CDC
revere | July 1, 2008As the tomato Salmonella outbreak heads past the 800 case level, it's time to ask some questions about why we don't know the source of what is the largest produce associated disease outbreak on record. CDC has its own explanation, namely, that figuring out where tomatoes come from and where they go is much harder than they thought. Said another way, the experts in foodborne disease outbreaks at CDC and FDA didn't know much about the industry. Since tomatoes have been a frequent cause of Salmonella outbreaks, that seems odd, except that my experience with CDC in recent years is that it is full…
revere | June 30, 2008We started blogging on public health at the beginning of the 2004 - 2005 flu season, although we didn't concentrate on flu immediately. We intended to use the public health problem of influenza, a disease that contributes to the death of almost 40,000 US citizens a year, as a lens through which to look at public health. The interest in bird flu and pandemic flu followed naturally. The intervening years saw seasonal influenza outbreaks that were milder than previous years, but this resourceful virus made a comeback in the flu season just concluded. CDC has just summarized the 2007 - 2008 flu…
revere | June 24, 2008The Atlanta Journal Constitution (AJC) newspaper is the Centers for Disease Control (CDC) worst nightmare because it continually runs in depth stories about why CDC is the worst nightmare for scientists concerned with laboratory safety. CDC is the agency supposedly ensuring the public's safety from laboratories researching contagious disease causing organisms. They have their own research labs which they need for identification of unknown organisms or scientific work on agents of special importance. In the Bush years, this has often meant CDC has worked on biowarfare agents. One of those…
revere | April 17, 2008Peter Doshi has a bone to pick with CDC . His particular idée fixe is that CDC is cooking the books on their estimates of excess mortality attributable to influenza and he aims to set the record straight. He's done it before. Doshi is not the kind of critic CDC is used to. He is a graduate student, not an established public health figure. But he's no shrinking violet and is getting in CDC's face again in the latest issue of the American Journal of Public Health. This time Doshi extends his criticism to imply CDC is pandemic fear mongering, perhaps in collusion with Big Pharma. This has been…
revere | April 15, 2008I haven't posted on the vaccine/autism question for several reasons. It is quite well covered by other science bloggers, it tends to generate more heat than light, and we didn't have anything new to say. I have on several occasions discussed it with two of the world's top experts on the health effects of mercury and one of the world's top autism experts. None of the three felt there was a vaccine-mercury connection to autism. But news that the US government was going to include vaccine critics in shaping national vaccine policy made me change my mind about posting. I won't be addressing the…
revere | April 14, 2008Boingboing had a short notice about the National Highway Traffic Safety Administration (NHTSA) Fatality Analysis Reporting System ("FARS"), plugging it as an all purpose dicing and slicing source for information on motor vehicle related deaths in the US. You can make your own custom queries to find out about auto fatalities in your own county. FARS is a great resource. But there is another one, hosted at CDC, that is even better: WISQARS (Web-based Injury Statistics Query and Reporting System, "whiskers").
WISQARS reports injury statistics for each state over time. You can also compare your…
revere | April 7, 2008To everything there is a season, including flu. We are now emerging from the other end of one of the more difficult flu seasons in recent years, although by no means out of the ordinary for the genre. Last time we commented, almost every state was experiencing widespread flu activity by the end of March only seven states reported widespread activity according to CDC:
States that were still reporting widespread flu the week of Mar 22 through 29 were Connecticut, Iowa, Maine, New York, North Carolina, Pennsylvania, and Vermont. Regional flu activity was reported in 27 states and local activity…
revere | March 23, 2008My children are no longer young. In fact they are old enough to have children of their own and when my daughter asked me if I thought her then 6 month old should get a flu shot I didn't hesitate: Absolutely, I said. And he did. Two of them, the required number. That was just before the flu season, which he has so far weathered just fine. Sadly that's not true for all children. The two most vulnerable groups for dying from influenza are children under 5 and the elderly (me). I got flu shots, too, although the evidence it will help me is not as good as the evidence my little grandson will be…
revere | March 17, 2008There are all sorts of ways to prepare for an emergency. One is to simulate it inside a computer (a computer model). But you don't have to simulate inside a computer. You can also do it in "meatspace" (aka, the real world). Dungeons and Dragons using books is one example of this. Another is to do a pandemic version of D&D. It's called a table top exercise, although the size of the table can be pretty big. Recently our wiki partner, DemFromCT (if you can call someone a partner who does all the work), observed a CDC exercise which he has described in detail over at the FluWiki Forum (here,…
revere | March 6, 2008We don't especially like being anonymous on this blog but we feel it is prudent given the retributive nature of this administration. We don't care that much ourselves as we are pretty well established. But we worry that our students, our colleagues and our institution will become collateral damage in retribution for things we say here. It's not just that we read about this stuff in the news. We know the people involved personally. Last week we posted about Deb Rice, a scientist in the State of Maine health department who is also one of the world authorities on the health effects of the…
revere | February 22, 2008CDC has just issued a report on the state of US readiness for a health crisis. Its assessment is upbeat:
In the first report of its kind, US health officials said the nation's cities and states made a strong effort to prepare for a flu pandemic, bioterrorism, or other emergency health crises, but big challenges remain.
"I think in terms of effort and progress, an 'A,' " Dr. Richard Besser of the Centers for Disease Control and Prevention said when asked to assign a letter grade. "In terms of amount of work to be done, I would say that's absolutely enormous." (AP)
Let's see if we can interpret…
revere | February 18, 2008Accidents in swimming pools can be serious or fatal (drowning, broken necks) but fortunately they are rare. For pool operators one of the more likely nightmares of daily operation is when someone has "a fecal accident." In other words, someone craps in the swimming pool. CDC has guidelines for chlorinated pools (which covers most public pools; they are guidelines because regulations are on the state, not federal, level). And they just revised them. It makes interesting reading, although I suppose this is an acquired taste. Here are the details, followed by a classic dramatic re-enactment on…
revere | February 16, 2008It's official. Living in one of the 120,000 trailers FEMA supplied after Hurrican Katrina is bad for you:
Federal health officials on Thursday urged hurricane victims to move out of trailers supplied by FEMA after tests showed dangerous levels of formaldehyde fumes.
Tests by the Centers for Disease Control and Prevention on more than 500 trailers in Louisiana and Mississippi showed formaldehyde levels that were five times higher than levels in a normal house. The levels in some trailers were nearly 40 times what is normal.
The CDC said people should move out quickly -- especially children,…
revere | February 12, 2008A recently published Commentary in the Journal of the American Medical Association (JAMA) raises some interesting and serious questions about conventional efforts for pandemic flu preparedness. The author is John Middaugh of the Florida State Health Department, a long time public health professional. The last I saw him he was in Alaska, so he seems to have put quite a bit of distance between his current and former places of employment. Indeed the question of people distancing themselves from each other is a central theme of the Commentary:
Although continuing to invest in diverse aspects of…
revere | February 3, 2008After our recent rant on the necessity of supporting the public health and social services infrastructure instead of cutting taxes, President Bush has replied. He is cutting the infrastructure:
President Bush's $3 trillion budget for next year slashes mental health funding and rural health care and freezes spending on medical research, among the cuts outlined in budget documents obtained by The Associated Press.
The budget for the Department of Health and Human Services would be reduced by almost 3 percent under the Bush budget plan to be released Monday. The $2 billion in HHS cuts are about…
revere | February 1, 2008I'm an environmental epidemiologist with a special interest in surveillance. So it would be nice to say that epidemiological investigations and surveillance systems were responsible for discovering most of the workplace diseases we see nowadays. But the simple truth seems to be that most environmental and occupational diseases are still discovered the old fashioned way: by astute clinicians, workers or family members. Such was the case for the recent cluster of cases of a progressive neurologic syndrome among slaughterhouse workers we posted on a while back. The Minnesota Department of Health…
revere | January 14, 2008The American Journal Constitution has a story today wondering if the notorious TB lawyer (see our posts here) that caused an international ruckus because he flew against medical advice (the evidence is a bit obscure on this point) may have been part of a CDC ploy to get increased funding for its TB program. I don't know the answer to that, but the fact it should even be raised and taken seriously in some serious quarters speaks volumes about CDC, its management and an air of desperation there:
Months before the Centers for Disease Control and Prevention made Atlanta lawyer Andrew Speaker the…
revere | December 19, 2007Bush and the Democratic Congress are still battling over the budget, although it is said they are getting closer. Getting closer to Bush unfortunately means giving him all the bombs and bullets he wants but not much else. A case in point is the latest proposal for the NIH and CDC budgets:
Over the weekend, Congress prepared a new version of appropriations following President George Bush's veto of previous bill in November. This new bill includes $760 million less for NIH and $240 million less for CDC than the vetoed bill, according to news reports today.
The result is an increase of less…
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 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…