CDC's 'zombie apocalypse' advice an Internet hit (AP)

ATLANTA � "Zombie apocalypse." That blog posting headline is all it took for a behind-the-scenes public health doctor to set off an Internet frenzy over tired old advice about keeping water and flashlights on hand in case of a hurricane.

"You may laugh now, but when it happens you'll be happy you read this, and hey, maybe you'll even learn a thing or two about how to prepare for a real emergency," wrote Dr. Ali Khan on the emergency preparedness blog of the federal Centers for Disease Control and Prevention.

Above the post is a photo of what appears to be a dirty-fingered female zombie.

Khan's postings usually draw 1,000 to 3,000 hits in a week. This one � posted Monday � got 30,000 within a day. By Friday, it had gotten 963,000 page views and was the top item viewed on the agency's Web site, thanks in part to media coverage that began mid-week.

As of Friday morning, the traffic showed no signs of abating.

"The response has been absolutely excellent. Most people have gotten the fact that this is tongue-and-cheek," Khan said.

More important, CDC officials said, it is drawing interest from teens and young adults who otherwise would not have read a federal agency's guidance on the importance of planning an evacuation route or how much water and what tools to store in case a major storm rolls in.

The idea evolved from a CDC Twitter session with the public earlier this year about planning for disasters. Activity spiked when dozens of tweets came in from people saying they were concerned about zombies.

Dave Daigle, a veteran communications specialist, proposed the idea of using a zombie hook to spice up the hurricane message. Khan, director of emergency preparedness, approved it immediately and wrote it himself.

"Most directors would have thrown me out of their office," Daigle laughed. "Ali has a good sense of humor."

In the blog, Khan discussed what fiction has said about flesh-eating zombies and the various infectious agents that different movies have fingered as the cause.

His favorite zombie flick is "Resident Evil," but his interest in unpredictable terrors is driven more by his decades of work tracking real-life infections like Ebola hemorrhagic fever, bird flu and SARS.

CDC officials said the feedback they've gotten is almost completely positive, including a nice note from the boss, Dr. Tom Frieden.

Almost as rewarding was a nice comment Daigle said he received from his 14-year-old daughter, who has shown little interest in her dad's work but saw the zombie post and said, "This is cool!"

There have been few comments asking whether this is the best way for the government to spend tax dollars. The agency is under a tight budget review at the moment and facing potentially serious budget cuts. But the zombie post involved no extra time or expenditure, CDC officials said.

"We have a critical message to get out and that is CDC saves lives while saving money. If it takes zombies to help us get that message out, then so be it," said agency spokesman Tom Skinner.

Whether the message sticks still has to be determined. The agency is planning a follow-up survey to see if people actually did prepare emergency kits or follow Khan's other advice.

CDC deserves credit for trying something like this, said Bill Gentry, director of the community preparedness and disaster management program at the University of North Carolina's school of public health.

But that doesn't mean the agency should start using vampires to promote vaccinations or space aliens to warn about the dangers of smoking.

"The CDC is the most credible source out there for public health information," he said. "You don't want to risk demeaning that."

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Online:

CDC's emergency preparedness blog: http://bit.ly/ikth7k

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Kept in chains: Mental illness rampant in Somalia (AP)

MOGADISHU, Somalia � Hassan Qasim lies shackled to a wall in a hallway with 25 other patients at a clinic for the mentally ill. He whispers under his breath and spits at his neighbors. Torn and dirty clothes hang off his skinny frame.

Doctors say the 25-year-old's brother and sister were killed in front of him, and that he was abducted and tortured by gunmen. Soon after, Qasim began wandering the streets naked, lashing out at passers-by.

In this Horn of Africa nation that has been mired in anarchy and war for two decades, nearly all families have been touched by tragedy. The World Health Organization estimates that one in three Somalis have suffered from some kind of mental illness, a rate that is among the highest in the world.

Gunfire crackles every few seconds in Mogadishu at night, and mortars scream out of the sky.

"We believe every bullet or mortar will cause more people to become mentally ill," said Dr. Abdirahman Ali Awale, a Somali psychiatrist.

Somalia's civil war also has simultaneously destroyed health care infrastructure to treat the traumatized. A World Health Organization report found that the country has only three psychiatrists and no psychologists working at its five main mental health facilities.

As a result, some Somalis have been chained up in mental wards for as long as eight years, according to the WHO. At one mental health facility, almost 50 percent of patients were chained. At other clinics, doctors recite the Quran to patients, hoping it will improve their condition.

This year, WHO began giving medicine and other supplies to the Habeb mental hospital, the only facility that treats patients without detaining them.

"Our treatment is chain-free. We never restrain them," said Dr. Abdirahman Habeb. He says the facility has treated more than 9,000 psychiatric patients using a combination of medicine and counseling. Still, the majority of mentally ill people in Somalia face much grimmer prospects.

The Somali government, which is consumed by political infighting and battling an al-Qaida-linked insurgency, is unable to even assert control over all of Mogadishu much less help its traumatized population. It relies on 9,000 African Union peacekeepers to retain control of half the country's capital.

Dr. Rizwan Hamayun, who helped write a WHO study earlier this year examining mental health in Somalia, said the chaos has resulted in a loss of jobs, family, homes and property which in turns can contribute to mental illness. His latest new patient was a shepherd who attempted suicide after losing all his animals not to war but to a natural calamity � an ongoing drought.

While poverty and fear are the main triggers for mental illness, some also have been intimidated by continuous threats made by insurgents over mobile phones. Insurgents call and threaten people they suspect of collaborating with the government. As punishment for alleged crimes, insurgents saw off captives' hands and feet in public squares and stone people to death.

The insurgents accused Ibrahim Nuraddin of selling phone credit, bread, and other small items to Somali soldiers. The elderly former shopkeeper had a mental breakdown after receiving frequent death threats, relative Ibrahim Farabadn said.

Nuraddin had already spent one year imprisoned in his family's house or tied to a tree. Finally, relatives sought treatment after hearing that a Mogadishu clinic was taking patients. Three hefty men dragged Nuraddin into the clinic but he struggled to escape. They quickly chained him up.

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Home births up, driven by natural birth subculture (AP)

ATLANTA � Home births rose 20 percent over four years, government figures show, reflecting what experts say is a small subculture among white women toward natural birth.

Fewer than 1 percent of U.S. births occur at home. But the proportion is clearly going up, study by researchers at the Centers for Disease Control and Prevention found. The new figures are for 2004 to 2008. Home births had been declining from 1990 to 2004.

The increase was driven by white women � 1 in 98 had their babies at home in 2008, the most recent year for which the statistics were available.

Only about 1 in 357 black women give birth at home, and just 1 in 500 Hispanic women do.

"I think there's more of a natural birth subculture going on with white women � an interest in a low-intervention birth in a familiar setting," said the lead author, Marian MacDorman of the CDC's National Center for Health Statistics.

For all races combined, about 1 in 143 births were at home in 2008, up from 1 in 179 in 2004.

Geographically, 27 states had significant increases during those four years. Montana, Vermont and Oregon had the most home births � about 1 in 50 births were at home in those states.

Alaska's rate was nearly as high, and it's clear that some home births occur because women are in remote locations and are not able to get to hospitals in time for delivery.

The increase is notable because doctors groups have been increasingly vocal about opposing home births, The American College of Obstetricians and Gynecologists has for years warned against home births, arguing they can be unsafe, especially if the mother has high-risk medical conditions, if the attendant is inadequately trained or if there's no quick way to get mother and child to a hospital if something goes awry.

Doctor participation in home births declined by 38 percent from 2004 to 2008. The percentage of home births attended by certified midwives and nurse-midwives grew, meanwhile.

Home births increasing? "From our perspective, that's not the best thing for the overall health of babies and women," said Dr. George Macones, an obstetrician at Washington University in St. Louis who chairs ACOG's Committee on Obstetric Practice.

Exactly how unsafe home births are is a matter of medical controversy, with studies offering conflicting conclusions. And some argue that hospitals present their own dangers of infection and sometimes unnecessary medical interventions.

The CDC researchers did find that home births involving medical risks became less common from 2004 to 2008. Home births of infants born prematurely fell by 16 percent, so that by 2008 only 6 percent of all home births involved preterm births. That's less than half the percentage in hospitals.

The study was done by two CDC researchers and a Boston university professor. It was electronically published Friday by a medical journal called Birth: Issues in Perinatal Care.

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