The USA began 2013 in the midst of a severe flu season. Then came renewed concern over improving mental health care in response to a mass shooting. And communities across the USA this year saw outbreaks of measles in areas with low vaccination rates.
With no new blockbuster drugs or breakthroughs in cancer and heart disease, many experts say that public health issues such as these dominated health news in 2013.
The flu hit early last year, killing 169 children and sickening an estimated 32 million Americans of all ages, according to the Centers for Disease Control and Prevention. More than 381,000 Americans were hospitalized during the 2012-13 flu season.
"The past year reminded us that flu really has unparalleled potential to do great harm," says CDC director Thomas Frieden. "It reminded us that we are all connected by the air we breathe."
New bird flu
World health officials became alarmed in March by the emergence of a deadly new strain of bird flu in China, called H7N9. Most of those infections were related to infected poultry. And most cases were severe, with about one-third of patients dying.
So far, the virus hasn't acquired the ability to spread easily from person to person, according to the World Health Organization. While the Chinese have developed vaccines, they "aren't great," Frieden says, because they require multiple doses and an adjuvant, or additional substance to boost immune response.
Frieden sounded the alarm this year about a family of "nightmare" superbugs - untreatable and often deadly - spreading through hospitals across the USA. Many doctors fear that it may soon be too late to stop the spread of the bacteria, known as carbapenem-resistant Enterobacteriaceae, or CRE.
"These are nightmare bacteria that present a triple threat," Frieden said in March. "They're resistant to nearly all antibiotics. They have high mortality rates, killing half of people with serious infections. And they can spread their resistance to other bacteria."
A USA TODAY investigation also found that MRSA (methicillin-resistant Staphylococcus aureus) bacteria, once confined to hospitals, are emerging in communities to strike an increasing number of children, as well as schools, prisons and even NFL locker rooms.
In April, the Obama administration launched an initiative, akin to the Human Genome Project, to map human brain cell activity. The project triggered disagreement among neuroscientists over whether such an effort is warranted or whether it threatens other, more vital research.
Fewer HIV-positive babies
There was good news in the global fight against AIDS. In March, doctors announced that they have cured the first baby of HIV, the virus that causes AIDS. The baby girl contracted HIV at birth from her mother. After treatment, the girl - now 2½ years old - remains HIV-free, according to doctors at the University of Mississippi Medical Center.
And in June, Secretary of State John Kerry announced the birth of the millionth baby born HIV-free because of the President's Plan for Emergency AIDS Relief, or PEPFAR. The 10-year-old aid program, launched by George W. Bush, pays for treatment, testing and counseling for millions of Africans every year.
In June, the White House hosted a National Conference on Mental Health, part of the Obama administration's response to the December 2012 mass shooting in Newtown, Conn. Thirty-six states and the District of Columbia increased funding for mental health, and in December, the White House announced $100 million in federal funding. In November,the Department of Health and Human Services issued final rules on implementing a 2008 law guaranteeing that insurance plans provide equal coverage for mental and physical health.
A national outbreak of antibiotic-resistant salmonella that began in October has sickened more than 416 people in 23 states as of mid-December, and is hospitalizing people at double the rate expected. Salmonella is a type of bacteria that can cause diarrhea, cramps and fever and sometimes chills, nausea and vomiting for up to seven days.
The outbreak is linked to Foster Farms-brand chicken. The seven strains of salmonella Heidelberg involved in the outbreak appear to be especially virulent. Thirty-nine percent of those who fell ill have been hospitalized, compared with the usual 20% hospitalization rate with salmonella, according to the CDC. A 2012 outbreak in 13 states that sickened 134 people with the same type of salmonella was also linked to Foster Farms.
"We never seem to have a shortage of food-borne outbreaks," says Douglas Powell, a food safety researcher who tracks outbreaks on barfblog.com. "The Foster Farm salmonella outbreak was sort of unique because it shows the 'Just cook it' message doesn't really work. People got sick from cooked Costco chickens" because of cross-contamination between raw meat and rotisserie chickens.
Growing concerns over dietary supplements
Both retailers and regulators expressed growing concern over the safety of dietary supplements, particularly those claiming to help people burn fat and build muscle.
In July, retail giant Wal-Mart announced that it would stop selling a popular sports dietary supplement on its website in the wake of a USA TODAY investigation. The investigation found that the product's maker, Matt Cahill, is a convicted felon who has a history of putting risky supplements on the market.
In November, USPlabs recalled its OxyElite Pro sports supplement, which was linked to an outbreak of serious liver injuries, including one death and some cases that have required transplants.
Two universities coped with outbreaks of bacterial meningitis this year, with four cases among students at the University of California-Santa Barbara and eight cases among students or visitors at Princeton University. One of the Santa Barbara students had both feet amputated because of the infection, caused by a strain of meningococcal bacteria not included in the standard vaccine. Princeton got special permission to administer a vaccine approved in Europe that does protect against this strain of bacteria.
In November, the Food and Drug Administration announced plans to take artificial trans fats entirely out of the food supply. Removing trans fats could save up to 7,000 lives and prevent up to 21,000 heart attacks a year, Frieden says.
In other heart news, leading cardiology associations in November announced new guidelines on the use of statins that would double the number of Americans taking the cholesterol-lowering drugs. About 31% of adults would take statins, according to the guidelines, developed by the American College of Cardiology and the American Heart Association, in collaboration with the National Heart, Lung and Blood Institute.
FDA warns controversial doctor
The FDA in December sent a strongly worded warning to a controversial Houston doctor who was the subject of a USA TODAY investigation. The doctor, Stanislaw Burzynski, has been treating patients with an unapproved drug through an FDA-sanctioned clinical trial since 1996. The FDA put that trial on hold, however, after the death of a 6-year-old New Jersey boy.
Diseases moving north
Doctors reported the spread of a number of infectious diseases whose ranges are expanding or shifting because of climate change. These expanding threats include Valley Fever, tick-borne illnesses and a brain-eating amoeba, health officials said.
As the year ended, the World Health Organization announced the first case in the Western Hemisphere of chikungunya virus, a painful, mosquito-borne disease that originated in Africa.