By Bette Begleiter and Mazvita Nyamukapa, Maternity Care Coalition
Many of us have suffered through the flu without tragic consequences. But it is important to remember that the virus can have catastrophic complications that can result in death - especially among vulnerable populations such as pregnant women, babies, young children, the elderly, immune-compromised individuals and those with respiratory, cardiac or neurological conditions. Since 1976, flu related deaths in the U.S. have ranged between 3,000- 49,000 depending on the type of flu that is common during a particular flu season (Flu Deaths).
Pregnant women are a particularly vulnerable population due to physiological changes that occur during pregnancy. For example, immune-suppression leaves women vulnerable to the flu and its complications. Cardiovascular and respiratory changes may also increase a pregnant woman’s susceptibility to flu.
Flu shots for pregnant women, which are safe to receive during pregnancy, not only reduce the risk of complications in the woman but also for the unborn child; antibodies the mother produces in response to the vaccine can be passed on to the child after birth and before six months when babies are too young to receive the flu vaccine. This also means that any other caregivers that babies come in contact with need to be vaccinated to ensure that they are not exposed to the flu virus.
Last week, the International Society for Traumatic Stress Studies had its annual meeting in Philadelphia. I was there, and discussions abound about “Criterion A.” Contrary to what its name might suggest, Criterion A is not a vitamin, nor is it a short-course bicycle race. Criterion A defines the types of experiences that are considered traumatic enough to cause post-traumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM). Criterion A has long been a point of contention, in part because it has significant bearing on who receives a PTSD diagnosis and is eligible for evidence-based treatments covered by insurance.
There are special rules when it comes to PTSD. As opposed to most other disorders in the DSM, for which diagnoses are based on symptoms alone, PTSD requires that a person be exposed to a “potentially traumatic event” and then develop specific symptoms. Criterion A defines what counts as: 1) a potentially traumatic event, and 2) a level of exposure sufficient to cause PTSD. Last May, Criterion A was changed with along with other modifications to the PTSD diagnosis in the new DSM 5.
What are considered potentially traumatic events in the DSM 5? A potentially traumatic event is one that involves “death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence.” As with the previous version of the DSM(4), a serious car accident is considered a potentially traumatic event, getting laid off, while highly stressful, is not. The definition of a potentially traumatic event in the DSM 5 is quite similar to that in the DSM 4, but differs in that sexual violence is explicitly named instead of being lumped together with other threats to “physical integrity.” This change can be interpreted as a small milestone in breaking the silence about sexual violence and its consequences. Depending upon the circumstances of the event, 30%-80% of sexual assault survivors develop PTSD—a rape takes place about every six minutes in the United States.
Janet Golden, professor of history at Rutgers University-Camden
The devastation in the Philippines following Typhoon Haiyan is enormous. Over 10,000 are dead. Survivors are without water, food, and shelter. Disease outbreaks have begun. International relief efforts are hampered by continuing storms and by devastating conditions. UNICEF estimates that up to 4 million children may be affected by this disaster. UNICEF along with governments and charities around the world have begun relief efforts to which you can donate. We all need to step up and help.
As we pause to consider the enormous destruction and horrific loss of life overseas we are reminded that we need to prepare for such events closer to home. It was just about a year ago that Superstorm Sandy hit our shores. We remember the damage and loss of life following Hurricane Katrina a few years ago. And this is not the first time we have watched from afar disasters overseas. We recall the Haitian earthquake that took 85,000 lives and the 2004 tsunami deaths that took nearly 230,000 lives and displaced nearly 1.5 million.
On November 1, President Obama signed an Executive Order “Preparing the United States for the Impacts of Climate Change,” following the recommendation of the Intragency Climate Change Adaptation Task Force. Federal, state, and local governments must be prepared for disasters and severe weather emergencies and they need plans that can be implemented quickly and knowledgably.
Janet Golden and Michael Yudell
The outbreak of polio in the Syrian Arab Republic announced by the World Health Organization a few weeks ago is a troubling reminder that global conflicts threaten the public’s health. Violence, like the 2-1/2-year-old civil war in Syria, can lead to significant disruption and/or long term damage to the public health infrastructure, including basic sanitation efforts, maintenance of a safe water supply, basic nutritional needs, and disease monitoring and prevention.
Because of the Global Polio Eradication Initiative, this latest outbreak is especially troubling. But it should not be surprising. The displacement of so many Syrians fleeing the fighting has devastated the county’s once robust public health infrastructure and stymied immunization efforts. Syria had been polio-free for a decade. Ten polio cases, with many more likely to be reported, are now confirmed.
Polio, technically known as poliomyelitis, is a viral disease that can lead to full or partial paralysis, and sometimes death. The United States experienced periodic local polio epidemics until the development of the Salk and Sabin vaccines, introduced in 1955 and 1963 respectively. Before the vaccines were introduced, tens of thousands of Americans contracted the virus, which could leave them either partially or completely paralyzed. Dr. Jonah Salk’s birthday, Oct. 24, is now celebrated as World Polio Day.
Gerald Markowitz and David Rosner, authors of “Lead Wars: The Politics of Science and the Fate of America’s Children”
For much of the 20th century, America was plagued by a terrible lead poisoning epidemic that sent children into comas, convulsions, and even death. Lead paint covered the walls of homes throughout the nation, especially in the old, industrial cities, and poisoned hundreds of thousands of children. Philadelphia, it turns out, was the birthplace of a revolution in thinking about the impact of lead on children’s development.
In the 1960s, as Civil Rights organizations, community groups and political activists turned the country’s attention to poverty, lead poisoning became a symbol of the terrible price that children paid for absentee landlords who crowded families into poorly maintained and crumbling tenements.
But as health departments began assessing and addressing the worst conditions, they uncovered ever-more troubling facts. Huge numbers of children had blood lead levels above 40 micrograms per deciliter (µg/dL), then the amount that was considered dangerous in children, but did not show overt clinical symptoms.(Today, blood-lead levels above 5 µg/dL are considered the “reference level” above which the Centers for Disease Control and Prevention recommends action be taken.)
Just when you thought our food supply was safe again.
In the wake of the government shutdown that suspended many of the essential protective services of the Food and Drug Administration and the U.S. Department of Agriculture (we wrote about this a few weeks back), an FDA report – released, appropriately, on Mischief Night – finds that the spices we season our foods with can be tainted with pathogens and filth.
A spicy meal, anyone?
“Tempeh Whiz wit'!” “Vegan cheesesteak!’’ Will these words soon be part of the cacophony of sizzling onion and clanking steel that echoes between Pat’s and Geno’s? Probably not, but recent activity in Philadelphia’s City Council indicates that this may not be as far off as you might imagine.
Well, OK, it's pretty far off. But it has reached the highest levels of government. Earlier this month, the City Council of Philadelphia unanimously approved a resolution in support of “Meatless Mondays.” The resolution, which is completely symbolic and includes no regulatory measures or spending, encourages residents and businesses across the City to curb carnivorous consumption on the first day of the work week. Simply put, the resolution is an attempt to raise awareness about healthy diet—a good thing from a public health perspective.
Councilman Bill Green (D-at large) was quoted in a press release from The Humane League stating: “I am happy to bring attention to this important issue. We can combat the epidemic of obesity, improve long-term health outcomes and potentially reduce the impact of livestock on global warming though this one, simple effort. And we can make our moms happy by eating our veggies and trying new things – a win-win-win!”
Teagan Keating, an MPH student at Drexel University
With a squeeze of lemon and a dash of hot sauce, raw oysters are a winter delicacy. Unfortunately, a recent letter in the New England Journal of Medicine warns, strains of Vibrio parahaemolyticus are contaminating some of them harvested from parts of the Atlantic Ocean.
What is Vibrio parahaemolyticus?
Vibrio is a group of bacteria that cause a variety of digestive issues. Other types of Vibrio cause severe illnesses such as cholera or blood infection. The bacteria noted in the letter, Vibrio parahaemolyticus, causes comparatively milder symptoms: diarrhea, vomiting, abdominal cramping, nausea, fever, and chills. Oysters and other shellfish become contaminated because V. parahaemolyticus naturally occurs in the waters where they live. These shellfish are the usual cause of the illness. Vibriosis can be especially dangerous for people with weakened immune systems but is rarely fatal for healthy people. The symptoms usually go away on their own within three days. (People taking antacids are more susceptible because stomach acid can help destroy bacteria, and antacids weaken the stomach acid.) The Centers for Disease Control and Prevention estimates there are around 4,500 cases of vibriosis caused by the species parahaemolyticus each year.