Please send items of interest for the E-News -- and any other feedback -- to E-News editor Dave Cundiff, MD, MPH <cundiff@reachone.com>. Thanks!
CONTENTS:
1) Avian Influenza Updates|
2) Register for AAPHP Sessions in Philadelphia 2005-12-11
3) "Notes in a Bottle" on Climate, Mortality Trends, CHD
4) Over 200 Jobs!
5) Conference Call on Response to Radiological Terrorism
6) Electronic Health Records and Adolescent Privacy Concerns
7) Smallpox Vaccine Clinic Planning - Software Alternatives
8) Member Update
9) Acknowledgements
1) Avian Influenza Updates:
Highly pathogenic avian influenza H5N1 (HPAI H5N1) continued to spread into western Asia, the Middle East, and eastern Europe. Intense surveillance has shown many other circulating avian viruses, including low-pathogenicity H5N1 variants. Some bird die-offs have been identified as being due to unrelated causes -- such as Newcastle disease -- that are not significantly pathogenic to humans.
Confirmed human cases of HPAI H5N1 remain limited to four countries -- Vietnam, Thailand, Indonesia, and Cambodia. Suspected human cases were reported from China, where hundreds of thousands of chickens were destroyed due to avian influenza. As of 2005-11-11, laboratory studies of suspected human cases from China are still inconclusive (and may remain so, although international investigation is underway).
On 2005-08-29, the United States Geological Survey's National Wildlife Health Center ( http://www.nwhc.usgs.gov/ ) issued "Interim Guidelines for the Protection of Persons Handling Wild Birds With Reference to Highly Pathogenic Avian Influenza H5N1", written for hunters and others who handle wild birds in the USA, at http://www.nwhc.usgs.gov/research/WHB/WHB_05_03.html .
On 2005-11-01, Public Health physician and CDC Director Julie L. Gerberding, MD, MPH answered on-line questions about influenza at an "Ask the White House" session on 2005-11-01. Questions varied widely. Accurate answers were given in fairly simple language. A session transcript is at http://www.whitehouse.gov/ask/20051101.html .
On 2005-11-03, CDC updated its information sheet on HPAI H5N1 in Asia, including preventive measures intended to decrease exposure among travelers, at http://www.cdc.gov/travel/other/avian_influenza_se_asia_2005.htm .
On 2005-11-09, the University of Minnesota Center for Infectious Disease Research and Policy (CIDRAP) posted an updated technical briefing on veterinary avian influenza clinical features, epidemiology, and prevention. They note that all influenza A is (at least potentially) "avian". "All 16 HA and 9 NA subtypes of influenza A can be found in avian populations; however, only subtypes H5 and H7 have caused HPAI." CIDRAP gives specific strategies for forming "a barrier between farms and the outside environment", to help farmers and agricultural regulators control avian influenza. This monograph, with references, is available at http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/biofacts/avflu.html .
Reports of healthy-appearing chickens infected with HPAI H5N1 have complicated animal surveillance efforts in Asia. Avian influenza could, at least theoretically, be found both inside and outside the shell of intact eggs from such chickens. Previous reports (including the NEJM report at http://content.nejm.org/cgi/content/full/353/13/1374 , which was summarized in the 2005-10-10 E-News) suggest that ingestion is an especially dangerous route of human exposure to HPAI H5N1.
[Editor's Note: Avian flu gives one more reason -- only a theoretical concern so far -- for vigilance about thorough cooking of eggs in all settings.]
2) Register for AAPHP Sessions in Philadelphia 2005-12-11:
AAPHP's semi-annual meeting is planned for Sunday, December 11, 2005, at the Marriott Hotel Philadelphia Downtown, 1201 Market Street, Philadelphia PA 19107.
All AAPHP members and guests are welcome to attend our Membership Business Meeting from 10:30 am to 11:30 am EST. Tentative location is Room 301 of the Marriott Hotel Philadelphia Downtown, 1201 Market Street. The agenda will be announced by 2005-12-04 in the E-News and on the "Meetings" page at http://www.aaphp.org . Pre-registration is not required for the AAPHP Business Meeting.
AAPHP will adjourn from 11:30 am to 2:30 pm, so that all members can attend the APHA Opening General Session at the Pennsylvania Convention Center.
From 2:30 pm to 6:30 pm we will co-host a jointly sponsored educational session at the Marriott Hotel, International Ballroom Salon I. Pre-registration is advised for all participants. AAPHP members who are not registered for the APHA Annual Meeting must pre-register in order to qualify for fee waiver. The announcement from AAPHP President Arvind K. Goyal, MD, MPH and APHA Executive Director Georges C. Benjamin, MD, FACP is below:
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Dear Colleagues:
"It is tough to make predictions, especially about the future." The famous Catcher and Coach probably wasn't talking about 9/11, Katrina, Rita, Wilma or other unpredictable Public Health disaster. He might as well have!
How we deal with similar or worse, undesired and unforeseen "crises" in the future may depend not only on the magnitude of the storm but also how prepared we are as Guardians of Public Health.
That is the theme of the Core Disaster management Course (CDLS) being offered at the upcoming Annual meeting of the American Public Health Association in Philadelphia. The course is being jointly sponsored by the American Public Health Association and the American Association of Public Health Physicians and will be under the direction of Dr. James J. James, MD, DrPH, MHA, the Director of the American Medical Association's Center for Public Health Preparedness and Disaster Response. Other details are as follows:
DATE: Sunday, December 11, 2005
TIME: 2:30 PM--6:30 PM EST
PLACE: Marriott Philadelphia, International Ballroom, Salon I
CME: 4 Hours provided by the AMA
REGISTRATION AND FEES: Fee waived for APHA Annual Meeting registrants, and for current AAPHP members who pre-register by E-mail ( cundiff@reachone.com ) by Sunday, December 4, 2005.
For further questions about this course, please contact either of the undersigned.
If you feel this course will benefit you and the communities you so well serve, please make every effort to attend. We hope that many Health Departments, Teaching Institutions and other organizations will see it fit to require this course as a part of training their Public Health Leadership for the future. Please feel free to pass on this letter to others who you feel might be interested.
Sincerely,
Arvind K. Goyal, MD, MPH
President
American Association of Public Health Physicians
Phone (847) 255-0095
and
Georges C. Benjamin, MD, FACP
Executive Director
American Public Health Association
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On-site registration for the APHA Annual Meeting will be available starting 2005-12-10 at the Pennsylvania Convention Center, 1101 Arch Street, Philadelphia. Rates for on-site registration are posted at http://www.apha.org/meetings/reg_fees.htm .
We hope to see you in Philadelphia at both AAPHP and APHA!
3) "Notes in a Bottle" on Climate, Mortality Trends, CHD:
AAPHP member Donald W. MacCorquodale, MD, MSPH sent us another installment in the "Notes Washed Up in a Bottle" series.
In this issue, he notes a recent book on Integration of Public Health with Adaptation to Climate Change ; discusses trends in U.S. mortality rates and causes of death; and summarizes a recent paper on declining cardiovascular deaths in England and Wales.
Today's note is available at http://www.aaphp.org/bottle/2005/nov12.htm . Past issues are indexed at http://www.aaphp.org/bottle/allnotes.htm .
4) Over 200 Jobs!
The AAPHP/ACPM Job Market Initiative (JMI) web page currently indexes 207 vacant jobs for which the skills of a Preventive Medicine Physician would significantly enhance job performance. Almost none of them are advertised in the original journals as "Public Health" or "Preventive Medicine" jobs, so the JMI seeks them in other places and summarizes the listings as a service to the specialty.
At the current level of volunteer support, we can maintain an inventory of between 150 and 250 current job listings at any one time. We believe that with more volunteers, we could locate and summarize at least twice as many jobs. To volunteer as an abstractor, contact JMI Chair Joel L. Nitzkin, MD, MPH, DPA ( jln@jln-md.com ).
This issue's Featured Job is the Duval County Health Director job in Jacksonville, Florida. You can link directly to the full-page ad at http://www.aaphp.org/Jobs/2005/Nov/111005flduvalctydir.htm , or browse your way in from the main JMI page at http://www.aaphp.org/JobMarket/PHP_positions.asp . Applications are due by 2005-11-30.
5) Conference Call on Response to Radiological Terrorism:
CDC's Clinician Outreach and Communications Activity (COCA) is sponsoring a conference call on "Radiological Terrorism: Medical Response to Mass Casualties". Speakers will be James Smith, PhD and Jeffrey Nemhauser, MD from CDC's National Center for Environmental Health.
This call will be held on Tuesday, 2005-11-15 at 1:00 pm EST. The call-in number is (888) 469-3182 and the Passcode is "Radiation".
6) Electronic Health Records and Adolescent Privacy Concerns:
The Association of State and Territorial Health Officials (ASTHO) recently advised officials of a potential problem with current Electronic Health Records software.
Some Federal and state laws designate adolescents' contraceptive-related, STD-related, and mental health visit records as confidential records, requiring special permission before parents (or, in some cases, the patient) can have access to these portions of their children's medical record.
These laws are designed to increase the timeliness and outcomes of such care. Without these confidentiality protections, it is thought that many adolescents might not otherwise seek out their clinicians, or might not inform their clinicians accurately.
Current electronic health record software does not facilitate selective on-screen viewing of a medical record. Specially protected information may need to be masked by manually committing the electronic record to paper before parent viewing.
The original article, "Privacy Laws for Adolescents Thwart Electronic Records" was published in the 2005-08-24 Wall Street Journal (subscription required). We saw it summarized in "ASTHO E-Health", October 2005.
7) Smallpox Vaccine Clinic Planning - Software Alternatives:
CDC's 2005-11-04 MMWR announces they now have not one, but two different software products for planning smallpox vaccination clinics. Edited and abridged announcement:
Maxi-Vac Alternative, a public use software program, is now available. CDC developed Maxi-Vac Alternative to refine human resource allocations (e.g., physicians and nurses) at smallpox vaccination clinics.
Maxi-Vac Alternative is a companion program to Maxi-Vac 1.0, which was released in 2003. The two programs differ in terms of the time patients will require at each station and the selections the user can make for number of personnel, size of patient pre-vaccination orientation rooms, and the need for vaccination witnesses. Because no one scenario can describe all contingencies of an emergency mass smallpox vaccination campaign, users should examine both versions before deciding which version to use.
Both Maxi-Vac Alternative and Maxi-Vac 1.0 and their manuals can be downloaded from http://www.bt.cdc.gov/agent/smallpox/vaccination/maxi-vac . Both programs and manuals are in the public domain and may be used and copied without permission; however, citation as to source (provided in the manuals and in online help functions) is appreciated.
(Original source: MMWR 2005 Nov 04; 54(43):1106. To see the unedited announcement, visit http://www.cdc.gov/mmwr/preview/mmwrhtml/mmt5443a6.htm .)
8) Member Update:
Thanks to Mark E. Battista, MD, JD; Jose J. Gorrin, MD, MPH; Elizabeth I. Krenz, MD; Douglas S. Lloyd, MD, MPH; Deborah Miller, MD, MPH; Ana M. Parrilla, MD, MPH; Karen R. Steingart, MD, MPH; M. Roy Schwarz, MD; and Milind Tilak, MD. These physicians joined or renewed AAPHP membership since the last issue of E-News.
2006 membership forms are available on the Web at http://www.aaphp.org/Membership/2006MembershipForm.pdf . Medical students and resident physicians (in any specialty) are eligible for free membership for 2006 and 2007. All others may join or renew at the 2005 membership rates until 2005-12-15.
Acknowledgements:
Thanks to the International Society for Infectious Diseases and to their update service, ProMED-Mail, for much of the material used to prepare this issue's "Influenza Update". Readers who want more detail on international infectious disease issues, and who want these details faster, can subscribe to ProMED-Mail at http://www.promedmail.org .
Thanks also to Margaret Shuhart, MD and the Department of Medicine, University of Washington; to AAPHP member Don MacCorquodale, MD, MSPH; and to AAPHP Webmaster Kim Buttery, MD, MPH. They supplied the E-News with helpful information; reviewed and commented on preliminary drafts; and provided technical support for E-News production.
And thanks to you, AAPHP members and E-News readers, whose interest and support makes the E-News worthwhile!
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Dave Cundiff, MD, MPH ( cundiff@reachone.com ) AAPHP Secretary and E-News Editor
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