public health
mikethemadbiologist | September 15, 2008One of the most important things in public health is surveillance. While it's not sexy, you can't solve health problems if you don't have good data. Recently, many professional societies sent a joint letter to several representatives asking their support for the National Integrated Public Health Surveillance Systems and Reportable Conditions Act which will be submitted to committee (the full text of the letter is at the end of the post).
The primary goal of the NIPHSSRCA (try saying that ten times fast....) is to modernize our surveillance infrastructure. When I would argue for electronic…
j7uy5 | September 14, 2008One important concept in psychotherapy studies is the concept of
href="http://www.indiana.edu/%7Efamlygrf/units/ambiguous.html">ambiguous
loss. This is a loss that is, in some
way, less than definitive. If you are at the hospital
visiting an ill beloved family member, and see the death, it is
perfectly clear that a specific loved one has in fact died.
If you are mature enough to grasp the permanence of the loss,
is it unambiguous.
Many losses, however, are ambiguous. Examples include
infertility, when the loss is a loss of opportunity, as opposed to the
loss of a specific person; a…
tsmith | September 4, 2008 Oh, let's go back to the start... --Coldplay, "The Scientist"
A decade ago, a paper by Andrew Wakefield and colleagues was published in The Lancet, detailing the cases of 12 children with autism spectrum disorder (ASD). Anecdotal reports from parents of several of these children suggested that the onset of their condition followed receipt of the measles, mumps, and rubella (MMR) vaccine. Wakefield concluded following this research that the MMR vaccine was unsafe, and could play a causative role in the development of autism as well as gastrointestinal disease--the first volley in the…
kcontreary | September 3, 2008Okay, Jake or anyone else out there with medical training--is this for real? Apparently there may be a new syndrome whereby young men suddenly and inexplicably die following police arrest. The phenomenon is being compared to a similar one wherein wild animals up and die upon capture, and may have something to do with a surge of stress hormones called catecholamines into the bloodstream.
The research is being done in Spain. No deaths considered in this investigation were supposed to be due to mistreatment, but if this is at all indicative of how Spanish police bring people into custody,…
mikethemadbiologist | August 18, 2008
This is not good. A recent article in Emerging Infectious Diseases describes two separate cases of community-acquired ST398 MRSA--and neither case was associated with agriculture. Let me explain what this means and why this is really bad news.
MRSA--methicillin resistant Staphylococcus aureus--is a serious problem: in the U.S., it kills more people annually than AIDS. Typically, the therapy used to treat MRSA is vancomycin, and strains resistant to vancomycin can't be treated on-label with any commercial antibiotics*. ST398 is a new clone of MRSA that is thought to be associated with…
tsmith | August 7, 2008So, after almost a week of intense media scrutiny and finger-pointing at USAMRIID scientist Bruce Ivins as the perpetrator of the 2001 anthrax attacks, the FBI has now released its documents pertaining to the case, and declares that Ivins was indeed their man. However, a lot of unanswered questions remain--about the investigation itself, the whole mess surrounding the anthrax attacks and what they meant to the "war on terror," and the science itself that linked the attack strain to Ivins' lab. A few of the remaining issues are discussed below...
First, as Glenn Greenwald notes, there was…
tsmith | August 1, 2008Real life work has once again stepped in, so I won't have the Helicobacter posts up until next week. However, in the meantime, a big story has broken regarding the 2001 anthrax attacks--a potential suspect, and his suicide before he could be arrested. Will we ever actually get to the bottom of this? More discussion below...
A bit of a primer on the anthrax attacks, as it's been awhile since they were in the news. Recall that just after the chaos of 9/11 in 2001, envelopes containing anthrax were sent to a number of news organizations and senators, resulting in 22 cases of anthrax and 5…
tsmith | July 25, 2008
As I've mentioned, this has been a busy year. In the span of 3 months, 3 small grants were funded; enough to keep me busy for the next year. Though my training prior to arriving here was almost exclusively in bench microbiology (mostly molecular microbiology/molecular epidemiology), I knew when I took my current job that I wanted to expand that and go beyond just examining whatever samples someone else had on hand, and set up my own studies. Being Iowa, a big focus of our work is rural health and agriculture, so this has taken me out to cattle and pig farms--previously with a technician…
tsmith | July 23, 2008So it's not quite a colonoscopy on live TV, but Janet's done the public health world a favor and blogged her mammogram.
However, one commenter notes:
How about a discussion of the ethics of this particular screening method since it's fairly equivocal whether it's actually worth the hassle and all the false positives in women aged 40?
I don't follow cancer diagnostics enough to be able to comment with any authority on that, so I'd be interested in hearing more from people out there with expertise in that area. However, a 2007 review and meta-analysis says this:
Meta-analyses of randomized…
tsmith | July 23, 2008Revere once again is the voice of reason regarding latest developments in Tomatogate (e.g., the ongoing outbreak of Salmonella, serovar Saintpaul). Has the source been identified?
For those of you who many not have been following this closely, the outbreak has now hit almost every state, with over 1200 confirmed cases identified since April and more than 200 hospitalizations. Though the outbreak was initially associated with tomatoes, investigators were unable to link tomatoes to the specific strain--a relatively rare one--and advice to consumers to avoid varieties of tomatoes didn't put…
mikethemadbiologist | July 14, 2008...seven years later? The bad news--for years, cephalosporin antibiotics (antibiotics derived from penicillin, such as ceftiofur, cephalothalin, cefoxitin, and ceftriaxone) were used 'off-label' (meaning irresponsibly) in agriculture (italics mine):
Inspectors found a common antibiotic has been misused in animals through practices such as injections into chicken eggs and ordered farmers to stop the unapproved treatments because of the risk to humans.
The drugs, called cephalosporins, were given in unapproved doses to chickens, beef, pigs and dairy cows, the U.S. Food and Drug Administration…
tsmith | July 11, 2008Marburg is a filovirus; a cousin of Ebola. Both cause hemorrhagic fever; both have been recently discovered in fruit bats; both have hit Africa in a small number of human outbreaks. Both also remain largely mysterious; we know very little about their ecology in the wild; how frequently they really infect humans (and other animal species; Ebola especially has taken a toll on great apes); and their mode of transmission from their wild reservoir to primate hosts. These enormous gaps in our knowledge remain despite recently passing the 40-year mark since the discovery of filoviruses in a lab…
j7uy5 | July 10, 2008This post is not about mental health parity. Although it is a
very important topic, there is no reason for me to write about it.
If you are interesting in the topic, just go read the (open
access) Perspectives column in the current NEJM:
href="http://content.nejm.org/cgi/content/full/359/2/113">Shuffling
toward Parity -- Bringing Mental Health Care under the Umbrella.
The column is short enough that there would not be any point in trying
to distill it any further. But I do want to make a couple of points, including a
mild-to-moderate quibble with one of the points mentioned:…
tsmith | June 20, 2008
Here in the Iowa City-Cedar Rapids corridor, the waters have been going down for several days, and people are being allowed back into their homes and businesses to begin assessing the damage and cleaning up what remains. However, while the dangers from the initial flooding are receding along with the waters, the clean-up and aftermath bring about a new set of misery.
Flooding is a potential nightmare when it comes to infectious diseases. The water can bring people returning to their flooded residences into contact with sewage, animal carcasses, and other sources of pathogens--and warm…
purepedantry | June 18, 2008There have been a lot of salmonella outbreaks in food in the news lately, but who is to blame? Last year, Paul Krugman set the responsibility squarely on the Bush administration and ideological libertarians like Milton Friedman who want to limit food safety regulations:
Without question, America's food safety system has degenerated over the past six years. We don't know how many times concerns raised by F.D.A. employees were ignored or soft-pedaled by their superiors. What we do know is that since 2001 the F.D.A. has introduced no significant new food safety regulations except those mandated…
mikethemadbiologist | June 16, 2008
I've been saying for a while now that the 'piggy MRSA*', known as ST398, is going to be a problem. Always listen to the Mad Biologist.
Last week, I was talking to someone who is monitoring MRSA in the New York area, and they've seen two cases of ST398 MRSA in hospitals. This really shouldn't come as a surprise since ST398 is sweeping through the swine population. The only question now is will ST398 simply replace the predominant MRSA strains, or will it add to the total number of MRSA infections and deaths.
Of course, those aren't mutually exclusive possibilities...
*MRSA is methicillin…
tsmith | June 14, 2008
Photo of Cedar Rapids, Iowa
The university has now canceled all classes through June 22nd, and told all "non-essential" employees to stay home. The town is almost impossible to navigate as bridges across the river have closed one by one. And it's not only in town; interstate 80 and 380 both have closed in places, where they cross over the Iowa and Cedar rivers, making travel in the area near impossible. To make things worse, river levels aren't even predicted to reach their high until Monday (assuming current rain forecasts hold). Luckily, we have some plans in place...more on that…
mikethemadbiologist | June 3, 2008I stumbled across this interesting post about San Francisco's recent paid sick leave bill:
* Anecdotally, paid sick leave is a good idea. Flocks told story after story of workers who were forced to go to work sick. She told of a server at the Cheesecake Factory whose boss told her that she would be fired if she didn't show up for work, despite the fact that she had pinkeye. So the boss "allowed" the sever to wear sunglasses.(Call me crazy, but I don't like people with pinkeye touching my food.) In another example, a woman who was pregnant and hemorrhaging lost her job because her boss told…
j7uy5 | May 26, 2008I'm harping on the same string. A month ago, I
href="http://scienceblogs.com/corpuscallosum/2008/05/poisoning_ourselves.php">noted
how it was not necessary for terrorists to figure out how to poison us.
Our own companies are doing it for them. Now, our
government is doing a heck of a job to make it easier for companies to
poison us, and to get away with it.
As noted by the former WaPo reporter, Ed Bruske, the USDA is no longer
keeping track of pesticide use. Formerly, the USDA published
an annual report a chemical usage in agriculture. It was the
only comprehensive, reliable…
mikethemadbiologist | May 20, 2008Two stories published in the New York Times today underscore the importance of handwashing in preventing infection. First, from a public hospital in New York:
Timeouts to wash hands and put on hairnets, a simple checklist to ensure that such seemingly obvious precautions are done, and advertising campaigns directed at everyone from the most senior doctors to the poorest of patients have been credited with drastically reducing the number of serious infections at New York City's public hospitals.
Since 2005, central-line bloodstream infections, which stem from bacteria invading a catheter…