18 July 2009

Slaughterhouse samples

(WARNING: There are some graphic pictures in this post that may offend or nauseate some of you. On the scale of pictures that I could have posted, they aren't so bad, but I still feel like I should give a warning.)

I can proudly say that I have survived two weeks of working in an Egyptian slaughterhouse (first mentioned in this post). The study that we're doing in the slaughterhouses in Egypt is designed as a risk assessment, to see what diseases are being carried by the animals and insects in the slaughterhouses and determine whether the employees who work in the slaughterhouses may be at risk for catching some of these diseases. (For those of you in the medical field, we're specifically interested in Rift Valley Fever, West Nile virus, Crimean-Congo Hemorrhagic Fever, Q-fever, Brucella spp., Leptospira spp. and two sandfly fevers.)

We decided to collect three different types of samples to analyze in our laboratories for these diseases: (1) blood samples from slaughtered animals, (2) ectoparasite collection (ticks, lice, biting flies, etc.) from slaughtered animals, and (3) insect collection (mosquitoes, flies, etc.) using light traps and sticky traps. I recruited a team from NAMRU-3 (mostly made up of vector biologists, laboratory staff and summer interns) to help with sample collection, and we spent four long days at the slaughterhouse. Slaughtering begins at 2:00 or 3:00 a.m. every day, so we had to be at the site by 4:00 a.m. and we worked most days until 9:30 a.m. I suppose that's not too many hours, but it's a lot of time to spend in a dark, smelly, bloody, hectic Egyptian slaughterhouse.

NAMRU-3 study team

As I mentioned, the first component of the sample collection was to take blood samples from slaughtered animals. In four days we collected blood specimens from over 500 animals, including cattle, buffalo, sheep and camels. To avoid any stigma or controversy, we decided to collect blood samples after the animals were killed rather than before, lest one of the butchers think we were using needles to inject the animals with something. By collecting the blood after slaughter, we were able to avoid using needles at all.

In Egypt, as throughout the Middle East, animals are slaughtered according to halal methods to meet religious requirements that forbid such things as the consumption of blood or of meat from an animal that has been strangled, beaten or gored. Animals are therefore killed by having their throats slit with a sharp knife (in all reality, their throats are cut all the way through to the spine so the animals are practically beheaded). Since the animals bleed for qutie some time after they are killed, it was rather easy for us to step in and collect blood directly from the jugular vein while the animal was laying on the ground after slaughter.
Inside the nicest area of the Muneeb abattoir
The second component of the study involved a group of vector biologists from our team. After we collected blood from each animal, the vector biologists checked the animal's body for ecoparasites like ticks, lice and biting flies. This was truly a messy job, to comb over each slaughtered animal's body searching for tiny little bugs and then removing each critter with a pair of tweezers and placing it in a tube. I was really impressed at how many ectoparasites they actually found.
Vector biologists examining an animal for ectoparasites
The third component of the project also involved collecting vectors, though in a less messy way. By examining the animals, we were able to collect insects that attach themselves to animals for a longer time period, but we were also interested in the insects that attach themselves for just a short period of time - insects like mosquitoes and flies. The vector biologists used two types of traps to collect these vectors. The first type of traps are called CDC light traps. The second type of traps are sticky traps, which look like a piece of cardboard covered in a stucky substance, attached to a stick and stuck in the ground. Both types of traps were set all around the slaughterhouse grounds.
Vector biologists setting CDC light traps
Vector biologists setting sticky traps
Clearly sample collection for this project wasn't a clean job, nor an easy one. It wasn't a pleasant thing to do; it didn't happen in a pleasant location; it didn't happen at a pleasant time of day (those of you who know me well can only imagine how excited I was to set my alarm clock for 2:30 a.m. every morning that we had to go out to the slaughterhouse); it didn't smell pleasant; in fact, there was nothing pleasant about it, except for one thing, and thankfully, that was one huge thing. My study team for this project was absolutely incredible. They were so great to work with, and I mean that in the very, very best way possible. Each person was meticulous and diligent with the work, followed direction without question and, somehow, in this environment, maintained a positive attitude, made jokes, smiled and laughed throughout the days. It was truly a pleasure to work with each and everyone of them and somehow it almost makes me look forward to the next time we have to go out and do this!
NAMRU-3 study team
NAMRU-3 study team

05 July 2009

Comino

I decided to spend my last night on a little island on the north side of Malta. The island is called Comino, and it's home to the Blue Lagoon, which is a breathtaking site!
Unfortunately the lagoon had pretty much been taken over with European university students on summer vacation when I was there, so I spent most of my time on the other side of the tiny island, where my hotel was located. I'm not usually one to hang around the hotel, but I loved laying on the beach in the sun in the peaceful quiet.

04 July 2009

H1N1 in Malta

All the newspapers I’ve seen in shops today have a huge headline that reads “4 cases of swine flu in Malta.”

Even now, I’m sitting in a small café in Valletta, and a woman, who is obviously a friend of the owner of the café, walked in and said “they have just taken my son to the hospital to be tested for the swine flu.”

Try as I may, I just can’t get away from it!

Castille Hotel

I do love the little hotel where I've been staying in Valletta. It's nothing too fancy, but the owners are so kind and it's in a great location. Plus breakfast is served on the roof and gives a terrific view of the city!

03 July 2009

Marsovin summer wine festival

Maltese wine + Italian food + a Spanish guitar and mandolin duet + perfect weather + fireworks = the most perfect night I’ve had in a while!
Earlier this afternoon I found out that Marsovin, a large wine producer in Malta, would be hosting its annual wine festival tonight in the Hastings Gardens, which are located just on the edge of the old city of Valletta, atop the city walls overlooking the sea. The event was described as a fusion of four Mediterranean cultures – Italian, Spanish, Maltese and Moroccan – over a celebration of Marsovin’s 90th anniversary. The gardens were divided into four areas, so that each culture could present food and entertainment to accompany the wine tastings. The Italian area served pasta and salads while classical music was performed by a pianist and flautist; the Spanish area had tapas and paella with a duet of Spanish guitar and mandolin, occasionally interrupted by Flamenco dancers; the Maltese area served traditional Maltese dishes, consisting mainly of rabbit and pasta, while two young men performed on the keyboard and guitar (mostly American music, oddly enough); the Moroccan area advertised shisha, falafel and belly dancing, but I have to admit I did my best to stay away from those reminders of Egypt.
It was a perfectly lovely evening. I wandered from area to area for a while, but settled for most of the night in the Spanish section of the gardens, listening to the hauntingly beautiful music of the guitar and mandolin and sipping on good wine. The scenery was beautiful with an incredible sunset over the harbor, and, just when I thought the night couldn’t get much better, fireworks began in the distance! I love love love fireworks, so this really made my night. Cheers!