Dr. Buttery's Public Health BLOG

UCSD — In an effort to curb the rising rates of HIV and sexually transmitted infections (STIs) along the Mexico-US border, a binational team of researchers led by the University of California, San Diego School of Medicine have shown that brief but personalized behavioral counseling significantly reduced rates and improved condom use among female sex workers in Tijuana and Ciudad Juarez, Mexico. The researchers observed a 40 percent decline in the combined rate of new STIs (including HIV, syphilis, gonorrhea and Chlamydia) in the group of female sex workers who received the 30-minute one-on-one counseling intervention.

Posted by at 11:34 AM | Permalink | Comments (0)

A wonderful example of how to confuse people. .Food and Drug Administration (FDA) has approved six influenza vaccines intended to target strains that "are likely to cause flu in the United States" during the 2008-09 season. Agency officials explained that every year, the "vaccines are modified to reflect the virus strains most likely to be circulating," and the "closer the match between the circulating strains and the strains in the vaccines, the better the protection." Last year's flu vaccine didn't match two of three main types of flu that sickened people. Still, the "vaccination remains the cornerstone of preventing influenza. Comment: The problem is that the flu virus mutates so rapidly, and dispersion is so simple (with air travel) that it is very difficult to predict what strain will be dominant in the US each fall. It still takes so long to identify and prepare a new targeted vaccine that we will have to wait for improved technology before a real annual match tor currently circulating strains can be developed..

Posted by at 9:39 AM | Permalink | Comments (2)

In a paper published in the Journal of the American Medical Association this week the authors recommend that "immigrants to the U.S. from Africa and Southeast Asia should be tested and treated for tuberculosis (TB) before they arrive, to prevent importing the disease. For example "screening immigrants and refugees from the Philippines and Vietnam would have detected almost half the average 250 TB cases brought into the U.S. each year from 2001 to 2006. The authors found that "over 50 percent of all cases of TB among foreign-born persons occurred among 20 percent of the overall foreign-born populations, especially persons born...in Southeast Asia [particularly the Philippines and Vietnam] and sub-Saharan Africa."
[JAMA. 2008;300(4):405-412.]

Posted by at 10:30 AM | Permalink | Comments (0)

The problems of antibiotic resistant bacteria including Methycillin resistant Staph, C.Difficile and Multiple drug resistant TB are discussed in this week's journal "Science". The medical professison has been telling patients and peers that too many antibiotics are used. In many countries they are used without much, if any, oversight. Because of the poor return on investment few pharmaceutical companies are willing to invest in necessary research. Law suits do not help. Governments, as usual, are day late and a penny short. This issue (July 18) and its main topic are so important any who have in interest in public health and infectious dseases should read the articles. The problems of an unlikely flu pandemic pale into comparison beside the damage already being done by antibiotic resistance. This is a much more important topic both in the US and wordwide than a possible flu pandemic.

Posted by at 6:22 PM | Permalink | Comments (0)

Another Editorial in today’s Lancet quotes Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases (NIAID), said that the number of new HIV infections per year in the USA was closer to 50 000 than 40 000. Fauci does not talk about diagnoses but new infections. He says that 52 000 is a new number that will soon become an official statistic. the figure shows that US efforts to prevent HIV have failed dismally. The CDC must not fail US citizens further by delaying the release of the data behind this fact.

Posted by at 10:55 AM | Permalink | Comments (0)

In the New York Times's (6/9) City Room blog, Sewell Chan wrote that "[m]ore than one-fourth of adult New Yorkers -- 26 percent, compared to the national average of 19 percent -- are infected with herpes simplex virus 2, the virus that causes genital herpes," according to a study published this month in the journal Sexually Transmitted Diseases. City health officials are "concerned about the prevalence of the condition because it facilitates the spread of HIV, and can also be transmitted to newborns, though such cases are rare."
Comment: The NYC Dept of PH has a strong STD program which may well being finding more STDs than the average community. STDs of all types have always been under-reported. One more reason for using “Safe Sex Practices.”

Posted by at 9:41 AM | Permalink | Comments (1)

More than 90% of patients with sinusitis-like symptoms are managed entirely in family practice without recourse to further investigations apart from point-of-care testing such as for C-reactive protein, which is commonly used in Scandinavia and some other European countries. As with many other common infections, sinusitis is challenging for clinicians because many patients expect antibiotic treatment and associate the drug with recovery. At the same time, evidence mounts that antibiotics confer little average benefit. However, a possible benefit in subgroups has not been ruled out. This article from today's Lancet may not be applicable to the US because too few patients have family doctors and are more likely to expect antibiotic use than in the UK. (Volume 371, Issue 9616, 15 March 2008-21 March 2008, Pages 874-876 )

Posted by at 11:03 AM | Permalink | Comments (0)

In this week's Lancet The authors say: "Our findings confirm the high incidence of rotavirus gastroenteritis during the first two years of life and, hence, a need for long-term protection induced by rotavirus vaccination. The human rotavirus vaccine RIX4414 showed high and sustained efficacy against severe rotavirus gastroenteritis and admission for rotavirus gastroenteritis." They conclude: "Our study findings show that, if integrated into routine infant immunization schedules, vaccination with RIX4414 could result in significant reduction not only of rotavirus disease burden but also of severe paediatric gastroenteritis during the first two years of life."

Posted by at 10:40 AM | Permalink | Comments (1)

People with sexually transmitted infections are putting themselves at risk by buying treatments over the internet, according to new research by the University of East Anglia. Owing to the stigma associated with sexually transmitted infections, patients may prefer to hide their illness, and choose instead to try out internet remedies in the privacy of their own homes. However, such remedies may prove hazardous if the sellers do not provide detailed advice on adverse effects, or on avoiding transmission and re-infection. If sexual partners are not treated at the same time, the treatment is bound to fail because the patient will be infected again and again. Patients can become unable to have children if gonorrhea and chlamydia are not properly treated. The researchers also found that almost half of the products were claimed to be effective, but there was actually very little solid evidence from the vendors to back this up. Rember what PT Barnum said about 'suckers'

Posted by at 10:36 AM | Permalink | Comments (0)

“In Sub-Saharan Africa, Malaria kills at least 800,000 children under the age of five each year,” said UNICEF Executive Director Ann M. Veneman. “Controlling malaria is vital to improving child health and economic development in affected countries. Studies show that malaria disproportionately affects the poorest people in these countries, and so contributes to their further impoverishment.” There has been a rapid increase in the supply of insecticide-treated nets, with annual production of nets more than doubling from 30 to 63 million. Another large increase in production is expected by the end of 2007.

Posted by at 11:12 AM | Permalink | Comments (0)

Nearly 230 Idaho residents have been sickened by a waterborne parasite this year, along with hundreds of others across the Rocky Mountain West, health officials said. An AP report states the cryptosporidium outbreak has reached record numbers, Idaho Department of Health and Welfare spokesman Tom Shanahan said, and has federal officials looking at the role water parks and public pools play in spreading the diarrhea-causing parasite. Health officials believe splash parks and other recreational water parks can offer the hardy parasite the opportunity to rapidly spread from person to person.

Posted by at 11:51 AM | Permalink | Comments (0)