Contagion; malaria vaccine

I am eagerly awaiting “Contagion”, starring Matt Damon, among others. It had two excellent science consultants–my high school classmate Dr. Ian Lipkin, who directs a center at Columbia (Mailman School of Public Health) and is a virologist and neurologist by training–but has also become an epidemiologist. He speaks highly of it. Laurie Garrett, the well known public health journalist, says that they got the science right this time.

I’ve been asked to review the film for the American Society of Tropical Medicine and Hygiene. I edit the online publications–really, the contents of the web related things–but my article will be in the newsletter. I’ll let you know what I think of the movie after tomorrow night.

On another front, there is no malaria vaccine that has been released for one of the major causes of mortality and morbidity in the world. Several are in Phase 3 clinical trials, and the first vaccine will be released before 2011. That may be nice for travelers, but how will the vaccine reach the people in endemic areas–the real sufferers of malaria?.GlaxoSmithKline will release their new RTS,S vaccine. A novel idea that shows promise has been written up in Science. The vaccine uses mosquitoes themselves (well, highly fragmented–a derivative) as a bioreactor. Really though, the vaccine is derived from the dissected salivary glands of infected anophelines, using the sporozoite stage of the parasite. It did not look like a good vaccine in early trials, but a recent study showed that if it is administered intravenously, it now shows much better efficacy in animal models. So, stand by! It reminds me of the contemporary use of leeches for stimulation of blood circulation in reattached fingers, toes, and other appendages, as well as the use of maggots to deride wounds–especially useful in diabetic ulcers and infections. While in the operating room, I asked one of the hand surgeons how he wrote up orders for maggots in an admissions note. At one of the hospitals where I spend much time, that is simple. “Use maggots per protocol” is the standard order. The hospital inpatient pharmacy has them in stock, and keeps them viable.
So, back to writing “in the news” for the trop med society.


About epihealth

Professor Emeritus of Epidemiology and Medical Geography, University of Washington, Seattle. Formerly Adjunct Prof, Depts of Medicine (Div of Infectious Diseases), Family Medicine, Health Services, and Global Health. President, Health Improvement and Promotion Alliance-Ghana Expertise in infectious diseases, epidemiology and clinical epidemiology, epi. of pain, community health, travel medicine, tuberculosis, disease control.
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