revere | December 12, 2007It's bad enough that health care workers have to worry about getting bird flu, Ebola and SARS. But even if they aren't in contact with infected patients there are many other hazards in a health care institution. Ergonomics issues are a big deal (I worked my way through school as a "transport" worker in a radiology department and lifting patients is a good wway to hurt your back; I know). And so are dangerous chemicals:
Nurses who are exposed to high levels of chemicals and drugs on the job are more likely to report having asthma, miscarriages and some cancers, according to a survey released…
revere | December 12, 2007The dramatic infectious agents like MRSA, Ebola and bird flu get the headlines but there are a lot of others out there, some of them capable of being just as nasty. Consider the new variant of adenovirus serotype 14, for example:
Infectious-disease expert David N. Gilbert was making rounds at the Providence Portland Medical Center in Oregon in April when he realized that an unusual number of patients, including young, vigorous adults, were being hit by a frightening pneumonia.
"What was so striking was to see patients who were otherwise healthy be just devastated," Gilbert said. Within a day…
revere | December 11, 2007One of the most effective environmental regulations that wasn't a command and control item was something called the Toxic Release Inventory (TRI) Program. Here's EPA's description:
The Toxics Release Inventory (TRI) is a publicly available EPA database that contains information on toxic chemical releases and other waste management activities reported annually by certain covered industry groups as well as federal facilities. This inventory was established under the Emergency Planning and Community Right-to-Know Act of 1986 (EPCRA) and expanded by the Pollution Prevention Act of 1990.
That…
revere | December 11, 2007Concern about cutting down the rain forests is not just a conservationists hobby horse. As more and more trees are cut down for their wood and the land cleared for agricultural use the unplanned consequence is that more an more mobile and traveling humans come in contact with animals for the first time. These animal populations are reservoirs for many viruses, some, like Ebola and AIDS, make their way into new homes, human bodies. The rain forest is no more than an incubation period's travel from major cities.
But this isn't the only way animals and humans are thrown together in intimate and…
revere | December 10, 2007There are a lot of diseases out there you haven't heard of and most of them are things you don't want to get. One of them is a neurological autoimmune disease called chronic inflammatory demyelinating polyneuropathy (CIDP) where the body attacks the covering of nerve fibers and prevents impulse transmission. It produces paresthesias (tingling), numbness and weakness. If not treated early it can become debilitating and incapacitating. As I said, you don't want to get it.
But apparently CIPD is exactly what 11 workers at Quality Pork Products in Minneapolis did get. All worked at the "head…
revere | December 10, 2007The debate about how much wild migratory birds contribute to the spread of highly pathogenic influenza/A H5N1 goes on. According to a sensible Commentary in Nature (Dec. 6) it needn't. We should have taken steps some time ago to answer an answerable question. But we didn't and still haven't initiated those steps:
Two years ago, some believed that H5N1 viruses were poised to spread around the globe on the wings of migrating wild birds. A massive effort was mounted to track their movement but, as of September 2007, very few positive birds have been found in tests of over 300,000 healthy wild…
revere | December 9, 2007There's a growing Ebola outbreak in Uganda. We've been watching it and I've gotten an email or two wondering why we weren't posting on it. There are a lot of nasty disease outbreaks in the world and we don't cover most of them. Ebola gets news because it is a hideous disease with high fright value but it isn't alone in that department. Ebola also isn't very contagious and like SARS, is mainly so in the later stages of the disease so less likely to spread worldwide. We discuss bird flu here because it is a way for us to talk about public health more generally. But we do talk about other…
revere | December 9, 2007Mitt Romney's "Mormons are Christians -- really!" speech ("I believe that Jesus Christ is the Son of God and the Savior of mankind."), also established that non-believers are not Americans -- really!
And you can be certain of this: Any believer in religious freedom, any person who has knelt in prayer to the Almighty, has a friend and ally in me. And so it is for hundreds of millions of our countrymen: we do not insist on a single strain of religion -- rather, we welcome our nation's symphony of faith.
And what about those of us who don't kneel in prayer to the Almighty? We don't have friend…
revere | December 8, 2007Earlier in the week we discussed the unfortunate 24 year old man who died of bird flu in Nanking in Jiangsu province. He had had no known contact with sick poultry. Now the father has bird flu. Did the father get it from the son? Did both get it from the same source? Or two different sources? Those are the open questions at the moment as Chinese health authorities struggle to follow up the health status of the father's 69 suspected contacts:
"The patient, a 52-year-old male surnamed Lu from Nanjing in Jiangsu, is the father of the serious case of bird flu diagnosed on December 2," said the…
revere | December 7, 2007A reader alerted me to a poignant "confessional" from arch conservative William F. Buckley (hat tip Cathie). Buckley, the founder and long time editor (now retired) of the very conservative National Review is devoted to the Free Market, devoted as in religoius adoration. But it seems that even he has his limits:
My own story is that I am the founder of a doughty magazine which, if space was solicited tomorrow by a tobacco company, would agree to sell the space. We would come up with serious arguments featuring personal independence and pain/pleasure correlations to justify selling the space…
revere | December 7, 2007This post is about something I've wanted to write about for a while, but never found the time. That's still true, but I've just spent five days as a natural environment for a norovirus or something similar. The good news is I lost 5 pounds. But the bad news -- and there was a lot of it -- is that as I recover I am desperately trying to catch up on too many urgent things that didn't get done. Still, this story is something I want to write about, so I'll do it more briefly now and come back at some later point for more analysis. What's bothering me? Press embargoes:
The World Health…
revere | December 6, 2007As an (unplanned) follow-up to today's morning post about public health use of the internet we have tonight's event in Second Life, a chance to meet and chat with wiki partner DemFromCT:
Our next installment of the Virtually Speaking interview series takes place TONIGHT, Thursday, at 6pm Pacific/9 pm Eastern.
We are very excited that DemFromCT can join us to talk about public health policy, in particular preparedness for a pandemic. He and I have been trading comments on some skepticism I have about this, so this is going to be an especially interesting discussion.
All skeptics are welcome…
revere | December 6, 2007YouTube is a phenomenon. We've gotten so used to it (and its user generated content cousins) sometimes we don't realize how potent it is. Potent and in the hands of all sorts of people. Creative, crazy, evil, well meaning, ordinary, boring . . . you get the idea. And getting ideas is another thing people get from YouTube. Sometimes the ideas are good. Sometimes not:
It may be better known as the place to go to watch a drunken David Hasselhoff eating a hamburger, but the video website YouTube has also become a popular and effective soapbox for people who believe vaccinations are harmful, a new…
revere | December 5, 2007Most people in the developed world think of measles as a pesky but fairly benign childhood disease. For the current generation, who has had the benefit of immunization with measles vaccine, it is also a historical curiosity. Not so for the developing world, where measles has been a major killer of children and infants. Africa has become the poster child for failed public health programs so it is nice to be able to say that when it comes to measles prevention, Africa is a special success story:
Africa, which has long had the most measles deaths, has seen the biggest drop, 91 percent. In many…
revere | December 5, 2007Indonesian Health Minister, Siti Fadilah Supari, has reiterated her refusal to share isolates of H5N1 virus (it's unclear if this is her decision alone or is the considered decision of the Indonesian government). This came at the current inter-minsterial conference on bird flu on underway in Delhi (how many of these conferences are there, anyway? It seems like every week there's another one.) Her demand is that every isolate have a Material Transfer Agreement (MTA) requiring a statement each time the isolate is shared with another laboratory, stating it is only for diagnostic purposes and not…
revere | December 4, 2007
If you need the antibiotic ciprofloxacin ("cipro") (famous for its use as prophylactic agent for those potentially exposed to weaponized anthrax in 2001), I know where you can find a lot of it. In Patancheru, India, near Hyderabad, one of the world's centers for production of generic drugs. Most of the cipro made there is shipped out, but it turns out a lot of cipro stays behind, in the sewage of Patancheru. A paper by Larsson et al. (Journal of Hazardous Materials 148 (2007) 751-755; hat tip SusieF) found the highest levels in sewage effluent of pharmaceuticals of any yet reported. The…
revere | December 4, 2007China has just registered its 26th known case of bird flu and its 17th death. I emphasize known, because in a country of over 1.3 billion that has not been able to eradicate this virus from its vast poultry population, it would seem the real number is probably quite a bit higher. But what I want to return to about this case is something I have discussed before regarding the Chinese cases (and pertains to most of the other reported cases as well), but is starkest for the Chinese reports. But first, the pertinent part of the case:
China's first human case of bird flu in six months shows that…
revere | December 3, 2007Carnegie-Mellon is a great university and when it comes to robotics and computer science is always on the cutting edge. But does that cutting edge have to be so sharply lethal?
Unmanned aircraft are showing up in the skies more often and today the US Army awarded $14.4 million to Carnegie Mellon to build a remote-controlled unmanned tank.
A certain amount of the award will go toward significantly improving the Crusher, a 6.5-ton unmanned support vehicle Carnegie engineers developed in 2006 in conjunction with DARPA. Since its introduction, the Crusher has demonstrated unparalleled toughness…
revere | December 3, 2007I'm traveling so I'll let other bloggers do the heavy lifting. And I can always count on flu bloggers of note, Crof and SophiaZoe. Both discuss and link to reports of H5N1 in refrigerated turkey meat sold in stores in Poland (I particularly recommend SZ's excellent summary of the safety issues). While I don't have a lot to add to their coverage, I'd like to inject just one more issue related to finding the virus in meat
An ongoing debate is the relative contributions of migratory (wild) birds and domestic poultry to spreading H5N1 geographically. There is evidence for both mechanisms, and…
revere | December 2, 2007It's been a while since we pressed this particular button but it seems it's time:
Baghdad is facing a 'catastrophe' with cases of cholera rising sharply in the past three weeks to more than 100, strengthening fears that poor sanitation and the imminent rainy season could create an epidemic.
The disease - spread by bacteria in contaminated water, which can result in rapid dehydration and death - threatens to blunt growing optimism in the Iraqi capital after a recent downturn in violence. Two boys in an orphanage have died and six other children were diagnosed with the disease, according to the…