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Monitoring Chikungunya virus and dozens more vectored diseases in the United States - a testing of our spatial analytics potential

Monitoring Chikungunya virus and dozens more vectored diseases in the United States - a testing of our spatial analytics potential | Episurveillance | Scoop.it

Outside the CDC and other epidemiological and public health work environments, other programs can monitor and report on their vectored diseases patterns.  The most rapid way to analyze any ecological, population base, or culturally and socioeconomically based disease pattern is by grid mapping.  


Grids have been criticized in the past because they are not exact.   Current systems can manage the small area grids and map results incredibly fast and with an incredibly high resolution less than the spatial error contribution.  These systems need not be GIS, but can include standard Big Data sets up designed for SAS (not SAS-GIS) and SQL.   Adding GIS also means your are also adding a tremendous amount of work due to whatever programming ("tweaking of the maps") is involved.  This also increases the cost for producing and maintaining an effective surveillance system, and it can increase the likelihood that researchers' or  presenters' bias and presentation error could impact your work.  


One can accomplish the same using Teradata.  It takes  just 10-20 minutes to map a total of 2400 25 mile areas, representing the outcomes for the entire U.S., up to 1000 maps per data run, 24k per day, for one analyst.  [See NPHG pages for more.]

Brian Altonens insight:
Chikungunya Cases Double in CaribbeanNBCNews.com-Jun 5, 2014... Vincent and the Grenadines, and Saint Maarten),” they wrote in theCDC's ... “As of May 30, 2014, a total of 103,018 suspected and 4,406 ... Officials have been cautioning that the virus could become established in the U.S. ...Mosquito-Borne Chikungunya Virus Spreads in the Americas
Medscape-Jun 6, 2014 The next mosquito-borne infection you might want to start worrying ...
Washington Post-Jun 5, 2014 Chikungunya Cases Increase in the Americas
Guardian Liberty Voice-Jun 7, 2014 Mosquito-borne chikungunya cases double in Caribbean
WXIA-TV-Jun 5, 2014 Mosquito-borne virus a public health nuisance
In-Depth-San Jose Mercury News-Jun 4, 2014
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21st century Epidemiological Surveillance. New maps, new formulas, new techniques.
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In the medical response to Ebola, Cuba is punching far above its weight

In the medical response to Ebola, Cuba is punching far above its weight | Episurveillance | Scoop.it
165 health professionals from the country arrived in Sierra Leone on Thursday.


A related question to ask is


'could Cuba in turn be impacted by the return of a physician who does not know he/she is infected?'



Brian Altonens insight:

Cuba has an excellent healthcare system, and has taken steps that outshine many of the other country's attempts to deal with Ebola.      


This has certainly been a feather in the cap so to speak.  But the next questions we all have to ask, the same that all other countries sending help need to ask as well, is how might this put 'Us' at risk back home?    


The point here is not to stop any international aid that is taking place due to Ebola.  The purpose of this posting is to more strongly state the criticisms out there about how borderline the success of preventing the international, intercontinental spread of Ebola has become.     


Cuba's problem, were Ebola to enter the region, according to my opinion (based on studies, but still an opinion), is that Cuba has that additional factor to contend with regarding possible Ebola migration and penetration.  Cuba has some high risk community settings due to low income related living conditions.  The rural neighborhoods in particular that are low income have additional risk factors to consider, such as the natural climate and topography settings that helped Ebola travel its paths over the decades in Africa, through both southern and northern hemispheres.  But there are also the vegetation settings and animal spatial ecology patterns to consider.  The potential hosts, carriers and the like are there in the Cuban setting.  There is enough rural territory, with rolling terrain and highly varied microclimate settings, to make it possible for a parallel to the African tropical nidus to be discovered in a part of Cuba.  That is the heart of the matter in terms of Ebola and its potential for migration to Cuba.   


Cuba is an isolated region, like Iceland was for the various Measles epidemics that have been researched there over the decades.  One of the last things Cuba needs is for Ebola to reach its homeland.  


The Cuban economy and healthcare system are generous in what its people are are doing right now, participating in the Ebola epidemic response programs.  So, it is up to WHO and CDC to develop a more effective, prevention-minded program in order to prevent an accidental transportation of the disease to other places.      


The Cuban healthcare workers are no doubt more alert to this problem of possibly travelling with Ebola by accident than even the international and governmental groups seem to be.   But the repeated migration of isolated cases, from one area to the next for other countries (including the US), isn't comforting when a disease highly epidemic due to its natural ecology becomes a  passenger finding its way to a new nidus or "hot spot".  The climate, topography, zoology, ecology and latitude and longitude for Cuba are right, making it possible for ebolavirus to become ecologically stable within this new setting.

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Pop health reality check: What have health orgs actually done? | Government Health IT

Pop health reality check: What have health orgs actually done? | Government Health IT | Episurveillance | Scoop.it
Big data in healthcare is the talk of many towns, but a new study by the Spyglass Consulting Group finds that for many systems there remains a long road ahead. Part of the problem is that physicians, for the most part, still don't have the training to do big data analytics.
Brian Altonens insight:

The companies on top in the US healthcare system have a fully functional GIS (not necessarily functioning) in place.  These innovators are followed by companies and businesses now in the Active stage of trying to start a GIS program for purposes of institutional population health surveillance and improved financial practices.  Most of the companies that exist today, haven't an inkling of an idea on how GIS could help them advance to the next step.


The real problem here is that administration and management are responsible for this inadequate experience and training.  Physicians are not primarily responsible for Big Data Utilization, just Big Data Entry.  Administration is responsible for Big Data Use.  Management determines if, when, why and how it is needed.  


Managers, Directors, COs, VPs and Presidents responsible for the many Health insurance companies, PBMs, large healthcare associations, companies overseeing multiple hospitals and clinics, now bear serious lapses in business intelligence (BI).     


If your company lacks BI and SI (spatial intelligence), it has to face the possibility of a seriously reduction in its ability to survive for the years ahead.  



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Measles Herd Immunity Won't Hold as Vaccinations Drop | Medpage Today

Measles Herd Immunity Won't Hold as Vaccinations Drop | Medpage Today | Episurveillance | Scoop.it
Nearly 9 million children in U.S. susceptible to measles infection
Brian Altonens insight:

There is a lesson in how slow people in medicine, not to mention the profession itself, is at initiating change.  


The first measles outbreak, which was a small one, happened in Palisades Mall in lower New York, late in 2013, when someone unimmunized brought the disease to a large public area, frequented daily by large numbers of people.  


The next outbreak was initiated nearly a year later, at a family recreation area in California  This time, the outbreak was sustained by the density and proximity of people who failed to be immunized, up and down the west coast. (My maps demonstrated the peak for this is Seattle and Portland, then California, the three hearts of the evolution of the naturopathic profession as accredited, fully schooled, MD-equivalent/ND, licensed health care practices).


In the New York outbreak region (the birthplace for naturopathy by the way, around 1898), we have the densest, broadest area with individuals who refused personal vaccination or vaccination of one or more of their children, for one or more of the recommended childhood vaccines. 


The few cases that emerged in California a year later however had a greater impact due to the spatial dispersion of the families that refused vaccinations.  This refusal involved more than just the measles-mumps-rubella (MMR) combination, so often associated with the falsely accusatory study of thimoseral, mercury and autism prevalence.  


In fact, as several of my earlier postings have demonstrated, this history of refusal extend back to the beginning of the 20th century, about 1895-1910, when the first social groups and professional organizations were formed out west contesting vaccination, along with several other morally questions practices in health research, like the anti-vivisection group actively protesting the value of live, caged animal studies.


Any leaders in the medical profession that do not know about this part of the history of vaccine refusals are naive in the history of their field.  This only delays the progress that might happen further, as we now try to level out the serious pubic health issue that is developing, and will continue to develop for the next several childhood immunization periods, 8 to 10 years to be exact.  


This means that if we are at our lowest point right now, in terms of the number of fully vaccinated children, from now on the likelihood for future outbreaks or repetitions of the 2014-2015 measles events is minimal.  


But it takes more than just a year or two to repair the leaks in our programs that developed due to refusal to immunize children.


More than two years ago, in early 2013, I proposed that the Herd Immunity theory be removed from our daily philosophy.  All that it is, in actuality, is just a theory; and a theory is merely the best way to define the circumstances for the moment.  [Herd immunity is a great teaching tool, as much as "Gate Theory of Pain" is.  But how much of Gate theory actually happens in the clinic; we use more specific anatomical/physiological reasons to explain why Gate Theory has to be "true".]


The herd immunity effect is no longer happening.  So why don't health care leaders eliminate this false, misleading ideology?


Such an ideology is why the Pacific Northwest remains the most at risk for the consequences of vaccine refusals.  As the maps I produced years ago demonstrate, this is not just true for childhood immunizations, but also for the adult immunization practices, such as for diphtheria.  (My other maps demonstrated the same for refusal to undergo tetanus, pertussis, yellow fever and even adult tuberculosis vaccines.)


This article cited is an important article, but it is mostly example of just how far behind the leaders in epidemiology, disease mapping and population health continue to be.  


It should be a reminder to us of when and where we failed, which on paper was just two years ago due to the outbreak initiated in California.  But the failures responsible for today's concerns happened a few years earlier, when enough of the population was not appropriately immunization.  


The 2014 and 2015 measles outbreak problem is due to failures that occurred from 2013 on back to 2000 (seven 2-year child generations for the childhood immunization PIP/QIA/MU metrics).  That provided the reduced density of immunized people that enabled the 2014-2015 outbreak to happen.  


If we go back further in the history of this behavior, when I was a student in the regular medical schools in the early to mid 1980s, this problem was already noticeable my myself when I took a few months off and attended classes at another non-allopathic medical school.  


One of the most common features in the anti-allopathic communities is the shared philosophy that immunizations need to be avoided, at all costs.   Not for the same reason as the years they were first avoided, but for every reason imaginable that people have been able to develop ever since.


Funny how human philosophy is just that--a philosophy.  Drop the herd immunity theory.  Pay more heed to the varying reasons why people don't immunize.  And then, research the same and explore the reasons that were given in the 1980s, the 1970s, the 1950s, the 1930s, the 1910s, and earlier.   They vary as much as our philosophies of how and why acupuncture must be working, biomedically speaking.  


NOTE: The direct predecessor to naturopathy is Eclectic MD training, which was renamed New Eclectics from 1895-1897, before "naturopathy" was born.  Eclectic MD schools were open until about 1930, with the last ones still teaching in California (Sierra Eclectic Medical School).  My entire series of articles/writings on the birth and evolution of Eclectic, New Eclectic, and Naturopathy--the results of a 20 year study, on site for naturopathy--are at my personal blog site, brianaltonenmph.com)


My basic coverage on where the Eclectic Doctors were:



New Eclectics: start with



The Utah (Mormon related) governor's study of naturopathy at :



Notes on the current naturopathy program and school, from its first year in operation, and first catalogue:



Review the National College of Naturopathic Medicine (Portland) and its later branch off, John Bastyr College of Naturopathy (Seattle), on line at their respective sites.


Finally, QuackWatch has its own review of the history of naturopathy and its philosophy and impact on immunization practices, at 

http://www.quackwatch.com/01QuackeryRelatedTopics/Naturopathy/immu.html ;








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Immunizable Diseases - A Reminder of the Past - YouTube

Produced 1 29 15. A video produced from my Powerpoint on the history of vaccinated diseases. The focus is on what these kids looked like or experienced due to this disease.  

Brian Altonens insight:

This video is my review of the history of immunizable diseases.  Many of the figures in this presentation demonstrate what these patients looked like, according to the medical schools books for the time--the 1940s--75 years ago.  

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"System. Heal Thyself." . . . Getting Started . . . HEALTHCARE HOTSPOTTING

"System.  Heal Thyself."  . . . Getting Started . . . HEALTHCARE HOTSPOTTING | Episurveillance | Scoop.it

"System, Heal Thyself" ????   This is the motto of a website devoted to the use of GIS for spatial analysis of healthcare data, in particular claims data.  A more fitting statement is "Director (or VP or CO), learn or leave!"  There are people out there with the knowledge base to develop useful maps, not just informative maps and "attention getters" for the next colloquium.

Brian Altonens insight:

This particular site is promoting an important new skillset for GIS technicians to learn--analyzing claims data for managed care population health monitoring programs (my personal blog (former CV site), brianaltonenmph.com, has an entire section on this).  


Recently,  I saw four spatial analysis products promoted internally in the healthcare system.  Two could be used by the IT technicians--but managers didn't know how to make good use of them.  Another product was simply marketing itself, but had yet to demonstrate any innovative productivity.  For one tenth the cost, I could obtain a much cheaper GIS and produce identical results.  A fourth individual wanted to sell the merchandise, but wouldn't reveal much more--guess that one was still in  the experimental stage.  


The major barrier to the implementation of the new analysis and reporting strategies with GIS is the lack of upper level knowledge base and know how at the institutional or corporate level.  That is due to the poor use of human resources, the lack of exploration of talented gifted individuals in the field, and the tendency for leaders to talk "innovation", and not really produce it.  


It is not HR or "talent searchers" that are at fault here - - - it is the lack of knowledge base. the lack of experience, and the lack of guidance management provides itself, in terms of what to do and how to apply spatial analysis at the healthcare administrative level. 


It's kind of like trying to teach a doc to switch from monaural tubes to binaural tubing more than 100 years ago.  Like anyone, we in the healthcare field are hesitant about change when it comes to certain forms of new medical technology.

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Woman being treated at Grant hospital; no Ebola test planned for now

Woman being treated at Grant hospital; no Ebola test planned for now | Episurveillance | Scoop.it
Doctors at OhioHealth Grant Medical Center will continue on Wednesday to monitor a woman who recently was in an Ebola-stricken west African country and reported feeling ill on Tuesday. As of Tuesday night, officials believed that the woman’s illness was caused by something other than Ebola, though the diagnosis was considered to be tentative, said Columbus Public Health spokesman Jose Rodriguez. The woman, who is in her 30s and is one of 36 travelers currently under daily monitoring in Columbus, reported concerning symptoms to nurses at Columbus Public Health, Rodriguez said. He said he could not specify what symptoms the woman described.
Brian Altonens insight:

It is easy to draw an Ebola conclusion due to some of the symptomatology.  I'll hold off on thinking about this right now.  Historically, since the 1700s, tropical diseases (yellow fever, malaria human cases, west nile, even Chikungunya possibly) enter this country during the peak warm months and the 2 or 3 week period afterwards.  In New York, that means primarily the last week of August, through September and up until the first week of October if it's a warm summer.

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CDC's top modeler makes estimates and courts controversy

CDC's top modeler makes estimates and courts controversy | Episurveillance | Scoop.it
ATLANTA (AP) — Last fall, when Martin Meltzer calculated that 1.4 million people might contract Ebola in West Africa, the world paid attention.
Brian Altonens insight:

The Social networking part of epidemiology.


From the article:  "CDC is supposed to prepare the America for the worst, so it makes sense for CDC modelers to explore extreme scenarios. If Meltzer's estimates push policymakers to bolster public health defenses, it's all to the greater good, some say.

But there are others who feel that the result corrupts both science and politics."


Teaming up is a normal social event, even amongst professionals.  What is interesting are some of the behaviors that I documented researching this event--the braggers who say they have something or know someone but won't release a bit of news about what it is, are the worst.  But the funny thing is "no response" is also a statistic, and is actually supportive in cases where innovations are at play.  Those who don't understand, don't believe and don't respond are as much a statistic as those who contest and respond in under ten minutes.


Two years ago, when I posted my model of Polio in the U.S. (not a prediction model, but a model of areas with a long history of high risk, and likelihood to re-erupt it once it comes to the U.S.), the most direct responses predictably came back to me in under ten minutes.  In terms of innovation, that means I reached my goal with the new idea.  My philosophy is that: Right or wrong, new ideas are always worth exploring, which means that new innovations and new inventions must be tried, until they can be inarguably proven wrong.


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Winter is Coming: Scientist Says Sun Will Nod Off in 15 Years

Winter is Coming: Scientist Says Sun Will Nod Off in 15 Years | Episurveillance | Scoop.it
Might want to start stockpiling those down jackets: The sun could nod off by 2030, triggering what scientists are describing as a "mini ice age."
Brian Altonens insight:

With El Niño in the air, what next?   Solar cycles are common to history, including human history.  The ""Ice Age" of the late 1770s plagued the troops camped out at Valley Forge.  The melting of the ice caps, the drying of prairie lands, all change the ecology of diseases.  The most noticeable change in disease ecology, that is not linked to water bodies like mosquito related outbreaks typically are, is the return of Hanta Virus to the western states.

West Nile also seems to be moving elsewhere according to some disease ecologists.  But the events that I am waiting to see happen include the introduction of some of the host-vectored disease patterns out of Russia, such as the the unusual tickborn forms of encephalitis and Omsk fever.   Australia and South America also have a number of diseases of this type, in need of new ecosystems.

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At least 5 kids given wrong immunizations at N.J. clinic

At least 5 kids given wrong immunizations at N.J. clinic | Episurveillance | Scoop.it
At least five children were given the wrong immunizations at a health clinic for the uninsured, including a 2-year-old boy who got an "excessive dose" of a cervical cancer prevention vaccine, authorities said.
Brian Altonens insight:

The annual HEDIS and QIA/PIP reviews on childhood immunization never measure the overimmunization of kids.  


When I was responsible for this project in Colorado (amongst the many other MCD/MCR projects), my evaluation included the number of excess immunizations given to kids.  I considered them a waste of product.  Since the year before I arrived, there was a serious shortage of one vaccine (only 78% could get the vaccine), this was a priority of the program I was working for.


My findings:  combination vaccines made it easy for PCPs to overadminister and underadminister.  Polio was rarely overvaccinated.  Measles was most often overvaccinated.  Dual vaccines (products that provide them in pairs) are often given, and then completed with a triple combo.  Some, like Chicken Pox were over reported, 2 different events, dates and/or activities noted per child were exceptionally common.


It ends up the rate reported on here is probably a typical rate for overvaccinating (1-4%).  Since we infrequently check for it, and normally don't record or report it, this new "discovery" is most likely due to a history of no prior review for the other products used and required.  

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Doc Told Hundreds of Healthy People They Had Cancer

Doc Told Hundreds of Healthy People They Had Cancer | Episurveillance | Scoop.it
Dr. Farid Fata put hundreds of people through hell in order to line his own pockets, and now federal prosecutors are seeking to put the Detroit-area oncologist away for 175 years.
Brian Altonens insight:

Two years ago, an orthopedist defrauded the government for procedures he claimed to perform costing the insurance companies in excess of 35 million dollars.    The number of events or procedures he performed per day were unbelievable, often numbering more than twenty.  In an eight hour day, that meant about 3 cases per hour.


Fortunately, with an effective GIS in place within the healthcare facility or business setting, with workers capable of assessing spatial data for fraud, inappropriate procedure and improper billing, companies can prevent this fraud from continuing.  All healthcare facilities and insurance companies have the potential for fraud.  The new statistics on capture of these cases suggests that we are unreliable when it comes to our own self-monitoring routines.  A well trained GIS individual would certainly reduce the lack of sufficient training and irresponsibility that helps cause these unhealthy practices.


There is a local story in the Hudson Valley with a similar history.  It's history is told in the following:  




http://ryortho.com/2013/09/fake-surgeries-alleged-in-poughkeepsie/ ;




http://www.dailymail.co.uk/news/article-2488932/Surgeon-pleads-guilty-fraud-faking-thousands-surgeries-years.html ;




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Biological weapons expert reportedly flees North Korea with gigabytes of data on human experiments

Biological weapons expert reportedly flees North Korea with gigabytes of data on human experiments | Episurveillance | Scoop.it
A North Korean biological weapons scientist has reportedly defected to Finland, taking with him 15 gigabytes of data detailing experiments on humans.
The 47-year-old — identified only by his surname Lee — fled a research facility near North Korea's border with China in June, The Independent reports. Citing a humans rights group, South Korean newspaper Yonhap says he plans to present his data to the EU in July. There is reason for caution, however: Neither his defection nor his planned presentation have been confirmed by European authorities.
Greg Scarlatoiun, director of the U.S. Committee for Human Rights in North Korea, reportedly told a Finnish newspaper that the story is at least plausible.
"We have been told similar stories in the past that human experiments are carried out in prison camps," he said, adding that the experiments in question likely involved chemical weapons. Nico Lauricella
Brian Altonens insight:

Some good news for once.  A defector of communist regime brings the biological weapons to Finland, the country with the world's experts on chemical and biological warfare.  Hope he gets to present.

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California Lawmakers Vote to Limit Vaccine Exemptions for School Children

California Lawmakers Vote to Limit Vaccine Exemptions for School Children | Episurveillance | Scoop.it
California lawmakers voted on Thursday to substantially limit vaccine exemptions for school children in the most populous U.S. state, an initiative prompted by last year’s measles outbreak at Disneyland that sickened more than 100 people.
Brian Altonens insight:

History repeats itself, especially in medicine.  


It is exactly 100 years since there was a significant outbreak of small pox in Niagara Falls, NY, a town that had just incorporated several years earlier.  


We have now we have gone full cycle on the reasons why Niagara Falls had such a memorable small pox outbreak--at least to some medical historians.  


The issue hand:  mothers decided not to vaccinate their children due to the anti-vaccination movement going on.  Animal Rights activists were its primary instigators.  Due to public pressure, New York allowed parents to decide on their own if theirs kids were to be vaccinated for a number of infectious diseases.  They called this ability to opt out--"compulsory."


Just a few years into this movement, 1914/5, a number of states had developed strong anti-vaccination movements, and large percentages of children began to attend school completely unvaccinated (85% to 100%).  In some towns, with strong religious leaders, in politics as well as the law, outbreaks ensued as a result of a lone infected person attending the same school  and coming down with the infection.  


A significant small pox outbreaks ensued in Niagara Falls due to this.


It is now 100 years later, and the Measles outbreaks of 2014 have just passed.  This outbreak started in California for much the same reason.  Once it took off, it quickly made its way back east to the same part of western NY where small pox made a brief stay.  


Ironically, both of these times we put Canada at risk, due to the same human behaviors in the U.S. and and the same economic geography and physical geography related reasons.  


So I wonder what Canada has to say about all of this!

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MERS - Initial Numbers

MERS - Initial Numbers | Episurveillance | Scoop.it

The Status:  South Korea currently experiences an outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) with 126 confirmed cases as reported by 12 June 2015. The figure below shows real-time estimates of the (case) reproduction number R together with the 95% confidence intervals (CIs) using the Wallinga/Teunis method. The analysis is based on the epidemic curve of 125 cases published by the European Centre for Disease Prevention and Control (ECDC). If the date of onset of symptoms is not known, the date of reporting is used instead. 

Brian Altonens insight:

" . . . the estimated reproduction number of the index case (R = 7.6, 95% CI 4.0-12.1) is not as high as reported (~30 cases), . . ."


A published description of this statistical process, as it was applied to SARS during the 2012-2013 outbreak, can be reviewed online via the American Journal of Epidemiology site at - -  http://aje.oxfordjournals.org/content/160/6/509.full.pdf+html ;


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Infibulation, version 1

http://youtu.be/0A95jfeAScw IMG 0815
Brian Altonens insight:

I have documented cases of this happening to children under 12 years of age, with some as young as 2.  A review of the practice of infibulation and the Sharia Law demonstrate that it must happen by the age of 9 for girls whose family is completely traditional in their upbringing.  Moreover, since some of these children marriages occur soon after birth, the importance of demonstrating faith, in accordance with Sharia Law, requires the parent of the child agree to an infibulation as soon as the spouse, spouse's parents, child's parents, relatives, or other leaders of the community fear the young girl may become promiscuous quite soon with her peers.


The hundred or more cases of children under 10 getting infibulation in recent years constitute serious cases of possible US practice of this tradition, in accordance with Sharia Law, but against US and most international health practice laws.  


Approximately 5 to 10 percent of the cases on this map generated constitute these illegal cases practiced in the U.S.  The malingering questions is:  Were these cases upon very young girls practiced by an M.D., or a Sharia/Muslim recognized physician who their community allows to perform this practice? 

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First Echinacea, now Anti-oxidants

First Echinacea, now Anti-oxidants | Episurveillance | Scoop.it

From 1987 to 2000 I ran a lab at the local university that specialized in testing phytochemicals.   My focus was on my own "discovery" of the local yew tree as a source for a new treatment for breast cancer, which would be marketed several years later as Taxol.  That study was second to my study of benzylisoquinoline (BIQ) alkaloids, metabolically active selective toxins capable of being applied as medicines.  I also monitored OTC herbal products for adulteration and counterfeits, and occasionally followed up on complaints of toxicity.

Brian Altonens insight:

This current argument, pertaining to antioxidants, mimics similar events that ensued in the late 1980s for Echinacea, when it was promoted for treating AIDs.  Many herbal medicines are potential victims of this slippery slope error, usually made by their most devoted (and highly biased) advocates.


During my 20 years working as a phytochemist and phytotaxonomist specialized in the pathways for developing new products, I attended hundreds of presentations, classroom teachings, and other public events about the new claims to herbal medicines arising over the years.  


Echinacea was the first attack I would make on these claims, as the researcher, lecturer and professor in natural products chemistry from 1989 to 2000.  The primary individual promoting Echinacea at this time recommended it for treating AIDs.  Attending one of his sessions, I asked about its mechanisms of action; he was unfamiliar with the contradictory nature of his claim, which stated that an herb stimulating the immune system would help "cure" or minimize AIDs related complications because of its non-specific "immunogenic" effect. (Lucky guess on which pathways to take, I guess.)  


For the next decade we contested each other's claims about what is "efficaciousness", when it came to herbal medications and their nutriceuticals.  Ultimately, some people in this profession developed a better understanding of the immune system processes, and the varying pharmaceutical nature of the  'Chemicals in Plants' (the name of my most popular course at PSU for 15 years).


Also note, these same incompletely researched arguments have been made for plant seed oils, in particular arguments that posed ideas about prostaglandins and prostacyclins, not to mention the other arachidonates and EPAs.  Such arguments claimed that assisting the body in its chemical processes generically somehow results in the therapeutic effect happening because nature selects the right sides of the pathway to health for a chemical to take. 


Similarly, herbalists rarely  take into account the opposing natures by which black cohosh and blue cohosh on uterine muscle and blood vessel walls; the effects of the two, when taken together, are in opposition to each other in some cases.


But one of the most embarassing things about the phytochemical drugs is what little herbalists know about the chemical nature and history of one of their most popular products.  


Since I specialized in BIQ alkaloids, I reviewed the "curative" BIQs purportedly in Goldenseal (Hydrastis canadensis) from 1990 to 1993; I presented these findings several times, including at OAS.  I found that hydrastine (green to gold on the TLC) rapidly decays to produce hydrastinine (sky blue).  The second product was a result of the oxidation of hydrastine to hydrastinine, by light, heat, exposure to oxygen, free radicalization,  etc.  This converts the antibiotic Goldenseal powder into a well-documented smooth muscle relaxant (see 'The Merck Index', 1970s).  Since the half life of hydrastine (the desired antibiotic chemical) is a just few months in powdered products, this means the capsules, teas, and such that are made from golden seal powder may be totally "ineffective" in therapy in overpriced in terms of their hydrastine content.  [I explain all of this on part of my page, http://brianaltonenmph.com/tag/selective-toxicity/ ].


During the 1990s, come of the OTC industries made corrections for these inconsistencies and even tried standardizing the testing of their alkaloid, flavonoid, phytochemical content.


But similar problems continue.  Concerns about the substitution of Devil's Claw with a closely related "unofficial" species (but perhaps allowable) has been a concern.  Since the 1920s, this has been an ongoing problem for identifying the right "Pau d'Arco".  Adulteration is also still a problem with herbal medicines, for examples, of many "legal highs" and neurotonics", or the use of "scullcap" (which is substituted for) for epilepsy.  


And as usual, poor management of OTC the plant product manufacturing industry remains a major problem with this unmonitored profession.  Last week, the story was once again countering the Echinacea immunogenic theory claims.


Finally, this problem is very much like one other series of legal cases I managed from 1989 to 1990, involving the Oregon patients who took the first bioengineered version of the OTC nutrichemical, tryptophan (TRP).  It was  produced by the Japanese company Showa Denko, using aggregate cell culturing ("bacillus soup") techniques (one of my first professors was Abe Krikorian, who sent the Daucus carota to the Moon and back during one of those Apollo missions, in aggregate rootcap bioengineered form; the cell aggregates survived and produced new plants on earth).  


The attempt to make a bioengineered form of TRP for the first time is resulted in the production of di-TRP, which was unexpected and therefore undetected, since it never existed before.   [See http://www.nemsn.org/Articles/summary_tryptophan%20Fagan.htm ]


PS: Don't forget the ZMAPP project!  This Ebola drug was bioengineered using Tobacco Plant, and the rights to its product and the genetic engineering processes are patented.  So this process and its unexpected problems it may cause at times may very well continue.  See my related ScoopIt! at http://www.scoop.it/t/episurveillance/p/4026182931/2014/08/12/zmapp-and-the-treatment-of-the-spanish-priest-in-the-madrid-hospital-for-ebola  ;  



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Anti-Vaxxers Accidentally Fund a Study Showing No Link Between Autism and Vaccines

Anti-Vaxxers Accidentally Fund a Study Showing No Link Between Autism and Vaccines | Episurveillance | Scoop.it

The pictures depict a child's throat with the false membrane produced by diphtheria.   The frequency of diphtheria outbreaks in the late 1800s is what led to the frequent use of the emergency trachotomy procedure to open up the respiratory passage.  





Brian Altonens insight:

First used successfully around 1832 by French physician Pierre Brettoneau, the tracheotomy became popular during the 1850s when it was commonly applied to patients with diphtheria and very severe croup.  The tracheotomy again became common during the early 1900s, when large numbers of polio outbreaks occurred in the U.S..


In a review of US cases of diphtheria I performed several years ago, I uncovered one episode of a large number of diphtheria cases recurring in the midwest, totalling over 100 cases (and/or suspected cases coded as such) between some time before 2008.  


The Mumps and Whooping Cough (Pertussis) are still recurring each year in this country.   Last year and earlier this year, Measles made the headlines.  Most recently, a cluster of infectious disease cases made the news close to where the previously noted diphtheria outbreaks occurred.  


Of course, this recurring theme of immunizable disease outbreaks points to the consequences of parents refusing to vaccinate their children.   The clusters in Utah may be related to a large religious community in that region, which has been into naturopathic medicine since the early 1900s.  


Incidentally, naturopathy is the only accredited "doctor of medicine" program in this country that has a large number of graduates against immunization program.  This resistance is due largely to the long history of anti-immunization beliefs professed by professors of these schools in the U.S., and their graduated physicians (NDs not MDs), licensed and able to practice naturopathy legally in 8 states (perhaps a few more by now).  [This profession is most often linked to the unaccredited naturopathy home-schooled practitioners, who don't undergo the same level of graduate level medical education as MDs or NDs).


This midwest diphtheria outbreak is referred to specifically on my video of immunized diseases, viewable on Youtube,

https://www.youtube.com/playlist?list=PLWrApErk5byaJjbbjS6TEAAChZ7apmbzg ,


or on my page entitled "The Childhood Immunization Problem"  (http://brianaltonenmph.com/gis/population-health-surveillance/production-examples/the-childhood-immunization-problem/ -- links to the videos are at the very end; the second video is of immunization refusal clusters).


I also review these diseases and how the patients appeared in a fairly lengthy presentation . . . . 


as a slideshow at:




and as an autoplay this slideshow entitled "Immunizable Diseases - A Reminder of the Past" (27 min.) at: 




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Immunizable Diseases, in unimmunized children less than 12 yo - YouTube

"Unimmunized children enter the US by land and water routes. Major points of entry include New York harbor, Seattle and Portland Pacific Northwest harbors. . . . " 


This first map details where diseases were reported in EMR/EHR data, from Big Data records representing nearly a quarter of the US population (years ago now).  It shows how diseases are dispersed when they are very rare (the pox and polio), versus when they are quite common (mumps, whooping cough).


For comparisons, with where the disease able video depicting where the refusals to immunize prevail, see https://www.youtube.com/watch?v=LyqSJQOqSHU 

Brian Altonens insight:

This is the first video I produced, which took several days to merge the various parts of it into one 3.75 minute video, that consisted of rotating U.S. maps of unimmunized and underimmunized children for the major vaccines provided to kids under the age of two.  


This data comes from a number of years ago, but came during a time when surveillance was failing to  detect clusters of non-immunized kids in the Pacific Northwest, and various managed care agencies in the Northwest misreported the health status of various urban settings, based on their Childhood Immunization QIA and PIP results..  


My greatest criticisms were to a national name brand of insurance companies that falsely reported miraculous success based upon a single year's study, using the standard performance improvement project strategy, marketing their 95%+ immunization rates as an incredible success.  The problem is, their population was not representative of the Pacific Northwest as a whole.  


This blind guidance enabled the failure of the immunization programs of children to continue for the next several years, until ultimately, the gaps suggested by my 3D mapping successfully predicted the two places where future outbreaks occurred:  NYC-Lower Hudson Valley area (recall the short lives 2013 outbreak of measles at the Palisades Mall), and the west coast due to its century+ long history of immunization refusals.


For the bulk of my videos on this popular topic, go to: 


"Childhood and Adult Immunization refusals."  http://brianaltonenmph.com/gis/population-health-surveillance/production-examples/childhood-immunization-refusals/


"Why is Measles Making a Comeback?"

http://brianaltonenmph.com/2014/11/15/why-is-measles-making-a-comeback/ ;


"The Origins of Today's Childhood Immunization refusals". [part of a LinkedIn discussion]



My NationalPopulationHealthGrid.com page on this,

http://nationalpopulationhealthgrid.com/applications/01-childhoodimmunization/ ;


And certainly visit my slideshare on the consequences of not immunizing--"A History of [Un]immunized Diseases" at 

http://www.slideshare.net/brianlaltonen/immunized-diseases ;


http://brianaltonenmph.com/2015/01/28/a-history-of-unimmunized-diseases/ ;


and my controversial Youtube video equivalent--my autopilot version of slideshow--at 


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Anthrax scare is latest safety lapse at CDC labs

Anthrax scare is latest safety lapse at CDC labs | Episurveillance | Scoop.it
Several dozen federal scientists in Atlanta may have been exposed to live anthrax after researchers in a biosecurity lab failed to properly inactivate the deadly bacteria.
Brian Altonens insight:

Events like this need to be documented, monitored and the results kept up to date on the web at its own unique site.  These "accidents" are akin to "The Doomsday Clock" (http://thebulletin.org/overview ;  ; https://www.washingtonpost.com/news/speaking-of-science/wp/2015/01/22/the-doomsday-clock-is-ticking-again-it-is-now-three-minutes-to-midnight-a-k-a-the-end-of-humanity/ ;).  


The difference of course is that the sudden onset of war is harder to predict and control than pathogens.  Or is it?  


The primary reason we needs health surveillance at the local level, outside of government agencies, is that transparency is more likely to be evident when the public at large is somehow engaged as well in its own "watchdog"/health-watch activities.   Small Pox, the Plague, genetically modified Anthrax, genetically modified Ebola, serious E. coli var., a number of livestock pathogens from Asia and Russia, meningococcal induding strains (the next polio to outbreak in this country), some serious, uniquely toxic Vibrio, drug resistant bacteria and fungi (Tb), and various vermin are at rest in experimental labs.  But carelessness is a natural flaw with human behavior, as this repeated news story tells us.  Homeland security researchers,  microbiologists and international surveillance, bioweapons agencies  are not expect from this rule.



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Record 108 contract Legionnaires disease in New York

Record 108 contract Legionnaires disease in New York | Episurveillance | Scoop.it
The number of people diagnosed with Legionnaires disease has risen to 108 as America's largest city suffers from a record outbreak of the form of pneumonia, authorities said Saturday. No new deaths have been reported on top of the 10 announced earlier in the week and officials say the outbreak is now on the decline. To date, 94 people have been admitted to the hospital with the infection since the outbreak began on July 10 in the south Bronx, the poorest section of New York state.
Brian Altonens insight:

Working in the heart of New York City right now, some thoughts about the nature of what is happening with Legionnaires makes me wonder how the press and people are going to deal with this.  

It is worth mentioning that I am perhaps two steps shy of feeling much concern for my developing this disease.  First and foremost, I use my "sense" of health and especially immune health (mostly subjective assumptions) to keep these concerns at a minimum.  Legionnaire's erupted in my medical school during my first year there, in 1982; I did not catch it then why might I catch it now?  May I add, this reasoning is identical to what I used to perform my field surveillance work around known houses with cases of West Nile inside; the purpose of being there was to map out the ecology of that setting and evaluate the species of vectors and determine if they were carriers.  The second reason I had was even more pinpoint--all of the cases I investigated then involved people who were much older than me . . . and therefore textbook cases.  


Everyday, I take a train past on of the hot spots for the most recent New York City Legionnaires outbreak, and may have even traveled to one or two of these sites as part of my work.  

But seeing the big picture of what's happening in the immediate one to two block area, around a potential outbreak nidus, and seeing how many people travel those streets and enter those buildings each and every hour, I find it amazing to think that anyone could actually design a model to accurate predict the diffusion activity down to the small area spatial level.  That's what makes spatial epidemiology as exciting as it is and formula writing the big brainteaser that it is.  


Taking a break at lunch, I counted about ten thousand people coming in and leaving a less than one block area in lower Manhattan per hour.  Therefore, it makes sense to guess that this is a place where an infectious disease could very easily come in.  


But exactly where the infectious person goes once he lands on Water Street is  a different story.  He or she could head to a hospital in the Bronx by taxi or subway, the many local tourist sites, the 911 monument, to times square, or to a small clinic north of Harlem by bus or company transit because that is where he or she works.  How and where a disease will actually diffuse away from the Old Slip is anyone's guess.  


What's also important here is to realize that is how Valentine Seaman thought when he was trying to map yellow fever out in 1799 or 1800,  following its repeated return in early October.  Seaman thought his disease had to be either locally airborne or came in by crew and passenger and/or by rotten foodstuffs and stinky ballast water. 


So, based upon Seaman's observations, applying this same logic to Legionnaire's makes no sense--or does it?  


The large air conditioning facility is the suspected culprit in this case--aerosolized water particles being spread about a facility.  But how can such an event commence almost simultaneously in multiple facilities?  Is there another commonality to these places and their people, be it environmentally or ecologically (human ecology that is)?  


Once again, that question has to be asked by modern New York epidemiologists--is the disease being spread by people or air-water effects.  The locations point to people.  The pattern suggests an aerosol nature.  The nature of the facilities point to the role or human transportation in all of this.


Relating all of this back to GIS--with GIS, we cannot make as accurate prediction for the cause and spread of Legionnaire's as we would like.   We would have a hard time predicting this outbreak, had we the foresight to think about looking this up months ago. But once it is there, we have a place to begin our spatial prediction modelling routine.


Fortunately, we can develop a very accurate model on how a disease can behave once it has erupted, and in retrospect why it is where it is.  

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Number of Legionnaires' disease cases in Bronx outbreak rises to 46, city says

Number of Legionnaires' disease cases in Bronx outbreak rises to 46, city says | Episurveillance | Scoop.it
Watch the video Number of Legionnaires' disease cases in Bronx outbreak rises to 46, city says on Yahoo News . Two rooftop cooling systems have tested positive so far, Concourse Plaza Housing, a private housing complex, and at Lincoln Hospital.
Brian Altonens insight:

There are human diffusion patterns linked to this outbreak.  The Legionnaires may be associated with identical events at different locations, but there are transportation related links between the different regions afflicted by this outbreak.  This cause and effect can only be proven using GIS technology and spatial statistics.

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El Niño Is Coming Back: Here's What You Need to Know

El Niño Is Coming Back: Here's What You Need to Know | Episurveillance | Scoop.it
Most of us haven't thought about El Niño, the havoc-wreaking global weather phenomenon, since 1998. Now, scientists are saying an El Niño is developing in the Pacific that could be as powerful as that record-setting year. Here's everything you need to know about El Niño and its potential effects. (Source: Bloomberg)
Brian Altonens insight:

And El Nino can have everything to do with diseases that bear a natural ecology part to their spatial habits.  Many of the following have that behavior.


As the "missed opportunities" list continues to get longer in 2015, due to no GIS in managed care, some of these are worth researching:


--Tularemia on the rise (July 2015)  http://www.healthmap.org/site/diseasedaily/article/tularemia-cases-rise-colorado-7315 ;

-- Aggressive HIV in Cuba (July 2015)  http://www.healthmap.org/site/diseasedaily/article/new-aggressive-hiv-strain-found-cuba-3115 ;

--Diphtheria returns to Spain 19 years later (June 2015)  http://www.healthmap.org/site/diseasedaily/article/spain-first-case-diphtheria-1986-61315 ;

--Vibrio vulnificus strikes in Florida (June 2015)  http://www.healthmap.org/site/diseasedaily/article/vibrio-vulnificus-florida-reports-eight-cases-two-deaths-61915 ;

-- Pakistan's Polio again a concern (May 2015)  http://www.healthmap.org/site/diseasedaily/article/blinding-syphilis-west-coast-cases-rise-32015 ;  [Pakistanians refuse to vaccine their children - http://www.healthmap.org/site/diseasedaily/article/pakistan-polio-3815 ]

--Anthrax containers mailed in error to Australia (@May 25, 2014)  http://fox13now.com/2015/05/27/utah-military-lab-inadvertently-sent-out-live-anthrax-samples-officials-checking-for-more/  

--New form of Syphilis, causing blindness (May 2015)  http://www.healthmap.org/site/diseasedaily/article/blinding-syphilis-west-coast-cases-rise-32015 ;

-- Powassan hits Connecticut (April 2015)  http://www.healthmap.org/site/diseasedaily/article/powassan-emerges-connecticut-41915 ;

--Enterobacteria "Superbugs" resistant to medications take another great leap (Feb. 2015)    http://www.healthmap.org/site/diseasedaily/article/%E2%80%9Csuperbug%E2%80%9D-outbreak-ucla-medical-center-22715 ;

--Avian Influenza on the rise in the U.S.  (Feb. 2015)   http://www.healthmap.org/site/diseasedaily/article/rise-avian-influenza-22015

-H5N1 strikes U.S.  http://www.healthmap.org/site/diseasedaily/article/h5n1-arrives-united-states-13015 ;

--Viral Meningitis strikes students in Texas  http://www.healthmap.org/site/diseasedaily/article/confirmed-viral-meningitis-texas-university-what-means-other-students-11314 ;

--Poliolike enterovirus strikes the country (Oct. 2014)  http://www.healthmap.org/site/diseasedaily/article/enterovirus-d68-and-paralysis-10314 ;

--Drug resitant TB becoming a problem (Sep. 2014)  http://www.healthmap.org/site/diseasedaily/article/holding-our-breath-multi-drug-resistant-tuberculosis-91114 ;

--Measles has an outbreak on west coast, and spreads to the Great Lakes (2014)  http://www.healthmap.org/site/diseasedaily/article/measles-america-why-vaccination-matters-21815 (outbreak is reviewed)

--Healthcare workers repeated ignore national public health safety and homeland biosecurity matters (July to Dec. 2014)

--Forgotten small pox vials (July 2014)   http://www.nature.com/news/nih-finds-forgotten-smallpox-store-1.15526  ;  Update:  http://www.usatoday.com/story/news/nation/2014/07/16/fda-update-on-vials-found-in-cold-storage-at-nih/12744543/ ;

--Chikungunya arrives in the Americas (Summer 2014)  http://www.healthmap.org/site/diseasedaily/article/virus-crossing-oceans-chikungunya-americas-92914 ;

--Wild Poliovirus in Sewage water in Brazil (June 2014)  http://www.healthmap.org/site/diseasedaily/article/wild-poliovirus-type-1-found-brazil-sewage-samples-%E2%80%93-what-does-it-mean-62414 ;

--Ebola goes out of control (May/June 2014)  http://www.healthmap.org/site/diseasedaily/article/ebola-one-year-later-32915 (reviewed one year later)

--MERS hits Florida  http://www.healthmap.org/site/diseasedaily/article/guest-post-details-second-case-mers-united-states-found-florida-traveler-51314 ;  [Middle East update: http://www.healthmap.org/site/diseasedaily/article/mers-update-old-data-emerges-saudi-arabia-news-jordan-and-algeria-6814 ]

--MERS hits Chicago (ca. May 1, 2014)    http://www.nbcchicago.com/news/health/First-US-MERS-Virus-Case-Entered-Through-Chicago-257714931.html ;

--Measles Outbreak in Texas (Sep. 2013)  http://www.usatoday.com/story/news/nation/2013/08/23/texas-measles-outbreak/2693945/ ;


--New England Creutzfeld-Jacob Outbreak (Sep. 2013)  http://www.healthmap.org/site/diseasedaily/article/rare-creutzfeld-jacob-outbreak-new-england-91113 ;


--Polio strikes the Middle East reducing chances for immediate eradication (Late 2013)  http://www.who.int/mediacentre/news/statements/2013/polio-syria-20131113/en/ ;

--Missed measles on the east coast (Fall 2013)  http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6236a5.htm ;



For more on 2014 - see  http://www.healthmap.org/site/diseasedaily/article/outbreaks-2014-123114 ;

For more on 2013 - see  http://www.healthmap.org/site/diseasedaily/article/outbreaks-2013-122013 ;

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Report: Ebola Outbreak Exposed “Organizational Failings” at WHO – Outbreak - FRONTLINE

Report: Ebola Outbreak Exposed “Organizational Failings” at WHO – Outbreak - FRONTLINE | Episurveillance | Scoop.it
A scathing review found the WHO unable to respond rapidly to global health emergencies, despite it status as the U.N. agency countries look to when dealing with crises like the Ebola outbreak.
Brian Altonens insight:

It's time for some "Blaming the Victim" moves.  Blame has shifted from direct line related events to administration, to other more intangible causes.  Plus, a typical "taming the best" response is being given--trying to redirect the cause for failure to less people-specific things, such as "lack of direct line communication" and "the failure of other countries to get a program in place".  Blaming the Victim.  Specific people were the cause here---name them, and then fire them.   “Organizational failings” by the U.N.'s public health team and this team's  incapacity or inability to operate an "organizational culture”  are not reasons that we can easily design a metric for, to demonstrate improvement.   No quality assurance process can be defined.  

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The all-payer health system: minimize waste, level the playing field

The all-payer health system: minimize waste, level the playing field | Episurveillance | Scoop.it

The uneven distribution of prices for health care are in dire need for a change.  Traditionally, the business approach to healthcare has been in favor of businesses and their financial ventures.  The unevenly distributed costs for the same medical venture is due to this healthcare billing practice.  But all of this could be changed over the next decade.

Brian Altonens insight:

It was once the case the amount and type of data in medical records differentiated one set of cases from another.  Open text entries still help differentiate one health care system's performance from another, although NLP is now even eliminating that difference that can be found between different service industries or companies.  


Quite soon, it is possible that there will be no difference between Company A that provides a specific line of services, and Company B that provides the same services, but for a lesser price.  Because EMR/EHR is standardizing data form, content and quality, the study of a group of patients with a specific ICD like epilepsy, will be different or better for Company A versus Company B only because the skills sets and utilization of hardward and software by the people employed by these two companies differs.  


As a spatial analyst, I can apply my spatial methods to a series of studies focused on seizures in much the same way that I correlate data for cancer patients, cardiac patients or chronic disease management patients.  The data content are very similar for all of these studies.  Even the genetic screenings are now becoming standardized enough to transfer the skills of reviewing breast cancer probabilities to the skills of estimating changes in patients' lives due to intrafamilial seizure prevalence or CRB1 induced blindness.    


The skills one company has over another when evaluating therapeutic outcomes has little to do with the data, except for data that are owned and held exclusively by that company.  It is the skillset of the workers of that company that make or break it.  The cost for a company's services might also make or break that company's long term chances for survival.


The all-payer, EMR/EHR mode that health care may develop into also means that utility and method patents are now a time-limited, even potentially time and money-wasting adventure.   Both of these allocate only 17 years of patent-based restrictions for potential competitors.  This means that unless your unique way of bettering healthcare and reducing costs using the EMR/EHR system becomes a success in three years of less, it is likely to not meet the goal of experiencing enough years of use to earn payback for your time.  


And since IT turnover rates for software and patented analytic methods are so brief (a product of Moore's Law, and well under ten years), you are going to have excel in the first years, to achieve 2 to 5 years worth of payback for your product.  


In the case of Medical GIS, the All-Payer system could have a positive effect.  Standardized costs seems very socialist to some.  But the development of an EMR/EHR system has changed the competitive aspects of the health data world into a less competitive, more socialized ["standardized"] looking means for assessing US population health.  


Medical GIS benefits from the development of a more standardized health information technology system.  Corporate IPR will be threatened.  The broader use of open source procedures for managed care analyses will be developed. 

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How Contagious Is Measles? Man Catches Virus at Airport Gate

How Contagious Is Measles? Man Catches Virus at Airport Gate | Episurveillance | Scoop.it
It's no secret that airports are hubs for germs, but one Minnesota man was particularly unlucky during his travels — he appears to have caught measles simply by passing a sick child while exiting his plane. The 46-year-old man was traveling from Minnesota to Massachusetts on a business trip in April 2014, with a connection in Chicago, according to a new report of the case. After he arrived in Massachusetts, the man developed a rash characteristic of measles, and his diagnosis was confirmed with a lab test.
Brian Altonens insight:

Beside Measles, do we need to be reminded of Tb, the flu, MERS, the Mumps, even Polio(!) . . . . . Ignorance is no longer an excuse.  Awareness is what needs to be taught.  

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Rachel Dolezal's world crumbles after racial identity flap

Rachel Dolezal's world crumbles after racial identity flap | Episurveillance | Scoop.it
SPOKANE, Wash. (AP) — Rachel Dolezal carefully constructed a life as a black civil rights activist in the last decade in the inland Northwest, but that world is falling apart following the disclosure by her parents that she was a white woman who for years has posed as African-American.
Brian Altonens insight:

It could be time for a new set of boxes to check on your application.


In medicine, we want to know race and ethnicity for population health reasons, reasons pertaining to health related information such as minority-linked higher incidence of missed health screenings, culturally-linked foodways and health, likelihood of suffering from SES-derived poor growing environments and poorly nourished upbringings. and even worse, genetic disease.


Administratively, the major reason we include these questions about race and ethnicity is that they are/it is required, and it makes us look good.  In reality, you know we are not fully into this, because after all, nine-tenths of the industry or more still fail to separate out the hispanic/non-hispanic question enough, and/or confuse race and ethnicity by assuming both are the same.


Traditionally, race is biological, and ethnicity is a combination of biological and cultural.  That is why they need to be separated.  


The kind of "black" or "African American" that Dolezal assigned to her self was none of these previous two or three options we have traditionally had.  Her self-proclaimed heritage is as applicable to health care as an Inuit calling themselves Saami.  It survive due to the confusion it can cause.


Yes, the health issues of an Inuit (formerly Eskimo) could be nearly identical with that of Saami (formerly Laplanders).  Both resided in the same geographical and climatic settings.  But do the two have the same genes?  Sometimes they do.  But only some of the time.


For self-proclaimed ethnicity, like a 7th generation Native American descendant, the gene responsible for their alpha-hypolipoproteinemia is just as relevant as as any other autosomal dominant gene that one inherits.  You may not live and look "Indian", but your arteries, dietary requirements, and heart reside biologically in you like you were from that culture.


So for Dolezal, she was lucky she didn't have the sickle cell problem, or that she didn't have to grow up in a ghetto dealing with the likelihood of becoming a gang member rather than go to college.  She didn't have brothers and sisters to care for because mom had to work two jobs.  She had the choice to be and represent African Americanism the way that she did.


This social behavior points out how much trouble still lies ahead with genetic racial diversity.  Perhaps knowing the genome through genetic screening is the only way to manage race and ethnicity as a biological health factor, and "preferred" or "presented" "culture" the way to deal with whatever sociological factors are responsible for our behavioral, psychosomatic and "physiosomatic" health and unhealthy states.


Nearly 100% of the health situation presented here for this former professor will be mostly psychological and behavioral in nature, and never biological, physiological or physically African in nature.  The Health Belief Model really prevails in this case, for understanding individuals' disease states or diagnostics when it comes to mapping out health, in relation to population features such as SES, Race, Ethnicity, and that new column in the census that  there ought to be--"Self-defined Race or Ethnicity Lifestyle Preference."




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U.S. health officials seek people who may have contacted TB patient

U.S. health officials seek people who may have contacted TB patient | Episurveillance | Scoop.it
By Suzannah Gonzales CHICAGO (Reuters) - A woman with a rare and potentially fatal drug-resistant form of tuberculosis visited Illinois, Missouri and Tennessee this spring, and U.S. and Illinois health officials were working on Tuesday to identify people who may have been exposed to her. Now in stable condition and in an isolation room at the National Institutes of Health Clinical Center in Maryland, the patient initially was held in respiratory isolation at a suburban Chicago hospital before being admitted on Friday at the NIH hospital, the NIH and U.S. Centers for Disease Control and Prevention (CDC), said in statements.
Brian Altonens insight:

This individual has quite a history of exposures that need to be traced, across three or more states.  Drug-resistant strains are the next generation of classic infectious diseases.  


See  "Get ready for a future where antibiotics no longer work" by Susannah Locke, produced a year ago (May 1, 2014).


http://www.vox.com/2014/5/1/5669526/get-ready-for-a-future-where-antibiotics-no-longer-work ;

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