revere | April 24, 2009Friday April 24, 1:40 pm: AP and NYT reporting that Mexican authorities are saying that they have determined that 16 of 60 deaths are "swine flu," with 44 more being tested. They have yet to confirm whether it is the same as the California/Texas cases, but that's a bit irrelevant since either way it sounds like a very worrisome development. There are already a reported 930 plus cases, with schools closed in Mexico City and contemplation of closing government offices. Obama has been notified and the White House is following the situation. WHO and CDC have activated their emergency centers and…
revere | April 24, 2009Late yesterday we summarized a CDC media briefing about the developing investigation of cases of influenza in California and Texas with a previously unknown flu virus with genetic components from pigs ("swine flu", humans and birds). At the same time reports were surfacing of an especially virulent respiratory disease outbreak in central and southern Mexico that had resulted in 20 deaths and hospitalizations with acute respiratory failure. 137 cases have been reported, including health care workers. When asked yesterday, CDC said they were in close touch with their Mexican counterparts but at…
revere | April 24, 2009As an academic epidemiologist I routinely do NIH funded research involving human subjects. That means my university must adhere to very strict regulations and guidelines for the protection of research subjects. Approval and monitoring of the ethical conduct of research funded by the Department of Health and Human Services (DHHS), of which NIH is a part, was made a legal requirement in the 1970s following widespread abuses, of which the Tuskeegee Syphilis Study and the experiments by Nazi doctors were the most notorious. But less flagrant ethical breeches were widespread in medical research. I…
revere | April 23, 2009This afternoon CDC held a "media availability" on the evolving swine flu cases. Evolving is an understatement. There are now more recognized cases, although not all cases are "new," with some cases retrospectively recognized now that more intense investigation is occurring. The total is now seven cases. Two occurred in San Antonio, Texas, two sixteen year old boys in the same school. Three more were found in California (in addition to the initial two cases), including a father - daughter pair. All California cases are in San Diego and neighboring Imperial counties, the location of the initial…
revere | April 23, 2009There are plenty of tragedies in this story about a plant manager sentenced to almost 6 years in prison for criminal conspiracy, covering up safety violations that killed a fork lift worker, and polluting the Delaware River. Fifty-nine year old John Prisque worked for Atlantic States Cast Iron Pipe Co., a company that two years ago was convicted of 32 of 34 charges of polluting the Delaware with oil (its garbage caused an eight and half mile oil slick in 1999).
Prisque, who was the manager of the Phillipsburg plant, was convicted of making false statements to federal investigators after three…
revere | April 22, 2009Late yesterday afternoon a Morbidity and Mortality Weekly Report (MMWR) Dispatch appeared on CDC's website that is unique in my experience. MMWR is usually heavily vetted and edited and nothing gets out of there fast. Indeed, in recent years, nothing at all got out of CDC very fast. And yet here is this Dispatch, with text referring to the same day of issue (April 21), reporting on two young patients with febrile respiratory illnesses, one of whose cases CDC only learned about on April 13, 8 days earlier. April 17 CDC determined that the two children, both from the San Diego, California area…
revere | April 21, 2009Every day, it seems, we find out that what we thought we knew about flu isn't the case. As one noted flu expert said to me once, "I knew much more about flu 20 years ago than I do now." So it's good to remember that we are also finding out a lot about flu that we never knew or even thought we knew. A case in point is an extremely important new paper in PLoS Medicine ( Khurana S, Suguitan AL Jr., Rivera Y, Simmons CP, Lanzavecchia A, et al.(2009) Antigenic Fingerprinting of H5N1 Avian Influenza Using Convalescent Sera and Monoclonal Antibodies Reveals Potential Vaccine and Diagnostic Targets.…
revere | April 20, 2009When a small body of water, say a slow flowing creek or water in a drainage ditch, "goes septic" it starts to stink, often giving off a rotten egg odor (hydrogen sulfide, H2S). This isn't a sign that the water is polluted in the chemical sense of toxic materials. It means that so much organic matter has entered the water that the bacteria there have gone on a food orgy. The initial gluttons are aerobic bugs that need oxygen as a final electron acceptor to generate energy for their needs. When the feasting aerobes use up all the oxygen they die and are replaced by a new set of diners, the…
revere | April 19, 2009The US national news is all about American journalist Roxana Saberi who has received an 8 year sentence in an Iranian prison for who knows what. There are plenty of places to read about it (CNN here). There aren't that many places to read about another Iranian miscarriage of justice affecting scientists and doctors, the Alaei brothers:
An Iranian appellate court rejected the appeal of Dr. Kamiar Alaei, an internationally recognized AIDS physician and doctoral student in the University at Albany's School of Public Health.
Alaei and his older brother, Dr. Arash Alaei, also an AIDS doctor, have…
revere | April 19, 2009A kind reader (h/t geodef) has passed on to me a really juicy item from the National Catholic Reporter about Reiki. Since I'm not much interested in alternative medicine I don't really know what Reiki is, other than it involves using a Reiki therapist's hands to pass some kind of "life energy" into an ailing part. You can imagine why I wouldn't be interested. But can you imagine why the U.S. bishops’ Committee on Doctrine would be? At first glance, the answer is truly hilarious:
A declaration by the U.S. bishops’ Committee on Doctrine that Reiki is based on superstition and incompatible with…
revere | April 18, 2009Scottish linguist Geoffrey Pullum's take-down in the Chronicle of Higher Education of the venerable Strunk and White Elements of Style has received some notoriety. It's Elements' 50th anniversary this month, but Pullum isn't celebrating in "50 Years of Stupid Grammar Advice." I have a copy of Elements and like many others thought its advice was the last word(s), but like many others have never managed to follow it because its advice, as Pullum neatly demonstrates, was unfollowable and shouldn't have been followed anyway. Pullum's piece is behind a subscription paywall (here), but since I…
revere | April 17, 2009This year's flu season isn't over, but it's almost over, and it was fairly typical and much better than last year, which was nasty. It began at the end of September but didn't take off until early January, peaking in mid Februrary. New cases are still appearing but much less frequently and they are mainly influenza B, which tends to be milder than influenza A. Most of flu/A this year was also of the milder H1N1 sort, which probably contributed to the better outcomes. Here's where we are (source for all charts here):
Comparing this year with previous years shows it to be relatively typical of…
revere | April 16, 2009The news of a new antiviral comes at a Press Conference. That could either mean a blockbuster breakthrough or an unwarranted device to get attention for some otherwise decent but not blockbuster science. Unfortunately, the news that "Experts Identify Compound That May Fight Bird Flu" is of the second type:
Scientists in Hong Kong and the United States have identified a synthetic compound which appears to be able to stop the replication of influenza viruses, including the H5N1 bird flu virus.
The search for such new "inhibitors" has grown more urgent in recent years as drugs, like oseltamivir…
revere | April 15, 2009The Wall Street Journal (WSJ) calls it a "reality check," meaning, in their terms, a check against the mistaken idea that there is more foodborne illness these days. That's one way to look at it. Another is a look that is reality based. The reality is that there is a tremendous health burden from tainted food that is unaddressed, at least going by the same CDC Morbidity and Mortality (MMWR) report the WSJ was citing. MMWR was reporting on 2008 data from FoodNet on the incidence of infection from enteric pathogens commonly transmitted via food:
Despite numerous activities aimed at preventing…
revere | April 14, 2009If you have any of your clothes dry cleaned it's more than likely you are being exposed to a chlorinated solvent called PCE (for perchloroethylene aka perc aka tetrachloroethylene/tetrachloroethene). You may be lucky enough to also get some in your drinking water, too (which means you are also breathing it and absorbing it through your skin) -- because PCE is also one of the most prevalent groundwater contaminants in the US. It has some other nice properties: it causes cancer and birth defects and probably autoimmune disease. And it isn't needed to dry clean clothes. Other than that, no…
revere | April 13, 2009The idea that if the United States joins the rest of developed nations and finally adopts a universal health care system it will bankrupt itself is not based in reality. The reality is that the US spends a larger proportion of its Gross Domestic Product (GDP) than any other developed nation. By far. Not even close. CDC has just documented it from data collected by the Organisation for Economic Co-operation and Development (OECD) in its 2008 health data yearbook (statistics and indicators for 30 countries). It suggests we are being bankrupted by our lack of a universal health care system:
CDC…
revere | April 12, 2009Fomites are inanimate objects that act as modes of transmission for infectious agents. You know. The doorknob or airplane armrest handled by someone who coughs on his hand or blows her nose. We know that some agents, like influenza viral particles, can remain viable (i.e., retain their ability to replicate in a host cell) for days or weeks. This doesn't automatically mean that fomites are an important mode of transmission, however. There is evidence those same viral particles lose their ability to replicate after only a few minutes on your hand. The apparent paradox is probably related to the…
revere | April 12, 2009Newsweek's Editor, Jon Meacham, himself a "liberal Episcopalian" and author of a book on the religious views of the Founders (American Gospel), has raised a large cloud of dust with a Newsweek cover story, "The Decline and Fall of Christian America." I saw Chritopher Hitchens on TV refer to it as "thoughtful." I read it. It's OK. I guess anything in the mass media that takes a relatively clear-eyed look at the state of religion in the US would have to look relatively thoughtful, but I don't see much depth. My yawn isn't typical, however, as the declining and falling Christian talking heads…
revere | April 11, 2009The Weekly Toll is at once inspiring and heartwrenching, a record of unending and unnecessary death in America's workplaces. We've posted about it a couple of times in years past (here, here; read some of the entries), but not for a while. The Weekly Toll appeared for some years on Jordan Barab's superb health and safety blog, Confined Space, and yesterday we brought you the wonderful news that Jordan has been selected as Deputy Assistant Secretary at OSHA (and in fact will be Acting OSHA Director starting next week). That's the good news. The bad news is that Death didn't decide to give it…
revere | April 10, 2009When we started Effect Measure almost four and half years ago, there were few public health oriented blogs. One notable exception -- and an exceptional exception it was -- was blogger Jordan Barab's Confined Space. It wasn't just a health and safety blog. It was the health and safety blog. It was almost the only way most health and safety professionals could keep track of what was happening in their field politically. When we started this blog Jordan had been blogging daily for about 18 months, and we met for coffee. Neither of us expected my blog would outlast his, but a couple of years ago…