Tag Archives: World Health Organization

Straight, No Chaser: Focus on the Rio Olympics, Zika and Worldwide Public Health


There are no words, yet I’ll write a few. In my lifetime, I cannot recall such an egregious breach of the public health trust than what will occur at the Rio Olympics. Consider the following: among other things, public health means to contain and limit exposure to disease. The nature of why vaccinations and quarantines are imposed support such a consideration. Now, let’s look at the potential ramifications of exposing a worldwide audience to a Zika virus hotbed.

  • You may have heard the suggestions that “it’s not the height of mosquito season in Brazil, or the outbreak started and is worse outside of Rio, so it’s ok.” Not true on all counts: Rio now appears to be the hotbed of Zika activity, and other diseases transmitted by mosquito bites (most notably dengue) have surged such that cases are six-fold higher than a year ago, with over 8,000 cases already having been reported this year. Furthermore, Rio’s Zika cases are more numerous than any other Brazilian location, totaling over 26,000. All of this is in the face of the country’s intense efforts to kill mosquitos.


  • You may have heard the suggestion that “male athletes or women not of childbearing age don’t have to worry about the pregnancy-related complications of Zika.” Really? First of all, Zika is transmitted in multiple ways, not limited to a mosquito bite. For example, sexual exposure to someone infected with Zika virus can cause the disease, even if the infected individual isn’t showing symptoms. It can be transmitted through blood transfusions and laboratory exposure. And of course, the virus is transmitted from mother to child during pregnancy. The concern isn’t just the obviously infected individual but also those who become carriers of the virus and can transmit it to others.
  • And the point of this? The Olympics is literally bringing approximately 500,000 individuals from around the world into a high-risk environment in which they can become carriers of the disease, subsequently exporting the disease around the world. This is about as irresponsible of an action as one can fathom – and to what end? What exactly are the ends here that justify these risks, primarily (but not limited) to unborn children? We know Zika infection is associated with pediatric microcephaly and brain damage, but it also has now been linked with adult conditions such as Guillain-Barré syndrome and acute disseminated encephalomyelitis, which are debilitating brain and nervous system conditions that can be fatal. Have I mentioned that in Rio, fully 29% of all women pregnant with Zika are displaying fetal abnormalities?

The World Health Organization’s silence on this matter is deplorable.
Even as this is bad enough, there’s more. Consider the water.


  • The Marina da Gloria is the visually stunning setting where the Olympic sailing events will be held. Nearly 1,400 of the more than 10,000 athletes competing at the Games will be directly exposed to it. This water is well-known to be contaminated with feces, and pre-Olympics cleaning efforts have fallen short of targets and expectations. On this matter, the World Health Organization has chosen to speak, recommending that athletes cover cuts and grazes with waterproof plasters prior to exposure, “try” to avoid swallowing the water, wash/shower as soon as possible after exposure and, simply minimize time in the water (especially avoiding going in the water after heavy rainfall).
  • As a means of quantifying the problem, the Associated Press has reported levels of bacteria and viruses so high that inadvertently swallowing just three teaspoons of water from the bay was likely to lead to severe stomach (intestinal illnesses including but not necessarily limited to diarrheal diseases) and respiratory illnesses. The concentrations of adenoviruses (a common cause of diarrheal disease) have been reported to be thousands of times higher than the levels considered safe in the US or Europe.


It’s easy to conclude that the calculus of the-powers-that-be has prioritized money above worldwide public health considerations and certainly above the health risks to participating athletes. This expands any existing precedent by which financial considerations have been allowed to endanger the vulnerable. If you’ve chosen to support this year’s Olympics by watching, you should consider (or at least be consciously aware of) the ramifications of your choice. If you’ve chosen to go to Rio, reconsider the logic of your decision. If you’re in any way potentially exposed to the Zika virus, please take recommended precautions.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser In the News: Zika Virus Update

zika pregnancy-button

The Zika virus continues to be in the news, especially regarding its effects on newborns. According to the Centers for Disease Control and Prevention (CDC), the number of pregnant women in the United States reported to have the Zika virus has increased from 48 to 157. Unfortunately and more importantly, that has now translated in up to a dozen babies or fetuses who have already suffered the consequences of Zika infection, with the obvious possibility of more to come. The most notable consequence is the condition known as microcephaly, representing a reduction in the size of the skull and the brain, causing developmental delays and defects.


Here’s one simple point for you to know. Not a single person is known to have contracted Zika from a mosquito bite in the U.S. The CDC has been clear in two specific warnings:

  • Do not travel to countries where Zika is endemic
  • Wear condoms when engaged in sexual intercourse with male who have traveled to such an area (Zika can be passed on through sperm).

Your travel to these areas pose specific risks even if you’re not a female of childbearing age. Such travel increases the risk of being infected without showing symptoms, spreading the disease and contributing to a worldwide expansion of the Zika virus. In fact the World Health Organizations notes that Zika virus is now poised to invade Africa, having spread to the African nation of Cabo Verde (Cape Verde). Your actions pose risks to others. 
Review this Straight, No Chaser for a refresher on transmission, symptoms and complications of the Zika Virus.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser In The News: Ebola Virus – Likely Not Coming Soon To a City Near You


We must be doing something right when so many of you are asking about Ebola virus. I say that because of the incredibly high probability that neither you nor I will ever see a case of Ebola. In the news is an outbreak of the Ebola virus in West Africa. In this Straight, No Chaser, we will discuss the threat and spread of Ebola, and in a subsequent post, we will review the disease itself.
The basis of concern of diseases such as Ebola is we have become a global community. Worldwide travel now imports and exports diseases in a way not previously common, exposing far-flung populations to seemingly esoteric and rare conditions. The concept that a deadly disease such as Ebola virus is simply a plane ride away is a scary one.


According to the Center for Disease Control and Prevention (CDC), Ebola has infected 1,323 people and killed 729 people in the current outbreak, which includes Liberia, Guinea and Sierra Leone. The Director of the CDC has described this outbreak as follows: “This is a tragic, painful, dreadful, merciless virus. It is the largest, most complex outbreak that we know of in history.” Notably, as the World Health Organization (WHO) has mobilized medical attention and support to those in need, some of those providing care have become infected. As such…
Your concerns are straightforward:

  • Is Ebola “coming” to my country?
  • Can I become infected by the Ebola virus?

Focusing on the United States, the answers to both questions are yes, but the risk of your becoming infected are so remote that you should simply understand how to avoid the threat. Furthermore it is important to understand that bringing an infected American home for treatment (as is occurring in Atlanta) is not the same as exposing the population to the disease.


And so, here are some quick facts for your consideration:

  • Ebola virus is not transmitted like the cold or flu. It requires significant exposure to blood or bodily fluids.
  • Prior to that contact, you’d be most likely be aware of its presence. Those infected with Ebola are so ill so quick that it’s obvious.
  • The chances of an infected and unrecognized person infected with Ebola making it to the U.S. through commercial air travel are infinitesimal.
  • Over $100 million in medical support is being provided by the WHO and CDC to combat this outbreak.
  • Medical management of Ebola is not especially complicated once identified.
  • It is estimated the current outbreak will be defeated within 3-6 months.

What should you do? Continue the same diligence you should be applying to your health everyday.

  • Engage in healthy habits, including hand washing and maintaining a level of health to support a vibrant immune system.
  • Avoid risky behaviors involving transfer of blood and other bodily fluids.
  • Get prompt medical attention for those appearing sick, particularly after recent travel to areas affected by disease outbreaks.

We end this post with another two thoughts from the Director of the CDC:

  • “Although it will not be quick and it will not be easy, we do know how to stop Ebola.”
  • “Ebola poses little risk to the U.S. general population.”

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook atSterlingMedicalAdvice.com and Twitter at @asksterlingmd.

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Straight, No Chaser: A Dream of Equal Access to Health Care

This weekend marked the celebrations of the 50th anniversary of the famous March on Washington. During this weekend’s remembrances, I couldn’t help but reflect back on Dr. Martin Luther King, Jr.’s most famous comments on health care in America.

“Of all the forms of inequality, injustice in health care is the most shocking and inhuman.”

Why would he say such a thing? Injustice in health care has taken many forms and resulted in predictably poor outcomes for those affected. I will be frequently reviewing these considerations and addressing health care disparities in this blog. Today, I will address the inequity in insurance coverage that formed the premise for the Affordable Care Act (aka Obamacare).
According to the Kaiser Family Foundation, in 2009-2010, 41% of low-income adults were uninsured, and 45% of poor adults were uninsured. Contrast this with the fact that only 6% of those who make four or more times the poverty rate were uninsured. This pretty clearly makes the case that health care is a desirable asset for Americans who can afford it, and a choice that too often can’t be afforded for others. Now consider that 14% percent of white Americans were uninsured, while 22% of African-Americans were uninsured, and 32% of Hispanic Americans were uninsured. Whether you believe this is just a correlation, coincidence or reflection of something more damning, it is a situation that screaming to be addressed and improved.
Even more recently, the Centers for Disease Control and Prevention released a survey showing that more than 45 million U.S. residents didn’t have health insurance during the first nine months of last year. Still even more people, 57.5 million, were uninsured for at least part of the 12 months before being polled (Be reminded that the total U.S. population is just over 311 million.).
Please take a moment and ponder the enormity of the numbers just presented. It begs the question “How can such be allowed to exist?” Dr. King’s comment begged the same question. The answer of course lies in the fact that the American health care system isn’t built on producing equality of access or outcomes. You’ve heard me say before that the American health care system remains the only system among all the major industrialized nations on earth that doesn’t ensure access for all its citizens. The American health care system is a business enterprise that has captured over $2 trillion annually, representing over 1/6 (17%) of the gross domestic product, and all the while leaving more than 45 million Americans uninsured. We are number one in money spent on health care by a large margin; in fact, the U.S. spends more on people aged over 65 than any other other country spends on its entire population. The business of medicine in America is business first. It is largely expected that good health care outcomes will result from good business in the same way that good cars, computers, smartphones, etc. are produced (theoretically). It’s important to note that according to the World Health Organization (the monitor of such things), the U.S. health care system was ranked #38 in the last WHO ranking based on standard health outcomes produced.
President Barack Obama’s health care reform law aims to extend health insurance coverage to a large portion of the uninsured. According to the Congressional Budget Office, health care reform will reduce the number of uninsured people by 27 million between 2014 and 2023. The Affordable Care Act (ACA) targets its assistance to the poor and near-poor who are least likely to have health care coverage. The ACA will provide Medicaid coverage to those with incomes up to 133 percent of the poverty level ($15,282 for a single person this year) — unless their home state opts out of the Medicaid expansion. People who earn between the poverty level and four times that amount will be eligible for tax credits for private health insurance.
Access to health care is the beginning of the process by which health care disparities can be erased. As long as failure to have equal access exists to the extent that it does, the types of disparities in life expectancy, disease rates and disease survival will remain predictably dismal for certain populations. This afternoon I will revisit the Affordable Care Act and it’s efforts to improve the current system. I welcome any questions or comments.
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