Category Archives: Infectious diseases

Dec 20 2013
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The Digital World's Response to Outbreaks

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Outbreaks can spread faster than you think. But luckily the development of new digital tools and technologies to assist with documenting, tracking and alerting the public of the spread of infectious disease is progressing even more rapidly. There are new databases, maps and communications technologies that make tracking down an outbreak and getting it under control a much quicker and more efficient process. Digital developments focusing on emergency preparedness and response can help protect more of the population from the next pandemic.

We’ve brought together a few examples of how the digital world is working to improve emergency response:

  • At the University of Pittsburgh School of Public Health, a new initiative called Project Tycho is working to convert 125 years worth of data from paper documents into an open-access database. Project Tycho will save researchers around the world the time of finding reliable historical data from different sources for infectious diseases, which is critical to understanding underlying epidemic dynamics, according to Dr. Willem van Panhuis, an assistant professor of epidemiology at University of Pittsburgh School of Public Health.
  • The Advanced Molecular Detection Initiative proposed in the President’s 2014 Budget could help make huge strides in controlling infectious disease. The initiative would bring together experts in laboratory science, epidemiology and bioinformatics to join forces like never before. By using genetic sequencing to examine infectious pathogens, these technologies are on the verge of revolutionizing medical professionals’ abilities to diagnose infectious diseases; investigate and control outbreaks; understand transmission patterns; develop and target vaccines; and determine antimicrobial resistance—all with increased timeliness and accuracy and decreased costs.
  • Social media and crowdsourcing technologies have helped medical professionals develop tools to track the spread of disease and where outbreaks are occurring and even make the data available to the general public. HealthMap is one of the original examples of using digital technologies to track outbreaks while keeping the public informed.
file CDC's "Solve the Outbreak"
  • In efforts to spread the skills needed to deal with public health issues such as outbreaks, the CDC has made learning more fun through games such and applications such as CDCology and Solve the Outbreak for the iPad. CDCology is a pilot program through the CDC and supported by HHSIgnite (beta). The pilot website uses CDC staff-created, student-solved, virtual microtasks to tackle public health challenges at CDC. As they complete the short microtasks, the students gain valuable educational experience, insight and exposure to the field of public health. Solve the Outbreak puts you in the shoes of a member of the Epidemic Intelligence Service. Playing the game presents the opportunities to use clues, analyze data, solve the scenario and save lives in this virtual world, but also helps teach the public more about the process behind handling a real outbreak.

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

Dec 19 2013
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Outbreak Response Dream Team: Pop Culture's Best Bets to Protect You in an Emergency

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Picture this: The world just ended. Well, not completely. But things aren’t looking up. An influenza strain has cut a deadly swath through nearly every continent. Or maybe the Black Death is making a special encore appearance. Or your now-undead neighbor—Phil, normally a great guy, invited you to a dinner party just last week—is shuffling around the front yard, trying to gnaw on your brains.

The point is it’s time for action. And since we’re talking theoretical, we might as well be talking fictional, too. Below is NewPublicHealth’s “Outbreak Dream Team”—pop culture characters with the diverse skills we’d need to respond to and cure a deadly epidemic. And maybe a dose of what’s really needed in the way of a public health workforce to keep us ready for whatever could happen next.

 

President

  • In a nationwide (or global) public health emergency such as a pandemic, the President has to step up and provide leadership among different sectors and divisions of the government to coordinate a response and assure the nation of a secure path forward.
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Laura Roslin, “Battlestar Galactica”

As a former Secretary of Education she has experience working with large groups with disparate goals. (Plus, she gets that education impacts health in so many ways). And as president of the roughly 50,000 humans left alive after a Cylon invasion wiped nearly everyone out, she’s adept at balancing public policy needs, working with everyone from public advocates to top military leaders. Some of her decisions are more-than-a-bit iffy, but you try pleasing everyone all the time when the last vestiges of humanity are spread across a fleet of ships drifting through space.

 

National Public Health Lead

  • Equivalent to the Director of the U.S. Centers for Disease Control and Prevention (CDC). The CDC safeguards the nation’s health by preparing for, detecting, rapidly responding to and preventing health threats 24/7 to save lives and protect communities. The director’s job is to make sure that happens.
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Ann Perkins, “Parks & Recreation”

As a practicing public health nurse and the PR Director of Pawnee's Health Department, Ann Perkins has dealt with infectious disease control from a hospital, a government and even a girlfriend perspective. Smart and determined, this go-getter can not only treat the symptoms of infectious diseases, she can detect and track them, coordinate response, and educate the community—all while maintaining a confident, calm and collected public face. While Leslie Knope leads the town through the city council, Ann has the potential to lead diverse teams and bridge health and health care to coordinate a swift and decisive response. If she can take on Pawnee's obesity epidemic one candy company at a time and teach sex ed to senior citizens, she can certainly handle a national outbreak or two. Plus, she gets bonus points for being (probably) the only true public health character on television.

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Dec 19 2013
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Throwback Thursday: The CDC Prepares for a Zombie Outbreak

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The pop culture craze of zombie apocalypse films, televisions shows and books penetrated deeper than many might have expected—even the U.S. Center for Disease Control and Prevention (CDC) weighed in on the cultural phenomenon, with a 2011 blog post on preparing for a real zombie apocalypse. The post covers everything from the history of zombie outbreaks to how to assemble an emergency supply kit should one of these possible apocalyptic zombie scenarios play out in your community.

At the time, NewPublicHealth spoke with the CDC’s Dave Daigle, who dreamed up the zombie post. The CDC campaign was crafted to help spread information on emergency preparedness for the upcoming hurricane season, while the zombie cover was designed both to attract a younger demographic and to offer an off-kilter slant that would make people pay attention. The post contains strong recommendations to help people prepare for many types of emergencies, from natural disasters to disease outbreaks—for example, your supply kit should include water, food, medications, important documents, and so on. The CDC was able to reach an even larger audience by packaging this valuable information in a playful nod to the fantastical fears that a zombie outbreak could actually happen.

Among the tips from the CDC’s Preparedness 101: Zombie Apocalypse: "Plan your evacuation route. When zombies are hungry they won’t stop until they get food (i.e., brains), which means you need to get out of town fast!"

Once the post went live, the staff sat back while it was tweeted, retweeted, Facebooked, commented on and reported on by a growing list of mainstream print and online publications. The result was an overwhelming success:

  • The initial tweet received 70,426 clicks
  • “CDC” and “Zombie Apocalypse” trended worldwide on Twitter
  • The CDC Emergency Facebook page gained more than 7,000 fans within the first month of its launch
  • There were more than 3,000 articles, broadcasts and other media coverage of the blog
  • The messages received an estimated 3.6 billion impressions with a marketing worth of $3.4 million—and all for a campaign that cost $87.00

The post even temporarily crashed the website due to such a high volume of traffic. Go back and read the original CDC blog post here.

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

Dec 18 2013
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Outbreaks on the Big Screen

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When it comes to movies, sometimes the most realistic scenarios are also the scariest. The dramatic, often global and always fatal spread of infectious disease is now a well-worn movie trope—but because it could happen it remains scary every time. The good news (in addition to them just being movies, so no need to grip the theater armrest so hard!) is these silver screen attempts at showing the story behind the spread and containment of infectious disease help to highlight the importance of public health. Without the many integrated public health systems that touch our lives daily and protect us in emergency situations, we’d be much more susceptible to all the many types of outbreaks that plague Hollywood characters.

Well, maybe not all of them...

As part of Outbreak Week, we’ve compiled a list of some of the scariest outbreaks to terrify movie watchers. What do you think they got right? (And spoilers below...)

Contagion
The scariest part of this outbreak is realizing how quickly disease can spread—and through interactions you may not even realize. It also highlights the wide range of reactions people can have to a disease spreading through a population. Several days pass before doctors and administrators at the U.S. Centers for Disease Control and Prevention realize the extent or gravity of this new infection. First they need to identify virus, then they can start working toward a means of combating it, a process that will likely take several months. As the contagion spreads to millions of people worldwide, people panic and society breaks down.

World War Z
A mysterious infection turns entire human populations into rampaging, mindless zombies. After barely escaping the chaos, United Nations Investigator Gerry Lane is persuaded to go on a mission to investigate the disease. What follows is a perilous global trek where Lane must brave horrific dangers and long odds to find answers before civilization falls. What at least the book gets right is the vast number of organizations and government groups that must come together to respond to an outbreak.

28 Days Later
How scary would it be to wake up after being in a month-long coma only to find your city completely deserted, with cars left empty and seemingly nothing but silence? One look at the film’s barren London streets will show you. Then think about how you’d feel if you found out that this emptiness was caused by rage virus-infected animals released by group of animal rights activists in protest of animals being used for medical research. And the virus was still out there...

12 Monkeys
An unknown virus wiped out five billion people in 1996. By 2035, only 1 percent of the population was still surviving, forced to live underground. A convict reluctantly volunteers to be sent back in time to 1996 to gather information about the origin of the epidemic (which he's told was spread by a mysterious "Army of the Twelve Monkeys") and locate the virus before it mutates, so that scientists from his time can study—and hopefully cure—the disease.

The Crazies
As a toxin begins to turn the residents of Ogden Marsh, Iowa into violent psychopaths, Sheriff David Dutton tries to make sense of the situation while he his wife, and two other unaffected townspeople band together in a fight for survival. Eventually military support is brought in to attempt to contain the outbreak.

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

(Image source: WikiCommons, Sailko)

Dec 18 2013
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Where Polio Remains a Threat: Q&A with Sona Bari, World Health Organization

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While it has been decades since polio was a critical threat for much of the developed world, the disease—a virus that can spread from person to person and affect the brain and spinal cord with the potential for paralysis—still causes disease and death in the developing world. Earlier this year cases were reported in Syria, while in Israel the polio virus was found in soil likely from human waste infected with the disease, prompting a revaccination campaign among children age 5 and under. Polio has continued to spread in Afghanistan, Nigeria and Pakistan, and has been reintroduced and continues to spread in Chad and in the Horn of Africa after the spread of the virus was previously stopped. Other countries have seen small numbers of cases recently after no cases for decades.

Because even a small spread of the disease could reach the United States if infected individuals carry the virus here, the U.S. Centers for Disease Control and Prevention (CDC) several years ago made polio one focus of their Emergency Operations Center. CDC staff work with the World Health Organization and foreign health departments on vaccination campaigns aimed at fully eradicating the disease.

>>Bonus Content: View the CDC's infographic, "The Time to Eradicate Polio is Now."

NewPublicHealth spoke recently with Sona Bari, senior communications officer at the World Health Organization about the efforts underway to eradicate polio globally.

NPH: How are you able to detect polio outbreaks?

Sona Bari: We have a global surveillance system for polio and know from it that since 1988 the reduction of the disease has been over 99 percent. Polio is now endemic, which means indigenous polio virus transmission has never been stopped in parts of three countries: Nigeria, Afghanistan and Pakistan. So the surveillance is important because you can get polio down to very low levels like you do now, but it can reemerge. To completely eradicate polio you have to have an effective intervention, which is largely by vaccination. And you can be bring polio under very tight control by massive vaccination, but the virus is very good at finding children who are unvaccinated or under-vaccinated, and in Nigeria, Afghanistan and Pakistan we still have large groups of unvaccinated children. So the reason that polio transmission has not been stopped in these areas is that not enough children are vaccinated.

NPH: Why is there insufficient vaccination in those countries?

Bari: The basic reason is the quality of vaccination activities. Do these countries have decent health systems—strong routine immunization systems where children are regularly taken to a medical facility for their immunizations? When there are mass vaccination campaigns, are we reaching all children? Then there are, on top of that, layers of political complexities. In one part of Pakistan, for example, there is a ban on polio vaccinations by the local warlords. So there are access and security issues, layered on top of the difficultly of reaching all who need vaccines in countries such as Nigeria or Pakistan. That said, we know that these circumstances are not unique. They may differ from country to country, and each country does have a unique combination of the obstacles, but polio has been eradicated in countries that are far poorer than Nigeria or Pakistan, that have had worse conflict and that have perhaps much worse health systems. So it can be done.

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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.

Dec 17 2013
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Recommended Reading: State Vaccine Exemptions’ Significant Impact on Vaccine Rates

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A new study published recently in the American Journal of Public Health finds that non-medical exemption laws for vaccines required for school or daycare admission have significantly impacted the vaccination rates of at least one disease. The researchers reviewed relevant laws and regulations for each year between 2001 and 2008 and rated them on their restrictiveness in granting exemptions. The study was funded by a grant from the Public Health Law Research program, a national program of the Robert Wood Johnson Foundation.

According to the study, state laws that make it difficult for children to be exempted from vaccines on religious or philosophical grounds could reduce the number of whooping cough cases, but did not have an impact on cases of measles, mumps, haemophilus influenza type B (Hib) or Hepatitis B.

“Our research shows that during the study period, if all states increased the restrictiveness of their non-medical exemption laws by one level, the number of U.S. whooping cough cases would decline by 1.14 percent, resulting in 171 fewer cases per year,” according to study author Y. Tony Yang, ScD, MPH, associate professor at the College of Health and Human Services at George Mason University.

The study found that the impact on whooping cough may be greater than for the other diseases studied simply because whooping cough affects more people. Researchers call this a “threshold effect,” which means laws may not have a significant impact unless they works to prevent a disease that affects a critical mass of people. During the study period, whooping cough was much more prevalent than the four other diseases studied—the average incidence rate for whooping cough was 18 per 100,000 individuals from 2001 to 2008. For Hib, Hepatitis B, measles, and mumps, the mean incidence rates were less than 1 per 100,000.

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Dec 17 2013
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NewPublicHealth Q&A: Litjen Tan, Immunization Action Coalition

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A new report from Trust for America’s Health finds that despite recommendations by medical experts about the effectiveness and safety of vaccines, an estimated 45,000 adults and 1,000 children die from vaccine-preventable diseases each year in the United States.

NewPublicHealth spoke with Litjen (L.J) Tan, MS, PhD, chief strategy officer of the Immunization Action Coalition, to ask about ongoing efforts to improve immunization rates among all age groups across the nation. The Coalition works to increase immunization rates and prevent disease by creating and distributing educational materials for health professionals and the public and facilitates communication about the safety, efficacy, and use of vaccines within the broad immunization community of patients, parents, health care organizations, and government health agencies. The Coalition is supported by the U.S. Department of Health and Human Services.

NewPublicHealth: What are the critical gaps in immunization in the United States—for children and adults?

Litjen Tan: Immunization rates are really high in our childhood population, but generally not at all high in the adult population, though for some vaccines the rates are improving. We are also not doing very well for adolescents. On the broader level I think what the immunization rates reflect is the state of preventive care in the United States when you come out of childhood, which is why I think the Affordable Care Act really is a great boon. We’ve got this wonderful preventive care model for our kids; we take our kids in, we get them their shots, they get protected and we’ve got high coverage rates generally over 90 percent for all major vaccines. We have almost no vaccine-preventable disease in the United States except for instances linked to pockets of populations that haven’t been vaccinated—as we’ve seen recently with measles.

But then we get to adolescence we have this breakdown. Rates for HPV vaccination are not so good. Our meningococcal vaccination rates are not where they should be and neither are the tetanus, diphtheria and pertussis booster rates in adolescents. What happens with the adolescents is parents don’t necessarily bring them in for prevention checkups anymore. We bring them in when there’s a problem or when they need a school sports visit, and so we plant in adolescents this idea that care is no longer about prevention but care is now about acute care, and that persists into adulthood. This is the thinking that stops us from saying, “hey, do I need my vaccines? When should I get them?”

We need to make sure that our adolescents get the idea that vaccines prevent disease and that they actually do have vaccines that are recommended for them and then I think we’ll begin to see an appreciation of immunizations for adults as well.

NPH: Do we need to target both parents and the adolescents themselves?

Tan: Absolutely, but there’s a lot of discussion about how we do that. It gets a little tricky because we push autonomy of the adolescent, and we have a precedent in public health—discussions between providers and adolescents about sexually transmitted infections—but there are a lot of legislative and regulatory barriers against directly talking to an adolescent in the absence of a parent.

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Dec 16 2013
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The Five Deadliest Outbreaks and Pandemics in History

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“Outbreak” is a relative word. A modern outbreak could be a virus that kills a couple hundred thousand (such as the recent swine flu), or simply an infected shipment of food that left dozens sick. However, a look back through history reveals outbreaks so expansive—so deadly—that they essentially changed the course of history. Below are the five deadliest outbreaks and pandemics in history.

Ask yourself—are we prepared as a nation for the next big outbreak?

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(Image source: WikiCommons)

1. The Black Death

A plague so devastating that simply saying “The Plague” will immediately pull it to the front of your mind, in the middle of the 14th century—from 1347 to 1351—the Black Death remade the landscape of Europe and the world. In a time when the global population was an estimated 450 million, at least 75 million are believed to have perished throughout the pandemic, with some estimates as high as 200 million. As much as half of Europe may have died in a span of only four years. The plague’s name comes from the black skin spots on the sailors who travelled the Silk Road and docked in a Sicilian port, bringing with them from their Asian voyage the devastating disease, now known to be bubonic plague.

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Dec 16 2013
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Top 5 Things You Didn’t Know Could Spread Disease

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Outbreaks can advance quickly and through a wide variety of vectors. We all know to be wary of mosquitos and ticks, but there are plenty of other ways diseases can spread that may not be top of mind for most. This is where food safety and other precautions around wild animals can help. But never fear. We have compiled a list of the top five strangest things that can spread disease so you can be prepared.

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(Image source: WikiCommons)

5. Bats

While their mythical status as vampires in another form might be what scares some people about bats, what’s even scarier is their potential to spread disease. A species of bats in China are believed to have helped spread SARS (severe acute respiratory syndrome), which killed more than 750 people worldwide between 2002 and 2003. Researchers found two SARS-like viruses in horseshoe bats found in China, suggesting that they could have been the origin of the human pandemic.

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