A Look Back at the New Hampshire Hepatitis C Outbreak

May 16 2013 :: Published in Infectious Diseases

By Celia Hagan, Manager, HIV, Hepatitis, STD, TB Programs, APHL

A Look Back at the New Hampshire Hepatitis C Outbreak | www.aphlblog.org

People often associate hepatitis with intravenous drug use or getting tattoos or piercings at dirty parlors.  They think it’s something that can’t happen to them. However, recent health-care associated outbreaks in Oklahoma and New Hampshire show that hepatitis is something that we all need to be aware of.  The New Hampshire case, in particular, demonstrated how a rapid public health response can identify a hepatitis C outbreak and stop transmission.

In the spring of 2012, the New Hampshire Department of Health and Human Services, Division of Public Health Services began investigating a cluster of four people who were recently diagnosed with hepatitis C and who had been treated at the same hospital. The public health laboratory initially coordinated blood draws and performed hepatitis C virus (HCV) testing. Additionally, the public health lab performed DNA sequencing on the non-structure 5B region of the HCV genome to subtype the virus and sequenced the hypervariable region 1 of the HCV genome to determine if individuals who were infected were part of the same outbreak. When sequencing was performed on the initial cluster, the four individuals had matching HCV viral sequences indicating a common source of infection.

As the outbreak unfolded over the next few weeks, mounting evidence suggested that the mode of transmission was a drug diversion by a cardiac catheterization laboratory technologist at Exeter Hospital. The technician is accused of stealing Fentanyl syringes intended for patients, injecting his own arm, refilling the empty syringes with a saline solution, and returning the used syringes as if they were untouched. Those dirty needles were then used on patients.

Dr. Christine Bean, New Hampshire’s public health laboratory director, and Dr. Fengxiang Gao, New Hampshire’s public health laboratory virology and special testing program manager, said that in the initial phase of the investigation, where the primary concern was focused on testing patients who received care at the cardiac catheterization laboratory of Exeter Hospital, the laboratory tested 1,072 specimens. This was well over their normal testing volume of about 200 specimens per month. All testing was performed at the public health laboratory and positive specimens were sent to CDC for additional testing.  When the investigation expanded to other units in the hospital that the technician had access to, an additional 3,300 patients needed testing. Community testing centers were set up to assist with rapid blood draws. In addition to the routine testing done at the public health laboratory, the clinics offered rapid HCV testing on site and also trained sentinel laboratories on rapid testing to help with the volume. Ultimately, 32 patients were identified as part of the NH outbreak, in addition to the infected technician. As the outbreak investigation expanded to include other states where the technician had previously worked, additional cases were found.

The Molecular Diagnostics group at New Hampshire's Public Health Laboratory. This group did the hepatitis C (HCV) sequencing during the 2012 outbreak to determine the HCV subtype and HCV genetic relatedness. | www.aphlblog.com

The overall response to the outbreak from the laboratory was phenomenal.  Quick detection may have prevented additional infections. Dr. Bean emphasized that their success in responding to the outbreak depended on a strong public health laboratory system—the public health laboratory and epidemiologists working together and the public health laboratory’s capability and capacity to perform both serology and molecular tests for HCV.

In the May 10, 2013 issue of MMWR, CDC released Testing for HCV Infections: An Update for Guidance for Clinicians and Laboratorians. The updated guidelines emphasize identifying persons with current HCV infections as opposed to those who have had past infections that have been resolved and encourage laboratories to utilize newer testing technologies. The new recommended testing sequence includes an initial test with an FDA-approved test for HCV antibodies, followed by an FDA-approved nucleic acid test (NAT) intended for the detection of HCV RNA in serum or plasma if the initial serology assay is reactive.

May 19, 2013 marks the second National Hepatitis Testing Day during a month that is already dedicated to raising the awareness of viral hepatitis. The day is committed to testing people at risk for hepatitis and to educating providers and the public about chronic viral hepatitis and testing.

To find a Hepatitis Testing Event near you or to register your event, click here.

 

 

 

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Arsenic in our Food (and Public Health Laboratories)

May 09 2013 :: Published in Environmental Health

By Surili Sutaria, senior specialist, Environmental Health, APHL

Over a year ago consumers expressed outrage following a Dr. Oz episode on arsenic levels in apple juice. The episode highlighted a Consumer Reports study that drew attention to arsenic in rice. The media coverage underscored that food and beverages represent the largest source of arsenic exposure for most Americans, yet arsenic is currently only regulated in drinking water.

Apple juice

Arsenic in drinking water comes either from naturally-occurring sources in the soil or from agricultural or industrial byproducts. For health reasons (arsenic is a well-known poison), the U.S. Environmental Protection Agency set a maximum contaminant level of 10 parts per billion for inorganic arsenic.

You may have noticed the reference to inorganic arsenic, which is one of the three forms of arsenic. The inorganic form of arsenic, created when arsenic combines with elements other than carbon, is potentially harmful to humans. Exposure to inorganic arsenic increases the risk for bladder, kidney, liver, lung and skin cancers. But there are limitations to this knowledge, such as at what concentration and over what period of time is arsenic considered harmful to humans. Although the type of arsenic predominately found in foods is organic, the World Health Organization states that some common foods in our diet (like rice, juices and vegetables) do contain inorganic arsenic.

The U.S. Food and Drug Administration’s deputy commissioner for foods, Michael Taylor, stated that the agency’s ongoing data collection and analysis aims to provide a basis for determining action to reduce exposure to arsenic in foods. Still, though, concerns escalate as consumers realize that infant foods such as rice cereal and some formulas contain potentially-contaminated rice. The lack of understanding of the science has prompted both the public and the media to demand action.

How can my state or local public health laboratory take action?

Public health laboratories have the technology and the knowledge to test for arsenic in drinking water, food and people, and to potentially help answer questions being raised by the media. This testing capability is largely due to CDC’s investment in chemical threat preparedness at the state and local levels. Funded laboratories looking to use their instruments more fully may consider biomonitoring – a tool used to assess people’s exposure to chemicals and toxic substances in the body – as an option. This dual-use opportunity will not only bridge gaps in research, but also lead to policy decisions that may help protect the health of Americans.

“I have long thought that public health laboratories should take advantage of ‘dual use’ opportunities offered by the CDC via our chemical threat funded instruments…especially in the realm of ICP-MS testing of heavy metals,” Dr. Patrick Luedtke, senior public health officer from the Lane County Department of Health and Human Services.

Recently, the Washington State Department of Health used their CDC Laboratory Response Network funding to conduct a state-wide biomonitoring study to test arsenic and other metals in humans and their environments. To learn more about how Washington State Department of Health completed their study, please see the “Efforts to Reduce Harmful Exposures to Washingtonians” article in the Winter 2013 issue of APHL’s Lab Matters.

 

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Proof of the Value of Newborn Screening at Every Milestone

Apr 26 2013 :: Published in Newborn Screening and Genetics

By Nancy Maddox, writer

Joe -- Living with PKU

“I was nervous. I was scared. I thought, ‘What’s wrong with my baby?’” said Kristen Vanags.

It was November 2006, and Kristen had just gotten off the phone with her pediatrician, who told her that her six-day-old son, Joe, had a presumptive positive newborn screening test result for phenylketonuria (PKU), a genetic disorder that renders the body unable to process most forms of protein.

The doctor said, “I don’t want you to worry, but I need you to right away call the Emory Genetics Lab” to arrange for follow-up testing, which Kristen did.

She said, “I was in a complete panic. I called my husband at work and said, ‘You need to come home right away.’ I was standing in front of the refrigerator crying… I wanted to make sure my baby was going to be okay.”

At that point, Kristen knew that PKU is a serious disorder, capable of causing permanent brain damage. However, her quick Internet research also revealed that it is treatable, with a special diet.

On that day, she said, “I remember being nervous. I thought, ‘What I’m feeding my child right now is dangerous. I could be poisoning my baby.’”

When her husband, Scott, came home, he, Kristen, Joe and their three-year-old daughter, Anna, piled into the car and went to Children’s Healthcare of Atlanta at Egleston. A genetics counselor from Emory Genetics Laboratory was there to meet them.

“I was very impressed,” said Kristen. “She was very, very calming. She obviously knew her stuff. And she came with a can of Phenex-1, a medical formula for PKU.”

The family and the genetics counselor waited together while Joe had his blood drawn for follow-up testing. “It was scary,” said Kristen. “He was crying. We were so anxious. I wouldn’t ever want to go through that again, but it was as good as it could have been.” The children’s hospital had Joe’s blood couriered to the laboratory for testing and told the worried family they could go home.

“I was upset,” said Kristen, “but I was in a mode of How do we take care of this? I knew there was going to be a plan and there would be people who were going to help us.”

“My husband was so shocked he could barely talk. He was very quiet… He’s an engineer who likes to fix things. I know he was thinking, ‘I don’t know if I can fix this.’”

Early the next morning, Kristen and Scott received a phone call confirming the original newborn screening result. Once again the family got into their car, and this time headed to the Metabolic Genetics and Nutrition Program at Emory University.

They met with Dr. Rani Singh, the head of the program, and a metabolic dietician. “They did an amazing job explaining to us what the PKU diet was all about,” said Kristen. Upon learning that both parents graduated from Georgia Institute of Technology, Dr. Singh told them, “Now I don’t want you to worry. Some day, Joe can go to Georgia Tech. You are wonderful parents, you can do this. He can have the greatest life.”

Armed with information, a list of phone numbers, and the injunction to call at any time, the family went home and began adjusting to a new diet for their son.

It took several months for Kristen and Scott to shed their worst worries and fears. Said Kristen, “It took seeing the milestones, seeing him sitting up and smiling and saying his first words. Every time he did something new, it was an affirmation of the impact of newborn screening and a blessing to me that his PKU was identified. I am truly grateful for that.”

Today, Joe is six-years-old and in kindergarten, having successfully completed pre-school. His proud mom says, “He is doing so well. His math skills are unbelievable, and he’s learning how to read right on time. It’s reassuring to see Joe meeting all the expectations from an academic standpoint.”

Last year, Joe played T-ball, but he loves soccer best. He has friends with PKU whom he sees regularly. “He’s a sweet boy, well-behaved and pretty funny,” said Kristen. “He always wants to try new things. Other than his diet, he’s like any other kid his age. He’s great. And he’s happy.”

From an early age, Joe has helped with his diet. He counts out his low-protein snacks or weighs them on a gram scale. He knows what he can and cannot eat. When Kristen and Joe go grocery shopping, Kristen said, “I show him all the fruits and vegetables and if he wants something, I buy it. It’s a really fun thing for him. We try to make it a positive experience, focusing on what he can have versus what he can’t have. We really want to empower Joe to manage his diet. That’s a huge thing.”

Reflecting on the beginning of newborn screening in 1963, Kristen said, “It’s unbelievable that it’s been 50 years. It’s wonderful.”

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My Global Experience as a Public Health Microbiologist

Apr 25 2013 :: Published in Global Health

By Sally Liska, DrPH

Being a public health microbiologist can mean more than just working at the lab bench helping diagnose communicable diseases or being involved in public health outbreak investigations.  There are many opportunities available.  One activity I particularly enjoy is teaching and mentoring clinical laboratorians in developing countries.  And now retired, I have more time to do this rewarding work.  Sharing my knowledge – something we in the field call “technology transfer” – with a willing group of lab personnel can be very uplifting.  To feel their enthusiasm, see their progress and receive their sincere thanks is truly heart-warming.

Sally Liska -- Global Health Consultant

For the past five years I’ve participated in about 12 laboratory management workshops in several African countries including Kenya, Nigeria and Ethiopia.  You never know what to expect during the training session; each class of laboratorians is different.   Are they going to be shy and reserved, as we lab folks tend to be, or are they going to be an enthusiastic bunch wanting to share their knowledge with their colleagues?   Will we have to draw them out to participate, or rein in their many comments and questions?  Of course they are always courteous and receptive during the presentations but blossom during the small group exercises where they take center stage.   Through group exercises, role-playing and presentation they get the opportunity to interact with their colleagues about the real-life situations they face.  For many participants, there is that special moment when they see themselves as important and integral parts of the health care system of their country; and to be there to witness that is truly special!  Throughout the week they network with their colleagues, forming bonds that last long past the end of the workshop.

Although we may differ in culture, age or mother tongue, we share many of the same issues of constantly striving to improve the quality of our work, gain recognition for our profession and do what’s best for our clients.

Being a public health laboratorian means not just doing what you know, but sharing it as well; I’ve been fortunate to experience that.   And teaching is a wonderful opportunity to do this on a close-encounters basis.

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Unlocking My Unselfish Gene

Apr 25 2013 :: Published in Infectious Diseases, Workforce & Professional Development

By Sharon Master, Biological Sciences Bureau Chief, Scientific Laboratory Division, New Mexico Department of Health

If I were yanked off the street five years ago and informed that I would soon be working in public health I might have been aghast, to say the least.  I was exceptionally clueless as to what public health was or what a public health laboratory did even though our state lab was located two buildings away from where I worked on campus at the University of New Mexico.  Fortuitously for me that soon changed.

Sharon Master -- New Mexico Public Health Laboratory

I have always been the blatantly curious type and, having more of a penchant for matters scientific than artistic, I left my home in India for the US to pursue my Ph.D. in Microbiology in the hopes that I could pursue my ambitions of trying to find a cure for some insidious disease.  A couple years after graduating, I returned to India where I shot into the world of clinical testing and research, with a focus on tuberculosis. Having witnessed the ravages of tuberculosis around me, I decided to make this disease the focus of the cure I longed to discover. I then hopped back across the ocean to an academic setting in the US.  After a decade or so of research with no concrete remedy for tuberculosis in my crosshairs, dwindling will-power, my rude realization that I was not really cut out for the cutthroat competition of research, and feeling overwhelmingly unmotivated, I searched ravenously for new challenges.

Serendipitously, through my network of friends I learned of a managerial position at the New Mexico state laboratory.  I interviewed for the job and got it. A little over three years have passed and I am still here as ecstatic and motivated as I can be, certain that this is exactly where I am meant to be.

Fortunately for me, my transition from academia has been relatively free from trauma as I attempt to fit into this new, fascinating world of public health, dwelling in the midst of some of the pathogens I love, while learning of others I never knew existed.  I’ve encountered a plethora of fascinating events, most of them pathogen and outbreak related, such as a plague case or two, several food outbreak investigations, and an elephant with tuberculosis, to name a handful.  On the whole, my experience has been overwhelmingly mesmerizing.

I am constantly brought back to a feeling from my early days in public health that has lodged itself in my psyche and liberates me.  It was during my first year at the state lab that I was dispatched to a national tuberculosis conference in Atlanta.  This was my first non-academic conference and, to me, wide-eyed as I was, the difference in the mentality of the conferees was astronomical.  I did not witness the furtive, egotistical, and selfish I, me, mine mentality that I experienced in the academic world but in fact observed quite the opposite.  The overall unselfish generosity, warmth, and pervading helpful attitude of the citizens of public health that I constantly bump into renders me awestruck, for the most part, and is something I try to aim for frequently.  This mind-set can be neatly summarized through a quote from Mister Spock, science officer of the USS Enterprise, “the needs of the many far outweigh the needs of the few.” With a bit of luck, in a few years I shall reach that destination of completely unlocking my unselfish gene.

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Into the Wild: Lab Edition

Apr 24 2013 :: Published in Infectious Diseases, Workforce & Professional Development

By Samantha Case, APHL/CDC EID Training Fellow, Arctic Investigations Program, Centers for Disease Control and Prevention

It looks like a scene from one of the countless reality shows based in Alaska: the main character is bundled up, but still cold. She has just boarded a small five-person bush plane after arriving to the landing strip via snow machine. Then, she takes off on a flight flying east toward Anchorage from the southwest coastal area of Alaska. She’s looking at the land beneath her, noticing how it changes from vast tundra to an intricate network of rivers and streams to beautiful mountain ranges. She’s returning from a small village of Alaska Natives where she was assisting with a public health study, and had the opportunity to hear the Yup’ik Eskimo language and purchase native crafts. Sound like an adventure? Well, it is – only I’m the main character and this is just a small part of my experience as an APHL/CDC Emerging Infectious Diseases (EID) Training Fellow.

Samantha Case -- APHL/CDC EID Training Fellow

As a microbiology major in college, I was fascinated with infectious diseases. It wasn’t until I traveled to Lima, Peru during my junior year of college that I discovered public health. I worked with a group of student volunteers to deliver mobile health clinics to impoverished communities. While others were interested in medicine or dentistry, I wanted to know more about big picture solutions that would improve health on a community level. The following year, I was able to combine my interests of microbiology and public health during a semester-long internship at the Vermont Department of Health Laboratory learning techniques in microbiology and how a public health laboratory functions. I was hooked! I wanted to learn even more so I applied to the EID fellowship program. I was ecstatic when I was accepted the following summer!

After narrowing down potential host laboratories for my year-long fellowship, I chose CDC’s Arctic Investigations Program (AIP) in Alaska because of the unique opportunity it would provide. AIP focuses on vaccine-preventable diseases and emerging infections, particularly ones that disproportionately affect the Alaska Native people. From networking with international partners for circumpolar surveillance to collaborating with local agencies here in Anchorage, AIP is certainly fundamental in enhancing public health in the state of Alaska and the arctic.

My fellowship has been incredibly diverse and has exceeded my expectations.  In addition to village trips, I have trained in traditional microbiology and molecular diagnostics within AIP. My main project involves looking at the population structure of Streptococcus pneumoniae (bacteria that cause invasive diseases, including meningitis and bacteremia), using a type of DNA sequencing called multilocus sequence typing (MLST). I have also been active outside of AIP: I rotated through the Alaska State Public Health Laboratory for two weeks, and I am currently assisting on a cellular immunity project with Alaska Native Tribal Health Consortium. I will also be training at the Alaska State Virology Laboratory in June.

When I told others I picked AIP as my host lab, I received many strange looks. People couldn’t believe I was moving all the way to Alaska from the east coast! However, I couldn’t be happier with my decision. My goal was to make the most out of my fellowship opportunity – to learn as much as possible, and to get hands-on experience in many different areas – and I have certainly done that. Each day, I work with an amazing group of people who are truly dedicated to their work, and they inspire me to continue on my path in public health.

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British Invasion – My Career in Public Health

Apr 23 2013 :: Published in Member News, Public Health Preparedness & Response

By Andrew C. Cannons, Ph.D., HCLD (ABB), Laboratory Director, Florida Bureau of Public Health Laboratories, Tampa

“What do you want to be when you grow up?” In England, students have to make these decisions early on, and at 14 my answer was a doctor or a chef. If you asked me back then what public health was I would have said “the health of the public!”

Andrew Cannons as a child

I was not to become a doctor, due to poor study habits as a child and I did not become a chef (except in my own kitchen), but I did get to university where I acquired a good tutelage in Eastern culture at the city of Bradford –known more for its excellent authentic curries and high volume of pubs than education. Four years later, I graduated with a degree in applied biology. I had a thirst for research, but no acquaintance yet with public health.

Having discovered I was good at research I stayed on at the University of Bradford to complete my Ph.D. in biochemistry, and followed that with a four-year post-doctorate at the University of Wales in Swansea where I also picked up a Welsh accent. I was trying to determine what I wanted to do, and quite frankly I drew a blank. As luck would have it, I soon met one of my field’s most world-renowned scientists at a conference in Spain.  He offered me a three-year post-doc opportunity in his lab at the University of South Florida (USF) in Tampa. I was excited, flattered and thrilled at the offer. And guess what… USF has a college of public health! I was getting closer to where I wanted to go without knowing it.

I had a blast for the first two years I was at USF, so much so that I wanted to stay. After a lot of work and a lot of payments to an immigration lawyer, I received my green card. But I was not really sure that research was my true vocation anymore. I had been an assistant professor in biology for five years and proved to be a good teacher, but it wasn’t fulfilling enough. During this time I met the assistant director of the Florida State Public Health Laboratory in Tampa. He was doing his Ph.D., and asked me to be on his dissertation committee. We became good friends and I started to find out more about public health, albeit at a very superficial level.

The turning point for my career in public health came one October morning. It was 5:00 AM on October 6th, 2001, three days after the index anthrax case was identified in Boca Raton and I received this message –“Can you help us at the public health lab? We are expecting an onslaught!”  No kidding.  By 6:00 PM that day we had processed 40 suspicious samples for Bacillus anthracis. I was tired and hungry, but more importantly, I was hooked. This was important, meaningful, critical work. Sign me up! Not so easy as there had to be a job.

Andrew Cannons -- adult

The following year I was asked if I had considered a career in public health, and specifically about directing a state public health laboratory. I had the Ph.D., the administration skills, and a research background. I just lacked some (a lot!) public health knowledge, and there was the small issue of a Florida Clinical License. So I spent the next eight years directing the research lab, volunteering in the public health lab, studying and building up my clinical licensure one level at a time. I also joined the Association of Public Health Laboratories (APHL) as an individual member and applied for and became a member of the Emergency Preparedness and Response Committee (now the Public Health Preparedness and Response Committee).  This was a really smart thing to do.  It was such an eye opener to understanding more about public health laboratories, the Laboratory Response Network (LRN) and a host of other partners as well as their operations! This was a tremendous education and learning experience for me. Joining APHL became crucial to honing my public health knowledge and skills. In addition to serving on the Public Health Preparedness and Response Committee, various sub-committees and participating in the national meetings, in 2010 I was given the chance to be a member of the APHL Emerging Leaders Cohort III, which seeks to engage APHL members who will play a crucial role in sustaining future leadership in the public health laboratory system. This was a tremendous opportunity to 1) network and share operational experiences with other emerging leaders; 2) enhance my professional development; and 3) collaborate to deliver a product that promoted public health laboratory science.

In 2011 I became qualified as a High-Complexity Clinical Laboratory Director through the American Board of Bioanalysis (ABB) and received my Florida Clinical Laboratory Director License. I was ready, and in April 2012 I assumed the position of Laboratory Director, Bureau of Laboratories (now Bureau of Public Health Laboratories), Tampa.  I acquired a great facility and a wonderful group of dedicated, hardworking and loyal staff, which has made this move so much easier and more fulfilling.

Since transitioning to a director of a major public health laboratory, I have worked on large-scale national events such as the Republic National Convention.  As a 14-year-old boy, I never thought I would end up partnering with the US Secret Service, the Federal Bureau of Investigation, the Department of Homeland Security, and the Centers for Disease Control and Prevention to protect the public’s health from all sorts of threats. Public health was the perfect career choice for me even though it took several forks in the road for me to get here.

Through it all, I’ve held to the motto: Keep Calm and Carry On!

 

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What We’re Reading—Earth Day Edition

Apr 22 2013 :: Published in Environmental Health, What We're Reading

Planet Earth

By Michael Heintz, Senior Specialist, Environmental Laboratories, APHL

As we near the end of Earth Day 2013, I always wonder if the momentum from the day will be maintained in the coming days, weeks, and months. Surili got us started with a great post on some of the latest issues with climate change, and there were articles and activities from a wide variety of sources. But what about tomorrow and the next day and the next? I recommend the links below to learn more about what you can do to continue the aims of Earth Day—reducing pollution, limiting resource consumption, and generally getting a little more green.

Take action!

Learn more!

  • Cradle to Cradle: Remaking the Way We Make Things, by Michael Braungart and William McDonough: This is a great book about the green economy and how sustainability can strengthen business.
  • American Chemistry Society: The ACS is a great resource for information on chemistry and other science topics in easy to digest forms (yes, I watched the podcast on the chemistry of beer foam—it was research!).
  • Involve Children: There are lots of resources for involving kids in environmental responsibility. Here are games organized by topic, activities you can do with them, and books on science and nature. (Of course, this list wouldn’t be complete without a reference to The Lorax.)
  • Earth Day Apps: No reason to leave your smartphone out of the fun!
  • New (to you?) Issues: If you are interested in learning about some of the new issues that seem to be making news, here are good resources on sustainability, toxic algae, and invasive species.

These links just scratch the surface of what’s out there. If you have additional ideas to share, we’d like to hear them! How are you making Earth Day more than just one day a year?

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Happy Earth Day — There’s Still More to Do

Apr 22 2013 :: Published in Environmental Health

By Surili Sutaria, Senior Specialist, Environmental Health, APHL

Today marks the 43rd Earth Day – a day to celebrate the place we all call home. Every year, people all over the world host events to honor the Earth and support the growing appreciation and awareness of environmental protection. The first Earth Day, held in 1970, was supported by nearly 20 million Americans. Today, there are over 190 countries that observe this day. Yet the encouraging message remains the same: protect our planet.

Planet Earth

This year, the Earth Day Network’s “Faces of Climate Change” promotes the diversity of climate change by raising awareness of climate change as an issue to human health, as well as its effects on wildlife  forests, severe weather patterns and more. The changing climate impacts all inhabitants of the Earth.

The U.S. Environmental Protection Agency eloquently describes the issues climate change presents to our planet: the earth is warming and it is affecting everyone. The Centers for Disease Control and Prevention explains the connection between climate change and human health: as the climate becomes warmer, extreme weather events (such as heat waves, floods, hurricanes and more) occur more frequently and more severely all over the world, and our ability to protect the health of our families and neighbors becomes more difficult. In some parts of the world, droughts and floods impact food and water sources leading to malnutrition or disease. Sometimes droughts force families to relocate leaving behind their homes and their way of life causing mental distress. Water sources can become contaminated. With increasing temperatures, the risk of emerging or reemerging infectious diseases (i.e., malaria or dengue fever) increases.  To learn more about climate change and public health, read Get the Facts: Climate is a Public Health Issue, by the American of Public Health Association.

Greenhouse gas graphic

Overwhelming scientific consensus indicates that the climate is changing in part because of human activity. According to the World Health Organization, our exceptional ability to emit carbon dioxide and other harmful greenhouse gases over the past 50 years has triggered changes in temperature, natural disasters and patterns of infection. Collectively, we emit these harmful pollutants via our use of electricity, transportation, industry, housing and agriculture. Individually, there are many steps we can take to reduce our use of greenhouse gases, such as walking, biking or taking public transportation; turning off lights when we are not at home, buying locally-sourced produce, and more.

Part of raising awareness of Earth Day is prompting individuals to take action by doing something different in their lives to protect our planet. In the spirit of doing something different, tell us what you are doing different to support the international Earth Day celebration.

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Newborn Screening Saves a Future NBA Star

Apr 18 2013 :: Published in Newborn Screening and Genetics

By Nancy Maddox

As a registered nurse working in the neonatal intensive care unit, Chantel Murray knows a lot about babies. When her son Christian was born in 2002, Chantel had a C-section and was looking forward to taking her baby home after being hospitalized for several days. “The nurse was giving me discharge instructions, and we were all ready to walk out the door,” she said, when Chantel asked about newborn screening.

It hadn’t been done.

Christian Murray -- Living with Cystic Fibrosis

“Let me take him back real quick and do a heel stick,” the nurse said, referring to the single prick babies receive in the foot so a few drops of blood can be collected on a special filter paper card for laboratory testing.

“African-Americans are at high risk for sickle cell anemia,” said Chantel, so she wanted to be sure Christian had the benefit of early screening for the blood disease as well as dozens of other newborn screening disorders.

A week later, the first-time mom was back in the hospital with a uterine infection. “It was a very scary time,” said Chantel, who was, perhaps, most upset about being separated from her infant son.

While she was still hospitalized, Chantel’s husband, Kevin, called with more bad news:  Christian’s newborn screening test results came back with an inconclusive finding for cystic fibrosis, a serious illness that affects the glands that secrete mucus and sweat.

“I thought I had a healthy baby boy,” said Chantel. “We were completely shocked.”

As soon as Chantel was released from the hospital, she and Kevin took Christian to the Children’s Hospital of Philadelphia for a follow-up test, which came back positive. Chantel still couldn’t quite believe it was true. “I disputed the findings,” she said. “I went through all the phases of grief: denial, anger and the rest. This just couldn’t be happening to us.”

The hospital redid the test.

Then, said Chantel, “they took us into a room and all the physicians told us, ‘Your son has cystic fibrosis.’ At that moment, it was a very tough thing to handle. We wondered, what do we do from here on out? How do we explain this to our families?”

Kevin, said Chantel, was a lifesaver  She said, “Thank God for my husband. Even though I’m the nurse and I’m used to being around sick babies, it being my own child now who needed help, I just couldn’t manage everything in my head. He said, ‘We’re going to take it one day at a time.’”

Christian, now ten-years-old, gets respiratory therapy twice a day to prevent mucus build-up in his airways and takes digestive medicines every time he eats to replace the enzymes lost because of mucus-blocked pancreatic ducts.

“He understands he has cystic fibrosis,” said Chantel, who reports Christian “has been nothing but a bundle of joy.” The ten-year-old is extremely athletic and plays a highly competitive game of basketball in the Amateur Athletic Union. He aspires to be the first National Basketball Association player with cystic fibrosis. Christian also loves hip hop dance and “smiles all the time,” said his mom. “People don’t usually know he has any problems.”

After Christian’s diagnosis, Chantel and Kevin had their own genetic tests performed “because we wanted to know how he got this disease.” Results showed that Chantel is a cystic fibrosis carrier but her husband is not. That means Christian inherited one defective gene from his mom, and the matching gene had a spontaneous mutation – an extraordinarily rare event. Christian’s five-year-old sister, Bryce—who also underwent genetic testing—has no cystic fibrosis mutations.

Today, the family is an avid supporter of the Cystic Fibrosis Foundation’s Great Strides National Walk fundraising event, heading up Team Christian.

Although Chantel has had to handle more than most moms, she said, “I give the credit to God and to Christian. He does the hard work every day. We feel so blessed to have him in our life.”

Christian was one of 142,380 babies born in Pennsylvania in 2002. With an incidence rate of roughly 1 in 5,000, there were about 28 new cases of cystic fibrosis in Pennsylvania that year. Blood spot-based newborn screening for Pennsylvania infants is done by PerkinElmer Genetics laboratory.

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