Category Archives: Infectious disease
EBOLA UPDATE: CDC Increases Deployments to West Africa
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The U.S. Centers for Disease Control and Prevention (CDC) has announced an increase in its deployments and efforts in West Africa in response to the ongoing Ebola outbreak, which is the largest in the history of the disease. The public health agency has activated its Emergency Operations Center to its highest response level and plans on adding 50 disease control experts to the region within the next month.
As of Monday, CDC deployments are:
- Guinea: 6 currently deployed,
- Liberia: 12 currently deployed
- Nigeria: 4 currently deployed
- Sierra Leone: 9 currently deployed
“The bottom line with Ebola is we know how to stop it: traditional public health. Find patients, isolate and care for them; find their contacts; educate people; and strictly follow infection control in hospitals. Do those things with meticulous care and Ebola goes away,” said CDC Director Tom Frieden, MD, MPH, in a release. “To keep America safe, health care workers should isolate and evaluate people who have returned from Guinea, Liberia, and Sierra Leone in the past 21 days and have fever or other symptoms suggestive of Ebola. We will save lives in West Africa and protect ourselves at home by stopping Ebola at the source.” Read more on Ebola.
Study: About Half of All Physicians Utilize EHRs
Electronic health records (EHRs) are increasingly being utilized by physicians and hospitals, according to two new studies in the journal Health Affairs. Researchers from the U.S. Department of Health and Human Services Office of the National Coordinator for Health Information Technology determined that in 2013 approximately 78 percent of office-based physicians used some form of EHRs and about 48 percent of all physicians used an EHR system with advanced functionalities. They also found that 59 percent of hospitals in 2013 were using an EHR system with certain advanced functionalities. “Patients are seeing the benefits of health IT as a result of the significant strides that have been made in the adoption and meaningful use of electronic health records,” said Karen DeSalvo, MD, MPH, national coordinator for health information technology. “We look forward to working with our partners to ensure that people’s digital health information follows them across the care continuum so it will be there when it matters most.” Read more on technology.
Number of Suicide Attempts Using Prescription Drugs Up Dramatically
Suicide attempts involving prescription medications and other drugs climbed 51 percent among people ages 12 and older from 2005 to 2011, according to two new reports from the Substance Abuse and Mental Health Services Administration. The greatest increase was seen in people between the ages of 45 and 64, with a 104 percent increase, followed by adults younger than 30, with a 58 percent increase. "We probably are seeing an increase in overall suicide attempts, and along with that we are also seeing an increase in drug-related suicide attempts," said Peter Delany, director of the agency's Center for Behavioral Health Statistics and Quality, in a release. "People have access to medications, and they are using both prescription and over-the-counter meds. It is clear that there are more drugs out there." Read more on prescription drugs.
EBOLA UPDATE: African Death Toll Hits 932 as Liberia Shuts Down a Major Hospital Over Continued Infections
(NewPublicHealth is monitoring the public health crisis in West Africa.)
St. Joseph's Catholic hospital in the Liberia capital of Monrovia has been shut down after the death of its hospital director from Ebola and the subsequent infections of six staff members, including two nuns and a priest. The World Health Organization reports that there were 45 deaths in the three days leading to August 4—bringing the death toll so far to 932—and is calling for an emergency meeting to determine whether the outbreak constitutes a "Public Health Emergency of International Concern" and to discuss what additional public health measures can be taken. Read more on infectious diseases.
‘Gluten-free’ Labels Must Now Fully Meet FDA Standards
What does a “gluten-free” food label actually mean? Exactly what it says, as of yesterday. August 5 was the deadline for all U.S. foods bearing a gluten-free label claim to meet the U.S. Food and Drug Administration’s (FDA) final rule covering the issue. The rule sets a gluten limit of less than 20 ppm (parts per million) in foods that carry the label, which is the lowest level that can be detected. The agency issued the rule last August, giving manufacturers one year to bring their product lines into compliance. “Gluten-free” labeling is critical to people with celiac disease, which has no cure and can only be treated through diet. "This standard ’gluten-free’ definition eliminates uncertainty about how food producers label their products. People with celiac disease can rest assured that foods labeled 'gluten-free' meet a clear standard established and enforced by FDA," said Felicia Billingslea, director of FDA's division of food labeling and standards, in a release. Read more on food safety.
Study: Daily Aspirin Linked to Reduction in Risk for Some Cancers
A daily dose of aspirin is linked to a reduction in the risk of developing and dying from colon, stomach and esophageal cancers, according to a new study in the Annals of Oncology. Researchers analyzed the results of available studies, determining “that most people between the ages of 50 and 65 would benefit from a daily aspirin," said lead researcher Jack Cuzick, head of the Center for Cancer Prevention at Queen Mary, University of London, adding, “It looks like if everyone took a daily aspirin, there would be less cancer, and that would far outweigh any side effects.” The most serious side effect associated with aspirin is gastrointestinal bleeding. According to HealthDay, Leonard Lichtenfeld, MD, deputy chief medical officer at the American Cancer Society, said that while the study does not mean that everyone should be taking aspirin as a cancer-prevention measure, if does mean they should discuss the possibility with their doctors. Read more on cancer.
The National Institute of Allergy and Infectious Diseases (NIAID), a division of the National Institutes of Health, is set to begin an early-stage clinical trial for a vaccine to protect against the Ebola virus. The trial should begin as early as September. The vaccine to be tested was developed by the NIAID’s Group Health Research Center in Seattle and does not contain infectious Ebola virus material. Instead, it’s what is known as an adenovirus vector vaccine containing an insert of two Ebola genes. The vaccine works by entering a cell and delivering the new genetic material, causing a protein expression that activates an immune response in the body. Researchers have seen success with studies in primates.
The vaccine being tested is not the experimental serum that was used on two Ebola-infected health workers recently evacuated from Liberia. In those cases, Samaritan’s Purse, the aid organization that sent the health workers to Africa, contacted officials from the U.S. Centers for Disease Control and Prevention (CDC) in Liberia to discuss the status of various experimental treatments they had identified through a medical literature search. CDC officials referred them to an NIH scientist in West Africa familiar with experimental treatment candidates who was then able to refer them to pharmaceutical companies working on experimental treatments. The serum being used is made by Mapp Biopharmaceutical of San Diego, Calif.
Read more on NIAID Ebola vaccine research.
>>Bonus Content: The CDC has released a new Ebola infographic.
Crowdsourcing Apps as Effective at Experts in Providing Healthy Food Information
Crowdsourcing healthy food information and feedback via smartphone apps can be as effective as working with trained experts, according to a new study in the Journal of the American Medical Informatics Association. Researchers used 450 photos of food/drink uploaded onto the Eatery app by 333 unique users in Europe and the United States, comparing the “healthiness” ratings from the app’s users to those from three public health students training in dietary assessment. The results were similar and both were in line with national dietary guidance. "Crowdsourcing has potential as a way to improve adherence to dietary self-monitoring over a longer period of time," wrote the researchers. "The results of this study found that when basic feedback on diet quality by peer raters is crowdsourced, it is comparable to feedback from expert raters, and that peers can rate both healthy and unhealthy foods in the expected direction.” Read more on nutrition.
HUD: $106M to Improve Home Visiting Programs for Pregnant Women, Parents of Young Children
The U.S. Department of Health and Human Services (HHS) has awarded nearly $106 million to expand voluntary, evidence-based home visiting services for pregnant women and the parents of young children. Forty-six states, the District of Columbia and five jurisdictions will share the funding from the Maternal, Infant, and Early Childhood Home Visiting Program; home visits have been shown to prevent child abuse and neglect, while promoting childhood health and development. “These awards allow states to reach more parents and families in an effort to improve children’s health while at the same time building essential supports within their communities,” said Mary Wakefield, PhD, RN, administrator of the Health Resources and Services Administration, in a release. Read more on maternal and infant health.
Study: Hepatitis C Could Be ‘Rare’ In the U.S. By 2036
A new computer model indicates that improved medicine and screening regimens could make hepatitis C a “rare” disease in the United States within the next two decades, according to a new study in the Annals of Internal Medicine. Currently approximately one in every 100 people in the United States are infected with the virus, which is a liver infection that can cause fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain and other symptoms, according to the U.S. Centers for Disease Control and Prevention. The researchers determined that this incidence rate could drop to approximately one in every 1,500 people by 2036 based on current and continuing improvements in treatment, and recommend a greater emphasis on identifying at-risk and infected patients. Read more on infectious disease.
EBOLA UPDATE: Nigeria Confirms Second Ebola Case
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Nigeria today confirmed its second case of Ebola amidst an epidemic that has so far killed more than 700 people in West Africa. Liberia has also ordered the cremation of all bodies of people who die from Ebola, in response to communities concerned over having the bodies buried nearby. However, even as the virus continues to spread in West Africa, Anthony S. Fauci, MD, Director of the National Institute of Allergy and Infectious Diseases, has told NBC that the risk posed by the return of the Ebola-infected health workers to the United States is "infinitesimally small.” The second U.S. patient is scheduled to arrive for treatment tomorrow. Read more on infectious disease.
HHS: New Committee to Advise on Children’s Health During Disasters
The U.S. Department of Health and Human Services (HHS) has announced the formation of a new federal committee to advise on children’s health issues during natural and manmade disasters. The National Advisory Committee on Children and Disasters’ contributions will include comprehensive planning and policies to meet kids’ health needs before, during and after disasters and other public health emergencies. The committee, formed under the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013, includes 15 members selected from 82 nominations. Seven are from outside the federal government and 8 are from within (the full list is available here). "Ensuring the safety and well-being of our nation's children in the wake of disasters is vital to building resilience in every community,” said HHS Secretary Sylvia M. Burwell, in a release. “We look forward to working with the committee toward this common goal." Read more on disasters.
Toledo Lifts Ban on Drinking Water; 400,000 Residents Affected Over the Weekend
The town of Toledo, Ohio, has lifted the ban on drinking water implemented over the weekend after dangerously high levels of algae were found in Lake Erie. The Great Lake provides much of the area’s drinking water. Approximately 400,000 residents were affected by the ban. Read more on water and air quality.
EBOLA UPDATE: CDC Issues Travel Warning for Three African Countries
(NewPublicHealth is monitoring the public health crisis in West Africa)
The U.S. Centers for Disease Control and Prevention (CDC) has issued a Level 3 Travel Warning for Guinea, Liberia and Sierra Leone, calling for Americans to avoid nonessential travel to the West African countries due to the growing Ebola outbreak. CDC officials are also on the ground:
- Tracking the epidemic including using real-time data to improve response
- Improving case finding
- Improving contact tracing
- Improving infection control
- Improving health communication
- Advising embassies
- Coordinating with the World Health Organization and other partners
- Strengthening Ministries of Health and helping them establish emergency management systems
“This is the biggest and most complex Ebola outbreak in history. Far too many lives have been lost already,” said CDC Director Tom Frieden, MD, MPH. “It will take many months, and it won’t be easy, but Ebola can be stopped. We know what needs to be done. CDC is surging our response, sending 50 additional disease control experts to the region in the next 30 days.” Read more on global health.
FDA Takes Steps to Improve Diagnostic Testing
The U.S. Food and Drug Administration (FDA) is taking new steps to ensure that patients have access to accurate, consistent and reliable diagnostic testing. The agency announced today that it was issuing a final guidance on the development, review and approval or clearance of companion diagnostics, which are used to determine whether patients should receive certain drugs. The FDA is also notifying Congress that it will publish a proposed risk-based oversight framework for laboratory developed tests. “Ensuring that doctors and patients have access to safe, accurate and reliable diagnostic tests to help guide treatment decisions is a priority for the FDA,” said FDA Commissioner Margaret A. Hamburg, MD, in a release. “Inaccurate test results could cause patients to seek unnecessary treatment or delay and sometimes forgo treatment altogether.” Read more on the FDA.
CDC: New Online Resource on Opportunities in U.S. Health System
The U.S. Centers for Disease Control and Prevention’s (CDC) Office for State, Tribal, Local and Territorial Support (OSTLTS) has launched a new website, Health System Transformation and Improvement Resources for Health Departments, to provide information, resources and training opportunities related to ongoing efforts to improve efficiency and effectiveness in the U.S. health system. This includes the public health, health care, insurance and other sectors. Topics covered by the new site range from shared services, community benefit assessment and accountable care organizations to public health law, workforce, return on investment and financing. Read more on access to health care.
Since March, several African countries have reported more than 1,000 cases of Ebola virus and more than 670 deaths. During a United Nations Foundation briefing in Washington, D.C., earlier this month, public health experts from the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization raised concerns about airline passengers from these countries spreading Ebola well beyond Africa. This week that fear became a reality when a U.S. citizen, Paul Sawyer, who had been in Liberia very recently as a consultant to the country’s finance ministry, fell ill on a flight from Liberia to Nigeria. Sawyer was hospitalized in Lagos, Nigeria, and died there of Ebola.
Several West African nations have responded by planning to set up monitoring stations at airports to identify people with fevers before they board planes. On a CDC conference call this week with reporters, Martin Cetron, MD, the CDC's director for Global Migration and Quarantine, said it makes more sense to put checkpoints in West African countries than to scan incoming passengers in the United States because there are few direct flights from West Africa, and fevers found among passengers entering the United States are unlikely to be Ebola.
“Ebola is contagious only when symptomatic, so someone unknowingly harboring the virus would not pass it on, “ said Stephan Monroe, deputy director of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, during the conference call, also adding that even passengers showing symptoms are unlikely to pass the disease on to fellow travelers because blood and stool carry the most viruses. Cetron also said that those at highest risk for Ebola infection are family members who care for sick loved ones and health care workers who treat patients or accidentally stick themselves with infected needles.
"We do not anticipate [Ebola] will spread in the U.S. if an infected person is hospitalized here," CDC Director Tom Frieden told reporters. "We are taking action now by alerting health care workers in the U.S. and reminding them how to isolate and test suspected patients while following strict infection-control procedures."
The National Geographic recently took an in-depth look at the Ebola virus in Africa and the risk of it spreading to the United States. Read the full article.
Study: EHRs Don’t Increase the Risk for Medicare Fraud
The use of electronic health records (EHRs) does not increase the risk of Medicare fraud, according to a new study from the University of Michigan Schools of Information and Public Health and the Harvard School of Public Health. In the study, scheduled to be published in the journal Health Affairs, researchers analyzed longitudinal data to determine whether U.S. hospitals that recently adopted EHRs also saw increases in the severity of patients’ conditions and payments from Medicare; they determined that adopters and non-adopters saw rates increase approximately equally. "There have been a lot of anecdotes and individual cases of hospitals using electronic health records in fraudulent ways. Therefore there was an assumption that this was happening systematically, but we find that it isn't," said Julia Adler-Milstein, U-M assistant professor of information, as well as an assistant professor of health management and policy in the U-M School of Public Health. Read more on technology.
Fist Bumps May Be the Best Greeting for Reducing Germ Transmission
Want to meet society’s hand-to-hand greeting expectation while also reducing the transmission of germs? Try a fist bump. Researchers from the Institute of Biological, Environmental, and Rural Sciences at Aberystwyth University in the United Kingdom used a germ-covered glove test to determine that handshakes transmit nearly twice as many bacteria as high-fives, which in turn transmit more bacteria than fist bumps. The study in the American Journal of Infection Control determined that duration and grip of a physical greeting also increased the number of bacteria transmitted. “Adoption of the fist bump as a greeting could substantially reduce the transmission of infectious diseases between individuals,” said author, David Whitworth, PhD. “It is unlikely that a no-contact greeting could supplant the handshake; however, for the sake of improving public health we encourage further adoption of the fist bump as a simple, free, and more hygienic alternative to the handshake.” Read more on infectious disease.
Fear a Greater Motivator than Data When it Comes to Using Sunscreen
Fear over developing skin cancer is a larger motivator for people’s usesof sunscreen than actual data that quantifies their risk, according to a new study in the Journal of Behavioral Medicine. Researchers analyzed data on approximately 1,500 people with no history of skin cancer, finding that for people who reported “never” using it and those who reported “always” using it, worry was a greater factor than education about risk, and the greater the worry, the more likely the use. “Most health behavior studies don’t account for the more visceral, emotional reactions that lead people to do risky behaviors, like eat junk food or ignore the protective benefits of sunscreen,” says Marc Kiviniemi, MD, lead researcher and assistant professor of community health and health behavior in the UB School of Public Health and Health Professions. “This study is important because most of what we do in public health communications focuses on spreading knowledge and information. By not addressing emotions, we are potentially missing a rich influence on behavior when interventions do not address feelings.” Read more on cancer.
United States, Mexico to Enhance Safety of Certain Agricultural Products
The U.S. Food and Drug Administration (FDA) and Mexico’s National Service for Agro-Alimentary Public Health, Safety and Quality and Federal Commission for the Protection from Sanitary Risks have entered an agreement to form a partnership to improve and promote the safety of fresh and minimally processed agricultural products. Each year, Mexico exports approximately $4.6 billion in fresh vegetables; $3.1 billion in fresh fruit, excluding bananas; $1.9 billion in wine and beer; and $1.5 billion in snacks to the United States.
The preventive practices and verification measures will include:
- Exchanging information to better understand each other’s produce safety systems
- Developing effective culturally-specific education and outreach materials that support industry compliance with produce safety standards
- Identifying common approaches for training auditors who will verify compliance with such standards
- Enhancing collaboration on laboratory activities as well as outbreak response and traceback activities
“To be successful as regulators, the FDA must continue developing new strategies and partnerships that allow us to more comprehensively and collectively respond to the challenges that come with globalization,” said FDA Commissioner Margaret A. Hamburg, MD, in a release. “The FDA is working with our Mexican government counterparts as well as stakeholders from industry, commerce, agriculture, and academia to ensure the safety of products for American and Mexican consumers.” Read more on food safety.
JAMA: Health Experts Call for End on Blood Donation Ban for Gay and Bisexual MenEx
perts writing in the Journal of the American Medical Association have called for the repeal of a 30-year ban on blood donations from gay and bisexual men. The U.S. Food and Drug Administration (FDA) instituted the ban for any man who had sex with another man in 1983, near the beginning of the AIDS crisis. Now, however, the experts said that technological and societal advances mean the ban should be lifted. "We think it's time for the FDA to take a serious look at its policy, because it's out of step with peer countries, it's out of step with modern medicine, it's out of step with public opinion, and we feel it may be legally problematic," said Glenn Cohen, who directs Harvard Law School's Petrie-Flom Center for Health Law Policy, Biotechnology & Bioethics, who co-wrote the article with Jeremy Feigenbaum of Harvard Law School and Eli Adashi, MD, of Brown University's medical school. They also noted that the ban is not in line with other FDA policies regarding people considered high-risk donors due to their sexual behavior. Read more on HIV/AIDS.
CDC Re-Opens Clinical TB Lab; Safety Reviews of Other Labs Continues
Less than two weeks after closing laboratories due to two serious lapses with anthrax and avian flu virus and an intensive review by its CDC’s internal Laboratory Safety Improvement Working Group, the U.S. Centers for Disease Control and Prevention (CDC) has resumed the transfer of inactivated materials out of its high-containment Clinical Tuberculosis Laboratory. The moratorium on material transfers remains in effect for BSL-3 and BSL-4 laboratories, with those supporting direct patient care receiving priority review. The working group’s ongoing lab assessments focus on two main areas:
- Each lab must demonstrate that its protocols for key control points—such as inactivation of a pathogen—are not only being used but that they are being used by appropriately trained and supervised individuals.
- Each lab is expected to establish redundant controls, similar to the two-key system used in other contexts for critical control points. For example, in the TB lab when heat is used to kill a pathogen, a second trained lab technician will witness the process to make sure the right temperature is used for the right amount of time. Both individuals then sign off on the process.
Strokes Fall Among Older Americans
Fewer older Americans are having strokes and those who do have a lower risk of dying from them, according to researchers at the Johns Hopkins Bloomberg School of Public Health. The study, published in JAMA, followed close to 15,000 stroke-free patients ages 45 to 64, beginning in the 1980s and ending in 2011. It found a 24 percent overall decline in first-time strokes in each of the last two decades and a 20 percent overall drop per decade in deaths after stroke. However, the decline was found mainly in people over age 65, with little progress in reducing the risk of strokes among younger people. The researchers say the decrease in stroke incidence and mortality is partly due to more successful control of risk factors such as blood pressure, smoking cessation and use of statin medications for controlling cholesterol, but that more efforts are needed to reduce strokes in younger people, including reducing obesity and diabetes and increasing physical activity. Read more on mortality.
Study: Insufficient Sleep Can Harm Memory
Lack of sleep, currently considered a public health epidemic in the United States, can also lead to errors in memory, according to a new study in Psychological Science. The study found that participants who didn’t get a full night’s sleep were more likely to make mistakes on the details of a simulated burglary they were shown in a series of images. “We found memory distortion is greater after sleep deprivation,” said Kimberly Fenn, an associate professor of psychology at Michigan State University and a co-investigator of the study. “And people are getting less sleep each night than they ever have.” The U.S. Centers for Disease Control and Prevention has linked the insufficient sleep epidemic to car crashes, industrial disasters and chronic diseases such as hypertension and diabetes. Read more on mental health.
The U.S. Environmental Protection Agency (EPA) has recently released a new graphic design available for use by insect repellent makers to more easily show how long the product is effective. “We are working to create a system that does for bug repellents what SPF labeling did for sunscreens,” said Jim Jones, Assistant Administrator of the Office of Chemical Safety and Pollution Prevention. “By providing vital information to consumers, this new graphic will help parents, hikers and the general public better protect themselves and their families from serious health threats caused by mosquitoes and ticks.” The release of the graphic design was accompanied by a joint statement from the EPA and the U.S. Centers for Disease Control and Prevention (CDC) urging the public to use insect repellents and take other precautions to avoid biting insects that carry serious diseases, including Lyme and West Nile virus. Incidence of insect-borne diseases is on the rise, according to the CDC. In order to place the new graphic on their labels, manufacturers must submit a label amendment, including test results on effectiveness. The public could see the graphic on repellent products early next year. Read more on infectious disease.