Anthrax on the Loose

CDC Employees Exposed to Deadly Bacteria

On June 19, 2014, the CDC announced that about 75 Atlanta based staff may have been exposed to life Bacillus anthracis, or anthrax, the deadly bacterial spores which were used as weapons of biological terrorism is 2001. The number of exposed staff has since been increased to 84, with 7 at increased risk because they had more direct exposure to the spores.

Bacillus anthracis Picture courtesty of PBS

bbc anthrax

Responders to CDC Anthrax Release Courtesy of BBC

B.anthracis is a spore-forming, gram positive bacillus, which when inhaled carries a high mortality. The spores can enter the body cutaneously, enterally, via injection or via inhalation. Patients with inhalation anthrax will present with fever, chills, headache, chest pain, cough and difficulty breathing, and will require hospitalization even though they may not appear critically ill. These patients are susceptible to sudden decline and hemodynamic monitoring should be initiated. Chest CT and CXR will show characteristically widened mediastinum and pleural effusions.

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A Whooping Shame: Pertussis Epidemic in California & Inside the Anti-Vax Mind

Pertussis Epidemic affecting California and much of the US

Another day, another vaccine-preventable illness is on the rise. I described the current measles outbreak in an earlier post , and so that we do not run of out diseases to discuss, a new one has recently captured media attention. So far in 2014, 3,498 cases of Whooping Cough, or Pertussis, have been reported in California – more than all that were reported in 2013,  Nationally, 24% more cases have been reported than in January to April 2013. Pertussis outbreaks occur cyclically, peaking every 3-5 years, with the last peak in 2010. A vaccine-preventable disease, Pertussis infection begins as a cold-like illness associated with mild cough and fever. Within 1-2 weeks, however, the severe, characteristic cough begins and can continue for weeks. Infants, however, may not cough, but may suffer from dangerous fits of apnea, or pauses in breathing. In vaccinated children the symptoms’ duration and severity is lessened. The CDC’s website further describes the disease characteristics.

CDC State Pertussis Reporting

Pertussis cases in California

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Major Earthquakes of 2013: One Year Later

Baluchistan Province, Pakistan

On September 24, 2013 a 7.8-magnitude earthquake devastated the Baluchistan province of Pakistan, causing at least 348 deaths and leaving thousands more homeless and injured. Aid groups and members of the Pakistani military struggled to reach people in some of the most heavily affected areas – including the Awaran and Kech districts – where early reports estimated that at least 21,000 houses had been damaged. Despite dispatching teams with medical aid and necessities such as food and water, officials from the Pakistani military confirmed that the sparsely populated and remote region with an underdeveloped communications and transportation infrastructures made delivering aid in an expeditious fashion a challenge.


(photo courtesy of

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Deadly Ebola Virus Ravaging Africa

Severe Pandemic in West Africa

A deadly pandemic has been brewing in western Africa since December 2013. This latest outbreak of the deadly Ebola Virus Disease (EVD) began in the Republic of Guinea and then spread to Sierra Leone and Liberia. To date, 344 suspected and confirmed cases of EVD have been reported in Guinea, 112 in Sierra Leone, and 13 in Libera. Since emerging in 1976 in Sudan and Congo, EVD outbreaks have occurred 33 times.

Courtesy of the CDC

Courtesy of the CDC

Spread of Ebola, Courtesy of Relief Web International

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Measles: Highly Contagious Disease Reaches New Epidemic Levels

Measles is Back and it’s Entirely Our Fault

If you haven’t heard by now, the measles virus is on the rise in the United States. As of May 23, 2014, 288 cases have been reported in 18 states with 15 distinct outbreaks making up 79% of the reported cases this year.

CDC Measles Cases and Outbreaks 2014

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Global Vaccine Programs: Health Security not National Security

White House Responds to Plea from Public Health Schools

In January 2013, deans from 13 schools of public health sent a letter to the White House declaring that it was dangerous and unethical to use public health workers for military intelligence gathering of any kind. This concern was prompted by the discovery that the Central Intelligence Agency (CIA) used a sham vaccination campaign against Hepatitis B in 2011 to gather DNA samples in Pakistan for the purpose of finding Osama bin Laden’s hiding compound.

After the fictitious campaign was discovered, the fragile trust that public health workers had managed to build, particularly those providing vaccines, was completely shattered in Pakistan and elsewhere. The Taliban banned health workers, villagers kept them away from their children, and some volunteers were even killed out of fear that they were spies or were attempting to sterilize young girls.

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Hurricane Season: Protecting the Most Vulnerable Populations

“Where are we going to go?”

I remember sitting in my living room as my parents debated our options. It was September 2005, just months after Hurricane Katrina ravaged the Louisiana shoreline, sending thousands of evacuees into Houston. The local meteorologist had made his proclamation: my zip code was located in Evacuation Zone B, meaning it was recommended we evacuate in the event of a Level 3 Hurricane. At the time, Rita was projected to well-surpass that rating.  I will never forget the fear I felt in the pit of my stomach as I helped my family move our furniture, valuable documents, and photo albums onto the second floor of our home. I was instructed to pack some clothes and whatever treasured items would fit into my small suitcase. We packed our bags, along with an estimated 3.7 million of our neighbors throughout the Houston area and Texas Coast. In the end, though Rita ended up veering eastward and sparing my family home, many weren’t so lucky. While the process of evacuating was frightening and painful (it took us over 24 hours to make the drive from Houston to the home of a friend-of-a-friend in Dallas), we were fortunate to have the resources to make the trip.

The price of emergency preparedness is much more difficult for many of our society’s most vulnerable to bear. As the 2014 Hurricane season begins June 1st, it is important to consider how to ensure all segments of the population are adequately prepared.

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California Fires: State Prepares for Unprecedented Wildfire Season

In California, 2014 has been the year of historic & devastating wildfires. Over the past week, nearly 5,000 firefighters have battled ten wildfires that have swiftly moved across San Diego County resulting in 176,000 evacuation notices and nearly $20 million in damages. Early reports note that this wildfire season has been more devastating than previous ones with nearly twice as many fires as the average number of fires over the past five years. These fires have required at least two dozen water trucks and bulldozers, four air tankers and at least twenty-two military helicopters to be contained and have damaged an estimated 25,000 acres of land.

Cal wildfire image

(courtesy of National Geographic)

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Los Angeles Urban Oil Spill: More than a Sticky Situation

On Thursday May 15th, the Los Angeles Fire Department (LAFD) was called  to respond to a 10,000 gallon crude oil spill at 5175 W San Fernando Road after an above-ground pipeline break that sprayed oil 20 feet into the air and onto the neighboring businesses, while fumes spread for miles.

LAFD Hazardous Materials (HAZ-MAT) teams worked to contain the runoff using sand from a local concrete company and built a 2.5ft high x 30ft wide lagoon of oil that was then suctioned off the road by vacuum trucks. Absorbents were used to soak up the remaining crude oil, and the asphalt and building were given a power-soak with high pressure water and soap solution. Luckily, no oil entered the L.A. River storm drains.


LA Response Worker - picture courtesy of USA Today

LA Response Worker –
picture courtesy of USA Today

LA Response Worker - picture courtesy of USA Today

LA Response Workers –
picture courtesy of USA Today

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Balkan Flooding: Worst Torrential Disaster in Region’s Recorded History

Monumental flooding from three months worth of rain falling a in few days in Serbia, Bosnia-Herzegovina, and Croatia has caused more than 40 deaths and the evacuation of more than 500,000 people.  There are also concerns that thousands of people are trapped in buildings without power or communication.


In the largest amount of flooding since the country started maintaining records 120 years ago, the River Sava has reached 6.3 meters (20.7 feet) and has flooded the town of Obrenovac, approximately 35 kilometers (22.7 miles) southwest from the capital of Belgrade.  Near Obrenovac is the Nikola Tesla power plant complex that supplies nearly half of the country with coal-generated electricity.  The flooding threatens to leave millions of people in Serbia without power.  Along the river’s path, residents of another 11 towns have been ordered to evacuate. Along the Danube River, a thermal power plant in Kostolac that supplies 20% of the nation’s power also confronts significant water damage, and workers are attempting to protect it with sandbags.  An estimated 300,000 people are without safe drinking water and electricity.  

serbia map

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