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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Measles Outbreaks, and an Unexpected Vulnerability

The second-greatest number of cases since ‘elimination.’

3D graphical representation of spherical-shaped, measles virus particle studded with glycoprotein tubercles. CDC/ Allison M. Maiuri, MPH, CHES

Last month, a state of emergency—which has now been halted by state court—was declared in nearby Rockland County, New York, barring children who hadn’t been vaccinated against measles from public places. The unprecedented step made worldwide news and highlights the public health measures being taken to stem the six currently ongoing measles outbreaks in the United States.

Measles was eliminated in the United States in 2000, but outbreaks have occurred since, increasingly so in recent years. The CDC reported this week that almost 400 cases of measles have been confirmed in 15 states during the first three months of this year alone. This is the second-greatest number of reported cases since eradication of the disease. The most—667 cases—occurred in 2014.

Public health authorities are clear about the cause of these outbreaks: people contract measles abroad and bring it back to the United States, where groups of people who are unvaccinated are particularly susceptible to developing and spreading this highly contagious disease. Up to 90% of unvaccinated […]

2019-04-08T07:55:37-04:00April 8th, 2019|infectious diseases, Nursing, Public health|3 Comments
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Acute Flaccid Myelitis: The Investigation Continues

The headlines of the past several weeks about kids with a polio-like illness have been pretty scary. The idea that a healthy child could suddenly be sidelined with extreme muscle weakness is a nightmare scenario for the parents of young children. While frustratingly little is known about acute flaccid myelitis (AFM), the good news is that it remains quite rare, affecting less than one in a million people in the U.S. each year.

According to the CDC, there have been a total of 404 confirmed cases of AFM in the U.S. since 2014, with a median age of eight years. The epidemiologic curve of cases indicates that the illness is seasonal, peaking in late summer and early fall. Oddly, the number of cases spiked in 2014, 2016, and 2018, while there were fewer cases during 2015 and 2017.

Signs and symptoms of AFM.

AFM often follows a respiratory illness or fever. Limb weakness (often unilateral) then occurs suddenly, progressing rapidly within hours or a few days. There may be facial muscle weakness, problems with eye movement, or speech or swallowing difficulties, but mental status generally is not affected. One death has been reported.

No clear cause.

Poliovirus, non-polio enteroviruses, adenoviruses, and West Nile virus are known to (rarely) […]

2018-11-12T08:25:04-05:00November 12th, 2018|infectious diseases, Public health|0 Comments
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