September 17th, 2011 by Public Health Matters in Health Tips
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With the release of the movie Contagion, I thought it would be appropriate to post my cheat sheet on how to investigate a disease outbreak. Aspiring disease detectives take notes!
What do you think of when you hear the word “outbreak”? Maybe you envision a population decimated by a terrible, novel, and incurable disease like in the aformentioned movie Contagion or you think of Dustin Hoffman roaming around California in a blue biocontainment suit with Rene Russo trying to protect folks from a tiny monkey and narrowly preventing an airstrike by the US military?
Hollywood has done their best to capture what an outbreak is…but here are the facts. An outbreak, or epidemic, occurs when there are more cases of disease than would normally be expected in a specific time and place. The disease may be something doctors have already seen before just in a new form or abnormally high numbers, such as foodborne or healthcare-associated infections, or it may be an emerging disease that we don’t know much about like SARS. Either way, we need to investigate to determine why it is happening and how to prevent other people from getting sick or dying. 
Outbreaks are usually noticed by an astute clinician, such as those who first noticed AIDS in New York City and San Francisco, but there are also many high tech disease detection systems available to help us spot any increase in illness. PulseNet is a laboratory network that uses PFGE (pulsed-field gel electrophoresis) to help identify foodborne outbreaks by monitoring the genetic make-up of the bacteria causing what may otherwise look like unrelated illnesses. In the recent events of the Salmonella outbreak in ground turkey, PulseNet and the National Antimicrobial Resistance Monitoring System helped identify the cause of the outbreak as well as determine how widely it had spread. Programs such as Biosense and First Watch monitor the chief complaint or reason that someone called 9-1-1 or went to the hospital (aka syndromic surveillance). We also monitor news media for reports of outbreaks and websites such as Google Flu trends, which tracks circulating viruses and illnesses. With new technology ordinary citizens can also increasingly report outbreaks in their communities too.
The Magic Formula
So how do you figure out the who, what, when, and where of a disease outbreak? Read more »
*This blog post was originally published at Public Health Matters Blog*
September 7th, 2011 by AliKhanMD in Health Policy
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The events of 9/11 will forever be engrained in our memories. The attacks on the twin towers, Pentagon, and the anthrax attacks which followed were unimaginable at the time. Ten years after these tragic events, what’s changed?
We now know that terrorist threats are ever present and that our nation must be in a constant state of vigilance in order to protect our communities. We’ve come a long way since 2001 in bolstering our nation’s ability to prepare for and respond to catastrophic events whether natural, accidental, or intentional. We are also learning more and more every day that the resources we need for the big disasters are much the same as the ones we use for everyday public health activities.
Check out my list of top 5 accomplishments in the years after the 2001 attacks: Read more »
*This blog post was originally published at Public Health Matters Blog*
September 2nd, 2011 by MuinKhouryMDPhD in Health Tips, Research
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Campaigns against public spitting in the 19th century were largely driven by concerns about the spread of tuberculosis. However, at the beginning of the 21st century, spitting seems to be making a comeback. Over the past few years, several companies have begun offering personal genomic tests online to the public. There have been famous images of “spit parties”, where celebrities are seen filling tubes with saliva to ship for DNA testing. Getting information on one’s genes has been promoted as fun, as part of social networking, and as a basis for improving health and preventing disease.
When it comes to spitting to improve one’s health, we say: think before you spit. Our knowledge of the potential benefits and harms of these tests is incomplete at best. Despite exciting research advances in genomics of common diseases, there is still much to learn about what this information means and how to use it to prevent disease. A little bit of incomplete or inaccurate information may even be harmful.
There are at least 2 key questions to consider when deciding whether personal genomic tests are worth your spit. Read more »
*This blog post was originally published at Genomics and Health Impact Blog*
August 24th, 2011 by Scott Bowen in Health Tips, Research
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A recent article in the Archives of General Psychiatry by Hallmayer et al. discussed the role of genetic and environmental factors in autism and autism spectrum disorders (ASD). The study was a heritability analysis of 192 pairs of twins, which attributed 37 percent of the variation in risk of autism to genetic factors and 55 percent to shared environmental factors. The authors contrasted their findings with those of previous studies, which had given genetics a much higher share (up to 90%).
Rather than contradicting previous research, the new results provide more evidence that autism, like many other common diseases, results from both genetic and environmental factors. The way that these elements – often called “nature and nurture” – influence health outcomes has been discussed for decades but is often misunderstood, even among scientists.
Disease Causation is Not as Easy as… Pie Read more »
*This blog post was originally published at Genomics and Health Impact Blog*
August 12th, 2011 by RyanDuBosar in Research
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Prescriptions for antidepressants given by nonpsychiatrists to patients without a specific psychiatric disorder increased more than 12% in 12 years, leading to the drug class becoming the third most commonly prescribed, a study found.
A study in the August issue of Health Affairs reported that antidepressant prescriptions by doctors who didn’t record a specific psychiatric disorder increased from 59.5% of all prescriptions by nonpsychiatrists in 1996 to 72.7% in 2007.
Researchers reviewed data on patients age eighteen or older from the 1996-2007 Centers for Disease Control and Prevention’s National Ambulatory Medical Care Surveys, a national sample of more than 233,000 office-based visits. The proportion of antidepressants prescribed for patients without a psychiatric diagnosis increased from 2.5% of all visits to nonpsychiatrist providers to 6.4% between 1996 and 2007. For visits to primary care providers, antidepressant prescribing grew from 3.1% to 7.1%. For other nonpsychiatric providers, visits without a psychiatric diagnosis grew from 1.9% to 5.8%. In contrast, antidepressants prescribed with a psychiatric diagnosis increased from 1.7% to 2.4%.
Patients who received antidepressants without a psychiatric diagnosis by nonpsychiatrist providers were more likely to be Read more »
*This blog post was originally published at ACP Internist*
