Tag: CDC

Measles and Tuberculosis

The old Oak Forest Hospital is slated for demolition and site redevelopment now. At one time it was a tuberculosis sanitarium. That’s when my grandmother was a patient there. She was one of the first patients who was actually cured of tuberculosis, or TB. The drugs which killed the bacteria left her deaf.

Tuberculosis and measles are both diseases that can travel quite a long way. That’s why patients with those diseases are placed on airborne precautions. You probably know there’s currently a measles outbreak impacting 13 states as I write — probably more by morning. That’s serious, make no mistake. But Tuberculosis is also a serious and much more common problem.

Every year near the end of March is World Tuberculosis Day. Normally the CDC has a massive release of data on that day. At this time I do not know whether the CDC will release that data. My local health district has already quietly released their data, which they normally hold until World Tuberculosis Day. My state has not. It is worth noting that locally, cases are up over where they were 2 years ago (but down from last year). This data is vital to me in a professional capacity to determine how much risk my patients and staff face from TB in the community.

Believe it or not there is a vaccine for TB! It was developed a couple of decades before we had a cure. We don’t generally use it here in the United States because it’s not as effective as would be desirable, we have a relatively low prevalence, and it interferes with the cheap “skin test” you may remember having done at some point in your life. But many of our nurses from places like South Korea or the Philippines have had this vaccine.

Now about curing TB. It’s not fun. Remember from the beginning of my post that the first treatments we had often had horrible life changing side effects. However, it was better than the alternative: dying. Unfortunately TB has developed resistance to many drugs over the years. It is important to treat TB even if it’s latent — meaning it’s not causing you to be very sick right now. Treatment can often involve multiple, very strong antibiotics, every day for months. In some cases, the local health department might call every day to make sure you took it.

And this brings me to another important point. People without insurance — or with lousy insurance — might not be able to afford those antibiotics. When that happens, they are not only a walking petri dish for incubating drug resistant strains of the disease, they are sharing their germs with everyone around them.

Also, tuberculosis does not care about your immigration status.

Places where people are crowded together — like jails and immigration detention centers — are a perfect place for one TB case to turn into dozens. Are you wondering how many undocumented immigrants are going to seek medical care for their TB or measles symptoms?

Omicron Thoughts

And so we drag over the two year mark with COVID. More variants, more sickness, more cases. And things will “likely get worse” according to experts. I have seem greater numbers in my facility, and “surprise” cases (we test on admit, thankfully). Objectively, we have more cases now than when we tried to lock down! Notice I said tried, because obviously it didn’t work out as planned.

Nevertheless, the CDC has changed guidelines to make it easier for people to get back to work. Or if you’re more cynical, to make it easier for companies to force people to get back to work. Nurses — both union and not — came out against. Other unions, including flight attendants, came out against. Will that change anything? Not known.

For the record, my company has a policy saying don’t come to work of you have a fever, productive cough, vomiting, diarrhea, generalized rash, conjunctivitis, or have been instructed to quarantine. People who are sick should stay home, period. Don’t try to soldier through, because you’ll both do a halfway job and potentially make other sick. I encourage everyone to follow this sane advice even outside a pandemic.

There is good news, however. The influenza rate is sharply down over the pre-panda era. In my area, we’ve had less than two dozen hospitalizations and (so far, knock on wood) no deaths. In fact, one line of influenza may be extinct!

Keep your hands clean and your masks on, folks. The mask goes over the nose, by the way.

Brave New Day

Yesterday, I received notification that COVID-19 data would be reported to the Department of Health and Human Services instead of the CDC. That change is effective today. This abrupt change was sent to me from the Association for Professionals in Infection Prevention, then confirmed about a half hour later by email from the CDC itself. As an Infection Preventionist, my duties include reporting regularly to the CDC’s National Healthcare Safety Network. Until today, this was the single largest and most accurate repository of infection information in the United States.

Some hours later, the various news services got wind of the change.

I am deeply concerned about the possibility that this could mean COVID-19 data may be buried or even falsified. While no evidence yet exists that this is the case, it is no secret that the Trump Administration and the CDC have disagreed about COVID-19 on many fronts. This administration does have a history of attempting to hide unflattering information.

If you want accurate COVID-19 information, I urge you to keep track of your local health district — my colleagues and I are still required to report to them too. Here’s links to help you find them. And don’t forget that Johns Hopkins still has data available.