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Free And Convenient Flu Vaccines Increase Vaccination Rates In Healthcare Workers

Far more health care workers got flu vaccines this year than at the same point last year, according to a survey by the Centers for Disease Control and Prevention, although rates are still far less than ideal.

While flu vaccination rates among health care professionals have risen slowly over the past decade, less than half this group were vaccinated until the 2009-10 season, when an estimated 62% of health care workers received seasonal flu vaccines and an additional 2% of workers got only the H1N1 influenza vaccination, the report said. In the 2010-11 season, 63.5% of health care professionals reported flu vaccination.
The Advisory Committee on Immunization Practices recommends that all health care professionals get the flu vaccine every year, and the national Healthy People 2020 objective for health care professionals influenza vaccination is 90%. Read more »

*This blog post was originally published at ACP Hospitalist*

Researchers Use Twitter To Track Diseases And Public Health Issues

A researcher has used social media to track attitudes about vaccination and how they correlate with vaccination rates, in the process creating a novel model to track a variety of disease states.

The study adds to a growing body of evidence that social networking can be used to track diseases and other natural disasters that affect public health. Earlier this year, researchers used Twitter to track rapidly-evolving public sentiment about H1N1 influenza, and found that tweets correlated with actual disease activity. Before that, researchers analyzed how Twitter was used to disseminate information (and misinformation) about flu trends.

In the latest study, Read more »

*This blog post was originally published at ACP Internist*

CDC Outlines The Steps For Investigating Disease Outbreaks

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!

Scientist in biocontainment suit examining a dead ratWhat 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. Several people in biocontainment suits collecting samples outside a building

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*

Chinese Study Compares Flu Treatments: Prescription Drug Vs. Herbal Remedy

During the early days of the 2009 H1N1 influenza A pandemic, the popular herbal formula maxingshigan–yinqiaosan was used widely by TCM practitioners to reduce symptoms. (It’s hard to pronounce and spell, so I’ll refer to it as M-Y.) A new study was done to test whether M-Y worked and to compare it to the prescription drug oseltamivir. It showed that M-Y did not work for the purpose it was being used for: it did not reduce symptoms, although it did reduce the duration of one sign, fever, allowing researchers to claim they had proved that it works as well as oseltamivir.

“Oseltamivir Compared With the Chinese Traditional Therapy: Maxingshigan–Yinqiaosan in the Treatment of H1N1 Influenza” by Wang et al. was published in the Annals of Internal Medicine earlier this month. The study was done in China, which is notorious for only publishing positive studies. Even if it were an impeccable study, we would have to wonder if other studies with unfavorable results had been “file-drawered.” It’s not impeccable; it’s seriously peccable.

It was randomized, prospective, and controlled; but not placebo controlled, because they couldn’t figure out how to prepare an adequate placebo control. They considered that including Read more »

*This blog post was originally published at Science-Based Medicine*

Immunizations: NCCAM Fails To Provide Responsible Information

If you go to the website of the National Center for Complementary and Alternative Medicine (NCCAM), you’ll find that one of its self-identified roles is to “provide information about CAM.” NCCAM Director Josephine Briggs is proud to assert that the website fulfills this expectation. As many readers will recall, three of your bloggers visited the NCCAM last April, after having received an invitation from Dr. Briggs. We differed from her in our opinion of the website: One of our suggestions was that the NCCAM could do a better job providing American citizens with useful and accurate information about “CAM.”

We cited, among several examples, the website offering little response to the dangerous problem of widespread misinformation about childhood immunizations. As Dr. Novella subsequently reported, it seemed that we’d scored a point on that one:

…Dr. Briggs did agree that anti-vaccine sentiments are common in the world of CAM and that the NCCAM can do more to combat this. Information countering anti-vaccine propaganda would be a welcome addition to the NCCAM site.

In anticipation of SBM’s Vaccine Awareness Week, I decided to find out whether such a welcome addition has come to fruition. The short answer: Nope. Read more »

*This blog post was originally published at Science-Based Medicine*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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