Deadly Meningitis Cases Worry Gay Community

By Randy Dotinga
HealthDay Reporter

TUESDAY, April 23 (HealthDay News) -- A series of bacterial meningitis cases in Southern California and New York City, resulting in the deaths of several gay men, have set the gay community on edge. However, preliminary tests suggest the cases on each coast aren't connected.

Health activists became concerned in Los Angeles after a 33-year-old gay attorney from West Hollywood suddenly became ill from meningitis and died on April 13. The AIDS Healthcare Foundation, which advocates for health for gay men, initially criticized local health officials for not pushing for vaccinations. However, "we don't think it's part of an outbreak or due to him being a gay man," said Dr. Wayne Chen, the organization's acting chief of medicine.

Still, the Los Angeles County's public health department is offering meningitis vaccinations for free for those who are poor or uninsured.

In New York City, health officials are recommending that certain groups of gay and bisexual men, along with certain visitors to the city, get vaccinated against meningitis.

According to Los Angeles County health officials, four cases of meningitis in gay or bisexual men have been confirmed in the region since December, including one 30-year-old who died of meningitis in Los Angeles, and another man of the same age who died in the San Diego area, both in December, according to news reports.

The officials say the four Los Angeles cases in gay and bisexual men don't appear to be "highly related" to those elsewhere in Southern California or in New York City.

In New York City, officials have noted more than 20 meningitis cases since 2010 in gay or bisexual men; seven of the men died. The city recommends vaccinations for any HIV-infected gay or bisexual men and those who have had close or intimate contact with men they met via websites, apps or at bars or parties. Visitors who have been to the city since Sept. 1 and engaged in these types of activities should get vaccinated too, city officials added.

Meningitis is transmitted through close contact with an infected person and kills, often quickly, by causing the lining around the brain to swell. It commonly spreads through places where people live closely together, such as dorms and military housing.

Meningitis hasn't previously been connected to gay men in particular, Chen said.

Many people have the bacteria that cause meningitis in their nasal passages, but the germs often don't cause problems, said infectious disease specialist Dr. William Schaffner, chair of the department of preventive medicine at Vanderbilt University Medical Center. "They can carry these bacteria for long periods of time and transmit them to other people without being aware of the process."

The germs can create a mild illness at first that can quickly turn deadly, especially if the bacteria gets into the bloodstream, he said.

"You feel kind of punky, and you maybe have a sore throat," Schaffner said. "You lose your appetite, you get drowsy. Then you can slip into a coma."

Antibiotics effectively treat bacterial meningitis, he said, but they must be given quickly. That's why people should seek medical care if they suffer from symptoms like stiff neck, high fever (beyond 100.1 degrees Fahrenheit) or severe headache, he said.

Meningitis vaccines cost about $100, Chen said, and can cause side effects that are similar to those possible in people who get flu vaccines. The vaccines work against most strains of meningitis, Schaffner said, and take 10 to 14 days to become effective.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: William Schaffner, M.D., professor and chair, department of preventive medicine, Vanderbilt University Medical Center, Nashville, Tenn.; Wayne Chen, M.D., acting chief, medicine, AIDS Healthcare Foundation, Los Angeles

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Number of U.S. Foodborne Illness Cases Stalled: CDC

THURSDAY, April 18 (HealthDay News) -- Progress in reducing foodborne illness in the United States seems to have stalled, health officials reported Thursday.

"Every year, we estimate that about 48 million of us -- that would be one in six people in the United States -- gets sick from eating contaminated food," said Dr. Robert Tauxe, deputy director of the division of foodborne, waterborne and environmental diseases at the U.S. Centers for Disease Control and Prevention.

In 2012, the nation's food surveillance program identified about 19,500 infections, about 4,500 hospitalizations and 68 deaths, Tauxe said at a noon press conference on the study results. Those numbers are similar to ones reported between 2006 and 2008, the report noted.

The findings appear in the April 19 issue of the Morbidity and Mortality Weekly Report, published by the CDC.

"We see, once again, that salmonella was the most commonly diagnosed and reported cause of infection among those that are tracked," Tauxe said, and while some types have decreased, others are on the rise.

Although the second most common infection, Campylobacter, decreased since the early 1990s, "it's still lower than it was in the 1990s but it has increased by 14 percent since a baseline period of 2006 to 2008," Tauxe said.

While still quite rare, he said Vibrio infections increased 43 percent in 2012, compared with 2006 to 2008.

"Vibrio organisms are found in marine waters where shellfish are harvested and many Vibrio infections are due to eating oysters," he noted. "However, not all are due to oysters and some infections are acquired from contact with marine water causing, for instance, wound infections."

E. coli O157 levels in 2012 were similar to those observed in 2006 to 2008, although in the past "substantial declines were observed following regulatory change and improvement in the food industry that particularly targeted ground beef," Tauxe noted.

"It is still the case now that numbers were lower than they were back in the 1990s," he said. "But right now we're just about where we were in 2006 to 2008, and we may need to identify additional ways to reduce contamination, as well as heightening awareness among consumers about the importance of thoroughly cooking and safely handling ground beef in their own homes."

A general measure that combines sickness from six key pathogens that are usually transmitted by food decreased 22 percent from the late 1990s, but really hasn't changed since 2006 to 2008, he added.

Last year, the highest incidence of foodborne illnesses caused by Cryptosporidium and bacteria other than listeria and Vibrio was among children younger than age 5. The highest incidence of illnesses caused by listeria and Vibrio was among seniors, according to the report.

Tauxe noted some caveats in the results. Surveillance data do not cover the entire country -- only about 15 percent of the population. Some of the illnesses are also acquired from sources other than food, and norovirus ("cruise virus") isn't covered because it typically isn't tested for in clinical labs.

Also speaking at the conference was Dr. David Goldman, assistant administrator at the Office of Public Health Science, part of the U.S. Department of Agriculture's Food Safety and Inspection Service.

"We have seen that there have been some positive trends . . . but compared to recent years we have seen some troubling trends that we continue to address," Goldman said.

In 2012, the USDA added six strains of E. coli in its industry testing of beef-trim products, he said, and the agency continues to evaluate data and is considering testing of other beef products.

They've also tightened standards for salmonella and implemented new Campylobacter standards for plants producing chicken and turkey, Goldman noted.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCES: April 18, 2013, news conference with: Robert Tauxe, M.D., M.P.H., deputy director, division of foodborne, waterborne and environmental diseases, U.S. Centers for Disease Control and Prevention, and David Goldman, M.D., M.P.H., assistant administrator, Office of Public Health Science, USDA Food Safety and Inspection Service; U.S. Centers for Disease Control and Prevention, news release, April 18, 2013

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HPV Vaccination Sends Genital Wart Cases Plummeting: Study

By Alan Mozes
HealthDay Reporter

THURSDAY, April 18 (HealthDay News) -- In the five years since launching a nationwide human papillomavirus (HPV) vaccination program among girls between the ages of 12 and 26, Australia has seen a huge drop in the number of cases of genital warts, new research reveals.

Among Australian girls in the targeted age range for vaccination, the country saw genital wart cases plummet by 59 percent within just the first two years of the program's launch in 2007.

By aggressively vaccinating girls against HPV (which is responsible for 90 percent of genital wart diagnoses), Australia appears to have offered considerable protection not just to its female population but also its men as well.

How? Researchers point to a phenomenon known as "herd immunity," whereby the immunity acquired by a certain segment of the population -- in this case, women -- ends up protecting an unvaccinated segment of the population (men).

In the same timeframe Australia has seen a 39 percent drop in genital wart cases among heterosexual men as well.

"All indications are that the program has been an overwhelming success," noted study author Dr. Basil Donovan, who heads the sexual health program at the Kirby Institute of the University of New South Wales, in Sydney.

"But we won't be certain until HPV-related cancers [also] start dropping," he added, explaining that while genital warts tend to appear roughly three months following infection with HPV, "the incubation period from HPV infection to HPV-related cancer is typically at least 20 to 30 years."

HPV-associated cancers include cervical, penile, anal and throat cancers, according to the U.S. Centers for Disease Control and Prevention.

Donovan and his colleagues published their findings in the April 18 issue of the BMJ.

To explore the impact of HPV immunization efforts in the Australian context, the authors analyzed data collected from eight different sexual health service organizations covering a period from 2004 to 2011.

Collectively, the organizations had seen nearly 86,000 first-time patients in that timeframe, of whom about 9 percent were diagnosed with genital warts.

By comparing the pre-vaccination period of 2004 to mid-2007 with the vaccination period of mid-2007 through the end of 2011, the team found a remarkable plunge in genital wart rates.

Among girls under the age of 21, that drop amounted to nearly 93 percent, while among those between 21 and 30 a decline of almost 73 percent was observed.

And while no appreciable genital wart rate drop-off took place among women or men over the age of 30, among men under 30 a notable dip was observed. Specifically, among heterosexual men below 21 the drop amounted to almost 82 percent, while among those between 21 and 30 genital wart rates fell by more than 51 percent.

But is the Australian experience translatable to other countries now engaged in various types of HPV vaccination programs?

Donovan said that how well other countries will fare in efforts to dampen genital wart rates will depend on the degree of public acceptance when it comes to HPV immunization efforts.

"There was little resistance to the HPV vaccine in Australia," he noted by way of explaining the program's success. By contrast, he suggested that the American public health effort -- which he characterized as "fractured" -- may very well produce less optimistic results, given the widespread controversy and reluctance to vaccinate that arose when the prospect of immunizing young girls was first proposed.

But in other countries, where the debate has been more muted, Donovan sees better prospects. "As the U.K. is achieving vaccine coverage rates at least as high as Australia," he said, "I would be certain that they will soon be reporting comparable drops in disease."

Commenting on the report, Dr. Jocylen Glassberg, an obstetrician/gynecologist at Scott and White Healthcare in Round Rock, Texas, said that "the take-home message is the vaccine is obviously working."

"It will take many more years to see the same decline in cervical cancer rates due to the naturally slow progression of that disease process," she said. "But the vaccine works. The fact that genital wart rates were virtually zero after such a short time in women and men, even in a program just aimed at vaccinated women, is a phenomenal result."

On that note, Glassberg pointed out that most vaccines do not offer similar levels of protection. "Flu vaccines keep 80 percent or so at bay," she explained. "This is almost 100 percent."

So, "aggressively educating the public should be key in the U.S.A. as well," she concluded. "And getting the vaccines covered in young women, and men, as a medical benefit could lead to a near eradication of genital warts here as well."

In the United States, the vaccines Gardasil and Cervarix are used to prevent HPV infection and are highly effective, according to the U.S. National Institute of Allergy and Infectious Diseases.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Basil Donovan, M.D., professor and head, sexual health program, the Kirby Institute, University of New South Wales, Sydney; Jocylen Glassberg, M.D., Ob/Gyn, department of obstetrics and gynecology, Scott and White Healthcare, Round Rock, Texas; April 18, 2013, BMJ, online

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Number of U.S. Foodborne Illness Cases Stalled: CDC

More vigilance needed from regulators, industry and consumers, health official says

By Robert Preidt

HealthDay Reporter

THURSDAY, April 18 (HealthDay News) -- Progress in reducing foodborne illness in the United States seems to have stalled, health officials reported Thursday.

"Every year, we estimate that about 48 million of us -- that would be one in six people in the United States -- gets sick from eating contaminated food," said Dr. Robert Tauxe, deputy director of the division of foodborne, waterborne and environmental diseases at the U.S. Centers for Disease Control and Prevention.

In 2012, the nation's food surveillance program identified about 19,500 infections, about 4,500 hospitalizations and 68 deaths, Tauxe said at a noon press conference on the study results. Those numbers are similar to ones reported between 2006 and 2008, the report noted.

The findings appear in the April 19 issue of the Morbidity and Mortality Weekly Report, published by the CDC.

"We see, once again, that salmonella was the most commonly diagnosed and reported cause of infection among those that are tracked," Tauxe said, and while some types have decreased, others are on the rise.

Although the second most common infection, Campylobacter, decreased since the early 1990s, "it's still lower than it was in the 1990s but it has increased by 14 percent since a baseline period of 2006 to 2008," Tauxe said.

While still quite rare, he said Vibrio infections increased 43 percent in 2012, compared with 2006 to 2008.

"Vibrio organisms are found in marine waters where shellfish are harvested and many Vibrio infections are due to eating oysters," he noted. "However, not all are due to oysters and some infections are acquired from contact with marine water causing, for instance, wound infections."

E. coli O157 levels in 2012 were similar to those observed in 2006 to 2008, although in the past "substantial declines were observed following regulatory change and improvement in the food industry that particularly targeted ground beef," Tauxe noted.

"It is still the case now that numbers were lower than they were back in the 1990s," he said. "But right now we're just about where we were in 2006 to 2008, and we may need to identify additional ways to reduce contamination, as well as heightening awareness among consumers about the importance of thoroughly cooking and safely handling ground beef in their own homes."

A general measure that combines sickness from six key pathogens that are usually transmitted by food decreased 22 percent from the late 1990s, but really hasn't changed since 2006 to 2008, he added.

Last year, the highest incidence of foodborne illnesses caused by Cryptosporidium and bacteria other than listeria and Vibrio was among children younger than age 5. The highest incidence of illnesses caused by listeria and Vibrio was among seniors, according to the report.

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Obesity Crisis May Be Fueling Big Jump in Sleep Apnea Cases

Researcher calls troubled sleep an 'uncalculated cost' of America's weight epidemic

By Randy Dotinga

HealthDay Reporter

FRIDAY, May 10 (HealthDay News) -- The widening American waistline may be feeding an epidemic of sleep apnea, potentially robbing millions of people of a good night's rest, a new study suggests.

The research didn't definitively link the rise in obesity to sleep apnea, and it only looked at 1,520 people, almost all white, in Wisconsin. But study author Paul Peppard believes the findings show a big spike in sleep apnea cases over the past two decades -- as much as 55 percent -- and may translate to the entire United States.

"There are probably 4 million to 5 million people who are more likely to have sleep apnea due to the obesity epidemic," estimated Peppard, an assistant professor of population health sciences at the University of Wisconsin-Madison. "It's certainly an uncalculated cost of the obesity epidemic, an epidemic of its own."

The researchers looked at adults aged 30 to 70 who were monitored as they slept. About 600 to 700 underwent sleep tests between 1988 and 1994, with some continuing to take part along with hundreds of new participants from 2007 to 2010.

The study considered the participants to have moderate-to-severe breathing problems if they had trouble breathing 15 or more times an hour while sleeping.

Sleep apnea is the main cause of breathing problems during sleep. People with the condition often have trouble staying in deep sleep because their throats close, blocking their airways and requiring them to partially awaken to start breathing properly. They don't realize they're waking up and may become very sleepy during the day.

Besides sleepiness, sleep apnea can contribute to heart and other health problems if untreated and increase the risk of work- and driving-related accidents, according to the U.S. National Heart, Lung, and Blood Institute.

The researchers extrapolated their findings to the entire United States and estimated that 10 percent of men aged 30 to 49 currently have symptoms of sleep apnea. The study estimates the number is 17 percent of men aged 50 to 70. For women, the estimate is 3 percent among those aged 30 to 49 and 9 percent among women aged 50 to 70.

Among all groups, heavier people were much more likely than thinner people to suffer from the symptoms.

The study estimates that these numbers have gone up by 14 percent to 55 percent from 1988-1994 to 2007-2010. Peppard estimated that 80 percent to 90 percent of the increase in symptoms is due to the growth in obesity.

But it's hard to know for sure how much of a role that obesity plays in causing more symptoms. While obesity is "almost certainly the biggest factor" in causing sleep apnea, Peppard said, "there's long list of things that cause sleep apnea or are related to sleep apnea, like being older, being male, having a narrower upper airway, having a genetic predisposition to it..."

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16 Cases of Kidney Damage in 6 States From Synthetic Pot: CDC

Title: 16 Cases of Kidney Damage in 6 States From Synthetic Pot: CDC
Category: Health News
Created: 2/14/2013 12:36:00 PM
Last Editorial Review: 2/15/2013 12:00:00 AM

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