CDC: Women Following New Pap Test Guidelines
Two new reports in the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report show most women ages 30 and younger are following the new national recommendations for Pap tests and about 60 percent of women continue having the tests after undergoing total hysterectomies. The U.S. Preventive Services Task Force, American College of Obstetricians and Gynecologists and American Cancer Society recommend Pap tests every three years beginning at the age of 21, not annually, in part to minimize unnecessary procedures. “As we monitor Pap test use among U.S. women, we can make sure that women are being screened in accordance with guidelines, to best maximize the benefits of screening and minimize the harms,” said Meg Watson, MPH, an epidemiologist with CDC’s Division of Cancer Prevention and Control, in a release. Read more on prevention.

Flu Season Could be Worst in Years
This year’s influenza season appears to have started early and could be one of the worst in years, according to reports from health care professionals across the country. In many areas the season was already going strong by November, although the normal peak for flu season is late January and early February. The U.S. Centers for Disease Control and Prevention says 16 states and New York City are reporting high levels of flu activity. The CDC estimates about 36,000 people die each season from flu-related causes. Read more on influenza.

Improving Work Conditions for Nurses Can Cut Readmission Rates
Positive work conditions for nurses also seem to cut the readmission rates for patients, according to a new study in the journal Medical Care. For such hospitals, readmission for Medicare patients ages 65 and older within 30 days was down 7 percent for heart failure, 6 percent for heart attack and 10 percent for pneumonia. "Our results suggest that improving nurses' work environment and reducing nurses' workload are organization-wide reforms that could result in fewer readmissions for Medicare beneficiaries with common medical conditions," said study author Matthew McHugh in a release. "This is consistent with the evidence showing significant associations between the nurse work environment, staffing, and other patient outcomes." Read more on access to health care.

APHA Supports Measures to Protect Against Gun Violence
The American Public Health Association (APHA) has expressed its strong support for action to protect our nation’s children and their families from the growing epidemic of gun violence. “Gun violence is one of the leading causes of preventable death in our country and we must take a comprehensive public health approach to addressing this growing crisis,” said APHA Executive Director Georges Benjamin, MD. “For too long, we as a nation have failed to take on this devastating problem in our communities, and we can wait no longer.” Key steps recommended by the APHA include:

• Adopting common sense gun control legislation (such as reinstating the federal ban on assault weapons and high-capacity magazines) and closing the “gun show loophole,” which exempts private sellers of firearms from conducting criminal background checks on buyers at gun shows.
• Expanding the collection and analysis of data related to gun violence and other violent deaths to better understand the causes and allow authorities to develop appropriate interventions to prevent such violence.
• Ensuring adequate funding for critical mental health services.

Read more on violence.

FDA Expands Use of Flu Drug for Kids Younger than 1 Year
The U.S. Food and Drug Administration (FDA) has expanded the approved use of Tamiiflu, a key drug used to treat influenza, for children as young as two weeks who have had flu symptoms for no longer than two days. Eight babies have already died of flu this season, so having an approved treatment is critical. Tamiflu was first approved in 1999 to treat adults. Its approved use was later expanded to treat children a year old and older as well as to prevent the flu in adults and in children a year old and older. The new approval is for treatment only, not for prevention of the flu. Vaccination with flu vaccine begins at six months of age, according to the CDC. Read more on flu.

HUD Awards $26M to Convert Apartments to Assisted Living or Enhanced Service Senior Housing
The U.S. Department of Housing and Urban Development (HUD) has awarded $26 million in grants to the owners of multi-family housing developments in nine states to convert some or all of their apartments into assisted living or service-enriched environments for elderly residents. The funding is provided through HUD’s Assisted Living Conversion Program, which helps convert apartments into units that can accommodate the special needs of seniors who want to “age in place.” “We’re getting older as a nation and with that demographic shift, there is a growing demand for affordable housing that will allow our seniors to live independently in their own homes,” said Carol Galante, HUD’s Assistant Secretary for Housing and Federal Housing Commissioner. Read more on aging.

University of North Carolina Researchers Receive Grant to Develop Post-Disaster Recovery Benchmarks
Two University of North Carolina (UNC) researchers have received a U.S. Department of Homeland Security Grant to develop indicators of effectiveness for post-disaster recovery efforts. "This project is particularly important because it focuses on giving practitioners at the federal, state, and local levels the tools they need to measure how well a community is recovering from a disaster," said Jennifer Horney, PHD, research assistant professor of epidemiology and director of the UNC Center for Public Health Preparedness at the University of North Carolina at Chapel Hill Gillings School of Global Public Health. The grant will be administered by the Coastal Hazards Center of Excellence at UNC. Read more on Hurricane Sandy.

CDC: This could be a Bad Flu Year
Centers for Disease Control and Prevention Director Thomas Frieden, MD, MPH, told reporters yesterday that 2012 is  the earliest regular flu season in a decade, “and while flu is always unpredictable, the early nature of the cases as well as the specific strains we're seeing suggest that this could be a bad flu year.” Read more on flu.

“Hiding” Cigarettes in Stores May Reduce Youth Smoking
A new study published in Pediatrics finds, using an interactive, virtual convenience store, that teens were less likely to try to buy tobacco products when they were hidden from view.

In the study, researchers asked more than 1,200 teens ages 13 to 17 to “shop” in a virtual store, using several store scenarios. Compared to teens who shopped in stores with openly visible tobacco products, those who shopped in stores where tobacco products were hidden were less aware that the products were for sale and were significantly less likely to try to purchase tobacco products.

The researchers say the study bolsters support for policies that would ban the display of tobacco products at the point of sale. Read more on tobacco.

Heart Healthy Diet May Help Protect People with Heart Disease
People with cardiovascular disease may get protection against future heart attacks and strokes by eating a heart healthy diet, according to a new study in the journal Circulation.

For the study, 31,546 adults (average age 66.5) with cardiovascular disease or end organ damage were asked how often they consumed milk, vegetables, fruits, grains, fish, meat and poultry in the past 12 months and were also asked about lifestyle choices such as alcohol consumption, smoking and exercise. Total scores were determined by daily fruits, vegetables, grains and milk consumed and the ratio of fish to meats consumed. During a follow-up of nearly five years, participants experienced 5,190 cardiovascular events.

Researchers found those who ate a heart-healthy diet had a:

• 35 percent reduction in risk for cardiovascular death;
• 14 percent reduction in risk for new heart attacks;
• 28 percent reduction in risk for congestive heart failure; and
• 19 percent reduction in risk for stroke.

Read more on heart health.

The proportion of flu-related doctor visits has reached a nine-year high for this time of year, according to the Centers for Disease Control and Prevention, as reported by USA TODAY. Correct anyone who tells you it’s too late to get a flu shot, though. The Centers for Disease Control and Prevention intentionally schedules National Influenza Vaccination Week in December as a reminder to get the shot for the many millions of Americans who still haven’t.

 “Flu season typically peaks in February and can last as late as May,” says Dr. Anne Schuchat, Assistant Surgeon General of the U.S. Public Health Service and Director of CDC’s National Center for Immunization and Respiratory Diseases. “We are encouraging people who have not yet been vaccinated to get vaccinated now.”

December holiday gatherings are optimal opportunities to spread the flu, and since it takes up to two weeks for full immunity to take effect, this week is a good time to roll up your sleeve if you’re still shot-less.

Flu shots come in several varieties. Children who never had a flu shot need two doses the first year they get the vaccine. There’s a nasal spray for adults 18-49 and a higher dose version for people 65 and older. Learn more from the CDC about different versions of the flu shot and what might be best for you and your family.  

Some people will exercise their right to protect themselves against the flu when they vote today. Throughout the country, “Vote & Vax” clinics have been set up at or near polling places to help improve the chance that people who still haven’t had their 2012/2013 flu shot get that shot in the arm. Vote & Vax, which had start up support from the Robert Wood Johnson Foundation, works with local public health providers including health departments to help set up the flu shot clinics. Project partners include the American Public Health Association, the Association of State and Territorial Health Officers and the National Association of County and City Health Officials.

In the last presidential election almost half of flu shot recipients who were vaccinated through Vote & Vax had not received a flu shot in the previous year or were not planning to get a flu shot that year.

Click here to see if there is a Vote & Vax clinic near, or at,  your polling place.

If not, search the American Lung Association's Flu Clinic Locator Site, to find the nearest site. 

‘Frankenstorm’ Likely Coming to U.S. East Coast
Forecasters are warning the east coast that Hurricane Sandy coming from the south could intersect with a wintry storm coming from the west to create a “Frankenstorm.” This combination of extreme rain, wind and tides could do as much as $1 billion in damage to the region, according to The Associated Press. Estimates are the storm will start Saturday and last through Halloween. Local governments are already marshaling their post-storm responses, as well as recommending people stock up as best they can on supplies and be prepared to sustain themselves for one to five days. Read more on preparedness.

Don’t Let Flu Myths Keep You from Being Vaccinated
As we move into flu season, health care providers and public health officials across the country are reminding people not to let myths stop them from being vaccinated. Common misconceptions include the belief the vaccine will actually give them the flu or that the current vaccine won’t protect against the current flu strain, according to Health Day. "The vaccine can give you some mild symptoms; you may feel a bit achy and your arm may be a little tender where you first get the shot," said Dennis Cunningham, MD, an infectious diseases doctor at Nationwide Children's Hospital in Columbus, Ohio. "But that's actually a good thing and shows that the vaccine is working. It tells us your body is responding appropriately to the vaccine." The U.S. Centers for Disease Control and Prevention especially recommends that young children and older adults receive the flu vaccine. Read more on the flu.

Smokers More Likely to Experience a Second Stroke
Smokers who have a stroke are at higher risk than non-smokers of experiencing another stroke, according to a new study in the journal Stroke. Ex-smokers who had a stroke were also at less risk than smokers. Researchers studied approximately 1,500 stroke patients, comparing data from 1996-1999 to data from a 10-year follow-up. They found that smokers were at 30 percent greater risk of a second stroke or heart attack. Smoking hardens arteries and increases the chance of stroke, according to Rafael Ortiz, MD, director of the Center for Stroke and Neuro-Endovascular Surgery at Lenox Hill Hospital in New York City, who was not a part of the study. "If you're a current smoker, stop, because it predisposes you to having a stroke and if you have a stroke it will have a worse outcome and it predisposes you to have a stroke at an earlier age." Read more on tobacco.

Group Pushes for Simplified, Standardized Medical Labels
The U.S. Pharmacopeial Convention (USP) is pushing for the standardization of medication labels in order to simplify directions and protect against unintentional misuse. Confusion over prescription drug labels contributes to more than 1 million dosage mistakes each year, according to HealthDay. Joanne Schwartzberg, MD, director of aging and community health at the American Medical Association and a member of the USP's Nomenclature, Safety and Labeling Expert Committee, pointed to confusion over directions such as "Take two pills twice daily," which leads some patients to think they only take two pills per day. "That's a mistake that [even] college-educated people make. The words are very simple, but understanding what they mean can be a problem," she said, according to HealthDay. Read more on access to health care.

Blood Test May Help Identify Risk of Heart Disease, Other Issues in Women
A new study in the Journal of the American Medical Association indicates that a blood test could help determine which women are at highest risk for heart disease, diabetes and breast cancer, enabling physicians to begin early preventative care. Researchers looked at the blood samples of approximately 4,600 people. "Women with high levels of proneurotensin in the blood died significantly earlier than women with normal proneurotensin concentrations, and the excess mortality with high proneurotensin was primarily caused by cardiovascular diseases," said Olle Melander, MD, professor of internal medicine at Lund University in Malmo, Sweden. Read more on heart health.

Study: Flu Vaccine Safe for Kids with Egg Allergies
The flu vaccine is developed using chicken eggs, often leaving parents and other caregivers concerned over giving the vaccine to kids with egg allergies. However, a new study in The Journal of Allergy and Clinical Immunology shows modern flu vaccines contain very little egg protein, meaning children with egg allergies are at very little risk of even mild reactions. "I think parents of children with egg allergy should be reassured about the safety of the influenza vaccine for their child, and understand that the benefits are likely to outweigh any risks," said Lynda Schneider, MD, director of the allergy program at Boston Children's Hospital, to Reuters. Children ages 6 months and older should receive the flu shot each year, especially children younger than five. Read more on influenza.

Back To School: Many Schools Unprepared for Pandemic Flu, Infectious Diseases
A new study in the American Journal of Infection Control shows that the majority of U.S. schools are not prepared to respond to a pandemic or an outbreak of an emerging infectious disease, as mandated by the U.S. Department of Education. Also, only 40 percent have even updated their pandemic response strategy since H1N1 in 2009. Researchers analyzed surveys from approximately 2,000 school nurses at elementary, middle and high schools across 26 states. “Findings from this study suggest that most schools are even less prepared for an infectious disease disaster, such as a pandemic, compared to a natural disaster or other type of event,” said Terri Rebmann, PhD, RN, CIC, lead study author and associate professor of Environmental and Occupational Health at the Saint Louis University School of Public Health. “Despite the recent H1N1 pandemic that disproportionately affected school-age children, many schools do not have plans to adequately address a future biological event.” Read more on infectious diseases.

Neurologic Disorders Puts Children at Higher Risk of Flu-related Death
Children with neurologic disorder are at higher risk than children without such disorders of dying from influenza-related health complications, according to a study of the H191 2009 pandemic by the Centers for Disease Control in the journal Pediatrics. Of the 336 children with reported underlying medical conditions who died during the pandemic, approximately 64 percent had a neurologic disorder, which can include cerebral palsy, intellectual disability or epilepsy. “Flu is particularly dangerous for people who may have trouble with muscle function, lung function or difficulty coughing, swallowing or clearing fluids from their airways,” said study coauthor and pediatrician Georgina Peacock, MD, of CDC’s National Center on Birth Defects and Developmental Disabilities.  “These problems are sometimes experienced by children with neurologic disorders.” Read more on influenza.

Coin-sized Batteries Present Health Danger for Children
The ingestion of coin-sized button batters—common in many household electronics—can result in serious injury and even death, according to a new report from the Consumer Product Safety Commission. Emergency department treated more than 40,000 children under the age of 13 for ingestion from 1997-2010—72 percent of the cases were for children ages 4 and under. The CPSC warns parents and caregivers to make sure these products are secure and out of the hands of children. Read more on pediatrics.

FDA Approves New Flu Vaccines
The U.S. Food and Drug Administration has approved all six manufacturer vaccines for the 2012-2013 influenza season. Under the FDA Vaccines and Related Biological Products Advisory Committee’s recommendations, the vaccines will target the A/California/7/2009 (H1N1)-like virus, A/Victoria/361/2011 (H3N2)-like virus and B/Wisconsin/1/2010-like virus flu strains. “The best way to prevent influenza is by getting vaccinated each year,” said Karen Midthun, MD, director of the FDA’s Center for Biologics Evaluation and Research, in a release. “It is especially important to get vaccinated this year because two of the three virus strains used in this season’s influenza vaccines differ from the strains included in last year’s vaccines.” Read more on the flu.

12 States Have Obesity Rates Above 30 Percent
The obesity rate is greater than 30 percent in 12 U.S. states, according to a new study from Trust for America’s Health and the Robert Wood Johnson Foundation. Mississippi tops the list with 34.9 percent. The analysis used date from the U.S. Centers for Disease Control and Prevention. Obesity is a major cause of chronic diseases and health care costs, according to Jeffrey Levi, PhD, TFAH executive director. “The good news is that we have a growing body of evidence and approaches that we know can help reduce obesity, improve nutrition and increase physical activity based on making healthier choices easier for Americans,” Levi said in a release. “The bad news is we’re not investing anywhere near what we need to in order to bend the obesity curve and see the returns in terms of health and savings.” Read more on the original CDC data.

Protective Eyewear Can Help Prevent Kids’ Sports-Related Injuries
In the midst of Children’s Eye Health and Safety Month, specialists at the Johns Hopkins Children’s Center and The Wilmer Eye Institute are reminding children, parents and caregivers that sports-related eye injuries in children can be easily prevented with protective eyewear. Goggles are especially important in sports such as fencing, boxing, soccer, basketball, softball, lacrosse and baseball, as eye injuries at a young age can lead to serious problems later in life. Proper eyewear can prevent 9 out of 10 injuries, according to specialists. Read more on injury prevention.

Joseph Bresee, MD, chief of influenza epidemiology at the Centers for Disease Control and Prevention, issued an update this afternoon on swine flu (H3N2v virus), now circulating in the US. The number of cases has increased from 29 in three states last week to at least 145 cases in four states (Ohio, Illinois, Hawaii and Indiana.) Beginning tomorrow , CDC will issue a report each Friday on the number of cases, but states will be allowed to confirm their own case numbers (though CDC will still confirm the results at its labs) thanks to better testing now available at the state level.

Almost all cases have been reported in children who have had contact with pigs at county fairs, and Bresee says he suspect the increase in cases is because it’s now county fair season around the country. The flu, which has been largely mild, according to Bresee, can be spread when people have direct contact with pigs, when pigs spit or sneeze, or from surfaces touched by humans the pigs had contact with. Kids are less likely to have immunity to the swine flu than adults, which is why few adult cases have been reported, says Bresee. There have been two hospitalizations, and both patients have recovered and been discharged, and no deaths, though the CDC says it expects to see additional hospitalizations and, perhaps, deaths as cases increase.

The seasonal flu vaccine, now arriving at physicians’ offices, does not protect against the swine flu, but precautions can help including washing hands before and after coming in contact with swine and avoiding visits to the swine pens at county fairs by anyone with a compromised immune system, including the very young and the very old.

Bresee says no recommendations has been issued at this point to close swine shows at county fairs, and that there is no evidence of sustained human to human transmission, though CDC does expect to see some limited spread among humans. “This is not a pandemic situation” said Bresee on a call with reporters this afternoon, but CDC is continuing to monitor the cases and will provide frequent updates. “So far, if you’re not exposed to pigs, we don’t think your risk is appreciable,” Bresee says.

The CDC says people who exhibit flu symptoms should contact their doctor; antiviral drugs for influenza are effective on the swine flu now circulating.

Precautions that can help children and adults contract swine flu include:

• Wash hands frequently with soap and running water before and after exposure to animals.
• Never eat, drink or put things in your mouth while in animal areas and don’t take food or drink into animal areas.
• Young children, pregnant women, people 65 and older and people with weakened immune systems should be extra careful around animals.
• If you have animals – including swine – watch them for signs of illness and call a veterinarian if you suspect they might be sick.
• Avoid close contact with animals that look or act ill, when possible.
• Avoid contact with pigs if you are experiencing flu-like symptoms.