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Virus

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By Daniel Dunaief

Daniel Dunaief

I’ve been on a long journey that’s taken me around the world for more than two and a half years. Many hosts have provided for me, enabling me to grow and, in some cases, make changes.

I don’t recall the beginning. The first host I remember was an incredibly kind doctor. She spent countless hours caring for others, looking into their eyes, assuring them she would do everything she could for them.

She was so focused on helping others that she didn’t even know she was hosting me. I stayed quiet just long enough to make the jump to a famous American actor who was working in Australia.

He and his wife didn’t enjoy their time with me. They warned the world about me and my extended family.

My next host was a businessman. He had been in a hospital with his son, who had a broken leg. The businessman stayed in the waiting room for hours, trying to do his work but unable to focus because he was so concerned about his boy.

Finally, after hours of surgery, the doctor came out to talk to him and that’s when I found a new host.

This businessman worked hard. Once he discovered his son was safe, he ignored me and my needs.

I developed without anyone noticing me. At one point, I heard someone come looking for me, but I hid just far enough away. I traveled a great distance on a plane with him. Once we were in a new country, I had so many choices.

Realizing it was time to go, I jumped to an elderly bus driver. He was a gentle man. The lighter laugh lines near his eyes looked like waves approaching the shore on his dark chocolate skin.

Before he collapsed into bed the second evening we were together, he seemed to be staring directly at me. In his house, I had a choice of other possible hosts, but decided to hitch a ride with his son.

That one almost cost me my life. His son soon realized I was there, and he stayed away from everyone. I was curled up alone with him. He barely moved for long periods of time, except when he coughed or sat up and sent text messages and emails. One night, when he was finally sleeping, a man came into his room to clean it. That’s when I escaped.

This man didn’t even know he hosted me. He wasn’t stuck in bed, and he didn’t cough. I traveled with him to several events. After other trips, I found an important politician. We took a ride in a helicopter and went to a hospital where doctors provided all kinds of new medicines.

I became like a game of telephone, passing along from one person to the next. And, like a game of telephone, the message changed, as I demanded different things from my host.

I found myself at a concert with a young woman who sang and danced for hours. She looked so vibrant and full of life.

She was a friendly enough host, until I set up camp with her mother. Then, she shouted at me, praying to keep me away. She took me to a hotel, where she seemed to stare at me while she prayed.

When someone delivered food and walked in the room to wait for payment, I made the jump to him. During the day, he was a student with a full and busy life. I didn’t stay long, moving on to his girlfriend, her roommate, and, eventually, to a professor.

I stayed with the professor for over a week. She spent considerable time grading papers, writing at her computer, talking to family members, and taking medicine.

I have made some changes along the way. I don’t travel with as much baggage as I used to. I know people think I’m not as much of a burden as I was in the early days. My most recent host would disagree. He couldn’t talk, had trouble sleeping and was exhausted all the time. I’m getting ready to travel the world again this fall and winter. You can ignore me all you want, but I’m still here, making changes and preparing to find more hosts.

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While the risk from the new deadly coronavirus that has closed cities in China remains low in New York, Long Island hospitals, including Stony Brook, are working with the New York Department of Health to prepare in case it makes its way to the New York area.

The respiratory virus, which originated at a seafood market in Wuhan Province in China during contact between humans and an animal that reportedly could have been a snake, has claimed the lives of 132 people as of Jan. 29. The virus has spread to three states, with single cases in Seattle, Washington, and Chicago, Illinois, and two cases in California.

The reported deaths from the virus are all in China, although people have also tested positive for coronavirus in countries including Australia, Canada, France, Japan and Vietnam, among others.

As of earlier this week, New York State had sent samples for nine people to the Centers for Disease Control and Prevention for testing. Four samples tested negative, while the state is awaiting results for the other five.

A Q&A with  Susan Donelan, Medical Director of Health Care Epidemiology, Stony Brook University Hospital, About the New Coronavirus

1. Is the outbreak plan for this new coronavirus any different than the plan for SARS or MERS at Stony Brook?

The 2019 novel coronavirus (2019-nCoV), a new virus that causes respiratory illness in people and can spread from person to person, shares a lot of similarities to other coronaviruses we have seen such as SARS and MERS-CoV. At Stony Brook Medicine, our teams are incorporating best practices from the Pandemic Influenza Plan. These practices are especially important during the flu season.

2. Is everyone in the emergency room taking a history on admission, particularly for people presenting with respiratory infections and a fever, that includes questions about travel to China?

As a matter of standard practice for many years, the hospital has asked all patients with any influenza-like illness [ILI] about recent travel history and is well versed in obtaining this information. Additionally, regardless of the presence or absence of travel, any patient presenting with an ILI immediately will be given a surgical mask to place over the nose and mouth, in order to limit the spread of any respiratory pathogen they may be harboring.

3. How much space could Stony Brook make available if the hospital needed to isolate people who might have this virus?

Stony Brook Medicine has already performed a walk-through of our facility to identify where patients could be cohorted if there were suspicions for this illness, and should they need hospitalization. As per the [CDC], people confirmed to have the 2019-nCoV infection, who do not need to be hospitalized, can receive care at home.

4. What is the current recommended treatment plan if someone either has or is suspected to have this virus?

Currently, there is no vaccine available to protect against 2019-nCoV and no specific antiviral treatment is recommended for the infection. People infected with 2019-nCoV should receive supportive care to help relieve symptoms.

“These five individuals remain in isolation as their samples are tested at CDC,” Gov. Andrew Cuomo (D) said in a statement. “While the risk for New Yorkers is currently low, we are still working to keep everyone informed, prepared and safe.”

China has been working to contain the virus by enforcing lockdowns in cities like Wuhan. Indeed, an unnamed Stony Brook scientist, who was visiting his family, has been unable to leave China to return to Long Island. Through a spokeswoman, Stony Brook said it is grateful for the help of Sen. Chuck Schumer (D-NY), the State Department and the university community in trying to bring him home.

When he returns to the United States, the professor will remain in quarantine until he could no longer be a carrier for the virus. 

Area hospitals, meanwhile, are watching carefully for any signs of coronavirus.

“There are procedure plans in place in every hospital,” said Dr. Bettina Fries, chief of the Division of Infectious Diseases in the Department of Medicine at Stony Brook University’s Renaissance School of Medicine. “There is always a concern when these outbreaks are announced.”

At this point, however, the World Health Organization has not declared the outbreak an emergency. The CDC has classified the new coronavirus threat level as “low.”

The coronavirus, called 2019-nCoV, is in the same family as sudden acute respiratory syndrome and the Middle East respiratory syndrome. The initial mortality rate from the current coronavirus is lower than the 10 percent rate for SARS, which spread in 2002, or the 30 to 35 percent rate from MERS, which started in Saudi Arabia in 2012.

The timing of the virus is challenging because the symptoms are similar to those for the flu, which has become more prevalent in New York and around the country this winter. Coronavirus symptoms, according to the CDC, include coughing, fever and shortness of breath.

While airports like John F. Kennedy Airport in Queens are screening people who arrive from Wuhan, efforts to determine whether they may be carrying the virus could be limited, in part because the incubation period could be as long as two weeks, during which time an infected person could be contagious.

Infectious disease experts suggested practicing the kind of hygiene that would reduce the likelihood of contracting the flu. This includes: washing hands for at least 20 seconds, using hand sanitizer and maintaining a distance of about 3 feet from anyone who has the sniffles or appears to be battling a cold. Infectious disease experts also suggest cutting back on handshakes, especially with people who appear to be battling a cold.

“If you have immunocompromised people, they should be extra careful,” Fries said, adding that the CDC, which has been regularly updating its web page, www.cdc.gov, has been working tirelessly with national and state health officials to coordinate a response to this virus, wherever it hits.

“The New York State Department of Health and the CDC need to be praised for all the work” they are doing, she said. “They have a task force that doesn’t do anything else but prepare for patients coming from outbreak areas.”

Scientists around the world have also been working to develop a vaccine for this new virus. According to a recent report in The Washington Post, researchers anticipate developing such a vaccine in as little as three months, which is considerably shorter than the 20 months it took to develop a vaccine for the SARS virus. The Post, however, suggested that the development of a vaccine would require testing before it received approval.

Fries said the concern about the coronavirus comes less with the current death toll than it does with the effect as it continues to spread.

“It’s important to see how far it spreads and what the real mortality is,” which is tough to track because the outbreak is still at the beginning and scientists and public health officials are still processing new information, she added.

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Puppies and older dogs are especially susceptible to contracting the Canine Influenza virus. Stock photo

By Matthew Kearns, DVM

There has been a lot of media attention recently about outbreaks of the canine influenza virus (CIV), the H3N8 strain, which was first reported in racing greyhounds in Florida in 2004.  Rather than the typical respiratory infections (both viral and bacterial) that were limited to mild upper respiratory signs (coughing, sneezing, etc.), many of these dogs developed a sudden onset of severe pneumonia and death.

Later that year similar cases were documented in shelters and veterinary clinics in the New York City area. Dogs that recovered were tested at the Cornell Animal Health Diagnostic Center at Cornell University and tested positive for the  CIV H3N8 strain. In 2011, there was another outbreak in the NYC Metro area (three cases in NYC, three in Nassau County but none in Suffolk County) of the CIV H3N8 strain.

Fast forward to 2015 — an outbreak of the CIV occurred in the Chicago area that affected more than 1,000 dogs and led to eight deaths. Another outbreak shortly after the Chicago incident occurred in the Atlanta area affecting approximately 80 dogs (no deaths). In December 2015, another outbreak occurred in the Seattle area affecting approximately 80 dogs (again, no deaths).

Interestingly, none of the cases in 2015 were caused by the CIV H3N8 strain, but rather an H3N2 strain. The H3N2 strain was previously only seen in Asia (first diagnosed in 2006-2007). It is believed that this Asian strain gained entrance to the United States through Chicago’s O’Hare Airport inside a dog from Korea.

CIV is passed from dog to dog via aerosolized respiratory secretions from coughing, barking, sneezing, contaminated objects (food and water bowls, kennel surfaces) and people moving between infected and uninfected dogs. Dogs that stay at kennels, groomers, doggy day care, parks etc. are more at risk.

Approximately 80 percent of dogs exposed to CIV will show symptoms of the disease and the other 20 percent will not. This is unfortunate because this 20 percent may not show symptoms, but they can still shed virus and spread disease.  Symptoms will start three to five days after exposure and can be very mild to severe. 

Mild symptoms include a low-grade fever, runny nose and cough. Severe symptoms include pneumonia and in some cases death. Risk factors include age (the very young and very old are most severely affected), pre-existing disease or genetic susceptibility. There is no evidence at this time that CIV poses any health risk for humans.

Treatment for CIV is supportive in nature. Less severe cases where the patient is able to eat and drink are self-limiting in nature and symptoms resolve within three to seven days. More severe cases require hospitalization, IV fluids/medications, nebulization treatments and, in some cases, supplemental oxygen.

Two vaccines against the CIV H3N8 strain (the first was approved by the FDA in 2009) are available for dogs at this time. The goal of the vaccine is to expose the host (in this case dogs) to a weakened or inactivated form of the virus and stimulate the immune system to produce antibodies against it. Then, if the host is exposed to the virus naturally, the immune system will respond rapidly and fight the infection before signs of disease will occur.

At this time there is good news and bad news. The good news is there have been no reported cases of either strain of CIV in Suffolk County. The bad news is there is no evidence at this time that the vaccine currently available will protect against the new Asian strain (it may, but the veterinary community just doesn’t know at this time).

Please consult with your veterinarian as to whether your dog is at risk for the CIV virus (H3N8 or H3N2 strain) and whether vaccine is warranted for your own dog.  I will keep everyone posted through Times Beacon Record Newspapers as new information becomes available.

Dr. Kearns has been in practice for 16 years.

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Huntington Hospital is taking preventative steps to ensure its patients know how to combat the Zika virus.

The World Health Organization declared the Zika virus a “public health emergency of international concern” this week, just days after three Long Island patients tested positive for the virus. The Centers for Disease Control issued a travel alert for anyone going to regions including South America and Latin America, and Huntington Hospital officials said they were making sure to educate their patients about the symptoms and steps to take if diagnosed with the viral infection that is being spread through mosquitoes.

Denise Naval, director of infection, prevention and control at Huntington Hospital, said that while there is currently no treatment for the virus, there are several precautions a person can take to fight off the mosquito-related Zika.

Naval said the virus is closely related to Yellow Fever, the West Nile Virus and the Dengue virus, which are all also spread through mosquito bites. She said the Zika virus is spread from the Aedes mosquito, specifically.

There are two types of Aedes species, Aedes aegypti and Aedes albopictus, but only the former currently carries Zika with it and it is not native to Long Island, she said. It’s most common in tropical areas of the world. The latter does not currently carry the virus and is found in certain parts of the United States, including Long Island, she said.

Naval also said Zika can not only be transmitted from a mosquito to a human, but also vice versa — from a human to a mosquito.

“Only 20 percent of people will get symptoms,” Naval said in a phone interview. “Eighty percent of people infected won’t even know they are.”

According to the CDC, symptoms from the Zika virus include a fever, rash, joint pain, headaches and more.

Once infected, the CDC says patients must get rest, drink fluids to prevent dehydration, and take medicine such as acetaminophen to relieve fever and pain.

New York Gov. Andrew Cuomo recently announced that the New York State Department of Health, in conjunction with the CDC, would offer free blood test screenings for individuals who have traveled to areas where the Zika virus is going on.

“We’re working closely with the CDC and local health departments to address potential cases of Zika Virus, and by offering free testing we are helping to stay ahead of this disease and protect the public health,” Cuomo said in a press release.

Naval said if anyone must travel to the tropic regions, where Zika is a problem, there are some key precautions they can take.

“Make sure to use bug spray with DEET; stay indoors with air conditioning if you can because insects prefer heat; and wear long sleeves and long pants,” she said.

Aside from a warning for all travelers to avoid these tropic areas, there is also an extra precaution for pregnant women, as there is an added risk for a child whose mother has the Zika virus while pregnant.

The baby can be born with microcephaly, a neurodevelopmental disorder where a baby is born with a smaller head than usual, or other neurological and autoimmune complications, officials said.

According to the WHO, in countries like Brazil there has been an increasing body of evidence about the link between Zika virus and microcephaly. This specific brain disorder is linked to seizures, developmental delays in speech and walking, intellectual disabilities, feeding and vision problems, and more, according to the CDC.

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County: 26 samples collected last month bring total up to 46 this year

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Twenty-six mosquito samples and one bird have tested positive for the West Nile virus in various parts of Suffolk County, Dr. James L. Tomarken, the county’s health commissioner, announced on Friday.

The bird, an American crow, was collected on July 31 from Port Jefferson. All the mosquito samples that came back positive were collected on July 29, according to the county. Five of them were from West Babylon, four were from Farmingville and three were from Lindenhurst; as well as two samples each from Northport, East Northport, Huntington Station, Nesconset and Port Jefferson; and one sample each from Greenlawn, Selden, North Babylon and West Islip.

To date this year, 46 mosquito samples and four birds have tested positive for West Nile virus.

The virus was first detected in birds and mosquitoes in Suffolk County in 1999. It is transmitted to humans by the bite of an infected mosquito. No humans or horses have tested positive for West Nile virus in Suffolk this year.

While Dr. Tomarken said there’s no cause for alarm, he urged residents to take steps to reduce exposure to the virus.

Residents should eliminate stagnant water, where mosquitos breed. Popular breeding grounds include tin cans, plastic containers, ceramic pots, discarded tires, wading pools, wheelbarrows and birdbaths. In addition, residents can make sure their roof gutters are draining properly, clean debris from the edges of ponds and drain water from pool covers.

Minimize outdoor activities between dusk and dawn to avoid mosquito bites, make sure windows and doors have screens and wear clothing that covers you when outdoors for long periods of time, or when mosquitos are more active.

To report dead birds, which may indicate the presence of the virus, residents should call the county’s West Nile virus hotline at 631-787-2200 from 9 a.m. to 4 p.m., Monday through Friday. Residents are encouraged to take a photograph of any bird in question.

To report mosquito problems or stagnant pools of water, call the vector control division at 631-852-4270.

For medical questions, call 631-854-0333.

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Mosquito samples from Port Jefferson Station, Rocky Point and East Northport have tested positive for West Nile virus, Suffolk County Health Services Commissioner James Tomarken announced on Friday.

In total, six mosquito samples tested positive for the virus, bringing this year’s total to 13. While the insects were infected, no humans, horses or birds have tested positive for the virus in Suffolk County this year.

Two samples collected from Port Jefferson Station on July 14; one sample collected from Rocky Point on July 16; and one sample collected from East Northport on July 17 tested positive, according to a press release from the health services department. Two other samples were gathered from Copiague and Dix Hills.

West Nile virus was first detected in birds and mosquito samples in Suffolk County in 1999, and is transmitted to humans by mosquito bites. According to the Center for Disease Control, 70 to 80 percent of those infected with the virus do not develop any of the symptoms, which can include fever, headache, body aches, joint pains, vomiting, diarrhea and rash. Severe cases — less than 1 percent of infections — could lead to a neurological illness.

Tomarken said while there is no cause for alarm, his department is asking residents to help in their efforts to reduce the exposure to the virus.

First, residents should try to eliminate stagnant water where mosquitoes breed. Popular breeding grounds include tin cans, plastic containers, ceramic pots, discarded tires, wading pools, wheelbarrows and birdbaths. In addition, residents can make sure their roof gutters are draining properly, clean debris from the edges of ponds and drain water from pool covers.

To avoid mosquito bites, residents should minimize outdoor activities between dusk and dawn, cover up when mosquitoes are most active, use repellent and make sure windows and doors have screens in good repair.

To report dead birds, which may indicate the presence of the virus, residents should call the county’s West Nile virus hotline at 631-787-2200 from 9 a.m. to 4 p.m., Monday through Friday. Residents are encouraged to take a photograph of any bird in question.

To report mosquito problems or stagnant pools of water, call the vector control division at 631-852-4270.

For medical related questions, call 631-854-0333.

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A deer tick is a common type of tick on Long Island. Stock photo

As Long Islanders are warned about an uptick in Lyme disease, another tick-borne virus has emerged in Connecticut across the Long Island Sound.

Nearly 12 years ago, Eric Powers, a biologist and wildlife educator, noticed an increase in the tick population at Caleb Smith park in Smithtown, after pulling nearly 40 ticks off a group of his students.

Powers conducted a survey of the park and discovered the population of tick predators had decreased, as feral and outdoor house cats either chased them off or killed them.

“It’s becoming a huge nationwide issue with our wildlife,” Powers said during a phone interview. “Wherever people are letting their cats out, we’re seeing this disruption in ecosystem where these tick predators are gone.”

But what Powers did not find was the prevalence of a tick-borne virus, the Powassan virus, which recently appeared in Bridgeport and Branford in Connecticut.

Between 1971 and 2014, 20 cases of POW virus were reported in New York, according to the Cornell Cooperative Extension in Suffolk County. The Centers for Disease Control and Prevention reports the virus has been found in Maine, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Virginia and Wisconsin.

Like Lyme disease, the virus can cause long-term neurological problems if left untreated. But Long Island POW virus incidences remain low despite the increase in tick population, according to Daniel Gilrein, an entomologist at Cornell Cooperative Extension.

POW virus, which is related to the West Nile virus, was first identified in Powassan in Ontario, Canada, in 1958 after a young boy was bitten by an infected tick.

Little is known about how much the tick population has exactly increased on Long Island, but Tamson Yeh, pest management and turf specialist for the Cornell Cooperative Extension, said it is unlikely cats are contributing to the increase by eating tick predators like birds.

“Birds will eat ticks, but not all birds are insect eaters,” Yeh said in a phone interview.

She said the snow cover during the winter months served as insulation for the ticks hiding in the ground, which helped them survive during the colder weather.

Richard Kuri, president of R.J.K. Gardens, a St. James-based landscaping company, has not noticed an increase in tick population recently. Regardless, he and his men continue to wear long sleeves and use a variety of sprays to ward off bugs while on the job. Kuri also said people may use more natural remedies to deter ticks.

“There are people who apply peppermint oil and rosemary mix that will help,” Kuri said. “But none of them are cure-alls.”

He added that granular insecticides, like Dylox, help kill a variety of unwanted bugs including ticks carrying viruses like Powassan.

There are two strains of the virus, which are carried by woodchuck and deer ticks. Since only about 60 cases of POW virus were reported in the United States in the past 10 years, Yeh said the chance of encountering POW virus is unlikely since the virus is rare.

Symptoms of the virus include fever, headaches, vomiting, weakness, confusion, drowsiness, lethargy, partial paralysis, disorientation, loss of coordination, speech impairment, seizures, and memory loss. Other complications in infected hosts may possibly arise, such as encephalitis, inflammation of the brain and meningitis.

Powers said he hopes to reduce tick population on Long Island through his quail program. He encourages local teachers, who use chicks or ducklings to educate their students about the circle of life, to raise bobwhite quails. He said releasing these quails annually will not only help them adjust to the presence of cats, but also control the tick population.

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Sacre bleu! Incoming Stony Brook researcher studies mind control in ladybugs

Nolwenn M. Dheilly photo from Dheilly

Mind control may not be unique to scriptwriters, hypnotists or even, as it turns out, humans. A parasitic wasp may have teamed up with a virus to turn an unsuspecting ladybug into a meal ticket and a sentry for its developing larva.

Wasps inject their larva into a ladybug where they turn the insect’s body fat into food for their young. When the larva extracts itself from the abdomen of the ladybug and spins a cocoon in which it pupates into an adult wasp, the ladybug remains in place on top of the cocoon, deterring predators by twitching.

These parasitized ladybugs often recover from the invasion, repairing the external and neurological damage.
Nolwenn M. Dheilly, who specializes in studying host-parasite interactions and is interested in the role of associated microorganisms, discovered the presence of the virus in this convoluted story of parasite and host.

Dheilly showed that the virus is transmitted to the ladybug during parasitism and the virus copies itself in the nervous system of the ladybug, whose immune system is suppressed during the invasion.

Dheilly, who will join Stony Brook University as an assistant professor in August from her native France, is part of a six-person multidepartment hire in genomics led by Bassem Allam, a professor at Stony Brook in the School of Atmospheric and Oceanic Sciences (SoMAS) and Jackie Collier, an associate professor at SoMAS.

“The search committee and my colleagues at SoMAS were impressed by the quality of [Dheilly’s] work and the forward thinking of her ideas,” explained Allam. She “brings state-of-the-art research tools to answer questions pertaining to the evolution of symbiotic associations.”

Lessons in middle school and high school biology classes often include a discussion of symbiotic relationships, which come in three different types: parasitism, like the wasp and the ladybug, mutualism, where both organisms benefit, and commensalism, where one benefits and the other neither benefits nor is harmed. Dheilly said the classification of symbiosis does not account for the inherent complexity in nature, where there is much more of a continuum from mutualism to parasitism.

Dheilly’s work suggests that other organisms, like the virus for the parasitic wasp, may affect the output of the infection.

“Many other parasites may use other microorganisms, including viruses, as partners,” Dheilly said. Many protozoan parasites, including human pathogens such as Plasmodium, are associated with viruses, she said. When a parasite infects its host, it can become co-infected with the virus.

“It remains to be demonstrated if these viruses are used as biological weapons,” Dheilly said.

To be sure, in the case of the wasp, the ladybug and the virus, Dheilly cautioned that other studies are necessary before completing a relationship diagram that specifies the way the virus and wasp might work together during parasitism.

“Many complementary studies are now necessary to demonstrate who between the wasp and the virus” is responsible for the particular effect on the ladybug,” she said. “We believe that the virus alone would be eliminated by the [ladybug’s] immune system and wouldn’t be able to induce the paralysis. We have no idea if the parasitoid wasp would be able to infect the [ladybug] without its associated virus.”

When Dheilly arrives on Aug. 12, she and Allam plan to work together to study disease susceptibility in oysters. They would like to study the role of mucosal secretions in early host-symbiont interactions.

Dheilly attributes some of her interest in marine science to her upbringing in Brest, Brittany, in northwestern France, which, she said, is much like Long Island. When she was young, Dheilly competed in windsurfing competitions and, later, worked for several summers as a windsurfing instructor. In her windsurfing days, Dheilly was the only girl at most competitions. Her windsurfing experience “made sure I had the right personality to be involved in an environment surrounded by men and not feeling as if I didn’t fit in.”

Dheilly explained that understanding viruses and microorganisms extends beyond the world of invertebrates.

“The co-evolution of host and parasites with microorganisms is applicable to any biological system, including humans,” she said. Even though she will focus most of her work at Stony Brook on marine organisms, she said she “would be happy to collaborate with researchers in other fields to verify my hypotheses.”

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