A comprehensive virus survey now could save billions in avoided health care costs later, experts say

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Imagine if pandemics could be forecast by infectious disease scientists the way that bad weather can be tracked by meteorologists. New viruses would still infect people, but the cost of monitoring the emergence of those novel pathogens would be far less than the expense of dealing with a worldwide outbreak. At least that’s the reasoning behind a new study, published today in mBio, in which researchers propose launching a billion-dollar-plus global surveillance plan to find all the viruses lurking in mammalian wildlife before those same viruses find us.

A consortium of scientists, funded by the US Agency for International Development (USAID), headquartered in Washington, DC, estimated that at least 320,000 viruses remain unidentified in the world’s 5,500 mammals. They argue that the cost of systematically searching for those new viruses would pale in comparison to the estimated $16 billion another epidemic such as SARS could cost.

That epidemic, which started in China in 2003 after a coronavirus carried by bats and palm civets started infecting humans, eventually killed more than 700 people and spread to 37 countries worldwide. The ongoing outbreak of Middle East respiratory syndrome (MERS) hasn’t yet reached such pandemic levels. But with 108 laboratory-confirmed cases of infection in nine countries, including 50 deaths, public health officials remain on high alert.

Eric Delwart, a virologist at the Blood Systems Research Institute in San Francisco who was not involved in the study, describes the virus-hunting proposal as “a feasible approach” to looking for zoonotic diseases that animals could transmit to humans. “This study provides one of the first data-based estimates of the scope of the viro-diversity which humans and their livestock have to face and from which the next viral epidemic will emerge,” he says. “Although other people have looked at pathogen levels before and estimated that there are two new human viruses coming each year, we don’t know where they’re coming from.”

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Autism reaches record high levels in the US

The US Centers for Disease Control and Prevention today reported that the number of children with autism spectrum disorders (ASD) has risen to an estimated 1 in 88 (1.1%), up from 1 in 110 (0.9%) according to agency estimates from two years previous. The prevalence figure is the highest since the CDC began its biennial nationwide survey of children ten years ago.

The survey released today assessed rates of autism in eight-year-olds at sites in fourteen states in 2008. The new US rate is on par with the 1% rate reported in the UK, and is significantly lower than the 2.6% prevalence observed in South Korea, according to reports from last September.

“Some of the increase is due to an increase in diagnosis, although how much is due to this is unknown,” Coleen Boyle, director of the CDC’s National Center on Birth Defects and Developmental Disabilities, said in a press telebriefing today. In the last decade, doctors, parents and teachers have gotten better at recognizing symptoms of ASD. But “a large portion of the increase, some 50%, remains unexplained,” said Mark Roithmayr, president of Autism Speaks, a New York-based advocacy group. “We need more research into potential environmental causes.”

Roithmayr is not alone in his concern that environmental factors may be partly to blame for the rise in autism. As Nature reported in November, the steady increase in ASD prevalence has led epidemiologists at the CDC and elsewhere to launch multiple studies in the past five years that have gathered environmental, developmental and genetic information from large numbers of children in the hopes of pinpointing the driving factors behind the disease. Yet, despite a slew of genetic markers have been correlated to high rates of autism, their actual importance and how and why those genes are expressed remains a mystery. The harrowing history of false alarms, such as the discredited link between vaccines and autism, raises the bar for such studies.

Regardless of the cause, all the experts at today’s press conference agreed that earlier detection of ASD is critical. Today’s report shows that the average age of diagnosis continues to hover near four years old, nearly unchanged from recent years, meaning that although detection is getting better overall, services are not getting to children any earlier. And, as the University of Rochester’s Susan Hyman, chairperson of the autism subcommittee of the American Academy of Pediatrics, pointed out, “To meet the need presented by increasing ASD diagnoses, federal autism resources will need to expand.”

Photo courtesy of the US Centers for Disease Control and Prevention

Screening sunscreens

A watchdop group has called on the US Food and Drug Administration to shed some light on sunscreens. The government agency has failed to finalize standards for testing and labeling sunscreens, says a report by the Washington, DC-based nonprofit Environmental Working Group. The report also concludes that 85% of sunscreens on the market either contain potentially toxic ingredients or fail to provide enough protection from both UVB and UVA radiation. Most products shield the skin from UVB rays, which cause sunburn as well as DNA damage associated with skin cancer.

A study published yesterday in the journal of the Federation of American Societies for Experimental Biology (FASEB), provides details to support the idea that UVB rays are more likely to cause cancer. However, research published in May suggests that the deeper-penetrating UVA rays that cause skin aging also suppress the immune system, compromising the body’s ability to protect itself against the development and spread of skin cancer.

The FDA is currently considering sunscreen labeling changes to help consumers make better choices, but in the meantime, the American Academy of Dermatology offers this advice: Use broad spectrum sunscreen products of SPF 15 that protect against UVA and UVB rays. Lather it on everyday and wear protective clothing.

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Image by Daquella manera

This is your city on drugs

What’s the drug of choice in your city? Cocaine? Methamphetamine? Or a simple cup of java?

Turns out it’s a lot easier to find out than lurking in alleyways or crashing hipster parties. Scientists from Oregon State University have figured out a way to test an entire city for its drug use — legal and illegal.

The scientists sampled about a teaspoon of water from the sewers — because that’s eventually where what people consume ends up — of 10 American cities and tested them for 15 different drugs.

The results, which they presented the Amercan Chemical Society meeting in Boston on Tuesday, are not all that surprising in the end. Here are a few gems:

Most Americans are not too wild and crazy, and their drug of choice is caffeine. People in the midwest are a little more conservative and don’t seem to indulge too much in meth use. One city with a heavy gambling industry — Las vegas, anyone? — shows meth levels five times higher than other cities.

I have no doubt New York has its share of drug use, what with all our models, actors and and hyperactive investment bankers. How do you think your city would fare?

The lead made me do it

Yesterday’s Washington Post ran an article that I found really provocative, linking the drop in crime in recent decades to… um, lead poisoning.

The general idea is that children who are exposed to lead are more prone to committing violent crime as adolescents presenting, according to the article, “a unifying new neurochemical theory for fluctuations in the crime rate.”

Sounds really good. Too good, in fact. I’m wary of “unifying theories” with such sweeping implications.

There is apparently a lot of literature linking lead exposure to aggressive behavior. But it’s a big step from that to linking crime rates across the world to lead levels.

The article is based on the work of economist Rick Nevin, who looked at nine countries with different abortion rates, police strategies, demographics and economic conditions and found that up to 90% of the variation in violent crime in these countries could be explained by lead.

In the U.S., for example, children were exposed to lead — in household paint at the turn of the 20th century and in gasoline fumes after World War II — and in each case, violent crime peaked roughly 20 years later. Much of the lead in gasoline was eliminated by the mid-1980s explaining, according to Nevin, the drop in crime in the 1990s (what do you have to say that, Rudy Giuliani?), and because this had the biggest impact on inner-city neighborhoods, Nevin says, violent crime in those neighborhoods has declined faster than the overall crime rate.

I know the writer, Shankar Vedantam, and deeply respect his journalistic abilities, so I’m sure he checked out the credibility of this research. But I would have felt better if pretty much the only other expert quoted in the article hadn’t been the editor of the journal, Environmental Research, in which Nevin has published most of his work. The article says Nevin’s work, and the other research that supports this hypothesis, hasn’t received much attention. If it’s good science, why ever not??

Tossing back mercury

Seafood lovers, pregnant women and lobbyists for the fishing industry heard some startling news this week from a study in The Lancet.

Offspring of women who ate a lot of seafood during pregnancy scored higher on tests of verbal and social ability than offspring of women who at little or none—despite concerns about high mercury levels in seafood. Even the study’s authors were surprised.

The take-home message of the study may seem positive, but it comes with ominous undertones: “The benefits of eating seafood outweigh the risks.” Somehow, I’m not fully comforted.

What the study did not address was how the seafood-reared children would have fared if their mothers had eaten mercury-free fish—a thing about as rare as coelacanth caviar. It’s a tough question, but it’s worth asking — given that mercury at the concentrations found in many fish is likely harmful to fetal development, as The National Academy of Sciences has concluded.

The new study didn’t take the bite out of mercury — it just suggests that omega-3 fatty acids and other substances in seafood are really good for the developing nervous system. The findings will certainly put pressure on US regulatory agencies to change their advisories limiting fish intake for vulnerable populations. Pregnant women in the study had to eat more than the level advised by the agencies, 340 grams per week, for the beneficial effect.

So what is fish lover to do — believe this one study and start chowing down on tuna fish sandwiches? Carefully parse lists of fish species with high and low mercury content, or just eat a lot of omega-3 containing flax seed?

There’s only one sure way to make things simpler — and safer. And that is to get rid of mercury in our waterways.

The Bush administration is notoriously backward on this front. The US Environmental Protection Agency — the same agency that issues advisories on fish consumption — has ruled that coal-fired power power plants have almost 20 years to cut their emissions by 70 percent. That stands in contrast to an overturned Clinton-era ruling calling for a 90 percent reduction by 2008.

The EPA has received hundreds of thousands of letters protesting the Bush-era ruling — so a single study from The Lancet is unlikely to change anything. But those letters show how strongly people feel that there should be only benefit, but no risk, to eating a basic food item.