My longtime readers know that I’m not one to panic when the media does. I wasn’t very worried about anthrax in the mail. I didn’t think swine flu was going to be a big deal. (See link below.) And I’m not concerned about the health effects of airport X-ray back-scatter machines.
But there’s plenty of stuff that worries me. Most of it is scary on time scales longer than the typical media attention span. What scares me is stuff that will hurt us decades from now. For example, I’m very worri...
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California’s Whooping Cough Epidemic
Pertussis or whooping cough is a bacterial respiratory disease marked by a runny nose for a week or two followed by a severe persistent cough. In adults it rarely causes severe illness, and usually resolves even without treatment, but in infants the disease can be life-threatening.
California is currently experiencing a whooping cough epidemic. Over 4,000 cases have been reported this year, the most since 1955. Nine have died, all babies. Three quarters of the patients that required hospita...
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Salmonella Sunny Side Up
This summer a Salmonella outbreak traced to contaminated eggs has sickened over 1,000 people and led to the recall of over 500 million eggs.
Eggs are particularly susceptible to Salmonella contamination. The outsides of egg shells can be contaminated by bacteria if they come into contact with chicken droppings or with dirt. That’s why you should discard cracked or dirty eggs. The shell itself is fairly resistant to bacteria, but if the chicken is infected with Salmonell...
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Time for Flu Shots
Summertime, and the livin’ is uneasy Stocks are slumpin’ Unemployment is high
(with apologies to George Gershwin)
Reminders of the end of summer are upon us. Kids are returning to school. Rain covers are thrown over backyard grills. Flu vaccines are arriving in doctor offices.
This season’s influenza vaccine is here. It contains the flu strains most likely to reach North America this fall includ...Zostavax is Safe, Effective, and Not Free
Varicella zoster virus (VZV) is the virus that causes chicken pox, usually a relatively minor childhood illness. Unlike other viruses that are cleared from our bodies after infection, VZV stays in our sensory nerve cells forever. Over the subsequent decades our immunity to VZV wanes. When our immunity falls too low, VZV can reactivate and cause shingles. Shingles is a painful blistering rash along the distribution of one sensory nerve. The rash resolves in a few weeks, but in some older pat...
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Your Food Is Pretty Safe, But it’s Not Getting Safer
In a world where journalism was free of hype the above headline would have been atop the many stories this week relating to a press release by the CDC about food-borne illness. The numbers are far less sensational than the headlines.
The CDC report reviewed statistics about food-borne illnesses in 2009. Overall there were 17,468 laboratory-confirmed food-borne infections in 2009. What the CDC press release doesn’t mention is that this number has stayed about the same for several years. (It ...
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Twelve Years Later, the Truth about Vaccines and Autism
Ideas have consequences. False ideas, especially popular false ideas, can cause harm. For example, the very popular false idea “corduroy pants and wide lapels are far out, man” made an entire nation ugly for about a decade. And some false ideas do even more harm than that.
In 1998 the British medical journal The Lancet published a paper authored by Dr. Andrew Wakefield that claimed to link autism to the vaccine against measles, mumps and rubella (MMR). The study looked at 12 children (that’...
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A New Treatment for Clostridium difficile
You may not yet have heard of the bacterium Clostridium difficile (C. dif.), but in the next few years it will likely become a household name, as well known as Staph and Strep. C. dif. causes a severe infection of the colon leading to severe diarrhea. It frequently results as a consequence of antibiotic use. Antibiotics can kill the normal intestinal bacteria and allow harmful bacteria like C. dif. to proliferate.
Decades ago, C. dif....
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End of Year Cheer
Short work weeks make for short posts, doubly so when virtually all the health-related news is about the healthcare bill in Congress. So I’ll end the year with two unrelated bits of good news.
The first is that the H1N1 flu pandemic is mostly behind us. The peak numbers of people getting sick both nationally and in California was about two months ago, with decreasing numbers ever since. As predicted by yours truly in April, the world did not end (though a bunch of my patients were plenty mis...
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Lemierre Syndrome: Rethinking Pharyngitis in Young Adults
One of the first outpatient problems a primary care trainee learns to manage is sore throat. The current algorithm is fairly simple. Most sore throats are caused by viruses and will not improve with antibiotics. Symptomatic medication for pain and fever is the best we can offer. But a significant minority of sore throats is caused by a bacterium called group A β-hemolytic streptococcus. These cases are more commonly known as “strep throat”. In strep throat antibiotics shorten the duration ...
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