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Applied Biotechnology, Health and Fitness, Stanford News

Fits like a glove: Stanford researchers develop medical applications for the Cooling Glove

Fits like a glove: Stanford researchers develop medical applications for the Cooling Glove

Weightlifting1-CoreControlTwo years ago we wrote about the Cooling Glove, a device developed by Stanford biologists Craig Heller, PhD, and Dennis Grahn that helps athletes cool off and recover from active play more easily. At the time, the Cooling Glove was being used by a few sports teams, especially Stanford football, but others included the San Francisco 49ers and Manchester United. This past July, the glove was used by the Germans in the FIFA World Cup soccer competition, where they handily beat the heavily favored Brazilian team on their home turf.

The device fits over an athlete’s hand and is connected to a cooler and a vacuum source. Grahn and Heller’s major insight was that the non-hairy skin of the palms, soles, and face are our major sites of heat dissipation. These areas have special blood vessels that can receive a large volume of blood and act as radiators, and the cooled blood from these surfaces flows back to the body’s core.

When asked about other applications for the glove, Heller rattles off half a dozen that his lab is looking into in quick succession. One includes building a prototype for military working dogs. If they’re in an extremely hot climate, they pant more, which compromises their ability to sniff and find the dangerous compounds they are searching for. A canine cooling device that keeps their body temperature cool can help their sniffers work more efficiently.

The team is also working on several medical applications. One variant aims to maintain patient’s temperature during surgery. In this application, booties can be used leaving the arms free for IV lines and other instrumentation. The researchers are also looking at how the Cooling Glove can help menopausal women manage their hot flashes. Heller will soon begin enrolling volunteers for this trial. Another application involves using the glove in its heating mode to stave off migraine headaches before they become full-blown.

The U.S. Department of Energy is interested in how personal heating and cooling devices could be used as an alternative to heating and cooling whole buildings or rooms. The glove or bootie technology could mean a broader dead band on thermostats – the temperature range within which neither the cooling or heating system needs to be turned on – thus saving lots of energy.

Despite the recent success at the World Cup, Heller says the Cooling Glove has not been as popular with athletes as it could be. He notes that Avacore, the company marketing the glove commercially, is relatively small and doesn’t have a large enough budget to develop a more streamlined and user-friendly version or market it widely. He says that the device’s novelty also slows down acceptance:

If you have a concept that doesn’t fit existing ideas, breaking into a market is difficult. We had to overcome skepticism that we were selling snake oil. We overcome that with research, but getting basic research translated and disseminated for the user community is not easy.

One finding of the research is that use of the glove in a conditioning program produces impressive results – beyond what is produced by performance enhancing substances, such as steroids. In a study involving students, some freshmen women – not varsity athletes – were did more than 800 pushups in less than 45 minutes. Some professional athletes tripled their capacities in particular routines such as dips or pullups in 5-6 weeks.

Heller is optimistic about the Cooling Glove’s future in sports. “I expect it will be adopted eventually. If, for no other reason, safety – in sports and many other endeavors such as emergency response.”

Heller is a founder of Avacore, but no longer affiliated with the company.

Previous: Researchers explain how “cooling glove” can improve exercise recovery and performance
Photo courtesy of Avacore

Applied Biotechnology, Research, Stanford News, Technology

Tiny size, big impact: Ultrasound powers miniature medical implant

Tiny size, big impact: Ultrasound powers miniature medical implant

14395-chip_newsFor years, scientists have been trying to create implantable electronic devices, but challenges related to powering such technologies has limited their success. Enter a prototype developed by Stanford engineer Amin Arbabian, PhD, and colleagues that uses ultrasound waves to operate the device and send commands.

As explained in a Stanford Report story, researchers designed the “smart chip” to use piezoelectricity, or electricity generated by pressure, as a source of power and selected ultrasound because it has been extensively, and safely, used in medical settings:

[The researchers’] approach involves beaming ultrasound at a tiny device inside the body designed to do three things: convert the incoming sound waves into electricity; process and execute medical commands; and report the completed activity via a tiny built-in radio antenna.

“We think this will enable researchers to develop a new generation of tiny implants designed for a wide array of medical applications,” said Amin Arbabian, an assistant professor of electrical engineering at Stanford.

Every time a piezoelectric structure is compressed and decompressed a small electrical charge is created. The Stanford team created pressure by aiming ultrasound waves at a tiny piece of piezoelectric material mounted on the device.

“The implant is like an electrical spring that compresses and decompresses a million times a second, providing electrical charge to the chip,” said Marcus Weber, who worked on the team with fellow graduate students Jayant Charthad and Ting Chia Chang.

The prototype is about the size of a ballpoint pen head, but the team ultimately wants to make it one-tenth that size. Arbabian and his colleagues are now working with other Stanford collaborators to shrink the device even further, specifically to develop networks of small implantable electrodes for studying brains of laboratory animals.

Previously: Miniature wireless device aids pain studies, Stanford researchers demonstrate feasibility of ultra-small, wirelessly powered cardiac device and Stanford-developed retinal prosthesis uses near-infrared light to transmit images
Photo by Arbabian Lab/Stanford School of Engineering

Applied Biotechnology, Genetics, In the News, Nutrition, Public Health, Research

“Frankenfoods” just like natural counterparts, health-wise (at least if you’re a farm animal)

"Frankenfoods" just like natural counterparts, health-wise (at least if you're a farm animal)

cow2More than a hundred billion farm animals have voted with their feet (or their hoofs, as the case may be). And the returns are in: Genetically modified meals are causing them zero health problems.

Many a word has been spilled in connection with the scientific investigation of crops variously referred to as “transgenic,” “bioengineered,” “genetically engineered” or “genetically modified.” In every case, what’s being referred to is an otherwise ordinary fruit, vegetable, or fiber source into which genetic material from a foreign species has been inserted for the purpose of making that crop, say, sturdier or  more drought- or herbicide- or pest-resistant.

Derided as “Frankenfoods” by critics, these crops have been accused of everything from being responsible for a very real global uptick in allergic diseases to causing cancer and autoimmune disease. But (flying in the face of the first accusation) allergic disorders are also rising in Europe, where genetically modified, or GM, crops’ usage is far less widespread than in North America. It’s the same story with autoimmune disease. And claims of a link between genetically modified crops and tumor formation have been backed by scant if any evidence; one paper making such a claim  got all the way through peer review and received a fair amount of Internet buzz before it was ignominiously retracted last year.

But a huge natural experiment to test GM crops’ safety has been underway for some time. Globally, between 70 and 90 percent of all GM foods are consumed by domesticated animals grown by farmers and ranchers. More than 95 percent of such animals – close to 10 billion of them – in the United States alone consume feed containing GM  components.

This was, of course, not the case before the advent of commercially available GM feeds in the 1990s. And U.S. law has long required scrupulous record-keeping concerning the health of animals grown for food production. This makes possible a before-and-after comparison.

In a just-published article in the Journal of Animal Science, University of California-Davis scientists performed a massive review of data available on performance and health of animals consuming feed containing GM ingredients and  products derived from them. The researchers conclude that there’s no evidence of GM products exerting negative health effects on livestock. From the study’s abstract:

Numerous experimental studies have consistently revealed that the performance and health of GE-fed animals are comparable with those fed [otherwise identical] non-[GM] crop lines. Data on livestock productivity and health were collated from publicly available sources from 1983, before the introduction of [GM] crops in 1996, and subsequently through 2011, a period with high levels of predominately [GM] animal feed. These field data sets representing over 100 billion animals following the introduction of [GM]crops did not reveal unfavorable or perturbed trends in livestock health and productivity. No study has revealed any differences in the nutritional profile of animal products derived from[GM]-fed animals.

In other words, the 100 billion GM-fed animals didn’t get sick any more frequently, or in different ways. No noticeable difference at all.

Should that surprise us? We humans are, in fact, pretty transgenic ourselves. About 5 percent of our own DNA can be traced to viruses who deposited their  genes in our genomes, leaving them behind as reminders of the viral visitations. I suppose that’s a great case against cannibalism if you fear GM foods. But I can think of other far more valid arguments to be made along those lines.

Previously: Ask Stanford Medicine: Pediatric immunologist answers your questions about food allergy research, Research shows little evidence that organic foods are more nutritional than conventional ones and Stanford study on the health benefits of organic food: What people are saying
Photo by David B. Gleason

Applied Biotechnology, Bioengineering, Events, Medical Education, Stanford News, Technology

Stanford physicians and engineers showcase innovative health-care solutions

Stanford physicians and engineers showcase innovative health-care solutions

scholar-poster

A “breathalyzer” that noninvasively determines if patients have unsafe levels of ammonia in their blood. The discovery of a previously approved drug that also fights the Dengue virus. A smartphone-based eye-imaging system that can be used to diagnose vision problems remotely.

These are a few of the 40-plus inventions and clinical solutions presented at the first annual Spectrum Innovation Research Symposium, held last Friday at the Stanford School of Medicine. The event demonstrated the power of bringing together teams of physicians, bioinformaticists and engineers to apply new technologies and ideas to challenging medical problems. Also showcased were budding physician-scientists supported by the Spectrum KL2 and TL1 clinical research training awards. (In the photo above, Colleen Craig, MD, an endocrinology fellow, describes a novel treatment that she’s developing for gastric-bypass patients who suffer from severely low blood sugar.)

The buzz is that it’s going to be a good year for health-care breakthroughs

Spectrum, the recipient of Stanford’s NIH Clinical and Translational Science Award, annually gives up to $50,000 to investigator teams for year-long projects in the areas of drug discovery, medical technologies, predictives/diagnostics, population health sciences and community engagement. This program also provides these teams with training and mentoring to help them move their ideas rapidly from bench to bedside and into the community.

“These modest pilot awards have been immensely successful in stimulating innovative ideas across the spectrum of translational research,” said Spectrum’s director, Harry Greenberg, MD. “They have lead to new inventions that promote individual’s health, new ways of improving the health of the populations and new efforts to assist our surrounding community on health issues.”

As this year’s grantees were rolling up their poster presentations, next year’s scholars were rolling up their sleeves to finish their 2014-15 Spectrum grant proposals, which are due in a few days.

It’s been a pivotal year in medical technology, with the launch of an unprecedented number of game-changing inventions, such as the Mini-ION, a $900 USB-powered DNA sequencer, and Apple HealthKit, a health-and-fitness dashboard and developer kit. In the coming year, these will provide Stanford scholars with amazing technology platforms from which to launch medical solutions that are better, faster and cheaper.

“We are in the middle of amazing biomedical innovation here in Silicon Valley,” said Atul Butte, MD, PhD, and faculty director of the diagnostics/predictives program. “Spectrum enables us to fund the earliest of early technologies, more risky than even the usual angel investments, but with higher potential impacts. In the end, this gets technologies to patients and families that much sooner.”

Because of this, anticipation among the grant-approval committee members at the symposium was high — the buzz is that it’s going to be a good year for health-care breakthroughs.

Previously: Spectrum awards innovation grants to 23 projects, Stanford awarded more than $45 million to spur translational research in medicine, As part of annual tradition, budding physician-scientists display their work, and New class of physician-scientists showcase research
Photo by Kris Newby

Applied Biotechnology, Bioengineering, Cancer, Research, Stanford News

New “decoy” protein blocks cancer from spreading

New "decoy" protein blocks cancer from spreading

14299-metastasis_news

Cancer becomes most deadly when it’s on the move – jumping from the breast to the brain or the pancreas to the liver and then onward.

But now, a team of Stanford researchers led by radiation biologist Amato Giaccia, PhD, and bioengineer Jennifer Cochran, PhD, have created a protein that may be able to thwart the metastasis.

They published their results this week in Nature Chemical Biology.

“This is a very promising therapy that appears to be effective and nontoxic in preclinical experiments,” Giaccia said in a Stanford release. ”It could open up a new approach to cancer treatment.”

The researchers created a protein that mimics Axl, a protein found on the surface of cancer cells. This decoy protein intercepts incoming messages – intended for the original Axl – cueing the cancer cells to find a new home.

The decoy Axl worked wonders in mice. Mice with breast cancer given the treatment had 78 percent fewer new tumors, and mice with ovarian cancer had 90 percent fewer new tumors than mice with cancer not given the treatment.

Becky Bach is a former park ranger who now spends her time writing about science or practicing yoga. She’s a science-writing intern in the Office of Communications and Public Affairs.

Previously: Studying the drivers of metastasis to combat cancer, A computer kit could lead to a better way to design synthetic molecules, Common drug class targets breast cancer stem cells, may benefit more patients, says study
Photo by Rod Searcey

Applied Biotechnology, Bioengineering, Genetics, Research, Stanford News

A computer kit could lead to better way to design synthetic molecules

A computer kit could lead to better way to design synthetic molecules

SmolkeSlipping something small into cells to regulate gene expression has long been a goal of biomedical researchers. And there have been many efforts to do just that. Usually researchers concoct a teeny strip of microRNA, or miRNA, and hope it does the trick.

But now, researchers at Stanford’s Department of Bioengineering have developed a computer model to take the guesswork out of designing miRNA. The model determines how to assemble a molecule so it will measure the level of a certain compound in a cell and then use that information to regulate the expression of a gene.

The research is featured in the current edition of Nature Methods, and senior author Christina Smolke, PhD, describes the process in a release issued this week:

“You start with an idea of what you want to do in the cell, and then you build and iterate on a design over and over until you reach something close to what you want,” Smolke said. “As we design and build more sophisticated systems, we will want the ability to efficiently achieve precise quantitative behaviors, and being able to accurately predict relationships between the system inputs and outputs are important to achieving this goal.”

She and Smolke’s team — which includes former graduate student Ryan Bloom and former undergraduate Sally Winkler —tested the model on the well-known Wnt signaling pathway, which plays a key role in embryonic development, stem cell production and cancer. The synthesized miRNA correctly monitored the protein produced by the pathway, validating their model.

Becky Bach is a former park ranger who now spends her time writing about science or practicing yoga. She’s a science writing intern in the Office of Communications and Public Affairs. 

Previously: A non-surgical test for brain cancer?, From plant to pill: Bioengineers aim to produce opium-based medicines without using poppies, Researchers engineer biological “devices” to program cells
Photo of Smolke by L.A. Cicero

Applied Biotechnology, Bioengineering, Global Health, In the News, Stanford News

Stanford bioengineer among Popular Science magazine’s “Brilliant 10”

Stanford bioengineer among Popular Science magazine’s “Brilliant 10”

prakash-popsci

Manu Prakash, PhD, a prolific inventor of low-cost scientific tools, has been named one of Popular Science magazine’s “Brilliant 10” for 2014 – an award that recognizes the nation’s brightest young minds in science and engineering.

In the last year Prakash has introduced two novel science tools made from everyday materials.

The first was a fully functional paper microscope, which costs less than a dollar in materials, that can be used for diagnosing blood-borne diseases such as malaria, African sleeping sickness and Chagas. It can also be used by children — our future scientists — to explore and learn from the microscopic world.

The second was a $5 programmable kid’s chemistry set, inspired by hand-crank music boxes. Like a music box, users crank a wheel that feeds a strip of hole-punched paper through the mechanism. When a pin hits a hole, it activates a pump that releases a precise, time-sequenced drop of a liquid onto a surface. This low-cost device can be used to test water quality, to provide affordable medical diagnostic tests, or to design chemistry experiments in schools.

The inventions are brilliant in both their elegant simplicity and their use of emerging technologies, such as 3D printers, microfluidics, laser cutters and conductive-ink printing.

“In one part of our lab we’ve been focusing on frugal science and democratizing scientific tools to get them out to people around the world who will use them,” Prakash told Amy Adams in a recent Stanford News story. “I’d started thinking about this connection between science education and global health. The things that you make for kids to explore science are also exactly the kind of things that you need in the field because they need to be robust and they need to be highly versatile.”

Sometimes, just for the fun of it, I’ll wander over to the Prakash lab to check out the team’s new inventions. They never fail to impress.

I heartily agree with the Popular Science editors on this year’s choices for the Brilliant 10: “Remember their names: they are already changing the world as we know it.”

Previously: Manu Prakash on how growing up in India influenced his interests as a Maker and entrepreneur, Dr. Prakash goes to Washington, The pied piper of cool science tools, Music box inspires a chemistry set for kids and scientists in developing countries and Free DIY microscope kits to citizen scientists with inspiring project ideas
Illustration courtesy of Popular Science magazine

Applied Biotechnology, Immunology, Infectious Disease, Research, Technology

Artificial spleen shown to filter dangerous pathogens from blood

Artificial spleen shown to filter dangerous pathogens from blood

79118_webOur spleens filter out toxins from our blood and help us fight infections. But serious infections can overpower our bodies’ ability to fight them off, especially among older adults whose immune systems are weaker. Now, a research team led by Donald Ingber, MD, PhD, of Harvard has come up with an artificial “biospleen” that can trap bacteria, fungi and viruses and remove them from circulating blood. Science Magazine describes the device in a news story:

The team first needed a way to capture nasties. They coated tiny magnetic beads with fragments of a protein called mannose-binding lectin (MBL). In our bodies, MBL helps fight pathogens by latching onto them. Ingber and colleagues showed that the sticky beads could grab a variety of microbes in the test tube.

With that key challenge out of the way, the researchers were ready to design the rest of the system. They engineered a microchiplike device a little bigger than a deck of cards that works somewhat like a dialysis machine. As blood enters the device, it receives a dose of the magnetic beads, which snatch up bacteria, and then fans out into 16 channels. As the blood flows across the device, a magnet pulls the beads—and any microbes or toxins stuck to them—out of the blood, depositing them in nearby channels containing saline.

The researchers first tested their device with donated human blood tainted with bacteria. They found that filtering the blood through the device five times could eliminate 90% of the microbes.

The device improved survival rates in rats and may decrease the incidence of sepsis, a dangerous side effect of severe infections. The researchers also found that the device could filter the total volume of blood in an adult human – about 5 liters or (1.3 gallons) – in about five hours.

Previously: Our aging immune systems are still in business, but increasingly thrown out of balance
Image, of the magnetic MBL-coated nanobeads beads capturing pathogens, from Harvard University Wyss Institute

Applied Biotechnology, Cancer, Genetics, Pediatrics, Research

Gene-sequencing rare tumors – and what it means for cancer research and treatment

Gene-sequencing rare tumors - and what it means for cancer research and treatment

Sequencing the genes of cancer patients’ tumors has the potential to surmount frustrating problems for those who work with rare cancers. Doctors who see patients with rare tumors are often unsure of which treatments will work. And, with few patients available, researchers are unable to assemble enough subjects to compare different therapies in gold-standard randomized clinical trials. But thanks to gene sequencing, that is about to change.

Though this specific research was not intended to shape the child’s treatment, similar sequencing could soon help doctors decide how to treat rare cancers in real time

That’s the take-away from a fascinating conversation about the implications of personalized tumor-gene sequencing that I had recently with two Stanford cancer experts. Cancer researcher Julien Sage, PhD, is the senior author of a recent scientific paper describing sequencing of a pediatric tumor that affects only one in every 5 million people. Alejandro Sweet-Cordero, MD, an oncologist who treats children with cancer at Lucile Packard Children’s Hospital Stanford, is leading one of Stanford’s several efforts to develop an efficient system for sequencing individual patients’ tumors.

In their paper, Sage’s team (led by medical student Lei Xu) analyzed the DNA and RNA of one child’s unusual liver tumor, a fibrolamellar hepatocellular carcinoma. The cause of this form of cancer has never been found. Curious about what genes drove the tumor’s proliferation, the scientists identified two genes that were likely culprits, both of which promoted cancer in petri dishes of cultured cells. One of the genes, encoding the enzyme protein kinase A, is a possible target for future cancer therapies.

Though this specific research was not intended to shape the child’s treatment, similar sequencing could soon help doctors decide how to treat rare cancers in real time. Sweet-Cordero is working to develop an efficient system for getting both the mechanics of sequencing and the labor-intensive analysis of the resulting genetic data completed in a few weeks, instead of the two to three months now required. “We’re trying to use this kind of technology  to really help patients,” Sage said. “If you’re dealing with a disease that may kill the patient very fast, you want to act on it as soon as possible.”

In addition to giving doctors clues about which chemotherapy drugs to try, gene sequencing gives them a new way to study tumors.

“What’s really important is that, instead of categorizing tumors based on how they look under a microscope, we’ll be able to categorize them based on their gene-mutation profile,” Sweet-Cordero said. Rather than setting up clinical trials based on a tumor’s histology, as doctors have done in the past, scientists will group patients for treatment trials on the basis of similar mutations in their tumors. “In my mind, as a clinical oncologist, this is the most transformative aspect of this technology,” he said. This is especially true for patients with rare tumors who might not otherwise benefit from clinical trials at all.

And for childhood cancers, knowing a tumor’s gene mutations could also help doctors avoid giving higher doses of toxic chemotherapy drugs than are truly needed.

“The way we’ve been successful in pediatric oncology is by being extremely aggressive,” Sweet-Cordero said. Oncologists take advantage of children’s natural resilience by giving extremely strong chemotherapy regimens, which beat back cancer but can also have damaging long-term side effects. “We end up over-treating significant groups of patients who could survive with less aggressive therapy,” Sweet-Cordero said. “If we can use genetic information to back off on really toxic therapies, we’ll have fewer pediatric cancer survivors with significant impairments.”

Meanwhile, Stanford cancer researchers are also tackling a related problem: the fact that not all malignant cells within a tumor may have the same genetic mutations, and they may not all be vulnerable to the same cancer drugs. Next month, the Stanford Cancer Institute is sponsoring a scientific symposium on the concept, known as tumor heterogeneity, and how it will affect the future of personalized cancer treatments.

Sage’s research was supported by the Lucile Packard Foundation for Children’s Health, Stanford NIH-NCATS-CTSA UL1 TR001085 and Child Health Research Institute of Stanford University. Sage and Sweet-Cordero are both members of the Stanford Cancer Institute, and the National Cancer Institute-designated Cancer Center.

Previously: Smoking gun or hit-and-run? How oncogenes make good cells go bad, Stanford researchers identify genes that cause disfiguring jaw tumor and Blood will tell: In Stanford study, tiny bits of circulating tumor DNA betray hidden cancers

Applied Biotechnology, In the News, Infectious Disease, Microbiology, Public Safety

How-to manual for making bioweapons found on captured Islamic State computer

Black DeathLast week I came across an article, in the usually somewhat staid magazine Foreign Policy, with this subhead:

Buried in a Dell computer captured in Syria are lessons for making bubonic plague bombs and missives on using weapons of mass destruction.

That got my attention. Just months ago, I’d written my own article on bioterrorism for our newspaper, Inside Stanford Medicine. So I was aware that, packaged properly, contagious one-celled pathogens can wipe out as many people as a hydrogen bomb, or more. Not only are bioweapons inexpensive (they’ve been dubbed “the poor man’s nuke”), but the raw materials that go into them – unlike those used for creating nuclear weapons – are all around us. That very ubiquity, were a bioweapon to be deployed, could make fingering the perp tough.

The focal personality in my ISM article, Stanford emergency-medicine doctor and bioterrorism expert Milana Trounce, MD, had already convinced me that producing bioweapons on the cheap – while certainly no slam-dunk – was also not farfetched. “What used to require hundreds of scientists and big labs can now be accomplished in a garage with a few experts and a relatively small amount of funding, using the know-how freely available on the internet,” she’d said.

This passage in the Foreign Policy article rendered that statement scarily apropos:

The information on the laptop makes clear that its owner is a Tunisian national named Muhammed S. who joined ISIS [which now calls itself "Islamic State"] in Syria and who studied chemistry and physics at two universities in Tunisia’s northeast. Even more disturbing is how he planned to use that education: The ISIS laptop contains a 19-page document in Arabic on how to develop biological weapons and how to weaponize the bubonic plague from infected animals.

I sent Trounce a link to the Foreign Policy article. “There’s a big difference between simply having an infectious disease agent and weaponizing it,” she responded in an email. “However, it wouldn’t be particularly difficult to get experts to help with the weaponization process. The terrorist has a picked a good infectious agent for creating a bioweapon. Plague is designated as a Category A agent along with anthrax, smallpox, tularemia, botulinum, and viral hemorrhagic fevers. The agents on the Category A list pose the highest risk to national security, because they: 1) can be easily disseminated or transmitted from person to person; 2) result in high mortality rates and have the potential for major public-health impact; 3) might cause public panic and social disruption; and 4) require special action for public-health preparedness.”

Islamic State’s interest in weaponizing bubonic plague should be taken seriously. Here’s one reason why (from my ISM article):

In 1347, the Tatars catapulted the bodies of bubonic-plague victims over the defensive walls of the Crimean Black Sea port city now called Feodosia, then a gateway to the Silk Road trade route. That effort apparently succeeded a bit too well. Some of the city’s residents escaped in sailing ships that, alas, were infested with rats. The rats carried fleas. The fleas carried Yersinia pestis, the bacterial pathogen responsible for bubonic plague. The escapees docked in various Italian ports, from which the disease spread northward over the next three years. Thus ensued the Black Death, a scourge that wiped out nearly a third of western Europe’s population.

Previously: Microbial mushroom cloud: How real is the threat of bioterrorism? (Very) and Stanford bioterrorism expert comments on new review of anthrax case
Photo by Les Haines

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