Grand Rounds Presentations

Law is a critical tool for protecting and promoting the health of the public. Some of history’s greatest public health successes, such as childhood immunization and safer workplaces, would not have been possible without changes to laws and policies.

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Sickle cell disease (SCD) describes a group of inherited disorders that can cause red blood cells to develop in an abnormal rigid sickle or crescent shape. In addition to sudden, excruciating pain events known as pain crises, SCD can lead to strokes, organ damage, joint and bone problems, and other severe health consequences.

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When it comes to tracking infectious diseases and outbreaks, determining who is infected with a particular pathogen is the first step in solving the puzzle and stopping the spread of the disease. In this session of Public Health Grand Rounds, you will hear how culture-independent diagnostic tests are changing the landscape of diagnosing infectious disease.

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Newborn screening began in the United States in the 1960s to test for medical conditions that may not be apparent just by looking at a baby. Finding these conditions soon after birth can help prevent certain serious problems, such as brain damage, organ damage, and even death.

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Neonatal Abstinence Syndrome (NAS) is a growing problem in the United States. NAS occurs when newborn babies experience withdrawal after being exposed to drugs in the womb.

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Aedes aegypti and Aedes albopictus mosquitoes are the primary vectors for dengue, chikungunya, yellow fever, and Zika viruses. Taken together, these viruses account for almost 100 million cases of mosquito-borne disease per year. Globally, dengue is the most important mosquito-borne viral disease. In the last 50 years, incidence has increased 30-fold by expanding into new countries and new areas. Chikungunya often occurs in large outbreaks with high infection rates, affecting more than a third of the population in areas where the virus is circulating. In 2014, more than a million cases were reported worldwide. While Chikungunya disease rarely results in death, the symptoms can be severe and disabling.

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As we celebrate CDC’s 70th anniversary this year, we are taking a look back at the events of the last seven decades that have helped CDC become the world’s leading public health agency. In order to recognize some of the accomplishments that have occurred at CDC over the past 70 years, former CDC Directors William H. Foege, MD, MPH; James O. Mason, MD, MPH; William L. Roper, MD, MPH; David Satcher, MD, PhD; Jeffrey P. Koplan, MD, MPH; and Julie Gerberding, MD, MPH will join us for this special Grand Rounds presentation.

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The environment plays an important role in our health and development. Research has shown that exposure to certain environmental hazards can lead to chronic disease, but for many years, we lacked the ability to reliably track the health effects of environmental factors.

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This session of Grand Rounds discusses how public health programs and healthcare providers are working together across the nation to identify and reduce stroke risks, and to improve the quality of stroke care and treatment.

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The risk factors for cancer are many and varied, and inherited genetic mutations play a major role in 5 to 10% of all cancers. When these mutations are identified early, patients are able to work with their healthcare providers to take crucial steps toward care and treatment. Many of those affected by genetic cancer syndromes don’t know that genetic testing is an option.

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The first years of a child’s life are some of the most important in terms of cognitive, social, and physical development. Early experiences occurring when a child’s brain and behavior are being shaped affect a child’s ability to learn, to get along with others, and to develop an overall state of well-being.

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We may know chronic fatigue syndrome by several other names, myalgic encephalomyelitis and systemic exertion intolerance disease among them. Doctors and scientists have not yet found what causes chronic fatigue syndrome.

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Where are infections spreading? How many people will be affected? What are some different ways to stop the spread of an epidemic? These are questions that the public and decision-makers, including health officials, often ask during an outbreak or emergency. In a process known as modeling, scientists analyze data using complex mathematical methods to provide answers to these and other questions during an emergency response.

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Laboratory safety may sound straightforward, but in reality it is supported by complex and ever-changing science. Safety standards and practices evolve as scientists learn more about the materials they handle regularly. Today, more than 2000 laboratory scientists in more than 150 labs at CDC work with specimens to identify new health threats, stop outbreaks, and gain new knowledge. Laboratory work saves lives and protects people. Though this work is critical, it is not without risk. Labs are often working with the deadliest germs, toxins, and environmental hazards in the world.

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Preterm birth is complex and remains a challenge because its causes are numerous, and poorly understood. Modern technology and stronger public health strategies have made a significant impact in reducing preterm births and infant mortality. However, we still have a lot to learn about the causes of premature birth in order to prevent it and protect the youngest members of our society, especially among racial and ethnic minorities.

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Electronic cigarettes, or e-cigarettes, are an emerging challenge for public health. The potential long-term benefits and risks associated with e-cigarette use are not currently known. What is known is that nicotine exposure at a young age may cause lasting harm to brain development, promote nicotine addiction, and lead to sustained tobacco use – making any use of these products among U.S. youth a major concern.

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Global health security is the protection of the health of people and societies worldwide. With diseases a plane ride or border crossing away, the importance of global health security has never been clearer. Patterns of global travel and trade pose greater opportunities for infectious diseases to emerge and spread nearly anywhere within 24 hours. The Ebola epidemic in West Africa, which has infected more than 28,000 people across 10 countries and has caused more than 11,200 deaths, highlights the importance of ensuring that every country is prepared to prevent, detect, and respond to outbreaks and emerging health threats. 

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Suicide is preventable and is a significant public health issue. In 2013, there were over 41,000 suicides in the United States – an average of 113 each day. The risk for suicidal behavior is complex. People of all genders, ages, and ethnicities can be at risk for suicide but some groups are at higher risk than others. While such services are critical, preventing suicide at a national level will require approaches that go beyond mental health issues to address broader family, community, and societal issues.

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Adolescence is a critical stage of development during which physical, intellectual, emotional, and psychological changes occur.  While adolescence is a relatively healthy period of life, adolescents begin to make lifestyle choices and establish behaviors that affect both their current and future health.  During this transition from childhood to adulthood, serious health and safety issues such as motor vehicle crashes, violence, substance use, and risky sexual behaviors can adversely affect adolescents and young adults.  

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Changes occurring in the world's climate continue to pose significant threats to human health and wellbeing and will have even greater impacts in the future. Since this session first aired in December of 2014 there have been some important new scientific findings and more frequent extremes of climate events that affect human health. Join us for this rebroadcast which will feature introductory remarks by VADM Vivek Murthy, US Surgeon General and a Beyond the Data update from doctor George Luber, Chief of CDC's Climate and Health program.

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Measles is a highly contagious virus that spreads through the air when an infected person coughs or sneezes. The virus can cause serious health complications. About 1 in 4 people in the U.S. who get measles will be hospitalized and globally 1 or 2 out of 1,000 people with measles will die, even with the best care.

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Aedes aegypti and Aedes albopictus mosquitoes are the primary vectors for dengue, chikungunya, yellow fever, and Zika viruses. Taken together, these viruses account for almost 100 million cases of mosquito-borne disease per year.

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Skin cancer is the most common form of cancer in the United States, affecting 5 million individuals each year. Melanoma, the third most common skin cancer, is the deadliest kind of skin cancer, resulting in approximately 9,000 deaths each year. Most cases of skin cancer are preventable, but despite efforts to address risk factors, skin cancer rates have continued to increase in the United States and worldwide.

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Public health emergencies can happen at any time, anywhere.  Natural disasters, epidemics, and terrorist attacks that have occurred in recent years have underscored the importance of local, state, and federal public health systems in preparing for potential health threats.  However, responses to past events also show that the unique needs of children have not been adequately addressed in the planning process.

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Polio is a crippling and potentially deadly infectious disease. The virus spreads from person to person and can invade an infected person’s spinal cord, causing life-long paralysis or in rare instances, death. The eradication of polio remains an important priority for the CDC and many of its global partners.  Over the past 25 years, the number of polio cases reported worldwide has fallen from an estimated 350,000 in 1988 to only 407 in 2013—a decline of more than 99%, but there remains work to be done.

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CDC and its partners are working together to identify both genetic and environmental risk factors that may contribute to the development of birth defects. Folic acid fortification has been a major success in the prevention of some types of birth defects and there is ongoing research on the impact of interventions that target obesity, smoking, and diabetes. We have made great advances, but there is still much that can be done to understand and prevent birth defects.

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Changes occurring in the world’s climate pose significant threats to human health and wellbeing and will have even greater impacts in the future. These threats are wide-ranging, including decreased air quality and increases in extreme weather events, wildfire, and illnesses transmitted by water, and disease-carriers, such as mosquitoes and ticks.

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While some organ transplantations are life-saving procedures, serious illness and death can occur from undetected infections in donor organs and tissues.

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The expanded role of 21st century pharmacists will position them to have greater impact in the shifting landscape of health care and public health. Beyond the dispensing of medications, pharmacists also provide a spectrum of prevention and treatment services to help improve health outcomes.

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Heart attacks and strokes contribute to the almost 800,000 deaths from cardiovascular disease each year. The trauma to families and communities is devastating; the cost to the US economy is nearly $1 billion each day in medical costs and lost productivity. To achieve sustainable prevention, the Department of Health and Human Services launched Million Hearts^®, a national initiative to prevent one million heart attacks and strokes by 2017.

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Thirty years ago family planning was synonymous with using contraception and the prevention of pregnancy. Today, that definition has changed immensely to recognize the importance of helping couples achieve pregnancy. In general, infertility is defined as not being able to get pregnant (conceive) after one year of unprotected sex (6 months for women 35 or older).

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Twenty-five years ago CDC played a pivotal role in the discovery of the virus that causes hepatitis C. After the isolation of HCV, implementation of screening of blood products and organs for donation led to a decrease in rates of HCV infection between 1990 and 2009. In spite of these successes, HCV still remains a serious threat, both domestically and abroad. HCV remains the most common chronic blood borne infection in the United States, affecting approximately 3.9 million individuals.

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An estimated 50,000 individuals become infected with the human immunodeficiency virus (HIV) in the United States annually. A new prevention strategy, Pre-exposure Prophylaxis (PrEP), is intended for high-risk populations to reduce their risk of becoming infected with HIV. PrEP includes daily medication and routine follow-up. When used consistently, PrEP is shown to reduce the risk of HIV infection.

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Autism spectrum disorder (ASD) is a group of developmental disabilities that can cause significant social, communication and behavioral challenges. Global prevalence of autism has increased twenty- to thirty-fold since the earliest studies 40–50 years ago.

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Tuberculosis is an ancient disease that remains an important global cause of morbidity and mortality. In most cases, TB can be treated and cured by taking a combination of several drugs for 6 to 12 months. When inappropriate or incomplete treatment takes place, however, TB bacteria can develop resistance to multiple drugs.

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This session of Grand Rounds will explore the societal burden of youth violence, and the evidence-based approaches and partnerships that are necessary to prevent youth violence and its consequences.

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Have you ever wondered what kind of impact CDC science has? Did you ever want to know if your published research is likely to have impact on a significant health outcome? Traditional citation data and journal metrics help us understand how widely the research is disseminated.

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For nearly 70 years, community water fluoridation has been used to prevent tooth decay and improve oral health. Community water fluoridation (CWF) is not only safe and effective, but also cost-saving – yielding approximately $38 savings in dental treatment costs for every $1 invested.

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This session of Grand Rounds will explore opportunities for CDC to leverage key aspects of Advanced Molecular Detection (AMD), bioinformatics and enhanced molecular tools, such as whole genome sequence, to improve our ability to diagnose/identify infectious diseases, investigate and control outbreaks, understand transmission patterns, develop and target vaccines, and determine antimicrobial resistance—all with increased timeliness, accuracy and decreased costs.

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Antibiotics are the most important tool we have to combat life-threatening bacterial diseases, but antibiotic use, especially when not needed, has unintended consequences.

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This session of Grand Rounds explored new ways that public health can increase the rate of evidence-based cancer screening, and decrease disparities in screening rates.

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This session of Grand Rounds explored new ways that public health can increase the rate of evidence-based cancer screening, and decrease disparities in screening rates.

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This session of CDC Public Health Grand Rounds will explore hypertension, or high blood pressure. Having high blood pressure increases the risk for cardiovascular disease, the leading cause of death in the United States. Nearly 800,000 people die in the United States each year from cardiovascular disease, which is 1 out of every 3 deaths.

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This session of Grand Rounds examined how immunization has helped reduce infectious disease disparities among U.S. children, reducing infectious disease burdens in children from racial/ethnic populations, and how immunization has, as a result, contributed to health equity.

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Teen birth rates in the United States have declined to the lowest rates seen in seven decades, yet they are still nine times higher than in most other developed countries and ethnic disparities continue to persist.

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This session of Grand Rounds will explore the burden of human papillomavirus (HPV)-associated cancer and disease in the United States and prevention through HPV vaccination.

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This session of Grand Rounds explores Venous Thromboembolism (VTE), which consists of 2 related conditions caused by blood clots: Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE).

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This session of Grand Rounds explores Public health practices to include people with disabilities.

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This session of Grand Rounds explored how unsafe injection practices which put patients at risk of infection have been associated with a wide variety of procedures and settings.

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This session of Grand Rounds explored public health approaches to reducing U.S. infant mortality.

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This session of Grand Rounds explored methods of rapid identification of emerging infectious diseases.

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This session of Grand Rounds explored High-Impact HIV Prevention in the United States.

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This session of Grand Rounds explored the control of tobacco use—the leading preventable cause of premature death and disease worldwide.

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This session of Grand Rounds explored Intimate Partner Violence (IPV), a serious, preventable public health problem that affects millions of Americans. The term "intimate partner violence" describes physical, sexual, or psychological harm caused by a current or former partner or spouse. IPV can vary in frequency and severity. It occurs on a continuum, ranging from one episode to chronic, severe battering.

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This session of Grand Rounds will explore the development of antibiotic resistance in Neisseria gonorrhoeae as a growing public health concern because the United States gonorrhea control strategy relies on effective antibiotic therapy. Since antibiotics were first used for treatment of gonorrhea, N. gonorrhoeae has progressively developed resistance to the antibiotic drugs prescribed to treat it: sulfonilamides, penicillin, tetracycline, and ciprofloxacin.

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Excessive alcohol use, including underage drinking and binge drinking, is responsible for 80,000 deaths and 2.3 million years of potential life lost in the U.S. each year. This powerful session of Public Health Grand Rounds explored the public health impact of excessive alcohol use and evidence-based strategies to prevent it, with specific attention to the role that state and local public health agencies play in addressing this important public health problem.

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Heart disease and stroke are, respectively, the first and fourth leading causes of death in the United States. Cardiovascular disease alone is responsible for 1 of every 3 deaths in the U.S. and costs the nation $444 billion per year in health care expenses and lost economic productivity. To reduce this burden, the Department of Health and Human Services (DHHS), CDC, CMS, and a broad range of public and private-sector partners have launched the Million Hearts™ initiative to enhance cardiovascular disease prevention activities with proven, effective, and inexpensive clinical and community interventions.

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Worldwide, 5.8 million people die each year from injuries. More than 180,000 fatal injuries occur in the U.S. alone. Motor vehicle crashes, falls, homicides, suicides, domestic violence, child maltreatment, and prescription drug overdoses are just some of the tragedies we hear about every day that affect us all, regardless of sex, race, or economic status.

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Traumatic brain injury, or TBI, is a serious public health problem that affects approximately 1.7 million Americans every year. Of all injury deaths in our country, one in three cases are TBI–related, and an estimated 5.3 million Americans are living with a TBI–related disability.

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In the last five decades, newborn screening has become a well–defined, nationwide prevention program. Each year, more than 4 million newborns in the United States are screened for hearing loss and certain genetic, endocrine, and metabolic disorders.

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Electronic health records (EHRs) allow for the systematic collection and management of patient health information in a form that can be shared across multiple health care settings. By providing easier access to patients’ medical records, EHRs can help improve healthcare quality, efficiency and safety.

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Beyond the inherent moral implications, child abuse is a crime, a tragedy, and a significant public health burden. In the United States, approximately 1 in 5 children have experienced some form of maltreatment, including physical and sexual abuse and the often overlooked danger of neglect.

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Lyme disease is one of the most rapidly emerging infectious diseases in North America and Europe. In 2009, nearly 30,000 confirmed and more than 8,500 probable cases of Lyme disease were reported to the CDC in the United States alone.

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The vast majority of US adults consume more than double the recommended maximum of sodium, which is a direct cause of hypertension, a condition that affects nearly 1 in 3 Americans.

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As we commemorate Dr. Robert Koch’s 1882 discovery of Mycobacterium tuberculosis, the bacteria that causes TB, we are reminded of the many advances over the past 129 years in TB control.

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The United States is in the grip of an epidemic of prescription drug overdoses. Over 27,000 people died from overdoses in 2007, a number that has risen five-fold since 1990 and has never been higher. Prescription drugs are now involved in more overdose deaths than heroin and cocaine combined.

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Rabies, a viral zoonotic disease, can be spread to humans through bites or scratches from infected wild or domestic animals. Without prompt and proper wound cleansing and immunization, rabies can lead to death in humans — more than 55,000 people worldwide die from this disease every year. Fortunately, rabies is a vaccine-preventable disease. The most cost-effective strategy for preventing rabies in people is by eliminating rabies in dogs through vaccination. However, recent increases in human rabies deaths in parts of Africa, Asia and Latin America suggest that rabies is re-emerging as a serious public health issue.

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On June 5, 1981, the MMWR became the first scientific publication to report cases of a mysterious disease that came to be known as acquired immunodeficiency syndrome (AIDS). During the next 30 years, this pandemic claimed as many as 25 million lives.

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Approximately half of the world′s population is at risk of malaria. In 2008, malaria caused an estimated 243 million cases of malaria and 863,000 deaths. Although cases occur across the globe, 85% of the world′s malaria deaths occur in Africa, where the disease accounts for up to 40% of public health expenditures.

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Sixteen months after reports of a potentially fatal new influenza virus took the world and media by storm, the World Health Organization (WHO) declared an end to the 2009 H1N1 pandemic on August 10, 2010. Although the Phase 6 alert has been lifted and H1N1 is no longer the dominant influenza virus it once was, evidence from prior pandemics suggests that the virus will come to model the behavior of seasonal influenza and continue to circulate for years to come.

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Vitamin D has become one of the most controversial nutrition issues of the day. While the vitamin’s role in preventing bone diseases such as osteoporosis is well documented, recent studies suggest that increased intake of vitamin D may also reduce the risk of various cancers, diabetes, and heart disease – a possibility that has many heralding it as a “miracle vitamin.” However, not only are these studies being called into question for their failure to show a direct cause and effect, but there is also evidence that excess intake of vitamin D can be toxic.

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With an estimated 8.8 million deaths of children under 5 years of age each year, the challenges of achieving health among the world’s children are rooted in myriad economic, cultural and geographic barriers – 51% of all child deaths occur in Africa and 42% in Asia, while only 7% occur in the rest of the world.

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According to the 2007-2008 NHANES (National Health and Nutrition Examination Survey), obesity now affects 17% of all children and adolescents in the United States – triple the rate from just one generation ago. America’s obese children are at an alarmingly heightened risk for elevated blood pressure, cholesterol, diabetes, and becoming obese adults. The financial cost of childhood obesity tips the scales at 3 billion dollars annually.

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With over 1.2 million cases reported annually, Chlamydia trachomatis infection (chlamydia) is the most commonly reported notifiable disease in the U.S. Chlamydia, a sexually transmitted infection, can lead to a host of serious reproductive health problems in women, including infertility and pelvic inflammatory disease. The burden of infection is highest among adolescents and there are also substantial racial disparities, with non-Hispanic blacks disproportionately affected.

Chlamydia is easily detected and treated, but recommended annual screening remains underutilized. Lack of awareness, social stigma, barriers to finding and treating sex partners of infected women, and difficulties in measuring public health impact all present challenges and opportunities for chlamydia prevention programs.

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Nanotechnology is the science of developing materials at the atomic, molecular or micro-molecular level. From smartphones to skincare, there are currently over 1,000 commercial products containing nanomaterials, with applications as far ranging as the fields of medicine, engineering, electronics and energy production.

This session of Public Health Grand Rounds focused on the current state of knowledge in nanotechnology and discussed concerns about the harmful impact that exposure to some nanomaterials may have on humans and the environment.

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Are we, as a nation, prepared for a radiological or nuclear attack?

With concern over continued terrorist threats at home and abroad, “dirty bombs”, and the nuclear armament of rogue states, this question is just as relevant today as it was on September 11. Due to limited resources, emergency management officials from many U.S. cities and states rely on the federal government to intercede in the event of such a catastrophe. However, the federal government is also limited in the support it can provide to states, not to mention that federal radiation programs are often not well integrated with state public health offices. To minimize these gaps, the federal government must enhance collaboration with state public health offices and ensure that the integration of these radiologic preparedness programs with other preparedness activities is effective.

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Every year, approximately 300,000 children around the world are born with neural tube defects (NTD), a failure of closure of the neural tube either in the cranial region or along the spine that result in anencephaly and spina bifida respectively. Infants born with anencephaly usually die within a few days of birth, and those with spina bifida typically live with various life-long disabilities and often experience mobility limitations.

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The polio crisis of the early 20^th century has been largely forgotten in the U.S. due to the creation of the Salk vaccine and the effective immunization campaigns of the 1950s. Unfortunately, the wild poliovirus (WPV) still remains a real public health threat in many corners of the world.

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On Thursday, December 17, CDC's National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED) presented the fourth Public Grand Rounds session entitled "Foodborne Diseases: Better Prevention with Better Public Health Information."

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On Wednesday, November 18, CDC's Office of Smoking and Health presented the third session of Public Health Grand Rounds entitled “The Public Health Impact of Tobacco Product and Advertising Regulation."

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On Thursday, October 15, Dr. Frieden introduced the second session of the Public Health Grand Rounds entitled “Eliminating HAIs: A Primer,” a presentation on healthcare-associated infections presented by Chesley Richards, MD, Deputy Director DHQP.

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On Thursday, September 17, Dr. Frieden kicked off the first session of the Public Health Grand Rounds entitled “Getting to Zero Traffic-related Deaths,” a presentation on motor vehicle safety sponsored by the Division of Unintentional Injury Prevention (DUIP), National Center for Injury Prevention and Control (NCIPC).

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