Author: Joy Authur

A Universe Within

Posted on by Joy Authur

Space. It was supposed to be the final frontier of discovery. On October 4, 1957 the Soviet Union launched its satellite Sputnik, kicking the race for supremacy of the skies between the United States and USSR into full throttle. Advances in space technology enabled humankind to walk on the moon, send dogs into orbit, and successfully land rovers on Mars. One could say we’ve come a long way.

But it turns out space wasn’t the final frontier. Over the past few decades, scientists have increasingly turned inwards for exploration. In the 1980s and 90s, mapping the human genome to unlock the mysteries of our DNA became the next big target. The Human Genome Project was an international effort spearheaded by the National Institutes of Health and U.S. Department of Energy to sequence the human genome as well as species such as fruit flies, influenza, and mice. It concluded in 2003 with the successful mapping of the human genome—a feat geneticists compared to the moon landing.

The journey inside continues. In 2008, the Human Microbiome Project was initiated to understand how the trillions of microorganisms such as eukaryotes, bacteria, and viruses found in and on our bodies affect our health. The human body contains about ten times as many microbial cells as human cells. Think about that for a second. By a cellular count, we are comprised more of microbes than ourselves. And the microbiomes in our gut are as individual to us as our fingerprints. Some of these strains we inherit at birth, others we gather over the years through diet. So does this mean health is more of a reflection of our genes or of our microbes?

The Microbiome Project aims to find out how these tiny microbial communities living (and thriving) in our nasal passages, urogenital, and gastrointestinal tracts work to keep us healthy, and how we might manage them to treat disease. For example, some microbes have been found to produce vitamins like folate in babies. However, separating and culturing individual microbes for study in experimental settings is largely impossible because many can’t be isolated for analysis. This is believed to be because they require specific environments for growth we haven’t been able to replicate in a lab setting.

The workaround this problem is metagenomics. Microbiologists use DNA sequences of microbial communities to analyze these populations in their natural habitat and compare them to strains they can isolate for a clearer picture of the roles they might play in our health. Understanding how these communities operate to protect against inflammation and infection could lead to advances in how physicians treat patients with debilitating conditions such as Crohn’s Disease.

Microbial samples were collected from 242 healthy adult men and women between the ages of 18 and 40 for the project. So far more than 1,300 reference strains that have been isolated from the human body have been sequenced to date. While the Microbiome Project is no longer recruiting participants, the American Gut Project, a similar mapping endeavor conducted by a consortium of university researchers around the world still is. So next time you’re looking up at the stars with wonder, consider the universe within you that remains unknown.

-KM

The Importance of Vaccines

Posted on by Joy Authur

Vaccines (also known as ‘immunizations’) are one of the most proactive steps you can take to protect your health. People’s Community Clinic promotes the recommended vaccine schedule for most patients. Why? Because vaccines work.

Let’s take a look into the science behind vaccines to see how they’re so effective in stemming the spread of contagious disease.
 

What are vaccines?

So what exactly is a vaccine? A vaccine is a very small dose of an agent that is similar to a virus, often a much weaker or inactive form of the virus itself. The dose stimulates our immune system to produce the antibodies needed to fight off the disease. This allows the body to develop immunity and fight off the disease efficiently next time it’s encountered.

Vaccines are an excellent example of preventative medicine: the practice of reducing risk and costs associated with treating an illness by working proactively to prevent the illness from developing in the first place.

An infographic using pictures to show that the body produces antibodies to fight a weakened form of the disease, which is injected during vaccination, so that it can better destroy the real germ later on.

 

The Bigger Picture

Since their discovery in the late 1700’s vaccines have worked to slow the spread of many debilitating and deadly diseases.

In the 1950’s the U.S.A. saw a rate of over 55,000 cases of polio a year. Thanks to the success of the polio vaccine, in 2017 there were only 113 cases reported. In 1980 the World Health Organization declared smallpox completely eradicated worldwide. Smallpox once took the lives of hundreds of thousands each year, yet successful global deployment of vaccines took that number down to zero. Vaccines save lives every day.
 

Herd Immunity

The concept of “herd immunity” helps explain the remarkable effectiveness of vaccines. We may feel that vaccines are something we do for ourselves to protect our own bodies from contagious disease. But the fact is, when we receive a vaccine we are helping protect our friends, families, and community as well.

Each person who receives a vaccine reduces their own risk of contracting a disease, subsequently reducing their risk of spreading the disease to others which in turn reduces everyone else’s risk of getting sick. So we all see the benefit of each vaccine, even those who chose to remain unvaccinated.
 

So, Why Should I Vaccinate?

You may be asking yourself: “If everyone else’s vaccines protect me from illness, and the rate of disease has already been dramatically reduced, do I still need to get a vaccine?” The answer is “yes!”

This excerpt from the CDC may help illustrate why:

“In 1974, Japan had a successful pertussis (whooping cough) vaccination program, with nearly 80% of Japanese children vaccinated. That year the country saw only 393 reported cases of pertussis, and there were no deaths from pertussis.

But then rumors began to spread that pertussis vaccination was no longer needed and that the vaccine was not safe. By 1976 the rate of infants vaccinated against pertussis in Japan dropped to 10%. In 1979 Japan suffered a major pertussis epidemic, with more than 13,000 cases of whooping cough and 41 deaths. In 1981 the government began vaccinating with acellular pertussis vaccine, and the number of pertussis cases dropped again.”

Each person who forgoes a recommended vaccine raises their own chance of contracting the disease and everyone else’s risk along with it. Even if we reduce the spread of a disease to only a few cases each year there is always a chance another epidemic could occur if we don’t take preventative measures.

Protect yourself and your community; follow the recommended vaccine schedule suggested by your doctor.

Open letter: Isolating children at border is harmful

Posted on by Joy Authur

Pictured: Louis Appel, MD, MPH performs a routine well child check up with a young girl and her mother.

June 11 letter to the editor, “Texas border a flashpoint in humanitarian crisis.”

To the Editor:

As a pediatrician at People’s Community Clinic, I am greatly alarmed by the long term adverse health consequences of forcibly separating children from parents at the border as described by the letter writer.

Research shows that traumatic events in childhood—even in infancy—are associated with poor health outcomes later in life. Chronic, unmitigated stress activation in the body—known as toxic stress— increases risks for everything from depression to heart disease. Parental support and nurturing–precisely what the family separation policy deprives children of–  are the critical protective factors.

Families arriving at our border have already experienced profound trauma, from violence in their home countries to the hardships of their journey. Inhumane detention practices here inflict further harm. Separating children from their parents in the name of deterrence is an unconscionable injury to children at a time when they need their parents the most. It must stop!

Sincerely,

Louis Appel, MD, MPH
Chief Medical Officer, People’s Community Clinic

 

–

Louis Appel, MD, MPH serves as Chief Medical Officer and Director of Pediatrics at People’s Community Clinic in Austin, Texas. Dr. Appel provides primary pediatric care at the Clinic in addition to overseeing the clinical programs. At the clinic he has championed projects on lactation support, group pediatric well child checks, postpartum depression screening, childhood obesity prevention focused on the prenatal and immediate postpartum periods, and promotion of parent-infant bonding. To learn more about Dr. Appel and other clinicians at People’s Community Clinic, click here.

Meet Chelsea, our #FluFighter

Posted on by Joy Authur

Did you know between 12,000 and 56,000 children and adults die of the flu every year?

Flu season is in full swing, and the CDC dedicates the first full week of December to reminding everyone 6 months and older that it’s not too late to get your flu shot. Although National Influenza Vaccination Week has passed, it’s important to keep fighting flu throughout the season — especially as this flu season is predicted to be particularly serious.

Here at People’s Community Clinic, Immunization Supervisor Chelsea Watson does everything she can to fight flu, ensuring that our patients are vaccinated against this serious, and sometimes deadly, virus.

In your role, how do you prepare for flu season each year?

As the primary vaccine coordinator for our clinic, I help to make sure that we have enough vaccine ordered so that we can give our patients the flu vaccine as soon as possible in the season – after all, the vaccine takes about 2 weeks to take full effect! I also help make sure the vaccine is stored properly, train staff on administering vaccines, provide educational materials about flu for our staff and patients, and help organize flu clinics.

What is the most difficult part of flu prevention?

Combating the overwhelming amount of misinformation about the flu vaccine that is out there!

Why do you think people underestimate the seriousness of flu illness?

Many people underestimate the seriousness of flu because they have not seen firsthand the devastating affects flu can have on patients. Each year hundreds of thousands of patients are hospitalized — and thousands to tens of thousands die – because of the flu, but because people do not always see this firsthand it is hard to remember the seriousness of the disease. Some people think influenza symptoms are like the common cold, but it is much more severe than that. I recently attended a talk where a father bravely told the story of his daughter Emily, a healthy 3 year old girl who died from the flu in 2004. Emily had not been vaccinated against the flu.

Why is it important to get the flu shot every year?

Since the flu virus is always changing it is important to get vaccinated every year. Getting the vaccine means you are not just protecting yourself from flu, but also others who may not be able to get the vaccine, including children less than 6 months of age and people with weakened immune systems. This is called herd immunity and is very important in lessening the chance of the virus spreading. If you get the vaccine and still get the flu, the severity and length of your illness, plus risk of serious complications, can be reduced.

What would you say to those who are hesitant about getting the flu shot?

While the flu shot varies in effectiveness each year, the flu vaccine is safe and our best way of preventing you and your loved ones from getting sick.

 

Thanks, Chelsea, for helping keep the Austin community healthy!

Legal Determinants of Health in the Aftermath of Harvey

Posted on by Joy Authur

Although we hope that all of our colleagues and patients were unaffected by Harvey, there may be plenty of local folks with legal needs related to flood or other property damage. Others may have family in the coastal area with a variety of health-harming legal needs.

Socio-legal determinants of health post-disaster can run the gamut from food and financial insecurity to a dangerous physical environment. Disaster victims may find themselves entangled in battles with their employers, their house/medical/disability insurance companies, their landlords, their neighbors, and, likely, with emergency needs assistance such as FEMA. Others may have pressing legal matters that are simply delayed by the weather.

Long-term, unhealthy living conditions, such as mold, difficulties with contractors, and insurance claim denials are common legal problems.

Fortunately, legal remedies may be available. For example, emergency SNAP benefits are available for those of modest income who are displaced from their homes, and expedited hearing is an option for anyone denied. Or if someone did not receive a regularly scheduled payment from Social Security as a result of a disaster, they can go to any open Social Security office and request an immediate payment.

Texas Legal Services Center, Austin MLP’s legal partner, has three resources that you may find useful:

  •  Disaster Assistance Manual at https://texaslawhelp.org/article/disaster-assistance-manual (plain language, but targeted at lawyers)
  • Live chat with an attorney at www.texaslawhelp.org (Monday-Friday, 10a-5p)
  • The TLSC Disaster Legal Helpline at (800) 889-3199 (Monday-Friday, 8a-5p)

 

Written by Keegen Warren-Clem, JD, LLM

 

Hurricane Harvey Disaster Relief Resources

Posted on by Joy Authur

Hurricane Harvey has impacted the lives of thousands of families along the Gulf Coast. People’s Community Clinic has gathered a list of resources for individuals affected by the storm, including how to access counseling and emotional support, unemployment benefits, and shelter. You can find the full PDF, in English and Spanish, here:

Disaster Relief Resources English

Disaster Relief Resources Spanish