In a budget memo released in late March, the Environmental Protection Agency (EPA) proposed eliminating two programs that focus on limiting exposure to lead paint. The suggested proposal would eliminate as much as $16.61 million in funding and over 70 full-time staff members. While the current federal government is looking to get rid of as much federal oversight as possible by transferring powers and responsibilities back to the states, environmental and public health advocates are extremely concerned about the hazardous consequences for citizens–particularly children.

History of Lead and Lead Paint Use

Lead is a naturally-occurring metal found in the Earth’s crust. As one of the earliest discovered metals in human history, lead quickly gained popularity due to its corrosion resistance and low boiling point. In ancient times, “sugar of lead” was used by Roman winemakers as one of the first artificial sweeteners. Up until the 19th century, white lead pigments were widely utilized in paints by artists, as the durability of lead made it an ideal paint additive. Lead-based paint was also used in the U.S. in the 1920s, though several European countries had already banned the use of it.

Usage of lead-based paint started to decline in the 1940s. In 1971, the Lead-Based Paint Poisoning Prevention Act (LBPPPA) was passed, which aimed to phase out lead paint use in housing built with federal dollars. Lead paint was eventually banned altogether by the American government in 1978.

Lead Poisoning

Lead poisoning occurs when you absorb too much lead by breathing or swallowing it. The neurotoxic effects of lead are substantial, and children are particularly susceptible. When the LBPPPA was passed in 1971, a blood lead level of 60 micrograms per deciliter was considered safe. It wasn’t until 1991 that the Centers for Disease Control and Prevention (CDC) lowered the “acceptable” blood lead level to nine micrograms per deciliter or less. That number has since been lowered again, and there is still no known level of lead exposure that is considered safe.

“Lead Paint” Courtesy of Mike Mozart : License: (CC BY 2.0)

Lead-based paint, which also includes any lead-contaminated dust, is one of the most common causes of lead poisoning. According to a 2011 national housing survey, more than a third of housing units across the nation contain lead-based paint. Risk of exposure is particularly high in older homes with flaked or chipped paint.

Some neurological and behavioral effects of lead poisoning are considered to be irreversible, and it’s estimated that 2.6 percent of American preschool children have a blood lead concentration over 5 micrograms per deciliter–the current level at which the government recommends public health intervention. Children may experience developmental delay and learning difficulties as a result of lead exposure. Most lead poisoning in children occurs from eating chips and flakes of deteriorating lead-based paint. Children with pica, a disorder which leads to a compulsive appetite to consume non-food items, are especially at risk of ingesting lead.

Lead Paint Programs

In October 1992, Congress passed the Residential Lead-Based Paint Hazard Reduction Act (Title X of Public Law 102-550). Title X amended the Toxic Substances Control Act, and was designed to develop a national strategy to address lead-based paint risks in all housing. Congress promulgated Title X after concerns that low-lead poisoning was widespread amongst American children, particularly those under six years old and minority and low-income populations.

EPA’s Proposed Budget Cuts

On March 31, 2017, a 64-page budget memo covering the EPA’s  2018 fiscal year was released by the Washington Post. The memo showed that officials within the EPA want to eradicate two programs that reduce children’s exposure to lead paint. One of the programs at risk is the Lead Risk Reduction Program. The new budget would slash $2.56 million from its funding and lay off about 73 full-time equivalent employees. This program requires professional remodelers to participate in training to learn safe practices for stripping away lead-based paint in homes. The program was created through an EPA regulation in 2010, which mandated federal certification for renovators.

Lead-based paint programs run by the EPA are also potentially at risk of losing $14.05 million. The EPA has been offering financial assistance to states and tribal jurisdictions, under Section 404(g) of the Toxic Substances Control Act, since 1994. States and tribal programs are given federal money to address lead-based paint risks. Money is granted to develop or carry out authorized lead-based paint activities programs; authorized lead pre-renovation education programs; or authorized renovation, repair, and paint programs.

While a spokeswoman for the EPA stated that the cuts are intended to give local and state governments the authority and responsibility to fund their own entities, the vast majority of states are unable to do so. Only fourteen states are actually able to operate programs which train contractors in removing lead paint. The rest depend on the federal government to successfully run their programs.

These changes come after a Trump Administration order to reduce the EPA’s overall budget by 31 percent. The EPA has proposed eliminating 25 percent of its employees and scrapping 56 programs including: lead reduction programs, water runoff control, and pesticide safety.

Environmental Racism?

Between 1997 and 2001, the CDC found that 60 percent of children who were reported with confirmed high blood-lead levels were black. Children living and playing in inner cities are more likely to be exposed to lead blowing across playgrounds. A 2015 analysis by the Huffington Post uncovered a strong correlation between high percentages of black populations and high lead poisoning rates. Between 1999 and 2004, black children were 1.6 times more likely to test positive for lead in their blood than white children. In Detroit, where 84 percent of the population is black, eight percent of children tested had elevated blood-lead levels in 2013.

Low-income and minority populations are far more likely to live in neighborhoods with dilapidated homes, thereby elevating their risk of exposure to lead paint. Other legal and environmental advocates note that the cuts to these programs will set the U.S. back decades in preventing lead poisoning and only stifle revenue streams. In other words, the government is likely dooming low-income and minority citizens to toxic living conditions.

CDC Lead Poisoning Prevention

The CDC still has programs to help study and eliminate childhood lead poisoning in America. The Lead Contamination Control Act of 1988 authorized the CDC to initiate these efforts. As a result, the CDC Childhood Lead Poisoning Prevention Program was created which helps to develop policies to prevent childhood exposure and poisoning, educate the public and health care providers, provide funding to state and local health departments, and support research to determine the efficacy of prevention efforts.

To date, the CDC has funded nearly 60 childhood lead poisoning prevention programs; developed the childhood blood lead surveillance system, which allows states to report their data to the CDC; expanded public health laboratory capacity; and provided training to public health professionals. The CDC, U.S. Department of Housing and Urban Development, EPA, and other agencies have created a federal interagency strategy to achieve the elimination of childhood lead poisoning as a public health issue by 2020.

Conclusion

While lead-based paint was banned almost forty years ago, its persistence in homes across the country is still alive and well to this day. Pre-1980 American housing contains upwards of three million tons of lead in the form of paint. If the EPA strips these lead reduction programs of funding, this nation will continue to have a high risk of lead exposure for children and adults. Since 36 states rely on federal money to keep programs running, the EPA’s proposed budget is establishing a permanent lead-based environment for the country’s most vulnerable populations.

Nicole Zub

Nicole is a third-year law student at the University of Kentucky College of Law. She graduated in 2011 from Northeastern University with Bachelor’s in Environmental Science. When she isn’t imbibing copious amounts of caffeine, you can find her with her nose in a book or experimenting in the kitchen. Contact Nicole at Staff@LawStreetMedia.com.

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In recent years, scientists have been paying a lot of attention to a striking development: the number of infectious diseases has increased considerably. That rise was not just one or two more diseases each year. In fact, over the last 100 years, the number of new infectious diseases discovered each year has quadrupled and outbreaks have tripled. What explains this dramatic increase in new infectious diseases? Read on to find out the answer to this question, how scientists are working to fight diseases, and what the consequences could be if we continue along this same trajectory.

Infectious Disease on the Rise

To begin to understand the rising levels of infectious disease, it is first imperative to understand the common terminology. Four terms, in particular, are used very frequently and require clarification. These terms are outbreaks, epidemics, pandemics, and endemic. An outbreak occurs when the number of cases of a specific disease in a specific community rises above what would normally be expected. Epidemics are, “a widespread increase in the observed rates of disease in a given population.” Pandemics are basically the multinational form of epidemics in that they encompass worldwide outbreaks beyond a particular population. Endemic is decidedly different than the other terms and essentially means a rate of disease that is consistently higher within a given group. These definitions are particularly important for the people treating an outbreak on the ground, as it helps them tune their methods to the reality of the situation. The following video gives an overview of how disease spreads:

Although that rise sounds troubling it is not all doom and gloom. While individual outbreaks are increasing, they are affecting fewer people now than before. Additionally, only a small variety of infectious diseases are responsible for the majority of outbreaks. Furthermore, of these strands, a little over half are zoonosis–diseases that are passed from animals to humans. Even among zoonosis, there are only a few zoonotic diseases that cause most outbreaks. In other words, outbreaks are on the rise but a decreasing number of diseases–passed from animals to humans–account for that rise. The question then becomes, what is leading to the rise in outbreaks?

Factors Leading to the Rise of Infectious Diseases

There are several reasons for this increase, but it starts with us and the actions we take. Many of the recent outbreaks are not new diseases, only new to us as a species. They have been incubating and traveling all across areas like rainforests for tens of thousands of years. However, with human encroachment in the form of farming, mining, housing, etc. people are starting to come into contact with these diseases more often and the results are not always good.

Other human manipulations of the environment are also leading to the rise of infectious diseases. These include seemingly benign activities such as reforestation, animal farming, and even flooding rice patties. Sometimes it can be a combination of human activity and environmental factors, such as when milder winters that are the result of global warming fail to kill off the usual number of pests. In fact, rising temperatures have the potential to be one of the greatest contributors to the continued rise of infectious diseases in the coming years, while ailments such as Malaria, which prosper in warmer climates, may become much more virulent. The video below details how global warming can increase the risk of infectious disease:

Other trends, like urbanization, may also contribute to the rise of infectious diseases. By clumping closer together, the chances of an infection spreading quickly are much higher. This is particularly true when urbanization occurs in poorer countries without effective public health monitoring and preventions systems. Similarly, more travel between countries and regions can introduce infections to places that have never seen them before and it can increase the likelihood that an epidemic becomes a pandemic. Even technology and modern supply chains can present a risk, as processing consolidation may increase the likelihood that contamination spreads.

Resistance to antibiotics and resulting superbugs are additional issues leading to the rising number of infectious diseases. However, this is also a problem for viral infections for many of the same reasons, including over prescription of certain medicines and prescribing the wrong medication for a specific disease. Viruses are especially problematic because they can evolve so quickly that it is impossible to stay ahead of them. The clearest example of this is influenza or the flu which changes from year to year. Along with antibiotics, many sanitation systems are also proving less useful than before. In this case, the issue has more to do with the lack of upkeep in existing public health systems that has led to outbreaks of old diseases such as cholera.

Efforts to Fight Outbreaks

Given this trend, what is being done to stem the tide? Actually, governments began addressing the rise of infectious diseases several years ago. A response was prompted back in 2014, following the outbreaks of MERS and bird flu. That year, the United States, along with dozens of countries and organizations, announced a plan to respond and treat new outbreaks where they start.

Currently, efforts to fight infectious disease in the United States fall under the authority of the Centers for Disease Control, or CDC. Specifically, many of those efforts are housed in the National Center for Emerging and Zoonotic Infectious Diseases or NCEZID. NCEZID focuses on reducing both illnesses and deaths that are associated with infectious diseases. It also strives to be proactive in protecting against the spread of infectious diseases.

At the international level, there is the World Health Organization (WHO). Much like the CDC in the United States, the WHO also focuses on reacting to and fighting epidemics. The WHO acts more like a clearinghouse encouraging individual countries to improve their own existing systems and work to integrate them internationally so a crisis in one country can be handled as effectively by its neighbor if it crosses international borders. When it comes to the spread of infectious disease, the WHO serves as an international monitor to identify and coordinate a response to outbreaks.

Conclusion

Foreseeing and preventing all outbreaks of infectious disease would be impossible. Just last year, for instance, several people in Russia were infected with Anthrax when frozen strains of the disease were released when permafrost melted. While this could easily lead to discussions about global warming, the truth is that it just as clearly exemplifies that it is impossible to anticipate everything. In fact, in some cases, efforts are even seen as misguided or unwanted.

Many recent efforts have focused on identifying and understanding new diseases, like those deep in the rainforest. However, such methods have also been criticized for spending scarce funding to search out new diseases when funds could instead be used for treating known maladies. Although it seems odd to criticize people for being proactive, that might be a fair critique in a world with finite resources. In fact, it might be fair to wonder why people are really that concerned with infectious diseases at all.

This is because non-communicable diseases, like cancer, which cannot be spread from one person to another, kill far more people each year than infectious diseases. However, those diseases also originate within us and frequently have to do with factors that we are less able to control, such as getting older. Conversely, based on the fact that only a few diseases cause most of the outbreaks, infectious disease can be managed and their threat reduced. Thus counteracting the rise of infectious diseases is likely to continue to be a mainstay of health policy both nationally and globally.

Michael Sliwinski

Michael Sliwinski (@MoneyMike4289) is a 2011 graduate of Ohio University in Athens with a Bachelor’s in History, as well as a 2014 graduate of the University of Georgia with a Master’s in International Policy. In his free time he enjoys writing, reading, and outdoor activites, particularly basketball. Contact Michael at staff@LawStreetMedia.com.

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According to a new study by the U.S. Center for Disease Control and Prevention, teens who use synthetic marijuana are more likely to engage in risky behavior, have unprotected sex, and abuse other, potentially more harmful drugs. The study interpreted data from the 2015 Youth Risk Behavior Survey to come to its conclusions.

Researchers found that “nearly one in 10 high school students had used synthetic marijuana at some point in their lifetime,” said Heather Clayton, the lead researcher of the CDC study, and a scientist with the center’s Division of Adolescent and School Health.

“The findings indicate that students who report using synthetic marijuana are possibly on a very concerning health trajectory, which is particularly serious given that synthetic marijuana use is relatively common among adolescents,” Clayton added.

Those who use synthetic pot–also known as “fake weed”–are more likely to carry a gun or engage in violent behavior than those who use traditional marijuana, the researchers said, and are more likely to have begun using marijuana at an early age. Synthetic marijuana use is also linked to having unprotected sex. So why do people turn to synthetic marijuana rather than the natural plant? It’s readily available, it’s cheap, and it’s hard for authorities to detect, due to manufacturers’ ever-changing formulas and marketing techniques.

Like traditional marijuana, the synthetic variety is classified as a Schedule I drug by the Drug Enforcement Administration. Though often packaged and marketed in a colorful, almost innocent fashion (K2 and Spice are common strain varieties), synthetic marijuana is tied to a variety of adverse effects. According to the National Institute on Drug Abuse, synthetic marijuana, which usually consists of dried leaves sprayed with a menagerie of chemicals, can lead to “rapid heart rate, vomiting, violent behavior, and suicidal thoughts.”

The CDC researchers said that their findings were not meant to establish a causal relationship between synthetic marijuana use and risky behavior in teens. For instance, people who are more likely to engage in risky or violent behaviors are also more likely to try synthetic marijuana. But “it’s still important for health professionals and school-based substance-prevention programs to focus on strategies that reduce the initiation of marijuana and synthetic marijuana use,” Clayton said.

Alec Siegel

Alec Siegel is a staff writer at Law Street Media. When he’s not working at Law Street he’s either cooking a mediocre tofu dish or enjoying a run in the woods. His passions include: gooey chocolate chips, black coffee, mountains, the Animal Kingdom in general, and John Lennon. Baklava is his achilles heel. Contact Alec at ASiegel@LawStreetMedia.com.

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On Monday, ten more people were confirmed by Florida Governor Rick Scott to have been infected by a Zika carrying mosquito in the Miami area. That brings the total number of local Zika cases–that is, those where transmission took place on American soil as opposed to an infected traveler from Latin America–to 14. All the cases, the first of which was reported a few weeks ago, are believed to have emerged in a one square mile area just north of downtown Miami, in the Wynwood arts district. The latest cases were found among more than 200 people who were tested for Zika within the affected area of Miami.

Governor Scott said in a statement that he will issue a travel notice to pregnant women or women who are thinking about conceiving a child in the near future. Zika is especially dangerous to pregnant women, because a child born to a Zika-infected mother has a high chance of developing microcephaly. Scott also said he will be calling on the Centers for Disease Control and Prevention to assist in investigating the Wynwood cases, as well as in preventing further transmission.

Dr. Antonio Crespo, an infectious disease specialist with Orlando Health, said it’s no shock that Florida is the site of the first local Zika transmissions in the U.S. Aedes aegypti, the mosquito that carries Zika and thrives in tropical climates, is common in Florida, Crespo said. That, combined with the fact that travelers from parts of Latin America where Zika is rampant often land in Florida, is why local cases were inevitable. “When you put the two together it’s not a surprise that at some point there was going to be a local transmission,” he told Law Street in a phone interview.

Dr. Crespo is optimistic that the disease will be contained, however. “I’m optimistic with Zika–maybe cautiously optimistic–because of what we have seen in the past,” he said, referring to the state’s successful campaigns to thwart dengue fever and chikungunya, two mosquito-borne diseases also carried by Aedes aegypti. Those diseases saw sporadic outbreaks in Florida over the past decade, but were contained by a process called vector control–a similar process is now being employed to deal with Zika.

Vector control is a two-pronged strategy, both to prevent further transmission and the spread of existing cases. First, people in an affected area–in this case, Miami-Dade and Broward counties–must take pains to avoid getting bitten. The best way to do that, according to Dr. Crespo, is to follow the precautions prescribed by the CDC: apply repellent and erect mosquito nets inside and around their homes. The mosquito’s population is then contained by draining standing water–a favorable breeding ground–and spraying the affected area with larvicide. Eventually, Dr. Crespo said, the disease will be contained and choked at the source.

Crespo is confident that Zika will be contained, but considering the connectedness of the world today, he said, the threat should not be taken lightly. “We live in a world where people travel, so it’s very easy for one disease to be transferred from one country to another in a matter of hours,” he said. “We need to continue to be on high alert.”

Alec Siegel

Alec Siegel is a staff writer at Law Street Media. When he’s not working at Law Street he’s either cooking a mediocre tofu dish or enjoying a run in the woods. His passions include: gooey chocolate chips, black coffee, mountains, the Animal Kingdom in general, and John Lennon. Baklava is his achilles heel. Contact Alec at ASiegel@LawStreetMedia.com.

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A study published on Thursday from the Centers for Disease Control and Prevention (CDC) revealed two historic lows regarding the behavior of American teens: sexual engagement and cigarette use. On average, teens are having less sex than ever before and smoking fewer conventional cigarettes than their parents’ and grandparents’ generations, though the proliferation of electronic cigarettes has muddled the overall picture of nicotine use.

Among the findings of the National Youth Risk Behavior Survey–which consists of data from 2015, and polled 16,000 students from 125 public and private schools across the country–is that teens are engaging in less sex. Forty-one percent said they have had sex, down from six percent from last decade. Thirty percent said they’d had sex within the previous three months, a three to four percent decline from surveys taken throughout the last decade.

Experts are flummoxed as to why sexual activity has dropped. Some attribute it to increased computer and video game use, others point to sex as being less of a taboo than it has ever been, thus rebellious teenagers are less intrigued by its nefarious allure.

Also in the report: Less than 11 percent of teens said they smoked a cigarette in the last month, the lowest figure since the study began in 1991. Cigarette use among teens hit its peak in 1997 at 36 percent. But with the explosion of vaping–smoking electronic cigarettes–nicotine is still being consumed at high rates: 24 percent said they vaped within the last month.

“The bottom line is that youth should not be using any form of tobacco product, irrespective of whether it’s e-cigarettes, a combustible product like cigarettes, or smokeless tobacco,” said Brian King, CDC’s deputy director for research translation in the Office on Smoking and Health, in a conference call with reporters.

And in perhaps the most disturbing find of the study, 17 percent of students said they had taken prescription drugs–Oxycontin, Vicodin, Adderall, and Ritalin–without a doctor’s consent. That too is a downward trending figure, but experts involved in the study still find it to be alarmingly high.

“It suggests that there’s a norming behavior among kids that it’s okay to take these powerful drugs without somebody prescribing them for you,” said Doctor Stephanie Zaza, director of CDC’s Division of Adolescent and School Health. “That is a pattern that can be held over to adulthood and it can lead to other forms of risky drug taking.”

Alec Siegel

Alec Siegel is a staff writer at Law Street Media. When he’s not working at Law Street he’s either cooking a mediocre tofu dish or enjoying a run in the woods. His passions include: gooey chocolate chips, black coffee, mountains, the Animal Kingdom in general, and John Lennon. Baklava is his achilles heel. Contact Alec at ASiegel@LawStreetMedia.com.

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Welcome to the RantCrush Top 5, where we take you through the top five controversial and crazy stories in the world of law and policy each day. So who is ranting and who is raving today? Check it out below:

What are your #Slogans4Hillary?

Twitter hasn’t really been a boon of positive hashtags for the Hillary Clinton campaign. But that doesn’t mean they’re not hilarious, right? Whether you’re #WithHer or not, check out Twitter’s #Slogans4Hillary:

“I’ll be there for you… unless it’s no longer politically advantageous, in which case, I’m ghost” #Slogans4Hillary pic.twitter.com/Fhi0A7l95w

— Progressive Greens (@ProgressivGreen) May 24, 2016

80 Percent of Aquatic Venues in Five US States Failed Health Inspections, CDC Says

Gross! No big surprise that this has been trending for the past couple days. Summer is coming up and all I daydream about is being able to relax by the community pool in shades and a ‘kini. Sadly, a recent report by the Center for Disease Control has found that nearly one out of every eight public aquatic venues in Arizona, Texas, New York, California, and Florida have serious safety violations–so serious some venues have been closed. And at eight out of 10 facilities, at least one violation was found. These violations can range from risk of waterborne illness, to drowning, and even chemical burns! Needless to say, it’s not a good year to be that friend with a pool.

Bill Cosby Will Stand Trial

Things are not looking good for Bill Cosby. Today, he is in court for his first criminal pretrial hearing and is facing three counts of indecent assault from a 2004 case involving Andrea Constand, a former employee at his alma mater, Temple University. Cosby fans are still reeling from the initial allegations and refuse to believe them, while others hope he’ll serve serious time. It should also be interesting to see the role the media plays in the heavily-covered trials.

Bill #Cosby in court: Accuser says she was dizzy, felt ‘like jelly’: https://t.co/vLuq2915LK pic.twitter.com/w06qsLO690

— Canoe (@Canoe) May 24, 2016

Former Miss Universe Opens Up About Trump’s Body Shaming

Alicia Machado, the 1996 Miss Universe Winner, says Donald Trump, who owned the pageant company until last year, called her degrading names mocking her body image and Latina heritage. Rude!

Machado told UniVision that Trump called her “Miss Piggy” and “Miss Housekeeping.” These claims shouldn’t be hard to believe, given Trump’s penchant for nicknames.

Edward Snowden Calls for Overhaul of Whistleblower Protections

These calls come after a new source from inside the Pentagon released an account of how the system makes it impossible for personnel to expose wrongdoing in the government. According to the source, it has essentially become a trap. Snowden has stepped up to corroborate this claim, saying that leaking information to the press is the only way to make a difference. “There are no incentives for people to stand up against an agency on the wrong side of the law today, and that’s got to change.”

I love my country, but I hate this. https://t.co/zmxXYymS9O

— Edward Snowden (@Snowden) May 22, 2016

Rant Crush

RantCrush collects the top trending topics in the law and policy world each day just for you.

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In an interesting twist of events on Saturday, Robert De Niro, Tribeca Film Festival’s co-founder, decided to pull controversial documentary, Vaxxed: From Cover-Up To Catastrophe, that accuses the Centers for Disease Control and Prevention of covering up the link between vaccines and autism. He initially defended the screening just one day before.

De Niro issued a statement discussing his decision to pull the film:

“My intent in screening this film was to provide an opportunity for conversation around an issue that is deeply personal to me and my family. But after reviewing it over the past few days with the Tribeca Film Festival team and others from the scientific community, we do not believe it contributes to or furthers the discussion I had hoped for.” 

The film’s Director Andrew Wakefield, and producer Del Bigtree said:

“Robert De Niro’s original defense of the film happened Friday after a one-hour conversation between De Niro and Bill Posey, the congressman who has interacted directly and at length with the CDC Whistleblower (William Thompson) and whose team has scrutinized the documents that prove fraud at the CDC.”

The issue at hand here is whether or not De Niro is simply censoring another opinion because it is different than his. Those opposed to the decision argue that it is censorship and believe that this is just another way the media wants to shut down unpopular opinions.

Wakefield, an anti-vaccine advocate and former gastroenterologist (his license has since been revoked by Britain’s General Medical Council, according to CBS News), was the author of a widely discounted study published in the Lancet medical journal in 1998 but was retracted in 2010. The study claimed there was a link between the MMR vaccine and the development of autism, but many organizations, such as the CDC and WHO, have since discredited the claim.

However, where do we draw the line between censorship and saying that these ideas are false and there is no reason to give them validity?

What it comes down to is whether or not the opinions being shared hold some sort of validity, because if it doesn’t, then it is probably wrong. Yet, we find that people still hold these beliefs, and begin to pass them off as true.

If the science says you’re wrong, there is no point to screening this film because the discussion is already over. Would it make sense to show a conspiracy theory documentary about 9/11 or The Holocaust? No, because the discussion is over and there is no reason to argue in circles with someone who believes, despite all evidence, that they are correct.

An open discussion of opinions is a valuable tool for gaining a comprehensive understanding of an issue. However, when some opinions are simply not valid, it gives off a sense of balance in the ideas, which leads to the balance fallacy. This is an issue that reporters face every day–do we give equal weight to both sides as we are taught, even if one side is more valid than another? An example of this is the coverage of climate change. If both sides are given equal weight in a story, this may lead to a false understanding by the public that discounted claims are well supported by professionals or experts in their respective fields.

An example of this is the coverage of climate change. If both sides are given equal weight in a story, that may lead to a false understanding by the public that discounted claims are well-supported by professionals or experts in their respective fields.

The Toronto Star’s Vinay Menon put it well saying:

“This isn’t about free speech. It’s about costly ignorance. It’s about living at a time when diseases like measles were close to eradicated from much of the developed world and then returned. It’s about knowing when a “conversation” is called for and when there is nothing left to say. It’s about drawing a line between bad science and dangerous science.”

Ultimately, the decision to keep “Vaxxed” from the big screen was a wise one.

Julia Bryant

Julia Bryant is an Editorial Senior Fellow at Law Street from Howard County, Maryland. She is a junior at the University of Maryland, College Park, pursuing a Bachelor’s degree in Journalism and Economics. You can contact Julia at JBryant@LawStreetMedia.com.

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In light of the prescription drug abuse epidemic, the Food and Drug Administration (FDA) is cracking down on the labeling of opioid painkillers. According to the FDA, immediate-release opioid painkillers will now carry what is called a “black box” warning, which will warn about the “risk of abuse, addiction, overdose and death.”

The new labeling will also state that prescribing immediate-release opioid painkillers “should be reserved for pain severe enough to require opioid treatment and for which alternative treatment options are inadequate or not tolerated.” There will also be clearer instructions for dosage and dosage changes throughout treatment.

Immediate-release opioid painkillers include almost 175 different brands and generics, including Vicodin and Percocet. According to the Chicago Tribune:

Those medications, which often combine oxycodone with lower-grade medications, are among the most commonly used drugs in the U.S. and account for 90 percent of all opioid painkillers prescribed.

The extensions of these warnings apply particularly to the immediate-release painkillers; the FDA already upped labeling restrictions for extended-release painkillers in 2013. Extended-release painkillers were thought to be a bigger risk for addiction, but after the labeling changes in 2013, increased cases of overdoses, addiction, and death continued. In 2014, there was a high of 19,000 deaths related to the misuse of opioid painkillers, according to the CDC.

There’s also a worrisome connection between opioid painkillers and heroin use–given that some individuals who have become addicted to painkillers eventually turn to heroin once they are no longer able to access painkillers, or because heroin is often cheaper. If you combine deaths from opioid painkillers and heroin, the number of fatalities in 2014 jumps to almost 29,000.

Despite the fact that this labeling comes with a very good intention–cutting down on the abuse of opioids and resulting tragic deaths. However, some experts say that the FDA isn’t going quite far enough. Dr. Andrew Kolodny, the executive director of Physicians for Responsible Opioid Prescribing, pointed out that the new labeling still does not recommend maximum amounts. According to the New York Times Dr. Kolodny stated:

Without an upper dose or maximum duration of use on the label, I don’t think the change will have much of an impact.

As heroin and prescription drug abuse remain huge issues in the U.S., it’s laudable that the FDA is trying common-sense approaches to address them. The Obama administration is pushing for action by federal agencies and governors, so we should probably expect to see more efforts to combat drug addiction in the coming months.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

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For all you milk lovers out there, West Virginia may just be the new place to visit, vacation in, or even move to after this week’s big milk decision. That’s right, you heard me! Raw milk will soon be more accessible in the state of West Virginia for the first time in almost four decades.

Senate Bill 387 was signed by Governor Earl Ray Tomblin on March 3 and will go into effect 90 days later. This bill, which is a newer draft of a bill that failed to pass last year,  specifically legalizes “herd sharing,” or the trading of animals for their milk. The most recent version of the bill also requires the Department of Agriculture and the Department of Health and Human Resources to work together to create rules that will regulate the distribution and consumption of raw milk, making it more passable. Now, don’t be too quick to celebrate, because the selling of raw milk in West Virginia is still illegal, but it will be easier to get access to raw milk on farms after signing liability waivers.

So, what does this mean for your milk drinking habits? Well, let’s take a second to break down raw milk for those of you who aren’t familiar with this delicacy. Simply put, raw milk is any milk that has not been pasteurized to kill bacteria. It’s a product that has recently been in the spotlight for controversy surrounding its potential health benefits and drawbacks.

It seems like scientists are still in the process of making a judgment on whether raw milk actually is better for you than regular milk, or this whole hypothesis is just a sham. Proponents of the natural movement cite several potential benefits of un-pasteurized milk over your everyday grocery store carton. These benefits include better taste, potential health and allergy benefits, and the freedom argument–we should be able to drink whatever milk we want to drink! On the other side of the issue, raw milk haters claim that raw milk really doesn’t have any benefits relative to pasteurized milk and it is significantly more risky to drink. The CDC falls on that side of the debate, noting “The risks of drinking raw milk outweigh any possible benefits.”

But, regardless of these risk factors, West Virginia has given raw milk the benefit of the doubt! The irony in all this? In the legislature’s celebration after passing this hip new bill, they passed around a glass of milk (unpasteurized, of course) for the entire group to try. A few hours later, several of the delegates who had partaken in the milk festivities became sick with some kind of stomach bug that may or may not be linked to the milk consumption.

Several of the lawmakers claim that they don’t think it was the milk that did them in, but, whatever it was, it certainly does not look good.

The milk enthusiast that day, Representative Scott Cadle, was pushing the other members of the legislative body to “live dangerously” and try the milk. Later that day, after the illness was running rampant, he defended the milk to the Charleston Gazette-Mail, which he did not think was the main cause of illness that day:

With that many people around and that close quarters and in that air and environment, I just call it a big germ. All that Capitol is is a big germ.

It’s unclear whether or not this milk was the source, but pretty much all of the legislators claim that it definitely was not. Is that all just a facade to promote the now-legal raw milk? Who knows.

So, drink up (at your own risk) America. And make sure to click here to learn more about raw milk in your state and to stay updated on all of the rawest raw milk happenings this country has to offer.

To learn more, read: What’s the Deal with Raw Milk?

Alexandra Simone

Alex Simone is an Editorial Senior Fellow at Law Street and a student at The George Washington University, studying Political Science. She is passionate about law and government, but also enjoys the finer things in life like watching crime dramas and enjoying a nice DC brunch. Contact Alex at ASimone@LawStreetmedia.com

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In a rare show of bipartisanship, the Senate managed to pass a bill that would create new block grants for states and government agencies to fund prevention, education, and treatment for opioid addiction. These efforts come as drug overdose deaths reached the highest level in history in 2014, surpassing traffic and gun-related deaths. Opioid overdoses, which involve drugs like prescription painkillers and heroin, make up the majority of drug overdoses and were involved in 28,647 deaths in 2014 based on data from the CDC.

The increase in drug deaths has been driven by a rise in painkiller and heroin overdoses, which were the cause of six in 10 overdose deaths in 2014. Opioid-related deaths have been steadily increasing for over a decade, going up 200 percent since 2000. Heroin overdoses alone tripled between 2010 and 2014.

In light of the epidemic, Congress may now be taking important steps to prevent these deaths. The Comprehensive Addition Recovery Act (CARA) passed the Senate on Thursday with a 94-1 vote. The bill aims to help fund education, treatment, and prevention programs to combat overdose deaths. Senators Sheldon Whitehouse and Rob Portman have done much of the work to push the bill through the Senate and make drug addiction a national priority.

A central goal of CARA is to increase the availability of Naloxone, a life-saving medication that can counter the effects of an overdose. Expanding law enforcement and first responders’ access to Naloxone can have significant effects on efforts to combat overdoses. Based on the CDC’s analysis of Naloxone training programs, between 1996 and 2010 about 53,000 people were trained to use the drug, resulting in over 10,000 overdose reversals.

The bill also prioritizes aid to states with laws that reduce liability for people administering Naloxone, which may encourage states to adopt similar laws in order to encourage responders to use the drug without fear of a lawsuit in the event of complications.

Provisions in CARA also seek to reduce misuse and overprescription of painkillers, which is a large contributor to drug overdoses. The bill would create a task force to issue new standards for painkiller prescription as well as implement safeguards to ensure proper disposal of unused medications to prevent children from accessing them.

One of the most important aspects of the bill is its focus on treatment. Not only would it help increase funding for evidence-based treatment programs, it would also reinforce the idea that drug addiction should be viewed as a disease that should be treated rather than punished. By funding treatment alternatives to incarceration, the bill could help shift drug policy toward efforts that reduce dependency rather than merely penalizing it.

While CARA has broad-based bipartisan support, it still has some challenges. It initially faced difficulty in the Senate after New Hampshire Senator Jeanne Shaheen attempted to add a Democratic-backed amendment calling for $600 million in additional emergency funding. The Republican leadership in the Senate holds that sufficient funding already exists for the legislation. The bill will also need to pass the House, where an identical piece of legislation is currently in committee. Relative to most bills, CARA has a decent chance of passing as it has been well received by both parties and the White House, but election year politics could end up derailing these efforts.

Kevin Rizzo

Kevin Rizzo is the Crime in America Editor at Law Street Media. An Ohio Native, the George Washington University graduate is a founding member of the company. Contact Kevin at krizzo@LawStreetMedia.com.

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The World Health Organization’s director general, Margaret Chan, recently warned her executive board and the world that the Zika virus is posed to “spread explosively” throughout North and South America this year. Another WHO officer suggested that three to four million new infections are likely in that time frame.

The Zika virus, (pronounced ZEE-kuh) named after the Ugandan forest where it was first discovered, is transmitted by mosquitos. When Brazil reported its first case of Zika in 2015, it marked the first instance of the illness in the Western Hemisphere.

While the illness poses a threat to the countries it affects, the Zika virus isn’t much of an immediate concern for people living in the United States. The Aedes mosquito which carries the virus is native only to parts of Florida, and prefers the warmer climates of South America and Mexico. A person who is infected with Zika by a mosquito may experience a mild fever, a skin rash, and conjunctivitis, lasting up to a week. At first glance, Zika’s symptoms are indistinguishable from and not much more threatening than influenza.

This map shows how over time, the virus has moved from mosquito populations across oceans.

MAP: The spread of the Zika virus http://t.co/4vFT5ok6R0 pic.twitter.com/L3FPytZqts

— Post Graphics (@PostGraphics) September 21, 2015

Zika’s effects, however, are more than skin deep. For one, many countries with inadequate health services may see symptoms worsen. But the far more concerning result of these infections is the effect of the virus on the next generation. Many doctors share concerns that the children of mothers who have contracted Zika during pregnancy are born with a condition known as microcephaly. The connection between the virus and the condition was only made recently, as doctors in Brazil found the virus in the placentas of affected children, and in one autopsy of a baby who died.

Microcephaly, literally meaning “small head,” is a birth defect/condition in which stunted or abnormal development of the brain during gestation causes a child to be born with a smaller head than is healthy. Children born with microcephaly often experience developmental delays, difficulties with coordination and balance, and mental retardation, among various other physical ailments, according to the Mayo Clinic.

The main prevention advice being dispensed by health organizations like WHO is to avoid mosquito exposure by using mosquito nets and insect repellent. One doctor went as far as to instruct women in affected areas to not get pregnant, and women of child-bearing age who may have children are advised against traveling to these areas.

This level of attention is reminiscent of the Ebola scare of from 2014 to 2015, and word of such a widespread outbreak leaves many wondering if they should be fearful for their health. A recent Center for Disease Control report that a dozen travelers returning to the United States had the Zika virus further fanned the flames of concern.

The ramifications of an outbreak as large as WHO is predicting could be heartbreaking–if any the millions of affected women become pregnant, their children are at great risk of conditions which would lower their quality of life. President Barack Obama has urged the rapid development of vaccines and treatments  for Zika infections among American doctors, but the fate of millions will rest on careful prevention and hopefully, medical advances.

Sean Simon

Sean Simon is an Editorial News Senior Fellow at Law Street, and a senior at The George Washington University, studying Communications and Psychology. In his spare time, he loves exploring D.C. restaurants, solving crossword puzzles, and watching sad foreign films. Contact Sean at SSimon@LawStreetMedia.com.

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Last week was all about the State of the Union and the massive Powerball jackpot. ICYMI, check out Law Street’s top stories of the week.

1. CDC: E-Cigarette Companies Targeting Teens Through Advertising

The Centers for Disease Control and Prevention (CDC) just conducted the annual National Youth Tobacco Survey and discovered that e-cigarettes are being heavily marketed to American teens. The study, which was released Tuesday, concluded that seven out of 10 middle and high school students are being reached by e-cigarette companies through advertising. The concepts and themes being used by the companies mirror those used in cigarette advertising in the past. Check out the full story here.

2 Anti-Gay Clerk Kim Davis to Attend President Obama’s Final SOTU

Do you guys remember Kim Davis? You know, the t-shirt layering Kentucky clerk who kicked off the Supreme Court’s landmark marriage equality ruling by illegally denying gay couples marriage licenses under “God’s authority?” Well if you thought her 15 minutes of fame were up, you’re wrong. Davis has reportedly been invited by a secret lawmaking admirer to attend President Obama’s final State of the Union tonight–and people are not happy about it. Read the full story here.

3. A Billion Dollar Powerball? It Depends On Your State

The Powerball lottery has worked the country’s ‘temporarily embarrassed millionaires‘ into a frenzy with an unprecedented jackpot that estimates put at around $1.5 billion. The next closest jackpot, from a Mega Millions lottery in 2013, lags behind at a measly$590 million. See the full story here.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

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The Centers for Disease Control and Prevention (CDC) just conducted the annual National Youth Tobacco Survey and discovered that e-cigarettes are being heavily marketed to American teens.

The study, which was released Tuesday, concluded that seven out of 10 middle and high school students are being reached by e-cigarette companies through advertising. The concepts and themes being used by the companies mirror those used in cigarette advertising in the past. The CDC report stated:

E-cigarette ads use many of the same themes — independence, rebellion, and sex — used to sell cigarettes and other conventional tobacco products.

Right now, there aren’t a lot of regulations dictating how e-cigarettes can or can’t be marketed. For example, e-cigarette producers can advertise on TV, which traditional cigarette manufacturers haven’t been able to do since laws were passed to prevent exactly those practices four decades ago. According to CDC Director Tom Frieden,

The e-cigarette advertising we’re seeing is like the old-time Wild West…No rules, no regulations and heavy spending advertising the products.

However, the Food and Drug Administration (FDA) is working on finalizing rules to govern sales to minors–it first proposed them in April of 2014, but they haven’t gone into place yet.

At the same time that more American teens and pre-teens are seeing e-cigarette ads, their use of e-cigarettes is also steadily climbing. More U.S. teenagers are using e-cigarettes than traditional cigarettes–13.4 percent reported e-cigarette use in 2014, but only 9.2 percent reported using traditional cigarettes. While e-cigarettes are believed to be less dangerous than traditional cigarettes, there’s a pretty serious concern that they could become a gateway to traditional cigarette use for young people. A study that was published in the Journal of the American Medical Association in August 2015 concluded that freshmen in high school who used e-cigarettes were 2.5 times more likely to try traditional cigarettes down the road.

This news from the CDC comes at a time when many parts of the United States are trying even harder to keep young people away from cigarettes. For example, the state of Hawaii just made history by becoming the first state to raise the legal smoking age to 21. Yet some serious work needs to be done if e-cigarettes are also going to be kept from teenagers.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

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Seattle, Washington just became one of the largest school districts in the country to switch its school start times past 8:30 AM in an attempt to allow students to sleep in later. The Seattle school board voted to switch times based on a large collection of research that indicates that providing young people with the opportunity for more sleep can improve learning and overall health.

The vote, which was six-to-one, will change the start time for all of Seattle’s high schools to 8:45 AM during the next school year (2016-2017.) Many, but not all, middle and elementary schools will follow suit. Others will start at either 7:55 or 9:35, presumably in order to stagger the bus schedules.

Beginning this summer, the federal Centers for Disease Control and Prevention (CDC) began urging schools to consider later start times. In doing so, the CDC joined other experts advocating for the same thing, including the American Academy of Pediatrics. It’s essential that young, still-developing teenagers average between 8.5 to 9.5 hours of sleep a night. However, a CDC study found:

That high schools that begin as late as 8:55 a.m. have 66 percent of students getting eight or more hours of sleep on school nights, which is the recommended amount for high school students. Schools that begin at 7:30 a.m. have an average of only 34 percent of students obtaining eight or more hours of sleep on school nights.

That makes a serious difference in how students learn throughout the day. According to a University of Minnesota study:

Researchers analyzed data from more than 9,000 students at eight high schools in Minnesota, Colorado, and Wyoming and found that shifting the school day later in the morning resulted in a boost in attendance, test scores, and grades in math, English, science, and social studies. Schools also saw a decrease in tardiness, substance abuse, and symptoms of depression. Some even had a dramatic drop in teen car crashes.

However, not everyone is happy with the changes–particularly the parents of the children who will be in one of the middle or elementary schools that will start at 9:35 AM. But pressure from the community to change the start times in a way that benefited as many children as possible seemed to outweigh the hesitations. Seattle hopes that by being one of the largest school districts in the country to make the switch to later start times it will start a trend and show other large school districts that it’s doable–maybe more will jump on the bandwagon for the 2016-2017 school year.

Learn More: School Start Times: Do More ZZZs Equal More As? 

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

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President Obama recently acknowledged that his failure to pass common sense gun control laws in the U.S. has been his greatest frustration in his presidency. In a Thursday interview with BBC, President Obama claimed that it was distressing not to have made progress on the issue, even in the face of repeated mass killings.

His comments came hours before another mass shooting took place in Lafayette, Louisiana Thursday night. John Houser killed two people and wounded nine others at the Lafayette multiplex Thursday night before he turned his gun on himself and took his own life, police said.

However Obama signaled that he would continue to work on gun laws during his remaining time in the White House. He stated: 

It is the fact that the United States of America is the one advanced nation on earth in which we do not have sufficient common-sense, gun-safety laws. Even in the face of repeated mass killings.

If you look at the number of Americans killed since 9/11 by terrorism, it’s less than 100. If you look at the number been killed by gun violence, it’s in the tens of thousands. And for us not to be able to resolve that issue has been something that is distressing. But it is not something that I intend to stop working on in the remaining 18 months.

Nationally, guns kill 33,000 Americans and injure 80,000 a year. The total cost of gun violence is $229 billion a year, almost as much as we spend on Medicaid. The Harvard Injury Control Research Center recently found that there’s a substantial evidence that indicates more guns means more murders. But despite the high levels of gun violence, Congress has no plans to investigate a solution.

In regard to gun control laws in the United States, Louisiana has some of the weakest gun laws in the nation. It does not require gun dealers to obtain a state license. The state also has no laws that restrict assault weapons or .50 caliber rifles.

One week after the shooting at Charleston’s Emmanuel AME Church, the House Appropriations Committee voted 32-19 against an amendment that would reverse a 19-year-old ban on funding for the Centers of Disease Control and Prevention (CDC) to research the causes of gun violence in public health. Their reasoning is that gun violence is not a disease, and therefore does not fall under the CDC’s research domain.

The CDC had been conducting research into gun violence as a “public health phenomenon” and began publishing studies that indicated a strong correlation between the presence of guns and firearm-related deaths. Prior this, the CDC’s budget was cut in 1996 by $2.6 million, the exact amount they had spent on researching gun facilities in 1995. As a result of that cut, many scientists stopped doing gun research, and the number of publications on firearm violence decreased dramatically. Reuters has reported that government research into gun mortality has shrunk by 96 percent since the NRA’s campaign in the 1990s.

Although Obama has claimed that he will work to address gun violence in the United States during his remaining time as president, it is unclear how he will go about endorsing these big changes without the support of Congress. That being said, last week’s events show that some sort of common sense change is clearly necessary.

Angel Idowu

Angel Idowu is a member of the Beloit College Class of 2016 and was a Law Street Media Fellow for the Summer of 2015. Contact Angel at staff@LawStreetMedia.com.

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Out of context, the words “climate change” don’t sound very scary at all. Here’s the context that makes it scary.

The earth’s climate has been in flux since it burst into existence some 4.5 billion years ago. It’s been hot and cold and everywhere in between. Carbon dioxide in the atmosphere danced between 200-300 parts per million (ppm) during the earth’s long lifespan. But starting in the 1900s, carbon dioxide  pushed past the 300 ppm marker and kept climbing. Today, carbon dioxide levels “weigh in” at about 400 ppm. So what? Well, carbon dioxide and other greenhouse gases trap heat and send average temperatures climbing. Even worse, experts believe human activities like burning fossil fuels and deforestation increased carbon dioxide and caused climate change.

We’ve only been on the earth for a fraction of its lifetime. We’ve evolved based on certain conditions, and now those conditions are changing. In other words, we’re not well adapted for the world we’re creating. The changing climate is a crucible of possible human health complications.

Here’s what the future of health looks like if we don’t combat and adapt to climate change.

 Climate Change: What’s Happening?

Before I run away with how climate change will kill us all (just kidding!), let’s do a quick overview.

Greenhouse gases like carbon dioxide hang out in our atmosphere and absorb heat from the sun. Since these gases don’t occur naturally, the extra heat they absorb causes temperatures to increase above normal levels. As of 1900, carbon dioxide emissions from human activities have billowed up by 40 percent and global temperatures keep creeping upward too.

In our interconnected world, increased temperatures have implications beyond needing more A/C. Increased heat warms our oceans, melts polar and alpine ice, and drives up the sea level, which in turn facilitates stronger and more devastating storms.

Why is climate change bad for our health?

Ripples from climate change impact things directly related to your health, like the water and food supply. The World Health Organization predicts that climate change will cause 250,000 additional deaths a year between 2030 and 2050 because of heat stress, malnutrition, malaria, and diarrhoeal disease. Areas with fewer resources to adapt will suffer the most.

Here are some startling health scenarios of the future, and how climate change might cause them.

Diseases Will Become More Virulent

Climate change will make it easier for existing diseases to infect more people by altering their geographic range and lengthening the infection season. For example, ticks carrying Lyme Disease will cover more ground as more regions warm to temperatures where they can survive. Mosquitoes, which carry many diseases like Malaria and Dengue, will also flourish in warmer temperatures. High temperatures increase their reproduction rate, grow their breeding season, and enable them to bite more people. In general, all bacteria multiply faster in warmer temperatures, so many pathogens will find our warming climate suitable for proliferation.

Climate change might also encourage emerging and shifting diseases. Experts at the University of Nebraska-Lincoln say climate change makes it easier for diseases to switch to new hosts. Many assume that the co-evolution of pathogens and specific hosts will make it harder for pathogens to shift and infect a new host with different biological makeup. Alarming evidence has shown that pathogens can shift to new hosts rather quickly when necessary. The researchers offer Costa Rica as an example, where humans decimated the population of capuchin and spider monkeys. A parasite once exclusive to these monkeys was unphased and latched on to howler monkeys, a different genus of monkey. If pathogens need to make rapid shifts, humans might find themselves facing several for which they have no immunity. Climate change threatens to uproot habitats and living patterns, bringing humans, animals, and insects into closer contact with each other–and their unfamiliar pathogens.

More Will Die From Extreme Heat

Heat stroke and heat-associated dehydration are the most common causes of weather-related deaths. People with existing cardiovascular issues are especially vulnerable to extreme heat. Furthermore, heat complications have a cumulative effect; your vulnerability to heat stroke increases after one episode. Cities have been heating up at a higher rate than rural areas in recent years. This leaves some of the world’s most populated areas in danger.

Basic Hygiene Won’t Be Guaranteed

As rainfall becomes less predictable, it will compromise our safe water supply. With less safe water, it won’t be nearly as easy to do simple things that prevent disease, like washing hands. People take hand-washing for granted, but it reduces risk of diarrhoeal disease by 20 percent, which actually kills 760,000 children five and under annually.

Too much water, brought from the climate change risks of severe flooding, also wreaks havoc on sanitation. Floods contaminate freshwater, spread waterborne disease, and create ideal living conditions for mosquitoes–one of the most prolific disease carriers.

Breathing Won’t Be as Easy

Warmer temperatures bring more ground-level ozone, a miasma of pollutants like carbon dioxide and nitrous oxide. Ground-level ozone is also called smog, a term you’re probably more familiar with. It’s been known to damage lung tissue and aggravate respiratory systems. Increased smog will make breathing an excruciating task for people with existing lung diseases and Asthma. It might even encourage the development of Asthma in otherwise healthy people.

People with allergies should also be very afraid of climate change. The spring allergy season has already grown in the United States and it threatens to continue expansion. Ragweed allergies? Tests show that more carbon dioxide and higher temperatures increases the yield of ragweed pollen.

More People Will Go Hungry

Climbing temperatures, patchy rainfall, droughts, and floods will devastate staple crop yields in the world’s poorest regions. Malnutrition and undernutrition will burgeon as a result. By as early as 2020, crop yields in some African countries could be halved.

Increasingly severe weather already destroys crops. Pollinators disappear while pathogens and pests flourish to chomp through human crops. For example, soybean rust, a fungal infection caused by the pathogen P. pachyrhizi, spreads easily in warm, moist environments. Soybean rust has been a scourge in Asia and Africa for years and was introduced to the United States by a hurricane. Winds carry the spores for miles, leaving behind crop devastation. Similar diseases will most likely plague crops in new climates.

911 Might Not Be Working

Scientists believe climate change will lead to much stronger storms. The World Health Organization says that natural disasters reported globally have tripled since 1960, resulting in over 60,000 deaths.

Strong storms and natural disasters destroy medical facilities, cut the electricity that powers medical equipment, interferes with emergency communications tools like 911, and hinders transportation. Many injuries will happen in times when disaster strikes, even though our responsive capabilities will be restricted.

We Gotta Do Something

It’s pretty clear that we have to do something before things get out of hand. Do something…but what?

We’re flooded by climate change recommendations, but here are some key points from the 2014 National Climate Assessment. The assessment distills climate change responses into two main categories:

• Adaptation: Reducing negative impacts of climate change through infrastructure and preparedness planning. An adaptation example is the creation of the State, Local, and Tribal Leaders Task Force on Climate Preparedness and Resilience that aims to prepare communities for the challenges of changing weather.
• Mitigation: Attempting to reduce the climate change itself through updated policies and practices. A mitigation example is the Appliance and Equipment Standards Program, which pushes for energy efficiency.

While these two categories encompass different approaches, we need both to achieve the greatest effect. If you’re interested in reading about more climate change adaptation and mitigation initiatives, check out this fact sheet on President Obama’s Climate Change Action Plan. In terms of public health, however, we’ll stick to a few health-related initiatives, most of which fall under the adaptation category.

The Sustainable and Climate-Resilient Healthcare Facilities Initiative

As the name suggests, this plan aims to prepare healthcare facilities for climate change and related complications. The Department of Health and Human Services released an intensive guide with a framework designed to help healthcare facilities revamp their infrastructure and technology. The initiative includes an online planning toolkit that serves as an interactive guide to walk professionals through these steps of resilience:

1. Identify the problem.
2. Determine vulnerabilities.
3. Investigate options.
4. Evaluate risks and costs.
5. Take action.

So far, healthcare industry leaders like Kaiser Permanente have committed to use the guides to help in their resilience planning.

The BRACE (Building Resilience Against Climate Effects) Framework

The Centers for Disease Control and Prevention developed a framework of preparedness geared more toward public health professionals working locally. Their framework involves projecting the impacts of climate change and assessing effectiveness of interventions. The evidence of effectiveness will be especially useful for people planning future interventions. Click here to see a chart made by the CDC to explain the BRACE framework.

NYC Cool Roofs

The NYC Cool Roofs initiative presents a perfect real-world example of an initiative already underway. Reflective surfaces are added to New York City roofs, which mitigate further climate change by reducing cooling energy needed, consequentially lowering greenhouse gas emissions. They’re also adaptive as they’ll help cool the city, and hopefully reduce heat-related deaths.

Controversy in Congress

Many look at the Keystone XL pipeline decision to judge the climate change temperature in Congress. To the dismay of environmentalists, the Senate rejected two amendments related to the Keystone XL pipeline bill that admitted the human role in climate change and called for more government interventions. The President just vetoed the bill and many believe Congress will not override it.

Still, many climate change advocates are alarmed that the bill went as far it did, saying it would contribute to climate change because of the sheer amount of extra energy it would require and carbon pollution it would make. According to this NRDC Issue Brief, building the pipeline would create the same carbon dioxide emissions as Americans driving 60 billion more miles this year.

Conclusion

If you’re frustrated with the accuracy of forecasts now, be prepared. While climate change poses a new challenge without guiding evidence or precedent, the health complications from climate change have already begun. We see more cases of Lyme disease. Allergies grow in severity. We’re not sure what will work, we’re not sure what the future will bring, but we’re sure we need to brace ourselves for coming changes and meet current changes head on. We all need to work together to make sure that we stay healthy in coming years.

Resources

Primary

World Health Organization: Climate Change and Health

Environmental Protection Agency: A Student’s Guide to Climate Change 

U.S. Global Change Research Program: National Climate Assessment 2014

White House: Strengthening the Climate Resilience of the Health Care Sector

City of New York: NYC Cool Roofs

World Health Organization: Diarrhoeal disease

Additional

Emergency Management: How a Warming Climate Impacts Public Health

Science Daily: More Infectious Diseases Emerging in Animals as Climate Changes

Nature: Climate Variation Explains a Third of Global Crop Yield Variability

Nature: Delays in Reducing Waterborne and Water-Related Infectious Diseases in China Under Climate Change

Science Daily: Heat Waves Becoming More Prominent in Urban Areas

Science Daily: Preparing for Hell and High Water: Research Advocate for Climate Adaption Science

New England Journal of Medicine: Climate Change and Human Health

American Meteorological Society: Climate Change Risk Management

American Phytopathological Society: Soybean Rust

The New York Times: Senate Rejects Human Role in Climate Change

Natural Resources Defense Council: Climate Impacts of the Keystone XL Tar Sands Pipeline

BBC News: Obama Vetoes Keystone Oil Pipeline Bill

Politico: President Obama Vetoes Keystone Bill; GOP Plans Override Vote

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Climate Change: How Will it Impact Our Health? appeared first on Law Street.

Measles probably doesn’t make your list of top Disneyland souvenirs. Unfortunately, many unvaccinated visitors to Disneyland in California brought measles home along with mouse ears this season. It gets worse, because these people unknowingly shared their viral souvenir with other unvaccinated people in schools, banks, and even on public transportation. The result? A multi-state measles outbreak that has sparked a tirade of vaccination discourse. If measles can happen in the “happiest place on Earth” of all settings, we’re all in trouble.

Read on to find out more about these measles everyone’s talking about and why some people choose to opt out of a vaccine that most experts agree is safe and effective.

Why We’re Seeing Cases Now

Once upon a time (in the year 2000), the United States declared measles eliminated. Don’t get too excited. Eliminated in this sense doesn’t mean annihilated or wiped out completely like Dodo birds or Blockbuster stores. In 2000, measles was no longer endemic, or transmitted in the United States for twelve months or more. That happily ever after did not last long. Since then, measles cases have slowly but surely crawled back up; check out the CDC’s breakdown here. Overall, there have been 121 cases reported from January 1 to February 6, 2015.

Why the climbing cases? Although measles was eliminated in the United States, there was still plenty of it going around the rest of the world, especially in places without the same vaccination resources as the United States. In developing countries, measles causes about one million deaths each year.

Measles from the rest of the globe crept back into the United States on the coattails of international visitors or jet-setting residents. For example, experts trace the California outbreak to a traveler who was infected overseas. This person exposed other Disneyland visitors and the virus quickly spread throughout unvaccinated clusters in California.

Why is measles so hard to fight?

We’ll chalk it up to two basic reasons, each individually complicated:

1. Measles spreads like wildfire.
2. Our defenses have some holes, especially from the decrease in herd immunity caused by a growing number of unvaccinated children.

Let’s talk about each in more detail.

Measles is Viral Wildfire

In this most recent outbreak, cases of measles grew by 19 percent in just one week according to the Centers for Disease Control and Prevention.

Here are some other reasons that measles is viral wildfire:

• Measles infects about 90 percent of the unvaccinated people it reaches, making it one of the world’s most contagious diseases.
• It doesn’t require direct contact to spread; the airborne virus jumps easily from person to person through aerosol droplets. (One germ-laden cough or sneeze is all it takes.)
• The first symptoms of measles include coughing, runny nose, and fever–pretty much the same as any other regular, old cold. Infected people will probably still be out and about, infecting other people.
• It has a high reproduction factor. One person can infect about 12 to 18 others. That’s six to nine times more infectious than the flu virus that caused the 1918 flu pandemic.
• Many young doctors have never seen a measles case, so infected people go undiagnosed and spread the disease.
• It’s hard to contain. Health workers have to track down exposed people, a task that gets harder as more become infected.
• It’s also expensive. The National Vaccine Advisory Committee says that Arizona hospitals spent $800,000 to isolate seven measles cases.

What’s more, measles can be severe. Before vaccinations, measles caused about 2.6 million deaths worldwide each year. In populations with malnutrition and poor health care, almost ten percent of measles cases end in death. Death occurs because of complications that result from measles, including encephalitis, pneumonia, and even blindness.

The World Health Organization calls the measles vaccine one of the best buys in public health, attributed to preventing about 15.6 million deaths in 13 years. Vaccines work because measles is considered antigenically stable; it doesn’t shift or drift to get around our immune system like the flu can. So one shot pretty much leads to lifetime immunity.

No antiviral treatment for measles exists. Most often it’s treated with supplements of Vitamin A and proper hydration, but you still have to let the disease run its course. Prevention through vaccinations avoids all of this.

The Breach in Herd Immunity

Tiny, adorable babies (and other vulnerable groups) physically can’t get vaccinated. Without immunization, measles plows through the population, causing the most harm to babies with developing immune systems; however, if many people are immunized, they create a buffer that keeps those who can’t get immunized safe from the disease.  It’s call herd immunity.

Anti-vaccination sentiments cluster in certain geographical areas, breaching herd immunity on a local level. California is one area with clusters of unvaccinated people, thus why the most recent outbreak is so difficult to control. Clusters of unvaccinated people make ideal kindling for measles wildfire.

Watch the video below for a great explanation of why vaccines are important and how opting out is bad for the herd.

The idea of herd immunity puts the public health context back in the very personal choice of vaccination. Cooperation leads to successful herd immunity. The World Health Organization says 95 percent of people should be vaccinated to eliminate measles.

So, why don’t people just get vaccinated?

Downward trends in vaccination rates leave the United States vulnerable to measles attacks as we’re exposed to measles by global visitors and travel. If measles is so serious yet preventable, why do people still opt out?

There are many reasons that parents don’t get their kids vaccinated. They range from distrust of government to fear of negative side effects. In the California outbreak, people cite religious, philosophical, or personal reasons for opting out of vaccinations. Many doctors balk at the generally non-medical tone of these excuses.

Experts respond to doubts with a profusion of facts that counter most fears raised about vaccination. A 12-year study of Measles, Mumps, Rubella (MMR) vaccines found that it does not increase the risk for several suspected health outcomes. The World Health Organization published data that found no association between measles vaccines and Crohn’s disease. And plenty of other studies debunk common vaccination fears.

Here’s an alarming fact: in the anti-vaccination argument, facts don’t necessarily work. In some cases, arguing with facts as weapons makes the outcome worse. Research found that busting vaccine myths actually increases hesitancy around vaccination instead of raising intent to vaccinate. This all means that the sole strategy of many health communicators might actually backfire among this particularly skeptical target audience.

Why Facts Don’t Win the Vaccination Argument

People, unlike computers, pepper even their logical decisions with colorful human emotions. Many social and emotional factors influence how we perceive, interpret, and react to facts and science. Here are some reasons why cold facts don’t work in contentious arguments, like the vaccine debate.

We Cling to Naive Beliefs

People accept facts, but often cling to their intuitions with stunning zeal. This study demonstrates how even people with advanced scientific knowledge express natural delays when asked if the Earth orbits the Sun. From our humble perspective on Earth, this doesn’t look true. That simple intuition influences our initial gut reaction, even when we know facts to the contrary.

We’re Easily Influenced by Personal Anecdotes

Personal stories heighten naive beliefs. We’ll believe a friend’s anecdote about vaccines causing her child’s autism even when numerous facts state that it’s unlikely. Cold, hard facts can’t compete with your emotional reaction to the anecdote. A little intrigue might produce a similar effect. This study found parents less likely to vaccinate their kids after reading conspiracy theories on vaccination.

We Conform to Group Values

People make decisions that affirm their cultural identities and connections to people with shared values. It’s a tendency called cultural cognition. New info will pass through a pre-existing lens and if it’s contrary to fundamental beliefs, it might lead to even more polarization.

We Love to Be Right

The fancy word? Confirmation bias. It’s the tendency to seek out evidence that supports our current beliefs, regardless of accuracy. Emotionally charged issues inflate this tendency. The internet and on-demand television makes this force unstoppable. You can easily ensure you only hear what you want to hear.

Our Resources Hamper Our Decisions

Experts call it bounded rationality. We face difficult scientific issues, yet we still evaluate them with limited information, a fixed set of cognitive abilities, and limited time. Think of reading the terms and conditions before you buy a song on iTunes. You know it’s theoretically a good idea (just in case), but who has 45 minutes for that?

We Love Negative Talk

Negative information inspires more shares than positive information. One bit of negative news can eclipse five bits of positive news. In fact, negative talk about vaccines is more socially contagious than positive talk. Researchers have found that both positive and negative Tweets result in only more negative buzz.

So, now what?

To keep measles cases from increasing, more people need to be vaccinated. We could try to convince more people they should have their kids vaccinated or strengthen immunization laws and policy (e.g. making exemptions harder).

Convince More People They Should Vaccinate

As outlined above, the most avid vaccination opponents might be nearly impossible to turn. In fact, some vaccination opponents actively seek out measles infections for their children by hosting measles parties. The trial and error process involved in developing and testing new communications materials to target this finicky audience would be time consuming. Many experts believe we should move to strengthening immunization laws immediately before measles is able to become a more serious problem in the United States.

Strengthen Immunization Laws and Policy

Vaccination isn’t legally required and exemption allowances vary from state to state and can get pretty complicated. Lawmakers who recognize the need for change are proposing to overhaul vaccination laws in many states.

California is proposing to end personal (as opposed to medical or religious) exemptions. They’re also moving to require that public schools publish the percentage of enrolled children who are vaccinated, an effort that Arizona is also pursuing.

Other states are moving in the opposite direction. Montana and New York have introduced bills that would make parental exemptions easier. You can read more about recent vaccination-related legislation here. Be prepared for some interesting immunization debates in the coming months.

In addition to cracking down on state-by-state exemption policy, the Network for Public Health Law provides a few more suggestions, including pursuing tort claims, and taking a more active role in fighting measles globally.

Conclusion

Whatever path we take, vaccinations are here to stay. Unless we completely eradicate measles globally, vaccines will always be necessary to protect the United States from outbreaks. The recent outbreak in California (and other states) illustrates how important herd immunity really is. Vaccination is a personal choice that affects public health. How will we weigh personal rights against this public responsibility? Only time will tell.

Resources

Primary

World Health Organization: Measles Factsheet

CDC: Measles Cases and Outbreaks

Additional

National Geographic: Why Do So Many Reasonable People Doubt Science?

Wall Street Journal: U.S. Measles Cases for 2015 Rise 18.6% Over Past Week

Center For Food Integrity: “Cracking the Code on Food Issues: Insights from Moms, Millennials and Foodies.”

Family Practice News: Measles Spread in Unvaccinated Clusters

Network for Public Health Law: Measles Control Made Easy: Stronger Laws Equal Less Disease

Family Practice News: Measles Deaths Slide by 74% as Immunizations Reach 82%

Expert Review of Vaccines: Vaccination Against Measles: A Neverending Story

Journal of Family Practice: Sobering Lessons from Two Travel Related Outbreaks

Future Virology: New Insights Into Measles Virus Propagation

Occidental College: Scientific Knowledge Suppresses But Does not Supplant Earlier Intuitions

Expert Review of Vaccines: Measles Elimination

Canadian Medical Association Journal: Measles Vaccination: A Shot of Common Sense

Science Daily: 12-year Study Confirms Overall Safety of Measles Vaccines

New Scientist: Ending MHR Shots Does Not Halt Rise in Autism

Family Practice News: MMR Shot Not Linked to Autism, Large Study Shows

Pediatrics: Neurologic Disorders After Measles-Mumps-Rubella Vaccination

Bulletin of the World Health Organization: Clinical Safety Issues of Measles, Mumps, and Rubella Vaccines

Pediatrics: Has the Measles-Mumps-Rubella Vaccine Been Fully Exonerated?

Infectious Disease Alert: Lack of Association of Measles, Mumps, and Rubella Vaccination with Autism

Ohio State University: Confidence in Government Linked to Willingness to Vaccinate

Huffington Post: Six Dangerous Anti-Vaccination Arguments Analyzed, Explained, and Shut Down

British Medical Journal: MMR Vaccination and Autism 1998: Deja Vu – Pertussis and Brain Damage 1974?

Science Daily: Social Norms Strongly Influence Vaccination Decisions, the Spread of Disease

Science Daily: Resurgence of Measles in U.S. Brings Pain, Suffering to Children

Science Daily: Vaccination Opt Out is a Cop Out That Literally is Making People Sick, Says Infectious Disease Leader

NBC Los Angeles: Timeline of Disneyland Measles Outbreak

Medical News Today: Why Myth-Busting Vaccination Fears is Trickier Than You Think

Science Daily: Anti-Vaccine Conspiracy Theories May Have ‘Detrimental Consequences’ for Children’s Health

EurekAlert: On Twitter, Anti-Vaccination Sentiments Spread More Easily Than Pro-Vaccination Sentiments

Politico: Vaccination Foes on the Defensive

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Measles: Why is it Back and What Can Be Done? appeared first on Law Street.

Start saving up your sick days. The Centers for Disease Control and Prevention (CDC) says that the upcoming flu season could be severe. The agency expects influenza A (H3N2) to dominate this year. H3N2 causes more hospitalizations and deaths than other flu types and has mutated since this year’s vaccine was created. Is it time for a quarantine? Probably not. But even if you’re vaccinated, you could be purchasing more tissues than usual from now until March as flu season peaks. I’ll break down what you need to know below.

How bad will it be?

Here’s some perspective: last year’s vaccine was only about 50-55 percent effective and experts estimate we won’t even reach those levels this year.

Here’s why

• Ninety-one percent of recent samples are influenza A (H3N2), an influenza (flu) subtype that typically causes more hospitalizations and deaths than other subtypes. (Don’t worry, I’ll explain subtypes later!)

• Over half of these samples don’t match this year’s vaccine because they’re drift variants; they’ve “drifted” to become structurally different from the H3N2 virus used to create this year’s vaccine. The drift could make this season’s vaccine less potent but it’s certainly not useless. In past flu seasons where influenza A (H3N2) drifted, vaccines were about 40 percent effective in stopping the virus. The vaccine still protects against other flu subtypes that haven’t drifted, like influenza A (H1N1) a.k.a the “swine flu.”

So, what is the flu anyway?

The flu we’re talking about should not be confused with the stomach flu, which is really just slang for gastroenteritis. It’s also not a blanket term for any ailment. You only have the flu if you’ve been infected with the flu virus.

A true flu is a viral infection that preys on your nose, throat, and lungs. The flu sees these mucous membranes as ideal ports of entry. Even innocently rubbing your eyes invites the flu into your body. Once the flu gets in, it causes an infection that leaves your respiratory system hampered and makes you feel generally miserable–sneezing, coughing, weak, and sluggish.

This video from Health 360 explains the flu virus and how it invades your body.

Flu Mechanics

Google a picture of a flu virus and you’ll see a circle covered in spikes, kind of like a balding koosh ball. Just like the koosh ball’s rubber fingers make the toy easier to catch, the flu virus’ spikes make the infection easier to catch. The flu virus would be nothing without its spikes.

The viral protein hemagglutinin (H) makes up most of the virus’ spikes. Hemagglutinin causes red blood cells to stick together (hema is heme molecules found in red blood and agglutinate means to stick together). Hemagglutinin enables the virus to attach to a host cell. Viruses can only spread if they hijack a host cell and replicate within it, so you can see why hemagglutinin’s role in host cell attachment is of the utmost importance…to a virus.

The viral protein neuraminidase (N) makes up the rest of the virus’ spikes. After the virus has infected a host cell and replicated itself, neuraminidase (N) allows the replicated virus to escape the host and infect other cells.

So hemagglutinin (H) assists in infecting the host cell and neuraminidase (N) helps the replicated virus proliferate. They work together to infiltrate as many immune systems as possible. Different subtypes of these viral proteins–Hs and Ns–are behind all of the confusing names for different flu viruses like H3N2, H1N1, etc. Let’s end that confusion once and for all.

H?N?: Naming flu types and subtypes

Three types of flu affect humans: A, B, and C.

• Influenza A: Infects both animals and humans and is usually responsible for large epidemics because of its ability to change.
• Influenza B: Infects only humans and is typically less severe than influenza A.
• Influenza C: Infects humans but is the least severe of all the types.

The ABC’s are the least of your worries in understanding flu names. Naming the flu gets complicated when we look at all of the subtypes of the viral proteins (spikes), hemagglutinin (H), and neuraminidase (N) that we just learned about above.

There are 16 possible subtypes of H and nine subtypes of N that can recombine to form 144 different subtypes of the flu virus that are named based on which H and N subtypes they contain. The influenza A virus dominating this year is named H3N2 because it has the viral protein subtypes H3 and N2 decorating its surface.

Viral proteins also come into play when we’re looking at how this year’s vaccine ended up being mismatched with this year’s dominant flu. Even among the 144 different subtypes, something called antigenic drift can cause different strains to form. The drift changes the structure of the viral proteins H and N to be different enough to befuddle your immune system, but not different enough for separate classification.

For example, this year’s dominant strain of influenza A (H3N2) drifted antigenically from the strain used to create the vaccine. So even if you’re vaccinated, your immune system might respond differently if you’re exposed to the newly drifted virus.

The Drifts and Shifts of the Flu

The flu virus has a sneaky habit of changing and tricking the immune system into letting it pass. The change happens through antigenic drift or antigenic shift. The preceding “antigenic” refers to antigens, which trigger your immune response. So the drifts and shifts produce a virus strain with altered antigens that your immune system will respond to differently. The antigens in this case are the viral proteins H and N. Your immune system responds to the shape of H and N subtypes you were vaccinated with. If those shapes change enough, you could have a problem.

Antigenic Drift

Antigenic drift happens when small changes naturally accumulate over time as a virus copies itself. At first, the drifted virus will be antigenically similar enough that a vaccinated immune system can recognize it. But small changes can compound over time so the shapes of the proteins drift enough that even a vaccinated immune system can’t recognize the drifted virus.

Think of a close friend getting a radically different haircut. She’s the same person, but at first glance you might not realize it because she looks completely different. If a virus drifts enough to create an antigenically different strain, the immune system might not be able to recognize and bind to the new shape of the viral proteins.

The flu drifts adeptly so we need to create a new vaccine every year. Drift is also why you’ll probably get the flu more than once in your life.

Antigenic Shift

An antigenic shift causes fast changes that make completely new H and N viral proteins. The virus is so altered that humans have no immunity to it, even if they were vaccinated. This happens when viruses shift from animal populations to infect humans.

Antigenic shift occurs rarely, but it can be devastating. Pandemics and epidemics like the 2009 H1N1 flu pandemic often happen when a flu virus shifts suddenly. Flu viruses usually shift to humans from domestic pigs and poultry. Don’t worry, this year’s dominant influenza A (H3N2) has only drifted not shifted.

Making a Vaccine

Since it takes so long to develop the vaccine, experts have to pick the virus strain they’ll use months in advance. There’s always a good chance the virus will drift in the interim as it has this year.

Private companies make flu vaccines but are subject to FDA safety and efficacy requirements. The FDA has approved three flu vaccines: egg-based, cell-based, and recombinant flu vaccines. The processes vary, but here are the basic steps:

• The CDC or other Influenza Collaborating Center provides the vaccine manufacturer with the vaccine viruses chosen.
• The viruses replicate in a controlled environment.
• The viruses are extracted from their growth host (eggs or cells).
• The manufacturer kills the virus and purifies the viral antigen to produce a vaccine that will not make people who take it sick.
• The manufacturer tests the vaccine before it goes to market.

Historyofvaccines.org has a great animated walk-through of the process. Check it out here.

Then what?

When you get your vaccine–the flu shot–it kind of tricks your body. Immunity builds when you’re exposed to a pathogen, such as a virus. In most cases you have to get sick to build this immunity. When your immune system fights off a virus once, it keeps a memory of the virus in case it returns.

A vaccination gives you the benefits of exposure and immunity building without making you suffer through the actual illness by exposing you to a harmless version of a pathogen. It won’t make you sick, but your immune system responds like a feisty dog that barks at anyone who knocks on your door. The overprotectiveness eventually pays off. If a harmful version of the virus tries to take you down, your immune system will have an immune memory to use in the fight.

That sounds OK, why doesn’t everyone do it?

There’s just something inherently scary and untrustworthy about getting injections. People come up with many fears and excuses for not getting vaccinated. Take a look at the video below.

And the list continues with NPR’s 32 Myths About The Flu Vaccine You Don’t Need To Fear. The good news? Most fears and excuses for not getting vaccinated are unfounded. The bad news? People don’t care if their fears are unsubstantiated.

Researchers have found that foiling flu vaccine myths doesn’t increase a skeptic’s intent to get a vaccine. It actually reduces it. The study suggests that explaining the facts about vaccines might remind people of why they were fearful of getting them in the first place or even give them new information to worry about. This only solidifies their anti-vaccination stance.

So what are we doing about this flu mess?

The CDC maintains that a flu shot is still the best way to protect yourself, but it also urges doctors to prescribe antivirals to people coming in with flu-like symptoms or those at high risk such as children, pregnant women, and adults 65 and older. Antivirals work best within 48 hours of flu symptom appearance, so most doctors will not wait for a positive test to prescribe them.

Is antiviral resistance a problem?

With doctors prescribing medication without lab test confirmation of the ailment, you might be wondering if antiviral resistance is a concern. Yes, it’s actually an inherent problem since the rapid replication process of viruses leads to mutations that can evade antivirals as well as immune systems and vaccines. Some strains of influenza have already become resistant to drugs that have been on the market for a while like oseltamivir, amantadine,  and rimantadine.

What are the benefits?

Results from past flu seasons and the 2009 H1N1 flu pandemic show that these drugs can reduce potentially devastating effects of influenza. Clinical trials and observation show reductions in symptoms, complications, and deaths from influenza with antiviral use.

All Things Considered, It’s Not So Bad

With its fast and unpredictable changes and complicated subtypes, the flu presents a formidable enemy for modern medicine. Flu shots and antivirals aren’t the perfect weapons, but they’re more effective than entering the battle unarmed. So how bad is this flu season going to be? Probably worse than last year’s, but a pandemic doesn’t seem likely.

Resources

Primary

CDC: Early Data Suggest Potentially Severe Flu Season

CDC: Health Advisory Regarding the Potential for Circulation of Drifted Influenza A (H3N2) Viruses

CDC: Types of Influenza Virus

CDC: How the Flu Virus Can Change: “Drift” and “Shift”

CDC: How Influenza (Flu) Vaccines Are Made

NIH: New Vaccine Technologies

Additional

Mayo Clinic: Influenza Treatments and Drugs

Synapse: “Flu” – Recombinant Genes on the Loose!

Science Daily: Correcting Myths About the Flu Vaccine: Effective?

Virology: Structure of Influenza Virus

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Are We in for a Bad Flu Season? appeared first on Law Street.

Petri dishes do far more than indicate if you have strep throat. They were a key prop in the theater of antibiotic discovery. A mere glance in a petri dish ushered in the antibiotic revolution.

On a bright and sunny (just a guess) day in 1928, Alexander Fleming puzzled over what he saw in a petri dish of Staphylococcus bacteria. One small, moldy area of the dish had somehow dodged the enterprising colonization of the bacteria. Fleming speculated this was not a coincidence. He wondered if the mold, Penicillium Notatum, was somehow inhibiting bacterial growth. He experimented some more and eventually published his findings in the British Journal of Experimental Pathology. Fleming’s brick wall had been isolating the penicillin from the mold to use as a drug. Luckily his research eventually ended up in the hands of two scientists at Oxford who were ready to take up the challenge.

Penicillin — the first antibiotic — was used to treat a human patient in 1941. We’ve probably all taken them, but what are they really? Antibiotics are microorganisms (and now synthesized drugs) that attack the bacteria that cause infection in your body. Just as bacteria couldn’t grow on the moldy part of Fleming’s petri dish, bacteria cannot grow in a body on antibiotics.

World War II soldiers were among the first to benefit from penicillin before it was released to the general public in the late 1940s. Newspapers hailed it as a miracle drug.

The potential downside of this miracle drug had not evaded the experts, however. Alexander Fleming himself warned of microbes developing penicillin resistance in his acceptance speech for the Nobel Prize in Physiology or Medicine in 1945.

Miracles Happen

Antibiotics thwarted some of the leading causes of death in human existence. Childbirth, ear infections, and even simple skin scrapes were often deadly before these saviors entered the fray. Many children didn’t see their first birthdays, succumbing to infections we don’t think twice about today. Having surgery in the early 1900s? Just kiss your family goodbye before you go under the knife.

Antibiotics are microorganisms ideally adapted to kill other microorganisms while causing little or no harm to the host. The word “antibiotic” actually means “against life.”

Scientists design synthetic versions of these antibiotic microorganisms so we may have a profusion of drug options. About 150 million prescriptions are written for antibiotics every year.

And that’s a problem because…?

Antibiotics may be miraculous, but bacteria are not taking the challenge lying down. They’re fighting back by developing mechanisms to resist antibiotics. Don’t take it personally, it’s what any organism would do for the sake of survival. It turns out that bacteria are marvelous adaptors. Two million people in the United States suffer from antibiotic-resistant infections every year and many die as a consequence. Additionally, the CDC estimates a cool $20 billion in resulting economic burdens.

In short, our arsenal of antibiotics is losing efficacy. If this continues unchecked, we risk being thrust back into the dark ages of medicine when common ailments put many a healthy body six feet under. Antibiotic resistance is also detrimental to treatments for more serious illnesses. Therapies for cancer and organ transplants are often complicated with infection. Doctors rely heavily on antibiotics to keep their patients’ strained bodies free of infection. If antibiotics become ineffective, these life-saving treatments might be relegated to the past. It would mark one monumental step back in health care.

If you’re not scared yet…

Everyone loves a good villain to embody their fears. Emerging “superbugs” epitomize scary. When antibiotics were new, development was explosive. New drugs essentially kept microbes on their toes and resistance was less prolific. Invention of new drugs has now stagnated enough that bacterial evolution threatens to overtake our developmental countermeasures.

Welcome to the world of superbugs, aka resistant germs. These include nightmares like:

Carbapenem‐resistant Enterobacteri‐aceae (CRE): Literally nicknamed “nightmare bacteria.” It’s resistant to nearly all antibiotics and kills about half of the people infected by it.

Staphylococcus aureus (MRSA): MRSA usually manifests as a skin infection. Because of its resistant capabilities, it can wreak havoc by spreading through medical facilities.

These monsters aren’t made up, they’re frighteningly real and we may soon lose our ability to fight them.

Let’s Get “Sciencey”

Microbes are tricky little beasts. They will always evolve to develop resistance to what threatens them. The more bacteria are exposed to antibiotics (which we just learned is quite frequently), the more chances they have to develop resistance. When bacteria are exposed to antibiotics, susceptible strains die, leaving zero competition for the resistant ones so they are free to survive and flourish. Scientists call this selective pressure.

Resistant bacteria get that way by acquiring resistance genes through genetic mutation or getting the resistance from another bacterium. They can even get multiple resistant traits and end up developing resistance to multiple families of antibiotics.

Watch the video below for a perfect explanation of how this happens.

Why is this happening?

1. They’re over-prescribed: Antibiotics are some of the most commonly prescribed drugs used in medicine. For example, the first Ebola patient in the United States was sent home on antibiotics before doctors knew what he had. Antibiotics won’t do anything for Ebola or even the sinus infection they believed he had. Most sinus infections are viral so antibiotics don’t do anything — unless it was 1 out of the 100 cases where the sinus infection is caused by bacteria.
2. They’re mis-prescribed: Physicians often have to use incomplete or imperfect information. They prescribe antibiotics as a an all-purpose band-aid.
3. They’re used heavily: The chance of bacteria developing resistance increases with antibiotic use. Unfortunately, doctors must rely heavily on antibiotics to reduce risk of infection in critically ill patients. Furthermore, close proximity among sick patients in hospitals creates an ideal environment for resistant germs to spread.
4. They’re used in agriculture: Agriculture use accounts for half of the antibiotics produced in the United States. Scientists agree that adding antibiotics to feed is a key problem in developing antibiotic resistance. Agriculturally, antibiotics are used to promote animal growth and proactively prevent infections in addition to just treating sick animals.

Who is going to save us?

The CDC released a report on the threat of antibiotic resistance in 2013. It was the first exhaustive compilation of the health threats antibiotic resistance presents. If you’re not up to reading the whole 100 pages, here is a snapshot of the strategies they recommend to save us all from antibiotic resistance:

1. Prevent infections from happening in the first place: No infection, no antibiotics, and consequently less risk that resistance develops.

2. Track antibiotic resistance: Tracking will shed light on the specific mechanisms of resistance development. With this knowledge, intervention strategies will be more informed and more effective.

3. Change the way antibiotics are used: Antibiotics are generally overused. Up to 50 percent of antibiotic prescriptions are unnecessary. Physicians can take up the mantle of antibiotic stewardship by using antibiotics only when necessary.

4. Develop drugs and diagnostic tests: Bacteria develop antibiotic resistance as they evolve — it’s a natural process resulting from biological pressure. Introduction of new drugs will slow down this natural evolution. Diagnostic tests will allow us to understand and track the evolution in a more timely way.

Hey…did we budget for all of this?

Federal spending to combat antimicrobial* resistance has been limited. In 2014, the budget was $450 million. That figure sounds grand, but it amounts to just about $1.04 per American. On the other hand, antibiotic resistance costs the United States an estimated $55-70 billion each year.

A little bit lopsided, don’t you think?

*Antimicrobial resistance includes antibiotic resistance but also refers to resistance of other microbes like parasites and viruses. Antibiotic resistance refers specifically to bacteria that cause infection. Most strategies cover the more comprehensive antimicrobial resistance.

Making plans…

The Obama Administration announced a game plan in September for facing antimicrobial resistance. Here’s the to-do list:

• Leverage findings from the President’s Council of Advisors on Science and Technology (PCAST) report on combating antimicrobial resistance. The report suggests doubling the current federal investments from $450 million to $900 million a year. It also outlines recommendations for strong federal leadership, effective surveillance, research, clinical trials, increasing economic incentives for development, increasing stewardship for current antibiotic use, limiting agricultural use of antibiotics, and increasing international coordination.

• Implement the National Strategy for Combating Antibiotic Resistant Bacteria. The PCAST report was used to create a National Strategy for Combating Antibiotic Resistant Bacteria. The strategy focuses on five major goals:

Slow the development of resistant bacteria and prevent the spread of resistant infections; strengthen national one-health surveillance efforts to combat resistance; advance development and use of rapid and innovative diagnostic tests for identification and characterization of resistant bacteria; accelerate basic and applied research and development for new antibiotics, other therapeutics, and vaccines; and improve international collaboration and capacities for antibiotic resistance prevention, surveillance, control, and antibiotic research and development.

• Form a task force that combats antibiotic resistant bacteria. Established by Executive Order, the task force is responsible for implementing the National Strategy for Combating Antibiotic Resistant Bacteria. It is working on a detailed report of specific action plans due in February 2015.

• Finance diagnostic innovation. A $20 million prize, co-sponsored by the National Institutes of Health and the Biomedical Advanced Research and Development Authority, will be granted for a point-of-care diagnostic test that identifies antibacterial-resistant infections.

A little legal setback…

The July ruling in the NRDC v. US FDA case was marked as a major setback in the fight against antimicrobial resistance. The plaintiffs (including the Natural Resources Defense Council and Center for Science in the Public Interest) were dismayed that the court ruled against compelling the FDA to ban the use of antibiotics in healthy animals used for food.

The case overturned two other district court rulings that would have required the FDA to rescind approved use of antibiotics for purposes other than to treat sick animals. Companies could have gotten around the ruling if they proved the drug in question posed little risk for contributing to the development of antimicrobial resistance in humans.

Some other hangups

There are a few other pesky issues that might hinder some of the strategies for reducing antimicrobial resistance:

• Individual privacy could potentially get in the way of optimal surveillance of antibiotic resistance. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) guarantees privacy of health information that is individually identifiable. Patient preferences could determine what information can be used to track antimicrobial resistance.

• Companies lack incentives to create new antibiotics because the traditional sales volume and price linkage is missing. Because fighting antibiotic resistance forbids overusing one particular drug, companies would probably not get a good return on investment.

• Ponderous approval processes for new drugs might also hinder the speed of new antibiotic drug development. A balance will need to be struck in ensuring speed of innovation without compromising safety.
  

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So the government has antimicrobial resistance under control?

It has a robust plan for taking action against antibiotic resistance, but being an informed patient never hurt anybody. The CDC recommends a few steps you can take, including abstaining from antibiotic use for viral infections, not saving leftover antibiotics, and not taking antibiotics prescribed for someone else.

The fight against antimicrobial resistance is really no fight at all, but a call for permanent change in our medical and agricultural systems. As long bacteria exist and want to survive, our desire to survive must be stronger.

Resources

Primary

CDC: Antibiotic Resistance Threats in the United States, 2013

President’s Council of Advisors on Science and Technology: Report to the President on Combating Antibiotic Resistance

Additional

Cochrane Summaries: Antibiotics for Acute Maxillary Sinusitis

Food Safety News: White House Calls for Action Plan to Address Antibiotic Resistance

The White House: New Executive Actions to Combat Antibiotic Resistance and Protect Public Health

CDC: Untreatable: Today’s Drug Resistant Health Threats

Explorable.com: History of Antibiotics

American Chemical Society: Discovery and Development of Penicillin

National Institute of Allergy and Infectious Diseases: Antimicrobial Drug Resistance

World Health Organzation: Antimicrobial Resistance

Huffington Post: Feds Failing to Act on Antibiotic Resistance Despite Grave Threat

Natural Resources Defense Council: Food, Farm Animals and Drugs

CDC: Legal Issues Associated with Antimicrobial Drug Resistance

CDC: White House Announces National Strategy for Combating Antibiotic Resistance

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

The post Are We Doing Enough to Prevent Antibiotic Resistance? appeared first on Law Street.

Mankind’s greatest enemy is not war or hunger but infectious disease. Throughout history it has cost countless deaths, and even in the twenty-first century our defenses against it remain limited. Above all, it is the threat of outbreak that unsettles us so; it is not just suffering and death, but fear. Whether it’s the Black Plague, Cholera, Spanish Influenza, H1N1, or Ebola, disease is a dark cloud looming over our lives.

Most of the microscopic killers with which we contend have been transmitted to us through animals. In the early ages of settled agriculture, close contact with domesticated chickens, pigs, cows, and others exposed humans to pathogens to which their immune systems had no previous exposure and consequently minimal means by which to combat them. There are two primary behavioral patterns of diseases. Some ascribe to the category of “chronic.” In this case, as geographer and ornithologist Jared Diamond explains, “…the disease may take a very long time to kill its victim; the victim remains alive as a reservoir of microbes to infect other[s]…” The other category is “epidemic.” In this case, Diamond continues, there might be no cases for a while, followed by a large number in an affected area, and then none for a while more. Such behavior is a consequence of the intensity of the disease’s manifestation; it strikes with such force that it basically burns itself out because the potential hosts all either die or become immune.

“Epidemic” is a widely feared term. Rather than consider the fact that they can and have been occurring on very small scales throughout human history, many people associate epidemic with things like the Black Plague in Europe, Smallpox in the New World, or a global zombie apocalypse. Since people naturally fear most what they do not understand, insufficient knowledge of disease vectors and behavior results in widespread fear and panic.

Ebola is a relatively late arrival on the scene. Originally suspected to be yellow fever, it was discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. Samples extracted from an ill nun who had been working in the region came to doctors and scientists in an Antwerp, Belgium laboratory. They eventually discerned that the infection behaved differently from what would be expected of the original diagnosis. After sending samples to the Center for Disease Control in Atlanta, their conclusions were confirmed and a new disease had been discovered. Shortly thereafter, another outbreak occurred relatively far away in Sudan. While knowledge of the initial source and starting location of the disease is still vague, it was determined that it had spread via unsterilized syringes and contact with bodies during funerals. Therefore a lack of knowledge of the nature of the disease lent itself to its spread.

Ebola in large dropped off the radar screen until the recent epidemic began in West Africa. Going hand in hand with lack of knowledge of the disease are incomprehensive and underdeveloped means of addressing it. On a recent edition of Global Public Square, the insightful international news show hosted by CNN’s Fareed Zakaria, international relations PhD Chelsea Clinton declared that the disease is spreading exponentially, necessitating exponential containment measures. This is very difficult to achieve, due to the poor technological and economic infrastructures of the region. As Dr. Paul Farmer — another guest on Zakaria’s show — expanded, the Liberian healthcare system is also very weak. Liberian Foreign Minister Augustine Ngafuan detailed how Liberians have deeply ingrained burial practices that involve close contact with bodies; this is an important aspect of cultural values in the region and not easily relinquished in the face of something that foreign experts, much less locals, barely understand.

A Liberian village, courtesy of jbdodane via Flickr.

Globalization and increased interconnectedness between individuals, societies, and locations has exacerbated the rate at which diseases spread. Many Americans cried out when infected aid workers were brought home to be treated. Appropriate measures were taken in this instance, with sanitary transportation vehicles bringing the patients to the Emory hospital in Georgia. Due to its affiliation with the CDC, this is one of the few facilities truly equipped to accommodate infectious diseases of this nature. Both those patients recovered, though they would likely have died if they were forced to remain in Africa. The situation was handled intelligently and effectively, without resounding negative consequences. Yet the outcry and fear demonstrates people’s lack of knowledge and tolerance of the unknown and perceived dangers. This was in fact the first occasion in which Ebola was present on American soil.

The situation changed with the death of Thomas Duncan. Having arrived from Liberia in late September, Duncan provided a new first by being the first patient diagnosed with Ebola in the United States. His illness was unknown during his transit, and so new fears arose as to the likelihood of Ebola crossing the ocean with traveler hosts. Now in a complete state of fear, Americans want more and more action taken in defense of the nation’s health, yet do not know what those measures ought to be because we do not know enough about the disease. Many airports have begun taking travelers’ temperatures. The CDC initially cited 101.4 degrees as the point at which one must be quarantined, but lowered it after some supposedly ill people were cleared. This demonstrates the uncertainty of the disease’s nature; in what ways does Ebola affect a person’s body temperature? At what point in their illness are they contagious? Is a body temperature an effective indicator of this? These questions have yet to be answered for the disease of whose existence we have known for less than 40 years.

Specialists clean up a Hazmat area, courtesy of sandcastlematt via Flickr.

The second set of problems that are causing fear are the alleged breaches of protocol that have enabled several other people to catch the disease in the United States. The Dallas hospital in which Duncan died was not equipped to handle this disease and consequently could not treat him effectively. Furthermore, the staff did not have the proper training insofar as interacting with Ebola, and this has been cited as the reason why nurse Nina Pham, who was treating him, became ill as well. A recent video surfaced wherein a patient is being transferred from one vehicle to another by four workers in “hazmat,” or hazardous material, uniforms. A fifth person, dubbed “clipboard man,” stands with them completely unprotected. Finally, CDC Director Dr. Tom Frieden has come under fire for making statements and then retracting them. Pennsylvania Republican Congressman Tom Marino has even called for him to step down. We have quickly forgotten, though, that in the early 1990s Frieden was instrumental in developing awareness and programs to combat a rising Tuberculosis epidemic in New York City. In addition to other stellar career highlights, Frieden is a highly capable leader experienced in engaging these concerns.

We are too wrapped up in fear of the unknown to do anything but demand immediate results. Ebola is a newcomer on the scene and will take some time to understand effectively. As we continue to discern our relationships with our surrounding environments, we do know that ebola is not nearly as contagious as other diseases. It requires direct contact with bodily fluids of infected patients. As we continue to learn how it works, and how our actions, societies, and cultures interact with it, we will become more effective at addressing it. In the meantime, we annually face airborne foes which are far more dangerous and contagious; do not forget to get your flu shot in the coming weeks.

Franklin R. Halprin

Franklin R. Halprin holds an MA in History & Environmental Politics from Rutgers University where he studied human-environmental relationships and settlement patterns in the nineteenth century Southwest. His research focuses on the influences of social and cultural factors on the development of environmental policy. Contact Frank at staff@LawStreetMedia.com.

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It seems like all anyone can talk about anymore is Ebola. Especially now that the first case of Ebola has been found in the United States, in Dallas, and the first case transmitted outside Africa reported in Madrid, people seem to be freaking out. One big concern has been that Ebola is going to become an issue in the U.S., which I just want to start by saying is unfounded and unrealistic. The public health infrastructure in the U.S., as well as our ability to isolate the disease make it incredibly unlikely that it becomes an epidemic. You’re still significantly more likely to die of the flu, or a car accident than even go near someone who has Ebola. As of press time, Thomas Eric Duncan — the man in Dallas who had contracted Ebola — has passed away of the disease, and while our thoughts and sympathy are with his family, this development does not change the risk factors in the U.S.

People are losing their minds over it. Seriously, check out #EbolaQandA on Twitter. It makes me terrified — not of Ebola, but at the extent to which our American education system appears to have failed people when it comes to very, very basic concepts of health and geography. Now Ebola is an incredibly important world issue right now, and combating it absolutely deserves our attention, vigilance, and support. That being said, we all need to take a deep breath over here in the U.S., and stop listening to misinformation and conspiracy theories, because this is getting silly. Here’s a helpful flowchart for anyone who’s concerned about the spread of Ebola in America.

Worried about Ebola? Here's a flowchart just for you! #diseases #outbreak #EbolaOutbreak #notenoughwine pic.twitter.com/U6uvQd8MKf

— Melody Butler (@MelodyButler) August 2, 2014

There have been many proposals to try to keep the United States from having Ebola-infected people cross over our borders. One of the most extreme is a “travel ban” aimed at West African countries with high infection rates.

This sounds like a good idea in theory, it really does. But in reality, it’s not something the U.S. will do, or should do. First of all, the best way to make sure that the United States does not experience problems with Ebola is to stop the epidemic. And if we restrict our access and communication with the affected region, it’s just going to get worse. When there’s not a huge risk of Ebola reaching any sort of epidemic levels in the United States, it doesn’t make sense to impede our relief efforts with a ban. A travel ban could mean that relief workers have a harder time going in, or refuse to go at all because they worry that they might not be able to get back.

Also, instituting a travel ban could make it more likely that someone with a case of Ebola makes it into the U.S. If we have a ban in place for countries heavily infected like Sierra Leone, Guinea, and Liberia, people are going to find a way around it. They could go to Senegal, or any other nearby nation where travel is not restricted. Because of the ban they may be incentivized to lie about whether or not they’ve been in contact with an infected person in hopes of not being prevented from getting on a plane. Right now we’re able to track people and examine them at the airport and upon arrival, and we’re going to strengthen our tools for that. We shouldn’t incentivize anything that makes it harder for us to do that.

I’m not an expert in public health; I don’t know what will happen with this epidemic. But what I do know is that panicking is going to do nothing. Educate yourself. Donate to the relief effort. Don’t feed the frenzy. This crisis needs a pragmatic approach, not a reactionary one.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Keep Calm and Carry On: You Don’t Have Ebola appeared first on Law Street.

For the first time in the United States during the current outbreak, a patient was diagnosed with the Ebola virus–the Centers for Disease control confirmed the case on Tuesday. As if Thomas Duncan, the infected Liberian man who came to the United States, doesn’t have enough to worry about, he’s also facing legal trouble. The Liberian government will prosecute Duncan when he returns to Liberia for allegedly lying on an airport questionnaire, the Associated Press reported.

Duncan left Liberia on September 19th to visit his family and wasn’t showing any symptoms at the time. Days before, he helped take a 19-year-old infected pregnant woman to a hospital and helped bring her back home when she was turned away for lack of space, the New York Times reported. The woman, Marthalene Williams, died the next day. Williams’ parents said that Duncan helped carry her back from the taxi to her house. Her brother, who accompanied her, her father, and Duncan on the taxi ride home, also started showing symptoms of Ebola and died less than a week later.

When Duncan was at the airport on his way out of Liberia, he received a questionnaire given to anyone intending to depart Liberia, Guinea, and Sierra Leone – the three West African countries countries most severely facing the Ebola epidemic – asking him about his recent contact history in the country. Duncan answered “no” when when asked whether he had been in contact with anyone who may have been infected.

Duncan passed the screening at the airport without showing any sign of symptoms and boarded his plane. The idea that Liberian officials would threaten to prosecute him might suggest double standards, since people are still able to move between countries in West Africa. But Liberia may have chosen to do this to make an example out of Duncan. It’s likely that Liberia wants to set a precedent that its screenings are serious business and wants countries to where Liberians travel to be reassured about that, Cornell University Law professor Jens Ohlin told the Atlantic.

The sudden decision to prosecute an infected person might also be an attempt not to upset U.S. officials, though Ohlin doesn’t seem to think so. This hasn’t happened in other major countries, so it is tough to say whether Liberia is singling out the United States.

Duncan is arguably very lucky that he happened to be in America when he started to show symptoms of Ebola. The average death rate has been up to 90 percent in previous outbreaks, according to the World Health Organization. But in August, two American aid workers who were working in West Africa were cured of the disease after being treated in Atlanta.

Currently being treated in a Dallas hospital, Duncan started showing symptoms on Sept. 24 and went in for treatment two days later. His family members in Dallas have also been quarantined in their apartment. While the situation is dire in West Africa, CDC Director guaranteed that it wouldn’t be a problem in the United States. “The United States has a strong health care system and public health professionals who will make sure this case does not threaten our communities,” he said in a press release on Tuesday.

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Zaid Shoorbajee (@ZBajee)

Featured image courtesy of [Phil Moyer via Flickr]

Zaid Shoorbajee

Zaid Shoorbajee is a an undergraduate student at The George Washington University majoring in journalism and economics. He is from the Washington, D.C. area and likes reading and writing about international affairs, politics, business and technology (especially when they intersect). Contact Zaid at staff@LawStreetMedia.com.

The post Liberia to Prosecute Ebola-Infected Traveler appeared first on Law Street.

In recent years, an increasing number of parents decided not to vaccinate their children for a number of diseases. Vaccinations are largely heralded as one of the most effective instruments for public health. Measles, declared eliminated in the United States in 2000, is now back in full force primarily due to lack of vaccination. Here’s what you need to know about the controversy surrounding vaccines, preventable diseases, and what more can be done.

Why are we worried about measles?

It’s true, those pesky measles are back. That contagious respiratory disease characterized by a fever, runny nose, cough, and itchy rash is once more making its way through towns in the United States. Most cases result from foreigners traveling to the United States infecting those who are not vaccinated. In the decade before the measles vaccine was introduced, the Centers for Disease Control and Prevention (CDC) reported an estimated 3 to 4 million people contracted measles each year. The disease caused many cases of chronic disability, hospitalization, and even death. Before the vaccine, the virus affected more than 95 percent of children. Measles kill approximately one in every 1000 cases. About 30 percent of cases develop further complications, including pneumonia, ear infections, or diarrhea. The vaccine for measles, commonly known as the vaccine for Measles Mumps and Rubella (MMR) was introduced in 1967. Following a large measles outbreak from 1989 to 1991, Congress instituted the Vaccines for Children Program to increase vaccination rates. Following, cases of measles rapidly fell. The recent return of measles has largely been blamed on the anti-vaccination movement. Watch below for an overview of the benefits of vaccines:

Why don’t parents want to vaccinate their kids?

Parents are hesitant to trust the government or pharmaceutical companies and have a number of concerns in allowing their children to be vaccinated. The anti-vaccination push began following a 1998 study by researcher Andrew Wakefield in the British journal, The Lancet. The study declared a link between the MMR vaccine and autism. However, the article has since been widely discredited in the scientific community due to conflicts of interest and manipulated evidence. The paper was retracted in 2010 and Wakefield lost his medical license. Despite the following events, many parents are still concerned that the MMR vaccine will cause autism. Watch below for some debate of the study:

Beyond this, the anti-vaccine movement has continued to gain traction for a variety of reasons:

Celebrity Support

Actress, model, and “The View” host Jenny McCarthy has been a vocal opponent of vaccination. McCarthy claims the vaccines have toxins that are generally unsafe, especially as the amount of required vaccines has increased. Scientists point out that vaccines contain a much less amount of toxins than other foods. Other opponents of vaccination include actor Aidan Quinn, who connects his daughter’s autism with the MMR vaccine, and reality star Kristin Cavallari, who opposes the vaccination of her children. Listen to Jenny McCarthy discuss autism and vaccination:

“Vaccine Load”

Some parents are worried about vaccine load, where the child’s immune system may not be able to handle multiple shots at one time. Children now receive up to 28 shots by age 2. Several studies show receiving multiple vaccines on the same day is not associated with increased chances of autism. Further, while the number of vaccines given to children has increased in recent years, the amount of main ingredients in vaccines has decreased. Worries of vaccine load mean many children are not vaccinated in a timely manner. The claim is also made that vaccines cause a permanently depressed immune system. Instead of vaccination, children should be allowed to build up natural immunity over time.

Mercury

Concerned parents cite the mercury-based preservative thimerosal in vaccinations as a cause of potential brain damage. Government officials have deemed thimerosal safe and found no evidence of harm. However, by taking the voluntary precaution to phase the compound out of vaccinations in 1999, the CDC instilled a greater fear of vaccinations.

Religion

Others object to vaccination solely on a religious basis. They claim vaccination interferes with natural law and God’s plan. Others believe the body is sacred and should not receive certain chemicals, blood, and tissue from animals.

Don’t parents have to vaccinate their kids?

In most cases, for a child to attend public school they must have certain vaccinations. However, some states allow exemptions for those with religious or even philosophical opposition to vaccinations. Private schools do not have the same mandate as public schools. Therefore,private schools vaccination rates are as low as 20 percent. The vast majority of parents vaccinate. According to USA Today, vaccination rates for all diseases are about 90 percent, and fewer than one percent  of Americans forgo all vaccinations. However, exemption rates from 2006 to 2011 doubled. Since states have different policies, vaccination rates are not geographically uniform. This leads to outbreaks only in specific areas.

All states allow vaccination exemptions for medical reasons. Nineteen states allow philosophical exemptions for vaccinations. In states with philosophical exemptions like Idaho, Michigan, and Vermont, more than 4.5 percent of kindergarteners last year were unvaccinated for non-medical reasons. These rates are four times the national average and are potential hotspots for outbreaks. Mississippi and West Virginia are the only states to not allow religious exemptions.  So far,  those states have not seen any disease outbreaks. A federal judge recently upheld a New York City policy that unvaccinated students are not allowed to attend school when another student has a vaccine-preventable illness. Ultimately the right to forgo vaccination for religious reasons doesn’t trump the fear that unvaccinated students may contract and spread the disease.

Until 2011, parents in Washington could opt out of vaccinating children simply by signing a form. This system meant up to a quarter of kids in some counties opted out of vaccinations. States that allow non-medical exemptions have seen more parents forgo their children’s vaccines. From 2000 to 2010, non-medical exemptions in California tripled. Watch for a description of a recent measles outbreak:

Has lack of vaccination led to more cases of disease?

The overwhelming majority of current measles infections occur in unvaccinated people. From the beginning of 2014 to June 20, 2014, the CDC declared 514 cases of measles and approximately 16 outbreaks, the most since 1996. Half of these casesare adults age 20 and over. Following a widespread measles outbreak in San Diego in 2008, roughly one in five children were not vaccinated against the disease. Even last year in California, USA Today reported 14,921 children were not vaccinated for philosophical reasons. In Colorado four percent of kindergarteners did not have shots for non-medical reasons. Watch below for information on the recent measles outbreak:

Another vaccine-preventable disease, pertussis, or whooping cough, increased considerably in recent years. In 2012, a fifty-year high of almost 50,000 cases of whooping cough were reported, a stark contrast from the 1980s and early 1990s when rates hovered around 5,000. Through June 16, 2014, almost 10,000 cases of whooping cough were reported, which is a 24 percent increase when compared with the same period in 2013. This is attributed to the anti-vaccination movement as well as weakened antibodies which wane as a person ages.

Should I be worried?

If you are vaccinated and your shots are up to date, probably not. The most vulnerable are infants who are too young to be vaccinated and the elderly who may not have proper boosters. The effects of vaccination deteriorate over time, so adults who have not gotten booster shots can still contract the disease from an unvaccinated person. Unvaccinated people may not even know if they are carrying a disease like measles, but they can still contagious before any symptoms arrive. A recent case study of an individual dubbed “Measles Mary” has even shown it is possible for a vaccinated person to contract measles and then unwittingly pass the disease on to others.

A recent study by the CDC showed routine childhood vaccinations given between 1994 and 2013 will save 732,000 lives while preventing 322 million cases of illness and 21 million hospitalizations over the course of the children’s lifetimes. According to the Washington Post, every $1 spent on vaccines provides $10 benefit to society.

Medical experts agree proper vaccination is extremely important. Having more people vaccinated makes it less likely that anyone in the community will get a disease, a phenomenon known as “herd immunity.” Aiming for vaccination rates higher than 90 percent can help protect the most vulnerable, especially infants who are too young to be vaccinated. Most officials think the best strategy to increase vaccination is a tireless public education campaign to dispel rumors regarding the danger of vaccines. Watch a video below aimed at educating parents:

 Resources

Primary

CDC: Measles Cases and Outbreaks

CDC: Pertussis Outbreak Trends

CDC: Benefits from Immunization During the VCP Era

CDC: Highest Number of U.S. Measles Cases Since 2000

CDC: Measles Vaccination

FDA: Thimerosal in Vaccines

Additional

USA Today: Anti-Vaccine Movement is Giving Diseases a 2nd Life

Newsweek: Anti-Vaccination Movement Strikes Out in Bible Belt States

Washington Post: How the Anti-Vaccine Movement is Endangering Lives

Time: Parents not Vaccinating Kids Contributed to Whooping Cough

Week: The Worrying Rise of the Anti-Vaccination Movement

National Vaccine Information Center: State Law and Vaccine Requirements

Washington Post: Measles Cases are Spreading, Despite High Vaccination Rates

Science: Measles Outbreak Traced to Fully Vaccinated Patient for the First Time

NCSL: Immunization Policy Issues Overview

The New York Times: Judge Upholds Policy Barring Unvaccinated Students

History of Vaccines: Cultural Perspectives on Vaccination

Alexandra Stembaugh

Alexandra Stembaugh graduated from the University of Notre Dame studying Economics and English. She plans to go on to law school in the future. Her interests include economic policy, criminal justice, and political dramas. Contact Alexandra at staff@LawStreetMedia.com.

The post The Anti-Vaccination Movement: Eradicated Diseases Making a Comeback appeared first on Law Street.

The Food and Drug Administration’s recent decision to curb the use of prescribed painkillers has quickly become a topic of huge media speculation. A debate focusing on the pros and cons of this verdict has been sparked between the drug-selling companies, health providers and the Centers for Disease Control and Prevention (CDC).  While few health providers argue that this might have serious consequences on patients suffering from acute pain, others believe that this is an attempt to reduce the increasing number of deaths caused due to the abuse of household painkillers.

According to the CDC, painkiller overdose death rates have more than tripled since the 1990. In 2009, abuse of prescription painkillers was the major reason behind all 475,000 emergency department visits across the nation.  Hydrocodone-the main ingredient behind most household painkillers included in the variety of opioid narcotics, is seen as the dominant cause for the increasing number of deaths.  In the past, hydrocodone was classified as a low-risk drug that permitted doctors to prescribe it over phone, and allowed patients to use it for a period of six months on a single prescription. Although, these rules eased the access to the drug and pushed the sales to new heights, it additionally fueled the widespread dependence and related deaths.

Last week, almost after a decade and a half of careful cross-examination, the FDA took a step forward to reduce the harmful effects of the drug. The new proposal eliminates the conveniences of prescribing painkilling drug. It reclassifies Hydrocodone under Schedule II drugs, thus bar phone-in prescriptions and place a 90-day limit on refills.  Most opponents of FDA’s decision complain that this will force ailing patients to schedule more frequent visits to the doctors, which might prove to be burdensome for most middle-income families. In response to this, FDA reaffirms that a change in regulations for Hydrocodone containing drug supply was absolutely necessary as it kills more people than any other forms of narcotics.

Controlling substance abuse has always posed a challenge for the FDA, and extension of this malpractice into the prescribed drug sector; could lead to results much more uglier than ever imagined. In my personal opinion, the FDA’s recent drug restrictions should be applauded as this initiative could save lives and mitigate the overall narcotic abuse rates. Hydrocodone supplying companies could experience an initial down surge in sale revenue, but that should not lead them to undermine the dangers of selling the drug.  It is time for drug-selling giants to realize and act on their social responsibilities.

[CDC]

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Featured image courtesy of [Eric Norris via Flickr]

Tanzoom Ahmed

Tanzoom Ahmed is a graduate of George Mason University with a Master of Public Policy. Contact Tanzoom at staff@LawStreetMedia.com.

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