by Madeline Sturgeon •
Although the residents of Flint,
Mich., had been complaining for
months about the color, smell
and taste of the community’s water, state and local o;cials maintained the water supply was safe.
Mona Hanna-Attisha, M.D.,
M.P.H., FAAP, however, was not
A dinner party conversation
with a water-quality expert stoked
the Flint pediatrician’s curiosity
and compelled her to seek evidence that would prove the water
supply was toxic.
“As the stewards of these chil-
dren, it is our responsibility to
protect them,” said Dr. Han-
na-Attisha, a mother of two. “When there is a clear
violation of public health that is going to impact
these kids today and forever, we couldn’t not do
With help from colleagues and the AAP Mich-
igan Chapter, Dr. Hanna-Attisha uncovered the
data to support her suspicions. A pediatrician at
Hurley Children’s Hospital, Dr. Hanna-Attisha
had access to a large body of routine blood test
records. She started investigating, and what she
found was disturbing: The percentage of Flint
www.aapnews.org Volume 36 • Number 12 • December 2015
See Water, page 4
In this issue
How antibiotics in animals hurt humans
Using low doses of antibiotics to promote growth in food
animals is big business. An AAP technical report uncovers
the science of how it has led to increased antibiotic resistance. Pages 22-23.
Chapters Views and News
Legislation to mandate
garners chapters response
from the AAP Department of Community,
Chapter and State Affairs
During the 2015 state legislative sessions, lawmakers again delved into the contentious issue of
cytomegalovirus (CMV) screening for newborns
who fail an infant hearing test.
Four states introduced bills that initially focused
on mandated screening for CMV in these infants
and were modeled after a Utah law that took e;ect
in 2013. No evidence, however, supports treatment
of newborns who test positive for CMV but are
otherwise asymptomatic. In addition, treatment
currently is limited to o;-label use of the antiviral
drug valganciclovir, which carries potential risks.
In response to concerns by AAP chapters and
others within the physician community, state
legislators amended provisions that would have
created screening and treatment requirements
that are not evidence-based.
“Unfortunately, when legislatures try to fix
practice standards into law, the law tends not to
keep up with scientific changes,” said William M.
McDonnell, M.D., J.D., FAAP, who lived in Utah
when the CMV legislation was
enacted and is chair of the AAP
Committee on Medical Liability and Risk Management.
“Clinicians practicing in the
best, most up-to-date fashion
may then face increased medical malpractice liability risk. If
states continue down this path,
it may threaten our ability to practice medicine in a
manner consistent with the best available science.”
In their response to the proposed legislation,
AAP chapters sought to balance the concerns of
families about infant hearing loss and the need
to ensure evidence-based practices — which do
not support screening of newborns for CMV
who fail an infant hearing test but are otherwise asymptomatic — are reflected in state law.
Ultimately, Connecticut, Hawaii, Illinois and Texas
enacted legislation this year requiring their state departments of public health to educate the public on
how to prevent the transmission of CMV. A similar
bill introduced in Tennessee was not enacted.
See Chapters, page 20
Pediatrician proves Michigan community’s
water was poisoning children
Photo courtesy of Doug Pike
“Nobody listened to the mom, to the activist, to the water expert. But when the
pediatrician spoke, that’s when the game changed.” said Mona Hanna-Attisha,
M.D., M.P.H., FAAP, after convincing state officials to remedy the toxic water
supply poisoning children in her community.
Record number energized at
85th AAP National Conference
The advocacy and education-filled event united
more than 10,000 professionals who assembled
in Washington, D.C., for the annual AAP National
Conference. The meeting and exhibition drew attendees from across the nation, as well as more
than 2,000 international attendees.