Archives for March 2012

Listeriosis
Last year we experienced the biggest food-borne outbreak of listeriosis in this country in over 20 years. At last count, 30 people across 28 states had died as a result of eating tainted cantaloupes that were linked to one Colorado farm. And a total of 146 cases were confirmed in this outbreak.

The causative bacterial organism, Listeria monocytogenes, is a common cause of US food recalls in products such as deli meats, hot dogs, and soft cheeses made with unpasteurized milk. Its emergence as a contaminant in fresh foods like this, however, is a new and concerning event.

One problem associated with listeriosis is that it can take weeks, and up to two months in some cases, for symptoms to develop post-infection. This is very different to the quick onset of symptoms that occurs in cases of food-borne illness due to salmonella and E. coli infections.

Listeria is a very common organism in general, and it can also proliferate to high levels in low temperatures, rather than becoming dormant. This combination of facts means that it can potentially be introduced onto food at any point in the food chain – whether out in the field, in your home, or somewhere in between.

Serious disease due to listeriosis is, however, uncommon. In order to cause serious illness the bacterium needs to get onto food and proliferate to levels high enough to cause disease – it’s been reported that people need to ingest over one million organisms to become sick.

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Symptoms?
Symptoms are generally non-specific. Flu-like complaints such as headache, muscle aches and fever, not too uncommon this time of year, can occur. Additionally, abdominal cramps and diarrhea commonly occur. Certainly the development of diarrhea and abdominal pain should prompt you to visit your doctor, especially if you have eaten cantaloupe in recent weeks.

In particular, older people, newborns, pregnant women, and people with weakened immune systems are at a higher risk of listeriosis.

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What To Do With Your Cantaloupe
If you are ever unclear as to whether that cantaloupe in your kitchen is safe to eat, you are advised to throw it away. And don’t assume that if it’s been sitting in the fridge, that it’s ok – remember it tends to multiply in cold temperatures.

So the longer a tainted cantaloupe is in the fridge, the higher your risk of developing listeriosis. Some people advise washing the cantaloupe to reduce the contamination risk, but inevitably this won’t sterilize the fruit, so the general advice from the CDC is: “If in doubt, throw it out”.

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Some General Guidelines Offered by the CDC to Help Avoid Listeriosis 

1) Rinse fruit and vegetables thoroughly before eating
2) Thoroughly cook raw meat and poultry
3) Cook hot dogs, deli meats, & cold cuts until steaming hot before serving
4) Avoid unpasteurized milk or cheeses containing unpasteurized milk
5) Keep your fridge at or below 40°F, and your freezer at or below 0°F

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Image Credit Kevin_P @morgueFile.com

Social and News Media Trends Correlated Well with Officially Reported Data During the 2010 Haitian Cholera Outbreak
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Social media certainly tends to get a bad rap sometimes – but did you know that during the 2010 Haitian cholera epidemic, information on disease parameters was transmitted faster via social media and internet news than via health officials?

Even more importantly, this early informal data correlated significantly with later official data.

Rumi Chunara, PhD, with Harvard Medical School, and colleagues reported their findings in the January 1st, 2012 issue of the American Journal of Tropical Medicine and Hygiene.

According to the authors, early epidemiologic assessment may be hindered during disease outbreaks because officially reported data are often unavailable for weeks. Since disease data from informal media sources, however, are available immediately, the authors set out to determine whether these unofficial reports correlated with officially released data.

Unofficial data from Twitter (188,819 tweets) and HealthMap (4,697 alerts), and official data from the Haitian Ministry of Public Health (MSPP) were examined from the first 100 days of the outbreak. The researchers compared the data over three major time periods of activity, corresponding to the initial period of the outbreak (Phase I: October 20 – November 3), the increase in cases during the flooding associated with Hurricane Tomas (Phase II: November 3 – December 1), and the first 100 days of the outbreak (Phase III: October 20 – January 28).

In phases I and II, MSPP hospitalization data correlated significantly with data from HealthMap (October 20 – November 3: 95% confidence interval [CI] = 0.55–0.88; November 3 – December 1: 95% CI = 0.63–0.85), and Twitter (October 20 – November 3: 95% CI = 0.71–0.93; November 3 – December 1: 95% CI = 0.36–0.72).

In phase III (October 20 – January 28), however, MSPP hospitalization data correlated poorly with data from HealthMap (95% CI = 0.29–0.51), and Twitter (95% CI = 0.13–0.37).

Although the study showed that informal media sources can provide good indicators that a disease outbreak is occurring, and highlight its dynamics, the authors stated that “Further research is needed to determine if informal media will be a good measure of morbidity in other epidemics, and how such sources can best be used for monitoring and characterizing future infectious disease epidemics.”

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Image credit jscreationzs @FreeDigitalPhotos

Last Tuesday I joined a bunch of other medical writers at an AMWA-New England networking lunch. We typically have our lunch meetings at a Chinese restaurant in Cambridge, MA –  it’s a great, central location for a midweek gathering because they have a parking lot – somewhat of a rarity in Boston, especially when there’s the added bonus of free parking! Plus it’s even better for me because I work in Cambridge, so only a 15 minute drive if traffic cooperates.

It was great to get out of the office, catch up with some old friends, and also to meet some new additions to the group.

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Starting Out in Medical Editing

One topic that arose was “editing”. Someone was discussing how they provide editing services for one of the “well known” companies that acts as a middle man, outsourcing work to medical editors who are willing to work with them as contractors  (most of you in medical writing and editing will know the companies that I’m referring to). Another new member in the group is thinking about getting into the field of medical writing, and thought she might like to try this.

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I encouraged her not to go down this route, and here are some reasons why:

  • Peanuts: Now I like peanuts, don’t get me wrong. But not in my bank account. If you work for these companies, you’d better not have a nut allergy – they’ll pay you a mere fraction of what they charge the client.
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  • Donkeys: You’ll be at the very end of their food chain – doing all the grunt work while they barely get their feet wet. Do you really like climbing mountains on the promise of a carrot?
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  • Goldfish: As long as you choose to stay with companies like these, you’ll be stuck in this tiny whirlpool, with little hope of reaching the ocean. They’ll throw no end of projects your way, you’ll work like a donkey for peanuts, and this will leave you zero time and energy to market yourself appropriately. And don’t expect a letter of recommendation or a testimonial either – you’ll be a ghost in the works. Acknowledging your brilliance would detract from their “efforts”. So you’ll continually go unnoticed and unrecognized. Consequently you’ll never gain clients who actually respect and value your work, and pay you accordingly.

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So What are the Alternatives?

If you’re just starting out in medical editing, it can be difficult finding your first client. So it’s understanding that some people will be tempted to join forces with companies like this. Obviously if you’re out of work and need “something” to help feed your family, then I can understand that “anything” is better than nothing. But if you’re serious about setting yourself up as a freelance medical editor, then you’d better work smarter, not harder.

A few options to get you out of the starting gate:

  • Get journaling: Choose your field of greatest expertise, and do some online research to find the names of a bunch of journals in that field. Then contact the editor for each of them, and ask if they would be willing to add your name to a list of freelance editors. Not all journals operate in this way, but some do – when authors submit manuscripts, if substantive editing is required, they will be advised to seek editing assistance before their paper is considered for publication. If asked by the author for a list of possible editors, the journal editor may provide this. Understand that you would not be working for the journal in this case, and that they would not be endorsing your work – you would merely be on a list of freelance editors. But it’s a start.
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  • Get pinning: Do you have a medical school or a university nearby? If so, get some exercise by wandering up and down their hallways to figure out where their general advertisement boards are. You know the ones I mean – where anyone can post a notice advertising a service, a car for sale, or a room for rent. Construct some business flyers to advertise your service – take them, along with some pins and a small envelope containing business cards, and fix them firmly to that wall (repeat this if there are numerous hallways used for this purpose).
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  • Get networking: If you’ve worked in science or medicine, you probably have science or medicine friends! Send some of your flyers and business cards their way – physically and electronically. Ask them to forward your details around to their colleagues, or even pin them to their academic walls if they’re in different geographical locations to you.
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  • Get new friends: Feel free to also forward these flyers and business cards to people who you don’t know! Pick a medical school or university, do some online research to find researchers there in your field of expertise, and send them a short, professional, friendly introductory email. Attach your flyer containing all your contact details, and let them know that if anyone in their group is looking for editing assistance, you’ll be happy to help. And ask if they’ll also kindly forward your flyer to other colleagues.
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  • Get visible: If you don’t have a website or blog, now is the time to get one! If people don’t know you’re offering editing services, they can’t contact you. An online presence is extremely useful, and amongst other things, it helps to make you more “real” – add the URL to your flyer & business card, and researchers can find out more about you and your background. It’s also a great way to showcase your portfolio for people to look through. Even if you don’t yet have any clients, chances are that you have some publications behind you. List these, and wherever possible, link up to pdf versions of various articles that you have authored.

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For any of you out there who are trying to break into the world of medical editing, I’d strongly encourage you to check out Katharine O’Moore-Klopf’s site – you’ll find lots of wonderful reading there, including her Copyeditors’ Knowledge Base – a wealth of information to help you get started in medical editing.

And not a peanut, donkey, or goldfish in sight.

Oh and by the way, the “no peanuts, donkeys, or goldfish” rule applies to any genre of freelance work  – editing, writing, even skydiving. They’re only allowed if you happen to be selling them…..

 

Image credit Pong @FreeDigitalPhotos

Another microscopy update for you!

If you’ve ever had to examine birefringent materials microscopically, chances are you’ve used polarizing microscopy. But if not, and you feel like learning something about it, check out this article at BitesizeBio!

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Image Credit ardelfin at Morguefile