public health
mikethemadbiologist | January 29, 2007I write often about irresponsible antibiotic use. But I want to make one thing clear: antibiotics are critical, life-saving and health-improving drugs. In the U.S., every year roughly two million people contract hospital-acquired infections (this ignores infections contracted outside the hospital). Roughly 96% don't die. Antibiotics are a major reason, if not the major reason, for why the mortality rate is so low. I'm pointing out the obvious because of an email I received (I've 'de-identified' all of the personal information):
hi, mike. i've been reading your blog on triclosan and…
tsmith | January 25, 2007Measles deaths down 60 percent in six years
Though we tend to think of measles as a mere childhood disease here in the U.S.--a nuisance more than anything--this is a reminder that worldwide, it's still a significant cause of morbidity and mortality. To counter this, a mass vaccine campaign was begun in 2001, and has served to drastically reduce the burden due to the disease:
Deaths from measles have fallen by 60 percent worldwide since 1999 in what experts described on Friday as an historic victory for global health.
Accelerated control measures including an increase in routine measles…
mikethemadbiologist | January 24, 2007Well, kinda sorta. I'm mentioned in a UPI article about rapid diagnosis of influenza and antibiotic use. Rather than repeat the UPI story, here's the abstract (don't worry, I'll translate):
Background: Rapid influenza testing decreases antibiotic and ancillary test use in febrile children, yet its effect on the care of hospitalized adults is unexplored.We compared the clinical management of patients with influenza whose rapid antigen test result was positive (Ag+) with the management of those whose rapid antigen test result was negative or the test was not performed (Ag0).
Methods: Medical…
tsmith | January 24, 2007I've previously mentioned a bacterial pathogen called Acinetobacter baumannii (a bit more information here), and Mike has discussed it rather frequently. A. baumannii is ordinarilly a commensal bacterium--one that may live on the skin of healthy people for many years without ever causing disease. It becomes a problem when one is immunocompromised in some manner, and unable to keep growth of the bacterium in check. Once this happens, it's difficult to reverse, as the bacterium brings new meaning to the term "antibiotic resistant." As Mike blogged previously, a genomic analysis revealed…
tsmith | January 23, 2007 As I described previously in this post, war and disease are inextricably intertwined:
War and its concomitant devastation and social upheaval leaves its victims at an increased risk of disease transmission to begin with due to poor sanitation, collapse of public health and medical facilities and support personnel, crowding in refugee camps, breaks in supply chains of food, medicine, and other necessary items, malnutrition and depression, and other factors.
This social upheaval frequently lasts much longer than the actual fighting. Additionally, in some cases where areas have been…
mikethemadbiologist | January 22, 2007Today is Blog For Choice Day. So I thought I would write about why I'm for legal and safe abortion. It's rather simple: because the alternative is illegal and unsafe abortions. As long as women can get pregnant, some will not want to be pregnant. I trust their judgment that most of the time, they're doing it because it's the best moral alternative. Women can be (and obviously are) independent moral agents. They don't need James Dobson's help.
But now, I would like to turn it over to Atrios, who deals with Compulsive Centrist Disorder, abortion stylee:
As we've been through many times…
mikethemadbiologist | January 18, 2007In the developed world, shigellosis, a diahrreal disease caused by the bacterial species Shigella, typically isn't considered dangerous, even though it makes about 450,000 ill in the U.S. To shorten the length of illness and to reduce potential infection of other people, antibiotics are typically prescribed, usually cotrmoxazole or ampicillin. However, recent shigellosis outbreaks are cause for concern (italics mine):
Surveillance data for antimicrobial resistance among all S. sonnei isolates received by NARMS during 1999--2003 indicated that 80% of the isolates were resistant to ampicillin…
mikethemadbiologist | January 17, 2007There's an interesting article about the norovirus outbreak in Boston (it also seems to be nationwide). At this point, over half a percent of all the residents of Boston have gone to the emergency room due to this virus--which means even more have been sick.
First, as always, wash your damn hands! Now, onto the public health. What's interesting is that Massachusetts has installed a real-time surveillance system to deal with bioterrorism and biopreparedness (i.e., avian flu--got that, Fumento?). But as the biosecurity 'community'* is beginning to learn, you can't separate biosecurity from…
tsmith | January 17, 2007Via Jonah comes this (depressing, as he notes) NY Times article on what else we could've bought with $1.2 trillion:
For starters, $1.2 trillion would pay for an unprecedented public health campaign -- a doubling of cancer research funding, treatment for every American whose diabetes or heart disease is now going unmanaged and a global immunization campaign to save millions of children's lives.
Combined, the cost of running those programs for a decade wouldn't use up even half our money pot. So we could then turn to poverty and education, starting with universal preschool for every 3- and 4-…
tsmith | January 16, 2007Chronic fatigue syndrome (CFS) is one of those nebulous diseases that's really more of a diagnosis of exclusion than anything else. As the name suggests, it's characterized by overwhelming fatigue--often so much so that patients can barely get out of bed--as well as a number of non-specific symptoms, including weakness, muscle pain, and insomnia. Currently, there is no diagnostic test for the disease, and the cause(s) is (are) unknown. Indeed, it should be noted that there's disagreement over even the most basic assumption that such a thing as CFS exists, or whether it's merely…
mikethemadbiologist | January 13, 2007The most common hospital-acquired infections in intensive care units are ventilator-associated pneumonias ('VAP'), which have mortality rates between 20-50 percent. The more quickly the appropriate antibiotic can be given to the patient, the more likely the patient is to survive. Researchers in Spain have developed a rapid technique for determining which antibiotic (or antibiotics) to use.
First, a very brief bit about VAP. These infections usually result from intubation--a tube is inserted into the the mouth, through the larynx, and into the trachea, and is hooked up to a ventilator (…
mikethemadbiologist | January 11, 2007Massachusetts is trying to tackle the problem of hospital-acquired ('nosocomial') infections by adding $1 million dollars in funding to track and monitor hospital compliance with infection control measures. As I've discussed before, nosocomial infections are a huge problem, and may account for roughly a quarter of all hospital costs. From the Boston Globe:
State officials plan to increase scrutiny of hospital-acquired infections in Massachusetts as a way to significantly lower their frequency, and they hope to require all hospitals to report their infection rates to the state by next year.…
tsmith | January 11, 2007In yesterday's post regarding the current outbreak of Rift Valley Fever in Kenya, I noted:
...while there's little people in the area can do about periodic flooding, scientists are actively examining the relationship between weather and RVF outbreaks. This hopefully will prove useful to predict--and potentially ward off--future disease outbreaks via animal vaccination.
Little did I know that this outbreak had already been predicted by scientists working in this area--back in September. More after the jump...
The deaths from Rift Valley fever could have been avoided if Kenya had heeded a…
scientificactivist | January 11, 2007What is big and flashy, capable of generating plenty of press, and claims to be the solution to all (or at least a sizeable chunk) of California's problems?
(a) Arnold Schwarzenegger
(b) his new health care proposal
(c) all of the above
You can decide for yourself, but from my perspective, the bold new semi-universal health care plan that Schwarzenegger is pushing for the state of California reminds me quite a bit of the Governator himself. And, like Schwarzenegger--whose policy agenda is largely shaped by external forces outside of his control due to the fact that he is a…
tsmith | January 10, 2007 When it comes to hemorrhagic fevers, Ebola and Marburg tend to get the lions' share of the press. Both are highly fatal, both can cause people to die in excruciating ways, and both have come to represent somewhat our fear of and fascination with emerging exotic diseases. However, as I've pointed out previously, as far as actual fatalities--or even illnesses go--both viruses are small potatoes. Other viruses that can also have hemorrhagic manifestations--including dengue and yellow fever--are much more common. One of these other viruses that frequently causes hemorrhagic fever is Rift…
tsmith | January 9, 2007This is bizarre....White rats pop up in toilets
Residents of a neighborhood next to the University of Arizona say small, live white rats have been swimming through sewer pipes and into their toilets.
Making it from the sewer into someone's toilet is a difficult trip. A 4-inch pipe runs from the house to a sewer main. And there's no "trap door" or other barrier in place. If the lines are running, the rats have to hold their breath and swim uphill against the water current.
The best part of the article:
The Pima County Health Department said it's best not to handle or touch a toilet-surfing rat…
tsmith | January 8, 2007When people think of Iowa, many of them think of our agriculture (for good reasons). Obviously, it's big business here. We ranked first in the nation in production of corn, soybeans, eggs, and pork in 2005. Indeed, population-wise, hogs here outnumber humans by more than 5 to 1. This is one reason research at our center focuses on zoonotic disease (diseases which can be transferred between animal species), and specifically, diseases of domesticated animals. A story in the news today shows one reason why we study what we do:
Iowa State health officials say someone in eastern Iowa has…
scientificactivist | January 5, 2007The UK's National Health Service (NHS) is a matter of British pride, despite some minor shortcomings. Strong on preventative and routine medical care, the NHS has on the other hand been criticized for its long waiting lists required for more involved procedures. The BBC reports today, though, that the NHS is making progress in this area, as waiting lists are now at an all-time low:
Between October and November 2006, NHS inpatient waiting lists dropped by 8,000 to 769,000.
This meant the number of patients waiting for treatment was the lowest since the records began in 1987....
Mr Burnham…
tsmith | January 5, 2007From the Seed mothership: Cancer is due to 'fate', Britons believe
More than a quarter of people believe that fate alone will determine whether they get cancer, not their lifestyle choices, according to a survey conducted by charity Cancer Research UK.
The poll of more than 4,000 adults across the country asked people if they thought they could reduce their risk of getting cancer or whether it was out of their hands.
A total of 27 percent of people said cancer was down to fate, with more women than men believing cancer was a matter of destiny than prevention through measures such as quitting…
tsmith | January 5, 2007 Gina Kolata has an interesting article from Wednesday's New York Times, discussing education and longevity.
James Smith, a health economist at the RAND Corporation, has heard a variety of hypotheses about what it takes to live a long life -- money, lack of stress, a loving family, lots of friends. But he has been a skeptic.
Yes, he says, it is clear that on average some groups in every society live longer than others. The rich live longer than the poor, whites live longer than blacks in the United States. Longevity, in general, is not evenly distributed in the population. But what, he…