revere | April 7, 2007Our colleagues at our sister site, The Pump Handle, are doing a good job of keeping the public health community aware and apprised of things that often go unnoticed but are of real importance. If TPH isn't one of your daily reads, I'd suggest you make room for it. Yesterday we learned that the Bush administration has just made another of its famed "recess appointments" (remember that supreme nutcase, John Bolton at the UN?). This one goes to Susan Dudley to head OIRA, the Office of Information and Regulatory Affairs at the Office of Management and Budget (OMB). Celeste Monforton covered her…
revere | April 6, 2007The RAND corporation is one of the country's foremost non-profit consulting companies. Their Reports carry weight. So I was interested to see the announcement of a new Rand panel report on key components of public health emergency preparedness. Emergency preparedness means many things to many people, and immediately after 9/11 it meant responding to a terrorist attack. These days we think more in terms of hurricanes and pandemics. I think that's progress. But I have to say the RAND report didn't seem to advance the ball much. Here are the three broad categories they believe communities should…
revere | April 6, 2007The US only requires meatpackers to test a small fraction of their cows for bovine spongiform encephalopathy (BSE), otherwise known as Mad Cow Disease. Literally. They cannot test a larger fraction. Does that sound stupid? It sounded stupid to a federal judge, too:
The federal government must allow meatpackers to test their animals for mad cow disease, a federal judge ruled Thursday.
Kansas meatpacker Creekstone Farms Premium Beef wants to test all its cattle for the disease, a move that larger companies feared. If Creekstone is allowed to advertise its meat as tested and safe, that could…
revere | April 5, 2007[A series of posts explaining a paper on the mathematical modeling of the spread of antiviral resistance. Links to other posts in the series by clicking tags, "Math model series" or "Antiviral model series" under Categories, left sidebar. Preliminary post here. Table of contents at end of this post.]
This is the last in a long series attempting to explain a recent paper by Lipsitch et al. on mathematical modeling of the effects on influenza control of antiviral resistance, published in PLoS Medicine in January 2007. Modeling is a valuable technique but for most readers, even most scientists…
revere | April 5, 2007Bird flu is spreading in poultry in Bangladesh. And Kuwait has had bird flu in its poultry but is hoping its cull of 1.7 million birds has stopped it. But not until four Bangladeshis working on the cull were hospitalized with possible bird flu infection. Isolation was undertaken because of blood tests. The Kuwaiti cullers are said to have received prophylactic Tamiflu and these workers were not reporting symptoms, but "preliminary tests" were positive (via crof's blog). More definitive tests are to come:
Preliminary tests for bird flu were positive on four Bangladeshi workers who had been…
revere | April 4, 2007[A series of posts explaining a paper on the mathematical modeling of the spread of antiviral resistance. Links to other posts in the series by clicking tags, "Math model series" or "Antiviral model series" under Categories, left sidebar. Preliminary post here. Table of contents at end of this post.]
We have now gone through the entire paper on modeling the impact of antiviral resistance in an influenza control program, by Lipsitch et al., published in PLoS Medicine. Since a number of assumptions were made, we take some time to consider what effects they have on the model's results. In the…
revere | April 4, 2007Just as we are preparing to wind up our marathon series of posts on a mathematical model of antiviral resistance, a new paper has appeared in the Journal of the American Medical Association (JAMA) with data on antiviral resistance from Japan, the country that uses more Tamiflu and Relenza (the two available neuraminiase inhibitor antiviral drugs) than any other. It turns out the accompanying Editorial in JAMA specifically mentions the modeling paper and its results as a key to understanding the significance of this work. So all our labor has not been in vain. Here's more.
Our eye was caught…
revere | April 3, 2007[A series of posts explaining a paper on the mathematical modeling of the spread of antiviral resistance. Links to other posts in the series by clicking tags, "Math model series" or "Antiviral model series" under Categories, left sidebar. Preliminary post here. Table of contents at end of this post.]
We conclude our section by section examination of the mathematical modeling paper by Lipsitch et al., published in PLoS Medicine. We have finally arrived at the final section, Discussion (starting on page 8 of the .pdf version). In the second post we said many scientists read only the Abstract,…
revere | April 3, 2007I'm an academic, where criticizing the management is common, although sometimes hazardous. I was also a long time department chair so I know what it's like to be on the other end. It's part of the job, both sides. That's not so true in government, even in those agencies where the culture is more like academia because the subject is science. Agencies like CDC and the FDA (h/t a pair of posts by Roy Poses at Health Care Renewal and my Wiki partner, DemFromCT). First, CDC.
Senator Charles Grassley (R., IndianaIowa, ranking member of the Senate Finance Committee) has been on CDC Director…
revere | April 2, 2007[A series of posts explaining a paper on the mathematical modeling of the spread of antiviral resistance. Links to other posts in the series by clicking tags, "Math model series" or "Antiviral model series" under Categories, left sidebar. Preliminary post here. Table of contents at end of this post.]
In this post we explain the remaining results presented in the paper by Lipsitch et al. in published in PLoS Medicine (the subsections headed, "Effects of resistance on epidemic size" and "Dependence of outcomes o fitness cost and intensity of control" on page 6).
These sections and the…
revere | April 2, 2007I like the British medical journal, The Lancet. I like it a lot. I read it, subscribed to it and I've published there. More than once. So I sympathize with their terrible dilemma:
Physicians from around the world urged the publisher of The Lancet medical journal to cut its links to weapons sales, calling on the editors to find another publisher if Reed Elsevier refused to stop hosting arms fairs.
The doctors made their appeal in the latest edition of The Lancet, released Friday.
Editors at The Lancet responded by backing the doctors, calling the situation "bizarre and untenable." They wrote…
revere | April 1, 2007[A series of posts explaining a paper on the mathematical modeling of the spread of antiviral resistance. Links to other posts in the series by clicking tags, "Math model series" or "Antiviral model series" under Categories, left sidebar. Preliminary post here. Table of contents at end of this post.]
We now take a look at what happens in the model when we vary the intensity of prophylaxis and treatment. The model treats the fraction of those prophylaxed, fp, and those treated, fT, separately, but for illustrative purposes the paper sets these two figures at the same number. In the previous…
revere | April 1, 2007When last we checked the problem of salmonella contaminated peanut butter they had traced it to the ConAgra Peter Pan factory in Sylvester, Georgia. But how could living organisms get into the peanut butter? Last week FDA investigators announced they had found two "environmental positives" in the plant, one in some cleaning equipment and the other "in relation to the roaster." The roaster? Give me a break. It would be a miracle if Salmonella survived in the roaster.
And apparently that's the answer. Here's what I found over at my SciBling Mike the Mad Biologist's blog:
Questions?
revere | March 31, 2007[A series of posts explaining a paper on the mathematical modeling of the spread of antiviral resistance. Links to other posts in the series by clicking tags, "Math model series" or "Antiviral model series" under Categories, left sidebar. Preliminary post here. Table of contents at end of this post.]
We've spent a long time in the previous posts looking inside the black box of a mathematical model for the spread and consequences of antiviral resistance to Tamiflu (described in the paper by Lipsitch et al., published in PLoS Medicine). From the last post you will recall the authors assume it…
revere | March 30, 2007[A series of posts explaining a paper on the mathematical modeling of the spread of antiviral resistance. Links to other posts in the series by clicking tags, "Math model series" or "Antiviral model series" under Categories, left sidebar. Preliminary post here. Table of contents at end of this post.]
Now we are almost ready to run the model described in the paper, "Antiviral resistance and the control of pandemic influenza," by Lipsitch et al., published in PLoS Medicine. If you have been following up to this point, you will know the model described in the Methods section is a homogeneous…
revere | March 30, 2007Tamiflu side effects have been much in the news and we have concurrently been posting our mega-series on modeling antiviral resistance in influenza control. The two subjects are related in two ways, one obvious (Tamiflu is the main antiviral being stockpiled for influenza control) and one not so obvious: both topics are related to the fact that million, tens of millions or hundreds of millions of doses are contemplated. For antiviral resistance this means even very rare mutations producing a fully transmission-competent resistant virus can spread widely through the population (you will see…
revere | March 29, 2007GlaxoSmithKline (GSK) is said to be the second largest pharmaceutical and food company in the world. They make and market an influenza antiviral (Relenza) and an H5N1 vaccine. We trust that they represent their products to the public and to public officials correctly. Maybe we shouldn't. At least not on the basis evidence adduced by two 14 year old New Zealand school girls:
Jenny and Anna decided to look at vitamin C content in juice for the Manukau Institute of Technology science fair because "we were both going through a juice phase".
Jenny said the Ribena ready-to-drink product was one of…
revere | March 29, 2007[A series of posts explaining a paper on the mathematical modeling of the spread of antiviral resistance. Links to other posts in the series by clicking tags, "Math model series" or "Antiviral model series" under Categories, left sidebar. Preliminary post here. Table of contents at end of this post.]
In the previous posts we have walked through the Introduction and Methods sections of the paper, "Antiviral resistance and the control of pandemic influenza," by Lipsitch et al., published in PLoS Medicine. The Methods section sets out the detailed model, which is summarized in the Figure in the…
revere | March 28, 2007[A series of posts explaining a paper on the mathematical modeling of the spread of antiviral resistance. Links to other posts in the series by clicking tags, "Math model series" or "Antiviral model series" under Categories, left sidebar. Preliminary post here. Table of contents at end of this post.]
We need to finish the Methods section of the mathematical model in the paper, "Antiviral resistance and the control of pandemic influenza," by Lipsitch et al., published in PLoS Medicine. Then we can move on to Results. In this post we will deal mainly with paragraphs 3 and 4 of Methods on page 3…
revere | March 28, 2007So the vaccine sharing summit in Jakarta is over and Indonesia says they will begin sharing virus again. The proviso is that they can't be shared with pharmaceutical companies until a vaccine-sharing agreement is hammered out with WHO and that will take an estimated 3 months. I'll be surprised if it is done that quickly, but Hope springs Eternal. Meanwhile the scientific community will be able to see the sequences (at least that's how I read it) and WHO can prepare seed strains but not distribute them. The agreement should also allow determination if any markers of antiviral resistance have…