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United States – In Scientio, Veritas

Tag: United States

Attrition through Intimidation, the New Immigration Policy Faced by Immigrant Professionals

This is not a space where I usually indulge in writing about politics per se, except whatever happens to impinge upon science policy, research funding and so forth. Scientists have long been accused of inhabiting a rarefied ivory tower, detached from any engagement with the general populace, but the portents are that the current political climate in the United States makes it imperative for science professionals to hang up their lab-coats and get more involved with the grand American political process in order to bring their educated, informed and expert perspectives to evidence-based, logically-consistent policy-making. Indeed, within the past couple of weeks, I can recall at least two instances of scientists feeling impelled to attempt joining the fray for this nation’s governance— NASA scientist Tracy Van Houten,  and UC Berkeley evolutionary biologist Michael Eisen —a most encouraging sign.

For me, however, the view of politics is a lot more fundamental than merely engaging in policy making. Political engagement is not ordinarily something I would have time to consider during my regular working hours as a research scientist. But as an immigrant to this land and person-of-color, I do believe that in certain situations, as the one we have reached in this nation, the whole existence of mine and people like me became inevitably political, a state in which remaining neutral for the sake of some esoteric neutrality is not possible without being a hypocrite. I simply no longer have the luxury of remaining blissfully unaware of the rapidly-changing circumstances around me, whose impact on the lives and livelihoods of my family, my friends and me is potentially grave. The most recent example of this blipped onto my radar a couple of hours ago, in form of a report in the Gothamist on the extreme immigration enforcement guidelines released today by the Department of Homeland Security, yes, the same department that is the supreme arbiter of my life and status as an immigrant/Permanent Resident in the United States.

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Foreign-born Biomedical Researcher in the United States, a Tale of Woe

It has been more than two years since I wrote about a tale of woe, the sad reality of being a non-immigrant biomedical researcher in the US. I chronicled the travails of my wife, who – even with a STEM PhD from a top-tier medical school in New York – was facing the murky uncertainties associated with doing science on a visa in the US. That uneasy disquietude still continues to haunt her; even though her Green Card application has been submitted, nothing is certain until she actually gets it in her hand – and we have no clue when that is going to happen.

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Spotlight on the recent outbreak of cyclosporiasis, a food- and water-borne parasitic disease

A balanced diet should contain fresh fruits and vegetables, whose long-term health benefits are indisputable. Simultaneously, it is crucial for continued good health to remember the importance of hygiene and safe handling of fruits and vegetables, as underscored by some recent findings of the Centers for Disease Control and Prevention (CDC) during an investigation into the suspected outbreak of a food-borne illness, called cyclosporiasis.

Cyclosporiasis is most common to tropical and subtropical regions; it has been found in Ghana, Guatemala, Egypt, Turkey, Nepal, Peru, and Haiti from water samples and human disease. Although it is not considered endemic to the continental United States, it is by no means unknown in this country; during 1990-95 three small outbreaks were reported in North America. Major outbreaks, confirmed by molecular methods, have been documented since c.1996, often associated with fresh produce – raspberries, lettuce, basil, and snow peas – mostly imported from countries endemic for the disease. Apart from multi-state outbreaks in 1996, 1997, and 2000, more than 1100 sporadic cases of confirmed cyclosporiasis occurred during 1997-2008, involving twelve US states. About a third of these cases were likely associated with international travel to endemic regions. In response, cyclosporiasis was made a nationally notifiable disease in January 1999; as of 2008, it is a reportable condition in 37 states, New York City (NYC), and the District of Columbia.

Earlier this year (June-August 2013), an unusually large number of cyclosporiasis reports were communicated to the CDC, involving more than 600 individuals from 25 states (with high numbers in Texas, Iowa, and Nebraska) and NYC. Epidemiologic and traceback investigations conducted jointly by the CDC, the Food and Drug Administration (FDA), and state and local public health officials revealed the possibility of two outbreaks; cases in Iowa and Nebraska were associated with restaurants, and involved a salad mix (iceberg and romaine lettuce, red cabbage, carrots) sourced from Taylor Farms de Mexico, whereas cases in Texas were associated with uncooked (but not cooked) cilantro sourced from Puebla, Mexico.

Cyclosporiosis outbreak case map October 2013
A total of 631 cases of cyclosporiasis were reported from 25 states and New York City: Texas (270), Iowa (140), Nebraska (87), Florida (33)¶, Wisconsin (18), Arkansas (16)†, Illinois (14)†, New York City (8)‡, Georgia (5), Missouri (5)†, Kansas (4)‡, New Jersey (4)†, Louisiana (3)‡, Massachusetts (3)†, Minnesota (3), Ohio (3), Virginia (4), Connecticut (2), New York (2)†, California (1)†, Michigan (1)†, New Hampshire (1), Pennsylvania (1), South Dakota (1), Tennessee (1), and Wyoming (1). † Includes one case that may have been acquired out of state. ‡ Includes two cases that may have been acquired out of state. ¶ May include one international travel-associated case. [Source: CDC]

Human cyclosporiasis is a disease caused by the single-celled apicomplexan protozoal parasite Cyclospora cayetanensis. Parasites of the genus Cyclospora have been found in nature in many members of the animal kingdom, including certain terrestrial arthropods (such as, centipedes), snakes, rodents, moles (a subterranean mammal), cattle (recently discovered in China), as well as in certain non-human primates (colobus monkeys, green monkeys, baboons and chimpanzees). Although there are about 18 different species of Cyclospora currently known, the four that infect non-human primates appear to be specific to these animals, and so far Cyclospora cayetanensis has been discovered only in humans. Attempts to create non-human animal models of C. cayetanensis infection have been unsuccessful, again suggesting host-specificity.

Cyclospora cayetanensis in stool sample; modified Acid-fast stain
Four Cyclospora cayetanensis oocysts in fresh stool sample in 10% Formalin, variably stained with Acid-fast stain. Image courtesy: PHIL/CDC/DPDx – Melanie Moser.

Cyclospora transmission occurs via the fecal-oral route. In excreted fecal matter, Cyclospora exists in the form of oocysts (a thick-walled structure containing immature, dormant parasite spores), a product of sexual reproduction of the parasite. Interestingly, these are non-infectious, although highly resistant to common disinfectants used in food- and water-processing industries. However, within two weeks, the spores mature – making the oocysts infectious. Neither the natural environments of this process, nor the exact manner of transmission, are yet known, but contamination of water and/or food (such as raw produce) with oocyst-containing fecal matter likely contributes to the dissemination. Epidemiological studies indicate that higher risks of infection are associated with consumption of untreated water and/or food, lack of adequate sanitation, and the presence of animals in the household.

This parasite primarily targets the small intestines, and an infection often causes gastro-intestinal symptoms, such as watery diarrhea, abdominal cramping, anorexia (loss of appetite), flatulence (gas) and bloating, along with nausea, fatigue, weight-loss, sometimes accompanied by low-grade fever. In absence of proper treatment, some of these symptoms may continue for weeks on end, while some may be temporarily relieved, only to recur. The good news is that the infection is not generally life-threatening and people with healthy immune systems may not require treatment. However, in children and in the elderly, as well in individuals with compromised immunity (such as AIDS or cancer patients), untreated cyclosporiasis may cause severe, and occasionally fatal, illness.

The anti-protozoal antimicrobial Trimethoprim/sulfamethoxazole is currently the drug of choice for Cyclospora infection. Anti-diarrheal medication, taken under medical supervision, may help reduce diarrhea. However, for an effective preventative, the CDC strongly advises that general fruit and vegetable safety recommendations – covering washing, preparation, and storage – be followed by consumers.

[An abridged version of this post was published in The Conversation UK.]

Suggested reading

  1. Bern C, et al. (1999) Epidemiologic Studies of Cyclospora cayetanensis in Guatemala. Emerg Infect Dis, vol.5, No.6: doi:10.3201/eid0506.990604
  2. Ynés R. Ortega and Roxana Sanchez (2010) Update on Cyclospora cayetanensis, a Food-Borne and Waterborne Parasite. Clin Microbiol Rev, 23(1): 218–234; doi:10.1128/CMR.00026-09
  3. Centers for Disease Control and Prevention (2011) Surveillance for Laboratory-Confirmed Sporadic Cases of Cyclosporiasis – United States, 1997-2008. MMWR, 60(No. SS-2):1-11; URL: CDC/MMWR
  4. US Food and Drug Adminstration (2013) FDA Investigates Multistate Outbreak of Cyclosporiasis. Report dated: October 23, 2013. Last accessed: November 1, 2013. URL: FDA
  5. Centers for Disease Control and Prevention (2013) Notes from the Field: Outbreaks of Cyclosporiasis — United States, June–August 2013. MMWR, 62(43):862; URL: CDC/MMWR

Sam Stein (Huffington Post) Exposes Ugly Effect of Sequestration on US Science

Many of you know that I have been extremely concerned about the continuing deleterious effect of the sequestration on Federally-funded Biomedical Research in the United States. I have tried to highlight how Science funding and the future prosperity of this nation have been put on the line via drastic spending cuts. A piece of heartening news came through last month in which a proposed Senate Bill sought to boost the NIH budget. I wrote at that time: “I hope the American political leadership wakes up soon to the loss of intellectual capital they are incurring due to the sequester.”

Fat chance of that, it seems, as time passes on. Today, in Huffington Post, noted political reporter Sam Stein wrote a long essay in which he exposed the ugly effects of the sequester already weighing heavy on scientific research in the US. He has interviewed real researchers in different universities whose invaluable research work is in clear and present danger of being shut down. As the essay goes on to say:

Over the past few months, The Huffington Post has set out to understand the breadth of these cuts. The roughly two dozen scientists and academic officials interviewed were naturally distraught over the impact sequestration is having on their own work and institutions. The nature of the business is to assume you’re on the cusp of a major breakthrough.

But beyond that, they shuddered at the damage being done to the field at large. Yes, they conceded, the NIH’s budget remains large at $29 billion. But without more investment, the nation’s role as an international leader in scientific research is at risk. Moreover, the money being cut now will have lasting damage, both economic and medical, as cures to diseases are left undiscovered and treatments left unearthed.

A lot of people were hoping for the benevolence of for-profit private parties to keep the research efforts afloat. But as Stein points out, it is not a viable proposition. The times have been so desperate that several scientists are actively considering the idea of setting up shop in other, more conducive countries where they can carry on their work unimpeded.

The saddest and most dire message that Stein has portrayed? This:

… (At the University of Virginia) Patrick Grant, an Associate Professor of Biochemistry and Molecular Genetics, said his lab was down to two researchers from a peak of a dozen. His federal funding ran out last year.

“I wouldn’t advise people to go into science,” he said. “I think it’s a tough career to follow. It’s not the career that I thought it was, or that it was for me a couple of years ago.”

Do go read the HuffPo piece. It is disheartening and reeks of despair, but it needs to be read and the message spread. They also have a project to record the experiences of real people affected by the sequester, and are asking for input from the reading public.

Sequestration Risks to Science and Public Health Programs: ASM Legislative Alert

This morning I received a legislative alert from the American Society for Microbiology (ASM, the world’s oldest and largest scientific membership organization), of which I am a member, via their Public and Scientific Affairs Board. I am not a citizen of the United States, the country I live and work in, and therefore, have no voting rights. But I am keenly aware of the current economic realities, as well as the politics and public policy-making surrounding them. And I think it is absolutely imperative for scientists, researchers and administrators to be aware of the direness of the situation – and to do their bit – because if not, the impact on scientific research and public health programs, both points of pride of this nation, is going to be devastating. I wanted to share this important missive for the sake of awareness.

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Fluoride in drinking water, yea or nay?

The effects of fluoride on human health has long been a matter of controversy. In small quantities, fluoride has beneficial effects on oral health, especially in preventing dental caries in children, which is a major public health concern in the industrialized countries as well as others. Therefore, the Oral Health program of the WHO supports fluoride containing toothpastes and mouth-rinses, as well as fluoridation of drinking water where necessary. As indicated in a 2004 report, systematic reviews of available datasets concluded that there was no credible evidence of adverse health effects of water fluoridation, and WHO Water Quality Guidelines recommended a maximum fluoride level of 1.5mg/L.

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