Sometimes all we need is a quick suggestion from our peers to zero in on a good story. Here we turn to front-line journalists for advice, some simple insight to add to our repository of “shared wisdom.”
The number of syphilis and gonorrhea cases is on the rise in the U.S. How should a reporter go about covering sexually transmitted diseases and watch for an outbreak in their community? – Judy Stone, M.D.
It’s tough to get timely data regarding STDs or other infections. You often hear things anecdotally at first and then need to follow up. Check with local colleges and urgent care centers, where people might go for more timely care. Talk to local internists and nurses—ask what problems they are seeing. Ask your own physician, nurse or friends for insights.
Try to give social justice and political context for the rise in STD infections, such the recent cuts in public funding for women’s health. For example, 21 STD clinics closed in 2012 alone. Planned Parenthood closed in Scott County, Ind., fueling a sharp rise in HIV. The clinic had been the only location for HIV testing in the county. It’s critical to give that social and political context for your stories.
Health departments may lag with STD data, but here are some web sites with useful information:
The CDC’s STD social media feed: @CDCSTD on Twitter
Columbia University’s health information website on sexually transmitted diseases; Go Ask Alice!
Respected STD blog site: The STD Project has interviews with patients as well as many resources.
Judy Stone (@drjudystone) is an infectious disease physician and writer. She also conducted clinical trials, prompting her to write "Conducting Clinical Research: A Practical Guide: (available as an open access PDF as well as for purchase). She is a Forbes contributor writing about antibiotic resistance and infections, public health, and drug development.
Why should you pay attention to infectious disease threats among hospital workers? – Michele Cohen Marill
Medically fragile and immune-suppressed patients spend a lot of time in the hospital, where they face an additional threat of getting a hospital-acquired infection. But when it comes to tracking the emergence and spread of diseases, the nurses and other professionals who care for them may actually be the “canaries in the coal mine.” While health care workers take precautions to prevent transmission, they sometimes become infected and their own illnesses can reveal important information about emerging diseases.
For example, methicillin-resistant Staphylococcus aureus (MRSA) was primarily a threat in hospitals before it emerged in the community, and even today the Centers for Disease Control and Prevention is wrestling with how to handle health care workers who are either infected or colonized with MRSA. (Health care workers can carry the organisms without having any symptoms.)
The epidemic of severe acute respiratory syndrome (SARS) killed 1,707 health care workers worldwide in 2002 and 2003 — which represented about one in five deaths from the disease overall. More recently, hospital workers have become infected with Middle East respiratory syndrome coronavirus (MERS-CoV), a disease that is not easily transmissible. The World Health Organization plans to vaccinate at-risk health care workers in Africa with the experimental Ebola vaccine.
Occupational medicine physicians treat work-related injuries and illnesses, and every major hospital will have an occupational medicine physician. You can tap into their network.
Michele Cohen Marill (www.michelemarill.com) is an Atlanta-based health and medical writer. She is a contributing editor for Atlanta magazine and has been published in Stat, Nature Medicine, Proto, WebMD magazine, and AARP online, among other publications. She was previously editor of Hospital Employee Health, a newsletter for employee health professionals in hospitals.
How can reporters explore the cultural stories behind vaccine doubters? – Wendy Wolfson
There has been a campaign of anti-vaccine activists targeting specific communities, such as Somali parents in Minneapolis, Orthodox Jewish parents in California and parents of homeschoolers.
Whether the groups are secular or religious, these communities tend to have their own internal social networks. Journalists looking for a local angle on the vaccine debate may want to explore whether such campaigns, like this, exist in their communities.
Some of the questions to explore include the mentality behind these anti vaccine groups as well as why some parents may be vulnerable to vaccine nay-sayers. Explore the social factors unique to each community. They are vulnerable to anti-vaccine propaganda for very different reasons, but the common thread that is used is some kind of emotional appeal.
For example, the Somalis in Minneapolis had children who were affected with autism. Many of these parents already felt their concerns were not addressed by their health care providers and were willing to listen to people who said they cared about their health. In the Los Angeles Orthodox Jewish community, where outbreaks spread in Jewish day schools and Yeshivas, many people believed that measles was a mild disease and that not vaccinating children was their way of exercising choice over health based on misinformation spread by anti-vaccine groups.
In the case of the L.A. Orthodox community, public health officials worked with leaders in the orthodox community to explain that by vaccinating their children, they were adhering to Jewish law by protecting the vulnerable.
To find out more about vaccination rates in your community, the Centers for Disease Control and Prevention has excellent data here.
Wendy Wolfson is a science writer based in Irvine, Calif. She covers innovation in biotechnology, medicine and healthcare. She was a columnist for Chemistry & Biology (Cell Press), and freelance contributor to Nature Biotechnology, Science, Red Herring, The Lancet, Bio-IT World, Wired, The Boston Globe and CURE magazine. She can be reached at firstname.lastname@example.org.
What are a few tips for reporters covering global health issues? – Keren Landman
First, subscribe to Pro-MED Mail, a mailing list on global emerging diseases that provides broadly sourced, up-to-date information on outbreaks important to both human and animal health worldwide. The volume can be a little high, but there's no better way to stay ahead of the curve on emerging infections – except, perhaps, for actually working in global health.
Global health issues unfold in complex contexts that we often hear very little about in daily mainstream news – but understanding those contexts can greatly inform your reporting. Read about issues in global aid and development both on-topic and peripheral to global health: Devex and The Development Set are both good resources for development-related news, and the Economist and Foreign Affairs are good for more general global sociopolitical context.
Although it's best to report global health issues from the places where they're happening, that's not always possible. When finding sources from afar, note that while large multilateral organizations like the Centers for Disease Control and Prevention, the World Health Organization, and United Nations agencies may give you good high-level information, they may also avoid addressing problems related to aid delivery, or developments in an outbreak that reflect poorly on their organizations.
For more nuanced viewpoints, look to the small, non-governmental organizations on the ground, especially organizations aligning themselves with human rights work, or academics affiliated with institutions who have research collaborations in the area. And be prepared for slow email communication or communicating by text message – SMS is often the most reliable way to communicate in remote areas in low- and middle-income countries, and a phone call may be nearly impossible.
Keren Landman (@landmanspeaking) is a practicing physician and writer who covers topics in medicine and public health. She is trained in internal medicine and pediatrics with specialties in infectious diseases and clinical microbiology, and served as a disease detective at the U.S. Centers for Disease Control and Prevention. As a researcher, she has focused on the prevention and treatment of HIV and malaria in resource-poor countries, and she has worked as a medical epidemiologist at the New York City health department. She lives in Atlanta.
What advice do you have for journalists covering emerging diseases? – Kris Hickman
Word choice matters, especially when it comes to covering a deadly disease.
You may hear health professionals use the terms “infectious” and “contagious” interchangeably. That is adequate in many instances. However, minor differences between the two terms may play a role in which one you decide to use in a story. Contagious means a bacteria or virus can be transmitted from person to person (a communicable disease), and is quantified by R-nought, a mathematical construct that predicts the number of people a contagious individual will infect.
Infectious refers to how many bacteria, virus, or other pathogens are needed to infect an exposed individual. Ebola, for example, is not terribly contagious, but it is dangerously infectious. This matters in determining a person’s risk of contracting a disease.
Also be careful with the words “quarantine” and “isolation.” They both refer to separation, but are for different purposes. For example, people who are already infected with Ebola would be isolated, while quarantine is for those who have been exposed and may become sick, but aren’t sick yet.
Kris Hickman (@the_index_case) was a graduate research assistant for AHCJ, pursuing a master’s degree in public health. She has a bachelor's degree in anthropology, with a minor in journalism, from the University of Missouri. She spent two years in Zambia as an HIV/AIDS community education volunteer in the Peace Corps. She aspires to be an epidemiologist and science writer.
What is a good starting point when you are looking for new sources for covering the infectious disease beat? – Bara Vaida
This may go without saying, but read as many books as you can for context on the disease and experts to call. For example, are you covering mosquito-borne diseases? Read “Zika” The Emerging Epidemic” by Donald G. McNeil Jr. and “The American Plague: The Untold Story of Yellow Fever, The Epidemic That Shaped Our History” by Molly Codwell Crosby. If you are covering local hospitals, read “The Checklist Manifesto,” by Atul Gawande, and find out if your hospital has a surgical checklist and is using it. If it is late summer, and writing about the seasonal flu, read “Flu: The Story of the Great Influenza Pandemic of 1918,” by Gina Kolata. All these books will also help deepen the context of your reporting and expand your source list.
Bara Vaida (@barav) is AHCJ's core topic leader on infectious diseases. An independent journalist, she has written extensively about health policy and infectious diseases. Her work has appeared in outlets that include the National Journal, Agence France-Presse, Bloomberg News, McClatchy News Service, MSNBC, NPR, Politico and The Washington Post.
What are some of the best resources you use regularly to cover antibiotic resistance as story? – Maryn McKenna
What makes a good anecdote in a health story? – Liz Szabo
If readers see themselves, or someone they love, in the person’s story, that’s a good anecdote. Reporters need to look for characters, not just quotes. A good anecdote dramatizes a situation rather than simply describing it, but it also illustrates the larger story while conforming to — not contradicting — the evidence. Inappropriate anecdotes are those that are not part of any trend and which are unsupported by the evidence or outright contradict the evidence base, such as Jenny McCarthy’s use of her son Evan to suggest that vaccines cause autism, a “poster child” for using an anecdote irresponsibly because it goes against the evidence.
Liz Szabo, John A. Hartford Senior Correspondent for Kaiser Health News, is an enterprise reporter focusing on acute care and end-of-life issues. She has an extensive background in medical reporting, including 12 years as a health writer at USA Today. Her work has won awards from the Campaign for Public Health Foundation, the American Urological Association and the American College of Emergency Physicians. Szabo worked for the Virginian-Pilot for seven years, covering medicine, religion and local news.