Category Archives: Flu
Add flu surveillance to the list of casualties of the current government shutdown.
Every flu season, states collect data on flu cases — including case reports and viral specimens — and send those to the Centers for Disease Control and Prevention (CDC) in Atlanta for recording and tracking. That tracking is critical in order to:
- provide information on how well-matched the seasonal flu vaccine is to the flu viruses found in the community;
- identify severe outbreaks that require increased supplies of antiviral medicines for people who contract the flu; and
- identify emerging strains that might require a new vaccine to be developed this season, which is what happened several years ago when CDC identified the H1N1 influenza virus toward the end of the flu season, and quickly ramped up for a new vaccine.
Flu season generally runs October through April, with the peak from about January to March. If the shutdown continues then, “as the flu season goes on, our knowledge of what’s happening will be impaired,” says William Schaffner, MD, Professor of Preventive Medicine and Infectious Diseases, Vanderbilt University School of Medicine, and the immediate past president of the National Foundation for Infectious Diseases.
CDC director Thomas Frieden, MD, MPH, underscored his concern in a tweet on the first day of the government shutdown: “CDC had to furlough 8,754 people. They protected you yesterday, can't tomorrow. Microbes/other threats didn't shut down. We are less safe.”
State AGs Urge FDA to Adopt New Regulations Covering E-cigarettes
The Attorneys General of 41 states are urging the U.S. Food and Drug Administration (FDA) to follow through on a pledge to issue regulations that would expand its oversight to include e-cigarettes. In a letter to FDA Commissioner Margaret Hamburg, they asked “the FDA to move quickly to ensure that all tobacco products are tested and regulated to ensure that companies do not continue to sell or advertise to our nation's youth.” The FDA was given authority to regulate cigarettes, cigarette tobacco and roll-your-own tobacco in 2009, as well as the authority to expand its authority after it issued new regulations. Last week a similar plea related to FDA authority was made to President Obama by the American Academy of Pediatrics and 14 other public health organizations, including the American Lung Association and American Heart Association. E-cigarettes continue to increase in sales (a projected $1.7 million in 2013) even while dropping in price. At the same time, there are no advertising restrictions for e-cigarettes. "Consumers are led to believe that e-cigarettes are a safe alternative to cigarettes, despite the fact that they are addictive, and there is no regulatory oversight ensuring the safety of the ingredients in e-cigarettes,” according to the Attorneys General’s letter. Read more on tobacco.
Expert: People Should Get Now-available Flu Vaccine As Soon As Possible
This season’s influenza vaccine is now available and people shouldn’t hesitate to go ahead and get it, according to Stephen Russell, MD, associated professor in the general internal medicine division at the University of Alabama at Birmingham and a lead physician at the university’s Medicine Moody Clinic. This year’s vaccine protects against four types of flu viruses (as opposed to the three of previous vaccines) and comes as either a traditional shot or a nasal spray. "Contrary to some beliefs, getting the flu shot in September is a good thing and will offer protection for the entirety of the flu season," he said. The U.S. Centers for Disease Control and Prevention recommends the vaccine for people ages 6 months and older, particularly for seniors, pregnant women, caregivers and people with chronic medical conditions. "Many people will say they do not need the vaccine, as they have never had the flu before, but that is like saying you don't need to wear your seatbelt because you have never had a wreck," Russell said. "You may have been fine in the past, but that should not offer security or protection for future exposures to the flu." Read more on influenza.
Study: Losing 10 Percent of Weight Can Greatly Reduce Arthritic Knee Pain, Put Off Knee Replacement
Losing just 10 percent of their weight could go a long way toward easing the knee pain from osteoarthritis in overweight and obese people ages 55 and older, according to a new study in the Journal of the American Medical Association. That would mean better knee function, improved mobility, enhanced quality of life…and reducing the odds of needed a knee replacement. "We've had a 162 percent increase in knee replacements over the last 20 years in people 65 and over, at a cost of $5 billion a year," said lead author Stephen Messier. "From our standpoint, we think this would be at least a good way to delay knee replacements and possibly prevent some knee replacements." The study tracked 454 overweight and obese people in three groups—diet-only, exercise-only and a combination—finding that people who did the combination were the most successful at losing weight and thus reducing knee pain. "We're not talking about people getting down to ideal body weight," said Patience White, MD, the Arthritis Foundation’s vice president of public policy and advocacy. "They just have to lose 10 percent of their total weight. Someone who is 300 pounds only needs to lose 30 pounds. I think that's within reach for people." Read more on obesity.
AAP: Children Should Be Immunized Against Influenza As Soon As Possible this Season
Parents and caregivers should have all children ages 6 months or older immunized against influenza as soon as possible, according to new updated recommendations from the American Academy of Pediatrics (AAP). Immunization options include the trivalent vaccine that protects against three influenza strains and the new quadrivalent vaccine that protects against four strains. “Parents should not delay vaccinating their children to obtain a specific vaccine,” said pediatrician Henry Bernstein, DO, FAAP, the lead author of the flu recommendations. “Influenza virus is unpredictable, and what’s most important is that people receive the vaccine soon, so that they will be protected when the virus begins circulating.” Other vulnerable groups that should definitely be vaccinated include children with chronic health conditions, children of American Indian or Alaskan Native heritage, health care workers, pregnant women, women who may become pregnant or are breastfeeding and people who have contact with children in high-risk populations. The U.S. Centers for Disease Control and Prevention estimates that between 135 million and 139 million doses of vaccine will be manufactured for the 2013-14 influenza season. Read more on influenza.
HUD: $37M to Oklahoma for ‘Unmet Needs’ of Disaster Recovery
The U.S. Department of Housing and Urban Development (HUD) has allocated approximately $37 million in disaster recovery funds for the state of Oklahoma and the City of Moore, Okla., which were severely damaged by extreme storms—including an EF5 tornado—on May 20. Dozens were killed and more than $1 billion in property damage was caused. The grants are part of HUD’s Community development Block Grant Program, which supports long-term disaster recovery efforts in places of “unmet need.” “The May storms cost the lives of dozens of Oklahomans and over $1 billion in property damage. “We are steadily rebuilding, but many families are still struggling to get back on their feet,” said Oklahoma Governor Mary Fallin. “The disaster relief grants provided by HUD—along with continued work from state and local governments and non-profits—will make a big difference in the lives of those affected by this year’s tornadoes. They will be particularly helpful as we work to provide assistance to low income Oklahomans, many of whom are uninsured.” About $26.3 million of the funds will go toward Moore, with the rest going toward the state. Read more on disasters.
Boys Faced Higher Death Risk than Girls from Multiple Causes
Boys on average face a higher risk of death than girls—not just from traumatic events such as accidents, homicides and suicides, but also from cancers and diseases of the heart, lungs and nervous system. The study found that from 1999 to 2008 there were about 76,700 more deaths among boys than girls, and that boys from infancy to age 20 were 44 percent more likely to die. The findings appear in the latest edition of the journal Pediatrics. The findings are not entirely surprising, as past research has indicated that girls have a certain survival advantage and experts already knew that boys are at increased risk of developing certain chronic health conditions. Still, the question is why. "This could be a story of resilience and ability to overcome," said study author Chris Feudtner, MD, a pediatrician at the Children's Hospital of Philadelphia. "Maybe there's some robustness factor that males are missing." Feudtner said that learning why boys faced these higher risks—and for chronic diseases in particular—could help health care experts better understand and treat the conditions. Read more on mortality.
Self-monitoring Tied to Improved Blood Pressure
Self-monitoring of blood pressure is tied to lower blood pressure in people with hypertension, according to a new study in the Annals of Internal Medicine. The study found the strategy was most successful when combined with providing extra resources to patients, such as online materials. Hayden Bosworth, of the Duke University Medical Center and the Durham Veterans Affairs Medical Center in North Carolina, said self-monitoring can provide more accurate results because the patients are not feeling the stress that they would in the doctor’s office. It also provides more in terms of actual data, which helps physicians to better determine treatments, and helps patients take a constant ownership of their health. "If you eat five ham biscuits for breakfast … you can see the implications of that through your blood pressure in monitoring that relatively quickly, as well as if you exercise," said Bosworth to Reuters. "It's no different than tracking your own weight. You need to know, on a daily basis, how you're doing, what sets it off and are you going too high or too low." Read more on heart health.
New Association Represents Accredited Public Health Schools and Programs
The new Association of Schools and Programs of Public Health (ASPPH), which represents schools and programs of public health accredited by the Council on Education for Public Health (CEPH), officially launched on August 1. “This is a seminal moment in CEPH-accredited public health education,” says Dr. Harrison Spencer, president and CEO of ASPPH. “Representing both accredited schools and programs of public health gives the association and our members an opportunity to strengthen public health education, research, teaching, and practice.” The U.S. Department of Education has recognized CEPH as the accrediting body for public health schools and programs, which helps ensure the quality education and training necessary to prepare graduates for the future of public health work. Read more on accreditation.
Flu Vaccine for All Four Seasonal Strains Approved for Shipment
The first vaccine to protect against all four strains of seasonal influenza has been approved for shipment for the U.S. Food and Drug Administration. GlaxoSmithKline’s Fluarix Quadrivalent vaccine was approved late last year for use in adults and children aged 3 and older, but regulations require flu vaccines to be approved before they are shipped to health care providers each season. The company estimates it will ship approximately 22 to 24 million doses globally, with 10 million doses in the United States. The U.S. Centers for Disease Control and Prevention has ordered more than 4 million doses. Read more on influenza.
FDA Uses ‘Substantial Equivalence’ Standard to Authorize Two New Tobacco Products, Deny Four Others
The U.S. Food and Drug Administration (FDA) has, for the first time, utilized the substantial equivalence pathway to deny the marketing of four new tobacco products and allow the marketing of two new ones. FDA was granted the authority under the Family Smoking Prevention and Tobacco Control Act of 2009. Manufacturers can seek approval of new products by showing they are substantially equivalent to other tobacco products currently on the market. “Today’s decisions are just the first of many forthcoming product review actions to be issued,” said Mitch Zeller, JD, director of the FDA's Center for Tobacco Products. “The FDA is committed to making science-based decisions on all product applications and providing the agency’s scientific rationale behind its actions to ensure the most transparent and efficient process possible for all involved parties, according to the law.” Read more on tobacco.
Daily Contacts Leave Kids, Teachers, Health Care Workers at Highest Flu Risk
Children, teachers and health care workers are at the greatest risk of catching and transmitting influenza, according to a new study in the journal Proceedings of the Royal Society B. The study utilizes online and mail surveys to analyze the daily social contacts of more than 5,000 people. "People working as teachers or health professionals are no doubt already aware that they have higher risks of picking up bugs like colds and flu. But before this study there was very little data mapping out the contact patterns humans have in their daily life," said Leon Danon, from the Mathematics Institute at the University of Warwick, England, in a release. "By quantifying those social interactions, we can better predict the risks of contracting and spreading infections and ultimately better target epidemic control measures in the case of pandemic flu, for example.” Researchers recommend the people at greatest risk be especially careful to wash their hands with soap and water; maintain clean surfaces; and use tissues when needed. Read more on influenza.
New Study Paints Larger Picture on Adolescent Concussions
New research on youth concussions gives a broader picture of the “silent epidemic” and shows that kids who smoke and drink are at increased risk. The study appears in the Journal of the American Medical Association. Canadian researchers found that about 20 percent of approximately 9,000 Ontario adolescents who were surveyed had suffered from a concussion. About half were related to sports, but they also found that teens who smoked marijuana or consumed alcohol were at three-to-five times higher risk. "This is the first study I'm aware of that looked at the general population," said Kenneth Podell, co-director of the Methodist Concussion Center at the Methodist Hospital System in Houston. U.S. emergency departments treat about 173,000 adolescents annually for traumatic brain injuries, which includes concussions, according to the U.S. Centers for Disease Control and Prevention. Read more on injury prevention.
HHS Launches Redesigned Website
The U.S. Department of Health and Human Services (HHS) has launched a redesigned website to make it easier for public health officials, health care experts and consumers navigate the agency’s diverse collection of resources. The new site emphasizes direct access to the latest news and top areas of interest—including priority websites manages by the large agency—while also highlighting ways to connect with HHS on social media, including Twitter and Facebook. Read more on HHS.
Overuse, Unsafe Methods Increase Serious Injury Risk in Youth Baseball
Non-adherence to pitch counts and general overuse has helped lead to a dramatic increase in youth baseball throwing injuries requiring surgery. The injuries now occur 16 times more often as they did only 30 years ago, according to Joseph Guettler, MD, an orthopedic surgeon and sports medicine specialist with the Beaumont Health System in Royal Oak, Mich. Factors include pitching more than one game per day, pitching on back-to-back days, not utilizing pitch counts and throwing curve balls before high school. "It became very clear that dangerous pitching behavior is occurring among pitchers as young as Little League all the way through their high school years,” said Guettler. “And, the blame doesn't usually lie with the leagues or coaches. Most were found to be adhering to nationally recognized guidelines for pitch limits and rest. It seems much of the blame lies with behavior of parents and their kids.” To avoid injuries, he recommends the “Rule of Ones,” which limits how often a kid pitches, how many positions they play, how many teams that play for and other factors that increase serious injury risk. Read more on injury prevention.
CDC Recommends FluBlok Influenza Vaccine for People with Egg Allergies
In a unanimous vote, the U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices has recommended FluBlok for the upcoming influenza season for people ages 18-49 who suffer from egg allergies. The production of FluBok, which was licensed by the U.S. Food and Drug Administration in January of this year, does not utilize the influenza virus or chicken eggs. Read more on influenza.
IOM Report Finds U.S. Global AIDS Efforts Successful, Stresses the Need to Help Countries Manage their Own Programs
A new report from the Institute of Medicine finds that the President's Emergency Plan for AIDS Relief (PEPFAR) has saved and improved millions of lives around the world. The report says the program also shows that HIV/AIDS services can be effectively delivered on a large scale even in countries with high rates of disease and resource challenges. The report also stresses the need for the program to increase its efforts to help partner countries develop the capacity to manage their own programs, sustain the gains that have been made in controlling the HIV epidemic and improve their citizens' access to services. PEPFAR was established in 2003 through legislation that authorized $15 billion for HIV/AIDS and other related global health issues over five years. In 2008, the legislation was reauthorized, providing up to $39 billion through 2013 for PEPFAR bilateral HIV/AIDS programs as well as U.S. contributions to the Global Fund to Fight AIDS, Tuberculosis, and Malaria. PEPFAR has supported HIV/AIDS programs in over 100 countries. As part of the reauthorization, Congress requested that IOM evaluate the program. That evaluation included visits to thirteen countries by the IOM's international committee of experts. Read more on HIV/AIDS.
Flu Vaccine 56 Percent Effective Overall, 27 Percent for Seniors
This season’s flu vaccine has been only 56 percent effective as of February and largely ineffective at protecting the elderly, according to the U.S. Centers for Disease Control and Prevention. It was only 27 percent effective for people ages 65 and older; 71 percent of Americans in that age group have been vaccinated. “The older you get, the less potent is your immune response,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Reuters. “This is just a fact of physiological life in the immune system.” He said better data on seniors is needed and there are ways to improve the vaccine going forward. Read more on influenza.
‘Smarter Lunchroom’ Setups Increase Kids’ Consumption of Fruits, Vegetables
Improving the location and attractiveness of fruits and vegetables in school cafeterias can help kids make healthier food choices, according to a new report in the Journal of Pediatrics. Researchers at the Cornell Center for Behavioral Economics in Child Nutrition Programs, in Ithaca, N.Y. also found that simply asking kids if they want to try one of the healthier choices can increase the odds. The inexpensive “smarter lunchroom” setup "not only preserves choice, but has the potential to lead children to develop lifelong habits of selecting and consuming healthier foods even when confronted with less healthy options," said study author Andrew Hanks. They found that post-makeover kids were 13 percent more likely to choose fruits and 23 percent more likely to choose vegetables. Read more on nutrition.
U.S. Adults with Mental Illness Have Higher Smoking Rates
Adults with mental illness have a smoking rate 70 percent higher than adults with no mental illness, according to the February 2013 Vital Signs report released yesterday by the U.S. Centers for Disease Control and Prevention. The report was done in collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSA) and found that 36 percent of adults with a mental illness are cigarette smokers, compared with only 21 percent of adults who do not have a mental illness. Among adults with mental illness, smoking prevalence is especially high among younger adults, American Indians, Alaska Natives, those living below the poverty line, and those with lower levels of education. Differences also exist across states. Smoking prevalence for people with mental illness ranges from 18.2 percent in Utah to 48.7 percent in West Virginia. The data used to determine the smoking rates in the Vital Signs report comes from 2009–2011 National Survey on Drug Use and Health. Mental illness was defined as having a diagnosable mental, behavioral, or emotional disorder, excluding developmental and substance use disorders, in the past 12 months. The report also found that, on average, adult smokers with mental illness smoke more cigarettes per month than those without mental illness (331 vs. 310 cigarettes) and are less likely to quit smoking. “Special efforts are needed to raise awareness about the burden of smoking among people with mental illness and to monitor progress in addressing this disparity,” said SAMHSA administrator, Pamela S. Hyde. Read more on tobacco.
NIH Announces Three Major Clinical Trials for Influenza Treatments
Three clinical trials aimed at finding more effective flu treatments are enrolling volunteers who have the virus at the National Institutes of Health’s Clinical Center in Bethesda, Md., as well as at several dozen other domestic and international sites.
- One study will look at whether the drug Tamiflu reduces the time that infected people continue to produce virus in the upper airway.
- The second trial will test whether a combination of three licensed antiviral drugs works better than Tamiflu in people with influenza that have chronic health conditions, such as heart or lung disease, which put them at greater risk of severe illness.
- The third trial will test whether treatment with plasma enriched with anti-influenza antibodies improves the condition of hospitalized influenza patients compared to standard antiviral treatment on its own.
“This year’s flu season came earlier than usual and has been particularly hard on the elderly,” said Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious diseases. “Despite our best efforts to prevent influenza through vaccination, people still get sick every year with the flu. At best, influenza infection is a miserable experience. At worst, it can be a deadly one. We need better ways to treat people with influenza, which kills thousands of people in the United States each year, and clinical research supported by NIAID helps to address that need.” Read more on flu.
Doctors Miss Opportunities for Underage Alcohol Screening
A new survey of more than 2,500 10th grade students published in Pediatrics found that 34 percent reported drinking alcohol in the past month and 26 percent said they had binged, defined as five or more drinks per occasion for males, and four or more for females. However, while more than 80 percent of those surveyed said they’d seen a doctor in the past year, just 54 percent of that group was asked by their physicians about drinking, and only 40 percent were advised about dangers associated with alcohol. In addition, of those students who had been seen by a doctor in the past year and who reported drinking in the past month, only 23 percent said they were advised to reduce or stop drinking. The survey was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAA). The researchers say studies have shown that screening and brief interventions by health care providers, such as asking patients about alcohol use and advising them to reduce risky drinking, can result in significant, lasting reductions in drinking levels and alcohol-related problems among adults. “Alcohol is by far the drug of choice among youth," says NIAAA acting director Kenneth R. Warren, PhD. “The findings reported [in this study] indicate that we must redouble our efforts to help clinicians make alcohol screening a routine part of patient care for young people in the United States.” Read more on alcohol.
USDA Releases New Regulations on Snack Foods Sold at Schools
New rules proposed by the U.S. Department of Agriculture would require snacks sold at schools to be lower in fat, salt and sugar and include more nutritious items such as whole grains, vegetables and fruits. The rules also require a limit of 200 calories on food items not sold in the school cafeteria. According to Reuters, the rules would apply to about 50 million children who are part of the school lunch program. “These proposed nutrition standards, the first update in more than 30 years, are long overdue and badly needed,” said Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation. The proposed regulations will be open for public comment once the rule is published in the Federal Register, which is likely to be this week. The final rule would probably not take effect before the fall of 2015. Read more on obesity.
Flu Shot May Protect Older People Against Heart Attacks
A new study from researchers at the University Of Iowa College Of Public Health suggests that the flu vaccine may provide protection against heart attacks in older adults, especially people over age 80. The researchers suspected acute infection caused by flu may trigger events leading to heart attacks and strokes, so they created a set of time-series models using inpatient data from a national sample of more than 1,000 hospitals and used flu activity to predict the incidence of heart attack and stroke. The team produced national models, as well as models based on four geographical regions and five age groups and across all models, and found consistent significant associations between heart attacks and influenza activity.
Flu Season 2013 Update: The most recent report from the U.S. Centers for Disease Control and Prevention finds that while there is still widespread flu activity in much of the country, an increasing number of states are starting to see a decline in reported flu cases.
Read more on flu.
Public Health School Partners with Churches to Improve Healthier Living
As part of a project led by the University Of South Carolina Arnold School Of Public Health, about 1,250 members of 74 African Methodist Episcopal churches in South Carolina participated in a program to help members lead healthier lifestyles through increased physical activity and healthier food choices. The five-year project was funded by the National Institutes of Health and found that members of churches who were part of the healthier lifestyle training were more likely to engage in physical activity and eat more fruits and vegetables than members from churches that did not undergo the training. The study's findings were published in the American Journal of Preventive Medicine. “Churches are natural partners to help eliminate health disparities in the African-American community, says Sara Wilcox, PHD, director of the school’s prevention research center. “For many, especially in the South, the church is the center of their life and is a trusted institution.” Read more on prevention.
The most recent update on flu activity in the U.S. from the Centers for Disease Control and Prevention finds 47 states showing widespread activity, down from 48 states the week before. “Widespread” means that more than half of the counties in a state are reporting flu activity. While the Western part of the country will likely see more cases, flu seems to be slowing some in the South, Southeast, New England and the Midwest—though still packing a punch in terms of illness, deaths, emergency room visits and hospital admissions.
NewPublicHealth spoke with Paul Etkind, MPH, DrPH, MPH, DrPH, Senior Director of Infectious Diseases at the National Association of County and City Health Officials about the role local health departments play in educating communities about flu prevention and helping to facilitate treatment.
NewPublicHealth: What, if anything, is different about the flu this year?
Paul Etkind: The flu severity that’s being experienced, which we haven’t seen for several years now, has gotten the public’s attention and they’re really heeding the public health urgings, communication and education that’s been going on all along saying hey, get your flu shots, protect yourself. So now, within a relatively short period of time, there’s a very large demand for flu shots.
During the H1N1 outbreak of a few years ago, there was much greater funding for what the health departments were doing. I saw some magic happening then. They had the funds to hold clinics in very unusual places, such as local baseball stadiums and airports. They went to places where people are most comfortable.