Infectious Diseases

The controversy over vaccinations and whether or not to regulate their administration has reached a boiling point in the United States with the recent measles outbreak originating in Disneyland, and prominent politicians like Senator Rand Paul and Governor Chris Christie have weighed in to support the anti-vaccine community's appeal for individual choice. What are the ethical, sociological, and political ramifications of these developments in the national vaccination debate, and how should the medical community respond? Joining Dr. Brian McDonough to discuss the vaccination controversy is Dr. Arthur Caplan, Professor and founding Director of the Division of Medical Ethics in NYU Langone Medical Center’s Department of Population Health.

The Gender, Sexuality and HIV Prevention Center at Ann & Robert H Lurie Children's Hospital of Chicago is the first of its kind facilty for adolescent patients. Host Dr. Jennifer Caudle welcoms the center's director, Dr. Robert Garofalo. Dr. Garofalo will share the center's mission of supporting multidisciplinary academic subjects including sexual health, gender, sexuality, HIV prevention and health disparities which affect adolescent and young adult populations at risk of acquiring HIV. The Center partners with similar organizations throughout the country in creating an environment where clinicians, academics and scientists can collaborate to design projects with public health significance.

Robert Garofalo, MD, MPH, is Professor of Pediatrics and Preventive Medicine at Northwestern University Feinberg School of Medicine. He is also an Attending Physician at Lurie Children's, where he directs the Adolescent/Young Adult HIV Program. Dr. Garofalo is a national authority on LGBT health issues, adolescent sexuality, and HIV clinical care and prevention.

This week, Mark and Margaret speak with Dr. Deane Marchbein, President of the American Board of Medecins Sans Frontieres (Doctors Without Borders). Dr. Marchbein joined MSF in 2006 to work as an anesthesiologist in MSF's surgical program in Ivory Coast. She has worked with MSF in Democratic Republic of Congo, Haiti, Libya, Nigeria, South Sudan, and Syria, and as a medical doctor in Libya and Lebanon.

Twenty-five years ago CDC played a pivotal role in the discovery of the virus that causes hepatitis C. After the isolation of HCV, implementation of screening of blood products and organs for donation led to a decrease in rates of HCV infection between 1990 and 2009. In spite of these successes, HCV still remains a serious threat, both domestically and abroad. HCV remains the most common chronic blood borne infection in the United States, affecting approximately 3.9 million individuals. However up to 50% of HCV-infected persons are unaware of their infection. Globally, there are 180 million people who are chronically infected with the virus, and 3-4 million new infections occur every year.

Recent therapeutic advances hold the potential to halt the progression of HCV infection and disease. While HCV-infected persons can be effectively treated, more effort is needed to screen, diagnosis, treat and provide continuity of care. This session of Public Health Grand Rounds will discuss how new screening guidelines, testing methods and therapeutic advances will provide us with an opportunity to improve individual outcomes and to eventually eliminate HCV infection.

To view the complete video recording of this and other CDC Public Health Grand Rounds sessions, visit http://www.cdc.gov/about/grand-rounds/

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Host Dr. John Russell chats with author Thomas Goetz about his recent book, The Remedy: Robert Koch, Arthur Conan Doyle, and the Quest To Cure Tuberculosis. The book chronicles the lives of two men: Robert Koch, great German scientist, who convinced the world of the germ theory of disease; and Arthur Conan Doyle, trained physician and author of Sherlock Holmes stories. The Remedy traces the history of tuberculosis, the people who brought its diagnosis, etiology, and treatment approaches to light, and ways in which scientific discoveries evolved into everyday realities. Mr. Goetz is a writer, entrepreneur and health care innovator.

Author and journalist Molly Caldwell Crosby joins host Dr. John Russell to discuss her second book, Asleep: The Forgotten Epidemic that Remains One of Medicine's Greatest Mysteries. Asleep is another fascnating look into medical history. In the 1920s and '30s, a team of neurologists investigated a rare but disturbing group of patients spread across various hospitals and insane asylums to try to solve the worldwide epidemic of encephalitis lethargica, or sleeping sickness.

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When the next pandemic arrives, what will it look like? From which innocent host animal will it emerge? Will we be ready? Addressing these and other questions is David Quammen, author of Spillover: Animal Infections and the Next Human Pandemic. Mr. Quammen's book illuminates the origins and dynamics of Ebola, SARS, bird flu, Lyme disease, and other emerging threats.

At the turn of the last century, a powerful smallpox epidemic swept the United States from coast to coast. The age-old disease spread swiftly through an increasingly interconnected American landscape: from southern tobacco plantations to the dense immigrant neighborhoods of northern cities to far-flung villages on the edges of the nascent American empire. In Pox, award-winning historian Michael Willrich offers a gripping chronicle of how the nation's continentwide fight against smallpox launched one of the most important civil liberties struggles of the twentieth century.

In his book, The Wildlife of Our Bodies, biologist Rob Dunn from the Department of Biology at North Carolina State University opines that while "clean living" has benefited us in some ways, it has also made us sicker in others. We are trapped in bodies that evolved to deal with the dependable presence of hundreds of other species. As Dunn reveals, our modern disconnect from the web of life has resulted in unprecedented effects that immunologists, evolutionary biologists, psychologists, and other scientists are only beginning to understand.

In this premiere edition of The Pharmacy Report®, host Dr. Linda Bernstein focuses on the growing threat of antimicrobial drug resistance. Top news stories include the CDC's "Threat Report 2013," and FDA drug and new indication approval updates. In this week's Movers and Shakers segment, Joseph Guglielmo, PharmD, Dean of the UCSF School of Pharmacy and a clinical pharmacist specialist in infectious disease will address antimicrobial stewardship and the role of the physician and pharmacist in these multidisciplinary programs.

References mentioned in this segment:

• Centers for Disease Control and Prevention:
  Threat Report 2013 Antibioitic Resistance Threats in the United States, 2013
• Antimicrobial stewardship guidelines Dellit TH, Owens RC, McGowan Jr JE, Gerding DN, Weinstein RA, Burke JP, Huskins WC, Paterson DL, Fishman NO, Carpenter CF, Brennan PJ, Billeter M, and Hooton TM. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship. Clin Infect Dis. 2007 Jan 15;44(2):159-77
• IDSA REPORT: Bad Bugs, No Drugs: No ESKAPE! An Update from the Infectious Diseases Society of America Boucher HW, Talbot GH, Bradley JS, Edwards JE, Gilbert D, Rice LB, Scheld M, Spellberg B, Bartlett …