Ouch Cervical cancer shots painful
Sat, 05 Jan 2008 01:13:46 GMTBy MIKE STOBBE, AP Medical Writer
ATLANTA - The groundbreaking vaccine that prevents cervical cancer in girls is gaining a reputation as the most painful of childhood shots, health experts say. As Austin Powers would say; "Ouch, baby. Very ouch."
Health officials have touted the Gardasil vaccine as an important new protection against a cancer-causing sexually transmitted virus. In recent months, they've also noted reports of pain and fainting from the shot.
During its first year of use, reports of girls fainting from vaccinations climbed, but it's not clear whether the pain of the cervical cancer vaccine was the reason for the reaction.
"This vaccine stings a lot," said Patsy Stinchfield, an infectious disease expert at Children's Hospitals and Clinics of Minnesota, speaking at a recent meeting of vaccination experts in Atlanta.
It sure does, said 18-year-old Lauren Fant. She said other shots tend to hurt only at the moment of the needle stick, and not after the vaccine plunges in.
"It burns," said the college freshman from Marrietta, Ga.
The pain is short-lived, girls say; many react with little more than a grimace. But some teens say it's uncomfortable driving with or sleeping on the injected arm for up to a day after getting the shot.
Officials at Merck & Co., which makes the vaccine, acknowledge the sting. They attribute it partly to the virus-like particles in the shot. Pre-marketing studies showed more reports of pain from Gardasil than from dummy shots, and patients reported more pain when given shots with more of the particles.
Meanwhile, U.S. health officials have noticed a rise in reports of vaccine-associated fainting in girls. From 2002-2004 there were about 50 reports of fainting; from 2005 until last July, there were about 230. About 180 of those cases followed a shot of Gardasil, which came on the market in 2006.
But it's not clear that Gardasil's sting is related to the fainting increase, said Dr. Barbara Slade, an immunization safety specialist at the U.S. Centers for Disease Control and Prevention.
Teens tend to faint from needles, so a three-dose vaccine for adolescents would be expected to prompt some added fainting, she said. Researchers aren't sure why teens faint more than other age groups, but nervousness may be a factor.
Gardasil is the first vaccine approved specifically to target the human papilloma virus, or HPV, which causes cervical and vaginal cancer. The Food and Drug Administration approved it for girls ages 9 to 26.
Preliminary studies indicate only 10 to 20 percent of them have gotten at least one dose.
But researchers said those rates are due to reasons other than worries about pain, including Gardasil's $120-a-shot price, limited supplies initially and mixed feelings by some parents and doctors about a vaccination that assumes girls have sex.
Dr. Andy Andrews, an Atlanta-area pediatrician, said he doesn't believe the shot's ouch has diminished demand.
"A lot of the older teens are coming in themselves, without a parent. So they themselves are motivated to come back in," Andrews said.
A second HPV vaccine, GlaxoSmithKline's Cervarix, is under FDA review and could become available in 2008. Complaints of injection pain have not surfaced in clinical trials, said Liad Diamond, a company spokeswoman.
Docs Home care OK for kids pneumonia
Fri, 04 Jan 2008 22:08:24 GMTBy MARIA CHENG, AP Medical Writer
LONDON - Children with severe pneumonia can be treated just as effectively at home as in a hospital, according to new research. Doctors in Pakistan found that children taking antibiotics at home were as likely to survive serious pneumonia as those treated in hospitals. The study was published Friday in the British medical journal, The Lancet.
"If this treatment was implemented on a wide scale, then we could potentially save millions of children," said Dr. Renee Van de Weerdt, a child health expert at UNICEF, who was not involved in the study.
"This shows us that we can do something about pneumonia at the community level," Van de Weerdt said. "It doesn't always require a sophisticated hospital."
Pneumonia is the top killer of children under five worldwide, causing one-fifth of the 10 million deaths every year.
Pneumonia is an inflammation of the lungs that causes coughing, breathing difficulties, fever and muscle pain. About five to 10 percent of all children under five in developing countries get pneumonia every year. Children with HIV or malaria are at particular risk.
Under current World Health Organization guidelines, health workers refer children with severe pneumonia to hospitals to receive antibiotics through injections. But in many poor countries, children referred to hospitals often don't receive care if their parents cannot afford it or if there is no nearby hospital.
In the Lancet study, doctors in Pakistan randomly assigned children with serious pneumonia to either receive antibiotic shots in the hospital for two days, or to take antibiotics at home for five days. Parents of the children sent home were instructed how and when to give their children the antibiotics.
The research was conducted at seven sites across Pakistan: 1,012 children were hospitalized and 1,025 were treated at home. The children were aged between about three months and five years old.
Among the hospitalized children, 87 children did not respond to the treatment or developed complications. That compared to 77 children in those treated at home. Five children died during the study; four were in the hospitalized group and one was at home.
The study was conducted by researchers at Boston University's School of Public Health and colleagues, and was paid for by WHO and the U.S. Agency for International Development.
Treating children with severe pneumonia at home would also save health systems thousands of dollars. A course of medicines to be taken at home costs $2 at most.
Based on the Pakistani results and those of previous studies, WHO said it would soon revise its guidelines for children with pneumonia.
UNICEF said that trained community health workers, rather than parents, should be the ones giving drugs to children at home with severe pneumonia. "At the implementation level, there are quality control challenges," Van de Weert said. "We don't want antibiotics to be used wildly by anyone."
WHO said that not all children with severe pneumonia could be treated at home, and that a small percentage would still require hospitalization.
"Pneumonia is the single biggest killer of children in the world," said Dr. Shamim Qazi, a pediatrician at WHO. "We are hopeful that with the results from this study, we may be able to change that."
Thousands of Britons sickened by virus
Fri, 04 Jan 2008 22:09:47 GMTLONDON - Thousands of people in Britain have been sickened by the biggest outbreak of a winter vomiting virus in five years. Doctors estimate that hundreds of thousands of people may be affected by norovirus in the coming days. Dozens of hospital wards across the country have already been closed to try to stop the virus' spread.
"General practitioners are seeing a huge number of cases of patients with the norovirus," said Steve Field, chairman of the Royal College of General Practitioners.
Norovirus is the most common stomach bug in the United Kingdom, and its incidence typically spikes during the winter.
"The norovirus season has started uncharacteristically early compared to other years," said the Health Protection Agency in a statement. Most cases go unreported, and the agency estimates that for every case, there are 1,500 others.
The virus is highly contagious, and is easily transmitted between people via contact with contaminated surfaces, or sharing contaminated food or water.
Symptoms include nausea, projectile vomiting, diarrhea, fever and muscle pain. Most people recover within two days without treatment, though the virus can be more serious in the very young or the elderly.
People struck by the virus are advised to stay at home, drink plenty of liquids, and to wash their hands regularly to prevent infecting others.
The Health Protection Agency estimates that there are between 600,000 and 1 million cases of norovirus in the U.K. every year. Numbers of cases vary every year, and the agency said that this year's figures are not yet exceptional.
Dengue fever killed 407 in Cambodia
Fri, 04 Jan 2008 22:11:04 GMTPHNOM PENH, Cambodia - Dengue fever killed 407 people in Cambodia last year, the highest number of fatalities in nearly a decade, a health official said Friday. Most of those who died from the disease were children, said Ngan Chantha, director of the National Anti-Dengue Fever Program.
Dengue is a chronic problem in Cambodia but health officials say the spike in cases last year was due partly to the early arrival of the rainy season, which typically runs from May through November.
More than 40,000 dengue patients were admitted to Cambodian hospitals last year, compared to 16,650 in 2006, when 158 people died.
The death toll from 2007 was the largest since 1998, when 474 people died from dengue fever.
In 2007, Southeast Asia experienced the worst outbreak of dengue fever in years, with large outbreaks also reported in Indonesia, Vietnam, Malaysia, Singapore and Thailand.
Dengue infects up to 50 million people worldwide every year, according to the World Health Organization.
Most of dengue's victims are children. There is no vaccine or cure for the mosquito-borne virus, which causes rashes, blistering headaches, nausea and excruciating joint aches. The most serious form of the disease can cause internal bleeding, liver enlargement and circulatory shut down.
In Cambodia, the government conducted intense public awareness campaign with the help of foreign aid donors that warned residents not to keep still water in containers around their houses where mosquitoes can breed.
Britain tops fastfood league as world obesity grows study
Wed, 02 Jan 2008 16:21:07 GMTLONDON - Britons are the world's biggest fans of fast food, just ahead of Americans, while famously gastronomic French are the least attracted by quick meals, according to a study published Wednesday.
The survey of 13 countries also confirmed growing concern over obesity worldwide, but noted different priorities and strategies in different parts of the world for tackling it.
"People are inherently contradictory and nowhere is it more obvious than on such a sensitive and important issue as their weight," said Steve Garton of polling body Synovate, who produced the survey jointly with the BBC.
"The results show there's a world of people who cannot deny themselves that hamburger or extra piece of pizza, but probably make themselves feel better by washing it down with a diet cola."
In terms of fast food, 45 percent of Britons agreed with the statement "I like the taste of fast food too much to give it up" ahead of 44 percent for Americans and Canadians at 37 percent.
The French, long proud of their reputation for high-class cuisine, strongly disagree: 81 percent rejected the statement, followed by 75 percent of Singaporeans and 73 percent of people from Hong Kong and Romania.
"Britons love their fish and chips," said Garton, while Synovate's head in France Thierry Pailleux underlined the different Gallic perspective.
"French people take care of their image as a matter of course. Being thin is part of our culture and a point of pride," he said. "On top of this there is increasing awareness of the devastation obesity can cause to one's health."
Overall the obesity problem is fuelling increasing concern worldwide -- although some are more concerned than others.
Fifteen percent of French people and 12 percent of Americans weigh themselves every single day, while at the other end of the spectrum only 15 percent of Hong Kongers get on the scales once or more every week.
In terms of how to shed weight there are also different strategies.
Globally most people say cutting food intake is the best answer, followed by 43 percent who do more exercise.
But there are regional variations: 57 percent of Americans, 56 percent of French and 54 percent of Britons cut down on food to shed pounds, while 14 percent of Malaysians opt for herbs and supplements to cut their weight.
People in the Middle East seem to combine all strategies: Saudi Arabia and the United Arab Emirates are among the top users of low-fat products and meal replacements, but also gym memberships and home exercise equipment.
Lisa Cooney of the World Cancer Research Fund voiced concern over Britain's results in the study.
"The news that fast food is so popular here is worrying, as fast food is often energy-dense and tends to be consumed in large portions," she said.
"We recommend that people only eat fast foods sparingly, if at all, to help prevent becoming overweight. This is because being overweight increases your risk of a number of types of cancer, as well as other chronic diseases."
