Week 6 ~ Drowsy Driving

Discussing road traffic injuries in class on Monday got me thinking about different risk factors that can lead to car crashes. We see and hear many commercials and advertisements about not drinking and driving or texting while driving, but not as many about not driving while fatigued or sleep deprived. Driving in this condition can be just as dangerous or even more dangerous depending on the situation, and the National Highway Traffic Safety Administration estimates that "one in every six deadly car crashes results from a fatigue-impaired driver" (Kotz, 2010). According to a study by the AAA Foundation for Traffic Safety, about 41% of drivers say they've fallen asleep at the wheel. It is pretty well known that it's more risky to drive while tired, but, just like drunk driving, people still do it.

Every state has laws against drunk driving, but New Jersey is the only state in the nation that has a law against driving while sleep deprived. Because the majority of the country has no laws about this, I feel that it leads many people to pass over how serious and dangerous it can be. This results in people not considering the fact that they're fatigued when they choose to drive somewhere, which puts themselves and other people on the road at risk. I think that one reason most of the states don't have any laws regarding this issue is due to the fact that sleep deprivation would be difficult to test or enforce, while BAC can be tested through a breathalyzer or blood test.

The law that New Jersey has put in place is called Maggie's Law; it was named after a 20-year-old who was killed by a driver who fell asleep at the wheel. It states that any driver who causes a fatality after being awake for 24 straight hours or more can be prosecuted for vehicular homicide. Although it is good that New Jersey has put a law into place, it seems hard to prove whether or not someone has been awake for 24 hours or more unless they decide to admit to it. Also, no prosecution can take place unless some sort of crash has occurred. Thankfully, many drunk drivers each day are pulled over and arrested before having the chance to cause serious damage on the road, either because they were driving recklessly or stopped at a check point. You don't really hear about sleep-deprived drivers getting pulled over and charged with anything unless their sleep-deprivation has resulted in an "accident."

The President of the AAA Foundation, Peter Kissinger, stated, "Sleepiness decreases awareness, slows reaction time, and impairs judgement, just like drugs or alcohol" (Kotz, 2010). Many of the effects from fatigue are so similar to those of alcohol, but at the same time, identifying drivers who are intoxicated is easier than spotting drivers who are tired. It is unfortunate that many of these sleep-deprived people aren't noticed until after they have hit another car, run off the road, hit a tree, etc. It seems like there should be a better way to enforce not driving while sleep deprived, but for now we can just make sure to keep ourselves educated, aware, and smart about when we should and should not drive. 

It is important to spread awareness and really emphasize to others the importance of not getting behind the wheel when tired. Many times people may not be aware of how tired they really are, so really becoming familiar with the warning signs of drowsiness is very crucial. I think there should be more commercials, advertisements, and programs devoted to educating and advocating for not driving while fatigued. It would also be beneficial to include more of this in driver education courses in order to inform new drivers about the seriousness of driving this way. Many deaths and injuries could have been prevented by just a simple choice of not to drive or of going to bed earlier. A lot of times people are just thinking about themselves and where they need to be, but effectively spreading awareness about this dangerous driving condition can hopefully work toward changing the choices people make.
 


References
1. Kotz, D. (2010). Driving drowsy as bad as driving drunk. US News. Retrieved from http://health.usnews.com/health-news/family-health/sleep/articles/2010/11/08/driving-drowsy-as-bad-as-driving-drunk 
2. Photo (top): http://blog.zenbedrooms.com/wp-content/uploads/2012/12/driving-whilst-tired.jpg
3. Photo (middle): http://www.fmcpestwire.com/wp-content/uploads/2013/04/DrowsyDriving.jpg
4. Photo (bottom): http://www.drivingcasualtiesdown.org/misc/fckeditorFiles/image/DfT%20Images/Tiredness.JPG

Week 5 ~ Vaccinating Against Poverty

When I typically think of poverty, I think of how it can lead to diseases that affect millions. But just like poverty can result in disease, disease can also cause poverty. It can go either way, and I never really thought about this before. An article I found by Dr. Peter Hotez, Science for the Poor: Making Vaccines to Combat Poverty (2014), asks the question: "Is it possible to vaccinate against poverty?" I'm guessing that if the average person were to hear this question, he or she would initially find this question somewhat odd or amusing. Some may understand the meaning right away, but for others it may take some time to really grasp the interpretation of the question.

My answer to this question is yes, it is possible to vaccinate against poverty. Of course it's not possible to create a vaccination or medication that directly prevents or treats poverty. Although, that would be very cool :) But it is possible to vaccinate against diseases that usually lead to poverty and/or keep people trapped in this impoverished state, thereby, also helping to vaccinate against poverty. When thinking about epidemiology, it is important to consider various connections, causes, risk factors, trends, correlations, etc., and how one action may lead to more than one type of change. Sometimes it can be a domino effect, so it is important to think of all the possibilities that can occur and how one change can either negatively or positively impact another aspect of health.

According to Dr. Hotez's article, there is an estimated 2.4 billion people who live on less than $2 per day, as well as 1.2 billion people who live on less than $1.25 per day (known as the bottom billion). Most of the bottom billion and many of the people living on less than $2 a day are held prisoners of poverty due to a group of diseases called neglected tropical diseases (NTDs). These are a group of parasitic and bacterial infections that cause significant illness for these people. Some include trichuriasis, hookworm, lymphatic filariasis, trachoma, Chagas disease, and ascariasis. 

The CDC website states that "NTDs impair physical and cognitive development, contribute to mother and child illness and death, make it difficult to farm or earn a living, and limit productivity in the workplace" (2011). All of these factors then lead to poverty because people can't function the way they need to. Even though most children don't need to work right now, their physical and/or intellectual development could become stunted: this can greatly impact their ability to work and support their families in the future. This just shows that NTDs are not only negatively affecting people today, but it is also affecting their lives to come. 

It is very hard to end this nightmare because disease and poverty can be a never-ending cycle: disease leads to poverty, which leads to the continuation and possible addition of new diseases, which keeps poverty going strong, and so on. It can be scary to think about, but it is definitely possible to put a halt to this sequence. Of course it will take a lot of time and effort, but any great change starts with making the first step. One current approach toward limiting these diseases is an annual mass treatment consisting of a package of essential medicines. They target several NTDs at once and cost just 50 cents per person. The WHO describes this method as "preventive chemotherapy." Over time, and with other supportive measures, it is leading to the elimination of lymphatic filariasis and trachoma, as well as river blindness in some cases.

The development and testing of some "antipoverty vaccines" are also underway. Like I discussed earlier, these vaccines would improve health, while also helping to lift the burden of poverty. Hookworm infection is a leading cause of anemia and childhood malnutrition in Africa, Asia, and the Americas, so a prototype hookworm vaccine has been developed and is now going through clinical trials. Modifications of this vaccine are also being worked on so it can target other parasitic infections as well.  There is also a new schistosomiasis vaccine being created that will soon undergo clinical trials.

These different approaches toward the fight against disease and poverty are all substantial steps being made that will hopefully make a vast difference in many people's lives. The creation of certain vaccines and new discoveries being made can help us advance toward being able to successfully and effectively vaccinate against poverty and end the harsh, brutal cycle for good.



References
1. Hotez, P. (2014). Science for the poor: making vaccines to combat poverty. Huffington Post. Retrieved from http://www.huffingtonpost.com/peter-hotez-md-phd/science-for-the-poor-maki_b_4731187.html
2. CDC. (2011). Neglected tropical diseases. Retrieved from http://www.cdc.gov/globalhealth/ntd/ 
3. Photo (top): http://www.newerapolitics.org/uploads/1/3/2/0/13202651/5049487_orig.png
4. Photo (middle): http://cdn.bionews-tx.com/wp-content/uploads/2013/04/size_550x415_P152HammondRwanda04.png
5. Photo (bottom): http://www.fairlawnavenueunited.ca/images/end_poverty.jpg

Week 4 ~ Diseases Jumping Species

Diseases that can jump from one species to another is a pretty freaky topic to think about, especially when the disease is transmitted from an animal to a human (this is known as zoonoses). According to an article by Robert Roy Britt (2011), there are more than 3,000 zoonoses we can catch directly through touch and more than 4,000 from bites. It's weird to think that these tiny, "invisible" agents can do so much damage to living things. "The cross-species infection can originate on farms or markets, where conditions foster mixing of pathogens, giving them opportunities to swap genes and gear up to kill previously foreign hosts (i.e. you)" (Britt, 2011). It's a bit scary but also very fascinating how bacteria and viruses deadly to one species can evolve to infect a completely different species. When these types of diseases start causing outbreaks, things can get pretty difficult and hectic (especially when there is no vaccine for the disease).

One major example of this type of disease is the group of influenza A viruses, which are divided into subtypes based on two proteins on the surface of the virus: the hemagglutinin (H) and the neuraminidase (N). The CDC's website (2012) says there are 17 different hemagglutinin subtypes and 10 different neuraminidase subtypes. Interestingly, all of these subtypes but one have been found among birds; H17N10 has only been found in bats. I also found it intriguing that most influenza viruses either cause asymptomatic or mild infection in birds, but when they transfer over to humans they can be much harsher.

I was also reading on the CDC website about pigs and influenza because I was curious how pigs, birds, and humans can all be connected when it comes to certain influenza viruses. Pigs are an interesting species because they can be infected with human and avian influenza viruses as well as their own (swine influenza viruses), and it's possible for them to be infected with two different species' influenza viruses at the same time. In this sort of situation, the creation of a new virus is possible by the mixing of genes among the two existing viruses. 

This could possibly lead to a change in the influenza A viruses known as antigenic shift: "if a pig were infected with a human influenza virus and an avian influenza virus at the same time, the viruses could mix (reassort) and produce a new virus that had most of the genes from the human virus, but a hemagglutinin and/or neuraminidase from the avian virus. The resulting new virus would likely be able to infect humans and spread from person to preson, but it would have surface proteins (hemagglutinin and/or neuraminidase) not previously seen in influenza viruses that infect humans" (CDC, 2012).

As seen from the above example, antigenic shift occurs when a new influenza A subtype infects humans. Due to the new surface proteins not previously seen in human flu viruses, people would have little to no immune protection against this new virus. This foreign virus could have the potential to cause illness and also be easily transmitted from person to person. If this were the case, then an influenza pandemic could easily occur. Fortunately, influenza infections transmitted directly from animals to humans is unusual, but of course it is still possible. Being aware of the possibilities and knowledgeable about these viruses is essential, even if the chances are low.

Life cycle of the parasitic microbe T. gondii

While doing some reading on zoonoses, I came across a few articles about a parasitic microbe that is commonly found in cats and can be transmitted to humans (Toxoplasma gondii). I have heard that cat litter is unsafe for pregnant women but never knew exactly why, so I was curious to learn more about this parasitic microbe. According to Ker Than's article "Study: Cat Parasite Affects Human Culture" (2006), infection by T. gondii could cause some people to become more prone to some forms of neuroticism, which could lead to differences among cultures if enough people were to become infected. This article also stated a finding by a U.S. Geological Survey scientist, Kevin Lafferty, that people living in countries with higher rates of T. gondii infection scored higher on average for neuroticism. I found this information about T. gondii very interesting because psychology is fascinating to me, especially mental disorders and possible causes.

T. gondii tissue cyst in mouse brain

This parasite is excreted by cats in their feces and causes toxoplasmosis. Pregnant women who become infected can end up transmitting the disease to the fetus, and in some cases severe brain damage or even death can occur to the baby. Another article I found also discusses the possibility of T. gondii affecting the human brain: it "may be changing connections between our neurons, altering how we act and feel" (Mcauliffe, 2012). In the early 1990s, a Czech scientist, Jaroslav Flegr, began to suspect that a single-celled parasite had invaded his brain and was subtly manipulating his personality. Flegr discovered in 1990 that he had T. gondii, and from then on he started researching more and more about the parasite. He learned that it can only sexually reproduce inside cats, so once the parasite is inside another animal or human host it starts working to return back to a cat. Flegr believes T. gondii may be able to manipulate behavior in other species in order for it to make its way back to the body of a cat so it can reproduce.

Reading about this parasitic microbe got me pretty interested in the possible affects it can have on the human brain. I'm glad it can't reproduce in species other than cats because who knows what it could do to our population if the neuroticism theory is true. Learning about new disease-causing organisms really gets me thinking about how many there are out there that we haven't even discovered yet. There could be some that function in ways we can't really even imagine right now, and maybe others could be beneficial to our health in some significant way rather than threatening. There is so much to learn and discover about diseases and their factors. I'm excited to continue growing my knowledge with this subject and encountering new and fascinating information.


References
1. Britt, R. R. (2011). 10 deadly diseases that hopped across species. Live Science. Retrieved from http://www.livescience.com/12951-10-infectious-diseases-ebola-plague-influenza.html 
2. CDC. (2012). Transmission of influenza viruses from animals to people. Retrieved from http://www.cdc.gov/flu/about/viruses/transmission.htm   
3. Mcauliffe, K. (2012). How your cat is making you crazy. The Atlantic. Retrieved from http://www.theatlantic.com/magazine/archive/2012/03/how-your-cat-is-making-you-crazy/308873/
4. Than, K. (2006). Study: cat parasite affects human culture. Live Science. Retrieved from http://www.livescience.com/933-study-cat-parasite-affects-human-culture.html
5. Photo (top): http://www.colourbox.com/preview/4326388-26830-swine-flu.jpg
6. Photo (middle): http://www.intechopen.com/source/html/44112/media/image6.jpeg
7. Photo: (bottom): http://upload.wikimedia.org/wikipedia/commons/3/3c/Toxoplasma_gondii_tissue_cyst
_in_mouse_brain.jpg