Beyond the Imodium, a One Health Discussion on Diarrhea and the Impact of Climate Change.

Our ability to tackle the looming human, animal, and global ecosystem health threats arising from the issues of climate change and extreme weather events will require effective and creative cross-disciplinary collaboration. There is a growing national and international interest in equipping the next generation of clinicians and health scientists for success in facing these important challenges by providing interprofessional training opportunities. This paper describes how we assembled an interdisciplinary team of experts to design and deliver a case-based discussion on a cross-species illness outbreak in animals and humans using a One Health framework. The small group, case-based approach highlighted the impact of climate change-driven extreme weather events on human and animal health using a diarrhea outbreak associated with a contaminated community water supply precipitated by extreme flooding. Post-activity survey data indicated that this team-taught learning activity successfully engaged a cross-disciplinary cohort of medical, veterinary, and public health students in the issues of environmental public health threats and helped them understand the importance of an integrative, cross-functional, team-based approach for solving complex problems. The data from this study is being used to plan similar interprofessional, One Health learning activities across the health sciences curriculum in our institution.

Aedes aegypti and Aedes albopictus (Diptera: Culicidae) Oviposition Activity and the Associated Socio-environmental Factors in the New Orleans Area.

The transmission of Aedes-borne viruses is on the rise globally. Their mosquito vectors, Aedes aegypti (Linnaeus, Diptera: Culicidae) and Ae. albopictus (Skuse, Diptera: Culicidae), are focally abundant in the Southern United States. Mosquito surveillance is an important component of a mosquito control program. However, there is a lack of long-term surveillance data and an incomplete understanding of the factors influencing vector populations in the Southern United States. Our surveillance program monitored Ae. aegypti and Ae. albopictus oviposition intensity in the New Orleans area using ovicups in a total of 75 sites from 2009 to 2016. We found both Aedes spp. throughout the study period and sites. The average number of Ae. aegypti and Ae. albopictus hatched from collected eggs per site per week was 34.1 (SD = 57.7) and 29.0 (SD = 46.5), respectively. Based on current literature, we formed multiple hypotheses on how environmental variables influence Aedes oviposition intensity, and constructed Generalized Linear Mixed Effect models with a negative binomial distribution and an autocorrelation structure to test these hypotheses. We found significant associations between housing unit density and Ae. aegypti and Ae. albopictus oviposition intensity, and between median household income and Ae. albopictus oviposition intensity. Temperature, relative humidity, and accumulated rainfall had either a lagged or an immediate significant association with oviposition. This study provides the first long-term record of Aedes spp. distribution in the New Orleans area, and sheds light on factors associated with their oviposition activity. This information is vital for the control of potential Aedes-borne virus transmission in this area.

Common Cell Lines Used to Study Bone Morphogenetic Proteins (BMPs).

Many research methods exist to elucidate the functions of BMPs during osteogenesis. This chapter briefly reviews common immortalized mesenchymal cell types used to measure the efficacy of osteogenic factors like BMP-2. Detailed information regarding media and culture conditions are provided. Parameters relevant to experimental reproducibility and cell line authentication are discussed.

Spatio-Temporal Distribution of Vector-Host Contact (VHC) Ratios and Ecological Niche Modeling of the West Nile Virus Mosquito Vector, Culex quinquefasciatus, in the City of New Orleans, LA, USA.

The consistent sporadic transmission of West Nile Virus (WNV) in the city of New Orleans justifies the need for distribution risk maps highlighting human risk of mosquito bites. We modeled the influence of biophysical and socioeconomic metrics on the spatio-temporal distributions of presence/vector-host contact (VHC) ratios of WNV vector, Culex quinquefasciatus, within their flight range. Biophysical and socioeconomic data were extracted within 5-km buffer radii around sampling localities of gravid female Culex quinquefasciatus. The spatio-temporal correlations between VHC data and 33 variables, including climate, land use-land cover (LULC), socioeconomic, and land surface terrain were analyzed using stepwise linear regression models (RM). Using MaxEnt, we developed a distribution model using the correlated predicting variables. Only 12 factors showed significant correlations with spatial distribution of VHC ratios (R² = 81.62, p < 0.01). Non-forested wetland (NFWL), tree density (TD) and residential-urban (RU) settings demonstrated the strongest relationship. The VHC ratios showed monthly environmental resilience in terms of number and type of influential factors. The highest prediction power of RU and other urban and built up land (OUBL), was demonstrated during May-August. This association was positively correlated with the onset of the mosquito WNV infection rate during June. These findings were confirmed by the Jackknife analysis in MaxEnt and independently collected field validation points. The spatial and temporal correlations of VHC ratios and their response to the predicting variables are discussed.

Factors associated with peridomestic Triatoma sanguisuga (Hemiptera: Reduviidae) presence in southeastern Louisiana.

Although rare, there have been isolated reports of autochthonous transmission of Trypanosoma cruzi Chagas in the United States. In June 2006, a human case of domestically transmitted T. cruzi was identified in southern Louisiana. To examine the localized risk of human T. cruzi infection in the area surrounding the initial human case, environmental surveys of households in the area and a serological survey of the residents were performed between September 2008 and November 2009. Human T. cruzi infection was determined using a rapid antigen field test, followed by confirmatory enzyme-linked immunosorbent assay testing in the laboratory. A perimeter search of each participating residence for Triatoma sanguisuga (LeConte), the predominant local triatomine species, was also performed. No participating individuals were positive for antibodies against T. cruzi; however, high levels of T. cruzi infection (62.4%) were detected in collected T. sanguisuga. Households with T. sanguisuga presence were less likely to use air conditioning, and more likely to have either chickens or cats on the property. While the human risk for T cruzi infection in southeastern Louisiana is low, a high prevalence of infected T. sanguisuga does indicate a substantial latent risk for T. cruzi peridomestic transmission. Further examination of the behavior and ecology of T. sanguisuga in the region will assist in refining local T. cruzi risk associations.

In vitro and in vivo studies of trypanocidal activity of dietary isothiocyanates.

Six dietary isothiocyanates, allyl-isothiocyanate, benzyl-isothiocyanate, phenylethyl-isothiocyanate, sulforaphane, erucin, and iberin, were tested for their trypanocidal activities in vitro using culture-adapted bloodstream forms of Trypanosoma brucei. All isothiocyanates showed a dose-dependent effect on the growth of trypanosomes. Five compounds displayed MIC values of 10 µM and GI50 values of around 1.5 µM, while allyl-isothiocyanate exhibited values of 100 and 11 µM, respectively. The compounds showed similar cytotoxic activities against human HL-60 cells with GI50 values of 1-4 µM and MIC values of 10-100 µM. Short-term experiments revealed that, with the exception of allyl-isothiocyanate, isothiocyanates at a concentration of 10 µM kill trypanosomes within 1-4 h of incubation. In contrast, HL-60 cells were not affected by any of the compounds in short-term incubation experiments. Sulforaphane, the most intensively studied isothiocyanate, was also investigated for its in vivo trypanocidal activity. However, administration of 50 mg/kg sulforaphane orally or intraperitoneally for four days had no effect on the parasitaemia in mice infected with T. brucei compared to control animals treated with vehicle alone.

Confronting socially generated uncertainty in adaptive management.

As more and more organizations with responsibility for natural resource management adopt adaptive management as the rubric in which they wish to operate, it becomes increasingly important to consider the sources of uncertainty inherent in their endeavors. Without recognizing that uncertainty originates both in the natural world and in human undertakings, efforts to manage adaptively at the least will prove frustrating and at the worst will prove damaging to the very natural resources that are the management targets. There will be more surprises and those surprises potentially may prove at the very least unwanted and at the worst devastating. We illustrate how acknowledging uncertainty associated with the natural world is necessary but not sufficient to avoid surprise using case studies of efforts to manage three wildlife species; Hector's Dolphins, American Alligators and Pallid Sturgeon. Three characteristics of indeterminism are salient to all of them; non-stationarity, irreducibility and an inability to define objective probabilities. As an antidote, we recommend employing a holistic treatment of indeterminism, that includes recognizing that uncertainty originates in ecological systems and in how people perceive, interact and decide about the natural world of which they are integral players.

Increase in West Nile neuroinvasive disease after Hurricane Katrina.

After Hurricane Katrina, the number of reported cases of West Nile neuroinvasive disease (WNND) sharply increased in the hurricane-affected regions of Louisiana and Mississippi. In 2006, a >2-fold increase in WNND incidence was observed in the hurricane-affected areas than in previous years.

A 41-year-old HIV-positive man with acute onset of quadriplegia after West Nile virus infection.

Most cases of West Nile encephalitis virus (WNV) infection are asymptomatic. In cases where WNV is symptomatic, patients usually experience high fever of sudden onset, myalgia, headache, and gastrointestinal symptoms, accompanied by a macular erythematous rash in a quarter to half of cases. More severe infections manifest as a poliomyelitis. Immunocompromise and immune senescence confer an increased risk of severe central nervous system (CNS) infection. Patients with human immunodeficiency virus (HIV) infection are therefore more susceptible, but, because the symptoms of WNV infection may be attributed to other CNS syndromes common in HIV patients, it is likely that the presence of WNV infection is underdiagnosed and underreported. We present a patient with severe WNV infection who was found to be HIV positive, who also suffered hearing loss. Several key differences in the presentation of WNV infection and Guillain-Barré syndrome that have treatment implications are discussed.

Policy windows, policy change, and organizational learning: watersheds in the evolution of watershed management.

Employing in-depth, elite interviews, this empirical research contributes to understanding the dynamics among policy windows, policy change, and organizational learning. First, although much of the research on agenda setting-how issues attract enough attention that action is taken to address them-has been conducted at the national scale, this work explores the subnational, regional scale. With decentralization, regional-scale environmental decision-making has become increasingly important. Second, this research highlights the role of policy windows and instances of related organizational learning identified by natural resources managers. Having practitioners identify focusing events contrasts with the more typical approach of the researcher identifying a particular focusing event or events to investigate. A focusing event is a sudden, exceptional experience that, because of how it leads to harm or exposes the prospect for great devastation, is perceived as the impetus for policy change.

Birth outcomes following West Nile Virus infection of pregnant women in the United States: 2003-2004.

BACKGROUND: Congenital West Nile virus (WNV) infection was first described in a single case in 2002. The proportion of maternal WNV infections resulting in congenital infection and clinical consequences of such infections are unknown. METHODS: In 2003 and 2004, women in the United States who acquired WNV infection during pregnancy were reported to the Centers for Disease Control and Prevention by state health departments. Data on pregnancy outcomes were collected. One of the maternal WNV infections was identified retrospectively after the infant was born. Maternal sera, placenta, umbilical cord tissue, and cord serum were tested for WNV infection by using serologic assays and reverse-transcription polymerase chain reaction. Infant health was assessed at delivery and through 12 months of age. RESULTS: Seventy-seven women infected with WNV during pregnancy were clinically followed in 16 states. A total of 71 women delivered 72 live infants; 4 women had miscarriages, and 2 had elective abortions. Of the 72 live infants, 67 were born at term, and 4 were preterm; gestational age was unknown for 1. Of 55 live infants from whom cord serum was available, 54 tested negative for anti-WNV IgM. One infant born with umbilical hernia and skin tags had anti-WNV IgM in cord serum but not in peripheral serum at age 1 month. An infant who had no anti-WNV IgM in cord blood, but whose mother had WNV illness 6 days prepartum, developed WNV meningitis at age 10 days. Another infant, whose mother had acute WNV illness at delivery, was born with a rash and coarctation of the aorta and had anti-WNV IgM in serum at 1 month of age; cord serum was not available. A fourth infant, whose mother had onset of WNV illness 3 weeks prepartum that was not diagnosed until after delivery, had WNV encephalitis and underlying lissencephaly detected at age 17 days and subsequently died; cord serum was not available. The following major malformations were noted among live-born infants: aortic coarctation (n = 1); cleft palate (n = 1); Down syndrome (n = 1); lissencephaly (n = 1); microcephaly (n = 2); and polydactyly (n = 1). One infant had glycogen storage disease type 1. Abnormal growth was noted in 8 infants. CONCLUSIONS: Of 72 infants followed to date in 2003 and 2004, almost all seemed normal, and none had conclusive laboratory evidence of congenital WNV infection. Three infants had WNV infection that could have been congenitally acquired. Seven infants had major malformations, but only 3 of these had defects that could have been caused by maternal WNV infection based on the timing of the infections and the sensitive developmental period for the specific malformations, and none had any conclusive evidence of WNV etiology. However, the sensitivity and specificity of IgM testing of cord blood to detect congenital WNV infection are currently unknown, and congenital WNV infection among newborns with IgM-negative serology cannot be ruled out. Prospective studies comparing pregnancy outcomes of WNV-infected and -uninfected women are needed to better define the outcomes of WNV infection during pregnancy.

Pesticide exposure and self reported home hygiene: practices in agricultural families.

Little is known about environmental exposure to pesticides and the extent to which exposure is affected by drift from agricultural applications and take home exposure from agricultural workers. The study focused on 24 agricultural families in the northwestern United States and measured levels of organophosphate pesticides (OP) in house dust. Pesticide residues were significantly associated with the number of individuals in the home whose work included high exposure pesticide activities. Mean levels of pesticides were higher in the homes of workers who reported waiting more than 2 hours before changing out of their work clothes compared with homes where workers change within 2 hours after returning from work (p < .01). The results of this study provide evidence that workers can inadvertently carry agricultural chemicals from their work into their homes, thereby increasing the risk of pesticide exposure to other family members inside the home.

West nile epidemic in louisiana in 2002.

In 2002, 329 cases of West Nile illness were reported in Louisiana, including 204 cases of West Nile meningoencephalitis and 125 cases of West Nile fever. Clinical presentation of meningoencephalitis or of West Nile fever was confirmed serologically. There were 24 deaths. Age group distribution showed predominance among persons aged 45 years or older. The epidemic curve, based on date of diagnosis, showed numerous foci progressing in successive waves. The first cases occurred in mid-June. A peak was reached by the first week of August, after which the epidemic progressively subsided.