AAPHP E-News, June 9, 2006


This is an electronic update for members and friends of the American Association of Public Health Physicians (AAPHP). We issue this from time to time, whenever several items of interest come to our attention.

Please send items of interest for the E-News -- and any other feedback -- to E-News editor Dave Cundiff, MD, MPH. Thanks!


 

CONTENTS:

 

1) AAPHP Bulletin Includes Meeting Announcements

2) Annual Meeting in Chicago 2006-06-11

3) Measles and Mumps, Europe and USA

4) HPAI H5N1 Raises Alarms, But No Evidence of Mutation

5) Parent Guides for Sex Education

6) Tobacco-Related Policy Controversies

7) In Memoriam - Drs. Atwood and McBeath

8) Dr. Harmon will Direct Jacksonville-Duval County HD

9) Acknowledgements

 


 

 

1) AAPHP Bulletin Includes Meeting Announcements:

 

AAPHP's June 2006 Bulletin was recently posted at http://www.aaphp.org/Bulletins/bulletin06jun.pdf and was delivered to the mailing house several days ago.

 

This includes information about this Sunday's Membership Meeting in Chicago, about the upcoming AMA House of Delegates meeting, and about other AAPHP activities on your behalf.

 

The paper Bulletin has been mailed to AAPHP members.  The PDF file is available free to all, at the Web address above.  Please tell your colleagues!


 

2) Annual Meeting in Chicago 2006-06-11:

 

Our Annual Meeting is still scheduled for SUNDAY, JUNE 11, 2006, at the HILTON CHICAGO, 720 South Michigan Avenue, Chicago, Illinois, (312) 922-4400.  We will meet in the Williford A room on the third floor, from 4:30 pm to 8:00 pm Central Time.

 

(There are several other Hiltons nearby.  We're at the Hilton Chicago, 720 South Michigan Avenue!  Directions, and other information about the hotel, can be found at http://www.chicagohilton.com/hotels_hiltonchicago.aspx.  A map of the third floor, showing the Williford room, is at http://www.hilton.com/en/hi/hotels/floorplans.jhtml?ctyhocn=CHICHHH&floor=3&tab=reception.)

 

From 4:30 pm to 5:30 pm, we will hold a Business Meeting, including elections of officers and trustees, and consideration of proposed bylaws amendments on outside business and on succession planning.

 

At 5:30 pm, we will share a presentation on "The AMA and Public Health" by MICHAEL D. MAVES, MD, MBA, Executive Vice President and Chief Executive Officer of the AMA.  Dr. Maves' presentation, including questions and answers, is scheduled from 5:30 pm to 6:00 pm.

 

From 6:00 pm to 8:00 pm, we will share a presentation from the AAPHP's Preventive Services ToolKit (PSTK) project.  Dave Cundiff, MD, MPH, from the PSTK faculty team, will present the team's work on "Implementing Preventive Services:  Tricks of the Trade".  Category 1 CME has been applied for.  We plan to serve pizza and soft drinks during the PSTK presentation.

 

We regret the short notice for this meeting.  We hope as many members as possible can attend.

 


 

3) Measles and Mumps, Europe and USA:

 

Measles Immunization is recommended for all travelers to the World Cup Soccer Tournament in Germany.  Since January 2006, 1106 cases of measles have been reported in the cities of Cologne, Dortmund and Gelsenkirchen. 

 

Measles outbreaks are also reported in Denmark, Greece, Spain, Sweden and Ukraine.

 

Pan American Health Organization (PAHO) recommends that immunization (MMR or MR) should be obtained at least 2 weeks prior to leaving for Germany.  The Western Hemisphere is free of indigenous measles, but has occasional outbreaks of imported disease.

 

The Pan American Health Organization press release on this advisory is at http://www.paho.org/English/DD/PIN/pr060602a.htm.

 

***

 

The Midwestern USA has an ongoing mumps outbreak.  During January 1 - May 2, 11 states reported 2,597 cases of mumps.  Twelve mumps viral isolates from six states were characterized; all were mumps genotype G.

 

For 80% of the 2,597 mumps cases with patient age available, the median age was 21 years (range: <1 year to 96 years).  The incidence rate was highest among persons aged 18--24 years (17.1 per 100,000 population), followed by persons aged 5--17 years (5.2) and 25--39 years (4.8).

 

Parotitis was reported in 66% of the 1,327 patients for whom such data were available. Data regarding mumps complications and hospitalizations are incomplete. However, complications have included 27 reports of orchitis, 11 meningitis, four encephalitis, four deafness, and one each of oophoritis, mastitis, pancreatitis, and unspecified complications.

 

Preliminary vaccination data in Iowa were reported through May 3, 2006.  Among 1,192 patients, 6% were unvaccinated, 12% had received one dose of MMR vaccine, and 51% had received 2 doses of MMR vaccine.  The rest -- most of them adults -- had unknown vaccination status.

 

A recent CDC summary on this outbreak, as of 2006-05-18, is at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm55d518a1.htm.


 

4) HPAI H5N1 Raises Alarms, But No Evidence of Mutation:

 

A recent family cluster of highly pathogenic avian influenza H5N1 (HPAI H5N1) showed much more efficient intra-family spread than expected, initially causing worldwide alarm.  Subsequent tests showed no change in the virus; presumably this was an unfortunate and unusual circumstance of family genetics or environment.

 

The European Centre for Disease Prevention and Control (ECDC) published a revised risk assessment for Europe on 2006-06-01.  They conclude that HPAI H5N1 is unlikely to disappear from Europe in the foreseeable future.  It has not yet mutated into a more dangerous form, but it could.  In any event, poultry workers (professional and amateur) should take extra precautions when working with wild or domestic fowl.

 

Another ECDC report as of 2006-06-09 concludes that there is only minimal human risk from possible HPAI H5N1 exposure while bathing in lakes and rivers this summer.

 

Both ECDC reports are at http://www.ecdc.eu.int.

 


 

5) Parent Guides for Sex Education:

 

Planned Parenthood Health Services of Southwestern Oregon (http://www.pphsso.org) recently issued a new adaptation of its “No Place Like Home” (for sexuality and sex education) parents’ guides. The book by Mary Gossert, MS was already published in English and Spanish versions.  It is divided into segments by age group, often subdivided by theme.  Medical student Jacqueline Sequoia, MPH and illustrator Kathleen Brewer have now adapted the series as an 86-page PDF file for American Indian/Alaska Native parents.

 

To read any of the three versions, go directly to http://www.noplacelikehome.org/contentsimages/contents.htm for viewing and download.  The PPHSSO Web site is planned for renovation soon.  If this Web address doesn't work, try http://www.pphsso.org or http://www.noplacelikehome.org for access to the "No Place Like Home" series.


 

6) Tobacco-Related Policy Controversies:

 

The National Institutes of Health is convening a "State-of-the-Science" conference on "Tobacco Use": Prevention, Cessation, Control" next week.  Will they limit themselves to only the "science" of randomized controlled trials, or will they consider community and policy interventions that don't lend themselves to that form of evaluation?  We haven't been able to find out -- but if and when we do, we'll let you know.

 

***

 

The World Health Organization (WHO) was criticized in the Washington Post for its 2006-05-31 World No-Tobacco Day theme of "Tobacco: Deadly in Any Form or Disguise".  Distinguished scientists and epidemiologists lined up to criticize or defend WHO's choice of slogan and message. WHO's supporters and detractors agreed that WHO appears to draw few practical distinctions between smoked tobacco products (proven to cause very high rates of illness and death) and smokeless tobacco products (proven to cause much lower rates of illness and death).  But they disagreed on whether the message, "Deadly in Any Form" is an appropriate one for public health authorities.

 

Some policy experts call for "harm reduction" -- in which most smokeless tobacco products are seen as an inexpensive and well-tolerated method of smoking cessation.  Many of them recommend a change in federal policy to allow smokeless tobacco to be promoted as an alternate cessation method, much safer than smoking.  Others laud pharmaceutical-grade nicotine delivery systems as the only safe nicotine source, warning that promotion of smokeless tobacco may primarily result in more non-users becoming addicted to nicotine.

 

None of this is happening in a financial vacuum.  "Big Tobacco", faced with the progress of smoking restrictions in North America, is beginning to promote smokeless tobacco products for its own reasons.  The pharmaceutical nicotine replacement industry has many scientists on its own payroll.  These scientists' objectivity is not above question.  Finally, some of the smokeless tobacco advocates decline to discuss any details of their funding, so there is no way to evaluate their potential conflicts of interest.

 

[E-News editor's note:  Until we have better public health data, it seems that personal beliefs will be the basis for much of the policy-setting on smokeless tobacco products.  Given the large number of people wanting to quit, and the poor success rates of all cessation methods, the need for community-based policy research seems urgent.]


 

7) In Memoriam - Drs. Atwood and McBeath:

 

Robert G. Atwood, MD, MPH, Health Officer of the Yakima (WA) Health District from 1974 to 2001, died in April 2006.  Bob was a member of AAPHP for many years, and attended AAPHP's national meetings regularly in the 1980's.  An obituary from the family is on the Web at http://archiver.rootsweb.com/th/read/ATWOOD/2006-05/1146714359.  A tribute from Yakima Health District is on Page 1 of the Health District's May Bulletin at http://www.co.yakima.us/health/documents/bulletin/bulletin5_3.pdf.

 

William H. McBeath, MD, MPH, who served as Executive Director of the American Public Health Association (APHA) from 1973 to 1993, died in May 2006.  Bill was a good friend of many of us in AAPHP, and of the public health community everywhere.  A brief memorial from APHA is at http://www.apha.org/news/press/2006/051906_McBeath.htm. 


 

8) Dr. Harmon will Direct Jacksonville-Duval County HD

 

AAPHP member and Preventive Services ToolKit faculty member Robert G. Harmon, MD, MPH will direct the Duval County Health Department in Jacksonville, Florida, beginning 2006-08-11.

 

We're proud that Dr. Harmon was introduced to this job opening as a result of the AAPHP/ACPM Job Market Initiative work.  We wish him every success!

 

An article about Dr. Harmon's experience is in the ad-supported Web site of the Florida Times-Union, which requires free registration and requests birthdates: http://www.jacksonville.com/tu-online/stories/052506/met_21961353.shtml.


 

9) Acknowledgements:

 

In addition to those listed above, thanks to AAPHP member Gloria Casale, MD, MPH and to the ProMED-Mail service of the International Society for Infectious Diseases (http://www.promedmail.org) for most of this issue's information on communicable diseases; and to Stephanie N. Craig Rushing, MPH, Director of the “Project Red Talon” for STD/HIV prevention at the Northwest Portland Area Indian Health Board, for information about the “No Place Like Home” sex education support programs.

 

Dave Cundiff, MD, MPH (cundiff@reachone.com)

AAPHP Secretary and E-News Editor

 


 

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