in the 2007 epidemic. Not surprisingly, many grocery stores and restaurants suffered financially because of the outbreak.

Many of you may be wondering why Salmonella food poisoning is becoming such a problem in the US. I don’t believe that the strains responsible for the most recent outbreaks are more virulent than the ones that have traditionally caused more localized outbreaks. Instead, the reliance of food manufacturers and grocery store chains on one or two major food distributors (rather than multiple suppliers) is likely responsible for the severity and breadth of these nationwide outbreaks. This suggests that regulatory agencies ought to more closely scrutinize the microbiological quality of the operations of the major distributors. I believe that those efforts would greatly reduce the likelihood of future major outbreaks of food poisoning.

Until next time.

Good Luck and Good Job Hunting (avoid raw vegetables, undercooked poultry and raw eggs)
 

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In an attempt to dispel the notion that it is “dysfunctional” and "lax in policing drugs once they are on the market", the US Food and Drug Administration (FDA) earlier this week launched MedWatch - The FDA Safety Information and Adverse Event Reporting Program. An integral part of the new program is The Drug Safety Newsletter a quarterly publication that provides information on the findings of selected postmarketing drug safety reviews from FDA's Center for Drug Evaluation and Research.

The newsletter also provides information on important emerging drug safety issues and recently approved new molecular entities. FDA hopes the newsletter will raise awareness of reported adverse events, and stimulate additional adverse event reporting by healthcare professionals. The first issue of the newsletter contains reviews of the following products (information in the brackets are the most serious side effects)

• Rituximab (marketed as Rituxan): [Progressive Multifocal Leukoencephalopathy (PML)]
• Modafinil (marketed as Provigil): [Serious Skin Reactions]
• Temozolamide (marketed as Temodar): [Aplastic Anemia]
• Deferasirox (marketed as Exjade) -recently approved new molecular entity
  

Publication of this newsletter fulfills a commitment FDA made in its January 2007 response to the Institute of Medicine's (IOM) 2006 Report on The Future of Drug Safety - Promoting and Protecting the Health of the Public.

The newsletter is available at The FDA website.  Also, it will be sent electronically to those who subscribe to the Drug Safety Newsletter or to the MedWatch E-list.

To subscribe to this publication directly, go to the Drug Safety Newsletter section of the FDA site, enter your name and e-mail address in the appropriate fields, and select the "Join the List" button.  Hopefully, this new publication will inform consumers about the potential adverse effects and side effects of marketed prescription medications.

Until next time.....

Good Luck and Good Job Hunting!!!!!!!!!!!

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