What We're Reading: Flint Water Crisis Possibly to Blame for Shigellosis Outbreak

What we’re reading, October 5, 2016: Flint residents’ reluctance to wash with water may have led to shigellosis cases; 88 innovative scientists receive grants for groundbreaking research; and free-standing EDs spark regulation concerns.

Michigan’s Genesee County, where Flint is located, has seen an increased incidence of the bacterial illness shigellosis, with some questioning if the outbreak was exacerbated by the city’s contaminated water crisis. The gastrointestinal illness is prevented by hand-washing, but many Flint residents concerned about the water’s lead contamination have been cleaning their hands with baby wipes, which do not kill the bacteria. Flint’s water was also a suspected cause of an outbreak of Legionnaire’s disease, which occurred shortly after the city’s water supply was switched from Lake Huron to the Flint River in 2014.

The National Institutes of Health (NIH) has awarded 88 grants to innovative scientists through its High-Risk, High-Reward Research Program, which encourages “bold approaches to major challenges in biomedical research.” The awards, which distributed a total of $127 million, fall into four categories: Pioneer, New Innovator, Transformative Research, and Early Independence. An example of this creative research is that of Jesse V. Jokerst, PhD, who received a New Innovator award for his work in developing a wearable sensor that uses photoacoustic imaging to monitor blood coagulation levels in patients taking heparin.

A Health Affairs study reports that there are currently 400 free-standing emergency departments (EDs) in 32 states across the US. These are regulated by state laws, not federal, but only 15 of the 32 states require an on-site physician during all operating hours, and just 18 states have laws similar to the federal Emergency Medical Treatment and Labor Act (EMTALA), which requires hospital EDs to treat and stabilize all patients regardless of insurance status or ability to pay. Study coauthor Jeremiah Schuur, MD, MHS, cautioned that even the states with comparable laws may not be as effective in policing free-standing EDs compared to EMTALA, which “carries a very big stick, with a large fine and potential loss of Medicare certification.”