How to Get Relief from Allergy Symptoms | Newsweek By The Numbers

300 Million Patients
Anne Underwood 5/19/2009 12:00:00 AM
Now Frieden is set to become the nation's top doc. On May 15, President Obama appointed him as head of the Centers for Disease Control and Prevention (CDC). Among the issues facing Frieden will be whether or not to develop a vaccine for the new flu. He will be in charge of tracking foodborne infections and conducting research into all the health scourges confronting American society. And he will be in charge of restoring morale at the sprawling bureaucracy. "It's a daunting task. But he's not just someone from the ivory tower," says Dr. Georges Benjamin, executive director of the American Public Health Association (APHA). "He has experience tracking infections in the hood, as they say. Having someone like that orchestrating national policy will be very helpful." At 48, Frieden has created in New York what is arguably the most effective and innovative public-health department in the country. In the process, he has also enraged restaurant owners, drawn fire from religious leaders, driven smokers into the streets and created a whole new category of souvenir: the official New York City condom. But he gets results. His 2002 Smoke-Free Air Act, 2006 ban of trans fat in restaurants and 2007 requirement that chain restaurants post calorie counts on their menus have all inspired similar measures around the country. Though with far less fanfare, he's also spearheaded introduction of electronic health records and dozens of other initiatives against problems like infant mortality, diabetes, HIV/AIDS and colon cancer. The combined effect has been to help bring death rates in the city to new lows. "We used to send out 60,000 death certificates a year," Frieden told NEWSWEEK last year. "Now we're issuing 55,000." Frieden brings passion to a field that few people think of passionately. Public health first seized his imagination during medical school at Columbia University when he read a classic series of articles by Berton Roueché called The Medical Detectives, in which scientific gumshoes unraveled the mysteries behind rare diseases, poisonings and parasites. "I loved clinical practice," says Frieden, who worked among Dominican populations in Manhattan during med school and speaks fluent Spanish. "But in public health, you can impact more than one person at a time. The whole society is your patient." He proved that when he went to work for the CDC in 1990. At the time, tuberculosis was emerging as a threat in New York City, with the caseload tripling between 1978 and 1992. As an epidemic-intelligence-service officer for the CDC, Frieden documented a dramatic increase in multidrug-resistant TB. Under Dr. Margaret Hamburg, then city health commissioner, now Obama's nominee to head the FDA, he set out to contain it. The key was making sure that patients took the complete, six-month course of antibiotics, even after they felt better. But how do you do that, especially when the disease is spreading through places like homeless shelters? He and Hamburg sent outreach workers to patients' homes and offices, not to mention street corners, bridges, subway stations, park benches and crack dens to make sure they were taking their medicines as directed. Over the next two years, infections in the city fell by 20 percent, and multidrug-resistant TB stopped spreading. In 1996, Frieden took the fight against TB overseas as a medical officer for the World Health Organization, on loan from the CDC. That's where he was in 2001, when Mayor-elect Michael Bloomberg began searching for a health commissioner. Bloomberg asked Dr. Alfred Sommer, then dean of public health at Johns Hopkins University, to name the most talented person in the field. "You can't have him," said Sommer. "Tom Frieden is curing tuberculosis in India for the World Health Organization." In five years, he said, Frieden had helped reduce new infections 50 percent in a part of the world known for massive red tape. "Give me his number," Bloomberg replied. Frieden almost rejected the call. In India, he was engaged in important work. It wasn't worth his time to come back for the interview, he said, unless the mayor was willing to tackle smoking or, as he calls it, "legalized drug pushing." It was a bold demand. In the wake of the terrorist attacks on 9/11, the rest of the world was focused on bioterrorism. Frieden recognized the importance of the issue, but said, "Terrorists will never kill as many New Yorkers as smoking." (Terrorists killed nearly 3,000 people on 9/11. Smoking kills 400,000 a year.) The mayor agreed and flew him back for the interviews. Frieden's appointment led to an extraordinary partnership. Bloomberg, who has a school of public health named for him at Johns Hopkins, has strongly backed Frieden's initiatives at a time when, as Sommer puts it, most health commissioners are treading water, just trying to hold together financing for basic services. Together Frieden and Bloomberg targeted smoking, as promised. They began in 2002 by persuading the city council to boost taxes on cigarettes, pushing prices to $7 a pack, then the highest in the country. Next, over the howls of the restaurant industry, they vastly expanded an existing smoking ban to apply to workplaces, including all restaurants and bars. Doomsday never arrived. Restaurant employment and revenues rose 9 percent in the first year while employment in other retail businesses inched up 1.4 percent.
The S Word
Lisa Miller 5/19/2009 12:00:00 AM
When President Barack Obama talks about finding common ground on abortion, as he did during his commencement address at Notre Dame over the weekend, he's not really talking about abortion at all. The president is pro-choice, which means that he believes that women should have access to legal abortions and that Roe v. Wade should remain the law of the land. What he's really talking about is sex—specifically, who should have it, under what circumstances, and who should bear responsibility for the (desired or undesired) consequences. Abortions—to state the obvious—result from sex. To reduce the number of women seeking abortion, domestic policy wonks need to find common ground on sex.
HEALTH
The Path of a Pandemic
5/2/2009 12:00:00 AM
Around Thanksgiving 2005 a teenage boy helped his brother-in-law butcher 31 pigs at a local Wisconsin slaughterhouse, and a week later the 17-year-old pinned down another pig while it was gutted. In the lead-up to the holidays the boy's family bought a chicken and kept the animal in their home, out of the harsh Sheboygan autumn. On Dec. 7, the teenager came down with the flu, suffering an illness that lasted three days. He visited a local clinic, then fully recovered, and nobody else in his family took ill.
HEALTH
Q&A: A Swine Flu Crisis?
4/27/2009 12:00:00 AM
An epidemic of swine flu has recently developed in Mexico and the United States, says the CDC. Swine flu has killed many people, and the outbreak has features that suggest it could become a global pandemic. A pandemic is an epidemic that spreads around the whole world. Pandemics also often cause more severe disease than epidemics.
ECONOMY
The Cost of Swine Flu
4/27/2009 12:00:00 AM
The media has been hyper-focused this weekend on the news that more than 1,000 people in Mexico have become infected with Swine flu, also known as Influenza A H1N1. Nearly 90 people have died from the outbreak. The strain appears to have spread to several countries including the United States. One of the most notable pieces of information about this outbreak is that in the US and Canada the cases have been described as "mild."
SCIENCE
Anatomy of a Scare
Sharon Begley 2/21/2009 12:00:00 AM
Like many people in London on that bleak February day in 1998, biochemist Nicholas Chadwick was eager to hear what the scientists would say. The Royal Free Hospital, where he was a graduate student in the lab of gastroenterologist Andrew Wakefield, had called a press conference to unveil the results of a new study. With flashbulbs popping, Wakefield stepped up to the bank of microphones: he and his colleagues, he said, had discovered a new syndrome that they believed was triggered by the MMR (measles, mumps, rubella) vaccine. In eight of the 12 children in their study, being published that day in the respected journal The Lancet, they had found severe intestinal inflammation, with the symptoms striking six days, on average, after the children received the MMR. But hospitals don't hold elaborate press conferences for studies of gut problems. The reason for all the hoopla was that nine of the children in the study also had autism, and the tragic disease had seized them between one and 14 days after their MMR jab. The vaccine, Wakefield suggested, had damaged the intestine—in particular, the measles part had caused serious inflammation—allowing harmful proteins to leak from the gut into the bloodstream and from there to the brain, where they damaged neurons in a way that triggered autism. Although in their paper the scientists noted that "we did not prove an association" between the MMR and autism, Wakefield was adamant. "It's a moral issue for me," he said, "and I can't support the continued use of [the MMR] until this issue has been resolved."