First cholera case confirmed in Baghdad
Thu, 20 Sep 2007 21:19:21 GMT
By SAMEER N. YACOUB, Associated Press Writer
BAGHDAD - The World Health Organization confirmed on Thursday the first cholera case in Baghdad since 2003, raising fears the disease is spreading from the north of the country where it has struck more than 1,000 people.
A 25-year-old woman from eastern Baghdad was found to have cholera after she turned up at a hospital with severe diarrhea, said Dr. Naeema al-Gasseer, the WHO's representative in Iraq.
Cholera is a gastrointestinal disease that is typically spread by drinking contaminated water and can cause severe diarrhea that, in extreme cases, can lead to fatal dehydration.
The disease broke out in Iraq in mid-August, but had been confined to northern Iraq, affecting the provinces of Sulaimaniyah, Irbil and Tamim, which is home to the oil-rich city of Kirkuk. At least 10 people have died, according to WHO.
Several suspected cholera cases also have been reported in Diyala province, north of Baghdad, but al-Gasseer said none had been confirmed.
Cholera is endemic to Iraq, with about 30 cases registered each year. But the last time there was an epidemic in the country was in 1999 when 20 cases were discovered in one day, said Adel Muhsin, the Health Ministry's inspector-general.
Al-Gasseer said health authorities were concerned the disease could spread because of the movement of people within Iraq's borders. Hundreds of thousands of displaced people have been forced to flee their homes because of violence.
A disease that would otherwise be easily treatable has been made all the more dangerous because of Iraq's precarious security situation following the U.S.-led invasion that toppled Saddam Hussein in 2003.
"We need to look at safe water, safe import of food, hygiene, the network of water and the network of sewage disposal," al-Gasseer said in a telephone interview.
The latest WHO report dated Sept. 14 reported a total of 24,532 cases of people with symptoms of cholera such as diarrhea and vomiting in the northern provinces. Out of those, laboratory tests have confirmed 1,055 cases of cholera.
It said 10 people have died — nine in Sulaimaniyah and one in Tamim.
Al-Gasseer also said some 100,000 tons of chlorine were being held up at Iraq's border with Jordan, apparently because of fears the chemical could be used in explosives. She urged authorities to release it for use in decontaminating water supplies.
Insurgents in the country staged several chlorine truck bombings this year, killing scores of Iraqis.
Muhsin confirmed such concerns were holding up the border shipment but said he was told the problem was solved and that the chlorine would arrive soon. Chlorine will be added in higher doses to Baghdad's water supply as a precaution against cholera, Muhsin said.
His teams recently tested drinking water across the capital and discovered chlorine levels on 20 locations were inadequate to prevent cholera. Also, several ice factories were closed in Iraq because of cholera concerns, he said.
The Health Ministry would continue checking drinking water in all Iraqi cities, Muhsin told The Associated Press, and teams would inspect ice factories and ice cream makers.
Each hospital in Iraq set up a special ward for diarrhea-stricken patients and the Health Ministry also launched an ad campaign, with 250,000 posters and 5 million leaflets printed to "educate and warn the people about cholera," Muhsin said.
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Associated Press writer Katarina Kratovac in Baghdad contributed to this report.
Sperm ban means some in short supply
Thu, 20 Sep 2007 21:21:33 GMT
By MARIA CHENG, AP Medical Writer
LONDON - For American parents looking for donor sperm to produce blond, blue-eyed Scandinavian babies, the search just got a little trickier. A ban on sperm from all European countries with exposure to mad cow disease means U.S. sperm banks are running low.
The May 2005 decision by the Food and Drug Administration effectively blocked donors from Denmark to the United Kingdom. And while some sperm banks have had enough frozen stocks to cope with demand, they are now facing shortages.
"We still have a little bit left, but not much," said Claus Rodgaard, manager of Cryos International, a Danish-based sperm bank with an office in New York.
"We're not here to promote people to have blond, blue-eyed babies, but if those are the kinds of characteristics you're looking for, then Danish sperm is good for that," Rodgaard said. "That's all we have in Denmark."
Scientists say the ban is not justified.
"The consensus in the United Kingdom is that this is a silly ban," said Dr. Allan Pacey, an andrology expert at the University of Sheffield and secretary of the British Fertility Society. "There's no evidence to show that mad cow disease can be transmitted in human semen."
The human form of mad cow disease, variant Creutzfeldt-Jakob disease, is mainly transmitted after people eat infected meat. In rare cases, the disease has been spread by contaminated surgical equipment or in transplants of brain tissue. There has never been a documented case of variant Creutzfeldt-Jakob being passed on after a sperm donation.
Pacey said concerned doctors could always screen potential donors to see if they might be at high-risk for mad cow disease, but that a blanket ban was unnecessary.
Dr. Gianpiero Palermo, an associate professor at Cornell University's Center for Reproductive Medicine, agreed. "I'd be more worried about genetic diseases," he said.
Diseases including HIV/AIDS, hepatitis, or bacterial infections like chlamydia would be far more likely to be spread by sperm donors, doctors said.
Rodgaard said the FDA has been asked to reconsider the ban, but there has been no sign it will be lifted soon. "It's a completely random decision," he said, pointing out that even though Canada has reported mad cow cases, "you are still allowed to import all the tissue you want from Canada."
For the moment, the best option for American parents desiring children of European stock may be to travel to Europe. "We just have not been able to import any more Scandinavian sperm," Rodgaard said.
Palermo said the ban has not had a big impact.
"There's absolutely no difference between American and European sperm," he said. "If you are looking for a specific type of donor, we can find whatever genetic qualities you want in the U.S."
Researchers examine purging disorder
Thu, 20 Sep 2007 21:29:23 GMT
By AMY LORENTZEN, Associated Press Writer
DES MOINES, Iowa - An Iowa researcher is studying a little-known eating disorder that some doctors may miss: purging disorder. Though similar to women with bulimia, patients who fit this description don't binge-eat. Yet they feel compelled to purge, usually by vomiting, even after eating only a small or normal amount of food, said Pamela Keel, the University of Iowa researcher who led a study on the subject.
Keel, a psychology professor, and colleagues from Iowa and the Harvard Medical School describe their research in this month's issue of Archives of General Psychiatry.
"Purging disorder is new in the sense that it has not been officially recognized as a unique condition in the classification of eating disorders. But it's not a new problem," Keel said. "Women were struggling with purging disorder long before we began studying it."
If further study supports that it is a distinct disorder, Keel said the American Psychiatric Association could revise its criteria for diagnosing eating disorders. That's important because doctors could then better screen these patients and identify treatments for them. Otherwise, they might be missed because they are normal weight and don't report binge-eating, she said.
"The bottom line is there are women out there right now who have this condition, and very little is being done to figure out why they have this problem or how to help them with it," Keel said.
The study focused on women because they are about 10 times more likely than men to suffer from bulimia, in which people compulsively overeat and then force themselves to vomit, fast, take laxatives or exercise excessively to burn calories.
The dangers of purging disorder are similar to those of bulimia: psychological problems, dehydration, electrolyte imbalances that can affect the heart and kidneys, and potential dental problems because of self-induced vomiting.
Keel's research, conducted from 2001-05, was funded by the National Institute of Mental Health. The study looked at 90 women: 20 women had symptoms of purging disorder, 37 had bulimia and purged after binge-eating, and 33 had no eating disorders. Each woman was interviewed about her eating habits, drank a liquid meal and had blood drawn before and after the meal.
Keel said there were significant differences in the groups when it came to satiety, or feeling full.
In response to the liquid meal, women with purging disorder and those who had no eating disorder had similar levels of a chemical called cholecystokinin. It is released from the upper tract of the small intestine and appears to signal people to stop eating.
"That makes sense, because in terms of eating patterns, women with purging disorder are not actually eating more" than the women who had no eating disorder, Keel said. The bulimic women had lower levels of the chemical.
The women with purging disorder said they felt much more full after the test meal, and they reported more stomach discomfort than the bulimic women and the women with no eating disorders.
"It kind of begins to provide a clue for why these women may feel a need to purge after eating an amount of food that most people would be fine with. They are actually responding to it differently," Keel said.
The women with purging disorder and the bulimics shared emotional and psychological characteristics, including body image problems, anxiety and depression. Both groups also had strict rules about what they could eat and when, Keel said.
Keel "has helped put purging disorder on the map" as something that should be studied, said Dr. Tim Walsh, professor of psychiatry at Columbia University Medical Center.
Many people with eating disorders don't meet all of the criteria for anorexia or bulimia, "so it suggests that we need additional descriptions to help patients," he said. Walsh heads a work group with the American Psychiatric Association that is charged with revising criteria for diagnosing such disorders.
Leslie Sim, a psychology professor and consultant with the Mayo Clinic's eating disorders program, called Keel a "great researcher" in the field and said her findings were new and interesting.
Sim said current criteria "are kind of limiting for diagnosis and treatment and also for reimbursement by insurance companies."
Keel is recruiting subjects for another study, which she said will look more closely into factors that give rise to the unique response to eating by women who have purging disorder.
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On the Net:
University of Iowa: http://www.uiowa.edu/
Mayo Clinic: http://www.mayoclinic.com/
CDC touts ample supply of flu vaccine
Thu, 20 Sep 2007 21:29:42 GMT
By LAURAN NEERGAARD, AP Medical Writer
WASHINGTON - Come one, come all: After years of shortages and confusion, this fall promises plenty of flu vaccine to go around — up to 132 million doses, more than the nation has ever produced.
The ample supplies have the government urging vaccinations not just for people at highest risk of dying from influenza, but for anyone who wants to avoid a week of aching misery.
"Flu is a formidable foe," Dr. Julie Gerberding, head of the Centers for Disease Control and Prevention, said Wednesday. "It is not an illness we should be complacent about."
But new CDC data show only a fraction of people who need flu shots the most get them, including just one in five babies and toddlers. And there's wide geographic variation, with Rhode Island reporting the most high-risk adults vaccinated and Nevada the fewest.
Shots aren't the only option. Wednesday, the government ruled that it's safe for younger kids than ever before to try a nasal-spray vaccine called FluMist. Once only an option for people ages 5 to 49, FluMist now can be used by children as young as 2.
Flu usually peaks in February, so a winter vaccination isn't too late. Still, Gerberding advised seeking vaccine early in case flu begins striking before the usual November.
Indeed, there already are reports of sick schoolchildren in Hawaii, although the geographic distance makes it impossible to predict if that signals an unusually early flu season for the rest of the country.
Perhaps of more concern, CDC is closely monitoring whether a new strain that emerged near the end of Australia's flu season will cause illness here — a strain that this year's vaccine doesn't specifically target.
Each year's vaccine contains protection against three influenza strains — two Type A strains, an H1N1 and an H3N2 version, plus a milder Type B — that experts predict will cause the most illness. The vaccine isn't always a perfect match, and this year's contains a different H3N2 version than the newly emerging one, nicknamed H3N2/Brisbane-like.
Get vaccinated anyway, Gerberding stressed. The other two strains in the vaccine are causing illness around the world, and even if the newer one travels here, too, the vaccine should provide some cross-protection.
Every year, flu infects up to 20 percent of the population, causes the hospitalization of 200,000 people and kills 36,000.
Who's at highest risk? Anyone over 50 or under 5; people of any age who have asthma, heart disease, weakened immune systems or other chronic illnesses; and pregnant women.
Vaccine also is particularly recommended for relatives and caregivers of those people, and health care workers — people who may be robust enough to recover themselves, but could infect the more vulnerable before they realize they're ill.
"The day before you become sick, you're already excreting the virus," warned Dr. William Schaffner of Vanderbilt University, vice president of the National Foundation for Infectious Diseases.
That equals 218 million people who should be vaccinated each year. Nowhere near that many seek vaccine. Last year, about 18 million of the nearly 121 million doses produced weren't used and had to be thrown away.
But the CDC's new estimates of how many high-risk patients get vaccinated, gleaned from public-health surveys, shed new light on the most troubling gaps.
People 65 and older are most likely to get vaccinated, 69 percent during the 2005-2006 flu season, the latest count available.
But that's still well under the national goal of vaccinating 90 percent of seniors — even though Medicare provides them flu shots for free.
Just over a third of 50- to 64-year-olds are getting vaccinated, and just 30 percent of high-risk younger adults, CDC found.
Flu vaccine is a little more complicated for young children, because they need two doses a month apart the very first year they're inoculated. Just 21 percent of youngsters ages 6 months to 2 years were fully vaccinated, and just over one in 10 who needed two doses got both, CDC reported.
If a young child missed that necessary second dose last year, health officials are recommending that he or she make it up this year with two shots.
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On the Net:
CDC: http://www.cdc.gov/flu
National Foundation for Infectious Diseases: http://www.nfid.org