As Another Coronavirus Begins to Spread, Follow Reasonable Precautions and Avoid Fear-Mongering

(Editor’s note: Published January 24. The situation has considerably changed in the intervening weeks, during which the virus has rapidly spread across the globe. We obviously now know a great deal more about the dangers it presents.)

Emerging infections are part of our world—more evident these days because we have the tools and global communication networks to quickly identify them. This month, we’ve begun another crash course in the initial management of a new pathogen.

Short timeline from first cases to screening test availability.

Rumors of a concerning cluster of undiagnosed pneumonia in Wuhan, China, surfaced on social media on December 31. The patients weren’t responding to antibiotic therapy, but tests were negative for the usual viral suspects. World Health Organization staff quickly connected with Chinese health officials and testing and epidemiological investigations kicked into high gear.

Many of the infected patients had worked at a fish and live animal market in Wuhan, suggesting that the illnesses might be zoonotic (passing from animals to human) in origin. On January 7, the pathogen was identified as a new coronavirus, related (though not closely) to the coronaviruses that cause SARS and MERS. The viral genome was quickly sequenced, and on January 12, China shared the genetic sequence with the global scientific community. […]

2020-03-19T17:12:45-04:00January 24th, 2020|infection control, infectious diseases, Nursing, Public health|1 Comment
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A Matter of Public Health: Physicians Make Case for Vaccinating Immigrants in Custody

For three days last week, physicians from around the country led demonstrations and a vigil outside of Customs Patrol and Border Protection (CBP) facilities in the San Diego area. After receiving no response to their repeated offers to the departments of Health and Human Services and Homeland Security to provide free flu vaccinations to immigrants in custody, the physicians (and a few NPs) had come to the border with donated influenza vaccine to press for a pilot vaccination program. CBP officials finally said they would pass the request up their chain of command.

Preventable deaths, plus a matter of the larger public health.

Three migrant children died in CBP detention centers during last year’s flu season. The last hours of 16-year-old Carlos Gregorio Hernandez Vasquez, who died in May of influenza, were documented on a grim surveillance camera video that recently circulated widely on the Internet. But the issue of influenza vaccination for migrants is not “merely” one of such preventable deaths; it is a  public health issue. This year’s flu season has ramped up in recent weeks, and a “window of opportunity” for vaccinating this vulnerable population is closing.

The CDC recommends that everyone six months of age and older receive influenza vaccination each year. […]

2019-12-19T14:10:39-05:00December 19th, 2019|infectious diseases, Nursing, Public health|1 Comment
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What Can We Do About Vaccine Misinformation?

“ . . . schools reported immunization rates ranging from 19% to 100%, with an average of 91%. . . . Alarmingly, one school reported that none of its students had been vaccinated.”

This year’s measles and mumps outbreaks are a reminder that many of us still think of vaccination as only a personal health practice. We forget that it is also something we do as a member of a community. When a vaccine-preventable disease starts to circulate, every vaccinated or otherwise immune person is a transmission dead end. It’s as though the virus skids to a stop in front of us, unable to pass through the closed door of our immunity to continue to replicate and spread disease.

In “Countering Vaccine Misinformation” in this month’s AJN, Lindsey Danielson and colleagues discuss vaccines, health literacy, and the ease with which misinformation can proliferate on social media. They emphasize the importance of understanding different kinds of opposition to vaccination:

“Vaccine hesitant describes a person who is hesitant about vaccines but still receptive to scientific evidence, while vaccine denier refers to a person who is against vaccination, denies scientific evidence, and uses rhetorical arguments to give the false appearance of legitimate debate.”

[…]

2019-10-21T07:57:26-04:00October 21st, 2019|infectious diseases, Nursing, nursing roles, Public health|1 Comment
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‘An Epidemic Transformed’: Where Are We With HIV Today?

“I wasn’t supposed to be here,” [the patient said] to the nurse as he watched the last few drops of his chemotherapy drug infuse into the port implanted in his chest… The nurse caring for him smiled while preparing to disconnect his IV tubing and flush the port….   What distinguished [this patient] from the nurse’s other patients was that he had been living with HIV for 32 years.”

At the very beginning of the HIV epidemic, a friend of mine worked on one of the first HIV units in New York City. The nursing staff followed Standard Precautions in their work with these patients, as we do today. They weren’t particularly concerned about risk to themselves, because it was already clear that this disease—as little as we knew about it then—was not easily transmitted to caregivers.

Remembering fear.

Yet many who worked in other parts of the hospital were not convinced of this. One of my friend’s stories always stayed with me: She relayed how dietary staff would take the elevator to the HIV unit, shove the meal cart out of the elevators into the elevator lobby, and quickly step back into the elevator and close the doors. Many times the nursing staff […]

2019-09-03T10:06:59-04:00September 3rd, 2019|infectious diseases, Nursing, Public health|0 Comments
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Are You Checking for Ticks?

” . . . cases of tick-borne diseases [in the U.S.] increased more than twofold between 2004 and 2017. . . .Tick-borne diseases now make up more than three-quarters of all vector-borne disease reports.”

I live in a small town dotted with grassy and wooded areas, brush, and plenty of mammalian wildlife, so the possibility of contact with ticks is present even on a walk to the compost bin or train station.

I’ve become really good at tick identification and removal, but I can’t claim any special expertise in recognizing the early signs of tick-borne diseases.

CDC warns of tick-borne rickettsial disease increase.

For that information, we have help this month from Centers for Disease Control and Prevention (CDC) staff, who steer readers to new resources in the Update from the CDC column in AJN’s July issue, “Increase in Reports of Tick-Borne Rickettsial Diseases in the United States.”

Alison Binder and Paige Armstrong tell us about the CDC’s new online training toolkit and learning module, both designed to raise awareness about tick-borne rickettsial diseases. […]

2019-07-08T09:03:50-04:00July 8th, 2019|environmental health, infectious diseases, Nursing, Public health|2 Comments
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