41. Prevention vs. Prescription: The Question About Opioids

Your first day at any new job is always a little stressful. But for Julia Petras, the day she started working at CDC was especially high stakes. In this episode of Contagious Conversations, we explore a mysterious outbreak that affected four patients in four months, sickened by a bacteria not seen before in North America. The FBI—and the public—wanted answers. We hear from CDC’s Julia Petras, Dr. Jennifer McQuiston and Dr. Eric Pevzner about how the outbreak was solved by disease detectives in the Epidemic Intelligence Service.    Episode Quotes “There is no replacement for shoe-leather epidemiology. You can have all of your advanced biostatistics, your sophisticated software, but it doesn't replace the importance of talking to real people, to being physically there, doing some of that boots-on-the-ground detective work. There is no replacement for that.” — Julia Petras, Regional Epidemiologist, Global Influenza Branch, CDC “As a disease detective, you get to go and figure out how can you help protect people so that you can give people the opportunity to have healthy lives? And there's nothing more rewarding than getting to do that than as a disease detective at CDC.” — Dr. Eric Pevzner, CAPT, U.S. Public Health Service; Chief, Epidemiology and Laboratory Workforce Branch, Epidemic Intelligence Service, CDC “I remember I came in on a weekend to pick up some papers from my office and she and her EIS supervisor were holed up in a conference room with a big whiteboard, and they were trying to connect the dots and figure out where to go next and what questions needed to be answered, and they were always trying to pursue getting an answer for that case. And so the tenacity that was required to solve it was really impressive.” — Dr. Jennifer McQuiston, Principal Deputy Director, Division of High Consequence Pathogens and Pathology, CDC   To watch the original 1979 interview with Dr. Alexander Langmuir featured in this podcast, visit https://www.youtube.com/watch?v=NICfQM9d0CM   For more information and full episode transcripts, go to Contagious Conversations.

Have you ever asked yourself what routine auto repairs can teach us about how we think of our investment in public health? Listen in on our latest Contagious Conversations podcast as host Claire Stinson uncovers the answers and details how quick action quashed a recent outbreak of an illness long considered to be eliminated in the United States. In this episode, “The Costs of Getting Sick,” we explore the overlap between public health and the health of our economy with guests Dr. Dan Filardo of CDC, Dr. Michael Osterholm of the Center for Infectious Disease Research and Policy and Dr. Alexander Sloboda of the Chicago Department of Public Health. Join us!   Episode Quotes “Obviously, the rash, the fever, cough, red, itchy eyes, runny nose are the symptoms commonly you get with measles, but it can also be very dangerous, and it can be deadly sometimes.” — Dr. Alexander Sloboda, Medical Director of Immunization and Emergency Preparedness Programs, Chicago Department of Public Health “Because this case was in a large congregate setting, we were really in communication with Chicago right off the bat, anticipating that there might be an outbreak.” — Dr. Dan Filardo, a medical officer with CDC’s measles team “You have outbreaks in schools with these vaccine-preventable diseases, you interrupt education substantially. Now, what's the cost of that? What does that mean? What happens when kids fall behind? What happens when the teachers can't teach? And, unfortunately, we don't have a lot of these things qualified or quantified in terms of what they really mean, economically.” — Dr. Michael Osterholm, author and director of the Center for Infectious Disease Research and Policy   Thanks to Our Guests Dr. Dan Filardo, a medical officer with the measles team at CDC Dr. Alexander Sloboda of the Chicago Department of Public Health Dr. Michael Osterholm, author and director of the Center for Infectious Disease Research and Policy   For more information and full episode transcripts, go to Contagious Conversations.

Host Claire Stinson welcomes you to a special year-end episode of Contagious Conversations focused on highlights from the 2023 season! Listen to selections from the year’s episodes on topics as diverse as heath threats facing Black women; training the next generation of public health professionals; and the respiratory triple threat posed by COVID-19, influenza and RSV. Highlights featured include the groundbreaking vaccination approach that led to the eradication of smallpox in 1980; how investigators zeroed in on the cause of an outbreak of a drug-resistant strain of pseudomonas aeruginosa found in contaminated eye drops; the health threats most common to women, and the particular challenges faced by Black women; a conversation with new CDC director Dr. Mandy Cohen; and more. For full episode transcription, visit Contagious Conversations.   Key Takeaways: [1:25] Drs. Bill Foege and Mark Rosenberg codeveloped a project called “Becoming Better Ancestors: Nine Lessons to Change the World”. Dr. Foege talks about his inspiration for this project. [3:09] Dr. Laura Evans discusses the triple threat of COVID-19, influenza and RSV, and shares with the audience her thoughts on how to stay healthy and the importance of vaccines against respiratory threats. [4:37] April was National Minority Health Month and for that occasion Dr. Judy Monroe spoke with Dr. Melody McCloud, an Atlanta-based obstetrician/gynecologist, who shared her insight into the most common health threats women face. [6:22] CDC epidemiologist Dr. Danielle Rankin talks about her role investigating the cause of the outbreak of a drug resistant strain of Pseudomonas Aeruginosa. [7:21] CDC director Dr. Mandy Cohen speaks with Dr. Judy Monroe about the experience she brings to her position and CDC’s priorities going forward. [8:59] Drs. Ezekiel Emanuel and Jerome Adams discuss hypertension in America and the risks it poses to almost half of U.S. adults. In this episode, Dr. Adams highlights the ethnic inequities in diagnosing and controlling this silent killer.

Doctors have long known that hypertension, or high blood pressure, is a leading risk factor for heart attack and stroke. Yet today, nearly half of all adults in the United States have hypertension, creating a silent public health threat. Host Dr. Judy Monroe is joined by Dr. Jerome Adams and Dr. Ezekiel Emanuel. Dr. Adams is a former U.S. Surgeon General of the United States and now serves as the executive director of Purdue University’s Health Equity Initiatives. Dr. Emanuel is vice provost for global initiatives and the Diane v.S. Levy and Robert M. Levy University Professor at the University of Pennsylvania. In this episode, the doctors discuss the health risks posed by hypertension, reasons why it is so prevalent in the U.S. and the steps we can all take to stay healthy. For full episode transcription, visit Contagious Conversations.   Key Takeaways: [1:46] Why is hypertension so prevalent?  [2:20] Dr. Emanuel discusses the lack of exercise as a contributing factor to high hypertension rates in the U.S. adult population. [2:52] Dr. Emanuel addresses the issues of poor diet, processed food and high sodium intake as they relate to hypertension. [3:13] Obesity is a major factor for hypertension. [3:50] Alcohol consumption as a contributor to high rates of hypertension. [4:23] Dr. Adams highlights the impact of poor hypertension control among those impacted.  [7:14] What steps can Americans take to address the higher impact of hypertension among the Black community? [8:53] Dr. Adams discusses systemic racism and its impact on hypertension control. [9:30] Dr. Emanuel emphasizes what he calls ‘huge’ health inequities in hypertension. [10:44] The lack of awareness regarding hypertension is part of the problem. [12:50] During the pandemic, more people were lost each year to hypertension than to COVID-19. [13:06] Dr. Adams explains the three goals of the Surgeon General’s call to action.   Mentioned in This Episode: Surgeon General’s Call to Action  

Each year, fall means heading back to school for the nation’s students. But as students, teachers and school staff return again this year, the social, academic and mental health impacts of the pandemic are still being felt. In this episode, host Claire Stinson speaks with Heather Martel-Balfour about the mental health challenges faced by students and teachers in today's educational environment, and the approaches educational professionals used to cope with the strains of the workplace. Heather is a social worker and behavioral interventionist for a small rural school in southern Maine. She is starting her 15th year in public education, with her roles spanning from educational technician and paraprofessional to her current role as a licensed clinical social worker.  For full episode transcription, visit Contagious Conversations.   Key Takeaways: [1:04] Heather talks about her role at the school she works in. [1:51] What does Heather love most about her job? [2:37] Heather shares her perspective regarding the overall mood of teachers and students in the first weeks of school. [3:15] Is there optimism or worry about being behind in the curriculum due to COVID-19? [4:21] What are some of the major challenges that affect teacher and staff mental health? [5:56] Heather affirms her work in education is harder now than ever before. [6:50] What are some particular challenges for students in rural settings? [9:13] What are the greatest challenges for teachers returning to school this year? [11:22] How do these challenges impact the students' mental health? [13:12] Heather discusses the resources she would like to see available for educational professionals. [14:12] What steps can teachers take to reduce stress? [17:26] What can students do to reduce stress? [20:09] What are the biggest opportunities for overcoming mental health challenges for teachers?   Mentioned in This Episode: Learn more about the How Right Now Campaign.

We're bringing you a special episode this month, as our president and CEO sits down for a conversation with Mandy K. Cohen, MD, MPH, the new director of the Centers for Disease Control and Prevention (CDC) and the Agency for Toxic Substances and Disease Registry Administrator. Dr. Cohen has extensive experience leading large and complex organizations and a proven track record protecting Americans’ health and safety. An internal medicine physician by training, Dr. Cohen led the North Carolina Department of Health and Human Services during the COVID crisis, where she was lauded for her outstanding leadership and her focus on equity, data accountability and transparent communication. She also transformed the North Carolina Medicaid program through the state’s Medicaid expansion. For full episode transcription, visit Contagious Conversations.   Key Takeaways: [1:58] What does Dr. Cohen want people to know about her? What were her thoughts while deciding to accept the position as CDC Director? [4:47] What are Dr. Cohen’s priorities as she becomes the CDC Director? [7:56] What skills did Dr. Cohen learn at the state level that she thinks will translate to this new position at CDC? [12:05] Dr. Cohen discusses the current status of COVID-19. [13:34] What does Dr. Cohen believe public health success looks like? [15:51] The nation faces considerable political divisions and there are trust gaps between public health organizations and some Americans. How do public health and CDC regain that trust? [18:03] What is CDC doing to address the health threats of climate change? [20:28] How is CDC preparing for new public health challenges?  [22:19] Where are we winning in public health and how will CDC replicate those wins? [25:15] What is the most exciting thing about your position at CDC?   Mentioned in This Episode: Learn more about the Heat & Health Tracker  

In 2022, a mysterious outbreak of a deadly drug-resistant bacteria began spreading across several U.S. states. A CDC investigation would eventually reveal an unusual culprit: common eye drops. In this episode, Dr. Danielle Rankin takes us behind the scenes of the investigation, sharing how they made their big break and what we've learned as a result. Dr. Rankin is an epidemiologist for the Antimicrobial Resistance Team in the Division of Healthcare Quality and Promotion at the Centers for Disease Control and Prevention. Prior to pursuing her PhD, she was an epidemiologist for the Florida Department of Health Healthcare Associated Infections Program. Dr. Rankin has published 28 manuscripts and throughout her career has conducted over 70 infection control assessments and investigated more than 60 domestic infectious disease outbreaks. For full episode transcription, visit Contagious Conversations.   Key Takeaways: [1:37] When did CDC first learn about the Pseudomonas aeruginosa infections? [2:58] What led to discovering the bacteria transmitted through eye drops? [4:30] What was Dr. Rankin’s first big break in this investigation? [6:42] What do we know about this bacteria and its origin? [8:25] Bacteria like these are constantly evolving to resist antibiotic treatment; Dr. Rankin talks about the cause of antibiotic resistance and the role of CDC in researching solutions. [10:08] Dr. Rankin talks about the role of CDC on a global scale. [10:39] What steps does CDC take when an outbreak like this occurs? [12:42] Why are partnerships critical in responding to outbreaks? [13:40] What is the outbreak investigation state currently? Do any threats remain? [15:48] Has anything surprised Dr. Rankin about this particular outbreak? [17:33] How is CDC preparing to meet the challenge of future outbreaks?    Mentioned in This Episode: CDC's Division of Healthcare Quality and Promotion  

According to the Centers for Disease Control and Prevention, suicide is the eleventh leading cause of death for Americans overall. And sadly, our nation’s veterans face even higher rates of suicide. In this month's episode, we discuss the crisis of veteran suicide and the community-based preventative approaches being taken today. Joining us in this conversation is Nicola Winkel, project director for the Arizona Coalition for Military Families. ACMF is a nationally recognized public-private partnership focused on building Arizona's statewide capacity to care for, serve and support service members, veterans and their families and communities. In her role, Nicola oversees the coalition’s Be Connected Program, a support ecosystem for service members, veterans and their families. Winkel is also the spouse of a veteran herself and has more than 20 years experience in nonprofit program development and implementation. If you know of a veteran experiencing a crisis, dial 988, then press 1 for help. For full episode transcription, visit Contagious Conversations.   Key Takeaways: [1:04] Nicola discusses the challenges many veterans and service members are facing.  [2:33] In the past decade, Americans have become more aware of the hardships faced by veterans. [3:24] Nicola shares the mission of the Arizona Coalition for Military Families.  [4:16] Nicola addresses the importance of upstream efforts in suicide prevention. [6:20] Why are organizations such as the Arizona Coalition for Military Families so important for veteran suicide prevention? [7:24] What is veteran engagement like with community-based organizations? [8:44] Nicola discusses how the community integration and connectedness model in building an ecosystem of support. [11:04] Nicola talks about the Coaching into Connection Program. [12:22] Veterans have shared experiences that helped them connect to each other through bad times. [14:35] Nicola discusses her organization’s involvement in the Veteran Suicide Prevention Evaluation project. [16:36] How has their increased capacity for evaluation most significantly impacted their work? [17:20] Nicola describes the evolution of their programming. [20:42] What does Nicola see as the greatest opportunity to prevent suicide and protect our veterans?     Mentioned in This Episode: Learn more about the CDC Foundation’s efforts to prevent veteran suicide.   

Physicians face many challenges in treating people living with pain, especially in light of the U.S. opioid overdose epidemic. In today's episode, we speak with Dr. Chris Jones on how physicians are handling these challenges, and the steps CDC is taking at a community level to help address the issue. Dr. Chris Jones is Director of the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention (CDC). Dr. Jones's career in public health includes leadership and advisory roles at the Substance Abuse and Mental Health Services Administration, the U.S. Food and Drug Administration and the U.S. Department of Health and Human Services and Mental Health.  This month's episode is hosted by Dr. Judy Monroe, president and CEO of the CDC Foundation. For full episode transcription, visit Contagious Conversations.   Key Takeaways: [1:39] Dr. Jones talks about his role at CDC. [3:15] Dr. Jones discusses the impact of the opioid epidemic in the United States. [5:05] Dr. Jones speaks of CDC’s Clinical Practice Guideline for Prescribing Opioids for Pain that was released last November. [5:41] What challenges do physicians face when treating people dealing with chronic pain during the opioid epidemic? [9:24] What was the response from physicians and pharmacists to the opioid prescribing guidelines released in 2022? [12:50] Dr. Jones talks about the work CDC is doing regarding the opioid epidemic at a community level. [17:48] Dr. Jones highlights the value of collaboration. [19:58] What is the greatest opportunity to address the opioid overdose epidemic?   Mentioned in This Episode: Learn more about the work of CDC regarding the opioid epidemic  

As we emerge from the COVID public health emergency, it is a critical time to think about the future of public health. The next generation of public health workers will be charged with leading through the challenges that lie ahead. In this episode, we speak with Anna Heilers and Dr. Antoine Denis, two public health students who are preparing to meet these public health challenges of tomorrow. Anna is currently an MPH candidate at Indiana University, Purdue University Richard M. Fairbanks School of Public Health. She works with the Indiana State Department of Health while in school, and during her schooling has had broad professional experience through research, internships, data collection and supporting infectious disease investigations. Antoine is an MPH student at the Columbia University Mailman School of Public Health. In 2022, he launched an effort to improve health safety in New York City by strengthening a network of hand sanitation stations in subway stations and other transportation nodes around the city. This month's episode is hosted by Dr. Judy Monroe, president and CEO of the CDC Foundation. For full episode transcription, visit Contagious Conversations.   Key Takeaways: [1:24] How did Anna get interested in public health? [2:28] Dr. Denis shares how he got involved in public health. [4:18] Why is engaging in the public health world important? [6:33] What is driving schools of public health to so actively support the work of health departments across the country? [8:20] Anna talks about the reasons for collaboration between the schools of public health and health departments. [10:03] Antoine talks about the goals of the RISE project. [12:35] What was the biggest surprise during the RISE project? [14:48] Antoine speaks of Academic Immersion in Health Care, a nonprofit organization he founded. [17:28] Anna shares her experience at the Department of Health and her current role as a Covid 19 epidemiologist on the CDC reporting team. [20:03] How does Anna balance the workload of study while engaging in active public health work? [21:55] Where are organizations strongest and weakest in providing public health students opportunities to interact with their communities? [24:20] How does Anna think her experiences will shape her future career in public health? [25:19] Antoine shares how he believes his experience will shape his future career in public health. [27:00] What does Antoine see as the most significant challenges ahead in public health? [28:38] Anna shares what she believes are the biggest challenges ahead in public health.   Mentioned in This Episode: Academic Immersion in Health Care Learn more about the CDC Foundation's Public Health work