Inaugural VCU Global Health Symposium

VCU Global Health and Health Disparities research team reunion
(from left to right: Dr. Bearman, Kate, Jackie, Gaby, Audrey)

Today the inaugural VCU Global Health Symposium was held in Richmond, Virginia, bringing together faculty and students from across the university who are involved in global health efforts.

One of the key goals of the meeting was to provide a platform for sharing ideas, networking and developing the framework for future collaboration. The meeting featured short talks focused on research at both the community and international levels, and a poster session.

Dr. Moskowitz presenting on a national rheumatic fever
project in the St. Vincent and the Grenadines

Researchers presented on both local community health projects (including our clean water project in northern Honduras, as well as a skin cancer prevention project in Peru and a dental project in Jamaica) and a later session focused on country-wide global health efforts. These included a project focused on rheumatic fever surveillance in St. Vincent and the Grenadines, trauma infrastructure development in Latin America, student education projects in India and medical simulation education in Poland. The meeting was capped off with an inspiring talk on global health research by the dean of the VCU School of Medicine Dr. Jerome Strauss.

Twenty students and residents presented 22 posters related to global health research and health outreach. Our northern Honduras group was well represented with 4 students presenting 5 posters (way to go Jackie/ Gaby/ Audrey/ Kate!).

I left the meeting inspired, re-charged and with some fresh ideas; better yet, our group now has some potential new collaborators. I am already looking forward to the 2014 symposium!

"Rams Reaching Out" Exhibit: Highlighting VCU Health Science Students' Outreach Work

For anyone in and around Richmond, there is a cool exhibit on display at the Tompkins-McCaw library. The exhibit includes photographs from VCU students who have participated in health outreach efforts (and highlights activities in rural Virginia, El Salvador, Peru, Honduras, Costa Rica, Togo and other places). Definitely a lot of good work going on and worth taking a look at if you are in the area.

Introducing The Medical Literary Messenger

I am excited to announce that the Medical Literary Messenger (MLM), the brainchild of my friend and colleague Dr. Gonzalo Bearman, has been launched.

This is an online literary magazine including works of fiction, nonfiction, poetry and photography focused on "the art of medicine and creative expression."

Anyone can submit works to the journal, and material focused on topics in and around healthcare, from any and all angles, will be considered.

I have the great honor of being the Associate Editor for Photography for MLM and am really excited about this project.

You can find out more at the journal's website.

SIGoVA: Pushing Antimicrobial Stewardship Forward in Virginia

With Drs. Lee, Collins and Bucheit
(founding members of SIGoVA). 

I had the great opportunity to present today on Antimicrobial Stewardship (AS) at the Virginia Society of Health-System Pharmacists' Spring Conference. My talk was given in the context of several hours of talks and a panel discussion designed to raise awareness about AS and to promote a regional AS interest group that was created over the past year: the Stewardship Interest Group of Virginia (SIGoVA).

My talk focused on why AS is so important (the problem of antibiotic resistance and our dwindling arsenal of antibiotics) and current best strategies in AS practice as well as key challenges facing AS practitioners today.

The SIGoVA group was created to provide a forum for

Antimicrobial stewardship panel participants 

people in an around Virginia to discuss issues surrounding antibiotic resistance, stewardship and to share information and best practices.

You can find out more about the problem of antibiotic resistance here; you can find out more about antibiotic stewardship here. To find out more about SIGoVA please visit our website.

As the 'pipeline' of new antibiotics for key multi-drug resistant organisms has essentially run dry, it is now more important than ever that we preserve the antibiotics we have and prevent infections wherever possible. Groups such as SIGoVA can help facilitate AS by sharing knowledge, experience and ideas.

Dengue: Over Three Times More Common Than Previously Thought

Aedes aegypti mosquito
(cdc.gov) 

Here is a new article on the worldwide incidence of dengue viral infections that was just published by Bhatt and colleagues in Nature.

Dengue is a viral infection transmitted by Aedes aegypti (and Aedes albopictus) mosquitoes; it is the most common mosquito-borne viral infection. It causes an acute febrile illness characterized by severe pain (which gives the disease its colloquial name: "breakbone" fever). Although not associated with high mortality, the disease is nonetheless associated with significant morbidity.

Using worldwide data on dengue incidence as well as statistical modeling, these authors estimate that there are upwards of 390 million dengue infections per year, with approximately one third of people actually having symptomatic disease. Three-hunded and ninety million is a pretty staggering figure (just around 5% of the world's population), and is over three times the estimated annual incidence per the WHO.

Here in the United States, this is definitely an issue "right in our backyards." In recent years we have seen dengue expand into previously unaffected areas, including the southern United States.

The study by Bhatt and colleagues will hopefully further raise awareness about dengue and the need for a coordinated global strategy to combat it.

Update on Human H7N9 Avian Influenza Cases in China

VCU Global Health & Health Disparities Program (GH2DP)
group entering Honduras during the H1N1 pandemic, 2009

Here is the latest update from the WHO on human H7N9 avian influenza cases in China; as of April 5 16 patients have laboratory-confirmed infection (up from just 3 a few days ago) and 6 have died. Contacts of the people who are infected are being closely watched for signs and symptoms of respiratory infection; to date no clear evidence of person to person transmission has been found.

Although it not clear yet where people acquired H7N9, the virus has been detected in pigeons in a major Chinese agricultural market, leading to the mass execution of 20,000 birds.

Here is an April 4th health advisory on H7N9 from the CDC and an April 5 'telebriefing' with the CDC's director Dr. Tom Frieden. Here is detailed, specific travel advice from the CDC for people going to China (emphasizing such things as avoiding live bird and poultry markets, practicing good hand hygiene, et cetera).

Much is unknown about the epidemiology and transmissibility of the H7N9 virus; to date it does not look efficient in terms of person to person transmission, which is the public health community's greatest concern. One thing is certain: these new human cases of "bird flu" illustrate how quickly novel infectious disease threats can emerge, and we must be vigilant and act quickly as a global community to identify, contain and development treatments for these diseases when they appear.

New Article on Zombies Published in Emerging Infectious Diseases

cdc.gov

Here is an interesting article that was just published in Emerging Infectious Diseases on the use of the public's general fascination with zombies for public health education.

The article refers to back to an earlier CDC blog post that used a "zombie apocalypse" as a vehicle for educating about disaster preparedness. I definitely remember when this clever 2011 CDC blog post was published, and the general content of the message. I have to admit that I can not recall any other general disaster preparedness messages delivered by the CDC or any other group... perhaps there really is something to tying health messages to fictional, highly memorable content?

The current Emerging Infectious Diseases article provides both historical background information on zombies as well as information on their popularity across a variety of media/ entertainment platforms (books, films, video games, et cetera).

The article discuss how public health messages that pull from fictional depictions of zombies could be used to educate about such real-world issues as infection control, risk for bioterrorism, disaster preparedness, provide a framework for ethical discussions, et cetera.

The authors provide a real-world example of the mass killing of 50,000 or so dogs in Bali in 2008 in an effort to control a rabies outbreak; this led to a discussion about the most optimal, ethical, control of rabies in a given area (e.g., mass killing versus vaccination). The authors of the Emerging Infectious Diseases article posit that ethical dilemmas depicted in fictional dramas (such as those involving zombies) can help provide a relatable framework for real-life infection control and infectious diseases issues.

Anyway, I am going to stop blogging now so I can go work on my emergency kit/ plan; you never know.

Three Human Cases of Avian Influenza A (H7N9) Reported in China

Photo credit: Dr. Gonzalo Bearman

Here is an alert from the World Health Organization on 3 H7N9 avian influenza cases ("bird flu") discovered in China. Two cases were reported in Shanghai with another case reported in Anhui province. Patients presented with respiratory infections that progressed to severe pneumonia between February and March 2013; 2 of these patients have died.

Investigation into these cases is ongoing; to date, there has been no evidence that person to person transmission has occurred.

Avian influenza A viruses do not typically infect people, although cases have been reported. When human infection occurs, it is usually in people who have been in close proximity to infected poultry. To date, human to human transmission of avian influenza has been rare.

There is always concern with influenza that viruses circulating in animals (such as birds) will "jump" to humans, combine with human strains and create new influenza strains that we, collectively, have little or no immunity to. This phenomenon led to the 1918-1919 global influenza pandemic that killed between 20 and 40 million people. This is why we must continue to be vigilant in monitoring for cases of human infection with animal influenza strains, such as H7N9 avian influenza.