An early warning system for health threats: the invaluable work of ProMED

Posted on Saturday, May 2, 2009 by nosleepingdog

ProMED Mail is one of the most important information resources on the net, and most of us have never heard of it. It’s an email list which describes itself as a “global electronic reporting system for outbreaks of infectious diseases and acute exposures to toxins that affect human health, including those in animals and in plants grown for food or animal feed”.

Unlike the official clearinghouses run by WHO and CDC, ProMED is, in its own words, “open to all sources” and its reports are freely available to us all. ProMED was first to raise concern about the aggressive respiratory disease spreading in China in 2003, which became known as SARS. Before the Chinese authorities had permitted their officials to report the disease to WHO, Catherine Strommen, an elementary school teacher in Fremont, California, spotted a post in an international teachers’ chat room from a concerned teacher in China describing “an illness that started like a cold, but killed its victims in days”.

Alarmed, Strommen emailed an old neighbor and friend, Stephen Cunnion, M.D., a retired Navy physician and epidemiologist who now lived in Maryland. A practical, no-nonsense man, Cunnion started searching the web. With no success, he tried a new tack—sending an email to ProMED-mail, a global electronic reporting system for outbreaks of emerging infections and toxins. After quoting Strommen’s missive, he asked: “Does anyone know anything about this problem?”

The tiny ProMED staff conducted its own web search. It, too, came up empty-handed. On February 10, it sent out to tens of thousands of subscribers a posting headed: “PNEUMONIA – CHINA (GUANGDONG): RFI,” or Request for Information.

Thus did the world first learn of SARS, the new and deadly infection that would kill 774 people and infect 8,000 in 27 countries.

From an article by Madeline Drexler in The Journal of Life Sciences.

H1N1 Reports (Swine-avian-human Influenza A)

To keep up on H1N1 flu [I agree with the pig farmers, “swine flu” sounds like your big risk is getting it from pigs and pork, not human sneezes and handshakes] check the ProMED main page. While all the media is now frothing over with “news” about this disease, some of it sounds as reliable as alien abduction accounts. ProMED is timely and scientifically accurate but understandable by non-biologists. It includes valuable, and interesting, commentary on reports and questions: “this has been reported, but here’s what we don’t know, or here are local factors that must be considered in evaluating it”.

What ProMED does

ProMED is a program of the International Society for Infectious Diseases which began in 1994. It does not simply print whatever comes in—this is an extremely well-moderated list. A group of specialists checks and filters the reports, seeks more information from local sources and other experts, and provides judicious commentary. This group also “scans newspapers, the internet, health department and government alerts, and other information sources for inklings that an infectious disease, perhaps not yet reported widely, is threatening animal, plant and/or human health.”

I think I first signed up to receive the digests back when “mad cow disease” was emerging, and have since used ProMED to follow diseases such as anthrax and Ebola.
A topic of interest to me recently concerns outbreaks of measles and mumps in Western nations due to falling rates of vaccination. And as a former zookeeper I keep up on diseases of wildlife and zoo animals, including the fungal disease threatening whole populations of wild bats in the Eastern US. ProMED also covers plant diseases (mostly of crops).

All of this, infectious diseases of humans, wildlife, and crops, is of greatly increased urgency because climate change, global transport, and destruction of wild areas all lead to the spread of familiar diseases to new locales and the emergence of “new” diseases previously only found in remote wild areas. With regard to contaminants and toxins, governments are unable to deal with this effectively due to the political power of corporations and lack f oversight in producing countries. ProMED can’t make your food and furniture non-toxic, but it can sound alarms that might otherwise be silenced.References to a topic’s prior appearances on the list are attached to current reports, and archives are easy to access. Editions in French, Portuguese, Russian and Spanish are now available.

“Each posting is limited to 25 KB bandwidth—to ensure that it slips through an old-fashioned dial-up modem in the most remote areas of the world (where new infectious threats tend to smolder). ‘We use technology that was state-of-the-art in 1994. We use email—plain-text email at that. We don’t use fancy fonts,’ Madoff says. ‘The power of the Internet is its ubiquity and speed; it’s not necessarily in all the neat things you can do.’ [from Drexler’s article cited above]

You can subscribe here.

Toxins and contaminants

ProMED also collects, evaluates, and disseminates reports of health problems related to toxins and contamination of food and medicines. These can be quite unusual. For example, the case of the toxic leather sofas in Britain:

Photo: Effect on leg of reaction to toxic chemical contained in sofas. From BBC.

A judge [in the UK] is expected to order several retailers to pay millions of
pounds to people who suffered burns and rashes from faulty leather
sofas….

More than 1600 people claim to have been affected by the problem. Tens
of thousands more people could have burns not yet traced to sofas.
The High Street stores, along with 11 others, may have to pay more
than 10 million pounds [USD 14.3 million] in compensation and legal
costs, the shoppers’ lawyers say. They claim that makes it “the
largest group compensation claim ever seen in British Courts.”

The sofas, which were manufactured in China, were packed with sachets
of an anti-mould chemical called dimethyl fumarate to stop them from
going moldy during storage in humid conditions.

Commonly known as DMF, the toxic, fine white powder has been used by
some manufacturers to protect leather goods like furniture and shoes
from mold. Even very small amounts can be harmful.

One sofa customer, who is well aware of the health problems caused by
her purchase, is a customer who bought a leather sofa suite from
Argos in April 2007. Almost a year later, she started to notice a
rash developing on her arms and legs. After a few weeks, her skin
started flaking off. She says the irritation was so bad, she was off
work for 2 months. This customer was seen by more than a dozen
doctors, who couldn’t work out what was causing the rash.

She said: “It was very, very painful; I couldn’t sleep at night; I
couldn’t walk about; I couldn’t drive; every time I did walk about,
the skin would fall off, and I would leave a trail of it, therefore,
I couldn’t go to work.”

Reliable histories of outbreaks/events

ProMED doesn’t just present breaking news and requests for additional reports; it frequently publishes very useful summaries of what’s been learned, and what action governmental agencies have taken. For example, “Melamine contaminated food products – Worldwide ex China” and “Prion disease Update 2009 (01)” (Mad Cow Disease and its human infectious disease, the fatal “variant Creutzfeldt-Jakob disease”.

Supporting ProMED

Believe it or not, ProMED is supported by individuals, with not a penny of funding from any government. That means they are independent (remember the movie Jaws, where the city council wants to suppress news of the shark attacks?) and fast to react. They sift a lot of news from all sorts of sources, put out calls for more information, and disseminate news in a responsible way.

If the work of this group seems like something you’d like to support, here’s your chance. They’re having a brief Spring fundraising campaign. To quote their email,

Your gift funds quick information every day – The economical, low-tech computer programs we use enable us to speed ProMED to your mailboxes, to post it online where anyone can find it, , and to provide the administrative services (accounting, office space, cell phone connections, etc.) required to support a small, agile worldwide enterprise.

ProMED-mail reaches over 50,000 public health officials, students, journalists, agricultural specialists, infectious disease professionals and others around the globe. Because it is free, subscribers in more than 187 countries have an equal opportunity to know when a disease outbreak occurs — and can spring into action when necessary to prevent or minimize its spread.

If the Spring campaign is past, here’s the main donations page.

Happy to be drooled on

Posted on Sunday, April 26, 2009 by nosleepingdog

Drool is back in our lives, finally; and wisps of fur in the corners, and the need to refill the water dish every few hours. We have a new mastiff.

Our beloved English Mastiff Bart, whose picture is at the top of this blog, died in February of old age at eleven and a half, very old for a mastiff. There will never be another Bart, but we knew after only a short time with him that we wanted a mastiff in our household always. We got Bart at 8 weeks but decided this time that a mastiff puppy was more than we were ready to handle, with us being older and my husband facing knee replacement surgery next month. Enter breed rescue: programs run by devoted volunteers for each dog breed, aimed at re-homing dogs of their breed.

These folks want the dogs’ new homes to work, since the dogs have already been through at least one sad parting (and sometimes neglect or worse, as well). We filled out extensive applications, with references; and someone in our area came to meet us and check out our surroundings. Is there a fenced yard? Are there stairs to the house that would be a problem for a mastiff when he’s old? Other pets, livestock? Feeling of stability? Would-be owners’ attitudes and familiarity with the breed, and commitment required? All that stuff and more. We passed, and last weekend we travelled to visit prospective young males in foster homes. The third one we visited was the right one for us, and we drove home with our new mastiff Jack.

We weren’t looking for a dog that resembled Bart, but it turned out that way. Jack is “fawn” like Bart, but is taller and longer-bodied. He has the same steady intelligent gaze, calm manner, and affectionate nature, that Bart did. He’s a little over three, and his previous home gave him good socialization and some training––age and training were important to us: a rambunctious rowdy 150-lb dog does not mix well with recovery from knee surgery.

Our elderly Rhodesian Ridgeback Brook went along on the trip, and got to spend a couple of hours with Jack after we decided (early in our visit) that he was the one.

She went from growling at him to following him around to sniff him, and they rode home uneventfully in the back of the SUV together. We did have to convince Jack not to ride in the front seat, right at the beginning, but that was easy. He is easy-going and wants to please. Essential, in a dog his size! English Mastiffs are protective of their owners’ person and property but have been bred for a long time to have a calm and gentle temperament. A mastiff’s size and formidable appearance mean that he or she rarely needs to give more than a look or a bark, to warn off some stranger. Responsible breeders (of any dog breed) pay as much attention to temperament as to physical characteristics. You want a dog who is healthy and reliable in both regards, mens sana in copore sano.

Jack has tried out all the dog beds in the house but has not gotten up on the couch even though he sees Brook up there. Until we can clip his long bear-claw-like nails, it is just as well. He hadn’t let the foster home’s vet draw blood for a heartworm test but our vet got one easily (and it was negative), with the old Cheez Wiz method (dog is busy licking the cheese-like substance out of the nozzle, and nothing else matters!) but by the time we got to the nail clipping part he’d had enough cheese and resisted. No growls, just pulling away, and believe me he is strong. We use a dremel for dog nails so I have left it on the floor the past two evenings to introduce him to it, and have also been getting him used to me holding his paws and touching his nails. He’s making progress, but no telling if that will hold when the actual clipping/grinding occurs. He has tried to eat the sandpaper cylinder off the grinder but I can’t interpret that, except he isn’t backing away from it any more.

Jack’s original home was with a couple and their teen-age daughter. He was the husband’s dog but when the marriage broke up the husband abandoned him, then the wife had to sell the house in order to give the husband his share of the money. She had a dog of her own, and could not keep Jack, BUT she was savvy enough to know about, or find out about, a breed rescue organization with a local presence. Friends of Rescued Mastiffs is a national organization, non-profit, providing care, foster homes, and re-homing to mastiffs. They deal with dogs from situations like Jack’s, dogs found as strays or in shelters, ones seized for neglect, and from puppy mills (both young ones and breeding stock). Good rescue organizations like FORM also check out the dogs to see if they are suitable for a new home, and what the conditions might be (OK with cats? other dogs? too rambunctious to be around small children at this age? needs someone who can do extensive training?). There are other good organizations helping mastiffs, but FORM was Jack’s salvation. We count ourselves very lucky to have found Jack and he seems to be settling in very happily with us. We’ll be sending photos and a report to the regional coordinator, in hopes she can pass the word on to the woman and girl who loved Jack and had to give him up. He has obviously been well loved and cared for.

No breed of dog is “for everyone” and English Mastiffs are no exception. They occupy a lot of space; fur and drool will find their way onto your furniture, clothing, etc.; and they want to be with you all the time. That’s usual for dogs, though, they aren’t toys with an on/off switch you can pay attention to only when you feel like it.

Giant dog breeds have shorter life spans than smaller dogs, and if they need medication or surgery the bills will be big too. That’s another reason to check out breeders carefully, see the parents, ask about testing for hip/elbow/eye problems that may be inherited. Visit someone with one or more mastiffs and see how it feels to be around such big dogs. Talk about the pros and cons. Think about your situation: how much time do you have to spend with a dog (for whom you will be the center of life)? How much space, indoors and out? We have a big house and fenced area, but our newly acquired 2005 Trail Blazer seems a bit crowded now with Brook and Jack in it!

Do you have plans to move, or have a baby? Dogs and babies are not at all mutually exclusive; pit bulls were reportedly used as “nanny” dogs to watch over toddlers a hundred years ago, and an adult mastiff who has been properly socialized is gentle, tolerant, and completely reliable around children. But you may not have enough time to do justice to both a new dog and a new baby; certainly you need to see how your dog of any breed behaves around children–does he or she get excited so that body or tail could knock a child over? Is the dog able to resist “taking candy from a baby”? and so on. None of these are reasons to give away your dog before having a baby, but they are factors in getting a dog, or in planning how your dog will be able to be around your children especially when dog or child is very young.

Educate yourself before acquiring any breed of dog! Even mixed breed dogs usually have some discernible breed heritage, and shelter employees or friends who really do know a lot about dogs, can be helpful. An as example, terriers and sheepdogs have higher energy levels than many other breeds: not a good choice for a dog that will spend a lot of time alone.

Helping National Guard and Reservists “re-enter” after deployment

Posted on Wednesday, April 15, 2009 by nosleepingdog

Sometimes local news should have a wider audience across the country.

Our US Senator Ron Wyden (D-OR) has earned great respect in this state for his humane principles and competence at building coalitions to get things done in DC. Here’s an example from the Oregonian newspaper on an issue that, typically for him, is not at all parochial but affects all of us deeply.

Sen. Wyden proposes extending Guard pay

The Oregon lawmaker wants to give soldiers returning from war 90 extra pay days

Wednesday, April 08, 2009

JULIE SULLIVAN, The Oregonian Staff

When Oregon Army National Guard soldiers returned from Iraq four years ago, fewer than half had a job waiting.

Employers wanted to help. Within a week, the Guard organized a reintegration fair that offered an estimated 500 jobs. But not a single soldier took one.

It was too soon.

“They are not ready to leave a combat zone and seven days later, go back to work,” Brig. Gen. Mike Caldwell said.

State and federal officials say they’ve learned how to do it right. U.S. Sen. Ron Wyden, D-Ore., wants to extend federal pay for National Guard and reservists for 90 days to ensure a “softer landing” when they return.

Oregon has posted some of the highest percentages of Guard members serving in Iraq and Afghanistan. Another 2,700 are training to deploy Iraq in July.

Unlike the regular Army, where soldiers return to their stateside military jobs and bases, the Oregon Guard and reservists scatter to hometowns. They lose their military salary, and more than $600 a month in other hazardous duty and separation pay.

When Oregon soldiers returned from Afghanistan two years ago, fewer than half of them younger than 35 had a job waiting. The younger the vet, the worse the outlook, with nearly 65 percent younger than 25 unemployed.

“About 79 percent returned to poverty,” said Sgt. First Class (Ret.) J.D. Baucom, a career assistance liaison for the Oregon Guard. He’s concerned in today’s economy those numbers are bound to get worse.

Wyden said paying the Guard for up to 90 days after they return would give them time to rebuild their lives before hitting a financial wall.

“We not willing to sit around and watch soldiers go from the front lines to unemployment lines,” he said.

Oregon has led in veterans’ advocacy. The Guard’s re-integration program — launched by wounded Alsea and Albany infantrymen in 2004 — is a national model. In 2007, the Legislature created a new veterans hiring preference for public employees. Now it is considering extending that preference from 15 years to a lifetime and granting 15 days unpaid leave to spouses of deploying soldiers.

Wyden’s bill covers returning soldiers so it would help only a fraction of the 350,000 Oregon veterans. He met former service members at the IBEW Local 48 in Northeast Portland on Tuesday morning in part to highlight job opportunities in the building trades. One federal program, Helmets to Hardhats, has put more than 1,757 veterans nationally into union apprentice programs. Across the hall, three young military veterans had found union jobs a good match on their own. They said that learning discipline, attention to detail and the ability to work in a team in the service has helped them apprentice as commercial electricians.

“I tried college, but I was working full time and going to school full time and that didn’t work,” said Craig Enneberg, 28, of Sherwood. “This works.”

Still, veterans advocates — and veterans themselves — told Wyden that a far more targeted approach is needed. Among the suggestions:

Reduce paperwork. “If we can’t get through the process, how we can we ask a 20-year-old from eastern Oregon who doesn’t know where to call?” said Sgt. 1st Class Phillip Maas, who manages career assistance for the reintegration team.

Connect veterans. Ret. Master Sgt. Mike Eschete, who recently graduated from Portland State University, proposed a mentoring program using military retirees. “They speak a different language and understand a dimension that is invisible to others,” he said.

Educate gatekeepers at agencies. “Put someone in that position who gives a damn,” said Erik Burris, a 12-year veteran of the Navy. Burris said one state employment specialist, Rene Garcia, helped him.

But little else has helped Burris in this economy.

The 41-year-old aviation structural mechanic and flight deck troubleshooter in the Navy has been laid off from four jobs in Portland since 2002. Wyden invited him to the Tuesday meeting. He arrived in a stylish blue shirt and tie, his carefully clipped hair and leather organizer in hand. He handed a reporter his resume.

After being laid off from jobs in quality control, sales, tech support and as a contractor at Intel he hasn’t worked since January 2008. He keeps applying, whittling his three-page resume into a one page “cram ad” and checking 12 job boards online a day. He does all the family cooking for his wife, Jeanmarie, and their daughter and keeps the kitchen immaculate in their “inexpensive” 900-square-foot Tigard apartment.

“Home is what you make it,” Jeanmarie says.

“You lose your pride and a little bit of yourself every time you get laid off,” he says. “And we have so much to give.”

juliesullivan@news.oregonian.com

2009 Oregonian

Why not let your senators and representatives know that you support this? The following pages help you get contact information and send emails:

for US representatives; need to know your ZIP code + the four digit addition to it

this one works for both representatives and senators (also yields info for state legislators); use the search box at the left to get names, click on name, click on “Contact” tab above the person’s photo.

Spring beauty: Erythroniums (Trout Lilies)

Posted on Sunday, April 5, 2009 by nosleepingdog

These elegant and delicate plants flower for a week or so, set seed (which are carried deep underground by ants, where some germinate) and vanish within weeks, spotted leaves and all, until next year. The leaves are beautiful in themselves, and give several Erythronium species their common names, Trout Lily and Fawn Lily. They may also be called dog’s-tooth violet and adder’s-tongue, for reasons unknown to me. Here we have Erythronium hendersonii, the only purplish species. Others are white, pink, or yellow. Species found in southern Oregon include E. hendersonii, E. oregonum, E. californicum, E. montanum (Avalanche Lily), E. citrinum (Citrus Fawn Lily or Cream Fawn Lily), E. howellii, and E. klamathense/klamathensis.

These pictures were taken April 3 and 4, 2009.