Immunization vs Vaccination

I wondered whether the words "immunzation" and "vaccination" are interchangeable. In fact, they are not. Immunization refers to any process by which the an individual may develop resistance to a disease (see diagram). Vaccination is one form of immunization. Vaccination refers to the process of exposing individuals to a biological preparation of a weakened or heat-killed disease-causing pathogen in order to induce an adaptive immune response in their bodies, rendering them immune to the disease. There are forms of immunization that do not involve vaccination. If an individual effectively fights off and survives an infection from a pathogen, that person has been"immunized." In the 1700s, milkmaids who caught cowpox developed immunity to small pox without being vaccinated. Vaccinations often take the form of injections but they are also frequently administered orally or through inhalation. ----------------------------------------------------------- sources: www.WHO.int/en and http://wordnet.princeton.edu/ Here is a faccinating article describing vaccine-produced immunity, or vaccination.

Poor Eye Health: A Silent Enemy

A report issued last November indicates that the world is facing an often overlooked opponent: poor eye health. An area that is often neglected by many health policy makers throughout the globe, eye health plays a crucial role in public health.

                Throughout the world, an estimated 285 million people are visually impaired; demographically, about 90% of these people live in developing countries. According to the report, only 3 in 10 people in Africa have access to eye health services, and in many other rural countries, the numbers are even worse. Another demographic study displayed that less than 15% of those suffering from eye conditions received treatment in Nigeria.

What’s more disturbing is the fact that over 80% of this blindness can be easily treated and cured. Over half of the world’s preventable blindness exists in the form of cataracts, a condition that only costs about 60 US dollars to cure. So why isn’t the job getting done? According to the WHO, effective eye health requires a workforce, effective service delivery, adequate funding, and government support and leadership. However, as previously mentioned, government support is often absent. In the continent of Africa where diseases such as HIV, malaria, and tuberculosis are running rampant, it is easy for health policy officials to overlook eye health as an important issue to address. Because of this limited government action and funding, there is a large deficit of skillful health workers, eye health drugs, and medical equipment needed to address these alarming eye health issues.

The report also shows that eye health issues have a huge impact on the global economy. Claire Gilbert, a professor of eye health in London, estimates that the global economy lost about 42 billion dollars in revenue due to preventable blindness and eye health issues; these numbers are only predicted to rise, as the annual global productivity loss is estimated to be 110 billion dollars by 2020 if no intervention programs are employed.

There is also a strong relationship between eye health and poverty. Studies in Kenya, Philippines, and Bangladesh show that people who are visually impaired are much more likely to live in poverty. In these countries, many rely on daily wages to put food on the table for their families. If one of the primary family providers becomes visually impaired, the family’s source of income immediately becomes cut in half, thus forcing the family into poverty. Similarly, studies in rural villages in Tanzania found that women with eye health issues were limited in daily activities such as cooking or caring for their children, thus also reducing the quality of life of the family. It is also because of eye health issues that many children in developing countries are forced to drop out of school, thus drastically reducing the countries’ work force.

In conclusion, eye health, although often overlooked and underestimated, is a crucial aspect to the health of the globe, and should not be ignored.

Something Smells Fishy

Some people like the taste of fish, and some don't. However, as found in this article, and as discussed this past week at the 2011 Experimental Biology meeting, a popular and highly nutritional stearidonic acid that was typically found only in fish is going to be available in a different form in hopes of increased consumption among our population. Stearidonic acid is a vital omega-3 acid that provides many benefits for the heart, along with a decrease in major depression symptoms as well as proper enzyme functioning. In fact, it is even recommended that American's find a way to eat two meals of seafood a week- and this reasoning stems mainly from various health organizations' desire for humans to intake an increased amount of two of the long-chain omega-3's :eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Another way to think about the amount of seafood that we are due to be eating is the normal person should consume 8 ounces per week of either fish or shellfish, and pregnant women are advised to eat up to 12 ounces.

As probably obvious, we are not even close to meeting these guidelines, with most Americans falling a stunning 75% short of the goal. Also, there are other things to be considered with this change in diet demands. Toxic levels of methyl mercury can be present in these nutritional sources as well, so this source of vital omega-3's is important, but not necessarily the panacea that we are seeking to fix the deficiency of these nutrients.

It has been recommended in the past that these essential fish oils be used in cooking, especially at restaurants, much like the addition of iodine to our salt sources. However, along with this idea there is also the consideration of the possibly fishy taste that this might add to the dishes, making many unwilling to consider this idea.

However, the good news as discussed at the Experimental Biology conference discussed earlier is that commercially derived searidonic acid (SDA) will soon be available to fill these gaps in usefulness and delivery of the nutrients. This new altervative calls for the genetical manipulation of soy, as presented by the commericial agriculture company of Monsanto. This company also petitioned the Food and Drug Administration (FDA) at this time to have their SDA-enriched soy oil granted the status of "generally recognized as safe". This company wants to bring this oil into baking mixes, meat products, milk products and various others. Now, this newly engineered oil is not a replacement of all the vital nutrients that are present in fish oils, but it is simply an answer to try and fill the hole of this major nutritional deficiency within our population. The company recently received the desired status from the FDA and products with this fortification are expected to be seen around 2012.

Department of Health and Human Services to Eliminate Inequity

The U.S. Department of Health and Human Services (HHS) launched an "Action Plan to Reduce Racial and Ethnic Health Disparities." This plan has five major goals: (1) expand access to care and insurance for racial and ethnic minorities, (2) strengthen the health workforce serving racial and ethnic minorities, (3) implement the CDC’s new Community Transformation Grants, focusing efforts on heart disease, childhood obesity, tabacco-related disease, maternal and child health, asthma, and flu, (4) advance disparity-related health research, and (5) "Increase the efficiency, transparency, and efficacy of HHS programs." The HHS plans to assess progress biannually to ensure efficacy.

Specific strategies for achieving these goals include the recruitment and training of undergraduates in undeserved communities for careers in community health, public health, and biomedical research.pursue careers in medicine and as community health workers. The National Health Service Corps and the NIH already offer incentives for newly-trained health workers to begin there careers in regions lacking access to primary care practitioners (see NHSC loan repayment program), but there are relatively few scholarships or loan repayment programs available to students pursuing careers in Public Health. The act also purports to implement cultural competence education into health worker training. The act has already taken effect.

All five goals rely on funding, especially the recruitment of health workers from undeserved communities. Depending on the outcome of arguments in Washington, budget cuts may negatively impact this initiative.

If the plan succeeds in having even half of its intended effect, the health status of this country would improve significantly. Outside of financial concerns, what limitations do you foresee in carrying out this action plan?

Government Shutdown and Public Health

In light of the impending government shutdown over the failure to reach a solution regarding budget cuts, the CNN posted this article on its potential impact on the health services of the country. The actual divide between Republicans and Democrats in Congress centers mainly on the issue of cutting particular health services for women, especially revolving around the use of federal funds for abortion. Both Democrats and Republicans agree that the budget needs to be cut by about $35-39billion, but refuse to budge on issues regarding womens health.

One consequence to the healthcare sector as a result of this government shutdown is the ceasing of research. The CDC and NIH will not be able to start any studies nor take on additional patients, nor will grants be handed out to research universities and institutions. Reducing services in the health sector may have a debilitating effect in our government's response to potential health threats that may occur over the course of the shutdown. While the government assures us that services such as food and drug treatment will not be affected, I struggle to see how the normal services can operate efficiently under such uncertainty. Additional sectors like the military, mail carrier, air traffic, environmental protection, law enforcement, emergency and disaster personnel, and TSA and coast guard could be affected as well, either by shutting down services or with-holding paychecks.

The last time government was shut down was 15 years ago, for 5 days, with a partial shutdown of 21 days afterwards. Here is more information on the shutdown.

Pennsylvania Calls for More Water Tests

In an article addressing both the role of policy makers in public health and the vital importance of water safety, the New York Times addressed a new push from environmental regulators in Pennsylvania to examine the state's rivers. These regulators fear that the increase of natural gas drilling in the area has caused an increase in radioactive materials in rivers there.

According to Michael Krancer, who is the secretary of the Pennsylvania Department of Environmental Protection, that state has been trying to both monitor the safety of the water supply and not interfere with the success of the natural gas industry.

In conjunction with this department, the state of Pennsylvania sent a letter to water treatment centers through the state (25 known) urging them to increase their levels of treatment. This happened after an earlier article in the times that revealed the large amount of radioactive waste being discharged from sewage treatment facilities in Pennsylvania. These facilities were not designed to remove radioactive materials, thus leading to a very dangerous contamination of the environment and water supply.

Another issue here is that many of the water treatment plants were taking the heavier biosolids (which can include radioactive elements) that settled out of the treated solutions and were selling them as commercial fertilizers. An official from the Pennsylvania Department of Environmental Protection said that they were looking into having the plants revise this policy, though they described it as a "guideline" rather than a mandate.

To me, this seems like a waste of the power that comes with the department. In some instances, it is important to utilize "nudges" in promoting health, but in an instance of such potential danger to the public (which they also have no control over, or probably knowledge of), it's a time when policy makers should step in with laws and regulations. This article also made me think about the risk associated with living in developed counties where we take things like safe water for granted. There still need to be policies and regulations implemented to ensure that the water supply remains safe, despite increased natural gas drilling, etc. 

Bad Mouthing Vaccines

In Somalia, a Measles outbreak that began five weeks ago has escalated. Unlike most every other disease, this outbreak has showed an aversion to the poorest members of Somalia's population. (See Related Article)

Actually, this highly contagious virus does not discriminate against poor children, but the poorest children in Somalia are more likely to be vaccinated against measles. Why? The measles vaccine is provided in all mother-child health facilities in Somalia every day free of charge. However, parents who can afford medical care shun free vaccinations because they are rumored to cause HIV/AIDS and interfere with a child's ability to reproduce. This is an instance where cultural beliefs eclipse resources that would protect individuals from disease.
Lul Mahamud Mohamed, the head of Pediatrics in Mogadishu said it is up to religious leaders to debunk rumors about the vaccines.
What obstacles do you think health authorities will face in trying to get religious leaders on their side? How would you approach negating wide spread rumors about the vaccines?