AIDS leaves 9 mln African children without mothers Yahoo! NEWS
Some 9 million children in Africa have lost a mother to AIDS, British charity Save the Children said Monday, calling on donors to sharply increase aid to meet their needs. "Incredibly, the impact of HIV and AIDS on children is still being ignored," Save the Children Chief Executive Jasmine Whitbread said in a statement. The charity said in a report that a lack of testing facilities meant that many mothers, especially in the poorest countries, did not know their HIV status until they were ill and unable to fight off even the simplest infections. "The AIDS pandemic robs millions of children of their childhoods as well as their mothers," Whitbread said. "Children are caring for their mothers, missing school, and having to work because their mothers are too sick to look after them." The charity called for a focus on children orphaned by AIDS as well as sick parents, adding red tape was slowing aid flows. "Donors must spend 12 percent of their AIDS funding on proper support for children," it said, adding this would amount to $6.4 billion over a three-year period. In 2006, if Britain, the United States and Ireland met all their pledges, there would be $412 million committed for children -- or about one quarter of the $2.1 billion needed per year. "This is best case scenario and it's not yet clear whether all of the donors will meet their commitments," a spokeswoman for Save the Children told Reuters by telephone from London. The charity addressed its appeal to the G8 wealthy nations, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank and the European Commission. Sub-Saharan Africa has about 10 percent of the world's population but 60 percent of the people living with HIV/AIDS. More than 3 million Africans were infected with HIV in 2005, representing 64 percent of all new infections globally and more than in any previous year for the impoverished continent, according to UNAIDS, the lead U.N. agency against AIDS. Across sub-Saharan Africa, an estimated 4.6 percent of young women aged 15 to 24 are infected with HIV, compared to 1.7 percent of young men, according to U.N. data. Save the Children said most of the 19.2 million women living with HIV around the globe were already mothers. "To truly make a difference we must also support children whose mothers are HIV positive," it said. "In sub-Saharan Africa alone, more than 12 million children under the age of 15 have lost one or both parents to AIDS. By 2010, at current rates of HIV infection, this number is likely to increase to 18 million," Save the Children said.
By Manoah Esipisu
Full Version: Health News
Common Ground Common Sense > Issues that Affect Our Lives > Health Care > Health Care Issues Archive
To head off allergies, expose your kids to pets and dirt early Yahoo! NEWS
Here's the conventional wisdom: Pets promote allergy, kids shouldn't eat peanuts until they're at least 3, and intestinal worms are nothing more than an icky reminder of life before flush toilets. Here's the new wisdom: Early exposure to pets, peanuts and intestinal worms might actually be good for you, because they program the developing immune system to know the difference between real threats, such as germs, and Aunt Millie's cat. (Graphic: Short-circuiting a cat allergy) Evidence to support this view has been mounting for more than a decade. But now, for the first time, researchers are beginning to test remedies based on these theories in patients. Other doctors are trying to make use of novel approaches to retrain the immune system once it's too late and allergies set in. "What we've learned is that it may, in fact, be important to be exposed early on to a sufficient quantity of allergy-causing substances to train the immune system that they are not a threat," says Andy Saxon of the University of California-Los Angeles. "And, in people who already have allergies, we see for the first time where the problems lie, and we have new opportunities to tweak the system." Scientists base this radical new thinking about human allergies on a deeper understanding of how the immune system works. They have begun to exploit fresh insights to attack allergies and other immune diseases in unexpected ways. No longer content just to treat allergy symptoms, they hope to outwit the immune system and stop allergic responses before they start. "When you're born, Day Zero, your immune system is like a new computer. It's not programmed. You have to add software," says Joel Weinstock of Tufts New England Medical Center. "Between the ages of zero and 12, you're learning to read, you're learning to write, and your immune system is learning to react to things. Part of that is learning to limit reactivity." If the new approaches work, millions might benefit. More than 50 million people have allergic diseases, which are the sixth-leading cause of chronic illness in the USA, according to the National Institute of Allergy and Infectious Diseases (NIAID), costing the health system $18 billion a year. Asthma alone accounts for 500,000 hospitalizations a year, including 2 million admissions to the emergency room, says a study in the May 2005 Journal of Allergy and Clinical Immunology. Since 1980, adult asthma cases have risen by 75% and childhood asthma by 160%, the Centers for Disease Control and Prevention reports. (Related: Asthmatic kids under a cloud) To test whether high-dose exposure breeds tolerance, researchers led by Gideon Lack at Imperial College in London are preparing to launch a counterintuitive - and some would say risky - seven-year, U.S.-financed study that will expose infants to peanuts. It's based on research showing that children who eat peanuts at an early age are less likely to develop peanut allergies. The study is risky because children with unrecognized peanut allergies might suffer anaphylactic shock, a deadly drop in blood pressure often combined with asthma, if they're exposed to peanuts. A second team of researchers, led by Patrick Holt of the University of Western Australia in Perth, will conduct a similar study in which children who are already allergic to other substances will be exposed to airborne allergens such as ragweed to see whether it will block the development of other allergies. Other studies suggest that short-lived infections with a benign parasite might relieve allergies and possibly autoimmune illnesses such as Crohn's disease and Type I diabetes by restoring the immune system's natural balance. Major human trials in the USA and Europe are set to begin this year. Although trying to link allergies to autoimmune diseases such as Crohn's might seem like a stretch, scientists say both types of ailments result from an immune system run amok. In allergies, the immune system goes on alert when ragweed or some other allergy-causing protein wafts through the air, settles on the skin or tickles the tongue. In autoimmune diseases, the immune system can no longer distinguish between the self and foreign proteins. Mistaking the self for those proteins, the immune system attacks the bowel in Crohn's disease or insulin-producing cells in Type 1 diabetes.
Early intervention
If educating the immune system is tough, re-educating it after allergies set in appears to be tougher. Allergy shots work, but they're costly and often must be continued for years, and the protection fades over time. Higher-tech approaches rely heavily on 21st-century molecular medicine to engineer proteins that block allergies. One strategy, pioneered by researchers at Dynavax Technologies in Berkeley, Calif., involves disguising a key ragweed protein with DNA from a bacterium. The goal: to create a new short course of allergy shots that tricks the immune system into permanently thinking that ragweed is a bacterium, so it will attack it like a germ and not mount an allergic response. The approach has appeared to work in early trials at Johns Hopkins University. A second strategy, now being developed by Saxon and his colleagues at UCLA and licensed to the biotech firm Biogen Idec, involves fusing a cat allergen with a snippet of a powerful antibody called IgG. This IgG snippet turns off cells that make histamine, the chemical responsible for scratchy throats, watery eyes, runny noses and asthma. Researchers hope the combo will lock histamine-producing cells in the off position, and, in time, retrain the immune system to accept that Aunt Millie's cat is harmless.
Hypothetically speaking
The new approach to allergy prevention and treatment arises from a paradox. Known as the hygiene hypothesis, it suggests that growing up in cities and suburbs, away from fields and farm animals, leaves people more susceptible to a host of immune disorders, including allergies and asthma. Weinstock says the divide between developed and undeveloped countries is still evident today. "Hay fever is the most common allergy in the developed world," he says. "Yet, there are some countries in the world where doctors don't know what hay fever is." What about urban life is triggering a rash of allergies and autoimmune diseases? It's a good question, and not an easy one to answer. The immune system isn't palpable as are the heart and lungs; you can't listen to it or feel its pulse. Yet the immune system is our most sensitive link to the environment, on alert for threats of all kinds, most of the time running in the background like computer anti-virus software. To accelerate the research, the National Institutes of Health and the Juvenile Diabetes Research Foundation in 1999 set up a seven-year, $144 million international consortium called the Immune Tolerance Network, says Marshall Plaut of NIAID. Already, research is turning up surprising results. Dennis Ownby of the Medical College of Georgia followed 474 infants in the Detroit area from birth to age 7, hoping to identify clues about why some would pick up allergies and others would not. Ownby, then at Henry Ford Hospital, says he was unprepared for what he found. Ownby's team compared 184 children who were exposed to two or more dogs or cats in their first year of life with 220 who didn't have pets. To their surprise, the scientists found that children raised with pets were 45% less likely to test positive for allergies than other kids. The study appeared in the Aug. 28, 2002 Journal of the American Medical Association. "We've been taught for at least a couple of decades that early exposure to an allergen increases the risk of becoming allergic later in life," Ownby says. "So when we first examined our data, we were very afraid that something had gone wrong. It's the opposite of what we would have predicted." The challenge now, Ownby says, is to figure out what's happening. One possible explanation is that dogs and cats shed a substance called endotoxin, from bacteria. A study by Andy Liu of National Jewish Medical and Research Center in Denver reported in 2000 that infants with the most endotoxin exposure were the least likely to have allergies, indicating that what researchers call the Pigpen Effect, the invisible cloud of dust and dirt surrounding us all, might not be a bad thing. Or consider the peanut paradox. In the past 10 years, peanut allergies have doubled in the USA, United Kingdom and other countries that advise against exposing unborn children to peanuts (through their mothers' diet) and during infancy, Imperial College's Lack says. He believes children become allergic to peanuts not by eating them but by coming into contact with peanut oil in their mothers' skin lotions, according to a study published in the March 2003 New England Journal of Medicine. Studies of rodents suggest eating peanuts conditions the immune system to tolerate them. Infants in regions of Africa and Asia who are exposed to peanuts rarely develop the allergy, Lack says, in contrast to countries such as the USA and UK, where the prevalence of peanut allergies might be more than 10 times higher. To test whether eating peanut products can protect children from peanut allergies, Lack plans to launch a dramatic seven-year study in which parents will regularly feed high doses of peanuts to about 200 children who have egg allergies or eczema, conditions that put them at high risk of developing other allergies. Parents of another 200 children will follow the government's advice and try to completely avoid peanuts. One key message, Lack says, is don't try this at home, without the safeguards of a carefully controlled trial. "Feeding babies peanuts can be extremely dangerous," he says. As high-risk as the trial is, it might be extremely rewarding, doctors say. Each year in the USA, about 15,000 people suffer severe allergic reactions from eating peanuts, and about 100 die. "It's the first large-scale trial of what we consider a very dangerous allergic food," Ownby says. To the squeamish, it might not matter that intestinal worms are less risky than foods that promote allergy. But some doctors say worms might do something that allergy-causing substances won't do - broadly reset the immune system so that it no longer reacts to allergy-causing substances or attacks the body's tissues, as it does in Crohn's disease and Type I diabetes. "This is an exciting new area with potential for opening new therapeutic avenues for diseases that are hard to control and treat," says Weinstock of Tufts New England Medical Center. Worms captured Weinstock's imagination and that of his collaborator, David Elliott of the University of Iowa, because worm infections appear to regulate the immune system so that it functions normally. The allergic response - itchy, watery eyes, a runny nose and constriction of smooth muscles - evolved to flush out intestinal worms. "The immune system didn't evolve for allergy," Weinstock says. "Why in a hundred billion years of evolution would we evolve a response for allergy?" In fact, says Robert Coffman, vice president of the biotech firm Dynavax Technologies, the immune system developed two sets of responses: one for bacteria and viruses and one for worms. Called Th1 for germs and Th2 for worms, they work in opposition. When Th1 is active, Th2 takes a break. When Th2 is active, it's Th1's turn. All of the symptoms people link with allergy are part of the Th2 response.
The worm turns
Weinstock, Elliott and other researchers believe that a low-grade infection with intestinal worms - pig whipworms because they can't reproduce in people - can restore the immune system's natural balance. A small-scale study in which 29 people with Crohn's disease drank whipworm eggs in Gatorade found that 23 responded to treatment and 21 of the 23 experienced complete remission. Although worms haven't been directly tested in allergic patients, researchers point to a study by Maria Yazdanbakhsh of Leiden University in the Netherlands, which found that treating schoolchildren in Gabon for worms, so that the worms were expelled from their bodies, doubled their risk of becoming allergic to house dust mites, a common allergen. Weinstock argues that it is exposure to the worms in the environment that confers protection against allergies. "That's one possibility," he says. "Whether it's due to worms, endotoxin, lifestyle, smoking or other factors that we haven't identified - that's the fun of it. But environment clearly plays a part."
By Steve Sternberg, USA TODAY
Here's the conventional wisdom: Pets promote allergy, kids shouldn't eat peanuts until they're at least 3, and intestinal worms are nothing more than an icky reminder of life before flush toilets. Here's the new wisdom: Early exposure to pets, peanuts and intestinal worms might actually be good for you, because they program the developing immune system to know the difference between real threats, such as germs, and Aunt Millie's cat. (Graphic: Short-circuiting a cat allergy) Evidence to support this view has been mounting for more than a decade. But now, for the first time, researchers are beginning to test remedies based on these theories in patients. Other doctors are trying to make use of novel approaches to retrain the immune system once it's too late and allergies set in. "What we've learned is that it may, in fact, be important to be exposed early on to a sufficient quantity of allergy-causing substances to train the immune system that they are not a threat," says Andy Saxon of the University of California-Los Angeles. "And, in people who already have allergies, we see for the first time where the problems lie, and we have new opportunities to tweak the system." Scientists base this radical new thinking about human allergies on a deeper understanding of how the immune system works. They have begun to exploit fresh insights to attack allergies and other immune diseases in unexpected ways. No longer content just to treat allergy symptoms, they hope to outwit the immune system and stop allergic responses before they start. "When you're born, Day Zero, your immune system is like a new computer. It's not programmed. You have to add software," says Joel Weinstock of Tufts New England Medical Center. "Between the ages of zero and 12, you're learning to read, you're learning to write, and your immune system is learning to react to things. Part of that is learning to limit reactivity." If the new approaches work, millions might benefit. More than 50 million people have allergic diseases, which are the sixth-leading cause of chronic illness in the USA, according to the National Institute of Allergy and Infectious Diseases (NIAID), costing the health system $18 billion a year. Asthma alone accounts for 500,000 hospitalizations a year, including 2 million admissions to the emergency room, says a study in the May 2005 Journal of Allergy and Clinical Immunology. Since 1980, adult asthma cases have risen by 75% and childhood asthma by 160%, the Centers for Disease Control and Prevention reports. (Related: Asthmatic kids under a cloud) To test whether high-dose exposure breeds tolerance, researchers led by Gideon Lack at Imperial College in London are preparing to launch a counterintuitive - and some would say risky - seven-year, U.S.-financed study that will expose infants to peanuts. It's based on research showing that children who eat peanuts at an early age are less likely to develop peanut allergies. The study is risky because children with unrecognized peanut allergies might suffer anaphylactic shock, a deadly drop in blood pressure often combined with asthma, if they're exposed to peanuts. A second team of researchers, led by Patrick Holt of the University of Western Australia in Perth, will conduct a similar study in which children who are already allergic to other substances will be exposed to airborne allergens such as ragweed to see whether it will block the development of other allergies. Other studies suggest that short-lived infections with a benign parasite might relieve allergies and possibly autoimmune illnesses such as Crohn's disease and Type I diabetes by restoring the immune system's natural balance. Major human trials in the USA and Europe are set to begin this year. Although trying to link allergies to autoimmune diseases such as Crohn's might seem like a stretch, scientists say both types of ailments result from an immune system run amok. In allergies, the immune system goes on alert when ragweed or some other allergy-causing protein wafts through the air, settles on the skin or tickles the tongue. In autoimmune diseases, the immune system can no longer distinguish between the self and foreign proteins. Mistaking the self for those proteins, the immune system attacks the bowel in Crohn's disease or insulin-producing cells in Type 1 diabetes.
Early intervention
If educating the immune system is tough, re-educating it after allergies set in appears to be tougher. Allergy shots work, but they're costly and often must be continued for years, and the protection fades over time. Higher-tech approaches rely heavily on 21st-century molecular medicine to engineer proteins that block allergies. One strategy, pioneered by researchers at Dynavax Technologies in Berkeley, Calif., involves disguising a key ragweed protein with DNA from a bacterium. The goal: to create a new short course of allergy shots that tricks the immune system into permanently thinking that ragweed is a bacterium, so it will attack it like a germ and not mount an allergic response. The approach has appeared to work in early trials at Johns Hopkins University. A second strategy, now being developed by Saxon and his colleagues at UCLA and licensed to the biotech firm Biogen Idec, involves fusing a cat allergen with a snippet of a powerful antibody called IgG. This IgG snippet turns off cells that make histamine, the chemical responsible for scratchy throats, watery eyes, runny noses and asthma. Researchers hope the combo will lock histamine-producing cells in the off position, and, in time, retrain the immune system to accept that Aunt Millie's cat is harmless.
Hypothetically speaking
The new approach to allergy prevention and treatment arises from a paradox. Known as the hygiene hypothesis, it suggests that growing up in cities and suburbs, away from fields and farm animals, leaves people more susceptible to a host of immune disorders, including allergies and asthma. Weinstock says the divide between developed and undeveloped countries is still evident today. "Hay fever is the most common allergy in the developed world," he says. "Yet, there are some countries in the world where doctors don't know what hay fever is." What about urban life is triggering a rash of allergies and autoimmune diseases? It's a good question, and not an easy one to answer. The immune system isn't palpable as are the heart and lungs; you can't listen to it or feel its pulse. Yet the immune system is our most sensitive link to the environment, on alert for threats of all kinds, most of the time running in the background like computer anti-virus software. To accelerate the research, the National Institutes of Health and the Juvenile Diabetes Research Foundation in 1999 set up a seven-year, $144 million international consortium called the Immune Tolerance Network, says Marshall Plaut of NIAID. Already, research is turning up surprising results. Dennis Ownby of the Medical College of Georgia followed 474 infants in the Detroit area from birth to age 7, hoping to identify clues about why some would pick up allergies and others would not. Ownby, then at Henry Ford Hospital, says he was unprepared for what he found. Ownby's team compared 184 children who were exposed to two or more dogs or cats in their first year of life with 220 who didn't have pets. To their surprise, the scientists found that children raised with pets were 45% less likely to test positive for allergies than other kids. The study appeared in the Aug. 28, 2002 Journal of the American Medical Association. "We've been taught for at least a couple of decades that early exposure to an allergen increases the risk of becoming allergic later in life," Ownby says. "So when we first examined our data, we were very afraid that something had gone wrong. It's the opposite of what we would have predicted." The challenge now, Ownby says, is to figure out what's happening. One possible explanation is that dogs and cats shed a substance called endotoxin, from bacteria. A study by Andy Liu of National Jewish Medical and Research Center in Denver reported in 2000 that infants with the most endotoxin exposure were the least likely to have allergies, indicating that what researchers call the Pigpen Effect, the invisible cloud of dust and dirt surrounding us all, might not be a bad thing. Or consider the peanut paradox. In the past 10 years, peanut allergies have doubled in the USA, United Kingdom and other countries that advise against exposing unborn children to peanuts (through their mothers' diet) and during infancy, Imperial College's Lack says. He believes children become allergic to peanuts not by eating them but by coming into contact with peanut oil in their mothers' skin lotions, according to a study published in the March 2003 New England Journal of Medicine. Studies of rodents suggest eating peanuts conditions the immune system to tolerate them. Infants in regions of Africa and Asia who are exposed to peanuts rarely develop the allergy, Lack says, in contrast to countries such as the USA and UK, where the prevalence of peanut allergies might be more than 10 times higher. To test whether eating peanut products can protect children from peanut allergies, Lack plans to launch a dramatic seven-year study in which parents will regularly feed high doses of peanuts to about 200 children who have egg allergies or eczema, conditions that put them at high risk of developing other allergies. Parents of another 200 children will follow the government's advice and try to completely avoid peanuts. One key message, Lack says, is don't try this at home, without the safeguards of a carefully controlled trial. "Feeding babies peanuts can be extremely dangerous," he says. As high-risk as the trial is, it might be extremely rewarding, doctors say. Each year in the USA, about 15,000 people suffer severe allergic reactions from eating peanuts, and about 100 die. "It's the first large-scale trial of what we consider a very dangerous allergic food," Ownby says. To the squeamish, it might not matter that intestinal worms are less risky than foods that promote allergy. But some doctors say worms might do something that allergy-causing substances won't do - broadly reset the immune system so that it no longer reacts to allergy-causing substances or attacks the body's tissues, as it does in Crohn's disease and Type I diabetes. "This is an exciting new area with potential for opening new therapeutic avenues for diseases that are hard to control and treat," says Weinstock of Tufts New England Medical Center. Worms captured Weinstock's imagination and that of his collaborator, David Elliott of the University of Iowa, because worm infections appear to regulate the immune system so that it functions normally. The allergic response - itchy, watery eyes, a runny nose and constriction of smooth muscles - evolved to flush out intestinal worms. "The immune system didn't evolve for allergy," Weinstock says. "Why in a hundred billion years of evolution would we evolve a response for allergy?" In fact, says Robert Coffman, vice president of the biotech firm Dynavax Technologies, the immune system developed two sets of responses: one for bacteria and viruses and one for worms. Called Th1 for germs and Th2 for worms, they work in opposition. When Th1 is active, Th2 takes a break. When Th2 is active, it's Th1's turn. All of the symptoms people link with allergy are part of the Th2 response.
The worm turns
Weinstock, Elliott and other researchers believe that a low-grade infection with intestinal worms - pig whipworms because they can't reproduce in people - can restore the immune system's natural balance. A small-scale study in which 29 people with Crohn's disease drank whipworm eggs in Gatorade found that 23 responded to treatment and 21 of the 23 experienced complete remission. Although worms haven't been directly tested in allergic patients, researchers point to a study by Maria Yazdanbakhsh of Leiden University in the Netherlands, which found that treating schoolchildren in Gabon for worms, so that the worms were expelled from their bodies, doubled their risk of becoming allergic to house dust mites, a common allergen. Weinstock argues that it is exposure to the worms in the environment that confers protection against allergies. "That's one possibility," he says. "Whether it's due to worms, endotoxin, lifestyle, smoking or other factors that we haven't identified - that's the fun of it. But environment clearly plays a part."
By Steve Sternberg, USA TODAY
Health Tip: Heart Attack or Indigestion? Yahoo! NEWS
As with a heart attack, indigestion can cause burning in the chest. But according to the U.S. Department of Health and Human Services, it's unlikely that pain from indigestion would spread to other parts of the body, as a typical heart attack does. Indigestion, frequently accompanied by nausea, often stems from eating too much, too quickly, or the wrong kinds of foods. If you have any of these symptoms, they could indicate something more serious than simple indigestion:
As with a heart attack, indigestion can cause burning in the chest. But according to the U.S. Department of Health and Human Services, it's unlikely that pain from indigestion would spread to other parts of the body, as a typical heart attack does. Indigestion, frequently accompanied by nausea, often stems from eating too much, too quickly, or the wrong kinds of foods. If you have any of these symptoms, they could indicate something more serious than simple indigestion:
- Vomiting, weight loss, or appetite loss.
- Black, tarry stools or blood in vomit.
- What feels like indigestion accompanied by shortness of breath; pain radiating to the jaw, neck or arm; or sweating.
B Vitamin Case Reaches Supreme Court Yahoo! NEWS
B vitamin deficiencies can cause a range of serious health effects, including spinal defects in children born to women with below-normal levels of folic acid and anemia in people not getting enough B12. That's why a two-step method of diagnosing those deficiencies that three medical school doctors patented in 1990 has become so widely used. It's performed tens of millions of times a year, at a cost of just a dollar or two, by laboratory testing companies nationwide. Now, to the surprise of patent attorneys, a case involving one of those companies, sued after it stopped paying some royalties, has landed in the Supreme Court, where arguments will be heard Tuesday. Even more surprising is that the Supreme Court may dredge up a bombshell question not asked when the lower courts considered the case: Have inventors been busy patenting laws of nature, natural phenomena and abstract ideas? At stake, attorneys on both sides of the case say, are 25 years of patent law and literally tens of thousands of patents on drugs, medical devices, computer software and other inventions. If the court reins in what can be patented, they say, it could be among the most important patent law decisions ever made. The two-step method covered by patent No. 4,940,658 is straightforward: The level of an amino acid called homocysteine is measured in a patient's blood or urine and, if elevated, it can be correlated with a deficiency of folic acid, or B12. The question before the Supreme Court is whether a doctor could infringe the patent "merely by thinking about the relationship" between homocysteine levels and B vitamin deficiencies after looking at a test result. In 1998, testing company Laboratory Corp. of America Holdings stopped paying some royalties on the patent. The patent's holders, including Metabolite Laboratories Inc. and Competitive Technologies Inc., sued. LabCorp lost, was ordered to pay about $5 million and then lost again on appeal. It now wants the Supreme Court to reverse the previous judgments. LabCorp, its attorneys and supporters argue in court filings that the patent gives its owners an effective monopoly over a basic scientific principle or natural phenomenon: high levels of homocysteine suggest deficiencies in two B vitamins. "If someone observes a correlation between X and Y and then announces he is going to use that correlation in a lab test, is that a patentable process? I think the court is troubled that that sort of correlation would be possible," said Jack Bierig, a Chicago attorney who filed a friend-of-the-court brief supporting LabCorp on behalf of the American Medical Association and five other medical groups. Metabolite Laboratories counters that the patent covers a practical application of the discovery made by the inventors when used as part of a diagnostic step. "The test itself is obvious when you have the correlation. It is the discovery of the correlation that is the real novelty here," said Mark Lemley, a Stanford University law professor who is helping represent Metabolite Laboratories. LabCorp originally argued that the patent was overly vague, and that allowed it to use tests, called assays, developed by other companies to measure homocysteine levels. Metabolite Laboratories disagreed. That sort of narrow dispute is the crux of many patent suits and normally wouldn't grab much attention. But the Supreme Court asked the federal government to weigh in on the case, specifically asking whether Metabolite Laboratories succeeded in patenting a law of nature, natural phenomenon or abstract idea — all no-no's under patent law. "They did pretty much shock everybody," said Chicago-Kent College of Law professor Lori Andrews, who submitted a friend-of-the-court brief supporting LabCorp. The Solicitor General's office replied to the Supreme Court that the question wasn't asked in the lower courts and thus LabCorp's isn't the case to decide it. It recommended the previous judgment be affirmed or the case be dismissed or sent back to the lower courts. Regardless of the outcome, that the Supreme Court even asked that question guarantees the case's lasting effect on patents and patent law, attorneys said. Glenn Beaton, an attorney for Metabolite Laboratories, suggested: "I think it's fair to say there will be a sudden surge in claiming unpatentable subject matter because defendants' lawyers out there are going to see someone on the Supreme Court has a question in their mind whether patents are getting granted on the type of thing when they shouldn't be." Since the original LabCorp ruling, there has been a rush to file patents on "scientific facts" or "mental processes," Andrews said. The case is Laboratory Corporation of America Holdings v. Metabolite Laboratories Inc. et al., No. 04-607.
On the Net: Supreme Court: http://www.supremecourtus.gov/
By ANDREW BRIDGES, Associated Press Writer
B vitamin deficiencies can cause a range of serious health effects, including spinal defects in children born to women with below-normal levels of folic acid and anemia in people not getting enough B12. That's why a two-step method of diagnosing those deficiencies that three medical school doctors patented in 1990 has become so widely used. It's performed tens of millions of times a year, at a cost of just a dollar or two, by laboratory testing companies nationwide. Now, to the surprise of patent attorneys, a case involving one of those companies, sued after it stopped paying some royalties, has landed in the Supreme Court, where arguments will be heard Tuesday. Even more surprising is that the Supreme Court may dredge up a bombshell question not asked when the lower courts considered the case: Have inventors been busy patenting laws of nature, natural phenomena and abstract ideas? At stake, attorneys on both sides of the case say, are 25 years of patent law and literally tens of thousands of patents on drugs, medical devices, computer software and other inventions. If the court reins in what can be patented, they say, it could be among the most important patent law decisions ever made. The two-step method covered by patent No. 4,940,658 is straightforward: The level of an amino acid called homocysteine is measured in a patient's blood or urine and, if elevated, it can be correlated with a deficiency of folic acid, or B12. The question before the Supreme Court is whether a doctor could infringe the patent "merely by thinking about the relationship" between homocysteine levels and B vitamin deficiencies after looking at a test result. In 1998, testing company Laboratory Corp. of America Holdings stopped paying some royalties on the patent. The patent's holders, including Metabolite Laboratories Inc. and Competitive Technologies Inc., sued. LabCorp lost, was ordered to pay about $5 million and then lost again on appeal. It now wants the Supreme Court to reverse the previous judgments. LabCorp, its attorneys and supporters argue in court filings that the patent gives its owners an effective monopoly over a basic scientific principle or natural phenomenon: high levels of homocysteine suggest deficiencies in two B vitamins. "If someone observes a correlation between X and Y and then announces he is going to use that correlation in a lab test, is that a patentable process? I think the court is troubled that that sort of correlation would be possible," said Jack Bierig, a Chicago attorney who filed a friend-of-the-court brief supporting LabCorp on behalf of the American Medical Association and five other medical groups. Metabolite Laboratories counters that the patent covers a practical application of the discovery made by the inventors when used as part of a diagnostic step. "The test itself is obvious when you have the correlation. It is the discovery of the correlation that is the real novelty here," said Mark Lemley, a Stanford University law professor who is helping represent Metabolite Laboratories. LabCorp originally argued that the patent was overly vague, and that allowed it to use tests, called assays, developed by other companies to measure homocysteine levels. Metabolite Laboratories disagreed. That sort of narrow dispute is the crux of many patent suits and normally wouldn't grab much attention. But the Supreme Court asked the federal government to weigh in on the case, specifically asking whether Metabolite Laboratories succeeded in patenting a law of nature, natural phenomenon or abstract idea — all no-no's under patent law. "They did pretty much shock everybody," said Chicago-Kent College of Law professor Lori Andrews, who submitted a friend-of-the-court brief supporting LabCorp. The Solicitor General's office replied to the Supreme Court that the question wasn't asked in the lower courts and thus LabCorp's isn't the case to decide it. It recommended the previous judgment be affirmed or the case be dismissed or sent back to the lower courts. Regardless of the outcome, that the Supreme Court even asked that question guarantees the case's lasting effect on patents and patent law, attorneys said. Glenn Beaton, an attorney for Metabolite Laboratories, suggested: "I think it's fair to say there will be a sudden surge in claiming unpatentable subject matter because defendants' lawyers out there are going to see someone on the Supreme Court has a question in their mind whether patents are getting granted on the type of thing when they shouldn't be." Since the original LabCorp ruling, there has been a rush to file patents on "scientific facts" or "mental processes," Andrews said. The case is Laboratory Corporation of America Holdings v. Metabolite Laboratories Inc. et al., No. 04-607.
On the Net: Supreme Court: http://www.supremecourtus.gov/
By ANDREW BRIDGES, Associated Press Writer
March 20, 2006
Bird Flu Likely in US This Year: Gov't Officials
By REUTERS
Filed at 5:18 p.m. ET
WASHINGTON (Reuters) - Bush administration officials said on Monday it was ``increasingly likely'' that bird flu could be detected in the United States this year, but added it may not mean the start of a human pandemic.
Speaking to reporters, Interior Secretary Gale Norton, Agriculture Secretary Mike Johanns and Secretary of Health and Human Services Michael Leavitt unveiled a plan to increase monitoring of migratory birds that are likely to bring the bird flu virus to U.S. shores.
``It is increasingly likely that we will detect the highly pathogenic H5N1 strain of avian flu in birds within the U.S. borders possibly as early as this year,'' Norton said.
As a result, the government is expanding its early warning system to deal with bird flu's eventual arrival.
``None of us can build a cage around the United States. We have to be prepared to deal with the virus here,'' Johanns said.
The H5N1 avian flu virus has spread across Europe, Africa and parts of Asia and killed at least 98 people worldwide since 2003. So far, it has a mortality rate of about 50 percent.
Although bird flu is hard to catch, people can contract the disease by coming into contact with infected birds, especially from bird droppings.
Scientists are concerned that the virus could develop the ability to transmit easily from person to person and trigger a worldwide pandemic which could kill millions.
Norton said the early detection plan would prioritize sampling in Alaska, where scientists believe the strain of highly pathogenic H5N1 virus currently affecting Southeast Asia would most likely spread to North America by migrating birds.
The government's expanded testing program will focus on Alaska, elsewhere in the Pacific Flyway for migrating birds and the Pacific islands, followed by the Central, Mississippi and Atlantic Flyways.
The Agriculture Department plans to collect between 75,000 and 100,000 samples from live and dead wild birds this year. Another 50,000 samples of water or feces from high-risk waterfowl habitats in the United States will also be taken.
Norton said she expected initial, so-called presumptive
H5N1 results could be announced some 20 to 100 times this year but those first tests would not tell whether the virus was the deadly strain or a weaker form.
Discovery of bird flu in the United States should not be reason to panic, Johanns said, noting that positive test results could turn out to be a harmless version of the virus.
The United States has dealt three times previously -- in 1924, 1983 and 2004 -- with outbreaks in domestic poultry of other forms of bird flu.
Should U.S. domestic poultry become infected with the high-pathogen H5N1, the Agriculture Department would act quickly to quarantine an affected area and destroy the infected flock, he said.
``Our producers have demonstrated that they will call us at the first sign of sick birds, knowing that with high-pathogen strains of bird flu we reimburse them for the birds that we destroy,'' Johanns said. ``This is a $29 billion industry in the U.S. and our producers are as eager as we are to protect the safety of our poultry.''
Poultry properly prepared would be safe to eat because cooking with high heat kills the virus, the officials said.
The U.S. poultry industry says it already has numerous safeguards in place to protect its flocks.
``Poultry in other parts of the world are in many cases allowed to run at large and are not protected from wild waterfowl or other birds that may be carrying viruses such as avian influenza,'' said Sherrill Davison, associate professor of avian medicine and pathology at the University of Pennsylvania School of Veterinary Medicine.
Meanwhile, U.S. regulators on Monday proposed banning the use of two types of human flu-fighting drugs in poultry to preserve their effectiveness for people in case of a bird flu pandemic.
The proposal would prohibit use of neuraminidase inhibitors, Roche Holding Ag's Tamiflu and GlaxoSmithKline Plc's Relenza, and the older drugs, rimantadine and amantadine, in chickens, turkeys and ducks, the Food and Drug Administration said.
While the federal government is stockpiling medicines and making other preparations, it is important for state and local governments, hospitals, businesses and schools to formulate their own plans, Leavitt said.
``Any community that fails to prepare, with the expectation that the federal government will at the last moment be able to come to the rescue, will be tragically wrong. There is no way in which 5,000 different communities can be responded to simultaneously,'' Leavitt said.
Copyright 2006 Reuters Ltd. Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top
Bird Flu Likely in US This Year: Gov't Officials
By REUTERS
Filed at 5:18 p.m. ET
WASHINGTON (Reuters) - Bush administration officials said on Monday it was ``increasingly likely'' that bird flu could be detected in the United States this year, but added it may not mean the start of a human pandemic.
Speaking to reporters, Interior Secretary Gale Norton, Agriculture Secretary Mike Johanns and Secretary of Health and Human Services Michael Leavitt unveiled a plan to increase monitoring of migratory birds that are likely to bring the bird flu virus to U.S. shores.
``It is increasingly likely that we will detect the highly pathogenic H5N1 strain of avian flu in birds within the U.S. borders possibly as early as this year,'' Norton said.
As a result, the government is expanding its early warning system to deal with bird flu's eventual arrival.
``None of us can build a cage around the United States. We have to be prepared to deal with the virus here,'' Johanns said.
The H5N1 avian flu virus has spread across Europe, Africa and parts of Asia and killed at least 98 people worldwide since 2003. So far, it has a mortality rate of about 50 percent.
Although bird flu is hard to catch, people can contract the disease by coming into contact with infected birds, especially from bird droppings.
Scientists are concerned that the virus could develop the ability to transmit easily from person to person and trigger a worldwide pandemic which could kill millions.
Norton said the early detection plan would prioritize sampling in Alaska, where scientists believe the strain of highly pathogenic H5N1 virus currently affecting Southeast Asia would most likely spread to North America by migrating birds.
The government's expanded testing program will focus on Alaska, elsewhere in the Pacific Flyway for migrating birds and the Pacific islands, followed by the Central, Mississippi and Atlantic Flyways.
The Agriculture Department plans to collect between 75,000 and 100,000 samples from live and dead wild birds this year. Another 50,000 samples of water or feces from high-risk waterfowl habitats in the United States will also be taken.
Norton said she expected initial, so-called presumptive
H5N1 results could be announced some 20 to 100 times this year but those first tests would not tell whether the virus was the deadly strain or a weaker form.
Discovery of bird flu in the United States should not be reason to panic, Johanns said, noting that positive test results could turn out to be a harmless version of the virus.
The United States has dealt three times previously -- in 1924, 1983 and 2004 -- with outbreaks in domestic poultry of other forms of bird flu.
Should U.S. domestic poultry become infected with the high-pathogen H5N1, the Agriculture Department would act quickly to quarantine an affected area and destroy the infected flock, he said.
``Our producers have demonstrated that they will call us at the first sign of sick birds, knowing that with high-pathogen strains of bird flu we reimburse them for the birds that we destroy,'' Johanns said. ``This is a $29 billion industry in the U.S. and our producers are as eager as we are to protect the safety of our poultry.''
Poultry properly prepared would be safe to eat because cooking with high heat kills the virus, the officials said.
The U.S. poultry industry says it already has numerous safeguards in place to protect its flocks.
``Poultry in other parts of the world are in many cases allowed to run at large and are not protected from wild waterfowl or other birds that may be carrying viruses such as avian influenza,'' said Sherrill Davison, associate professor of avian medicine and pathology at the University of Pennsylvania School of Veterinary Medicine.
Meanwhile, U.S. regulators on Monday proposed banning the use of two types of human flu-fighting drugs in poultry to preserve their effectiveness for people in case of a bird flu pandemic.
The proposal would prohibit use of neuraminidase inhibitors, Roche Holding Ag's Tamiflu and GlaxoSmithKline Plc's Relenza, and the older drugs, rimantadine and amantadine, in chickens, turkeys and ducks, the Food and Drug Administration said.
While the federal government is stockpiling medicines and making other preparations, it is important for state and local governments, hospitals, businesses and schools to formulate their own plans, Leavitt said.
``Any community that fails to prepare, with the expectation that the federal government will at the last moment be able to come to the rescue, will be tragically wrong. There is no way in which 5,000 different communities can be responded to simultaneously,'' Leavitt said.
Copyright 2006 Reuters Ltd. Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top
March 21, 2006
Experts Reveal the Secret Powers of Grapefruit Juice
By NICHOLAS BAKALAR
In 1989, a group of Canadian researchers studying a blood pressure drug were astonished to discover that drinking a glass of grapefruit juice dangerously increased the drug's potency.
They were testing the effects of drinking alcohol on a medicine called Plendil. The scientists needed something that would hide the taste of alcohol so that subjects would know only that they were taking the drug and not know whether they were drinking alcohol with it.
"One Saturday night, my wife and I tested everything in the refrigerator," said David G. Bailey, a research scientist at the London Health Sciences Center in London, Ontario, and the lead author on the study. "The only thing that covered the taste was grapefruit juice."
So they used it in their experiment, expecting the grapefruit juice to be irrelevant to their results. But blood levels of the drug went up significantly in the control group that drank just grapefruit juice, without alcohol.
"People didn't believe us," Dr. Bailey said. "They thought it was a joke. We had trouble getting it published in a major medical journal."
Eventually the paper was accepted and published by Lancet, in February 1991.
Finding why juice had that effect was the next question.
The answer, it turned out, lay in a family of enzymes called the cytochrome P-450 system, in particular one known as CYP 3A4. This enzyme metabolizes many drugs, and toxins as well, into substances that are less potent or more easily excreted or both.
Grapefruit juice interferes with the ability of CYP 3A4 to do that, increasing the potency of a drug by letting more of it enter the bloodstream, in effect producing an excessive dose.
Grapefruit interacts with this enzyme only in the intestines, not in the liver or other places where it is found. As a result, the effect is seen only with medicines taken orally, not with injected drugs.
Numerous studies now show the interaction of grapefruit juice with many widely used medicines. Most interactions have no serious consequences, but a few do. For example, drugs used to lower cholesterol, like Lipitor, Mevacor and Zocor, have increased potency when taken with grapefruit juice. Excessive levels of those drugs can lead to a serious and sometimes fatal muscle disorder called rhabdomyolysis.
Does this mean a person could reduce the amount of medicine required simply by drinking grapefruit juice? No, according to Dr. Bailey.
"The problem is the unpredictability of the effect," he said. "You can't just lower your dose of Lipitor and increase your consumption of grapefruit juice. There's no uniformity from one individual to another or from one bottle of grapefruit juice to the next.
"There's huge variation in the amount of enzyme people have in their guts. Fooling around with grapefruit juice is not a good idea."
Grapefruit juice can also interfere with the metabolism of selective serotonin reuptake inhibitors, or S.S.R.I.'s, like Prozac, which are used to treat depression.
Dr. Marshall Forstein, an associate professor of psychiatry at Harvard, said he told patients to switch from grapefruit juice to something else because most oranges and other citrus fruits do not have the same effect.
"If they insist," Dr. Forstein said, "I try to prescribe the S.S.R.I. or other medication to be taken at a time when the grapefruit juice would have mostly been metabolized."
Among fruit juices, grapefruit has the strongest effect, but lime juice and orange juice made from Seville oranges similarly inhibit the CYP 3A4 enzyme. With some drugs, apple juice may interact in the same way.
While Dr. Bailey suggests avoiding grapefruit juice entirely when taking medicine, some experts say the effect of the juice should not be exaggerated.
"The circumstances under which an interaction will occur are relatively unusual," said Dr. David J. Greenblatt, a professor of pharmacology at Tufts. First, he said, the drug has to be metabolized significantly by intestinal CYP 3A4, and relatively few are. "When you look at the actual data for each drug, the scientific conclusions are that the interactions are unusual, sometimes quite small and not of clinical importance. But there are some cases in which it's significant."
Dr. Greenblatt and his co-investigators at Tufts have conducted research sponsored by the National Institutes of Health in this field for years, and he has been a paid consultant to the Florida Citrus Commission.
Dr. Richard B. Kim, a professor of medicine and pharmacology at Vanderbilt University, agreed that the interaction was a serious health concern in some patients.
"Grapefruit consumption is a clinically relevant issue, especially for the elderly, who are most likely to be taking the drugs affected by it," Dr. Kim said. "If you're taking multiple medications, or have recently switched to a different type of medication, you should be particularly careful. The easiest thing to do under those circumstances is to take the medicine with water and avoid the juice completely."
Copyright 2006The New York Times Company Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top
Experts Reveal the Secret Powers of Grapefruit Juice
By NICHOLAS BAKALAR
In 1989, a group of Canadian researchers studying a blood pressure drug were astonished to discover that drinking a glass of grapefruit juice dangerously increased the drug's potency.
They were testing the effects of drinking alcohol on a medicine called Plendil. The scientists needed something that would hide the taste of alcohol so that subjects would know only that they were taking the drug and not know whether they were drinking alcohol with it.
"One Saturday night, my wife and I tested everything in the refrigerator," said David G. Bailey, a research scientist at the London Health Sciences Center in London, Ontario, and the lead author on the study. "The only thing that covered the taste was grapefruit juice."
So they used it in their experiment, expecting the grapefruit juice to be irrelevant to their results. But blood levels of the drug went up significantly in the control group that drank just grapefruit juice, without alcohol.
"People didn't believe us," Dr. Bailey said. "They thought it was a joke. We had trouble getting it published in a major medical journal."
Eventually the paper was accepted and published by Lancet, in February 1991.
Finding why juice had that effect was the next question.
The answer, it turned out, lay in a family of enzymes called the cytochrome P-450 system, in particular one known as CYP 3A4. This enzyme metabolizes many drugs, and toxins as well, into substances that are less potent or more easily excreted or both.
Grapefruit juice interferes with the ability of CYP 3A4 to do that, increasing the potency of a drug by letting more of it enter the bloodstream, in effect producing an excessive dose.
Grapefruit interacts with this enzyme only in the intestines, not in the liver or other places where it is found. As a result, the effect is seen only with medicines taken orally, not with injected drugs.
Numerous studies now show the interaction of grapefruit juice with many widely used medicines. Most interactions have no serious consequences, but a few do. For example, drugs used to lower cholesterol, like Lipitor, Mevacor and Zocor, have increased potency when taken with grapefruit juice. Excessive levels of those drugs can lead to a serious and sometimes fatal muscle disorder called rhabdomyolysis.
Does this mean a person could reduce the amount of medicine required simply by drinking grapefruit juice? No, according to Dr. Bailey.
"The problem is the unpredictability of the effect," he said. "You can't just lower your dose of Lipitor and increase your consumption of grapefruit juice. There's no uniformity from one individual to another or from one bottle of grapefruit juice to the next.
"There's huge variation in the amount of enzyme people have in their guts. Fooling around with grapefruit juice is not a good idea."
Grapefruit juice can also interfere with the metabolism of selective serotonin reuptake inhibitors, or S.S.R.I.'s, like Prozac, which are used to treat depression.
Dr. Marshall Forstein, an associate professor of psychiatry at Harvard, said he told patients to switch from grapefruit juice to something else because most oranges and other citrus fruits do not have the same effect.
"If they insist," Dr. Forstein said, "I try to prescribe the S.S.R.I. or other medication to be taken at a time when the grapefruit juice would have mostly been metabolized."
Among fruit juices, grapefruit has the strongest effect, but lime juice and orange juice made from Seville oranges similarly inhibit the CYP 3A4 enzyme. With some drugs, apple juice may interact in the same way.
While Dr. Bailey suggests avoiding grapefruit juice entirely when taking medicine, some experts say the effect of the juice should not be exaggerated.
"The circumstances under which an interaction will occur are relatively unusual," said Dr. David J. Greenblatt, a professor of pharmacology at Tufts. First, he said, the drug has to be metabolized significantly by intestinal CYP 3A4, and relatively few are. "When you look at the actual data for each drug, the scientific conclusions are that the interactions are unusual, sometimes quite small and not of clinical importance. But there are some cases in which it's significant."
Dr. Greenblatt and his co-investigators at Tufts have conducted research sponsored by the National Institutes of Health in this field for years, and he has been a paid consultant to the Florida Citrus Commission.
Dr. Richard B. Kim, a professor of medicine and pharmacology at Vanderbilt University, agreed that the interaction was a serious health concern in some patients.
"Grapefruit consumption is a clinically relevant issue, especially for the elderly, who are most likely to be taking the drugs affected by it," Dr. Kim said. "If you're taking multiple medications, or have recently switched to a different type of medication, you should be particularly careful. The easiest thing to do under those circumstances is to take the medicine with water and avoid the juice completely."
Copyright 2006The New York Times Company Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top
America's Most Polluted Cities Forbes
Pollution
U.S. cities continue to pollute at a great rate. Still, to put this in perspective, they are all better than Chinese cities that hold the title of the world's worst. The Chinese wrested that title from Mexico City--since all ten in China are more polluted than Mexico's capital. China's dilemma is that it is caught between its response to outsourcing needs by Western nations (and their own industrial expansion) and its inability to contain the harmful emissions all this activity generates--from smokestacks to trucks, buses, construction equipment and, now, an increasing number of automobiles. There is no way to disassociate the state of air quality and the efficiency of transportation and its infrastructure. Trucks, buses and most particularly off-road vehicles contribute a large portion of the harmful pollutants. Their diesel emissions are a major source of both ozone and particle pollution. By 2010, in the U.S. these vehicles must by Environmental Protection Agency standards produce 95% less pollution than they do today. Smog reduces visibility and adds significantly to driving hazards and delay. Logistics costs as a measure against GDP are more than three times higher in China than in the U.S. Nor is there any sensible way to disassociate air pollution from health risks and death rates. In the U.S., the EPA has put out a series of timed regulations designed to improve air quality here. According to the EPA, an average person breathes in 3,400 gallons of air per day. Some 25% of Americans, according to the American Lung Association (ALA), are breathing air that is hazardous to their health. The EPA and other monitoring organizations have two major categories of emissions: particle pollution and ozone pollution. Particle pollution (traditionally known as soot in the air) is a mixture of solids and liquid droplets suspended in air. The solids are made up of nitric acid and sulfuric acid accompanied by traces of metals, dirt and organic chemicals. Ground-level ozone (often referred to as smog) is produced when sunlight combines with hydrocarbons and nitrogen oxide. It is most apparent on sunny days near busy highways and in cities, and appears as a dirty yellow haze from a distance. For the EPA, the next big round involving the Clean Air Act is slated for 2007, and it calls for more stringent emissions reduction (basically sulfur emissions). For U.S. truckers, this will require specifically reducing sulfur emissions from the use of new diesel fuel down to 15 parts per million from levels typically as high as 500 parts per million. The ALA sees the need for action and cooperation around the EPA mandate. It cites dreadful life-threatening and life-taking consequences from the levels of pollution in U.S. cities. Heart attacks and asthma attacks lead the list. The ALA states that 152 million U.S. citizens, or 52% of the population, are at risk from ozone and particle pollutants. Children, the elderly and people with asthma, diabetes, chronic bronchitis or emphysema (16.9 million) are severely at risk. Others with heart conditions are also at risk. "The emissions from cars and trucks have been a big problem for the past 40 years," says Janice Nolen, ALA director of national policy. Some communities, according to Nolen, have thought that building more roads to reduce congestion would be a prime way to solve the problem, but in fact that hasn't solved anything. Some experts are now looking at alternatives to how communities themselves are built so that commutes and distances traveled by vehicles are shorter, making roads less congested. Polluting emissions are also generated from vehicles moving or idling on highways and city streets while engines and exhaust systems are operating at less than optimum levels. The ATA makes a point of singling out off-road vehicles as very heavy polluters. Their fuel is among the dirtiest. Diesel locomotives with inadequately designed engines generate pollutants as well. Of course, factories produce pollution along with electrical generation plants (often coal driven), and known carcinogenic emissions are even created by dry cleaners. Nolen notes one positive development: She sees an increase in the use of electrical plugs in facilities at truck rest stops. This maintains refrigeration for the load and air conditioning for the trucker while reducing idling time. The trucking world today is a mix of good business and difficulties that are not always within the control of a particular trucking company. The downside of more stringent regulations includes higher diesel-fuel costs, a lack of trained truckers, a continuing loss of experienced drivers and more complex security processes and costs. The 2007 EPA rules are another large hurdle. Glen Casey, spokesman for American Trucking Association, has a different set of concerns than the ALA does. He sees two sides that have to be considered: first, taking the sulfur out of the diesel fuel and, second, factors governing engine emissions that have required redesign of truck engines, exhaust systems and subsequent costs. "Will there be an adequate supply of the new ultra-low-sulfur diesel fuel across the country in all locations?" he asks. "There may be contamination along the pipeline, and some fuel may not meet the 15 parts per million goal." There does not seem to be any clear idea as to how much this diesel fuel will increase in price. It will be significantly higher than the 1999 EPA prediction of 4 to 5 cents per gallon. The second side is the question of engines designed to meet the EPA standards. New engines are rolling out slowly into the fleets of trucks. The ATA had wanted two years' worth of testing and creation of data from fleets with, and fleets without, the new engines. There has been very limited testing to date of the fleets (around 250 trucks). Economic choices, of course, would best be made from reliable data about truck performance in a wide variety of conditions. The ATA does not feel this has been accomplished. More thorough testing would give an indication as to how many trucks to purchase and when, according to the ATA. Right now, many fleets are pre-buying 2006 trucks to avoid the 2007 EPA mandate. Some see increased time for testing as a delaying game, while others might agree with the ATA and see it as a prudent measure. Regardless of being pro-EPA mandate or not, many cities stand condemned, and they can take no comfort in being better than China. The list indicates that California and Texas have a great deal of work to do.
Ten Most Polluted U.S. Cities (Ozone Rated Only)
1. Los Angeles (Long Beach, Calif., Riverside, Calif.)
2. Bakersfield, Calif.
3. Fresno-Madera, Calif.
4. Visalia-Porterville, Calif.
5. Merced, Calif.
6. Houston (Baytown, Huntsville, Tex.)
7. Sacramento (Arden, Calif., Arcade, Calif., Truckee, Nev.)
8. Dallas/Forth Worth
9. New York (Newark, N.J., Bridgeport, Conn.)
10. Philadelphia (Camden, N.J., Vineland, N.J.)
Source: American Lung Association (for 2005)
Below are the most polluted cities in China (and the world), according to China’s Environmental Protection Administration. Most of these cities are west of Beijing in central China and in the mountainous regions of Shanxi Province. The dominant pollution source is coal burning and less than adequate emissions performance from trucks and other vehicles.
Most Polluted Cities In China (And The World)
1. Linfen, Shanxi Province
2. Yangquan, Shanxi Province
3. Datong, Shanxi Province
4. Shizuishan, Ningxia Hui Autonomous Region
5. Sanmanxia, Henan Province
6. Jincheng, Gansu Province
7. Shijiazhuang, Hebei Province
8. Xianyang, Shanxi Province
9. Zhuzhou, Hunan Province
10. Luoyang, Henan Province
Robert Malone
Pollution
U.S. cities continue to pollute at a great rate. Still, to put this in perspective, they are all better than Chinese cities that hold the title of the world's worst. The Chinese wrested that title from Mexico City--since all ten in China are more polluted than Mexico's capital. China's dilemma is that it is caught between its response to outsourcing needs by Western nations (and their own industrial expansion) and its inability to contain the harmful emissions all this activity generates--from smokestacks to trucks, buses, construction equipment and, now, an increasing number of automobiles. There is no way to disassociate the state of air quality and the efficiency of transportation and its infrastructure. Trucks, buses and most particularly off-road vehicles contribute a large portion of the harmful pollutants. Their diesel emissions are a major source of both ozone and particle pollution. By 2010, in the U.S. these vehicles must by Environmental Protection Agency standards produce 95% less pollution than they do today. Smog reduces visibility and adds significantly to driving hazards and delay. Logistics costs as a measure against GDP are more than three times higher in China than in the U.S. Nor is there any sensible way to disassociate air pollution from health risks and death rates. In the U.S., the EPA has put out a series of timed regulations designed to improve air quality here. According to the EPA, an average person breathes in 3,400 gallons of air per day. Some 25% of Americans, according to the American Lung Association (ALA), are breathing air that is hazardous to their health. The EPA and other monitoring organizations have two major categories of emissions: particle pollution and ozone pollution. Particle pollution (traditionally known as soot in the air) is a mixture of solids and liquid droplets suspended in air. The solids are made up of nitric acid and sulfuric acid accompanied by traces of metals, dirt and organic chemicals. Ground-level ozone (often referred to as smog) is produced when sunlight combines with hydrocarbons and nitrogen oxide. It is most apparent on sunny days near busy highways and in cities, and appears as a dirty yellow haze from a distance. For the EPA, the next big round involving the Clean Air Act is slated for 2007, and it calls for more stringent emissions reduction (basically sulfur emissions). For U.S. truckers, this will require specifically reducing sulfur emissions from the use of new diesel fuel down to 15 parts per million from levels typically as high as 500 parts per million. The ALA sees the need for action and cooperation around the EPA mandate. It cites dreadful life-threatening and life-taking consequences from the levels of pollution in U.S. cities. Heart attacks and asthma attacks lead the list. The ALA states that 152 million U.S. citizens, or 52% of the population, are at risk from ozone and particle pollutants. Children, the elderly and people with asthma, diabetes, chronic bronchitis or emphysema (16.9 million) are severely at risk. Others with heart conditions are also at risk. "The emissions from cars and trucks have been a big problem for the past 40 years," says Janice Nolen, ALA director of national policy. Some communities, according to Nolen, have thought that building more roads to reduce congestion would be a prime way to solve the problem, but in fact that hasn't solved anything. Some experts are now looking at alternatives to how communities themselves are built so that commutes and distances traveled by vehicles are shorter, making roads less congested. Polluting emissions are also generated from vehicles moving or idling on highways and city streets while engines and exhaust systems are operating at less than optimum levels. The ATA makes a point of singling out off-road vehicles as very heavy polluters. Their fuel is among the dirtiest. Diesel locomotives with inadequately designed engines generate pollutants as well. Of course, factories produce pollution along with electrical generation plants (often coal driven), and known carcinogenic emissions are even created by dry cleaners. Nolen notes one positive development: She sees an increase in the use of electrical plugs in facilities at truck rest stops. This maintains refrigeration for the load and air conditioning for the trucker while reducing idling time. The trucking world today is a mix of good business and difficulties that are not always within the control of a particular trucking company. The downside of more stringent regulations includes higher diesel-fuel costs, a lack of trained truckers, a continuing loss of experienced drivers and more complex security processes and costs. The 2007 EPA rules are another large hurdle. Glen Casey, spokesman for American Trucking Association, has a different set of concerns than the ALA does. He sees two sides that have to be considered: first, taking the sulfur out of the diesel fuel and, second, factors governing engine emissions that have required redesign of truck engines, exhaust systems and subsequent costs. "Will there be an adequate supply of the new ultra-low-sulfur diesel fuel across the country in all locations?" he asks. "There may be contamination along the pipeline, and some fuel may not meet the 15 parts per million goal." There does not seem to be any clear idea as to how much this diesel fuel will increase in price. It will be significantly higher than the 1999 EPA prediction of 4 to 5 cents per gallon. The second side is the question of engines designed to meet the EPA standards. New engines are rolling out slowly into the fleets of trucks. The ATA had wanted two years' worth of testing and creation of data from fleets with, and fleets without, the new engines. There has been very limited testing to date of the fleets (around 250 trucks). Economic choices, of course, would best be made from reliable data about truck performance in a wide variety of conditions. The ATA does not feel this has been accomplished. More thorough testing would give an indication as to how many trucks to purchase and when, according to the ATA. Right now, many fleets are pre-buying 2006 trucks to avoid the 2007 EPA mandate. Some see increased time for testing as a delaying game, while others might agree with the ATA and see it as a prudent measure. Regardless of being pro-EPA mandate or not, many cities stand condemned, and they can take no comfort in being better than China. The list indicates that California and Texas have a great deal of work to do.
Ten Most Polluted U.S. Cities (Ozone Rated Only)
1. Los Angeles (Long Beach, Calif., Riverside, Calif.)
2. Bakersfield, Calif.
3. Fresno-Madera, Calif.
4. Visalia-Porterville, Calif.
5. Merced, Calif.
6. Houston (Baytown, Huntsville, Tex.)
7. Sacramento (Arden, Calif., Arcade, Calif., Truckee, Nev.)
8. Dallas/Forth Worth
9. New York (Newark, N.J., Bridgeport, Conn.)
10. Philadelphia (Camden, N.J., Vineland, N.J.)
Source: American Lung Association (for 2005)
Below are the most polluted cities in China (and the world), according to China’s Environmental Protection Administration. Most of these cities are west of Beijing in central China and in the mountainous regions of Shanxi Province. The dominant pollution source is coal burning and less than adequate emissions performance from trucks and other vehicles.
Most Polluted Cities In China (And The World)
1. Linfen, Shanxi Province
2. Yangquan, Shanxi Province
3. Datong, Shanxi Province
4. Shizuishan, Ningxia Hui Autonomous Region
5. Sanmanxia, Henan Province
6. Jincheng, Gansu Province
7. Shijiazhuang, Hebei Province
8. Xianyang, Shanxi Province
9. Zhuzhou, Hunan Province
10. Luoyang, Henan Province
Robert Malone
Daytime TV tied to poorer mental scores in elderly Yahoo! NEWS
Older women who say talk shows and soap operas are their favorite TV programs tend to score more poorly on tests of memory, attention and other cognitive skills, researchers reported Monday. That doesn't mean that daytime television is a brain drain, they say, since it's not clear that there's a direct relationship between the two. But the findings do point to some association between TV choices and intellectual function, and that could prove useful in evaluating older people for cognitive decline, according lead investigator Dr. Joshua Fogel of Brooklyn College of the City University of New York. A study of 289 older women without dementia found that those who rated talk shows and soaps as their favorite programs performed more poorly on tests of memory, attention and mental quickness than their peers who cited other types of shows. What's more, they were at greater risk of showing signs of clinical impairment. For example, compared with women who preferred to watch news programs, those who favored soaps were more than seven times more likely to show signs of impairment on one of the tests, while talk show fans were more than 13 times more likely to demonstrate impairment. "Those findings are quite robust," Fogel told Reuters Health He said it's not possible to tell whether the programs somehow contribute to cognitive decline or whether women in the early stages of decline gravitate toward those shows. Preferences for daytime TV could also be a marker of a sedentary, homebound lifestyle, and research suggests that staying physically and socially active can help stave off mental decline. But regardless of the reasons, a preference for talk shows and soaps "is a marker of something suspicious," Fogel said. He believes that doctors could ask older patients about their favorite TV shows as one way of spotting those who might need more screening for cognitive decline. "It's really a simple, friendly question to ask," Fogel said. The findings, which are published in the Southern Medical Journal, are based on questionnaires and standard cognitive tests completed by 289 women ages 70 to 79. None had dementia or physical disabilities and the researchers factored in variables such as education, race, depression and history of heart attack, high blood pressure or diabetes. Even with those factors considered, TV habits were related to cognitive performance. According to Fogel, a potential explanation rests in the fact that talk shows and soap operas involve so-called "parasocial relationships," where viewers feel a connection to a show's characters or host. Such shows may, for instance, be better able to hold the attention of older women with some cognitive impairment. "This doesn't mean 'Oprah' is bad for you," Fogel said. However, an older woman's fondness for the show could signal a possible problem, according to the researcher. Asking patients about TV viewing and other daily activities could be "very useful" in assessing their cognitive health, according to Dr. Joe Verghese of Albert Einstein College of Medicine in New York. But it's not time to toss the remote control, he writes in an accompanying editorial. Some programs, Verghese notes, might actually benefit intellectual functioning, and TV watching can help some people manage their stress levels.
By Amy Norton
Older women who say talk shows and soap operas are their favorite TV programs tend to score more poorly on tests of memory, attention and other cognitive skills, researchers reported Monday. That doesn't mean that daytime television is a brain drain, they say, since it's not clear that there's a direct relationship between the two. But the findings do point to some association between TV choices and intellectual function, and that could prove useful in evaluating older people for cognitive decline, according lead investigator Dr. Joshua Fogel of Brooklyn College of the City University of New York. A study of 289 older women without dementia found that those who rated talk shows and soaps as their favorite programs performed more poorly on tests of memory, attention and mental quickness than their peers who cited other types of shows. What's more, they were at greater risk of showing signs of clinical impairment. For example, compared with women who preferred to watch news programs, those who favored soaps were more than seven times more likely to show signs of impairment on one of the tests, while talk show fans were more than 13 times more likely to demonstrate impairment. "Those findings are quite robust," Fogel told Reuters Health He said it's not possible to tell whether the programs somehow contribute to cognitive decline or whether women in the early stages of decline gravitate toward those shows. Preferences for daytime TV could also be a marker of a sedentary, homebound lifestyle, and research suggests that staying physically and socially active can help stave off mental decline. But regardless of the reasons, a preference for talk shows and soaps "is a marker of something suspicious," Fogel said. He believes that doctors could ask older patients about their favorite TV shows as one way of spotting those who might need more screening for cognitive decline. "It's really a simple, friendly question to ask," Fogel said. The findings, which are published in the Southern Medical Journal, are based on questionnaires and standard cognitive tests completed by 289 women ages 70 to 79. None had dementia or physical disabilities and the researchers factored in variables such as education, race, depression and history of heart attack, high blood pressure or diabetes. Even with those factors considered, TV habits were related to cognitive performance. According to Fogel, a potential explanation rests in the fact that talk shows and soap operas involve so-called "parasocial relationships," where viewers feel a connection to a show's characters or host. Such shows may, for instance, be better able to hold the attention of older women with some cognitive impairment. "This doesn't mean 'Oprah' is bad for you," Fogel said. However, an older woman's fondness for the show could signal a possible problem, according to the researcher. Asking patients about TV viewing and other daily activities could be "very useful" in assessing their cognitive health, according to Dr. Joe Verghese of Albert Einstein College of Medicine in New York. But it's not time to toss the remote control, he writes in an accompanying editorial. Some programs, Verghese notes, might actually benefit intellectual functioning, and TV watching can help some people manage their stress levels.
By Amy Norton
Ebola Test Urgent Amid Globalism
http://www.terradaily.com/reports/Ebola_Te..._Globalism.html
Washington (UPI) Mar 21, 2006 - A rapid, inexpensive blood test that can identify 10 viral hemorrhagic diseases, including the Ebola virus and yellow fever, has been developed by researchers at the Mailman School of Public Health at Columbia University.
http://www.terradaily.com/reports/Ebola_Te..._Globalism.html
Washington (UPI) Mar 21, 2006 - A rapid, inexpensive blood test that can identify 10 viral hemorrhagic diseases, including the Ebola virus and yellow fever, has been developed by researchers at the Mailman School of Public Health at Columbia University.
March 22, 2006
Flaw Seen in Genetic Test for Breast Cancer Risk
By ANDY POLLACK
The widely used genetic test for breast cancer risk can miss mutations that help cause the disease, according to a new study, a finding that is likely to increase the pressure to develop more thorough testing methods.
The test, which looks for mutations in genes called BRCA1 and BRCA2, missed them in about 12 percent of breast cancer patients from families with multiple cases of breast or ovarian cancer, according to the study's authors at the University of Washington.
Experts cautioned that the chances of such false negative results were much smaller for women who were not from such high-risk families, so that most women who tested negative had little cause for concern.
In addition, experts said that even Ashkenazi Jews, who have a relatively high incidence of mutations, tend to have specific types that are not likely to be missed by the test. In addition, if a woman is tested for the same specific mutation her mother has, the test is not likely to miss it if it is there.
Still, experts said women in families with multiple cases of breast and ovarian cancer should take precautions as if they had a mutation, even if none was found.
"Everyone who has a strong family history and is negative should be considering how negative that result really was," said Dr. Judy E. Garber, director of the cancer risk and prevention program at the Dana-Farber Cancer Institute in Boston.
The new study, being published in The Journal of the American Medical Association, is likely to increase the pressure on Myriad Genetics, which offers the test.
The company, based in Salt Lake City, has long been the focus of controversy because its patents give it a monopoly on the test, for which it charges as much as $3,000. Some geneticists say the monopoly has slowed development of better testing.
"A fuller testing process would include more than one technology, and competition would enable that to develop," Mary-Claire King, a professor of medicine and genome sciences at the University of Washington and senior author of the paper, said in an interview.
Professor King said a technique that could detect many of the missed mutations was already available in Europe but not in the United States, except in research projects.
Dr. Gregory C. Critchfield, president of the genetic testing division of Myriad Genetics, denied that the company's monopoly had impeded progress. The company hoped to have a more thorough test available by the end of the year, Dr. Critchfield said.
Five percent to 10 percent of breast cancers in white women in the United States stem from inherited mutations in the BRCA genes. Tens of thousands of women a year get the test, Myriad Genetics said.
Women with a mutation have a much higher risk of getting breast or ovarian cancer than the general population. Such women usually undergo more frequent screening to try to catch the cancer early, when it is more treatable. Some women opt to have their ovaries or breasts removed to prevent the disease.
Experts have long known that Myriad Genetics's test misses certain types of mutations it is not designed to detect. But the new study is believed to be the most extensive effort to quantify how often that occurs.
"We've known parts of the story but she's pulled it together very well," Dr. Lynn Hartmann, a professor of oncology at the Mayo Clinic, said of Dr. King.
Dr. King and her co-authors studied 300 women who had negative test results and who came from families with four or more cases of breast or ovarian cancer. The authors used various testing techniques beyond the one used by Myriad Genetics and found mutations in 35 of the women. None of the 30 Jewish women in Dr. King's study were found to have mutations undetected by Myriad Genetics.
Dr. Critchfield of Myriad Genetics said only 6 percent of the women who got the test came from such high-risk families. If the test is wrong for 12 percent of them, he said, then the rate of false negatives for all women tested is less than 1 percent.
The Myriad Genetics test looks for mistakes in the sequence of genetic letters in parts of the gene that contain the recipe for proteins. But it can miss errors in other parts of the gene, or deletions and duplications of chunks of DNA.
Copyright 2006The New York Times Company Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top
Flaw Seen in Genetic Test for Breast Cancer Risk
By ANDY POLLACK
The widely used genetic test for breast cancer risk can miss mutations that help cause the disease, according to a new study, a finding that is likely to increase the pressure to develop more thorough testing methods.
The test, which looks for mutations in genes called BRCA1 and BRCA2, missed them in about 12 percent of breast cancer patients from families with multiple cases of breast or ovarian cancer, according to the study's authors at the University of Washington.
Experts cautioned that the chances of such false negative results were much smaller for women who were not from such high-risk families, so that most women who tested negative had little cause for concern.
In addition, experts said that even Ashkenazi Jews, who have a relatively high incidence of mutations, tend to have specific types that are not likely to be missed by the test. In addition, if a woman is tested for the same specific mutation her mother has, the test is not likely to miss it if it is there.
Still, experts said women in families with multiple cases of breast and ovarian cancer should take precautions as if they had a mutation, even if none was found.
"Everyone who has a strong family history and is negative should be considering how negative that result really was," said Dr. Judy E. Garber, director of the cancer risk and prevention program at the Dana-Farber Cancer Institute in Boston.
The new study, being published in The Journal of the American Medical Association, is likely to increase the pressure on Myriad Genetics, which offers the test.
The company, based in Salt Lake City, has long been the focus of controversy because its patents give it a monopoly on the test, for which it charges as much as $3,000. Some geneticists say the monopoly has slowed development of better testing.
"A fuller testing process would include more than one technology, and competition would enable that to develop," Mary-Claire King, a professor of medicine and genome sciences at the University of Washington and senior author of the paper, said in an interview.
Professor King said a technique that could detect many of the missed mutations was already available in Europe but not in the United States, except in research projects.
Dr. Gregory C. Critchfield, president of the genetic testing division of Myriad Genetics, denied that the company's monopoly had impeded progress. The company hoped to have a more thorough test available by the end of the year, Dr. Critchfield said.
Five percent to 10 percent of breast cancers in white women in the United States stem from inherited mutations in the BRCA genes. Tens of thousands of women a year get the test, Myriad Genetics said.
Women with a mutation have a much higher risk of getting breast or ovarian cancer than the general population. Such women usually undergo more frequent screening to try to catch the cancer early, when it is more treatable. Some women opt to have their ovaries or breasts removed to prevent the disease.
Experts have long known that Myriad Genetics's test misses certain types of mutations it is not designed to detect. But the new study is believed to be the most extensive effort to quantify how often that occurs.
"We've known parts of the story but she's pulled it together very well," Dr. Lynn Hartmann, a professor of oncology at the Mayo Clinic, said of Dr. King.
Dr. King and her co-authors studied 300 women who had negative test results and who came from families with four or more cases of breast or ovarian cancer. The authors used various testing techniques beyond the one used by Myriad Genetics and found mutations in 35 of the women. None of the 30 Jewish women in Dr. King's study were found to have mutations undetected by Myriad Genetics.
Dr. Critchfield of Myriad Genetics said only 6 percent of the women who got the test came from such high-risk families. If the test is wrong for 12 percent of them, he said, then the rate of false negatives for all women tested is less than 1 percent.
The Myriad Genetics test looks for mistakes in the sequence of genetic letters in parts of the gene that contain the recipe for proteins. But it can miss errors in other parts of the gene, or deletions and duplications of chunks of DNA.
Copyright 2006The New York Times Company Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top
March 22, 2006
Researchers Find New Details on Transmission of Avian Flu
By NICHOLAS WADE
Two groups of researchers, in Japan and in Holland, have discovered why the avian flu virus is transmitted rarely if ever from one person to another.
The reason is simply that the cells bearing the type of receptor the avian virus is known to favor turn out to be clustered in the deepest branches of the human respiratory tract. The viruses thus cannot be spread by coughs and sneezes, as are human flu viruses which infect cells in the upper respiratory tract.
The avian flu virus would need to accumulate many favorable mutations in its genetic material before it could become a pandemic strain, said Yoshihiro Kawaoka, a virologist at the both the University of Tokyo and the University of Wisconsin. According to a press statement he approved, "The finding suggests that scientists and public health agencies worldwide may have more time to prepare for an eventual pandemic."
Dr. Kawaoka's finding is published in today's issue of Nature and a similar finding, by Thijs Kuiken and colleagues of the Erasmus Medical Center in Rotterdam, appears in this week's Science.
Flu experts already knew that those attacked by the current avian flu virus, a type known as H5, were infected in the lower lung.
Paul Offit, a virologist at the Children's Hospital of Philadelphia, said the new reports made a lot of sense in explaining why the H5N1 virus, though it can infect people, does not easily spread from one person to another, making its outbreaks very limited.
Virologists agree that another flu pandemic will happen sooner or later as one of the 16 types of flu virus in the animal world, probably one that infects birds, will manage to switch hosts and grow and spread in humans. But they differ as to whether H5 is the likeliest candidate to make this switch. Previous known pandemics have been caused by H1 type viruses (the 1918 pandemic), H2 (the 1957 Asian) or H3 (the Hong Kong flu of 1968).
The H5 strain of avian flu has been infecting people since the late 1950's but has so far failed to develop a form that is easily transmissible from one person to another. Some virologists believe it could easily do so because it may only need better transmissibility to set off a pandemic. That could be obtained simply by switching its preference from the cell receptor found in the lower lung, known as alpha 2-3, to the receptor found on cells in the upper airways, known as alpha 2-6.
A team of scientists at the Scripps Research Institute reported in Science last week that only a couple of mutations might be needed to enable the H5 virus to make this switch to the alpha 2-6 receptor. This is about the same number of mutations as made by the H1, H2 and H3 viruses when they learned to infect people. Since viruses mutate quickly, a two-mutation step is not so big a hurdle.
Because the H5 virus has killed about half of the 187 people it has so far infected, "a lot of its genes are already optimized for virulence," said James C. Paulson, a member of the Scripps team. For H5 to become pandemic, "The key gene that needs to be mutated is the HA gene," he said, referring to the hemagglutinin gene, which makes the probe used by the virus to latch on to a cell's receptor sites.
But though H5 might seem only a couple of easy steps away from transmissibility among people, many virologists believe mutations in several other genes would be necessary as well. Viruses find it very hard to switch hosts, and though they may quite often cause outbreaks in just a few individuals, "viruses that produce a self-sustaining chain of transmission in the new host appear rare," Dr. Kawaoka wrote recently in the Annual Review of Microbiology,
The H5 virus has been present in the human population since the late 1950's, but has never acquired the full set of mutations needed to set off a pandemic. The epidemiological evidence "should make us feel safe that there's a substantial barrier," Dr. Offit said.
Dr. Offit said it was a good thing to worry about the next pandemic, given that about three can be expected every century. "What's not good is to try to sell the public on their fear of pandemic flu being this particular bird flu, since if it's not, crying wolf will lose you credibility," he said.
Peter Palese, a virologist at the Mount Sinai School of Medicine, said he did not believe the H5 virus could infect people, except when they were exposed to very large doses, such as by sleeping with chickens in the same room. "I feel strongly that H5 has been around in humans for a long time and never caused a pandemic, suggesting that this is not the virus which is likely to be the next pandemic."
But like Dr. Offit, Dr. Palese said he fully supported plans to get better prepared for the next flu pandemic. "People have to understand we are not really prepared should it come," he said.
Copyright 2006The New York Times Company Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top
Researchers Find New Details on Transmission of Avian Flu
By NICHOLAS WADE
Two groups of researchers, in Japan and in Holland, have discovered why the avian flu virus is transmitted rarely if ever from one person to another.
The reason is simply that the cells bearing the type of receptor the avian virus is known to favor turn out to be clustered in the deepest branches of the human respiratory tract. The viruses thus cannot be spread by coughs and sneezes, as are human flu viruses which infect cells in the upper respiratory tract.
The avian flu virus would need to accumulate many favorable mutations in its genetic material before it could become a pandemic strain, said Yoshihiro Kawaoka, a virologist at the both the University of Tokyo and the University of Wisconsin. According to a press statement he approved, "The finding suggests that scientists and public health agencies worldwide may have more time to prepare for an eventual pandemic."
Dr. Kawaoka's finding is published in today's issue of Nature and a similar finding, by Thijs Kuiken and colleagues of the Erasmus Medical Center in Rotterdam, appears in this week's Science.
Flu experts already knew that those attacked by the current avian flu virus, a type known as H5, were infected in the lower lung.
Paul Offit, a virologist at the Children's Hospital of Philadelphia, said the new reports made a lot of sense in explaining why the H5N1 virus, though it can infect people, does not easily spread from one person to another, making its outbreaks very limited.
Virologists agree that another flu pandemic will happen sooner or later as one of the 16 types of flu virus in the animal world, probably one that infects birds, will manage to switch hosts and grow and spread in humans. But they differ as to whether H5 is the likeliest candidate to make this switch. Previous known pandemics have been caused by H1 type viruses (the 1918 pandemic), H2 (the 1957 Asian) or H3 (the Hong Kong flu of 1968).
The H5 strain of avian flu has been infecting people since the late 1950's but has so far failed to develop a form that is easily transmissible from one person to another. Some virologists believe it could easily do so because it may only need better transmissibility to set off a pandemic. That could be obtained simply by switching its preference from the cell receptor found in the lower lung, known as alpha 2-3, to the receptor found on cells in the upper airways, known as alpha 2-6.
A team of scientists at the Scripps Research Institute reported in Science last week that only a couple of mutations might be needed to enable the H5 virus to make this switch to the alpha 2-6 receptor. This is about the same number of mutations as made by the H1, H2 and H3 viruses when they learned to infect people. Since viruses mutate quickly, a two-mutation step is not so big a hurdle.
Because the H5 virus has killed about half of the 187 people it has so far infected, "a lot of its genes are already optimized for virulence," said James C. Paulson, a member of the Scripps team. For H5 to become pandemic, "The key gene that needs to be mutated is the HA gene," he said, referring to the hemagglutinin gene, which makes the probe used by the virus to latch on to a cell's receptor sites.
But though H5 might seem only a couple of easy steps away from transmissibility among people, many virologists believe mutations in several other genes would be necessary as well. Viruses find it very hard to switch hosts, and though they may quite often cause outbreaks in just a few individuals, "viruses that produce a self-sustaining chain of transmission in the new host appear rare," Dr. Kawaoka wrote recently in the Annual Review of Microbiology,
The H5 virus has been present in the human population since the late 1950's, but has never acquired the full set of mutations needed to set off a pandemic. The epidemiological evidence "should make us feel safe that there's a substantial barrier," Dr. Offit said.
Dr. Offit said it was a good thing to worry about the next pandemic, given that about three can be expected every century. "What's not good is to try to sell the public on their fear of pandemic flu being this particular bird flu, since if it's not, crying wolf will lose you credibility," he said.
Peter Palese, a virologist at the Mount Sinai School of Medicine, said he did not believe the H5 virus could infect people, except when they were exposed to very large doses, such as by sleeping with chickens in the same room. "I feel strongly that H5 has been around in humans for a long time and never caused a pandemic, suggesting that this is not the virus which is likely to be the next pandemic."
But like Dr. Offit, Dr. Palese said he fully supported plans to get better prepared for the next flu pandemic. "People have to understand we are not really prepared should it come," he said.
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March 23, 2006
Younger Breast Cancer Patients More at Risk: Study
By REUTERS
Filed at 8:46 a.m. ET
LONDON (Reuters) - Young women under 45 years old diagnosed with early breast cancer have a higher risk of dying from the disease than older patients, scientists said on Thursday.
``The younger the woman, the poorer the chance of survival,'' said Dr Vincent Vinh-Hung, of University Hospital in Brussels.
Breast is the most common cancer in women, with more than a million new cases detected worldwide each year. Most are in women over 50 -- the disease is rare in young women.
But Vinh-Hung told Reuters that although only a small fraction of early breast cancers occur in young women, they account for a disproportionate percentage of deaths.
In a study of 45,000 breast cancer patients presented at the 5th European Breast Cancer Conference in Nice, France, Vinh-Hung and his colleagues found that the odds of dying from breast cancer rose by 5 percent for every year that a woman was under 45 when diagnosed.
They focused on women with early breast cancer which had not spread beyond the breast and whose tumors were less than 2 cm (0.8 inches) in size.
Doctors had previously suspected that the poorer prognosis in young women was due to being diagnosed later with a more advanced cancer. Breast tissue in younger women is usually denser which can make detecting a tumor more difficult.
Younger women may also ignore a suspicious lump in their breast thinking it is harmless or that they are too young to have breast cancer.
But Vinh-Hung said the findings suggest that in young women, age, more than other factors, affects the chance of survival.
He and his team suspect there may some type of unknown genetic damage that may increase the chances of developing the disease early and contribute to the poor prognosis in younger patients.
A family history of breast cancer, early puberty, late menopause, not having children or having them late and genetic mutations are risk factors for breast cancer.
Copyright 2006 Reuters Ltd. Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top
Younger Breast Cancer Patients More at Risk: Study
By REUTERS
Filed at 8:46 a.m. ET
LONDON (Reuters) - Young women under 45 years old diagnosed with early breast cancer have a higher risk of dying from the disease than older patients, scientists said on Thursday.
``The younger the woman, the poorer the chance of survival,'' said Dr Vincent Vinh-Hung, of University Hospital in Brussels.
Breast is the most common cancer in women, with more than a million new cases detected worldwide each year. Most are in women over 50 -- the disease is rare in young women.
But Vinh-Hung told Reuters that although only a small fraction of early breast cancers occur in young women, they account for a disproportionate percentage of deaths.
In a study of 45,000 breast cancer patients presented at the 5th European Breast Cancer Conference in Nice, France, Vinh-Hung and his colleagues found that the odds of dying from breast cancer rose by 5 percent for every year that a woman was under 45 when diagnosed.
They focused on women with early breast cancer which had not spread beyond the breast and whose tumors were less than 2 cm (0.8 inches) in size.
Doctors had previously suspected that the poorer prognosis in young women was due to being diagnosed later with a more advanced cancer. Breast tissue in younger women is usually denser which can make detecting a tumor more difficult.
Younger women may also ignore a suspicious lump in their breast thinking it is harmless or that they are too young to have breast cancer.
But Vinh-Hung said the findings suggest that in young women, age, more than other factors, affects the chance of survival.
He and his team suspect there may some type of unknown genetic damage that may increase the chances of developing the disease early and contribute to the poor prognosis in younger patients.
A family history of breast cancer, early puberty, late menopause, not having children or having them late and genetic mutations are risk factors for breast cancer.
Copyright 2006 Reuters Ltd. Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top
CDC Reports Increase in Resistant TB
By MIKE STOBBE, Associated Press Writer
2 hours, 3 minutes ago
Health officials said Thursday they are seeing what appears to be a disturbing increase around the world in tuberculosis infections resistant to both the first- and second-line antibiotics used against TB.
"It's basically a death sentence. If people are failing first- and second-line drugs and we don't have in the pipeline a new drug for immediate use, that's a crisis," said Dr. Marcos Espinale, executive secretary of the World Health Organization's Stop TB Partnership.
The CDC and WHO surveyed a network of 25 tuberculosis laboratories on six continents from 2000 to 2004 and found that one in 50 TB cases around the world is resistant not only to the usual first-choice TB treatments, but also to many medications that represent the second line of defense.
The survey represents the first international data on what is being called "extensively drug-resistant" TB.
For more than a decade, health officials have worried about "multidrug-resistant" TB, which can withstand the mainline antibiotics isoniazid and rifampin. One in five TB cases falls into that category, according to the survey.
But the survey also found many cases of a more difficult form of TB — one that does not respond to at least three of six classes of second-line drugs. That is especially worrisome, because second-line drugs are generally considered more toxic and less effective.
"These are individuals who are virtually untreatable with available drugs," said Dr. Kenneth Castro of the CDC.
The survey looked at 17,690 TB cases that were analyzed for drug susceptibility. Of those, 20 percent were multidrug-resistant and 2 percent were extensively drug-resistant.
The problem was worst in Latvia, where public health care deteriorated after the Soviet Union collapsed. Doctors believe TB develops resistance to drugs because some patients fail to complete a full course of medication.
In the United States, health officials looked at 169,654 TB cases from 1993 to 2004 that were analyzed for their drug response and found that 1.6 percent were multidrug-resistant and 0.04 percent extensively drug-resistant.
U.S. multidrug-resistant cases rose from 2003 to 2004, from 113 to 128. Though the number was small, it represented the largest single-year increase in more than 10 years. Ninety-seven of those 128 cases were in people born in other countries, mostly Mexico, the Philippines and Vietnam.
Overall, the TB rate in the United States has never been lower. In 2005, about 14,100 cases were reported, or 4.8 cases per 100,000 people. That is a 4 percent decline in the rate from 2004. However, the TB rate in foreign-born people in the United States was 8.7 times that of U.S. natives.
"Worsening resistance around the world poses a problem in the U.S.," Castro said.
Dr. Henry Blumberg, an Emory University medical school professor, said the figures are preliminary and the problem may be bigger than the numbers indicate.
Some drugs under development might become effective treatments for these difficult forms of TB. But CDC funding for TB control and research has not kept up with inflation in the past decade, Blumberg said.
Copyright © 2006 The Associated Press. All rights reserved. The information contained in the AP News report may not be published, broadcast, rewritten or redistributed without the prior written authority of The Associated Press.
Copyright © 2006 Yahoo! Inc. All rights reserved.
Questions or Comments
Privacy Policy -Terms of Service - Copyright/IP Policy - Ad Feedback
By MIKE STOBBE, Associated Press Writer
2 hours, 3 minutes ago
Health officials said Thursday they are seeing what appears to be a disturbing increase around the world in tuberculosis infections resistant to both the first- and second-line antibiotics used against TB.
"It's basically a death sentence. If people are failing first- and second-line drugs and we don't have in the pipeline a new drug for immediate use, that's a crisis," said Dr. Marcos Espinale, executive secretary of the World Health Organization's Stop TB Partnership.
The CDC and WHO surveyed a network of 25 tuberculosis laboratories on six continents from 2000 to 2004 and found that one in 50 TB cases around the world is resistant not only to the usual first-choice TB treatments, but also to many medications that represent the second line of defense.
The survey represents the first international data on what is being called "extensively drug-resistant" TB.
For more than a decade, health officials have worried about "multidrug-resistant" TB, which can withstand the mainline antibiotics isoniazid and rifampin. One in five TB cases falls into that category, according to the survey.
But the survey also found many cases of a more difficult form of TB — one that does not respond to at least three of six classes of second-line drugs. That is especially worrisome, because second-line drugs are generally considered more toxic and less effective.
"These are individuals who are virtually untreatable with available drugs," said Dr. Kenneth Castro of the CDC.
The survey looked at 17,690 TB cases that were analyzed for drug susceptibility. Of those, 20 percent were multidrug-resistant and 2 percent were extensively drug-resistant.
The problem was worst in Latvia, where public health care deteriorated after the Soviet Union collapsed. Doctors believe TB develops resistance to drugs because some patients fail to complete a full course of medication.
In the United States, health officials looked at 169,654 TB cases from 1993 to 2004 that were analyzed for their drug response and found that 1.6 percent were multidrug-resistant and 0.04 percent extensively drug-resistant.
U.S. multidrug-resistant cases rose from 2003 to 2004, from 113 to 128. Though the number was small, it represented the largest single-year increase in more than 10 years. Ninety-seven of those 128 cases were in people born in other countries, mostly Mexico, the Philippines and Vietnam.
Overall, the TB rate in the United States has never been lower. In 2005, about 14,100 cases were reported, or 4.8 cases per 100,000 people. That is a 4 percent decline in the rate from 2004. However, the TB rate in foreign-born people in the United States was 8.7 times that of U.S. natives.
"Worsening resistance around the world poses a problem in the U.S.," Castro said.
Dr. Henry Blumberg, an Emory University medical school professor, said the figures are preliminary and the problem may be bigger than the numbers indicate.
Some drugs under development might become effective treatments for these difficult forms of TB. But CDC funding for TB control and research has not kept up with inflation in the past decade, Blumberg said.
Copyright © 2006 The Associated Press. All rights reserved. The information contained in the AP News report may not be published, broadcast, rewritten or redistributed without the prior written authority of The Associated Press.
Copyright © 2006 Yahoo! Inc. All rights reserved.
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What Makes a Lefty: Myths and Mysteries Persist Yahoo! NEWS
Can openers, scissors and spiral-bound notebooks discriminate against lefties. Despite such challenges, 10 to 12 percent of the human population has historically preferred the left hand. Why doesn't the number ever waiver? Nobody knows for sure, but new research supports a body of evidence that suggests genetics have a hand in it all. In the meantime, the myth remains that lefties are more artistic. And the idea that left-handed fighters have an advantage persists on scant evidence, supported by Scottish lore and Rocky Balboa's heroics in the ring.
Look, Mom: Both hands!
Like many traits, handedness is probably determined by a complex interaction between genes and the environment, experts figure. Left-handers are more likely to have a left-handed relative. But researchers have yet to find the gene or set of genes that pick one hand over the other. Most scientists agree that handedness exists on a continuum. The idea helps explain why some people bowl with their left but hold a spoon in their right. Truly ambidextrous people, who have indifferent preference for either hand, are extremely rare. In a new study, researchers measured the width of elbows in living people and in skeletons from a medieval British farming community. The researchers assumed the 9-to-1 ratio of handedness would match the ratio of bigger right to left elbows. The prediction held true in the modern-day group, but not for the medieval bones. Most of the ancient farmers' left and right elbows were the same size. "It's obvious that they were using both hands equally," said anthropologist Amanda Blackburn from the University of Manitoba. "It's not fair to say they were ambidextrous in the true sense of the word, but they may have had a tendency to use both hands equally. It's a behavior they may have learned rather than just being born like that." The findings will be published in the April issue of the journal Current Anthropology.
Oppressing the left
Lefties have long suffered. In India and Indonesia, eating with the left hand is considered impolite. Chinese characters prove extremely difficult to write with the left hand. Not so long ago, teachers slapped the wrists of left-handed American elementary students. Humans have shown the ability to learn to use their non-preferred hand after injuries, when required to perform manual labor, or in the face of cultural pressure. Yet preference for handedness appears to take root in the womb, or even earlier. One genetic model, called the right shift theory and developed by psychologist Marian Annett at the University of Leicester, suggests that a single gene increases the likelihood of being right-handed. "The essence of my right shift theory is that there is a gene that helps to develop speech in the left hemisphere of the brain and increases the probability of right-handedness," Annett told LiveScience. Whatever evolutionary jog made humans left-brain dominant for speech also made us right-side dominant, Annett argues. Since our closest relatives—chimpanzees—can't talk, the gene must have arisen in recent evolutionary history. One study found most chimps prefer to fish for termites with their left hand. But other recent research shows most chimpanzees favor their right hand when throwing overhand. "The prevailing genetic model seems to be pretty strong. There are only a few weak points that are yet to be addressed. Not only can they not pinpoint a gene, there's conflicting data out there too," said David Wolman, author of "A Left Hand Turn Around the World" (Da Capo Press, 2005). In a twist on the genetic model, the gene for hand preference might also be the gene for hair whorl direction, the way a person's hair turns on the top of their head. Half of people with counterclockwise whorls prefer their left hand, according to research by Amar Klar at the National Cancer Institute. The same system that patterns hair and handedness could also play a role in the asymmetrical organization of the brain. "It is clear that the same genetics control both traits, along with the side of the brain where language is processed," said Klar.
The artistic myth
The answer to left-handedness is likely in the brain, and probably has to do with that organ's asymmetry, scientists generally believe. Somewhere in our lopsided brains is something, probably a gene or two that determines which hand prefers to throw a ball and which hand likes to write. Unfortunately, scientists can't open up someone's brain and see a sign for hand preference Wolman said. For anyone to move their left hand, or anything on their left side, instructions come from the right side of the brain. Motor centers of the brain control the hands; lefties have more dominant motor centers on the right side of their brain. But just because the directions come from the side of the brain associated with artistic function, doesn't mean a lefty's more likely to compose a Shakespearean sonnet. "The big myth is that the right side of the brain is somehow a creativity bull's-eye. That's not the case, and doesn't have anything to do with handedness. You need resources from both sides of your brain to be creative. All people use both sides of the brain," Wolman told LiveScience.
Fighting advantage
Lefties have had the upper hand in hand-to-hand combat since the Bronze Age, and even today, in the boxing ring. Left-handedness could be beneficial in times of violence, and genetically passed from one generation of fighters to the next, as shown by Charlotte Faurie and Michel Raymond of the University of Montpellier II in France. While a righty fought with a sword in his right hand and a shield in his left, a left-handed swordsman could make strong surprise attack on the opponent's unprotected right side. Recall Rocky Balboa's last-minute switch to his southpaw. The Kerr family of Scotland, known for sinister swordsmanship, went so far as to build Ferniehirst Castle with an unusual staircase that spiraled counterclockwise. The architecture provided left-handed fighters more freedom to swing their sword. Today, the common Scottish terms Kerr-handed, kerry-fisted and corry-fisted mean left-handed. The concept of lefties advantageously killing off all the righties doesn't hold strong, however. The 9-to-1 ratio of right- to left-handedness existed long before the advent of sword and shield warfare and continues to this day. Some researchers suggest prenatal levels of testosterone determine hand preference. Brain damage from trauma in the delivery room is another explanation. "Proud lefties cringe at the thought of it," said the left-handed Wolman. "The genetic model has wider support among the laterality community than brain damage at birth or levels of hormones in the womb," Wolman said. "At the end of the day, everyone seems to go back to the gene."
Corey Binns, Special to LiveScience, LiveScience.com
Can openers, scissors and spiral-bound notebooks discriminate against lefties. Despite such challenges, 10 to 12 percent of the human population has historically preferred the left hand. Why doesn't the number ever waiver? Nobody knows for sure, but new research supports a body of evidence that suggests genetics have a hand in it all. In the meantime, the myth remains that lefties are more artistic. And the idea that left-handed fighters have an advantage persists on scant evidence, supported by Scottish lore and Rocky Balboa's heroics in the ring.
Look, Mom: Both hands!
Like many traits, handedness is probably determined by a complex interaction between genes and the environment, experts figure. Left-handers are more likely to have a left-handed relative. But researchers have yet to find the gene or set of genes that pick one hand over the other. Most scientists agree that handedness exists on a continuum. The idea helps explain why some people bowl with their left but hold a spoon in their right. Truly ambidextrous people, who have indifferent preference for either hand, are extremely rare. In a new study, researchers measured the width of elbows in living people and in skeletons from a medieval British farming community. The researchers assumed the 9-to-1 ratio of handedness would match the ratio of bigger right to left elbows. The prediction held true in the modern-day group, but not for the medieval bones. Most of the ancient farmers' left and right elbows were the same size. "It's obvious that they were using both hands equally," said anthropologist Amanda Blackburn from the University of Manitoba. "It's not fair to say they were ambidextrous in the true sense of the word, but they may have had a tendency to use both hands equally. It's a behavior they may have learned rather than just being born like that." The findings will be published in the April issue of the journal Current Anthropology.
Oppressing the left
Lefties have long suffered. In India and Indonesia, eating with the left hand is considered impolite. Chinese characters prove extremely difficult to write with the left hand. Not so long ago, teachers slapped the wrists of left-handed American elementary students. Humans have shown the ability to learn to use their non-preferred hand after injuries, when required to perform manual labor, or in the face of cultural pressure. Yet preference for handedness appears to take root in the womb, or even earlier. One genetic model, called the right shift theory and developed by psychologist Marian Annett at the University of Leicester, suggests that a single gene increases the likelihood of being right-handed. "The essence of my right shift theory is that there is a gene that helps to develop speech in the left hemisphere of the brain and increases the probability of right-handedness," Annett told LiveScience. Whatever evolutionary jog made humans left-brain dominant for speech also made us right-side dominant, Annett argues. Since our closest relatives—chimpanzees—can't talk, the gene must have arisen in recent evolutionary history. One study found most chimps prefer to fish for termites with their left hand. But other recent research shows most chimpanzees favor their right hand when throwing overhand. "The prevailing genetic model seems to be pretty strong. There are only a few weak points that are yet to be addressed. Not only can they not pinpoint a gene, there's conflicting data out there too," said David Wolman, author of "A Left Hand Turn Around the World" (Da Capo Press, 2005). In a twist on the genetic model, the gene for hand preference might also be the gene for hair whorl direction, the way a person's hair turns on the top of their head. Half of people with counterclockwise whorls prefer their left hand, according to research by Amar Klar at the National Cancer Institute. The same system that patterns hair and handedness could also play a role in the asymmetrical organization of the brain. "It is clear that the same genetics control both traits, along with the side of the brain where language is processed," said Klar.
The artistic myth
The answer to left-handedness is likely in the brain, and probably has to do with that organ's asymmetry, scientists generally believe. Somewhere in our lopsided brains is something, probably a gene or two that determines which hand prefers to throw a ball and which hand likes to write. Unfortunately, scientists can't open up someone's brain and see a sign for hand preference Wolman said. For anyone to move their left hand, or anything on their left side, instructions come from the right side of the brain. Motor centers of the brain control the hands; lefties have more dominant motor centers on the right side of their brain. But just because the directions come from the side of the brain associated with artistic function, doesn't mean a lefty's more likely to compose a Shakespearean sonnet. "The big myth is that the right side of the brain is somehow a creativity bull's-eye. That's not the case, and doesn't have anything to do with handedness. You need resources from both sides of your brain to be creative. All people use both sides of the brain," Wolman told LiveScience.
Fighting advantage
Lefties have had the upper hand in hand-to-hand combat since the Bronze Age, and even today, in the boxing ring. Left-handedness could be beneficial in times of violence, and genetically passed from one generation of fighters to the next, as shown by Charlotte Faurie and Michel Raymond of the University of Montpellier II in France. While a righty fought with a sword in his right hand and a shield in his left, a left-handed swordsman could make strong surprise attack on the opponent's unprotected right side. Recall Rocky Balboa's last-minute switch to his southpaw. The Kerr family of Scotland, known for sinister swordsmanship, went so far as to build Ferniehirst Castle with an unusual staircase that spiraled counterclockwise. The architecture provided left-handed fighters more freedom to swing their sword. Today, the common Scottish terms Kerr-handed, kerry-fisted and corry-fisted mean left-handed. The concept of lefties advantageously killing off all the righties doesn't hold strong, however. The 9-to-1 ratio of right- to left-handedness existed long before the advent of sword and shield warfare and continues to this day. Some researchers suggest prenatal levels of testosterone determine hand preference. Brain damage from trauma in the delivery room is another explanation. "Proud lefties cringe at the thought of it," said the left-handed Wolman. "The genetic model has wider support among the laterality community than brain damage at birth or levels of hormones in the womb," Wolman said. "At the end of the day, everyone seems to go back to the gene."
- Why You Can't Tickle Yourself
- Peace or War? How Early Humans Behaved
- How Fingerprints are Created
- The Biggest Popular Myths
Corey Binns, Special to LiveScience, LiveScience.com
http://upi.com/InternationalIntelligence/v...23-020654-3936r
Bird flu may threaten animals
By LAUREN MACK
UNITED NATIONS, March 23 (UPI) -- United Nations officials warn bird flu is a potential threat to biological diversity and a wide range of species including rare and endangered animals.
Experts attending a conference of the Convention on Biological Diversity in Curitiba, Brazil, said Wednesday there is growing evidence the H5N1 virus can infect cats, mammals and 80 percent of migratory and non-migratory birds. The CBD is administered by the U.N. Environment Program.
Big cats like leopards and tigers, small cats such as the civet, mammals like badgers and weasels and members of the crow and vulture families are some of the animals that may be impacted, said experts. They suspect the highly refined olfactory systems of some mammals may make them particularly susceptible to infections like bird flu.
Experts at the conference called for increased monitoring of wild birds and mammals, more training of wildlife and veterinarian staff, vaccination of rare species in the wild and in zoos, and compensation for owners of culled poultry as ways to protect biological diversity. Biodiversity is the term given to the variety of life on Earth and the natural patterns it forms.
"Firstly, that the impact on biological diversity and on species may be far wider and more complex than might have been initially supposed," Ahmed Djoghlaf, CBD executive secretary, told conference attendees. "Secondly, that it is in many ways a threat of our own making. For example, reduced genetic diversity in domestic animals like poultry in favor of a 'monoculture' in the last 50 years has resulted in a reduction of resistance to many diseases."
"There is also growing evidence that a healthy environment can act as a buffer against old and the emergence of new diseases whereas a degraded one favors the spread of infections. If we are to realize international targets on fighting poverty by 2015 and on conserving biodiversity by 2010, we must urgently address these key links," said Djoghlaf.
Culling wild birds and draining resting sites like wetlands would do more harm than good, said the specialists. Such a move -- especially in developing countries where chicken is a key source of protein -- may lead to people turning to "bushmeat," which, in turn, may put pressure on a wider range of animals including wild pigs, chimpanzees and gorillas as people seek out alternative meat to eat.
The loss of predators from some habitats could trigger an abundance of pests like mice and rats which could lead to a rise in human and animal infections, according to the specialists.
Concern is particularly high for countries like Vietnam, which is a big poultry producer, and countries with extraordinary bird biodiversity like Brazil. Some islands like Hawaii, Galapagos, the Seychelles and Mauritius may want to consider a ban on poultry and wild birds to protect their biodiversity, said the experts.
A big contributor to spreading bird flu may be the illegal trade of animals across borders, they added, calling for an increase in surveillance and tougher penalties for illegal traders.
In an effort to encourage people to report potential outbreaks of the virus, experts have suggested governments give compensation to owners of culled poultry in poor countries.
Since the first human case of the latest avian influenza outbreak was reported in January 2004, U.N. agencies have been working with health organizations and government agencies to curb the spread of the deadly disease.
There have been 184 cases of bird flu including 103 deaths since 2003 and more than 150 million domestic birds have died or been collected in an effort to curb the spread the current outbreak, according to the World Health Organization.
Avian influenza was first identified 100 years ago during an outbreak in Italy and has cropped up several times since. The first documented cases involving humans infected with bird flu occurred in Hong Kong in 1997 and 1998. Hong Kong's entire poultry population, estimated at around 1.5 million birds, was destroyed in three days which probably averted a pandemic, said the WHO.
The disease is highly contagious and spread by excrement from migratory birds and from human interaction with infected animals. H5N1 is a particular concern because it mutates rapidly, said the WHO.
Migratory waterfowl, like wild ducks, are a natural reservoir for the virus, and are the most resistant to infection. Domestic poultry, including chickens and turkeys, are particularly susceptible.
The WHO has warned the virus could evolve into a human influenza pandemic that could kill tens of millions of people if it mutates into a form which could transmit easily between people. U.N. health officials have said a human flu pandemic is inevitable.
Bird flu may threaten animals
By LAUREN MACK
UNITED NATIONS, March 23 (UPI) -- United Nations officials warn bird flu is a potential threat to biological diversity and a wide range of species including rare and endangered animals.
Experts attending a conference of the Convention on Biological Diversity in Curitiba, Brazil, said Wednesday there is growing evidence the H5N1 virus can infect cats, mammals and 80 percent of migratory and non-migratory birds. The CBD is administered by the U.N. Environment Program.
Big cats like leopards and tigers, small cats such as the civet, mammals like badgers and weasels and members of the crow and vulture families are some of the animals that may be impacted, said experts. They suspect the highly refined olfactory systems of some mammals may make them particularly susceptible to infections like bird flu.
Experts at the conference called for increased monitoring of wild birds and mammals, more training of wildlife and veterinarian staff, vaccination of rare species in the wild and in zoos, and compensation for owners of culled poultry as ways to protect biological diversity. Biodiversity is the term given to the variety of life on Earth and the natural patterns it forms.
"Firstly, that the impact on biological diversity and on species may be far wider and more complex than might have been initially supposed," Ahmed Djoghlaf, CBD executive secretary, told conference attendees. "Secondly, that it is in many ways a threat of our own making. For example, reduced genetic diversity in domestic animals like poultry in favor of a 'monoculture' in the last 50 years has resulted in a reduction of resistance to many diseases."
"There is also growing evidence that a healthy environment can act as a buffer against old and the emergence of new diseases whereas a degraded one favors the spread of infections. If we are to realize international targets on fighting poverty by 2015 and on conserving biodiversity by 2010, we must urgently address these key links," said Djoghlaf.
Culling wild birds and draining resting sites like wetlands would do more harm than good, said the specialists. Such a move -- especially in developing countries where chicken is a key source of protein -- may lead to people turning to "bushmeat," which, in turn, may put pressure on a wider range of animals including wild pigs, chimpanzees and gorillas as people seek out alternative meat to eat.
The loss of predators from some habitats could trigger an abundance of pests like mice and rats which could lead to a rise in human and animal infections, according to the specialists.
Concern is particularly high for countries like Vietnam, which is a big poultry producer, and countries with extraordinary bird biodiversity like Brazil. Some islands like Hawaii, Galapagos, the Seychelles and Mauritius may want to consider a ban on poultry and wild birds to protect their biodiversity, said the experts.
A big contributor to spreading bird flu may be the illegal trade of animals across borders, they added, calling for an increase in surveillance and tougher penalties for illegal traders.
In an effort to encourage people to report potential outbreaks of the virus, experts have suggested governments give compensation to owners of culled poultry in poor countries.
Since the first human case of the latest avian influenza outbreak was reported in January 2004, U.N. agencies have been working with health organizations and government agencies to curb the spread of the deadly disease.
There have been 184 cases of bird flu including 103 deaths since 2003 and more than 150 million domestic birds have died or been collected in an effort to curb the spread the current outbreak, according to the World Health Organization.
Avian influenza was first identified 100 years ago during an outbreak in Italy and has cropped up several times since. The first documented cases involving humans infected with bird flu occurred in Hong Kong in 1997 and 1998. Hong Kong's entire poultry population, estimated at around 1.5 million birds, was destroyed in three days which probably averted a pandemic, said the WHO.
The disease is highly contagious and spread by excrement from migratory birds and from human interaction with infected animals. H5N1 is a particular concern because it mutates rapidly, said the WHO.
Migratory waterfowl, like wild ducks, are a natural reservoir for the virus, and are the most resistant to infection. Domestic poultry, including chickens and turkeys, are particularly susceptible.
The WHO has warned the virus could evolve into a human influenza pandemic that could kill tens of millions of people if it mutates into a form which could transmit easily between people. U.N. health officials have said a human flu pandemic is inevitable.
http://upi.com/ConsumerHealthDaily/view.ph...22-033044-9230r
Capital tries to stem HIV/AIDS epidemic
By CHRISTINE DELL'AMORE
UPI Consumer Health Correspondent
WASHINGTON, March 22 (UPI) -- In a city where new AIDS cases have reached 10 times the national average, government and community leaders here have taken promising steps to halt the disease, yet in many areas they continue to falter, a report card released today shows.
The DC Appleseed Center for Law and Justice graded the city in 12 areas originally targeted by their landmark August 2005 report, "HIV/AIDS in the Nation's Capital," which illuminated a dearth of leadership and coordination in fighting HIV/AIDS.
"We want to applaud and celebrate where steps forward have occurred, but criticize and lament where steps have not been taken," said Walter Smith, executive director of DC Appleseed, an independent non-profit. "We're talking about an issue that is of life-and-death consequence in the nation's capital."
The Washington AIDS Partnership, a local grant-making organization, commissioned the DC Appleseed report to address grave concerns about city leadership and a lack of overall data on the epidemic.
Since the document surfaced, a "surge of constructive energy" has motivated reforms in the district, where one in 20 residents is infected with the virus, the report card states. The district is thought to have the highest rate of HIV/AIDS in the country: New AIDS cases hit 179.2 per 100,000 residents in 2004, vs. 15.0 cases per 100,000 nationwide.
The district government has also embraced the DC Appleseed report as a blueprint for change, and Mayor Anthony Williams has publicly committed to putting the recommendations in action.
Although the six-month report card did not assign an overall grade to the district's efforts, the mixed grades reflect a city still struggling to come to grips with a public-health quagmire.
In the arena of leadership, city officials earned a relatively high grade -- B minus -- for working to make HIV/AIDS a top health priority. On Aug. 11, the day after the DC Appleseed report was released, Williams announced the formation of a task force that he would lead. The Administration for HIV Policy and Programs recruited 28 of the "best and the brightest" among corporate, government, non-profit and community entities, and the group will be officially announced very soon, Marsha Martin, director of the AHPP, told UPI.
The report has been a "rallying document" for the Washington community, said Martin, who was hired to head the agency a few weeks after its publication.
"Everybody would say unequivocally there is a renewed, reinvigorated energy of the government about HIV," she added.
Martin also emphasized although the DC Appleseed report is a useful tool, it is not the only way to bring about change.
This new leadership in the HIV office is substantial, said Washington Councilmember Jim Graham, who was the executive director of Whitman Walker Clinic from 1984 to 1999. Whitman Walker is the largest provider of care and services for people living with AIDS in the district.
"If you don't have confident people at the helm, you're whistling in the wind," he added.
Still, many of the leaders who rally against HIV do so in a hushed tone.
"With HIV, it can't be done quietly," said Josh Levinson, deputy director of DC Appleseed, who works with the HIV project. "You have to be loud, you have to be vocal, because at the end of the day, this is about sex and drugs."
Perhaps the most crucial issue in the report is data and surveillance, or how the city tracks infected people. DC Appleseed assigned an incomplete grade to this category, opting for a wait-and-see approach. Although the government attempts to collect data, their ability to do so is limited. For instance, AHPP's Surveillance Division has a staff vacancy rate of more than 50 percent.
As a result, no one actually knows how many people are infected with the virus.
"Who would have thought 25 years into the epidemic, one of the biggest problems would be that we don't know what the problem is?" Levinson said.
Martin cautioned that the lack of data means the rate of infection could turn out less dismal than imagined.
"We don't have the survey capacity to really know how to discern what our epidemic looks like locally," she said.
But that might change with the AHPP's new partnership with the George Washington University School of Public Health and Health Services, which will oversee and improve the current surveillance program. The university also plans to recruit a Ph.D.-level epidemiologist to assist AHPP in collecting data.
The district's management of grants to community-based organizations has also become more efficient, earning a grade of B.
Roberta Geidner-Antoniotti, the interim executive director of the Whitman Walker Clinic, said her organization has run more smoothly since timely deliverance of grants.
The district's public school system got a B minus for adopting revised health education curricula, which includes HIV prevention material. Barbara Rockwood, the executive director for health, physical education and athletics for the system, refrained from describing the particulars of the new health education material, but it will likely appear in the classroom by 2007.
In addition, a separate resolution passed in September 2005 by the School Board will take a harder look at the efficacy of the HIV curriculum. However, the superintendent of schools, Clifford Janey, has not responded to the School Board's request to present a plan for HIV education.
On the downside, the city's track record on substance-abuse treatment has not improved, warranting a D plus. Recommendations by the mayor's Interagency Taskforce on Substance Abuse, Prevention, Treatment and Control have gone largely unnoticed; their 2005 annual report stated the district "is not making significant progress" toward its goal of reducing alcohol and drug abusers. Cutting drug use is a clear prevention strategy for contracting HIV.
The city has also failed to make condoms widely available. AHPP distributed only 290,000 condoms in 2004, falling short of its goal of 600,000. Condom distribution received a D grade from Appleseed.
The lack of condoms represents only one example of how much still needs to be done, said Channing Wickham, executive director of the Washington Aids Partnership.
"With numbers like 1 in 20, the issue is impossible to ignore, yet people have found a way to ignore it," Wickham said.
Most community and government leaders agreed the key is visibility -- the more people place a spotlight the epidemic, the more action will occur.
"The Appleseed report put into words what most of us in the community level already knew. But we finally have the curtains drawn on this problem," said Adam Tenner, director of Metro TeenAids, an organization supporting young people in the fight against HIV.
"Unlike a lot of reports that are left on the shelf when they're written, we want to make the Appleseed report a living document," Wickham said. "This is a chance for a fresh start for a lot of people."
Capital tries to stem HIV/AIDS epidemic
By CHRISTINE DELL'AMORE
UPI Consumer Health Correspondent
WASHINGTON, March 22 (UPI) -- In a city where new AIDS cases have reached 10 times the national average, government and community leaders here have taken promising steps to halt the disease, yet in many areas they continue to falter, a report card released today shows.
The DC Appleseed Center for Law and Justice graded the city in 12 areas originally targeted by their landmark August 2005 report, "HIV/AIDS in the Nation's Capital," which illuminated a dearth of leadership and coordination in fighting HIV/AIDS.
"We want to applaud and celebrate where steps forward have occurred, but criticize and lament where steps have not been taken," said Walter Smith, executive director of DC Appleseed, an independent non-profit. "We're talking about an issue that is of life-and-death consequence in the nation's capital."
The Washington AIDS Partnership, a local grant-making organization, commissioned the DC Appleseed report to address grave concerns about city leadership and a lack of overall data on the epidemic.
Since the document surfaced, a "surge of constructive energy" has motivated reforms in the district, where one in 20 residents is infected with the virus, the report card states. The district is thought to have the highest rate of HIV/AIDS in the country: New AIDS cases hit 179.2 per 100,000 residents in 2004, vs. 15.0 cases per 100,000 nationwide.
The district government has also embraced the DC Appleseed report as a blueprint for change, and Mayor Anthony Williams has publicly committed to putting the recommendations in action.
Although the six-month report card did not assign an overall grade to the district's efforts, the mixed grades reflect a city still struggling to come to grips with a public-health quagmire.
In the arena of leadership, city officials earned a relatively high grade -- B minus -- for working to make HIV/AIDS a top health priority. On Aug. 11, the day after the DC Appleseed report was released, Williams announced the formation of a task force that he would lead. The Administration for HIV Policy and Programs recruited 28 of the "best and the brightest" among corporate, government, non-profit and community entities, and the group will be officially announced very soon, Marsha Martin, director of the AHPP, told UPI.
The report has been a "rallying document" for the Washington community, said Martin, who was hired to head the agency a few weeks after its publication.
"Everybody would say unequivocally there is a renewed, reinvigorated energy of the government about HIV," she added.
Martin also emphasized although the DC Appleseed report is a useful tool, it is not the only way to bring about change.
This new leadership in the HIV office is substantial, said Washington Councilmember Jim Graham, who was the executive director of Whitman Walker Clinic from 1984 to 1999. Whitman Walker is the largest provider of care and services for people living with AIDS in the district.
"If you don't have confident people at the helm, you're whistling in the wind," he added.
Still, many of the leaders who rally against HIV do so in a hushed tone.
"With HIV, it can't be done quietly," said Josh Levinson, deputy director of DC Appleseed, who works with the HIV project. "You have to be loud, you have to be vocal, because at the end of the day, this is about sex and drugs."
Perhaps the most crucial issue in the report is data and surveillance, or how the city tracks infected people. DC Appleseed assigned an incomplete grade to this category, opting for a wait-and-see approach. Although the government attempts to collect data, their ability to do so is limited. For instance, AHPP's Surveillance Division has a staff vacancy rate of more than 50 percent.
As a result, no one actually knows how many people are infected with the virus.
"Who would have thought 25 years into the epidemic, one of the biggest problems would be that we don't know what the problem is?" Levinson said.
Martin cautioned that the lack of data means the rate of infection could turn out less dismal than imagined.
"We don't have the survey capacity to really know how to discern what our epidemic looks like locally," she said.
But that might change with the AHPP's new partnership with the George Washington University School of Public Health and Health Services, which will oversee and improve the current surveillance program. The university also plans to recruit a Ph.D.-level epidemiologist to assist AHPP in collecting data.
The district's management of grants to community-based organizations has also become more efficient, earning a grade of B.
Roberta Geidner-Antoniotti, the interim executive director of the Whitman Walker Clinic, said her organization has run more smoothly since timely deliverance of grants.
The district's public school system got a B minus for adopting revised health education curricula, which includes HIV prevention material. Barbara Rockwood, the executive director for health, physical education and athletics for the system, refrained from describing the particulars of the new health education material, but it will likely appear in the classroom by 2007.
In addition, a separate resolution passed in September 2005 by the School Board will take a harder look at the efficacy of the HIV curriculum. However, the superintendent of schools, Clifford Janey, has not responded to the School Board's request to present a plan for HIV education.
On the downside, the city's track record on substance-abuse treatment has not improved, warranting a D plus. Recommendations by the mayor's Interagency Taskforce on Substance Abuse, Prevention, Treatment and Control have gone largely unnoticed; their 2005 annual report stated the district "is not making significant progress" toward its goal of reducing alcohol and drug abusers. Cutting drug use is a clear prevention strategy for contracting HIV.
The city has also failed to make condoms widely available. AHPP distributed only 290,000 condoms in 2004, falling short of its goal of 600,000. Condom distribution received a D grade from Appleseed.
The lack of condoms represents only one example of how much still needs to be done, said Channing Wickham, executive director of the Washington Aids Partnership.
"With numbers like 1 in 20, the issue is impossible to ignore, yet people have found a way to ignore it," Wickham said.
Most community and government leaders agreed the key is visibility -- the more people place a spotlight the epidemic, the more action will occur.
"The Appleseed report put into words what most of us in the community level already knew. But we finally have the curtains drawn on this problem," said Adam Tenner, director of Metro TeenAids, an organization supporting young people in the fight against HIV.
"Unlike a lot of reports that are left on the shelf when they're written, we want to make the Appleseed report a living document," Wickham said. "This is a chance for a fresh start for a lot of people."
Alzheimer's May Be Diabetes-Like Illness Yahoo! NEWS
Giving more weight to the notion that Alzheimer's may be a diabetes-like disease, researchers say rats depleted of insulin in the brain went on to develop an Alzheimer's-like illness. By depleting insulin and its related proteins in the rodent's brains, the researchers say they have been able to replicate the progression of Alzheimer's disease. This included amyloid plaque deposits, neurofibrillary "tangles," impaired cognitive functioning, cell loss, and overall brain deterioration. All of these are characteristic of Alzheimer's disease. "True Alzheimer's disease is a kind of insulin resistance in the brain," concluded lead researcher Dr. Suzanne M. de la Monte, a neuropathologist at Rhode Island Hospital and a professor of pathology and clinical neuroscience at Brown Medical School, in Providence, R.I. She called the study "very exciting," adding that it "leads to new concepts of how to treat the disease." According to the researchers, the study demonstrates that Alzheimer's is a brain-specific disorder, distinct from other types of diabetes, such as the inherited form, type 1, and obesity-linked type 2. "This study shows that Alzheimer's is a [new] type of diabetes," de la Monte said. "It's type 3 diabetes." Other experts remained unconvinced, however. "To date, the construct that Alzheimer's is type 3 diabetes remains largely unsupported," said Dr. Sam Gandy, chairman of the Medical and Scientific Advisory Council at the Alzheimer's Association and director of the Farber Institute for Neurosciences at Thomas Jefferson University, Philadelphia. The report appears in the March issue of the Journal of Alzheimer's Disease. According to de la Monte, a loss of insulin in the brain may trigger Alzheimer's onset because brain cells need insulin to function and survive. When this happens, oxidative stress increases, the brain deteriorates, and there is loss of cognitive function, plus a buildup of plaques and tangles in the brain, she said. Whether restoring insulin to the brain can slow or reverse the progression of Alzheimer's is something that de la Monte's team is looking at now in animals. "The results are under review," she said. "We are looking at a brain form of diabetes," de la Monte said. "One can look forward to approaches that may work in the brain which we already have available, or that might be modified to treat patients with neurodegeneration," she said. De la Monte is convinced that what doctors call Alzheimer's is really several different conditions under one umbrella. "We will have to develop ways to be certain who has what kind of neurodegeneration," she said. About 50 percent of patients diagnosed with dementia have Alzheimer's, de la Monte noted. "The others have a mixed condition or something else wrong with them," she said. "There are a number of conditions that people call Alzheimer's disease," de la Monte said. "People are developing ways of testing insulin resistance in the brain, which will be necessary to validate any therapy that comes out of this." However, one expert doesn't think that her team has yet made a convincing case for the theory. "The paper overreaches," said Gandy. He noted that de la Monte's group injected the rats' brains with Streptozotocin, the compound they used to inhibit local insulin production. So, it's not clear whether the brain changes her group noted were related to a lack of insulin, or this insult to the brain. "Streptozotocin, which causes oxidative stress, would be predicted to cause such stress in many tissues, including the brain," Gandy said. In addition, changes the researchers observed in the brains of the mice were only modest, with no clear structural pathology evident, he said. Another expert believes insulin's role in Alzheimer's may only be part of the picture. "There is definitely speculation that insulin is linked to Alzheimer's," said Dr. Zoe Arvanitakis, an assistant professor of neurological sciences at Rush University Medical Center, in Chicago. "But given the complexity of the illness, it is probably unlikely that addressing a single mechanism of illness, for example giving insulin, is probably unlikely to cure the disease," Arvanitakis said. "It might help some people. It might help to some extent. But it is unlikely that a single approach will be the answer to the problem," she said. More information For more on Alzheimer's disease, head to the Alzheimer's Association.
By Steven Reinberg, HealthDay Reporter
Giving more weight to the notion that Alzheimer's may be a diabetes-like disease, researchers say rats depleted of insulin in the brain went on to develop an Alzheimer's-like illness. By depleting insulin and its related proteins in the rodent's brains, the researchers say they have been able to replicate the progression of Alzheimer's disease. This included amyloid plaque deposits, neurofibrillary "tangles," impaired cognitive functioning, cell loss, and overall brain deterioration. All of these are characteristic of Alzheimer's disease. "True Alzheimer's disease is a kind of insulin resistance in the brain," concluded lead researcher Dr. Suzanne M. de la Monte, a neuropathologist at Rhode Island Hospital and a professor of pathology and clinical neuroscience at Brown Medical School, in Providence, R.I. She called the study "very exciting," adding that it "leads to new concepts of how to treat the disease." According to the researchers, the study demonstrates that Alzheimer's is a brain-specific disorder, distinct from other types of diabetes, such as the inherited form, type 1, and obesity-linked type 2. "This study shows that Alzheimer's is a [new] type of diabetes," de la Monte said. "It's type 3 diabetes." Other experts remained unconvinced, however. "To date, the construct that Alzheimer's is type 3 diabetes remains largely unsupported," said Dr. Sam Gandy, chairman of the Medical and Scientific Advisory Council at the Alzheimer's Association and director of the Farber Institute for Neurosciences at Thomas Jefferson University, Philadelphia. The report appears in the March issue of the Journal of Alzheimer's Disease. According to de la Monte, a loss of insulin in the brain may trigger Alzheimer's onset because brain cells need insulin to function and survive. When this happens, oxidative stress increases, the brain deteriorates, and there is loss of cognitive function, plus a buildup of plaques and tangles in the brain, she said. Whether restoring insulin to the brain can slow or reverse the progression of Alzheimer's is something that de la Monte's team is looking at now in animals. "The results are under review," she said. "We are looking at a brain form of diabetes," de la Monte said. "One can look forward to approaches that may work in the brain which we already have available, or that might be modified to treat patients with neurodegeneration," she said. De la Monte is convinced that what doctors call Alzheimer's is really several different conditions under one umbrella. "We will have to develop ways to be certain who has what kind of neurodegeneration," she said. About 50 percent of patients diagnosed with dementia have Alzheimer's, de la Monte noted. "The others have a mixed condition or something else wrong with them," she said. "There are a number of conditions that people call Alzheimer's disease," de la Monte said. "People are developing ways of testing insulin resistance in the brain, which will be necessary to validate any therapy that comes out of this." However, one expert doesn't think that her team has yet made a convincing case for the theory. "The paper overreaches," said Gandy. He noted that de la Monte's group injected the rats' brains with Streptozotocin, the compound they used to inhibit local insulin production. So, it's not clear whether the brain changes her group noted were related to a lack of insulin, or this insult to the brain. "Streptozotocin, which causes oxidative stress, would be predicted to cause such stress in many tissues, including the brain," Gandy said. In addition, changes the researchers observed in the brains of the mice were only modest, with no clear structural pathology evident, he said. Another expert believes insulin's role in Alzheimer's may only be part of the picture. "There is definitely speculation that insulin is linked to Alzheimer's," said Dr. Zoe Arvanitakis, an assistant professor of neurological sciences at Rush University Medical Center, in Chicago. "But given the complexity of the illness, it is probably unlikely that addressing a single mechanism of illness, for example giving insulin, is probably unlikely to cure the disease," Arvanitakis said. "It might help some people. It might help to some extent. But it is unlikely that a single approach will be the answer to the problem," she said. More information For more on Alzheimer's disease, head to the Alzheimer's Association.
By Steven Reinberg, HealthDay Reporter
Dozens Fight New Orleans Hospital Closure Yahoo! NEWS
Doctors, former patients and preservationists rallied outside a public hospital that closed in the wake of Hurricane Katrina, urging officials not to abandon the shuttered medical center. Charity Hospital, the city's only Level 1 trauma center, was closed after its basement flooded, ruining its electrical system. Officials have said the hospital cannot be saved because of asbestos in the interior and bacteria that flourished in the steamy, late-summer air after the Aug. 29 hurricane. "This hospital is not as damaged as they say it is," said Dr. James Moises, a former emergency room physician who resigned from the Louisiana State University-run Charity Hospital system so he could speak at the rally without violating a gag order imposed by hospital administrators. "Reopening our public hospital right now is the right thing to do," Moises said. The crowd of about 100 called Saturday for an independent group of architects and engineers to evaluate the building, saying they're skeptical of the findings by an LSU-hired consulting firm. LSU is working with the U.S. Department of Veterans Affairs to build a shared medical center in New Orleans. Hospital officials said it likely would be five years before the medical center could open. It's unclear how much the joint medical center — or LSU's individual hospital on the site — would cost. In the meantime, the system has opened small clinics in the New Orleans area, one in an old department store that also flooded after Katrina. Moises said he believed Charity could be reopened in a matter of weeks if there was the political will to do so. The state should not leave the city without a public hospital in the meantime, even if it means only reopening only parts of the building. The first Charity Hospital opened in New Orleans in 1736. The current building — a massive, multiple-wing, 21-story hospital built in 1939 of steel and pale limestone embellished with allegorical reliefs — was designed by Julius Dreyfous, who also helped design the Louisiana State Capitol in Baton Rouge.
By BRETT MARTEL, Associated Press Writer
Doctors, former patients and preservationists rallied outside a public hospital that closed in the wake of Hurricane Katrina, urging officials not to abandon the shuttered medical center. Charity Hospital, the city's only Level 1 trauma center, was closed after its basement flooded, ruining its electrical system. Officials have said the hospital cannot be saved because of asbestos in the interior and bacteria that flourished in the steamy, late-summer air after the Aug. 29 hurricane. "This hospital is not as damaged as they say it is," said Dr. James Moises, a former emergency room physician who resigned from the Louisiana State University-run Charity Hospital system so he could speak at the rally without violating a gag order imposed by hospital administrators. "Reopening our public hospital right now is the right thing to do," Moises said. The crowd of about 100 called Saturday for an independent group of architects and engineers to evaluate the building, saying they're skeptical of the findings by an LSU-hired consulting firm. LSU is working with the U.S. Department of Veterans Affairs to build a shared medical center in New Orleans. Hospital officials said it likely would be five years before the medical center could open. It's unclear how much the joint medical center — or LSU's individual hospital on the site — would cost. In the meantime, the system has opened small clinics in the New Orleans area, one in an old department store that also flooded after Katrina. Moises said he believed Charity could be reopened in a matter of weeks if there was the political will to do so. The state should not leave the city without a public hospital in the meantime, even if it means only reopening only parts of the building. The first Charity Hospital opened in New Orleans in 1736. The current building — a massive, multiple-wing, 21-story hospital built in 1939 of steel and pale limestone embellished with allegorical reliefs — was designed by Julius Dreyfous, who also helped design the Louisiana State Capitol in Baton Rouge.
By BRETT MARTEL, Associated Press Writer
March 27, 2006
Study: Pumping Iron Helps Cancer Survivors
By THE ASSOCIATED PRESS
Filed at 12:17 a.m. ET
ATLANTA (AP) -- Weightlifting appears to improve breast cancer survivors' outlook on life, suggests one of the first studies to scientifically measure the effects of such exercise.
About 80 percent of women who took up twice-a-week weight-training saw improved scores on a quality-of-life survey, researchers said, in a study to be published in an upcoming issue of the journal Cancer.
In contrast, 51 percent of participants in a control group did.
The physical and psychological benefits of exercise are well-documented. But this study is the first to apply scientific methodology to looking at how weight-training helps women who have had breast cancer.
''This may seem like common sense to most folks, but there's really been no literature or science where researchers tried to quantify and verify the effect,'' said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society.
Researchers recruited 86 women from the Minneapolis-St. Paul area in late 2001 and early 2002. Each of the women had completed successful treatment of breast cancer within the previous three years.
Half the women were assigned to an exercise group. For three months they met twice a week with personal fitness trainers to develop a weightlifting regimen. They were then encouraged to follow it for another three months.
The second group had no such regimen.
Researchers asked women in both groups a series of questions about physical well-being, marital happiness, sexual activity and other aspects of life.
Women in the exercise group had a modest improvement over members of the non-exercising group, Lichtenfeld noted.
However, the women in the exercise group said they felt they had more strength, speed and self-confidence as a result of the workouts. It appears the weightlifting helped them regain a feeling of control of their bodies, researchers said.
The more women improved on bench press, the better they said they felt overall. That may be because breast cancer treatment can reduce the ability to lift and carry things, said Kathryn Schmitz, a University of Pennsylvania researcher who co-authored the study.
The study also tried to observe weight-training's effect on depression. The researchers didn't measure any significant effect, but they said that might be because such a small number of women were deemed to suffer from depression at the outset of the study.
Copyright 2006 The Associated Press Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top
Study: Pumping Iron Helps Cancer Survivors
By THE ASSOCIATED PRESS
Filed at 12:17 a.m. ET
ATLANTA (AP) -- Weightlifting appears to improve breast cancer survivors' outlook on life, suggests one of the first studies to scientifically measure the effects of such exercise.
About 80 percent of women who took up twice-a-week weight-training saw improved scores on a quality-of-life survey, researchers said, in a study to be published in an upcoming issue of the journal Cancer.
In contrast, 51 percent of participants in a control group did.
The physical and psychological benefits of exercise are well-documented. But this study is the first to apply scientific methodology to looking at how weight-training helps women who have had breast cancer.
''This may seem like common sense to most folks, but there's really been no literature or science where researchers tried to quantify and verify the effect,'' said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society.
Researchers recruited 86 women from the Minneapolis-St. Paul area in late 2001 and early 2002. Each of the women had completed successful treatment of breast cancer within the previous three years.
Half the women were assigned to an exercise group. For three months they met twice a week with personal fitness trainers to develop a weightlifting regimen. They were then encouraged to follow it for another three months.
The second group had no such regimen.
Researchers asked women in both groups a series of questions about physical well-being, marital happiness, sexual activity and other aspects of life.
Women in the exercise group had a modest improvement over members of the non-exercising group, Lichtenfeld noted.
However, the women in the exercise group said they felt they had more strength, speed and self-confidence as a result of the workouts. It appears the weightlifting helped them regain a feeling of control of their bodies, researchers said.
The more women improved on bench press, the better they said they felt overall. That may be because breast cancer treatment can reduce the ability to lift and carry things, said Kathryn Schmitz, a University of Pennsylvania researcher who co-authored the study.
The study also tried to observe weight-training's effect on depression. The researchers didn't measure any significant effect, but they said that might be because such a small number of women were deemed to suffer from depression at the outset of the study.
Copyright 2006 The Associated Press Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top
March 27, 2006
Q&A
How Serious Is the Risk?
By DENISE GRADY and GINA KOLATA
Over the last year, it has been impossible to watch TV or read a newspaper without encountering dire reports about bird flu and the possibility of a pandemic, a worldwide epidemic. First Asia, then Europe, now Africa: like enemy troops moving into place for an attack, the bird flu virus known as A(H5N1) has been steadily advancing. The latest country to report human cases is Azerbaijan, where five of seven people have died. The virus has not reached the Americas, but it seems only a matter of time before it turns up in birds here.
Even so, a human pandemic caused by A(H5N1) is by no means inevitable. Many researchers doubt it will ever happen. The virus does not infect people easily, and those who do contract it almost never spread it to other humans. Bird flu is what the name implies: mostly an avian disease. It has infected tens of millions of birds but fewer than 200 people, and nearly all of them have caught it from birds.
But when A(H5N1) does get into people, it can be deadly. It has killed more than half of its known human victims—an extraordinarily high rate. Equally alarming is that many who died were healthy, not the frail or sickly types of patients usually thought to be at risk of death from influenza.
The apparent lethality of A(H5N1), combined with its inexorable spread, are what have made scientists take it seriously. Concern also heightened with the recent discovery that the 1918 flu pandemic was apparently caused by a bird flu that jumped directly into humans.
In addition, A(H5N1) belongs to a group of influenza viruses known as Type A, which are the only ones that have caused pandemics. All those viruses were originally bird flus. And given the timing of the past pandemics — 1918, 1957, 1968 — some researchers think the world is overdue for another. It could be any Type A, but right now (A)H5N1 is the most obvious.
The virus lacks just one trait that could turn it into a pandemic: transmissibility, the ability to spread easily from person to person. If the virus acquires that ability, a pandemic could erupt.
Everything hangs on transmissibility. But it is impossible to predict whether A(H5N1) will become contagious among people. The virus has been changing genetically, and researchers fear that changes could make it more transmissible, or that A(H5N1) could mix with a human flu virus in a person, swap genetic material and come out contagious.
But most bird flu viruses do not jump species to people. Some experts say that since A(H5N1) has been around for at least 10 years and the shift has not occurred, it is unlikely to happen. Others refuse to take that bet.
The A(H5N1) strains circulating now are quite different from the A(H5N1) strain detected in Hong Kong in 1997, which killed 6 of 18 human victims. Over time, A(H5N1) seems to have developed the ability to infect more and more species of birds, and has found its way into mammals—specifically, cats that have eaten infected birds.
The actual number of human cases may well exceed the number that have been reported, and may include mild cases from which victims recovered without even seeing a doctor. If that is true, the real death rate could be lower. But no one knows whether mild cases occur, or whether some people are immune to the virus and never get sick at all.
In the absence of more information, health officials must act on what they see — an illness that apparently kills half its victims.
Q. How will we know if the virus starts spreading from person to person and becomes a pandemic?
A. If there is a pandemic, it would be everywhere, not in just one city or one country. To detect such an event as early as possible there is an international surveillance system, involving more than 150 countries, that searches for signs that a new flu strain is taking hold in humans. One hallmark of a pandemic flu would be an unusual pattern of illnesses — lots of cases, possibly cases that are more severe than normal and, possibly, flu infections outside the normal flu season.
Ordinary human flu viruses, for reasons that are not entirely understood, circulate only in winter. But pandemics can occur at any time. A pandemic would also involve a flu virus that was new to humans, meaning that no one would have immunity from previous infections.
Q. If bird flu reaches the United States, where is it likely to show up first?
A. Although health officials expect bird flu to reach the United States, it is impossible to predict where it may show up first, in part because there are several routes it could take. If it is carried by migrating birds, then it may appear first in Alaska or elsewhere along the West Coast.
But if the virus lurks in a bird being smuggled into the United States as part of the illegal trade in exotic birds, it could land in any international airport. Bird smuggling is a genuine problem: in 2004, a man was caught at an airport in Belgium illegally transporting eagles from Thailand, stuffed into tubes in his carry-on luggage. The birds turned out to be infected with A(H5N1), and they and several hundred other birds in a quarantine area at the airport had to be destroyed.
In theory, an infected human could also bring bird flu into the United States, and that person could fly into just about any international airport and go unnoticed if the virus had yet to produce any symptoms.
Q. Does bird flu affect all birds?
A. No one knows the full story. Scientists say A(H5N1) is unusual because it can infect and kill a wide variety of birds, unlike a vast majority of bird flus, which are usually found in wild birds, not domestic fowl, and which cause few symptoms.
Some researchers suspect that wild ducks, or perhaps other wild birds, are impervious to A(H5N1), and may be the Typhoid Marys of bird flu — getting the virus, spreading it to other birds but never becoming ill themselves. No one has good evidence of this yet, but that may be because the way scientists discovered A(H5N1) infections was by finding birds that had gotten the flu and died.
As virologists like to point out, dead birds don't fly. So migratory birds cannot spread the virus if they are dying shortly after being infected. That is why some researchers say that if wild birds are spreading the A(H5N1) virus, it must be a bird species that can be infected but does not become ill.
Q. When people die from avian flu contracted from birds, what kills them?
A. Like victims of severe pneumonia, many patients die because their lungs give out. The disease usually starts with a fever, fatigue, headache and aches and pains, like a typical case of the flu. But within a few days it can turn into pneumonia, and the patients' lungs are damaged and fill with fluid.
In a few cases, children infected with A(H5N1) died of encephalitis, apparently because the virus attacked the brain. A number of people have also had severe diarrhea — not usually a flu symptom — meaning that this virus may attack the intestines as well. Studies in cats suggest that in mammals the virus attacks other organs, too, including the heart, liver and adrenal glands.
But more detailed information about deaths in people is not available because very few autopsies have been done. In some countries, like Vietnam, where many of the deaths occurred, autopsies are frowned upon. Researchers say they may glean useful information from autopsies, but fear that pressing for them would alienate the public in some areas.
Q. When experts refer to bird flu as A(H5N1), what does that mean?
Click here to see the answer.
Q. If I got bird flu, how would I know?
A. There is no reason to suspect the disease unless you may have been exposed to it. Since the virus has not reached North America, doctors do not look for bird flu in people unless they have traveled to affected regions or have been exposed to sick or dead birds.
The early stages of the illness in people are the same as those of ordinary flu: fever, headache, fatigue, aches and pains. But within a few days, people with bird flu often start getting worse instead of better; difficulty breathing is what takes many to the hospital.
In any case, patients with flulike symptoms that turn severe or involve breathing trouble are in urgent need of medical care.
Q. Can I be tested for avian flu?
A. There is no rapid test for bird flu. There is a rapid test for Type A influenza viruses, the group that A(H5N1) belongs to, but the test is only moderately reliable, and it is not specific for A(H5N1).
State health departments and some research laboratories can perform genetic testing for A(H5N1) and give results within a few hours, but they do not have the capacity to perform widespread testing.
Because of the limited availability of testing and the extremely low probability of A(H5N1) in people in the United States, the test is recommended only for patients strongly suspected of having bird flu, like travelers with flulike symptoms who were exposed to infected birds.
Q. Do any medicines treat or prevent bird flu?
A. Two prescription drugs, Tamiflu and Relenza, may reduce the severity of the disease if they are taken within a day or two after the symptoms begin. But Relenza, a powder that must be inhaled, can irritate the lungs and is not recommended for people with asthma or other chronic lung diseases.
Both drugs work by blocking an enzyme — neuraminidase, the "N" part of A(H5N1) — that the virus needs to escape from one cell to infect another. But just how effective these medicines are against A(H5N1) is not known, nor is it clear whether the usual doses are enough. Also unknown is whether the drugs will help if taken later in the course of the disease. Although government laboratories and other research groups are trying to develop vaccines to prevent A(H5N1) disease in people, none are available yet.
Q. If there is an epidemic of flu in humans, how can I protect myself?
A. If there is a vaccine available, that would be the best option. But if there is no vaccine it may be hard to avoid being infected. Flu pandemics spread quickly, even to isolated regions. The 1918 flu reached Alaskan villages where the only way visitors could arrive was by dog sled.
The vaccines produced every year to prevent seasonal flu are unlikely to be of any use in warding off a pandemic strain. But a flu shot could provide at least some peace of mind, by preventing the false alarm that could come from catching a case of garden-variety flu.
Similarly, people over 65 and others with chronic health problems should consult their doctors about whether they should be vaccinated against pneumococcal pneumonia, a dangerous illness that can set in on top of the flu. Again, that vaccine will not stop bird flu, but it may prevent complications.
Some health officials have recommended stockpiling two to three months’ worth of food, fuel and water in case a pandemic interferes with food distribution or staffing levels at public utilities, or people are advised to stay home.
Many health experts have advised against stockpiling Tamiflu or Relenza, the prescription-only antiviral drugs that may work against bird flu. Doctors say the drugs are in short supply and hoarding may keep them out of reach of people who genuinely need them.
Also, they say, self-prescribing may lead to waste of the drugs or misuses that spur the growth of drug-resistant viruses. But people may not trust the government to distribute these drugs, and may want their own supplies. Doctors say people can take precautions like avoiding crowds, washing their hands frequently and staying away from those who are sick. Masks may help, but only if they are a type called N-95, which has to be carefully fitted. So far, masks and gloves have been recommended only for people taking care of sick patients.
Avoiding the flu can be hard because it is not always possible to spot carriers. Many people get and spread flu viruses and but never know they are infected.
Q. Is the government prepared for a bird flu pandemic?
A. No. The nation does not have an approved flu vaccine for people or enough antiviral drugs or respirators for all who would need them. The best protection in any flu pandemic will come from a vaccine, but scientists cannot tell ahead of time what strain the vaccine should protect against.
Efforts are under way to make a vaccine for A(H5N1). But the virus could mutate in a way that makes experimental vaccines ineffective, requiring more than one vaccine.
Moreover, there is no assurance that the next pandemic will even involve A(H5N1). It may involve a different strain of bird flu, and an A(H5N1) vaccine would not work for it. Recent efforts to develop a sort of universal flu vaccine that would work across strains have failed.
For now, the hope is to spot a pandemic early and quickly make a vaccine. Investigators are developing new and better ways to make vaccines — a bird flu, for example, cannot be grown in fertilized eggs like other flu viruses because it kills the chicken embryos — but these new methods must first be approved by the Food and Drug Administration.
Preparations also include government plans to stockpile drugs to protect people who were exposed to the flu and to reduce the severity of the disease in those who are ill. But the one antiviral drug that everyone wants to buy and stockpile, Oseltamivir, also sold by Roche as Tamiflu, is in short supply.
In retrospect, scientists say, maybe the nation should have started preparing sooner. But until the current bird flu appeared, there was little interest in such expensive and extensive preparations.
Graphic: Stockpiling Drugs
Q. If bird flu reaches the United States, will it be safe to eat poultry or to be around birds or other animals?
A. Poultry is safe to eat when it is cooked thoroughly, meaning that the meat is no longer pink and has reached a temperature of 180 degrees Fahrenheit. The risk is not from cooked meat — cooking kills viruses. Instead, it is from infected birds that are still alive or have recently died. So the person who killed an infected chicken, butchered it or put it in the pot would be at greater risk than the one who ate it.
It's not clear how long the virus lives on a dead bird, but it is unlikely to survive more than a couple of days. And it seems unlikely that infected chicken will find its way to supermarkets.
If the bird flu strikes poultry farms, the farmers will know there is a problem. Before they die, the birds develop major hemorrhages, with blood streaming from their cloacas and beaks. When the flu gets to a poultry farm, farmers have to destroy their flocks, and poulgreater risk than the one who ate it.
It's not clear how long the virus lives on a dead bird, but it is unlikely to survive more than a couple of days. And it seems unlikely that infected chicken will find its way to supermarkets.
If the bird flu strikes poultry farms, the farmers will know there is a problem. Before they die, the birds develop major hemorrhages, with blood streaming from their cloacas and beaks. When the flu gets to a poultry farm, farmers have to destroy their flocks, and poultry from infected farms cannot be sold for meat.
As for contact with healthy birds or animals, there is no need to panic. The A(H5N1) virus is a nasty one. If chickens or other animals became infected they would get sick and die, and you would know the virus was present.
But animals can carry many diseases besides influenza, and whenever you are around animals it is a good idea to wash your hands afterward. Because cats in Europe have caught A(H5N1), apparently from eating infected birds, health officials there advise keeping pet cats indoors, but no such recommendation has been made in the United States.
For now, officials at the Centers for Disease Control and Prevention say it is safe to have bird feeders, and they note that even if the virus does arrive here, the kinds of birds that perch at feeders are far less likely to carry A(H5N1) than are aquatic birds like ducks and geese.
Q. Is it safe to buy imported feather pillows, down coats or comforters and clothing or jewelry with feathers?
A. Imported feathers may not be safe. There is a risk to handling products made with feathers from countries with outbreaks of bird flu, according to the Centers for Disease Control and Prevention. Feathers from those countries are banned in the United States unless they have been processed to destroy viruses.
Copyright 2006The New York Times Company Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top
Q&A
How Serious Is the Risk?
By DENISE GRADY and GINA KOLATA
Over the last year, it has been impossible to watch TV or read a newspaper without encountering dire reports about bird flu and the possibility of a pandemic, a worldwide epidemic. First Asia, then Europe, now Africa: like enemy troops moving into place for an attack, the bird flu virus known as A(H5N1) has been steadily advancing. The latest country to report human cases is Azerbaijan, where five of seven people have died. The virus has not reached the Americas, but it seems only a matter of time before it turns up in birds here.
Even so, a human pandemic caused by A(H5N1) is by no means inevitable. Many researchers doubt it will ever happen. The virus does not infect people easily, and those who do contract it almost never spread it to other humans. Bird flu is what the name implies: mostly an avian disease. It has infected tens of millions of birds but fewer than 200 people, and nearly all of them have caught it from birds.
But when A(H5N1) does get into people, it can be deadly. It has killed more than half of its known human victims—an extraordinarily high rate. Equally alarming is that many who died were healthy, not the frail or sickly types of patients usually thought to be at risk of death from influenza.
The apparent lethality of A(H5N1), combined with its inexorable spread, are what have made scientists take it seriously. Concern also heightened with the recent discovery that the 1918 flu pandemic was apparently caused by a bird flu that jumped directly into humans.
In addition, A(H5N1) belongs to a group of influenza viruses known as Type A, which are the only ones that have caused pandemics. All those viruses were originally bird flus. And given the timing of the past pandemics — 1918, 1957, 1968 — some researchers think the world is overdue for another. It could be any Type A, but right now (A)H5N1 is the most obvious.
The virus lacks just one trait that could turn it into a pandemic: transmissibility, the ability to spread easily from person to person. If the virus acquires that ability, a pandemic could erupt.
Everything hangs on transmissibility. But it is impossible to predict whether A(H5N1) will become contagious among people. The virus has been changing genetically, and researchers fear that changes could make it more transmissible, or that A(H5N1) could mix with a human flu virus in a person, swap genetic material and come out contagious.
But most bird flu viruses do not jump species to people. Some experts say that since A(H5N1) has been around for at least 10 years and the shift has not occurred, it is unlikely to happen. Others refuse to take that bet.
The A(H5N1) strains circulating now are quite different from the A(H5N1) strain detected in Hong Kong in 1997, which killed 6 of 18 human victims. Over time, A(H5N1) seems to have developed the ability to infect more and more species of birds, and has found its way into mammals—specifically, cats that have eaten infected birds.
The actual number of human cases may well exceed the number that have been reported, and may include mild cases from which victims recovered without even seeing a doctor. If that is true, the real death rate could be lower. But no one knows whether mild cases occur, or whether some people are immune to the virus and never get sick at all.
In the absence of more information, health officials must act on what they see — an illness that apparently kills half its victims.
Q. How will we know if the virus starts spreading from person to person and becomes a pandemic?
A. If there is a pandemic, it would be everywhere, not in just one city or one country. To detect such an event as early as possible there is an international surveillance system, involving more than 150 countries, that searches for signs that a new flu strain is taking hold in humans. One hallmark of a pandemic flu would be an unusual pattern of illnesses — lots of cases, possibly cases that are more severe than normal and, possibly, flu infections outside the normal flu season.
Ordinary human flu viruses, for reasons that are not entirely understood, circulate only in winter. But pandemics can occur at any time. A pandemic would also involve a flu virus that was new to humans, meaning that no one would have immunity from previous infections.
Q. If bird flu reaches the United States, where is it likely to show up first?
A. Although health officials expect bird flu to reach the United States, it is impossible to predict where it may show up first, in part because there are several routes it could take. If it is carried by migrating birds, then it may appear first in Alaska or elsewhere along the West Coast.
But if the virus lurks in a bird being smuggled into the United States as part of the illegal trade in exotic birds, it could land in any international airport. Bird smuggling is a genuine problem: in 2004, a man was caught at an airport in Belgium illegally transporting eagles from Thailand, stuffed into tubes in his carry-on luggage. The birds turned out to be infected with A(H5N1), and they and several hundred other birds in a quarantine area at the airport had to be destroyed.
In theory, an infected human could also bring bird flu into the United States, and that person could fly into just about any international airport and go unnoticed if the virus had yet to produce any symptoms.
Q. Does bird flu affect all birds?
A. No one knows the full story. Scientists say A(H5N1) is unusual because it can infect and kill a wide variety of birds, unlike a vast majority of bird flus, which are usually found in wild birds, not domestic fowl, and which cause few symptoms.
Some researchers suspect that wild ducks, or perhaps other wild birds, are impervious to A(H5N1), and may be the Typhoid Marys of bird flu — getting the virus, spreading it to other birds but never becoming ill themselves. No one has good evidence of this yet, but that may be because the way scientists discovered A(H5N1) infections was by finding birds that had gotten the flu and died.
As virologists like to point out, dead birds don't fly. So migratory birds cannot spread the virus if they are dying shortly after being infected. That is why some researchers say that if wild birds are spreading the A(H5N1) virus, it must be a bird species that can be infected but does not become ill.
Q. When people die from avian flu contracted from birds, what kills them?
A. Like victims of severe pneumonia, many patients die because their lungs give out. The disease usually starts with a fever, fatigue, headache and aches and pains, like a typical case of the flu. But within a few days it can turn into pneumonia, and the patients' lungs are damaged and fill with fluid.
In a few cases, children infected with A(H5N1) died of encephalitis, apparently because the virus attacked the brain. A number of people have also had severe diarrhea — not usually a flu symptom — meaning that this virus may attack the intestines as well. Studies in cats suggest that in mammals the virus attacks other organs, too, including the heart, liver and adrenal glands.
But more detailed information about deaths in people is not available because very few autopsies have been done. In some countries, like Vietnam, where many of the deaths occurred, autopsies are frowned upon. Researchers say they may glean useful information from autopsies, but fear that pressing for them would alienate the public in some areas.
Q. When experts refer to bird flu as A(H5N1), what does that mean?
Click here to see the answer.
Q. If I got bird flu, how would I know?
A. There is no reason to suspect the disease unless you may have been exposed to it. Since the virus has not reached North America, doctors do not look for bird flu in people unless they have traveled to affected regions or have been exposed to sick or dead birds.
The early stages of the illness in people are the same as those of ordinary flu: fever, headache, fatigue, aches and pains. But within a few days, people with bird flu often start getting worse instead of better; difficulty breathing is what takes many to the hospital.
In any case, patients with flulike symptoms that turn severe or involve breathing trouble are in urgent need of medical care.
Q. Can I be tested for avian flu?
A. There is no rapid test for bird flu. There is a rapid test for Type A influenza viruses, the group that A(H5N1) belongs to, but the test is only moderately reliable, and it is not specific for A(H5N1).
State health departments and some research laboratories can perform genetic testing for A(H5N1) and give results within a few hours, but they do not have the capacity to perform widespread testing.
Because of the limited availability of testing and the extremely low probability of A(H5N1) in people in the United States, the test is recommended only for patients strongly suspected of having bird flu, like travelers with flulike symptoms who were exposed to infected birds.
Q. Do any medicines treat or prevent bird flu?
A. Two prescription drugs, Tamiflu and Relenza, may reduce the severity of the disease if they are taken within a day or two after the symptoms begin. But Relenza, a powder that must be inhaled, can irritate the lungs and is not recommended for people with asthma or other chronic lung diseases.
Both drugs work by blocking an enzyme — neuraminidase, the "N" part of A(H5N1) — that the virus needs to escape from one cell to infect another. But just how effective these medicines are against A(H5N1) is not known, nor is it clear whether the usual doses are enough. Also unknown is whether the drugs will help if taken later in the course of the disease. Although government laboratories and other research groups are trying to develop vaccines to prevent A(H5N1) disease in people, none are available yet.
Q. If there is an epidemic of flu in humans, how can I protect myself?
A. If there is a vaccine available, that would be the best option. But if there is no vaccine it may be hard to avoid being infected. Flu pandemics spread quickly, even to isolated regions. The 1918 flu reached Alaskan villages where the only way visitors could arrive was by dog sled.
The vaccines produced every year to prevent seasonal flu are unlikely to be of any use in warding off a pandemic strain. But a flu shot could provide at least some peace of mind, by preventing the false alarm that could come from catching a case of garden-variety flu.
Similarly, people over 65 and others with chronic health problems should consult their doctors about whether they should be vaccinated against pneumococcal pneumonia, a dangerous illness that can set in on top of the flu. Again, that vaccine will not stop bird flu, but it may prevent complications.
Some health officials have recommended stockpiling two to three months’ worth of food, fuel and water in case a pandemic interferes with food distribution or staffing levels at public utilities, or people are advised to stay home.
Many health experts have advised against stockpiling Tamiflu or Relenza, the prescription-only antiviral drugs that may work against bird flu. Doctors say the drugs are in short supply and hoarding may keep them out of reach of people who genuinely need them.
Also, they say, self-prescribing may lead to waste of the drugs or misuses that spur the growth of drug-resistant viruses. But people may not trust the government to distribute these drugs, and may want their own supplies. Doctors say people can take precautions like avoiding crowds, washing their hands frequently and staying away from those who are sick. Masks may help, but only if they are a type called N-95, which has to be carefully fitted. So far, masks and gloves have been recommended only for people taking care of sick patients.
Avoiding the flu can be hard because it is not always possible to spot carriers. Many people get and spread flu viruses and but never know they are infected.
Q. Is the government prepared for a bird flu pandemic?
A. No. The nation does not have an approved flu vaccine for people or enough antiviral drugs or respirators for all who would need them. The best protection in any flu pandemic will come from a vaccine, but scientists cannot tell ahead of time what strain the vaccine should protect against.
Efforts are under way to make a vaccine for A(H5N1). But the virus could mutate in a way that makes experimental vaccines ineffective, requiring more than one vaccine.
Moreover, there is no assurance that the next pandemic will even involve A(H5N1). It may involve a different strain of bird flu, and an A(H5N1) vaccine would not work for it. Recent efforts to develop a sort of universal flu vaccine that would work across strains have failed.
For now, the hope is to spot a pandemic early and quickly make a vaccine. Investigators are developing new and better ways to make vaccines — a bird flu, for example, cannot be grown in fertilized eggs like other flu viruses because it kills the chicken embryos — but these new methods must first be approved by the Food and Drug Administration.
Preparations also include government plans to stockpile drugs to protect people who were exposed to the flu and to reduce the severity of the disease in those who are ill. But the one antiviral drug that everyone wants to buy and stockpile, Oseltamivir, also sold by Roche as Tamiflu, is in short supply.
In retrospect, scientists say, maybe the nation should have started preparing sooner. But until the current bird flu appeared, there was little interest in such expensive and extensive preparations.
Graphic: Stockpiling Drugs
Q. If bird flu reaches the United States, will it be safe to eat poultry or to be around birds or other animals?
A. Poultry is safe to eat when it is cooked thoroughly, meaning that the meat is no longer pink and has reached a temperature of 180 degrees Fahrenheit. The risk is not from cooked meat — cooking kills viruses. Instead, it is from infected birds that are still alive or have recently died. So the person who killed an infected chicken, butchered it or put it in the pot would be at greater risk than the one who ate it.
It's not clear how long the virus lives on a dead bird, but it is unlikely to survive more than a couple of days. And it seems unlikely that infected chicken will find its way to supermarkets.
If the bird flu strikes poultry farms, the farmers will know there is a problem. Before they die, the birds develop major hemorrhages, with blood streaming from their cloacas and beaks. When the flu gets to a poultry farm, farmers have to destroy their flocks, and poulgreater risk than the one who ate it.
It's not clear how long the virus lives on a dead bird, but it is unlikely to survive more than a couple of days. And it seems unlikely that infected chicken will find its way to supermarkets.
If the bird flu strikes poultry farms, the farmers will know there is a problem. Before they die, the birds develop major hemorrhages, with blood streaming from their cloacas and beaks. When the flu gets to a poultry farm, farmers have to destroy their flocks, and poultry from infected farms cannot be sold for meat.
As for contact with healthy birds or animals, there is no need to panic. The A(H5N1) virus is a nasty one. If chickens or other animals became infected they would get sick and die, and you would know the virus was present.
But animals can carry many diseases besides influenza, and whenever you are around animals it is a good idea to wash your hands afterward. Because cats in Europe have caught A(H5N1), apparently from eating infected birds, health officials there advise keeping pet cats indoors, but no such recommendation has been made in the United States.
For now, officials at the Centers for Disease Control and Prevention say it is safe to have bird feeders, and they note that even if the virus does arrive here, the kinds of birds that perch at feeders are far less likely to carry A(H5N1) than are aquatic birds like ducks and geese.
Q. Is it safe to buy imported feather pillows, down coats or comforters and clothing or jewelry with feathers?
A. Imported feathers may not be safe. There is a risk to handling products made with feathers from countries with outbreaks of bird flu, according to the Centers for Disease Control and Prevention. Feathers from those countries are banned in the United States unless they have been processed to destroy viruses.
Copyright 2006The New York Times Company Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top
March 28, 2006
Making a Ferret Sneeze for Hints to the Transmission of Bird Flu
By DENISE GRADY
ATLANTA — One way to collect nasal secretions from a ferret is to anesthetize it, hold a petri dish under its snout and squirt a little salt water up its nose so that it will sneeze into the dish.
At the Centers for Disease Control and Prevention, ferret sneezes are frozen in tiny vials and locked up in a high-security chamber called an enhanced biosafety Level 3 laboratory. It takes a fingerprint scan to get in, and an iris scan to open the freezer. Scientists wear scrub suits, gowns, double gloves and hoods, breathe filtered air and open vials only by reaching into a safety cabinet designed to keep germs from escaping into the air.
The vials are in this lab because the animals have been exposed to A(H5N1), the notorious avian flu virus that has swept across Asia, Europe and Africa, wiping out flocks of poultry and sometimes killing people as well. Researchers at the disease centers and in other labs are studying the transmission and virulence of bird flu in ferrets and mice, trying to answer questions that take on more urgency as the virus advances.
"We have never had a situation like the world is experiencing today, such an unprecedented spread among poultry," said Dr. Timothy Uyeki, an epidemiologist and influenza expert at the disease centers. "The geographic spread is unprecedented, and the mortality unprecedented as well, and this virus has been clearly confirmed to transmit directly from poultry to people and to cause severe and fatal illness."
The big question is, will A(H5N1) cause a human pandemic? Many scientists think the world is overdue for one and find it worrisome that this dangerous virus has popped up now. Even so, in its present form this flu does not seem to be a pandemic germ because it does not spread easily from birds to humans, and because infected people rarely transmit it to others. But everything could change if the virus were to mutate in a way that made it easier for people to catch and spread.
"Why would a particular virus be transmitted easily human to human, and another not?" asked Dr. Peter Palese, chairman of microbiology at the Mount Sinai School of Medicine in New York. "Even though I am 35 years in this field, we do not have molecular parameters or signatures which make that clear, although many groups, including my own, are working on this exact question."
The virus is a moving target, and two distinct subsets of it have developed, one from Vietnam and one from Indonesia, that differ enough to make scientists think separate vaccines will be needed. Scientists are trying to understand how a virus can be wildly contagious among birds but almost impossible to spread in mammals — and what type of mutation could change that. They are also comparing different strains of A(H5N1) to see if it is becoming more virulent, and they are examining the structure of the virus in hopes of figuring out what makes it so deadly.
Ferrets are used for some studies because, unlike mice, they easily catch human flu viruses and get sick, and so are considered a better model for people. At the disease centers, Taronna Maines and Terrence Tumpey have infected ferrets with A(H5N1) and then monitored them to see if the severity of the disease varies by strain and by dose, and to see if the infected animals cough up the virus or sneeze it out and spread it to healthy ones.
It turns out that ferrets do not transmit the disease easily, though some healthy animals develop antibodies to the virus, indicating that they have been exposed. If a strain comes along that is contagious in ferrets, it might be bad news for people.
Research like this may help determine whether (A)H5N1 is heading down the path to becoming a pandemic strain, and may also help to guide the development of vaccines and drugs.
Aside from the virus's recent horrible track record, several other things about it can help explain why some scientists worry that it has pandemic potential. The A means it belongs to a larger group known as Type A influenza viruses, which cause many of the human flu epidemics that occur every winter. But more ominously, Type A also includes the only viruses ever known to have caused human pandemics, in 1918, 1957 and 1968.
Flu viruses mutate a lot, and pandemics occur when a Type A virus undergoes a big genetic change to produce a new type of virus to which people have little or no resistance. Sometimes the change occurs when a person or a pig acts as a "mixing vessel" for two flu viruses — maybe a human one and a bird one — which swap genes to produce a new virus. That kind of change is believed to have caused the 1957 and 1968 pandemics. But the 1918 pandemic, the worst by far, is thought to have occurred without a gene swap, when a bird flu somehow mutated enough to jump into humans.
All Type A viruses are found in birds. They probably originated in wild birds and usually do them little or no harm. Only a few evolved into strains that could easily infect people. A(H5N1) is not adapted to people, and researchers suspect that human victims so far may have been infected because they were exposed to enormous amounts of the virus from birds.
The letters H and N stand for two proteins on the outside of all Type A viruses. The H, hemagglutinin, helps the virus get into cells, which it must do to reproduce. The N, neuraminidase, helps it get back out to infect more cells. There are 16 kinds of H and 9 kinds of N; they mix and match, and so can produce 144 possible Type A strains. The worrisome thing about H5 is that H5 viruses are avian flus and have not been known to cause human epidemics, so many people may have little or no resistance to them.
Not long ago, A(H5N1) may well have been what scientists call a perfect parasite, meaning one that does little harm to its host, Dr. Ruben Donis, a flu expert at the disease centers. said. Some wild ducks seem to carry it without getting sick at all, so scientists think that ducks were probably its original host and that the two evolved together into a peaceful coexistence: the virus did not hurt the duck, and the duck's immune system ignored the virus. Thriving in the bird's intestines, the virus multiplied rapidly and was spread far and wide by droppings. Other aquatic birds may have adapted in a similar way.
Not so for chickens or other domestic fowl: A(H5N1) attacks their lungs and other organs, and it quickly kills them. But the chicken's immune system tries to fight back, and that battle may alter the virus. The bird may fight off some viruses, ones with certain mutations. Other viruses survive, multiply and become more common. And since they have beaten out the chicken's immune system, they may also be nastier.
It is just a theory, but some scientists suspect that its forays into huge poultry flocks may have brought out more virulent forms of A(H5N1), which may explain why the virus now seems to be killing off more wild birds than in the past. At the same time, the virus has begun to invade more species, including mammals — infected cats, pigs and dogs have been reported. Researchers consider that a bad sign.
"The more opportunities this virus has to mutate during replication in a mammalian host, the more likely it is to mutate," said Dr. Nancy Cox, director of the influenza branch at the disease centers.
In the laboratory, Dr. Maines and Dr. Tumpey have found that the virus seems to have become more virulent over time. With some strains, an unbelievably small amount of virus will kill a mouse, Dr. Tumpey said. Last September, in the Journal of Virology, they reported that viruses from people infected in 2003 and 2004 were more deadly in mice and ferrets than were samples taken from 1997 victims. But there is not enough information about the human cases to tell whether the disease in people has gotten more severe.
Recent studies by several research teams have focused on hemagglutinin. The virus can attach only to cells that have the right receptors — compatible molecules on their surfaces. Many scientists think hemagglutinin, and mutations that change its structure, may control where the virus can go and what it can do. For instance, hemagglutinin may determine which species the virus can infect and which tissues it can invade.
The more organs and tissues a virus can attack, the more likely it is to cause severe disease. Scientists are especially interested in a part of the hemagglutinin that sets A(H5N1) apart from many other bird flu viruses by enabling it, in some species at least, to latch onto many types of cells and thus to cause systemic disease.
Studies published recently in Science and Nature by two research groups suggested that one reason A(H5N1) is not transmissible among people is that the virus can latch on only to cells deep in the respiratory tract, too far down to be coughed up or sneezed out to infect other people. They discovered that only the deeper cells had the right type of receptors.
But if the virus were to mutate so that it could connect with cells higher in the respiratory tract, then it might become transmissible. Several mutations would be needed, and virologists disagree about whether they are likely to occur.
Another major unanswered question concerns how severe bird flu really is in people. Based on cases in hospitals, it looks like a horrific disease with a 50 percent death rate.
But what if some people get infected and recover without seeing a doctor, or never get sick at all, and so are not counted? Then, the death rate would be lower.
A study published in January in The Archives of Internal Medicine suggests that there may be mild, unreported bird flu cases. Over a three-month period in 2004, researchers studied 45,478 residents in a rural district in Vietnam that had A(H5N1) outbreaks to find out how many had contact with sick birds and how many had flulike illnesses.
They found that statistically, those exposed to sick birds were most likely to have gotten sick, and of 8,149 who had a flulike illness, 650 to 750 probably caught it from birds. The study was not conclusive because the researchers did not test their subjects to find out for sure whether they had A(H5N1).
But if human cases are more common than previously thought, it could be both good news and bad news: good if not everyone becomes deathly ill, but not good if more people are infected and might act as the dreaded "mixing vessels" that could let A(H5N1) trade genes with an ordinary human flu virus and produce a new, highly contagious strain that could turn into a pandemic.
"The viruses are changing, and in ways of concern to me and other scientists," Dr. Cox said.
She said scientists had a unique window of opportunity now, in which they could see the disease in both birds and people and try to stop it or at least slow it down.
"Could we quench an incipient pandemic?" Dr. Cox asked. "I don't know, but we could try."
Copyright 2006The New York Times Company Home Privacy Policy Search Corrections XML Help Contact Us Work for Us Site Map Back to Top
Making a Ferret Sneeze for Hints to the Transmission of Bird Flu
By DENISE GRADY
ATLANTA — One way to collect nasal secretions from a ferret is to anesthetize it, hold a petri dish under its snout and squirt a little salt water up its nose so that it will sneeze into the dish.
At the Centers for Disease Control and Prevention, ferret sneezes are frozen in tiny vials and locked up in a high-security chamber called an enhanced biosafety Level 3 laboratory. It takes a fingerprint scan to get in, and an iris scan to open the freezer. Scientists wear scrub suits, gowns, double gloves and hoods, breathe filtered air and open vials only by reaching into a safety cabinet designed to keep germs from escaping into the air.
The vials are in this lab because the animals have been exposed to A(H5N1), the notorious avian flu virus that has swept across Asia, Europe and Africa, wiping out flocks of poultry and sometimes killing people as well. Researchers at the disease centers and in other labs are studying the transmission and virulence of bird flu in ferrets and mice, trying to answer questions that take on more urgency as the virus advances.
"We have never had a situation like the world is experiencing today, such an unprecedented spread among poultry," said Dr. Timothy Uyeki, an epidemiologist and influenza expert at the disease centers. "The geographic spread is unprecedented, and the mortality unprecedented as well, and this virus has been clearly confirmed to transmit directly from poultry to people and to cause severe and fatal illness."
The big question is, will A(H5N1) cause a human pandemic? Many scientists think the world is overdue for one and find it worrisome that this dangerous virus has popped up now. Even so, in its present form this flu does not seem to be a pandemic germ because it does not spread easily from birds to humans, and because infected people rarely transmit it to others. But everything could change if the virus were to mutate in a way that made it easier for people to catch and spread.
"Why would a particular virus be transmitted easily human to human, and another not?" asked Dr. Peter Palese, chairman of microbiology at the Mount Sinai School of Medicine in New York. "Even though I am 35 years in this field, we do not have molecular parameters or signatures which make that clear, although many groups, including my own, are working on this exact question."
The virus is a moving target, and two distinct subsets of it have developed, one from Vietnam and one from Indonesia, that differ enough to make scientists think separate vaccines will be needed. Scientists are trying to understand how a virus can be wildly contagious among birds but almost impossible to spread in mammals — and what type of mutation could change that. They are also comparing different strains of A(H5N1) to see if it is becoming more virulent, and they are examining the structure of the virus in hopes of figuring out what makes it so deadly.
Ferrets are used for some studies because, unlike mice, they easily catch human flu viruses and get sick, and so are considered a better model for people. At the disease centers, Taronna Maines and Terrence Tumpey have infected ferrets with A(H5N1) and then monitored them to see if the severity of the disease varies by strain and by dose, and to see if the infected animals cough up the virus or sneeze it out and spread it to healthy ones.
It turns out that ferrets do not transmit the disease easily, though some healthy animals develop antibodies to the virus, indicating that they have been exposed. If a strain comes along that is contagious in ferrets, it might be bad news for people.
Research like this may help determine whether (A)H5N1 is heading down the path to becoming a pandemic strain, and may also help to guide the development of vaccines and drugs.
Aside from the virus's recent horrible track record, several other things about it can help explain why some scientists worry that it has pandemic potential. The A means it belongs to a larger group known as Type A influenza viruses, which cause many of the human flu epidemics that occur every winter. But more ominously, Type A also includes the only viruses ever known to have caused human pandemics, in 1918, 1957 and 1968.
Flu viruses mutate a lot, and pandemics occur when a Type A virus undergoes a big genetic change to produce a new type of virus to which people have little or no resistance. Sometimes the change occurs when a person or a pig acts as a "mixing vessel" for two flu viruses — maybe a human one and a bird one — which swap genes to produce a new virus. That kind of change is believed to have caused the 1957 and 1968 pandemics. But the 1918 pandemic, the worst by far, is thought to have occurred without a gene swap, when a bird flu somehow mutated enough to jump into humans.
All Type A viruses are found in birds. They probably originated in wild birds and usually do them little or no harm. Only a few evolved into strains that could easily infect people. A(H5N1) is not adapted to people, and researchers suspect that human victims so far may have been infected because they were exposed to enormous amounts of the virus from birds.
The letters H and N stand for two proteins on the outside of all Type A viruses. The H, hemagglutinin, helps the virus get into cells, which it must do to reproduce. The N, neuraminidase, helps it get back out to infect more cells. There are 16 kinds of H and 9 kinds of N; they mix and match, and so can produce 144 possible Type A strains. The worrisome thing about H5 is that H5 viruses are avian flus and have not been known to cause human epidemics, so many people may have little or no resistance to them.
Not long ago, A(H5N1) may well have been what scientists call a perfect parasite, meaning one that does little harm to its host, Dr. Ruben Donis, a flu expert at the disease centers. said. Some wild ducks seem to carry it without getting sick at all, so scientists think that ducks were probably its original host and that the two evolved together into a peaceful coexistence: the virus did not hurt the duck, and the duck's immune system ignored the virus. Thriving in the bird's intestines, the virus multiplied rapidly and was spread far and wide by droppings. Other aquatic birds may have adapted in a similar way.
Not so for chickens or other domestic fowl: A(H5N1) attacks their lungs and other organs, and it quickly kills them. But the chicken's immune system tries to fight back, and that battle may alter the virus. The bird may fight off some viruses, ones with certain mutations. Other viruses survive, multiply and become more common. And since they have beaten out the chicken's immune system, they may also be nastier.
It is just a theory, but some scientists suspect that its forays into huge poultry flocks may have brought out more virulent forms of A(H5N1), which may explain why the virus now seems to be killing off more wild birds than in the past. At the same time, the virus has begun to invade more species, including mammals — infected cats, pigs and dogs have been reported. Researchers consider that a bad sign.
"The more opportunities this virus has to mutate during replication in a mammalian host, the more likely it is to mutate," said Dr. Nancy Cox, director of the influenza branch at the disease centers.
In the laboratory, Dr. Maines and Dr. Tumpey have found that the virus seems to have become more virulent over time. With some strains, an unbelievably small amount of virus will kill a mouse, Dr. Tumpey said. Last September, in the Journal of Virology, they reported that viruses from people infected in 2003 and 2004 were more deadly in mice and ferrets than were samples taken from 1997 victims. But there is not enough information about the human cases to tell whether the disease in people has gotten more severe.
Recent studies by several research teams have focused on hemagglutinin. The virus can attach only to cells that have the right receptors — compatible molecules on their surfaces. Many scientists think hemagglutinin, and mutations that change its structure, may control where the virus can go and what it can do. For instance, hemagglutinin may determine which species the virus can infect and which tissues it can invade.
The more organs and tissues a virus can attack, the more likely it is to cause severe disease. Scientists are especially interested in a part of the hemagglutinin that sets A(H5N1) apart from many other bird flu viruses by enabling it, in some species at least, to latch onto many types of cells and thus to cause systemic disease.
Studies published recently in Science and Nature by two research groups suggested that one reason A(H5N1) is not transmissible among people is that the virus can latch on only to cells deep in the respiratory tract, too far down to be coughed up or sneezed out to infect other people. They discovered that only the deeper cells had the right type of receptors.
But if the virus were to mutate so that it could connect with cells higher in the respiratory tract, then it might become transmissible. Several mutations would be needed, and virologists disagree about whether they are likely to occur.
Another major unanswered question concerns how severe bird flu really is in people. Based on cases in hospitals, it looks like a horrific disease with a 50 percent death rate.
But what if some people get infected and recover without seeing a doctor, or never get sick at all, and so are not counted? Then, the death rate would be lower.
A study published in January in The Archives of Internal Medicine suggests that there may be mild, unreported bird flu cases. Over a three-month period in 2004, researchers studied 45,478 residents in a rural district in Vietnam that had A(H5N1) outbreaks to find out how many had contact with sick birds and how many had flulike illnesses.
They found that statistically, those exposed to sick birds were most likely to have gotten sick, and of 8,149 who had a flulike illness, 650 to 750 probably caught it from birds. The study was not conclusive because the researchers did not test their subjects to find out for sure whether they had A(H5N1).
But if human cases are more common than previously thought, it could be both good news and bad news: good if not everyone becomes deathly ill, but not good if more people are infected and might act as the dreaded "mixing vessels" that could let A(H5N1) trade genes with an ordinary human flu virus and produce a new, highly contagious strain that could turn into a pandemic.
"The viruses are changing, and in ways of concern to me and other scientists," Dr. Cox said.
She said scientists had a unique window of opportunity now, in which they could see the disease in both birds and people and try to stop it or at least slow it down.
"Could we quench an incipient pandemic?" Dr. Cox asked. "I don't know, but we could try."
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Diabetes limb loss 'unnecessary' BBC NEWS
People with diabetes are having to have unnecessary lower limb amputations, a study has suggested. Diabetes can lead to amputation because of damage to the nerves and blood vessels that serve the limbs. People with diabetes are 15 times more at risk of lower limb amputation than people without the condition. A study by Wolverhampton-based researchers showed too few were getting the right foot care, leading to the unnecessary limb loss. Diabetes is the UK's second most common cause of lower limb amputation. Data published by Diabetes UK shows up to 70% of people die within five years of having an amputation.
Lack of education
Research presented at the Diabetes UK Annual Professional Conference in Birmingham looked at the care of people with diabetes prior to amputation. A survey of 30 people with diabetes, aged between 60 and 80, who had had amputations, found 90% had been considered high risk in the period leading up to the procedure. A history of ulcers, nerve damage, circulation problems and foot deformities can all put people at high risk of amputation. But more than a quarter of those thought to be at high risk of amputation are not being offered any kind of specialist care, the Wolverhampton study suggested. And two in five are not being educated on how to prevent and treat infections which can lead to amputation. Over a third did not have any kind of diabetes review to assess how they managed their condition and to ensure they did not develop any other complications prior to amputation becoming a risk.
Foot checks
Dr Baldev Singh, who carried out the research, said, "This research clearly shows that care for high-risk patients is inadequate. "Mandatory foot care plans should be put in place to ensure that all people get the right care and education." Douglas Smallwood, chief executive at Diabetes UK said: "It is shocking that some people with diabetes are getting sub-standard specialist foot care, or even none at all, if they are at high risk of amputation. "We know that the rate of amputation may be reduced by 40% or more through effective care. "All people with diabetes should receive at least a yearly foot check. "Those who have problems need to be provided with a foot care plan which incorporates specialist care and education on what to look out for and how to avoid infections."
People with diabetes are having to have unnecessary lower limb amputations, a study has suggested. Diabetes can lead to amputation because of damage to the nerves and blood vessels that serve the limbs. People with diabetes are 15 times more at risk of lower limb amputation than people without the condition. A study by Wolverhampton-based researchers showed too few were getting the right foot care, leading to the unnecessary limb loss. Diabetes is the UK's second most common cause of lower limb amputation. Data published by Diabetes UK shows up to 70% of people die within five years of having an amputation.
Lack of education
Research presented at the Diabetes UK Annual Professional Conference in Birmingham looked at the care of people with diabetes prior to amputation. A survey of 30 people with diabetes, aged between 60 and 80, who had had amputations, found 90% had been considered high risk in the period leading up to the procedure. A history of ulcers, nerve damage, circulation problems and foot deformities can all put people at high risk of amputation. But more than a quarter of those thought to be at high risk of amputation are not being offered any kind of specialist care, the Wolverhampton study suggested. And two in five are not being educated on how to prevent and treat infections which can lead to amputation. Over a third did not have any kind of diabetes review to assess how they managed their condition and to ensure they did not develop any other complications prior to amputation becoming a risk.
Foot checks
Dr Baldev Singh, who carried out the research, said, "This research clearly shows that care for high-risk patients is inadequate. "Mandatory foot care plans should be put in place to ensure that all people get the right care and education." Douglas Smallwood, chief executive at Diabetes UK said: "It is shocking that some people with diabetes are getting sub-standard specialist foot care, or even none at all, if they are at high risk of amputation. "We know that the rate of amputation may be reduced by 40% or more through effective care. "All people with diabetes should receive at least a yearly foot check. "Those who have problems need to be provided with a foot care plan which incorporates specialist care and education on what to look out for and how to avoid infections."
Bird flu case hits Czech Republic BBC NEWS
The authorities in the Czech Republic have confirmed their first case of the H5N1 bird flu virus. Preliminary tests on a dead swan found last week 130km (80 miles) south of Prague show the bird had the strain, which can be lethal to humans. Further tests are being carried out at the EU reference laboratory in the UK. The European Commission has proposed additional aid to farmers in member states hit by a drop in egg and poultry consumption due to bird flu outbreaks. Thirteen EU countries have now confirmed outbreaks of bird flu, which has killed more than 100 people in Asia since 2003. "A definitive confirmation of the highly-pathogenic type... can be expected from the EU reference laboratory in Weybridge in Great Britain in the middle of next week," the Czech agriculture ministry said in a statement. Spokesman Tomas Loskot said another dead swan had tested positive for the H5 virus and would be tested for the H5N1 strain. The Czech authorities have implemented safety measures in accordance with EU rules - including a protection area around the site on the Vltava river where the swan was found.
Compensation
The European Commission has put forward proposals to help those affected by the crisis. It says that consumption of poultry and eggs has fallen dramatically in some member states, leading to a sharp reduction in prices. Current rules only allow the EU to offer compensation to farms directly hit by bird flu or to those prevented from moving stock because of restrictions. The regulations do not take into account problems of falling sales due to lack in consumer confidence. But the commission says the EU should now help to fund half the cost of programmes undertaken by member states to restore confidence in the sector. "This unprecedented situation can no longer be dealt with using the existing tools," said EU Agriculture Commissioner Mariann Fischer Boel. "Each member state will then be able to design the measures best suited to its particular situation." The proposal will be sent to the European Parliament and the EU Council of Ministers for adoption by the end of April. The H5N1 virus can be caught by humans who handle infected birds, but it is not yet known to have passed from one person to another. However, experts fear the virus could mutate to gain this ability and in its new form trigger a flu pandemic that could kill millions.
The authorities in the Czech Republic have confirmed their first case of the H5N1 bird flu virus. Preliminary tests on a dead swan found last week 130km (80 miles) south of Prague show the bird had the strain, which can be lethal to humans. Further tests are being carried out at the EU reference laboratory in the UK. The European Commission has proposed additional aid to farmers in member states hit by a drop in egg and poultry consumption due to bird flu outbreaks. Thirteen EU countries have now confirmed outbreaks of bird flu, which has killed more than 100 people in Asia since 2003. "A definitive confirmation of the highly-pathogenic type... can be expected from the EU reference laboratory in Weybridge in Great Britain in the middle of next week," the Czech agriculture ministry said in a statement. Spokesman Tomas Loskot said another dead swan had tested positive for the H5 virus and would be tested for the H5N1 strain. The Czech authorities have implemented safety measures in accordance with EU rules - including a protection area around the site on the Vltava river where the swan was found.
Compensation
The European Commission has put forward proposals to help those affected by the crisis. It says that consumption of poultry and eggs has fallen dramatically in some member states, leading to a sharp reduction in prices. Current rules only allow the EU to offer compensation to farms directly hit by bird flu or to those prevented from moving stock because of restrictions. The regulations do not take into account problems of falling sales due to lack in consumer confidence. But the commission says the EU should now help to fund half the cost of programmes undertaken by member states to restore confidence in the sector. "This unprecedented situation can no longer be dealt with using the existing tools," said EU Agriculture Commissioner Mariann Fischer Boel. "Each member state will then be able to design the measures best suited to its particular situation." The proposal will be sent to the European Parliament and the EU Council of Ministers for adoption by the end of April. The H5N1 virus can be caught by humans who handle infected birds, but it is not yet known to have passed from one person to another. However, experts fear the virus could mutate to gain this ability and in its new form trigger a flu pandemic that could kill millions.
New Orleans Health Care Still in Shambles Yahoo! NEWS
The city of New Orleans has only 456 staffed hospital beds, compared with 2,269 before the city was struck by Hurricane Katrina, according to government auditors who say rebuilding the health care system will be vital for bringing people back. While emergency care is available, auditors noted that patients at two hospitals waited up to two hours to be unloaded from ambulances. They also found patients being kept and treated in the emergency room because beds weren't available elsewhere. The Government Accountability Office said several planning efforts are under way about how to rebuild that system, but no clear consensus has emerged. The lack of clarity stems in part from the uncertain estimates of how many people plan to return. The latest estimates put the city's population at about one-third of the 485,000 people who lived there before Katrina hit. Democrats who requested the study said the findings show the Bush administration must be more aggressive in leading the rebuilding efforts. "It is unacceptable that six months after Hurricane Katrina, people are still receiving health care services in mobile tents and old department stores," said Rep. John Dingell, D-Mich., taking aim at Health and Human Services Secretary Mike Leavitt. "Exactly how does the secretary expect the Gulf Coast region to prepare for a potential flu pandemic or the next hurricane season given the current state of their health care system?" Leavitt spokeswoman Christina Pearson said the secretary has met regularly with state officials to hear how they would like to see the health care system improved, and he sees opportunities to make the system better than it was before the hurricane struck, particularly through the use of health information technology. She did not have a timetable for when those improvements would be proposed. The GAO report said that when auditors visited New Orleans, they found primary and emergency health care was available, but access to specialty care was quite limited. The report also noted that the federal government's estimate of repair costs for two major hospitals run by Louisiana State University — Charity Hospital and University Hospital — amounts to about $36 million. But a private consultant estimated it would cost more than $360 million to repair both hospitals — aging facilities LSU had wanted to replace before the storm. The city also relied on a network of clinics to treat poor patients before the hurricane, but more than three quarters of those clinics are closed. About 19 clinics are open now, but they generally operate at less than half of capacity.
On the Net: Government Accountability Office report: http://www.gao.gov/new.items/d06576r.pdf
By KEVIN FREKING, Associated Press Writer
The city of New Orleans has only 456 staffed hospital beds, compared with 2,269 before the city was struck by Hurricane Katrina, according to government auditors who say rebuilding the health care system will be vital for bringing people back. While emergency care is available, auditors noted that patients at two hospitals waited up to two hours to be unloaded from ambulances. They also found patients being kept and treated in the emergency room because beds weren't available elsewhere. The Government Accountability Office said several planning efforts are under way about how to rebuild that system, but no clear consensus has emerged. The lack of clarity stems in part from the uncertain estimates of how many people plan to return. The latest estimates put the city's population at about one-third of the 485,000 people who lived there before Katrina hit. Democrats who requested the study said the findings show the Bush administration must be more aggressive in leading the rebuilding efforts. "It is unacceptable that six months after Hurricane Katrina, people are still receiving health care services in mobile tents and old department stores," said Rep. John Dingell, D-Mich., taking aim at Health and Human Services Secretary Mike Leavitt. "Exactly how does the secretary expect the Gulf Coast region to prepare for a potential flu pandemic or the next hurricane season given the current state of their health care system?" Leavitt spokeswoman Christina Pearson said the secretary has met regularly with state officials to hear how they would like to see the health care system improved, and he sees opportunities to make the system better than it was before the hurricane struck, particularly through the use of health information technology. She did not have a timetable for when those improvements would be proposed. The GAO report said that when auditors visited New Orleans, they found primary and emergency health care was available, but access to specialty care was quite limited. The report also noted that the federal government's estimate of repair costs for two major hospitals run by Louisiana State University — Charity Hospital and University Hospital — amounts to about $36 million. But a private consultant estimated it would cost more than $360 million to repair both hospitals — aging facilities LSU had wanted to replace before the storm. The city also relied on a network of clinics to treat poor patients before the hurricane, but more than three quarters of those clinics are closed. About 19 clinics are open now, but they generally operate at less than half of capacity.
On the Net: Government Accountability Office report: http://www.gao.gov/new.items/d06576r.pdf
By KEVIN FREKING, Associated Press Writer
Baby breathing aid study cleared BBC NEWS
A way to help premature babies breathe does not cause long-term harm as previously feared, a study has shown. Nottingham researchers, unconnected to the original trial in the early 1990s, assessed CNEP therapy - continuous negative-extrathoracic pressure. It was pioneered by controversial Stoke-based paediatrician Professor David Southall. The study appears in the Lancet, where child health experts say Professor Southall's work has been vindicated.
Concerns
The Nottingham researchers followed up 133 of the 205 children still alive - now aged between nine and 15 - who were involved in the original CNEP study.
Protection
Concerns over the CNEP treatment led one couple whose daughter died after the trial to take action against the doctors who treated her. Carl and Debbie Henshall, of Clayton in Staffordshire, recently won an Appeal Court hearing which said the GMC should review its decision to reject their complaints that doctors did not give properly informed consent to medics for their girls to take part. The CNEP trial has also been investigated by the hospital twice and been the subject of police inquiries. The government also ordered a public inquiry into the trial. But the author of that 2000 report - which was critical of the study - said it would have been less negative if he had had access to fuller information. None of the investigations has supported parents' claims they were misled and consent forms forged. In a commentary piece in this week's Lancet, Professor Southall and Dr Martin Samuels, who also led the original CNEP study, welcomed the latest findings.
Progress fears
They added: "We fear that over the last six years many infants with bronchiolitis [a potentially fatal chest infection] presenting to our children's unit have received unnecessarily intensive care." Professor Sir Alan Craft, President of the Royal College of Paediatrics and Child Health, and Dr Neil McIntosh from the University of Edinburgh Department of Child Life and Health supported Professor Southall's work. They said CNEP should probably be retained for older children with bronchiolitis because other techniques have been developed since the original trial to help other babies. They added: "We must protect patients, but we must also find better ways to protect professionals. "If we do not, medical progress will cease, particularly in controversial and distressing areas." The Department of Health said it would look at the findings of the study with interest. Professor Southall was found guilty of serious professional misconduct by the General Medical Council last year, over a matter not related to the CNEP trial. He had suggested the husband of solicitor Sally Clark, who was wrongly convicted of murdering her two sons, was responsible for the babies' deaths, after watching a TV documentary. The GMC said he could continue to practise, but he could not work in child protection.
A way to help premature babies breathe does not cause long-term harm as previously feared, a study has shown. Nottingham researchers, unconnected to the original trial in the early 1990s, assessed CNEP therapy - continuous negative-extrathoracic pressure. It was pioneered by controversial Stoke-based paediatrician Professor David Southall. The study appears in the Lancet, where child health experts say Professor Southall's work has been vindicated.
Concerns
The Nottingham researchers followed up 133 of the 205 children still alive - now aged between nine and 15 - who were involved in the original CNEP study.
QUOTE("Professor Sir Alan Craft @ president of the Royal College of Paediatrics and Child Health and Dr Neil McIntosh, University of Edinburgh")
We must protect patients, but we must also find better ways to protect professionals
Half had the CNEP treatment - where pressure is applied to a child's chest to aid breathing. The rest were given the standard treatment of a breathing tube being inserted through the larynx - part of the windpipe. After the study was published, some parents of the children given CNEP became concerned after suggestions it was linked to a small increase in deaths and in infants with abnormal brain scans. This follow-up study found any differences between the two groups of children could be explained by chance. In addition, no evidence was seen of a higher risk of long-term disabilities for children given CNEP. Professor Neil Marlow, of Queen's Medical Centre, who led the study, said: "Our long-term study of the original trial participants suggests no evidence of disadvantage, in terms of long-term disability or psychological outcomes, from the use of CNEP."Protection
Concerns over the CNEP treatment led one couple whose daughter died after the trial to take action against the doctors who treated her. Carl and Debbie Henshall, of Clayton in Staffordshire, recently won an Appeal Court hearing which said the GMC should review its decision to reject their complaints that doctors did not give properly informed consent to medics for their girls to take part. The CNEP trial has also been investigated by the hospital twice and been the subject of police inquiries. The government also ordered a public inquiry into the trial. But the author of that 2000 report - which was critical of the study - said it would have been less negative if he had had access to fuller information. None of the investigations has supported parents' claims they were misled and consent forms forged. In a commentary piece in this week's Lancet, Professor Southall and Dr Martin Samuels, who also led the original CNEP study, welcomed the latest findings.
Progress fears
They added: "We fear that over the last six years many infants with bronchiolitis [a potentially fatal chest infection] presenting to our children's unit have received unnecessarily intensive care." Professor Sir Alan Craft, President of the Royal College of Paediatrics and Child Health, and Dr Neil McIntosh from the University of Edinburgh Department of Child Life and Health supported Professor Southall's work. They said CNEP should probably be retained for older children with bronchiolitis because other techniques have been developed since the original trial to help other babies. They added: "We must protect patients, but we must also find better ways to protect professionals. "If we do not, medical progress will cease, particularly in controversial and distressing areas." The Department of Health said it would look at the findings of the study with interest. Professor Southall was found guilty of serious professional misconduct by the General Medical Council last year, over a matter not related to the CNEP trial. He had suggested the husband of solicitor Sally Clark, who was wrongly convicted of murdering her two sons, was responsible for the babies' deaths, after watching a TV documentary. The GMC said he could continue to practise, but he could not work in child protection.
http://www.whotv.com/Global/story.asp?S=4695150
Mumps In Iowa
Des Moines, March 28, 2006 - It first showed up in January and by the end of February. Iowa had 26 cases of the mumps. Three weeks later, that number more than doubled. Today, health officials believe there are more than 200 Iowans with the disease. Iowa hasn't seen an outbreak like this in nearly 20 years. About one-third of Iowa counties are reporting cases of mumps. Dubuque county alone has already had 85 cases this year. But who's at risk?
Health officials say it's not kids that should worry as much as the Baby Boomer generation. That's the age group health officials say might not have had a second dose of the M.M.R., or measles, mumps, rubella vaccine.
The number of mumps cases peaked in 1968, when the state reported more than 12,000 cases. Iowa hasn't seen an outbreak like this for decades.
"We just knew they were going to have measels, chicken pox, mumps." Growing up Carol Stevenson says getting the mumps was a fact of life. She had it, just like most everyone at the senior center here in Des Moines. "I remember I was in grade school...9 maybe 10." That was about the same age her kids got it.
However the disease skipped a generation. None of her 8 grandchildren ever came down with the mumps. Mainly because a vaccine- which is 95 percent effective- is required for all school-aged children. Now, the state health department says the mumps are now showing up in that 3 to 18-year-old age group.
While Drake hasn't seen any cases, college aged students are most at risk. They account for about a third of all cases in Iowa. Health officials say the virus is spread by coughing or sneezing and campuses act much like a breeding ground for diseases like the mumps.
The Centers for Disease Control says the mumps virus in Iowa has shown up in other parts of the world. It's similar to a strain seen in an outbreak in the United Kingdom in 2004 and 2005.
Mumps In Iowa
Des Moines, March 28, 2006 - It first showed up in January and by the end of February. Iowa had 26 cases of the mumps. Three weeks later, that number more than doubled. Today, health officials believe there are more than 200 Iowans with the disease. Iowa hasn't seen an outbreak like this in nearly 20 years. About one-third of Iowa counties are reporting cases of mumps. Dubuque county alone has already had 85 cases this year. But who's at risk?
Health officials say it's not kids that should worry as much as the Baby Boomer generation. That's the age group health officials say might not have had a second dose of the M.M.R., or measles, mumps, rubella vaccine.
The number of mumps cases peaked in 1968, when the state reported more than 12,000 cases. Iowa hasn't seen an outbreak like this for decades.
"We just knew they were going to have measels, chicken pox, mumps." Growing up Carol Stevenson says getting the mumps was a fact of life. She had it, just like most everyone at the senior center here in Des Moines. "I remember I was in grade school...9 maybe 10." That was about the same age her kids got it.
However the disease skipped a generation. None of her 8 grandchildren ever came down with the mumps. Mainly because a vaccine- which is 95 percent effective- is required for all school-aged children. Now, the state health department says the mumps are now showing up in that 3 to 18-year-old age group.
While Drake hasn't seen any cases, college aged students are most at risk. They account for about a third of all cases in Iowa. Health officials say the virus is spread by coughing or sneezing and campuses act much like a breeding ground for diseases like the mumps.
The Centers for Disease Control says the mumps virus in Iowa has shown up in other parts of the world. It's similar to a strain seen in an outbreak in the United Kingdom in 2004 and 2005.
Long-term mobile phone use raises brain tumor risk: study Yahoo! NEWS
The use of mobile phones over a long period of time can raise the risk for brain tumors, a new Swedish study said on Friday, contradicting the conclusions of other researchers. The Dutch Health Council, in an overview of research from around the world, last year found no evidence radiation from mobile phones and TV towers was harmful. A four-year British survey released in January showed no link between regular, long-term use of cell phones and the most common type of tumor. However, researchers at the Swedish National Institute for Working Life said they looked at the mobile phone use of 905 people between the age of 20 and 80 who had been diagnosed with a malignant brain tumor and found a link. "A total 85 of these 905 cases were so-called high users of mobile phones, that is they began early to use mobile and, or wireless telephones and used them a lot," the study said. "The study also shows that the rise in risk is noticeable for tumors on the side of the head where the phone was said to be used," it added. Kjell Mild, who led the study, said the figures meant that heavy users of mobile phones, for instance of who make mobile phone calls for 2,000 hours or more in their life, had a 240 percent increased risk for a malignant tumor on the side of the head the phone is used. "The way to get the risk down is to use handsfree," he told Reuters. He said his study was the biggest yet to look at long-term users of the wireless phone, which has been around in Sweden in a portable form since 1984, longer than in many other countries.
The use of mobile phones over a long period of time can raise the risk for brain tumors, a new Swedish study said on Friday, contradicting the conclusions of other researchers. The Dutch Health Council, in an overview of research from around the world, last year found no evidence radiation from mobile phones and TV towers was harmful. A four-year British survey released in January showed no link between regular, long-term use of cell phones and the most common type of tumor. However, researchers at the Swedish National Institute for Working Life said they looked at the mobile phone use of 905 people between the age of 20 and 80 who had been diagnosed with a malignant brain tumor and found a link. "A total 85 of these 905 cases were so-called high users of mobile phones, that is they began early to use mobile and, or wireless telephones and used them a lot," the study said. "The study also shows that the rise in risk is noticeable for tumors on the side of the head where the phone was said to be used," it added. Kjell Mild, who led the study, said the figures meant that heavy users of mobile phones, for instance of who make mobile phone calls for 2,000 hours or more in their life, had a 240 percent increased risk for a malignant tumor on the side of the head the phone is used. "The way to get the risk down is to use handsfree," he told Reuters. He said his study was the biggest yet to look at long-term users of the wireless phone, which has been around in Sweden in a portable form since 1984, longer than in many other countries.
Crafty Sea Lion Befuddles Fish Biologists Yahoo! NEWS
In his way, C404 is kind of cute, with those sea-lion whiskers, soft brown eyes and furry little head. But to many he is a sea lion either from hell — or from Harvard. C404 has driven the U.S. Army Corps of Engineers at Bonneville Dam to near distraction as he and his ilk sit at the base and munch salmon gathered to continue upriver to spawn. Numerous sea lions head for the dam each spring, but C404 is in a class by himself. He has figured out how to get into fish ladders that help fish past the dam — where endangered salmon and other fish become his easy prey. The engineers have used everything legal to get rid of the California sea lion, who may weigh 1,000 pounds or more. They have installed grated exclusion gates and tried huge firecackers, rockets, rubber bullets, and noises sea lions don't like. But C404 has given them the flipper. He and a handful of cohorts already are waiting for the spring run of chinook salmon, which starts in earnest in April. Then C404, named because of a brand applied by a state and federal program, will personify a larger problem, as 100 or more of his buddies join him. Last year they ate about 3.5 percent of the migrating run at a time when salmon numbers were down and demand was up. This year's commercial salmon season may be cancelled because of river problems elsewhere. The loss percentage is climbing. Robert Stansell, a fish biologist at Bonneville with the Corps of Engineers, knows the lively and alert C404 all too well. "If he were in a litter of puppies, he's the one you would pick," he said. He said C404 has been showing up each year since at least 2003 and has learned to rub it in. Last year he appeared in a window where fish counters keep track of salmon migrating upstream. The data helps predict the size of future runs. "He even rolled over a little so we could get a look at his brand," Stansell said. Other marine mammals haven't learned to pull that trick off. Stansell says the sea lions are intelligent and can be taught. He would rather they not be taught by C404. But he said the animals are showing up earlier and in greater numbers, and they are staying later. Now they have begun crawling onto the rocks to rest. "They're becoming comfortable here," he said. The run peaks in about September, but the sea lions head back to southern California breeding grounds around late May when the water temperature in the river rises. They'll be back next year with their friends, and maybe their friends' friends too. The animals have always been in the river. But now that the fish mass at the base of the dam, they provide a quick and easy meal for the sea lions. C404 and his kind aren't endangered, but they are protected under the 1972 Marine Mammal Protection Act and can't be killed. Incorrigibles can be singled out for "lethal removal," a long, complicated process, Stansell said. He said that nearly happened at the Ballard Locks in Seattle, where sea lions that nearly wiped out a winter steelhead run in the 1990s were marked for death. But the Humane Society sued and then-President Clinton urged clemency. The worst of the miscreants were packed off to Sea World in Orlando, Fla.
By JOSEPH B. FRAZIER, Associated Press Writer
In his way, C404 is kind of cute, with those sea-lion whiskers, soft brown eyes and furry little head. But to many he is a sea lion either from hell — or from Harvard. C404 has driven the U.S. Army Corps of Engineers at Bonneville Dam to near distraction as he and his ilk sit at the base and munch salmon gathered to continue upriver to spawn. Numerous sea lions head for the dam each spring, but C404 is in a class by himself. He has figured out how to get into fish ladders that help fish past the dam — where endangered salmon and other fish become his easy prey. The engineers have used everything legal to get rid of the California sea lion, who may weigh 1,000 pounds or more. They have installed grated exclusion gates and tried huge firecackers, rockets, rubber bullets, and noises sea lions don't like. But C404 has given them the flipper. He and a handful of cohorts already are waiting for the spring run of chinook salmon, which starts in earnest in April. Then C404, named because of a brand applied by a state and federal program, will personify a larger problem, as 100 or more of his buddies join him. Last year they ate about 3.5 percent of the migrating run at a time when salmon numbers were down and demand was up. This year's commercial salmon season may be cancelled because of river problems elsewhere. The loss percentage is climbing. Robert Stansell, a fish biologist at Bonneville with the Corps of Engineers, knows the lively and alert C404 all too well. "If he were in a litter of puppies, he's the one you would pick," he said. He said C404 has been showing up each year since at least 2003 and has learned to rub it in. Last year he appeared in a window where fish counters keep track of salmon migrating upstream. The data helps predict the size of future runs. "He even rolled over a little so we could get a look at his brand," Stansell said. Other marine mammals haven't learned to pull that trick off. Stansell says the sea lions are intelligent and can be taught. He would rather they not be taught by C404. But he said the animals are showing up earlier and in greater numbers, and they are staying later. Now they have begun crawling onto the rocks to rest. "They're becoming comfortable here," he said. The run peaks in about September, but the sea lions head back to southern California breeding grounds around late May when the water temperature in the river rises. They'll be back next year with their friends, and maybe their friends' friends too. The animals have always been in the river. But now that the fish mass at the base of the dam, they provide a quick and easy meal for the sea lions. C404 and his kind aren't endangered, but they are protected under the 1972 Marine Mammal Protection Act and can't be killed. Incorrigibles can be singled out for "lethal removal," a long, complicated process, Stansell said. He said that nearly happened at the Ballard Locks in Seattle, where sea lions that nearly wiped out a winter steelhead run in the 1990s were marked for death. But the Humane Society sued and then-President Clinton urged clemency. The worst of the miscreants were packed off to Sea World in Orlando, Fla.
By JOSEPH B. FRAZIER, Associated Press Writer
British push for catnaps at work Yahoo! NEWS
Zzzzzz.... Mmm? Sorry, I must have nodded off. Not a bad thing, actually - in fact I shouldn't be apologizing at all. You see, it's "National Nap at Work Week" here, a good excuse to celebrate one of the most delicious antidotes to an overpacked schedule: the power nap. JFK and Reagan were apparently big catnappers. So, too, Edison and Einstein, Brahms and da Vinci. Napoleon dozed on the battlefield, while Winston Churchill napped throughout World War II, enthusing that a good afternoon snooze created two days out of one. So we're in illustrious company. Dozing is definitely not just for pensioners and babies. In fact, sleep experts seem to believe that more and more of us should try to power down for a few minutes at work every day. They point to a large body of research suggesting that the catnap can improve productivity and boost morale in a bleary-eyed society. Surveys consistently indicate that people feel sleep deprived. A poll this week for Britain's GMTV found two-thirds of people said they had trouble sleeping, and 4 in 5 said they do not feel refreshed after a night's sleep. Only 19 percent said they got the recommended eight hours per night. On average, people sleep for 90 minutes less each night than their forebears did a century ago, according to Stanford University research. Blame multichannel TV, shiftwork, international travel, caffeine, or the always-on working culture. Or just restless children. "I have a real down period in the afternoon - by 2 or 3 I'm flagging," says Claire Walker, a working mom who's normally up before dawn and often still working late at night. She set up a quiet room at her South London consultancy, Firefly, with dim lighting, a big leather chair like the recliners used by dentists, and a set of headphones. People duck in at different times of the day, but not for long, she says. "A quick blast is a way to reenergize for the rest of day." Sleep experts say deep, lengthy slumber in the middle of the day can prove counterproductive and create an effect akin to jet lag. Salvador Dali apparently guarded against this by napping with a spoon in his hand, held above a metal bowl. As he descended deeper into the surreal world of REM slumber, the spoon would clatter into the bowl, waking him up. "You don't go into a deep sleep, but just drift off," explains Jessica Alexander of the Sleep Council, a lobby group. "It helps recharge and can improve productivity." Some are beginning to catch on. Long-haul British Airways pilots are encouraged to rest in the air to make them more alert on landing. Doctors are calling for nap rooms to help them through night shifts. Britain's round-the-world yachtswoman Ellen MacArthur seems to survive on napping alone while at sea. And two London business men recently set up Zzed Sheds, a private club where city workers can take naps in sleep pods similar to those set up at New York City's MetroNaps three years ago. "We know from personal experience that people who work in the city work very long hours and are exhausted a lot of the time," says Nigel Mitchell, a founder of the company that is pioneering the Zzed Sheds, which he says are used mainly from late morning through the afternoon. "If you get to your desk at 6 in morning, by 11 o'clock you are ready to shut your eyes for half an hour." The idea has caught on in at least a few European cities. MetroNaps pods debuted at Copenhagen airport last year, and Barcelona businessman Federico Busquets is doing brisk business in Spain with his napping-parlor franchise. Yet it's one thing to nap in a private club with sleep pods, and quite another to doze at work. Few British employers appear to be entering into the spirit of National Nap at Work Week. Perhaps this is not surprising in a country with the longest working hours in Europe, where the average lunch break is now just 19 minutesand the "siesta" is still something for Continental Europeans - though even among that set, the tradition of long afternoon breaks is fading. An impromptu (and rather unscientific) Monitor survey of employees at a dozen British companies, small and large, found only one that had a "chill-out room" for power napping. "It's really not the done thing," says Anna Harrison, an editor at a London publishing house. Professor Jim Horne, director of the Sleep Research Centre at Loughborough University, says there's a good reason for such suspicious attitudes. Workplace napping is easily open to abuse, particularly for people tempted by the many nocturnal distractions outside office life. "I'm not in favor of napping if you've had a night out for social reasons," he says. "Why should employers provide beds for people who didn't get enough sleep because they've been watching videos or out clubbing?"
By Mark Rice-Oxley
Zzzzzz.... Mmm? Sorry, I must have nodded off. Not a bad thing, actually - in fact I shouldn't be apologizing at all. You see, it's "National Nap at Work Week" here, a good excuse to celebrate one of the most delicious antidotes to an overpacked schedule: the power nap. JFK and Reagan were apparently big catnappers. So, too, Edison and Einstein, Brahms and da Vinci. Napoleon dozed on the battlefield, while Winston Churchill napped throughout World War II, enthusing that a good afternoon snooze created two days out of one. So we're in illustrious company. Dozing is definitely not just for pensioners and babies. In fact, sleep experts seem to believe that more and more of us should try to power down for a few minutes at work every day. They point to a large body of research suggesting that the catnap can improve productivity and boost morale in a bleary-eyed society. Surveys consistently indicate that people feel sleep deprived. A poll this week for Britain's GMTV found two-thirds of people said they had trouble sleeping, and 4 in 5 said they do not feel refreshed after a night's sleep. Only 19 percent said they got the recommended eight hours per night. On average, people sleep for 90 minutes less each night than their forebears did a century ago, according to Stanford University research. Blame multichannel TV, shiftwork, international travel, caffeine, or the always-on working culture. Or just restless children. "I have a real down period in the afternoon - by 2 or 3 I'm flagging," says Claire Walker, a working mom who's normally up before dawn and often still working late at night. She set up a quiet room at her South London consultancy, Firefly, with dim lighting, a big leather chair like the recliners used by dentists, and a set of headphones. People duck in at different times of the day, but not for long, she says. "A quick blast is a way to reenergize for the rest of day." Sleep experts say deep, lengthy slumber in the middle of the day can prove counterproductive and create an effect akin to jet lag. Salvador Dali apparently guarded against this by napping with a spoon in his hand, held above a metal bowl. As he descended deeper into the surreal world of REM slumber, the spoon would clatter into the bowl, waking him up. "You don't go into a deep sleep, but just drift off," explains Jessica Alexander of the Sleep Council, a lobby group. "It helps recharge and can improve productivity." Some are beginning to catch on. Long-haul British Airways pilots are encouraged to rest in the air to make them more alert on landing. Doctors are calling for nap rooms to help them through night shifts. Britain's round-the-world yachtswoman Ellen MacArthur seems to survive on napping alone while at sea. And two London business men recently set up Zzed Sheds, a private club where city workers can take naps in sleep pods similar to those set up at New York City's MetroNaps three years ago. "We know from personal experience that people who work in the city work very long hours and are exhausted a lot of the time," says Nigel Mitchell, a founder of the company that is pioneering the Zzed Sheds, which he says are used mainly from late morning through the afternoon. "If you get to your desk at 6 in morning, by 11 o'clock you are ready to shut your eyes for half an hour." The idea has caught on in at least a few European cities. MetroNaps pods debuted at Copenhagen airport last year, and Barcelona businessman Federico Busquets is doing brisk business in Spain with his napping-parlor franchise. Yet it's one thing to nap in a private club with sleep pods, and quite another to doze at work. Few British employers appear to be entering into the spirit of National Nap at Work Week. Perhaps this is not surprising in a country with the longest working hours in Europe, where the average lunch break is now just 19 minutesand the "siesta" is still something for Continental Europeans - though even among that set, the tradition of long afternoon breaks is fading. An impromptu (and rather unscientific) Monitor survey of employees at a dozen British companies, small and large, found only one that had a "chill-out room" for power napping. "It's really not the done thing," says Anna Harrison, an editor at a London publishing house. Professor Jim Horne, director of the Sleep Research Centre at Loughborough University, says there's a good reason for such suspicious attitudes. Workplace napping is easily open to abuse, particularly for people tempted by the many nocturnal distractions outside office life. "I'm not in favor of napping if you've had a night out for social reasons," he says. "Why should employers provide beds for people who didn't get enough sleep because they've been watching videos or out clubbing?"
By Mark Rice-Oxley
http://www.raidersnewsupdate.com/lead-story35.htm
U.S. to create a bird flu virus mutation
The U.S. Centers for Disease Control and Prevention has begun a series of experiments to see how likely the bird flu virus could result in a human pandemic.
The six-month series of experiments seeks to simulate the mixing and matching of genes from the H5N1 avian flu virus that has plagued Asia and a common human flu virus that public-health experts fear could turn avian flu into a pandemic, the Wall Street Journal reported Thursday.
CDC scientists inside an ultra-secure laboratory have started swapping the genes of the H5N1 avian virus with the genes of an H3N2 virus, the strain behind most recent human flu outbreaks.
The goal is to substitute the eight genes of each virus, one by one, with the eight genes from the other virus to see which of more than 250 possible combinations create flu viruses that could spread easily among humans.
The work responds to fears by global public health experts that the bird flu virus could mutate to form one that could spawn a global outbreak of the disease.
Copyright 2006 United Press International
U.S. to create a bird flu virus mutation
The U.S. Centers for Disease Control and Prevention has begun a series of experiments to see how likely the bird flu virus could result in a human pandemic.
The six-month series of experiments seeks to simulate the mixing and matching of genes from the H5N1 avian flu virus that has plagued Asia and a common human flu virus that public-health experts fear could turn avian flu into a pandemic, the Wall Street Journal reported Thursday.
CDC scientists inside an ultra-secure laboratory have started swapping the genes of the H5N1 avian virus with the genes of an H3N2 virus, the strain behind most recent human flu outbreaks.
The goal is to substitute the eight genes of each virus, one by one, with the eight genes from the other virus to see which of more than 250 possible combinations create flu viruses that could spread easily among humans.
The work responds to fears by global public health experts that the bird flu virus could mutate to form one that could spawn a global outbreak of the disease.
Copyright 2006 United Press International
http://www.forbes.com/markets/feeds/afx/20...afx2640033.html
AFX News Limited
400 Chinese students hospitalized with unknown flu
04.02.2006, 08:52 AM
BEIJING (AFX) - Over 400 students at a university in central China's Henan province were hospitalized with high fevers linked to an unknown flu virus, state press and a school official said.
The outbreak began on March 26 when 22 students were hospitalized with high fevers, Xinhua news agency said.
The next day the number of sick students at the Henan University of Science and Technology in Luoyang city rose to 88, and on March 28 there were 208 sick students in the university's infirmary, it said.
'There were over 400 students that became feverish with the flu,' a university official who declined to be named told Agence France-Presse when contacted by phone.
He refused to detail what type of flu it was or how the outbreak had succeeded in infecting so many students.
Local health officials were currently trying to identify the flu strain, Xinhua said.
The temperatures of some of the students reached 39.6 degrees celsius, it said.
The sick students were quarantined while school officials, under directions from provincial health authorities, cancelled classes and began disinfecting the university's 2,000 dormitory rooms, dining halls and classrooms, it said.
Most students were only hospitalized for about three days and released, the report said, adding that only several dozen students remained hospitalized as of today.
AFX News Limited
400 Chinese students hospitalized with unknown flu
04.02.2006, 08:52 AM
BEIJING (AFX) - Over 400 students at a university in central China's Henan province were hospitalized with high fevers linked to an unknown flu virus, state press and a school official said.
The outbreak began on March 26 when 22 students were hospitalized with high fevers, Xinhua news agency said.
The next day the number of sick students at the Henan University of Science and Technology in Luoyang city rose to 88, and on March 28 there were 208 sick students in the university's infirmary, it said.
'There were over 400 students that became feverish with the flu,' a university official who declined to be named told Agence France-Presse when contacted by phone.
He refused to detail what type of flu it was or how the outbreak had succeeded in infecting so many students.
Local health officials were currently trying to identify the flu strain, Xinhua said.
The temperatures of some of the students reached 39.6 degrees celsius, it said.
The sick students were quarantined while school officials, under directions from provincial health authorities, cancelled classes and began disinfecting the university's 2,000 dormitory rooms, dining halls and classrooms, it said.
Most students were only hospitalized for about three days and released, the report said, adding that only several dozen students remained hospitalized as of today.
A paradigm for an Avian Flu pandemic?
http://www.medpagetoday.com/InfectiousDise...cHealth/tb/2979
Iowa Mumps Outbreak Spreads Quickly to Other States
By Peggy Peck, Managing Editor, MedPage Today
Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine.
April 03, 2006
MedPage Today Action Points
Explain to patients who ask that difficulty swallowing caused by parotitis may be caused by mumps, but laboratory tests are needed to confirm the diagnosis.
Explain to patients who ask that current recommendations are for the first dose of mumps/measles/rubella vaccine at 12 to 15 months with a second dose at ages four to six years.
Review
DES MOINES, Iowa, April 3 - The mumps outbreak that started in Iowa has spread to Illinois, Minnesota, Nebraska, South Dakota, and Wisconsin, an epidemiologist with the Iowa Department of Public Health said today.
Meghan Harris, M.P.H., said all states bordering Iowa -- with the exception of Missouri -- have reported cases of mumps. Moreover, said Harris, the end is no where in site.
"You can expect the numbers that we report tomorrow to be up [from cases reported March 30] and the numbers that will be reported Thursday are likely to be higher again," she said in an interview.
The Iowa Department of Public Health said will update mumps information tomorrow and again on Thursday.
The 245 confirmed, probable, or suspected cases of mumps reported to the Iowa Department of Public Health already represent the nation's largest mumps outbreak in 17 years.
Early on most of the Iowa cases were reported in college-age students. The mean age at onset was 21, and almost 35% of the cases occurred in 19-year-olds. But Harris said that no single college or university was implicated in the outbreak.
"We can assume that this outbreak is associated with some aspects of college life such as living in dorms or mixing together at the same clubs," she said. The best explanation, according to Harris, is that college students "in general have a higher risk of sharing saliva."
The probable cases of mumps were those that met the clinical case definition but had no confirmed serologic or virologic testing. Suspect cases were those with positive IgM serology and confirmed cases were those that met clinical definition that were also laboratory-confirmed or epidemiologically linked.
Follow-up reports have been completed on 136 cases of which 66% were in patients who had received two doses of the measles/mumps/rubella vaccine, which is considered sufficient to guarantee full immunity.
Blaise Congeni, M.D., director of infectious diseases at Akron Children's Hospital in Ohio, said that with any vaccine there is always a chance of primary vaccine failure, "meaning that the vaccine never achieved conversion, or the possibility of secondary vaccine failure, meaning that immunity wanes over time."
The current recommendation is that a first dose of measles-mumps-rubella (MMR) vaccine be administered at 12 to 15 months with a second dose at four to six years, but Dr. Congeni said that "if the second dose is missed it can also be administered during adolescence."
Based on published reports, Dr. Congeni speculated that secondary vaccine failure may be a factor in the mumps outbreak, but Harris said that theory failed to pan out after investigation. "There is no correlation between time since immunization and outbreak," she said. "There are cases among people who were immunized two years ago and other who were immunized 23 years ago. There is also no correlation with lot number of the vaccine, manufacturer, or physician who gave the immunization."
Dr. Congeni also speculated that it may be difficult to identify an index case because the primary symptom of mumps -- parotitis -- is often not fully evaluated by clinicians. "If the patient's record indicates that he or she has been received two MMR doses, the assumption would be that this is caused by another virus," he said. If the symptoms abate, the episode would be little more than a notation in a medical record.
Harris agreed that Dr. Congeni's theory best explains what has happened in Iowa, especially since the mumps strain is the same one that caused outbreaks in England over the past few years. That suggests that mumps arrived with a recent visitor from Britain, but "because these symptoms are often overlooked -- especially in people who have received the required vaccinations -- we doubt we will ever identify the index case," she said.
Dr. Congeni said, however, that a mumps outbreak does not carry the potential for public health disaster that would be associated with a measles or rubella outbreak.
"There is a small risk that some kids will develop viral meningitis and orchitis is a concern, but we know that orchitis doesn't cause sterility," Dr. Congeni said. As of March 30, 5% of cases included orchitis among symptoms and one case of encephalitis was being investigated.
http://www.medpagetoday.com/InfectiousDise...cHealth/tb/2979
Iowa Mumps Outbreak Spreads Quickly to Other States
By Peggy Peck, Managing Editor, MedPage Today
Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine.
April 03, 2006
MedPage Today Action Points
Explain to patients who ask that difficulty swallowing caused by parotitis may be caused by mumps, but laboratory tests are needed to confirm the diagnosis.
Explain to patients who ask that current recommendations are for the first dose of mumps/measles/rubella vaccine at 12 to 15 months with a second dose at ages four to six years.
Review
DES MOINES, Iowa, April 3 - The mumps outbreak that started in Iowa has spread to Illinois, Minnesota, Nebraska, South Dakota, and Wisconsin, an epidemiologist with the Iowa Department of Public Health said today.
Meghan Harris, M.P.H., said all states bordering Iowa -- with the exception of Missouri -- have reported cases of mumps. Moreover, said Harris, the end is no where in site.
"You can expect the numbers that we report tomorrow to be up [from cases reported March 30] and the numbers that will be reported Thursday are likely to be higher again," she said in an interview.
The Iowa Department of Public Health said will update mumps information tomorrow and again on Thursday.
The 245 confirmed, probable, or suspected cases of mumps reported to the Iowa Department of Public Health already represent the nation's largest mumps outbreak in 17 years.
Early on most of the Iowa cases were reported in college-age students. The mean age at onset was 21, and almost 35% of the cases occurred in 19-year-olds. But Harris said that no single college or university was implicated in the outbreak.
"We can assume that this outbreak is associated with some aspects of college life such as living in dorms or mixing together at the same clubs," she said. The best explanation, according to Harris, is that college students "in general have a higher risk of sharing saliva."
The probable cases of mumps were those that met the clinical case definition but had no confirmed serologic or virologic testing. Suspect cases were those with positive IgM serology and confirmed cases were those that met clinical definition that were also laboratory-confirmed or epidemiologically linked.
Follow-up reports have been completed on 136 cases of which 66% were in patients who had received two doses of the measles/mumps/rubella vaccine, which is considered sufficient to guarantee full immunity.
Blaise Congeni, M.D., director of infectious diseases at Akron Children's Hospital in Ohio, said that with any vaccine there is always a chance of primary vaccine failure, "meaning that the vaccine never achieved conversion, or the possibility of secondary vaccine failure, meaning that immunity wanes over time."
The current recommendation is that a first dose of measles-mumps-rubella (MMR) vaccine be administered at 12 to 15 months with a second dose at four to six years, but Dr. Congeni said that "if the second dose is missed it can also be administered during adolescence."
Based on published reports, Dr. Congeni speculated that secondary vaccine failure may be a factor in the mumps outbreak, but Harris said that theory failed to pan out after investigation. "There is no correlation between time since immunization and outbreak," she said. "There are cases among people who were immunized two years ago and other who were immunized 23 years ago. There is also no correlation with lot number of the vaccine, manufacturer, or physician who gave the immunization."
Dr. Congeni also speculated that it may be difficult to identify an index case because the primary symptom of mumps -- parotitis -- is often not fully evaluated by clinicians. "If the patient's record indicates that he or she has been received two MMR doses, the assumption would be that this is caused by another virus," he said. If the symptoms abate, the episode would be little more than a notation in a medical record.
Harris agreed that Dr. Congeni's theory best explains what has happened in Iowa, especially since the mumps strain is the same one that caused outbreaks in England over the past few years. That suggests that mumps arrived with a recent visitor from Britain, but "because these symptoms are often overlooked -- especially in people who have received the required vaccinations -- we doubt we will ever identify the index case," she said.
Dr. Congeni said, however, that a mumps outbreak does not carry the potential for public health disaster that would be associated with a measles or rubella outbreak.
"There is a small risk that some kids will develop viral meningitis and orchitis is a concern, but we know that orchitis doesn't cause sterility," Dr. Congeni said. As of March 30, 5% of cases included orchitis among symptoms and one case of encephalitis was being investigated.
Premature babies 'feel true pain' BBC NEWS
Premature babies experience feelings of pain rather than simply displaying reflex reactions, a study says. Experts have never been sure how a premature baby responds to pain, the Journal of Neuroscience reported. But a team from University College London found that they do feel pain after analysing brain scans taken when blood samples were being drawn. They hope the findings will lead to more formal plans for managing pain in premature babies. Lead researcher Professor Maria Fitzgerald said: "We have shown for the first time that the information about pain reaches the brain in premature babies.
Conception
The scientists registered the brain activity in the babies - aged between 25 and 45 weeks from conception - before, during and after nurses performed blood tests using a heel lance. The results showed a surge of blood and oxygen in the sensory area of their brains, meaning the pain was processed in the higher levels of the brain, the team said. The team claimed the implications of the findings were clear, saying there was a potential for pain experience to influence brain development. Each baby requiring intensive care is subjected to an average of 14 procedures per day, many of which are considered by clinical staff to be painful, such as heel lancing for blood tests and inserting chest tubes. Premature baby charity Bliss said: "These findings show that premature babies experience 'true' pain and confirm the need for a protocol for pain for premature babies. "Only 20% of neonatal units in the UK regularly use a pain tool to assess chronic pain. "We strongly believe there is no justification for babies to be in pain and that more attention should be paid to providing comfort and relief when painful procedures are undertaken whilst they are in neonatal care."
Premature babies experience feelings of pain rather than simply displaying reflex reactions, a study says. Experts have never been sure how a premature baby responds to pain, the Journal of Neuroscience reported. But a team from University College London found that they do feel pain after analysing brain scans taken when blood samples were being drawn. They hope the findings will lead to more formal plans for managing pain in premature babies. Lead researcher Professor Maria Fitzgerald said: "We have shown for the first time that the information about pain reaches the brain in premature babies.
QUOTE("Spokeswoman for Bliss")
We strongly believe there is no justification for babies to be in pain and that more attention should be paid to providing comfort and relief
"Beforehand, although we could assume it, we did not know for sure that these babies could feel pain. "These babies' brains are so immature that it was difficult to genuinely know that the pain was going to their brain." Previous research had shown that premature babies are capable of displaying behavioural, physiological and metabolic signs of pain and distress. However, the measures were all indirect and could be dismissed as bodily reflex reactions, rather than measures of true pain experience. Researchers conducted brain scans on 18 babies in the neonatal unit at the Elizabeth Garrett Anderson and Obstetric Hospital in central London.Conception
The scientists registered the brain activity in the babies - aged between 25 and 45 weeks from conception - before, during and after nurses performed blood tests using a heel lance. The results showed a surge of blood and oxygen in the sensory area of their brains, meaning the pain was processed in the higher levels of the brain, the team said. The team claimed the implications of the findings were clear, saying there was a potential for pain experience to influence brain development. Each baby requiring intensive care is subjected to an average of 14 procedures per day, many of which are considered by clinical staff to be painful, such as heel lancing for blood tests and inserting chest tubes. Premature baby charity Bliss said: "These findings show that premature babies experience 'true' pain and confirm the need for a protocol for pain for premature babies. "Only 20% of neonatal units in the UK regularly use a pain tool to assess chronic pain. "We strongly believe there is no justification for babies to be in pain and that more attention should be paid to providing comfort and relief when painful procedures are undertaken whilst they are in neonatal care."
Netflix may face tough fight in Blockbuster patent suit Yahoo! NEWS
Netflix Inc may face a tough fight in enforcing its patents for its pioneering online DVD rental service against rival Blockbuster Inc., but could reap substantial benefits if it wins or the companies settle, lawyers and analysts said on Wednesday. Netflix on Tuesday sued Blockbuster in federal court in San Francisco, seeking an injunction to stop Blockbuster from infringing on two patents that protect Netflix's business method. The patents cover Netflix's practice of having subscribers prioritize "queues," or lists of titles they want to rent, on Netflix's Web site, and of automatically replacing each DVD that is returned for the next title on the subscriber's queue. Piper Jaffray analyst Safa Rashtchy likened the suit to one filed by Yahoo Inc. (Nasdaq:YHOO - news) subsidiary Overture Services against Google Inc. in connection with claims that Google infringed on Overture's paid search patent. Google ultimately settled the case by agreeing to take out a license to the Overture patent and several related patents for shares of Google stock worth about $450 million, according to the Web site of Overture's attorney, Robert Fram. "Netflix really did create this model when no one else was doing online DVD rental and they made a business of it," Rashtchy said. "As far as I know, no one had created a monthly subscription model where you were not purchasing but renting." Rashtchy said, however, that some holders of business process patents have trouble enforcing them and noted that Blockbuster Online, which has 1.2 million subscribers to Netflix's 4.2 million, is not yet making a profit and may not have the revenue to pay royalties. A victory in court for Netflix also could dissuade other competitors from entering the online DVD rental market, Rashtchy said. Marc Lieberstein, a patent attorney with Pitney Hardin, said there is little legal precedent for business process patent disputes of the type Netflix is bringing, because most actions settle before they get to trial. Lieberstein said Netflix could be entitled to seek royalty payments that would accumulate "every time someone rents a Blockbuster movie." Lieberstein said it would be difficult for Blockbuster to claim not to have known about Netflix's patent. But he said Blockbuster, which is the largest North American rental chain, could try to invalidate the patents by proving that the online renter's business methods were invented before Netflix applied for the patents. Netflix's patents were granted in 2003 and on Tuesday. But Netflix could face successful challenges on its decision to wait until Blockbuster had spent more than $300 million to build and market its online service, said patent attorney Lloyd Smith of law firm Buchanan Ingersoll. "Why did it take Netflix 18 months to sue Blockbuster?" Smith said. "Blockbuster might be able to say, 'Hey, you knew we were doing it."' Smith also said that business method patents were "relatively controversial and criticized in recent years, so I do think ... there is a reasonable chance" that Netflix's patents will be invalidated by the court. Blockbuster declined to comment on pending litigation.
By Gina Keating
Netflix Inc may face a tough fight in enforcing its patents for its pioneering online DVD rental service against rival Blockbuster Inc., but could reap substantial benefits if it wins or the companies settle, lawyers and analysts said on Wednesday. Netflix on Tuesday sued Blockbuster in federal court in San Francisco, seeking an injunction to stop Blockbuster from infringing on two patents that protect Netflix's business method. The patents cover Netflix's practice of having subscribers prioritize "queues," or lists of titles they want to rent, on Netflix's Web site, and of automatically replacing each DVD that is returned for the next title on the subscriber's queue. Piper Jaffray analyst Safa Rashtchy likened the suit to one filed by Yahoo Inc. (Nasdaq:YHOO - news) subsidiary Overture Services against Google Inc. in connection with claims that Google infringed on Overture's paid search patent. Google ultimately settled the case by agreeing to take out a license to the Overture patent and several related patents for shares of Google stock worth about $450 million, according to the Web site of Overture's attorney, Robert Fram. "Netflix really did create this model when no one else was doing online DVD rental and they made a business of it," Rashtchy said. "As far as I know, no one had created a monthly subscription model where you were not purchasing but renting." Rashtchy said, however, that some holders of business process patents have trouble enforcing them and noted that Blockbuster Online, which has 1.2 million subscribers to Netflix's 4.2 million, is not yet making a profit and may not have the revenue to pay royalties. A victory in court for Netflix also could dissuade other competitors from entering the online DVD rental market, Rashtchy said. Marc Lieberstein, a patent attorney with Pitney Hardin, said there is little legal precedent for business process patent disputes of the type Netflix is bringing, because most actions settle before they get to trial. Lieberstein said Netflix could be entitled to seek royalty payments that would accumulate "every time someone rents a Blockbuster movie." Lieberstein said it would be difficult for Blockbuster to claim not to have known about Netflix's patent. But he said Blockbuster, which is the largest North American rental chain, could try to invalidate the patents by proving that the online renter's business methods were invented before Netflix applied for the patents. Netflix's patents were granted in 2003 and on Tuesday. But Netflix could face successful challenges on its decision to wait until Blockbuster had spent more than $300 million to build and market its online service, said patent attorney Lloyd Smith of law firm Buchanan Ingersoll. "Why did it take Netflix 18 months to sue Blockbuster?" Smith said. "Blockbuster might be able to say, 'Hey, you knew we were doing it."' Smith also said that business method patents were "relatively controversial and criticized in recent years, so I do think ... there is a reasonable chance" that Netflix's patents will be invalidated by the court. Blockbuster declined to comment on pending litigation.
By Gina Keating
UK has first deadly bird flu case: farmers Yahoo! NEWS
Tests have shown a wild Mute swan found dead in a Scottish coastal town had the lethal H5N1 strain of bird flu -- Britain's first case of the disease, a British farmers' group said on Thursday. "The highly pathogenic H5N1 strain of avian influenza has now been confirmed in the dead swan," the National Farmers' Union (NFU) said in a statement on its Web site. An NFU spokeswoman said the union had been given the information by British authorities. The Scottish Department of Environment and chief veterinary officer could not confirm that the swan, found last week in Cellardyke harbor, had the deadly flu strain, but they promised an announcement imminently. The discovery in the swan of the highly pathogenic strain blamed for 108 human deaths elsewhere since 2003 would make Britain the 14th country in the European Union to find the disease on its territory. Amid a media frenzy over the discovery of H5N1 in Britain, government and officials tried to calm the public's concerns about the risk of transmission of the disease to humans. "There is a better chance of a person winning the national lottery than catching bird flu in the U.K. today," doctor Jim Robertson from the National Institute for Biological Standards and Control said.
UNWELCOME DEVELOPMENT
"This is an unwelcome and important development from the point of view of poultry health, but there are no implications either for human health or consumers," the NFU said. Scotland's chief veterinary officer Charles Milne said it was not known whether the swan was from a local or migratory flock. The partially eaten carcass of the swan was found in Fife, eastern Scotland, late on March 29 and sent to a laboratory in Weybridge, southern England, for analysis on March 31, he added. Milne said there was no indication of infections in domestic poultry, and no reason to believe the carcass had been partially eaten by a domestic animal. Officials have set up a 3-km (1.8-mile) protection zone around where the swan was found. Owners of birds within the zone have been told to take them indoors. A further 10-km surveillance zone is in force. Government officials reviewed bird flu contingency plans at a London meeting on Thursday and concluded that "all relevant steps are being taken." Bird flu remains essentially an animal disease, but can infect people who come into direct contact with infected birds. Milne said properly prepared poultry and poultry products were entirely safe for human consumption. Bob McCracken, past president of the British Veterinary Association, said that contact between wild birds that may be infected and poultry should be kept to a minimum. "We also have to work on the assumption that there is some spread among wild birds ... There is no doubt we are getting closer to the day when moving birds indoors will be necessary," he said. Scientists said they were confident that surveillance for possible cases of the disease was good enough.
By Ian MacKenzie
Tests have shown a wild Mute swan found dead in a Scottish coastal town had the lethal H5N1 strain of bird flu -- Britain's first case of the disease, a British farmers' group said on Thursday. "The highly pathogenic H5N1 strain of avian influenza has now been confirmed in the dead swan," the National Farmers' Union (NFU) said in a statement on its Web site. An NFU spokeswoman said the union had been given the information by British authorities. The Scottish Department of Environment and chief veterinary officer could not confirm that the swan, found last week in Cellardyke harbor, had the deadly flu strain, but they promised an announcement imminently. The discovery in the swan of the highly pathogenic strain blamed for 108 human deaths elsewhere since 2003 would make Britain the 14th country in the European Union to find the disease on its territory. Amid a media frenzy over the discovery of H5N1 in Britain, government and officials tried to calm the public's concerns about the risk of transmission of the disease to humans. "There is a better chance of a person winning the national lottery than catching bird flu in the U.K. today," doctor Jim Robertson from the National Institute for Biological Standards and Control said.
UNWELCOME DEVELOPMENT
"This is an unwelcome and important development from the point of view of poultry health, but there are no implications either for human health or consumers," the NFU said. Scotland's chief veterinary officer Charles Milne said it was not known whether the swan was from a local or migratory flock. The partially eaten carcass of the swan was found in Fife, eastern Scotland, late on March 29 and sent to a laboratory in Weybridge, southern England, for analysis on March 31, he added. Milne said there was no indication of infections in domestic poultry, and no reason to believe the carcass had been partially eaten by a domestic animal. Officials have set up a 3-km (1.8-mile) protection zone around where the swan was found. Owners of birds within the zone have been told to take them indoors. A further 10-km surveillance zone is in force. Government officials reviewed bird flu contingency plans at a London meeting on Thursday and concluded that "all relevant steps are being taken." Bird flu remains essentially an animal disease, but can infect people who come into direct contact with infected birds. Milne said properly prepared poultry and poultry products were entirely safe for human consumption. Bob McCracken, past president of the British Veterinary Association, said that contact between wild birds that may be infected and poultry should be kept to a minimum. "We also have to work on the assumption that there is some spread among wild birds ... There is no doubt we are getting closer to the day when moving birds indoors will be necessary," he said. Scientists said they were confident that surveillance for possible cases of the disease was good enough.
By Ian MacKenzie
Massachusetts becomes first US state with universal health insurance Yahoo! NEWS
Massachusetts is set to become the first state to set up a system of virtually compulsory health insurance in the only major industrial nation not to have universal care. The northeastern state's Democratic-controlled legislature passed a law on Tuesday night setting out the system. The Republican governor, Mitt Romney, said he will sign the law with only minor modifications. The legislation requires that all of the state's population of about 6.3 million people have medical insurance by July 1, 2007. No new taxes are planned but employers with more than 10 staff -- who do not provide health insurance -- will have to make a contribution of about 295 dollars per worker. The plan will cost about 1.2 billion dollars over three years. Massachusetts residents who are already covered will see their contributions fall slightly while the poor will receive improved coverage and public subsidies to help them pay. Those who do not have insurance and refuse to subsribe to health insurance will face mounting tax penalties. Under the plan, some 515,000 people in the state without health insurance will get it within three years. This represents about 95 percent of the uninsured. "It's another example of how the states are really the laboratories of democracy in our federalist system," White House spokesman Scott McClellan told reporters in Washington. An explosion in medical costs has made health insurance a major issue in the United States. About 16 percent of gross domestic product now is spent on health care and successive federal governments have been unable to introduce a national insurance system. Massachusetts could be the first of a series of states to introduce their own coverage plans. Paul Ginsburg, president of the Center for Studying Health System Change, said the new Massachusetts system "is going to be inspiring to other states" particularly after anti-spending Republicans reached a compromise with Democrats. "They found a way to get to a major expansion of coverage that people could agree on," Ginsburg told The New York Times newspaper. "For a conservative Republican, this is individual responsibility. For a Democrat, this is government helping those that need help." Hawaii introduced legislation in 1974 demanding that companies give insurance to all staff working at least 20 hours a week. But 10 percent of the population is said to be still without insurance. Laws laying out plans for universal coverage were introduced by Massachusetts in 1988 and in the states of Minnesota and Vermont in 1992 but these were knocked down during the 1990s. California also introduced a law which was later cancelled by a referendum. Maryland has voted a law ordering all companies with more than 10,000 workers must spend at least eight percent of their salary costs on health insurance. Republicans have particularly attacked the law, which notably targets the Wal-Mart supermarket giant. Kentucky and West Virginia are considering similar laws.
Massachusetts is set to become the first state to set up a system of virtually compulsory health insurance in the only major industrial nation not to have universal care. The northeastern state's Democratic-controlled legislature passed a law on Tuesday night setting out the system. The Republican governor, Mitt Romney, said he will sign the law with only minor modifications. The legislation requires that all of the state's population of about 6.3 million people have medical insurance by July 1, 2007. No new taxes are planned but employers with more than 10 staff -- who do not provide health insurance -- will have to make a contribution of about 295 dollars per worker. The plan will cost about 1.2 billion dollars over three years. Massachusetts residents who are already covered will see their contributions fall slightly while the poor will receive improved coverage and public subsidies to help them pay. Those who do not have insurance and refuse to subsribe to health insurance will face mounting tax penalties. Under the plan, some 515,000 people in the state without health insurance will get it within three years. This represents about 95 percent of the uninsured. "It's another example of how the states are really the laboratories of democracy in our federalist system," White House spokesman Scott McClellan told reporters in Washington. An explosion in medical costs has made health insurance a major issue in the United States. About 16 percent of gross domestic product now is spent on health care and successive federal governments have been unable to introduce a national insurance system. Massachusetts could be the first of a series of states to introduce their own coverage plans. Paul Ginsburg, president of the Center for Studying Health System Change, said the new Massachusetts system "is going to be inspiring to other states" particularly after anti-spending Republicans reached a compromise with Democrats. "They found a way to get to a major expansion of coverage that people could agree on," Ginsburg told The New York Times newspaper. "For a conservative Republican, this is individual responsibility. For a Democrat, this is government helping those that need help." Hawaii introduced legislation in 1974 demanding that companies give insurance to all staff working at least 20 hours a week. But 10 percent of the population is said to be still without insurance. Laws laying out plans for universal coverage were introduced by Massachusetts in 1988 and in the states of Minnesota and Vermont in 1992 but these were knocked down during the 1990s. California also introduced a law which was later cancelled by a referendum. Maryland has voted a law ordering all companies with more than 10,000 workers must spend at least eight percent of their salary costs on health insurance. Republicans have particularly attacked the law, which notably targets the Wal-Mart supermarket giant. Kentucky and West Virginia are considering similar laws.
Cervical cancer jab lasts years BBC NEWS
A vaccine for cervical cancer has been found to offer protection for at least four-and-a-half years in trials. The vaccine protects against strains of the human papilloma virus (HPV) which are thought to be the most common cause of cervical cancer. HPV is spread through sex, so it is planned to offer the vaccine to girls before they become sexually active. The US study, by Dartmouth Medical School in New Hampshire, is published online by The Lancet.
Smear tests
The US researchers took smear test samples from 800 women who took part in a trial of the vaccine. Each woman either received three doses of the vaccine or a dummy pill. Analysis showed the women given the vaccine had high levels of antibodies against HPV-16 and HPV-18 for up to four-and-a-half years after receiving the last dose. The vaccine was effective against persistent and new infections and also protected against infection with HPV-45 and HPV-31 - the third and fourth most common types of HPV. Lead researcher Dr Diane Harper said the results showed the vaccine was safe, and effective in the long term. She said: "These findings set the stage for the wide scale adoption of HPV vaccination for prevention of cervical cancer."
'Good news'
Dr Anne Szarewski, clinical consultant for Cancer Research UK, said: "Since the vaccine is being targeted initially at girls of around 12, it is very important that the protection lasts as long as possible. "The vaccine is totally effective against cervical abnormalities due to HPV types 16 and 18, which is very encouraging. "The fact that it also protects against two more HPV types is extremely exciting, as this may mean that around 80% of cervical cancers could be prevented with this vaccine. "This is very good news for women in the UK." A new survey from GlaxoSmithKline has found that just one in 25 British women was aware that HPV leads to cervical cancer. Although a quarter of the 978 women (26%) questioned had heard of the virus, only 4% knew it was the main cause of cervical cancer. Almost a third (31%) of women said they did not know the cause of the cancer, while 36% said it was related to "sexual practices". Glaxo submitted its vaccine to the European Medicines Agency for approval in March. A second similar vaccine is being developed by Merck and Co, who applied for marketing approval in Europe and the US in December.
A vaccine for cervical cancer has been found to offer protection for at least four-and-a-half years in trials. The vaccine protects against strains of the human papilloma virus (HPV) which are thought to be the most common cause of cervical cancer. HPV is spread through sex, so it is planned to offer the vaccine to girls before they become sexually active. The US study, by Dartmouth Medical School in New Hampshire, is published online by The Lancet.
QUOTE("Dr Anne Szarewski")
This is very good news for women in the UK
Cervical cancer kills more than 1,000 women in the UK every year. It is thought that two strains of HPV, 16 and 18, are responsible for more than 70% of cases of the disease. The vaccine, under development by GlaxoSmithKline, is designed to protect against these two HPV strains.Smear tests
The US researchers took smear test samples from 800 women who took part in a trial of the vaccine. Each woman either received three doses of the vaccine or a dummy pill. Analysis showed the women given the vaccine had high levels of antibodies against HPV-16 and HPV-18 for up to four-and-a-half years after receiving the last dose. The vaccine was effective against persistent and new infections and also protected against infection with HPV-45 and HPV-31 - the third and fourth most common types of HPV. Lead researcher Dr Diane Harper said the results showed the vaccine was safe, and effective in the long term. She said: "These findings set the stage for the wide scale adoption of HPV vaccination for prevention of cervical cancer."
'Good news'
Dr Anne Szarewski, clinical consultant for Cancer Research UK, said: "Since the vaccine is being targeted initially at girls of around 12, it is very important that the protection lasts as long as possible. "The vaccine is totally effective against cervical abnormalities due to HPV types 16 and 18, which is very encouraging. "The fact that it also protects against two more HPV types is extremely exciting, as this may mean that around 80% of cervical cancers could be prevented with this vaccine. "This is very good news for women in the UK." A new survey from GlaxoSmithKline has found that just one in 25 British women was aware that HPV leads to cervical cancer. Although a quarter of the 978 women (26%) questioned had heard of the virus, only 4% knew it was the main cause of cervical cancer. Almost a third (31%) of women said they did not know the cause of the cancer, while 36% said it was related to "sexual practices". Glaxo submitted its vaccine to the European Medicines Agency for approval in March. A second similar vaccine is being developed by Merck and Co, who applied for marketing approval in Europe and the US in December.
World 'lacks 4m health workers' BBC NEWS
Four million health workers are needed to combat the "chronic shortage" around the world, a report from the World Health Organization has warned. Fifty-seven countries have a serious shortage of health workers, affecting children's jabs, pregnancy care and access to treatment, it said.
Thirty-six of these countries are in sub-Saharan Africa. The WHO's World Health Report 2006 said the shortage affected how diseases such as HIV/Aids could be tackled.
Countries with a shortage of health service providers
It says that at least 1.3 billion people worldwide lack access to the most basic healthcare, often because there is no health worker. The burden is greatest in countries overwhelmed by poverty and disease where these health workers are needed most. The report led to calls for Western countries to stop "poaching" healthcare staff from these countries.
Four million health workers are needed to combat the "chronic shortage" around the world, a report from the World Health Organization has warned. Fifty-seven countries have a serious shortage of health workers, affecting children's jabs, pregnancy care and access to treatment, it said.
Thirty-six of these countries are in sub-Saharan Africa. The WHO's World Health Report 2006 said the shortage affected how diseases such as HIV/Aids could be tackled.
Countries with a shortage of health service providers
It says that at least 1.3 billion people worldwide lack access to the most basic healthcare, often because there is no health worker. The burden is greatest in countries overwhelmed by poverty and disease where these health workers are needed most. The report led to calls for Western countries to stop "poaching" healthcare staff from these countries.
QUOTE("Dr Timothy Evans @ WHO Assistant Director-General
")
")
Not enough health workers are being trained or recruited where they are most needed
Nurses goes back to Malawi
'I want to quit Nigeria'[/quote]Sub-Saharan Africa has 11% of the world's population and 24% of the global burden of disease but only 3% of the world's health workers. A lack of personnel, combined with a lack of training and knowledge, is also a major obstacle for health systems as they attempt to respond effectively to chronic diseases and bird flu. The WHO says life expectancies in the poorest countries are half of those in the richest nations. It says each country needs to improve the way in which it plans for, educates and employs its doctors, nurses and support staff, the report says and sets out a 10-year plan to address the crisis.
Child health need
It calls for national leaders to urgently formulate and implement country strategies for the health workforce, backed by international donor assistance. Infectious diseases and complications of pregnancy and delivery cause at least 10 million deaths each year. The WHO says there is clear evidence that having a higher ratio of health workers to people increases boosts infant, child and maternal survival. Dr Timothy Evans, WHO Assistant Director-General, said: "Not enough health workers are being trained or recruited where they are most needed. "And increasing numbers are joining a brain drain of qualified professionals who are migrating to better-paid jobs in richer countries, whether those countries are near neighbours or wealthy industrialised nations. "Such countries are likely to attract even more foreign staff because of their ageing populations, who will need more long-term, chronic care." The WHO is calling for more direct investment in the training and support of health workers. It says health budgets should increase by at least US$10 per person per year in the 57 countries with severe shortages, to educate and pay for the four million health workers needed. National and international funding would be needed to achieve this goal. The report says that meeting that target within 20 years is "ambitious but reasonable". The UK government said it was against poaching. Health Minister Rosie Winterton said: "We have one of the strongest ethical recruitment codes in the world. "The UK is the only rich country to have a policy of not actively looking for healthcare workers in deprived countries to staff the NHS."
Click to return
Nurses goes back to Malawi
'I want to quit Nigeria'[/quote]Sub-Saharan Africa has 11% of the world's population and 24% of the global burden of disease but only 3% of the world's health workers. A lack of personnel, combined with a lack of training and knowledge, is also a major obstacle for health systems as they attempt to respond effectively to chronic diseases and bird flu. The WHO says life expectancies in the poorest countries are half of those in the richest nations. It says each country needs to improve the way in which it plans for, educates and employs its doctors, nurses and support staff, the report says and sets out a 10-year plan to address the crisis.
Child health need
It calls for national leaders to urgently formulate and implement country strategies for the health workforce, backed by international donor assistance. Infectious diseases and complications of pregnancy and delivery cause at least 10 million deaths each year. The WHO says there is clear evidence that having a higher ratio of health workers to people increases boosts infant, child and maternal survival. Dr Timothy Evans, WHO Assistant Director-General, said: "Not enough health workers are being trained or recruited where they are most needed. "And increasing numbers are joining a brain drain of qualified professionals who are migrating to better-paid jobs in richer countries, whether those countries are near neighbours or wealthy industrialised nations. "Such countries are likely to attract even more foreign staff because of their ageing populations, who will need more long-term, chronic care." The WHO is calling for more direct investment in the training and support of health workers. It says health budgets should increase by at least US$10 per person per year in the 57 countries with severe shortages, to educate and pay for the four million health workers needed. National and international funding would be needed to achieve this goal. The report says that meeting that target within 20 years is "ambitious but reasonable". The UK government said it was against poaching. Health Minister Rosie Winterton said: "We have one of the strongest ethical recruitment codes in the world. "The UK is the only rich country to have a policy of not actively looking for healthcare workers in deprived countries to staff the NHS."
Click to return
Weak brain links 'explain autism' BBC NEWS
The difficulties people with autism have in relating to others could be due to poor communication between brain areas, scientists suggest. It may explain why they do not interact well, as the weak links mean they benefit less from social situations. It had been thought that their lack of social skills was due to abnormalities in particular brain areas. The study in Neuroimage, carried out by University of London researchers, compared brain scans of 32 people.
The difficulties people with autism have in relating to others could be due to poor communication between brain areas, scientists suggest. It may explain why they do not interact well, as the weak links mean they benefit less from social situations. It had been thought that their lack of social skills was due to abnormalities in particular brain areas. The study in Neuroimage, carried out by University of London researchers, compared brain scans of 32 people.
QUOTE("Dr Geoff Bird @ University College London")
The face processing areas of the brain are not well connected to those parts of the brain that control attention
The researchers took brain scans of 16 people with autism spectrum disorders (ASD) and above-average IQs, as well as those of 16 unaffected volunteers. They were shown four images on the screen - two of houses and two of faces. They were then asked to concentrate on either the faces or houses and decide if they were identical. Scans showed there were marked differences in the brain activity of the two groups. In the control group, paying attention to pictures of faces caused a significant increase in brain activity. But for people with ASD, paying attention to faces made no impact at all on the brain, explaining their lack of interest in faces. Both groups had the same reaction to houses. Dr Geoff Bird, at the UCL Institute of Cognitive Neuroscience, who led the research, said: "The standard view of social problems in ASD is that there is a problem in the part of the brain that processes faces. "Our research suggests that this is not the real problem - it seems to be that paying attention to faces doesn't lead to the normal increase in brain activity. "This is because the face-processing areas of the brain are not well connected to those parts of the brain that control attention - such as the frontal and parietal regions. "We all know that it is harder to pick a face out of a busy crowd, for instance, but when we do find the right face and pay attention to it, we are easily able to tune-out all the other distractions and focus on that one face. "It seems that, for people with ASD, paying attention to a face is much harder to do and doesn't have the same effect." Richard Mills, director of research for the National Autistic Society, said: "We welcome this research, which examines the underlying mechanisms related to complex 'instinctive' social responses. "We know that many people with ASD have particular difficulties in this area and we are hopeful that an improved understanding of these processes will enable people to receive appropriate and helpful support."
Prostate cancer cholesterol link BBC NEWS
Scientists have produced evidence linking high cholesterol levels to a raised risk of prostate cancer. The Italian researchers, who analysed data on 2,745 men, say more work is needed to establish a firm association. However, they believe the key may be that cholesterol is used by the body to produce male hormones which have been linked to prostate cancer. Other experts said the Annals of Oncology study findings were plausible, but disputed the hormone theory.
Gallstones
The analysis also found prostate cancer patients were 26% more likely to have had gallstones. Thinner men appeared to be particularly vulnerable. Researcher Dr Cristina Bosetti said: "Androgens - hormones that have a role in prostate tissue and cancer - are synthesised from cholesterol, suggesting a possible biological relationship between high cholesterol and prostate cancer. "Gallstones are related to high cholesterol levels as well and are often composed of cholesterol. "So, the direct relationship we found between gallstones and prostate cancer, while it was not statistically significant, suggests a similar biological mechanism may explain the link." Dr Bosetti said there was some evidence suggesting cholesterol-lowering statin drugs may help protect against prostate cancer. However, she said studies investigating the link had so far been limited and inconclusive. Professor Nick James, a cancer specialist at the University of Birmingham, said it was "entirely plausible" that cholesterol was linked to prostate cancer. He said: "There is a lot of circumstantial evidence suggesting that diet is a factor in developing prostate cancer. For instance, the disease is more common in northern European countries, where consumption of animals fats is relatively high. "This research carries a positive message: it suggests that people can do something themselves to reduce the chances of getting a disease which is among the biggest killers of men." However, Professor James was unconvinced by the idea that male hormones were key. Instead, he said some of the chemicals produced by the breakdown of cholesterol were known to be carcinogenic. Chris Hiley, of the Prostate Cancer Charity, said: "Further research is needed to confirm this but in the meantime the health benefits of a varied diet are indisputable. "We encourage men to cut down their intake of fatty foods and red and processed meat, but continue to eat oily fish and a high fibre diet with porridge oats, as well as plenty of fresh fruit and vegetables daily."
Scientists have produced evidence linking high cholesterol levels to a raised risk of prostate cancer. The Italian researchers, who analysed data on 2,745 men, say more work is needed to establish a firm association. However, they believe the key may be that cholesterol is used by the body to produce male hormones which have been linked to prostate cancer. Other experts said the Annals of Oncology study findings were plausible, but disputed the hormone theory.
QUOTE("Professor Nick James")
It suggests that people can do something themselves to reduce the chances of getting a disease which is among the biggest killers of men
The researchers, from the Istituto di Ricerche Farmacologiche Mario Negri in Milan, admitted the study had to rely on patients reporting details of their own medical conditions. However, they said the apparent association between high cholesterol and prostate cancer seemed to be a real one - particularly as the study uncovered no evidence of a link between the disease and ten other medical conditions. The researchers examined data on 1,294 men with prostate cancer, and 1,451 men admitted to hospital with non-cancerous conditions. They found men with prostate cancer were around 50% more likely to have had high cholesterol levels. The association was particularly strong among men diagnosed with prostate cancer before the age of 50, and after the age of 65. Both these groups were 80% more likely to report high cholesterol levels than men free from cancer.Gallstones
The analysis also found prostate cancer patients were 26% more likely to have had gallstones. Thinner men appeared to be particularly vulnerable. Researcher Dr Cristina Bosetti said: "Androgens - hormones that have a role in prostate tissue and cancer - are synthesised from cholesterol, suggesting a possible biological relationship between high cholesterol and prostate cancer. "Gallstones are related to high cholesterol levels as well and are often composed of cholesterol. "So, the direct relationship we found between gallstones and prostate cancer, while it was not statistically significant, suggests a similar biological mechanism may explain the link." Dr Bosetti said there was some evidence suggesting cholesterol-lowering statin drugs may help protect against prostate cancer. However, she said studies investigating the link had so far been limited and inconclusive. Professor Nick James, a cancer specialist at the University of Birmingham, said it was "entirely plausible" that cholesterol was linked to prostate cancer. He said: "There is a lot of circumstantial evidence suggesting that diet is a factor in developing prostate cancer. For instance, the disease is more common in northern European countries, where consumption of animals fats is relatively high. "This research carries a positive message: it suggests that people can do something themselves to reduce the chances of getting a disease which is among the biggest killers of men." However, Professor James was unconvinced by the idea that male hormones were key. Instead, he said some of the chemicals produced by the breakdown of cholesterol were known to be carcinogenic. Chris Hiley, of the Prostate Cancer Charity, said: "Further research is needed to confirm this but in the meantime the health benefits of a varied diet are indisputable. "We encourage men to cut down their intake of fatty foods and red and processed meat, but continue to eat oily fish and a high fibre diet with porridge oats, as well as plenty of fresh fruit and vegetables daily."
'Bubble boy' therapy cancer risk BBC News
Gene therapy used to treat children with no immune system could be far riskier than previously thought, a US study has suggested. The treatment is used for children with X-SCID - commonly known as "bubble boy" syndrome. The latest animal study in Nature found the treatment itself can cause cancer. But experts from Great Ormond Street, where nine children were successfully treated, said the study had used unnaturally high doses of the gene.
Caution urged
In this latest research, a team from the Salk Institute for Biological Studies in Los Angeles, California, looked at the long-term effect of infecting the IL2RG gene into mice. They were injected with the gene - the same gene that is given in the treatment of X-SCID. They studied for an average of 18 months - three times longer than in previous animal studies. A third of the animals developed lymphoma, with most doing so when they were about 10 months old. Dr Neils-Bjarne Woods, who led the study, said: "We were surprised by the strength of the association. "These results suggest that curing X-SCID by replacing IL2RG in the manner it is currently being done puts patients at an increased risk of developing cancer."
'Unhelpful'
A earlier trial of the gene therapy in France had found nine out of 10 children were successfully cured of their condition. But three were diagnosed with T-cell leukaemia, and the study was halted in 2002. Two developed the disease because IL2RG inserted itself into the cellular genome next to a known cancer-causing gene and activated it, but the cause of the third cancer case had not been found. The Salk Institute researchers say their work could provide the explanation. Professor Woods said: "The bottom line here is that if you replace a gene that has multiple effects, you have to know more about its regulation and its ability to affect other genes, and that requires extensive preclinical work and a much more careful analysis." The gene therapy team at Great Ormond Street Hospital was highly critical of the study. A spokeswoman said: "The paper in Nature is in our view, not helpful." Professor Adrian Thrasher, who led the GOSH work, added: "This is a very preliminary study published in an incomplete form. "The researchers have taken artificially high doses of these genes and given them to animals. "I'm not sure how it is relevant to human treatment. "We know already that, in lower doses, the gene therapy does not have that effect."
Gene therapy used to treat children with no immune system could be far riskier than previously thought, a US study has suggested. The treatment is used for children with X-SCID - commonly known as "bubble boy" syndrome. The latest animal study in Nature found the treatment itself can cause cancer. But experts from Great Ormond Street, where nine children were successfully treated, said the study had used unnaturally high doses of the gene.
QUOTE("Professor Adrian Thrasher @ Great Ormond Street Hospital")
This is a very preliminary study published in an incomplete form
They said other studies showed the cancer risk was not present when lower doses were given. The gene therapy does have a chequered past. A major study was halted after three children developed leukaemia. And US research found the treatment could cause cancer through genes inserted into cells to replace faulty copies spreading and damagining healthy genes. X-SCID is caused by mutations in the IL2RG gene, which governs the behaviour of a protein involved in the development of a number of immune system cells. Without the protein, the cells cannot develop normally, and are unable to protect the body. The gene therapy works by replacing a defective gene. A sample of bone marrow cells is taken from the patient deliberately infecting them with a non-infectious retrovirus modified to carry the corrective gene. The retrovirus is then used as a "vehicle" to insert the therapeutic DNA randomly into the cells' chromosomes. Hopefully, when the cells are returned to the patient, they are able to initiate the creation of a functioning immune system.Caution urged
In this latest research, a team from the Salk Institute for Biological Studies in Los Angeles, California, looked at the long-term effect of infecting the IL2RG gene into mice. They were injected with the gene - the same gene that is given in the treatment of X-SCID. They studied for an average of 18 months - three times longer than in previous animal studies. A third of the animals developed lymphoma, with most doing so when they were about 10 months old. Dr Neils-Bjarne Woods, who led the study, said: "We were surprised by the strength of the association. "These results suggest that curing X-SCID by replacing IL2RG in the manner it is currently being done puts patients at an increased risk of developing cancer."
'Unhelpful'
A earlier trial of the gene therapy in France had found nine out of 10 children were successfully cured of their condition. But three were diagnosed with T-cell leukaemia, and the study was halted in 2002. Two developed the disease because IL2RG inserted itself into the cellular genome next to a known cancer-causing gene and activated it, but the cause of the third cancer case had not been found. The Salk Institute researchers say their work could provide the explanation. Professor Woods said: "The bottom line here is that if you replace a gene that has multiple effects, you have to know more about its regulation and its ability to affect other genes, and that requires extensive preclinical work and a much more careful analysis." The gene therapy team at Great Ormond Street Hospital was highly critical of the study. A spokeswoman said: "The paper in Nature is in our view, not helpful." Professor Adrian Thrasher, who led the GOSH work, added: "This is a very preliminary study published in an incomplete form. "The researchers have taken artificially high doses of these genes and given them to animals. "I'm not sure how it is relevant to human treatment. "We know already that, in lower doses, the gene therapy does not have that effect."
Mild form of avian flu found in New Jersey Yahoo! News
Authorities have discovered a mild form of avian influenza at a live bird market in New Jersey, but it is not the deadly H5N1 strain governments around the world are trying to contain, the state's agriculture department said. "The strain was found in a live bird market in Camden County. None of the birds in the market died from this virus, which is an indicator that the virus was low pathogenic and not harmful to humans," said a statement by New Jersey's Agriculture Secretary Charles Kuperus which was posted on Friday. Details were not immediately available on precisely when the avian flu in Camden County was discovered. The H5N1 strain of avian influenza not only kills chickens quickly, but can now infect people, and governments around the world are scrambling to contain its spread. Scientists fear that if the virus acquires the ability to pass easily from person to person, it could cause a pandemic that would kill millions. The H5N1 avian flu strain has already infected 205 people and killed 113 since 2003. Its spread has forced several countries to ban poultry imports from nations where the disease has spread. The H5N1 virus has spread from Asia to Europe, the Middle East and Africa. Kuperus said preliminary tests from the National Veterinary Services laboratory were negative for type N1 of the virus. More tests are pending at laboratories of the U.S. Agriculture Department in Ames, Iowa, to confirm the strain of the virus, he added. "The market owner voluntarily depopulated his existing flock, and the market has undergone cleaning and disinfecting under New Jersey Department of Agriculture supervision," said Kuperus. The market in Camden County will be inspected again by New Jersey's Division of Animal Health before being allowed to reopen.
Authorities have discovered a mild form of avian influenza at a live bird market in New Jersey, but it is not the deadly H5N1 strain governments around the world are trying to contain, the state's agriculture department said. "The strain was found in a live bird market in Camden County. None of the birds in the market died from this virus, which is an indicator that the virus was low pathogenic and not harmful to humans," said a statement by New Jersey's Agriculture Secretary Charles Kuperus which was posted on Friday. Details were not immediately available on precisely when the avian flu in Camden County was discovered. The H5N1 strain of avian influenza not only kills chickens quickly, but can now infect people, and governments around the world are scrambling to contain its spread. Scientists fear that if the virus acquires the ability to pass easily from person to person, it could cause a pandemic that would kill millions. The H5N1 avian flu strain has already infected 205 people and killed 113 since 2003. Its spread has forced several countries to ban poultry imports from nations where the disease has spread. The H5N1 virus has spread from Asia to Europe, the Middle East and Africa. Kuperus said preliminary tests from the National Veterinary Services laboratory were negative for type N1 of the virus. More tests are pending at laboratories of the U.S. Agriculture Department in Ames, Iowa, to confirm the strain of the virus, he added. "The market owner voluntarily depopulated his existing flock, and the market has undergone cleaning and disinfecting under New Jersey Department of Agriculture supervision," said Kuperus. The market in Camden County will be inspected again by New Jersey's Division of Animal Health before being allowed to reopen.
Fear the phone, not the doorknob, US germ expert says Yahoo! News
Worried about colds, flu and other germs? Go ahead and touch those doorknobs and elevator buttons, but watch out for the telephone, fresh laundry and sinks, a top expert advises. And while you should always wash your hands before making a meal, many people do not realize that they should do so afterwards also, says Charles Gerba, a microbiologist and clean water expert at the University of Arizona. "Most of the common infections -- colds, flu, diarrhea -- you get environmentally transmitted either in the air or on surfaces you touch. I think people under-rate surfaces," Gerba said in a telephone interview. And when they are cautious, they are usually cautious about the wrong things. Germs do not stick where people believe they will. "Doorknobs are usually on the low side," said Gerba, who has conducted dozens of surveys of bacteria and viruses in workplaces and homes. "I guess they are not moist. Never fear a doorknob." A recent informal survey of a Reuters office helped him illustrate how microbes take advantage of misconceptions to propagate themselves. Two computer keyboards, for example, carried far more bacteria than an elevator button, the handles and button on the communal microwave oven or the office water fountain, an analysis by Gerba's lab found. Keyboards and telephones -- especially when they are shared -- are among the most germ-laden places in a home or office, Gerba said.
LUNCH COUNTER FOR GERMS
"Keyboards are a lunch counter for germs," Gerba said. "We turn them over in a lot of studies and we are amazed at what comes out of a keyboard." In fact, the average desk harbors 400 times more bacteria than the average toilet seat, says Gerba, whose latest survey focuses on the germiest professions. "Nobody cleans the desktop, usually, until they stick to it," he says. Perhaps not surprisingly, teachers have the highest exposure to bacteria and viruses, Gerba has found. Accountants, bankers and doctors also tend to have microbe-laden offices, while lawyers came out surprisingly clean in the germ-count stakes. Offices are, however, becoming cleaner, Gerba says. His lab does a simple overall bacteria count for its most general surveys. The person swabs each surface and sends it to Gerba's lab, which then cultures the bacteria in a lab dish. The growth of whatever bacteria are present can be used to estimate an overall load of germs, including harmless E. coli bacteria -- which are found in the gut and are an indicator of what scientists delicately call "fecal contamination." Some other bacteria usually present are Klebsiella pneumonia, Streptococcus, Salmonella and Staphyloccus aureus, some of which cause disease and some of which do not. And where there are bacteria, there can be viruses, which can hang onto a clean and dry surface for days and to a wet surface for weeks. Such knowledge may be particularly useful as experts warn that a pandemic of H5N1 avian influenza may be looming. While the virus currently infects birds almost exclusively, experts say it shows the greatest potential of any virus in decades to cause a human pandemic. If it begins to spread, basic hygiene would be essential to avoid infection. But viruses are of course invisible to the human eye and Gerba notes that people tend not to know where the most infectious places are. For example, the bathroom. "Toilets get a bad rap. So does the door on the way out," Gerba said. Bathroom sinks, however, are another matter. "Sinks are usually high (in bacterial counts) to begin with," Gerba said. "They have got everything a bacteria likes. It's wet, it's moist. In a home we usually find more E. coli in a sink than a toilet." Men's rooms, too. "Usually the dirtiest handles in public restrooms are urinal flush handles," he said.
DIARRHEA, NOT GONORRHEA
But urban legends about getting sexually transmitted diseases in a public restroom are untrue, Gerba said. "It's really diarrhea, not gonorrhea, you have to worry about," he said. Commonly found restroom germs include noroviruses, shigella, hepatitis A and Salmonella. Food preparation is another good way to get germy, especially when handling raw meat, Gerba said. And few people know just how dirty laundry is -- clean laundry. "Most people don't realize that they actually should wash their hands after they make dinner and also after they do the laundry," Gerba said. Americans have moved to short-cycle, cold-water washes to save energy and wear and tear on clothing, but this leaves viruses and bacteria largely intact. "Water at 140 degrees F (60 degrees C) will sanitize laundry," Gerba said. But only 5 percent of Americans use hot water for laundry. And viruses such as hepatitis A, rotavirus and bacteria such as Salmonella -- all of which cause stomach upsets and diarrhea -- can easily survive the average 28-minute drying cycle. These are all carried fecally. "There is about a 10th of a gram of feces in the average pair of underwear," Gerba says. "You don't want to be doing your handkerchiefs with your underwear." Gerba's studies are often funded by companies that make disinfectants, but Gerba says antimicrobial wipes and alcohol-based gel hand sanitizers do work. "It has been shown that you can reduce a lot of absenteeism by using hand sanitizers," he says. "We don't want to make people overly paranoid here," Gerba added. "You can reduce your risk of getting colds and flu by a few simple actions. You are always gambling with germs. You just want to keep the odds in your favor."
By Maggie Fox, Health and Science Correspondent
Worried about colds, flu and other germs? Go ahead and touch those doorknobs and elevator buttons, but watch out for the telephone, fresh laundry and sinks, a top expert advises. And while you should always wash your hands before making a meal, many people do not realize that they should do so afterwards also, says Charles Gerba, a microbiologist and clean water expert at the University of Arizona. "Most of the common infections -- colds, flu, diarrhea -- you get environmentally transmitted either in the air or on surfaces you touch. I think people under-rate surfaces," Gerba said in a telephone interview. And when they are cautious, they are usually cautious about the wrong things. Germs do not stick where people believe they will. "Doorknobs are usually on the low side," said Gerba, who has conducted dozens of surveys of bacteria and viruses in workplaces and homes. "I guess they are not moist. Never fear a doorknob." A recent informal survey of a Reuters office helped him illustrate how microbes take advantage of misconceptions to propagate themselves. Two computer keyboards, for example, carried far more bacteria than an elevator button, the handles and button on the communal microwave oven or the office water fountain, an analysis by Gerba's lab found. Keyboards and telephones -- especially when they are shared -- are among the most germ-laden places in a home or office, Gerba said.
LUNCH COUNTER FOR GERMS
"Keyboards are a lunch counter for germs," Gerba said. "We turn them over in a lot of studies and we are amazed at what comes out of a keyboard." In fact, the average desk harbors 400 times more bacteria than the average toilet seat, says Gerba, whose latest survey focuses on the germiest professions. "Nobody cleans the desktop, usually, until they stick to it," he says. Perhaps not surprisingly, teachers have the highest exposure to bacteria and viruses, Gerba has found. Accountants, bankers and doctors also tend to have microbe-laden offices, while lawyers came out surprisingly clean in the germ-count stakes. Offices are, however, becoming cleaner, Gerba says. His lab does a simple overall bacteria count for its most general surveys. The person swabs each surface and sends it to Gerba's lab, which then cultures the bacteria in a lab dish. The growth of whatever bacteria are present can be used to estimate an overall load of germs, including harmless E. coli bacteria -- which are found in the gut and are an indicator of what scientists delicately call "fecal contamination." Some other bacteria usually present are Klebsiella pneumonia, Streptococcus, Salmonella and Staphyloccus aureus, some of which cause disease and some of which do not. And where there are bacteria, there can be viruses, which can hang onto a clean and dry surface for days and to a wet surface for weeks. Such knowledge may be particularly useful as experts warn that a pandemic of H5N1 avian influenza may be looming. While the virus currently infects birds almost exclusively, experts say it shows the greatest potential of any virus in decades to cause a human pandemic. If it begins to spread, basic hygiene would be essential to avoid infection. But viruses are of course invisible to the human eye and Gerba notes that people tend not to know where the most infectious places are. For example, the bathroom. "Toilets get a bad rap. So does the door on the way out," Gerba said. Bathroom sinks, however, are another matter. "Sinks are usually high (in bacterial counts) to begin with," Gerba said. "They have got everything a bacteria likes. It's wet, it's moist. In a home we usually find more E. coli in a sink than a toilet." Men's rooms, too. "Usually the dirtiest handles in public restrooms are urinal flush handles," he said.
DIARRHEA, NOT GONORRHEA
But urban legends about getting sexually transmitted diseases in a public restroom are untrue, Gerba said. "It's really diarrhea, not gonorrhea, you have to worry about," he said. Commonly found restroom germs include noroviruses, shigella, hepatitis A and Salmonella. Food preparation is another good way to get germy, especially when handling raw meat, Gerba said. And few people know just how dirty laundry is -- clean laundry. "Most people don't realize that they actually should wash their hands after they make dinner and also after they do the laundry," Gerba said. Americans have moved to short-cycle, cold-water washes to save energy and wear and tear on clothing, but this leaves viruses and bacteria largely intact. "Water at 140 degrees F (60 degrees C) will sanitize laundry," Gerba said. But only 5 percent of Americans use hot water for laundry. And viruses such as hepatitis A, rotavirus and bacteria such as Salmonella -- all of which cause stomach upsets and diarrhea -- can easily survive the average 28-minute drying cycle. These are all carried fecally. "There is about a 10th of a gram of feces in the average pair of underwear," Gerba says. "You don't want to be doing your handkerchiefs with your underwear." Gerba's studies are often funded by companies that make disinfectants, but Gerba says antimicrobial wipes and alcohol-based gel hand sanitizers do work. "It has been shown that you can reduce a lot of absenteeism by using hand sanitizers," he says. "We don't want to make people overly paranoid here," Gerba added. "You can reduce your risk of getting colds and flu by a few simple actions. You are always gambling with germs. You just want to keep the odds in your favor."
By Maggie Fox, Health and Science Correspondent
Diabetes raises early death risk BBC News
Younger people with Type 2 diabetes are three times more likely to die early than those of the same age without the disease, a study suggests. A study of 264,000 patients in the journal of Diabetic Medicine found those with the disease were twice as likely to die early than those without. Patients with Type 2 diabetes aged 35 to 54 were three times as likely to die early as non-sufferers of the same age. Type 2 Diabetes tends develop in later life and is linked to obesity and diet. Charity Diabetes UK said the results of the study published in the journal Diabetic Medicine were "shocking". It develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work properly (known as insulin resistance).
'Younger and younger'
But research author Henrietta Mulnier of Surrey University said data like this showed it was just as dangerous. Her team compared information from GPs' records in the UK on deaths from all causes between January 1992 and October 1999. "We did expect that people with Type 2 diabetes would have a higher risk of dying earlier rather than later," she said. She added that the findings would have an impact on how decisions on how to deal with the disease and provide health care are made. "With people being diagnosed with Type 2 diabetes younger and younger, the figures are going to get worse. "We really do need to focus on early detection and treatment." Douglas Smallwood, chief executive at Diabetes UK, said the results were shocking but people with diabetes had to be made aware of the seriousness of the condition.
Healthy lives
"Diabetes deaths are predicted to rise by 25% over the next decade." But he said that many of the deaths would have been needless. "However, the risk of complications leading to death can be reduced if people with diabetes get the care they need to manage their condition. "There is no reason why people with diabetes cannot live long and healthy lives," he added. It is thought that there up to three quarters of a million people with Type 2 diabetes in the UK who have not been diagnosed. The longer patients have the condition, the more likely they are to develop complications which can be deadly.
Younger people with Type 2 diabetes are three times more likely to die early than those of the same age without the disease, a study suggests. A study of 264,000 patients in the journal of Diabetic Medicine found those with the disease were twice as likely to die early than those without. Patients with Type 2 diabetes aged 35 to 54 were three times as likely to die early as non-sufferers of the same age. Type 2 Diabetes tends develop in later life and is linked to obesity and diet. Charity Diabetes UK said the results of the study published in the journal Diabetic Medicine were "shocking". It develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work properly (known as insulin resistance).
QUOTE("Henrietta Mulnier @ Research author")
We really do need to focus on early detection and treatment
Type 1 diabetes is diagnosed at a much earlier age and occurs when the body cannot make any insulin at all. Type 2 diabetes is treated with lifestyle changes such as a healthier diet, weight loss and increased physical activity. But the condition is progressive and tablets and/or insulin may also be required to achieve normal blood glucose levels. Both types lead to associated conditions such as heart disease, strokes, kidney failure, nerve damage leading to amputations and blindness. Some view Type 2 diabetes as a milder form of the disease because patients do not necessarily have to have insulin injections.'Younger and younger'
But research author Henrietta Mulnier of Surrey University said data like this showed it was just as dangerous. Her team compared information from GPs' records in the UK on deaths from all causes between January 1992 and October 1999. "We did expect that people with Type 2 diabetes would have a higher risk of dying earlier rather than later," she said. She added that the findings would have an impact on how decisions on how to deal with the disease and provide health care are made. "With people being diagnosed with Type 2 diabetes younger and younger, the figures are going to get worse. "We really do need to focus on early detection and treatment." Douglas Smallwood, chief executive at Diabetes UK, said the results were shocking but people with diabetes had to be made aware of the seriousness of the condition.
Healthy lives
"Diabetes deaths are predicted to rise by 25% over the next decade." But he said that many of the deaths would have been needless. "However, the risk of complications leading to death can be reduced if people with diabetes get the care they need to manage their condition. "There is no reason why people with diabetes cannot live long and healthy lives," he added. It is thought that there up to three quarters of a million people with Type 2 diabetes in the UK who have not been diagnosed. The longer patients have the condition, the more likely they are to develop complications which can be deadly.
US bird flu plan aims to slow, not stop, pandemic Yahoo! News
Americans should prepare for travel restrictions and school closures if an influenza pandemic hits, but such measures can only temporarily slow the inevitable spread of disease, the government's new flu plan says. The White House influenza plan released on Wednesday builds on an earlier plan to combat a potential pandemic of H5N1 avian influenza, including preparations to build a stockpile of vaccines and drugs, already under way, and work to develop newer and better vaccines. "In terms of its scope, the impact of a severe pandemic may be more comparable to that of a war or a widespread economic crisis than a hurricane, earthquake or act of terrorism," the report reads. The advice ranges from general recommendations to prepare and consult, to detailed information -- for instance, that keeping people three feet (one meter) apart should reduce transmission of the virus and that it can survive on dry surfaces for days. At the height of a pandemic, people should prepare to hunker down for a while, Frances Fragos Townsend, assistant to the president for homeland security and counterterrorism, told a news conference. "Imagine your average summer vacation. It would be limiting nonessential travel that you don't have to take inside the United States," she said. "I wouldn't be going to the mall if I didn't need to be there."
WORKING ON A VACCINE
The plan does not give specifics on who would get vaccinated first or who would be the first to get scarce antiviral drugs. Administration officials said research on vaccines is moving too fast to make it possible to plan yet. There is currently no licensed vaccine against H5N1 avian influenza but experimental forms are being tested. Some Democrats immediately attacked this omission. "A flu plan that doesn't say how to distribute vaccine is about as useful as a hurricane plan that doesn't say how to rescue people from a flood," Massachusetts Sen. Ted Kennedy said. The administration of President George W. Bush, whose approval ratings have been sagging, was broadly criticized for responding slowly to Hurricane Katrina last year. The widely leaked plan has changed considerably from earlier versions, according to sources who saw drafts. It makes clear that closing borders would not be a major part of the U.S. defense. "Measures at our borders may provide an opportunity to slow the spread of a pandemic to and within the United States, but are unlikely to prevent it," the report reads. "When you look at border restrictions, there's a period of time very early on in a potential pandemic where they may be effective not in stopping the arrival of the virus but in buying us time and slowing the spread of the pandemic to allow communities, frankly, and individuals to get better prepared, if they haven't already," Townsend said. "And so we look at things like departure screening, on-plane screening and arrival screening."
"INCREDIBLE PROGRESS"
"We have made incredible progress," said Mike Osterholm, an infectious disease expert at the University of Minnesota who has been warning of the risks of a pandemic for years. "The one area that I continue to worry about in a very real way is the lack of resources. Planning for pandemic influenza at the local, state and federal level is not cheap," Osterholm added. Townsend said local governments and businesses will have to provide much of the funding themselves. "We believe that this should be a priority for resource allocation and for planning -- for policy implementation and planning," she said. The plan also lays out specific responsibilities for each government department, but makes clear the Department of Homeland Security will be in overall charge should a pandemic hit. Democrats attacked this, also. "Given the Department of Homeland Security's track record, I don't think I'm alone in raising concerns about whether they're prepared to execute and manage a crisis of this magnitude," said Illinois Rep. Rahm Emanuel.
By Maggie Fox, Health and Science Correspondent
Americans should prepare for travel restrictions and school closures if an influenza pandemic hits, but such measures can only temporarily slow the inevitable spread of disease, the government's new flu plan says. The White House influenza plan released on Wednesday builds on an earlier plan to combat a potential pandemic of H5N1 avian influenza, including preparations to build a stockpile of vaccines and drugs, already under way, and work to develop newer and better vaccines. "In terms of its scope, the impact of a severe pandemic may be more comparable to that of a war or a widespread economic crisis than a hurricane, earthquake or act of terrorism," the report reads. The advice ranges from general recommendations to prepare and consult, to detailed information -- for instance, that keeping people three feet (one meter) apart should reduce transmission of the virus and that it can survive on dry surfaces for days. At the height of a pandemic, people should prepare to hunker down for a while, Frances Fragos Townsend, assistant to the president for homeland security and counterterrorism, told a news conference. "Imagine your average summer vacation. It would be limiting nonessential travel that you don't have to take inside the United States," she said. "I wouldn't be going to the mall if I didn't need to be there."
WORKING ON A VACCINE
The plan does not give specifics on who would get vaccinated first or who would be the first to get scarce antiviral drugs. Administration officials said research on vaccines is moving too fast to make it possible to plan yet. There is currently no licensed vaccine against H5N1 avian influenza but experimental forms are being tested. Some Democrats immediately attacked this omission. "A flu plan that doesn't say how to distribute vaccine is about as useful as a hurricane plan that doesn't say how to rescue people from a flood," Massachusetts Sen. Ted Kennedy said. The administration of President George W. Bush, whose approval ratings have been sagging, was broadly criticized for responding slowly to Hurricane Katrina last year. The widely leaked plan has changed considerably from earlier versions, according to sources who saw drafts. It makes clear that closing borders would not be a major part of the U.S. defense. "Measures at our borders may provide an opportunity to slow the spread of a pandemic to and within the United States, but are unlikely to prevent it," the report reads. "When you look at border restrictions, there's a period of time very early on in a potential pandemic where they may be effective not in stopping the arrival of the virus but in buying us time and slowing the spread of the pandemic to allow communities, frankly, and individuals to get better prepared, if they haven't already," Townsend said. "And so we look at things like departure screening, on-plane screening and arrival screening."
"INCREDIBLE PROGRESS"
"We have made incredible progress," said Mike Osterholm, an infectious disease expert at the University of Minnesota who has been warning of the risks of a pandemic for years. "The one area that I continue to worry about in a very real way is the lack of resources. Planning for pandemic influenza at the local, state and federal level is not cheap," Osterholm added. Townsend said local governments and businesses will have to provide much of the funding themselves. "We believe that this should be a priority for resource allocation and for planning -- for policy implementation and planning," she said. The plan also lays out specific responsibilities for each government department, but makes clear the Department of Homeland Security will be in overall charge should a pandemic hit. Democrats attacked this, also. "Given the Department of Homeland Security's track record, I don't think I'm alone in raising concerns about whether they're prepared to execute and manage a crisis of this magnitude," said Illinois Rep. Rahm Emanuel.
By Maggie Fox, Health and Science Correspondent
http://www.cnn.com/2006/HEALTH/conditions/...g.ap/index.html
CDC wants HIV tests for everyone
ATLANTA, Georgia (AP) -- Testing for the AIDS virus could become part of routine physical exams for adults and teens if doctors follow new U.S. guidelines expected to be issued by this summer.
Federal health officials say they would like HIV testing to be as common as a cholesterol check.
The guidelines for routine testing would apply to every American ages 13 to 64, according to the proposed plan by the U.S. Centers for Disease control and Prevention.
One-quarter of the 1 million Americans with the AIDS virus don't know they are infected, and that group is most responsible for HIV's spread, CDC officials said.
"We need to expand access to HIV testing dramatically by making it a routine part of medical care," said the agency's Dr. Kevin Fenton.
CDC officials presented the plans at a scientific conference in February. Last week, they said the guidelines should be released in June or July.
The recommendations are not legally binding, but they influence what doctors do and what health insurance programs cover.
Currently, the CDC recommends routine testing for those at high-risk for catching the virus, such as IV drug users and gay men, and for hospitals and certain other institutions serving areas where HIV is common. It also recommends testing for all pregnant women.
Under the new guidelines, patients would be tested for HIV as part of a standard battery of tests they receive when they go for urgent or emergency care, or even during a routine physical.
Patients would not get tested every year: Repeated, annual testing would only be recommended for those at high-risk.
There would be no consent form specifically for the HIV test; it would be covered in a clinic or hospital's standard care consent form. Patients would be allowed to decline the testing.
Standardizing HIV testing should reduce the stigma as well as transmission, CDC officials said. Nearly half of new HIV infections are discovered when doctors are trying to diagnose an illness in a patient who has come for care, they noted.
The American Medical Association supports the proposed recommendations, said Dr. Nancy Nielsen, a Buffalo, New York-based physician who is speaker of the AMA's House of Delegates.
Some doctor's offices will face challenges implementing the recommendations, she added. For example, they should not give a positive HIV test result over the phone and would have to provide or arrange for counseling.
But the benefits of reducing the spread of HIV far outweigh the logistical challenges, said Nielsen, an infectious disease specialist.
"I'm so happy the CDC is recommending this," she said. "HIV is an infectious disease and it should be treated like any other infectious disease. The fact that it has been treated so differently, I think, in some ways has contributed to the stigma."
Some patients' advocates have voiced concern that the recommendations do not include pre-test counseling and sufficient informed consent.
At many HIV testing sites, patients sit through a counseling session to explain the procedure before any blood is drawn. Many centers also require a patient to give "informed consent," indicating they understand the risks and benefits of the test.
The proposed recommendations do not require pre-test counseling in medical settings. They call for post-test counseling to be offered only to patients who test positive.
Pre-test counseling and informed consent ensure that patients are warned of possible mistakes in test results, said Catherine Christeller, executive director of the Chicago Women's AIDS Project.
They also can explain the implications of HIV testing, she added. For example, undocumented workers who test positive for the AIDS virus may be deported and need to understand that, Christeller said.
CDC officials say they understand advocates' concerns and are optimistic physicians will follow the recommendations carefully.
"Doctors should be explicit that 'You're going to be tested,"' said Dr. Tim Mastro, acting director of the CDC's division of HIV/AIDS prevention.
CDC wants HIV tests for everyone
ATLANTA, Georgia (AP) -- Testing for the AIDS virus could become part of routine physical exams for adults and teens if doctors follow new U.S. guidelines expected to be issued by this summer.
Federal health officials say they would like HIV testing to be as common as a cholesterol check.
The guidelines for routine testing would apply to every American ages 13 to 64, according to the proposed plan by the U.S. Centers for Disease control and Prevention.
One-quarter of the 1 million Americans with the AIDS virus don't know they are infected, and that group is most responsible for HIV's spread, CDC officials said.
"We need to expand access to HIV testing dramatically by making it a routine part of medical care," said the agency's Dr. Kevin Fenton.
CDC officials presented the plans at a scientific conference in February. Last week, they said the guidelines should be released in June or July.
The recommendations are not legally binding, but they influence what doctors do and what health insurance programs cover.
Currently, the CDC recommends routine testing for those at high-risk for catching the virus, such as IV drug users and gay men, and for hospitals and certain other institutions serving areas where HIV is common. It also recommends testing for all pregnant women.
Under the new guidelines, patients would be tested for HIV as part of a standard battery of tests they receive when they go for urgent or emergency care, or even during a routine physical.
Patients would not get tested every year: Repeated, annual testing would only be recommended for those at high-risk.
There would be no consent form specifically for the HIV test; it would be covered in a clinic or hospital's standard care consent form. Patients would be allowed to decline the testing.
Standardizing HIV testing should reduce the stigma as well as transmission, CDC officials said. Nearly half of new HIV infections are discovered when doctors are trying to diagnose an illness in a patient who has come for care, they noted.
The American Medical Association supports the proposed recommendations, said Dr. Nancy Nielsen, a Buffalo, New York-based physician who is speaker of the AMA's House of Delegates.
Some doctor's offices will face challenges implementing the recommendations, she added. For example, they should not give a positive HIV test result over the phone and would have to provide or arrange for counseling.
But the benefits of reducing the spread of HIV far outweigh the logistical challenges, said Nielsen, an infectious disease specialist.
"I'm so happy the CDC is recommending this," she said. "HIV is an infectious disease and it should be treated like any other infectious disease. The fact that it has been treated so differently, I think, in some ways has contributed to the stigma."
Some patients' advocates have voiced concern that the recommendations do not include pre-test counseling and sufficient informed consent.
At many HIV testing sites, patients sit through a counseling session to explain the procedure before any blood is drawn. Many centers also require a patient to give "informed consent," indicating they understand the risks and benefits of the test.
The proposed recommendations do not require pre-test counseling in medical settings. They call for post-test counseling to be offered only to patients who test positive.
Pre-test counseling and informed consent ensure that patients are warned of possible mistakes in test results, said Catherine Christeller, executive director of the Chicago Women's AIDS Project.
They also can explain the implications of HIV testing, she added. For example, undocumented workers who test positive for the AIDS virus may be deported and need to understand that, Christeller said.
CDC officials say they understand advocates' concerns and are optimistic physicians will follow the recommendations carefully.
"Doctors should be explicit that 'You're going to be tested,"' said Dr. Tim Mastro, acting director of the CDC's division of HIV/AIDS prevention.
http://www.newyorker.com/printables/critic...515crat_atlarge
PARADISE SOLD
by STEVEN SHAPIN
What are you buying when you buy organic?
Issue of 2006-05-15
Posted 2006-05-08
The share price of the Whole Foods Market, Inc., now stands at $62.49. Adjusting for stock splits and dividends, one share would have cost you $2.92 when the company opened on Nasdaq, in January of 1992, so it has done extremely well. Last year, its total revenue was more than $5 billion and its gross profit was more than $1.6 billion. In 2004, according to the Financial Times, Whole Foods was “the fastest-growing mass retailer in the US, with same-store sales rising 17.1 per cent quarter-on-quarter.” Having opened in 1978 with a single countercultural vegetarian establishment in Austin, Texas, Whole Foods now has a hundred and eighty-one natural-food supermarkets, including many acquired in purchases of smaller chains: among them, Wellspring Grocery, in 1991; Bread & Circus, in 1992; Mrs. Gooch’s Natural Foods, in 1993; and Fresh Fields, in 1996. In 2004, Whole Foods opened a fifty-eight-thousand-square-foot mega-mart in the new Time Warner Center, at Columbus Circle, with forty-two cash registers, a two-hundred-and-forty-eight-seat café, and three hundred and ninety employees. “Our goal is to provide New Yorkers with an engaging shopping experience and to become an integral part of this truly unique community,” a company executive said. And in 2004 Whole Foods crossed the Atlantic, acquiring six Fresh & Wild stores in London and making plans to open others there under its own name. Its ambitions are global.
I like to shop at Whole Foods. Sometimes I go there just to see the variety and the colors: what new kinds of chard and kale will they have today? The employees—“team members,” as they’re called—seem reasonably happy and are often quite knowledgeable about the things they sell. A Wellesley graduate is one of the company’s prize exhibits. “I just hang on to the fact that my job is good in some larger sense,” she says on the corporate Web site. “If people buy the sprouts, they’re eating healthier foods, the farmer is doing well, and it’s good for the planet because they’re grown organically.” Since 1998, Whole Foods has ranked high among Fortune’s “100 Best Companies to Work For in America.” Although the company is as ferociously anti-union as Wal-Mart—John Mackey, the volubly libertarian founder and C.E.O., has called unions “parasites”—Whole Foods limits the compensation of its highest-paid executives to no more than fourteen times the employee salary average, and it likes to talk about how it rewards team members’ initiative. Mackey once told Forbes, “Business is simple. Management’s job is to take care of employees. The employees’ job is to take care of the customers. Happy customers take care of the shareholders. It’s a virtuous circle.” Whole Foods gives people what they want, or, at least, the increasing number of people who don’t blanch at the prices, which have earned the company the presumably affectionate nickname “Whole Paycheck”: $3.98 for a five-ounce plastic box of Earthbound Farm organic baby arugula salad; $2.98 for six and three-quarter ounces of intricately packaged Earthbound Farm organic “mini-peeled carrots with Ranch Dip.” For the price of the fixings for a modest family dinner at Whole Foods, you could just about afford one share of its stock. The motto of the great English supermarket pioneer Sir Jack Cohen was “Pile it high; sell it cheap.” Whole Foods has shown the rewards that can flow from the opposite policy.
Whole Foods is only the most visible face of the newly confident organic industry. In February, Consumer Reports announced that sales of organic products had gone up twenty per cent a year during the past decade, reaching $15 billion in 2004—out of a total U.S. food system worth a trillion dollars—and that nearly two-thirds of American consumers bought organic foods last year, paying, on average, a fifty-per-cent premium over conventional foods. In March, Wal-Mart made the remarkable announcement that it would double its organic-grocery offerings immediately. Wal-Mart is betting that, if it follows its usual practice of squeezing suppliers and cutting prices ruthlessly, the taste for organic foods will continue to spread across the social landscape. “We don’t think you should have to have a lot of money to feed your family organic foods,” its C.E.O. said at the most recent annual general meeting.
But icons beget iconoclasm, and, just when the organic business has attained cultural legitimacy, a market has opened up for debunkers. “Organic, Inc.: Natural Foods and How They Grew” (Harcourt; $25), by the business writer Samuel Fromartz, is a cultural, political, and economic history of the modern organic industry that is markedly critical of the distance that “Big Organic” has come from its anti-industrial roots in the early twentieth century. “Agrarian Dreams: The Paradox of Organic Farming in California” (California; $21.95), by the geographer Julie Guthman, is a meticulous academic study of the institutional dynamics of the state’s organic agriculture and asserts that organic agriculture, far from escaping the logic of capitalism, has wholly embraced it. And Michael Pollan’s outstanding “The Omnivore’s Dilemma: A Natural History of Four Meals” (Penguin; $26.95) is a wide-ranging invitation to think through the moral ramifications of our current eating habits. Pollan undertakes a pilgrim’s progress along modern food chains, setting standards for ethical eating which the industrial approach of Whole Foods and its suppliers fails to satisfy.
Such criticisms reflect growing discontent among many veterans of the organic movement. As one consumer advocate told Pollan, “Organic is becoming what we hoped it would be an alternative to.” This disillusionment is fuelled by questions about quality, sustainability, and business ethics—but it is also, crucially, a matter of ideology and morality. For many who participated in the early phase of organic farming, its subsequent history is a story of paradise lost—or, worse, sold—in which cherished ideals have simply become part of the sales pitch. According to the Web site of Earthbound Farm, a major supplier of Whole Foods, eating organic is an almost spiritual quest: “We honor the fragile complexity of our ecosystem, the health of those who work the land, and the long-term well-being of customers who enjoy our harvest. . . . Organic farming encourages an abundance of species living in balanced, harmonious ecosystems.” This is late-modern georgic in its ripest vein. Where Virgil asked, “What makes the cornfield smile?,” Earthbound Farm’s Web site has the answer: the use of “earth-friendly methods to grow healthful crops without relying on chemical pesticides or using synthetic fertilizers.” But the reality is no idyll.
The plastic package of Earthbound Farm baby arugula in Whole Foods was grown without synthetic fertilizers; no toxic pesticides or fumigants were used to control insect predators; no herbicides were applied to deal with weeds; no genes from other species were introduced into its genome to increase yield or pest resistance; no irradiation was used to extend its shelf life. It complies with the U.S. Department of Agriculture’s National Organic Program, a set of standards that came into full effect in 2002 to regulate the commercial use of the word “organic.” So what’s the problem?
It all depends on what you think you’re buying when you buy organic. If the word conjures up the image of a small, family-owned, local operation, you may be disappointed. Like Whole Foods, Earthbound Farm is a very big business. Earthbound’s founders, Drew and Myra Goodman, Manhattanites who went to college in the Bay Area, and then started a two-and-a-half-acre raspberry-and-baby-greens farm near Carmel to produce food they “felt good about,” are now the nation’s largest grower of organic produce, with revenues for this year projected at more than $450 million. Their greens, including the arugula, are produced on giant farms in six different counties in California, two in Arizona, one in Colorado, and in three Mexican states. Earthbound grows more than seventy per cent of all the organic lettuce sold in America; big organic retailers like Whole Foods require big organic suppliers. (Earthbound actually dropped the “organic” specification when it started its mass-distribution program, in 1993—even though the stuff was organic—because its first client, Costco, thought it might put customers off.) By 2004, Earthbound was farming twenty-six thousand acres; its production plants in California and Arizona total four hundred thousand square feet, and its products are available in supermarkets in every state of the Union. The Carmel Valley farm stand is still there, largely for public-relations purposes, and is as much an icon of California’s entrepreneurial roots as the Hewlett-Packard garage in downtown Palo Alto.
Success is not necessarily a sin, of course, and, for many people, buying organic is a way of being environmentally sensitive. Earthbound notes that its farming techniques annually obviate the use of more than a quarter of a million pounds of toxic chemical pesticides and almost 8.5 million pounds of synthetic fertilizers, which saves 1.4 million gallons of the petroleum needed to produce those chemicals. Their tractors even use biodiesel fuel.
Yet the net benefit of all this to the planet is hard to assess. Michael Pollan, who thinks that we ought to take both a wider and a deeper view of the social, economic, and physical chains that deliver food to fork, cites a Cornell scientist’s estimate that growing, processing, and shipping one calorie’s worth of arugula to the East Coast costs fifty-seven calories of fossil fuel. The growing of the arugula is indeed organic, but almost everything else is late-capitalist business as usual. Earthbound’s compost is trucked in; the salad-green farms are models of West Coast monoculture, laser-levelled fields facilitating awesomely efficient mechanical harvesting; and the whole supply chain from California to Manhattan is only four per cent less gluttonous a consumer of fossil fuel than that of a conventionally grown head of iceberg lettuce—though Earthbound plants trees to offset some of its carbon footprint. “Organic,” then, isn’t necessarily “local,” and neither “organic” nor “local” is necessarily “sustainable.”
Earthbound and other large-scale organic growers have embraced not only the logic of capitalism but the specific logic of California agribusiness. Julie Guthman’s book shows how, ever since the gold rush, the state’s growers have aimed at maximizing monetary yield per acre. First, it was wheat to feed the influx of gold miners and those dependent on the mining industry; then, after railways and refrigerated cars enabled the delivery of shining fresh produce across the country, it was orchard fruit. Later still, tract housing and mini-malls proved more profitable, which is why you’ll have a hard time finding orange groves in Orange County. Guthman writes that big, concentrated, high-value organic agriculture in California is “the legacy of the state’s own style of agrarian capitalism.” You saw this style in action when, in 1989, a “60 Minutes” exposé about residues of the carcinogenic pesticide Alar found on apples caused a consumer stampede to the organic-produce bins. “Don’t panic, buy organic,” was the mantra, and growers responded by borrowing heavily to expand their organic enterprises. When the scare subsided, supply outstripped demand, and, in the inevitable shakeout, some small-scale organic farmers had to sell out to larger players in the food industry. Washington State’s Cascadian Farm was one such. Its founder, a “onetime hippie” named Gene Kahn, sold a majority holding to Welch’s, and now it is a division of the $17.8 billion giant General Mills. He hasn’t the least regret: “We’re part of the food industry now.” The investors bankrolling Big Organic have no reason to fear the vestigial hippie rhetoric: it’s not so much a counterculture as a bean-counter culture.
According to Samuel Fromartz, ninety per cent of “frequent” organic buyers think they’re buying better “health and nutrition.” They may be right. If, for any reason, you don’t want the slightest pesticide residue in your salad, or you want to insure that there are no traces of recombinant bovine somatotropin hormone (rbST) in your children’s milk, you’re better off spending the extra money for organically produced food. But scientific evidence for the risks of such residues is iffy, as it is, too, for the benefits of the micro-nutrients that are said to be more plentiful in an organic carrot than in its conventional equivalent.
Other people are buying taste, but there’s little you can say about other people’s taste in carrots and not much more you can intelligibly articulate about your own. The taste of an heirloom carrot bought five years ago from the Chino family farm in Rancho Santa Fe, California, sticks indelibly in my memory, though at the time I hadn’t any idea whether artificial fertilizers or pesticides had been applied to it. (I later learned that they had not.) For many fruits and vegetables, freshness, weed control, and the variety grown may be far more important to taste than whether the soil in which they were grown was dosed with ammonium nitrate. Pollan did his own taste test by shopping at Whole Foods for an all-organic meal: everything was pretty good, except for the six-dollar bunch of organic asparagus, which had been grown in Argentina, air-freighted six thousand miles to the States, and immured for a week in the distribution chain. Pollan shouldn’t have been surprised that it tasted like “cardboard.”
The twentieth-century origins of the organic movement can be traced to the writings of the English agronomist Sir Albert Howard, particularly his 1940 book “An Agricultural Testament.” Howard was a critic of the rise of scientific agriculture. In the mid-nineteenth century, following the work of the German chemist Justus von Liebig, it was thought that all plants really needed from the soil was the correct quantities and proportions of nitrogen, phosphorus, and potassium: the N-P-K ratios that you see on bags of garden fertilizer. For many crops, it is the availability of nitrogen that limits growth. Legumes apart, plants cannot extract nitrogen directly from the practically unlimited stores of the gas in the atmosphere, so farmers in the nineteenth century routinely enhanced soil fertility using animal manures, guano, or mined nitrates. But, just before the First World War, the German chemist Fritz Haber and the industrialist Carl Bosch devised a way of synthesizing ammonia from atmospheric nitrogen. From there, the commercial production of enormous quantities of nitrogenous fertilizers was a relatively easy matter. The result was a technological revolution in agriculture.
But Howard had worked in India as “Imperial Economic Botanist” to the government of the Raj at Pusa, and his experiences there convinced him that traditional Indian farming techniques were in many respects superior to those of the modern West. Howard was a pragmatist—the criterion of agricultural success was what worked—but he was also a holist and a taker of the long view. The health of the soil, the health of what grew in it, and the health of those who ate what grew in it were “one great subject.” To reduce this intricacy to a simple set of chemical inputs, as Liebig’s followers did, was reductionist science at its worst. Soils treated this way would ultimately collapse, and so would the societies that abused them: “Artificial manures lead inevitably to artificial nutrition, artificial food, artificial animals and finally to artificial men and women,” racked with disease and physically stunted. You could indeed get short-term boosts in yield through the generous application of synthetic fertilizers, but only by robbing future generations of their patrimony. Soil, Howard wrote, is “the capital of the nations which is real, permanent, and independent of everything except a market for the products of farming.” We have no choice but to go “back to nature” and to “safeguard the land of the Empire from the operations of finance.” The “supremacy of the West” depends upon it.
Howard’s ideas reached America largely through J. I. Rodale’s magazine Organic Gardening and Farming, and, later, through a widely read essay by Wendell Berry in “The Last Whole Earth Catalogue.” The organic movement that sprang up in America during the postwar years, manured by the enthusiasm of both the hippies and their New Age successors, supplemented Howard’s ideas of soil health with the imperative that the scale should be small and the length of the food chain from farm to consumer short. You were supposed to know who it was that produced your food, and to participate in a network of trust in familiar people and transparent agricultural practices. A former nutritionist at Columbia, who went on to grow produce upstate, recalls, “When we said organic, we meant local. We meant healthful. We meant being true to the ecologies of regions. We meant mutually respectful growers and eaters. We meant social justice and equality.”
There is no way to make food choices without making moral choices as well, and anthropologists have had much to say about the inevitable link between what’s good to eat and what’s good to think. Decisions about how we want our food produced and delivered are decisions about what counts as social virtue. One of the founding texts of modern social theory, Émile Durkheim’s “The Division of Labor in Society,” drew a distinction between what he called mechanical and organic solidarity. In societies characterized by mechanical solidarity, each person knew pretty much what every other person did and each social unit encompassed pretty much all the functions it needed in order to survive. Mechanical solidarity, in Durkheim’s scheme, was largely a premodern form. By contrast, organic solidarity flowed from the division of labor. Individuals depended upon one another for the performance of specialized tasks, and, as modernity proceeded, the networks of dependence that bound them together became increasingly anonymous. You didn’t know who grew the food at the end of your fork, or, indeed, who made the fork. But, then, the original English sense of “organ” was an instrument or a machine made up of interdependent specialized parts, as in the musical pipe organ. The application to living things came only later, by way of analogy with machines; the eye, for example, is the “organ of seeing.” And so, by semantic inversion, champions of organic farming actually seek virtue not in organic but in mechanical solidarity.
The quest for the shortest possible chain between producer and consumer is the narrative dynamic of Michael Pollan’s book, which is cleverly structured around four meals, each representing a different network of relations between producers, eaters, and the environment, and each an attempt at greater virtue than the last. Pollan’s first meal is fast food, and he follows a burger back to vast monocultural industrial blocs of Iowan corn, planted by G.P.S.-guided tractors and dosed with tons of synthetic fertilizer, whose massive runoff into the Mississippi River—as much as 1.5 million tons of nitrogen a year—winds up feeding algal blooms and depleting the oxygen needed by other forms of life in the Gulf of Mexico. Pollan then follows the corn to enormous feedlots in Kansas, where a heifer that he bought in South Dakota is speed-fattened—fourteen pounds of corn for each pound of edible beef—for which its naturally grass-processing rumen was not designed, requiring it to be dosed with antibiotics, which breed resistant strains of bacteria. Pollan would have liked to follow his heifer through the industrial slaughterhouse, but the giant beef-packing company was too canny to let him in, and so we are spared the stomach-churning details, which, in any case, were minutely related a few years ago in Eric Schlosser’s “Fast Food Nation.” Pollan also follows the American mountains of industrial corn into factories, where the wonders of food technology transform it into the now ubiquitous high-fructose corn syrup, which sweetens the soda that, consumed in super-sized quantities across the nation, contributes to the current epidemic of type 2 diabetes. All very bad things.
The second meal is the Big Organic one that he bought at his local Whole Foods store in California, featuring an “organic” chicken whose “free-range” label was authorized by U.S.D.A. statutes, but which actually shared a shed with twenty thousand other genetically identical birds. Two small doors in the shed opened onto a patch of grass, but they remained shut until the birds were five or six weeks old, and two weeks later Pollan’s “free range” chicken was a $2.99-a-pound package in his local Whole Foods. This meal was better—the corn-and-soybean chicken feed was certified organic and didn’t contain antibiotics—but still not perfect. Pollan’s third meal was even more virtuous. After spending several weeks doing heavy lifting on a polycultural, sustainable smallholding in the Shenandoah Valley, Pollan cooked a meal wholly made up of ingredients that he himself had a hand in producing: eggs from (genuinely) free-range, grub-eating hens, corn grown with compost from those happy birds, and, finally, a chicken whose throat he had slit himself. Very good, indeed—and no nitrogenous runoff, and no massive military machine to protect America’s supplies of Middle East oil and the natural gas needed to make the synthetic fertilizer.
Finally, Pollan decides to eat a meal—“the perfect meal”—for which he had almost total personal responsibility: wild morels foraged in the Sierra foothills, the braised loin and leg of a wild pig he had shot himself in Sonoma County, a chamomile tisane made from herbs picked in the Berkeley Hills, salad greens from his own garden, cherries taken by right of usufruct from a neighbor’s tree, sea salt scraped from a pond at the southern end of San Francisco Bay, and—O.K., strict perfection is unobtainable—a bottle of California Petite Sirah, presumably organic. This was not a way of eating that Pollan thinks is realistic on a routine basis, but he wanted to test what it felt like to have “a meal that is eaten in full consciousness of what it took to make it.” That consciousness, for Pollan, is more religious than political—every meal a sacrament. “We eat by the grace of nature, not industry, and what we’re eating is never anything more or less than the body of the world,” he says.
Pollan winds up demanding that we know much more about what we’re putting into our mouths: “What it is we’re eating. Where it came from. How it found its way to our table. And what, in a true accounting, it really cost.” The “naked lunch,” William Burroughs wrote, is the “frozen moment when everyone sees what is on the end of every fork.” Burroughs meant it metaphorically; Pollan means it literally. He wants to know his farmer’s name, and to know that his hamburger was once part of the muscles of a particular cow. He wants to do his bit to save the planet. That means he wants to eat locally, within a network of familiarity. But, even so, the knowledge required is potentially infinite. What particular bacteria, fungi, and trace elements lurk in the soil of your sustainable community farm? Does your friendly local farmer use a tractor or a horse? If a tractor, does it use fuel made from biomass? If a horse, are the oats it eats organic? If the oats are organic, does the manure with which they were grown come from organically fed animals? How much of this sort of knowledge can you digest?
Pollan seems aware of the contradictions entailed in trying to eat in this rigorously ethical spirit, but he doesn’t give much space to the most urgent moral problem with the organic ideal: how to feed the world’s population. At the beginning of the twentieth century, there was a serious scare about an imminent Malthusian crisis: the world’s rapidly expanding population was coming up against the limits of agricultural productivity. The Haber-Bosch process averted disaster, and was largely responsible for a fourfold increase in the world’s food supply during the twentieth century. Earl Butz, Nixon’s Secretary of Agriculture, was despised by organic farmers, but he might not have been wrong when he said, in 1971, that if America returned to organic methods “someone must decide which fifty million of our people will starve!” According to a more recent estimate, if synthetic fertilizers suddenly disappeared from the face of the earth, about two billion people would perish.
Supporters of organic methods maintain that total food-energy productivity per acre can be just as high as with conventional agriculture, and that dousings of N-P-K are made necessary only by the industrial scale of modern agriculture and its long-chain systems of distribution. Yet the fact remains that, to unwind conventional agriculture, you would have to unwind some highly valued features of the modern world order. Given the way the world now is, sustainably grown and locally produced organic food is expensive. Genetically modified, industrially produced monocultural corn is what feeds the victims of an African famine, not the gorgeous organic technicolor Swiss chard from your local farmers’ market. Food for a “small planet” will, for the foreseeable future, require a much smaller human population on the planet.
Besides, for most consumers that Earthbound Farm organic baby arugula from Whole Foods isn’t an opportunity to dismantle the infrastructures of the modern world; it’s simply salad. Dressed with a little Tuscan extra-virgin olive oil, a splash of sherry vinegar, some shavings of Parmigiano Reggiano, and fleur de sel from the Camargue, it makes a very nice appetizer. To insist that we are consuming not just salad but a vision of society isn’t wrong, but it’s biting off more than most people are able and willing to chew. Cascadian Farm’s Gene Kahn, countering the criticism that by growing big he had sold out, volunteered his opinion on the place that food has in the average person’s life: “This is just lunch for most people. Just lunch. We can call it sacred, we can talk about communion, but it’s just lunch.”
PARADISE SOLD
by STEVEN SHAPIN
What are you buying when you buy organic?
Issue of 2006-05-15
Posted 2006-05-08
The share price of the Whole Foods Market, Inc., now stands at $62.49. Adjusting for stock splits and dividends, one share would have cost you $2.92 when the company opened on Nasdaq, in January of 1992, so it has done extremely well. Last year, its total revenue was more than $5 billion and its gross profit was more than $1.6 billion. In 2004, according to the Financial Times, Whole Foods was “the fastest-growing mass retailer in the US, with same-store sales rising 17.1 per cent quarter-on-quarter.” Having opened in 1978 with a single countercultural vegetarian establishment in Austin, Texas, Whole Foods now has a hundred and eighty-one natural-food supermarkets, including many acquired in purchases of smaller chains: among them, Wellspring Grocery, in 1991; Bread & Circus, in 1992; Mrs. Gooch’s Natural Foods, in 1993; and Fresh Fields, in 1996. In 2004, Whole Foods opened a fifty-eight-thousand-square-foot mega-mart in the new Time Warner Center, at Columbus Circle, with forty-two cash registers, a two-hundred-and-forty-eight-seat café, and three hundred and ninety employees. “Our goal is to provide New Yorkers with an engaging shopping experience and to become an integral part of this truly unique community,” a company executive said. And in 2004 Whole Foods crossed the Atlantic, acquiring six Fresh & Wild stores in London and making plans to open others there under its own name. Its ambitions are global.
I like to shop at Whole Foods. Sometimes I go there just to see the variety and the colors: what new kinds of chard and kale will they have today? The employees—“team members,” as they’re called—seem reasonably happy and are often quite knowledgeable about the things they sell. A Wellesley graduate is one of the company’s prize exhibits. “I just hang on to the fact that my job is good in some larger sense,” she says on the corporate Web site. “If people buy the sprouts, they’re eating healthier foods, the farmer is doing well, and it’s good for the planet because they’re grown organically.” Since 1998, Whole Foods has ranked high among Fortune’s “100 Best Companies to Work For in America.” Although the company is as ferociously anti-union as Wal-Mart—John Mackey, the volubly libertarian founder and C.E.O., has called unions “parasites”—Whole Foods limits the compensation of its highest-paid executives to no more than fourteen times the employee salary average, and it likes to talk about how it rewards team members’ initiative. Mackey once told Forbes, “Business is simple. Management’s job is to take care of employees. The employees’ job is to take care of the customers. Happy customers take care of the shareholders. It’s a virtuous circle.” Whole Foods gives people what they want, or, at least, the increasing number of people who don’t blanch at the prices, which have earned the company the presumably affectionate nickname “Whole Paycheck”: $3.98 for a five-ounce plastic box of Earthbound Farm organic baby arugula salad; $2.98 for six and three-quarter ounces of intricately packaged Earthbound Farm organic “mini-peeled carrots with Ranch Dip.” For the price of the fixings for a modest family dinner at Whole Foods, you could just about afford one share of its stock. The motto of the great English supermarket pioneer Sir Jack Cohen was “Pile it high; sell it cheap.” Whole Foods has shown the rewards that can flow from the opposite policy.
Whole Foods is only the most visible face of the newly confident organic industry. In February, Consumer Reports announced that sales of organic products had gone up twenty per cent a year during the past decade, reaching $15 billion in 2004—out of a total U.S. food system worth a trillion dollars—and that nearly two-thirds of American consumers bought organic foods last year, paying, on average, a fifty-per-cent premium over conventional foods. In March, Wal-Mart made the remarkable announcement that it would double its organic-grocery offerings immediately. Wal-Mart is betting that, if it follows its usual practice of squeezing suppliers and cutting prices ruthlessly, the taste for organic foods will continue to spread across the social landscape. “We don’t think you should have to have a lot of money to feed your family organic foods,” its C.E.O. said at the most recent annual general meeting.
But icons beget iconoclasm, and, just when the organic business has attained cultural legitimacy, a market has opened up for debunkers. “Organic, Inc.: Natural Foods and How They Grew” (Harcourt; $25), by the business writer Samuel Fromartz, is a cultural, political, and economic history of the modern organic industry that is markedly critical of the distance that “Big Organic” has come from its anti-industrial roots in the early twentieth century. “Agrarian Dreams: The Paradox of Organic Farming in California” (California; $21.95), by the geographer Julie Guthman, is a meticulous academic study of the institutional dynamics of the state’s organic agriculture and asserts that organic agriculture, far from escaping the logic of capitalism, has wholly embraced it. And Michael Pollan’s outstanding “The Omnivore’s Dilemma: A Natural History of Four Meals” (Penguin; $26.95) is a wide-ranging invitation to think through the moral ramifications of our current eating habits. Pollan undertakes a pilgrim’s progress along modern food chains, setting standards for ethical eating which the industrial approach of Whole Foods and its suppliers fails to satisfy.
Such criticisms reflect growing discontent among many veterans of the organic movement. As one consumer advocate told Pollan, “Organic is becoming what we hoped it would be an alternative to.” This disillusionment is fuelled by questions about quality, sustainability, and business ethics—but it is also, crucially, a matter of ideology and morality. For many who participated in the early phase of organic farming, its subsequent history is a story of paradise lost—or, worse, sold—in which cherished ideals have simply become part of the sales pitch. According to the Web site of Earthbound Farm, a major supplier of Whole Foods, eating organic is an almost spiritual quest: “We honor the fragile complexity of our ecosystem, the health of those who work the land, and the long-term well-being of customers who enjoy our harvest. . . . Organic farming encourages an abundance of species living in balanced, harmonious ecosystems.” This is late-modern georgic in its ripest vein. Where Virgil asked, “What makes the cornfield smile?,” Earthbound Farm’s Web site has the answer: the use of “earth-friendly methods to grow healthful crops without relying on chemical pesticides or using synthetic fertilizers.” But the reality is no idyll.
The plastic package of Earthbound Farm baby arugula in Whole Foods was grown without synthetic fertilizers; no toxic pesticides or fumigants were used to control insect predators; no herbicides were applied to deal with weeds; no genes from other species were introduced into its genome to increase yield or pest resistance; no irradiation was used to extend its shelf life. It complies with the U.S. Department of Agriculture’s National Organic Program, a set of standards that came into full effect in 2002 to regulate the commercial use of the word “organic.” So what’s the problem?
It all depends on what you think you’re buying when you buy organic. If the word conjures up the image of a small, family-owned, local operation, you may be disappointed. Like Whole Foods, Earthbound Farm is a very big business. Earthbound’s founders, Drew and Myra Goodman, Manhattanites who went to college in the Bay Area, and then started a two-and-a-half-acre raspberry-and-baby-greens farm near Carmel to produce food they “felt good about,” are now the nation’s largest grower of organic produce, with revenues for this year projected at more than $450 million. Their greens, including the arugula, are produced on giant farms in six different counties in California, two in Arizona, one in Colorado, and in three Mexican states. Earthbound grows more than seventy per cent of all the organic lettuce sold in America; big organic retailers like Whole Foods require big organic suppliers. (Earthbound actually dropped the “organic” specification when it started its mass-distribution program, in 1993—even though the stuff was organic—because its first client, Costco, thought it might put customers off.) By 2004, Earthbound was farming twenty-six thousand acres; its production plants in California and Arizona total four hundred thousand square feet, and its products are available in supermarkets in every state of the Union. The Carmel Valley farm stand is still there, largely for public-relations purposes, and is as much an icon of California’s entrepreneurial roots as the Hewlett-Packard garage in downtown Palo Alto.
Success is not necessarily a sin, of course, and, for many people, buying organic is a way of being environmentally sensitive. Earthbound notes that its farming techniques annually obviate the use of more than a quarter of a million pounds of toxic chemical pesticides and almost 8.5 million pounds of synthetic fertilizers, which saves 1.4 million gallons of the petroleum needed to produce those chemicals. Their tractors even use biodiesel fuel.
Yet the net benefit of all this to the planet is hard to assess. Michael Pollan, who thinks that we ought to take both a wider and a deeper view of the social, economic, and physical chains that deliver food to fork, cites a Cornell scientist’s estimate that growing, processing, and shipping one calorie’s worth of arugula to the East Coast costs fifty-seven calories of fossil fuel. The growing of the arugula is indeed organic, but almost everything else is late-capitalist business as usual. Earthbound’s compost is trucked in; the salad-green farms are models of West Coast monoculture, laser-levelled fields facilitating awesomely efficient mechanical harvesting; and the whole supply chain from California to Manhattan is only four per cent less gluttonous a consumer of fossil fuel than that of a conventionally grown head of iceberg lettuce—though Earthbound plants trees to offset some of its carbon footprint. “Organic,” then, isn’t necessarily “local,” and neither “organic” nor “local” is necessarily “sustainable.”
Earthbound and other large-scale organic growers have embraced not only the logic of capitalism but the specific logic of California agribusiness. Julie Guthman’s book shows how, ever since the gold rush, the state’s growers have aimed at maximizing monetary yield per acre. First, it was wheat to feed the influx of gold miners and those dependent on the mining industry; then, after railways and refrigerated cars enabled the delivery of shining fresh produce across the country, it was orchard fruit. Later still, tract housing and mini-malls proved more profitable, which is why you’ll have a hard time finding orange groves in Orange County. Guthman writes that big, concentrated, high-value organic agriculture in California is “the legacy of the state’s own style of agrarian capitalism.” You saw this style in action when, in 1989, a “60 Minutes” exposé about residues of the carcinogenic pesticide Alar found on apples caused a consumer stampede to the organic-produce bins. “Don’t panic, buy organic,” was the mantra, and growers responded by borrowing heavily to expand their organic enterprises. When the scare subsided, supply outstripped demand, and, in the inevitable shakeout, some small-scale organic farmers had to sell out to larger players in the food industry. Washington State’s Cascadian Farm was one such. Its founder, a “onetime hippie” named Gene Kahn, sold a majority holding to Welch’s, and now it is a division of the $17.8 billion giant General Mills. He hasn’t the least regret: “We’re part of the food industry now.” The investors bankrolling Big Organic have no reason to fear the vestigial hippie rhetoric: it’s not so much a counterculture as a bean-counter culture.
According to Samuel Fromartz, ninety per cent of “frequent” organic buyers think they’re buying better “health and nutrition.” They may be right. If, for any reason, you don’t want the slightest pesticide residue in your salad, or you want to insure that there are no traces of recombinant bovine somatotropin hormone (rbST) in your children’s milk, you’re better off spending the extra money for organically produced food. But scientific evidence for the risks of such residues is iffy, as it is, too, for the benefits of the micro-nutrients that are said to be more plentiful in an organic carrot than in its conventional equivalent.
Other people are buying taste, but there’s little you can say about other people’s taste in carrots and not much more you can intelligibly articulate about your own. The taste of an heirloom carrot bought five years ago from the Chino family farm in Rancho Santa Fe, California, sticks indelibly in my memory, though at the time I hadn’t any idea whether artificial fertilizers or pesticides had been applied to it. (I later learned that they had not.) For many fruits and vegetables, freshness, weed control, and the variety grown may be far more important to taste than whether the soil in which they were grown was dosed with ammonium nitrate. Pollan did his own taste test by shopping at Whole Foods for an all-organic meal: everything was pretty good, except for the six-dollar bunch of organic asparagus, which had been grown in Argentina, air-freighted six thousand miles to the States, and immured for a week in the distribution chain. Pollan shouldn’t have been surprised that it tasted like “cardboard.”
The twentieth-century origins of the organic movement can be traced to the writings of the English agronomist Sir Albert Howard, particularly his 1940 book “An Agricultural Testament.” Howard was a critic of the rise of scientific agriculture. In the mid-nineteenth century, following the work of the German chemist Justus von Liebig, it was thought that all plants really needed from the soil was the correct quantities and proportions of nitrogen, phosphorus, and potassium: the N-P-K ratios that you see on bags of garden fertilizer. For many crops, it is the availability of nitrogen that limits growth. Legumes apart, plants cannot extract nitrogen directly from the practically unlimited stores of the gas in the atmosphere, so farmers in the nineteenth century routinely enhanced soil fertility using animal manures, guano, or mined nitrates. But, just before the First World War, the German chemist Fritz Haber and the industrialist Carl Bosch devised a way of synthesizing ammonia from atmospheric nitrogen. From there, the commercial production of enormous quantities of nitrogenous fertilizers was a relatively easy matter. The result was a technological revolution in agriculture.
But Howard had worked in India as “Imperial Economic Botanist” to the government of the Raj at Pusa, and his experiences there convinced him that traditional Indian farming techniques were in many respects superior to those of the modern West. Howard was a pragmatist—the criterion of agricultural success was what worked—but he was also a holist and a taker of the long view. The health of the soil, the health of what grew in it, and the health of those who ate what grew in it were “one great subject.” To reduce this intricacy to a simple set of chemical inputs, as Liebig’s followers did, was reductionist science at its worst. Soils treated this way would ultimately collapse, and so would the societies that abused them: “Artificial manures lead inevitably to artificial nutrition, artificial food, artificial animals and finally to artificial men and women,” racked with disease and physically stunted. You could indeed get short-term boosts in yield through the generous application of synthetic fertilizers, but only by robbing future generations of their patrimony. Soil, Howard wrote, is “the capital of the nations which is real, permanent, and independent of everything except a market for the products of farming.” We have no choice but to go “back to nature” and to “safeguard the land of the Empire from the operations of finance.” The “supremacy of the West” depends upon it.
Howard’s ideas reached America largely through J. I. Rodale’s magazine Organic Gardening and Farming, and, later, through a widely read essay by Wendell Berry in “The Last Whole Earth Catalogue.” The organic movement that sprang up in America during the postwar years, manured by the enthusiasm of both the hippies and their New Age successors, supplemented Howard’s ideas of soil health with the imperative that the scale should be small and the length of the food chain from farm to consumer short. You were supposed to know who it was that produced your food, and to participate in a network of trust in familiar people and transparent agricultural practices. A former nutritionist at Columbia, who went on to grow produce upstate, recalls, “When we said organic, we meant local. We meant healthful. We meant being true to the ecologies of regions. We meant mutually respectful growers and eaters. We meant social justice and equality.”
There is no way to make food choices without making moral choices as well, and anthropologists have had much to say about the inevitable link between what’s good to eat and what’s good to think. Decisions about how we want our food produced and delivered are decisions about what counts as social virtue. One of the founding texts of modern social theory, Émile Durkheim’s “The Division of Labor in Society,” drew a distinction between what he called mechanical and organic solidarity. In societies characterized by mechanical solidarity, each person knew pretty much what every other person did and each social unit encompassed pretty much all the functions it needed in order to survive. Mechanical solidarity, in Durkheim’s scheme, was largely a premodern form. By contrast, organic solidarity flowed from the division of labor. Individuals depended upon one another for the performance of specialized tasks, and, as modernity proceeded, the networks of dependence that bound them together became increasingly anonymous. You didn’t know who grew the food at the end of your fork, or, indeed, who made the fork. But, then, the original English sense of “organ” was an instrument or a machine made up of interdependent specialized parts, as in the musical pipe organ. The application to living things came only later, by way of analogy with machines; the eye, for example, is the “organ of seeing.” And so, by semantic inversion, champions of organic farming actually seek virtue not in organic but in mechanical solidarity.
The quest for the shortest possible chain between producer and consumer is the narrative dynamic of Michael Pollan’s book, which is cleverly structured around four meals, each representing a different network of relations between producers, eaters, and the environment, and each an attempt at greater virtue than the last. Pollan’s first meal is fast food, and he follows a burger back to vast monocultural industrial blocs of Iowan corn, planted by G.P.S.-guided tractors and dosed with tons of synthetic fertilizer, whose massive runoff into the Mississippi River—as much as 1.5 million tons of nitrogen a year—winds up feeding algal blooms and depleting the oxygen needed by other forms of life in the Gulf of Mexico. Pollan then follows the corn to enormous feedlots in Kansas, where a heifer that he bought in South Dakota is speed-fattened—fourteen pounds of corn for each pound of edible beef—for which its naturally grass-processing rumen was not designed, requiring it to be dosed with antibiotics, which breed resistant strains of bacteria. Pollan would have liked to follow his heifer through the industrial slaughterhouse, but the giant beef-packing company was too canny to let him in, and so we are spared the stomach-churning details, which, in any case, were minutely related a few years ago in Eric Schlosser’s “Fast Food Nation.” Pollan also follows the American mountains of industrial corn into factories, where the wonders of food technology transform it into the now ubiquitous high-fructose corn syrup, which sweetens the soda that, consumed in super-sized quantities across the nation, contributes to the current epidemic of type 2 diabetes. All very bad things.
The second meal is the Big Organic one that he bought at his local Whole Foods store in California, featuring an “organic” chicken whose “free-range” label was authorized by U.S.D.A. statutes, but which actually shared a shed with twenty thousand other genetically identical birds. Two small doors in the shed opened onto a patch of grass, but they remained shut until the birds were five or six weeks old, and two weeks later Pollan’s “free range” chicken was a $2.99-a-pound package in his local Whole Foods. This meal was better—the corn-and-soybean chicken feed was certified organic and didn’t contain antibiotics—but still not perfect. Pollan’s third meal was even more virtuous. After spending several weeks doing heavy lifting on a polycultural, sustainable smallholding in the Shenandoah Valley, Pollan cooked a meal wholly made up of ingredients that he himself had a hand in producing: eggs from (genuinely) free-range, grub-eating hens, corn grown with compost from those happy birds, and, finally, a chicken whose throat he had slit himself. Very good, indeed—and no nitrogenous runoff, and no massive military machine to protect America’s supplies of Middle East oil and the natural gas needed to make the synthetic fertilizer.
Finally, Pollan decides to eat a meal—“the perfect meal”—for which he had almost total personal responsibility: wild morels foraged in the Sierra foothills, the braised loin and leg of a wild pig he had shot himself in Sonoma County, a chamomile tisane made from herbs picked in the Berkeley Hills, salad greens from his own garden, cherries taken by right of usufruct from a neighbor’s tree, sea salt scraped from a pond at the southern end of San Francisco Bay, and—O.K., strict perfection is unobtainable—a bottle of California Petite Sirah, presumably organic. This was not a way of eating that Pollan thinks is realistic on a routine basis, but he wanted to test what it felt like to have “a meal that is eaten in full consciousness of what it took to make it.” That consciousness, for Pollan, is more religious than political—every meal a sacrament. “We eat by the grace of nature, not industry, and what we’re eating is never anything more or less than the body of the world,” he says.
Pollan winds up demanding that we know much more about what we’re putting into our mouths: “What it is we’re eating. Where it came from. How it found its way to our table. And what, in a true accounting, it really cost.” The “naked lunch,” William Burroughs wrote, is the “frozen moment when everyone sees what is on the end of every fork.” Burroughs meant it metaphorically; Pollan means it literally. He wants to know his farmer’s name, and to know that his hamburger was once part of the muscles of a particular cow. He wants to do his bit to save the planet. That means he wants to eat locally, within a network of familiarity. But, even so, the knowledge required is potentially infinite. What particular bacteria, fungi, and trace elements lurk in the soil of your sustainable community farm? Does your friendly local farmer use a tractor or a horse? If a tractor, does it use fuel made from biomass? If a horse, are the oats it eats organic? If the oats are organic, does the manure with which they were grown come from organically fed animals? How much of this sort of knowledge can you digest?
Pollan seems aware of the contradictions entailed in trying to eat in this rigorously ethical spirit, but he doesn’t give much space to the most urgent moral problem with the organic ideal: how to feed the world’s population. At the beginning of the twentieth century, there was a serious scare about an imminent Malthusian crisis: the world’s rapidly expanding population was coming up against the limits of agricultural productivity. The Haber-Bosch process averted disaster, and was largely responsible for a fourfold increase in the world’s food supply during the twentieth century. Earl Butz, Nixon’s Secretary of Agriculture, was despised by organic farmers, but he might not have been wrong when he said, in 1971, that if America returned to organic methods “someone must decide which fifty million of our people will starve!” According to a more recent estimate, if synthetic fertilizers suddenly disappeared from the face of the earth, about two billion people would perish.
Supporters of organic methods maintain that total food-energy productivity per acre can be just as high as with conventional agriculture, and that dousings of N-P-K are made necessary only by the industrial scale of modern agriculture and its long-chain systems of distribution. Yet the fact remains that, to unwind conventional agriculture, you would have to unwind some highly valued features of the modern world order. Given the way the world now is, sustainably grown and locally produced organic food is expensive. Genetically modified, industrially produced monocultural corn is what feeds the victims of an African famine, not the gorgeous organic technicolor Swiss chard from your local farmers’ market. Food for a “small planet” will, for the foreseeable future, require a much smaller human population on the planet.
Besides, for most consumers that Earthbound Farm organic baby arugula from Whole Foods isn’t an opportunity to dismantle the infrastructures of the modern world; it’s simply salad. Dressed with a little Tuscan extra-virgin olive oil, a splash of sherry vinegar, some shavings of Parmigiano Reggiano, and fleur de sel from the Camargue, it makes a very nice appetizer. To insist that we are consuming not just salad but a vision of society isn’t wrong, but it’s biting off more than most people are able and willing to chew. Cascadian Farm’s Gene Kahn, countering the criticism that by growing big he had sold out, volunteered his opinion on the place that food has in the average person’s life: “This is just lunch for most people. Just lunch. We can call it sacred, we can talk about communion, but it’s just lunch.”
Worst cholera outbreak in Angola BBC News
A cholera epidemic in Angola has now killed more than 1,200 people in the past three months: the worst outbreak ever recorded in the country. About 35,000 people have fallen ill, half of them in the capital, Luanda, aid group Medecins sans Frontieres and the World Health Organization say. The first cases of the current outbreak were found in Luanda slums in February. Despite an oil-fuelled 20% economic growth rate, Angola's crowded slums lack adequate water and sanitation. The disease has also been reported in 11 of the country's 18 provinces. Easier movement of people between the cities and the countryside since the end of the war four years ago, is one of the reasons for the spread of the epidemic. MSF says between 500 and 700 new cholera cases, and an average of 10 deaths, are being seen every day. "These figures are likely to be underreported," MSF's country co-ordinator for Angola, Richard Veerman, told the BBC. "Many people are likely to be remaining at home and dying at home without the opportunity to come to a treatment centre." Over the past 10 years, Angola has suffered only minor outbreaks of cholera, mostly in the slums of Luanda.
A cholera epidemic in Angola has now killed more than 1,200 people in the past three months: the worst outbreak ever recorded in the country. About 35,000 people have fallen ill, half of them in the capital, Luanda, aid group Medecins sans Frontieres and the World Health Organization say. The first cases of the current outbreak were found in Luanda slums in February. Despite an oil-fuelled 20% economic growth rate, Angola's crowded slums lack adequate water and sanitation. The disease has also been reported in 11 of the country's 18 provinces. Easier movement of people between the cities and the countryside since the end of the war four years ago, is one of the reasons for the spread of the epidemic. MSF says between 500 and 700 new cholera cases, and an average of 10 deaths, are being seen every day. "These figures are likely to be underreported," MSF's country co-ordinator for Angola, Richard Veerman, told the BBC. "Many people are likely to be remaining at home and dying at home without the opportunity to come to a treatment centre." Over the past 10 years, Angola has suffered only minor outbreaks of cholera, mostly in the slums of Luanda.
http://www.washingtonpost.com/wp-dyn/conte...1500875_pf.html
Forever Pregnant
Guidelines: Treat Nearly All Women as Pre-Pregnant
By January W. Payne
Washington Post Staff Writer
Tuesday, May 16, 2006; HE01
New federal guidelines ask all females capable of conceiving a baby to treat themselves -- and to be treated by the health care system -- as pre-pregnant, regardless of whether they plan to get pregnant anytime soon.
Among other things, this means all women between first menstrual period and menopause should take folic acid supplements, refrain from smoking, maintain a healthy weight and keep chronic conditions such as asthma and diabetes under control.
While most of these recommendations are well known to women who are pregnant or seeking to get pregnant, experts say it's important that women follow this advice throughout their reproductive lives, because about half of pregnancies are unplanned and so much damage can be done to a fetus between conception and the time the pregnancy is confirmed.
The recommendations aim to "increase public awareness of the importance of preconception health" and emphasize the "importance of managing risk factors prior to pregnancy," said Samuel Posner, co-author of the guidelines and associate director for science in the division of reproductive health at the Centers for Disease Control and Prevention (CDC), which issued the report.
Other groups involved include the American College of Obstetricians and Gynecologists, the March of Dimes, Dartmouth Hitchcock Medical Center, the National Center for Chronic Disease Prevention's Division of Reproductive Health and the National Center on Birth Defects and Developmental Disabilities.
The idea of preconception care has been discussed for nearly 20 years, experts said, but it has drawn more attention recently. Progress toward further reducing the rate of unhealthy pregnancy results, including premature birth, low birthweight and infant mortality, has slowed in the United States since 1996 "in part because of inconsistent delivery and implementation of interventions before pregnancy to detect, treat and help women modify behaviors, health conditions and risk factors that contribute to adverse maternal and infant outcomes," according to the report.
Nearly 28,000 U.S. infants died in 2003, according to the National Center for Health Statistics (NCHS). The infant mortality rate increased in 2002 for the first time in more than 40 years to seven deaths per 1,000 live births, but it did not change significantly in 2003. Birth defects, low birthweight and sudden infant death syndrome (SIDS) were the leading causes of infant death in 2003, according to NCHS.
The U.S. infant mortality rate is higher than those of most other industrialized nations -- it's three times that of Japan and 2.5 times those of Norway, Finland and Iceland, according to a report released last week by Save the Children, an advocacy group.
Preconception care should be delivered by any doctor a patient sees -- from her primary care physician to her gynecologist. It involves developing a "reproductive health plan" that details if and when children are planned, said Janis Biermann, a report co-author and vice president for education and health promotion at the March of Dimes.
"The recommendations say we need to be opportunistic," or deliver care and counseling when opportunities arise, said Merry-K. Moos, a professor in the University of North Carolina's maternal fetal medicine division who sat on the CDC advisory panel. "Healthier women have healthier pregnancies."
Women should also make sure all vaccinations are up-to-date and avoid contact with lead-based paints and cat feces, Biermann said.
The report recommends that women stop smoking and discuss with their doctor the danger alcohol poses to a developing fetus.
Research shows that "during the first few weeks (before 52 days' gestation) of pregnancy" -- during which a woman may not yet realize she's pregnant -- "exposure to alcohol, tobacco and other drugs; lack of essential vitamins (e.g., folic acid); and workplace hazards can adversely affect fetal development and result in pregnancy complications and poor outcomes for both the mother and the infant," the report states.
The CDC report also discusses disparities in care, noting that approximately 17 million women lack health insurance and are likely to postpone or forgo care. These disparities are more prominent among minority groups and those of lower socioeconomic status, the report states.
The NCHS data also reflect these disparities. Babies born to black mothers, for example, had the highest rate of infant death -- 13.5 per 1,000 live births. Infants born to white women had a death rate of 5.7 per 1,000.
Obstacles to preconception care include getting insurance companies to pay for visits and putting the concept into regular use by doctors and patients. Experts acknowledge that women with no plans to get pregnant in the near future may resist preconception care.
"We know that women -- unless you're actively planning [a pregnancy], . . . she doesn't want to talk about it," Biermann said. So clinicians must find a "way to do this and not scare women," by promoting preconception care as part of standard women's health care, she said.
Some medical facilities have already found a way to weave preconception care in with regular visits. At Montefiore Medical Center in Bronx, N.Y., a form that's filled out when checking a patient's height, weight and blood pressure prompts nurses to ask women, "Do you smoke, and do you plan to become pregnant in the next year? And if not, what birth control are you using?"
"It's a simple way of getting primary care providers to think about preconception care," said Peter Bernstein, a maternal fetal medicine specialist who sat on the advisory committee that helped produce the report. "It's simple and [it] costs nothing." ·
Forever Pregnant
Guidelines: Treat Nearly All Women as Pre-Pregnant
By January W. Payne
Washington Post Staff Writer
Tuesday, May 16, 2006; HE01
New federal guidelines ask all females capable of conceiving a baby to treat themselves -- and to be treated by the health care system -- as pre-pregnant, regardless of whether they plan to get pregnant anytime soon.
Among other things, this means all women between first menstrual period and menopause should take folic acid supplements, refrain from smoking, maintain a healthy weight and keep chronic conditions such as asthma and diabetes under control.
While most of these recommendations are well known to women who are pregnant or seeking to get pregnant, experts say it's important that women follow this advice throughout their reproductive lives, because about half of pregnancies are unplanned and so much damage can be done to a fetus between conception and the time the pregnancy is confirmed.
The recommendations aim to "increase public awareness of the importance of preconception health" and emphasize the "importance of managing risk factors prior to pregnancy," said Samuel Posner, co-author of the guidelines and associate director for science in the division of reproductive health at the Centers for Disease Control and Prevention (CDC), which issued the report.
Other groups involved include the American College of Obstetricians and Gynecologists, the March of Dimes, Dartmouth Hitchcock Medical Center, the National Center for Chronic Disease Prevention's Division of Reproductive Health and the National Center on Birth Defects and Developmental Disabilities.
The idea of preconception care has been discussed for nearly 20 years, experts said, but it has drawn more attention recently. Progress toward further reducing the rate of unhealthy pregnancy results, including premature birth, low birthweight and infant mortality, has slowed in the United States since 1996 "in part because of inconsistent delivery and implementation of interventions before pregnancy to detect, treat and help women modify behaviors, health conditions and risk factors that contribute to adverse maternal and infant outcomes," according to the report.
Nearly 28,000 U.S. infants died in 2003, according to the National Center for Health Statistics (NCHS). The infant mortality rate increased in 2002 for the first time in more than 40 years to seven deaths per 1,000 live births, but it did not change significantly in 2003. Birth defects, low birthweight and sudden infant death syndrome (SIDS) were the leading causes of infant death in 2003, according to NCHS.
The U.S. infant mortality rate is higher than those of most other industrialized nations -- it's three times that of Japan and 2.5 times those of Norway, Finland and Iceland, according to a report released last week by Save the Children, an advocacy group.
Preconception care should be delivered by any doctor a patient sees -- from her primary care physician to her gynecologist. It involves developing a "reproductive health plan" that details if and when children are planned, said Janis Biermann, a report co-author and vice president for education and health promotion at the March of Dimes.
"The recommendations say we need to be opportunistic," or deliver care and counseling when opportunities arise, said Merry-K. Moos, a professor in the University of North Carolina's maternal fetal medicine division who sat on the CDC advisory panel. "Healthier women have healthier pregnancies."
Women should also make sure all vaccinations are up-to-date and avoid contact with lead-based paints and cat feces, Biermann said.
The report recommends that women stop smoking and discuss with their doctor the danger alcohol poses to a developing fetus.
Research shows that "during the first few weeks (before 52 days' gestation) of pregnancy" -- during which a woman may not yet realize she's pregnant -- "exposure to alcohol, tobacco and other drugs; lack of essential vitamins (e.g., folic acid); and workplace hazards can adversely affect fetal development and result in pregnancy complications and poor outcomes for both the mother and the infant," the report states.
The CDC report also discusses disparities in care, noting that approximately 17 million women lack health insurance and are likely to postpone or forgo care. These disparities are more prominent among minority groups and those of lower socioeconomic status, the report states.
The NCHS data also reflect these disparities. Babies born to black mothers, for example, had the highest rate of infant death -- 13.5 per 1,000 live births. Infants born to white women had a death rate of 5.7 per 1,000.
Obstacles to preconception care include getting insurance companies to pay for visits and putting the concept into regular use by doctors and patients. Experts acknowledge that women with no plans to get pregnant in the near future may resist preconception care.
"We know that women -- unless you're actively planning [a pregnancy], . . . she doesn't want to talk about it," Biermann said. So clinicians must find a "way to do this and not scare women," by promoting preconception care as part of standard women's health care, she said.
Some medical facilities have already found a way to weave preconception care in with regular visits. At Montefiore Medical Center in Bronx, N.Y., a form that's filled out when checking a patient's height, weight and blood pressure prompts nurses to ask women, "Do you smoke, and do you plan to become pregnant in the next year? And if not, what birth control are you using?"
"It's a simple way of getting primary care providers to think about preconception care," said Peter Bernstein, a maternal fetal medicine specialist who sat on the advisory committee that helped produce the report. "It's simple and [it] costs nothing." ·
Potent antibiotic to target MRSA BBC News
A potent antibiotic which kills many bacteria, including MRSA, has been discovered by scientists. The researchers, from the drug company Merck, isolated platensimycin from a sample of South African soil. If the compound passes clinical trials it will become only the third entirely new antibiotic developed in the last four decades. Details in the journal Nature reveal the antibiotic works in a completely different way to all others.
Natural extracts
The researchers hit upon platensimycin during a project in which they screened 250,000 natural product extracts for their antibiotic potential. It is produced by a strain of the bacteria Streptomyces platensis. In lab tests the antibiotic cleared mice of infection with a form of bacteria related to MRSA and did not appear to cause toxic side effects. Further testing showed activity against a variety of drug-resistant organisms, including MRSA. Professor Tony Maxwell, who is carrying out similar work at the John Innes Centre (JIC) at Colney in Norfolk, said: "This sounds very promising. "A number of big pharmaceutical firms have pulled out of antibiotic drug discovery. "With MRSA cases increasing, and the number of new drugs on the market decreasing we very much need new drugs in the pipeline as soon as we can." Alan Johnson, an expert at the Health Protection Agency, said: "There is an increasing problem with antibiotic resistance. "The Agency welcomes the news that a new antibiotic has been identified that could help to treat infections, particularly those caused by organisms such as MRSA which are resistant to many currently available drugs. "It should be stressed, however, that the drug is at a very early stage of development and it may be several years before it could be used to treat humans."
A potent antibiotic which kills many bacteria, including MRSA, has been discovered by scientists. The researchers, from the drug company Merck, isolated platensimycin from a sample of South African soil. If the compound passes clinical trials it will become only the third entirely new antibiotic developed in the last four decades. Details in the journal Nature reveal the antibiotic works in a completely different way to all others.
QUOTE("Professor Tony Maxwell")
We very much need new drugs in the pipeline as soon as we can.
It acts to block enzymes involved in the synthesis of fatty acids, which bacteria need to construct cell membranes. Most classes of antibiotic were discovered in the 1940s and 1950s, and work by blocking synthesis of the cell wall, DNA and proteins within bacteria. Most of today's antibiotics are simply tweaks of this basic format. The fact that they work in similar ways may be one reason why bacteria are proving so adept at developing resistance. Thus a new class of antibiotics with a different method of action could represent a major breakthrough.Natural extracts
The researchers hit upon platensimycin during a project in which they screened 250,000 natural product extracts for their antibiotic potential. It is produced by a strain of the bacteria Streptomyces platensis. In lab tests the antibiotic cleared mice of infection with a form of bacteria related to MRSA and did not appear to cause toxic side effects. Further testing showed activity against a variety of drug-resistant organisms, including MRSA. Professor Tony Maxwell, who is carrying out similar work at the John Innes Centre (JIC) at Colney in Norfolk, said: "This sounds very promising. "A number of big pharmaceutical firms have pulled out of antibiotic drug discovery. "With MRSA cases increasing, and the number of new drugs on the market decreasing we very much need new drugs in the pipeline as soon as we can." Alan Johnson, an expert at the Health Protection Agency, said: "There is an increasing problem with antibiotic resistance. "The Agency welcomes the news that a new antibiotic has been identified that could help to treat infections, particularly those caused by organisms such as MRSA which are resistant to many currently available drugs. "It should be stressed, however, that the drug is at a very early stage of development and it may be several years before it could be used to treat humans."
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