A Tumultuous Seven Weeks for Public Health in the United States

Editor’s note: AJN news director Karen Roush, PhD, RN, FNP, will be providing regular updates on AJN Off the Charts about the details and implications of rapid and potentially momentous changes being made by the Trump administration to the public health system in the United States.

It’s been a tumultuous seven weeks since President Trump’s inauguration. Changes in leadership and priorities have swept across every federal department, bringing uncertainty and disruption. Trump signed more than 70 executive orders (EOs) in his first month in office, including orders to erase diversity, equity, and inclusion efforts from federal agencies and the military (EO 14151); limit the rights of transgender people and declare that only two “sexes,” biological males and females, would be recognized by the federal government (EO 14168); end birthright citizenship (EO 14160); and further limit access to abortion (EO 14182). Elon Musk’s Department of Government Efficiency, known as DOGE, has fired tens of thousands of federal employees, dismantled entire agencies, including USAID, and pulled grant funding from universities, nongovernmental organizations, and the National Institutes of Health (NIH).

The appointment of Robert F. Kennedy, Jr. to head HHS.

Many of the […]

2025-03-07T10:02:20-05:00March 7th, 2025|health care policy, infection control, infectious diseases, Nursing, Public health|0 Comments
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H5N1 Avian Influenza (Bird Flu) Update for Nurses and Other Health Providers

Influenza is a clever virus and one that deserves respect. Current concerns with the H5N1 avian influenza virus strain demonstrate why public health around the world continues to watch and monitor for impact on human health. Although the situation is not one that currently affects us on a day-to-day basis, it is important that we have a basic understanding of why this remains newsworthy.

Spread and evolution of H5N1.

Since its emergence, H5N1 has spread across multiple continents, affecting wild birds, poultry, and mammals. In late 2023, the virus was detected in Antarctica for the first time, raising concerns about its impact on native wildlife. By 2024, H5N1 had been reported in various regions, including Europe, Asia, and the Americas, leading to significant poultry losses and economic challenges.

In the United States, H5N1 has been detected in wild birds, poultry, and mammals across all 50 states. As of early 2025, nearly 70 human cases have been confirmed, primarily among individuals with direct exposure to infected animals. In December 2024, the Centers for Disease Control and Prevention (CDC) confirmed the first severe human case of H5N1 in Louisiana, involving a patient hospitalized with severe illness.

We have seen H5N1 move across nonhuman animal species, to situations where humans have become mildly ill after contact with animals, and now to situations where animal contact has resulted in severe human illness.

Since this particular strain of influenza has been detected in a variety of animals, but rarely in humans, what is the concern? The concern […]

2025-02-13T12:42:43-05:00February 13th, 2025|infection control, infectious diseases, Nursing, Public health|0 Comments
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Dengue Fever: What Nurses Need to Know Now

This summer the Centers for Disease Control and Prevention (CDC) has issued a health advisory as countries in the Americas report 9.7 million cases of dengue, the highest number in any year. The United States and Puerto Rico have reported 2,559 cases of dengue since January. The CDC expects the numbers to continue to rise as the environment warms.

Nurses in every specialty, but especially those who prepare individuals and families for international travel, will want to know about this latest dengue surge. All U.S. nurses will want to know how to triage, manage, and follow-up these patients to prevent local outbreaks and life-threatening complications.

Dengue (“den-gay”) fever is an age-old viral illness rapidly expanding its global impact beyond the tropics. According to the Rockefeller Foundation, “dengue fever is the most rapidly spreading mosquito-borne viral infection in the world.”

Also known as “breakbone fever” because of the painful arthralgias and myalgias associated with the infection, dengue is a common disease in the Americas, Africa, the Middle East, Asia, and the Pacific Islands, where it is a health risk for travelers and locals alike.

Currently 3.9 billion people are at risk in 129 countries, including certain areas of the United States. The WHO estimates […]

2024-07-18T15:10:04-04:00July 18th, 2024|climate change, infection control, infectious diseases, Nursing, Public health|0 Comments
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The Monkeypox Vaccine: What Nurses Need to Know

Colorized transmission electron micrograph of monkeypox particles (red) found within an infected cell, cultured in the laboratory. Credit: NIAID. (Wikimedia Commons)

In the current monkeypox outbreak, the pandemic-strained U.S. public health system is once again faced with a major threat. This time, a vaccine is already available, but only in limited quantities. Here’s what nurses need to know. It will remain important to keep up with new developments as they occur.

The Jynneos vaccine

Jynneos is a live but nonreplicating vaccine for the prevention of both monkeypox and smallpox. It is made from vaccinia virus, a less virulent relative of these two viruses. The vaccine is given subcutaneously in two separate doses administered at least 28 days apart, and a person is considered fully vaccinated two weeks after the second dose.

The most common vaccine side effects are pain, redness, induration, swelling, or itching at the vaccination site. (People with HIV infection or atopic dermatitis do not seem to experience additional or more severe side […]

2022-08-17T06:34:29-04:00August 17th, 2022|infection control, infectious diseases, Nursing|0 Comments
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Monkeypox Update: As Knowledge Increases, More to Be Learned

Colorized transmission electron micrograph of monkeypox particles (red) found within an infected cell (blue), cultured in the laboratory. Credit: NIAID. (Wikimedia Commons)

It seems impossible that we have to confront the rapid spread of a new virus when we’re still dealing with the effects of COVID-19. But for monkeypox, we didn’t have to respond “from scratch.” After decades of research and clinical work on smallpox, a related but considerably more lethal virus, testing protocols and vaccines were already available for use in monkeypox.

Nearly 20,000 cases of monkeypox have been reported around the world since May, with more than 5,000 infections reported in the U.S. There are probably many more undiagnosed and unreported cases.

Variations in presentation.

In New York City, where more than 1,000 cases of monkeypox have been reported, clinicians are seeing variations from “classic” presentations of monkeypox. The NYC Department of Health and Mental Hygiene reports that many people with monkeypox are not experiencing prodromal symptoms […]

2022-08-01T14:17:20-04:00August 1st, 2022|infection control, infectious diseases, Nursing, Public health|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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