ATLANTA, GA. n “Health doesn’t happen in the doctor’s office, even if you do have access. Health happens in the homes and schools and in our communities,” said Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention.
As one of 10 Midwest Fellows of the Association of Health Journalists (and a handful of national media) who received a two-day visit to the CDC in Atlanta last week, I spoke to some of the nation’s leading health experts and scientists who study, track and find treatments for naturally occurring and man-made health outbreaks.
Poverty is still the No. 1 health problem globally, according to Gerberding, a point made clear at our first stop n an afternoon at The Carter Center.
The institute was founded in 1982 by former President Jimmy Carter and his wife, Rosalynn, in partnership with Emory University to promote world conflict resolution, peace, democracy, disease prevention and improving mental health care.
Clean water and proper sanitation create a great difference in the overall health of persons in impoverished nations. Geography, topography, politics and war complicate those efforts.
Carter Center representatives provide insecticide-treated mosquito nets, water filters and build latrines in remote parts of Africa to eliminate vector-borne disease. They also teach taking precautions to prevent transmission.
One pest that is hopefully on its way to extinction due to the work of the Carter Center is the Guinea worm. Its larvae are ingested by drinking contaminated water. Once inside the body, it incubates for several months to a year and grows into a spaghetti-like parasite two to three feet long before it snakes its way out through the lower extremities of the body, causing debilitating pain.
Once the Guinea worm pokes through in a painful blister, it takes another 30 to 60 days to come out. As treatment, the worm has to be carefully wound up slowly on a stick and the area cleansed and wrapped every two days until it is completely removed and destroyed.
The cycle continues when persons with protruding worms go into water and unwittingly re-contaminate it, as the female worm releases its larvae into the water.
Two days after our visit, the Carter Center announced major new progress toward eradicating dracunculiasis, or Guinea worm disease, which included $55 million in pledged support to end it once and for all in the African nations where less than 5,000 cases remain n Sudan, Ghana, Mali, Ethiopia, Nigeria and Niger.
“Guinea worm is poised to be the second disease eradicated from Earth, ending needless suffering for millions of people from one of the world’s oldest and most horrific afflictions,” said former U.S. President Jimmy Carter, founder of The Carter Center.
When the Carter Center eradication program began in 1986, 3.5 million cases of Guinea worm disease were found in 20 countries in Africa and Asia. It is now reduced by more than 99 percent.
“At this stage of the campaign, we need to redouble case containment efforts and enforce strict surveillance activities to ensure Guinea worm disease eradication,” said Dr. Margaret Chan, director general of the WHO. Guinea worm disease will be the first disease eradicated without a vaccine or medicine.
Climate change and the CDC
At the CDC, scientists have a command center to monitor and coordinate emergency response to public health threats and outbreaks around the world and do so by invitation in 55 countries. They also respond to natural and manmade disasters and test to identify and treat suspicious pathogens in a highly secure and technologically advanced facility.
Dr. Sharif Zaki and other scientists study mysterious, infectious diseases and unexplained deaths brought to the attention of the CDC.
His colleague showed reporters an enlarged dissected heart of a 50-year-old man who lived in the Southwest. He died a few days after cleaning out a shed. State authorities suspected the hanta virus. Upon further examination, the CDC concluded the man died from a staff infection that settled in an abnormality in the aortic valve of his heart.
Zaki said state and local health departments send hundreds of specimens each year for the CDC to conduct their medical detective work to find the cause of death.
Pandemic flu preparation now makes up 21 percent of the CDC budget. The CDC message of preparedness is in all 50 states and 30 countries.
The CDC said effects of global warming n warmer sea surfaces, higher carbon dioxide concentrations in urban environments and ground level ozone emissions n will cause across the board health effects, including:
• Allergies/respiratory irritation due to higher pollen counts and longer growing seasons
• Cardiovascular failure due to heat stress
• Stronger severe weather events
• Vector borne diseases n from mosquitoes, flies, etc.
• Increased seafood toxins – due to algae eaten by fish
• Water borne illness
• Agricultural changes affecting food supply
• Mental health trauma
• Environmental refugees
CDC officials said some call the violence in Dafur as the first conflict due to scarce resources due to climate change.
Although climate change is global, George Luber, associate director of global climate health at the CDC, said the effects will be on the local level and responses will have to be regional or city-specific.
Studying obesity, the health effects of smoking, food borne disease outbreaks and environmental and genetic causes of disease and injury are other areas of focus at the CDC.
The vast reach of the CDC behind the scenes in population health is what I find most impressive. Although the CDC is a non-regulatory agency, it does have quarantine power over select, deadly pathogens.