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Dengue Fever: Mosquito Born Illness Now Found In Texas, Florida, And Hawaii

Asian tiger mosquito, Aedes albopictsDengue fever is a viral (flavivrus) disease transmitted by Aedes albopictus and female A. aegypti mosquitoes. It is estimated that 50 to 100 million people in more than 100 countries are infected each year with dengue viruses.

There are four different types of dengue virus, and there is no cross-immunity, so a person may be stricken with dengue fever four times in his life. The most active feeding times for dengue vector mosquitoes is for a few hours after daybreak and in the afternoon for a few hours just after dark (dusk).

As opposed to the night-feeding mosquitoes that transmit malaria, these species tend to be “urban,” may also feed during daylight hours (also indoors, in the shade, and during overcast weather), and are known to bite below the waist. Dengue fever is seen chiefly in the Caribbean and South America, as well as other tropical and semitropical areas, such as Southeast Asia, Africa, and Mexico. In the United States, cases have been noted in Texas, Hawaii and Florida. The larvae flourish in artificial water containers (e.g., vases, tires), often in a domestic environment.

The incubation period following a mosquito bite is two to eight days. The disease is self-limited (five to seven days) and characterized in older children and adults by a sudden onset of symptoms, including: Read more »

This post, Dengue Fever: Mosquito Born Illness Now Found In Texas, Florida, And Hawaii, was originally published on Healthine.com by Paul Auerbach, M.D..

The New-Patient Fallout: How It Might Affect Primary Care

Sunset on Hanalei Bay by Alaska Dude via FlickrWith the prospect of 32 million new patients clamoring for care comes sorting out who will see them all. New medical schools are opening and students say they relish the idea of entering a market that will demand their services. American College of Physicians member Manoj Jain, M.D., offers a more tempered view of how the fallout might affect primary care. (AP, American Medical News, Fort Worth Star-Telegram, Memphis Commercial Appeal)

Even Hawaii has a shortage, especially in primary care, but also cardiology and orthopedic surgery. It’s hard to believe recruiters couldn’t sell Hawaii as a destination. (Honolulu Advertiser)

*This blog post was originally published at ACP Internist*

Hawaii Learns Tough Lession: Free Childrens Health Insurance Program Abused By Wealthy Parents

Fascinating commentary on human nature. Thanks to Grace-Marie Turner at the Galen Institute (this excerpt is part of an article published in the NY Post today):

HAWAII just had a vivid les son in health-care economics, learning that if you offer people insurance for free – surprise, surprise – they’ll quickly drop other coverage to enroll.

As a result, Hawaii is ending the only state universal child health-care program in the country after just seven months.

The program, called the Keiki (Child) Care Plan, was designed to provide coverage to children whose parents can’t afford private insurance but who make too much to qualify for other public programs (such as Medicaid and Hawaii’s State Children’s Health Insurance Program). Keiki Care was free for these gap kids, except for a $7 office-visit fee.

But then state officials found that families were dropping private coverage to enroll their children in the plan. “People who were already able to afford health care began to stop paying for it so they could get it for free,” said Dr. Kenny Fink of Hawaii’s Department of Human Services.

In fact, 85 percent of the children in Keiki Care previously had been covered under a private, nonprofit plan that costs $55 a month.

When Gov. Linda Lingle saw the data, she pulled the plug on funding. With Hawaii facing budget shortfalls, she realized it was unwise to spend public money to replace private coverage that children already had.

Yet Lingle is facing a political firestorm in the state from critics who say that she’s denying children health insurance – notwithstanding the fact that children in Hawaiian families earning up to $73,000 a year are eligible for Medicaid…

The Hawaiian debacle should also be a caution to Barack Obama, who wants to mandate that all children have health insurance. This would plainly not only require penalties for those who didn’t comply but also new programs to help parents get their children covered. The risk of crowd-out will be great.

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