Congo Ebola outbreak might soon be over
Tue, 02 Oct 2007 16:30:15 GMTBy MARIA CHENG, AP Medical Writer
LONDON - With only two patients left in an isolation ward Tuesday, doctors are hopeful an outbreak of the deadly Ebola virus in Congo may soon be contained.
But because people can carry Ebola for up to three weeks before getting sick, experts say it's too soon to consider the outbreak over.
"We are close to controlling the Ebola outbreak," Dr. Michel Van Herp, an epidemiologist with Medecins Sans Frontieres, said Monday. "But we remain vigilant because the virus is still circulating."
Van Herp recently spent three weeks helping track the virus in Kampungu, the outbreak's epicenter.
To date, health authorities have confirmed 24 cases and six deaths of Ebola. More cases are expected to be announced by Congo's Ministry of Health on Tuesday.
Officials at the World Health Organization first became aware of the outbreak in August. Since then, dozens of international epidemiologists and other public health experts have flown to Congo to help contain the virus.
Experts are encouraged with their education efforts about the disease.
They say the word is getting out about the importance of seeking medical help if people develop symptoms including a fever, muscle aches, intense weakness or a sore throat.
One woman recently walked into the isolation ward by herself after becoming symptomatic, said Dr. Dominique Legros, a medical epidemiologist from WHO.
"She didn't want to infect anyone else who might have had to carry her," he said from Congo. "We think that's a very good sign that the population understands how serious this is."
About 200 people are still being watched closely by health authorities. Every day, health teams visit about 20 villages within a radius of about 20 miles around Kampungu.
Fighting Ebola has been complicated by the presence of other diseases like shigella, typhoid, and malaria. All of those diseases have symptoms similar to Ebola in the early stages.
"Ebola is never a nice disease, and having other things to handle has made the outbreak more difficult," said Rosa Crestani, a nurse with Medecins Sans Frontieres who has been working in Kampungu. She spoke by phone from Congo.
The Zaire subtype of Ebola that has been detected in the Congo can kill up to 90 percent of people infected. The virus attacks the body's internal organs, and can cause bleeding from the ears, eyes and elsewhere.
Ebola is transmitted by close contact with infected animals or humans. Experts are not sure how the current outbreak began, but think that it may have started when villagers in the area ate an infected animal. It was then probably spread at several funerals, where people typically touch the body during the burial ceremony.
U.S. labs mishandling deadly germs
Tue, 02 Oct 2007 20:14:06 GMTBy LARRY MARGASAK, Associated Press Writer
WASHINGTON - American laboratories handling the world's deadliest germs and toxins have experienced more than 100 accidents and missing shipments since 2003, and the number is increasing as more labs do the work.
No one died, and regulators said the public was never at risk during these incidents. But the documented cases reflect poorly on procedures and oversight at high-security labs, some of which work with organisms and poisons that can cause illnesses with no cure. In some cases, labs have failed to report accidents as required by law.
The mishaps include workers bitten or scratched by infected animals, skin cuts, needle sticks and more, according to a review by The Associated Press of confidential reports submitted to federal regulators. They describe accidents involving anthrax, bird flu virus, monkeypox and plague-causing bacteria at 44 labs in 24 states. More than two-dozen incidents were still under investigation.
The number of accidents has risen steadily. Through August, the most recent period covered in the reports obtained by the AP, labs reported 36 accidents and lost shipments during 2007 — nearly double the number reported during all of 2004.
Likewise, the number of labs approved by the government to handle the deadliest substances has nearly doubled to 409 since 2004, and there are now 15 of the highest-security labs. Labs are routinely inspected by federal regulators just once every three years, but accidents trigger interim inspections.
In a new report by congressional investigators, the Government Accountability Office said little is known about labs that aren't federally funded or don't work with any of 72 dangerous substances the government monitors most closely.
"No single federal agency ... has the mission to track the overall number of these labs in the United States," said the GAO's report, expected to be released later this week. "Consequently, no agency is responsible for determining the risks associated with the proliferation of these labs."
The House Energy and Commerce investigations subcommittee plans hearings on the issue Thursday.
"It may be only a matter of time before our nation has a public health incident with potentially catastrophic results," said Rep. Bart Stupak, D-Mich., the panel's chairman.
Lab accidents have affected the outside world: Britain's health and safety agency concluded there was a "strong probability" a leaking pipe at a British lab manufacturing vaccines for foot-and-mouth disease was the source of an outbreak of the illness in livestock earlier this year. Britain was forced to suspend exports of livestock, meat and milk products and destroy livestock. The disease does not infect humans.
Accidents aren't the only concern. While medical experts consider it unlikely that a lab employee will become sick and infect others, these labs have strict rules to prevent anyone from stealing organisms or toxins and using them for bioterrorism.
The reports were so sensitive the Bush administration refused to release them under the Freedom of Information Act, citing an anti-bioterrorism law aimed at preventing terrorists from locating stockpiles of poisons and learning who handles them.
Among the previously undisclosed accidents:
_In Rockville, Md., ferret No. 992, inoculated with bird flu virus, bit a technician at Bioqual Inc. on the right thumb in July. The worker was placed on home quarantine for five days and directed to wear a mask to protect others.
_An Oklahoma State University lab in Stillwater in December could not account for a dead mouse inoculated with bacteria that causes joint pain, weakness, lymph node swelling and pneumonia. The rodent — one of 30 to be incinerated — was never found, but the lab said an employee "must have forgotten to remove the dead mouse from the cage" before the cage was sterilized.
_In Albuquerque, N.M., an employee at the Lovelace Respiratory Research Institute was bitten on the left hand by an infected monkey in September 2006. The animal was ill from an infection of bacteria that causes plague. "When the gloves were removed, the skin appeared to be broken in 2 or 3 places," the report said. The worker was referred to a doctor, but nothing more was disclosed.
_In Fort Collins, Colo., a worker at a federal Centers for Disease Control and Prevention facility found, in January 2004, three broken vials of Russian spring-summer encephalitis virus. Wearing only a laboratory coat and gloves, he used tweezers to remove broken glass and moved the materials to a special container. The virus, a potential bio-warfare agent, could cause brain inflammation and is supposed to be handled in a lab requiring pressure suits that resemble space suits. The report did not say whether the worker became ill.
Other reports describe leaks of contaminated waste, dropped containers with cultures of bacteria and viruses, and defective seals on airtight containers. Some recount missing or lost shipments, including plague bacteria that was supposed to be delivered to the Armed Forces Institute of Pathology in 2003. The wayward plague shipment was discovered eventually in Belgium and incinerated safely.
The reports must be submitted to regulators whenever a lab suffers a theft, loss or release of any of 72 substances known as "select agents" — a government list of germs and toxins that represent the horror stories of the world's worst medical tragedies for humans and animals.
A senior CDC official, Dr. Richard Besser, said his agency is committed to ensuring that U.S. labs are safe and that all such incidents are disclosed to the government. He said he was unaware of any risk to the public resulting from infections among workers at the high-security labs, but he acknowledged that regulators are worried about accidents that could go unreported.
"If you're asking if it's possible for someone to not report an infection, and have it missed, that clearly is a concern that we have," Besser said.
Texas A&M's laboratory failed to report, until this year, one case of a lab worker's infection from Brucella bacteria last year and three others' previous infection with Q fever — missteps documented in news reports earlier this year. The illnesses are characterized by high fevers and flu-like symptoms that sometimes cause more serious complications.
"The major problems at Texas A&M went undetected and unreported, and we don't think that it was an isolated event," critic Edward Hammond said. He runs the Sunshine Project, which has tracked incidents at other labs for years and first revealed the Texas A&M illnesses that the school failed to report.
Rules for working in the labs are tough and are getting more restrictive as the bio-safety levels rise. The highest is Level 4, where labs study substances that pose a "high risk of life-threatening disease for which no vaccine or therapy is available." Besides wearing wear full-body, air-supplied suits, workers undergo extensive background checks and carry special identification cards.
"The risk that a killer agent could be set loose in the general population is real," Hammond said.
In other lab accidents recounted in the reports, the Public Health Research Institute in Newark, N.J., was investigated by the FBI in 2005 when it couldn't account for three of 24 mice infected with plague bacteria. The lab and the CDC concluded the mice were cannibalized by other plague-infested mice or buried under bedding when the cage was sterilized with high temperatures.
The lab's director, Dr. David Perlin, told the AP it would be impossible for mice to escape from the building and said a worker failed to record their deaths.
"I feel 99 percent comfortable that was the case," Perlin said. "The animals become badly cannibalized. You only see bits and pieces. They're in cages with shredded newspaper. You really have to search hard with gloves and masks."
A worker at the Army's biological facility in Fort Detrick, Md., was grazed by a needle in February 2004 and exposed to the deadly Ebola virus after a mouse kicked a syringe. She was placed in an isolation ward called "The Slammer," but the Army said she did not become ill.
In other previously undisclosed accidents:
In Decatur, Ga., a worker at the Georgia Public Health Laboratory handled a Brucella culture in April 2004 without high-level precautions. She became feverish months later and tested positive for exposure at a hospital emergency room in July. She eventually returned to work. The lab's confidential report defended her: "The technologist is a good laboratorian and has good technique."
In April this year at the Loveless facility in Albuquerque, an African green monkey infected intentionally with plague-causing bacteria reached with its free hand and scratched at a Velcro restraining strap, cutting into the gloved hand of a lab worker. The injured worker at the Lovelace Respiratory Research Institute received medical treatment, including an antibiotic.
The National Animal Disease Center in Ames, Iowa, reported leaks of contaminated waste three times in November and December 2006. While one worker was preparing a pipe for repairs, he cut his middle finger, possibly exposing him to Brucella, according to the confidential reports.
A researcher at the CDC's lab in Fort Collins, Colo., dropped two containers on the floor last November, including one with plague bacteria.
A worker at Walter Reed Army Institute of Research-Naval Medical Research Center in Silver Spring, Md., sliced through two pair of gloves while handling a rat carcass infected with plague bacteria. The May 2005 report said she was sent to an emergency room, which released her and asked her to return for a follow-up visit.
States to challenge Bush over insurance
Tue, 02 Oct 2007 01:01:04 GMTBy TOM HESTER Jr., Associated Press Writer
EAST ORANGE, N.J. - Several states said Monday they would challenge the Bush administration in federal court over its new rules that block the expansion of a health insurance program for children from low-income families.
Arizona, California, Illinois, Maryland, New Hampshire, New Jersey, New York and Washington are joining in the litigation, either as plaintiffs or by filing supporting briefs.
The states object to rules issued by the Bush administration in August that make it harder for them to provide coverage to children in middle-income families by limiting the total income of families who participate.
The states accuse the administration of overstepping the federal government's authority to set income limits for participants in the State Children's Health Insurance Program.
The lawsuit and supporting briefs, which will be filed in federal district court for the Southern District of New York, are another battle between Democrats and the Bush administration over the program that covers 6.6 million children from modest-income families that aren't poor enough to qualify for Medicaid. The federal program was set to expire but has been temporarily continued until Congress and the administration can reach a funding agreement.
Democrats want to expand the program by $35 billion over five years, funded by new tobacco taxes, to allow a total of about 10 million uninsured children to participate nationwide.
Legislation recently passed by Congress would do that, but Bush has threatened to veto the measure.
"We are confident that our requirements are appropriate and will be sustained in a court of law," said Jeff Nelligan, a spokesman for the Centers for Medicare and Medicaid Services. "Our chief goal with SCHIP is to ensure that the poorest kids and those with no health insurance are placed at the front of the line."
The president wants to increase funding by $5 billion over five years. Democrats argue that wouldn't even cover the 6.6 million children currently enrolled.
New Jersey Gov. Jon S. Corzine told reporters that health insurance coverage for 10,000 poor children in his state is at stake.
"We frankly don't understand the administration's position," he said.
New Jersey's program, called FamilyCare, provides free and low-cost health care, immunizations, hospitalization, lab tests and X-rays, prescription drugs, dental and mental health services to 122,525 children and 89,050 adults. It costs the state $480 million per year, with $312 million paid for by the federal government.
Other governors expressed similar frustrations with the new policy.
"These barriers imposed by the Bush administration mortgage both the fiscal and health future of our nation," Maryland Gov. Martin O'Malley said.
New York Gov. Eliot Spitzer said the legal challenge was necessary.
"It sends a powerful and compelling message when the U.S. Congress, states across the nation and the public are so clearly committed to ensuring that families have access to affordable health care for their children."
Arizona Gov. Janet Napolitano's spokeswoman said the state has no direct stake in the dispute over the Bush administration's proposed rules but likely would file a supportive brief to the legal challenge.
In Napolitano's view, "this is just the right thing to do," spokeswoman Jeanine L'Ecuyer said.
___
Associated Press writer Brian Witte in Annapolis, Md., and Kevin Freking in Washington, D.C., contributed to this report.
Canadian court acquits in AIDS scandal
Mon, 01 Oct 2007 21:44:02 GMTBy ROB GILLIES, Associated Press Writer
TORONTO - A judge acquitted three doctors, a New Jersey company and a former Red Cross official of criminal charges Monday in a tainted-blood scandal that infected thousands of Canadians with HIV or hepatitis and resulted in more than 3,000 deaths.
Toronto Superior Court Justice Mary Lou Benotto ruled that the defendants did not show conduct displaying wanton and reckless disregard in the use of the blood and that there was no marked departure from the standards of a reasonable person.
"The conduct examined in detail over one and a half years confirms reasonable and responsible and professional actions and responses during this difficult time," she said. "The allegations of criminal conduct on the part of these men and this corporation were not only unsupported by the evidence, they were disproved.
"The events here were tragic," the judge said. "However, to assign blame where none exists is to compound the tragedy."
John Plater of the Canadian Hemophilia Society expressed bewilderment at the verdict, questioning how the judge could suggest that the defendants' actions "were somehow professional and reasonable."
"If you, on the one hand, have a study that says there's a problem, and on the other hand have a study that says maybe there isn't a problem, any reasonable person takes the product off the market. They didn't. People were infected, and people died," Plater said. "How that could be considered reasonable behavior is beyond us."
The case involved blood products produced by New Jersey-based Armour Pharmaceutical Co. in the 1980s and early 1990s that turned out to be infected. Also charged were Dr. Roger Perrault of the Red Cross; Dr. John Furesz and Dr. Donald Wark Boucher, formerly of Canada's Health Protection Branch, and Dr. Michael Rodell, a former vice president of Armour.
Perrault pleaded not guilty to criminal negligence causing bodily harm for allegedly giving hemophilia patients an HIV-infected blood-clotting product.
The other doctors and the drug company also pleaded not guilty. Lawyers argued that prosecutors didn't present enough evidence to prove its case.
A second trial for Perrault is set to begin later this year in Hamilton, Ontario, where he will face more criminal charges stemming from allegations that the Red Cross and its senior officials failed to take adequate measures to screen blood donors.
The Canadian Red Cross pleaded guilty in 2005 to distributing blood tainted with HIV and hepatitis C and was fined 5,000 Canadian dollars, which is now about $5,000. The Red Cross apologized and provided 1.5 million Canadian dollars for a scholarship fund and research project aimed at reducing medical errors.
Responsibility for Canada's blood supply for all provinces except Quebec was later transferred from the Canadian Red Cross to another entity, Canadian Blood Services. After a five-year investigation, police filed criminal charges.
Last year, the Canadian government announced a compensation package of 1 billion Canadian dollars for all those infected with hepatitis C from the tainted blood, expanding a previous program that excluded thousands of people.
Porn links found on British school39s website
Fri, 28 Sep 2007 22:54:01 GMTLONDON - A British school closed its website after links to hardcore pornography and impotence drugs were discovered on the parents' forum.
Other links guided parents towards online casinos and indecent images of US singer Britney Spears.
Cath Scallon, the deputy headteacher at Sandown High School on the Isle of Wight, off the mainland's south coast, said spam rather than parents or pupils appeared to be to blame.
&;It was the parents' forum which was affected. We did discuss whether to have it password-protected but we decided to leave it open so prospective parents could look at it,&; she said.
&;It's a shame because it was a positive thing with lots of interesting threads such as about school instruments and the school uniform.
&;But it appears that these links were added through Internet spam and if you do not check a site every 10 seconds this is what can happen.
&;We have taken it off for the moment because we do not want people to think these are the sorts of things we condone.&;
Parkinson39s and Alzheimer39s dementia very different
Tue, 02 Oct 2007 21:07:37 GMTNEW YORK - Dementia associated with Parkinson's disease is distinctively different from that seen in Alzheimer's disease, Norwegian researchers report in the Journal of Neurology, Neurosurgery and Psychiatry.
Dr. Kolbjorn Bronnick at Stavanger University Hospital, Norway, and colleagues conducted a neurological assessment of 488 patients with Parkinson's disease dementia and another 488 patients with Alzheimer's disease, using the Mini-Mental State Examination and the Alzheimer's Disease Assessment Scale-Cognitive Subscale.
The objective of the study by was to assess whether or not a diagnosis could be made based on the results of the cognitive profiles.
&;Both groups showed memory impairment, Alzheimer's disease patients performing worse than Parkinson's disease dementia patients,&; the investigators report. &;On the verbal memory tasks in the Alzheimer's Disease Assessment Scale-Cognitive Subscale, however, both groups were clearly impaired relative to a normal control group, with very large effect sizes.&;
&;Poor performance of the Alzheimer's disease patients on the orientation test in Alzheimer's Disease Assessment Scale-Cognitive Subscale best discriminated between the groups, followed by poor performance of the Parkinson's disease dementia patients on the attentional task in Mini-Mental State Examination,&; Bronnick's team found.
&;Diagnosis was predicted from the cognitive profile, with an overall accuracy of 74.7 percent,&; they report.
&;In conclusion,&; the researchers write, &;we found differential cognitive profiles in patients with Parkinson's disease dementia and Alzheimer's disease.&;
This strongly supports the hypothesis that Parkinson's disease dementia occurs through a mechanism that is quite different than the one associated with Alzheimer's disease, and that there exist pathological and physiological mechanisms specifically related to Parkinson's disease dementia.
SOURCE: Journal of Neurology, Neurosurgery and Psychiatry, October 2007.
