Category Archives: Infectious disease
CDC: Man Previously Reported Having MERS Does Not Harbor the Virus
After completing additional and more definitive laboratory tests, the U.S. Centers for Disease Control and Prevention (CDC) has retracted a report made last week that an Illinois man contracted the potentially deadly MERS virus from a patient who was diagnosed with MERS in the United States after spending time as a health care worker in Saudi Arabia. The confusion over the diagnosis came from earlier tests that indicated antibodies to a coronavirus, the class of virus MERS belongs to. However, more definitive tests found that he did not harbor the MERS virus. There are six known versions of the coronavirus; four cause mild illness and two cause the much more serious MERS and SARS viruses. Read more on infectious disease.
Study: 30 Percent of the World’s Population is Obese
A new analysis of global obesity trends finds that approximately 2.1 billion people—or nearly 30 percent of the world population—are obese, according to a new study in The Lancet. Researchers found that rates of being obese or overweight climbed 20 percent in adults and 47 percent in children during the 33 years analyzed. The study, which was funded by the Bill & Melinda Gates Foundation, determined that while obesity was once more common in wealthier nations, approximately two-thirds of the world’s obese population lives in developing countries. In addition, the statistics for the United States were especially troubling; while only 5 percent of the world’s population lives in the United States, the country is home to approximately 13 percent of the world’s obese population. Read more on obesity.
Study: Lung Cancer Screening Can Scare People into Quitting Smoking
In addition to early detection and treatment of lung cancer, early screening can also scare people into quitting smoking before they even develop the disease, according to a new study in the JNCI: Journal of the National Cancer Institute. Researchers based their findings on an analysis of 14,621 current smokers, 55-70 years old, with a 30 or more pack-year smoking history and who had smoked during the last 15 years. The data was taken from the Lung Screening Study component of the U.S. National Lung Screening Trial. The study found that "...abnormal screening results may present a 'teachable moment'" and that "[f]uture lung cancer screening programs should take advantage of this opportunity to apply effective smoking cessation programs." Read more on tobacco.
Study: Family Stress Can Impact Mortality Risk
Stressful family situations can significantly increase the risk of death, according to a new study in the Journal of Epidemiology and Community Health. Using health data on 9,875 men and women aged 36-52 years from The Danish Longitudinal Study on Work, Unemployment and Health, researchers determined that frequent worries and/or demands from a partner or children were linked to a 50-100 percent increase in mortality risk, and that frequent conflicts with any type of social relation were linked to a 2-3 times increase in mortality risk. Researchers also concluded that people outside the labor force were at higher risk of exposure to stress family situations. Read more on mortality.
National Task Force Recommends Regular Hep B Screening for People at Highest Risk
The U.S. Preventive Services Task Force is recommending regular screening for all people at high risk for contracting hepatitis B virus. If left untreated, the chronic illness can lead to liver cancer. Among the groups that the national panel says should be screened are:
- People born in countries with a high rate of infection, mainly in Asia, sub-Saharan Africa, the Pacific Islands, the Middle East and Eastern Europe.
- Those who share risk factors similar to those for HIV, including injection drug users, men who have sex with men, and people living with or having sex with someone with a hepatitis B infection.
- Patients with a weakened immune system or who are undergoing treatment for kidney failure.
"We have treatments that are effective at suppressing the virus and at improving abnormalities in the liver, so we can prevent some of the damage that occurs due to chronic hepatitis B," said Roger Chou, MD, an assistant professor at Oregon Health & Science University in Portland and director of the Pacific Northwest Evidence-based Practice Center, as well as lead author for the evidence review that formed the basis of the task force's recommendation. Read more on infectious disease.
Fewer Smokers See E-cigarettes as a Safer Smoking Alternative
While the national profile of e-cigarettes continues to increase, smokers are also increasingly less likely to view them as safer than traditional cigarettes, according to a new study in the American Journal of Preventive Medicine. Using data collected from the Health Information National Trends Survey (HINTS), researchers determined that awareness of e-cigarettes rose to 77.1 percent in 2013 from 16.4 percent in 2009. However, while 84.7 percent of smokers in 2010 viewed e-cigarettes as less harmful than traditional cigarettes, that number was down to 65 percent in 2013. Current estimates are that c-cigarette sales will soon reach $1.7 billion annually, or approximately 1 percent of all U.S. cigarette sales. Read more on tobacco.
CDC Confirms First U.S. Case of MERS Virus
The U.S. Centers for Disease Control and Prevention (CDC) has confirmed the first U.S. case of MERS, a respiratory virus first identified in the Middle East two years ago. The virus was diagnosed in a U.S. patient who recently traveled from Saudi Arabia. The patient is being treated at a hospital in Indiana and people who traveled with the patient on an airplane from the Middle East are being contacted and told to see a doctor if respiratory symptoms develop. In some Middle Eastern countries, the virus has spread from person to person through close contact, but the CDC says there is no evidence of the sustained spread of the virus in general settings. "The virus has not shown the ability to spread easily in a community setting," said Ann Schuchat, MD, director of CDC's National Center for Immunization and Respiratory Diseases, during a telephone press conference on Friday.
"In this interconnected world we live in, we expected MERS to make its way to the United States....We have been preparing since 2012 for this possibility,” said Tom Frieden, MD, director of the CDC in a statement.
The CDC says that anyone who experiences respiratory illness within 12 weeks of traveling to Saudi Arabia, or becomes ill after contact with someone who recently traveled to Saudi Arabia, should contact their doctor. The CDC has not recommended that anyone change their travel plans based on the MERS virus. So far there have been 401 confirmed cases of the MERS virus in twelve countries, including the United States; 93 people have died of the virus. Camels have been identified as carriers of MERS, but it's not known how the virus is being spread to people. Read more on infectious disease.
WHO: World Polio Threat an ‘Extraordinary Event’ That Requires a Coordinated International Response
Despite the near cessation of the international spread of wild polio virus in the low transmission seasons (January to April) from January 2012 through 2013, a new report from the World Health Organization (WHO) finds that the current international spread of polio can now be considered an “extraordinary event.” WHO experts say the public health risk—the WHO Emergency Committee unanimously agreed that the conditions for a Public Health Emergency of International Concern (PHEIC) have been met—requires a coordinated international response. So far in 2014 there has already been international spread of wild polio virus from 3 of the 10 States that are currently infected: in central Asia (from Pakistan to Afghanistan), in the Middle East (Syrian Arab Republic to Iraq) and in Central Africa (Cameroon to Equatorial Guinea). Pakistan, Cameroon and the Syrian Arab Republic pose the greatest risk in 2014, according to the WHO. Read more on global health.
Study: Even Outbreaks May Not Change the Minds of Parents Opposing Childhood Vaccines
Parents who choose not to have their children receive mandatory immunizations may not change their minds even in the face of outbreaks of childhood illnesses, according to a new study. Researchers studied a pertussis outbreak in Washington State from October 2011 through December 2012, finding “no significant increase” in the vaccination rates of approximately 80,000 infants ages 3 to 8 months, according to HealthDay. Paul Offit, MD, chief of the division of infectious diseases at the Children's Hospital of Philadelphia, said parents using “personal belief” exemptions to not have their children vaccinate is likely beyond the resurgence of diseases that were once all but eradicated in the United States. "The problem is not theoretical,” he said. "You are starting to see eroding of herd immunity with outbreaks of measles and pertussis. The main reason is people are choosing not to vaccinate their children. It's becoming a more dangerous world from the standpoint of infectious diseases. Measles and pertussis are back. These are serious diseases that before vaccine caused a lot of death.” Offit was not a part of the recent study. Read more on vaccines.
Study: MERS Virus Outbreak Linked to Camels
New evidence strongly implicates camels as the carrier and cause of an ongoing outbreak of Middle East Respiratory Syndrome (MERS) that has infected 300 people and killed approximately 100 since the first documented case in Saudi Arabia in September 2012. According to a new study in the journal mBio, scientists at the Center for Infection and Immunity at Columbia University's Mailman School of Public Health, King Saud University, and EcoHealth Alliance have extracted a complete, live, infectious sample of MERS coronavirus from two Saudi Arabian camels. "The finding of infectious virus strengthens the argument that dromedary camels are reservoirs for MERS-CoV," says first author Thomas Briese, PhD, associate director of the Center for Infection and Immunity and associate professor of Epidemiology at the Mailman School, in a release. "The narrow range of MERS viruses in humans and a very broad range in camels may explain in part the why human disease is uncommon: because only a few genotypes are capable of cross species transmission.” Co-author Abdulaziz N. Alagaili, PhD, director of the Mammals Research Chair at King Saud University, added that the next step is “investigating potential routes for human infection through exposure to camel milk or meat products.” Read more on infectious disease.
This Friday RWJF to Discuss How to Make Sure Patients Are Getting the Right Care
As much as 30 percent of health care delivered in the United States is unnecessary, won’t help improve help or may even harm health, according to some health care experts. The Robert Wood Johnson Foundation’s (RWJF) Choosing Wisely effort has, for the past two years, worked to identify more than 250 tests and procedures that that physician groups say are overused in their own field. This Friday, May 2 from 12-1 p.m. ET, Susan Dentzer, senior policy adviser to RWJF, will lead a discussion with physicians and a patient about how to shift the cultural mindset from “more care is better” to “the right care, and no more. Go here to RSVP.
Study: As Many as 5.3M Americans Have Untreated Chronic Viral Hepatitis
Despite public health efforts over the past several years, untreated chronic viral hepatitis continues to be a serious problem, according to a new commentary being published in the Annals of Internal Medicine. The disease affects between 3.5 and 5.3 million Americans and contributes to the rise of incidences in progressive liver disease, liver failure and liver cancer. The U.S. Department of Health and Human Services (HHS) in 2011 unveiled the Action Plan for the Prevention, Care and Treatment of Viral Hepatitis in the United States in order to advance both the prevention and treatment of viral hepatitis. The updated 2014-2016 HHS Viral Hepatitis Action Plan expands on the 2011 plan and will include additional metrics to help monitor the plan’s major goals. Read more on HHS.
CDC Identifies Rare U.S. Case of Lassa Fever
A severe viral disease common in West Africa has been confirmed in a person returning to the United States from the region, according to the U.S. Centers for Disease Control and Prevention (CDC) and the Minnesota Department of Health (MDH). The patient was admitted to a Minnesota hospital for Lassa fever on March 31, with the CDC confirming diagnosis on April 3 and the patient now recovering and in stable condition. The last case of Lassa fever in the United States, of which there have been seven confirmed and all related to travel, was in Pennsylvania in 2010. The virus is not transmitted through direct contact with a sick person’s blood of bodily fluids and cannot by transmitted by casual contact; there are up to 300,000 cases and 5,000 deaths each year in West Africa. “This imported case is a reminder that we are all connected by international travel. A disease anywhere can appear anywhere else in the world within hours,” said CDC Director Tom Frieden, MD, MPH. Read more on infectious disease.
Public Health Officials in Developing Countries Use Social Marketing to Promote Health Behaviors
Public health officials in developing countries are successfully using social marketing strategies to educate people about the importance of behaviors related to water and sanitation, according to a new study in the journal Social Science & Medicine. In a systematic review of 32 studies, researchers led by W. Douglas Evans, PhD, a professor of prevention and community health at Milken Institute School of Public Health at the George Washington University, looked at how public health officials utilized social marketing tools such as door-to-door visits and public education campaigns for school children to promote behaviors such as regular hand washing and water purification. Read more on global health.
Depression, Anxiety Linked to Poor Diabetes Management
Depression and anxiety can be significant impediments to proper management of diabetes, according to a new study in the journal BioMed Central. Researchers from The University of Texas School of Public Health examined 500 Mexican-American adults from the Cameron County Hispanic Cohort in Brownsville, Texas, each of whom had been diagnosed diabetes and were taking medication for diabetes. Each t was interviewed about symptoms of depression and anxiety, and researchers also took measurements for body mass index (BMI), waist circumference, physical activity, fasting glucose and average blood sugar levels over time. “Unfortunately, greater depression and anxiety are associated with higher BMI and greater waist circumference, both indicators of obesity, as well as engaging in less physical activity and having less favorable indicators of glycemic control,” said Darla Kendzor, PhD, principal investigator and assistant professor at the School of Public Health Dallas Regional Campus, part of The University of Texas Health Science Center at Houston. Eighty one percent of Mexican-Americans are obese or overweight nationwide, with a nationwide diabetes rate of 16.3 that climbs to 30 percent for those who live along the U.S.-Mexico border. Read more on obesity.
Tomorrow, March 25, the day after World Tuberculosis Day, the Public Broadcasting Program Frontline will present TB Silent Killer a new documentary that looks at tuberculosis in Swaziland, the country with the highest incidence of the disease.
While many people, especially in the United States, think tuberculosis has long since been eradicated, there are in fact more than 8 million new infections every year, many of them virulent new drug-resistant strains that are passed—throughout the world—through a cough or a sneeze. According to the World Health Organization, tuberculosis has become the second-leading cause of death from an infectious disease on the planet.
Jezza Neumann, the filmmaker who created TB Silent Killer, tells the story of several people in Swaziland suffering daily from the disease, including ten-year-old Nokubegha, whose mother recently died of a multidrug resistant strain of tuberculosis and whose 17-year-old brother cares for her.
“In Swaziland, a quarter of all adults are HIV-positive, which means their immune systems are compromised and especially susceptible to TB infection,” said Neumann, “But globalization and international travel mean that these infections have the potential to spread all over the world.”
NewPublicHealth spoke by phone with Jezza Neumann a few days before the documentary was scheduled to air on Frontline (Check local PBS schedules here.)
NewPublicHealth: Why did you choose tuberculosis as your topic?
Jezza Neumann: The idea being to make films that make a difference and give voice to the voiceless. In doing so, we’ve made and kept relationships with nonprofits and NGOs and other organizations and look to find the issue that’s hidden in the background that no one is hearing about, that’s not getting the platform that it needs.
One of the organizations we’d worked a lot with is MSF, Medecins Sans Frontieres, or Doctors Without Borders as it’s known over here. The press officer at the U.K. office knew that Doctors Without Borders had been struggling to get the issue of tuberculosis out on the mainstream. People had done small reports but she knew there was a big impact possible with a documentary because the reality is if you combine the facts, stats and figures in documents with a film that has a human face and a human cost of those facts, stats and figures, it becomes something so much bigger. The documentary becomes a platform that has a life far further reaching than just the transmission.
HHS: Common Sports Injuries Mean High Costs for People Without Insurance
The ASPE Office of Health Policy, part of the U.S. Department of Health and Human Services (HHS), has released a new issue brief analyzing the incidence and average health care charges associated with common sports injuries. The injuries range from minor sprains and strains to more serious injuries such as broken bones and concussions, where direct medical bills can be significant, placing an especially heavy burden on people without health insurance. Such individuals could be made to pay not just out-of-pocket costs, but also providers’ full stated charges. Breaking down health care costs by age and sometimes gender, the brief found, for example, that the average cost to fix a leg fracture for a person 10-19 years old was $4,689 and for those ages 25-40 was $3,403. Read more on injury prevention.
CDC: Drexel Meningitis Death Linked to Princeton Outbreak
Researchers at the U.S. Centers for Disease Control and Prevention have confirmed through “genetic fingerprinting” that a Drexel University student who died March 10 from meningitis died from the same serogroup B meningococcal strain that previously caused an outbreak at Princeton University. Health department officials confirmed that the Drexel student had been in close contact with Princeton students a week before becoming ill, indicating that the strain may still be present in the Princeton University community. Health officials have already administered antibiotic prophylaxis to prevent additional cases of meningococcal disease in people who had been close to the Drexel student. No new cases have since been reported. Read more on infectious diseases.
Study: ICU Survivors Face Heightened Risk for Mental Health Problems
Critically ill people who survive a stay in a hospital intensive care unit (ICU) are at heightened risk for mental health problems such as depression and anxiety in the following months, according to a new study in the Journal of the American Medical Association. Examining the records of more than 24,000 Danish ICU patients, researchers found that in the three months post-discharge that about 0.5 percent had a new diagnosis—which was 22 times higher than the rate in the general population. Approximately 13 percent received a new prescription for a psychiatric medication, including antidepressants and drugs for anxiety and insomnia, during that period. Researchers said the findings indicate that as doctors become better at saving the lives of critically ill patients, more people will also be at risk for problems beyond their physical health. Read more on mental health.
CDC: Reducing High-risk Antibiotic Prescriptions Could Also Reduce Deadly Infections
The most recent Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC) finds that if prescriptions of high-risk antibiotics in hospitals were reduced by just 30 percent, then there could be as many as 26 fewer cases of deadly diarrhea infections with Clostridium difficile. “Improving antibiotic prescribing can save today’s patients from deadly infections and protect lifesaving antibiotics for tomorrow’s patients,” said CDC Director Tom Frieden, MD, MPH. “Health care facilities are an important part of the solution to drug resistance and every hospital in the country should have a strong antibiotic stewardship program.” As part of its ongoing efforts to improve antibiotic prescribing, the CDC has release a checklist of seven core elements for hospitals:
- Leadership commitment: Dedicate the necessary human, financial, and IT resources.
- Accountability: Appoint a single leader responsible for program outcomes. Physicians have proven successful in this role.
- Drug expertise: Appoint a single pharmacist leader to support improved prescribing.
- Act: Take at least one prescribing improvement action, such as requiring reassessment of prescriptions within 48 hours to check drug choice, dose, and duration.
- Track: Monitor prescribing and antibiotic resistance patterns.
- Report: Regularly report prescribing and resistance information to clinicians.
- Educate: Offer education about antibiotic resistance and improving prescribing practices.
Read more on infectious diseases.
Poorer Women Most Likely to Be Caught in ‘Vicious’ Caregiving, Financial Well-being Cycle
Low-income women are at increased risk of finding themselves caught in a “vicious cycle” of parental caregiving and financial well-being, according to a new study in The Journals of Gerontology. While women of better financial means can afford additional caregiver assistance and better health care for aging parents, poorer women lack those options. "People who had less household income and less financial resources were more likely to take care of their parents so there is this cycle that they cannot get out of—they are poor, then taking care of parents, then being poor and taking care of their parents—there's this kind of cycle," said lead author Yeonjung Lee, a researcher and professor at the Faculty of Social Work at the University of Calgary in Alberta, Canada, according to Reuters. Read more on aging.
Young Skin Cancer Survivors at Heightened Risk for Other Cancers
Younger skin cancer survivors are at increased risk for additional cancer types later in life, according to a new study in the journal Cancer Epidemiology, Biomarkers & Prevention. A review of data of more than 500,000 people with a history of nonmelanoma skin cancer found that while all age groups were at heightened risk for melanoma and other types of cancers, the increase was especially significant for people under the age of 25, who were 23 times more likely to develop cancer than people who had never had nonmelanoma cancer. The risk was 3.5 times higher for nonmelanoma survivors ages 25-44, 1.74 times higher for those ages 45-59 and 1.32 times higher for those older than 60. The types of cancer they are at risk for include melanoma skin cancer, and cancers of the breast, colon, bladder, liver, lung, brain, prostate, stomach and pancreas. Read more on cancer.
FDA Proposes New ‘Nutrition Facts’ Food Labels
The U.S. Food and Drug Administration (FDA) has put forth a new proposed Nutrition Facts label for packaged foods. The updated design would reflect scientific information not available when the current label was designed two decades ago. For example, it would replace out-of-date serving sizes and feature a design that highlights key parts of the label, such as calories and serving sizes. “For 20 years consumers have come to rely on the iconic nutrition label to help them make healthier food choices,” said FDA Commissioner Margaret A. Hamburg, MD. “To remain relevant, the FDA’s newly proposed Nutrition Facts label incorporates the latest in nutrition science as more has been learned about the connection between what we eat and the development of serious chronic diseases impacting millions of Americans.” Read more on nutrition.
Study: One in Five U.S. Health Facilities Don’t Provide Hand Sanitizer Everywhere Needed
One in five U.S. health facilities don’t make hand sanitizer available everywhere necessary, needlessly increasing the risk for health-care associated infections, according to a new study in the American Journal of Infection Control. In addition, approximately half of the hospitals, ambulatory care facilities and long-term care facilities included in their budgets funds for proper hand hygiene training. The study examine compliance with the World Health Organization’s hand hygiene guidelines at 168 facilities in 42 states and Puerto Rico. "When hospitals don't focus heavily on hand hygiene, that puts patients at unnecessary risk for preventable health care-associated infections," said by Laurie Conway, RN, MS, CIC, PhD student at Columbia Nursing, in a release. "The tone for compliance with infection control guidelines is set at the highest levels of management, and our study also found that executives aren't always doing all that they can to send a clear message that preventing infections is a priority." Read more on infectious disease.
CDC Foundation Expands Safe Injection Campaign
The CDC Foundation and Eli Lilly are partnering to expand the U.S. Centers for Disease Control and Prevention’s (CDC) Safe Injection Practices Coalition—a safety awareness campaign that provides information for health providers and patients. According to CDC data, more than 150,000 patients have been notified of potential exposure to hepatitis and HIV because of unsafe injection practices in U.S. health care settings since 2001, and CDC researchers have found that medical injections are an overlooked source of infections and outbreaks. Planned actives of the partnership include:
- Expand the One & Only Campaign to new audiences such as individual and group-owned physician practices
- Educate health care providers through new and enhanced training and communication materials to address emerging issues
- Improve the Safe Injection Practices Coalition website and social media platforms to share resources and toolkits with new audiences
- Engage new and existing Safe Injection Practices Coalition partners
Read more on prevention.
What’s that cute blue thing shining its lights in the patient rooms and hallways of the National Institutes of Health’s (NIH) clinical center in Bethesda, Md.? A literal life saver.
Tru-D, a new robot now gainfully employed at the NIH, shoots beams of ultraviolet (UV) light. The rays kill a range of pathogens, including many of the bacterial strains—such as MRSA and C.diff—that have been linked to 90,000 health system deaths each year, according to the U.S. Centers for Disease Control and Prevention (CDC).
Manual disinfecting rids surfaces of about half of the bacteria in an area. Limitations of human cleaning squads include the probability they can miss a few—or many—spots and that disinfectants must remain wet on a surface for a full ten minutes to fully do their job and then be rinsed away. That time commitment is often very costly for hospitals that typically need to turn over patient rooms quickly. But incomplete disinfection can leave a lot of disease. MRSA, for example, can remain on surfaces for as long as nine months.
The UV light units work by disrupting the DNA structure of pathogens, which destroys some and makes others harmless.
Tru-D is just one of several UV light units on the market. It has been getting some attention recently both because of the NIH purchase and because it has some especially interesting features, including a cloud-computing system that lets it link up to health system records and automatically chart which rooms have been disinfected.
UV light doesn’t come cheap. Units, which come in different sizes that determine how wide a space they can disinfect simultaneously, can range from about $60,000 to $120,000. But hospitals also consider what they’re saving by making the purchase—such as new fines under the Affordable Care Act for some hospital readmissions before thirty days after a discharge. And some of those readmissions are for infections acquired during a hospital stay.
The units won’t displace the human cleaning staff, says Steve Streed, system director of Epidemiology/Infection Control at the Lee Memorial Health System in Fort Myers, Fla. and a member of the Association for Professionals in Infection Control and Epidemiology For example, the robots can’t rid spaces of blood and other substances humans leave behind.
UV units can disinfect a space in ten or twenty minutes. One limitation on their power and cleaning time is the wattage in hospitals. Units can be made more powerful but would blow out a hospital’s circuits. Streed says one company is working on a hybrid unit that would use both electricity and battery to amp up the wattage—and likely reduce the time needed—to disinfect hospital spaces.
Streed says recent studies have found that human disinfecting still leaves 50 percent of residual bacteria and UV light gets rid of 99 percent of what remains. Another disinfecting system, fogging rooms with hydrogen peroxide, gets rid of 99.9 percent, but takes more time since air ducts have to be closed before it use and then reopened afterwards. Either option gets rid of sufficient bacteria, says Streed. What remains is generally not in high enough levels to infect a patient.
>>Bonus Link: Read a CDC Vital Signs Report on Hospital Acquired Infections.