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Antibiotic resistance: World on cusp of 'post-antibiotic era

Discussions related to the physiological and psychological effects of peak oil on our members and future generations.

Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby Pops » Tue 06 Dec 2016, 09:39:16

Bad Dot:
$this->bbcode_second_pass_quote('', 'C')arbapenems are a last line of defense against drug-resistant bacteria. While plasmid-mediated carbapenem-resistant Enterobacteriaceae (CRE) have been reported in European and Asian livestock and are known to cause life-threatening infections in US healthcare settings, this is the first time they have been identified in US livestock.

http://www.cidrap.umn.edu/news-perspect ... swine-farm
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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby onlooker » Fri 13 Jan 2017, 15:16:38

http://www.livescience.com/57248-nightm ... unity.html
'Nightmare' Superbug May Have Spread Outside Hospitals
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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby Tanada » Sat 21 Jan 2017, 12:14:30

$this->bbcode_second_pass_quote('', '[')size=150]A Woman Just Died From an Infection No U.S. Antibiotics Could Beat[/size]

The woman from Washoe, Nevada was in her 70s and had an infection in her hip. She’d contracted it in a hospital in India after fracturing her leg. Doctors in Reno attempted to tame her infection, trying every antibiotic they had. 26 in all. None of them worked, not even colistin, their last line of defense. The woman died.

The CDC’s report on her case, issued January 13, is sending a chill through the medical world: They’ve been worried for years about the appearance of a superbug that beats all of our antibiotics. Is this what happened here? It turns out that maybe she could have been saved using an antibiotic called fosfomycin not approved in the U.S. for treating the kind of infection she had. Even so, her case has troubling implications.

Post-mortem testing of the woman’s bacteria revealed that something new is going on. Previous infections that have been resistant to treatment with colistin have had a single critical gene, MCR-1. This woman’s bacteria didn’t have this gene, so there’s some previously undiscovered mechanism at work.

Even prior to this, the protective firewall provided by colistin has been cracking. The drug was discovered in 1949 but went largely unused for a long time due to its harmful effect on the kidneys. It came to prominence as a last-line drug after bacteria strains showed signs of developing resistance to other key antibiotics — colistin had been so infrequently used meant that bacteria hadn’t yet had the chance to develop resistance to it.

But those days are apparently over. Colistin has become a popular, inexpensive additive to animal feed as both an antibiotic and also a way to quickly add muscle to animals. Agricultural demand for the drug reached 11,942 tons per year in 2015, and is expected to reach 16,500 tones by 2022. (73% of it is used in Asia, and 28.7% in Europe.) And the MCR-1 gene is now found in livestock and humans, suggesting that colistin’s days as a super-antibacterial are numbered.

One of the scariest aspects of the MCR-1 gene, by the way, is that it doesn’t live in a bacteria’s chromosome. Instead, it’s contained in a plasmid, a small, unattached bit of DNA. What’s worrisome about this is that, being independent, it can attach to any bacteria, thus making it resistant to colistin. The danger is that an MCR-1 plasmid, having been consumed in pork or chicken, attaches to some other bacteria it encounters in your gut. This is clearly already happening in patients carrying the MCR-1 gene. And it may a lethal recipe for the evolution of pan-resistant bacteria.

Fosfomycin, the antibiotic to which the woman’s bacteria showed some reaction post-mortem, is another old drug for which little resistance has yet been developed. It’s approved in the U.S. for treatment of urinary-tract infections, but not for intravenous use in fighting infections. Some wonder if and when the U.S. FDA will widen its availability for use.

As for the woman in Nevada, she was, thankfully, kept well-isolated from other patients and staff. Samples taken from the hospital have so far shown no sign of her bacteria anywhere, so a deadly outbreak seems to have been avoided. For now.


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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby Ibon » Sun 22 Jan 2017, 07:20:37

For years we have been hearing about these super bugs, isolated cases of patients dying due to failure of antibiotics. None of these bugs have yet jumped the confines of isolated cases in hospitals and have managed to spread far.

I am not holding my breath that this will happen any time soon. The Overshoot Predator is a lazy bastard for some reason when it comes to using pathogens.

A recent article mentions only 600 deaths in the past year to superbugs in the US. That's insignificant .

https://www.statnews.com/2017/01/16/cre-superbug/

This article is typical, full of the potential threat but when it comes down to actual transmission we see that these superbugs, for all their resistance, seem to be poor at transmitting disease.

Hanage said they didn’t find a lot of evidence of transmission, but they did see “a riot of diversity.” There were more specific families of bacteria represented among the CREs than they had expected. And there were additional surprises.

Folks, go back to worrying about climate change. I don't see anything on the horizon regarding superbugs coming to the aid of our planets infestation with the biggest superbug of all.........us.
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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby onlooker » Sun 22 Jan 2017, 08:30:35

The Influenza Pandemic of 1918
The influenza pandemic of 1918-1919 killed more people than the Great War, known today as World War I (WWI), at somewhere between 20 and 40 million people. It has been cited as the most devastating epidemic in recorded world history. More people died of influenza in a single year than in four-years of the Black Death Bubonic Plague from 1347 to 1351. Known as "Spanish Flu" or "La Grippe" the influenza of 1918-1919 was a global disaster. "
Have to agree in the sense that as a percentage of the population the world had approximately 1.8 billion people in 1918, so the Spanish flu killed about between 2 to 3 percent of the population. Now the plague was said to have killed from 1/3 to 1/2 of the European population. Which was before we had any of the modern effective medical techniques and knowledge of infection treatment and control. I can think of nothing really that will control our population and decrease it substantially except food shortages on a massive scale and an all out nuclear war. We may be in fact able to adapt to climate change over the long terms albeit with a smaller population.
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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby Ibon » Sun 22 Jan 2017, 08:59:42

$this->bbcode_second_pass_quote('onlooker', 'T')he Influenza Pandemic of 1918
The influenza pandemic of 1918-1919 killed more people than the Great War, known today as World War I (WWI), at somewhere between 20 and 40 million people. It has been cited as the most devastating epidemic in recorded world history. More people died of influenza in a single year than in four-years of the Black Death Bubonic Plague from 1347 to 1351. Known as "Spanish Flu" or "La Grippe" the influenza of 1918-1919 was a global disaster. "
Have to agree in the sense that as a percentage of the population the world had approximately 1.8 billion people in 1918, so the Spanish flu killed about between 2 to 3 percent of the population. Now the plague was said to have killed from 1/3 to 1/2 of the European population. Which was before we had any of the modern effective medical techniques and knowledge of infection treatment and control. I can think of nothing really that will control our population and decrease it substantially except food shortages on a massive scale and an all out nuclear war. We may be in fact able to adapt to climate change over the long terms albeit with a smaller population.



The scale of human overpopulation often reminds me of the level of debt the USA has which is now in the trillions. These are numbers that we can no longer wrap our heads around. Let's take the 1918 influenza pandemic as a good example. It was estimated that 3% of the worlds population perished some 50 million people.

That would mean approx 220 million people dying today if a similar pandemic appeared killing 3% of the population. Try to take a moment and grasp that 220 million people would die and this represents an insignificant 3% of the human population.

This would represent a minor fender bender. Not a head on collision by any means on putting on the brakes of our overpopulated world.
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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby Cog » Sun 22 Jan 2017, 09:38:03

The next series of bugs will be destroyed by genetic engineering.
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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby Shaved Monkey » Sun 22 Jan 2017, 22:34:48

or Phage Therapy
Phages are naturally occurring viruses that kill bacteria.
Once they get into bacterial cells the phages' DNA replicates until it kills the host.
Soviets have been doing it for 90 years
Still Popular in Russia Poland and Georgia


https://en.wikipedia.org/wiki/Phage_therapy

http://www.bbc.com/news/health-21799534
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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby Ibon » Mon 23 Jan 2017, 07:33:16

$this->bbcode_second_pass_quote('Cog', 'T')he next series of bugs will be destroyed by genetic engineering.


Or perhaps created by genetic engineering. You know, that disgruntled liberal pathologist who just cant handle Trump if office and directs all his micro biological talents in creating a super bug in his laboratory and then releases somewhere left of DC with prevailing westerly winds.
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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby onlooker » Mon 23 Jan 2017, 08:51:23

So it is not enough that we may need to take control of the Climate System from Nature but now we also have to take control of the Eon long battle with our nemesis bacteria and Viruses. Just another example of hubris thinking "our" technology can replace Nature/God.
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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby Tanada » Mon 23 Jan 2017, 12:21:05

I vaguely recalled that the cure for everything was posted about some time ago and after nearly an hour of searching I found the thread.

peakoil.com/forums/post1212118.html
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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby onlooker » Sat 11 Feb 2017, 22:02:39

http://www.cnn.com/2016/05/26/health/fi ... index.html
A dreaded superbug found for the first time in a U.S. woman
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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby ralfy » Sun 12 Feb 2017, 09:07:19

"MAP: Find Out What New Viruses Are Emerging In Your Backyard"

http://www.npr.org/sections/goatsandsod ... r-backyard
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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby vox_mundi » Mon 26 Jun 2017, 11:42:20

Closing Border in Extreme Pandemics Worthwhile for Island Nations

$this->bbcode_second_pass_quote('', '[')img]https://shenanitims.files.wordpress.com/2012/10/resident-evil-afterlife-zombies-at-the-gate.png?w=450&h=245[/img]

It may sometimes make sense for island nations like New Zealand to temporarily close their borders in extreme pandemic situations, a new study by Wellington researchers suggests.

The study of costs and benefits of complete border closure in New Zealand in response to new pandemic threats has just been published in the international journal PLoS ONE.

One of the authors Professor Nick Wilson from the University of Otago, Wellington, says the study found that despite the costs/disruptions caused to tourism and even trade, there could be significant overall societal benefits to border closure in certain severe pandemic scenarios.

"With increasing risks of new pandemics due to the growing density of human populations and various socio-economic, environmental and ecological factors, there is a need to look at different scenarios for better pandemic planning," says Professor Wilson.
$this->bbcode_second_pass_quote('', '[')b]"It will be a very hard call – but in the case of some severe pandemics it could save thousands of lives and huge costs from illness if border closure is rapidly achieved"

The study analysed data from past influenza pandemics and looked at healthcare costs, valuation of life, lost tourism revenue and even lost trade. It also considered the option of trade still occurring without cargo ship crews ever having to leave their vessel.

Study co-author Professor Michael Baker, also from University of Otago, Wellington says: "Indeed, the options for New Zealand will improve in this regard if current international work on drone cargo ships with minimal or no crew becomes a reality."
http://journals.plos.org/plosone/articl ... ne.0178732

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Insensible before the wave so soon released by callous fate. Affected most, they understand the least, and understanding, when it comes, invariably arrives too late.
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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby EnergyUnlimited » Sat 12 Aug 2017, 16:01:42

$this->bbcode_second_pass_quote('onlooker', 'h')ttp://www.cnn.com/2016/05/26/health/first-superbug-cre-case-in-us/index.html
A dreaded superbug found for the first time in a U.S. woman

I wonder when man in his 20-ties seeing a woman will think about cesspool of superbugs first and about sex only later or not at all.
Once this is a case, one can conclude that all gates of doom are opened.
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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby onlooker » Sat 12 Aug 2017, 16:33:30

$this->bbcode_second_pass_quote('EnergyUnlimited', '')$this->bbcode_second_pass_quote('onlooker', 'h')ttp://www.cnn.com/2016/05/26/health/first-superbug-cre-case-in-us/index.html
A dreaded superbug found for the first time in a U.S. woman

I wonder when man in his 20-ties seeing a woman will think about cesspool of superbugs first and about sex only later or not at all.
Once this is a case, one can conclude that all gates of doom are opened.

Well Aids had a pretty widespread devastating run and is still creating havoc in some places
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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby EnergyUnlimited » Sat 12 Aug 2017, 17:07:32

Well, regardless what actual truth about AIDS is, most are viewing it as a problem of predominant concern for certain risk groups.
These views are officially deemed politically incorrect but are rather prevalent and so most of men in their 20-ties do not perceive women as a cesspool of HIV.
"Use condom" mantras are also reassuring.
So we probably need a better superbug to get there.
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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby onlooker » Wed 23 Aug 2017, 09:58:17

http://www.who.int/features/qa/79/en/
$this->bbcode_second_pass_quote('', 'W')hat is multidrug-resistant tuberculosis (MDR-TB) and how do we control it?
The 2 reasons why multidrug resistance continues to emerge and spread are mismanagement of TB treatment and person-to-person transmission
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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby ralfy » Sun 04 Feb 2018, 22:44:14

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Re: Antibiotic resistance: World on cusp of 'post-antibiotic

Unread postby vox_mundi » Mon 05 Feb 2018, 12:35:21

How Contagious Pathogens Could Lead to Nuke-Level Casualties

$this->bbcode_second_pass_quote('', '[')img]http://data.whicdn.com/images/17696859/2u61ro6_large.jpg[/img]

What if nuclear bombs could reproduce? Get your hands on one today, and in a week's time you've got a few dozen. Of course, nukes don't double on their own. But contagious, one-celled pathogens do. Properly packaged as a bioweapon, they could kill as many people as a hydrogen bomb would, or more.

Milana Trounce, MD, a clinical associate professor of emergency medicine, wants to get people to worry about this possibility. For the fourth year in a row, she is presiding over a course called Biosecurity and Bioterrorism Response, which aims to get students thinking about how to prevent bioterror and, in the event of a biological attack, what to do about it. More than 100 Stanford undergraduate, graduate, postdoctoral and professional students, representing disciplines ranging from public policy to biological science to engineering and bioengineering, have enrolled.

... "The advent of modern molecular genetic technologies is making it increasingly feasible to engineer bioweapons," said Block, who is also the Stanford W. Ascherman Professor of Sciences and a guest lecturer in Trounce's class. "It's making people with even moderate skills able to create threats they couldn't before."

A natural anthrax strain mailed to public officials in a series of homegrown terrorist incidents in late 2001—while deadly—was treatable, Block said. But the technology for making drug-resistant anthrax—or, for that matter, creating all manner of novel "designer diseases"—is becoming increasingly available worldwide, not to mention cheaper and more sophisticated.

Trounce agrees. "We are undergoing a biotechnology revolution," she said. "Even in the last 10 years, science has advanced so much that you can engineer some of the scariest organisms—for example, smallpox."
$this->bbcode_second_pass_quote('', '[')i]In laboratory experiments, scientists have mutated H5N1—a deadly influenza strain that so far has been transmitted to humans only by birds—to become transmissible by other humans. They have synthesized the Spanish flu virus, a naturally occurring strain that swept the globe in a 1918 pandemic, killing far more people than died in all the battles of World War I. What if any of those were to get out of the lab?


Image

... "The United States abandoned offensive bioweapons research," Trounce said. "Unfortunately, the Soviets did not." Despite signing the treaty, the Soviet Union conducted a massive, ultra-secret bioweapons effort that continued through the early 1990s.

At its peak, the Soviets' bioweapons program, called Biopreparat, employed close to 60,000 people at nearly 40 facilities throughout the country. As she examined one of those facilities, which housed dangerous microorganisms, Trounce said, "It immediately struck me that it was not in good shape. The only barrier to entry was a barbed-wire fence, with nobody at the gate. I saw cats wandering in and out.
$this->bbcode_second_pass_quote('', '[')i]"It blew my mind," Trounce continued. "As a Soviet citizen, I had had no idea these facilities even existed. To come as a U.S. citizen and see these facilities where thousands of scientists had been working on the deadliest pathogens was unbelievable. Who knows what I didn't see?"

Did that massive Soviet bioweapons inventory ever get entirely dismantled? "I don't know," says Trounce. "I don't think anybody really does, and if they do it's classified information. What we do know is that there are three Russian Ministry of Defense bioweapons laboratories that remain closed to international examination."

"What took hundreds of scientists and huge resources just a few decades ago now can be done within just a few weeks," Trounce said. Moreover, it can be done without the massive footprint characterizing both Cold War bioweapons projects and current nuclear-weapons programs.

A bioweapon is a poor man's nuke. The secrets involved in building one aren't hard to come by ...
It's easy to mask bioweapons research.
You can buy equipment such as gene and protein synthesizers over the Internet. "They're the same as what you see in the legitimate biotech industry, so it wouldn't look suspicious," Trounce said. The materials and equipment you'd use are largely ubiquitous laboratory reagents and glassware, as opposed to the hard-to-get raw materials and instrumentation needed for making nuclear weapons. Information on how to configure pathogens' underlying genetic structures is public.
$this->bbcode_second_pass_quote('', '[')b]"Smallpox has a 35-40 percent fatality rate and is not as contagious as measles," said Block. "Now imagine an organism as fatal as HIV and as contagious as measles. With modern air travel, a pandemic caused by a pathogen of this sort could take out maybe 90 percent of the people it reached. That would destroy a society."

A high-tech bioweapon could cost only $1 million to build, Block said. "That's thousands of times cheaper than going nuclear. Iran's centrifuges alone cost them billions."

... there's no need to create a brand-new organism from scratch. Lots of potentially suitable pathogens are ready-made, courtesy of Mother Nature. The bacterial pathogens that cause anthrax and botulinum, to name a couple, are found in the wild. Once you have such a biological agent, you can have 10 times as much of it tomorrow, because it grows exponentially. It costs only a few thousand dollars to culture it. You can store it in a freezer.

Image
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Botulinum Toxin Jumps to Ubiquitous Gut-Bacterial Family

$this->bbcode_second_pass_quote('', '[')b]Botulinum toxin is regarded as one of the deadlier substances in the world—so much so that it has been (and most likely still is) used as a biological weapon by many nation states. Yet, until now, scientists only needed to worry about the deadly neurotoxin being produced by a single bacterial species, Clostridium botulinum, most often associated with foodborne illness. Now, a collaborative team of investigators led by scientists at Harvard Medical School have discovered botulinum toxin in a strain of Enterococcus—hardy microbes that thrive in the gastrointestinal tracts of nearly all land animals, including our own—isolated from cow feces sampled at a South Carolina farm.
$this->bbcode_second_pass_quote('', '[')b]“This is the first time a botulinum neurotoxin has been found outside of Clostridium botulinum — and not just the toxin, but an entire unit containing the toxin and associated proteins that prevent the toxin from being degraded in the GI tract,”

- Min Dong, PhD, a scientist in Boston Children’s Hospital’s Department of Urology and Harvard Medical School and one of the world’s experts on botulinum toxins

When the research team tested the toxin in rodents in the lab, it had little or no effect. Only when they manipulated the toxin to better target mouse and rat neurons did it become potent, shutting down nerve function and causing paralysis. The researchers are currently testing BoNT/En on cultured neurons to determine if it is toxic to humans.

"We were not looking for a neurotoxin in E. faecium," stated co-lead investigator Francois Lebreton, Ph.D., an instructor at Harvard Medical School who specializes in examining the genome sequences of these microbes. "There was no reason to suspect its existence."

The researchers found that the BoNT/En botulinum toxin genes were carried by a plasmid. Plasmids are mobile structures that contain DNA independently of the chromosomes and can be swapped from one bacterium to another. Plasmids are quite common in enterococci—in fact, they have been associated with the acquisition of resistance to vancomycin, a last-resort antibiotic, and transfer of resistance to the fearsome Staphylococcus aureus
$this->bbcode_second_pass_quote('', '[')size=150]... "Enterococcus is a central hub for gene transfer within the gut, and that makes it potentially scary,"[/size]
This ability to swap genes is what worries many researchers. Could a potent toxin from C. botulinum end up in a multidrug-resistant, human E. faecium strain? Many investigators now seem to think that it is at least theoretically possible.
$this->bbcode_second_pass_quote('', '[')i]"This is a unique discovery of a botulinum neurotoxin in a bacterium that is both ubiquitous in animals and a serious problem in human health," Dr. Lebreton stated. "E. faecium is in the gut of nearly every human—it is extremely tough and survives a lot of stresses, often including efforts to disinfect hospital surfaces. A hospital-adapted, antibiotic-resistant, hard-to-kill bug carrying a neurotoxin would be a worst-case scenario."

Image

CDC: Influenza, Pneumonia Related Deaths Now Epidemic

$this->bbcode_second_pass_quote('', '[')img]http://image.masslive.com/home/mass-media/width600/img/breakingnews/photo/2018/02/03/pneumoniajpg-6a8f5be078e10ab6.jpg[/img]Based on National Center for Health Statistics mortality surveillance data available on Feb. 1, 9.7 percent of the deaths occurring during the week ending Jan. 13 were due to pneumonia and influenza viruses. This percentage is above the epidemic threshold of 7.2 percent for this week.(Centers for Disease Control and Prevention)

CDC Director Resigns Over Financial Conflicts Including Stock in Tobacco, Beer and Soda Companies

$this->bbcode_second_pass_quote('', '[')b]The head of the Centers for Disease Control and Prevention resigned Wednesday following reports that she traded in tobacco stocks despite being the nation's top public health official and heading an agency that has led U.S. anti-smoking initiatives for decades

Dr. Brenda Fitzgerald, whom President Trump tapped in the summer to head the CDC, purchased shares in Japan Tobacco International as well as stocks in a number of healthcare companies after taking office, according to a report this week by Politico.

Among the companies whose stock Fitzgerald purchased last year after taking office were pharmaceutical giants Merck & Co. and Bayer, and health insurer Humana, and stock in Japan Tobacco, a multinational that sells Winston and Camel cigarettes around the world, according to financial disclosures first reported by Politico.

Fitzgerald, canceled her first scheduled appearance before Congress last fall to discuss the opioid epidemic, citing potential conflicts of interest because she continued to hold investments in companies involved in the public health crisis.
$this->bbcode_second_pass_quote('', '[')b]... "There is an untenable conflict between seeking to personally profit from tobacco use and being a credible voice on tobacco and other public health issues,"
The stock trading echoes the behavior of Trump's first Health and Human Services secretary, Tom Price, who was forced to resign last year amid questions about his frequent use of charter aircraft at taxpayer expense.

While a congressman, Price also traded extensively in healthcare companies even as he pushed legislation and took other actions that affected many of those same companies.

Fitzgerald's resignation also fueled new criticism about lax ethics in the Trump administration.

DHS Super Bowl Bio-Terrorism Documents Left on Plane

$this->bbcode_second_pass_quote('', '[')b]The Department of Homeland Security documents critiquing the response to a simulated anthrax attack on Super Bowl Sunday were marked "For Official Use Only" and "important for national security."

Recipients of the draft "after-action" reports were told to keep them locked up after business hours and to shred them prior to discarding. They were admonished not to share their contents with anyone who lacked "an operational need-to-know."

A CNN employee discovered copies of them, along with other sensitive DHS material, in the seat-back pocket of a commercial plane. The reports were accompanied by the travel itinerary and boarding pass of the government scientist in charge of BioWatch, the DHS program that conducted the anthrax drills in preparation for Super Bowl LII in Minneapolis.

The reports were based on exercises designed to evaluate the ability of public health, law enforcement and emergency management officials to engage in a coordinated response were a biological attack to be carried out in Minneapolis on Super Bowl Sunday.

The exercises identified several areas for improvement, including the problem that "some local law enforcement and emergency management agencies possess only a cursory knowledge of the BioWatch program and its mission."

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In addition to requesting that CNN not publish prior to the Super Bowl, DHS officials argued that disclosure of some material contained in the draft reports could threaten national security, regardless of when it was published. Based on that concern, CNN is withholding some details contained in the documents.
Last edited by vox_mundi on Mon 05 Feb 2018, 13:29:34, edited 4 times in total.
“There are three classes of people: those who see. Those who see when they are shown. Those who do not see.” ― Leonardo da Vinci

Insensible before the wave so soon released by callous fate. Affected most, they understand the least, and understanding, when it comes, invariably arrives too late.
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