Surveillance
kkrisberg | July 12, 2016Mining is one of the most dangerous jobs in America, with more than 600 workers dying in fatal workplace incidents between 2004 and the beginning of July. And many more miners die long after they’ve left the mines from occupational illnesses such as black lung disease, while others live with the debilitating aftermath of workplace injuries. Today, researchers know a great deal about the health risks miners face on the job, but some pretty big gaps remain.
Kristin Yeoman and her colleagues at the National Institute for Occupational Safety and Health (NIOSH) hope to begin closing that knowledge…
kkrisberg | February 14, 2014Most people infected with mosquito-borne West Nile virus don’t experience any symptoms at all. However, the tiny percentage of cases that do end up in the hospital total hundreds of millions of dollars in medical costs and lost productivity.
Published earlier this week in the American Journal of Tropical Medicine and Hygiene, researchers estimated that the cumulative cost of reported hospitalized cases of West Nile virus between 1999 and 2012 totaled $778 million. The study is the first to examine the economic burden of West Nile on infected patients who were hospitalized with conditions such…
kkrisberg | July 19, 2013When I asked Teresa Schnorr why we should be worried about the loss of a little-known occupational health data gathering program, she quoted a popular saying in the field of surveillance: "What gets counted, gets done."
Schnorr, who serves as director of the Division of Surveillance, Hazard Evaluations and Field Studies at CDC's National Institute for Occupational Safety and Health (NIOSH), was referring to the Adult Blood Lead Epidemiology and Surveillance program (ABLES), a state-based effort that collects and analyzes data on adult lead exposure. For more than two decades, NIOSH has been…
kkrisberg | July 5, 2013Last year, reported cases of West Nile virus in the United States hit their highest levels in nearly a decade. It's a good reminder to keep protecting yourself from getting bitten, but it also begs the question: Is this just a sign of a much bigger threat? The answer is just as wily as the pesky mosquito.
According to recent data published June 28 in CDC's Morbidity and Mortality Weekly Report, the federal public health agency received reports of 5,780 nationally notifiable arboviral disease cases in 2012. (Arboviral diseases are those transmitted by arthropods, such as ticks and mosquitoes…
lborkowski | March 7, 2013Haiti's cholera epidemic began in October 2010, as the country was still reeling from the devastation of the January 2010 earthquake. The epidemic has now claimed nearly 8,000 lives, and although transmission has slowed, more than 1,500 new cases are still reported each week. Evidence suggests the cholera bacteria arrived in Haiti via UN peacekeepers from Nepal and spread because of an inadequate sanitation system in peacekeeper housing. Last month, however, the UN responded to a compensation lawsuit by invoking immunity under section 29 of the Convention on the Privileges and Immunities of…
lborkowski | October 11, 2011Last Friday, CDC's Morbidity and Mortality Weekly Report included a report on the listeriosis outbreak associated with Jensen Farms cantaloupe (the grower is recalling the melons; look for "Rocky Ford" on the label). So far, 84 cases have been confirmed in 19 states, and 15 of these victims have died.
The number of cases may continue to rise, because even though the contaminated cantaloupes are at or near the end of their shelf life, the illness has a long incubation period (usually 1-3 weeks, but as much as 70 days). People who ingested the bacteria in late September might still experience…
lborkowski | June 10, 2011After blaming cucumbers, backpedaling on the cucumbers and blaming bean sprouts, then backpedaling on the sprouts, German authorities have now concluded that bean sprouts are, in fact, to blame for the spread of E. coli O104:H4, which has sickened more than 3,000 people and killed 31. Patients with the most severe cases have suffered kidney and neurological damage.
This morning, authorities announced in Berlin that epidemiologic evidence, rather than laboratory results, pointed to bean sprouts from an organic farm in Lower Saxony as the source of the outbreak. The New York Times' Alan Cowell…
revere | March 29, 2010A day or two after CDC's Morbidity and Mortality Weekly Reports (MMWR) released a report about risks to pregnant women from pandemic 2009 flu, CDC held a suddenly announced press briefing about the current H1N1 situation (I listened in but a transcript should be up on the site by the time you read this; check this page). The occasion for the briefing was a worrisome increase in hospitalizations and deaths in CDC's Georgia backyard. Despite housing CDC, Georgia has one of the lower flu vaccination rates in the country and now is experiencing an unexpected recrudescence of H1N1 flu, with…
revere | March 19, 2010As predicted, the pandemic of 2009 is beginning to yield more data, some of it directly applicable to pressing practical questions. The answers are still preliminary, and, as with all science, subject to revision. But it's what we have at the moment, and a letter that just appeared in the CDC sponsored journal Emerging Infectious Diseases, addresses an important question. During a flu outbreak, can hospitalized patients contract influenza from blood transfusions? Since people getting transfusions already have compromised health (else why would they be getting a transfusion?), they are at high…
revere | March 6, 2010Two days ago I went with my daughter to the pediatrician to check out her 20 month old who had a fever and rash. Viral origin, probably. Also an ear infection. Pretty much par for the course at this time of year. But lots of little ones and their older sibs weren't so lucky this flu season. As we've had too many occasions to mention, the severity of the 2009 pandemic has yet to be gauged, but trying to compare it to seasonal flu is misleading as its epidemiology is very different. Nowhere is this seen more clearly than in the melancholy figures for pediatric deaths.
Since the beginning of…
revere | February 26, 2010It is becoming conventional wisdom that the 2009 H1N1 pandemic was not as severe as a bad seasonal flu year. That might be true, although I don't find it much comfort because a bad seasonal flu year is no less bad for being more familiar. But I am not yet willing to assent to the conventional wisdom yet. I don't think we have had sufficient time to collate all the information that would enable us to make that kind of judgment, which sometimes takes years to evaluate. However bad it was or wasn't, the pandemic flu strain could kill you just as dead as any other flu. CDC has just released…
revere | February 20, 2010The National Health Interview Survey (NHIS) has been conducted since 1957 and is one of the main instruments to get a glimpse at the health of the US population. The NHIS is a "multistage area probability design," or what many call cluster sampling. The idea is to first sample geographic areas in all 50 sates and the District of Columbia, where the area might be a county, a small adjoining group of counties in sparsely populated places or a metropolitan area where population is dense. The list of areas to be sampled has about 1900 entries and 428 are drawn at random, although all states are…
revere | February 5, 2010We still don't know if we are experiencing a lull in flu or the virus has burned itself out for the season, but it's as good a time as any to reflect a bit on where we've been and where we still need to go. Being otherwise occupied (I'm sure you are sick of hearing about my grant writing obsession but not half as sick as I am about having it!), I'll start with something relatively straightforward: how CDC did on the epidemiology and surveillance front. Historically this is the agency's strong suit and so it is expected they would have acquitted themselves well. And pretty much, they did. A…
revere | January 22, 2010It was some time after the pandemics of 1957 and 1968 that we were able to judge their severity and it will likely be some time after this one has finally burned itself out, most likely to become "just another" seasonal flu, that we will be able to gauge the 2009 swine flu pandemic. A lot of data is being generated but it will take time to harvest it and send it to the scientific market for consumption. A report in today's Lancet reminds us that we aren't seeing all there is to see, even with unprecedentedly rapid means of communication and better surveillance than ever in the history of our…
revere | January 18, 2010Many years ago we had a terrific carpenter build stairs in our old house using a technique called housed stringer construction. This guy was fairly young but a skilled wood worker. He was also missing several fingers on his right hand. Table saw.
I used to have a table saw, too, but its spinning blade always made me nervous. So I gave it to my brother-in-law who is a cop and tends to be very careful. He still has all his fingers. But a lot of hobbyist and home do-it-yourselfers don't, courtesy table saws, the woodworking tool associated with more injuries than any other. A new study by the…
revere | January 17, 2010There is an old vaudeville joke where a man goes to the doctor complaining about pain in his arm:
Doctor: Have you ever had it before?
Man: Yes, once before.
Doctor: Well, you have it again.
CDC reported on their weekly FluView website on Friday that the Iowa Department of Public Health (IDPH) reported to CDC that in September a boy (age not stated) had a flu like illness from which he fully recovered and for which he hadn't required hospitalization. In November IDPH determined it was swine flu, but not the pandemic H1N1 but a swine-origin H3N2. According to CDC there was "no clear exposure"…
revere | December 25, 2009So far the pandemic of 2009 has been bad enough but not anywhere near as bad as one could imagine. Let's hope it stays that way. While winning new knowledge from actual disease and sickness is not anyone's favorite strategy, it is likely we will learn a great deal about influenza in the years to come as we begin to mine the wealth of data it is producing. Science, even at its most urgent, is still a slow, methodical process, but this pandemic and the resources devoted to tracking it and the tools being developed to analyze it is a watershed event in flu science. Dogmas will fall and probably…
revere | December 7, 2009Any concerns about the current swine flu vaccine inevitably bring up the swine flu episode of 1976. This is not 1976. For starters, this year we have a bona fide pandemic and in 1976 the virus never got out of Fort Dix, NJ. That in itself is a game changer. If there are any risks from a vaccine (and there are usually some risks, even though they are much safer than most over the counter drugs) and they are for a disease no one is at risk for, the risk - benefit equation has nothing on one side and if there is anything, no matter how rare, on the other, it makes it unfavorable for the vaccine…
revere | December 2, 2009While I was otherwise occupied with family matters last week there was news on the flu front that got past me. Declan Butler at Nature News reported on the extensive efforts to get a handle on the prevalence of swine flu infection in various populations by looking for evidence the immune system has reacted to the presence of the virus. All of the studies mentioned are still underway or being peer reviewed so Butler didn't report results, but Fergus Walsh did report some preliminary but leaked results from one of the smaller studies in the UK. Both reports have interesting information, but I'…
revere | November 21, 2009The Norwegian Institute of Public Health is reporting sporadic occurrences of a mutation in a portion of the flu virus that is involved with the process by which it attaches to cells. I use the word "sporadic" because at this point there is no evidence that the cases where the genetic change has been found are epidemiologically linked. Therefore we don't see it spreading from person to person but rather arising in people after they have been infected. At least that's how it appears from reports, but we have only preliminary information at this point. According to WHO, the mutation has been…