General Motors OnStar to work with CDC
Wed, 21 Mar 2007 05:08:53 GMTBy KEN THOMAS, Associated Press Writer
WASHINGTON - General Motors Corp.'s OnStar service is working with the Centers for Disease Control and Prevention to help emergency responders more effectively treat crash victims.
On Wednesday, the automaker was scheduled to announce a partnership with federal health officials to create guidelines, expected in 2008, for the use of real-time crash data to help emergency services provide a more targeted response to those injured in a car accident.
GM's OnStar system alerts emergency rescue officials when an air bag deploys or the vehicle is struck in a moderate to severe crash. Subscribers can also receive driving directions, roadside assistance and other services.
Emergency responders could benefit from the OnStar system because its sensors transmit real-time data pinpointing where a vehicle was struck, whether it rolled over or if it was hit several times.
That type of precision can help emergency officials make the "absolutely critical decision" of whether to send a crash victim to a Level I trauma center, which provides the highest level of trauma care, said Dr. Richard Hunt, who leads the http://www.onstar.com
Millions of flu shots to be destroyed
Wed, 21 Mar 2007 08:22:54 GMTBy MARILYNN MARCHIONE and MIKE STOBBE, AP Medical Writers
Millions of doses of flu vaccine will expire at midnight June 30, unsold during this year's mild flu season and written off as trash. Still perfectly good, and possibly useful for a few more years, the vaccine will wind up being destroyed. This annual ritual is supposed to ensure that Americans get the most up-to-date vaccine, but the leftovers — more than 10 million of a record 110 million doses produced — will be destroyed before a new supply is guaranteed.
An Associated Press examination of this long-standing practice raises questions about its consequences. For years, policymakers have talked about letting doctors keep unused vaccine until new doses are in hand, donating leftover supplies to poor countries, or pushing back the expiration date. Wasted vaccine means lost money for drug companies and one stopped making flu shots because of it — setting the stage for a flu shot shortage in 2004.
Having no vaccine in the summer deprives travelers of the chance to get a shot before they visit places where flu is in season. It also prevents summer vaccinations for children, who need two doses the first time around.
"All of those issues have come up in the past," but there is a strong reluctance to change policy, said Dr. William Schaffner of Vanderbilt University, a government vaccine adviser. "These ideas clearly have merit and at the very least ought to be discussed."
The June 30 expiration date is set by the federal Food and Drug Administration and has less to do with the vaccine's shelf life than with the desire to tweak the recipe each year to include the three strains causing the most cases.
Manufacturers test throughout a flu season to ensure the vaccine stays potent, but they don't test beyond June 30 because it's assumed that new vaccine will be made, said Len Lavenda, spokesman for Sanofi-Aventis SA, which supplies most of the nation's flu shots.
However, vaccine degrades very slowly and not into anything harmful, said Dr. Peter Patriarca, a scientist who formerly worked for vaccine maker MedImmune Inc. and once headed the FDA's vaccine division. Patriarca says most vaccines would be stable for another year or two years, some as long as three or four.
The June 30 date is mostly to ensure that all old vaccine is gone before new doses come out.
"What they don't want to have happen is people inadvertently getting vaccinated with last year's vaccine," because it will not be as effective since it targets older strains, he said.
"There is some benefit to a system where unused vaccine is discarded even if it hasn't really lost that much potency," said Dr. John Treanor, a vaccine expert at the University of Rochester in New York.
Old vaccine could be a tough sell if one of the strains is not well-matched to what's expected to circulate. "You'd have to tell people next year that the vaccine they got could be inferior," said Dr. Walter Orenstein, a vaccine expert at Emory University.
One more argument for the current system: Straying from a set expiration date for an entire season's vaccine would probably cause a huge headache for those trying to manage vaccine supplies, and for manufacturers trying to calculate the following season's demand, added Dr. Carolyn Bridges of the federal Centers for Disease Control and Prevention.
But there also is risk in destroying old before new is available — the first shipments are usually by early fall.
After the 2002-03 season, Wyeth Pharmaceuticals had to destroy a third of the 20 million doses it produced because of low sales. The company lost about $35 million and then dropped out of the flu shot business. A national shortage followed in October 2004, when Chiron Corp. lost a manufacturing license that deprived the nation of half of its flu shot supply during the height of vaccination season.
Although there are more suppliers now than then, brewing vaccine takes six months at best and remains vulnerable to the vagaries of millions of chicken eggs and a fragile production system.
Stockpiling leftover vaccine until new vaccine is available "doesn't sound like an unreasonable thing to be doing," said another vaccine scientist, Dr. Robert Belshe at St. Louis University. After all, usually only one of the three vaccine strains changes — often, only slightly. Twice in the last decade, the recipe didn't change at all, said Alexander Klimov, a CDC flu strain expert.
And three times in the last decade, the vaccine strains recommended for the United States in one winter were identical to what was recommended for the Southern hemisphere the following summer, he said.
Also, several recent studies showed that even poorly matched vaccine can still be highly effective — something to consider amid worries about bird flu and efforts to stockpile vaccine to protect in a pandemic.
Dr. Stuart Brown, Georgia's director of public health, suggested a second wave of flu shots every spring and availability of one season's shot into the following summer.
"That would allow us to purchase just as much vaccine as we need and maybe a little more," he said, without worrying as much about losing money and tossing vaccine if deliveries don't arrive until November or later.
Georgia got less than half of its flu shot orders by Nov. 1 last year, and expects to have thousands of doses left this spring.
Despite a big 'Flu Shots Available' banner outside his Atlanta pharmacy, Ira Katz says few customers are interested this time of year and he's left with about 40 doses. "We're not at all hurting for vaccine, that's for sure," he said.
"This past year, the demand definitely was down," said Jean Ellis of the Visiting Nurse Associations of America. Many late-season orders were canceled, and lots of vaccine remains on shelves. Doctors and VNA clinics will get a refund of taxes paid but will still lose about $10 per dose. Losses of up to $20,000 a season have caused some clinics to quit offering shots.
As long as public demand falls short of supply and manufacturers can make enough fresh vaccine, "there doesn't appear to be any reason to hang on to it," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
Even better, Fauci said, would be a universal, permanent flu vaccine effective for all strains of the virus, something his office has been researching.
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Marilynn Marchione reported from Milwaukee, Wis., and Mike Stobbe reported from Atlanta.
Exercise helps prevent falls in elderly
Wed, 21 Mar 2007 02:45:14 GMTBy JAMIE STENGLE, Associated Press Writer
DALLAS - Like a lot of people, former flight attendant Mary Nicholson wasn't an exerciser. But two years ago she changed all that — at age 71. For Nicholson, part of the motivation to exercise was to be strong and agile enough to avoid a fall. "I'm bound and determined I'm not going to fall and break a bone," she said during a workout that included balancing on one leg, working with weights and stair-climbing.
Nicholson says she feels better, is stronger, and her balance is much improved.
With one in three adults over the age of 65 falling each year, experts say that people should follow Nicholson's lead as they get older.
In 2004, the most recent year statistics are available, almost 15,000 people 65 and older died from falls and about 1.9 million were treated for injuries in emergency rooms, said Judy Stevens, an epidemiologist with the Centers for Disease Control and Prevention.
"I think the magnitude of the problem is something that people don't recognize," Stevens said. "It really is a serious issue for older adults."
Making sure that people over the age of 65 know how to avoid falling or being injured by a fall is the goal of a campaign launched this month by the National Athletic Trainers' Association and American Academy of Orthopaedic Surgeons.
The organizations say in addition to exercise, older people can make their homes safer by installing night lights, bathroom grab bars and slip-resistant floors.
"If we continue to exercise, especially strength training, we decrease the loss of bone density. Just by working on strength training, you're working your muscles to keep strong," said Joe Scott, a NATA member who is outpatient orthopedic team leader for Southcoast Hospitals Group in New Bedford, Mass.
Scott said that as people get older, they're less active so they lose strength. Also, sight and balance problems can creep in.
Stevens also said it's a good idea for older people to have a doctor review their medicines each year to look for things like drug interactions that could lead to dizziness.
Experts say certain exercises — yoga, tai chi, and trying to balance on one leg with your eyes closed — can help improve balance.
If a younger person slips, they'll usually catch themselves, but older people often have less strength and slower reaction times, experts say.
Injuries from falls in the elderly can include broken wrists, elbows, arms and hips, said Dr. Jay Mabrey, chief of orthopedics at Baylor University Medical Center in Dallas.
"We don't heal as quickly when we're older," Stevens said. "The older a person is when they fall, the harder it is to recover. For very elderly people, it can be devastating."
Nicholson said that before joining the Baylor Tom Landry Fitness Center two years ago, she was not an exerciser.
"I just gradually got into it," said Nicholson, who works out with a trainer twice a week takes classes three times a week, including working out in water.
She said she now just pops up off the couch instead of having to hoist herself up and she's able to confidently walk a straight line.
"I wanted good balance and the strength that goes along with it," she said. "You just feel more secure."
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On the Net:
American Academy of Orthopaedic Surgeons: http://www.orthoinfo.org
National Athletic Trainers' Association: http://www.nata.org
Centers for Disease Control and Prevention: http://www.cdc.gov/injury
Japan drug firm Tamiflu not for teens
Wed, 21 Mar 2007 09:59:43 GMTBy CHISAKI WATANABE, Associated Press Writer
TOKYO - Japanese doctors were warned on Wednesday against prescribing Tamiflu to teenagers after several young patients taking the bird flu-fighting drug reportedly exhibited dangerous behavior.
The Health Ministry issued emergency instructions Tuesday to a Japanese Tamiflu distributor, Chugai Pharmaceutical Co., to warn doctors not to give the drug to teenagers, a Chugai official said on condition of anonymity, citing protocol.
Chugai began distributing warnings to doctors, hospitals and pharmacies across Japan on Wednesday, the official said.
Martina Rupp, a spokeswoman for Swiss manufacturer Roche Holding AG, said the company didn't understand the Japanese government's rationale for the action.
"No causal relationship has been established between Tamiflu and these reports, and we don't see this as an appropriate course of action," Rupp told The Associated Press.
Concerns over Tamiflu, also known as oseltamivir, have spiked in Japan after a boy and a girl, both 14, fell to their deaths from their condominiums while taking the drug in separate incidents in February.
The U.S. Food and Drug Administration has said it received more than 100 reports of delirium, hallucinations and other unusual psychiatric behavior, mostly in Japanese children treated with Tamiflu, between Aug. 29, 2005, and July 6, 2006. The Japanese government has not released detailed figures.
The FDA added a new precaution to Tamiflu's label in November, bringing the U.S. label more in line with the Japanese one that already warned that such abnormal behavior could occur.
Both Roche and the FDA have said that severe cases of the flu can spark the abnormal behavior displayed by some patients.
Two 12-year-old boys also taking Tamiflu both broke legs after jumping out of their houses in separate incidents in February and March, the official said.
Tamiflu, one of the few drugs believed to be effective in treating bird flu, is widely used in Japan to treat influenza.
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Associated Press Writer Eliane Engeler in Geneva contributed to this report.
