CDC Reports Salmonella Reading Outbreak: Urges Food Preparation Precautions

MedicalResearch.com Interview with:
wash-hands-well . CDC wellAaron E. Glatt, MD, FACP, FIDSA, FSHEA

Chairman, Department of Medicine & Hospital Epidemiologist
South Nassau Communities Hospital
Clinical Professor of Medicine
Icahn School of Medicine at Mount Sinai
Oceanside, NY 11572 

MedicalResearch.com: What is the background for the CDC alert regarding a multistate outbreak of multidrug-resistant Salmonella Reading infections linked to raw turkey products?   Is this Salmonella strain different or more dangerous than other Salmonella food poisoning outbreaks? 

Response: The CDC has reported that as of yesterday, there have been 90 people infected with Salmonella Reading from 26 states. No deaths have been reported, but 40 patients to date required hospitalization. There was a previous outbreak of S. Reading in 2016 related to contaminated alfalfa sprouts, but this organism is not that much different nor is it more virulent than many other salmonella strains.  Continue reading

Antibiotics Still Overprescribed in Many Outpatient Settings

MedicalResearch.com Interview with:

Dr. Katherine Fleming-Dutra, MD, senior author Deputy Director Office of Antibiotic Stewardship CDC

Dr. Fleming-Dutra

Dr. Katherine Fleming-Dutra MD
Deputy Director
Office of Antibiotic Stewardship
CDC

MedicalResearch.com: What is the background for this study?

Response: Antibiotics are life-saving medications that treat bacterial infections. Any time antibiotics are used, they can lead to antibiotic resistance and could cause side effects such as rashes and adverse events, such as Clostridium difficile infection, which is a very serious and sometimes even fatal diarrheal disease. This is why it is so important to only use antibiotics when they are needed. When antibiotics aren’t needed, they won’t help you and the side effects could still hurt you.

A previous study* reported at least 30% of antibiotic prescriptions written in doctor’s offices and emergency departments were unnecessary. However, the data from that study did not include urgent care centers or retail health clinics. We conducted the current analysis to examine antibiotic prescribing patterns in urgent care centers, retail health clinics, emergency departments, and medical offices.

*Fleming-Dutra, K., et al. (2016). “Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011.” JAMA: the Journal of the American Medical Association 315(17): 1864-1873. https://jamanetwork.com/journals/jama/fullarticle/2518263

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CDC’s Change in HIV Policy Impacted Providers’ Role in Prevention

MedicalResearch.com Interview with:

Rogério M. Pinto, LCSW, Ph.D. Associate Professor Associate Dean for Research School of Social Work University of Michigan Ann Arbor, USA

Dr. Pinto

Rogério M. Pinto, LCSW, Ph.D.
Associate Professor
Associate Dean for Research
School of Social Work
University of Michigan
Ann Arbor, Michigan

MedicalResearch.com: What is the background for this study?

Response: This research, published in Health Education & Behavior (https://doi.org/10.1177/1090198118760681),highlights the crucial role of providers of social and public health services in helping patients to access lifesaving HIV services. Before 2012, providers were encouraged and trained to link patients to behavioral interventions to help patients modify their behaviors to protect themselves against HIV transmission and infection. A shift in policy from targeting anyone at risk to those at highest risk (called “High Impact Prevention”) made these interventions less available (they were actually discontinued) and new policy dictated that providers should have as many people as possible access HIV testing and link them to HIV primary care in order to receive antiretroviral medication.

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Fewer US Children Taking Prescription Medications

MedicalResearch.com Interview with:

Craig M. Hales, MD, MPH, MS CDR, U.S. Public Health Service Division of Health and Nutrition Examination Surveys National Center for Health Statistics Centers for Disease Control and Prevention

Dr. Hales

Craig M. Hales, MD, MPH, MS
CDR, U.S. Public Health Service
Division of Health and Nutrition Examination Surveys
National Center for Health Statistics
Centers for Disease Control and Prevention

MedicalResearch.com: What is the background for this study?

Response: Monitoring trends in prescription medication use among children and adolescents is an important part of understanding the health of youth in the U.S. and the healthcare they receive.

For this study we used data from the National Health and Nutrition Examination Survey or NHANES, which is a nationally representative survey of the US population and as part of this face-to-face survey in the home, we ask participants about their prescription medication use in the last 30 days and collect information about the prescription directly from the medication package.

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Falls in Older Adults Cost US Over $50 Billion Dollars Annually

MedicalResearch.com Interview with:

Curtis Florence, PhD Division of Analysis, Research and Practice Integration  CDC’s Injury Center

Dr. Florence

Curtis Florence, PhD
Division of Analysis, Research and Practice Integration
CDC’s Injury Center

MedicalResearch.com: What is the background for this study?

Response: The estimates in this study provide a more robust indicator of the economic impact falls have on the U.S. economy.  Previous studies focused on Medicare spending. This study includes Medicare, Medicaid and out-of-pocket spending.

MedicalResearch.com: What are the main findings? 

Response: Our study found that older adult (65 years and over) falls impose a large economic burden on the U.S. healthcare system. In 2015, with a total medical cost $50 billion for non-fatal and fatal falls.  About three-quarters of the total cost was paid by government-funded programs.  Medicare paid nearly $29 billion for non-fatal falls, Medicaid $8.7 billion, and $12 billion was paid for by Private/Out-of-pocket expenses.  For fatal falls, $754 million was spent in 2015.

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Obesity Increased in Adults But Not Youth in Last Ten Years

MedicalResearch.com Interview with:
Craig M. Hales, MD Cheryl D. Fryar, MSPH; Margaret D. Carroll, MSPH; David S. Freedman, PhD; Cynthia L. Ogden, PhD

National Center for Health Statistics
National Center for Chronic Disease Prevention and Health Promotion
US Centers for Disease Control and Prevention
Atlanta, Georgia

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In this analysis we examined recent trends in the prevalence of obesity and severe obesity among both youth and adults, by sex and age group.

Among adults, obesity and severe obesity prevalence has increased over the last 10 years.  Obesity prevalence increased from 33.7% in 2007-2008 to 39.6% or almost 40% in 2015-2016, and severe obesity increased from 5.7% in 2007-2008 to 7.7% in 2015-2016.  We see this same pattern of increasing prevalence of obesity and severe obesity in both men and women, and in different age groups.

On the other hand, among youth, we saw no increasing or decreasing trends in obesity or severe obesity prevalence over the 10 year period.  And this was true for both boys and girls and for different age groups.

Measured height and weight is the gold standard for generating accurate estimates of obesity prevalence.  The National Health and Nutrition Examination Survey is unique in that it combines both interviews in the home and physical examinations in mobile examination centers, and it is the only national survey where people’s height and weight are physically measured.  This is why NHANES is such an important source of data for understanding trends in obesity in youth and adults. 

Citations: 

Hales CM, Fryar CD, Carroll MD, Freedman DS, Ogden CL. Trends in Obesity and Severe Obesity Prevalence in US Youth and Adults by Sex and Age, 2007-2008 to 2015-2016. JAMA. Published online March 23, 2018. doi:10.1001/jama.2018.3060

 

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Frequent Exertion and Frequent Standing at Work Varies By Industry and Occupation Group

MedicalResearch.com Interview with:
Taylor M. Shockey, MPH

Title 42 Fellow
Division of Surveillance, Hazard Evaluations and Field Studies
NIOSH

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Research has linked repeated exposure to occupational ergonomic hazards, such as frequent exertion and frequent standing, to injuries and musculoskeletal disorders (MSDs) among workers.

To determine the industry and occupation groups that have the highest prevalence rates of frequent exertion at work and frequent standing at work, NIOSH researchers analyzed 2015 National Health Interview Survey data. The results showed large differences among the groups with the agriculture, forestry, fishing, and hunting industry group having the highest prevalence of frequent exertion and standing at work (70.9%) and the construction and extraction occupation group having the highest prevalence of frequent exertion and standing at work (76.9%). These differences indicate a need for targeted interventions to reduce workplace exposure.

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Prevalence of Severe Obesity Drops for First Time Among All Age, Sex and Race/Ethnic Groups

MedicalResearch.com Interview with:
Liping Pan, MD, MPH
Epidemiologist,
Epidemiology & Surveillance Team
Obesity Prevention and Control Branch
Division of Nutrition, Physical Activity and Obesity
National Center for Chronic Disease Prevention & Health Promotion
CDC 

MedicalResearch.com: What is the background for this study?

Response: Children with severe obesity face significant health and social challenges. Children with obesity and severe obesity are at higher risk for having other chronic health conditions and diseases, such as asthma, sleep apnea, bone and joint problems, and type 2 diabetes. They also have more risk factors for heart disease like high blood pressure, impaired glucose tolerance, and high cholesterol than their normal weight peers.

These lifelong health risks associated with severe obesity during early childhood indicate the importance of preventing and identifying severe obesity. Childhood obesity disproportionately affects children living in low-income families. However, no recent trends on severe obesity in this population have been reported.
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Breast Cancer Survival Remains Lower For Black Women

MedicalResearch.com Interview with:
“Family Weekend 2014-Breast Cancer Walk” by Nazareth College is licensed under CC BY 2.0
Dr. Jacqueline Miller, MD
Division of Cancer Prevention and Control
CDC 

MedicalResearch.com: What efforts have proven successful in reducing racial disparities like these?

Response: While some racial disparities will exist due to differences in tumor types, improving early diagnosis and providing specific treatment based on tumor characteristics in a timely fashion would result in reducing breast cancer disparities.

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Disparities in Ovarian Cancer Survival in the United States

MedicalResearch.com Interview with:

The Centers for Disease Control and Prevention CDC image

Site of Ovarian Cancer CDC image

Dr. Sherri Stewart, PhD
Division of Cancer Prevention and Control
CDC

MedicalResearch.com: What do women most need to know about ovarian cancer detection and treatment?

Response: There is no effective test to detect ovarian cancer at an early stage where treatment is most likely to be effective.  Many women mistakenly believe that the Pap test can detect ovarian cancer, but it does not. The Pap test is recommended only for the detection of cervical cancer.

 Recognizing early symptoms of ovarian cancer and seeking timely care may help lead to detection of the cancer at an earlier stage, where treatment is likely to be more effective.  Symptoms – such  as abdominal and back pain, feeling full quickly after eating, and frequent urination – are often present among women with ovarian cancer.  Women should talk with their doctors if they experience any of these symptoms for 2 weeks or longer and the symptoms persist or worsen.

If a woman is diagnosed with ovarian cancer, she should seek treatment from a gynecologic oncologist, a physician specially trained to treat ovarian cancer.  Ovarian cancer patients who have been treated by gynecologic oncologists have been shown to survive longer than those treated by other physicians.           Continue reading

Black Men and Women Continue To Have Lower Colon Cancer Survival Rates

MedicalResearch.com Interview with:

“Large Colon Cancer Arising in Adenoma” by Ed Uthman is licensed under CC BY 2.0

“Large Colon Cancer Arising in Adenoma” by Ed Uthman

Dr. Arica White PhD MPH
Division of Cancer Prevention and Control
CDC

MedicalResearch.com: What is the likelihood of reaching the 80% CRC screening rate goal by next year?

Response: As of 2016, 67% of adults age 50-75 years reported being up-to-date with colorectal cancer screening. The 80% by 2018 initiative represented an aspirational goal that public health, non-profit, and community-based organizations will continue to strive for regardless of the outcome in 2018.

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Vast Majority of Adults Do Not Consume Enough Fruit and Vegetables

MedicalResearch.com Interview with:

Seung Hee Lee-Kwan, PhD Epidemiologist, Division of Nutrition, Physical Activity, and Obesity Centers for Disease Control and Prevention (CDC).

Dr. Seung Hee Lee-Kwan

Seung Hee Lee-Kwan, PhD
Epidemiologist, Division of Nutrition, Physical Activity, and Obesity
Centers for Disease Control and Prevention (CDC).

Seung Hee Lee-Kwan has a PhD in International Health at Johns Hopkins Bloomberg School of Public Health. Her previous work focused community-based interventions that aimed to promote healthy eating. Dr. Lee-Kwan’s current work at CDC is on fruits and vegetable surveillance, and research of health behaviors and environmental factors associated with obesity.

 

MedicalResearch.com: What is the background for this study?

Response: The purpose of the study was to update a 2013 report that estimated how many people in each state are meeting fruit and vegetable intake recommendations with the latest data from 2015. These estimates looked at the percent of adults meeting the intake recommendations by age, sex, race/ethnicity, and income-to-poverty ratio for the 50 states and District of Columbia (DC).

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CDC Study Finds Lyme Disease Remains a Public Health Challenge

MedicalResearch.com Interview with:

This 2007 photograph depicts the pathognomonic erythematous rash in the pattern of a “bull’s-eye”, which manifested at the site of a tick bite on this Maryland woman’s posterior right upper arm, who’d subsequently contracted Lyme disease. Lyme disease patients who are diagnosed early, and receive proper antibiotic treatment, usually recover rapidly and completely. A key component of early diagnosis is recognition of the characteristic Lyme disease rash called erythema migrans. This rash often manifests itself in a “bull's-eye” appearance, and is observed in about 80% of Lyme disease patients. Lyme disease is caused by the bacterium Borrelia burgdorferi, and is transmitted to humans by the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, and as illustrated here, the characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. Note that there are a number of PHIL images related to this disease and its vectors.

This 2007 photograph depicts the pathognomonic erythematous rash in the pattern of a “bull’s-eye”, which manifested at the site of a tick bite on this Maryland woman’s posterior right upper arm, who’d subsequently contracted Lyme disease.
Lyme disease patients who are diagnosed early, and receive proper antibiotic treatment, usually recover rapidly and completely. A key component of early diagnosis is recognition of the characteristic Lyme disease rash called erythema migrans. This rash often manifests itself in a “bull’s-eye” appearance, and is observed in about 80% of Lyme disease patients.
Lyme disease is caused by the bacterium Borrelia burgdorferi, and is transmitted to humans by the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, and as illustrated here, the characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. From CDC image library

Kiersten Kugeler, PhD
Division of Vector-Borne Diseases
CDC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Lyme disease has been a nationally notifiable disease in the United States since 1991. Each year, possible cases of Lyme disease are investigated and tallied by state and local public health officials according to criteria set by the surveillance case definition. States voluntarily share human case data with CDC, which summarizes the data to provide a national perspective on disease trends.

This report summarizes national Lyme disease data reported during 2008-2015. Lyme disease continues to be the most commonly reported vector-borne disease in the United States with more than 275,000 cases of Lyme disease reported to CDC during the study period. Although most cases continue to be reported from states with high incidence in the Northeast, mid-Atlantic, and upper Midwest regions, case counts in most of these states have remained stable or decreased during this time. In contrast, case counts have increased in states that neighbor those with high incidence. The trend of stable to decreasing case counts in many states with high incidence may be due to multiple factors, including the possibility that occurrence of the disease has stabilized in these areas or that some state health agencies have changed their reporting practices to lower the resource burden associated with Lyme disease surveillance. Lyme disease surveillance is not meant to document every case, but rather to indicate disease trends over time, define high-risk groups, and describe the geographic distribution of the condition.

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Rapid Increase in ER Visits For Young Girls With Self-Inflicted Injuries

MedicalResearch.com Interview with:

Dr. Melissa C. Mercado PhD, MSc, MA Behavioral scientist Division of Violence Prevention National Center for Injury Prevention and Control CDC

Dr. Mercado

Dr. Melissa C. Mercado PhD, MSc, MA
Behavioral scientist
Division of Violence Prevention
National Center for Injury Prevention and Control
CDC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Suicide ranks as the 10th leading cause of death for all age groups combined and has been among the top 12 leading causes of death since 1975 in the U.S. In 2015, across all age groups, suicide was responsible for 44,193 deaths in the U.S., which is approximately one suicide every 12 minutes.

Suicide was the second leading cause of death among U.S. youth aged 10-24 years in 2015. Self-inflicted injury is one of the strongest risk factors for suicide.

This study examined trends in non-fatal self-inflicted injuries treated in hospital emergency departments (EDs) among youth aged 10 to 24 years in the United States from 2001-2015.  The overall weighted age-adjusted rate for this group increased by 5.7% annually during the 2008 to 2015 period.  Age-adjusted trends for males overall and across age groups remained stable throughout 2001-2015.  However, rates among females increased significantly, by 8.4% annually. The largest increase among females was observed among those aged 10-14 years, with an increase of 18.8% annually from 2009 to 2015.

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US Heat-Related Deaths Disproportionately Affect Non-Citizens

MedicalResearch.com Interview with:
“Wood for Heat” by Alternative Heat is licensed under CC BY 2.0
Ethel V. Taylor, DVM, MPH
Division of Environmental Hazards and Health Effects
National Center for Environmental Health,
Centers for Disease Control and Prevention
Atlanta, GA

MedicalResearch.com: What is the background for this study?

Response: CDC sought to identify and measure whether or not differences exist for deaths associated with extreme heat among non-citizens, who had been identified by previous studies as higher risk due to occupation.

CDC compared heat-related deaths among non-US and US citizens from 2005-2014. Heat-related deaths accounted for 2.4% of all deaths among non-U.S. citizens (n=999) compared to 0.02% of U.S. citizens (n=4196).

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Nearly Half of Adolescents Had At Least One Sunburn In Past Year

MedicalResearch.com Interview with:
“Dymchurch Beach - May 2012 - Sunburn with Matching Bikini” by Gareth Williams is licensed under CC BY 2.0
Dawn M. Holman, MPH
Behavioral Scientist
Division of Cancer Prevention and Control
Centers for Disease Control and Prevention

MedicalResearch.com: What is the background for this study?

Response: Scientific evidence clearly shows that even one sunburn during adolescence can increase a person’s chances of developing skin cancer as an adult. Surprisingly, little research has been done to understand the factors associated with sunburn during this phase of life. The CDC wanted to examine beliefs, behaviors, and demographic characteristics that might be associated with adolescent sunburns in hopes that the findings could inform future intervention efforts. We used data from the 2015 YouthStyles survey (adolescents aged 12 to 17 years) to explore this research question

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Overdose Deaths Increase Across Urban Status, Sex and Race Lines

MedicalResearch.com Interview with:
“Pills” by Kurtis Garbutt is licensed under CC BY 2.0
Christopher M. Jones, PharmD
Office of the Assistant Secretary for Planning and Evaluation
Office of the Secretary
U.S. Department of Health and Human Services 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Drug overdoses are the leading cause of injury death in the United States, resulting in approximately 52,000 deaths in 2015. Although prescription drugs, in particular opioid pain relievers, were primarily responsible for the rapid expansion of this large and growing public health crisis, illicit drugs (heroin, illicit fentanyl, cocaine, and methamphetamines) now are contributing substantially to the problem. Understanding differences in illicit drug use, illicit drug use disorders, and overall drug overdose deaths in metropolitan and nonmetropolitan areas is important for informing public health programs, interventions, and policies.

We found that the prevalence of self-reported past-month use of illicit drugs increased significantly across urban status (large metropolitan, small metropolitan, and nonmetropolitan) between 2003-2005 and 2012-2014. Prevalence was higher for males than females, however, in the large metropolitan group, the percentage increase in prevalence from 2003–2005 to 2012–2014 was greater for females (23.4%) than for males (21.6%). There were notable differences by age. During 2012–2014, respondents aged 18–25 years had the highest prevalence of past-month use of illicit drugs for all urban levels. For respondents in this age group, the prevalence increased slightly from 2003–2005 to 2012–2014 in large metropolitan areas while the prevalence remained stable among small metropolitan area respondents and nonmetropolitan area respondents. Past-month use of illicit drugs declined over the study period for the youngest respondents (aged 12–17 years), with the largest decline among small metropolitan area youth.

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40% of Cancers Associated With Overweight and Obesity

MedicalResearch.com Interview with:
Dr. C. Brooke Steele D.O.

Division of Cancer Prevention and Control
Centers fo Disease Control and Prevention 

MedicalResearch.com: What is the background for this study?

Response: This report contains new information about cancer risk and people being overweight and obese. Research shows that being overweight or having obesity is associated with at least 13 types of cancer (adenocarcinoma of the esophagus; cancers of the breast [in postmenopausal women], colon and rectum, endometrium, gallbladder, gastric cardia, kidney, liver, ovaries, pancreas, and thyroid; meningioma; and multiple myeloma). We also know that the number of people who weigh more than recommended has increased over the past few decades. Therefore, we looked at the numbers of new cases of cancers associated with overweight and having obesity in the United States, as well as how the rates have changed over a 10-year period. Because screening for colorectal cancer can reduce colorectal cancer incidence through detection and removal of precancerous polyps before they become cancerous, we analyzed trends with and without colorectal cancer.

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Healthy Behaviors and Academic Success Go ‘Hand in Hand’

MedicalResearch.com Interview with:

Catherine N. Rasberry, PhD Health Scientist, Division of Adolescent and School Health CDC Atlanta

Dr.Raspberry

Catherine N. Rasberry, PhD
Health Scientist, Division of Adolescent and School Health
CDC Atlanta

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: For many years, researchers have documented links between health-related behaviors and educational outcomes such as letter grades, test scores, and other measures of academic achievement. However, many of those studies are becoming out-of-date or have used samples that were not nationally representative. The aim of this study was to see if previous findings held in a current, national sample of high school students.

Consistent with previous studies, our findings revealed that regardless of sex, race/ethnicity and grade-level, high school students who received mostly A’s, mostly B’s, or mostly C’s had higher levels of most protective health-related behaviors and lower levels of most health-related risk behaviors. For example, we found that:

  • Students who reported receiving mostly Ds and Fs, were nine times more likely than students who received mostly As to report having ever injected any illegal drugs.
  • Also, students who reported receiving mostly Ds and Fs were more than four times more likely than students who received mostly As to report that they had four or more sexual partners.
  • Conversely, students who reported receiving mostly As were twice as likely as students who received mostly Ds and Fs to report eating breakfast every day in the past week.

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CDC Finds Public Health Preparedness Improved Since 9/11, Needs Ongoing Support

MedicalResearch.com Interview with:

Dr. Bhavini Patel Murthy, MD MPH Division of State and Local Readiness Office of Public Health Preparedness and Response and Epidemic Intelligence Service CDC, Atlanta 

Dr. Murthy

Dr. Bhavini Patel Murthy, MD MPH
Division of State and Local Readiness
Office of Public Health Preparedness and Response and
Epidemic Intelligence Service
CDC, Atlanta 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Public health preparedness is critical to ensure national health security. Recurring disasters (both natural and man-made), especially recent weather emergencies in Texas in Florida, have highlighted the need for robust coordination between federal, state, local, territorial and tribal governments to adequately prepare and respond to public health emergencies.

The Public Health Emergency Preparedness (PHEP) program provides funding to state, local and territorial governments to prevent, protect, respond, and rapidly recover from large and small public health emergencies.

This is the first analysis of preparedness capabilities based on reports from all 62 jurisdictions that receive PHEP funding across the United States and its territories. We found that most jurisdictions had limited preparedness capacity prior to 9/11, but now have made considerable progress. For example, all 62 jurisdictions now report having an incident management infrastructure.

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