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Tracking Dengue: An Interview With Alisa Aliaga-Samanez

The rapid spread of Dengue could lead to a global pandemic, and so the geographical extent of this spread needs to be assessed and predicted. There are also reasons to suggest that transmission of Dengue from non-human primates in tropical forest cycles is being underestimated.

Alisa Aliaga-Samanez sitting by the computer
Alisa Aliaga-Samanez

 

Exactly one month ago, on June 7th, PLOS Neglected Tropical Diseases published a research article Worldwide dynamic biogeography of zoonotic and anthroponotic Dengue. The study is the first high-resolution analysis of how the risk of Dengue transmission has been changing geographically since the late 20th century, indicating the virus (DENV) has been making a home in previously low-risk areas, potentially due to global warming and deforestation. 

We spoke with the corresponding author Alisa Aliaga-Samanez, who worked alongside Marina Cobos-Mayo, Raimundo Real, Marina Segura, David Romero, Julia E. Fa, and Jesús Olivero, to learn more about the importance of this study and her experience working with GIDEON data. 

 

How did you find out about GIDEON?  

We got to know GIDEON thanks to an article published in PNAS by Kris A. Murray and colleagues entitled “Global biogeography of human infectious diseases.”

 

What were the reasons behind choosing the GIDEON database as one of your data sources?

We know that GIDEON is one of the most complete data sources worldwide on zoonoses, so we wanted to use it to build our database. For that reason, the project where I work at the University of Malaga funded our access to GIDEON.

 

What is the importance of biogeography studies like this one to public health management?  

Biogeographical studies, through modeling, applied to pathogens, allow us to understand the distribution of infectious diseases. The occurrence of disease cases is related to social factors but also to environmental variables that determine the degree to which certain environments favor the occurrence of disease, even where it has not been recorded. Thanks to the tool we use in our study, we are able to propose different management strategies depending on which factors favor the risk of transmission in different regions of the world. We took into account three possible biogeographical scenarios related to Dengue transmission risk: (1) zones with favorable conditions for viruses and vectors, (2) favorable conditions for virus only, and (3) favorable conditions for vectors only. Besides, our biogeographical approach helped us to analyze the extent of the areas where non-human primates could be involved in sylvatic Dengue cycles.

 

What is the importance of biogeography studies like this one to public health management?  

Biogeographical studies, through modeling, applied to pathogens, allow us to understand the distribution of infectious diseases. The occurrence of disease cases is related to social factors but also to environmental variables that determine the degree to which certain environments favor the occurrence of disease, even where it has not been recorded. Thanks to the tool we use in our study, we are able to propose different management strategies depending on which factors favor the risk of transmission in different regions of the world. We took into account three possible biogeographical scenarios related to Dengue transmission risk: (1) zones with favorable conditions for viruses and vectors, (2) favorable conditions for virus only, and (3) favorable conditions for vectors only. Besides, our biogeographical approach helped us to analyze the extent of the areas where non-human primates could be involved in sylvatic Dengue cycles.

 

Do you believe the risks of the Dengue pandemic are exacerbated by global warming?  

We think global warming may be one of the factors that could be favoring vectors to adapt to new environments. A study published by Messina and colleagues in 2019 concluded that the World’s population at risk of Dengue could experience an almost 60% increase by 2080. In addition, they suggested that outbreaks could reach areas in continents such as Australia, Argentina, Japan, eastern China, and southern Europe.

Melting ice
Photo by William Bossen on Unsplash

 

In your experience, how effective study such as yours at influencing change in government and health policies, and do you think work like this will be taken more seriously following the COVID-19 pandemic?  

We have seen that governmental bodies such as WHO or CDC rely on scientific studies to manage risk areas, but we feel that this work is being limited in Africa, for example. On the other hand, some diseases already have a vaccine available, such as yellow fever, but its application might not be well managed in some African countries, where large outbreaks occur. In the case of Dengue, a vaccine has already been developed, but it is only licensed for people aged 9-45 years in some countries. The WHO recommends that the vaccine should only be administered to people with confirmed previous Dengue virus infection. As we show in our paper, Dengue is currently spreading together with its vectors. The COVID-19 pandemic should serve to demonstrate that global pandemics are possible and, so, must be prevented.

 

What value did having access to global spatio-temporal data add to your study?  

GIDEON helped us to get quick access to the available information on the disease. This allowed us to build our databases in a short time and to validate our models with recent cases in order to assess the reliability of the tool we use and to predict new areas favorable for new Dengue cases.

 

What are your thoughts regarding data availability on sylvatic transmitted Dengue?  

Most of the available data on human cases do not differentiate whether they were caused by sylvatic or urban transmission. Some research studies in certain local areas may be able to determine this, but globally there is no such information. Our biogeographic outputs related to Africa and Asia are consistent with the scarce information available and provide the context in which on-the-ground prospections on sylvatic Dengue should be addressed. This is especially important in South America, where sylvatic Dengue has not been detected yet (although the presence of sylvatic Yellow Fever and other evidences are starting to suggest its existence).

Aedes aegypti Mosquito. Close up a Mosquito Mosquito on leaf,Mosquito Vector-borne diseases,Chikungunya.Dengue fever.Rift Valley fever.Yellow fever.Zika virus.
Aedes aegypti mosquito, the vector of Dengue

 

What areas do you think GIDEON could improve to make our data more useful to you in the future?  

We appreciate the great work GIDEON does in collecting data globally. We found the new GIDEON interface very useful. Perhaps it would make it easier in the future, if it is possible, to distinguish between imported and autochthonous cases within the database. It is true that in many cases the database does mention it but not for all countries.

 

About Alisa:

Alisa Aliaga-Samanez has a degree in Biology from the Federico Villarreal University (Peru) and a Master’s degree in Biodiversity and Environment from the University of Malaga (Spain). Currently, she is working at the Animal Biology Department of the University of Malaga, being part of the Biogeography, Diversity and Conservation Group,  developing her Ph.D. thesis. The thesis is focused on the study of primate biogeography, applied to conservation and human health. She is currently mapping vector-borne zoonotic diseases through global distribution modeling. 

Aliaga uses high-resolution global maps and the most up-to-date databases to analyze geographical changes in the risk of zoonotic disease transmission. In addition, in these analyses, she considers the biogeographical contribution of primates in increasing the risk of transmission. She seeks to determine the potential natural range of endemic and emerging zoonotic diseases in the world, with the aim of suggesting specific management strategies according to the spatial distribution of risk factors.

Click here to read the open-access article: Worldwide dynamic biogeography of zoonotic and anthroponotic Dengue 

 

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Dr. Oli prepares medical students for real-life situations

Multi ethnic group of medical students in uniform looking on the x-ray sitting at the desk in the modern classroom
Dr. Oli has created the “GIDEON diagnostic game” where students take on different roles to diagnose a disease

 

Due to the COVID-19 pandemic, universities all over the world had to accelerate their digital teaching programs. This has created a greater need for online tools that support the challenges of preparing students for life after graduation. This is especially true when teaching medical students – it is critically important future health professionals are taught practical and critical thinking techniques that are based on real-life situations.

Dr. Monika Oli has been speaking with Times Higher Education about the challenges of teaching microbiology online and how GIDEON can bring value to the virtual classroom. Dr. Oli explains that traditional teaching techniques may focus on identifying a few pathogens found in most laboratories, which can create “a completely artificial scenario which would never happen in the real world”.

How can a future medical doctor learn to differentiate between diseases with similar symptoms, such as Rocky Mountain Spotted Fever and Lyme disease? In a real-world scenario, you can’t “just open page 510 of the textbook and diagnose the patient…You have to think outside the box” and this is where Dr. Oli brings GIDEON in.

Dr. Oli has created the “GIDEON diagnostic game” where students take on different roles – epidemiologist, doctor, microbiologists, etc. – and use GIDEON’s Bayesian analysis-driven diagnostic tools to help create the list of likely diseases. This is followed by exploring the database to determine the best treatment plan and even speculating whether the patient would have survived or not in a given scenario!

The game proved to be very popular with students. But Dr. Oli didn’t stop there, she further encouraged future medics to analyze issues relevant today by building an exam around secondary infections of COVID-19.

“Many COVID-19 patients get secondary infections that are bacterial, so I built my whole exam around it. Students were given data and had to use GIDEON to analyze the secondary infection, how it should be treated, whether it will contribute to COVID-19 resistance, so the role play continued even during the exams.”

If you are a teacher looking for new ways to engage and challenge your students, GIDEON might be the right tool for the job. Try it free!

Read the original Times Higher Education article here

 

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‘It’s not just COVID-19’ – Dr. Berger on Outbreak News Today podcast

HazMat team in protective suits decontaminating public transport, bus interior during virus outbreak

The global pandemic caused by COVID-19 has rightly taken center stage in media and scientific journals but overshadowed other concerning outbreaks that could do with some attention. GIDEON co-founder Dr. Stephen A. Berger has been speaking with Outbreak News Today to discuss the diseases that are flying under the radar in the media but are still being tracked and reported by GIDEON. 

Listen to the podcast or watch a video recording here.

In 2020, significant outbreaks of Cholera in Yemen, Dengue in Brazil, and neighboring South American countries have been recorded in addition to the COVID-19 pandemic. Numerous diseases such as Ebola, Lassa fever, Chikungunya, Plague, and Monkeypox have broken out in regions of Africa and Asia in recent years as well. Ebola and Monkeypox have proved a persistent threat in the Democratic Republic of Congo, with thousands of cases in the last couple of years alone. Meanwhile, Lassa fever cases in Nigeria in 2020 were the highest recorded by any country in history (nearly 7,000). The disease spreads through rodents, leaving many of its surviving victims deaf.

These and other diseases have historically been considered tropical or exotic and don’t trouble the western population too much, however, the spread of COVID-19 has proven that diseases can and will spread given the opportunity. For instance, Monkeypox, Plague, and West Nile Fever have all had outbreaks within the US in the past. 

Tune in to Outbreak News Today and hear from Dr. Berger and Robert Herriman on this timely subject.

Haven’t got a GIDEON account yet? Sign up for a free trial here.

 

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Dr. Berger speaks with CNN about dining out during pandemic

Christmas eve holiday party decorated table set with disposable medical mask and alcohol hand sanitizer bottle. Coronavirus (Covid 19) spreading prevention concept. Christmas micro led lights wire.

 

As the festive season approaches, the temptation of treating yourself to a dinner in your favorite eatery could become too much. But before you give in to your cravings, be sure to heed the advice of our co-founding doctor, Dr. Stephen Berger, who has been speaking with CNN about the risks of dining out during the ongoing pandemic, especially in cities.

2020 has been a tough year for everyone across the world. The local and state-wide lockdowns have forced us to stay at home and business to close their doors for what feels like forever. While takeaways have mostly stayed open, it is perfectly normal to miss the buzz of your favorite restaurant. 

Even though it may have opened the doors again and taken measures to protect you and their staff, we must not forget the virus is still at large. The risk of contracting COVID-19 remains, especially within the cities and built-up areas, so consider your acceptable levels of risk. The virus is particularly dangerous if you or anyone in your family or social group are immunocompromised. 

 

Why is it risky?

Restaurants are easy places for the virus to spread as there are multiple contact points (cutlery, napkins, plates, glasses, etc), often an enclosed space with recirculated air, where you are also generally close to fellow diners and staff. Most importantly, you will need to take off your mask.

“Eating means having to take off your mask, and that’s the golden rule of avoiding coronavirus,” Dr. Berger told CNN. When combined with the other risk factors, the decision to dine out is not one you should make idly. “Think twice about going to a restaurant,” said Dr. Berger. And if you live in a big city, make it “three times.”

 

Consider alternatives to dining out

Thankfully, many businesses are providing takeaway services, where perhaps they did not before, so if you can still get the food you want without compromising your safety and that of others – consider that option.

And if you are getting your food delivered, remember to be a little more generous with the tip if you can, as the staff and drivers are working hard to keep you fed and safe.

Should you decide to go and dine out nevertheless, then please head over to the CNN article and follow their collection of expert advice to keep yourself and others healthy and safe.

Read the ‘New Yorker’s guide to dining out safely during the pandemic’ here

 

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How to safely visit loved ones during COVID-19

Family wearing face masksSince COVID-19 arrived, there has been a constant stream of concern and curiosity about how to safely visit loved ones during the pandemic. Can I give them a hug? Should we enjoy a meal together? Are my elderly grandparents off-limits? 

GIDEON Founder, Dr. Stephen Berger, shares with Livestrong what to consider before planning an in-person visit with family and friends. 

First, it is important to acknowledge that keeping yourself safe is just as important as keeping those whom you are visiting safe.   

Secondly, realize that not everyone has obvious symptoms who may be carrying the virus. “It is possible to be an asymptomatic carrier of COVID-19,” Dr. Berger told Livestrong.

Ideally, both you and those you are going to be with would isolate for 14 days prior to your get-together—especially if you each have already ventured outside your home. 

Make sure to have a frank talk with friends and family beforehand about any symptoms experienced or previous exposure to the virus, and do not feel guilty about rescheduling if there are any concerns. 

Dr. Berger also reminds us that the Centers for Disease Control and Prevention (CDC) states those who are over 65 years and who have underlying health issues should avoid group gatherings altogether. He says the risks far outweigh the benefits of a visit. 

Some tips to help best protect you and your loved ones as you make plans to meet include:

  • Keep gatherings to a limited number of people.
  • Select somewhere outdoors, preferably a private setting like a backyard, where you can maintain a safe social distance of six feet apart. 
  • If meeting somewhere in public, try to keep touching of any objects or surfaces to a minimum, then avoid touching your face, and disinfect hands immediately afterward.  
  • Also, while in public, avoid using restrooms as much as possible. 

Dr. Berger also says to be sure and wear a mask, but remember that even masks have limitations because “extremely small particles, including the virus itself, might pass through the spaces that allow air to pass.” Evidence suggests that is essential to adhere to a combination of multiple, safe practices (mask-wearing, handwashing, social-distancing, etc.) to protect yourselves and loved ones from spreading the virus to each another. 

You can read the entire article in Livestrong here.

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Catching COVID-19 In A Crowd (Even If You’re Outside)

Crowd protesting

Recent waves of crowd protests throughout the country in the wake of George Floyd’s death have set off alarming new concerns about the spread of COVID-19. 

Even though it is thought to be safer outside where the virus may be less contagious, those who are not practicing social distancing and congregating in close crowds could be putting themselves and others at risk. 

GIDEON Founder, Dr. Stephen Berger, recently explained in both Healthline and YahooFinance how easily COVID-19 could be transmitted in a crowd. 

“The center of a large crowd is no different than a sealed off, an unventilated room filled with potentially infected individuals — many holding large signs which will block the flow of clean air,” Dr. Berger said.   

Many protests document people not wearing masks or keeping a safe distance of six feet apart from one another. 

“If even one carrier of COVID-19 was present at these gatherings, we can expect to see a wave of cases appearing during the next 2 to 14 days,” explained Dr. Berger.

He adds that along with a potential spike in new cases attributed to protests, more spread could come during these summer months as businesses begin to open up and people grow tired of cautionary restrictions and guidelines, such as wearing masks and social distancing.  

He further recommends that those who participate in protests or other large summer gatherings should be vigilant about using a face mask and maintaining distance. Dr. Berger says that it is wise to “assume that the stranger next to you is spreading the virus.”

You can read the entire articles in Healthline here and YahooFinance here

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Dr. Berger On Face Shields: Are They Functional or Just Fashionable?

Face shield 3D medical visualization, Surgical equipment

Plastic face shields, or now “COVID visors,” are one piece of PPE still questionable as to how effective and necessary they are at protecting against the virus. 

Unlike fabric face masks which are recommended by the CDC (Centers for Disease Control and Prevention) in many situations and settings, there are no official guidelines or suggestions for wearing face shields. 

This begs the question: are face shields merely just in fashion at the moment – with many style influencers on social media sporting them — or are they actually functional? 

GIDEON Founder, Dr. Stephen Berger, answers questions about face shields for a recent article in InStyle magazine. 

“Theoretically, the virus of COVID-19 could arrive at the eyes and travel down through our tear ducts into the nose and throat,” says Dr. Berger. In this scenario, a face shield could protect the eyes from infected respiratory droplets potentially entering the body. 

However, there is still little to suggest that someone going about their everyday business would need to wear one. A protective fabric mask that fits snuggly over the mouth and nose is still the better option. “Plastic visors and shields do not filter air, and at most, prevent larger droplets of infectious material from arriving at our face directly,” Dr Berger explains. 

Additionally, face masks could lend a sense of false security with the wearer getting too close to someone else or feeling confident in attending large gatherings which are still considered unsafe. 

To help prevent the spread of the disease, the best protection remains wearing a cloth face mask, social distancing, and practising good hand hygiene.

Medical experts concede that the few instances when it may be helpful to wear a face shield are when working out and it is difficult to breathe in a tighter mask, or when it is necessary for someone who is hearing impaired to read lips and see facial expressions. 

The full article from InStyle is available here.  

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Dining Out Amid COVID-19: Dr. Berger speaks with Healthline

Family dining in a restaurant with face masks on

Missing dining out in your favorite restaurant? As businesses have begun to reopen, many are wondering if it is safe to eat out again.

GIDEON Founder and infectious disease and microbiology specialist, Dr. Stephen Berger, recently answered questions about safe dining amid COVID-19 for Healthline

One of the most important things to take into consideration, Dr. Berger says, is whether a restaurant is set up for safe social distancing and keeping the designated six-foot separation between tables. 

Also, he says, “before sitting down and asking for a menu, check to confirm that the restaurant staff is wearing masks and that these masks cover their noses and mouths.”

Dr. Berger reminds those venturing to dine out that any number of objects found in a restaurant could potentially be contaminated with the virus–such as tablecloths, menus, salt shakers, credit card machines, chairs, and doorknobs—but it is only harmful if it then gets into the body. Scrupulous attention to basic hygiene (handwashing and sanitizing) before and after eating must be followed. 

Other ways you can check if a restaurant is working hard to keep the spread of the virus to a minimum are if they offer disposable menus and silverware, hand sanitizer for guests, contactless payment, and strictly adhere to limited seating.  

Finally, Dr. Berger suggests it might be better to opt for a table outside if possible, or a spot that is “large, open, and ventilated.” 

You can read the entire article in Healthline here

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Do gloves protect you from COVID-19?

Can gloves protect you from COVID-19? Blue surgical gloves hanging on clothesline string with clothespinThere have been many recommendations set forth over the past few months by the CDC (Centers for Disease Control and Prevention) on wearing face masks to prevent the spread of COVID-19. Gloves have also been suggested as a way of preventing the spread, there are no official recommendations on wearing them.

Because the virus is transmitted via respiratory droplets and not through the skin, the jury is still out on whether or not gloves are beneficial at all. 

Our co-founder and infectious disease expert, Dr. Stephen Berger, recently commented on the efficacy of gloves for an article in InStyle magazine. He says “there is no evidence that gloves can protect us from acquiring COVID-19.”

Dr. Berger adds that, if anything, they are more likely to prevent someone from passing the virus to others rather than protecting one’s self from getting it. 

It is also important to remember that wearing gloves can potentially promote a false sense of security in the event you touch something thinking it’s safe while wearing them and then inadvertently touch your face.

Along with Dr. Berger, most medical experts agree that gloves are not necessary unless you are an essential worker (perhaps somewhere like at a grocery store) or a medical professional. 

Frequent and thorough hand washing is still recommended as the best defense against the virus, but for those who still want to cover their hands, some tips for best use include: 

1. Opt for disposable latex versions and throw them in the trash after each use. 

2. Wait until the last possible moment to put gloves on before going out. 

3. Minimize touching your face while wearing gloves. 

You can read the entire article from InStyle here.

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Can Cell Phones Carry COVID-19?

spray disinfecting phone from germs and viruses

It’s long been known that cell phones can carry a multitude of germs, bacteria, and different forms of fungi. With the arrival of the COVID-19 virus, it begs the question if it too can live on the surface of a phone and subsequently be transmitted to another person. 

A compilation of studies from across 24 countries over the past 13 years indicates that it is a very likely possibility. 

Although COVID-19 was not included in any of these original studies, the rapid rate at which it has spread throughout the world, and the increased and ever-growing physical attachment that people have to their cell phones, leads researchers to believe that phones could in fact harbor the virus. 

Our co-founder, Dr. Stephen Berger, who is double board-certified in infectious disease and microbiology, recently commented on this topic for an article in HealthDay

“Cellular phones are ideal vehicles for the virus of COVID-19,” he agreed. “They are repeatedly exposed to material exhaled from our mouth and nose and spend literally hours in our rather filthy hands. Viruses of this type are known to survive on plastics and stainless steel for two to three hours; on aluminum for two to eight hours, on cardboard and paper for up to 24 hours, and ceramic or glass for up to five days.”

While many experts suggest wiping down your phone frequently with a disinfectant and abstaining from sharing your phone with others, Dr. Berger says that it is our hands and not the phones that merit the extra attention when it comes to disinfecting. 

“Whenever these and other objects in our daily life are examined in the laboratory, a veritable ‘zoo’ of bacteria, parasites, fungi, and viruses are discovered. But the common denominator for all of these is the human hand that touches them, and then goes to our mouth or nose.”

Keeping your phone clean may help limit exposure to the virus, but even more helpful is to keep your hands clean with frequent washing and then away from your face as much as possible. 

You can read the entire article here

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