 |
 |
|
|
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.
Mail this post
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.
Mail this post
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.”
Mail this post
ATLANTA – Cigarette smoking rose slightly for the first time in almost 15 years, dashing health officials’ hopes that the U.S. smoking rate had moved permanently below 20 percent.
A little under 21 percent of U.S. adults said they smoked, according to a 2008 national survey by the U.S. Centers for Disease Control and Prevention. That’s up slightly from the year before, when just 19.8 percent said they were smokers. It also is the first increase in adult smoking since 1994, experts noted.
The increase was so small, it could be just a blip, so health officials and experts say smoking prevalence is flat, not rising. But they are unhappy.
“Clearly, we’ve hit a wall in reducing adult smoking,” said Vince Willmore, spokesman for the Campaign for Tobacco-Free Kids, a Washington, D.C.- based research and advocacy organization.
There’s a general perception that smoking is a fading public health danger. Feeding that perception are indoor smoking laws, cigarette taxes and Congress’ recent decision to allow the Food and Drug Administration to regulate tobacco.
But health officials believe gains have been undermined by cuts in state tobacco control campaigns. Some advocates believe tobacco companies are overcoming increasing obstacles.
Cigarette marketing has persisted and is effectively reaching kids and minorities with messages about flavored or menthol products, said Dr. Clyde Yancy, president of the American Heart Association.
The tobacco industry also has been discounting cigarettes to offset tax increases and keep smokes affordable, Willmore said.
Between 1997 and 2004, the average retail price of a pack of cigarettes — adjusted for inflation — jumped 63 percent, and adult smoking declined about 15 percent. Between 2004 and 2008, the price rose just 2 percent, while adult smoking declined by just about 1 percent, he said, citing industry sales data.
“There’s a clear correlation,” Willmore said.
Cigarette smoking is the leading preventable cause of death and illness in the United States, and is a cause of cancers, heart disease and other fatal conditions.
The adult smoking rate has been dropping, in starts and stops, since the mid-1960s when roughly 2 out of 5 U.S. adults smoked. Now it’s 1 in 5. However, federal health goals for the year 2010 had hoped to bring the rate down to close to 1 in 10.
Adult smoking hovered at about 21 percent from 2004 to 2006, then dropped a full percentage point in 2007, said Dr. Matthew McKenna, director of the CDC’s Office on Smoking and Health.
The 2007 drop gave CDC officials hope that U.S. smoking was plummeting again. “Now that appears to be a statistical aberration,” McKenna said.
The new survey’s results come from in-person interviews of nearly 22,000 U.S. adults.
The study was released Thursday, published in the CDC publication, Morbidity and Mortality Weekly Report.
Also on Thursday, the CDC released state-by-state results on smoking from a different survey, conducted by telephone, of more than 400,000 adults. West Virginia and Indiana had the highest smoking rates, at about 26 percent, but four other states — Kentucky, Missouri, Oklahoma and Tennessee — had rates about as high.
Utah had, by far, the lowest smoking rate, with only about 9 percent of Utah residents describing themselves as current smokers.
Many of the states that have the lowest smoking rates are those that have been the most aggressive about indoor smoking laws and about state taxes that drive up the cost of cigarettes, said Dr. Thomas Frieden, the CDC’s director.
Health officials are optimistic that more and more smokers will be discouraged from lighting up by escalating cigarette taxes, including a 62-cent federal tax that took effect in April. That may cause smoking to go down when the 2009 smoking data comes in, some advocates said.
Perhaps the recession will have an impact, too.
“In general, when people have less money, they smoke less,” Frieden said. “Time will tell.”
Mail this post
A drug for people with a form of leukemia holds promise as a possible treatment for ovarian cancer, new research suggests.
The drug dasatinib (Sprycel) is used to treat chronic myeloid leukemia. Researchers at the University of California at Los Angeles report that the drug limited the growth and invasive powers of ovarian cancer cells.
It also proved to have even more cancer-fighting powers when it was combined with chemotherapy and used to fight certain kinds of ovarian cancer cells known as Src dependent, according to the report published in the Nov. 10 issue of the BMJ.
Ovarian cancer is the most deadly cancer that strikes the female reproductive system and is expected to kill 15,500 women in the United States this year. The cancer is very difficult to treat.
“It is important to remember that this work is only on cancer cell lines, but it is significant enough that it should be used to justify clinical trials to confirm that women with this type of ovarian cancer could benefit,” Gottfried Konecny, an assistant professor of hematology/oncology and first author of the study, said in a UCLA news release.
An estimated one-third of women with ovarian cancer have the type known as Src dependent.
“We were able to identify markers in the pre-clinical setting that would allow us to predict response to Sprycel,” Konecny said. “These may help us in future clinical trials in selecting patients for studies of the drug.”
Mail this post
WASHINGTON - As federal regulators take their first tentative steps toward policing the wild west of medical information online, pharmaceutical companies are pressing their case to market drugs via Google, Twitter and other Web sites.
The Food and Drug Administration will convene a two-day meeting beginning Thursday to hear the drug industry’s position on Internet marketing. The agency has agreed to consider developing rules for online advertising after companies complained that the current guidelines for traditional media — which require a detailed list of possible side effects — have left them hamstrung on the Web.
An estimated 83 percent of Internet users search for health information online, according to a recent survey from the Pew Research Center.
A few drugmakers have begun trying to reach patients via social networking sites like Facebook and YouTube. But overall the industry’s online presence trails other sectors, including retail, financial services and computer makers.
In the first half of 2009, pharmaceutical companies represented just 4 percent of the $10.9 billion spent on online advertising, according to a report from PricewaterhouseCoopers.
Industry observers say companies have largely steered clear of the Web for fear of running afoul of FDA regulators, who have not defined the rules of operating online.
In a public statement announcing the meeting, the FDA acknowledged that “emerging technologies may require the agency to provide additional guidance.” But some industry experts worry the FDA’s rule development process — which often takes years — cannot keep pace with online innovation.
“What’s happening is these new media are emerging at an increasingly rapid rate, and are being regulated by an agency that moves very slowly,” said attorney Mark Senak, who advises drug companies as a consultant for communications firm Fleishman-Hillard. “In essence, you have a regulatory communication crisis developing.”
The vast majority of the pharmaceutical industry’s roughly $4.5 billion in annual marketing is still spent on traditional TV and magazine advertising, where the rules are clear: all ads that mention a drug must provide a balanced picture of its risks and benefits.
The requirement to disclose risk information demands those long lists of side effects heard during TV and radio spots, as well as the large blocks of small print seen in magazine ads.
When drug companies have tried to adapt such ads to the abbreviated language of Google and Yahoo, they’ve run into trouble. In April, the FDA fired off warning letters to Pfizer Inc., GlaxoSmithKline PLC and a dozen other drugmakers for search engine ads that did not mention drug risks.
The ads — called sponsored links — appear on the screen margins of sites like Google when users search for certain key words. With a maximum of just 25 words, the links did not include information about potential side effects, making them illegal, according to the FDA.
On Thursday, the Pharmaceutical Research and Manufacturers of America group will argue that the FDA should relax its standards to accommodate new online approaches to marketing.
In documents released ahead of the meeting, PhRMA suggests the agency develop a logo that could be used in place of hundreds of words about drug risks. The logo would link viewers to the drug’s full risk information, allowing manufacturers to send messages about their drugs on sites like Twitter, which has a 140-character limit.
But industry observers say the online marketing environment is not as restrictive to drugmakers as some suggest. Pharma Marketing News publisher John Mack says drug companies already are free to post abbreviated ads about diseases and treatments — provided they don’t mention a specific product.
“They are very hell-bent on including brand names in their ads,” said Mack. “If all they wanted to do is direct people to useful health information, there are lots of ways to accomplish that.”
PhRMA will also press the FDA to narrowly define drug companies’ responsibility for policing information about their products.
Pharmaceutical promotions can only discuss drug uses that have been cleared by the FDA. But manufacturers worry they could be held responsible for comments about unapproved uses posted by users of blogs and interactive Web sites like YouTube, where some drug companies offer videos about diseases and medical science.
“Pharmaceutical companies control their own sites, their own agents and their own employees,” PhRMA assistant general counsel Jeffrey Francer said in a media briefing Monday. “But there is no sensible basis to hold manufacturers accountable for third-party statements.”
The FDA also is slated to hear from individual drug companies, medical device makers, attorneys and advertising executives.
Even after the FDA transcribes and reviews hours of testimony, the agency will only be in the preliminary stages of crafting new guidelines. According to Senak, the FDA is unlikely to release its final regulations until 2011 — when they may already be outdated.
“The danger is that the agency takes so long to get this done, and done right, that tremendous opportunities are lost,” said Senak.
A spokeswoman for the FDA declined to comment on the agency’s timeline.
“Next steps after the meeting will be to review all the testimony provided at the hearing and the comments, information and data submitted to the docket,” Shelly Burgess wrote in an e-mail.
Mail this post
WASHINGTON (AFP) – The US Food and Drug Administration (FDA) on Friday warned consumers to avoid buying medicines online to treat swine flu, saying one such product contained nothing more than talc and over-the-counter fever-reducer.
The FDA raised the warning after some of its investigators purchased and analyzed products represented online as Tamiflu (oseltamivir), one of the anti-viral medicines that has been shown to be effective against A(H1N1) flu.
“One of the orders, which arrived in an unmarked envelope with a postmark from India, consisted of unlabeled, white tablets taped between two pieces of paper,” the food and drug safety watchdog said.
“The tablets were found to contain talc and acetaminophen (paracetamol), but none of the active ingredient oseltamivir,” it said.
In buying several of the products, the FDA investigators were not asked to produce a doctor’s prescription.
The two antiviral drugs approved by the FDA for treatment and prophylaxis of the 2009 A(H1N1) influenza virus, Tamiflu and Relenza, require prescriptions.
“Medicines purchased from websites operating outside the law put consumers at increased risk due to a higher potential that the products will be counterfeit, impure, contaminated or have too little or too much of the active ingredient,” FDA Commissioner Margaret Hamburg said.
Patients who buy prescription drugs from websites run an “increased risk of suffering life-threatening adverse events, such as side effects from inappropriately using prescription medications, dangerous drug interactions, contaminated drugs, and impure or unknown ingredients found in unapproved drugs,” the FDA said.
Bogus drugs are more common in times of a public health emergency, such as an influenza outbreak, when unlicensed manufacturers take advantage of high demand for medications and try to turn a quick profit, the FDA warned.
It’s possible to buy Tamiflu online, however prescription is required.
Mail this post
Waning international donor support for the fight against AIDS is a threat to a decade of progress in HIV treatment, Doctors Without Borders (MSF) warned on Thursday.
“Some of the spotlight has come off of HIV largely due to the fact that there has been tremendous success in scaling up. There are four million people alive on ARVs (anti-retrovirals) that otherwise wouldn’t have been,” MSF spokeswoman Sharonann Lynch told AFP.
“The dirty secret is that donors want to be let off the hook for what is lifelong and unfortunately, right now, expensive treatment.”
The charity, in a new 12-page report, warns that a retreat in donor support could have “catastrophic implications”.
“Both political commitment and funding allocations are waning,” it said.
“The most glaring sign of the decreasing political commitment to HIV-AIDS is a major funding deficit,” the report added.
A “dangerous trend” underway in global health policy arena had seen calls for foreign aid to be diverted from HIV to other health priorities but MSF said cutting AIDS aid was not the answer.
“This killer disease is an ongoing emergency that requires dedicated resources at the national and international levels,” it said.
Funding cuts in Uganda had resulted in HIV positive patients being turned away and now-resolved financial shortages in South Africa saw treatment disrupted and uptake of new HIV positive patients.
While four million people are on anti-AIDS drugs in the world, some six million people are still in need of treatment, MSF said.
Mail this post