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ATLANTA – Let us give thanks — and pass the Purell.
Your family might be sharing more than turkey and pumpkin pie this Thanksgiving. Swine flu may also be on the table — and at crowded airports and shopping malls.
Just as the pandemic seems to be waning around the country, some health officials are worried that holiday gatherings could lead to more infections. So the government has launched a new travel-health campaign.
“It’s important to remember the things that everybody can do to stay healthy,” said Dr. Beth Bell of the Centers for Disease Control and Prevention.
Thanksgiving is typically followed by at least a modest bump in early seasonal flu cases, according to reports from the past few years. But this, of course, is not a typical year. Swine flu is a new virus that accounts for nearly all flu cases right now.
Despite weeks of declining infections, health officials are staying vigilant. The federal government is putting up posters in airports, seaports and border crossings in time for Thanksgiving. The campaign also includes advertisements with slogans such as “Stop, Wash & Go.”
The CDC urges people to travel only if they are well, get vaccinated against swine and seasonal flu, wash their hands often, and cover coughs and sneezes with a tissue or sleeve.
Some 33 million Americans are expected to hit the nation’s highways over the Thanksgiving holiday, a slight increase from last year. About 2.3 million more will travel by airplane.
The elbow-to-elbow conditions expected on many flights may pose more of an infection threat than a runny-nosed tike at the other end of a Thanksgiving dinner table. One CDC official even suggested asking that a sick passenger be moved to another part of a plane.
But that’s not likely to happen on a crowded airliner or bus, and it isn’t much of a solution anyway, said a few people waiting at Atlanta’s downtown Greyhound station on Tuesday morning.
“That’s just putting it next to somebody else,” said Judd Nelson, 39, waiting to start a two-day bus trip to Phoenix.
Nelson had not been vaccinated against swine flu, and he did not have any hand sanitizer. He was resigned to his fate if someone with swine flu happens to be aboard his bus.
“The way I look at it is, if I get it, I’m going to get it no matter what,” he said.
Swine flu has sickened an estimated 22 million Americans, hospitalized about 98,000 and killed 4,000 since it was first identified last April. It is similar to seasonal flu but poses a much bigger threat to children and young adults.
Usually, seasonal flu is just getting going in late November, and holiday get-togethers allow illness to jump from small pockets to other parts of the country. Swine flu, in contrast, has been widespread for months.
“It’s not like we expect to see a bunch of infected people going to uninfected cities and towns,” said Andrew Pekosz, a flu expert at Johns Hopkins University.
The swine flu pandemic hit in two waves: first in the spring, then a larger wave that started in the late summer.
For the past three weeks, fewer states have been reporting widespread cases. School closings have dropped to the point that there were none on Monday — the first time that’s happened since late August — though there were six on Tuesday, according to the U.S. Department of Education.
But there are still plenty of ill people — as many as during the peak of many regular flu seasons, CDC officials say.
Indeed, disease trackers are quick to say that flu is unpredictable. A variety of things could happen, including a third wave or a mutation that could make the virus more deadly or less susceptible to medicines.
“We really don’t know what the trajectory is going to be,” said Bell, a CDC epidemiologist who has been a leader in the agency’s swine flu response.
Seasonal flu usually emerges at this time of year, but some experts think swine flu will muscle aside the seasonal viruses. That probably will not be known until next month, said Dr. Richard Whitley, an infectious diseases specialist at the University of Alabama at Birmingham.
At New York’s Pennsylvania Station, Katie Almroth was waiting to board a train Tuesday with her 11-month-old daughter Anna, who’s been vaccinated for seasonal flu but not for swine flu. They were headed to Harrisburg, Pa., to visit relatives for Thanksgiving.
The 33-year-old nurse from Jersey City, N.J., said she was not worried about traveling during the swine flu pandemic, but felt more comfortable on a train than an airplane with her daughter.
“I must admit I did bring little wipes along,” said Almroth, showing the antiseptic wipes she had tossed in her bag with small bottles of hand sanitizer.
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MONDAY, Nov. 23 (HealthDay News) — Body weight and co-existing health problems don’t explain why black colon cancer patients have lower survival rates than whites, U.S. researchers say.
In an effort to determine why blacks have lower survival rates than whites for nearly all cancers, including colon cancers, investigators have explored a variety factors, such as differences in health care access, exposure to risk factors and tumor characteristics. However, the role these factors play in survival rate disparities remains unclear.
In the new study, researchers at the University of Alabama at Birmingham looked at how weight and comorbidity (the presence of other diseases in addition to colon cancer) affected colon cancer survival in 496 patients who had surgery for colon cancer between 1981 and 2002.
Black patients were 34 percent more likely than white patients to have died by 2008, according to the study published online Nov. 23 and in the Dec. 15 print issue of the journal Cancer.
Among patients with early-stage cancer, the risk of death from any cause was 2.2 times higher in those with a high level of comorbidity. Among patients with advanced cancer, being underweight was associated with an 87 percent increased risk of death. However, being overweight or obese reduced the risk of death by 42 percent among patients with stage IV colon cancer, the study authors noted.
These findings were the same regardless of race, which suggests that differences in weight or comorbidity don’t explain why black patients are more likely to die than white patients, the researchers concluded.
“Further efforts are needed to identify the basis for the survival difference by race for patients with colon cancer. A greater understanding of this complex issue may help eliminate the disparity,” research leader Upender Manne said in a news release from the journal’s publisher.
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WASHINGTON – Federal health officials said Tuesday a popular variety of heartburn medications can interfere with the blood thinner Plavix, a drug taken by millions of Americans to reduce risks of heart attack and stroke.
The Food and Drug Administration said the stomach-soothing drugs Prilosec and Nexium cut in half the blood-thinning effect of Plavix, known generically as clopidogrel.
Regulators said the key ingredient in the heartburn medications blocks an enzyme the body needs to break down Plavix, muting the drug’s full effect. Procter & Gamble’s Prilosec OTC is available over-the-counter, while AstraZeneca’s Nexium is only available with a prescription.
“Patients at risk for heart attacks or strokes who use clopidogrel to prevent blood clots will not get the full effect of this medicine,” the agency said in a statement.
Plavix is marketed by Sanofi-Aventis and Bristol-Myers Squibb. With global sales of $8.6 billion last year, it’s the world’s second-best selling drug behind Pfizer’s cholesterol drug Lipitor.
Because Plavix can upset the stomach, it is often prescribed with stomach acid-blocking drugs.
The FDA says patients who need to reduce their acid should take drugs from the H-2 blocker family, which include Johnson & Johnson’s Mylanta and Boehringer Ingelheim’s Zantac. FDA scientists say there is no evidence those drugs interfere with Plavix’s anti-blood clotting action.
Nexium and Prilosec are part of a class of drugs known as proton pump inhibitors, but FDA regulators said they don’t have enough information to say whether other drugs in that class shouldn’t be used with Plavix.
“There’s not enough data to tell us how those drugs interact with,” the enzyme that activates Plavix, said Mary Ross Southworth, FDA’s deputy director for safety of cardiovascular products. “There are ongoing studies looking at those other drugs.”
The FDA said the warnings on Plavix have been strengthened based on a 150-patient study submitted by Sanofi over the summer.
But some consumer advocates said the agency’s action fell short, arguing that regulators should have placed the information in a “black box” warning label, the most serious available.
“This information still has not risen to as prominent a level of warning as it should have,” said Dr. Sidney Wolfe, director of health research at the consumer advocacy group Public Citizen.
Information about the drug interaction between Plavix and other medications is not new. Researchers at pharmacy benefit manager Medco Health Solutions reported last year that taking Plavix with Nexium significantly increased patients’ chances of being hospitalized for a heart attack, stroke or chest pain.
In May, Sanofi and Bristol-Myers updated Plavix’s labeling to advise against using it in combination with certain heartburn drugs.
A Sanofi spokeswoman said Tuesday that the company has bolstered that language labeling.
“We’ve strengthened the label to say that these drugs should be avoided altogether, not just discouraged,” said Noelle Boyd, Sanofi’s senior communications director.
WBB Securities analyst Steven Brozak said the news would put pressure on Paris-based Sanofi and New York-based Bristol-Myers to provide more safety data on their best-selling product.
“This is going to create a chain reaction as patients start calling their physicians, and they are forced to make a spot decision on limited information,” said Brozak. “That’s not gonna help either company’s bottom line.”
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