Public Health Genomics

About 180 million people worldwide are chronically infected with hepatitis C virus (HCV), with 3-4 million newly infected each year. Only 15-25% of acute HCV infections clear spontaneously, and the remainder persists as chronic HCV infection. More than 350,000 people die every year from hepatitis C-related liver failure and cancer. There is currently no vaccine and the standard-of-care therapies--peg-interferon alpha (pegIFN) plus ribavirin (RBV)--are expensive and have serious side effects. Also, they may be effective in only 40-50% of patients infected with HCV genotype 1, the most common HCV genotype in the US. Interleukin 28B (IL28B) genotype was recently and convincingly associated with response to pegIFN and RBV therapy. It has emerged as a robust pretreatment predictor of sustained virological response (SVR, i.e. virologic clearance) to pegIFN and RBV as well as to new triple therapy regimens that include a direct-acting antiviral agent with pegIFN and RBV and increase SVR rates as much as 75% in patients infected with HCV genotype 1. Testing for IL28B genotype may contribute to clinical decision-making and could inform clinical guidelines and public health policies.CC999999/Intramural CDC HHS/Intramural CDC HHS/United States2019-08-02T00:00:00Z23859951PMC66764836525vault:3360

Public Health Genomics

Genome sequences are available for 3 human-infecting malaria parasites, Plasmodium falciparum, P. vivax and P. knowlesi, and population genomics data are available for many endemic regions. This review summarizes how genomic data have been used to develop new, species-specific molecular targets for better malaria diagnosis. The combination of bioinformatics and genomics has been used to identify new sequence targets suitable for diagnostic applications and assess their viability within the context of global Plasmodium sequence variation. The selection criteria maximized the sensitivity and specificity of the novel targets. At least one target from each species was found to be suitable for molecular diagnosis of malaria with some advantages over existing molecular methods. The promise of using genome sequence data to develop sensitive, genus- or species-specific diagnostic methods for other pathogens of public health interest is strong. This undertaking together with what we envision as the future of malaria diagnosis in the 'omic' era is discussed.CC999999/Intramural CDC HHS/United States2015-12-29T00:00:00Z23548716PMC469456

Public Health Genomics

The field of public health genomics has matured in the past two decades and is beginning to deliver genomic-based interventions for health and health care. In the past few years, the terms precision medicine and precision public health have been used to include information from multiple fields measuring biomarkers as well as environmental and other variables to provide tailored interventions. In the context of public health, "precision" implies delivering the right intervention to the right population at the right time, with the goal of improving health for all. In addition to genomics, precision public health can be driven by "big data" as identified by volume, variety, and variability in biomedical, sociodemographic, environmental, geographic, and other information. Most current big data applications in health are in elucidating pathobiology and tailored drug discovery. We explore how big data and predictive analytics can contribute to precision public health by improving public health surveillance and assessment, and efforts to promote uptake of evidence-based interventions, by including more extensive information related to place, person, and time. We use selected examples drawn from child health, cardiovascular disease, and cancer to illustrate the promises of precision public health, as well as current methodologic and analytic challenges to big data to fulfill these promises.20192020-07-17T00:00:00ZCC999999/Intramural CDC HHS/United States31315115PMC6687519799

Public Health Genomics

For decades, newborn screening was the only public health program in the US focused on reducing morbidity, mortality and disability in people affected by genetic conditions. The landscape has changed, however, as evidence-based recommendations are now available for several other genomic applications that can save lives now in the US. Many more such applications are expected to emerge in the next decade. An action plan, based on evidence, provides the impetus for a new paradigm for public health practice in genomics across the lifespan using established multilevel processes as a guide. These include policy interventions, education, clinical interventions, and surveillance. Applying what we know today in hereditary breast/ovarian cancer, Lynch syndrome and familial hypercholesterolemia has the potential to affect thousands of people in the US population every year. Enhanced partnerships between genetic and nongenetic providers of clinical medicine and public health are needed to overcome the challenges for implementing genomic medicine applications both now and in the future.CC999999/Intramural CDC HHS/United States2016-02-10T00:00:00Z22986915PMC474871

Public Health Genomics

The genetic diversity among human immunodeficiency virus (HIV) subtypes as well as the variability of viral sequences found in HIV-infected individuals presents a number of difficult obstacles for the development of universally effective HIV treatment and prevention methods. Here, we present a brief summary of recent developments in the analysis of viral genetics and human genomics to provide insight into future methods for HIV treatment and prevention. Recent studies have mined viral sequences found in newly infected individuals to identify common features of all transmitted viruses that could provide potential targets for HIV vaccine development. Analysis of human immunogenetics has identified specific alleles associated with reduced virus loads in HIV-infected individuals providing valuable information that may influence individual responses to treatment and prevention methods. Increased sensitivity of antiretroviral drug resistance testing has improved the detection of hidden drug resistant virus but also highlighted the potential for drug resistant viruses to reduce the effectiveness of clinical treatment regimens. The rapidly expanding amount of data generated by studies of viral genetics and human immunogenetics will provide valuable information to guide the design of new strategies to improve clinical treatment and enhance HIV vaccine development.CC999999/Intramural CDC HHS/United States2017-08-07T00:00:00Z23548715PMC554568

Public Health Genomics

BackgroundThe growing availability of genomic information to the public may spur discussion about genetics and genomics on social media. Sites, including Twitter, provide a unique space for the public to access and discuss health information. The objective of this study was to better understand how social media users are sharing information about genetics and genomics in health and healthcare and what information is most commonly discussed among Twitter users.MethodsWe obtained tweets with specific genetics- and genomics-related keywords from Crimson Hexagon. We used Boolean logic to collect tweets containing chosen keywords within the timeframe of October 1, 2016, to October 1,2017. Features of the software were used to identify salient themes in conversation, conduct an emergent content analysis, and gather key demographic information.ResultsWe obtained 347,196 tweets from our search. There was a monthly average volume of 28,432 tweets. The five categories of tweets included: genetic disorders/disease (45.3%), health (15.6%), genomics (8%), and genetic testing (7.3%). Top influencers in the conversation included news outlets and universities.ConclusionsThis content analysis provides insight about the types of conversation related to genomics and health. Conversations about genomics are occurring on Twitter, and they frequently emphasize rare genetic diseases and genetic disorders. These discussions tend to be driven by key influencers who primarily include news media outlets. Further understanding of the discussions related to genomics and health in social media may offer insight about topics of importance to the public.CC999999/Intramural CDC HHS/United StatesZ99 CA999999/NULL/Intramural NIH HHS/United States2019-05-08T00:00:00Z30466105PMC65049266242vault:3211

Public Health Genomics

CC999999/ImCDC/Intramural CDC HHS/United States2019-08-29T00:00:00Z30814471PMC6715129661

Office of Public Health Genomics state public health genomics programs

Implementing Evidence-based Genomic Tests and Family Health HistoryOver 1 million Americans are at increased risk for early-onset cancer due to one of two genetic conditions:\u2022 BRCA-associated hereditary breast, ovarian, and other cancers (BRCA);\u2022 Lynch syndrome (LS)\u2014hereditary colorectal, endometrial, ovarian, and other cancers; andMost people with these conditions are not aware they have them, yet early detection and intervention could save their lives.State public health genomics programs are helping to reach people at risk by implementing evidence-based recommendations.Innovative State Public Health Genomics Programs: Since 2008, CDC, through the Office of Public Health Genomics (OPHG) and the Division of Cancer Prevention and Control (DCPC), has supported state genomics programs in Michigan, Oregon, Georgia, and more recently Utah, Connecticut and Colorado, to implement evidence-based genomics recommendations.implementation_factsheet.pd

Public Health Genomics: The Essentials. By Claudia N. Mikail

The sequencing of the human genome in 2001 provided researchers, clinicians, policymakers, ethicists, and public health practitioners with a myriad of information to potentially improve disease outcomes on an individual and population basis. Genomics is a burgeoning field of study that examines the interactions among the genetic material in the human body, including interactions with environmental and behavioral factors. The role of public health in this new field of study is complementary, since population trends, health disparities, and the social determinants of health contribute to our understanding of the underlying causes of disease provided by genomic research. Thus, the new discipline of public health genomics has improved our ability to carry out the health professional’s mission to promote health and prevent disease. Public Health Genomics: The Essentials is a recent book that describes this emerging ‘‘interface between science and society.’

The evolution of public health genomics: Exploring its past, present, and future

Public health genomics has evolved to responsibly integrate advancements in genomics into the fields of personalized medicine and public health. Appropriate, effective and sustainable integration of genomics into healthcare requires an organized approach. This paper outlines the history that led to the emergence of public health genomics as a distinguishable field. In addition, a range of activities are described that illustrate how genomics can be incorporated into public health practice. Finally, it presents the evolution of public health genomics into the new era of “precision public health.