3 Global Health Stories You Should Definitely Be Following as an American

When we moved to Nashville at the beginning of the year, Craig and I decided to forgo any traditional cable service. 10 year old me would be SCREAMING about not having access to Nickelodeon and Disney Channel but current me kind of loves it. We have Netflix and basically every single other streaming service/app that we could ever want; but one thing I noticed fairly quickly was the lack of daily news, kind of by choice, kind of not.

I’m not a huuuuuuge news watcher. I prefer to read it, but I tend to put it on in the background and kind of had a routine when I was working from home last fall where I would watch the news passively while working so I could glean even a sliver of information. Local news is way too repetitive and I don’t give a flying hoot about small-town drama (unless it’s an unsolved murder, that I am HERE for), and national news is predictable and veeery focused on Trump. For good reason, but let’s not make this one too political (or lets, I’m sipping some wine so by the end of this I could be right (or left) up on my pedestal, who knows).

Right, back to the news. Well, since I don’t consciously turn on the news anymore, and try to not rely on Facebook as a news source (sorry, friends), I’ve taken to setting up some daily newsblasts to my email on topics that I do want to stay informed on. Any guesses?

G L O B A L  H E A L T H

You got it, dude. My morning literally doesn’t begin until I open my Global Health NOW newsletter from Johns Hopkins Bloomberg School of Global Health. IT IS MY CRACK. Which is weird, but just roll with it.

So, why? Why do I shun/avoid all other news outlets? Please see above about Trump focused media. I 100000000% understand it. It’s a weird time, America. The whole world is watching what our leader is going to do next. But sometimes I really want to not only talk about Trump, but to talk about the whole world and what’s going on out there. Hence Global Health NOW.

Global Health NOW has definitely opened my eyes up to things happening around the world that I was either unaware of, misinformed about, or just totally confused by. There is A LOT happening in health. Daily. Like every single day there are things happening somewhere that we should all be watching but aren’t. Why should we all be concerned with global health? Well, because it has serious implications for basically every single other thing going on in the world. News flash: if we’re all dying of Ebola, it doesn’t matter what Trump’s last tweet said.

Chill out though, we’re not all dying from an Ebola outbreak. BUT here are 3 headlines I’ve seen recently that you should be watching because they are important and if we’ve learned anything in the past few years, its that we CANNOT only look within our borders for answers ( I said it could get political, back off).

1. Yellow Fever-Brazil is working very hard to make sure that their most recent outbreak of the mosquito-borne infection does NOT get into its major cities–thereby exacerbating the infection rate. They are going door to door with the vaccine around Rio de Janeiro and Sao Paulo to hopefully avoid a yellow fever epidemic, the first in Brazil since 1942. While the mortality rate has remained low, if the virus reaches the slums of major urban areas they’re looking at A LOT of casualties. Health officials are attempting to vaccinate 23 million people, and quickly. So, why should you be concerned? Well, Brazil’s initial response to an uptick was pretty delayed. Instead of vaccinating between small outbreaks, Brazil waited for an outbreak to come closer to major cities before they began a massive vaccination campaign. By the time they did start vaccinating, there was a robust anti-vaccine (EYE ROLL) campaign all over social media, hampering their reach. SAY IT LOUDER FOR THE ONES IN THE BACK: You should get all routine vaccines, but you should ESPECIALLY get vaccines for outbreaks of potentially deadly infectious diseases, you dummy. Oh, you don’t care about potentially millions of Brazilians? Well, consider the economy then. Brazil is one to watch. You should not count them out from the big-table discussions, nor should you discount their wisdom as a former developing nation. BRAZIL IS SMART AF. A major outbreak of yellow fever could be catastrophic to their status as a BRIC nation (to the older folk “second world country”). We should all be watching how they handle the containment of this outbreak and if they learn anything from it that could impact the global economy.
2. Ethnic Cleansing in Myanmar-I was assigned a global health mentor from Myanmar last year through a program that will remain nameless. We did a single video call before I realized that my mentor was incredibly racist and while insanely intelligent, was not someone I wanted to learn from long term. The Rohingya, a majority Muslim ethnic group in Myanmar have not been able to leave their coastal state without government permission however theirs is one of the poorest in the country, so many have left in search of a better life. There is a touchy line of whether the Rohingya are from Myanmar or Bangladesh-which goes back to British Rule (a whole ‘nother issue #whitemansburden), and post-independence the Rohingya were denied the right to gain citizenship in Myanmar due to the discrepancy. Ya-de-ya-60 years later, bad things continue to occur in Myanmar against the Rohingya. There are plenty of sources detailing accounts of ethnic cleansing and more subtle starvation techniques, please look them up. This is important, however, because the Rohingya have been fleeing this persecution and murder for decades—creating camps in Banglaesh. This is important for a few reasons. 1. We all know refugee camps are not healthy living quarters. and 2. Aung San Suu Kyi-the leader of Myanmar-does not recognize the Rohingya as an ethinic group. Did I mention she’s a Nobel Peace Prize Laureate? There are MAJOR human rights violations occurring in SE Asia right now and everyone needs to open their eyes and do something about it.
3. Lassa Fever in Nigeria– Are you listening? Ok good. Remember Ebola? The fear that a hard working selfless nurse coming home to the US was going to infect the entirety of our nation? Ok great, now think about that minus the direct threat to the US. Yeah, isn’t it crazy? There ARE terrifying outbreaks that occur that don’t even hit our radar maps. Lassa, like Ebola, is a viral hemorrhagic fever that has a pretty high mortality rate. Usually, it has a fatality rate of 1%, but the current outbreak could be as high as a 20% fatality rate. Basically right now everyone’s trying to figure out why this outbreak is so intense, if there is a vaccine candidate that could reduce the outbreak from becoming a global health emergency, and where the gaps are in Nigeria (and beyonds) healthy systems. In order to stop epidemics, national and hyper-local health systems NEED to be robust, and that relies on international funding-something that the current President does not deem essential.

 

Alright, alright. I could go on for hours on these (an many other–especially Syria but that is it’s own post) global health topics. Please PLEASE do not discount international media as a source of information. Knowing about an outbreak of bird flu in Asia could help you with your stocks, so stop avoiding the international tab on your favorite news site. Keep an eye out for outbreaks. Being alive is pretty pivotal to the global economy, so personally I think global health news should be the first thing you read in the morning.

 

 

**Disclaimer: I WISH I were paid for this but it is seriously just me hoping you read into some international global health concerns and how they can impact the rest of the world**

 

What should I discuss next? Please let me know, I want to write more!

 

 

Down with the seemingly intelligent sounding pseudo-science

I get a LOT of weird emails at work. Like, on a daily basis, probably 5 or so that would require the writer to have a quick lil’ mental evaluation if they were saying these things NOT behind a veil of secrecy (strange email addresses etc.). I could quote them for hours. Most are insane right off the bat, sometimes they lure you in with a normal introduction before BAM! the crazy person comes  out. We got one last week telling men to PURPOSEFULLY harass/assault women at work because if all men are guilty, it will “expose the foolishness of women.” Seriously. That was in my inbox first thing in the morning. Safe to say I could have used a little something extra in my coffee that day.

There are also some mailings we receive from various organizations, pushing different legislation one way or the other…using facts or twisted truths to get their point across. Generally the second I see a typo or something that is blatantly false, it goes in the trash. If its factual, I’ll save it in case we get a call or a letter from someone about that issue or if it comes up in a bill or whatever. (Not whatever but I don’t need to bore you with how I keep mail).

ANYHOW…we got something in the ol’ mailbox over the weekend that reaaaaaallllly makes my blood boil. Because they take the word “freedom” and apply it to vaccines. Say it with me folks-VACCINES SAVE LIVES YOU NINCOMPOOPS. I’ll save us all from wanting to scratch our heads at why this is even still an argument being made by educated adults and also will save you from my list of reasons why I think people who don’t vaccinate their children are some of the worst in this world (harsh? Sorry, went there) and stick to the facts in what was delivered to us and how MANIPULATIVE the language of it all is. Because that’s what they’re doing. Manipulating people into seeing correlations between completely unrelated things in order to instill fear about something that saves lives. I’m going to be a little controversial today, I’m feeling spicy.

“vaccines are not required to undergo long-term double-blind inert-placebo controlled trials to assess safety. In fact, not a single one of the clinical trials for vaccines given to babies and toddlers had a control group receiving an inert placebo.”

Lets chat, shall we? One of the main arguments against childhood vaccines is the sheer number of injections that the child receives. I’ll give it to you-its a lot. The current CDC vaccine schedule for children is 56 injections of 73 doses of 30 different vaccines, of which multiple doses of 10 vaccines are given before the age of one. So, yes, that’s a lot of pokes for a tiny little human. Lot’s of parents feel like its cruel to subject their child to so many in such a small amount of time, sometimes they spread them out a little bit more than normal, and some idiots think that  a 0.2 second pinch is worse than their child getting the measles. Either way, if there were to be double-blind inert-placebo controlled trials to assess safety for infant and toddler vaccines….your kid would still be getting a lot of injections. And, if they’re in the control group, then your SOL if they actually do get the measles, or they’re getting pricked twice as much as if they had just received the vaccines on schedule, also they’re late to the game and are therefore susceptible to more infections before they finish their doses.  Are there currently safe and effective trials for vaccines that don’t involve babies being needlessly pricked with sugar water only to then be pricked AGAIN with the actual vaccine? Yes.

“In 2016, the Vaccine Adverse Events Reporting System (VAERS) received 59,117 reports of adverse vaccine events, including 432 deaths, 1,091 permanent disabilities, 4,132 hospitalizations, and 10,284 emergency room visits…However only a tiny fraction of adverse vaccine events are reported to VAERS…..fewer that 1% of vaccine adverse events are reported.”

“Assuming VAERS captures a full 1 percent of adverse events-which is more than is estimated- the VAERS data from 2016 may reflect that in that year alone there were 5,911,700 adverse vaccine events, including 43,200 deaths, 109,100 permanent disabilities, 413,200 hospitalizations, and 1,028,400 emergency room visits.”

OH GOOD GOD. Where do I even begin? 43,200 people did NOT die from vaccines administered in 2016. They simply did not. This is a scare tactic to get you to think that vaccines are more dangerous than they are. You cannot scale up the numbers to show what you want to show-that is not a sound research method! Some things to consider with this data-it is not specifically about childhood vaccines. A number of these “adverse events” occurred in elderly patients receiving their annual flu shot. Sorry folks, old people get the flu a lot worse than younger ones, and NEWS FLASH, lots of them have the flu in their system before they are vaccinated. If they come down with the virus soon after receiving the vaccine, their “adverse event” could be attributed to the vaccine rather than the virus that is actually causing their symptoms. Also lets define what an adverse event is. Are we talking a little redness at the injection site? If so, grow up. I want the nitty gritty about what the events actually are.

This particular document then took a turn towards the vaccine/autism connection and I really had to stop reading. I’m writing this post though, because it scared me how convincing this group is. They cited sources, they have sound research based findings interwoven with their far-fetched science. They almost convinced me, ME-someone who knows enough about vaccines to laugh at the first sight of vaccines and autism in the same sentence, to look into things further. No, they scare me because they make it LOOK like they’re right.

“The CDC has not addressed a study which found a 300% increased rate of autism among newborns receiving the hepatitis B vaccine at birth compared to those that did not.”

The number of infants who do not receive the Hep B vaccine is low. Much lower than the percentage who do receive the vaccine. So, take a pool of 1,000 fish and a pool of 10 fish. In the pool of 10 fish, 3 of them have spots and 7 of them do not. In the pool of 1,000 fish….if only NINE of them have spots that is 300% more than the smaller pool. Of course there are going to be more fish with spots in a pool that has more fish! Same goes for children with autism who did receive the vaccine versus those who did not; numbers people. You can skew ’em however you want.

So, I write this not to say that you need to listen to my viewpoints on vaccines, I would love it if you did but you’re free to make your own decision and I am free to forever call you an idiot if you don’t vaccinate. I write this to say that there is some VERY convincing pseudo-science out there, stuff on .edu and .gov websites with footnotes to government sites and broad research organizations. What is important-in every scientific position piece, regardless of what side you are on-is digging into the numbers they are using and the bits and pieces that they are pulling from their reputable sources to fully understand just what exactly they are trying to make you see.

 

Read with your brain, not with your heart.

NASHVILLE

I consider myself a planner. As in, someone who thinks about their 5-, 10-, and even 20-year plan pretty darn regularly. So when Craig said “If I was going to live anywhere other than New England for a while, I think it would be Nashville” last February it kind of threw me off. See, because while I see myself as a master planner, I also see myself as a person who’s made the decision multiple times to live near no one I know (just ask my mother about when I went to sleep away camp when I was 8 and didn’t want to go home). I like to take my life, stick it in a blender, shake it up….and see where that takes me. I did it with college in a part of the country I knew nothing about, I did it with grad school knowing no one at all, and now I (we) are doing it again.

Craig’s brother was a kind of impetus in this, at least for me. He had been in a skiing accident and fell into a freak coma and it was iffy there for a little bit. Thankfully, he’s absolutely fine, but it did make me think about ~life~ and where I want to be and what I want to be doing.

I took my current job at the state house right out of grad school, after about 2-ish months of looking. That’s not to say I haven’t loved it and learned a heck of a lot from it, but now 3 years in…I feel incredibly stagnant. About a year and a half ago I started looking for global health jobs in Boston; but didn’t have the response I was hoping to get. I had a LOT of interviews, I would get to the very final round…and then, nothing. I was meeting casually with people in industries that I wanted to be in, I was updating my resume and tailoring my cover letter to each job, I was getting great feedback. Everyone was saying “the right position is out there, this just isn’t it” and honestly? It sucked hard.

I felt so incredibly stupid for getting my masters in something I loved so much. Something that interested me more than anything else rather than getting an entry level job right out of undergrad. I questioned whether one of the best things I’ve ever done was also one of the stupidest. I started going through these cycles of excitement about global health, where I would blog a ton and read a lot and find great jobs to apply to and people to meet with, and then kind of fall back into the day to day monotony of my current job and be comfortable with where I was, feeling down on myself for not using my degree. I was in this cycle for probably….4 months or so. I was working on the Global Health Council’s annual report which was awesome, but I would still just feel dumb about not making money from something that I had invested so much time into.

That’s kind of where I was when Craig brought up the idea of moving to Nashville. My first thought was “Yeah well that’s not on the ocean and there’s no way I can live without the beach”. But the more I thought about it and we talked about it the more excited I was about  shaking up my life again. We started talking about the actual possibility of leaving Boston and moving to Nashville. I stopped beating myself up over not finding the perfect global health job in Boston and started thinking about what Nashville might have to offer.

In June we went down to the city that we had only been to ONE time previously, and spent a week looking at apartments and actually determining whether we could see ourselves there. We literally viewed 15 different apartment buildings and explored a lot of the neighborhoods of Nashville, as opposed to just the bars on Broadway like we had done the first time. I think we kind of both knew it after the first day, this was going to be our new city.

Nashville has a ton of perks, cost of living is significantly lower than the Boston area, less snow, and just overall very very different from where we are both from. It does not have as robust of a global health scene. Sure, the universities have research and the State has epidemiologists, but nothing compared to the multitude of global health non-profits that call Boston home. I started reading a LOT of articles and books about whether my passion has to be my paycheck, and I realized that it really doesn’t. It really really doesn’t.

I LOVE global health. I could talk about tuberculosis and cholera outbreaks and the WHO all day and all night. I have a few too many books on the shelf about pandemics and cringe-worthy infections. But really…right now…I can work in an industry that ISN’T global health, and do my weird gross global health project stuff on the side to fuel that fire.

So when it comes to the Nashville job hunt (currently going on) I’m searching more for jobs that use skills I’ve developed in the last three years. I realized that the parts of my job that I love the most all include writing: press releases, speeches, social media posts, and making sure that the boss man has a robust social media following. So…that’s kind of what I’m going for. PR, social media management, stuff that is kind of more creative than I ever thought my brain could be but I’m just rollin’ with it.  Honestly I’ve had some GREAT first contacts with companies already and feel significantly less stressed about searching for a job over 1,000 miles away than I did about the Boston hunt I was shoulder-deep in a year ago.

So I’ll continue to develop my global health brain through volunteering both locally and virtually (whaddup CatchAFire volunteering?) while developing more business-related skills…with the goal to be to start my own Global Health non-profit at some point…but that’s still in the baby baby stages! Oh and Craig? He will have zero difficultly finding the perfect job in the architecture sector…he’s almost too employable, especially in a city with a ton of development! Big plans to flip houses and be the next couple on HGTV…I’ll be the one doing nothing other than picking tiles and paint colors, thank you very much.

So come along on this crazy journey with us as we say sayonara to everyone and everything we know in Massachusetts and go to the land of country music and whiskey…may God have mercy on my liver.

This is Global Health-Without the United States

According to the Kaiser Family Foundation , the United States Government spends roughly $10 billion annually on health aid efforts around the world. THAT’S A LOT OF MONEY! Or, is it? Yes, its 1/5 of total aid from the entire human world, which is both pathetic and sad, but it is also a mere 16 percent of what American will fork over to spend on their pets this year. LITERALLY WHAT?!? Yes, animals deserve love, care and attention, but at what point do we stop prioritizing Fluffy’s bi-weekly blowout and start prioritizing saving children under 5 from dying from preventable diseases? (RHETORICAL QUESTION I KNOW DOGS AND CATS MATTER SO DON’T GET MAD AT ME). But honestly…

If you need more evidence that are pets are treated just like children, look no further than the socialization experiences that Los Angeles-area company Pussy and Pooch offer. Its “Pawbar” is a gourmet cafe for three animals so they can meet new friends. It also throws “Mutt Mingles” and “Cat Socials” three or four times a month to allow for play dates. (more here)

While $10 billion might seem low when comparing it to money spent on animals, it becomes even more, whats the word, terrifying when compared to the proposed cuts to federal aid recently made by the Trump Administration.

The ~$10 billion is currently spent on a lot of infectious disease interventions. According to this article by Amanda Glassman, COO and senior fellow at the Center for Global Development, PEPFAR and local partners have been able to locate 70% of the 900,000 people living with HIV in Malawi, and enrolled 89% of them on treatment. Results throughout the African Continent paint a similar picture, by partnering with local governments and NGO’s American funded health interventions have made huge impacts on some of the worlds most infectious diseases. Cutting the funding to PEPFAR and other global health interventions would have MASSIVE trickle down effects on international trade, economics, and population. Not to mention the possibility of political instability due to the inability to keep citizens healthy, the world does not need any more civil wars.

Are all US Government funded interventions as effective as they could be? No, there are definitely some major pitfalls and some huge lessons to learn from previous interventions. But arbitrarily and suddenly stopping funding of essential aid is going to do so much bad. So so much bad.

For those of you who constantly make comments about how “we need to focus on American health! Think about the health issues in our country, Obamacare! Obesity! Heart Disease” SHUUUUUUUUT IT. I know, and I agree that those are extremely important things that also deserve a lot of attention from our  President (and he’s already made some moves there). But I’m talking about diseases that transcend our boarders. Cutting funding to international health aid will only make the US more at risk of highly infectious outbreaks.

The increased “America centric” mindset is going to be our nations biggest downfall. Global health aid from the United States supports early detection and response of outbreaks around the world. The WHO lists a lot of outbreaks in 2016. Like, well over 100 outbreaks of dozens of strains of infections. Almost zero of them were on the news in the United States…you know why? Because they were squished out by intelligent doctors and scientists in their country or region of origin. Many of these countries cannot fund the necessary quelling efforts, that’s where US global health aid steps in. Without US global health aid any number of those diseases could have created the next pandemic.

I’m not going to touch the Mexico City Policy-I think that deserves its own post (if you want me to, that is). But if more life saving and disease eradicating interventions are to be cut, I hope our government has the intelligence to examine each and every current intervention and does not make across the board cuts that will dramatically alter the upward curve of global health success.

America’s anti-vax chair of the vaccine commission

This post is solely with regard to Donald Trump’s recent appointment of Robert F. Kennedy Jr.as the chairman of a commission on vaccine safety and is not intended to reflect my personal or political views on ANY other cabinet appointment or election of any recent political office. I cannot write about politics. I can write about vaccines.

I think I’ll start off with a little biography of Mr. Kennedy (and before you ask, yes he’s the OG RFK’s son). He received his Bachelor of Arts degree in American History and Literature from Harvard and went on to received his J.D. from UVA and Master of Laws from Pace University. So we’ll begin this by saying that while he definitely is an intelligent man, he has NO formal training in infection, immunology, vaccine development, biology, or general science.

That’s where we’ll start.

He’s done amazing legal work. After being charged with heroin possession, he was sentenced to rehab and community service. He ended up doing his community service with an organization called Riverkeeper, where he helped to sue groups that had allegedly polluted the Hudson river.Once his community service was up, they hired him full time and while he made some questionable hiring/firing decisions, was able to expand the reach of Riverkeeper and create an alliance of over 300 Waterkeeper programs to keep water around the world safe. Kennedy is also a professor of Environmental Law at Pace University School of Law…long story short, the man does great things to ensure that waterways are protected. There is nothing bad about that.

He’s a wonderful environmental activist. He protested the use of the island of Vieques, Puerto Rico by the US Navy for training exercises and spent thirty days in jail because of it. He protested the Keystone pipeline in 2013 in front of the White House and was arrested. He’s controversial, but considered by many to be someone to turn to when you want to have action-based results in environmental law. He was named one of Time.com “Heroes of the Planet” in 2010 for his Riverkeeper work. He has based his entire career on saving the environment, and that is awesome.

What Kennedy Jr. has not done, is work anywhere remotely close to vaccine development, implementation, planning of vaccine distribution, or anything close to immunology. He has NO knowledge base from where he asserts his opinions (I cringe at even giving his loony, non-factually based thoughts the right to the word “opinion” but I will use it for the sake of argument).

In 2005, Kennedy Jr. wrote an article published by Rolling Stone and Salon.com entitled “Deadly Immunity” in which Kennedy alleges a government conspiracy to cover up the connection between thimerosal (a preservative used in vaccines) and autism. Let me be clear about something here: THERE IS NO LINK BETWEEN THIMEROSAL AND AUTISM. NONE, ZERO, ZILCH, STOP TRYING TO MAKE THIS A THING. His article was eventually retracted by Salon.com due to the number of factual errors. If you want to read it, you can go here.

You might think “Well, that was 12 years ago, people change their views!”

Nope. In 2014, Kennedy co-authored an anti-thimerosal book, entitled “Thimerosal: Let the Science Speak” calling for the removal of thimerosal from all vaccines. In 2015, Kennedy promoted the film Trace Amounts, which links autism to vaccinations. While attending a screening of the film in California, Kennedy called the alleged incidents of vaccinations causing autism as a holocaust. A HOLOCAUST.

So, my question as an American, as someone with a small amount…but still more education than Mr. Kennedy  on vaccines, is WHY. Why appoint an environmental lawyer as the chair of a commission on vaccine safety?

I don’t have that answer. What I do have is the intelligence and the passion to make sure that everyone knows the truth about necessary, life saving vaccines. Do your research, read reputable literature, make your own informed decision. DO NOT blindly follow the recommendations of a man with no background in science. We can only hope that the rest of the commission is filled with the brightest and loudest  voices that vaccine science can provide.

*Please let me know if you would like any help finding un-biased scientific data on vaccines, thimerosal, or autism.*

 

Staying Tremendously Interested

Having re-read my anti-new years resolutions post yesterday to celebrate the end of 2016 and the beginning of 2017 I realized something. While I do still agree with every word I wrote in that post three years ago, I do think that trying to better oneself in one or more areas is a great thing to strive for.

I’ve noticed over the past few months (honestly probably the last year) that I still crave education. When my best friend and my boyfriend got into graduate school last spring, I was excited for them, and jealous of what that meant. They were both going to be learning and expanding in their respective realms and I felt kind of…in a rut. I honestly got about 75% of the way through about 3 applications for subsequent masters programs, really just wanting to dive into something, like I saw them both doing when their classes started in the fall. I explored classes on EdX(which is wonderful and I highly recommend if you want to learn a new skill!), but didn’t have the motivation to finish a course where there was no feedback or interaction or really no grading scale whatsoever. I, for a brief insane period, considered PhD programs. I know, I KNOW!!!! INSANITY. That’s not something that I’ve ever wanted, and it all boiled down to the jealousy of my friends studying their passions…something that I was lucky enough to do a few years ago, but that I really haven’t been able to hone in on in the past two years.

I have loved every single second of working at the State House with my amazing boss. I’ve learned a ton about local and state issues, things that 3 years ago I didn’t know existed, and things that honestly impact our communities way more than I ever thought they did. I have had the opportunity to expand in areas that I never dreamed…me? Well versed in charter school legislation?! You betcha. I’ve learned and I’ve been challenged and I am energized by the work. But if I really really really dig deep down, no matter how many times I’ve gotten to attend hearings on health care financing, or ensure that someone has healthcare before a big medical procedure, or speak to a local group about the ballot questions from November, it isn’t my passion.

I’m blessed to have a boss who wants me to succeed in every way. He’s an amazing mentor and a fantastic legislator. When I told him that I was going to start looking for jobs he couldn’t have been more supportive. And while that process continues, he still helps me to find new opportunities….even if they do lead to me replacing him in the legislature in 15 years when he wants to retire (never going to happen!!!!!!!).

So, in addition of upgrading myself to Linkedin Premium (Add me! For the love of God, add me!!!), networking my socks off, and applying and interviewing and following up more than I’d like to admit…I’ve decided to remind myself what my passion truly is! It’s global health, and seriously guys if you’ve gotten this far into something on this blog and didn’t know that global health was my jam…we might need to reevaluate your critical reading skills. So, here are my non-resolution changes I’m making for 2K17 to remind my brain what it likes!

1. I’m getting a mentor! No, seriously. I applied through the Canadian Society for International Health (don’t tell them I’m not a Canadian) to their MentorNet program. I wrote essays, said what my goals for the future are with regards to global health, and was one of 35 young professionals chosen globally! I am really excited to find out who my mentor is (hopefully in the next week or two) and start connecting with them. Past mentees have worked with their mentor on published journal articles(!!!) and some have even secured employment from their mentor after the program ends. Honestly, I’m excited to regularly talk to someone who’s more advanced in the field and learn how they got to their current position.
2. I’m enrolled in a certificate program! Remember my little sob story at the beginning of this post about being jealous of people in school? Well financially, I don’t want to take on another masters program, but through UniteForSight’s Global Health University, I can obtain a certificate in Monitoring and Evaluation of Global Health Interventions for a really low cost. It’s all online which will test my concentration abilities, but I am looking forward to having some skin in the game and wanting to get the most out of my investment. They have over 20 programs so if you’re even remotely interested, the classes are all open-source and you can apply for any of the certificate programs on their website.
3. I’m reading a lot of global health literature. I’ll probably do a separate post about all of the books I recently bought myself, but lets just say I don’t think I’ll finish them all anytime soon!
4. I’m volunteering as much as I can in the global health community. I’ve been attending Partners in Health volunteer nights, where you basically just call recent donors to thank them, but you also get to listen to a talk from someone who works in the field for PIH while eating pizza so I really can see no downside! (Want to join me on Wednesday night? You don’t need a global health background and you get to start off 2017 doing something good!) I also have been finding some volunteer work through CatchAFire. It’s an awesome website that takes your resumes or skills and finds you volunteer positions, mostly remote and with non-profit organizations. So far, I designed the Global Health Council’s annual report and am currently working on a marketing campaign for AYZH which is a NGO working to ensure women have safe births globally. I think the coolest part about CatchAFire is that once you start volunteering with them, you are given your impact score, which is basically how much money you’ve saved the organizations by volunteering to do work that they would otherwise have to pay to have completed (and before you get all high and mighty saying that I’m taking away a good paying job from someone, I’m not. These organizations  just simply don’t have the manpower or the money to outsource the work.) So far I’ve saved organizations $5,000 in my spare time.

So, while I hate the idea of resolutions (because they set you up to fail!!!!!) I don’t hate the idea of personal and professional development. Bring on 2017.

West Nile Virus

**PREVIOUSLY POSTED BLOG BUT RELEVANT TO MY PRESENTATION NEXT WEEK**

I’m sure the majority of us from New England (at least) remember/still get periodic updates about spraying for West Nile or pamphlets in the mail about how to protect yourself about this mosquito borne illness, but what do you REALLY know about it? Well, luckily for you, I just so happened to be part of a group paper written about THIS VERY VIRUS! Aren’t you all lucky?! So, here we go!

West Nile virus was first identified in a Ugandan woman in 1937 during a research project on yellow fever. Getting its name from the region of the world in which it was discovered, West Nile Virus was a disease of primarily Eastern Africa for most of the early half of the 20^th century, with smaller instances of infection in the tropical and sub-tropical regions of the continent. The disease spread north into Europe and the Middle East with small outbreaks in humans in both Israel and France.While there were limited numbers of cases throughout most of the 20^th century, it was determined that nearly 40% of Egyptians were carriers for the virus in 1950, that’s a heck of a lot of Egyptians. An outbreak in South Africa in 1974, where 10,000 cases were reported, has been the largest outbreak to date.

The United States entered the game late (as usual…) in 1999, when a cluster of patients was discovered in New York City experiencing symptoms. The disease was subsequently found in many horses, cats, dogs, and birds in the Northeast U.S.  But how did it get here? I mean, the Atlantic Ocean is pretty big after all…but since New York City is a multi-cultural mecca for both American and worldwide tourists, it is easy to understand how a single person carried the virus and then quickly spread from the epicenter in the borough of Queens outwards. Over the next five years, most of the continental United States, Canada, parts of Mexico and Latin America, as well as many Caribbean islands experienced “clinically significant infections”, meaning that patients had symptoms instead of just carrying the virus. (Imma be honest with my MA crowd here; If I could hazard a guess, I would say at least 50% of us would be “positive” for WNV, but that doesn’t mean we have the virus, it just means we’ve come into contact with it! Not everyone experiences symptoms). In the five years following the first instance of infection in New York City, over 7,000 cases were reported in the United States alone.  What was previously believed to be primarily a disease of Africa and the Middle East was flourishing in my backyard…scary right?

Cases of WNV reported to the CDC in 2014 to date

While West Nile Virus utilizes a mosquito as the taxi and humans as the destination, it is unlikely that it will become a worldwide epidemic. While nearly 40% of Egyptians were carriers for the disease in 1950, more recent outbreaks of the disease, namely the New York City outbreak of 1999 saw only 2.6% of residents being infected, with only a small fraction of the infected becoming ill. With such a low infection rate, it is hard to perpetuate an infection in a non-migrant population, let alone one through which millions of people pass through annually. While the 7,000 cases in 5 years does seem like a daunting amount considering the absence of past infections, for a disease that is so readily transmitted, it is an amount that could be exponentially higher. Recent figures from 2012 show that the United States experienced 5,387 cases of West Nile Virus with 243 deaths.

So….what happens when someone starts to experience symptoms of WNV?

The clinical presentation in humans with West Nile Virus ranges from a complete lack of symptoms to death. Between 70-80% of infected individuals with WNV will not develop any symptoms at all, lucky buggers. Approximately 20% of patients will develop an illness similar to the flu, including symptoms ranging from body aches, headache, vomiting, diarrhea, or rash. While this illness is debilitating, most patients will recover completely although weakness related to the illness can linger for weeks. A small percentage (less than 1%) of patients who experience the febrile illness will then develop severe neurological illness from WNV. These symptoms include encephalitis or meningitis (brain swelling), and will present clinically as headaches, high fevers, neck pain or stiffness, disorientation, tremors, seizures, paralysis, or coma. People who are at higher risk for the severe infection of West Nile Virus include those with underlying medical conditions including certain cancers, kidney disease, hypertension, organ transplantation, HIV and diabetes. Pregnant women are also at risk of passing along the virus to the child through breast milk. While recovery is expected for the majority of severe cases, the recovery time is long, with some of the neurological effects lasting a lifetime. In 10% of severe cases of West Nile Virus, the patient will die.

Once correctly diagnosed, treatment of WNV is relatively simple as there are no vaccines or antiviral treatments currently available. To ease fever and some symptoms of the mild form of West Nile Virus infection, simple pain killers can help to reduce the burden alongside bed rest and plenty of fluids. For those with the neurological implications…it gets tough. In reality, there isn’t much that can be done aside from supportive care and rehab following recovery.

So how do you avoid West Nile? You could be in the lucky 2-3% of Americans that have immunity…for no apparent reason whatsoever. Understandably, some African and Middle Eastern inhabitants have developed immunity over centuries, but the US is a little behind in that category. Using mosquito nets, long sleeves or pants, light coloured clothes, avoiding too much activity during the more active mosquito hours (dusk and dawn) and using insect repellent containing DEET for use on skin. It is important to remove any mosquito breeding grounds such as standing water in swimming pools, tires or gutters, especially in residential areas where transmission can be quick in large populations in small, clustered areas. Vegetation in ponds should be removed to prevent mosquito breeding in them (CLEAN YOUR KOI PONDS DANG IT!) Screens and netting should be fixed so as to prevent entry into the house. In areas that have suffered an outbreak, outdoor public spraying is another method than can help to reduce the transmission of West Nile Virus. The EPA has approved of the insecticides in use against this disease and, though it can hinder those with asthma (although “hinder” is not defined…), it is not harmful to humans…iffy on crops.

West Nile Virus is not going away any time soon in the United States, at least, not until there is advancement in the development of a vaccine. While current control measures are effectively containing the spread of the West Nile Virus, the disease cannot be fully eradicated while still present in asymptomatic carriers.  Therefore, public awareness campaigns (TAAADAAAA), insecticide treatments of homes, fields, marshes, stagnant water alongside clothing and exposed skin, will only go so far (but are still helpful!).

I feel like I just set the plot for an environmental thriller movie…screenplays are now being accepted.

PRESENTATION AT THE CENTER FOR ACTIVE LIVING JUNE 24th AT 10:30.

Up next…..

Zika and Rio 2016

ZIKA VIRUS. The latest infection to hit media outlets and cause mass chaos throughout the world. Bad? Very. Babies born to infected mothers have a higher risk of being born with microcephaly, aka tiny heads. The virus has been found in 60 countries. It’s a very real problem for a very large number of people.

There are plenty of fantastic articles about Zika Virus and its transmission and symptoms, but I will not be writing about that (unless that’s something you want to see?) Instead, I’ll discuss the upcoming Olympics, and the potential for Zika to become more than a global public health emergency (dare i say…epidemic?)

ALL of this info comes from the World Health Organization. So it’s good stuff that people generally listen to. So you should too.

A panel of experts concluded that the 2016 Summer Olympics pose a “very low risk” of further spreading the Zika Virus internationally (side note- when i picture a “panel of experts” i always picture a huge board room and superheroes). The “Emergency Committee on Zika Virus” (chaired by Spiderman, of course) made a statement after a bunch of groups worldwide called for the Rio de Janeiro games to be canceled or moved because of worries that athletes and fans would return to their home countries infected by the tropical disease, allowing it to spread to local mosquitoes and by sexual transmission.

However, mass gatherings, such as the World Cup (which was also held in Brazil in 2014), have not led to a spread of similar outbreaks in the past, suggesting that the Olympics aren’t likely to lead to more outbreaks in new regions of the world.

Here are some reasons why its going to all be OK and Michael Phelps can swim without fear of mosquitoes:

• Because it will be winter in Brazil during the games, the low point of mosquito season
• Strong measures have been taken to kill mosquitoes
•  Condoms are being given to athletes in absolute overabundance(seriously…450,000 condoms, and that’s just for the athletes!)

Moving the Olympics at this point is not practical; economically or from a public health standpoint. Should you avoid the Olympics if you or your partner is pregnant or trying to get pregnant? Probably. Should female athletes who are pregnant maybe think about…not participating? Maybe. Should everyone boycott the best sport-related thing to happen every 4 years (because no one likes winter Olympics like they do the summer)?Nah. You’ll be fine, if you wear bug spray, sleep under a mosquito net, and use precautions as you would already because BRAZIL IS FULL OF INFECTIOUS DISEASES! Seriously I’d list them but I don’t want to scare you away from South America.

So, look out for Zika Virus, but don’t act like everyone at the Olympics is a vehicle for international infection.

SHAMELESS PROMOTION: Worried about Zika on the home front? I’m giving a presentation next Friday (June 24th) at the Plymouth Center for Active Living at 10:30 on this and a few other skeeter diseases. I would love to see you there!

Calm down, the antibiotic apocalypse isn’t starting

The superbug that doctors have been dreading just reached the U.S

This is the heading on a Washington Post article that came out May 27th. The article started with more crisis-inducing language :

“For the first time, researchers have found a person in the United States carrying bacteria resistant to antibiotics of last resort, an alarming development that the top U.S. public health official says could mean “the end of the road” for antibiotics.”

PANIC! DEVASTATION! EVERYTHING YOU’VE SEEN IN MOVIES ABOUT EVERYONE DYING OF A SUPER-DISEASE IS GOING TO COME TRUE!!!!!!

Or is it?

Here’s the deal. A 49 year old woman, who has not traveled outside the U.S. recently, has a UTI (owwwwwwch). Said infection is with E. coli. You know, the bacteria that occasionally pops up in the news for causing a certain food to be recalled. Or, well, that’s one type of E. Coli. The patient presented with a type of E.Coli infection that has never been seen in America; the strain is completely resistant to the last-resort antibiotic colistin.

Scary, am I right?!

Well…yeah, but seriously calm down before you have all the facts, ok?! It’s about to get a little science-y up in here, so hold on to your hats.After analyzing the DNA of the E.coli that caused the infection,   researchers determined that it is resistant to colistin because it carries a resistance gene called mcr-1 on a circular piece of DNA called a plasmid.

That resistance gene, mcr-1, was first found last year in Asia, China to be exact. The initial concern was there because the gene is in a position that makes it easy to be transmitted to other bacteria. Colistin resistance had been reported before in other bacteria—including in bacteria found in the US—but the colistin resistance genes were on bacterial chromosomes, which aren’t shareable.

Ok…enough science.

This resistance gene has now been found on literally every inhabited continent. It is not news that it was found in the US. It’s the 21st century! We move around, we touch more people than I like to think about touching (ew, stranger germs), but that is most likely how she got this colistin resistant E. coli infection. Sidenote-this is also how I most likely got TB, but more on that here.

Basically, there is still SO much we need to learn about this resistance. We don’t even know how long it’s been around, so there’s not much of a way to track how fast it’s moving and how soon we are to the so-called “antibiotic apocalypse” that major news outlets are claiming is imminent.

Most importantly, the Washington Post gets it completely wrong right off the bat. “For the first time, researchers have found a person in the United States carrying bacteria resistant to antibiotics of last resort.” This is not true. Here are some other instances of people in the United States with extremely drug resistant infections:

1. A 1991 outbreak at a Brooklyn hospital of a bacterium resistant to vancomycin.
2. Several medical centers in Detroit in 2009 reported resistant infections to colistin and carbapenem-two last resort antibiotics.
3. A 2011 outbreak of carbapenem resistant bacteria infected 18 and killed 11 at a NIH clinic.
4. Need I talk about tuberculosis again? No. Granted, there aren’t nearly as many XDR-TB cases in the United States as there are elsewhere…but it’s something that’s on the radar.

However, this is the first instance of a mcr-1 based colistin resistance in a patient in the United States. Concerning? Yeah. Could it jump into other bacteria and potentially be a bigger issue down the road? Yes, but at this point we have no way to predict the trajectory of resistance. Should we all build underground chambers and start stocking canned goods for the end of the world? No way Jose.

This was, is, totally blown out of proportion, however, it does raise a very VERY important point about antibiotic resistance in general. That is a problem. We are over prescribing what we are comfortable with and not looking into novel forms of treatment. Honestly, when is the last time you went to the doctor with what might have been an infection and they give you a Z-Pack just in case? We do that too much.

So for now let’s not lose our minds over this colistin resistance. Keep it on the backburner and use it as fuel to fund research into novel treatment options, but lets get away from headlines like this:

Ultimate Superbug Reaches USA

Long-Dreaded Superbug Found in Human and Animal in U.S.

Humanity cannot afford to lose germ-killing drugs

How TED Talks have shaped my views on Global Health

I’m very excited to be back to writing about global health and how my views have been shaped and changed by other global health advocates and champions. I have big plans for a long post (about one of the topics I asked you to vote for in last weeks post), but I’ve been watching a number of AMAZING TED talks lately and they’re absolutely worth a share.

If you don’t know what TED Talks are, they are short but powerful speeches given at conferences around the world on literally any topic under the sun. They are given by accomplished scientists, doctors, professors, advocates, writers, and almost anyone from any background you could think of. There are talks on mindfulness, on sports performance, letter writing, comedy, poetry, health, and more. I am obviously drawn to the videos on public and global health. Below are some of my favorites. They’re all less than 20 minutes long, you really don’t have to look at the screen when you’re listening. Pop one on when you’re mindlessly scrolling through Facebook or Twitter. Who knows, maybe you’ll learn something new!

The first one was given by Dr. Pradis Sabeti, who works in Boston on some of the worst viruses known to man; most notably, Ebola. She provides an interesting point of view with regards to international collaboration on medical research. Why do labs working on incredible life-saving treatments compete instead of collaborate?

The next one was shared by the Bill and Melinda Gates Foundation on their Facebook page. Sue Desmond-Hellman combines innovative math, science, and marketing tools to create individualized plans for global health. While health is a human right, the path to health is very different in different parts of the world. What works in Lesotho might not work in India.

This one does require you to look. It’s about XDR-TB. Tuberculosis that is totally resistant to all drugs currently available. How terrifying is that?

And finally, to follow up to the problem of XDR-TB, lets talk about antibiotics. Have you heard that there is a woman in the US with an infection that is totally resistant to all treatments? We’re there people. We need to figure out the future without antibiotics. This is something I think I’ll revisit in the future as its own post, but for now, watch this talk by Ramanan Laxminarayan.

 

Let me know if you watched any of these, and if you did, comment with your thoughts!