DOCSLIB.ORG

Chronic Multisymptom Illness Affecting Air Force Veterans of the Gulf War

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Chronic Multisymptom Illness Affecting Air Force Veterans of the Gulf War Chronic Multisymptom Illness Affecting Air Force Veterans of the Gulf War Keiji Fukuda, MD, MPH; Rosane Nisenbaum, PhD; Geraldine Stewart, MA; William W. Thompson, PhD; Laura Robin, DO, MPH; Rita M. Washko, MD; Donald L. Noah, DVM, MPH; Drue H. Barrett, PhD, MS; Bonnie Randall, MCP; Barbara L. Herwaldt, MD, MPH; Alison C. Mawle, PhD; William C. Reeves, MD, MSPH Context.—Gulf War (GW) veterans report nonspecific symptoms significantly was much lower than expected.9 No spe- more often than their nondeployed peers. However, no specific disorder has been cific illness is evident among the 18 598 identified, and the etiologic basis and clinical significance of their symptoms remain GW veterans, according to the Depart- unclear. ment of Defense Comprehensive Clini- 6 Objectives.—To organize symptoms reported by US Air Force GW veterans into cal Evaluation Program. Other investi- a case definition, to characterize clinical features, and to evaluate risk factors. gators have found no unusual increases in birth defects,10 unexplained illness,11 Design.—Cross-sectional population survey of individual characteristics and excess hospitalizations,12 or excess mor- symptoms and clinical evaluation (including a structured interview, the Medical tality13 among GW veterans. However, Outcomes Study Short Form 36, psychiatric screening, physical examination, clini- one study reported excess mortality due cal laboratory tests, and serologic assays for antibodies against viruses, rickettsia, to unintentional injuries rather than parasites, and bacteria) conducted in 1995. from disease.14 Evidence of an Iraqi Participants and Setting.—The cross-sectional questionnaire survey included chemical and biological weapons pro- 3723 currently active volunteers, irrespective of health status or GW participation, gram has been documented,15 and al- from 4 air force populations.The cross-sectional clinical evaluation included 158 though use of such weapons during the GW veterans from one unit, irrespective of health status. GW has not been confirmed,16 troops Main Outcome Measures.—Symptom-based case definition; case prevalence may have been exposed to chemical or rate for GW veterans and nondeployed personnel; clinical and laboratory findings biological warfare agents during the de- struction of storage bunkers. The long- among veterans who met the case definition. term effects of such chemical exposures Results.—We defined a case as having 1 or more chronic symptoms from at are uncertain, although some investiga- least 2 of 3 categories (fatigue, mood-cognition, and musculoskeletal). The preva- tors have suggested that wartime expo- lence of mild-to-moderate and severe cases was 39% and 6%, respectively, among sures may have contributed to chronic 1155 GW veterans compared with 14% and 0.7% among 2520 nondeployed per- neurotoxic syndromes.17,18 sonnel. Illness was not associated with time or place of deployment or with duties during the war. Fifty-nine clinically evaluated GW veterans (37%) were noncases, For editorial comment see p 1010. 86 (54%) mild-to-moderate cases, and 13 (8%) severe cases. Although no physi- cal examination, laboratory, or serologic findings identified cases, veterans who met the case definition had significantly diminished functioning and well-being. In December 1994, the US Secretary Conclusions.—Among currently active members of 4 Air Force populations, a of Defense and the Secretary of Veter- ans Affairs, and the Commonwealth of chronic multisymptom condition was significantly associated with deployment to the Pennsylvania asked the Centers for Dis- GW. The condition was not associated with specific GW exposures and also ease Control and Prevention (CDC), At- affected nondeployed personnel. lanta, Ga, to investigate a “mystery ill- JAMA. 1998;280:981-988 ness” reported among GW veterans from an Air National Guard (ANG) unit SOON AFTER cessation of Gulf War to concerns about a “Gulf War syn- in Lebanon, Pa.19 In the first phase of the (GW) hostilities, anecdotal reports of ill- drome.”1-3 Subsequent studies have investigation,weinterviewedandexam- ness and speculation over environmen- shown that GW veterans report numer- inedillGWveteransandfoundthattheir tal, biological, and chemical hazards led ous chronic nonspecific symptoms, such major health problems consisted of per- asfatigue,neurocognitiveproblems,and sistent fatigue and other chronic symp- From the Divisions of Viral and Rickettsial Diseases musculoskeletal pain, significantly more toms that began during deployment or (Drs Fukuda, Noah, Mawle, and Reeves) and Parasitic oftenthantheirnondeployedpeers.4,5 No soon after returning from the GW, but Diseases (Dr Herwaldt), National Center for Infectious widespread disorder has been linked to we did not find associated physical signs Diseases, the Division of Environmental Hazards and 4 Health Effects, National Center for Environmental that conflict, and the etiologic basis and or clinical laboratory abnormalities. Pa- Health (Dr Barrett), and the Epidemic Intelligence Ser- clinical significance of veterans’ symp- tients’ illnesses resembled those re- vice, Epidemiology Program Office (Drs Robin and tomatology remain unclear.6 ported previously, and the classification Washko), Centers for Disease Control and Prevention, 2 Atlanta, Ga; Klemm Analysis Group, Atlanta, Ga (Dr The evidence for unique health prob- and etiology remain unclear. Nisenbaum); and Abt Associates Inc, Cambridge, lems among GW veterans is mixed. Al- This article reports the second phase Mass (Mss Stewart and Randall and Dr Thompson). though acute gastroenteritis was fre- of our survey of the index ANG unit and Reprints: William C. Reeves, MD, MSPH, Centers for 7,8 Disease Control and Prevention, Mail Stop A-15, 1600 quently reported among troops, the 3 comparison air force populations. Our Clifton Rd, Atlanta, GA 30333 (e-mail: [email protected]). overall occurrence of infectious diseases primary objectives were to determine JAMA, September 16, 1998—Vol 280, No. 11 Chronic Illness Among Gulf War Veterans—Fukuda et al 981 ©1998 American Medical Association. All rights reserved. Downloaded From: by a Harvard University User on 03/12/2018 Table 1.—Factor Analysis Loadings (3 100) consecutive unit training weekends factors. After rotation, the factor pattern Exploratory Sample and Confirmatory Sample* (held monthly) to maximize participa- was examined to determine whether an Loading Values tion rates. Unit C was surveyed during oblique rotation yielded high loadings in a 10-day period. only one factor. Symptoms with factor Factor Factor On each base, one of us (K.F., L.R., loadings of greater than 0.40 were kept Symptoms PC 1 1PC22PC3R.W., or D.N.) met with small groups, fortheconfirmatoryfactoranalysis.22 The Depression 76 71 −3 −17 −1 explained the study, and distributed exploratory analysis yielded 10 compo- Anxiety 73 73 −5 −20 1 questionnaires to subject volunteers nents with an eigenvalue greater than 1. Moodiness 71 62 2 0 −10 whose identities remained anonymous. Memory 59 61 6 6 0 The first (feeling depressed, feeling anx- problems The questionnaire took 15 to 45 minutes ious, feeling moody, difficulty remember- Fatigue 50 50 19 19 3 to complete and queried health status, ing or concentrating, trouble finding Difficulty with 48 61 −15 −9 4 demographic and military characteris- words,difficultysleeping,andfatigue)ac- words tics, and potential risk factors for illness. counted for 16.8% of the total common Difficulty 45 42 30 14 −2 We asked about the 35 symptoms that variance.Thesecond(jointstiffness,joint sleeping hadbeenidentifiedduringtheearlierex- pain, and muscle pain) accounted for Joint stiffness 2 −5 85 76 4 ploratory study4 including their sever- 11.9% of the variance. The third (wheez- Joint pain 3 −13 84 85 −1 ity (mild, moderate, or severe) and du- ing, shortness of breath, coughing, and Muscle pain 0 12 63 47 1 ration (,6 months or $6 months). chest pain) accounted for 10.4%. The re- Wheezing −14 19 0 8 75 maining components each contributed Shortness of 10 35 3 21 73 Case Definition breath less than 10% of the total variance. Cough −8 29 2 13 59 We used 2 conceptually different ap- Confirmatory Factor Analysis.— Chest pain 11 33 0 17 53 proaches to develop exploratory case Only symptoms from the first 3 princi- definitions from the symptom data. The pal analysis components were used in the *The exploratory sample represents the first 3 prin- 23 cipal components of 35 symptoms submitted to a pro- first exploratory case definition was de- confirmatory factor analysis. These max oblique rotation (n = 1631). The confirmation factor rived from clinical and epidemiological symptoms were submitted to an un- analysis represents symptoms from the first 3 principal analysis components that were submitted to an un- reasoning; the second used statistical weighted least squares factor analysis 24 weighted, least squares factor analysis with a Pro- methods. with a Procrustes oblique rotation. Con- crustes oblique rotation (n = 1624). Intercorrelations for Clinical Approach.—We reasoned firmatory factor analysis identified 2 fac- factors 1 and 2 were 42% and 69%, respectively, for exploratory and confirmatory samples. PC indicates that if an illness existed among GW vet- tors (mood-cognition-fatigue and mus- principal components. erans, case-defining symptoms would be culoskeletal) (Table 1). chronic,prominentamongGWveterans, Preliminary Working Case Defini- whether the prevalence of symptoms and more common among GW veterans tions.—The 10 symptoms from factor was increased
Load more

Recommended publications
  • February 27, 2018Ighp
    iGHP Special Lecture series "How Does Politics Influence Global Health Policy? Antimicrobial Resistance (AMR) and Pandemic Influenza" Institute for Global Health Policy Research (iGHP), the Bureau of International Health Cooperation, in joint collaboration with the Disease Control and Prevention Center (DCC) of National Center for Global Health and Medicine (NCGM), is pleased to announce the upcoming seminar entitled, "How Does Politics Influence Global Health Policy?: AMR and Pandemic Influenza", which is to be held on February 27, 2018 in Tokyo. The seminar includes a special lecture by Professor Keiji Fukuda, the Director and Clinical Professor at the University of Hong Kong School of Public Health, and a panel discussion with Japanese leading experts in the fields of infectious diseases and epidemiology who have extensive knowledge and experiences in clinical practice, research, education, and domestic and international health policy. 1. Seminar Details Date & Time Tuesday, February 27, 2018, 17:00-19:00 Venue Institute for Global Health Policy Research, Bureau of International Cooperation (Ground floor, Training Center Building), National Center for Global Health and Medicine, Tokyo Access http://kyokuhp.ncgm.go.jp/eng/aboutus/access.html Language English only (No Japanese interpretation will be available) Participation Free of charge and open to general public, and a light meal will be provided. Seating capacity Approximately 80 2. Agenda (tentative) 17:00-17:05 Welcome Remarks (Kenji Shibuya, Director, Institute for Global Health
    [Show full text]
  • Introduction to the World Health Assembly: a Briefing for New Delegates
    Introduction to the World Health Assembly: A Briefing for New Delegates Organised by the Global Health Centre at the Graduate Institute and the United Nations Foundation Biographies of Speakers 22 May 2016 Maison de la paix The Graduate Institute, Geneva | 14:30 – 15:00 | NETWORKING COFFEE | 15:00 – 15:10 | WELCOME JOHN E. LANGE Ambassador; Senior Fellow for Global Health Diplomacy, United Nations Foundation Ambassador (Retired) John E. Lange is the Senior Fellow for Global Health Diplomacy at the United Nations Foundation in Washington, DC. He is one of the leaders of the Global Polio Eradication Initiative in his capacity as co-chair of the Polio Partners Group. Lange worked at the Bill & Melinda Gates Foundation from 2009-2013, where he engaged in high-level advocacy with governments to advance the foundation’s global health goals in Africa. Ambassador Lange had a distinguished 28-year career in the Foreign Service at the U.S. Department of State, where he was a pioneer in the field of global health diplomacy. He served as the Special Representative on Avian and Pandemic Influenza; Deputy U.S. Global AIDS Coordinator at the inception of the President’s Emergency Plan for AIDS Relief; and U.S. Ambassador to Botswana (1999-2002), where HIV/AIDS was his signature issue. Lange headed the U.S. Embassy in Dar es Salaam, Tanzania, as chargé d'affaires during the August 7, 1998, terrorist bombing. Earlier, he served at the U.S. Mission to the UN in Geneva and at U.S. Embassies in Lomé, Paris and Mexico City. Ambassador Lange is the author of a case study on pandemic influenza negotiations in the book “Negotiating and Navigating Global Health: Case Studies in Global Health Diplomacy” (2012).
    [Show full text]
  • Emergent Covid-19 and Sars-Cov-2 in Social Imagery and Social Video: Initial Three Months of Viral Dispersion
    PART I PART 1: GLOBAL PUBLIC HEALTH 13 11 EMERGENT COVID-19 AND SARS-COV-2 IN SOCIAL IMAGERY AND SOCIAL VIDEO: INITIAL THREE MONTHS OF VIRAL DISPERSION Shalin Hai-Jew 15 16 EMERGENT COVID-19 AND SARS-COV-2: THREE MONTHS VIRAL DISPERSION Abstract The pandemic potential of emergent SARS-CoV-2, a zoonotic virus which causes COVID-19, has captured the world’s attention, through formal mass media and informal social media (esp. social imagery and social video). This work explores multiple social imagesets (thousands of images) from Google Images (captured from various seeding terms related to the outbreak) and social video transcripts from Google’s YouTube platform to infer focuses of mass human attention in terms of (1) messaging and information sourcing, (2) meta-messaging and subtexts, and (3) invisibilities (what is not expressed). This compares the imageset messaging against mass media articles from the same time frame. This work has implications for a mass-scale social response to an unfolding global biosafety/biosecurity risk based on learning from more organic and emergent social communications. Key Words Novel Coronavirus, 2019-nCoV, COVID-19 disease, SARS- CoV-2, Severe Acute Respiratory Illness, Community Spread, Self-Quarantine, Quarantine, Social Distancing, Chains of Infec- tion, Contact Tracing EMERGENT COVID-19 AND SARS-COV-2: THREE MONTHS VIRAL DISPERSION 17 Introduction “Assume this virus is everywhere. This is a global influenza pan- demic caused by a coronavirus.” — Michael Osterholm in Peter Bergen’s “The disease expert who warned us” in CNN (March 10, 2020) COVID-19, the disease outbreak caused by the novel zoonotic virus termed SARS-CoV-2 (and prior, 2019-nCoV), is a major threat to human health in part because people do not have a natural immunity to this pathogen, which spreads quickly and invisibly.
    [Show full text]
  • Episode 4: Conversation with UC Berkeley and HKU Experts Facebook Live Webinar Thursday, March 5, 2020 Program 09:30 HKT, Close 10:30 HKT
    Asia Society Hong Kong Center March 2020 Program Coronavirus Updates: Facts from Hong Kong and Beyond Episode 4: Conversation with UC Berkeley and HKU Experts Facebook Live Webinar Thursday, March 5, 2020 Program 09:30 HKT, Close 10:30 HKT On January 30, the World Health Organization declared a global health emergency on the spread of COVID-19 that originated in Wuhan. Healthcare experts have warned that COVID-19 could rapidly spread, if not properly contained, and many governments around the world have begun to take precautionary measures to ensure public health safety. Amid the international concern and heightened fears about the disease, what is fact and what is fiction? The Asia Society Hong Kong Center brings you regular updates on the coronavirus story via live webinars with on-the-ground public health experts and renowned specialists sharing the latest facts and evidence- based findings. In episode 4, hear from a panel of experts from UC Berkeley and HKU, with the discussion moderated by S. Alice Mong, Executive Director of Asia Society Hong Kong Center. Keiji Fukuda is Director and Clinical Professor in the Community Medicine and Public Health Practice Division at The University of Hong Kong’s School of Public Health. He was a staff member of the WHO in 2005-2016, serving most recently as Special Representative for Anti-Microbial Resistance for the Director-General and Assistant Director-General for Health Security. At WHO, Prof. Fukuda led field investigations related to global outbreaks, such as influenza H5N1 and H7N9, pandemic influenza, SARS, MERS and Ebola. He most recently facilitated the development of an intergovernmental multi-sectoral process that resulted in a historic Heads of State level meeting at the U.N.
    [Show full text]
  • Emerging Health Threats Journal
    Emerging Health Threats Journal Supplement 1, 2013 Co-Edited by Suwit Wibulpolprasert, Louise S. Gresham and Mark S. Smolinski A World United Against Infectious Diseases: Connecting Organizations for Regional Disease Surveillance Emerging Health Threats Journal The Emerging Health Threats Journal is an international, peer-reviewed journal publishing the latest and best research on emerging threats to human health. Its focus is threats from any source, including the environment, chemicals, radiation, pathogens, and society. It welcomes papers on the preparedness and response to natural or man-made disasters, including those that involve the deliberate release of chemical, biological, or radio-nuclear material. Content will be determined by novelty and scope of the threat, and by scientific excellence. TheJournal welcomes investigative studies that promote the understanding of factors involved in the emergence, prevention, and elimination of health threats. Articles on lessons learned from disaster and crisis response are particularly encouraged. The Journal seeks high-quality submissions from academic, industrial, clinical practice, public health, and government research and planning sectors of original research articles, reviews, policy reviews, lessons learned, commentaries, and perspectives on emerging threats to human health. EDITORIAL TEAM EDITORIAL BOARD Editor-in-Chief: Roy Anderson, United Kingdom Andrew Robertson Mahdi Balali-Mood, Islamic Republic of Iran Western Australian Department of Health Peter George Blain, United Kingdom
    [Show full text]
  • A Comparative Analysis of COVID-19 News Framing in Sweden, the UK, and Egypt
    American University in Cairo AUC Knowledge Fountain Theses and Dissertations Student Research Summer 6-19-2021 A Feverish Spring: A Comparative Analysis of COVID-19 News Framing in Sweden, the UK, and Egypt Hend Abdelgaber Ahmed El-Behary [email protected] Follow this and additional works at: https://fount.aucegypt.edu/etds Part of the Health Communication Commons, Journalism Studies Commons, and the Mass Communication Commons Recommended Citation APA Citation El-Behary, H. (2021).A Feverish Spring: A Comparative Analysis of COVID-19 News Framing in Sweden, the UK, and Egypt [Master's Thesis, the American University in Cairo]. AUC Knowledge Fountain. https://fount.aucegypt.edu/etds/1616 MLA Citation El-Behary, Hend Abdelgaber Ahmed. A Feverish Spring: A Comparative Analysis of COVID-19 News Framing in Sweden, the UK, and Egypt. 2021. American University in Cairo, Master's Thesis. AUC Knowledge Fountain. https://fount.aucegypt.edu/etds/1616 This Master's Thesis is brought to you for free and open access by the Student Research at AUC Knowledge Fountain. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of AUC Knowledge Fountain. For more information, please contact [email protected]. The American University in Cairo School of Global Affairs and Public Policy A FEVERISH SPRING: A COMPARATIVE ANALYSIS OF COVID-19 NEWS FRAMING IN SWEDEN, THE UK, AND EGYPT A Thesis Submitted by Hend Abdel Gaber Ahmed El-Behary to the Department of Journalism and Mass Communication in partial fulfillment of the requirements for the degree of Master of Arts in Journalism and Mass Communication under the supervision of Professor Shahira Fahmy (May 2021) 1 Dedication To the soul of my Father, who was my biggest supporter, May Allah bless him.
    [Show full text]
  • Effectiveness and Cost-Benefit of Influenza Vaccination of Healthy Working Adults a Randomized Controlled Trial
    ORIGINAL CONTRIBUTION JAMA-EXPRESS Effectiveness and Cost-Benefit of Influenza Vaccination of Healthy Working Adults A Randomized Controlled Trial Carolyn Buxton Bridges, MD Context Although the cost-effectiveness and cost-benefit of influenza vaccination William W. Thompson, PhD are well established for persons aged 65 years or older, the benefits for healthy adults Martin I. Meltzer, PhD younger than 65 years are less clear. Objective To evaluate the effectiveness and cost-benefit of influenza vaccine in pre- Gordon R. Reeve, PhD venting influenzalike illness (ILI) and reducing societal costs of ILI among healthy work- Walter J. Talamonti, MD, MPH ing adults. Nancy J. Cox, PhD Design Double-blind, randomized, placebo-controlled trial conducted during 2 in- fluenza seasons. Heather A. Lilac, RN Setting and Participants Healthy adults aged 18 to 64 years and employed full- Henrietta Hall, BS time by a US manufacturing company (for 1997-1998 season, n=1184; for 1998- Alexander Klimov, PhD 1999 season, n=1191). Keiji Fukuda, MD, MPH Interventions For each season, participants were randomly assigned to receive ei- ther trivalent inactivated influenza vaccine (n=595 in 1997-1998 and n=587 in 1998- HE COST-EFFECTIVENESS OF IN- 1999) or sterile saline injection (placebo; n=589 in 1997-1998 and n=604 in 1998-1999). activated influenza vaccina- Participants in 1997-1998 were rerandomized if they participated in 1998-1999. tion in reducing influenza ill- Main Outcome Measures Influenzalike illnesses and associated physician visits and ness, hospitalization, and death work absenteeism reported in biweekly questionnaires by all participants, and serologi- Tis well established in persons aged 65 cally confirmed influenza illness among 23% of participants in each year (n=275 in 1997- years or older, a group that is at in- 1998; n=278 in 1998-1999); societal cost of ILI per vaccinated vs unvaccinated person.
    [Show full text]
  • The COVID-19 Pandemic, Donald Trump, and the Future of American Politics
    42 J O U R N A L O F I N T E R N A T I O N A L A N A L Y T I C S Research Articles Research The COVID-19 Pandemic, Donald Trump, and the Future of American Politics Andrei V. Korobkov https://doi.org/10.46272/2587-8476-2020-11-1-42-57 ABSTRACT The United States of America was disproportionally severely affected by the COVID-19 pandemic. The current crisis exposed significant flaws in the national health care system and provoked a serious socio-economic crisis. The health care scare overlaps with the ongoing presidential electoral campaign and the extreme political polarization of the country, leading to the politicization of discussions regarding the ways and means of resolving the health care crisis and complicating the process of decision making. The pandemic is also enhancing the autarchic tendencies in the US foreign policy and it’s the increasingly anti-Chinese orientation that became visible during Donald Trump’s White House tenure. Even under these circumstances, the American elites were able to negotiate several stabilization measures designed to deal with the medical and socio-economic aspects of the current crisis. Their willingness and ability to continue such collaboration in the future will have a direct bearing on the US socio-economic and political stability. KEYWORDS Pandemic, COVID-19, Coronavirus, USA, Donald Trump, Joseph Biden, Health Care М Е Ж Д У Н А Р О Д Н А Я А Н А Л И Т И К А 43 Исследовательские статьи Исследовательские The ongoing COVID-19 coronavirus pandemic exerts a serious and ever- increasing negative influence on countries’ health care systems, economies, and politics worldwide, further aggravating the prolonged crisis of the liberal global order that was formed over the 30 years that have passed since the end of the Cold War.
    [Show full text]
  • The Chronic Fatigue Syndrome: a Comprehensive Approach to Its Definition and Study
    See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/247808895 The Chronic Fatigue Syndrome: A Comprehensive Approach to Its Definition and Study Article in Journal of Chronic Fatigue Syndrome · December 2011 CITATIONS READS 1,642 1,587 7 authors, including: Keiji Fukuda Ian Hickie The University of Hong Kong The University of Sydney 130 PUBLICATIONS 24,420 CITATIONS 903 PUBLICATIONS 36,750 CITATIONS SEE PROFILE SEE PROFILE Michael Sharpe Anthony L Komaroff University of Oxford Harvard Medical School 424 PUBLICATIONS 26,066 CITATIONS 427 PUBLICATIONS 15,995 CITATIONS SEE PROFILE SEE PROFILE Some of the authors of this publication are also working on these related projects: A longitudinal study of young people seeking mental healthcare View project Oxytocin for children with ASD View project All content following this page was uploaded by Michael Sharpe on 12 March 2014. The user has requested enhancement of the downloaded file. DIAGNOSIS AND TREATMENT The Chronic Fatigue Syndrome: A Comprehensive Approach to Its Definition and Study Keiji Fukuda, MD, MPH; Stephen E. Straus, MD; Ian Hickie, MD, FRANZCP; Michael C. Sharpe, MRCP, MRC Psych; James G. Dobbins, PhD; Anthony Komaroff, MD; and the International Chronic Fatigue Syndrome Study Group* • The complexities of the chronic fatigue syndrome Issues in Chronic Fatigue Syndrome Research and the methodologic problems associated with its study indicate the need for a comprehensive, system­ The central issue in chronic fatigue syndrome research atic, and integrated approach to the evaluation, classi­ is whether the chronic fatigue syndrome or any subset of fication, and study of persons with this condition and it is a pathologically discrete entity, as opposed to a other fatiguing illnesses.
    [Show full text]
  • American Support for World Health Organization Funding
    American Support for World Health Organization Funding As the United States and the world confront an unprecedented global health crisis, it has never been more urgent to ensure that the World Health Organization (WHO), the primary institution with the technical ca- pacity and mandate to support all countries at this critical time, has the resources it needs for urgent, front- line response. WHO’s essential work on COVID-19 is in American interests and the world’s interests and needs our fullest support. The Better World Campaign strongly urges the administration to resume funding for WHO. But don’t take our word for it. Here is what others are saying in support of the WHO. What scientists and doctors are saying: “The WHO helps to ensure that effective treatments and vaccines also spread quickly through international coordination and collaboration. This work cannot be interrupted and the Academy calls on Congress as well as leaders within the Trump Administration to divert from finalizing any measures that would take us down the path of terminating our country’s import- ant relationship with the WHO.” – American Academy of Nursing “In the grip of a global pandemic that has already killed more than 100,000 Americans, severing ties with the World Health Organization (WHO) serves no logical purpose and makes finding a way out of this public health crisis dramatically more challenging. This senseless action will have significant, harmful repercussions now and far beyond this perilous moment, particularly as the WHO is leading worldwide vaccine development and drug trials to combat the pandemic... In the stron- gest terms possible, the American Medical Association urges the president to reverse course and not abandon our country’s leadership position in the global fight against COVID-19.” – American Medical Association “Withdrawing support from the WHO not only harms the global response against COVID-19 and prevents the United States from engaging the agency to enact meaningful reforms, but undermines the response to other major health threats impacting children.
    [Show full text]
  • The Economic Impact of Pandemic Influenza in the United States: Priorities for Intervention
    Publisher: CDC; Journal: Emerging Infectious Diseases Article Type: Research; Volume: 5; Issue: 5; Year: 1999; Article ID: 99-0507 DOI: 10.321/eid0505.990507; TOC Head: Research The Economic Impact of Pandemic Influenza in the United States: Priorities for Intervention Martin I. Meltzer, Nancy J. Cox, and Keiji Fukuda Centers for Disease Control and Prevention, Atlanta, Georgia, USA Suggested citation: Meltzer MI, Cox NJ, Fukuda K. The Economic Impact of Pandemic Influenza in the United States: Priorities for Intervention. Emerg Infect Dis [serial on the Internet]. 1999, Oct [date cited]. Available from http://www.cdc.gov/ncidod/eid/vol5no5/meltzer.htm Appendix II This paper provides additional information on methods, data, and results and is intended to supplement the above referenced published paper. Table of Contents Introduction Methods Objectives Modeling approach Gross attack rates Age group distribution of number of cases Percentages of high risk cases Total numbers of cases Health outcomes: Four categories Health outcomes: Deaths Non-high risk groups High risk groups: Publisher: CDC; Journal: Emerging Infectious Diseases Article Type: Research; Volume: 5; Issue: 5; Year: 1999; Article ID: 99-0507 DOI: 10.321/eid0505.990507; TOC Head: Research Comparisons with other data sets Health outcomes: Hospitalizations Non-high risk: High risk: Comparisons with other data sets: Health outcomes: Outpatient (ambulatory care) Non-high risk groups: High risk groups: Comparisons with other data sets: Hospitalizations and outpatient
    [Show full text]
  • Keiji Fukuda, MD, MPH
    Keiji Fukuda, MD, MPH Dr. Fukuda is team leader of the epidemiology unit, influenza branch, Centers for Disease Control and Prevention (CDC). He also is a captain in the U.S. Public Health Service, a clinical assistant professor in the department of community and preventive medicine, Emory University School of Medicine, in Atlanta, Georgia, an assistant clinical professor, department of medicine, school of medicine, University of California San Francisco in San Francisco, California, and a visiting professor, department of public health, Osaka City University. Dr. Fukuda joined CDC in 1990 as an epidemic intelligence service officer. In 1996, he joined the influenza branch as chief of the epidemiology section. The responsibilities of this section include national influenza surveillance, working with the Advisory Committee on Immunization Practices to develop recommendations for the control and prevention of influenza and conducting outbreak investigations and epidemiologic research related to influenza. Dr. Fukuda has published widely on influenza and has supervised several important influenza outbreak investigations. During 1997, he traveled to Hong Kong and China to supervise CDC’s field investigations during the outbreak of avian influenza A (H5N1) virus. In 1999, he returned to Hong Kong to investigate the emergence of avian influenza A (H9N2) virus. In 2003, he worked in China and Hong Kong on SARS and most recently, in 2004, was in Vietnam to assist with WHO efforts to investigate and control H5N1. Prior to working on influenza, Dr. Fukuda studied the epidemiology of HTLV viruses, chronic fatigue syndrome and unexplained illnesses in Persian Gulf veterans. Dr. Fukuda received a bachelor of arts from Oberlin College in Oberlin, Ohio, a medical degree from the University of Vermont in Burlington, Vermont, and completed a residency in internal medicine at Mount Zion Hospital and Medical Center in San Francisco, California.
    [Show full text]