CDC identifies two new norovirus strains
Thu, 23 Aug 2007 20:04:31 GMT
By MIKE STOBBE, AP Medical Writer
ATLANTA - A 90-year-old nursing home patient died from the stomach flu last year, marking the first time U.S. health officials confirmed that the highly contagious bug is sometimes fatal.
The North Carolina woman so far is the only person for whom lab tests confirmed norovirus as the killer, but health officials believe the virus killed at least 18 others and caused thousands of illnesses late last year.
Noroviruses are a group of viruses that cause the stomach flu, or gastroenteritis. They also are sometimes called Norwalk-like viruses.
Health officials don't systematically count and diagnose norovirus cases. But last winter seemed to be particularly nasty, with more than 1,300 outbreaks reported in 24 states, according to the U.S. Centers for Disease Control and Prevention.
Two new strains of norovirus were identified in the outbreaks, and may have driven the heavy caseloads, according to an article this week in a CDC publication, Morbidity and Mortality Weekly Report.
It isn't known which strains caused the deaths, said Jackie Tate, a CDC investigator who co-authored the article.
In recent years, cruise ships have become famous norovirus carriers, with several large outbreaks grabbing headlines. But nursing homes and other long-term care facilities were the scene of many of last winter's outbreaks, she said.
Proof that the virus killed the North Carolina patient is significant but not surprising, said Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt University.
"It is likely norovirus has been responsible for at least some fatal infections in the past," Schaffner said.
The virus is particularly dangerous for the very old, the frail and the very young, he added.
Symptoms include nausea, vomiting, diarrhea and stomach cramping. Some people also suffer a low-grade fever, chills, headache, muscle aches and tiredness. The illness often begins suddenly, but in most people symptoms last only one or two days.
There's no good treatment for norovirus. Doctors usually advise drinking fluids and try to treat the symptoms, Tate said.
The virus is spread through food, personal contact and touching contaminated surfaces. It's not clear how the virus spread in many of the nursing home settings, Tate said.
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On the Net:
The CDC's Morbidity and Mortality Weekly Report: http://www.cdc.gov/mmwr
CDC Whooping cough cases misdiagnosed
Thu, 23 Aug 2007 21:06:23 GMT
By MIKE STOBBE, AP Medical Writer
ATLANTA - A reported boom in U.S. whooping cough cases is now being questioned after health officials discovered a regularly used lab test misdiagnosed cases in suspected outbreaks in New Hampshire, Massachusetts and Tennessee.
The false test results led thousands of people to take antibiotics unnecessarily and even caused a New Hampshire hospital to limit the number of patients admitted since hospital workers were thought to be infected.
The testing errors were reported Thursday by researchers with the Centers for Disease Control and Prevention.
Pertussis, or whooping cough, is a potentially fatal bacterial respiratory infection. Its name comes from the sound victims make as they try to recover their breath after a coughing fit.
Government health officials say cases have tripled in the United States since 2001, with nearly 26,000 cases reported in 2005. Nearly half of those cases were diagnosed with the testing method now called into question, and that has raised doubts about the true number of cases.
"Are we in fact seeing an increase?" asked Dr. Tom Clark, summarizing what some are wondering. Clark, a CDC epidemiologist, is co-author of the report on the misdiagnoses.
The most accurate diagnostic testing for whooping cough requires a week or more to grow the pertussis bacteria from a sample from a patient's nose or throat. Sometimes that's too long for health authorities to take action to prevent the disease from spreading.
Increasingly, doctors have depended on a faster, but less accurate test. Different labs do the tests differently, leading to uneven results, experts say.
Last October, the less accurate method was used to diagnose a 20-month-old child with whooping cough at Children's Hospital Boston. Three dozen specimens from hospital workers also tested positive as well. But those results were wrong, according to the more reliable bacteria culture test results, the CDC reported.
The same situation occurred in March 2006, when a lab worker at Dartmouth-Hitchcock Medical Center in Lebanon, N.H., was diagnosed with the illness. Nearly 1,000 hospital workers were tested, treated and furloughed to prevent infecting patients. Thousands were given antibiotics and vaccinations. The precautions affected staffing levels, and the hospital had to close off some beds. About 100 employees were diagnosed with pertussis using the speedy test, results later found to be wrong.
In April 2004, a 5-week-old infant in one Tennessee community, which CDC wouldn't identify, was diagnosed with whooping cough. Health officials began looking for the illness in other residents. Ultimately nearly 1,500 people were checked or offered antibiotics; 43 tested positive at first. But the more reliable test turned up negative results for all except the baby, the CDC said.
"It's been a roller coaster. Whoa, looks at this big outbreak! Whoa, it wasn't really pertussis!" said Dr. William Schaffner, chairman of Vanderbilt University's department of preventive medicine.
It's not clear why so many errors were detected in each incident, Clark said. Contamination of samples does not appear to be the explanation, he added.
The CDC is planning a study to improve and standardize the method of faster testing. In the meantime, people should still get recommended pertussis vaccinations, Clark said.
Clark said he believes there is a real increase in cases, and that many are going undiagnosed. Two states, Minnesota and Massachusetts, have beefed up their case-finding and testing and have both seen whooping cough increases, he said.
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On the Net:
The CDC's Morbidity and Mortality Weekly Report: http://www.cdc.gov/mmwr
FDA proposes new rules for sunscreens
Thu, 23 Aug 2007 20:13:46 GMT
By ANDREW BRIDGES, Associated Press Writer
WASHINGTON - It may be the summer of 2009 before beachgoers can count on finding sunscreens to protect against the deeper, penetrating rays linked to wrinkles and cancer.
The Food and Drug Administration on Thursday proposed long-delayed rules covering the ingredients, labeling and testing of sunscreens that boast of protecting against both the sun's ultraviolet B rays, which cause sunburn, and the ultraviolet A rays that cause tanning but also are associated with more serious and longer-term damage.
The proposed rules keep in place the so-called SPF, or sun protection factor, numerical rating system for UVB protection, while tweaking the testing requirements. The FDA proposes capping the highest SPF value at 50, unless companies can provide the results of further testing that would support a higher number, implying better protection against UVB.
The proposal would add a requirement that sunscreen makers assess UVA protection in the laboratory and on people as well if they want to make any claim that their products protect against those rays, whose damage is rarely immediately apparent.
Until recently, most sunscreens sold in the United States have filtered out mostly UVB but not UVA rays — even if they promised broad protection.
The proposed rules would institute a four-star system to rate the UVA protection provided by sunscreens and spell out the protection level as "low," "medium," "high," or "highest."
"Under today's proposal, consumers will also now know the level of UVA protection in sunscreens, which will help them make informed decisions about protecting themselves and their children against the harmful effects of the sun," FDA commissioner Dr. Andrew von Eschenbach said.
A product's UVB protection would also be described, alongside its SPF rating. Both the UVA and UVB ratings would receive equal prominence on sunscreen labels.
Companies that choose not to do the UVA testing would have to label their products "No UVA protection," according to the proposed rules. The FDA assumes three-quarters of the estimated 3,000 sunscreens on the market would undergo such testing.
Schering-Plough Corp., maker of Coppertone, is reviewing the rules, spokeswoman Mary-Fran Faraji said.
FDA announced its intent to draft sunscreen rules in 1978 and published them in 1999. The agency then put them on indefinite hold until it could address issues concerning both UVA and UVB protection.
While the FDA said it would work to expeditiously finalize the rules, it will be at least several years before they take effect.
The agency will collect public comments for 90 days, make revisions as necessary and then publish a final rule. That rule, once it appears, would take effect only 18 months later — which puts it sometime in 2009, at earliest.
For Connecticut Attorney General Richard Blumenthal, that's not soon enough.
"Not only should these rules have been released earlier but they should have a swifter deadline for implementation," said Blumenthal, who petitioned the FDA earlier this year to release the rules. "These rules should be mandatory so they help consumers next summer."
Under the rules, sunscreen labels also would be updated to further encourage sunbathers to reapply sunscreen as needed. And those sunscreens making any claim for water resistance would have to list, in minutes, how long the products block the sun's rays before they have to be reapplied following swimming, or simply sweating.
Blumenthal and others who pushed for the new rules have long been worried about sunscreens that claim to be "waterproof" or offer "all-day" protection.
The FDA rules also propose allowing sunscreens to combine avobenzone and other existing ingredients, which could lead to more products, agency officials said.
While increased sun exposure has been linked to an increased risk of cancer, the FDA has no data that show sunscreen use reduces that risk, FDA scientist Matthew Holman said. Instead, the FDA proposes updating labels to stress that beyond using sunscreen, limiting sun exposure and wearing protective clothing also can help in guarding against the sun's effects.
"We don't want to give people a false sense of security," said Portland, Ore., dermatologist Dr. Diane Baker, president of the American Academy of Dermatology. "That's why I think the extra warnings are very important."
Melanoma, the most lethal skin cancer, will strike almost 60,000 Americans this year and kill some 8,100.
___
On the Net:
FDA consumer update on sunscreen:
http://www.fda.gov/consumer/updates/sunscreen082307.html
AMA touts plans for uninsured Americans
Thu, 23 Aug 2007 20:07:38 GMT
By LINDSEY TANNER, AP Medical Writer
CHICAGO - The nation's largest doctors' group on Thursday launched a multimillion-dollar media campaign to promote its proposals for helping uninsured Americans get health insurance.
The American Medical Association calls its campaign "Voices for the Uninsured" and placed full-page color ads promoting it in Thursday's New York Times and USA Today.
The AMA's solution includes tax credits and increasing federal funds to expand government programs, including the State Children's Health Insurance Program and Medicaid.
The group's president-elect, Dr. Nancy Nielsen, said some people assume the uninsured all are homeless or unemployed.
But today, they're "your own families or your working neighbors," she said at a Washington, D.C., news conference.
Nielsen, the mother of five, said she was uninsured while in graduate school. She recalled lacking money to feed her young children after paying for emergency care when one of them got sick.
"If this can happen to me, it can happen to anyone," Nielsen said.
The AMA is spending $5 million on the initial campaign, timed to coincide with the upcoming presidential elections. It will involve newspaper, television and radio ads in early primary states including Iowa, New Hampshire and South Carolina. It will go national next year and will include lobbying Congress to pass legislation to "fix this national problem."
The AMA joined other interest groups earlier this year including AARP and the U.S. Chamber of Commerce to advocate for helping the nation's 45 million uninsured.
"One out of seven of us doesn't have health insurance. But we all have a voice and a vote," the AMA's ads say. "Please vote with this issue in mind."
The AMA doesn't endorse candidates for president but is urging presidential hopefuls to incorporate its proposals into their health-care platforms.
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On the Web:
AMA campaign: http://www.VoiceForTheUninsured.org
Old folk are still having sex US study
Thu, 23 Aug 2007 05:29:27 GMT
WASHINGTON -
Aging people in the United States are still having active sex lives, unrestrained by age-related sexual problems affecting around half of them, according to a major nationwide report published Thursday.
&;A majority of older Americans are sexually active and view intimacy as an important part of life, despite a high rate of 'bothersome' sexual problems,&; the National Institutes of Health said in a report on the new study.
The research found that sexual appetite declines only slightly between the ages of 50 and 70, with many men and women practising vaginal intercourse, oral sex and masturbation well into their 70s and 80s.
Researchers at the University of Chicago surveyed 3,005 people aged 57 to 85, said the NIH, part of the US Department of Health.
The study &;suggests a previously uncharacterized vitality and interest in sexuality that carries well into advanced age,&; said Richard Suzman of the National Institute on Aging which took part in the study.
Half of those surveyed up to the age of 75 admitted to having oral sex, said the summary report released here Wednesday on the study, which is published in Thursday's issue of The New England Journal of Medicine.
More than half of men and a quarter of women admitted masturbating.
Nearly three-quarters of those aged 57 to 64 said they were sexually active. The figure dropped to just over half of those in the 65 to 74 age range, and a quarter of those aged 75 to 85.
Sexual activity was more common among older men than among older women.
The survey sheds light on the impact of physical health on people's sex lives, including sexual problems related to conditions such as arthritis, diabetes and hypertension, the report summary said. Overall health, it found, was more important than age in boosting a person's sex life.
The research may also help promote health education efforts to prevent sexually transmitted disease in older people.
&;Sexual activity among older adults poses risks for new cases of HIV, as approximately 15 percent of newly diagnosed HIV infections are among Americans over age 50,&; the summary said.
About half of the sexually active older adults reported at least one &;bothersome&; sexual problem. More than a third of active men said they had erectile difficulties, and 43 percent of women reported &;low desire.&;
American men spend more than a billion dollars each year on medications to improve their sexual function, the researchers said, with 14 percent of those surveyed taking medicine to boost their performance.
FDA proposes sunscreen rule cancer warning
Thu, 23 Aug 2007 20:51:37 GMT
By Kim Dixon
WASHINGTON -
Sunscreen labels should spell out
precisely how well they protect against sun damage and
manufacturers should conduct new tests for a subtler type of
ultraviolet radiation that can cause cancer, U.S. regulators
said on Thursday.
The U.S. Food and Drug Administration proposed testing and
rating the level of protection in over-the-counter sunscreens
against ultraviolet &;A.&;
Ultraviolet rays from the sun are the leading cause of skin
cancer, the most common cancer in the United States. There are
two types of UV rays: UVA rays are responsible for tanning, and
UVB rays, which lead to burning. The FDA wants to make it clear
to consumers that both types are equally dangerous.
Manufacturers currently indicate the level of ultraviolet
&;B&; protection in products by &;sun protection factor&;
ratings.
Richard Wiles, executive director of the consumer-oriented
Environmental Working Group, noted that an FDA proposal in 1999
encountered industry opposition and was never put into effect.
As it stands, if a product provides minimal UVA protection,
makers can claim it, he said, adding the new rule would &;change
things dramatically from the consumer end.&;
A new warning in bold type on product labels would remind
consumers that using sunscreen should not be a reason for
extending time in the sun and that &;UV exposure from the sun
increases the risk of skin cancer, premature skin aging, and
other skin damage.&;
A new UVA rating system would use a scale of one to four
stars, with four representing the highest UVA protection
available in an over-the-counter sunscreen.
The FDA said arriving at labeling pertaining to UVA was
more complicated and challenging than with UVB because of a
lack of international standards and a many testing options.
The public and manufacturers have 90 days to comment on the
proposal.
Large sunscreen manufacturers include Johnson & Johnson,
Playtex Products Inc and Schering-Plough. All three companies
said they were reviewing the FDA proposal.