Michigan Legislature Aims to Restrict Public Health

Now that Memorial Day has passed in the United States and I've had some time to get over last week's emotion-draining post, it seems like a good time to take a look at what lies ahead. What developments are in the works? Where is public health headed? We can expect the pertussis outbreaks in the U.S. to continue to spread, very likely including more pertussis deaths. We will likely see cases of measles imported from Europe. And we'll see public health officials work hard to prevent and contain outbreaks of disease.

Legislators, on the other hand, may need a bit of prodding.

In Michigan, it appears that the legislature is taking steps to make it harder for health care facilities to protect the health of their patients. A group of 11 republicans and 1 democrat have introduced legislation that aims to dictate to hospitals and other health facilities and agencies what they can and cannot do with regard to ensuring their staff are not a potential source of influenza infection.

In Memoriam - U.S. Pertussis Deaths Through May 2012

Catherina over at Just the Vax gave us all a reminder of the real impact of pertussis, or whooping cough. In that vein, this post is in tribute to those who have lost their lives to pertussis this year. My heart goes out to all of these families. Please go out and get your boosters and learn what to look for.

In Memoriam

Brady Alcaide
Age 2 months
Massachusetts

Name Unknown
Age 2 months
Arizona

Francesca Marie McNally
Age 3 months
Michigan

Ariel Renee Esther Salazar
Age 10 1/2 weeks
New Mexico

Kenadee Elizabeth Wilde
Age 9 weeks
Idaho

Name Unknown
Age 1 month
Texas

Name Unknown
Age 1 month
Wisconsin

It's Just a Cold

The other day I shared a little bit of insight into how my brain works at times. Subject associations lead from one thing to another, and before you know it, what began as a relatively mundane musing has taken on cosmic proportions. I certainly never thought that, waking up with the beginnings of a cold, I would end up writing about how a lack of gravity would affect medical care in space.

At any rate, the common cold has been bounding about my head (both as a topic and somewhat more literally). While I've been fortunate in that I've only really had to deal with a stuffy nose and only a minor cough, some of my coworkers have been less fortunate. Some manner of respiratory illness has been making the rounds, resulting in some of my workmates having been home for a day or two, both before I got my cold, and after. Talking to them, some actually brought up the subject of pertussis, or whooping cough. No one really knew much about it or what the symptoms were, but it's been in the news a bit lately, with a current epidemic in Washington state (1,484 cases reported as of May 12 [PDF], 2012, compared to 965 cases in all of 2011 and 608 for all of 2010), as well as smaller outbreaks in other states like Montana (142 cases), Idaho (31 cases, including 1 death), Iowa (150 cases), Wisconsin (~1,900 cases, including 1 death), Maine (55 cases [PDF]), Florida (112 cases [PDF]) and others.

Washington pertussis cases through May 12, 2012

I figured it might be a good idea, then, to pull some stuff together about the differences between a cold and whooping cough.

Cold Space

The other morning, I awoke with my nose deciding it didn't want to function properly and allow me to breathe through both nostrils. The harbinger of a cold, one nostril was stubbornly blocked with the various accumulations of the night. Lovely image, I know. Personally, I blame the exertion and physical stress (particularly the dunking in cold water and subsequent extreme chills) of the zombie run for this state of affairs. I mean, trudging through wet, muddy trails with hundreds of other people in relatively close proximity, dunking in icy water and waiting (soaked) for the better part of an hour in the breezy cool of a spring afternoon can't be all that good for you. Couple that with staying up late and waking early and voilà. A cold.

I actually have a point for relating this. You see, as I commuted to work and noticed my breathing passages start to open, I mused upon what a cold must be like in space. We take for granted that gravity helps our sinuses and nasal cavities drain. But in space, where there is no (or only a weak) gravitational field, would someone with a stuffy nose find absolutely no relief from natural drainage? How would the lack of gravity affect blowing one's nose? Would it be easier or harder?

As I pondered these questions, my mind began to drift toward bigger issues. I might be stepping on Phil Plait's area a bit, but I hope he won't mind. What about more serious medical care in space?

After the Zombie Apocalypse

This past weekend, I ran the Run for Your Lives zombie 5K obstacle course. The race served a couple purposes for me: 1) it was a good motivation to get back into running on a semi-regular basis and 2) it served as a good hook to raise money for vaccine research. Just to recap, I was raising money for the Vaccine & Immunotherapy Center at Massachusetts General Hospital. Specifically, they have two projects that caught my attention: creating an improved cholera vaccine and developing a laser-based vaccine adjuvant. My goal was to raise $3,000, and toward that end, I issued a challenge that if I hit $2,000 by race day, I'd double my personal donation. I'll come back to this later.

First, the race.

Useful Interactive Map of Worlwide Disease Outbreaks

My news alerts have been populated, lately, with numerous stories about pertussis outbreaks in the U.S. The biggest, currently, appears to be in Washington state, with over 1,100 cases so far this year, compared to a total of 961 cases of pertussis for all of 2011. But Washington isn't the only state seeing outbreaks of pertussis. Most likely due to a combination of lower vaccine uptake rates coupled with teens and adults skipping their pertussis boosters, Wisconsin, Illinois, Iowa, New York, New Jersey and others are all seeing outbreaks of an easily preventable disease. As these news items have cropped up, I began to see a pattern, that what started in California two years ago is making its way eastward. Whether this pattern is real or just an artifact of news reports, I'm not certain, but it did bring to mind a tool that is very helpful in examining progression of outbreaks from year to year.

I thought I had mentioned this in a previous post, but was unable to find it. The Council on Foreign Relations has devised an interactive map of infectious disease outbreaks around the world:

A Brief Note: Post Zombie 5K

The zombie 5K is done. I made it to the end and spent the weekend recovering. Once I've had some time to go through photos and have talked with MGH to find out my total fundraising, I'll put up a more lengthy post about the whole experience.

In the meantime, here's a spoiler:

Guaranteed Autism Prevention! Oh, really?

There's no doubt that autism represents a significant health issue, not just in the U.S., but around the world. Current estimates put the prevalence of autism spectrum disorders (ASD) at around 1 in 88 children. Over the years, awareness of ASDs has increased; tests and diagnostic tools have been developed that can detect ASDs earlier and within a wider range of severities; and diagnostic criteria have shifted, generally leading to more inclusive criteria, meaning that a greater number of less severe cases are diagnosed. For those families dealing with more severe autism, the burden can be incredible, physically, emotionally and financially. Frequent, violent behavior from those more severely affected, as well as bolting or self-injurious behaviors, can wear a person out very quickly. Going out is often difficult, due in part to the needed vigilance and in part because of the lack of understanding from members of the public; families tend to withdraw and become isolated, lacking the emotional support they need day by day. States are beginning to enact legislation that requires insurance companies to cover certain autism treatments, but there is still a long, long way to go to ensure that those who need services get them without undue financial burden and stress. Even with good health coverage, there may be other costs to bear, such as respite care or remodeling of the home space to meet the needs and challenges of autistic family members. (This is not to say that all people with ASDs deal with this level of hardship; there is a broad range, from those requiring professional support to those who are "quirky".)

Thus it should come as no surprise that wanting to prevent autism in the first place would be a godsend. Part of the difficulty, however, lies in the fact that, to date, we know very little about the causes of autism. We know about congenital rubella syndrome, Fragile X and Reyes' Syndrome as causes of ASDs, and current research strongly hints at multiple genetic and prenatal factors that could play some role in ASDs. But without solid understanding of how autism comes about in the first place, there is not a whole lot that we can do to prevent it.

Enter Dr. David Berger of Wholistic Pediatrics in Tampa, FL. Dr. Berger was interviewed by Heather VanNest, an anchor with WTSP 10 News, in an article titled How to prevent autism: 3 ways to lower the risk.

The NECSS of Thought and Reality - Year 2

I attended the fourth annual Northeast Conference on Science and Skepticism, or NECSS, April 21-22. This is a conference that was put together by the New York City Skeptics and New England Skeptical Society, the folks that bring you the weekly Skeptics Guide to the Universe podcast. Since I had such a great time last year, I decided to go again, for my sophomore year of NECSS attendance.

As with last year's account, I think it is good to take a moment to address just what "skepticism" actually involves. In popular reference, it's generally taken to refer to someone who just doesn't believe X, and that's the end of it. There's not really a provisional approach to whatever X is. When it comes to topics that tend to crop up among the skeptical community, such as alternative medicine or UFOs, proponents of those topics sort of sneer when they use the word "skeptic", almost as if it's a pejorative akin to many a four-letter-word. But those who espouse a skeptical approach, whether they self-identify as skeptics or not, view claims based on the evidence available and follow where it leads. Sometimes the evidence changes their minds; sometimes it is insufficient to do so; but always a position is provisional, since you never know what new information will come their way.

With that out of the way, on with the show.

Break My Bank

Just a quick exhortation and reminder to all of my readers regarding my race to raise funds for improved vaccines. This Saturday, I will face the hordes of undead at Run for Your Lives. My goal in running this race is not only to finish (and stay "alive"), but also to raise money for two projects at the Massachusetts General Hospital Vaccine & Immunotherapy Center (VIC): an improved cholera vaccine and development of a novel laser adjuvant for vaccines (which may replace aluminum adjuvants).

I'm adding another carrot to tempt you to give. The folks at MGH have been great in getting me updates as to how much money I've raised. As of this writing, I'm at slightly over $1,000 raised for VIC. If my total hits $2,000 by Saturday, May 5, I will double my own personal donation. If you have not given, please consider doing so. You can find more information on my blog or on this site MGH helped me set up. If you want to skip the discussion about the project and just make a gift, you can go to the actual donation page.

MGH is a registered 501(c)(3), so donations are tax deductible. You might also want to contact your employer to inquire about matching gifts. Most companies will match donations to hospitals above a certain amount (usually $25). Finally, if you happen to live outside the U.S., keep in mind that if successful, this research would have a global impact.

So, make a gift, tell your friends and make me double my own gift.