Live Long and Prosper

7:40 PM

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Yesterday was the 50th anniversary of Star Trek, so of course I had to walk around all day in the dress I bought because it looked like a Starfleet uniform.



Dress: Modiste
Shoes: Nine West

If Starfleet existed, you can bet I'd enlist as a member of Starfleet medical and be a science officer. One day I'll pin my Starfleet badge on this dress and wear it to a con, but til then it's a work dress. It's supposed to be a bodycon dress, but even the XS is a little bit loose on me, which makes me happy because it means that even though it's a bit short it's still relatively work appropriate (with a blazer, especially). The only thing I don't like about the dress is that despite the coolness and ease of a front zipper, when I walk or sit the zipper bunches up awkwardly, in a way not unlike the zipper of my boy’s uniform pants bunched up in high school. It’s annoying, and though not quite annoying enough to stop me from wearing the dress I probably won’t buy another dress with the same silhouette if it has a front zipper. 



Since I’m already on the subject of the future, and since in last week’s post I briefly discussed infant mortality, which was the bulk of what we discussed in class this week, I’d like to delve into what the future of global maternal and child health might look like. Last week I asked where we were in the timeline of MCH, and though I still don’t know the answer to that question because I can’t predict the future, I’d like to mention something currently happening in the field that demonstrates how much progress we’ve made over the past few decades and hint at where we might be a few decades from now.

Over the past year and a half or so, I’ve been closely following the progress of polio eradication. I watched with excitement as Nigeria was removed from the list of countries with circulating wild polio virus in 2015 and then with dismay as two cases were reported last month. However, the one thing that I’ve been anticipating the most took place in April of this year.

In April, a global move was made to discontinue administration of the trivalent oral polio vaccine and replace it with the bivalent oral polio vaccine. Think for a minute about what this means.

There are three types of wild poliovirus: type 1, type 2, and type 3. The trivalent vaccine provides protection against all three types; the bivalent vaccine only protects against types 1 and 3. No cases of wild poliovirus type 2 have been detected since 1999, and in 2015 it was announced that wild poliovirus type 2 has been eradicated. This means that there are now only two circulating types of wild poliovirus, and the reasoning behind eliminating vaccination for type 2 is that there were more cases of vaccine-derived poliovirus type 2 than wild poliovirus type 2. (The term vaccine-derived poliovirus is a bit confusing. It doesn’t mean that the people who have been vaccinated still get polio. It means that those who have been vaccinated are excreting the virus and can spread it to the unvaccinated, usually in areas of poor sanitation. This can happen when someone has been vaccinated with the oral polio vaccine, which contains a live attenuated – or weakened – virus.*) The vaccine-derived viruses can circulate when not enough people are being vaccinated to provide herd immunity.

By mid-May of this year all countries reported that they had stopped administration of the trivalent oral polio vaccine. Now, the WHO is recommending that in countries where the polio vaccine is administered, inactivated poliovirus vaccine be given alongside the bivalent oral polio vaccine. This is because the inactivated vaccine protects against type 2 paralytic polio, and there is less of a chance of circulating the virus because it reduces the amount of viral shedding and boosts immunity to poliovirus types 1 and 3.**

We are so close to eradicating polio I can almost feel it. Of course, there’s still a long way to go – Pakistan and Afghanistan still have wild poliovirus transmission – and there are still gaps in surveillance and resistance to vaccination. Even so, a decade from now we might be able to say that we’ve eradicated two human diseases: smallpox and polio.

According to NASA, we are a projected 15-20 years from getting humans to Mars. There are currently humans living in space on an international space station. Human tissue can be 3D printed, there’s a pill that can prevent HIV, and we might just be a few years from completely eliminating wild circulation of a virus that has paralyzed and killed so many.  I don’t know about you, but I feel like I’m living in the future already. So, to anyone reading this right now I wish you well and have one thing to say: Live long and prosper.

* "What is vaccine-derived polio?" World Health Organization. 2015. 
** "Cessation of Trivalent Oral Polio Vaccine and Introduction of Inactivated Poliovirus Vaccine - Worldwide 2016" CDC. 2016.



FACT OF THE DAY!

Curiosity sang "Happy Birthday" to itself on its first birthday. One year after it landed on Mars, on August 5, 2013, the Mars rover Curiosity used its Sample Analysis at Mars (SAM) instrument to sing "Happy Birthday" to itself.
source: NASA

photocred for this post goes out to my SO, who also loves Star Trek

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