Infectious Disease

Infectious disease physicians and clinicians writing on KevinMD about outbreaks, antimicrobial resistance, vaccines, and the ongoing challenge of preventing and treating infection. Contributors include the physicians who treat infectious disease and the public health physicians who track it. For a maintained record of what physicians have said about vaccines and vaccine refusal since 2004, see Vaccines: what physicians say, in their own words. For what clinicians wrote during the COVID-19 pandemic as it happened, see COVID-19: what physicians wrote as it happened.

3 amazing medical advances that haven’t caught on

Ilana Yurkiewicz

Conditions and Diseases

January 23, 2015

The life cycle of a medical advance usually goes something like this: from discovery at the research bench and replication of findings to translational research and clinical trials, to implementation. The bottleneck can be at any one of these stages, and often it is in the discovery one; we just haven’t yet found the thing that works.

But other times, we have — the intervention works, we have shown and confirmed …

Measles in Disneyland is entirely preventable

Roy Benaroch, MD

Conditions and Diseases

January 19, 2015

NPR recently reported, “Measles makes an unwelcome visit to Disneyland.” Nine people who visited Disneyland theme parks in California over winter break had caught measles, almost all of them unvaccinated children. The next day, ABC reported that the number of cases has grown to 19. Of these, only two had been fully vaccinated. Some of the cases were too young to receive vaccines, others apparently chose not to get vaccinated. …

The strain of the influenza epidemic on emergency departments

Meeta Shah, MD

Conditions and Diseases

January 19, 2015

Influenza has arrived refusing to be ignored or be the ugly step-virus to Ebola any longer. This influenza season is officially an epidemic. The Washington Post’s Wonkblog reported earlier this month that December 2014 was “one of the worst flu months in years.” In fact, they found that it was “the worst December since the polling organization started tracking flu season in 2008.”

As of January 3rd, the CDC reported widespread …

MKSAP: 74-year-old man with fever and chills

mksap

Conditions and Diseases

January 17, 2015

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 74-year-old man is evaluated in the emergency department for a 3-day history of fever and chills as well as confusion. He has a 5-week history of a nonhealing ulcer on the plantar surface of his left foot. He has diabetes mellitus, hypertension, and peripheral vascular disease for which he takes metformin, …

Scared of the flu vaccine? Let’s see what’s really inside it.

Jennifer Gunter, MD

Medications

January 14, 2015

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Dangerous ingredients, like toxins, antifreeze, and mercury, are touted by many as reasons to decline vaccination against influenza. However, toxin is an inaccurate term regarding vaccines (a toxin is a poisonous substance made by cells or organisms and is definitely not in any vaccine), mercury is a non-issue (see below), and there is no antifreeze in vaccines (although some contain propylene glycol, …

MKSAP: 46-year-old woman undergoing a dental cleaning

mksap

Conditions and Diseases

January 10, 2015

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 46-year-old woman is evaluated before undergoing a dental cleaning procedure involving deep scaling. She has a history of mitral valve prolapse without regurgitation and also had methicillin-resistant Staphylococcus aureus(MRSA) aortic valve endocarditis 10 years ago treated successfully with antibiotics. The patient notes an allergy to penicillin characterized by hypotension, hives, and …

3 ways to use bacon as medical treatment

Jennifer Gunter, MD

Conditions and Diseases

January 8, 2015

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You might think of bacon, that thing of gustatory beauty that is salted, cured pork, as just pleasure for your taste buds. However, one of the first medical facts I learned in 2015 was that bacon has medicinal purposes (apart from making you feel better after eating it). With this new knowledge at hand, the time just seemed right for a …

The microbiology versus the psychology of kissing

Manoj Jain, MD, MPH

Conditions and Diseases

January 1, 2015

This year, we celebrated our 25th wedding anniversary. So, last week, one evening, I told my wife about a news story I heard on National Public Radio (NPR) about the microbiology of a kiss. My wife smiled.

A group of researchers, I said, looked at the oral bacterial flora of 21 couples to determine how many bacteria were transferred by a kiss. …

Our fascination with Ebola exposes a double standard

Robert Pearl, MD

Conditions and Diseases

December 29, 2014

Since Ebola was first discovered in 1976, there have been an estimated 16 to 22 recorded outbreaks. In August, the World Health Organization designated the most recent outbreak a global emergency.

Ebola is a deadly infection and the scope of the current epidemic in West Africa is unprecedented. More than 17,000 people have contracted Ebola virus disease (EVD) with more than 6,000 estimated deaths.

Many in the health care field have criticized the response of world …

How antibiotics are killing us and the new ones can’t come fast enough

Michael Lubrano, MD, MPH

Medications

December 19, 2014

I stared down at the tired, deteriorating woman sprawled across a bariatric bed before me. A breathing tube was in her throat while multiple catheters pierced her arms and neck, pouring powerful medications directly into her veins. Among several functions, these infusions would maintain her blood pressure high enough to keep her organs alive. This was my initial, visual impression of a patient I was responsible for during my first …

The flu vaccine is imperfect, but please get it anyways

David L. Katz, MD

Medications

December 19, 2014

This year’s flu vaccine, as you likely know, is taking a drubbing. The contention is that CDC flubbed, and didn’t get quite the right flu strains in the mix. That is apparently true, although more the “fault” of the influenza virus and its natively wily ways, than of the CDC. Either way, the drubbing is disproportionate to any flubbing.

The drubbing occurs in …

The paranoia surrounding hospital infection rates

Karen S. Sibert, MD

Physician

December 13, 2014

No one wants a hospital-acquired infection — a wound infection, a central line infection, or any other kind. But today, the level of concern in American hospitals about infection rates has reached a new peak — better termed paranoia than legitimate concern.

The fear of infection is leading to the arbitrary institution of brand new rules. These aren’t based on scientific research involving controlled studies. As far as I can tell, …

Science bashing: The latest threat to research in America

Sherry Pagoto, PhD

Health Policy

December 11, 2014

In the midst of multiple public health crises, the NIH budget is in an unprecedented period of stagnation. So why the growing chorus of voices calling to slash more science?

Senator Rand Paul recently slammed the NIH, specifically calling out a study of “origami condoms” which he says are “designed with Japanese folding paper in mind.” In fact, this research is …

The origins of HIV and the making of an AIDS scapegoat

Rod Tanchanco, MD

Conditions and Diseases

December 6, 2014

The cherry trees are still there, blossoming every spring, on a patch of land near Stanley Park in Vancouver. They were planted in 1985 by a group of volunteers from AIDS Vancouver, to honor the memory of three Canadian sons who were among the early victims of AIDS. One of these men was Gaetan Dugas, who died in 1984. During this same period in San Francisco, Randy Shilts, a reporter …

A diagnosis of HIV: God had nothing to do with it

Lawrence Rifkin, MD

Physician

November 23, 2014

It didn’t seem like my college-age patient Quincy had any idea what was in store when I entered the exam room.

“Hi Dr. Rifkin,” he said with a warm smile as I sat next to him. Quincy (not his real name) had been my pediatric patient for years.

I didn’t delay. “Hi Quincy. I’m afraid I have some terrible news. Your lab work came back — you’re HIV-positive.”

His head went back slightly. …

The mystery of diagnosing Lyme disease

Andrew Pugliese, MD

Conditions and Diseases

November 23, 2014

Four months ago, a 44-year-old woman was referred to me by her audiologist and ENT for acute deafness of the right ear. She is a healthy woman without any past medical history and was not on any medication. Her otolaryngologist (ENT) could not find any physical reason for the patient’s acute unilateral deafness, including a negative CT scan. She was being referred to me to determine if there was an …

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The mystery of diagnosing Lyme disease

The public’s lack of trust in science is alarming

Bob Doherty

Physician

November 19, 2014

Cynicism appears to have replaced idealism as America’s defining characteristic. So many of us just don’t trust the government, scientists, the clergy, journalists, business CEOs, labor unions, lawyers, or just about anyone for that matter, to say or do the right thing.

Two years ago, the National Journal reported that as a consequence of the Great Recession, “Americans are losing faith …

Ebola is yesterday’s news, but should the media move on?

David L. Katz, MD

Conditions and Diseases

November 17, 2014

Remember when we were trying not to panic about Ebola? Seems like that was only yesterday. Oh wait — it was only yesterday. But it already seems as if we are trying to remember that we were trying not to panic.

I listened to my favorite news radio station out of New York City while driving to the office recently. They address all of the major news stories in the first eight …

The ethics of researching Ebola

Ruth Macklin, PhD

Conditions and Diseases

November 12, 2014

As we learn of new suspected cases of Ebola infection in the United States, causing worries among the population and renewed efforts by the Centers for Disease Control and Prevention to contain the epidemic.

A student in the postgraduate course in research ethics that I teach at Albert Einstein College of Medicine recently asked whether we could discuss the Ebola epidemic in class. Because I had prepared the syllabus for the course months ago, I hadn’t …

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The ethics of researching Ebola