Category Archives: Infectious disease

Sep 25 2014
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Preparing for Ebola in the U.S. Makes Good Public Health Sense

U.S. public health officials have continually said that it is highly unlikely that the Ebola virus will spread in the United States, even if infected travelers land here. Officials at the U.S. Centers for Disease Control and Prevention (CDC) say that the disease is most contagious when people come into contact with the bodily fluids of someone who is ill—and someone that ill would be very likely be identified by border and airline personnel quickly. If hospital admission became necessary, U.S. infection control procedures could stem an outbreak, according to Tom Frieden, MD, the CDC’s director and the point person for the U.S. government on the current Ebola outbreak. Frieden has discussed the issue repeatedly during several news conferences in the last few weeks.

Of course, that changes if the virus becomes transmissible through the air, rather than just via bodily fluids, as Michael T. Osterholm, PhD, MPH, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, suggested in the New York Times last week. While Osterholm often addresses the direst potential outcomes of infectious disease outbreaks, it’s prudent to at least know what to do, which is why agencies such as the CDC and the Network for Public Health Law say what’s needed is information and procedures...but not panic.

Last month, the Network held an online webinar on preparedness measures and Ebola which was watched by more than 1,200 public health officials. Following the webinar, Network experts posted answers to follow-up questions, including one about the right of public health or hospital workers to refuse to care for/help with someone suspected of having Ebola.

The Network also recently created an online primer on preparedness and legal issues surrounding the Ebola outbreak, both for public health officials engaged in the response overseas and for those with current or future responsibility for handling Ebola-related issues in the United States.

>>Bonus Link: Richard Besser, MD, now the chief health editor for ABC News, was formerly the CDC’s head of disaster response and led the early response to the H1N1 outbreak in the United States several years ago. In a recent opinion piece for the Washington Post, Besser laid out what’s being accomplished and what still needs to be done to stem the Ebola outbreak in West Africa.

Sep 8 2014
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Public Health News Roundup: September 8

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Mandatory Policies Increase Flu Shot Rates for Health Care Workers
Hospitals can improve their flu vaccination rate among health care workers by using a mandatory employee vaccination policy, according to a study by researchers at the Henry Ford Health System in Detroit. At Henry Ford, getting the flu shot is a condition of employment and the health system now has a 99 percent compliance rate. Nationally, only 63 percent of health care workers were immunized against the flu in the past two years, according to the Centers for Disease Control and Prevention, which poses a risk to patients. The study was presented this weekend at the Interscience Conference on Antimicrobial Agents and Chemotherapy in Washington D.C.

Before making flu vaccination mandatory, the vaccination rate at Henry Ford was between 41 percent and 55 percent. An increasing number of health systems are making flu shots mandatory for employees. At Henry Ford, employees can opt out for religious or medical reasons so long as they have documentation from clergy or a physician and then must take other precautions against the flu, such as wearing a mask when caring for patients.

Many doctors’ offices, pharmacies and clinics already have the flu shot on hand for the upcoming flu season. The HealthMap flu shot locator has been updated for the 2014-2015 flu season.

Read more on the flu.

Study: Alcohol Ad Reminders to “Drink Responsibly” Promote Drinking
A new study by researchers at the Johns Hopkins School of Public Health finds that magazine ads from the alcohol industry that advise readers to “drink responsibly” or “enjoy in moderation” fail to convey important information about dangers associated with alcohol consumption.

The study, published in Drug and Alcohol Dependence, analyzed all alcohol ads that appeared in U.S. magazines from 2008 to 2010 to determine whether messages about responsibility define responsible drinking or provide clear warnings about the risks associated with alcohol consumption.

According to the study, 87 percent of the ads analyzed included a responsibility message, but none actually defined responsible drinking or promoted abstinence at particular times or in certain situations. When responsibility messages were accompanied by a product tagline or slogan, the messages were displayed in smaller font than the company’s tagline or slogan 95 percent of the time.

Responsibility statements are voluntary and are also frequently included in ads appearing in other media including radio and online ads. The researchers say more effective ads would have prominently placed tested warning messages that directly address behaviors and that do not reinforce marketing messages. “We know from experience with tobacco that warning messages on product containers and in advertising can affect consumption of potentially dangerous products,” say Katherine Clegg Smith, a professor at the Johns Hopkins Bloomberg School of Public Health and a lead author of the study. “We should apply that [tobacco ad] knowledge to alcohol ads and provide real warnings about the negative effects of excessive alcohol use.”

Read more on alcohol.

NYC Health Department Investigating Meningitis Outbreak among HIV Positive Men
The New York City Health Department is currently investigating a cluster of meningitis cases among HIV-positive men who have sex with men. Three cases of meningitis have occurred in Brooklyn and Queens since August 24, with the last two cases reported since early September.

Meningitis is a severe bacterial infection that has a high fatality rate. A previous outbreak of the disease among men who have sex with men ended in February 2013 after 22 cases were reported, including seven fatal cases.

The Health Department recommends meningitis vaccination for all HIV-positive men who have sex with men. Meningitis vaccinations are also recommended for men, regardless of HIV status, who regularly have intimate contact with other men met through a website, digital application (“app”), or at a bar or party.

People living with HIV are at a greater risk than the general population of acquiring meningitis and, if infected, dying from infection. This disease is spread by prolonged close contact with nose or throat discharges from an infected person.

Read more on sexual health.

 

 

Sep 3 2014
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Recommended Reading: Ebola Is Also an International Security Threat

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In the last few days, the U.S. Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and the medical aid group Doctors Without Borders have sounded alarms on the growing needs of several countries in West Africa fighting the Ebola outbreak. The groups have called for increased funding, equipment and expert health personnel to help stem the rapidly increasing numbers of infections.

As of last week, there have been more than 3,000 cases and more than 1,500 deaths, making it by far the largest outbreak since Ebola was discovered during the 1970s, according to the WHO. CDC Director Tom Frieden, MD, MPH, who last week visited the main West African countries dealing with the Ebola outbreak, said the number of cases could spike to 20,000 if more isn’t done to stem spread of the disease in those countries.

In addition, a recent post on ForeignPolicy.com said that the epidemic must be controlled before it also poses a security threat. Liberia, which has seen the highest number of Ebola cases and deaths in the region so far, has been under the watch of an international United Nations (U.N.) peacekeeping force since a civil war ended in 2003. While the U.N. had planned to begin drawing down the force next year, U.N. Secretary General Ban Ki-moon said he’d like to delay any drawdown for at least three months because of the virus outbreak, which has needed troops to help secure order.

However, several countries want to pull out troops now in order to reduce the risk to their personnel and to citizens at home who they worry could be infected by returning soldiers. Ban has said that the nature of the illness poses little risk to the troops, who are unlikely to have contact with the bodily fluids of people who are ill—which is the way the virus spreads—and some of the countries involved are considering sending their own experts to assess the risks.

Read more

Aug 7 2014
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Public Health News Roundup: August 7

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.

Aug 6 2014
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Public Health News Roundup: August 6

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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.

Aug 5 2014
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Ebola Update: NIH Testing of a Potential Ebola Vaccine Set to Begin this Fall

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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.

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>>Bonus Links:

Aug 5 2014
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Public Health News Roundup: August 5

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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.

Aug 4 2014
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Public Health News Roundup: August 4

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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.

Aug 1 2014
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Public Health News Roundup: August 1

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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.

Jul 30 2014
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Recommended Reading: 'National Geographic' on the Recent Ebola Outbreak

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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.