Rabies in the Americas

I’ve just returned from the Rabies In The Americas (RITA) conference in Quebec, Canada.  It was a fantastic meeting of scientists, public health officials, veterinarians, doctors, students and others all interested in rabies.  It was a week long event which included many presentations about the latest discoveries in rabies research.

Participants from all over the Americas attended including Mexico, Brasil, Argentina, other South and Central American countries as well as the United States and Canada.  There were even participants from as far away as the Philippines, China, Sri Lanka and Thailand among other Asian countries.  Africa and Europe were also represented with participants from those regions as well.  All presentations were simultaneously presented in French, English, Spanish and Portugese  through a translation service.

It was the 20th anniversary of the meeting, which was in part founded by rabies hero Dr. George Baer.  The conference organizers honored Dr. Baer’s family during the event and named a scholarship for him – the George M. Baer Latin American Investigator Award.  This award recognizes an outstanding rabies researcher from Latin America every year.  This year, the prize went to Dr. Roberto Carrasco-Hernandez who presented a model for helping limit the impact of rabies in cattle caused by vampire bats.

The conference included a Gala night of celebration, where some of the scientists attending the conference dressed up in traditional 18th century French-Canadian costumes.  A raucus auction was held to raise money for rabies research.  It was quite a spectacle to behold!

I felt honored to be among the many rabies experts at RITA.  I learned so much more about rabies and the efforts that are ongoing to limit the impact of this terrible scourge.  I felt encouraged to meet and talk to so many people who are dedicating their lives to helping wipe out rabies.

Finally, we were given the privilege to host RITA XXII at Yale University in 2011.  We now have alot of planning and organization to do!  Wish us good luck!

RW

HAART – Another chance at Life

Grace was only in her mid-forties, yet AIDS had taken its toll.  When I first met her, she was confined to a hospital bed -her facial bones protruded, eyes sunken, too weak to move.  In fact, she had bedsores over the sacrum and heels.  Those were a product of immobility, as the skeletal bones pressed in one spot for too long, cutting off circulation and forming ulcers.

Grace’s condition was so bad, she only had four CD4 cells left.  These were the ‘troops’ of the immune system.  Most people had at least 1oo times more cells per drop of blood than she had.  Only the very advanced AIDS patients had counts this low.  

I talked to her.  She had not wanted to take medications because she was concerned about side-effects.  But had she tried all the medications?  Clearly she had not.  Her medical doctors were ready to give up.  They wished to start ‘comfort measures’ where she would be given morphine and made comfortable.  She was suffering in her present condition.

I wasn’t ready to give up.  She had a family – a husband, a daughter and a wonderful grandson. I promised to do all I could to help.  I asked the medical doctors to give her one more chance – I would try a new medicine for her HIV that she hadn’t had before.  I would add a protease inhibitor – a powerful antiviral medicine used in conjunction with two other HIV medications.  Effectively this created a one-two-three punch on the virus.  This was called ‘HAART’ or Highly Active Anti Retroviral Therapy, which targeted different points in the viral life cycle. 

All we could do now was wait.  Grace was discharged home, although she was still extremely weak and couldn’t stand.  I was hoping for a miracle.  Ten days later, she came to the outpatient office.  She got up out of a wheelchair and walked a few steps into the exam room.  I was overwhelmed to see that, it took my breath away!  

Over the next few weeks she came into the clinic, visibly getting stronger.  She no longer needed the wheel chair.  The bed sores started to close and finally healed.  Her CD4 cells increased to almost 200.  The virus circulating in her blood was locked away with HAART.                               

That was three years ago and Grace is alive and well today.  I just saw her in the office with her grandson.  It was an important lesson to me as a doctor – to never give up on an AIDS patient, they deserve every chance.  I will always remember Grace’s triumph.

RW

The amazing blueberry

One of my favorite summer activities is hiking. Connecticut is blessed with an impressive array of wooded parks and semi-wild public lands. Some of my favorite hiking areas are among the ‘Hanging Hills’ of Meriden, where I’ve discovered an abundance of wild blueberries. Once I learned to recognize the leaf patterns, I realized blueberry bushes were everywhere! They often grow as ‘undergrowth’, shadowed by trees, yet they thrive at the tops of mountains where the sunlight is better. I have found blueberry bushes growing up through crags in the rock – amazing to see Life making the best of every environmental niche. There are different varieties of blueberry as well. These can be distinguished based on leaf appearance, ripening time and the taste of the berries. Nature loves diversity!

The wild blueberry is more flavorful than the cultivated variety. In fact, it’s hard to ‘go back’ after having tasted that real blueberry flavor. Although the wild berries are smaller, a handful will unleash a symphony of tart juicy sweetness! Blueberries are one of the best foods to eat. In fact, a respected doctor of nutrition – Dr. Stephen Sinatra – recommends daily consumption of blueberries. This is because of the high levels of antioxidants (anthocyanins) they contain. These compounds are thought to slow the aging process and reduce some forms of cancer. Blueberries are a foundation of good health.

Wild blueberries can still be found here in the Connecticut wilderness because of the cool summer this year. You can pick your own on a hike or seek out the cultivated variety at my favorite blueberry farm - Hrubiec Farms, 421 Southington Rd, in Kensington CT. Happy picking!

RW

Rabies Hero, Dr. George Baer

There are some people who accomplish so much in life, they shine like beacons for the rest of us. Dr. George Baer is one such figure who contributed so much.

Although he passed from this life on June 2nd, he is immortalized as a ‘Rabies Hero’ – a pioneer in the field.

I first ‘discovered’ who he was after picking up a copy of his book ‘The Natural History of Rabies‘. That book was part of my introduction to rabies, after having learned firsthand about that horrible disease on a clinical rotation in the Philippines – see my blog “My first patient with rabies“. I read everything I could find about rabies and I learned what an important figure he was.

Dr. Baer had a long and productive scientific career. He worked for the public good out of a genuine compassion and concern for humanity. He served as head of the CDC rabies laboratory for a number of years. He went on to work in Mexico, where his efforts led to dramatic improvements in reducing rabies transmission.

Among his great contributions was the development of an oral rabies vaccine. That led to eradication of wildlife rabies in most of Europe. Even up-to the time of his passing, he was busy working on an improved vaccine for influenza.

Dr. Baer influenced so many people around the world. He is an inspiration we will never forget.

RW