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Now, I want to talk about an outbreak/epidemic that we do not know all that much about. We all know there is a problem with teenagers and adults using e-cigarettes, or vaping. But, we are now seeing an outbreak of what they call “emergency department visits related to e-cigarette, or vaping products.” Yes, that is pretty vague, but that is the name for now, until they nail down something more concrete to give it a real name. So, lets see wars going on with the vaping world.

I remember when vaping came out when I was an early teenager. It was a novelty to some, just something so cool that people bought them just because. But, years later, as of February 18,2020 there have been 2,807 cases or deaths in the United States. The visits to the ER have declined after September and spike in August. Why, you might ask? The CDC believes that there has been riding awareness, especially with THC containing E – cigarettes, as well as the removal of the vitamin E acetate from the products. There has also been more law enforcement intervention in enforcing the underage laws.

Now, the Vitamin E problem. The labs showed us that Vitamin E acetate was strongly associated to the outbreak. The vitamin E was identified in the bronchoalveolar lavage fluid samples from the lungs. Since having the vitamin E removed we have seen the huge decline in cases of EVALI (the name given to the problems associated with vaping). At Yale medicine they have started to routine ask their patients about vaping in hopes to educate them and continue their healthy bodies. Any child over age 12 is screened as well because vaping problems can appear to be something such as asthma. Well, for now, the CDC and associates are hoping the increase in cases was due to the vitamin E acetate and with the removal of the vitamin the decrease will continue. Like everyone, they hope people will stop completely and not start just because they think it’s safe again.

Humira is a monoclonal antibody drug approved by the FDA. It can be used to treat rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, chown’s disease(adult and pediatric), ankylosing spondylitis, juvenile idiopathic arthritis, ulcerative colitis, and non – infectious uveitis. Wow, okay those were a lot of big words, but now we want to know what Humira is. What is a monoclonal drug. Monoclonal drugs are antibody drugs that are produced in a lab for people who need their body-made antibodies replaced or helped out. These drugs will help their body to fight off whatever target they are after more efficiently.

Humira is a tumor necrosis factor blocker (TNF). Humira specifically targets helping the body with inflammation. This drug produces proteins through DNA technology. They are made in labs and use genetic engineering. A person who has an auto immune disease the body attacks something that is actually harmless, but it mistakes it as a threat, leading to conditions, like the ones I stated above. Although we still dont know all about the conditions, we do know that tumor necrosis factor alpha(TNFa) plays a big role in regards to inflammation. TFNa is what triggers the inflammation, which can end up being harmful with healthy tissue. This is where Humira comes in. Humira kinds to the TNFa and blocks it from being able to cause inflammation. This will reduce the pain from the inflammation for patients who have one of these diseases.

With everything good in medicine, there is usually a fallback. Now, I’m going to list the side affects slowly and not sound like a super stressed auctioneer like they do when they whisper the side affects at the end of the commercial. The Humira side affects are as followed:

• redness, rash, swelling, itching or bruising at the injection site
• infections, especially upper respiratory tract and sinuses
• headaches
• nausea
• Tuberculosis can occur and other infections caused by viruses, bacteria, or fungi. You have to be regularly checked while taking Humira
  • Cannot take if you have TB because TNFa is also used in the body for tuberculosis, and blocking this chemical will allow latent TB to emerge
• allergic reactions (hives wheezing, itching)
• Nervous system problems (weakness limbs, visual distrubances)
• blood problems (low platelet count)
• heart conditions (worsen or develop)
• weight gain
• Immune reactions (lupus like syndrome )
• joint pain
• liver problems(yellow skin, eyes)
• vomiting
• Psoriasis
• Can cause lymphoma of the liver, spleen, or bone marrow
• Swollen glands
• pale skin

Humira affects your immune system. As shown above you will become more susceptible to infections. Humira lowers the blood cells that fight the infections in your body. Because of this it is better for you to stay clear of anyone sick. Humira may also affect your blood’s ability to clot. You will have to be checked for this often and avoid activities with a bleeding risk. With Humira affecting your innate immune response and a bleeding risk, it can prove hard to do any activities and be in crowds. This was a whole lot of information, but I hope this was a better read than having to put the TV on slow mode. Do your own research to see if you think Humira is right for you!

Guillain-Barre syndrome (GBS) is an immune-mediated disease that could affect anyone. GBS is an immune attack that targets the nervous system. The nervous system is something you don’t want to mess with, it could be bad. GBS is actually the leading cause of nerve paralysis. GBS is divided into different types depending on certain features. But, even with the understanding of the pathophysiology and treatment options, there is still high morbidity rated.

Now, I really wanted to talk about something other than COVID today, but I guess it just weasels itself into everything. Guillain – Barre has always been interesting to me ever since it was introduced to me in anatomy and physiology class in high school. Well, I go to refresh myself on the disease before writing about it, and I see information that a case of COVID presented itself as GBS- like. Weakness and tingling in your limbs aero usually the first symptoms. These spread quickly and paralyze the whole body. Well, even though I didn’t want to, it is still pretty cool to look into this. So, let’s see what the GBS and COVID idea is about.

In January, a 61 year old woman showed weakness in her legs and severe fatigue. She had retuned from Wuhan the week before. But, she did not have fever, cough, or chest pain. She had good oxygen stats, but her weakness in the limbs was showing. She was diagnosed with GBS. But, then on day 8 she was developed a dry cough and fever. Her lungs began to show opacities. She was then tested for COVID and put into isolation. She regained muscle strength back in her limbs and her tests for COVID were negative. But, then her relatives tested positive for COVID. The final conclusion they made was that this is the first GBS associated with COVID. They believe she was infected in Wuhan, but the testing failed them.

So, let’s jump right back into this. Everyone across the world is chomping at the bit to try to cure COVID-19. A medical journal gives one prospective of hoping neutralizing antibodies (NAbs) will help to further the recovery and protection of COVID-19. NAbs have not been studied a lot in a clinical setting with patients. SARS-CoV-2 specific NAbs were found in patients from day 10-15 after the onset of COVID-19 and staying from there on out. The elderly and the middle aged patients had higher levels of plasma Nab titers. The article says, ” The correlation of NAb titers with age, lymphocyte counts, and blood CRP levels suggested that the interplay between virus host immune response in the coronavirus infections should be further explored for the development of effective vaccine against SARS-CoV-2 virus.”

This study was done in China and I hope to see opportunities like this being a global effort and formulating a way to help fight this pandemic. There are people recovering. Not everyone is dying. Because of this we need to be able to test to see if you currently have COVID or if you HAD COVID. Well, antibodies are our friend for testing. Dr. Zania Stamataki in viral immunology from the University of Birmingham tells us that there are two types of the test. One test is a PCR test that tells you if you currently have the virus. The other test is a serology test that asks if you have made antibodies against the virus.

IgM antibodies are detectable early in the infection of COVID. IgG antibodies will show up after them. Since this is a new disease for the whole world, no one had the antibodies for it if you have not been infected. We don’t even know for sure if the antibodies you get after having it will ensure you will not be re-infected. IgM could possibly be in the blood one day after infection, but it will not be enough for a reliable test. Because of this, the best test will be combining the antibody test and the PCR test. This will give them a 98.6% detection rate within the first 5 days of infection. If they detect for both IgM and IgG that means they are within the first month of infection and hopefully, not get re infected.

COVID-19… This is something that you are hearing everyday. It is what we revolve around right now. Everyday life as we knew it has changed immensely. Going out isn’t the same at all. Kids aren’t at school, customers aren’t at restaurants, and no one is hugging or shaking hands. All of these things are vital aspects of the South. Good ole southern hospitality isn’t here. So now the question everyone is asking is when will it end. Will there be a cure? Will there be a vaccine? How many people will die?

Vaccines. This is a controversial issue and has been for as long time. But, I sure dont see many Karens out there protesting for a vaccine to not be made for their kids. I guess the anti-vaxxers are quarantined and don’t know what to say. Is this what our life would look like everyday if there were no vaccines at all? Come on Karen, open your eyes. Well lets check in on what is happening with vaccines/treatment for COVID-19. The first thing that was done was to look and see if any existing drugs will work. Anti-Malaria drugs hydroxychloroquine and chloroquine are at the top of the list for an anti-viral approach in the United States. If a clinical trial isn’t available, these drugs have been distributed to give to patients. The hope is that the antiviral will block the infection. So far, hydroxychloroquine has not shown to be affective in treating COVID-19. Some are even arguing this approval process was all too rushed. What do you think?

China. Oh China. We always hear how they do so much different than us. Let’s be thankful they just banned the eating and farming certain wild animals. Yay, no more bats in the markets. But, this difference isn’t cultural. What drugs are China using for COVID-19? Favilavir is the first approved antiviral treatment for COVID-19 in China. Favilavir is used to fight RNA infections by inhibiting the RNA-dependant RNA polymerase. The Ministry of Science in China has said that Favilavir has shown to prevent COVID-19 from spreading further in the patient and causing extensive damage, if caught early enough. They have had X rays showing improvement in the lungs of patients, which are attacked the most. Despite being approved for use in China, the US Food and Drug Administration hasn’t approved Favilavir in the United States for an effective treatment.

It is likely that everyone has known someone with cancer. Cancer is something that we always see for benefits, research, etc… Cancer is a beast that everyone wants to be killed. Lymphoma is a type of blood cancer that started in the white blood cells. It can tend to be very aggressive and deadly. There is a therapy called CAR T-cell therapy. This therapy involves the extraction of white blood cells and reprogramming the T cells. These T cells have a protein called Chimeric Antigen Receptor (CAR). CAR is like an antibody, which makes the T cells a good component for immunity. Once returned to the body, these T cells attack the diseased cells to fight the cancer.

The engineering of a type of CAR T-cell therapy eventually called axicabtagene ciloeucel (Yescarta) has been formed for decades. This therapy has given years of people’s lives back to them that cancer wanted to take. Like so many other things, it cannot be all good. While it does give back many years back, this therapy has the possibility to cause some deficits. It can cause neurological problems. Some of these include speech issues, delirious episodes, and seizures. These are severe and can be fatal.

Because of these issues the NCI researches changed the original design of the CAR T-cell. In clinal trials it has been proved to cause fewer neurological problems while remaining to be as effective as the first trial. The new therapy showed lower cytokine levels in the blood. The researchers are attributing this to the reduced neurological problems. There is an aspect that I wish was different. One treatment of CAR T-Cell therapy can cost upwards of $375,000. This does not even include hospital stays, housing, transportation, etc… Cancer doesn’t have a filter. It doesn’t choose who it attacks or if they have enough money or not. Despite the immense cost, moments like this are monumental in medicine and I hope to see the cure for cancer in my lifetime available for people of all financial backgrounds.

Tuberculosis is caused by bacteria and is tough on the lungs. Tuberculosis is easily spread through the air. Tuberculosis was trampled immensely in the 2 decades prior to 2014. In the recent years, there have been many new strains arising. Among these strains, there are still a lot of TB drug – resistant strains. This means we should worry about the number of infected getting high again, due to lack of drugs available for effective treatment. Finding new ways to combat TB are expensive. That is why there are foundations, like the Bill and Melinda Gates Foundation to help these efforts. Like they do for many other diseases, the Gates’ donate to finding new ways to cure. On their webpage they discuss that their hope is to have an even more effective vaccine, to reduce the number of infected, which will reduce the need for drugs. The current approaches are inadequate and the Gates’ believe there should better practices in place from prevention to treatment.

Since seeing the advances slowing down, organizations like the National Institutes of Health (NIH) have put plans in place to re-vamp their approach to Tuberculosis. In September of 2018 the NIH made a plan to hope to eliminate or greatly reduce TB. Because of this new plan, 2019 was a groundbreaking year for making steps forward. There was a trial that studied people of all ages living in the home with people who had drug resistant TB. These were the core people. If they could figure out hope for them, they could move onto protecting the others. They tried administering the BCG vaccine (the world’s only licensed vaccine) intravenously instead of the usual intra dermal route in hopes to be more effective. Sure enough, it must have shown something because they had enough promising evidence to continue looking into it. Tuberculosis is a beast, and without people willing to donate, study, and research, we wouldn’t be where we are with it today.

In my lifetime I hope to see tuberculosis completely eradicated. I feel like we live in a world where medicine changes every day. Look at where we are now with COVID-19. If someone would’ve told me that this is what I would be doing in 2020, I would have had them sent for counseling. But, the good part of this is that we never know what’s coming. I hope that there is something that pops up tomorrow, next year, next decade, or as soon as possible to rid TBf from the world. The authors at the NIH note that the hope for 2020 is to build the momentum and the excitement for seeing advances for TB.

Hello, me here, Paige. Let me lay down for you what its like on an everyday basis where I live, prior COVID-19. I was born and raised in a small town in Eastern North Carolina. I come from a long line of farmers, but my farmers are not the average. My family farms, but most also have 8-5 jobs on top of it. This proves difficult in times of natural disasters, like hurricanes because they have two jobs to handle and a family. Anywho, back to the town. We are growing, but we all know everyone. If an older woman asks “who are you”(while pointing a little finger at you), she is wanting to know who your parents, grandparents, and cousins are. She also wants to know what road/part of town you grew up on. She will then tell you how she knows your grandparents. Everyday you are likely to be caught behind a 18 wheeler, tractor, or just an older couple on a Sunday cruise. Main Street is 15 mph with family businesses struggling to compete. People may have their differences, but when is comes down to do it, we support one another.

Our daily life, the hustle and bustle, the hand shaking, the hugging, and the dinner sharing, and all of it, has stopped. It doesn’t seem like life. We are a community. Life as we know it has been disrupted by COVID-19. When I first returned from UNC, nothing felt different. People were still out and moving, but now I see the terror of the elderly, the cluelessness of the kids, the empty parks, the teen hangouts deserted, and the church house empty. It just doesn’t seem normal. But, no matter what, the farmers are still out. Someone has to put the food on our tables and the clothes on our back. So many people still have to go to their office jobs as well. I work at a CPA office and I am still working, just as so many people in other towns, cities, and states. No matter how different life may seem, so many day to day operations have to be ran.

I am a first year at UNC. First semester was very hard on me. Being from a small town and a small school, I was a homebody. I went home a lot first semester, but second semester I had just gotten into the groove. I had amazing study friends for the weekend and was beginning to feel at home. I was very ready for summer, but I wasn’t ready to leave before classes being over. I enjoyed being at UNC to stay focused on my school work and home to have relief from school work. Now, the two are merged. I did online classes a lot in high school, but this is so different. I have a lot of other responsibilities at home and the farm during this hard time, so it is difficult to adjust. I know everyone is also having a hard time, so I am taking it day by day. My small town may look different, but I know our flame won’t be put out.

He we are again, ready to talk about the Corona virus? If it isn’t thrown in your face every ten seconds, do you even live on this planet? There is as much fake news about this virus as there are facts, if not more. So lets talk honestly about it because we don’t always have to be right, as long as you aren’t spreading panic. Opinions are okay, but incorrect “facts” are just waiting for disaster.

Okay, now that I’m off my soapbox lets talk about an epidemic. An epidemic is when a virus is an outbreak in a community above what we would expect. Then after is reaches all of the criteria for epidemic it is possible to move onto pandemic. An article from 6 days ago tells us that COVID-19 has already met two out of the three criteria for a pandemic. It has infected people and caused illness and it can easily be spread from person to person. The last thing is has to meet is to have worldwide spread. If I was trying to label the Corona virus I would label it pandemic because it has spread to various countries and continents, but I am not by any means an expert, so we will leave that to the qualified.

Now, let’s talk about our beloved Tar-Heel state. Just yesterday North Carolina had its first reported case of the Corona Virus in Wake county. The person is quarantined in his home and is doing well. The infected individual was exposed to the virus at the long term care facility in Washington State that has the COVID-19 outbreak. It is not us that we really need to be worried about, but our elders and the immune compromised. When I worry about this virus, it is not for me, but for my grandparents. We need to do everything we can to protect ourselves so we can also protect those that we love. Wash your hands, don’t touch your face, and like always, be careful because you don’t want to give it to granny!

In October of 2019 the CDC published a press release addressing the growing rate of newborn deaths to syphilis. The 2019 press release was discussing the data collected from 2017-2018. Congenital syphilis is the number one killer among newborns resulting from sexually transmitted diseases. In 2017 the death among newborns from syphilis increased by 22 percent. When I read this, it shocked me. Why are we having an increase in deaths from STDs in this time period? I assumed we were making such medical advances with these diseases, and this much of a downfall seems insane.

While the death rate of newborn syphilis did increase by 20 percent, the overall increase of infection was 40 percent from 2017 to 2018. This is a dangerous increase and the question we all want to know is why. Congenital syphilis can be prevented by early prenatal care. The tests are not invasive or difficult. The CDC tells us that the common driving factors for cases going undetected are drug use, poverty unstable housing, budget cuts, and decreased condom use overall. I hope to see more availability for free screenings in the next few years and see this trend turn around. It is one thing for a condition to affect the person making the decisions, but when an innocent child is involved we need to take more action.

Syphilis does have a latent stage. The latent phase can last for several years, but this is where regular testing can come in handy. The bacteria is still present, even without symptoms. If we could get more people tested, then we could treat it before symptoms even occur. At the latent stage Tertiary syphilis can occur. This is 10-30 years after the onset of the infection. This can cause major damage to the heart, blood vessels, liver, bones, and joints. Tertiary syphilis is very dangerous and often leads to death. If the patient is treated early with penicillin this can be avoided. If nerve or organ damage occurs you can treat at that stage to stop further destruction, but you cannot unto the damage that has been done. I believe if we educate more on STD like this to our young people they would be more likely to practice safe sex and get tested. It is terrible that they need this scare, but it is reality and if we lose the “taboo” of speaking on STDs a lot can change.