#OutbreakWeek — Hashtags of the Week (HOTW): (Week of December 23, 2013)

Proof of Party

Heading home for the holidays? Going to parties? Meeting up with old friends? All of these are potential ways in which infectious diseases are transmitted across the country, and across the globe. In preparation for this, there was a major public health outreach effort on Twitter last week called Outbreak Week, with the obvious hashtag. Here are some highlights and tips from that initiative.

Project Tycho – Data for health

TychoBraheProject Tycho, from the University of Pittsburgh (with funding from the Bill & Melinda Gates Foundation & the National Institutes of Health), is a database created to advance the availability & use of public health data for science & policy.

The project has completed the digitization of the entire history of weekly Nationally Notifiable Disease Surveillance System (NNDSS) reports for the United States (1888-2013) into a database in computable format (Level 3 data); standardized a major part of these data for online access (Level 2 data); and a subset of the U.S. data was cleaned further and used for a study on the impact of vaccination programs in the United States that was recently published in the NEJM (Level 1 data).

Read more about this fascinating project here.  You can also find it on the Health Statistics research guide on the “Incidence/Prevalence” & “Visualization” pages.

Hat tip to Gillian Mayman!

Vaccinating babies for rotavirus protects the whole family

From NPR’s Shots blog:

A 7-year-old vaccine that has drastically cut intestinal infections in infants is benefiting the rest of America, too.

A study published Tuesday from the Centers for Disease Control and Prevention shows that vaccinating infants against rotavirus has also caused a striking decline in serious infections among older children and adults who didn’t get vaccinated.

“This is called herd immunity,” the CDC’s Ben Lopman tells Shots. “By vaccinating young children, we not only prevent them from getting infected, but we also prevent them from transmitting [the virus] to their siblings, their parents and their classmates.”

Rotavirus is highly contagious and hardy — it can persist on doorknobs and other surfaces. It causes abdominal cramps and severe watery diarrhea, often accompanied by vomiting and fever.

The indirect benefit of rotavirus vaccination is enormous, among both the vaccinated kids and everyone else.

Since the vaccine was introduced in 2006, rotavirus hospitalizations have dropped in infants and young children by 80 percent. “About 40,000 hospitalizations per year have been averted by the vaccination program,” Lopman says.

The vaccine costs about $65 a dose, and infants need two or three doses.

The current study, which was published in JAMA, the journal of the American Medical Association, shows that the rotavirus vaccine is indirectly preventing thousands of hospitalizations for diarrhea among older children and adults.

Read the complete post here.

Public health’s wicked problems: Can InfoVis save lives?

IEEE-VisualAnalytics2013From the CDC’s Office of Infectious Diseases:  Call for submissions



Public health is charged with assessing current and emerging health threats and issues, developing effective population-based policies and interventions to address these problems, and monitoring delivery and outcomes of public health actions (IOM, 2010 & 2008). Many public health problems, such as the obesity epidemic, HIV/STI transmission, and environmental hazards are called “wicked” due to their complexity and multi-layered causal factors at individual, group, and social levels (Kreuter, 2004). Such problems must be tackled with a mix of interventions that can include changes in health care delivery systems, community and neighborhood planning, social and educational institutions, and social and individual behavior change programs (Dahlgreen and Whitehead, 1991; Dean and Fenton, 2010). Other public health actions require rapid response and public engagement using the best data possible as it emerges in real-time, such as emerging infectious diseases, outbreaks, and emergency operations to protect public safety.

To make decisions about when and where to deploy resources that produce the greatest net benefits in complex or rapidly evolving situations, public health practitioners need new tools to integrate multiple sources of data from formal disease surveillance systems, secondary sources of geographic and demographic data, and new data streams such as real-time social media content. The field of information visualization, in which datasets are explored, analyzed, and presented through a range of graphical means, could offer entirely new ways of representing, seeing, and solving population-based health problems (Isenberg, 2011; Khan, 2009; Sopan, 2012).

We are soliciting full papers and extended abstracts/presentations across the range of focus areas of visualization, from issues in data collection for maximizing visualization opportunities, to analysis techniques, traditional and novel presentation formats, and data storytelling. Submissions should focus on the use of visualization to identify, analyze, and solve public health and related health system challenges.

For more information and to submit a proposal, click here.

Deadline:  6 September 2013

Mold toxins tied to AIDS epidemic

From the New York Times:

Aflatoxins — poisons produced by fungi that grow on moldy peanuts and corn — may be worsening Africa’s AIDS epidemic by helping suppress the immune systems of newly infected people, a new study has found.

The study, by researchers at the University of Alabama at Birmingham and published recently in the World Mycotoxin Journal, measured blood levels of aflatoxins and H.I.V. in 314 Ghanaians who had never taken antiviral drugs.

The more aflatoxins they had, the more likely they were to have high blood levels of H.I.V. — even those with higher levels of CD4 blood cells, meaning they had not been infected long and were not yet eligible for triple-therapy cocktails under the latest World Health Organization guidelines.

The toxins, produced by aspergillus fungi that grow on damp grains, nuts and beans, are so common as to be almost unavoidable in humid climates, but so dangerous that federal law limits concentrations in food to 20 parts per billion. American peanut-butter makers are always on the watch for them. Ground peanuts are a staple food of West Africa.

In high doses, aflatoxins can be deadly. A 2004 outbreak in Kenya killed 125 people; samples of moldy corn had up to 8,000 parts per billion. Regular exposure to low doses can cause liver cancer.

The authors suggested that aflatoxins either contribute proteins that help H.I.V. reproduce or somehow lessen the numbers of the white blood cells that the virus targets, making its attack on the immune system more potent.

Polio virus is found in Cairo’s sewers

From the New York Times:

The polio virus has been found in the sewers of Cairo, and it appears to have come from Pakistan, the World Health Organization said Wednesday. Egypt has not had a case of polio since 2004. A vaccination drive is being planned for Feb. 25, and health workers are canvassing the neighborhoods where the sewage samples were taken, looking for children or adults who may have recently been paralyzed, said Sona Bari, a spokeswoman for the W.H.O. Pakistan has said it will post teams at its international airports vaccinating all outward-bound passengers under age 5. Last month, at least nine Pakistani volunteers in an internationally supported polio vaccination drive were killed by militants across Pakistan in a campaign of intimidation that has hurt efforts to eradicate the disease there. Pakistan is one of the last three countries, with Afghanistan and Nigeria, with indigenous polio.

Disease detection: Laboratories on the front lines

From the CDC’s blog, Public Health Matters:

lab tech working with samples under a hood

You can’t respond to threats if you don’t know what they are, which is one reason that laboratories play such an important role in public health. Public health laboratories have helped detect all kinds of threats to the public’s health; including anthrax, monkey pox, novel flu viruses, and foodborne disease outbreaks caused by germs like listeria. Since 1999, CDC, the Federal Bureau of Investigation (FBI), and the Association of Public Health Laboratories (APHL) have been working together to support the Laboratory Response Network (LRN). The LRN is a network of 160 domestic and international laboratories that work around the clock to provide rapid testing of biological and chemical threat agents and support for other public health emergencies.  They use standardized tests so results from one laboratory mean the same thing as results from another laboratory within the network.

The LRN’s mission to respond to public health emergencies was tested in the summer of 2011, when a 61-year-old retiree from Florida was diagnosed with anthrax. The man was on a 3-week vacation with his wife visiting the national parks of Wyoming, Montana, and the Dakotas when he came down with a rare and extremely deadly type of anthrax infection that experts believe he picked up from natural sources while on his road trip.

Read the complete post here.

New from NAP – The Continuing Epidemiological Transition in Sub-Saharan Africa

From the National Academies Press:

Among the poorest and least developed regions in the world, sub-Saharan Africa has long faced a heavy burden of disease, with malaria, tuberculosis, and, more recently, HIV being among the most prominent contributors to that burden. Yet in most parts of Africa-and especially in those areas with the greatest health care needs-the data available to health planners to better understand and address these problems are extremely limited. The vast majority of Africans are born and will die without being recorded in any document or spearing in official statistics. With few exceptions, African countries have no civil registration systems in place and hence are unable to continuously generate vital statistics or to provide systematic information on patterns of cause of death, relying instead on periodic household-level surveys or intense and continuous monitoring of small demographic surveillance sites to provide a partial epidemiological and demographic profile of the population.

In 1991 the Committee on Population of the National Academy of Sciences organized a workshop on the epidemiological transition in developing countries. The workshop brought together medical experts, epidemiologists, demographers, and other social scientists involved in research on the epidemiological transition in developing countries to discuss the nature of the ongoing transition, identify the most important contributors to the overall burden of disease, and discuss how such information could be used to assist policy makers in those countries to establish priorities with respect to the prevention and management of the main causes of ill health.

This report summarizes the presentations and discussions from a workshop convened in October 2011 that featured invited speakers on the topic of epidemiological transition in sub-Saharan Africa. The workshop was organized by a National Research Council panel of experts in various aspects of the study of epidemiological transition and of sub-Saharan data sources. The Continuing Epidemiological Transition in Sub-Saharan Africa serves as a factual summary of what occurred at the workshop in October 2011.

Download the free PDF or buy the book here.

Chickenpox down 80 percent since 2000

From the New York Times:

Signaling the retreat of a childhood rite of passage, the incidence of chickenpox in the United States fell by 80 percent from 2000 to 2010, the Centers for Disease Control and Prevention reported last week.

The decline results from widespread use of the chickenpox vaccine, researchers said.

From 2000 to 2005, a period when a single dose of vaccine was recommended for children 12 to 18 months old and for older unvaccinated children, cases fell by 43 percent. The decline steepened once a second dose was recommended in 2006, with incidence falling 72 percent in the second half of the decade.

Read the complete article here.  Read the CDC report here.

Rapid H.I.V. home test wins federal approval

From the New York Times:

After decades of controversy, the Food and Drug Administration approved a new H.I.V. test on Tuesday that for the first time makes it possible for Americans to learn in the privacy of their homes whether they are infected.

The availability of an H.I.V. test as easy to use as a home-pregnancy kit is yet another step in the normalization of a disease that was once seen as a mark of shame and a death sentence.

The OraQuick test, by OraSure Technologies, uses a mouth swab and gives results in 20 to 40 minutes. A previous test sold over the counter required a user to prick a finger and mail a drop of dried blood to a lab.

Dr. Anthony S. Fauci, the longtime AIDS researcher and director of the National Institute of Allergy and Infectious Diseases, called the new test a “positive step forward” and one that could help bring the 30-year-old epidemic under control.

Getting an infected person onto antiretroviral drugs lowers by as much as 96 percent the chance that he or she will transmit the virus to someone else, so testing and treatment have become crucial to prevention. About 20 percent of the 1.2 million infected Americans do not know they have the disease, the Centers for Disease Control and Prevention estimates, and about 50,000 more get infected each year.

Dr. Robert Gallo, who headed the National Institutes of Health lab that developed the first American blood test for the virus in 1984, called the F.D.A. approval “wonderful because it will get more people into care.”

Read the complete story here.