December 31st, 2011 by Toni Brayer, M.D. in News, Opinion
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| Kwashiorkor in Niger |
Is it plausible that one small hospital in rural Northern California treated 1,030 cases of Kwashiorkor within a two year period?
Before you answer that, let me explain what Kwashiorkor is. It is a severe form of protein malnutrition…starving to death actually. It is the type of starvation you see in African children. It is so severe that the patient needs special nutritional support including special re-feeding with vitamins and it occurs mainly in children ages 1-4. Adults can starve to death, but they do not develop classic Kwashiorkor.
Medicare pays hospitals a flat rate based on diagnosis codes for patients. Patients with more severe coded illnesses get paid at a much higher rate. Shasta Regional Medical Center, located in Redding, Shasta County, California is under the microscope for billing Medicare (our tax dollars at work) for 1,030 cases of Kwashiorkor to the tune of $11,463 for each diagnosis. This medical center is Read more »
*This blog post was originally published at EverythingHealth*
September 17th, 2011 by admin 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*
