Jun 6, 2022 | Featured, Global Health, Infectious Diseases, Your Health
Mpox—a rare disease caused by the monkeypox virus that results in fever and a blistery rash—has been in the news lately. Normally found in parts of Africa, an increasing number of mpox cases have been confirmed in Europe and the United States. In this Q&A, Bernard Camins, MD, Medical Director for Infection Prevention at the Mount Sinai Health System, says most people shouldn’t be too worried about mpox, but calls for a bit of vigilance by physicians and the public. “It’s good to just inform people, even though the likelihood of the average person living in New York being exposed to someone with mpox is low,” Dr. Camins says.
What is mpox?
The monkeypox virus is a virus that is in the same family as smallpox and cowpox. As you probably know, smallpox was eradicated years ago. But we do have to worry about mpox every now and then.
Should I be concerned about mpox?
Most of us should not really worry about getting exposed to or getting mpox. The current situation is that some people who have traveled to countries in Europe or Africa have been exposed to people with mpox, and potentially they could be at risk for also having mpox. These returning travelers have exposed other people within their social circles, so there are reports of people contracting mpox who have not left the United States. You should only worry about mpox if you know someone who has symptoms of mpox or who has been diagnosed with mpox.
Click
here to read the latest travel advisory on mpox from the CDC
What are the symptoms of mpox?
The hallmark of mpox is a rash, but before the rash appears, people can have a fever and a feeling of malaise or tiredness. Another hallmark is “diffuse lymphadenopathy” or enlarged lymph nodes. So if you do have fever and enlarged lymph nodes, and you were exposed to someone suspected of having mpox or someone who has been diagnosed with mpox, then you need to seek medical care.
What should doctors do if they see a patient with mpox symptoms?
If a doctor suspects a patient has mpox, even before the rash appears, we instruct them to isolate the person in a private room. The medical team will then wear personal protective equipment that includes an N95 respirator, gowns, and gloves, and then they will do an extensive interview. We need to know the details of the patient’s interactions with people who may have mpox. One of the key things that decides if someone needs to be tested is whether they have an epidemiological link to someone with mpox—meaning that either they traveled abroad and were exposed to someone with mpox or that they are at high risk for having mpox. While mpox is not usually considered a sexually transmitted infection, the latest outbreak has been observed among sexual partners.
Why are we talking about mpox now?
While mpox is a viral infection that is rare, a large outbreak has occurred in the United States before, in 2003. Mpox is endemic in Africa, meaning it is normally found there, but because we have a lot of people traveling around the world, it is spreading in countries where it is not endemic.
You can get more information about mpox and the latest updates from the New York City Department of Health and Mental Hygiene and the Centers for Disease Control and Prevention.
Feb 25, 2020 | Featured, Global Health
Keynote speaker Karenna Gore with conference host Robert Wright, MD, MPH.
Global warming is having an increasingly profound effect upon human health, making it harder to breathe, giving rise to more infectious diseases, and even lowering nutritional levels in our food supply.
These were among the many consequences cited on Friday, January 24, when the Institute for Exposomic Research at the Icahn School of Medicine at Mount Sinai hosted its second annual Clinical Climate Change Conference at the New York Academy of Medicine. The event drew more than 150 clinicians and other members of the U.S. medical community.
“Health care professionals are on the front lines of this planetary health problem,” which is having a disproportionate effect on “the poor, the marginalized, the elderly and infirm, and nonhuman life,” said Karenna Gore, the Conference’s keynote speaker, and the founder and Director of the Center for Earth Ethics at Union Theological Seminary.
She told the audience, “This is no ordinary time and we are together in not knowing how it will turn out. We need you to warn, and we need you to heal.” Ms. Gore is the daughter of former U.S. Vice President Al Gore, who received the 2007 Nobel Peace Prize for his work on climate change.
Robert Wright, MD, MPH, the Ethel H. Wise Chair of the Department of Environmental Medicine and Public Health, Director of the Institute for Exposomic Research, and Professor of Pediatrics at the Icahn School of Medicine at Mount Sinai, said exposomics—a new field of science that uses technology to measure an individual’s total environmental exposures over their lifetime—could help physicians understand the effects of global warming.
Satellites, for example, are used to help measure a person’s external exposure to air pollution, whereas mass spectrometry is used to measure an individual’s internal chemical exposures. As the field matures, Dr. Wright said, exposomic data will be used more widely to determine cause and effect and monitor the success of interventions.
Dr. Wright shared information from the U.S. Centers for Disease Control and Prevention (CDC), which highlighted the negative impact of extreme heat and air pollution on cardiovascular health and asthma and showed that warmer weather would lead to an increase in tick-and-mosquito-borne illnesses such as Lyme disease and the Zika virus, since insects could live and breed in more places.
Conference attendees gathered at the New York Academy of Medicine in New York City.
As a point of reference, Dr. Wright cited the European heat wave of 2003, which led to tens of thousands of deaths. France, he said, had the highest temperatures and the most deaths. Another example, he said, was chronic kidney disease of unknown origin, a progressive loss of kidney function that has killed more than 20,000 people in Central America over the past 10 years, most of whom were agricultural workers.
“The leading theory of the cause,” he said, “is a combination of dehydration and pesticide exposure. With climate change and higher temperatures, workers may be dehydrated for longer periods of time.”
Lewis Ziska, PhD, Associate Professor of Environmental Health Sciences at the Columbia University Mailman School of Public Health, and a former plant physiologist at the U.S. Agricultural Service, said increasing levels of carbon dioxide in the atmosphere were creating an imbalance in many plant species that people consume. Rice, wheat, potatoes, and barley, he said, were all showing a decline in protein, nitrogen, sulfur, zinc, and iron. Extreme weather-related events that take place in one part of the continent also affect the health of people living thousands of miles away.
Allan C. Just, PhD, Assistant Professor of Environmental Medicine and Public Health at the Icahn School of Medicine, discussed the unprecedented Canadian wildfires of 2015, which followed a hot, dry spring. The forest fires burned millions of acres and displaced thousands of people, mainly in Saskatchewan. Airborne particles from the fires spread to the Eastern United States, he said, and led to unsafe levels of air pollution in cities as far away as Baltimore.
In her closing remarks, Ms. Gore reminded the audience of the earth’s interconnectedness. “The climate crisis is a force that will ultimately spare no one,” she said. “Solving it should be a unifying cause.”
Updated on Mar 5, 2020 | Featured, Global Health
Pathology technicians at work in the new laboratory at John F. Kennedy Medical Center in Monrovia, Liberia.
The only pathology laboratory in Liberia recently opened, thanks to a collaboration led by Ann Marie Beddoe, MD, MPH, Director of Global Women’s Health and Associate Professor of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai. The laboratory, which became operational in October 2019, is a crucial step in rebuilding the health infrastructure in Liberia after years of civil war. “The impetus for founding this laboratory was our mission to improve women’s health,” Dr. Beddoe says. “But this is not just for women or for cancer. This is something that will benefit the entire country.”
In an event attended by President George Weah of Liberia, the 4,000-square-foot laboratory at the John F. Kennedy Medical Center in Monrovia, Liberia, was dedicated in July 2019, along with an imaging center donated by the National Institutes of Health and an infectious disease center donated by the United States Agency for International Development. The new facilities are part of an overarching mission to provide evidence-based care in Liberia, which was wracked by civil wars for more than a decade. Around 2006, Ellen Johnson Sirleaf, then president of Liberia, noted that only 50 physicians were left in the nation of more than 4 million people, and she sent out a call for volunteers to help restore health care. In 2008, Dr. Beddoe was part of a group from Mount Sinai who answered that call, led by Jeffrey S. Freed, MD, Clinical Professor of Surgery, Icahn School of Medicine at Mount Sinai; and Eileen Solomon, Senior Director, Special Events, Mount Sinai Health System. “Our early teams recognized the need for gynecologic oncology services, and Dr. Beddoe had the courage and fortitude to make it happen,” says Dr. Freed, who has made many trips to Liberia to care for patients there.
From the beginning, Dr. Beddoe was struck by the prevalence of cervical cancer in Liberia. “Women would walk to the clinic, or come in strapped to motorbikes, and when we examined them, we found they were dying of cervical cancer,” she says. “I couldn’t walk away from this.” Low-income nations bear most of the burden of cervical cancer because industrialized nations benefit from widespread prevention, screening, and early treatment. For example, among more than 500,000 new cases of cervical cancer each year, only 14,000 are in the United States, Dr. Beddoe says. In addition, cancer carries a stigma in Liberia. “We couldn’t really treat these patients,” she says. “Nobody even acknowledged that they had cancer.”
Over the years, she has returned to Liberia every few months to work with physicians there to improve the diagnosis and treatment of cancer. The first step in securing any health care funding from the Liberian government is building a registry to document the nation’s cancer burden, Dr. Beddoe says. The creation of the pathology laboratory, where diseases can be diagnosed through the analysis of body fluids and tissues, is integral to this effort.
Ann Marie Beddoe, MD, MPH, at the dedication of the laboratory with Jerry Brown, MD, Chief Executive Officer of the John F. Kennedy Medical Center.
The $250,000 facility was built in a suite of storage rooms at JFK Medical Center and funded partly by The Women Global Cancer Initiative, a nonprofit led by Dr. Beddoe. Sakura Finetek USA, a pathology supply company, donated equipment, including a tissue processor and slide stainer, and Mount Sinai donated computers and printers, and a year’s worth of “consumable” supplies, such as reagents, alcohol, blades, and gloves.
Staffing the laboratory presented a challenge. Licensed clinical laboratory technicians—known as histotechnicians—are crucial to a pathology laboratory, and there were none in Liberia. So in 2019, four Liberians were trained by the American Society of Clinical Pathology, a crucial partner in the project. JFK Medical Center hired two physicians specializing in pathology, and other physicians at the hospital are being trained in handling and labeling specimens and in the discipline of evidence-based medicine.
“I am 99 percent sure that when I see a cervical cancer, it’s a cervical cancer, but that is not the way to introduce cancer care to a country that is trying to do things right,” Dr. Beddoe says. “Having pathology, and good diagnoses, will start generating more research, which is what you need to provide good medicine.”
Mount Sinai’s Division of Global Women’s Health focuses on the long term in its overall mission to improve research and clinical care. “We try to do a lot of capacity building—training people, and focusing on ongoing, sustainable projects,” Dr. Beddoe says. Her years of dedication were acknowledged at the ceremony in July, when the pathology laboratory was dedicated in her name.
Oct 21, 2019 | Community, Featured, Global Health
On a tour of The Mount Sinai Hospital, from left: Che-Kai Tsao, MD, Medical Director, Ruttenberg Treatment Center, The Tisch Cancer Institute, and Associate Professor of Medicine (Hematology and Medical Oncology), Icahn School of Medicine at Mount Sinai; Madame Zhang Ai Ping; Tao Xu, MD, Medical Director, Mount Sinai International, and Assistant Professor of Medicine (Hospital Medicine), Icahn School of Medicine; Ambassador Huang Ping; and Xing Jijun, MD, Science and Technology Counselor, Consulate General of China in New York.
Ambassador Huang Ping, Consul General of China in New York, took a wide-ranging tour of The Mount Sinai Hospital, sponsored by Mount Sinai International, an organization within the Mount Sinai Health System that is dedicated to advancing health care around the world. The ambassador, who is one of the highest-ranking Chinese officials in the United States; his wife, Madame Zhang Ai Ping; and a group of consular officials were hosted on Tuesday, September 17, by Arthur A. Klein, MD, President of the Mount Sinai Health Network, and Szabi Dorotovics, MD, MBA, President of Mount Sinai International. The group also met with David L. Reich, MD, President and Chief Operating Officer, The Mount Sinai Hospital; and Shirish Huprikar, MD, Chief Medical Officer, The Mount Sinai Hospital.
The Taikang Xianlin Drum Tower Hospital in Nanjing, China, recently began a 10-year strategic collaboration with Mount Sinai International. The consular group was guided by two Icahn School of Medicine physicians who serve as “workstream leaders” in the collaboration: Che-Kai Tsao, MD, Medical Director, Ruttenberg Treatment Center, The Tisch Cancer Institute, and Associate Professor of Medicine (Hematology and Medical Oncology); and Tao Xu, MD, Medical Director, Mount Sinai International, and Assistant Professor of Medicine (Hospital Medicine).
“The United States and China face many common challenges in medicine and health,” Dr. Klein said. “Mount Sinai and China have extensive and long-lasting relationships in clinical care, scientific research, and medical education.”
From left: Xing Jijun, MD, Science and Technology Counselor, Consulate General of China in New York; Arthur A. Klein, MD, President of the Mount Sinai Health Network; Ambassador Huang Ping; Madame Zhang Ai Ping; and Szabi Dorotovics, MD, MBA, President of Mount Sinai International.
Mar 6, 2018 | Community, Global Health
Dennis S. Charney, MD, left, and Kevin Chason, DO, far right, with the volunteers who attended the reception, front row from left: Colleen Fischer, RN; Emma Kaplan-Lewis, MD; Tamairi Vildoso, RN; and Stacy A. Conklin, MSN, MS, RN. And back row from left: Sarah Schaefer, MD; Melanie Pratts, RN; Erin Hogan, RN; Trina Cosme, RN; Christine Mahoney, MS, RN; and Madeline Hernandez, RN.
The 20 physicians, nurse practitioners, and nurses who participated in two medical relief missions to Puerto Rico in October following the devastation of Hurricane Maria were saluted by Mount Sinai leadership at a reception Wednesday, January 17, held on The Mount Sinai Hospital campus.
The volunteers—representing all hospitals in the Mount Sinai Health System—were part of a massive effort involving the New York State Governor’s Office and the Department of Health, along with the U.S. Department of Health and Human Services, the Greater New York Hospital Association, the Healthcare Association of New York State, the New York State Nurses Association, and 1199 SEIU.
“For long hours, you worked in makeshift clinics, you helped several thousand American citizens cope with the loss of hygienic living conditions and the scarcity of critical medicines, and you brought humanity back to those who felt they had been forgotten,” Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai, and President for Academic Affairs, Mount Sinai Health System, told the volunteers.
“You did not know what to expect, where you would be, the types of patients you would treat, or the conditions where you would live,” added Kevin Chason, DO, Clinical Director of Emergency Management, Mount Sinai Health System, and Assistant Professor of Emergency Medicine, Icahn School of Medicine at Mount Sinai. “Still, you managed to experience something few are able to do today in the practice of medicine—you were able to feel what it is like to practice medicine in the purest form.”
Volunteers were presented with an inscribed keepsake from Mount Sinai leadership recognizing their contributions. The Mount Sinai Health System also received a plaque, which was unveiled at the reception, from Governor Andrew Cuomo and others that thanked the Mount Sinai Health System and said, in part: “Your work exemplifies health care providers’ highest values of service and caring.”
Feb 5, 2018 | Community, Global Health
Sandeep Kishore, MD, PhD
The Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai has partnered with the drug company Teva Pharmaceutical Industries to address the increasing incidence of multiple chronic conditions (MCCs) among adults worldwide, an issue tied to decreased quality of life and rising health care costs.
Mount Sinai and Teva announced the collaboration at the World Economic Forum’s Sustainable Development Impact Summit in New York City last fall. At the event, Teva introduced data showing that globally one in three adults, and two in three adults over the age of 65, have MCCs—defined as having two or more chronic conditions, such as hypertension, high cholesterol, diabetes, asthma, obesity, substance use disorders, and anxiety. The study showed that in the United States, patients with MCCs account for more than 70 percent of total health care spending, and that health care costs almost double with each additional chronic condition. The study also showed that MCCs greatly reduce a patient’s ability to comply with medication, increase the likelihood of depressive symptoms, and increase the burden of care placed upon families and health facilities.
Under the leadership of Sandeep Kishore, MD, PhD, Associate Director at The Arnhold Institute for Global Health, Mount Sinai will work with Teva to research innovative primary care models that coordinate treatment of different conditions across providers, using behavioral economics to simplify medication adherence. Mount Sinai also will help advance technology-based solutions such as apps to monitor and manage symptoms and side effects. Initially, patients will be drawn from Mount Sinai’s outpatient Peak Health program, which assigns teams of physicians, nurses, social workers, and coordinators to care for people with MCCs.
