CDC Advisors Make Recommendations for Use of Vaccine Against Novel H1N1

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) met July 29 to make recommendations for use of vaccine against novel influenza A (H1N1).

The committee met to develop recommendations on who should receive vaccine against novel influenza A (H1N1) when it becomes available, and to determine which groups of the population should be prioritized if the vaccine is initially available in extremely limited quantities.

The committee recommended the vaccination efforts focus on five key populations. Vaccination efforts are designed to help reduce the impact and spread of novel H1N1. The key populations include those who are at higher risk of disease or complications, those who are likely to come in contact with novel H1N1, and those who could infect young infants. When vaccine is first available, the committee recommended that programs and providers try to vaccinate:

pregnant women,
people who live with or care for children younger than 6 months of age,
health care and emergency services personnel,
persons between the ages of 6 months through 24 years of age, and
people from ages 25 through 64 years who are at higher risk for novel H1N1 because of chronic health disorders or compromised immune systems.
The groups listed above total approximately 159 million people in the United States.

The committee does not expect that there will be a shortage of novel H1N1 vaccine, but availability and demand can be unpredictable. There is some possibility that initially the vaccine will be available in limited quantities. In this setting, the committee recommended that the following groups receive the vaccine before others:

pregnant women,
people who live with or care for children younger than 6 months of age,
health care and emergency services personnel with direct patient contact,
children 6 months through 4 years of age, and
children 5 through 18 years of age who have chronic medical conditions.

The committee recognized the need to assess supply and demand issues at the local level. The committee further recommended that once the demand for vaccine for these prioritized groups has been met at the local level, programs and providers should begin vaccinating everyone from ages 25 through 64 years. Current studies indicate the risk for infection among persons age 65 or older is less than the risk for younger age groups. Therefore, as vaccine supply and demand for vaccine among younger age groups is being met, programs and providers should offer vaccination to people over the age of 65.

The committee also stressed that people over the age of 65 receive the seasonal vaccine as soon as it is available. Even if novel H1N1 vaccine is initially only available in limited quantities, supply and availability will continue, so the committee stressed that programs and providers continue to vaccinate unimmunized patients and not keep vaccine in reserve for later administration of the second dose.

The novel H1N1 vaccine is not intended to replace the seasonal flu vaccine. It is intended to be used alongside seasonal flu vaccine to protect people. Seasonal flu and novel H1N1 vaccines may be administered on the same day.

-----
www.georgiafrontpage.com
Georgia Front Page
www.fayettefrontpage.com
Fayette Front Page

CDC Art Show Exhibits 'Consequential Matters'

Too often, art and science are treated as opposing forces considering their subjects in contradictory fashion. An artistic look at something might focus on the warmth it exudes or the emotion it drives, while a scientific look can be a cold, hard assessment of the facts. But sometimes facts aren’t enough to convince and art isn’t sufficient to spur action. Treated together, though, art and science can both persuade us with passionate arguments and increase our understanding of our world.

The Global Health Odyssey Museum at the Centers for Disease Control and Prevention (CDC) in Atlanta is bringing together art and science for a look at our world in the exhibit, Consequential Matters, from June 15 - September 11, 2009. The show consists of the investigations of four Atlanta-based artists of the consequences of urbanization, technology consumption, indulgence and globalization.

"We want to address the audience on an emotional level, an instinctive level,” explained Carl DiSalvo, assistant professor of Digital Media at the Ivan Allen College of Liberal Arts at Georgia Tech. “We asked ourselves, how do we use the skills we have in taking the scientific data and making it more visceral and not hide the emotion and experience that lies behind the data.”

The title of DiSalvo’s and Ph.D. candidate Jonathan Lukens’ exhibit, “Smog is Democratic,” is taken from sociologist Ulrich Beck. The installation looks at particulate matter, the dust and debris that people produce as they wear away at the city, according to the artists. It’s comprised of five pieces in all.

"Particulate matter is not just man-made, it’s evidence of life. Life leaves a residue,” explained DiSalvo.

To illustrate this, their piece “Do you see what I see?” is comprised of 25 images of common sources of particulate matter. The images were all taken in the greater Atlanta area.

"We wanted to give people an idea of where this pollution comes from, so we made a list of sources and photographed what we could find,” said DiSalvo.

In another piece, “Smog Alert Days 2008,” they combined a four-minute video clip of a flyover of I-85 with daily particulate matter measurements of the city of Atlanta.

"We used the data to change the image, so that the image comes to represent the data. Part of the image shows the flyover without any effects. The other half shows an image that gets more distorted as the particulate matter measurement gets higher,” said DiSalvo.

Other pieces in “Smog is Democratic” juxtapose images of Atlanta with data from the smog alert days so that those alert days appear as holes, either in white or gray in the image. One piece compares that image with an image of a home air filter, giving the viewer an idea of the entire scale of the visible spectrum of pollution.

"We’re trying to bring together a scientific approach to the data with an artistic approach, so that we can creatively interpret this data and address the audience on an emotional level,” said DiSalvo.

Another exhibit in the show is “High Tech Trash,” a look at the trade in electronic waste, such as computers, cell phones and hard drives across Asia, Africa, Europe and the United States. The photo essay, by National Geographic photographer Peter Essick, chronicles the workers who mine these discarded products for reusable metals, while exposing themselves to health risks.

"XLounge x 3” by Atlanta sculptor Mark Wentzel has adapted three iconic Eames Lounge Chairs and Ottomans to make a comment on American consumption.

The show can be seen at the CDC’s Global Health Odyssey Museum through September 11 from 9AM to 5PM weekdays and 9AM to 7PM on Thursdays. Admission and parking are free.

-----
www.georgiafrontpage.com
Georgia Front Page
www.fayettefrontpage.com
Fayette Front Page
www.artsacrossgeorgia.com
Arts Across Georgia

Georgia Division of Public Health confirms novel H1N1 cases

The Centers for Disease Control and Prevention Friday awarded validation to the Georgia Public Health Lab (GPHL) to perform novel H1N1 virus confirmatory testing.

This means that the Georgia Public Health Lab has been able to quickly test and confirm all the probable samples in their facility.

"In total Georgia has 25 confirmed cases of novel H1N1 virus. The surge in cases is mainly due to the probables cases now being considered confirmed," said Dr. Sandra Ford, acting director of the Georgia Division of Public Health (GDPH).

Five of the cases were tested out-of-state.

"The Georgia Division of Public Health is actively engaged in the analysis and research on this new virus," said Dr. Ford. "State and federal public health agencies have enough information about this virus to assess its effects on individuals. Now we have started to focus our efforts in testing those who present the most severe cases, such as the hospitalized."

As part of state influenza surveillance system the lab will also test samples submitted by its Influenza Sentinel Providers Surveillance Network, as well as samples sent by private providers to the Public Health Districts.

Respiratory illnesses circulate in Georgia all year round. Current influenza surveillance shows that both seasonal flu virus and the novel H1N1 virus are present in Georgia. Frequent hand washing, covering coughs and sneezes and staying home when ill are the most effective ways to avoid getting sick.

------
www.georgiafrontpage.com
Georgia Front Page
www.fayettefrontpage.com
Fayette Front Page
www.artsacrossgeorgia.com
Arts Across Georgia

CDC Briefing on Investigation of Human Cases of H1N1 Flu

May 6, 2009
1 pm EST

Glen Nowak: Thank you and thank you all for your interest and attendance today, both on the phone and in the room. The media briefing on H1N1 virus will be conducted by Dr. Richard Besser.

Richard Besser: Thanks very much, Glenn. I want to thank you all for being here for today's briefing. This remains a dynamic situation. Each day, we learn a lot more about transmission here and around -- around the world. And I want to say that we remain concerned. I will be giving the number shortly but we are seeing continued spread around the country. We are seeing increase in numbers of cases and I want to make sure that people understand that changes in guidance that take place are based on science, based on what we think are the appropriate measures to maximize people's health. As we learn more, as the science develops and is refined, we are able to tailor those measures more appropriately. Yesterday, we heard in the news at the CDC the death of a woman in Texas. I want to send my sympathies to the woman's family. Any death is bad. This reminds us that influenza can be a very serious infection and it's one that we need to continue to take very seriously. Yesterday, we refined our guidance, we issued new guidance on school closure and day care closure and I want to make sure people know that those guidances are up on the web. This is a good example of how we use science to inform policy and so as we've learned more about the severity of the virus, as we learn more about the severity of infection, as we learn more about transmission, we are going to continue to refine our guidance and that's something that people should expect. We have had some questions from the media about the length of time for school closure and why we had 14 days before and why we are talking now about 7 for children. This plays in, again, to the issue of uncertainty and severity. At a time when we still knew very little, when the reports out of Mexico were of a much higher severity disease than we are currently recognizing, the guidance was saying up to 14 days. The reason for that is one incubation period is about 7 days and so if you're dealing with something that's quite severe, you may see some variability on shedding. You go for safety zone. And there we recommended two incubation periods. As we now see this infection, it is not as severe as we had initially feared, we can cut back on that. And realize that, yes, after 7 days there maybe some children still shedding but they will be shedding less virus and appropriate action after 7 days they can may return to school. Let me give the case number updates. As of 11 a.m. today, we are reporting 1487 probable and confirmed cases in 44 states. That's an increase of around 400 from yesterday there are around 850 probable cases and 642 confirmed cases. The confirmed cases are in 41 states, increase of three states with confirmed cases from yesterday. In terms of the age range the median age for cases is 16 years with a range of 3 months to 81 years. 58% of the cases in the U.S. are under 18 years of age. We have reported a total of two deaths and we have 35 hospitalizations, which are confirmed. Plus 17 hospitalizations that are -- that are probable. The median age of -- for hospitalized patients is 15 years. That's for confirmed hospital case and that's about the same as for cases, in general. The age range for hospitalization is 8 months to 53 years. We have reported hospitalization confirmed cases from 14 states. Looking at underlying disease for the 13 individuals for whom we have that detailed information, seven of them had known conditions that would put them at risk for more severe infection. The world health organization is reporting 1500 cases, roughly 1500 cases in 22 countries, with Canada, Spain and the united Kingdom having the highest counts outside of the U.S. and Mexico. Mexico had been reporting 822 confirmed cases and 29 deaths. We have been talking about what does the epidemic look like in Mexico? We have quite a number of people in Mexico, I will talk about that in a moment. But I think that we need to put in context the idea of is it going away in Mexico? What we hear about in Mexico is what we are seeing and will continue to see here is when you see a large outbreak or an epidemic, it's frequently made up of a series of smaller outbreaks and epidemics, so, what they are seeing in Mexico is parts of the country where they are seeing increases in disease and parts of the country where they are seeing decreases. When you add that all up together it may show some leveling off but it doesn't really give a sense of how dynamic the situation is. Here in the United States, each day we are reporting new states that are seeing disease. And so, we will start to see in those states increases and at some point, we will be starting to see in states decreases. The rapid increases in confirmed cases that I had predicted for today that were reporting is largely due to the ability of more and more states to do testing and so some of the backlog on testing is going to lead to catch up and we are going to continue to see those numbers increase. In addition, we are going to see additional people get sick. I don't want to attribute it all to testing, but in terms of our ability to confirm cases, we are seeing more of that around the country. We are continuing to see virus spread in the United States and around the globe. The majority of the confirmed cases in this country are in younger people. And it's important that people have respect for this virus, because it does cause severe disease, hospitalization and death. We don't know yet about issues of population immunity. What we are seeing, as we talked about in previous days, we are not seeing as much disease in the elderly. This could be due to some underlying protection or it could be due to just the dynamic of it starting with the younger population before it traveled to the elderly. Everything we've seen to date leaves us with the understand that we need to remain vigilant. We cannot let up on this it's important that people understand that there's shared responsibility, that people need to continue to wash their hands, cover their coughs and most importantly, when they are sick, not send their children to school, not go to work when they are sick. Those measures can help reduce the spread in communities and keep people protected. An update on some of the public health actions, the stockpile of -- all states have received their 25% allotment. We are in the process of replenishing some of our stockpiles through purchases. CDC has been actively engaged, over 900 CDC employees are responding to this outbreak that does not include our individuals around the globe who work in laboratory, working with other countries on their surveillance. We have 93 people in the field, including 16 in Mexico, and we have 33 more who are pending deployment. The PCR test kit has been deployed around the country, so all states and Puerto Rico, we have shipped it as well to 16 countries, so this will help with the diagnostic capabilities around the world. And as I said this will also increase the number of cases through testing alone. We continue to work to understand the virus and the illness that it is causing. It's very important that we understand transmission in various population. We are working with Texas and California and we will be tending to investigation team there is to look in particular at the issue of health care worker transmission. We want to see what are the dynamics of transmission, are there certain practices putting people at risk and if so, what can be done to tailor the guidance that we currently are providing in that area? I want to put a little focus today on the issue of pregnancy and disease risk. So far, we are aware of six confirmed and five probable cases of H1N1 infection involving pregnant women. This is not a higher rate than would be expected in the general population. However, pregnancy is a risk factor, a known risk factor for known disease. We want to make sure that clinicians have information on how they should approach the issue of infection in pregnancy and that women who are pregnant have this information as well. So, on our website, we have for pregnant women, fact sheets on what pregnant women should know and guidance for clinicians, if they have a patient who is pregnant, they will understand how anti-virals should be used what, the treatment strategy should be in that circumstance. So, in closing, I want to remind you, we do expect to see more school outbreaks. We do expect to see more clusters around the country. We do expect to see more transmission and we do expect to see disease in all states. We it continue -- continue to be working actively in the area of vaccine development and that is a critical part of strategies moving forward. Seasonal vaccine is in production. We are moving forward on the development process for novel H1N1 vaccine. We are taking those initial steps that are very important and necessary should a vaccine need to be made. There are a lot of decisions that would need to be made between now and people receiving a vaccination and the decisions will be based on the best available science. Lastly, I want to just address the issue of who and levels and as we have discussed before, who levels have to do with the number of factors. One is there sustained transmission of a novel virus? We have met that. For us to move or for W.H.O. to move from a level five or level six, they will look to see is there sustain vaned transmission of this virus in more than one W.H.O. region? They have not confirmed that they just have the same transmission in this world health organization region. With the number of cases in other countries, I would be surprised if we don't get to a level six. But we are not there yet and W.H.O. has not made that move. One of the hallmarks of any virus is they undergo constant change, we are actively looking at the virus in the laboratory. As the flu season starts in the southern hemisphere, what takes place there is going to be incredibly important, how does the virus compete with other viruses that are circulating in the community, does it change, does it mutate? If so, in what way? Does it develop resistance?Those are factors, studies that will be ongoing as we move through that period. When continue here at CDC to give you the information we when know it continue to tell you what we don't know and provide the daily updates as long as necessary for that, let me turn to your questions. Starting here in the room.

Betsy McKay: Thanks, Dr. Besser. I'm from the Wall Street Journal. I have two questions, one about vaccine and one about hospitalization. On the vaccine question is would -- if the virus change, mutates and becomes more virulent, sort of a 1918 pattern, are we able to know right now that a vaccine that you're developing would be protected against the more virulent form? The second about hospitalizations. I'm wondering how a normal a pattern the age group that is hospitalized, how normal that really is for, you know, compared with seasonal flu vaccine, the median age is 16 seems really young.

Richard Besser: Right. The first question, in terms of, you know -- if the virus changes over this period of time, will the vaccine work? That's great question. Each year with seasonal flu, the virus changes and at the time decisions are made as to what strain goes in the vaccine, you don't know what will be here the following season. And so there's a process to pick that each year for seasonal flu. And it involves experts from around the world making their best science-informed decision. But at some point, there will need to be a decision if you're going to go forward, which strain you use. And you don't -- you won't know for sure until you know what's circulating in the following season. But what we're seeing so far during the short period of time is a fair amount of stability in the virus, but what happens in the fall is not known. In terms of the age distribution, you're right. We are seeing the same distribution in hospitalized parents as we are in milder cases in the community. And that's younger than what you would see in seasonal flu. In seasonal flu, you tend to see a predominance of burden to the elderly and the very young. And here, we are seeing it more in younger population. And so, that is something we are keeping our eye on, that is something that raises concerns and it plays into the question of why is that happening? Is it because that's the population that got sick first? The population that may have traveled to Mexico on spring break or is it something else regarding a protection, elderly potentially protected for some reason? Those are things that we are continuing to look at, but that is a great question. Another question here in the room?

Ceci Connolly: Doctor, Ceci Connolly from the Washington Post. You mentioned Mexico. I'm wondering if you can elaborate a little bit more in terms of exactly your teams are doing there, now that we are two weeks or so into this. Are you starting to gather more useful information and you mentioned epiteams going to California and Texas to look at health care workers. Can you elaborate on that? Do you have a particular concern at this point?

Richard Besser: Let me start with Mexico. I'm looking for the numbers, how many people I said down in Mexico. Thank you. Yeah. 16 from Mexico and we are -- we are going to be sending additional people there. There are two -- a number of things we are doing. One is just working on trying to describe the basic epidemiology. That's been so incredible useful over the past five days in helping us understand the issue of severity. When initial reports out of Mexico were of very high rates of hospitalization and death, that was suggesting a very severe virus, a virus that could have devastating consequences. As we've learned more, we've seen that this is a virus that appears to be widespread in the community and that the issue of hospitalization and death was the tip of the iceberg phenomenon. So, that has been very useful, getting laboratory set up is something that Canada, the U.S. and Mexico work on together and that has been very helpful in sorting -- sorting that out to. Looking at spread around the country, Mexican government is putting teams in various states to be able to describe in more detail the epidemiology on the state basis. That is something that we do here and it is very useful, because your decisions on what you're going to implement are most appropriately taken at that state and local level .Different areas will be seeing different things and experiencing the outbreak in a different way. So that's part of the assistance. But some of the new work that's going to be going on there is in the area of health care worker transmission and transmission to contact the cases. This will be very useful in understanding prevention strategies. You know, when you're thinking about risk, who comes in contact with the most individuals who are sick and have flu? Health care workers, people come in when they are sick. And we want to make sure that our guidance is as evidence-based as possible. And if there are opportunities to prevent infections in that setting, we want to know what those are and what works. We have guidance up on the web now, but as I've said, as we gain more information, we will be able to tailor those interim guidance so that they are most effective. So, that's the kind of work that's going to go on in Texas and California and that's what the teams are assisting the Mexican government with as well. Take a question from the phone, please?

Operator: The first from Ann Pistone at ABC. Your line is open.

Ann Pistone: Thank you very much. Doctor, from the experience of the CDC and the public health community has garnered the last few weeks dealing with H1N1, what is the most important changes or enhancements that need to be made to biofence, better prepare for more severe or intentional outbreak?

Richard Besser: Thanks. Biofence is an electronic surveillance system that took place in many places to look at various syndromes, so we can look and see how many people are coming in with flu-like symptoms, see how many people are coming in with a number of different conditions and it's one of the systems that we are currently using to look at visits to hospitals. It's a useful piece of surveillance information. And so, you know, we will -- we will, as we go forward, look to see what pieces of surveillance information were most useful and provided good insight in terms of what was taking place on the ground and what wasn't. I think it is premature for me to comment on any of the particulars, because we haven't done -- we haven't done the look become to say, okay, which pieces of information were critical, critically important to decisionmaking at what point? How can we make sure that we've got a detail understanding of what's going on in various places? Next question from the phone?

Operator: The next is from Robert Lowes, Medscape Medical News. Your line is open.

Robert Lowes: Dr. Besser, the people at W.H.O. have announced they will be looking a at possibility of one starting wholesale or mass production on the H1N1 vaccine as well as possibly halting production of seasonal flu vaccine. That is predicated on how much has been produced of the seasonal flu vaccine. What is your reaction to that? Is it a prudent step? Consider halting seasonal flu vaccine production?

Richard Besser: I missed the first part. Where did you say that was taking place?

Robert Lowes: The officials at W.H.O. announced today they would be convening experts to consider wholesale production of a new implemented virus as well as halting production of seasonal flu vaccine.

Richard Besser: Thanks. The world health organization has an expert committee they convene to address global issues around pandemic flu. That's the body that helps inform them whether it's time to move phases of a pandemic. And that's body that will help inform them as well in terms of the global position on vaccination. And the U.S. government has participation on that committee. I think we have three members on that committee. And so I will be very interested to see what their discussions say and where they come down on vaccine production. Here in the United States, we are pushing forward with production of seasonal flu vaccine and that's moving forward very aggressively. We are also undertaking those steps in the development of an H1N1 vaccine that are necessary to do now, so that's providing the virus strength, growing that up as a stock and once that's grown up, providing that to manufacturers so they could do initial study it is they were to move forward with the vaccine. And so you know, world health organization has a responsibility for developing recommendations for the world and we would definitely welcome and we will be participating in those discussions. Let me take the next question here in the room.

Mike Stobbe: Thanks, from the AP. Two questions, following about hospitalizations and the age, is age appearing to be as great or greater a risk for hospitalization than underlying conditions? And second --

Richard Besser: I wouldn't put too much data on the hospitalization. In terms of condition, that was based on 13 people, there is -- that kind of information, dealing with very small numbers is subject to great change. And given the number of people hospitalized is very small, you run the risk of overinterpretation, the range there is three months from 81 -- eight months to 53 years, so it is a very wide range. You talk about it as a median, middle number of 15 it may signal a little more than you want to interpret there. But looking at hospitalizations and risk by age is really, really important. I mean, as this progresses, I fully expect we are going to see more hospitalized individuals and we are going to continue to look at that factor.

Mike Stobbe: Second question, on underlying conditions, understanding the point you just made about the small number of cases, can you tell us what underlying conditions are recurring in those, I guess, 13, and there's a lot of attention on the death yesterday. Was the pregnancy in that case be an underlying condition or did she have something else that you believe exacerbated the death?

Richard Besser: I don't have any additional information on the woman from Texas. The other patients, it was a wide range. There wasn't something that was popping up as predominant, but there were only seven people with a chronic condition. As we gathered more information on that what we will be looking to see is there a risk factor that is putting people at greater risk? Is it something that we can alert people to that would have protective value? But right now we don't have that information. Thankfully, the number of hospitalized individuals is small. In the room?

Michelle Marsh: Michelle Marsh from CBS Atlanta News. I have two questions. One is how soon do you project a vaccine will be available? And second, various health officials are discussing the possibility of asking people to get three vaccinations by this fall, one for the regular flu and two installments for the H1N1 virus. I just want to get your response to that and whether these a possibility.

Richard Besser: Well, when the vaccine would be available, you know, is difficult to say. That is -- [ inaudible ] making sure that that's going to be available for manufacturers, engaging the discussions with the industry so they understand the virus and understand what studies they are going to need to be undertaking. In terms of a number of doses to put it in perspective, before a vaccine is administered to anybody there is a series of studies that need to be taken under the direction of the NIH and approved by the Food and Drug Administration. They what they are looking at is they need to do studies to determine how much stuff needs to be in the vaccine, how much of an antigen needs to be in the vaccine to stimulate protection and immunity. Then they also need to see, do you get sufficient immunity from one dose? Do you need more than one dose? And with each vaccine, it's different. With different age groups, it's different. And so, it is really early to say how many vaccines someone's going to need till those studies are done. But that's going to be very important information because it will -- the number of doses you need will impact on how many people you will be able to vaccinate. And, you know, hopefully, we will be able to find a vaccine that worked very readily with one dose. Back to the phone?

Operator: Elizabeth Weise with USA Today, your line is open.

Elizabeth Weise: Hi, thanks for taking my call. I actually a question about the number of cases in Illinois, which has jumped and is now the highest in the nation. I know part of that's testing artifact, because they just got their kits over the weekend, but do your folks there have any sense of why Illinois has even more cases than New York at this point?

Richard Besser: No I would have to refer you to the folks in Illinois to understand the testing dynamic. Mayor Bloomberg was here visiting CDC a little while ago and his comment when he was meeting with the media was you want 200 more cases? We will test 200 more people. And so, you may see in different places different approaches and strategies to testing. And so I don't know the specifics on Illinois, but I'd refer to you them on that. But differences you will see by state are have to do with viruses and transmission. Some are going to do have to be much more where they are in ramping up their laboratory testing capability and what they report out. Another from the phone?

Operator: The next question is from Suzanna Hoholik with the Columbus Dispatch, your line is open.

Suzanne Hoholik: I know you keep talking about these test kits and the Ohio authority said they have not received theirs even though a couple of days ago, it was supposed to be on their way. How many are coming and when will they be here?

Richard Besser: Well, I will follow up after this press conference and see what the situation is there the test kits have come out. Some of the states have not been able to fully use them yet because the first five runs need to be validated with our laboratory. And so, we will follow up and see what's going on with Ohio, but I appreciate that information. Next question from the phone?

Operator: The next is from Delthia Rick of Newsday. Your line is open.

Delthia Ricks: Thank you, Dr. Besser. I would like to know rather than a pandemic strain, could this possibly be a newly emergent H1N1 that may compete with or replace the current H1N1 in circulation?

Richard Besser: I think I missed the beginning, whether this H1N1 could replace the current H1N1?

Delthia Ricks: Pandemic strain that is newly emergent but ultimately replace the H1N1 in is circulation? In other words, we may not really be looking a at pandemic strain?

Richard Besser: What we need to look at is what happens in the southern hemisphere, and that is going to be very important. How does the H1N1 compete with other H1N1s and other strains in circulation in the difference between this strain and other H1N1 is that this is a novel strain. That originally -- has many components, has a swine component, it has an avian component, it has a human component and it is a strain to which we feel the population does not have immunity. The other H1N1 that's been circulating is one to which many people probably have some baseline immunity, given that if they were vaccinated last year or they have been exposed to this before. So it's kind of a confusing point. There are different H1N1s. This one here -- this novel strain is one we feel more people would be at risk for and that's why it's different than the one in circulation. Whether it replace it is or not, it will be hard to say but that is what we want to look at coming up. Back to the room.

Michelle Marsh: Just a follow-up to the question that I had before. There's been a lot of concern that by the fall season, this may look like the calm before the storm. Can you speak to that as to what is being done to make sure that when the fall season comes around, things are not -- we are not overwhelmed with even more cases than we are seeing now?

Richard Besser: Thanks. You know, I wish I could predict what we are going to see in the fall because that would make it very easy to make the kinds of decisions we are going to need to make as a nation over the next few months. And we could see a number of things happen. We could see the current strain fizzle out and never come back again. We could see the current strain come back as it currently is or see it mutate and change and come back in a more severe form. What we need to do during this period is really a shared responsibility and that is make sure that we are prepared and that is making sure that we are prepared as a government and as a public health agency and that our laboratories are ready and our epidemiologists are ready and we are ready, should this come back much more -- as a much more severe infection. We need our communities to be ready so that they would know, what would they do if this came back and was really severe and we needed to take measures like closing schools? How would they ensure that children who got school lunch got that at home? We are not going to see problems in terms of nutrition. How do we ensure that parents who want to do the right thing and stay home with their child when they are sick can do that and not lose their jobs? That kind of preparedness efforts over this period of time will really help minimize or reduce the impact, should this come back more severe and will also leave us prepared for any other type of emergency that could come to our community. Okay, last question from the phone and then we will take the last one in the room.

Operator: The next is from David Brown, Washington Post. Your line is open.

David Brown: Yes, thank you. Dr. Besser, does CDC or HHS have any preproduction contracts, standing orders, so to speak, with vaccine manufacturers to buy a pandemic strain vaccine? And I'm not talking about H5N1 which is already bought, but standing orders now? And if it does, how many doses do you have on a standing order and with what companies?

Richard Besser: David, I'm going to have to refer you on that question. Bruce Gellin in the department is the head of the national vaccine program office. And that's the -- that's the office that really coordinates a lot of these efforts and I don't know the answer to that question, but he would be able to address that. Last question in the room?

Mike Stobbe: Thanks. Doctor, just following up on your comment about preparation for the fall. When mayor Bloomberg was here this morning, we asked if he was -- had any special preparations under way for the fall. He said no. What should local communities be doing? Should the health departments be hiring or certain staff be trained in giving vaccinations? What do you they communities should be doing specifically?

Richard Besser: I think just to clarify the mayor's comments, New York has done intensive pandemic plans and so, in terms of doing something special based on this, I think they are doing what everyone's doing, and that is looking at their plans, making sure that they are making the changes to those plans based on this strain and what's circulating and what needs to take place. At the federal government, we are doing that. We are constantly looking to see what have we learned so far what changes do we need to make? As we go forward to the fall, what pieces of information are going to be critical to some of the decisions that need to be made? What do we need to be sure that we are ready? I mean, one of the things that we have done that I already mentioned is already worked to replace some of the stocks of anti-viral and Tamiflu distributed so we will be building those stockpiles back up, so should they be needed, we have them ready. Thank y'all very much. Appreciate it.

-----
Community News You Can Use
Follow on Twitter @GAFrontPage
www.georgiafrontpage.com
Georgia Front Page
www.fayettefrontpage.com
Fayette Front Page
www.artsacrossgeorgia.com
Arts Across Georgia

Statement by HHS Secretary Kathleen Sebelius and Acting CDC Director Dr. Richard Besser Regarding the Change in CDC's School and Childcare Closure

Statement by HHS Secretary Kathleen Sebelius and by Acting CDC Director
Dr. Richard Besser

Since the beginning of this outbreak, the CDC has been working to
update, or in some cases, quickly develop interim guidelines to help
healthcare providers, health departments and communities take effective
action to prevent the spread of this novel H1N1 virus. In doing so, we
acknowledged that our interim guidelines would be based on the data
available at the time, be guided by science, and designed so that
resources and efforts would be directed toward actions and activities
that would make a difference in preventing spread of this virus. If new
information or developments indicated a need to adjust our guidance, we
indicated we would do so.

Today, we are announcing a change with respect to CDC's interim guidance
on closing schools and childcare facilities. The initial guidance CDC
issued on May 1st recommended that affected communities with
laboratory-confirmed cases of influenza A H1N1 consider adopting school
dismissal and childcare closure measures, including closing for up to 14
days depending on the extent and severity of illness. At the onset of
this outbreak of a previously unknown influenza virus, we believed it
could be helpful to close affected schools while we learned more about
the virus's transmission and the severity of disease. Further, the U.S.
national strategy for pandemic influenza suggested that ongoing
community-wide closure of all schools and daycare centers should be
considered in the event of a severe outbreak, especially if these
measures could be implemented early.

As CDC's daily press briefings have illustrated, much has been learned
quickly about the virus's severity and its spread. We now believe that
the disease currently being caused by this novel flu virus is similar to
that typically caused by seasonal influenza. Although many people will
get sick and a small number, unfortunately, may become quite ill or even
die, the available data do not indicate that this virus is causing
unusually severe influenza at this time.

With the modified policy being issued today, CDC no longer recommends
that communities with a laboratory-confirmed case of influenza A H1N1
consider adopting school dismissal or childcare closure measures.
Rather, in line with policies being undertaken in Seattle, New York and
Canada, CDC has modified its policy to recommend implementation of
measures that focus on keeping all student, faculty and staff with
symptoms of influenza out of schools and childcare facilities during
their period of illness and recuperation, when they are potentially
infectious to others.

More specifically, at this time, CDC recommends the primary means to
reduce spread of influenza in schools focus on early identification of
ill students and staff, staying home when ill, and good cough and hand
hygiene etiquette. Students, faculty or staff with influenza-like
illness (fever with a cough or sore throat) should stay home and not
attend school or go into the community except to seek medical care for
at least 7 days even if symptoms resolve sooner. Students, faculty and
staff who appear to have an influenza-like illness at arrival or become
ill during the school day should be isolated promptly in a room separate
from other students and sent home.

It's important to note that schools that were closed based on previous
interim CDC guidance related to this outbreak may reopen. That said,
decisions about school closure are at the discretion of local
authorities based on local considerations, including public concern and
the impact of school absenteeism and staffing shortages.

We appreciate the efforts that communities, particularly school
districts, have taken to protect students and staff from this influenza
A H1N1 virus. Communities and schools are at the forefront of
protecting people's health, and we are committed to providing them the
flexibility they need to deal with local conditions, and the best
possible guidance that reflects our most current understanding of the
scientific and medical facts.

Finally, we should add that there are many individuals in our
communities -- the elderly, the very young, and individuals with
suppressed immune systems -- for whom influenza represents a potentially
lethal threat. The 2009 influenza A H1N1 virus is likely to circulate
widely in our communities; if not now then almost certainly in the fall.
We all have a special responsibility during this time to protect
ourselves and protect our neighbors and others in our community by
behaving responsibly and doing whatever we can to minimize the spread of
disease. A virus that may only cause sniffles and mild inconvenience in
one person may put the next into the hospital.

We have more information on the 2009 H1N1 virus today than we did only
one week ago, but much uncertainty remains. We should all be prepared
for a potentially rocky influenza season this fall. The Administration
and the CDC will continue to actively investigate this outbreak as it
unfolds and protect the health of the American public.

-----
www.georgiafrontpage.com
Georgia Front Page
www.fayettefrontpage.com
Fayette Front Page
www.artsacrossgeorgia.com
Arts Across Georgia
www.politicalpotluck.com
Political News You Can Use
Follow us on Twitter and Facebook

CDC: 109 Confirmed Cases of H1N1 Flu

GFP Note: The CDC released this information before the one case in Georgia was confirmed. The total may now be adjusted to 110. According to the Georgia hospital where the 30 year old female is, she is in isolation and has just returned from a trip to Cancun.

In response to an intensifying outbreak in the

U.S. Human Cases of Swine Flu Infection
(As of April 30, 2009, 10:30 AM ET)

States	# of laboratory confirmed cases	Deaths
Arizona	1
California	14
Indiana	1
Kansas	2
Massachusetts	2
Michigan	1
Nevada	1
New York	50
Ohio	1
South Carolina	10
Texas	26	1
TOTAL COUNTS	109 cases	1 death

United States and internationally caused by a new influenza virus of swine origin, the World Health Organization raised the worldwide pandemic alert level to Phase 5External Web Site Policy. on April 29, 2009. A Phase 5 alert is a “strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.”

The United States Government has declared a public health emergency in the United States. CDC’s response goals are to reduce transmission and illness severity, and provide information to help health care providers, public health officials and the public address the challenges posed by this emergency. CDC is issuing and updating interim guidance daily in response to the rapidly evolving situation. CDC’s Division of the Strategic National Stockpile (SNS) continues to send antiviral drugs, personal protective equipment, and respiratory protection devices to all 50 states and U.S. territories to help them respond to the outbreak. The swine influenza A (H1N1) virus is susceptible to the prescription antiviral drugs oseltamivir and zanamivir. In addition, the Federal Government and manufacturers have begun the process of developing a vaccine against this new virus.

-----
Community News You Can Use
www.georgiafrontpage.com
Georgia Front Page
www.fayettefrontpage.com
Fayette Front Page
Follow on Twitter and Facebook

Governor Perdue Signs House Bill 217 for Access to Flu Vaccine

Governor Sonny Perdue yesterday signed House Bill 217, the “Access to Flu Vaccines Act,” which permits pharmacists and nurses to order and dispense flu shots pursuant to a protocol agreement with a physician. The bill also grants the Governor broader emergency powers if a pandemic influenza is declared by the World Health Organization or the Centers for Disease Control.

“The flu affects thousands of people each year and our citizens should be able to access flu vaccines to protect themselves and their families,” said Governor Perdue. “This legislation makes it easier for Georgians to receive flu shots and allows the state to respond quickly and effectively to any flu outbreak.”

The bill was introduced in January by State Rep. Jimmy Pruett, one of the Governor’s floor leaders in the House. The bill was intended to clarify the ability of pharmacists and nurses to dispense flu shots without individual prescriptions. Last fall, the Composite Board of Medical Examiners, in consultation with the Attorney General’s office, determined the flu shot to be a “dangerous drug” and therefore each person seeking a vaccination would need an individual prescription.

The “Access to Flu Vaccines Act” returns the state to the past practices of more than a decade, allowing physicians to enter into protocol agreements with pharmacists and registered nurses to allow the ordering and dispensing of flu shots without a physician’s individual prescription. To ensure quality control, physicians may issue no more than 10 standing orders with pharmacists and nurses within the same county or adjacent county to the physician’s primary place of business. Corporations with more than one location are also included in this agreement. This includes grocery stores and drug stores.

HB 217 ensures hospitals have the explicit authority to offer its staff or patient any vaccination, test or prophylactic matter required or recommended by the CDC.

The bill also includes an emergency powers provision that allows the Governor to declare a “pandemic influenza” state of emergency if the WHO declares a Phase 5 Pandemic Alert for influenza in the United States and/or Georgia or the CDC declares at least a Category 2 Pandemic Severity index for influenza in the United States or Georgia.

-----
Community News You Can Use
www.georgiafrontpage.com
Georgia Front Page
www.fayettefrontpage.com
Fayette Front Page
Twitter @GAFrontPage

CDC April 28 Update on Confirmed Swine Flu Numbers

To date, there are no confirmed cases of swine flu in Georgia. All residents are reminded to wash hands often and stay away from those who are ill.

U.S. Human Cases of Swine Flu Infection
(As of April 28, 2009 11:00 AM ET)

State # of laboratory
confirmed cases

California 10 cases
Kansas 2 cases
New York City 45 cases
Ohio 1 case
Texas 6 cases
TOTAL COUNT 64 cases

-----
www.georgiafrontpage.com
Georgia Front Page
www.fayettefrontpage.com
Fayette Front Page
Follow us on Twitter and Facebook

Less Than a Year After CDC Announced the U.S. HIV Epidemic Is Much Larger Than Previously Thought, Public's Sense of Urgency Is Down

Less Than a Year After CDC Announced the U.S. HIV Epidemic Is Much Larger Than Previously Thought, Public's Sense of Urgency Is Down, Even Among Some Higher Risk Groups


/PRNewswire/ -- Less than a year after the Centers for Disease Control and Prevention (CDC) recalculated the size of the HIV/AIDS epidemic and announced that there were 40 percent more new HIV infections each year than previously believed, a new survey by the Kaiser Family Foundation finds that Americans' sense of urgency about HIV/AIDS as a national health problem has fallen dramatically and their concern about HIV as a personal risk has also declined, even among some groups at higher risk.

Key findings of the survey include:

-- The share of Americans naming HIV/AIDS as the most urgent health
problem facing the nation dropped precipitously from 44 percent in
1995 to 17 percent in 2006 and to six percent now.
-- CDC estimates that HIV rates are seven times higher among African
Americans and three times higher among Latinos compared to whites.
While these groups are more likely than whites to see HIV/AIDS as an
urgent problem, fewer say it is a "more urgent" problem for their
community now than in 2006 (declining from 23% to 17% of all adults,
49% to 40% of African Americans, and 46% to 35% of Latinos).
-- The share of those ages 18-29 who say they are personally very
concerned about becoming infected with HIV declined from 30 percent in
1997 to 17 percent today; personal concern among young African
Americans declined from 54 percent to 40 percent over the same time
period.
-- More than half (53%) of non-elderly adults say they have been tested
for HIV, including 19 percent who say they were tested in the past
year. Testing is most common among adults under the age of 30, with
three in ten young adults and nearly half (47%) of young African
Americans reporting having been tested in the past year. However,
reported testing rates for all these groups have not changed much in
the past decade.


"Many indicators of urgency and concern are moving in the wrong direction, including for higher risk groups," said Kaiser President and CEO Drew Altman. "The survey underscores the need for a new focus on domestic HIV," he added.

At a time when there have been calls for increased attention to the domestic HIV/AIDS crisis including the recent Obama administration announcement of the five year public awareness campaign, Act Against AIDS, the survey also finds public support for more spending.

Half of the public thinks that the federal government is spending too little on domestic HIV/AIDS, while just five percent say it spends too much. More than a third (36%) of Americans say they have personally donated money to an HIV/AIDS-related charity, including nearly half (45%) of African Americans, and there is confidence that new efforts in prevention will make a difference.

While down somewhat from 2006, public support for continued or increased government spending on HIV/AIDS is notable considering the current economic recession and a decline in reported visibility of the domestic epidemic. The share saying they have heard, seen, or read "a lot" or "some" about the problem of HIV/AIDS in the U.S. in the past year declined from 70 percent in 2004 to 45 percent in 2009, and the share that saw "a lot" was cut in half for not only the general public, but also among African Americans and Latinos.

Despite a polarizing debate in recent years about such issues as abstinence and condoms, six in ten Americans believe that spending more money on HIV prevention in the U.S. will lead to meaningful progress, and about half believe the same about spending on treatment.

Some Signs of Progress, But Misconceptions And Stigma Remain

The survey indicates some signs that HIV/AIDS in the U.S. may carry less stigma than in the past. For instance, there has been a slow and steady increase since the late 1990s in the share of people who say they would be very comfortable with a coworker who has HIV/AIDS (44% now, up from 32% in 1997). However, stigmatizing attitudes towards people with HIV have not gone away; fully half (51%) of the public says they would be uncomfortable having their food prepared by someone who is HIV positive.

Misconceptions may be a factor in stigma, and several remain when it comes to correct information about HIV transmission. One-third (34%) of Americans incorrectly believe or are unsure whether HIV can be transmitted by one of the following actions: sharing a drinking glass (27%), touching a toilet seat (17%), or swimming in a pool with an HIV positive person (14%).

Confusion about HIV transmission may contribute to discomfort around those who are HIV positive. People who harbor misconceptions about transmission are more likely to say they would be uncomfortable working with someone with HIV (43% versus 13% who correctly answered questions about transmission) and more likely to be uncomfortable having their food prepared by an HIV positive person (71% compared to 40%).

A significant share of the public also harbors misconceptions about prevention and treatment of HIV/AIDS. Nearly one in five (18%) do not know there is no cure for AIDS and about one-quarter (27%) believe or are unsure whether former professional basketball player Magic Johnson has been cured of AIDS. Additionally, a quarter (24%) believe or are unsure whether there is a vaccine available to prevent HIV infection. Many of these misconceptions are more common in the African American community, including that Magic Johnson has been cured (37% of African Americans think he has been cured or are unsure), that there is a vaccine available to prevent infection (36%), and that there are drugs available that can cure HIV and AIDS (30%).

Methodology

The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted January 26 through March 8, 2009, among a nationally representative random sample of 2,554 adults ages 18 and older. Telephone interviews conducted by landline (N=1,951) and cell phone (N=603, including 214 who had no landline telephone) were carried out in English and Spanish. The survey includes oversamples of African American and Latino respondents as well as respondents ages 18-29. Results for all groups have been weighted to reflect their actual distribution in the nation. The margin of sampling error for the overall survey is plus or minus 3 percentage points, for whites it is plus or minus 4 percentage points, for African Americans it is plus or minus 5 percentage points, and for Latinos it is plus or minus 6 percentage points. For results based on other subgroups, the margin of sampling error may be higher.

-----
www.georgiafrontpage.com
Georgia Front Page
www.fayettefrontpage.com
Fayette Front Page
Follow us on Twitter: @GAFrontPage

CDC Reports Progress in Foodborne Illness Prevention has Reached a Plateau

The incidence of the most common foodborne illnesses has changed very little over the past three years, according to a 10-state report released last week by the Centers for Disease Control and Prevention.

The findings are from 2008 data reported by the Foodborne Diseases Active Surveillance Network (FoodNet), a collaborative project of CDC, U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS), U.S. Food and Drug Administration, and 10 state sites.

FoodNet monitors foodborne disease and conducts related epidemiologic studies to help health officials better understand the epidemiology of these infections in the United States. Each year, the current data is compared to the previous three years and the period from 1996 to 1998, the first three years of surveillance. The FoodNet population is similar to the U.S. population and therefore provides reliable information on the incidence and trends of foodborne illness in the United States.

Campylobacter, Cryptosporidium, Listeria, Shiga toxin-producing Escherichia coli (STEC) O157, Salmonella, Shigella, Vibrio, and Yersinia did not change significantly when compared to the previous three years (2005-2007), the latest data showed. Although there have been significant declines in the incidence of some foodborne infections since surveillance began in 1996, these declines all occurred before 2004. The incidence of Salmonella infections has remained between 14 and 16 cases per 100,000 persons since the first years of surveillance.

“This year’s report confirms a very important concern, especially with two high-profile Salmonella outbreaks in the last year,’’ said Robert Tauxe, M.D., M.P.H, deputy director of CDC’s Division of Foodborne, Bacterial and Mycotic Diseases. “We recognize that we have reached a plateau in the prevention of foodborne disease and there must be new efforts to develop and evaluate food safety practices from the farm to the table. The foodborne division at CDC is planning to increase the capacity of several health departments so that outbreaks can be better detected and investigated.”

The USDA’s Salmonella Initiative Program, which began in 2006, has already significantly reduced the presence of Salmonellain raw meat and poultry products, according to David Goldman, M.D., M.P.H., assistant administrator of USDA’s Food Safety Inspection Service. “We have worked hard to reduce contamination in FSIS-regulated products and have seen marked success in Salmonella and Listeria monocytogenes. We are concerned about the lack of progress in reducing the incidence of foodborne illness and believe this report points to the need for better information about sources of infection.”

The FDA is using new tools to help predict potential threats to foods and the best options for prevention to meet the many challenges of an increasingly complex food-supply chain, according to David Acheson, M.D., associate commissioner for foods. “The FDA is embarking on an aggressive and proactive approach in protecting and enforcing the safety of the U.S. food supply. The Agency is committed to make the necessary changes to keep unsafe products out of the marketplace before they reach consumers.”

Consumers can reduce their risk for foodborne illness by following safe food-handling and preparation recommendations and by avoiding consumption of unpasteurized milk, raw or undercooked oysters, or other raw or undercooked foods of animal origin such as eggs, ground beef, and poultry. Risk also can be decreased by choosing pasteurized eggs, high pressure-treated oysters, and irradiated produce. Everyone should wash hands before and after contact with raw meat, raw foods derived from animal products, and animals and their environments. More detailed information on food safety practices is available at www.foodsafety.gov and www.fightbac.org.

The full report, “Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly Through Food -- 10 States, United States, 2008” appears in this week′s Morbidity and Mortality Weekly Report (April 10, 2008) and is available online at www.cdc.gov/mmwr. To learn more about FoodNet, please visit www.cdc.gov/foodnet/. To learn more about foodborne infections, visit www.cdc.gov/ncidod/dbmd/diseaseinfo/foodborneinfections_g.htm.

-----
www.georgiafrontpage.com
Georgia Front Page
www.fayettefrontpage.com
Fayette Front Page
Follow us on Twitter and Facebook

Georgia Deptartment of Human Resources Launches Online Health/Wellness Resource in Eight Counties‏

The Georgia Department of Human Resources (DHR) Division of Public Health (DPH), in association with Longitude Health, announced today an innovative program, MyHealthVillage, to help identify and reduce the major risk factors for chronic conditions. The program will focus on improving cardiovascular health including issues associated with cardiovascular disease, diabetes and obesity.

MyHealthVillage is being introduced throughout the state of Georgia. With funding from the Centers for Disease Control and Prevention (CDC), the program is a holistic approach — addressing the whole person and the whole population — and improves health and wellness by recognizing how cardiovascular disease, diabetes and obesity are interrelated and share a common set of modifiable risk factors.

“Georgia faces a high prevalence of cardiovascular disease, diabetes and obesity. When these conditions are combined they reduce our citizens’ quality of life, hurt the productivity of our workers and raise healthcare expenses for our employers,” said Dr. Sandra Elizabeth Ford, acting director of the Division of Public Health. “This program provides a proven prevention, wellness and disease management service that will help individuals assess and manage their health risk factors including how they eat, exercise and manage tobacco, alcohol and stress. As a result, we hope to see improved health and productivity among participants.”

The innovative healthcare program includes:

· Longitude Health’s MyHealthVillage.com Health Assessment - A comprehensive health risk assessment questionnaire delivered online or on paper.

· Onsite biomedical screening for additional health risk factors.

· One-to-one health guidance on understanding the Health Assessment and reducing risk factors with Longitude Health Healthguides, who are trained, allied health professionals.

· Access to online health tools and workplace-delivered resources including proprietary Longitude Health content and the American Heart Association’s Search Your Heart Curriculum.

· MyHealthVillage.com incentives and communications resources to encourage and reward maximum participation in the program as well as coordinate with DHR Division of Public Health’s promotion activities.

Once an employer enrolls in the program, employees and their spouses can participate with no out of pocket cost to either the employer or the participants. The MyHealthVillage program is free to selected worksites through an application process with the DHR Division of Public Health’s Office of Health Behaviors (http://health.state.ga.us/programs/healthpromo/index.asp).

“Our mission is to prevent unnecessary death, disease and disability by providing carefully planned and appropriately implemented health promotion, disease prevention and care activities,” said B.J. Walker, Commissioner of the Department of Human Resources. “We are excited to be able to provide our citizens with a comprehensive health solution that easily adapts to Georgia’s varying communities.”

“Over the years, Georgia has been working actively to support worksite wellness and promote healthy behaviors. We are thrilled to be included in this effort and we look forward to introducing Longitude Health’s resources,” concluded Dr. Jan Swaney, Founder and CMO of Longitude Health.

-----
www.georgiafrontpage.com
Georgia Front Page
www.fayettefrontpage.com
Fayette Front Page
Follow us on Twitter: @GAFrontPage

Emory Receives $14 Million Gates Foundation Grant to Reduce Tobacco Use in China

Emory University has received a $14 million, five-year grant from The Bill & Melinda Gates Foundation to help reduce the burden of tobacco use in China. The Emory Global Health Institute, in collaboration with the Tobacco Technical Assistance Consortium (TTAC) of Emory’s Rollins School of Public Health, will establish the Emory Global Health Institute – China Tobacco Partnership.

The Emory Global Health Institute will manage the partnership, which will collaborate with public health leaders in China to promote evidence-based approaches to reducing tobacco use that are tailored to the culture and circumstances of individual cities and provinces in China. The Emory Global Health Institute will also provide funding and support to establish national tobacco control resource centers in China.

"This grant will allow Emory to combine its significant public health expertise with that of health and government leaders in China to address a major international public health challenge," says Fred Sanfilippo, MD, PhD, Emory executive vice president for health affairs.

"Tobacco is the largest cause of preventable deaths globally and China has the most smokers in the world. There is a huge opportunity in this project to have a major impact on global health," says Jeffrey Koplan, MD, MPH, Emory vice president for global health and director of the Emory Global Health Institute.

Koplan will serve as principal investigator of the grant and will lead the partnership along with Pamela Redmon, MPH, executive director of TTAC, a nationally recognized tobacco control leader and technical assistance provider in the United States.

Co-principal investigators for the partnership will be Kathy Miner, PhD, MPH, associate dean of applied public health at Emory’s Rollins School of Public Health and principal investigator of TTAC and Michael Eriksen, ScD, a noted expert in national and global tobacco control efforts and director of the Institute of Public Health at Georgia State University.

Nearly two-thirds of the world's smokers live in 10 countries, with China having the highest tobacco use prevalence by far, according to the World Health Organization (WHO, 2008). Also according to WHO (2003), there are more smokers in China than there are people living in the United States. In China, two-thirds of men are smokers, and it is estimated that 100 million tobacco-related deaths will occur among people currently age 0-29 if tobacco prevention and control efforts are not implemented (Leming, et. al, Health VII Project, 2004).

Not only does China have the largest population of smokers, it also is the chief producer of tobacco products in the world. The national tobacco monopoly is the leading manufacturer and seller of cigarettes, earning billions in tobacco profits and excise tax revenues (WHO, 2003).

According to research reported recently in the New England Journal of Medicine (Gu, et. al, Jan. 8, 2009), tobacco smoking was responsible for about 673,000 premature deaths in Chinese adults age 40 or older in 2005.

The Emory Global Health Institute – China Tobacco Partnership will support the development of effective, accountable and sustainable tobacco prevention and control initiatives that address China’s unique needs and challenges. The program will be able to quickly and efficiently identify and mobilize global resources to assist China in reducing tobacco use.

The Emory Global Health Institute was established to advance Emory University’s efforts to improve health around the world through the creation of innovative global health programs. The TTAC, a trusted partner and collaborator with national tobacco control organizations, has developed and delivered training and assistance to all 50 states and the U.S. territories.

The Emory Global Health Institute – China Tobacco Partnership will coordinate and collaborate with the American Cancer Society (ACS) and the Centers for Disease Control and Prevention (CCD) Office on Smoking and Health. The program's advisory board will include representatives from Emory, Georgia State, ACS and CDC.

-----
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page

Peanut Corporation of America Announces Voluntary Nationwide Recall of Peanut Butter

Peanut Corporation of America (PCA), a peanut processing company and maker of peanut butter for bulk distribution to institutions, food service industries, and private label food companies, today announced a voluntary recall of peanut butter produced in its Blakely, Georgia processing facility because it has the potential to be contaminated with Salmonella.

All product affected was produced on or after July 1, 2008, specific to the lot numbers and descriptions listed below.

The peanut butter being recalled is sold by PCA in bulk packaging to distributors for institutional and food service industry use. It is also sold under the brand name Parnell’s Pride to those same industries. Additionally, it is sold by the King Nut Company under the label King Nut. PCA customers who received the recalled product are being notified by telephone and in writing.

None of the peanut butter being recalled is sold directly to consumers through retail stores.

“We deeply regret that this has happened,” said Stewart Parnell, owner and president of PCA. “Out of an abundance of caution, we are voluntarily withdrawing this product and contacting our customers. We are taking these actions with the safety of our consumers as our first priority.”

PCA initiated this recall after an open container of King Nut brand peanut butter in a long-term care facility in Minnesota was found to contain a strain of salmonella. King Nut brand peanut butter is produced by PCA.

According to the Minnesota Department of Health and Minnesota Department of Agriculture, the Minnesota laboratory analyses on the contamination in the already-opened container of peanut butter have the same genetic fingerprint as the cases in the national outbreak that has sickened almost 400 people in 42 states.

The voluntary recall of 21 lots of its peanut butter, in containers ranging from five to 50 pounds, is being taken immediately. PCA is notifying its institutional customers and has set up a toll-free hotline number 1-877-564-7080 to answer questions.

PCA is continuing to work closely and cooperating with the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC), as well as state officials as part of this ongoing investigation.

According to a CDC update issued on their website today (January 13, 2009), preliminary analysis of an epidemiologic study conducted by CDC and public health officials has suggested peanut butter as a likely source. The CDC and other public health officials are continuing to conduct surveillance for cases of infection with the outbreak strains, and to gather and analyze data or exposures that may be associated with illness. To date, no association has been found with common brand names of peanut butter sold in grocery stores.

Customers are asked to take all peanut butter manufactured with the lot numbers listed below out of distribution immediately. Customers can call the following toll-free 24-hour number 1-877-564-7080 for further instructions on what to do with the product or visit the company website at www.peanutcorp.com for additional information.

Eating food contaminated with Salmonella can result in abdominal cramping, diarrhea, and fever. Most people infected with Salmonella develop the symptoms 12 to 72 hours after infection. The illness usually lasts 4 to 7 days, and most people recover without treatment. However, in some persons, the diarrhea may be so severe that the patient needs to be hospitalized. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses. For more information on the salmonella bacteria, please visit the Centers for Disease Control and Prevention’s Website at http://www.cdc.gov.

Lot Numbers Affected:

8193, 8194, 8197, 8233, 8234, 8235, 8241, 8255, 8256, 8275, 8276, 8282, 8283, 8284, 8296, 8316, 8330, 8331, 8336, 8345, 8354

Stock Numbers Descriptions Pack Size Affected

551000 Creamy Stabilized Peanut Butter 6 ct / 5 lb

551006 Crunchy Stabilized Peanut Butter 6 ct / 5 lb

551020 Creamy Stabilized Peanut Butter 35 lb

551022 Natural Course Peanut Paste 35 lb

551025 Old Fashioned Creamy Peanut Butter with 1% Salt 35 lb

551035 Crunchy Natural Peanut Butter 35 lb

551040 Creamy Natural Peanut Butter 35 lb

551050 Creamy Stabilized Peanut Butter 50 lb

551050-D Dark Creamy Stabilized Peanut Butter 50 lb

551051 Creamy Stabilized Peanut Butter with Monodiglyceride 50 lb

551053 Crunchy Stabilized Peanut Butter 50 lb

551072 Peanut Butter Variegate 45 lb

-----
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page

CDC Statement on Oseltamivir (Tamiflu®) Resistance and Antiviral Recommendations

On December 19, 2008, CDC issued interim guidance for health care professionals on the use of influenza antiviral medications this flu season. The guidance was issued in response to early data from a limited number of states indicating that a high proportion of influenza A (H1N1) viruses are resistant to the influenza antiviral medication oseltamivir (Tamiflu®). Worldwide, the proportion of H1N1 viruses that are resistant to oseltamivir has been increasing so this development is not surprising....More

-----
www.georgiafrontpage.com
Georgia Front Page
www.fayettefrontpage.com
Fayette Front Page

CDC Study: Failures to Follow Infection Practices Have Placed More than 60,000 Patients at Risk for Hepatitis B and C

In the last decade, more than 60,000 patients in the United States were asked to get tested for hepatitis B virus (HBV) and hepatitis C virus (HCV) because health care personnel in settings outside hospitals failed to follow basic infection control practices, according to a new study by the CDC.

This first full review of all the CDC investigations over the past 10 years of healthcare-associated viral hepatitis outbreaks appears in the January 6th issue of the journal Annals of Internal Medicine.

"This report is a wake-up call," said Dr. John Ward, director of CDC's Division of Viral Hepatitis. "Thousands of patients are needlessly exposed to viral hepatitis and other preventable diseases in the very places where they should feel protected. No patient should go to their doctor for health care only to leave with a life-threatening disease."

In the United States, transmission of HBV and HCV while receiving health care has been considered uncommon. However, a review of CDC outbreak information revealed a total of 33 identified outbreaks outside of hospitals in 15 states, during the past decade: 12 in outpatient clinics, six in hemodialysis centers and 15 in long-term care facilities, resulting in 450 people acquiring HBV or HCV infection.

Patients were exposed to these potentially deadly diseases because health care personnel failed to follow basic infection control procedures and aseptic technique in injection safety. Reuse of syringes and blood-contamination of medications, equipment and devices were identified as common factors in these outbreaks.

"More and more patients in the United States receive their health care in outpatient settings," said Dr. Denise Cardo, director of CDC's Division of Healthcare Quality Promotion. "To protect patients, infection control training, professional oversight, licensing, innovative engineering controls and public awareness are needed in these health care settings."

CDC officials say the report shows the need for ongoing professional education for health care providers, as well as consistent state oversight in detecting and preventing the transmission of bloodborne pathogens in health care settings.

CDC assists local health departments by providing routine surveillance, outbreak investigation support, field personnel and lab expertise. CDC also works with key partners to ensure adherence to proper infection control practices.

CDC and its partners are working to address this important patient safety problem through a number of efforts, including:

-- Improving viral hepatitis surveillance, case investigation and
outbreak response, such as support for health departments to
thoroughly investigate all individuals identified to have HBV or HCV
infection;
-- Strengthening the capacity of state and local viral hepatitis
prevention programs;
-- Augmenting the CDC's National Healthcare Safety Network, the national
surveillance system for tracking health care-associated infections, to
collect outpatient setting information;
-- Partnering with the Hepatitis Outbreaks' National Organization for
Reform (HONOReform), a patient advocacy foundation, to create patient
and provider education materials;
-- Continued improvement of injection safety practices through
educational outreach efforts with professional nursing and
anesthesiology organizations;
-- Working with partners in the dialysis, diabetes and long-term care
communities to promote safe care practices;
-- Working with regulators and professional societies to strengthen
licensure and accreditation processes with emphasis on safe injection
practices;
-- Exploring ways to improve curricula in nursing and medical schools
related to safe health care practices.

-----
www.georgiafrontpage.com
Georgia Front Page
www.fayettefrontpage.com
Fayette Front Page
Community News You Can Use
Fayetteville, Peachtree City, Tyrone

New CDC Report Finds Motor Vehicles and Falls are Causes of Most Child and Teen Injuries and Deaths in the United States

An estimated 55 million children and teens from birth to age 19 were treated in emergency departments for unintentional injuries from 2001 to 2006, according to a new report released today by the Centers for Disease Control and Prevention (CDC).

The report also notes that between 2000 and 2005, unintentional injuries resulted in 73,052 deaths among children and teens. Falls caused most non-fatal injuries (about 2.8 million each year), while most deaths were transportation-related (about 8,000 deaths each year involved a motor vehicle occupant, pedestrian or pedal cyclist).

According to the report, every year, an estimated 9.2 million children visited emergency departments for unintentional injuries. Falls were associated with over half of the nonfatal injuries involving children less than one year, while transportation-related injuries and deaths were highest among children 15 to 19 years of age. Overall, males were almost twice as likely to die as a result of unintentional injuries than females.

To help parents and other adults prevent child injuries, CDC is also launching the "Protect the Ones You Love" initiative. More about this initiative can be found at www.cdc.gov/safechild.

"Injury risks change as our children grow and we want them to be appropriately protected as they develop," said Dr. Ileana Arias, Director of CDC's Injury Center. "We encourage parents to be vigilant and to understand that there are proven ways to help reduce injuries at each life stage."

Other notable findings in the CDC report include:

-- The highest fatality rates were among occupants of motor vehicles;
-- Drowning was the leading cause of unintentional injury death for
children ages one to four. For those ages 5 to 19, most injury deaths
were due to being an occupant in a motor vehicle crash; and
-- Children ages one to four also had the highest nonfatal injury rates
due to poisoning and falls.

-----
www.georgiafrontpage.com
Georgia Front Page
www.fayettefrontpage.com
Fayette Front Page

Georgia Tech and CDC Work to Improve Safety of Blood Supply

The Georgia Tech College of Computing, working in partnership with the Centers for Disease Control and Prevention, has developed a Web-based tool for tracking blood safety. The tool is expected to help developing countries improve the adequacy and safety of their national blood supplies through better monitoring and evaluation.

The tool, which is accessed through a standard Web browser, tracks about 80 blood safety indicators continuously at the hospital and provincial levels. A pilot test in Zambia showed that the tool could improve the timeliness and accuracy of data collection efforts, allowing blood safety officials to better forecast or predict regional and seasonal blood usage patterns.

“A simple, scalable, Web-based tool like this can make a tremendous difference in public health around the world,” said Santosh Vempala, distinguished professor in the College of Computing’s School of Computer Science and faculty leader for the project. “The Zambian health officials immediately saw the benefits of real-time data collection and the ability to compare different regions’ needs and see trends over time.”

The project started when John Pitman, public health advisor in CDC’s Global AIDS Program, met Vempala and explained the challenges involved in ensuring global blood safety. Their vision of a web-based tracking system was taken up in 2008 by students in the College of Computing’s Computing for Good class, co-taught by Vempala. Using information about current conditions and future demands within the target countries, the Georgia Tech team, computer science Ph.D. students Adebola Osuntogun and Stephen Thomas, built a Web-based system that resource-limited countries of any size could use to report data to national authorities. The system could also be used by a global organization, like CDC, to monitor multiple projects.

The Georgia Tech team developed the new Web-based tool from a Microsoft Excel version created by CDC. The team field-tested the Web-based tool in Zambia in July-August 2008 to obtain feedback from blood safety program staff.

“I was impressed by the team’s ability to adapt to the computing environment in Zambia, and to make the changes necessary to ensure this would be an appropriate solution for developing countries,” Pitman said. “Including staff from the Zambian national blood transfusion service in the development process was essential to be sure it fit their needs.”

Ministries of health in Botswana, Cote d’Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda and Zambia will begin using the new tracking system on January 1, 2009. All 14 countries are recipients of U.S. financial support through the President’s Emergency Plan for AIDS Relief (PEPFAR).

Georgia Tech’s Computing for Good class gives students the opportunity to understand how computing can be used to improve the human condition, according to Vempala. “Projects such as this collaboration with the CDC present computer science as a cutting-edge technological discipline that empowers our students to solve problems and make a positive impact on society.”

-----
www.fayettefrontpage.com
Fayette Front Page
www.georgiafrontpage.com
Georgia Front Page

New CDC Study Finds Community Physical Activity Programs Are Money Well Spent

Community-based physical activity interventions designed to promote more active lifestyles among adults are cost-effective in reducing heart disease, stroke, colorectal and breast cancers, and type 2 diabetes, according to a study by the Centers for Disease Control and Prevention, with support from the Robert Wood Johnson Foundation.

Using a rigorous economic model developed to assess the cost-effectiveness of community-based physical activity interventions, the study found these interventions to be cost-effective; reducing new cases of many chronic diseases and improving quality of life.

Researchers found that community-based physical activity programs appeared to reduce new cases of disease by: 5-15 cases per 100,000 people for colon cancer; 15-58 cases per 100,000 for breast cancer; 59-207 cases per 100,000 for type 2 diabetes; and 140-476 cases per 100,000 for heart disease.

Community-based physical activity interventions broadly fall under the following strategies:

-- Community campaigns such as mass communication efforts (TV/radio,
newspapers, billboards, advertisements).
-- Social support networks such as exercise groups to encourage behavior
change.
-- Tailored behavior change to encourage people to set physical activity
goals and monitor their individual progress.
-- Enhanced access to services that support active lifestyles such as
fitness centers, bike paths and walking trails.


"Our study found that public health strategies that promote physical activity are cost effective, and compared with other well-accepted prevention strategies, such as treatment for high cholesterol or motor vehicle air bags, offer good value for the money spent," said Larissa Roux, M.D., Ph.D., lead author of the study.

The study, "Cost Effectiveness of Community-Based Physical Activity Intervention," is being published in the online version of the American Journal of Preventive Medicine.

"This study supports the value and effectiveness of the physical activity interventions that were studied," said William Dietz, M.D., Ph.D., director of CDC's Division of Nutrition, Physical Activity and Obesity. "This study also shows the importance of the new physical activity guidelines put forth last month by the U.S. Department of Health and Human Services."

The HHS guidelines recommend:
-- Two and a half hours each week of moderate-intensity aerobic activity,
such as brisk walking or,
-- An hour and 15 minutes each week of vigorous-intensity aerobic
activity such as jogging or running.


In addition, all adults should include muscle strengthening activities that work all the major muscle groups on two or more days per week.

CDC's Division of Nutrition, Physical Activity and Obesity funds programs in 23 states designed to prevent obesity and promote healthy lifestyle habits such as physical activity.

-----
www.georgiafrontpage.com
Georgia Front Page
www.fayettefrontpage.com
Fayette Front Page

Slightly Lower Adult Smoking Rates

Fewer U.S. adults smoke, but cigarette smoking continues to impose substantial health and financial costs on society, according to new data from CDC.

An estimated 19.8 percent of U.S. adults (43.4 million people), were current smokers in 2007, down from 20.8 percent in 2006, according to a study in CDC′s Morbidity and Mortality Weekly Report, released in advance of the Great American Smokeout. However, based on the current rate of decline, it is unlikely that the national health objective of reducing the prevalence of adult cigarette smoking to 12 percent or lower will be met by 2010.

Smoking causes at least 30 percent of all cancer deaths, including more than 80 percent of lung cancer deaths, and 80 percent of deaths from chronic obstructive pulmonary disease. Smoking is responsible for early cardiovascular disease and death. As a result, about half of all long-term smokers, particularly those who began smoking as teens, die prematurely, many in middle age.

“The good news, we continue to see fewer people smoking,” said Janet Collins, Ph.D., director of CDC′s National Center for Chronic Disease Prevention and Health Promotion. “The bad news is we need more people to quit. Quitting smoking is the most important step smokers can take to improve their health and protect the health of nonsmoking family members. Smokers should be aware that there are treatments and services available to help them quit now more than ever before. Smokers can more than double their likelihood of successfully quitting by using medications and telephone counseling.”

Another MMWR study released this week by CDC assessed the U.S. health consequences and productivity losses attributable to smoking.

National estimates of annual smoking deaths indicate that, during 2000–2004, cigarette smoking and exposure to secondhand smoke resulted in approximately 443,000 annual premature deaths, consistent with previous estimates.

In addition, during 2001–2004, average annual smoking-attributable health care expenditures were approximately $96 billion, compared to $75 billion in 1998. Accounting for direct health care expenditures and productivity losses ($97 billion), the total economic burden of smoking is approximately $193 billion per year.

November 20, 2008, marks the American Cancer Society′s 32nd Great American Smokeout. The event encourages smokers to quit for at least one day in the hope that this might help them to stop using tobacco permanently. The Smokeout also draws attention to the many proven ways to encourage people to stop smoking. These include making it more affordable for people to use medical treatments, establishing smoke-free environments in homes, workplaces and restaurants, increasing the price of cigarettes, and mass media campaigns to inform and help motivate tobacco users to quit.

“If we want to see far more people quit smoking, we need expanded access to stop smoking programs, continued progress in eliminating secondhand smoke exposure and ongoing investment in programs that work,” said Matthew McKenna, M.D., M.P.H., director, CDC′s Office on Smoking and Health. “If, starting in 2009, all states were to fully implement tobacco control programs at CDC-recommended levels of investment, an estimated five million fewer people in this country would smoke within five years, and hundreds of thousands of premature tobacco-related deaths would be prevented each year.”

Tobacco users who want help in quitting can call 1-800-QUIT-NOW (1-800-784-8669) (TTY 1-800-332-8615) for free telephone-based counseling anywhere in the United States or visit http://1800quitnow.cancer.gov for quitting assistance. Information about the Great American Smokeout is available at http://www.cancer.org/docroot/ped/ped_10_4.asp.

-----
www.georgiafrontpage.com
Georgia Front Page
www.fayettefrontpage.com
Fayette Front Page