December 7 – Who Flu There?

Today’s factismal: Just 2,500 Americans have had the flu thus far this season.

Every year, the influenza virus strikes (actually, a couple of them strike). And every year, millions of Americans and hundreds of millions of people elsewhere come down with it. Though most of the people who come down with the flu eventually recover, hundreds of thousands of people die every year. Thus far this year, we’ve been lucky; only about 2,500 people have come down with the flu.

So far, the flu has only hit a few places in the USA - but the season is early yet! (Image courtesy CDC)

So far, the flu has only hit a few places in the USA – but the season is early yet!
(Image courtesy CDC)

That is due in large part to the efforts of the CDC and other medical authorities; thanks to them, influenza is now the ninth most common cause of death instead of being the most common cause.  One reason that flu is less deadly now is because our medical care is better. Another reason is the introduction of annual vaccines; though sometimes they don’t quite match the flu strains that occur, they still reduce hospitalizations from the flu by nearly 70%.

Do the

Do the “Dracula sneeze”
(Image courtesy the University of Arizona)

What can you do other than get a flu vaccine? Doctors recommend three things: First, wash your hands a lot and practice “vampire sneezes”; that helps reduce the spread of germs and keeps the flu form infecting others. Second, get the flu vaccine; that helps keep you healthy even when someone else forgets to cover their sneeze. And third, report your flu on Flu Near You. They’ll track outbreaks and help us make certain that next year’s flu is even less of a problem than this year’s!

November 1 – Not-So-Sweet

Today’s factismal: November is National Diabetes Awareness Month

Diabetes mellitus (its name means “passing through sweet”, a reference to the increased sugar levels in the urine of diabetics) is one of the more common diseases; world-wide, nearly 300 million people have diabetes. In the US about one out of every ten people have diabetes and one out of every four has prediabetes, indicating that they are at a higher risk for developing the disease. And diabetes is nothing new. Egyptians in the court of King Tut diagnosed it, as did the Greeks of Socrates’ time who gave the disease its name. And until 1922, diabetes was a death sentence.

There are 30 million people in the USA with diabetes and 86 million with prediabetes

There are 30 million people in the USA with diabetes and 86 million with prediabetes

Diabetes damages blood vessels, leading to stroke, heart attacks, blindness, and kidney damage ; it also attacks nerves, muscle, and even your gums. In advanced cases, the patient’s body releases glucose in response to low insulin levels and put them into a coma that led to death. Though the less severe complications can be treated with a combination of diet and exercise (which is still the recommended course of action today), there was no cure for diabetic coma. Once a patient slipped into a coma, death was sure to follow within a few weeks. And even the diets used to treat patients in the 1900s were severe enough to cause death; a typical “menu” included under 400 calories a day (roughly what you would get from an Egg McMuffin) and so led to weight loss and starvation.

But that changed in 1922. Just one year earlier, Banting and Best had identified a lack of insulin as the culprit in diabetes, and had managed to develop a method for extracting insulin from the pancreas of sheep. (Interestingly, only Banting was awarded the Nobel Prize for the discovery. That made him so mad that he refused to accept the medal and shared the prize money with Best!) Their discovery was put to the test by Leonard Thompson, a 14 year old boy who had just been diagnosed with diabetes.

The first injection was nearly a disaster. Early extraction methods sometimes left impurities in the insulin, and one of those sparked an allergic reaction that nearly killed Leonard. But he survived and did not go into a coma, which was miracle enough in those days. Another researcher was able to develop a better method for extracting insulin using beef pancreases. The new insulin was a success and allowed Leonard to live to the ripe old age of 27, when he died of pneumonia. Insulin was soon the “go-to” medicine for diabetes; within five years, it was available world-wide and diabetes had changed from a death sentence to a manageable condition.

So how do you prevent diabetes? Simple: eat well, exercise a lot, and pick the right parents. Diets low in sugar and fat and high in fiber have been shown to reduce the odds of getting diabetes. (They also help keep you looking good and feeling strong. Score!) Exercise does more than burn calories; it also improves your muscle’s ability to use glucose which eases the workload on your insulin-producing cells. (It also helps keep you looking good and feeling strong. Score!) And diabetes has been shown to be more common in some families and ethnic groups; if your parents or siblings have diabetes, there is an increased chance that you’ll get it, too. Unfortunately, it is very hard to pick the right parents so you should concentrate on your diet and exercise.

If you’d like to see your odds of getting diabetes, why not take the Diabetes risk test?

And if you score too high for comfort, then head over to the American Diabetes Month® website to learn more:

October 31 – Vampire Function

Math is often called the language of science. And the beautiful thing about that language is that it says the same thing whether you are working in chemistry or biology. Peter and Daniel will learn that as they discover why vampires can’t be real!

It was a bright, sunny fall afternoon. The houses were all decorated with pumpkins, mummies, and ghosts. The sky was clear and the air was crisp with the promise of a cool, clear night just perfect for trick-or-treating. Even better, the sidewalks were piled high with leaves that Peter and Daniel ran through on their way to the school’s annual Fall Festival. The crunch of the leaves and the smell of the air promised great things to come and both of the boys were looking forward to the candy that they would collect that night. Both were in their costumes. Peter had on the cape, fangs, and slicked back hair of a vampire while Daniel had decided to go as a mad scientist, complete with labcoat, black gloves, and goggles.

“It sure is a shame that Mary couldn’t come,” Daniel said after crunching thourgh a particularly large pile of leaves. “Her costume was great! I love Doctor Who.”

“Yeah, she even had the little K-9 on a chain to tow behind her,” Peter replied. “But her dad is pretty strict; if your homework isn;t done, you don;t get to play.”

“Maybe that’s why she gets such good grades.” Daniel felt sorry for Mary; his dyslexia made studying a chore so he knew how it felt to miss a bright afternoon.

“You should talk, Mr. Brain!”

“That’s Dr. Brain to you!” The boys laughed and turned into the school grounds. There at the entrance to the gymnasium was their favorite teacher, Mr. Medes; for the holiday, he was wearing insect wings and a pair of antennas but had painted his face grey and green.

“Hi, Mr. Medes!” the boys chorused. Then Peter asked “I don’t get it. What are you supposed to be?”

“I’m a zombee,” Mr. Medes replied. As the boys groaned at the pun, he explained. “There is a fly that lays its eggs inside of bees. The larva eats the bee’s brain and takes over, creating what biologists call a zombee.”

“So there really are zombies?” Daniel said. “Cool!”

“Are there really vampires, too?” Peter asked.

“Well, there are a lot of animals that drinkt he blood of other animals. There’s the female mousquito who needs the blood to make her eggs.There’s the hagfish, which rasps a hole in other fish with its tongue and sucks their blood. And then there’s the vampire bats; all three species live off of the blood of others. But if you mean creaturees like Dracula, then the answer is no; there can’t be.”

“Why not?” Peter insisted. “If we can have real live zombies that eat brains, why can’t we have real live vampires?”

“Because there would be too many predators and not enough prey,” Mr. Medes replied. “Here, let’s go inside and we’ll do an experiment to show you what I mean.”

At that the boys perked up. They both wanted to be scientists and doing experiments was one of their favorite things. They quickly followed mr. Meddes inside the gym and over to a table.

“Have a seat while I grab some apparatus from my lab,” Mr. Medes said. “I’ll be right back!”

As the boys waited, they speculated on what the experiment would be.

“Maybe he’s got some blood for us to look at,” Peter said. “That would be cool.”

“Nah,” Daniel replied. “It has to be neater than that; I’ll bet he’s got some real, live zombees for us!”

In just a few moments, Mr. Medes returned with a piggy bank in his hands. The boys stared at him, confused.

“A piggy bank? What does that have to do with vampires?” Peter demanded.

“Patience,” Mr. Medes advised. “We’re going to be doing a model of how vampires would interact with humans. And since we can’t use real humans and real vampires in our experiment, we’ll substitute something else. The people will be pennies and the vampires will be nickles. We’re going to need about 100 pennies and 100 nickles.”

With that, he pulled the cork from the bottom of his piggy bank so that the change spilled out. Quickly the three of them sorted the coins and piled up the necessary change. Pouring the rest of the money back into the piggy bank, Mr. Medes began explaining the experiment.

“Here’s the way it works,” he began. “There are twenty vampires, represeented by our twenty nickles. And there are fifty people, represented by fifty pennies. The remaining coins will come into play later. The vampires go first. Peter, you’ll gather up the nickles and shake them in your hands, then drop them on the table. The nickles that land face up get to eat; you’ll take away one penny for every face up nickle because the vampire just killed a person. And then you’ll add a nickle for every person eaten so your vamprie population will grow.”

Peter picked up the nickles and shook them over the table before letting them drop. When they landed, he quickly sorted them into five that landed face up and fifteen that landed face down. Peter then took eight pennies from Daniel’s pile and added eight nickles to his.

“Hah!” Peter said in his best Transylvanian accent. “You people sure are tasty!”

“OK, now it is Daniel’s turn,” Mr. Medes said. “Shake your pennies and then drop them just like Peter did with his nickles. When they land, set the face up ones in groups of four; for every group, you get a new penny.”

Daniel quickly shook up the pennies and let them fall. Sorting them, he found that he had twenty-four face up pennies, so he added six pennies to his pile.

“Hah right back!” Daniel said. “We added more people than you ate!”

“So you both know how to play, right?” At the boys’ nods, Mr. Medes continued. “Then here’s the question: can vampires exist if they eat people?”

“Sure,” came Peter’s response. “My vampires ate eight people but they added thirteen. So we can eat forever and there is no reason that we can’t exist.”

“I dont know,” Daniel said. “You added almost as many vampires as we did people. If you grow too fast or we don’t grow fast enough, we might all get eaten.”

“Well, there is only one way to find out for sure,” Mr. Medes said. “Let’s do the experiment!”

What do you think will happen? Do the experiment!

The boys eagerly nodded and started flipping coins. In Peter’s next round, he had eight face up nickles, so his vampires had eaten eight people and gained eight new members. Daniel did well that round and again had twenty-four face up pennies, so he had six more people added.

“Hey! Not so hungry!” Daniel said.

“We’ll see about that!” Peter crowed. His face fell when just three nickles landed face up but he quickly brightened when Daniel could only muster five face up pennies. “You people sure are slow; you just added one new one!”

As the game continued, the boys started to add sound effects and other silliness. Peter began to chuckle like a B-movie Dracula each time his vampires ate a person. And Daniel cried out “My baby! My baby!” each time he gained a new penny.

Peter gained fourteen vampires in the next round while Daniel only added nine people. And the following round was even more disastrous; sixteen new vampires were created but only four new people. For the first time, the vampires outnumbered the people. The end came swiftly. In each of the next three rounds, far more people were eaten than were born and the vampire population exploded. In the final round, there were nearly a hundred vampires and just thirteen people.

“Wow!” Peter said. “I didn’t think that would happen!”

“Yeah,” agreed Daniel. “For awhile it looked like the people could stay alive but then, BOOM!”

“What you two have just seen is what is known as a population collapse,” Mr. Medes said. “Biologists like to study this because it can tell us things such as how long a disease outbreak will last or how many fish we can take from an area. And, as you’ve seen, it shows that vampires simply cannot exist.”

“How can this one experiment show so much?” Daniel asked.

“Well, the experiment looks pretty specific but when you express it in math, it becomes general. The math doesn’t care whether you are talking about the number of people who catch a disease like vampirism or the number of fish that get caught or the amount of chemicals left in a reaction; it works equally well in all situations,” Mr. Medes explained. “That’s why we say that math is the language of science. It helps us take what we learn in one area and apply it in another.”

“Wow,” Daniel said. “That’s cool.”

“It sure is,” Peter said. “But how did we discover that we could use math to talk about vampires?”

Mr. Medes chuckled. “Actually, Lotka was trying to describe a chemical reaction when he came across this idea. He used math to describe how the reaction happened and discovered that sometimes the solutions led to never-ending chemical reactions. He then applied the idea to biology and created what we call the predator-prey relationship. In our experiment, the vampires are the predators and the humans are the prey. Because the vampires always grow in population, they will always end up eating all of the prey and the humans will always be wiped out.”

“Cool!” Peter said. “So that’s why you said that vampires couldn’t exist. We still have people -”

“Which means that vampires haven’t eaten us all and the only way that they wouldn’t do that is if they don’t exist!” Daniel finished.

“The neat thing is that we do have something very like a vampire,” Mr. Medes said. “Every year, it attacks the human population and tries to convert as many people as possible into its slaves. This model helps groups like the CDC predict just how bad this year’s attack will be.”

“Really? What is it?” Peter asked.

“The flu! Simple diseases like the flu behave a lot like vampires,” Mr. Medes explained. “The only differences are that you are only turned into a flu monster until your body can get better and that we have a vaccine that works against it much better than garlic works on vampires. But it still builds up every year about this time, infects a lot of people, and then has a population collapse when it runs out of victims. And speaking of victims, I think I see a new one over there!”

Peter and Daniel turned to look where Mr. Medes was pointing. In the doorway was Mary, complete with a long scarf, floppy hat, and long coat. Peeking out from behind her was a model of K-9.

“Mary!” the boys chorused. Eagerly, they ran over to bring her into the party and tell her about their new experiment.

October 7 – A Real Shot In The Arm

Today’s factismal: In 1900, influenza was the leading cause of death in the USA; thanks to vaccines, it is the ninth most common cause today.

Flu season officially started this week. Of course, there is never a week without someone, somewhere having the flu but this is the start of the long slow climb in cases that will peak sometime around January before dying back until next October. And doctors are doing their best to make that peak as small as possible by encouraging everyone to get a flu shot. (I just had mine. I’m having the side effect of a sore arm. I’m also having the side effect of not dying from the flu.) Sadly, this year, the nasal spray is not an option.

Behold the mighty syringe! (Image courtesy the CDC)

Behold the mighty syringe!
(Image courtesy the CDC)

Even if you had one last year, doctors urge you to get one this year, too. You need to do this because, just like the common cold, the flu is a family of viruses and not a single virus (like polio). The family of flu viruses is made up of rapidly changing variants that are identified by the proteins on the outside of the shell that holds the virus (that’s what the “H1” and “N1” mean). Because the virus itself changes from year-to-year, the vaccine that you had last year won’t work against this year’s strain any more than a polio vaccine will prevent the measles. And because we don’t know which virus will be the most common in any given year, all that the researchers can do is make a vaccine that protects against the most likely strains; because it provides some protection against all strains, it helps to lower the infection rate.

Gobs of the H1 influenza virus, all lumped together (Image courtesy CDC)

Gobs of the H1 influenza virus, all lumped together
(Image courtesy CDC)

The flu vaccine reduces the chances of getting the flu by nearly 70% (that is, if 100 people who took the vaccine would have gotten the flu then only 30 actually do). Even better, the vaccine reduces the length and severity of flu symptoms in those folks who do get sick. And that’s important because the flu acts as a “gateway infection”; people sick with the flu can develop bronchitis or pneumonia. (That’s happened to me twice.) And the deal gets even worse for folks with heart disease – the flu is known to make heart failure much more likely. Though this is most likely to happen for people who haven’t developed a good immune system yet (such as babies and toddlers) and for folks who have older and less active immune systems (like senior citizens). But in some cases (like the 1918 outbreak), the flu targets healthy people instead, which is why everyone should get the vaccine!

Do the "Dracula sneeze" (Image courtesy Arizona State University)

Do the “Dracula sneeze”
(Image courtesy Arizona State University)

OK, but what can you do other than get a flu vaccine? Doctors recommend three things: First, wash your hands a lot and practice “vampire sneezes”; that helps reduce the spread of germs and keeps the flu form infecting others. Second, get the flu vaccine; that helps keep you healthy even when someone else forgets to cover their sneeze. And third, report your flu on Flu Near You; that helps the doctors track the outbreak and send resources where they are needed.

September 12 – One Small Pox

Today’s factismal: The last death due to smallpox happened thirty-eight years ago.

Normally, extinction is not something that we’d celebrate. It means that something is gone forever, taking its unique genetic signature with it. For animals such as the Carolina parakeet and the Western Black Rhinoceros, it is a tragedy. But for diseases such as smallpox and rinderpest, it is a cause for celebration. That’s because smallpox infected millions of people and killed two million each year; even if you were lucky enough to survive, you’d be marked forever by the disease with scars covering much of your body.

The smallpox virus (Image courtesy CDC)

The smallpox virus
(Image courtesy CDC)

Starting in 1950, a concerted effort was made to eradicate smallpox in South America. Vaccines were prepared and injected into people in every country on the continent. The success was so great that a world-wide initiative was proposed in 1958. Within a short time, smallpox was eliminated in North America (you can tell when an American was born by looking at their left shoulder; if they have a scar from the smallpox vaccination, they were born before 1965). By 1975, smallpox was only found in one small part of Africa. And two years later, it was gone from the wild.

Janet Parker, the last known victim of smallpox (Image courtesy Ben Gross)

Janet Parker, the last known victim of smallpox
(Image courtesy Ben Gross)

But it still lived in laboratories. And that’s where the last victim of smallpox caught it. In 1978, Janet Parker was a medical photographer documenting the work done at the University of Birmingham Medical School where she was accidentally exposed to the virus. Two weeks later, she became the last person that smallpox would claim. Ever since then, smallpox has been extinct except for two small samples kept in epidemiology labs in the US and Russia as a hedge against any future outbreaks.

When will the polio vaccine make scenes like this just a memory? (Image courtesy US NIH)

When will the polio vaccine make scenes like this just a memory?
(Image courtesy US NIH)

Now smallpox isn’t the only disease out there. And it isn’t the only one that we can conquer with education and vaccination.  Today there is a concerted effort to drive polio into extinction. This disease causes muscles to weaken and atrophy and bones to warp; in extreme cases, it can cause the diaphragm to weaken so much that the person suffocates. If you’d like to help drive this disease into extinction, then make certain that you and your family have had your vaccinations, and join the Global Polio Eradication Initiative:

September 8 – Something’s In The Water

Today’s factismal: 162 years ago, a cholera epidemic was stopped by removing a pump handle.

Cholera is one of those disgusting diseases that nobody likes. Princesses never die of it in fairy tales and heroes never conquer it – except in real life. And that’s a story far more interesting than any fairy tale!

The story starts, as all good stories must, long ago and far away in the hidden depths of India more than 2000 years ago. A bacterium decided that it wanted to give up its free-wheeling days and live in the human gut, just as millions of other bacteria do. Unfortunately for the people, the bacterium was Vibrio cholerae (“creator of cholera”). This unloveable little bug causes muscle cramps, restlessness, irritability, a rapid heart rate, vomiting and diarrhea. Without that last complication, it would be just another unpleasant form of food poisoning. But with it, the victim can lose so much water that they die. To make a bad thing worse, the diarrhea acts to spread the bug to yet more victims by contaminating the water supply.

Public (health) Enemy #1: Cholera (Image courtesy Dartmouth College)

Public (health) Enemy #1: Cholera
(Image courtesy Dartmouth College)

That last happens because it wasn’t until the turn of the last century that people started to realize that the best place for an outhouse was far away from the place they got their water; before then, the outhouse and the well were frequently side-by-side. As a result, any contamination from the outhouse could easily slip back into the well water and keep the cycle going. This was bad in the countryside. In a city, it was disaster.

Most cities were designed to get their water either from cisterns that were fed by aqueducts or from wells drilled under the city. And, until very recently, few cities had sewers capable of removing all of the “output” from their citizens; sewage often backed up and overflowed into the cisterns. And if some of that sewage happened to come from someone with cholera, an epidemic was born.

Our hero, John Snow (Image courtesy Wikipedia)

Our hero, John Snow
(Image courtesy Wikipedia)

That’s what happened in London in 1854. Large numbers of people were dying of cholera; more that 127 in the first three days of the epidemic and more than 600 before it was done. Those that could fled the city for safer climes. But the poorest people, who were also those most likely to get cholera, couldn’t flee. Luckily for them, a hero by the name of John Snow was able to track down the common factor in all of the cases: everyone was getting their water from the same pump. Though nobody at the time knew how cholera was transmitted (Snow suspected bacteria but couldn’t prove it), Snow had enough evidence to convince the town council to remove the pump handle at the center of the outbreak. With the handle gone, people stopped getting contaminated water and the outbreak was over and John Snow had helped invent the science of epidemiology.

If you’d like to help the epidemiologists of today, then why not work with them on chronic diseases at the Chronic Collaborative Care Network (C3N):

August 1 – A Real Shot In The Arm

Today’s factismal: August is National Immunization Awareness Month.

The smallpox virus (Image courtesy CDC)

The smallpox virus, former public enemy number one
(Image courtesy CDC)

If you want to be thankful for modern medicine, all you have to do is look at what used to kill us. In 1900, influenza was the leading cause of death in the USA (153,000 deaths or 202/100,000); today, it is the ninth most common (50,097 or 16/100,000). In 1964-1965, there were 20,000 babies born with congenital rubella syndrome in the USA; in the past ten years, there were none, thanks to vaccines. In 1916 in the US alone, there were more than 27,000 new cases of polio that paralyzed thousands and killed 6,000 people; in 2012 for the entire world, there were just 223 new cases of polio and no deaths or paralyzations. And then there is the best example for why we vaccinate – smallpox. In 1967, 2,000,000 people were killed each year by smallpox and countless others were left scarred or blind; today, nobody dies of smallpox thanks to an effective vaccination campaign.

Vaccines contain trivial amounts of antiseptics (Data courtesy CDC)

Vaccines contain trivial amounts of antiseptics
(Data courtesy CDC)

Unfortunately, a lot of people have forgotten how dangerous things used to be and are no longer vaccinating their children. They are worried by vaccine ingredients such as aluminum potassium sulfate (the stuff that makes pickles taste sour), agar (the stuff that makes toothpaste a paste), formaldehyde (made by your body as part of the energy cycle), and dihydrogen monoxide (water). Even though the ingredients are tested and known to be safe, scaremongering news stories have led many to stop vaccinating. And that’s a bad thing.

A simplified view of herd immunity

A simplified view of herd immunity

It is bad because vaccines do more than protect the people who take them; they also protect the people who can’t. People such as newborn infants (like the ones who were infected with measles by a missionary returning from overseas), people with compromised immune systems (such as children with cancer), and people for whom the vaccine never took (estimated to be about 5% of the population). By getting vaccinated, we create a “ring of immunity” that keeps the disease from spreading as quickly as it otherwise would (the Disneyland outbreak is a good example of herd immunity at work). And, of course, if enough people use the vaccine, then the disease is eradicated which means that we can stop using the vaccine!

A comparison of the deaths caused by measles and those caused by vaccines; the vaccine deaths were exaggerated for clarity. Each face represents 1,000 deaths.

A comparison of the deaths caused by measles and those caused by vaccines; the vaccine deaths were exaggerated for clarity. Each face represents 1,000 deaths.

Now it is true that vaccines are not perfectly safe. An estimated 10,000 people have died from vaccines. But it is also true that getting vaccinated is much, much, much safer than not doing so. Let’s take the flu for example. The flu vaccine reduces the chances of getting the flu by nearly 70% (that is, if 1,000,000 people who took the vaccine would have gotten the flu then only 300,000 actually do); experts estimate that the flu vaccine has saved at least 40,000 people’s lives. Similarly, the polio vaccine prevents two million cases each year which would kill nearly 500,000 people and leave another 750,000 paralyzed.

So what can you do for National Immunization Awareness Month? First, take care of yourself and your family by making sure that everyone’s vaccinations are up to date. Then take care of others by working with Global Vaccines. They are using their profits from vaccines in countries like the USA to pay for vaccinations in poor countries:

If you’d like to help drive a disease into extinction, then join the Global Polio Eradication Initiative:

And remember that flu season is just around the corner. Flu vaccines are safe, effective, and free under most health plans!