New Lab Matters: Time to welcome the next generation of public health laboratory scientists

New Lab Matters: Time to welcome the next generation of public health laboratory scientists | www.APHLblog.org

The Bureau of Labor Statistics estimates that 12,000 new laboratory professionals are needed each year to meet consumer demand. At the same time, while automation has eliminated some less-skilled laboratory jobs, the growing sophistication of public health laboratory analyses has generated demand for scientists with highly specialized training. As our feature article shows, laboratories are recruiting new talent for the “hidden profession” by taking a hard look into what they really want, and how they want to work.

Here are just a few of this issue’s highlights:

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Watch rising river levels after Hurricane Florence

Hurricane Florence brought a lot of rain, which in turn made river levels rise. The New York Times animated the rise over a five-day period. The height of the bars represents the rise of the river level, as compared to levels on Thursday.

I like the visual metaphor of bars going up with river levels. I’m not sure the sudden rise and falls in such short periods of time would appear as surprising.

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Turning water pollution into audiolized awareness

Brian House collected polluted water with acid mine drainage in the Tshimologong Precinct, Johannesburg and translated pollution levels to sound:

Acid Love comprises vessels of AMD gathered from a mine on the outskirts of the city. These are connected in an electrical circuit that measures the conductivity from the metals of the water and coverts it into sound. The sound is further modulated by data gathered from remediation efforts at the mine. The installation itself also performs a remediation process—over time the metals will precipitate to the bottom of the vessels, and both the sound and the color of the water will change as it is purified.

[via @blprnt]

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A transforming river seen from above

The Padma River in Bangladesh is constantly shifting its 75-mile path. Joshua Stevens for the NASA Earth Observatory shows what the shifting looked like through satellite imagery, over a 30-year span.

Kasha Patel:

The upper section of the Padma—the Harirampur region— has experienced the most erosion and shows the most notable changes. The river has become wider at this section by eroding along both banks, although most activity occurred on the left bank. Using topographic, aerial, and satellite imagery, scientists found that the left bank shifted 12 kilometers towards the north from 1860 to 2009 and developed a meandering bend. The river left a scar where the water once flowed, as you can see in the 2018 image.

See also the dramatic shifts of the Ucayali River in Peru.

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Why Diarrhea & Swimming Don’t Mix

 

Kids by PoolThe summer swim season is here, and millions of Americans will be flocking to local pools for fun in the sun and exercise. However, swimming, like any form of exercise, does not come without health risks. The good news is that we can all take a few simple but effective steps to help keep ourselves and other swimmers we know healthy and safe.

While sunburn and drowning might be the health risks that first come to mind when you think about swimming, diarrhea is another culprit. Outbreaks of diarrheal illness linked to swimming are on the rise. And this Healthy and Safe Swimming Week, we want to make sure you know these important facts about diarrhea-causing germs at aquatic venues, like swimming pools and water playgrounds, and how to protect yourself and loved ones.

  1. When swimmers have diarrheal incidents in the water, they release diarrhea-causing germs into the water. For example, a swimmer infected with the parasite Cryptosporidium can release 10–100 million infectious germs into the water. Swallowing 10 or fewer Cryptosporidium germs can make someone sick.
  2. Don't leave your mark at the pool this summerSome diarrhea-causing germs can survive in properly treated water for days. Standard levels of chlorine and other disinfectants can kill most germs in swimming pools within minutes. However, Cryptosporidium has a tough outer shell and can survive for up to 10 days in properly treated water. Outbreaks of diarrhea linked to pools or water playgrounds and caused by the parasite Cryptosporidium have doubled since 2014.
  3. Swim diapers won’t keep diarrhea out of a pool. Using swim diapers might give parents a false sense of security when it comes to containing diarrhea. Research has shown that swim diapers might hold in some solid feces but these diapers only delay diarrhea-causing germs, like Cryptosporidium, from leaking into the water by a few minutes. Swim diapers do not keep these germs from contaminating the water.
  4. Don’t swallow the water you swim in. Swallowing just a small amount of water with diarrhea germs in it can make you sick for up to 3 weeks.
  5. Don’t swim or let your kids swim if sick with diarrhea. We all share the water we swim in. Do your part to help keep loved ones healthy by not getting in the water if you or your children have diarrhea.

CDC’s Michele Hlavsa is a nurse and the chief of CDC’s Healthy Swimming Program. As a parent, it is important for her to know how to protect her children from not only diarrhea, but all types of germs and injuries linked to swimming. Michele encourages swimmers to follow a few easy and effective steps each time they swim in a pool or get in a water playground this summer and year-round.

 

After Matthew: The Hidden Dangers of Hurricanes

Fallen trees and damaged electrical power lines blocking a road; hazards after a natural disaster wind storm

The thrashing winds have died down. Relentless rain has ceased. The clouds have cleared and the sun is shining. But this is no time to let your guard down.

Last week, Hurricane Matthew pounded its way through the Caribbean before bearing down on the eastern U.S. coastline from Florida to North Carolina. Many lives and homes were tragically lost. But not all of the death and destruction happens during the storm itself. The aftermath is a treacherous time, with still-rising floodwaters, power outages, breaks in healthcare services, and increased risks for injury or illness. The mental and physical toll of a hurricane continues to mount even as it dispels and fades off into the ocean. We must remember that, although the storm has passed, danger remains present.

Beware of rising waters

After the rain ends, it can take days for rising rivers and streams to crest, or reach their highest point. This means that homes and roads that are not underwater at the end of the storm may be flooded in the days following.

In North Carolina, Matthew dumped 6 to 18 inches of rain, causing flooding that rivaled or surpassed that of Hurricane Floyd in 1999. But much of the water damage didn’t happen right away. Even as rescue and recovery efforts began, the state’s rivers continued to swell and overflow their banks, creating a second wave of destruction.

Driving on water-covered roads or through flooded areas can leave you hurt or stranded – or worse. Help may not be able to reach you right away if you get stuck, and you won’t be able to see hazards like debris or sinkholes in your path. Avoid driving through flooded areas, especially when the water is fast moving. As little as six inches of water can cause you to lose control of your vehicle.

Avoid risks during power outagesAre you prepared? infographic

Hurricane Matthew knocked out power to millions of homes and businesses. People die from carbon monoxide poisoning after a hurricane or other disaster when trying to generate power, keep warm, or cook using gasoline or charcoal-burning devices. The carbon monoxide (CO) these devices produce is a silent killer – you can’t see it or smell it. To avoid being a victim, always use generators, grills, camp stoves, or other gasoline or charcoal-burning devices outdoors, and keep them at least 20 feet away from any windows, doors, or vents. Use a battery-powered carbon monoxide detector to alert you to any CO in your home.

Power outages can also result in injuries or deaths from fires. If the power is out, try to use flashlights or other battery-powered lights instead of candles. If candles are all you have, place them in safe holders away from anything that could catch fire, and never leave them unattended.

Drink safe water, eat safe food

After a hurricane, it’s important that the water you drink and food you eat is safe. Spoiled food or dirty water can make you and your family sick. Listen for water reports from local authorities to find out if your water is safe for drinking and bathing. If an advisory has been issued concerning contaminated water, use only bottled, boiled, or treated water for drinking, cooking, preparing food, and washing your hands. To keep from getting sick, throw away any food, drinks, or bottled water that may have come in contact with flood or storm water, or any food that has been in the refrigerator if you have been without power for more than four hours.

Stay healthy in shelters

Shelters keep you safe while you wait to return to your home, but can also present some health risks. Illnesses can erupt and spread quickly, which is why CDC and other organizations send experts after a hurricane like Matthew to watch for any sign of an outbreak. It can also be harder to manage chronic illnesses while you’re in a shelter, especially if you need medications or special supplies to care for yourself or your loved ones. Keep extra copies of your prescriptions in case of an emergency.

Home safe home

Be sure to wait to return home until authorities say it is safe to do so. Returning to your home after the storm can present a whole new set of dangers, including downed power lines, flooded roads, and the difficult work of cleaning up. Remember, never touch a downed power line or anything in contact with them. Use chainsaws safely, and wear safety gear like a hard hat, safety glasses, ear plugs, thick work gloves, and boots as you make repairs.

If your home has been affected by flooding, follow these guidelines for safe cleanup after disasters. People with certain health conditions should not take part in the cleanup, and everyone should be careful to use the proper protective equipment. Any items that cannot be washed and cleaned should be removed from the home. Any drywall or insulation that has been contaminated with sewage or flood waters should be removed and discarded. You may want to take photos or hold onto items for which you’ll be filing an insurance claim.

Look around your home and drain any standing water. Standing water after a hurricane or flood is the perfect breeding ground for mosquitoes. Use insect repellant and consider staying indoors at dawn, dusk, or in the early evening when mosquitoes are most active.

Take care of your mind and heart

The mental and emotional effects of a disaster like Matthew can linger even months or years afterward. Be prepared to cope with feelings of fear, grief and depression. “Loss and displacement are some of the most stressful situations we face in our lives,” says CDC behavioral scientist Ruth Perou, PhD. “Even briefly being in a shelter can be very hard.”

Remember to take care of yourself. Try to get 6 to 8 hours of sleep, eat regular meals, and exercise as much as you can. ”The best thing you can do,” says Perou, “is get back to some sort of routine as quickly as possible, especially for children.”

Stress and feeling overwhelmed are normal and expected reactions to any sudden change. Reach out to family and friends, and talk to others in your community about your worries. Let your child know that it’s okay to feel upset when something bad or scary happens. Coping with these feelings and getting help when you need it will help you, your family, and your community recover from a disaster.

The Substance Abuse and Mental Health Services Administration (SAMHSA) Disaster Distress Helpline is available 24 hours a day, 7 days a week. Trained counselors are ready to answer any questions or help cope in the aftermath of Hurricane Matthew and other disasters. To connect with them, call 1-800-985-5990 or text TalkWithUs to 66746.

Small Changes, Big Dividends: A Global Look at Preparedness

Soumbedioune fish market in Dakar, Senegal

Dr. Stephen Redd, Director, Office of Public Health Preparedness and Response
Dr. Stephen Redd, Director, Office of Public Health Preparedness and Response

There’s a big difference between seeing something in a picture and experiencing it in 360-degree reality, saturated with sounds and smells. In the summer of 1987, I traveled to Senegal for three weeks. This was the first time I had really traveled and seen firsthand what the rest of the world was like.

In Dakar, fishermen brought their catches to beach on the edge of town. An open sewer drained directly into the ocean almost in the middle of where the fishermen landed their boats. In addition to the smells, that sewer pipe seemed guaranteed to make people sick. It also seemed that something simple, like moving the drain, could prevent illness. It might have been a naïve idea, but it struck me that there were many opportunities to make small changes that would improve people’s health.

Many of us came to public health because, at some point in our life, we had a similar realization. As a clinician, treating one patient at a time undoubtedly helps people and is rewarding, but working to protect and benefit the community as a whole can provide larger-scale benefits.

Preparedness at the forefront

This is why I’m passionate about being prepared. When an emergency hits, having trained people who know what to do, and having the resources in place to allow them to do their jobs, saves lives. And – as we have seen all too clearly – a lack of preparedness can turn an outbreak into an epidemic, or a natural disaster into a crucible for infectious disease.

Planning ahead and being ready are the most critical things we can do to keep people safe. The world recognizes this, which is why countries have signed international agreements like the International Health Regulations and the Global Health Security Agenda that commit them to being prepared for a public health emergency. We have a long way to go, but we have a clear roadmap for what needs to be done.

And, here in the U.S., we are doing our part to fulfill our obligation to the global community. Recently, we invited a team of international experts to evaluate the ability of the U.S. to prevent, detect, and respond to public health threats. Looking at 19 different areas, they gave us feedback on where we are succeeding, and where we can do better. We will use the results of their report as we continue to build on our expertise.

Knowledge benefits everyone

The benefits of improving our expertise are twofold: not only do we protect ourselves, but we gain knowledge that we can share across the globe as other countries build their capabilities to respond to health threats. We are doing this every day.

CDC’s efforts in developing our Emergency Operations Center provide a great example. What we’ve learned is that the most important investment a country can make is having highly trained people at the ready. When people know what to do, a conference room and a few computers is all it takes to coordinate a response that can mitigate disaster and save lives.

CDC is able to share this kind of information with partners in countries around the world who may not have the resources to do everything at once. From working with Kenya on how to regulate the labs that handle the world’s deadliest germs and poisons, to working with Cameroon and Ethiopia on how to manage an emergency stockpile of medicines, we are helping others learn from our experience, and also learning from them as we go.

We are all connected

Our connection to other countries is more important than ever. As we help build capacity across the globe, we also protect our health here at home. We have to think globally as we build the knowledge we need to prepare for, and respond to, emergencies.

We must keep in mind that, somewhere in the world, there is a draining sewer that might be ground zero for an outbreak. And, somewhere, there is a conference room we could fill with trained responders to help stop it.

Read our other National Preparedness Month blogs:

Danger in the Water: When Algae Becomes Toxic

NYDOH-bloom2_banner

Ever wondered what’s causing the water in your favorite lake to turn red?  Or were the family photos from your river rafting trip spoiled by brown water in the background?

You may be looking at an algal bloom. Summer is upon us and warm weather is the perfect environment for these algal blooms, which can cause a range of problems, from simply being an eyesore to becoming a harmful algal bloom (HAB) that can make people and animals sick or damage local environments.

So, what is an algal bloom?

Red algal bloomAlgae are plant-like organisms that come in a variety of shapes and sizes – ranging from microscopic to large seaweed that may be over 100 feet long. Algae are found all over the planet, and can live in sea water, fresh water, and brackish water (a combination of fresh and sea water). Algae are vitally important building blocks of the food chain and ecosystem.

Algal blooms occur when there are overgrowths of algae, including green, brown, or red microalgae, or cyanobacteria that are commonly referred to as blue-green algae.

Not all algal blooms are harmful; however, when there is fast growth of algae and cyanobacteria that can harm people, animals and the environment, they are referred to as harmful algal blooms (HABs). HABs can produce toxins that are harmful to people and animals. The algae and cyanobacteria also reduce the levels of oxygen in the water when they decompose, and these lower oxygen levels may kill other plants and animals in the water.

Can HABs make you sick?

If people and animals are exposed to the toxins produced by HABs through water, food, or air they may experience symptoms that can range from mild to severe. These symptoms may affect the skin, stomach and intestines, lungs, and nervous system.

You may be exposed to HABs while enjoying outdoor recreational activities, while working near a body of water with a HAB, or from drinking water or food that has been contaminated.

  • Between 2009 and 2010, three states reported 11 outbreaks associated with HABs after people were exposed to freshwater in a recreational setting. These accounted for nearly half of all reported outbreaks associated with untreated recreation water that year.
  • Between 2007 and 2011, 273 people became sick after eating food that was contaminated as a result of a HAB. These illnesses were reported after people ate fish or shellfish contaminated with HAB toxins.

Are HABs increasing?

There is evidence that HABs are occurring more often, and that they are becoming more severe due to climate change, farming practices, and storm and wastewater runoff.  It is important to identify when and where HABs occur in order to protect water and food supplies, and to let people know when there may be a problem in their community.

CDC and partners have created the One Health Harmful Algal Bloom System for state and territorial public health partners to report cases of human and animal illness after being exposed to a HAB and environmental data about HABs. Data about the number of people and animals who get sick from HABs, the symptoms they experience after exposure, and where HABs occur is important to understand and prevent HABs and HAB-associated illnesses.

Learn more about HABs from CDC’s Harmful Algal Bloom-Associated Illness website.

Protecting the Air We Breathe: A deeper look at Legionnaires’ disease

Medical illustration of Legionella pneumophila

CDC scientists discovered Legionnaires’ disease in 1976, during one of the largest respiratory disease investigations in U.S. history. CDC’s disease detectives were called upon when people became sick with pneumonia, a serious lung infection, while attending an American Legion convention at a hotel in Philadelphia. Findings from the investigation suggested that a germ was being spread by the hotel’s air conditioning system.  Six months later, CDC scientists identified that germ.  It was a previously unknown bacteria, which they named Legionella.

Legionnaires’ disease is on the rise

Legionnaires’ disease is caused by breathing in small water droplets that are contaminated with Legionella germs. In 2015, about 5,000 people were diagnosed with Legionnaires’ disease and in recent years there have been at least 20 reported outbreaks. Most people who get sick need hospital care and make a full recovery; however, about 1 in 10 people will die from the infection.

Between 2000 and 2014, the number of people with Legionnaires’ disease grew by nearly four times. This increase is likely due to a number of factors, including:

  • A greater number of people who are at risk for Legionnaires’ disease because of an underlying illness or medications that weaken the immune system
  • An aging U.S. population, with adults over the age of 50 being at a higher risk of getting the disease
  • An outdated plumbing infrastructure, which allows for Legionella to grow in the pipes

Outbreaks of Legionnaires’ disease are preventable9 in 10 CDC investigations show almost all outbreaks were caused by problems preventable with more effective water management.

CDC investigations of Legionnaires’ disease outbreaks show that the most common places for getting the disease are hotels, long-term care facilities, and hospitals.  The most likely sources for spreading water droplets contaminated with Legionella germs are showers and faucets, cooling towers that are part of large, centralized air conditioning systems, hot tubs, and decorative fountains and water features.

Four different types of problems have been associated with Legionnaires’ disease outbreaks. In nearly half of these outbreaks, more than one of these problems was identified.

  • Process failures, such as not having a Legionella water management program
  • Human errors, such as a hot tub filter not being cleaned or replaced as recommended by the manufacturer
  • Equipment breakdowns, such as a disinfection system that was not working
  • Changes in water quality that were due to reasons external to the building itself, such as nearby construction

Building owners and managers need to take steps to reduce the risk of Legionnaires’ disease through effective water management. It is important for everyone to work together to lower this risk by reducing the growth of Legionella in buildings and limiting places where people can be exposed.

This July marks the 40th anniversary of the convention of the American Legion in Philadelphia.  This anniversary serves as a reminder that implementing effective water management programs in buildings could go a long way toward reducing the risk of Legionnaires’ disease.

Learn more about Legionnaires’ disease in this month’s issue of Vital Signs: www.cdc.gov/vitalsigns/legionnaires

Zika, Mosquitoes, and Standing Water

Zika, Mosquitoes, and Standing Water

With spring weather and mosquito season coming soon in the United States, the Zika virus – and the mosquitoes that carry the virus – may be a major concern. Zika is currently affecting more than 30 countries and territories in the Americas and Pacific Islands. Zika virus is primarily spread through the bite of an infected Aedes aegypti mosquito. People and communities can take steps to reduce the number of mosquitoes in their homes and communities to protect themselves from Zika.

How Does Water Help Mosquitoes Breed?

Aedes aegypti is known as a “container-breeding mosquito” because it likes to lay eggs in and around standing water. Studies show that female mosquitoes prefer to lay eggs in water that collects or is stored in manmade containers.

Water-filled bioassay trays were used to attract resident female mosquitos to deposit their eggs, where they hatched, and from which the larvae were collected.Aedes aegypti mosquitoes lay eggs on the walls of water-filled containers. Eggs stick to containers like glue and remain attached until they are scrubbed off. The eggs can survive when they dry out—up to 8 months. When it rains or water covers the eggs, they hatch and become adults in about a week.

Reduce mosquitoes at home

Here are a couple of steps you can take to prevent mosquitoes from living and breeding around your home.

Remove standing water

Keep mosquitoes from laying eggs inside and outside of your home. Items in and around people’s homes can collect water. Once a week, empty and scrub, turn over, cover, or throw out containers that hold water, such as

  • Vases
  • pet water bowls
  • flowerpot saucers
  • discarded tires
  • buckets
  • pool covers
  • birdbaths
  • trash cans, and
  • rain barrels.

These actions can help reduce the number of mosquitoes around areas where people live.

Follow safe water storage tips

If water must be stored, tightly cover storage containers to prevent mosquitoes from getting inside and laying eggs.

Reduce mosquitoes in the community

Communities also can take steps to reduce the number of mosquitoes and the chances of spreading disease.

Build systems that distribute safe water

If people have access to clean and safe water in their communities, they will not need to store it in and around their homes. Research has shown that when community-wide distribution systems are built, the number of mosquitoes decreases, because water is not being stored near areas where people live.

Improve sanitation

When water is contaminated with organic matter (for example, human or animal waste, grasses, and leaves), the chances that mosquito larvae will survive may increase because contaminated matter provides food for larvae to eat. Sanitation departments and wastewater treatment plants remove organic wastes and treat water with chlorine or other disinfectants. These activities may decrease mosquito populations and, simultaneously, prevent diarrheal diseases.

*Basic sanitation includes access to facilities for the safe disposal of human waste, and the ability to maintain hygienic conditions, through services such as garbage collection, industrial/hazardous waste management, and wastewater treatment and disposal.

Water, sanitation, and hygiene* (WASH) are critical to keep people healthy and prevent the spread of many different disease, including Zika. World Water Day recognizes the importance of safe drinking water and improved sanitation and hygiene in the health of our world’s population.

Learn more about World Water Day at www.unwater.org/worldwaterday and visit www.cdc.gov/healthywater/global for more information about CDC’s efforts to ensure global access to improved water, sanitation, and hygiene.

For more information on the Zika virus, and for the latest updates, visit www.cdc.gov/zika.