Category Archives: Infectious disease
Study: Global Child TB Rates 25 Percent Higher than Previously Realized
The true number of children who develop tuberculosis (TB) each year in the 22 countries with the worst TB rates is nearly 25 percent higher than the World Health Organization (WHO) estimated as recently as 2012, according to a new study in The Lancet Global Health. Researchers used mathematical modeling to determine that approximately 650,000 children in these countries develop TB each year; the WHO estimate was 530,000. The study also determined that approximately 15 million children are exposed to TB every year and 53 million are living with latent TB infections which can become infectious active TB. While the findings are troubling, they also indicate promising ways to reduce the risk. "Our findings highlight an enormous opportunity for preventive antibiotic treatment among the 15 million children younger than 15 years of age who are living in the same household as an adult with infectious TB,” said lead author Peter Dodd, MD, from the University of Sheffield in the United Kingdom, in a release. "Wider use of isoniazid therapy for these children as a preventative measure would probably substantially reduce the numbers of children who go on to develop the disease." Read more on global health.
Severe Obesity Can Cut a Person’s Lifespan by Nearly 14 Years
Severe obesity can take nearly 14 years off a person’s life, according to a new study in the journal PLOS Medicine. Using data from 20 previous studies, researchers determined that severe obesity—defined as a body mass index (BMI) greater than 40—can cut lives short by anywhere from 6.5 to 13.7 years, due to increased risk of health problems such as heart disease, cancer and diabetes. "We found that the death rates in severely obese adults were about 2.5 times higher than in adults in the normal weight range," said lead investigator Cari Kitahara, a research fellow at the U.S. National Cancer Institute, according to HealthDay. Approximately 6 percent of U.S. adults are severely obese; severe obesity accounts for approximately 509 deaths per 100,000 men annually and 382 deaths per 100,000 women annually. Read more on obesity.
HHS: $100M for 150 New Community Health Centers
The U.S. Department of Health and Human Services (HHS) has announced approximately $100 million in available funds for communities to expand access to affordable, high-quality primary care through an estimated 150 new community health centers in 2015. Currently there are approximately 1,300 health centers with more than 9,200 service sites providing care to more than 21 million people in the United States and its territories. The centers, made possible under the Affordable Care Act (ACA), have also helped approximately 4.7 million people enroll for ACA coverage. Read more on community health.
Study: Indoor Cooking Can Lead to Exposure to Dangerous Pollutants
Routine cooking also routinely exposes many Americans to dangerously high levels of pollutants such as carbon monoxide (CO), nitrogen dioxide (NO2) and particulate matter (PM), according to a new study in the journal Environmental Health Perspectives. While the World Health Organization is currently establishing guidelines for indoor air quality, neither the U.S. Environmental Protection Agency (EPA) nor any other U.S. agency regulate indoor air quality in non-industrial buildings. Researchers determined that during the average winter week approximately 1.7 million Californians could be exposed to excessively high CO levels simply because of cooking on gas stoves without range hoods; 12 million could be exposed to excessive NO2 levels. “That’s a lot of people in California, and those results ballpark-apply across the country,” said Brett Singer, study author and a staff scientist at Lawrence Berkeley National Laboratory (LBNL). “The EPA would say we don’t have a carbon monoxide or nitrogen dioxide problem in this country...In reality, we absolutely do have that problem; it’s just happening indoors.” The researchers listed improved ventilation; improved filtration; and improved building codes and standards as ways to combat the public health danger. Read more on air and water quality.
Multiple Errors Behind CDC’s Anthrax Exposure Incident
Multiple protocol breaches at a U.S. Centers for Disease Control and Prevention (CDC) laboratory led to 84 workers being exposed to live anthrax, including the fact that CDC researchers allowed only 24 hours to kill the pathogens—half the recommended time—according to Reuters. So far no one has died or become ill from the unprecedented U.S. exposure incident, but they are being treated with a vaccine and antibiotics. The errors at the biosafety level 3 facility raise new concerns over lax laboratory oversight. "If the protocol was already there, then there is really no excuse for it," said Amesh Adalja, MD, an infectious disease expert at the University of Pittsburgh Medical Center. "The question goes down to personnel and why wasn't protocol followed.” Read more on infectious disease.
Study: Autism Risk Higher in Children Whose Mothers Lived Near Commercial Pesticides
Pregnant women who live within a mile of places where commercial pesticides area used—including farms, golf courses and other public places—are more likely to have children with an autism spectrum disorder, according to a new study in the journal Environmental Health Perspectives. In a study of approximately 1,000 families, researchers determined that depending on the kinds of chemicals used, proximity to the treated area and when during the pregnancy the mother was exposed, their children were 60 to 200 percent more likely to develop autism; exposure during the third trimester brought the highest risk. Approximately one in every 68 children has autism, according to the U.S. Centers for Disease Control and Prevention. Read more on maternal and infant health.
CDC: Two U.S. MERS-CoV Cases Did Not Spread Any Further
In May of this year the U.S. Centers for Disease Control and Prevention (CDC) announced two cases of imported Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in the United States, with one in Florida and the other in Indiana. Both patients were health care providers who lived and worked in Saudi Arabia. The CDC has now confirmed that in neither case did the disease spread to either members of the patients’ households or health care workers who treated the patients. “The negative results among the contacts that CDC considered at highest risk for MERS-CoV infection are reassuring.” said David Swerdlow, MD, who is leading CDC’s MERS-CoV response. “Today, the risk of MERS-CoV infection in the United States remains low, but it is important that we remain vigilant and quickly identify and respond to any additional importations.” Read more on infectious disease.
FDA Approves the Manufacture of Cell-based Influenza Vaccine
Yesterday the U.S. Food and Drug Administration (FDA) announced approval to manufacture the first cell-based seasonal influenza vaccine in a U.S. facility. The Holly Springs, N.C., facility, which is owned by the Swiss company Novartis, will also be capable of manufacturing vaccines against pandemic influenza viruses. The technology was created in partnership with the Biomedical Advanced Research and Development Authority, part of the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response. According to a statement from Robin Robinson, PhD, ASPR Director and Deputy Assistant Secretary for Preparedness and Response, the cell-based vaccines will be part of multi-use approach that “strengthens everyday systems and increases our resilience in emergencies.” Read more on influenza.
Study Links Air Pollution, Cognitive Decline in Older Adults
One way to help reduce age-related cognitive decline may be to reduce air pollution, according to a new study in The Journals of Gerontology: Series B. Researchers determined that older adults who live in areas with low concentrations of fine particulate matter air pollution—from sources such as vehicle exhaust—made fewer cognitive errors on math and memory tests than did older adults who lived in areas with high pollution levels. “Although finding a link between the air we breathe on a daily basis and our long-term brain health is alarming, the good news is that we have made remarkable progress in the last decade in reducing levels of air pollution across the country, and there are efforts underway to further reduce air pollution,” said study co-author Jennifer Ailshire, of the Center for Biodemography and Population Health and the Andrus Gerontology Center at the University of Southern California in Los Angeles. Read more on aging.
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.