Healthline Connects

Lancet Retracts Study Linking Autism to Measles Vaccine

2010-02-02T09:31:00.000-08:00

Leading medical journal The Lancet on Tuesday issued a full retraction of a controversial and immensely influential 1998 paper that had linked autism to the measles, mumps, and rubella vaccination (often referred to as the "MMR" vaccine).

The retraction came after a ruling made the previous week by the General Medical Council (GMC) found Dr. Andrew Wakefield - the lead researcher on the 1998 paper - and two fellow colleagues to have broken various research rules and standards while developing the paper. The GMC is the regulatory body responsible for licensing doctors and supervising medical ethics in the United Kingdom (UK).

More than 30 charges were found proven against Wakefield, including counts of mistreating developmentally challenged children by causing "high-risk," invasive research - such as spinal taps and brain scans - to be carried out without ethical approval and against their best health interests. Another example mentioned by the GMC of Wakefield's "callous disregard" for the children he was studying was the time he went around to children guests at his son's fifth birthday party and offered them £5 for blood samples. The GMC is still debating whether or not to strike Wakefield from the medical register.

The GMC also affirmed that Dr. Wakefield's research had been at least partially funded by lawyers and other representatives acting on behalf of parents who believed that their children had been medically harmed by the MMR vaccine. In 2004, Brian Deer of The Sunday Times (UK) led an investigation that exposed a deal made by Wakefield with a lawyer named Richard Barr. Barr, in the late 1990's, was preparing a civil suit against the manufacturers of the MMR vaccine. Deer also discovered that Wakefield had patented a single measles vaccine - which seemed to suggest that Wakefield was more interested in heading a successful business coup against the makers of MMR vaccine than in legitimate (and ethical) medical discovery.

The Lancet stated that Wakefield's unethical practices compromised the results of his studies beyond repair. In their official statement, the editors of The Lancet said: "In particular, the claims in the original paper that children were 'consecutively referred' and that investigations were 'approved' by the local ethics committee have been proven to be false. Therefore we fully retract this paper from the published record."

Following the initial publication of the paper in 1998, sales of the MMR vaccine plummeted, resulting in a rise in the measles throughout Europe and North America. The paper also instigated what has become an ongoing debate regarding the possible dangers of many types of vaccines - including the more recent concern of possible negative consequences of H1N1 and seasonal influenze vaccines.

Since 1998, a number of other studies have disproved Wakefield's findings, and it is generally the consensus of the medical community that the MMR vaccine is safe. In fact, in 2004, The Lancet issued a partial retraction.

Whether or not this latest retraction will reignite trust in the MMR vaccine is yet to be seen; according to Deer, writing for The Times (UK) Online, Wakefield had vocal support at the GMC hearing from the "hard core of the families of children with autism." The subject remains divisive and heatedly debated.

To learn more about autism and autism spectrum disorders, visit Healthline's autism learning center.

Written By: Elijah Wolfson

Celebrities and Schoolkids: Money for Haiti Coming from All Directions

2010-01-19T09:21:00.000-08:00

The citizens of the world are responding en masse to the January 12 disaster in Haiti, mainly in the form of money. The Chronicle of Philanthropy has been tracking the overwhelming response to fund-raising efforts across the US. In a January 18 report, it estimates that donors have contributed more than $210 million to major US relief groups.

Politicians, celebrities, major charity groups, universities, local schools, and various small organizations are all getting into the mix. Sandra Bullock donated $1 million to Doctors Without Borders. Drake University students put together 50,000 much needed meals to send to Haiti. Elementary schools across the country are having bake sales and silent auctions to raise funds. Social media outlets, texting technology, and websites have been used effectively to raise millions of dollars. The following is an abbreviated list of events and groups that are sending money to Haiti (Source: Chronicle of Philanthropy website):

Charity Groups
• As of January 18, the American Red Cross (ARC) had raised more than $112 million for relief efforts - with approximately $22 million of that coming from its texting campaign that encourage people to donate $10 per text. By comparison, the ARC raised $200,000 via text campaigns during the 2008 hurricane season.

• The Salvation Army had raised $3.32-million online as of Saturday.

• Save the Children USA had raised more than $7.5-million as of Saturday morning. The group has set a fund-raising goal of $20-million.

• Catholic Relief Services had secured $10.6-million in gifts and pledges as of Saturday. Approximately $6-million was donated online.

• American Jewish World Service had raised $1.5-million as of Friday.

• Islamic Relief USA had raised more than $500,000 online and another $100,000 from fund raising at mosques as of Saturday.

• Lutheran World Relief had raised nearly $550,000 in online gifts as of Saturday

• Convio, the company that provides software to charities, has processed nearly $110-million since Tuesday as of 10 a.m. CST Saturday. As a yardstick, the company processed $20-million on December 31, 2009, typically the biggest fund-raising day of the year.

Politicians, Celebrities, Athletes
• Former Presidents Bill Clinton and George W. Bush joined President Obama at the White House on Saturday to announce that they would spearhead a bipartisan effort to raise money for the Haitian relief effort from corporations, foundations, and American citizens.

• Bill Clinton's foundation has already raised more than $7 million for relief efforts.

• University of Kentucky men's basketball coach John Calipari, along with Lexington, KY, business owners, planned an impromptu telethon, “Hoops for Haiti,” to raise money for the Red Cross. Kentucky basketball players manned the phones, as former coaches, players, and local/regional celebrities made appearances and were interviewed by Coach Calipari on the air. Through donations from Kentucky sports fans and matching funds by participating business, the telethon raised more than $1 million.

• Sandra Bullock, Madonna, Brad Pitt, and Angelina Jolie are among a list of celebrities that have given six- and seven-figure donations to various organizations, including Doctors Without Borders.

• Wyclef Jean's Yele Haiti Foundation has raised more than $2 million through a text-messaging system that allows people to instantly donate $5.

• NFL wide receiver Dante Stallworth pledged to donate $1 per Twitter follower that he had by midnight Sunday, Jan. 17. His friend and former teammate Wes Welker (WR, New England Patriots) jumped on board to match the funds. As word spread, the followers came in droves. By the end of the day, the pair of wide receivers had raised $68,400 for Project Medishare.

• George Clooney and MTV are organizing a telethon for Jan. 22. Wyclef Jean will co-host, and music megastars Justin Timberlake and Bono are set to perform.

Follow all of Healthline's Haiti Coverage:
On the Ground in Haiti: Anil Menon's Blog
The World Rushes to Haiti
Haitian Health Concerns Grow Due to Devastating Quake

The World Rushes to Haiti

2010-01-19T08:45:00.000-08:00

As Haitians waited for international aid to arrive, their shock turned to desperation in the absence of food and medical care. After many logistical hurdles in the days immediately following the earthquake, international aid groups began arriving in Haiti over the weekend – ranging from search-and-rescue teams with large equipment for digging through the rubble to health organizations that are setting up field hospitals and distributing food.

However, many food-distribution efforts turned to chaos in the absence of an organized security force, as mobs of people fought for food. Reports of looting and violence are increasing. The local police force has been decimated, either injured, killed, or simply not reporting to work because of their own desperate situations. Nine thousand UN troops are in Haiti. Monday morning, 2,200 US Marines arrived in Haiti, and 10,000 total are being deployed. President Obama has called up reserve military personnel and ordered a Coast Guard unit to head to Haiti to provide support in several areas, including security.

After heavy equipment arrived, search-and-rescue teams began digging through rubble and, miraculously, found survivors who had been trapped for four to six days. US Ambassador Kenneth Merten reported that, as of Monday afternoon, 75 people had been rescued, and rescue crews continue to dig for both the living and the dead. Paul Antoine Bien-Aime, Haiti's interior minister, told Reuters that around 50,000 dead bodies have been collected. He expects the death toll to be between 100,000 and 200,000 people, while admitting that they will never know the exact amount. With much of the media focused on the devastation in Port-Au-Prince, little attention has been given to other parts of Haiti affected by the earthquake. Haiti's Ministry of Interior and Civil Protection is reporting that approximately 10,000 people were killed in the towns surrounding the capital city. And 80% and 90% of the homes were destroyed in the towns of Gressier and Leogane, respectively.

Health Concerns Increasing
In terms of health issues, the World Health Organization (WHO) has been submitting daily status updates. Scarcity of basic provisions, such as food and water, remains the biggest challenge, and a major concern is the sheer overwhelming numbers of the injured and the lack of facilities and medical supplies to treat them. The WHO is reporting that at least eight hospitals were destroyed or severely damaged in the earthquake. At least five are functioning in some capacity. According to the WHO, "Untreated trauma wounds and infection of wounds are major health concerns that need priority attention." Similarly, Doctors Without Borders (Medicins Sans Frontieres) is reporting that, because of limited treatment capacity, injuries that were minor three days ago are now life-threatening due to infections that come from the lack of immediate medical attention.

Groups from all over the world are in or are headed to Haiti to set up field hospitals. Teams from the US, Israel, Colombia, France, Canada, Indonesia, Russia, and more have arrived or are on the way to set up hospitals or provide medical care in existing hospitals. Supplies are coming in by the ton; however, there is no organized distribution process or method of tracking what is actually in each shipment. As a result, surgical supplies are ending up in places that aren’t equipped to use them, when that same field hospital is lacking basic items such as splints and sterile bandages.

Another issue that is beginning to take shape is the potential stress that this disaster is putting on the health of the Dominican Republic's population. Because of the influx of patients from Haiti, hospitals in the surrounding countryside and border towns of the Dominican Republic are overflowing, denying those sick from normal illnesses (unrelated to the earthquake) the access to medical care. For example, a 20-bed hospital in the Dominican Republic border city of Jimani saw 2,000 people on Saturday and conducted 200 major surgeries. The overflow from that hospital is being sent on to Santo Domingo.

Many ongoing medical efforts in Haiti are being severely disrupted. Around 70,000 babies are born annually in the country, and the overwhelmed health centers and hospitals are focusing on trauma injuries from the earthquake instead of obstetric care. Furthermore, the Haitian Health Organization (HHO) normally runs an obstetrical transport ambulance that performs around 20 emergency evacuations of pregnant women every month. Expecting mothers use cell phones to call the ambulance when they need help. The HHO is reporting that this service has been halted because all cell towers have been knocked out by the quake, and there is no way to communicate with the pregnant women.

As reported in our Friday blog post, Haiti's numerous existing health issues – tuberculosis, HIV/Aids, malaria, respiratory diseases, diarrhea, disease associated with intestinal worms, dengue fever – will only be escalated by the disaster. Furthermore, as masses of people flee the dangers and chaos of Port-Au-Prince and crowd into other towns and tent cities, other health concerns will arise. "Displaced people are at high risk from outbreaks of water-, sanitation-, and hygiene-related diseases, as well as foodborne diseases, due to reduced access to safe water and sanitation systems. Salmonella typhi (causing typhoid fever), hepatitis A and hepatitis E are present and have epidemic potential," the WHO reports on its website. "Population displacement can result in overcrowding in resettlement areas, raising the risk of transmission of certain communicable diseases spread from person-to-person, such as measles, tetanus, and diphtheria." Other concerns include malnutrition, skin infections, reproductive health, and even non-communicable diseases such as cancer, diabetes, and cardiovascular issues.

Catch up on Healthline's Haiti Coverage:

Celebrities and Schoolkids: Money for Haiti Coming from All Directions

Haitian Health Concerns Grow Due to Devastating Quake

Healthline Bloggers in Haiti:

Anil Menon's Blog

News, January 15, 2010

2010-01-15T16:21:00.000-08:00

Green Tea May Reduce Risk of Lung Cancer

Taiwanese researchers have discovered that green tea may reduce the risk of lung cancer in both smokers and non-smokers. A study presented this week at conference jointly sponsored by the American Association for Cancer Research and the International Association for the Study of Lung Cancer compared the smoking and green tea consumption habits of 170 lung cancer patients and 340 healthy patients. The results showed that among smokers and non-smokers, those who did not drink green tea were over five times more likely to have cancer than those who drank at least one cup a day. Smokers who did not drink green tea were nearly 13 times more likely to be diagnosed with lung cancer than those who did.

In an AACR press release, lead researcher I-Hsin Lin stated that the study "may represent a clue that in the case of lung cancer, smoking-induced carcinogenesis could be modulated by green tea consumption and the growth factor environment.” Nevertheless, drinking green tea can only modulate the negative effects of smoking, and will not reverse them. The best thing you can do to prevent lung cancer is to quit smoking. Lung cancer is the leading cause of cancer deaths in the United States and in Taiwan. Learn more about this deadly - and often preventable – form of cancer.

Written By: Elijah Wolfson

Judge Orders FDA to Stop Blocking Import of E-Ciggs

This week, Judge Richard J. Leon of the Federal District Court in Washington issued a preliminary injunction in a lawsuit brought against the FDA. The injunction effectively lifted an import ban that the federal regulator had placed on "e-cigarettes" from China. Judge Leon agreed with the distributors who brought the suit, arguing that e-cigarettes are not meant to be medical devices to help smokers quit, but rather are a safer substitute that gives users the nicotine they crave but with less negative side effects than traditional cigarettes. In a statement made to the FDA website, the agency reiterated its growing concern regarding the current lack of regulation of e-cigarettes. "The public health issues surrounding electronic cigarettes are of serious concern to the F.D.A. The agency is reviewing Judge Leon’s opinion and will decide the appropriate action to take.”

Read our smoking cessation expert, Dr. Jonathan Gould's take on e-cigarettes at his blog, Freedom From Smoking.

Written By: Elijah Wolfson

Raising Kids Lowers Blood Pressure

New research out of Brigham Young University suggests that raising children can lower your blood pressure, and more so in women than in men. This, of course, flies in the face of the conventional wisdom of parenthood, popularly thought of as a full-time job of chasing, worrying about, disciplining, and caring for active and often unruly kids. But the study’s author, BYU psychologist Julianne Holt-Lunstad, found that the existential side of parenting wins in the end. “While caring for children may include daily hassles, deriving a sense of meaning and purpose from life’s stress has been shown to be associated with better health outcomes,” Holt-Lunstad said in a news release.

The study followed 198 adults – parents and non-parents – for 24 hours. Each person wore a monitoring device that recorded BP levels at random intervals, even while they were sleeping. The study accounted for other factors known to influence BP – age, body mass, gender, exercise, employment and smoking – and found that parents scored 4.5 lower on systolic BP (top number) and 3 points lower on diastolic BP (bottom number) than non-parents. The differences were greater for mothers – 12 points and 7 points lower, respectively, than non-mothers. This does not meant that more kids equals lower pressure, Holt-Lunstad said. The study simply connects parenthood, in general, to lower BP.

Find out how you can lower your blood pressure today.

Written By: Ryan Wallace

OTC Medication Recall – Tylenol, Motrin, Benadryl, Rolaids, and more

Johnson & Johnson's McNeil Consumer Healthcare, in consultation with the US Food & Drug Administration (FDA), has expanded a December 2009 recall of over-the-counter medications. Initially, six million packages of children’s and adult Tylenol were recalled due to a “moldy odor” coming from the products. At least 70 people have been sickened by the odor, reporting symptoms of nausea, diarrhea, vomiting, and stomach pain. Today, the company announced that 54 million more packages of 27 products have been added to the initial recall – including Motrin, Benadryl, Rolaids, Simply Sleep, and St. Joseph Aspirin. The recall includes products in the Americas, United Arab Emirates, and Fiji.

According to a McNeil press release, an investigation determined that the “uncharacteristic smell is caused by the presence of trace amounts of a chemical called 2,4,6-tribromoanisole … This can result from the breakdown of a chemical that is sometimes applied to wood that is used to build wood pallets that transport and store product packaging materials.” For those who have been sickened, the symptoms went away on their own, and no one has been seriously injured.

For a full list of recalled products, click here.

Written By: Ryan Wallace

Haitian Health Concerns Grow Due to Devastating Quake

2010-01-14T14:46:00.000-08:00

As President Barack Obama pledges one of the biggest relief efforts in recent history and begins the 3,500-soldier and 2,200-marine rescue mission to Haiti, it is becoming clear through various correspondents that the situation in the major cities of the island nation is becoming increasingly desperate. Tens of thousands are estimated to be dead – 50,000 is the Red Cross's best guess at this time – and over 3 million affected. Thousands are buried under the rubble of fallen buildings and the search and rescue teams currently working on the ground lack the necessary heavy lifting equipment to help the trapped victims. Medicine, food, and water are in short supply and growing more scarce by the hour as groceries and food stores are raided by people who have lost their own homes and places of work. In a written statement to the Washington Post, former President Bill Clinton called the quake "one of the great humanitarian emergencies in the history of the Americas."

One of the most disastrous effects of the quake is the current shortage of health care and supplies. Nearly all the hospitals and health care facilities in Port-Au-Prince, capital of Haiti and epicenter of the earthquake, have been severely damaged or destroyed completely. In any case such structural damage would be detrimental to relief efforts, but in the case of Haiti the damage may lead to an inconceivable crisis. Before the quake, Haiti had appalling levels of public health issues: 80% of the population of Haiti lives below the poverty line – the nation is by far the poorest country in the Western Hemisphere – and there are abnormally high rates of tuberculosis, HIV/AIDS, malaria, respiratory diseases, diarrhea, disease associated with intestinal worms, dengue fever, and many other health concerns on the Haitian side of the island of Hispaniola.

The main cause of Haiti's health concerns prior to the earthquake were the poor conditions of the country's water and sanitation infrastructure. The majority of Haitians lacked access to clean drinking water before; the earthquake has wrought unimaginable further damage to an already broken system, and the consequences may be dire and long-term.

Doctors Without Borders (or Medecins Sans Frontieres) stated in a recent CNN article that even before the earthquake, basic health services in Port-au-Prince were essentially nonexistent due to poor management, lack of supplies, and limited trained personnel. The few hospitals that did exist were already stretched to their limits. According to Fox News correspondent Dr. Manny Alvarez, "the people of Haiti are going to be at increased risk of developing gastrointestinal diseases, food poisoning, as well as worsening of injuries sustained by those in high-risk groups like children and seniors."

International aid and rescue teams are beginning to arrive on the island, but it is still unclear how much they will be able to help; though the airport runway outside Port-Au-Prince is functional, the tower communications system is not working. An Air Force Special Forces unit has been deployed to set up temporary air-traffic control systems that will handle the waves of international aid headed to Port-Au-Prince. But as of now, many parts of the city remain inaccessible except by helicopter.

Healthline.com's Chief Medical Officer and outdoor health expert Dr. Paul Auerbach is en route to Haiti to provide emergency medical care. He’s going with the International Medical Corps, along with a small group from the Stanford Medical Center, with which he is affiliated. We hope to receive on-the-ground correspondances from Dr. Auerbach in the coming weeks. Please check his blog http://www.healthline.com/blogs/outdoor_health/ for updates.

How You Can Help

Secretary of State Hillary Clinton and the American Red Cross are urging Americans who wish to help to text "Haiti" to the number 90999 – doing so will automatically add a $10 donation charge to your monthly cell phone bill. 100% of the funds donated will go to support Red Cross efforts in Haiti. You can print a receipt through mGive, a foundation that helps nonprofits take advantage of mobile technology.

You may also make a donation to the American Red Cross International Response Fund at Redcross.org or by calling 1-800-RED-CROSS. Here's a list of a few other nonprofits currently working in Haiti:

UNICEF is the United Nations Fund focusing on children. Donate here.
Doctors Without Borders is an international NGO that sends doctors and medical supplies to places in need. Donate here.
Mercy Corps is an NGO with a lot of earthquake-specific relief experience. Donate here.
Partners in Health is an NGO that focuses on delivering medical supplies and staff in emergencies. Donate here.
Wyclef Jean’s Haiti-focused foundation, Yele. Donate here, or give $5 by texting YELE to 501501.

For even more places to donate, see MSNBC's comprehensive list here.

Written By: Elijah Wolfson

News, January 12, 2010

2010-01-12T16:36:00.000-08:00

FDA Begins Transparency Initiative

Today, as the initial phase of an ongoing initiative towards greater transparency, the U.S. Food and Drug Administration (FDA) announced the launch of a new website that the agency is calling "FDA Basics." FDA Basics, according to an agency press release, is aimed at helping the public better understand what the agency does and how it does it. The website includes an agency-related Q&A, short videos about the agency, and interviews with important agency personnel. In the press release FDA commissioner Dr. Margaret A. Hamburg stated that "this initiative will make information about the FDA more user-friendly and accessible to the public."

Most States Fail When Tobacco Control Assessment

The American Lung Association (ALA) published its State of Tobacco Control 2009, which assesses and assigns letter grades to each of the 50 states and the District of Columbia for four key tobacco control policies: Tobacco Prevention and Control Spending; Smokefree Air; State Cigarette Excise Tax and Cessation Coverage (how well states help smokers quit). The grades are disappointing; nearly all states have an overall failing grade. The ALA pointed out some positive trends, including the doubling of the federal tax on cigarettes and individual action of 14 states to raise state taxes on tobacco. Yet the negatives outweigh the positives; many states severely reduced funding for tobacco control and prevention programs, and it seems as though the push to end smoking has stalled – 20% of adults still smoke, the same amount as the year before.

If you're trying to quit, visit the smoking cessation learning center for a wide range of tools that may help. Or visit our smoking cessation expert's blog, Freedom From Smoking, to learn about the best ways to quit.

Soda Fountains May Contain Fecal Matter, Study Shows

According to a study published in the January issue of International Journal of Food Microbiology, nearly half of 90 fountain drinks taken from restaurants in Virginia tested positive for coliform bacteria – which could be a sign of fecal contamination. In addition, 11 percent contained E. coli (which are mostly harmless, but some can cause diarrhea, urinary tract infections, respiratory illness and pneumonia), and 17 percent had Chryseobacterium meningosepticum (which could sicken newborns or adults with weakened immune systems). CNN reports that industry spokespersons, including representatives from the National Restaurant Association, the American Beverage Association, and Manitowoc Foodservice (a leading manufacturer of beverage equipment), all rushed to distance themselves from the findings. Dr. Renee Godard, lead author of the study, admitted that food-related illnesses are notoriously challenging to pinpoint.

Learn more about E. coli and other issues related to drinking water quality and safety.

Excess TV May Help Draw Death Near

According to a large-scale Australian study published in Circulation, too much TV can be catastrophic for your health. The study followed 8,800 adults for six years at a time, and found that, compared to those who watched less than two hours of TV a day, those who watched four or more hours were 80 percent more likely to die from heart disease. According to the study, ach additional hour spent in front of the TV increased the risk of dying from heart disease by 18 percent. For TV-lovers though, there is a silver lining: the cause of health risk is not TV in-and-of-itself, but rather the "default position" for TV watching; that is, sitting down. Too much TV equals too much sitting and not nearly enough movement – not to mention all of the junk food that tends to be consumed during prolonged TV watching sessions. Basically, TV watching leads to bad health practices. So, if you want to watch TV, make sure you're eating well, getting enough exercise, no watching for too long – and try to exercise during the commercials.

Written By: Elijah Wolfson

News, January 11, 2010

2010-01-11T16:34:00.000-08:00

Synthetic Bone Made of Wood Almost as Good as the Real Thing

The BBC reports that at the Institute of Science and Technology for Ceramics, located in Faenza, Italy, researches have developed a method to transform wood into a synthetic bone that is so like the real thing that real bone will fuse to the implant. The wood-based synthetic is also so strong and durable that once implanted, it does not have to be replaced. It has already been tested, successfully, on replacing joint in sheep. Unfortunately, according to experts, the new synthetic is at least five years away from being used in humans. Learn about current methods of joint replacement.

Smoking Increases Risk of Vision Loss

According to a study published in the American Journal of Ophthalmology, smoking tobacco significantly increases a person's risk for developing Age-Related Macular Degeneration (AMD). AMD is one of the most common causes of vision loss in later life. The study also found that alcohol consumption similarly increased the risk for AMD. Learn more about the disease.

Stanford Announces Education Program for Doctors, Free of Drug Company Influence

The Stanford University School of Medicine announced that it will use a $3 million dollar grant to develop a continuing education program for doctors that is free of influence from drug companies. Although the grant comes from the pharmaceutical giant Pfizer, it has no strings attached and Pfizer has guaranteed that it will stay out of the program's development. In a press release, medical school dean Dr. Philip Pizzo stated that "learning and teaching has to be free of marketing or influence and focused on truly improving the lives of the patients we serve and the students and physicians we educate." Pfizer's Chief Medical Officer Dr. Freda Lewis-Hall agreed: "Our multi-year support of Stanford’s efforts demonstrates our willingness to help redefine how CME is funded so that practicing physicians can get access to the latest science, presented in ways that unquestionably put the interests of the patient first and foremost.”

Yoga Reduces Inflammation

A new study, published in the journal Psychosomatic Medicine, showed that women who regularly practice yoga had lower amounts of cytokine interleukin-6 (IL-6) in their blood than those who do not. IL-6 is a compound involved in the body's inflammatory response; lower levels of IL-6 tend to mean reduced inflammation in response to physical and psychological stress. Dr. Ron Glaser, one of the writers of the study, stated that the results indicate that yoga may act as an "intervention that might reduce risks for developing heart disease, diabetes and other age-related diseases.” What other health benefits can be had from yoga practice? Learn 10 good reasons to try yoga.

Written By: Elijah Wolfson

NYC Announces Initiative to Reduce Salt in Foods

2010-01-11T14:21:00.000-08:00

New York City continues to lead the way in the effort to increase food content transparency and assist consumers in obtaining access to and choosing healthier food options. In the past decade, the New York City mayor's office has prohibited indoor smoking, forced restaurants to post calorie counts of their food items offered, and banned trans fats from the city entirely.

Today, the New York City Health Department announced the National Salt Reduction Initiative, a partnership of cities, states, and national health organizations who have come together to guide a voluntary reduction in salt levels in packaged and restaurant foods across the United States. The stated goal of the Initiative, which is led by the New York City government, is to cut the salt content in packaged and restaurant foods by 25% during the next five years.

Salt is used to enhance the flavor of foods and acts as a preservative for many types of food. It's used almost indiscriminately in the food production and packaging industries: according to the NYC Health Department, nearly 80% of the average American's salt intake has been added to food before it is sold – a staggering amount that suggests Americans' overindulgence in salt may be, to some extent, beyond their control. And the amount of salt we eat can have intense adverse effects on our long-term health. According to Dr. J. James Rohack, president of the American Medical Association (AMA), "excess sodium greatly increases the chance of developing hypertension, heart disease, and stroke. Dr. Rohack spoke on behalf of the AMA in a NYC Health Department press release.

The AMA recommends a daily sodium intake limit of about 1,500 mg for the average adult. But according to a report published by the U.S. Centers for Disease Control and Prevention (CDC), the average American consumes closer to 3,500 mg per day. "At current levels, the salt in our diets poses health risks for people with normal blood pressure, and it’s even riskier for [those] with high blood pressure," said Dr. Thomas Farley, New York City Health Commissioner, in a press release. “If we can reduce the sodium levels in packaged and restaurant foods, we will give consumers more choice about the amount of salt they eat and reduce their risk of heart disease and stroke in the process.”

The Initiative has developed a comprehensive framework for companies to reduce the amount of sodium in the foods that they produce. The plan is completely voluntary and includes no legislation. Critics say that without legislation it has little chance of success – the city's campaign against trans fats, for example, was ineffective until legislation to ban trans fats was passed. Nevertheless, similar collaborations and initiatives to fight high sodium content in food in other countries have already produced positive results. The New York Times reports that officials expect the campaign to work through the pressure of public scrutiny.

A number of large food providers have already made statements reflecting their willingness to come on board, including the A&P supermarket chain and the Subway chain of sandwich shops. With many of the major national health organizations committed to the Initiative's goals, many more food producers and providers are expected to join soon.

Written by: Elijah Wolfson

Food Label Calorie Counts All Wrong

2010-01-08T15:35:00.000-08:00

And just when you thought you had your calorie intake under control, your healthy dinner plans set, and your weight loss goals just around the corner. A new study published in the Journal of the American Dietetic Association shows that restaurants and makers of frozen food often provide calorie counts that are up to 18% inaccurate.

Professor Susan Roberts of Tufts University, who initiated the study, said she analyzed 10 frozen-food product lines and 29 restaurants, purposely selecting foods that she thought dieters would choose – full meals that were listed at about 500 calories per serving. But in the lab, tests revealed striking inaccuracies. Restaurant meals underestimated their calories by about 18%; frozen foods tended to be about 8% off. But even that 8% is far from innocuous. According to Roberts, "the 18% and 8% figures are just what you need not to lose weight.”

Unfortunately, there are currently no devices in place to regulate the propagation of this type of misinformation. Although federal regulations are very strict regarding the accuracy of other packaging stats – such as the net weight of food packaging – calorie counts only have to come with 20% of accurate lab readings. The sad truth is that without more careful regulation, even the most vigilant calorie-counter can be deceived.

Healthline can help. Learn to diet safely and effectively.

News, January 7 2010

2010-01-07T13:22:00.000-08:00

Drugs Work Best on Severe Depression

According to a new report published in the JAMA, antidepressants seem to be significantly more effective in treating cases of severe depression than mild depression; in cases of mild depression, placebos were found to be just as effective as the drugs. The report studied two commonly prescribed types of drugs: SSRI's and tricyclics. Learn more.

Cell Phone Waves Reverse Memory Damage

Researchers were surprised to learn that mice exposed to electromagnetic waves similar to those emitted by cell phones were protected from Alzheimer's and even reversed memory damage caused by the disease. The study directly contradicts common wisdom on cell phone radiation. Scientists are now looking into the use of electromagnetic waves in the treatment of Alzheimer's in human adults. Discover more about Alzheimer's disease.

Vitamin D May Be the Difference in Heart Attack Rates

Researchers discovered that the disparity between blacks and whites in heart attack and stroke-related deaths may be at least partially caused by a vitamin D deficiency in the former. Lead researcher Dr. Kevin Facella stated that the deficiency is caused by a number of genetic and lifestyle factors, including a higher rate of lactose intolerance and a reduced ability to absorb vitamin D via sun exposure. Learn how to get more vitamin D into your diet.

Heartburn: The Gift that Keeps On Giving

2010-01-07T09:32:00.000-08:00

The holidays are over, and the warm, fuzzy feelings that come with them have passed. Although the celebrations – the eating, drinking, and merrymaking – are no more, there is one feeling that may still linger as a result of those indulgences: heartburn. But have no fear; there are several easy fixes to this common post-holiday problem. Read on to learn more about heartburn and its treatments.

Most people will experience some degree of heartburn in their lifetimes. But don’t let the name fool you; heartburn has nothing to do with the heart. It is simply a painful burning sensation, caused by a backup (or reflux) of acidic stomach content in the esophagus, just below or behind the breastbone. The acid irritates the esophagus, thus causing the burning sensation. Heartburn is usually an occasional annoyance. However, some people experience frequent, long-lasting heartburn – a condition called gastroesophageal reflux disease (GERD).

You can reduce the risk of heartburn by avoiding foods or beverages that often trigger reflux. These include alcohol, spicy foods, citrus fruits/juices, chocolate, and carbonated or caffeinated drinks. Eating smaller meals will also help, as stomach material is more likely to back up in an overly full stomach. Obesity, smoking, and stress are also known to increase the risk of heartburn.

There are also many over-the-counter medications to treat varying degrees of heartburn:

Antacids neutralize stomach acidity and are commonly used to relieve minor symptoms of heartburn, as well as acid indigestion and upset/sour stomach. Brand examples: TUMS, Mylanta, Rolaids, Maalox, Pepto-Bismol, and Alka-Seltzer
H2 blockers (a.k.a. H2-receptor antagonists) are used to treat mild symptoms of heartburn by preventing the chemical histamine2 from signaling the stomach to produce acid. A lower amount of stomach acid reduces the risk of heartburn, GERD, Peptic ulcer disease, and dyspepsia. Brand examples: Pepcid AC and Zantac
Proton pump inhibitors (PPIs) are the most potent blockers of stomach acid production and are used for the long-term treatment of chronic heartburn (caused by gastroesophageal reflux disease), as well as dyspepsia, peptic ulcers, stress gastritis, and more. Brand examples: Prilosec, Prevacid, Nexium, Zurcal, and Aciphex

If your symptoms worsen or do not improve after lifestyle changes or treatment with over-the-counter medication, it is important to contact your healthcare provider. Furthermore, you should see your doctor if you experience any advanced symptoms of GERD, including hoarseness, vomiting, choking and/or trouble swallowing, bleeding, loss of appetite, or weight loss.

To learn more about gastroesophageal reflux disease, click here.

Historic Kidney Transplant

2009-12-18T15:53:00.000-08:00

In Washington, D.C. this past week, thirteen patients suffering from life-threatening illnesses were given a new lease on life. In the span of six days, skilled surgeons performed an unprecedented and record-setting 26-person kidney transplant.

The massive transplant was made possible by a simple, yet innovative type of program referred to as a "paired kidney donation," or sometimes as a "domino surgery." In the simplest version of a paired kidney donation, one incompatible donor/recipient pair (A) is matched to another incompatible donor/recipient pair (B). Then, donor A gives recipient B a kidney, while donor B gives recipient A a kidney. In this way, two patients who otherwise could not find a suitable donor can get kidneys.

This particular paired kidney donation was a bit more complicated, truly meriting the name "domino surgery." It began when St. Louis resident Irene Otton couldn't find a suitable donor – in fact, tests showed that only about 5% of the population would have a kidney that matched her needs. So while Irene's husband Tom was more than willing to offer one of his kidneys, it wouldn't have helped Irene one bit. At the same time, a D.C. woman, Roxanne Boyd Williams, also couldn't track down a suitable donor. And as it turned out, Tom could donate a kidney to Williams. Williams' father agreed to donate one of his kidneys – but it wasn't a match for Irene. Williams' father's kidney ended up going to another woman. Eventually, after lots of juggling, doctors found Irene a kidney. Tom flew out to D.C., gave a kidney to Williams; Irene flew out with him, and got a kidney from a complete stranger. By that point, 13 perfect matches had been made.

There are currently over 88,000 people on the national kidney waiting list and less than 17,000 transplants are performed annually. According to the National Kidney Foundation, paired donation will one day allow for an additional 3,000 living donor kidney transplants a year nationwide.

Learn more about kidney transplants.

Stem Cell Therapy Repairs Heart Damage

2009-12-18T15:50:00.000-08:00

New research out of the University of Miami has found that stem cells can reverse the damage caused by heart attacks. The study used 53 human patients that were treated with the stem cell product Prochymal within 10 days of their first heart attack. The product – made by Osiris Therapeutics Inc., which sponsored the trial – was administered intravenously to ¾ of the patients. The rest received an inactive placebo.

The primary goal of the study, which was published in the Journal of the American College of Cardiology, was to see if Prochymal is safe. There were fears that the cells could cause growth of unwanted tissue in the arteries or the lungs. However, this did not happen, and in fact, patients receiving the stem cells had fewer adverse events than those who were administered the placebo.

The study also achieved a secondary goal of the study – to find out of the treatment actually helped. Evidence showed that it did, especially in patients with the most damage. Researchers posit that this could be due to the emergency signals sent out by damaged heart tissue. These signals attract help from the stem cells; the more damage, the stronger the signals.

As many heart attack patients go on to experience heart failure, being able to repair damage caused by heart attacks would go a long way to reverse that trend.

While the study’s researchers warn that this is just a first step, they also see these findings as an important step toward widespread clinical use of stem cell treatment for heart patients. A phase 2 trial is currently enrolling heart attack patients.

Learn more about the steps you should take following a heart attack to guard against further complications..

Mammograms In The Headlines

2009-11-18T14:51:00.001-08:00

The U.S. Preventive Services Task Force issued new guidelines this week recommending that women should begin regular breast cancer screening – including getting a mammogram every two years – starting at age 50. For years, it has been widely recommended that women have mammograms done biannually starting at age 40; the new guidelines represent a significant departure from past medical advice.

The new guidelines are meant to limit the growing frequency of unnecessary extra tests and surgeries being performed because of unclear screening results. According to the Task Force, the “additional benefit gained by starting screening at age 40 years rather than at age 50 years is small and that moderate harms from screening remain at any age.” The Task Force did urge that women at high risk for breast cancer should continue being screened for the disease early on in their lives. Nevertheless, for the rest of the population, the Task Force believes that starting screening at age 40 doesn’t save enough lives¬ – 1 in every 1,940 – to make up for the extra tests and treatments, the accompanying anxiety and emotional distress, and the related financial burdens.

It didn’t talk long for other health experts around the country to respond to the Task Force’s new guidelines with guarded skepticism. A popular rebuttal: One in every 1,940 doesn’t seem like that much, but what if you’re the one? Influential groups such as the American Cancer Society and the American College of Obstetricians and Gynecologists quickly announced that they are sticking with the earlier guidelines.

In response to the confusion generated by the Task Force’s recommendations, Human and Health Services (HHS) Secretary Kathleen Sebelius issued a statement advising women to “Keep doing what you have been doing for years – talk to your doctor about your individual history, ask questions, and make the decision that is right for you.” According to Sebelius, the Task Force’s findings are not indicative of the HHS’s opinions and will not set federal policies. Furthermore, early mammograms should continue to be covered by health insurance policies, said Sebelius.

Breast cancer is the one of the most common forms of cancer in the United States; more than 200,000 women are diagnosed with breast cancer every year and about 40,000 die annually from breast cancer-related complications.

Learn more about the disease by visiting our breast cancer learning center: http://www.healthline.com/channel/breast-cancer.html

Learn when and how to test for breast cancer: http://www.healthline.com/channel/breast-cancer_tests

A Foundation for the House of Medicine

2009-09-30T17:30:00.000-07:00

When you build a house, you begin with the foundation. The same holds true for the U.S. health care system. The President and Congress are scrambling to put up a reform structure that would have a better chance to succeed if the cinderblocks and joists were in place. No health care system in our country can develop adequately unless supported by validated information, policies and procedures based upon accurate data related to its most important features, and updated continuously. While there are agencies and institutions that can answer some of our questions, a comprehensive assessment is lacking. We should learn much more - the sooner, the better. Conflicted entities cannot be relied upon for objectivity, so if the government would like to increase its role in health care, creating a method for objectifying the rationale for change is the correct place to start.

The need to do something about health care is predicated upon the notions that we spend too much, perhaps to achieve inadequate outcomes and leave too many people without access to a reasonable desired amount of care. The rush component is fiscal and therefore political. Predecessors created entitlement programs that have grown for many reasons and are projected to break our bank. So, we have come to the brink where there is little tolerance for growth in health care, and the rhetoric of rationing. Difficult choices lie ahead.

What might we do to establish the foundation? I believe that it will be best achieved by incremental processes that can be managed to significant contributions. I want to learn much more about what health care I should be receiving and why I should want it. While we spin expensive and frustrating cycles on global reform, biting off much more than we can chew, I urge federal and state governments, science agencies, medical societies and organizations, and academic institutions to put forth all necessary effort to accomplish the following, in order to provide a foundation for successful health care reform:

Focus on outcomes.

As a doctor, I can do the best job for my patients if I’m able to form an impression and make decisions based upon facts. A man comes to me with the worst headache of his life and a stiff neck. Does he have a migraine, meningitis, bleeding aneurysm, brain tumor, abscess or something else? My physical examination puts me in the ballpark, but then I need assistance. What tests are available and what are their costs and risks? Is there a decision tree for best practices that I can follow? Is there a neurologist or neurosurgeon available with whom I can consult? If he needs an operation, do I know the skill and success rates of the operators to whom I can refer him? Would he be better off staying in my hospital or being transferred?

We cannot afford to keep practicing medicine by impression when there is a clear need to objectify our behaviors. Whether by creating a national clearinghouse for health care-related data or accomplishing this through individual efforts, we should seek to be evidence-based. There are means to establish, for instance, the immediate and long-term outcomes of a similar, if not identical, brain surgery on a doctor-by-doctor, hospital-by-hospital, and state-by-state basis. The same way that we enjoy consumer reports for automobiles and computers, we should be privy to analyses that guide us to the best doctors, hospitals and practices. For starters, each medical specialty can accomplish systematic reviews. These will guide us to complete the necessary prospective evaluations needed to refine our initial conclusions about clinical, financial and societal implications.

Rationalize drug therapy. Assign the Food and Drug Administration to compare every drug on the U.S. market with branded and generic versions available anywhere, worldwide. If there are not yet reasonable comparative analyses, then design and implement them as soon as possible. Ensure drug quality, then purchase at low cost. Next, compare alternative drug therapies and regimens. Strive to determine the precise incremental differences in outcomes. Create scoring systems if need be, and make them understandable and functionally interoperable.

Define the needs and desires of the American people for health care. I’m tired of listening to middle-aged pundits preach the value of an elder’s life, as if they have insight. Let’s put the issues to the American people and find out what they really want. And whatever “it” is, let’s find out if the respondents are willing to pay for it for others, even if they don’t want it for themselves. Carefully designed interview and polling methods should shed light on the desires, if not necessarily the needs, of persons who pay taxes, care about their families and deserve credit for their life histories and ability to make these sorts of decisions.

Create a mandate for advance directives. This recommendation is directed at a potentially controllable aspect of cost containment, and relies upon on the explicit desires of individuals. As part of each person’s state tax return, he or she should be required to complete an advance directive, which could be changed or amended at any time for any reason. A person should be allowed to decline to complete the directive, but only by officially indicating their declination.

Pay active attention to medical manpower issues. The U.S. population is growing. The ratios of doctors to consumers, and the distribution of primary care physicians and specialists, will perpetually be out of whack unless there is active manipulation of training incentives and financial support for doctors who are necessary to keep this nation healthy. We are not training enough doctors to handle our increasingly elderly and medically complex population. There should be active management to train and recruit doctors, nurses, therapists, technicians and other allied health professionals.

Use computers for decision support. Someone needs to take a strong hand to prevent proliferation of an electronic Tower of Babel. My impression of current electronic medical record offerings is that they are designed for billing purposes, not to facilitate real-time clinical decision support. The promise of cost containment because of computer technology will not be fulfilled unless their use guides practitioners to be more effective, eliminate unnecessary hospitalizations and procedures, and diminish errors. Furthermore, electronic medical records are not yet easy to use. Do we really have our best and brightest software engineers working on these tools?

Create health coaches. Uncoordinated care is the most expensive kind, because it leads to delay in diagnosis, redundancies, excess testing and procedures and failure to put episodes into context. Every person, particularly elders, should have access to a qualified health coach, whose responsibility is to allow the patient to be aware of history and options.

Support medical science to the maximum degree possible. Consider this list: cancer, dementia, diabetes, stroke, arthritis, immunodeficiency, infectious diseases. All of these are unsolved mysteries unless we allow scientists to create new knowledge. Discovery advances all aspects of medicine. Arbitrarily restricting research budgets is a foolish approach to cost containment.

And while we’re at it…

Stop demonizing doctors. With the exception of a small percentage, physicians are not driven by the desire to make enormous sums of money. Physicians struggle with themselves constantly about providing expensive life-prolonging care to neonates, elders and terminally ill persons, the cost of drugs, and our current global financial dilemma. Our debates are also about decency, compassion, wanting to do our duty, and accepting enormous responsibilities each day of our careers. Physicians who succumb to perverse incentives to magnify their incomes should be controlled, but they do not define U.S. health care, any more than greedy lawyers define the legal profession, child molesters define the clergy or corrupt politicians define government.

Understand what rationing really means. We are nowhere near the need to ration healthcare in this country. What we are near is an unwillingness to devote the amount of financial resources necessary to support the projected rate of growth in health care spending. To understand which programs need to be curtailed, or never initiated, we have to get our priorities straight. Let’s deal with two situations that will never change. First, we are governed by elected officials who have varying degrees of health care knowledge and interest. They have never shown a willingness to allow doctors to take the lead on reforming the system, arguing that if the health care profession wanted change, it would have created it. The problem with that logic is that no industry in this country makes the laws, and changes in the system cannot come any other way. What our government should do is put the best and brightest doctors in charge of setting the standards and working within the system to make incremental changes that address the foundation issues I discussed above. The second situation is that you cannot teach people health care economics when they don’t feel well. It is human nature to seek relief from suffering and improvement in one’s personal situation. The enlightened individual at the end of his or her days may go quietly (and inexpensively) into the night, but that is not the basis upon which we should expect to build our health care system.

Analyze health care systems of other countries. How many opinions are there about whether or not U.S. citizens would be better off with the Canadian system, British system, Swedish system or some other system? Let’s decide what’s important to us – mortality, morbidity, life span, wait time for hip replacement, drug rehabilitation – and do the comparative analyses. If there is a system that performs better than ours on issues that really matter to us, then we ought to be able to understand why and determine whether and how we can make the situation better here.

Quit considering a visit to the emergency department to be a failure. The maturation of emergency medicine as a specialty, and the way our EDs have responded to the failure of the health care system is a success story. Unless a patient has immediate access to the right specialist, the ED is the fastest, most accurate, and often only reliable direct route to the doctor who knows how to treat the problem. Think about it. You need a CT scan, neurologist and perhaps interventional radiologist when you have a stroke. Will you find that in your general practitioner’s office? Never. You need hydration, antibiotics, metabolic testing and a chest x-ray when you have pneumonia. Call your family doctor? Not likely. Rather than trying to drive patients out of the ER to an understaffed and overbooked community clinic that will immediately bounce anyone who is truly ill, why not refine and expand the ER concept to provide cost effective urgent care to people? Which leads me to…

Don’t count on healthy lifestyles to solve our problems. I am not a pessimist by nature, but it is difficult to believe that non-mandated suggestions to correct our diets, lower our weight, stop drinking and using drugs, and show caution on the freeways will thrive in our culture of consumption, fast food and cars, diminishing exercise, and disregard for the environment. If our laws allow the use of tobacco, firearms and fast foods, then we will continue to have lung cancer, gunshot wounds and fat people. We actually have a “sick care system,” not a health care system, and to suggest that it could be otherwise any time soon is to put way too much faith in human nature. What is reality? I think we should plan to live longer while being less able to care for ourselves, continue to blow ourselves up during wars with weapons, birth too many babies, and celebrate the right to be sugar and grease eaters, not wear helmets and lay out without using sunscreen. We won’t live forever, and our health care system should be designed for how we actually live, not the way we have been instructed to live. If and when we wise up, we can make the adjustments.

So, if we wish to build a house of medicine upon a foundation of data, communication, collaboration, value and accountability, then let’s be real about where we are, what we want, and how quickly we can alter health habits. Let our best medical minds work together to control our destiny by gathering and facing the facts, with every measure at our disposal.

By Dr. Paul Auerbach

The Weight Debate: Obama’s Pick for Surgeon General

2009-07-22T09:55:00.000-07:00

Right around the time the Senate finished grilling Obama’s Supreme Court nominee, Sonia Sotomayor, Obama’s pick for surgeon general—Dr. Regina Benjamin—began her own version of a confirmation hearing in the arena of public opinion.

On one side of the scale is the above-average weight of Dr. Benjamin’s extraordinary resume; on the other side, her above-average personal weight. The question that is hanging in the balance and one that has sparked a lively (and hopefully healthy) debate in the blogosphere and beyond is this: Despite her credentials, does Regina Benjamin’s perceived weight issue disqualify her from being the country’s leading spokesperson on matters of public health?

Dr. Benjamin’s resume speaks for itself. She is a highly decorated family physician from rural Alabama and a champion of the medically underserved—having made headlines for her tireless work after Hurricane Katrina. She has had heaps of honors bestowed upon her, including a McArthur genius award and a Nelson Mandela Award. She was the first African-American woman elected to the American Medical Association’s board of trustees. This list goes on and on.

However, the full-figured Benjamin has been called out by many in online comment forums who think the surgeon general should, at the very least, look healthy at first glance, with the goal of leading by example. Some question the choice for a country plagued by obesity. Some question her stint as the president of Alabama Medical Association—in one of the unhealthiest states in the nation.

Talk to political experts, and most will agree that the surgeon general is a largely symbolic post with some inherent influence but without much administrative authority. Interestingly enough, that makes this debate even more relevant. But it seems symbolism is in the eye of the beholder. Do you see an award-winning African-American family doctor who works selflessly to help those who struggle to help themselves. Or do you see an overweight physician from one of the unhealthiest states in America. It’s a debate that has sparked conversations about health all across the country, which we all can agree is a good thing.

We want your thoughts: Which matters most—Dr. Benjamin’s credentials or her weight?

Go for a Run, and Help Kids in Need

2009-07-16T16:42:00.000-07:00

The Fresh Air Fund is looking for runners to join its NYC Half-Marathon team. Through sponsorships, each runner on the team raises money that will fund free programs for kids from low-income communities. More runners means more money going to kids in need.

The Fresh Air Fund has been around since 1877 and has provided free summer vacations for nearly 2 million children in that time. Last summer, nearly 5,000 kids escaped the hot, crowded streets of New York City to stay with host families in cities and towns across 13 U.S. states and Canada. The organization also hosts Fresh Air camps and other enrichment programs for thousands of kids throughout the year.

Last year, the Fresh Air Fund Racers raised more than $125,000 through the NYC Half-Marathon. That money directly funded their programs, and they are hoping to raise even more this year. It’s a great race and a great cause. Click here to register with the Fresh Air Fund Racers. The organization is also looking for families to host kids for a summer vacation. Find out how.

By Ryan Wallace

Your Questions Answered

2009-05-05T10:02:00.000-07:00

Our regular updates on the H1N1 virus have sparked a lot of questions among our readers, so we've provided a list of your most frequently asked questions and their answers in order to keep you informed, allay your fears, and help keep you safe and healthy.

Q: At what point should I seek medical attention if I believe I've been exposed to the swine flu?
A: You should seek medical attention if you've been suffering from any flu-like symptoms (such as fever, headache, body aches and cough) for more than 24 hours. Let your healthcare professional know if you suspect you've been exposed to the H1N1 virus (widely known as the "swine flu") because of recent travel to Mexico or contact with someone diagnosed with the disease.

Q: If I received a swine flu vaccine during the swine flu outbreak of 1976, am I safe from infection by the current swine flu virus?
A: No. The vaccine you were given to guard against the H1N1 virus is unlikely to provide protection against the current strain of the virus. But a new vaccine is being developed and could be available as soon as June, 2009.

Q: Can I get swine flu from eating pork products?
A: No. The flu is not spread through food, so there is no danger of getting swine flu from consuming pork products.

Q: Can I be infected with swine flu if I handle a pig fetus during a classroom dissection?
A: No, it's highly unlikely for you to be infected in this way. The preservatives used to prepare a pig fetus for dissection should kill any virus the fetus may have been exposed to.

Q: Can my pets become infected with swine flu?
A: Not likely. According to veterinarian Michael Watts, "There is no evidence that dogs, cats, or 'pocket pet' species can be infected with the new H1N1. Although the virus contains some genetic material from an avian influenza virus, there is no evidence this strain can infect birds." Even so," the doctor says, "You should contact your veterinarian any time your pet develops symptoms of a respiratory infection."

Q: How effective is the use of facemasks in preventing swine flu infection?
A: Masks can be effective when used properly. The mask should fit snugly over your mouth and nose, and it should be changed every couple of hours, because prolonged exposure to your own moist breath can turn the mask into a sponge that soaks up outside germs, making you even more susceptible to infection.

Q: I'm pregnant. Should I take greater precautions than others when it comes to the swine flu?
A: Yes. There's evidence that pregnant women could be at higher risk for complications when it comes to infection with H1N1, so pregnant women should be tested for H1N1 and get treatment immediately if they test positive.

Q: How can frequent travelers avoid becoming infected with the swine flu?
A: Frequent travelers should take the precautions everyone else does to prevent infection, including washing hands frequently and avoiding contact with sick people. Make sure to use disposable paper towels in public restrooms for drying hands, turning off faucets and opening doors.

Q: Why has there been such a high death rate for those infected with swine flu in Mexico?
A: The World Health Organization is still investigating the spread of H1N1 in Mexico and why mortality from the virus has been so high in that country. Some experts point to the poverty of the victims, the large concentration of people in such a small area, and the hesitation of those inflicted to seek swift medical attention as possible answers.

Q: What are my chances of a full recovery should I be infected with the swine flu?
A: Excellent. The anti-viral drug treatments Tamiflu and Relenza have proven extremely effective in combating the H1N1 virus. Just make sure you keep a close eye on your health and get treatment if you come down with symptoms that point to the swine flu.

Swine Flu: What You Need To Know

2009-04-26T17:03:00.000-07:00

Swine Flu Update - Tuesday, May 5, 5:00pm:

A 33-year-old Texas woman, already suffering from other health problems, died today from the H1N1 virus. Though not yet reflected in today’s report from the Centers for Disease Control and Prevention, this makes the second H1N1 death in the United States. Last week, a toddler from Mexico died from the flu in a hospital in Texas.

According to many experts, most of the confirmed cases in the U.S. have been much less severe than expected. "We have started to see encouraging signs that this virus may be mild, and its spread may be limited," said Homeland Security Secretary Janet Napolitano in a press conference.

Also today, President Felipe Calderón lessened the national alert level in Mexico, where the flu has apparently begun to taper off. The government did cancel Cinco de Mayo festivities, though, as a precaution.

Swine Flu Update - Tuesday, May 5, 8:00am:

With 403 confirmed cases in nearly 40 states, U.S. health officials are backing off severe public alerts. Most of the cases have been milder than expected, and school closings do not seem to help stop the spread.

“So far, the severity of illness in this country is similar to that of [seasonal] flu, and that's very encouraging, said Richard Besser, acting director of the Centers for Disease Control and Prevention.

On a global scale, H1N1 has sickened at least 1,124 people in 21 countries. The virus appears to be easing off in Mexico, where it hit the hardest.

Swine Flu Update - Monday, May 4, 3:00pm:

After four days with most of the country’s operations shut down, Mexican officials announced today that many businesses will reopen on Wednesday. The Mexican Health Ministry said Saturday that the worst of the virus is over.

Meanwhile, China has quarantined dozens of Mexican travelers, leading Mexican government officials to say their citizens are being unfairly targeted.

Here in the United States, the Centers of Disease Control reports confirmed cases 36 states, up six states since Sunday. However, most of the 279 cases have been relatively mild. "While we're not out of the woods, we're seeing a lot of encouraging signs," said CDC Acting Director Richard E. Besser in a press briefing today.

Swine Flu Update - Monday, May 4, 8:00am:

The World Health Organization’s official tally lists 985 confirmed cases in 20 countries. Colombia and El Salvador are the latest countries joining the list.

Responses in different parts of the world are causing political tensions, not to mention travel problems. Roughly 70 Mexican travelers have been quarantined in Chinese hospitals and hotels, leading Mexico authorities to claim discrimination. On Saturday the Chinese government cancelled all flights from Mexico, leaving many Chinese travelers stranded.

Adding to the overall controversy is the statement by Mexican health officials that the H1N1 flu is easing off. Some health experts claim WHO may have overreacted with warnings that a pandemic is imminent.

“I’m not predicting the pandemic will blow up, but if I miss it and we don’t prepare, I fail,” WHO General Director Margaret Chan said in a recent interview. “I’d rather over-prepare than not prepare.”

Swine Flu Update - Sunday, May 3, 6:00pm:

Latest totals have reached 898 confirmed cases in 18 countries, with Colombia reporting the first confirmed case in South America. Here in the United States, 226 confirmed cases have been reported across 30 states, the most recent being in Pennsylvania.

In Mexico, Health Secretary Jose Angel Cordova said evidence suggests that the H1N1 flu is on the decline in that country, with 506 confirmed cases and 19 deaths. The epidemic has slowed, Cordova said, because of the government’s lockdown on schools and businesses and ban on public events.

Meanwhile, the World Health Organization urges that any farm animals possibly infected with H1N1 must be contained and monitored. The concern follows an outbreak among pigs in Alberta, Canada, where the virus was apparently spread when a farm worker, after becoming ill in Mexico, unknowingly infected the animals. Health officials are working to understand how the virus was passed from person to pig.

Swine Flu Update - Sunday, May 3, 10:00am:

The number of confirmed cases continues to rise, but the World Health Organization says there are still no signs of a pandemic.

According to the latest tally from the Centers for Disease Control and Prevention, 21 states have reported 160 confirmed cases in the U.S., with one death. WHO announced 787 confirmed cases in 17 countries. Officials stress that a pandemic indicates the geographic spread of a disease, not the severity. To become a full-fledged pandemic, H1N1 would need to spread across communities in at least one other country in a new region of the world.

On Saturday, Canadian health officials reported that a herd of pigs in Alberta had become infected, apparently by a farm worker who became ill on a recent trip to Mexico. This is the first reported case of H1N1 showing up in pigs, and the first case where the virus has apparently crossed from human to animals. Both the farm worker and the 2,200 pigs have recovered.

In a joint statement released Saturday, the United Nation’s Food and Agriculture Organization, WHO, and other international health groups said the H1N1 virus cannot be spread by eating pork and pork products. "To date there is no evidence that the virus is transmitted by food," the statement said.

Swine Flu Update - Saturday, May 2, 10:00am:

The first confirmed case of H1N1 in Hong Kong has led to the quarantine of close to 300 people after health officials determined that a hotel guest had contracted the virus.

After a 25-year-old Mexican man stayed in the hotel and later became sick, officials ordered some 200 guests and 100 staff to remain in the hotel for seven days to stop the spread of the virus.

On Saturday morning, the World Health Organization said that although it is still preparing for a pandemic, the sharp rise in the number of confirmed cases of swine flu to 658 was due to the confirmation of suspected cases in Mexico as opposed to newly reported instances. While the majority of cases have been in Mexico, a total of 16 countries now have confirmed of H1N1.

"What the increase reflects is that we are moving forward in confirming many of the cases that have been left untested for some time, so in an way that's reassuring," said WHO spokesman Paul Garwood. "So we haven't seen, say, a spike in new cases or new influenza cases appearing in Mexico City, for example," Garwood continued. "It's just the fact that this reporting backlog is bearing fruit and we're seeing the results of that."

Read Dr. Paul Auerbach's blog about who should get tested for the virus.

Swine Flu Update - Friday, May 1, 9:00am:

The warning level remains at Phase 5 on a six-step scale, indicating that a pandemic is imminent. So far 11 states have had confirmed cases of the H1N1 virus, commonly called swine flu. Today the number of confirmed cases worldwide rose to 331, up from 257 on Thursday, according to the World Health Organization.

During a pandemic, a new virus affects people in several parts of the world at the same time, with mild to severe consequences. “Influenza pandemics must be taken seriously precisely because of their capacity to spread rapidly to every country in the world,” said WHO General Director Margaret Chan in a statement on the organization’s web site. “On the positive side, the world is better prepared for an influenza pandemic than at any time in history.” U.S. officials and drug manufacturers are working on a vaccine.

Swine Flu Update - Wednesday, April 29, 9:30am:

The CDC has confirmed the first fatality in the US from swine flu, a 22-month-old child who traveled from Mexico to Houston, Texas for treatment.

"I can confirm very sad news coming out of Texas that a child has died from the H1N1 virus," Richard Besser, MD, acting director of the CDC, said in an interview with CNN. "As a parent and a pediatrician, my heart goes out to the family."

This is the first death attributed to the outbreak in the US, where the reported cases have to date been relatively mild compared to those in Mexico. Health officials have been warning the public for several days that that could change.

Swine Flu Update - Monday, April 27, 4:30pm:

The World Health Organization’s Emergency Committee met today and recommended that the level of influenza pandemic alert be raised from a phase 3 to a phase 4. This indicates that the likelihood of a pandemic has increased, not that one is certain. Epidemiological data about the human-to-human transmission and the ability of this specific virus to cause community-level outbreaks led to the decision. The WHO is not recommending the closing of borders or the limiting of international travel at this time.

Visit the World Health Organization’s website for more information on a phase 4 pandemic alert.

Here’s what you need to know about swine flu:

Why is Swine Flu in The News?
The number of fatalities in Mexico coupled with reported cases in the US, Canada and New Zealand brought the outbreak to the attention of health officials and the media. Also of concern is the fact that the strain in Mexico is attacking healthy young people, a trait usually associated with pandemic flu bugs.

What is Swine Flu?
Swine flu is just what it sounds like…a strain of flu that effects pigs and usually remains just that. Sometimes a strain of swine flu will mutate and is contracted by humans. This strain appears to be a mixture of swine, avian and human viruses and mutated viruses concern health officials due to their resistance to existing vaccines. A high fever, consistent cough, sore throat and possibly vomiting and diarrhea are the most common symptoms of swine flu, but those symptoms can be caused by countless other conditions as well. If you or someone you’ve been in close contact with has recently returned from Mexico and your flu-like symptoms persist, contact your doctor. Only a lab test can identify swine flu.

No vaccine for swine flu exists currently, but the Center for Disease Control has begun the steps needed to create one, in case that becomes necessary. This season’s flu shot does not offer protection to this virus.

What is the Government Doing?
Since this is a quickly developing outbreak and there are still many unknowns, the White House has likened their efforts to preparing for a hurricane. "Really that's what we're doing right now. We're preparing in an environment where we really don't know ultimately what the size or seriousness of this outbreak is going to be," Homeland Security Secretary Janet Napolitano told reporters. The act of declaring this a public health emergency clears the way for shipping roughly 12 million doses of flu-fighting medications from a federal stockpile to states that may need them. The Center for Disease Control says that isn’t currently needed, as the cases in the US are less severe than those in Mexico.

While the government is taking the right precautions, it’s important to point out that this is not a global pandemic — at least not yet. The true number of cases, why the Mexican cases are more severe and how easily the virus spreads are sill unanswered.

Can Swine Flu be Treated?
Yes. This specific strain can be treated with Tamiflu and Relenza.

How to Protect Yourself
The most common question on everyone’s mind is “how can I protect myself?” The good news is that common health tips that help stop the spread of seasonal flu can be effective with preventing swine flu as well. The following are recommended steps from the CDC:

Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
Avoid touching your eyes, nose or mouth. Germs spread this way.
Try to avoid close contact with sick people.
If you get sick with influenza, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them. What is the best way to keep from spreading the virus through coughing or sneezing?

At this point, the best advice is to take the right precautions and to not panic. The CDC will be issuing statements and advice as more information is known. Follow the developments on Healthline.com and other major news outlets.

Healthline’s Chief Medical Officer, Dr. Paul Auerbach will be posting ongoing updates about this outbreak in his blog.

Drinking Milk After the Expiration Date

2009-04-17T10:44:00.000-07:00

Question: Can I Drink Milk After The Expiration Date?

Answer: This is a common question we receive at Healthline and there’ve been plenty of headlines over the past year to keep food safety issues on everyone’s minds. Chances are most of us can confess to pulling a carton of milk out of the fridge, frowning when noticing the expiration date has passed and then unscrewing the lid to subject it to the “smell” test.

When milk is pasteurized, most of the truly harmful bacteria are destroyed. But even pasteurized milk begins to deteriorate pretty quickly and really only remains “fresh” for a couple of days after the expiration date. Keep in mind that other factors, such as leaving the milk out at room temperature for too long, can cause the milk to spoil faster. Even the temperature of your refrigerator, which is typically lower than that of the cases at the supermarket, can have an impact.

While the bacteria that causes milk to turn sour and spoil can cause food poisoning and be dangerous for young children or those with compromised immune systems, it is unlikely that drinking spoiled milk could kill an adult, but that’s assuming you can get past the smell and taste to drink it.

If you have drunk milk past the date on the carton and are concerned, remember that the FDA gets involved in regulating package expiration dates in a surprisingly few number of instances. That’s not because they aren’t keenly interested in public safety, but instead that in most cases, the dates have to do with the quality of the food and aren’t indicators of safety.

The Bottomline: Use common sense. It isn’t likely to kill you, but drinking smelly milk a couple days past the expiration date has some obvious health risks.

What Package Terms Mean:

“Sell By” – This is really meant to be used as guidance for the store or market to direct them when to remove items from the shelf. Lots of shelf-stable products, like canned fruits and vegetables, have sell-by dates and you really shouldn’t purchase these products after their respective dates.

“Best If Used By” or “Best Before” – This term refers to the flavor or quality of foods and in most cases, products will be safe for some length of time after their best-before dates. Packaged baked goods, for instance, often use a best-before date to indicate when the product will start to taste stale.

“Use By” – Products display a “use by” date as more of an expiration date. This should be treated as a slightly less formal expiration date and is also the last date that manufacturers are going to vouch for a product’s quality.

“Expiration Date” – It is safer to discard products after their expiration date. While other terms have some ambiguity, treat this one as what it says.

Read more about food safety.

What is Supplemental Health Insurance?

2009-03-19T15:46:00.000-07:00

Even if you have a robust employer-provided health insurance plan, you may be surprised to discover what isn’t covered by the plan and what you have to pay out-of-pocket for your health expenses like doctor visits and prescriptions. When you start to add up your medical expenses (and those of your spouse and children) it might make sense to consider a supplemental health insurance plan. These plans can help lower your insurance costs, expand the number of healthcare providers available to you and also expand the services you can receive at a discounted cost. Your individual needs will help determine what kind of supplemental plan would serve you best, as specific plans have specific goals.

Supplemental Dental Plans

Many employer-provided dental plans are great at covering major procedures, but may be less effective at paying for regular maintenance like teeth cleanings, fillings and check-ups. A supplemental dental plan can help lower your out-of-pocket costs for your more common dental needs. Another option could be a dental discount program. These aren’t quiet insurance plans, but can offer discounts on services at member dentists.

Plans Covering Alternative Medicine

Very few employer insurance plans cover alternative or complementary medicine like acupuncture, massage therapy or the services of a chiropractor. Depending on your individual needs and how frequently you use these types of services, a supplemental insurance that helps cover the costs of alternative treatments might make financial sense for you.

Medicare Part D

Seniors often find themselves paying out-of-pocket costs for prescriptions. A Part D plan is a supplemental insurance plan that helps cover costs that fall in the “gap”, the difference between when your plan has paid a certain amount for covered medications and until your drug costs hit a specific limit ($3850 in ’08). Learn more about Medicare Part D.

Finding the Right Supplemental Dental Insurance

2009-03-18T11:17:00.000-07:00

40% of Americans are not receiving the dental care they need. And 70% of Americans either don’t have dental insurance or the ability to pay for full-price dental work out of pocket. Even those who have work-sponsored dental insurance may be surprised by how little many of the programs actually cover. That reality coupled with the rising cost of dental care has led many people to secure either supplemental dental insurance or a discount dental plan or both.

Supplemental dental insurance is meant to cover costs not covered by your primary dental insurance. Most work-sponsored plans cover the most expensive procedures but skip more common needs, which can over time be quite expensive. If you are considering finding a supplemental dental insurance plan, start by getting the complete details of what your current plan covers and what it doesn’t. Then work with your dentist to create an estimate of your dental needs for the next two years. This should include regular cleaning and maintenance, any other expected work and some buffer for emergencies. From there you can match your needs to the right supplemental plan.

Discount dental plans aren’t technically insurance plans, but they will help lower your dental costs. A dental discount plan leverages the large quantity of their members to secure lower prices for their members. When you visit one of the member dentists, you’ll receive special (and often significant) discounts on treatments and procedures. A discount dental plan can cost as little as $5 per month and can save several times that on an annual basis. When selecting a discount dental plan, check to make sure that your regular dentist is in the group.

When you’re ready to compare supplemental dental plans, visit an online resource like www.esurance.com or a company specializing in supplemental plans like www.reassurancehealth.com.

The Benefits of Genetic Testing

2009-02-03T11:38:00.000-08:00

Lately I’ve been thinking more and more about the second half of my life. The fact that I turned 40 last year may be the cause. Or it may be that I’ve had two close friends (same age as me) who’ve recently faced sudden and frightening health scares. It might even be dealing with my aging parents and thinking about the health issues they might face.

Whatever the reason, my one resolution this year was to get serious and take steps to help ensure that I stay healthy and independent as I age. So at the top of my to-do list was figuring out which medical conditions I might be more at risk for, and taking steps to prevent them. One reason this is a bit more difficult for me is that I’m pretty healthy today. Ever since college I’ve maintained a healthy weight of about 135 pounds, which for my height of 5 ft 9 in, puts my BMI right in the middle of “normal”. I get annual physicals and since I’ve been a vegetarian for about 20 years, I also get detailed blood work done so that I can make sure that I’m getting the right nutrition. Outside of the normal colds and a nasty case of food poisoning in Mexico last year, I’ve really never been that sick.

Some folks can poke around their family history for clues on what might be in their future. But I come from a very small family…an only child of two only children. Both parents are mid-60s, and still relatively healthy. One grandmother is still alive and the others died young from accidents. Again: no clues.

I could simply look at the statistics for my gender and lifestyle choices and make guesses about the “most-likely” culprits like heart disease and colon cancer, but I’d really like to be more aggressive.

Luckily I found a service that can help: Navigenics.

Through a simple process, they screen your genome and look for “markers” that are tied to specific conditions. They factor in how much risk is associated with each marker, how common that marker is as well as how common the condition is to come up with an individual risk percentage for each condition. (They scan against over 20 common conditions including Crohn’s disease, breast cancer, osteoarthritis and glaucoma.)

For instance, if my results showed a higher-than-average risk for colon cancer, I might want to talk to my doctor about starting screening earlier than normally advised. If diabetes is flagged, even though is doesn’t seem to run in my family, I might take preventative steps when it comes to my diet.

I got my kit in the mail which contained some print info, an addressed mailing pouch and a sample tube that I needed to fill with saliva and return. I promptly filled the tube and dropped the sample in a FedEx box. In a few business days, I’ll be notified that my results are available online. I’ll also be scheduled for a discussion with one of their genetic counselors, who will help explain the results and ask questions that will help fill in the puzzle pieces.

So check back in with this blog when I share the results from my test and when I take steps to prevent those conditions I’m at risk for.

____________________________________________________________________________

Disclosure: Navigenics provided the sample test for the author, but had no input into the creation of this article.

To learn more about Navigenics, request you free info kit.

Kitchen Prescriptions

2008-12-15T17:04:00.001-08:00

Each winter ushers in another cold and flu season and now is the perfect time to begin prepping yourself to strengthen your immune system and try to avoid getting sick altogether. To get started, you don’t have to look any further than you own kitchen cupboard.

Hot and hearty soups packed with ginger, garlic and other bacteria-busting ingredients can be your first line of defense this year. Warm broths have been proven to help reduce congestion and stews full of vegetables and beans can provide needed vitamins, nutrients and fiber. Plus liquids help you stay hydrated.

Most soups have some benefits, but look for those starring these special flavor favorites:

Garlic
Garlic gets its unique flavor and odor from the compound allicin—a natural antibiotic that helps fight bacterial infections. Additional studies indicate garlic can help prevent and lessen the effects of the common cold.

Peppers
Capsaicin is what gives peppers like jalapenos their spice and heat. It can also help loosen congestion and help you breath better. A runny nose can be an unwanted side-effect of spicy foods, but keep in mind the end result is that you will breathe better.

Ginger
A natural anti-inflammatory, fresh ginger is packed with antioxidants. In fact the Chinese have been using it to ease sinus pain and sore throats for over 2,500 years.

For easy ways to work cold-preventing ingredients into your diet, try these great recipes.

Carrot and Ginger Soup
Ingredients
1 cup chopped onion
2 tablespoons olive oil
4 cups diced carrot (5 or 6 large carrots)
3 cups cubed peeled potato (3 large potatoes)
1 tablespoon minced fresh ginger
3/4 teaspoon salt
1/2 teaspoon chili powder
1/4 teaspoon curry powder
1/4 teaspoon black pepper
3 (15.75-ounce) cans low-sodium chicken broth

Preparation
1. Cook onion in oil in a sauté pan over medium high heat until tender, about 4 minutes. Add carrot and potato and cook for an additional 2 minutes. Stir in remaining ingredients and bring to a boil. Cover and reduce heat.

2. Simmer for 50 minutes, or until vegetables are tender. Place in batches in a food processor and process until smooth. Return soup to pan and stir well.

Spicy Chicken Soup with Barley
Ingredients
1 cup uncooked quick-cooking barley
3 (14-ounce) cans fat-free, less-sodium chicken broth
2 cups chopped onion
1 tablespoon olive oil
1 tablespoon chopped garlic
1 teaspoon minced jalapeno pepper
1 (12-ounce) package frozen mixed vegetables
2 cups chopped cooked chicken
1/4 teaspoon salt
1/4 teaspoon black pepper

Preparation
1. Combine barley and chicken broth in a large saucepan and bring to a boil. Reduce heat and simmer 7 minutes.

2. Cook onion in oil in a sauté pan over medium high heat until tender, about 5 minutes. Stir in garlic and pepper and sauté 3 minutes. Stir in frozen mixed vegetables and sauté 3 minutes. Combine cooked vegetable mixture, cooked chicken, salt, thyme, and pepper with barley and broth. Simmer 5 minutes or until thoroughly heated.

Vegetarian Four-Bean Chili
Ingredients
2 cups chopped onion
1 tablespoon minced garlic
1 tablespoon olive oil
2 tablespoons chili powder
2 tablespoons Worcestershire sauce
2 (14.5-ounce) cans diced tomatoes, undrained
2 cups canned chicken broth
1 (15 1/2-ounce) can garbanzo beans, drained
1 (15-ounce) can black beans, drained
1 (15-ounce) can kidney beans, drained
1 (16-ounce) can small white beans, drained
1 (6-ounce) can tomato sauce
Shredded cheddar cheese

Preparation
1. Cook onion and garlic in oil in a large soup pot over medium-high heat. Sauté until tender, about 5 minutes. Stir in remaining ingredients except cheddar cheese.

2. Bring to a boil and reduce heat. Simmer for 10 minutes. Ladle into individual bowls and top with shredded cheddar cheese.

Clostridrum Difficile Infections: Increased Threat

2008-09-22T10:22:00.000-07:00

C. difficile or CDAD (Clostridium difficile associated diseases) are gastrointestinal infections caused by an anaerobic bacterium and usually acquired by people who are already sick and often in a health care facility. Symptoms can range from mild, watery diarrhea along with fever, abdominal pain and loss of appetite to life-threatening complications like toxic megacolon, sepsis, pseudomembranous colitis and can be fatal. Being on antibiotics (either prior to exposure to the bacterium or approximately the same time as exposure, which wipe out the normal intestinal flora, is a major risk factor for this infectious disease. The bacteria are found in the feces. A stool sample will be needed to confirm the diagnosis.

The CDC reports that the scenario for acquisition is usually:

patient with advanced age and underlying illness
colonic microflora disturbed (usually due to antibiotic use)
acquisition of C. difficile
the incubation period is unknown at this time

There are half a million cases of C. difficile in the US each year, up from 150, 000 cases in 2001. The infection may be responsible for as many as 30,000 US deaths each year. The number may be higher as it is not yet a reportable disease. Hands and surfaces contaminated with feces spread the disease. Recent outbreaks of an epidemic strain indicate increased virulence and antibiotic resistance. More people are affected by the disease, and more are showing severe symptoms. Like MRSA, C. difficile is now being seen in what used to be considered "low risk" populations - healthy people in the community (CA-CDI) and pregnant women. The mortality rates have risen from 6 deaths per million in 1999 to 24 deaths per million in 2004.

Long term care facilities are particularly vulnerable and it is important for the general public to know that infections can occur from contact with contaminated environmental surfaces. 10% bleach is known to be an effective agent against C. difficile. Alcohol gel and antiseptic hand wipes are NOT as effective as good old-fashioned water and soap at removing C. difficile from the hands. Of note - skin contamination with C. difficile continued for as long as 1o days after diarrhea stopped, so that is the rationale for continued isolation of a contaminated patient who is no longer symptomatic.

The CDC is investigating a possible food-borne transmission link as C. difficile is a pathogen of calves and piglets, and has been isolated from retail meat products. Transmission from animals to humans is circumstantial at this point.

Wash your hands before eating and after using the bathroom.
Clean surfaces in the bathroom and kitchen and patient care areas with 10% bleach.
Clorox and Safeway manufacture Disinfecting Wipes that are easy to use for decontaminating surfaces. They can be purchased in On The Go packs for taking with you to restaurants or other places where you may be exposed to contaminants. If you are visiting a loved one in a facility, you may want to consider packing your own disposable gloves and decontaminating the call bell, hand rails and other surfaces.
Health care professionals are known to spread infections. Don't be embarrassed to insist that anyone wash their hands before having contact with you or your loved ones.

Thank you vjmari's photos for use of image.