The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

Harrison's Principles of Internal Medicine

Emerging infectious diseases (EIDs) of free-living wild animals can be classified into three major groups on the basis of key epizootiological criteria: (i) EIDs associated with “spill-over” from domestic animals to wildlife populations living in proximity; (ii) EIDs related directly to human intervention, via host or parasite translocations; and (iii) EIDs with no overt human or domestic animal involvement. These phenomena have two major biological implications: first, many wildlife species are reservoirs of pathogens that threaten domestic animal and human health; second, wildlife EIDs pose a substantial threat to the conservation of global biodiversity.

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Emerging Infectious Diseases of Wildlife-- Threats to Biodiversity and Human Health

Objective.The purpose of this study was to provide a national estimate of the number of healthcare-associated infections (HAI) and deaths in United States hospitals.Methods.No single source of nationally representative data on HAIs is currently available. The authors used a multi-step approach and three data sources. The main source of data was the National Nosocomial Infections Surveillance (NNIS) system, data from 1990–2002, conducted by the Centers for Disease Control and Prevention. Data from the National Hospital Discharge Survey (for 2002) and the American Hospital Association Survey (for 2000) were used to supplement NNIS data. The percentage of patients with an HAI whose death was determined to be caused or associated with the HAI from NNIS data was used to estimate the number of deaths.Results.In 2002, the estimated number of HAIs in U.S. hospitals, adjusted to include federal facilities, was approximately 1.7 million: 33,269 HAIs among newborns in high-risk nurseries, 19,059 among newborns in we...

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Estimating Health Care-Associated Infections and Deaths in U.S. Hospitals, 2002:

The World Health Organisation estimates that the warming and precipitation trends due to anthropogenic climate change of the past 30 years already claim over 150,000 lives annually. Many prevalent human diseases are linked to climate fluctuations, from cardiovascular mortality and respiratory illnesses due to heatwaves, to altered transmission of infectious diseases and malnutrition from crop failures. Uncertainty remains in attributing the expansion or resurgence of diseases to climate change, owing to lack of long-term, high-quality data sets as well as the large influence of socio-economic factors and changes in immunity and drug resistance. Here we review the growing evidence that climate-health relationships pose increasing health risks under future projections of climate change and that the warming trend over recent decades has already contributed to increased morbidity and mortality in many regions of the world. Potentially vulnerable regions include the temperate latitudes, which are projected to warm disproportionately, the regions around the Pacific and Indian oceans that are currently subjected to large rainfall variability due to the El Nino/Southern Oscillation sub-Saharan Africa and sprawling cities where the urban heat island effect could intensify extreme climatic events.

https://faculty.washington.edu/jhannah/geog270aut07/readings/ClimateChange/Patz%20-%20impact%20of%20climate%20change%20on%20health.pdf

Impact of regional climate change on human health

Until recently, continuous monitoring of global vegetation productivity has not been possible because of technological limitations. This article introduces a new satellite-driven monitor of the global biosphere that regularly computes daily gross primary production (GPP) and annual net primary production (NPP) at 1-kilometer (km) resolution over 109,782,756 km 2 of vegetated land surface. We summarize the history of global NPP science, as well as the derivation of this calculation, and current data production activity. The first data on NPP from the EOS (Earth Observing System) MODIS (Moderate Resolution Imaging Spectroradiometer) sensor are presented with different types of validation. We offer examples of how this new type of data set can serve ecological science, land management, and environmental policy. To enhance the use of these data by nonspecialists, we are now producing monthly anomaly maps for GPP and annual NPP that compare the current value with an 18-year average value for each pixel, clearly identifying regions where vegetation growth is higher or lower than normal.

https://bioone.org/journals/BioScience/volume-54/issue-6/0006-3568(2004)054[0547:ACSMOG]2.0.CO;2/A-Continuous-Satellite-Derived-Measure-of-Global-Terrestrial-Primary-Production/10.1641/0006-3568(2004)054[0547:ACSMOG]2.0.CO;2.pdf

A Continuous Satellite-Derived Measure of Global Terrestrial Primary Production

Background
Notifiable disease surveillance in the United States is predominantly a passive process that is often limited by poor timeliness and low sensitivity. Interoperable tools are needed that interact more seamlessly with existing clinical and laboratory data to improve notifiable disease surveillance.

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PHSkb: A knowledgebase to support notifiable disease surveillance

Background On 9 January 2015, in a rural town in Mozambique, >230 persons became sick and 75 died of an illness linked to drinking pombe, a traditional alcoholic beverage. Methods An investigation was conducted to identify case patients and determine the cause of the outbreak. A case patient was defined as any resident of Chitima who developed any new or unexplained neurologic, gastrointestinal, or cardiovascular symptom from 9 January at 6:00 am through 12 January at 11:59 pm. We conducted medical record reviews, healthcare worker and community surveys, anthropologic and toxicologic investigations of local medicinal plants and commercial pesticides, and laboratory testing of the suspect and control pombe. Results We identified 234 case patients; 75 (32%) died and 159 recovered. Overall, 61% of case patients were female (n = 142), and ages ranged from 1 to 87 years (median, 30 years). Signs and symptoms included abdominal pain, diarrhea, vomiting, and generalized malaise. Death was preceded by psychomotor agitation and abnormal posturing. The median interval from pombe consumption to symptom onset was 16 hours. Toxic levels of bongkrekic acid (BA) were detected in the suspect pombe but not the control pombe. Burkholderia gladioli pathovar cocovenenans, the bacteria that produces BA, was detected in the flour used to make the pombe. Conclusions We report for the first time an outbreak of a highly lethal illness linked to BA, a deadly food-borne toxin in Africa. Given that no previous outbreaks have been recognized outside Asia, our investigation suggests that BA might be an unrecognized cause of toxic outbreaks globally.

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Description of a Mass Poisoning in a Rural District in Mozambique: The First Documented Bongkrekic Acid Poisoning in Africa.

Public health reporting of laboratory results requires unambiguous identification of the test performed and the result observed. Some laboratories are currently using Logical Observation Identifier Names and Codes (LOINC) for the electronic reporting of laboratory tests and their results to public health departments. Initial use revealed inconsistent identification and use of LOINC concepts by laboratories and public health agencies and an inability to systematically extend, for public health use, the tables when adding new concepts. We applied simple, logical rules to existing LOINC concepts to facilitate the creation of a hierarchy of concepts and to allow the identification and specification of appropriate terms for public health reporting and subsequent data aggregation. The hierarchy also allows the systematic addition of new concepts further supporting public health reporting. Application of the hierarchy is illustrated by using all laboratory LOINC concepts assigned to the subset of microbiology test types (CLASS MICRO).

Introduction of a hierarchy to LOINC to facilitate public health reporting.

On July 19, 2006, the director of a children's aquatic sports day camp notified the Miami-Dade County Health Department (MDCHD) of three campers who had received a diagnosis of cutaneous larva migrans (CLM), or \"creeping eruption,\" a skin condition typically caused by dog or cat hookworm larvae of the genus Ancylostoma. MDCHD conducted an investigation to determine the source and magnitude of the outbreak and prevent additional illness. This report summarizes the results of that investigation, which identified exposure to cat feces in a playground sandbox as the likely source of infection. Although CLM outbreaks are reported rarely to the Florida Department of Health, evidence indicates that CLM is a potential health hazard in Florida. This disease cluster highlights the importance of appropriate environmental hygiene practices and education in preventing CLM.

Timothy J. Doyle

Papers

PHSkb: A knowledgebase to support notifiable disease surveillance

Description of a Mass Poisoning in a Rural District in Mozambique: The First Documented Bongkrekic Acid Poisoning in Africa.

Introduction of a hierarchy to LOINC to facilitate public health reporting.

Outbreak of cutaneous larva migrans at a children's camp - Miami, Florida, 2006.

Hantavirus pulmonary syndrome.