US Deficit to Soar Towards $1.6 Trillion

August 25, 2009

BBC News

The US budget deficit will soar to almost $1.6 trillion (£978bn) this year, the highest on record, both the White House and Congress have warned.

Fuelled by President Obama’s $787bn stimulus package and reduced tax revenues due to the recession, it compares with a $455bn deficit in 2008.

The White House says the deficit will grow further, predicting it will hit a cumulative $9tn from 2010-2019.

However, it continues to expect the US economy to start to recover this year.

The White House expects US unemployment to pass 10% this year, before slowly declining in 2010. The most recent official figures showed the rate at 9.4% in July.

‘Out of control’

The latest deficit predictions have come from the White House and the non-partisan Congressional Budget Office (CBO).

“Overall, it underscores the dire fiscal situation that we inherited, and the need for serious steps to put our nation back on a sustainable fiscal path,” the White House’s Office of Management and Budget director Peter Orszag said.

Christina Romer, one of the president’s economic advisers, said the recession “was simply worse” than first predicted.

Republicans said the latest figures were a serious concern.

“The alarm bells on our nation’s fiscal condition have now become a siren,” said Senate Republican minority leader Mitch McConnell.

“If anyone has any doubts that this burden on future generations is unsustainable, they’re gone – spending, borrowing and debt are out of control.”

Analysts said the latest deficit figures increased the likelihood of US tax rises once it is confirmed that the US has exited recession.

The CBO said such a move would be required.

“Putting the nation on a sustainable fiscal course will require some combination of lower spending and higher revenues than the amounts now projected,” it said.

Click here for the full report from BBC News

Green Tea Nutrients Prevent Leukemia

August 25, 2009

Natural News

By David Gutierrez

One of the potent antioxidants found in green tea may slow and possibly even reverse the progress of leukemia.

Scientists have been aware since 1970s that green tea can help fight cancer, as demonstrated by lower cancer rates in countries with high consumption of the beverage. In 2004, a study showed that the naturally occurring tea chemical epigallocatechin gallate (EGCG) could actually kill leukemia cells.

In a new study, published in the Journal of Clinical Oncology, researchers from the Mayo Clinic found a significant improvement in the symptoms of cancer patients treated with EGCG extract.

Researcher Tait D. Shanafelt and colleagues became interested in carrying out a clinical trial when they noticed that chronic lymphocytic leukemia (CLL) patients self-medicating with tea polyphenols actually began showing signs of improvement. They designed a study in which 33 CLL patients were treated with between 400 and 2,000 milligrams of EGCG extract twice per day.

“We found not only that patients tolerated the green tea extract at very high doses, but that many of them saw regression to some degree of their CLL,” Shanafelt said.

Treatment with EGCG led to noticeable decreases in two symptoms of CLL — increased white blood cell (lymphocyte) count and enlarged lymph nodes. Lymphocyte levels decreased by 20 percent or more in 15 of 33 patients, an improvement that lasted for two months in 11 of them. Of 12 patients who began the study with swollen lymph nodes, 11 experienced a 50 percent or greater decrease in swelling.

Few side effects were observed from the treatment.

CLL is currently incurable, and is aggressive and fatal in 50 percent of patients. There is also currently no therapy capable of slowing or halting the progression of the disease.

The researchers expressed hope that EGCG could be used to stabilize early-stage CLL, increasing survival time at worst and improving the effectiveness of other treatments at best.

Click here for the full report from Natural News

Up to Half of U.S. Population Could Get Swine Flu

August 24, 2009

ABC News

By David Kerley, Ryan Owens, and Sadie Bass

Thirty to 50 percent of the entire U.S. population could be infected with swine flu this fall and winter, according to a report from the President’s Council of Advisors on Science and Technology.

As many as 1.8 million people may end up in the hospital, and 30,000 to 90,000 could die, with a concentration among children and young adults, the presidential panel of the nation’s leading scientists said today in outlining what it called a plausible scenario. That’s more than twice the annual average of deaths typically associated with the seasonal flu, and those occur mainly in people older than 65.

“We’re going to have people hospitalized and we will, unfortunately, have more deaths,” said Health and Human Services Secretary Kathleen Sebelius.

The report says this swine flu is a “serious threat to our nation and the world.” Because it’s a new strain of the flu, people do not have a built-in immunity.

Many swine flu experts view the numbers as reasonable.

“This looks like reasonable estimates and consistent with how pandemic viruses act,” said Greg Poland of the Mayo Clinic in Rochester, Minn.

“My reaction is that the numbers, although scary, may be quite accurate,” said Joan Nichols of the University of Texas, Galveston.

But others are more skeptical, saying these numbers seem to be a worst-case scenario.

“These speculations have no firm scientific basis, only a historical precedent from almost a 100 years ago and epidemiologic data from recent circulating virus patterns,” said UCLA’s Peter Katona. “Viruses have a mind of their own, and we will have to just see what happens.”

Marc Lipsitch of the Harvard School of Public Health emphasized that the numbers are not predictions, but scenarios.

“It is not possible to predict with certainty how many cases or deaths will occur from this flu,” he said.

With 20 weeks left to go in the year, the 2008-09 flu season has 17 more pediatric deaths than the previous year, and there have been at least 7,963 hospitalizations and 522 deaths from swine flu. The CDC says 75 percent of the hospitalizations are in those under 49, and 60 percent of the deaths are also in those under age 49.

The numbers, while higher than usual, are still low. But if the virus spreads throughout the population, it could be far more problematic.

Swine Flu Vaccine

The report says the skyrocketing infections will peak on Oct. 15 — the exact date a vaccine is expected to be delivered. The White House advisors suggest backing up the vaccine date by a full month — meaning a vaccine and dosage that is still being tested would be used.

“Trying to rush in with an unknown, with an untested quantity of vaccine doesn’t appeal to me at all,” said Vanderbilt University’s William Schaffner.

The council recommended that manufacturers begin to package the vaccine so that it could be used by those that are at high risk in September. All five manufacturers have already been asked by the government to bottle the vaccine when it’s ready.

But health officials announced a delay in the vaccine production last week. Originally, the government expected 120 million doses to be available on Oct. 15, but it now estimates there will only be 45 million, with 20 million more each week through December.

With children heading back to school for the fall, health officials have changed their recommendations for how to deal with students who become infected. They say it’s no longer necessary to close an entire school.

In Ft. Worth, Texas, any child with a suspected case of the flu will be isolated in the nurse’s office until a parent can pick him or her up. Last year, the superintendent closed all the district’s 140 schools and sent 80,000 students home for six days — all because of one case.

A vaccine is the most effective way to fight the flu, but until it is ready, schools are urging students to wash their hands thoroughly and use hand sanitizer.

Click here for the full report from ABC News

Herbicide Found in Water May Pose Greater Danger

August 25, 2009

Chicago Sun Times

By Kari Lydersen

Drinking water containing a common herbicide could pose a greater public health risk than previously thought because regular municipal monitoring doesn’t detect frequent spikes in the chemical’s levels, according to a report released Monday by the Natural Resources Defense Council.

The report documented spikes in atrazine in the water supplies of Midwestern and Southern towns in agricultural areas, where the herbicide is applied to the vast majority of corn, sorghum and sugar cane fields.

Atrazine, an endocrine disrupter, can interfere with the body’s hormonal activity and the development of reproductive organs. The Environmental Protection Agency looks at annual average levels of the chemical in drinking-water systems, but the Natural Resources Defense Council (NRDC) says this misses spikes likely to occur after rain and springtime application of the herbicide.

“Our biggest concern is early-life-stage development,” said NRDC senior scientist Jennifer Sass. “If there’s a disruption during that time, it becomes hard-wired into the system. These endocrine disrupters act in the body at extremely low levels. These spikes matter.”

She said the chemical could also be linked to menstrual problems and endocrine-related cancers in adults.

Scientists with atrazine manufacturer Syngenta called the NRDC study alarmist and said the spikes fall within one- and 10-day limits that the EPA considers safe.

“Atrazine is one of the best studied, most thoroughly regulated molecules on the planet,” said Syngenta toxicologist Tim Pastoor. “Those momentary spikes are not going to be injurious to human health.”

Under the Safe Drinking Water Act, municipal water supplies are typically tested for chemicals, including atrazine, four times a year. The EPA considers an annual average atrazine level below 3 parts per billion as safe for human consumption. But biweekly data collected by the EPA from 139 municipal water systems found that atrazine was present 90 percent of the time and that 54 water systems had one-time spikes above 3 parts per billion in 2003 and 2004, according to an analysis by the NRDC.

NRDC scientists and lawyers argue that the EPA’s limits are too lenient, given studies showing the effects of low levels of atrazine on rats and other animals and the fact that it is nearly impossible to epidemiologically trace the chemical’s effects on humans.

Steve Owens, assistant administrator for the EPA’s office of prevention, pesticides and toxic substances, said the agency will review its atrazine policies as part of a larger reassessment of how chemicals and pesticides are regulated.

“The Obama EPA will take a hard look at atrazine and other substances,” he said. “This thorough review will rely on transparency and sound science, including independent scientific peer review. We will continue to closely track new scientific developments and will determine whether a change in our regulatory position is appropriate.”

Atrazine can be removed by carbon filters at water treatment plants or in households. Many water treatment plants use such filters, but others do not. The Washington Aqueduct, which treats water from the Potomac River for about 1 million Washington area customers, does not treat for atrazine because it is rarely found at levels over 0.5 parts per billion in the water.

The NRDC is asking the EPA to step up its atrazine monitoring and make the results public. The group is also encouraging farmers to greatly reduce or end use of the herbicide. Atrazine is effectively banned in the European Union, though Pastoor said a similar chemical, terbuthylazine, is widely used in Europe. He noted that atrazine, introduced in 1958, is especially attractive to farmers because it lasts for about 40 days in the soil and can be applied before, during or after planting. It is considered conducive to no-till practices that reduce a field’s carbon footprint.

Atrazine is also used on lawns and golf courses in the South, and Sass said children playing on treated grass could be dangerously exposed to it. It can also concentrate in rain and fog.

Since 2003, the EPA has monitored atrazine levels in surface and ground water in 40 watersheds in the central and southern United States. The NRDC says the results raise grave concerns for wildlife and ecosystems in these areas and in the Gulf of Mexico, where much of the agricultural runoff from the Midwest ends up. Atrazine has been found to cause limb deformities and hermaphroditism in frogs at concentrations as low as 0.1 parts per billion. It is also known to kill algae and micro-organisms that make up the base of aquatic food chains, and in conjunction with other pesticides and herbicides, it suppresses animals’ immune systems.

In 2003 the NRDC filed a lawsuit charging that the EPA violated the Endangered Species Act during the atrazine re-registration process by failing to adequately consult with the Fish and Wildlife Service and the National Marine Fisheries Service about how the herbicide could affect about 20 endangered species of frogs, fish, turtles and other reptiles and amphibians.

A 2008 letter from the Fish and Wildlife Service says atrazine could harm endangered Alabama sturgeon and Chesapeake Bay dwarf wedgemussel, since it is known to damage such organisms and affect food supplies, even at lower levels than what the EPA considers safe.

Negotiations between the Fish and Wildlife Service and the EPA could result in different limits or requirements for atrazine.

Click here for the full report from the Chicago Sun Times

Sweet Surrender: Sugar Curbs Urged

August 25, 2009

Wall Street Journal

By Ron Winslow and Shirley S. Wang

The American Heart Association is taking aim at the nation’s sweet tooth, urging consumers to significantly cut back on the amount of sugar they get from such foods as soft drinks, cookies and ice cream.

In a scientific statement issued Monday, the organization says most women should limit their sugar intake to 100 calories, or about six teaspoons, a day; for men, the recommendation is 150 calories, or nine teaspoons.

The recommendations are likely to prove challenging for many consumers to meet. Just one 12-ounce can of cola has about 130 calories, or eight teaspoons of sugar.

Data gathered during a national nutrition survey between 2001 and 2004 suggest that Americans consume on average 355 calories, or more than 22 teaspoons, of sugar a day.

“We’re trying to make reasonable recommendations around the amount of sugar in a diet that enables people to achieve or maintain a healthy weight,” said Rachel Johnson, associate provost and professor of nutrition at the University of Vermont in Burlington and lead author of the statement.

As the heart association’s statement acknowledges, the science directly linking added sugar consumption to obesity is inconsistent. This in part reflects, the impact of such things as genetics, physical activity and diet have on weight.

The heart association has encouraged consumers to moderate sugar consumption, but the new statement is the first time it has suggested specific limits. The recommendations apply only to what are known as added sugars—those that are added to foods during manufacturing, or by consumers. They don’t include sugar that occurs naturally in fruits, vegetables, dairy products and other foods.

Marion Nestle, a professor of nutrition and food studies at New York University who wasn’t involved with the document, said it was a significant departure from previous recommendations, in part because “nobody has ever said it quite so forcefully.”

The statement heightens the battle against foods that many public-health officials say contribute to the higher risk of such problems as diabetes and cardiovascular disease among the nation’s overweight and obese consumers. A recent unrelated study by the U.S. Centers for Disease Control and Prevention said the medical costs associated with treating obesity-related conditions may have reached $147 billion last year, up from $74 billion a decade ago.

Major Sources

The chief sources of added sugar in the diet include soft drinks, candy, desserts such as cakes and cookies, fruit drinks and sweetened dairy products, including ice cream and yogurt, the statement says. Sugar in alcoholic beverages also counts as added sugar, Dr. Johnson said.

Added sugars “offer no nutritional value other than calories to the diet,” Dr. Johnson said. “The majority of Americans could reduce their risk of heart disease by achieving healthy weight and the evidence is fairly clear that reducing the amount of sugars can help with that.”

While many studies associate increased consumption of soft drinks with higher calorie intake, weight gain and obesity, others have failed to support the connection. Similarly, research investigating added sugar’s impact on blood pressure, heightened inflammation and on changes in blood fats called triglycerides is inconclusive. And there are no studies linking the recommended limits to preventing weight gain or promoting weight loss.

Instead, Dr. Johnson and her colleagues on the heart association’s nutrition committee based the suggestions on the concept of discretionary calories that are part of the U.S. Department of Agriculture’s dietary guidelines called Mypyramid. Discretionary calories are those allotted to a person beyond what are necessary to consume nutrients essential to a healthy diet while still maintaining a proper weight.

Under the Mypyramid guidelines, people on a 2,000-calorie-per-day diet have 267 discretionary calories. Active young people on a 3,000-calorie-a-day-diet have 512 discretionary calories.

Dr. Johnson said the committee decided that allocating half of the discretionary calories for added sugar was a proper course. More than that risks displacing necessary nutrients with calories from added sugar, she said.

For a moderately active middle-aged woman on a 1,800 calorie-a-day diet, the recommendations translate to about 100 calories for added sugar. For a sedentary middle-aged man consuming 2,200 calories a day, the allotment is about 150 calories.

Dr. Johnson said the statement doesn’t tell people to eliminate sugar from their diets. She does recommend using the allotment to make healthier foods more tasty, such as adding sugar to whole-grain cereal, instead of using it on candy. People who get regular exercise, she said, can consume higher quantities of added sugar.

William Dietz, director of the division of nutrition, physical activity and obesity at the CDC, said the guidelines are reasonable, but he said it may be difficult for the public to understand the recommendation in terms of grams of sugar intake.

‘Sugar Burden’

Instead, “I think it’s easier to talk to people about what types of foods are likely to contribute to the sugar burden,” with sugar-sweetened beverages like soft drinks and fruit juices at the top of the list, he said.

Consuming added sugar in drinks is particularly problematic, he said, because it doesn’t make you feel as full as when you eat solid food.

Quillian Haralson, 38, of Waldorf, Md., says he would try to adhere to the recommendations and pay special attention to the sugar intake of his two children.

But, he said, it would be challenging to figure out how much added sugar is in different foods.

Mr. Haralson, a high-school teacher, said he is attentive to his three-year-old son’s sugar intake, for instance, but he said he couldn’t estimate how much the child is currently consuming.

“That’s the sad part; I can’t tell you,” he said.

Current food labels don’t list sugar content in calories or teaspoons and don’t distinguish between natural and added sugars, Dr. Johnson said.

Click here for the full report from the Wall Street Journal

Overuse of Antivirals Could Make H1N1 Pandemic Even Worse

August 24, 2009

LA Times

By Shari Roan

Indiscriminate use of antiviral medications to prevent and treat influenza could ease the way for drug-resistant strains of the novel H1N1 virus, or swine flu, to emerge, public health officials warn — making the fight against a pandemic that much harder.

Already, a handful of cases of Tamiflu-resistant H1N1 have been reported this summer, and there is no shortage of examples of misuse of the antiviral medications, experts say.

People often fail to complete a full course of the drug, according to a recent British report — a scenario also likely to be occurring in the U.S. and one that encourages resistance. Stockpiling is rife, and some U.S. summer camps have given Tamiflu prophylactically to healthy kids and staff, and have even told campers to bring the drug to camp. Experts anticipate more problems in the fall as children return to school and normal flu season draws nearer.

“Influenza viruses mutate frequently and any viral resistance could be acquired easily,” said Dr. Anne Schuchat, director of the National Center on Immunization and Respiratory Disease at the Centers for Disease Control and Prevention in Atlanta. “It won’t surprise us if we see resistance emerge as a bigger problem in the fall or in the years ahead.”

Prescribed in pill form, Tamiflu (oseltamivir) works by preventing the flu virus from leaving infected cells and spreading to new ones. Because a vaccine against pandemic H1N1 influenza will not be widely available for several months, Tamiflu and to a lesser extent Relenza (zanamivir), an antiviral that acts similarly, are key medical tools for fighting the pandemic in the meantime.

On Friday, however, the World Health Organization advised doctors that even those who are sickened with swine flu do not need to be given Tamiflu or Relenza if they are only mildly or moderately sick and are not in a high-risk group (such as children under 5, pregnant women and those with an underlying health condition).

Both drugs can help prevent illness in people exposed to the virus and reduce illness severity in people already sickened with it. On Aug. 14, after U.S. national soccer team forward Landon Donovan was diagnosed with H1N1 flu, players, coaches and support staff of the U.S. and Galaxy teams were advised to take Tamiflu as a preventive measure.

Tamiflu was chosen a few years ago for stockpiling by the federal government to deal with future pandemics.

Health authorities in the United States and elsewhere are keeping a sharp eye on prescriptions of the drug as they prepare for a surge of H1N1 cases in the fall. The U.S. government has issued detailed guidelines on prescribing antivirals. But health professionals may not follow the recommendations or may give in to patients who pester them for prescriptions that are ill-advised, said Dr. Robert Schechter, acting chief of the immunization branch of the California Department of Public Health.

“These medicines can be very helpful to those who could get very sick,” Schechter said. “But excessive use will accelerate the development of resistance and lead to the lack of a medication for everybody.”

Anxiety over indiscriminate use is growing, and taking the medications cavalierly is not without consequence. British health authorities reported Aug. 2 that cases of side effects from Tamiflu had doubled in the prior week, coinciding with the July 24 launch of a program in England to provide antivirals to anyone with H1N1 influenza who requests it over the phone or online.

In the first three days of the program, 150,000 packets of Tamiflu were dispensed and 293 cases of side effects were reported. Tamiflu can cause vomiting, diarrhea and mild neuropsychiatric effects.

Some U.S. health authorities have also expressed concern over misuse of the medications. Last month, the CDC urged directors of summer camps to stop handing out Tamiflu to healthy campers.

Americans are known to hoard antivirals: A 2006 study showed that heightened anxiety over a possible avian flu pandemic caused Tamiflu prescriptions to soar 300% in 2004 and 2005.

Just as with antibiotics, of central importance to antivirals’ success is taking them properly, including completing the recommended course.

However, a study published in late July found poor adherence among children in London who took Tamiflu for prevention of pandemic H1N1 in the spring.

Less than half of the grade-school-age children and only 76% of the 13- and 14-year-old students completed a full course of medication.

More than half of the children reported side effects, such as nausea, stomach cramps and trouble sleeping. Almost one in five reported a neuropsychiatric side effect, such as poor concentration, confusion or bad dreams, even though the U.S. Food and Drug Administration says neuropsychiatric side effects are rare.

Moreover, a study published this week found that Tamiflu and Relenza are unlikely to prevent complications, such as asthma flare-ups or ear infections, in children who have seasonal influenza. But they do increase the risk of vomiting.

The authors of the study, published in the British Medical Journal, said they don’t know if their findings can be generalized to the pandemic flu strain.

Antiviral drugs can be underutilized as well as overused, Schechter said. Some Californians who have died from novel H1N1 influenza did not receive antivirals.

“I’m afraid the medications are not being used in some instances where they should,” he said. “But there are also international reports of resistance developing. Both of those extremes are concerning.”

A handful of resistant H1N1 cases have been reported worldwide among people who had taken Tamiflu preventively: three in Japan, and one each in Canada, Hong Kong and Denmark.

Those cases are not surprising nor of great concern to health authorities, said Dr. Tim Uyeki, a medical epidemiologist with the CDC. They are cropping up sporadically and don’t seem to be spreading from person to person.

“The most important question for public health is not whether sporadic cases occur but whether there is ongoing transmission of oseltamivir-resistant strains,” Uyeki said.

The most perplexing case of Tamiflu resistance arose in June when a San Francisco teen who had flown to Hong Kong was found by authorities there to be ill with pandemic H1N1 flu. The girl, who recovered, had never taken Tamiflu.

A state investigation of people who were in close contact with the girl, as well as tests of 251 H1N1 virus samples from sick patients in California, has not turned up evidence of a resistant strain circulating here, Schechter said.

But nothing, in theory, would stop such a strain from developing, then circulating. In recent years, several strains of regular, seasonal H1N1 influenza have developed resistance to antiviral medications.

And a study published in March on the spread of the H5N1 avian flu, which has been circulating worldwide in bird flocks in recent years and has killed 262 people, showed the virus rapidly developed resistance to a different class of antiviral drugs, adamantanes.

“With bird flu, we found some resistance started in China and spread throughout the world in a few years,” said study author Daniel Janies, an evolutionary biologist at Ohio State University. “Overuse contributes to resistance. Basic natural selection predicts it. We can demonstrate why you should not use these drugs unless you have to.”

Other antiviral drugs exist, but the pandemic H1N1 virus is resistant to the adamantane class. If it develops resistance to Tamiflu also, only Relenza would be left to treat the illness, barring the development of new antiviral medications.

Relenza, Schechter said, is indicated only for ages 5 and older. Used less commonly than Tamiflu, it is inhaled as a powder, and people who are seriously ill or have difficulties with breathing cannot take it.

“The more choices you have, the better for treatment,” Schechter said. “To lose any one of those options would pose great challenges for treatment of those who are most vulnerable or likely to die.”

Click here for the full report from the LA Times

Swine Flu Campaign Waits on Vaccine

August 24, 2009

The Washington Post

By Rob Stein

Government health officials are mobilizing to launch a massive swine flu vaccination campaign this fall that is unprecedented in its scope — and in the potential for complications.

The campaign aims to vaccinate at least half the country’s population within months. Although more people have been inoculated against diseases such as smallpox and polio over a period of years, the United States has never tried to immunize so many so quickly.

But even as scientists rush to test the vaccine to ensure it is safe and effective, the campaign is lagging. Officials say only about a third as much vaccine as they had been expecting by mid-October is likely to arrive by then, when a new wave of infections could be peaking.

Among the unknowns: how many shots people will need, what the correct dosage should be, and how to avoid confusing the public with an overlapping effort to combat the regular seasonal flu.

To prepare, more than 2,800 local health departments have begun recruiting pediatricians, obstetricians, nurses, pharmacists, paramedics and even dentists, along with a small army of volunteers from churches and other groups. They are devising strategies to reach children, teenagers, pregnant women and young and middle-aged adults in inner cities, suburban enclaves and the countryside.

“This is potentially the largest mass-vaccination program in human history,” said Howard Markel, a professor of medical history at the University of Michigan who is advising the Centers for Disease Control and Prevention as it spearheads the effort.

Public health officials describe the effort as crucial to defend against the second wave of the Northern Hemisphere’s first influenza pandemic in 41 years.

As schools reopen, the number of cases could jump sharply within weeks, sparking a second wave potentially far larger than the outbreak last spring. Although the swine flu appears no more dangerous than the typical seasonal flu, the new virus — known as H1N1 — is likely to infect many more people because most have no immunity against it.

The vaccine effort carries political risks for the Obama administration. “If the outbreak fizzles, they will be susceptible to being criticized for spending billions of dollars,” said Harvey V. Fineberg, president of the National Academy of Sciences’ Institute of Medicine, which advises Congress about medical issues. “On the other hand, if this outbreak is early and severe and there isn’t enough vaccine, they’ll be criticized for under-preparation.”

Officials stress that they are proceeding cautiously. A final decision to move forward will not be made until they get the results of clinical trials — testing to determine safety and dosing — and assess the virus’s threat. But officials are confident the vaccine will pass muster and expect a campaign will be launched as soon as manufacturers deliver the first vials.

“There’s little doubt we’re going to vaccinate people,” said Anthony S. Fauci of the National Institute of Allergy and Infectious Diseases, who is leading the government’s testing of the vaccine. “Who and when and exactly how — we have to figure out.”

The campaign is haunted by memories of the government’s ill-fated 1976 effort to vaccinate against swine flu. The epidemic fizzled, but the vaccine was given to 40 million people and blamed for causing a rare paralyzing disorder known as Guillain-Barré Syndrome.

Another wild card will be whether the vaccine will be delivered with an “adjuvant” to boost its effectiveness or stretch limited supplies into more doses. Adjuvants have been used in Europe, but the Food and Drug Administration has not authorized their use in the United States.

“This is an overreaction,” said Barbara Loe Fisher of the National Vaccine Information Center, which opposes many vaccine policies. “There is no national security threat here. Why are we operating like this? This is not polio. This is not smallpox.”

Fears and misinformation about the vaccine are circulating, including inaccurate claims that it will be mandatory.

“I’m very concerned about the dangers of vaccines,” said Janice Smith, 58, of Misawaka, Ind., who attended a public hearing Aug. 15, one of a series of meetings the CDC has sponsored to gauge public sentiment about the vaccine.

Authorities are adamant that vaccination will be voluntary, and they say there is no reason to think the vaccine will be any less safe than the usual flu vaccine. An adjuvant will be used only if necessary and proven safe, they say.

To address concerns of pregnant women and parents with young children, some vaccine is being produced without a mercury additive. And because the short-term studies can identify only common, immediate side effects, the CDC will step up monitoring for rarer, serious complications such as Guillain-Barré.

“We’re putting into place systems that are as good as we can have to identify problems quickly if they do occur,” CDC Director Thomas R. Frieden said.

On Friday, officials reported that no “red flags regarding safety” had emerged in the clinical trials. “We are continuing oversight on the quality and safety of the vaccine being produced, and the production process itself,” said Jesse Goodman of the FDA. “That’s going well so far, but our oversight is continuing.”

In the meantime, local officials are drafting plans tailored to their communities. The shots in the arms and squirts up the nose will happen in schools, medical offices, hospitals, public health clinics, workplaces, drug stores and at mass vaccination events, possibly including drive-through clinics in parking lots where people would stick their arms out their car windows for a stab.

“It is clearly what we would call an all hands on deck,” said James Blumenstock of the Association of State and Territorial Health Officials. “We’re not starting from scratch, but we also don’t have everything on the shelf that we can just pull off and put in place. It’s a full-court press in moving forward to have everything in place when we’re ready to go.”

In Maryland, officials estimate that 2.9 million people fall into the priority groups for the vaccine; Virginia estimates the number at 2.5 million and the District at 225,000. The national total is about 159 million people.

Public health departments “have suffered from decades of neglect and are now facing a fiscal crisis in many places where they have had to lay staff off, or furlough staff or freeze hiring,” Frieden said. “So H1N1 has not come at a particularly good time.”

Setting priorities for delivering the vaccines will bring other complications. The elderly, usually first in line for flu shots, will not be this time because they seem more resistant to the virus. But they remain a top priority for the seasonal shots.

Schools considering giving shots to children are making plans to get permission from parents and have to determine how best to line up anxious, rambunctious students.

Everyone who gets a swine flu shot may need a booster several weeks later, potentially causing mix-ups about who got which shot when.

But Frieden and other outside observers expressed confidence that the program would be safe and successful.

The federal government has spent close to $2 billion to buy up to 195 million doses of vaccine and adjuvant, including the standard shots and the newer FluMist nasal spray vaccine made by MedImmune of Gaithersburg.

The government is prepared to buy enough to vaccinate every person — 600 million doses all together — if the pandemic or demand warrants it. That could increase the cost to $5 billion for the vaccine alone. It would cost at least $9 billion to administer the vaccine to the entire population, according to the Association of State and Territorial Health Officials.

Although five companies are racing to produce as much vaccine as possible, the first batches are not expected for two months, in part because the virus grew at about half the projected rate. Production appears to be increasing, but the first 45 million to 52 million doses — about a third of what officials were anticipating — won’t be ready until mid-October, with about 20 million doses a week expected after that to continue the campaign through the winter.

Experts are uncertain whether they will face a shortage of vaccine because of high demand or will have plenty of vaccine but little interest.

“People’s enthusiasm will depend largely on what they see happening around them,” Fauci said. “If we get into the fall season and we don’t see an explosion of cases, people will be less enthusiastic. If they see a lot of young people and kids getting sick, people will be very enthusiastic about getting vaccinated.”

The CDC is formulating a $4.8 million multimedia campaign to encourage people to get vaccinated and help alleviate concerns and confusion, including radio and television public service announcements, print ads, and messages delivered via Twitter, RSS feeds and video podcasts on YouTube.

Although the vaccine will be free, providers could charge about $15 to administer it — a fee that will be covered by Medicare and many health insurance plans.

Experts also worry the swine flu will divert attention from the seasonal flu, which can cause serious illness. Officials will launch the seasonal flu vaccine campaign Sept. 10 — about a month early in the hopes of vaccinating as many people as possible before the swine flu campaign. The more people who get both vaccines, the less likely the swine flu virus will mingle with one of the others to produce a more dangerous mutant.

“We really don’t want those ugly viruses mixing together,” said Kim Elliott of the Trust for America’s Health, a private nonprofit research and advocacy group.

Click here for the full report from the Washington Post

CSL Starts U.S. Swine Flu Vaccine Trial

August 24, 2009

Reuters

CSL Ltd started testing its swine flu vaccine on U.S. children and adults on Monday, joining other companies testing the H1N1 vaccine as they also step up production.

The Australian-based company said it would test 1,300 adults and 450 children with different doses of its vaccine to help determine what the best dose will be.

“Children are often at greater risk from influenza infection and its complications than adults, so it is extremely important to understand the efficacy of an H1N1 vaccine in this very vulnerable population,” Dr. Pedro Piedra of Baylor College of Medicine in Texas, who will help conduct the trial, said in a statement.

“The clinical trials of CSL’s candidate vaccine will be the first to use a thimerosal-free formulation of the H1N1 vaccine antigen.”

Some people object to the use of thimerosal, which is a mercury-based preservative. U.S. health officials say there is no evidence to support persistent beliefs that thimerosal causes autism, but companies have removed it from most vaccines anyway.

Last week, the U.S. Department of Health and Human Services said only 45 million doses of the new H1N1 vaccine would be on hand in mid-October, instead of 120 million previously forecast, with 20 million a week due after that.

HHS plans to eventually vaccinate at least 160 million people by December, with pregnant women, health-care workers, children and young adults at the front of the line.

Five companies are making the H1N1 vaccine for the U.S. market — AstraZeneca’s MedImmune unit, CSL, GlaxoSmithKline Plc, Novartis AG and Sanofi-Aventis SA. Sanofi has also started trials in the United States and several companies, including Glaxo, have trials ongoing in Europe.

Click here for the full report from Reuters

Abuse of ADHD Drugs on the Rise

August 24, 2009

Health Day News

As more and more prescriptions are being written for medications to treat attention-deficit hyperactivity disorder (ADHD), more and more children are abusing these drugs.

That’s the conclusion of new research in the September issue of Pediatrics that found the rate of ADHD medication abuse was up 76 percent from 1998 to 2005, and at the same time, the rates of prescriptions for these medications rose about 80 percent.

“We looked at all the poison control centers across the nation and found a significant increase in the number of calls for ADHD medication abuse that parallels the amount of prescriptions being written,” said Dr. Jennifer Setlik, an emergency physician at Cincinnati Children’s Hospital Medical Center in Ohio and a study author.

What’s more, Setlik said, is that this study is “not an estimate of the total problem” because it looks only at data from poison control centers, but it gives doctors and parents a snapshot of the trend toward rising abuse of these medications with increasing availability.

ADHD affects between 8 percent and 12 percent of children, and as many as 4 percent of adults worldwide, according to background information in the study. The disorder is commonly treated with stimulant medications, which have a seemingly paradoxical effect on people with ADHD, allowing them to concentrate and function more effectively. The drugs most often prescribed are mixed amphetamine salts (Adderall) and methylphenidate (Ritalin, Concerta), according to the study.

The study also reports that next to marijuana, prescription medications are the most common drugs that teenagers use to get high. This may be because teens believe these medications are safe because they’ve been prescribed by a doctor, or simply because of their availability.

To assess whether increased availability of ADHD medications would also cause a rise in the number of teens abusing the drugs, Setlik and her colleagues reviewed data from the National Poison Data System, which includes information from poison control centers across the United States.

The researchers looked for cases of intentional abuse or misuse of ADHD medications in youths 13 to 19 years old from 1998 through 2005.

They found that over the eight-year study period, the number of calls to poison control centers regarding ADHD medication use went up 76 percent, from 330 calls during the first year to 581 calls the last year.

At the same time, overall ADHD prescriptions increased by 80 percent for all children and teens, and about 86 percent for kids between 10 and 19 years old.

The data didn’t include information about whether a teen abusing an ADHD medication was the one who had been prescribed the drug or whether the abuser was a teen without ADHD who was taking the medications.

Parents “need to be aware of the potential for the abuse of these medications for teens that have and haven’t been prescribed them,” Setlik said.

If a child is taking ADHD medication, she recommended keeping an eye on the amount the child is using.

Tom Hedrick, one of the founding members of The Partnership for a Drug-Free America, agreed that parents need to monitor any prescription medications their children use to make sure that they’re being used properly. He also advised parents to safeguard their own prescriptions.

But what’s critical, he said, is letting your kids know that taking drugs that weren’t prescribed for them, or taking more than what was prescribed is not OK.

“We have to start thinking proactively instead of reactively,” said Hedrick. “Fifty percent of kids report never hearing a single word about prescription drug abuse, but these drugs are just as dangerous, just as addictive and just as deadly as illicit drugs.”

“Right now, parents may feel a sense of relief that their kids are taking medicines and not street drugs,” he said. “But what we really have is the perfect storm because there’s a lack of awareness and an ease of availability.”

Click here for the full report from Atlanta Journal Constitution

MRIs Harm More than Help Women with Early Breast Cancer

August 24, 2009

Natural News

By Sherry Baker

A new review of breast cancer treatment just published online in CA: A Cancer Journal for Clinicians concludes that the growing use of high tech magnetic resonance imaging (MRI) to assess the extent of early breast cancer may be harming instead of helping women with early breast malignancies. The study shows MRIs increase the odds a woman will be subjected to more extensive surgery, i.e. a mastectomy, over conservative approaches such as a simple lumpectomy — and there is absolutely no evidence that the radical surgical approach does anything to improve the treatment or prognosis of women with early breast cancer.

“Overall, there is growing evidence that MRI does not improve surgical care, and it could be argued that it has a potentially harmful effect,” the authors of the study, scientists from the University of Sydney in Australia and the University of Michigan Comprehensive Cancer Center in Ann Arbor, Michigan, concluded.

A number of randomized controlled trials have demonstrated that women diagnosed with early stage breast cancer who are treated with conservative therapy (consisting of a simple local excision and radiotherapy, if indicated) have the same survival rates as women who are subjected to the major surgery and trauma of total breast removal. However, in recent years the medical industry has pushed for MRIs to be used more and more in the preoperative staging of the affected breast in women with newly diagnosed breast cancer. The reason? MRIs supposedly can detect additional areas of cancer that do not show up on conventional imaging such as mammography and the imaging technique helps surgeons plan for breast tissue removal.

But when Dr. Nehmat Houssami of the University of Sydney and Dr. Daniel F. Hayes of the University of Michigan Comprehensive Cancer Center reviewed all the available data on the use of preoperative MRI scans in women with early stage breast cancer, the researchers found a lot of assumptions on the benefits of MRIs have simply never been validated. For example, it has been assumed that the detection capability of MRIs must improve surgical treatment by improving surgical planning and that could potentially lead to a reduction of more surgery in the future for breast cancer patients. In addition, by guiding surgeons to remove additional disease detected by MRI, the odds of a recurrence of breast cancer have been assumed to be reduced.

However, after reviewing the data, Dr. Houssami and Dr. Hayes concluded that using the MRI approach to local staging of breast cancer changes surgical management from breast conservation to more radical surgery without evidence of improvement in surgical outcomes or an improved long-term prognosis. In a statement to the media, the researchers called for well-designed, randomized controlled trials to find out any potential benefit of MRIs versus the harm they could be causing, including harm to the quality of life of women who may be having unnecessary radical mastectomies.

“We acknowledge that logistics and costs of conducting such large-scale, multicenter trials are enormous. If the technology is truly as beneficial as its proponents claim, then these costs are worth it. If it is not, then they are outweighed by the costs of adopting expensive technology and associated intervention without evidence of clinical benefit,” they concluded.

Click here for the full report from Natural News

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