Off the Kuff Rotating Header Image

Ebola

The Texas Infectious Disease Readiness Task Force

We have such a thing, and at a time like this that’s good to know.

Most Texans don’t regularly concern themselves with infectious diseases such as typhus, Ebola, Zika, or the plague. But in the aftermath of Hurricane Harvey, public health experts worry that tetanus and MRSA, an antibiotic-resistant skin infection, could become more prevalent.

Thanks to the establishment of the Texas Infectious Disease Readiness (TX IDR) task force, citizens now have access to online courses and other resources geared at increasing the public’s knowledge of a variety of infectious diseases.

The program was launched in late 2014 when then-Gov. Rick Perry signed an executive order establishing the Task Force on Infectious Disease Readiness and Response due to an increase in infectious disease cases in Texas.

Typhus, which is transmitted by fleas and potentially fatal, infected only 27 Texans in 2003. Centers for Disease Control and Prevention In 2016, the state saw 364 cases, according to the Texas Department of State Health Services. With so few cases in the past, typhus’ symptoms – chills, muscle aches, a rash, and vomiting – were likely mistaken for something else.

Described by some as a “Texas-specific CDC,” the task force gathers information from many sources and adapts it to Texas’ needs. In addition to sharing information on current cases, the TX IDR designs online courses specific to the diseases seen in Texas, explaining how the diseases are transmitted, who is at risk, and how to control their spread.

The need for such an initiative became evident after the first cases of Ebola were diagnosed in the United States.

[…]

In addition to educating traditional health care professionals, the program also targets first responders, who typically have limited access to resources about infectious diseases, [Dr. Jan E. Patterson, chair of TX IDR] said. With the establishment of the TX IDR website, they can now learn about infectious disease readiness and potentially avoid contracting a deadly virus.

We know about typhus. As one of those Texans that don’t regularly concern themselves with infectious diseases, I’m glad to know someone does.

Improving infections disease response

This is an Ebola-inspired bill, but not an Ebola bill. So say the stakeholders, anyway.

Months after three people in Texas were diagnosed with Ebola, several key state lawmakers on Wednesday proposed ways to prepare the state for the next disease-related emergency.

The proposal, Senate Bill 538, would allow the governor to declare a state of infectious disease emergency, create stockpiles of protective equipment, and grant health officials greater power to stop public transportation vehicles and detain individuals who may be infected.

“We’d have a clear line of authority,” state Sen. Charles Schwertner, R-Georgetown, chairman of the Senate Health and Human Services Committee, said at a Capitol press conference. “There would be stockpiles of personal protective equipment. First responders would be able to know when they were going to have to be around individuals with potentially infectious disease, a deadly infectious disease.”

The legislation stems from recommendations by a task force established by then-Gov. Rick Perry in October after a man in Dallas became the first person in the United States diagnosed with Ebola. The bill is designed to fix problems — highlighted by the Ebola scare — with the state’s ability to respond to an outbreak.

“This bill, although based on the Ebola emergency, is not an Ebola bill,” said Dr. Brett Giroir, director of the Texas Task Force on Infectious Disease Preparedness and Response. “This is preparation for any infectious disease emergency in the future.”

[…]

Based on the task force’s recommendations, two Ebola treatment facilities were established in Galveston and North Texas in October. A more detailed report released in December by the task force recommended establishing a treatment facility for children, training health workers to identify new diseases and expanding state executive power in disease-related emergencies.

“This emergency highlighted needs for profound changes in our training, in our preparedness, our protocols,” said Giroir, who is also CEO of the Texas A&M Health Science Center.

The bill would implement several of those changes, including new authority to quarantine infected people.

Under current law, the head of the Department of State Health Services can order a potentially exposed or infectious person to remain in his or her home, Giroir said. But the state cannot enforce that order until after the person has already broken the order and left the home, a redundancy that the new bill would eliminate.

See here and here for some background. I’m okay with this. I agree with Dr. Giroir that this is unlikely to be an “Ebola bill” in the sense that there are other infectious diseases that are much more likely to need containment in Texas. Measles, for example. We’ve got another bill that would help with that, and I hope it gets at least as much attention as this one does.

Texas Progressive Alliance taps Denton’s “fracktivists” Texans of the Year

From the Inbox:

In one of the organization’s more closely contested votes, the Texas Progressive Alliance — the state’s consortium of liberal blogs and bloggers — named Frack Free Denton and its diverse group of activists 2014’s Texan of the Year.

“The biggest win for progressives in the Lone Star State on Election Night happened in Denton, Texas,” said Charles Kuffner, president of the Alliance. “The people showed the powerful who is still in charge. No matter that the Texas Railroad Commission or the state’s Legislature may try to undo the will of Denton’s Republican, Democratic, and independent voters; for one day in November of 2014, those North Texans came together and said, “No more. No more polluting our air and water and poisoning our children for profit without accountability. The people together spoke, and they were heard.”

There were also three Honorable Mentions for the coveted award. Finishing a close second: the medical staff of Dallas Presbyterian Hospital, who were at the front lines of the nation’s Ebola crisis, notably Dr. Kent Brantley and nurses Nina Pham and Amber Vinson, who all contracted the virus and lived to tell about it. In addition, two other large groups of Texans on either side of the political spectrum were selected: the 33% of Texans who turned out to vote in last month’s midterm elections, predominantly Caucasian male Republican voters; and the Democratic volunteer army of deputy voter registrars, blockwalkers, and those who spent long hours on their phones calling prospective voters to urge them to cast their ballots.

“To the victors go the spoils, someone famous once said,” noted Kuffner, in reference to the GOP base vote. “But no one worked any harder than the folks in their precincts, neighborhoods, counties, and across the state to turn back the tide, at least a bit,” he added.

The TPA’s member bloggers salute all the Texans who were nominated this year, which included several candidates, some elected officials, and other activist groups.

See here for the background. Always a little weird quoting myself in a post like this, but the award is well earned. The victory may be short-lived, but it was hard won and it made a strong statement. I wish them well going forward.

Please get a flu shot

It’s always a good idea, even if it’s more effective in some years than in others.

The flu vaccine may not be very effective this winter, according to U.S. health officials who worry this may lead to more serious illnesses and deaths.

Flu season has begun to ramp up, and officials say the vaccine does not protect well against the dominant strain seen most commonly so far this year. That strain tends to cause more deaths and hospitalizations, especially in the elderly.

Only 48 percent of the 85 samples of H3N2 influenza viruses that have been tested since Oct. 1 are closely related to the strain that was picked for the vaccine distributed in North America, according to the agency.

“Though we cannot predict what will happen the rest of this flu season, it’s possible we may have a season that’s more severe than most,” said Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, at a news conference Thursday.

CDC officials think the vaccine should provide some protection and still are urging people to get vaccinated. But it probably won’t be as good as if the vaccine strain was a match.

Flu vaccine effectiveness tends to vary from year to year. Last winter, flu vaccine was 50 to 55 percent effective overall, which experts consider relatively good.

[…]

Current flu vaccines are built to protect against three or four different kinds of flu virus, depending on the product. The ingredients are selected very early in the year, based on predictions of what strains will circulate the following winter.

The ingredients always include a Type A H3N2 flu virus. The most severe flu seasons tend to be dominated by some version of that kind of flu bug. The three most deadly flu seasons of the last 10 years – in the winters of 2003-2004, 2007-2008, and 2012-2013 – were H3N2 seasons.

In March, after the H3N2 vaccine strain was vaccine production was underway, health officials noted the appearance of a new and different strain of H3N2. “This is not something that’s been around before,” Frieden said.

But health officials weren’t sure if the new strain would become a significant problem in the United States this winter until recently, they said. Lab specimens from patients have shown that the most commonly seen flu bug so far is the new strain of H3N2. Specifically, about 48 percent of the H3N2 samples seen so far were well matched to what’s in the vaccine, but 52 percent were not, the CDC said.

Not perfect, but your odds are still a lot better with the vaccine than without. As the story notes, in an average year about 24,000 Americans die from the flu. I’ll have to check my math on this, but I’m pretty sure that’s more than the number of Americans that die from Ebola. (Which we still need to fight against as well, but Congressional Republicans have lost interest in Ebola since it’s not generating scary cable news stories any more.) So don’t fall for the hysteria. Please put the odds in your favor and get a flu shot, OK? Thanks.

UTMB continues to do well post-Ike

Good to see.

Ashbel Smith building at UTMB

The morning after Hurricane Ike crashed into Galveston Island six years ago, David Callender surveyed the sea of mud coating the 84-acre University of Texas Medical Branch campus.

The UTMB president saw oak tree limbs blocking the doors to John Sealy Hospital, which would be knocked out of service for the rest of the year. The 13-foot storm surge caused $1 billion in damage, plunging UTMB’s finances into the red and prompting the layoffs of nearly 3,000 workers. A consultant even recommended that the hospital be moved off the island, an idea that found favor with the University of Texas Board of Regents and a few legislators.

Six years later, UTMB is not only off life support, it appears to have made a full recovery.

The university is close to completing more than $1 billion in improvements and repairs to protect against future hurricanes, ranging from moving essential functions to a higher level to adding protective walls that can rise around certain buildings.

It is building a 13-story hospital in Galveston and a smaller medical center in League City. Last week, UTMB officially announced its takeover of the Angleton-Danbury Medical Center in Brazoria County.

[…]

While struggling to operate after the storm, UTMB officials made a discovery that would fuel eventual expansion, said Donna K. Sollenberger, CEO of UTMB Health Systems. With UTMB’s hospital shut down, patients were sent to Texas Medical Center and other hospitals. Meanwhile, UTMB rented offices in Texas City and other mainland cities to treat outpatients.

“In doing that” Sollenberger said, “we found we had a whole subset of patients who preferred or liked being seen closer to home.”

Galveston County, especially the League City area, was growing rapidly and suffered a doctor shortage. Within the next six years, Sollenberger said, the area will be short by about 1,000 doctors of what it needs.

UTMB opened clinics that were close to people who were going without primary care either because doctors were too far away or because they faced waits of as long as six months for an appointment. Patients normally will forgo primary care if they have to drive more than 15 or 20 minutes, Sollenberger said.

“If you have primary care services within that radius, they will come to you,” she said.

UTMB now operates 40 clinics at 30 sites in Galveston and Brazoria counties and 34 regional child and maternal clinics, including clinics outside the Galveston-Brazoria region in Orange, New Caney and McAllen.

Read the whole thing, it’s a good overview of what’s happened with UTMB and its environs over the past 6 years. I’ve had a few things to say about it as well, not all of it positive. More recently, UTMB was in the news for its Ebola-related work. Hurricane Ike was a tremendous disaster for Galveston, and recovery from it would have been a lot tougher had the island lost UTMB and all the services and jobs it provides. It’s good to see them thrive.

Ebola treatment progress

Some good news.

A study out [recently] shows that an experimental treatment for Marburg virus – a close cousin to Ebola – can be given after symptoms of the terrible disease have started to appear.

[…]

One experimental drug – given to two Americans and several Liberians who showed signs of the disease – appears to have been helpful, though it is not clear whether the victims would have survived anyway or what other treatments they received. The drug, ZMapp, includes proteins that interfere with the way Ebola attaches and enters a host cell.

[Wednesday]’s study, published in Science Translational Medicine, looks at a different drug that takes a genetic approach to fighting the disease. The drug uses bits of genetic material to block Ebola genes from acting, the way sticking gum in a lock would prevent a key from slipping in.

The research team from the University of Texas Medical Branch-Galveston and Canadian drug company Tekmira Pharmaceuticals injected the Marburg virus into four groups of four rhesus monkeys. The first group got the drug 30-45 minutes after infection; the second one day after infection; the third two days later; and the last group three days later. All of the treated animals lived, regardless of when they received the drug.

Although the study was on the Marburg virus, not Ebola, senior researcher Thomas Geisbert said he thinks the results mean that a related Ebola treatment, called TKM-Ebola, will also work once symptoms appear.

As we know, the Galveston National Lab is where the action is for Ebola research in the US. I don’t have anything to add here, I’m just glad to see them make things happen.

Working on Ebola in Galveston

Given what’s been going on lately I thought this would be of interest.

As the worst recorded Ebola outbreak in history sweeps across West Africa, hope for a cure is centering on scientists thousands of miles away at the Galveston National Laboratory, where researchers are working on three of the most promising potential cures.

The National Lab, on the campus of the University of Texas Medical Branch at Galveston, has been awarded $6 million from the National Institutes of Health and the U.S. Department of Defense to develop cures for Ebola and the equally deadly Marburg virus, UTMB said this week.

The Ebola virus that has infected more than 1,000 people in West Africa and killed more than 700 is a new strain, which could complicate efforts to develop a cure, said Scott Weaver, the National Lab’s scientific director.

The outbreak is the longest-lasting and most widespread Ebola outbreak ever recorded, Weaver said, and cases are being reported for the first time in highly populated cities.

The National Laboratory is the only academic lab in the country to be rated Level 4, meaning it is equipped to research the deadliest biological agents known because of the sophisticated safeguards in place. Weaver said scientists at the National Laboratory have been working with the Ebola virus for 10 years, making them a natural choice to pursue the cures.

[…]

Even if an infected person arrives in the U.S., there is little chance that Ebola could get a foothold here, said T.G. Ksiazek, a pathology professor at UTMB. Ebola can only be transmitted through contact with bodily fluids and is easily controlled with modern medical techniques, said Ksiazek, who will leave for Africa this month to assist in efforts to halt the spread of Ebola.

“We do occasionally have diseases like this imported into the U.S. and we fare well,” he said.

Good to know. I don’t even want to think about the panic and overreaction that would occur here if there ever was such an outbreak, even though there’s not that much danger of actually catching it. This is one of those times when being – how shall I put this? – less scientifically literate that we might be as a society would be a major negative. The politics of ignorance and fearmongering that we already have are quite enough, thanks.

One more thing:

The bulk of the research on Ebola is being done in the U.S. because the federal government has been willing to fund research into cures of what are known as “emerging diseases,” such as the Ebola and West Nile viruses. Private companies are reluctant to invest the millions – or hundreds of millions – of dollars needed to develop a cure for a disease like Ebola because there is little chance of making a profit.

“There is really no market for this in a typical sense,” Weaver said. “There is no company that thinks they can market this in West Africa for a profit.”

Sarah Kliff explored that question in more detail a few days ago. Keep that in your back pocket the next time a debate about the role of government comes up in your vicinity. I wish the scientists working on this problem and others like it all the success in the world.