Category Archives: Infectious disease
To what lengths will hospitals go to make sure their employees are washing their hands? The answer for North Shore University Hospital on Long Island, N.Y., is thousands of miles to India where far-flung employees check their monitors, trained on the hospital floors, to find workers who skip the sinks on their way to the hospital’s intensive care units. According to a recent article in the New York Times, that is just one of many ways hospitals are working to increase hand washing and stop the spread of germs that can kill hospitalized patients. Other methods include free pizza and coffee incentives for frequent hand-washers and embedded chips on hospital employees that emit an alarm when a doctor bypasses a sink outside a patient room.
A March report from the Centers for Disease Control and Prevention (CDC) easily explains the increasing emphasis on hospital hand washing. According to the report, a family of bacteria called Carbapenem-Resistant Enterobacteriaceae, which includes e.coli, have become increasingly resistant to last-resort antibiotics during the past decade, and more hospitalized patients are developing incurable infections. CDC researchers found that during the first half of 2012, 4 percent of hospitals and 18 percent of long-term care facilities treated a patient with this type of infection.
Some hospitals have incentive ideas that employers and families can adopt including buttons that say, “Ask me if I’ve washed my hands?”
>>Read the article.
Legislation Would Dramatically Expand FDA’s Oversight of Compounding Pharmacies
New legislation proposed from Representative Edward Markey of Massachusetts would give the U.S. Food and Drug Administration (FDA) authority over compounding pharmacies that make and ship over state lines sterile and non-sterile products. This would be more significant than a bill recently approved by a Senate committee, which would give FDA authority only over sterile products, leaving states with the authority over non-sterile products. This has left some concerned that states would be overtaxed by the effort. “State pharmacy regulators vary widely in their ability to oversee large-scale non-traditional compounding," wrote the Pew Charitable Trusts in comments to the Senate health committee that drafted the legislation, according to Reuters. The calls for increased oversight come in response to a 2012 meningitis outbreak which killed 53 people and was linked to steroids produced by the Framingham, Massachusetts-based New England Compounding Center. Read more on infectious diseases.
Study: Diners Dramatically Underestimate Calories in Fast Food
Diners at fast food restaurants dramatically underestimate their caloric intake, according to a new study in BMJ. "Teens underestimate the number of calories in their meals by as much as 34 percent, parents of school-age children by as much as 23 percent, and adults by as much as 20 percent," study Jason Block, MD, in a release from the Robert Wood Johnson Foundation. Researchers found that the average adult meal was 836 calories—but they thought, on average, it was 175 fewer calories. As many as 1 in 4 of the people surveyed missed the mark by at least 500 calories. "These findings tell us that many people who eat at fast-food restaurants may not be making informed choices because they don't know how many calories they're consuming," Block said. "Having the information is an important first step for anyone wanting to make changes." Read more on nutrition.
FDA Approves Marketing of A1c Test for Diabetes
The U.S. Food and Drug Administration is for the first time allowing the marketing of an HbA1c (or A1c) test for the diagnosis of diabetes. A1c tests measure the percentage of hemoglobin A1c bound the glucose; people with diabetes are unable to properly convert glucose. Nearly 26 million Americans are estimated to have diabetes, which untreated can lead to heart disease, stroke and other serious medical conditions. “Providing health care professionals with another tool to identify undiagnosed cases of diabetes should help them provide patients appropriate guidance on treatment before problems develop,” said Alberto Gutierrez, PhD, director of the Office of In Vitro Diagnostics and Radiological Devices at FDA’s Center for Devices and Radiological Health. Read more on diabetes.
WHO Reports First Patient-to-Nurse Transmission of SARS-like Virus
The World Health Organization (WHO) is reporting that two health care workers in Saudi Arabia have become infected with a potentially fatal new SARS-like virus after catching it from patients, which represents the first case of the virus spreading this way within a hospital. Novel coronavirus, or nCoV, is thought to be spread through close contact, but, "scientists are on the alert for any sign that nCoV is mutating to become easily transmissible to multiple recipients, like SARS -- a scenario that could trigger a pandemic," according to Reuters. Read more on infectious disease.
Repeated Head Injuries Raise Soldiers' Suicide Risk
Soldiers who sustain multiple traumatic brain injuries, even if they are mild, are at greater risk for suicide, according to a study published in the journal JAMA Psychiatry. Researchers found that the risk for suicidal thoughts or behaviors increased for soldiers with such injuries over the course of a lifetime -- not just in the short term after the injuries occur. Suicide is the second-leading cause of death among U.S. military personnel, and researchers say this study provides further guidance on assessing risks and supporting wounded soldiers. Read more on military health.
HHS Announces $1 Billion to Fuel Health Care Innovation
The U.S. Department of Health and Human Services (HHS) launched a nearly $1 billion initiative -- the Health Care Innovation Awards -- that will fund work to transform the health care system by demonstrating better care and lower costs. This is the second round of the award. In the first round, the Centers for Medicare & Medicaid Services awarded 107 Awards out of nearly 3,000 applications. Round one awardees included a medical home for people with disabilities that showed a 71 percent reduction in hospitalization rates. Read more on access to health care.
Drug Patent Expirations Helped Lower Patient Spending for First Time in 55 Years
Per patient spending on medicine dropped 3.5 percent from 2012 to 2011, the first such drop since 1957, according to the IMS Institute of Healthcare Informatics. Spending was $325.8 billion overall and $898 per person in 2012. The main contributor to the decline was the expiration of patents on major drugs such as Lipitor and Plavix, allowing people to instead opt for cheaper generic versions. Michael Kleinrock, director of research development at IMS, said this is likely the first of several years in which spending on prescriptions won’t grow as quickly as overall health care spending. Read more on prescription drugs.
CDC Releases New Resources on Lyme Disease Prevention, Treatment
As across the country the weather is gradually getting warmer and kids are spending more time outdoors, the U.S. Centers for Disease Control and Prevention (CDC) has released new resources to help kids prevent tick bites that can lead to Lyme disease and a reference guide for health care providers. The kid-targeted comic strip includes tips for both kids and their parents. Tickborne Diseases of the United States includes information on types of ticks and the various diseases they can transmit. There were more than 24,000 confirmed cases of Lyme disease in 2011, according to the CDC. Read more on infectious diseases.
Study: Everyday Noises Can Effect Heart Health
Even basic, everyday background noises can affect heart function, according to a new study in the journal Environmental Health Perspectives. That includes increased heart rate as noises become louder than normal conversation levels and a decrease in natural, healthy heart beat variability. A decrease in heart bear variability, such as when someone is stressed, has been linked to a greater risk for heart attack. While these noise effects to individuals is minimal, they could provide greater insight into the health effects of community noise on the broader population level, according to Charlotta Eriksson, a researcher at the Karolinska Institute, in Stockholm, Sweden, who was not involved in the study. Read more on heart health.
HHS Makes Hospital Cost Information Available to Consumers
The U.S. Department of Health and Human Services (HHS) has announced a new initiative that, for the first time, gives consumers information on what hospitals charge for many procedures and services. The information will be posted on the website of the Centers for Medicare and Medicaid Services and will show comparative charges for services that may be provided during the 100 most common Medicare inpatient stays, such as knee replacements. The new data shows significant variation across the country and within communities in what hospitals charge for common inpatient services. The agency is also providing close to $90 million to states to collect, analyze, and publish health pricing and medical claims reimbursement data. To help show how the data can be used the Robert Wood Johnson Foundation has announced a data visualization challenge. Read more on access to health care.
CDC Issues Updated Hepatitis C Screening Guidelines
The U.S. Centers for Disease Control and Prevention (CDC) has issued new screening guidelines for Hepatitis C that recommend anyone born between 1945 and 1965 be screened for the infection, as well as anyone who received a blood transfusion or organ donation before 1992 when screening of the blood supply was improved, and anyone who has ever injected drugs. The CDC is making the new recommendations because only half of Americans identified as ever having had hepatitis C received follow-up testing to see if they were still infected, according to a new Vital Signs issued by the agency. CDC researchers looked at data from eight areas across the country and found that of the hepatitis C cases reported in those areas, follow-up testing was only done in 51 percent of the cases. “Complete testing is critical to ensure that those who are infected receive the care and treatment for hepatitis C that they need in order to prevent liver cancer and other serious and potentially deadly health consequences,” says said CDC Director Tom Frieden, MD, MPH. According to the CDC, about 3 million Americans are infected with hepatitis C and up to 3 out of 4 do not know they are infected. Read more on infectious disease.
Researchers Call for Independent Review Process for DSM-5 Updates
Arguing that that the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) missed “crucial population-level and social determinants of mental health disorders,” a group of researchers at the Columbia University Mailman School of Public Health and Columbia University Medical School are calling for an independent review for any future revisions of the American Psychiatric Association’s guidelines. The article appears in the journal Health Affairs. “As the DSM evolves, we must ensure the accuracy of psychiatric diagnoses and their equitable use in health care by systematically reviewing and applying the lessons in the population health and social science literature,” wrote the authors. The factors include various environmental factors, cultural perceptions and institutional pressures. Read more on mental health.
In recent years many bacteria have become resistant to drugs that commonly vanquished them, depleting a natural resource—antibiotics—that has saved millions of lives around the globe. Using these drugs only when necessary, and using the right drug for the right infection will help ensure that the medications are available and effective when they’re needed.
>>Watch a new, three-minute animated video that tells the story of how antibiotic-resistant “superbug” bacteria have become a serious public health threat that affects everyone. The video frames the problem uniquely: We must treat antibiotics as a natural resource that can be depleted with overuse, just like water, trees, and other resources on which we all depend. The video lays out specific steps that everyone – including doctors, hospitals, and consumers – can take to tackle the problem.
Extending the Cure (ETC), a project of the Center for Disease Dynamics, Economics & Policy based in Washington, D.C., and New Delhi, released the Superbugs video this week, along with a new report on trends in antibiotic resistance.
Last year, the organization also released research showing that certain types of bacteria responsible for causing urinary tract infections (UTIs) are becoming more difficult to treat with current antibiotics. ETC released the research via its online ResistanceMap, an online tool created to track changes in antibiotic drug use and resistance. A new, added feature of the ResistanceMap is ETC’s Drug Resistance Index, a way for non-experts to track changes in antibiotic effectiveness.
This research was funded by the Robert Wood Johnson Foundation. Urinary tract infections account for about 8.6 million visits to health care providers each year, according to the Centers for Disease Control and Prevention. More than half of U.S. women will get a UTI in their lifetime.
“Without proper antibiotic treatment, UTIs can turn into bloodstream infections, which are much more serious and can be life-threatening,” said Ramanan Laxminarayan, director of Extending the Cure (ETC). “These findings are especially disturbing because there are few new antibiotics to replace the ones that are becoming less effective,” says Laxminarayan.
Read a previous NewPublicHealth interview with Ramanan Laxminarayan about ETC’s research and Drug Resistance Index.
Study: Single Can of Sugary Soda Can Increase Diabetes Risk 22 Percent
Drinking even a single 12-ounce can of sugary soda once a day can up the risk of diabetes by 22 percent, according to a new study out of Imperial College London. Researchers looked at the data of approximately 350,000 European residents. "Given the increase in sweet beverage consumption in Europe, clear messages on the unhealthy effect of these drinks should be given to the population," said study leader Dora Romaguera, according to Reuters. Previous studies have also shown a link between sugary drinks and increased risk of obesity and type 2 diabetes, which affects approximately 310 million people, according to the World Health Organization. Read more on diabetes.
Teen Years in the ‘Stroke Belt’ Ups Risk of Stroke Later in Life
Growing up as a teenager in the U.S. “stroke belt”—an area in the country’s southeast—can increase the risk of stroke later in life by as much as 17 percent, according to a new study in the journal Neurology. Risk factors including high blood pressure and diabetes are only partially responsible for the increase risk. "Many social and behavioral risk factors, such as smoking, are set in place during the teenage years, and teens are more exposed to external influences and gain the knowledge to challenge or reaffirm their childhood habits and lifestyle," said study author Virginia Howard, with the School of Public Health at the University of Alabama at Birmingham, in a release. Across all age groups the risk was double for black Americans when compared to white Americans. Researchers were careful to note that the findings do not demonstration causation. Read more on strokes.
Poultry Probably Source of China’s New Bird Flu Strain
Researchers believe that poultry-to-human transmission from “wet” markets is likely responsible for the new H7N9 bird flu strain that has killed 22 people in China and infected more than 100. Wet markets sell and immediately slaughter poultry. So far the strain does not seem to pass easily between people, so the researchers feel relatively confident that closing the markets and slaughtering the birds will control the outbreak. “Overall, the evidence, in terms of epidemiology and virology, suggests that it is a pure poultry to human transmission, and that controlling [the epidemic in humans] will therefore depend on controlling the epidemic in poultry,” said Kwok-Yung Yuen of the University of Hong Kong, according to MSNBC. The findings were published in the journal Lancet. Read more on infectious disease.
‘Clean Your Plate’ Order Can Lead to Negative Results
The seemingly reasonable parental edict of “clean your plate” may in fact be counterproductive toward maintaining a healthy weight, according to a new study in the journal Pediatrics. The same can be true with instruction to eat less. Researchers found that restrictive instructions were more common with kids who were overweight and obese, while kids who weren’t overweight were more often linked to encouragement to finish meals. "In the 1950s, cleaning your plate meant something different,” said author Katie Loth, a registered dietician, doctoral candidate and research assistant at the University of Minnesota in Minneapolis. “Portion sizes have gotten bigger over time, and if you encourage kids to rely on environmental indicators, like how much food is on their plates or the time of day, they'll lose the ability to rely on internal cues to know whether they're hungry or full." About 17 percent of U.S. youth and adolescents are obese, according to the U.S. Centers for Disease Control and Prevention. Read more on obesity.
Study: Lack of Insurance Leading Cause of Difficulty for Young Adults with Asthma
Leaving high school and a lack of adult supervision are both factors that may explain the general decline in asthma control for young adults once they’re over the age of 18. However, the main cause is a loss of health insurance, according to a new study in the journal Pediatrics. Researchers found that those under 18 were more likely to utilize primate care and medications. On the other hand, those over age 18 were more likely to turn to emergency care and have difficulty getting costly treatments. While young adults are generally healthier than older adults, people with chronic conditions such as asthma still need to be sure to seek out proper treatment. "Young people with asthma need to work with their care providers to create transition plans from pediatric to adult care that take into account their medical and social history," said study leader Kao-Ping Chua, a staff physician in the division of emergency medicine at Boston Children's Hospital. Read more on access to health care.
China’s Bird Flu Outbreak Keeps Growing; 20 Dead, 105 Infected
China’s outbreak of H7N9 virus—a new strain of bird flu—continues to spread, with 20 people dead and 105 overall infected, according to Reuters. The World Health Organization is conducting field investigations into the infections and the public health response to the outbreak. Ho Pak-leung, an associate professor in the Department of Microbiology at the University of Hong Kong, recently British Medical Journal that this outbreak has already caused twice as many Chinese infections as the H5N1 strain did in about a decade. "H7N9 is much more transmissible to humans, and it's much more difficult to track down," he said. "We don't understand why it's so difficult to find." Read more on infectious disease. Also, read more on what you need to know about H7N9 on APHA's Get Ready blog.
National Public Health Week Events: ‘Public Health is ROI: Saves Lives, Saves Money’
"Public Health is ROI: Saves Lives, Saves Money" is the theme of this year’s National Public Health Week, from April 1 to 7. By emphasizing prevention and ensuring strong public health systems, public health helps to saves lives and stop diseases before they have a chance to happen. The end result is improved public health and reduced health care spending, meaning those valuable financial resources can go toward strengthening other aspects of a community. Communities and public health schools across the county are celebrating the week and spreading the messages of public health. Read more about National Public Health Week.
WHO: Strain of Bird Flu Kills Two in China; Third Person Infected
While a strain of bird flu has taken the lives of two Chinese men, there is at the moment no evidence to show it can be transmitted from person to person, according to the World Health Organization. The men died in February; a third person, a woman, is in critical condition. The H7N9 virus had previously infected only animals. "At this point, these three are isolated cases with no evidence of human-to-human transmission", said Michael O'Leary, MD, the WHO representative in China. "A new virus tends to be more virulent in the beginning. Either it is going to become a truly human virus, in which case we have to start dealing with it regularly, or it is going to be primarily an animal virus with just a rare human case." Read more on infectious disease.
Given Disease Labels for Children, Many Parents Push for Ineffective Medications
When it comes to doctors insisting sick infants don’t need medication, many parents refuse to take that “no” as an answer, according to a new study in the journal Pediatrics. Instead when given a simple disease label they often push for medications that won’t actually have any effect. Researchers say this demonstrates how simple disease labels can influence parents’ decision-making and shows the importance of good communication. "The disease label seems to send the message that there is an illness that requires medical treatment," said lead author Laura Scherer, an assistant professor in the department of psychological sciences at the University of Missouri. "But, depending on the situation, medical treatments may be necessary, or not. In the case of [gastroesophageal reflux disease], an otherwise healthy infant probably will not benefit from medication. So in this case [that] label can be misleading." Read more on infant and maternal health.
Analysis: ‘Big Box’ Stores Offer Best Costs on Prescription Drugs
People looking to save money on generic prescription drugs should ask their pharmacists about comparison shopping and should generally look to big box stories rather than smaller pharmacies, according to a new analysis by Consumer Reports. The report found the lowest prices at Costco and the highest at CVS Caremark. "Especially for the independent pharmacies, if they want to retain your business and loyalty, they will help you get the best price," said Lisa Gill, an editor at Consumer Reports. "It really comes down to a store's business model. For example, big box stores tend to use their pharmacies as a way to get consumers through the door with the expectation that they'll buy other things.” Read more on prescription drugs.
CDC: Sharp Increase in Valley Fever in Past Decade
The U.S. Centers for Disease Control and Prevention has identified changes in weather, an increase in population of changes in disease detection and reporting as possible explanations for the dramatic increase in Valley Fever from 1998 to 2011. In Arizona, California, Nevada, New Mexico and Utah there were about 22,000 cases in 2011; there were only 2,265 in 1998. The fungal respiratory infection, caused by a fungus found in the southwestern United States, is caused by flu-like symptoms that can lead to hospitalization. "Valley Fever is causing real health problems for many people living in the southwestern United States," said CDC Director Tom Frieden, MD, MPH. "Because fungus particles spread through the air, it’s nearly impossible to completely avoid exposure to this fungus in these hardest-hit states. It’s important that people be aware of Valley Fever if they live in or have travelled to the southwest United States." Read more on infectious disease.
CDC Study Offers More Proof of Non-link Between Vaccines, Autism
A new study in the Journal of Pediatrics offers yet more scientific proof that there is no link between vaccinations and autism. Researchers at the U.S. Centers for Disease Control and Prevention (CDC) found that exposure to vaccine antigens was the same for kids with and without autism. "This should give more reassurance to parents," said lead researcher Frank DeStefano, MD, director of the CDC's Immunization Safety Office. A small study in the Lancet in 1998 originally linked vaccinations and autism; the study has since been retracted. Still, about one-third of parents believe young children receive too many vaccinations and that they could lead to autism. Read more on vaccines.