#14,589
One of the reasons I devote so much blog space each year to highlighting research papers is because - with very few exceptions - mainstream reporting on emerging infectious diseases is insultingly bad.
While scientific research isn't 100% right 100% of the time, it at least makes an attempt to be accurate.Somehow as we end 2019, major media outlets are still calling African Swine Fever `Swine Flu', few reporters either know or care about the difference between correlation and causation or absolute vs. relative risk, and `forward looking' press statements from commercial entities and universities are often passed off as fact.
A decade ago I took many of the more egregious examples to task in this blog, but since decided my efforts were wasted, and instead began to highlight as much research as I could. Not that journal articles get a pass. Over the year's we've taken critical looks at scientific research as well.
When Scientists Behave Badly
RCTs: All That’s Gold Standard Doesn’t Glitter
Dysfunctional Science
When Studies Collide
When Studies Collide (Revisited)Despite the occasional misstep from academia, during the last couple weeks of December - when the publication of new papers is reduced and outbreak news is generally slow - I try to revisit some of research from earlier in the year that I found particularly interesting.
During the month of February, most of our immediate attention was focused on a major uptick of MERS in Saudi Arabia and Oman, ASF in China and Vietnam, and Lassa Fever in Nigeria, but we also looked at the following studies.
Eurosurveillance: Novel influenza A(H1N2) Seasonal Reassortant - Sweden, January 2019
A report on the second H1N2 human infection reported over the previous year in Europe. The first case was reported in the spring of 2018 (see Netherlands Reports A Reassorted H1N2 Flu Virus).
Nature: Bat Influenza Receptors In Other Mammals (Including Humans)
In February of Feb 27, 2012) we looked at an announcement from scientists from the U.S. CDC and the Universidad del Valle in Guatemala City of the first identification of an influenza virus in bat (see A New Flu Comes Up To Bat).
While the consensus since then has been `. . . that bat flu viruses are very unlikely to reassort with other flu viruses' and that bat flu viruses `. . . would need to undergo significant changes to become capable of infecting and spreading easily among humans' (cite Bat Flu FAQ) - a new study published in Nature suggests it is possible, and may have already happened.
Epi.& Inf.: Global Status Of MERS-CoV In Camels - A Systemic Review
Fig. 2. Virological and serological evidence for MERS CoV in dromedary camels.
Despite six years of research, many questions remain unanswered about the MERS-camel connection, including:
- Why 100% of the known and suspected camel-to-human transmissions have been recorded on the Arabian peninsula, while the MERS virus and antibodies have been detected in camels from both Africa and South-Central Asia.
- Why roughly 90% of Middle Eastern human MERS infections have been reported by Saudi Arabia
- Why spillover from camels appears to peak in the winter and spring
Definitive answers for many of the questions remain elusive, but this lengthy and detailed review of the literature regarding the carriage of MERS by camels was published last February in Epidemiology & Infection.
- And why human cases were never identified before 2012, despite evidence of MERS circulation in camels going back 30 years.
J. Clinical Med. : A Review Of The Emerging Influenza D Virus
Credit JCM
One of the more fascinating flu discoveries of the second decade of the 21st century has been Influenza D, which primarily affects pigs and cattle.
While it isn't known if Influenza D can cause symptomatic illness in humans, in the summer of 2016 in Serological Evidence Of Influenza D Among Persons With & Without Cattle Exposure, researchers reported finding a high prevalence of antibodies against Influenza D among people with cattle exposure.
Frontiers in Microbiology: A Novel Reasortant H7N6 Is Transmissible in Guinea Pigs via Respiratory Droplets
Aa study, published in Frontiers in Microbiology, that examined a novel LPAI H7N6 virus detected in Hubei Province in 2017 - which appears to be a reassortment of H7N9 and H5N6 - and finds that it already has significant mammalian adaptations.
- This novel H7N6 binds equally well to avian-like and human-like receptors
- It is virulent in mice without prior adaptation
All qualities we really don't like to see in novel viruses.
- It is transmissible via direct contact and the airborne route in guinea pigs
J. Virology:Genetic Compatibility of Reassortants Between Avian H5N1 & H9N2 Influenza Viruses
A cautionary study from late 2018, that looked at the results of experimental reassortments of Egyptian H5N1 and H9N2 viruses in the laboratory. They used reverse genetics to generate 63 possible reassortants, and found that several H5N1-H9N2 reassortants could be transmitted efficiently to mammals with significant public health risk.
A few weeks later, Egypt reported a Reassorted H5N2 Detected On Duck Farm, which was later confirmed to be a reassortment between H5N1 and H9N2.
Just over two weeks ago, in EID Journal: Novel Reassortant HPAI A(H5N2) Virus in Broiler Chickens, Egypt, we saw that yet another H5N1-H9N2 reassortment had been identified in Egypt this year.
EID Journal: Human-Origin Influenza A(H3N2) Reassortant Viruses in Swine, Southeast Mexico
A CDC's EID Journal research article which surveyed swine herds in Southeast Mexico, and identified 15 novel genotypes of H1 and H3 reassortant viruses in circulation.
AHA: Flu, Flu-like Illnesses Linked to Increased Risk of Stroke, Neck Artery Tears
And lastly, adding to the growing list of complications that may be brought on by, or at least exacerbated by, influenza infection; a study presented at the American Stroke Association’s International Stroke Conference - that linked respiratory infections like influenza to as much as a 40% increased risk of stroke.
Past studies in the same vein include:
Chest: Flu Vaccine Reduces Severe Outcomes Among Hospitalized Patients With COPD
NFID: Chronic Health Problems & The Flu
Eur. Resp.J.: Influenza & Pneumonia Infections Increase Risk Of Heart Attack and Stroke
NEJM: Acute Myocardial Infarction After Laboratory-Confirmed Influenza Infection
Int. Med. J.: Triggering Of Acute M.I. By Respiratory InfectionWhile none of these studies carry clickbaitable headlines, or include bombastic prose, at least when you read them you won't feel your IQ dropping steadily by the minute.
