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CDC Again Stresses Urgent Need to Adjust Practices or Pay a Steep Price

Posted on March 8, 2013  Comments (3)

Untreatable and hard-to-treat infections from Carbapenem-resistant Enterobacteriaceae (CRE) germs are on the rise among patients in medical facilities. CRE germs have become resistant to all or nearly all the antibiotics we have today. Types of CRE include Klebsiella pneumoniae Carbapenemase (KPC) and New Delhi metallo-beta-lactamase (NDM). By following the United States Center for Disease Control (CDC) guidelines, we can slow the penetration of CRE infections in hospitals and other medical facilities and potentially spread to otherwise healthy people outside of medical facilities.

The CDC has worked with hospitals to successfully apply these measures. The CDC worked with Florida to stop a year-long CRE outbreak in a long-term acute care hospital. With the improved use of CDC recommendations (such as educating staff; dedicating staff, rooms, and equipment to patients with CRE; and improving use of gloves and gowns) the percentage of patients who got CRE at the facility dropped from 44% to 0.

One travesty has been how poorly health care professionals have been about prescribe antibiotics wisely We need to improve and follow CDC antibiotics guidelines (stop the overuse of antibiotics) and use culture results (for patients undergoing treatment) to modify prescriptions, if needed. Antibiotic overuse contributes to the growing problems of Clostridium difficile (c-diff) infection and antibiotic resistance in healthcare facilities. Studies indicate that nearly 50% of antimicrobial use in hospitals is unnecessary or inappropriate (per CDC web site).

Israel decreased CRE infection rates in all 27 of its hospitals by more than 70% in one year with a coordinated prevention program. The USA is at a critical time in which CRE infections could be controlled if addressed in a rapid, coordinated, and consistent effort by doctors, nurses, lab staff, medical facility leadership, health departments/states, policy makers, and the federal government.

As I have been saying for years the damage we are creating due to our actions around the use and abuse of antibiotics is likely to kill tens of thousands, or more people. Because the deaths are delayed and often not dramatic we have continued dangerous practices for years when we know better. It is a shame we are condemning so many to increased risks. The CDC, and others, are doing good work, unfortunately too much bad work is continuing in the face of evidence of how dangerous that is.

Related: CDC Urges Increased Effort to Reduce Drug-Resistant Infections (2006) – Key scientific articles on Healthcare Associated Infections via CDC – Our Dangerous Antibiotic Practices Carry Great Risks – Dangerous Drug-Resistant Strains of TB are a Growing Threat

CDC Report on Failures to Vaccinate

Posted on May 25, 2011  Comments (6)

Science brought us the miracle of vaccines and the near elimination of many diseases. Unfortunately people are choosing to bring those diseases to many more people because they failed to get vaccinated or failed to vaccinate their children. The needless pain and suffering caused by these poor decisions are a sad testament to scientific illiteracy.

The financial implications of the US measles outbreaks

One reason measles outbreaks are so scary (and so difficult to contain) is that measles is the most infectious microbe known to man–it’s transmission rate is around 90 percent. It has also killed more children than any other disease in history.
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The most significant factor in the spread of measles in the United States is declining vaccination rates — and, similar to what occurred in the UK in the early part of the last decade, that decline can be traced back to the press-fueled panic…

CDC report on Measles

Children and adults who remain unvaccinated and develop measles also put others in their community at risk…

In Europe in recent years, measles has been fatal for several children and adolescents, including some who could not be vaccinated because they were immune compromised.

Rapid control efforts by state and local public health agencies, which are both time intensive and costly, have been a key factor in limiting the size of outbreaks and preventing the spread of measles into communities with increased numbers of unvaccinated persons. Nonetheless, maintenance of high 2-dose MMR vaccination coverage is the most critical factor for sustaining elimination. For measles, even a small decrease in coverage can increase the risk for large outbreaks and endemic transmission, as occurred in the United Kingdom in the past decade…

Related: Vaccines Don’t Provide Miraculous Results if We Don’t Take Them – The Illusion of Understanding – 500 Year Floods

CDC Urges Reduction in Salt Intake to Save Hundreds of Thousands of Lives

Posted on July 1, 2010  Comments (6)

Most people know we eat far too much salt and that it is killing lots of us. It is still amazing that we have over 100,000 people in the USA every year die this way and yet we barely pay attention. Doesn’t it seem like we should care more about life?

Excessive dietary sodium consumption increases blood pressure, which increases the risk for stroke, coronary heart disease, heart failure, and renal disease. Based on predictive modeling of the health benefits of reduced salt intake on blood pressure, a population-wide reduction in sodium of 1,200 mg/day would reduce the annual number of new cases of coronary heart disease by 60,000—120,000 cases and stroke by 32,000—66,000 cases.

Fewer than 10% of all adults in the USA met their recommended limit. U.S. adults consumed an average of 3,466 mg/day of sodium. Most of the daily sodium consumed came from grains (1,288 mg; 36.9%) and meats, poultry, fish, and mixtures (994 mg; 27.9%).

In the United States, an estimated 77% of dietary sodium intake comes from processed and restaurant foods and approximately 10% comes from table salt and cooking. More details from the CDC.

Related: CDC: Reduce Salt in Your Diet – Food Rules: An Eater’s Manual – Eat Less Salt and Save Your Heart – Another Strike Against Cola

Swine Flu: a Quick Overview

Posted on April 26, 2009  Comments (8)

World Health Organization on Swine influenza

After reviewing available data on the current situation, Committee members identified a number of gaps in knowledge about the clinical features, epidemiology, and virology of reported cases and the appropriate responses. The Committee advised that answers to several specific questions were needed to facilitate its work.

The Committee nevertheless agreed that the current situation constitutes a public health emergency of international concern.

Based on this advice, the Director-General has determined that the current events constitute a public health emergency of international concern, under the Regulations.

Swine flu: a quick overview–and new New York and Kansas cases by Tara Smith

while the cases in the US have been mild and no deaths have occurred that we’re aware of, it seems in Mexico that young people are dying from this–a group that is typically not hard-hit by seasonal influenza viruses. Readers familiar with influenza and know the history of the 1918 influenza pandemic will recall that the “young and healthy” were disproportionally struck by that virus as well–so this knowledge is currently disconcerting and worrisome, but there are so many gaps in our information as far as what’s really going on in Mexico that it’s difficult to make heads or tails out of this data right now.

Third, is this really a new virus? So few influenza isolates are actually analyzed each year (in proportion to the number of people infected) that we aren’t sure yet whether this is something brand-new, or something that has been circulating at a low level for awhile, but just hadn’t been picked up. After all, H1N1 is a common serotype, so additional molecular testing is needed to determine that it’s “swine flu” versus “human” H1N1.
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this is a fast-developing story, and it will take much more investigation and field work to determine the true extent of the virus’s spread in the population; to figure out… how efficiently it’s transmitted…

This is very early in the scientific inquiry process looking into what exactly is going on. It is too early to tell how serious a threat this is. The reaction of WHO, CDC though shows they are taking the threat seriously. By far the biggest danger in such situations, is reacting too slowly to serious and contagious threats. If you wait to react until proof exists that the situation is very serious the situation can be almost impossible to control. So you need to react quickly to shut down the spread of the threat, hopefully before it has spread too far.

Related: CDC site on Human Swine Influenza Investigation – Interview with Dr. Tara Smith – Reducing the Impact of a Flu Pandemic – H5N1 Influenza Evolution and Spread
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