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NIMBY Disease: Yes, U.S. Residents, You’re Vulnerable To Parasites Too

Photo by CDC/Jim Gathany: An adult triatomine, or kissing bug, with eggs. Triatomines transmit the parasite that causes Chagas disease.

Photo by CDC/Jim Gathany: An adult triatomine, or kissing bug, with eggs. Triatomines transmit the parasite that causes Chagas disease.

Just in time for outdoor-frolicking season, yet another thing to worry about: parasitic disease.

You may think this topic should be filed under: “no cause for concern;” indeed many people believe that illnesses transmitted by parasites are primarily a problem of the developing world, something you might pick up on an exotic trip, but never here at home.

Think again, says the CDC.

In a special supplement to the American Journal of Tropical Medicine and Hygiene, CDC scientists offer abundant detail on the health dangers of parasites.

Here’s the news release from the public health agency:

…parasitic infections also occur in the United States, and in some cases affect millions of people. Often they can go unnoticed, with few symptoms. But many times the infections cause serious illnesses, including seizures, blindness, pregnancy complications, heart failure, and even death. Anyone—regardless of race or economic status—can become infected.

CDC has targeted five neglected parasitic infections (NPIs) in the United States as priorities for public health action based on the numbers of people infected, the severity of the illnesses, or our ability to prevent and treat them. These NPIs include Chagas disease, cysticercosis, toxocariasis, toxoplasmosis, and trichomoniasis.

Parasitic infections affect millions around the world causing seizures, blindness, infertility, heart failure, and even death,” said CDC Director Tom Frieden, M.D., M.P.H. “They’re more common in the US than people realize and yet there is so much we don’t know about them. We need research to learn more about these infections and action to better prevent and treat them.” Continue reading

A Surprising New View Of Flu: Rethinking The 1918 Pandemic

Giving treatment to influenza patient at the U.S. Naval Hospital. New Orleans, Louisiana, Circa 1918. (Navy Medicine/Flickr)

Giving treatment to influenza patient at the U.S. Naval Hospital. New
Orleans, Louisiana, Circa 1918. (Navy Medicine/Flickr)

By Richard Knox
Guest Contributor

Ever since 1918, the world has wondered why a novel flu virus touched off an explosive pandemic that killed as many as 50 million people – most of them healthy young adults — and whether it could happen again.

Flu researchers today report some surprising news: They say the 1918 virus was no super-bug. Instead, its deadliness had to do with how very different it was from the flu viruses circulating 25 or 30 years before, when the young adults of 1918 were first exposed to the flu.

Indeed, the new study says it’s that first childhood exposure that determines how people will fight off – or fall prey to – every other flu virus they will encounter in a lifetime.

That’s a very different way of looking at flu, both pandemics and regular seasonal outbreaks.

Much of the current emphasis is on the virus itself. Scientists around the world are doing controversial “gain-of-function” experiments – adding and subtracting pieces of genes from flu strains to see what mutations make some viruses so virulent.

Instead of focusing on flu virus itself, authors of a paper published Monday in the Proceedings of the National Academy of Sciences say scientists and public health experts should pay attention to the vulnerabilities of different age groups to any new flu virus – and how those immune gaps might be filled in by targeted vaccine strategies.

“Childhood exposure seems to give kick-ass immunity to that kind of flu virus for many, many decades,” says evolutionary biologist Michael Worobey of the University of Arizona, the paper’s lead author. Continue reading

What Teens Say Teens Should Know About Sexually Transmitted Diseases

(Planned Parenthood)

(Planned Parenthood League of Massachusetts)

By Joey Boots-Ebenfield
Guest contributor

I’ve gotten used to hearing myths and misinformation when I talk about sex with fellow teens.

And I talk about sex often in my role as an 17-year-old peer educator with the Planned Parenthood Get Real Teen Council (GRTC) — a year-long high school sexual health program for 10th-12th graders who are trained to facilitate sex education workshops and serve as resources for peers, families and communities.

If teens are uncomfortable talking about topics related to sex and sexuality, or don’t have a trusted source of information about their health, it’s easy for all kinds of misinformation to spread. And of course, there’s the Internet, where bad information is often rampant, so it’s not always a reliable place to find accurate health information.

The subject of sexually transmitted diseases (STDs) is no exception. I’ve heard some pretty interesting misconceptions about what STDs are and what it’s like to get tested. One myth is that STDs have obvious symptoms, like localized pain or some other physical sign.

In fact, this is quite the opposite! STDs often show NO symptoms. This myth is especially dangerous because it means that someone can have an STD and not even know it. As a result, many STDs go untreated, which can cause cause some pretty nasty complications. Continue reading

CDC: Autism Rate Up To 1 in 68 Kids, But Still No Why

A new CDC analysis of autism prevalence shows a nearly 30 percent jump in cases between 2008 and 2010: that means 1 out of every 68 eight-year-olds in the U.S. is diagnosed with the disorder.

But health officials still don’t agree on what’s driving the increase. Debate continues to rage over whether the increase in cases is due to changing definitions and greater awareness of autism spectrum disorders, or if it’s due to some environmental or other factor.

Karen Weintraub reports for USA Today:

…virtually every grade in every elementary school has at least one child with autism – a seemingly astonishing rise for a condition that was nearly unheard of a generation ago.

What’s still unknown is the driver of that increase. Many experts believe the rise is largely due to better awareness and diagnosis rather than a true increase in the number of children with the condition.

(Jesse Costa/WBUR)

(Jesse Costa/WBUR)

“We don’t know the extent those factors explain in terms of the increase, but we clearly know they do play a role,” said Coleen Boyle, director of the National Center on Birth Defects and Developmental Disabilities at the CDC. “Our system tells us what’s going on. It (only) gives us clues as to the why.”

The aging of parents is also known to be a factor; the chances of autism increase with the age of parents at conception.

“But that’s not the whole story is it?” said Robert Ring, chief science officer for Autism Speaks, a research and advocacy group. Whether something in the environment could be causing the uptick remains “the million-dollar question,” Ring said.

Despite their concern, experts said they were not surprised by the increase, because other data had suggested the numbers would continue to climb. In New Jersey, for instance, autism rates were 50% higher than in the rest of the nation in 2000, and they remained that much higher in 2010 – suggesting the national rates will continue to rise to catch up, said Walter Zahorodny, a psychologist who directs the New Jersey Autism Study. “To me it seems like autism prevalence can only get higher,” Continue reading

To Turn Undergrads On To Sex-Ed: Phallic Name Tags And Orgasm Trivia

Attention-grabbing nametags at a sex-ed event for undergrads (Photo: Sascha Garrey)

Attention-grabbing nametags at a sex-ed event for undergrads (Photo: Sascha Garrey)

By Sascha Garrey
Guest contributor

How do you get busy undergrads to focus on their sexual health? Try penis name tags.

That was among the many strategies deployed this week at a sex-themed trivia night organized by the Boston University Health and Wellness Office.

Diners who went to the Sunset Cantina just for the Mexican food on a recent evening were in for a surprise. Amidst the usual busy hum of this popular night spot, the thunderstorm of phrases like “female orgasm” and “pus-like discharge” booming continually across the restaurant may have shocked some into choking on their tacos.

The Cantina played host to BU’s sex-ed evening, “Sex at the Sunset”: students sporting comical penis-shaped name tags were spread around the venue, talking excitedly and sipping drinks from pink, labia-inspired straws.

A team of peer-health educators, known as the BU Student Health Ambassadors (SHAs), partnered with Bedsider — a pro-sex health outreach organization that advocates for the responsible use of birth control — to bring this racy, but informative, event aimed at BU students as a casual and amusing opportunity to learn and talk about sex.

Meilyn Santamaria, a senior at BU majoring in health sciences and one of the SHAs, helped organize the event and was also the mastermind behind the mood enhancing playlist — hot, throwback tunes like “Sexual Healing” and “Like a Virgin” were thumping all night.

Santamaria has learned a thing or two as a peer-health educator. For instance, she says, approaches to sex-ed like this light, fun-filled evening are important because they engage kids on a different level; and they sure beat those dry, awkward gym class lectures on hygiene.

“You actually get to interact with the material,” says Santamaria. “It’s exciting, it’s fun, it’s a safe environment that is a less intimidating way for people to learn this kind of important information about sex.” Continue reading

Study Finds Fivefold Increase In Alzheimer’s Deaths: Why It Matters

JAQ'S PhotoStorage/flickr

JAQ’S PhotoStorage/flickr

By Nell Lake
Guest contributor

Consider a hypothetical 70-year-old woman; she could be your mother, your sister, your wife. Call her Margaret. She’s becoming ever-more forgetful; one day she gets lost on her way home from the grocery store. A neurologist diagnoses Alzheimer’s.

Over the next five years, Margaret’s thinking continues to decline. She speaks less, confuses words, falls often. She needs a wheelchair, becomes incontinent. No longer able to manage her care, you move her to a nursing home. A year later, the disease has spread to the part of Margaret’s brain that controls swallowing; she has difficulty eating. Because of this she “aspirates” her food — bits of it enter her lungs, and Margaret develops pneumonia. Within weeks, her lungs stop working, and Margaret dies.

Margaret’s story is a difficult one, but common. It also illustrates a conundrum: Did Margaret die of pneumonia, or Alzheimer’s?

On some level, the answer doesn’t matter much: death is death. But as a matter of public health, the answer is deeply important: funding for medical research, new treatments and ultimately, someday, a cure, tends to flow toward the most widespread and deadly diseases. That’s why a new study out this week is getting so much attention; should its findings become widely accepted, they could substantially increase the pace and effectiveness of Alzheimer’s research in the U.S.

Massive Underreporting

The study, published Wednesday in the journal Neurology, confirmed what clinicians and researchers have long assumed: Alzheimer’s deaths have been greatly underreported.

The research found that 500,000 people die each year from Alzheimer’s — more than five times the number most recently reported by the CDC. That makes Alzheimer’s the third leading cause of death in the United States, after heart disease and cancer. Currently the CDC ranks Alzheimer’s sixth as a cause of mortality, with 84,000 deaths reported on death certificates.

The new report’s fuller accounting of Alzheimer’s deaths reinforces a basic but frequently overlooked fact: The illness is entirely fatal. A progressive brain disease that gradually impairs memory, reasoning and personality, Alzheimer’s eventually damages all brain functions, so that even walking, eating and breathing become impossible. Alzheimer’s kills because the brain is no longer able to keep the body alive. Continue reading

New Home Birth Data: Numbers Rise A Bit, Controversy Remains Unchanged

A new CDC analysis of trends in out-of-hospital births from 1990-2012 found that home births are on the rise — but only a tiny bit.

The federal agency reports that 1.36 percent of U.S. births occurred outside a hospital in 2012, up
from 1.26 percent in 2011. Those new numbers mark the highest level of non-hospital births since 1975, according to the CDC.

In terms of actual births, that means 53,635 births in the U.S. took place out of a hospital in 2012, including 35,184 home births and 15,577 birthing center births, the CDC says.

(Source: CDC)

(Source: CDC)

Here are some more findings from the CDC news release:

• In 2012, 1 in 49 births to non-Hispanic white women were out-of-hospital births;

•The percentage of out-of-hospital births was generally higher in the northwestern United States and lower in the southeastern United States;

•Out-of-hospital births generally had a lower risk profile than hospital births.

Continue reading

The Good News, Bad News Story On Measles

Back of female with measles/ Wellcome Library, London. Wellcome Images/flickr

Back of female with measles/ Wellcome Library, London. Wellcome Images/flickr

By Alexandra Morris
CommonHealth Intern

Lately, when you hear about measles in the news, the reports tend to be grim: outbreaks in 2011 and 2013 in the U.S., parents who are choosing not to vaccinate their children for religious or philosophical reasons. But a new report from the CDC this week paints a bigger – and far more heartening – picture: from 2000 to 2012, 13.8 million deaths were prevented through measles immunizations globally. In other words, a population roughly the size of New England is still alive thanks to the measles vaccine.

Deaths from measles have dropped 78% since 2000. “These figures represent historic lows for estimated measles deaths globally,” said James Goodson, a co-author of the CDC report published in this week’s Morbidity and Mortality Weekly Report.

Since 2000, the Measles and Rubella Initiative – a partnership between various agencies including the CDC and the World Health Organization – has provided over a billion doses of measles vaccinations worldwide.

Measles was eliminated in the U.S. in 2000, but there have been a couple of recent spikes in cases. Just last year, there were three times as many measles infections in the U.S. than in previous years. In raw numbers, that translates to 189 cases, according to the CDC. While that doesn’t seem like a lot, such a highly contagious disease can spread rapidly, especially among people who haven’t been vaccinated.

Countries around the world are also aiming to eliminate measles by 2020 or earlier. Europe, for example, set a goal of measles elimination by 2015. But it doesn’t look like they’re on track to meet that goal, said Goodson. That may be due in part to parents’ fears about the possibility of vaccine side effects.

In 1998, a British medical journal issued a report suggesting the measles vaccine was linked to autism cases, which led to a sharp decline in vaccinations. Although the report was discredited, and later retracted by the journal, parent and anti-vaccine groups continue to fight against routine immunizations.

Misinformation is a major threat to vaccine efforts, say public health officials. Continue reading

Want Better, Cheaper, More Seamless Health Care? Ask Me How

Dr. Myechia Jordan (Courtesy)

Dr. Myechia Minter-Jordan (Courtesy)

By Dr. Myechia Minter-Jordan
Guest contributor

Dr Myechia Minter-Jordan is president and CEO of the Dimock Center, a nationally recognized community health center in Roxbury.

Growing up, I always knew I wanted to be a doctor. I remember being fascinated by all the cool gadgets in the doctor’s office, from the cold feeling of the stethoscope on my skin as the doctor listened to my breathing, to the funny feeling as my doctor tapped my knee with the small hammer to test my reflexes. It always felt exciting to me, even when we had to make two or three visits to separate clinics for doctor’s appointments and medical care. As a young child, it seemed like an adventure.

What I didn’t realize was that it was not an adventure for my parents. They often had to take multiple days off of work to go to those appointments and they weren’t happy about it. They ran in circles giving the same information over and over to different nurses and doctors, receiving few helpful results. They often left those appointments more frustrated and perplexed than when we arrived.

Now, as an adult and a doctor reflecting back on those times, I can say with certainty that my family’s primary care provider never spoke with our dentist and eye doctors about our health and wellness. My mother’s OB-GYN never communicated directly to our pediatrician about her care or anticipated my needs as a new infant. Fragmented, clunky and often disempowering, that was our health care system then in many ways. And it still is now.

Why are there not more people knocking at my door to learn from our model of care?

Throughout its history, our health care system became increasingly disjointed, and we are now faced with the reality that we must seek alternate models that are centered on the patient. We must seek models that are streamlined, efficient, less expensive and more empowering for the patient. We need models that enhance communication among providers about the patient and their health care experience. And we need to improve the collective health of our communities.

In other words, we need a model that has existed in our country since 1965: the community health centers.

Here’s what community health centers offer: Continue reading

Cigarette Study: Increased Nicotine ‘Yield’ May Make Quitting Even Harder

kenji.aryan/flickr

kenji.aryan/flickr

Fifty years after the U.S. Surgeon General issued the first report on the health hazards of smoking, cigarettes are potentially more addictive than ever, according to a new study that examines so-called “nicotine yields” — essentially the amount of nicotine delivered via smoke.

The study, led by the Massachusetts Department of Public Health and researchers at UMass Medical School, found that nicotine yield “increased sharply from 1998 to 2012 even as the total amount of nicotine in cigarettes has leveled off.”

Public health officials suggest that cigarette makers have cleverly changed the design of their product to increase the amount of nicotine smokers are taking in. (I asked whether the researchers had confronted the tobacco companies directly on these findings. Their response: No, tobacco companies were not directly questioned: “We use the data that they are required to provide to DPH annually,” a UMass Medical School spokesperson emailed.

Here’s more from the news release:

“This study indicates that cigarette manufacturers have recently altered the design of cigarettes. This can significantly increase the amount of nicotine a person receives while smoking,” said Thomas Land, PhD, director of the Office of Health Information Policy and Informatics for the Massachusetts Department of Public Health (MDPH) and principal investigator for the study.

“Cigarettes have a more efficient nicotine delivery system than ever before,” Dr. Land said. “Because smokers have no way of knowing that the level of nicotine they are receiving has increased, they can become more addicted more easily without knowing why.” Continue reading