Medicine and Health
sschoenbaum | July 9, 2010In this post I want to address disease control opportunities for EIS officers, many of which are detailed in "Inside the Outbreaks: One of the first things we learned about on joining the EIS was John Snow's determination that an outbreak of cholera in London was attributable to contamination of the water from the Broad St. pump and his stopping the epidemic by removing the pump handle. On reading "Inside the Outbreaks" one is struck with the number of EIS officers whose efforts have removed pump handles....
The efforts of Jeff Koplan, subsequently director of CDC, and Mark Rosenberg,…
sb admin | July 7, 2010Karen Starko writes: Several basic questions related to Reye's syndrome (RS) have come to me from readers of Mark's book, Inside the Outbreaks. These show the importance of continued education on health issues. (For example, some physicians thought that fever was essential to getting RS). Again, thanks to Mark Pendergrast for a wonderful addition to our public health knowledge.
Is an influenza or chickenpox infection necessary to acquire RS?
The answer is no. RS generally has two phases: the antecedent illness and usually, within a few days of this, the syndrome of vomiting and…
sb admin | July 6, 2010Liz Borkowski writes: I wrote last week about how federal agencies can solve the problems that create conditions for disease outbreaks - or fail to solve them, as is too often the case. This week, I wanted to focus on the role Congress plays in public health agencies' effectiveness, because that's another angle that crops up repeatedly in Inside the Outbreaks.
Congress's creation of federal agencies is clearly a huge achievement, and they've also periodically given new powers to already existing agencies. For instance, Mark Pendergrast tells the story of the Dalkon Shield, an IUD that turned…
sb admin | July 2, 2010Steve Schoenbaum writes: In his blog this week, Mark Pendergrast challenges someone/anyone to take on explaining the differences between case-control studies vs. cohort studies. As an EIS officer, back in late May/early June 1968, I did a case-control study as part of the investigation of a common source outbreak of hepatitis in Ogemaw County, Michigan, so I will try to pick up the challenge. I believe it was only the second time case-control methods were used in a CDC epidemic investigation. In using this method I learned about the power of comparison, not just that numerators need…
sschoenbaum | July 2, 2010Steve Schoenbaum writes: In his blog this week, Mark Pendergrast challenges someone/anyone to take on explaining the differences between case-control studies vs. cohort studies. As an EIS officer, back in late May/early June 1968, I did a case-control study as part of the investigation of a common source outbreak of hepatitis in Ogemaw County, Michigan, so I will try to pick up the challenge. I believe it was only the second time case-control methods were used in a CDC epidemic investigation. In using this method I learned about the power of comparison, not just that numerators need…
sb admin | June 30, 2010Karen Starko writes: When the "financial crisis" started and the news media started throwing around numbers in the trillions and projected fixes in the billions, I realized I just didn't get it. So I got a little yellow post-it, labeled it "understanding trillions," and started a list of examples. And when I learned that the US GDP in 2006 was 13T and the derivative market, estimated in June 2007, was valued at 500T, I quickly got a sense of the potential drain of the derivative market (in which money is spent on items without real value...my definition, please correct me if I am wrong). I…
sb admin | June 29, 2010Liz Borkowski writes: Mark Pendergrast wrote yesterday about how politics plays into the work of the EIS, and it's something that I kept noticing as I read Inside the Outbreaks. As he points out, my post last week highlighted the solution to the Reye's Syndrome puzzle - which was solved by Karen Starko, who's also one of the Book Club bloggers! - but didn't get into the larger issue: there can be a big difference between solving the puzzle and solving the problem. In yesterday's post, Mark writes:
Although Karen's and subsequent CDC studies clearly demonstrated that giving children aspirin…
sschoenbaum | June 24, 2010Steve Schoenbaum writes: "Inside the Outbreaks", Mark Pendergrast's wonderful history of the Centers for Disease Control's Epidemic Intelligence Service (EIS), can be read on many levels. I confess that as a former EIS officer (1967-1969), personally familiar with most of the "elite medical detectives" of the first few decades, I tended to read it "between the lines". I found myself recalling many personal incidents, interactions with others, and themes mentioned but not necessarily fully developed in the book. I'd like to consider a couple of those here:
Early on in "Inside the Outbreaks…