Shorts: MPox, polio, miscarriage, and mental health
September 12, 2024
1. Mpox outbreak reported in an Iowa prison
Iowa officials have confirmed that they have diagnosed at least one case of mpox in a correctional facility. They have not stated how many cases have been found. Infectious diseases found in prisons can spread to the general population, and hopefully this prison will mount an aggressive vaccination campaign. Here’s a link to a post on mpox from last week, and an article we published in Harvard Business Review (2022).
2. Polio outbreak in Gaza
At least one case of paralytic polio was diagnosed in Gaza, and the United Nations has embarked on a vaccination campaign to try to prevent future spread. Polio has been eliminated from most of the world, although the disease tends to come back during wars, due to civilian displacement and lack of access to proper sanitation and clean water. There was a case of paralytic polio in New York state in 2022 that was imported; a widespread vaccination program prevented further spread although poliovirus was detected in wastewater. Those who are traveling internationally for business or pleasure should be sure that their vaccinations, including polio, are up to date. Here are some resources for employers on polio:
Center for Disease Control and Prevention: About Polio
Advisory Committee on Immunization Practices: Polio Vaccine Recommendations
European CDC Polio Fact Sheet
Kaiser Health News Frequently Asked Questions
3. Miscarriage is common, and abortion bans could threaten care
Researchers in Health Affairs calculated that there are 1,034,000 miscarriages each year in the US, where there are 3.7 million live births annually. Many miscarriages lead to expulsion of the nonviable fetus without medical intervention, although the researchers point to previous research that between 10-35% of miscarriages require some intervention. The medical treatment for a miscarriage is to remove any nonviable fetal tissue to avoid risk of infection or other complications. This can be done with medications that encourage expulsion of this tissue, or through a procedure where nonviable tissue is evacuated from the inside of the uterus. Medical and surgical interventions for miscarriage are the equivalent to either a medical or a procedural abortion. In fact, in medical parlance, a miscarriage is called a “spontaneous abortion.”
Restrictions on the use of mifepristone and misoprostol, two drugs used for both abortions and to treat miscarriages, could require more surgical interventions, which are increasingly difficult to obtain in states with severe restrictions or bans on abortions. Employers should recognize that obtaining appropriate local care for miscarriages could become increasingly difficult in many states. Some members might need to travel, and others might be at increased risk of hospitalization and complications.
4. Mental health patients held against their will
The New York Times reported last weekend that a for-profit mental health hospital system that has been accused of keeping patients against their will to maximize insurance reimbursement. This is harmful to those patients and exacerbates the shortage of mental health beds. This demonstrates that prior authorization in some instances can help protect vulnerable patients. Employers can ask their health plan if this system is part of their current network.
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Illustration by Dall-E