Posts Tagged ‘TB’

Tuberculosis & Mankind

March 24th, 2014

Tuberculosis and mankind share a dramatic and intertwined history.  TB has caused millions of deaths every year for centuries, been found in Egyptian mummies, has placed patients into sanatoriums, and has  even has a folklore link relating it with vampires,  The drama continues into this decade: in 2012, there were 8.8 million new cases of TB diagnosed worldwide and around 1.2 million deaths. 

Public health departments have been fighting for TB elimination since their creation.  Efforts in the 1950s decreased mortality by nearly 90%, but a resurgence in cases and deaths occurred after drug-resistant strains emerged in the ‘80s.  Soon after, the WHO declared TB a global health emergency, and the next decade saw TB control targets developed in an attempt to eliminate TB. 

Arizona continues to strive to hit these targets.  In 2013, there were 184 TB cases reported in the state, a 13% decrease from the year before.  Arizona also has a lower case rate compared to the nationwide average.  Our programs use “directly observed therapy”, evidence-based policies, and partnerships with counties and Cure TB to ensure patients are completing treatment and reducing their risk of developing drug-resistant TB

Our Arizona State Public Health Laboratory also supports TB control.  In 2013, we adopted the Cepheid GeneXpert, a test that detects TB in only 2 hours while identifying mutations associated with drug-resistant TB.  Specimens found to have these mutations are forwarded to the CDC for a full battery of molecular tests to confirm drug resistance. 

World TB Day is coming up on March 24th, which is commemorated annually to bring global awareness about the effects of TB.  You can join us for a Twitter Chat at 10 a.m., March 24, 2014 to discuss TB in Arizona.  Follow us on Twitter and follow the chat using #azhealthchat.

AZ Disease Detective Software Overhaul

January 14th, 2014

Our statewide disease detectives (whose job it is to slow the spread of communicable diseases) need real-time electronic surveillance in order to get the job done.  Our I.T. folks and the people in Public Health Preparedness have been working on an upgraded system to help them for the last several months- and our new Medical Electronic Disease Surveillance Intelligence System (MEDSIS) went online last  week.  

MEDSIS allows all 15 county and 4 tribal health departments to monitor and manage infectious diseases.  Some hospitals in the state are tapping into the system as well.  This newest edition has a Spanish version so our counterparts in Sonora can enter data and we can track diseases that may pop up on both sides of the border – like influenza, Valley Fever and TB. 

The bottom line is we can now track these diseases more quickly and more accurately and we have something new in the toolbox to quickly discover an outbreak.  Many thanks to all the staff who worked so diligently on this project- including Nita Surathu, Javed Mukarram, Michael Conklin, Shandy Odell, Lloyd Kalicki and Victor Sanchez, Arup Sinha, Joe Enos, Noel Ramirez, Robert Howard, and Srinivasa Venkatesan.

Sonoran Public Health Department & ADHS Snag the Paul Fannin Award

June 11th, 2012

 The Secretario de Salud Publica & the ADHS jointly received the Arizona Mexico Commission’s Paul Fannin award for our public health collaborations last Friday night.  This is a top award for the Commission- with the award going to “… an organization that has demonstrated acts of goodwill and support toward the development of the Arizona-Sonora relationship.”  It’s named after the AMC’s founder, Governor Paul Fannin.  This is the first Fannin award that has gone to binational recipients.  ASU and UA got a joint award as did ADOT and the Yuma Port Authority a few years ago…  but this is the first one with binational recipients. 

 

We were jointly recognized for our awesome collaboration on things like valley fever surveillance and interventions, real-time infections bi-national disease reporting, TB case and treatment coordination, collaboration during the H1N1 pandemic, laboratory science teamwork, teen pregnancy and substance abuse prevention, collaboration on assisted living standards, and much more.  Thanks to all of you who have made our relationship with Salud Sonora a success!

 

Arizona Mexico Commission Progress

February 10th, 2012

I’m writing this from my hotel room in Rocky Point- after a long day (and night) of the inter Plenary Session.  The 2 day conference started Thursday and goes through tonight.  We meet twice a year- it’s basically an opportunity for us to form partnerships across the border and to develop regional approaches to things like valley fever surveillance, burn patient infrastructure, substance abuse, TB, border first aid, farmworker health, and Sonora’s efforts to provide licensing and quality assurance services for assisted living in Sonora (and how we can partner with them as they set up their program). 

During last summer’s Session we signed a bi-national Declaration to develop regional surveillance for valley fever.  We’ve made a lot of progress in the last 6 months, and tomorrow we’ll be following up on that initiative at Sonora’s public health laboratory, checking out the lab instruments and equipment that we were able buy (with federal funds) and indefinitely post in Hermosillo in their lab. We’ll also be setting up some joint training sessions. There are lots of other examples of what we do through the Commission on health- this is just an example. 

The Arizona Mexico Commission was started by then Arizona Governor Paul Fannin in 1959 to improve partnering between Arizona and Sonora in a wide range of areas.  It’s evolved over the years to become a premiere and unique cross-border nonprofit organization whose mission is to improve the well-being and quality of life for residents of Arizona by promoting a strong, cooperative relationship with Mexico and Latin America through advocacy, trade, networking and information.  The Commission has 14 bi-national committees that act as industry and community advocates in partnership with the Commission Sonora-Arizona (from Sonora, Mexico) to facilitate cross-border trade, business and community networking and bi-national information sharing.  Our link is through the Health Services Committee.

Click here to see some of the public health facilities and an ambulance they use on the beach.

Building a Healthier Border

October 28th, 2011

You can think of the border public health advocacy network as a binational matrix of public health partners that collaborate to improve conditions along the US-Mexico border.  The network includes national organizations like the U.S.-Mexico Border Health Commission along with state based partnerships like the Arizona-Mexico Commission and the annual U.S.-Mexico Border Governor’s Conference.  Community based binational partnerships are also a key component for setting public health priorities and implementing effective interventions.  The acronym, COBINAS, stands for Consejos Binacionales de Salud, or Binational Health Councils, in English.  Our partnerships span the full width of public health- from infectious disease work (like TB control), to substance abuse, physical activity & nutrition (like Cinco Pasos), tobacco cessation, environmental disease work (likeValley Fever), prescription drug misuse, lab capacity- even developing regional licensing standards. 

As part of my job as the Director, I’m a member of the U.S.-Mexico Border Health Commission, whose mission is to provide international leadership to optimize health along the U.S.-México border.  The Commission is comprised of the federal secretaries of health, the lead health officers of the ten border states, and prominent community health professionals from both nations. As a member, I help to educate folks (including policy-makers) about the unique challenges at the border through outreach efforts and conduct joint collaborative public health initiatives with public and private partners in the border health community.  The primary goal of the Arizona Delegation is to strengthen and support bi-national public health projects and programs along the Arizona-Sonora border.  

I was fortunate to be able to spend a couple of days this week for a meeting of the U.S.-Mexico Border Health Commission Arizona and Sonora Delegation Outreach Offices.  The COBINAS workshop meetings (in Magdelena de Kino, Sonora) developed community priorities and updated program developments within the binational health councils.  We’ll also be using their input as we develop our work plans through the November 7, 8 US-Mexico Border Health Commission meeting, as well as the December Arizona-Mexico Commission, and next year’s U.S.-Mexico Border Governor’s Health Worktable joint resolutions.  By the way, the 3 local COBINAS for the AZ-Sonora region are San Luis Rio Colorado, Sonora/Yuma County; Ambos Nogales; and Noreste de Sonora/Cochise County, Arizona and the Tohono O’odham Nation/Western Pima County/Sasabe, Caborca, and Sonoyta, Sonora binational community health council.

Who is Louis Pasteur?

September 8th, 2011

In 1862, a French chemist named Louis Pasteur discovered that heat kills germs in liquids, preventing bacterial growth, food spoilage and foodborne illnesses. He used his discovery to invent methods that have been used for the last 150 years as a sanitary treatment for milk – which at the time was a prime source of TB. 

His experiment?  He exposed boiled broths to air in vessels that contained a filter to prevent particles from passing through to the growth medium via a long tube that didn’t allow dust particles to pass. Nothing grew in the broths unless the flasks were broken open- allowing him to conclude that the living organisms that grew in the broths came from outside rather than “spontaneously generated” within the broth (as was the conventional wisdom). This was one of the last and most important experiments disproving the theory of spontaneous generation. The experiment also supported germ theory.

Pasteur’s research also showed that the growth of micro-organisms was responsible for spoiling beverages, such as beer, wine and milk. With this established, he invented a process in which liquids such as milk were heated to kill most bacteria and molds already present within them. He and Claude Bernard completed the first test on April 20, 1862. This process was soon afterwards known as pasteurization.  Because of his study in germs, Pasteur encouraged doctors to sanitize their hands and equipment before surgery. Prior to this, few doctors or their assistants practiced the procedure of washing their hands and equipment.

Border Health Partnerships

July 12th, 2011

A few weeks ago I blogged about the June plenary session of the Arizona Mexico Commission called Arizona & Sonora: Gateway for Innovation.  The conference provided an opportunity to move forward a bi-national agenda supported by Arizona and Sonora.  The health committee discussed regional approaches to valley fever surveillance, burn patient infrastructure, substance abuse, TB, border first aid services and Sonora’s upcoming efforts to provide licensing and quality assurance services for assisted living in Sonora (and how we can partner with them as they set up their program).

 A couple of weeks ago I was in Washington DC working on another border partnership called the US-Mexico Border Health Commission.  The Commission was created in July 2000 and is comprised of the federal secretaries of health, the health officers of the 10 border states and appointed community health professionals from both nations. The Commission provides a unique opportunity to bring together the two countries and its border states to solve border health problems.

 Each year the Commission establishes strategic objectives.  This year’s priority areas include TB, physical activity and nutrition, infectious disease and public health emergencies, access to care, data collection, and academic alliances.  We develop action items for each of the strategic objectives.  Through the Commission, each of our border states are able to directly communicate with our respective federal agencies so that we can better align federal priorities with our border strategic objectives.  A couple of weeks ago we were able to meet with several sub-cabinet agency decision-makers as well as several members of the House of Representatives and made real progress toward synchronizing federal policy with our strategic objectives for the border.

Arizona Mexico Commission

June 4th, 2011

The Arizona Mexico Commission was started by then Arizona Governor Paul Fannin in 1959 to improve partnering between Arizona and Sonora in a wide range of areas.  It’s evolved over the years to become a premiere and unique cross-border nonprofit organization whose mission is to improve the well-being and quality of life for residents of Arizona by promoting a strong, cooperative relationship with Mexico and Latin America through advocacy, trade, networking and information.  The Commission has 14 bi-national committees that act as industry and community advocates in partnership with the Commission Sonora-Arizona (from Sonora, Mexico) to facilitate cross-border trade, business and community networking and binational information sharing.  Our link is through the Health Services Committee. 

This week we kicked off this year’s plenary session called: Arizona & Sonora: Gateway for Innovation.  The three-day conference is an opportunity for attendees to get more involved and maximize their exposure to the bi-national agenda supported by both states.  The health committee will be discussing regional approaches to valley fever surveillance, burn patient infrastructure, substance abuse, TB, border first aid services and Sonora’s upcoming efforts to provide licensing and quality assurance services for assisted living in Sonora (and how we can partner with them as they set up their program).

New TB Diagnostic Test on Horizon?

September 29th, 2010

One of the major challenges for global control of tuberculosis is that the current diagnostic tests are very slow and can require significant laboratory infrastructure.  The tests are particularly difficult to manage in developing countries and are more complicated for folks with HIV.  It’s also difficult to test for drug sensitivity.   The challenge is that early detection is essential to interrupt transmission.

However, a new rapid (2-3 hour) test may be on the horizon.  Researchers published an article in the New England Journal of Medicine this month that demonstrates promising results.  The new test (called MTB/RIF) correctly identified more than 98% of patients with “smear-positive tuberculosis” and 72% of patients with “smear-negative tuberculosis”.  The test also have very few false positives.  Importantly, the new MTB/RIF test correctly identified (97%) of patients that had rifampin-resistant or -sensitive TB.  More work will need to be done before the test replaces the current slow and labor intensive tests, but these are encouraging results that could provide a valuable new tool in the global TB fight.

The 2010 Infectious Disease Training and Tabletop Exercise

August 13th, 2010

was held at ASU July 27th -29th.  This is the first time that we have brought together all of the fields of infectious disease including HIV, TB, STDs, Vector-borne Disease, Foodborne Disease and Invasive Bacterial Infections in a unified training.  The training:

  • Had almost 300 attendees from across the state, including physicians, nurses, sanitarians, local health department staff, and public health partners.
  • Was conducted at ASU without a facility charge
  • Had speakers from agencies nationwide, including FDA, USDA, Fry’s, CDC, and Universities in two states (Iowa and New Mexico)
  • Demonstrated great collaboration across areas to provide valuable information to our partners
  • Received great reviews from participants
  • Provided professional continuing education credit
  • Accomplished inexpensively through collaboration with partners, internal team work and creative thinking.