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If it's not clear by now, I am an advocate of early intervention. It's such a simple premise towards disease treatment: the earlier you intervene, the better your chances of reducing - and even preventing - disease. That's true on an individual/clinical level, as well - and more importantly - on a population level (a little understood paradox of the health insurance industry, for instance, is that they perceive disease prevention to be cost prohibitive, since the average enrollee only stays in plan for a few years, too short a time to wield any profit on preventive medicine). The basic principle of early intervention is that you identify risks of disease, rather than wait for causes or symptoms. And one fascinating result of that principle is that we now have a range of diseases which are fundementally risks. Metabolic syndrome, which I've written about, is one example; high cholesterol is probably the paragon of risk-based disease.

As I talk to people about the future of medicine and the future of public health, vis a vis genetics, one big caveat that always comes up is that, in this grand future when we can tap into our genetic profiles, we must have some way to protect that information so that it's not used against us - particularly in employment and insurance. Esther Dyson, for instance, speaking at Fortune's iMeme conference last week, said that protecting our genetic privacy looms as among the biggest impediments to letting this genetic information flourish. If we're afraid to let it out, for fear of it turning against us, we'll never be able to act on or learn from the information (even if we have the means to see it for a mere $1,000). The surprising thing here is that there is, in fact, a solution in the works: The Genetic Information Non-Discrimination Act, or GINA - pending federal legislation that would prohibit employment and insurance discrimination based on your genetic profile. Surprising, because this is, to my recollection, one of the rare occasions when Congress is getting ahead of a problem. Even though genomic sequencing for the common man is years off, and even though genetic testing now is by and large infrequent and often inconclusive, it's clear that, assuming the scientists are right, we will eventually need some sort of protection in place. Indeed,  the lack of privacy protections may actually slow the emergence of this genetic future, because companies are wary to venture into genetic testing unprotected. Pharmaceutical companies, for instance, have found it difficult to do clinical trials for genetics related drugs because of the perceived risks of genetic information floating out there.

I've ranted a bit before about how confusing is the steady onslaught of genetic associations to disease. Every day there seems to be a new genetic tag for another disease. Some diseases, though, have very clear and well-established genetic associations. Among the most researched is the connection between breast cancer and mutated BRCA genes (typically called BRCA1 and BRCA2). The generally accepted statistic is that between 5 and 10 percent of women with breast cancer will carry an altered BRCA gene. According to the National Cancer Institute, women with an altered BRCA gene have three to seven times higher chance of developing breast cancer than those without (altered BRCA genes are also associated with other cancers, including male prostate cancer). Women who have BRCA1 or BRCA2 gene changes have between a 36% and 85% chance of developing breast cancer and between a 16% and 60% chance of developing ovarian cancer during their lifetimes.

That's P as in "polio". This week the CDC's MMWR reports that worldwide polio rates were pretty much flat in from 2005 to 2006, at about 2,000 cases - this despite the WHO's Global Polio Eradication Initiative, which has set a date of 2010 for worldwide polio eradication. This 2010 date has been moved back several times, as the disease proves itself more tenacious than expected. The two-step-forward/one-step-back deadline history is rather fascinating, to me:

George Bush's former surgeon general told a House committee today that he was routinely muzzled from speaking out on public health issues by the White House.

On the one hand, no surprise: there's been no end of critique that this admininstration is hostile to science when it doesn't suit their politics. And he's not the first former official to complain once he's out from under their thumb.

I've always been fascinated with the art of crisis management - how companies strategize and react publicly (and behind the scenes) to negative publicity. So even though this is going around, I thought it worth a link: an internal memo from BlueCross on how to deflect the criticism's of Michael Moore's new movie, Sicko.

A stunning little chart in this week's MMWR from the CDC. If you're between 18 and 25 years old, your chances of dying from homicide exceed your chances of dying by suicide. For all older age groups, suicide far exceeds the risk of homicide.

Through the looking glass: A nice post in Wired Science, picking up on a New York Times story, that references a New York Times Magazine story, about a published piece of research, about... sending coded messages through DNA sequences.

Much in the news about methicillin-resistant Staphylococcus aureus, or MRSA. Seems this dangerous bug - which can cause fatal infections, and which loves the highly conducive atmosphere of a hospital - is 10 times more prevalent in hospitals than previously thought. The risk here is that these bacteria are hovering all over the place in hospitals, and have taken advantage of the highly sterilized environment to evolve ever more formidable strains. Meanwhile, hospitals are filled with people with compromised immune systems and open wounds who are particularly vulnerable to infection. If you're healthy, you could be exposed to these bacteria without any problem; our immune systems keep the bacteria in check. Indeed, many of us may have already been colonized with the bacteria - they're just sitting on our arms, and no Irish Spring will get rid of them. But they're no real threat, unless our immune systems somehow fall off guard or unless they somehow find a way in to more vulnerable tissue.

Ah, I don't mean "social diseases" as in that euphamism for sexually transmitted diseases - I mean social diseases meaning those which have a community component. To wit: ourhealthcircle.org, a new social-networking site around specific health or wellness topics. Sounds a lot like PatientsLikeMe, which I blogged about last month. One difference is the slightly broader spin of Our Health Circle. My hunch: expect to see lots more of this sort of thing. My wish: that these won't be merely 2.0 chat rooms, but will somehow find a way to compile and use the data.

Via ScienceRoll