Vaccinations

September 26, 2019

While it’s still warm and sunny, saunter in for that annual flu shot

The weather may be sunny and temperate, the seasonal foliage a slowly changing delight to behold. But the savvy are prepping for sterner days ahead. It’s that time of year when doctors and public health officials urge us all to get that annual flu shot.

It’s never easy to forecast the severity with which influenza will sweep the country. But early indications — including a child’s death already attributed to the illness — suggest this may be a bad year for the bug.

Don’t downplay the harms of this all-too-common sickness: The federal Centers for Disease Control and Prevention estimates that there were as many as 43 million flu illnesses in this nation in the 2018-19 season, with more than 20 million cases serious enough to cause patients to seek medical care. The CDC says there were as many as 647,000 hospitalizations and up to 61,200 flu-related deaths. That toll included more than 100 children killed by flu.

September 6, 2019

Europe is seeing a ‘dramatic resurgence’ of measles, and the U.S. may not be far behind

by Patrick A. Malone

A key feature of great civilizations is that they strive to prevent outbreaks of deadly contagious diseases. So it’s more than worrisome that measles is making what the World Health Organization calls a “dramatic resurgence” in Europe.

Measles, an entirely preventable disease, has in a single year doubled the number of its cases in four European nations, including Great Britain, in the first half of 2019: 90,000 cases versus 44,000 in 2018. Measles has come back with such force that the countries no longer may be considered as having eliminated the infection.

This is a continental meance, too, as the New York Times reported:

August 22, 2019

Do health care’s perverse incentives lure MDs into deliberate misdiagnosis for profit?

by Patrick A. Malone

When doctors become medical outliers, shouldn’t hospitals, colleagues, insurers, and the rest of us ask how and why an individual practitioner diverges so much from the way others provide care?

Olga Khazan details for the Atlantic magazine the disturbing charges involving Yasser Awaad, a pediatric neurologist at a hospital in Dearborn, Mich. As she describes him, for a decade he racked up hundreds of cases in which he is accused by patients of “intentionally misreading their EEGs and misdiagnosing them with epilepsy in childhood, all to increase his pay.” Khazan says his case “shines a light on the grim world of health-care fraud—specifically, the growing number of doctors who are accused of performing unnecessary procedures, sometimes for their own personal gain.”

In the malpractice cases that are unfolding against him, Awaad’s pay has become a central issue, with evidence showing his hospital contract rewarded him for boosting the number of screenings he ordered and diagnoses he made. Jurors have been told that Awaad, whose salary increased from 1997 to 2007 from $185,000 annually to $300,000, “turned that EEG machine into an ATM.” He earned bonuses exceeding $200,000, if he hit billing targets.

August 21, 2019

Glimmers of hope in new therapies to battle killer Ebola and lethal TB strain

by Patrick A. Malone

Rare good news on destructive infections is emerging from Africa: Medical scientists, Good Samaritans, and public health officials are hailing the successes of powerful new therapies in treating a deadly and extremely drug-resistant strain of tuberculosis and Ebola, a killer viral hemorrhagic fever that spreads like wildfire.

Americans may skip over dispatches about these “foreign” news developments. They would be wise not to do so, because they have heightened importance these days, domestically, including in providing key lessons to be learned about how to safeguard the public health.

The TB care that is winning great attention overseas requires patients to take three drugs in a regimen in which they take five pills a day for six months. That already is a boon compared with other, now common therapies in which they might need 40 pills a day for as long as two years, or daily antibiotics shots with bad side effects like deafness, kidney failure, and psychosis.

June 28, 2019

‘Grass-roots’ vaccination foes funded by wealthy few

by Patrick A. Malone

With children in tow and emotions cranked to the max, parents from coast to coast have protested officials’ efforts to protect the public’s health by requiring children to be immunized against contagious and infectious diseases that can cause great harm. A cornerstone of the vaccination resistance has been its proponents push to portray themselves as a grass-roots movement of independent individuals fighting medical overreach by the state.

But the Washington Post, as part of its coverage of the nation’s most severe outbreak of measles in three decades (more than 1,000 cases with just half the year over), reported that Bernard Selz, a philanthropic Manhattan hedge fund manager, and his wife, Lisa, have given more than $3 million to groups that oppose vaccination. This has allowed individuals associated with the groups to organize vaccination opponents, giving them leaders to coalesce around and an out-sized voice in public controversies over kids and shots.

Selz money has gone to Andrew Wakefield, a British doctor who brought professional disgrace on himself and who had his medical license in his home country stripped over falsehoods he spread through a since-retracted article in a medical journal purporting to link vaccine shots to autism — a claim not only unsupported but debunked repeatedly by rigorous, published, follow-on research.

May 19, 2019

Terps draw new fire for staying mostly mum about a fatal viral outbreak

by Patrick A. Malone

Just as the nation grapples with the worst measles outbreak in a quarter century, the University of Maryland and public health officials are drawing fire for the way they handled the strange confluence of mold infections in dorms and the spread of an contagious virus among students on the College Park campus.

The university and its advisers tried to keep a lid on public information about the dual problems, leading students and parents to assail the school and to blame its sluggish response and silence for the death of an immune-compromised coed.

Her death late last year — following the fall heat-stroke fatality involving Jordan McNair, a 19-year-old football player — has renewed concerns that the university and its staff may lack the expertise, training, and sensitivity to protect vulnerable young people, the Washington Post reported as part of its investigation of the confused health scenario involving Olivia Shea Paregol.

April 29, 2019

Measles outbreaks increase, with cases hitting highest level since 2000

by Patrick A. Malone

Almost two decades after public health officials declared them eradicated from this nation’s children, measles infections have returned with a vengeance to the United States, rising to the highest level in almost two decades, with hundreds of cases in almost two dozen states, and the incidences climbing still.

The outbreaks have been concentrated in New York, in Brooklyn in a religious community, and in Washington state. But authorities have taken aggressive steps, including quarantine orders for hundreds of students and staff on two big college campuses across town from each other (UCLA and Cal State, LA), to ensure that the disease is contained and does not spread in Los Angeles.

Alex Azar, who heads the federal Health and Human Services Department, said in a statement about the familiar infection: “Measles is not a harmless childhood illness, but a highly contagious, potentially life-threatening disease. We have the ability to safely protect our children and our communities. Vaccines are a safe, highly effective public health solution that can prevent this disease. The measles vaccines are among the most extensively studied medical products we have, and their safety has been firmly established over many years in some of the largest vaccine studies ever undertaken.”

April 9, 2019

Concern rises about vaccination exemptions, as infectious diseases spread

by Patrick A. Malone

As outbreaks of preventable infectious diseases rise to concerning levels, doctors, regulators, and lawmakers may need to toughen important laws requiring youngsters to be inoculated, protecting better our collective health and closing off legal loopholes for sketchy vaccination exemptions.

It would be ideal if more than a century of lifesaving experience and decades of rigorous scientific research were sufficient to persuade parents to get their children vaccinated against an array of harmful and dangerous infections. But grownups’ hesitancy or rejection of shots, out of unfounded personal belief or due to medical disinformation, has set in and spread. This has undercut local, national, and global campaigns to rid humanity of contagions like measles. Public information campaigns and evidence-based persuasion hasn’t worked as well as experts might hope, leading officials to pass vaccination laws.

But those protective measures have been eroded by the exploitation by a few, so far, of well-intentioned exemptions, reporters for the independent, nonpartisan Kaiser Health News reported.

March 26, 2019

In battle for science and against anti-vacciners, experts reckon with social media’s sway

by Patrick A. Malone

As doctors and public health officials coast-to-coast battle infectious outbreaks — of measles, mumps, meningitis, whooping cough, influenza, as well as typhus, hepatitis, and TB — the nation is also struggling with the right response for yet another contagion: the viral spread of medical misinformation on social media.

Medical nonsense isn’t new, and savvy patient-consumers long have needed to do a little work to protect themselves from what can be its real and significant harms. But a season of rapidly spreading and 100% preventable infectious diseases has forced modern medicine to confront generational dilemmas with health disinformation that is “shared” widely online and especially via social media.

For the rising generation that now parents youngsters who need and should be vaccinated, social media sites like Facebook, YouTube, and Instagram, as well as information searches via Google have become as ordinary and accepted as once were daily newspapers and the 6 o’clock TV news. But cyber world’s ubiquity also has allowed counter factual, unfounded, nonscientific, and extreme notions to proliferate, as users of all kinds “create content” online. This has fueled the dangerous normalizing and further rise of the anti-vaccination or anti-vaxxer movement.

March 21, 2019

Rise in ‘medieval’ ills and other infections should send a big health warning

by Patrick A. Malone

Americans have battled for at least a decade over the role of government in individuals’ health, specifically through health insurance. But communities across the county may be grappling with the baleful and more direct consequences of society’s ignoring others’ well-being, as a public health crisis erupts over the re-emergence and spread of “medieval diseases.”

Say what you’d like about the vanity and superficiality of Tinsel Town. But it’s no matter for mockery that Los Angeles municipal employees are deathly afraid of and have been infected in the heart of the city’s busy downtown by typhus, a bacterial infection that brings high fever, stomach pain, and chills. It can be treated with antibiotics.

But its outbreak—168 cases since January 2018, including one staffer at Los Angeles City Hall—speaks to significant problems that cities especially are battling with infections borne by vermin, notably rats and the fleas that they carry, as well as lice.