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Mar 19 2014
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Public Health News Roundup: March 19

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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.

Mar 10 2014
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Public Health News Roundup: March 10

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Majority of Youth C. Difficile Infections Linked to Doctor Visits
Antibiotics prescribed in a doctor’s office for other conditions are associated with the majority of Clostridium difficile infections, according to a new study in the journal Pediatrics. Researchers from the U.S. Centers for Disease Control and Prevention (CDC) determined that 71 percent of the cases for youth ages 1-17 were linked to the visits, rather than to overnight stays in health care facilities; two-thirds of adult cases are linked to hospital stays. The findings raise the profile of ongoing efforts to reduce unnecessary prescriptions. “Improved antibiotic prescribing is critical to protect the health of our nation’s children,” said CDC Director Tom Frieden, MD, MPH. “When antibiotics are prescribed incorrectly, our children are needlessly put at risk for health problems including C. difficile infection and dangerous antibiotic resistant infections.” Read more on prescription drugs.

Study: Even Slightly Elevated Blood Pressure Can Do Cardiovascular Damage Over Time
Even slightly elevated blood pressure that does not rise to the clinical definition of hypertension can do cardiovascular damage over time, according to a new study in the Journal of the American Medical Association. Researchers at the University of Oklahoma Health Sciences Center analyzed blood pressure data on more than 4,600 participants, all of whom had their readings tracked over 25 years from young adulthood to middle age. They placed the participants in five blood pressure trajectory categories:

  • Low-stable: blood pressure that starts low and stays low
  • Moderate-stable: blood pressure that begins only slightly elevated and stays that way
  • Moderate-increasing: blood pressure begins only slightly elevated and increases over time
  • Elevated-stable: blood pressure that starts at elevated levels, but does not increase
  • Elevated-increasing: blood pressure that begins elevated and increases over time

The study determined that participants in the moderate-stable group were 44 percent more likely to have coronary artery calcification than those in the low-stable group. Read more on heart health.

Study: Men Die Earlier in More Patriarchal Societies
Gender differences when it comes to mortality rates are higher in more patriarchal societies, meaning women’s rights are good for men’s health, according to a new study in the American Psychological Association’s Evolutionary Behavioral Sciences. Utilized sociodemographic and mortality data from the World Health Organization, researchers from the University of Michigan (UM) School of Public Health found that men living in the top 25 percent most-patriarchal societies were 31 percent more likely to die than men in the least patriarchal quartile, compared to mortality rates for women. Researchers noted that the study only included societies with infrastructures capable of providing reliable data, so the difference could be even more pronounced. Possible explanations include:

  • Males in societies where they are more socially dominant tend to engage in riskier behaviors that can lead to death.
  • These societies tend to have more resources and social status concentrated in a smaller group of elite men, and men with greater control of resources and social status historically have had more reproductive success.
  • In their quest for social dominance, men will go up against other men to gain power and engage in forms of competitive, and sometimes dangerous, behavior.

"Gender inequality is inherently related to inequality in general, and this is bad for both men and women's health, though especially harmful to men in increasing the risk of death," said UM researcher Daniel Kruger. Read more on health disparities.

Mar 7 2014
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Public Health News Roundup: March 7

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CDC: Reducing High-risk Antibiotic Prescriptions Could Also Reduce Deadly Infections
The most recent Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC) finds that if prescriptions of high-risk antibiotics in hospitals were reduced by just 30 percent, then there could be as many as 26 fewer cases of deadly diarrhea infections with Clostridium difficile. “Improving antibiotic prescribing can save today’s patients from deadly infections and protect lifesaving antibiotics for tomorrow’s patients,” said CDC Director Tom Frieden, MD, MPH. “Health care facilities are an important part of the solution to drug resistance and every hospital in the country should have a strong antibiotic stewardship program.” As part of its ongoing efforts to improve antibiotic prescribing, the CDC has release a checklist of seven core elements for hospitals:

  1. Leadership commitment: Dedicate the necessary human, financial, and IT resources.
  2. Accountability: Appoint a single leader responsible for program outcomes. Physicians have proven successful in this role.
  3. Drug expertise: Appoint a single pharmacist leader to support improved prescribing.
  4. Act: Take at least one prescribing improvement action, such as requiring reassessment of prescriptions within 48 hours to check drug choice, dose, and duration.
  5. Track: Monitor prescribing and antibiotic resistance patterns.
  6. Report: Regularly report prescribing and resistance information to clinicians.
  7. Educate: Offer education about antibiotic resistance and improving prescribing practices.

Read more on infectious diseases.

Poorer Women Most Likely to Be Caught in ‘Vicious’ Caregiving, Financial Well-being Cycle
Low-income women are at increased risk of finding themselves caught in a “vicious cycle” of parental caregiving and financial well-being, according to a new study in The Journals of Gerontology. While women of better financial means can afford additional caregiver assistance and better health care for aging parents, poorer women lack those options. "People who had less household income and less financial resources were more likely to take care of their parents so there is this cycle that they cannot get out of—they are poor, then taking care of parents, then being poor and taking care of their parents—there's this kind of cycle," said lead author Yeonjung Lee, a researcher and professor at the Faculty of Social Work at the University of Calgary in Alberta, Canada, according to Reuters. Read more on aging.

Young Skin Cancer Survivors at Heightened Risk for Other Cancers
Younger skin cancer survivors are at increased risk for additional cancer types later in life, according to a new study in the journal Cancer Epidemiology, Biomarkers & Prevention. A review of data of more than 500,000 people with a history of nonmelanoma skin cancer found that while all age groups were at heightened risk for melanoma and other types of cancers, the increase was especially significant for people under the age of 25, who were 23 times more likely to develop cancer than people who had never had nonmelanoma cancer. The risk was 3.5 times higher for nonmelanoma survivors ages 25-44, 1.74 times higher for those ages 45-59 and 1.32 times higher for those older than 60. The types of cancer they are at risk for include melanoma skin cancer, and cancers of the breast, colon, bladder, liver, lung, brain, prostate, stomach and pancreas. Read more on cancer.

Feb 7 2014
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Public Health News Roundup: February 7

Decrease in Pediatric Antibiotic Leveling Off 
The number of children taking antibiotics has decreased over the past decade, but that decrease has stalled in recent years in certain age groups and geographic locations, according to a study in Pediatrics. Researchers reviewed pharmacy and outpatient claims over a 10-year period (2000 to 2010) in three health plans located in three different geographic locations to determine the number of antibiotics dispensed each year for children ages 3 months to 18 years. Although the overall antibiotic-dispensing rate in each age group and health plan was lower in 2009-2010 than in 2000-2001, the rate of decline in antibiotic use has slowed. The highest rate of antibiotic use was in children age 3 months to less than 24 months of age in all years of the study.

The study authors say the previous downward trend in antibiotic use in children may have reached a plateau, and continued improvements in judicious antibiotic dispensing are needed. Read more on pediatrics.

NHTSA Gives Okay for Vehicle to Vehicle Communication to Help Prevent Crashes
The National Highway Traffic Safety Administration has announced that it will begin taking steps to allow vehicle-to-vehicle (V2V) communication technology for light vehicles, which will allow vehicles to "talk" to each other and ultimately avoid many crashes by exchanging basic safety data, such as speed and position, ten times per second.

The safety applications currently being developed provide warnings to drivers so that they can prevent imminent collisions, but do not automatically operate any vehicle systems, such as braking or steering, although NHTSA is also considering future actions on active safety technologies that rely on on-board sensors.

V2V communications can provide the vehicle and driver with 360-degree situational awareness to address additional crash situations — including those, for example, in which a driver needs to decide if it is safe to pass on a two-lane road (potential head-on collision), make a left turn across the path of oncoming traffic, or in which a vehicle approaching at an intersection appears to be on a collision course. In those situations, V2V communications can detect threats hundreds of yards from other vehicles that cannot be seen, often in situations in which on-board sensors alone cannot detect the threat. Read more on transportation.

Many Hospital ICUs Don't Follow Infection Prevention Rules
While most hospitals have evidence-based guidelines in place to prevent health care-associated infections in intensive care units (ICUs), clinicians often fail to follow them according to new research from the Columbia University School of Nursing published in the American Journal of Infection Control. The study, on over 1600 ICUs, found lax compliance in intensive care units where patients are more likely to be treated with devices linked to preventable infections – such as central lines, urinary catheters and ventilators.

The study focused on three of the most common preventable infections — central line-associated bloodstream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections and determined that despite decades of research, establishing best practices for prevention of these infections, approximately one in 10 hospitals lack checklists to prevent bloodstream infections, and one in four lack checklists to help avoid pneumonia in ventilator patients, and that in hospitals with checklists, they are followed only about half of the time.

Health care-associated infections kill an estimated 100,000 Americans a year and result in over $30 billion in excess medical costs, according to the Centers for Disease Control and Prevention. Read more on injury prevention.

Jan 28 2014
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Public Health News Roundup: January 28

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Obese Children More Susceptible to Air Pollution-Related Asthma
Obese children are more susceptible to air pollution-related asthma, according to a new study in the journal Environmental Research. Researchers followed the health of 311 children, ages 5 and 6, in predominantly Dominican and African-American neighborhoods of New York City, finding that high exposure to polycyclic aromatic hydrocarbons (PAH)—a family of air pollutants—was only associated with asthma among obese children The study determined that obese children exposed to the PAH chemicals 1-methylphenanthrene and 9- methylphenanthrene were two to three times more likely to have asthma. PAHs are emitted by vehicles, cigarette smoke, cooking, incense, burning candles and various other indoor sources. Two possible explanations for the disparity are that obese children tend to be less active, so are more likely to be exposed to indoors sources of PAH, and that they may breathe more rapidly than children of healthier weights Better understanding of the risk factors opens the door to more targeted interventions. “These findings suggest that we may be able to bring down childhood asthma rates by curbing indoor, as well as outdoor, air pollution and by implementing age-appropriate diet and exercise programs,” said senior author Rachel Miller, MD, professor of medicine (in pediatrics) and environmental health sciences, and co-deputy director of the Columbia Center for Children’s Environmental Health at the Mailman School of Public Health. Read more on pediatrics.

Report: Antibiotics Dangerous to Humans Still Used in Livestock
Despite knowing their risk to humans, the U.S. Food and Drug Administration (FDA) continues to allow the use of certain antibiotics as additives in animal feed and water, according to a new report from the Natural Resources Defense Council based on documents acquired under the Freedom of Information Act. In a review from 2001 to 2010 the FDA concluded that 30 such antibiotics posed a significant risk of exposing people to antibiotic- resistance bacteria. The drugs were approved for “non-therapeutic” use in farm animals, such as preventing disease or promoting growth of the animals, instead of treating specific illnesses. In December the FDA announced its intention to combat the spread of antibacterial resistance by prohibiting the use of medically important antimicrobials in food animals for food production purposes, while also adding veterinary oversight to therapeutic use of the drugs in animals. Read more on food safety.

Residents of Public Housing Developments, Rental Assistance Units See Significant Gap in Oral Health Care
People who live in public housing developments and rental assistance units are less likely to have routine preventive dental care and more likely to have suffered serious oral health issues related to tooth loss, according to a new study in The Journal of Urban Health. The study was conducted by the Partners in Health and Housing Prevention Research Center (PHH-PRC) at the Boston University School of Public Health. The researchers looked at four indicators for people living in Boston’s publicly supported housing: having had a dental visit in the last year, having had a dental cleaning in the last year, having had six or more teeth extracted, and having dental insurance. They found that people in public housing, despite being as likely to have had a dental visit in the past year, were significantly less likely to have had a cleaning. The gap in health care is especially serious for the seniors in this already vulnerable population: Compared to younger residents, seniors 65-75 years old were 30 times as likely to have had six or more teeth removed. Read more on prevention.

Jan 24 2014
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Public Health News Roundup: January 24

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FDA Looking to Revise Nutrition Fact Labels
The U.S. Food and Drug Administration (FDA) is looking to revise nutrition fact labels for the first time in more than two decades. The changes should reflect our improved understanding of nutrition, according to nutritionists. "The food environment has changed and our dietary guidance has changed," said Michael Taylor, the FDA's deputy commissioner for foods. "It's important to keep this updated so what is iconic doesn't become a relic." For example, there is now more of a focus on calories and better understanding of the different types of fats. Nutrition experts also have called for more prominent calorie counts, as well as information on added sugar and the percentage of whole wheat in the food. The FDA has sent its proposed guidelines to the White House. Read more on nutrition.

Study: ERs Need to do More to Cut Unnecessary Antibiotic Prescriptions
Despite growing concerns over antibiotic resistance, emergency departments are not decreasing their inappropriate use of antibiotics, according to a new study in the journal Antimicrobial Agents and Chemotherapy. Researchers analyzed data from 2001 to 2010, finding no decrease in emergency department use of antibiotics for adults with respiratory infections caused by viruses, which are not affected by antibiotics. There are approximately 126 million emergency department visits for acute respiratory infections each year in the United States. Halting excessive and unnecessary antibiotic prescriptions in emergency departments is especially critical because many uninsured people also look to them for primary care. "The observed lack of change...is concerning," study co-author Henry Wang, MD, vice chair for research in the department of emergency medicine at the University of Alabama at Birmingham. "This may indicate that efforts to curtail inappropriate antibiotic use have not been effective or have not yet been implemented in all medical settings." Read more on prescription drugs.

CDC: Strategies on Reducing Sodium Levels in Restaurants
A new report from the U.S. Centers for Disease Control and Prevention (CDC) includes strategies on how health departments and restaurants can work together to lower the amount of sodium in foods. The report, “From Menu to Mouth: Opportunities for Sodium Reduction in Restaurants,” appears in the CDC journal Preventing Chronic Disease. While the U. S. Dietary Guidelines recommend the general population limit sodium to under 2,300 mg a day, meals from fast food restaurants contain an average of 1,848 mg of sodium per 1,000 calories and foods from dine-in restaurants contain 2,090 mg of sodium per 1,000 calories. The strategies include:

  • Health department dietitians help restaurants analyze the sodium content of their foods and recommend lower-sodium ingredients.
  • Restaurants clearly post nutrition information, including sodium content, at the order counter and on menus or offer lower-sodium items at lower cost.
  • Health departments and restaurants explain to food service staff why lower sodium foods are healthier and how to prepare them.

“The bottom line is that it’s both possible and life-saving to reduce sodium, and this can be done by reducing, replacing and reformulating,” said CDC Director Tom Frieden, MD, MPH. “When restaurants rethink how they prepare food and the ingredients they choose to use, healthier options become routine for customers.” Read more on the CDC.

Dec 20 2013
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Outbreaks and Pandemics: What’s Next?

file MERS-CoV

For “Outbreak Week” we’ve already covered the deadliest pandemics in human history. But which outbreaks could be around the corner? Outbreaks: Protecting Americans from Infectious Diseases, 2013, the new report from Trust for America’s Health and the Robert Wood Johnson Foundation, lays out a few possibilities on which infectious diseases may pose the more serious threats in the future. Here are the greatest threats to the United States, according to Tom Inglesby, MD, Chief Executive Officer and Director of the UPMC Center for Health Security.

Middle East Respiratory Syndrome (MERS)
Spread across 12 countries, the virus has killed almost 40 percent of the people it’s infected. And while it may currently be confined to one region of the world, the high level of air travel between the Middle East and the United States increase the chance that it could find its way into the country, according to Inglesby, who said “we still don’t have a good handle on how it spreads, and there is no treatment for it or vaccine against it.”

Novel influenza virus
A new flu strain that, like the seasonal flu, is far reaching, but which would have a “far higher mortality rate.” Recent examples of major flu pandemics include the 2009 H1N1 outbreak; recent studies indicate the swine flu may have killed more than 200,000 people. The new H7N9 is also notable because of its high mortality rate.

Accident involving a lethal engineered virus
With scientists experimenting on viruses — enhancing their lethality or ability to spread — the risk grows of an accident releasing an engineered virus into the population.

Tuberculosis
It’s the most common infectious disease in the world and drug-resistant strains are only making the matter worse. “The level of drug resistance is growing and coping with this needs to be a real priority,” said Inglesby.

Antibiotic resistance
Not a pathogen, but a reason why pathogens could become even more dangerous. The U.S. Food and Drug Administration is taking steps to combat this growing issue, including new regulations on antimicrobial use in food animals and new restrictions on antibacterial soaps.

Deliberate biological threats
A biological attack, whether from another nation or as a terrorist act, could cause not only severe illness and death, but also communication problems that would hinder the ability of public health departments to respond.

Mosquito-borne illness
Climate change is making this already existing problem even greater—with the regional climate shifts, places that haven’t had to deal with mosquito-based threats are now seeing them swarm in because of the warmer weather. Notable examples include the West Nile Virus and Dengue Fever. “We need to reinvigorate our strategy for mosquito control and the infectious diseases that come with mosquitoes.

>>Follow our complete coverage of Outbreak Week and join the conversation on Twitter with #outbreakweek.

Dec 20 2013
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It’s ‘Outbreak Week’ on NewPublicHealth

We've declared this week "Outbreak Week" on NewPublicHealth, and we're using it as an opportunity to crystallize discussion among the public health community and beyond about whether we're prepared as a nation to handle the next big outbreak. Spread the word, not the germs.

The most viral video ever

Here are the highlights of our coverage this week:

>>Follow our complete coverage of Outbreak Week and join the conversation on Twitter with #outbreakweek.

Dec 20 2013
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Public Health News Roundup: December 20

CDC’s Top Accomplishments for 2013 Include Progress in Curtailing Outbreaks
A review by the U.S. Centers for Disease Control and Prevention (CDC) of progress in 2013 include improvements in preventing and curtailing infectious disease and foodborne illness outbreaks in the United States and globally:

  • More than 12,000 facilities now track health care-associated infections using CDC’s National Healthcare Safety Network (NHSN), and bloodstream infections in patients with central lines have decreased by 44 percent and surgical-site infections have decreased by 20 percent since 2008.
  • 2013 marks the 10th anniversary of the U.S. President’s Plan for Emergency AIDS Relief(PEPFAR). In 2013, PEPFAR prevented the one millionth baby from being infected with HIV and has 6.7 million people on treatment, with HIV incidence falling in nearly all PEPFAR countries.
  • CDC published its first estimates of which foods were causing foodborne illnesses in the United States, referred to as Attribution Estimates. These estimates help regulators, industry and consumers more precisely target and implement effective measures to prevent food contamination, and allow people to use it to help guide their own food safety practices.
  • CDC scientists traced the newly discovered Heartland virus that infected two men from northwestern Missouri to populations of lone star ticks in the region. This discovery helps CDC stay one step ahead of what could become another public health threat carried by ticks.
  • In conjunction with public health officials in Eurasia’s Republic of Georgia, CDC helped identify a new poxvirus (related to smallpox) that sickened shepherds in Akhmeta, Georgia. The successful investigation shows that rapid detection saves precious time during response to emerging health threats.
  • CDC researchers found that two new antibiotic regimens using existing drugs successfully treat gonorrhea infections. This is especially important given growing antibiotic resistance and dwindling treatment options for gonorrhea.

Read more on infectious disease.

‘Consumer Reports’ Study Finds Harmful Bacteria in Many Samples of Chicken Sold in the United States
A new investigation of the safety of chicken breasts sold in retail stores across the United States by Consumer Reports found potentially harmful bacteria on 97 percent of the samples tested. And about half of the chicken samples had at least one type of bacteria that was resistant to three or more classes of antibiotics. “We are looking to the government to ensure the safety and sustainability of the entire food supply,” said Urvashi Rangan, PHD, executive director of the Consumer Reports Food Safety and Sustainability Center. “We need to attack the root causes of the problems. Without a government focus on effective solutions, meat safety will continue to be compromised.” Consumer Reports has several recommendations for the U.S. government aimed at reducing bacterial contamination in the food supply:

  • Congress should give the U.S. Department of Agriculture (USDA) the authority to mandate a recall of meat and poultry products.
  • The FDA should prohibit antibiotic use in food animals except for the treatment of sick ones. (According to Consumer Reports, FDA’s action last week giving voluntary guidance to drug companies to end labeling of antibiotics for growth promotion uses is an important first step, but is far from what is needed overall.)
  • The USDA should classify strains of salmonella bacteria that are resistant to multiple antibiotics and known to have caused disease as “adulterants,” so that inspectors look for those strains routinely and when found, the products cannot be sold.
  • The USDA should move quickly to set strict levels for allowable salmonella and campylobacter in chicken parts.
  • The USDA’s proposed rule to increase maximum line speeds and reduce the number of USDA inspectors at slaughter plants should be dropped.

Read more on bacteria.

Health Insurers Extend Deadline for Many 2013 Health Insurance Premium Payments
The trade association for many health insurance plans has announced that many plans will be extending the deadline for consumers to pay their first month’s premium. Consumers who select their plans by December 23 and pay their premiums by January 10 will be able to have coverage effective January 1. Under current rules and guidance, consumers who want to begin coverage on January 1 must select a plan by December 23 and pay the first month’s premium by December 31. The short time period in which to complete these steps, particularly around the holidays, combined with the ongoing technical issues with the Affordable Care Act insurance purchasing site healthcare.gov have raised concerns that some consumers’ coverage may not be able to begin on January 1.  The association, America’s Health Insurance Plans, is urging consumers to check with the plan they have selected for more details about their specific coverage policy. Read more on the Affordable Care Act.

Dec 17 2013
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INFOGRAPHIC: A Close Look at How Prepared We Are for the Next Outbreak

From antibiotic-resistant superbugs to the seasonal flu to Salmonella, infectious diseases are a serious health threat that also cost individuals and the health care industry billions. A new report from Trust for America’s Health and the Robert Wood Johnson Foundation, Outbreaks: Protecting Americans from Infectious Diseases, assesses gaps in our public health system that could severely limit our ability to effectively respond to an outbreak.

NewPublicHealth created an infographic that illustrates many of the key findings of the new report.

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>>Follow our complete coverage of Outbreak Week and join the conversation on Twitter with #outbreakweek.