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IANPHI

Cholera in the time of disaster

Alex Larsen couldn’t make it to the 2010 International Association of National Public Health Institutes (IANPHI) annual meeting. That’s because Larsen, Haiti’s minister of health, was attending to an outbreak of cholera in this impoverished republic.

Vibrio cholerae bacteria

Larsen was scheduled to speak on NPHIs’ role in disaster preparedness and response. Instead, Scott Dowell, director of the CDC’s division of global disease detection and emergency response, updated attendees about goings-on in Haiti since the massive January 12 earthquake and the recent outbreak of cholera.

The first two weeks after the tremblor and its immediate aftershocks, human and monetary resources were spent on search and rescue, including emergency trauma care, orthopedic surgery and amputations, says Dowell.

The number killed now stands at 200,000. The number displaced: 1.3 million. In addition to an initial lack of safe drinking water, hunger and poor sanitation, anecdotal accounts of diphtheria and tetanus outbreaks circulated. The headquarters housing the ministry of public health was itself devastated when it collapsed, killing most of the minister’s staff who had remained inside.

Since the earthquake, Dowell says the water supply has slowly improved with long-term sources coming on line. Efforts to better separate sewage and water are coming to fruition, too.

As far as the cholera outbreak is concerned, this chapter of Haiti’s public health challenges is just beginning thanks in part to Haiti having never before experienced a known cholera epidemic, says Dowell. That is, its population is most likely immunologically naïve to cholera, making people vulnerable to the bacteria’s devastating ways: severe diarrhea, vomiting, and abdominal pain culminating in overwhelming dehydration and even death.

Despite its troubles, Dowell says there’s long-term hope for Haiti. As found in other countries affected by cholera, an aggressive program to provide clean water and keep sewage and water separate, can eventually squelch the bacteria’s rampage—and in the meantime prevent other diseases from taking hold.

Posted on by Robin Tricoles in Uncategorized Leave a comment

Linking science and action through national public health institutes

As public health leaders from nearly 50 countries gathered this week at the Emory Conference Center, they had a common goal: strengthening individual public health institutes and establishing partnerships to significantly reduce death and disease globally.

The International Association of National Public Health Institutes (IANPHI) held its fifth annual meeting – and the first in the United States – in Atlanta, jointly hosted by IANPHI, located in the Emory Global Health Institute, and by the CDC. IANPHI is not a typical organization, pointed out IANPHI President Jeff Koplan. It’s a partnership of more than 80 members who are directors of CDC-like institutes around the world, and it exists for the partners to build relationships and actively support each other. IANPHI is funded by the Bill & Melinda Gates Foundation.

Jeffrey Koplan, MD, MPH, president of IANPHI

As the world “shrinks” due to easier and more frequent air travel and migration, the effects on public health can be both positive and negative. On the negative side, communicable diseases and lifestyles that contribute to non-communicable diseases are transmitted much more rapidly around the world. But on the positive side, nations can work together much more efficiently to address public health challenges as committed partners.

Tom Frieden, director of the CDC, emphasized the importance of a national focus in each country on public health problems, and linking national efforts with local programs. Having adequate resources for public health will be essential in successful monitoring and disease response as well as driving down healthcare costs around the world, he said.

A major theme of the IANPHI conference was non-communicable diseases (NCDs) in addition to communicable diseases (CDs), which traditionally have been the focus of global public health efforts.  NCDs now kill far more people than CDs throughout the world, Frieden pointed out.  Significant progress can be made against NCDs with the right approach. Frieden gave the example of Uruguay, where 1 in 4 smokers quit smoking after a major public health effort.

Kevin DeCock, director of the CDC’s new Center for Global Health, pointed out the fundamental changes in public health that have come about because of new technologies, such as cell phones and computers as well as new public health networks that allow much quicker responses. Only a few decades ago, information about disease outbreaks in less developed countries was communicated only after the disease had already peaked. Now that information can be sent almost instantaneously.

Public health leaders from four countries – Nigeria, Guinea-Bissau, Tanzania, and Ethiopia – gave examples of successful IANPHI-funded projects. Despite extremely limited resources in many countries, Koplan pointed out, these countries have made extraordinary and concrete progress in improving public health infrastructure and in decreasing disease and death from challenging public health problems.

Posted on by Holly Korschun in Uncategorized Leave a comment