How hospitals, nursing homes keep lethal ‘superbug’ outbreaks secret

Reuters, 22 December 2016
Authors: Deborah J. Nelson, David Rohde, Benjamin Lesser and Ryan McNeill
“Across the U.S., vague rules give healthcare providers lots of leeway in deciding when, or even whether, to report unusual clusters of infections. And when they do alert officials, that information is usually kept from the public. A patchwork of state laws and guidelines, inconsistently applied, tracks clusters of the deadly infections that the federal government 15 years ago labeled a grave threat to public health. As a result, the United States has no way to count the deadly spikes in infections that hit the nation.”
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U.N. Apologizes for Role in Haiti’s 2010 Cholera Outbreak

NYT, 1 December 2016
Author: Somini Sengupta
“After six years and 10,000 deaths, the United Nations issued a carefully worded public apology on Thursday for its role in the 2010 cholera outbreak in Haiti and the widespread suffering it has caused since then. The mea culpa was an implicit acknowledgment that cholera was not present in Haiti until United Nations peacekeepers arrived in the country from Nepal, where a cholera outbreak was underway.”
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New AIDS vaccine: ‘Final nail in coffin’ for disease?

Aljazeera, 1 December 2016
Source: AFP
“South Africa has launched a major clinical trial of an experimental vaccine against the AIDS virus, which scientists hope could be the “final nail in the coffin” for the disease. It is one of the biggest clinical trials involving the disease ever undertaken and has revived hopes of a breakthrough in the battle against AIDS.”
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Victims, vectors and villains: are those who opt out of vaccination morally responsible for the deaths of others?

J Med Ethics 2016; 42:762-768
Authors: Euzebiusz Jamrozik, Toby Handfield, Michael J Selgelid
“Mass vaccination has been a successful public health strategy for many contagious diseases. The immunity of the vaccinated also protects others who cannot be safely or effectively vaccinated—including infants and the immunosuppressed. When vaccination rates fall, diseases like measles can rapidly resurge in a population. Those who cannot be vaccinated for medical reasons are at the highest risk of severe disease and death. They thus may bear the burden of others’ freedom to opt out of vaccination. It is often asked whether it is legitimate for states to adopt and enforce mandatory universal vaccination. Yet this neglects a related question: are those who opt out, where it is permitted, morally responsible when others are harmed or die as a result of their decision?”
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Removing disclosure law will help stop HIV spread, health experts say

SMH, 27 November 2016
Author: Kirsty Needham
“The Baird government will finally close the door on a chapter of NSW history that involved harsh laws being enacted at the height of the AIDS epidemic, driven by a fear of the unknown and public panic.”
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UK has highest rates of cocaine use and gonorrhoea in Europe

The Guardian, 24 November 2016
Source: Press Association
“The UK is a European hotspot for cocaine use and gonorrhoea, a new report suggests. Across Europe, 1.9% of young adults aged 15 to 34 report using cocaine in the last year. But in the UK this figure stands at 4.2%, according to the Health at a Glance: Europe 2016 report from the European Commission and the OECD. Out of every 100,000 people in the British population, 60 were found to have the sexually transmitted infection – compared with a European average of 20 cases per 100,000 people.”
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Rethinking the Ban — The U.S. Blood Supply and Men Who Have Sex with Men

NEJM, November 16, 2016
Authors: Chana A. Sacks, Robert H. Goldstein, Rochelle P. Walensky
“The ban on donations from men who have sex with men was instituted at a time of public health panic and vast uncertainty, but 31 years later, scientific advances in testing and in understanding of disease transmission offer new tools and better ways than a sweeping ban to minimize the risk of transfusion-related HIV. Thousands of people died from HIV that they contracted from the blood supply, and their memories demand that we not fall victim to the hubris of believing that there will not be emerging threats or new knowledge to be gained. Greatest respect can be paid to the people who died and to this tragic and complicated history not by maintaining outdated policies but by constantly reevaluating and implementing changes in line with what we do know and by advancing science in areas we do not fully understand. We must be committed to empirical rigor in the evaluation of the outcomes of any new policy changes, and in that way we can continue to ensure a safe blood supply for every person, of every community, who may need it.”
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Most of 260,000 young Australians with chlamydia STI don’t know

SMH, 14 November 2016
Author: Rania Spooner
“Hundreds of thousands of young Australians are living with a sexually transmitted infection and researchers warn most don’t know they’ve got it. According to the Australian Annual Surveillance Report into sexually transmissible infections and blood-borne viruses, there were an estimated 260,000 new cases of chlamydia in 15 to 29-year-olds by the end of 2015. The report also reveals that despite HIV levels stabilising overall, new infections in Aboriginal and Torres Strait Islander populations have continued to rise.”
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NHS loses court appeal over ‘game-changing’ HIV drugs

The Guardian, 10 November 2016
Author: Sarah Boseley
“NHS England does have the power to pay for drugs to protect thousands of people against HIV, the appeal court has ruled, but they may still miss out if it decides it does not have enough money to prioritise them over treatments for other conditions. The case was brought by the National Aids Trust (NAT) after NHS England said responsibility for public health, including HIV prevention, had been passed to local authorities.”
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Australian law needs a refresher on the science of HIV transmission

The Conversation, 8 November 2016
Authors: Mark Boyd, Andrew Grulich, David Cooper et al
“In our consensus statement published this week in the Medical Journal of Australia, we detail the latest evidence on HIV transmission risk and recent advances in HIV prevention and treatment. We propose that legal cases relating to HIV transmission should be considered in light of such evidence, and that alternatives to prosecution such as the public health management approach are often appropriate.”
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