Office of Public Relations

[newsclippings/dhmh_header.htm]
Visitors to Date
Office of Public Relations
			Friday, May 22, 2009 News Clipping Archives *Maryland / Regional* Official Tries to Reassure Lawmakers About Cost Hikes, Timetable (Washington Post) Hours cut at senior centers in Brunswick, Emmitsburg and Urbana (The Gazette) Forest Service closes caves to stop bat fungus (Carroll County Times) State Watch \| New Maryland Law Requires Insurers To Provide Incentives for EHR Adoption (kaisernetwork.org) *National / International* USTR vows to expand meat trade by enforcing rules (Washington Post) Ruling: Tobacco companies lied, must change marketing (USA Today) At the Bridge Table, Clues to a Lucid Old Age (New York Times) Study Detects Flu Immunity in Older People (Washington Post) Swine flu genes circulated undetected for years (Washington Post) U.S. to Spend $1 Billion on H1N1 Flu Vaccine Production (Wall Street Journal) Flu Spreads, but Some Countries Ease Measures (New York Times) Tax on Medical Benefits Gains Traction (Washington Post) Yes, Bisphenol A Does Enter the Body from Plastic Bottles (Wall Street Journal) PROMISES, PROMISES: Before peanut recall, FDA did half of food safety audits it promised to do (Baltimore Sun) *Opinion* --- *Maryland / Regional* Official Tries to Reassure Lawmakers About Cost Hikes, Timetable By Christian Davenport Washington Post Friday, May 22, 2009 The Navy official in charge of the Walter Reed Army Medical Center consolidation tried to assure lawmakers yesterday that the project was on schedule and that cost increases were the unavoidable result of an increased focus on providing care for wounded warriors coming home from Iraq and Afghanistan. But Vice Adm. John M. Mateczun's comments in a House subcommittee hearing were met with skepticism by powerful Reps. John P. Murtha (D-Pa.) and James P. Moran Jr. (D-Va.), who said there was no comprehensive plan in place, no clear sense of how much the project would cost and great uncertainty that the 2011 deadline would be met. "If our highest priority is the care of our patients, we are going to fall short," Moran said. "You're going right up against the deadline, and there's no Plan B." Under the Pentagon's 2005 Base Realignment and Closure plan, Walter Reed is to shut down by Sept. 15, 2011, and merge with the National Naval Medical Center in Bethesda and Fort Belvoir in Fairfax County. The Bethesda campus will be renamed the Walter Reed National Military Medical Center, and Fort Belvoir would get a new 120-bed hospital, which is under construction. The move, as Mateczun has said, is "the largest infrastructure investment that has ever been made in military medicine." News reports detailing poor conditions and bureaucratic nightmares at Walter Reed led to significant changes in the treatment of service members wounded in combat and in the consolidation plans, officials said. As a result, the initial budget of $800 million jumped to $2.4 billion. After the scandal broke, costs to better accommodate the wounded increased by $1.1 billion, Rick Bond, the deputy director of the joint task force set up to oversee the hospitals, said after the hearing. A warrior-care unit with 50 intensive-care beds was added to the plans, as were dedicated clinic space and private rooms. The timeline of the project was pushed up to ease the transition, which also raised the cost. The initial plan used outdated pricing projections and underestimated the staffing the new Bethesda campus would require -- and thus the need for office space and parking, Bond said. "The fundamental project has changed since it was originally conceived," he said. He said it would be completed on time, "given what we know about the construction schedule today." But, he said, "a lot can happen in the next two years." During the hearing, Moran was somewhat sympathetic given the massive scope of the project, calling it "an impossible mission." Still, he said, "we don't want to be told at the eleventh hour: 'You have to give us all this money, or it can't be done.' " Murtha, who opposed the closing of Walter Reed, said that the congressionally mandated deadline was nearing and that Congress didn't have a sense of how much it was going to cost. "We get inadequate figures, and then the taxpayer has to pay," he said. Copyright 2009 Washington Post. Hours cut at senior centers in Brunswick, Emmitsburg and Urbana Centers to close one day a week starting in June after compromise struck By Sherry Greenfield The Gazette Friday, May 22, 2009 The Frederick County Department of Aging has reached a compromise with Brunswick and Emmitsburg officials to close their towns' senior centers one day a week instead of the proposed two. Starting next month, the Brunswick Senior Center will close on Tuesdays, but remain open Monday, Wednesday, Thursday and Friday. The Emmitsburg Senior Center will close on Mondays, but remain open Tuesday through Friday. The Urbana Senior Center will also close on Fridays. Rearranging hours will allow staff to serve the county's busier centers. Frederick County commissioners unanimously approved the closings on Thursday after asking Department of Aging officials to find a way to allow the Emmitsburg and Brunswick senior centers to close one day a week instead of two. Commissioners wanted to appease the concerns of Emmitsburg and Brunswick leaders opposed to the closings. "We sat down and took into consideration what [the commissioners] had proposed and the various suggestions that were presented, as well as the different ways we may accomplish what we are trying to do, which is to essentially add staff to the different programs where we really need them the most right now," said Carolyn True, director of the Department of Aging. "It still gives seniors that attend the senior centers four days a week." Brunswick and Emmitsburg leaders appreciate the compromise. "I think this one is a better plan, and I am supportive of it," said Emmitsburg Mayor James Hoover. Brunswick Mayor Carroll Jones agreed. "Carolyn and I spoke yesterday [May 20], and we're in support of the compromise and in support of the recommendations," Jones said. Though the senior centers serve as a place for older residents looking for friendship, activities and lunch, the centers in Brunswick, Emmitsburg and Urbana do not attract a large number of people. The Brunswick center brings in eight to 10 people a day, while Emmitsburg averages 14. The Urbana Senior Center also has few visitors. In comparison, the Frederick Senior Center averages 100-125 people a day, said Linda McGinnes, the center's coordinator. At the May 14 meeting, the Department of Aging proposed closing the Brunswick center on Tuesdays and Fridays, the Emmitsburg Senior Center Mondays and Thursdays, and the Urbana Senior Center every other Friday. This would allow staff to move to other more active senior centers and provide additional staff to the Meals on Wheels home delivery meal program. But Hoover and Jones voiced their concerns over closing the senior centers for two days, saying this would be a hardship for those who use them. Commissioners asked that a compromise be reached before they would approve any changes. They were pleased Thursday that an agreement had been reached. "I appreciate the efforts going into this and trying to resolve some of the concerns," Commissioner Kai J. Hagen (D) said. Board President Jan H. Gardner (D) agreed. "I do think it's a good compromise," she said. "We do appreciate the participation." Copyright 2009 The Gazette. Forest Service closes caves to stop bat fungus Associated Press By Brian Farkas Carroll County Times Friday, May 22, 2009 CHARLESTON, W.Va. — The U.S. Forest Service is closing thousands of caves and former mines in national forests in 33 states in an effort to control a fungus that has already killed an estimated 500,000 bats. Bats have been dying at alarming rates from what scientists call “white-nose syndrome,” so-named because it appears as a white powder on the face and wings of hibernating bats. The problem was first spotted in New York and within two years has spread to caves in West Virginia and Virginia. There’s no evidence the fungus is harmful to people. Researchers believe the fungus is spread from bat to bat, but they have not ruled out the possibility that humans tromping from cave to cave might help to transmit it on their shoes and equipment, said Dennis Krusac, a biologist with the service’s Southern region. “We don’t have the answers at this point,” he said. “If we have answers in a year or sooner, we can open them back up.” Forest Service biologist Becky Ewing said an emergency order was issued last week for caves in 20 states from Minnesota to Maine. A second order covering the Forest Service’s 13-state Southern region should be issued later this month. The sites will be closed for up to a year, she said. The orders follow a March request by the U.S. Fish and Wildlife Service for people to voluntarily stay out of caves in 17 states. Biologists are concerned the fungus could wipe out endangered Indiana, Virginia and Ozark big-eared and gray bats. Bats play a key role in keeping insects such as mosquitoes under control. Between April and October, they usually eat their body weight in bugs per night. The loss of 500,000 bats means 2.4 million pounds of bugs aren’t eaten in a year, Ewing said. New York caver Peter Haberland said organized caving groups shouldn’t object to the closures. “For a period of a year, most people can deal with that,” said Haberland, who serves on the Northeastern Cave Conservancy’s board. He said the order should have little effect in the Northeast since just a few national forests there offer caving and many caves are on private property. Peter Youngbaer, white nose syndrome liaison for the National Speleological Society, another caving group, said education will be key because many people who explore caves don’t belong to organized groups. “There is a huge concern,” he said. “The recreation aspect is probably the least of our concerns.” The Forest Service order says people caught in a cave or mine face up to six months in jail and fines of up to $10,000. Ewing said Forest Service officials will enforce the bans. Youngbaer said he isn’t convinced humans help transmit the fungus, which kills the bats because it affects their hibernation habits, causing them to starve. A study based on soil samples taken from 200 sites in 30 states should help resolve that question. “There is no question that it’s spreading bat to bat and spreading from bat to bat rapidly,” he said. “If it turns out the fungus is living in the caves anyway ... humans moving around doesn’t mean anything.” Many of the caves in question are in the 919,000-acre Monongahela National Forest in West Virginia, which this week announced it would extend a ban imposed last year that only affected caves considered to be at high risk for the fungus. On Friday, the Indiana Department of Natural Resources moved to close caves on state-owned property until April even though the disease has not been found in Indiana. Last month, officials closed all of the caves in the Great Smoky Mountains National Park. Krusac said the orders do not affect commercial caves on private property. Officials in the Ozark National Forest are debating whether to impose restrictions on wild cave adventures on the forest’s Blanchard Springs Caverns. Copyright 2009 Carroll County Times. State Watch \| New Maryland Law Requires Insurers To Provide Incentives for EHR Adoption Kaiser Daily Health Policy Report kaisernetwork.org Friday, May 22, 2009 Maryland Gov. Martin O'Malley (D) on Tuesday signed a bill making the state the first to require private insurance companies to offer physicians financial incentives for adopting electronic health records, the Baltimore Sun reports. Starting in 2011, insurers will have to provide physicians who adopt EHRs with increased reimbursements, a single sum payment or in-kind services that have monetary value. According to the Sun, physicians who do not adopt EHR systems by 2015 could face penalties. The bill also requires Maryland to establish a health information exchange that eventually will link all the state's physicians, hospitals, medical laboratories and pharmacies. Last summer, the Maryland Health Care Commission asked two state physician groups to develop and launch pilot health information exchange programs in an effort to see how a state system should work. Groups wanting to design the statewide system have until June 12 to submit applications to the commission, which will award the contract in August. The seed money for the system will come in part from stimulus funds and from hospitals fees. According to state Health Secretary John Colmers, the network is likely to be gradually phased in with the first elements coming online as early as fall. Colmers said that he expects "fairly rapid adoption" of the information exchange system, adding that "with the incentives in the stimulus package and in this bill beginning to go into effect in 2011, it will be important for it to be certainly ramped up and ready to operate by then." O'Malley said, "This is where government and private health care providers can come together to really improve not only the quality of care but also, hopefully, create some cost savings as well." Colmers said, "The goal here in Maryland was to assure that all of the payers pull their oars in the same direction," adding that the promise of EHRs "comes when it's done in a coordinated fashion, across all payers" (Brown/Brewington, Baltimore Sun, 5/19). Copyright 2009 kaisernetwork.org. *National / International* USTR vows to expand meat trade by enforcing rules Reuters By Roberta Rampton Washington Post Friday, May 22, 2009 WASHINGTON (Reuters) - The U.S. government wants to boost meat trade by tougher enforcement of trade agreements, Trade Representative Ron Kirk said on Friday, vowing to work to lift technical, standards-based barriers curbing U.S. meat exports. The United States stands to gain more markets for beef and pork by working to ease restrictions on meat that are based on unjustified concerns about the H1N1 flu virus, mad cow disease, and other technical issues than it would by inking more small trade deals, Kirk told the U.S. Meat Export Federation. "We can open up market access by stronger enforcement of our existing rules," Kirk said. "In this challenging economic climate, our partners simply have to play by the rules." Last year, U.S. beef trade was worth more than $3.6 billion and pork trade more than $4.6 billion, Kirk noted. But the U.S. meat trade has been hurt by high grain costs at a time when consumers around the world are cutting back on buying expensive cuts of meat. The strength of the U.S. dollar compared with currencies in major importing nations like Mexico, South Korea and Russia has also priced U.S. meat out of some markets. The industry also has been plagued by barriers based on sanitary and phytosanitary concerns about human and animal health, which scientists and trade bodies have called unjustified. "It is absolutely a priority ... to make sure that our good, safe meat products are not frozen out of international markets because of myths, because of anything unrelated to sound science," Kirk said. Bans on U.S. meat by more than a dozen countries following the outbreak of the new flu virus are unfair and have jeopardized as much as $900 million in annual U.S. exports, Kirk said. Russia is restricting U.S. meat trade with measures not based on international standards, Kirk said, noting the "arbitrary delisting" of U.S. plants during the past year. He also said too many countries continue to have restrictions on U.S. beef after the United States reported its first case of mad cow disease in 2003, pointing to Japan, Taiwan, China and Hong Kong. "Our administration is currently reviewing all of these trade-related measures that have been put in place by these governments, and seeing if we can't work with them to try to resolve some of those and open up some of those important markets" he said. Kirk pointed to a recent agreement on beef trade with the European Union as an example of how the United States can work to pragmatically seek market access for farm goods. The two trading partners have fought for more than 20 years about the safety of beef raised with growth hormones -- a common practice in the United States that is not accepted by the European Union. The four-year beef deal sees the U.S. pulling back from a threat to apply new sanctions to EU products in exchange for a duty-free quota for beef raised without growth hormones. Kirk acknowledged the agreement does not solve the outstanding disagreement about hormones, or the use of washes used by U.S. beef processors to reduce pathogens like e.coli -- another practice not approved by EU regulators. But the deal gives the EU time to approve the washes and the United States time to make progress negotiating the long-term issue of beef hormones, Kirk said. "If not, we always reserve the right to go back to the WTO," Kirk said, referring to the long-standing battle over the issue at the World Trade Organization. (Editing by Walter Bagley) © 2009 Reuters. Ruling: Tobacco companies lied, must change marketing Associated Press By Nedra Pickler USA Today Friday, May 22, 2009 WASHINGTON — A federal appeals court on Friday largely endorsed a landmark ruling that found cigarette makers deceived the public for decades about the heath hazards of smoking. The U.S. Court of Appeals in Washington upheld the major elements of a 2006 ruling that found the nation's top tobacco companies guilty of fraud and violating racketeering laws. The ruling said manufacturers must change the way they market cigarettes. It bans labels such as "low tar," "light," "ultra light" or "mild," because such cigarettes have been found to be no safer than others because of how people smoke them. It also said the companies must publish "corrective statements" on the adverse health effects and addictiveness of smoking and nicotine. The changes have not taken affect while the case has been under appeal. Throughout the 10 years the case has been litigated, tobacco companies have denied committing fraud in the past and said changes in how cigarettes are sold now make it impossible for them to act fraudulently in the future. The government filed the civil case under a 1970 racketeering law commonly known as RICO used primarily to prosecute leaders of organized crime in cases in which there has been a group effort to commit fraud. The suit was filed first in 1999 during the administration of President Clinton. The next administration, headed by Republican George W. Bush, pursued it after receiving early criticism for openly discussing the case's perceived weaknesses and attempting unsuccessfully to settle it. During the nine-month bench trial, U.S. District Judge Gladys Kessler heard accusations that the companies established a "gentleman's agreement" in which they agreed not to compete over whose products were the least hazardous to smokers. That was to ensure they did not have to speak publicly about the harm caused by smoking, government lawyers said. Tobacco lawyers denied the contention. The defendants in the lawsuit were: Philip Morris USA and its parent, Altria Group; R.J. Reynolds Tobacco; Brown & Williamson Tobacco; British American Tobacco; Lorillard Tobacco; Liggett Group; Counsel for Tobacco Research-U.S.A.; and the now-defunct Tobacco Institute. Liggett was excluded from the ruling because the judge said the company came forward in the 1990s to admit smoking causes disease and is addictive and cooperated with government investigators. The appeals court ruled that the Counsel for Tobacco Research-U.S.A. and Tobacco Institute be dismissed from the suit. Both are trade organizations for the cigarette manufacturers but did not manufacture or sell tobacco products. The companies had no immediate response to the appeals court decision. Copyright 2009 The Associated Press. All rights reserved. At the Bridge Table, Clues to a Lucid Old Age Brain Power By Benedict Carey New York Times Friday, May 22, 2009 LAGUNA WOODS, Calif. — The ladies in the card room are playing bridge, and at their age the game is no hobby. It is a way of life, a daily comfort and challenge, the last communal campfire before all goes dark. “We play for blood,” says Ruth Cummins, 92, before taking a sip of Red Bull at a recent game. “It’s what keeps us going,” adds Georgia Scott, 99. “It’s where our closest friends are.” In recent years scientists have become intensely interested in what could be called a super memory club — the fewer than one in 200 of us who, like Ms. Scott and Ms. Cummins, have lived past 90 without a trace of dementia. It is a group that, for the first time, is large enough to provide a glimpse into the lucid brain at the furthest reach of human life, and to help researchers tease apart what, exactly, is essential in preserving mental sharpness to the end. “These are the most successful agers on earth, and they’re only just beginning to teach us what’s important, in their genes, in their routines, in their lives,” said Dr. Claudia Kawas, a neurologist at the University of California, Irvine. “We think, for example, that it’s very important to use your brain, to keep challenging your mind, but all mental activities may not be equal. We’re seeing some evidence that a social component may be crucial.” Laguna Woods, a sprawling retirement community of 20,000 south of Los Angeles, is at the center of the world’s largest decades-long study of health and mental acuity in the elderly. Begun by University of Southern California researchers in 1981 and called the 90+ Study, it has included more than 14,000 people aged 65 and older, and more than 1,000 aged 90 or older. Such studies can take years to bear fruit, and the results of this study are starting to alter the way scientists understand the aging brain. The evidence suggests that people who spend long stretches of their days, three hours and more, engrossed in some mental activities like cards may be at reduced risk of developing dementia. Researchers are trying to tease apart cause from effect: Are they active because they are sharp, or sharp because they are active? The researchers have also demonstrated that the percentage of people with dementia after 90 does not plateau or taper off, as some experts had suspected. It continues to increase, so that for the one in 600 people who make it to 95, nearly 40 percent of the men and 60 percent of the women qualify for a diagnosis of dementia. At the same time, findings from this and other continuing studies of the very old have provided hints that some genes may help people remain lucid even with brains that show all the biological ravages of Alzheimer’s disease. In the 90+ Study here, now a joint project run by U.S.C. and the University of California, Irvine, researchers regularly run genetic tests, test residents’ memory, track their activities, take blood samples, and in some cases do postmortem analyses of their brains. Researchers at Irvine maintain a brain bank of more than 100 specimens. To move into the gated village of Laguna Woods, a tidy array of bungalows and condominiums that blends easily into southern Orange County, people must meet several requirements, one of which is that they do not need full-time care. Their minds are sharp when they arrive, whether they are 65 or 95. They begin a new life here. Make new friends. Perhaps connect with new romantic partners. Try new activities, at one of the community’s fitness centers; or new hobbies, in the more than 400 residents’ clubs. They are as busy as arriving freshmen at a new campus, with one large difference: they are less interested in the future, or in the past. “We live for the day,” said Dr. Leon Manheimer, a longtime resident who is in his 90s. Yet it is precisely that ability to form new memories of the day, the present, that usually goes first in dementia cases, studies in Laguna Woods and elsewhere have found. The very old who live among their peers know this intimately, and have developed their own expertise, their own laboratory. They diagnose each other, based on careful observation. And they have learned to distinguish among different kinds of memory loss, which are manageable and which ominous. A Seat at the Table Here at Laguna Woods, many residents make such delicate calculations in one place: the bridge table. Contract bridge requires a strong memory. It involves four players, paired off, and each player must read his or her partner’s strategy by closely following what is played. Good players remember every card played and its significance for the team. Forget a card, or fall behind, and it can cost the team — and the social connection — dearly. “When a partner starts to slip, you can’t trust them,” said Julie Davis, 89, a regular player living in Laguna Woods. “That’s what it comes down to. It’s terrible to say it that way, and worse to watch it happen. But other players get very annoyed. You can’t help yourself.” At the Friday afternoon bridge game, Ms. Cummins and Ms. Scott sit with two other players, both women in their 90s. Gossip flows freely between hands, about residents whose talk is bigger than their game, about a 100-year-old man who collapsed and died that week in an exercise class. But the women are all business during play. “What was that you played, a spade was it?” a partner asks Ms. Cummins. “Yes, a spade,” says Ms. Cummins, with some irritation. “It was a spade.” Later, the partner stares uncertainly at the cards on the table. “Is that ——” “We played that trick already,” Ms. Cummins says. “You’re a trick behind.” Most regular players at Laguna Woods know of at least one player who, embarrassed by lapses, bowed out of the regular game. “A friend of mine, a very good player, when she thought she couldn’t keep up, she automatically dropped out,” Ms. Cummins said. “That’s usually what happens.” Yet it is part of the tragedy of dementia that, in many cases, the condition quickly robs people of self-awareness. They will not voluntarily abandon the one thing that, perhaps more than any other, defines their daily existence. “And then it’s really tough,” Ms. Davis said. “I mean, what do you do? These are your friends.” Staying in the Game So far, scientists here have found little evidence that diet or exercise affects the risk of dementia in people over 90. But some researchers argue that mental engagement — doing crossword puzzles, reading books — may delay the arrival of symptoms. And social connections, including interaction with friends, may be very important, some suspect. In isolation, a healthy human mind can go blank and quickly become disoriented, psychologists have found. “There is quite a bit of evidence now suggesting that the more people you have contact with, in your own home or outside, the better you do” mentally and physically, Dr. Kawas said. “Interacting with people regularly, even strangers, uses easily as much brain power as doing puzzles, and it wouldn’t surprise me if this is what it’s all about.” And bridge, she added, provides both kinds of stimulation. The unstated rule at Laguna Woods is to support a friend who is slipping, to act as a kind of memory supplement. “We’re all afraid to lose memory; we’re all at risk of that,” said one regular player in her 90s, who asked not to be named. Woody Bowersock, 96, a former school principal, helped a teammate on a swim team at Laguna Woods to race even as dementia stole the man’s ability to form almost any new memory. “You’d have to put him up on the platform just before the race, just walk him over there,” Mr. Bowersock said. “But if the whistle didn’t blow right away, he’d wander off. I tell you, I’d sometimes have to stand there with him until he was in the water. Then he was fine. A very good swimmer. Freestyle.” Bridge is a different kind of challenge, but some residents here swear that the very good players can play by instinct even when their memory is dissolving. “I know a man who’s 95, he is starting with dementia and plays bridge, and he forgets hands,” said Marilyn Ruekberg, who lives in Laguna Woods. “I bring him in as a partner anyway, and by the end we do exceedingly well. I don’t know how he does it, but he has lots of experience in the game.” Scientists suspect that some people with deep experience in a game like bridge may be able to draw on reserves to buffer against memory lapses. But there is not enough evidence one way or the other to know. Ms. Ruekberg said she cared less about that than about her friend: “I just want to give him something more during the day than his four walls.” Drawing the Line In studies of the very old, researchers in California, New York, Boston and elsewhere have found clues to that good fortune. For instance, Dr. Kawas’s group has found that some people who are lucid until the end of a very long life have brains that appear riddled with Alzheimer’s disease. In a study released last month, the researchers report that many of them carry a gene variant called APOE2, which may help them maintain mental sharpness. Dr. Nir Barzilai of the Albert Einstein College of Medicine has found that lucid Ashkenazi Jewish centenarians are three times more likely to carry a gene called CETP, which appears to increase the size and amount of so-called good cholesterol particles, than peers who succumbed to dementia. “We don’t know how this could be protective, but it’s very strongly correlated with good cognitive function at this late age,” Dr. Barzilai said. “And at least it gives us a target for future treatments.” For those in the super-memory club, that future is too far off to be meaningful. What matters most is continued independence. And that means that, at some point, they have to let go of close friends. “The first thing you always want to do is run and help them,” Ms. Davis said. “But after a while you end up asking yourself: ‘What is my role here? Am I now the caregiver?’ You have to decide how far you’ll go, when you have your own life to live.” In this world, as in high school, it is all but impossible to take back an invitation to the party. Some players decide to break up their game, at least for a time, only to reform it with another player. Or, they might suggest that a player drop down a level, from a serious game to a more casual one. No player can stand to hear that. Every day in card rooms around the world, some of them will. “You don’t play with them, period,” Ms. Cummins said. “You’re not cruel. You’re just busy.” The rhythm of bidding and taking tricks, the easy conversation between hands, the daily game — after almost a century, even for the luckiest in the genetic lottery, it finally ends. “People stop playing,” said Norma Koskoff, another regular player here, “and very often when they stop playing, they don’t live much longer.” Copying 2009 New York Times. Study Detects Flu Immunity in Older People Antibodies Found In One-Third of Americans Over 60 By David Brown Washington Post Friday, May 22, 2009 A substantial portion of older Americans may have some immunity to the swine-origin H1N1 influenza virus, a finding that may prove useful when and if a vaccine to the new flu strain becomes available. The questions of whom to target with a swine flu vaccine and how to stretch the supply if it is limited are among the most important issues facing public health officials over the next four months. Scientists at the Centers for Disease Control and Prevention announced yesterday that a study using stored blood samples found that one-third of people older than 60 have antibodies that might protect them from infection with the new virus. If further research is able to better define who has partial immunity, those people might need only one dose of vaccine, not two. "Our working hypothesis is that everyone who gets this vaccine is likely to need two doses," Anne Schuchat, CDC's deputy director for science and public health, said yesterday. She added, however, that the new study suggests "perhaps there will be some people where preexisting immunity will be there, and one dose would lead to a 'primed' response. That is definitely . . . something we're interested in." If a swine flu vaccine is produced, about 2 billion doses would be ready by next fall, the World Health Organization estimates. Public health authorities presumably would recommend it for people at greatest risk for severe illness and death. As of yesterday, the United States had 5,764 confirmed cases and nine deaths, in 47 states and the District of Columbia. Epidemiologists believe, however, that more than 100,000 people have been infected since the new virus came to public attention a month ago. Worldwide, 41 countries have reported 11,034 cases and 85 deaths -- numbers that are almost certainly also an undercount. The blood study, published yesterday in CDC's Morbidity and Mortality Weekly Report, gives an immunological explanation for a surprising observation in the swine flu outbreak: that very few old people are getting sick. Nearly two-thirds of the U.S. cases are in people between 5 and 24 years old. Less than 1 percent are in people older than 65, those most susceptible to typical seasonal outbreaks of influenza. Of the people ill enough to be hospitalized, 40 percent have been 19 to 49. In the study, researchers tested blood collected since 2005 for research on the effectiveness of seasonal flu vaccine. They exposed the blood to samples of the swine flu to see whether it contained antibodies that attacked the virus. Samples from children 6 months to 9 years old contained virtually no antibodies against the swine flu strain. However, 6 percent of people 18 to 40, 9 percent of people 18 to 64 and 33 percent of people older than 60 had the antibodies. When blood samples taken after the same people had received seasonal flu vaccine were tested, the percentage with active antibodies against the swine flu strain increased in the two older groups. Specifically, for the 18-to-64-year-olds, it increased from 9 to 25 percent; and for the older-than-60 group, from 33 to 43 percent. Overall, the findings suggest that many older people may have been exposed to a flu virus decades ago that bore a similarity to the new strain and triggered an immune response. Seasonal flu shots appear to boost that "memory" response a little. A vaccine made from the new strain would be expected to both increase and sharpen the response -- perhaps enough that a single shot would suffice. However, people whose immune systems have never encountered a flu strain even remotely like the new one would almost certainly need two shots to gain protection. Schuchat, the CDC epidemiologist, said no firm conclusions can be drawn yet. It is not known whether the "cross-reactive" antibodies found in the study will prove to be protective against illness, or whether the 79 children and 280 adults whose blood samples were tested are representative of the population at large. Studies to answer those questions are underway. Copyright 2009 Washington Post. Swine flu genes circulated undetected for years Associated Press By Randolph E. Schmid Washington Post Friday, May 22, 2009 WASHINGTON -- Genes included in the new swine flu have been circulating undetected in pigs for at least a decade, according to researchers who have sequenced the genomes of more than 50 samples of the virus. Researchers led by Rebecca Garten of the Centers for Disease Control and Prevention studied samples of the flu isolated in Mexico and the United States. The findings suggest that in the future pig populations will need to be closely monitored for emerging influenza viruses, according to the report, released Friday by the journal Science. First detected last month, the H1N1 flu has sickened more than 11,000 people in 41 countries and killed 85, according to the World Health Organization, whose figures often trail those of individual countries. Mexico has reported 75 swine flu deaths, the United States 10, and there has been one death each in Canada and Costa Rica. Garten's team said the exact combination of the virus' eight gene segments has not previously been reported among swine or human influenza viruses. They said all of the segments originated in bird hosts and then began circulating in pigs at various times in history, from 1918 through 1998. Infected pigs might not have shown signs of illness, but gave the viruses an opportunity to mix with other viruses and create more dangerous strains. Six of the eight segments include genetic material from human, avian and swine viruses as the result of these viruses' tendency to swap pieces of their genomes with each other, the researchers said. These have been circulating since at least 1998. The other two segments originated from Eurasian swine viruses, they reported. The sequences for the gene segments did not reveal the signatures of high transmissibility or virulence that have been found in other influenza A viruses, suggesting that other, yet-unknown sequences are responsible for the new virus' ability to replicate and spread in humans. The H in H1N1 stands for the protein hemagglutinin, which is responsible for the virus' ability to bind to and infect its host cell. The researchers focused on that protein in experiments and say they will need to continue to look for changes in the hemagglutinin protein in the new virus, which may affect the selection of vaccine candidates, the authors say. While the journal Science normally publishes on Thursday, the new study was released immediately because of the widespread interest in the topic. On the Net: Science:http://www.sciencemag.org © 2009 The Associated Press U.S. to Spend $1 Billion on H1N1 Flu Vaccine Production By Jennifer Corbett Dooren Wall Street Journal Friday, May 22, 2009 WASHINGTON -- Health and Human Services Secretary Kathleen Sebelius said Friday the U.S. will spend $1 billion to start the process of making an H1N1 influenza vaccine. The money, which comes from funds already set aside for pandemic influenza, will fund new and existing contracts with influenza vaccine makers such as Sanofi Aventis SA, GlaxoSmithKline and Novartis. The money will be used partly to purchase bulk ingredients to be placed in a federal stockpile that could be used if officials decide to move forward with a wide-scale vaccination campaign. Ms. Sebelius said while no decision has been made on whether to start wide-scale production of an H1N1 vaccine, developing candidate vaccines now are necessary. World health officials are expected to decide in the coming weeks whether an H1N1 vaccine should be made. The seasonal influenza vaccine currently being made for the 2009-2010 influenza season won’t protect against the new H1N1 strain. The funds will pay for the production of a pilot H1N1 vaccine that would be used for clinical tests this summer to help determine how much active ingredients are needed in each individual vaccine and the best dosing likely to offer protection against the new H1N1 influenza strain. The Centers for Disease Control and Prevention is currently growing “seeds” that contain the H1N1 virus that will then be turned over to vaccine makers who will develop pilot lots. CDC officials have said they hope to turn over the seed strains later this month. The earliest the first doses of H1N1 influenza vaccine would be available is September. Meanwhile, the World Health Organization said Friday it may alter criteria regulating when pandemic alert levels move to Phase 6, the highest. Several countries requested the WHO use more flexibility in looking at what would warrant a move higher from Phase 5, the current alert level, Keiji Fukuda said at the agency’s daily briefing devoted to the H1N1 virus. Dr. Fukuda is the WHO’s acting assistant director-general for health security and environment. The WHO is weighing current criteria -- which Fukuda called “quite good,” because “there is nothing like reality to tell you whether something is working or not.” Specifically, the WHO is considering taking a virus’ severity into account as well as geographic spread, Dr. Fukuda said. This would mean an adjustment of terms laying out when to raise alert levels, which are meant to inform countries how to prepare. Input from several countries had led to intense discussion about the appropriate response at this week’s World Health Assembly, Dr. Fukuda said. Earlier Friday, the WHO said H1N1 influenza has infected 11,168 individuals in 42 countries, and caused 86 deaths. Katharina Bart contributed to this article. Copyright 2009 Dow Jones & Company, Inc. All Rights Reserved. Flu Spreads, but Some Countries Ease Measures By Sharon Otterman New York Times Friday, May 22, 2009 Japanese authorities began to ease measures aimed at controlling the spread of swine flu on Friday, saying the virus was not as lethal as feared. Mexico City, meanwhile, lifted all of its flu restrictions and lowered its alert level, after authorities said no new cases had been confirmed there for a week, news services reported. Health authorities worldwide have been struggling to fine-tune prevention measures for the new strain of the Influenza A(H1N1) virus, which spreads rapidly but causes mostly mild illness. While the epidemic in Mexico, the epicenter of the original outbreak in April, appears to be winding down, cases are continuing to rise elsewhere, including in the United States, Asia, South America, Europe and Australia. The World Health Organization reported 11,168 laboratory-confirmed cases of the virus in 42 countries on Friday, including 86 deaths, mostly in Mexico. Outside of North America, Japan has reported the highest number of confirmed cases, with 307, Japanese health officials said. Russia reported its first confirmed case on Friday, in a Russian citizen returning from the United States, according to the Interfax news agency. “From a global perspective, this is still pretty early in the spread of this virus,” said Dr. Keiji Fukuda, the W.H.O.’s assistant director-general, in a Friday news briefing. “We are in an evolving situation.” Japan’s health minister, Yoichi Masuzoe, told reporters on Friday that though the new influenza was continuing to spread in the country, it “has strong similarities to seasonal flu” and that there had been no fatalities. He said anti-flu drugs had been effective, Reuters reported. Japanese officials downgraded an earlier warning against nonessential travel to Mexico, instead urging caution when visiting the country. People who suspect they have the flu in areas where infections are rapidly increasing can now go to regular medical institutions rather than special “fever centers,” and schools will not be closed automatically when an infection is reported. The spread of the flu had put Japan in crisis mode: more than 4,800 schools in western Japan have been closed, medical services are swamped and testing laboratories are working around the clock. Japan’s fears hit a new high when the area around Tokyo confirmed its first swine flu cases late Wednesday, in two high school students who returned Tuesday from a trip to New York. Authorities are trying to stem the panic by striking a balance between appropriate caution and national paralysis. In Mexico City, Mayor Marcelo Ebrard on Thursday dropped the epidemic alert level to green, the lowest level. All public facilities have been reopened. The last confirmed case in the city was on May 14, news services reported. “There’s no longer any need” to wear masks, Mr. Ebrard said. “Now you can come to the city without any risk.” Mr. Ebrard also urged Mexicans to remain vigilant, to maintain sanitary conditions in places where crowds gather, like subways and schools, and to support a “culture of health.” The Federal Health Ministry continued to run radio advertisements urging Mexicans to wash their hands regularly and take other sanitary measures to ensure that influenza cases do not rise again. Fewer Mexicans appear to be wearing masks and restaurants that put large containers of hand gel at their entrances have discontinued the practice. The fear appears to be diminished, with sneezes and coughs not eliciting the panic they did at the height of the crisis. Passengers at Mexico City’s airports still must stand in front of a camera to measure their body temperature and fill out forms asking whether they have flu symptoms. As the virus continued to hop-scotch around the globe, students returning from the United States at the end of the school semester seem to be among the most common carriers. Many governments, meanwhile, are continuing to take stringent steps to slow the spread of the disease. In Italy, the Health Ministry ordered the closing on Friday of two high schools in Rome after four students contracted the virus on a recent trip to the United States, Reuters reported. Deputy Health Minister Ferruccio Fazio ordered the closings “out of precaution and so as to limit as much as possible the spread of the new A(H1N1) flu virus,” a statement said. In Australia, where there were 11 confirmed cases, health authorities raised the threat level on Friday, allowing the government to close schools, public places and major events if necessary. Taiwan confirmed three new cases on Friday, one in a woman returning from the Philippines and two in students flying back from the United States, bringing the island’s total infections to five.More information continued to emerge, meanwhile, about those who are most at risk of dying of the flu. In Mexico, authorities said Thursday that of the 78 people who died there of the disease, nearly 80 percent were between 20 and 54 years old. That is in keeping with other research showing that people born before 1957 may have some immunity from older flu strains. Dr. Fukuda said that a W.H.O analysis of serious cases found half of the people who had to go to the hospital with the swine flu were re young and healthy with no underlying medical conditions. The other half had existing conditions, including diabetes, respiratory problems, and pregnancy. Many of those who died in Mexico had underlying medical conditions, the Health Ministry said. Almost 30 percent were obese or had metabolic problems, and 13 percent had cardiovascular problems, Reuters reported. The strain must be closely monitored in the southern hemisphere, as it could mix with ordinary seasonal influenza and mutate in “unpredictable ways,” W.H.O. executive director Margaret Chan told the organization’s annual assembly in Geneva on Friday, Reuters reported. “This is a subtle, sneaky virus,” Dr. Chan said. “We have clues, many clues, but very few firm conclusions.” Marc Lacey contributed reporting from Mexico City. Copyright 2009 New York Times. Tax on Medical Benefits Gains Traction Health-Care Overhaul Could Be Funded by Levy on Employer-Paid Insurance Premiums By Lori Montgomery Washington Post Friday, May 22, 2009 A new tax on employer-provided health insurance is emerging as a likely option to finance an overhaul of the nation's health-care system, key Democrats say, despite opposition from organized labor and possibly the Obama administration. Critical details have yet to be resolved, including whether to tax the benefits of all workers regardless of income and what portion of their employer-paid insurance premiums to tax. But the idea won a surprising degree of acceptance during a closed-door meeting of the Senate Finance Committee this week, according to several people present. And once-fierce opposition among House Democrats is softening as lawmakers confront their limited options for raising the estimated $1.2 trillion that will be needed to pay for reform over the next decade. "There's a strong sentiment that still exists in the House" against taxing employer-provided benefits, said Rep. John B. Larson (D-Conn.), a member of House leadership who sits on the tax-writing Ways and Means Committee. "But we understand how important it is to get a package through." Implementing such a tax would create a tricky political situation for President Obama, who last year spent millions on campaign ads that harshly criticized a similar idea advanced by his Republican opponent, Sen. John McCain of Arizona. But while continuing to express opposition to the proposal, White House officials have repeatedly stated that all financing options are on the table. And some Democrats are already calculating how to explain a reversal. That task may have been made easier this week when congressional Republicans proposed using the tax to finance their own health-reform blueprint, lending the idea a bipartisan stamp of approval. Excluding employer-provided benefits from taxation "is one of the distortions in the health-care marketplace that needs to be fixed," said Rep. Paul D. Ryan (R-Wis.), one of the plan's authors. "It was put in place in the mid-20th century when everyone had the same jobs for most of their lives. And we don't live like that anymore." According to U.S. Census data, 177 million Americans received health insurance from their employers in 2007, the most recent year for which data are available. Nearly two-thirds of people under 65 have at least some of their insurance premiums paid by their own employer or that of a family member. Under current law, those benefits are not taxed as income, one of the largest loopholes in the U.S. tax code. If the loophole were eliminated, congressional tax analysts estimate that the IRS would have collected an extra $133 billion last year alone. Senate Finance Committee Chairman Max Baucus (D-Mont.), who expects to unveil health-reform legislation next month, has said he is not interested in closing the loophole, but in establishing limits. Among the options: Taxing only the benefits of high-earning individuals who make at least $200,000 a year ($400,000 for families). Or taxing benefits for all workers above some pre-set amount. One figure under discussion is $13,000, the national average value of employer-provided coverage for families. Both options have disadvantages. Taxing only wealthy families, for example, "doesn't make sense," said Sen. John F. Kerry (D-Mass.), because it would raise too little money -- only about $160 billion over 10 years, according to Finance Committee aides. But "you've got to be very careful how far you go" down the income ladder, Kerry said. "If you come down too low, you're impacting workers and threatening the employer-based system." Some Democrats are particularly concerned that the tax would fall heavily on union members, who tend to have generous health packages sometimes derided as "Cadillac" plans. But those plans are expensive because they include dental and vision benefits, large provider networks and low co-payments -- "things every American wants and should have," said Richard Kirsch, national campaign manager of Health Care for America Now, a coalition of unions and community organizations. Kirsch yesterday endorsed an alternative tax plan drafted by Citizens for Tax Justice that would target corporations and the wealthy for $1 trillion in tax increases over the next decade. Capping employer-provided health benefits would generate around $500 billion over the next 10 years, by various estimates, and key Democrats say it may be the only politically viable option for raising that kind of cash. "Everyone hates it," said a member of the House Ways and Means Committee, speaking on condition of anonymity because he has yet to discuss the issue with his colleagues. "But where else do you go?" Copyright 2009 Washington Post. Yes, Bisphenol A Does Enter the Body from Plastic Bottles Wall Street Journal Friday, May 22, 2009 A study out from the Harvard School of Public Health doesn’t resolve the controversy around the health effects of bisphenol A, but it does demonstrate that drinking from hard plastic bottles with BPA increases the amount of the chemical in people’s bodies. Some 77 Harvard students drank all cold beverages from stainless steel bottles for a week to get the BPA out of their bodies, the Boston Globe reports. Then they drank all cold beverages for a week from bottles made from BPA. Urine samples showed their BPA levels jumped during the second week. The study can be found on the Web site of the journal Environmental Health Perspectives. Some experts believe exposure to BPA interferes with baby’s development, and there’s been some noise about the chemical’s impact on diabetes, heart disease and liver toxicity in adults. About a year ago, Nalgene said it would stop using BPA in its water bottles, and Wal-Mart said it would convert its entire stock of baby bottles to BPA-free products. More recently, the six largest manufacturers of baby bottles said they will end U.S. sales of bottles made with the BPA. The FDA has said that BPA isn’t a health hazard at current exposure levels, though it’s gotten some heat over the methods it used to make that decision. The agency told the Globe yesterday that its new chief scientist, Jesse Goodman, will “take a fresh look at this important issue from a scientific and policy position.” The American Chemistry Council told the Globe that the Harvard study shows that exposure to BPA from the bottles is “extremely low” and shows that “even exclusive use of polycarbonate bottles does not lead to unusually high levels of bisphenol A in the urine.” Copyright 2008 Dow Jones & Company, Inc. All Rights Reserved. PROMISES, PROMISES: Before peanut recall, FDA did half of food safety audits it promised to do Associated Press By Mary Clare Jalonick Baltimore Sun Friday, May 19, 2009 WASHINGTON (AP) — The Food and Drug Administration conducted only about half the state food safety audits it promised in the two years before the recent peanut salmonella outbreak, according to new documents the agency sent to Congress. The documents show the agency did not do any of the required audits of state-run food inspections in five states during those states' budget years spanning 2007 and 2008. And the FDA was unable to say whether audits were conducted at all in 11 additional states during that time, including Georgia and Texas, where salmonella was found in two peanut plants during a wide-ranging peanut recall earlier this year. Only 14 states saw 100 percent of the audits completed. The FDA audits are a key part of the federal government's ability to ensure that food is inspected properly by states that contract with the FDA to perform safety checks. The agency turned over its records on the audits to Republicans on the House Energy and Commerce Committee in response to questioning at hearings earlier this year. Officials traced the salmonella outbreak to the Peanut Corp. of America's plant in Georgia and blamed the outbreak for the deaths of at least nine people. Hundreds more were sickened. Additional numbers for 2006 and 2007 showed that no audits were done in Texas and seven other states during that period. "The FDA food safety program is a major turnaround project," said Rep. Joe Barton, R-Texas, who requested information on the state audits with Rep. Greg Walden, R-Ore. The FDA itself acknowledged as much in a letter sent to Barton this month. Stephen R. Mason, acting assistant commissioner for legislation at the agency, said the recent salmonella outbreak "has highlighted limitations in our current approach and has prompted internal discussions on potential enhancements to the audit program." In 2000, a report from the inspector general of the Health and Human Services Department, which oversees FDA, said the agency needed to place a high priority on better evaluating the effectiveness of state inspections of food production facilities, which are done in place of federal inspections through contracts with the FDA. Part of the agency's response to that recommendation, put in place several years later, was a standard set by the FDA itself that 7 percent of all state inspections should be audited by the federal agency. In the documents provided to Barton, FDA acknowledges that it has fallen far short of that goal. A summary of audits for 2007-2008 lists the total number of state contract inspections at 10,218, with only 358 audits completed — about 3.5 percent. Audits were not done at all in 2007-2008 in California, Iowa, Kansas, Nebraska and Wyoming. In the previous period documented by the agency, 2006-2007, audits were not done at all in Arkansas, Maryland, South Carolina, Tennessee, Texas, Virginia, West Virginia and Wyoming. Only 9 percent of the promised audits were done in California in 2006-2007, during which time an E. coli outbreak in spinach caused more than 200 illnesses and three deaths. The data were collected from regional FDA coordinators; the specific time covered varies according to each state's budget year. FDA spokeswoman Susan Cruzan says the agency is "evaluating approaches" for improving the audits. "Although FDA has not been able to fulfill the goal of conducting 100 percent of the audits expected under FDA's internal auditing policy, FDA has audited each state at least once, has good knowledge of the state programs and state inspection personnel, and works to improve the programs as needed," she said. Congress has vowed to step up oversight of the FDA, which does the bulk of food safety inspections, in the wake of the peanut recall and several other high-profile recalls in recent years. Several members have introduced bills to overhaul the agency, including proposals to separate its food safety and drug oversight duties, and to significantly increase funding. Associated Press writer Ricardo Alonso-Zaldivar contributed to this report. Copyright 2009 Associated Press. All rights reserved. *Opinion* --- BACK TO TOP


[newsclippings/dhmh_footer.htm]