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HIV and ID Observations NEJM

Well, I finally found a doctor who shares my thoughts about world health challenges, though they may lurking in our own homes, as we post this….. Enjoy! From the NEJM - New England Journal of Medicine and Dr. Paul Sax, MD.


April 1st, 2018

News Flash — The World Isn’t Sterile


I am a serious biothreat.


You might have missed this press release from the National Institute of Allergy and Infectious Diseases (NIAID):


Bethesda, MD Dr. Paul Sax @paulsaxMD in NEJM Journal Watch


The National Institute of Allergy and Infectious Diseases, at the National Institutes of Health, invites grant applications which propose research in the following 3 critical world health challenges:

1.  Development of an effective HIV vaccine.

2.  Global eradication of malaria.

3.  Identification of the germs you can find lurking on or inside everyday objects. Priority items for this research include the kitchen drying rack, the shower curtain, and bathtub toys.


Well, not really.


But the inspiration for that (lame) April Fool’s Day joke was this recently published study finding bacteria inside your kid’s rubber duck.


And it’s not just rubber ducks. A prior study found these and other scary bugs in your office coffee maker.


While we’re at it, let’s take a look at your flight’s tray table.


On your kitchen sponge.


Or in the other room, on your TV remote control.


Outside, in the playground sandbox.


And beware your doctor’s necktie and stethoscope. And that white coat? Teeming. I could go on and on.


(In fact, I already did!)


Indeed, if you look hard enough, bacteria can be found literally everywhere — except perhaps inside your hospital’s autoclave.


What’s missing from all these studies, of course, is a correlation between identification of these bugs and any subsequent diseases. It’s not as if kids with rubber ducks were coming down with more infections than kids who don’t have them.


Perhaps a competing bath toy company will fund a clinical outcomes study, but don’t hold your breath. The rubber ducks have quite a stranglehold on this market.


In summary, bacteria on common household, work, and travel items are ubiquitous; furthermore we lack any clinical data that this is important in any way.


Hence I wonder — why are these “we found bacteria on [common-item]” studies so common? Even more perplexing, why are they such popular news fodder? The press can’t seem to get enough.


According to its Altmetric score (pictured to the right), the above-mentioned rubber duck study is a bigger news story than the fact that rates of tuberculosis in the USA have reached historic lows.


(Since TB control is one of the few things our crazy US healthcare system does really well, I like to publicize these data whenever possible. You’re welcome.)

  And what do we call these studies? Clearly the very category deserves a name

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