New Haven Independent

City to Viruses: We’re Ready for You

by Allan Appel | August 20, 2009 7:55 AM | Permalink | Comments (4)

nhiwestnile%20005.JPG “If the mosquitoes bite me,” said Judy Papuga, “I’ll bite them back.”

“If you can catch them,” said city health director William Quinn.

The humorous exchange Wednesday concerned a deadly serious subject: West Nile virus.

Quinn, accompanied by the mayor, came to the Atwater Senior Center in Fair Haven to distribute to Papuga and some 60 other seniors among the first of 500 bottles of insect repellent being given to the elderly citywide via the centers.

It was the beginning of the city’s prevention and protection campaign against the virus and other mosquito-born diseases. Seniors are the primary at-risk population for West Nile, which is distinct from H1N1 (aka swine flu) as well as seasonal flu.

In response to a senior’s question, Quinn made those distinctions right away.

Seniors are, oddly, at low risk for H1N1, which in any event can be relatively mild.

However, they are at high risk for West Nile, which can kill, and did, three years ago in the West River neighborhood. (Click here to read an article on last year’s prevention efforts.) Mosquitoes infected with West Nile are exceptionally active in August and September; thus the campaign.

Seniors — including 95 year-old Helen Mailhot, at left, and 85-year old Jennie Martone — gratefully took their insect repellent. Martone was going to share hers with her grandchildren.

Mayor John DeStefano told them he had good news and bad news to report regarding West Nile.

The bad news: This season there are more mosquitoes. The good news is that fewer are infected with West Nile, and none yet detected with the virus in the New Haven area.

In addition to reducing and eliminating stagnant water that attracts mosquitoes, seniors were urged to wear long sleeves when they go outside and, of course, to use the repellent.

The seniors-focused distribution campaign has been going on since 1999, when the West Nile virus was first detected. These seniors have long memories and appreciation of the program, said the center’s president Gus Cuomo.

And they can joke about it.

“Remember,” said the mayor, as he passed out his share of the Cutter-brand “Skinsations,” “Do not drink it. Spray it!”

nhiwestnile%20003.JPG Quinn (in the background, with Judy Papuga in the foreground) assured the crowd, “We haven’t had any positive mosquitoes in the area. But it’s early.”

H1N1 Update

As the seniors moved on to their next activities, including some manicures for the women, and bingo for all, Quinn provided an update on area preparations for H1N1 vaccine distribution and new prevention measures being undertaken at the schools.

He said he’d just gotten off a conference call with state health officials who heard from the Centers for Disease Control and Prevention that there would be sufficient supplies in the area for inoculations in October.

The vaccine will be given to primary providers, that is, doctors and hospitals. Those most at risk for H1N1 remain not seniors, but pregnant women, people who live with children two years and under, health care providers and, finally, kids 18 and under.

nhiwestnile%20004.JPG “Least at risk,” said Quinn, “are seniors.” He speculated there may be H1N1 immunity built up in older people from past generations of epidemics.

The vaccine will be available in October, to be given in two doses, requiring two separate doctor visits.

For kids who do not get the vaccine through their primary provider, Quinn said, the 14 school-based clinics will offer the vaccine. Vaccination is not mandatory.

At the schools, he emphasized, that prevention, largely through hand washing, will be emphasized.

To that end he said he was assured by Will Clark, the schools’ chief operating officer, that soap dispensers will be regularly filled in school bathrooms.

The city also plans to add several new dispensers of hand sanitizer in cafeterias and other points “where there is heavy traffic.”

Quinn was at pains to point out that using hand sanitizer should be viewed as an addition to, not a substitute for, regular hand washing, the best prevention for H1N1. He said “kids are well aware” of these issues from last year, when some 3,000 students, he estimated, came down with H1N1 and cycled through that condition’s relatively mild symptoms.

Those lucky kids, he said, will now be immune.

Quinn said his staff will meet with principals and administrators of the schools next week on these matters. He also said that with regard to H1N1 prevention, the schools “will be cleaned on a daily basis.”

In addition to the H1N1 vaccine, scheduled to be in the area in October, the vaccine for the regular seasonal flu will also be available for use by local doctors and clinics in September.

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Posted by: jeffreykerekes | August 20, 2009 9:28 AM

"The humorous exchange Wednesday concerned a deadly serious subject: West Nile virus."

You left out the most humorous part of the story. Did you see those bottles up close? Its John DeStefano Repellent. He's got his face plastered on each and every bottle. Its almost too funny. Check out the picture here: DeStefano Repellent

Posted by: Josiah Brown | August 20, 2009 5:34 PM

West Nile fever and Lyme disease are the focus of one of the latest curriculum units (by Kathleen Rooney) that 50 New Haven Public School teachers produced as Fellows in the Yale-New Haven Teachers Institute in 2009. The latest volumes of units -- from five different months-long seminars in the humanities as well as the sciences and math -- will be online in September at: http://www.yale.edu/ynhti/curriculum/units/

In the meantime, below are brief synopses previewing just three of the units Fellows developed in one of the seminars, that on "Evolutionary Medicine." The seminar leader: Paul E. Turner, Associate Professor of Ecology and Evolutionary Biology at Yale http://www.yale.edu/turner/people/pturner.htm

Each of the three examples below is a unit by a teacher who has not only participated as an Institute Fellow but is also assuming responsibility in the coming academic year as a teacher Representative for his or her school. These three colleagues are Fallon Daniels of Co-op (science), Paul Jones of High School in the Community (science), and Kathleen Rooney of Career (math). As Representatives, they will be part of the group shaping the program's seminar offerings for 2010 in response to teachers' and students' needs and district curricula, as well as disseminating the 2009 Institute curricular resources once they are published in the fall.

The Teachers Institute is an educational partnership between Yale University and the New Haven Public Schools -- and one means of supporting the district's effort to attract, develop, and retain additional effective teachers. Through the Institute, Yale faculty members and New Haven school teachers work together in a collegial relationship. The Institute is also an interschool and interdisciplinary forum for teachers to collaborate on new curricula. Each participating teacher becomes an Institute Fellow and prepares a curriculum unit to be taught the following year. Teachers have primary responsibility for identifying the subjects the Institute addresses.
. . .

Creating a Mathematical Model for the Spread of Disease, by Kathleen Z. Rooney

"This is a cross-discipline mathematics unit, designed for students in Algebra 2 or beyond. It incorporates functions with statistics to illuminate the useful nature of functions in translating data into models. It is application-driven. The unit's areas of focus are two emerging diseases: West Nile fever and Lyme disease. Both have important links to New Haven. We will examine the history and epidemiology of the diseases and use evolutionary principles as well as primary source data to lead us to questions and predictions, best modeled through math. Math can help us study the process of evolving diseases. The engine of evolution is random mutation, mimicked by probability. The pressure of environment leads to success or failure of a mutation. Statistics helps us look at variation and possibilities and find patterns. Through our study of data and statistical analysis, we may find patterns created by that data. Writing a function that emulates the data we have collected is a powerful tool, known as modeling. When we discover correlations between variables such as environmental influences and populations, we can explore these relationships through linear functions. Modeling, combined with evolutionary prediction and analysis can help us to understand and reduce the risk of diseases."
. . .

Human Population's Response to Re-emerging and Emerging Infectious Diseases, by Fallon Lorraine Daniels

"This unit discusses: What is an infectious disease? How do infectious diseases impact humans? Why is evolutionary biology important in the treatment of infectious diseases? The unit covers transmission, replication process of bacteria and viruses, genetic variability, human immunity defense and evolutionary defense mechanisms, and medical treatment. The unit will be useful in comparing bacteria and viruses, demonstrating the importance of evolution, displaying the relationships between humans and microbes, and illustrating the importance of genetic variability. Students will be engaged in a hands-on approach to learning through student-driven discussions, laboratories, debates, and independent research projects. The strategies for teaching this unit must coincide with the 5 E's of learning: Engage, Explore, Explain, Elaborate, and Evaluate. The unit also seeks to teach science by incorporating other subjects such as history, reading and literacy, and math."
. . .

The Behavior and Evolution of Viruses, by Paul M. Jones

"This unit is for high-school biology students; its main objective is to teach evolution, using viruses and pathogens as the model. As many students are reluctant to accept human evolution given their religious beliefs, this unit focuses on evolution and natural selection while using viruses as the main example of an organism undergoing change. By using viruses as the target organism, this unit attempts to disarm reluctant learners by showing evolution happening over the short term as a demonstration for how more complex organisms evolved over time. Student lessons focus on various viral structures, geologic time scale, and a hands-on activity to enforce the mechanism of natural selection on micro-organisms. The overview offers a synopsis of evolution and virology concepts."
. . .

For context, below is the description that Paul E. Turner had prepared in response to teachers' requests for a seminar addressing biology, ecology, disease, and medicine. This description formed the syllabus that Fellows then used as they developed their own curriculum units during the seminar that unfolded over the spring and summer.

Evolutionary Medicine

Evolutionary medicine is the application of evolutionary thinking to gain valuable insights and new perspectives into human health and disease. This merger establishes evolutionary biology as an essential science that complements medicine. Integrating evolutionary thought into medical research and practice helps explain the origins of many medical conditions, including obesity, diabetes, asthma, heart disease, allergies and aging. Why are our bodies not better designed? How do cancers evolve? Why must we grow old? This seminar will examine aspects of medicine where evolutionary approaches make important contributions.

Although all organisms suffer disease, we know the most about disease pathogens important to human medicine. However, despite this understanding, we have much to learn and discover; human societies remain highly vulnerable to the mortality and economic losses inflicted by disease pathogens. For these reasons, control of infectious disease constitutes one of the greatest challenges currently faced by humans. But these challenges are not new. Both human biological and cultural evolution have been profoundly impacted by our past interactions with disease pathogens, which have literally shaped our DNA as well as our art, music and other traditions. How do pathogens cause disease in humans and other organisms? What are the hallmarks of past human diseases, as revealed through cultural artifacts, human genetic variation, and the human genome project? How vulnerable are we and other host species to global epidemics - or even extinction - caused by disease pathogens?

The seminar will incorporate hands-on laboratory experiments that address some of the topics covered. The seminar will focus on the following specific topics, and related topics that are motivated by the interests of the participants:
*Recent human evolution, genetic variation, and mismatches to modernity - human history, geography and genetics; genetic variation in response to drugs and pathogens; the Hygiene/Old Friends Hypothesis: parasites and autoimmune disease
*Natural selection and evolutionary conflicts - kin selection to conflict to genetic imprinting: reproduction and mental disease; aging and disease resistance; immune system variation and mate choice; human mortality rates
*Ecology and epidemiology of disease - fundamentals of epidemiology; ecology and evolution of ordinary and vector-borne pathogens; causes of disease outbreaks and cycling
*Methods of Control - examining vaccines, antibiotics and other methods to control pathogen spread, and determining the reasons why these methods sometimes fail
*The Great Pandemics and their Historical Significance - examining ancient and modern scourges, and how they have directly and indirectly shaped human history
*Noninfectious and degenerative disease - evolutionary approaches to understanding aging; lifestyle, diet and chronic risks to health; cancer as an evolutionary process; autoimmune diseases: costs and benefits of evolving immune defenses
*Pathogen Virulence and Manipulation of Host Behavior - examining why pathogens can evolve greater - or lesser - virulence, and ways that they purposefully alter host behavior
*New Frontiers - a discussion of unusual infectious diseases, such as prion diseases (e.g., Creutzfeldt-Jakob Disease) and transmissible cancers, and novel approaches for combating disease.

In addition to offering opportunities for teachers of science at the elementary, middle, and high-school levels to participate as Fellows, this seminar may appeal to teachers of math. Mathematical skills and concepts such as estimation, graphing, fractions, percent, probability, and population dynamics may be included in response to participants' interests and their students' needs.

A number of teachers of social studies, art, and other subjects may also identify opportunities for interdisciplinary curriculum units. For example, historical interactions between Europeans, Africans, and Native American inhabitants of what are now both North America and South America could present angles of study.

Resources

Books:

R.M. Nesse & G.C. Williams. 1996. Why We Get Sick: The New Science of Darwinian Medicine. Vintage.

S.C. Stearns & J.C. Koella (eds). 2008. Evolution in Health and Disease, 2nd Ed. Oxford University Press.

W.R. Trevathan, E.O. Smith & J. McKenna. 2007. Evolutionary Medicine and health: New Perspectives. Oxford University Press.

City to Viruses: We’re Ready for You

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