Public Health

Philadelphia's only school of public health had been open for just two years when it lost its first dean in the fiery crash of Swiss Air Flight 111 off the coast of Nova Scotia in 1998. Then came the watchdogs from Drexel University, who took over management of the foundering school after its parent company, Allegheny health systems, declared bankruptcy. "The School of Public Health was losing a couple million dollars a year when we took it over," recalled Constantine Papadakis, Drexel's president.

Delaware County residents will be able to see the full results of the study done by the Johns Hopkins Bloomberg School of Public Health by the end of next week, officials said yesterday. A public meeting will be scheduled by mid-April. "We just want to do a little bit of homework before we go into a public meeting to make sure everyone [on the County Council] understands the contents of the study," Council Chairman Jack Whelan said. The county is trying to arrange for the lead Johns Hopkins investigator and members of the county Health Advisory Board to attend the public meeting, he said.

"On a typical day in Philadelphia," begins the recently released Pew Charitable Trusts report on public health in Philadelphia, "six babies are born to adolescent mothers; eight infants are delivered who weigh less than 5.5 pounds, and there are 29 reports of child abuse. "On a typical day," it continues, "49 people are admitted to a publicly funded treatment program for drug or alcohol abuse (21 of them for cocaine); 12 new gonorrhea cases are diagnosed in teens, and two new cases of AIDS are reported.

In the city with the country's worst outbreak of measles, only two City Council members bothered to show up last week to hear City Health Commissioner Maurice Clifford deliver his austerity budget request. Two members - Council President Joe Coleman and Councilman John Street. They heard the health commissioner say that cuts would cause the waits for doctor's appointments at some clinics to grow by six weeks. That means, in many cases, a total wait of nine weeks. Not for measles shots, particularly.

Three years ago Shoshanna Goldin underwent treatment at Children's Hospital of Philadelphia for a brain tumor that was strangling her vestibular nerve, making walking difficult. The tumor was benign, but it took Goldin three years to recover. She had to learn to walk again. The tumor left behind another lasting effect: a burning desire to help others by unraveling medical mysteries. Goldin, 17, who lives in Allentown and is a junior at Moravian Academy, is one of two high school students in the area who pursued everyday health questions to the finals of the Young Epidemiology Scholars Competition, which ended Sunday in Washington.

A woman who is 20 going on 40 stands on a littered sidewalk a few miles from Center City. She'll provide sex if a man comes along with 15 bucks; then she'll use the money to buy and shoot cocaine. Thanks to coaxing from city- paid health workers, she might use condoms with her "johns" and she'll probably clean the needle with bleach. Those precautions could save other people's lives, but not hers. She's pregnant and infected with the AIDS virus, with a 30 to 50 percent chance of passing it to her newborn.

Wall Street delivered the strongest testimonial to David Kessler's leadership of the Food and Drug Administration: Tobacco stocks surged on the news that he's stepping down. Investors were betting that his successor won't be so hard on tobacco's lethal product line. Anybody interested in public health - and that should be a universal concern - ought to insist that Dr. Kessler's successor be equally committed. With his degrees in medicine, business and law, Dr. Kessler brought extraordinary expertise to the musty, demoralized FDA. More important than his smarts, however, was his zeal to turbocharge the agency in the public interest.

It started with a sick little kitty, but before it was over, police were called in, state Health Department officials were calling for the kitten's head, and its stubborn owner was pleading to wait and see. The state won. Little "Fluf" was humanely put to sleep, her head was removed and her brain was analyzed. The veterinarian's worst suspicion was confirmed: The kitten had rabies, the result of a nasty scuffle last month with a rabid raccoon. This week, Fluf became Camden County's 77th documented rabies case since 1989.

The public had no right to know that Liberace died of AIDS nor should anyone's medical records be released without the patient's informed consent, medical officials argued in a public forum here yesterday. That right to privacy extends to celebrities, politicians and individuals carrying the AIDS virus and should never be abridged unless a substantial public health risk can be demonstrated, top experts from the American Medical Association and other health groups said. Dr. James Todd, the AMA's senior deputy executive vice president, strongly defended the sanctity of medical records and chastised the media for its "insatiable desire to know what's going on. " "Of what benefit is it to the general public to know that Liberace died of AIDS?"

Everyone agrees it's long past time for Pennsylvania to begin collecting data on people with HIV infections. State and city health officials and AIDS activist groups concur that HIV - the infectious period that precedes full-blown AIDS - should be reported just like a host of other diseases ranging from AIDS to syphilis to TB. A person can have HIV for 10 years or more before developing AIDS. The sufferer may seem healthy but is presumed infectious the entire time. Yet Pennsylvania's health officials can't track the trend of this deadly disease because they don't know how many people have HIV and who they are. Without that information, it's impossible to plan effective prevention outreach for groups most at risk.