revere | October 11, 2009The Reveres finally knew the blog had become an established site on the internet when we started getting regular publicity emails from commercial sites and people with products they thought "our readers would be especially interested in." We get quite a few, now, and we almost never yield. Almost. But this particular product seemed like it might interest our you, so we're putting the commercial up. It runs on Edward Current, which is direct:
revere | October 10, 2009When swine flu poked its head above water in the northern hemisphere in April our "normal" flu season was just ending. A surge of swine flu cases during a time when influenza was not usually seen was bewildering and confusing, not to mention alarming. We didn't know what to expect nor were we sure if it would peter out over the summer, as flu usually seems to (we may learn differently in the future as we start to do surveillance over that period) and then come roaring back or just disappear. While it didn't peter out very much, the big question was going to happen when the northern…
revere | October 9, 2009Skeptical, but Hope Springs Eternal.
The heaviest of the heavy-hitter science journals in the US is Science Magazine, a publication of the American Association for the Advancement of Science (AAAS). It publishes in all aspects of science. Its main competitor is the venerable Nature magazine in the UK. I subscribe to both. They come every week. Since I am overwhelmed by work and scientific papers in general and have a journal of my own to edit (full disclosure), these weekly news and science sources more likely than not pile up unread. But because I subscribe I can easily get the latest hot…
revere | October 8, 2009A Catholic hospital system in Arkansas seems to have come up with an innovative solution to encouraging health care workers be vaccinated while allowing them the autonomy to make their own decision. When we last brought up this question one of our commenters said he'd like to see a button on health care workers that said, "I'm not vaccinated." St. Vincent hospital system seems to have figured out a way to do this while still protecting both the worker and the patient. The idea is surprisingly simple:
Given the choice between face masks or the seasonal flu vaccine, nearly all 3,200 employees…
revere | October 7, 2009This is the internet. Like the newspaper, you shouldn't automatically believe everything you read on it, and when it comes to some of the more outlandish stuff, most people don't. But there are a lot of sites that appear quite legitimate, and maybe for some of the material on them they are fine, but sometimes mixed in is some real dangerous stuff. One genre we know is influential and a major source of information is what is sometimes called a "Mommy Blog," blogs or websites that cater to the insatiable hunger for reliable information of newly pregnant women or new moms. We wouldn't have…
revere | October 6, 2009Vaccines is a topic I don't like writing about so much for many reasons. Vaccination programs are important to public health but we (all the Reveres, including this one) have always interested either in basic science or programs that are applied to the whole population at once, such as clean water, air or food or safe products in the marketplace. But vaccines keep coming up so we talk about them. Since this blog has spent a lot of time on flu, most of it has related to influenza vaccine, but not always. This is a "not always" post, and it is partially about the latest news that US Army and…
revere | October 5, 2009In an earlier post I said I opposed mandatory vaccination for adults (but not for children), the one exception being for health care workers because they come in contact with people at high risk. My view then was that if you work in a health care institution and won't get vaccinated against flu, then you shouldn't come to work. Now I am re-evaluating my position as a result of some cogent and pragmatic comments from lawyer-bioethicist George Annas, professor of health law, bioethics and human rights at Boston University School of Public Health, and author of "The Rights of Patients." I know…
revere | October 4, 2009This is about a paper published Friday. The post is long because the paper provides practical advice on a problem of importance, the issue of school closures. The advice is based on data and could be implemented at the level of a school district or even a single school without requiring a lot of money or effort. It's not cost free, but could probably be done with existing personnel and resources. The fact that it would be grounded in empirical evidence makes a decision to keep a school open or to close it much easier to defend. It would not be arbitrary or a guess. Improvements in the…
revere | October 4, 2009When life is hard, you need to get a grip on it:
Bonus: Watch Bill Maher interview a Senator. This man is not an idiot Republican. He's an idiot Democrat. The video isn't embeddable but you can watch it here.
revere | October 3, 2009As Mrs. R. remarked, it's American ingenuity at work. Or something. She was referring to the winner of the 2009 Public Health IgNobel Award. For those of you who don't know about the IgNobel Prizes given each year in a variety of categories for scientific or engineering achievements (as documented in scientific journal articles or patent applications) that "make people laugh, and then make them think." There is a well-attended public ceremony each year at Harvard's Sanders Theater and the 2009 version was two nights ago. There are lots of winners each year, often for achievements from some…
revere | October 2, 2009I should be writing a substantive blog post, but I'm dead tired after 14 hours spent listening to very stimulating science presented by talented grad students, post-docs and residents at a large medical center, after which they were in turn subjected to an invited lecture from me, a lecture I've been obsessing over for a month. I'm thousands of miles from home and I miss Mrs. R. and if I'm lucky I'll soon be at 30,000 feet over some western Canadian prairie and homeward bound.
See you soon, sweetheart. Keep a light on for me.
revere | October 1, 2009A couple of days ago Dr. Marion Koopmans, chief of virology in the infectious diseases laboratory of the National Institute of Public Health, The Netherlands, notified the infectious disease community through the website/email list ProMed that two of their swine flu isolates showed a particular genetic change in one of the virus's eight genetic segments. Even though this virus has been described as relatively stable genetically, individual viruses, even within the same patient, often have small differences in the thousands of letters that make up their genetic code. Influenza A virus is a…
revere | September 30, 2009For the first time in medical history we may be seeing an influenza pandemic unfold in real time, but that doesn't mean we know what we are seeing. There remains some uncertainty about virulence, both in terms of how often it kills and how it kills when it does kill. You'd think both would be easy to determine, but those who have been following along know the problem of how often infection with this virus kills is made almost impossible by not knowing how many people it is infecting. But what about the question of how it kills? There are mainly three scenarios of interest: primary viral…
revere | September 29, 2009Hand gel sanitizers are making an appearance all over our medical center. There's one right next to the elevator on the ground floor of the building where my office is and don't have to touch a thing. Just put your hand under it and it dispenses a cool alcohol-based gel that sanitizers my hands and dries very quickly. Alcohol does that. And other things:
Alcohol hand gel meant to combat swine flu has been banned from a prison after inmates started eating it and became embroiled in a drunken brawl.
Inmates have been drinking the liquid soap placed on their wing after realising it contained…
revere | September 28, 2009A good story by the AP's Lauran Neergaard yesterday highlighted the need for better public health surveillance and the efforts being made to improve it so as to keep track of possible rare side effects from the swine flu vaccine. This is an issue we've talked about a lot here, most recently in the context of not being able to fully test any vaccine for rare adverse outcomes prior to deployment. There's more involved than that, but first here's Neergaard's lede:
The U.S. government is starting an unprecedented system to track possible side effects as mass swine flu vaccinations begin next…
revere | September 27, 2009We don't do vaccines so much here, so I missed it last Sunday (Sept. 20) when it was posted over at JustTheVax, but there's an excellent summary of this year's swine flu vaccine offerings by Science Mom. It's hard to keep track of all this stuff so this is really valuable, and I know many readers here are interested. Thanks to Science Mom.
revere | September 27, 2009Flu season has started in earnest, even though it's not "officially" flu season until week 40 (first week in October this year). How do we know it's flu season if we don't test everyone and can't count flu? We use a surveillance system. The flu surveillance system has lots of moving parts and five or six components (or as many as nine, depending on how you count). None of them tell us exactly what we want and putting the different pieces together can sometimes be like the blind men and the elephant. But the system does work better than you'd think and it's undergoing modifications and…
revere | September 26, 2009I'm afraid I have to complain about crappy journalism again. AlterNet is an online newsmagazine I quite like. We've been linked by them numerous times and know their influence. Sometimes, though, some very smart writers write some very dumb things, even if they do it in a smart way. Alas, Joshua Holland has done it today on the front page of Alternet.org with a supremely wrongheaded story about why you don't have to be scared shitless about swine flu. We agree with that bottom line, but how he got there is the problem (that and the fact that he doesn't understand much about influenza).
Let's…
revere | September 25, 2009There's hopeful news about the possibility of an effective HIV/AIDS vaccine and a weird story from Canada about "preliminary results" saying that you are more at risk from swine flu if you get the seasonal flu vaccine. With flu, anything is possible, but that is more than a little counterintuitive and strikes me as unlikely. Nowhere else has reported a similar experience. Since we don't know the methods or the data or the limitations or much of anything else that could allow us to consider how much to weigh this as evidence I won't say any more about it.
While we do write about vaccines here…