Panel recommends FluMist for young kids
Wed, 24 Oct 2007 20:46:29 GMT
By MIKE STOBBE, AP Medical Writer
ATLANTA - Children as young as 2 can be given a nasal spray flu vaccine, a federal advisory panel said Wednesday.
Government advice now recommends only traditional shots for children younger than 5. But recent studies have shown the vaccine FluMist, made by Maryland-based MedImmune Inc., to be safe and effective in kids as young as 2.
FluMist was initially approved in 2003 for use in healthy people ages 5 to 49. The U.S. Food and Drug Administration last month approved its use for the 2 to 5 age group as well.
Now, the Advisory Committee on Immunization Practices, which advises government health officials, is recommending FluMist's use for kids in the 2 to 5 age bracket. Committee members said Wednesday that children with a history of asthma or wheezing should opt for a shot.
Recommendations by the panel usually are accepted by U.S. health officials, and they influence insurance companies' decisions on vaccination coverage.
The committee didn't recommend FluMist over flu shots, merely making it an option for young children who may dread a shot with a needle. Flu shots are still recommended for children ages 6 months to 5 years and those 50 and over as well as other groups at risk for flu complications.
The committee also voted that a government program that pays for vaccines extend its FluMist coverage to the younger age group, meaning more than 5 million children will now be eligible for free FluMist. That includes children eligible for Medicaid, members of Native American and Alaska Native groups, and some children who don't have insurance that covers the vaccination.
"This is a significant step forward in our vision to have a significant impact on influenza disease in all age groups," said Frank Malinoski, MedImmune's senior vice president for medical and scientific affairs.
MedImmune is a wholly owned subsidiary of London-based AstraZeneca PLC. The company had $36 million in FluMist sales last year, and has made about 4.5 million doses for the current flu season, a company spokeswoman said.
A dose of FluMist costs about $18, roughly the cost of a flu shot. One dose is recommended annually, but if it's the first time a young child was ever vaccinated against flu, two doses should be given, spaced at least a month apart.
The committee also discussed a proposal to recommend flu vaccinations for all school-age children.
Health officials believe vaccinating more children would reduce the spread of flu in general as well as protecting the students themselves. But experts say they're concerned about the strain on pediatricians and schools if they tried to give annual flu shots to so many children.
The discussion was tabled until the committee's next meeting in February.
___
On the Net:
CDC: http://www.cdc.gov/vaccines/
NYC tries again to get calories on menus
Wed, 24 Oct 2007 20:52:03 GMT
By DAVID B. CARUSO, Associated Press Writer
NEW YORK - Burger joints beware: New York's calorie crusaders are at it again. City health officials announced Wednesday that they hope to revive their stalled plan to force fast-food chains to add calorie counts to the big menu boards that hang above their counters.
The city's original effort to put calories on menus was struck down by a judge in September, but Health Commissioner Thomas Frieden said the regulation has been reworked and is ready for a second try.
"People deserve to have more information when they are ordering food," he said.
Like the previous regulation, the new version presented to the Board of Health on Wednesday would require restaurants like McDonald's, Burger King and Taco Bell to list a calorie count for each menu item as prominently as the price.
City officials have argued that action is needed to address an obesity epidemic in the city, which they blame partly on more residents relying on fast food for a large percentage of their regular meals.
The idea, Frieden said, is to make people think twice about ordering a 1,000 calorie lunch, which for many people is about half the recommended daily total of calories.
Health officials believe that New York City was the first place in the U.S. to attempt to implement a regulation requiring some restaurants to put calorie information on menus.
Since then, other cities and states have considered similar rules. California lawmakers passed a bill similar to New York's regulation, but it was vetoed by Gov. Arnold Schwarzenegger earlier this month.
As with the original rule, the new policy wouldn't apply to most fine dining establishments, or the thousands of family owned delis and pizza shops around the city; only chains with 15 or more stores will be covered, and then only restaurants serving standardized portion sizes that can easily be measured for calorie content.
Restaurants are, nevertheless, almost certain to sue for a second time over the plan.
New York State Restaurant Association Executive Vice President E. Charles Hunt called the proposal unfortunate.
"It goes beyond the scope of good government," he said. "It is micromanaging small business."
Fast-food companies have argued that the calorie data will clutter menus and irritate customers, who don't necessarily want to be confronted with health data.
In their first lawsuit, restaurants also argued that the health department doesn't have the authority to impose such a rule.
A federal judge agreed, to some extent. U.S. District Judge Richard J. Holwell said the initial rule conflicted with federal food labeling laws. But he also suggested that a few adjustments could resolve those legal hurdles.
The revised rule contains one major change:
Initially, the policy only applied to restaurants that had already decided to offer nutritional information voluntarily to customers. Most fast-food giants have made nutritional information available on posters or Web sites for years, and the city argued that it would be easy for them to provide some of the same information on their menus.
This time, restaurants would be required to post calorie information whether they had done so previously or not.
The city's Board of Health took the first step toward approving the regulation Wednesday by voting to publish it and hold a public hearing. A final approval vote would not take place until January.
Laura Bush meets breast cancer survivors
Wed, 24 Oct 2007 20:33:42 GMT
By DONNA ABU-NASR, Associated Press Writer
RIYADH, Saudi Arabia - One Saudi woman ignored the cancer growing in her breast for fear of seeing a male doctor. Another was summarily divorced on the mere suspicion she had the disease, while a third was dragged away from a mammogram machine — the technicians were men.
Breast cancer is considered a taboo in the religiously conservative Arab countries of the Persian Gulf even as the disease claims more and more victims, but some women are pushing for greater openness about the illness. Their efforts received a boost this week: a visit from first lady Laura Bush to raise awareness about breast cancer.
On Wednesday, her second day in Saudi Arabia, Mrs. Bush met with breast cancer survivors in the western seaport of Jiddah. As a token of appreciation, they presented her with a long black scarf — the kind Saudi women use to cover their hair in public — with pink ribbons symbolizing the disease attached to both ends.
They then helped her wrap it around her head, even though visiting female dignitaries are exempt from Saudi Arabia's strict Islamic dress codes for women.
"No campaigns, ads or programs would have had the kind of impact that Laura Bush's trip has given to breast cancer awareness in the kingdom," said Samia al-Amoudi, a gynecologist who was diagnosed with the disease in 2006.
"Her trip will make people ask: 'Why is she here? For breast cancer? Is it that serious in this country?'" she added.
In Saudi Arabia, about 70 percent of breast cancer cases are not reported until they are at a very late stage, al-Amoudi said. In the U.S., most breast cancers are diagnosed much sooner, when they are more easily cured.
Al-Moudi also said 30 percent of Saudi patients are under age 40, compared to 5 percent in the U.S.
Breast cancer is the No. 1 killer of women in the United Arab Emirates, according to official statistics, with many dying because the stigma surrounding the disease prevents early detection and treatment.
Breast cancer awareness campaigns are becoming more prevalent in the Arab world. In Lebanon, for instance, a public service TV announcement shows two round, lit candles. One of them is extinguished as an announcer reads statistics about the disease and reminds women to have mammograms.
But in the more conservative Persian Gulf region, such campaigns are less aggressive, not as organized and unlikely to use such bold imagery.
In Saudi Arabia, a campaign that began this month offers price discounts on mammograms and, in billboards, urges women: "Do the test now, for peace of mind."
The problem is not a matter of resources. The kingdom has some of the world's best medical equipment and doctors, and even the poor have access to free medical care.
But many Saudis, like other Arabs, won't even refer to cancer by name, calling it just "that disease" because of the fear surrounding the illness. Some families are afraid no one will marry their daughters if a mother's cancer becomes known.
For others, however, the greatest obstacle is the idea of women being examined by male doctors.
Al-Amoudi, who chronicled her struggle with cancer in a newspaper, recounted the story of a woman whose husband always pulls her away from the mammogram room because the technicians are male.
"The first thing women ask me when I tell them to get a mammogram is: 'Will the radiologist be male or female?'" she said.
Asma'a al-Dabag, a radiologist for 27 years, said the woman who was divorced turned out to be cancer-free, while the woman who had cancer kept her disease a secret even from her two brothers — both of them doctors.
"Some people feel that this is something private and if they talk about it, they become exposed," she said.
Al-Dabag said even many gynecologists rarely talk to patients about breast self-examinations or routine mammograms.
She also has yet to hear from the government about a proposal made months ago calling for research on why there are so many breast cancer patients in the kingdom and recommending that a center be established to help patients cope with all aspects of the illness.
Al-Amoudi has urged clergymen to "enlighten the people and take up the issue of women's health in their sermons."
Somaia al-Thagafi, 32, who discovered a lump in her breast while in London a couple of months ago, was happy with the support she received from her husband and immediate family. But other reactions were depressing.
"Some treated me as if I was on my death bed," she said. "Others told me stories about women who died during reconstructive surgery. Some even told me to drop my treatment and take herbal medicines instead."
Fawzia al-Zewid, a 45-year-old mother of six, said her husband's support was overwhelming after she was diagnosed with the disease two years ago. When she began losing her hair from chemotherapy, he shaved her hair before shaving his. Her two young sons also shaved their heads.
"They didn't want me to have the only bald head in the house. What more support could you ask for?" said al-Zewid.
Her husband died of a heart attack last year.
"When he was alive, I wasn't afraid of breast cancer," she said. "Today, without his support, I am."
White House denies editing CDC testimony
Wed, 24 Oct 2007 20:28:48 GMT
By H. JOSEF HEBERT, Associated Press Writer
WASHINGTON - The White House significantly edited testimony prepared for a Senate hearing on the impact of climate change on health, deleting key portions citing diseases that could flourish in a warmer climate, documents obtained by The Associated Press showed Wednesday.
The White House on Wednesday denied that it had "watered down" the congressional testimony that Dr. Julie Gerberding, director of Centers for Disease Control and Prevention, had given the day before to the Senate Environment and Public Works Committee.
But a draft of the testimony submitted for White House review shows that six pages of details about specific disease and other health problems that might flourish if the Earth warms were not delivered at the hearing.
Gerberding on Wednesday downplayed the significance of the changes made in her prepared text saying she never felt she was being censored and that she was free to go beyond her text — and did when testifying. "I was absolutely happy with my testimony in Congress. We finally had a chance to go and say what we though was important," she said at a luncheon appearance in Atlanta.
Later, she added, "I don't let people put words in my mouth and I stand for science."
The draft noted that "scientific evidence supports the view that the earth's climate is changing" and that many groups are working to address climate change. "Despite this extensive activity, the public health effects of climate change remain largely unaddressed. CDC considers climate change a serious public health concern," the draft declares.
That paragraph was not in Gerberding's text as approved by the White House.
The draft document was obtained Wednesday by The Associated Press from a source other than the CDC, the Atlanta-based agency considered the government's premier disease tracking and monitoring agency.
Two people familiar with the documents told the AP on Tuesday, after the Senate hearing, that the White House Office of Management and Budget edited the CDC director's congressional testimony, removing specific scientific references to potential health risks.
Gerberding told a Senate hearing on Tuesday that climate change "is anticipated to have a broad range of impacts on the health of Americans."
But her prepared testimony was devoted almost entirely to the CDC's preparation, with few details on what effects climate change could have on the spread of disease. The prepared remarks covered six pages. The draft submitted for OMB was twice as long.
Referring to the draft, one CDC official familiar with both versions, who spoke on condition of anonymity because of the sensitive nature of the review process, said that "it was eviscerated."
White House press secretary Dana Perino said the prepared testimony went through an interagency review process and the Office of Science and Technology Policy did not believe that the science in the testimony matched the science that was in a report by the International Panel on Climate Change.
"She testified yesterday. Her spokesperson said that she was able to say everything she wanted to say," Perino said. "It was not watered down in terms of its science. It wasn't watered down in terms of the concerns that climate change raises for public health."
The CDC official said that while it is customary for testimony to be changed in a White House review, these changes were particularly "heavy-handed."
The deleted sections of the draft, covering more than half of the original text, included a list of specific impacts on which "climate change is likely to have a significant impact on health." The list included the effect of more frequent hot spells on vulnerable populations, the impact of extreme weather, more air pollution in drought areas, and greater likelihood of vector-borne and waterborne diseases as well as mental health problems.
While these impacts would be expected to be less significant in the United States than in the developing world, one deleted section says, "nevertheless many Americans will likely experience difficult challenges."
"Climate change-driven ecological changes such as variations in rainfall and temperature could significantly alter the range, seasonality and human incident of many zoonotic and vector-borne diseases," the draft says in another section deleted.
At Tuesday's hearing, Gerberding addressed some of those issues during questioning from senators after she delivered her prepared remarks.
Sen. Barbara Boxer, D-Calif., committee chairman, produced a CDC chart, listing many of the same concerns — deleted from Gerberding's draft text — that could be exacerbated by global warming.
"These are the potential things you can expect," replied Gerberding when asked about the items by Boxer. "... In some of these areas its not a question of if, it's a question of who, what, how and when."
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Associated Press reporter Doug Gross contributed to this report from Atlanta.
Town changes street name over Viagra jibe
Wed, 24 Oct 2007 15:28:20 GMT
AMSTERDAM -
The Dutch town of Breda has decided
to rename a new street that was to have been called St.
Fiacrius court after people started calling it Viagra court.
The town council changed the street's name to &;Hofhage&;
after people about to move into a planned housing development
there complained about the negative associations of living in a
street with a name that sounds like the popular impotence drug.
Cholesterol therapy slows lung function decline
Wed, 24 Oct 2007 19:55:06 GMT
NEW YORK -
Treatment with statins, the
widely prescribed class of cholesterol-lowering drugs, appears
to slow the age-related decline in lung function in elderly
individuals, even among those who smoke, according to a report
in the American Journal of Respiratory and Critical Care
Medicine.
Statins, which include drugs such as Lipitor, Crestor and
Zocor, are known to have anti-inflammatory and antioxidant
properties, which may be responsible for their beneficial
effects on the lung, Dr. Joel Schwartz of Harvard School of
Public Health in Boston and colleagues suggest.
The researchers examined the association between statin use
and lung function decline in 803 elderly men, participating in
a Veterans Administration study on aging. The subjects had
their lung function measured two to four times between 1995 and
2005. Data on smoking and statin use were also collected at
each visit.
The researchers' analysis revealed that statin users
experienced a much slower annual decline in lung function. For
example, the estimated decline in forced expiratory volume in 1
second was more than twice as great in men who did not use
statins compared with men who did use statins. The results were
similar for annual decline using other measures of lung
function as well.
Furthermore, when the men were grouped by smoking status --
never-smokers, long-time quitters, recent quitters and current
smokers -- &;the effect of statins was always estimated to be
beneficial, but the size of the improvement in the decline rate
varied,&; Schwartz and colleagues report.
When the researchers analyzed the men according to smoking
status, it appeared that long-time and recent quitters
experienced greater benefits from statins compared with current
smokers and those who never smoked.
However, &;additional studies including more current smokers
would be needed to confirm that finding,&; Schwartz's group
noted.
&;This research,&; they conclude, &;adds to the growing body
of knowledge indicating the positive effects of statin use
beyond its cholesterol-lowering properties.&;
SOURCE: American Journal of Respiratory and Critical Care
Medicine, October 2007.