A New Threat: H7N9

The last week of classes is here, so naturally I'm studying for finals next week! The first final to study for is Epidemiology because I have that exam on Monday. Taking a break from studying, I decided to look into recent health news around the world and came across a story about Hong Kong confirming human cases of bird flu. The report was released today, December 3. For Hong Kong this is their first case of human bird flu. In February and April, China dealt with H7N9, but controlled the issue by shutdowns of chicken markets and farm quarantines. It has already taken the lives of 45 people in eastern China and a middle aged woman is in critical condition now. The woman may have become infected with the strain when she traveled to a bordering city called Shenzhen and bought and slaughtered a chicken. The virus is very lethal to humans, but birds show no symptoms at all. A few people have been in contact with the infected woman and are showing mild symptoms. Officials believe their are many more cases, but the lack of technology to diagnose the strain is a problem. The city's government has tightened their requirements, especially in hospitals, and is hoping to eliminate H7N9 soon. In order to control H7N9, the government may need to kill a number of birds, which is the global standard for controlling the avian flu that was established in 1997 after the H5N1 outbreak. Reading the article, I came across a segment about how diseases do not respect boundaries, I thought that was so interesting because as epidemiologists our work is not just isolated to an area, but may be spread out among many cities or even countries. It makes the job that much harder, but also that much more rewarding to trace how the disease traveled and figure out a plan of action for those affected. I’ll be following this story more as the government and health officials receive more information.
Stay tuned and happy studying to my fellow epidemiologists!


Source: http://www.businessweek.com/news/2013-12-02/hong-kong-confirms-city-s-first-human-case-of-h7n9-bird-flu

A Rare Re-emergence

In recent news, Princeton University has been making headlines, but not because of their brilliant students. Yesterday, ABC news reported the Ivy League university has been faced with the re-emergence of Meningitis B. Since March, seven cases have been diagnosed, a majority of these being students. There has been debate among the FDA, the nation and the school on whether to import the vaccine, Bexsero, into the United States, but after much deliberation, the FDA has approved the importation. The vaccine is approved in Europe and Australia, but not yet in the United States. Bexsero is the only vaccine used for the type B strain. Bacterial meningitis is pretty rare, but the B strain is seen frequently in the United States and Europe. One in ten die and one in five suffer permanent disability. New Jersey mandates those living in college dorms to receive the vaccine against the other strains of meningitis, but type B has a separate vaccination, which is why many are not aware. College campuses provide a perfect breeding ground for the bacteria and officials are urging students to not have close contact, drink from each other, share items, but to wash hands and cover their mouths. Symptoms can quickly develop and meningitis can be fatal! The major symptom attributed to meningitis is a stiff neck. Among the students interviewed, many seemed willing to consider the vaccine. From an epidemiologist standpoint, I would be interested in figuring out how the disease was transmitted among those infected individuals and why hasn't the U.S. approved this vaccine yet? I believe the United States needs to always be prepared for the re-emergence of once rare, or even eradicated diseases and have the necessary vaccines, prevention strategies and treatment to be as success as possible in all their efforts to eliminate the spread.

Source: http://abcnews.go.com/Health/wireStory/princeton-university-considers-meningitis-vaccine-20921420

Water: Something We Shouldn't Take For Granted

On Monday, we had a guest speaker, Dr. Duran from Virginia Tech's faculty talk to our class about the water issues among developing countries around the world. He was such a knowledge person and very personable! I learned a lot from his lecture, but a very interesting finding he presented was how the women, in developing countries, were usually the gatherers of the water for the household. I found this unfair because women have so many other chores they must complete around the home daily and producing safe drinking water seems like the most daunting of the chores. In some developing countries, the government has installed pipes that run water into these areas, but when tested the water from the pipes usually contains fecal coliforms. We learned, the pipes do not circulate water continuously, creating pressure so this leads to cracking, which increases the chance of bacteria within the pipes.
Properly boiling and storing the water can prevent these fecal coliforms from appearing and reduce an individual's risk for illness, but many people in these developing areas run into obstacles. Dr. Duran was discussing how some people did not understand how to properly boil their water and were merely heating the water and then storing it in uncovered tubs. He also discussed how many people do not have the time or space to properly boil their drinking water and since those in their household seem free from disease, the "raw" water must be fine to consume without boiling. Listening to the guest speaker made me realize how I take such a basic necessity for granted. In our country, water is always available. We can make it hot or cold, run slow or fast, and have access to it everywhere! For those in developing countries, water can be deadly if it is not properly treated or an area is lacking it. I have found a new appreciation for my water and now I think twice about long showers and letting the water run continuously when brushing my teeth. Water shouldn't be something we take for granted, it should be something we always appreciate.

Let's Be The Cultural Cure!

The world is vast and full of unexplored outlets pertaining to health. Dr. Wallis and her Epidemiology class have begun to open my eyes to not only the issues existing in our own country, but those throughout the world. On Monday, we listened to a lecture on global health and it reinforced the notation that her class is providing insight into other parts of the world and the issues they are battling. On Monday, November 4, Nicaragua has been battling Dengue. This illness is a classic staple of the humid, South American climate and other parts of the world. Mosquitos are the main vector for the illness and thrive in moist, tropical climates. It has been an epidemic for some time and continues to cause illness throughout these populations. Currently, five children, ranging in age from 5 to 15, have Dengue fever and are in critical condition. Over 1,000 people have become hospitalized as a result of Dengue fever in Nicaragua. The government and Cuban health officials have acknowledged the current epidemic and are planning strategies to control the outbreak. Becoming educated about issues around the globe allows for a more diverse outlook on health prevention and treatment. It's so easy sometimes to enclose yourself in your own world and not explore areas outside of it. Dr. Wallis challenges me to take a step back out of this world and dive into one that I never paid attention too. By becoming educated and understanding other nations, you become more culturally competent and can then begin to think critically about prevention and implementation strategies that may be more successful than those strategies before. For example, the issue of unsuccessful relocation attempts of individuals living in urban slums, understanding their mindset, culture and way of life could lead to more successful strategies to overcome this problem not only in Europe, but throughout the world!

Source: http://latino.foxnews.com/latino/health/2013/11/04/5-kids-in-critical-condition-with-dengue-fever-in-nicaragua/

Around the World: Polio in Syria

In the United States, we have been fortunate enough to have a quite peaceful nation, free from many detrimental diseases. In Syria, the aren't as fortunate. Polio, an eradicated disease in many areas, like the United States, has resurfaced. The ongoing civil war is a major contributing factor in the resurfacing of the disease. Another factor is the prevalence of the disease among border countries, like Afghanistan. Officials believe twenty- two individuals have contracted Polio, a majority of these cases involve young children. To combat this suspected Polio outbreak, the World Health Organization is implementing a six month emergency vaccination program to hopefully prevent others from contracting Polio as well. Officials believe the only way to rid Syria of Polio is to "start over" with a new vaccination program. This new program would benefit all of the people of Syria, especially children. Children born after the beginning of the civil war have not had the opportunity to become vaccinated, thus leading to an increased likelihood of contracting Polio. Hopefully, the people of Syria can receive the vaccines and the prevention efforts will help to decrease Polio. THe ultimate goal is to eradicate the disease from the area, altogether.
In Epidemiology, I learned diseases don’t contain themselves within borders, they can spread amongst many countries and be detrimental to a vast majority of individuals. The study of Epidemiology can help to understand the spread of the disease throughout various populations, but also addresses ideas for prevention, like the implementation of the Polio vaccination program. They want to help prevent those who are not ill from becoming ill and limiting the amount of people that are sick. Throughout the class and writing these blogs I am learning so much about how Epidemiology can take many different shapes and help combat various issues all over the world.


Source: http://abcnews.go.com/Health/polio-outbreak-prompts-vaccine-operation-syria/story?id=20704872

The Gambia

On Monday, we were fortunate enough to have a guest speaker present via Skype. The guest speaker was Mr. Ed Sanyang from the University of The Gambia. He discussed with us the development of a study on traffic injuries within The Gambia. He was very passionate and had much knowledge about this developing study and I found it interesting how traffic injuries were such a big problem in the area. After class, I found a blog posting from last year addressing the number of crashes in The Gambia. The blog highlighted The Gambia has over 750 road traffic crashes a year and 95% can be prevented. The police reports suggest a major component is careless and irresponsible individuals. A point addressed by Mr. Sanyang that I thought was very surprising was the fact that alcohol and drinking under the influence is not a common problem associated with these traffic injuries, unlike crashes in the United States. The United States differs from The Gambia in this respect because in recent news many crashes in the U.S. involve distracted or drunk, irresponsible drivers. Mr. Sanyang agreed with the class that more road signs may help decrease traffic injuries, but with the geographical location of The Gambia many people travel through the area to get to other places, like Senegal. Having a guest speaker, like Mr. Sanyang increases my knowledge and awareness of other parts of the world. It is easy and common to enclose yourself in a bubble and never have the ability to gain knowledge outside of your own country. Listening to Mr. Sanyang speak about The Gambia makes me more aware of the problems and research going on in the area and also realize how diverse epidemiology can be.

Source: http://gambianewsonline.blogspot.com/2012/08/more-than-750-road-traffic-accidents.html

Return of TB

Epidemiology is the glue of public health. It helps tremendously in uncovering the diseases within the populations all over the world. The study of epidemiology has helped the United States eradicate many, once fatal, diseases. Recent ABC news, from October 9, 2013, discusses a disease that has been at its lowest levels in the United States over the years has actually begun popping back up and claiming lives. Tuberculosis has been at record low findings among the United States populating for years, which is why doctors and other healthcare workers are having trouble recognizing the signs and symptoms. It is hard to understand a disease that has not been seen in our population for a long time. In Nevada, a mother of twins had a fatal encounter with the illness and so did her babies. After her death, an autopsy was performed, determining the cause was Tuberculosis. It is unclear whether the mother was tested for Tuberculosis, but only one of the twin babies was tested. In the hospital, screening took place among the workers there and 26 people tested positive for Tuberculosis. A major concern was the babies in the NICU. Special consideration must be taken with these babies because of their sensitive, underdeveloped immune systems. The attorney of the deceased woman is searching for answers and questioning the hospital staff in what tests where given and which ones were not. If the hospital failed to perform a Tuberculosis test then a lawsuit could happen. As we learned in class, mortality is always a tragedy, but the information gained from a death and the autopsy can hold valuable information for public health and epidemiology. Reading this article made me realize the realistic value of epidemiology and how the study of epidemiology applies to events like these in our own U.S. population.

Source: http://abcnews.go.com/Health/wireStory/nev-expert-mom-baby-deaths-put-tb-back-20523946

The Future?

With every class lecture, more insight is gained about the subject of epidemiology. I look forward to the next guest speaker, as well as the facebook group invitation. The field of epidemiology is dynamic and I am fascinated by all the different outlets. Being a senior and graduating in the spring of next year, I have begun to look into potential career options. While online, I came across a posting with regards to an epidemiologist. I know without graduate school I would certainly not qualify for the position, but decided to look into the description and qualifications. It wasn't one of those job postings with set criteria to accomplish and a black and white frame. The description seemed a bit "gray". There were so many different, exciting responsibilities and opportunities, it seemed you would never have a dull moment! Within the posting were multiple available spaces for epidemiologists for various locations and even opportunities to travel the world! One of my biggest goals in life is to be able to travel the world and help underdeveloped areas in their health practices. I want to be able to make a positive impact on others and help educate others with the knowledge I have learned. Underdeveloped countries need the most help, but our nation has its own set of problems. The United States needs improvements to its current health care system and visual depictions have highlighted this issue. When looking at the powerpoint slides this past monday, on age adjustment, countries with the best health and decreased mortality rates were those with universal health care systems, like parts of Europe. I would like to help be a part of advocating for change in our nation and hopefully in the future we can have a better health care system for all.
Thinking about all the opportunities, graduate school may be an option I consider, after all. Guess I should start studying not only for the midterm but the GRE! Wish me luck :)

Mortality

On Monday we discussed, in class, mortality. After the lecture, I began to think about all the people in the world that die and even though we have good data collection from death certificates and such there are still many people that die without being known. The world has become so desensitized to death and horrible things happen in the world every day. Many healthy people start and continue bad habits even after seeing harmful effects. Smoking is known to be bad, there is tiny writing on each pack of cigarettes from the Surgeon General stating it’s bad and a plethora of statistics, but people continue to smoke until they become one of the statistics.
It's so interesting to see the statistics on the causes of death, but what was surprising to me was the fact that doctors and medical examiners can alter the specific causes like suicide to something more broad like unintentional injuries upon the request from loved ones. The numbers seem so hard to wrap your head around when talking about national mortality statistics, but when they are put into a population sample of 100,000, as seen in class, it is an easier number to wrap your brain around. It also puts into perceptive how fatal several diseases can be, like pancreatic cancer. Fortunately, pancreatic cancer is not see too often in our population, but unfortunately it is extremely deadly.
I would enjoy studying more about morality in epidemiology because I feel like we could understand so much from the deaths of individuals in our own nation and around the world. More research in this area may help us find cures to diseases we did not think we ever could!

What's media's role? Education or Entertainment

The media has such skewed views on the issues around the world. I took Dr. Wallis' suggestion in class on Monday and decided to pick up a newspaper and watch a little news that night. Besides the fact that media, especially the news has desensitized many people because of all the horrible things happening in the world, it also magnifies many issues. In order to get the viewers attention and keep them watching, the media sometimes educates the public with inflated numbers and distorted facts. While watching the news, I realized the reporters talked about more negativity than positivity. When talking about research or ongoing studies, the reporters highlighted the setbacks instead of discussing the positive aspects and what they have found. For example, they will highlight the flu shot, but then talk about the amount of people that have gotten sick and not the majority who received the shot and were fine. Unfortunately, I have come to terms with the fact that some viewers do not like happy endings, but instead find interest in more traumatic events. In epidemiology, I like learning about real facts and numbers. No one has added extra "fluff" to the studies and research to make it more appealing. It's just real data. The study of epidemiology is interesting because their are so many different applications. I look forward to our next guest speaker via Skype. I believe listening to guest speakers will allow for a better understanding of how epidemiology has many different outlets. I still hope to one day be able to travel around the world and if I become an epidemiologist I will be able to travel as part of my job (hopefully). After looking at the media, I see it in a totally different light. I now know to take every bit with a grain of salt!

Epidemiology Around The Globe

At JMU, students are usually within their own bubbles. I have been at this school for almost four years and just last week went downtown to sight see. Harrisonburg is said to be a diverse community, but I have never gone outside my comfort zone to be able to see how diverse and beautiful the area really is. After listening to Alexandru Coman, I realized how vast epidemiology really is! His study in the delta with domestic birds was fascinating. I hope the human population in Romania or surrounding areas do not become affected by the fowl. Thank goodness Dr. Coman said the possibility of the virus being transmitted from the birds to the human population was very unlikely! So I'm not exactly a world traveler. I have never been outside of the country and never pay much attention to international affairs, but listening to Dr. Coman and his study of influenza in Romania, I was intrigued. I'm beginning to understand epidemiology has so many outlets and can be applied to different aspects around the world. I really enjoyed hearing about the new psychiatric hospital being built and how it will be much better for the patients than the old, crowded hospital. I thought having a guest speaker from another country was very cool and I hope we have many more in the coming semester! Listening to others experiences allows for a better understanding of the subject and I like to see how epidemiology relates.
I hope one day I will be able to travel the world and see different cultures. I would love to study abroad one semester or even summer and see how epidemiology is used throughout the world. After graduation, I want to break out of the JMU bubble and experience things outside of my own comfort zone. I'm going to need a good, firm push and a lot of luck!

Blog 2

The unknown in the world spikes curiosity but also fear. Many individuals are frightened by questions that cannot be answered and the occurrence of unpredictable events, but I want to be able to help discover those answers. In 1918, no one was prepared nor imagined the influenza pandemic. Influenza killed several million people in various areas, among different age groups, and throughout a variety of cultures. The lack of technology and modern medicine in the early 1900s allowed the virus to have such high mortality rates. No one knew how to stop or even control influenza. Good nursing care was the best remedy for the infected because medicine was not an option. The influenza virus is much more severe than the common seasonal flu. Influenza symptoms last for two weeks or longer and include high fever, fatigue, dry cough, and headaches. The common flu usually affects the very young and very old, whereas influenza in 1918 affected many young adults. In 2013, even with the advancement of technology and ongoing research, the virus is still unpredictable. It is now known, that the virus can be transmitted through airborne droplets, hand contact, or contact with a contaminated surface. Healthcare professionals, public health educators, and epidemiologists are continuously working together to understand unpredictable illnesses, like influenza and other unanswered questions about health and disease to better prepare the public for future events. As a newcomer to epidemiology, I am fascinated by the ever changing field of healthcare and disease. I learned in a previous class on infectious diseases, as our technology advances, more complex viruses and diseases began to emerge. It is worrisome to imagine a future pandemic or epidemic could strike the United States like the influenza of 1918, but as the field of epidemiology continues to grow we can keep up with the ever changing world of health.
See you next Wednesday and remember to always wash your hands!

Blog 1

Contagion is a realistic event that I believe could actually occur. Technology is advancing every day, but infectious diseases are evolving quickly as well. I believe there will always be an ongoing arms race between technology and disease findings. The government does its best to protect its citizens, but sometimes it seems as if they are misleading the public and not providing people with accurate information. I believe the government holds information from the public for fear of how they will interpret it and because of privacy conflicts. In the film, the public began to riot and become violent as the unknown disease began to kill many more. The public was not receiving much accurate information from the government and the media, which was increasing their fears. In the end, the route of transmission given to the first victim seemed so simple. The transmission began with bats, then to pigs, and finally from the Chef's unwashed hands to the first victim. This route of transmission happens every day. Surprisingly, I believe many people working in restaurants and food establishments do not wash their hands and it is pure luck we do not end up contracting such infectious diseases. It is not unrealistic for an epidemic like Contagion to happen in the future. After watching the movie, I think more about disease transmission and all of the ways individuals can contract pathogens from each other, from handrails to sink faucets to airborne particles after sneezing. I did enjoy how Contagion had many realistic ideas and topics. However, I disliked the ending. It was a cliffhanger and I would have enjoyed a few follow up scenes with the World Health Organization investigator and the Chinese village. I would have been curious to see if the investigator revealed to the village that the vaccines were placebos and the village's reaction to the news. See you next Wednesday for more blogging on epidemiology!