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 80   0  

IamA scientist who has spent my entire career studying terrible diseases - Ebola, smallpox, rabies, anthrax and many others. I'm here to answer your questions on infectious diseases of biodefense. AMA!

My short bio: I earned my Ph.D. in Molecular and Cellular Biology from the University of Arizona working to understand how herpes viruses replicate their DNA. I went on to work at USAMRIID studying Ebola, pox viruses, SARS, tick-borne encephalitis virus and others. I was at USAMRIID when the 9/11 and subsequent anthrax letter attacks happened and was scrutinized (along with many others) by the FBI. I worked at the CDC studying live smallpox virus, and at the time, was one of only 20 or so people in the world authorized to have access to the virus. I went on to work at the world's largest biorepository and then to different non-profit contract research organizations helping to develop new vaccines and antibiotics/antivirals for many high-hazard pathogens. I have worked extensively under biosafety level 4 (BSL-4) containment, worked with many different species of animals to develop models of these diseases, and serve as a subject matter expert on biodefense for various parts of the government on sometimes-classified projects.

My current projects include work on different viruses, bacteria, toxins and fungi.

Viruses:

Flu, Zika, Ebola, VEE, EEE, WEE, MERS, SARS, Dengue, Chikungunya, rabies

Bacteria:

B. anthracis, Y. pestis, B. mallei, B. pseudomallei, MRSA, Pseudomonas

Toxins:

Staph enterotoxin B, ricin, Botulinum neurotoxin

Fungi:

Candida albicans and Aspergillus.

My Proof:

My business card

My linkedIn profile

Other specific proof has been submitted to and verified by the mods.

AMA!

 10   0  

What are some uncommon ways for a disease to spread?

 14   0  

Good question. None of them seem too weird to me anymore. But a couple might count. First is rabies. It is spread from the bite of an infected mammal in the saliva. The virus is specifically adapted to transmit that way, so it's not just happenstance like the bacteria that normally just live in the mouth infecting the bite wound.

The other might be a bacterium called Francicella tularensis. You can get it from the blood of an infected animal (from hunting for example). But it can infect protists in water, and you can get it by drinking that water. And you can also get it by aerosol. There was one case where a person got infected while mowing a lawn and they hit the carcass of a rabbit that died of the disease. They breathed in a tiny amount of aerosolized tissue and blood containing the bacteria and got the disease. Gross.

 2   0  

He died didn't he?

 2   0  

I believe so.

 1   0  

I got bit by a cat on the street and we believe it had rabies so I got the shots and everything. Hands down scariest month of my life. First the doctor dug needles into my finger where I got bit (I fainted) because of the pain then 1 shot every Friday for a month on each arm... the pain was terrible......

 2   0  

Yep, rabies is nothing to joke around about. The shots kind of suck, but they are way better than they used to be, when you had to get them in the stomach. And they are WAY better than getting rabies...

 7   0  

Hello:) I'd like to know why it takes so long to make a vaccine to cure an infectious disease? What are the procedures of making a vaccine?

 14   0  

Making a vaccine to use in people is a really complicated process. The goals are to make the vaccine effective in protecting people, and to make sure it is safe to use in people. We perform a lot of tests to ensure both of those things.

There are multiple ways to make a vaccine - killed, live attenuated, subunit, DNA, etc, etc. They all have their advantages and disadvantages. And for reasons we don;t always understand, some work for a given pathogen and some don't. So, often we'll try several strategies.

Once we have some test vaccines, we can put them into animals and see if the animals immune system reacts the way we want. Then we can put the vaccines into more animals and see if it protects them from the disease (assuming that we have already developed an animal model of that disease that looks like the disease in humans - that's a whole different hurdle). Then we can test the vaccine for safety in animals, usually more than one species of animals. All of that can take 2 or 3 years and several million dollars depending on how it goes, the animals needed, the biocontainment needed, etc.

If all that looks good, then we can go to the FDA and ask for an Investigational New Drug (IND) license. They review ALL of the data and ALL of the labs that did the work. If they like it, then we can move on to human testing. First comes safety testing in a small number of humans. Then testing in more to see if it behaves the same as it did in animals. Then you can give it to more people who are at risk of the disease and see if it helps keep them from catching it. This can take 2-3 more years, easily, and cost millions more.

Then you can go back to the FDA and ask for a full license. Just that review and approval step can take a year or more.

So, it's long and costly. But that is how we make sure it's safe and effective to give to people and that it will not cause more harm than good.

 4   0  

What is the best way to keep my bread from getting mold before I eat it all from the bag?

 6   0  

Put it in the fridge. That slows down the growth of the mold cells. But it does make it taste stale faster...

 4   0  

Why are people in Japan more conscious of not spreading their germs/sickness/diseases to others compared to the USA and Europe?

 8   0  

Good questions. Most people think it is part of their society. They tend to be more polite and think of how their actions impact others, in general. This is probably due to the fact that they have lived in high population density centers a lot longer than many other areas, and so there is selective pressure to think that way in order to better get along. We're not there yet.

 4   0  

If you had to predict the one contagious disease that was most likely to destroy the entire human race, which would it be?

 10   0  

Influenza. Hands down. Highly contagious, survives well on surfaces and in the air, changes rapidly so broad immunity is difficult and highly-pathogenic strains emerge regularly, and most people think it's no big deal and are lax.

 1   0  

Thank you for your answer, and for the AMA!

I'm very surprised actually... it seems like the news is always talking about some strain of flu that will kill everyone, but then it turns into nothing eventually. Could be a "boy who cried wolf" scenario eventually.

 7   0  

I agree. It's tough. The media of course will hype anything they can because that gets them readers/listeners/watchers. Public health agencies walk a fine line - they run this risk of being seen as overreacting and losing credibility, or under reacting and being accused of not being prepared or informing people. They tend to err on the side of caution and give more of a worst-case warning, because then at least fewer people die. At least that's the idea.

On the other hand, you could think of it this way: they push the panic button and say that the flu is bad, people respond by increasing awareness, doctors are on the lookout, the government assists with additional resources, we monitor and test and quarantine, etc. And all of that together helps everything get under control faster.

The bottom line is that we have seen bad (really bad) flu outbreaks every 60 years or so. These tend to kill a lot of people (millions to hundreds of millions). There is no reason to think another is not going to come. We just have to try to be vigilant and not get jaded when one, thankfully, turns out to not be as bad as we feared.

 2   0  

When was the last?

 2   0  

The last severe flu pandemic was the Hong Kong flu pandemic in 1968.

 4   0  

[deleted]

 10   0  

There are several I hear a lot. First, that Ebola kills everyone who gets infected. Not true. In some outbreaks it has killed 90%, so almost everyone. But in more recent outbreaks it has been much closer to 50%. That's still really bad, but not as bad as something like rabies, actually. Also that Ebola is easy to catch from an infected person. Not really. It's transmitted by body fluid contact, so it's not easy to catch unless you're caring for a sick person or handling people who have died from it. It's also a pretty fragile virus and easy to kill with chemicals or heat.

 4   0  

Did anyone ever get infected in the lab?

 8   0  

Not in my lab, no. I'm very proud of the fact that in all the places I have worked and with all the people that have worked with me or for me, none of them have ever caught anything from the lab. But, yes, there are cases when people have caught things in the lab. Some of those people have died. Thankfully, it is very, very rare. But what we do does have it's risks and we have to stay aware of those and be safe.

 6   0  

What are the most highly held misconception about viruses, bacteria, and fungi?

 5   0  

Probably the biggest one is that most people don't know the difference between them. I guess that counts as a misconception. But I think many people also think that these things just fly around on little wings or jet packs or something, and that by simply being near someone with an infection will get you sick. Not always so. Something has to kick them up in the air (wind, cough, sneeze or deliberately in the case of a bioweapon) for you to have a chance of being infected, unless you touch infected people or materials. This is why cleanliness and isolation work so well in stopping infectious diseases in general.

 6   0  

Who are your science role models & heroes?

 8   0  

I love all the classic, elegant experiments in molecular biology, many of which led to Nobel Prizes. I love Rosalin Franklin, who was the woman who provided all the data to Watson and Crick so they could solve the structure of DNA, and who ended up getting no credit for it when she should have shared in their Nobel Prize. I love Neil DeGrasse Tyson, Bill Nye and the late Carl Sagan for their wonderful ability to explain complex science to regular people, and for their dedication to science education.

 3   0  

What's the scariest moment in the lab that you've ever had?

 20   0  

Probably holding an uncapped syringe filled with a highly concentrated sample of smallpox virus when the lights went out and there were multiple other people around. In the space suits we used at the time in the BSL-4 lab, you couldn't hear anything and I was scared to death someone was going to reach over to try to help and end up getting stuck with that needle. Sure, we were vaccinated, but with that much virus, it probably wouldn't have saved them.

 3   0  

What are some things the average person can do to stop the spread of an infectious disease?

 4   0  

Stay home if you are sick. Wash your hands thoroughly and regularly. Use an alcohol-based hand sanitizer. If you cough or sneeze, do so into your elbow, and tissue or the like, not into your hand.

 3   0  

Do you think that over medicating is creating bacteria that will become so resilient that antibiotics will no longer work? If so, what will happen?

 4   0  

Well, yes, if by over medicating you mean overusing antibiotics. Not so with other kinds of medicines. But yes, this is a huge problem. Over use in humans and in food animals is the major driver of antibiotic resistance in bacteria. And we will continue to see more and more bacteria become resistant to more and more antibiotics. It's an arms race and we are not doing enough to win it.

 3   0  

Thanks for doing this AMA, it's super interesting! Have you ever had any big mistakes at the lab? What happened?

 4   0  

Fortunately very few mistakes. We have had some accidents and exposures. I've had a BSL-4 lab get flooded because left the water in the sink running and the drain plugged. I have had someone accidentally break a window leading into the BSL-4 lab. I have had a monkey chew through my air hose in the BSL-4 lab. I have had the power go out or the air compressors go out in the BSL-4. I've had holes in my suit or other breaches in personal protective equipment. I've had monkeys escape their cages and run around the room and have to catch them. I had the entire power system for my BSL-3 lab die in such a way that the emergency generator couldn't come on - on Christmas Eve.

Yeah, things happen.

 2   0  

God that seems scary. Do you get extra vaccines to make sure that if a monkey does chew your suit, you're a bit safer?

 3   0  

No, because there are no vaccines for BSL-4 agents. But, there are filters between the suit and the air hose that are designed to catch anything that gets into the hose.

 3   0  

Hello,

Sun Devil here <---- >:) !!!

Two questions, if I may:

What is the next greatest biological threat purported to be the most probabilistically possible? Perhaps you know of one that the general public isn't privy to?

Also

I was witness to a couple's conversation when I was serving them; they extended the question to me after I showed interest. The question went something like: All life seeks to procreate and survive. However, viruses just destroy, even at their own expense. Why would they do this at their own expense?

I hope I did their topic justice in recreating the question here... But, I think I got the jist of it, and it was very interesting. Perhaps you are familiar with this concept and can shed light on it some how?

Thank you!

 2   0  

I think the greatest threat going forward will be the ease by which people with less and less education and ability will be able to do more and more powerful molecular biology to change pathogens.

That's a great conversation topic. And yes, viruses replicate and sometimes kill their host with countless members of their species still inside, left to die. But viruses are focused on the survival of the species, not the individual.

By the same token, humans are doing the exact same thing - over replicating and destroying even at their own expense.

 5   0  

Is it normal to have red patches on your testicles?

Asking for a friend

 18   0  

Probably, but your 'friend' should show them to his doctor and ask. Please don't send the pictures to me!

 2   0  

Given with what you know, your life experiences, with work personal experiments and assignments. How do you protect yourself in your daily life knowing that all these threats and invisible dangers are out there? I know some might say that washing your hands. Is it really that simple??

 8   0  

Yeah, I have to say that I'm a bit of a germophobe in the world. Not neurotic or anything, but I am more aware than most of the things I touch and the people I am around. As for avoiding those dangers, it's not quite that simple, but actually, regular thorough hand washing is one of the very best things you can do to stay healthy. Especially before you eat or touch your eyes/nose/mouth. Also, use alcohol-based hand sanitizer. On top of hand washing, hand sanitizer really helps a lot against most viruses and bacteria. But make sure it has alcohol in it. Lastly, limit what you touch out in public as much as you can. Open doors with your elbow instead of your hand. And whatever you do, don't touch the rubber railing on an escalator with your hands!

 2   0  

Do you think the Dengue vaccine is a failure?

 5   0  

I thin the Dengue vaccine is a challenge. There are 4 types of Dengue, and you need to protect against them all to do much good. But Dengue is unique in that if you get infected with one type, and then get infected with a different time some time later, it makes you more sick than it would have alone. It's called antibody-dependent enhancement (ADE) of infection, and that is a huge challenge to developing an effective vaccine. But, I think it's getting closer. So, yes, we have largely failed so far, but I think there is good reason to be optimistic for the future development of Dengue vaccines.

 2   0  

Why is it that rabies is almost certainly fatal once it presents symptoms? What keeps us from being able to treat it at this "late?" stage?

 11   0  

Mainly because it gets into the brain, which is behind the 'blood-brain barrier'. That barrier makes it really hard to get drugs into the brain. And by then it is too late to vaccinate anyway.

Add to this that rabies is quite rare in the US and other well-developed countries and there is little interest in devoting money to develop such drugs. But it is a very dangerous virus for multiple reasons, and it's one of my personal goals to develop such a drug. And I have ideas on how to do that.

 2   0  

What do you think of the movies: "Outbreak" and "Contagion"?

 7   0  

I love them! But, I also enjoy poking holes in their science. You have to be able to suspend disbelief and enjoy them for what they are.

Fun fact, I know several excellent scientists who were technical consultants on Contagion. That is honestly the closest to reality (scientifically) of any movie in that genre. Very close.

 2   0  

Do you carry around Wet Wipes and purell with you?

 2   0  

You bet I do! Purell. And I give extra credit in my Virology and Bacteriology classes to students who carry it with them too. Of course, carrying it is not enough - you have to use it too. Often.

 2   0  

Have you written any magazine articles? If, so in which magazines and about which subjects in particular?

 3   0  

Just boring scientific articles in scientific journals.

 2   0  

How many months/years have you been at your current job?

 2   0  

I have been at my most recent job for almost 2 years now.

 2   0  

What are some ways diseases are spread by animals and plants to humans? Which disease are these and does this happen in the USA and what is done to stop and prevent it?

 2   0  

There are way, way too many diseases that spread from animals to humans (zoonotic diseases) to list, even in the US. But, probably the hardest ones to stop are the insect-transmitted diseases, for examples Zika virus. We try to prevent this through education (what areas are at risk, how to prevent mosquito bites, what you should do if you think you have been infected, etc) and through 'vector control', meaning spraying for mosquitoes, draining or emptying standing water breeding areas, etc. It's a multi-prong approach.

 2   0  

Does studying terrible disease have an impact on your personal life?

 4   0  

Well, it does make for excellent cocktail party talk, even if people do tend to take a step back from me when I tell them what I do. I sometimes have to work very long hours or get called in on the weekends when there is a problem. And I tend to be hyper aware or sick people and sources of contamination around me. But, no, not much.

 2   0  

Have you done TV and Radio interview in the past?

 2   0  

Yes, quite a few.

 2   0  

Thanks for the AMA, I hope this makes a little sense.

Do you have any specific or general insights or directions of interest regarding big picture evolution/biology or astrobiology/biogenesis that flow through your own specialization but are further inspired by recent exciting advances and trends in microbiology, viruses, genetic and epicenter sciences etc..?

 2   0  

Those are outside of my core areas of expertise, but I am very interested in astrobiology especially. And that specifically crosses my areas in two ways: first is concerns about alien pathogens infecting humans, and the other is in us contaminating alien environments with our microbes and thus confounding our search for life. I'm not all worried about alien microbes - their biology is likely to be so very different from ours that there will be no real chance of an infectious relationship. The second is very real and is why NASA goes through extreme measures to sterilize spacecraft that are going to land places.

 2   0  

How is the lab culture in a BSL-4 lab compared to other labs?

 3   0  

Yes. It's a smaller group. Everyone does everything, down to mopping the floors and handling the trash - no janitorial service in a BSL-4 lab. And that includes most equipment maintenance, since it is a process to decontaminate equipment out of the lab for service. People are generally really good about watching out for each other. And because of the space suits and hearing protection, it's more isolated and 'quiet', which can be really nice.

 2   0  

What do you think are our chances of the likihood of smallpox returning?

 7   0  

Accidentally? Probably pretty low. There are some thoughts that live virus might be found in bodies that were buried in permafrost areas that are now thawing due to global warming. That risk is real, but small. More risky and likely is someone recreating smallpox from scratch. Yes, that can be done, though it would take some specialized knowledge to do it.

 2   0  

Thank you for this AMA! It's fascinating stuff!
I have a couple of questions.
First, what would be the best way to educate someone who is either on the fence or misinformed about vaccines?
Second, what has been your proudest moment as a virologist?
Third, what has been your career goal?

 10   0  

First, I wish I knew a good answer for this one. I think it depends on what they perceive the issue to be with vaccines.

Autism? That has been thoroughly debunked, the paper withdrawn, the author's medical license taken away and convincing proof put forward as to how he made up the results on behalf of a law firm prosecuting vaccine injury cases.

Bad reactions? The vast majority of vaccine adverse reactions are due to allergic reactions. Doctors monitor for these and can intervene if necessary.

Vaccines cause allergies? There is no evidence whatsoever that childhood vaccines, or any others, cause allergies later in life. Anecdotal, but I have received more vaccines than most people realize exist and I have no allergies. This effect is simply not true.

Trying to describe herd immunity and why an ever-growing population of unvaccinated people puts at risk a larger and larger swath of people is difficult.

There are some good resources out there that are easy to under stand. This web site talks about the lowering of morbidity and mortaility by vaccines. And this is a simple short discussion from the CDC about what would happen if we stopped vaccinating.

As for my proudest moment as a virologist, I think that was spread out on my work on an antiviral drug called Tecovirimat, a drug that works against smallpox. I ran the drug screening effort that found this drug when I was at USAMRIID. Then later at other jobs, I ran the animal studies that showed that it could protect animals against poxvirus infections even when they were really, really sick. This drug got Emergency Use Authorization and was given to a small child who caught the vaccinia virus from his service member father on accident after he was vaccinated with it and was about to die. Tecovirimat saved the boy's life. It is now part of the Strategic National Stockpile to be used in the event of smallpox being reintroduced.

As for my career goal, well, I'm pretty much doing it right now!

 2   0  

What disease/toxin scares you the most and why?

 5   0  

Scares me personally? Probably Eastern Equine Encephalitis virus. It kills about 60% of those it infects and most of the survivors end up with permanent brain damage. There is no treatment and only an experimental vaccine that very few people ever get. It's normally transmitted (here in the US) by mosquitoes, but you can also aerosolize it and breathe it in and get it that way, hence why we study it for biodefense. Very nasty.

For others? Rabies. 100% fatal once it gets into the central nervous system. We have a vaccine, but it is not very good and is very expensive to make. But it is simply a brutal disease.

 1   0  

Wait, is my rabies vaccine not going to help me if I get attacked by a rabies-infected mammal?

 1   0  

Sorry, I should have said that rabies is 100% fatal in non-vaccinated people once the virus makes it to the CNS. Your rabies vaccination is very protective, though if you do get bitten, the doctors will probably re-vaccinate you on the spot anyway.

 2   0  

What are some of the more exotic vaccinations you've received to work in the BSL-4 environment or in the field? How often do you need to get them, and have they effected your health in any way?

Thanks for the interesting AMA!

 4   0  

Actually, there are no vaccines for BSL-4 viruses. Well, except for smallpox, but that is a special case. But I have received vaccinations for EEE, WEE, VEE, botulinum neurotoxin, yellow fever, Japanese encephalitis, rabies, smallpox, cholera, anthrax, Rift Valley fever, and all of the standard childhood type vaccines.

No health effects from any of them!

 2   0  

What method of treating infection will replace Antibiotics if we were to enter a 'Post Antibiotic Era'?

 3   0  

I wish I knew. I wish anyone knew. Right now, nothing. And that is scary.

 2   0  

Since BSL-4 is dealing with the most dangerous diseases, do you have to be vetted to make sure you're not trying to make a biological weapon? Because if someone bad were able to get into a BSL-4 area, that wouldn't be good, too say the least.

 3   0  

Not just BSL-4, but BSL-3 as well, and even BSL-2. But yes, in order to work with the most dangerous pathogens and those with the greatest potential for misuse, you have to be vetted. I and my staff have high-level security clearances, go through psychological evaluations, random drug tests and a bunch more. We also work in 2-person teams to help prevent bad actors. It's not certain, but it helps.

After the insider who we think sent the anthrax letters, we take this threat very seriously.

 1   0  

Are there biological toxins that have been created by man just for the sake of biological warfare? If so, are there instances where they have been "released" to collect data on the infectious outcome?

 4   0  

No, not really. We're not good at developing things like that from scratch yet. Nature has done a much better job than we can at making really toxic toxins. The neurotoxin produced by the bacterium Clostridium botulinum is literally the most toxic substance ever discovered. i have held enough of that toxin in my hand to kill every person on the planet, it's that toxic.

Not surprisingly, governments and a few other rogue individuals or groups have tried to use that and other toxins for biological warfare or biological terrorism. We certainly don't do any open-air tests of those kinds of things anymore for multiple reasons. But, back in the days of the offensive biological warfare programs in the US and USSR, yes, they tested biological weapons and toxin weapons in releases to collect data. Now, we can do that much cheaper and safer in lab experiments to get good enough data for defensive purposes.

 1   0  

Would you then say it's something of a miracle that one of those old tests didn't run amok and end up as a global disaster?

 2   0  

No, not really. The bacteria, viruses and toxins that we used to use for biological weapons have been around for a very long time. If they were going to wipe out all humans, they have had plenty of time to do so. Humans have selected the most pathogenic of them, and learned how to put them in the air and keep them alive for longer, etc. But I can pretty much guarantee that there is not going to be a global plague that kills of the human species. There may be one that kills a lot of us, even a majority, but not all.

 1   0  

what is the weirdest but effective defense against an infectious disease you've seen/heard of?

 1   0  

I can think of a bunch of weird ones, but unfortunately, none of them are effective... Stick to the tried and true.

 2   0  

are the masks typically worn in asian countries when people are sick effective or do they just encourage people to go out and about when they should be at home?

 4   0  

They have some efficacy in cutting down large droplets and in making people aware not to touch their face as often as most people do. But they do not protect against small particles or if you touch something then pull down your mask to rub your nose or something.

 1   0  

How has media affected your job? With news sources and social media outlets like facebook fanning the flames of fear each time a new disease is discovered, has that in your opinion had a positive or negative impact on what you do?

 4   0  

In general it doesn't affect us too much. What does happen is once a disease gets some attention, you get a lot of people misunderstanding it, misinterpreting it, miscommunicating it or just outright lying about how to protect yourself to sell some cure or something. This just ends up confusing people and causing mistrust of the scientists who actually do know how to help. The one thing I love about media attention to these kinds of issues is that it generally gets people asking questions, and it let's me help clear up confusion. It's really not the mainstream media that frustrates me (though they do sometimes get things completely wrong), but the rumors and crap that circulate on social media and other such places.

 1   0  

How is it possible to get a syringe of a virus?

 1   0  

I'm not sure what you mean. If this is in response to a previous answer I provided about smallpox, then I had grown up the virus and loaded it into a syringe to inject into an animal in an attempt to develop a model of the human disease.

 1   0  

Ok, the whole concept of putting a virus in a syringe is kind of weird to me. I don't understand it.

 1   0  

Well, we do it when we need to inject the virus into something, and we have extensive safety protocols when we do it to minimize the risk of anyone getting stuck with that needle. But you have to do it if you are going to inject it, so there is no way around it sometimes.

 1   0  

How do you personally feel about the readiness state of CDC in the face of ever increasing antibiotics resistant bacteria as well as an ever increasing population density in cities?

 1   0  

I don't think that this is just a CDC issue at all. Multiple government agencies, at all levels, need to commit to preparedness for these kinds of things. And let's not rule out the things that doctors and the general public can do to help. Antibiotic resistance is rising faster than we can develop, test and license new antibiotics. And population density just increases the chance of spread of such bacteria. We need additional research funding for development and testing from the government. We need doctors to prescribe antibiotics less frequently and only when necessary. We need people to be aware of their health and to take steps not to spread infectious diseases (see other answers for what can be done).

The CDC generally does a great job. But they are just one group tasked with a LOT of different locations, diseases, conditions, monitoring, tracking, trending, preparing, testing, etc.

 1   0  

Do you use Lysol and wipes everyday?

 2   0  

Lysol is great stuff. But most wet wipes are worthless. Stay away from them. Use Lysol or a cleaner with actual bleach in it (you have to look at the ingredients - don't just trust a brand name) at home. And use an alcohol-based hand sanitizer often!

 1   0  

Do you watch and/or attend Arizona Wildcat sports games?

 1   0  

Whenever I can!

 1   0  

Have you written any books? If so what are the titles? If not, do you want to in the future?

 7   0  

Nothing that is publicly available. But I have wanted to write a 'Virology for Dummies' type book for a long time. My wife wants me to write a book that addresses anti-vaxer points one-by-one, but I don't think it would do much good.

 1   0  

How did you like living in Georgia when you worked at the CDC?

 1   0  

Atlanta is a great, fun city with some really good food! But the traffic is terrible.

 1   0  

What are your hobbies outside of work?

 6   0  

I teach traditional Japanese jujusu (3rd degree black belt), I'm a private pilot and love to fly (when I have time and money), I homebrew beer and I love to cook. I have about a hundred other hobbies too, but those are the biggest ones.

 1   0  

That's cool, have you ever tried BJJ?

 2   0  

Yes, I have studied BJJ as well and I have black belts in 3 styles of jujutsu.

 1   0  

How does the IIT Research Institute get Its funding for Its budget?

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From sponsors such as both small and large biotech companies, and also from the government. They fund us to use our facilities and expertise to test their drug or vaccine, to test detection technologies, to develop new models, to research new assays or to manufacture new materials will let others improve their research. We are a 501c3 non-profit.

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When and how did you get interesting in terrible diseases?

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I was working on my Ph.D. in virology when I started reading more about the high-hazard pathogens, and read The Hot Zone by Richard Preston. That got me interested in these viruses and ultimately lead to my job at USAMRIID.

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Leafs capitals tonight who wins?

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Go Caps!

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Do you have any pets? If so, which types, what breeds/colors? What are their names?

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No current pets, but I have had cats, dogs and even snakes in the past.

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Have you studied the brain eating ameoba that enters through the nose from warm water like lakes, ponds, streams, and rivers?

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I have not had the chance to work on that one yet!

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How do you not have nightmares from your line of work?

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I'm not afraid of what I do. I have a healthy respect for these organisms and what they can and will do to me if I am careless. But there is no reason to be scared of them.

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If you know about AIDS, HIV...Can you please explain it to me/us? Thanks.

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You might have to get a little more specific... HIV is a virus. It infects and kills a subset of a persons white blood cells called T-cells. This cripples the persons immune system and makes it more and more difficult to fight off other infections. This leads to a syndrome called AIDS. HIV mutates very rapidly, so it is difficult to produce a vaccine or a single drug that works for very long - the virus becomes resistant quickly. So, we give people with HIV cocktails of multiple antiviral drugs that work better in combination than any one does alone. HIV is transmitted by body fluid contact.

What else would you like to know?

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In my science class, we are currently learning about genetics, is there any interesting facts about the diseases that you listed that somehow fit with genetics that I can share with my class and teacher?

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You bet! But keep in mind that bacterial genetics are a bit different than Mendelian genetics (pea plants and such) that you are probably learning about. A great example of genetics in bacteria is antibiotic resistance. One bacterium gets exposed to a low level of an antibiotic and that increases it's chance of becoming resistant. If it does become resistant, it may be able to pass on that genetic trait (resistance) to its offspring by cell division (this is called vertical transfer). It might also be able to transfer the resistance gene to another bacteria, or even another bacterial species, by conjugation or other means (horizontal transfer). This is a great example of why we need to limit the use of antibiotics to limit the development of resistance and it's spread among bacteria.

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Medical student here passionate about contributing to solutions to mitigate and slow/reverse antimicrobial resistance. What's currently being done on a technological or policy level, and what's the best thing I can do to contribute?

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Good luck in your studies! There are a lot of things you can do. First off, most doctors don't understand the problem of antimicrobial resistance nearly well enough. Educate yourself and then others about not over prescribing antibiotics, or prescribing antibiotics that are too strong/broad. Educate patients every time to take all of their meds. We need to create policies at the FDA level that allow us to hold critical new antibiotics in reserve for the extensively drug-resistant cases and not allow them to be used for any other case. And to appropriately compensate or incentivize the drug makers for allowing that.

As a doctor you can also help with clinical trials of new drugs to help them get to licensure. Such trials need doctors to participate and enroll their patients in order to get the data needed for these new antimicrobials to make it through the FDA.

Educate your colleagues, patients and students about these issues.

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Can a zombie apocalypse happen?

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No, I think we're okay. But if anything comes close, it's rabies virus.

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When out in parts of SE Asia, I noted the prevalence of fake animal vaccines (swine mostly) easy to spot due to the pricing, lack of refrigeration and labeling. The actual contents were unknown - it could have been sugar water or some f***ed-up concoction.

  • Could these conditions fuel or create new avian or swine flu threats that cross-over to humans?
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No, probably not. But what they can do is make farmers think that their animals are protects and keep them from taking other precautions, exacerbating an ongoing outbreak.

Pretty sad people will exploit situations like that.

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What was your major and how did you know this is what you wanted to do on your life?

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I majored in Molecular biology. I knew it was what I wanted to do because it was interesting and fun for me and I found that I was good at it. And then I started to learn about the virology and the high-hazard pathogens and they are so fascinating, so challenging and we need to know so much more about them that they really caught my attention. I found that my molecular biology background really trained me with an excellent set of tools to study these organisms and all work on all the associated technologies.

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How dangerous actually is HIV?

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Well, that's a tough question. If you get it, it's likely to be the thing that kills you. Especially if you live in a country with poor healthcare. But in developed countries, people are living for decades with HIV just fine. It's not the certain death sentence it once was.

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Is it stressful to handle dangerous diseases like anthrax and ebola or do you feel confident in the protection that you have ?

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Both. It can be stressful and you are definitely hyper vigilant while in the lab. It can be tiring and stressful. But at the same time, I trust in my protective equipment, the procedures and my ability. So, yeah, it's stressful but manageable.

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What are your comments on Operation Dark Winter? If a similar situation did strike the United States, where it be a bio weapon developed by a certain power to attack us, or a naturally developed virus, would our health system collapse eventually after the infection rate is too high? I am very interested in this topic, and I would love to hear from a professional 's view on this. Thanks.

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Dark Winter was an interesting exercise. It was a best-guess scenario for a massive outbreak, in that case, smallpox. And yes, I think it modeled quite well how things would likely play out. But keep in mind that the exercise was carried out almost 16 years ago now. Things have changed a lot in many areas of healthcare and diagnostics/detection. Obviously a massive, coordinated attack in multiple locations simultaneously is far harder to defend against or respond to than a very small number of natural introductions. Even so, something highly communicable like smallpox presenting in tens or even hundreds of thousands of people around the country would very quickly overwhelm our ability to care for those people, much less the worried well and all the other people with the illnesses and emergencies that we see every day in hospitals. It would be interesting to see a similar exercise today.

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Have you ever met Dr. Ken Alibek by any chance?

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Yes, many times.

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He cool? I emailed him awhile ago because I wanted to ask him some questions for a school essay. He didn't respond though.

Also, I recall reading in his biography (or somewhere else) that the Soviet Union tried producing hybrids of smallpox and Venezuelan Equine Encephalitis (Veepox) and an Ebola-smallpox hybrid. Do you think the Soviet Union could have feasibly accomplished that?

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I wouldn't hold my breath for a reply...

Smallpox and VEE or Ebola are very different viruses, and I don't see how (or why) you would bother to try to combine them. Until I see some methods and data on that, I'm calling shenanigans.

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reading this IAMA i got many interesting fact...

i got a question, if there is new virus that really deadly and really contagious like flu, how long to make the vaccine?

can govern skip the 3 year testing at animal or something?

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The government does have in place ways to get vaccines or drugs to people in shorter periods of time and with less testing required. It's called Emergency Use Authorization. The government would insist on some kind of safety data to make sure that anyone receiving the vaccine or drug isn't going to drop dead. But, if the vaccine appears safer than the disease, and helps to prevent the disease, then they can let it be used. Still manufacture and testing of such a vaccine could take 6-12 months, or more.

Interestingly, the government (DARPA) is funding work to make that timeline shorter, with a goal to be from virus identification to effective medical countermeasure in just 60 days. That is a hard goal!

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What are your thoughts on superbugs? Do you think we're going to have another Black Plague type of event soon?

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No, nothing like the black plague. But we are seeing now an increase in extensively drug-resistant super bacteria. People are dying of these infections when we thought they were basically gone or of no consequence. And those kinds of infections are only going to increase in the future. We desperately need more research on new classes of antibiotics along with effective policies for their use.

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Are some of the pharmaceutical companies responsible for the creation of some of the infectious diseases?

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No. Why would they do that? Nature is far more effective in evolving infectious diseases. We are a long, long way from designing microorganisms from scratch to have specific properties.

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Do you have any reading recommendations for someone who is very interested in virology and such diseases but has little knowledge of a such field?

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I would take a look at this book. It's pretty good, but also can be a bit technical. It may push you.

I would also HIGHLY recommend listing to the This Week in Virology (TWiV) podcast. Very good and entertaining!

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Thank you! Another question. I've heard that in gene therapy scientists use dead viruses as vectors to transfer the good genes into cells. If dangerous viruses can be modified like this, is there any theoretical possibility to "tame" a virus and program one to attack another? For example modify a flu virus so that it will start destroying itself or another virus.

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It's fairly easy to make a defective virus that is still able to deliver genes but cannot replicate. We do that a lot with Adenoviruses, Adeno-associated viruses and lentiviruses. But remember, viruses don't prey on each other - a virus does not infect another virus. So you would be dependent on having the good virus infect the same cells that the bad viruses are already infecting. And the gene that the good virus delivers has to actually do something against the bad virus, and not just be shut off by the bad virus. It's complicated, and there are easier ways to get this done.

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As a Colombian who lives in a town where everyone always has these troubles, these are my 3 questions: 1. How do you prevent mosquitoes from appearing in your home? 2. How the heck do you know if the water you consume isn't going to make you miserable with an stomach infection?. That trouble is very common in the town I live in, and even though we use ozone filters and the one with various types of stones we had still suffers from many stomach infections through the years and even monthly... And 3. Does boiled water used in food can also have virus or bacteria?... Thanks for doing this post doe, there are some really helpful comments up there.

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  1. Make sure you have good window screens, and make sure there is no standing water in or around your home for them to breed in. You can also put up mosquito nets over beds.

  2. Ozone works on some pathogens, but not all. There are commercial chemicals you can add to your water, chlorine dioxide being one of the better ones. Or filters. Or UV light. But some pathogens are more or less resistant to these as well. But, the simplest is to boil your water with a lid on the pot for 30 minutes. Also, make sure that the container you're putting your boiled water into is clean and was not washed with contaminated water (wash it with soap and boiled water, then rinse with boiled water). Same with cups and glasses. Same with your toothbrush.

  3. Yes, boiling your water for 30 minutes can be very effective!

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Which race or group of people that genetically more resistant towards virus or bacteria you've studied?

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None.

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Do you foresee a mini-industrial revolution in artificial flavouring, dyes and paints, electronics, pharmaceuticals, etc. by stuffing material into envelopes and running the envelopes through a USPS mail sorting machine? Or do you think that the method of defeating van der Waals attraction in very fine powder is more complex?

Dr. Alibek observed in his book Biohazard that he suffers from severe allergies, which he attributes to vaccine overload (pages 51, 287). I noticed in your reply to u/Realtra that you said there's no evidence of this. Why then does Dr. Alibek believe it?

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I'm not able to comment on USPS mail sorting.

As for Ken Alibek's comments in his book, I obviously cannot say what he does or does not believe. I will say that of all the people I have worked with who received extensive immunizations, none suffer from allergies any more than would be expected for the average person. Perhaps Ken is an outlier, or perhaps the vaccines the Soviet Union gave to him were dirtier than those we get.

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When you get sick do you ever worry that it could possibly be something you came in contact with in the lab? Also, when you get sick are there any special procedures that you have to go through?

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Good question. Yes, we are trained to think about what we have been doing and what we have been working with whenever we get sick. In addition, certain groups we work for in the government have their own requirements, and we are required to report any time we are sick, as well as all other medical conditions, medications, etc. It's for our health, to make sure there is nothing in our regular health that would make us more susceptible to the organisms we are working with, or would prevent us from getting treatment should we be exposed.

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What do you think about the anti-vaccination movement? Why do you think they believe in all the conspiracy theories about vaccines causing autism/genetic mutation/neurological conditions and all that? Surely there's plenty of scientific proof that vaccines are safe and effective?

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I am a firm believer in the efficacy and safety of vaccines, in the vast majority of people, the vast majority of the time. I think anti-vaxers are mostly well-meaning people, but are usually terribly uninformed or misinformed. They don't understand the science behind it and they have been sold a bill of goods by people who say that all scientists are in it for the profit and public health be damned. That is patently false. Yes, vaccine makers are there to make a profit. But the process of researching, making, testing, licensing, manufacturing and monitoring the efficacy/safety of vaccines is a very long and very, very costly process.

Yes, there is a ton of scientific research out there that shows vaccines are safe and effective. Anti-vaxers either don't understand it or choose not to believe it. They hear a few annecdotal tails of where some child might (or might not) have had a bad reaction to a vaccine and then lump all kids and all vaccines into the same pot. They never look at or understand the others that do not have such reactions.

It is very frustrating for me personally.

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Do you believe there is any validity to the idea that it would be better to space vaccines out over a longer time period vs. the standard schedule right now? Which Vaccines do you believe are the most important and why?

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There is no scientific evidence that the current childhood vaccine schedule is a problem at all. The longer you space out vaccines, the greater the risk of coming into contact with an agent without adequate immune protection. As for the importance, they are all important to the majority of people. Of course, different life circumstances might make one vaccine more important over another for any given individual, but that is up to the primary care physician to determine.