public health
ddobbs | October 5, 2009Never know what'll top the charts. Top post was a post I put up in January, "Pfizer takes $2.3 billion offl-label marketing fine." That post reported the news (via FiercePharma) that Pfizer had tucked away in its financial disclosure forms a $2.3 billion charge to end the federal investigation into allegations of off-label promotions of its Cox-2 painkillers, including Bextra. (Lot of money ... but it didn't quite wipe out the company's 2008 net income.) The company had set aside the money as part of a deal it was negotiating Justiice. Finalizing the deal, however, took until September. At…
ddobbs | October 5, 2009Lots of flu news out there. Here's my short list for the day:
Helen Branswell reports that WHO is unpersuaded by the unpublished paper showing seasonal flu vaccine may raise chance of getting swine flu. (Anomalies are usually anomalies.) Canada has been thrown into quite a bit of confusion by this report, with some provinces holding off on seasonal flu vaccines.
Meanwhile, an OB notes an extraordinary death toll of H5N1 among pregnant women.
Greg Laden has an extremely short post suggesting how difficult these two bits of news are when you (or your wife) are actually pregnant. The gist: The…
ddobbs | October 1, 2009You have to move fast these days to keep up with the flu. Or outrun it.
A quick roundup from the last 24:
From the invaluable H5N1:
Mexico: 4,000 H1N1 cases in 7 days
Spain: 31,322 cases and 6 deaths in one week
US: 15 states could run out of hospital beds
Scotland sees it Worst week yet for swine flu, with new cases running at 2,000 a day
Toronto catches the wave.
Meanwhile, Helen Branswell reports that Dutch researchers find mutation linked to greater virulence in swine flu virus -- but so far it doesn't appear to be the big upgrade in nasty we've been fearing. Effect Measure…
mikethemadbiologist | September 30, 2009One of the thing we need to pay attention to during TEH SWINEY FLOO! is the role of bacterial infections in flu-related mortality: a fair number of the deaths ultimately could result from a secondary bacterial infection by organisms like Staphylococcus (including MRSA), Streptococcus, and some of the Gram-negative organisms. Unfortunately, this is happening in a significant fraction of cases:
Nevertheless, the 22 cases (among 77 deaths confirmed to be from H1N1) emphasize that bacterial co-infections are playing a role in the ongoing pandemic, something that was not clear at first, the CDC…
ddobbs | September 29, 2009Updates from the flu front:
Confusion grows over the still-unreleased study
that apparently finds, contrary to other studies, that getting this
year's seasonal flu shot may raise your risk of getting swine flu. Peter Sandman, meanwhile, argues that since the swine flu seems
to have largely displaced the seasonal flu, getting vaccinated for the
latter doesn't make much sense. (I'm doing so this afternoon anyway.)
WaPo notes that the swine flu's second wave is starting to really make itself felt in the U.S., with over half the states reporting widespread flu activity.
Low stocks of Tamiflu (…
mikethemadbiologist | September 22, 2009Whenever drug legalization is raised, the anti-legalization side always raises the specter of increased addiction. That is, the argument is framed as a choice between legalization and the harm due to increased addiction. But this ignores a key factor--the death toll due to the 'War' on (Some People Who Use) Drugs:
We've heard a lot about the terrible death toll Mexico has suffered during the drug war -- over 11,000 souls so far...
Still, we've heard nothing about the American death toll. Isn't that strange? So far as I can tell, nobody has even tried to come up with a number.
Until now. I'…
ddobbs | September 22, 2009
Eric Michael Johnson contemplates the hearts, minds, teeth, and claws of bonobos and other primates.
Tara Smith explains why she'll be getting her kids their (seasonal) flu vaccines. Revere does likewise
Daniel Menaker, former honcho at Random House, defends the midlist. (Where was he when my book was getting so much push?)
Just in case you missed it, lack of insurance is killing 45,000 people a year (Times) in the U.S. This doesn't include preventable deaths among the underinsured (like yours truly, who is sitting on some surgery that he'd rather put behind him). You can download the…
ddobbs | September 22, 2009
The swine flu triage tent at Dell's Children's Medical Center, in Austin, Texasphoto: Ralph Barerra, Austin American-Statesman
I can't keep up with the flu news. (If you want to, best single bet -- the wide net -- is Avian Flu Diary.) But as the World Health Organisation meets in Hong-Kong to discuss, among other things, swine flu, here are a couple that make good follow-ups to my Slate piece on how adjuvants gobble up vaccine antigen supply:
WHO pushes for worldwide swine flu vaccinations (hoping to vaccinate 3 billion) -- despite that overall supply will fall short .
The U.S. (and some…
ddobbs | September 22, 2009
"One in six patients 'wrongly diagnosed by NHS doctors'," shouts the Daily Mail (via EvidenceMatters. This should not surprise us: Autopsies have been finding a similar percentage of misdiagnosis among the dead for decades. Doctors will always miss some diagnoses. Progress is a matter of ever narrowing the list of things doctors miss -- so the other problems can be diagnosed and treated, letting the patients live longer (till they did of something incurable -- or something we still haven't learned to diagnose. Learn to properly diagnose, say, appendicitis, and you can save the life of a10-…
tsmith | September 18, 2009Taking a brief hiatus from my hiatus to discuss a question I've been asked a number of times in recent weeks by friends and family: what about flu shots? Are you getting one for yourself? Your kids? The answer is yes to both, with more explanation after the jump.
First, for readers unfamiliar with this blog, let me be frank regarding my opinion on vaccine "controversies," such as "vaccines cause autism." As I've discussed here several times already (and more can be found by searching my older posts), this assertion is completely unsupported by many scientific studies, so this is not a…
ddobbs | September 17, 2009
My latest piece for Slate examines the unsettling consequences of the United States' choice of swine flu vaccines.
The good news about these vaccines is that, to judge by the first vaccine trial results, published last week, they appear to work fast, safely â and at about a half to a quarter of the doses that the CDC expected. This means we effectively have about two to four times as many vaccines as we had figured we would. Since we ordered 195 million doses, we could vaccinate damn near the whole country.
If the fast-tracking efforts continue to work and the flu peaks closer to Christmas…
mikethemadbiologist | September 16, 2009
This is not good public hygiene
...WASHING YOUR DAMN HANDS! From the NY Times:
In one study of four residence halls at the University of Colorado, two of the dorms had hand sanitizer dispensers installed in every dorm room, bathroom and dining area, and students were given educational materials about the importance of hand hygiene. The remaining two dorms were used as controls, and researchers simply monitored illness rates.
During the eight-week study period, students in the dorms with ready access to hand sanitizers had a third fewer complaints of coughs, chest congestion and fever. Over…
mikethemadbiologist | September 14, 2009...the rest of us. Shorter version: you are an ambulatory germ dispersal unit, so be responsible.
I try to make it a regular habit to go through the ScienceBlogs 24-hour feed, and in doing so, I came across this post by ScienceBlogling Jason Rosenhouse talking about his experience with what might have been TEH SWINEY FLOO!, and my jaw dropped when I read this:
I didn't even cancel any of my classes, though I did cancel some office hours to get home and back into bed more quickly.
I became more troubled as none of the commenters seemed bothered by this. Fortunately, Orac showed up and…
j7uy5 | September 14, 2009The SEIU website makes an
href="http://www.seiu.org/2009/09/domestic-violence-victims-have-a-pre-existing-condition.php">astonishing
claim:
But, in DC and nine other states, including Arkansas,
Idaho, Mississippi, North Carolina, North Dakota, Oklahoma, South
Carolina, South Dakota, and Wyoming, insurance companies have gone too
far, claiming that "domestic violence victim" is also a pre-existing
condition.
Words cannot describe the sheer inhumanity of this claim. It serves as
yet further proof that our insurance system is broken, destroyed by the
profit-mongering of the very companies…
ddobbs | September 2, 2009You can't make this stuff up. As PharmaGossip (among others, including the Times) reportst, a drug company pays $2.3 billion in fines to settle charges of unprecedented seriousness about practices that directly put patients at risk, and that came out of a four-year federal investigation. And some yahoo right-winger asserts this fine -- years in the works, unprecedented in scope, settling allegations rising from an investigation that started during the Bush Administration -- is really part of Obama's effort to "federalize" medicine and cut costs.
Here's the video of the DOJ's press conference…
j7uy5 | August 28, 2009...and the steel hits the flesh.
Mark Rosenberg, MD, representing the
href="http://www.researchamerica.org/pgr_society">Paul G. Rogers
Society for Global Health Research, had an opinion piece published
in the Boston Globe. He makes a good point about health. It
is not just doctors and hospitals. Urban design, and
infrastructure maintenance have a role to play.
href="http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2009/08/18/roads_that_are_designed_to_kill/">Roads
that are designed to kill
By Mark Rosenberg
August 18, 2009
...Most people think we are doing…
ejohnson | August 25, 2009
Though reported Swine Flu cases have dwindled over the summer months, the Centers for Disease Control warns that a full-blown pandemic is on the horizon as fall inaugurates the 2009-2010 Flu Season, mirroring the progression of the 1918 Spanish Influenza. Now, with the advent of vaccines and medical technologies, as well as improved personal and public hygiene, communities are better equipped to control the spread of infectious disease. As the nation waits for the release of the H1N1 vaccine, ScienceBloggers weigh in on the implications, applications, and ethics of preventing, tracking, and…
mikethemadbiologist | August 21, 2009A couple days ago, while waiting for the T, a guy about ten feet away sneezed several times without even attempting to cover his face; he didn't even make a 'matador', bullshit fake effort. Because of the angle of the light and what not, I could easily see the massive spray of mucus flying out of his nose. I mean stuff everywhere. Kinda like this:
(from here)
Long time readers of this blog will know my battle cry, "WASH YOUR DAMN HANDS!", but other forms of public hygiene, such as not spraying your snot hither and yon, matter too. In fact, it's important enough that public health…
terrasig | August 21, 2009The other day Orac at Respectful Insolence wrote about yet another case where failure to vaccinate has caused a resurgence, in this case of measles in New Zealand.
Otherwise preventable and potentially fatal diseases are popping up in communities around the world as the importance of immunization is ignored by a generation of parents who never knew these diseases.
Well, looks as though they're beginning to find out.
I'm keeping my eye on a similar case brought to my attention by my Twitter feeds from Colorado (if I can't be there, I'll at least read about it). This report from the…
mikethemadbiologist | August 18, 2009...I was wrong. African-Americans and Latinos are already showing elevated numbers of swine flu hospitalizations in Massachusetts:
Since its arrival in Boston in late April, swine flu has proved to be a particular source of misery to the city's African-American and Hispanic residents, causing hospitalizations at far higher levels than other groups, disease trackers report.
More than 3 of every 4 Bostonians who have spent time in the hospital because of the viral ailment are black or Hispanic, a finding that may reflect broader social ills, the top official at the Boston Public Health…