Maryn McKenna

Journalist and Author

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Polio Declared An International Health Emergency

May 6, 2014 By Maryn Leave a Comment

Prefvotuporanga (CC), Flickr

Image: André Luiz D. Takahashi (CC), Flickr

In a move that is simultaneously discouraging, urgent and deeply unusual, the World Health Organization has declared that the resurgence of polio is a “public health emergency of international concern.” It’s an extraordinary statement, coming less than four months after India — once considered a place where polio might never be vanquished — was declared polio-free after three years without a new case.

That achievement left only Afghanistan, Nigeria and Pakistan as countries where the chain of polio transmission had never been broken. But as the virus persists in those countries, it is also moving out across their borders. Seven other nations that previously had beaten polio — Cameroon, Equatorial Guinea, Ethiopia, Iraq, Israel, Somalia and Syria — have now been reinfected, and the virus is spreading in communities there.

If the continued existence of polio is news to you, you’re not alone. It’s a largely forgotten disease in the industrialized West; the last United States case occurred in 1979. The WHO, the Centers for Disease Control and Prevention, the fraternal organization Rotary International and a raft of partners have been pressing an international and very expensive eradication campaign since 1988. Every time the world has gotten close, though, polio has flared up again. The WHO once thought it would be able to declare the disease eradicated in 2000; then it set 2005 as a target; then 2008; 2012; 2015; and now, a hoped-for 2018. (Here’s my archive of posts.)

But the past couple of months have thrown even that into doubt. The trigger for the WHO’s action was the discovery that there have been 74 cases of polio so far this year. That seems like a low number, but there were only 417 in all of 2013. And, crucially, winter is considered polio’s “low season” — so for polio to be spreading now rings an alarm bell for the warmer, wetter months when it usually spreads faster and further.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, CIA, Pakistan, polio, Who

CDC: Foodborne Illness in the U.S. Not Getting Better

April 17, 2014 By Maryn Leave a Comment

AnotherPintPlease (CC), Flickr

Image: AnotherPintPlease (CC), Flickr

The Centers for Disease Control and Prevention today released their annual survey of foodborne illnesses in the United States, and the news is, well, not great. In the words of the press announcement they sent out to announce the data release: “limited progress.”

The survey — technically the Foodborne Diseases Active Surveillance Network, but usually known as FoodNet — doesn’t cover the entire US; it’s a representative sample drawn from 10 sites in nine states where the CDC already has arrangements with epidemiologists and laboratory personnel. Those 10 sites, most of them at state health departments, cover 48 million people, or about 15 percent of the US population. So among that slice, in 2013, there were:

  • 19,056 lab-confirmed foodborne illnesses,
  • 4,200 of which were severe enough to cause the person to be hospitalized,
  • and 80 of which caused the person’s death.

(For context, the CDC’s extrapolation of foodborne illness nationwide, made in 2011, was 48 million illnesses, 128,000 hospitalizations and 3,000 deaths.)

The agency compared the 2013 numbers against two sets of data, one set taken covering 2010-12 and the other 2006-08. Its summation, from its report in its weekly publication MMWR:

Compared with 2010–2012, the estimated incidence of infection in 2013 was lower for Salmonella, higher for Vibrio, and unchanged overall. Since 2006–2008, the overall incidence has not changed significantly. More needs to be done.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, E. coli, FSIS, salmonella, USDA

Traveling Abroad? Careful What You Carry Back… In Your Guts

April 10, 2014 By Maryn Leave a Comment

Photo: Ariel Zamblich/WIRED

Photo: Ariel Zambelich/WIRED

If you do any kind of challenging travel — adventure travel, backpacking, even just going to less-developed parts of the world — you’ve probably evolved some sort of protective routine. You get shots, take your malaria medication, wash raw things before eating them and take a water filter for the bad places. (Please tell me you do this. Condoms, too.)

But a new study just published in EuroSurveillance, the peer-reviewed journal of Europe’s equivalent of the CDC, raises the possibility that even if you are doing the right thing, you could pick up some very nasty stuff while you’re abroad — and that what you bring back could endanger not only you, but others around you as well. A team of French researchers reports that healthy travelers who had no contact with foreign medical systems brought back extremely drug-resistant bacteria, probably just from drinking water, and that the bacteria persisted in their guts for at least two months after they came home.
[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, ECDC, EU, NDM

A Patient in Minnesota Has Lassa Hemorrhagic Fever. (Don't Panic.)

April 4, 2014 By Maryn Leave a Comment

Daliborlev (CC), FLickr

Daliborlev (CC), FLickr

News from the Minnesota Department of Public Health and the Centers for Disease Control and Prevention: A Minnesota traveler returning from Africa has been hospitalized with what the CDC confirms to be Lassa fever, a viral hemorrhagic fever that is often lumped together with Ebola hemorrhagic fever, though they are caused by different organisms.

Given the news from West Africa of the growing Ebola outbreak there — 127 cases including 83 deaths, according to the World Health Organization’s last posted update — I suspect there’s going to be some attention to this case, possibly even some alarm. So, switching from Scary Disease Girl to Scary Disease Killjoy (which is sort of like Phoenix becoming Dark Phoenix, only without any planets blowing up): The Minnesota department says there’s no sign the disease has spread. The CDC says it’s not even likely to have infected passengers on the same airplane.

And if you’re thinking, well, surely this has never happened before, a viral hemorrhagic fever coming to the US via airline: Actually, it’s happened seven times before. And no one caught Lassa from the infected travelers in any of those times — not from sitting next to them, not from living in the same house with them, not from having sex with them. It is a very bad disease. But it is not the threat we like to imagine.

(Sorry to spoil the fun.)

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, Ebola, minnesota, risk

CDC: Some Hospitals Need Assistance Using Antibiotics Properly (And the New Federal Budget May Help)

March 4, 2014 By Maryn Leave a Comment

Image: Zach Bulick/Flickr

Image: Zach Bulick/Flickr

Double-barreled news today from the US Centers for Disease Control and Prevention. In an analysis of several sets of hospital data, gathered by the agency and also purchased from independent databases, the CDC said it found that more than 37 percent of prescriptions written in hospitals involved some sort of error or poor practice, increasing the risk of serious infections or antibiotic resistance. And in a surprise announcement timed to the release of the federal draft budget, the agency said it is in line to receive $30 million to enhance its work combating antibiotic resistance in the US.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, C.diff, CDC, Resistance, Science Blogs, stewardship

H7N9 Flu, Year Two: What Is Going On?

February 10, 2014 By Maryn Leave a Comment

Live-poultry market, Shandong, China, 2009. Jonas_in-China (CC), Flickr

Live-poultry market, Shandong, China, 2009. Jonas_in-China, Flickr

Cast your mind back to about this time a year ago. A novel strain of flu, influenza A (H7N9), had emerged in China, in the provinces around Shanghai. International health authorities were deeply concerned, because any new strain of flu bears careful watching — and also because, on the 10th anniversary of the SARS epidemic, no one knew how candid China would be about its cases.

By the time peak season for flu ended in China, there had been 132 cases and 37 deaths from that newest flu strain. But, confounding expectations, the Chinese government was notably open about the new disease’s occurrence, and scientists worldwide were able to ramp up to study it. Still, no one could say whether that flu would be the one to make the always-feared leap to a pandemic strain that might sweep the globe. As with other, earlier, worrisome strains of flu, science could only wait and see whether it might return.

And now it has.
[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: avian flu, CDC, chicken, China, flu, H5N1, H7N9, influenza, poultry, Science Blogs, Who

Measles Cases Triple in U.S., Vaccine Refusal Here and Elsewhere to Blame

December 6, 2013 By Maryn Leave a Comment

Image: Teseum (CC), Flickr

Measles, one of the most communicable of all infectious diseases, is spiking in the United States, with three times as many cases as usual this year, the Centers for Disease Control and Prevention said Thursday. The spike is due to both foreign importations — infected travelers coming from places where measles is not under control — and local vulnerability: unvaccinated children and adults in the United States.

In a press briefing, the CDC’s director Dr. Thomas Frieden said that from January to November, there were 175 known cases of measles in the US, with 20 of those people having to be hospitalized. The agency would expect to see about 60 cases, he said. Those cases came from 52 separate travelers. Most of the time, the imported virus found only a few people to infect — but nine times, the imports caused large outbreaks, always in people who had not received the vaccine.

“It is not a failure of the vaccine,” Frieden said. “It’s a failure to vaccinate. Around 90 percent of the people who have had measles in this country were not vaccinated either because they refused, or were not vaccinated on time.”
[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, measles, Science Blogs, vaccination

CDC Director: In the Shutdown, 'We Are Juggling Chainsaws'

October 16, 2013 By Maryn Leave a Comment

The CDC’s Emergency Operations Center in Atlanta, from which it monitors disease outbreaks around the world.
Left: Currently. Right: Before the shutdown began.

We’re now on the sixteenth day of the federal shutdown. As I write, the Senate has announced a deal to avoid a debt default and open the government. It remains to be seen whether that will work, or how fast. Yesterday, on Day 15, I had a long conversation with Dr. Thomas R. Frieden, director of the U.S. Centers for Disease Control and Prevention, about what this shutdown has meant for his agency, its employees, and the health of Americans, and the world. I have lightly edited the conversation for clarity.

Maryn McKenna, WIRED: You’re on Day 15 of sending home 68 percent of your 13,000-person staff, in Atlanta and around the world. How is the CDC coping?

Thomas R. Frieden, CDC: Every day this goes on, it gets harder to manage. We’re used to juggling things at CDC, but this is like juggling chain saws.

We’ve got two-thirds of our staff out. The exempt staff, the ones who are here, are here just because of a happenstance of how they’re paid: They are people who are on multi-year money, or grant money, or people in the Commissioned Corps, the uniformed Public Health Service. Of the people who are furloughable, 95 percent are furloughed.

I walk through the offices and talk to the remaining staff to thank them for being here. A woman who was the only person on her floor said to me, “We have no idea what we’re missing right now.” For years people have asked me, ‘Do you sleep well, knowing all these terrible threats we face?” And I’ve always said, “I sleep great because I know we have fantastic staff on watch.” And now I’m not sleeping.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, EIS, Science Blogs, Shutdown

Shutdown Salmonella Outbreak Continues. CDC Food Safety Chief: 'We Have a Blind Spot.'

October 10, 2013 By Maryn Leave a Comment

Image: Ben Husmann, (CC), Flickr

We’re 11 days now into the federal shutdown and four days since the announcement of a major foodborne outbreak in chicken that is challenging the shutdown-limited abilities of the food-safety and disease-detective personnel at the Centers for Disease Control and Prevention, Food and Drug Administration and Department of Agriculture. Here’s an update.
[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: agriculture, antibiotics, CDC, FDA, food policy, food safety, Resistance, salmonella, Science Blogs, Shutdown

There's a Major Foodborne Illness Outbreak and the Government's Shut Down

October 7, 2013 By Maryn Leave a Comment

image: BokChoi-Snowpea (CC), Flickr

Late-breaking news, and I’ll update as I find out more: While the government is shut down, with food-safety personnel and disease detectives sent home and forbidden to work, a major foodborne-illness outbreak has begun. This evening, the Food Safety and Inspection Service of the US Department of Agriculture announced that “an estimated 278 illnesses … reported in 18 states” have been caused by chicken contaminated with Salmonella Heidelberg and possibly produced by the firm Foster Farms.

“FSIS is unable to link the illnesses to a specific product and a specific production period,” the agency said in an emailed alert. “The outbreak is continuing.”

(Updates to this post are at the bottom.)

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, chicken, FDA, foodborne, FSIS, salmonella, Science Blogs, Shutdown, USDA

A Few Ways the Government Shutdown Could Harm Your Health (And the World's)

October 1, 2013 By Maryn Leave a Comment

image: BMills (CC), Flickr

There’s going to be a lot — a lot — of coverage today on the federal shutdown, what it means and how long it might go on. I thought it might be worth quickly highlighting how it affects the parts of the government that readers here care most about: public health, global health, food safety and the spread of scary diseases.

Most of those government functions are contained within the Cabinet-level Department of Health and Human Services, where 52 percent of the employees have been sent home. So the news is not good.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, FDA, FSIS, influenza, MERS, NCoV, Science Blogs, Shutdown, USDA

CDC Threat Report: Yes, Agricultural Antibiotics Play a Role in Drug Resistance

September 17, 2013 By Maryn Leave a Comment

Campylobacter bacteria. Image: CDC

The grave assessment on the advance of drug resistance, released Monday by the US Centers for Disease Control and Prevention, contained some important observations about the relationship between antibiotic use in agriculture and resistant infections in humans. Those observations, combined with remarks made yesterday by the director of the CDC and also with testimony given in the past by other CDC personnel, ought to put to rest what seems like a persistent meme: that the CDC has never said, or doesn’t believe, that agricultural antibiotic use plays a role in the advance of resistance.

This is important because it puts the CDC in line with a substantial body of research pointing to agricultural use playing a role in the emergence of resistance outside farm properties. With the CDC agreeing — plus, to some degree, the Food and Drug Administration — surely it’s time to move on to whether there are things that could be done to curb the risks posed by some ag practices, while respecting the role that livestock-raising in particular plays as a substantial economic sector, and as an engine in feeding the world.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: agriculture, animals, antibiotics, CDC, E. coli, FDA, Resistance, salmonella, Science Blogs

CDC Threat Report: 'We Will Soon Be in a Post-Antibiotic Era'

September 16, 2013 By Maryn Leave a Comment

Image: CDC

The U.S. Centers for Disease Control and Prevention has just published a first-of-its-kind assessment of the threat the country faces from antibiotic-resistant organisms, ranking them by the number of illnesses and deaths they cause each year and outlining urgent steps that need to be taken to roll back the trend.

The agency’s overall — and, it stressed, conservative — assessment of the problem:

  • Each year, in the U.S., 2,049,442 illnesses caused by bacteria and fungi that are resistant to at least some classes of antibiotics;
  • Each year, out of those illnesses, 23,000 deaths;
  • Because of those illnesses and deaths, $20 billion each year in additional healthcare spending;
  • And beyond the direct healthcare costs, an additional $35 billion lost to society in foregone productivity.

“If we are not careful, we will soon be in a post-antibiotic era,” Dr. Tom Frieden, the CDC’s director, said in a media briefing. “And for some patients and for some microbes, we are already there.”

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, CDC, CRE, IDSA, Resistance, Science Blogs

More Tickborne Diseases Other Than Lyme. Maybe Just Don't Go Outside.

August 23, 2013 By Maryn Leave a Comment

source: L’Olio (CC), Flickr

I said in Monday’s post (about the CDC changing its estimate of Lyme disease diagnoses in the US, raising it 10-fold from 30,000 new cases per year to 300,000) that there has been a run of recent news about other tickborne diseases. If you are someone who loves the outdoors — or even, you know, your back garden — it’s important to pay attention to such research, because these diseases are just becoming known and thus are often not recognized by physicians. Which means, of course, that someone who has the misfortune to contract one might be misdiagnosed, might be given antibiotics that won’t work against the organism, or might even be dismissed as malingering.

The most recent and saddest piece of news: Joseph Osumbe Elone, a 17-year-old high school student from Poughkeepsie, NY, died earlier this month from what is believed to have been an infection with Powassan virus, one of these lesser-known tickborne diseases. According to his family, he had been mildly ill for several weeks, with a cough but no striking symptoms, and collapsed and died Aug. 4.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, Lyme, Science Blogs, tickborne, ticks

CDC: Lyme Disease May Be Diagnosed 10 Times More Than Estimated

August 19, 2013 By Maryn Leave a Comment

source: Cuatrok77 (CC), Flickr

Recently I visited a relative on the eastern end of Long Island, about 90 miles outside New York City. The heat was brutal, and the house had no air conditioning and wasn’t accommodating to breezes — so on the first night I arrived, I sat out on the deck as the sun sank and the air cooled. Just as it became too dim to see the far end of the garden, there was a thrashing noise, as though something had gotten caught in the hedge beyond the pool, and then a whffft as whatever had tangled itself sailed over the obstacle. A moment later, something spiny but soft-edged poked into the sliver of light from the window, and bobbed, and bowed toward the ground. The spiny bits were antlers; the intruders were two white-tailed bucks, at least a year old, come to munch on the unattended lawn.

Because I am a city kid, my first thought was, “Aww, that’s pretty.” And because I am me, my next one was: “I wonder what the Lyme disease situation is out here?”

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, Lyme, Science Blogs, tickborne, ticks

More on 'Nightmare Bacteria': Maybe Even Worse Than We Thought?

July 30, 2013 By Maryn Leave a Comment

Flickr: CelesteH, CC

In my last post I talked about the under-appreciated emergence of “nightmare bacteria” (those are the Centers for Disease Control and Prevention’s words, not mine) that are widely distributed in hospitals and nursing homes around the world and do not respond to a last-ditch small family of antibiotics called carbapenems. That seemed dire enough, but new research suggests the problem, bad as it looks, has been understated.

There’s an ahead-of-print article in Antimicrobial Agents and Chemotherapy whose authors include David Shlaes, a physician-researcher and former pharmaceutical executive, now consultant, and Brad Spellberg, an infectious disease physician on the UCLA medical faculty and author among other books of Rising Plague, about antibiotic resistance. In a commentary examining the Food and Drug Administration’s promised “reboot” of antibiotic development rules, they analyze privately gathered data on resistance in the United States and conclude the incidence of highly resistant bacteria is greater than the CDC has estimated.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, carbapenems, CDC, CMO, CRE, CRKP, drug development, FDA, KPC, NDM-1, Resistance, Science Blogs

Where 'Nightmare Bacteria' Came From, And How Our Inattention Helped Them Emerge

July 25, 2013 By Maryn Leave a Comment

Zebbie (CC), Flickr

Cast your minds back a few months ago, to when the director of the US Centers for Disease Control and Prevention announced, “We have a very serious problem” with “nightmare bacteria,” and the chief medical officer of the United Kingdom backed him up a few days later, describing a “ticking time bomb” that threatens national security as seriously as terrorism.
[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, carbapenems, CDC, CMO, CRE, CRKP, KPC, NDM-1, Resistance, Science Blogs

To Prevent MRSA In Hospitals, Don't Prevent Only MRSA

May 30, 2013 By Maryn Leave a Comment

Practically since the multi-drug resistant bacterium MRSA became a public health issue in the 1960s, health care has been arguing over how best to prevent its spread — particularly in hospitals, where the bug first became a problem and where the most vulnerable patients are concentrated. The camps break down, more or less, into procedures which look for MRSA specifically, and procedures which reduce the risk of spreading any pathogen in the hospital environment. The MRSA-specific strategies, popular in Europe and in some health-care systems in the US, involve checking patients to see who is carrying the bacterium, and then taking extra care with those who are positive, usually by isolating them within the hospital and making sure health care workers wear protective gear when they encounter them. The more general ones involve mandating actions, usually but not always things  that health care workers do — such as washing their hands more regularly and bathing patients with disinfectant — which will reduce the risk of not only MRSA transmission but of any other pathogen as well.

The back and forth between these views has been intense and prolonged; most of the infectious-disease meetings I’ve attended over the past 6 years have staged some sort of debate between representatives of the two sides. In the United States, the “active detection and isolation” strategy (often just called “search and destroy”) has been ascendant; among other things, it has been written into law in at least nine states, and adopted by the VA healthcare system. It has been demonstrated to work (though that demonstration was later challenged), but it is costly in staff time and also in equipment, since detection is usually done by molecular methods; and isolation has been shown to be rough on patients as well.

In the latest round — though given the contentiousness of this debate, probably not the last — a strong study just published in the New England Journal of Medicine, describing a careful trial of both systems, establishes that the non-specific strategy works better to reduce not just MRSA, but hospital-associated infections of all kinds.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, MRSA, Science Blogs

World Health Organization Annual Meeting: New Flu, Coronavirus Urgent Priorities

May 20, 2013 By Maryn Leave a Comment

In Geneva today, the World Health Assembly — that is, the annual meeting of the 194 governments whose collective commitment support the World Health Organization — opened as traditional, with a speech by the WHO’s director-general, Dr. Margaret Chan. It is a very interesting time, not just for the WHA to be meeting, but for Dr. Chan to be addressing them. That’s because, 10 years ago when SARS exploded into the world from China, she was the director of health for Hong Kong, the city that was hit first and hardest. Ten years later, with H7N9 flu emerging from China, and a viral relative of SARS — the novel coronavirus now being dubbed MERS — bubbling in the Middle East, the questions and lessons of SARS are bizarrely resonant. That has been true for the past several weeks, but is even more so today, with one more case of MERS announced, in one more country: Tunisia, this time.

Here are the opening paragraphs from Chan’s speech (full text online here). To me it’s quite interesting how much she praises China for its transparency in dealing with H7N9 flu — while not extending the same praise to the Kingdom of Saudi Arabia, where MERS is concentrated. In fact, she doesn’t even mention Saudi Arabia by name; whether that is meant to give offense, or to avoid it, other public-health tea-leaf readers can say better than me. Though her closing comment — “the current situation demands collaboration and cooperation from the entire world” — sounds pretty pointed to me.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, China, coronavirus, hCoV-EMC, MERS, NCoV, SARS, Saudi Arabia, Science Blogs, transparency, Tunisia, Who

More On The New Coronavirus: Cases in France, The WHO In Saudi Arabia

May 12, 2013 By Maryn Leave a Comment

My last two posts looked at the problems that might be caused by hospital spread of the new coronavirus, based on what happened during the early days of SARS 10 years ago. Hospital spread of this new virus is a real concern; it was first identified, retrospectively, in an outbreak in a hospital in Jordan a year ago, and international concern really picked up after the acknowledgement of a current outbreak in the Al-Ahsa region of Saudi Arabia. Now it appears there is a third instance of hospital spread, in France. Several days ago the French Ministry of Health announced a single case, a Frenchman who had traveled to Dubai and may have been infected there. This morning, there is news of a second case, a person who shared a hospital room with the first patient. Here’s the announcement from the French Ministry and one from the World Health Organization. (And if you read French, I talk to the French newspaper Le Figaro about it here.) Simultaneously, the WHO has announced that two more patients have been recognized in that Saudi hospital cluster. That makes 15 patients (three of whom died) in that cluster, and 34 patients (18 deaths) worldwide.

There’s additional news today as well, which is both heartening and a little concerning too.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, coronavirus, france, hCoV-EMC, MERS, NCoV, SARS, Saudi Arabia, Science Blogs, transparency, Who

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