Report Toddler contracts rare infection
Sat, 17 Mar 2007 11:15:30 GMT
CHICAGO - A 2-year-old Indiana boy and his mother contracted a rare and life-threatening infection from his soldier father's smallpox vaccination, according to a published report.
The boy and his mother were being treated in a specially ventilated room at the University of Chicago's Comer Children's Hospital, the Chicago Tribune reported Saturday.
The family's name and home town were not released at their request.
The boy developed a virulent rash over 80 percent of his body earlier this month after coming in contact with his father, who had recently been vaccinated for smallpox before he was to be deployed overseas by the Army, the paper said.
Physicians stressed that the boy was not suffering from smallpox, but from the related vaccinia virus which is used to convey immunity to the much deadlier disease. They said the infection was a rare condition called eczema vaccinatum, which has not been reported since at least 1990, when the military ended a previous program of smallpox vaccination. Smallpox was declared eradicated in 1980.
The military began smallpox vaccinations again in 2002 because of bioterrorism fears.
Doctors said the child suffered from eczema, which is a known risk factor for vaccinia infection. People with eczema are warned not to have close physical contact with the recently vaccinated because the condition allows the virus to enter the skin, they said.
The U.S. Defense Department and federal, state and local health authorities have been in daily contact with the hospital about the case. Health officials say there is no infection risk for the general population because the vaccinia virus can be spread only through close physical contact.
Nonetheless, Dr. Madelyn Kahana, the hospital's chief of pediatric intensive care, said staff members treating the boy and his mother were required to wear face masks and gloves, and that the two had been placed in a special room with negative air pressure, so all air would blow inward.
Kahana said the boy had been treated with a potent antiviral drug, as well as with an anti-vaccinia agent supplied by the
CDC and the experimental drug ST-246, which was untried as a therapy in humans.
She said the boy appeared to be improving this week, but will probably lose 20 percent of his outer skin layer.
Mandates complicate HPV vaccine debate
Fri, 16 Mar 2007 23:14:08 GMT
By MARTHA IRVINE, AP National Writer
The scenario might go something like this: A drug company develops a vaccine that could help wipe out most future cases of cervical cancer. State governments add it to their list of required vaccines for school. Girls line up for shots. Years later, fewer of them die prematurely — and everyone is happier.
Easy, right?
But in the real world, the notion of requiring the HPV vaccine for young people is much more complicated than that.
Part of the controversy comes from the fact that — unlike the measles or whooping cough — you don't get the genital warts and cancer caused by the human papillomavirus from casual contact.
"The fact that it is a sexually transmitted disease has elevated it to another level," says Alina Salganicoff, the director of women's health policy at the Kaiser Family Foundation.
While proponents say requiring the vaccine would get it to the most people, critics have complained that the HPV vaccine would give teens a false sense of security and undermine abstinence-only education and parental autonomy.
The debate has been especially hot in states such as Texas, where state lawmakers are making moves to rescind a vaccine mandate backed by Gov. Rick Perry.
But not all the criticism for mandates is coming from conservative family groups and parents who oppose any vaccines.
For one, some members of the medical establishment have expressed discomfort with the lobbying efforts from Merck & Co., the maker of the HPV vaccine known as Gardasil.
That wariness persists even though Merck backed off from its mandate push last month, saying it would instead provide vaccine information only if requested by government officials.
Meanwhile, there are concerns about the cost of the vaccine and whether insurance companies will pay for it .
Some also worry that, in this age of drug recalls, more research is needed to determine the long-term effects of the HPV vaccine.
"I think the vaccine has a lot of potential to do a lot of good, but after more testing has been done," says Yvonne K. Fulbright, a sexologist and author based in New York and Washington, D.C. "You need to have the people's public health at interest and not just financial gain."
She says it would probably surprise some people to hear her say it — "but right now, if I had a daughter, I would not want her to get the vaccine."
Even one researcher whose work has been funded by Merck says he feels "ambivalent" about the current push for mandates in Texas, New Mexico and Virginia.
"I understand that mandates are the best way to protect the greatest number of people. It's the best way to deal with health care disparity issues for those who have trouble accessing health care and those who don't get Pap testing as regularly," says Gregory Zimet, a pediatrics professor at the Indiana University School of Medicine who has studied parents' attitudes toward the vaccines for HPV and other diseases.
But like others in his field, he thinks Merck pushed too quickly for mandates.
"There should have been more reasoned and thought-out debate," he says. "It's distracted from the fact that we have a way to reduce health care costs, reduce suffering and save lives."
In this country, there are about 9,700 new cases of cervical cancer and 3,700 deaths each year. Keeping those numbers in mind, Zimet says his surveys of parents have found that the large majority are interested in vaccinating their daughters against HPV.
Even two of the largest conservative family groups — Focus on the Family and the Family Research Council — say they have no problem with the vaccine, only a mandate.
"Anything that is a preventative to help women — and prevent cancer — is a good thing," says Moira Gaul, director of women's and reproductive health at the Family Research Council. "A vaccine in and of itself doesn't promote or deter behavior."
She says her organization simply believes that parents should make the decision about whether the vaccine is best for their children.
Other parents worry that, amid all the political discussion, ultimately, girls who are eligible for the vaccine will be left out of the discussion.
"Does the child have no rights whatsoever? Don't they have a say?" asks Laurie Rhind, a mom in Salem, N.H., who has two teenagers. After making the decision together, her 13-year-old daughter is scheduled to get the first of three HPV vaccine shots next month.
"I think there are too many adults thinking that our teenagers are uninformed and belligerent and can't make the right decision."
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On the Net:
http://www.cdc.gov/nip/vaccine/hpv/hpv-faqs.htm
Man with hand transplant to go home
Fri, 16 Mar 2007 23:17:18 GMT
By BRUCE SCHREINER, Associated Press Writer
LOUISVILLE, Ky. - A Michigan man who became the nation's third successful hand transplant recipient expects his new right hand to get a workout holding a fishing rod once he returns home. David Savage, an auto-parts plant supervisor from Bay City, Mich., will go home Saturday to continue his painstaking therapy following his 15-hour surgery Nov. 29 at Jewish Hospital in Louisville. The nation's first two hand transplant recipients underwent surgery at the same hospital.
Savage said Friday that his new hand is getting stronger and more flexible.
"I'm getting more movement out of the fingers and thumb," he said in an interview. "Sensation is starting to come back. I'm feeling a lot of things that I didn't feel at first."
Savage, 54, said he feels a tingling sensation in his right palm and sometimes gets "little shooting pains into the fingertips." He said he can feel cold sensation with the hand but still doesn't feel anything hot.
He lost his right hand in a machine press accident more than 30 years ago. After his accident, Savage used a prosthetic device.
Savage, who wears a brace on the new hand, said he expects to return to work in about a month, and looks forward to using it for "basic, everyday life stuff."
"I can't wait to get out fishing and use two hands," he said.
But he won't push it. He'll cast with his left hand until he gets a stronger grip with his new hand.
"But I will be able to hold the pole with the right hand," he said.
He was right-handed until his accident, then learned how to throw and write with his left hand.
Savage has started writing with his new hand after mastering how to grip a pen. He said he'll use the new hand to write instructions for the workers he supervises.
"Maybe they'll be able to read it," Savage said, laughing.
Savage said he's been throwing a small football with the right hand, keeping his relatives on their toes. He tried to surprise one family member recently by tossing the ball.
"I just picked it up and whipped it at him," Scott said.
Dr. Warren Breidenbach, the lead transplant surgeon, said Savage has made good progress.
Savage received the new hand from a donor who died the day he underwent the surgery.
One difference between Savage and the other two patients at Jewish Hospital is that Savage's drug regimen to try to keep his body from rejecting his new hand doesn't include steroids, which carry such potential harmful side effects as diabetes, hypertension and high blood pressure.
Keeping transplant patients off steroids, Breidenbach said, would be a "huge step forward."
The doctor said it will take another three months or so for Savage to get feeling in his fingertips, and the progress will continue for several years. "It's steady and slow."
Matt Scott of Mays Landing, N.J., who lost his left hand in a fireworks accident in 1985, received the first successful hand transplant at Jewish Hospital in 1999. The medical team at Jewish performed a second hand transplant in February 2001 on Jerry Fisher, a Michigan contractor.
Savage was released from Jewish Hospital on Dec. 8 and had been staying at a local hotel while undergoing therapy. He'll return to Louisville in June for a checkup.
Savage said he finds himself flexing the fingers on his new hand.
"It's like a new toy," he said. "You're just going to play with it for awhile."
New meningitis test gets OK from feds
Fri, 16 Mar 2007 23:14:41 GMT
WASHINGTON - A test to help doctors rapidly distinguish between viral meningitis and less common but more severe spinal cord and brain infections caused by bacteria received federal approval Friday.
The Xpert EV test can give meningitis test results in 2 1/2 hours, or far less than the week it can now take, the
Food and Drug Administration said. Sunnyvale, Calif.-based Cepheid developed the test and the company's shares jumped 78 cents, or 9 percent, to $9.44 on the Nasdaq Stock Market.
Meningitis is an infection of the fluid surrounding the spinal cord and brain. The newly approved test, when used in combination with other laboratory tests, can distinguish between viral and bacterial meningitis. That can minimize delays in treating patients, the FDA said.
Bacterial meningitis can lead to brain damage, hearing loss and even death if not treated. Patients with viral meningitis can recover on their own within two weeks — yet often are treated, ultimately unnecessarily, with antibiotics as a safeguard against bacterial meningitis, the FDA said.
