Alabama Mystery Illness Solved

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According to a press release, testing at a state lab and at the CDC showed that different groups of pathogens were present. All seven Alabama patients were tested and six of the samples came back positive for either influenza A, rhinovirus or a combination of the two. Three patients were found to have bacterial pneumonia.

Southeast Alabama is home to a military base and several aircraft plants that have frequent international travel. Public Health officials took extraordinary caution due to the recent emergence of H7N9 and novel coronavirus in Asia and the Middle East. To date, there have been 131 confirmed cases of H7N9, including 32 deaths. Globally, from September 2012 to date, the WHO has been informed of a total of 44 confirmed cases of novel coronavirus infection, including 22 deaths.

Department spokesperson Dr. Mary McIntyre, assistant state health officer for disease control and prevention, said “While enhanced surveillance associated with this cluster is no longer necessary, health care providers are encouraged to continue routine year-round influenza surveillance activities and submit specimens to the state laboratory for testing.”

Novel Coronavirus Infects Hospital Workers in France and Saudi Arabia

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Since the beginning of May, a total of 21 cases and nine deaths have been reported form the outbreak linked to a healthcare facility in Saudi Arabia. From September 2012 to date, the WHO has been informed of a global total of 40 laboratory-confirmed cases of human infection with nCoV, including 20 deaths, from 6 countries–France, Germany, Jordan, Qatar, Saudi Arabia, United Kingdom.

The WHO has also issued a press release in which they state:

At this point, several urgent actions are needed. The most important ones are the need for countries, both inside and outside of the region, to increase their levels of awareness among all people but especially among staff working in their health systems and to increase their levels of surveillance about this new infection. In Saudi Arabia, we have seen the importance of better surveillance. When new cases are found, as is likely, it is critical for countries to report these cases and related information urgently to WHO as required by the International Health Regulations because this is the basis for effective international alertness, preparedness and response.

The press release goes on to suggest that “one of the reasons why more cases have been identified in [Saudi Arabia] may be because they have gone ahead to strengthen their surveillance system and lab capacities and network.”

Video: Superbugs are Closer Than You Think

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The ETC research team, based at the Center for Disease Dynamics, Economics & Policy (CDDEP), believes that while we can’t beat the bacteria, we can slow them down by recognizing that antibiotics are a natural resource that we must use conservatively if we want them to remain effective. By issuing regular research and commentary on topics such as health care-associated infections, trends in drug resistance, and the costs—both human and economic—posed by rising resistance rates, ETC is laying groundwork for the comprehensive solutions needed to combat this problem.

H7N9 Spreads Beyond Mainland China

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Taiwanese health officials said they are screening travelers arriving from China for signs of H7N9. This is the first case of H7N9 to be seen outside of mainland China. In response to the news, Malaysia has joined Vietnam and Indonesia in temporarily banning the import of poultry from China.

Keiji Fukuda, the WHO’s assistant director-general for health, security and the environment told reporters this week that H7N9 is “one of the most lethal influenza viruses that we have seen so far.” So far, there is no evidence of sustained human-to-human transmission. “We do want to note, however, that if limited person-to-person transmission is demonstrated in the future, this really will not be surprising,” Fukuda warned, adding that it was critical to remain vigilant, monitoring the virus’s spread and mutation.

The CDC has already begun bracing for H7N9 by preparing a vaccine, and U.S. doctors have been urged to promptly report suspected bird flu cases to their state health departments.

 

Public Health Agency Readiness for Meaningful Use Stage 2

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According to the Recommendations, Public Health Agencies are strongly encouraged, though not required, to support Meaningful Use Stage 2 public health objectives. These objectives represent tremendous opportunities for Public Health Agencies to improve their surveillance capabilities. Meaningful Use Stage 2 regulations for public health objectives suggest that Public Health Officials need to perform four new administrative tasks to fully support Meaningful Use Stage 2. These processes are:

· Publicize what Meaningful Use Stage 2 objectives the Public Health Agency will support

· Register Providers that plan to submit public health data to a Public Health Agency for Meaningful Use Stage 2 objectives

· Test and validate ongoing data submissions from Providers

· Provide written communication(s) (which may be in electronic format) to Providers that have achieved ongoing submission of data relevant to public health for Meaningful Use Stage 2 objectives.

For more information, view the complete Meaningful Use Stage 2 Public Health Agency Readiness Guidance and Recommendations.

 

Metagenomics Identifies Organisms in Outbreaks of Serious Infectious Disease

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Metagenomics reconstructs the genome sequence through the direct sequencing DNA extracted from microbiologically complex samples. A recent study published in the Journal of the American Medical Association (JAMA) highlights the potential of this approach to identify and characterize bacterial pathogens directly from clinical specimens. For the study, 45 samples were selected from fecal specimens obtained from patients in Germany with diarrhea during the 2011 STEC outbreak, and those samples were submitted to a 3-phase sequencing analysis.

The international team of researchers was coordinated by Mark Pallen, Professor of Microbial Genomics at Warwick Medical School, who summarized what this means for the identification of future outbreaks, “There are numerous drawbacks to the use of nineteenth-century approaches such as microscopy and culture when it comes to classification. Our results illustrate the potential of metagenomics as an open-ended, culture-independent approach for the identification and characterization of bacterial pathogens during an outbreak.

“There are challenges, of course, including speeding up and simplifying workflows, reducing costs and improving diagnostic sensitivity. However, given the dizzying pace of progress in high-throughput sequencing, these are not likely to remain problems for very long.”

 

Manufacturing Airborne Bird Flu

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When the two teams announced in 2011 that they had discovered how to make a mutated strain of H5N1 that could spread between people, the U.S. National Science Advisory Board for Biosecurity (NSABB) was so alarmed that it took an unprecedented step and attempted to censor publication of the studies. In January 2012, amidst widespread fears that the details of the work could fall into the wrong hands and be used for bioterrorism, both teams of researchers voluntarily agreed to temporarily suspend their studies.

Now, according to a recent Reuters article, many scientists are calling for an end to the moratorium on bird flu transmissibility research in light of the emergence of H7N9. Ab Osterhaus, a world leading flu researcher who is head of viroscience at the Erasmus Medical Center in the Netherlands, says “This virus might be on the brink of gaining function of transmissibility (in humans). I think it’s crucial to know the rules of the game.”

With fourteen cases of the new H7N9 bird flu confirmed in China since Sunday, including six deaths, Vietnam has banned the import of Chinese poultry, and Beijing, Japan, and Hong Kong have all begun mobilizing resources against the threat.

 

Creating the Patient Records of the Future

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First Place – gravitytank

The first place winners sought out to identify the pain points of current medical records before beginning the actual design process. They made a few interesting assessments:

• Most people have a minimal understanding of their own healthcare

• Therefore, people have little ownership of their own healthcare and seek out doctors to interpret records for them

• Medical records are poorly organized and should have the appearance of a grocery store receipt that lists medications, doctors, lab results, etc. in a clear order.

Based on these discoveries, they decided the solution should be designed based on these four principles: Dynamic, Holistic, Understandable and Personalized.

Second Place – StudioTACK

StudioTACK is actually an architecture firm that took on the challenge to showcase their additional talents. The project leader for StudioTACK stated, “You don’t start with design, you start with observation and analysis.” They interviewed doctors and nurses and found that most doctors do not read patient records in order. With this information, they approached the design with “problem first, timeline second” and it resulted in a design that listed what doctors needed to see in order from first to last.

Third Place – Blue Button by Method

Method discovered the Healthcare Challenge two weeks before the deadline. With limited time to do research, they approached the challenge with a focus on the different ways to present information – cell phone, tablet, computer – in order to give patients access to their records from anywhere.

The full interview is available on the Profitable Practice blog.

 

Submit Your Health Information or Pay a Fine?

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CVS Pharmacy recently sent out a memo to employees that has public health professionals—and the media—discussing just how far an employer can go to mandate employee health management. CVS employees will now be required to submit their weight, body fat, glucose levels, and other vital statistics to the company. If they don’t, they’ll be subject to a $50 monthly fine.

While those opposed to the mandate are calling it “coercion,” according to an article on ABCNews, others believe that it is a positive step toward putting employees in charge of their health—and rewarding them with decreased health insurance premiums.

“The goal of these kinds of programs is to end up with a healthier work force. If your employees are healthy they’re going to work better and they’re going  to cost the employer a lot less money,” says Dr. Richard Besser, ABC News’ chief health and medical editor.

What’s your opinion? Will mandates like CVS’ lead to increased public health?

 

New Study Spotlights How Influenza Spreads

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Science Daily reports that “people may more likely be exposed to the flu through airborne virus than previously thought.” The article cites a University of Maryland School of Public Health study that concluded “there are nearly nine times more influenza virus present in the smallest airborne droplets in the breath exhaled from those infected with flu than in the larger droplets that would be expected to carry more virus

Dr. Donald Milton, who directs the Maryland Institute for Applied Environmental Health and led the study, states that “this has important implications for how we prevent the spread of flu.”

The CDC has long recommended that people with influenza wear surgical masks to prevent transmission of the virus. But the University of Maryland study is the first that provides data showing that mask use can reduce spread of even small exhaleddroplets containing a virus. “For this reason, health care facilities should put surgical masks on those suspect of having influenza, and individuals with influenza can protect their families by wearing a mask.”