Four New Year's Resolutions for ID Specialists: Public Health Watch

With the dawn of a new year upon us, it’s time for reflection and goal-setting.

For infectious disease (ID) specialists, and related clinicians, though, the objectives may seem obvious. The various bugs that plague the world are very much top of mind, after all, given their virtual omnipresence in the headlines. But, while curing Zika is an admirable goal, it’s not something that is realistically on the plate of every ID specialist in practice.

So what should be on the agenda in 2018? Herewith, 4 New Year’s resolutions for the infectious disease community—at least according to us here on the Public Health Watch:

1. Track the Opioid Epidemic Readers outside the ID realm might ask themselves, “What does the abuse and misuse of painkillers have to do with infectious diseases?” However, those in the field should know the answer all too well, what with multiple studies identifying a link between injection opioid use and outbreaks of certain infectious diseases, including HIV and hepatitis C. Most recently, these links were highlighted in a study published online on December 21 by the American Journal of Public Health, which found a 2-fold increase in the annual incidence rate of acute hepatitis C virus (from 0.3 to 0.7 cases per 100,000 population) from 2004 to 2014, figures that mirrored those associated with admissions for substance use disorder attributed to the injection of heroin and prescription opioid analgesics over the same period. The crisis is particularly acute for younger adults. The authors of the paper, from the US Centers for Disease Control and Prevention (CDC), note that among Americans between the ages of 18 and 29, rates of hepatitis C increased by 400%, while admissions related to injection opioid use grew by 622%. With injection drug use an obvious risk factor for hepatitis C, these are worrying figures indeed, and a call to action for ID professionals to get involved in efforts to end the opioid epidemic and educate drug users on the health implications.
2. Get Ticked About Tick-Borne Infections In its first-ever “Public Health Grand Rounds Year in Review” for 2017, posted online on December 18, CDC researchers note that “the key to… tick-borne diseases” such as Lyme, “is awareness and education of the clinicians...” Part of this education must address the potential overuse of antibiotics in the treatment of “chronic Lyme,” a controversial diagnosis that has been covered in this space before. It has long been understood that antibiotic stewardship is now a fundamental part of the practice of ID medicine; that mission should also include the education of clinicians who lack ID expertise as to when antibiotics should be used in Lyme disease treatment.
3. Educate Patients About Antibiotic Resistance No, patients aren’t overprescribing antibiotics, but they may be pressuring their primary care physicians for Rx’s whenever they get sick. Patients need to understand that antibiotics aren’t always necessary—and are not appropriate for all bugs. Indeed, their overuse has consequences, and not just for providers stumped for effective options against certain resistant infections. The Office of National Statistics in Britain, according to a December 1 report in The Telegraph, has projected that babies born in 2060 will have a shorter life expectancy (by 2 years) than those born in 2010. It attributes this reduction to antibiotic resistance. If statistics such as these don’t alarm patients—and, in the case of children, their parents—then nothing will. It’s incumbent upon the ID community to make them aware of these startling figures.
4. Advocate on Political Issues They say “all politics is local.” And if you think decisions in Washington, DC won’t impact your practice, you need to think again. The American Public Health Association (APHA) earlier in December released its position on the new tax reform legislation, which was signed into law on December 22. The APHA expressed concern that the new tax rules would result in budget cuts for important initiatives such as the Prevention and Public Health Fund (covered previously by Contagion^®), and that the repeal of the individual mandate provision of the Affordable Care Act, which is a fundamental part of the new tax bill, will increase the number of uninsured Americans and result in a rise in health insurance premiums. Whether or not you agree with the APHA, using your knowledge of these issues, based on clinical practice, to educate others (including political leaders) is a worthwhile goal for 2018 and beyond.

Not that you need more items for your things-to-do lists for next year; however, we hope you’ll consider these for inclusion.

Happy New Year!

Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous health care-related publications. He is the former editor of Infectious Disease Special Edition.