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			Wednesday, May 20, 2009 News Clipping Archives *Maryland / Regional* Low-cost health program lagging (Baltimore Sun) New laws for drivers, police (Baltimore Sun) Stimulus funds spur flurry of research grants (Baltimore Sun) Changes at Kennedy Krieger Institute make the hospital friendlier for Patients (Baltimore Sun) Fake cigarettes, fake smoke, real nicotine (Baltimore Sun) New state biotech center to open with two locations (Washington Post) Carroll Hospital Center nurses get history lesson (Carroll County Times) FDA clears drug maker in Beebe deaths (Salisbury Daily Times) *National / International* Take a bit out of dog bites (Baltimore Sun) Survey Finds Link Between Obesity and Flu Severity (Washington Post) Vermont Acts to Make Drug Makers’ Gifts Public (New York Times) Swine Flu Spreads in Japan, Despite Quarantine Inspections (Washington Post) *Opinion* Media flu coverage fell short (Carroll County Times Commentary) Healthcare reform (Annapolis Capital Letter to the Editor) *Maryland / Regional* Low-cost health program lagging Low enrollment clouds Howard uninsured plan By Larry Carson Baltimore Sun Tuesday, May 19, 2009 Howard County's highly praised attempt to provide low-cost, preventive medical care for uninsured residents is off to a slower than expected start. Only about 200 people have joined since enrollment in Healthy Howard began last Oct. 1, county health officer Dr. Peter L. Beilenson said, falling short of the admittedly ambitious goal he set of signing up 2,000 members in the program's first year. "Enrollment is not where I hoped it would be," Beilenson admitted under critical questioning at a recent county council budget hearing. He did note, however, that another 250 applications, many representing entire families, are being processed. The program is under close scrutiny for how successfully it addresses on a local level one of the most persistent problems facing the nation: how to provide health care for the uninsured, who number 50 million across the country and more than 700,000 in Maryland. As the Obama administration tackles national health care reform, Howard's effort to provide coverage for every uninsured resident who wants health services will provide a glimpse into what works - or doesn't. The program is also a signature initiative for County Executive Ken Ulman, a Democrat, and Beilenson, the former Baltimore City health officer who ran unsuccessfully for Congress in 2006, and could figure into any future ambitions of both. Beilenson said the major roadblock to signing up more clients is lack of awareness. "I think it's very clear people just don't know about it," he said. Another factor, officials said, is a reluctance of some residents to pay even a small monthly charge for coverage during a time of economic uncertainty. The sluggish start to enrollment provided an opportunity for the program's chief critic, County Councilman Greg Fox, a Republican, to question whether there is a demand for it and if it merits a second $500,000 infusion of county funding for the coming fiscal year. "The bottom line is, they're down to enrolling 20 or 25 a month, not 150 a month, and that's going to drop off, not increase," Fox said. Fox is pushing to cut in half the county's contribution in the fiscal 2010 budget, which the County Council will vote on Wednesday. Supporters of the program say it needs both time and continued funding to succeed. Patients in the program only began seeing doctors in January, they noted. Karen Davis, president of the New York-based Commonwealth Fund, a private foundation that supports research on health care issues, said Healthy Howard "seems like it's off to a great start" compared to other locally sponsored programs around the country. Most require contributions from employers, which Howard doesn't do, but that kind of private funding would have allowed for more advertising, she said. Davis credited Healthy Howard for directing residents who had called its offices to existing state and federal insurance programs, who contacted Healthy Howard and found they were eligible for existing state and federal insurance programs like the federally funded Children's Health Insurance Program (SCHIP). About 2,500 Howard residents, many of them children, were assisted in this way, partly because of a specialized electronic enrollment system imported from California that identifies the programs for which they are eligible. "None of those applications would have happened without announcing the [Healthy Howard] program," said Glenn E. Schneider, the Health Department's director of health policy and planning. Healthy Howard is not insurance, but a network of local providers that charges members $50 to $115 a month for comprehensive medical coverage, including the use of health coaches to improve people's general health and over time lower crisis care expenses. In Maryland, every uninsured person's visit to an emergency room racks up big charges, most of which are paid by insured patients through higher premiums and charges. Beilenson said his goal of enrolling 2,000 members the first year was overly ambitious and clearly not going to happen. His latest projections are for 908 plan members by July 2010. "The biggest problem with all this is me," he said. "I made the definition of success this arbitrary 2,000 number." An initial deluge of 1,100 calls swamped program workers and took several months to work through, he said. The recession has made it harder for some to afford the program's monthly charge. Beilenson has witnessed the lack of knowledge about the program first-hand. Earlier this month, he screened 14 Howard County women for breast cancer as part of a free health department program, and 12 told him they had no health insurance. Yet not one had heard about Healthy Howard, he said. Beilenson estimates there are at least 12,000 uninsured legal county residents who need access to health care. "You have to give us a year or a year and a half to penetrate this market," he said. Copyright 2009 Baltimore Sun. New laws for drivers, police Governor also signs bills that deal with child pornography, Silver Alert and domestic abuse By Laura Smitherman Baltimore Sun Wednesday, May 20, 2009 Gov. Martin O'Malley, seeking to highlight his administration's public safety efforts, agreed Tuesday to crack down on repeat drunken drivers, to catch speeders through automated cameras and to expand judges' power to take guns from domestic abusers. The Democratic governor also signed into law a measure strengthening penalties for the possession of child pornography - a measure that critics worry could ensnare teenagers increasingly engaged in the practice of "sexting," or sharing nude images via cell-phone message. And he approved legislation creating a Silver Alert program to help find vulnerable seniors that's similar to the Amber Alert system for lost or missing children. "There is no more important thing that we do in government than take part in protecting the lives of our people," O'Malley said during his final signing ceremony for bills approved by the General Assembly, which adjourned in April. Other measures that became law addressed disputes that have ensnared law enforcement agencies in recent months. One bill prohibits the covert infiltration of protest groups without reasonable suspicion of criminal activity. It was adopted after the American Civil Liberties Union uncovered a surveillance operation by Maryland State Police of anti-death penalty activists and other organizations. Another law requires police departments to report on SWAT team activities after the mayor of a Prince George's County municipality had his home raided last summer. Police erroneously thought Mayor Cheye Calvo's wife was involved in drug trafficking, and shot and killed their dogs during the operation. Several of the bills have rankled some lawmakers and advocacy groups. One measure, to permit speed cameras and $40 fines for people caught driving at least 12 mph above the speed limit near schools and in highway work zones, has inspired a movement to have it overturned by referendum. Maryland for Responsible Enforcement, the group spearheading the effort, has so far gathered about 10,000 signatures, or about one-fifth of the number needed to put the question to voters. O'Malley said that he was "agnostic" on the referendum drive. "Most people that I've talked to believe we all should be encouraged to slow down," he said. The child pornography bill, which had prompted lengthy debate in the legislature, addresses possession of a film, videotape or photograph of a child under 16 years old engaged in sexual acts. It raises the maximum prison sentence for a misdemeanor first offense from two to five years, and makes subsequent offenses a felony punishable by up to 10 years. While the bill passed unanimously in both chambers, some lawmakers raised concerns that teenagers engaged in sexting could be targeted for prosecution. Others, including Senate President Thomas V. Mike Miller, dismissed those worries and said the new provisions would be used in cases against criminals, not teenagers. "Nobody is for child pornography, but there is a wave of behavior among teenagers that violates this law," said Sen. Brian E. Frosh, a Montgomery County Democrat and chairman of the Judicial Proceedings Committee. "I'm concerned about criminalizing juvenile behavior that is bad but doesn't warrant stigmatizing someone for the rest of his or her life." O'Malley also signed measures requiring pawn brokers to electronically submit transactions to aid in investigations of property crimes, and enabling better information sharing among law enforcement agencies in Maryland, Virginia and the District of Columbia. In addition, bills to require licensure of locksmiths and athletic trainers became law, as did legislation aimed at helping military families. One measure authorizes tuition assistance for Maryland National Guard members; another facilitates the transfer of children who need to change schools because parents are deployed or moved. Copyright 2009 Baltimore Sun. Stimulus funds spur flurry of research grants $13 billion set aside for health and science studies could bring hundreds of jobs By Stephanie Desmon Baltimore Sun Wednesday, May 20, 2009 After years of flat government funding for medical and scientific research, officials at the Johns Hopkins University and the University of Maryland, Baltimore have been working overtime recently, putting in hundreds of grant requests in hopes of grabbing some of the $13 billion in stimulus money set aside for the National Institutes of Health and the National Science Foundation. Researchers nationwide are scrambling to create proposals that, under normal circumstances, would take many months, but instead are being done in a matter of weeks. So many submissions have come to the NIH that it has had to search the globe to find qualified people to review them quickly. And the competition for the dollars, part of President Barack Obama's $787 billion stimulus package, will be fierce, with 20,000 applications alone for so-called NIH challenge grants worth a total of $200 million, just a fraction of what will be spent. "It's just going to be a big shot in the arm for science in general," said Dr. Sally Rockey, acting deputy director for extramural research at the Bethesda-based NIH. In the end, the money for projects from drug research to lab expansions could mean hundreds of jobs and many millions of dollars to Baltimore, because of the scientific research powerhouses that are Hopkins and Maryland. "There are a lot of really good ideas that were dying on the vine because they weren't getting funded," said James Hughes, vice president for research and development at the University of Maryland, Baltimore. But with the stimulus money, Hughes estimates that his medical, pharmacy, dental and nursing schools could see as much as an additional $100 million over the next two years - money that will not only further research, but create hundreds of good jobs. Even without funding in place, Hopkins held a job fair this month so it can be ready once the federal dollars are allocated. Maryland, Hughes said, has already submitted 500 to 600 grants for money from the American Recovery and Reinvestment Act of 2009. In April, Johns Hopkins put in 729 grant applications for a total of $404 million - a threefold increase in applications over a normal month. Some are for new research projects; others would extend research already under way. All projects are required to spend the stimulus grants over the next two years to help get the economy going. Long-term benefits Scott Zeger, acting provost at Hopkins, sees the grants as a way not only to fuel the economy right now, but also to generate ideas and discoveries that could lead to business opportunities in the future. "It's not the same as building a road. A road is done in 18 months," Zeger said. "It's a way to stimulate both short-term and long-term economic benefit." Last year, the NIH's research budget was $23 billion. Hopkins has long been the agency's No. 1 grantee and Maryland is in the top 20. Zeger said Hopkins usually gets about one-third of the money it requests from the NIH. But this is no ordinary year, and officials from both institutions say it is difficult to predict how well they will do. Many of the requests would fund scientists, graduate students and laboratory technicians. Others would pay for supplies; that spreads money to outside companies. And some of the dollars are for construction. At Maryland's School of Pharmacy, for example, officials have asked for $10 million to expand and upgrade a facility that makes pills and tablets for drug trials. The NIH's Rockey said the agency will have to work quickly to approve the grants - the process typically takes six to nine months, but must be completed by Sept. 30. She said the parameters of the funding have forced scientists to consider where they can have an impact in a compact time frame. NIH grants are typically for four years, with an opportunity to renew. The challenge grants, which have drawn so many applications, were designed by NIH officials to jump-start research in areas they considered under-studied - from middle ear infections to autism to comparing the effectiveness of different anti-retroviral therapies for people with HIV/AIDS. A pleasant surprise Antonia Tolson, a third-year graduate student at Maryland's pharmacy school, has already secured a small share of the NIH stimulus money. She found out last month that her grant was approved to study the interaction between methadone and drugs to treat illnesses such as HIV and Hepatitis C. The 26-year-old Silver Spring native will get $25,000 annually for the next two years, money that will help her earn her doctorate. Her proposal was highly rated by the NIH, but she didn't expect the government to have enough money to fund it. She was thrilled to learn she was wrong. "It's definitely important to find your own funding," she said. "It's something that you have to do if you're going to go into academia. It's how scientists live." From 1998 to 2003, Congress doubled the budget of the National Institutes of Health, but since then funding has essentially been flat. According to the American Association for the Advancement of Science, inflation has driven purchasing power down 13 percent in real dollars over the past five years. "The money has gotten a lot tighter. More people, less dollars," said Paul Shapiro, associate dean for research and graduate studies at the school of pharmacy. "People have had to be let go because of loss of research dollars. "[Stimulus funding] could have a huge impact and really push a lot of research forward with the goal of treating diseases, which is what we're all about." Proposed projects The National Institutes of Health and the National Science Foundation have $13 billion in stimulus funds to spend. Johns Hopkins University and the University of Maryland, Baltimore have submitted more than 1,200 grant requests, including proposals to: •Upgrade and expand Maryland school of pharmacy facility that produces tablets and pills for drug trials. •Install ventilated stoves to see if reducing indoor air pollution reduces infection/death rates in Southern Nepal, where children die of respiratory disease at a rate 50 times that of developing countries. (Hopkins request) •Create a "physics of cancer" center at Hopkins to study use of nanotechnology in fighting the disease. Copyright 2009 Baltimore Sun. Changes at Kennedy Krieger Institute make the hospital friendlier for patients By Edward Gunts Baltimore Sun Wednesday, May 20, 2009 The entrance is marked by a block-long garden with outdoor "rooms" and a circular labyrinth where therapists can work with patients learning to use a wheelchair or walk with a cane. The main lobby features a mini-aquarium and lounge where teens can shoot pool or play Wii games. The top floor is a light-filled aquatic center containing swimming pools with underwater treadmills and hydraulic lifts. These are a few of the features of the Harry and Jeanette Weinberg Building, a $35 million, state of the art outpatient center that the Kennedy Krieger Institute is opening this spring as part of an effort to improve and expand services to children and young adults with developmental disabilities and spinal cord injuries. The six-story, 115,000-square-foot building at 801 N. Broadway is the first of two structures that Kennedy Krieger will open this spring in East Baltimore, along with a $20 million, four-story clinical research building nearing completion at 716 N. Broadway. On May 28, institute leaders will hold a ceremony to dedicate the first building and announce the successful completion of a $55 million campaign to fund the expansion. Besides the Weinberg Foundation, which gave $7.15 million, major donors include Arthur and Pat Modell and Fred and Farideh Mirmiran. For institute president Gary Goldstein, the openings mark the end of a 15-year effort to grow beyond a 1960s-era building at 707 N. Broadway and bring Kennedy Krieger's facilities up to the level of care offered by the institute's staff. He said the new outpatient building, particularly, was designed to send "a very positive message" about Kennedy Krieger and the work it does. Unlike hospitals that offer a full range of patient care, Kennedy Krieger focuses on providing aggressive treatment for children and young adults with autism, cerebral palsy, and brain and spinal cord injuries. "This is our mission," he said. "This is what we do, so we wanted to make the most of it. Our program is rare enough that we get patients from all over the country and all over the world. The building sends the message, along with the staff and the program, that this is a very different place." The design team, led by Stanley Beaman & Sears of Atlanta as the architect and Mahan Rykiel Associates of Baltimore as the landscape architect, made a strong effort to create spaces that are open and full of natural light. "Light promotes hope," said architect Veronique Pryor. "The whole idea behind this building is the idea that one day the patients will get better. We really wanted it to be uplifting." Founded in 1937 by Dr. Winthrop Phelps as the Children's Rehabilitation Institute in Cockeysville, the institute moved to Broadway in 1967 and was renamed the Kennedy Institute, after former President John F. Kennedy. In 1992, it became the Kennedy Krieger Institute, adding the name of philanthropist Zanvyl Krieger. Today it has 1,700 employees and is internationally recognized, serving more than 13,000 people a year through inpatient and outpatient clinics, home and community services and school-based programs. Fifteen percent of its patients come from outside Maryland. The Weinberg building is expected to give Kennedy Krieger the capacity to serve 25 percent more patients a year. It already has boosted morale among patients and staff, who began moving in less than a month ago. "Being here is so much livelier," said activities specialist Kassandra Ford. "It's open. There's more room. We have a garden now. Kids can go outside. I look at the expressions on patients' faces - they're elated." "The staff and patients are so thrilled, I can't tell you," said Lainy Lebow-Sachs, senior vice president of external relations. "Even though we're dealing with disabilities of children ... the sense of joy is everywhere. It's a very happy place." Copyright 2009 Baltimore Sun. Fake cigarettes, fake smoke, real nicotine Some debate advantages of electronic smoking device By Stephanie Desmon Baltimore Sun Tuesday, May 19, 2009 From a distance, it looks like Tal Broustin is lighting up a cigarette, right in the middle of Arundel Mills, a clear no-no. And he is trying to get others to take drags, too, luring passersby to his kiosk by asking if they are trying to quit smoking. Up close, it is clear that Broustin is taking puffs not from an actual cigarette, but from a battery-powered gadget designed to look like the real thing. Called an "e-cigarette," or electronic cigarette, it contains no tobacco, gives off no smoke but instead is a nicotine delivery device that gives off heated water vapor. Some companies are pitching e-cigarettes simply as less harmful alternatives to smoking, saying that smokers who can't quit might be better off "vaping" one of their products. Other companies, though, are selling their e-cigarettes as smoking cessation tools, claims that have not been backed up by any science. Regardless, the relatively new devices - available online, at truck stops and at mall kiosks like the one where Broustin works - are drawing fire, mostly from groups such as the American Cancer Society and the American Lung Association, and from scientists who say they fear the products may pose unknown dangers, even if they're not from the known carcinogens in cigarette smoke. Some have called on the Food and Drug Administration to ban them immediately. The FDA says e-cigarettes are "unapproved drug-device combinations," and, in the past two months, has detained 17 shipments from China at the border and sent them back. "We don't know its safety profile," said spokeswoman Karen Riley. Despite the recent FDA actions, the industry says more than 100,000 e-cigarettes have been sold in the United States, and the number grows every day. "Relatively little is known about how they're used, how much nicotine gets into people, what other chemicals are coming along for the ride," said Dr. Jonathan Samet, director of the Institute for Global Health at the University of Southern California and a former department chairman at the Johns Hopkins School of Public Health in Baltimore. "To make a therapeutic claim, you need to do the proper testing." One selling point of e-cigarettes is that they can be used where smoking is banned - in bars, in restaurants, at the mall. Samet said he thinks people who use them could get even more nicotine than before because they will be able to "light up" in more places. One consequence of smoking bans, he said, has been that more people have quit smoking. Jack Leadbeater, chief executive officer of NJOY, a Scottsdale, Ariz., e-cigarette maker, is chairman of the E-Cigarette Association. The industry group includes many of those who sell the products, though it doesn't include Smoking Everywhere, the company whose kiosk is at Arundel Mills and other malls. He says his association's members make no claims that their device will help people quit smoking. "It's really sold just as an alternative to allow current smokers to get nicotine in a manner that's more palatable," he said. "If this was a form of vodka that didn't cause liver damage, would we be having the same sort of problems?" A starter e-cigarette kit typically goes for about $100. When the user inhales through the cigarette-like tube, a heating element is activated and it vaporizes a nicotine solution stored in the mouthpiece. A red light will glow on the end, simulating the burning of tobacco. The mouthpiece contains about the same amount of nicotine in a pack of cigarettes and is flavored to taste like tobacco or menthol (though some offer mint, vanilla or other flavors). The nicotine needs to be replenished at an additional charge. William T. Godschall, executive director of Smokefree Pennsylvania, said he finds the debate about e-cigarettes to be counterproductive. He agreed that clinical trials have not been conducted, but he finds it odd that a government that can't seem to regulate cigarettes - which are known to cause cancer - is upset over a much less hazardous product. "These e-cigarettes are at least 99.9 percent less deadly than cigarettes," he said. "Let's worry about the products that are actually killing people." Back at the Smoking Everywhere mall kiosk, Broustin is closing in on a sale. He has blown vapor into the air to show James Papanicolas, a 19-year-old mover from Laurel, that it doesn't stink like cigarette smoke. He has explained that his product can actually help reduce nicotine addiction by allowing a smoker to choose less and less concentrated amounts of the drug over time. Papanicolas' friend, Rose Sanders of Taneytown, isn't sold. The 27-year-old doesn't understand how an e-cigarette could ease her addiction. "It's still going to make you want another cigarette," she said. "If you have this, you're still thinking about smoking." But Papanicolas planned to buy the e-cigarette. He thinks it will save him money in the long run, since the new filters cost far less than the $6 to $8 he shells out for a pack of Newports. Will it help him stop smoking? "It might," Papanicolas said. "I know it will help me stop buying cigarettes." Copyright © 2009, The Baltimore Sun. New state biotech center to open with two locations Washington Post Wednesday, May 20, 2009 Gov. Martin O'Malley announced Monday the planned opening of the Maryland Biotechnology Center in Montgomery County, intended as a resource for the state's life sciences sector, as he prepared to head for a conference in Atlanta on the industry's future. The center, expected to open within 60 days, will be in the Shady Grove Life Sciences Park with another office "co-located" at the World Trade Center in Baltimore, state Commerce Department officials said. O'Malley said the new biotechnology center would be "a one-stop shop, yes with two locations" for the industry. Maryland is home to more than 400 biotech companies. O'Malley plans to detail a state strategy for courting and sustaining the industry while in Atlanta that would include assisting companies to find venture capital and sustain job growth. He noted that the industry has continued to generate jobs, even in the economic downturn. O'Malley made the announcement after a tour of the Aeras Global TB Vaccine Foundation in Rockville, which is working to develop and distribute a new tuberculosis vaccine worldwide. - The Washington Post Copyright 2009 Washington Post. Carroll Hospital Center nurses get history lesson By Erica Kritt Carroll County Times Wednesday, May 20, 2009 Some of Carroll Hospital Center’s nurses received a visit Tuesday from Florence Nightingale. Nightingale, who died 99 years ago, was not actually present. There was an impersonator. The CHC nurses were participating in a program called the Nursing Clinical Ladder, which promotes career development among nurses working at the hospital. Bill Ebeling, a nurse at the hospital, and a fan of history, presented the other nurses with information about Nightingale and how she made a mark in the nursing world. Ebeling lamented that a lot of nurses did not have a great understanding of the history of their profession and it is important to learn. “I think they can learn a lot from Florence Nightingale,” he said. The presentation also included input from a panel of three nurses who researched Nightingale. Libby Fuss, an infection control manager at CHC, served on the panel and thought that Nightingale did a lot not only for nursing but for women in general. “She was ahead of her time,” she said. Ebeling explained that Nightingale understood that clean water and fresh air promoted health. Nightingale also collected statistics to study her work. “She really was one of the first people to use pie charts,” Fuss said. Reach staff writer Erica Kritt at 410-857-7876 or erica.kritt@carrollcountytimes.com. Copyright 2009 Carroll County Times. FDA clears drug maker in Beebe deaths Existing medical condition blamed The News Journal By Dan Shortridge Salisbury Daily Times Wednesday, May 20, 2009 LEWES -- A federal investigation has cleared a drug maker in the deaths of two patients who were being treated at Beebe Medical Center in Lewes, attributing the deaths of the patients to their existing medical conditions instead of blaming heparin, the drug they were given. The deaths and the illness of a third patient who suffered intercranial bleeding were not connected to any problems with the anticoagulant heparin, which prevents blood clots from growing, the drug maker and federal authorities said. The two patients -- a 71-year-old man and a 64-year-old woman -- died last weekend after they were taken to other hospitals for treatment. Both suffered bleeding after being given heparin from a premixed IV bag supplied by Illinois-based Baxter Healthcare Corp. The third patient also was transferred to another hospital, and neither federal nor Beebe officials have released an update on the person's condition. Baxter officials did not cast blame for the deaths on the hospital but offered no explanation as to why three patients at the same hospital would have similar problems. Following national guidelines for use of drugs such as heparin doesn't guarantee there will be no problems, said Baxter spokeswoman Erin Gardiner. "Even when those protocols are followed, bleeding at a site, including intercranial bleeding, can occur -- especially in high-risk patients, which is an established side effect of all anticoagulant therapies," she said. Meanwhile, Beebe's ongoing investigation has found no evidence of human error, the hospital said. "We appreciate the support and cooperation given by the patients' families throughout this difficult ordeal," Wallace Hudson, vice president for corporate affairs said. "Our thoughts and prayers are with them." The Food and Drug Administration, which investigated the cases, said its authority stopped with the negative test results. Further investigation would have to come from state authorities, FDA spokeswoman Karen Riley said. "Our responsibility is for the safety of the product," she said. Spokesman Jay Lynch of the Delaware Department of Health and Social Services, which oversees licensing and certification of healthcare facilities, said it would be premature to talk about an investigation. dshortridge@delawareonline.com 302-463-3338 Copyright 2009 Salisbury Daily Times. *National / International* Take a bit out of dog bites Unleashed Blog By Jill Rosen Baltimore Sun Wednesday, May 20, 2009 Nearly 5 million Americans are bitten by dogs each year, and one in five dog bites results in injuries that require medical attention, according to the Centers for Disease Control and Prevention. May 17 to 23 is National Dog Bite Prevention Week. The CDC wants to be sure people are aware there are ways to decrease the liklihood of dog bites. Almost one in five of people who are bitten by dogs, or 885,000 people, require medical attention for their injuries, the CDC says. And In 2006, more than 31,000 people underwent reconstructive surgery because of dog bites. Children, adult males and people with dogs in their homes are the most likely to get bit, according to the CDC. For kids, most dog bites happen to those who are 5 to 9 years old. The CDC recommends teaching children the following techinques and tips to help them interact safely with dogs: * Do not approach an unfamiliar dog. * Do not run from a dog or scream. * Remain motionless (e.g., "be still like a tree") when approached by an unfamiliar dog. * If knocked over by a dog, roll into a ball and lie still (e.g., "be still like a log"). * Do not play with a dog unless supervised by an adult. * Immediately report stray dogs or dogs displaying unusual behavior to an adult. * Avoid direct eye contact with a dog. * Do not disturb a dog that is sleeping, eating, or caring for puppies. * Do not pet a dog without allowing it to see and sniff you first. * If bitten, immediately report the bite to an adult. Copyright 2009 Baltimore Sun. Survey Finds Link Between Obesity and Flu Severity By David Brown and Robin Shulman Washington Post Wednesday, May 20, 2009 A survey of people hospitalized because of swine flu in California has raised the possibility that obesity is as much of a risk factor for serious complications from the flu as diabetes, heart disease and pregnancy, all known to raise a person's risk. In all, about two-thirds of the California patients had some underlying medical condition, according to a report yesterday in the weekly bulletin of the Centers for Disease Control and Prevention. Nationwide, 47 states and the District have reported 5,469 cases and six deaths since the start of the outbreak in late April, according to the CDC's count. Yesterday, officials in Missouri reported a seventh U.S. death -- that of a 44-year-old man who had no underlying medical problems, wire services reported. "We were surprised by the frequency of obesity among the severe cases that we've been tracking," said Anne Schuchat, one of the CDC epidemiologists managing the outbreak. She said scientists are "looking into" the possibility that obese people should be at the head of the line along with other high-risk groups if a swine flu vaccine becomes available. Other studies have shown that pregnant women are also at higher risk for serious influenza infection, especially in the third trimester, when the fetus and womb compress the lower parts of the lungs. This makes it harder to breathe deeply and cough forcefully; it may also alter blood flow in the chest. A similar thing may be occurring in severely overweight people, some experts speculated. The average age of the 30 Californians hospitalized for swine flu was 27.5 years. Nearly three-quarters were women, and 65 percent were Hispanic. Half lived in two counties bordering Mexico. Of the 30 people, 11 had a lung ailment such as asthma or emphysema, six had an immune disorder, five had heart disease, five were pregnant, four had diabetes and four were obese. In New York, Mayor Michael R. Bloomberg (I) said officials were investigating whether 16-month-old Jonathan Castillo, who died with a high fever Monday night at a Queens hospital, had contracted the H1N1 virus. The toddler's 3-year-old sibling was treated for flulike symptoms and released. The mayor said lack of health insurance or immigration status should not deter people who feel sick from seeking attention. "Whether you have health insurance coverage or your immigration status is in question, it doesn't matter," Bloomberg said. "We will not ask about that." The mayor also said four inmates at a Rikers Island jail had been confirmed to have the H1N1 virus and four more are likely to have it. The union representing the city's correctional officers criticized the response to the swine flu outbreak among inmates and filed a letter of protest with the state Labor Department. "If I had to design a place where you could put people who were sick and get as many people sick as possible, it's the New York City jail," said Richard J. Koehler, a lawyer for the Correction Officers' Benevolent Association. Shulman reported from New York. Copyright 2009 New York Times. Vermont Acts to Make Drug Makers’ Gifts Public By Natasha Singer New York Times Wednesday, May 20, 2009 Cracking down on medical industry payments to doctors, the Vermont legislature has passed a law requiring drug and device makers to publicly disclose all money given to physicians and other health care providers, naming names and listing dollar amounts. The law, scheduled to take effect on July 1, is believed to be the most stringent state effort to regulate the marketing of medical products to doctors. It would also ban nearly all industry gifts, including meals, to doctors, nurses, medical staff, pharmacists, health plan administrators and health care facilities. In practice, the new law would let Vermonters learn each year which doctors have been paid, and how much, by the makers of the brand-name drugs for which they wrote prescriptions — or how much money certain surgeons have received from the makers of the stents, pacemakers, artificial knees and such that the doctors implanted. The action by Vermont has been watched around the country, as national legislators and medical groups look for links between industry marketing and health care costs. Minnesota already requires drug companies to report payments to doctors. New Massachusetts regulations limit gifts to health care practitioners and call for disclosure of any payment or benefit worth $50 or more. In Congress, Senators Charles E. Grassley, Republican of Iowa, and Herb Kohl, Democrat of Wisconsin, have sponsored a bill requiring disclosure of pharmaceutical industry payments to doctors. But Vermont has gone further with its new law, which Gov. Jim Douglas, a Republican, is expected to sign by early next month. It will require public disclosure of all payments by companies to any health care provider with authority to write prescriptions for drugs, medical devices and biologics, drugs that are typically administered by injection or infusion. The law is also the first to ban all free meals, long a favorite gift in marketing to doctors. The law also closes a loophole in previous regulations that had allowed companies to keep specific expenses private by claiming them as trade secrets. The required disclosures, though, do not include payments for clinical research on products under review by the Food and Drug Administration. “This is a much more comprehensive law because it makes clear — whether devices, biologics or drugs are involved — the issue is inappropriate gift-giving,” said Sharon Treat, the executive director of a nonprofit group, the National Legislative Association for Prescription Drug Pricing, and a Democrat in the Maine House of Representatives. The Vermont law promises to provide a window into the considerable efforts and spending by device and drug makers to woo doctors even in a small state. Makers of medical products spent about $2.9 million in fiscal year 2008 on marketing to health care professionals in Vermont, according to a report last month from the state’s attorney general. Of Vermont’s 4,573 licensed health practitioners, almost half received remuneration, including payments for lectures, meals or lodging from pharmaceutical companies in the 2008 fiscal year, the report said. “If the drug industry gives $3 million on average for three years now to physicians in a small state like Vermont, what is happening in California and New York?” said Ken Libertoff, director of the Vermont Association for Mental Health, an advocacy group that supported the law. The Vermont attorney general’s report, compiled before passage of the law, provides only aggregate data because companies declared 83 percent of the payments to be trade secrets. Even so, without naming names, the disclosed expenses highlighted a widely used industry strategy of focusing much of the marketing money on a group of influential doctors. Of the $2.9 million spent in Vermont, for example, about $1.8 million went to only 100 health care providers. That meant only about 4 percent of doctors received 60 percent of the payments, the report said. A psychiatrist received about $112,000, the highest amount spent on one person. But specialists in internal medicine, neurology, endocrinology and diabetes also received more than $100,000 each during the year. To reduce the perception of undue industry influence, the Pharmaceutical Research and Manufacturers of America or PhRMA, a trade association, instituted a voluntary code in January that prohibits noneducational gifts to doctors and restricts meals. About 50 manufacturers the code. With such a code, Vermont’s new reporting requirements seem redundant, said Marjorie E. Powell, a senior lawyer for PhRMA. “We think this is unnecessary, and it is not going to improve patient care,” Ms. Powell said. “It makes it onerous not only for the company but also for the physician in Vermont, because this is going to be on a Web site.” But the Vermont Medical Society, which represents 65 percent of the physicians in the state, supported the bill. Peter Shumlin, president pro tempore of the Vermont state senate, said he hoped his state would provide a model on marketing disclosures for the rest of the country. “Our goal is not to prohibit this practice,” Mr. Shumlin said, “but to have the first system in this country where providers’ acceptance of this money is on full public record.” Copyright 2009 New York Times. Swine Flu Spreads in Japan, Despite Quarantine Inspections By Blaine Harden Washington Post Foreign Service Wednesday, May 20, 2009 TOKYO, May 19 -- To stop swine flu before it could sneak off airplanes arriving from North America, Japan dispatched masked health inspectors with fever-sensing guns to walk among passengers. But the flu has taken hold in this island nation anyway, with rapidly increasing numbers of confirmed cases in its western region. It is now inevitable, experts said, that the H1N1 virus will spread to the Tokyo-Yokohama metropolitan area, where about 35 million people live and commuters are packed cheek to jowl daily on a vast network of trains and buses. The government reported Tuesday that the number of H1N1 cases in Japan has reached 191 -- more than in any other country except the United States, Mexico and Canada, according to the World Health Organization. Meanwhile, in Geneva, WHO officials said the swine flu virus is not growing as fast as hoped in research laboratories, which means drug manufacturers will not be able to start making a vaccine for it until at least mid-July. WHO chief Margaret Chan said drug companies would be able to make 5 billion doses of the vaccine, at best, in the first year of production, the Associated Press reported, which is not enough to cover the world's 6.8 billion people. In Japan, illness caused by the virus has been relatively mild, and there have been no deaths. But, because of the spread of the virus, more than 4,000 schools in and around the cities of Osaka and Kobe have been closed for the rest of the week. Prime Minister Taro Aso has begun appearing in public service announcements on national television, urging people to stay calm and assuring them they have nothing to fear if treated early. As in the United States, the flu has spread most rapidly among students, and it appears that school closures here, as elsewhere, might not stop young people from hanging out together. In Osaka, students formed long lines in front of karaoke clubs because they had nothing else to do, according to local news media. One club owner put up a sign saying that students from closed schools were not welcome. Also in Osaka, some family restaurants that employ teenagers have asked them not to come to work. Quarantine inspections at airports will probably end soon, the government said, so that health officials can redeploy workers. "We have to shift our focus to domestic measures in line with the spread of the flu," said Takeo Kawamura, Aso's chief cabinet secretary. By sending health inspectors onto hundreds of jumbo jets arriving from North America, the government found four confirmed cases of swine flu among Japanese students and teachers returning from a trip to Canada by way of the United States. But the government might have been looking in the wrong place. A 17-year-old student from Kobe who had the first confirmed infection in western Japan had made no recent overseas trips, authorities said. He is thought to have been at the center of a cluster of infection that has spread rapidly in the past 10 days, after five high schools competed in a volleyball tournament. "We can assume that the virus is spreading domestically already," said Yoichi Masuzoe, minister of health, labor and welfare. The flu has also begun to spread to workers in convenience stores and train kiosks in Osaka and Kobe, according to the Yomiuri newspaper. "As people other than high school students are confirmed infected, I'm afraid the situation has entered a phase of an epidemic," Chika Shirai, chief of the Kobe municipal government's disease prevention and sanitation section, told the newspaper. Special correspondent Akiko Yamamoto contributed to this report. Copyright 2009 Washington Post. *Opinion* Media flu coverage fell short By Tom Zirpoli, Columnist Carroll County Times Commentary Wednesday, May 20, 2009 It seems that the big scare regarding the H1N1 virus or “swine flu” is mostly over. We were lucky. It could have been much worse. But perhaps now is the time to reflect on how we handled the crisis and what we can learn for the future. The H1N1 flu is a hybrid combination of the swine, avian and human flu strains. It is a respiratory disease, just like the regular flu, and is spread through coughing and sneezing. With all the alarming news about the H1N1 flu, I was surprised to learn some facts about the regular seasonal flu that seem much scarier, but don’t get much attention. So far, there have been five confirmed deaths in the United States related to the H1N1 flu: three in Texas, one in Washington State and one in Arizona. To put this into perspective, about 500,000 people die in the world each year from the seasonal flu. According to the Centers for Disease Control and Prevention, the seasonal flu infects millions of Americans and kills 36,000 of us each year. More than 13,000 Americans have died from the seasonal flu this year. Hundreds of flu related deaths are reported to the CDCP in the United States every week. Given this comparison, it is interesting to note that all the attention and all the precautions people are taking regarding the H1N1 flu, while almost ignoring the real threat found in the seasonal flu. It seems that we should be educating people to take universal precautions all the time to avoid the seasonal flu which is a significant killer in our nation and around the world. The media’s presentation of the H1N1 flu outbreak did not make an effort to educate us or to put this virus in perspective. Then again, in their defense, health professionals could not predict the potential intensity of the H1N1 virus until enough people were infected to measure the outcome. Did the media over-react? Perhaps, they did. But a more important question is did the media inform the public about our risks and appropriate precautions to consider. Fear doesn’t make people smarter, just more anxious. And fear, mixed with misinformation - and there was plenty of that - makes people do silly things. For example, it was common to see pictures of people in the newspaper or on television wearing face masks to protect themselves from the flu. In reality, according to Richard Besser, acting director of the CDCP, the evidence is not very strong that masks work outside the health care setting where people are working face-to-face with sick people. In Egypt, the government ordered the unnecessary killing of the country’s 350,000 pigs, leaving poor farmers without an income or meat to eat. Not a single pig or person in Egypt had been diagnosed with the H1N1 flu prior to the mandated slaughter. China, Russia and Indonesia have banned the import of pork products even though you can’t catch the flu from eating pork. Some people in America took advantage of peoples’ fears to push their case against illegal immigrants from Mexico. Yet most people infected here are Americans who crossed into Mexico while on vacation, then spread the disease to other Americans. During uncertain times like these, we need the media to provide us with smart and useful information so that we can make smart and useful decisions. My recommendation would be for more information and less drama. Tom Zirpoli writes from Westminster. His column appears on Wednesdays. E-mail him at tzirpoli@mcdaniel.edu. Copyright 2009 Carroll County Times. Healthcare reform Annapolis Capital Letter to the Editor Wednesday, May 20, 2009 Maryland needs to continue receiving Ryan White funds at no less than level funding. The Baltimore Eligible Metropolitan Area is in need of better surveillance of HIV/AIDS, a waiver on name-based reporting requirements from HRSA, and continued focused funding for African-American and other communities that are at higher risk for infection and need better support systems. This support is vital to the continued viability of our state's constituents and its economy. Maryland is facing a shortfall in its budget and federal support to address the HIV/AIDS pandemic is absolutely required. As a HIV consumer, I sincerely thank you for sharing this statement with the public and pray that everyone can understand the positive effects that continued funding will produce. CAROLYN MASSEY Laurel Copyright 2009 Annapolis Capital. BACK TO TOP


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