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Ebola: 2014 Outbreak in West Africa – CRS In Focus (August 8, 2014)

August 20, 2014 Comments off

Ebola: 2014 Outbreak in West Africa – CRS In Focus (PDF)
Source: Congressional Research Service (via U.S. State Department Foreign Press Center)

An ongoing outbreak of Ebola Virus Disease (EVD), the largest, most persistent ever documented, and the first in West Africa, began in March 2014 in Guinea, Sierra Leone, and Liberia (the “affected countries”) and has spread to Nigeria. More people have contracted and died from EVD in this outbreak than in any single prior outbreak. In the current outbreak, the case fatality rate (the estimated percentage of infected persons dying) is about 55%; past outbreak rates have ranged between 41% and 88%.

Prior human EVD outbreaks had occurred in the Democratic Republic of Congo, Gabon, Sudan, and Uganda, primarily in rural and forested areas (Figure 2). The current outbreak is more geographically extensive and cases are emerging in both urban and rural settings. Health experts are accelerating efforts to contain the outbreak, as transmission in densely populated urban areas may be far more difficult to control and lead to higher death tolls. According to the World Health Organization (WHO), from March through August 6, Ebola was known or suspected to have infected 1,779 persons and caused 961 deaths; of these, 1,134 cases had been confirmed in laboratories.

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Prevalence of Coronary Heart Disease or Stroke Among Workers Aged <55 Years — United States, 2008–2012

August 20, 2014 Comments off

Prevalence of Coronary Heart Disease or Stroke Among Workers Aged <55 Years — United States, 2008–2012
Source: Morbidity and Mortality Weekly Report (CDC)

Cardiovascular disease accounts for one in three deaths in the United States each year, and coronary heart disease and stroke account for most of those deaths (1). To try to prevent 1 million heart attacks and strokes by 2017, the U.S. Department of Health and Human Services launched the Million Hearts initiative, promoting proven and effective interventions in communities and clinical settings. In workplace settings, cardiovascular disease can be addressed through a Total Worker Health program, which integrates occupational safety and health protection with health promotion. To identify workers likely to benefit from such a program, CDC analyzed data from the National Health Interview Survey (NHIS) for the period 2008–2012 to estimate the prevalence of a history of coronary heart disease or stroke (CHD/stroke) among adults aged <55 years by selected characteristics, employment status, occupation category, and industry of employment. The results of that analysis showed that 1.9% of employed adults aged <55 years reported a history of CHD/stroke, compared with 2.5% of unemployed adults looking for work, and 6.3% of adults not in the labor force (e.g., unemployed adults who stopped looking for work, homemakers, students, retired persons, and disabled persons). Workers employed in service and blue collar occupations were more likely than those in white collar occupations to report a history of CHD/stroke. Two industry groups also had significantly higher adjusted prevalence ratios (aPRs) for CHD/stroke: Administrative and Support and Waste Management and Remediation Services* and Accommodation and Food Service.† Workers in these occupation and industry groups might especially benefit from a Total Worker Health approach to reducing the risk for CHD/stroke.

Understanding CAM Natural Health Products: Implications of Use Among Cancer Patients and Survivors

August 19, 2014 Comments off

Understanding CAM Natural Health Products: Implications of Use Among Cancer Patients and Survivors
Source: Journal of the Advanced Practitioner in Oncology

Herbs, vitamins, and other natural health products are being used by cancer patients and survivors with increasing prevalence in the United States. These complementary and alternative medicine (CAM) products, which are also referred to as natural health products in Canada and abroad, are used during cancer treatment and the survivorship period to ease the burden of symptoms such as pain, fatigue, insomnia, anxiety, and depression and hence improve overall quality of life. Data indicate that while patients choose these products for self-treatment, they often do not inform their health-care providers, thereby presenting the potential for negative interactions. This article gives an overview of CAM natural health products, including discussion of herbs, vitamins, and other supplements such as minerals, enzymes, and more. Related research is presented, and implications for advanced practitioners are discussed. Insights into guiding safe and effective use among patients as well as appropriate decision-making strategies are explored.

Acupuncture: What You Need To Know

August 18, 2014 Comments off

Acupuncture: What You Need To Know
Source: National Center for Complementary and Alternative Medicine

What’s the Bottom Line?

How much do we know about acupuncture?
There have been extensive studies conducted on acupuncture, especially for back and neck pain, osteoarthritis/knee pain, and headache. However, researchers are only beginning to understand whether acupuncture can be helpful for various health conditions.

What do we know about the effectiveness of acupuncture?
Research suggests that acupuncture can help manage certain pain conditions, but evidence about its value for other health issues is uncertain.

What do we know about the safety of acupuncture?
Acupuncture is generally considered safe when performed by an experienced, well-trained practitioner using sterile needles. Improperly performed acupuncture can cause serious side effects.

Notes from the Field: Hospitalizations for Respiratory Disease Among Unaccompanied Children from Central America — Multiple States, June–July 2014

August 18, 2014 Comments off

Notes from the Field: Hospitalizations for Respiratory Disease Among Unaccompanied Children from Central America — Multiple States, June–July 2014
Source: Morbidity and Mortality Weekly Report (CDC)

During October 2013–June 2014, approximately 54,000 unaccompanied children, mostly from the Central American countries of El Salvador, Guatemala, and Honduras, were identified attempting entry into the United States from Mexico, exceeding numbers reported in previous years (1). Once identified in the United States, U.S. Customs and Border Protection, an agency of the U.S. Department of Homeland Security, processes the unaccompanied children and transfers them to the Office of Refugee Resettlement (ORR), an office of the Administration for Children and Families, U.S. Department of Health and Human Services. ORR cares for the children in shelters until they can be released to a sponsor, typically a parent or relative, who can care for the child while their immigration case is processed. In June 2014, in response to the increased number of unaccompanied children, U.S. Customs and Border Protection expanded operations to accommodate children at a processing center in Nogales, Arizona. ORR, together with the U.S. Department of Defense, opened additional large temporary shelters for the children at Lackland Air Force Base, Texas; U.S. Army Garrison Ft. Sill, Oklahoma; and Naval Base Ventura County, California.

On July 10, 2014, CDC was informed by the California Department of Public Health and ORR about four unaccompanied male children aged 14–16 years with respiratory illnesses at Naval Base Ventura County, three of whom were hospitalized with pneumonia. Among the three patients with pneumonia, two were bacteremic with Streptococcus pneumoniae, ultimately determined to be serotype 5, one of whom also had laboratory-confirmed influenza B virus by polymerase chain reaction (PCR). The fourth patient, without pneumonia, had PCR-confirmed influenza A(H1N1)pdm09. Pneumococcal bacteremia is uncommon among U.S. adolescents, particularly serotype 5, with only three such cases identified in the past 10 years by CDC (2). In addition, influenza activity in the United States is typically lowest in the middle of summer, and Ventura County had no reports of an unusual increase in influenza activity in the community at the time. ORR asked CDC to investigate the scope of this apparent outbreak and implement measures to interrupt transmission.

During July 6–19, 2014, CDC was informed of other clusters of hospitalized children with respiratory disease, increasing the total to 16 cases. The cases were from Naval Base Ventura County (eight cases), Ft. Sill (three), Lackland Air Force Base (two), a standard ORR shelter near Houston, Texas (two), and the Nogales processing center (one). Cases were in persons aged 14–17 years. Diagnoses included laboratory-confirmed pneumococcal pneumonia with laboratory-confirmed influenza (three cases) and without laboratory-confirmed influenza (four cases), influenza pneumonia (one case), and pneumonia with no identified etiology (eight cases). Five patients experienced septic shock requiring intensive care. No case was fatal. All six cases for which pneumococcal isolates were available were identified as serotype 5, a serotype included in 13-valent pneumococcal conjugate vaccine (PCV13) (Prevnar-13, Pfizer). Of the 16 patients identified in this cluster, 11 were tested for influenza viruses; four (36%) were positive (two for influenza A[H1N1]pdm09, one for influenza B, and one for influenza A by rapid test).

Because of the concern that unaccompanied children were at increased risk for influenza and pneumococcal pneumonia in this outbreak setting and the clinically important interaction between influenza and pneumococcal infections (3), CDC recommended that all children residing in temporary or standard ORR shelters receive influenza vaccine and PCV13 in addition to routinely recommended vaccines. Approximately 2,000 children in four affected shelters were vaccinated during July 18–30 with PCV13 and with Food and Drug Administration–approved extended expiration date–specific lots of 2013–14 seasonal influenza vaccine, which includes influenza A(H1N1)pdm09 and influenza B viruses. The shelters reported no serious adverse events.

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP) — United States, 2014–15 Influenza Season

August 15, 2014 Comments off

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP) — United States, 2014–15 Influenza Season
Source: Morbidity and Mortality Weekly Report (CDC)

This report updates the 2013 recommendations by the Advisory Committee on Immunization Practices (ACIP) regarding use of seasonal influenza vaccines (1). Updated information for the 2014–15 influenza season includes 1) antigenic composition of U.S. seasonal influenza vaccines; 2) vaccine dose considerations for children aged 6 months through 8 years; and 3) a preference for the use, when immediately available, of live attenuated influenza vaccine (LAIV) for healthy children aged 2 through 8 years, to be implemented as feasible for the 2014–15 season but not later than the 2015–16 season. Information regarding issues related to influenza vaccination not addressed in this report is available in the 2013 ACIP seasonal influenza recommendations (1).

Fatal injuries and nonfatal occupational injuries and illnesses involving insects, arachnids, and mites

August 14, 2014 Comments off

Fatal injuries and nonfatal occupational injuries and illnesses involving insects, arachnids, and mites
Source: Bureau of Labor Statistics

Although not often associated with injuries and deaths at the workplace, insects, arachnids, and mites were involved in 83 fatal occupational injuries from 2003 to 2010. The majority of these workplace deaths were due to bee stings. Annual nonfatal work-related injury and illness case counts involving insects, arachnids, and mites that led to days away from work ranged from 4,930 to 6,870 between 2008 and 2010. Most of these nonfatal cases were due to stings or bites, some venomous and some nonvenomous.

This issue of Beyond the Numbers article examines fatal and nonfatal workplace injuries and illnesses related to insects, arachnids, and mites using data from two Bureau of Labor Statistics (BLS) sources: the Census of Fatal Occupational Injuries (CFOI) and the Survey of Occupational Injuries and Illnesses (SOII). CFOI data used here are from 2003 to 2010 and aggregated to support extended analysis. SOII data are from 2008 to 2010. BLS began publishing national SOII estimates for state and local government in 2008, so that period was chosen to keep the coverage of CFOI and SOII data in this study as comparable as possible. For this article, the term “insects” refers to the entire category, for short.

See also: Workplace Safety & Health Topics – Insects and Scorpions (CDC)

Review of the Formaldehyde Assessment in the National Toxicology Program 12th Report on Carcinogens

August 13, 2014 Comments off

Review of the Formaldehyde Assessment in the National Toxicology Program 12th Report on Carcinogens
Source: National Research Council

Many people in the United States are exposed to formaldehyde. Exposure can occur from environmental sources (for example, combustion processes, building materials, and tobacco smoke) or in occupational settings (for example, the furniture, textile, and construction industries). Formaldehyde exposure also has endogenous sources–it is produced intracellularly as a component of the one carbon pool intermediary metabolism pathway. Scientists have studied formaldehyde for decades to determine whether exogenous formaldehyde exposure may be associated with cancer in humans. In 1981, The National Toxicology Program (NTP) first listed formaldehyde in the 2nd Report on Carcinogens as “reasonably anticipated to be a human carcinogen”. In 2011, NTP upgraded the listing of formaldehyde to “known to be a human carcinogen”. Following the new listing, Congress directed the Department of Health and Human Services to arrange for the National Academy of Sciences to independently review formaldehyde’s substance profile and listing. This report presents the findings and conclusions of the committee formed in response to the congressional request.

Review of the Formaldehyde Assessment in the National Toxicology Program 12th Report on Carcinogens concurs with NTP that there is sufficient evidence in studies that had adequate characterization of relevant exposure metrics to enable a strong conclusion about the association between formaldehyde exposure and cancer in humans. Additionally, the authoring committee independently reviewed the scientific evidence from studies in humans, experimental animals, and other studies relevant to the mechanisms of carcinogenesis and made level-of-evidence conclusions. This report finds clear and convincing epidemiologic evidence of an association between formaldehyde exposure and nasopharyngeal and sinonasal cancers in humans.

CRS Insights — Safe at Home? Letting Ebola-Stricken Americans Return (August 5, 2014)

August 13, 2014 Comments off

CRS Insights — Safe at Home? Letting Ebola-Stricken Americans Return (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

In early August 2014 two American healthcare workers who contracted Ebola virus infections while working to stem an outbreak in West Africa returned to the United States to continue receiving medical care here. Ebola infection is highly deadly and there is no approved specific treatment. Although the patients were to be transported and cared for under strict isolation protocols, some have voiced concern about Ebola infection being brought to the United States for the first time intentionally.

Ebola infection is one of several communicable diseases for which aliens are generally barred from entry into the United States. Although U.S. citizens are entitled to certain constitutional protections related to the right to travel and reenter the United States, these rights may be balanced against the government’s interest in preventing the spread of a dangerous communicable disease. In any event, U.S. practice has been to isolate and/or quarantine arriving U.S. citizens who have been infected with or exposed to a dangerous communicable disease, rather than barring their entry into the country outright (though circumstances could conceivably arise where this practice would be altered).

WHO Statement on the Meeting of the International Health Regulations Emergency Committee Regarding the 2014 Ebola Outbreak in West Africa

August 12, 2014 Comments off

WHO Statement on the Meeting of the International Health Regulations Emergency Committee Regarding the 2014 Ebola Outbreak in West Africa
Source: World Health Organization

The current EVD outbreak began in Guinea in December 2013. This outbreak now involves transmission in Guinea, Liberia, Nigeria, and Sierra Leone. As of 4 August 2014, countries have reported 1 711 cases (1 070 confirmed, 436 probable, 205 suspect), including 932 deaths. This is currently the largest EVD outbreak ever recorded. In response to the outbreak, a number of unaffected countries have made a range of travel related advice or recommendations.

In light of States Parties’ presentations and subsequent Committee discussions, several challenges were noted for the affected countries:

  • their health systems are fragile with significant deficits in human, financial and material resources, resulting in compromised ability to mount an adequate Ebola outbreak control response;
  • inexperience in dealing with Ebola outbreaks; misperceptions of the disease, including how the disease is transmitted, are common and continue to be a major challenge in some communities;
  • high mobility of populations and several instances of cross-border movement of travellers with infection;
    several generations of transmission have occurred in the three capital cities of Conakry (Guinea); Monrovia (Liberia); and Freetown (Sierra Leone); and
  • a high number of infections have been identified among health-care workers, highlighting inadequate infection control practices in many facilities.

See: More on Ebola virus disease

Elections Matter 2014

August 12, 2014 Comments off

Elections Matter 2014
Source: Bread for the World Institute
From website:

The elections in 2014 (congressional) and 2016 (congressional and presidential) are vitally important to Bread for the World.

Bread wants to help end hunger by 2030, and to do that, it needs to help build the political will to make hunger a national priority by 2017.

Starting with this year’s elections, Bread hopes it can get a Congress and new president who are behind these goals.

This summer and fall, during the campaigns leading up to the 2014 mid-term congressional elections, Bread is asking its members all over the country to engage all candidates on hunger and poverty issues.

Prevalence of Amyotrophic Lateral Sclerosis — United States, 2010–2011

August 11, 2014 Comments off

Prevalence of Amyotrophic Lateral Sclerosis — United States, 2010–2011
Source: Morbidity and Mortality Weekly Report (CDC)

Problem/Condition:
Amyotrophic lateral sclerosis (ALS), commonly known as Lou Gehrig’s disease, is a progressive and fatal neuromuscular disease for which no cure has been identified. Although ALS has no known definitive cause, familial ALS (a hereditary form) occurs in 5%–10% of cases. Many hypotheses have been formulated about what causes ALS, including chemical exposures, occupational exposure, military service, infectious agents, nutritional intake, physical activity, and trauma. Worldwide, ALS affects white males aged >60 years more often than any other group. In the United States, ALS surveillance is necessary to estimate the incidence and prevalence of ALS and collect data on risk factors. ALS is not a nationally notifiable condition in the United States (i.e., it is not a reportable condition in all jurisdictions), and individual state reporting requirements differ, with Massachusetts being the only state that mandates reporting.
Period Covered: October 19, 2010–December 31, 2011.

Description of System:
In 2009, the federal Agency for Toxic Substances and Disease Registry (ATSDR) implemented the National ALS Registry to collect and analyze data regarding persons with ALS in the United States. The main goals of the Registry, as defined by the 2008 ALS Registry Act, are to describe the incidence and prevalence of ALS better, examine risk factors such as environmental and occupational exposures, and characterize the demographics of those living with ALS. The Registry uses a two-pronged approach to identify all cases of ALS. The first approach uses four existing national administrative databases (maintained by Medicare, Medicaid, the Veterans Health Administration, and the Veterans Benefits Administration) to identify prevalence of ALS. The second approach uses a secure web portal (http://www.cdc.gov/als) that was launched to the public on October 19, 2010, to identify cases not included in the four national administrative databases and to collect risk-factor data on known ALS cases. ALS patients who have registered via the web portal can complete brief risk-factor surveys online that are intended to attain a better understanding of ALS (e.g., genetics and environmental and occupational exposures) and help determine disease progression.

Results:
During October 19, 2010–December 31, 2011, a total of 12,187 persons meeting the surveillance case definition of definite ALS were identified by the Registry, for a prevalence of 3.9 cases of ALS per 100,000 persons in the U.S. general population. Incidence cannot be measured because the date of diagnosis was not noted in all patient records. Overall, ALS was more common among white males, non-Hispanics, and persons aged 60–69 years. The age groups with the lowest number of persons with ALS were age 18–39 years and age >80 years. Males had a higher prevalence rate of ALS than females overall and across all data sources.

Interpretation:
This is the first (and to date the only) effort to estimate the national prevalence of ALS in the United States. Using the combined approach of the national databases and the web-based portal enables researchers to estimate ALS prevalence more accurately. Registry findings for the prevalence of ALS are consistent with findings from long-established ALS registries in Europe and from smaller-scale epidemiologic studies conducted previously in the United States. Although incidence cannot be measured with Registry data at this time, incidence is being measured in smaller geographic areas that have participated in ATSDR’s State and Metropolitan Area ALS surveillance projects.

Workplace Stress in the United States: Issues and Policies

August 11, 2014 Comments off

Workplace Stress in the United States: Issues and Policies
Source: OECD

Despite relative affluence, workplace stress is a prominent feature of the US labour market. To the extent that job stress causes poor health outcomes – either directly through increased blood pressure, fatigue, muscle pain, etc. or indirectly through increased rates of cigarette smoking – policy to lessen job stress may be appropriate. Focusing predominantly on the United States, this report reviews the literature on a variety of economic concerns related to job stress and health. Areas in which economists may provide valuable insights regarding job stress include empirical selection concerns in identifying the effect of stress on health; measurement error with respect to stress; the existence and magnitude of compensating differentials for stress; and the unique “job lock” effect in the United States created by a system of employer-provided health insurance. This report concludes with a brief discussion of US policies related to job stress.

FDA takes steps to help ensure the reliability of certain diagnostic tests

August 4, 2014 Comments off

FDA takes steps to help ensure the reliability of certain diagnostic tests
Source: U.S. Food and Drug Administration

Today, the U.S. Food and Drug Administration took important steps to ensure that certain tests used by health care professionals to help diagnose and treat patients provide accurate, consistent and reliable results.

First, the FDA is issuing a final guidance on the development, review and approval or clearance of companion diagnostics, which are tests used to identify patients who will benefit from or be harmed by treatment with a certain drug. Companion diagnostic tests are intended to aid physicians in selecting appropriate therapies for individual patients. These tests are commonly used to detect certain types of gene-based cancers.

Second, consistent with the requirements of the Food and Drug Administration Safety and Innovation Act of 2012 (FDASIA), the agency is notifying Congress of its intention to publish a proposed risk-based oversight framework for laboratory developed tests (LDTs), which are designed, manufactured and used within a single laboratory. They include some genetic tests and tests that are used by health care professionals to guide medical treatment for their patients. The FDA already oversees direct-to-consumer tests regardless of whether they are LDTs or traditional diagnostics.

Notes from the Field: Outbreak of Pertussis in a School and Religious Community Averse to Health Care and Vaccinations — Columbia County, Florida, 2013

August 3, 2014 Comments off

Notes from the Field: Outbreak of Pertussis in a School and Religious Community Averse to Health Care and Vaccinations — Columbia County, Florida, 2013
Source: Morbidity and Mortality Weekly Report (CDC)

On August 30, 2013, the Florida Department of Health in Columbia County was notified of a Bordetella pertussis laboratory-positive unimmunized child attending a local charter school (316 students from pre-K through 8th grade) in a large religious community averse to health care and vaccinations. Kindergarten immunization records showed that only five (15%) of 34 students were fully immunized with pertussis-antigen–containing vaccines. In seventh grade, only one (5%) of 22 students was fully immunized with pertussis-antigen–containing vaccines. Of the children who were not fully immunized in these two grades, 84% had religious exemptions (1).

Interviews confirmed that a sibling of the patient had symptoms consistent with pertussis. By September 3, two additional children from the same school were confirmed by polymerase chain reaction to have pertussis. On September 12, the Florida Department of Health in Columbia County declared a communicable disease emergency; children with cough illness were excluded from school, and reentry required an evaluation by a health care provider. After this declaration, 38 additional students were excluded. Prophylaxis or treatment with antibiotics following current guidelines were provided to patients and household contacts (2). The local health department offered to provide these services free of charge to persons without health care coverage. Pertussis vaccine administered at the health department was available; however, fewer than five persons from the community used this opportunity for vaccination.

Impact of Time of Presentation on Process Performance and Outcomes in ST-Segment–Elevation Myocardial Infarction

August 1, 2014 Comments off

Impact of Time of Presentation on Process Performance and Outcomes in ST-Segment–Elevation Myocardial Infarction
Source: Circulation: Cardiovascular Quality and Outcomes

Background—
Prior studies demonstrated that patients with ST-segment–elevation myocardial infarction presenting during off-hours (weeknights, weekends, and holidays) have slower reperfusion times. Recent nationwide initiatives have emphasized 24/7 quality care in ST-segment–elevation myocardial infarction. It remains unclear whether patients presenting off-hours versus on-hours receive similar quality care in contemporary practice.

Methods and Results—
Using Acute Coronary Treatment and Intervention Outcomes Network-Get With The Guidelines (ACTION-GWTG) database, we examined ST-segment–elevation myocardial infarction performance measures in patients presenting off-hours (n=27 270) versus on-hours (n=15 972; January 2007 to September 2010) at 447 US centers. Key quality measures assessed were aspirin use within first 24 hours, door-to-balloon time, door-to-ECG time, and door-to-needle time. In-hospital risk-adjusted all-cause mortality was calculated. Baseline demographic and clinical characteristics were similar. Aspirin use within 24 hours approached 99% in both groups. Among patients undergoing primary percutaneous coronary intervention (n=41 979; 97.1%), median door-to-balloon times were 56 versus 72 minutes (P<0.0001) for on-hours versus off-hours. The proportion of patients achieving door-to-balloon time ≤90 minutes was 87.8% versus 79.2% (P<0.0001), respectively. There were no differences attaining door-to-ECG time ≤10 minutes (73.4% versus 74.3%, P=0.09) and door-to-needle time ≤30 minutes (62.3% versus 58.7%; P=0.44) between on-hours versus off-hours. Although in-hospital all-cause mortality was similar (4.2%) in both groups, the risk-adjusted all-cause mortality was higher for patients presenting off-hours (odds ratio, 1.13; 95% confidence interval, 1.02–1.26).

Conclusions—
In contemporary community practice, achievement of quality performance measures in patients presenting with ST-segment–elevation myocardial infarction was high, regardless of time of presentation. Door-to-balloon time was, however, slightly delayed (by an average of 16 minutes), and risk-adjusted in-hospital mortality was 13% higher in patients presenting off-hours.

See: Time of arrival at hospital impacts time to treatment and survival of heart attack patients (EurekAlert!)
Hat tip: PW

CDC — Outbreak of Ebola in Guinea, Liberia, and Sierra Leone

July 31, 2014 Comments off

Outbreak of Ebola in Guinea, Liberia, and Sierra Leone
Source: Centers for Disease Control and Prevention

Highlights

  • July 23, 2014, the Guinea Ministry of Health announced a total of 427 suspect and confirmed cases of Ebola virus disease (EVD), including 319 fatal cases.
  • Affected districts include Conakry, Guéckédou, Macenta, Kissidougou, Dabola, Djingaraye, Télimélé, Boffa, Kouroussa, Dubreka, Fria, and Siguiri; several are no longer active areas of EVD transmission (see map).
  • 311 cases across Guinea have been confirmed by laboratory testing to be positive for Ebola virus infection.
  • In Guinea’s capital city, Conakry, 73 suspect cases have been reported to meet the clinical definition for EVD, including 37 fatal cases.
  • July 23, 2014, the Ministry of Health and Sanitation of Sierra Leone and WHO reported a cumulative total of 525 suspect and confirmed cases, including 419 laboratory confirmations and 224 reported fatal cases.
  • Cases have been reported from 6 Sierra Leone districts: Kailahun, Kambia, Port Loko, Kenema, Bo, and Western.
  • July 23, 2014, the Ministry of Health and Social Welfare of Liberia and WHO have reported 249 suspect and confirmed EHF cases (including 84 laboratory confirmations) and 129 reported fatalities.
  • Genetic analysis of the virus indicates that it is closely related (97% identical) to variants of Ebola virus (species Zaire ebolavirus) identified earlier in the Democratic
  • Republic of the Congo and Gabon (Baize et al. 2014External Web Site Icon).
  • The Guinean Ministry of Health, the Ministry of Health and Sanitation of Sierra Leone, and the Ministry of Health and Social Welfare of Liberia are working with national and international partners to investigate and respond to the outbreak.

The Surgeon General’s Call to Action to Prevent Skin Cancer

July 31, 2014 Comments off

The Surgeon General’s Call to Action to Prevent Skin Cancer
Source: Surgeon General of the United States
From Executive Summary:

The Surgeon General’s Call to Action to Prevent Skin Cancer calls on partners in prevention from various sectors across the nation to address skin cancer as a major public health problem. Federal, state, tribal, local, and territorial governments; members of the business, health care, and education sectors; community, nonprofit, and faith-based organizations; and individuals and families are all essential partners in this effort. The goal of this document is to increase awareness of skin cancer and to call for actions to reduce its risk. The Call to Action presents the following five strategic goals to support skin cancer prevention in the United States: increase opportunities for sun protection in outdoor settings; provide individuals with the information they need to make informed, healthy choices about ultraviolet (UV) radiation exposure; promote policies that advance the national goal of preventing skin cancer; reduce harms from indoor tanning; and strengthen research, surveillance, monitoring, and evaluation related to skin cancer prevention.

Body Mass Index, Sex, and Cardiovascular Disease Risk Factors Among Hispanic/Latino Adults: Hispanic Community Health Study/Study of Latinos

July 30, 2014 Comments off

Body Mass Index, Sex, and Cardiovascular Disease Risk Factors Among Hispanic/Latino Adults: Hispanic Community Health Study/Study of Latinos
Source: Journal of the American Heart Association

Background
All major Hispanic/Latino groups in the United States have a high prevalence of obesity, which is often severe. Little is known about cardiovascular disease (CVD) risk factors among those at very high levels of body mass index (BMI).

Methods and Results
Among US Hispanic men (N=6547) and women (N=9797), we described gradients across the range of BMI and age in CVD risk factors including hypertension, serum lipids, diabetes, and C‐reactive protein. Sex differences in CVD risk factor prevalences were determined at each level of BMI, after adjustment for age and other demographic and socioeconomic variables. Among those with class II or III obesity (BMI ≥35 kg/m2, 18% women and 12% men), prevalences of hypertension, diabetes, low high‐density lipoprotein cholesterol level, and high C‐reactive protein level approached or exceeded 40% during the fourth decade of life. While women had a higher prevalence of class III obesity (BMI ≥40 kg/m2) than did men (7% and 4%, respectively), within this highest BMI category there was a >50% greater relative prevalence of diabetes, hypertension, and hyperlipidemia in men versus women, while sex differences in prevalence of these CVD risk factors were ≈20% or less at other BMI levels.

Conclusions
Elevated BMI is common in Hispanic/Latino adults and is associated with a considerable excess of CVD risk factors. At the highest BMI levels, CVD risk factors often emerge in the earliest decades of adulthood and they affect men more often than women.

NIH-commissioned Census Bureau report highlights effect of aging boomers

July 28, 2014 Comments off

NIH-commissioned Census Bureau report highlights effect of aging boomers
Source: National Institutes of Health/U.S. Census Bureau

While rates of smoking and excessive drinking have declined among older Americans, prevalence of chronic disease has risen, and many older Americans are unprepared to afford the costs of long-term care in a nursing home, according to a report from the U.S. Census Bureau commissioned by the National Institutes of Health.

The report highlights those trends and others among America’s older population, now over 40 million and expected to more than double by mid-century, growing to 83.7 million people and one-fifth of the U.S. population by 2050. Population trends and other national data about people 65 and older are presented in the report, 65+ in the United States: 2010 (PDF, 12.0M). It documents aging as quite varied in terms of how long people live, how well they age, their financial and educational status, their medical and long-term care and housing costs, where they live and with whom, and other factors important for aging and health.

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