Ark. officials promote getting flu shots
Fri, 05 Oct 2007 21:32:25 GMTBy PEGGY HARRIS, Associated Press Writer
LITTLE ROCK - As cooler weather approaches, Arkansas health officials are stressing the importance of flu shots to two groups in particular — young children and pregnant women.
The two groups are among those most threatened by the virus, as are the elderly and those with heart trouble, diabetes, weakened immune systems or other serious health problems.
But young children are the main "distributors" of influenza, said Dr. James Phillips, branch chief of infectious diseases for the state Health Department. They shed the highly contagious virus in greater amounts and for longer periods of time, so the agency is hoping to vaccinate more children this season, ages 6 months to 5.
In addition, the deaths of three pregnant women in Arkansas from the flu last season impressed upon officials the importance of getting the word out that flu shots can save lives.
The flu vaccine poses no danger to a woman's pregnancy or the baby, Phillips said. In the three cases last season, the babies survived while their mothers got fatally sick. "And that, of course, is a very sad and preventable situation," Phillips said.
Phillips said obstetricians this year have undertaken a deliberate campaign to try to get more pregnant women vaccinated for the flu.
A person can get the virus any time of the year, but the greatest number of cases occur from mid-December to early March. Phillips said the importance of the flu shot is reflected in the number of deaths each year, which varies greatly depending on the number of people vaccinated and the virulence of the organism.
"What kind of year we're going to have is impossible to predict," he said.
The department provided figures Friday by calendar year, instead of by flu season. The state recorded four deaths in 2001; nine in 2002; 33 in 2003; seven in 2004; 14 in 2005; nine in 2006, including one of the three pregnant women; and seven so far this year, including the two other pregnant women.
Unlike the 2004-05 flu season, when the country experienced a shortage of flu vaccines, Phillips said, there is plenty this year. Arkansas will receive about 220,000 doses; general distribution to the public health clinics begins in November. Around the second weekend of that month, the Health Department is planning a mass vaccination program in every county, Phillips said. Children who are not insured or who are underinsured receive the vaccine for free; otherwise, the charge is $20, up from $15 last season.
The agency recommends that healthy adults, ages 50 and older, get a flu shot each year. Those older than 65 fall in a high-risk group, with the risk increasing dramatically every year after that, Phillips said.
Friday, Little Rock Mayor Mark Stodola, 58, got his annual flu shot from a St. Vincent visiting nurse. The Visiting Nurses Association is offering to schedule flu clinics for businesses.
Phillips said a flu shot should provide protection for both influenza A and influenza B, a milder organism. The effectiveness will depend on how soon exposure to the virus occurs after a person gets a shot.
"It's a crap shoot because you don't know really when the season is going to start," Phillips said.
Besides a flu shot, avoiding people who have flu symptoms helps reduce the risk of getting the virus, although a person can be contagious a day before developing the symptoms. The symptoms include sore throat, stuffy nose, fever, and muscle aches.
A person with the flu should not visit the elderly or work in a nursing home, he said. Child-care and health-care workers should get flu shots.
Officials say drug caused Nigeria polio
Fri, 05 Oct 2007 19:55:01 GMTBy MARIA CHENG, AP Medical Writer
LONDON - A polio outbreak in Nigeria was caused by the vaccine designed to stop it, international health officials say, leaving at least 69 children paralyzed.
It is a frightening paradox in a part of the world that already distrusts western vaccines, making it even tougher to stamp out age-old diseases.
The outbreak was caused by the live polio virus that is used in vaccines given orally — the preferred method in developing countries because it is cheaper and doesn't require medical training to dispense.
"This vaccine is the most effective tool we have against the virus, but it's like fighting fire with fire," said Olen Kew, a virologist at the U.S. Centers for Disease Control and Prevention.
The CDC and the World Health Organization announced the cause of the polio outbreak last week, even though they knew about it last year.
Outbreaks caused by the oral vaccine's live virus have happened before. But the continuing Nigerian outbreak is the biggest ever caused by the vaccine. It also follows a nearly yearlong boycott of the vaccine in Africa's most populous country because of unfounded fears the vaccine was a Western plot to sterilize Muslims.
Officials now worry that the latest vaccine-caused Nigerian outbreak could trigger another vaccine scare.
Experts say such outbreaks only happen when too few children are vaccinated. In northern Nigeria, only about 39 percent of children are fully protected against polio.
The oral polio vaccine contains a weakened version of polio virus. Children who have been vaccinated excrete the virus, and in unsanitary conditions it can end up in the water supply, spreading to unvaccinated children.
In rare instances, as the virus passes through unimmunized children, it can mutate into a form that is dangerous enough to spark new outbreaks.
In 2001, officials reported that 22 children were paralyzed from polio in the Dominican Republic and Haiti in this way. Subsequent vaccine-caused polio outbreaks have occurred in the Philippines, Madagascar, China and Indonesia.
In the West, the polio vaccine is given as a shot and uses an inactivated virus, but that method is more expensive and requires training.
In Nigeria, the outbreak comes "in the wake of all the other problems they've had in," said Dr. Donald A. Henderson, who led WHO's smallpox eradication campaign in the 1970s.
In 2003, politicians in northern Nigeria canceled vaccination campaigns for nearly a year, claiming the vaccine was a Western plot to sterilize Muslims. That led to an explosion of polio, and the virus jumped to about two dozen countries.
Now, health officials' decision to keep quiet about the cause of the outbreak for so long may look suspicious.
Dr. David Heymann, WHO's top polio official, said that because the organization considered the outbreak to be a problem for scientists and not something that would change global vaccination practices, they thought it was was unnecessary to immediately share publicly.
CDC's Kew added: "The people who are against immunization may seize on anything that could strengthen their position, even if it's scientifically untenable."
Rumors are still rife among Nigerians that the vaccine is unsafe, and several religious leaders continue to lecture on its dangers. Another mass vaccine boycott could lead to further polio spread, derailing long-standing eradication efforts for good.
Nigerian health officials contacted by The Associated Press declined to comment on the situation.
"Convincing the Nigerians to take even more of this vaccine will be a tough sell," said Dr. Samuel Katz, an infectious diseases specialist at Duke University and co-inventor of the measles vaccine.
More than 10 billion polio doses have been given to children worldwide, and the vaccine has been credited with cutting polio incidence by more than 99 percent since 1988. Far more children are paralyzed by the wild polio virus than the virus spread by the oral vaccine. But no vaccine is risk-free.
WHO said that changing the vaccination strategy is unnecessary. "It would be nice if we had a more stable oral polio vaccine, but that's not the way it is today," Heymann said. "We will continue working the way we have been working because we don't want children to be paralyzed anywhere."
Experts Amoeba doesnt pose health risk
Fri, 05 Oct 2007 20:55:45 GMTTUCSON, Ariz. - Recent tests have shown that a brain-eating amoeba is in Tucson's water supply, but experts say the microscopic bug doesn't pose any health risks.
Tucson Water chlorinates its well water before distribution, killing the amoeba known as Naegleria fowleri before the water hits taps. But the amoeba's presence in our underground water source — probably as a result of biodegradable oil used in pumps — is a surprise to some researchers. The amoeba is usually found in surface water such as rivers and lakes.
"The organism is everywhere," said Charles Gerba, a microbiology professor with the University of Arizona's Department of Soil, Water and Environmental Science. "It feeds on bacteria."
Naegleria fowleri made headlines recently when it killed a 14-year-old boy who had gone swimming in Lake Havasu last month.
The amoebas enter the body through the nose and travel to the brain, where they feed until the person dies. The only way to get infected is to snort water. A person can drink water that has Naegleria fowleri and never be infected.
The amoeba lives in soil and is often present in warm bodies of water, particularly hot springs and lakes. Pools, if not chlorinated properly, can become homes to the microbes Tucson Water joined Maricopa County cities in a study of well water in 2005 to determine the amoeba's presence in drinking water and develop treatment to eliminate any potential health risks.
The study, which is being led by Gerba, was sparked, in part, by the deaths of two Peoria boys in 2002 from the organism.
Gerba and others sampled 35 Tucson Water wells and initially found some presence of the bug in 12 of the wells. Those 12 wells were resampled and five were confirmed to have the bug.
A year passed, and the 12 wells were sampled again. Eleven came out clean, and one well needs to be resampled because of an error, Gerba said, adding that the inconsistency in testing is common with Naegleria.
While Tucson Water chlorinates its groundwater before distribution, Gerba said he was concerned about private wells that aren't necessarily chlorinated.
There were roughly 250 private wells in the greater Tucson area in 2004, state records show. Researchers also sampled 20 private wells, but they found no presence of Naegleria.
The discrepancy has led Gerba to think Naegleria fowleri is showing up in the Tucson Water wells because of biodegradable oil that's used as a lubricant for pumps.
Pumping capacity in private wells is much smaller, and, as such, the pumps don't rely on engines, he said.
Naegleria was discovered in the 1960s and the federal Centers for Disease Control and Prevention have tracked only several hundred cases worldwide.
Between 1995 and 2004, 23 people in the United States were infected by Naegleria fowleri, according to the CDC.
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Information from: Arizona Daily Star, http://www.azstarnet.com
China agrees not to take inmates organs
Fri, 05 Oct 2007 18:11:59 GMTLONDON - Chinese medical officials agreed Friday not to transplant organs from prisoners or others in custody, except into members of their immediate families.
The agreement was reached at a meeting of the World Medical Association in Copenhagen.
China has previously acknowledged that kidneys, livers, corneas and other organs are routinely removed from prisoners sentenced to death row. But officials insist that this only happens when consent is provided.
Critics argue that death-row prisoners are not truly free to consent and may feel compelled to become donors, violating personal, religious or cultural beliefs.
The announcement Friday comes after several years of discussions between the World Medical Association and the Chinese Medical Association.
Last year, the WMA adopted a resolution stressing the importance of free and informed choice in organ donation, stating that prisoners and other individuals in custody were not in a position to provide consent. They demanded that the Chinese Medical Association condemn any violation of these ethical principles and ensure that Chinese doctors were not involved in the removal or transplantation of organs from executed prisoners.
Earlier this year, a delegation from the international body traveled to Beijing for talks on the issue.
"We shall now continue our dialogue with the Chinese Medical Association and include other national medical associations in a project to find best practice models for ethically acceptable organ procurement programs," said Dr. Edward Hill, WMA's chairman.
In a letter to the WMA, the Chinese Medical Association said it would work to strengthen the management of organ transplantation and prevent possible violations of the Chinese government's regulations.
The underground organ trade in China has been a notorious supplier of organs to foreigners desperately in need of transplants, who make up as much as 40 percent of the market. Brokers regularly arrange transplants in weeks rather than the months or years it generally takes in the West.
Health officials say the country faces a severe organ shortage, estimating that 1.5 million people need transplants in China each year, and that only about 10,000 operations are carried out.
Low pregnancy weight gain OK for obese
Fri, 05 Oct 2007 00:06:57 GMTBy CHERYL WITTENAUER, Associated Press Writer
ST. LOUIS - Obese women can gain little or no weight during pregnancy — and even lose a few pounds — without harming their babies, new research suggests.
Obese mothers who put on less than the recommended 15 pounds were less likely to develop pregnancy-related high blood pressure or deliver by Caesarean section and more likely to have a normal-weight baby, the study showed.
The findings, in the October issue of Obstetrics & Gynecology, fuel growing concern that national weight-gain guidelines for pregnant women are outdated and don't take into account the nation's obesity epidemic.
The Institute of Medicine, which issued the weight guidelines in 1990, is about to consider changing them.
Dr. Raul Artal, one of the study's authors, said the fear has been that not gaining weight would hurt the fetus.
"Not only were there no deleterious effects, but there are benefits," said Artal of Saint Louis University School of Medicine, who supports changing the weight guidelines.
In an accompanying editorial, Dr. Patrick Catalano of Case Western Reserve University, noted that the current guidelines were written when the concern was low birth weights. Now it's shifted to rising obesity, he said.
Artal said pregnancy is one of the main causes of obesity in women.
Using information from birth certificates, the study analyzed the pregnancies of more than 120,000 obese women from Missouri to see how weight gain affected their blood pressure, C-sections and the baby's birth weight. Obesity increases a woman's risk of miscarriage and other serious complications such as gestational diabetes.
The study found that 23 percent of the obese women gained less than 15 pounds, 31 percent gained 15 to 25 pounds and nearly half gained more than 25 pounds. Those who gained less had better outcomes.
The researchers considered three levels of obesity based on body mass index, or BMI, and came up with optimal ranges of weight gain. For a BMI of 30-34.9, the best outcomes came with a weight gain of 10 to 25 pounds; gaining less than 9 pounds was best for a BMI of 35-39.9 and losing up to 9 pounds was best for those with a BMI over 40.
The study's strengths are its size — drawing from an entire state — and that it is the first to look at different levels of obesity, "not a lumping of all obese women together," said Dr. Emily Oken, a Harvard Medical School professor and researcher on obesity, nutrition and weight gain in pregnancy.
The Missouri study found that the least-heavy obese women who lost weight were at somewhat higher risk to have a low birth-weight baby. However, they still benefited by having fewer other complications. Obese women who gain too much are also at risk for low birth-weight babies, Oken said, adding "It is a balance." Artal said that occurs predominantly in obese women with high blood pressure.
Catalano said that because almost half of pregnant women gain more than the recommended amount of weight, encouraging them to stay within the current guidelines is a significant challenge. But Artal said he has found women are more likely to modify their behavior during pregnancy because of concern for their child.
Catalona suggested advising pregnant women to eat a balanced diet low in sugars and saturated fats and to get moderate exercise, like walking or swimming. He also recommended referring obese women to a nutritionist and urging patients to lose weight after they give birth to avoid problems in future pregnancies.
In the coming weeks, the Institute of Medicine, a private organization that advises the federal government, is expected to begin the lengthy process of gathering scientific evidence to decide whether the guidelines should be changed, said spokeswoman Christine Stencel.
Under the institute's 1990 guidelines, those with a "normal" body mass index — a combination of height and weight — are encouraged to gain 25 to 35 pounds. Women considered overweight have a lower target: 15 to 25 pounds. Women with a low BMI should gain more weight during pregnancy — up to 40 pounds.
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Obstetrics & Gynecology: http://www.greenjournal.org/cgi/content/short/110/4/752
Toxic waste dump killing children in Kenya UN report
Fri, 05 Oct 2007 15:58:36 GMTNAIROBI - One of Africa's largest dumping sites is threatening the lives of thousands of children in the Kenyan capital Nairobi, a new United Nations report warned Friday.
The 30-acre Dandora Municipal Dumping Site, located at the centre of three slum settlements home to about a million people, receives around 2,000 tonnes of waste generated by the capital's 4.5 million people everyday.
Hundreds of impoverished slum dwellers and homeless families searching for recyclables work daily amidst the heaps of rubbish, also populated by vultures and other scavengers.
The report, commissioned by the Nairobi-based UN Environment Programme , found that half of 328 children examined had concentrations of lead in their blood exceeding internationally accepted levels.
Some 42 percent of soil samples recorded lead levels almost 10 times higher than what is considered unpolluted soil, with 400 parts per million compared to the 50 ppm threshold, it added.
&;Children have been exposed to pollutants such as heavy metals and toxic substances through soil, water and air with implications for respiratory, gastrointestinal and dermatological or skin diseases,&; said a UNEP statement.
&;Almost half of the children tested were suffering from respiratory diseases, including chronic bronchitis and asthma,&; it added.
UNEP Executive Director Achim Steiner said the findings were worrying and pledged to assist authorities in developing an improved waste management system.
&;The site here is killing children and people.... it is a human tragedy and an ecological disaster. Dumping sites are poisonous if they are not handled properly,&; Steiner said.
&;The Dandora site may pose some special challenges for the city of Nairobi and Kenya as a nation. But it is also a mirror to the condition of rubbish sites across many parts of Africa and other urban centres of the developing world,&; he added.
The Nairobi City Council, ranked by many watchdogs as one of the most corrupt institutions in the country, has already been singled out for its failure to manage waste in East Africa's largest city.
Thalidomide helps elderly cancer patients study
Fri, 05 Oct 2007 18:26:33 GMTBy Michael Kahn
LONDON - Elderly patients with an aggressive form of blood cancer lived about 20 months longer when given the drug thalidomide as part of their treatment, French researchers said on Friday.
The drug also slowed the spread of myeloma, a disease that accounts for about 1-2 percent of all cancers, usually affects older people, and kills its victims within three years, they reported in the Lancet medical journal.
&;The main message is the addition of thalidomide is able to improve survival,&; Thierry Facon, a specialist in blood diseases at Lille University in France who led the study, told Reuters.
The standard treatment, established 40 years ago, is a combination chemotherapy of two drugs called melphalan and prednisone. In recent years, some patients have also received bone marrow treatment that has boosted survival, Facon said.
But bone marrow transplants are too harsh for frail, elderly patients, so researchers turned to thalidomide, a drug used to fight nausea in pregnant women in the 1950s and 60s until doctors found it caused limb deformity in unborn children.
Once shunned, thalidomide is now considered a cancer fighter, with scientists testing it on lung, blood and brain cancers. It has also been approved to treat leprosy.
Facon and his colleagues analyzed 447 untreated patients aged 65 to 75, giving some the standard drugs and adding thalidomide into the mix for others.
They used Pharmion's Thalidomide, currently under review by European regulators for treating multiple myeloma, Facon said. Celgene sells the drug in the United States under the brand name Thalomid.
In a follow-up nearly six years later, the researchers found those who received thalidomide lived on average nearly 52 months, versus 33 months for those on standard therapy.
Progression-free survival -- the time it takes before the disease worsens -- also improved by about 10 months.
&;After 50 years of unsuccessful attempts to find new and more effective treatment approaches... we now have extensive evidence to support the introduction of as the standard of care for elderly patients with multiple myeloma,&; Antonio Palumbo and Mario Boccadoro of the University of Torino, wrote in a Lancet commentary.
