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Health

CDC: 2 children sickened by novel swine flu strain (AP)

September 3, 2011 – 7:29 pm

A new strain of swine flu has shown up in two children in Pennsylvania and Indiana who had direct or indirect contact with pigs. The virus includes a gene from the 2009 pandemic strain that might let it spread more easily than pig viruses normally do. So far, there's no sign that the virus has spread beyond the two children, the Centers for Disease Control and Prevention reported Friday. "We wanted to provide some information without being alarmist," because people have contact with pigs at fairs this time of year and doctors should watch for possible flu cases, said Lyn Finelli, the CDC's flu surveillance chief. "We're always concerned when we see transmission of animal viruses to humans." People rarely get flu from pigs — only 21 cases have been documented in the last five years — and it's too soon to know how infective this virus will be, she said. The new strain is a hybrid of viruses that have infected pigs over the last decade and a gene from the H1N1 strain that caused the pandemic two years ago. It is the first combination virus to turn up in people since the pandemic, said Michael Shaw, a lab chief at the CDC. It's classified as an H3N2 virus. The first case was an Indiana boy under age 5 who was sickened in late July. He had no contact with pigs, but a caretaker did in the weeks before the boy fell ill. He was hospitalized and has recovered, and no other family members appear ill. The second case was a Pennsylvania girl, also under age 5, who had contact with pigs at an agricultural fair last month. She, too, has recovered, and health officials are investigating reports of illness in other people who went to the fair. No additional cases have been confirmed so far. The viruses in the two children were similar but not identical. Both were resistant to older flu medicines but not to Tamiflu or Relenza. The gene from the 2009 pandemic is one of the things that makes this new strain worrisome, said Dr. John Treanor, a flu specialist at the University of Rochester School of Medicine. "There is some evidence that that gene is particularly important for transmission from person to person," he said. This year's vaccine, which is the same as last year's, likely would not protect against the new swine strain, Treanor and Finelli said. They are encouraged that so far it does not appear to have spread easily between people, and that local health officials detected and reported the novel strain so quickly. "Maybe it will be no big deal but it's important to keep track of this," Treanor said. ___ Online: CDC: http://www.cdc.gov/mmwr/pdf/wk/mm60e0902.pdf ___ Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP Follow Yahoo! News on Twitter, become a fan on Facebook

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Health

WTC studies find no big jump in cancer, deaths (AP)

September 2, 2011 – 9:04 am

NEW YORK – Two major medical studies have failed to find significant increases in deaths or cancer among people exposed to dust from the World Trade Center. In one, researchers who studied cancer rates among nearly 9,000 firefighters who spent time at ground zero found four more cases of the disease than might normally be expected in a group of American men of the same age and ethnicity, an increase independent experts said was small enough to be caused by chance alone. Fire Department doctors also compared exposed firefighters to a group of 926 colleagues who were never at the trade center, and had no contact with the dust. There, they found that cancer rates were about 19 percent higher for in the exposed group, but, again, experts uninvolved in the study said the difference was not statistically significant. Advocates for the firefighters said the trend was still worrisome, however, and doctors said they could not rule out the possibility that more cancer cases will develop among the firefighters as time goes on. In the other study, researchers with New York City's health department who studied death rates among 42,000 people potentially exposed to trade center dust found no evidence of a spike in fatalities. In fact, they found that the 790 deaths among people in the study group was about 43 percent lower than the mortality rate for New Yorkers in general. They were also less likely to have suffered fatal respiratory ailments. Those findings, however, was also written off by scientists as too premature to mean much. Because the attacks happened in a business district and presumably involved people who were fit enough to be reporting to work, the study group was probably healthier than the general public to begin with, said New York City's health commissioner, Dr. Thomas Farley. "I wouldn't interpret it as that the World Trade Center has somehow helped people live longer," he said. Also, the types of toxins released in the trade center disaster usually take decades to result in deaths, not the few years covered in the study, he and other experts said. Donald Berry, a professor of biostatistics at the University of Texas M.D. Anderson Cancer Center, said the two studies "provide no evidence that living or working in the former shadow of the World Trade Center increases one's risk of anything." "Occupational hazards are real," he said. "An extreme example is the plight of asbestos workers. But occupational risks accrue over years of exposure. With the exception of a nuclear explosion or meltdown, it's difficult for any single event to cause an increase in cancer or in mortality." Both studies were being published Friday in The Lancet, a British medical journal. Also set for publication in The Lancet on Friday is a study of nearly 27,500 people enrolled in a World Trade Center health monitoring program that found that nearly 28 percent had asthma, 42 percent had sinus problems and 39 percent had acid reflux disease, a condition related to heartburn. The study also found large numbers of rescue and recovery workers suffering from depression or panic disorders. Those findings echo the results of several other studies. Dr. David Prezant, the fire department's chief medical officer, said he believed the firefighters study indicated "a moderately strong correlation" between World Trade Center dust and cancer. He said he did not agree with other experts who said the study failed certain key tests of statistical significance. The inquiry found that 242 of the nearly 9,000 firefighters exposed to the attacks had developed cancer within the study period, compared to the 238 that researchers would have expected in the general public. Researchers found less lung cancer than expected — only 9 cases instead of the 21 they expected to see. That's reassuring because people are concerned about inhaled dust particles. All 9 of the cases involved smokers. Conversely, they found 12 cases of thyroid cancer in the study group, compared to the 6 they might have expected based on rates in the general public. Dr. James M. Melius, director of the New York State Laborers' Health Fund and one of the leading advocates for ground zero workers suffering health problems, said that even though the cancer research on firefighters was inconclusive, it showed enough possibility of a risk that U.S. officials should consider adding cancers to a list of conditions covered by a multi-billion dollar health aid bill passed by Congress last year. Doing so would qualify exposed people for sizeable compensation payments. "Are we going to wait until we have definitive evidence, which could be 20 or 30 years? Are we going to say, decades from now, `Yeah, you did get cancer because of the World Trade Center, and we should have helped you out back then?'" he said. "It's limited information. It isn't a perfect study ... It still provides compelling evidence that we should be providing at least health care for these people." Experts said both the mortality study and the cancer study are limited, in part because of the difficulty of finding a proper comparison group. Drawing conclusions can also be difficult because researchers don't know the full medical history of the subjects. Dr. Michael Thun, vice president emeritus of epidemiological research for the American Cancer Society, said it isn't surprising that the study would fail to detect any major trends so soon after attacks. Typically, the types of cell mutations caused by toxic and carcinogenic exposures take decades to develop into a diagnosable cancer, he said. Outside of cancers in children, he said, "You can't really go from the earliest stage to lethal in just a few years." But it is possible that a cancer that already existed might have been accelerated by something in the dust, and on that point, "the results are neither conclusively negative, or conclusively positive," Thun said. He called the Fire Department research "a solid first study on the issue," but said it will likely be another decade before scientists can really see whether people exposed to trade center toxins have an increased risk of getting cancer. Follow Yahoo! News on Twitter, become a fan on Facebook

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Health

Panel reveals new details of 1940's experiment (AP)

August 31, 2011 – 10:57 pm

ATLANTA – A presidential panel on Monday disclosed shocking new details of U.S. medical experiments done in Guatemala in the 1940s, including a decision to re-infect a dying woman in a syphilis study. The Guatemala experiments are already considered one of the darker episodes of medical research in U.S. history, but panel members say the new information indicates that the researchers were unusually unethical, even when placed into the historical context of a different era. "The researchers put their own medical advancement first and human decency a far second," said Anita Allen, a member of the Presidential Commission for the Study of Bioethical Issues. From 1946-48, the U.S. Public Health Service and the Pan American Sanitary Bureau worked with several Guatemalan government agencies to do medical research — paid for by the U.S. government — that involved deliberately exposing people to sexually transmitted diseases. The researchers apparently were trying to see if penicillin, then relatively new, could prevent infections in the 1,300 people exposed to syphilis, gonorrhea or chancroid. Those infected included soldiers, prostitutes, prisoners and mental patients with syphilis. The commission revealed Monday that only about 700 of those infected received some sort of treatment. Also, 83 people died, although it's not clear if the deaths were directly due to the experiments. The research came up with no useful medical information, according to some experts. It was hidden for decades but came to light last year, after a Wellesley College medical historian discovered records among the papers of Dr. John Cutler, who led the experiments. President Barack Obama called Guatemala's president, Alvaro Colom, to apologize. He also ordered his bioethics commission to review the Guatemala experiments. That work is nearly done. Though the final report is not due until next month, commission members discussed some of the findings at a meeting Monday in Washington. They revealed that some of the experiments were more shocking than was previously known. For example, seven women with epilepsy, who were housed at Guatemala's Asilo de Alienados (Home for the Insane), were injected with syphilis below the back of the skull, a risky procedure. The researchers thought the new infection might somehow help cure epilepsy. The women each got bacterial meningitis, probably as a result of the unsterile injections, but were treated. Perhaps the most disturbing details involved a female syphilis patient with an undisclosed terminal illness. The researchers, curious to see the impact of an additional infection, infected her with gonorrhea in her eyes and elsewhere. Six months later she died. Dr. Amy Gutmann, head of the commission, described the case as "chillingly egregious." During that time, other researchers were also using people as human guinea pigs, in some cases infecting them with illnesses. Studies weren't as regulated then, and the planning-on-the-fly feel of Cutler's work was not unique, some experts have noted. But panel members concluded that the Guatemala research was bad even by the standards of the time. They compared the work to a 1943 experiment by Cutler and others in which prison inmates were infected with gonorrhea in Terre Haute, Ind. The inmates were volunteers who were told what was involved in the study and gave their consent. The Guatemalan participants — or many of them — received no such explanations and did not give informed consent, the commission said. The commission is working on a second report examining federally funded international studies to make sure current research is being done ethically. That report is expected at the end of the year. Meanwhile, the Guatemalan government has vowed to do its own investigation into the Cutler study. A spokesman for Vice President Rafael Espada said the report should be done by November. ___ Associated Press writer Sonia Perez in Guatemala City contributed to this report. ___ Commission Website: http://www.bioethics.gov/ Follow Yahoo! News on Twitter, become a fan on Facebook

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Health

FDA approves gene-targeting lung cancer drug (AP)

August 29, 2011 – 2:53 am

WASHINGTON – The Food and Drug Administration has approved a new Pfizer drug for a subset of lung cancer patients with a particular genetic mutation. The twice-a-day pill, called Xalkori, is part of a new wave of personalized medications that fight disease by targeting specific genes found in certain patients. Last week, the FDA approved another drug that uses similar gene targeting technology to treat two rare forms of lymph node cancer. Xalkori is approved to treat a small subset of non-small cell lung cancer patients, less than 7 percent, who have an abnormal gene that stimulates cancer cells and causes tumor growth. It works by blocking proteins produced by the gene. "It's another example of how we're using molecular medicine to subtype lung cancer into more specific and treatable diseases," said Dr. Roy Herbst, a lung cancer expert who is chief of medical oncology at Yale University. Including previously approved targeted therapies, "we have specific therapies now that we can offer for about 18 percent of lung cancer patients that are far superior to chemotherapy and that in many cases can cause their tumors to melt away with few side effects," Herbst said. The FDA said it also approved a genetic test to screen for the mutation, known as an abnormal anaplastic lymphoma kinase gene. The test is made by Abbott Laboratories. About 187,000, or 85 percent, of the 220,000 lung cancer cases diagnosed each year are non-small cell lung cancer. Roughly three-fourths of patients aren't diagnosed until tumors have spread, and only 6 percent of those patients live five years. "It's pretty exciting," said Dr. David Carbone, a lung cancer specialist at Vanderbilt University, one of the sites that tested the drug. Only a small share of lung cancer patients have the gene mutation this drug targets, "but for those people it makes a huge difference," he said. Analysts predict Xalkori could be a blockbuster product for Pfizer, eventually reaping more than $2 billion in annual sales by 2021. The FDA approved the drug under its accelerated approval program, which speeds up the clearance of therapies that show promising early results. Pfizer released follow-up data on the drug in June, reporting that 88 percent of patients in one study saw their tumors shrink at least somewhat after one year on Xalkori. In a second study, 54 percent of patients had their tumors shrink by about a third or more and 83 percent had tumors shrink somewhat. Most patients had only mild side effects, but two of the nine patient deaths during that study were considered treatment-related. The most common side effects of the drug include vision disorders, nausea, diarrhea and inflammation. The FDA's accelerated approval program has come under criticism in the last year after follow-up studies showed the best-selling cancer drug Avastin did not extend the lives of patients with breast cancer. The FDA granted the drug accelerated approval because a single study suggesting it slowed tumor growth. The FDA is now in the process of trying to remove the drug's indication, though the drug maker, Roche, has appealed the decision. ___ AP Medical Writer Marilyn Marchione contributed reporting from Milwaukee. Follow Yahoo! News on Twitter, become a fan on Facebook

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Health

Teen vaccinations against cervical cancer lagging (AP)

August 27, 2011 – 4:40 pm

ATLANTA – Only about half of the teenage girls in the U.S. have rolled up their sleeves for a controversial vaccine against cervical cancer — a rate well below those for two other vaccinations aimed at adolescents. The vaccine hit the market in 2006. By last year, just 49 percent of girls had gotten at least the first of the recommended three shots for human papilloma virus, or HPV, a sexually-transmitted bug that can cause cervical cancer and genital warts. Only a third had gotten all three doses, the Centers for Disease Control and Prevention said Thursday. In contrast, the CDC said about two-thirds of teens had gotten the recommended shot for one type of bacterial meningitis and a shot for meningitis and tetanus, diphtheria and whooping cough. Granted, it can take many years for a new vaccine to catch on and reach the 90 percent and above range for many longstanding childhood vaccines. But use of HPV vaccine has been "very disappointing" compared to other newer vaccines, said the CDC's Dr. Melinda Wharton. "If we don't do a much better job, we're leaving another generation vulnerable to cervical cancer later in life," said Wharton. Why aren't more girls getting HPV shots? The vaccine can be very expensive, and it can be a bit of a hassle. It takes three visits to the doctor over six months. But sex no doubt has something to do with it, experts said. Girls are supposed to start the series when they are 11 or 12 — before most girls become sexually active. The vaccine only works if a girl is vaccinated before she's first exposed to the virus. But some parents may misunderstand, thinking their daughters don't need it at such a young age because they aren't sexually active. Others may believe that it would require a discussion about sex and sexuality — a talk they may not feel ready to have, some experts said. The government needs to be more aggressive about changing those perceptions with a major education campaign, Jeff Levi, executive director of the Trust for America's Health, a Washington, D.C.-based research group, said in a statement. Millions of Americans — women and men — become infected with HPV each year, though most show no symptoms and clear the virus on their own. But some strains persist and can cause genital warts and cancer. About 12,000 women are diagnosed with cervical cancer each year, and about 4,000 die from it, according to CDC statistics. The new study was based on a 2010 telephone survey of the parents of more than 19,000 adolescents ages 13 to 17, who allowed researchers to check their kids' vaccination records. Rhode Island and Washington had the highest HPV vaccination rates, both around 70 percent for at least one shot. Idaho had the lowest rates, at about 29 percent. The study was published online in a CDC publication, Morbidity and Mortality Weekly Report. ___ Online: The CDC report: http://www.cdc.gov/mmwr Follow Yahoo! News on Twitter , become a fan on Facebook

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