Times of the Internet RSS Feed - health

CDC: H1N1 down some, but could return

ATLANTA, Nov. 20 (UPI) --

Influenza cases are down in some parts of the United States, but 43 states are still reporting activity, health officials said Friday.

Even if things do get better and better over the next several weeks, we look at that 1957 experience where after the first of the year, a second wave of mortality occurred, Dr. Anne Schuchat, director of CDC's National Center for Immunization and Respiratory Diseases, told reporters at a briefing in Atlanta.

The latest report of flu cases in 43 states was down from 46.

I wish I knew if we had hit the peak, Schuchat said. What I can say is that even when a peak has occurred, half of the people who are going to become ill haven't gotten ill yet.

Overall, about two-thirds of U.S. children (laboratory confirmed) who died from influenza have had an underlying conditions such as asthma or neurological problems like cerebral palsy, and about one-third have not, Schuchat said.

The children have an influenza virus causing disease and then they get one of these common bacterial infections and it's very severe pneumonia on top. We've seen staph aureus and we've also seen the pneumococcus, but it's a bacteria that we have a good vaccine for, a vaccine that's good in children and high-risk adults, Schuchat said.

Specifically, 54.1 million doses of H1N1 vaccine have become available for the states -- 11 million doses more than we were at a week ago -- about half of the vaccines have gone to children, Schuchat said.

Four cases of H1N1 Tamiflu resistant

DURHAM, N.C., Nov. 20 (UPI) --

Four patients with H1N1 influenza at Duke University Hospital in Durham,N.C., were resistant to Tamiflu, university officials confirmed Friday.

A team of experts from the Centers for Disease Control and Prevention, the North Carolina Public Health Department, Durham County Health Department and Duke University are working collaboratively to better understand the nature of the cases, which occurred in the past six weeks, the school said.

All four patients were very ill with underlying severely compromised immune systems and multiple other complex medical conditions.

We're partnering with all of the involved agencies to examine these cases, Dr.Daniel Sexton, director of the Duke infection control outreach network, said in a statement.

Our extensive investigation thus far has revealed that appropriate infection control procedures have been diligently practiced on this isolated unit, and throughout the hospital, and we have experienced no illness among employees taking care of these patients in the affected unit over this period of time.

CDC reported that all confirmed cases of oseltamivir-resistant virus to date have been susceptible to zanamivir, or Relenza, a second anti-viral medication used to treat H1N1. At this time, CDC does not recommend any changes in anti-viral guidance.

Flu tests: H1N1 may have peaked in Oct.

MADISON, N.J., Nov. 20 (UPI) --

Data from a laboratory testing company suggests the H1N1 flu may have peaked in October in the United States, company officials said.

A report by Quest Diagnostics Inc., a leading provider of diagnostic testing services, released Friday said the rates of infection by the H1N1 influenza virus may have peaked in late October, but the pandemic flu virus continues to be a potential source of illness in all age groups, including the elderly.

Officials at Quest Diagnostics analyzed results of more than 142,000 de-identified patient specimens tested for the H1N1 influenza virus between May 11 and Nov. 10 in the United States. Other report findings include:

-- In the weeks following Oct. 27, H1N1 test demand declined after several weeks of strong growth.

-- About 99 percent of positive influenza A specimens tested were positive for H1N1 influenza.

-- The number of specimens that tested positive for H1N1 influenza dropped in all age groups since late October, with the exception of those age 65 and older. In this age group, rates of positivity have tripled since late August, and are now at about 14 percent.

-- Rates of positive test results for the pandemic have declined in recent weeks in most regions, with the exception of the Northeast, where rates have more than doubled during the two weeks ending Nov. 10.

Study: A little anxiety, not so bad

LONDON, Nov. 20 (UPI) --

British and Norwegian researchers said depression is as big of a mortality risk factor as smoking.

However, the study found, unlike depression alone, a combination of depression and anxiety lowers mortality.

One of the main messages from this research is that 'a little anxiety may be good for you,' Dr. Robert Stewart of Kings College London said in a statement.

Possible reasons may that be those with anxiety may be more willing to ask for help and doctors may be more likely to investigate further to calm anxieties, the researchers said.

The researchers tracked 60,000 people for four years. The mortality risk was increased in a similar extent in people who were depressed as in people who were smokers.

It appears that we're talking about two risk groups here. People with very high levels of anxiety symptoms may be naturally more vulnerable due to stress, for example through the effects stress has on cardiovascular outcomes, Stewart said.

On the other hand, people who score very low on anxiety measures, i.e. those who deny any symptoms at all, may be people who also tend not to seek help for physical conditions, or they may be people who tend to take risks. This would explain the higher mortality.

The findings are published in the British Journal of Psychiatry.

'Heartburn' damage or GERD not acid burn

DALLAS, Nov. 20 (UPI) --

Reflux damage to the esophagus may be an immune response, not acid burn, U.S. researchers say.

Dr. Stuart Spechler and Dr. Rhonda Souza of The University of Texas Southwestern Medical Center in Dallas said their animal study, published in Gastroenterology, found gastroesophageal reflux disease may develop in response to chemicals -- called cytokines -- that attract inflammatory cells to the esophagus.

The researchers say they produced GERD in rats in a way similar to how it develops in humans -- by having acidic digestive juices from the stomach surge into the esophagus.

After the operation, the researchers said they expected to see surface cells of the esophagus die and the injury progress to the deeper layers. However, three days after the surgery, there was no damage to surface cells, but the researchers did find inflammatory cells in the deeper layers of the esophagus. Those inflammatory cells did not rise to the surface layer until three weeks after the initial acid exposure.

Currently, we treat GERD by giving medications to prevent the stomach from making acid but if GERD is really an immune-mediated injury, maybe we should create medications that would prevent these cytokines from attracting inflammatory cells to the esophagus and starting the injury in the first place, Souza, the lead author, said in a statement.

Thanksgiving: Time to discuss end-of-life

CHICAGO, Nov. 20 (UPI) --

Thanksgiving is a perfect time to talk to family members about end-of-life wishes, a U.S. group of doctors who specialize in end-of-life issues says.

The American Academy of Hospice and Palliative Medicine offers assistance for such conversations to ensure death wishes are understood.

To help a family have end-of-life conservations:

-- Gather around a comfortable spot such as the living room or the dining room table.

-- Set aside a period of time, an hour should be enough, depending on how many family members participate.

-- Take turns discussing end-of-life wishes, including what level of treatment and whether every possible medical treatment should be performed, and when treatment should be stopped once quality of life is severely diminished, discussing quality of life means and whether resuscitation should be performed.

-- Discuss who should be a healthcare proxy, a person who will make medical decisions for a person who cannot.

-- Write end-of-life wishes down.

-- End-of-life issues should be discussed long before they need to be answered, and discussed more than once over the years.

To help prepare for an end-of-life discussion, such as developing an advance directive and designating a healthcare proxy see: http://www.aah pm.org/patient/resources/directives.html.

Giant snails could help fight hunger

UYO, Nigeria, Nov. 20 (UPI) --

A readily available giant land snail could help reduce malnutrition and iron deficiency in African countries, a Nigerian researcher says.

The West African land snail, Archachatina marginata, is cheaper and more nutritious than beef, and is tasty when prepared in small pies, said Ukpong Udofia of the Department of Home Economics at Nigeria's University of Uyo.

Mothers and children asked to taste the pies preferred them to pies made with beef, Udofia said, noting the snails are rich in protein and iron. The snails, which can grow up to 350 grams, more than 12 ounces, also contain healthy amounts of fat, calcium, magnesium, copper, zinc and vitamins A, B6, B12, K, she said.

The land snail inhabits many forests and swamps in Africa and in recent years has been domestically cultivated, though more for pets than for food.

Iron and protein deficiencies affect many mothers and their children in Africa and lead to serious health problems, the World Health Organization said.

Budget cuts hurting STD control

WASHINGTON, Nov. 20 (UPI) --

State and local government budget cuts are impacting health departments in controlling the spread of sexually transmitted diseases, U.S. researchers said.

The study by the National Coalition of STD Directors is based on a recent survey of health department budget cuts in states, large U.S. cities and U.S. territories and the impact on public health departments.

Lead author Dr. William Wong, STD program director for the Chicago Department of Public Health, said budget cuts, coupled with the long-term effects of flat or declining federal resources, have severely hampered the ability of STD programs to keep pace with the increasing demand for STD testing and treatment services and the rising rates of STDs.

Sixty-nine percent of the STD programs surveyed experienced funding cuts from 2008-2009. Between 2008-2009, 39 clinics supported by state and local STD programs closed their doors due to inadequate funding.

The number of disease intervention specialists, the frontline public health workers comprising nearly half of the STD program workforce in health departments, declined nationwide by 20 percent over the last decade, Wong said.

The NCSD study comes on the heels of a study by the Centers for Disease Control and Prevention showing persistent high rates of STDs. In 2008, more than 1.2 million chlamydia cases were reported in the United States and syphilis increased 18 percent from 2007-2008, Wong said.

The study is at www.ncsddc.org/stdprogramcapacity2009.xml.

New guidelines issued for Pap smears

LOS ANGELES, Nov. 20 (UPI) --

A test for cervical cancer is needed less frequently than previously recommended, regardless of a woman's age, a doctors' group says.

New guidelines issued by the American College of Obstetricians and Gynecologists advise young women to forgo having Pap smears until they reach the age of 21, the Los Angeles Times reported Friday.

The updated guidelines, published in the journal Obstetrics & Gynecology, recommend an initial Pap test three years after becoming sexually active or at age 21, whichever comes first.

Testing is recommended every two years for women 21-29 and every three years for women 30 or older who have had three normal Pap smears in a row.

The guideline changes for Pap smears were issued just days after a federal panel scaled back advice on breast cancer screening.

The U.S. Preventative Services Task Force dismissed routine breast cancer screenings for most women under the age of 50.

Making shopping less 'germy' during H1N1

NEW ORLEANS, Nov. 20 (UPI) --

As shoppers prepare for Black Friday retail sales, a U.S. infectious disease expert warns stores can be an H1N1 virus petri dish.

Simply walking into a store can be a hazard as the door handle contains germs from everyone who has touched it in the past eight hours, Dr. Katherine Baumgarten, medical director of infection control of the Ochsner Medical Center in New Orleans, says in a statement.

Obviously, it's impossible to shop 'germ-free,' but if you're conscious of the ways in which germs travel from person-to-person, it's much easier to protect yourself.

Common shopping actions can put a person in contact with viruses, such as H1N1 via: opening doors, picking up merchandise, touching elevator buttons and escalator handles, exchanging money or credit cards, eating with fingers, or sampling hand lotions and perfumes.

You've heard it before, but the single best way to protect yourself is through hand washing or hand sanitizers, Baumgarten says.

Other germ-reducing tips to keep shoppers healthy include:

-- Wash hands before eating anything.

-- Find a table on the edge of the food court to avoid crowds.

-- Avoid finger-foods.

-- Don't rub eyes, nose or cover cough/sneeze with hands sneeze into elbow.

-- Use a paper towel to exit public bathrooms.

-- Avoid sampling the perfumes/lotions. Simply pushing the pumps on lotions or perfumes can add germs to a clean hand.

Child asthma, mother's depression linked

BALTIMORE, Nov. 20 (UPI) --

Maternal depression may aggravate a child's asthma but how often a child had symptoms did not seem to affect the mother's symptoms, U.S. researchers said.

Researchers at Johns Hopkins Children's Center in Baltimore analyzed data from interviews with 262 mothers of African-American children with asthma -- a population disproportionately affected by the inflammatory airway disorder.

The study, in the Journal of Pediatric Psychology, found children whose mothers had more depressive symptoms had more frequent asthma symptoms during the six-month study. Conversely, children whose mothers reported fewer depressive symptoms had less frequent asthma symptoms.

Senior investigator Kristin Riekert, a pediatric psychologist and co-director of the Johns Hopkins Adherence Research Center, and colleagues tracked ups and downs in maternal depression as related to the frequency of symptoms among children.

Even though our research was not set up to measure just how much a mom's depression increased the frequency of her child's symptoms, a clear pattern emerged in which the latter followed the earlier, Riekert said in a statement.

Intuitively, it may seem that we're dealing with a chicken-egg situation, but our study suggests otherwise. The fact that mom's depression was not affected by how often her child had symptoms really caught us off guard, but it also suggested which factor comes first.

Most know salt is bad, few shake habit

EDMONTON, Alberta, Nov. 20 (UPI) --

Most Canadians say they know too much salt isn't healthy, but many don't do anything to reduce their salt intake, researchers say.

Anna Farmer and Diana Mager of the University of Alberta say their survey of 890 people indicates 85 percent understood too much sodium can lead to health problems but fewer than half were aware of how much salt was too much.

It's good news that Canadians understand some of the issues around excessive sodium consumption, and that at least half are willing to adjust their behavior to reduce salt use, Farmer said in a statement. Most respondents in this survey understood that canned or processed foods are among the highest sources of dietary sodium. But the results also show that there's still room for more education.

Farmer said she wants to see salt-reduction messages aimed at young adults, ages 18-24. Fewer people in this age group understood that salt is the major contributor to total sodium consumed, or that foods cooked from scratch are generally lower in sodium.

Smoked salmon recalled for Listeria

NEW YORK, Nov. 20 (UPI) --

Some lots of Brooklyn's Best Brand smoked salmon are being recalled because of a potentially deadly bacteria found in some packages, U.S. authorities said.

Packages sampled by the U.S. Food and Drug Administration contained Listeria monocytogenes, an organism which can serious and sometimes fatal infections in children, the elderly and people with weakened immune systems, the agency said in a release.

Listeria infection also can cause miscarriages and stillbirths in pregnant women, the FDA said, noting no illnesses had been reported to date.

Service Smoked Fish Corp., Brooklyn, N.Y, is recalling Brooklyn's Best Brand smoked Nova salmon with Use-By dates of Dec. 3, 2009 through Dec. 19, 2009. The salmon was distributed in New York, New Jersey, Connecticut, Baltimore, Los Angeles and Portland, Ore.

Do doctor's neckties spread swine flu?

CHICAGO, Nov. 20 (UPI) --

Doctors' neckties may be vectors of communicable diseases, including swine flu, U.S. infectious disease experts say.

The American Medical Association is considering a resolution that would recommend bans on doctors wearing neckties while they are in contact with patients. The ban could also apply to long sleeves and other excess clothing that could pick up viruses or bacteria.

The organization is seeking more information before it takes a vote.

The British Medical Association has already acted. In 2006, it recommended doctors stop wearing functionless clothing.

Some hospitals in the United States have already asked doctors to give up their neckties.

Few necktie users wash or clean them frequently. When both doctors and patients are sitting down, ties tend to fall forward at a likely height to be sneezed on.

SaefeSmart, a company based in St. Augustine, Fla., is marketing a tie reportedly resistant to the H1N1 virus. The ties with a tasteful design based on the virus are covered with an anti-microbial coating.

Prescription drugs, abortions linked

MONTREAL, Nov. 20 (UPI) --

Half of expectant mothers taking prescription drugs that may harm the fetus terminate their pregnancies, Canadian researchers found.

The researchers examined data from the Quebec Pregnancy Registry on 109,344 women ages15-45 and found 6,871 pregnant women consumed one of 11 prescription drugs known to be harmful to fetuses through the first, second or third trimester.

Of those women, 3,229 had an abortion, 6 percent had a miscarriage and 8.2 percent gave birth to a child with major congenital malformations.

I never expected such results and I was extremely surprised, study senior author Anick Berard of the University of Montreal said in a statement.

Berard, currently a visiting professor at the Universite Claude Bernard in Lyon, France, said she is concerned there were 11,400 prescriptions for dangerous medicines to treat acne, anxiety and epilepsy that increase the risk of malformations by 30 percent yet are freely available without proper risk management.

Some drugs, Berard said, may be overused -- such as benzodiazepine to treat symptoms of anxiety -- but anti-epileptics may be necessary.

In those cases, the pregnancy must be carefully planned and medication use must be at a strict minimum during the first trimester, Berard stressed. And the expectant mother must meet with her physician regularly.

The findings are published in the British Journal of Obstetrics and Gynaecology.

Study: Few pregnancy complications with MS

STANFORD, Calif., Nov. 20 (UPI) --

Pregnant women with multiple sclerosis are slightly more likely to have Cesarean deliveries and babies with poor prenatal growth rate, U.S. researchers say.

Researchers at Stanford University School of Medicine found a woman with MS was no more likely to have pre-eclampsia and other high blood pressure problems or premature rupture of membranes, than women in the general population.

Women with MS had only a slightly higher chance of having a Cesarean deliveries or babies with poor prenatal growth.

The study involved 38 states, included an estimated 18.8 million deliveries, with about 10,000 of those occurring in women with MS, the researchers say.

These results are reassuring for women with MS, study author Dr. Eliza Chakravarty said in a statement. Women and their doctors have been uncertain about the effect of MS on pregnancy, and some women have chosen to delay or even avoid pregnancy due to the uncertainty. We found that women with MS did not have an increased risk of most pregnancy complications.

The findings are published in Neurology.

Bird flu human-to-human spread unlikely

LONDON, Nov. 20 (UPI) --

Bird flu would need two simultaneous mutations to spread from human to human, British and U.S. researchers say.

The study, published in PLoS One, finds the unlikelihood of two mutations occurring at the same time makes sustained human-to-human transmission less probable.

Our new research suggests that it is less likely than we thought that H5N1 will cause a pandemic, because it's far harder for it to infect the right cells, corresponding author Wendy Barclay of the Imperial College London says in a statement. However, viruses mutate all the time, so we shouldn't be complacent. Our new findings do not mean that this kind of pandemic could never happen. It's important that scientists keep working on vaccines so that people can be protected if such an event occurs.

The researchers say H5 strains of influenza are widespread in bird populations around the world and occasionally infect humans. The H5N1 strain has infected more than 400 people since 2003. The mortality rate in humans is at around 60 percent, the study says.

2008 typhus outbreak in Texas atypical

ATLANTA, Nov. 19 (UPI) --

An outbreak of murine typhus was confirmed in Travis County, Texas, last year, federal health officials said.

The Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report said Thursday although murine typhus, a flea-borne disease often transmitted to humans through contact with rats, is endemic in southern Texas, only two cases had been reported in central Texas in the past 10 years.

This central Texas outbreak had 33 confirmed cases, 73 percent of whom were hospitalized, and was comparable to previous outbreaks of murine typhus, the report said.

However, the suspected vector -- cat flea -- and reservoir -- an opossum -- were atypical for a suburban setting, health officials said.

Clinicians and the public should be aware of the symptoms, appropriate treatment and prevention measures, and the importance of promptly notifying local or state health officials of suspected cases of murine typhus, health officials said.

Murine typhus symptoms include: abdominal pain, backache, dull red rash that begins on the middle of the body and spreads, extremely high fever of 105-106 degrees Fahrenheit, hacking, dry cough, headache, joint pain, nausea and vomiting.

Niacin may not help arteries

BALTIMORE, Nov. 19 (UPI) --

Prescribing niacin -- a B vitamin -- may not help open arteries, U.S. researchers said.

Senior study investigator Dr. Joao Lima of the Johns Hopkins University School of Medicine in Baltimore said vascular imaging of 145 men and women age 65 and older with existing artherosclerosis showed no measurable difference in arterial wall thickness reductions between the half who took dual niacin-statin therapy for 18 months and the rest who remained on statin therapy alone.

However, results showed the group taking both niacin and a statin -- a cholesterol lowering drug -- had blood levels of low-density lipoprotein or the bad cholesterol, go down 5 percent more than those of taking statins alone.

Also, high-density lipoprotein, the good cholesterol increased 14 percent over those taking statins alone.

Our findings tell us that improved cholesterol levels from taking combination vitamin B niacin and statin therapy do not necessarily translate into observable benefits in reversing and stalling carotid artery disease, Lima said in a statement.

This does not mean that niacin therapy may not have other cardiovascular benefits, but any such benefits are independent of reducing the amount of plaque buildup and patients should be aware of that.

The findings was presented at the American Heart Association's annual scientific sessions in Orlando, Fla.

Most middle-age adult don't get screenings

ATLANTA, Nov. 19 (UPI) --

Seventy-five percent of U.S.adults ages 50-64 do not get recommended preventive screenings and immunizations, federal health officials said.

The report by Centers for Disease Control and Prevention in collaboration with AARP and the American Medical Association identifies recommended preventive services such as influenza vaccine, cholesterol screening, breast and cervical cancer screening, as well as preventive screenings for behaviors that could negatively impact health such as binge drinking.

People ages 50-64 need access to preventive services to help them improve their overall health and to live vibrant, productive lives, Dr. Thomas Frieden, director of the CDC, said in a statement.

CDC and our partners AARP and AMA are excited about this new resource because it enables our partners and others to more easily and effectively monitor improvements in health behaviors, screenings and immunizations. Our goal is to enhance the delivery and use of these recommended preventive services.

To view the full report and for more information about CDC's health aging activities visit www.cdc.gov/aging.