by tyler | Mar 29, 2023 | CNN, health
The West African country of Equatorial Guinea declared an outbreak of the Marburg virus disease in mid-February. There have been at least nine laboratory-confirmed cases, seven of which resulted in death, and 20 probable cases of dead individuals in this outbreak, according to the World Health Organization.
Now, authorities in Tanzania, in East Africa, have confirmed that country’s first-ever case of the fatal disease. Health officials are investigating a total of eight cases, five of whom have died, and they have identified a total of 161 contacts who are being monitored.
As most people know now from the height of the Covid-19 pandemic, a virus can spread from one country to another and hop from continent to continent through human transmission. In terms of infection, we are one community, which is why I turned to CNN Medical Analyst Dr. Leana Wen to ask about the Marburg virus. Wen is an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health
I asked about the disease’s symptoms, what makes it so dangerous, how it is spread, whether there is a vaccine, and how the disease is treated. Finally, who should worry about the Marburg virus?
CNN: What is the Marburg virus disease?
Dr. Leana Wen: The Marburg virus disease is caused by the Marburg virus, which is in the same family of viruses as the Ebola virus. Like Ebola, Marburg causes a severe hemorrhagic fever that impacts multiple organ systems and can include profuse bleeding, and affects both humans and nonhuman primates. The viral infection is a zoonotic disease, meaning that the origin of the disease is transmission from animals to humans. With previous outbreaks, fruit bats have been identified as the hosts of the Marburg virus, from which the virus is then transmitted to people.
CNN: What are symptoms and what makes this disease so dangerous?
Wen: Marburg virus disease is extremely deadly and is highly contagious when engaging in direct contact with an infected person. With previous outbreaks, case fatality rates have ranged from 24% to 88%, with an average fatality rate of around 50%. That means about half the people who contract the disease will die from it.
Symptoms often start suddenly, with infected patients experiencing high fever, headache, muscle aches and malaise. It’s also common to have abdominal pain and cramping and heavy watery diarrhea.
This disease, like Ebola, is a hemorrhagic fever, in which infected individuals bleed from multiple orifices. Externally, patients might bleed from the nose, gums and eyes, and internal bleeding manifests as blood in vomit, urine and stool. Severe blood loss can cause shock and death.
The incubation period — the period from infection to the start of symptoms — is as short as two days to as long as three weeks. Most symptoms start within a week, with death occurring between eight and nine days after initial symptoms.
CNN: How is the Marburg virus spread?
Wen: Similar to Ebola, Marburg is spread via direct person-to-person contact. That includes contact with blood or other bodily fluids or objects contaminated with the bodily fluids of an infected person — such as bedding, clothing, needles and other medical equipment. Some cases have also been documented in which semen from a man who has recovered from Marburg has resulted in transmission to his partners.
Those most at risk of Marburg are people in direct contact with infected individuals. That includes family members, caregivers and health care workers. Individuals with suspected or confirmed Marburg virus should be placed in isolation. Those caring for them should wear protective gowns, gloves and masks to prevent direct physical contact with the patient.
CNN: Is there a vaccine? How is Marburg virus disease treated?
Wen: No vaccine has been developed against the Marburg virus, though there is an experimental vaccine and other vaccine candidates. There is no specific antiviral treatment. Infected patients are treated with symptomatic and supportive therapies, meaning that they would get fluids, oxygen and blood transfusions as necessary.
CNN: Who should worry about the Marburg virus?
Wen: At this time, cases of the Marburg virus disease have been found in just the two countries, Equatorial Guinea and Tanzania. Efforts are underway to contain these outbreaks. Successful containment has occurred in the past. Marburg is not a new disease — it was detected in 1967 after simultaneous outbreaks in Germany and Serbia. Numerous outbreaks have occurred since, including in Uganda, Democratic Republic of the Congo and most recently, in 2022, in Ghana.
Though the Marburg virus causes severe disease, there are ways to contain it. Individuals transmitting it to others are generally symptomatic. In addition, the Marburg virus is not an airborne virus. That makes it easier to control compared with Covid-19, which is often transmitted by people who are not exhibiting symptoms and is so contagious that it does not require direct contact and can be carried on microscopic aerosols.
The two Marburg outbreaks in West and East Africa must be monitored closely. Health care workers in these regions should be on high alert, and efforts to test a vaccine and treatments should be expedited. At this time, there is no need for most of the world to worry about the danger of Marburg infection. However, the Marburg virus is yet another reminder of the many zoonotic pathogens that are capable of causing severe harm to human health.
by tyler | Mar 29, 2023 | CNN, health
With drug overdose deaths continuing to hover near record levels, the US Food and Drug Administration on Wednesday approved for the first time an over-the-counter version of the opioid antidote Narcan.
“The FDA remains committed to addressing the evolving complexities of the overdose crisis. As part of this work, the agency has used its regulatory authority to facilitate greater access to naloxone by encouraging the development of and approving an over-the-counter naloxone product to address the dire public health need,” FDA Commissioner Dr. Robert Califf said in a statement.
“Today’s approval of OTC naloxone nasal spray will help improve access to naloxone, increase the number of locations where it’s available and help reduce opioid overdose deaths throughout the country. We encourage the manufacturer to make accessibility to the product a priority by making it available as soon as possible and at an affordable price.”
The nasal spray will come in a package of two 4-milligram doses, in case the person overdosing does not respond to the first dose. However, the drug’s maker, Emergent BioSolutions, says most overdoses can be reversed with a single dose. The product could be given to anyone, even children and babies.
The nasal spray is expected to be available for purchase in store sand online by late summer, Emergent BioSolutions said Wednesday.
The company does not currently have information on how much the OTC Narcan nasal spray will cost.
More than a million people have died of drug overdoses in the two decades since the US Centers for Disease Control and Prevention began collecting that data. Many of those deaths were due to opioids. Deaths from opioid overdoses rose more than 17% in just one year, from about 69,000 in 2020 to about 81,020 in 2021, the CDC found.
Opioid deaths are the leading cause of accidental death in the US. Most are among adults, but children are also dying, largely after ingesting synthetic opioids such as fentanyl. Between 1999 and 2016, nearly 9,000 children and adolescents died of opioid poisoning, with the highest annual rates among adolescents 15 to 19, the CDC found.
Nearly every state in the US has standing orders that allow pharmacists or other qualified organizations to provide the medication without a personal prescription to people who are at risk of an overdose or are helping someone at risk, but making it available over the counter can make it easier for people to access the opioid antidote.
Research shows that wider availability could save lives as opioid overdoses have skyrocketed in recent years – much of it due to synthetic opioids like illicitly made fentanyl.
Emergent BioSolutions President and CEO Robert Kramer hailed the FDA’s decision as a “historic milestone.”
“We are dedicated to improving public health and assisting those working hard to end the opioid crisis – so now with leaders across government, retail and advocacy groups, we must work together to continue increasing access and availability, as well as educate the public on the risks of opioid overdoses and the value of being prepared with NARCAN® Nasal Spray to help save a life,” Kramer said in a statement.
Narcan works by blocking the effects of opioids on the brain and restoring breathing. For the most effectiveness, it must be given as soon as signs of overdose appear.
The drug works on someone only if there are opioids in their system. It won’t work on any other type of drug overdose, but it won’t have adverse effects if given to someone who hasn’t taken opioids.
Naloxone reverses an overdose for up to about 90 minutes, but opioids can stay in the system for longer, so it’s still important to call 911 after giving the drug.
People given naloxone should be watched carefully until medical help arrives and monitored for another two hours.
About 1.2 million doses of naloxone were dispensed by retail pharmacies in 2021, according to data published by the American Medical Association – nearly nine times more than were dispensed five years earlier.
Harm reduction experts say the price of naloxone has inhibited its accessibility to people who need it most. And although the cost will probably drop as it becomes available over the counter, they say it will probably still be out of reach for many.
“We’re not going to be able to ramp up naloxone distribution in a game-changing way until we get a better handle on the price,” said Nabarun Dasgupta, a scientist at the University of North Carolina’s Injury Prevention Research Center who studies drugs and infectious diseases. “There’s the promise on paper versus on the street, and it’s going to come down to the dollars and cents.”
Separate changes to grant funding by both the CDC and the Substance Abuse and Mental Health Services Administration will make it easier for states and local health departments to buy naloxone, he said.
However, experts said the most meaningful work in the fight against the devastating outcomes of the drug overdose epidemic will come with ongoing emphasis on treatment for opioid use disorder and other harm-reduction strategies.
“While enabling people to access quality treatment for substance use disorders is critical, we must also acknowledge that people need to survive in order to have that choice,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse, said in January.
Caleb Banta-Green, principal research scientist at the University of Washington’s Addictions, Drug & Alcohol Institute, has described naloxone as the “gateway drug” to a conversation about what substance use disorder is.
“It’s a conversation starter. It’s life-saving for the individual. It’s not a game-changer at the population level,” he said. “We need to do more. And we need to use treatment medications – methadone and buprenorphine – which are far higher overdose preventive approaches.”
by tyler | Mar 28, 2023 | CNN, health
One of the most memorable lectures during my first year of medical school at the University of Michigan was delivered by Dr. Julian “Buz” Hoff. He was the chair of neurosurgery and a master at teaching the natural history of brain diseases. We learned about brain tumors, vascular diseases and trauma.
Hoff had a way of explaining things that made them really stick, and that was particularly clear in his lecture called “GSW.” Anyone who works in a hospital probably knows that the acronym GSW stands for “gunshot wound,” and the way Hoff wanted us to learn the topic was for us see the impact firsthand.
So on the last day of his class, we went to an outdoor gun range in Ann Arbor for our GSW lecture. There were handguns there, as well as rifles. In the distance, I saw several watermelons on top of old barrels that would serve as targets. After putting in his ear plugs and donning safety glasses, Hoff shot a watermelon with a handgun. I saw the bullet hit the watermelon but wasn’t confident I saw the bullet exit. The watermelon was then brought to us for inspection.
First thing to notice, he told us: There was an obvious entrance and exit “wound,” and they were around the same size. We could see the green skin folding in on itself around the entrance wound and the outward beveled tissue around the exit. After we chopped the watermelon open, he pointed out that the bullet seemed to have traveled in a fairly predictable trajectory, a linear bullet-sized line through the body of the watermelon.
Next came the same demonstration with a rifle. This time, I saw the watermelon shudder as it was struck and then immediately saw a significant amount of red tissue fly out the backside. Upon inspection, the first thing I noticed was how much bigger the exit wound was, compared with the entrance. And after opening the watermelon, the purpose of the demonstration became clear: Instead of a predictable linear track, the watermelon looked like it had been cored out and what was left was shredded. He explained that this was a phenomenon known as cavitation, which is just what it sounds like: The bullet doesn’t simply travel through the body, it creates a big cavity inside it.
The message was clear: I want you to imagine that had been a human body.
Much in the way pictures of black lungs had left an indelible impression of smoking on all medical students, Hoff had done the same with me for GSWs.
I was reflecting on that demonstration recently when I operated on a patient with a GSW to the head. It was a handgun injury, and we were able to quickly control the bleeding and relieve the pressure on the brain. The patient spent one day in the ICU for observation and was discharged a few days later. Had it been a rifle injury, there was hardly any chance he would’ve survived.
With guns front and center yet again with the recent shooting in Nashville, I wanted to share what I have learned over the years about what bullets do to the human body and the challenge it is for surgeons to repair the damage.
Nearly 30 years after my med school gun range demonstration, Dr. Ernest E. Moore, trauma surgeon and director of trauma research at the Shock Trauma Center named after him at Denver Health, is also using the watermelon example to draw a comparison between different firearms.
“I often use the analogy that the injury to the liver [with a semi-automatic rifle] would be similar to just taking a watermelon and dropping it on the cement. It’s incredible the amount of energy delivered. … By comparison, the 9 millimeter would drill a hole through the liver. So you’d have a sizable hole, but if you didn’t hit a major blood vessel, it’s a pretty tolerable injury. In fact, we in civilian trauma will often manage a 9-millimeter liver injury without an operation, whereas a patient with an assault rifle would be dead within 20 minutes if you didn’t operate,” he said.
Other human tissue in the body reacts differently. “If you struck a bone with an AR-15, like your femur in your leg, it would literally shatter into multiple fragments that would sort of serve as secondary missiles. Whereas … we’ve seen 9 millimeters that will actually drill a hole right to the femur,” he said. (An AR-15 is a lightweight semi-automatic – that is, self-loading – rifle manufactured by Colt; other gunmakers make rifles in a similar style.)
Moore also brings up cavitation as a way of visualizing what is happening in the body. He describes cavitation “as the result of a rapid expansion of the tissues surrounding the path of the bullet. … In essence, instead of a virtual drill hole with a 9 millimeter, your path of injury in tissue with an AR-15 will be 6 inches wide. And the path beyond that is even wider, but the tissue recoils back into it,” said Moore, noting that inelastic tissue – like the liver, heart and brain – are the most vulnerable to this type of energy.
Although the Department of Justice noted last year that 77.2% of mass shootings – which it counts as four or more deaths, excluding the shooter – involve handguns, many of the highest-profile incidents involved assault-style rifles: the 2012 Sandy Hook Elementary School shooting in Newtown, Connecticut; Orlando’s Pulse nightclub shooting in 2016; the 2017 shooting at a music festival in Las Vegas; and the 2018 Marjory Stoneman Douglas High School shooting in Parkland, Florida; the 2022 shooting at Robb Elementary in Uvalde, Texas, and the shooting at Covenant School in Nashville, just to name a few.
This kind of rifle unleashes a lot of power, said Moore, who, in addition to being a trauma surgeon since 1976 (who operated on some of the Columbine survivors), co-edited a major textbook on trauma surgery, authored more than 1,700 scientific articles and was the longtime editor of the Journal of Trauma and Acute Care Surgery.
“The capacity for tissue injury is reflected in the so-called kinetic energy. And the kinetic energy, simplistically, is the mass or weight of the bullet times the velocity squared. So the velocity – the speed of the bullet exiting the gun – is really its primary effectiveness,” he said.
Moore said a 9-millimeter handgun has a muzzle energy – the kinetic energy of a bullet as it leaves the gun’s muzzle – of roughly 400 foot-pounds of force. For a rifle like the AR-15, that number is 1,300. “So you have a huge increase in the amount of energy imparted from the gun,” he explained.
He said the size of the bullet has less to do with the damage it causes.
“I think there are some misconceptions with … rifles. A lot of people say, ‘Oh, they’re big bullets.’ Actually, they’re small bullets – interestingly, they’re even smaller than many handguns. So the actual bullet that’s discharged from an AR-15, for example, is a half the size of the bullet from a 9 millimeter. The difference is the … velocity,” he said.
And, if that rifle is a semi-automatic weapon, the weapon can be fired repeatedly, without manually reloading, simply by pulling the trigger. In Uvalde, hundreds of rounds were fired into classrooms in the first four minutes, according to Texas Department of Public Safety Director Steven McCraw.
Moore, who grew up in a hunting family, owns firearms and is an avid hunter, has been outspoken in his opposition to civilians owning AR-15-style semi-automatic weapons and does not own one himself.
“The rifle that our military uses to fight our enemies is the same rifle that we allow civilians access to and can create these mass shootings,” he said.
During my neurosurgery training and the first several years of my career, I didn’t encounter these sorts of injuries. That’s because between 1994 and 2004, certain semi-automatic firearms were banned. In fact, it was in 2003, while I was covering the war in Iraq, that I first saw the damage these weapons cause on the human body, not just a watermelon.
I was embedded with the Devil Docs, the Navy medical team that provides front-line medical care for the Marines. There are things that my cameraman Mark Biello and I saw on the battlefield that we still have a hard time talking about. They are still hard to even write about. Limbs blown clean off the body and wounds so horrific, I thought for sure they must’ve been caused by a bomb or IED.
I never imagined that just a couple of years later, I would see the same sorts of injuries in US cities, including my own, Atlanta. Those are the days when I come home from the hospital simply unable to talk, let alone describe what I had just witnessed.
Still, as you may have read after the tragedy in Uvalde last year, some folks raised whether we should have an “Emmett Till moment.”
Emmett Till was a 14-year-old Black teen who was abducted and violently murdered in 1955 by white racists in Mississippi after a white woman accused him of whistling at her. Till’s mother took the unusual step of holding an open-casket funeral and allowing a photographer from Jet magazine to photograph her son’s disfigured, unrecognizable face to show the country the result of racial violence. Many consider that moment a turning point in the country’s collective support for the civil rights movement.
Many of my colleagues have urged me to further describe the horrific injuries I have seen over the last nearly 20 years as a neurotrauma surgeon.
The truth is, I’m not sure America is ready to see that. More important, it isn’t a decision anybody can make unless it’s their loss and their story to tell – like Emmett Till’s mother.
Louis Klarevas, research professor at Columbia University and author of the 2016 book “Rampage Nation,” credits the 10-year federal assault weapons ban between 1994 and 2004 with significantly reducing the number of mass shooting incidents and deaths (which he defined as injuring or killing six or more people) before rebounding to even higher levels after the ban expired. In 2020, there were an estimated 20 million AR-15 style weapons in circulation in the United States, according to the National Shooting Sports Foundation.
Between 1990 and 1999, during the decade in which I traveled to that gun range with Hoff, mass shootings claimed an average of 21 lives per year; from 2012 to 2021, that average had gone up to 51, according to the Violence Project. It defines a mass shooting as four or more people in a public place being killed with firearms, without any underlying criminal activity, excluding the shooter. (CNN defines mass shootings as those in which four or more people other than the shooter are injured or killed by gunfire during one event.)
Federal data on the overall impact of gun violence is lacking. Even obtaining the basic numbers can be a challenge, as I learned writing this article. While the US Centers for Disease Control and Prevention has dashboards for Covid-19 and mpox, gun violence is still an enigma for the public health community. That’s in large part due to the Dickey amendment, which, in 1996, made it challenging and potentially financially punitive for the CDC to conduct or fund research on gun violence if it were to be used in any way to promote gun control.
Even today, it is organizations like the Gun Violence Archive – an independent data collection and research group that collects information on gun violence from more than 7,500 sources daily – and not the CDC that provide some of the most up-to-date statistics on gun violence and deaths on a daily basis.
The rise of gun violence is something Dr. Bellal Joseph has seen firsthand. He is the chief of the Division of Trauma, Surgical Critical Care, Burns, and Acute Care Surgery at the Banner University Medical Center at the University of Arizona and a professor in the Department of Surgery in the University of Arizona College of Medicine – Tucson.
“I can tell you from our own data, but also from a national perspective, there’s no doubt that … every trauma center in the country is seeing unprecedented numbers of trauma,” he said referring to “violent trauma: more shootings, more victims.”
“Mass shootings are more prevalent at trauma centers than people actually think,” said Joseph. “Oftentimes, it takes a high [profile] school shooting to activate the media, but it actually happens a lot more than we think, unfortunately.”
Joseph, who back in 2011 helped treat nine of the survivors of the mass shooting that targeted US Rep. Gabrielle Giffords, like every other surgeon we spoke to, wanted to emphasize that injuries from AR-15-style semi-automatic firearms are not like other injuries.
“When you see … victims from AR-type assaults, what you’re seeing is a violent crime against others,” he said.
According to an analysis by the Institute for Health Metrics and Evaluation, the US ranks first in firearm homicides per capita among high-income countries of more than 10 million – that’s an age-adjusted rate 13 times greater than France’s and 23 times greater than Australia’s.
In 2021, for the second year in a row, firearms were the leading cause of death among children and adolescents, according to a CNN analysis of data from the US Centers for Disease Control and Prevention. That year, 4,733 children and adolescents ages 1 to 19 died from firearms, a 9% increase from 2020 and a 42% jump from 2018. About a tenth of all firearm-related deaths in the United States were among children and adolescents in 2021.
About four hundred more children and adolescents died from firearms than car crashes, the second leading cause of death.
The gun deaths are only a small fraction of those affected. The lives of people who are injured, the victims’ families, friends and the community at large are forever ripped apart.
And if you need a reason to look beyond the human cost of gun violence, there is also the cost to society: According to a February 2021 report by Everytown Research and Policy, it comes out to an estimated $280 billion a year, which includes medical, criminal justice and other expenses.
The American College of Surgeons, the professional organization that represents the people who see this type of injury all too often, has been calling for tighter control of weapons and more common-sense rules. In 2018, the ACS’s Firearms Strategy Task Force released 13 recommendations that includes items like regulating heavy-duty firearms, more safety training, and increasing recognition of mental health issues.
After this week’s shooting, President Joe Biden reiterated his call to Congress to pass a ban on assault weapons.
“We have to do more to stop gun violence. It’s ripping our communities apart, ripping the soul of this nation,” Biden said. “We have to do more to protect our schools, so they aren’t turned into prisons.”
“There has to be some vetting, training,” said Joseph, especially when it comes to weapons like AR-15-style semi-automatic rifles. He noted that to be allowed to drive, a person needs many hours of coaching and practice in order to pass an exam and get a license – “no one is getting into a car and just driving.”
As for objections that “the government can’t tell us what to do,” Moore says, yes, citizens have rights, but they are not limitless.
“We don’t drive tanks through the street. We don’t throw a grenade into the parks. … We need to have some rational thinking,” he said.
The same sort of rational thinking Hoff impressed on us so many years ago on a gun range in Ann Arbor, Michigan.
by tyler | Mar 28, 2023 | CNN, health
Good friends and good physical health may be even more closely linked than previously thought, new research has found.
Researchers discovered that positive social experiences impact not only a person’s stress level and ability to cope, but also markers of physical health, according to a study published Monday in the journal Society for Personality and Social Psychology.
The study followed more than 4,000 people over three weeks as they completed check-ins every three days on their smartphones or smartwatches regarding their positive and negative experiences with their closest social relationships, as well as assessments of their blood pressure, heart rate, stress and coping.
Having more positive experiences in social relationships was generally associated with better coping, lower stress and lower systolic blood pressure, or spikes in blood pressure under stress, according to the study.
But having social relationships which bounce between good and bad often can be unhelpful. When there is a lot of volatility, the negative experiences seemed to have a bigger impact on a person than the positive, said lead study author Brian Don of the University of Auckland.
“Both positive and negative experiences in our relationships contribute to our daily stress, coping, and physiology,” Don said in a statement. “Additionally, it’s not just how we feel about our relationships overall that matters; the up’s and downs are important too.”
The results are not surprising, given that previous studies have also documented a link between healthy relationships and healthier bodies, said Dr. Kathleen Mullan Harris, a professor of sociology at the University of North Carolina at Chapel Hill. Harris was not involved in the study.
But seeing how friendships affect specific aspects of physical health does add to the scientific understanding of the connection, she said.
The research, which took place from 2019 to the end of 2021, may also offer insight into the impacts of the Covid-19 pandemic, which put strain on social relationships for many people, Don said.
“Because the COVID-19 pandemic has created considerable strain, turbulence, and variability in people’s relationships, it may indirectly alter stress, coping, and physiology in daily life, all of which have important implications for physical well-being,” he added.
It is important to remember that the study cannot prove that good relationships cause better health, Don said.
But it does show that physical health and social relationships are often intertwined, he said.
And the association can also work the other way, Harris said.
“People who are in better health often have better relationships with people, because they’re not moody, they’re not grouchy, they’re not in pain, they don’t have worries,” she said.
Don hopes that future studies expand the areas that are investigated.
“It would be useful to examine other physiological states, such as neuroendocrine or sympathetic nervous system responses as outcomes of daily positive and negative relationship experiences, which may reveal different patterns of associations,” he said.
If hearing the importance of good social relationships makes you lament that you might not have enough, you aren’t alone, said Adam Smiley Poswolsky, workplace belonging expert and author of “Friendship in the Age of Loneliness.”
Many people may feel lonely and want closer connections, but the prospect of making new friendships — or strengthening existing ones — can be daunting, Poswolsky said.
“It’s intimidating to think about friendship in adulthood, and often overwhelm keeps us from even trying,” he said.
His suggestion? Start small. Text a friend that you haven’t talked to in a long time, commit to meeting one new person a month, host a dinner party, or join a class.
“If you do just one thing, make a list of five people in your life that you care about, and give one of them a phone call,” Poswolsky added. “The most remarkable friendships often begin with tiniest moments of connection.”
Remember that you likely won’t form a strong connection overnight, he added.
Research shows that it takes 90 hours of time together to consider someone a friend and more than 200 hours to consider them a close friend that you have an emotional connection with, he said.
“In our busy world, we need to put our friendship on the calendar, and commit to recurring activities,” Poswolsky said.
But studies also reveal that it isn’t just about having relationships — the quality matters.
There might not be just one definition of a good friendship, but most strong relationships share some similar qualities, he said.
They tend to prioritize laughter, joy, excitement, courage, vulnerability, affirmation and a lack of judgment, Poswolsky said. And good friendships are often two people helping each other become better versions of themselves, he added.
“Even when — especially when — their friend is struggling or going through something hard,” Poswolsky said. “You know someone is a true friend when they have your back when you’re sick, when you lose your job, when you make a mistake, when you’re going through a break-up, when you’re stressed, when you’re sad.”
by tyler | Mar 27, 2023 | CNN, health
Almost two months after a train carrying hazardous materials derailed in the town of East Palestine, Ohio, the state Department of Health is preparing to offer blood and urine testing and physical exams to first responders who rushed to fight the blaze.
The testing is set to start within the next two weeks and will be the first step in a long-term effort to monitor the health of responders to the accident, according to an email obtained by CNN.
This move closely follows an announcement that a health assessment clinic for East Palestine residents that has been operating out of a local church will become permanent and expand its services.
Roughly 300 firefighters from 50 departments – many of whom were volunteers – responded to the derailment and fire, which happened the night of February 3 and continued to burn for several days.
Many of the firefighters had their gear ruined by the heat and chemicals. Some wore breathing apparatus to protect themselves from the fumes and smoke, but others didn’t have or didn’t know that they needed self-contained breathing apparatus to protect their lungs and airways, according to firefighters who were at the scene and spoke with CNN.
The email about health testing, which was sent to area fire chiefs Sunday, says the long-term monitoring plans for the first responders are still being developed, but a first step will be the physicals, which will include “blood work, urinalysis, and an exam.” It does not describe what the tests will look for or their purpose.
The Ohio Department of Health has acknowledged a CNN request for more information on the testing and monitoring, but it has not offered further details.
In addition to the testing through the Ohio Department of Health, firefighters who responded to the derailment will be followed by the Firefighter Cancer Cohort Study, Candice McDonald, deputy chief executive of the National Volunteer Fire Council, said Monday.
The study, which is funded by the Federal Emergency Management Agency, aims to follow 10,000 firefighters for 30 years to learn more about how their exposures contribute to cancer risks.
Cancer caused by chemicals in smoke is the leading cause of death for firefighters, according to the International Association of Fire Fighters.
First responders to the Ohio derailment were among the most heavily exposed to a cocktail of chemicals that spilled into the ground and nearby creeks.
David Comstock, chief of the Western Reserve Joint Fire District, says there are still a lot of unknowns about the nature of the chemical hazards that the firefighters were exposed to that night.
“One of the things that I’ve raised is, what’s in tank car A? And what’s in tank car B? But what happens when they mix and burn? Now, what do I have?” he said.
Comstock says that three firefighters from his station responded to the derailment and were 50 to 100 feet from a burning railcar. He asked them what was in the derailed cars, “and my crews couldn’t answer me,” he said.
It was hard to get information about the chemicals on the scene, he said.
He arranged physical exams for the firefighters at his station within a week, but he wishes they had happened even faster. He spoke to some doctors who advised blood testing within 48 hours.
“Your blood, your body, processes many of the chemicals out of it within that time period, that they don’t become detectable at that point,” he said.
It’s unclear how much information testing will yield now, Comstock said, but he hopes the exams and tests from the Department of Health will offer a baseline so the first responders will know if their health changes over time.
East Palestine residents will also soon get expanded access to health services. The temporary health assessment clinic that opened in downtown in the wake of the train derailment will remain open permanently, Gov. Mike DeWine testified Wednesday before the US Senate Committee on Commerce, Science and Transportation.
“We started back clinic shortly after this tragedy occurred. This morning … I met with medical leaders from the East Liverpool City Hospital. And we are announcing today that we’ll be making this clinic into a permanent clinic for the community,” DeWine said last week.
“This is going to be a full-service clinic that will provide comprehensive care and treatment. Anybody can walk in anyone can be treated. And this is a long-term commitment to the health of the people of East Palestine,” said DeWine, who offered his testimony remotely, from the library of East Palestine High School.
DeWine gave few details on the services that might be available to the clinic or who would ultimately pay for them.
Currently, residents can walk into the clinic to get information about their risk, answer questions as part of an ongoing health study, and meet with a physician to get a basic exam and advice on any necessary follow-up care.
DeWine suggested that these offerings might be expanded under a partnership with East Liverpool City Hospital. His comments were also an acknowledgment of ongoing health needs in the community.
East Palestine residents are “worried about their future they’re worried about where things are going to be in five or 10 or 15 years. It’s important that they be able to continue to get assessed,” he said.
DeWine said it would be particularly important for the health of the first responders to continue to have regular checkups.
“They all need to be assessed. That needs to be established – a baseline – and they need to be assured that in five years or 10 years, there’s still a place where they can go.”
DeWine said Norfolk Southern would be expected to pay for those things.
“We look to the railroad to establish that fund,” he said.
by tyler | Mar 25, 2023 | CNN, health
Four sea otters in California have died from a rare strain of the Toxoplasma gondii parasite that scientists said could pose a risk to human health.
Researchers called the finding a “complete surprise” because this strain of T. gondii had never been reported in any aquatic animal or in coastal California. Their study, led by researchers from the California Department of Fish and Wildlife and University of California, Davis, was published this week in the journal Frontiers in Marine Science.
“Since Toxoplasma can infect any warm-blooded animal, it could also potentially cause disease in animals and humans that share the same environment or food resources, including mussels, clams, oysters, and crabs that are consumed raw or undercooked,” Melissa Miller, a California Department of Fish and Wildlife researcher and author of the paper, said in news release.
The four sea otters stranded from 2020 to 2022, and each had an “unusual and severe” condition called steatitis, or inflammation of body fat. Toxoplasmosis is common in sea otters, and it’s known that it can be deadly, the researchers wrote, but this strain of T. gondii was able to rapidly kill apparently healthy adult otters.
No cases have been reported in humans, but researchers called the otters “important sentinels” of the circulating strain, which could be a risk to people eating seafood or ingesting contaminated water.
“Because this parasite can infect humans and other animals, we want others to be aware of our findings, quickly recognize cases if they encounter them and take precautions to prevent infection,” Miller said. “We encourage others to take extra precautions if they observe inflamed systemic fat deposits in sea otters or other marine wildlife.”
Most people infected with T. gondii have no symptoms and aren’t aware of their infection, but severe toxoplasmosis can cause damage to the brain, eyes and other organs, according to the US Centers for Disease Control and Prevention. It can be transmitted from mother to fetus during pregnancy and can lead to significant health problems after birth. People at higher risk for severe infection are infants born to mothers who were infected during or shortly before pregnancy and people with weakened immune systems.
To prevent any toxoplasmosis infection, the CDC recommends typical food safety practices such as cooking foods to a high internal temperature, rinsing fruits and vegetables and washing utensils.
Cat feces is known to contain high levels of the parasite, so the CDC urges people to keep pet cats inside, change the litter box every day – before the parasite becomes infectious – and wash hands well.
In the study, the researchers said more work is needed to investigate habitat or climate change factors that may have led to the spread of the rare strain in otters, and to examine whether other aquatic wildlife are infected.
