NEW YORK (AP) — The director of the Centers for Disease Control and Prevention resigned Wednesday over financial conflicts of interest involving her investments in health care businesses.
Dr. Brenda Fitzgerald’s complex financial investments presented conflicts that made it difficult to do her job, according to a statement from the Department of Health and Human Services, which oversees the CDC. In an ethics agreement filed in September, Fitzgerald had said that legal and contractual restrictions prevented her from selling the two investments.
The new HHS head, Alex Azar, who took office on Monday, accepted her resignation Wednesday after discussing the investments with her and their effect on her work.
Her investments were “limiting her ability to complete all of her duties as CDC Director,” HHS spokesman Matt Lloyd said in the statement. “Due to the nature of these financial interests, Dr. Fitzgerald could not divest from them in a definitive time period.”
Fitzgerald’s resignation follows a news report Tuesday that her financial manager bought tobacco and drug stocks after she took the job in July, while selling other stocks that posed a conflict of interest.
Before she became the CDC’s chief, she owned a range of stocks, including holdings in beer and soda companies, the tobacco company Philip Morris International, and a number of health care companies. She said she sold the stocks, but in December, U.S. Sen. Patty Murray (D-Wash.) wrote Fitzgerald saying she was concerned about the unresolved financial holdings.
In the ethics agreement, Fitzgerald discussed long-term investments in an electronic medical records company and a biotech startup that focuses on early cancer detection. She said in the agreement that she would not participate in matters that might affect those companies. Those investments prevented her from talking about cancer and prescription drug monitoring programs, Murray wrote.
On Tuesday, Politico reported that a month after becoming CDC director, Fitzgerald’s financial manager bought new stocks, including shares in Japan Tobacco and the drug companies Bayer and Merck & Co. Those stocks were later sold, Politico reported.
Fitzgerald could not be reached for comment. Her predecessor, Dr. Tom Frieden, said he talked to her after the Politico story came out, and Fitzgerald told him she didn’t know about the purchase of the new stocks when they were made.
“I have spoken with Dr. Fitzgerald and believe her when she says that she was unaware that a tobacco company investment had been made, she understands that any affiliation between the tobacco industry and public health is unacceptable, and that when she learned of it, she directed that it be sold,” Frieden said in a statement.
Fitzgerald, 71, was a longtime OB-GYN in the Atlanta area, a former major in the U.S. Air Force, and campaigned twice, unsuccessfully, as a Republican candidate for Congress in the 1990s. She led Georgia’s state health department for six years before being tapped for the CDC job.
Fitzgerald kept a low-profile in the job. She said she wanted to spend time learning about the agency, but also acknowledged a financial conflict of interest kept her from appearing at a Congressional hearing on opioids in early October.
She was appointed by Dr. Tom Price, who was a Republican congressman from Georgia before Trump picked him to head HHS. Price resigned in late September after his costly travel on chartered planes triggered investigations and angered Trump.
Murray issued a statement Wednesday after Fitzgerald’s resignation.
“It is unacceptable that the person responsible for leading our nation’s public health efforts has, for months, been unable to fully engage in the critical work she was appointed to do. Dr. Fitzgerald’s tenure was unfortunately the latest example of the Trump Administration’s dysfunction and lax ethical standards,” Murray said.
The CDC, the nation’s top public health agency, is the only federal agency headquartered outside of Washington, D.C. It has nearly 12,000 employees, and about three-quarters of them are based in the Atlanta area.
The cambodian cure for resistant scabies mites
A member shares his story in how he was cured from resistant scabies mites in Cambodia. Where ivermectin and permethrin failed a local monk in a small town in Cambodia combated it with natural herbs and ancient remedies
Facebook group: Human Parasites Support Network
New Lyme disease tests could offer quicker, more accurate detection
New tests to detect early Lyme disease — which is increasing beyond the summer months -could replace existing tests that often do not clearly identify the infection before health problems occur.
In an analysis published on December 7 in Clinical Infectious Diseases, scientists from Rutgers University, Harvard University, Yale University, National Institute of Allergy and Infectious Diseases of the NIH and other academic centers, industry and public health agencies say new diagnostic methods offer a better chance for more accurate detection of the infection from the Lyme bacteria.
“New tests are at hand that offer more accurate, less ambiguous test results that can yield actionable results in a timely fashion,” said Steven Schutzer, a physician-scientist at Rutgers New Jersey Medical School and senior author. “Improved tests will allow for earlier diagnosis which should improve patient outcomes.”
Lyme disease is the most common tick-borne infection in North America and Europe. There are currently over 300,000 cases of Lyme disease annually in the United States alone and the disease is increasing and spreading into new regions. Lyme disease frequently, but not always, presents with a bull’s-eye rash. When the rash is absent, a laboratory test is needed.
The only FDA approved Lyme disease tests, based on technology developed more than two decades ago, rely on detecting antibodies that the body’s immune system makes in response to the disease. These antibody-based tests are the most commonly used tests for Lyme disease and are the current standard.
One problem, however, is that many people produce similar — called “cross-reactive” — antibodies in response to other bacteria not associated with Lyme disease, which causes confusing results and makes test accuracy more difficult.
“New tests are more exact and are not as susceptible to the same false-positive or false-negative results associated with current tests,” said Schutzer.
Schutzer and his colleagues say more accurate testing would help doctors decide when to prescribe the antibiotics used to clear the infection and help avoid severe long-term health problems. Antibody tests, can take three weeks or more for the antibody levels to reach a point where the tests can pick up a positive result.
Those involved in the paper joined forces after meeting at Cold Spring Harbor Laboratory’s Banbury Center, a nonprofit research institution in New York. The meeting organized and chaired by Schutzer and John A. Branda, assistant professor of pathology at Harvard Medical School, focused on current Lyme disease tests and new scientific advances made in increasing the accuracy of the diagnosis.
“This meeting and paper resulting from it are particularly significant,” said Jan Witkowski, professor in the Watson School of Biological Sciences at Cold Spring Harbor Laboratory who along with Nobel Laureate James Watson asked Schutzer to lead several symposia. “The participants noted that there are greatly improved diagnostic tests for Lyme disease that can be implemented now, and that the way is open to the development of further tests.”
- John A Branda, Barbara A Body, Jeff Boyle, Bernard M Branson, Raymond J Dattwyler, Erol Fikrig, Noel J Gerald, Maria Gomes-Solecki, Martin Kintrup, Michel Ledizet, Andrew E Levin, Michael Lewinski, Lance A Liotta, Adriana Marques, Paul S Mead, Emmanuel F Mongodin, Segaran Pillai, Prasad Rao, William H Robinson, Kristian M Roth, Martin E Schriefer, Thomas Slezak, Jessica Snyder, Allen C Steere, Jan Witkowski, Susan J Wong, Steven E Schutzer. Advances in Serodiagnostic Testing for Lyme Disease Are at Hand. Clinical Infectious Diseases, 2017; DOI: 10.1093/cid/cix943
Possible new way to treat parasitic infections discovered
A chemical that suppresses the lethal form of a parasitic infection caused by roundworms that affects up to 100 million people and usually causes only mild symptoms has now been identified by researchers.
UT Southwestern Medical Center researchers have identified a chemical that suppresses the lethal form of a parasitic infection caused by roundworms that affects up to 100 million people and usually causes only mild symptoms.
“The approach we used could be applied generally to any nematode parasite, not just this one type,” said Dr. David Mangelsdorf, Chair of Pharmacology, an Investigator in the Howard Hughes Medical Institute (HHMI), and one of three corresponding authors of the study published in the Proceedings of the National Academy of Sciences. The study’s other corresponding authors are at two universities in Philadelphia.
“The plan is to develop better compounds that mimic the Δ7-dafachronic acid used in this study and eventually to treat the host to stop parasitic infection,” he added.
The Centers for Disease Control and Prevention (CDC) reports that the soil-dwelling Strongyloides stercoralis nematode, or roundworm, is the primary strongyloides species that infects humans. Experts estimate that between 30 million and 100 million people are infected worldwide, and most of them are unaware of it because their symptoms are so mild. The parasite can persist for decades in the body because of the nematode’s unique ability to reinfect the host, repeatedly going through the early stages of its life cycle. The nematode that causes the original infection exists in dirt on all continents except Antarctica, and it is most common in warmer regions, particularly remote rural areas in the tropics and subtropics where walking barefoot combined with poor sanitation leads to infection.
However, in people with compromised immune systems — such as those using long-term steroids for asthma, joint pain, or after an organ transplant — the mild form of the illness can progress to the potentially lethal form, a situation called hyperinfection. Studies indicate that mortality from untreated hyperinfection can be as high as 87 percent.
The World Health Organization reports that although the parasitic illness has almost disappeared in countries where sanitation has improved, children remain especially vulnerable in endemic regions due to their elevated contact with dirt. Further, the drug of choice, ivermectin, is unavailable in some affected countries.
“Ivermectin is used to treat the disease but is less effective in the lethal form of the infection,” said Dr. Mangelsdorf, a Professor of Pharmacology and Biochemistry. “We do not know exactly how the glucocorticoid [steroid] causes hyperinfection, but once it does, ivermectin is much less effective, prompting the search for new drugs. The new drug we used in our mouse model appears to be very effective,” he said.
To study the still unknown pathogenesis of the disease, the researchers developed a mouse model susceptible to the full range of infection by the human parasite. Because mice with intact immune systems are resistant to S. stercoralis infection, the researchers began with an immunocompromised strain of mice, and then exposed some to a synthetic steroid called methylprednisolone (MPA) that is commonly used to treat asthma in humans.
The mice were then exposed to the parasitic worms. Compared with untreated mice, those that received the steroid showed a tenfold increase in the number of parasitic female worms and a 50 percent increase in mortality, said Dr. Mangelsdorf, who holds both the Alfred G. Gilman Distinguished Chair in Pharmacology and the Raymond and Ellen Willie Distinguished Chair in Molecular Neuropharmacology in Honor of Harold B. Crasilneck, Ph.D.
In addition, third-stage larvae — the life cycle stage in which the worms can initiate hyperinfection — were found in higher numbers in the steroid-treated versus untreated mice, he added.
“Strikingly, treatment with a steroid hormone called Δ7-dafachronic acid, a chemical that binds to a parasite nuclear receptor called Ss-DAF-12, significantly reduced the worm burden in MPA-treated mice,” Dr. Mangelsdorf said. The Ss-DAF-12 receptor corresponds to a similar receptor in the long-studied C. elegans worm.
Dr. Mangelsdorf and colleagues previously showed (PNAS, 2009) that the DAF-12 receptor pathway is found in many parasitic species. They also showed that activating the receptor with Δ7-dafachronic acid could override the parasite’s development and prevent S. stercoralis from becoming infectious.
“Overall, this latest study provides a useful mouse model for S. stercoralis autoinfection and opens the possibility of new chemotherapy for hyperinfection by targeting the parasite’s own steroid hormone mechanism,” Dr. Mangelsdorf said.
- John B. Patton, Sandra Bonne-Année, Jessica Deckman, Jessica A. Hess, April Torigian, Thomas J. Nolan, Zhu Wang, Steven A. Kliewer, Amy C. Durham, James J. Lee, Mark L. Eberhard, David J. Mangelsdorf, James B. Lok, David Abraham. Methylprednisolone acetate induces, and Δ7-dafachronic acid suppresses,Strongyloides stercoralishyperinfection in NSG mice. Proceedings of the National Academy of Sciences, 2018; 201712235 DOI: 10.1073/pnas.1712235114
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