New CCDM edition now available; download Ebola chapter for free

The latest edition of APHA’s renowned guide to controlling disease is now out and for sale at the Public Health Expo.

The 20th edition of the “Control of Communicable Diseases Manual,” which includes new updates on Ebola, West Nile virus and Middle East respiratory syndrome, is designed to serve as a comprehensive field manual for epidemiologists and public health practitioners working to control and curb infectious disease. All 138 chapters of the new edition have been updated with the latest information and three diseases — Japanese encephalitis, West Nile virus and Rift Valley Fever — now have their own chapters.

To aid in the Ebola outbreak, APHA has made the manual’s Ebola chapter free to download.

In addition, the manual contains a new chapter on the interconnectedness of human, animal and environmental health and the critical role of partnerships between public health practitioners, veterinarians and ecologists.

“We can learn a lot from the agents of infectious diseases,” said David Satcher of Morehouse School of Medicine and a former U.S. surgeon general in an APHA news release. “They teach us the value of eternal vigilance and the price of neglect of our public health infrastructure. We need CCDM to remind us of the challenge we face and to keep us updated as to the latest approaches to control of these communicable disease agents.”

To pick up a copy of the brand new edition, stop by APHA Press at the Public Health Expo or visit APHA Press online. 



A life in words

Michael Patrick MacDonald, author of "All Souls: A Family Story from Southie," signed copies of his book today at the Public Health Expo. In the book, MacDonald chronicles his family's life growing up in a poor neighborhood in Boston and the struggles of working-class communities. Right before his book signing, MacDonald spoke about the effects of poverty and trauma on low-income black and white communities during a scientific session titled "Too Young to Die: Teen Black Homicide and White Suicide." Stop by APHA Press at the Public Health Expo to pick up a copy of MacDonald's book.

Photo by Kim Krisberg

Forming partnerships to prevent prescription drug abuse state by state

When Paul Jarris had a bicycle crash this summer and injured his collarbone, the 30 Percocet pills prescribed to him in the emergency room seemed to be a pretty standard amount. It would help keep his pain at bay until he could see a surgeon.

But in just the next 10 days, he received prescriptions for 210 additional opioid pills from three different health providers.

“Fortunately, I knew enough not to fill it," said Jarris, executive director of the Association of State and Territorial Health Officials. “But we have to keep in mind, very well-intentioned people get addicted in the health care system. We really do have a systematic problem in this country with prescription opioids.”

That problem is one that organizations such as ASTHO are hoping to change with the help of state-based organizations.

In Monday’s session on “Mobilizing State Action to Prevent Prescription Opioid Misuse, Abuse and Overdose,” Jarris joined other presenters to discuss what is being done across the nation to prevent, reduce and treat the opioid abuse epidemic.

There have been 125,000 prescription drug-related deaths between 1999 and 2010, and health providers wrote more than 259 million opioid painkiller prescriptions in 2012, said Grant Baldwin, director of the Division of Unintentional Injury Prevention at the Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control. Additionally, in 2012, 16,000 people died from a prescription-related overdose — that’s one death every 33 minutes, Baldwin told session attendees.

One of the initiatives working to turn the tide on opioid abuse is ASTHO’s President’s Challenge to reduce unintended overdose deaths and nonmedical use of controlled prescription drugs by 15 percent by the end of 2015, said Terry Cline, president of the ASTHO Board of Directors. Currently, 46 states and two territories — Guam and the Northern Mariana Islands — have joined the pledge, said Cline, who is also commissioner of the Oklahoma State Department of Health.

The challenge calls on agencies and organizations across those states and territories to pledge to make inroads into worrisome abuse rates or create new programs concentrated on four areas: prevention and education; monitoring and surveillance; law enforcement; and treatment and recovery.

When it comes to prevention and education, more than a dozen states have pledged to step up their overdose prevention activities and widen access to naloxone, a drug that can be used to reverse an opioid overdose and can be easily administered by first responders and other bystanders.

In New Jersey, for example, a naloxone pilot program has been expanded statewide. Today, New Jersey state troopers and police in all 21 counties can get certified to administer the life-saving drug, Cline said.

“We are only as strong as our weakest link,” Cline told session attendees. “If we neglect any piece of this, our approach will not be as effective as it could be otherwise.”

Visit ASTHO’s President’s Challenge for more information and get statistics on the opioid abuse epidemic at the Centers for Disease Control and Prevention.

— N.M.

Hunger games: Low-income residents have less access to healthy options

Looking for healthy food options in New Orleans? Depending on the neighborhood you’re in, you may be out of luck. And that’s unfortunate in a city struggling with high rates of obesity, diabetes and physical inactivity.

At this morning’s session on “Healthography of the Food Environment,” presenter Megan Tulikangas of the Louisiana Public Health Institute talked about the organization’s research on the New Orleans food environment, residents’ access to healthy foods and youth exposure to tobacco, alcohol and junk food marketing. The study comes out of the institute’s Louisiana Campaign for Tobacco-Free Living. In explaining the connection between the anti-tobacco campaign and food access, Tulikangas noted that examining the impact of the retail environment on community health can’t be limited to just tobacco — you have to look at food and alcohol as well.

Tulikangas told session attendees that much of the study questions focused on the marketing theory known as the Four Ps: product (is it designed to appeal to certain groups?); placement (are ads and products purposefully placed at the eye level or near the register?); price (is the product priced to be affordable to its target audience?); and promotion (is the product promoted in a particular way to appeal to young people?). Of course, Tulikangas noted that “not all marketing is equal.” For example, tobacco companies specifically target youth and minorities, and food ads targeting kids are more likely to promote high-fat, sugary products.

To conduct the study, teams of data collectors spread out across the city, collecting information and surveying storeowners in Orleans Parish. They ended up visiting 465 retail stores altogether and at every location, teams gathered information on tobacco, alcohol and food (both healthy and unhealthy). The study sample included 424 tobacco outlets, 315 alcohol outlets and only 41 — 41 — locations that sold a selection of healthy food choices. The study was incredibly comprehensive — teams gathered 600 data points for each store.

So, do New Orleans’ minority and low-income neighborhoods experience less access to healthy foods and more exposure to unhealthy marketing? The answer, unfortunately, is yes. Session presenter Alexandra Priebe, also with the Louisiana Public Health Institute, reported that low-income neighborhoods were home to more tobacco and alcohol outlets per capita and less access to healthy food choices per capita. For example, people living in minority and low-income neighborhoods would have a pretty easy time finding access to cigarillos. However, they’d have a much harder time finding a place to buy milk, apples or oranges, Priebe reported.

The study also found that local minority and low-income neighborhoods are home to more advertising for unhealthy products (with the exception of high-tourist areas) as well as more ads and product placements specifically designed to appeal to young people. Priebe did report that most store owners said they did feel connected to their communities, but that their retail offerings were limited by customer preference and that most weren’t willing to take an economic loss on fresh produce that may end up rotting on the shelf. A possible solution? Taking a comprehensive approach to building healthier communities that includes both educating residents as well as business owners.

“Changing the (point-of-sale) environment is complex and will require a multi-pronged approach,” Priebe said.

— K.K.

Arts and crafts

“When you’re talking about recovery from Katrina, one of the things that made it possible for people to return and feel comfortable is the music and the culture,” said photographer L.J. Goldstein, one of the artists displaying his wares at this year’s new Art @ the Expo.

“Without looking deeply into the African American community, you can’t understand what New Orleans is all about.”

For $20, you can pick up a poster of one of Goldstein’s most popular photos, and a third of the proceeds will benefit the Young Traditional Brass Band Program.

Art @ the Expo is tucked into the 500 aisle of the Public Health Expo and features local artists whose crafts have a science- or health-related theme. Marek and Shelagh Dloughy’s DCZ Designs offers nature-based jewelry. Amber Luning is a medical illustrator whose biomedical artwork really will blow your mind. One of her pieces shows the nerves of the hand and was made from a combination of pencil drawing and Adobe Photoshop color. It’s indescribable. Go see for yourself.

Photographer Andy Levin’s New Orleans photos are a delight. His booth spotlights work he’s done over the past 30 years, the most recent 10 in New Orleans. He has everything from heartbreaking post-Katrina shots of flooded neighborhoods to the joy of children turning cartwheels at the water’s edge.

And everyone really shouldn’t go home without a T-shirt from Contagion Clues Creations. A former public health department director, Deb Scholten, designed the shirts emblazoned with the motto “Public Health: Protecting America from Tiny Terrorists.” Those tiny terrorists include Ebola, TB, pandemic influenza and the duo called Sam ‘n Ella (salmonella, get it?). The booth also has aprons for sale that give the safe cooking temperatures for a variety of foods and have a thermometer tucked into a top front pocket.

The Public Health Expo is open today and tomorrow from 9 a.m.-5 p.m. and Wednesday from 8:30 a.m. until 12:30 p.m.

— D.C.

Above, a local photographer shows off his creations at Art @ the Expo. Photo by Donya Currie

Public health passion in action: APHA President Joyce Gaufin

Video from APHA President Joyce Gaufin's Opening Session presentation is here! You don't want to miss this one, folks — it was truly an Annual Meeting moment to remember. Visit APHA's YouTube page for more video coming soon! And read our coverage of yesterday's Opening Session here.

APHA Storify: Opening!

Today's APHA Storify sums up yesterday's passionate APHA Annual Meeting Opening Session!

Monday’s Have You Heard

Confronting Ebola: Learn more about what your fellow public health colleagues are doing to contain the global outbreak at session 3108.1, “Ebola Virus Disease Epidemic,” from 10:30 a.m. to noon in room R01 in the Ernest N. Morial Convention Center.

Support the arts!: Check out our inaugural Art @ the Expo offerings at the Public Health Expo, which is located in Halls B/C in the convention center. Art @ the Expo features local artists who make health- and science-related crafts, such as jewelry and photography. It’s the perfect public health holiday gift!

Shhhhhhh: Don’t forget to check out the many offerings of the 11th Annual APHA Film Festival, organized by the APHA Public Health Education and Health Promotion Section’s Health Communications Working Group and the International Health Section. Some of this year’s films include: “The Waiting Room,” a documentary that goes behind the scenes of an American public hospital; “The Cola Road,” a film about the launch of the first attempt to use Coca-Cola’s crates and distribution know-how to deliver life-saving anti-diarrhea kits; and “Clutters,” a documentary about a compulsive hoarder and her family.

Say no to tobacco!: Visit the #SmokeFreeNOLA campaign at the Public Health Expo — they’re at booth 1436 — and pick up a Smoke-Free New Orleans sticker or button you can sport while out and about this week. And if you’re wanting to get out and celebrate the fresh air, join fellow anti-tobacco advocates at the Smokefree New Orleans Secondline Parade & Rally on Monday at noon. Rally participants will meet just outside the convention center at the corner of Convention Center Boulevard and Julia Street and walk to Fulton Street Square alongside the Hot 8 Brass Band. Click here for more info on smoke-free advocacy while you’re in town.

Stretch those legs: APHA’s Physical Activity Section is sponsoring a walking tour of New Orleans on Monday. If you feel like going on a jaunt, meet at 3:30 p.m. outside the convention center.

What’s up, docs?: APHA’s new Monday General Session is jam-packed with public health leaders — literally. For your public health pleasure, we present five former U.S. surgeons general as well as Acting Surgeon General Boris Lushniak, who will discuss the future of health in America and how they used the Office of the Surgeon General to help create healthier communities for all. The Monday General Session takes place 4:30–5:30 p.m. in the Great Hall of the convention center.