Media and the Public Health Response

Recently, I have become interested in how the media influences the public health response and watched with fascination as the H1N1 saga unfolded. As Mike pointed out earlier, the New York Times has written about the recent transplant-related transmission of Balamuthia mandrillaris and whether this one-off event should change overall transplantation guidelines nationwide. I hope the NY Times' assertion that patients with undiagnosed neurological conditions should be barred from donating organs is analyzed and public health officials don't make a knee-jerk decision based on immediate/transitory media attention or political pressure.

Decisions like these are quite complicated and proper analysis can turn-up unexpected findings. Two years ago, I co-authored an article in the American Journal of Transplantation with Eugene Schweizer and others at the University of Maryland that analyzed what would happen if kidneys were transplanted from donors considered high-risk for HIV or Hepatitis C, yet had tested negative. The current practice is to discard these valuable organs. Our most surprising finding was that the total number of viral infections in recipients was actually LOWER with the policy of transplanting these organs. The reason? It turns out that discarding kidneys from high-risk donors led to more time on hemodialysis which resulted in a higher Hepatitis C incidence in recipients. The transplant policy also resulted in higher quality of life and lower cost of care.

Now, the NY Times article is quite balanced, but this won't necessarily stop public health officials from making decisions before a proper analysis is completed. Let's hope cooler heads prevail before a "national policy on whether to bar people with poorly defined neurological disorders as donors" is decided by officials and not scientists. The one thing that is certain is that there is nothing harder to define than a neurological condition.


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