public health
tsmith | January 25, 2006Day 1: History of Pandemic Influenza.
Day 2: Our adventures with avian flu.
Day 3: Challenges to pandemic preparedness
Day 4: 1918 influenza virus reconstructed
Day 5: How ready are we, and what can YOU do?
Many more influenza posts can be found at this link.
tsmith | January 24, 2006So, like Kevin over at No Se Nada, this started out as a comment on his avian flu policymaking post but got rather wordy, so I'm spinning it off over here. For those keeping track, the initial volley was this post, but previous discussion was had over here as well (and this post discussed some of his comments from that one).
So, in response, I think we are talking past each other a bit. I see a lot of difference between "wolf-crying" and simple education. I'll re-post what I said in the comments here regarding that issue (in response to the question, "How do you inform people that this…
tsmith | January 18, 2006I generally don't discuss a lot of politics on here. It's not that it's a topic I'm uninterested in; it's just that, for the most part, other people do it so much better than I do, so I leave a lot of it to them. There are, of course, exceptions. Intelligent design is much more of a cultural and political issue than a scientific one, despite the protestations of its advocates. There are others that occupy a similar niche. The idea that abortion causes breast cancer, for example, is one that has made its way into information packets that must be given to women contemplating termination of…
tsmith | January 17, 2006As noted in the comments to his post, Cervantes over at Stayin' Alive has written a "depressingly excellent" summary of the state of health in Iraq as we approach the 3-year post-invasion mark. To put it mildly, it ain't a pretty picture.
Iraq, public health
tsmith | January 10, 2006This comes as no surprise to many health care providers and public health officials: most states are unprepared for health crises.
Few states are equipped to handle emergency medical crises such as a terrorist attack, a natural disaster or an influenza outbreak, according to an analysis being released today by the American College of Emergency Physicians.
Emergency care specialists such as [Angela] Gardner said they expected to find some deficiencies in a field that has seen budget cuts and rising demand. But the panel was startled at how poorly prepared the nation is as a whole to manage…
tsmith | January 5, 2006Microbial ecology, and its relation to the development of infectious disease, is an ever-growing field of study. Of course, there are a vast number of bacterial species living amongst us, most of which do not cause us any harm. Others may infect us only when, so to speak, the stars align in a certain manner: when a number of factors collide that result in the development of a diseased state. For instance, we may already be immunocompromised due to the presence of another infection--something minor, such as a rhinovirus, or something more serious, such as HIV--and this chink in our armor…
tsmith | December 24, 2005NHANES is an abbreviation that's quite familiar to epidemiologists of all stripes: the National Health and Nutrition Examination Survey. This survey dates back to 1956 with the passage of the National Health Survey Act, providing legislative authorization for "a continuing survey to provide current statistical data on the amount, distribution, and effects of illness and disability in the United States." Generally, information from these surveys has been used to look at the effect of nutrition, particularly micronutrients, on the health status of the population, or subgroups within the…
tsmith | December 16, 2005 I love these historical analyses of disease--real, or fictional. One historical event that has been the subject of much speculation over the decades has been the Plague of Athens, a mysterious outbreak that is thought to have changed the direction of the Peloponnesian War, and for which the cause still remains uncertain:
[2] As a rule, however, there was no ostensible cause; but people in good health were all of a sudden attacked by violent heats in the head, and redness and inflammation in the eyes, the inward parts, such as the throat or tongue, becoming bloody and emitting an unnatural…
tsmith | December 5, 2005Clostridium difficile has joined MRSA, SARS, avian influenza, and West Nile as a hot new emerging disease. This bacterium, a cousin to Clostridium tetani-the causative agent of tetanus--and Clostridium botulinum--the botulism bacterium--is a spore-forming anaerobe. Carried by about 3 percent of healthy adults, the bacterium is generally present as a metabolically inactive spore. The bacterium typically causes problems in the nosocomial (hospital) environment, where up to 40 percent of hospital patients may be colonized. Clinical disease generally presents as watery diarrhea and cramps, and…
tsmith | December 1, 2005As I've mentioned before, Ebola is a virus near and dear to my heart. (Figuratively, not literally. I'm not quite that enamored of it). In that previous post, I mentioned that we didn't know the reservoir of Ebola in nature. It certainly isn't for lack of trying that it wasn't determined previously. The first field studies took place shortly after the initial 1976 outbreaks in the Democratic Republic of Congo (DRC) and Sudan. In the former, 818 bedbugs, 1500 mosquitoes, 10 domestic pigs, one cow, seven bats, 123 rodents, eight squirrels, six Cercopithecus monkeys, and three small antelopes…
tsmith | November 22, 2005I've mentioned many times on here reservations I have over the current avian flu numbers--how many subclinical or mild infections are being missed? Are they indeed offset by the number of serious disease cases we're also missing? There's a reason for these questions, and it's now out in electronic form in Clinical Infectious Diseases.
A bit of background. I work in Iowa as part of the Center for Emerging Infectious Diseases. One of our pet pathogens happens to be influenza virus, and we have ongoing studies looking at serological evidence of prior infection with swine and avian viruses in…
tsmith | November 9, 2005Wonder what the anti-vaccination crowd makes of this?
Measles cases and deaths fall by 60% in Africa since 1999
Largely due to the technical and financial support of the Measles Initiative and commitment from African governments, more than 200 million children in Africa have been vaccinated against measles and one million lives have been saved since 1999. Measles cases and deaths have dropped by 60%, thanks to improvements in routine and supplementary immunization activities in Africa.
This dramatic drop has occurred in only a few years, coinciding with a massive measles vaccination campaign…
tsmith | October 31, 2005 As mentioned in the comments to this post, there is a brewing controversy over upcoming guidelines outlining who should receive the "cervical cancer vaccine," a vaccine against the human papilloma virus (HPV). Briefly, the HPV vaccine is a highly effective (100% in a 2-year clinical trial) vaccine which is targeted against two specific serotypes of the human papilloma virus: HPV 16 and HPV 18. Together, these types cause about 70% of cervical cancers in the United States. Previously, Bridget Maher of the Family Research Council, a leading Christian lobby group, has said this about the HPV…
tsmith | October 24, 2005Doctors recommend hepatitis shot for kids
Hepatitis A is a virus that causes (obviously) hepatitis, as well as jaundice, fatigue, nausea, fever, loss of appetite, and diarrhea. It's often spread fecal-orally; that is, you put something in your mouth that has fecal contamination. (Just makes you want to run to the bathroom and brush your teeth, doesn't it?) It also can be spread via sexual contact and shared needles (or other contact with blood or body fluids). It's estimated that there are ~40,000 acute cases of Hep A per year, with many of them going undiagnosed. It's one of those diseases…
tsmith | October 19, 2005It's situations like this that really irk me.
I mentioned the tularemia detection in DC here almost 2 weeks ago, already annoyed that there hadn't been more information about it. There has been some discussion on the ProMed list, but it's hardly been a blip in the mainstream media. Yesterday, there was an article in Salon further discussing it.
The background:
On Sept. 24, 2005, tens of thousands of protesters marched past the White House and flooded the National Mall near 17th Street and Constitution Avenue. They had arrived from all over the country for a day of speeches and concerts to…
tsmith | October 12, 2005On Monday, I mentioned a survey MSNBC and Zogby conducted regarding attitudes about sex and STDs. Today on MSNBC, they have another article on the rise of STDs in America, highlighting some depressing trends. Meanwhile, in what you'd think would be across-the-board good news, a vaccine has been tested against 2 types of human papilloma virus (HPV), an STD which is the most common cause of cervical cancer. Despite having a 100% effectiveness in preventing infection with these viruses (which together cause ~70% of all cervical cancers), there is organized resistance to the vaccine, on the…
tsmith | October 12, 2005In the October issue of Emerging Infectious Diseases, James Hughes and Jeffrey Koplan discuss the problem of safe water. Hazardous drinking water and poor sanitation is something that gets brought up when there's a disaster (like Katrina, or the tsunami earlier this year), but many people don't realize that a large portion of the earth's population has to deal with this situation everyday.
Unsafe water is a global public health threat, placing persons at risk for a host of diarrheal and other diseases as well as chemical intoxication. Unsanitary water has particularly devastating effects…
tsmith | October 10, 2005Okay, so it's just an MSNBC survey (aided by none other than Dr. Ruth), but geez, when will people ever wise up about sex?
MSNBC.com and Zogby International asked online readers to share some intimate details about their personal lives, and more than 56,000 adult men and women -- one of the largest responses ever to a sex survey in the United States -- revealed that many are playing a pretty risky game.
Just 39 percent of people who took the survey always ask whether a new partner is infected with HIV, the virus that causes AIDS, or other STDs. Nearly one-third said they never check on a…
tsmith | October 7, 2005Thus far this week, I've discussed the history of pandemic influenza in general, and avian flu in particular. I've discussed some issues that must be addressed to prepare us for a pandemic, and the groundbreaking resurrection of the Spanish influenza virus. Today I want to end the series with a look at how prepared we currently are as a nation, and highlight some personal preparedness steps you can take.
If you recall from Tuesday, the first outbreak of H5N1 was back in 1997. The anthrax attacks were in 2001. Surely by now we're prepared for some kind of serious, large-scale, biological…
tsmith | October 6, 2005I know I said I was going to discuss a bit more about pandemic preparedness today, but I think I'll hold off on that to discuss this story:
It sounds like a sci-fi thriller. For the first time, scientists have made from scratch the Spanish flu virus that killed millions of people in 1918.
Why? To help them understand how to better fend off a future global epidemic from the bird flu spreading in Southeast Asia.
Researchers believe their work offers proof the 1918 flu originated in birds, and provides insights into how it attacked and multiplied in humans. On top of that, this marks the first…