November 12, 2010

CHANGE: Dengue Fever Strikes Miami: First Local Case in 50 Years. “The first locally acquired case of dengue fever in Miami-Dade County in more than 50 years was confirmed Thursday by health officials. They warned people to take precautions against the mosquitoes that carry it.”

UPDATE: Reader Douglas Chandler writes: “I noticed that the Dengue feaver story followed the bad week for AGW. If one takes the contrarian viewpoint on AGW, which seems to be proving the most accurate, then the coming freeze will kill off enough of the skeeters so we won’t have to ramp the DDT production again.” Well, that’s the upside of a Little Ice Age, i suppose. Though I’ve seen some pretty big mosquitoes in Alaska. . . . I remember waking up and seeing two of them at the foot of my bed. One said, “Should we eat him here, or take him home?” The other replied: “We’d better eat him here — if we take him home, the big guys might get him away from us.”

ANOTHER UPDATE: Reader Owen Hughes writes:

Your little joke about the Alaskan mosquitoes made ms smile. I grew up in the Yukon. Same problem there; although the mosquitoes ran the first shift, from June through end July; and the blackflies ran things from late July until September frost. We hated the mosquitoes, but by second week of August we were missing them.

Regarding the emergence in USA of pathogens usually found elsewhere, this is part of a larger public health issue around infectious disease management. The chronic underinvestment in new antibiotics, and to some extent in new vaccines, has really left us exposed. Many diseases like TB have no vaccines, so there is no population-level protection. And as cases break out, the available antibiotics “self-obsolesce,” because they exert selective pressure on the pathogen. Particularly if people don’t finish the course of antibiotics, they just end up with a tougher strain. Even if they do behave, the general effect over time is to drive the emergence of strains of pathogen resistant to the current drugs. And since it’s hard to make money from antibiotics, and because the FDA has ignored good science that could speed clinical trials, we end up with fewer and fewer drugs that still work.

Right now, I figure that the next mass killer, probably XDR (extremely drug resistant) TB, is incubating in the lungs of some immune-compromised prisoner in Russia or South Africa. Once it breaks loose, it will take only months or a few years to wreak havoc on us all. Meanwhile it will take a decade or more to develop a countermeasure.

So we definitely need to do something about this.

Yes. Bill Frist wanted a crash program to develop techniques for quick vaccine production, but that never happened.

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