U.S. sees first case of bacteria resistant to last-resort antibiotic


U.S. health officials on Thursday reported the first case in the country of a patient with an infection resistant to a last-resort antibiotic, and expressed grave concern that the superbug could pose serious danger for routine infections if it spreads.

“We risk being in a post-antibiotic world,” said Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, referring to the urinary tract infection of a 49-year-old Pennsylvania woman who had not travelled within the prior five months.

Frieden, speaking at a National Press Club luncheon in Washington, D.C., said the bacteria was resistant to colistin, an antibiotic that is reserved for use against “nightmare bacteria.”

The infection was reported Thursday in a study appearing in Antimicrobial Agents and Chemotherapy, a publication of the American Society for Microbiology. It said the superbug itself had first been infected with a tiny piece of DNA called a plasmid, which passed along a gene called mcr-1 that confers resistance to colistin.

“(This) heralds the emergence of truly pan-drug resistant bacteria,” said the study, which was conducted by the Walter Reed National Military Medical Center. “To the best of our knowledge, this is the first report of mcr-1 in the USA.”

The patient visited a clinic on April 26 with symptoms of a urinary tract infection, according to the study, which did not describe her current condition. Authors of the study could not immediately be reached for comment.

The study said continued surveillance to determine the true frequency of the gene in the United States is critical.

“It is dangerous and we would assume it can be spread quickly, even in a hospital environment if it is not well contained,” said Dr. Gail Cassell, a microbiologist and senior lecturer at Harvard Medical School.

But she said the potential speed of its spread will not be known until more is learned about how the Pennsylvania patient was infected, and how present the colistin-resistant superbug is in the United States and globally.

“MEDICINE CABINET IS EMPTY FOR SOME”

In the United States, antibiotic resistance has been blamed for at least 2 million illnesses and 23,000 deaths annually.

The mcr-1 gene was found last year in people and pigs in China, raising alarm.

The potential for the superbug to spread from animals to people is a major concern, Cassell said.

For now, Cassell said people can best protect themselves from it and from other bacteria resistant to antibiotics by thoroughly washing their hands, washing fruits and vegetables thoroughly and preparing foods appropriately.

Experts have warned since the 1990s that especially bad superbugs could be on the horizon, but few drugmakers have attempted to develop drugs against them.

Frieden said the need for new antibiotics is one of the more urgent health problems, as bugs become more and more resistant to current treatments.

“The more we look at drug resistance, the more concerned we are,” Frieden added. “The medicine cabinet is empty for some patients. It is the end of the road for antibiotics unless we act urgently.”

Overprescribing of antibiotics by physicians and in hospitals and their extensive use in food livestock have contributed to the crisis.

More than half of all hospitalized patients will get an antibiotic at some point during their stay. But studies have shown that 30 percent to 50 percent of antibiotics prescribed in hospitals are unnecessary or incorrect, contributing to antibiotic resistance.

Many drugmakers have been reluctant to spend the money needed to develop new antibiotics, preferring to use their resources on medicines for cancer and rare diseases that command very high prices and lead to much larger profits.

In January, dozens of drugmakers and diagnostic companies, including Pfizer, Merck & Co, Johnson & Johnson and GlaxoSmithKline, signed a declaration calling for new incentives from governments to support investment in development of medicines to fight drug-resistant superbugs.

URJ and NFTY sued over sand fly bites on Israel youth trip


Parents of four Jewish high school students in Los Angeles County filed a lawsuit on May 4 alleging that the Union for Reform Judaism (URJ) and its youth movement, the North American Federation of Temple Youth (NFTY), did not adequately warn and protect their children from infected sand flies during a 2014 group trip to Israel.

The complaint filed in Los Angeles Superior Court states that the four high school students each were bitten multiple times by the sand flies and as a result contracted leishmaniasis, a parasitic disease that, according to the Centers for Disease Control (CDC), often causes painful skin ulcers, swollen glands, and, in serious cases. swelling of the spleen and liver, as well as low red and white blood-cell counts. Some sores can take months or years to heal and can leave behind “ugly scars”, according to the CDC’s website. The CDC estimates that between 900,000 and 1.6 million people contract leishmaniasis every year. It’s known to exist in parts of the Far East, the Middle East, Africa, Mexico and Central and South America.

The suit lists only the students’ initials and the parents’ first name and last initial, does not name any of the NFTY staff members on the trip to Israel, and does not detail the injuries suffered by the students. The plaintiffs argue that the defendants were negligent in not warning the students or their families about the possible presence of infected sand flies in some places they visited in Israel, and also in failing to provide the students with insect repellant or bed nets. The four families also allege that the teenagers were sleeping on “bug infested bedding”.

The attorney representing the plaintiffs, John C. Taylor of Taylor & Ring, LLP, did not respond to multiple requests for comment, and a spokeswoman for the URJ did not provide comment before this story went to press. Taylor, though, previously told the Los Angeles Times the students have had “ongoing medical treatment with little success” to treat the leishmaniasis and that the URJ and NFTY “had previous problems” with sand flies but still didn’t warn the students or their parents.

Although there are no vaccines that can prevent the contraction of leishmaniasis, the CDC recommends avoiding overnight outdoor activities where sand flies are present, applying insecticide, and, if not sleeping in a well-screened indoor area, sleeping in a bed protected by a bed net.

Are anti-vaxxers’ religious exemption claims grounded in actual religious laws?


As the debate on vaccination heats up again in the U.S., some anti-vaxxers are requesting exemptions from vaccinating their children on religious grounds. But what do their faiths, including Judaism, actually say about the issue?

The recent outbreak of measles that began in the Disneyland theme park in southern California has led to the infection of more than 100 people who then potentially exposed countless others to the disease around the country. 

This is not the first such outbreak of a disease thought to have been nearly eradicated in 2000. Last May, the Centers for Disease Control and Prevention (CDC) released figures showing that 288 cases of measles had been reported between Jan. 1 and May 23, 2014, the largest number of reported cases in the U.S. in the first five months of a year since 1994. 

That “increase in measles cases [was] being driven by unvaccinated people, primarily U.S. residents, who got measles in other countries, brought the virus back to the United States and spread to others in communities where many people are not vaccinated,” said Dr. Anne Schuchat, assistant surgeon general and director of CDC’s National Center for Immunizations and Respiratory Diseases. 

Also in 2014, 383 other people fell ill with measles in Ohio’s Amish country after catching the disease from unvaccinated Amish missionaries who returned from the Philippines with the virus. That outbreak, based on the number of the sick, was four times the current California outbreak, The Associated Press reported.

The year prior, the CDC announced 58 cases of measles among the Hasidic Jews in Brooklyn’s Boro Park and Williamsburg neighborhoods. Seventy-nine percent of the people who became sick in Boro Park were members of “three extended families whose members declined use of measles vaccine.”

There has been some opposition to vaccination in the haredi Jewish community in the U.S. In August of 2014, Rabbi Shmuel Kamenetsky called vaccination “a hoax” in an interview with the Baltimore Jewish Times. There is also an anti-vaccine Orthodox magazine titled P.E.A.CH that launched last April.

But according to the New York City Department of Health and Mental Hygiene, 96 percent of students at yeshivas in Brooklyn are still vaccinated, the Forward reported, and vaccination in general is highly common in that community, which likely limited the scope of a 2013 measles outbreak in Brooklyn.

The religious perspective

In Judaism, no religious law actually forbids vaccination, even in cases where the vaccine includes gelatin, an ingredient made from pig tissue. The ban on consuming non-kosher meat does not apply to vaccines administered via injection.

An article titled “What the World’s religions teach, applied to vaccines and immune globulins,” written for the journal Vaccine in 2012 by John Grabenstein, a researcher at the vaccine-producing company Merck Vaccines, the Jewish value of pikuach nefesh means that believers must place the safeguarding of their own health as well as community-wide disease prevention above their individual desires. 

Grabenstein concludes that “contemporary Jewish vaccine decliners are more likely to cite concerns about vaccine safety than to invoke a specific religious doctrine.”

In fact, when Tablet Magazine recently used a public immunization database of the California Department of Public Health to determine how many of 68 Jewish elementary schools cited by Private School Review had high rates of vaccine refusal, they found 14 such schools. At the same time, a 2005 ruling by the Conservative movement’s Rabbinical Assembly allows Jewish day schools to make immunizations compulsory in accordance with halacha (Jewish law).

In Christianity, which has its roots in Judaism, most contemporary denominations also do not object to vaccinations based on direct scripture or canon law. 

One reason that members of some Christian denominations do oppose vaccination is over the use of cells from aborted embryos in the production of the rubella vaccine, and some other viral vaccines, back in the 1960s. 

Churches that believe in faith healing, or in the general reliance on God and divine providence rather than on science, may also oppose vaccines. In addition, some conservative Christian groups have opposed the HPV vaccine because they see it as giving permission to young women to engage in premarital sexual relations.

Grabenstein’s article also states that in some Amish communities, those who decline immunizations might do so less out of religious beliefs and more due to a tradition of rejecting technology in general, limited access to healthcare, and limited knowledge of or exposure to information about vaccines and diseases.

In Islam, the “law of necessity” states, “That which is necessary makes the forbidden permissible.” Therefore, while Islam theoretically forbids any type of consumption of gelatin made from pork, exceptions can be made when there is no other choice.

In 2001, after consulting with more than 100 Muslim scholars, the World Health Organization announced that the use of gelatin in vaccines should be considered halal-certified and thus permitted. Five years earlier, more than 100 Islamic legal scholars met and clarified Islamic purity laws to indicate that when a substance is converted into another substance “different in characteristics,” this “changes substances that are prohibited into lawful and permissible substances.”

There has been Muslim opposition to immunization programs for the polio virus in countries such as Nigeria, Pakistan, and Afghanistan, but the objections, though often cited as religious in nature, were largely social. There were beliefs that the vaccines spread the HIV virus, or were being used to sterilize people, among other fears.

The view from the state level

In the U.S., 48 out of 50 states grant exemptions for parents to not to vaccinate their children on religious grounds, and applying for a religious exemption does not need to be a complicated process. A frequently cited example is New Jersey, where parents only need to sign a letter stating that vaccination would interfere “with the free exercise of the pupil’s religious rights.”

On Jan. 4, California Governor Jerry Brown, who previously preserved the religious exemption option in his state in 2012, said he is open to legislation that would eliminate all exemptions except for waivers on medical grounds. Brown’s announcement came in response to an earlier promise by five California state lawmakers to introduce legislation banning all religious and personal-belief exemptions on the vaccination of children before they enter the school system, the Los Angeles Times reported.

If such stringent legislation passes in California, or in other states, it would also affect those who, regardless of their faith, oppose vaccinations because they support the heavily criticized movement arguing that vaccinations can cause autism in children. Celebrities such as Jim Carey, Bill Maher, and Jenny McCarthy, whose son has autism, have long been promoting that idea to the American public.

“We are a non-vaccinating family, but I make no claims about people’s individual decisions,” Jewish actress Mayim Bialik has said. “We based ours on research and discussions with our pediatrician, and we’ve been happy with that decision, but obviously there’s a lot of controversy about it.”

This dispute between those who believe in the link between vaccines and autism and those who dismiss it, both in and out of the scientific community, shows no sign in letting up. But one statistic is not easily refuted. The CDC states that “more than 95 percent of the people who receive a single dose of MMR (the measles, mumps, and rubella vaccine) will develop immunity to all three viruses. A second vaccine dose gives immunity to almost all of those who did not respond to the first dose.” 

But this means that some vaccinated people will still be susceptible to contracting the illness. Meanwhile, since some people cannot be vaccinated, either because they are too young or because they have health issues that preclude it, such individuals are also at risk when encountering a sick person who could have been vaccinated, but was not. This means that not vaccinating a child puts other people around that child at significant risk.

As Jewish mom Sally Kohn wrote in The Daily Beast on Feb. 3, “I’m embarrassed to say that the idea that we might be putting other people at risk by not vaccinating our daughter never really crossed our minds. We were focused on keeping our daughter safe, and little else. That was a mistake.”

CDC says returning Ebola medical workers should not be quarantined


Federal health officials on Monday revamped guidelines for doctors and nurses returning home to the United States from treating Ebola patients in West Africa, stopping well short of controversial mandatory quarantines being imposed by some U.S. states.

Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention (CDC), called for voluntary home quarantine for people at the highest risk for Ebola infection but said most medical workers returning from the three countries at the center of the epidemic would require daily monitoring without isolation.

New York and New Jersey are among a handful of states to impose mandatory quarantines on returning doctors and nurses amid fears of the virus spreading outside of West Africa, where it has killed nearly 5,000 people in the worst outbreak on record.

The Obama administration's new guidelines are not mandatory and states will have the right to put in place policies that are more strict. Some state officials, grappling with an unfamiliar public health threat, had called federal restrictions placed on people traveling from Ebola-affected countries insufficient to protect Americans and have imposed tougher measures.

With thousands already dead from Ebola in Liberia, Sierra Leone and Guinea, concerns are high in the United States about stopping its spread. In New York City on Monday, a 5-year-old boy who arrived in the United States from Guinea and was in hospital for screening for fever, tested negative for Ebola.

The CDC's Frieden, on a conference call with reporters,

warned against turning doctors and nurses who are striving to tackle Ebola in West Africa before it spreads more widely into “pariahs.”

Under new CDC guidelines that spell out four risk categories, most healthcare workers returning from West Africa's Ebola hot zone would be considered to be at “some risk” for infection, while healthcare workers tending to Ebola patients at U.S. facilities would be seen as “low but non-zero” risk.

In other Ebola-related developments, the U.S. military said it was isolating troops returning from their mission to help West African countries curb Ebola even though they showed no sign of infection. And a nurse who treated patients in Sierra Leone was released to go to her home state of Maine after New Jersey had forced her into quarantine. The nurse had been kept in quarantine for two days after testing negative for the Ebola virus.

There has been a growing chorus of critics, including public health experts, the United Nations, medical charities and even the White House, denouncing mandatory quarantines as scientifically unjustified and an obstacle to fighting the disease at its source in West Africa.

“At CDC, we base our decisions on science and experience. We base our decisions on what we know and what we learn. And as the science and experience changes, we adopt and adapt our guidelines and recommendations,” Frieden said.

Medical professionals say Ebola is difficult to catch and is spread through direct contact with bodily fluids from an infected person and not transmitted by asymptomatic people. Ebola is not airborne.

Frieden said high-risk people include healthcare workers who suffer a needle stick while caring for an Ebola patient or who tend to a patient without protective gear.

He said returning health workers at “some risk” would have their health monitored daily by a local health department official who would check their temperature, look for signs of fatigue and review their daily activity plans to determine what activity “makes sense for that individual, at that time.”

President Barack Obama's spokesman, Josh Earnest, made clear Monday that the White House was not thrilled that individual states had implemented quarantines viewed as unfair to returning healthcare workers, though he acknowledged the states' rights to set them.

“We want to make sure that whatever policies are put in place in this country to protect the American public do not serve as a disincentive to doctors and nurses from this country volunteering to travel to West Africa to treat Ebola patients,” Earnest said.

MAJOR GENERAL ISOLATED

The Pentagon move went well beyond previously established military protocols. The U.S. Army has already isolated about a dozen soldiers at part of a U.S. base in Vicenza, Italy, including Major General Darryl Williams, who oversaw the initial response to the Ebola outbreak, the worst on record with nearly 5,000 dead.

Dozens more will be isolated in the coming days as they rotate out of West Africa, where the military has been building infrastructure to help health authorities treat Ebola victims, the Pentagon said.

“We are billeted in a separate area (on the base). There's no contact with the general population or with family. No one will be walking around Vicenza,” Williams told Reuters in a telephone interview.

“Nobody is symptomatic. No Army soldier came in contact with Ebola-stricken patients,” Williams said, calling the move precautionary.

The case of nurse Kaci Hickox, put into quarantine on Friday under a New Jersey policy that exceeded precautions adopted by the U.S. government, underscored the dilemma that federal and state officials are facing.

New Jersey Governor Chris Christie, who has defended his state's policy of automatic quarantine for medical workers returning from treating patients in Liberia, Sierra Leone and Guinea, told reporters he did not reverse the policy in allowing her to be discharged from the hospital and to return to Maine.

“We're very happy that she has been released from the hospital,” said Christie, who Hickox had criticized for making comments about her health that she said were untrue while calling her quarantine unjust.

“She hadn't had any symptoms for 24 hours and she tested negative for Ebola so there's no reason to keep her,” said Christie, a potential Republican Party 2016 U.S. presidential candidate known for his combative style.

Christie said he sees no reason to talk to her and expressed “goodwill” toward Hickox, who had worked with the medical charity Doctors Without Borders in Sierra Leone. “But she needs to understand that the obligation of elected officials is to protect the public health of all the people,” Christie said.

Christie said his state was providing transportation for her to Maine, whose health officials “will take over her care and monitoring from there” as she completes a 21-day quarantine at home. The quarantine matches the incubation period of the virus.

U.N. Secretary-General Ban Ki-moon on Monday became the latest to criticize quarantines, saying through his spokesman these create difficulties for medical workers risking their lives in the battle against the deadly disease.

“Returning health workers are exceptional people who are giving of themselves for humanity,” said Ban's spokesman, Stephane Dujarric. “They should not be subjected to restrictions that are not based on science. Those who develop infections should be supported, not stigmatized.”

Four people have been diagnosed with Ebola in the United States, with one death – a Liberian man visiting Texas. The only patient now being treated for Ebola in the country is a New York doctor, Craig Spencer, who was diagnosed last Thursday. He had worked with Doctors Without Borders treating Ebola patients in Guinea.

Additional reporting by David Morgan, Jeff Mason, Steve Holland, Phil Stewart, David Alexander, Roberta Ramptom and Susan Heavey in Washington, Louis Charbonneau, Laila Kearney and Joseph Ax, Bill Berkrot in New York, and Steve Scherer in Rome; Writing by Will Dunham; Editing by Lisa Shumaker and Grant McCool

Jews at the helm of U.S. Ebola response


The United States’ two main point men in dealing with the Ebola crisis, Ronald (Ron) A. Klain and Thomas (Tom) R. Frieden, have some things in common.

Both are 53, high achievers and Jewish.

Each is well-known in his professional circles, and now as both men find themselves in the national and global spotlight, they are subject to intense scrutiny, including both warm praise and fierce criticism.

Frieden, born in Manhattan and raised in suburban Westchester County, has served for the past five years as director of the U.S. Center for Disease Control and Prevention (CDC), which has an annual budget of nearly $7 billion. In that role he has been under fire in recent days over the CDC’s handling of the care of Thomas Eric Duncan, the Liberian man who became the first person in the U.S. to be diagnosed with Ebola, and over the missteps that exposed hospital workers and may have exposed others to Ebola as a result of Duncan’s illness.

Frieden became accustomed to political pressure while serving as New York City’s Commissioner of Health and Mental Hygiene from 2002-2009. In 2005, when he was honored for his work as Public Official of the Year by Governing magazine, a laudatory article started:

“Consider [Frieden] the consummate Jewish mom — except that he isn’t nudging you about wearing a scarf so you won’t catch a cold. Rather, the admonitions that [he] slings relate to much more serious illnesses — HIV/AIDS, heart disease, lung cancer, tuberculosis, hepatitis and diabetes.”

Frieden grew up the youngest of three sons of a cardiologist (father) and human rights lawyer (mother). The oldest brother, Jeffry, is now a renowned political economist at Harvard and middle son, Ken, is chair of Interdisciplinary Judaic Studies at Syracuse University, N.Y.

In interviews with the Journal, both older brothers described their upbringing as religiously secular, but culturally and intellectually intensely Jewish.

As CDC head, Tom Frieden lives in Atlanta, where the agency’s headquarters are located, but remains a New Yorker at heart. As The New York Times reported, he always returns from visits to his native city carrying a bagful of bagels.

Frieden is married and has two sons, but is as private in his personal life as he is public in his job, He has persuaded the media not to write about — or even mention the names — of his immediate family members.

Ron Klain, an Indianapolis native, was appointed last week by President Obama as “Ebola Response Coordinator for the Executive Office of the President,“ a title shortened by the media to “Ebola czar.” His job is to coordinate the U.S. efforts to combat and contain the deadly virus.

Klain’s appointment was quickly attacked by Republican Sen. Ted Cruz of Texas, and others, focusing on his lack of medical background, and he has been denounced as a purely political appointment. The Obama administration responded to the criticism by saying that what is needed in this situation is precisely a man who knows the politics of Washington and can draw diverse agencies together in a single-focused effort.

Klain has been a player in the capital’s political waters since graduating from Georgetown University in Washington, D.C., in 1983, and then Harvard Law School, in 1987.

Klain has served as chief of staff for two vice presidents, Al Gore and Joe Biden, and is considered one of the best-connected Washington insiders. Already in 1999, Washingtonian magazine named him the top D.C. lawyer under 40.

He headed Gore’s efforts during the nail-biting vote recount of the 2000 presidential election and was portrayed by actor Kevin Spacey in the HBO special “Recount.”

Klain is married to Monica Medina, who was a classmate at Georgetown University and now works as an environmental lawyer for the National Geographic Society. They have three children, Daniel, Hannah and Michael.

The Klains were featured in a 2007 New York Times article on the “December dilemma” of interfaith couples of whether and how to celebrate Christmas and Chanukah.

When Ron and Monica married, according to the article, “they struck a deal: their children would be raised Jewish (for him), but they would celebrate Christmas (for her).

Ron Klain observed, “I grew up in Indiana, with a decent-sized Jewish community, but we were a distinct minority. Not having a Christmas tree was very much part of our Jewish identity in a place where everyone else did.”

The new high visibility of Frieden and Klain has been a particular boon to livid anti-Semitic bloggers, who see the two men’s roles as further “proof” that Jews are running the U.S. government.

This story was an update of this

The facts of Ebola


When the young woman in the seat next to me asked the flight attendant for a glass of cabernet, I took it as a sign that projectile vomiting and explosive diarrhea would not be part of my trip from PHL to LAX.   I also took it as a reminder that the Ebola irrationality I’ve slammed in others is not as foreign to me as I’d like to believe.

I’d been in Philadelphia for a “>facts don’t change our minds, they just make us dig our heels in harder.  We process information both rationally and emotionally, and our emotional apparatus gets there faster.  We use shortcuts, called “>put it, “Don’t make reasoning, free people choose between knowing what’s known and being who they are.”

It’s tempting to think that people who conflate knowledge and identity are Others, not Us.  Our team knows better; we get the difference between the truth claims of science and the tribal claims of culture.  It’s tempting, but it’s delusional. 

That was driven home to me last Friday, on the final morning of the conference. Just before the session began, one of the panelists showed me a distraught message he’d received from a faculty member at Syracuse University.  The night before, I read in the email, Syracuse provost Eric Spina had disinvited Washington Post photojournalist Michel duCille from a workshop at the Newhouse School of Public Communications because he’d been in Liberia three weeks before.  For the 21 days since he’d been in West Africa, which the CDC says is Ebola’s incubation period, duCille had monitored his temperature twice a day.   As far as the experts were concerned, with no symptoms he was in the clear. 

But that didn’t cut it for Syracuse.  The “>Rand Paul?  Some cable news fearmonger?  The CDC isn’t infallible, but they don’t pull numbers out of the air, either; they’re scientists, and their guidelines come from evidence.  “Some suggest” that vaccines cause autism.  Should Syracuse, out of “an abundance of caution,” make inoculations optional?  If a journalism school doesn’t have an obligation to avoid false equivalence between science and paranoia, it might as well fold up its tent.

But by the time I got to the airport, I’d had a change of heart.  What if I were a parent of a Newhouse student?  What if 21 days is just an average?  What’s the harm in delaying the workshop for a week or two?  What if this young woman sitting next to me on the plane is a nurse, or a roommate of a nurse, at Texas Presbyterian?

There’s plenty of Ebola ignorance going around and plenty of political and financial incentives to keep it that way.  I’d like to say that the antidote to my fevered speculations is familiarity with the facts.  But if that were fully true, I’d be more Vulcan than human.  I’d like to believe that my calculations of risk are driven by what science knows about infectious diseases, not by my identities as parent, catastrophist, bureaucrat or disaster-porn addict.  But if I were able to process information independent of my affiliations and afflictions, I’d be an algorithm, not a person.  The next time I try to persuade someone that they’re wrong and science is right, I hope I first take a moment to walk in their shoes, and to feel uncomfortable about how comfortably they fit.


Marty Kaplan is the Norman Lear professor of entertainment, media and society and directs the Norman Lear Center at the USC Annenberg School for Communication and Journalism.  Reach him at martyk@jewishjournal.com.

Top U.S. Ebola point men are Jewish


Any mother, Jewish or otherwise, would kvell over the accomplishments of her three sons, although at the moment she might wish that the youngest one weren’t constantly in the news.
 
That would be Thomas (Tom) R. Frieden, director of the U.S. Center for Disease Control and Prevention (CDC), who is the government’s primary point man in dealing with the Ebola crisis and its possible threat to this country.
 
As such, the youthful-looking Frieden, 53, has been grilled – and frequently criticized – at congressional hearings and media interviews. (President Barack Obama on Friday, Oct. 17, named as Ebola “czar,” Ron Klain, who is Jewish and served as Vice President Joe Biden’s chief of staff.)
 
Frieden learned how to cope with pressure in his previous job as New York City’s Commissioner of Health and Mental Hygiene. When he was honored for his work as a Public Official of the Year by Governing magazine in 2005, the lead paragraph read:
 
“Consider [Frieden] as the consummate Jewish mom – except that he isn’t nudging you about wearing a scarf so you won’t catch a cold. Rather, the admonitions that [he] slings relate to much more serious illnesses – HIV/AIDS, heart disease, lung cancer, tuberculosis, hepatitis and diabetes.
 
“And it isn’t galoshes that Dr. Frieden wants people to don as a preventive measure, it’s condoms. In fact, he has a bowl of them in his office for the taking.”
 
Frieden grew up in Larchmont and New Rochelle in New York City’s suburban Westchester County in a family of overachievers.
 
His late father, Julian, was chief of coronary care at New York’s Montefiore Hospital, and his mother Nancy is a family and human rights lawyer.
 
Oldest brother Jeffry (ok) Frieden is a renowned political economist and Stanfield Professor of International Peace at Harvard University.
 
Middle brother Kenneth (Ken) is Chair of Interdisciplinary Judaic Studies at Syracuse University, New York, and a prolific author on Hebrew and Yiddish literature – as well as clarinetist in The Wandering Klezmorim band.
 
The Frieden boys grew up in a religiously largely secular Jewish home, whose forebears immigrated from Eastern Europe and Germany to the United States in the late 19th century.
 
In an extended phone interview, Ken Frieden recalled brother Tom, two years younger, as “studious, but not bookish, whose first academic interest was in philosophy.
 
“I remember reading Samuel Taylor Coleridge’s ‘The Rime of the Ancient Mariner’ to Tom, and he was fascinated by it,” Ken Frieden said. As a family of five, counting the parents and three brothers “we hold six advanced degrees,” he added.
 
In a separate interview, Jeffry Frieden recalled brother Tom as “a sweet, thoughtful kid, always trying to do better. At one point, he wanted to become a pitcher and he would keep throwing balls for hours at a time.”
 
For a while, the three brothers attended a Torah study group, taught by a knowledgeable neighborhood lawyer, and the boys used to come home with all kinds of questions and arguments, Jeffry Frieden said.
 
Although all branches of the Frieden family are culturally and intellectually fully conscious of their Jewishness, Ken Friedman is the only one who has made Jewish studies the focus of his life’s work.
 
The impetus, oddly enough, was a 1980 conference he attended in Germany.
 
Having lived in New York and Chicago, Frieden had always taken the presence of a large Jewish community for granted. But during the meeting, and later while studying and teaching in Germany, he keenly “felt the absence of Jews,” he said.
 
From that beginning, Ken Frieden decided to master Hebrew and Yiddish and subsequently has written extensively on the influence of translations on literary history and especially on the impact of Hebrew on Yiddish.

White House shifts into crisis mode on Ebola response


Rising public anxiety about the Ebola virus has forced the White House to shift into crisis mode and cancel two days of planned political events as President Barack Obama strives to show he has control over stopping the spread of the deadly disease.

Just three weeks ahead of critical midterm elections, Obama is facing increased pressure from Republican critics. They say he has been too slow to protect Americans, drawing parallels to what they have described as foot-dragging on dealing with the threat from Islamic State militants in Iraq and Syria.

Democrats who are at risk of losing control of the Senate in the November elections are worried that public concerns over Obama's management of Ebola could hurt them, too.

Obama's job approval ratings are at 39 percent, according to Reuters-Ipsos polls in the first week of October.

“At a time in which his job approval rating is quite low and his party is suffering because of it, I think that this is just one more cut in what's turned out to be the death by a thousand cuts for President Obama,” said Ross Baker, a political scientists at Rutgers.

Republican lawmakers, including U.S. House Speaker John Boehner, turned up the pressure on Wednesday with calls for travel bans for the three African nations afflicted by the Ebola outbreak.

Polls show that move would be popular with Americans. The White House has ruled out a ban, saying it would hamper the movement of supplies and aid workers needed to help stop the epidemic in the region.

Other lawmakers, including some Democrats, have urged the White House to name a point person to coordinate the response, lead briefings, and command public confidence.

“It's getting away from them, and this is becoming a real concern for us,” said a Democratic Senate aide, who spoke on condition of anonymity.

Proponents of the approach are seeking a figure like former Coast Guard Admiral Thad Allen who took charge of the response to the BP oil spill in the Gulf of Mexico in 2010.

Until now, Tom Frieden, the head of the Centers for Disease Control, has been the face of the administration on Ebola. But the new domestic cases have forced him to backtrack from some early overconfident statements about the ability of the U.S. medical system to contain the threat.

The White House has resisted calls for a “czar” to pull together the international and domestic response to the disease, arguing that Lisa Monaco, Obama's homeland security aide, has been adeptly filling that role. A White House spokesman declined to comment late on Wednesday on whether that thinking has changed.

But lawmakers worry Monaco, who also plays a lead role coordinating U.S. efforts to combat Islamic State militants, has too much on her plate.

Over the past few weeks, the White House has sought to reassure the public by trying to strike a balance between demonstrating the administration is on top of the situation while not trying to feed a sense of public panic.

On Wednesday, that balance shifted. A second Texas nurse contracted Ebola from a patient who died from the disease.

The nurse had recently traveled by plane and officials began tracing a large network of people who may have had contact with her. The nurse had told the CDC she had a fever before she boarded the plane, but was not stopped from boarding, a federal source said late on Wednesday. Frieden earlier in the day told reporters she should not have been aboard.

The new infection contributed to a slide in the stock market.

Obama, who seldom changes his schedule, no matter what crisis is before him, canceled speeches and fundraisers in Connecticut, New Jersey, Rhode Island and New York.

He met with his cabinet for about two hours, and then told Americans that the risk of a widespread outbreak was very low.

Obama needs to make more such efforts to talk directly to Americans about Ebola to show he is in control, said Peter LaMotte, a senior vice president at Levick, a crisis communications firm.

“He needs to be taking a leadership role rather than letting the experts speak on his behalf,” LaMotte said.

Rather than taking the symbolic step of appointing an Ebola czar, Obama should take a more forward role himself to explain the risks and urge calm, said Stephen Morrison, a senior vice president at the Center for Strategic and International Studies.

“The biggest danger here is public fear, and panic,” Morrison said, noting there may be more cases of Ebola to come.

“The president, it seems to me, is the person who should be there, walking that line,” he said.

Second Texas nurse with Ebola had traveled by plane


A second Texas nurse who tested positive for Ebola after caring for a patient with the virus had traveled by jetliner a day before she reported symptoms, U.S. and airline officials said on Wednesday.

The worker at Texas Health Presbyterian Hospital in Dallas had taken a Frontier Airlines flight from Cleveland, Ohio to Dallas/Fort Worth International Airport on Monday, the officials said.

The woman, identified to Reuters by her grandmother as Amber Vinson, 29, was isolated immediately after reporting a fever on Tuesday, Texas Department of State Health Services officials said. She had treated Liberian patient Thomas Eric Duncan, who died of Ebola and was the first patient diagnosed with the virus in the United States.

The circumstances under which Vinson traveled were not immediately known. But the latest revelation raised fresh questions about the handling of Duncan's case and its aftermath by both the hospital and the U.S. Centers for Disease Control and Prevention (CDC).

At least 4,447 people have died in West Africa in the worst Ebola outbreak since the disease was identified in 1976, but cases in the United States and Europe have been limited. The virus can cause fever, bleeding, vomiting and diarrhea, and spreads through contact with bodily fluids.

“Health officials have interviewed the latest patient to quickly identify any contacts or potential exposures, and those people will be monitored,” the health department said in a statement.

During the weekend, 26-year-old nurse Nina Pham became the first person to be infected with Ebola in the United States. She had cared for Duncan during much of his 11 days in the hospital. He died in an isolation ward on Oct. 8.

The hospital said on Tuesday that Pham was “in good condition.”

News of the second nurse's diagnosis follows criticism of the hospital's nurses of its initial handling of the diseases, in a statement Tuesday by National Nurses United, which is both a union and a professional association for U.S. nurses.

The nurses said the hospital lacked protocols to deal with an Ebola patient, offered no advance training and provided them with insufficient gear, including non-impermeable gowns, gloves with no taping around wrists and suits that left their necks exposed.

'PILED TO THE CEILING'

Basic principles of infection control were violated by both the hospital's Infectious Disease Department and CDC officials, the nurses said, with no one picking up hazardous waste “as it piled to the ceiling.”

“The nurses strongly feel unsupported, unprepared, lied to, and deserted to handle the situation on their own,” the statement said.

The hospital said in a statement it had instituted measures to create a safe working environment and it was reviewing and responding to the nurses' criticisms.

Speaking early Wednesday on CBS “This Morning,” U.S. Health and Human Services Secretary Sylvia Burwell declined to comment on the nurses' allegations.

Dallas Mayor Mike Rawlings said at a news conference Wednesday that the second infected nurse lived alone and had no pets.

He said local health officials moved quickly to clean affected areas and to alert her neighbors and friends. A decontamination could be seen taking place at her residence.

EARLY WAKEUP

Residents at The Bend East in the Village apartment complex were awoken early Wednesday by text messages from property managers saying a neighbor had tested positive for Ebola, and pamphlets had been stuffed beneath doors and left under doormats, said a resident, who asked not to be named.

Other residents were concerned enough that they were limiting time spent outdoors.

“Everybody thinks this won't happen because we are in the United States. But it is happening,” said Esmeralda Lazalde, who lives about a mile from where the first nurse who contracted Ebola resides.

Texas Health Presbyterian Hospital is doing everything it can to contain the virus, said Dr. Daniel Varga of Texas Health Resources, which owns the hospital. “I don't think we have a systematic institutional problem,” he said at a news conference on Wednesday.

At the same briefing, Dallas County Judge Clay Jenkins, the county's chief political officer, said authorities were anticipating additional possible Ebola cases.

“We are preparing contingencies for more, and that is a very real possibility,” Jenkins said.

The CDC said in a statement that it was performing confirmation testing of Texas' preliminary tests on the new patient.

CDC Director Dr. Thomas Frieden said Tuesday the agency was establishing a rapid-response team to help hospitals “hands on, within hours” whenever there is a confirmed case of Ebola.

Frieden has come under pressure over the response and preparedness for Ebola, but White House spokesman Josh Earnest said U.S. President Barack Obama was confident of Frieden's ability to lead the public health effort.

REINFORCEMENTS

Burwell, in a series of television interviews on Wednesday, said officials were adding staff to ensure the hospital in Dallas followed procedures to prevent transmission of the virus.

She said there would be round-the-clock site managers to oversee how healthcare workers put on and remove the protective gear used when treating Ebola patients.

In addition to extra CDC staff on site, two nurses from Emory University, in Atlanta, which has a specialized hospital that has treated other Ebola patients flown in from West Africa, were in Dallas to train staff.

Obama was due to hold a video conference Wednesday with British, French, German and Italian leaders to discuss Ebola and other international issues, the White House said.

Prospects for a quick end to the contagion diminished as the World Health Organization predicted that Liberia, Sierra Leone and Guinea, the three worst-hit countries, could produce as many as 10,000 new cases a week by early December.

Additional reporting by Jim Forsyth in San Antonio, Susan Heavey and Doina Chiacu in Washington D.C. and Jon Herskovitz in Austin, Texas; Writing by Jonathan Kaminsky and Curtis Skinner; Editing by Mohammad Zargham, Doina Chiacu, Bernadette Baum and Jonathan Oatis

U.S. funds to fight Ebola now top $1 billion, may rise


The U.S. government now has more than $1 billion available to fight the spread of Ebola from West Africa and is proceeding with plans to deploy up to 4,000 military personnel to the region by late October.

Key congressional committee leaders signed off last week on the transfer of $750 million in Defense Department funds to support the military effort.

Here is a rundown of U.S. monetary commitments so far and the status of future funds in the fight against Ebola:

FUNDS COMMITTED:

Various agencies, including the U.S. Agency for International Development (USAID), the Pentagon and the U.S. Centers for Disease Control and Prevention (CDC), had committed to spend about $311 million through Oct. 10, according to the White House Office of Management and Budget.

This includes $11 million for personal protective equipment, $95 million to develop medical countermeasures, $10 million for community health workers, $35 million to expand laboratory capacity for disease detection, $22 million for field hospitals, $1 million for security and $137 million for laboratory surveillance, logistics and relief commodities and disease detection activities.

AVAILABLE FUNDS:

The chairmen and ranking members of the Senate and House of Representatives Armed Services committees and Appropriations defense subcommittees approved the Pentagon's transfer of $750 million from its war operations budget, enough to support the West Africa Ebola mission for about six months.

The Pentagon's plan for humanitarian aid includes building 17 Ebola treatment facilities with 100 beds each, training of up to 500 healthcare workers each week and a $22 million, 25-bed field hospital to care for sick health workers.

Congress approved $88 million in a stop-gap government funding measure, including $58 million to accelerate production and development of antiviral drugs and vaccines, and $30 million for CDC personnel, equipment and supplies.

USAID and the State Department have announced a $10 million grant to the African Union to train and equip more than 100 medical workers for West Africa. USAID has also announced plans for up to $75 million in additional Ebola funds.

REQUESTED FUNDS

Republican leaders on the four panels have withheld approval of another $250 million in Pentagon funds from the Obama administration's original $1 billion transfer request. Senator James Inhofe is insisting that another funding source be identified for U.S. operations in Africa beyond six months, and that the effort be shifted to other “more appropriate” agencies and non-profit groups.

FUTURE FUNDS

Appropriations committees in Congress are trying to get a handle on the future funding needs of a sprawling, multi-agency Ebola response effort. The information will help them craft a fiscal 2015 spending bill that needs approval by Dec. 11, when a temporary extension of government funding runs out.

House Appropriations Committee Chairman Harold Rogers, a Republican, and Representative Nita Lowey, the panel's top Democrat, have asked the administration for a detailed, government-wide Ebola plan by Friday. (Compiled by David Lawder. Additional reporting by Roberta Rampton and David Alexander.; Editing by Grant McCool and Andre Grenon)

U.S. says 75 government scientists possibly exposed to anthrax


As many as 75 scientists working in U.S. federal government laboratories in Atlanta may have been exposed to live anthrax bacteria and are being offered treatment to prevent infection from the deadly organism, the U.S. Centers for Disease Control and Prevention said on Thursday.

The potential exposure occurred after researchers working in a high-level biosecurity laboratory at the agency's Atlanta campus failed to follow proper procedures to inactivate the bacteria. They then transferred the samples, which may have contained live bacteria, to lower-security CDC labs not equipped to handle live anthrax.

Two of the three labs conducted research that may have aerosolized the spores, the CDC said. Environmental sampling was done and the lab areas are closed until decontamination is complete.

Dr. Paul Meechan, director of the environmental health and safety compliance office at the CDC, said the agency discovered the potential exposure on June 13 and immediately began contacting individuals working in the labs who may have unknowingly handled live anthrax bacteria.

“No employee has shown any symptoms of anthrax illness,” Meechan told Reuters.

Meechan said the CDC is conducting an internal investigation to discover how the exposure occurred and said disciplinary measures would be taken if warranted.

“This should not have happened,” he said. For those exposed, he said, “We're taking care of it. We will not let our people be at risk.”

The normal incubation period for anthrax can take up to five to seven days, though there are documented cases of the illness occurring some 60 days after exposure, Meechan said.

As many as seven researchers may have come into direct contact with the live anthrax, he said. But the agency is casting as wide a net as possible to make sure all employees at the agency who may have walked into any of the labs at risk are being offered treatment.

Around 75 people are being offered a 60-day course of treatment with the antibiotic ciprofloxacin as well as an injection with an anthrax vaccine.

Meechan said it is too early to determine whether the transfer was accidental or intentional. He said that all employees who were doing procedures to inactivate the bacteria were working in a biosecurity laboratory and had passed a security check.

The CDC said in a statement it has reported the lab-safety incident to the Federal Select Agent Program, which oversees the use and transfer of biological agents and toxins that pose a severe threat to the public.

CDC spokesman Tom Skinner did not say whether the Federal Bureau of Investigation was investigating. The FBI was not immediately available to comment.

LAWMAKERS EXPRESS CONCERN

Henry Waxman, the top Democrat on the House Energy and Commerce Committee, said he is “extremely concerned” but said “we understand CDC has taken swift action to respond to the possible exposure and will be investigating how this exposure occurred and appropriate measures to prevent such an event from happening in the future.”

Dr. William Schaffner, an infectious diseases expert at Vanderbilt University Medical Center, said the potential exposures are still “profoundly unfortunate and serious.”

“What's good about it is the exposures are minimal,” he said. CDC responded appropriately, aggressively and transparently. The risk to the individual is low and to the surrounding community, essentially nil.”

Schaffner said it is not yet clear exactly what the breach in infection control protocol was, but said, “Whatever it was, it should not have happened.”

Anthrax is a potentially deadly infectious disease caused by exposure to the bacterium Bacillus anthracis. The bacteria most commonly affect hoofed animals such as goats, but people can also become infected.

Infection can occur through a cut in the skin, breathing in anthrax spores or eating tainted meat.

Meechan said CDC workers in the lower-security labs were likely not wearing masks.

With anthrax, the biggest threat is inhalation anthrax, in which bacterial spores enter the lungs where they germinate before actually causing disease, a process that can take one to six days. Once they germinate, they release toxins that can cause internal bleeding, swelling and tissue death.

Inhalation anthrax occurs in two stages. In the first stage, symptoms resemble a cold or the flu. In the second stage, anthrax causes fever, severe shortness of breath and shock. About 90 percent of people with second-stage inhalation anthrax die, even after antibiotic treatment.

Reporting by Julie Steenhuysen in Chicago; Additional reporting by David Morgan in Washington; Editing by Michele Gershberg, Eric Walsh and Lisa Shumaker

‘Nightmare bacteria,’ shrugging off antibiotics, on rise in U.S.


“Nightmare bacteria” that have become increasingly resistant to even the strongest antibiotics infected patients in 4 percent of U.S. hospitals in the first half of 2012 and in 18 percent of specialty hospitals, public health officials said on Tuesday.

“Our strongest antibiotics don't work and patients are left with potentially untreatable infections,” Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, said in a statement before an afternoon news conference. He said doctors, hospitals and public health officials must work together now to “stop these infections from spreading.”

Over the past decade more and more hospitalized patients have been incurably infected with the bug, Carbapenem-Resistant Enterobacteriaceae (CRE), which kills up to half of patients who get bloodstream infections from them, according to a new CDC report.

The bacteria belong to the Enterobacteriaceae family, which includes more than 70 species that normally live in the water, soil and human digestive system, such as the well-known E. coli. Over the years, some Enterobacteriaceae have become resistant to all or almost all antibiotics, including last-resort drugs known as carbapenems.

Over the past decade, the percentage of Enterobacteriaceae that are resistant to these last-ditch antibiotics rose by 400 percent. One type of CRE, a form of Klebsiella pneumoniae, has increased sevenfold in the last decade.

Almost all CRE infections occur in patients receiving medical care for serious conditions in hospitals, long-term acute-care facilities (such as those providing wound care or ventilation) or nursing homes.

These patients often have catheters or ventilators and are therefore receiving antibiotics to reduce the risk of infection or battle an existing infection. When the antibiotics wipe out susceptible bacteria, the coast is clear for CRE to proliferate.

Northeastern states report the most cases of CRE. In one of the worst outbreaks, 18 patients at the National Institutes of Health Clinical Center in Bethesda, Maryland, contracted a CRE strain of Klebsiella pneumoniae in 2011. Seven patients, including a 16-year-old boy, died.

Last month, CDC reported that unusual forms of CRE – with such exotic names as New Delhi Metallo--lactamase and Verona Integron-mediated Metallo--lactamase – are becoming more common in the United States. Of the 37 unusual forms ever identified, the last 15 have been reported since July.

The germs themselves spread from person to person, often on the hands of doctors, nurses and other health care professionals. They can easily pass their antibiotic resistance – contained in a speck of genetic material – to other kinds of germs, making additional kinds of bacteria potentially untreatable as well, CDC said.

That “can create additional life-threatening infections for patients in hospitals and potentially for otherwise healthy people,” the CDC said in a statement.

The CDC is trying to make health care facilities more aware of the resistant germs, since their spread can be controlled with proper precautions and better practices: Israel, for instance, cut CRE infection rates in all 27 of its hospitals by more than 70 percent in one year.

Such measures include such standard infection control precautions as washing hands, as well as grouping patients with CRE together and dedicating staff, rooms and equipment to the care of patients with CRE alone. When an acute-care hospital in Florida recently had a yearlong CRE outbreak, implementing such measures cut the percentage of patients who got CRE from 44 percent to zero.

Reporting by Sharon Begley; Editing by Doina Chiacu