Tuesday, March 15, 2005
Monday, March 14, 2005
Thursday, June 19, 2003
Experts: Risk of stroke may start in the womb
Last Updated: 2003-06-19 16:43:50 -0400 (Reuters Health)
By Alison McCook
NEW YORK (Reuters Health) - Researchers have long struggled to explain why some people living in certain regions of the U.S. and UK are more likely to develop stroke than others. Now, two experts are looking to the womb to explain this uneven pattern. They found that UK regions marked by high stroke rates also showed high rates of death among mothers and infants in the early 20th century, the years when many stroke patients were born. This trend suggests that the mysterious variations in stroke rates may be the result of historical, regional differences in maternal health, they write in a report released Thursday. If this theory proves correct, study author Dr. David J. P. Barker of the University of Southampton in the UK told Reuters Health that, in the next generation, stroke prevention may lie "in good nutrition among mothers at conception and beyond."
In the U.S., the southeast is known as the "stroke belt," a region where stroke rates and the risk of death from stroke are significantly higher than in the rest of the country. In England and Wales, researchers have found that stroke rates tend to spike in northern towns, where they are accompanied by similar increases in the rates of high blood pressure and death from heart disease. Researchers who have investigated the potential reasons behind the patchwork distribution of stroke rates in the U.S. have shown they bear no relationship to inequalities in medical care, and have uncovered no explanation for why they occur.
Now, in the journal Stroke: Journal of the American Heart Association, Barker and co-author Dr. Daniel T. Lackland of the Medical University of South Carolina in Charleston propose that the differences in stroke rates may stem from previous geographical variations in overall prenatal health. In the report, Barker and Lackland compare stroke-related death rates in different regions of England and Wales between 1968 and 1978 to the rate of maternal and infant deaths during the first part of the 20th century, approximately the time when many stroke patients were born. In an interview, Barker said that places in the UK that are characterized by high rates of stroke had historically high rates of death among mothers and babies. "It's a very strong relationship," he explained.
As further evidence that the risk of stroke may begin before birth, Barker said that people with low birth weights -- a sign of poor prenatal nutrition -- are more likely to eventually develop stroke. He added that the phenomenon of the U.S. stroke belt and other regions with high stroke rates applies to people who were born in these areas, and not those who moved there later in life. "The place where you're born is a strong determinant of your stroke risk," he said.
In an accompanying editorial, Dr. Larry B. Goldstein of Duke University in Durham, North Carolina cautions that the current report only links stroke risk to in utero health, and does not show that one causes the other. "Despite this inherent limitation ... the data provide another compelling argument to ensure adequate prenatal care and maternal nutrition," Goldstein writes.
Source: Stroke 2003;10.1161/01.STR.0000077257.27430.7E
Last Updated: 2003-06-19 16:43:50 -0400 (Reuters Health)
By Alison McCook
NEW YORK (Reuters Health) - Researchers have long struggled to explain why some people living in certain regions of the U.S. and UK are more likely to develop stroke than others. Now, two experts are looking to the womb to explain this uneven pattern. They found that UK regions marked by high stroke rates also showed high rates of death among mothers and infants in the early 20th century, the years when many stroke patients were born. This trend suggests that the mysterious variations in stroke rates may be the result of historical, regional differences in maternal health, they write in a report released Thursday. If this theory proves correct, study author Dr. David J. P. Barker of the University of Southampton in the UK told Reuters Health that, in the next generation, stroke prevention may lie "in good nutrition among mothers at conception and beyond."
In the U.S., the southeast is known as the "stroke belt," a region where stroke rates and the risk of death from stroke are significantly higher than in the rest of the country. In England and Wales, researchers have found that stroke rates tend to spike in northern towns, where they are accompanied by similar increases in the rates of high blood pressure and death from heart disease. Researchers who have investigated the potential reasons behind the patchwork distribution of stroke rates in the U.S. have shown they bear no relationship to inequalities in medical care, and have uncovered no explanation for why they occur.
Now, in the journal Stroke: Journal of the American Heart Association, Barker and co-author Dr. Daniel T. Lackland of the Medical University of South Carolina in Charleston propose that the differences in stroke rates may stem from previous geographical variations in overall prenatal health. In the report, Barker and Lackland compare stroke-related death rates in different regions of England and Wales between 1968 and 1978 to the rate of maternal and infant deaths during the first part of the 20th century, approximately the time when many stroke patients were born. In an interview, Barker said that places in the UK that are characterized by high rates of stroke had historically high rates of death among mothers and babies. "It's a very strong relationship," he explained.
As further evidence that the risk of stroke may begin before birth, Barker said that people with low birth weights -- a sign of poor prenatal nutrition -- are more likely to eventually develop stroke. He added that the phenomenon of the U.S. stroke belt and other regions with high stroke rates applies to people who were born in these areas, and not those who moved there later in life. "The place where you're born is a strong determinant of your stroke risk," he said.
In an accompanying editorial, Dr. Larry B. Goldstein of Duke University in Durham, North Carolina cautions that the current report only links stroke risk to in utero health, and does not show that one causes the other. "Despite this inherent limitation ... the data provide another compelling argument to ensure adequate prenatal care and maternal nutrition," Goldstein writes.
Source: Stroke 2003;10.1161/01.STR.0000077257.27430.7E
Thursday, June 12, 2003
Skinny On Online Nutrition Data
PALO ALTO, Calif. June 12, 2003
There are plenty of books, software programs and Web sites that provide nutrition information about foods, including calories, carbohydrates, protein and calcium. But what many of these commercial products don't tell you is that the data itself - more often than not - comes from the U.S. Department of Agriculture and that it can be obtained free of charge.
The USDA maintains extensive data on 6,220 food items in what it calls "The USDA Nutrient Database for Standard Reference." Over time, the database is revised and it is currently working with "release 15."
The data is available on CD-ROM for $20, but you can also search it over the Internet for free and download free software for use on a Windows computer or a personal digital assistant that runs the Palm operating system. You can also download it as an Excel spreadsheet, a Microsoft Access database file or a standard text file that can be read by any word processing program.
You can find a link to these files at http://www.nal.usda.gov/fnic/foodcomp/ or at my nutrition Web site, www.NoBellyPrize.com.
The Windows software, "USDA Food Search for Windows," is a lot faster and easier to use than the USDA's Web site. The file itself is quite large (30 megabytes), which means that it can take about two hours to download using a 56 K modem, though it only takes a few minutes to download if you have a high-speed broadband connection. However, once you have it on your PC, you can easily access all the information. Unlike using the Web site, there are no long delays when you search this program.
And there is plenty information besides calories and carbs, fiber, most vitamins, total sugar and more are covered too. In addition to reporting total fat, it also reports the breakdown of saturated, monounsaturated and polyunsaturated fat. This is important because saturated fat (along with trans-fat, which is not yet reported) has been associated with an increased risk of cardiovascular disease. Many experts believe that polyunsaturated and monounsaturated fat, though high in calories, can be good for the cardiovascular system.
Portion size is, of course, critical, when understanding data on nutrition. The program usually defaults by reporting nutrients per 100 gram edible portion, but you can set it to report by different increments, including by the ounce or, when applicable, by the piece.
You can view data on the screen or print out a complete report on any food.
The Palm version of the software includes a search screen as well as a table of contents broken down by food group, such as Baby Foods, Baked Products, Beef Products, Beverages, etc. Having this data on a Palm device can be especially handy if you need to look something up while on the road or even in a restaurant, though I don't recommend that you bring it out while the waiter is at your table unless you plan to leave a very large tip.
Downloading the data as an Excel spreadsheet or a Microsoft Access database file can also be handy but, unless you're quite skilled at using those programs, it might be a bit daunting. Programmers, however, can use the data in these formats - or as text files - to incorporate into their software or Web sites.
Though the information can be very useful, the USDA database is just a database. It does not come with any suggested eating plans or any other recommendations. There are many programs and Web sites that add value to the database by including it within planning programs that help you lose weight, including fee-based professional diet sites like eDiets.com, Cyberdiet.com and WeightWatchers.com.
Ediets, for example, helps you design a weight-loss program based on your preferences and goals. The company can tailor a diet based on the Atkins (very low carbohydrate) principles, the Zone (a mixture of carbs and protein) approach or one customized to fit your needs or desires, such as a cholesterol-lowering diet, a "heart smart" diet or even a "healthy soy" diet.
The company, of course, hopes that you'll pay for its services (it charges $5 a week, billed quarterly with the option to cancel at any time), but even if you don't join you can get a quick analysis that may be of value to some people.
The Internet, of course, offers many other free and paid resources, including online calorie counters and activity counters that estimate how many calories you burn in a day or while doing a particular activity. All of these numbers are approximate but are a good place to start if you don't already have a strong background in the role that exercise can play in helping to lose or maintain weight.
You'll find plenty of links to diet resources, links to download the USDA database as well as some of my writings on the subject at www.NoBellyPrize.com.
Source: CBSnews.com
PALO ALTO, Calif. June 12, 2003
There are plenty of books, software programs and Web sites that provide nutrition information about foods, including calories, carbohydrates, protein and calcium. But what many of these commercial products don't tell you is that the data itself - more often than not - comes from the U.S. Department of Agriculture and that it can be obtained free of charge. The USDA maintains extensive data on 6,220 food items in what it calls "The USDA Nutrient Database for Standard Reference." Over time, the database is revised and it is currently working with "release 15."
The data is available on CD-ROM for $20, but you can also search it over the Internet for free and download free software for use on a Windows computer or a personal digital assistant that runs the Palm operating system. You can also download it as an Excel spreadsheet, a Microsoft Access database file or a standard text file that can be read by any word processing program.
You can find a link to these files at http://www.nal.usda.gov/fnic/foodcomp/ or at my nutrition Web site, www.NoBellyPrize.com.
The Windows software, "USDA Food Search for Windows," is a lot faster and easier to use than the USDA's Web site. The file itself is quite large (30 megabytes), which means that it can take about two hours to download using a 56 K modem, though it only takes a few minutes to download if you have a high-speed broadband connection. However, once you have it on your PC, you can easily access all the information. Unlike using the Web site, there are no long delays when you search this program.
And there is plenty information besides calories and carbs, fiber, most vitamins, total sugar and more are covered too. In addition to reporting total fat, it also reports the breakdown of saturated, monounsaturated and polyunsaturated fat. This is important because saturated fat (along with trans-fat, which is not yet reported) has been associated with an increased risk of cardiovascular disease. Many experts believe that polyunsaturated and monounsaturated fat, though high in calories, can be good for the cardiovascular system.
Portion size is, of course, critical, when understanding data on nutrition. The program usually defaults by reporting nutrients per 100 gram edible portion, but you can set it to report by different increments, including by the ounce or, when applicable, by the piece.
You can view data on the screen or print out a complete report on any food.
The Palm version of the software includes a search screen as well as a table of contents broken down by food group, such as Baby Foods, Baked Products, Beef Products, Beverages, etc. Having this data on a Palm device can be especially handy if you need to look something up while on the road or even in a restaurant, though I don't recommend that you bring it out while the waiter is at your table unless you plan to leave a very large tip.
Downloading the data as an Excel spreadsheet or a Microsoft Access database file can also be handy but, unless you're quite skilled at using those programs, it might be a bit daunting. Programmers, however, can use the data in these formats - or as text files - to incorporate into their software or Web sites.
Though the information can be very useful, the USDA database is just a database. It does not come with any suggested eating plans or any other recommendations. There are many programs and Web sites that add value to the database by including it within planning programs that help you lose weight, including fee-based professional diet sites like eDiets.com, Cyberdiet.com and WeightWatchers.com.
Ediets, for example, helps you design a weight-loss program based on your preferences and goals. The company can tailor a diet based on the Atkins (very low carbohydrate) principles, the Zone (a mixture of carbs and protein) approach or one customized to fit your needs or desires, such as a cholesterol-lowering diet, a "heart smart" diet or even a "healthy soy" diet.
The company, of course, hopes that you'll pay for its services (it charges $5 a week, billed quarterly with the option to cancel at any time), but even if you don't join you can get a quick analysis that may be of value to some people.
The Internet, of course, offers many other free and paid resources, including online calorie counters and activity counters that estimate how many calories you burn in a day or while doing a particular activity. All of these numbers are approximate but are a good place to start if you don't already have a strong background in the role that exercise can play in helping to lose or maintain weight.
You'll find plenty of links to diet resources, links to download the USDA database as well as some of my writings on the subject at www.NoBellyPrize.com.
Source: CBSnews.com
Tuesday, June 03, 2003
Two Painkillers Fail to Slow Alzheimer's
Study Finds That Two Popular Pain Relievers Fail to Slow the Progression of Alzheimer's Disease
CHICAGO June 3
Two popular pain relievers failed to slow the progression of Alzheimer's disease in people with mild to moderate mental decline, a study found, dampening hopes that widely used anti-inflammatory drugs might be an effective treatment.
After a year on the prescription drug Vioxx or over-the-counter Aleve, known generically as naproxen, patients were no better off than those taking dummy pills.
The results "are not encouraging for those who are in need of an effective immediate intervention," said Georgetown University's Dr. Paul Aisen, who led the study.
Despite the disappointing findings in people already diagnosed with Alzheimer's, nonsteroidal anti-inflammatory drugs such as those studied could still prove effective in preventing the disease in the first place, said Neil Buckholtz, chief of the National Institute on Aging's division of dementias in aging. The institute helped pay for the study and is sponsoring continuing research on the theory.
Some previous studies have suggested that certain pain relievers might slow or prevent Alzheimer's. The theory is based in part on evidence that some people who use a lot of anti-inflammatory medication, such as those with arthritis, seem to be less prone to Alzheimer's.
Researchers believe that inflammation contributes to the neurological damage found in the mind-robbing disease.
But the earlier studies were less rigorous than Aisen's research, which compared anti-inflammatory drugs and dummy pills head-to-head.
His study involved 351 men and women about 74 years old on average with Alzheimer's symptoms. The findings appear in Wednesday's Journal of the American Medical Association.
NIA researcher Lenore Launer said in an accompanying editorial that it might be that when Alzheimer's has progressed to the point of causing symptoms, it is too far advanced to be affected by anti-inflammatory drugs.
"Full-blown Alzheimer's disease exhibits extensive brain pathology," Launer said, adding, "Slowing the progression at that stage may be too late."
Many people hoping to reduce Alzheimer's symptoms take drugs such as Vioxx and Aleve but should stop because they can cause serious gastrointestinal problems, Aisen said. Six people in the study developed serious gastrointestinal bleeding.
Patients took 25 milligrams once daily of Vioxx a standard dose or 220 mgs twice-daily of Aleve a relatively low dose for a year. They were compared to patients taking a placebo.
Northwestern University professor Linda Van Eldik said it is possible that higher doses would have a beneficial effect and that other anti-inflammatory drugs would have better results.
"It would have been great if it had worked, but I don't think it's closing the door" to the use of such drugs against Alzheimer's, said Van Eldik, a member of the Alzheimer's Association's scientific advisory council.
Naproxen and other older nonsteroidal anti-inflammatory drugs target two enzymes involved in inflammation. Vioxx is a newer painkiller called a cox-2 inhibitor that targets only one of the enzymes.
Source: ABCNews.com
Study Finds That Two Popular Pain Relievers Fail to Slow the Progression of Alzheimer's Disease
CHICAGO June 3
Two popular pain relievers failed to slow the progression of Alzheimer's disease in people with mild to moderate mental decline, a study found, dampening hopes that widely used anti-inflammatory drugs might be an effective treatment.
After a year on the prescription drug Vioxx or over-the-counter Aleve, known generically as naproxen, patients were no better off than those taking dummy pills.
The results "are not encouraging for those who are in need of an effective immediate intervention," said Georgetown University's Dr. Paul Aisen, who led the study.
Despite the disappointing findings in people already diagnosed with Alzheimer's, nonsteroidal anti-inflammatory drugs such as those studied could still prove effective in preventing the disease in the first place, said Neil Buckholtz, chief of the National Institute on Aging's division of dementias in aging. The institute helped pay for the study and is sponsoring continuing research on the theory.
Some previous studies have suggested that certain pain relievers might slow or prevent Alzheimer's. The theory is based in part on evidence that some people who use a lot of anti-inflammatory medication, such as those with arthritis, seem to be less prone to Alzheimer's.
Researchers believe that inflammation contributes to the neurological damage found in the mind-robbing disease.
But the earlier studies were less rigorous than Aisen's research, which compared anti-inflammatory drugs and dummy pills head-to-head.
His study involved 351 men and women about 74 years old on average with Alzheimer's symptoms. The findings appear in Wednesday's Journal of the American Medical Association.
NIA researcher Lenore Launer said in an accompanying editorial that it might be that when Alzheimer's has progressed to the point of causing symptoms, it is too far advanced to be affected by anti-inflammatory drugs.
"Full-blown Alzheimer's disease exhibits extensive brain pathology," Launer said, adding, "Slowing the progression at that stage may be too late."
Many people hoping to reduce Alzheimer's symptoms take drugs such as Vioxx and Aleve but should stop because they can cause serious gastrointestinal problems, Aisen said. Six people in the study developed serious gastrointestinal bleeding.
Patients took 25 milligrams once daily of Vioxx a standard dose or 220 mgs twice-daily of Aleve a relatively low dose for a year. They were compared to patients taking a placebo.
Northwestern University professor Linda Van Eldik said it is possible that higher doses would have a beneficial effect and that other anti-inflammatory drugs would have better results.
"It would have been great if it had worked, but I don't think it's closing the door" to the use of such drugs against Alzheimer's, said Van Eldik, a member of the Alzheimer's Association's scientific advisory council.
Naproxen and other older nonsteroidal anti-inflammatory drugs target two enzymes involved in inflammation. Vioxx is a newer painkiller called a cox-2 inhibitor that targets only one of the enzymes.
Source: ABCNews.com
Monday, June 02, 2003
Scientists identify new virus: Germ may cause many unexplained infections
June 2 — It isn’t SARS, but infectious disease specialists are trying to learn more about a recently discovered virus that some think may be the culprit in many unexplained respiratory illnesses around the world.
THE EXACT prevalence of human metapneumovirus isn’t known, but Yale University researchers recently found it in 6.4 percent of retested lab samples from 296 children with respiratory symptoms in late 2001 and early 2002, according to a study published Monday in the June edition of Pediatrics.
It was also discovered after the fact in about 4 percent of retested specimens taken from Rochester, N.Y.-area adults in 1999 through 2001, University of Rochester researchers reported in a Journal of Infectious Diseases article earlier this year.
While those sites are the only published evidence of the virus in the United States, it is thought to be far more prevalent and also has been found in Canada, Europe and Australia.
NOT AS INFECTIOUS AS SARS
Like SARS, or severe acute respiratory syndrome, human metapneumovirus has been associated with flu-like infections and pneumonia-like symptoms, but it does not appear to be as infectious as SARS, said Dr. Jeffrey Kahn of Yale University medical school, senior author of the Pediatrics study.
None of the patients in the Yale or Rochester reports died.
Symptoms may include nasal congestion, wheezing, and lung inflammation, and the symptoms may range from mild to serious enough to require hospitalization, Kahn said.
“It can be added to the list of newly emerging human respiratory viruses and really represents another challenge for the medical community,” Kahn said.
It belongs to the paramyxovirus family, which also includes a common bug called respiratory syncytial virus, or RSV. SARS is believed to be caused by a different pathogen.
A CULPRIT IN CHILDHOOD ILLNESSES?
The average child gets about 10 respiratory infections by age 1 and many more throughout childhood. Many are caused by cold viruses, influenza or RSV, but doctors aren’t able to pinpoint a cause in about a third of the cases, Kahn said.
Human metapneumovirus may be the culprit in many such cases, he said.
The virus, nicknamed hMPV, was first identified about two years ago in the Netherlands but likely has been around for a long time, said Dr. Ann Falsey of the University of Rochester.
It has less conspicuous features under the microscope than other viruses and may simply have gone undetected or misdiagnosed before the Dutch discovery, Falsey said.
“This may be one more piece to the puzzle as to what all these respiratory infections are,” she said.
The Yale and Rochester researchers detected the virus in specimens retested after the Dutch discovery.
Early efforts to find a potential vaccine for the virus are under way, said Dr. Larry Anderson, a respiratory disease specialist at the federal Centers for Disease Control and Prevention.
There are no commercially available tests for hMPV; diagnoses can only be made at special research labs, Kahn said.
More research is needed to learn how common it is, whether it occurs seasonally like influenza, and to determine the range of symptoms it can cause and what treatments might help, Kahn said.
“There’s a lot more that we don’t know than we do know right now,” he said.
Source: msnbc.com
June 2 — It isn’t SARS, but infectious disease specialists are trying to learn more about a recently discovered virus that some think may be the culprit in many unexplained respiratory illnesses around the world.
THE EXACT prevalence of human metapneumovirus isn’t known, but Yale University researchers recently found it in 6.4 percent of retested lab samples from 296 children with respiratory symptoms in late 2001 and early 2002, according to a study published Monday in the June edition of Pediatrics.
It was also discovered after the fact in about 4 percent of retested specimens taken from Rochester, N.Y.-area adults in 1999 through 2001, University of Rochester researchers reported in a Journal of Infectious Diseases article earlier this year.
While those sites are the only published evidence of the virus in the United States, it is thought to be far more prevalent and also has been found in Canada, Europe and Australia.
NOT AS INFECTIOUS AS SARS
Like SARS, or severe acute respiratory syndrome, human metapneumovirus has been associated with flu-like infections and pneumonia-like symptoms, but it does not appear to be as infectious as SARS, said Dr. Jeffrey Kahn of Yale University medical school, senior author of the Pediatrics study.
None of the patients in the Yale or Rochester reports died.
Symptoms may include nasal congestion, wheezing, and lung inflammation, and the symptoms may range from mild to serious enough to require hospitalization, Kahn said.
“It can be added to the list of newly emerging human respiratory viruses and really represents another challenge for the medical community,” Kahn said.
It belongs to the paramyxovirus family, which also includes a common bug called respiratory syncytial virus, or RSV. SARS is believed to be caused by a different pathogen.
A CULPRIT IN CHILDHOOD ILLNESSES?
The average child gets about 10 respiratory infections by age 1 and many more throughout childhood. Many are caused by cold viruses, influenza or RSV, but doctors aren’t able to pinpoint a cause in about a third of the cases, Kahn said.
Human metapneumovirus may be the culprit in many such cases, he said.
The virus, nicknamed hMPV, was first identified about two years ago in the Netherlands but likely has been around for a long time, said Dr. Ann Falsey of the University of Rochester.
It has less conspicuous features under the microscope than other viruses and may simply have gone undetected or misdiagnosed before the Dutch discovery, Falsey said.
“This may be one more piece to the puzzle as to what all these respiratory infections are,” she said.
The Yale and Rochester researchers detected the virus in specimens retested after the Dutch discovery.
Early efforts to find a potential vaccine for the virus are under way, said Dr. Larry Anderson, a respiratory disease specialist at the federal Centers for Disease Control and Prevention.
There are no commercially available tests for hMPV; diagnoses can only be made at special research labs, Kahn said.
More research is needed to learn how common it is, whether it occurs seasonally like influenza, and to determine the range of symptoms it can cause and what treatments might help, Kahn said.
“There’s a lot more that we don’t know than we do know right now,” he said.
Source: msnbc.com
Wednesday, May 28, 2003
More Smallpox Vaccine Concerns
WASHINGTON, D.C., May 27, 2003
There is new concern about the government's already troubled smallpox vaccination program. Few of the half-million healthcare workers eligible for innoculation under phase one of the program chose to get vaccinated. And some healh experts are warning -- not so fast.
Some states, including Florida and Virginia, are already moving ahead with phase two of the government's smallpox vaccination program, to include as many as three million firefighters, police and paramedics.
But a new report issued by an Institute of Medicine panel says all civilian vaccinations should temporarily stop, and that the federal government should actively get out the word to states, CBS News Correspondent Sharyl Attkisson reports.
The Committee on Smallpox Vaccine Implementation earlier recommended a "pause" in civilian smallpox vaccination, in part due to unexpected adverse events emerging in what was already known to be the most toxic vaccine on the market.
The head of the committee, Dr. Brian Strom, says the Centers for Disease Control, which advises states on their vaccine programs, recently accepted the idea of a pause. Yet, Strom says, the CDC didn't explicitly notify states of this change of heart. Tuesday's report encourages the CDC to take more action.
"What we're asking is one step further – that they go out of their way to make it easy for those states who want to pause to make it easy for them to be able do that," says Strom.
"We think that it's better for public health, we think it's better for the campaign, that all information be learned about to the degree possible before launching into phase two in a large-scale way. We thought that it was very important that people stop, they take stock of where they are, look to learn from the experience gained today before proceeding onward with the rest of the campaign."
The report says several issues should be resolved "before deciding whether and how to proceed with vaccination."
On the issue of safety, the report says a "pause" is needed to collect and evaluate adverse event reports. Although every civilian who receives the smallpox vaccine is supposed to be individually tracked, only 34 percent of vaccinees have made it into the surveillance system so far; two-thirds have not.
"Some adverse events might not arouse concern on a state level, but aggregated nationally, new patterns could emerge," says the report. "Cardiac complications were unexpected adverse events, and there may be others."
Says Strom: "At this point only about one-third of the civilian patients who've gotten the vaccination are in the surveillance system. And one of the things we'd like know about is the outcomes in the other two-thirds of the patients."
The report also says the consent forms and educational materials should be revised with updated material and information that can be understood clearly by firefighters, police and paramedics instead of the health care workers who were targeted in phase one.
"In many ways, the most important message we have is that maximum preparedness doesn't require huge numbers; it requires it be done very safely and very carefully. That's what's been done so far. The CDC has done a terrific job. And the CDC should use (a pause in the state's vaccination programs) as an opportunity to learn maximally from the experience to date, in order to be sure that as we launch into phase two it's given to the right people, it's the right size and it's done as safely as possible," says Strom.
The panel that issued the new report was created by the Institute of Medicine to advise the federal government on implementing the smallpox vaccine program.
But it's unclear whether the federal government will take the committee's advice to publicly encourage states to "pause." Doing so would highlight touchy subjects in some political circles: unexpected adverse events, and what some view as the lackluster response to President Bush's smallpox vaccine program. Out of roughly 500,000 eligible health care workers, only a small fraction, 30,000, volunteered to receive the vaccine in phase one.
Many who refused the vaccine were concerned about the vaccine's risks. Some states have already stopped their smallpox vaccination programs on their own, others are "skipping" phase two altogether.
The inherent conflict involved in this issue is apparent. Strom, chair of the committee that wrote the new report, told CBS News it was issued quickly because of its importance and urgency. Yet a spokesman for the Institute of Medicine told reporters, in advance, there would be nothing particularly newsworthy in the committee's report.
Source: cbsnews.com
WASHINGTON, D.C., May 27, 2003
There is new concern about the government's already troubled smallpox vaccination program. Few of the half-million healthcare workers eligible for innoculation under phase one of the program chose to get vaccinated. And some healh experts are warning -- not so fast. Some states, including Florida and Virginia, are already moving ahead with phase two of the government's smallpox vaccination program, to include as many as three million firefighters, police and paramedics.
But a new report issued by an Institute of Medicine panel says all civilian vaccinations should temporarily stop, and that the federal government should actively get out the word to states, CBS News Correspondent Sharyl Attkisson reports.
The Committee on Smallpox Vaccine Implementation earlier recommended a "pause" in civilian smallpox vaccination, in part due to unexpected adverse events emerging in what was already known to be the most toxic vaccine on the market.
The head of the committee, Dr. Brian Strom, says the Centers for Disease Control, which advises states on their vaccine programs, recently accepted the idea of a pause. Yet, Strom says, the CDC didn't explicitly notify states of this change of heart. Tuesday's report encourages the CDC to take more action.
"What we're asking is one step further – that they go out of their way to make it easy for those states who want to pause to make it easy for them to be able do that," says Strom.
"We think that it's better for public health, we think it's better for the campaign, that all information be learned about to the degree possible before launching into phase two in a large-scale way. We thought that it was very important that people stop, they take stock of where they are, look to learn from the experience gained today before proceeding onward with the rest of the campaign."
The report says several issues should be resolved "before deciding whether and how to proceed with vaccination."
On the issue of safety, the report says a "pause" is needed to collect and evaluate adverse event reports. Although every civilian who receives the smallpox vaccine is supposed to be individually tracked, only 34 percent of vaccinees have made it into the surveillance system so far; two-thirds have not.
"Some adverse events might not arouse concern on a state level, but aggregated nationally, new patterns could emerge," says the report. "Cardiac complications were unexpected adverse events, and there may be others."
Says Strom: "At this point only about one-third of the civilian patients who've gotten the vaccination are in the surveillance system. And one of the things we'd like know about is the outcomes in the other two-thirds of the patients."
The report also says the consent forms and educational materials should be revised with updated material and information that can be understood clearly by firefighters, police and paramedics instead of the health care workers who were targeted in phase one.
"In many ways, the most important message we have is that maximum preparedness doesn't require huge numbers; it requires it be done very safely and very carefully. That's what's been done so far. The CDC has done a terrific job. And the CDC should use (a pause in the state's vaccination programs) as an opportunity to learn maximally from the experience to date, in order to be sure that as we launch into phase two it's given to the right people, it's the right size and it's done as safely as possible," says Strom.
The panel that issued the new report was created by the Institute of Medicine to advise the federal government on implementing the smallpox vaccine program.
But it's unclear whether the federal government will take the committee's advice to publicly encourage states to "pause." Doing so would highlight touchy subjects in some political circles: unexpected adverse events, and what some view as the lackluster response to President Bush's smallpox vaccine program. Out of roughly 500,000 eligible health care workers, only a small fraction, 30,000, volunteered to receive the vaccine in phase one.
Many who refused the vaccine were concerned about the vaccine's risks. Some states have already stopped their smallpox vaccination programs on their own, others are "skipping" phase two altogether.
The inherent conflict involved in this issue is apparent. Strom, chair of the committee that wrote the new report, told CBS News it was issued quickly because of its importance and urgency. Yet a spokesman for the Institute of Medicine told reporters, in advance, there would be nothing particularly newsworthy in the committee's report.
Source: cbsnews.com
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